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54, 95% confidence interval [CI] 2.12-3.05) and revision (hazard ratio 2.16, 95% CI 1.78-2.62) TKA patients without pulmonary HTN. Rate of medical complications within 90 days from surgery was 6.5% and 14% in primary and revision TKAs. The 10-year cumulative incidence of any revision was 5% and 16% in primaries and revisions, respectively.

Patients with pulmonary HTN undergoing primary and revision TKAs had excess risk of death and experience a high rate of medical complications within 90 days of surgery. Counseling of risks, medical optimization, and referral to tertiary centers should be considered.

Level IV.

Level IV.

In recent time, there has been an increased push toward transparency in industry funding toward physicians. The Physician Payments Sunshine Act called for the creation of the Open Payments Database managed by the Centers for Medicare & Medicaid Services. To our knowledge, there have been no studies evaluating the trends in payments among adult reconstruction fellowship-trained orthopedic surgeons. The purpose of this study is to investigate trends in all payments to adult reconstruction-trained orthopedic surgeons from 2014 to 2019. Secondary outcomes included evaluating trends in yearly subpayment categories, regional variations, as well as characterizing the top 5 industry companies.

A review of the Centers for Medicare & Medicaid Services Open Payments Database was performed to identify all payments to adult reconstruction-trained orthopedic surgeons. A total of 94,265 payments were made to 4911 surgeons accounting for a total of $258,865,231.20 during the study period. Our primary outcome was nd in median payment per surgeon (21.6%, r=-0.109, P < .001), whereas the others remained unchanged.

In this study, we found a nonsignificant increasing trend in payments to adult reconstruction-trained surgeons as well as an increasing number of surgeons receiving payments. There were increasing trends in median payment per surgeon for education and entertainment expenses, but a decreasing trend for honoraria payments. No significant regional trends were identified. The majority of the top 5 companies had nonsignificant trends in their payments. Further studies are needed to characterize the disclosure of payments and the impact of industry payments on clinical outcomes.

IV.

IV.

To clarify the incidence and risk factors of acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) in pediatric patients with febrile status epilepticus (FSE).

We retrospectively surveyed patients with FSE (≥20min and ≥40min) who were younger than 6years by mailing a questionnaire to 1123 hospitals in Japan. The survey period was 2years. We then collected clinical data on patients with prolonged febrile seizures (PFS) ≥40min and those with AESD, and compared clinical data between the PFS and AESD groups.

The response rate for the primary survey was 42.3%, and 28.0% of hospitals which had applicable cases responded in the secondary survey. The incidence of AESD was 4.3% in patients with FSE ≥20min and 7.1% in those with FSE ≥40min. In the second survey, a total of 548 patients had FSE ≥40min (AESD group, n=93; PFS group, n=455). Univariate analysis revealed significant between-group differences in pH, aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, creatine kinase, NH

, procalcitonin (PCT), uric acid, blood urea nitrogen, creatinine (Cr), and lactate. Multivariate analysis using stratified values showed that high PCT was an only risk factor for AESD. A prediction score of more than 3 was indicative of AESD, as determined using the following indexes HCO3

< 20mmol/L (1 point), Cl <100mEq/L (1 point), Cr ≥0.35mg/dL (1 point), glucose ≥200mg/dL (1 point), and PCT ≥1.7pg/mL (2 points). The scoring system had sensitivity of 84.2% and specificity of 81.0%.

Incidence data and prediction scores for AESD will be useful for future intervention trials for AESD.

Incidence data and prediction scores for AESD will be useful for future intervention trials for AESD.

Cervical cancer (CC) is a common female malignant tumor. With the trend of younger onset, people pay more and more attention to it. Numberless evidence has been indicated that long non-coding RNAs (lncRNAs) can take part in progression of cancers and can exert the regulatory roles in assorted cancers. Nevertheless, the roles of FEZ family zinc finger 1-antisense RNA 1 (FEZF1-AS1) in CC cells are still undiscovered.

Thus, the central purpose of our research was to reveal the specific functions and molecular mechanisms of FEZF1-AS1 in CC cells.

RT-qPCR was utilized to test FEZF1-AS1 expression in CC cells. In addition, functional assays were conducted to evaluate cell proliferation, apoptosis, and migration as well as invasion. In addition, mechanism experiments verified relationship among FEZF1-AS1, miR-367-3p and solute carrier family 12 member 5 (SLC12A5).

FEZF1-AS1 was highly expressed in CC cells. Moreover, FEZF1-AS1 depletion suppressed proliferation, migration, invasion, and induced cell apoptosis. Importantly, mechanism experiments confirmed that miR-367-3p could bissnd to FEZF1-AS1 and SLC12A5. The rescue assays determined that FEZF1-AS1 could up-regulate SLC12A5 through binding to miR-367-3p.

The up-regulated FEZF1-AS1 could accelerate the malignant behaviors of CC cells by miR-367-3p/SLC12A5 signal axis.

The up-regulated FEZF1-AS1 could accelerate the malignant behaviors of CC cells by miR-367-3p/SLC12A5 signal axis.We challenge the widespread appraisal that organic farming is the fundamental alternative to conventional farming for harnessing biodiversity in agricultural landscapes. Certification of organic production is largely restricted to banning synthetic agrochemicals, resulting in limited benefits for biodiversity but high yield losses despite ongoing intensification and specialisation. In contrast, successful agricultural measures to enhance biodiversity include diversifying cropland and reducing field size, which can multiply biodiversity while sustaining high yields in both conventional and organic systems. Achieving a landscape-level mosaic of natural habitat patches and fine-grained cropland diversification in both conventional and organic agriculture is key for promoting large-scale biodiversity. This needs to be urgently acknowledged by policy makers for an agricultural paradigm shift.

To evaluate national trends in adoption of different surgical approaches for colectomy and compare clinical outcomes and resource utilization between approaches.

Retrospective study of patients aged ≥18 years who underwent elective inpatient left or right colectomy between 2010 and 2019 from the Premier Healthcare Database. Patients were classified by operative approach open, minimally invasive either laparoscopic or robotic. Postoperative outcomes assessed within index hospitalization include operating room time, hospital length of stay, rates of conversion to open surgery, reoperation, and complications. Post-discharge readmission, hospital-based encounters, and costs were collected to 30 days post-discharge. Multivariable regression models were used to compare outcomes between operative approaches adjusted for patient baseline characteristics and clustering within hospitals.

Among 206,967 patients, the robotic approach rates increased from 2.1%/1.6% (2010) to 32.6%/26.8% (2019) for left/right colectomy, offset by a decrease in both open and laparoscopic approaches. Median length of stay for both left and right colectomies was significantly longer in open (6 days) and laparoscopic (5 days) compared to robotic surgery (4 days; all P values <.001). Robotic surgery compared to open and laparoscopic was associated with a significantly lower conversion rate, development of ileus, overall complications, and 30-day hospital encounters. Robotic surgery further demonstrated lower mortality, reoperations, postoperative bleeding, and readmission rates for left and right colectomies than open. Robotic surgery had significantly longer operating room times and higher costs than either open or laparoscopic.

Robotic surgery is increasingly being used in colon surgery, with outcomes equivalent and in some domains superior to laparoscopic.

Robotic surgery is increasingly being used in colon surgery, with outcomes equivalent and in some domains superior to laparoscopic.

Tall cell variant of papillary thyroid carcinoma is an aggressive subtype of papillary thyroid carcinoma. We examined expression of cancer stem cell markers in tall cell variant compared with other well-differentiated thyroid cancers.

Expression of cancer stem cell markers was examined in 572 thyroid tumors from The Cancer Genome Atlas Thyroid Cancer database and tall cell variant and papillary thyroid carcinoma tumors by immunohistochemistry.

Expression of the PROM1 gene, encoding the cancer stem cell marker CD133, was elevated in tall cell variant compared to classic papillary thyroid carcinoma in a large cohort of unmatched samples from The Cancer Genome Atlas Thyroid Cancer database (P < .001). By immunohistochemistry in age and stage matched samples, CD133 protein was confirmed to be significantly increased in tall cell variant versus classic papillary thyroid carcinoma (P= .006). Analyzing all thyroid cancers, high PROM1 expression was associated with worse disease-specific survival. Proteasome structure Optimal cutoffs were determined to define a tall cell variant-like cancer stem cell signature characterized by high PROM1, high ALDH1A3, and low CD24 expression. Classic papillary thyroid carcinoma with a tall cell variant-like gene signature had worse recurrence disease-free survival compared to classic papillary thyroid carcinoma with a non-tall cell variant signature (P= .02).

Tall cell variant of papillary thyroid carcinoma has increased expression of cancer stem cell markers compared to classic papillary thyroid carcinoma. The tall cell variant-like cancer stem cell gene signature identified a molecular subtype of classic papillary thyroid carcinoma that has a worse recurrence-free survival.

Tall cell variant of papillary thyroid carcinoma has increased expression of cancer stem cell markers compared to classic papillary thyroid carcinoma. The tall cell variant-like cancer stem cell gene signature identified a molecular subtype of classic papillary thyroid carcinoma that has a worse recurrence-free survival.

Frequency, microbiology, and outcomes of necrotizing soft tissue infections vary based on locoregional and environmental factors; however, there has been no global survey of these patterns. We performed a systematic review/meta-analysis on published reports of necrotizing soft tissue infections from across the globe.

Peer-reviewed empirical studies examining rates of polymicrobial and monomicrobial necrotizing soft tissue infections with microbial isolation and overall mortality rate were extracted along with geographic location using PubMed, Scopus, ProQuest, and Web of Science. Random-effects meta-analyses and sensitivity analyses were performed, adjusting for publication bias. Meta-regression analyses examined moderator effects of risk factors.

One hundred and five studies (8,718 total patients) were included. Pooled prevalence of polymicrobial and monomicrobial infections were 53% and 37.9%, respectively. Truncal necrotizing soft tissue infections were commonly polymicrobial (P < .001), whereas monomicrobial infections prevailed in extremities (P= .