bluuebunny/crossref_metadata_2025 huggingface dataset:
Youssou N’Dour
Authors: Jensen Emma
Published: January 2021

Youssou N’Dour (b. 1959) is a world-renowned Senegalese pop star. He was born into a devout Muslim home in Dakar to Elimane N’Dour and Ndèye Sokhna Mboup. His mother and grandmother (Marie Sène Mawo) come from a line of griots, a tradition which N’Dour carries on as a self-proclaimed “modern griot.” N’Dour began singing casually at the age of twelve at public celebrations (weddings, baptisms, and kassak ceremonies which celebrate the end of circumcisions), joined a local theater group (Sine Dramatique) at fourteen, and was recruited to Star Band de Dakar in 1975. After his first radio recording circulated widely in Senegal in 1978, N’Dour’s growing reputation allowed him to break off from Star Band with several other previous members to form Étoile de Dakar in 1979. Two years later, Étoile fractured once again with N’Dour creating Le Super Étoile de Dakar and El Hadji Faye leading Étoile 2000. N’Dour was among several musicians and groups who began experimenting with the mbalax sound but most scholars credit him with both naming the genre and making it famous by moving Senegalese drum parts (tama and sabar rhythms) to electronic instruments. Before he had gained any attention internationally, he had already been a part of at least thirty albums on cassette. N’Dour made his first appearance in Europe in 1983 and his reputation grew rapidly. Not long after, he collaborated with musicians such as Peter Gabriel and Paul Simon. He gained more attention for his albums Nelson Mandela (1985) and Immigrés (1988) and his presence in the Amnesty International “Human Rights Now!” tour in 1988, which marked the beginning of his history of activism. However, it was his 1994 single “7 Seconds” with Neneh Cherry that made him an international star. N’Doour’s newfound fame did not pull him away from Senegal. He invested in Dakar and opened the Thiossane night club, Xippi recording studio (formerly SAPROM production company), record label Jololi (now renamed Prince Arts), and Futurs Medias media group. In 2004 he won a Grammy for Egypt—an Islamic praise album made in collaboration with the Fathy Salama Orchestra. N’Dour has also been chosen as the winner of the Polar Music Prize (2013) and the Praemium Imperiale (2017). His most recent international albums are Africa Rekk (2016) and History (2019). Outside his musical career, N’Dour ran for Senegalese president in 2012, but was disqualified for not having enough signatures. However, he has held various ministerial positions under President Macky Sall.
Early Modern English
Authors: Nevalainen Terttu
Published: January 2021

The English language spoken and written in the 16th and 17th centuries has many names: it is variously known as Renaissance English, as the language of Tudor and Stuart England, and as Shakespeare’s English. These labels reflect the various criteria used to identify the period. This bibliography follows the common practice of referring to it as Early Modern English (1500–1700), in distinction to Middle English (c. 1150–1500) and Late Modern English (1700–1900). The Middle English period is often characterized as an era of dialects because the textual evidence that has come down to us shows extensive regional variation. In the early modern period, the language of many forms of writing converged to the extent that it could no longer be localized. Cultural historians associate this development with “modernity,” which is also reflected in regional mobility, urban as opposed to rural residence, and contact with mass media, notably through the rise of printing. More people were able to read than those who could also write at the time, but full literacy increased as the period advanced. A related process was vernacularization, the expanding use of English in new registers, which shows in styles of writing and the linguistic means of expressing them. Many features of Standard English were consolidated in the 16th and 17th centuries. Standardization is visible particularly in spelling and the vocabulary that was created as a result of the spread of English into new specializations. Gradual developments were also under way in pronunciation, in processes such as the Great Vowel Shift, and in grammar, where changes often resulted in new means of expression and greater transparency. Word order, for example, became more fixed over time. Many of these processes had started well before the early modern period, and some have continued into the present day. Digital resources have promoted new research not only on the traditional levels of language but also on various other aspects of Early Modern English. Regional variation is increasingly discussed in its own right rather than in the context of language standardization. Furthermore, there is a growing body of work on the users and uses of Early Modern English. Sociolinguistic research has helped tackle the question of what kind of people were the driving force behind language change at the time and whose language was therefore preserved for posterity. Studies in historical pragmatics have, in turn, looked into the ways in which language was used at the time and how these uses gave rise to new means of expressing communicative needs.
Measurement in Health Psychology Research and Practice
Authors: Johnston Marie , Weinman John , Ozakinci Gozde
Published: January 2021

Health psychology is the investigation of psychological and behavioral processes in health, illness, and health care. It investigates the behavior of people who are healthy or ill as well as practitioners and policymakers delivering or making decisions that influence health care. Measures may be used in studies aiming to elucidate and understand processes to advance theory and evidence, or to gain greater understanding or even intervening to improve health and health-care outcomes. A wide range of research designs are used including observational, intensive longitudinal (or ecological momentary assessment [EMA]), experimental laboratory, pre-post event or intervention, and randomized controlled trials. Frequently investigations measure a target behavior or psychological state and examine (a) whether it can be predicted or influenced by antecedents (events, environments, cognitions, interventions) and (b) whether it predicts or influences consequences, especially health/illness outcomes. Health psychology shares measurement issues that are challenging for psychology in general, including establishing reliability and validity, scaling mental processes, and reactivity of measures. Additionally, self-report measures are frequently used to assess symptoms such as pain or reports of health behaviors such as smoking, and these assessments may be used to assess a clinical condition and to guide clinical decisions. They may be validated against an objective measure, but the objective measure may fail to represent the full range, context, or occurrence of the target construct and can therefore only give an indication rather than a solid assessment of validity of the self-report. Measures are often used to measure change over time, especially change associated with an intervention or a changing clinical state, and therefore need to be repeatable while retaining meaning; sensitivity to change may be more important than test-retest reliability. Longitudinal measurement has been aided by the use of digital mobile technologies, including wearables and automatic measurement of physiological processes. Additionally, physiological functioning, especially autonomic, immune, and cardiac, are commonly measured. Data collected routinely by health-care organizations such as attendance at appointments or health outcomes may be useful, but these data may be incomplete or only give indirect evidence of the target behaviors or outcomes. Finally, the context of measurement may determine what is possible: ill patients could be burdened by a long questionnaire; health-care professionals may have limited time and opportunity to respond to assessments and measures may need to be adapted for a clinical environment. The following sections address measures of key psychological constructs, health-related behaviors, and responses to health, illness, and health care.
Graffiti
Authors: Ganz Nicholas
Published: January 2021

Graffiti can be seen as one of the most original art forms of mankind, with origins, according to some scholars, dating back as far as 40,000 years. Probably the best known examples of early graffiti can be found in the caves of Lascaux, France, and Altamira, Spain. The word “graffiti” was first used by archaeologists and antiquaries around the year 1850 to describe scratched inscriptions found at ancient archaeological sites. Indeed, the word graffiti derives from the Italian word graffito (translated as “something scratched”). These early examples of graffiti help to shed light on ancient societies, while contemporary graffiti is considered to be a reflection of urban life. This article focuses on the modern forms of graffiti, with its several subgenres, as well as exploring the way we understand the term “graffiti” as it is used today. Many practitioners have an artistic approach toward graffiti, though some may approach it in a manner that could be construed as vandalism. The modern practice of graffiti in public spaces emerged around 1965–1966 in Philadelphia and New York, although other forms of unsolicited art in public spaces existed in Europe and Arabic countries around the same time. Toward the end of the 1980s, the publications Spraycan Art and Subway Art helped to popularize graffiti all over the world. The rise of the internet also played a major role in bringing this art form into every corner of the world. Today, graffiti can be found almost everywhere, having quickly become a global movement that shares common philosophies, techniques, and roots. There is now a substantial body of popular publications devoted to the subject of graffiti or street art, as it is sometimes classified, though most scholars differentiate the two categories. Many of these publications, as the topic suggests, are illustrated books, focusing on particular artists, different styles of graffiti, and historic backgrounds. Other sources go beyond the visual aspects, including extended texts with commentary, interviews, and quotes from the artists themselves. Each book functions as a sort of time-capsule, because graffiti is ever-evolving, not to mention ephemeral, as many of the works shown in these books do not exist anymore. Scientific research on the social, cultural, psychological, or criminal aspects of graffiti are mainly carried out as dissertations or scientific treatises. Some of these commentaries are presented in this article. Graffiti, as an art, contains various forms of expression and is constantly evolving to accommodate new styles, techniques, and approaches. So too must the scholarship in this field, as illustrated by the sampling of sources included here.
Ephemeral Art and Performance in Africa
Authors: Bessire Aimée
Published: January 2021

Ephemeral art presents an interesting and not often covered lens in the field of African studies. It provides insight into the values placed on materials and the opportunity for deeper understanding of cultural traditions, spiritual beliefs, or individual philosophies. Ephemeral art may include transient materials intended to decay, those created in order to be destroyed, or even a piece marking a temporal instant, as in performances and site-specific installations. The ephemeral is what is seen, used, or performed until it decays, is buried, destroyed, or completes its durational moment. Performances exist as a moment in time—once past, they remain a memory. In this sense performance is ephemeral. While there is a great deal of scholarship on performance traditions, there is very little on African ephemeral art. The two topics remain distinct in the scholarly literature with overlaps in studies on the symbolism of ephemeral materials in performance traditions. The following bibliography is organized in two separate categories: ephemeral art and performance art, each connected through the trope of transiency.
IL-37—a putative therapeutic agent in cardiovascular diseases
Authors: McCurdy S , Yap J , Irei J , Lozano J , Boisvert W A
Published: January 2021

Although it is a member of the Interleukin (IL)-1 family, IL-37 is unique in that it has wide-ranging anti-inflammatory characteristics. It was originally thought to prevent IL-18-mediated inflammation by binding to the IL-18-binding protein. However, upon discovery that it binds to the orphan receptor, IL-1R8, further studies have revealed an expanded role of IL-37 to include several intracellular and extracellular pathways that affect various aspects of inflammation. Its potential role specifically in cardiovascular diseases (CVD) stemmed initially from the discovery of elevated plasma IL-37 levels in human patients with acute coronary syndrome and atrial fibrillation. Other studies using mouse models of ischemia/reperfusion injury, vascular calcification and myocardial infarction have revealed that IL-37 can have a beneficial role in these conditions. This review will explore recent research on the effects of IL-37 on the pathogenesis of CVD.
Telemedicine in the management of rheumatoid arthritis: maintaining disease control with less health-care utilization
Authors: Müskens Wieland D , Rongen-van Dartel Sanne A A , Vogel Carine , Huis Anita , Adang Eddy M M , van Riel Piet L C M
Published: January 2021

Objectives

We aimed to evaluate the use of an eHealth platform and a self-management outpatient clinic in patients with RA in a real-world setting. The effects on health-care utilization and disease activity were studied.

Methods

Using hospital data of patients with RA between 2014 and 2019, the use of an eHealth platform and participation in a self-management outpatient clinic were studied. An interrupted time series analysis compared the period before and after the introduction of the eHealth platform. The change in trend (relative to the pre-interruption trend) for the number of outpatient clinic visits and the DAS for 28 joints (DAS28) were determined for several scenarios.

Results

After implementation of the platform in April 2017, the percentage of patients using it was stable at ∼37%. On average, the users of the platform were younger, more highly educated and had better health outcomes than the total RA population. After implementation of the platform, the mean number of quarterly outpatient clinic visits per patient decreased by 0.027 per quarter (95% CI: −0.045, −0.08, P = 0.007). This was accompanied by a significant decrease in DAS28 of 0.056 per quarter (95% CI: −0.086, −0025, P = 0.001). On average, this resulted in 0.955 fewer visits per patient per year and a reduction of 0.503 in the DAS28.

Conclusion

The implementation of remote patient monitoring has a positive effect on health-care utilization, while maintaining low disease activity. This should encourage the use of this type of telemedicine in the management of RA, especially while many routine outpatient clinic visits are cancelled owing to COVID-19.
PMLA 2002’s Gremlins: Anatomizing the Labyrinth of Recent Amendments and Precedent
Authors: Lalli Jaideep Singh , Garg Nikita
Published: January 2021

Enacted to regulate the incubus of organized crime, India’s Prevention of Money Laundering Act has quickly degenerated into interpretative chaos, with conflicting judicial opinions straining its otherwise sound provisions. Instead of chastening statutory mercuriality, close to eleven amendments to the Act have only fuelled incertitude further. The most damaging feature of the PMLA’s disarray is that the interpretive conflict eclipses the most basic punitive machinery of the Act. Part 2 of the article clarifies the relationship between the offence of money laundering and its predicate offences in the realm of how the latter ought to influence property attachment and prosecution proceedings for the former. Part 3 dissects the complication of Indian Criminal Procedure’s applicability to investigations under the PMLA and proposes an inventive two-step enquiry to determine the extent of said applicability in view of the provisions of both statutes. Part 4 chronicles the peculiar acquiescence of some Indian courts in not insisting upon furnishing written grounds of arrest to a detenu and explains why that jurisprudential course deserves to be abandoned. Lastly, Part 5 addresses the topical disputation of the effect of recent amendments on the potential revival of sui generis bail conditions under the PMLA that had previously been declared unconstitutional. The article presents a syncretism of recommended interpretative paths that the judiciary must take to remedy the recognized flaws.
Physiologic Specialization and Genetic Differentiation ofPuccinia triticinaCausing Leaf Rust of Wheat on the Indian Subcontinent During 2016 to 2019
Authors: Bhardwaj S. C. , Kumar S. , Gangwar O. P. , Prasad P. , Kashyap P. L. , Khan H. , Savadi S. , Singh G. P. , Gupta N. , Thakur R.
Published: January 2021

Wheat is the second most cultivated cereal crop in the world and is an important crop in India. Leaf (brown) rust, caused by Puccinia triticina, was the most prevalent among the three rusts found in all the wheat-growing areas of India, Bhutan, and Nepal during 2016 to 2019. Leaf rust samples from wheat crops in these countries were pathotyped using the wheat differential genotypes and binomial Indian system of nomenclature. To facilitate international communication, each pathotype identified was also tested using the North American differentials. A total of 33 pathotypes were identified from 1,086 samples, including three new pathotypes: 61R47 (162-5 = KHTPM) and 93R49 (49 = NHKTN) from India and 93R57 (20-1 = NHKTN) from Nepal. Two pathotypes, 121R60-1 (77-9/52 = MHTKL) and 121R63-1 (77-5 = THTTM), accounted for 79.46% of the population. Virulence on Lr19 was identified in 0.27% of the samples from Nepal only. The proportion of pathotype 121R60-1 (77-9 = MHTKL) increased to 57.55% during these years. Virulence was not observed on Lr9, Lr24, Lr25, Lr28, Lr32, Lr39, Lr45, and Lr47 in the population of the Indian subcontinent. Eighteen polymorphic simple sequence repeat (SSR) primer pairs tested on the isolates amplified 48 alleles with an average of 2.66 alleles per primer pair. Based on SSR genotyping, these pathotypes could be grouped into two clades with another two subclades each. Many of the Lr genes present in Indian wheat germplasm (Lr1, Lr3a, Lr10, Lr11, Lr14a, Lr15, Lr16, Lr17, Lr20, Lr23, and Lr26) were ineffective for a majority of pathotypes. Most of these varieties possessed a high degree of leaf rust resistance. The field resistance of wheat varieties could be attributed to the interaction of genes, unknown resistance, or adult plant resistance.
Spinal Anesthesia Reduces Myocardial Ischemia–triggered Ventricular Arrhythmias by Suppressing Spinal Cord Neuronal Network Interactions in Pigs
Authors: Omura Yukiko , Kipke Jasmine P. , Salavatian Siamak , Afyouni Andrew Shea , Wooten Christian , Herkenham Robert F. , Maoz Uri , Lashgari Elnaz , Dale Erica A. , Howard-Quijano Kimberly , Mahajan Aman
Published: January 2021

Background

Cardiac sympathoexcitation leads to ventricular arrhythmias. Spinal anesthesia modulates sympathetic output and can be cardioprotective. However, its effect on the cardio-spinal reflexes and network interactions in the dorsal horn cardiac afferent neurons and the intermediolateral nucleus sympathetic neurons that regulate sympathetic output is not known. The authors hypothesize that spinal bupivacaine reduces cardiac neuronal firing and network interactions in the dorsal horn–dorsal horn and dorsal horn–intermediolateral nucleus that produce sympathoexcitation during myocardial ischemia, attenuating ventricular arrhythmogenesis.

Methods

Extracellular neuronal signals from the dorsal horn and intermediolateral nucleus neurons were simultaneously recorded in Yorkshire pigs (n = 9) using a 64-channel high-density penetrating microarray electrode inserted at the T2 spinal cord. Dorsal horn and intermediolateral nucleus neural interactions and known markers of cardiac arrhythmogenesis were evaluated during myocardial ischemia and cardiac load–dependent perturbations with intrathecal bupivacaine.

Results

Cardiac spinal neurons were identified based on their response to myocardial ischemia and cardiac load–dependent perturbations. Spinal bupivacaine did not change the basal activity of cardiac neurons in the dorsal horn or intermediolateral nucleus. After bupivacaine administration, the percentage of cardiac neurons that increased their activity in response to myocardial ischemia was decreased. Myocardial ischemia and cardiac load–dependent stress increased the short-term interactions between the dorsal horn and dorsal horn (324 to 931 correlated pairs out of 1,189 pairs, P < 0.0001), and dorsal horn and intermediolateral nucleus neurons (11 to 69 correlated pairs out of 1,135 pairs, P < 0.0001). Bupivacaine reduced this network response and augmentation in the interactions between dorsal horn–dorsal horn (931 to 38 correlated pairs out of 1,189 pairs, P < 0.0001) and intermediolateral nucleus–dorsal horn neurons (69 to 1 correlated pairs out of 1,135 pairs, P < 0.0001). Spinal bupivacaine reduced shortening of ventricular activation recovery interval and dispersion of repolarization, with decreased ventricular arrhythmogenesis during acute ischemia.

Conclusions

Spinal anesthesia reduces network interactions between dorsal horn–dorsal horn and dorsal horn–intermediolateral nucleus cardiac neurons in the spinal cord during myocardial ischemia. Blocking short-term coordination between local afferent–efferent cardiac neurons in the spinal cord contributes to a decrease in cardiac sympathoexcitation and reduction of ventricular arrhythmogenesis.

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A Multisite Survey of NICU Healthcare Professionals' Perceptions About Family-Centered Care
Authors: Franck Linda S. , Cormier Diana M. , Hutchison Jennifer , Moore Dishon , Bisgaard Robin , Gay Caryl , Ngo Samantha , Kriz Rebecca M. , Lin Carol , Ekno Mary , Ribero Denise , Sun Yao
Published: January 2021

Background:

Family-centered care contributes to improved outcomes for preterm and ill infants. Little is known about the perceptions of neonatal intensive care unit (NICU) healthcare professionals regarding the degree to which their NICU practices or values family-centered care.

Purpose:

The aims of this study were to describe attitudes and beliefs of NICU healthcare professionals about family-centered care and to explore professional characteristics that might influence those views.

Methods:

Data were derived from the baseline phase of a multicenter quasi-experimental study comparing usual family-centered NICU care with mobile-enhanced family-integrated care. Neonatal intensive care unit healthcare professionals completed the Family-Centered Care Questionnaire—Revised (FCCQ-R), a 45-item measure of 9 core dimensions of Current Practice and Necessary Practice for family-centered care.

Results:

A total of 382 (43%) NICU healthcare professionals from 6 NICUs completed 1 or more of the FCCQ-R subscales, 83% were registered nurses. Total and subscale scores on the Necessary Practice scale were consistently higher than those on the Current Practice scale for all dimensions of family-centered care (mean: 4.40 [0.46] vs 3.61 [0.53], P < .001). Only years of hospital experience and NICU site were significantly associated with Current Practice and Necessary Practice total scores.

Implications for Practice:

Ongoing assessment of the perceptions of NICU healthcare professionals regarding their current practice and beliefs about what is necessary for the delivery of high-quality family-centered care can inform NICU education, quality improvement, and maintenance of family-centered care during the COVID-19 pandemic.

Implications for Research:

Further research is needed to identify additional factors that predict family-centered care perceptions and behaviors.
Do We Really Need to Worry About Calcaneocuboid Subluxation During Lateral Column Lengthening for Planovalgus Foot Deformity?
Authors: Siebert Matthew , Hedrick Brittany N. , Zide Jacob R. , Thomas Danielle M. , Shivers Claire , Pierce William A. , Kanaan Yassine , Harris Mitchell C. , Riccio Anthony I.
Published: January 2021

Background:

Although lengthening of the lateral column through an osteotomy of the anterior calcaneus is an integral component of flatfoot reconstruction in younger patients with flexible planovalgus deformities, the procedure has been implicated in iatrogenic calcaneocuboid (CC) subluxation and subsequent degenerative changes at the CC articulation. The purpose of this study is to characterize alterations at the CC joint after lateral column lengthening (LCL) and determine if Steinmann pin stabilization of the CC joint before distraction maintains a normal relationship.

Methods:

Seven matched pairs of fresh-frozen cadaveric feet underwent preprocedure plain radiography and cross-sectional computed tomography (CT) imaging. LCL by osteotomy through the anterior calcaneus was then performed. One foot of each matched pair had a single smooth Steinmann pin placed centrally across the CC joint before osteotomy distraction. Distraction across each osteotomy was then performed and maintained with a 12-mm porous titanium wedge. Repeat imaging was obtained and compared with preprocedure studies to quantify sagittal and rotational differences at the CC articulation.

Results:

Following LCL, plain radiography demonstrated statistically significant increases in the percentage of the calcaneal articular surface dorsal to the superior aspect of the cuboid in both the pinned (8.2% vs. 17.6%, P=0.02) and unpinned (12.5% vs. 16.3%, P=0.04) specimens. No difference in the percentage of subluxation was found between the 2 groups after LCL. CT imaging demonstrated statistically significant increases in rotation between the calcaneus and cuboid after LCL in both the pinned (7.6±5.6 degrees, P=0.01) and unpinned (17±12.3 degrees, P=0.01) specimens. The degree of rotation was greater in unpinned specimens after LCL (P=0.043).

Conclusions:

Both sagittal and rotatory subluxation seem to occur at the CC joint after LCL regardless of pin stabilization. As a single pin would be expected to limit pure translation while having little effect on rotation, it is possible that the rotational changes identified on 3-dimensional imaging are interpreted as dorsal translation when viewed 2 dimensionally using plain radiography. Consideration should therefore be given to CC stabilization with 2 pins during LCL to prevent this rotatory subluxation.

Level of Evidence:

Level V—cadaver study.
Does Interbody Support at L5-S1 Matter in Long Fusions to the Pelvis?
Authors: Lara Nina J. , Chung Andrew S. , Lockwood Donovan , Revella Jan , Crandall Dennis , Chang Michael S.
Published: January 2021

Study Design.

Retrospective review of prospectively collected data.

Objective.

To determine if the addition of L5-S1 interbody support in long fusion deformity constructs is associated with superior long-term clinical and radiographic outcomes. To compare the 5-year clinical and radiographic outcomes and complications between long fusion constructs with L5-S1 interbody support versus posterolateral fusion (PLF) alone.

Summary of Background Data.

Cadaveric biomechanical studies have suggested that an interbody fusion at L5-S1 is beneficial in long fusion constructs with sacropelvic fixation. However, there is limited data reflecting the superiority of interbody support augmentation in optimizing arthrodesis and deformity correction relative to PLF alone.

Methods.

Eighty-eight consecutive adults with spinal deformity who underwent at minimum T11-pelvis posterior pedicle screw instrumentation with 5-year follow-up were included. Two cohorts were compared based on technique used at the lumbosacral junction (L5-S1): (A) no interbody (PLF; n = 23), or (B) interbody support at L5-S1 (IB; n = 65). Radiographic measurements and clinical outcome measures were compared at multiple time points. Complications were recorded and compared.

Results.

No differences in baseline patient characteristics between cohorts. One nonunion occurred at L5-S1 in the PLF group (P = 0.091). Initial postop sagittal alignment was better in the IB group (PLF: 6.46 cm, IB: 2.48 cm, P = 0.007); however, this was not maintained over long-term follow-up. No significant differences in proximal junctional kyphosis (PLF: 7/23, IB: 9/65, P = 0.076). Proximal junctional failure was more frequent in the PLF group (PLF: 6/23, IB: 6/65, P = 0.043). No significant differences in complications were found. Both cohorts had improvement from baseline pain and functional scores.

Conclusion.

There is no absolute long-term advantage for lumbar interbody support in adult spinal deformity patients undergoing spinal arthrodesis to the pelvis.

Level of Evidence: 3
Melatonin Alleviates Radiculopathy Against Apoptosis and NLRP3 Inflammasomes Via the Parkin-Mediated Mitophagy Pathway
Authors: Xie Lin , Zhao Zhiming , Chen Zhenhao , Ma Xiaosheng , Xia Xinlei , Wang Hongli , Zheng Chaojun , Jiang Jianyuan
Published: January 2021

Study Design.

Animal experimental study with intervention.

Objective.

To investigate the effect of melatonin on rat radiculopathy model and dorsal root ganglion (DRG) cells, and to elucidate the underlying mechanism.

Summary of Background Data.

Melatonin has a well-documented efficacy in intervertebral disc degeneration (IVDD) and low back pain. IVDD can also lead to other complications such as disc herniation which will cause radiculopathy. Herniated nucleus pulposus (NP) induced apoptosis and NLR pyrin domain containing 3 (NLRP3) activation in DRG. However, the effect and underlying mechanism of melatonin on radiculopathy and DRG cells are still unclear.

Methods.

Rat radiculopathy model was induced by implanting NP tissue from the tail disc of the same rat into the left L4/5 inter-laminar space near the left DRG. Melatonin was injected intraperitoneally in the treated group to test its function. Apoptosis was determined by Tunnel staining and flow cytometry. NLRP3 inflammasome activation was determined by levels of NLRP3, ASC, GSMDM-N, IL-1β, and Caspase-1. Mitophagy was determined by levels of Parkin, Beclin-1, p62, and LCB-II. Mitophagy was blocked by treatment with Parkin-si or cyclosporine A (CsA).

Results.

NLRP3 was significantly upregulated in DRG of rat radiculopathy model; moreover, melatonin markedly decreased pain behavior in rat radiculopathy model. Furthermore, melatonin treatment decreases the incidence of apoptosis in DRG cells. Melatonin also promotes mitophagy and inhibits NLRP3 inflammasomes in DRG cells. In addition, mitophagy was blocked by treatment with Parkin-si and CsA. Both Parkin-si and CsA attenuated melatonin's inhibitory effect on apoptosis and the NLRP3 inflammasome, indicating that the beneficial effects of melatonin in DRG cells are mediated through the Parkin-mediated mitophagy.

Conclusion.

Melatonin alleviates radiculopathy against apoptosis and NLRP3 inflammasomes by promoting Parkin-mediated mitophagy, which may help us provide a potential target for the treatment of radiculopathy.

Level of Evidence: N/A
Derivation and Validation of an Ensemble Model for the Prediction of Agitation in Mechanically Ventilated Patients Maintained Under Light Sedation
Authors: Zhang Zhongheng , Liu Jingtao , Xi Jingjing , Gong Yichun , Zeng Lin , Ma Penglin
Published: January 2021

OBJECTIVES:

Light sedation is recommended over deep sedation for invasive mechanical ventilation to improve clinical outcome but may increase the risk of agitation. This study aimed to develop and prospectively validate an ensemble machine learning model for the prediction of agitation on a daily basis.

DESIGN:

Variables collected in the early morning were used to develop an ensemble model by aggregating four machine learning algorithms including support vector machines, C5.0, adaptive boosting with classification trees, and extreme gradient boosting with classification trees, to predict the occurrence of agitation in the subsequent 24 hours.

SETTING:

The training dataset was prospectively collected in 95 ICUs from 80 Chinese hospitals on May 11, 2016, and the validation dataset was collected in 20 out of these 95 ICUs on December 16, 2019.

PATIENTS:

Invasive mechanical ventilation patients who were maintained under light sedation for 24 hours prior to the study day and who were to be maintained at the same sedation level for the next 24 hours.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

A total of 578 invasive mechanical ventilation patients from 95 ICUs in 80 Chinese hospitals, including 459 in the training dataset and 119 in the validation dataset, were enrolled. Agitation was observed in 36% (270/578) of the invasive mechanical ventilation patients. The stepwise regression model showed that higher body temperature (odds ratio for 1°C increase: 5.29; 95% CI, 3.70–7.84; p < 0.001), greater minute ventilation (odds ratio for 1 L/min increase: 1.15; 95% CI, 1.02–1.30; p = 0.019), higher Richmond Agitation-Sedation Scale (odds ratio for 1-point increase: 2.43; 95% CI, 1.92–3.16; p < 0.001), and days on invasive mechanical ventilation (odds ratio for 1-d increase: 0.95; 95% CI, 0.93–0.98; p = 0.001) were independently associated with agitation in the subsequent 24 hours. In the validation dataset, the ensemble model showed good discrimination (area under the receiver operating characteristic curve, 0.918; 95% CI, 0.866–0.969) and calibration (Hosmer-Lemeshow test p = 0.459) in predicting the occurrence of agitation within 24 hours.

CONCLUSIONS:

This study developed an ensemble model for the prediction of agitation in invasive mechanical ventilation patients under light sedation. The model showed good calibration and discrimination in an independent dataset.
Severe Acute Respiratory Syndrome Coronavirus-2-Associated Acute Kidney Injury: A Narrative Review Focused Upon Pathophysiology
Authors: Redant Sébastien , De Bels David , Honoré Patrick M.
Published: January 2021

OBJECTIVE:

Severe acute respiratory syndrome coronavirus-2 acute kidney injury is a condition that in many ways resembles classical acute kidney injury. The pathophysiology appears to be multifactorial, and accordingly, our main objective was to review possible components of this form of acute kidney injury.

DATA SOURCES:

Literature review.

DATA SYNTHESIS:

Our principal observation was that the various components of severe acute respiratory syndrome coronavirus-2 acute kidney injury appear to be relatively similar to the classical forms. Temporality of injury is an important factor but is not specific to severe acute respiratory syndrome coronavirus-2 acute kidney injury. Several insults hit the kidney at different moments in the course of disease, some occurring prior to hospital admission, whereas others take place at various stages during hospitalization.

Conclusions and Relevance:

Treatment of severe acute respiratory syndrome coronavirus-2 acute kidney injury cannot be approached in a “one-size-fits-all” manner. The numerous mechanisms involved do not occur simultaneously, leading to a multiple hit model that may contribute to the prevalence and severity of acute kidney injury. A personalized approach to each patient with acute kidney injury based on the timing and severity of disease is necessary in order to provide appropriate treatment. Although data from the literature regarding the previous coronavirus infections can give some insights, more studies are needed to explore the different mechanisms of acute kidney injury occurring as a result of severe acute respiratory syndrome coronavirus-2.
Cancer Stem Cells in Head and Neck Cutaneous Squamous Cell Carcinoma Express Cathepsins
Authors: Featherston Therese , Brasch Helen D. , Siljee Sam D. , van Schaijik Bede , Patel Josie , de Jongh Jennifer , Marsh Reginald W. , Itinteang Tinte , Tan Swee T.
Published: January 2021

Background:

Cancer stem cell (CSC) subpopulations within moderately differentiated head and neck cutaneous squamous cell carcinoma (MDHNcSCC) express the components of the renin–angiotensin system (RAS). This study investigated the expression of cathepsins B, D, and G, which constitute bypass loops of the RAS, by CSCs in MDHNcSCC.

Methods:

Immunohistochemical staining was performed on MDHNcSCC tissue samples from 15 patients to determine the expression of cathepsins B, D, and G. Co-localization of these cathepsins with the embryonic stem cell markers Octamer-binding transcription factor 4 (OCT4) and c-MYC was investigated with immunofluorescence staining. Reverse transcription quantitative polymerase chain reaction was performed on 5 MDHNcSCC tissue samples to investigate transcript expression of cathepsins B, D and G. Western blotting and enzymatic activity assays were performed on 5 MDHNcSCC tissue samples and 6 MDHNcSCC-derived primary cell lines to confirm protein expression, transcript expression, and functional activity of these cathepsins, respectively.

Results:

Immunohistochemical staining demonstrated the expression of cathepsins B, D, and G in all MDHNcSCC tissue samples. Immunofluorescence staining showed localization of cathepsins B and D to the c-MYC+ CSC subpopulations and the OCT4+ CSC subpopulations within the tumor nests and the peritumoral stroma. Cathepsin G was expressed on the tryptase+/c-MYC+ cells within the peritumoral stroma. Reverse transcription quantitative polymerase chain reaction demonstrated transcript expression of cathepsins B, D and G in the MDHNcSCC tissue samples. Western blotting and enzymatic activity assays confirmed protein expression and functional activity of cathepsins B and D in the MDHNcSCC tissue samples and MDHNcSCC-derived primary cell lines, respectively.

Conclusions:

Cathepsins B, D, and G are expressed in MDHNcSCC with functionally active cathepsins B and D localizing to the CSC subpopulations, and cathepsin G is expressed by mast cells, suggesting the potential use of cathepsin inhibitors in addition to RAS blockade to target CSCs in MDHNcSCC.
The Surgical Nasoalveolar Molding: A Rational Treatment for Unilateral Cleft Lip Nose Deformity and Literature Review
Authors: Rossell-Perry Percy
Published: January 2021

Background:

The purposes of this study were to evaluate surgical outcomes after primary surgery to address unilateral cleft lip, nose, and palate deformities and to perform a review of the literature to evaluate the effects of nasoalveolar molding (NAM) plus primary surgical repair on nonsyndromic unilateral cleft lip and palate.

Methods:

A cohort study of 37 primary complete unilateral cleft lip nasal deformity repairs was performed by a single surgeon. The outcomes were anthropometric measurements of the repaired lip, nose, and alveolar cleft width at the age of 1 and 5 years. A review of the literature was performed for studies published until March 2020 to evaluate the effect of presurgical NAM on nasolabial aesthetics.

Results:

Statistically significant differences were observed between pre- and postoperative columellar angle and alveolar cleft width. A total of 308 studies were identified, and 8 were included in the final analysis of 684 patients. The overall study quality was low according to the Oxford Centre of Evidence-Based Medicine, and GRADE level of evidence was low.

Conclusions:

Primary cheilorhinoplasty alone is a good approach to improve nose appearance and alveolar gap in patients with unilateral cleft lip nose and palate deformity. Definitive conclusions about the effectiveness of presurgical NAM cannot be drawn. Available scientific evidence is not sufficient to demonstrate that combined use of presurgical nasoalveolar molding and primary surgery provides better nasolabial aesthetic outcomes than does primary surgery alone.
The Value of Tumescent Infiltration in Bilateral Breast Reduction: Optimizing Vasoconstriction
Authors: Hudson Don A.
Published: January 2021

Background:

Surgical adjuncts should improve surgical outcomes but should not increase complications. Epinephrine reduces bleeding in breast reduction, but various doses and volumes have been used. The ideal dose of epinephrine is still debated. The aim of this study was to assess blood loss after infiltration of 1 L of tumescent fluid containing epinephrine at a concentration of 1 in 100,000 (1 in 105) and 1200 mg of lignocaine in patients undergoing bilateral breast reduction.

Methods:

Thirty-three consecutive patients undergoing bilateral breast reduction were included in the study. Data captured included age, mass of tissue removed, volume of blood loss, and surgical complications, especially hematoma formation.

Results:

The mean age was 41 years (range, 17–74 years). The mean mass of tissue removed was 786 g (range, 307–1339 g). The mean total blood loss was 76 mL (range, 50–200 mL)—that is, 38 mL per side. One patient presented with a unilateral swelling and pain after 48 hours and underwent exploration. A venous pool of <100 mL of blood was evacuated. One patient suffered bilateral nipple loss of >50%, and another patient suffered loss of 30%. The mean follow-up is 9 months (range, 2–20).

Conclusion:

One liter of Ringer’s lactate containing epinephrine at a concentration of 1 in 105, when injected into the breasts (500 mL per breast) before breast reduction, results in a massive reduction in blood loss.
Mycobacterium abscessus Infection after Breast Lipotransfer: A Report of 2 Cases
Authors: Miguel Escuredo Iker , Vicario Elorduy Eduardo , Guío Carrión Laura , Elvira Segura Javier , Iraurgui Arcarazo Patricia , García Gutiérrez Juan J.
Published: January 2021

Mycobacterium abscessus is a rare, non-tuberculous, rapidly growing mycobacterium. Although it has been usually associated with chronic pulmonary infections in cystic fibrosis patients, the second most frequent infection sites are the skin and subcutaneous tissue. Most of the cutaneous infections described in the literature occur secondary to cosmetic invasive procedures, many of them in the context of medical tourism. Its atypical presentation and antibiotic-resistant nature make its diagnosis and therapeutics challenging. In this case report, we present 2 cases of M. abscessus infections secondary to breast lipotransfer reported in the same private center. Case 1 patient underwent surgery to treat scar contracture resulting from previous quadrantectomy. Case 2 patient underwent breast augmentation with lipotransfer. Both of them developed lesions in the breast and in the donor site (abdomen). The therapeutic regimen used was amikacin (1 g/24 h) + tigecycline (50 mg/12 h). In case 1, we performed a simple mastectomy, and in case 2, periodical ultrasound-guided drainages were performed as additional procedures. To our knowledge, these are the first 2 cases that describe an infection secondary to breast lipotransfer. The aim of our report was to illustrate the presentation, diagnosis, therapeutic management, and strategies available to prevent this complication.
Simulation Surgery Using 3D 3-layer Models for Congenital Anomaly
Authors: Ueda Koichi , Kino Hiromi , Katayama Misato , Hirota Yuka
Published: January 2021

Background:

We made realistic, three-dimensional, computer-assisted 3-layered elastic models of the face. The surface layer is made of polyurethane, the intermediate layer is silicone, and the deep layer is salt, representing the skin, subcutaneous tissue, and the bone. We have applied these 3-layer models to congenital anomaly cases and have understood that these models have a lot of advantages for simulation surgery.

Methods:

We made 8 models. The models consisted of 2 models of 2 cases with Crouzon disease, 1 model of Binder syndrome, 1 model of facial cleft, 2 models of one case with Goldenhar syndrome, 1 model of cleft lip and palate, and 1 model of the hemifacial macrosomia.

Results:

We could try several methods, could recognize whether the graft size is adequate, and could visualize the change of the facial contour. We could analyze how to approach the osteotomy line and actually perform osteotomy. The changes of the lower facial contour can be observed. We grafted the models of the graft and confirmed that the incisions could be closed well. We were able to visualize the change in the soft tissue contour by simulating distraction.

Conclusions:

The most versatile merit of our models is that we could visualize the change of the soft tissue by movement of the hard tissue with bone graft, distraction osteogenesis, and so on. We must improve the model further to make it more realistic.
Superficial Circumflex Iliac Perforator–Osteocutaneous Flap for Reconstruction of Extensive Composite Defects in the Forefoot
Authors: Yamashita Shuji , Hattori Yoshitsugu , Tomioka Yoko , Kurita Masakazu , Miyamoto Shimpei , Iida Takuya , Okazaki Mutsumi
Published: January 2021

Although the great toe plays important roles in walking, loading, and maintaining balance when compared with other toes, there are few reports on great toe reconstruction, including the reconstruction of distal phalanx. This report aims to describe the use of a superficial circumflex iliac artery perforator (SCIP)–osteocutaneous flap for reconstructing a complex tissue defect of the great toe. A 62-year-old man presented with a crush injury to the forefoot. Because the great toe was severely crushed, the defect distal to the proximal phalanx of the great toe was reconstructed using a SCIP-osteocutaneous flap. The immediate postoperative course was uneventful; however, surgical revision was necessary. Signs of osseous union could be observed on radiographic images taken 2 months after the initial surgery. Twenty-four months after surgery, the patient could freely walk without resorption of the transferred bone. We demonstrated that SCIP-osteocutaneous flaps may be promising free flaps in complex tissue defect reconstruction of the great toe.
Commemorating the 10th Anniversary of the ASPS/ACAPS Resident Education Curriculum: A Model for Collaboration, Adaptation, and Sustainability
Authors: Hollenbeck Scott T. , Janis Jeff E. , Losee Joseph E.
Published: January 2021

The Resident Education Curriculum (REC) is one of the most widely recognized learning resources for plastic surgeons in training. The efforts that went into developing this program came from numerous individuals all driven by the same purpose – to create a lasting, up to date repository of all things plastic surgery related. As the program enters its 10th year of existence a closer look at the origins and evaluation is warranted.
Tracing: A Simple Interpretation Method for the DIEP Flap CT Angiography to Help Operative Decision-making
Authors: Sandberg Lars Johan
Published: January 2021

CT angiography (CTA) is an established technique that allows preoperative planning in DIEP flap reconstruction. However, innovative technological developments with extensive amounts of information require processing of data. It also requires user knowledge to interpret findings. Descriptions by radiologists are many times disappointingly limited to caliber and exit points of the perforator from the rectus fascia. Many DIEP flap surgeons similarly fail to utilize the CTA to its full extent. This is likely due to information overload. By tracing the DIEA on the CTA on a computer screen, using an ordinary ballpoint pen and a white sheet of paper, the surgeon can create a stylistic map of the dissectional-path of the DIEA. The map illustrates unusual branching patterns, perforator caliber and location, interconnections between individual perforators (or lack thereof), length of intramuscular dissection, and also rectus abdominis muscle intersections. The mapping can help in the choice of perforator(s) and may also speed up decision-making during surgical dissection. A penciled map also eases a round-table discussion, if multiple surgeons are involved in the operation. The map can also easily be brought to the operating room for guidance. Tracing is a user-friendly, time-efficient, intuitive, low-cost, and low-tech method that generates data that are easy to interpret, easy to share, and easy to discuss with other surgeons. The method is also not dependent on a radiologist for interpretation.