bluuebunny/crossref_metadata_2025 huggingface dataset:
Revival of a forgotten valve: use of the percutaneous clip for the treatment of tricuspid regurgitation
Authors: Bartorelli Antonio L , Ferrari Cristina , Olivares Paolo , Monizzi Giovanni , Grancini Luca
Published: October 2021

Tricuspid regurgitation (TR) is common in patients with left-sided valvular heart disease and is independently associated with increased mortality and morbidity because it leads to right-sided heart failure and recurrent hospitalization. The prognostic benefit of isolated TR surgical repair or replacement is unclear and medical treatment of decompensated right heart failure alone does not prevent the progression of the disease. Recently, minimal invasive catheter-based techniques have emerged as a feasible and effective option for TR treatment in selected high-risk patients who would clinically benefit from tricuspid valve repair. We provide an overview of the current state of transcatheter TR treatment using the edge-to-edge technique.
Aortic and mitral bioprosthetic valve dysfunction: surgical or percutaneous solutions?
Authors: Belluschi Igor , Buzzatti Nicola , Castiglioni Alessandro , De Bonis Michele , Maisano Francesco , Alfieri Ottavio
Published: October 2021

In the last years, there has been a trend to prefer biological prostheses, especially among young patients, with the aim to avoid anticoagulant treatment. Surgical tissue valves have so far demonstrated their solid long-term durability. However, younger age has been identified as one of the main risk factors for developing structural valve deterioration (SVD). As a consequence, the proportion of subjects at risk for valve dysfunction will constantly rise in the near future. However, while surgical reintervention has always been considered the gold standard for treatment of prosthesis deterioration, the introduction of transcatheter heart valves could offer new therapeutical options, particularly among high-risk patients, aiming a second less invasive chance. The recent standardization of valve durability definitions will soon allow a more comprehensive understanding of the mechanism underlying SVD and guide the choice of prosthesis for patients needing valve replacement.
Correlation between cardiovascular risk factors and cognitive decline
Authors: Desideri Giovambattista , Bocale Raffaella
Published: October 2021

The number of people suffering from dementia in the world is progressively increasing due to the expansion of the geriatric population in which this clinical condition is more frequent. The appearance of a variable degree of cognitive decline up to full-blown dementia does not, however, represent the inevitable fate of those who age, as the studies conducted in the centenarians clearly indicate. Indeed, the age-specific incidence of dementia has progressively decreased in many geographical areas, probably due to an improvement in lifestyles and health care. In fact, a growing number of scientific evidence shows how chronic exposure over the course of life, starting from young adulthood, to various risk factors—arterial hypertension, diabetes mellitus, obesity, tobacco smoke, sleep disorders—contribute significantly to the development of cognitive decline and dementia in the course of senescence. These risk factors, in fact, can trigger and amplify the various neuropathological mechanisms underlying the development of decline, progressively reducing the functional reserve of the brain. Although definitive evidence deriving from ad hoc intervention studies is not currently available, it is legitimate to assert that the early control of cardiovascular risk factors can represent today the most effective tool for the prevention of dementia.
The wireless pacemaker is on again; from electro-stimulation to synchronization
Authors: Stazi Filippo
Published: October 2021

Leadless stimulation of the right ventricle is now a reality, especially in patients with very specific indications and clinical characteristics, even in the absence of randomized studies to support its use. The reduction of device costs and the refinement of atrioventricular synchronization algorithms will sanction its greater diffusion in the future. The possibility of using leadless technology also for resynchronization therapy, on the other hand, is currently a promising option but, pending randomized studies with robust case histories and adequate follow-ups, it should still be considered as a niche therapy, to be limited to centres highly specialized and in patients in whom conventional resynchronization has been impossible or ineffective.
The myosin activator: is another step forward in heart failure therapy?
Authors: Abete Raffaele , Iacovoni Attilio , Senni Michele
Published: October 2021

Selective cardiac myosin activators constitute a new class of drugs capable of increasing cardiac contractility independently of intracellular calcium concentrations. In the GALACTIC-HF study, the first of this class of molecules, omecamtiv mercabil, was compared with the standard of care according to current guidelines, showing a significant reduction in the composite endpoint of first episode of heart failure or mortality due to cardiovascular causes in patients exposed to treatment compared with placebo. In particular, the effect was more pronounced for decreasing ejection fraction values, suggesting a potential further benefit of selective cardiac myosin activators in this category of patients.
Thrombosis in pre- and post-vaccination phase of COVID-19
Authors: Violi Francesco , Cammisotto Vittoria , Pastori Daniele , Pignatelli Pasquale
Published: October 2021

Acute infections may be complicated by thrombosis occurring in the venous and arterial circulation. This may be observed in patients with community-acquired pneumonia (CAP) and also in patients with coronavirus 2019 (COVID-19), that is a pandemic characterized by severe acute respiratory syndrome (SARS-CoV-2) needing mechanical ventilation and intensive care unit treatment. However, the type and rate of thrombosis can vary according to the cause of pneumonia as is more frequently complicated by arterial thrombosis in CAP, while an equal incidence of venous and arterial thrombosis occurs in SARS-CoV-2. The mechanisms of disease are overall platelet-related in CAP while activation of both platelets and clotting system is implicated in the pathogenesis of thrombosis in SARS-CoV-2; this finding could imply a different therapeutic approach of the two settings. Thrombosis may also occur in subjects vaccinated against SARS-CoV-2 even if its incidence is not so high (1/100 000); this rare effect occurs more prevalently in young women, is independent from known risk factors of thrombosis, is caused by antibodies against platelet PF4 and is counteracted by treatment with immunoglobulin and glucocorticoids.
A multi-intervention protocol to improve sleep quality in a coronary care unit
Authors: Beltrami Flávia Gabe , John Ângela Beatriz , de Macedo Bruno Rocha , Corrêa Júnior Vicente , Nguyen Xuân Lan , Pichereau Claire , Maury Eric , Fleury Bernard , Gus Miguel , Fagondes Simone Chaves
Published: October 2021

Aims

Poor sleep is a frequent occurrence in the critical illness. Evaluate sleep quality and test the effect of a multi-intervention sleep care protocol in improving sleep quality in a coronary care unit (CCU).

Methods and results

Quasi-experimental study, carried out in two phases. During the first phase, the control group (n = 58 patients) received usual care. Baseline sleep data were collected through the Richards-Campbell Sleep Questionnaire (RCSQ) and the Sleep in the Intensive Care Unit Questionnaire (SICUQ). During the second phase (n = 55 patients), a sleep care protocol was implemented. Interventions included actions to promote analgesia, reduce noise, brightness, and other general measures. Sleep data were collected again to assess the impact of these interventions. The intervention group had better scores in overall sleep depth [median (interquartile range)] [81 (65–96.7) vs. 69.7 (50–90); P = 0.046]; sleep fragmentation [90 (65–100) vs. 69 (42.2–92.7); P = 0.011]; return to sleep [90 (69.7–100) vs. 71.2 (40.7–96.5); P = 0.007]; sleep quality [85 (65–100) vs. 71.1 (49–98.1); P = 0.026]; and mean RCSQ score [83 (66–94) vs. 66.5 (45.7–87.2); P = 0.002] than the baseline group. The main barriers to sleep were pain [1 (1.0–5.5)], light [1 (1.0–5.0)], and noise [1 (1.0–5.0)]. The most rated sources of sleep-disturbing noise were heart monitor alarm [3 (1.0–5.25)], intravenous pump alarm [1.5 (1.0–5.00)]. and mechanical ventilator alarm [1 (1.0–5.0)]. All were significantly lower in the intervention group than in the baseline group.

Conclusion

A multi-intervention protocol was feasible and effective in improving different sleep quality parameters and reducing some barriers to sleep in CCU patients.
Irreversibility analysis of induced swirl flow inside the pipes of flat-plate solar collector using dual tangential nozzles
Authors: Cao Yan , Ayed Hamdi , Issakhov Alibek , Sene Ndolane , Bouallegue Belgacem
Published: October 2021

In the present research, dual-nozzle swirl generator was installed at the blocked end of the straight tube to inject flow tangential to the wall of the pipe with various injection inclinations compared to the longitudinal axis. This causes a swirl flow inside the pipe. Altering some decisive variables, including injection angle, side of nozzle cross-section, pipe diameter, and flow rate, caused to attain various cases with unique hydraulic-geometrical characteristics. Classes ‘A…-D50-N…-M…’ and ‘A…-D20-N…-M…’ bear the main characteristics of the cases embodied in their sub-classes. Entropy generation (St), Nu*, NE, Heat Transfer Improvement (HTI) index and ${\eta}_{w-s}$ were used as effective tools for the basement of the system based on the irreversibility concept. The results showed that all of the cases of class ‘A…-D50-N…-M…’ cause lower frictional-contributed and higher thermal-contributed entropy generation compared to the class ‘A…-D20-N…-M…’. The highest values of the HTI index are 1.5 and 1.763 obtained by ‘A30-D20-N5-M0.4’ and ‘A90-D20-N6.25-M0.1’, respectively.
Work status and work ability of patients receiving kidney replacement therapy: results from a European survey
Authors: de Jong Rianne W , Boezeman Edwin J , Chesnaye Nicholas C , Bemelman Frederike J , Massy Ziad A , Jager Kitty J , Stel Vianda S , de Boer Angela G E M
Published: October 2021

Background

Employment is important for the quality of life and financial security of patients of working age receiving kidney replacement therapy (KRT). We aimed to examine self-reported work status and general, physical and mental work ability and to determine associations between demographic, disease-related, work-related and macroeconomic factors and employment. 

Methods

Europeans from 37 countries, ages 19–65 years, treated with dialysis or kidney transplantation, filled out the web-based or paper-based cross-sectional EDITH kidney patient survey between November 2017 and January 2019. We performed descriptive analyses and multivariable generalized logistic mixed models.

Results

Of the 3544 patients, 36.5% were employed and working [25.8% of dialysis patients, 53.9% of kidney transplant recipients (KTRs)]. The mean general work ability was 5.5 out of 10 (dialysis: 4.8, KTRs: 6.5). Non-working patients (all: 4.1, dialysis: 3.9, KTRs: 4.7) scored lower than working patients (all: 7.7, dialysis 7.3, KTRs: 8.0). Working dialysis patients scored lower on physical and mental work ability (7.1 and 8.1) than working KTRs (8.0 and 8.4; P < 0.001). Impaired physical work ability (42.7%) was more prevalent than impaired mental work ability (26.7%). Male sex, age 40–49 years, higher education, home dialysis or kidney transplantation as current treatment, treatment history including kidney transplantation, absence of diabetes mellitus, better general work ability and higher country gross domestic product were positively associated with employment (P < 0.05).

Conclusions

Low employment rates and impaired work ability were prevalent among European patients receiving KRT. Demographic, disease-related, work-related and macro-economic factors were associated with employment.
Hybrid Robotics for Endoscopic Transnasal Skull Base Surgery: Single-Centre Case Series
Authors: Zappa Francesca , Madoglio Alba , Ferrari Marco , Mattavelli Davide , Schreiber Alberto , Taboni Stefano , Ferrari Erika , Rampinelli Vittorio , Belotti Francesco , Piazza Cesare , Fontanella Marco Maria , Nicolai Piero , Doglietto Francesco
Published: October 2021

BACKGROUND

Only preclinical studies and case reports have described robotic surgery for endoscopic transnasal skull base surgery.

OBJECTIVE

To evaluate the role of a novel robotic endoscope holder, developed for transsphenoidal surgery.

METHODS

Patients were prospectively enrolled for 3 mo at the Neurosurgery Unit of Brescia. Endoscope Robot® was used to assist during the sphenoidal phase of the approach, tumor removal, and skull base reconstruction. A Likert scale questionnaire was given to all surgeons after each procedure. Patients who underwent robotic-assisted surgery were matched with nonrobotic ones for pathology and type of procedure. All surgical videos were evaluated during bimanual phases.

RESULTS

Twenty-one patients underwent robot-assisted, endoscopic transsphenoidal surgery for different pathologies (16 pituitary adenomas, 3 chordomas, 1 craniopharyngioma, 1 pituitary exploration for Cushing disease) for a total of 23 procedures (1 patient underwent 2 endoscopic revisions of a skull base reconstruction). Subjective advantages reported by surgeons included smoothness of movement, image steadiness, and improvement of maneuvers in narrow spaces and with angled endoscopes; as the main limitation, Endoscope Robot® appeared to be relatively heavy during the initial endoscope positioning. A comparative analysis with a historical matched cohort documented similar clinical outcomes, while endoscope lens cleaning and position readjustments were significantly less frequent in robotic procedures.

CONCLUSION

Although confirmation in larger studies is needed, Endoscope Robot® was a safe and effective tool, especially advantageous in lengthy interventions through deep and narrow corridors.
Symptomatic Epidural Hematoma After Elective Cervical Spine Surgery: Incidence, Timing, Risk Factors, and Associated Complications
Authors: Abola Matthew V , Du Jerry Y , Lin Charles C , Schreiber-Stainthorp William , Passias Peter G
Published: October 2021

BACKGROUND

As the rate of elective cervical spine surgery increases, studies of complications may improve quality of care. Symptomatic postoperative cervical epidural hematomas (PCEH) are rare but result in significant morbidity. Because of their low incidence, the risk factors and complications associated with symptomatic PCEH remain unclear.

OBJECTIVE

To clarify the prevalence, timing, variables, and complications associated with PCEH following elective cervical spine surgery.

METHODS

Using the American College of Surgeons National Surgical Quality Improvement Program database, cervical spine surgeries performed between 2012 and 2016 were identified using Current Procedural Terminology codes. Symptomatic PCEH was defined as readmission or reoperation events specifically associated with International Classification of Diseases code diagnoses of postoperative hematoma within 30 d of index surgery. Multivariate models were created to assess the independent association of symptomatic PCEH with other postoperative complications.

RESULTS

There were 53233 patients included for analysis. The overall incidence of symptomatic PCEH was 0.4% (n = 198). Reoperation occurred in 158 cases (78.8%), of which 2 required a second reoperation (1.3%). The majority (91.8%) of hematomas occurred within 15 d of surgery. Multivariate analysis identified male gender, American Society of Anesthesiologists classes 3 to 5, bleeding disorder, increasing number of operative levels, revision surgery, dural repair, and perioperative transfusion as independent factors associated with PCEH. Upon controlling for those confounders, PCEH was independently associated with cardiac arrest, stroke, deep vein thrombosis, surgical site infection, and pneumonia.

CONCLUSION

Postoperative epidural hematomas requiring readmission or reoperation following elective cervical spine surgery occurred at an incidence of 0.4%. Symptomatic PCEHs are associated with increased rates of numerous major morbidities.
Coupling Stokes Flow with Inhomogeneous Poroelasticity
Authors: Taffetani Matteo , Ruiz-Baier Ricardo , Waters Sarah
Published: October 2021

We investigate the behaviour of flux-driven flow through a single-phase fluid domain coupled to a biphasic poroelastic domain. The fluid domain consists of an incompressible Newtonian viscous fluid while the poroelastic domain consists of a linearly elastic solid filled with the same viscous fluid. The material properties of the poroelastic domain, that is permeability and elastic parameters, depend on the inhomogeneous initial porosity field. We identify the dimensionless parameters governing the behaviour of the coupled problem: the ratio between the magnitudes of the driving velocity and the Darcy flows in the poroelastic domain, and the ratio between the viscous pressure scale and the size of the elastic stresses in the poroelastic domain. We consider a perfusion system, where flow is forced to pass from the single-phase fluid to the biphasic poroelastic domain. We focus on a simplified two-dimensional geometry with small aspect ratio and perform an asymptotic analysis to derive analytical solutions. The slender geometry is divided in four regions, two outer domains that describe the regions away from the interface and two inner domains that are the regions across the interface. Our analysis advances the quantitative understanding of the role of heterogeneous material properties of a poroelastic domain on its mechanical response when coupled with a fluid domain. The analysis reveals that, in the interfacial zone, the fluid and the elastic behaviours of this coupled Stokes—poroelastic problem can be treated separately via (i) a Stokes–Darcy coupling and (ii) the solid skeleton being stress free. This latter finding is crucial to derive the coupling condition across the outer domains for both the elastic part of the poroelastic domain and the fluid flow. Via specification of heterogeneous material properties distribution, we reveal the effects of heterogeneity and deformability on the mechanics of the poroelastic domain.
Phylogenetics and Evolution of Potato Virus V: Another Potyvirus that Originated in the Andes
Authors: Fuentes Segundo , Gibbs Adrian J. , Adams Ian P. , Hajizadeh Mohammad , Kreuze Jan , Fox Adrian , Blouin Arnaud G. , Jones Roger A. C.
Published: October 2021

Potato virus V (PVV) causes a disease of potato (Solanum tubersosum) in South and Central America, Europe, and the Middle East. We report here the complete genomic sequences of 42 new PVV isolates from the potato’s Andean domestication center in Peru and of eight historical or recent isolates from Europe. When the principal open reading frames of these genomic sequences together with those of nine previously published genomic sequences were analyzed, only two from Peru and one from Iran were found to be recombinant. The phylogeny of the 56 nonrecombinant open reading frame sequences showed that the PVV population had two major phylogroups, one of which formed three minor phylogroups (A1 to A3) of isolates, all of which are found only in the Andean region of South America (Peru and Colombia), and the other formed two minor phylogroups, a basal one of Andean isolates (A4) that is paraphyletic to a crown cluster containing all the isolates found outside South America (World). This suggests that PVV originated in the Andean region, with only one minor phylogroup spreading elsewhere in the world. In minor phylogroups A1 and A3, there were two subclades on long branches containing isolates from S. phureja evolving more rapidly than the others, and these interfered with dating calculations. Although no temporal signal was directly detected among the dated nonrecombinant sequences, PVV and potato virus Y (PVY) are from the same potyvirus lineage and are ecologically similar, so “subtree dating” was done via a single maximum likelihood phylogeny of PVV and PVY sequences, and PVY’s well-supported 157 ce “time to most common recent ancestor” was extrapolated to date that of PVV as 29 bce. Thus the independent historical coincidences supporting the datings of the PVV and PVY phylogenies are the same; PVV arose ≥2,000 years ago in the Andes and was taken to Europe during the Columbian Exchange, where it diversified around 1853 ce, soon after the European potato late blight pandemic. PVV is likely to be more widespread than currently realized and is of biosecurity relevance for world regions that have not yet recorded its presence.

[Formula: see text] Copyright © 2022 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Genomic Sequence Data of Bacterial Isolates from Pistachio Trees and Other Woody Plants in California Are Inconsistent with the Role of Rhodococcus as the Causative Agent of Pistachio Bushy Top Syndrome
Authors: Riely Brendan K. , Nouri Mohamed T. , Riaz Kashif , Tufail Muhammad Rizwan , Gai Yunpeng , Carrasquilla Noelia , Fayyaz Amna , Chang Peter L. , Leveau Johan H. J. , Cook Douglas R. , Trouillas Florent P.
Published: October 2021

Pistachio bushy top syndrome (PBTS) is a serious problem for pistachio growers in the western United States, but the cause of this disorder remains controversial. Recently, it was proposed that the Rhodococcus species R. fascians and R. corynebacterioides caused PBTS outbreaks in 2011 and 2015. To investigate the association of Rhodococcus spp. with PBTS in California's pistachio-growing region, Rhodococcus-like isolates were collected from diverse hosts and environments, including pistachio nurseries and orchards. Whole genome sequence analysis of 231 isolates revealed their evolutionary relationships and identified six Rhodococcus species. Combined with data on geography and host of origin, the data reveal that Rhodococcus generally, and R. fascians specifically, is ubiquitous in nature, frequently occurring in both symptomatic and asymptomatic pistachio trees and on other woody and native species. Core gene and single nucleotide polymorphism-based phylogenies and pangenome analyses differentiate R. fascians into distinct genotypes. Although we found examples of common genotypes shared between nurseries and orchards, the observed patterns are most consistent with an environmental source of strains and do not support a scenario in which individual nurseries are point sources of Rhodococcus. Moreover, none of the collected strains harbored known virulence genes, calling into question the role of these common environmental bacteria in causing PBTS.

[Formula: see text] Copyright © 2022 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
COVID-19 and opioid use disorder
Authors: Mumba Mercy Ngosa , Jaiswal Jessica , Langner-Smith Natalia , Mugoya George T. , Brown Whitnee , Davis Lori L.
Published: October 2021

Substance use treatment inequities among rural populations are well documented and the COVID-19 pandemic has exacerbated these inequalities, forcing healthcare providers to be creative in the delivery of treatment. Systematic reviews on the use of telehealth to treat patients with substance use disorder indicate that it is a promising alternative to in-person services. This article examines the evidence supporting the use of telehealth in treating patients with opioid use disorder and explores other promising options that can help overcome pandemic-related barriers to treatment.
Antegrade Intramedullary Fixation for Clavicular Shaft Fracture: A Technical Trick
Authors: Youn Seung-Min , Kim Jong Dae , Jeong Ho Yeon , Ro Kyunghan , Kim Myung Seo , Rhee Yong Girl , Rhee Sung-Min
Published: October 2021

The standard open reduction and internal fixation technique with a plate and screws for a simple mid shaft clavicular fracture necessitates a relatively large incision and can also lead to variable amount of keloid scar formation. Historically, other techniques of more minimally invasive retrograde intramedullary fixation with the entry point posterolaterally on the shoulder have shown their own disadvantages and complications. We present a surgical technique of antegrade intramedullary fixation for mid shaft clavicular fractures and an illustrative case series.
Ocular Phenotype of Peters-Plus Syndrome
Authors: Shah Parth R. , Chauhan Bharesh , Chu Charleen T. , Kofler Julia , Nischal Ken K.
Published: October 2021

Purpose:

Peters-plus syndrome is a rare, autosomal recessive congenital disorder of glycosylation caused by mutations in the gene B3GLCT. A detailed description of the ocular findings is currently lacking in the scientific literature. We report a case series of Peters-plus syndrome with deep ocular phenotyping using anterior segment optical coherence tomography and ultrasound biomicroscopy. Where available, we describe the histology of host corneal buttons.

Methods:

A retrospective chart review of patients with Peters-plus syndrome was conducted under the care of the senior author between January 2000 and June 2019. Demographic and clinical data including ocular and systemic features, ophthalmic imaging, and molecular diagnostic reports were collected.

Results:

Four cases of Peters-plus syndrome were identified. Three patients were male and 1 was female. Five of the 8 eyes had an avascular paracentral ring opacity with relative central clearing. The paracentral opacity is due to iridocorneal adhesion and the relative central clearing associated with posterior stromal thinning. One eye had persistent fetal vasculature and microphthalmia, which has not previously been reported. One eye from each of 2 patients had a significantly different phenotype with a large vascularized central corneal opacity.

Conclusions:

The most common ocular phenotype seen in Peters-plus syndrome is an avascular paracentral ring opacity with relative central clearing. A different phenotype with a large vascularized corneal opacity may also be observed.
Multicenter Study of Needle-Free Blood Collection System for Reducing Specimen Error and Intravenous Catheter Replacement
Authors: Pendleton Brian , LaFaye Ryan
Published: October 2021

Inpatient hospital settings require access to high-quality blood specimens and durable peripheral intravenous (IV) catheters for patient care. The most common standard-of-care method for acquiring each blood specimen—venipuncture—often results in a non-negligible preanalytical error rate, patient discomfort, and tissue inflammation. In a 2-year, multicenter (23 hospitals) retrospective study, a novel blood collection system that collects blood specimens through existing inpatient IVs without a needle (PIVO, Velano Vascular) was compared with the current standard of care, in regards to its effect on specimen quality and IV catheter longevity. Using the PIVOTM device for blood collection decreased the rate of preanalytical errors by 56% compared with other collection methods, including venipuncture and conventional line draws. In addition, peripheral IV catheters that were used with PIVOTM for blood draws also had a 19% lower rate of replacement compared with those that did not. This is the largest study to date of PIVO use and demonstrates significant quality improvement outcomes compared with the current standard of care in blood collection, providing an opportunity to innovate inpatient hospital care.
Pediatric otolaryngology in the coronavirus disease 2019 pandemic: what have we learned?
Authors: Lee David R. , Dedhia Kavita
Published: October 2021

Purpose of review

Coronavirus disease 2019 (COVID-19) has changed the face of healthcare. The current review is to discuss the major aspects that have changed in pediatric otolaryngology, from surgical operations management, to clinic workflow, to procedural precautions.

Recent findings

There have been many studies over the past year describing different ways to improve the safety of healthcare delivery in pediatric otolaryngology amidst a global pandemic, as well as ways to improve clinic and surgical logistics along with guidelines for telehealth of a surgical specialty.

COVID-19 has forever altered how healthcare is viewed and practiced, and pediatric otolaryngology was not exempt. With an increased focus on provider safety, as well as novel ways of utilizing changes in methods of communication, the practice of pediatric otolaryngology has evolved with the rest of healthcare to take on the new challenges brought on by this global pandemic.
Classification and Clinical Treatments for Unfavorable Fractures of the Proximal Segment in Sagittal Spilt Ramus Osteotomy: A Retrospective Study of 964 Cases
Authors: Jiang Nan , Wang Min , Bi Ruiye , Wu Guomin , Zhu Songsong
Published: October 2021

Unfavorable fractures in sagittal split ramus osteotomy are hard to manage. The aim of this study is to develop a new classification method for unfavorable fractures of the proximal segment to guide clinical managements. After reviewing 964 cases of sagittal split ramus osteotomy, we found that the unfavorable fractures can be divided into 3 types: mandibular ramus transverse fractures (Type 1), bad fractures accompanied by free fragments (Type 2), and unexpected separation patterns without free fragments (Type 3). We calculated the incidence of each fracture type and provided instructions for their corresponding treatments. Thirty-six patients suffered from unfavorable fractures (7.4% of patients), among which 32 patients had unilateral fractures and 4 patients had bilateral fractures. There were 2 Type 1 fractures (0.2% of split sites), 8 Type 2 fractures (0.8% of split sites), and twenty-six Type 3 fractures (2.3% of split sites). Type 1 unfavorable fractures are difficult to deal with, but Types 2 and 3 are generally manageable and they have no significant impact on the final outcomes. The new classification can effectively guide treatment strategies for unfavorable fractures. Severe cases of unfavorable fractures are rare, and most unfavorable fracture cases have a positive prognosis if correctly treated in time.
Chemotherapy and targeted therapies for meningiomas: what is the evidence?
Authors: Graillon Thomas , Tabouret Emeline , Chinot Olivier
Published: October 2021

Purpose of review

Although most meningiomas are slow growing tumors mainly controlled by surgery with or without radiotherapy, aggressive meningiomas that fail these conventional treatments constitute a rare situation, a therapeutic challenge and an unmet need in neuro-oncology.

Recent finding

Mutational landscape in recurrent high-grade meningiomas includes mainly NF2 mutation or 22q chromosomal deletion, whereas telomerase reverse transcriptase promoter, BAP-1 and CDK2NA mutations were also found in aggressive meningiomas. Pi3K-Akt-mTOR pathway is currently the most relevant intracellular signaling pathway target in meningiomas with preliminary clinical activity observed. Assessment of drug activity with progression free survival rate at 6 months is challenging in regard to meningioma growth rate heterogeneity, so that 3-dimensional growth rate before and during treatment could be considered in the future to selected new active drugs.

Despite a low evidence level, some systemic therapies may be considered for patients with recurrent meningioma not amenable to further surgery or radiotherapy. In recurrent high-grade meningioma, everolimus-octreotide combination, bevacizumab, sunitinib and peptide receptor radionuclide therapy exhibit a signal of activity that may justify their clinical use. Despite a lack of clear signal of activity to date, immunotherapy may offer new perspectives in the treatment of these refractory tumors.
Defining the analytical and clinical sensitivity of the ARTIC method for the detection of SARS-CoV-2
Authors: Alikhan Nabil-Fareed , Quick Joshua , Trotter Alexander J. , Robson Samuel C. , Bashton Matthew , Kay Gemma L. , Loose Matt , Rooke Stefan , McHugh Martin , Darby Alistair C , Nicholls Samuel M. , Loman Nicholas J. ,   The COVID-19 Genomics UK (COG-UK) consortium, Dervisevic Samir , Page Andrew J. , O’Grady Justin
Published: October 2021

The SARS-CoV-2 ARTIC amplicon protocol is the most widely used genome sequencing method for SARS-CoV-2, accounting for over 43% of publicly-available genome sequences. The protocol utilises 98 primers to amplify ∼400bp fragments of the SARS-CoV-2 genome covering all 30,000 bases. Understanding the analytical performance metrics of this protocol will improve how the data is used and interpreted. Different concentrations of SARS-CoV-2 control material were used to establish the limit of detection (LoD) of the ARTIC protocol. Results demonstrated the LoD was a minimum of 25-50 virus particles per mL. The sensitivity of ARTIC was comparable to the published sensitivities of commercial diagnostics assays and could therefore be used to confirm diagnostic testing results. A set of over 3,600 clinical samples from three UK regions were then evaluated to compare the protocols performance to clinical diagnostic assays (Roche Lightcycler 480 II, AusDiagnostics, Roche Cobas, Hologic Panther, Corman RdRp, Roche Flow, ABI QuantStudio 5, Seegene Nimbus, Qiagen Rotorgene, Abbott M2000, Thermo TaqPath, Xpert). We developed a Python tool, RonaLDO, to perform this validation (available under the GNU GPL3 open-source licence fromhttps://github.com/quadram-institute-bioscience/ronaldo). Positives detected by diagnostic platforms were generally supported by sequencing data; platforms that used RT-qPCR were the best predictors of whether the sample would subsequently sequence successfully. To maximise success of sample sequencing for phylogenetic analysis, samples with Ct <31 should be chosen. For diagnostic tests that do not provide a quantifiable Ct value, adding a quantification step is recommended. The ARTIC SARS-CoV-2 sequencing protocol is highly sensitive, capable of detecting SARS-CoV-2 in samples with Cts in the high 30s. However, to routinely obtain whole genome coverage, samples with Ct <31 are recommended. Comparing different virus detection methods close to their LoD was challenging and significant discordance was observed.
Unidirectional protein recruitment is essential for viral latency
Authors: Lavi Ido , Bhattacharya Supriya , Awase Ankita , Orgil Ola , Avital Nir , Journo Guy , Gurevich Vyacheslav , Shamay Meir
Published: October 2021

Kaposi’s sarcoma associated herpesvirus (KSHV, HHV-8) is associated with several human malignancies. During latency the viral genomes reside in the nucleus of infected cells as large non-integrated plasmids, known as episomes. All KSHV infected cells express LANA, and LANA is essential for viral latency. LANA binding to the viral episomes is critical for both replication of the viral genomes during latency, and for tethering the viral episomes to the cell chromosomes during cell division. Directional recruitment of protein complexes are critical for proper function of many nuclear processes. To test for recruitment directionality between LANA and cellular proteins we directed LANA via catalytically inactive Cas9 (dCas9) to a repeat sequence to obtain easily detectable dots. Then, recruitment of nuclear proteins to these dots can be evaluated. We found that LANA recruited its known interactors ORC2 and SIN3A. Interestingly, LANA was unable to recruit MeCP2, but MeCP2 recruited LANA. Both LANA and histone deacetylase 1 (HDAC1) interact with the transcriptional-repression domain (TRD) of MeCP2. Similar to LANA, HDAC1 was unable to recruit MeCP2. While heterochromatin protein 1 (HP1) which interacts with the N-terminal of MeCP2, was able to recruit MeCP2. Forcing MeCP2 dimerization via the tandem epitopes of SunTag, allows LANA to recruit MeCP2 in infected cells. We propose that available interacting domains force this recruitment directionality. Knock-down of MeCP2 by shRNA, as well as cells derived from Rett syndrome and express a mutant MeCP2 (T158M), dramatically reduced the ability of LANA to support viral latency. Therefore, this unidirectional recruitment of LANA by MeCP2 identified MeCP2 as a critical factor for KSHV viral maintenance.

Significance Statement

Using a CRISPR/Cas9 recruitment assay, we show that some interacting proteins have a unidirectional recruitment property, where only one of the proteins can recruit its partner. We found unidirectional recruitment relations between the methylated DNA binding protein MeCP2 and KSHV encoded LANA. Where MeCP2 recruits LANA, but LANA is unable to recruit MeCP2. We were able to break this unidirectional recruitment by forcing MeCP2 dimerization. We propose that this unidirectional recruitment is the result of available interacting domains. Furthermore, this unidirectional recruitment seems to be critical for viral latency since LANA fails to maintain the viral genomes in MeCP2 mutant cells. Therefore, in this case unidirectional recruitment is a matter of survival or extinction.
Regional development and the institutional environment for franchise chains: frontiers of small and medium-sized cities
Authors: Melo Pedro Lucas de Resende , Borini Felipe Mendes , Isaac Victor Ragazzi , Correa Victor Silva
Published: October 2021

Purpose

The purpose of this paper is to understand and identify the various characteristics of the institutional environment and the factors that propitiate the attraction of franchise chains to cities in the interior, using Brazil as an analysis.

Design/methodology/approach

Secondary data from the Brazilian Institute of Geography and Statistics were used. It comprised a sample of 1,683 Brazilian cities with commercial outlets featuring franchise brands. It was limited to cities with populations of up to 100,000 inhabitants that did not constitute metropolitan regions. The statistical technique performed was multiple regression.

Findings

The results of the multiple regression confirm the explanatory power of R² = 36% for the analyzed model. Such presence of franchise chains is based on four institutional dimensions and their environmental characteristics: demographic (demographic density); economic and financial (average monthly salary of formal workers and number of banking agencies); business (number of active companies and presence of shopping centers); and human resources (presence of higher education units).

Research limitations/implications

The main contribution of the study encompasses the call that regional institutional characteristics are part of knowledge guidelines on regional development and institutional environments for entrepreneurship. In this sense, the paper contributes to studies on regional development in particular, by punctuating the characteristics of the institutional environment of cities that are related to the existence of franchise chain brands.

Practical implications

Such contributions are addressed to managers and directors of expanding franchise chains, given the choice of locations that best enable the concept of their franchises. The fact that only 20% of franchises have a presence in these cities, even if it is admitted that for 70% of these chains, their businesses have the capacity to make these locations viable, shows the importance of this contribution.

Social implications

This study is addressed to public managers, represented by secretaries of municipal developments, in view of the construction of an institutional environment conducive to entrepreneurial activity, in this specific case, by franchises. It is an important mechanism for attracting new businesses and creating a virtuous cycle of regional development.

Originality/value

Specifically, knowledge is generated about the insertion of ventures based on the franchise business model in small- and medium-sized regional markets. A second feature involves the understanding of the insertion of enterprises in a large and heterogeneous emerging market.
Social media activity: its impact on career-related perceptions
Authors: O'Connor Kimberly W. , McDonald Kimberly S. , McDaniel Brandon T. , Schmidt Gordon B.
Published: October 2021

Purpose

The purpose of this exploratory study is to examine individual perceptions about the impact that social media use has on career satisfaction and perceived career benefits. We examined whether informal online learning through “typical” types of social media behaviors (e.g. liking a post or messaging another user) and “networking” types of social media behaviors (e.g. endorsing another user, writing recommendations, going “live,” or looking for a job) impacted career-related perceptions.

Design/methodology/approach

In this study, we analyzed Amazon Mechanical Turk survey data gathered from adult participants (n = 475). We focused our inquiry specifically on two social media sites, Facebook and LinkedIn. We asked participants about their social media use and behaviors, as well as their perceptions of career satisfaction and career benefits related to social media.

Findings

We found that both typical and networking types of social media behaviors positively predicted the “knowing whom” career competency (defined as career relevant networks and contacts that individuals use to develop their careers) and career satisfaction. Only networking behaviors were positively associated with perceived career benefits of social media use. We further found that LinkedIn users’ career satisfaction was lower compared to non-LinkedIn users.

Originality/value

This study adds to the small, but growing body of career research focusing on social capital and social media. Our results suggest that informal online learning via social media may have a positive impact on employees’ career-related perceptions.
Authentic leadership, person-organization fit and collectivistic orientation: a moderated-mediated model of workplace safety
Authors: Liu Shuzhen , Chu Fulei , Guo Ming , Liu Yuanyuan
Published: October 2021

Purpose

Workplace safety has been a persistent issue for safety-critical organizations. Based on self-verification theory, this study investigates how authentic leadership affects safety behaviors in a collectivistic context.

Design/methodology/approach

This research collected 259 matching questionnaires for high-speed railway (HSR) drivers and their supervisors in China. Specifically, HSR drivers were invited to fill in their general perceived authentic leadership, person-organization fit and collectivistic orientation. In addition, their direct supervisors were invited to assess their safety behaviors.

Findings

Authentic leadership exhibits a significant positive impact on safety compliance and safety participation, implying that authentic leadership positively impacts safety behavior. The person-organization fit partially mediated the relationship between authentic leadership and safety behavior (safety compliance and participation). Furthermore, collectivistic orientation moderates the relationship between authentic leadership and person-organization fit.

Originality/value

The findings of this study provide important insights into authentic leadership and person-organization fit for developing effective strategies to improve workplace safety.
Financing liabilities and inefficient investment of listed companies: Based on the adjustment effect of different financial structures
Authors: Wang Yuanyue , Yu Zhaohui , Yi Xiaojing
Published: October 2021

For national development, the investment efficiency of listed companies should be improved. We take samples of non‐financial and non‐real estate listed companies to investigate the mechanism of financial liabilities on the inefficient investment behaviour of listed companies from a financial structure perspective. Results of our empirical research indicate an inverted U‐shaped relationship between financing liabilities and investment efficiency, and that financing liabilities inhibit underinvestment and exacerbate overinvestment. Operating liabilities were found to have a restraining effect on underinvestment. A bank‐led financial structure is more effective in regulating financing liabilities and alleviating overinvestment, while a market‐led financial structure is more conducive to regulating financing liabilities and, thus, curbs underinvestment. Therefore, a company's financial structure should be adjusted in a timely manner, according to demand, the scale of financial liabilities should be adjusted to reduce inefficient investment, and operational liabilities can be appropriately expanded. Additionally, attention should be focused on the role of administrative intervention and financial development to improve the investment efficiency of listed companies and eventually realise stable development of the national economy.
Moving Beyond Sex: Prostitutes, Migration and Knowledge in Late‐Medieval Mediterranean Port Cities
Authors: McDonough Susan
Published: October 2021

Based in archival research from Barcelona, Marseille, Valencia and Palermo, this article argues for a reconsideration of the gendering of the medieval Mediterranean. It focuses on prostitutes and their movement to and from Mediterranean port cities and queries how they used the institutions of the law courts and the notariat to integrate themselves into the everyday workings of the city. The article concludes with a call to rethink whose movement counts in the medieval Mediterranean when scholars think of the region as a whole.
Extracorporeal life support and cardiopulmonary bypass for central airway surgery: A systematic review
Authors: O'Malley Thomas J. , Yost Colin C. , Prochno Kyle W. , Saxena Abhiraj , Grenda Tyler R. , Evans Nathaniel R. , Cowan Scott W. , Morris Rohinton J. , Massey Howard Todd , Tchantchaleishvili Vakhtang
Published: October 2021

Background

Major airway surgery can pose a complex problem to perioperative central airway management. Adjuncts to advanced ventilation strategies have included cardiopulmonary bypass, veno‐arterial, or veno‐venous extracorporeal life support. We performed a systematic review to assess the existing evidence utilizing these strategies.

Methods

An electronic search was conducted to identify studies written in English reporting the use of extracorporeal life support (ECLS) during central airway surgery. Thirty‐six articles consisting of 78 patients were selected and patient‐level data were analyzed.

Results

Median patient age was 47 [IQR: 34‐53] and 59.0% (46/78) were male. Indications for surgery included central airway or mediastinal cancer in 57.7% (45/78), lesion or injury in 15.4% (12/78), and stenosis in 12.8% (10/78). Support was initiated pre‐operatively in 9.9% (7/71) and at the time of induction in 55.3% (42/76). It was most commonly used at the time of tracheal resection/repair [93.2% (68/73)], intubation of the tracheal stump [94.4% (68/72)], and re‐anastomosis [94.2% (65/69)]; 13.7% (10/73) patients were supported post‐operatively. The most commonly performed surgery was tracheal repair or resection in 70.3% (52/74). Median hospital stay was 12 [8, 25] days and in‐hospital mortality was 7.9% (6/76). There was no significant difference in survival between the three groups (p = .54).

Conclusions

Extracorporeal membrane oxygenation offers versatility in timing, surgical approach, and ECLS runtime that makes it a viable addition to the surgical armamentarium for treating complex central airway pathologies.
Letter: proton pump inhibitor use and bone fracture risk—a mechanistic point of view
Authors: Sugiyama Toshihiro
Published: October 2021

LINKED CONTENT

This article is linked to Labenz et al and Labenz & Schattenberg papers. To view these articles, visit https://doi.org/10.1111/apt.16008 and https://doi.org/10.1111/apt.16257