bluuebunny/crossref_metadata_2025 huggingface dataset:
Fresh mortifications, or a demonstration that seeming calamities may be real blessings
Authors: Goldsmith Oliver
Published: February 2022

The journey of my daughters to town was now resolved upon, Mr. Thornhill having kindly promised to inspect their conduct himself, and inform us by letter of their behaviour. But it was thought indispensably necessary that their appearance should equal the greatness of their expectations, which could not be done without expence. We debated therefore in full council what were the easiest methods of raising money, or, more properly speaking, what we could most conveniently sell. The deliberation was soon finished, it was found that our remaining horse was utterly useless for the plow, without his companion, and equally unfit for the road, as wanting an eye, it was therefore determined that we should dispose of him for the purposes above-mentioned, at the neighbouring fair, and, to prevent imposition, that I should go with him myself. Though this was one of the first mercantile transactions of my life, yet I had no doubt about acquitting myself with reputation. The opinion a man forms of his own prudence is measured by that of the company he keeps, and as mine was mostly in the family way, I had conceived no unfavourable sentiments of my worldly wisdom. My wife, however, next morning, at parting, after I had got some paces from the door, called me back, to advise me, in a whisper, to have all my eyes about me.
Offences are easily pardoned where there is love at bottom
Authors: Goldsmith Oliver
Published: February 2022

The next morning I took my daughter behind me, and set out on my return home. As we travelled along, I strove, by every persuasion, to calm her sorrows and fears, and to arm her with resolution to bear the presence of her offended mother. I took every opportunity, from the prospect of a fine country, through which we passed, to observe how much kinder heaven was to us, than we to each other, and that the misfortunes of nature’s making were very few. I assured her, that she should never perceive any change in my affections, and that during my life, which yet might be long, she might depend upon a guardian and an instructor. I armed her against the censures of the world, shewed her that books were sweet unreproaching companions to the miserable, and that if they could not bring us to enjoy life, they would at least teach us to endure it.
None but the guilty can be long and completely miserable
Authors: Goldsmith Oliver
Published: February 2022

Some assiduity was now required to make our present abode as convenient as possible, and we were soon again qualified to enjoy our former serenity. Being disabled myself from assisting my son in our usual occupations, I read to my family from the few books that were saved, and particularly from such, as, by amusing the imagination, contributed to ease the heart. Our good neighbours too came every day with the kindest condolence, and fixed a time in which they were all to assist at repairing my former dwelling. Honest farmer Williams was not last among these visitors; but heartily offered his friendship. He would even have renewed his addresses to my daughter; but she rejected them in such a manner as totally represt his future solicitations. Her grief seemed formed for continuing, and she was the only person of our little society that a week did not restore to chearfulness. She now lost that unblushing innocence which once taught her to respect herself, and to seek pleasure by pleasing. Anxiety now had taken strong possession of her mind, her beauty began to be impaired with her constitution, and neglect still more contributed to diminish it. Every tender epithet bestowed on her sister brought a pang to her heart and a tear to her eye; and as one vice, tho’ cured, ever plants others where it has been, so her former guilt, tho’ driven out by repentance, left jealousy and envy behind. I strove a thousand ways to lessen her care, and even forgot my own pain in a concern for her’s, collecting such amusing passages of history, as a strong memory and some reading could suggest. ‘Our happiness, my dear,’ I would say, ‘is in the power of one who can bring it about a thousand unforeseen ways, that mock our foresight. If example be necessary to prove this, I’ll give you a story, my child, told us by a grave, tho’ sometimes a romancing, historian.
The Life of Samuel Johnson, LL.D.
Authors: Boswell James
Published: February 2022

To write the Life of him who excelled all mankind in writing the lives of others, and who, whether we consider his extraordinary endowments, or his various works, has been equalled by few in any age, is an arduous, and may be reckoned in me a presumptuous task.
On Actors and Acting
Authors: Hazlitt William
Published: February 2022

Players are ‘the abstracts and brief chronicles of the time;’* the motley representatives of human nature. They are the only honest hypocrites. This life is a voluntary dream; a studied madness. The height of their ambition is to be beside themselves. To-day kings, to-morrow beggars, it is only when they are themselves that they are nothing. Made up of mimic laughter and tears, passing from the extremes of joy or woe at the prompter’s call, they wear the livery of other men’s fortunes; their very thoughts are not their own. They are as it were train-bearers in the pageant of life, and hold a glass up to humanity frailer than itself. We see ourselves at secondhand in them: they shew us all that we are, all that we wish to be, and all that we dread to be.
The Indian Jugglers
Authors: Hazlitt William
Published: February 2022

Coming forward and seating himself on the ground in his white dress and tightened turban, the chief of the Indian Jugglers* begins with tossing up two brass balls, which is what any of us could do, and concludes with keeping up four at the same time, which is what none of us could do to save our lives, nor if we were to take our whole lives to do it in. Is it then a trifling power we see at work, or is it not something next to miraculous? It is the utmost stretch of human ingenuity, which nothing but the bending the faculties of body and mind to it from the tenderest infancy with incessant, ever-anxious application up to manhood can accomplish or make even a slight approach to.
On the Spirit of Monarchy
Authors: Hazlitt William
Published: February 2022

The Spirit of Monarchy then is nothing but the craving in the human mind after the Sensible and the One. It is not so much a matter of state-necessity or policy, as a natural infirmity, a disease, a false appetite in the popular feeling, which must be gratified. Man is an individual animal with narrow faculties, but infinite desires, which he is anxious to concentrate in some one object within the grasp of his imagination, and where, if he cannot be all that he wishes himself, he may at least contemplate his own pride, vanity, and passions, displayed in their most extravagant dimensions in a being no bigger and no better than himself. Each individual would (were it in his power) be a king, a God: but as he cannot, the next best thing is to see this reflex image of his self-love, the darling passion of his breast, realized, embodied out of himself in the first object he can lay his hands on for the purpose. The slave admires the tyrant, because the last is, what the first would be. He surveys himself all over in the glass of royalty. The swelling, bloated self-importance of the one is the very counterpart and ultimate goal of the abject servility of the other.
My First Acquaintance with Poets
Authors: Hazlitt William
Published: February 2022

My father was a Dissenting Minister at W — m* in Shropshire; and in the year 1798 (the figures that compose that date are to me like the ‘dreaded name of Demogorgon’*) Mr. Coleridge came to Shrewsbury, to succeed Mr. Rowe* in the spiritual charge of a Unitarian Congregation there. He did not come till late on the Saturday afternoon before he was to preach; and Mr. Rowe, who himself went down to the coach in a state of anxiety and expectation, to look for the arrival of his successor, could find no one at all answering the description but a round-faced man in a short black coat (like a shooting-jacket) which hardly seemed to have been made for him, but who seemed to be talking at a great rate to his fellow-passengers. Mr. Rowe had scarce returned to give an account of his disappointment, when the round-faced man in black entered, and dissipated all doubts on the subject, by beginning to talk.
On Londoners and Country People
Authors: Hazlitt William
Published: February 2022

I do not agree with Mr. Blackwood in his definition of the word Cockney.* He means by it a person who has happened at any time to live in London, and who is not a Tory — I mean by it, a person who has never lived out of London, and who has got all his ideas from it.
Mr. Wordsworth
Authors: Hazlitt William
Published: February 2022

Mr. Wordsworth’s genius is a pure emanation of the Spirit of the Age. Had he lived in any other period of the world, he would never have been heard of. As it is, he has some difficulty to contend with, the hebetude of his intellect, and the meanness of his subject. With him ‘lowliness is young ambition’s ladder:’* but he finds it a toil to climb in this way the steep of Fame. His homely Muse can hardly raise her wing from the ground, nor spread her hidden glories to the sun. He has ‘no figures nor no fantasies, which busy passion draws in the brains of men:’* neither the gorgeous machinery of mythologic lore, nor the splendid colours of poetic diction. His style is vernacular: he delivers household truths. He sees nothing loftier than human hopes; nothing deeper than the human heart.
Our National Theatres
Authors: Hazlitt William
Published: February 2022

The motto of the English nation is ‘exclusion.’ In this consists our happiness and our pride. If you come to a gentleman’s park and pleasure-grounds, you see written up, ‘Man-traps and steel-guns set here’ — as if he had no pleasure in walking in them, except in the idea of keeping other people out. Having little of the spirit of enjoyment in ourselves, we seek to derive a stupid or sullen satisfaction from the privations and disappointment of others. Every thing resolves itself into an idea of property, that is, of something that our neighbours dare not touch, and that we have not the heart to enjoy. The invidious distinction of the private boxes* arose out of this principle; and has done a great deal of harm. Was it to secure the best place for the best company? Are they filled with peers and peeresses eager to see the play, and enjoying it at the height? On the contrary, they are quite empty; or you see nobody there but Madame Vestris and her friends.
The Letter-Bell
Authors: Hazlitt William
Published: February 2022

Complaints are frequently made of the vanity and shortness of human life, when, if we examine its smallest details, they present a world by themselves. The most trifling objects, retraced with the eye of memory, assume the vividness, the delicacy, and importance of insects seen through a magnifying glass. There is no end of the brilliancy or the variety. The habitual feeling of the love of life may be compared to ‘one entire and perfect chrysolite,’* which, if analyzed, breaks into a thousand shining fragments. Ask the sum-total of the value of human life, and we are puzzled with the length of the account, and the multiplicity of items in it: take any one of them apart, and it is wonderful what matter for reflection will be found in it! As I write this, the Letter-Bell passes: it has a lively, pleasant sound with it, and not only fills the street with its importunate clamour, but rings clear through the length of many half-forgotten years.
His General Line of Business
Authors: Dickens Charles
Published: February 2022

No landlord is my friend and brother, no chambermaid loves me, no waiter worships me, no boots admires and envies me. No round of beef or tongue or ham is expressly cooked for me, no pigeonpie is especially made for me, no hotel–advertisement is personally addressed to me, no hotel–room tapestried with great–coats and railway–wrappers is set apart for me, no house of public entertainment in the United Kingdom greatly cares for my opinion of its brandy or sherry. When I go upon my journeys, I am not usually rated at a low figure in the bill; when I come home from my journeys, I never get any commission. I know nothing about prices, and should have no idea, if I were put to it, how to wheedle a man into ordering something he doesn’t want.
The Italian Prisoner
Authors: Dickens Charles
Published: February 2022

The rising of the Italian people* from under their unutterable wrongs, and the tardy burst of day upon them after the long long night of oppression that has darkened their beautiful country, have naturally caused my mind to dwell often of late on my own small wanderings in Italy. Connected with them, is a curious little drama, in which the character I myself sustained was so very subordinate, that I may relate its story without any fear of being suspected of selfdisplay. It is strictly a true story.
Bound For The Great Salt Lake
Authors: Dickens Charles
Published: February 2022

Behold me on my way to an Emigrant Ship, on a hot morning early in June. My road lies through that part of London generally known to the initiated as “Down by the Docks.” Down by the Docks, is Home to a good many people—to too many, if I may judge from the overflow of local population in the streets—but my nose insinuates that the number to whom it is Sweet Home might be easily counted. Down by the Docks, is a region I would choose as my point of embarkation aboard ship if I were an emigrant. It would present my intention to me in such a sensible light; it would show me so many things to be run away from.
An Old Stage-Coaching House
Authors: Dickens Charles
Published: February 2022

Before the waitress had shut the door, I had forgotten how many stage-coaches she said used to change horses in the town every day. But it was of little moment; any high number would do as well as another. It had been a great stage-coaching town in the great stagecoaching times, and the ruthless railways had killed and buried it.
A Fly–Leaf in a Life
Authors: Dickens Charles
Published: February 2022

once upon a time (no matter when), I was engaged in a pursuit (no matter what), which could be transacted by myself alone; in which I could have no help; which imposed a constant strain on the attention, memory, observation, and physical powers; and which involved an almost fabulous amount of change of place and rapid railway travelling. I had followed this pursuit through an exceptionally trying winter in an always trying climate, and had resumed it in England after but a brief repose. Thus it came to be prolonged until, at length—and, as it seemed, all of a sudden—it so wore me out that I could not rely, with my usual cheerful confidence, upon myself to achieve the constantly recurring task, and began to feel (for the first time in my life) giddy, jarred, shaken, faint, uncertain of voice and sight and tread and touch, and dull of spirit.
Dissecting Schizotypy and Its Association With Cognition and Polygenic Risk for Schizophrenia in a Nonclinical Sample
Authors: Tiego Jeggan , Thompson Kate , Arnatkeviciute Aurina , Hawi Ziarih , Finlay Amy , Sabaroedin Kristina , Johnson Beth , Bellgrove Mark A , Fornito Alex
Published: February 2022

Schizotypy is a multidimensional construct that captures a continuum of risk for developing schizophrenia-spectrum psychopathology. Existing 3-factor models of schizotypy, consisting of positive, negative, and disorganized dimensions have yielded mixed evidence of genetic continuity with schizophrenia using polygenic risk scores. Here, we propose an approach that involves splitting positive and negative schizotypy into more specific subdimensions that are phenotypically continuous with distinct positive symptoms and negative symptoms recognized in clinical schizophrenia. We used item response theory to derive high-precision estimates of psychometric schizotypy using 251 self-report items obtained from a non-clinical sample of 727 (424 females) adults. These subdimensions were organized hierarchically using structural equation modeling into 3 empirically independent higher-order dimensions enabling associations with polygenic risk for schizophrenia to be examined at different levels of phenotypic generality and specificity. Results revealed that polygenic risk for schizophrenia was associated with variance specific to delusional experiences (γ = 0.093, P = .001) and reduced social interest and engagement (γ = 0.076, P = .020), and these effects were not mediated via the higher-order general, positive, or negative schizotypy factors. We further fractionated general intellectual functioning into fluid and crystallized intelligence in 446 (246 females) participants that underwent onsite cognitive assessment. Polygenic risk scores explained 3.6% of the variance in crystallized intelligence. Our precision phenotyping approach could be used to enhance the etiologic signal in future genetic association studies and improve the detection and prevention of schizophrenia-spectrum psychopathology.
The trochlear physeal line angle: a novel method to assess coronal plane alignment of the paediatric distal humerus
Authors: Generoso Talissa O. , Pacífico Junior Giovani M. , Barcelos Filipe M. , Blumetti Francesco C. , Braga Susana R. , Pegoraro Maurício , Ramalho Junior Amancio
Published: February 2022

Supracondylar humeral fractures account for 60% of elbow fractures in childhood, with cubitus varus being its most common complication. It can be avoided by accurate assessment of distal humeral alignment after fracture reduction, and the Baumann angle is the usual measurement for this purpose. However, several reports demonstrate an inconsistency of this angle, and our hypothesis is that reliability could be improved with angles drawn between the trochlear physeal line and the humeral longitudinal axis. The aim of the study was to compare intra- and interobserver reliability between the Baumann angle and angles drawn between the trochlear physeal line and (1) humeral longitudinal axis (X-angle), (2) humeral lateral cortex line (Y-angle), (3) humeral medial cortex line (Z-angle). Angle measurements were performed on 141 distal humerus’ radiographs of children aged 3–10 years by five observers in a tertiary hospital. The measurements were compared for their intra- and interobserver agreement. All measurements showed good or excellent intraobserver agreement levels, with the highest for Z-angle [intraclass correlation coefficient (ICC) = 0.906] and the lowest for Baumann angle. There were also excellent interobserver agreement levels for all angles, the highest for Z-angle (ICC = 0.885). There are indications that Z-angle had higher agreement levels when compared to the others (ICC = 0.954; 0.936–0.969) in the group aged 7–10 years. The angle drawn between the humeral medial cortex and trochlear physeal line showed greater agreement than the other angles analysed, becoming a potentially useful tool for evaluation of children with supracondylar humeral fractures in daily practice.
Prevalence of benign bone lesions of the lower extremity in the pediatric spinal disorders: a whole-body imaging study
Authors: Yucekul Altug , Karaytug Kayahan , Bakircioglu Sancar , Zulemyan Tais , Sirin Basak Kumbasar , Karaarslan Ercan , Yilgor Caglar , Alanay Ahmet
Published: February 2022

There is a paucity of knowledge about benign bone lesions. The advances in imaging methods can screen bone lesions incidentally, and missing information can be provided. The aim of the study is to collect information about the prevalence and natural history of benign bone lesions with the use of whole-body biplanar slot-scanning imaging (EOS). EOS images acquired between 2015 and 2020 were retrospectively analyzed. Anatomical locations of lesions, number of lesions with polyostotic involvement and radiographic features of each were recorded. Fibrous lesions were further categorized according to the transition stages. The natural course was noted as remained in the same stage, progressed and disappeared during follow-up. A total of 1944 EOS images of 1378 (936 women and 442 men) patients were analyzed. The mean age was 12.3 (5–18) years. Bone lesions of the lower extremities were found in 278 scans (14.3%) of 196 (139 women and 57 men) patients (14.2%). Monostotic lesions were observed in 172 patients, and 24 had polyostotic lesions. The prevalence of lesions was 10.5%, 1.8%, 1.7%, 1.7% and 1.4‰ for fibrous cortical defect (FCD), nonossifying fibroma (NOF), osteochondroma, bone island and simple bone cyst, respectively. Among 145 FCDs, 55.2% of the lesions were stage A, 27.6% were stage B, 9.6% were stage C and 7.5% were stage D. EOS images acquired predominantly for spinal pathologies revealed a prevalence of 14% of benign bone tumors in the lower extremities. With the developments in imaging methods, the probability of encountering incidental lesion increases, and information about bone pathologies can be gathered.
My child’s leg is in a plaster. Can they fly?
Authors: Whelan Lucy , Zgoda Marcin , Bradman Hannah
Published: February 2022

Air travel in a cast with a fracture is associated with an increased risk of leg swelling in a tight compartment. We have hypothesised that there should be an accessible, universal policy for travel recommendations with the cast supported by high-quality literature. We have checked the 20 biggest airlines looking for their guidance on travel recommendation /restrictions in the presence of a broken leg in a cast, particularly in children. We have also carried out a literature review in the last 30 years to ascertain whether there is the best evidence relating to flying safely with a child in a cast. Nine airlines have an accessible policy on flying in a cast. Most airlines recommend to delay the flight 24–48 h after cast application. Four airlines require splitting the cast if applied 48 h before the flight. None of the airlines have specific recommendations related to children. A comprehensive review of the literature revealed 11 relevant articles. None of those studies were experimental studies on flying with a fracture, only one assessed flying in a cast. We did not find a research study focused specifically on children. The recommendation regarding flying restrictions varies among airlines and often there is no coherent policy available. The existing recommendations cannot be fully supported by experimental studies in the existing literature. Flying in a full cast should be delayed until 24–48 h after cast application. If the flight is an emergency, the cast should be bivalved.
Patient Reported Outcomes in Metastatic Spine Disease: Concurrent Validity of PROMIS with the Spine Oncology Study Group Outcome Questionnaire
Authors: Richardson Michelle A. , Bernstein David N. , Kulp Andrea , Mesfin Addisu
Published: February 2022

Study Design.

Cross-sectional prospective study.

Objective.

To evaluate the Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF), Pain Interference (PI), and Depression domains in comparison to the Spine Oncology Study Group-Outcomes Questionnaire (SOSG-OQ) in patients with metastatic spine disease.

Summary of Background Data.

While there remains a significant movement toward incorporating patient-reported outcome measures (PROMs) into clinical care, there are few validated PROMs for patients with metastatic spine disease. The SOSG-OQ was designed and validated for metastatic spine tumor patients. However, the use of general symptom-based PROMs, such as PROMIS domains, may reduce both patient and physician burden and improve interdisciplinary care if shown to be concurrently valid.

Methods.

Metastatic spine tumor patients from January 2017 to July 2021 at a single academic medical center were asked to complete PROMIS PF, PI, and Depression domains and the SOSG-OQ. Spearman correlation (p) coefficients were calculated.

Results.

A total of 103 unique visits, representing 79 patients met our inclusion criteria. A majority were men (59; 57%) and Caucasian (93; 90%), and the average age was 64-years-old (range: 34–87). There were 13 different types of histologies reported, with multiple myeloma, breast cancer, and prostate cancer representing 28 (27%), 26 (25%), and 13 (13%), respectively. Additional cancers included renal cell carcinoma, lung cancer, colon cancer, thyroid cancer, large B-cell lymphoma, nonHodgkin lymphoma, esophageal cancer, plasmacytoma, metastatic paraganglioma, and metastatic spindle cell sarcoma. SOSG-OQ was strongly correlated with PROMIS PI (ρ = 0.78) and PROMIS PF (ρ = 0.71), and moderately correlated with PROMIS Depression (ρ = 0.58).

Conclusion.

PROMIS PF, PI, and Depression appear to capture similar clinical insight as the SOSG-OQ. Spine surgeons can consider using these PROMIS domains in lieu of the SOSG-OQ in metastatic spine tumor patients.

Level of Evidence: NA
The Usefulness of Trabecular CT Attenuation Measurement at L4 Level to Predict Screw Loosening After Degenerative Lumbar Fusion Surgery
Authors: Shin Hee Kwon , Koo Hae-Won , Kim Kwang Hyeon , Yoon Sang Won , Sohn Moon-Jun , Lee Byung-Jou
Published: February 2022

Study Design.

Retrospective study.

Objective.

To evaluate the absolute value of L4 trabecular region-of-interest (t-ROI) computed tomography (CT) attenuation, which can predict pedicle screw loosening, and determine the changes in value according to number of fused levels and sagittal balance in patients undergoing lumbar fusion surgery.

Summary of Background Data.

Although osteoporosis was not diagnosed in spinal dual x-ray absorptiometry preoperatively, we encountered several cases of screw loosening within 1 year of lumbar fusion surgery.

Methods.

We enrolled 478 patients and analyzed factors related to screw loosening. We evaluated the association between L4 t-ROI CT attenuation and screw loosening and determined the best cutoff value of t L4 t-ROI CT attenuation for predicting screw loosening.

Results.

The number of fused levels, postoperative C7-S1 sagittal vertical axis (SVA), and L4 t-ROI CT attenuation were independently correlated with screw loosening. According to number of fused level and postoperative C7-T1 SVA (≥36.9 mm or <36.9 mm), in patients with one-level fusion and C7-S1 SVA less than 36.9 mm, the optimal cutoff point of the L4 t-ROI CT attenuation predicting screw loosening was 106.5 Hounsfield unit (HU). L4 t-ROI attenuation did not change until two-level fusions. In patients with three-level fusions and C7-S1 SVA less than 36.9 mm, the optimal cutoff point of the L4 t-ROI CT attenuation predicting screw loosening was 159.0 HU. The optimal cutoff point of L4 t-ROI CT attenuation in patients with three-level fusions and C7-S1 SVA more than or equal to 36.9 mm was 191.0 HU.

Conclusion.

L4 t-ROI CT attenuation value considering number of fused levels and sagittal balance is an accurate measurement method to predict screw loosening. Spine surgeons should be aware of the L4 t-ROI attenuation before surgery to improve the fusion rate and reduce instrument-related complications of lumbar spine surgery in osteoporotic patients.

Level of Evidence.

3
CPEB3 overexpression caused by miR-106b-5p inhibition inhibits esophageal carcinoma in-vitro progression and metastasis
Authors: Wang Huanyuan , Peng Dexin , Gan Mei , He Zhisheng , Kuang Yukang
Published: February 2022

This study investigates the role of CPEB3 in esophageal cancer (EC) progression. The prognosis of EC patients was shown by survival analysis. CPEB3-targeting microRNAs were predicted by bioinformatics tools and further validated by dual-luciferase assay and RNA immunoprecipitation. CPEB3 expression in EC cell lines and EC tissues was analyzed by quantitative reverse transcription PCR. The viabilities of KYSE150 and EC9706 cells were measured by MTT and Cell Counting Kit-8 assays. The migration, invasion and tube formation of KYSE150 and EC9706 cells were examined by wound healing, Transwell and tube formation assay, respectively. E-cadherin, N-cadherin, fibronectin, vimentin and vascular endothelial growth factor (VEGF), epidermal growth factor receptor (EGFR) [and phosphorylation (p)] and STAT3 levels (and phosphorylation) in KYSE150 and EC9706 cells were determined by western blot analysis or quantitative reverse transcription PCR. In addition, a xenograft tumor model was established through subcutaneously implanting KYSE150 and EC9706 cells transfected with Lv-CPEB3 or Lv-control viruses. CPEB3 expression was downregulated in EC cells and tissues, and its overexpression inhibited viability, migration, invasion and the expressions of N-cadherin, fibronectin, vimentin and VEGF, EGFR, p-EGFR and p-STAT3 levels in KYSE150 cells, but promoted E-cadherin expression. Small interfering RNA (siRNA)-CPEB3 inversely affected these phenotypes and gene expressions in EC9706 cells. miR-106b-5p targeted CPEB3 and negatively regulated CPEB3 expression. miR-106b-5p mimics reversed the effect of CPEB3 overexpression on KYSE150 cells, and miR-106b-5p inhibitor reversed the effect of siRNA-CPEB3 on EC9706 cells. In mice, tumor volumes, weights and Ki-67 expression were lower in mice treated with Lv-CPEB3 than that with Lv-control. CPEB3 overexpressed by miR-106b-5p inhibition suppressed EC progression involved in EGFR and STAT3 signaling.
Comparing Cardiac Output Measurements Using a Wearable, Wireless, Noninvasive Photoplethysmography-Based Device to Pulse Contour Cardiac Output in the General ICU: A Brief Report
Authors: Dvir Ayana , Goldstein Nir , Rapoport Avigal , Balmor Ronen Gingy , Nachman Dean , Merin Roei , Fons Meir , Ben Ishay Arik , Eisenkraft Arik
Published: February 2022

OBJECTIVES:

Cardiac output (CO) measurements in the ICU are usually based on invasive techniques, which are technically complex and associated with clinical complications. This study aimed to compare CO measurements obtained from a noninvasive photoplethysmography-based device to a pulse contour cardiac output device in ICU patients.

DESIGN:

Observational, prospective, comparative clinical trial.

SETTING:

Single-center general ICU.

PATIENTS:

Patients admitted to the general ICU monitored using a pulse contour cardiac output device as per the decision of the attending physician.

INTERVENTIONS:

Parallel monitoring of CO using a photoplethysmography-based chest patch device and pulse contour cardiac output while the medical team was blinded to the values obtained by the noninvasive device.

MEASUREMENTS AND MAIN RESULTS:

Seven patients (69 measurements) were included in the final analysis. Mean CO were 7.3 ± 2.0 L/m and 7.0 ± 1.5 L/m for thermodilution and photoplethysmography, respectively. Bland-Altman showed that the photoplethysmography has a bias of 0.3 L/m with –1.6 and 2.2 L/m 95% limit of agreement (LOA) and a bias of 2.4% with 95% LOA between –25.7% and 30.5% when calculating the percentage of difference from thermodilution. The values obtained by thermodilution and photoplethysmography were highly correlated (r = 0.906).

CONCLUSIONS:

The tested chest patch device offers a high accuracy for CO compared to data obtained by the pulse contour cardiac output and the thermodilution method in ICU patients. Such devices could offer advanced monitoring capabilities in a variety of clinical settings, without the complications of invasive devices.
Inflammasome Activation in an In Vitro Sepsis Model Recapitulates Increased Monocyte Distribution Width Seen in Patients With Sepsis
Authors: Eisinger Gregory J. , Osman Wissam , Prather Evan R. , Julian Mark W. , Gavrilin Mikhail A. , Crouser Elliott D. , Wewers Mark D.
Published: February 2022

OBJECTIVES:

Increased monocyte distribution width (MDW) has recently been shown to be a reliable indicator of early sepsis detection. This study therefore sought to determine if inflammasome activation can be linked to monocyte size changes in sepsis.

DESIGN:

An in vitro sepsis model using bacterial endotoxin (lipopolysaccharide [LPS]) to study the effect of inflammasome activation on monocyte cell size distribution by microscopy and MDW measurements using a standard clinical hematology analyzer.

SETTING:

University research laboratory.

SUBJECTS:

Healthy adult volunteers and cultured human monocyte cells in wild-type state and after clustered regularly interspaced short palindromic repeats/CRISPR-associated protein 9 knockout of key inflammasome components (apoptosis-associated speck-like protein containing a caspase recruitment domain, caspase-1, gasdermin-D).

INTERVENTIONS:

In vitro treatment of specimens with bacterial LPS.

MEASUREMENTS AND MAIN RESULTS:

Wild-type THP1 cells demonstrated a significant increase in cell area (207 μm2 [159–400 μm2] vs 160 μm2 [134–198 μm2]; p < 0.001) and distribution width (198 vs 55 μm2; p < 0.0001) by microscopy following treatment with LPS. Increased MDW correlated with inflammasome activation as demonstrated by release of interleukin (IL)-1β and with the presence of large distended pyroptotic cells by microscopy. All of these effects were blocked in the inflammasome knockout cells. Whole blood samples treated similarly also demonstrated IL-1β release and increased MDW (median 24.7 U [22.2–27.2 U] vs 16.3 U [15.1–17.6 U]; p = 0.008) as measured using the Beckman-Coulter Unicel DxH900 analyzer. When peripheral blood mononuclear cells were isolated prior to treatment with LPS, microscopy confirmed the presence of large pyroptotic cells correlating to IL-1β release in the human subject samples as well.

CONCLUSIONS:

The increased MDW seen in patients with sepsis can be reproduced in an in vitro sepsis model and blocked using clustered regularly interspaced short palindromic repeats/CRISPR-associated protein 9 technology to inactivate the inflammasome. These findings suggest that pyroptotic cellular swelling underlies changes in MDW in septic patients and connect MDW to early events in the inflammatory cascade of sepsis.
Cardiotoxicity in relation to treatment with aromatase inhibitors in breast cancer
Authors: Lund Marie , Ejlertsen Bent
Published: February 2022

With the success of modern cancer therapy, breast cancer survival has steadily improved over the last decades. Treatment with aromatase inhibitors has become the preferred endocrine treatment in postmenopausal women with estrogen receptor-positive breast cancer. However, concerns have been raised over a possible cardiotoxic potential. The aim of the current paper is to review the evidence regarding cardiotoxicity with aromatase inhibitors in breast cancer.

Weighing benefits vs. risks, the improved effect of aromatase inhibitors vs. tamoxifen on breast cancer recurrence in most patients outweighs the potential risk of CV adverse events. At present it is advisable to ensure that standard measures of cardiovascular disease (CVD) management are applied to women with breast cancer, i.e., lifestyle intervention and if needed medical treatment of CVD and risk factors for CVD.
Supercharged Mechanical Stromal-cell Transfer (MEST)
Authors: Copcu H. Eray
Published: February 2022

PRP and fat-derived stromal-cell applications are the 2 most commonly used methods in regenerative medicine. PRP has a wide spectrum of indications. Mechanical methods have become very popular recently in fat-derived stromal-cell applications due to the advantages they provide. Combining these 2 methods has produced more successful results. To date, this combination has been in the form of combining 2 products obtained separately just before they are administered to the patient. In this study, fat tissue and blood samples obtained from eight volunteers were mixed with PPP as a new idea not previously reported in the literature, and stromal cells were obtained mechanically with sharp blades (adinizing). Later, the obtained PRP was added to the final product and became “supercharged.” The results were tested by the dual fluoroscopy method for cell number and viability, and the results obtained were analyzed statistically. By adding the plasma to the oil before stromal cells were obtained and cutting with sharp blades by mechanical separation, twice the volume and 4.7 times more cells were obtained compared with that obtained in the saline group (P < 0.001). We believe that the reason for this is the “binding” effect of the proteins in the plasma. This approach provided a higher cell count by using PPP, which is a “waste product,” and in addition, the potential efficiency was increased by adding PRP. However, the clinical results of this innovative method should be evaluated with advanced clinical studies.
Expert consensus statement on the perioperative management of adult patients undergoing head and neck surgery and free tissue reconstruction from the society for head and neck anesthesia
Authors: Healy David W. , Cloyd Benjamin H. , Straker Tracey , Brenner Michael J. , Damrose Edward J. , Spector Matthew E. , Saxena Amit , Atkins Joshua H. , Ramamurthi Radhamangalam J. , Mehta Arpan , Aziz Michael F. , Cattano Davide , Levine Adam I. , Schechtman Samuel A. , Cavallone Laura F. , Abdelmalak Basem B.
Published: February 2022

The perioperative care of adult patients undergoing free tissue transfer during head and neck surgical (microvascular) reconstruction is inconsistent across practitioners and institutions. The executive board of the Society for Head and Neck Anesthesia (SHANA) nominated specialized anesthesiologists and head and neck surgeons to an expert group, to develop expert consensus statements. The group conducted an extensive review of the literature to identify evidence and gaps and to prioritize quality improvement opportunities. This report of expert consensus statements aims to improve and standardize perioperative care in this setting. The Modified Delphi method was used to evaluate the degree of agreement with draft consensus statements. Additional discussion and collaboration was performed via video conference and electronic communication to refine expert opinions and to achieve consensus on key statements. Thirty-one statements were initially formulated, 14 statements met criteria for consensus, 9 were near-consensus, and 8 did not reach criteria for consensus. The expert statements reaching consensus described considerations for preoperative assessment and optimization, airway management, perioperative monitoring, fluid management, blood management, tracheal extubation, and postoperative care. This group also examined the role for vasopressors, communication, and other quality improvement efforts. This report provides the priorities and perspectives of a group of clinical experts to help guide perioperative care and provides actionable guidance for and opportunities for improvement in the care of patients undergoing free tissue transfer for head and neck reconstruction. The lack of consensus for some areas likely reflects differing clinical experiences and a limited available evidence base.
Mandibular osteosarcoma: diagnosis and treatment
Authors: Ferri Andrea , Bianchi Bernardo , Ferrari Silvano
Published: February 2022

Purpose of review

This article presents a review of the literature on mandibular osteosarcoma, focusing on the main aspects of its management, including diagnosis, histotype, and treatment. The literature published in the last 5 years was considered but because of the rarity of mandibular osteosarcoma, major publications from the past have also been included.

Recent findings

Management of mandibular osteosarcoma still lacks a clear standard of care, and treatment has not changed markedly over the past several years. The mainstay of treatment is surgical resection with free margins, but chemotherapy has recently begun to play a role in both adjuvant and neoadjuvant settings.

Mandibular osteosarcoma is a rare tumor and extensive randomized trials are not available in the international literature. Therefore, the standard of care is not defined, and diagnosis and treatment protocols have been extrapolated from analysis of multiple reports that are often discordant. This makes an interdisciplinary approach mandatory for the management of these patients, to provide the best care possible based on tumor size, site, and patient characteristics.
Prepectoral and Subpectoral Tissue Expander–Based Breast Reconstruction: A Propensity-Matched Analysis of 90-Day Clinical and Health-Related Quality-of-Life Outcomes
Authors: Nelson Jonas A. , Shamsunder Meghana G. , Vorstenbosch Joshua , Polanco Thais O. , Matros Evan , Coriddi Michelle R. , Mehrara Babak J. , Allen Robert J. , Dayan Joseph H. , Disa Joseph J.
Published: February 2022

Background:

Prepectoral placement of tissue expanders for two-stage implant-based breast reconstruction potentially minimizes chest wall morbidity and postoperative pain. The authors explored 90-day clinical and health-related quality-of-life outcomes for prepectoral versus subpectoral tissue expander breast reconstruction.

Methods:

The authors conducted a propensity score-matching analysis (nearest neighbor, 1:1 matching without replacement) of patients who underwent immediate prepectoral or subpectoral tissue expander breast reconstruction between December of 2017 and January of 2019. Matched covariates included age, body mass index, race/ethnicity, smoking status, chemotherapy, radiotherapy, nipple-sparing mastectomy, and laterality of reconstruction. Outcomes of interest were perioperative analgesia use, 90-day postoperative patient-reported pain, complication rates, and BREAST-Q physical well-being of the chest scores.

Results:

Of the initial cohort of 921 patients, 238 were propensity-matched and included in the final analysis. The matched cohort had no differences in baseline characteristics. Postoperative ketorolac (p = 0.048) use was higher in the subpectoral group; there were no other significant differences in intraoperative and postoperative analgesia use. Prepectoral patients had lower pain on postoperative days 1 to 2 but no differences on days 3 to 10. BREAST-Q physical well-being of the chest scores did not differ. Prepectoral patients had higher rates of seroma than subpectoral patients (p < 0.001). Rates of tissue expander loss did not differ.

Conclusions:

This matched analysis of 90-day complications found lower early postoperative pain in prepectoral tissue expander patients but no longer-term patient-reported differences. Although prepectoral reconstruction patients experienced a higher rate of seroma, this did not translate to a difference in tissue expander loss. Long-term analysis of clinical and patient-reported outcomes is needed to understand the full profile of the prepectoral technique.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, III.
Immediate Breast Reconstruction Using the Goldilocks Procedure: A Balance between More Surgery and Patient Satisfaction
Authors: Manrique Oscar J. , Kuruoglu Doga , Yan Maria , Bustos Samyd S. , Boughey Judy C. , Harless Christin A. , Tran Nho V. , Martinez-Jorge Jorys , Forte Antonio J. , Nguyen Minh-Doan T.
Published: February 2022

Background:

Since its first description in 2012, the Goldilocks procedure has become an option for immediate breast reconstruction, particularly for obese patients who are poor candidates for traditional implant or autologous reconstruction. In this work, the authors performed a longitudinal study of patients who underwent mastectomy with Goldilocks reconstruction to assess the incidence of additional surgical procedures, and to assess surgical outcomes and patient satisfaction.

Methods:

A retrospective review of patients who underwent mastectomy with the Goldilocks procedure only at Mayo Clinic Rochester between January of 2012 and September of 2019 was performed. Demographics, complications, additional breast procedures performed to attain the final results, and patient-reported outcomes using the BREAST-Q were recorded. Univariate and multivariable analyses were performed to identify statistical associations and risk factors.

Results:

Sixty-three patients (108 breasts) were included. Mean age was 57.8 years. Mean body mass index was 37.6 kg/m2. Median follow-up time after the mastectomy with the Goldilocks procedure was 15 months. The major complication rate within the first 30 days was 9.3 percent. Forty-four breasts (40.7 percent) underwent additional surgery. Dyslipidemia was significantly associated with an increased risk of additional surgery (adjusted hazard ratio, 2.00; p = 0.045). Scores in the four BREAST-Q domains were not statistically different between patients who had additional procedures and those who did not.

Conclusions:

Based on the results, the authors recommend a thorough preoperative discussion with patients who are candidates for the Goldilocks procedure to explore all options for reconstruction and their expectations, because it is crucial to reduce the necessity for additional operations in this high-risk population.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Risk, III.
The Impact of a Single Dual-Trained Surgeon in the Management of Mastectomy and Reconstruction
Authors: Piper Merisa L. , Nathan Shelby , Henderson Stacy , Lee Alfred , Broach Robyn B. , Kozak Geoffrey , Davis Harrison , Wu Liza C.
Published: February 2022

Background:

Oncoplastic breast surgery is typically performed using a two-surgeon, two-team approach. The authors present their experience with patients undergoing mastectomy and immediate reconstruction performed by a single, dual-trained breast surgical oncologist and plastic and reconstructive microsurgeon.

Methods:

Patients who underwent mastectomy and/or immediate reconstruction performed by the senior author between 2015 and 2019 were divided into single-surgeon or dual-surgeon cohorts, and matched by age, body mass index, reconstruction type, and cancer stage.

Results:

The authors included 158 patients in their analysis (single-surgeon, n = 45; dual-surgeon, n = 113). Single-surgeon patients underwent surgery 13.2 days earlier than dual-surgeon patients (p < 0.01), and required significantly fewer preoperative (1.9 versus 3.4; p < 0.01) and postoperative visits (6.8 versus 10.7; p < 0.01). Operative duration was comparable (single-surgeon, 245 minutes; dual-surgeon, 245 minutes; p = 0.99). The authors found no significant difference in surgical-site infection, seroma, hematoma, abdominal donor-site healing, or flap and prosthesis loss between the groups. The authors did find that dual-surgeon patients had a significantly higher rate of mastectomy flap necrosis (20 percent versus 4 percent; p = 0.01), which held true on logistic regression when controlling for other variables. BREAST-Q data demonstrated that single-surgeon patients had significantly higher overall scores (p = 0.04), and were significantly more satisfied with their outcomes, surgeon, and the information provided (p = 0.03, p = 0.03, and p = 0.01, respectively).

Conclusions:

The single-surgeon approach has the potential to decrease patient burden by requiring fewer preoperative and postoperative visits without compromising surgical outcomes or oncologic safety. Further investigation is warranted into the financial implications and patient outcomes.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, III.