bluuebunny/crossref_metadata_2025_split huggingface dataset:
Downregulated ribosomal protein L39 inhibits trophoblast cell migration and invasion by targeting E‐cadherin in the placenta of patients with preeclampsia
Authors: Jie Qiuling , Sun Fei , Li Qi , Zhu Juan , Wei Yunjian , Yang Huamei , Long Ping , Wang Zhen , Yang Xiaohui , Li Dan , Huang Liping , Ma Yanlin 
Published: March 2021

AbstractEarly‐onset preeclampsia (PE) is a pregnancy complication that can lead to severe adverse maternal and fetal outcomes. However, the mechanisms underlying the development of early‐onset PE are not fully understood. Ribosomal protein L39 (RPL39) is a member of the S39E family of ribosomal proteins that plays an important role in stem cell self‐renewal, cancer metastasis, and chemoresistance. In this study, we aimed to explore the potential function of RPL39 in placental trophoblast cells. We analyzed the expression of RPL39 in early‐onset PE and normal placental tissues using real‐time PCR, western blot analysis, and immunohistochemistry. The results showed that RPL39 was markedly downregulated in early‐onset PE placental tissues. RPL39 knockdown inhibited trophoblast cell proliferation, migration, and invasion, as well as placental explant outgrowth. Flow cytometry analysis suggested that knockdown of RPL39 resulted in cell cycle arrest at the G0/G1 phase, but had no significant effect on cell apoptosis. We also found that RPL39 knockdown could alter cell morphology. We then measured the expression of the epithelial cell marker E‐cadherin following knockdown of RPL39 in Bewo and HTR8/SVneo cells. RPL39 knockdown increased the expression of E‐cadherin. Furthermore, E‐cadherin expression was upregulated in placental explant outgrowth tissues transfected with RPL39 small interfering RNA. In conclusion, RPL39 plays an essential role in proliferation, invasion, and migration of trophoblast cells by targeting E‐cadherin. Our findings provide novel insight into the mechanisms underlying the occurrence of early‐onset PE.
AMPK is indispensable for overload‐induced muscle glucose uptake and glycogenesis but dispensable for inducing hypertrophy in mice
Authors: Kido Kohei , Egawa Tatsuro , Fujiyoshi Haruna , Suzuki Hikari , Kawanaka Kentaro , Hayashi Tatsuya 
Published: March 2021

AbstractChronic muscle loading (overload) induces skeletal muscles to undergo hypertrophy and to increase glucose uptake. Although AMP‐activated protein kinase (AMPK) reportedly serves as a negative regulator of hypertrophy and a positive regulator of glucose uptake, its role in overload‐induced skeletal muscle hypertrophy and glucose uptake is unclear. This study aimed to determine whether AMPK regulates overload‐induced hypertrophy and glucose uptake in skeletal muscles. To this end, skeletal muscle overload was induced through unilateral synergist ablations in wild‐type (WT) and transgenic mice, expressing the dominant‐negative mutation of AMPK (AMPK‐DN). After 14 days, parameters, including muscle fiber cross‐sectional area (CSA), glycogen level, and in vivo [3H]‐2‐deoxy‐D‐glucose uptake, were assessed. No significant difference was observed in body weight or blood glucose level between the WT and AMPK‐DN mice. However, the 14‐day muscle overload activated the AMPK pathway in WT mice skeletal muscle, whereas this response was impaired in the AMPK‐DN mice. Despite a normal CSA gain in each fiber type, the AMPK‐DN mice demonstrated a significant impairment of overload‐induced muscle glucose uptake and glycogenesis, compared to WT mice. Moreover, 14‐day overload‐induced changes in GLUT4 and HKII expression levels were reduced in AMPK‐DN mice, compared to WT mice. This study demonstrated that AMPK activation is indispensable for overload‐induced muscle glucose uptake and glycogenesis; however, it is dispensable for the induction of hypertrophy in AMPK‐DN mice. Furthermore, the AMPK/GLUT4 and HKII axes may regulate overload‐induced muscle glucose uptake and glycogenesis.
The Ponseti Method for the Treatment of Clubfeet Associated With Amniotic Band Syndrome: A Single Institution 20-Year Experience
Authors: Esparza Melissa , Tran Elaine , Richards Benjamin Stephens , Jo Chan-hee , Shivers Claire , Karacz Chelsea , Polk Jordan , Riccio Anthony I. 
Published: March 2021

Background:
Amniotic band syndrome (ABS) is a congenital disorder resulting in fibrous bands that can cause limb anomalies, amputations, and deformities. Clubfoot has been reported in up to 50% of patients with ABS. The purpose of this study is to compare treatment characteristics and outcomes of clubfoot patients with ABS to those with idiopathic clubfoot treated with the Ponseti method.

Methods:
An Institution Review Board (IRB) approved retrospective review of prospectively gathered data was performed at a single pediatric hospital over a 20-year period. Patients with either idiopathic clubfeet or clubfeet associated with concomitant ABS who were <1 year of age and treated by the Ponseti method were included. Initial Dimeglio score, number of casts, need for heel cord tenotomy, recurrence, and need for further surgery were recorded. Outcomes were classified as “good” (plantigrade foot±heel cord tenotomy), “fair” (need for a limited procedure), or “poor” (need for a full posteromedial release).

Results:
Forty-three clubfeet in 32 patients with ABS, and 320 idiopathic clubfeet in 215 patients were identified. Average age at last follow up was not different between ABS and idiopathic cohorts (7.4 vs. 5.2 y, P=0.233). Average Dimeglio score was lower in the ABS cohort (12.3 vs. 13.7, P=0.006). Recurrence rate was significantly higher in the ABS (62.8%) compared with idiopathic cohort (37.2%) (P=0.001). Clinical outcomes were significantly better in the idiopathic cohort (69.4% “good”, 26.9% “fair”, 3.8% “poor”) compared with the ABS cohort (41.9% “good”, 34.9% “fair”, and 23.3% “poor”) (P<0.001). Within the ABS cohort, no significant differences in clinical outcomes were found based upon location, severity, or presence of an ipsilateral lower extremity band.

Conclusion:
Clubfeet associated with ABS have higher rates of recurrence, a greater need for later surgery, and worse clinical outcomes than idiopathic clubfeet. This information may prove helpful in counseling parents of infants with ABS associated clubfeet.

Level of Evidence:
Level III.
Later in Career Surgeon Performance Assessment: Why, When, What, and by Whom
Authors: Waters Peter M. , Williams David 
Published: March 2021

Background:
The average age of practicing surgeons is increasing, consistent with the overall population; one third of Americans are over 55 years of age. Aging is clearly associated with varying loss of skills, yet there are no age-based state or federal requirements for professional skill assessment; or age-specific criteria for board certification, recertification, or retirement. Capability based policies are preferred to age based criteria (3) but very few organizations have such policies in place.

Methods:
A Delphi method study was utilized to answer: When should a surgeon’s performance be assessed? If mandatory, then at what age? If adverse events triggered, then what events? What should be assessed? By whom? And, who determines the result-based actions? A systematic literature review indicated institutional stakeholders. On the basis of this a 20-member expert panel was created drawing from 13 US pediatric institutions: orthopaedic surgical department—division chiefs (14), children’s hospital general counsel (3), surgical chief responsible for hospital bylaws-medical peer review (1), OR nursing managers (2). Three rounds of iterative questionnaires were utilized.

Results:
A 100% response rate was achieved. Consensus supported recommendations included: Mandatory assessments should start at the age of 65 years, after a medical disability, and or at the request of other health care professionals. Assessments should include criteria for behavioral health, mental capacity, physical health, surgical performance, 360 human resource reviews, and surgical adverse events. Assessments should be performed by an external group with validated tools and reviewed by the department and overall surgeon-in-chief. The final decisions for an action plan based on results should be made by departmental and overall surgeon-in-chief.

Conclusions:
Our expert panel Delphi method study recognized aging is a risk factor in performance and recommended surgeon assessments should be automatically triggered by the age of 65 years, negative health events, or serious performance concerns. Assessments should be multifaceted, fair, reliable with minimal bias, and performed by an external professional group. Decisions should be managed by departmental and surgical chiefs.

Level of Evidence:
Level V.
Venous Thromboembolism After Pelvic Osteotomy in Adolescent Patients: A Database Study Characterizing Rates and Current Practices
Authors: Allahabadi Sachin , Faust Millis , Swarup Ishaan 
Published: March 2021

Background:Current risks and practices in medical prophylaxis of venous thromboembolism (VTE) after major elective lower extremity surgeries such as pelvic osteotomies have not been well-defined in the pediatric population. The purpose of this study was to (1) evaluate population rates of VTE in adolescents undergoing pelvic osteotomies, and (2) characterize current practices on types of VTE prophylaxis being utilized after pelvic osteotomies.Methods:The study evaluated the Pediatric Health Information System database between October 1, 2015 and January 1, 2020 for patients between 10 and 18 years of age meeting selected ICD-10 procedure and diagnosis codes relating to pelvic osteotomies. The rate of VTE was calculated within 90 days of index procedure. Types of pharmacologic prophylaxis were characterized. Continuous variables were compared with 2-samplettests; proportions and categorical variables were compared with Fisher exact or χ2tests, all with 2-tailed significance <0.05.Results:Of 1480 included patients, 9 were diagnosed with VTE within 90 days of surgery (VTE rate: 0.61%). Four of 9 (44.4%) had received pharmacologic prophylaxis postoperatively. There were no differences in baseline demographics or length of stay between patients that did or did not develop VTE (P>0.05). Overall, 52.0% received at least one form of pharmacologic prophylaxis postoperatively. The most common pharmacologic prophylaxis used was aspirin (47.6%), of which 64.4% received 81 mg dosing. There was no difference in VTE rates in those with or without prophylaxis (0.52% vs. 0.70%,P=0.75). However, those prescribed prophylaxis were significantly older (15.2±2.3 vs. 13.6±2.4 y,P<0.0001) and had a higher proportion of females (71.8% vs. 54.6%,P<0.01).Conclusions:The overall rate of VTE in pediatric patients after pelvic osteotomies is non-negligible. There is heterogeneity in the type of anticoagulant utilized; however, VTE prophylaxis is most commonly prescribed in older adolescents and female patients. Guidelines for medical prevention of deep venous thrombosis and pulmonary embolism in the pediatric population are warranted after hip preservation surgery.Level of Evidence:Level IV, case series.
The Long-term Fate of Asymptomatic Proximal Junctional Kyphosis Following Long Instrumented Fusion in Elderly Patients with Sagittal Imbalance
Authors: Park Se-Jun , Park Jin-Sung , Nam Yun-Jin , Choi Youn-Taek , Lee Chong-Suh 
Published: March 2021

Study Design.
Retrospective study.

Objective.
The aim of this study was to investigate the long-term fate of asymptomatic PJK focusing on the elderly patients with sagittal imbalance by comparing the patients with and without PJK.

Summary of Background Data.
Most of previous studies demonstrated that PJK does not negatively affect the clinical outcome compared to that of the patients without PJK. The question “will the asymptomatic PJK remain asymptomatic even in long-term follow-up?” has not been answered yet because the previous results were based on the short follow-up duration.

Methods.
Patients >60 years who underwent four or more level fusions to the sacrum for sagittal imbalance were followed up for >5 years. The radiographic and clinical outcomes were compared between PJK (n = 30) and non-PJK groups (n = 43). PJK was defined by proximal junctional angle (PJA) >10°. Only patients with >3 years of follow-up duration after PJK development were included in PJK group. The clinical outcome measures included visual analog scale (VAS) for the back and leg, Oswestry disability index (ODI), and Scoliosis Research Society (SRS)-22 scores.

Results.
The mean age was 69.2 years. Total follow-up duration was 92.4 months. Time between PJK development and the last follow-up was 67.4 months in PJK group. Although there were no differences between the two groups in terms of pelvic incidence-lumbar lordosis mismatch, pelvic tilt, or sacral vertical axis, PJA significantly increased from 6.5° postoperatively to 21.2° at the final follow-up in the PJK group. The clinical outcomes were worse (such as VAS for the back, ODI, and SRS-22 scores) in the PJK group than in non-PJK group, except for the satisfaction domain. Three (10%) of 30 patients underwent a revision surgery for PJK progression.

Conclusion.
Even if PJK was asymptomatic at initial development, it progressed radiographically with time and eventually gave a negative impact on the clinical outcomes in long-term follow-up.

Level of Evidence: 3
Severe Acute Respiratory Syndrome–Associated Coronavirus 2 Infection and Organ Dysfunction in the ICU: Opportunities for Translational Research
Authors: Verhoef Philip A. , Kannan Sujatha , Sturgill Jamie L. , Tucker Elizabeth W. , Morris Peter E. , Miller Andrew C. , Sexton Travis R. , Koyner Jay L. , Hejal Rana , Brakenridge Scott C. , Moldawer Lyle L. , Hotchkiss Richard S. , Blood Teresa M. , Mazer Monty B. , Bolesta Scott , Alexander Sheila A. , Armaignac Donna Lee , Shein Steven L. , Jones Christopher , Hoemann Caroline D. , Doctor Allan , Friess Stuart H. , Parker Robert I. , Rotta Alexandre T. , Remy Kenneth E. 
Published: March 2021

Objectives:
Since the beginning of the coronavirus disease 2019 pandemic, hundreds of thousands of patients have been treated in ICUs across the globe. The severe acute respiratory syndrome–associated coronavirus 2 virus enters cells via the angiotensin-converting enzyme 2 receptor and activates several distinct inflammatory pathways, resulting in hematologic abnormalities and dysfunction in respiratory, cardiac, gastrointestinal renal, endocrine, dermatologic, and neurologic systems. This review summarizes the current state of research in coronavirus disease 2019 pathophysiology within the context of potential organ-based disease mechanisms and opportunities for translational research.

Data Sources:
Investigators from the Research Section of the Society of Critical Care Medicine were selected based on expertise in specific organ systems and research focus. Data were obtained from searches conducted in Medline via the PubMed portal, Directory of Open Access Journals, Excerpta Medica database, Latin American and Caribbean Health Sciences Literature, and Web of Science from an initial search from December 2019 to October 15, 2020, with a revised search to February 3, 2021. The medRxiv, Research Square, and clinical trial registries preprint servers also were searched to limit publication bias.

Study Selection:
Content experts selected studies that included mechanism-based relevance to the severe acute respiratory syndrome–associated coronavirus 2 virus or coronavirus disease 2019 disease.

Data Extraction:
Not applicable.

Data Synthesis:
Not applicable.

Conclusions:
Efforts to improve the care of critically ill coronavirus disease 2019 patients should be centered on understanding how severe acute respiratory syndrome–associated coronavirus 2 infection affects organ function. This review articulates specific targets for further research.
Decision-Making Authority During Tele-ICU Care Reduces Mortality and Length of Stay—A Systematic Review and Meta-Analysis*
Authors: Kalvelage Christina , Rademacher Susanne , Dohmen Sandra , Marx Gernot , Benstoem Carina 
Published: March 2021

OBJECTIVES:
Although the current coronavirus disease 2019 pandemic demonstrates the urgent need for the integration of tele-ICUs, there is still a lack of uniform regulations regarding the level of authority. We conducted a systematic review and meta-analysis to evaluate the impact of the level of authority in tele-ICU care on patient outcomes.

DATA SOURCES:
We searched MEDLINE, EMBASE, CENTRAL, and Web of Science from inception until August 30, 2020.

STUDY SELECTION:
We searched for randomized controlled trials and observational studies comparing standard care plus tele-ICU care with standard care alone in critically ill patients.

DATA EXTRACTION:
Two authors performed data extraction and risk of bias assessment. Mean differences and risk ratios were calculated using a random-effects model.

DATA SYNTHESIS:
A total of 20 studies with 477,637 patients (n
tele-ICU care = 292,319, n
control = 185,318) were included. Although “decision-making authority” as the level of authority was associated with a significant reduction in ICU mortality (pooled risk ratio, 0.82; 95% CI, 0.71–0.94; p = 0.006), we found no advantage of tele-ICU care in studies with “expert tele-consultation” as the level of authority. With regard to length of stay, “decision-making authority” resulted in an advantage of tele-ICU care (ICU length of stay: pooled mean difference, –0.78; 95% CI, –1.46 to –0.10; p = 0.14; hospital length of stay: pooled mean difference, –1.54; 95% CI, –3.13 to 0.05; p = 0.06), whereas “expert tele-consultation” resulted in an advantage of standard care (ICU length of stay: pooled mean difference, 0.31; 95% CI, 0.10–0.53; p = 0.005; hospital length of stay: pooled mean difference, 0.58; 95% CI, –0.04 to 1.21; p = 0.07).

CONCLUSIONS:
In contrast to expert tele-consultations, decision-making authority during tele-ICU care reduces mortality and length of stay in the ICU. This work confirms the urgent need for evidence-based ICU telemedicine guidelines and reveals potential benefits of uniform regulations regarding the level of authority when providing tele-ICU care.
Current status of home monitoring technology for age-related macular degeneration
Authors: Busquets Miguel A. , Sabbagh Osama 
Published: March 2021

Purpose of review
Evidence suggests that patients present with exudative age-related macular degeneration (AMD) in a delayed fashion. Increased lesion size associated with this delay directly impacts visual acuity. Upon treatment initiation, patients are monitored largely with optical coherence tomography (OCT) technology to determine the need for treatment. Home-monitoring systems using preferential hyperacuity perimetry (PHP) and OCT may optimize management.

Recent findings
Comparison of Age-related Macular Degeneration Treatment Trials study and American Academy of Ophthalmology's Intelligent Research in Sight registry data suggest smaller lesion size and better visual acuity upon choroidal neovascularization (CNV) capture are associated with better final visual acuity with therapy. The HOME study and recent PHP-based ForeseeHome data indicate that this modality leads to earlier detection of CNV. Results of a real-world data analysis demonstrate 82% retention of ≥20/40 vision with median visual acuity of 20/40 at time of CNV detection using PHP home-monitoring. Home OCT data suggests excellent patient useability, with >90% of patients obtaining analyzable images. The Notal OCT Analyzer demonstrates superiority over human interpreters regarding the ability to detect intraretinal and subretinal fluid (82% vs. 47% sensitivity).

Summary:
PHP may improve treatment outcomes for exudative AMD by allowing for earlier detection of lesions. Home OCT platforms could allow for more convenient monitoring of patients undergoing treatment for exudative AMD and better enable true PRN models.
Risk factors for anastomotic leakage after gastrectomy for Siewert type II/III adenocarcinoma of the esophagogastric junction: a retrospective case-control study
Authors: Li Yibo , Shi Yinan , You Jun , Hu Wenqing , Xu Yingying , Wei Haotang , Abe Masanobu , Cheng Jiajia , Zong Liang , Dong Jianhong 
Published: March 2021

Objective:
To identify risk factors for anastomotic leakage after gastrectomy in patients with Siewert type II/III adenocarcinoma (AEG) of the esophagogastric junction.

Methods:
This was a retrospective case-control study of 903 patients with Siewert type II/III AEG treated from January 2012 to January 2015 at the Shanxi Cancer Hospital in China. All patients underwent gastrectomy, and their clinical characteristics were analyzed to identify associations with anastomotic leakage. Independent risk factors were identified by binary logistic regression. The 2-year disease-free survival was calculated and compared between patients with anastomotic leakage and control patients. The study was approved by the Institutional Review Board of Shanxi Medical University (approval No. 2014-09-39) on September 19, 2014.

Results:

Out of the 903 patients were included in the study, 80 (8.86%, 80/903) experienced anastomotic leakage. The mortality rate attributed to anastomotic leakage was 8.75% (7/80). Logistic regression analysis revealed that preoperative hypoalbuminemia (odds ratio (
OR
)=3.249, 95% confidence interval (
CI
): 1.569-6.725,
P
=0.002), type of reconstruction (
OR
=1.795, 95%
CI
: 1.026-3.142,
P
=0.040), and combined organ resection (
OR
=1.807, 95%
CI
: 1.069-3.055,
P
=0.027) were independent risk factors for anastomotic leakage.

Conclusion:
Preoperative hypoalbuminemia, type of reconstruction, and combined organ resection were identified as risk factors for anastomotic leakage in patients undergoing gastrectomy for Siewert type II/III AEG.
Successful Treatment of Infraorbital Trapdoor Following Transposition Flap Using Intralesional Corticosteroid: A Case Report
Authors: Djawad Khairuddin 
Published: March 2021

Abstract

Introduction:
The trapdoor effect can pose a significant cosmetic issue after transposition flap surgery or trauma. It is characterized with bulging of tissue around a circular or semi-circular scar commonly found after removal of cutaneous tumors.
Here, we report a female with infraorbital trapdoor successfully treated by intralesional corticosteroid.

Case presentation:
A 60-year-old female patient with trapdoor effect after surgery was successfully treated with long-term non-invasive technique of intralesional triamcinolone acetate set with a biweekly interval for twelve months.

Discussion:
There are currently no definitive methods of removing this condition. Non-surgical approach is often more preferred by patients, such as with the use of intralesional corticosteroid of triamcinolone acetate. However, information about this is still limited. In this case, the patient experienced satisfying result without observed complications related to corticosteroids injection on the infraorbital region.

Conclusion:
Intralesional corticosteroid is a safe and economical method to treat the trapdoor effect.