bluuebunny/crossref_metadata_2025 huggingface dataset:
Albert algebras and the Tits-Weiss conjecture
Authors: Thakur Maneesh
Published: May 2022

We prove the Tits-Weiss conjecture for Albert division algebras over fields of arbitrary characteristic in the affirmative. The conjecture predicts that every norm similarity of an Albert division algebra is a product of a scalar homothety andUU-operators. This conjecture is equivalent to the Kneser-Tits conjecture for simple, simply connected algebraic groups with Tits indexE8,278E^{78}_{8,2}. We prove that a simple, simply connected algebraic group with Tits indexE8,278E_{8,2}^{78}orE7,178E_{7,1}^{78}, defined over a field of arbitrary characteristic, isRR-trivial, in the sense of Manin, thereby proving the Kneser-Tits conjecture for such groups. The Tits-Weiss conjecture follows as a consequence.
CUPID Lip Lift: Advanced Lip Design Using the Deep Plane Upper Lip Lift and Simplified Corner Lift
Authors: Talei Benjamin , Pearlman Steven J
Published: May 2022

Background

Upper lip lift is achieved with a variety of techniques but many questions remain about the benefits and drawbacks of each technique. The CUPID deep plane or modified upper lip lift procedure has recently been introduced to help mitigate risk and optimize outcomes.

Objectives

The aims of this study were: (1) to better characterize and simplify the complex and artistic decision-making process involved in upper lip lift and corner lip lift; (2) to present a mathematical guide to maintain the natural balance of the upper lip, optimizing muscle function, and to indicate when to add a corner lift; and (3) to elucidate design elements, aging, and future treatment considerations.

Methods

A PubMed (United States National Library of Medicine, Bethesda, MD) search was performed in October 2021 for all journal articles published on upper lip lift and corner lip lifts. The search covered from 1950 to the present day in all languages and without exclusion criteria. Outcomes and the evolution of deep plane upper lip lift design over the last 6 years were analyzed.

Results

By following the patterns demonstrated in over 2440 consecutive lip lifts, the authors have been better able to understand the nuances involved in proper design that will avoid acceleration of aging and exaggeration of appearance, and reduce the need for revision while maximizing results.

Conclusions

Upper lip lift design is more complex than most practitioners realize. The mathematical concept described herein makes it possible to obtain more aesthetically pleasing and consistent outcomes. This novel approach to lip lift design enables the practitioner to improve lip balance, facial harmony, and tooth show, and obtain adequate exposure of the lateral vermillion.

Level of Evidence: 4
SPRISS: approximating frequentk-mers by sampling reads, and applications
Authors: Santoro Diego , Pellegrina Leonardo , Comin Matteo , Vandin Fabio
Published: May 2022

Motivation

The extraction of k-mers is a fundamental component in many complex analyses of large next-generation sequencing datasets, including reads classification in genomics and the characterization of RNA-seq datasets. The extraction of all k-mers and their frequencies is extremely demanding in terms of running time and memory, owing to the size of the data and to the exponential number of k-mers to be considered. However, in several applications, only frequent k-mers, which are k-mers appearing in a relatively high proportion of the data, are required by the analysis.

Results

In this work, we present SPRISS, a new efficient algorithm to approximate frequent k-mers and their frequencies in next-generation sequencing data. SPRISS uses a simple yet powerful reads sampling scheme, which allows to extract a representative subset of the dataset that can be used, in combination with any k-mer counting algorithm, to perform downstream analyses in a fraction of the time required by the analysis of the whole data, while obtaining comparable answers. Our extensive experimental evaluation demonstrates the efficiency and accuracy of SPRISS in approximating frequent k-mers, and shows that it can be used in various scenarios, such as the comparison of metagenomic datasets, the identification of discriminative k-mers, and SNP (single nucleotide polymorphism) genotyping, to extract insights in a fraction of the time required by the analysis of the whole dataset.

Availability and implementation

SPRISS [a preliminary version (Santoro et al., 2021) of this work was presented at RECOMB 2021] is available at https://github.com/VandinLab/SPRISS.

Supplementary information

Supplementary data are available at Bioinformatics online.
Startups and employment following the COVID-19 pandemic: a calculator
Authors: Benedetti-Fasil Cristiana , Sedláček Petr , Sterk Vincent
Published: May 2022

Early indicators suggest that startup activity across countries is heavily affected by the COVID-19 pandemic and the associated lockdowns. At the same time, empirical evidence has shown that such disturbances may have long-lasting effects on aggregate employment. This paper presents a calculator which can be used to compute these effects under different scenarios regarding (i) the number of startups, (ii) the growth potential of startups and (iii) the survival rate of young firms. We apply our calculator to the United States and four European countries: France, Germany, Italy and Spain. We find that employment losses can be substantial and last for more than a decade, even when the assumed slump in startup activity is only short-lived. Almost half of the long-run losses is caused by fewer high-growth firms, ‘gazelles’, starting up during the pandemic. Our results also suggest that the long-run effects of the pandemic may vary across countries substantially with Germany possibly being shielded due to its low business dynamism.
Childhood Socioeconomic Disadvantage and Pathways to Memory Performance in Mid to Late Adulthood: What Matters Most?
Authors: Ford Katherine J , Kobayashi Lindsay C , Leist Anja K
Published: May 2022

Objectives

Childhood socioeconomic disadvantage is consistently associated with lower cognitive function in later life. This study aims to distinguish the contribution of specific aspects of childhood socioeconomic disadvantage for memory performance in mid to late adulthood, with consideration for direct and indirect effects through education and occupation.

Methods

Data were from adults aged 50 to 80 years who completed the life history module in the 2006/2007 wave of the English Longitudinal Study of Aging (n = 4,553). The outcome, memory score, was based on word recall tests (range: 0–20 points). We used the g-formula to estimate direct and indirect effects of a composite variable for childhood socioeconomic disadvantage and its 4 individual components: lower-skilled occupation of the primary breadwinner, having few books in the home, overcrowding in the home, and lack of water and heating facilities in the home.

Results

Few books were the most consequential component of childhood socioeconomic disadvantage for later-life memory (total effect: −0.82 points for few books; 95% confidence interval [CI]: −1.04, −0.60), with roughly half being a direct effect. The total effect of a breadwinner in lower-skilled occupations was smaller but not significantly different from a few books (−0.67 points; 95% CI: −0.88, −0.46), while it was significantly smaller with overcrowding (−0.31 points; 95% CI: −0.56, −0.06). The latter 2 total effects were mostly mediated by education and occupation.

Discussion

A literate environment in the childhood home may have lasting direct effects on memory function in mid to later life, while parental occupation and overcrowding appear to influence memory primarily through educational and occupational pathways.
Most Common Refusals of Personal Care in Advanced Dementia: Psychometric Properties of the Refusal of Care Informant Scale
Authors: Backhouse Tamara , Khondoker Mizanur , Killett Anne , Mioshi Eneida
Published: May 2022

Background and Objectives

Refusals of care in dementia can be a source of distress for people with dementia and their caregivers. Informant-based measures to examine refusals of care are limited and often measure other behaviors such as agitation. We aimed to assess the validity and reliability of the newly developed, 14-item, Refusal of Care Informant Scale (RoCIS) and then use the scale to verify the most common refusal behaviors.

Research Design and Methods

Data from 129 dyads were analyzed. Dyad was defined as a person with advanced dementia either living in a care home or supported in their own home and their caregiver. Data about the person with dementia were gathered using informant-based questionnaires. The psychometric properties of the RoCIS were investigated using Rasch analysis to determine validity and reliability.

Results

Following Rasch analysis, the item “upset” was removed from the RoCIS. The reduced 13-item RoCIS is unidimensional and achieved a reliability index of 0.85 (Cronbach’s alpha 0.88). Sixty-eight percent of people with dementia had refused care in the last month, with “verbally refused” the most common type of refusal behavior. People in the “very severe/profound” stage of dementia showed more refusal behaviors than those in the “severe” stage.

Discussion and Implications

Results provide initial evidence that the RoCIS is a valid and reliable informant-based scale measuring refusals of care in advanced dementia. Results indicate a need to develop new approaches and techniques to make assistance with personal care more acceptable to people with dementia.
F-Box Protein 11 Suppresses Cell Proliferation and Aerobic Glycolysis in Glioblastomas by Mediating the Ubiquitin Degradation of Cdc25A
Authors: Liu Chao , Chen Xi , Zhang Li , Liu Jiaxiu , Li Chunmei , Zhao Jinxi , Pu Jun , Tang Peipei , Liu Bolin , Huang Xiaobin
Published: May 2022

Glioblastoma is a malignant CNS tumor with an extremely poor prognosis. F-box protein 11 (FBXO11) has E3 ubiquitin ligase activity and participates in the pathogenesis of multiple tumors but the role and mechanism of FBXO11 activity in glioblastoma remain unknown. In this study, FBXO11 was first observed to be downregulated in glioblastoma tissues and cell lines. 3-(4,5)-dimethylthiahiazo (-z-y1)-3,5-di- phenytetrazoliumromide (MTT) and colony formation assays and enzyme linked immunosorbent assay (ELISA) demonstrated that overexpression of FBXO11 suppressed proliferation and aerobic glycolysis and induced cell cycle arrest in U251-MG and A172 cells. FBXO1 decreased cell division cycle 25 A (Cdc25A) expression through ubiquitin degradation in a coprecipitation assay. A Western blot assay validated FBXO11 suppression of PKM2 dephosphorylation and c-Myc-mediated aerobic glycolysis via reduction of Cdc25A. In addition, a rescue experiment revealed that FBXO11 suppressed proliferation and aerobic glycolysis, both of which were reversed by overexpression of Cdc25A. FBXO11 overexpression also inhibited tumorigenesis via suppressing Cdc25A expression in vivo. These findings indicate that FBXO11 suppresses cell proliferation and aerobic glycolysis in glioblastomas by mediating the ubiquitin degradation of Cdc25A thereby providing insight into mechanisms of glioblastoma tumorigenesis and identifying a new potential therapeutic strategy.
Usefulness of urinary biomarkers to estimate the interstitial fibrosis surface in diabetic nephropathy with normal kidney function
Authors: González Jorge , Jatem Elias , Roig Jordi , Valtierra Naiara , Ostos Elena , Abó Anabel , Santacana Maria , García Alicia , Segarra Alfons
Published: May 2022

Background

Kidney biopsies of patients with diabetic nephropathy (DN) and normal kidney function may exhibit interstitial fibrosis (IF) without reduction of glomerular filtration rate (GFR) because of hyperfiltration. The aim of our study was to analyse the performance of a set of biomarkers of tubular injury to estimate the extent of IF in patients with DN and normal kidney function.

Methods

This cross-sectional study included 118 adults with DN diagnosed by kidney biopsy and GFR ≥90 mL/min/1.73 m2 and a control group of healthy subjects. We measured the urinary excretion of monocyte chemoattractant protein-1 (MCP-1) neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), liver-type fatty acid-binding protein (L-FABP), β2-microglobulin and dickkopf-3 protein (DKK-3) at the time of kidney biopsy. GFR was measured by chromium-51 labeled ethylenediamine tetraacetic acid (Cr-EDTA) (measured GFR). IF was quantified using a quantitative morphometric procedure. Predictive multivariate models were developed to estimate the IF surface.

Results

Patients with DN showed significantly higher levels of DKK-3, MCP-1 and L-FABP and significantly lower levels of epidermal growth factor (EGF) than healthy controls. There were no significant between-group differences in the levels of β2-microglobulin, KIM-1 or NGAL. IF was negatively associated with EGF and positively with age, proteinuria, MCP-1, DKK-3 and L-FABP, but not with β2-microglobulin, KIM-1, NGAL or GFR. The best model to predict IF surface accounted for 59% of its variability and included age, proteinuria, EGF, DKK-3 and MCP-1.

Conclusions

Our study provides a model to estimate the IF in DN that can be useful to assess the progression of IF in patients with normal kidney function.
Transformation of a Study Abroad Experience Into a Virtual Community Health Clinical
Authors: Lugger Suzanne M. , Koonmen Jamie M.
Published: May 2022

The COVID-19 pandemic forced nursing faculty to transform an international study abroad service-learning course into a virtual community health clinical experience with a global focus. The course was piloted with seven students who would have completed their community health clinical during a short-term immersion trip to Kenya. Clinical assignments were changed to closely mirror the immersion service-learning experience in a virtual environment. Student feedback reflected positive learning outcomes. This transformation has implications for expanding student opportunities in the virtual environment to gain a deeper understanding of global health.
Legacy of the Role of Medicine and Nursing in the Holocaust: An Educational Intervention to Support Nursing Student Professional Identity Formation and Ethical Conduct
Authors: Kruse Julie A. , Wald Hedy S.
Published: May 2022

Reflecting on history of medicine and nursing in the Holocaust scaffolds professional identity formation. Students grapple with 1) nurses’ active participation in identifying/killing patients with mental and physical disabilities, camouflaged as “euthanasia” or “mercy killing” of German citizens and others, preceding mass murder of Jews and others at death camps; 2) involvement in unethical, cruel experiments; 3) resistance narratives; and 4) relevance for contemporary nursing. Impact of a seminar/colloquium on historical knowledge and personal/professional relevance included reported increased historical awareness/knowledge and themes of nurse as patient advocate/judicious obedience, importance of ethics/values adherence, and value of art/reflective writing for processing experience.
Anterior Cervical Discectomy and Fusion in Professional Athletes
Authors: Hotchkiss William R. , Clavenna Andrew L. , Nimmons Scott J.B. , Dossett Andrew B.
Published: May 2022

Study Design:

Level III—retrospective study.

Objective:

The aim was to evaluate the effect method of bone grafting and contract status have on outcomes in a cohort of professional athletes treated with anterior cervical discectomy and fusion (ACDF).

Summary of Background Data:

The choice of graft-type in ACDF is controversial, with current reports limited to smaller cohorts.

Materials and Methods:

Retrospective analysis of 54 professional athletes treated with single level ACDF for cervical disc herniation, cervical fracture, or transient paraparetic event.

Results:

A case series of professional athletes with ACDF by the senior surgeon were evaluated, 39 with structural iliac crest autograft and 15 with allograft. All autograft patients had confirmed bony fusion, whereas 13/15 allograft patients had a confirmed bony fusion. Each of these players (2/15, 13.3%) was delayed for clearance for return to play by 1 season. In total, 43/50 players (88%) returned to professional play; 25/27 (92.6%) of them “self-employed” and 18/23 (78.2%) “league-contracted.”

Conclusions:

Surgical treatment of cervical pathology in the professional athlete with structural iliac crest autograft results in high union and return to play rates. Use of allograft resulted in a 13.3% increased rate of missing an additional season. Self-employed athletes returned to play 1 season earlier than league-contracted athletes on average.
Not Just a Linear Closure: Aesthetic Flat Closure after Mastectomy
Authors: Morrison Kerry A. , Karp Nolan S.
Published: May 2022

Currently, there is an increasing trend in women seeking aesthetic flat closure after mastectomy. To date, there is no plastic surgery literature on specific techniques to achieve an aesthetic flat closure after mastectomy. As plastic surgeons, we need to continue to innovate and to iterate new surgical techniques in our reconstructive armamentarium to address the desires of and to optimize the outcomes for our reconstructive breast surgery patients. Herein, we seek to delineate key considerations and employed techniques for reconstructive plastic surgeons performing aesthetic flat closure after mastectomy. Namely, it is crucial to listen to the patient, and to fully understand the patient’s concerns, wishes, and particular aesthetic desired. From a technical perspective, the key surgical pearls include completely obliterating the inframammary fold, ensuring the same size and flap thickness bilaterally, appropriately de-fatting medially on the chest wall to allow for a smooth contour, obviating any presence of dog ears medially or laterally with precise tissue excision, and confirming that the incisions are entirely symmetric bilaterally. Intraoperatively, it is important to sit these patients up to assess soft tissue re-draping, and to confirm that there are no dog ears nor any excess tissue that could compromise the perfectly flat aesthetic chest closure. With the increasing demand for flat closures after mastectomy, plastic surgeons need to be keen on employing modified surgical techniques to best optimize the desired aesthetic flat closure reconstructions for these patients, as these reconstructions are not simply linear closures.
Efficacy and Safety of Micropulse Transscleral Laser Therapy in Silicone Oil-induced Glaucoma
Authors: Zbiba Walid , Sayadi Sana , Kharrat Malek , Daoued Maroua
Published: May 2022

Purpose:

To assess the efficiency and safety of MicroPulse® Transscleral Laser Therapy (TLT) in the management of silicone oil-induced glaucoma.

Methods:

A prospective case series of 33 eyes with uncontrolled silicone oil-induced glaucoma was enrolled at the department of ophthalmology of Mohamed Taher Maamouri Hospital, Nabeul, Tunisia. Patients were treated with MicroPulse TLT using the IRIDEX Cyclo G6® Glaucoma Laser System with the MicroPulse P3® fiberoptic handheld probe. Patients underwent complete ophthalmologic examination during the 12-month follow-up period.

Results:

The study included 33 eyes of 33 patients. The mean age was 50.39 years old. We included patients with silicone oil-induced glaucoma. Silicone oil tamponade was indicated for complicated rhegmatogenous retinal detachment in 22 cases, diabetic tractional retinal detachment in 10 cases, and post-traumatic retinal detachment in one case. Silicone oil was already removed before the procedure in 23 eyes. Silicone oil tamponade duration varied between 3 to 26 months. IOP measurements at enrolment, day 1, day 7, day 15, 1 month, 3 months, 6 months and 12 months was respectively 37.94±13.61, 19.03±10.98, 16.5±6.17, 19.45±9.73, 19.27±8.33, 19.39±9.52, 19.97±10.03 and 19.7±9.58▒mmHg. The percentage of IOP lowering was 45.38% at 6 months and 45% at 12 months. The success rate was 93.93% at 6 months remaining stable at 12 months. No major side effects were observed, in particular, no phthisis bulbi nor prolonged inflammation. There was no difference in IOP lowering between patients with silicone oil or those after silicone oil removal (P=0.99).

Conclusion:

MP-TLT was safe and effectively lowered intraocular pressure in uncontrolled silicone-oil induced glaucoma.
Comparison of the Structure-Function Relationship Between Advanced Primary Open Angle Glaucoma and Normal Tension Glaucoma
Authors: Sung Mi Sun , Ji Yong Sok , Heo Hwan , Park Sang Woo
Published: May 2022

Purpose:

The aim was to investigate and compare the characteristics of visual field (VF) defects in primary open angle glaucoma (POAG) and normal-tension glaucoma (NTG) with advanced glaucomatous damage and to determine whether the structure-function relationships found in advanced glaucoma differ based on their glaucoma classification.

Patients and Methods:

Ninety-seven eyes of 97 patients (59 eyes with POAG and 38 eyes with NTG) with advanced glaucoma were included in this cross-sectional study. Scores at each test point of the 30-2 VF total deviation map were recorded, and average values at each test point were point-wise compared between the groups. Peripapillary retinal nerve fiber layer (RNFL) and macular thickness (total, RNFL, ganglion cell layer, and inner plexiform layer thickness) were measured. The structure-function relationship based on the map of Garway-Heath was determined and compared between the 2 groups.

Results:

At advanced stage of glaucoma, POAG eyes demonstrated more diffusely distributed VF defects, whereas NTG eyes had more severe VF defects at the superior nasal quadrant, showing increased asymmetry. Overall, peripapillary RNFL, macular ganglion cell layer, and macular inner plexiform layer thickness showed good relationships with 30-2 VF parameters in both groups. However, in total macula and macular RNFL thickness, the structure-function relationships tended to show different characteristics depending on the glaucoma classification; NTG eyes showed overall better relationships.

Conclusions:

In advanced glaucoma, differences in patterns of VF damage were found between POAG and NTG eyes. Conventional peripapillary RNFL and macular measurements showed generally good performance for estimating functional status, particularly in NTG eyes.
A Customized Electronic Health Record-Based Tool Highlights and Addresses Gaps in Patient Safety
Authors: Cavalier Joanna S. , Griffith Brian , Setji Noppon , Vanam Krishna , Woo Myung , Krishnan Govind , Chung Sunny , Chandiramani Anisha
Published: May 2022

The authors present a tool to improve gaps in patient safety using the electronic health record. The tool integrates gap identification, passive alerts, and actions into a single interface embedded within clinicians’ workflow. The tool was developed to address venous thromboembolism prophylaxis, prevention of hypo- and hyperglycemia, code status documentation, bowel movement frequency, and skilled nursing facility transitions. Alerts and actions during silent and live periods were retrospectively analyzed. The most prevalent safety gaps were lack of venous thromboembolism prophylaxis (40.4% of alerts), constipation (19.3%), and lack of code status (18.4%). Disparities in safety gaps were present by patient race, sex, and socioeconomic status. Usability testing showed positive feedback without significant alert burden. Thus, a safety gap tool was successfully built to study and address patient safety issues. The tool’s strengths are its integration within the electronic health record, ease of use, customizability, and scalability.
Network pharmacology explores the mechanisms of Eucommia ulmoides cortex against postmenopausal osteoporosis
Authors: Shao Yan , Chen Song , Zhou Ke , Gan Kaifeng , Li Jin , Xia Chenjie
Published: May 2022

Postmenopausal osteoporosis (PMOP) has become one of most frequent chronic disease worldwide with aging population. Eucommia ulmoides cortex (EU), a traditional Chinese medicine, has long since been used to treat PMOP. The aim of this study is to explore pharmacological mechanisms of EU against PMOP through using network pharmacology approach.

The active ingredients of EU were obtained from Traditional Chinese Medicine System Pharmacology database, and target fishing was performed on these ingredients in UniProt database for identification of their relative targets. Then, we screened the targets of PMOP using GeneCards database and DisGeNET database. The overlapping genes between PMOP and EU were obtained to performed protein–protein interaction, Gene Ontology analysis, Kyoto encyclopedia of genes, and genomes analysis.

Twenty-eight active ingredients were identified in EU, and corresponded to 207 targets. Also, 292 targets were closely associated with PMOP, and 50 of them matched with the targets of EU were considered as therapeutically relevant. Gene ontology enrichment analysis suggested that EU exerted anti-PMOP effects via modulating multiple biological processes including cell proliferation, angiogenesis, and inflammatory response. Kyoto encyclopedia of genes and genomes enrichment analysis revealed several pathways, such as PI3K-AKT pathway, mitogen-activated protein kinase pathway, hypoxia-inducible factors-1 pathway, tumor necrosis factor pathway, and interleukin-17 pathway that might be involved in regulating the above biological processes.

Through the method of network pharmacology, we systematically investigated the mechanisms of EU against PMOP. The multi-targets and multi-pathways identified here could provide new insights for further determination of more exact mechanisms of EU.
Postoperative early and proactive grip strength training program for distal radius fractures promotes earlier recovery of grip strength
Authors: Kaji Yoshio , Yamaguchi Konosuke , Nomura Yumi , Oka Kunihiko , Nakamura Osamu , Ishibashi Yoichi , Yamamoto Tetsuji
Published: May 2022

The use of volar locking plates (VLPs) for distal radius fractures has remarkably improved clinical outcomes; however, there are some reports of delayed recovery of grip strength. Since January 2019, we have been conducting an early and proactive grip strength training program (EGTP). In this program, 20 minutes of grip strength training—using a gripper with a load of 0.7 kg—was initiated from 2 weeks after surgery; the load was then gradually increased. From 6 weeks postsurgery, daily home grip strength training was performed using a gripper with a load of 5 kg, provided to the patient.

We investigated whether the introduction of the EGTP could lead to earlier recovery of grip strength. We also examined whether the EGTP caused postoperative correction loss at the fractured site, or contributed to the early improvement of wrist function.

Thirty-nine patients who underwent surgery using VLPs for distal radius fractures were included in this study; 20 followed the EGTP (EGTP group) and 19 patients did not (NGTP group). For these patients, grip strength and range of motion of the wrist joint were evaluated both 3 and 6 months postoperatively. The Quick Disabilities of the Arm, Shoulder, and Hand (qDASH) scores were also evaluated 6 months postoperatively. Additionally, corrective losses of radial inclination (RI), palmar tilt (PT), and ulnar variance (UV)—occurring from immediately postsurgery to 6 months after surgery—were evaluated.

At both 3 and 6 months postoperatively, the grip strength of the EGTP group was significantly higher than that of the NGTP group. Regarding range of motion, only palmar flexion was significantly improved in the EGTP group at 3 months postoperatively. Conversely, no differences in corrective losses of RI, PT, and UV, or in qDASH scores, were observed between the two groups.

The results of this study suggest that the EGTP can provide early recovery of grip strength and palmar flexion of the wrist without causing corrective loss at the fracture site.
Survival and clinicopathological characteristics of cT4b oral squamous cell carcinoma based on different treatment modalities
Authors: Lin Nan-Chin , Hsu Jui-Ting , Chen Michael Y.C. , Tsai Kuo-Yang
Published: May 2022

Introduction:

Primary surgical treatment for oral squamous cell carcinoma (OSCC) is reserved for T1 to T4a tumors, but not for T4b tumors, according to the present National Comprehensive Cancer Network clinical practice guidelines. In this retrospective study, we aimed to determine the association between the clinicopathological characteristics and different treatment modalities for T4b OSCC based on whether patients received primary surgical treatment. Therefore, we conducted a survival analysis based on different treatment modalities.

Methods:

This retrospective cohort study enrolled 125 patients with clinical stage T4b OSCC who received treatment and were followed up at Changhua Christian Hospital between January 1, 2008 and December 31, 2018.

Results:

Overall, 81 patients received primary surgical treatment and 44 received primary nonsurgical treatment. Comparison of the clinicopathological characteristics between those who did and did not undergo surgery revealed no significant differences in age at tumor diagnosis, tumor location, clinical N stage, and involved tumor area based on computed tomography or magnetic resonance imaging, or stratified Charlson Comorbidity Index scores. In the survival analysis, Kaplan–Meier curves revealed that patients who received treatment modalities including surgery exhibited better survival than those who received treatment modalities that did not include surgery.

Conclusions:

In the present study, patients with T4b OSCC treated with primary surgery had a better overall survival rate than those who received nonsurgical treatment. In the future, it will be necessary for clinicians worldwide to report the treatment outcomes of patients with T4b OSCC based on the common criteria.
Management strategy for extracranial carotid artery aneurysms
Authors: Choi Eol , Gwon Jun Gyo , Kwon Sun U. , Lee Deok Hee , Kwon Tae-Won , Cho Yong-Pil
Published: May 2022

This single-center, retrospective study aimed to describe the anatomic and clinical characteristics of extracranial carotid artery aneurysms (ECAAs) and to compare various ECAA management strategies in terms of outcomes.

A total of 41 consecutive patients, who underwent treatment for ECAAs between November 1996 and May 2020, were included in this study. The ECAAs were anatomically categorized using the Attigah and Peking Union Medical College Hospital (PUMCH) classifications. The possible study outcomes were restenosis or occlusion of the ipsilateral carotid artery after treatment and treatment-associated morbidity or mortality.

The 41 patients were stratified into three groups according to the management strategies employed: surgical (n = 25, 61.0%), endovascular (n = 10, 24.4%), and conservative treatment (n = 6, 14.6%). A palpable, pulsatile mass was the most common clinical manifestation (n = 16, 39.0%), and degenerative aneurysms (n = 29, 65.9%) represented the most common pathogenetic or etiological mechanism. According to the Attigah classification, type I ECAAs (n = 24, 58.5%) were the most common. Using the PUMCH classification, type I ECAAs (n = 26, 63.4%) were the most common. There was a higher prevalence of Attigah type I ECAAs among patients who underwent surgical treatment compared with those who underwent endovascular treatment (64.0% vs 40.0%, P = .09), whereas patients with PUMCH type IIa aneurysms were more likely to receive endovascular treatment (12.0% vs 30.0%). False aneurysms were more likely to be treated using endovascular techniques (20% vs 70%, P = 0.02). Except for two early internal carotid artery occlusions (one each among patients who underwent surgical and endovascular treatments, respectively), there were no early or late restenoses or occlusions during follow-up. Cranial nerve injuries were noted in three patients after surgical treatment, and late ipsilateral strokes occurred in two patients (one each among patients who underwent endovascular and conservative treatment, respectively). There were no other treatment-associated complications or deaths during the study period.

Conclusions:

Both surgical and endovascular treatments could be performed safely for ECAAs with good long-term results according to anatomic location and morphology.
Prevalence and Time Course of Thiamine Deficiency in Critically Ill Children: A Multicenter, Prospective Cohort Study in Turkey
Authors: Akkuzu Emine , Yavuz Sinan , Ozcan Serhan , Sincar Sahin , Bayrakci Benan , Kendirli Tanil , Pasaoglu Hatice , Kalkan Gokhan
Published: May 2022

OBJECTIVES:

To determine the prevalence and time course of thiamine deficiency (TD) in PICU patients.

DESIGN:

Multicenter, prospective, cohort study between May 2019 and November 2019.

SETTING:

Three university-based tertiary care, mixed medical-surgical PICUs in Ankara, Turkey.

PATIENTS:

PICU patients 1 month to 18 years old.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

We studied 476 patients and grouped them by TD status on days 1 and 3 of the PICU admission. There might be a risk of unintended bias since we excluded 386 patients because of the absence of consent, inadequate blood samples, loss of identifier information, and recent vitamin supplementation. On day 1, TD was present in 53 of 476 patients (11.1%) and median (minimum–maximum) thiamine levels were 65.5 ng/mL (5–431 ng/mL). On day 3, TD was present in 27 of 199 patients (13.6%) with repeated measurement. The median (minimum–maximum) thiamine levels were 63 ng/mL (13–357 ng/mL). The time course of TD from day 1 to day 3 in these 199 patients was as follows. In 21 of 199 patients (10.6%) with TD on day 1, 11 of 21 (52%) continued to have TD on day 3 and the other 10 of 21 patients (48%) improved to no longer having TD. In 178 of 199 patients (89.4%) without TD on day 1, 16 of 178 (9%) went on to develop TD by day 3, and the other 162 of 178 (91%) continued to have normal thiamine status.

CONCLUSIONS:

In the PICU population in three centers in Turkey, the prevalence of TD in the sample of patients was 11.1%. In those TD patients who had serial studies, we also identified that by day 3 some continued to be TD, and some patients improved to normal thiamine status. Of concern, however, is the population who develop TD over the course of PICU stay.
Current Concepts in Maxillary Reconstruction
Authors: Lee Z-Hye , Cripps Courtney , Rodriguez Eduardo D.
Published: May 2022

Defects involving the midface and maxilla pose unique challenges to reconstructive surgeons. The maxilla serves as the central keystone of the face and interfaces with various other facial subunits to affect form and function. Reconstructive methods range from prosthetics to free tissue transfer, and the indications for different options are reviewed here. Finally, special considerations including management of the orbit, dental rehabilitation, and future directions are discussed.
Solitary Sphenoid Sinus Lesion Presenting as Chronic Headache
Authors: Kim Seo Bin , Kim Jooyeon , Kwon Jae Hwan
Published: May 2022

Background and Objectives:

Headache is a common symptom with etiologies that are difficult to distinguish, 1 of which is sinusitis. A solitary sphenoid lesion, which is rare, can also cause acute or chronic headaches. The authors investigated whether endoscopic sinus surgery (ESS) for solitary sphenoid lesions could reduce headache symptoms.

Subjects and Methods:

The authors reviewed the charts of patients who underwent ESS from 2012 to 2017, whose main symptom was a chronic headache for several years. There were no remarkable pathologic findings in the nasal cavity upon endoscopic examination. Medications for reducing headaches had transient effect. Brain magnetic resonance imaging or computed tomography scans showed a solitary sphenoid lesion and the patients underwent ESS by the same otolaryngologist. In total, 16 out of 547 ESS cases that met the above conditions were included in this study. The authors evaluated the duration, character, and degree of the headaches pre- and post-operatively. The authors also determined if there was a correlation between headaches, sphenoidal lesions, and pathologic outcomes.

Results:

There were significant improvements in headaches after surgery. The pre- and post-operative mean visual analog scale score for headaches was 7.27 ± 1.67 and 3.80 ± 1.82, respectively. The pathologic outcomes revealed chronic inflammation in 11 patients, nasal polyp in 1 patient, inverted papilloma in 1 patient, and fungal infections in 3 patients, but there was no clinical correlation between the headache, lesion site, and pathology.

Conclusions:

A solitary sphenoid lesion can be the cause of acute or chronic headaches. Headaches from a solitary sphenoid sinus lesion, which were not controlled by medical treatments, could be improved by surgical procedures.
Endovascular Perfusion Augmentation for Critical Care Decreases Vasopressor Requirements while Maintaining Renal Perfusion
Authors: Patel Nathan T.P. , Gaffley Michaela , Leblanc Mathias J.R. , Lane Magan R. , Kratky Lauren E. , Hoareau Guillaume L. , Johnson M. Austin , Jordan James E. , Neff Lucas P. , Williams Timothy K.
Published: May 2022

Background:

Ischemia reperfusion injury causes a profound hyperdynamic distributive shock. Endovascular perfusion augmentation for critical care (EPACC) has emerged as a hemodynamic adjunct to vasopressors and crystalloid. The objective of this study was to examine varying levels of mechanical support for the treatment of ischemiareperfusion injury in swine.

Methods:

Fifteen swine underwent anesthesia and then a controlled 30% blood volume hemorrhage followed by 30 min of supra-celiac aortic occlusion to create an ischemia-reperfusion injury Animals were randomized to standardized critical care (SCC), EPACC with low threshold (EPACC-Low), and EPACC with high threshold (EPACC-High). The intervention phase lasted 270 min after injury Hemodynamic markers and laboratory values of ischemia were recorded.

Results:

During the intervention phase, SCC spent 82.4% of the time avoiding proximal hypotension (>60 mm Hg), while EPACC-Low spent 97.6% and EPACC-High spent 99.5% of the time avoiding proximal hypotension, P 
< 0.001. Renal artery flow was statistically increased in EPACC-Low compared with SCC (2.29 mL/min/kg vs. 1.77 mL/ min/kg, P 
< 0.001), while renal flow for EPACC-High was statistically decreased compared with SCC (1.25 mL/min/kg vs. 1.77 mL/min/kg, P 
< 0.001). EPACC animals required less intravenous norepinephrine, (EPACC-Low: 16.23mcg/kg and EPACC-High: 13.72 mcg/kg), compared with SCC (59.45 mcg/kg), P = 0.049 and P = 0.013 respectively.

Conclusions:

Compared with SCC, EPACC-High and EPACC-Low had decreased norepinephrine requirements with decreased frequency of proximal hypotension. EPACC-Low paradoxically had increased renal perfusion despite having a mechanical resistor in the aorta proximal to the renal arteries. This is the first description of low volume mechanical hemodynamic support in the setting of profound shock from ischemia-reperfusion injury in swine demonstrating stabilized proximal hemodynamics and augmented distal perfusion.
Contribution of IL-38 in Lung Immunity during Pseudomonas Aeruginosa-induced Pneumonia
Authors: Wei Qiang , Chen Xi , Chen Xia , Yuan Zhongzhen , Wang Chuanjiang
Published: May 2022

Objective:

Interleukin-38 (IL-38), a new type of cytokine, is involved in processes such as tissue repair, inflammatory response, and immune response. However, its function in pneumonia caused by Pseudomonas aeruginosa (P. aeruginosa) is still unclear.

Methods:

In this study, we detected circulating IL-38 and cytokines such as IL-1β, IL-6, IL-17A, TNF-α, IL-8, and IL-10 in adults affected by early stage pneumonia caused by P. aeruginosa. Collected clinical data of these patients, such as the APACHE II score, levels of PCT, and oxygenation index when they entering the ICU. Using P. aeruginosa-induced pneumonia WT murine model to evaluate the effect of IL-38 on Treg differentiation, cell apoptosis, survival, tissue damage, inflammation, and bacterial removal.

Results:

In clinical research, although IL-38 is significantly increased during the early stages of clinical P. aeruginosa pneumonia, the concentration of IL-38 in the serum of patients who died with P. aeruginosa pneumonia was relatively lower than that of surviving patients. It reveals IL-38 may insufficiently secreted in patients who died with P. aeruginosa pneumonia. Besides, the serum IL-38 level of patients with P. aeruginosa pneumonia on the day of admission to the ICU showed significantly positive correlations with IL-10 and the PaO2/FiO2 ratio but negative correlations with IL-1β, IL-6, IL-8, IL-17, TNF-α, APACHE II score, and PCT In summary, IL-38 might be a molecule for adjuvant therapy in P. aeruginosa pneumonia. In experimental animal models, first recombinant IL-38 improved survival, whereas anti-IL-38 antibody reduced survival in the experimental pneumonia murine model. Secondly, IL-38 exposure reduced the inflammatory response, as suggested by the lung injury, and reduced cytokine levels (IL-1β, IL-6, IL- 17A, TNF-α, and IL-8, but not IL-10). It also increased bacterial clearance and reduced cell apoptosis in the lungs. Furthermore, IL-38 was shown to reduce TBK1 expression in vitro when naive CD4+ T lymphocytes were differentiated to Tregs and played a protective role in P. aeruginosa pneumonia.

Conclusions:

To summarize, the above findings provide additional insights into the mechanism of IL-38 in the treatment of P. aeruginosa pneumonia.
Impact of Underlying Disease and Preoperative Factors on Postoperative Outcomes After Laparoscopic Splenectomy: A Bicentric Retrospective Analysis
Authors: Peltrini Roberto , Di Nuzzo Maria M. , De Capua Michele , Andreuccetti Jacopo , D’Alessio Rossella , Baldoni Daniele , Bracale Umberto , Pignata Giusto , Corcione Francesco
Published: May 2022

Background:

Although the laparoscopic approach is considered the gold standard for elective splenectomy, it is still debated whether the underlying disease affects postoperative outcomes. Given the importance of good patient selection in the early stages of the learning curve for laparoscopic splenectomy (LS), this study aimed to compare the postoperative outcomes following LS for malignant diseases and benign diseases (MDs and BDs).

Materials and Methods:

A retrospective review of patients who underwent LS was performed at 2 different institutions between January 2013 and September 2020. Patients were classified into 2 groups based on the underlying BDs or MDs, and the 30 days postoperative outcomes were compared. Risk factors for overall complications were determined using logistic regression analysis.

Results:

LS was performed for BDs and MDs in 51 (67%) and 25 (33%) patients, respectively. The overall morbidity rate and the intraoperative and postoperative complication rates were significantly higher in the MD group (P<0.05). In the univariate analysis, the underlying MD, age above 49.5 years, body mass index >24.9, the long axis of the spleen >16 cm, and spleen weight >600 g were significantly associated with increased postoperative morbidity.

Conclusion:

In addition to the underlying disease, preoperative conditions may also affect the complication rates after LS. These findings may be helpful in patient selection, especially in the early stages of the learning curve for minimally invasive splenectomies.
Delivering siRNA Compounds During HOPE to Modulate Organ Function: A Proof-of-concept Study in a Rat Liver Transplant Model
Authors: Bonaccorsi-Riani Eliano , Gillooly Andrew R. , Iesari Samuele , Brüggenwirth Isabel M.A. , Ferguson Chantal M. , Komuta Mina , Xhema Daela , Daumerie Aurélie , Maistriaux Louis , Leuvenink Henri , Kupiec-Weglinski Jerzy , Porte Robert J. , Khvorova Anastasia , Cave David R , Gianello Pierre , Martins Paulo N.
Published: May 2022

Background.

Apoptosis contributes to the severity of ischemia-reperfusion injury (IRI), limiting the use of extended criteria donors in liver transplantation (LT). Machine perfusion has been proposed as a platform to administer specific therapies to improve graft function. Alternatively, the inhibition of genes associated with apoptosis during machine perfusion could alleviate IRI post-LT. The aim of the study was to investigate whether inhibition of an apoptosis-associated gene (FAS) using a small interfering RNA (siRNA) approach could alleviate IRI in a rat LT model.

Methods.

In 2 different experimental protocols, FASsiRNA (500 µg) was administered to rat donors 2 h before organ procurement, followed by 22 h of static cold storage, (SCS) or was added to the perfusate during 1 h of ex situ hypothermic oxygenated perfusion (HOPE) to livers previously preserved for 4 h in SCS.

Results.

Transaminase levels were significantly lower in the SCS-FASsiRNA group at 24 h post-LT. Proinflammatory cytokines (interleukin-2, C-X-C motif chemokine 10, tumor necrosis factor alpha, and interferon gamma) were significantly decreased in the SCS-FASsiRNA group, whereas the interleukin-10 anti-inflammatory cytokine was significantly increased in the HOPE-FASsiRNA group. Liver absorption of FASsiRNA after HOPE session was demonstrated by confocal microscopy; however, no statistically significant differences on the apoptotic index, necrosis levels, and FAS protein transcription between treated and untreated groups were observed.

Conclusions.

FAS inhibition through siRNA therapy decreases the severity of IRI after LT in a SCS protocol; however the association of siRNA therapy with a HOPE perfusion model is very challenging. Future studies using better designed siRNA compounds and appropriate doses are required to prove the siRNA therapy effectiveness during liver HOPE liver perfusion.
Elucidating the signal for contact guidance contained in aligned fibrils with a microstructural–mechanical model
Authors: Bersie-Larson Lauren M. , Lai Victor K. , Dhume Rohit Y. , Provenzano Paolo P. , Barocas Victor H. , Tranquillo Robert T.
Published: May 2022

Despite its importance in physiological processes and tissue engineering, the mechanism underlying cell contact guidance in an aligned fibrillar network has defied elucidation due to multiple interdependent signals that such a network presents to cells, namely, anisotropy of adhesion, porosity and mechanical behaviour. A microstructural–mechanical model of fibril networks was used to assess the relative magnitudes of these competing signals in networks of varied alignment strength based on idealized cylindrical pseudopods projected into the aligned and orthogonal directions and computing the anisotropy of metrics chosen for adhesion, porosity and mechanical behaviour: cylinder–fibre contact area for adhesion, persistence length of pores for porosity and total force to displace fibres from the cylindrical volume as well as network stiffness experienced upon cylinder retraction for mechanical behaviour. The signals related to mechanical anisotropy are substantially higher than adhesion and porosity anisotropy, especially at stronger network alignments, although their signal to noise (S/N) values are substantially lower. The former finding is consistent with a recent report that fibroblasts can sense fibril alignment via anisotropy of network mechanical resistance, and the model reveals this can be due to either mechanical resistance to pseudopod protrusion or retraction given their signal and S/N values are similar.