bluuebunny/crossref_metadata_2025_split huggingface dataset:
Percutaneous Bone-Anchored Hearing Implant Surgery: Do Syndromic Children Have More Adverse Perioperative Outcomes?
Authors: Salameh Samer , El-Khoury Sabine , Bezdjian Aren , Roy Catherine F. , Khneisser Edwina , Bianchi Marco , Daniel Sam J. 
Published: June 2023

Objective
To evaluate and compare perioperative outcomes of percutaneous bone-anchored hearing implant (BAHI) surgery in syndromic and nonsyndromic pediatric patients.

Study Design
Retrospective cohort study

Setting
McGill University Health Centre in Montreal, Quebec, Canada.

Patients
Forty-one pediatric patients (22 syndromic, 19 nonsyndromic) who underwent percutaneous BAHI surgery between March 2008 and April 2021.

Intervention
Percutaneous BAHI surgery.

Main Outcome Measures
Patient demographics (age at surgery, gender, implant laterality), operative information (American Society of Anesthesia [ASA] score, anesthesia type, surgical technique, implant/abutment characteristics), and postoperative outcomes (implant stability, soft tissue integrity, surgical revisions, implant failure).

Results
The most frequent syndromes among implanted patients were Treacher Collins (27.3%), Goldenhar (13.6%), Trisomy 21 (13.6%), and Nager (9.1%). Syndromic patients were more frequently given higher ASA scores: 2 (p = 0.003) and 3 (p = 0.014). All cases of implant extrusion were in syndromic patients: two posttraumatic and two failures to osseointegrate. Nine (40.9%) syndromic patients experienced a Holgers Grade 4 skin reaction at one of their postoperative follow-up visits as compared to 0% of nonsyndromic patients (p < 0.001). Implant stability was similar between cohorts at all postoperative time-points, except for significantly greater nonsyndromic implant stability quotient scores at 16 weeks (p = 0.027) and 31+ weeks (p = 0.016).

Conclusions
Percutaneous BAHI surgery is a successful rehabilitation option in syndromic patients. However, it presents a relatively higher incidence of implant extrusion and severe postoperative skin reactions as compared to nonsyndromic patients. In light of these findings, syndromic patients may be great candidates for novel transcutaneous bone conduction implants.
Correlation Between Laterality of Hearing Loss and Migraine Features in Menière's Disease
Authors: Tawk Karen , Kim Joshua K. , Frank Madelyn , Goshtasbi Khodayar , Abouzari Mehdi , Djalilian Hamid R. 
Published: June 2023

Objectives
The objective of this study is to understand whether the hearing loss laterality in Menière's disease (MD) correlates with migraine symptoms laterality such as headache, neck stiffness, and otalgia.

Methods
We performed a retrospective review of prospectively obtained data on patients presenting between September 2015 and October 2021 with definite or probable MD. A custom-designed, comprehensive questionnaire was used to identify patients' migraine-related symptoms. The clinical and audiometric data were used to diagnose patients with definite or probable MD using criteria set by the American Academy of Otolaryngology–Head and Neck Surgery.

Results
In total, 113 patients with definite or probable MD were included in the study. The mean age of the patients was 60 ± 15 years with no gender predominance (49.6% male and 50.4% female). A total of 57 (50%) patients were presented with headaches. Among the migraine headache cohort, headache and otalgia were on the same side as the MD ear affected by hearing loss. In addition, in patients who present with otalgia as the primary feature of headache, otalgia was more likely to be on the same side as the ear affected by the hearing loss.

Conclusions
The high prevalence of migraine symptoms on the same side of the ear affected by MD among this cohort could suggest a shared pathophysiology in both MD and migraine, possibly involving migraine-related changes in both the cochlea and vestibule.
Gastric Intestinal Metaplasia in Children: Natural History and Clinicopathological Correlation
Authors: Mansuri Ishrat , Goldsmith Jeffrey D. , Liu Enju , Bonilla Silvana 
Published: June 2023

Introduction:
Gastric intestinal metaplasia (GIM) is defined as the replacement of the normal gastric epithelium by intestinal-type epithelium. GIM is considered a preneoplastic lesion for gastric adenocarcinoma in adults and is found in 25% of Helicobacter pylori (H pylori) exposed adults. However, the significance of GIM in pediatric gastric biopsies is still unknown.

Methods:
We conducted a retrospective study of children with GIM on gastric biopsies at Boston Children’s Hospital between January 2013 and July 2019. Demographic, clinical, endoscopic, and histologic data were collected and compared to age and sex-matched cohort without GIM. Gastric biopsies were reviewed by the study pathologist. GIM was classified as complete/incomplete based on Paneth cell presence or absence and limited/extensive based on its distribution in the antrum or both antrum and corpus.

Results:
Of 38 patients with GIM, 18 were male (47%), mean age of detection was 12.5 ± 5.05 years (range, 1–18 years). The most common histologic was chronic gastritis (47%). Complete GIM was present in 50% (19/38) and limited GIM was present in 92% (22/24). H pylori was positive in 2 patients. Two patients had persistent GIM on repeat esophagogastroduodenoscopy (2/12). No dysplasia or carcinoma was identified. Proton-pump inhibitor use and chronic gastritis were more common in GIM patients compared to control (P = 0.02).

Conclusion:
Most children with GIM had low-risk histologic subtype (complete/limited) for gastric cancer; GIM was rarely associated with H pylori gastritis in our cohort. Larger multicenter studies are needed to better understand outcomes and risk factors in children with GIM.
Prognostic Factors Among Colonic Adenocarcinomas Invading Into the Muscularis Propria
Authors: Paulsen John D. , Polydorides Alexandros D. 
Published: June 2023

Depth of invasion through the intestinal wall, categorized as primary tumor stage (pT), is an important prognostic factor in colorectal cancer. However, additional variables that may affect clinical behavior among tumors involving the muscularis propria (pT2) have not been examined at length. We evaluated 109 patients with pT2 colonic adenocarcinomas (median age: 71 y, interquartile range: 59 to 79 y) along various clinicopathologic parameters, including invasion depth, regional lymph node involvement, and disease progression after resection. Tumors extending to the outer muscularis propria (termed pT2b) were associated in multivariate analysis with older patient age (P=0.04), larger tumor size (P<0.001), higher likelihood of lymphovascular invasion (LVI; P=0.03) and higher lymph node stage (pN; P=0.04), compared with tumors limited to the inner muscle layer (pT2a), and LVI was the single most important variable predicting regional lymph node metastasis at resection in these tumors (P=0.001). The Kaplan-Meier analysis during a median clinical follow-up of 59.7 months (interquartile range: 31.5 to 91.2) revealed that disease progression was more likely in pT2 tumors that exhibited, at the time of staging: size >2.5 cm (P=0.039), perineural invasion (PNI; P=0.047), high-grade tumor budding (P=0.036), higher pN stage (P=0.002), and distant metastasis (P<0.001). Proportional hazards (Cox) regression identified high-grade tumor budding (P=0.02) as independently predicting shorter progression-free survival in pT2 tumors. Finally, among cases that would not ordinarily be candidates for adjuvant treatment (ie, pT2N0M0), the presence of high-grade tumor budding was significantly associated with disease progression (P=0.04). These data suggest that, during the diagnosis of pT2 tumors, pathologists may wish to pay particular attention and ensure adequate reporting of certain variables such as tumor size, depth of invasion within the muscularis propria (ie, pT2a vs. pT2b), LVI, PNI, and, especially, tumor budding, as these may affect clinical treatment decisions and proper patient prognostication.
Clinical and Histopathologic Characteristics of Recurrent Sarcoidosis in Posttransplant Lungs
Authors: Lu Liang , Wein Alexander N. , Villanueva Ana , Jones Christopher , Anderson Adam , Ritter Jon , Lin Chieh-Yu 
Published: June 2023

Lung transplantation is the definitive therapy for end-stage pulmonary sarcoidosis. While recurrent sarcoidosis in allografts has been described in several case reports, the incidence and clinicopathologic characteristics remain unclear. In this study, we characterize the clinical and histopathologic features of recurrent sarcoidosis diagnosed in posttransplant lung surveillance transbronchial biopsies (TBBx). We identified 35 patients who underwent lung transplant for pulmonary sarcoidosis during the study period. Among them, 18 patients (51%) experienced recurrent sarcoidosis posttransplant. These included 7 females and 11 males with mean age at recurrence of 51.6 years. The average time interval from transplant to recurrence was 252 days (22 to 984 d). All TBBx contained >4 pieces of alveolated lung tissue with no evidence of International Society for Heart and Lung Transplantation (ISHLT) grade A2, A3, or A4 acute cellular rejection; chronic rejection; or antibody-mediated rejection. There were 33 surveillance TBBx that contained granulomatous inflammation with a mean of 3.6 well-formed granulomas per TBBx (range: 1 to >20). Multinucleated giant cells were identified in 11 TBBx (33.3%), with 1 case containing asteroid bodies. While most of the granulomas were “naked granulomas,” 5 cases (15.2%) showed prominent lymphoid cuffing. Two cases showed evidence of fibrosis. One of the granulomas had focal necrosis; however, no infectious organisms were identified by special stains and clinical correlation suggested this case represented recurrent sarcoidosis. Biopsies of recurrent sarcoidosis usually show multiple well-formed granulomas with giant cells in more than half of the cases, while lymphoid cuffing, fibrosis, asteroid bodies, and necrotizing granulomas are uncommon findings. Pathologists should be aware of these features, as recurrence of sarcoidosis following lung transplant occurs in more than half of patients.
Preoperative Nutritional Laboratory Values, Demographics, and Wound Healing Following Facial Trauma Surgery: Which Variables Predict Postoperative Complications?
Authors: Fahmy Mina D. , Clegg Devin J. , Deek Andrew J. , Scott Christopher A. , Bloom Graysen , Heidel Robert E. , Hechler Benjamin L. 
Published: June 2023

In individuals who have sustained maxillofacial trauma, inadequate nutrition is often a sequela and may lead to complications. The purpose of this study was to investigate the association between preoperative laboratory values and postoperative complications in patients with maxillofacial trauma requiring surgical intervention.
A retrospective cohort study of patients with maxillofacial trauma requiring surgical repair from 2014 to 2020 was performed at a single academic Level I Trauma Center. The primary predictor variables were preoperative laboratory values including serum albumin, white blood cell count, absolute neutrophil count, and lymphocyte count. Complications related to surgical reconstruction of facial injuries represented the primary outcome variable.
The patient cohort included 152 patients, of whom 50 (32.9%) were female. When controlling for all other variables, female gender (odds ratio=2.08, 95% confidence interval, 1.02–4.21; P=0.04) and number of procedures performed (P=0.02) were the only statistically significant predictors of postoperative complications. There were no significant differences between the complication groups for age (P=0.89), injury severity score (P=0.59), hospital length of stay (P=0.30), serum albumin (P=0.86), hemoglobin (P=0.06), white blood cell count (P=0.20), absolute neutrophil count (P=0.95), lymphocyte count (P=0.23), or absolute neutrophil/lymphocyte count ratio (P=0.09).
In this study, it was found that only gender and the number of procedures performed significantly predicted postoperative complications, while preoperative nutritional laboratory values did not. Further study with a larger cohort of patients is likely required.
Persistence of Poverty and its Impact on Surgical Care and Postoperative Outcomes
Authors: Lima Henrique A , Moazzam Zorays , Woldesenbet Selamawit , Alaimo Laura , Endo Yutaka , Munir Muhammad Musaab , Shaikh Chanza F , Resende Vivian , Pawlik Timothy M. 
Published: June 2023

Objective:
We sought to characterize the association between prolonged county-level poverty with postoperative outcomes.

Summary Background Data:
The impact of long-standing poverty on surgical outcomes remains ill-defined.

Methods:
Patients who underwent lung resection, colectomy, coronary artery bypass graft (CABG), or lower extremity joint replacement (LEJR) were identified from Medicare Standard Analytical Files Database (2015-2017) and merged with data from the American Community Survey and United States Department of Agriculture. Patients were categorized according to duration of high poverty status from 1980-2015 (i.e., never high poverty [NHP], persistent poverty [PP]). Logistic regression was used to characterize the association between duration of poverty and postoperative outcomes. Principal component and generalized structural equation modeling were used to assess the effect of mediators in achievement of textbook outcomes (TO).

Results:
Overall, 335,595 patients underwent lung resection (10.1%), colectomy (29.4%), CABG (36.4%) or LEJR (24.2%). While 80.3% of patients lived in NHP, 4.4% resided in PP counties. Compared with NHP, patients residing in PP were at increased risk of serious postoperative complications (OR=1.10, 95%CI 1.05-1.15), 30-day readmission (OR=1.09, 95%CI 1.01-1.16), 30-day mortality (OR=1.08, 95%CI 1.00-1.17) and higher expenditures (mean difference, $1,010.0, 95%CI 643.7-1376.4)(all P<0.05). Notably, PP was associated with lower odds of achieving TO (OR=0.93, 95%CI 0.90-0.97, P<0.001); 65% of this effect was mediated by other social determinant factors. Minority patients were less likely to achieve TO (OR=0.81, 95%CI 0.79-0.84, P<0.001), and the disparity persisted across all poverty categories.

Conclusions:
County-level poverty duration was associated with adverse postoperative outcomes and higher expenditures. These effects were mediated by various socioeconomic factors and were most pronounced among minority patients.
The futility of closed chest compressions after trauma: A multi-institutional study
Authors: Fierro Nicole M. , Dhillon Navpreet K. , Park Greigory , Stupinski John , Drevets Peter , Zheng Dennis J. , Tillou Areti , Ugarte Chaiss , Schellenberg Morgan , Tay-Lasso Erika , Nahmias Jeffry , Parker Paige , Ley Eric J. 
Published: June 2023

BACKGROUND
The desire to deliver appropriate care after trauma creates challenges when deciding to proceed if care appears futile. This study aimed to analyze survival rates for trauma patients who undergo closed chest compressions by decade of life.

METHODS
A multicenter retrospective review of trauma patients with an Injury Severity Score ≥16 who underwent closed chest compressions from 2015 to 2020 at four large, urban, academic Level I trauma centers was conducted. Those with intraoperative arrest were excluded. The primary endpoint was survival to discharge.

RESULTS
Of the 247 patients meeting inclusion criteria, 18% were 70 years or older, 78% were male, and 24% presented due to a penetrating mechanism of injury. Compressions occurred in the prehospital setting (56%), emergency department (21%), intensive care unit (19%), and on the floor (3%). On average, patients arrested on hospital day 2, and survived 1 day after arrest if return of spontaneous circulation was achieved. Overall mortality was 92%. Average hospital length of stay was lower in patients 70 years or older (3 days vs. 6 days, p < 0.01). Survival was highest in patients 60 years to 69 years (24%), and although patients 70 years or older presented with lower Injury Severity Scores (28 vs. 32, p = 0.04), no patient 70 years or older survived to hospital discharge (0% v 9%, p = 0.03).

CONCLUSION
Closed chest compressions are associated with a high mortality rate after moderate to severe trauma with 100% mortality in patients older than 70 years. This information may assist with the decision to withhold chest compression, especially in older adults.

LEVEL OF EVIDENCE
Prognostic and Epidemiological; Level IV.
Defining the single base importance of human mRNAs and lncRNAs
Authors: Fan Rui , Ji Xiangwen , Li Jianwei , Cui Qinghua , Cui Chunmei 
Published: June 2023

ABSTRACTAs the fundamental unit of a gene and its transcripts, nucleotides have enormous impacts on molecular function and evolution, and thus on phenotypes and diseases. Given that different nucleotides on one gene often exhibit diverse levels of effects, it is quite crucial to comprehensively and quantitatively measure the importance of each base on a gene transcript, however, tools are still not available. Here we proposed Base Importance Calculator (BIC), an algorithm to calculate the importance score of single bases based on sequence information of human mRNAs and long noncoding RNAs (lncRNAs). We then confirmed its power by applying BIC to three different tasks. Firstly, we revealed that BIC can effectively evaluate the pathogenicity of both genes and single bases by analyzing the BIC scores and the pathogenicity of single nucleotide variations (SNVs). Moreover, the BIC score in the Cancer Genome Atlas (TCGA) somatic mutations is able to predict the prognosis of some cancers. Finally, we show that BIC can also precisely predict the transmissibility of SARS-CoV-2. The above results indicate that BIC is a useful tool for evaluating the single base important of human mRNAs and lncRNAs.Key PointsBIC could measure the single base importance of human mRNAs and lncRNAs.BIC could be applied to many aspects including measuring the pathogenicity of SNVs and enhancing the ability of predicting cancer survival.BIC could predict the transmissibility of SARS-CoV-2
Glycochenodeoxycholic acid and ceramide suppress the antiviral effect of 25-hydroxycholesterol against human norovirus infection in human intestinal enteroids
Authors: Mboko Wadzanai P. , Chhabra Preeti , Montmayeur Anna , Xu Ruijie , Costantini Verónica , Vinjé Jan 
Published: June 2023

AbstractThe human intestinal enteroid (HIE) cell culture system with the support of glycine-conjugated bile acid glycochenodeoxycholic acid (GCDCA) and ceramide (C2) facilitate successful replication of several norovirus strains. Here we investigate how the presence of GCDCA/C2 impacts gene expression of norovirus-infected HIE and the impact of 25 hydroxycholesterol (25-HC), a key regulator of cholesterol homeostasis and bile acid production on norovirus replication. In absence of GCDCA/C2, 0.01 and 0.1 μM 25-HC suppressed virus (GII.4 Sydney[P16]) replication by 1.3 log and 1.1 log respectively (p<0.05). In the presence of GCDCA/C2, 5 μM 25-HC was required to achieve a 1 log decrease (p<0.05) in viral titers demonstrating that 25-HC restricts norovirus replication in HIE. RNA sequence analysis showed that during human norovirus infection, 25-HC downregulated expression of genes (CYP3A4, APOB, APOA1, and ABCG1) involved in cholesterol metabolism and transport as well as interferon stimulated genes such as ISG15 and IFIT1. GCDCA/C2 counteracts the suppressive effect of 25-HC expression of some genes related to these pathways including APOA4 and CYP27A1 however, other cholesterol genes such as APOA1 were further suppressed in the presence of GCDCA/C2.ImportanceNorovirus is the leading cause of epidemic and endemic acute gastroenteritis worldwide and currently, there are no effective therapeutic strategies against this highly contagious pathogen. Our study provides insights into the effect of bile during norovirus infection, highlight the role of the cholesterol/oxysterol pathways during human norovirus replication, and demonstrate the potential utility of oxysterols in developing norovirus therapeutics.
Partially hydrolyzed guar gum attenuates the symptoms of SARS-CoV-2 infection through gut microbiota modulation in an animal model
Authors: Yang Jiayue , Song Isaiah , Saito Misa , Hartanto Tenagy , Ichinohe Takeshi , Fukuda Shinji 
Published: June 2023

AbstractThe coronavirus disease 2019 (COVID-19) pandemic has caused worldwide health issues. Although several vaccines have been developed, it is still difficult to prevent and reduce the inflammation caused by the infection. Studies have shown that there are correlations between the gut environment and severity of symptoms caused by SARS-CoV-2 infection. Several gut metabolites produced by the gut microbiota such as SCFAs and the secondary bile acid UDCA are reported to improve the survival rate of the host after viral infection in an animal model through modulation of the host immune system. Therefore, in this study, we attempted to use the prebiotic dietary fiber PHGG to modulate the gut microbiome and intestinal metabolites for improvement of host survival rate after SARS-CoV-2 infection in a Syrian hamster model. We were able to show that PHGG significantly improved the host survival rate and body weight reduction. Analysis of the gut microbiome, serum, and intestinal metabolites revealed that PHGG significantly increased the concentrations of several intestinal SCFAs, fecal secondary bile acids, and serum secondary bile acids. Furthermore, several microbial species and metabolites identified in this study are consistent with reports in humans. Taken together, our data suggest that PHGG is a candidate prebiotic food for reducing the morbidity of COVID-19.
IKKα kinase coordinates BRD4 and JAK/STAT signaling to subvert DNA damage-based anticancer therapy
Authors: Pecharromán Irene , Solé Laura , Álvarez-Villanueva Daniel , Lobo-Jarne Teresa , Alonso-Marañón Josune , Bertran Joan , Guillén Yolanda , Montoto Ángela , Martínez-Iniesta María , García-Hernández Violeta , Giménez Gemma , Salazar Ramon , Santos Cristina , Garrido Marta , Borràs Eva , Sabidó Eduard , Bonfill-Teixido Ester , Iurlaro Raffaella , Seoane Joan , Villanueva Alberto , Iglesias Mar , Bigas Anna , Espinosa Lluís 
Published: June 2023

SUMMARYActivation of the IKK kinase complex has recurrently been linked to colorectal cancer (CRC) initiation and progression. However, identification of downstream effectors other than NF-κB has remained elusive.Analysis of IKK-dependent substrates after UV-treatment revealed that BRD4 phosphorylation by IKKα is required for chromatin-binding dynamics upon damage. Moreover, IKKα induces the NF-κB-dependent transcription of LIF leading to STAT3 activation, association of BRD4 to STAT3 and recruitment to specific target genes. IKKα abrogation results in defective BRD4 and STAT3 function leading to irreparable DNA damage and apoptotic cell death upon different stimuli. Simultaneous inhibition of BRAF-dependent IKKα activity or BRD4 and the JAK/STAT pathway enhanced the therapeutic potential of 5-FU plus irinotecan in CRC cells, and is curative in a chemotherapy-resistant CRC xenograft model. Coordinated expression of LIF and IKKα is a poor prognosis marker for CRC patients.Our data uncover a functional link between IKKα, BRD4 and JAK/STAT signaling with clinical relevance.