bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transmission Potential of the Omicron Variant of Severe Acute Respiratory Syndrome Coronavirus 2 in South Korea, 25 November 2021–8 January 2022
Authors: Shim Eunha , Choi Wongyeong , Kwon Donghyok , Kim Taeyoung , Song Youngji 
Published: May 2022

Abstract
Our study indicates sustained transmission (effective reproduction number, 1.3; serial interval, 4.2 days; regional doubling times, 3.3–11.4 days) of the severe acute respiratory syndrome coronavirus 2 Omicron (B.1.1.529) variant (N = 2351) in South Korea (25 November 2021–8 January 2022), implicating insufficient protection through vaccination and supporting nonpharmaceutical control measures.
Acidosis regulation of epithelial barrier function and immune signaling
Authors: Cartwright Ian M. , Hanson Camila , Dowdell Alexander S. , Steiner Calen A. , Colgan Sean P. 
Published: May 2022

A common but often underappreciated aspect of the inflammatory microenvironment is extracellular acidification. As with other chronic inflammatory diseases, tissue acidification has been observed in inflammatory bowel disease (IBD) patients. Colonic pH as low as 4 have been reported in IBD patients. In contrast, the pH of a healthy colon is between a pH of 7.0‐7.4. Recently, we identified an adaptive tissue response in intestinal epithelial cells (IEC) which buffered extracellular acidification during neutrophil transepithelial migration, suggesting pH homeostasis is an important aspect of acute inflammation. Extensions of these studies identified a previously undescribed CREB‐dependent pathway for sensing extracellular pH and a unique acidosis gene signature in IEC. The full impact of acidosis on IEC function remains unclear. To better understand the impact of chronic extracellular acidification on IEC function, we investigated changes in IEC immune signaling and barrier function in the setting of acute and chronic exposure to acidosis. We initially examined barrier function in T84 IEC cultured under acidic conditions and observed a significant decrease in barrier function, as determined by transepithelial electrical resistance (TER) and paracellular flux, in cells exposed to acidosis in a pH range of 6.0 – 7.4. Interestingly, following acute acidification, treatment with low pH for less than 8hr, barrier function recovered within 16hr. However, following chronic acidification, treatment with low pH beyond 16hr resulted in an appreciable barrier dysfunction for several days. We extended these studies to examine expression and localization of tight‐junction proteins in IEC exposed to acidosis and observed a time and dose‐dependent decrease in ZO‐1 and E‐cadherin expression, with almost complete loss of expression after 72hr at a pH of 6.0. Likewise, expression and localization of claudins 1, 2, and 4 decreased over time. In parallel to a loss of barrier function, IEC exposed to chronic acidosis revealed a prominent increase in the expression of inflammatory markers including several chemokines (IL‐8, CCL20, TNF) as well as anti‐microbial peptides (mucins and beta‐defensins).Thus, chronic extracellular acidosis induces the loss of IEC tight junction function, while inducing the expression of several pro‐inflammatory chemokines and the production of various anti‐microbial peptides. These results identify extracellular acidification as significant signaling mechanism which induces a loss of epithelial features and the acquisition of a more immune‐like phenotype. Furthering our understandings of the mechanisms involved in acidosis induced phenotype switching in IEC has the potential to uncover novel therapeutic drug targets.
Intermicrovillar adhesion complex assembly requires Myosin 5b
Authors: Engevik Kristen , Digrazia Jessica , Kaji Izumi , Engevik Amy C. 
Published: May 2022

BackgroundIntestinal enterocytes have a complex apical membrane consisting of actin rich protrusions known as microvilli. Microvilli increase the surface area of the intestine and facilitate absorption of nutrients and water. Enterocytes have approximately 1000 microvilli lining their apical membrane which is collectively known as the brush border. To accommodate a multitude of microvilli on a single cell, the microvilli must be densely packed and highly organized. The brush border assembly is tightly regulated by the intermicrovillar adhesion complex (IMAC). IMAC forms physical adhesion links at the tips of microvilli, connecting the distal tips of adjacent microvilli to control packing and microvillar length. IMAC is composed of protocadherins, such as protocadherin 24 (CDHR2) and mucin like protocadherin (CDHR5), and scaffolding proteins USH1C, ANKS4B and Myosin 7b (Myo7b). Defects in IMAC complexes results in stunted microvilli and has been linked in the ileum to Crohn's disease (a subset of inflammatory bowel disease). Myosin 5b (Myo5b) is a molecular motor that is critical for the delivery of diverse cargo to the apical membrane of enterocytes. We hypothesized that loss of Myo5b in vivo would result in alterations in the localization of key proteins involved in the IMAC.MethodsWe used germline Myo5b KO mice, littermate controls and adult intestinal specific tamoxifen inducible VillinCreERT2;Myo5bflox/flox(Myo5b KO) mice and Myo5bflox/flox(control mice) to determine the localization of IMAC proteins following loss of Myo5b in the small intestine.ResultsRNA sequencing revealed decreased expression of CDHR2, CDHR5, USH1C and ANKS4B in both germline and adult inducible Myo5b KO mice compared to control mice. Myo7b mRNA expression was unchanged between Myo5b KO mice and control mice. Immunostaining for CDHR2 in neonatal germline Myo5b KO mice showed loss of apical CDHR2 in the brush border compared to littermate controls. CDHR5 localized to the brush border in neonatal control mice, but in neonatal germline Myo5b KO mice CDHR5 was detected below the apical membrane in the subapical compartment. In neonatal control mice, USH1C was observed to localize to the tips of microvilli as identified by gamma actin staining to delineate the actin rich brush border. USH1C was observed on the apical membrane of germline Myo5b KO mice however, USH1C did not appear to be enriched at the tips of microvilli. ANKS4B had decreased apical expression in germline M‐‐‐yo5b KO mice compared to littermate control mice. Similarly, there was a decrease in Myo7b staining on the apical membrane of germline Myo5b KO mice and adult inducible Myo5b KO mice compared to control mice.ConclusionsThese data indicate that Myo5b plays a key role in proper brush border formation and packing of microvilli in vivo and suggests‐‐‐ that mutations in Myo5b likely impact intestinal barrier function.
Total knee arthroplasty versus unicompartmental knee arthroplasty in management of anteromedial knee osteoarthritis: a randomized clinical trial
Authors: Alkersh Ahmed Abd El Samad , Osman Wael Samir , Abdeldayem Sherif Mostafa , Metwaly Radwan G. , Awad Mohamed El Sayed , Zakaria Zeiad M. 
Published: May 2022

Background:
Both total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA) are options to manage anteromedial knee osteoarthritis. This study’s aim was to determine the functional outcome, time taken to walk without support, and postoperative complications after either TKA or UKA in treatment of anteromedial knee osteoarthritis.

Methods:
A prospective randomized cohort study was performed at a level 1 academic center on 60 patients with mean age of 56.2 yr who had isolated anteromedial knee osteoarthritis. Thirty patients were managed by UKA (group 1), and the other thirty patients were managed by TKA (group 2). Diagnosis was confirmed by plain radiographs (anteroposterior standing, lateral, skyline, stress varus, and valgus views). Follow-up was done for at least 12 mo postoperatively.

Results:
Mean preoperative functional Knee Society Score (KSS) was 65.83 and 62.67 for group 1 and group 2, respectively. Mean functional KSS after 1 yr was 86.3 for group 1 and 84.6 for group 2. In group 1, one patient developed lateral joint line pain, and another patient developed postoperative blood loss of more than 400 mL. In group 2, one patient developed pattelofemoral pain, and another patient developed postoperative blood loss of more than 400 mL. The mean time that it took for patients to walk without support was 1.6 wk in group 1 and 1.93 wk for group 2.

Conclusions:
Both UKA and TKA have the same functional outcome for treatment of anteromedial knee osteoarthritis and the same rate of complications, but early postoperative rehabilitation is better in patients managed by UKA.

Level of Evidence:
Level I.
Operative Planning of Chest Wall Reconstructions Illustrated by a Large Defect in a Child
Authors: André-Lévigne Dominik , Modarressi Ali , Karenovics Wolfram , Joseph Jean-Marc , Wilde Jim C.H. , Pittet-Cuénod Brigitte 
Published: May 2022

Summary:
Reconstruction of large chest wall defects is challenging. Here we discuss the process of decision-making in planning chest wall reconstruction, considering the requirements of tumor removal, stabilization of the chest wall, and soft tissue coverage, illustrated by a case of a hemi-chest wall defect in a child. Ewing sarcoma measuring 10 × 9 × 13 cm was resected in a 9-year-old boy, followed by stabilization using a Gore-Tex patch. Due to extension of the oncologic resection far into the superomedial quadrant of the chest, tension-free coverage with a classical latissimus-dorsi flap could not be achieved. Integrating the serratus-anterior muscle into the flap creating a chimeric latissimus-dorsi/serratus-anterior flap allowed for excellent soft tissue coverage of the foreign body. As the skin could be preserved, careful incision planning was necessary to allow for best possible exposure during oncologic resection and flap harvest, while ensuring skin vascularization impaired by underlying tumor resection. Two vertical skin incisions were chosen, one presternal and a second in the mid-axillary fold delineating a large bipedicled skin flap. Postoperative recovery was excellent. Solid skin vascularization and adequate soft tissue coverage of the alloplastic material allowed for the patient to receive two cycles of postoperative radiotherapy without developing wound dehiscence. Careful interdisciplinary planning of skin incisions allowed for good exposure for tumor resection and flap harvest while preserving skin vascularization. Choosing a chimeric latissimus-dorsi/serratus-anterior flap provided larger coverage than a classical latissimus-dorsi flap with minimal additional donor site morbidity. Taken together, we here present a pragmatic solution to a complex problem.
Structural imaging studies of patients with chronic pain: an anatomical likelihood estimate meta-analysis
Authors: Henn Alina T. , Larsen Bart , Frahm Lennart , Xu Anna , Adebimpe Azeez , Scott J. Cobb , Linguiti Sophia , Sharma Vaishnavi , Basbaum Allan I. , Corder Gregory , Dworkin Robert H. , Edwards Robert R. , Woolf Clifford J. , Habel Ute , Eickhoff Simon B. , Eickhoff Claudia R. , Wagels Lisa , Satterthwaite Theodore D. 
Published: May 2022

Abstract
Neuroimaging is a powerful tool to investigate potential associations between chronic pain and brain structure. However, the proliferation of studies across diverse chronic pain syndromes and heterogeneous results challenges data integration and interpretation. We conducted a preregistered anatomical likelihood estimate meta-analysis on structural magnetic imaging studies comparing patients with chronic pain and healthy controls. Specifically, we investigated a broad range of measures of brain structure as well as specific alterations in gray matter and cortical thickness. A total of 7849 abstracts of experiments published between January 1, 1990, and April 26, 2021, were identified from 8 databases and evaluated by 2 independent reviewers. Overall, 103 experiments with a total of 5075 participants met the preregistered inclusion criteria. After correction for multiple comparisons using the gold-standard family-wise error correction (P < 0.05), no significant differences associated with chronic pain were found. However, exploratory analyses using threshold-free cluster enhancement revealed several spatially distributed clusters showing structural alterations in chronic pain. Most of the clusters coincided with regions implicated in nociceptive processing including the amygdala, thalamus, hippocampus, insula, anterior cingulate cortex, and inferior frontal gyrus. Taken together, these results suggest that chronic pain is associated with subtle, spatially distributed alterations of brain structure.
Corneal shape changes after vitreoretinal surgery with fluid–gas exchange
Authors: Watanabe Akira , Ninomiya Wakana , Mizobuchi Kei , Watanabe Tomoyuki , Nakano Tadashi 
Published: May 2022

Abstract
To investigate changes in the corneal shape caused by fluid–gas exchange after vitrectomy.
This retrospective case-control study included 43 eyes that underwent a combination of cataract surgery and vitrectomy. The corneal shape was measured using anterior segment optical coherence tomography CASIA2. The corneal shape measurements were performed preoperatively, 1 day, 1 week, 1 month, and 3 months after surgery. After calculating the real K value from the actual measured values of the posterior shape of the corneal refracting power and the single posterior corneal refracting power value, Fourier analysis values were examined. Fluid–gas exchange was performed in 23 eyes (gas group), while it was not performed in 20 eyes (nongas group).
There was a significant increase in the real K value in the regular and asymmetry components (0.61 ± 0.36, 0.82 ± 0.64) in the gas group only on the first day after surgery (Steel–Dwass test; P < .05). There was also a significant increase in the real K value in the higher-order irregular astigmatism components (Steel–Dwass test; P < .05) for longer periods in the gas versus the nongas group. The shape of the posterior cornea increased in all components in the gas group on the first day after surgery (spherical power −6.35 ± 0.20, regular astigmatism 0.32 ± 0.12, asymmetry 0.22 ± 0.13, and higher-order irregular astigmatism 0.12 ± 0.05, Steel–Dwass test; P < .05).
Postoperative changes caused by surgical invasion in the corneal shape appeared to be greater in the gas versus the nongas group, in addition to affecting the time periods of the postoperative corneal shape changes.
The severity and clinical characteristics of COVID-19 among patients with type 2 diabetes mellitus in Jazan, Saudi Arabia
Authors: Badedi Mohammed , Muhajir Abdulrahman , Alnami Awaji , Darraj Hussain , Alamoudi Aymn , Agdi Yasir , Mujayri Ahoud , Ageeb Atif 
Published: May 2022

Abstract

Background:
The objectives of the current study were to assess the severity and clinical characteristics of coronavirus disease 2019 (COVID-19) among Saudi adults with type 2 diabetes mellitus (T2DM) in Jazan region, Saudi Arabia.

Methods:
This retrospective cohort study included 412 patients with COVID-19 selected randomly from the Health Electronic Surveillance Network system, which contains the primary data on COVID-19 infections in Jazan.

Results:
COVID-19 disease duration was significantly longer in patients with T2DM (mean = 10.7 days) compared with those without T2DM (mean = 8.3 days) (P = .01). Six (7%) patients experienced an increase in blood glucose concentrations and had to escalate their total daily insulin dose accordingly. Median fasting and random blood glucose levels increased after infection with COVID-19 (pre-COVID median = 119 and 172 mg/dL, respectively; post-COVID median = 148 and 216 mg/dL, respectively) (P = .02). The total insulin dose pre-COVID (median = 42 units/d) increased after infection with COVID-19 (median = 58 units/d) (P = .01). Most patients with T2DM had clinical COVID-19 symptoms (91%) and the remainder (9%) were asymptomatic. A large proportion (80%) of T2DM patients with mild COVID-19 symptoms self-isolated at home. COVID-19 patients with T2DM (11%) who had an oxygen saturation of ≤ 90% and admitted to the intensive care unit were higher than those without T2DM (5%) (P =  < .001). COVID-19 patients with T2DM (9%) had higher mortality rate than COVID-19 patients without T2DM (1%) (P =  < .001).

Conclusion:
COVID-19 patients with T2DM were associated with a higher risk of admission to the intensive care unit and mortality than COVID-19 patients without T2DM.
Relationship between metabolic syndrome and follicle-stimulating hormone in postmenopausal women
Authors: Lee Suk Woo , Hwang In Sun , Jung Gyul , Kang Hee Jin , Chung Yoo Hyun 
Published: May 2022

Abstract
Depletion of ovarian reserve during menopausal transition raises follicle-stimulating hormone (FSH) markedly and menopause is related to an increased risk for metabolic syndrome (MetS). This study examined the relationship between FSH and MetS in postmenopausal women.
We evaluated the anthropometric values, lipid profiles, high-sensitivity C-reactive protein (hs-CRP) level, Homeostasis model assessment for insulin resistance (HOMA-IR), and serum adipokines levels in 219 postmenopausal women. Serum FSH and estradiol levels were significantly lower in the MetS group than in the non-MetS group. An inverse correlation was observed between FSH with body fat mass (BFM), and HOMA-IR, and a positive correlation was found between FSH and adiponectin level after adjustment for age, years since menopause, BMI, and serum estradiol.
The odds ratio for MetS was higher significantly in the lowest quartile of FSH level than the highest quartile of FSH level (odd ratio = 1.32, 95% CI = 1.09–1.75). Our study showed an increased FSH level favored insulin sensitivity with a higher adiponectin and lower HOMA-IR as well as a lower incidence of MetS in postmenopausal women.
These findings suggest a new approach to the role of FSH for regulating energy metabolism and for use as a biomarker of MetS risk in postmenopausal women.
This systematic review is based on published researches, so there is no ethical approval required.
Etiological Surveillance of Genital Ulcer Syndrome in South Africa: 2019 to 2020
Authors: Kularatne Ranmini , Venter Johanna M. E. , Maseko Venessa , Muller Etienne , Kufa Tendesayi 
Published: May 2022

Background
Herpes simplex virus (HSV) has been the leading cause of genital ulcer syndrome (GUS) in South Africa for more than a decade, and acyclovir therapy is incorporated into syndromic management guidelines. We conducted surveillance at 3 sentinel sites to define the common sexually transmitted etiologies of GUS and to determine whether current syndromic management is appropriate. Secondary objectives of surveillance were to determine the seroprevalence of coinfections (HIV, syphilis, HSV-2) in persons presenting with GUS.

Methods
Consecutive, consenting adult men and women presenting with visible genital ulceration were enrolled between January 1, 2019, and December 31, 2020. Genital ulcer swab and blood specimens were collected and transported to a central sexually transmitted infection reference laboratory in Johannesburg.

Results
Among 190 participants with GUS, HSV-2 was the most frequently detected ulcer pathogen (49.0%; 95% confidence interval [CI], 41.9%–56.1%). The relative prevalence of the second most common ulcer-derived pathogen, Treponema pallidum, was 26.3% (95% CI, 20.5%–33.1%), with 90% of primary syphilis cases having a positive rapid plasma reagin (RPR) titer. Male sex was independently associated with primary syphilis compared with herpetic ulcers, after adjusting for the effect of casual sex partners and other exposures (adjusted odds ratio, 3.53; 95% CI, 1.35–9.21; P = 0.010). The overall HIV prevalence among participants was 41.3% (78 of 189; 95% CI, 34.2%–48.6%).

Conclusions
Herpes simplex virus 2 remains the predominant cause of GUS, justifying the continued use of acyclovir in syndromic guidelines. Adequate supplies of benzathine penicillin G for syphilis treatment are essential at primary health care level, in addition to the provision of syphilis and HIV risk reduction services.
Etiological Surveillance of Vaginal Discharge Syndrome in South Africa: 2019 to 2020
Authors: Kularatne Ranmini , Muller Etienne , Maseko Venessa , Dias Bianca Da Costa , Kufa Tendesayi 
Published: May 2022

Background
The syndromic management of vaginal discharge syndrome (VDS) is challenging because of the prevalence of mixed infection with sexually transmitted infection (STI) pathogens and non-STI causes, such as bacterial vaginosis and candidiasis (CA). We aimed to determine the relative prevalence of VDS etiologies in women presenting to sentinel primary health care clinics in South Africa. Secondary objectives were to ascertain the predictive value of speculum findings for the presence of STI pathogens and the proportion of women presenting with clinical features of CA who had identifiable yeast on vaginal smear microscopy.

Methods
Consecutive, consenting women with complaints of abnormal vaginal discharge were enrolled between January 1, 2019, and December 31, 2020. Genital discharge swab and blood specimens were collected and transported to a central STI reference laboratory in Johannesburg.

Results
A total of 364 women were enrolled at 3 sentinel sites. Bacterial vaginosis was the most common cause of VDS (163 of 361 [45.2%]; 95% confidence interval [CI], 40.1%–50.3%); however, a significant proportion had STI coinfection (71 of 163 [43.6%]; 95% CI, 35.8%–51.5%). The predominant STI etiology was Chlamydia trachomatis (73 [20.2%]; 95% CI, 16.4%–24.7%). An abnormal speculum finding had poor predictive value for STIs, and Gram stain microscopy showed yeast in only 37.2% of vaginal smears from women with CA symptoms.

Conclusions
Bacterial vaginosis is the predominant cause of VDS in South Africa; however, STI coinfection is common. Clinical findings are poorly predictive of STI etiologies or candidiasis; therefore, a rapid and accurate STI point-of-care test would be useful in optimizing VDS management.
Patient perspectives of pain and function after knee replacement: a systematic review and meta-synthesis of qualitative studies
Authors: Taylor Carrie E.V. , Murray Carolyn M. , Stanton Tasha R. 
Published: May 2022

Abstract

Introduction:
Joint replacement surgery typically results in good clinical outcome, although some people experience suboptimal pain relief and functional improvement. Predicting surgical outcome is difficult.

Objectives:
There is merit in better understanding patients' perspectives of pain and function to identify avoidable problems perceived to contribute to their outcome, to inform prognostic expectations, and to identify potential cointerventions to sit alongside surgery that might mitigate pain/functional problems. Here, we aimed to synthesise the available literature exploring perspectives of people with knee osteoarthritis about their pain and function following joint replacement.

Methods:
Six electronic databases and 2 websites were searched. Two independent reviewers completed study inclusion, quality assessment, and data extraction. Data were iteratively synthesised using first-, second-, and third-order analyses.

Results:
Twenty-eight studies were included. Four themes were identified; perceptions of pain and function were inseparable. Theme 1 addressed experiences of recovery after surgery, which often differed from expectations. Theme 2 described the challenges of the pain experience and its functional impact, including the difficulty navigating medication use in context of personal beliefs and perceived stigma. Theme 3 articulated the toll of ongoing problems spanning pain–function–mood, necessitating the need to “endure.” Theme 4 encompassed the importance of clinical/social interactions on mood and pain, with reports of concerns dismissed and practical support missing.

Conclusions:
Together, these findings show that numerous individual considerations beyond the technical aspects of surgery influence experiences of pain and function. A tailored approach addressing these considerations from the patient perspective could provide a basis for improved success of knee replacement surgery.