bluuebunny/crossref_metadata_2025 huggingface dataset:
High heart rate amplifies the risk of cardiovascular mortality associated with elevated uric acid
Authors: Palatini Paolo , Parati Gianfranco , Virdis Agostino , Reboldi Gianpaolo , Masi Stefano , Mengozzi Alessandro , Casiglia Edoardo , Tikhonoff Valerie , Cicero Arrigo F G , Ungar Andrea , Rivasi Giulia , Salvetti Massimo , Barbagallo Carlo M , Bombelli Michele , Dell’Oro Raffaella , Bruno Berardino , Lippa Luciano , D’Elia Lanfranco , Verdecchia Paolo , Angeli Fabio , Mallamaci Francesca , Cirillo Massimo , Rattazzi Marcello , Cirillo Pietro , Gesualdo Loreto , Mazza Alberto , Giannattasio Cristina , Maloberti Alessandro , Volpe Massimo , Tocci Giuliano , Georgiopoulos Georgios , Iaccarino Guido , Nazzaro Pietro , Galletti Ferruccio , Ferri Claudio , Desideri Giovambattista , Viazzi Francesca , Pontremoli Roberto , Muiesan Maria Lorenza , Grassi Guido , Borghi Claudio ,   from the Working Group on Uric Acid and Cardiovascular Risk of the Italian Society of Hypertension (SIIA)
Published: January 2021

Aims 

Whether the association between uric acid (UA) and cardiovascular disease is influenced by some facilitating factors is unclear. The aim of this study was to investigate whether the risk of cardiovascular mortality (CVM) associated with elevated UA was modulated by the level of resting heart rate (HR).

Methods and results 

Multivariable Cox analyses were made in 19 128 participants from the multicentre Uric acid Right for heArt Health study. During a median follow-up of 11.2 years, there were 1381 cases of CVM. In multivariable Cox models both UA and HR, either considered as continuous or categorical variables were independent predictors of CVM both improving risk discrimination (P ≤ 0.003) and reclassification (P < 0.0001) over a multivariable model. However, the risk of CVM related to high UA (≥5.5 mg/dL, top tertile) was much lower in the subjects with HR <median [71.3 b.p.m., adjusted hazard ratio 1.38, 95% confidence interval (CI) 1.20–1.59] than in those with HR ≥median [2.09 (95% CI 1.75–2.51)]. In the participants stratified by HR tertile, the risk related to hyperuricaemia was 2.38 (95% CI 1.82–3.10) in people with HR ≥76 b.p.m. and was 1.24 (95% CI 0.92–1.67) in those with HR <66 b.p.m. Similar results were obtained in the hypertensive patients, in the participants ≥65 years, and in the subjects not taking beta-blockers.

Conclusion 

This data suggest that the contribution of UA to determining CVM is modulated by the level of HR supporting the hypothesis that activation of the sympathetic nervous system facilitates the action of UA as a cardiovascular risk factor.
MAD and Taboo: US Expert Views on Nuclear Deterrence, Coercion, and Non-Use Norms
Authors: Avey Paul C
Published: January 2021

This research note reports views on nuclear deterrence, coercion, and non-use norms from surveys of 320 current and former US national security officials and 1,303 US-based international relations scholars. It finds that both groups hold relatively optimistic views on these key issues. Majorities express confidence that nuclear weapons are useful for deterrence, but are skeptical that a nuclear arsenal can translate into coercive foreign policy success. Respondents are also confident that the nuclear taboo constrains countries from using nuclear weapons in a first strike, but the intensity varies by the country in question. Although limited, the results demonstrate overlap between academics and policymakers on key nuclear concepts. To the extent that experts hold these topline nuclear views that can influence their decision-making, teaching, and research. The results also point to a common tension in thinking about deterrence against conventional attack and norms constraining nuclear first use.
Transcriptome annotation in the cloud: complexity, best practices, and cost
Authors: Alvarez Roberto Vera , Mariño-Ramírez Leonardo , Landsman David
Published: January 2021

Background

The NIH Science and Technology Research Infrastructure for Discovery, Experimentation, and Sustainability (STRIDES) initiative provides NIH-funded researchers cost-effective access to commercial cloud providers, such as Amazon Web Services (AWS) and Google Cloud Platform (GCP). These cloud providers represent an alternative for the execution of large computational biology experiments like transcriptome annotation, which is a complex analytical process that requires the interrogation of multiple biological databases with several advanced computational tools. The core components of annotation pipelines published since 2012 are BLAST sequence alignments using annotated databases of both nucleotide or protein sequences almost exclusively with networked on-premises compute systems.

Findings

We compare multiple BLAST sequence alignments using AWS and GCP. We prepared several Jupyter Notebooks with all the code required to submit computing jobs to the batch system on each cloud provider. We consider the consequence of the number of query transcripts in input files and the effect on cost and processing time. We tested compute instances with 16, 32, and 64 vCPUs on each cloud provider. Four classes of timing results were collected: the total run time, the time for transferring the BLAST databases to the instance local solid-state disk drive, the time to execute the CWL script, and the time for the creation, set-up, and release of an instance. This study aims to establish an estimate of the cost and compute time needed for the execution of multiple BLAST runs in a cloud environment.

Conclusions

We demonstrate that public cloud providers are a practical alternative for the execution of advanced computational biology experiments at low cost. Using our cloud recipes, the BLAST alignments required to annotate a transcriptome with ∼500,000 transcripts can be processed in <2 hours with a compute cost of ∼$200–$250. In our opinion, for BLAST-based workflows, the choice of cloud platform is not dependent on the workflow but, rather, on the specific details and requirements of the cloud provider. These choices include the accessibility for institutional use, the technical knowledge required for effective use of the platform services, and the availability of open source frameworks such as APIs to deploy the workflow.
Hair Analysis of Methoxphenidine in a Forensic Chemsex Case
Authors: Goncalves Ruben , Castaing Nadege , Titier Karine , Dumestre-Toulet Véronique
Published: January 2021

Methoxphenidine (MXP, 2-MeO-diphenidine) is a dissociative anesthetic drug of the diarylethylamine type, recently introduced for recreational purposes through the online-based sale of new psychoactive substances (NPSs). The concentration of MXP in hair has never been reported, either in cases of chemsex use or in fatal cases. A 55-year-old man was found dead at his home the morning after a chemsex party. Toxicological analyses indicated high concentrations of MXP in femoral blood (606 µg/L), cardiac blood (254 µg/L) and hair (13 ng/mg). We also identified 3-methylmethcathinone (3-MMC) in femoral blood (traces) and urine (238 µg/L). The concentrations of all other drugs were consistent with living subjects. This case highlights the risk of MXP poisoning in the context of chemsex and emphasizes the importance of including NPS in postmortem toxicology examinations.
Ohio’s Criminal Justice Coordinating Center of Excellence
Authors: Munetz Mark R. , Bonfine Natalie , Simera Ruth H. , Nicastro Christopher
Published: January 2021

This chapter describes the development and operation of the Criminal Justice Coordinating Center of Excellence (CCoE), a collaboration between the Northeast Ohio Medical University and the Ohio Department of Mental Health and Addiction Services. It provides an example of the “Center of Excellence” concept, involving the delivery of designated services to key players in the criminal justice system. The Ohio CCoE used the Sequential Intercept Model as a basis for prioritizing services such as training to police (e.g., CIT) and systems mapping workshops, and it employed the larger partnership to pursue additional funding through foundation and government grants. The broad focus of the collaboration has been on systems-level interventions. It offers a model for this approach to collaborative partnership.
University–Public Behavioral Health Collaboration
Authors: Moore Kathleen , Barnett Joshua T. , Christy Annette , McPherson Marie , Carlson Melissa
Published: January 2021

This chapter describes a partnership between faculty at the Florida Mental Health Institute, University of South Florida, and various public agencies. It is a broad and wide-ranging collaboration, including areas such as civil commitment (providing a reporting center), Medicaid drug therapy management for behavioral health, and problem-solving courts. Advantages to these multiple partnerships have included the more extensive provision of research and evaluation services and the partnership with public agencies as part of application for extramural funding in the form of grants and contracts. These partnerships illustrate the scope of the projects that can be developed through successful collaboration.
The Development of the Center for Forensic Behavioral Science
Authors: Ogloff James R. P.
Published: January 2021

This chapter describes a large collaborative project based in Melbourne, Australia, between a public agency providing forensic and correctional mental health services and a research and training center at Swinburne University of Technology. There are several aspects of this partnership that make it distinctive. First, the size of the initiative and the number of individuals working on it is striking. Second, the collaboration has grown very substantially but also evolved through various changes in partners, thus illustrating the importance of flexibility and adaptiveness. Third, it is the only example of a collaborative project of the kind discussed in this volume that is based outside of the United States. It clearly illustrates the value that can be provided through such a partnership, and has important implications for similar partnerships on a large scale.
Peers as Change Agents
Authors: Hawkins Renee O. , Katherine Gerrard Mary , Newman Christa L. , McIntire Hannah
Published: January 2021

This chapter details the many advantages of utilizing peers as change agents in behavioral interventions, including being a readily available and free resource, increasing opportunities to respond, promoting generalization, being socially valid and culturally relevant, increasing student engagement with intervention, providing access to natural reinforcement, promoting social skill development, and supporting the development of peer social relationships. The chapter also positions peer-mediated interventions as relevant to the development of children and highlights the value and usefulness of identifying the behaviors the intervention is targeting and then emphasizing the importance of the peer’s role. This chapter also discusses the research supporting the effectiveness of peers as interventionists, indicating that they can be reliably trained to carry out interventions in schools.
Peer-Mediated Academic Interventions
Authors: Musti-Rao Shobana , Nobel Michele M.
Published: January 2021

Peer-mediated academic interventions (PMAIs) have a robust evidence base that support their use in classrooms to improve a variety of academic behaviors. In this chapter, we define PMAIs, discuss strengths and challenges of using these interventions in classrooms with diverse groups of learners, and provide a detailed review of the literature to support each of four highlighted PMAIs: peer tutoring, Peer-Assisted Learning Strategies, cooperative learning, and peer-mediated writing interventions. This chapter also introduces the practical chapters in this section, which cover each of the four highlighted PMAIs.
Peer-Mediated Behavioral Interventions
Authors: Radley Keith C.
Published: January 2021

This chapter defines and describes peer-mediated behavioral interventions. This chapter introduces all peer-mediated behavioral interventions that directly train peers to work with other students to improve non-academic behaviors, including peer management interventions, peer-mediated social skills training, peer support arrangements, peer-mediated Pivotal Response Treatment, peer-mediated play interventions, and restorative and conflict resolution interventions. This chapter also briefly discusses the research supporting each of the interventions included in this section.
Peer Modeling Interventions
Authors: King Hunter C. , Fischer Aaron J. , Lewis Heather L. J. , Cesar Payan Julio
Published: January 2021

Peer modeling (PM) is a peer-mediated intervention that can be effective in teaching students’ appropriate social skills and classroom behaviors and has been shown to be effective in students with autism spectrum disorders, emotional behavioral disorders, and other developmental disabilities. To implement PM, a peer model is carefully selected and instructed display a desired behavior in close proximity of the targeted student, or learner, how to behave in a similar context. There are two variations of PM that can be utilized in a classroom setting including in vivo PM, which is when the targeted student is in close proximity to the peer model, and video PM (VPM), which utilizes video recordings rather than in person scenarios for the targeted student to watch an imitate. Recommendations for implementation, advantages, and diversity considerations in both PM and VPM are discussed in this chapter.
Peer-Mediated Play Interventions
Authors: Nabors Laura A.
Published: January 2021

Play provides an excellent opportunity for young children to practice appropriate social behaviors and develop friendships. This chapter discusses examples of interventions that directly teach peers how to interact appropriately in play situations. Students can be utilized as powerful intervention agents in prompting, initiating, and reinforcing social play. Recommendations for implementing peer-mediated play interventions are included. This chapter also includes considerations of diversity and equity in the use of students to promote positive play in their peers.
Restorative and Conflict Resolution Interventions
Authors: Nese Rhonda N. T. , McDaniel Sara C. , Meng Paul Michael , Spraggins Lisette Franklin , Babbs Victoria T. , Girvan Erik J.
Published: January 2021

Conflicts between peers are inevitable in schools, and schools must be equipped with strategies to assist students in avoiding conflicts and engaging in problem-solving when conflicts occur. Restorative practices and other conflict resolution interventions such as peer mediation are gaining popularity, particularly as an alternate framework to the overutilization of disciplinary punishment with ethnic minoritized students. This chapter discusses the effective use of restorative practices and conflict resolution interventions, with an emphasis on establishing these types of practices in schools using best practices. Particular attention is paid to the role of restorative practices in a social justice approach to serving students and families in schools.
Technology-Based Classroom Management
Authors: Krach Shelley Kathleen , Kern Lori R.
Published: January 2021

Many recent studies incorporate technology into classroom management strategies. Technology-based interventions can be used to increase the engagement of students in schools because they can be personalized to each student and meaningfully incorporated into the existing classroom ecology. This chapter describes how to effectively implement technology-based classroom management strategies. There is a particular focus on intervention selection and implementation. An evaluation of ClassDojo is included as an evaluative case study. Also, considerations of diversity and equity within classroom management interventions incorporating technology are included.
Interdependent Group Contingencies
Authors: Maggin Daniel M. , Brown Christerallyn A. J. , Kumm Skip
Published: January 2021

Interdependent group contingencies involve a common consequence based on the behavior of all members of the group, as groups may have to meet a behavioral criterion together or all group members must meet a criterion to access a consequence. Interventions such as the Good Behavior Game, Peer Reporting Interventions, and mystery motivators are examples of interdependent group contingencies that utilize peer influence to improve appropriate behaviors in classrooms. This chapter discusses implementation issues with group contingencies, including target behavior selection, classroom training, addressing group sabotage, and managing contingencies. This chapter also discusses considerations of diversity and equity within interdependent group contingencies.
Independent and Dependent Group Contingencies
Authors: Cariveau Tom
Published: January 2021

Group contingencies include the arrangement of a common consequence for responding by members of a group. Independent group contingencies involve a common consequence being delivered to an individual student based on her performance. Dependent group contingencies involve the consequence being delivered to the entire group based on the performance of an individual or small group of students. Numerous variables may be altered in a group contingency and arranging an effective intervention requires planful incorporation of each. This chapter reviews the components of independent and dependent group contingencies and considerations when designing and implementing group contingencies in educational settings.
Interpersonal Psychotherapy
Authors: Markowitz John C.
Published: January 2021

This chapter introduces the basic principles, structure, and techniques of IPT: a brief treatment manual for the (tele-)clinician. IPT is a time-limited, affect- and life event–based psychotherapy that helps patients master a life crisis, often by mobilizing social support and learning to use feelings to understand and manage interpersonal encounters. The basic paradigm is that feelings and symptoms arise in an interpersonal context: feeling and situation are connected. The IPT framework includes making a diagnosis, taking an interpersonal inventory to explore the patient’s relationships and current life crises, giving patients the no-fault, medical model “sick role,” setting a time limit, and providing a formulation linking the patient’s diagnosis to a focal problem area on which the therapy will thereafter focus. The problem areas are grief (complicated bereavement following the death of a significant other), role dispute (a struggle with someone), or a role transition (any major life change). The chapter also stresses the importance of affect tolerance and building a treatment alliance and provides a Social Rhythm Metric and a Covid Behavioral Checklist.
Life Crises
Authors: Markowitz John C.
Published: January 2021

This chapter details the process of the IPT therapeutic treatment approach in the three focal problem areas: grief (complicated bereavement), role dispute, and role transition. (The potential fourth IPT problem area is unneeded in the setting of disaster.) Each involves a basic treatment paradigm spread across the three phases of treatment, including an opening question to determine recent affectively charged events; communication analysis, to help patients understand their feelings in a recent interpersonal situation; exploring options, to resolve interpersonal difficulties; and role play, to help patients practice those options. IPT assigns no homework but uses the time limit to press treatment forward. Although the three problem areas differ thematically, all involve solving an interpersonal crisis by interpersonal means.
Major Depression
Authors: Markowitz John C.
Published: January 2021

Utilizing the elements described in the previous chapters, this one applies the IPT approach to patients with major depressive disorder in the setting of the Covid-19 pandemic. Major depression is a common sequela of disaster. Major depression is also the disorder for which IPT was first tested and has been most frequently evaluated, and for which it is considered a first line, practice guideline-recommended treatment. Four extended, detailed Covid-19 related case examples cover the three focal IPT problem areas of grief (complicated bereavement), role dispute, and role transition. These cases also underscore the importance of cultural issues in personalizing IPT to the treatment of individuals.
Termination
Authors: Markowitz John C.
Published: January 2021

This chapter elaborates on the termination phase of acute IPT, already briefly discussed in Chapter 3 of this book. It describes the need to consolidate and reinforce treatment gains; to ask the patient why he or she is feeling better; and to acknowledge feelings associated with the role transition of ending treatment. Patients who have not improved in brief IPT should be offered alternative effective treatment. The chapter also addresses indications for and utilization of making a new therapeutic contract for continuation and maintenance IPT and the likelihood that extending treatment will be beneficial in the setting of ongoing disaster.
Dealing with Post-Catastrophe—Resilience
Authors: Markowitz John C.
Published: January 2021

This final chapter discusses the complex phenomenon of resilience: how some people weather the storm of crisis. It also describes the limitations of resilience and the importance of treating individuals who lack or lose it. A discussion of attachment as a factor relevant to IPT and to resilience suggests one mechanism through which IPT may benefit patients and impart resilience. Brief IPT may actually repair long-standing attachment difficulties, thus improving interpersonal comfort and functioning. The chapter also reviews the concept of post-traumatic growth in the context of the pandemic. Finally, it documents the uncertain situation in which we find ourselves at this juncture in the pandemic.
Seizure activity and anion gap metabolic acidosis secondary to adverse effect of nalidixic acid—a case report
Authors: Galvin Michael , Al Qaisy Mohammad Saleh , Cajazeiro Junia
Published: January 2021

Nalidixic acid is a commonly prescribed treatment for suspected dysentery in Middle Eastern populations. We describe a case of convulsions resulting from a single dose of nalidixic acid in a previously healthy two-month-old child in Northern Iraq who was being treated for a diarrhoeal illness. The child presented to us with new onset seizures, irritability, and acidaemia. Nalidixic acid was thought to be responsible after the exclusion of other potential causes of seizures. Symptoms resolved by treatment with intravenous (IV) diazepam, and cessation of nalidixic acid, and the child recovered fully and was discharged home neurologically intact after two days of observation. In regions where it is commonly prescribed, such as Northern Iraq, nalidixic acid should be considered as a cause of convulsions in any seizing child who has been exposed to the drug. Furthermore, quinolones such as nalidixic acid are contraindicated in children < 3 months of age.
Simulation study on the effects of diffractive collisions on the prediction of the observables in ultra-high-energy cosmic-ray experiments
Authors: Ohashi Ken , Menjo Hiroaki , Itow Yoshitaka , Sako Takashi , Kasahara Katsuaki
Published: January 2021

The mass composition of ultra-high-energy cosmic rays is important for understanding their origin. Owing to our limited knowledge of the hadronic interaction, the interpretations of the mass composition from observations include several open problems, such as the inconsistent interpretations of $\langle X_{\mathrm{max}}\rangle $ and $\langle X_{\mathrm{max}}^{\mu}\rangle $. Furthermore, a large difference between the predictions exists in the hadronic interaction models. Diffractive collision is one of the proposed sources of the uncertainty. In this paper, we discuss the effect of the detailed characteristics of diffractive collisions on the observables of ultra-high-energy cosmic-ray experiments, focusing on three detailed characteristics. These are the cross-sectional fractions of different collision types, the diffractive-mass spectrum, and diffractive-mass-dependent particle production from the diffractive dissociation system. We demonstrate that the current level of uncertainty in the cross-sectional fraction can affect $\langle X_{\mathrm{max}}\rangle $ by 8.9 $\mathrm{g/cm^2}$ and $\langle X_{\mathrm{max}}^{\mu}\rangle $ by 9.4 $\mathrm{g/cm^2}$, whereas the other details of diffractive collisions exhibit relatively minor effects.
Endophytic Bacterial Communities in Apple Leaves Are Minimally Impacted by Streptomycin Use for Fire Blight Management
Authors: Wallis Anna , Gu Ganyu , Ramachandran Padmini , Reed Elizabeth , Ottesen Andrea , Nou Xiangwu , Cox Kerik D.
Published: January 2021

In apple fruit, streptomycin is routinely used to manage fire blight, a devastating disease that greatly affects commercial apple production. Applications of streptomycin may affect the endophytic bacterial communities, which are increasingly recognized for their valuable roles in plant hosts. Altering these communities may have implications for plant health and selection for streptomycin resistance in off-target bacteria. In a previous study, we found rapid selection of streptomycin-resistant epiphytes following season-long streptomycin use, and now sought to investigate the season-long impact of streptomycin applications (one, three, or nine postbloom applications) on endophytic bacterial communities. Studies were conducted in two orchards, and both culture-dependent and independent methods were used to assess the bacterial endophytic community. Streptomycin programs were compared with untreated trees and two programs approved for organic production. Treatments minimally affected abundance of culturable endophytic bacteria as determined by culture-dependent methods. Similarly, there were no significant differences in relative bacterial abundance or community composition between treatments as determined by 16S ribosomal RNA high-throughput sequencing (culture independent). There were greater differences between orchards than between treatments, suggesting a stronger influence of locality. Communities were dominated by the families Pseudomonadaceae, Enterobacteriaceae, Desulfovibrionaceae, Bacillaceae, and Burkholderiaceae, which are commonly described in other investigations of microbial communities of apple orchards. In addition, we found a high abundance of Amoebophiliaceae, a family dominated by arthropod parasites. Our results provide evidence that season-long applications of streptomycin in apple orchards have minimal impact on endophytic bacterial communities, which is in contrast to some reports on epiphytic communities.
Single-Stage Versus 2-Stage Bilateral Intramedullary Nail Fixation in Patients With Bilateral Femur Fractures: A Multicenter Retrospective Review
Authors: Flagstad Ilexa R. , Tatman Lauren M. , Heare Austin , Parikh Harsh R. , Albersheim Melissa , Atchison Jared , Breslin Mary , Davis Patrick , Feinstein Shawn , Hak David J. , Labrum Joseph T. , Lufrano Reuben C. , Lund Erik A. , Connelly Daniel , Matar Robert N. , Nadeau Jason , Ries de Chaffin Danielle , Rodriguez-Buitrago Andres F. , Schmidt Tegan , Shaw Nichole , Simske Natasha , Siy Alexander B. , Titter Julie , Vang Sandy , Wagstrom Emily , Westberg Jerald R. , Hahn Jesse , Mauffrey Cyril , Mir Hassan R. , O'Toole Robert V. , Obremskey William T. , Sanders Roy W. , Schmidt Andrew H. , Vallier Heather A. , Whiting Paul S. , Cunningham Brian P.
Published: January 2021

Objective:

To evaluate rates of complications in patients with bilateral femur fractures treated with intramedullary nailing (IMN) during either 1 single procedure or 2 separate procedures.

Design:

A multicenter retrospective review of patients sustaining bilateral femur fractures, treated with IMN in single or 2-stage procedure, from 1998 to 2018 was performed at 10 Level-1 trauma centers.

Setting:

Ten Level-1 trauma centers.

Patients/Participants:

Two hundred forty-six patients with bilateral femur fractures.

Interventions:

Intramedullary nailing.

Main Outcome Measures:

Incidence of complications.

Results:

A total of 246 patients were included, with 188 single-stage and 58 two-stage patients. Gender, age, injury severity score, abbreviated injury score, secondary injuries, Glasgow coma scale, and proportion of open fractures were similar between both groups. Acute respiratory distress syndrome (ARDS) occurred at higher rates in the 2-stage group (13.8% vs. 5.9%; P value = 0.05). When further adjusted for age, gender, injury severity score, abbreviated injury score, Glasgow coma scale, and admission lactate, the single-stage group had a 78% reduced risk for ARDS. In-hospital mortality was higher in the single-stage cohort (2.7% compared with 0%), although this did not meet statistical significance (P = 0.22).

Conclusions:

This is the largest multicenter study to date evaluating the outcomes between single- and 2-stage IMN fixation for bilateral femoral shaft fractures. Single-stage bilateral femur IMN may decrease rates of ARDS in polytrauma patients who are able to undergo simultaneous definitive fixation. However, a future prospective study with standardized protocols in place will be required to discern whether single- versus 2-stage fixation has an effect on mortality and to identify those individuals at risk.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Evidence-based Plastic Surgery: Assessing Progress over Two 5-year Periods from 2009 to 2019
Authors: Mihailidis Toni Huw , Al-Benna Sammy
Published: January 2021

Background:

Publications on evidence-based medicine have increased. Previous articles have examined evidence-based plastic surgery, but the latest was published in 2013. The aim of this study was to examine the trend in the number of high-evidence publications over two 5-year periods across 3 main plastic surgery journals. Further, this study aimed to quality-assess randomized controlled trials (RCTs) published in the latter period.

Methods:

All articles were identified using PubMed Search Tools and Single Citation Matcher. Three journals were manually screened from May 15, 2009, to May 15, 2014, and from May 16, 2014, to May 16, 2019. The reporting of RCTs was assessed using a modified Consolidated Standards of Reporting Trials (CONSORT) checklist.

Results:

Of a total of 17,334 publications, 6 were meta-analyses of RCTs, 120 were other meta-analyses, and 247 were initially identified as RCTs. Although a significant increase in the number of higher-evidence publications is observed, these represent 2.09% (n = 363) of the total. An estimated 86 RCTs were eligible for quality-assessment, with the most popular sub-specialty being breast surgery (n = 30). The most highly reported criteria were inclusion/exclusion criteria and blinding (both n = 67; 77.91%), and the least reported criterion was allocation concealment (n = 21; 24.42%).

Conclusions:

This study observes a positive trend in high-evidence publications. The number of RCTs published has increased significantly over a breadth of sub-specialties. The reporting of several CONSORT criteria in RCTs remains poor. Observation to standard reporting guidelines is advocated to improve the quality of reporting.
LATE PRESENTATION OF RETINAL DETACHMENT
Authors: Anguita Rodrigo , Roth Janice , Makuloluwa Achini , Shahid Syed , Katta Mohamed , Khalid Hagar , Charteris David G.
Published: January 2021

Purpose:

To describe and evaluate demographic, clinical features, prognostic factors, and rate of success of surgery and visual outcomes in patients with late presentation of retinal detachment.

Methods:

A retrospective, comparative, observational case series of patients with late presentation retinal detachment, defined as retinal detachment with the loss of central vision for 4 weeks or more, over a period of 12 months.

Results:

The mean of onset of central visual loss was 12.7 weeks (SD, 21.3). Proliferative vitreoretinopathy at the first operation was identified in 69% of eyes. The overall primary success rate was 69.2%, significantly less than that was found in outcomes for nonselected retinal detachment (primary success rate, 86%; P = 0.006). The initial best-corrected visual acuity was 20/500, and the final was 20/160 (P = 0.0027). There were no identifiable statistically significant socioeconomic factors related to late presentation.

Conclusion:

A high rate of established proliferative vitreoretinopathy on presentation was identified, and although cases can be treated with good anatomical results, visual outcomes are often less favorable. Primary surgical success is lower, and more reoperations are required compared with standard retinal detachments.
TEMPORAL CHANGES OF PARAFOVEAL MICROVASCULATURE AFTER EPIRETINAL MEMBRANE SURGERY
Authors: Kim Jongshin , Park Kyu Hyung
Published: January 2021

Purpose:

To investigate whether the parafoveal capillary architecture predicts clinical course and visual outcomes after epiretinal membrane (ERM) surgery.

Methods:

A total of 71 eyes of 71 patients treated with vitrectomy for idiopathic ERM were enrolled. The parafoveal capillary displacement and fractal geometries were compared according to the stage of ERM. Correlations between the parafoveal capillary displacement in the superficial capillary plexus, the fractal dimension and lacunarity in the deep capillary plexus (DCP), foveal thickness, and visual outcomes were evaluated.

Results:

Compared with eyes with mild ERM, eyes with severe ERM exhibited higher parafoveal capillary displacement in the superficial capillary plexus, lower fractal dimension and higher lacunarity in the DCP, and greater foveal thickness (P < 0.05). The parafoveal capillary displacement in the superficial capillary plexus and fractal dimension and lacunarity in the DCP improved significantly, particularly at 1 month postoperatively (P < 0.05) and reached a plateau thereafter. The preoperative fractal dimension in the DCP showed a significant correlation with the best-corrected visual acuity at all follow-up time points (P < 0.05).

Conclusion:

The parafoveal fractal dimension in the DCP was significantly correlated with the visual acuity before and after ERM surgery. The parafoveal fractal dimension may serve as a predictive marker for visual outcomes after ERM surgery.
Clinical efficacy and safety of modified Sijunzi decoction for the treatment of ulcerative colitis
Authors: Tian Shu Wei , Zhang Yan Ling , Wang Bin , Liu Ji Ping , Wang Chuan , Zhang Juan
Published: January 2021

Background:

Ulcerative colitis (UC) is a chronic non-specific intestinal inflammatory disease with unknown etiology. In recent years, the global incidence has been increasing. Sijunzi decoction (SJZD) is a traditional Chinese medicine that has been used for treatment of other diseases in previous studies as it has no side effects and it has a pharmacological effect in gastrointestinal function, immune system, ulcers, and tissue repair.

Methods:

PubMed, Embase, Cochrane Library, GeenMedical, China National Knowledge Infrastructure, Chinese Sci-tech Journals full-text Database, Chinese Biomedical Database, and Chinese Science Citation Database were searched to screen the related literatures of “ulcerative colitis” and “Jiawei Sijunzi decoction”. The research data extracted from above studies was analyzed by Review Manager 5.3 and Stata14.2 software.

Results:

This systematic review and meta-analysis will evaluate the efficacy and safety of Jiawei SJZD in the treatment of UC and provide effective evidence for clinical use.

Conclusion:

In this study, the published evidence of modified SJZD in the treatment of UC was systematically summarized and evaluated, so that it can be better applied in clinic.

INPLASY registration number:

INPLASY2020100102
Lactic dehydrogenase-lymphocyte ratio for predicting prognosis of severe COVID-19
Authors: Li Guojun , Xu Fumin , Yin Xinru , Wu Na , Li Yuanjie , Zhang Tinghong , Chen Dongfeng , Liu Kaijun , Qiu Qiu
Published: January 2021

To develop a useful score for predicting the prognosis of severe corona virus disease 2019 (COVID-19) patients.

We retrospectively analyzed patients with severe COVID-19 who were admitted from February 10, 2020 to April 5, 2020. First, all patients were randomly assigned to a training cohort or a validation cohort. By univariate analysis of the training cohort, we developed combination scores and screened the superior score for predicting the prognosis. Subsequently, we identified the independent factors influencing prognosis. Finally, we demonstrated the predictive efficiency of the score in validation cohort.

A total of 145 patients were enrolled. In the training cohort, nonsurvivors had higher levels of lactic dehydrogenase than survivors. Among the 7 combination scores that were developed, lactic dehydrogenase-lymphocyte ratio (LLR) had the highest area under the curve (AUC) value for predicting prognosis, and it was associated with the incidence of liver injury, renal injury, and higher disseminated intravascular coagulation (DIC) score on admission. Univariate logistic regression analysis revealed that C-reactive protein, DIC score ≥2 and LLR >345 were the factors associated with prognosis. Multivariate analysis showed that only LLR >345 was an independent risk factor for prognosis (odds ratio [OR] = 9.176, 95% confidence interval [CI]: 2.674–31.487, P < .001). Lastly, we confirmed that LLR was also an independent risk factor for prognosis in severe COVID-19 patients in the validation cohort where the AUC was 0.857 (95% CI: 0.718–0.997).

LLR is an accurate predictive score for poor prognosis of severe COVID-19 patients.
Diabetes mellitus risk after hysterectomy
Authors: Chiang Ching-Hsiang , Chen Weishan , Tsai I-Ju , Hsu Chung Y. , Wang Jen-Hung , Lin Shinn-Zong , Ding Dah-Ching
Published: January 2021

We explored whether hysterectomy with or without bilateral oophorectomy was associated with the increasing incidence of diabetes mellitus (DM) in an East Asian population. This was a retrospective population-based cohort study that analyzed DM risk in Taiwanese women, using a health insurance research database of 1998 to 2013 containing nearly 1 million people. We identified 7088 women aged 30 to 49 years who had undergone hysterectomy with or without oophorectomy. The comparison group included 27,845 women without a hysterectomy who were randomly selected from the population and matched to women in the hysterectomy group by age (exact year) and year of the surgery. DM comorbidities were identified. The incidence and hazard ratios for DM were calculated with Cox proportional hazard regression models. The median ages of patients in the hysterectomy and comparison groups were both approximately 44 years. After a median 7.1 years of follow-up, the incidence of DM was 40% higher in the hysterectomized women as compared with the comparisons (9.12 vs 6.78/1000 person-years, P < .001), with an adjusted hazard ratio (aHR) of 1.37 (95% confidence interval [CI] = 1.23 –1.52). However, the DM risk was not increased in the women with hysterectomy plus oophorectomy (aHR=1.28, 95% CI = 0.93–1.76). Furthermore, among women aged 30 to 39 years, 40 to 49 years, the risk in hysterectomized women was higher than the comparisons (aHR = 1.75, 95% CI = 1.27–2.41; aHR = 1.33, 95% CI = 1.19–1.49, respectively). Our study provides essential and novel evidence for the association between hysterectomy and DM risk in women aged 30 to 49 years, which is relevant to these women and their physicians. Physicians should be aware of the increased DM risk associated with hysterectomy and take this into consideration when evaluating a patient for a hysterectomy. The current results might help gynecologists prevent DM and encourage diagnostic and preventive interventions in appropriate patients.
Multimodal Treatment of Children With Sacrococcygeal Yolk Sac Tumor: Retrospective Analysis of Clinicopathology Characteristics and Relapse-free Survival
Authors: Zhu Jia , Chen Huadong , Chen Tingting , Zhen Zijun , Wang Juan , Sun Feifei , Lu Suying , Huang Junting , Zhang Yizhuo , Sun Xiaofei
Published: January 2021

The aim of the study was to explore the clinicopathologic characteristics of sacrococcygeal yolk sac tumor (SYST) associated with relapse and the role of sensitivity to neoadjuvant chemotherapy in predicting outcome. The authors investigated prognostic factors of age, stage, initial tumor size, pathologic response to neoadjuvant chemotherapy, and alfa fetoprotein. A total of 26 patients with SYST were enrolled. Neoadjuvant chemotherapy was administered to 20 cases. Six patients underwent resection as initial therapy. Recurrence occurred in 12 patients. Nine patients with specimens exhibiting no malignant component after chemotherapy did not experience recurrence. By contrast, relapses occurred in 7 of 11 patients with viable residual tumor after neoadjuvant chemotherapy. All relapsed patients still achieved partial remission or complete remission after salvage therapy. Five-year relapse-free survival and overall survival rates were 55.2% and 100%, respectively (median follow-up, 59.5 mo; range, 16 to 155). Patients with complete necrosis after neoadjuvant chemotherapy had a better outcome compared with children with viable residual tumor. Relapse-free survival of pediatric SYSTs in this cohort were still low and warrants the multidisciplinary effort.
Moderate Gastrointestinal Complications Due to “Superglue” Ingestion in a Pediatric Patient
Authors: Sabag Liat , Slae Mordechai , Millman Peri Nicole , Wexler Isaiah D. , Rekthman David
Published: January 2021

Childhood cases of cyanoacrylates generally do not cause moderate or severe gastrointestinal complications. We report the case of a 3-year-old boy referred to our pediatric emergency room and admitted to the pediatric department with signs of upper gastrointestinal obstruction that required invasive intervention. Although it is rare, cyanoacrylate ingestion may injure esophageal and gastric mucosa in the pediatric population.
Primary Central Nervous System Lymphoma Revealed by 68Ga-FAPI and 18F-FDG PET/CT
Authors: Zhang Ying , Cai Jiawei , Lin Zefang , Yao Shaobo , Miao Weibing
Published: January 2021

A 67-year-old woman presented with left limb weakness, facial paralysis, and unsteady gait for 1 month. Brain MRI detected a mass in the right frontal lobe with prominent peritumoral edema, suggesting a malignant brain tumor. In 18F-FDG PET/CT, the mass was very FDG avid, and 68Ga-FAPI PET/CT showed the mass had heterogeneously mild to moderate increased uptake of the tracer. Histopathological examination after surgical resection of the mass confirmed the diagnosis of diffuse large B-cell lymphoma. The current case indicated the existence of fibrosis in the lymphoma lesion to some extent.
β-Amyloid Orchestrates Factor XII and Platelet Activation Leading to Endothelial Dysfunction and Abnormal Fibrinolysis in Alzheimer Disease
Authors: García-Mejía Karen A. , Custodio-Chablé Santiago J. , Vázquez-Franco José E. , Reyes-Maldonado Elba , Lezama Ruth A.
Published: January 2021

Alzheimer disease (AD) is the most common form of dementia in humans. However, to date, the cause of sporadic AD (SAD), which is the most frequent form, is still unknown. Although it has not been possible to determine the origin of this disease, the amyloid hypothesis is one of the most accepted to explain the etiology of AD. This hypothesis proposes that the pathogenesis of AD is derived from the toxic effect produced by the amyloid-β (Aβ) peptide in the brain parenchyma, but it does not make clear how Aβ is capable of producing such damage. Furthermore, it has been observed that SAD is accompanied by disruptions in the vascular system, such as damage to the blood-brain barrier. This facilitates the transfer of some systemic proteins, such as fibrinogen, to the brain parenchyma, where Aβ is abundant. Therefore, this Aβ interacts with fibrinogen, which favors the formation of clots resistant to fibrinolysis, inducing a risk of thrombosis and neuroinflammation. Notably, Aβ is not only of neuronal origin; platelets also contribute to high Aβ production in the circulation. The Aβ present in circulation favors the activation of coagulation factor XII, which leads to the generation of thrombin and bradykinin. In addition to Aβ-induced platelet activation, all these events favor the development of inflammatory processes that cause damage to the brain vasculature. This damage represents the beginning of the toxic effects of Aβ, which supports the amyloid hypothesis. This review addresses the relationship between alterations in the vascular and hemostatic systems caused by Aβ and how both alterations contribute to the progression of SAD.
Prospective and detailed behavioral phenotyping in DDX3X syndrome
Authors: Tang Lara , Levy Tess , Guillory Sylvia , Halpern Danielle , Zweifach Jessica , Kiss Ivy Giserman , Foss-Feig Jennifer H , Frank Yitzchak , Lozano Reymundo , Belani Puneet , Layton Christina , Frowner Emanuel , Breen Michael S. , De Rubeis Silvia , Kostic Ana , Kolevzon Alexander , Buxbaum Joseph D , Siper Paige M , Grice Dorothy E
Published: January 2021

Background

DDX3X syndrome is a recently identified genetic disorder that accounts for 1-3% of cases of unexplained developmental delay (DD) and/or intellectual disability (ID) in females and is associated with motor and language delays, and autism spectrum disorder (ASD). To date, the published phenotypic characterization of this syndrome has primarily relied on medical record review; in addition, the behavioral dimensions of the syndrome have not been fully explored.

Methods

We carried out multi-day, prospective, detailed phenotyping of DDX3X syndrome in 14 females and 1 male, focusing on behavioral, psychological, and neurological measures; three participants in this cohort have been previously reported. We compared results against population norms and contrasted phenotypes between individuals harboring either (i) protein-truncating variants or (ii) missense variants and in-frame deletions.

Results

Eighty percent of individuals met criteria for ID, 60% for ASD and 53% for attention-deficit/hyperactivity disorder (ADHD). Motor and language delays were common as were sensory processing abnormalities. The cohort included 5 missense, 3 intronic/splice-site, 2 nonsense, 2 frameshift, 2 in-frame deletions, and one initiation codon variant. Genotype-phenotype correlations indicated that missense variants/in-frame deletions were associated with more severe language, motor, and adaptive deficits in comparison to protein-truncating variants.

Limitations

Sample size is modest, however, DDX3X is a rare and underdiagnosed disorder.

Conclusion

This study, representing a first, prospective, detailed characterization of DDX3X syndrome, extends our understanding of the neurobehavioral phenotype. Gold-standard diagnostic approaches demonstrated high rates of ID, ASD, and ADHD. In addition, sensory deficits were observed to be a key part of the syndrome. Even with a modest sample, we observe evidence for genotype-phenotype correlations with missense variants/in-frame deletions yielding a more severe phenotype.