bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differentiation of Cool-Virulent Strains in the Ralstonia solanacearum Species Complex by Melt Curve of a DNA Fragment from Effector Gene Rips1
Authors: Schachterle J. K. , Huang Q. 
Published: February 2023

The Ralstonia solanacearum species complex ( Rssc) causes bacterial wilt diseases across hundreds of plant species. Phylogenetic analysis of DNA sequences has allowed the grouping of Rssc strains into phylotypes based on genetic relatedness. Although specific phenotypes are associated with corresponding phylotypes, the molecular bases for these differences are not always well understood. The complex trait of cool-virulence that allows several members of phylotype II to cause disease at temperatures below 25°C is one of these poorly understood traits. Here, we report that a 96-bp DNA fragment from a gene encoding the type III secretion system effector protein RipS1, which was recently reported to play a role in the cool-virulence phenotype, has a melting temperature that varies based on the strain of origin. By testing 81 Rssc strains with melt-curve analysis, we found a bimodal distribution with clear separation between the group of strains with a melting temperature below 87.5°C that includes phylotypes I, III, and IV strains and the group with a melting temperature above 87.5°C that includes all 35 tested select agent race 3 biovar 2 (phylotype IIB sequevars 1 and 2) and seven phylotype IIB sequevar 4 strains, previously known to possess cool-virulence capability, with a few exceptions. This provides further support that sequence differences in this effector differentiate cool-virulent strains from non-cool-virulent strains and show potential for use as a marker in continued studies of the cool-virulence phenotype. [Formula: see text] The author(s) have dedicated the work to the public domain under the Creative Commons CC0 “No Rights Reserved” license by waiving all of his or her rights to the work worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law, 2023.
Lateral Mass Screws Versus Pedicle Screws at C7 - Reoperation Rates for Adjacent Segment Disease (Operative ASD) and Nonunions (Operative Nonunions) in Posterior Cervical Fusions
Authors: Brara Harsimran S. , Royse Kathryn E. , Fennessy Jacob , Harris Jessica E. , Guppy Kern H. 
Published: February 2023

Study Design.A retrospective cohort study.Objective.To determine if there a difference in reoperation rates for symptomatic adjacent segment disease (operative ASD) and symptomatic nonunions (operative nonunions) in posterior cervical fusions (PCFs) stopping at C7 using either lateral mass screws (LMS) or cervical pedicle screws (CPS) at C7.Summary of Background Data.Stopping PCFs at C7 has been controversial because of the risks of adjacent segment disease or nonunions. The two commonly used fixation techniques at the C7 level are LMS and CPS.Methods.A retrospective analysis from the Kaiser Permanente Spine Registry identified a cohort of patients with cervical degenerative disc disease who underwent primary PCFs stopping at C7 with either LMS or CPS at C7. Demographic and operative data were extracted from the registry and operative ASD and operative nonunions were adjudicated via chart review. Patients were followed until validated operative ASD or nonunion, membership termination, death, or end of study (03/31/2022). Descriptive statistics and multivariable Cox proportional hazards models were calculated for operative ASDs and operative nonunions.Results.We found 481 patients with PCFs stopping at C7 with either LMS (n=347) or CPS (n=134) at C7 with average follow-up time of 5.6 (±3.8) years, time to operative ASD of 3.0 (±2.8) years and to operative nonunion of 1.2 (±0.7) years. There were 11 operative ASDs (LMS=8, CPS=3) and 8 operative nonunions (LMS=4, CPS=4). There was no statistical difference between patients stopping at C7 with LMS versus CPS for operative ASDs (HR: 0.68, 95% CI=0.17-2.77,P=0.60) or operative nonunions (HR: 2.09, 95% CI=0.45-8.58,P=0.37).Conclusion.A large cohort of patients with PCFs stopping at C7 with an average follow-up of > 5 years found no statistical difference in reoperation rates for symptomatic ASD (operative ASD) or operative nonunion using either LMS or CPS at C7.
Age Moderates the Effect of Obesity on Mortality Risk in Critically Ill Patients With COVID-19: A Nationwide Observational Cohort Study*
Authors: den Uil Corstiaan A. , Termorshuizen Fabian , Rietdijk Wim J. R. , Sablerolles Roos S. G. , van der Kuy Hugo P. M. , Haas Lenneke E. M. , van der Voort Peter H. J. , de Lange Dylan W. , Pickkers Peter , de Keizer Nicolette F. ,   the Dutch COVID-19 Research Consortium
Published: February 2023

OBJECTIVES:
A high body mass index (BMI) is associated with an unfavorable disease course in COVID-19, but not among those who require admission to the ICU. This has not been examined across different age groups. We examined whether age modifies the association between BMI and mortality among critically ill COVID-19 patients.

DESIGN:
An observational cohort study.

SETTING:
A nationwide registry analysis of critically ill patients with COVID-19 registered in the National Intensive Care Evaluation registry.

PATIENTS:
We included 15,701 critically ill patients with COVID-19 (10,768 males [68.6%] with median [interquartile range] age 64 yr [55–71 yr]), of whom 1,402 (8.9%) patients were less than 45 years.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
In the total sample and after adjustment for age, gender, Acute Physiology and Chronic Health Evaluation IV, mechanical ventilation, and use of vasoactive drugs, we found that a BMI greater than or equal to 30 kg/m2 does not affect hospital mortality (adjusted odds ratio [ORadj] = 0.98; 95% CI, 0.90–1.06; p = 0.62). For patients less than 45 years old, but not for those greater than or equal to 45 years old, a BMI greater than or equal to 30 kg/m2 was associated with a lower hospital mortality (ORadj = 0.59; 95% CI, 0.36–0.96; p = 0.03).

CONCLUSIONS:
A higher BMI may be favorably associated with a lower mortality among those less than 45 years old. This is in line with the so-called “obesity paradox” that was established for other groups of critically ill patients in broad age ranges. Further research is needed to understand this favorable association in young critically ill patients with COVID-19.
Early Fractional Ablative Laser for Skin Cancer Excision Scars: A Randomized Split-Scar Study
Authors: Lin Matthew J. , Dubin Danielle P. , Torbeck Richard L. , Bernstein Daniel M. , Nabatian Adam , Dolan Christopher K. , Bacigalupi Robert , Zade John , Zheng Zhong , Desman Garrett , Khorasani Hooman 
Published: February 2023

BACKGROUND
Fractional ablative laser resurfacing has been shown to improve the final cosmetic appearance of surgical scars, but optimal timing is unknown.

OBJECTIVE
To compare surgical scars treated with fractional carbon dioxide (CO2) laser performed on Day 0 and Day 14.

METHODS
Prospective, randomized, split-scar, physician-blinded study of 30 surgical scars on the limbs. Scars halves received fractional CO2 laser on either Day 0 or Day 14. Scar assessment at 6 months evaluated patient preference, physician modified Manchester Scar Scale (MMSS) score, and quantitative scar analysis on histology (fractal dimension [FD] and lacunarity [L] analysis).

RESULTS
There was no significant difference in patient assessment (54% preferred Day 0 side, 46% preferred Day 14 side, p = .58) or physician assessment (mean MMSS 8.4 for Day 0 vs 8.7 for Day 14, p = .28). Fractal dimensions were similar for both interventions (mean 1.778 for Day 0 vs 1.781 for Day 14, p = .80). Lacunarity was similar for both interventions (mean 0.368 for Day 0 vs 0.345 for Day 14, p = .44).

LIMITATIONS
Single-center study with wounds limited to limbs of skin Phototype I-II subjects; 4 of whom were lost to follow-up.

CONCLUSION
Intraoperative CO2 laser is noninferior to Day 14 laser resurfacing for surgical scar treatment.
THREE-DIMENSIONAL HEADS-UP VITRECTOMY VERSUS CONVENTIONAL MICROSCOPIC VITRECTOMY FOR PATIENTS WITH EPIRETINAL MEMBRANE
Authors: Kim Dong Ju , Kim Dong Geun , Park Kyu Hyung 
Published: February 2023

Purpose:
To investigate the efficacy and safety of 3D heads-up display (3D-HUD) vitrectomy compared with conventional microscopy (CM) vitrectomy in epiretinal membrane (ERM) surgery.

Methods:
Epiretinal membrane removal with or without internal limiting membrane (ILM) peeling was performed using a 3D-HUD or CM system. The mean changes in best-corrected visual acuity (BCVA) and in central macular thickness (CMT) and postoperative complications were assessed.

Results:
Baseline demographics were comparable except for the follow-up period. Both BCVA and CMT improved at the final visit (all P < 0.05). The ERM recurrence and dissociated optic nerve fiber layer (DONFL) rates were lower in the 3D group (both P < 0.05). conventional microscopic vitrectomy (odds ratio [OR] = 12.86, P = 0.02) and absence of ILM peeling (OR = 45.25, P < 0.05) were associated with ERM recurrence. In the DONFL, CM vitrectomy (OR = 1.98, <0.05) and combined phacovitrectomy (OR = 2.33, P = 0.03) were analyzed as risk factors for DONFL.

Conclusion:
The improvement in BCVA and CMT in ERM surgery using a 3D-HUD is comparable with that of CM vitrectomy, with a significantly low rate of ERM recurrence and DONFL occurrence. Therefore, 3D vitrectomy might have an advantage for ERM surgery.
Comparison of Pre-Descemet Endothelial Keratoplasty and Descemet Membrane Endothelial Keratoplasty in Endothelial Decompensation
Authors: Shanmugam Chandradevi , Agarwal Rinky , Asif Mohamed Ibrahime , Bafna Rahul Kumar , Maharana Prafulla Kumar , Agarwal Tushar , Sinha Rajesh , Titiyal Jeewan Singh , Sharma Namrata 
Published: February 2023

Purpose:
The purpose of this study was to compare the outcomes of pre-Descemet endothelial keratoplasty (PDEK) and Descemet membrane endothelial keratoplasty (DMEK) in cases of endothelial decompensation.

Methods:
This was a prospective, randomized, interventional study conducted at a tertiary eye hospital in North India. Thirty eyes of 28 patients with corneal decompensation were randomly subjected to PDEK (n = 15 eyes) and DMEK (n = 15 eyes). Preoperative demographic details, surgical indications, uncorrected distance visual acuity, corrected distance visual acuity, contrast sensitivity, anterior and posterior segment details, intraocular pressure, central corneal thickness, endothelial cell count, and corneal aberrometry tracing on wavefront analysis were recorded. Patients were followed up for 6 months postsurgery. Visual and graft survival outcomes were assessed.

Results:
Intraoperatively, a surgeon reported better ease of preparation and intracameral handling with PDEK grafts. Both groups showed comparable improvement in visual acuity, contrast, and high-order aberrations. A decrease in central corneal thickness was significantly higher in DMEK (196 ± 26 vs. 140 ± 14 μm) patients. DMEK grafts were significantly thinner than PDEK grafts at the 6-month follow-up (16 ± 2.17 vs. 27.2 ± 1.93 μm). Endothelial cell loss (35% in DMEK vs. 33.4% in PDEK, P = 0.48) and rise of intraocular pressure (from 15.33 ± 2.85 mm Hg to 15.53 ± 2.2 mm Hg in the DMEK group vs. from 14.6 ± 1.99 mm Hg to 16.2 ± 1.43 mm Hg in the PDEK group) were comparable. Rebubbling rates were higher in the DMEK group (3/15, 20%) compared with the PDEK group (1/15, 6.66%; P = 0.165).

Conclusions:
DMEK and PDEK were comparable for both quantitative and qualitative visual outcomes and anatomically for graft survival at the 6-month follow-up.
Comprehensive treatment of Cronkhite-Canada syndrome: A case report and literature review
Authors: Hu Hailong , Wu Yating , Zhang Yaqin , Zhang Li , Zhang Jianfa , Zhang Rui 
Published: February 2023

Introduction:
Cronkhite-Canada syndrome (CCS) is currently considered to be a non-hereditary disease, which is relatively rare clinically. It is also known as polyposis hyperpigmentation alopecia nail dystrophy syndrome, it is a syndrome characterized by gastrointestinal polyposis and ectodermal changes, the main manifestations are gastrointestinal symptoms, skin pigmentation, alopecia, and hypothyroidism.

Case presentation:
In this paper, the clinical characteristics, diagnosis and treatment of a case of CCS admitted to Huanghe Sanmenxia Hospital were analyzed. In the course of treatment, traditional Chinese medicine was used, but no hormone, and the patient’s clinical symptoms were greatly relieved.

Conclusions:
CCS is rare, there is no specific treatment, and traditional Chinese medicine may can greatly relieve the clinical symptoms of patients. However, it’s still having to be verified by a large sample, multi-center, long-term treatment follow-up studies.
Brown tumor of the cervical spine with primary hyperparathyroidism: A case report and literature review
Authors: Liu Zirui , Yang Hao , Tan Hongyu , Song Ruipeng , Zhang Yang , Zhao Liang 
Published: February 2023

Rationale:
Brown tumor (BT), an uncommon focal lytic bone tumor, is a non-neoplastic and reactive process caused by increased osteoclastic activity and fibroblastic proliferation in primary or secondary hyperparathyroidism. Vertebral tumor causing neural compression is relatively rare, especially in the cervical spine.

Patient concerns:
A 29-year-old man developed neck pain and arm radicular pain 4 months ago, with the level of serum calcium significantly higher than normal. Computed tomography scan of the cervical spine revealed an expansile lytic lesion occupying the C6 body, left pedicle, and left lamina of C5–6.

Diagnoses:
Osteoclastoma according to imaging and histopathological results.

Interventions:
A laminectomy of C5–6 was performed.

Outcomes:
One month later, he was re-hospitalized due to nausea and vomiting and the serum calcium, was still, kept at a high level. Additionally, the parathormone (PTH) was greatly higher than normal. BT with primary hyperparathyroidism due to the parathyroid tumor was considered. After the surgery of the right parathyroid gland was performed, serum calcium and PTH both decreased, and computed tomography showed good recovery.

Lessons:
BTs might be misdiagnosed as other giant cell tumors, thus when giant cell tumors are considered, serum calcium and PTH examination may be needed to exclude BTs.
Personalized downstaging treatment with ADT, chemotherapy and add-on zimberelimab for very-high-risk clinically localized prostate cancer: A case report
Authors: Li Jie , Gu Tengfei , Hu Shengping , Wang Liang , Chen Ting 
Published: February 2023

Rationale:
Very-high-risk prostate cancer (PCa) is associated with poor prognosis. Radical prostatectomy (RP) is an option for selected high-risk PCa cases, especially in younger, healthier patients. However, a high Gleason score and high T stage can increase the risk of RP. Neoadjuvant therapy has been reported in high- or very-high-risk PCa, but its clinical use remains controversial.

Diagnoses and patient concerns:
A 53-year-old male patient diagnosed with PCa was referred to our hospital. The patient’s Gleason score was 4 + 5, and the clinical stage was T4N0M0, with an abnormally enlarged prostate adhering to the rectum and leading to decreased mobility of the rectum, suggesting a very-high-risk PCa inappropriate for RP. However, instead of external beam radiation therapy, which is the standard treatment for inoperable PCa, the patient insisted on RP.

Interventions:
Androgen deprivation therapy plus docetaxel was chosen as the first downstaging treatment; however, the tumor was too slightly downsized to undergo RP. Therefore, zimberelimab was added after confirmation of a genomic feature of high microsatellite instability and high tumor mutational burden status.

Outcomes:
After 4 doses of zimberelimab, the prostate shrank significantly. The patient successfully completed RP after another dose of zimberelimab, and achieved a pathological complete response (pCR).

Lessons:
Our case represents a successful attempt at personalized treatment and provides preliminary evidence for the clinical use of downstaging therapy of androgen deprivation therapy, chemotherapy, and add-on zimberelimab for very-high-risk clinically localized PCa.
Primary acinic cell carcinoma of the trachea: A case report and literature review
Authors: Yang Mai-Qing , Wang Zhi-Qiang , Li Xiu-Feng , Chen Li-Qian , Zhang Hai-Ning , Zhang Ke-Xin , Xu Hong-Tao 
Published: February 2023

Rationale:
Salivary gland-type acinic cell carcinoma (ACC) is a low-grade malignancy. Primary ACC of the trachea and lungs is rare; here, we describe 1 such case. The histological morphology of tracheal ACC was similar to that of its salivary gland-associated equivalent. Because of its rarity, it is easily misdiagnosed as another type of tracheal or lung tumor. Microscopic analysis of pathological features and immunohistochemistry help diagnose primary ACC of the trachea and lungs.

Patient concerns:
A 33-year-old female complained of shortness of breath and hemoptysis for 2 years, and reported the symptoms to have aggravated over the last 4 months. The patient was admitted to our hospital for further treatment. Enhanced computed tomography revealed a soft tissue density nodule shadow in the trachea, which was approximately 1.3 × 1.2 cm in size.

Diagnoses:
Based on the clinical information, morphological features, and immunohistochemistry, the pathological diagnosis was primary ACC of the trachea.

Intervention:
The tracheal lesion was resected with an electric snare, electrotomy, freezing, and an argon knife using a rigid bronchoscope.

Outcomes:
The patient’s postoperative course was uneventful.

Lessons:
It is important to prevent misdiagnosis of this type of tumor as another type of lung tumor. Morphological and immunohistochemical features can be useful in diagnosing primary ACC of the trachea and lungs.
Meta-analysis of the occurrence of hepatocellular carcinoma after the treatment of entecavir and tenofovir for chronic hepatitis B
Authors: Tang Kaiyue , Cheng Huizhen , Wang Haiyan , Guo Yueping 
Published: February 2023

Background:Tenofovir and Entecavir are recommended as the first-line medicine of treatment for chronic hepatitis B. The occurrence of hepatocellular carcinoma after the treatment of chronic hepatitis B is a major problem. For the time being it is still unclear whether there remains a difference in risk correlation of hepatocellular carcinoma after the treatment of Tenofovir and Entecavir for chronic hepatitis B. Since previous studies have raised different ideas, this article aims to come to a conclusion targeting such a topic through analyzing the latest data.Methods:We searched some databases, such as PubMed, Web of Science, and Cochrane Library, for related studies on patients with chronic hepatitis B receiving the treatment of Tenofovir and Entecavir and then developing hepatocellular carcinoma. The search time was set to begin from the establishment time of the above-mentioned databases to May 2022. Two researchers were designated to screen the literature independently according to the inclusion and exclusion criteria set in this study; they then evaluated the quality of the literature included and extracted the data. Revman 5.3 software was used for meta-analysis.Results:After screening the literature, a total of 20 pieces of cohort study literature conformed to the inclusion criteria. Among which were 62,860 cases of patients receiving Entecavir, and 27,544 cases of patients receiving Tenofovir; there were 3669 cases with the occurrence of hepatocellular carcinoma in the Entecavir group and 1089 cases with the occurrence of hepatocellular carcinoma in Tenofovir group. The result of Meta analysis of these 20 pieces of literature shows that compared with the Tenofovir group, the Entecavir group has a lower occurrence rate of hepatocellular carcinoma, and the difference is statistically significant. The results are expressed as odd ratio (OR) and 95% confident interval (95%CI), (OR = 1.66, 95%CI: 1.35–2.05, P < .05). The result of Meta analysis of 10 studies related to Korea shows that the occurrence rate of hepatocellular carcinoma in the Tenofovir group is lower than that of the Entecavir group, and the difference is statistically significant (OR = 1.59, 95%CI: 1.29–1.95, P < .05). The result of meta-analysis of 5 studies related to China shows that the occurrence rate of hepatocellular carcinoma of Tenofovir group is lower than that of Entecavir group, and the difference is statistically significant (OR = 2.35, 95%CI: 1.15–4.81, P < .05).Conclusion:The occurrence rate of hepatocellular carcinoma after the treatment of tenofovir for chronic hepatitis B is lower than that of the treatment of entecavir.
Diffusion tensor tractography of the corticobulbar tract in a dysphagic patient with progressive supranuclear palsy: A case report
Authors: Han In Jun , Kwon Hyeok Gyu , Lee Woong-Woo , Yoon Ra Gyoung , Choi Hyoseon , Kim Hyun Jung 
Published: February 2023

Rationale:
This paper reports the changes over time in the corticobulbar tract (CBT) analyzed using diffusion tensor tractography (DTT) in a dysphagic patient with progressive supranuclear palsy (PSP).

Patient concerns:
A 53-year-old man initially presented with dysarthria, gait disturbance, and bradykinesia, and approximately 1-year later, downward gaze paralysis appeared. Initially, there was no dysphagia; however, approximately 2 years after visiting the hospital, symptoms of dysphagia, including difficulty swallowing pills, aspiration, and oral movement impairments appeared. The symptoms gradually progressed, and finally, mouth opening was severely damaged to the extent that it was difficult to orally feed.

Interventions:
We performed diffusion tensor imaging 3 times; at 3-month, 20-month, and 41-month from onset.

Outcomes:
On 3-month DTT, the left CBT was well reconstructed, whereas the right CBT showed partial tearing. In the 20-month DTT, both CBTs became thinner compared to the 3-month DTT. On 41-month DTT, both CBTs became much thinner than after 3-month and 20-month DTT.

Lessons:
We observed the degree of CBT injury over time in a dysphagic patient with PSP. These results suggest that the analysis of CBT using DTT is helpful in predicting the degree of dysphagia and prognosis in patients with PSP.
Femoral head cartilage reconstruction using autologous osteochondral mosaicplasty: A case report
Authors: Lee Hyeonjoon , Kim Hyoung Tae , Jo Suenghwan 
Published: February 2023

Rationale:
Cartilage injuries of the femoral head may occur following hip dislocation. As a rare injury, controversy persists regarding ideal treatment of damaged femoral head cartilage. Here we report the case of a patient who developed a large cartilage injury to the femoral head following anterior hip dislocation for which autologous osteochondral mosaicplasty with a graft harvested from the ipsilateral femoral head achieved a satisfactory outcome.

Patient concerns:
A 62-year-old man developed a right hip dislocation after a fall from a 5-m height and was referred to our institution.

Diagnoses:
The initial diagnosis was anterior hip dislocation. Upon hip joint reduction, a simple radiograph and computed tomography scan showed a large cartilage defect in the superolateral region of the femoral head. Multiple bony fragments were visible within the joint.

Interventions:
The hip joint was surgically dislocated. The large cartilage defect of the femoral head was treated with autologous mosaicplasty using an osteochondral autograft transfer system using multiple osteochondral plugs retrieved from a non-weight-bearing portion of the ipsilateral femoral head.

Outcomes:
Diagnostic hip arthroscopy performed at 8 months postoperative confirmed full incorporation of the osteochondral graft into the native femoral head. At the 2-year follow-up, the patient was pain-free, had a normal range of motion and displayed no evidence of osteoarthritis.

Lessons:
Isolated femoral head cartilage injuries may occur as a consequence of anterior hip dislocation. A femoral head with a large irregular cartilage defect can be treated with mosaicplasty using an osteochondral autograft from a non-weight-bearing portion of the ipsilateral femoral head.