bluuebunny/crossref_metadata_2025_split huggingface dataset:
Novel roles for voltage‐gated T‐type Ca2+ and ClC‐2 channels in phagocytosis and angiogenic factor balance identified in human iPSC‐derived RPE
Authors: Mamaeva Daria , Jazouli Zhour , DiFrancesco Mattia L. , Erkilic Nejla , Dubois Gregor , Hilaire Cecile , Meunier Isabelle , Boukhaddaoui Hassan , Kalatzis Vasiliki 
Published: March 2021

AbstractHuman‐induced pluripotent stem cell (hiPSC)‐derived retinal pigment epithelium (RPE) is a powerful tool for pathophysiological studies and preclinical therapeutic screening, as well as a source for clinical cell transplantation. Thus, it must be validated for maturity and functionality to ensure correct data readouts and clinical safety. Previous studies have validated hiPSC‐derived RPE as morphologically characteristic of the tissue in the human eye. However, information concerning the expression and functionality of ion channels is still limited. We screened hiPSC‐derived RPE for the polarized expression of a panel of L‐type (CaV1.1, CaV1.3) and T‐type (CaV3.1, CaV3.3) Ca2+ channels, K+ channels (Maxi‐K, Kir4.1, Kir7.1), and the Cl− channel ClC‐2 known to be expressed in native RPE. We also tested the roles of these channels in key RPE functions using specific inhibitors. In addition to confirming the native expression profiles and function of certain channels, such as L‐type Ca2+ channels, we show for the first time that T‐type Ca2+ channels play a role in both phagocytosis and vascular endothelial growth factor (VEGF) secretion. Moreover, we demonstrate that Maxi‐K and Kir7.1 channels are involved in the polarized secretion of VEGF and pigment epithelium‐derived factor (PEDF). Furthermore, we show a novel localization for ClC‐2 channel on the apical side of hiPSC‐derived RPE, with an overexpression at the level of fluid‐filled domes, and demonstrate that it plays an important role in phagocytosis, as well as VEGF and PEDF secretion. Taken together, hiPSC‐derived RPE is a powerful model for advancing fundamental knowledge of RPE functions.
Preoperative Depression and Anxiety Impact on Inpatient Surgery Outcomes
Authors: Geoffrion Roxana , Koenig Nicole A. , Zheng Meimuzi , Sinclair Nicholas , Brotto Lori A. , Lee Terry , Larouche Maryse 
Published: March 2021

Objectives:
To determine the association of preoperative mood symptoms and postoperative adverse outcomes; to explore sex-specific differences.

Background:
Depression and anxiety can increase postoperative mortality. Psychological stress is associated with a chronic inflammatory response unfavorable to postsurgical healing.

Methods:
Prospective cohort study. Patients were recruited from surgical preadmission clinics at a university hospital. Preoperative depression and anxiety were measured via the Beck Depression and Beck Anxiety Inventories (BDI-II and BAI). Our primary outcome was a composite of postoperative complications, extended length of stay (ELOS) and early readmission. Associated variables included demographics, preoperative pain, pain tolerance/catastrophizing, coping mechanisms, postoperative pain, and opioid use. We adjusted for age, comorbidities, and surgical specialty.

Results:
Of 1061 recruited patients (ten surgical specialties, 2015–2020), 455 males and 486 females had preoperative and postoperative data available. Mean age was 62.9 (range 20.2–96.2). At baseline, 9.3% of patients had moderate or severe depression; 7.4% had moderate or severe anxiety. Females were more likely to be moderately or severely depressed (11% vs 7%, P = 0.036) and moderately or severely anxious (9% vs 6%, P = 0.034). Females had significantly fewer reported comorbidities and lower American Society of Anesthesiologists category (P < 0.001). Increasing BDI-II and BAI scores significantly increased likelihood of postoperative complications, ELOS, and/or hospital readmission in females (adjusted odds ratio [aOR] = 2.57 for BDI-II 1-19 vs 0, P = 0.041; aOR = 4.48 for BDI-II > 19 vs 0, P = 0.008; aOR = 1.54 for BAI ≤ 6 vs >6, P = 0.038) but not in males. Mood symptoms did not influence postoperative pain or opioid use.

Conclusion:
Preoperative depression and anxiety negatively impact surgical outcomes in female patients undergoing major surgery.
Risk Factors for Posttraumatic Stress Disorder in Acute Trauma Patients
Authors: Joseph Noah M. , Benedick Alex , Flanagan Christopher D. , Breslin Mary A. , Vallier Heather A. 
Published: March 2021

Objective:
To identify risk factors for posttraumatic stress disorder (PTSD) after traumatic injury.

Setting:
Single urban Level I trauma center.

Design:
Prospective.

Patients/Participants:
Three hundred men (66%) and 152 women treated for traumatic injuries were administered the PTSD checklist for a Diagnostic and Statistical Manual of Mental Disorders fifth edition (PCL-5) survey during their first post-hospital visit over a 15-month period.

Intervention:
Screening for PTSD in trauma patients.

Main Outcome Measurement:
The prevalence of disease and risk factors for the development of PTSD based on demographic, medical, injury, and treatment variables.

Results:
One hundred three patients screened positive for PTSD (26%) after a mean of 86 days after injury. Age less than 45 years was an independent risk factor for the development of PTSD [odds ratio (OR) 2.64, 95% confidence interval (CI) (1.40–4.99)]. Mechanisms of injury associated with the development of PTSD included pedestrians struck by motor vehicles [OR 7.35, 95% CI (1.58–34.19)], motorcycle/all terrain vehicle crash [OR 3.17, 95% CI (1.04–9.65)], and victims of crime [OR 3.49, 95% CI (0.99–9.20)]. Patients sustaining high-energy mechanism injuries and those who were victims of crime scored higher on the PCL-5 [OR 2.39, 95% CI (1.35–4.22); OR 4.50, 95% CI (2.52–8.05), respectively].

Conclusions:
One quarter of trauma patients screened positive for PTSD at 3 months after their injury. A mechanism of injury is a risk factor for PTSD, and younger adults, victims of crime, and pedestrians struck by motor vehicles are at higher risk. These findings offer the potential to more effectively target and refer vulnerable patient populations to appropriate treatment.

Level of Evidence:
Prognostic Level II. See Instructions for Authors for a compete description of levels of evidence.
A Modified Levine Approach for Exposure of the Anterior Column, Anterior Wall, and Sacroiliac Joint: A Surgical Technique and a Case Series
Authors: Jang Yohan , Virkus Walter , Mckinley Todd 
Published: March 2021

Summary:
Surgical exposure of the anterior column, anterior wall, pelvic brim, and sacroiliac joint is accessible through the lateral window of the ilioinguinal approach. Residual attachment of the abdominal muscles and inguinal ligament to the anterior superior iliac spine (ASIS) is often a limiting factor to expanded distal and medial exposure, especially in patients with a large abdomen that hangs over the pelvis. An ASIS osteotomy has been described to improve exposure, particularly of the distal anterior wall and joint capsule, pubic ramus, and anterior quadrilateral plate. However, an ASIS osteotomy can be troublesome to reattach. In this study, we introduce a soft tissue release technique to mobilize the abdominal muscles and inguinal ligament to allow expanded surgical access to the distal anterior column/wall and sacroiliac joint and to create a working space for fracture reduction and fixation.
The Effects of Cannabis: Implications for the Surgical Patient
Authors: Copeland-Halperin Libby R. , Herrera-Gomez Laura C. , LaPier Jennifer R. , Shank Nina , Shin Joseph H. 
Published: March 2021

Background:
Cannabis use is increasingly prevalent. Cannabinoid receptors regulate pro-inflammatory cytokines, and compounds in marijuana exert diverse physiologic effects. As more patients use cannabis, clinicians should recognize implications of perioperative cannabis use. Although the role of cannabis use in perioperative pain control has been explored, little is known about its effect on perioperative wound healing or on hematologic, pulmonary, and cardiovascular physiology.

Methods:
We searched PubMed for English-language articles related to cannabis (ie, marijuana, cannabidiol oil, and tetrahydrocannabinol) and wound healing, cardiovascular, pulmonary, or hematologic outcomes, and surgery. Titles and abstracts were reviewed, and relevant articles were analyzed. Human, animal, and pathology studies were included. Editorials, case reports, and review articles were excluded.

Results:
In total, 2549 wound healing articles were identified; 5 human studies and 8 animal/pathology studies were included. Results were conflicting. An estimated 2900 articles related to cardiovascular effects were identified, of which 2 human studies were included, which showed tetrahydrocannabinol and marijuana caused tachycardia. A total of 142 studies regarding pulmonary effects were identified. Three human studies were included, which found no difference in respiratory complications. In total, 114 studies regarding hematologic effects were identified. The 3 included human studies found conflicting venous thromboembolism risks. The overall study quality was poor. Information about dose/duration, administration route, and follow-up was reported with variable completeness.

Conclusions:
Surgeons should consider effects of cannabis in the perioperative setting. Little is known about its perioperative effects on wound healing, or on cardiovascular, pulmonary, and hematologic physiology. Further research should elucidate the effects of administration route, dose, and timing of cannabis use among surgical patients.
The Biomechanical Properties of Meshed versus Perforated Acellular Dermal Matrices (ADMs)
Authors: Sweitzer Keith , Carruthers Katherine H. , Blume Lauren , Tiwari, Pankaj , Kocak, Ergun 
Published: March 2021

Background:
Acellular dermal matrices (ADMs) are used for soft tissue augmentation across surgical specialties. Since allograft incorporation depends on direct opposition between the ADM and a vascular bed, seroma formation can be detrimental to incorporation. Since most ADM products are available in many meshed and perforated forms, there is a lack of consistency between manufacture designs. We set out to determine the fluid egress properties and increase in surface area resulting from common cut patterns.

Methods:
Three ADM cut patterns were studied: 1 meshed and 2 perforated. We calculated the surface area of these modified ADM samples. Fluid was passed through each ADM, and time required for fluid passage was recorded. An ANOVA (P < 0.05) was used to determine if there was a significant difference in egress properties across the 3 patterns.

Results:
Meshing in a 1:1 pattern resulted in a 97.50% increase in surface area compared with the uncut product. In comparison, only a 0.30% increase resulted from Perforation Pattern #1 and a 0.59% increase resulted from Perforation Pattern #2. There was a significant difference in egress properties across the three cut patterns (P = 0.000). The average egress time of Mesh Pattern #1 was 1.974 seconds. The average egress time of Perforation Pattern #2 was 6.504 seconds, and of Perforation Pattern #1 was 10.369 seconds.

Conclusions:
Quantitative comparison revealed that meshing ADM significantly improves fluid egress and increases the surface area. Therefore, the use of meshed ADM tissue could improve the incorporation of ADM with the recipient, with improved patient outcomes.
Lower Lip Reanimation: Experience Using the Anterior Belly of Digastric Muscle in 2-stage Procedure
Authors: Tzafetta Kallirroi , Ruston Julia C. , Pinto-Lopes Rui , Mabvuure Nigel Tapiwa 
Published: March 2021

Background:
Lower lip depression was historically regarded a neglected area of facial paralysis, but, with refinement of techniques, has gained increasing attention. We present the first detailed description and evaluation of a 2-stage technique, using first cross facial nerve graft and then the anterior belly of digastric muscle (ABDM), innervated by the cross facial nerve graft, to restore dynamic and spontaneous lower lip depression.

Methods:
Retrospective analysis of 2-stage lower lip reanimations between 2010 and 2018 was performed. Demographics, etiology, and operative details were recorded. Videos were graded pre/postoperatively using a 5-point Likert scale by 21 independent observers. Objective changes of symmetry were analyzed using Photogrammetry (Emotrics).

Results:
Twenty-seven patients were identified (median age 34.9 years, range 6–64). The mean duration between the 2 stages was 15.1 months. Follow-up ranged from 18–72 months. There were minor complications in 4 patients, and 1 case was abandoned due to insufficient length of anterior belly of digastric muscle. Average peer-reviewed scores improved from 2.1 to 3.2 (P < 0.05). Emotrics did not show improvement in static symmetry (P > 0.05). However, during open-lip smiling, lower lip height improved significantly (P < 0.05) whilst dental show improvements approached significance (P < 0.08). Lower lip symmetry was also improved during lower lip depression, as shown by improvements in lower lip height (P < 0.05), smile angle, and dental show (both P < 0.05).

Conclusions:
These results show the safety and efficacy of 2-stage lower lip reanimation using anterior belly of digastric muscle transposition. This procedure is our choice for longstanding lower lip paralysis and provides coordinated spontaneous lower lip depression, thus enhancing the overall perioral animation and smile.
Going Silent: Redesigning the Activation Process for In-Hospital Cardiopulmonary Arrests
Authors: Stinehart Kyle R. , Spitzer Carleen R. , Evans Kimberly A. , Buehler Jeri , Attar Talal , Besecker Beth 
Published: March 2021

ABSTRACT

Introduction:
Reducing environmental noise has become a priority for many health systems. Following a 10-week preparation period, our health system transitioned from an overhead-activated to a silently activated in-hospital code team notification system. The goal of this initiative was to reduce environmental noise and support code team communication and function without adversely affecting response time, provider availability, or key quality metrics.

Methods:
Transitioning from overhead to silently activated events involved a three-step quality improvement approach. Input from key stakeholders and preimplementation education were of key importance. Multiple timed trials and a full in situ simulation were completed before going live with the new process.

Results:
Evaluation of 6-month pre- and postimplementation quality metrics showed no significant difference in compliance with defibrillating shockable rhythms within two minutes, event survival, or survival to discharge. Provider survey data and Hospital Consumer Assessment of Healthcare Providers and Systems “quiet at night” scores were not significantly different.

Conclusion:
By utilizing a multistep implementation approach, transitioning from overhead pages to a silently activated system for in-hospital code team activation was feasible and safe. Abandoning the overhead paging system did not lead to a decrease in key quality metrics nor impair team perception of code function.
Effect and safety of acupuncture for autism spectrum disorders
Authors: Zhang Ying , Zeng Jianfei , Wu Dan , Li Xiujuan , Chen Yangxia , Dai Shixia , Wang Bing , Qi Yu , Lu Jianping 
Published: March 2021

Abstract

Background:
Autism spectrum disorder (ASD) is a complex neurodevelopmental condition, which is characterized by impairment in social interaction or communication and lack of flexibility of imagination and behavior. Acupuncture is one of the most common modality of Traditional Chinese medicine (TCM) and has been used to treat various disease in clinical practice for more than 2000 years in China by correcting disharmony and dysregulation of body. It has sometimes been used as a treatment aimed at improving ASD symptoms and outcomes, but its clinical effectiveness and safety has not been rigorously reviewed. We will plan to conduct a systematic review and meta-analysis to summarize the current evidence on the effects and safety of acupuncture for ASD.

Methods:
The following databases will be searched: PubMed, the Cochrane Library, Embase, Wanfang Data, China National Knowledge Infrastructure, SinoMed, and VIP. Randomised controlled trials will be included to evaluate the effect and safety of acupuncture on patients with ASD. The primary outcome will be the core features of ASD. The risk of bias will be assessed by the Cochrane risk of bias tool. We will conduct a meta-analysis and sensitivity analysis, as well as a subgroup analysis if high heterogeneity is present, using Revman 5.3. We will use funnel plots to identify potential reporting biases. The Grading of Recommendations Assessment, Development and Evaluation will be used to evaluate the quality of evidence.

Results:
This study will be to assess the effect and safety of acupuncture for ASD.

Conclusions:
This study will assess the effect of acupuncture for ASD and provide reliable evidence for the choice of treatments.

Ethics and dissemination:
The protocol will not need ethical approval because no issues of participant privacy exist. The results of this systematic review will provide evidence about the effect and safety of acupuncture for ASD. The results will be disseminated through peer review.
Quantification of immobilization-induced changes in human calf muscle using speed-of-sound ultrasound
Authors: Ruby Lisa , Sanabria Sergio J. , Martini Katharina , Frauenfelder Thomas , Jukema Gerrolt Nico , Goksel Orcun , Rominger Marga B. 
Published: March 2021

Abstract
Short-term immobilization leads to fatty muscular degeneration, which is associated with various negative health effects. Based on literature showing very high correlations between MRI Dixon fat fraction and Speed-of-Sound (SoS), we hypothesized that we can detect short-term-immobilization-induced differences in SoS.
Both calves of 10 patients with a calf cast on one side for a mean duration of 41 ± 26 days were examined in relaxed position using a standard ultrasound machine. Calf perimeters were measured for both sides. A flat Plexiglas-reflector, placed vertically on the opposite side of the probe with the calf in-between, was used as a timing reference for SoS. SoS was both manually annotated by two readers and assessed by an automatic annotation algorithm. The thickness values of the subcutaneous fat and muscle layers were manually read from the B-mode images. Differences between the cast and non-cast calves were calculated with a paired t test. Correlation analysis of SoS and calf perimeter was performed using Pearson's correlation coefficient.
Paired t test showed significant differences between the cast and non-cast side for both SoS (P < .01) and leg perimeter (P < .001). SoS was reduced with the number of days after cast installment (r = −0.553, P = .097). No significant differences were found for muscle layer thickness, subcutaneous fat layer thickness, mean fat echo intensity, or mean muscle echo intensity.
Short-term-immobilization led to a significant reduction in SoS in the cast calf compared to the healthy calf, indicating a potential role of SoS as a biomarker in detecting immobilization-induced fatty muscular degeneration not visible on B-mode ultrasound.
The risk factors for delayed recovery in patients with cardiopulmonary bypass
Authors: Chen Baozeng , Feng Mingjing , Sheng Chen , Wang Yinhua , Cao Wenya 
Published: March 2021

Abstract
Cardiopulmonary bypass (CPB) is very commonly performed among the cardiovascular surgeries, and delayed recovery (DR) is a kind of serious complications in patients with CPB. It is necessary to assess the risk factors for DR in patients with CPB, to provide evidence into the management of CPB patients.
Patients undergoing CPB in our hospital from January 2018 to March 2020 were included. Cases that consciousness has not recovered 12 hours after anesthesia were considered as DR. The preoperative and intraoperative variables of CPB patients were collected and analyzed. Logistic regressions were conducted to analyze the potential influencing factor.
A total of 756 CPB patients were included, and the incidence of DR was 9.79%. There were significant differences on the age, aspartate aminotransferase (AST), glutamic pvruvic transaminase (ALT), blood urea nitrogen (BUN), and serum creatinine (SCr) between patients with and without DR (all P < .05); there were no significant differences in the types of surgical procedure (all P > .05); there were significant differences on the duration of CPB, duration of aortic cross clamp (ACC), duration of surgery, minimum nasopharyngeal temperature, and transfusion of packed red blood cells between patients with and without DR (all P < .05). Logistic regression analysis indicated that duration of CPB ≥132 minutes (odds ratio [OR] 4.12, 1.02–8.33), BUN ≥9 mmol/L (OR 4.05, 1.37–8.41), infusion of red blood cell suspension (OR 3.93, 1.25–7.63), duration of surgery ≥350 minutes (OR 3.17, 1.24–5.20), age ≥6 (OR 3.01, 1.38–6.84) were the independent risk factors for DR in patients with CPB (all P < .05).
Extra attention and care are needed for those CPB patients with duration of CPB ≥132 minutes, BUN ≥9 mmol/L, infusion of red blood cell suspension, duration of surgery ≥350 minutes, and age ≥60.
Endobronchial lipoma with tracheobronchial aspergillosis
Authors: Wang Yuanyuan , Teng Yongliang , Li Jie , Lin Tingting , Lu Na , Yuan Ye 
Published: March 2021

Abstract

Introduction:
Benign neoplasm of the endobronchial tree is quite rare, while endobronchial lipoma is extremely rare. Tracheobronchial aspergillosis is a relatively uncommon but severe form of invasive aspergillosis involving the tracheobronchial tree.

Patient concerns:
A 54-year-old male presented to our hospital for investigation and treatment of a cough and hemoptysis.

Diagnosis:
The diagnosis was confirmed as endobronchial lipoma with tracheobronchial aspergillosis.

Interventions:
The patient received pneumonectomy and voriconazole treatment.

Outcomes:
The patient's postoperative course was uneventful, and he was discharged 10 days after surgery. The patient had no evidence of the fungal infection and recurrence during 1 year of follow-up.

Conclusion:
Endobronchial lipoma is a rare benign lung tumor, and this is the first report of endobronchial lipoma with tracheobronchial aspergillosis. In patients with suspected endobronchial lipoma, especially those who present with hemoptysis as the initial symptom, it is advisable to exclude coexistent aspergillosis.