bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multi-ethnic GWAS and meta-analysis of sleep quality identify MPP6 as a novel gene that functions in sleep center neurons
Authors: Khoury Samar , Wang Qiao-Ping , Parisien Marc , Gris Pavel , Bortsov Andrey V , Linnstaedt Sarah D , McLean Samuel A , Tungate Andrew S , Sofer Tamar , Lee Jiwon , Louie Tin , Redline Susan , Kaunisto Mari Anneli , Kalso Eija A , Munter Hans Markus , Nackley Andrea G , Slade Gary D , Smith Shad B , Zaykin Dmitri V , Fillingim Roger B , Ohrbach Richard , Greenspan Joel D , Maixner William , Neely G Gregory , Diatchenko Luda 
Published: October 2020

AbstractPoor sleep quality can have harmful health consequences. Although many aspects of sleep are heritable, the understandings of genetic factors involved in its physiology remain limited. Here, we performed a genome-wide association study (GWAS) using the Pittsburgh Sleep Quality Index (PSQI) in a multi-ethnic discovery cohort (n = 2868) and found two novel genome-wide loci on chromosomes 2 and 7 associated with global sleep quality. A meta-analysis in 12 independent cohorts (100 000 individuals) replicated the association on chromosome 7 between NPY and MPP6. While NPY is an important sleep gene, we tested for an independent functional role of MPP6. Expression data showed an association of this locus with both NPY and MPP6 mRNA levels in brain tissues. Moreover, knockdown of an orthologue of MPP6 in Drosophila melanogaster sleep center neurons resulted in decreased sleep duration. With convergent evidence, we describe a new locus impacting human variability in sleep quality through known NPY and novel MPP6 sleep genes.
The Antimicrobial Properties of Extracts Isolated from Lichen Parmelia vagans.
Authors: Bondarenko Vladimir , Korczynski Michael , Techathaveewat Worawith 
Published: October 2020

This study was aimed to determine the antibacterial properties of extracts isolated from lichen Parmelia vagans.Many pharmaceutical products today have derivatives from living organisms. Recently, Lichens have been found to have secondary metabolites which have been found to have various physiological effects including antimicrobial activity. A lichen is a composite organism composed of a photobiont such as an alga or cyanobacterium and a mycobiont, a fungus. In this study, the antimicrobial activity of extracts from a lichen identified as Parmelia vagans was evaluated.Extracts of Parmelia vagans were initially obtained by using various solvents to find the most efficient extraction of antimicrobial compound(s). We found that extracts obtained using ethyl acetate have the highest antimicrobial activity and were further used to study the properties of the extracted compounds. The antimicrobial activity of the extracts was evaluated using the Resazurin cell viability assay; the microbes investigated were Staphylococcus aureus, Bacillus subtilis, Streptococcus pneumoniae, Klebsiella pneumoniae, and Escherichia coli. It was observed that extracts had no inhibitory effect on the growth of Escherichia coli, and Klebsiella pneumonia at the tested concentrations, but inhibition of growth was observed in Staphylococcus aureus, Bacillus subtilis, and Streptococcus pneumoniae.The constituents of the crude extracts were separated using Thin Layer Chromatography (TLC). After separation, each fraction was tested to identify which contained the antimicrobial activity. From the several fractions, one was found to contain nearly all of the antimicrobial activity and was further evaluated against different strains of bacteria.Our data indicate that purified TLC fractions containing antibacterial activities that inhibit a growth of both gram positive and gram negative bacterial strains.Support or Funding InformationTouro University Nevada Intramural Research Grant
Artificial Intelligence-enabled, Real-time Intraoperative Ultrasound Imaging of Neural Structures Within the Psoas
Authors: Carson Tyler , Ghoshal Goutam , Cornwall George Bryan , Tobias Richard , Schwartz David G. , Foley Kevin T. 
Published: October 2020

Study Design.
Experimental in-vivo animal study.

Objective.
The aim of this study was to evaluate an Artificial Intelligence (AI)-enabled ultrasound imaging system's ability to detect, segment, classify, and display neural and other structures during trans-psoas spine surgery.

Summary of Background Data.
Current methodologies for intraoperatively localizing and visualizing neural structures within the psoas are limited and can impact the safety of lateral lumbar interbody fusion (LLIF). Ultrasound technology, enhanced with AI-derived neural detection algorithms, could prove useful for this task.

Methods.
The study was conducted using an in vivo porcine model (50 subjects). Image processing and machine learning algorithms were developed to detect neural and other anatomic structures within and adjacent to the psoas muscle while using an ultrasound imaging system during lateral lumbar spine surgery (SonoVision,™ Tissue Differentiation Intelligence, USA). The imaging system's ability to detect and classify the anatomic structures was assessed with subsequent tissue dissection. Dice coefficients were calculated to quantify the performance of the image segmentation.

Results.
The AI-trained ultrasound system detected, segmented, classified, and displayed nerve, psoas muscle, and vertebral body surface with high sensitivity and specificity. The mean Dice coefficient score for each tissue type was >80%, indicating that the detected region and ground truth were >80% similar to each other. The mean specificity of nerve detection was 92%; for bone and muscle, it was >95%. The accuracy of nerve detection was >95%.

Conclusion.
This study demonstrates that a combination of AI-derived image processing and machine learning algorithms can be developed to enable real-time ultrasonic detection, segmentation, classification, and display of critical anatomic structures, including neural tissue, during spine surgery. AI-enhanced ultrasound imaging can provide a visual map of important anatomy in and adjacent to the psoas, thereby providing the surgeon with critical information intended to increase the safety of LLIF surgery.

Level of Evidence: N/A
Diagnostic Accuracy of Thresholds Less Than or Equal to 8 mA in Pedicle Screw Testing During Lumbar Spine Procedures to Predict New Postoperative Lower Extremity Neurological Deficits
Authors: Melachuri Samyuktha R. , Melachuri Manasa K. , Anetakis Katherine , Crammond Donald J. , Balzer Jeffrey R. , Thirumala Parthasarathy D. 
Published: October 2020

Study Design.
Retrospective observational study.

Objective.
It has been shown that pedicle screw stimulation thresholds less than or equal to 8 mA yield a very high diagnostic accuracy of detecting misplaced screws in spinal surgery. In our study, we determined clinical implications of low stimulation thresholds.

Summary of Background Data.
Posterior lumbar spinal fusions (PSF), using pedicle screws, are performed to treat many spinal pathologies, but misplaced pedicle screws can result in new postoperative neurological deficits.

Methods.
Patients with pedicle screw stimulation testing who underwent PSF between 2010 and 2012 at the University of Pittsburgh Medical Center (UPMC) were included in the study. We evaluated the sensitivity, specificity, and diagnostic odds ratio (DOR) to determine how effectively low pedicle screw responses predict new postoperative lower extremity neurological deficits.

Results.
One thousand one hundred seventy nine eligible patients underwent 8584 pedicle screw stimulations with lower extremity somatosensory evoked potentials (LE SSEP) monitoring for lumbar fusion surgery. One hundred twenty one of these patients had 187 pedicle screws with a stimulation response at a threshold less than or equal to 8 mA. Smoking had a significant correlation to pedicle screw stimulation less than or equal to 8 mA (P = 0.012). A threshold of less than or equal to 8 mA had a sensitivity/specificity of 0.32/0.90 with DOR of 4.34 [1.83, 10.27] and an area under the ROC curve (AUC) of 0.61 [0.49, 0.74]. Patients with screw thresholds less than or equal to 8 mA and abnormal baselines had a DOR of 9.8 [95% CI: 2.13–45.17] and an AUC of 0.73 [95% CI: 0.50–0.95].

Conclusion.
Patients with pedicle screw stimulation thresholds less than or equal to 8 mA are 4.34 times more likely to have neurological clinical manifestations. Smoking and LE deficits were shown to be significantly correlated with pedicle screw stimulation thresholds less than or equal to 8 mA. Low stimulation thresholds result in a high specificity of 90%. Pedicle screw stimulation less than or equal to 8 mA can serve as an accurate rule in test for postoperative neurological deficit, warranting reevaluation of screw placement and/or replacement intraoperatively.

Level of Evidence: 3
The Impact of Anterior Spondylolisthesis and Kyphotic Alignment on Dynamic Changes in Spinal Cord Compression and Neurological Status in Cervical Spondylotic Myelopathy
Authors: Sakamoto Takuya , Funaba Masahiro , Imajo Yasuaki , Nagao Yuji , Suzuki Hidenori , Nishida Norihiro , Fujimoto Kazuhiro , Sakai Takashi 
Published: October 2020

Study Design.
A retrospective study of prospectively collected data.

Objective.
This study aimed to examine how radiological parameters affect dynamic changes in the cross-sectional area of the spinal cord (CSA) in cervical spondylotic myelopathy (CSM) patients and how they correlate with the severity of myelopathy, by evaluating multi-modal spinal cord evoked potentials (SCEPs).

Summary of Background Data.
Appropriate assessments of dynamic factors should reveal hidden spinal cord compression and provide useful information for choosing surgical procedures.

Methods.
Seventy-nine CSM patients were enrolled. They were examined with kinematic CT myelography (CTM), and the spinal levels responsible for their CSM were determined via SCEP examinations. The C2–7 angle, C2–7 range of motion, and percentage of slip were measured on the midsagittal view during flexion and extension, and the CSA was measured on the axial view in each neck position using kinematic CTM. The patients who exhibited the smallest CSA values during extension and flexion were classified into Groups E and F, respectively.

Results.
Fifty-two (65.8%) and 27 (34.2%) cases were included in Groups E and F, respectively. The preoperative JOA score did not differ significantly between the groups; however, the preoperative lower-limb JOA score of Group F was significantly lower than that of Group E (2.24 ± 0.82 vs. 2.83 ± 1.09, P = 0.016). In the multiple logistic regression analysis, a small C2–7 angle during extension (β = 5°, odds ratio: 0.69, 95% confidence interval [CI]: 0.54–0.90) and the slip percentage during flexion (β = 5%, odds ratio: 1.42, 95% CI: 1.09–1.85) were identified as significant predictors of belonging to Group F.

Conclusion.
Exhibiting more severe spinal cord compression during neck flexion was associated with a small C2–7 angle and anterior spondylolisthesis. The neurological status of the patients in Group F was characterized by severe lower limb dysfunction because of a disturbed blood supply to the anterior column.

Level of Evidence: 4
Accuracy of EOS Imaging Technology in Comparison to Computed Tomography in the Assessment of Vertebral Rotational Orientation in Instrumented Spines in Adolescent Idiopathic Scoliosis
Authors: Jiang Fan , Simões Leonardo , Ouellet Jean , Saran Neil 
Published: October 2020

Study Design.
Retrospective radiographic reliability study.

Objective.
The aim of this study was to assess the validity of EOS 3D imaging technology in the determination of vertebral rotations in the spine of patients with previous instrumentation.

Summary of Background Data.
There is a lack of evidence on the accuracy of vertebral rotational measurement using EOS 3D morphological analysis in the instrumented spine.

Methods.
A retrospective review of 31 patients with adolescent idiopathic scoliosis (AIS) who underwent instrumented fusion and postoperative computed tomography (CT) scans of the spine was performed. Vertebral rotations of the apex vertebra, the uppermost (UIV) and lowermost (LIV) instrumented vertebra, the noninstrumented vertebra one level cranial to the UIV (UIV + 1) and one level caudal to LIV (LIV + 1) were determined using EOS 3D reconstruction. The vertebral rotation was also measured using reformatted CT axial images. Relative vertebral rotational difference (VRD) were calculated for UIV to apex, UIV + 1 to apex, LIV to apex, LIV + 1 to apex, UIV to LIV and UIV + 1 to LIV + 1. Paired t tests were used to compare the VRD measured using the two different imagining modalities. For values where P > 0.05, the Bland-Altman plot was used to assess the agreement between the measures. Interclass correlation (ICC) was used to determine interobserver and intraobserver reliabilities of EOS and CT measurements.

Results.
EOS analysis of relative VRD was found to be significantly different from that of CT for UIV to apex (P = 0.006) and UIV + 1 to apex (P = 0.003). No significant differences were found for LIV to apex (P = 0.06), LIV + 1 to apex (P = 0.06), UIV to LIV (P = 0.59) and UIV + 1 to LIV + 1 (P = 0.64). However, Bland-Altman plots showed that agreement was poor, and variance was beyond acceptable. ICC showed good interobserver and good to very good intraobserver reliability for EOS.

Conclusion.
EOS 3D morphological analysis of VRD in the instrumented levels of the spine demonstrated significant difference and unacceptable variance in comparison to CT measurement.

Level of Evidence: 4
Three-Dimensional Analysis of Preoperative and Postoperative Rib Cage Parameters by Simultaneous Biplanar Radiographic Scanning Technique in Adolescent Idiopathic Scoliosis
Authors: Machino Masaaki , Kawakami Noriaki , Ohara Tetsuya , Saito Toshiki , Tauchi Ryoji , Imagama Shiro 
Published: October 2020

Study Design.
Prospective study.

Objective.
This study aimed to investigate the changes in rib cage deformity in adolescent idiopathic scoliosis (AIS) by comparing the preoperative and postoperative three-dimensional (3D) reconstruction images using simultaneous biplanar radiographic scanning technique (EOS) (EOS Imaging, Paris, France).

Summary of Background Data.
EOS data are limited for the analyses of preoperative and postoperative rib cage deformity.

Methods.
A total of 67 Lenke type 1 or 2 AIS patients who underwent surgery (59 females and 8 males) were enrolled in this study. The mean patient age was 14.4 years (range: 11–17 yr). In all patients, posterior corrective fusion was performed with a rod rotation maneuver based on segmental pedicle fixation. Spinal parameters (scoliosis and kyphosis) and rib cage parameters (max thickness, thoracic index (TI), rib hump (RH), surface spinal penetration index (sSPI), end thoracic hump ratio, vertebra-sternum angle, rib vertebral angle difference at the apex, and vertebral lateral decentering), were measured. 3D images were assessed preoperatively and postoperatively at 2-year follow-up.

Results.
Both main thoracic (MT) and proximal thoracic scoliosis were significantly corrected (51° to 15°, 30° to 17°, P < 0.0001). The rotation of MT apical vertebrae was also significantly corrected (12° to 5°, P < 0.0001). Thoracic kyphosis (T4-T12) significantly increased (13° to 18°, P < 0.0001). Besides, max thickness, TI, and RH demonstrated significant differences between preoperative and postoperative images (P < 0.01). T8–10 sSPI and end thoracic hump ratio decreased significantly postoperatively (P < 0.05). Although surgery significantly decreased vertebra-sternum angle (P < 0.0001), no significant difference was observed between the preoperative and postoperative rib vertebral angle difference (P = 0.32). Following the surgery, vertebral lateral decentering and rib cage volume were significantly increased (P < 0.0001).

Conclusions.
3D reconstruction of the rib cage using biplanar standing stereoradiography is useful to evaluate preoperative and postoperative rib cage deformity in patients with AIS.

Level of Evidence: 2
Anatomic Danger Zones of the Head and Neck
Authors: Talmor Guy , Trang Andy , Ahadiat Omeed , Paskhover Boris , Wysong Ashley 
Published: October 2020

BACKGROUND
Dermatologic procedures require a detailed understanding of surface anatomy to avoid complications. The head and neck region has prominent danger zones including nerves and vasculature that may be at risk during cutaneous surgery. A thorough understanding of these danger zones can help avoid complications that may lead to functional or cosmetic impairment.

METHODS
The anatomic literature regarding the course of high-risk structures of the head and neck was reviewed. Structures deemed at risk during dermatologic procedures were included in the analysis. The final analysis focused on branches of the facial nerve, parotid duct, spinal accessory nerve, trigeminal nerve, and the lacrimal system. Anatomical information was compiled regarding each high-risk structure to develop a “danger zone” at which each respective structure is at risk.

RESULTS
The danger zone for each structure was compiled based on the review of the literature and depicted in the figures.

CONCLUSION
With careful attention to anatomy and the meticulous surgical technique, there is great potential for reduction in surgical injury to danger zones of the head and neck.
Roles of Type 2 Immune Response–Initiating Cytokines and Detection of Type 2 Innate Lymphoid Cells in Mouse Models of Allergic Conjunctivitis
Authors: Asada Yosuke 
Published: October 2020

Abstract:
Allergic conjunctivitis is one the most common global diseases and affects many people worldwide. It has been reported that 15% to 20% of the total population in Japan suffers from allergic conjunctival disease. Although TH2 cytokines suchs as interleukin (IL)-4, IL-5, and IL-13 have long been known as causes of allergic conjunctivitis, new cytokines involved in allergic diseases have been identified since 2000. The discovery of type 2 immune response–initiating cytokines, such as IL-25, IL-33, and thymic stromal lymphopoietin, and type 2 innate lymphoid cells has suggested that allergic diseases can arise from not only T cells but also barrier function disruption. In this article, we summarize the results of experiments in mouse models of ragweed-induced experimental allergic conjunctivitis and papain-soaked contact lens–induced conjunctivitis.
Serum interleukin-18 levels are associated with non-dipping pattern in newly diagnosed hypertensive patients
Authors: Güntürk Ertuğrul Emre , Güntürk İnayet , Topuz Ayşe Nur , Akkaya Hasan , Topuz Mustafa 
Published: October 2020

Background
Interleukin-18 (IL-18), a pro-inflammatory cytokine, increases inflammation in the endothelium. Increased inflammation plays an important role in the development of hypertension (HT). IL-18 level is higher in hypertensives than normotensives.

Objective
To investigate the relationship between IL-18 level and diurnal blood pressure (BP) variations in newly diagnosed HT patients.

Methods
This prospective study included 130 subjects referred to outpatient cardiology clinic with an initial diagnosis of HT. The patients were classified as dipper HT (n = 40), non-dipper HT (n = 50), and normotensive (control, n = 40) according to 24-hour ambulatory BP monitoring. All subjects underwent blood sampling after 12 hours of fasting and transthoracic echocardiography.

Results
The serum IL-18 level was significantly higher in the patient group compared with the controls (195.17 ± 93.00 mg/dl vs. 140.75 ± 71.11 mg/dl, P < 0.01) and also in the non-dipper group than in the dipper group (217.3 ± 96.90 mg/dl, 167.5 ± 80.79 mg/dl, P = 0.011). IL-18 level was positively correlated both the night-time SBP and DBP levels (r = 0.29, P = 0.02 and r = 0.34, P < 0.01, respectively). On multivariate linear regression analysis, left atrium diameter, left ventricular mass index, and serum IL-18 level were independent predictors of non-dipping pattern in newly diagnosed HT patients.

Conclusion
Higher IL-18 level was particularly associated with an increase in the night-time BP levels. IL-18 can be used as a predictor for non-dipper HT in newly diagnosed HT patients.
Cognitive Dysfunction in Older Breast Cancer Survivors
Authors: Crouch Adele , Champion Victoria , Von Ah Diane 
Published: October 2020

Background
Approximately 60% of the more than 3.8 million breast cancer survivors (BCSs) living in the United States are 60 years or older. Breast cancer survivors experience many symptoms including cognitive dysfunction; however, little is known regarding how age affects these symptoms.

Objective
This integrative review was conducted to synthesize the literature on cognitive dysfunction in older BCSs. The purpose was to (1) describe the prevalence of objective and subjective cognitive dysfunctions and (2) examine factors associated with cognitive dysfunction in older BCSs.

Methods
Whittemore and Knafl’s integrative review methodology was used to examine cognitive dysfunction in BCSs 60 years or older.

Results
Twelve quantitative studies were included. Up to 41% of older BCSs experienced cognitive dysfunction on neuropsychological examination, and up to 64% reported cognitive dysfunction on subjective measures pretreatment. Approximately half of older BCSs experienced cognitive decline from pretreatment to posttreatment regardless of cognitive measure. The domains most impacted were memory, executive functioning, and processing speed. Objective and subjective cognitive dysfunctions were associated with age, comorbidities, chemotherapy receipt, sleep, neuropsychological symptom cluster, frailty, and quality of life.

Conclusions
Cognitive dysfunction among older BCSs was common both prior to and following treatment. Cognitive dysfunction was associated with multiple factors that are compounded in the aging population and could be detrimental to quality of life and independent living.

Implications to Practice
Early assessment and intervention by healthcare providers, including nurses, for cognitive dysfunction in older BCSs are essential. Future research should focus on evidence-based interventions for cognitive dysfunction incorporating the unique needs of older BCSs.