bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differences in Outcome Between Open vs Laparoscopic Insertion of Ventriculoperitoneal Shunts
Authors: Lopacinski Aaron B. , Guy Kevin M. , Burgess Jessica R. , Collins Jay N. 
Published: November 2021

Background Abdominal access during ventriculoperitoneal (VP) shunt insertion has historically been obtained by neurosurgeons via an open abdominal approach. With recent advances in laparoscopy, neurosurgeons frequently consult general surgery for aid during the procedure. The goal of this study is to identify if laparoscopic assistance improves the overall outcomes of the procedure. Methods This retrospective study included all patients who underwent open or laparoscopic VP shunt placement between September 2012 and August 2020 at our tertiary referral hospital. Patient demographics, comorbidities, prior history of abdominal surgery, open vs. laparoscopic insertion, operation time, and complications within 30 days were obtained. Results Neurosurgery placed 107 shunts using an open abdominal technique and general surgery placed 78 using laparoscopy. The average OR time in minutes was 75.5 minutes for the open cohort and 61.8 for the laparoscopic cohort ( p = 0.006). In patients without a history of abdominal surgery, the average OR time in minutes was 79.4 in the open cohort and 57.1 in the laparoscopic cohort ( p = 0.015). The postoperative shunt infection rate was 10.2% in the open group and 3.8% in the laparoscopic group ( p = 0.077). Discussion Laparoscopic placement of VP shunts is a reasonable alternative to open placement and results in shorter OR times. There is also a trend toward few infections in the laparoscopic placement. There appears to be an advantage with a team approach and laparoscopic placement of the peritoneal portion of the shunt.
Patients’ Perceptions of Residents Involved in Their Care in a Community General Surgery Practice
Authors: Chambers James G. 
Published: November 2021

Background Resident involvement in patient care in the general surgery setting is most often encountered in an academic setting. Many community hospitals have residents involved in patient care as well. There are no studies that gauge patients’ perceptions in the involvement of residents in their general surgery care in the community setting. Methods Patients were given a Northeast Georgia Health System Graduate Medical Education Department Institutional review Board approved 26-question questionnaire during their office visit gauging their wiliness to allow a resident be involved in their care, and their understanding of what a resident is. Results A total of 196 patients completed the survey with answers that could be analyzed. Overall, 67.3% would allow residents be involved in their care. The main reasons for this were to educate future surgeons, they enjoy a teaching environment, and that they have had residents involved in their care and it was a good experience. Of the 27 % that did not want a resident involved in their care, the main reason was they only wanted their doctor involved in their care. Of the respondents, 58 % were comfortable having a resident involved in their surgery or procedure. Only 14% noted that they would prefer not to have a resident involved in their procedure or surgery. Conclusions Patents appear receptive to general surgery residents’ involvement in their care in the community setting. This is reassuring as community practices may be more receptive to including residents in their practices, based upon these findings.
Diatrizoate (Gastrograffin®) Small Bowel Follow Through for Small Bowel Obstructions: Timing and Outcomes
Authors: Licata Andrew , El Moudden Ismail , Bandy Nicholas , Sternick Molly , Britt Rebecca 
Published: November 2021

Introduction The advent of the Gastrograffin® small bowel follow through (G-SBFT) has resulted in a decreased rate of operative intervention of small bowel obstructions (SBO); however, there is no data to suggest when G-SBFT should be performed. Methods We retrospectively reviewed 548 patients, admitted to 1 of 9 hospitals with a diagnosis of SBO. Patients were divided into two categories with regards to timing of G-SBFT: before (early) or after (late) 48 hours from admission. Primary outcomes were length of stay (LOS) and total cost. Secondary outcomes were operative interventions and mortality. Results Of the reviewed patients, 71% had the G-SBFT ordered early. Comparing early versus late, there were no differences in patient characteristics with regards to age, sex, or BMI. There was a significant difference between LOS (4 vs 8 days, P < 0.05) and total cost ($17,056.19 vs $33,292.00, P < 0.05). There was no difference in mortality (1.3% vs 2.6%, P = 0.239) or 30-day readmission rates (15.6% vs 15.9%, P = 0.509). Patients in the early group underwent fewer operations (20.7% vs 31.9%, P = 0.05). Discussion Patients that had a G-SBFT ordered early had a decreased LOS, total cost, and operative intervention. This suggests there is a benefit to ordering G-SBFT earlier in the hospital stay to reduce the overall disease burden, and that it is safe to do so with regards to mortality and readmissions. We therefore recommend ordering a G-SBFT within 48 hours to reduce LOS, cost, and need for an operation
Factors Affecting Time to Surgery in Breast Cancer Patients
Authors: Chagpar Anees B. , Howard-McNatt Marissa , Chiba Akiko , Levine Edward A. , Gass Jennifer S. , Gallagher Kristalyn , Lum Sharon , Martinez Ricardo , Willis Allric I. , Fenton Andrew , Solomon Naveenraj L. , Senthil Magi , Edmonson David , Namm Jukes P. , Walters Laura , Brown Eric , Murray Mary , Ollila David , Dupont Elisabeth , Garcia-Cantu Carlos 
Published: November 2021

Background We sought to determine factors affecting time to surgery (TTS) to identify potential modifiable factors to improve timeliness of care. Methods Patients with clinical stage 0-3 breast cancer undergoing partial mastectomy in 2 clinical trials, conducted in ten centers across the US, were analyzed. No preoperative workup was mandated by the study; those receiving neoadjuvant therapy were excluded. Results The median TTS among the 583 patients in this cohort was 34 days (range: 1-289). Patient age, race, tumor palpability, and genomic subtype did not influence timeliness of care defined as TTS ≤30 days. Hispanic patients less likely to have a TTS ≤30 days ( P = .001). There was significant variation in TTS by surgeon ( P < .001); those practicing in an academic center more likely to have TTS ≤30 days than those in a community setting (55.1% vs 19.3%, P < .001). Patients who had a preoperative ultrasound had a similar TTS to those who did not (TTS ≤30 days 41.9% vs 51.9%, respectively, P = .109), but those who had a preoperative MRI had a significantly increased TTS (TTS ≤30 days 25.0% vs 50.9%, P < .001). On multivariate analysis, patient ethnicity was no longer significantly associated with TTS ≤30 ( P = .150). Rather, use of MRI (OR: .438; 95% CI: .287-.668, P < .001) and community practice type (OR: .324; 95% CI: .194-.541, P < .001) remained independent predictors of lower likelihood of TTS ≤30 days. Conclusions Preoperative MRI significantly increases time to surgery; surgeons should consider this in deciding on its use.
Biologic Augmentation for the Operative Treatment of Osteochondral Defects of the Knee: A Systematic Review
Authors: Chona Deepak V. , Kha Stephanie T. , Minetos Paul D. , LaPrade Christopher M. , Chu Constance R. , Abrams Geoffrey D. , Safran Marc R. , Sherman Seth L. 
Published: November 2021

Background: Various surgical treatment options exist for repairing, replacing, or regenerating tissue to fill osteochondral defects. Biologic augmentation has been increasingly studied as an adjunct in the surgical treatment of osteochondral defects of the knee in animal and human models. Purpose/Hypothesis: The purpose of the study was to systematically review use of platelet-rich plasma (PRP) and bone marrow concentrate (BMC) augmentation in the surgical treatment of osteochondral knee defects and to describe the outcomes. It was hypothesized that both PRP and BMC augmentation will result in improved outcomes in osteochondral knee surgery in both animal and human models. Study Design: Systematic review. Methods: PubMed, MEDLINE, and Embase were searched for studies relating to PRP or BMC and treatment of osteochondral defects of the knee, from database inception to February 1, 2020. Included were articles that (1) studied PRP or BMC augmentation; (2) used osteochondral autograft, allograft, or biologic scaffold; and (3) treated osteochondral defects in the knee. Data on use of PRP or BMC, outcomes assessed, and results were recorded for each publication. Results: Of the 541 articles identified initially, 17 were included in the final review. Five articles studied osteochondral grafts in animals, 5 studied biologic scaffolds in animals, and 7 studied scaffolds or allografts in humans; the combined sample size was 202 patients. Of 4 histologic scaffold studies, 3 PRP-augmented scaffold studies identified histologic improvements in regenerated cartilage in animal models, while 1 BMC study demonstrated similar improvement in histologic scores of BMC-augmented scaffolds compared with controls. Three studies associated greater collagen type 2 and glycosaminoglycan content with PRP treatment. Comparative studies found that both augments increase osteogenic proteins, including bone morphogenetic protein–2 and osteoprotegerin. Two of 3 studies on BMC-augmented osteochondral allografts reported no difference in radiographic features postoperatively. Long-term improvement in clinical and radiographic outcomes of PRP-augmented scaffolds was demonstrated in 1 human study. Conclusion: Animal studies suggest that biologics possess potential as adjuncts to surgical treatment of osteochondral knee defects; however, clinical data remain limited.
Arthroscopic Medial Meniscus Root Repair With Transtibial Ripstop Technique
Authors: Dandu Navya , DeFroda Steven F. , Trasolini Nicholas A. , Darwish Reem Y. , Yanke Adam B. 
Published: November 2021

Background: Meniscal root tears are radial tears occurring at or within 1 cm of the meniscal root attachment. These injuries have been shown to be the biomechanical equivalent of a total meniscectomy and are thought to be responsible for a rapid progression of osteoarthritis if left untreated. Indications: Meniscal root repair is indicated if possible, with the exception of patients who have diffuse Outerbridge 3-4 osteoarthritis of the ipsilateral compartment, those who are poor surgical candidates due to age or medical comorbidity, or in whom nonsymptomatic tears are found incidentally. Technique Description: Standard 2-portal arthroscopy is performed. Once a medial root tear has been identified and concomitant pathology has been addressed, we typically begin the repair by trephinating the deep medial collateral ligament with an 18-gauge needle to enhance visualization and avoid iatrogenic cartilage injury. Arthroscopic shaver is used to debride the meniscal root as needed. A meniscal root guide is introduced into the joint and an incision is made on the anteromedial tibia for outside-in drilling of a transosseous tunnel. Drilling is performed with a 5-mm retroreaming device, and a 10-mm socket is created. Nonabsorbable suture is then passed through the meniscus using a self-capture device in an inverted mattress configuration, following by 2 cinch stitches. The sutures are then shuttled into the transosseous tunnel, and the meniscal root is reduced and tensioned in full extension, with the sutures being fixated into a suture anchor on the anteromedial tibia. Results: A recent large systematic review of 1086 patients undergoing treatment of meniscal root tear via either debridement or nonoperative management compared with meniscal repair found that conversion to total knee arthroplasty occurred in 11% to 54% of those managed via debridement or nonoperative care versus 0% to 1% for those with root repair. Discussion/Conclusion: Currently, meniscal root repair offers the greatest improvement and lowest risk of conversion to arthroplasty following meniscal root tear. The present technique offers a durable repair that we believe combines ease of execution with decreased risk of suture pull-out, by creating a ripstop-type construct. Long-term outcome studies are needed for this and other root repair techniques.
Drug exposure and susceptibility of second-line drugs correlate with treatment response in patients with multidrug-resistant tuberculosis: a multicentre prospective cohort study in China
Authors: Zheng Xubin , Davies Forsman Lina , Bao Ziwei , Xie Yan , Ning Zhu , Schön Thomas , Bruchfeld Judith , Xu Biao , Alffenaar Jan-Willem , Hu Yi 
Published: November 2021

BackgroundUnderstanding the impact of drug exposure and susceptibility on treatment response of multidrug-resistant tuberculosis (MDR-TB) will help to optimise treatment. This study aimed to investigate the association between drug exposure, susceptibility and response to MDR-TB treatment.MethodsDrug exposure and susceptibility for second-line drugs were measured for patients with MDR-TB. Multivariate analysis was applied to investigate the impact of drug exposure and susceptibility on sputum culture conversion and treatment outcome. Probability of target attainment was evaluated. Random Forest and CART (Classification and Regression Tree) analysis was used to identify key predictors and their clinical targets among patients on World Health Organization-recommended regimens.ResultsDrug exposure and corresponding susceptibility were available for 197 patients with MDR-TB. The probability of target attainment was highly variable, ranging from 0% for ethambutol to 97% for linezolid, while patients with fluoroquinolones above targets had a higher probability of 2-month culture conversion (56.3%versus28.6%; adjusted OR 2.91, 95% CI 1.42–5.94) and favourable outcome (88.8%versus68.8%; adjusted OR 2.89, 95% CI 1.16–7.17). Higher exposure values of fluoroquinolones, linezolid and pyrazinamide were associated with earlier sputum culture conversion. CART analysis selected moxifloxacin area under the drug concentration–time curve/minimum inhibitory concentration (AUC0–24h/MIC) of 231 and linezolid AUC0–24h/MIC of 287 as best predictors for 6-month culture conversion in patients receiving identical Group A-based regimens. These associations were confirmed in multivariate analysis.ConclusionsOur findings indicate that target attainment of TB drugs is associated with response to treatment. The CART-derived thresholds may serve as targets for early dose adjustment in a future randomised controlled study to improve MDR-TB treatment outcome.
Preparation and Magnetic Properties of Cobalt-Doped FeMn2O4 Spinel Nanoparticles
Authors: Spivakov Aleksandr A. , Lin Chun-Rong , Lin En-Szu , Chen Ying-Zhen , Tseng Yaw-Teng 
Published: November 2021

AbstractMixed-metal oxide nanoparticles have attracted great scientific interest since they find applications in many fields. However, the synthesis of size-controlled and composition-tuned mixed-metal oxide nanoparticles is a great challenge that complicates their study for practical application. In this study, Co-doped FeMn2O4 nanoparticles were synthesized by the solvothermal method in which the crystallization was carried out under autogenous pressure at temperatures of 190 °C for 24 h. The influence of Co doping on the evolution of the structural and magnetic properties was investigated by various methods. It was found from XRD data that crystallite size decreases from 9.1 to 4.4 nm with the increase in Co content, which is in good agreement with the results of TEM. Based on the results of magnetic measurements, it was found that the saturation magnetization first increases with an increase in the cobalt content and reaches its maximum value at x = 0.4, and a further increase in x leads to a decrease in the saturation magnetization. The influence of cation redistribution on the observed changes has been discussed.
Mental health-related visits in a pediatric emergency department during the COVID-19 pandemic
Authors: Fernandez Arnaud , Gindt Morgane , Babe Phillipe , Askenazy Florence 
Published: November 2021

AbstractWe aimed to describe the epidemiology of all pediatric emergency department visits (focusing on mental health-related visits versus total visits) at the University Children’s Hospital of Nice (France) from 1 January to 31 December 2020 (year of the COVID-19 pandemic) and to compare it with the earlier 3-year period. The increase in mental health-related visits (44.2%) that we observed, while total visits decreased (30.0%), suggests an impact of the pandemic on children’s and adolescents’ mental health.
A peculiar case of psychosis: anti-NMDAr encephalitis
Authors: Kouba Lamia , Alhosain Dalia 
Published: November 2021

Abstract
Background
Psychosis in pregnancy is rare and could be life-threatening. It requires prompt evaluation and proper management accordingly. Anti-N-methyl-d-aspartate receptor (anti-NMDAr) encephalitis following herpes simplex virus (HSV) infection is a rare cause of psychosis during pregnancy.

Case presentation
A 20-year-old woman at 18 weeks gestation presented with agitation and a 3-day history of hallucinations. She had a prior hospitalization for HSV encephalitis 6 weeks before. Her laboratory workup was unremarkable except for positive anti-NMDAr antibodies in the CSF. The patient was treated with high-dose corticosteroids and plasmapheresis, and she was discharged 2 weeks later fully recovered.

Conclusions
Anti-NMDAr encephalitis can be the culprit behind a new-onset of psychosis in pregnancy. Early diagnosis and treatment are crucial.
The Role of Cell Organelles in Rheumatoid Arthritis with Focus on Exosomes
Authors: Payandeh Zahra , Pirpour Tazehkand Abbas , Azargoonjahromi Ali , Almasi Faezeh , Alagheband Bahrami Armina 
Published: November 2021

AbstractAuto-immune diseases involved at least 25% of the population in wealthy countries. Several factors including genetic, epigenetic, and environmental elements are implicated in development of Rheumatoid Arthritis as an autoimmune disease. Autoantibodies cause synovial inflammation and arthritis, if left untreated or being under continual external stimulation, could result in chronic inflammation, joint injury, and disability. T- and B-cells, signaling molecules, proinflammatory mediators, and synovium-specific targets are among the new therapeutic targets. Exosomes could be employed as therapeutic vectors in the treatment of autoimmune diseases. Herein, the role of cell organelle particularly exosomes in Rheumatoid Arthritis had discussed and some therapeutic applications of exosome highlighted.
Dexamethasone priming enhances stemness and immunomodulatory property of tissue-specific human mesenchymal stem cells
Authors: Rawat Sonali , Dadhwal Vatsla , Mohanty Sujata 
Published: November 2021

Abstract
Background
Human Mesenchymal Stem Cells (hMSCs) represent a promising cell source for cell-based therapy in autoimmune diseases and other degenerative disorders due to their immunosuppressive, anti-inflammatory and regenerative potentials. Belonging to a glucocorticoid family, Dexamethasone (Dex) is a powerful anti-inflammatory compound that is widely used as therapy in autoimmune disease conditions or allogeneic transplantation. However, minimal immunomodulatory effect of hMSCs may limit their therapeutic uses. Moreover, the effect of glucocorticoids on the immunomodulatory molecules or other regenerative properties of tissue-specific hMSCs remains unknown.

Method
Herein, we evaluated the in vitro effect of Dex at various dose concentrations and time intervals, 1000 ng/ml, 2000 ng/ml, 3000 ng/ml and 24 h, 48 h respectively, on the basic characteristics and immunomodulatory properties of Bone marrow derived MSC (BM-MSCs), Adipose tissue derived MSCs (AD-MSCs), Dental Pulp derived MSC (DP-MSCs) and Umbilical cord derived MSCs (UC-MSCs).

Results
The present study indicated that the concentration of Dex did not ramify the cellular morphology nor showed cytotoxicity as well as conserved the basic characteristics of tissue specific hMSCs including cell proliferation and surface marker profiling. However, quite interestingly it was observed that the stemness markers (Oct-4, Sox-2, Nanog and Klf-4) showed a significant upregulation in DP-MSCs and AD-MSCs followed by UC-MSCs and BM-MSCs. Additionally, immunomodulatory molecules, Prostaglandin E-2 (PGE-2), Indoleamine- 2,3-dioxygenase (IDO) and Human Leukocyte Antigen-G (HLA-G) were seen to be upregulated in a dose-dependent manner. Moreover, there was a differential response of tissue specific hMSCs after pre-conditioning with Dex during mixed lymphocyte reaction, wherein UC-MSCs and DP-MSCs showed enhanced immunosuppression as compared to AD-MSCs and BM-MSCs, thereby proving to be a better candidate for therapeutic applications in immune-related diseases.

Conclusion
Dex preconditioning improved the hMSCs immunomodulatory property and may have reduced the challenge associated with minimal potency and strengthen their therapeutic efficacy.

Graphical Abstract
Preconditioning of tissue specific hMSCs with dexamethasone biomanufacturers the enhanced potential hMSCs with better stemness and immunomodulatory properties for future therapeutics.
Temporal expression study of miRNAs in the crown tissues of winter wheat grown under natural growth conditions
Authors: Wang Menglei , Yang Chenhui , Wei Kangning , Zhao Miao , Shen Liqiang , Ji Jie , Wang Li , Zhang Daijing , Guo Junqiang , Zheng Yun , Yu Juanjuan , Zhu Mo , Liu Haiying , Li Yong-Fang 
Published: November 2021

Abstract
Background
Winter wheat requires prolonged exposure to low temperature to initiate flowering (vernalization). Shoot apical meristem of the crown is the site of cold perception, which produces leaf primordia during vegetative growth before developing into floral primordia at the initiation of the reproductive phase. Although many essential genes for winter wheat cold acclimation and floral initiation have been revealed, the importance of microRNA (miRNA) meditated post-transcriptional regulation in crowns is not well understood. To understand the potential roles of miRNAs in crown tissues, we performed a temporal expression study of miRNAs in crown tissues at the three-leaf stage, winter dormancy stage, spring green-up stage, and jointing stage of winter wheat grown under natural growth conditions.

Results
In total, 348 miRNAs belonging to 298 miRNA families, were identified in wheat crown tissues. Among them, 92 differentially expressed miRNAs (DEMs) were found to be significantly regulated from the three-leaf stage to the jointing stage. Most of these DEMs were highly expressed at the three-leaf stage and winter dormancy stage, and then declined in later stages. Six DEMs, including miR156a-5p were markedly induced during the winter dormancy stage. Eleven DEMs, including miR159a.1, miR390a-5p, miR393-5p, miR160a-5p, and miR1436, were highly expressed at the green-up stage. Twelve DEMs, such as miR172a-5p, miR394a, miR319b-3p, and miR9676-5p were highly induced at the jointing stage. Moreover, 14 novel target genes of nine wheat or Pooideae-specific miRNAs were verified using RLM-5′ RACE assay. Notably, six mTERFs and two Rf1 genes, which are associated with mitochondrial gene expression, were confirmed as targets of three wheat-specific miRNAs.

Conclusions
The present study not only confirmed the known miRNAs associated with phase transition and floral development, but also identified a number of wheat or Pooideae-specific miRNAs critical for winter wheat cold acclimation and floral development. Most importantly, this study provided experimental evidence that miRNA could regulate mitochondrial gene expression by targeting mTERF and Rf1 genes. Our study provides valuable information for further exploration of the mechanism of miRNA mediated post-transcriptional regulation during winter wheat vernalization and inflorescent initiation.