bluuebunny/crossref_metadata_2025 huggingface dataset:
Minimally Invasive Transforaminal Lumbar Interbody Fusion for 2-Level Degenerative Lumbar Disease in Patients With Osteoporosis: Long-Term Clinical and Radiographic Outcomes
Authors: Tsai Cheng-Yu , Su Yu-Feng , Kuo Keng-Liang , Ko Huey-Jiun , Su Hui-Yuan , Wu Chieh-Hsin , Chou Yu-lin , Lin Chih-Lung , Tsai Tai-Hsin
Published: February 2021

BACKGROUND

Spine fusion surgery in osteoporosis remains controversial because it is related to a high incidence of osteoporosis-related complications, such as cage nonfusion, pedicle screw loosening, and new vertebral compression fractures (VCFs).

OBJECTIVE

To treat 2-level degenerative lumbar disease in osteoporosis patients as an effective and safe surgical treatment for long-term results using minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF).

METHODS

We retrospectively assessed 12 patients with osteoporosis who underwent MIS-TLIF on L4 and L5 between 2011 and 2012 to assess the clinical and radiographic results for 2-level lumbar degenerative spine disease. All patients were followed-up for at least 2 yr after surgery and assessed by using X-ray. Basic patient data and clinical and radiological outcomes were collected and analyzed.

RESULTS

Of all 12 patients, 11/12 (91.6%) and 1/12 (8.3%) demonstrated cage fusion and cage subsidence, respectively. Pedicle screw loosening was found in 1/12 (8.3%) patients. The P-values calculated using the F-test for changes in the vertebral body height pre- and postoperation in L3, L4, and L5 were .69, .87, and .39, respectively. The data revealed no significant variants of new VCFs.

CONCLUSION

MIS-TLIF provided a high cage fusion rate and low pedicle screw loosening rate in patients with osteoporosis with 2-level degenerative spine disease. Furthermore, no new VCFs were found in long-term follow-up. The clinical outcomes also demonstrated no significant difference compared with traditional open spine fusion surgery. Therefore, MIS-TLIF could be considered an effective and safe surgical treatment modality for 2-level degenerative spine disease in osteoporosis.
A 1-Donor 2-Recipient Superficial Temporal Artery-Middle Cerebral Artery Bypass for Moyamoya Syndrome: 2-Dimensional Operative Video
Authors: Khan Nickalus R , Morcos Jacques J
Published: February 2021

We present the case of a 34-yr-old male who suffered repeated ischemic events resulting in right-sided weakness. He was found to have left M1 segment near occlusion on angiography with a large area of uncompensated hypoperfusion. The patient underwent a direct superficial temporal artery-middle cerebral artery (STA-MCA) bypass. Direct bypass in the acute setting of ischemia has been previously described.1–5
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5
Moyamoya ischemic disease can be treated with either direct or indirect surgical revascularization. There have been several techniques developed for direct bypasses in moyamoya ischemic disease. These include the standard 1-donor 1-recipient (1D1R) end-to-side (ES) bypass, the “double-barrel” 2-donor 2-recipient (2D2R) ES bypass, and the more recently developed 1-donor 2-recipient (1D2R)
6

,

7
utilizing both an ES and a side-to-side (SS) bypass with a 1-donor vessel. The case presentation, surgical anatomy, decision-making, operative nuances, and postoperative course and outcome are reviewed. The patient gave verbal consent for participating in the procedure and surgical video.
Microsurgical Resection and Stabilization of a Giant Spinal Schwannoma: 2-Dimensional Operative Video
Authors: Dimentberg Ryan , Glauser Gregory , Detchou Donald K , Vaughan Kerry A , Choudhri Omar
Published: February 2021

We illustrate the microsurgical resection of a giant lumbar spinal schwannoma in a 37-yr-old male who presented with worsening low back pain, weakness, and numbness and tingling in the bilateral legs and feet. Lumbar spine imaging demonstrated a large, heterogeneously enhancing intradural mass with notable bony erosion. Given the thinning of the pedicles, large tumor size, and bony remodeling, instrumentation was performed in addition to decompression, with direct stimulation-triggered electromyography and intraoperative neurophysiological monitoring. This video demonstrates the surgical technique for resection and accompanied reconstruction necessary for the management of these giant intradural lesions. Postoperatively, the patient had no complications, with improvement of neurological symptoms at follow-up. Though improved, the patient had some residual numbness at postoperative follow-up visit. The patient consented to the procedure.

This video was deemed Institutional Review Board (IRB) exempt by the University of Pennsylvania IRB, as it is considered a case report, which does not require IRB approval or patient consent.
Surgical Trapping of a Large Complex Middle Cerebral Artery Aneurysm With Double-Barrel Bypass: 3-Dimensional Operative Video
Authors: Chiluwal Amrit K , Nouri Mohsen , Knobel Denis , Dehdashti Amir R
Published: February 2021

Large middle cerebral artery (MCA) bifurcation aneurysms are known vascular lesions that are usually symptomatic but often difficult to treat (whether with open or endovascular techniques), especially when the M2 branches originate from the aneurysm dome.
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The challenge lies in securing the aneurysm while fully maintaining the flow in the vessels arising from the dome. Standard microsurgical clipping or endovascular techniques are not feasible in perfectly treating these aneurysms. Revascularization of the MCA branches with bypass and trapping of the aneurysm is often necessary. Here, we present a case of a large complex partially thrombosed right MCA bifurcation aneurysm with both the superior and the inferior divisions arising from the dome. The patient initially presented with a right MCA stroke and left hemiparesis. Using radial artery as an interposition graft, 2 bypasses—internal maxillary artery to the inferior division and superficial temporal artery to the superior division—were performed. The aneurysm was trapped and decompressed by placing clips at the M1 terminus and the M2 origins. Intraoperative angiography and postoperative NOVA (VasSol Inc.) magnetic resonance angiography (MRA) confirmed patency and excellent flow in the bypass grafts. The patient's postoperative course was uncomplicated, and at 2-mo follow-up, had significant improvement of her hemiparesis. The patient provided informed consent for the procedure.
Deserpentinization in Subduction Zones as a Source of Oxidation in Arcs: a Reality Check
Authors: Evans Katy A , Frost B Ronald
Published: February 2021

Previous studies have concluded that dehydration of serpentinites in subduction zones produces oxidizing fluids that are the cause of oxidized arc magmas. Here, observations of natural samples and settings are combined with thermodynamic models to explore some of the factors that complicate interpretation of the observations that form the basis of this conclusion. These factors include the variability of serpentinite protoliths, the roles of carbon and sulfur in serpentinite evolution, variability in serpentinization in different tectonic settings, changes in the bulk compositions of ultramafic rocks during serpentinization, fundamental differences between serpentinization and deserpentinization, and the absence of precise geothermobarometers for ultramafic rocks. The capacity of serpentinite-derived fluids to oxidize sub-arc magma is also examined. These fluids can transport redox budget as carbon-, sulfur-, and iron-bearing species. Iron- and carbon-bearing species might be present in sufficient concentrations to transport redox budget deep within subduction zones, but are not viable transporters of redox budget at the temperatures of antigorite breakdown, which produces the largest proportion of fluid released by serpentinite dehydration. Sulfur-bearing species can carry significant redox budget, and calculations using the Deep Earth Water (DEW) model show that these species might be stable during antigorite breakdown. However, oxygen fugacities of ∼ΔFMQ + 3 (where FMQ refers to the fayalite–magnetite–quartz buffer, and ΔFMQ is log fO2 – log fO2, FMQ), which is close to, or above, the hematite–magnetite buffer at the conditions of interest, are required to stabilize oxidized sulfur-bearing species. Pseudosection calculations indicate that these conditions might be attained at the conditions of antigorite breakdown if the starting serpentinites are sufficiently oxidized, but further work is required to assess the variability of serpentinite protoliths, metamorphic pressures and temperatures, and to confirm the relative positions of the mineral buffers with relation to changes in fluid speciation.
Heat shock protein 101 (HSP101) promotes flowering under nonstress conditions
Authors: Qin Feng , Yu Buzhu , Li Weiqi
Published: February 2021

Heat shock proteins (HSPs) are stress-responsive proteins that are conserved across all organisms. Heat shock protein 101 (HSP101) has an important role in thermotolerance owing to its chaperone activity. However, if and how it functions in development under nonstress conditions is not yet known. By using physiological, molecular, and genetic methods, we investigated the role of HSP101 in the control of flowering in Arabidopsis (Arabidopsis thaliana (L.) Heynh.) under nonstress conditions. Knockout and overexpression of HSP101 cause late and early flowering, respectively. Late flowering can be restored by rescue of HSP101. HSP101 regulates the expression of genes involved in the six known flowering pathways; the most negatively regulated genes are FLOWERING LOCUS C (FLC) and SHORT VEGETATIVE PHASE (SVP); downstream integrators of the flowering pathways are positively regulated. The late-flowering phenotype of loss-of-HSP101 mutants is suppressed by both the mutations of FLC and SVP. The responses of flowering time to exogenous signals do not change in HSP101 mutants. HSP101 is also found in nonspecific regions according to subcellular localization. We found that HSP101 promotes flowering under nonstress conditions and that this promotion depends on FLC and SVP. Our data suggest that this promotion could occur through a multiple gene regulation mechanism.
The serine/threonine/tyrosine kinase STY46 defends against hordeivirus infection by phosphorylating γb protein
Authors: Zhang Xuan , Wang Xueting , Xu Kai , Jiang Zhihao , Dong Kai , Xie Xialin , Zhang He , Yue Ning , Zhang Yongliang , Wang Xian-Bing , Han Chenggui , Yu Jialin , Li Dawei
Published: February 2021

Protein phosphorylation is a common post-translational modification that frequently occurs during plant–virus interaction. Host protein kinases often regulate virus infectivity and pathogenicity by phosphorylating viral proteins. The Barley stripe mosaic virus (BSMV) γb protein plays versatile roles in virus infection and the coevolutionary arms race between plant defense and viral counter-defense. Here, we identified that the autophosphorylated cytosolic serine/threonine/tyrosine (STY) protein kinase 46 of Nicotiana benthamiana (NbSTY46) phosphorylates and directly interacts with the basic motif domain (aa 19–47) of γb in vitro and in vivo. Overexpression of wild-type NbSTY46, either transiently or transgenically, suppresses BSMV replication and ameliorates viral symptoms, whereas silencing of NbSTY46 leads to increased viral replication and exacerbated symptom. Moreover, the antiviral role of NbSTY46 requires its kinase activity, as the NbSTY46T436A mutant, lacking kinase activity, not only loses the ability to phosphorylate and interact with γb but also fails to impair BSMV infection when expressed in plants. NbSTY46 could also inhibit the replication of Lychnis ringspot virus, another chloroplast-replicating hordeivirus. In summary, we report a function of the cytosolic kinase STY46 in defending against plant viral infection by phosphorylating a viral protein in addition to its basal function in plant growth, development, and abiotic stress responses.
Kinase SnRK1.1 regulates nitrate channel SLAH3 engaged in nitrate-dependent alleviation of ammonium toxicity
Authors: Sun Doudou , Fang Xianming , Xiao Chengbin , Ma Zhen , Huang Xuemei , Su Jingrong , Li Jia , Wang Jiafeng , Wang Suomin , Luan Sheng , He Kai
Published: February 2021

Nitrate (NO3−) and ammonium (NH4+) are major inorganic nitrogen (N) supplies for plants, but NH4+ as the sole or dominant N source causes growth inhibition in many plants, known as ammonium toxicity. Small amounts of NO3− can significantly mitigate ammonium toxicity, and the anion channel SLAC1 homolog 3 (SLAH3) is involved in this process, but the mechanistic detail of how SLAH3 regulates nitrate-dependent alleviation of ammonium toxicity is still largely unknown. In this study, we identified SnRK1.1, a central regulator involved in energy homeostasis, and various stress responses, as a SLAH3 interactor in Arabidopsis (Arabidopsis thaliana). Our results suggest that SNF1-related protein kinase 1 (SnRK1.1) functions as a negative regulator of SLAH3. Kinase assays indicate SnRK1.1 strongly phosphorylates the C-terminal of SLAH3 at the site S601. Under high-NH4+/low-pH condition, phospho-mimetic and phospho-dead mutations in SLAH3 S601 result in barely rescued phenotypes and fully complemented phenotypes in slah3. Furthermore, SnRK1.1 migrates from cytoplasm to nucleus under high-NH4+/low-pH conditions. The translocation of SnRK1.1 from cytosol to nucleus under high-ammonium stress releases the inhibition on SLAH3, which allows SLAH3-mediated NO3− efflux leading to alleviation of high-NH4+/low-pH stress. Our study reveals that the C-terminal phosphorylation also plays important role in SLAH3 regulation and provides additional insights into nitrate-dependent alleviation of ammonium toxicity in plants.
Building public trust in COVID-19 vaccines through the Catholic Church in the Philippines
Authors: Gopez Jose Ma W
Published: February 2021

Due to the expedited production of the COVID-19 vaccines and other issues related to it, many Filipinos are hesitant to receive the inoculation program set by the government. Because of this, it is crucial to gain public trust for the COVID-19 vaccines. This paper argues that the Catholic Church, being an influential institution in the Philippines, can help in building public trust in COVID-19 vaccines in the country.
The Micro-Level Anatomy of the Labor Share Decline*
Authors: Kehrig Matthias , Vincent Nicolas
Published: February 2021

The labor share in U.S. manufacturing declined from 61% in 1967 to 41% in 2012. The labor share of the typical U.S. manufacturing establishment, in contrast, rose by over 3 percentage points during the same period. Using micro-level data, we document five salient facts: (i) since the 1980s, there has been a dramatic reallocation of value added toward the lower end of the labor share distribution; (ii) this aggregate reallocation is not due to entry/exit, to “superstars” growing faster, or to large establishments lowering their labor shares, but is instead due to units whose labor share fell as they grew in size; (iii) low labor share (LL) establishments benefit from high revenue labor productivity, not low wages; (iv) they also enjoy a product price premium relative to their peers; and (v) they have only temporarily lower labor shares that rebound after five to eight years. This transient pattern has become more pronounced over time, and the dynamics of value added and employment are increasingly disconnected. Taken together, we interpret these facts as pointing to a significant role for demand-side forces.
Self-face and emotional faces—are they alike?
Authors: Żochowska Anna , Nowicka Maria M , Wójcik Michał J , Nowicka Anna
Published: February 2021

The image of one’s own face is a particularly distinctive feature of the self. The self-face differs from other faces not only in respect of its familiarity but also in respect of its subjective emotional significance and saliency. The current study aimed at elucidating similarities/dissimilarities between processing of one’s own face and emotional faces: happy faces (based on the self-positive bias) and fearful faces (because of their high perceptual saliency, a feature shared with self-face). Electroencephalogram data were collected in the group of 30 participants who performed a simple detection task. Event-related potential analyses indicated significantly increased P3 and late positive potential amplitudes to the self-face in comparison to all other faces: fearful, happy and neutral. Permutation tests confirmed the differences between the self-face and all three types of other faces for numerous electrode sites and in broad time windows. Representational similarity analysis, in turn, revealed distinct processing of the self-face and did not provide any evidence in favour of similarities between the self-face and emotional (either negative or positive) faces. These findings strongly suggest that the self-face processing do not resemble those of emotional faces, thus implying that prioritized self-referential processing is driven by the subjective relevance of one’s own face.
Sleep and mental health in athletes during COVID-19 lockdown
Authors: Facer-Childs Elise R , Hoffman Daniel , Tran Jennie N , Drummond Sean P A , Rajaratnam Shantha M W
Published: February 2021

The global coronavirus 19 (COVID-19) pandemic and associated lockdown restrictions resulted in the majority of sports competitions around the world being put on hold. This includes the National Basketball Association, the UEFA Champions League, Australian Football League, the Tokyo 2020 Olympic Games, and regional competitions. The mitigation strategies in place to control the pandemic have caused disruption to daily schedules, working environments, and lifestyle factors. Athletes rely on regular access to training facilities, practitioners, and coaches to maintain physical and mental health to achieve maximal performance and optimal recovery. Furthermore, participation in sport at any level increases social engagement and promotes better mental health. It is, therefore, critical to understanding how the COVID-19 pandemic and associated lockdown measures have affected the lives of athletes. We surveyed elite and sub-elite athletes (n = 565) across multiple sports. Significant disruptions were reported for all lifestyle factors including social interactions, physical activity, sleep patterns, and mental health. We found a significant increase in total sleep time and sleep latency, as well as a delay in mid-sleep times and a decrease in social jetlag. Training frequency and duration significantly decreased. Importantly, the changes to training and sleep-related factors were associated with mental health outcomes. With spikes in COVID-19 cases rising around the world and governments reinstituting lockdowns (e.g. United Kingdom; Melbourne, Australia; California, USA) these results will inform messaging and strategies to better manage sleep and mental health in a population for whom optimal performance is critical.
Nutritional value of some raw materials for guinea pigs (Cavia porcellus) feeding
Authors: Castro-Bedriñana Jorge , Chirinos-Peinado Doris
Published: February 2021

To formulate economically viable foods and achieve high performance in guinea pig production, it is important to know the nutritional value of the feeds, which requires determining their chemical composition, availability of nutrients, and energy content. Chemical analysis, digestibility tests, and digestible energy (DE) and metabolizable energy (ME) content of 63 feeds were determined using male guinea pigs of 4–5 mo of age. The test feeds were fodder, agricultural residues, agro-industrial and kitchen waste, energy flours, and protein flours of animal and vegetable origin. The result showed wide variability in the chemical composition and energy density of the feeds evaluated. In the case of forages, the main feed source for the guinea pigs, the average contents ± SD of crude protein (CP), crude fiber (CF), organic matter (OM), DE, and ME were 18.06 ± 6.50%, 23.08 ± 7.14%, 89.95 ± 2.62%, 2963.71 ± 442.68, and 2430.24 ± 363.00 kcal/kg; for the agro-industrial and kitchen waste, the values were 11.52 ± 4.72%, 22.80 ± 14.61%, 91.37 ± 4.74%, 3006.31 ± 554.01, and 2465.18 ± 454.29 kcal/kg; for protein feeds, the values were 55.18 ± 22.87%, 5.11 ± 5.72%, 91.18 ± 6.92%, 3681.94 ± 433. 24, and 3019.19 ± 355.26 kcal/kg; for energy feeds, the values were 12.73 ± 3.22%, 5.46 ± 1.96%, 95.33 ± 3.32%, 3705.41 ± 171.78, and 3038.43 ± 140.86 kcal/kg. The ME content is directly associated with CP content (R2 = 0.19) and OM digestibility (R2 = 0.56) and inversely with CF (R2 = 0.40) and ash (R2 = 0.13) content (P < 0.01). The results of this study can be used to design feeding programs for family and commercial guinea pig production for meat.
Smokers with and without Epilepsy show Similar Smoking Rate, Dependence Level, Cessation Attempts, and Motives
Authors: Johnson Adrienne L , McLeish Alison C , Shear Paula K , Privitera Michael , Luberto Christina M
Published: February 2021

Background

Individuals with epilepsy are up to twice as likely to be current cigarette smokers compared to those without. Moreover, one study showed current smoking is associated with an increased likelihood of seizures. However, outside of this one study, there is limited data on the presentation of specific smoking-related behaviors and cognitions in people with epilepsy, inhibiting our understanding of the severity of this behavior and our ability to formulate effective treatments for this population.

Purpose

The current study examined smoking-related behaviors and cognitions among smokers with epilepsy compared to smokers without epilepsy.

Methods

Participants were 43 smokers with (Mage = 43.4, SD = 11.6) and 43 smokers without (Mage = 45.5, SD = 8.8) epilepsy recruited from an urban, academic setting within the U.S. Separate Analyses of Covariance (ANCOVAs) were conducted to evaluate differences between smokers with and without epilepsy in terms of smoking behavior (i.e., daily smoking rate, nicotine dependence, number of quit attempts, smoking duration, age of smoking onset) and smoking-related cognitive processes (i.e., smoking motives, perceived barriers to smoking cessation, cessation motives) after controlling for race and problematic alcohol use.

Results

Smokers with epilepsy did not differ from smokers without epilepsy in terms of smoking rate (p = .51, ηp2 = .01), nicotine dependence (p = .12, ηp2 = .03), age of smoking onset (p = .42, ηp2 = .01), number of quit attempts (p = .43, ηp2 = .01), barriers to cessation (p = .30 to .80, ηp2 = .00 to .01), or cessation motives (p = .28 to .60, ηp2 = .00 to .02). Smokers without epilepsy reported higher levels of smoking for sensorimotor manipulation reasons (p = .03, ηp2 = .06) and longer smoking duration (p = .03, ηp2 = .06) than smokers with epilepsy.

Conclusions

Smokers with epilepsy do not appear to differ significantly from smokers without epilepsy in terms of smoking-related behaviors and cognitions, and may therefore benefit from current evidence-based treatments for smoking cessation that are not contraindicated for epilepsy (i.e., bupropion, varenicline).
CaWRKY28 Cys249 is Required for Interaction with CaWRKY40 in the Regulation of Pepper Immunity to Ralstonia solanacearum
Authors: Yang Sheng , Zhang Yangwen , Cai Weiwei , Liu Cailing , Hu Jiong , Shen Lei , Huang Xueying , Guan Deyi , He Shuilin
Published: February 2021

WRKY transcription factors have been implicated in plant response to pathogens but how WRKY-mediated networks are organized and operate to produce appropriate transcriptional outputs remains largely unclear. Here, we identify a member of the WRKY family from pepper (Capsicum annuum), CaWRKY28, that physically interacts with CaWRKY40, a positive regulator of pepper immunity and thermotolerance. We confirmed CaWRKY28–CaWRKY40 interaction by coimmunoprecipitation, bimolecular fluorescence complementation, and microscale thermophoresis. Our findings supported the idea that CaWRKY28 is a nuclear protein that acts as positive regulator in pepper responses to infection by the pathogenic bacterium Ralstonia solanacearum. It performs its function not by directly modulating the W-box containing immunity-related genes but by promoting CaWRKY40 via physical interaction to bind and activate its immunity-related target genes, including CaPR1, CaNPR1, CaDEF1, and CaABR1, but not its thermotolerance-related target gene, CaHSP24. All of these data indicate that CaWRKY28 interacts with and potentiates CaWRKY40 in regulating immunity against R. solanacearum infection but not thermotolerance. Importantly, we discovered that CaWRKY28 Cys249, shared by CaWRKY28 and its orthologs probably only in the family Solanaceae, is crucial for the CaWRKY28–CaWRKY40 interaction. These results highlight how CaWRKY28 associates with CaWRKY40 during the establishment of WRKY networks, and how CaWRKY40 achieves its functional specificity during pepper responses to R. solanacearum infection.

[Formula: see text] Copyright © 2021 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Cobalt–Chromium Alloy Has Superior Antibacterial Effect Than Titanium Alloy
Authors: Watanabe Kota , Fukuzaki Satoshi , Sugino Atsushi , Benson Nicholas , Metcalf Newt , Nakamura Masaya , Matsumoto Morio
Published: February 2021

Study Design.

In vitro and in vivo laboratory studies.

Objective.

This study aimed to compare bacterial survival on titanium alloy (Ti) and cobalt–chromium alloy (CC) using in vitro and in vivo experiments.

Summary of Background Data.

Spinal implants are frequently manufactured from Ti and CC. These foreign materials are thought to be susceptible to biofilm formation that contributes to the development of surgical site infections. Certain metals (i.e., silver, cobalt) are known to have antibacterial properties.

Methods.

In the in vitro study, discs made of Ti or CC were incubated with one of two common bacteria: Staphylococcus aureus (S. aureus) and Propionibacterium acnes (P. acnes). After incubation, discs were assessed to determine the number of viable bacterial cells. In the in vivo study, the discs that were made of CC or Ti were implanted into the subcutaneous layer of BALB/c mice. After skin closure, a suspension including either S. aureus or P. acnes was directly inoculated on the implanted discs. The discs were retrieved and analyzed to determine the number of viable bacteria at 0.5, 1, and 3 days after inoculation.

Results.

The number of viable S. aureus cultured from the CC discs was 0.9 ± 0.2 × 103 CFU/disc, which was significantly lower than the cultured Ti discs (114.8 ± 18.3 × 103 CFU/disc). Moreover, a significantly lower mean number of P. acnes were cultured with CC (1.9 ± 1.2 × 103 CFU/disc) compared with the Ti (180.0 ± 72.1 × 103 CFU/disc). The in vivo infection model testing against S. aureus or P. acnes showed a significantly lower number of viable S. aureus or P. acnes on CC discs than Ti discs. The result was seen at all measured time points.

Conclusion.

CC suppressed S. aureus and P. acnes proliferation compared with Ti in vitro and in an in vivo infection model.

Level of Evidence: N/A
When Indirect Decompression Fails
Authors: Morgan Clinton D. , Walker Corey T. , Godzik Jakub , Ohiorhenuan Ifije E. , Catapano Joshua S. , Hemphill Courtney , Uribe Juan S.
Published: February 2021

Study Design.

A consecutive series of patients who underwent minimally invasive spinal surgery by a single surgeon at a high-volume academic medical center were studied.

Objective.

The objective of this study was to identify the prevalence, radiographic features, and clinical characteristics of patients who require unplanned secondary decompressive laminectomy or foraminotomy after lateral lumbar interbody fusion (LLIF).

Summary of Background Data.

LLIF indirectly decompresses the spinal canal, lateral recess, and neural foramen when properly performed. However, indirect decompression relies on endplate integrity, reasonable bone quality, and sufficient contralateral release so that ligament distraction can occur. Some patients have insufficient decompression, resulting in persistent axial low back pain or radiculopathy.

Methods.

Patients undergoing LLIF for radiculopathy or refractory low back pain were enrolled in a prospective registry. Preoperative and postoperative imaging, clinical presentation, and operative reports were reviewed from this registry.

Results.

During registry collection, 122 patients were enrolled (220 lumbar levels treated), with nearly even representation between men (64/122, 52.5%) and women (58/122, 47.5%). Overall, right-sided lumbar spinal approaches (74/122, 60.7%) were more common. Ultimately, 4.1% (five of 122) of patients required unplanned direct decompressive laminectomy or foraminotomy because of refractory radiculopathy and persistent radiographic evidence of compression at the index LLIF level. All patients for whom indirect decompression failed were men who underwent stand-alone LLIF and had radiculopathy contralateral to the side of the LLIF approach. Most patients (59.8%, 73/122) had evidence of graft subsidence (grade 0 or 1) or osteoporosis.

Conclusion.

We report a 4.1% rate of return to the operating room for failed indirect decompression after LLIF for refractory radiculopathy. Graft subsidence and osteoporosis were common in these patients. All five patients who required secondary decompressive laminectomy or foraminotomy underwent stand-alone primary LLIF, and the persistent radiculopathy was consistently contralateral to the initial side of the LLIF approach.

Level of Evidence: 4
Do Author Conflicts of Interest and Industry Sponsorship Influence Outcomes of Systematic Reviews and Meta-Analyses Regarding Glaucoma Interventions? A Cross-sectional Analysis
Authors: Wise Audrey , Mannem Deepika , Anderson Jon Michael , Weaver Michael , Hartwell Micah , Vassar Matt
Published: February 2021

Précis:

In our sample of systematic reviews focusing on treatments for glaucoma, reviews conducted by authors with a conflict of interest were more likely to reach favorable conclusions compared with reviews without conflicted authors.

Purpose:

Previous studies have demonstrated that authors’ conflict of interest can influence outcomes of systematic reviews. Therefore, we aimed to determine whether the presence of 1 of more conflicts was associated with more favorable results and conclusions in systematic reviews of glaucoma interventions.

Materials and Methods:

MEDLINE and Embase were searched for systematic reviews of glaucoma treatments published between September 1, 2016 and June 2, 2020. Author conflicts of interest were located using multiple databases (eg, CMS Open Payments Database, Dollars for Profs, Google Patents, the United States Patent and Trademark Office USPTO) and previously published disclosure statements. Study sponsorship was determined using each review’s funding disclosure statement.

Results:

Our study included 26 systematic reviews conducted by 108 authors. Of these reviews, 9 (35%) were conducted by at least 1 author with an undisclosed conflict of interest. Of those 9, 3 (33%) reported results favoring the treatment group, and 5 (56%) reported conclusions favoring the treatment group. Of the 17 systematic reviews with no conflicted authors, 1 (6%) reported results favoring the treatment group, and 2 (12%) reported conclusions favoring the treatment group. The Fisher exact tests demonstrated that these differences held a statistically significant association between author conflicts and the favorability of the reviews’ conclusions toward the treatment group (P=0.04).

Conclusions:

We found that systematic reviews conducted by 1 or more authors with conflicts of interest were more likely than those with no conflicted authors to draw favorable conclusions about the investigated intervention.
Ten-Year Clinical Outcomes of Acute Primary Angle Closure Randomized to Receive Early Phacoemulsification Versus Laser Peripheral Iridotomy
Authors: Chan Poemen P. , Tang Fang Y. , Leung Dexter Y. , Lam Thomas C. , Baig Nafees , Tham Clement C.
Published: February 2021

Purpose:

To compare the 10-year clinical outcomes of eyes with acute primary angle closure (APAC) randomized to receive either early phacoemulsification or laser peripheral iridotomy (LPI).

Methods:

Sixty-two APAC patients, who underwent either early phacoemulsification (phaco group) or laser peripheral iridotomy (LPI group) in a previous randomized controlled trial, were invited for assessment 10 years after the interventions. The results of the 2 groups were compared.

Results:

Forty of 62 patients (64.5%; 19 in phaco group and 21 from LPI group) were examined. None of them underwent additional glaucoma procedure but 15 (71.4%) patients in the LPI group received lens extraction before this assessment. The mean follow-up duration was 10.7±0.7 years. The phaco group used less medication (0.16±0.37 vs. 0.76±1.09 bottle per eye, P=0.028), had less extensive anterior synechiae (120.0±116.12 vs. 244.3±139.8 degree, P=0.010), and greater mean Shaffer gonioscopy grading (1.79±0.84 vs. 1.40±0.87; P=0.021) than the LPI group. Five eyes had persistent intraocular pressure elevation of >21 mm Hg in 2 consecutive visits and 4 eyes had blindness (best-corrected visual acuity worse than 6/60 and/or central visual field of <20 degree) in the LPI group, compared with none in the phaco group (P=0.022 and 0.045, respectively). There was no significant difference in the mean intraocular pressure, best-corrected visual acuity, and the number of eyes with visual field progression.

Conclusion:

At 10 years, APAC eyes that underwent early phacoemulsification required less medication, less peripheral anterior synechiae, lower incidence of intraocular pressure elevation and a lower incidence of blindness compared with APAC eyes that underwent initial LPI.
Novel Pedagogical Training for Nursing Doctoral Students in Support of Remote Learning
Authors: Burton Candace W. , Rodrigues Sarah M. , Jones-Patten Alexandria E. , Ju Eunae , Abrahim Heather L. , Saatchi Babak , Wilcox Stephen P. , Bender Miriam
Published: February 2021

Background

The need for faculty to educate prospective nurses is urgent: without sufficient nursing faculty, schools regularly reject qualified applicants, despite an increasing need for nurses. At the same time, many graduate-prepared nurses lack preparation in teaching and pedagogical frameworks.

Problem

Literature on how PhD programs in nursing prepare graduates for teaching indicates that there is typically more emphasis on research than pedagogical learning.

Approach

With the shift to remote learning under the COVID-19 pandemic, the University of California Irvine created a Graduate Fellows program to provide support to faculty while offering graduate students education in pedagogy and remote learning.

Outcomes

Fellows were satisfied and reported increased understanding of challenges in teaching and increasing comfort with nurse faculty roles.

Conclusions

The collaborative efforts of fellows and faculty provided important resources at a critical time, and insights gained can inform similar projects in nursing faculty development.
Localized Peritumoral AL Amyloidosis Associated With Mantle Cell Lymphoma With Plasmacytic Differentiation
Authors: Yabe Mariko , Ozkaya Neval , de Jong Daphne , Aypar Umut , Ritorto M. Stella , Barbé Ellis , Miedema Iris H.C. , Sen Filiz , Chapman Jessica R. , Landau Heather J. , Dogan Ahmet
Published: February 2021

Immunoglobulin light chain (AL) amyloidosis is characterized by the deposition of amyloid fibers derived from pathologic immunoglobulin light chains. Although systemic plasma cell neoplasms are the most common cause of AL amyloidosis, a subset of cases is caused by B-cell lymphoproliferative disorders such as lymphoplasmacytic lymphoma or extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue. Recently, SOX11-negative IGH hypermutated mantle cell lymphoma (MCL) is recognized to show frequent plasmacytic differentiation and indolent clinical course. Here, we report 3 cases of peritumoral AL amyloidosis associated with SOX11-negative MCL. All 3 cases showed cyclin D1 expression by immunohistochemistry and CCND1 translocation as detected by fluorescence in situ hybridization analysis. Peritumoral AL amyloidosis was observed at the biopsy sites in the gastrointestinal tract, a supraclavicular lymph node, and a cervical lymph node, and all presented with marked plasmacytic differentiation of lymphoma cells. None of the cases showed evidence of bone marrow involvement by morphology and immunophenotyping. None of the patients had distant organ involvement with systemic amyloidosis. All 3 patients had an indolent clinical course and are alive with disease at the time of the last follow-up (range: 48 to 74 mo). Our findings show that MCL with plasmacytic differentiation can cause amyloid deposition and CCND1 abnormalities should be performed in all cases of extramedullary AL amyloidosis. Recognition of indolent MCL as a cause of peritumoral AL amyloidosis may have important clinical management implications.
The Predictive Value of Health Anxiety for Cancer Incidence and All-Cause Mortality: A 44-Year Observational Population Study of Women
Authors: Sigström Robert , Hällström Tore , Waern Margda , Skoog Ingmar
Published: February 2021

Objective

Long-term data concerning mortality and serious illness as a function of health anxiety are scarce. We aimed to study health anxiety in relation to long-term mortality and cancer morbidity among women.

Methods

A Swedish population sample of women (n = 770; ages, 38–54 years) took part in a general medical and psychiatric examination in 1968 to 1969 and were followed up until 2013 in national Swedish registries for all-cause mortality and first diagnosis of cancer. A modified version of the Whiteley Index questionnaire (maximum score, 12) was used to measure health anxiety. Scores were trichotomized based on quartiles as no (score 0, lowest quartile), mild-moderate (score 1–2, middle quartiles), and high (score ≥3, highest quartile) health anxiety. Risks of death and cancer were evaluated with Cox regression models.

Results

Compared with women with mild-moderate health anxiety levels, women with no health anxiety had a higher risk of death (age-adjusted hazard ratio [HR] = 1.22, 95% confidence interval [CI] = 1.00–1.49; fully adjusted for baseline sociodemographic, mental, and physical health variables: HR, 1.44, 95% CI = 1.17–1.76). Women with high health anxiety levels had a greater risk of death in age-adjusted analysis (HR = 1.26, 95% CI = 1.04–1.54; fully adjusted HR = 1.21, 95% CI = 0.98–1.49). For both groups, the mortality risk was time dependent and declined during follow-up. We observed no between-group differences in the risk of cancer.

Conclusions

In this population-based cohort of midlife women, health anxiety was moderately associated with mortality in a U-shaped fashion. Absence of health anxiety entailed the greatest risk when other factors were taken into account.
Pharmacokinetics, Dialysability, and Safety of Gadopiclenol, a New Gadolinium-Based Contrast Agent, in Patients With Impaired Renal Function
Authors: Bradu Andrei , Penescu Mircea , Pitrou Camille , Hao Jing , Bourrinet Philippe
Published: February 2021

Objectives

The aims of this study were to evaluate the pharmacokinetics (PK) of gadopiclenol, a new macrocyclic gadolinium based-contrast agent, in subjects with impaired renal function, and to assess its dialysability in subjects with end-stage renal disease (ESRD).

Methods and Materials

This 2-center, open-label, phase 1 study included 5 successive cohorts of 8 adult subjects: healthy subjects (cohort 1), subjects with mild (cohort 2), moderate (cohort 3), severe (cohort 4) renal impairment, or ESRD (cohort 5), who received a single intravenous injection of gadopiclenol (0.1 mmol/kg). Blood and urine samples were collected at different time points in cohorts 1 to 4, and blood and dialysate samples were collected at each hemodialysis session (4-hour session on day 1, day 3, and day 5) in cohort 5. Gadopiclenol elimination and safety were assessed for up to 6 months. Pharmacokinetics parameters were calculated using noncompartmental analysis.

Results

A total of 40 subjects were included, with a mean age of 51.5 years (range, 18–71 years). No significant difference in the mean maximum concentration values and the distribution volume was observed among cohorts 1 to 4. Urinary excretion of unchanged gadopiclenol was delayed with the degree of renal impairment and ranged between 96% and 84% in subjects with mild to severe renal impairment. Compared with that of healthy subjects, the mean area under the plasma concentration curve was 54%, 148%, and 769% higher in subjects with mild, moderate, or severe renal impairment, respectively. The mean terminal half-life was prolonged with the degree of renal impairment (1.9, 3.3, 3.8, and 11.7 hours for cohorts 1–4). In ESRD subjects, gadopiclenol was effectively removed from the plasma (95% to 98%) after the first hemodialysis session. Gadopiclenol concentration in plasma was below the limit of quantification for all subjects after the second hemodialysis session. Gadopiclenol concentration was below limit of quantification in all plasma and urine samples collected at 1, 3, and 6 months. Five subjects (12.5%) experienced adverse events related to gadopiclenol, none serious and all resolved. Laboratory measurements, vital signs, and electrocardiography did not raise any safety concern.

Conclusions

Gadopiclenol elimination half-life was prolonged in subjects with mild to severe renal impairment, yet its renal clearance remains complete or nearly complete. In ESRD subjects, gadopiclenol was effectively removed from the plasma after 1 hemodialysis session, and up to 3 hemodialysis sessions were sufficient to completely clear it. No safety concern was raised. Therefore, no dose adjustment seems necessary in this patient population.
Mandible Fractures Associated With the Introduction of an E-Scooter-Sharing System
Authors: Lentzen Max-Philipp , Grandoch Andrea , Buller Johannes , Kreppel Matthias , Zöller Joachim E. , Zirk Matthias
Published: February 2021

With the introduction of an e-scooter-sharing system in Germany, standing electric scooters became popular modes of transportation in many urban areas. But the increase in popularity has resulted in an increase in traumatic injuries associated with e-scooter accidents. The purpose of this investigation was to determine the common fracture pattern of patients with mandible fractures as a result of an electric scooter accident. The authors performed a retrospective investigation of 52 patients who were admitted to the trauma unit of an oral and maxillofacial department from June until November 2019 with a fracture of the mandible. Our study investigated the first 6 months of e-scooter sharing system in a major city with more than 1 million inhabitants. Our cohort consists of 52 patients, 38 males, and 14 females with a mean age of 37 years. E-scooter related mandible fractures were with 21% the third biggest group, after physical assault and falls. 45% of these patients were intoxicated by alcohol. Furthermore, the majority of e-scooter patients presented more than one fracture of the mandible (73%). For our cohort, a typical combination of a symphysis or body fracture and bilateral affected ramus and/or condyle was the prevalent recorded fracture combination (55%) of e-scooter related traumata. Small scooter wheels, a speed of 15 miles or 20 kilometers per hour and the individual clinging to the handlebar falling predestinate these vehicles for accidents with craniofacial trauma. Among all cranio-facial traumas mandible fractures were mostly documented for e-scooter accidents. The severity of e-scooter related mandible fractures and their fracture pattern should be recognized by trauma units.
Individuality, self and sociality of vascular plants
Authors: Baluška František , Mancuso Stefano
Published: February 2021

Vascular plants are integrated into coherent bodies via plant-specific synaptic adhesion domains, action potentials (APs) and other means of long-distance signalling running throughout the plant bodies. Plant-specific synapses and APs are proposed to allow plants to generate theirselfidentities having unique ways of sensing and acting as agents with their own goals guiding their future activities. Plants move their organs with a purpose and with obvious awareness of their surroundings and require APs to perform and control these movements. Self-identities allow vascular plants to act as individuals enjoying sociality via their self/non-self-recognition and kin recognition. Flowering plants emerge as cognitive and intelligent organisms when the major strategy is to attract and control their animal pollinators as well as seed dispersers by providing them with food enriched with nutritive and manipulative/addictive compounds. Their goal in interactions with animals is manipulation for reproduction, dispersal and defence.

This article is part of the theme issue ‘Basal cognition: multicellularity, neurons and the cognitive lens’.
The chemical brain hypothesis for the origin of nervous systems
Authors: Jékely Gáspár
Published: February 2021

In nervous systems, there are two main modes of transmission for the propagation of activity between cells. Synaptic transmission relies on close contact at chemical or electrical synapses while volume transmission is mediated by diffusible chemical signals and does not require direct contact. It is possible to wire complex neuronal networks by both chemical and synaptic transmission. Both types of networks are ubiquitous in nervous systems, leading to the question which of the two appeared first in evolution. This paper explores a scenario where chemically organized cellular networks appeared before synapses in evolution, a possibility supported by the presence of complex peptidergic signalling in all animals except sponges. Small peptides are ideally suited to link up cells into chemical networks. They have unlimited diversity, high diffusivity and high copy numbers derived from repetitive precursors. But chemical signalling is diffusion limited and becomes inefficient in larger bodies. To overcome this, peptidergic cells may have developed projections and formed synaptically connected networks tiling body surfaces and displaying synchronized activity with pulsatile peptide release. The advent of circulatory systems and neurohemal organs further reduced the constraint imposed on chemical signalling by diffusion. This could have contributed to the explosive radiation of peptidergic signalling systems in stem bilaterians. Neurosecretory centres in extant nervous systems are still predominantly chemically wired and coexist with the synaptic brain.

This article is part of the theme issue ‘Basal cognition: multicellularity, neurons and the cognitive lens’.