bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chronic Stress Burden, Visceral Adipose Tissue, and Adiposity-Related Inflammation: The Multi-Ethnic Study of Atherosclerosis
Authors: Delker Erin , AlYami Bandar , Gallo Linda C. , Ruiz John M. , Szklo Moyses , Allison Matthew A. 
Published: July 2021

ABSTRACT

Objective
We investigated the role of chronic stress burden on adiposity and adiposity-related inflammation with two hypotheses: a) greater chronic stress is associated with higher central adiposity and selective accumulation of visceral adipose tissue (VAT) compared with subcutaneous adipose tissue (SAT), and b) associations between VAT and inflammatory biomarkers are exacerbated when chronic stress is high.

Methods
Data come from 1809 participants included in a Multi-Ethnic Study of Atherosclerosis ancillary study of body composition and adiposity-related inflammation. Chronic psychosocial stress was measured with a five-item version of the Chronic Stress Burden Scale. First, we tested associations between chronic stress (three-level categorical variable) and VAT, SAT, and VAT/SAT ratio. Second, we tested whether associations between VAT and inflammatory biomarkers varied by level of chronic stress.

Results
Participants were approximately 65 years, 50% female, and 40.5% White, 25.6% Hispanic, 21.2% African American, and 12.8% Chinese American. About half of the sample reported little to no stress, and a quarter and a fifth of the sample reported medium and high levels of stress. Higher levels of chronic stress were associated with greater VAT and SAT, but not VAT/SAT ratio. Greater levels of VAT were associated with increased levels of adiposity-related inflammation in a graded pattern. These associations did not vary by stress level.

Conclusions
Greater chronic stress burden is associated with both central and subcutaneous adiposity. We found no evidence that the associations between VAT and inflammatory biomarkers are exacerbated by chronic stress. Findings contribute to ongoing literature untangling pathways in which psychosocial stress contributes to adiposity-related inflammation.
Modulatory Effects of Actual and Imagined Acupuncture on the Functional Connectivity of the Periaqueductal Gray and Ventral Tegmental Area
Authors: Cao Jin , Tu Yiheng , Orr Scott P. , Wilson Georgia , Kong Jian 
Published: July 2021

ABSTRACT

Objective
Both acupuncture and guided imagery hold promise for treating pain. The mechanisms underlying these alternative interventions remain unclear. The reported study aimed to comparatively investigate the modulation effect of actual and imagined acupuncture on the functional connectivity of descending pain modulation system and reward network.

Methods
Twenty-four healthy participants (mean [standard error], 25.21 [0.77] years of age; 66.67% female) completed a crossover study that included five sessions, a training session and four intervention sessions administered in randomized order. We investigated the modulation effect of real acupuncture, sham acupuncture, video-guided acupuncture imagery treatment (VGAIT) and VGAIT control on the resting-state functional connectivity (rsFC) of periaqueductal gray (PAG) and ventral tegmental area (VTA). These are key regions of the descending pain modulatory system and dopaminergic reward system, respectively.

Results
Compared with sham acupuncture, real acupuncture produced decreased PAG-precuneus (Pcu) rsFC and increased VTA-amygdala/hippocampus rsFC. Heat pain threshold changes applied on the contralateral forearm were significantly associated with the decreased PAG-Pcu (r = 0.49, p = .016) and increased VTA-hippocampus rsFC (r = −0.77, p < .001). Compared with VGAIT control, VGAIT produced decreased PAG–paracentral lobule/posterior cingulate cortex/Pcu, middle cingulate cortex (MCC), and medial prefrontal cortex rsFC, and decreased VTA-caudate and MCC rsFC. Direct comparison between real acupuncture and VGAIT showed that VGAIT decreased rsFC in PAG–paracentral lobule/MCC, VTA-caudate/anterior cingulate cortex/nucleus accumbens, and VTA-MCC.

Conclusions
Results suggest that both actual and imagined acupuncture can modulate key regions in the descending pain modulatory system and reward networks, but through different pathways. Identification of different pain relief mechanisms may facilitate the development of new pain management methods.
Relationships Between Early Maternal Warmth and Social Connection: A Randomized Clinical Trial With Naltrexone
Authors: Ross Lauren P. , Andreescu Carmen , Inagaki Tristen K. 
Published: July 2021

ABSTRACT

Objective
Early experiences of having received maternal warmth predict responses to opportunities to connect with others later in life. However, the understanding of neurochemical mechanisms by which such relationships emerge remains incomplete. Endogenous opioids, involved in social connection in both animals and humans, may contribute to this link. Therefore, the current study examined a) relationships between early maternal warmth and brain and self-report responses to novel social targets (i.e., outcomes that may promote social connection) and b) the effect of the opioid antagonist, naltrexone, on such relationships.

Methods
Eighty-two adult participants completed a retrospective report of early maternal warmth. On a second visit, participants were randomized to 50 mg of oral naltrexone (n = 42) or placebo (n = 40), followed by a magnetic resonance imaging scan where functional brain activity in response to images of novel social targets (strangers) was assessed. Approximately 24 hours later, participants reported on their feelings of social connection since leaving the scanner.

Results
In the placebo condition, greater early maternal warmth was associated with less dorsal anterior cingulate cortex, anterior insula, ventral striatum, and amygdala activity in response to images of novel social targets (r values ≥ −0.360, p values ≤ .031), and greater feelings of social connection (r = 0.524, p < .001) outside of the laboratory. The same relationships, however, were not present in the naltrexone condition.

Conclusions
Results highlight relationships between early maternal warmth and responses to the social world at large and suggest that opioids might contribute to social connection by supporting the buffering effects of warm early life experiences on social connection later in life.

Trial Registration: Clinical Trials NCT02818036.
Using Deep Learning Segmentation for Endotracheal Tube Position Assessment
Authors: Schultheis William G. , Lakhani Paras 
Published: July 2021

Purpose:
The purpose of this study was to determine the efficacy of using deep learning segmentation for endotracheal tube (ETT) position on frontal chest x-rays (CXRs).

Materials and Methods:
This was a retrospective trial involving 936 deidentified frontal CXRs divided into sets for training (676), validation (50), and 2 for testing (210). This included an “internal test” set of 100 CXRs from the same institution, and an “external test” set of 110 CXRs from a different institution. Each image was labeled by 2 radiologists with the ETT-carina distance. On the training images, 1 radiologist manually segmented the ETT tip and inferior wall of the carina. A U-NET architecture was constructed to label each pixel of the CXR as belonging to either the ETT, carina, or neither. This labeling allowed the distance between the ETT and carina to be compared with the average of 2 radiologists. The interclass correlation coefficients, mean, and SDs of the absolute differences between the U-NET and radiologists were calculated.

Results:
The mean absolute differences between the U-NET and average of radiologist measurements were 0.60±0.61 and 0.48±0.47 cm on the internal and external datasets, respectively. The interclass correlation coefficients were 0.87 (0.82, 0.91) and 0.92 (0.88, 0.94) on the internal and external datasets, respectively.

Conclusion:
The U-NET model had excellent reliability and performance similar to radiologists in assessing ETT-carina distance.
Estimation of Sex From Dental Arch Dimensions: An Odontometric Analysis
Authors: Kanchan Tanuj , Chugh Vinay , Chugh Ankita , Setia Puneet , Shedge Rutwik , Krishan Kewal 
Published: July 2021

Abstract
Sex estimation is one of the “big three” of human identification and is a vital aspect of the process of generating biological profile of unknown deceased. Anthropometric and odontometric methods that utilize measurement of distances between certain landmarks are commonly employed to differentiate between the 2 sexes. Teeth are the most robust and well-preserved parts of the human body, and studies have shown that the sex of an unknown individual can be estimated using their measurements. The present study was carried out to analyze the sex differences based on the dental arch dimensions of both the jaws in an Indian population. A proper understanding of dental arch dimensions not only help forensic odontologists in human identification, but also help dental practitioners in teeth restoration, and to quantify selection of anterior teeth in bonding of dentures. The dental arch dimensions of the canines, premolars, and the molars of both the jaws were recorded in dental casts of 307 participants. Comparison of the dental arch dimensions of males and females was done and logistic regression models were generated to estimate sex. Receiver Operating Characteristic analysis was done to find out the potential to estimate sex for all the dental arch dimensions in both the sexes. It was observed that maxillary intermolar II distance gave the best results in estimating the sex. The sexing accuracy is seen to increase as we go distally from canines to molars in each jaw; minimum for intercanine distance and maximum for distance between the 2nd molars. The sexing accuracy from dental arch dimensions was found to be between 72.7% and 86.5%. The models derived for estimation of sex from dental arch dimensions can be used in cases of skeletal remains.
Anthropometric Analysis of the Growth Proportions of the Head and Face in Koreans
Authors: Yeo In-Seung , Park Jung-Ah , Lee Hye-In , Koh Ki-Seok , Song Wu-Chul 
Published: July 2021

Abstract
The present study is to identify primarily the morphological characteristics in the growth proportion of the head and face for young Korean (8–24 years) and compare the magnitude of growth changes to the sex-related differences. Total 1255 were divided into 3 age groups: childhood (8–10 years), adolescence (14–16 years), and young adult (20–24 years). The anthropometric assessments were performed with 11 landmarks on the head and facial dimensions. The standardized frontal and lateral head and face photographs were analyzed the craniofacial growth proportions and morphological features for the comparison of both sexes. The noteworthy differences of anthropometric measurements between sexes with growing were noted on the lower head height (22.6%, 17.8%), midface height (22.0%, 19.6%), lower face height (23.5%, 14.7%), and face length (21.1%, 14.9%), face breadth (14.8%, 11.3%) of males and females, respectively. Whereas the upper head height (7.9%, 6.0%) and upper face height (4.2%, 0%, respectively) were less growing features. The most remarkable changes are the dimension of midface height and lower face height in both sexes. The present study could demonstrate a fundamental example to elucidate the sex-related dimensional differences for the analysis of the growth proportion of both sexes in Koreans.
Comparison of Conduits Fabricated by Fresh and Predegenerated Skeletal Muscles for Peripheral Nerve Repairing
Authors: Chen Zi-Xiang , Yi Zhen , Lu Hai-Bin , Chen Lu-Lu , Yang Xiao-Nan , Qi Zuo-Liang 
Published: July 2021

Abstract
Reconstruction of peripheral nerve injury remains a challenge for clinical medicine. Previous reports have confirmed that external oblique muscle-fabricated nerve conduit (EMC) could effectively be used to promote peripheral nerve regeneration. In this study, we compared between conduits fabricated from fresh muscle and conduits fabricated from predegenerated muscle for the repair of peripheral nerve defects in a mouse sciatic nerve transection model. We found that the number, diameter, and myelin sheath thickness of the myelinated nerve fibers of the regenerative nerve in the EMC group were larger than those of the predegenerated-EMC (P-EMC) group eight weeks after surgery. The sciatic function index and gastrocnemius wet-weight mass ratio in the EMC group were higher than those in the P-EMC group. The Bcl-2/Bax ratio and the number of Schwann cell nucleus in the proximal nerve stumps in the EMC group were greater than those in the P-EMC group. In conclusion, our results confirmed that the use of fresh skeletal muscle nerve conduit increased the Bcl-2/Bax ratio and promoted the survival of Schwann cells of the proximal nerve stump compared with that of predegenerated skeletal muscle nerve conduits, thus achieving better functional recovery after sciatic nerve defect.
Distichiasis: An Unusual Complication of the Preseptal Transconjunctival Approach and Its Management
Authors: John Centina Rose , Ganesh Praveen , Rao Venkata Mahipathy Surya Rao 
Published: July 2021

Abstract
Distichiasis is a rare condition where the accessory row of eyelashes exit from the posterior lid margin apparently from the opening of the meibomian glands, causing corneal irritation and ulceration. The authors report a rare clinical presentation of acquired distichiasis, as a complication of a preseptal transconjunctival approach. The patient presented with complaints of discomfort over the right eyelid after the management of zygomaticomaxillary complex fracture. On evaluation, the diagnosis of acquired distichiasis was made and was surgically managed by direct tarsal strip excision. During the follow up the complete resolution of symptoms without lid margin deformity was noted. Acquired distichiasis as a complication of the preseptal transconjunctival approach was rarely reported. Hence the understanding of the condition and its management is necessary to avoid the sequela.
The Development of Frontal and Sphenoid Sinuses After Full-House Endoscopic Sinus Surgery in a Child
Authors: Nomura Kazuhiro , Numano Yuki , Sugawara Mitsuru 
Published: July 2021

Abstract
Although endoscopic sinus surgery (ESS) is a standard procedure for adults and is considered a safe and effective procedure in children as well, some uncertainty remains when it comes to children, especially with regard to the future facial and sinus development. Overall, limited ESS does not affect sinus development, and extended ESS does not affect facial features. However, whether or not full-house ESS affects the sinus development, especially the frontal and sphenoid sinuses, remains unclear. The authors herein report a 15-year-old child who received full-house ESS and later re-examined the paranasal sinuses at 24 years old, at which point the frontal and sphenoid sinuses had developed. This is the first report showing the development of the frontal and sphenoid sinuses after such a procedure.
Versatility of Superficial Temporal Artery Pedicle for Postburn Facial Reconstruction: Our Center experience
Authors: Bhandari Padam Singh , Singh Sukhbir 
Published: July 2021

Objectives:
Superficial temporal artery (STA) is the one of the terminal branches of external carotid artery. Superficial temporal artery divides into frontal and parietal terminal branches. Various types of locoregional flaps can be based on the STA as a pedicle to provide effective and robust cover. In this article, we shall discuss the various applications of STA and its terminal branches as a pedicle for postburn facial reconstruction in our clinical experience of more than 20 years.

Methods:
This is a retrospective review of 531 cases of postburn facial reconstruction using STA and one its terminal branches as a pedicle done at Department of Plastic and Reconstructive Surgery, Lok Nayak Hospital, which is tertiary care government hospital in New Delhi for burn care from March 2000 to March 2020. We started use of this flap initially for postburn ear reconstruction cases and slowly expanded our indications over the period of time due to its high vascularity and versatile nature. There were 269 females and 262 males included in this review.

Results:
We have used STA and one its terminal branches as a pedicle to our advantage with varied indications and excellent results. We had minor complications which were easily manageable with 7 cases of partial flap loss and zero case of total flap loss. We shall discuss all the details in our review.

Conclusions:
We wish to conclude that STA and one its terminal branches as a pedicle offers excellent versality and vascularity for postburn facial reconstruction with good long-standing results.
A Diagnostic Nomogram for Predicting the Risk of Anastomotic Leakage in Elderly Patients With Rectal Cancer: A Single-center Retrospective Cohort Study
Authors: Liu Dongliang , Zhou Hong , Liu Liu , Zhu Zhiqiang , Liu Shaojun , Fang Yu 
Published: July 2021

Background:
Laparoscopic resection for rectal cancer has been gaining popularity over the past 2 decades. Whether elderly patients had more benefits from laparoscopy-assisted anterior resection (LAR) need further investigation when comparing with open anterior resection (OAR).

Objectives:
This study aimed to evaluate the clinical outcomes and prognosis of LAR in elderly patients (65 y and above) with rectal cancer and investigate the factors associated with the anastomotic leakage (AL). Besides, the study sought to create a nomogram for precise prediction of AL after anterior resection for rectal cancer.

Materials and Methods:
A total of 343 rectal cancer patients over 65 years old who underwent LAR or OAR at a single center between January 2013 to January 2021 were retrospectively reviewed. Univariate analysis was conducted to explore potential risk factors for AL, and a nomogram for AL was created based on the multivariate logistic regression model.

Results:
A total of 343 patients were included in this study, 271 patients in LAR group and 72 patients in OAR group. Most of the variables were comparable between the 2 groups. The mean operative time was longer in the LAR group than that in the OAR group (191.66±58.33 vs. 156.85±53.88 min, P<0.0001). The LAR group exhibited a significantly lower intraoperative blood loss than the OAR group (85.17±50.03 vs. 131.67±79.10 mL; P<0.0001). Moreover, laparoscopic surgery resulted in shorter postoperative hospital stay, lower rates of diverting stoma and receiving sphincter sparing surgery in comparison with open surgery. The overall rates of complications were 25.1% and 40.3% in the LAR and OAR groups (P=0.011), respectively. And the reoperation rates in the OAR group (0%) was lower than in the LAR group (1.5%), but the difference did not reach statistical significance (P=0.300). Sex, location of tumor, diverting stoma and combined organ resection were identified as independent risk factors for AL based on multivariate analysis. Such factors were selected to develop a nomogram. After a median follow-up of 37.0 months, our study showed no significant difference in overall survival or disease free survival between the 2 groups for treatment of rectal cancer.

Conclusions:
This study suggests that LAR is an alternative minimally invasive surgical procedure in patients above 65 years with better short-term outcomes and acceptable long-term outcomes compared with OAR. In addition, our nomogram has satisfactory accuracy and clinical utility may benefit for clinical decision-making.
The Diagnostic Value of Coagulation Indicators and Inflammatory Markers in Distinguishing Between Strangulated and Simple Intestinal Obstruction
Authors: Li Haijun , Sun Dian , Sun Duocheng , Xiao Zhong , Zhuang Jiongyu , Yuan Chunlei 
Published: July 2021

Background:
Intestinal obstruction with strangulation can be life-threating, and it is critical to make an accurate and timely diagnosis for emergency surgery.

Objective:
This was aimed to investigate the value of coagulation indicators and inflammatory markers in distinguishing between strangulated and simple intestinal obstruction.

Materials and Methods:
Fifty-four patients with intestinal obstruction were retrospectively studied. The correlation between coagulation indicators and inflammatory markers with intestinal obstruction was analyzed. Receiver operating characteristic curves were created to assess their ability in discriminative diagnosis.

Results:
Levels of fibrinogen (Fib), C-reactive protein (CRP), neutrophil ratio, and D-Dimer were significantly greater, while thrombin time was significantly shorter in strangulated intestinal obstruction compared with simple intestinal obstruction. Furthermore, Fib levels in the necrosis subgroup of strangulated intestinal obstruction were significantly higher than those in the ischemia subgroup and simple intestinal obstruction group. The areas under the receiver operating characteristic curve were 0.58 for white blood cells, 0.78 for CRP, and 0.80 for Fib. Using the optimal cutoff values of Fib (3.71 g/L) and CRP (14.54 mg/L), the sensitivity, specificity, positive predictive value, and negative predictive value in discriminating between strangulated intestinal obstruction and simple intestinal obstruction were 51.43%, 100%, 100%, and 52.78% for Fib, and 56.25%, 94.44%, 94.74%, and 54.84% for CRP, respectively.

Conclusions:
Fib and CRP demonstrate good performance in predicting strangulation and are indicative of intestinal necrosis and ischemia. The combination of this coagulation indicator and inflammatory marker holds potential for better discrimination between strangulated and simple intestinal obstruction.
Serious health-related suffering and palliative care in South Asian countries
Authors: Nambiar Ashwin R. , Rana Smriti , Rajagopal M.R. 
Published: July 2021

Purpose of review
South Asia, with a population of 1.79 billion, has close to 9.9 million individuals experiencing serious health-related suffering (SHS). South Asia accounts for 10.23% of the world's cancer incidence. The prevalence of cancer mortality in the region is 68.44%, significantly higher than the world average of 59.74%. This poor outcome highlights the need to focus on SHS in the region. This review was undertaken to assess the current status of palliative care inequities in the region and to guide future action.

Recent findings
Using morphine-equivalent doses of opioid analgesics (excluding methadone) per cancer death as a proxy measure for access to palliative care, the International Narcotics Control Board data in 2020 show poor access to palliative care. Less than 4% of those in need are able to access palliative care in India, whereas in Afghanistan only 0.2% have access. Inappropriate end-of-life care (EOLC) and catastrophic out-of-pocket health expenditure compound the problem.

Summary
The solutions involve the introduction of national programs for palliative care, demonstration of culturally appropriate best practices as proof of concept, favourable legislation for medical opioid access, community participation, engagement of civil society to improve awareness, inclusion of palliative and adding EOLC to medical education and need-based research.

Video abstract

http://links.lww.com/COSPC/A30.