bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of inter-centre agreement across multidisciplinary team meetings for patients with retroperitoneal sarcoma
Authors: Tirotta Fabio , Hodson James , Alcorn Des , Al-Mukhtar Ahmed , Ayre Gareth , Barlow Adam , Chong Peter , Cosker Thomas , Dileo Palma , Figueiredo Rodrigo , French Jeremy , Gulamhusein Aziz , Jones Robert , Hayes Andrew , Key Catherine , Malik Hassan , Mahrous Ahmed , Mihai Radu , Nixon Ioanna , Partington Karen , Quinn Martha , Roberts James , Sayyed Raza , Shankar Arjun , Strauss Dirk , Turner Paul , Desai Anant
Published: June 2023

Background

Decision-making in the management of patients with retroperitoneal sarcoma is complex and requires input from a number of different specialists. The aim of this study was to evaluate the levels of agreement in terms of resectability, treatment allocation, and organs proposed to be resected across different retroperitoneal sarcoma multidisciplinary team meetings.

Methods

The CT scans and clinical information of 21 anonymized retroperitoneal sarcoma patients were sent to all of the retroperitoneal sarcoma multidisciplinary team meetings in Great Britain, which were asked to give an opinion about resectability, treatment allocation, and organs proposed to be resected. The main outcome was inter-centre reliability, which was quantified using overall agreement, as well as the chance-corrected Krippendorff’s alpha statistic. Based on the latter, the level of agreement was classified as: ‘slight’ (0.00–0.20), ‘fair’ (0.21–0.40), ‘moderate’ (0.41–0.60), ‘substantial’ (0.61–0.80), or ‘near-perfect’ (>0.80).

Results

Twenty-one patients were reviewed at 12 retroperitoneal sarcoma multidisciplinary team meetings, giving a total of 252 assessments for analysis. Consistency between centres was only ‘slight’ to ‘fair’, with rates of overall agreement and Krippendorff’s alpha statistics of 85.4 per cent (211 of 247) and 0.37 (95 per cent c.i. 0.11 to 0.57) for resectability; 80.4 per cent (201 of 250) and 0.39 (95 per cent c.i. 0.33 to 0.45) for treatment allocation; and 53.0 per cent (131 of 247) and 0.20 (95 per cent c.i. 0.17 to 0.23) for the organs proposed to be resected. Depending on the centre that they had attended, 12 of 21 patients could either have been deemed resectable or unresectable, and 10 of 21 could have received either potentially curative or palliative treatment.

Conclusions

Inter-centre agreement between retroperitoneal sarcoma multidisciplinary team meetings was low. Multidisciplinary team meetings may not provide the same standard of care for patients with retroperitoneal sarcoma across Great Britain.
Determination of Atropine by HPLC in Plant of Datura by Liquid–Liquid Extraction and Magnet Solid-Phase Extraction
Authors: Mahmoudi Shaida , Chaichi Mohamad Javad , Shamsipur Mojtaba , Nazari Ome Leila , Samadi Mayodi Abdol Rauf
Published: June 2023

Atropine is a tropane alkaloid found in abundance in Datura plant. We used two liquid–liquid extraction methods and magnet solid-phase extraction to compare the amount of atropine in these two types of plants (Datura innoxia and Datura stramonium). The surface magnetic nanoparticle Fe3O4 correction with an amine and dextrin, and finally, magnetic solid-phase extraction Fe3O4@SiO2-NH2-dextrin (MNPs-dextrin), was prepared. We determined the effect of significant parameters in the removal step and optimization of atropine measurements with half-fractional factorial design (25–1) and response surface methodology via central composite design. The optimum conditions are for desorption solvent = 0.5 mL methanol and desorption time of 5 min. We obtained an extraction recovery of 87.63% with a relative standard deviation of 4.73% via six frequented measurements on a 1 μg L−1 atropine standard solution based on the optimum condition. Preconcentration factors for MNPs are 81, limit of detection = 0.76 μg L−1 and limit of quantitation = 2.5 μg L−1.
Magnetic sphincter augmentation as treatment of gastroesophageal reflux disease after sleeve gastrectomy
Authors: Grover Karan , Khaitan Leena
Published: June 2023

The sleeve gastrectomy’s efficacy for the reduction of excess weight- and obesity-related comorbidities has been consistently demonstrated though the improvement of postoperative reflux symptoms has been questionable. The purpose of this article is to offer a diagnostic and treatment algorithm for patients suffering from GERD after the sleeve gastrectomy. This article is comprised of recommendations of from a single expert bariatric and foregut surgeon. While previously thought to be a relative contraindication, evidence suggests that select patients with a history of sleeve gastrectomy can safely and effectively undergo magnetic sphincter augmentation (MSA) and achieve improved control of reflux and discontinuation of PPIs. Concomitant hiatal hernia repair with MSA is recommended. MSA is a fantastic strategy for managing GERD after sleeve gastrectomy with careful patient selection.
Heart transplantation as a rescue strategy for patients with refractory electrical storm
Authors: Martins Raphael P , Hamel-Bougault Mathilde , Bessière Francis , Pozzi Matteo , Extramiana Fabrice , Brouk Zohra , Guenancia Charles , Sagnard Audrey , Ninni Sandro , Goemine Céline , Defaye Pascal , Boignard Aude , Maille Baptiste , Gariboldi Vlad , Baudinaud Pierre , Martin Anne-Céline , Champ-Rigot Laure , Blanchart Katrien , Sellal Jean-Marc , De Chillou Christian , Dyrda Katia , Jesel-Morel Laurence , Kindo Michel , Chaumont Corentin , Anselme Frédéric , Delmas Clément , Maury Philippe , Arnaud Marine , Flecher Erwan , Benali Karim
Published: June 2023

Aims

Heart transplantation (HT) can be proposed as a therapeutic strategy for patients with severe refractory electrical storm (ES). Data in the literature are scarce and based on case reports. We aimed at determining the characteristics and survival of patients transplanted for refractory ES.

Methods and results

Patients registered on HT waiting list during the following days after ES and eventually transplanted, from 2010 to 2021, were retrospectively included in 11 French centres. The primary endpoint was in-hospital mortality. Forty-five patients were included [82% men; 55.0 (47.8–59.3) years old; 42.2% and 26.7% non-ischaemic dilated or ischaemic cardiomyopathies, respectively]. Among them, 42 (93.3%) received amiodarone, 29 received (64.4%) beta blockers, 19 (42.2%) required deep sedation, 22 had (48.9%) mechanical circulatory support, and 9 (20.0%) had radiofrequency catheter ablation. Twenty-two patients (62%) were in cardiogenic shock. Inscription on wait list and transplantation occurred 3.0 (1.0–5.0) days and 9.0 (4.0–14.0) days after ES onset, respectively. After transplantation, 20 patients (44.4%) needed immediate haemodynamic support by extracorporeal membrane oxygenation (ECMO). In-hospital mortality rate was 28.9%. Predictors of in-hospital mortality were serum creatinine/urea levels, need for immediate post-operative ECMO support, post-operative complications, and surgical re-interventions. One-year survival was 68.9%.

Conclusion

Electrical storm is a rare indication of HT but may be lifesaving in those patients presenting intractable arrhythmias despite usual care. Most patients can be safely discharged from hospital, although post-operative mortality remains substantial in this context of emergency transplantation. Larger studies are warranted to precisely determine those patients at higher risk of in-hospital mortality.
A Comprehensive Overview of Unit-Level Modeling of Survey Data for Small Area Estimation Under Informative Sampling
Authors: Parker Paul A , Janicki Ryan , Holan Scott H
Published: June 2023

Model-based small area estimation is frequently used in conjunction with survey data to establish estimates for under-sampled or unsampled geographies. These models can be specified at either the area-level, or the unit-level, but unit-level models often offer potential advantages such as more precise estimates and easy spatial aggregation. Nevertheless, relative to area-level models, literature on unit-level models is less prevalent. In modeling small areas at the unit level, challenges often arise as a consequence of the informative sampling mechanism used to collect the survey data. This article provides a comprehensive methodological review for unit-level models under informative sampling, with an emphasis on Bayesian approaches.
Spatio-temporal dynamics of the metabolome of climacteric fruit during ripening and post-harvest storage
Authors: Nicolaï Bart M , Xiao Hui , Han Qianyun , Tran Dinh Thi , Crouch Elke , Hertog Maarten L A T M , Verboven Pieter
Published: June 2023

Fruit quality traits are determined to a large extent by their metabolome. The metabolite content of climacteric fruit changes drastically during ripening and post-harvest storage, and has been investigated extensively. However, the spatial distribution of metabolites and how it changes in time has received much less attention as fruit are usually considered as homogenous plant organs. Yet, spatio-temporal changes of starch, which is hydrolyzed during ripening, has been used for a long time as a ripening index. As vascular transport of water, and hence convective transport of metabolites, slows down in mature fruit and even stalls after detachment, spatio-temporal changes in their concentration are probably affected by diffusive transport of gaseous molecules that act as substrate (O2), inhibitor (CO2), or regulator (ethylene and NO) of the metabolic pathways that are active during climacteric ripening. In this review, we discuss such spatio-temporal changes of the metabolome and how they are affected by transport of metabolic gases and gaseous hormones. As there are currently no techniques available to measure the metabolite distribution repeatedly by non-destructive means, we introduce reaction–diffusion models as an in silico tool to compute it. We show how the different components of such a model can be integrated and used to better understand the role of spatio-temporal changes of the metabolome in ripening and post-harvest storage of climacteric fruit that is detached from the plant, and discuss future research needs.
The SATIN project – I. Turbulent multiphase ISM in Milky Way simulations with SNe feedback from stellar clusters
Authors: Bieri Rebekka , Naab Thorsten , Geen Sam , Coles Jonathan P , Pakmor Rüdiger , Walch Stefanie
Published: June 2023

We introduce the star formation and supernova (SN) feedback model of the satin (Simulating AGNs Through ISM with Non-Equilibrium Effects) project to simulate the evolution of the star forming multiphase interstellar medium (ISM) of entire disc galaxies. This galaxy-wide implementation of a successful ISM feedback model tested in small box simulations naturally covers an order of magnitude in gas surface density, shear and radial motions. It is implemented in the adaptive mesh refinement code ramses at a peak resolution of 9 pc. New stars are represented by star cluster (sink) particles with individual SN delay times for massive stars. With SN feedback, cooling, and gravity, the galactic ISM develops a three-phase structure. The star formation rates naturally follow observed scaling relations for the local Milky Way gas surface density. SNe drive additional turbulence in the warm (300 < T < 104 K) gas and increase the kinetic energy of the cold gas, cooling out of the warm phase. The majority of the gas leaving the galactic ISM is warm and hot with mass loading factors of 3 ≤ η ≤ 10 up to h = 5 kpc away from the galaxy. While the hot gas is leaving the system, the warm and cold gas falls back onto the disc in a galactic fountain flow. The inclusion of other stellar feedback processes from massive stars seems to be needed to reduce the rate at which stars form at higher surface densities and to increase/decrease the amount of warm/cold gas.
3D evolution of neutron star magnetic fields from a realistic core-collapse turbulent topology
Authors: Dehman Clara , Viganò Daniele , Ascenzi Stefano , Pons Jose A , Rea Nanda
Published: June 2023

We perform the first 3D fully coupled magneto-thermal simulations of neutron stars (including the most realistic background structure and microphysical ingredients so far) applied to a very complex initial magnetic field topology in the crust, similar to what was recently obtained by proto-neutron stars dynamo simulations. In such configurations, most of the energy is stored in the toroidal field, while the dipolar component is a few per cent of the mean magnetic field. This initial feature is maintained during the long-term evolution (∼106 yr), since the Hall term favours a direct cascade (compensating for Ohmic dissipation) rather than a strong inverse cascade, for such an initial field topology. The surface dipolar component, responsible for the dominant electromagnetic spin-down torque, does not show any increase in time, when starting from this complex initial topology. This is in contrast to the timing properties of young pulsars and magnetars which point to higher values of the surface dipolar fields. A possibility is that the deep-seated magnetic field (currents in the core) is able to self-organize in large scales (during the collapse or in the early life of a neutron star). Alternatively, the dipolar field might be lower than is usually thought, with magnetosphere substantially contributing to the observed high spin-down, via e.g. strong winds or strong coronal magnetic loops, which can also provide a natural explanation to the tiny surface hotspots inferred from X-ray data.
A decade of near-infrared variability in NGC4388: insights into the AGN structure
Authors: Dahmer-Hahn Luis G , Rodríguez-Ardila Alberto , Bianchin Marina , Riffel Rogemar A , Riffel Rogério , Storchi-Bergmann Thaisa , Hao Lei
Published: June 2023

Variability studies have proven to be a powerful diagnostic tool for understanding the physics and properties of active galactic nuclei (AGNs). They provide insights into the spatial and temporal distribution of the emitting regions, the structure and dynamics of the accretion disc, and the properties of the central black hole. Here, we have analysed the K-band spectral variability of the Seyfert 1.9/2 galaxy NGC 4388 spanning five epochs over a period of 10 yr. We have performed spectral synthesis of the nuclear region and found that the contribution of warm dust (T ∼ 800 K) declined by 88 per cent during these 10 yr. In the same period, the [Ca viii] coronal line decreased 61 per cent, whereas Br γ emission declined 35 per cent. For the He i and H2, we did not detect any significant variation beyond their uncertainties. Based on the time span of these changes, we estimate that the region where the warm dust is produced is smaller than 0.6 pc, which suggests that this spectral feature comes from the innermost part of the region sampled, directly from the AGN torus. On the other hand, the bulk of [Ca viii] is produced in the inner ∼2 pc and the nuclear Br γ region is more extended, spanning a region larger than 3 pc. Lastly, He i and H2 are even more external, with most of the emission probably being produced in the host galaxy rather than in the AGN. This is the first spectroscopic variability study in the near-infrared for an AGN where the central source is not directly visible.
Tidal evolution of close-in exoplanets and host stars
Authors: Ferraz-Mello S , Beaugé C
Published: June 2023

The evolution of exoplanetary systems with a close-in planet is ruled by the tides mutually raised on the two bodies and by the magnetic braking of the host star. This paper deals with consequences of this evolution and some features that can be observed in the distribution of the systems' two main periods: the orbital period and the stars rotational period. The results of the simulations are compared to plots showing both periods as determined from the light curves of a large number of Kepler objects of interest. These plots show important irregularities as a dearth of systems in some regions and accumulations of hot Jupiters in others. It is shown that the accumulation of short-period hot Jupiters around stars with rotation periods close to 25 d results from the evolution of the systems under the joint action of tides and braking, and requires a relaxation factor for Solar-type stars of around $10 \, \mathrm{ s}^{-1}$.
Origin and trends in NH4+ observed in the coma of 67P
Authors: Lewis Z M , Beth A , Altwegg K , Galand M , Goetz C , Heritier K , O’Rourke L , Rubin M , Stephenson P
Published: June 2023

The European Space Agency/Rosetta mission escorted comet 67P/Churyumov–Gerasimenko and witnessed the evolution of its coma from low activity (∼2.5–3.8 au) to rich ion-neutral chemistry (∼1.2–2.0 au). We present an analysis of the ion composition in the coma, focusing on the presence of protonated high proton affinity (HPA) species, in particular $\mathrm{{ NH}_{4}}^{+}$. This ion is produced through the protonation of NH3 and is an indicator of the level of ion-neutral chemistry in the coma. We aim to assess the importance of this process compared with other $\mathrm{{ NH}_{4}}^{+}$ sources, such as the dissociation of ammonium salts embedded in dust grains. The analysis of $\mathrm{{ NH}_{4}}^{+}$ has been possible thanks to the high mass resolution of the Rosetta Orbiter Spectrometer for Ion and Neutral Analysis/Double Focusing Mass Spectrometer (ROSINA/DFMS). In this work, we examine the $\mathrm{{ NH}_{4}}^{+}$ data set alongside data from the Rosetta Plasma Consortium instruments, and against outputs from our in-house ionospheric model. We show that increased comet outgassing around perihelion yields more detections of $\mathrm{{ NH}_{4}}^{+}$ and other protonated HPA species, which results from more complex ion-neutral chemistry occurring in the coma. We also reveal a link between the low magnetic field strength associated with the diamagnetic cavity and higher $\mathrm{{ NH}_{4}}^{+}$ counts. This suggests that transport inside and outside the diamagnetic cavity is very different, which is consistent with 3D hybrid simulations of the coma: non-radial plasma dynamics outside the diamagnetic cavity is an important factor affecting the ion composition.
Planetesimals drifting through dusty and gaseous white dwarf debris discs: Types I, II and III-like migration
Authors: Veras Dimitri , Ida Shigeru , Grishin Evgeni , Kenyon Scott J , Bromley Benjamin C
Published: June 2023

The suite of over 60 known planetary debris discs which orbit white dwarfs, along with detections of multiple minor planets in these systems, motivate investigations about the migration properties of planetesimals embedded within the discs. Here, we determine whether any of the migration regimes which are common in (pre-)main-sequence protoplanetary discs, debris discs, and ring systems could be active and important in white dwarf discs. We investigate both dust-dominated and gas-dominated regions, and quantitatively demonstrate that Type I and Type II migration, as well as their particulate disc analogues, are too slow to be relevant in white dwarf discs. However, we find that the analogue of Type III migration for particulate discs may be rapid in the dusty regions of asteroid- or moon-generated (>1018 kg) white dwarf discs, where a planetesimal exterior to its Roche radius may migrate across the entire disc within its lifetime. This result holds over a wide range of disc boundaries, both within and exterior to 1R⊙, and such that the probability of migration occurring increases with higher disc masses.
Polyarteritis nodosa diagnosed in a young male after COVID-19 vaccine: A case report
Authors: Makiyama Ayako , Abe Yoshiyuki , Furusawa Hoshiko , Kogami Masahiro , Ando Taiki , Tada Kurisu , Onimaru Mitsuho , Ishizu Akihiro , Yamaji Ken , Tamura Naoto
Published: June 2023

In response to the coronavirus disease 2019 pandemic, the coronavirus disease 2019 vaccine was rapidly developed and the effectiveness of the vaccine has been established. However, various adverse effects have been reported, including the development of autoimmune diseases. We report a case of new-onset polyarteritis nodosa in a 32-year-old male following the coronavirus disease 2019 vaccination. The patient developed limb pain, fever, pulmonary embolism, multiple subcutaneous nodules, and haematomas. Skin biopsy revealed necrotising inflammation accompanied by fibrinoid necrosis and high inflammatory cell infiltration in the walls of medium to small arteries. The symptoms resolved following corticosteroid treatment. Although it is difficult to prove a relationship between the vaccine and polyarteritis nodosa, similar cases have been reported and further reports and analyses are therefore necessary.
Disparities in Psychosis Risk Symptoms for New Zealand Māori May Be Explained by Systemic Stressors and Inappropriate Conceptualization of Culturally Normative Experiences
Authors: Grattan Rebecca E , Mehta Aleesha , Clifford Amanda
Published: June 2023

Background and Hypothesis

Māori, the indigenous peoples of New Zealand, experience increased rates of psychotic disorders and first-episode psychosis. However, it is unclear whether they also present with increased psychosis risk symptoms, such as subclinical psychotic-like experiences (PLEs). Measurement of risk symptoms is key for early intervention. Further, it is unclear if systemic factors such as the increased rates of social adversity and discrimination or cultural biases contribute to this disparity in psychosis rates.

Study Design

This study surveyed 466 18- to 30-year olds in New Zealand, and compared Māori to non-Māori participant responses on the Prodromal Questionnaire Brief, alongside the history of childhood trauma, discrimination, and financial adversity.

Study Results

Māori reported a higher number of PLEs compared to non-Māori—however, this was not associated with increased distress related to these experiences. The increased number of psychosis-like experiences reported by Māori was likely explained by systemic factors such as childhood trauma, discrimination, and financial stress. Māori were more likely to report that the PLEs were positive.

Conclusions

Measurement of psychosis risk for Māori is nuanced, and increased scores on these tools may reflect pathologizing potentially normative experiences for Māori, such as spiritual encounters or discrimination, alongside the impact of increased rates of systemic discrimination, trauma, and financial stress.
Extent of Tissue Washing Can Significantly Alter the Composition of Adipose-Derived Stromal Vascular Fraction Cell Preparations: Implications for Clinical Translation
Authors: Aguilo-Seara Gabriela , Molair William , Shang Hulan , Northrup Scott , Grosser Joshua A , Llull Ramon , Katz Adam
Published: June 2023

Stromal vascular fraction (SVF) cell preparations have recently attracted much interest as a form of autologous cell therapy. These heterogenous cell populations typically include some proportion of blood-derived cells (BDCs)—including both red blood cells (RBCs) and leukocytes (WBCs). The objectives of this paper were to evaluate the effects of tissue washing and hypotonic RBC lysis—separately and together—on BDC concentrations within SVF, and further to explore whether BDCs can confer detectable and modifiable effects on adipose-derived cell activity. Using various cell culture assays, flow cytometry and ELISA analysis of human-derived SVF preparations, we show that thorough washing of adipose tissue prior to enzymatic dissociation effectively removes RBCs from SVF preparations as well as standard lysis methods and significantly alters the type and relative quantities of WBCs. In addition, these studies demonstrate that potentially toxic RBC components are detectable for up to 1 week in cultures containing RBC lysate, but not those with intact RBCs, and, that culture-expanded cells proliferate significantly more in the presence of intact RBCs versus RBC lysis products or control media. Broadly, these data exemplify how different seemingly mundane tissue processing steps can significantly influence SVF identity/composition, purity, and potency. Based on the findings of this work, we propose that translational efforts in the field would benefit by a better understanding of the impact of RBCs, WBCs, and non-viable cells on the in vivo therapeutic activity of SVF therapies.
Use of Phosphodiesterase Inhibitors in the Postoperative Period of Skin Flaps: A Systematic Review
Authors: Daronch Oona Tomiê , Marcante Renata Fernanda Ramos , Neto Aristides Augusto Palhares , Viterbo Fausto
Published: June 2023

Background:

Ischemia-reperfusion injury can occur in several clinical conditions, and it has been widely studied in the context of skin flaps. Vascular distress results in an imbalance between the supply and demand of oxygen to living tissues, and the result of this process is tissue necrosis. Several drugs have been studied to reduce vascular distress of skin flaps and tissue loss.

Methods:

The present study performed a systematic review of literature in the main databases (PubMed, Web of Science, LILACS, SciELO, and Cochrane), including articles published in the last 10 years.

Results:

It was observed that phosphodiesterase inhibitors, mainly types III and V, have shown promising results in terms of vascularization of the postoperative skin flap, especially when started on the first postoperative day and maintained for 7 days.

Conclusion:

New studies with different posology, duration of use, and new drugs are needed to better elucidate the use of this substance to optimize the circulation of skin flaps.
Early Second Free Flap is Required in Osteoradionecrosis-related Nonunion after Primary Mandible Reconstruction
Authors: Tee Richard , Schweizer Riccardo , Gomez-Martinez-de-Lecea Cristina , Vejbrink Kildal Villiam , Thor Andreas , Rodriguez-Lorenzo Andres
Published: June 2023

Background:

Osteoradionecrosis (ORN) manifested as symptomatic nonunion between primary free flap and native mandible after primary bony reconstruction of the mandible is an entity not included in current conventional ORN staging guidelines. This article reports on and proposes early management of this debilitating condition using a chimeric scapular tip free flap (STFF).

Methods:

A retrospective review was performed examining cases with bony nonunion at the junction of primary free fibula flap (FFF) and native mandible at a single center over a 10-year duration, which required a second free bone flap. Details of each case (patient demographics, oncological details, primary surgery, presentation, and secondary surgery) were documented and analyzed. Outcomes of the treatment were assessed.

Results:

Four patients (two men and two women; age range, 42–73 years) out of a total of 46 primary FFF were identified. All patients presented with symptoms of low-grade ORN and radiological signs of nonunion. All cases were reconstructed with chimeric STFF. The duration of follow-up ranged from 5 to 20 months. All patients reported resolution of symptoms and radiological evidence of union. Two of four patients subsequently received osseointegrated dental implants.

Conclusions:

Institutional rate of nonunion after primary FFF requiring a second free bone flap is 8.7%. All the patients of this cohort presented with a similar clinical entity easily discounted as an infected nonunion postosseous flap reconstruction. There is no ORN grading system that currently guides the management of this cohort. Good outcomes are possible with early surgical intervention with a chimeric STFF.
Validation of the Short-Form 36 for Adolescents Undergoing Reduction Mammaplasty
Authors: McNamara Catherine T. , Parry Gareth , Netson Rebecca , Nuzzi Laura C. , Labow Brian I.
Published: June 2023

Background:

Health-related quality of life improvements after reduction mammaplasty have been reported by patients. Although instruments exist for adults, a validated outcomes survey is not available for adolescents. This study aims to validate the Short-Form 36 (SF-36) for adolescents undergoing reduction mammaplasty.

Methods:

Patients aged 12–21 years were prospectively recruited between 2008 and 2021 to unaffected or macromastia cohorts. Patients completed four baseline surveys: SF-36, Rosenberg Self-esteem Scale, Breast-related Symptoms Questionnaire, and Eating Attitudes Test. Surveys were repeated at 6 and 12 months postoperatively (macromastia cohort), and at 6 and 12 months from baseline (unaffected cohort). Content, construct, and longitudinal validity were assessed.

Results:

A total of 258 patients with macromastia (median age: 17.5 years), and 128 unaffected patients (median age: 17.0 years) were included. Content validity was established, and construct validity was fulfilled: internal consistency was confirmed for all domains (Cronbach alpha >0.7); convergent validity was satisfied through expected correlations between the SF-36 and Rosenberg Self-esteem Scale, Breast-related Symptoms Questionnaire, and Eating Attitudes Test, and known-groups validity was established through significantly lower mean scores in all SF-36 domains in the macromastia cohort compared with unaffected patients. Longitudinal validity was established by significant improvements in domain scores from baseline to 6 and 12 months postoperatively in patients with macromastia (P < 0.05, all).

Conclusions:

The SF-36 is a valid instrument for adolescents undergoing reduction mammaplasty. Although other instruments have been used for older patients, we recommend the SF-36 when assessing health-related quality of life changes in younger populations.
Brain morphology predicts individual sensitivity to pain: a multicenter machine learning approach
Authors: Kotikalapudi Raviteja , Kincses Balint , Zunhammer Matthias , Schlitt Frederik , Asan Livia , Schmidt-Wilcke Tobias , Kincses Zsigmond T. , Bingel Ulrike , Spisak Tamas
Published: June 2023

Sensitivity to pain shows a remarkable interindividual variance that has been reported to both forecast and accompany various clinical pain conditions. Although pain thresholds have been reported to be associated to brain morphology, it is still unclear how well these findings replicate in independent data and whether they are powerful enough to provide reliable pain sensitivity predictions on the individual level. In this study, we constructed a predictive model of pain sensitivity (as measured with pain thresholds) using structural magnetic resonance imaging–based cortical thickness data from a multicentre data set (3 centres and 131 healthy participants). Cross-validated estimates revealed a statistically significant and clinically relevant predictive performance (Pearson r = 0.36, P < 0.0002, R
2 = 0.13). The predictions were found to be specific to physical pain thresholds and not biased towards potential confounding effects (eg, anxiety, stress, depression, centre effects, and pain self-evaluation). Analysis of model coefficients suggests that the most robust cortical thickness predictors of pain sensitivity are the right rostral anterior cingulate gyrus, left parahippocampal gyrus, and left temporal pole. Cortical thickness in these regions was negatively correlated to pain sensitivity. Our results can be considered as a proof-of-concept for the capacity of brain morphology to predict pain sensitivity, paving the way towards future multimodal brain-based biomarkers of pain.
Additional neoadjuvant immunotherapy does not increase the risk of anastomotic leakage after esophagectomy for esophageal squamous cell carcinoma: a multicenter retrospective cohort study
Authors: Hong Zhinuan , Xu Jinxin , chen Zhen , Xu Hui , Huang Zhixin , Weng Kai , Cai Junlan , Ke Sunkui , Chen Shuchen , Xie Jinbiao , Duan Hongbing , Kang Mingqiang
Published: June 2023

Purpose:

Neoadjuvant chemoimmunotherapy (nICT) is a novel and promising therapy model for locally advanced esophageal squamous cell carcinoma (LA-ESCC).The objective of this study aimed to assessed the impact of additional neoadjuvant immunotherapy on patients’ short-term outcomes, particularly the incidence of anastomotic leakage (AL) and pathological response.

Methods:

Patients with LA-ESCC who received neoadjuvant chemotherapy(nCT)/ nICT combination with radical esophagectomy were enrolled from three medical centers in China. We used propensity score matching (PSM， ration：1:1, caliper=0.01) and inverse probability processing weighting (IPTW) to balance the baseline characteristics and compare the outcomes. Conditional logistic regression and weighted logistic regression analysis were used to further evaluate whether additional neoadjuvant immunotherapy would increased the risk of postoperative AL.

Results:

A total of 331 patients getting partially advanced ESCC receiving nCT or nICT were enrolled from three medical centers in China. After PSM/IPTW, the baseline characteristics reached a equilibrium between the two groups. After matching, there were no significant difference in the AL incidence between the two groups(P=0.68, after PSM; P=0.97 after IPTW), and the incidence of AL in the two groups was 15.85% versus 18.29%, and 14.79% versus 15.01%, respectively. After PSM/IPTW, both groups were similar in pleural effusion and pneumonia. After IPTW, the nICT group had a higher incidence of bleeding(3.36% vs. 0.30%, P=0.01), chylothorax(5.79% 0.30%, P=0.001), and cardiac events(19.53% vs. 9.20%, P=0.04). recurrent laryngeal nerve palsy(7.85% vs. 0.54%, P=0.003). After PSM, both groups were similar in palsy of recurrent laryngeal nerve(1.22% vs. 3.66%, P=0.31) and cardiac events(19.51% vs. 14.63%, P=0.41). Weighted logistic regression analysis showed that additional neoadjuvant immunotherapy wasn’t responsible for AL (OR=0.56, 95%CI: [0.17,1.71], after PSM; 0.74, 95%CI: [0.34,1.56], after IPTW). The nICT group had dramatically higher pCR in primary tumor than the nCT group (P=0.003, PSM; P=0.005, IPTW), 9.76% versus 28.05% and 7.72% versus 21.17%, respectively.

Conclusions:

Additional neoadjuvant immunotherapy could benefit pathological reactions without increasing the risk of AL and pulmonary complications.We require further randomized controlled research to validate whether additional neoadjuvant immunotherapy would make a difference in other complications, and determine whether pathologic benefits could translate into prognostic benefits, which would require longer follow-up.
Changes in Physician Recommendations for Early Physical Activity After Pediatric Concussion: A Retrospective Study
Authors: Plumage Emily F. , Bista Saroj , Recker Robyn , Cuff Steven , Fischer Anastasia , Tiso Michael , Yang Jingzhen
Published: June 2023

Objectives:

This study aimed to analyze changes in physical activity (PA) recommendations after pediatric concussions and examine the associations of patient and injury characteristics with physicians' PA recommendations.

Design:

Retrospective observational study.

Setting:

Concussion clinics associated with a pediatric hospital.

Patients:

Patients aged 10 to 18 years with a concussion diagnosis, presenting to the concussion clinic within 14 days of the injury were included. A total of 4727 pediatric concussions and corresponding 4727 discharge instructions were analyzed.

Independent Variables:

The independent variables for our study were time, injury characteristics (eg, mechanism and symptom scores), and patient characteristics (eg, demographics and comorbidities).

Main Outcome Measures:

Physician PA recommendations.

Results:

From 2012 to 2019, the proportion of physicians recommending light activity at an initial visit increased from 11.1% to 52.6% (P < 0.05) within 1-week postinjury and from 16.9% to 64.0% during the second week postinjury (P < 0.05). A significantly increased odds of recommending “light activity” (odds ratio [OR] = 1.82, 95% confidence interval [CI], 1.39-2.40) and “noncontact PA” (OR = 2.21, 95% CI, 1.28-2.05), compared with “no activity” within 1-week postinjury, was observed in each consecutive year. In addition, higher symptom scores at the initial visit were associated with lower likelihood of recommending “light activity” or “noncontact PA.”

Conclusions:

Physician recommendation of early, symptom-limited PA after a pediatric concussion has increased since 2012, which mirrors a shift in acute concussion management. Further research assessing how these PA recommendations may facilitate pediatric concussion recovery is warranted.
Cerebral Small Vessel Disease in Elderly Patients With Menière’s Disease
Authors: Oussoren Fieke K. , van Leeuwen Roeland B. , Schermer Tjard R. , Poulsen Louise N. F. , Kardux Joost J. , Bruintjes Tjasse D.
Published: June 2023

Background:

Menière’s disease (MD) is an inner ear disease characterized by vertigo attacks, progressive hearing loss, tinnitus, and the sensation of aural fullness. Although the exact pathophysiology of MD is unknown, endolymphatic hydrops is considered to be its histopathological hallmark. It has been suggested that endolymphatic hydrops results from lowered perfusion pressure due to cardiovascular comorbidity. Cardiovascular risk factors can cause cerebral small vessel disease (CSVD), visible on MRI. The presence of CSVD in turn raises the risk of developing a stroke.

Objectives:

This study aimed to compare the presence of CSVD and cardiovascular risk factors in elderly patients with MD to a control cohort.

Methods:

Patients diagnosed with MD, aged 50 years and older, were retrospectively reviewed and compared with a control cohort. The primary outcome was the difference in CSVD on MRI imaging, which was assessed by the number of white matter hyperintensities using the ordinal Fazekas scale. The secondary outcome was the presence of brain infarctions on MRI.

Results:

A total of 111 patients with MD were compared with a control cohort of 111 patients. No difference in the degree of white matter hyperintensities (P = 0.890) was found between the MD and control cohort. Brain infarctions were seen in 8 of 111 patients with MD and 14 of 111 patients from the control cohort (P = 0.261).

Conclusion:

CSVD is not more frequently visible on MRI in elderly patients with MD than in controls. This result does not support hypoperfusion-induced ischemia in the pathophysiology of MD.
A Psychosocial Care Model for Families Affected by Congenital Heart Disease*
Authors: Driscoll Colleen F. B. , Christofferson Jennifer , McWhorter Linda G. , Demianczyk Abigail C. , Brosig Cheryl L. , Jackson Emily A. , Gramszlo Colette , Zyblewski Sinai C. , Kazak Anne E. , Sood Erica
Published: June 2023

OBJECTIVES:

To develop a model of family-based psychosocial care for congenital heart disease (CHD).

DESIGN:

Qualitative study using crowdsourced data collected from parents of young children with CHD who received care across 42 hospitals.

SETTING:

Yammer, a social networking platform used to facilitate online crowdsourcing and qualitative data collection.

SUBJECTS:

Geographically diverse sample of 100 parents (72 mothers and 28 fathers) of young children with CHD.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Parents joined a private group on Yammer and responded to 37 open-ended study questions over a 6-month period. Qualitative data were coded and analyzed using an iterative process. Three broad themes corresponding to pillars of family-based psychosocial care were identified: pillar 1) parent partnership in family-integrated medical care, pillar 2) supportive interactions focused on parent and family wellbeing, and pillar 3) integrated psychosocial care and peer support for parents and families. Each pillar was supported by subthemes corresponding to specific intervention strategies. Most parents described the need for intervention strategies across multiple pillars, with almost half reporting needs across all three pillars of psychosocial care. Parents’ preferences for psychosocial support changed over time with changes to their child’s medical status and across care settings (e.g., hospital, outpatient clinic).

CONCLUSIONS:

Results support a model of family-based psychosocial care that is multidimensional and flexible to meet the needs of families affected by CHD. All members of the healthcare team play an important role in providing psychosocial support. Future research incorporating components of implementation science is needed to promote uptake of these findings, with the goal of optimizing family-based psychosocial support in the hospital setting and beyond.
Rare Recurrent Giant Frontal Osteoma With Skin Multiple Keratinous Cysts and Multinucleated Giant Cell Granulomas
Authors: Deng Huiling , Peng Shuyi , Wu Fan , An Ran , Wang Jiecong
Published: June 2023

Background:

Osteoma is the most common benign tumor of the craniomaxillofacial region. Its etiology remains unclear, and the computed tomography and histopathologic examination contribute to its diagnosis. There are very rare reports of recurrence and malignant transformation after surgical resection. Furthermore, giant frontal osteomas that occurred repeatedly and were accompanied by skin multiple keratinous cysts and multinucleated giant cell granulomas have not been reported in previous literature.

Methods:

The previous cases of recurrent frontal osteoma in the literature and all cases of frontal osteoma in our department in the last 5 years were reviewed.

Results:

A total of 17 cases of frontal osteoma (mean age 40 y, all female) were reviewed in our department. All patients underwent open surgery to remove the frontal osteoma, and no evidence of complications was found during postoperative follow-up. Two patients underwent 2 or more operations due to the recurrence of osteoma.

Conclusions:

Two cases of recurrent giant frontal osteoma were reviewed emphatically in this study, including 1 case of giant frontal osteoma with skin multiple keratinous cysts and multinucleated giant cell granulomas. As far as we know, this is the first giant frontal osteoma that occurred repeatedly and was accompanied by skin multiple keratinous cysts and multinucleated giant cell granulomas.
Age-related changes in thromboelastography profiles in injured children
Authors: Morgan Katrina M. , Abou-Khalil Elissa , Strotmeyer Stephen , Richardson Ward M. , Gaines Barbara A. , Leeper Christine M.
Published: June 2023

BACKGROUND

The role of age in mediating coagulation characteristics in injured children is not well defined. We hypothesize thromboelastography (TEG) profiles are unique across pediatric age groups.

METHODS

Consecutive trauma patients younger than 18 years from a Level I pediatric trauma center database from 2016 to 2020 with TEG obtained on arrival to the trauma bay were identified. Children were categorized by age according to the National Institute of Child Health and Human Development categories (infant, ≤1 year; toddler, 1–2 years; early childhood, 3–5 years; older childhood, 6–11 years; adolescent, 12–17 years). Thromboelastography values were compared across age groups using Kruskal-Wallis and Dunn's tests. Analysis of covariance was performed controlling for sex, Injury Severity Score (ISS), arrival Glasgow Coma Scale (GCS) score, shock, and mechanism of injury.

RESULTS

In total, 726 subjects were identified; 69% male, median (interquartile range [IQR]) ISS = 12 (5–25), and 83% had a blunt mechanism. On univariate analysis, there were significant differences in TEG α-angle (p < 0.001), MA (p = 0.004), and fibrinolysis 30 minutes after MA (LY30) (p = 0.01) between groups. In post hoc tests, the infant group had significantly greater α-angle (median, 77; IQR, 71–79) and MA (median, 64; IQR, 59–70) compared with other groups, while the adolescent group had significantly lower α-angle (median, 71; IQR, 67–74), MA (median, 60; IQR, 56–64), and LY30 (median, 0.8; IQR, 0.2–1.9) compared with other groups. There were no significant differences between toddler, early childhood, and middle childhood groups. On multivariate analysis, the relationship between age group and TEG values (α-angle, MA, and LY30) persisted after controlling for sex, ISS, GCS, shock, and mechanism of injury.

CONCLUSION

Age-associated differences in TEG profiles across pediatric age groups exist. Further pediatric-specific research is required to assess whether the unique profiles at extremes of childhood translate to differential clinical outcomes or responses to therapies in injured children.

LEVEL OF EVIDENCE

Prognostic and Epidemiological; Level IV.
The resuscitation-promoting factor (Rpf) from Micrococcus luteus and its putative reaction product 1,6-anhydro-MurNAc increase culturability of environmental bacteria
Authors: Guzman Juan , Raval Dipansi , Hauck Dirk , Titz Alexander , Poehlein Anja , Degenkolb Thomas , Daniel Rolf , Vilcinskas Andreas
Published: June 2023

Bacterial dormant cells do not divide and are not immediately culturable, but they persist in a state of low metabolic activity, a physiological state having latent clinical relevance, for instance in tuberculosis. Resuscitation promoting factors (Rpf) are proteins that act as signaling molecules mediating growth and replication. In this study we aimed to test the effect of Rpf on the number and diversity of cultured bacteria using insect and soil samples, and to examine if the increase in culturability could be reproduced with the putative reaction product of Rpf, 1,6-anhydro-MurNAc. The rpf gene from Micrococcus luteus was amplified and cloned into a pET expression vector and the protein was expressed in E. coli BL21(DE3) cells and purified by affinity chromatography using a hexa-histidine tag. 1,6-anhydro-N-acetylmuramic acid (1,6-anhydro-MurNAc) was prepared using reported chemical synthesis methods. Recombinant Rpf protein or 1,6-anhydro-MurNAc were added to R2A cultivation media, and their effect examined on the culturability of bacteria from eight environmental samples including four cockroach guts and four soils. Colony forming units, 16S rRNA gene copies and Illumina amplicon sequencing of the 16S rRNA were measured for all eight samples subjected to three different treatments: control, Rpf or 1,6-anhydro-MurNAc. Both Rpf and 1,6-anhydro-MurNAc increased the number of colony forming units, and 16S rRNA gene copies across the samples although the protein was more effective. The Rpf and 1,6-anhydro-MurNAc promoted the cultivation of a diverse set of bacteria and specially certain clades of the phyla Actinomycetota and Bacillota. This study opens the path for improved cultivation strategies aiming to isolate and study yet undescribed living bacterial organisms.
Streptomyces hilarionis sp. nov. and Streptomyces hayashii sp. nov., two new strains associated with potato scab in Brazil
Authors: Vitor Lucas , Amaral Danilo Trabuco , Corrêa Daniele Bussioli Alves , Ferreira-Tonin Mariana , Lucon Emanuel Torres , Appy Mariana Pereira , Tomaseto Alex Augusto , Destéfano Suzete Aparecida Lanza
Published: June 2023

Two new actinobacteria, designated strains IBSBF 2807Tand IBSBF 2953T, isolated from scab lesions on potato tubers grown in the southern Brazilian states of Rio Grande do Sul and Santa Catarina, respectively, were characterized and identified through a polyphasic approach. Phylogenetic analyses of 16S rRNA sequences revealed that these two strains belong to the genusStreptomyces. Multilocus sequence analysis using five concatenated genes,atpD,gyrB,recA,rpoBandtrpB, allocated strains IBSBF 2807Tand IBSBF 2953Tin distinct branches ofStreptomycesphytopathogenic strains. PCR-RFLP analysis of theatpDgene also confirmed that these strains differ from the type strains ofStreptomycesassociated with potato scab. The morphological, physiological and biochemical characterization, along with the overall genome-related index properties, indicated that these two strains could be distinguished from their closest phylogenetic relatives and each other. According to the data, IBSBF 2807Tand IBSBF 2953Trepresent two newStreptomycesspecies related to potato scab. The proposed names for these strains areStreptomyces hilarionissp. nov. (IBSBF 2807T=CBMAI 2674T=ICMP 24297T=MUM 22.66T) andStreptomyces hayashiisp. nov (IBSBF 2953T=CBMAI 2675T=ICMP 24301T=MUM 22.68T).