bluuebunny/crossref_metadata_2025_split huggingface dataset:
NOX2 is the primary source of superoxide in the macula densa in angiotension II induced hypertension
Authors: Zhang Rui , Lu Deyin , Fu Yiling , Juncos Luis , Liu Ruisheng 
Published: June 2021

Tubuloglomerular feedback (TGF) is one of the main mechanisms that regulate the renal microcirculation, NaCl excretion, and ultimately blood pressure. Superoxide (O−2) in the macula densa (MD) enhances TGF by scavenging nitric oxide. MD expresses NOX2 and NOX4 isoforms of NAD(P)H oxidase. We hypothesize that NOX2 is the primary isoform for O−2 in angiotensin II (Ang II) induced hypertension.MD like cell line, MMDD1, was used. O−2 was measured using lucigenin chemiluminescence with a luminometer and expressed by units/min/106 cells.To measure whether Ang II induces O−2 production in MMDD1 cells, we stimulated the cells with Ang II (106 M) for 30 min. O−2 production increased from 198.4 ± 14.7 to 447.6 ± 21.2 units/min/105 cells. To determine if the Ang II induced O−2 is mediated through AT1 or AT2 receptors, we used specific receptor antagonists. In the presence of AT1 receptor antagonist losorten (10−6 M), O−2 was from 198.4 ± 14.7 to 214.7 ± 35.4 unit/min/106 cells. In the presence of AT2 receptor antagonist PD‐123319 (10−6 M), O−2 was from 198.4 ± 14.7 to 435.1 ± 25.3 unit/min/105 cells. To study which NOX is the primary source of Ang II induced O−2 , we knocked down NOX2 or NOX4 with siRNA and measured O−2. In the cells treated with siRNA‐NOX2, Ang II induced O−2 was from 163.9 ± 32.6 to 239.5 ± 51.8 unit/min/105 cells. In the cells treated with siRNA‐NOX4, O−2 was from 117.2 ± 19.3 to 422.8 ± 21.7 unit/min/105 cells. Scramble treated cells are not different in O−2 when compared with control.ConclusionsAng II induces O−2 production in MMDD1 cells mediated via AT1 receptors. NOX2 is the primary source of in Ang II induced O−2.
Comparison of the Analgesic Effects of Intravenous Infusion of Dexmedetomidine Versus Bilateral Superficial Cervical Plexus Block After Thyroidectomy
Authors: Xing Jibin , Wu Ranliang , Liang Ling , Fang Hongyi , Chen Liubing , Luo Chenfang 
Published: June 2021

Objectives:Dexmedetomidine (DEX) is widely used in clinical practice because of its safety and effectiveness. Superficial cervical plexus block (SCPB) can reduce pain in thyroid surgery. The objective of this study was to investigated whether intravenous DEX has an equivalent analgesic effect and patients’ satisfaction to SCPB for thyroid surgery.Materials and Methods:Ninety patients who had been scheduled for thyroidectomy under general anesthesia with endotracheal intubation were randomly divided into 3 groups. Group D: DEX was administered intravenously at an initial dose of 1 µg/kg over 10 minutes; then induction and endotracheal intubation performed, and then a continuous intravenous infusion of DEX was administered at a rate of 0.4 μg/kg/h until 30 minutes before the end of surgery. Group B: ultrasound-guided bilateral SCPB was performed, with 10 mL of 0.375% ropivacaine injected on each side. Group C: intravenous saline was administered at the same rate and dose as in group D. Patients’ perioperative status, visual analog scale scores, complications and patients’ satisfaction were recorded.Results:The pain at rest at 1 hour after extubation and the movement-evoked pain within 24 hours after extubation were significantly lower in groups D and B than in group C. Patients’ satisfaction was significantly higher in groups D and B than in group C. There was no difference in pain at rest, movement-evoked pain and patients’ satisfaction between group D and B.Conclusions:Perioperative intravenous infusion of DEX can effectively reduce wound pain after thyroidectomy, and the analgesic effect is equivalent to that of bilateral SCPB.
Minimally invasive approach to the management of tubo-ovarian abscesses
Authors: Hattiangadi Rohan , McEntee Kelli , Dahlman Marisa 
Published: June 2021

Purpose of review
The purpose of this publication is to review the most up-to-date literature regarding the pathogenesis, diagnosis and management of tubo-ovarian abscesses.

Recent findings
Prior to the advent of broad-spectrum antibiotics, tubo-ovarian abscesses necessitated total abdominal hysterectomy and bilateral salpingo-oophorectomy. Although it carries a risk of treatment failure, antibiotic therapy enabled fertility-sparing treatment for many women. Recent studies have identified key predictors for antibiotic treatment failure, including age, BMI and abscess diameter. C-reactive protein was also found to be a strong predictor of antibiotic treatment response. Given the growing evidence of treatment failure with antibiotic therapy alone, along with increased availability and access to interventional radiology, image-guided drainage with or without catheter placement, combined with broad-spectrum antibiotics, is now considered first-line therapy.

Summary
Tubo-ovarian abscess is a diagnostic challenge, as presentation can vary. Inadequate treatment is associated with severe morbidity and mortality. Despite adequate conservative treatment, recurrence risk is high and clinical sequelae can have devastating effects on reproductive health. Recent evidence-based developments, including a risk score system to predict antibiotic failure, serve to provide appropriately directed risk-based care. However, large-scale randomized controlled trials are needed to clarify the most appropriate treatment modalities.
Bone Morphogenetic Protein-2 and Demineralized Bone Matrix in Difficult Bony Reconstructions in Cleft Patients
Authors: Makar Katelyn G. , Buchman Steven R. , Vercler Christian J. 
Published: June 2021

Summary:
Reconstruction of alveolar clefts includes fistula repair and bone grafting. However, bone is often harvested from the iliac crest or the skull, which can be associated with considerable donor site morbidity, and the failure rate may be as high as 20%. As such, some centers utilize bone morphogenetic protein (BMP)-2 to reconstruct the bony cleft. However, this remains an off-label use, and therefore we propose using BMP-2 only in patients with tenuous soft tissues, when the likelihood of graft failure is high. In four patients, we used BMP-2 with demineralized bone matrix (DBM) to reconstruct defects related to clefts—three patients had alveolar clefts, and the fourth patient was referred to us, with resorption of a necrotic premaxilla after premaxillary setback. In all cases, the decision was made to forego bone grafting intraoperatively given the poor quality of soft tissue and the increased risk of bone graft exposure. BMP-2 was infused onto a carrier and placed in the fistula, and Grafton DBM was then packed into the defect. In three cases, small amounts of bone from the piriform aperture were mixed with the BMP-2/DBM. After 3–7 months, all patients had generated bone in the clefts and did not require bone grafting. While we continue to prefer a “like with like” reconstruction, bone grafting has a high likelihood of failure in patients with suboptimal soft tissues or tight closures. We suggest that combining BMP-2 and DBM in higher risk patients is an excellent option to avoid bone graft loss and reoperation.
Training the Trainers in Microsurgery: A Success Story from Vietnam’s Hanoi National Hospital of Odonto-stomatology
Authors: Nguyen Hong Nhung , Chen Jill , Nguyen Tan Van , Le Duc Thanh , Nguyen Tai Son , Jeng Seng-Feng 
Published: June 2021

Background:
Microsurgery is a highly specialized skill that requires advanced training. This is a recount of the 12-year development of Hanoi National Hospital of Odonto-Stomatology (NHOS) from a basic plastic surgery unit to a high-volume, subspecialized reconstructive center.

Methods:
We present a 12-year retrospective account of the development of NHOS with a brief summary of microsurgical reconstructive outcomes.

Results:
From 2008 to 2020, NHOS has performed 665 microsurgical flaps for reconstruction of various maxillomandibular defects. In the pioneering stage (2008-2011), without surgical microscopes, all five free flaps failed. After acquiring a microscope and mentoring from Hanoi's 108 Military Hospital, mandibular bone defect reconstruction with free fibula flaps had 85% success rate. In the growth stage (2012-2015), reconstruction advanced toward more complex defects requiring soft tissue, with a 98.7% success rate. The maturation stage (2016-2020) focused on refinement of reconstructive service to provide subspecialized care for malignant head and neck cancer patients with help from Taiwan's E-Da Hospital and Operation Smile's charity program. The charity mission trips were structured to facilitate good quality teaching rather than hit a quantitative goal of the number of surgeries done. And with a success rate of 99.4%, we have begun further education of the plastic surgery community in Vietnam.

Conclusions:
Our rapid 12-year maturation into a high-volume, subspecialized microsurgical center is the embodiment of the generous efforts of many international friends who invested their time and expertise. And we highly recommend charity mission trips to adopt the “training the trainers” concept to maximize lasting, local impact.
The Use of Peripheral Nerve Stimulation in Conjunction with TMR for Neuropathic Pain
Authors: Agrawal Nikhil A. , Gfrerer Lisa , Heng Marilyn , Valerio Ian L. , Eberlin Kyle R. 
Published: June 2021

Summary:
Targeted muscle reinnervation and regenerative peripheral nerve interfaces are increasingly utilized strategies to mitigate phantom and residual limb pain in amputees. These interventions are successful, yet often imperfect in completely ameliorating neuropathic pain following amputation. Implantable peripheral nerve stimulators are another tool in the armamentarium for management of neuropathic pain. These devices have been utilized adjacent to the spinal cord and more recently in the extremities with good results, and there has been additional interest in their utility for nerve regeneration. In this case report, we present the first reported case in the readily available literature of combining contemporary peripheral nerve strategies with an implantable peripheral nerve stimulator for postamputation neuropathic pain. The patient is a 72-year-old man who presented with severe neuropathic pain following prior below knee amputation with an osseointegrated implant and regenerative peripheral nerve interfaces. The authors performed targeted muscle reinnervation with intra-operative placement of a peripheral nerve stimulator. He did well after the procedure, and his pain improved with activation of the device. The most symptomatic nerve is targeted with the nerve stimulator, and it is placed adjacent to the nerve transfer(s). Combining these contemporary techniques may lead to improved prosthetic use and quality of life for these patients.
Effectiveness and Predictors of Discontinuation of Aripiprazole Long-acting Injection
Authors: Aftab Romaisa , Pereira Marco , Hewitt Jed , Whale Richard 
Published: June 2021

Abstract

Purpose/Background
This study aimed to explore the discontinuation rate of aripiprazole long-acting injection (LAI) in a naturalistic clinical setting.

Methods/Procedures
A retrospective cohort study of 1 year duration was conducted on the first 200 patients registered to receive aripiprazole LAI in Sussex, UK. Rate of discontinuation and the association of robustly recorded clinical variables with discontinuation or a new acute care episode were explored.

Findings/Results
Of 200 registered, 173 patients initiated aripiprazole LAI and 40% discontinued this by 1 year. Mean discontinuation time was 18 weeks. The commonest discontinuation reason was “patient choice,” independent of efficacy or adverse effects. Not having a diagnosis of schizophrenia spectrum was the only variable significantly associated with treatment continuation after 1 year. No single diagnostic group accounted for this, although a greater continuation rate was observed in those with bipolar disorder. Illness severity factors at baseline, including apparent treatment resistance, had no impact on later aripiprazole LAI discontinuation or on acute service use over the year. Medication-related variables had no identified impact on acute service use.

Implications/Conclusions
This study supports the clinical utility of aripiprazole LAI for its licensed indications. The 1-year discontinuation rate is equivalent to that in reports of similarly designed studies of paliperidone LAI. Further exploration of nonmedication factors influencing LAI discontinuation is required. Preferential use of aripiprazole LAI over other medications may be supported due to fewer associated metabolic adverse effects.
Preoperative nutrition care in Enhanced Recovery After Surgery programs: are we missing an opportunity?
Authors: Martin Lisa , Gillis Chelsia , Ljungqvist Olle 
Published: June 2021

Purpose of review
A key component of Enhanced Recovery After Surgery (ERAS) is the integration of nutrition care elements into the surgical pathway, recognizing that preoperative nutrition status affects outcomes of surgery and must be optimized for recovery. We reviewed the preoperative nutrition care recommendations included in ERAS Society guidelines for adults undergoing major surgery and their implementation.

Recent findings
All ERAS Society guidelines reviewed recommend preoperative patient education to describe the procedures and expectations of surgery; however, only one guideline specifies inclusion of routine nutrition education before surgery. All guidelines included a recommendation for at least one of the following nutrition care elements: nutrition risk screening, nutrition assessment, and nutrition intervention. However, the impact of preoperative nutrition care could not be evaluated because it was rarely reported in recent literature for most surgical disciplines. A small number of studies reported on the preoperative nutrition care elements within their ERAS programs and found a positive impact of ERAS implementation on nutrition care practices, including increased rates of nutrition risk screening.

Summary
There is an opportunity to improve the reporting of preoperative nutrition care elements within ERAS programs, which will enhance our understanding of how nutrition care elements influence patient outcomes and experiences.
Status Triphasicus Versus Status Epilepticus?
Authors: Bicchi Manuel M. , Alkhachroum Ayham , Kanner Andres M. 
Published: June 2021

Summary:
Generalized periodic patterns with triphasic wave morphology, long referred to as triphasic waves [TWs], had been associated with metabolic encephalopathies, although other neurologic and systemic causes have since been identified. In a recent classification of periodic patterns, TWs were formally grouped with the generalized periodic discharges, which are often associated with ictal activity. The interpretation of generalized periodic patterns with TWs as nonictal can have significant implications in the management of comatose patients in nonconvulsive status epilepticus. Electrographic characteristics that help distinguish nonictal periodic patterns with TWs from generalized periodic discharge ictal patterns include (1) TWs in long runs of periodic bilaterally synchronous and symmetric discharges, maximal in frontocentral or posterior head regions with and without a frontal-to-occipital lag or posterior-to-anterior lag, respectively; (2) recurrent spontaneous and/or low-dose benzodiazepine-induced attenuation and/or suppression of the periodic pattern and replacement with a diffuse slow wave activity throughout a prolonged EEG recording; and (3) stimulation-induced activation and/or increase in frequency and/or organization of TWs. We coined the term of status triphasicus to describe the electrographic periodic pattern of TWs with these three distinct characteristics. In this article, we discuss the advantages and limitations of keeping the status triphasicus pattern as a distinct electrographic entity different from periodic ictal generalized periodic discharge patterns. We discuss the circumstances in which a status triphasicus pattern can be associated with ictal activity and propose a simple pragmatic classification of status triphasicus that encompasses the different clinical scenarios it can be associated with.
Evidence-based pandemic preparedness: an infrastructure for population-scale genome-based based testing for COVID-19
Authors: Lehrach Hans , Curtis Jon , Lange Bodo , Ogilvie Lesley A , Gauss Richard , Steininger Christoph , Scholz Erhard , Kreck Matthias 
Published: June 2021

ABSTRACTOur lives (and deaths) have been dominated for more than a year by COVID-19, a pandemic that has caused hundreds of millions of disease cases, millions of deaths, trillions in economic costs, and major restrictions on our freedom. We argue that much of this could have been avoided by repeated and systematic population-scale PCR-based testing and targeted quarantine. We describe key elements of the current implementations of such a system and demonstrate (with Germany as an example), that this strategy could have suppressed the pandemic within weeks, eliminating the vast majority of its overall impact in terms of deaths, economic costs and restrictions. It can, however, still play a major role in further reducing the worldwide impact of the current phase of the pandemic, and remain as a key protection against similar dangers in the future.
Evidence for Peroxisomal Dysfunction and Dysregulation of the CDP-Choline Pathway in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
Authors: Che Xiaoyu , Brydges Christopher R. , Yu Yuanzhi , Price Adam , Joshi Shreyas , Roy Ayan , Lee Bohyun , Barupal Dinesh K. , Cheng Aaron , Palmer Dana March , Levine Susan , Peterson Daniel L. , Vernon Suzanne D. , Bateman Lucinda , Hornig Mady , Montoya Jose G. , Komaroff Anthony L. , Fiehn Oliver , Lipkin W. Ian 
Published: June 2021

AbstractBackgroundMyalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic and debilitating disease that is characterized by unexplained physical fatigue unrelieved by rest. Symptoms also include cognitive and sensory dysfunction, sleeping disturbances, orthostatic intolerance, and gastrointestinal problems. A syndrome clinically similar to ME/CFS has been reported following well-documented infections with the coronaviruses SARS-CoV and MERS-CoV. At least 10% of COVID-19 survivors develop post acute sequelae of SARS-CoV-2 infection (PASC). Although many individuals with PASC have evidence of structural organ damage, a subset have symptoms consistent with ME/CFS including fatigue, post exertional malaise, cognitive dysfunction, gastrointestinal disturbances, and postural orthostatic intolerance. These common features in ME/CFS and PASC suggest that insights into the pathogenesis of either may enrich our understanding of both syndromes, and could expedite the development of strategies for identifying those at risk and interventions that prevent or mitigate disease.MethodsUsing regression, Bayesian and enrichment analyses, we conducted targeted and untargeted metabolomic analysis of 888 metabolic analytes in plasma samples of 106 ME/CFS cases and 91 frequency-matched healthy controls.ResultsIn ME/CFS cases, regression, Bayesian and enrichment analyses revealed evidence of peroxisomal dysfunction with decreased levels of plasmalogens. Other findings included decreased levels of several membrane lipids, including phosphatidylcholines and sphingomyelins, that may indicate dysregulation of the cytidine-5’-diphosphocholine pathway. Enrichment analyses revealed decreased levels of choline, ceramides and carnitines, and increased levels of long chain triglycerides (TG) and hydroxy-eicosapentaenoic acid. Elevated levels of dicarboxylic acids were consistent with abnormalities in the tricarboxylic acid cycle. Using machine learning algorithms with selected metabolites as predictors, we were able to differentiate female ME/CFS cases from female controls (highest AUC=0.794) and ME/CFS cases without self-reported irritable bowel syndrome (sr-IBS) from controls without sr-IBS (highest AUC=0.873).ConclusionOur findings are consistent with earlier ME/CFS work indicating compromised energy metabolism and redox imbalance, and highlight new abnormalities that may provide insights into the pathogenesis of ME/CFS.One Sentence SummaryPlasma levels of plasmalogens are decreased in patients with myalgic encephalomyelitis/chronic fatigue syndrome suggesting peroxisome dysfunction.
Interferon Gamma Release Assays for Latent Mycobacterium tuberculosis Detection in Elderly Hispanics
Authors: Scordo Julia M. , Aguillón-Durán Génesis P. , Ayala Doris , Quirino-Cerrillo Ana Paulina , Rodríguez-Reyna Eminé , Joya-Ayala Mateo , Mora-Guzmán Francisco , Ledezma-Campos Eder , Villafañez Alejandro , Schlesinger Larry S. , Torrelles Jordi B. , Turner Joanne , Restrepo Blanca I. 
Published: June 2021

SUMMARYBackgroundAging is a tuberculosis co-morbidity. Interferon Gamma Release Assays (IGRAs) are used to detect latent Mycobacterium tuberculosis (M.tb) infection (LTBI) in adults, but their performance in the elderly is not well-established. We aim to evaluate the performance of IGRAs for LTBI detection in healthy elderly Hispanics with recent, remote or no history of M.tb exposure.Study Design and MethodsCross-sectional study in Hispanic elderly (60+y) and adult (18-50y) recent TB contacts (ReC) or community controls (CoC). LTBI was based on a positive T-SPOT.TB and/or QuantiFERON-Gold in-tube or –Plus assay.ResultsWe enrolled 193 CoC (119 adults/74 elderly) and 459 ReC (361 adults/98 elderly). LTBI positivity increased with age in CoC (range 19-59%; trend p <0.001), but was similar in ReC (range 59-69%; trend p=0.329). The elderly had lower concordance between IGRAs (kappa 0.465 vs. 0.688 in adults) and more inconclusive results (indeterminate/borderline; 11.6% vs. 5.8% in adults; p=0.012). Exclusion of inconclusive results improved concordance between assays, notably in elderly ReC, who have the highest TB risk (from kappa 0.532 to 0.800). When both IGRAs were done simultaneously, inconclusive results were resolved in all cases as positive or negative with the other IGRA. The magnitude of the response to M.tb peptides used in the assays was similar between age groups, but responsiveness to mitogens was lower in the elderly.ConclusionsIGRAs are suitable for LTBI detection in the elderly. Discordant and inconclusive findings are more prevalent in the elderly, but results were resolved when performing different IGRAs simultaneously in the same participant.
Testing & Opening in Augustusburg A Success Story?
Authors: Diederichs Marc , Mitze Timo , Schulz Felix , Wälde Klaus 
Published: June 2021

AbstractThe city of Augustusburg allowed for opening of, inter alia, restaurants and hotels joint with large-scale testing. We evaluate this testing & opening (T&O) experiment by comparing the evolution of case rates in Augustusburg with the evolution in other communities of Saxony. We have access to small-scale SARS-CoV-2 infection data at the community level (” Gemeinde”) instead of the county level (” Landkreis”) usually used for disease surveillance. Despite data challenges, we conclude that T&O did not lead to any increase in case rates in Augustusburg compared to its control county. When we measure the effect of T&O on cumulative cases, we find a small increase in Augustusburg. This difference almost completely disappears when we control for the effect of higher case rates due to more testing. Generally speaking, T&O worked much better than in comparable projects elsewhere.