bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evolution of ACE2-independent SARS-CoV-2 infection and mouse adaption after passage in cells expressing human and mouse ACE2
Authors: Yan Kexin , Dumenil Troy , Tang Bing , Le Thuy T , Bishop Cameron R , Suhrbier Andreas , Rawle Daniel J 
Published: July 2022

Abstract
Human ACE2 Human angiotensin converting enzyme 2 (hACE2) is the key cell attachment and entry receptor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with the original SARS-CoV-2 isolates unable to use mouse ACE2 (mACE2). Herein we describe the emergence of a SARS-CoV-2 strain capable of ACE2-independent infection and the evolution of mouse-adapted (MA) SARS-CoV-2 by in vitro serial passaging of virus in co-cultures of cell lines expressing hACE2 and mACE2. MA viruses evolved with up to five amino acid changes in the spike protein, all of which have been seen in human isolates. MA viruses replicated to high titers in C57BL/6J mouse lungs and nasal turbinates and caused characteristic lung histopathology. One MA virus also evolved to replicate efficiently in several ACE2-negative cell lines across several species, including clustered regularly interspaced short palindromic repeats/CRISPR-associated protein 9 (CRISPR/Cas9) ACE2 knockout cells. An E484D substitution is likely involved in ACE2-independent entry and has appeared in only ≈0.003 per cent of human isolates globally, suggesting that it provided no significant selection advantage in humans. ACE2-independent entry reveals a SARS-CoV-2 infection mechanism that has potential implications for disease pathogenesis, evolution, tropism, and perhaps also intervention development.
Impact of Care Coordination on the Content of Communication Between Surgeons and Patients With Rectal Cancer
Authors: Lawson Elise H. , Sommovilla Joshua , Buffington Anne , Zelenski Amy , Schwarze Margaret L. 
Published: July 2022

Background:
Management of patients with rectal cancer can be complex, requiring significant care coordination and decisions that balance functional and oncologic outcomes.

Objective:
To characterize care coordination occurring during surgical consultation for rectal cancer and consequences of using face-to-face time in clinic for care coordination.

Methods:
Secondary analysis was performed on audio recordings of clinic visits with colorectal surgeons to discuss surgery for rectal cancer at 5 academic medical centers. Analysis included the content of communication related to types of care coordination, specific details and conditions under which care coordination was conducted, and consequences.

Results:
The cohort included 18 patients seen by 8 surgeons. Care coordination consumed much of the conversation; on average 23.7% (SD 14.6) of content. Communication about care coordination included gathering information from work-up already performed, logistics for completing further work-up, gathering multidisciplinary opinions, and logistics for treatment planning. Obtaining imaging results was particularly challenging and surgeons went to great lengths to gather this information. To mitigate information gaps, surgeons asked patients about critical clinical details. Patients expressed remorse when they could not provide needed information, relay technical details, or had missing reports. Surgeons voiced frustration at the system related to the need to gather information from multiple sources and coordinate logistics. Surgeons worked to inform patients about their disease and discuss important lifestyle and cancer-related tradeoffs. However, the ability to solicit patient input and engage in shared decision making was often limited by incomplete data or conditioned on approval by a multidisciplinary tumor board.

Conclusion:
Much of the conversation between surgeons and patients with rectal cancer is consumed by care coordination. Organizing care coordination outside of the clinic visit would likely improve the experience for both patients and surgeons, addressing both clinician burnout and variation in management and outcomes.
Frailty and Sarcopenia: Impact on Outcomes Following Elective Degenerative Lumbar Spine Surgery
Authors: Chotai Silky , Gupta Rishabh , Pennings Jacquelyn S. , Hymel Alicia M. , Archer Kristin R. , Zuckerman Scott L. , Stephens Byron F. , Abtahi Amir M. 
Published: July 2022

Study Design.This is a retrospective review of prospectively collected data.Objective.The aim was to evaluate the impact of frailty and sarcopenia on outcomes after lumbar spine surgery.Summary of Background Data.Elderly patients are commonly diagnosed with degenerative spine disease requiring surgical intervention. Frailty and sarcopenia result from age-related decline in physiological reserve and can be associated with complications after elective spine surgery. Little is known about the impact of these factors on patient-reported outcomes (PROs).Methods.Patients older than 70 years of age undergoing elective lumbar spine surgery were included. The modified 5-item frailty index (mFI-5) was calculated. Sarcopenia was defined using total psoas index, which is obtained by dividing the mid L3 total psoas area by VB area (L3-TPA/VB). PROs included Oswestry disability index (ODI), EuroQual-5D (EQ-5D), numeric rating scale (NRS)-back pain, NRS leg pain (LP), and North American Spine Society (NASS) at postoperative 12 months. Clinical outcomes included length of stay (LOS), 90-day readmission and complications. Univariate and multivariable regression analyses were performed.Results.Total 448 patients were included. The mean mFI-5 index was 1.6±1.0 and mean total psoas index was 1.7±0.5. There was a significant improvement in all PROs from baseline to 12 months (P<0.0001). After adjusting for age, body mass index, smoking status, levels fused, and baseline PROs, higher mFI-5 index was associated with higher 12-month ODI (P<0.001), lower 12-month EQ-5D (P=0.001), higher NRS-LP(P=0.039), and longer LOS (P=0.007). Sarcopenia was not associated with 12-month PROs or LOS. Neither sarcopenia or mFI-5 were associated with 90-day complication and readmission.Conclusions.Elderly patients demonstrate significant improvement in PROs after elective lumbar spine surgery. Frailty was associated with worse 12 months postoperative ODI, EQ-5D, NRS-LP scores, and longer hospital stay. While patients with sarcopenia can expect similar outcomes compared with those without, the mFI-5 should be considered preoperatively in counseling patients regarding expectations for disability, health-related quality of life, and leg pain outcomes after elective lumbar spine surgery.Level of Evidence.3.
Lung Ultrasound Signs to Diagnose and Discriminate Interstitial Syndromes in ICU Patients: A Diagnostic Accuracy Study in Two Cohorts*
Authors: Heldeweg Micah L. A. , Smit Marry R. , Kramer-Elliott Shelley R. , Haaksma Mark E. , Smit Jasper M. , Hagens Laura A. , Heijnen Nanon F. L. , Jonkman Annemijn H. , Paulus Frederique , Schultz Marcus J. , Girbes Armand R. J. , Heunks Leo M. A. , Bos Lieuwe D. J. , Tuinman Pieter R. 
Published: July 2022

OBJECTIVES:
To determine the diagnostic accuracy of lung ultrasound signs for both the diagnosis of interstitial syndrome and for the discrimination of noncardiogenic interstitial syndrome (NCIS) from cardiogenic pulmonary edema (CPE) in a mixed ICU population.

DESIGN:
A prospective diagnostic accuracy study with derivation and validation cohorts.

SETTING:
Three academic mixed ICUs in the Netherlands.

PATIENTS:
Consecutive adult ICU patients that received a lung ultrasound examination.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULT:
The reference standard was the diagnosis of interstitial syndrome (NCIS or CPE) or noninterstitial syndromes (other pulmonary diagnoses and no pulmonary diagnoses) based on full post-hoc clinical chart review except lung ultrasound. The index test was a lung ultrasound examination performed and scored by a researcher blinded to clinical information. A total of 101 patients were included in the derivation and 122 in validation cohort. In the derivation cohort, patients with interstitial syndrome (n = 56) were reliably discriminated from other patients based on the presence of a B-pattern (defined as greater than or equal to 3 B-lines in one frame) with an accuracy of 94.7% (sensitivity, 90.9%; specificity, 91.1%). For discrimination of NCIS (n = 29) from CPE (n = 27), the presence of bilateral pleural line abnormalities (at least two: fragmented, thickened or irregular) had the highest diagnostic accuracy (94.6%; sensitivity, 89.3%; specificity, 100%). A diagnostic algorithm (Bedside Lung Ultrasound for Interstitial Syndrome Hierarchy protocol) using B-pattern and bilateral pleural abnormalities had an accuracy of 0.86 (95% CI, 0.77–0.95) for diagnosis and discrimination of interstitial syndromes. In the validation cohort, which included 122 patients with interstitial syndrome, bilateral pleural line abnormalities discriminated NCIS (n = 98) from CPE (n = 24) with a sensitivity of 31% (95% CI, 21–40%) and a specificity of 100% (95% CI, 86–100%).

CONCLUSIONS:
Lung ultrasound can diagnose and discriminate interstitial syndromes in ICU patients with moderate-to-good accuracy. Pleural line abnormalities are highly specific for NCIS, but sensitivity is limited.
Paradoxical Positioning: Does “Head Up” Always Improve Mechanics and Lung Protection?*
Authors: Selickman John , Crooke Philip S. , Tawfik Pierre , Dries David J. , Gattinoni Luciano , Marini John J. 
Published: July 2022

OBJECTIVES:
Head-elevated body positioning, a default clinical practice, predictably increases end-expiratory transpulmonary pressure and aerated lung volume. In acute respiratory distress syndrome (ARDS), however, the net effect of such vertical inclination on tidal mechanics depends upon whether lung recruitment or overdistension predominates. We hypothesized that in moderate to severe ARDS, bed inclination toward vertical unloads the chest wall but adversely affects overall respiratory system compliance (Crs).

DESIGN:
Prospective physiologic study.

SETTING:
Two medical ICUs in the United States.

PATIENTS:
Seventeen patients with ARDS, predominantly moderate to severe.

INTERVENTION:
Patients were ventilated passively by volume control. We measured airway pressures at baseline (noninclined) and following bed inclination toward vertical by an additional 15°. At baseline and following inclination, we manually loaded the chest wall to determine if Crs increased or paradoxically declined, suggestive of end-tidal overdistension.

MEASUREMENTS AND MAIN RESULTS:
Inclination resulted in a higher plateau pressure (supineΔ: 2.8 ± 3.3 cm H2O [p = 0.01]; proneΔ: 3.3 ± 2.5 cm H2O [p = 0.004]), higher driving pressure (supineΔ: 2.9 ± 3.3 cm H2O [p = 0.01]; proneΔ: 3.3 ± 2.8 cm H2O [p = 0.007]), and lower Crs (supine Δ: 3.4 ± 3.7 mL/cm H2O [p = 0.01]; proneΔ: 3.1 ± 3.2 mL/cm H2O [p = 0.02]). Following inclination, manual loading of the chest wall restored Crs and driving pressure to baseline (preinclination) values.

CONCLUSIONS:
In advanced ARDS, bed inclination toward vertical adversely affects Crs and therefore affects the numerical values for plateau and driving tidal pressures commonly targeted in lung protective strategies. These changes are fully reversed with manual loading of the chest wall, suggestive of end-tidal overdistension in the upright position. Body inclination should be considered a modifiable determinant of transpulmonary pressure and lung protection, directionally similar to tidal volume and positive end-expiratory pressure.
Short-term ambient air pollution exposure and risk of atrial fibrillation in patients with intracardiac devices
Authors: Dahlquist Marcus , Frykman Viveka , Stafoggia Massimo , Qvarnström Eva , Wellenius Gregory A. , Ljungman Petter L. S. 
Published: July 2022

Introduction:
Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with substantial morbidity and mortality. Short-term exposure to fine particulate matter (PM2.5) has been causally linked to higher risk of cardiovascular disease, but the association with atrial fibrillation (AF) is less clear.

Methods:
We conducted a time-stratified case-crossover study to estimate the association between short-term air pollution levels and risk of AF episodes. The episodes were identified among patients with paroxysmal AF and an intracardiac devices able to register and store AF episodes. We obtained air pollution and temperature data from fixed monitoring stations and used conditional logistic regression to quantify the association of PM2.5, particulate matter (PM10), nitrogen dioxide (NO2) and ozone (O3) with onset of AF episodes, adjusting for temperature and public holidays.”.

Results:
We analyzed 584 episodes of AF from 91 participants and observed increased risk of AF episodes with PM2.5 levels for the 48–72 hours lag (OR 1.05; CI [1.01,1.09] per IQR)] and 72–96 hours (OR 1.05 CI [1.00,1.10] per IQR). Our results were suggestive of an association between O3 levels and AF episodes during the warm season. We did not observe any statistically significant associations for PM10 nor NO2.

Conclusion:
Short-term increases in PM2.5 in a low-pollution level environment were associated with increased risk of AF episodes in a population with intracardiac devices. Our findings add to the evidence of a potential triggering of AF by short-term increases in air pollution levels, well below the new WHO air quality guidelines.
High Surgical Complication Rates after Silicone Implant Use for Improvement of Glans Ridge Appearance
Authors: Reddy Soumya A. , Crane Curtis N. , Safir Michael , Santucci Richard A. 
Published: July 2022

Background:
Construction of the glans is an important aspect of gender-affirming phalloplasty. In these surgeries, the glans ridge is commonly constructed using the Norfolk technique or a similar technique. In cases of glans ridge flattening after creation, we generally recommend a redo/revision glansplasty, which is often curative. However, in situations when the glans ridge flattens again, we developed a silicone glans implant technique in an effort to create a satisfactory and lasting glans ridge.

Methods:
We conducted a pilot study of our first 12 glans implant cases. A retrospective chart review and brief, ad-hoc patient survey measured patient demographics, implant status, and patient satisfaction.

Results:
A total of 12 patients received a silicone glans implant between November 2017 and February 2020. One patient had the glans implant removed before the survey, and also could not be contacted. Three patients did not respond to the survey. Of the eight patients who responded, only five (5/8, 63%) patients still had the silicone implant at the time of the survey. The average satisfaction score was 3.25 (range 1 = very satisfied and 5 = very dissatisfied). Common complaints cited included dissatisfaction with implant appearance, as well as infection, discomfort, and pain.

Conclusions:
Patients and surgeons should be aware of the possibility of a novel silicone implant technique to create a glansplasty in those with failed/flattened previous glansplasty surgery. However, the technique is in development: patient satisfaction remains spotty and complication rates are high, although technical improvements may increase future success rates.
Optimizing Nonopioid Analgesia and Different Pain Management Options following Abdominoplasty: A Systematic Literature Review
Authors: Mortada Hatan , Barasain Omar , Altamimi Lamees Abdullah , Alzarmah Israa Mohammed , Almenhali Ahmed Abdullah , Neel Omar Fouda 
Published: July 2022

Introduction:
Postoperative pain remains a significant challenge with the growing number of abdominoplasties every year. Opioids are currently considered the mainstay modality for controlling postoperative pain. However, opioid-related side effects raise the need for a safer and more effective approach. In this study, we aimed to investigate these alternative evidence-based postoperative pain relief modalities following abdominoplasty.

Methods:
This systematic review was designed and conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The literature was systematically searched in December 2021 using the following databases: MEDLINE, Cochrane, and EMBASE. The MeSH terms used to aid the search were the following: abdominoplasty, postoperative pain management, postoperative analgesia, pain control, analgesia, and pain.

Results:
Reviewing the literature resulted in a total of 851 publications. After implementing our criteria, only 13 articles were included in this study, with 990 patients. A continuous infusion pump was the most commonly used method of analgesia (n = 3), followed by a transversus abdominis plane block (n = 2). The postoperative pain assessment scale was mentioned in nine out of the 13. Compared to controls, all interventions resulted in considerably lower pain levels in all the patients. Patient satisfaction was reported in three studies, and all studies reported higher satisfaction rates than the control groups.

Conclusions:
The authors performed a systematic review of the existing database of high-quality research on pain management after cosmetic abdominoplasty to determine the best pain management options currently available. However, future studies are recommended to assess the optimum dosing and administration methods.
FLUIDIC PERFORMANCE OF A DUAL-ACTION VITRECTOMY PROBE COMPARED WITH A SINGLE-ACTION PROBE
Authors: Steel David H. , Charles Martin , Zhu Ying , Tambat Sonalee , Irannejad A. Mani , Charles Steve 
Published: July 2022

Purpose:
To assess flow rates, nearfield effects, and traction of a dual-cutting 20,000 cpm vitrectomy probe (HYPERVIT, Alcon) versus a single-cutting 10,000 cpm probe (Advanced ULTRAVIT, Alcon).

Methods:
Flow rates were evaluated for 25+ and 27+ gauge probes using balanced salt solution or porcine cadaver vitreous (biased open, 50/50, and biased closed duty cycles). Probes were suspended in an open beaker, and flow rates were calculated using a precision balance. Nearfield effects and flow pulsatility were assessed using a validated simulation model based on experimental microparticle image velocimetry. Traction was assessed by attaching vitreous to a cantilever beam and measuring the deflection of the beam.

Results:
For HYPERVIT probes, aqueous flow rates were similar across all cutting rates. Vitreous flow rates increased with increasing cutting rates. At maximum cutting rates, aqueous flow was 62%–67% greater (25+) and 63% greater (27+) with HYPERVIT versus Advanced ULTRAVIT (P < 0.05); vitreous flow was 44%–47% greater (25+) and 26%–32% greater (27+) with HYPERVIT versus Advanced ULTRAVIT (P < 0.05). Nearfield effects were reduced, and peak traction forces were significantly lower for HYPERVIT versus Advanced ULTRAVIT (P < 0.05).

Conclusion:
Significantly greater aspiration flow, reduced nearfield effects, and reduced traction were observed with dual-action versus single-action probes.
Keratopathy in Noonan Syndrome
Authors: Yang Yelin , Woo Jyh Haur , Ali Asim 
Published: July 2022

Purpose:
Anterior segment abnormalities associated with Noonan syndrome are rare. We report our experience with 2 patients who developed keratopathy with significant visual sequelae.

Methods:
case series.

Results:
The first patient is a 9-year-old boy with genetically confirmed Noonan syndrome. At presentation, he was noted to have diffuse inferior epitheliopathy with vascularization and bilateral mild ptosis. Over 1 year, he developed focal areas of scarring with deterioration of vision and underwent superficial keratectomy in the left eye. However, over the following 2 years, he experienced recurrent corneal scarring and vascularization. The second patient is a 7-year-old boy with phenotypic Noonan syndrome. At presentation, he had an anterior subepithelial corneal scar inferiorly with epithelial defects in both eyes. He also had bilateral moderate ptosis and lagophthalmos. Despite lubrication, he developed recurrent bilateral corneal erosions with focal areas of scarring associated with vascularization and underwent superficial keratectomy for both eyes. Despite this, there was worsening corneal scarring and vascularization over time, eventually requiring deep anterior lamellar keratoplasty in the left eye. The host cornea showed a disturbed Bowman layer and an acellular mass of fibrous collagenous tissue between epithelium and stroma.

Conclusions:
Noonan syndrome may be associated with visually significant keratopathy, manifesting as focal corneal scarring with vascularization. These changes may due to an excessive fibrotic response in Noonan syndrome. Early recognition and treatment can help to delay the progression of keratopathy and need for surgical intervention.
The relation between average 1-year home blood pressure and the change in pro-BNP and left ventricle mass index
Authors: Hayiroğlu Mert İlker , Çinier Göksel , Pay Levent , Yüksel Gizem , Durak Furkan , Palice Ali , Ayhan Görkem , İnan Duygu , Parsova Kemal Emrecan , Vatanoğlu Elif Gökçen , Şeker Mehmet , Çinar Tufan , Cilli Hayiroğlu Selin , Özkan Asibe , Tekkeşin Ahmet İlker 
Published: July 2022

Background
The purpose of this investigation was to examine the association between average 1-year home blood pressure and the change in left ventricular mass index (LVMI) and pro-brain natriuretic peptide (BNP) levels.

Methods
This prospective study was a subgroup analysis of lifestyle intervention using mobile technology in patients with high cardiovascular risk: a pragmatic randomized clinical Trial (LIGHT). In total, 242 patients were stratified into tertiles according to their average 1-year home blood pressure.

Results
Patients grouped into the tertile 3 (T3) had a lower 1-year mean, SBP and DBP. The T3 group had a 2.1 times higher rate of decrease in pro-BNP and a 1.6 times higher rate of decrease in LVMI compared with T1, compared with the reference group. The area under curve (AUC) value of average 1-year home blood pressure was higher than that of mean SBP or DBP. (AUC, 0.75 vs. AUC, 0.70 vs. AUC, 0.69, respectively). Spearman rank correlation demonstrated that average 1-year home blood pressure had a correlation with Δpro-BNP and ΔLVMI.

Conclusion
The present study showed that average 1-year home blood pressure may have a significant association with a decrease in LVMI and pro-BNP. Our study appears to be the first to evaluate the association between average 1-year home blood pressure and the change in LVMI and pro-BNP.