bluuebunny/crossref_metadata_2025 huggingface dataset:
Galactic halo bubble magnetic fields and UHECR deflections
Authors: Shaw Vasundhara , van Vliet Arjen , Taylor Andrew M
Published: September 2022

We consider the synchrotron emission from electrons out in the Galactic halo bubble region where the Fermi bubble structures reside. Utilizing a simple analytical expression for the non-thermal electron distribution and a toy magnetic field model, we simulate polarized synchrotron emission maps at a frequency of 30 GHz. Comparing these maps with the observational data, we obtain constraints on the parameters of our toy Galactic halo bubble magnetic field model. Utilizing this parameter value range for the toy magnetic field model, we determine the corresponding range of arrival directions and suppression factors of ultra high energy cosmic rays (UHECRs) from potential local source locations. We find that high levels of flux suppression (down to 2 per cent) and large deflection angles (≥80°) are possible for source locations whose line of sight pass through the Galactic halo bubble region. We conclude that the magnetic field out in the Galactic halo bubble region can strongly dominate the level of deflection UHECRs experience whilst propagating from local sources to Earth.
High-resolution ALMA and HST imaging of κCrB: a broad debris disc around a post-main-sequence star with low-mass companions
Authors: Lovell J B , Wyatt M C , Kalas P , Kennedy G M , Marino S , Bonsor A , Penoyre Z , Fulton B J , Pawellek N
Published: September 2022

$\kappa \,$ CrB is an ∼2.5 Gyr old K1 sub-giant star, with an eccentric exo-Jupiter at ∼2.8 au and a debris disc at tens of au. We present ALMA (Atacama Large Millimetre/submillimetre Array) Band 6 (1.3 mm) and Hubble Space Telescope scattered light (0.6$\, \mu$m) images, demonstrating $\kappa \,$CrB’s broad debris disc, covering an extent $50\!-\!180\,$au in the millimetre (peaking at 110 au), and $51\!-\!280\,$au in scattered light (peaking at 73 au). By modelling the millimetre emission, we estimate the dust mass as ${\sim }0.016\, {\rm M}_\oplus$, and constrain lower-limit planetesimal sizes as $D_{\rm {max}}{\gtrsim }1\,$km and the planetesimal belt mass as $M_{\rm {disc}}{\gtrsim }1\, {\rm M}_\oplus$. We constrain the properties of an outer body causing a linear trend in 17 yr of radial velocity data to have a semimajor axis 8–66 au and a mass $0.4\!-\!120\, M_{\rm {Jup}}$. There is a large inner cavity seen in the millimetre emission, which we show is consistent with carving by such an outer massive companion with a string of lower mass planets. Our scattered light modelling shows that the dust must have a high anisotropic scattering factor (g ∼ 0.8–0.9) but an inclination (i ∼ 30°–40°) that is inferred to be significantly lower than the i ∼ 61° millimetre inclination. The origin of such a discrepancy is unclear, but could be caused by a misalignment in the micrometre- and millimetre-sized dust. We place an upper limit on the CO gas mass of $M_{\rm {CO}}{\lt }(4.2\!-\!13) \times 10^{-7}\, {\rm M}_\oplus$, and show this to be consistent with levels expected from planetesimal collisions, or from CO-ice sublimation as $\kappa \,$CrB begins its giant branch ascent.
The three-dimensional structure of galactic molecular cloud complexes out to 2.5 kpc
Authors: Dharmawardena T E , Bailer-Jones C A L , Fouesneau M , Foreman-Mackey D , Coronica P , Colnaghi T , Müller T , Henshaw J
Published: September 2022

Knowledge of the three-dimensional structure of Galactic molecular clouds is important for understanding how clouds are affected by processes such as turbulence and magnetic fields and how this structure affects star formation within them. Great progress has been made in this field with the arrival of the Gaia mission, which provides accurate distances to ∼109 stars. Combining these distances with extinctions inferred from optical–infrared, we recover the three-dimensional structure of 16 Galactic molecular cloud complexes at ∼1 pc resolution using our novel three-dimensional dust mapping algorithm dustribution. Using astrodendro, we derive a catalogue of physical parameters for each complex. We recover structures with aspect ratios between 1 and 11, i.e. everything from near-spherical to very elongated shapes. We find a large variation in cloud environments that is not apparent when studying them in two dimensions. For example, the nearby California and Orion A clouds look similar on sky, but we find California to be more sheet-like, and massive, which could explain their different star formation rates. By calculating the total mass of these individual clouds, we demonstrate that it is necessary to define cloud boundaries in three dimensions in order to obtain an accurate mass; simply integrating the extinction overestimates masses. We find that Larson’s relationship on mass versus radius holds true whether you assume a spherical shape for the cloud or take their true extents.
Actinide opacities for modelling the spectra and light curves of kilonovae
Authors: Fontes C J , Fryer C L , Wollaeger R T , Mumpower M R , Sprouse T M
Published: September 2022

We extend previous ab initio calculations of lanthanide opacities to include a complete set of actinide opacities for use in the modelling of kilonova (KN) light curves and spectra. Detailed, fine-structure line features are generated using the configuration-interaction approach. These actinide opacities display similar trends to those observed for lanthanide opacities, such as the lighter actinides producing higher opacity than the heavier ones for relevant conditions in the dynamical ejecta. A line-binned treatment is employed to pre-compute opacity tables for 14 actinide elements (89 ≤ Z ≤ 102) over a grid of relevant temperatures and densities. These tabular opacities will be made publicly available for general usage in KN modelling. We demonstrate the usefulness of these opacities in KN simulations by exploring the sensitivity of light curves and spectra to different actinide abundance distributions that are predicted by different nuclear theories, as well as to different choices of ejecta mass and velocity. We find very little sensitivity to the two considered distributions, indicating that opacities for actinides with Z ≥ 99 do not contribute strongly. On the other hand, a single actinide element, protactinium, is found to produce faint spectral features in the far-infrared at late times (5–7 d post merger). More generally, we find that the choice of ejecta mass and velocity have the most significant effect on KN emission for this study.
Molecular mechanism underlying the di-uridylation activity ofArabidopsisTUTase URT1
Authors: Hu Qian , Yang Huiru , Li Mingwei , Zhu Lingru , Lv Mengqi , Li Fudong , Zhang Zhiyong , Ren Guodong , Gong Qingguo
Published: September 2022

In Arabidopsis, HESO1 and URT1 act cooperatively on unmethylated miRNA and mRNA uridylation to induce their degradation. Their collaboration significantly impacts RNA metabolism in plants. However, the molecular mechanism determining the functional difference and complementarity of these two enzymes remains unclear. We previously solved the three-dimensional structure of URT1 in the absence and presence of UTP. In this study, we further determined the structure of URT1 in complex with a 5′-AAAU-3′ RNA stretch that mimics the post-catalytic state of the mRNA poly(A) tail after the addition of the first uridine. Structural analysis and enzymatic assays revealed that L527 and Y592 endow URT1 with a preference to interact with purine over pyrimidine at the -1 RNA binding position, thus controlling the optimal number of uridine added to the 3′ extremity of poly(A) as two. In addition, we observed that a large-scale conformational rearrangement in URT1 occurs upon binding with RNA from an ‘open’ to a ‘closed’ state. Molecular dynamic simulation supports an open-closed conformational selection mechanism employed by URT1 to interact with RNA substrates and maintain distributive enzymatic activity. Based on the above results, a model regarding the catalytic cycle of URT1 is proposed to explain its di-uridylation activity.
Ribocentre: a database of ribozymes
Authors: Deng Jie , Shi Yaohuang , Peng Xuemei , He Yuanlin , Chen Xiaoxue , Li Mengxiao , Lin Xiaowei , Liao Wenjian , Huang Yuanyin , Jiang Taijiao , Lilley David M J , Miao Zhichao , Huang Lin
Published: September 2022

Ribozymes are excellent systems in which to study ‘sequence - structure - function’ relationships in RNA molecules. Understanding these relationships may greatly help structural modeling and design of functional RNA structures and some functional structural modules could be repurposed in molecular design. At present, there is no comprehensive database summarising all the natural ribozyme families. We have therefore created Ribocentre, a database that collects together sequence, structure and mechanistic data on 21 ribozyme families. This includes available information on timelines, sequence families, secondary and tertiary structures, catalytic mechanisms, applications of the ribozymes together with key publications. The database is publicly available at https://www.ribocentre.org.
Tourism Histories in Africa
Authors: Pirie Gordon
Published: September 2022

Tourism history in Africa is both a phenomenon and a field of inquiry. Both practices take multiple forms. It is convenient to speak about “tourism development” on the continent, but this creates an impression of a wholly positive and uniform progression of activity detached from the ideas on which it rests and from the data and discourses that give it form. Both the facts and framings of past tourism in Africa need acknowledging. Published histories point to significant episodes in African tourism history, as well as to how tourism was presented and undertaken in the past. There is need to move beyond empiricist and instrumentalist histories of tourism; these are a by-product of research often hosted in management and public policy disciplines. Because the scope and type of African tourism histories that will be possible to write in future depend partly on the baseline tourism research being done at present, a sharpened historical consciousness is required from tourism practitioners and researchers.
Effect of Different Surgical Positions on the Changes in Cerebral Venous Drainage in Patients Undergoing Neurosurgery: A Prospective Observational Study
Authors: Thakkar Keta D. , Sethuraman Manikandan , Praveen C.S. Ranganatha , Vimala Smita , Hrishi P. Ajay Prasad , Prathapadas Unnikrishnan
Published: September 2022

Background:

Some patient positions employed to facilitate neurosurgery can compromise cerebral venous drainage and lead to increased intracranial pressure, intraoperative bleeding, and brain bulge. This study evaluated the impact of different surgical positions on internal jugular vein (IJV) flow as a measure of cerebral venous drainage and on optic nerve sheath diameter (ONSD) as an indirect assessment of intracranial pressure.

Methods:

Ninety patients scheduled for elective primary brain tumor resection surgery were included in 3 groups of 30 each according to the surgical position: supine, prone, or lateral. Bilateral IJV flow was recorded at 3-time points: before the induction of anesthesia in the supine position (T0), 10 minutes after the induction of anesthesia in the supine position (T1), and 10 minutes after final positioning (T2). The ONSD was measured at T1 and T2.

Results:

Mean IJV flow decreased from baseline by 36%, 10% and 38% in the supine, prone and lateral position groups, respectively. Mean IJV flow was 1005.9±463 mL/min versus 634.7±245 mL/min (P=0.036) in Group S, 752.5±384.8 mL/min versus 672.3±391.0 mL/min (P=0.002) in group P, and 831.8±337.4 mL/min versus 514.4±305.3 mL/min (P<0.001) in group L at T0 and T2, respectively. Mean ONSD did not change between T1 and T2 in Groups S and P but increased in group L (P<0.05).

Conclusions:

Mean IJV flow decreased from baseline following the final neurosurgical positioning. Ultrasound-guided assessment of IJV flow could be a useful tool to quantify position-related changes in IJV drainage.
Combination of C-reactive protein and fibrinogen is useful for diagnosing periprosthetic joint infection in patients with inflammatory diseases
Authors: Xu Hong , Xie Jinwei , Wan Xufeng , Liu Li , Wang Duan , Zhou Zongke
Published: September 2022

Background:

The screening of periprosthetic joint infection (PJI) in patients with inflammatory diseases before revision arthroplasty remains uncertain. Serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), plasma fibrinogen (FIB), monocyte/lymphocyte ratio, and neutrophil/lymphocyte ratio (NLR) can help screening PJI, but their values in patients with inflammatory diseases have not been determined.

Methods:

Patients with inflammatory diseases who underwent revision hip or knee arthroplasty at West China Hospital, Sichuan University, from January 2008 to September 2020 were divided into infected and non-infected groups based on the 2013 International Consensus Meeting criteria. Sensitivity and specificity of the tested biomarkers for diagnosing infection were determined based on receiver operating characteristic (ROC) curves, and optimal cutoffs were determined based on the Youden index. The diagnostic ability of these biomarkers was re-assessed after combining them with each other.

Results:

A total of 62 patients with inflammatory diseases were studied; of them 30 were infected. The area under the ROC curve was 0.813 for CRP, 0.638 for ESR, 0.795 for FIB, and 0.656 for NLR. The optimal predictive cutoff of CRP was 14.04 mg/L with a sensitivity of 86.2% and a specificity of 68.7%, while FIB had a sensitivity of 72.4% and a specificity of 81.2% with the optimal predictive cutoff of 4.04 g/L. The combinations of CRP with FIB produced a sensitivity of 86.2% and specificity of 78.1%.

Conclusion:

CRP with a slightly higher predictive cutoff and FIB are useful for screening PJI in patients with inflammatory diseases, and the combination of CRP and FIB may further improve the diagnostic values.

Trial Registration:

ChiCTR.org.cn, ChiCTR2000039989
Construction of a 3-mRNA hypoxia prognostic model to evaluate immune microenvironment in hepatocellular carcinoma
Authors: Wang Jue , Jin Zongrui , Wu Guolin , Deng Zhenfeng , Wang Jilong , Xu Banghao , Zhu Hai , Guo Ya , Wen Zhang
Published: September 2022

Background:

Hypoxia is a key factor in the development of hepatocellular carcinoma (HCC), which is the most common primary liver cancer with poor prognosis. The current study aimed to identify the potential prognostic biomarkers of the hypoxia-associated gene signature in patients with HCC, and to further explore the relationship between hypoxia and immune infiltration.

Methods:

After the determination of differentially expressed genes (DEGs) using the HCC transcriptome data of The Cancer Genome Atlas database and hypoxia-related gene set, the prognosis-associated genes were identified using univariate Cox regression analysis. Then, the hypoxia prognosis model was established via multivariate Cox regression analysis, with functional annotation conducted using Gene Set Enrichment Analysis. CIBERSORT was utilized to analyze the degree of tumor immune invasion, and an International Cancer Genome Consortium cohort to verify the reliability of the prognosis model. Expression levels of hypoxia-associated genes were detected by real-time quantitative polymerase chain reaction in HCC samples.

Results:

3 genes (ENO1, SAP30, and STC2) constructed the hypoxia prognosis model. The patients were subdivided into 2 groups based on median risk score, with a high hypoxic score indicating poor prognosis of HCC. The hypoxia signature could be employed as an independent prognostic factor in HCC. In addition, the proportion of macrophages was higher in the high-risk group.

Conclusion:

The hypoxia-associated signature could be a potential prognostic marker of HCC and provides a different perspective for immunotherapy of HCC.
Correlation between serum β2-microglobulin level and systemic lupus erythematosus disease activity: A PRISMA-compliant meta-analysis
Authors: You Tao , Lin Xiaoyin , Zhang Chunhong , Wang Weilun , Lei Meihong
Published: September 2022

Background:

Numerous studies have explored whether serum beta 2-microglobulin (β2-MG) can be used as a biomarker for monitoring systemic lupus erythematosus (SLE) disease activity, but the results are conflicting. Therefore, we performed a systematic meta-analysis to further investigate the correlation between serum β2-MG level and SLE disease activity.

Methods:

PubMed, Web of Science, Embase, and CNKI databases were thoroughly searched for eligible studies through April 2022. Standardized mean differences with 95% confidence intervals (95% CIs) were used to depict the differences in serum β2-MG levels between groups compared in the studies. The correlation between serum β2-MG level and SLE disease activity was assessed using Fisher z-values.

Results:

Sixteen articles with combined 1368 SLE patients were included in this meta-analysis. Serum β2-MG levels were significantly higher in SLE patients than in healthy controls (pooled standardized mean difference: 3.98, 95% CI: 2.50–5.46, P < .01). In addition, patients with active SLE had an increased serum β2-MG concentration compared to their inactive SLE counterparts. Furthermore, a positive correlation was observed between serum β2-MG levels and SLE disease activity (pooled Fisher z = 0.78, 95% CI: 0.61–0.96, P < .01).

Conclusions:

This study suggests that patients with SLE have higher serum β2-MG levels than healthy controls and that serum β2-MG levels are positively correlated with SLE disease activity. Thus, serum β2-MG level may be a promising biomarker for monitoring SLE disease activity.
A new mutation c.685G>A:p.E229K in the KCNJ11 gene: A case report of maturity-onset diabetes of the young13
Authors: Song Xinjie , Cao Yonghong , Ye Jun , Dai Wu , Zhang Suwan , Ye Shuai
Published: September 2022

Introduction:

Maturity-onset diabetes of the young (MODY) is an autosomal dominant monogenic diabetes. We report a pair of father and son diagnosed as MODY13 with a new mutation c.685G>A:p.E229K in the inwardly rectifying subfamily J, member 11 (KCNJ11) gene.

Case presentation:

A pair of father and son was examined after admission to the hospital and a whole exome test performed. Whole exome test showed that there was a mutation c.685G>A:p.E229K in the KCNJ11 gene encoding a potassium channel, KCNJ11.

Conclusions:

The diagnosis of MODY13 requires genetic testing. After confirmation, medication and diet need to be adjusted to control blood glucose. The treatment plan was adjusted. After glimepiride was administered, symptoms of diabetes were effectively improved. According to our knowledge, this is the first reported mutation of c.685G>A:p.E229K in the KCNJ11 gene.
Comparison of chest CT features between progressive and nonprogressive patients with COVID-19 pneumonia: A meta-analysis
Authors: Wang Haijing , Luo Lin , Lv Wenwu , Jin Tao , Jiang Mingkuan , Miao Miao , Chen Qiang
Published: September 2022

Objective:

The aim of this study was to compare the radiographic features of patients with progressive and nonprogressive coronavirus disease 2019 (COVID-19) pneumonia.

Methods:

PubMed, Embase, and Cochrane Library databases were searched from January 1, 2020, to February 28, 2022, by using the keywords: “COVID-19”, “novel Coronavirus”, “2019-novel coronavirus”, “CT”, “radiology” and “imaging”. We summarized the computed tomography manifestations of progressive and nonprogressive COVID-19 pneumonia. The meta-analysis was performed using the Stata statistical software version 16.0.

Results:

A total of 10 studies with 1092 patients were included in this analysis. The findings of this meta-analysis indicated that the dominating computed tomography characteristics of progressive patients were a crazy-paving pattern (odds ratio [OR] = 2.10) and patchy shadowing (OR = 1.64). The dominating lesions distribution of progressive patients were bilateral (OR = 11.62), central mixed subpleural (OR = 1.37), and central (OR = 1.36). The other dominating lesions of progressive patients were pleura thickening (OR = 2.13), lymphadenopathy (OR = 1.74), vascular enlargement (OR = 1.39), air bronchogram (OR = 1.29), and pleural effusion (OR = 1.29). Two patterns of lesions showed significant links with the progression of disease: nodule (P = .001) and crazy-paving pattern (P = .023). Four lesions distribution showed significant links with the progression of disease: bilateral (P = .004), right upper lobe (P = .003), right middle lobe (P = .001), and left upper lobe (P = .018).

Conclusion:

Nodules, crazy-paving pattern, and/or new lesions in bilateral, upper and middle lobe of right lung, and lower lobe of left lung may indicate disease deterioration. Clinicians should formulate or modify treatment strategies in time according to these specific conditions.
Comprehensive analysis of clinical prognosis and CLIC1 immune invasion in lung adenocarcinoma
Authors: Chen Zhiqiang , Chen Wenmin , Huang Ruilan , Chen Daman , Li Zhuoyao , Qi Xiangjun , Sun Lingling , Lin Lizhu , Zhang Zhiquan
Published: September 2022

Background:

Chloride intracellular channel 1 (CLIC1) plays an important role in the process of cell epithelial transport, and is also involved in tumor invasion and metastasis. Due to its aberrant expression in cancer, the mechanism of action of CLIC1 in cancer has been carefully studied. In this study, we tried to investigate the relationship between CLIC1 and lung adenocarcinoma (LUAD).

Methods:

The RNA-sequencing data and clinical information of CLIC1 in lung adenocarcinoma were collected from the the cancer genome altas (TCGA) database and analyzed with R software. Paired t test and Mann–Whitney U test were used to detect differences between LUAD tissue and adjacent normal tissue, and the pROC software package performed reactive oxygen species (ROC) curves to detect cutoff values for CLIC1. The expression of CLIC1 in normal human tissues was extracted from the human protein altas (HPA) database, and analyzed clinical proteomic tumor analysis consortium by using UALCAN programme. The relationship between CLIC1 and LUAD was explored by enrichment analysis using gene oncology and Kyoto encyclopedia of genes and genomes. The tumor immunity estimation resource (TIMER) and integrated repository portal for tumor-immune system interactions (TISIDB) databases were used to analyze the correlation between CLIC1 and LUAD immune cell infiltration. Survival analysis of CLIC1 in LUAD was assessed by the PrognoScan database.

Results:

Compared with normal tissues, both mRNA (messenger Ribose Nucleic Acid) and protein of CLIC1 were overexpressed in LUAD, which was associated with shorter overall survial (OS). In addition, CLIC1 expression was in connection with some clinical-pathological characteristics like tumor node metatasis stages and lymph node metastases. What’s more, CLIC1 may play a role in the immune infiltration of LUAD.

Conclusion:

In summary, CLIC1 is up-regulated in LUAD and is associated with tumor metastasis, tumor staging, and OS. It may be regarded as a novel marker for prognostic judgement in LUAD.
Predictive nomogram of cage nonunion after anterior cervical discectomy and fusion: A retrospective study in a spine surgery center
Authors: Zhou Kai , Ji Longfei , Pang Shuwei , Tang You , Liu Changliang
Published: September 2022

The cage nonunion may cause serious consequences, including recurrent pain, radiculopathy, and kyphotic deformity. The risk factors for nonunion following anterior cervical discectomy and fusion (ACDF) are controversial. The aim of the study is to investigate the risk factors for nonunion in cervical spondylotic cases after ACDF. We enrolled 58 and 692 cases in the nonunion and union group respectively and followed up the cases at least 6 months. Patient demographic information, surgical details, cervical sagittal parameters, and the serum vitamin D level were collected. A logistic regression was performed to determine the independent predictors for nonunion, which were used for establishing a nomogram. In order to estimate the reliability and the net benefit of nomogram, we applied a receiver operating characteristic curve analysis, calibration curves and plotted decision curves. Using the multivariate logistic regression, we found that age (odds ratio [OR] = 1.16, P < .001), smoking (OR = 3.41, P = .001), angle of C2 to C7 (OR = 1.53, P < .001), number of operated levels (2 levels, OR = 0.42, P = .04; 3 levels, OR = 1.32, P = .54), and serum vitamin D (OR = 0.81, P < .001) were all significant predictors of nonunion (Table 3). The area under the curve of the model training cohort and validation cohort was 0.89 and 0.87, respectively. The calibration curves showed that the predicted outcome fitted well to the observed outcome in the training cohort (P = .102,) and validation cohort (P = .125). The decision curves showed the nomogram had more benefits than the All or None scheme if the threshold probability is >10% and <100% in training cohort and validation cohort. We found that age, smoking, angle of C2 to C7, number of operated levels, and serum vitamin D were all significant predictors of nonunion.
Risk of obstetric and neonatal morbidity in gestational diabetes in a single institution: A retrospective, observational study
Authors: Chung Yun Soo , Moon Hanna , Kim Eui Hyeok
Published: September 2022

Gestational diabetes mellitus (GDM) is defined as a carbohydrate intolerance with onset or first recognition occurring during pregnancy and GDM could be risk factor for various maternal fetal complications. This study aimed to investigate risks of maternal and neonatal outcomes according to GDM and normal glucose tolerance. This retrospective, observational study included singleton pregnant women who had received a 50-g oral glucose challenge test in 2nd trimester of gestation and gave birth at National Health Insurance Service Ilsan Hospital. Maternal and neonatal complications were compared between GDM and non-GDM groups. Among the 682 women, 56 were diagnosed with GDM and 626 were non-GDM group. Maternal age was older and prepregnant body mass index was higher in GDM. The rate of cesarean delivery, preeclampsia, and transfusion was similar; however, the incidence of preterm birth was higher in GDM. Multivariate analysis, however, showed that GDM was independent risk factor only for preterm birth in <37 weeks (adjusted odds ratio, 2.25; 95% confidence interval, 1.16–4.36). Regarding neonatal morbidities, APGAR score <7 at 5 minutes and the rate of macrosomia were similar; however, the rates of neonatal intensive care unit (NICU) admission, large for gestational age (LGA), and intubation were higher in GDM. Multivariate analysis, however, showed that GDM was not independent risk factor for LGA, NICU admission, and intubation rate. Compared with the non-GDM group, GDM was associated with an increased likelihood of preterm birth <37 weeks, however, did not increase cesarean delivery, postpartum hemorrhage, LGA, and NICU admission rate. This study showed that the majority of women with GDM delivered with similar maternal and neonatal outcomes in non-GDM women.
Feasibility analysis of high pitch cervical spine CT in uncooperative patients with acute cervical spine trauma: An initial experience
Authors: Cao Juntao , Xie Na , Qian Pingkang , Hu Ming , Tu Jianchun
Published: September 2022

Cervical computed tomography (CT) often suffers from examination failure in uncooperative patients with acute cervical spinal trauma. Therefore, this study aimed to evaluate the feasibility of using high-pitch cervical CT (HP-CT) in such populations. A total of 95 patients with acute neck/head-neck trauma who underwent HP-CT (n = 29) or standard cervical CT (SD-CT, n = 66) from October 2020 to June 2021 were included in this study. Differences in patient characteristics between the HP-CT group and the SD-CT group were firstly compared. Then, the objective image quality based on the mean score of the signal-to-noise ratio (SNR)/contrast noise ratio (CNR) was evaluated, while double-blind five-point scoring was adopted for the subjective evaluation. Finally, radiation doses in HP-CT and SD-CT were compared. Furthermore, the Student t test and/or Mann–Whitney U test were performed to analyze differences in patient characteristics, image quality, and radiation dose between the two regimes. A total of 17 cases of cervical spine fractures were found in 95 patients, including 6 cases in the HP-CT group and 11 cases in the SD-CT group. The average age of patients who received HP-CT was higher than that of those who received SD-CT, and the scan time using HP-CT was shorter than that SD-CT. The differences were statistically significant (both, P < .05). In addition, there was no significant difference between HP-CT and SD-CT in terms of sex, body mass index, field of view (FOV), and scan length (all P > .05). The SNR/CNR at the middle and upper neck was not significantly different between HP-CT and SD-CT (all P > .05). However, the SNR/CNR at the lower neck in HP-CT was lower than that in SD-CT (all P < .05). There was no significant difference in the subjective scores between HP-CT and SD-CT images in both the soft tissue and bone window (P = .129 and 0.649, respectively). The radiation dose in HP-CT was lower than that in SD-CT (all P < .05). With a scan time reduction of 73%, radiation dose reduction of 10%, and similar image quality, high-pitch cervical CT was of feasibility to evaluate cervical spine injury in uncooperative patients with acute cervical spine trauma.
Comorbidities associated with risk of ICU admission in elderly patients with COVID-19: Data from academic hospital in Saudi Arabia
Authors: Alsaad Saad , Addweesh Abdurahman , Beyari Mohammed , Alkhateb Munib , Alswat Abdulrahman , Alshabnan Abdulrahman , Alsaad Abdulaziz , AlSaif Haytham
Published: September 2022

The coronavirus disease 2019 (COVID-19) has affected millions of people worldwide, of which 5% required intensive care, especially mechanical ventilation. The prognosis depends on several factors including comorbidities. This study was conducted to identify the comorbidities associated with the intensive care unit (ICU) admission in elderly with COVID-19 admitted to a tertiary academic hospital. A retrospective cross-sectional study was conducted at KSUMC including all hospitalized patients (age ≥ 65 years) with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection admitted between March 2020 and August 2021. Data collection included sociodemographic characteristics, underlying comorbidities, and the Charlson comorbidity index. Comorbidities were compared between the elderly patients with COVID-19 admitted to the ICU and those not admitted to the ICU. The odds ratios were calculated and a P value of < .05 and 95% confidence intervals were used to report the statistical significance A total of 444 patients (ICU = 147, non-ICU = 297) were included in the study. The study revealed that elderly patients with COVID-19 admitted to ICU had a higher rate of mortality (n = 64, 67.4%; P < .0001) and a higher proportion of them had shortness of breath (n = 97, 38.3%; P = .007) compared to the elderly patients not admitted to ICU. The mean length of stay (P < .0001), and weight (P = .02) among ICU patients were higher than the values for the non-ICU group, while the mean oxygen saturation (SpO2; P = .006) was lower among the ICU group. The comorbidities that demonstrated a statistically significant association with ICU admission were heart failure (P = .004, odd ratio (OR) = 2.02, 95% confidence intervals (CI) [1.263, 3540]), chronic obstructive pulmonary disease (COPD; P = .027, OR = 3.361, 95% CI [1.080, 10.464]), and chronic kidney disease (P = .021, OR = 1.807, 95% CI [1.087, 3.006]). The current study identified that the comorbidities such as COPD, heart failure, and factors like SpO2 and length of stay are associated with an increased risk of ICU admission in elderly patients with COVID-19. These findings highlight the clinical implications of comorbidity among geriatric population.
Perfusion-only imaging in pregnant women: A comparative reader study with implications for practice patterns
Authors: Schroeder Jennifer A. , Cao Quy , Sotirchos Vlasios S. , Gillman Jennifer A. , Anderson Thomas , Pilati Stamatoula , Dubroff Jacob G. , Farwell Michael , Kozlov Andrew , Korhonen Katrina , Pryma Daniel A. , Pantel Austin R.
Published: September 2022

This study seeks to understand the value of ventilation imaging in pregnant patients imaged for suspected pulmonary embolism (PE). Ventilation-perfusion (VQ) scans in this high-risk population were compared to ventilation-only scans. We hypothesize that in this relatively healthy population, the exclusion of ventilation scans will not impact the rate of scans interpreted as positive. This retrospective blinded comparative reader study on collated VQ scans performed on pregnant patients in the course of routine clinical care in a > 5 year period (03/2012 to 07/2017). Each set of VQ and perfusion only (Q) studies were reviewed by 8 readers (4 nuclear radiology fellows and 4 nuclear medicine faculty) in random order; the Q scans simply omitted the ventilation images. Readers recorded each study as PE, no PE, or non-diagnostic (prospective investigative study of acute PE diagnosis classifications). Logistic mixed effects models were used to test the association between scan type (VQ vs Q). 203 pairs of studies in 197 patients were included (6 patients had 2 scans). Subjects ranged from 14 to 45 years of age, with a median 28 years. A significant association between scan type and positive/negative classification. Q-scans received more positive classifications than VQ-scans (median of 7.6% vs 6.7%). No association was seen between scan type and positive/indeterminate classification, nor between scan type and negative/indeterminate classification. The exclusion of ventilation images in VQ-scans was associated with a higher rate of positive studies, but this difference was small (<1%). Given the overwhelmingly normal percentage of Q-exams (>90% in our study), and the benefits of omitting ventilation imaging, perfusion-only imaging should be considered a reasonable option for imaging the pregnant patient to exclude PE.
Esophageal cervical spondylosis complicated with cervical disc herniation: A rare case report
Authors: Zhu Chaojun , Tao Jianhong , Mo Songquan
Published: September 2022

Rationale:

Esophageal cervical spondylosis is rare in clinical practice, and the patients with cervical disc herniation are more rare.

Patient concerns:

A 56 year old male patient had dysphagia for 2 years, which was more obvious in the last month, and presented with pain and numbness in the right shoulder and upper arm.

Diagnosis:

The patient suffered from dysphagia. Gastroscope showed that the inner membrane of the esophagus was intact, chronic esophagitis, local smooth swelling, and no new organisms. DR shows a huge osteophyte in front of the cervical spine.

Intervention:

Anterior approach of cervical 4 and 5 anterior osteophyte resection, cervical 4/5 intervertebral disc resection, interbody fusion and internal fixation.

Outcomes:

Three days after operation, the dysphagia of the neck was significantly improved, and the numbness and pain of the right limb disappeared. The patient was very satisfied with the treatment.

Conclusion:

Anterior cervical anterior osteophyte resection, cervical disc resection, interbody fusion and internal fixation can effectively solve esophageal cervical spondylosis with cervical disc herniation.

Lessons:

Through the understanding of the disease, we can better understand the disease. It provides a treatment scheme for similar diseases.
A case report of possible concurrent vasculitis in vertebral bodies and partial transverse myelitis following COVID-19 vaccination
Authors: Chen Yanyi , Li Yuxin , Zhan Tao
Published: September 2022

Introduction:

Cases with organ-specific and systemic vasculitis associated with corona virus disease 2019 (COVID-19) vaccination have been reported. However, acute partial transverse myelitis (APTM) is rare adverse events following received COVID-19 vaccines. To the best of our knowledge, there is no report on vaccine-associated APTM accompanied by possible concurrent vasculitis. Herein we present a case with possible concurrent spinal vasculitis and APTM following the second dose of inactivated COVID-19 vaccine.

Case summary:

A 33-year-old man presented with weakness of left lower limb and aberrant sensation of his left lower trunk and limb (from T9 level to toes) for 2 days following receipt of an inactivated COVID-19 vaccine. Remarkable demyelinating lesion at T7 spinal cord was showed by 3.0T magnetic resonance imaging (MRI) scan. Moreover, vertebral bodies of T3-T7 also presented high signal in T-2 weighted imaging (T2WI) accompanied by multiple sites of flowing void effect indicating possible vasculitis. Oligoclonal band was positive in cerebrospinal fluid (CSF) while it was negative in sera. Intravenous methylprednisolone (1 g/d) was administrated for 5 days followed by subsequent dose-tapering prednisone. His limb weakness and aberrant sensation both improved and he was able to walk unaided after treatment. The MRI recheck also showed remarkable improvement on the lesions in spinal cord and vertebral bodies.

Conclusion:

this case illustrates the concurrence of possible vasculitis in vertebral bodies and acute transverse myelitis (ATM) following COVID-19 vaccination.
Steinmann pin retractor: An auxiliary reduction equipment for the minimally invasive treatment of calcaneal fractures
Authors: Zhao Bin , Zhao Wenqian , Liu Chao , Assan Isaac , Bi Rongxiu
Published: September 2022

A minimally invasive approach has been widely used for the treatment of calcaneal fractures, however, its downside in exposing the calcaneal body, affects fracture reduction. We used a Steinmann pin retractor mentioned in our previous case series study to solve this issue. To further evaluate the efficacy of this reduction technique, and elucidate its mechanism, we compared it with the control groups in this study. Between March 2017 and November 2020, 52 patients were included in this retrospective comparative study. 20 patients were included in the S-S group (Steinmann pin retractor with internal fixation via the sinus tarsi approach), 17 patients were included in the S group (internal fixation via sinus tarsi approach), and 15 patients were included in the L group (internal fixation via L-shaped approach). Patients in each group were operated on by a distinctly skilled surgeon who is specialized in one of the specified surgeries mentioned above. All patients received positive postoperative radiological and clinical evaluations. The patients were followed up for at least 6 months postoperatively. At the last S-S group follow-up, the VAS value (0.29 ± 0.46) improved compared to the L group. The AOFAS (American Orthopedic Foot and Ankle Society) Ankle-Hindfoot score (94.38 ± 5.05) also improved significantly compared to the S and L groups. The Böhler angle (32.34 ± 3.56°), width (36.48 ± 3.91 mm), and height (88.87 ± 4.12 mm) of the calcaneal improved (34.38 ± 18.50°, –10.13 ± 6.98 mm, 8.75 ± 4.82 mm) compared to the preoperative state, the S and L groups. These parameters (the Böhler angle: 31.76 ± 3.37°, width: 36.47 ± 3.72 mm, height: 87.23 ± 3.83 mm) were maintained at the last follow-up. Steinmann pin retractor effected a sound reduction. It also manifested radiological and clinical advantages over the S and L protocols. By reason of the aforementioned, it could be recommended as useful reduction equipment for the minimally invasive treatment of calcaneal fractures.
The efficacy of transitional care services in patients with transient ischemic attack: A retrospective cohort study
Authors: Lin Jing , Jiang Meiling , Liu Jinmiao , Yao Lan
Published: September 2022

Transient ischemic attack (TIA) carries a particularly high short-term risk of stroke, which is associated with brain dysfunction caused by a regional reduction in blood flow. Transitional care services present benefits in improving ischemic neurological function and decreasing the recurrence in patients with TIA. The purpose of this study was to investigate the effects of transitional care on clinical outcomes in patients hospitalized for TIA. We retrospectively collected data about 1288 patients with TIA from May 2017 to June 2019. Patients were divided into mild (n = 438), moderate (n = 420) and severe group (n = 430) accessed by age, blood pressure, type of TIA, and duration (ABCD2) score. Participants were patients hospitalized due to TIA, assigned to transitional care (n = 643) or usual care (n = 645), and followed up for 24 months. Physical function of patients was evaluated using the 6-minute walk test. We evaluated patient reach, implementation using hospital quality measures, hospital-level sustainability physical function, ischemic neurological score, composite quality indicator score, and recurrence of TIA between transitional care or usual care group. TIA patients in transitional care group had better physical function and quality indicator score, lower ischemic neurological score and recurrence of TIA, and shorter hospital stay than patients in usual care group. Results demonstrated that transitional care significantly improved the patients’ satisfaction compared to usual care. Patients in mild, moderate, and severe group presented more benefits than usual care clinical outcomes in patients hospitalized for TIA. Transitional care is associated with better functional status for patients with TIA.
Vascular Analysis of Soft Tissues Around the Bone Lesion in Osteoradionecrosis, Medication-Related Osteonecrosis, and Infectious Osteomyelitis of the Jaw
Authors: Wang Zhuo , Xu Jiamin , Wan Jinbo , Zhang Wei , Wang Yuli , Du Yifei
Published: September 2022

Objective:

The histopathological differences of the surrounding soft tissues in osteoradionecrosis of the jaw, medication-related osteonecrosis of the jaw as well as infectious osteomyelitis of the jaw patients were rarely investigated. Here, we focused on the vascular microarchitecture of the soft tissues around bone lesion and compared the microvessel difference of ORNJ, MRONJ, and IOMJ in a quantitative fashion.

Methods:

A series of consecutive patients diagnosed as ORNJ, MRONJ, and acute/chronic IOMJ was retrospectively reviewed. All cases received preoperative cone bean computed tomography scans. Immunohistochemistry of CD34 was performed with the streptavidin-peroxidase method and the variables including vascular density, vascular area fraction, mean vessel lumen area, perimeter and diameter of the vessels as well as percentage of lumen less than 400 μm2 were analyzed.

Results:

The results showed that the vascular-like structures were visible in more cases of acute/chronic IOMJ compared with ORNJ and MRONJ by hematoxylin-eosin staining. Quantitively, our results demonstrated the decreased vascular density, mean perimeter and diameter of the vessels but increased percentage of small vessels in ORNJ and MRONJ patients in contrast with IOMJ patients.

Conclusions:

Hypovascularity of surrounding soft tissues could play important roles in the etiology of IOMJ, ORNJ, and MRONJ, and microvessel profile may be a useful pathological diagnostic indicator to differentiate these 3 types of OMJ.
Endoscopic-Assisted Intraoral Approach for Osteosynthesis of Mandibular Subcondylar Fractures
Authors: Ho Nguyen Chon Thanh , Lam Phuong Hoai
Published: September 2022

Introduction:

The aim of this study is to follow-up and evaluate the treatment result of mandibular subcondylar (MSC) fractures by osteosynthesis via endoscopy-assisted intraoral approach.

Materials and Methods:

This is a prospective study, in which 47 patients with 51 sites of MSC fractures treated osteosynthesis via endoscopic-assisted intraoral approach at the Department of Maxillofacial Surgery, National Hospital of Odonto-Stomatology HoChiMinh City—Vietnam were followed-up and evaluated clinically and radiographically up to 6 months postoperative.

Results:

Before surgery, all of the patients were malocclusion, 15% of patients were isolated MSC fractures, the rate of concomitant midface fractures were 30%, 92.2% of fracture sites with moderate displacement, 7.8% of fracture sites with severe displacement, 5.9% of fracture sites with dislocation. After surgery, all of the patients had preinjured centric occlusion; no patient had facial paralysis; 6% of patients had surgical site infection within 1 week; pain frequency were 56.9% at 1 month, 35.3% at 2 months, 7.8% at 3 months, and 2.0% at 6 months with Visual Analog Scale (VAS) means of pain were 1.74±1.85 at 1 month, 0.55±1.12 at 2 months, 0.08±0.27 at 3 months and 0.02±0.14 at 6 months; 90% of fracture sites had precise anatomy at 1 week and 96% at 6 months; 96% fracture sites had no displacement the of correlation between condyle and articular fossa at 1 week and 98% at 6 months; 1 fracture site had screw loosening at 2 months; 88% fracture sites had stage-4 radiographic bone healing at 6 months.

Conclusion:

Endoscopic-assisted intraoral approach for osteosynthesis of MSC fractures have provided the esthetic and functional success and good bone healing.
Evaluation of the Effects of Systemic Irisin Application on Guided Bone Regeneration in Peri-implant Bone Defects
Authors: Bulmus Ozgur , Dundar Serkan , Bozoglan Alihan , Artas Gokhan , Kirtay Mustafa , Canpolat Sinan
Published: September 2022

This study aimed to investigate the effects of systemic irisin hormone application on new bone formation in peri-implant bone defects. After surgically creating peri-implant bone defects in the metaphyseal part of the tibiae of rats, the rats were randomly divided into 2 equal groups: a control group and an irisin group. In the control group, the rats received no further treatment during the 4-week experimental period after the surgery. The rats in the irisin group, 100 ng/kg irisin was administered intraperitoneally 3 days a week during the 8 weeks experimental period after the surgery. At the end of the experimental period, the rats were euthanized. Implants and surrounding bone tissues were collected for histological new bone formation analysis. The Student t test was used for statistical analysis. There were no significant differences between the groups in the histological analysis, new bone formation and fibrosis (P>0.05). Also, in the irisin group, there was numerically but not statistically more new bone formation detected compared with the controls. Within the limitations of this study, irisin did not affect new bone formation in peri-implant defects, although the numerical values favored the irisin group.
Clinical Application of CAD/CAM-Guided Modified Dautrey’s Procedure in Recurrent Temporomandibular Joint Luxation
Authors: Zhu Taomin , Li Chengfeng , Jia Xueke , Li Huimin , Feng Yaping , Ke Jin
Published: September 2022

This study aimed to introduce the clinical application of the CAD/CAM-guided modified Dautrey’s procedure in recurrent anterior temporomandibular joint luxation and evaluate its clinical effects. Four selected patients were treated by the CAD/CAM-guided modified Dautrey’s procedure and were followed-up to access their curative effect. Joint pain and sound, recurrence rate, mandibular function, maximum mouth opening (MMO), symptoms of facial nerve injury, and changes in zygomatic facial appearance were observed in postoperative follow-up. The followed-up period ranged from 3 months to 1 year with an average time of 7.5 months. There was no recurrence in all 4 patients, and no symptoms of facial nerve injury and zygomaticofacial appearance changes were found. All patients showed improvement in MMO, with a mean preoperative and postoperative MMO of 4.74 and 3.74 cm, respectively. All of them showed relief of joint pain or sound 3 months or more after the operation and could exercise mandibular normally. This results showed that the CAD/CAM-guided modified Dautrey’s procedure was effective in the treatment of recurrent temporomandibular joint luxation and could be used as a good alternative treatment for it.