bluuebunny/crossref_metadata_2025 huggingface dataset:
Differences of 2-year longitudinal changes of locomotive syndrome among patients treated with thoracolumbar interbody fusion, total hip arthroplasty, and total knee arthroplasty for degenerative diseases
Authors: Taniguchi Naofumi , Jinno Tetsuya , Ohba Tetsuro , Endo Hiroshi , Wako Masanori , Fujita Koji , Koyama Kensuke , Ichikawa Jiro , Ando Takashi , Ochiai Satoshi , Haro Hirotaka
Published: December 2021

Objectives

To clarify the longitudinal changes in patients with preoperative Stage-3 locomotive syndrome (LS) according to different types of surgeries, we investigated the changes in the LS stage in patients who underwent surgery for degenerative musculoskeletal diseases.

Methods

A prospective cohort study was conducted on 168 patients with degenerative diseases [46 spinal deformities treated with thoracolumbar interbody fusion (T/LIF), 86 hips with osteoarthritis treated with total hip arthroplasty (THA), and 36 knees with osteoarthritis treated with total knee arthroplasty (TKA)]. The results for the LS stage, stand-up test, two-step test, and 25-question Geriatric Locomotive Function Scale (GLFS-25) were evaluated preoperatively and at 6 months, 1 year, and 2 years postoperatively.

Results

Preoperatively, most patients had Stage-3 LS (89.1, 90.8, and 80.6% in the T/LIF, THA, and TKA groups, respectively). At 2 years postoperatively, the Stage-3 LS improved in 41.5, 75.6, and 55.2% of patients in the T/LIF, THA, and TKA groups, respectively. All groups showed similar improvements in the two-step test. The THA group showed the best result in the GLFS-25.

Conclusions

LS stage improved in different patterns over 2 years postoperatively and the LS risk test revealed differences in postoperative movement ability according to the type of surgery.
Trend in prescription and treatment retention of molecular-targeted drugs in 121,131 Japanese patients with rheumatoid arthritis: A population-based real-world study
Authors: Takabayashi Katsuhiko , Ando Fumihiko , Ikeda Kei , Fujita Shinsuke , Nakajima Hiroshi , Hanaoka Hideki , Suzuki Takahiro
Published: December 2021

Objectives

To describe the real-world prescription and treatment retention of molecular-targeted drugs for rheumatoid arthritis (RA) in Japan.

Methods

A total of 204,416 patients with RA were prescribed at least one of the eight molecular-targeted drugs in 7 years from the National Database of Health Insurance Claims and Specific Health Checkups of Japan covering 98.3% of the Japanese population. The retention rates of each drug as well as head-to-head comparisons were estimated by Kaplan–Meier method.

Results

A total of 121,131 RA patients were prescribed any molecular-targeted drug for the first time, while 36,633 uses of molecular-targeted drug were switched from another (switch use). The overall retention rates of molecular-targeted drugs at 12, 36, and 60 months were 0.64, 0.42, and 0.32 for the naïve use and 0.59, 0.40, and 0.31 for the switch use, respectively. Non-tumour necrosis factor (TNF)-inhibitor molecular-targeted drugs, particularly tocilizumab and tofacitinib, had higher retention rates than TNF inhibitors for both naïve and switch uses regardless of the previous drug and showed higher retention rates in head-to-head comparisons between eight molecular-targeted drugs.

Conclusions

Our data reveal that the real-world drug retention is overall lower than previously reported and higher with non-TNF inhibitors than with TNF inhibitors.
CCPE: cell cycle pseudotime estimation for single cell RNA-seq data
Authors: Liu Jiajia , Yang Mengyuan , Zhao Weiling , Zhou Xiaobo
Published: December 2021

Pseudotime analysis from scRNA-seq data enables to characterize the continuous progression of various biological processes, such as the cell cycle. Cell cycle plays an important role in cell fate decisions and differentiation and is often regarded as a confounder in scRNA-seq data analysis when analyzing the role of other factors. Therefore, accurate prediction of cell cycle pseudotime and identification of cell cycle stages are important steps for characterizing the development-related biological processes. Here, we develop CCPE, a novel cell cycle pseudotime estimation method to characterize cell cycle timing and identify cell cycle phases from scRNA-seq data. CCPE uses a discriminative helix to characterize the circular process of the cell cycle and estimates each cell's pseudotime along the cell cycle. We evaluated the performance of CCPE based on a variety of simulated and real scRNA-seq datasets. Our results indicate that CCPE is an effective method for cell cycle estimation and competitive in various applications compared with other existing methods. CCPE successfully identified cell cycle marker genes and is robust to dropout events in scRNA-seq data. Accurate prediction of the cell cycle using CCPE can also effectively facilitate the removal of cell cycle effects across cell types or conditions.
The Evolution of Competition: A Darwinian Perspective
Authors: Winegard Ben , Geary David
Published: December 2021

Human competition is, at least partially, responsible for some of the transcended achievements of the species (walking on the moon, the polio vaccine, etc.), but the forces unleashed by competition have also led to profound human suffering (warfare, domination of one group by another group, etc.). In this article, the authors approach competition from an evolutionary perspective, applying Darwin’s theories of natural and sexual selection to understand better the nature of human competition. From the perspective of evolutionary psychology, humans engage in competition to gain resources, including status, food, and mating opportunities. Males tend to engage in more overt and aggressive forms of competition than females, but both sexes desire access to material and cultural goods associated with reproductive fitness. In the last roughly seventy years, the nature of men’s competition has transformed dramatically leading to declines in both within and between-group violence. As developed societies have succeeded in suppressing more overt and destructive forms of male–male competition, men attempt to gain status through occupational success, cognitive sophistication, moral signaling, and other relatively nonviolent behaviors. In this sense, men’s and women’s competition is more similar than it was a century ago. However, women’s competition is still less visible and relies on more indirect mechanisms (e.g., spreading gossip, subtle use of body language). For this reason, female–female competition has attracted less study than male–male competition. Fortunately, in the last decade, psychologists have partially redressed this imbalance.
Spectra as Theoretical and Practical Models in Gérard Grisey’s Creative Process
Authors: Féron François-Xavier
Published: December 2021

Combining sketch studies, musical analysis, and acoustic analysis, this article examines the impact of spectral models on Grisey’s creative process in the 1970s. First, it focuses on Grisey’s establishment of initial theoretical models in Dérives and Périodes, composed during his residence at the Villa Medici (1972–74), during which period he conducted his own study of acoustics. The article then looks at how, back in Paris, the composer started studying with the acoustician Émile Leipp and then worked with Michèle Castellengo, with whom in 1977 he undertook for the first time the spectral analysis of instrumental sounds. Finally the article examines in detail how some spectrograms, once transcribed, were used in Modulations (1976–77) to construct a complex spectral polyphony. If Grisey draws his inspiration from sound phenomena and the characteristics of auditory perception, he does not for all that neglect structuralism: spectral models serve both to simulate natural phenomena and to formalise his compositional processes.
Jeremiah and Prophetic Authority
Authors: de Jong Matthijs J.
Published: December 2021

The book of Jeremiah provides a fitting opportunity for dealing with the issue of prophetic authority. While many scholars are inclined to focus on the ways in which the book of Jeremiah construes prophetic authority, to lay bare the patterns that turn Jeremiah into the authoritative mouthpiece of YHWH, in stark opposition of those who speak falsehood, the author’s query in this chapter is different. The author’s key interest is in prophetic authority as a sociohistorical phenomenon. What did the interaction of prophets and their public look like in late monarchic Judah? And how was authority bestowed on a prophet?
The Neo-Futurists
Authors: Korchagin Kirill
Published: December 2021

Interest in the Russian Futurist poetry of the first two-and-a-half decades of the twentieth century was revived in Soviet literary circles in the mid-1950s. Initially focused on the work of Vladimir Mayakovsky, interest spread to other writers. At the turn of the fifties and sixties, this revival resulted in regular “unsanctioned” poetry readings at the Mayakovsky monument in Moscow, which were eventually banned by the authorities. Against this backdrop, several young poets tried to build on the creative strategies of the Futurists. Gennady Aigi, who debuted as a Chuvash-language poet, was the first of these poets to arrive on the literary scene. Vladimir Kazakov and Vadim Kozovoy, poets who came onto the literary scene in the sixties, consciously established their styles at the intersection of the Russian and international avant-gardes, trying to overcome the isolationism of Soviet poetry. In the seventies, poems by their elder contemporary, Elizaveta Mnatsakanova, claiming to complete the project of a revived Futurism, were published abroad. All four poets borrowed numerous formal features of their work from Russian Futurism and sought to see themselves as its successors, while setting aside the avant-garde’s socio-political agenda and its desire for a radical transformation of culture and society.
LGBTQ+ Communities and Digital Media
Authors: Robards Brady , Byron Paul , D’Souza Sab
Published: December 2021

Digital media offer spaces to many lesbian, gay, bisexual, transgender, and queer people (LGBTQ+) for connection, support, and friendship and hosts vital resources for learning and practicing diverse genders and sexualities. In this chapter, the authors review key research on LGBTQ+ communities and identities in digital spaces over several decades, dividing the chapter into three main sections: (1) community and connection, (2) romance and dating, and (3) identity work. In the first section on community and connection, they examine research centered on how LGBTQ+ people use digital media to forge connections and build “communities.” While this term is contested in the literature, many LGBTQ+ people use it to describe their experiences of digital networks. Second, they outline the growing body of research on how LGBTQ+ people use digital media in their romantic and sexual lives, from dating/hook-up apps to social media. They consider the challenges, pleasures, and opportunities in how LGBTQ+ people use digital media for sex and dating practices and potential. Third, they reflect on how these connections have figured into ongoing research on LGBTQ+ identities, where digital media allow LGBTQ+ people to develop shared languages to describe their experiences, to reflect on their lives, and to rehearse modes of self-representation.
Formal Models of International Political Economy
Authors: Johns Leslie
Published: December 2021

This chapter examines how scholars use formal models to study International Political Economy (IPE). This small, but important, body of research revolves around three substantive research questions. First, scholars have asked: how do states promote international trade by reducing tariffs and non-tariff barriers? Second, they ask: how do states encourage foreign investment by making binding pledges to protect foreign investors? Finally, scholars have studied: how do states stabilize and grow their economies? For each of these topics, the chapter looks back at past findings from formal models. It then discusses how IPE scholars can profitably move forward in their future research on these important topics.
Émilie Du Châtelet on Newtonianism and Hypotheses in the Eighteenth Century
Authors: Detlefsen Karen
Published: December 2021

Émilie Du Châtelet produced one of the first fully articulated accounts of the role of hypothesis in science, problematizing the debate in mid-eighteenth-century France over the roles of hypotheses, experimentation, and speculation in scientific methodology. This chapter examines her original views on the general topic of hypotheses by examining her extended attack throughout her Institutions de physique against the specific hypothesis regarding the cause of gravity held by Newtonians John Keill (1671–1721) and John Freind (1675–1728). In light of Du Châtelet’s criticism of the Keill-Freind hypothesis, we can interpret her as a clarifier of Newton (as per recent interpretations) who believes that hypothesizing about the cause of gravity, for example, can aid in that clarification, but who also believes in strict constraints placed upon the role of hypotheses in science.
Negative Interplay between Cabinet and Opposition Agendas: Evidence from Croatia
Authors: Poljak Željko
Published: December 2021

Despite the contemporary notion that government and opposition parties’ agendas in the long run positively influence each other, there are reasons to argue that different dynamics are at play as well. More specifically, previous studies neglected to address the short-term, transient interplay between parties’ agendas (within a year) while dominantly focussing on what governing parties talk about (and not on what they actually decide). Therefore, this article focuses on this short-term dynamic by hypothesising that governing parties (in cabinet meetings) and opposing parties (in parliamentary questions) feature issues that are undisclosed by the other side in the recent past, and as such create a negative issue attention influence. In other words, if the government places a certain issue high on its cabinet agenda, it will cause the opposition to avoid that issue in their parliamentary questions in the following months and vice versa. By analysing issue-coded data from the government’s cabinet meetings and opposition questions in Croatia (1992–2017) across multiple issues, I can provide evidence that supports these hypotheses. As such, this study contributes to the current knowledge on the relationship between government and opposition issue attention by offering another take on their interaction from a negative influence perspective.
Alternative oxidase (AOX) 1a and 1d limit proline-induced oxidative stress and aid salinity recovery in Arabidopsis
Authors: Oh Glenda Guek Khim , O’Leary Brendan M , Signorelli Santiago , Millar A Harvey
Published: December 2021

Proline (Pro) catabolism and reactive oxygen species production have been linked in mammals and Caenorhabditis elegans, while increases in leaf respiration rate follow Pro exposure in plants. Here, we investigated how alternative oxidases (AOXs) of the mitochondrial electron transport chain accommodate the large, atypical flux resulting from Pro catabolism and limit oxidative stress during Pro breakdown in mature Arabidopsis (Arabidopsis thaliana) leaves. Following Pro treatment, AOX1a and AOX1d accumulate at transcript and protein levels, with AOX1d approaching the level of the typically dominant AOX1a isoform. We therefore sought to determine the function of both AOX isoforms under Pro respiring conditions. Oxygen consumption rate measurements in aox1a and aox1d leaves suggested these AOXs can functionally compensate for each other to establish enhanced AOX catalytic capacity in response to Pro. Generation of aox1a.aox1d lines showed complete loss of AOX proteins and activity upon Pro treatment, yet full respiratory induction in response to Pro remained possible via the cytochrome pathway. However, aox1a.aox1d leaves displayed symptoms of elevated oxidative stress and suffered increased oxidative damage during Pro metabolism compared to the wild-type (WT) or the single mutants. During recovery from salt stress, when relatively high rates of Pro catabolism occur naturally, photosynthetic rates in aox1a.aox1d recovered slower than in the WT or the single aox lines, showing that both AOX1a and AOX1d are beneficial for cellular metabolism during Pro drawdown following osmotic stress. This work provides physiological evidence of a beneficial role for AOX1a but also the less studied AOX1d isoform in allowing safe catabolism of alternative respiratory substrates like Pro.
Touched by loneliness—how loneliness impacts the response to observed human touch: a tDCS study
Authors: Saporta Nira , Peled-Avron Leehe , Scheele Dirk , Lieberz Jana , Hurlemann René , Shamay-Tsoory Simone G
Published: December 2021

Lonely people often crave connectedness. However, they may also experience their environment as threatening, entering a self-preserving state that perpetuates loneliness. Research shows conflicting evidence about their response to positive social cues, and little is known about their experience of observed human touch. The right inferior frontal gyrus (rIFG) is part of an observation–execution network implicated in observed touch perception. Correlative studies also point to rIFG’s involvement in loneliness. We examined the causal effect of rIFG anodal transcranial direct current stimulation on high- and low-loneliness individuals observing human touch. In a cross-over design study, 40 participants watched pictures of humans or objects touching or not touching during anodal and sham stimulations. Participants indicated whether pictures contained humans or objects, and their reaction time was measured. Results show that the reaction time of low-loneliness individuals to observed human touch was significantly slower during anodal stimulation compared to high-loneliness individuals, possibly due to them being more emotionally distracted by it. Lonely individuals also reported less liking of touch. Our findings support the notion that lonely individuals are not drawn to positive social cues. This may help explain the perpetuation of loneliness, despite social opportunities that could be available to lonely people.
Urban-Rural Differences in Schizophrenia Risk: Multilevel Survival Analyses of Individual- and Neighborhood-Level Indicators, Urbanicity and Population Density in a Danish National Cohort Study
Authors: Pedersen Carsten Bøcker , Antonsen Sussie , Timmermann Allan , Pedersen Marianne Giørtz , Ejlskov Linda , Horsdal Henriette Thisted , Agerbo Esben , Webb Roger T , Raaschou-Nielsen Ole , Sigsgaard Torben , Sabel Clive E , Fan Chun Chieh , Thompson Wesley K
Published: December 2021

Background

Urban-rural differences in schizophrenia risk have been widely evidenced across Western countries. However, explanation of these differences is lacking. We aimed to identify contextual risk factors for schizophrenia that explain urban-rural differences in schizophrenia risk.

Methods

Utilizing Danish population-based registers, we partitioned Denmark into 1885 geographic “neighborhoods” homogeneously sized in terms of population. Information on the entire Danish population from 1981 to 2016 was used to quantify a spectrum of neighborhood-level domains. We subsequently conducted multilevel survival analyses following persons born in Denmark from 1971 to 1982 for the development of schizophrenia allowing for clustering of people within neighborhoods. We used this method to tease apart the effects of individual, specific, and general contextual risk factors for schizophrenia.

Results

A significant general contextual effect in schizophrenia risk across neighborhoods was estimated (Medium Incidence Rate Ratio (MRR):1.41; 95% CI:1.35–1.48). Most of the specific contextual factors examined were associated with schizophrenia risk. For instance, neighborhood-level proportion of lone adult households (Incidence Rate Ratios (IRR):1.53; 95% CI:1.44–1.63) had largest risk estimate. Adjustment for all individual-level and specific contextual constructs reduced the IRR for urbanicity from 1.98 (95% CI:1.77–2.22) to 1.30 (95% CI:1.11–1.51).

Conclusions

In the largest prospective multilevel survival analyses of schizophrenia risk conducted to date, multiple neighborhood-level characteristics were associated with raised schizophrenia risk, with these contextual factors explaining most of the elevated risk linked with urbanicity. However, the unexplained heterogeneity that was evident in our multilevel models indicates that our understanding of the role of urbanicity in schizophrenia’s etiology remains incomplete.
Incremental Cost-effectiveness Analysis on Length of Stay of an Enhanced Recovery After Spine Surgery Program: A Single-center, Retrospective Cohort Study
Authors: Naik Bhiken I. , Dunn Lauren K. , Wanchek Tanya N.
Published: December 2021

Background:

Enhanced recovery after spine surgery (ERAS) is increasingly utilized to improve postoperative outcomes and reduce cost. There are limited data on the monetary benefits of ERAS when incorporating the costs of developing, operationalizing, and maintaining ERAS programs. The objective of this study was to calculate the incremental cost-effectiveness of a spine surgery ERAS program, modeling hospital and operational cost and length of stay (LOS).

Methods:

The study included adult patients undergoing spine surgery before and after implementation of an ERAS program. Variables included individual patient-level and ERAS personnel costs, with LOS as the outcome utility of interest. Propensity score matching was used to create a quasi-experimental design to equate the standard care and ERAS groups.

Results:

Four hundred and nine patients were included in the unmatched group, with 54 patients each in the standard care and ERAS groups after matching. In the matched cohort, the only imbalance in predictors (standard mean difference [SMD] >0.2) were race (SMD, 0.21), American Society of Anesthesiologist (ASA) physical status (SMD, 0.32), fluid balance in the operating room (SMD, 0.21), median (interquartile range) LOS (standard care, 2.0 [1.0, 3.75] days vs. ERAS, 4.0 [3.0, 5.0]; SMD, 0.81) and mean (±SD) total cost (standard care, $19,291.57±13,572.24 vs. ERAS, $24,363.45±26,352.45; SMD, 0.24). In the incremental cost effectiveness analysis, standard care was the dominant strategy in both 1-way and 2-way sensitivity analysis.

Conclusions:

We report a real-world, cost-effectiveness analysis following implementation of an ERAS program for spine surgery at a quaternary medical center. Our study demonstrated that considering LOS as the sole determinant, standard care is the dominant cost-effective strategy compared with the ERAS protocol.
Characterizing the Effect of Perioperative Narcotic Consumption and Narcotic Prescription Dosing at Discharge on Satisfaction With Pain Control for Patients Undergoing Single-level Anterior Cervical Discectomy and Fusion
Authors: Owusu-Sarpong Stephane , Iweala Uchechi , Bloom David , Buckland Aaron J. , Protopsaltis Themistocles S. , Fischer Charla R.
Published: December 2021

Study Design:

A single-center, retrospective review of prospectively collected data on patients who underwent single-level anterior cervical discectomy and fusions (ACDFs) between October 2014 and October 2019.

Objective:

To investigate the effect of perioperative narcotic consumption and amount of narcotic prescribed at discharge on patient satisfaction with pain control after single-level ACDF.

Summary of Background Data:

Prior research has demonstrated that opioid prescription habits may be related to physician desire to produce superior patient satisfaction with pain control.

Methods:

Patients with complete Press-Ganey Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey information were analyzed. Inpatient opioid prescriptions were recorded and converted to milligram morphine equivalents (MME) and tablets of 5 mg oxycodone. HCAHPS scores were converted to a Likert-type 5-point scale.

Results:

A total of 47 patients met inclusion criteria for this study. Average age was 48.1±10.9 y. Average inpatient opioids prescribed was 102±106 MME. Average opioids prescribed at discharge was 437±342 MME. No statistically significant correlation was found between satisfaction with pain control and opioid consumption while in the hospital [r=−0.106, P=0.483]. Similarly, there was no statistically significant correlation between satisfaction with pain control and opioids prescribed upon discharge [r=−0.185, P=0.219]. No statistically significant correlation was found between date of surgery and inpatient MME consumption [r=−0.113, P=0.450]. Interestingly, more opioids were prescribed at discharge the earlier the date of surgery [r=−0.426, P=0.003]. For every additional month further along in the study period, the odds of a patient reporting a top box score for satisfaction with pain control increased by 5.5% [P=0.025].

Conclusion:

Our study found no correlation between patient satisfaction with pain control and inpatient opioid dosage or outpatient prescription dosage after single-level ACDF. Moreover, satisfaction with pain control increased over time despite a decrease in MME prescribed at discharge. This suggests that factors other than narcotic consumption play a more important role in patient satisfaction with pain control.

Level of Evidence:

Level III.
Is There a Correlation Between Cobb Angle and Pulmonary Function Tests at 2-year Follow-up in Patients With Severe Spinal Deformity Treated by Posterior Vertebral Column Resection?
Authors: Zhang Zhaoquan , Song Zhibo , Yang Xiaochen , Li Tao , Bi Ni , Wang Yingsong
Published: December 2021

Study design:

A retrospective study.

Objective:

The aim was to evaluate the relationships of Cobb angle and pulmonary function tests (PFTs) changes in severe spinal deformity and underwent posterior vertebral column resection (PVCR).

Summary of Background Data:

No previous study focused on the correlation of deformity correction and PFTs changes in patients with cobb angle >90 degrees.

Methods:

PFTs values [forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and percent-predicted values FVC%, FEV1%] were evaluated preoperative and at 2 years after PVCR. FVC% <80% were defined as restrictive ventilation dysfunction (RVD), the severity of RVD were divided into mild (FEV1% ≥70%), moderate (70% > FEV1% ≥50%) and severe (FEV1% <50%). The relationships among PFTs values improvements and all possible impact factors (mainly correction cobb angle) collected in this study were analyzed. PFTs data were compared among the 3 RVD subgroups (mild vs. moderate vs. severe) and between residual >30 versus <30 degrees.

Results:

A total of 53 cases (28 male/25 female, mean ages 18.9 Y) underwent PVCR in one center from 2004 to 2016 were enrolled cobb angle. When 2 years after PVCR, average PFTs values showed significant improvements. PFTs values changes showed no correlation with correction rate and correction angle. The only significant impact factor in this study for FVC, FVC%, FEV1 improvements was preoperative FVC% and the only impact factor for FEV1% improvement was preoperative FEV1%, the relationships were negative. In accordance with the regression analysis, PFTs values improvements among the 3 RVD subgroups from high to low was severe>moderate>mild. However, patients with residual cobb angle <30 degrees had less PFTs values improvements than patients with residual cobb angle >30 degrees.

Conclusions:

Two years after PVCR, PFTs values were significantly improved. There is no linear correlation between cobb angle change and PFTs values improvements. Lower preoperative FVC% and FEV1% indicate more PFTs values improvements at 2 years post-PVCR.

Level of Evidence:

Level III.
Pilot Study
Authors: Chory Ashley , Bank Matthew , Sison Cristina , Bloom Ona
Published: December 2021

Study Design:

In a pilot study from an American College of Surgeons (ACS)-verified Level One Trauma Center, we performed a retrospective analysis of patients with cervical spine fractures with or without spinal cord injury (SCI). Long-term mortality was determined from the National Death Index as of December 31, 2013.

Objective:

Examine the influence of age and presence of SCI on time-to-surgery and long-term mortality in patients with cervical spine fractures.

Summary of Background Data:

Cervical spine fractures with or without SCI disproportionately impact the elderly, who constitute an increasing percentage of the US population. Early surgical intervention is a safe, modifiable factor that enables early mobilization and may reduce complications. Because of increased comorbidities, surgical treatment of elderly patients with cervical spinal fractures is complex, but prolonged time to surgery is increasingly considered as a factor impacting potential recovery after SCI.

Materials and Methods:

Retrospective chart review using hospital medical charts and mortality data from the National Death Index.

Results:

Data from patients with cervical spine fractures treated surgically were analyzed, with nearly equal numbers under and over age 65. There was no statistically significant difference between the 2 age groups with respect to time-to-surgery or long-term mortality. In addition, there was no statistically significant difference between the 2 groups of patients, with or without SCI, with respect to time-to-surgery or long-term mortality.

Conclusions:

There was no statistically significant differences between patients by age or by SCI status with respect to time-to-surgery or long-term mortality.
Reappraising the Value of Fetal First-Trimester Ultrasonography
Authors: Tang Huirong , Zheng Mingming
Published: December 2021

In the last few years, the introduction of cell-free DNA has rapidly altered prenatal screening regimens and is increasingly offered as the second- or, at times, even the first-tier screening test. Should an early anomaly scan also be part of an up-to-date screening policy? This paper reappraises the value of fetal first-trimester ultrasonography. The primary aims of the first-trimester scan are to establish gestational age based on the measurement of fetal crown-rump length, to detect multiple pregnancy and chorionicity, and to measure fetal nuchal translucency thickness as part of a combined screening test for chromosomal abnormalities. With recent advancements in ultrasound technology, there is compelling evidence that a majority of fetuses with major structural abnormalities and almost half of them without chromosomal abnormalities can be detected in the first trimester. We focused on the first-trimester screening of fetal major defects, especially including fetal congenital heart disease and cleft lip and palate by ultrasound markers and views. Moreover, it is critical to highlight that after a detailed anomaly scan in the first trimester without major structural anomalies and positive genetic tests, the residual chance of favorable outcome in fetuses with isolated increased nuchal translucency is relatively high. The discussion on the role of cell-free DNA in prenatal screening is still ongoing. Even in the event of it becoming a first-line screening test for aneuploidies, the importance of a first-trimester fetal scan, including assessment of markers for other anomalies, remains undisputed.
Cell-based immunotherapies in gynecologic cancers
Authors: Lang Susan M. , Dorigo Oliver
Published: December 2021

Purpose of review

This review provides an update on recent developments in cell-based immunotherapy in gynecologic cancers.

Recent findings

Chimeric antigen receptor (CAR) technology has made significant progress allowing now for not only expressing CARs on T-cells, but also on other immune effector cells, such as natural killer cells and macrophages. Cell-based vaccines have started to show promising results in clinical trials.

Cell-based immunotherapies in gynecologic cancers continue to evolve with promising clinical efficacy in select patients.
Vocational Outcomes of Service Members and Veterans After Traumatic Brain Injury: A Scoping Review
Authors: Nguyen Michael V. , Hackman Dawn E. , Truitt Anjali R.
Published: December 2021

Objective:

The purpose of this scoping review was to evaluate the current literature related to vocational outcomes among US service members and veterans with traumatic brain injury (TBI).

Methods:

Seven research databases (Ovid MEDLINE, PsycINFO, EMBASE, CINAHL Plus, Cochrane Library, Scopus, and SPORTDiscus) were queried for human studies between the database inception and February, 2020. We included studies that focused on US service members and veterans who sustained a TBI and their vocational outcomes. Conference abstracts, systematic reviews, literature reviews, editorials, consensus reports, commentaries, dissertations, and qualitative studies were excluded. Two rounds of independent reviews were performed. Details of study design, intervention, and vocational outcomes were recorded.

Results:

The search yielded 5667 articles; 48 articles met inclusion criteria. Forty-three studies were observational (90%), and 5 were randomized controlled trials. A majority of interventions were in the outpatient setting (71%). Interventions related to return to work and duty utilized physical therapy and occupational therapy to address cognitive skills and functional deficits and provide supportive employment.

Conclusion:

Community reintegration research among service members and veterans with brain injuries is underdeveloped. Because of heterogeneity of severity and smaller sample sizes, no consensus was reached on interventions that improve vocational outcomes. Evidence thus far suggests that future studies should incorporate an interdisciplinary team approach beyond physical therapy and occupational therapy, longer-term outcomes, and sample subgroups.
TRANSCARUNCULAR DOUBLE INJECTION TECHNIQUE FOR PERIBULBAR ANESTHESIA IN VITREORETINAL SURGERY
Authors: Savastano Alfonso , Crincoli Emanuele , Gambini Gloria , Savastano Maria Cristina , Rizzo Clara , Rizzo Stanislao
Published: December 2021

Purpose:

Local anesthesia is commonly adopted in vitreoretinal surgery to reach painless and akinesia surgical condition. Currently, peribulbar anesthesia (PBA) and subtenon injection (STN) are the most widely used methods. We propose a transcaruncular double injection peribulbar technique (TRS) and aim to compare it with both standard PBA and STN injections.

Methods:

A total of 105 patients underwent TRS, PBA, or STN. A numerical rating scale was used to assess preoperative, postoperative, and intraoperative pain. Best akinesia score and onset and duration of akinesia were evaluated by two independent graders. The need for supplementary injection was also registered.

Results:

TRS group was characterized by a lower intraoperative numerical rating scale variation and absolute numerical rating scale score both at the beginning of surgery (P 0.046), after 30 minutes (P 0.032), and at the end of surgery (P 0.002) compared with the other groups. The TRS group also showed better akinesia score (P 0.004), fastest onset (P 0.002), and longer duration (P 0.042) compared with both PBA and STN. No injection-related complications were reported in the three groups.

Conclusion:

The newly proposed transcaruncular PBA provided superior pain control and akinesia level with no additional adverse events.
A Novel Method for Transillumination
Authors: Lee Seung Min , Chun Jinsuk , Kim Min
Published: December 2021

Purpose:

To introduce a cost-efficient device for transillumination in the management of uveal melanoma.

Methods:

Todorich Illuminated Depressor is a ball-point depressor, designed to work with the 23-, 25- and 27-gauge Alcon Constellation endoillumination. It was invented to allow indentation and peripheral vitreous visualization for vitrectomy.

Results:

Todorich depressor combined with endoillumination can also work as a device for transillumination for tumor localization. We started using this method of transillumination for the management of uveal melanomas since September 2020 and have successfully performed Ru-106 plaque brachytherapy for 10 cases of uveal melanoma. Three were large choroidal melanoma cases, and en bloc tumor resection by partial lamellar sclerouvectomy was successfully performed after precise localization of tumors using this method.

Conclusion:

Alcon Constellation endoillumination capped with Todorich Illuminated Depressor is an affordable and viable alternative for transillumination of intraocular tumors.
SUBRETINAL TRANSIENT HYPOREFLECTIVITY IN AGE-RELATED MACULAR DEGENERATION
Authors: Astroz Polina , Miere Alexandra , Amoroso Francesca , Semoun Oudy , Khorrami Alexis , Srour Mayer , Querques Giuseppe , Souied Eric H.
Published: December 2021

Purpose:

To describe and assess the prognostic significance of subretinal transient hyporeflectivity (STHR) on a novel spectral domain optical coherence tomography (SD-OCT) in age-related macular degeneration.

Methods:

Consecutive patients with age-related macular degeneration (AMD) presenting STHR, defined as a small, well-defined, round subretinal, hyporeflective lesion, on SD-OCT and without exudative signs were included. Clinical examination and SD-OCT (SPECTRALIS, Heidelberg Engineering, Heidelberg, Germany) were analyzed at inclusion, 1 month before inclusion, and until the onset of exudative signs during the 12-month follow-up.

Results:

Thirty-five STHR in 21 eyes of 20 patients were included. Among the 21 eyes, 2 eyes had early AMD, 1 eye had nonexudative asymptomatic macular neovascularization, and 18 eyes presented late AMD: 17 eyes neovascular AMD and 1 eye geographic atrophy. During the 2-month follow-up, 97.1% (34/35) of STHR disappeared. During the 12-month follow-up, 57.1% of eyes (12/21) developed exudative signs on 1 eye with early AMD and 11 eyes with neovascular AMD.

Conclusion:

Subretinal transient hyporeflectivity is a novel SD-OCT sign in patients with AMD. The eyes with isolated STHR should be closely monitored on a monthly basis to detect further exudation.
Supratherapeutic Infliximab Levels Do Not Predict Risk of Short-term Complications in Adults With Crohn’s Disease
Authors: Bhattacharya Abhik , Travis Daniel , Osterman Mark T. , Lewis James D. , Bhagya Rao Bhavana , Lee Helen , Lichtenstein Gary R.
Published: December 2021

Background:

It is uncertain if higher infliximab trough levels (TLs) confer a greater risk of infectious/noninfectious complications (IC/NIC). We aimed to assess the risk of IC and NIC in patients with different TLs.

Methods:

We retrospectively evaluated a cohort of Crohn’s disease (CD) patients treated with infliximab who underwent therapeutic drug monitoring (TDM), at a tertiary inflammatory bowel disease center, between January 1, 2010, and December 1, 2019. TDM was defined as checking of infliximab trough and antibody levels within a 48-hour period before administration. Patients with a minimum of 3-month assessment pre-TDM and post-TDM were included. In the case of multiple TDMs, the highest TL was considered, and patients were distributed across 4 predefined TL groups (A: <5 µg/mL, B: 5 to 10 µg/mL, C: 10 to 15 µg/mL, and D: ≥15 µg/mL). Rates of IC and NIC during the 3-month prior and following TDM were compared across the groups. In addition, duration of exposure, in terms of months up to TDM, was collected to analyze differences in rates of IC and NIC.

Results:

Our study included 341 CD patients (median age: 35 y, 58% men). IC and NIC occurred in 52 (15%) and 30 (9%) patients, respectively. Rates of IC and NIC were similar across the 4 TL groups (P=0.9 and 0.7, respectively for IC and NIC). On multivariable analysis, exposure to infliximab >40 months (as determined by receiver operating characteristic curve analysis) was associated with decreased odds for IC (adjusted odds ratio=0.51, P=0.04), but not NIC (adjusted odds ratio=0.72, P=0.46).

Conclusions:

In this large CD cohort, there was no association between infliximab TL and risk of short-term IC or NIC. Interestingly, a shorter duration of exposure predicted higher rates of IC. This supports the safety of targeting higher infliximab TLs when necessary and greater vigilance during the early stages of treatment.
Association of Alcohol Drinking and Helicobacter pylori Infection
Authors: Du Pengqiang , Zhang Chao , Wang Aifeng , Ma Zhichao , Shen Su , Li Xingang
Published: December 2021

Background:

The association between drinking and Helicobacter pylori infection was not clear in the literature. Owing to mixed and inconclusive results, a meta-analysis was conducted to summarize and clarify this association systematically.

Methods:

Based on a comprehensive search of PubMed, Embase, and Web of Science databases, studies investigating the association between drinking and H. pylori infection were retrieved. We evaluated the strength of this relationship using odds ratios (ORs) with 95% confidence intervals. Sensitivity analysis was also conducted.

Results:

A total of 24 individual studies were included in this meta-analysis. The risk of H. pylori infection was significantly lower in alcohol drinkers than nondrinkers (OR=0.83). People who drink wine (OR=0.90) or mixed types of alcoholic beverages (OR=0.78) had a lower risk of infection compared with those who drink beer. Among people aged 40 years or older, alcohol drinkers had a lower risk of H. pylori infection than nondrinkers (OR=0.68). Among people less than 40 years of age, alcohol drinking was not associated with H. pylori infection risk. Data showed that women were at a lower risk of H. pylori infection than men (OR=0.86).

Conclusions:

This meta-analysis suggests that the risk of H. pylori infection among alcohol drinkers is lower than that of nondrinkers. Drinking wine and mixed types of alcohol are better at reducing H. pylori infection than drinking beer. Nonetheless, we discourage reducing H. pylori infection through drinking, which increases the risk of other diseases.
Association of Social Determinants of Health With Adherence to Second-generation Antipsychotics for People With Bipolar Disorders in a Medicaid Population
Authors: Li Nien Chen , Alcusky Matthew , Masters Grace A. , Ash Arlene S.
Published: December 2021

Background:

About 7 million people, 2.8% of US adults, have bipolar disorder (BD). While second-generation antipsychotics (SGA) are indicated as acute and maintenance treatments for BD, therapeutic success requires medication adherence and reported nonadherence estimates to range as high as 60%. Identifying patient risk factors for nonadherence is important for reducing it.

Objective:

The objective of this study was to quantify the associations of risk factors, including social determinants of health, with SGA nonadherence among patients with BD.

Methods:

In this cross-sectional study of 2015–2017 MassHealth Medicaid data, we examined several definitions of adherence and used logistic regression to identify risk factors for nonadherence (medication possession ratio <0.8) among all adults aged 18–64 diagnosed with BD who could be followed for 12 months following SGA initiation.

Results:

Among 5197 patients, the mean (±SD) age was 37.7 (±11.4) years, and 42.3% were men. Almost half (47.7%) of patients were nonadherent to SGAs when measured by medication possession ratio. The prevalence of nonadherence peaked at middle age for men and younger for women. Nonadherence was less common among Massachusetts’ Department of Mental Health clients (odds ratio=0.60, 95% confidence limit: 0.48–0.74) and among those who used other psychotropic medications (odds ratios between 0.45 and 0.81); in contrast, increase in neighborhood socioeconomic stress was associated with increased odds of nonadherence.

Conclusions/Implications:

Adherence to SGA treatment is suboptimal among people with BD. Recognizing risk factors, including those related to social determinants of health, can help target interventions to improve adherence for people at high risk and has implications for adherence-based quality measures.
Evaluating the correlation of serum leptin levels with evidence of coronary artery disease on myocardial perfusion single-photon emission computed tomography in suspected coronary artery disease patients
Authors: Ghanizadeh Sina , Ghaedian Tahereh , Firuzyar Tahereh , Faghihi Amir , Jahani Taklimi Navid
Published: December 2021

Background

Cardiovascular disease is currently the most common cause of death worldwide. Several risk factors have been identified for cardiovascular diseases, including hypertension, hyperlipidemia and diabetes. Leptin is a peptide hormone that acts as a proinflammatory cytokine and has a variety of effects in hemostasis and metabolism such as lipid metabolism, production of glucocorticoid, angiogenesis, etc. The aim of this study was to determine the relationship between the concentrations of leptin with evidence of coronary artery disease in the myocardial perfusion scan.

Method

A one year retrospective cross-sectional study was conducted on patients who are suspected of coronary artery disease that referred to the nuclear medicine department for performing myocardial perfusion scan. The patients were classified based on the results of the myocardial perfusion scan. Serum leptin was measured with ELISA assay. The correlation of serum leptin with these parameters and also with different groups of age, sex and coronary artery disease risk factors was also compared.

Results

The mean serum level of leptin was 290.44 ng/ml (82.9-1600 ng/ml). There is no meaningful relation between serum leptin and coronary artery disease risk factors, age and sex; also, none of the quantitative myocardial perfusion scan parameters have a significant correlation with serum leptin.

Conclusion

Based on our findings, there was no significant correlation between myocardial perfusion scan parameters and leptin levels. Serum leptin and different groups of age, sex and coronary artery risk factors were not correlated as well.
VNTR polymorphism in the SLC6A3 gene does not influence dopamine transporter availability measured by [18F]FE-PE2I PET or [123I]FP-Cit SPECT
Authors: Jakobson Mo Susanna , Axelsson Jan , Stiernman Lars J , Larsson Anne , af Bjerkén Sara , Bäckström David , Kellgren Therese Gabrielsson , Varrone Andrea , Riklund Katrine
Published: December 2021

Objective

To investigate the potential impact of polymorphism in the 3′-untranslated region (3′UTR) of the SLC6A3 gene (DAT1) on normal variation in dopamine transporter (DAT) imaging with [18F]FE-PE2I PET and [123I]FP-Cit SPECT.

Methods

Thirty-six individuals (mean age 70.4±5.4 years) with normal [18F]FE-PE2I PET and [123I]FP-Cit SPECT were genotyped for variable number of tandem repeats (VNTR) in the 3′UTR of the DAT1 gene. The DAT-availability in the caudate and putamen as measured with [18F]FE-PE2I PET and [123I]FP-Cit SPECT, as well as in the substantia nigra with [18F]FE-PE2I PET were compared between the participants carrying one or two 9-repeat alleles (i.e. 9R+10R or 9R+9R; 47%) and the participants without a 9R allele (i.e. 10R+10R or 10R+11R; 53%). Nonparametric tests, linear regression analysis and mixed model analysis were used to assess any statistical difference in measured DAT availability between the two allele groups.

Results

The measured DAT-availability in PET- and SPECT-imaging tended to be slightly higher in the 9R-group; however, the difference did not reach statistical significance in either the caudate or the putamen or the substantia nigra. Instead, age did have a significant effect on the DAT level (P < 0.05) notwithstanding the genotype.

Conclusion

No significant effect of DAT1-genotype was detectable in imaging with [18F]FE-PE2I PET or [123I]FP-Cit, instead, age accounted for the normal variation in DAT-PET and DAT-SPECT.
Therapeutic application of genome editing in dyslipidemia
Authors: Whittaker Madelynn N. , Musunuru Kiran
Published: December 2021

Purpose of review

To summarize recent advances with respect to the use of genome editing to modify blood lipid levels in vivo.

Recent findings

Genome-editing technologies have been successfully used to target the PCSK9 gene in the livers of nonhuman primates and significantly reduce blood LDL cholesterol levels.

Multiple proof-of-concept nonhuman primate studies raise the prospect of genome editing empowering ‘one-and-done’ therapies for the treatment of dyslipidemic patients.