bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of dietary plant and animal protein intakes on mitigating sarcopenia risk
Authors: Carbone John W. , Pasiakos Stefan M. 
Published: July 2022

Purpose of review
To highlight contemporary findings comparing the digestibility of animal and plant proteins, their stimulatory effects on muscle protein synthesis, and associations with sarcopenia.

Recent findings
Animal proteins are more digestible than plant proteins, resulting in greater amino acid availability and stimulation of muscle protein synthesis. However, isolated plant proteins, plant protein blends, and modified plant proteins enriched with indispensable amino acids can elicit comparable digestion and absorption kinetics to animal proteins. More research is needed to determine whether these modified plant protein sources can effectively mitigate sarcopenia risk.

Summary
Both animal and plant protein foods can be incorporated into a healthful eating plan that limits risk of age-related diseases, such as sarcopenia. Humans eat food rather than isolated nutrients; as such, considering the context of the overall diet and its impact on health, instead of solely focusing on individual nutrients in isolation, is important.
Who Trains the Trainers?
Authors: Lavoie Megan E. , Tay Khoon-Yen , Nadel Frances 
Published: July 2022

Objectives
Attending physicians in pediatric emergency medicine (PEM) must be able to perform lifesaving procedures, yet guidelines for maintaining procedural competency do not exist. We implemented a biannual 2-hour “bootcamp” designed to help PEM faculty maintain procedural competency.

Methods
A survey-based needs assessment was used to create a set of goals and objectives for the session and determine which procedural skills to include. Sessions of 4 simulated skills were held twice a year and limited to 12 faculty. Post-bootcamp evaluations were administered at the 1-year and 6-year marks to evaluate the usefulness of the training.

Results
Twenty-eight of our 55 current faculty members (50%) responded to the 6-year follow-up evaluation. Overall, the bootcamp was felt to be beneficial, with 64% of faculty rating it “great” (5) or “highly useful” (6) on a 6-point Likert scale. The majority of participants also rated the airway, vascular access, and cardiopulmonary resuscitation/defibrillator training favorably. Faculty who later had the opportunity to perform specific resuscitation procedures clinically felt that the circulation (cardiopulmonary resuscitation/defibrillator) and airway stations contributed to the success of their procedure performance.

Conclusions
The clinical setting alone may be insufficient in maintaining procedural competency in lifesaving skills in PEM. Giving faculty the opportunity to practice these skills is feasible and can be effective in increasing confidence. Future training sessions should aim toward practicing to a defined mastery level.
Comparative Effectiveness of Physical Therapy and Electrophysiotherapy for the Treatment of Lateral Epicondylitis: A Network Meta-Analysis
Authors: Wood Shannon M. , Yoon Alfred P. , Tseng Hsiao-Jung , Yang Lan-Yan , Chung Kevin C. 
Published: July 2022

Background:
Lateral epicondylitis (LE) is a common enthesopathy, possibly caused by overuse and repetitive activity. Although non-operative management is the primary approach for treating LE, clinical guidelines and the literature fail to identify the most effective non-operative treatment. Therefore, we conducted a network meta-analysis to compare the effectiveness of physical therapy and electrophysiotherapy treatments for the treatment of LE.

Methods:
We searched MEDLINE, EMBASE, Web of Science, and Scopus for peer-reviewed, randomized controlled trials evaluating the effectiveness of physical therapy and electrophysiotherapy treatments. Data related to article characteristics and outcomes (grip strength and pain VAS) were collected.

Results:
Twenty-three clinical trials, including 1,363 participants (mean [SD] age, 47.4 [7.5], 53.1% women) were eligible in this study. Pain VAS demonstrated significant reductions in scores following treatment with magnetic field (mean difference (MD) [95% CI],-1.88 [-2.66 to -1.11]), exercise (MD [95% CI], -0.90 [-1.69 to -0.1]), and acoustic waves (MD [95% CI], -0.83 [-1.37 to -0.29]) compared to placebo. For grip strength, no treatment modality was found to be significantly effective. A sensitivity analysis that excluded studies with high publication bias and high degrees of heterogeneity produced similar results to the main analysis with the exception of statistically improved grip strength after light therapy (MD [95% CI], 5.38 [1.71 to 9.04]) and acoustic wave therapy (MD [95% CI], 7.79 [2.44 to 13.15]).

Conclusion:
Overall, electrophysiotherapy treatments should be prioritized over physical therapy. Magnetic field therapy was associated with pain reduction, whereas acoustic wave and light therapy were associated with increased grip strength.
Sonographic Changes in the Median Nerve Predict Conversion to Surgery after Corticosteroid Injection of the Carpal Tunnel
Authors: Wessel Lauren E. , Kerluku Jona , Nwawka Ogonna K. , Miller Theodore T. , Nguyen Joe , Fufa Duretti T. 
Published: July 2022

Background:
Risk factors for conversion to surgical management of moderate severity carpal tunnel syndrome (CTS) are poorly understood. We hypothesized that sonographic findings along the carpal tunnel could predict failure of conservative management for CTS.

Methods:
We report on 96 wrists with moderate clinical signs and symptoms of CTS. Sonographic evaluation with measurement of median nerve cross-sectional area (CSA) was performed at 3 consistent anatomic locations. We recorded median nerve morphology, inlet/outlet dimensions of the carpal tunnel, and maximal thickness of the transverse carpal ligament. Subsequently, steroid injection was performed. Patients were followed for a minimum of one year after injection and progression to surgical management was recorded.

Results:
54% (n = 52) patients converted to surgical management within 1 year following injection. Median nerve CSA decreased over the course of the carpal tunnel from proximal to distal in 81 of 96 wrists. A greater decrease in CSA of the median nerve between the pisiform and the hamate was associated with conversion to operative intervention for CTS with the average decrease in median nerve CSA among those who failed conservative treatment being 5.01 mm2 compared to 2.97 mm2 among those who did not progress to surgical treatment.

Conclusions:
Our study demonstrates that ultrasound may be one additional tool used by clinicians in order to better counsel patients about the severity and progression of their disease. Patients who demonstrate a decrease in cross-sectional area of the median nerve along the carpal tunnel demonstrate a higher likelihood of progression to operative management.
“Thou shalt not throw away a living thing” - Innovative use of perforator flaps in abdominal wall reconstruction.
Authors: Brunetti Beniamino , Morelli Coppola Marco , Ciarrocchi Silvia , Salzillo Rosa , Tenna Stefania , Persichetti Paolo 
Published: July 2022

Abdominal wall reconstruction represents a complex challenge for plastic surgeons, given the variable range of clinical situations requiring restoration of abdominal wall integrity. When significant myo-fascial defects are encountered, repair with either a synthetic or biological mesh is indicated, both with their respective advantages and drawbacks.
Taking inspiration from the Gillies’ fourth plastic surgery “commandment” (Thou shalt not throw away a living thing), an innovative technique to obtain a vascularized autologous mesh from the tissues usually discarded during abdominal contouring procedures was conceived.
In this paper the authors describe how to maximize the use of perforator flaps derived from abdominoplasty excision patterns in abdominal wall reconstruction, in order to simultaneously obtain restoration of abdominal wall integrity and improvement of the abdominal contour.
Surgical Treatment for Postparalytic Facial Synkinesis — A 35 Year Experience
Authors: Chuang David Chwei-Chin , Chang Tommy Nai-Jen , Lu Johnny Chuieng-Yi , Zavala Abraham 
Published: July 2022

Background:
Surgical intervention with Combined myectomy & neurectomy followed by functioning free muscle transplantation (FFMT) has been proposed to effectively resolve the problem of postparalytic facial synkinesis (PPFS) since 1985, and continues to be our standard-of-care. We aim to provide evidence that this surgical strategy is effective for treatment of synkinesis and smile quality.

Methods:
103 patients with PPFS were investigated (1985-2020). They all underwent extensive removal of the synkinetic muscles and triggered facial nerve branches in the cheek, nose and neck regions, followed by gracilis FFMT for facial reanimation. Ninety-four patients with 50 Type II and 44 Type III PPFS patients, all of whom had at least one year of postoperative follow-up were included in the study. Patient’s demographics, functional and aesthetic evaluations before and after surgery were collected.

Results:
In the yearly distribution of the facial paralysis reconstruction, the incidence of surgical intervention increased from 15% prior to 2012 up to 24% in the years after. Young adults (79%) and female patients (63%) were the dominant population. Results showed a significant improvement of the facial smile quality with more teeth visible while smiling, and a long-lasting decrease of facial synkinesis. Ninety six percent of patients did not require botulinum-A toxin injection after surgery. Revision surgery for secondary deformity was 53%.

Conclusion:
Combined myectomy & neurectomy followed by FFMT for Type II and III synkinetic patients leads to promising and long-lasting results despite high revision rates. Refined techniques to decrease the revision rates are needed in the future.
Health Literacy-Based Self-Management Intervention for Patient–Family Caregiver Dyads Undergoing Hemodialysis
Authors: Park Yusun , Kim Sung Reul 
Published: July 2022

Abstract

Purpose
The aim of this study was to determine the effect of a health literacy-based self-management intervention for patient–family caregiver dyads undergoing hemodialysis.

Design
A quasi-experimental design was used.

Methods
The intervention group (n = 20) received a health literacy-based self-management intervention for patient–family caregiver dyads, whereas the control group (n = 23) received standard informational messages through a short messaging service for 8 weeks. All participants were assessed for hemodialysis knowledge, self-efficacy, family support, self-management, the ratio of interdialytic weight gain to dry weight, and serum phosphorus and potassium levels at pretest and posttest.

Results
Participants in the intervention group exhibited higher scores on hemodialysis knowledge, self-efficacy, family support, and self-management than those in the control group. In addition, the ratio of interdialytic weight gain to dry weight decreased significantly in the intervention group.

Conclusions
The health literacy-based self-management intervention for patient–family caregiver dyads undergoing hemodialysis was effective in improving hemodialysis knowledge, self-efficacy, family support, self-management, and the ratio of interdialytic weight gain to dry weight.

Clinical Relevance
Because health literacy is an important factor influencing self-management, interventions for patients undergoing hemodialysis should consider the health literacy level of patients and their family caregivers.
Burnout reduction in acute care surgeons: Impact of faculty schedule change at a level 1 trauma and tertiary care center
Authors: Jones Caitlin Elizabeth , Fox Elizabeth Dora , Holsten Steven B. , White Cassandra Q. , Sayyid Rashid K. , O'Keeffe Terence , Lawson Andrew G. 
Published: July 2022

BACKGROUND
Acute care surgeons are prone to burnout because of heavy workload, concurrent clinical responsibilities, and busy in-house call. Modifiable burnout factors have been identified, but few studies have looked for longitudinal effects after change is implemented. We hypothesized that optimizing faculty workflow could decrease burnout without compromising productivity.

METHODS
We streamlined the faculty schedule at our institution to eliminate 24-hour call by creating weekly blocks of 12-hour day and night call, free from other clinical obligations. Protected academic time was added. The Maslach Burnout Inventory and Areas of Worklife Survey for health care providers were given to faculty, as well as close friends or family, at baseline, 6 months, and 12 months. Maslach Burnout Inventory and Areas of Worklife Survey proprietary formulas were used to assess change in factors contributing to burnout. Our primary outcome measure was the presence of factors contributing to burnout. Chart delinquency, relative value units, and academic projects were secondary outcome measures assessing clinical productivity change.

RESULTS
Survey completion rates were 92% for faculty and 80% for family. All burnout risk factors improved at 6 and 12 months. In surgeon and family groups, the following improvements were noted in the mean scores of risk factors at 1 year: workload (74%, 68%), control (38%, 16%), reward (14%, 24%), fairness (69%, 22%), emotional exhaustion (27.5%, 24%), depersonalization (37.5%, 14%), personal accomplishment (12.5%, 2%), community (3%, 5%), values (10%, 15%), and over-all burnout (12.5%, 23.3%). There was a reduction in charts reaching delinquent status. Relative value unit production did not decrease.

CONCLUSION
This study demonstrates that implementing a weekly, 12-hour call schedule can improve factors leading to burnout. Improvements were noted in surgeon and family groups alike, signifying both subjective improvements and observed change in the surgeons' behavior, without compromising clinical productivity.

LEVEL OF EVIDENCE
Therapeutic/Care Management; Level III.
One size does not fit all: Sex bias in pharmacologic venous thromboembolism prophylaxis
Authors: Modi Rishi N. , Borst Johanna M. , Kirchberg Tyler N. , Box Kevin , Smith Alan M. , Godat Laura N. , Doucet Jay J. , Costantini Todd W. , Berndtson Allison E. 
Published: July 2022

BACKGROUND
The optimal enoxaparin dosing strategy to achieve venous thromboembolism (VTE) prophylaxis in trauma patients remains unclear. Current dosing guidelines often include weight, age, and renal function but still fail to achieve appropriate prophylactic anti-Xa levels in many patients. We hypothesized that additional patient factors influence anti-Xa response to enoxaparin in trauma patients.

METHODS
This is a retrospective review of patients admitted to a Level 1 trauma center for ≥4 days from July 2015 to September 2020, who received enoxaparin VTE prophylaxis per protocol (50–59 kg, 30 mg/dose; 60–99 kg, 40 mg/dose; ≥100 kg, 50 mg/dose; all doses every 12 hours) and had an appropriately timed peak anti-Xa level. Multivariate regression was performed to identify independent predictors of prophylactic anti-Xa levels (0.2–0.4 IU/mL) upon first measurement.

RESULTS
The cohort (N = 1,435) was 76.4% male, with a mean ± SD age of 49.9 ± 20.0 years and a mean ± SD weight of 82.5 ± 20.2 kg (males, 85.2 kg; females, 73.7 kg; p <0.001). Overall, 68.6% of patients (n = 984) had a prophylactic anti-Xa level on first assessment (69.6% of males, 65.1% of females). Males were more likely to have a subprophylactic level than females (22.1% vs. 8.0%, p <0.001), whereas females were more likely to have supraprophylactic levels than males (26.9% vs. 8.3%, p < 0.001). When controlling for creatinine clearance, anti-Xa level was independently associated with dose-to-weight ratio (odds ratio, 0.191 for 0.5 mg/kg; p < 0.001; confidence interval, 0.151–0.230) and female sex (odds ratio, 0.060; p < 0.001; confidence interval, 0.047–0.072). Weight and age were not significant when controlling for the other factors.

CONCLUSION
Male patients have a decreased anti-Xa response to enoxaparin when compared with female patients, leading to a greater incidence of subprophylactic anti-Xa levels in male patients at all dose-to-weight ratios. To improve the accuracy of VTE chemoprophylaxis, sex should be considered as a variable in enoxaparin dosing models.

LEVEL OF EVIDENCE
Therapeutic/Care Management; Level III.
Update in the clinical application of focused ultrasound
Authors: Natera-Villalba Elena , Matarazzo Michele , Martinez-Fernandez Raúl 
Published: July 2022

Purpose of review
To review the most recent evidence about the clinical applicability of transcranial MRI-guided focused ultrasound (MRgFUS), including clinical evidence and indications, recent technical developments for its use and future prospects.

Recent findings
Unilateral MRgFUS thalamotomy for both essential and parkinsonian tremors is an approved and well established therapy. Recent studies have focused on its long-term safety and efficacy as well as technical advances for refining the approach. Moreover, ultrasound has expanded its application in Parkinson's disease, with clinical trials successfully targeting other brain regions like the subthalamic nucleus, the globus pallidus and the pallidothalamic tract, providing benefits for features that thalamotomy neglects. New indications, such as focal dystonia or neuropsychiatric conditions (namely obsessive–compulsive disorder and depression) have also been explored, with encouraging preliminary results. Finally, the application of ultrasound in low-intensity modality allows other approaches like focal blood–brain barrier opening and neuromodulation, which promise to be highly relevant in translational research.

Summary
MRgFUS is a growing emergent technique. Its application in clinical routine is becoming widely accepted as a therapeutic option. Novel approaches and new potential applications are anticipated.
Movement disorders in COVID-19 times: impact on care in movement disorders and Parkinson disease
Authors: Poonja Sabrina , Chaudhuri K. Ray , Miyasaki Janis M. 
Published: July 2022

Purpose of review
The purpose of this review is to outline the impact of the COVID-19 pandemic on movement disorder holistic care, particularly in the care of people with Parkinson disease (PWP).

Recent findings
As the pandemic unfolds, a flurry of literature was published regarding the impact of COVID-19 on people with Parkinson disease including the direct impact of infection, availability of ambulatory care, loss of community-based team care, and acceptability of telemedicine.

Summary
COVID-19 has impacted the care of PWP in numerous ways. Recognizing infection in PWP poses challenges. Specific long-term complications, including emerging reports of long COVID syndrome is a growing concern. Caregivers and PWP have also been impacted by COVID-19 social isolation restrictions, with radical changes to the structure of social networks and support systems globally. In a matter of weeks, the global community saw an incredible uptake in telemedicine, which brought benefits and pitfalls. As PWP adapted to virtual platforms and the changing architecture of care delivery, the pandemic amplified many preexisting inequities amongst populations and countries, exposing a new ‘digital divide’.
The genomic basis of evolutionary novelties in a leafhopper
Authors: Li Zheng , Li Yiyuan , Xue Allen Z. , Dang Vy , Holmes V. Renee , Johnston J. Spencer , Barrick Jeffrey E. , Moran Nancy A. 
Published: July 2022

AbstractEvolutionary innovations generate phenotypic and species diversity. Elucidating the genomic processes underlying such innovations is central to understanding biodiversity. In this study, we addressed the genomic basis of evolutionary novelties in the Glassy-Winged Sharpshooter (Homalodisca vitripennis, GWSS), an agricultural pest. Prominent evolutionary innovations in leafhoppers include brochosomes, proteinaceous structures that are excreted and used to coat the body, and obligate symbiotic associations with two bacterial types that reside within cytoplasm of distinctive cell types. Using PacBio long-read sequencing and Dovetail Omni-C technology, we generated a chromosome-level genome assembly for the GWSS, then validated the assembly using flow cytometry and karyotyping. Additional transcriptomic and proteomic data were used to identify novel genes that underlie brochosome production. We found that brochosome-associated genes include novel gene families that have diversified through tandem duplications. We also identified the locations of genes involved in interactions with bacterial symbionts. Ancestors of the GWSS acquired bacterial genes through horizontal gene transfer (HGT), and these genes appear to contribute to symbiont support. Using a phylogenomics approach, we inferred HGT sources and timing. We found that some HGT events date to the common ancestor of the hemipteran suborder Auchenorrhyncha, representing some of the oldest known examples of HGT in animals. Overall, we show that evolutionary novelties in leafhoppers are generated by the combination of acquiring novel genes, produced bothde novoand through tandem duplication, acquiring new symbiotic associations that enable use of novel diets and niches, and recruiting foreign genes to support symbionts and enhance herbivory.
No functional contribution of the gustatory receptor, Gr64b, co-expressed in olfactory sensory neurons of Drosophila melanogaster
Authors: Mahadevan Venkatesh Pal , Lavista-Llanos Sofía , Knaden Markus , Hansson Bill S. 
Published: July 2022

AbstractChemosensation is essential for the survival of insects. Activities like searching for food, mating, and oviposition in the fruit fly, Drosophila melanogaster are to a great extent governed by chemical cues detected via olfaction and gustation. This chemical information is conveyed to higher brain centres via populations of diverse olfactory sensory neurons (OSNs) and gustatory sensory neurons (GSNs) expressing olfactory receptors (ORs) and gustatory receptors (GRs), respectively. ORs are exclusively expressed in the antenna and in the maxillary palps, while GRs are widely expressed in the labellum, tarsi, genitalia etc. Interestingly, 14 GRs were previously reported to be expressed in the antenna of D. melanogaster. However, the spatial expression pattern for all GRs and their functional role are still unclear. Recent data challenge the dogma that single OSNs express a single OR. In the present study, we studied the expression of 12 previously reported GRs among sensory structures on the fly antenna using the Gal4-UAS binary expression system. We observed antennal expression of nine out of the 12 reported. Out of these nine, consistent expression was only apparent for Gr64b, and we reconfirmed its presence in OSNs innervating three glomeruli in the antennal lobe. These glomeruli are known to be innervated by ab5A, ab5B and ab8A OSNs, respectively. Next, we generated double labelling crosses with Gr64b and observed co-expression of Gr64b with Or47a, which is expressed in the ab5B neuron. To elucidate the functional role of Gr64b co-expressed with Or47b, we challenged Or47a-expressing OSNs in wild type and Gr64b-/- mutant flies with odor stimulation using the single sensillum recording technique in two satiation states (fed and starved). Notably, we did not observe any significant odor sensitivity or specificity changes in Gr64b mutants as compared to wild type flies. Taken together, our results reveal co-expression of GRs with ORs in olfactory sensory neurons, while the functional contribution of the GR in this context remains obscure.