bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative study of flexor hallucis longus tendon length through single incision or accessory plantar medial incision: a cadaver study
Authors: Curtis Crocker Caitlin , Abyar Eildar , Young Sean , Razaghi Fatemeh , McGwin Gerald , Johnson Michael D. 
Published: November 2021

Background:
Flexor hallucis longus (FHL) tendon transfer to the calcaneus is used in treatment of Achilles pathology. Tendon harvest is through a posterior or medial incision. This study quantified the tendon length obtained through each technique.

Methods:
Seven pair-matched cadaver legs were used. One leg was randomly selected for posterior harvest, and the contralateral leg was selected for medial harvest. A dorsal to plantar calcaneus tunnel was prepared. Two tendon measurements were obtained: the total and the functional tendon length.

Results:
Using a posterior incision, the total and functional tendon lengths were 4.2 cm and 4.0 cm, respectively. Using the medial incision, the total and functional tendon lengths were 8.2 cm and 7.2 cm, respectively.

Conclusions:
The single incision provided length to anchor the FHL into the calcaneus suggesting this technique is adequate for fixation with an interference screw. For other indications, the medial incision provides additional 4.0 cm (P=0.003) total length or 2.9 cm (P=0.0016) functional length.

Level of Evidence:
Level V.
Non-obstructive Coronary Artery Disease in Chinese Patients with Angina Diagnosed by Coronary Angiography: A Retrospective Study
Authors: Peng Chengfei , Nie Shaoping , Sun Yingxian , Chen Hui , Yuan Zuyi , Gong Yanjun , Wang Xiaozeng , Han Yaling 
Published: November 2021

Abstract

Objective:
This study aimed to estimate the proportion of non-obstructive coronary artery disease (CAD) patients in large percutaneous coronary intervention (PCI) centers in China.

Methods:
The study was conducted at 6 large PCI centers in China from January 1, 2013 to December 31, 2015. Demographic and clinical data were collected from medical records, prescription records, and laboratory reports of patients with symptoms of angina who underwent coronary angiography (CAG).

Results:
A total of 1713 patients were consecutively screened, 1600 of whom were included in the study. CAG showed that 300 patients had non-obstructive CAD while 1300 had obstructive CAD. Among the 300 patients with non-obstructive CAD, 203 displayed mild coronary stenosis (20%–49%) and 91 had normal coronary status (ie, <20% stenosis). Of the 1300 patients with obstructive CAD, 61.6% (801/1300) had typical symptoms of angina, compared with 49.3% (148/300) for patients with non-obstructive CAD. In addition, there were more women than men in the non-obstructive CAD group, whereas the reverse was observed among obstructive CAD patients.

Conclusion:
The prevalence of non-obstructive CAD in the Chinese population with coronary heart disease was estimated to be approximately 20%. Additionally, typical angina symptoms were correlated with obstructive CAD, whereas female gender was identified as a risk factor for non-obstructive CAD.
Virtual reality and hypnosis for anxiety and pain management in intensive care units
Authors: Rousseaux Floriane , Dardenne Nadia , Massion Paul B. , Ledoux Didier , Bicego Aminata , Donneau Anne-Françoise , Faymonville Marie-Elisabeth , Nyssen Anne-Sophie , Vanhaudenhuyse Audrey 
Published: November 2021

BACKGROUND
Virtual reality and hypnosis are little studied in complex contexts, such as intensive care, where patients need significant physical and psychological assistance.

OBJECTIVES
To compare and combine hypnosis and virtual reality benefits on anxiety and pain on patients before and after cardiac surgery.

DESIGN
Prospective randomised controlled clinical trial.

SETTING
The study was conducted in the University Hospital of Liege (Belgium) from October 2018 to January 2020.

PATIENTS
One hundred patients (66 ± 11.5 years; 24 women, 76 men) were included. Participants were adults undergoing cardiac surgery. Exclusion criteria: psychiatric diseases, claustrophobia, acrophobia, hearing loss, visual impairment, extreme fatigue, confusion surgery cancelled.

INTERVENTIONS
Patients were randomly assigned to four arms (control; hypnosis; virtual reality; virtual reality hypnosis) and had 20 min of one of the techniques the day before and the day after surgery.

MAIN OUTCOMES MEASURES
Anxiety, pain, fatigue, relaxation, physiological parameters, and opioid use were evaluated before and after each session.

RESULTS
The main results did not show any significant differences between the groups. In all groups, anxiety decreased and pain increased from baseline to the postoperative day. Relaxation increased in all groups in the pre-operative (P < 0.0001) and postoperative period (P = 0.03). There were no significant differences for fatigue, physiological measures, or opioid use.

CONCLUSION
As there were no significant differences between groups for the measured variables, we cannot affirm that one technique is better than another. Additional studies are required to compare and evaluate the cost-effectiveness of these techniques for critical care patients and caregivers.

TRIAL REGISTRATION
ClinicalTrials.gov: NCT03820700. https://clinicaltrials.gov/ct2/show/NCT03820700. Retrospectively registered on 29 January 2019.
Red and processed meat consumption and food insecurity are associated with hypertension; analysis of the National Health and Nutrition Examination Survey data, 2003–2016
Authors: Ba Djibril M. , Gao Xiang , Chinchilli Vernon M. , Liao Duanping , Richie John P. , Al-Shaar Laila 
Published: November 2021

Objective:
This study examined the joint association of red and processed meat intake and food insecurity with hypertension.

Methods:
Adult participants of the National Health and Nutrition Examination Survey 2003–2016 were included. Total red meat intake was estimated using 24 h dietary recalls. Food insecurity was defined as having three or more affirmative responses using the Food Security Survey Module. Hypertension was defined as having mean SBP of at least 130 mmHg or DBP of at least 85 mmHg or use of antihypertensive drugs. Multivariable surveylogistic regression models were used to examine the independent and joint associations of total red meat and food insecurity with hypertension.

Results:
A total of 31 314 participants [mean (SE) age of 46.8 (0.3) years] were included, of whom 18.3% were food insecure. Total red meat consumption and food insecurity were independently associated with higher odds of hypertension. Compared with the first quintile of total red meat intake, participants in the fourth and fifth quintiles of total red meat intake had 29 and 39% higher odds of hypertension, respectively (P = 0.003). These associations were stronger among food insecure participants (P value for interaction <0.001). Substituting one serving/day of poultry, fish, eggs, dairy products, or plant-based protein sources for total red meat was each associated with 8–15% lower odds of hypertension.

Conclusion:
This study provides further evidence regarding the health hazards of total red meat consumption in relation with hypertension and calls for more awareness among food insecure groups.
Prognostic significance of pretreatment 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) in patients with primary T cell lymphomas
Authors: Zhang Jian-Hua , Zhao Jing , Fan Yan , Fu Zhan-Li , Zhang Xu-Chu , Liu Meng , Zhao Guang-Yu , Cen Xi-Nan , Chen Xue-Qi , Ning Jing , Li Xiang , Wang Rong-Fu 
Published: November 2021

Objective
T cell lymphomas are associated with an aggressive worse prognosis. This study is designed to assess T cell lymphomas using 18F-FDG PET/CT.

Methods
Sixty-four patients with newly diagnosed T cell lymphomas underwent PET/computed tomography (PET/CT) scans, 47 cases who were fully followed up were retrospectively reviewed and analyzed. Overall survival (OS) and progression-free survival (PFS) were recorded for prognosis. We measured the maximum standardized uptake value (SUVmax) in all cases, analyzed the correlation between SUVmax and survival and other clinicopathologic parameters. Kaplan–Meier log-rank tests were then used to compare the survival of high and low PET/CT parameter groups, and multivariate Cox proportional hazards regression analysis was carried out to identify predictors of OS and PFS.

Results
With a median follow-up of 26.5 (range 0.7–117.5) months, the 1-, 2- and 3-year OS were 75.6, 61.7 and 49.2%, and PFS were 49.3, 39.9 and 29.9%, respectively in 47 patients. Among them, 33 cases progressed with a median time of 9.5 (0.7–115.0) months, and 26 patients died with a median survival time of 26.5 (0.7–117.5) months. Multivariate analysis showed the following independent prognostic factors for OS: age >60 years (P = 0.002), SUVmax >9.7 (P = 0.009) and extranodal involvement of more than one site (P = 0.018). In addition, lactate dehydrogenase level (P = 0.003) and B symptoms (P = 0.018) were independent risk factors for PFS.

Conclusion
Pretherapy SUVmax may serve as an independent predictor of outcome in patients with newly diagnosed T cell lymphomas.
Congenital neutropenia: disease models guiding new treatment strategies
Authors: Touw Ivo P. 
Published: November 2021

Purpose of reviewMyeloid diseases are often characterized by a disturbed regulation of myeloid cell proliferation, survival, and maturation. This may either result in a severe paucity of functional neutrophils (neutropenia), an excess production of mature cells (myeloproliferative disorders) or in clonal expansions of dysplastic or immature myeloid cells (myelodysplasia and acute myeloid leukemia). Although these conditions can be regarded as separate entities, caused by the accumulation of distinct sets of somatic gene mutations, it becomes increasingly clear that they may also evolve as the prime consequence of a congenital defect resulting in severe neutropenia. Prominent examples of such conditions include the genetically heterogeneous forms of severe congenital neutropenia (SCN) and Shwachman-Diamond Syndrome. CSF3 treatment is a successful therapy to alleviate neutropenia in the majority of these patients but does not cure the disease nor does it prevent malignant transformation. Allogeneic stem cell transplantation is currently the only therapeutic option to cure SCN, but is relatively cumbersome, e.g., hampered by treatment-related mortality and donor availability. Hence, there is a need for new therapeutic approaches.Recent findingsDevelopments in disease modeling, amongst others based on induced pluripotent stem cell and CRISPR/Cas9 based gene-editing technologies, have created new insights in disease biology and possibilities for treatment. In addition, they are fueling expectations for advanced disease monitoring to prevent malignant transformation.SummaryThis review highlights the recent progress made in SCN disease modeling and discusses the challenges that are still ahead of us to gain a better understanding of the biological heterogeneity of the disease and its consequences for patient care.
Is Grade Group 1 (Gleason score 3 + 3 = 6) adenocarcinoma of the prostate really cancer?
Authors: Epstein Jonathan I. 
Published: November 2021

Purpose of review
Whether Grade Group 1 (GG1) prostate cancer is really cancer remains controversial.

Recent findings
Favoring renaming GG1 with a noncancerous diagnosis are: fear of the term cancer, which will lead to overtreatment of GG1; and indolence of GG1. Favor designating GG1 as cancer are: morphologically, GG1 may be indistinguishable from GG2 to GG5 and GG1 is invasive (lacks basal cells), can show perineural invasion and extraprostatic extension; molecularly, GG1 has many of the hallmarks of prostate cancer; calling GG1 noncancer would lead to inconsistencies and confusion in reporting; sampling error with GG1 on biopsy can miss higher grade cancer; removing the label of cancer in men with GG1 on biopsy may make it challenging to insure follow-up during active surveillance; the prognosis of treated GG1 may not be the same if GG1 called noncancer and not treated; with Grade Group terminology, GG1 is more intuitive to patients as lowest grade cancer; and patients are increasingly adopting active surveillance, recognizing that not all prostate cancers are the same and GG1 can be followed carefully and safely on active surveillance.

Summary
There is strong support for retaining the carcinoma designation for GG1.
Management of Multiple Skeletal Tuberculosis Wounds Complicated With Multiple Deep Sinus Tracts
Authors: Zhang Yinhua , Zhou Hui , Wu Xifang , Xia Beinan , Wang Fudong , Zhu Jun 
Published: November 2021

BACKGROUND:
Tuberculosis (TB) is a leading infectious disease worldwide. It rarely occurs in the scapula and toe joints and is easily misdiagnosed. Without prompt treatment, the associated lesions can spread to surrounding soft tissues such as joint capsules, muscles, tendons, and fascia. In severe cases, the bones and articular surfaces can become significantly damaged; it is not uncommon for deep skeletal TB wounds with sinus tracts to form, which are very difficult to treat. We report our successful wound care management approach for one patient with multiple skeletal TB complicated with multiple deep sinus tracts.

CASE:
The patient was treated with anti-TB medications, and wound and bone debridement (sharps, surgical) combined with vacuum-shielded drainage (VSD) (Kula, CG Bio Co Ltd, Gyeonggi-do, South Korea) to fill the sinus tract. We removed the caseous (cheese-like) necrotic tissue, purulent drainage, and necrotic tissue at the base of the wound to ensure optimal wound care. Throughout the course of treatment, we selected different types of dressings to maintain moist wound healing and absorb excessive drainage. After 144 days of treatment, the wound and deep sinus tracts completely healed.

CONCLUSIONS:
Wounds related to skeletal TB with multiple sinus tracts are difficult to manage and heal. We found our wound protocol that included timely debridement and use of VSD was effective for the management of these complex wounds. Specifically, our approach filled the dead space in the sinus tract, removed excessive drainage, promoted the growth of granulation tissue, and overall promoted tissue healing.
Neurofilament light protein as a biomarker in depression and cognitive function
Authors: Travica Nikolaj , Berk Michael , Marx Wolfgang 
Published: November 2021

Purpose of review
Converging evidence suggest axonal damage is implicated in depression and cognitive function. Neurofilament light protein, measured within serum and cerebrospinal fluid, may be a biomarker of axonal damage. This article examines the emerging evidence implicating neurofilament light protein in depression and cognitive function.

Recent findings
Preliminary cross-sectional and case–control studies in cohorts with depression have yielded inconsistent results regarding the association between neurofilament light protein and symptomatology. However, these studies had methodological limitations, requiring further investigation. Importantly, neurofilament light protein concentrations may be a marker of progression of cognitive decline and may be associated with cognitive performance within cognitively intact cohorts.

Summary
Axonal damage is implicated in the neuropathology of depression and cognitive dysfunction. Consequently, neurofilament light protein is an emerging biomarker with potential in depression and cognitive function. Results are more consistent for cognition, requiring more research to assess neurofilament light protein in depression as well as other psychiatric disorders. Future longitudinal studies are necessary to determine whether neurofilament light protein can predict the onset and progression of depression and measure the effectiveness of potential psychiatric interventions and medications.
Repeat Subcutaneous Administration of REGEN-COV® in Adults is Well-Tolerated and Prevents the Occurrence of COVID-19
Authors: Isa Flonza , Forleo-Neto Eduardo , Meyer Jonathan , Zheng Wenjun , Rasmussen Scott , Armas Danielle , Oshita Masaru , Brinson Cynthia , Folkerth Steven , Faria Lori , Heirman Ingeborg , Sarkar Neena , Musser Bret J. , Bansal Shikha , O’Brien Meagan P. , Turner Kenneth C. , Ganguly Samit , Mahmood Adnan , Dupljak Ajla , Hooper Andrea T. , Hamilton Jennifer D. , Kim Yunji , Kowal Bari , Soo Yuhwen , Geba Gregory P. , Lipsich Leah , Braunstein Ned , Yancopoulos George D. , Weinreich David M. , Herman Gary A. ,   the COVID-19 Multi-dose Trial Team
Published: November 2021

AbstractBackgroundData show that a single dose of casirivimab and imdevimab (REGEN-COV®) is effective in treating hospitalized individuals and outpatients with COVID-19 and in post-exposure prophylaxis. We present results from a phase 1, double-blind, placebo-controlled trial evaluating the safety, tolerability, and efficacy of repeat monthly doses of subcutaneous (SC) REGEN-COV in uninfected adult volunteers who were healthy or had chronic stable medical conditions.MethodsSubjects were randomized (3:1) to SC REGEN-COV 1200 mg or placebo dosed every 4 weeks for up to 6 doses. The primary and secondary endpoints evaluated the safety, pharmacokinetics, and immunogenicity of multiple-dose administration of REGEN-COV. Efficacy was evaluated by the incidence of COVID-19 or SARS-CoV-2 seroconversion.ResultsIn total, 969 subjects were treated. Repeat monthly dosing of SC REGEN-COV led to a 92.4% relative risk reduction in clinically-defined COVID-19 compared to placebo (3/729 [0.4%] vs 13/240 [5.4%]; odds ratio: 0.07 [95% CI, 0.01–0.27]), and a 100% reduction in laboratory-confirmed COVID-19 (0/729 vs 10/240 [4.2%]; odds ratio 0.00). Development of anti-drug antibodies was low (<5% subjects). No grade ≥3 injection-site reactions (ISRs) or hypersensitivity reactions were reported. A slightly higher percentage of subjects reported TEAEs with REGEN-COV (54.9%) than placebo (48.3%), due to ISRs (all grade 1-2). Serious adverse events were rare and occurred at similar percentages in the REGEN-COV and placebo groups. No deaths were reported in the 6-month treatment period.ConclusionsRepeated monthly administration of 1200 mg SC REGEN-COV was well-tolerated with low immunogenicity, and showed a substantial risk reduction in COVID-19 occurrence.(ClinicalTrials.gov identifier, NCT04519437)
First-in-clinical application of a time-gated diffuse correlation spectroscopy system at 1064nm using superconducting nanowire single photon detectors
Authors: Poon Chien-Sing , Langri Dharminder S. , Rinehart Benjamin , Rambo Timothy M. , Miller Aaron J. , Foreman Brandon , Sunar Ulas 
Published: November 2021

AbstractRecently proposed time-gated DCS (TG-DCS) has significant advantages compared to conventional CW-DCS, but it is still in an early stage and clinical capability has yet to be established. The main challenge for TG-DCS is the lower SNR when gating for the deeper travelling late photons. Longer wavelengths, such as 1064nm have a smaller effective attenuation coefficient and a higher power threshold in humans, which significantly increases the SNR. Here, we demonstrate the clinical utility of TG-DCS at 1064nm in a case study on a patient with severe traumatic brain injury admitted to the neuroscience intensive care unit (NSICU). We showed a significant correlation between TG-DCS early (ρ = 0.67) and late (ρ = 0.76) gated against invasive thermal diffusion flowmetry. We also analyzed TG-DCS at high temporal resolution (50 Hz) to elucidate pulsatile flow data. Overall, this study demonstrates the first clinical translation capability of the TG-DCS system at 1064nm using superconducting nanowire single photon detector.
Structural and functional characterization of NEMO cleavage by SARS-CoV-2 3CLpro
Authors: Hameedi Mikhail Ali , Prates Erica T. , Garvin Michael R. , Mathews Irimpan , Kirtley Amos B , Demerdash Omar , Bechthold Mark , Iyer Mamta , Rahighi Simin , Kneller Daniel W. , Kovalevsky Andrey , Irle Stephan , Vuong Van-Quan , Mitchell Julie C. , Labbe Audrey , Galanie Stephanie , Wakatsuki Soichi , Jacobson Daniel 
Published: November 2021

AbstractIn addition to its essential role in viral polyprotein processing, the SARS-CoV-2 3C-like (3CLpro) protease can cleave human immune signaling proteins, like NF-κB Essential Modulator (NEMO) and deregulate the host immune response. Here, in vitro assays show that SARS-CoV-2 3CLpro cleaves NEMO with fine-tuned efficiency. Analysis of the 2.14 Å resolution crystal structure of 3CLpro C145S bound to NEMO226-235 reveals subsites that tolerate a range of viral and host substrates through main chain hydrogen bonds while also enforcing specificity using side chain hydrogen bonds and hydrophobic contacts. Machine learning- and physics-based computational methods predict that variation in key binding residues of 3CLpro- NEMO helps explain the high fitness of SARS-CoV-2 in humans. We posit that cleavage of NEMO is an important piece of information to be accounted for in the pathology of COVID-19.
Paratype: A genotyping framework and an open-source tool for Salmonella Paratyphi A
Authors: Tanmoy Arif M. , Hooda Yogesh , Sajib Mohammad S. I. , Silva Kesia E. da , Iqbal Junaid , Qamar Farah N. , Luby Stephen P. , Dougan Gordon , Dyson Zoe A. , Baker Stephen , Garrett Denise O. , Andrews Jason R. , Saha Samir K. , Saha Senjuti 
Published: November 2021

AbstractBackgroundSalmonella enterica serovar Paratyphi A (Salmonella Paratyphi A) is the primary causative agent of paratyphoid fever, which is responsible for an estimated 3.4 million infections annually. However, little genomic information is available on population structure, antimicrobial resistance (AMR), and spatiotemporal distribution of the pathogen. With rising antimicrobial resistance and no licensed vaccines, genomic surveillance is important to track the evolution of this pathogen and monitor transmission.ResultsWe performed whole-genome sequencing of 817 Salmonella Paratyphi A isolates collected from Bangladesh, Nepal, and Pakistan and added publicly available 562 genomes to build a global database representing 37 countries, covering 1917-2019. To track the evolution of Salmonella Paratyphi A, we used the existing lineage scheme, developed earlier based on a small dataset, but certain sub-lineages were not homologous, and many isolates could not be assigned a lineage. Therefore, we developed a single nucleotide polymorphism based genotyping scheme, Paratype, a tool that segregates Salmonella Paratyphi A into three primary and nine secondary clades, and 18 genotypes. Each genotype has been assigned a unique allele definition located on a conserved gene. Using Paratype, we identified genomic variation between different sampling locations and specific AMR markers, and mutations in the O2-polysaccharide synthesis locus, a candidate for vaccine development.ConclusionsThis large-scale global analysis proposes the first genotyping tool for Salmonella Paratyphi A. Paratype has already been released (https://github.com/CHRF-Genomics/Paratype) as an open-access, command-line tool and is being adopted for large scale genomic analysis. This tool will assist future genomic surveillance and help inform prevention and treatment strategies.