bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reservoir of Fibroblasts Promotes Recovery From Limb Ischemia
Authors: Meng Shu , Lv Jie , Chanda Palas K. , Owusu Iris , Chen Kaifu , Cooke John P. 
Published: August 2020

Background:
The angiogenic response to ischemia restores perfusion so as to preserve tissue. A role for mesenchymal-to-endothelial transition in the angiogenic response is controversial. This study is to determine if resident fibroblasts contribute to angiogenesis.

Methods:
We utilized the murine model of hindlimb ischemia, and in vivo Matrigel plug assay together with lineage tracing studies and single cell RNA-sequencing to examine the transcriptional and functional changes in fibroblasts in response to ischemia.

Results:

Lineage tracing using Fsp1-Cre: R26R-EYFP mice revealed the emergence within the ischemic hindlimb of a small subset of YFP
+
CD144
+
CD11b
−
fibroblasts (E* cells) that expressed endothelial cell (EC) genes. Subcutaneous administration of Matrigel in Fsp1-Cre: R26R-EYFP mice generated a plug that became vascularized within 5 days. Isolation of YFP
+
CD11b
-
cells from the plug revealed a small subset of YFP
+
CD144
+
CD11b
−
E* cells which expressed EC genes. Pharmacological or genetic suppression of innate immune signaling reduced vascularity of the Matrigel plug and abrogated the generation of these E* cells. These studies were repeated using human fibroblasts, with fluorescence-activated cell sorting analysis revealing that a small percentage of human fibroblasts that were induced to express EC markers in Matrigel plug assay. Pharmacological suppression or genetic knockout of inflammatory signaling abolished the generation of E* cells, impaired perfusion recovery and increased tissue injury after femoral artery ligation. To further characterize these E* cells, single cell RNA-sequencing studies were performed and revealed 8 discrete clusters of cells expressing characteristic fibroblast genes, of which 2 clusters (C5 and C8) also expressed some EC genes. Ischemia of the hindlimb induced expansion of clusters C5 and C8. The C8 cells did not express CD144, nor did they form networks in Matrigel, but did generate angiogenic cytokines. The C5 fibroblasts most resembled E* cells in their expression of CD144 and their ability to form EC-like networks in Matrigel.

Conclusions:
Together, these studies indicate the presence of subsets of tissue fibroblasts which seem poised to contribute to the angiogenic response. The expansion of these subsets with ischemia is dependent on activation of innate immune signaling and contributes to recovery of perfusion and preservation of ischemic tissue.
Negligible Unforced Historical Pattern Effect on Climate Feedback Strength Found in HadISST-Based AMIP Simulations
Authors: Lewis Nicholas , Mauritsen Thorsten 
Published: August 2020

AbstractRecently it has been suggested that natural variability in sea surface temperature (SST) patterns over the historical period causes a low bias in estimates of climate sensitivity based on instrumental records, in addition to that suggested by time variation of the climate feedback parameter in atmospheric general circulation models (GCMs) coupled to dynamic oceans. This excess, unforced, historical “pattern effect” (the effect of evolving surface temperature patterns on climate feedback strength) has been found in simulations performed using GCMs driven by AMIPII SST and sea ice changes (amipPiForcing). Here we show, in both amipPiForcing experiments with one GCM and by using Green’s functions derived from another GCM, that whether such an unforced historical pattern effect is found depends on the underlying SST dataset used. When replacing the usual AMIPII SSTs with those from the HadISST1 dataset in amipPiForcing experiments, with sea ice changes unaltered, the first GCM indicates pattern effects that are indistinguishable from the forced pattern effect of the corresponding coupled GCM. Diagnosis of pattern effects using Green’s functions derived from the second GCM supports this result for five out of six non-AMIPII SST reconstruction datasets. Moreover, internal variability in coupled GCMs is rarely sufficient to account for an unforced historical pattern effect of even one-quarter the strength previously reported. The presented evidence indicates that, if unforced pattern effects have been as small over the historical record as our findings suggest, they are unlikely to significantly bias climate sensitivity estimates that are based on long-term instrumental observations and account for forced pattern effects obtained from GCMs.
Multi-Instrument Rainfall-Rate Estimation in the Peruvian Central Andes
Authors: Valdivia Jairo M. , Scipión Danny E. , Milla Marco , Silva Yamina 
Published: August 2020

AbstractAgriculture is one of the main economic activities in the Peruvian Andes; rainwater alone irrigates more than 80% of the fields used for agriculture purposes. However, the cloud and rain generation mechanisms in the Andes still remain mostly unknown. In early 2014, the Instituto Geofísico del Perú (IGP) decided to intensify studies in the central Andes to better understand cloud microphysics; the Atmospheric Microphysics And Radiation Laboratory officially started operations in 2015 at IGP’s Huancayo Observatory. In this work, a Ka-band cloud profiler [cloud and precipitation profiler (MIRA-35c)], a UHF wind profiler [Clear-Air and Rainfall Estimation (CLAIRE)], and a VHF wind profiler [Boundary Layer and Tropospheric Radar (BLTR)] are used to estimate rainfall rate at different conditions. The height dependence of the drop size diameter versus the terminal velocity, obtained by the radars, in the central Andes (3350 m MSL) was evaluated. The estimates of rainfall rate are validated to ground measurements through a disdrometer [second-generation Particle, Size, and Velocity (PARSIVEL2)] and two rain gauges. The biases in the cumulative rainfall totals for the PARSIVEL2, MIRA-35c, and CLAIRE were 18%, 23%, and −32%, respectively, and their respective absolute biases were 19%, 36%, and 63%. These results suggest that a real-time calibration of the radars, MIRA-35c and CLAIRE, is necessary for better estimation of precipitation at the ground. They also show that the correction of the raindrop terminal fall velocity, obtained by separating the vertical wind velocity (BLTR), used in the estimation the raindrop diameter is not sufficient, especially in convective conditions.
Reconstruction of Mastoid Cortex Defects with Hydroxyapatite Cement for Negative Sequelae of Mastoidectomy
Authors: Thomas Julia Marie Naman , Gluth Michael Brian 
Published: August 2020

Objectives: Mastoid cortex defects resulting from mastoidectomy surgery can rarely lead to negative sequelae, including unsightly post-auricular depression and discomfort. This study sought to evaluate the use of hydroxyapatite cement (HAC) to reconstruct mastoidectomy cortex defects. Methods: Retrospective chart review was undertaken for all patients that underwent reconstruction of the mastoid cortex using HAC at a single tertiary medical center between 2013 and 2019. Collected data included demographics, indications for mastoidectomy, complications, and associated symptom status. Results: Twenty-nine patients that underwent mastoid cortex repair using HAC were included, and ten of these underwent mastoid revision in a secondary procedure to reconstruct the mastoid cortex with a specific goal to eliminate negative signs and symptoms. There were no associated postoperative complications and no instances of post-auricular depression following repair. All cases of secondary reconstruction resolved the primary signs and symptoms that prompted mastoid revision. Conclusions: HAC mastoid cortex reconstruction may be a safe and effective method to resolve negative sequelae resulting from previous mastoidectomy defects. Also, upfront HAC mastoid cortex reconstruction appears viable in select instances as an option to prevent potential future complications.
General Complications after Endoscopic Sinus Surgery in Smokers: A 2005-2016 NSQIP Analysis
Authors: Teitelbaum Jordan I. , Grasse Catie , Quan Dennis , Abi Hachem Ralph , Goldstein Bradley J. , Hua Xiaoyang , Jang David W. 
Published: August 2020

Background: Exposure to cigarette smoke has been associated with a higher incidence of postoperative complications across a variety of surgical specialties. However, it is unclear if smoking increases this risk after endoscopic sinus surgery (ESS). Because complication rates after ESS are relatively low, a large national database allows for a statistically meaningful study of this topic. Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) dataset from 2005 to 2016 was analyzed. Patients who underwent ESS were identified. Thirty-day postoperative complication rates between smokers and nonsmokers were compared. Complications included infection, thromboembolic events, reintubation, readmission, acute renal failure, and cardiovascular events. Results: 921 patients who underwent ESS were identified. 182 (20%) were smokers and 739 (80%) were nonsmokers. 609 patients underwent outpatient ESS, while 312 patients underwent inpatient ESS. A total of 12 patients experienced postoperative surgical site infections involving the deeper tissues beyond the wound (organ/space SSI). On univariate analysis, smoking was associated with a higher incidence of organ/space SSI ( P = .0067) and pulmonary embolism ( P = .0321) after ESS. On multivariate logistic regression, smoking was associated with increased odds (4.495, 1.11- 8.17, P = .0347) of organ/space SSI after ESS. Conclusions: This study demonstrates an association between exposure to cigarette smoke and potentially serious surgical site infections in the 30-day postoperative period after ESS. Our findings may help when counseling smokers who are considering ESS. Further study is required to understand the nature of these infections and ways to prevent them. Level of Evidence: 2c (“health outcomes”).
Displacement of a Total Ossicular Replacement Prosthesis Following Ossicular Chain Reconstruction
Authors: Govindan Aparna , Bahethi Rohini R. , Schwam Zachary G. , Wanna George B. 
Published: August 2020

Objective: Herein we describe the diagnosis and management of total ossicular replacement prosthesis (TORP) displacement following tympanoplasty with ossicular chain reconstruction (OCR). Methods: Case report with literature review. Results/Case: A 40-year-old male with otorrhea and tympanic membrane perforation underwent a right revision tympanoplasty with OCR using a TORP with a tragal chondroperichondrial graft. On postoperative day (POD) 4, he developed vertigo and profound right-sided hearing loss. Temporal bone computed tomography showed the prosthesis in the vestibule. After a steroid taper with mild improvement in symptoms, the TORP was removed two weeks later and the patient continued to improve. Conclusion: TORP displacement into the vestibule is a very rare complication following OCR. Conservative management with high dose steroids may improve symptoms, however further middle ear exploration and surgical management may be warranted depending on the depth of displacement into the inner ear as well as symptom severity.
Delivery of urological services (telemedicine and urgent surgery) during COVID-19 lockdown: experience and lessons learnt from a university hospital in United Kingdom
Authors: Somani Bhaskar K , Pietropaolo Amelia , Coulter Primrose , Smith Julian 
Published: August 2020

Background and aims Our departmental planning for COVID-19 was actioned a week before the lockdown (13th March 2020). We look at a 7- week lockdown activity for all scheduled outpatient clinics and urgent procedures. Methods and results A total of 2361 outpatient clinic slots (52.6% oncology slots and 47.4% benign urology slots) were scheduled during this period. The oncology slots included 330 (26.5%) flexible cystoscopy, 555 (44.7%) prostate cancer and 357(28.8%) non-prostate cancer slots. The benign urology slots included 323 (28.8%) andrology, 193 (17.2%) stones and 603 (54%) lower urinary tract symptoms (LUTS) slots. Of the total oncology outpatient slots (n = 1242), 66.3% were virtual consultations, 20% were face-to-face and 13.6% were cancelled. Of the total benign outpatient slots (n = 1119), 81% were virtual consultations, 9.7% were face-to-face and 9.3% were cancelled. A total of 116 anaesthetic surgical procedures were carried out, of which 54 (46.5%) were oncological procedures, 18 (15.5%) were benign urological procedures, and 44 (38%) were diagnostic procedures. Conclusions Hospitals and urologists can benefit from the model used by our hospital to mitigate the impact and prioritise patients most in need of urgent care. Reorganisation and flexibility of healthcare delivery is paramount in these troubled times and will allow clinical activity without compromising patient safety.
Everolimus-induced pneumonitis in neuroendocrine neoplasms: correlation of CT findings and clinical signs
Authors: Fehrenbach Uli , Rodríguez-Laval Víctor , Jann Henning , Fernández Carmen M Pérez , Pavel Marianne , Denecke Timm 
Published: August 2020

Background Everolimus, a mammalian target of rapamycin (mTOR)-inhibitor, is approved for the treatment of advanced neuroendocrine neoplasms (NEN). A rare major adverse event is the occurrence of drug-induced pneumonitis. Purpose To evaluate the correlation between clinical signs and computed tomography (CT) findings in everolimus-induced pneumonitis in patients with NEN. Material and Methods Ninety patients with NEN treated with everolimus were retrospectively enrolled (approved by our Institutional Review Board). All patients received chest CTs before the initiation of everolimus and during the treatment along with physical examinations. Clinical signs of pneumonitis were scored (symptomatic score) according to CTCAE v5.0. Pulmonary function tests (PFT) were evaluated if available. CT images were analyzed based on the severity of interstitial lung disease (ILD), the overall pneumonitis extent (PnE), and regarding presence of typical lung opacification patterns. Follow-up examinations of patients with pneumonitis were analyzed. Results Pneumonitis was diagnosed in 18 (20%) patients. There was no significant correlation between symptomatic score or PFT and ILD score or PnE. In case of a cryptogenic organizing pneumonia pattern (n = 14), symptomatic scores were significantly lower ( P = 0.035) than in case of other opacification patterns (n = 4). In the follow-up analysis, we could identify four different clinical courses. Conclusion CT detects everolimus-induced pneumonitis at a subclinical stage. In this setting, CT findings, clinical severity, and PFT do not clearly correlate. Opacification pattern analysis seems to be of importance when assessing the severity of CT findings. Asymptomatic patients with positive CT findings should be closely monitored to timely initiate specific treatment.
Risk factors associated with postoperative intensive care unit delirium in patients undergoing invasive mechanical ventilation following acute exacerbation of chronic obstructive pulmonary disease
Authors: Tian Huiyu , Chen Meiji , Yu Weiguang , Ma Qinying , Lu Peng , Zhang Jie , Jin Yujie , Wang Mingwei 
Published: August 2020

Objective This study was performed to determine the risk factors associated with intensive care unit delirium (ICUD) in patients undergoing invasive mechanical ventilation (IMV) secondary to acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods Data involving 620 patients undergoing IMV secondary to acute exacerbation of COPD from 2009 to 2019 at the First Hospital of Hebei Medical University were retrospectively analysed. The primary endpoint was the risk factors associated with developing ICUD. Univariable and multivariable logistic regression analyses were used to identify these risk factors. Results Of 620 patients, 93 (15.0%) developed ICUD. In the multivariable analysis, risk factors that were significantly associated with ICUD were increased age, male sex, alcoholism with active abstinence, current smoking, stage 3 acute kidney injury (AKI), and an American Society of Anesthesiologists (ASA) physical status of III. Conclusion This study showed that increasing age, male sex, alcoholism with active abstinence, current smoking, stage 3 AKI, and an ASA physical status of III might be associated with a risk of developing ICUD. Even if these risk factors are unaltered, they provide a target population for quality improvement initiatives.
Secondary headache attributed to exposure to or overuse of a substance
Authors: Toom Kati , Braschinsky Mark , Obermann Mark , Katsarava Zara 
Published: August 2020

Background Secondary headaches attributed to exposure to or the overuse of a substance are classified under chapter eight in the International Classification of Headache Disorders 3rd edition. Three distinct sub-chapters consider: 1. Headache attributed to exposure to a substance, 2. Medication overuse headache, and 3. Headache attributed to substance withdrawal. Headache attributed to exposure to a substance refers to a headache with onset immediately or within hours after the exposure, while medication overuse headache is a headache occurring on 15 or more days per month that has developed as a consequence of regular usage of acute headache medication(s) for more than three consecutive months in a patient with a pre-existing primary headache disorder. The withdrawal of caffeine, oestrogen, and opioids is most often associated with the development of headache. Discussion Despite the current headache classification, there is no certainty of a causal relationship between the use of any substance and the development of headache. Some substances are likely to provoke headache in patients that suffer from a primary headache disorder like migraine, tension-type headache or cluster headache, while others were described to cause headache even in people that generally do not get headaches. Toxic agents, such as carbon monoxide (CO) are difficult to investigate systematically, while other substances such as nitric oxide (NO) were specifically used to induce headache experimentally. If a patient with an underlying primary headache disorder develops a headache, in temporal relation to exposure to a substance, which is significantly worse than the usual headache it is considered secondary. This is even more the case if the headache phenotype is different from the usually experienced headache characteristics. Medication overuse headache is a well-described, distinct disease entity with only marginally understood pathophysiology and associated psychological factors. Managing medication overuse headache patients includes education, detoxification, prophylactic treatments and treating comorbidities, which is reflected in available guidelines. Viewing medication overuse headache as a separate entity helps clinicians and researchers better recognise, treat and study the disorder. Conclusion Identification of substances that may cause or trigger secondary headache is important in order to educate patients and health care professionals about potential effects of these substances and prevent unnecessary suffering, as well as deterioration in quality of life. Treatment in case of medication overuse and other chronic headache should be decisive and effective.
Brazilian Portuguese version of the Headache Disability Inventory: Cross-cultural adaptation, validity, and reliability
Authors: Pradela Juliana , Bevilaqua-Grossi Débora , Cristina Chaves Thais , Dach Fabiola , Ferreira Carvalho Gabriela 
Published: August 2020

Background The Headache Disability Inventory assesses the dimensions of headache disability, but it is not available in Brazilian Portuguese yet. We aimed to translate the Headache Disability Inventory into Brazilian Portuguese and analyze its measurement properties. Methods Consecutive patients with headaches diagnosed by expert neurologists as per the International Classification of Headache Disorders were included. For the cross-cultural adaptation, 30 individuals answered the translated Headache Disability Inventory version. The internal consistency was evaluated, and the structural validity was assessed through exploratory factor analysis. For the construct validity assessment, 132 individuals answered the Headache Disability Inventory-Brazil, 12-item Short Form Survey (SF-12), and Headache Impact Test (HIT-6). After 1–3 weeks, 67 individuals again answered the Headache Disability Inventory-Brazil for the reliability assessment. The Pearson's correlation test, the intraclass correlation coefficient and the standard error of measurement were analyzed. Results The pre-stage version of the questionnaire was considered as the final version. The Headache Disability Inventory-Brazil had an internal consistency of 0.84 and consisted of a functional, emotional and social participation domain (factor loads > 0.3). The internal consistency ranged from 0.81 to 0.93 for each of the three domains. For the construct validity, the Headache Disability Inventory-Brazil presented moderate correlation with the SF-12 (r = −0.70, p < 0.05) and with the HIT-6 (r = 0.67, p ≤ 0.05). Its test-retest reliability was considered to be excellent (intraclass correlation coefficient = 0.95) and the standard error of measurement was 2.26 points. Conclusion The Headache Disability Inventory-Brazil was successfully translated and culturally adapted to the Brazilian population. It can be used for the impact assessment of primary and secondary headaches with validity and reliability equivalent to its original version.
Platelet-Rich Plasma Versus Corticosteroids for the Treatment of Plantar Fasciitis: A Systematic Review and Meta-analysis
Authors: Hohmann Erik , Tetsworth Kevin , Glatt Vaida 
Published: August 2020

Background: Plantar fasciitis is a common cause of heel pain. Corticosteroid injections are commonly used and proven to be effective, and lately platelet-rich plasma (PRP) has been used with mixed results. Purpose: To perform a systematic review and meta-analysis comparing intralesional injections of PRP and steroid infiltration. Study Design: Systematic review and meta-analysis. Methods: A systematic review of Medline, Embase, Scopus, and Google Scholar including all level 1 and 2 studies from 2010 to 2019 was perfomed. American Orthopaedic Foot and Ankle Society and visual analog scale for pain scores were used as outcome variables. Publication bias and risk of bias was assessed with the Cochrane Collaboration tools. The Grading of Recommendations, Assessment, Development and Evaluations system was used to assess the quality of the body of evidence. Heterogeneity was assessed with χ2 and I2 statistics. Results: Fifteen studies were included in the analysis. Nine studies had a high risk of bias. There was 1 study with high quality, 9 with moderate, 2 studies with low, and 3 with very low quality. The pooled estimate for the American Orthopaedic Foot and Ankle Society score demonstrated nonsignificant differences at 1 month ( P = .4) and 3 months ( P = .076). At 6 months ( P = .009) and 12 months ( P = .009), it indicated significant differences in favor of PRP. The pooled estimate for visual analog scale demonstrated nonsignificant differences at 1 month ( P = .653). At 3 months ( P = .0001), 6 months ( P = .002), and 12 months ( P = .019), it yielded significant differences in favor of PRP. Conclusion: The results of this systematic review and meta-analysis suggest that PRP is superior to corticosteroid injections for pain control at 3 months and lasts up to 1 year. In the short term, there is no advantage of corticosteroid infiltration. However, the low study quality, high risk of bias, and different protocols for PRP preparation reduce the internal and external validity of these findings, and these results must be viewed with caution.