bluuebunny/crossref_metadata_2025 huggingface dataset:
Rotating Lifshitz-like black holes in F(R) gravity
Authors: Jafarzade Kh , Rezaei E , Hendi S H
Published: April 2023

One of the alternative theories of gravitation with a possible UV completion of general relativity is Horava–Lifshitz gravity. Regarding a particular class of pure F(R) gravity in three dimensions, we obtain an analytical rotating Lifshitz-like black hole solution. We first investigate some geometrical properties of the obtained solution that reduces to a charged rotating Banados–Teitelboim–Zanelli black hole in a special limit. Then, we study the optical features of such a black hole, like the photon orbit and the energy emission rate, and discuss how electric charge, angular momentum, and exponents affect them. To have acceptable optical behavior, we should apply some constraints on the exponents. We continue our investigation by studying the thermodynamic behavior of solutions in the extended phase space and explore the validity of the first law of thermodynamics as well as local thermal stability using heat capacity. Evaluating the existence of van der Waals-like phase transition, we obtain critical quantities and show how they change under the variation of black hole parameters. Finally, we construct a holographic heat engine of such a black hole and obtain its efficiency in a cycle. Comparing the obtained results with the well-know Carnot heat engine efficiency, we examine the second law of thermodynamics.
DISTRIBUTION OF RADIONUCLIDES IN RIVER SEDIMENTS OF KATHMANDU VALLEY, NEPAL AND THE EVALUATION OF ASSOCIATED RADIATION HAZARD
Authors: Bhatta Ramchandra , Rijal Bipin , Acharya Ashish , Shah Deepak R , Karki Ram S , Shah Buddha R
Published: April 2023

The natural radioactivity in our living environment is mainly due to radionuclides of 40K, 232Th and 238U. We studied the distribution of these radionuclides in the sediment of different rivers and streams throughout the Kathmandu valley. The activity concentrations were determined by using digiBase NaI(TI) gamma-ray spectrometer, and further they were used to calculate radiological hazard indices to estimate the risk associated with the use of these sediments. The average activity concentrations for 40K, 232Th and 238U were found to be 378.54 ± 109.06, 45.95 ± 18.47 and 26.90 ± 9.61 Bq per kg, respectively. The average concentrations and calculated hazard indices have been compared with the respective reported activity concentration in different countries. This study reveals that there is no radiological threat using these local sediments as building materials and for other purposes.
Girls’ Education at Scale
Authors: Evans David K , Mendez Acosta Amina , Yuan Fei
Published: April 2023

Many educational interventions boost outcomes for girls in settings where girls face educational disadvantages, but which of those interventions are proven to function effectively at large scale? In contrast to earlier reviews, this review focuses on large-scale programs and policies—those that reach at least 10,000 students—and on final school outcomes such as completion and student learning rather than intermediate school outcomes such as enrollment and attendance. Programs and policies that have boosted school completion or learning at scale across multiple countries include school fee elimination, school meals, making schools more physically accessible, and improving the quality of pedagogy. Other interventions, such as providing better sanitation facilities or safe spaces for girls, show promising results but either have limited evidence across settings or focus on intermediate educational outcomes (such as enrollment) or post-educational outcomes (such as income earning) in their evaluations. These and other areas with limited or no evidence demonstrate many opportunities for education leaders, partners, and researchers to continue innovating and testing programs at scale. We discuss three considerations for incorporating evidence-based solutions into local education policies—constraints to girls’ education, potential solutions, and program costs—as well as lessons for scaling programs effectively.
Determinants of the Vertical Distribution of the Phyllosphere Differ Between Microbial Groups and the Epi- and Endosphere in a Tropical Forest
Authors: Schimann Heidy , Vacher Corinne , Coste Sabrina , Louisanna Eliane , Fort Tania , Zinger Lucie
Published: April 2023

The determinants of phyllosphere microbial communities are drawing much attention given their functional importance for their plant host fitness and health. Identifying these determinants remains challenging in neotropical forests, considering the diversity of the tree hosts and the strong vertical heterogeneity of abiotic conditions within the canopy and at the scale of the leaf. Here, we studied fungal and bacterial communities living in the endophytic and epiphytic phyllosphere in tree species across vertical gradients, from the top of the canopy to the ground. We used DNA metabarcoding to characterize microbial communities and measured abiotic variables and foliar traits to characterize environmental heterogeneity. The assembly of fungal communities was more driven by deterministic processes compared with bacteria, with endo- and epiphytic communities being similarly shaped by the host identity and unmeasured parameters. In contrast, in bacterial communities, the relative importance of deterministic processes decreased from endophytic to epiphytic communities. Bacterial epi- and endophytic communities were partly and differently determined by the position within the canopy, the host identity, and leaf traits, suggesting an effect of the vertical gradient and a stronger selection in the inner tissues of the leaf than on its surface. The tree host exerts a selective pressure on microbial communities but the leaf as microhabitat also contributes significantly to the assembly of microbial communities. Discrepancies exist between fungi and bacteria that probably reflect different life-history traits and ecological strategies, emphasizing the need to study these communities jointly if we are to fully understand plant–phyllosphere interactions.

[Formula: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Preferences on Delivery of Cancer Rehabilitation Services for Cancer-Related Disability Among Older Individuals Surviving Breast Cancer: A Qualitative Study
Authors: Brick Rachelle , Lyons Kathleen Doyle , Bender Catherine , Eilers Rachel , Ferguson Robert , Pergolotti Mackenzi , Toto Pamela , Skidmore Elizabeth , Leland Natalie E.
Published: April 2023

Background:

Older individuals surviving breast cancer often encounter cancer-related disability as a short-term or long-term effect of cancer and related treatment. Cancer rehabilitation interventions have the potential to prevent, mitigate, or remediate cancer-related disability. However, use of these services remains limited. Understanding the priorities and perspectives of older individuals surviving breast cancer is key to developing effective and implementable cancer rehabilitation interventions. This qualitative descriptive study examined individuals' preferred and valued methods of cancer rehabilitation intervention delivery.

Methods:

Using a qualitative descriptive design, older individuals surviving breast cancer (n = 14) completed a single, telephone-based, semistructured interview. Interviews explored survivors' preferences for cancer rehabilitation service delivery. Interview transcriptions were thematically analyzed. Open codes were inductively generated and reviewed for agreement by an independent reviewer. The codes were deductively organized. Differences were resolved through consensus meetings.

Results:

Findings revealed preferred intervention delivery characteristics for intervention setting, mode of delivery, format, and timing. Participants predominantly preferred interventions delivered in community-based settings, with both in-person and remote components. Participants also appeared to value one-on-one interventions and those delivered posttreatment. Survivors' overarching preferences were based on desire for patient-centric care, one-on-one therapist time, complex medical schedules, and financial concerns.

Conclusion:

Study findings provide guidance on the modification of existing and creation of new cancer rehabilitation interventions addressing cancer-related disability in older individuals surviving breast cancer. Adoption of stakeholder-driven intervention delivery characteristics may improve value and acceptability of interventions. Future intervention research should incorporate and test these characteristics to ensure their effectiveness in real-world settings.
Application of the R2C2 Model to In-the-Moment Feedback and Coaching
Authors: Lockyer Jocelyn , Lee-Krueger Rachelle , Armson Heather , Hanmore Tessa , Koltz Elizabeth , Könings Karen , Mahalik Anne , Ramani Subha , Roze des Ordons Amanda , Trier Jessica , Zetkulic Marygrace , Sargeant Joan
Published: April 2023

Purpose

The R2C2 (relationship, reaction, content, coaching) model is an iterative, evidence-based, theory-informed approach to feedback and coaching that enables preceptors and learners to build relationships, explore reactions and reflections, confirm content, and coach for change and cocreate an action plan. This study explored application of the R2C2 model for in-the-moment feedback conversations between preceptors and learners and the factors that influence its use.

Method

A qualitative study using framework analysis through the lens of experiential learning was undertaken with 15 trained preceptor–learner dyads. Data were collected during feedback sessions and follow-up interviews between March 2021 and July 2022. The research team familiarized themselves with the data, used a coding template to document examples of the model’s application, reviewed the initial framework and revised the coding template, indexed and summarized the data, created a summary document, examined the transcripts for alignment with each model phase, and identified illustrative quotations and overarching themes.

Results

Fifteen dyads were recruited from 8 disciplines (11 preceptors were paired with a single resident [n = 9] or a single medical student [n = 2]; 2 preceptors each had 2 residents). All dyads were able to apply the R2C2 phases of building relationships, exploring reactions and reflections, and confirming content. Many struggled with the coaching components, specifically in creating an action plan and follow-up arrangements. Preceptor skill in applying the model, time available for feedback conversations, and the nature of the relationship impacted how the model was applied.

Conclusions

The R2C2 model can be adapted to contexts where in-the-moment feedback conversations occur shortly after a clinical encounter. Experiential learning approaches applying the R2C2 model are critical. Skillful application of the model requires that learners and preceptors go beyond confirming an area of change and deliberately engage in coaching and cocreating an action plan.
Anterior cervical discectomy and fusion and pneumonia: use of the VASQIP database
Authors: Koutsouras George W. , Wade Michael , Marawar Satyajit
Published: April 2023

Background:

Anterior cervical discectomy and fusion (ACDF) may alleviate cervical radiculopathy and myelopathy, with risks including dysphagia, cerebrospinal fluid leakage, neurological injury, and post operative pneumonia (POP). The incidence of POP among non-veteran patients who underwent ACDF surgery was 0.45%. Military veterans may have higher overall complication rates after undergoing ACDF. We aimed to describe the incidence and risk factors of POP among military veterans undergoing ACDF.

Methods:

This study was a retrospective analysis of the United States Veteran Affairs Surgical Quality Improvement Program database. We assessed the patients who underwent ACDF between January 2001 and December 2017. Bivariate and multivariate statistical analyses were performed to identify the rates of POP and the factors that may increase POP risk.

Results:

Among the 18,468 patients, 195 (1.06%) experienced POP. Independent risk factors included male sex, chronic steroid use, preoperative sepsis, diabetes, poor overall health, inpatient surgery, and emergency surgery. Multilevel ACDF was associated with a higher POP rate (P<0.001). In the multivariate analysis, patients with a history of severe chronic obstructive pulmonary disease (COPD) were more than twice as likely to experience POP than those without severe COPD (P<0.001). An additional hour in surgery was associated with 16% higher odds of POP (P<0.001).

Conclusions:

The incidence of POP following ACDF is greater than the nonveteran population, which may be contributed by several factors including COPD, inpatient surgery and length of surgery. The identification of veterans as a high-risk population can potentially help guide decision making when ACDF is considered.

Level of Evidence:

III.
Outcomes of primary total joint arthroplasty in patients with a history of solid organ transplantation, a single institution analysis
Authors: Alvarez Paul M. , Curatolo Christian , Desai Miraj N. , Malik Azeem T. , Roebke Logan J. , Pigott Matthew
Published: April 2023

Background:

An increasing number of patients with a history of solid organ transplantation (SOT) are presenting for total joint arthroplasty (TJA). The primary aim of this study is to evaluate clinical outcomes after primary total joint arthroplasty in patients with a history of SOT compared to matched controls.

Methods:

We performed a review of prospectively collected data on consecutive adult patients with a history of SOT undergoing TJA from January 2014 to January 2021. Pearson-Chi square tests were used to compare differences in baseline demographics and clinical characteristics between SOT and matched controls. Multi-variate logistic regression analyses were used to assess whether patients who had a prior SOT were at higher risk of experiencing post-operative complications, readmissions, reoperations, longer length of stay and non-home discharges after primary TJA.

Results:

A total of 81 operations met inclusion criteria which were compared to 82 age matched controls without a history of SOT. Patients with a history of SOT were more likely to require a hospitalization greater than 2 days compared to the control group (n=63, 77.8% vs. n=16, 19.5%; P=0.011), had an increased risk of hyperkalemia (n=15, 18.5% vs. n=1, 1.2%; P=0.049), and any post-operative complication (n=55, 67.9% vs. n=21, 25.6%; P=0.025).

Conclusions:

Despite the increased risk of acute post-operative complications and longer hospital stays, primary TJA has been shown to be a safe and effective option for treatment of DJD or AVN in patients with a history of SOT when completed via a multi-disciplinary approach.

Level of Evidence:

Retrospective Analysis, Level IV.
More than six months delay in anterior cruciate ligament reconstruction is associated with a higher risk of pre-reconstruction meniscal and chondral damage
Authors: Safdari Mohammadreza , Rasuli Ostadi Abdolshakur , Makhmalbaf Nahid , Makhmalbaf Mahshid , Makhmalbaf Hadi
Published: April 2023

Background:

There is no consensus regarding the optimal timing of anterior cruciate ligament reconstruction (ACLR) and its clinical importance. Here, we compared the rate of the pre-reconstruction meniscus and cartilage injury, also the knee function, between the early ACLR (within six months of injury) and late ACLR (after six months of the injury).

Methods:

Retrospectively, 192 patients with an ACL tear who underwent ACLR within six months of injury (n=53) or after six months of injury (n=132) were included. Autograft bone patellar tendon bone was used as the graft choice. The rate of pre-reconstruction meniscal injury and chondral damage (Outerbridge classification) was compared between the two groups. The knee function, evaluated in the last follow-up using the Lysholm knee scale, was also compared.

Results:

The mean time from injury to surgery was 3.9±1.3 mo in the early group and 8.8±2.3 mo in the late group The pre-reconstruction meniscal injury was detected in 24 (45.3%) patients in the early ACLR group and 93 (66.9%) patients in the late ACLR group (P=0.006). Pre-reconstruction chondral damage was detected in six (11.3%) patients of the early ACLR group and 32 (23%) patients of the late ACLR group (P=0.049). The mean Lysholm knee scale was 86.7±6 (range 82-92) in the early ACLR group and 81.9±4.4 (range 80-84) in the late ACLR group (P<0.001).

Conclusion:

The higher rate of pre-reconstruction meniscal and chondral damage and lower functional score in the late ACLR group suggests avoiding ACLR delay more than six months after the injury.

Level of Evidence: IV.
Feasibility for Immediate Targeted Muscle Reinnervation Based on Lower Extremity Amputations Trends
Authors: De la Fuente Hagopian Alexa , Farhat Souha , Doval Andres F. , Reddy Narainsai K. , Yazid Mark M. , Echo Anthony
Published: April 2023

Background:

Targeted muscle reinnervation has been adopted as a strategy for the management and prevention of phantom limb pain and symptomatic neuroma formation for patients undergoing lower extremity amputation. The procedure is often performed by surgeons different from those performing the amputation, creating scheduling dilemmas. The purpose of this study was to analyze historic trends in lower extremity amputation scheduling in a single hospital system to evaluate if offering routine immediate targeted muscle reinnervation is practical.

Methods:

De-identified data over a five-year period for all patients undergoing lower extremity amputation were collected. The data gathered included the specialty performing the amputation, weekly distribution of cases, start time, and end time, among others.

Results:

A total of 1549 lower extremity amputations were performed. There was no statistically significant difference in average number of below-the-knee amputations (172.8) and above-the-knee amputations (137.4) per year. Top specialties performing amputations were vascular surgery (47.8%), orthopedic surgery (34.5%), and general surgery (13.85%). No significant difference was noted in the average number of amputations across the week, per year. Most cases started between 6 am and 6 pm (96.4%). The average length of stay after surgery was 8.26 days.

Conclusions:

In a large, nontrauma hospital system, most lower extremity amputations are performed during typical working hours and are evenly distributed throughout the week. Understanding peak timing of amputations may allow for targeted muscle reinnervation to be performed concurrently with amputation procedure. Data presented will be a first step to optimizing amputation scheduling for patients in a large nontrauma health system.
TRPM2 regulates cell cycle through the Ca2+-CaM-CaMKII signaling pathway to promote HCC
Authors: Cai Xiaobo , Yu Xiazhen , Yang Jiawen , Lu Lin , Hua Ning , Duan Xin , Ye Peiwu , Ni Lei , Jiang Linhua , Yang Wei , Liang Tingbo , Yu Peilin
Published: April 2023

Background:

HCC is one of the most common causes of cancer-related deaths. Transient receptor potential melastatin 2 (TRPM2), a Ca2+-permeable cation channel, was reported to be involved in carcinogenesis and tumor growth recently. However, whether TRPM2 is involved in the pathogenesis and progression of HCC remains unclear. Herein, we systematically elucidated the functional role of TRPM2 in HCC cell cycle regulation and proliferation.

Approach and Results:

We determine TRPM2 expression to be strongly upregulated in the tumor tissues of HCC patients and associated with a negative prognosis. TRPM2 is highly expressed in HCC cell lines Huh-7 and HepG2 cells, rather than in normal hepatocytes. Inhibition or silencing of TRPM2, or inhibition of the downstream Ca2+-CaM-CaMKII signaling pathway, significantly suppressed the proliferation of Huh-7 and HepG2 cells by arresting the cell cycle at the G1/S phase, accompanied with reduced expression of G1/S checkpoint proteins. Importantly, inhibition or depletion of TRPM2 remarkably slowed down the growth of patient-derived xenografts and Huh-7 xenografts in mice.

Conclusion:

Our results indicate that TRPM2 promotes HCC cell proliferation via activating the Ca2+-CaM-CaMKII signaling pathway to induce the expression of the key G1/S regulatory proteins and accelerate the cell cycle. This study provides compelling evidence of TRPM2 involvement in a previously unrecognized mechanism that drives HCC progression and demonstrates that TRPM2 is a potential target for HCC treatment.
Metabolic reprogramming and its clinical implication for liver cancer
Authors: Yang Flora , Hilakivi-Clarke Leena , Shaha Aurpita , Wang Yuanguo , Wang Xianghu , Deng Yibin , Lai Jinping , Kang Ningling
Published: April 2023

Cancer cells often encounter hypoxic and hypo-nutrient conditions, which force them to make adaptive changes to meet their high demands for energy and various biomaterials for biomass synthesis. As a result, enhanced catabolism (breakdown of macromolecules for energy production) and anabolism (macromolecule synthesis from bio-precursors) are induced in cancer. This phenomenon is called “metabolic reprogramming,” a cancer hallmark contributing to cancer development, metastasis, and drug resistance. HCC and cholangiocarcinoma (CCA) are 2 different liver cancers with high intertumoral heterogeneity in terms of etiologies, mutational landscapes, transcriptomes, and histological representations. In agreement, metabolism in HCC or CCA is remarkably heterogeneous, although changes in the glycolytic pathways and an increase in the generation of lactate (the Warburg effect) have been frequently detected in those tumors. For example, HCC tumors with activated β-catenin are addicted to fatty acid catabolism, whereas HCC tumors derived from fatty liver avoid using fatty acids. In this review, we describe common metabolic alterations in HCC and CCA as well as metabolic features unique for their subsets. We discuss metabolism of NAFLD as well, because NAFLD will likely become a leading etiology of liver cancer in the coming years due to the obesity epidemic in the Western world. Furthermore, we outline the clinical implication of liver cancer metabolism and highlight the computation and systems biology approaches, such as genome-wide metabolic models, as a valuable tool allowing us to identify therapeutic targets and develop personalized treatments for liver cancer patients.
The role of the gut microbiome in the development of hepatobiliary cancers
Authors: Daniel Neil , Genua Flavia , Jenab Mazda , Mayén Ana-Lucia , Chrysovalantou Chatziioannou Anastasia , Keski-Rahkonen Pekka , Hughes David J.
Published: April 2023

Hepatobiliary cancers, including hepatocellular carcinoma and cancers of the biliary tract, share high mortality and rising incidence rates. They may also share several risk factors related to unhealthy western-type dietary and lifestyle patterns as well as increasing body weights and rates of obesity. Recent data also suggest a role for the gut microbiome in the development of hepatobiliary cancer and other liver pathologies. The gut microbiome and the liver interact bidirectionally through the “gut-liver axis,” which describes the interactive relationship between the gut, its microbiota, and the liver. Here, we review the gut-liver interactions within the context of hepatobiliary carcinogenesis by outlining the experimental and observational evidence for the roles of gut microbiome dysbiosis, reduced gut barrier function, and exposure to inflammatory compounds as well as metabolic dysfunction as contributors to hepatobiliary cancer development. We also outline the latest findings regarding the impact of dietary and lifestyle factors on liver pathologies as mediated by the gut microbiome. Finally, we highlight some emerging gut microbiome editing techniques currently being investigated in the context of hepatobiliary diseases. Although much work remains to be done in determining the relationships between the gut microbiome and hepatobiliary cancers, emerging mechanistic insights are informing treatments, such as potential microbiota manipulation strategies and guiding public health advice on dietary/lifestyle patterns for the prevention of these lethal tumors.
Efficiency of a polymer-coated phacoemulsification tip in cataract surgery
Authors: Cardenas Ivan A. , Ungricht Emilie L. , Zaugg Brian , Olson Randall J. , Pettey Jeff H.
Published: April 2023

Purpose:

To determine whether there is a difference in efficiency during phacoemulsification when using the hybrid polymer tip compared with the metal balanced tip, as measured by cumulative dissipated energy (CDE) and total procedure time.

Setting:

John A. Moran Eye Center, University of Utah, Salt Lake City, Utah.

Design:

Experimental study.

Methods:

Phacoemulsification was performed with the Centurion Vision System and Infiniti OZil handpiece, with a 30-degree bevel metal balanced tip and hybrid polymer tip. The vacuum was set at 500 mm Hg and the aspiration flow rate at 50 mL/min. Power was changed for torsional and longitudinal ultrasound (US) at 20%, 40%, 60%, 80%, and 100%. Hardened porcine lenses were cut into 200 two mm cubes, 10 for each specified tip/power setting. They were placed into an artificial anterior chamber filled with a balanced salt solution, and phacoemulsification was performed. A second observer randomly assigned the US type and power. The same observer timed trials with a stopwatch, and CDE was recorded.

Results:

There were no significant differences in time or CDE for any power levels or US modes when comparing the 2 tips.

Conclusions:

No significant difference in efficiency was observed when comparing the metal balanced tip with the hybrid polymer tip. Given the known improved safety profile and the overall equivalent efficiency of the hybrid tip, it could improve the performance of beginning and advanced surgeons in the future. Future study is needed to evaluate other setting combinations and to evaluate the hybrid tip in clinical settings.
Outcomes after microsurgical treatment of lymphedema: a systematic review and meta-analysis
Authors: Meuli Joachim N. , Guiotto Martino , Elmers Jolanda , Mazzolai Lucia , di Summa Pietro G.
Published: April 2023

Background:

Microsurgical treatment options for lymphedema consist mainly of lymphovenous anastomosis (LVA) and vascularized lymph node transfers (VLNTs). There are no standard measurements of the effectiveness of these interventions and reported outcomes vary among studies.

Methods:

A systematic review and meta-analysis were performed based on a structured search in Embase, Medline, PubMed, Cinahl, Cochrane, and ProQuest in October 2020, with an update in February 2022. Firstly, a qualitative summary of the main reported outcomes was performed, followed by a pooled meta-analysis of the three most frequently reported outcomes using a random effects model. Randomized controlled trials, prospective cohorts, retrospective cohorts, and cross-sectional and case–control studies that documented outcomes following microsurgery in adult patients were included. Studies of other surgical treatments (liposuction, radical excision, lymphatic vessel transplantation) or without reported outcomes were excluded. The study protocol was registered on PROSPERO (International Prospective Register of Systematic Reviews) (ID: CRD42020202417). No external funding was received for this review.

Results:

One hundred fifty studies, including 6496 patients, were included in the systematic review. The qualitative analysis highlighted the three most frequently reported outcomes: change in circumference, change in volume, and change in the number of infectious episodes per year. The overall pooled change in excess circumference across 29 studies, including 1002 patients, was −35.6% [95% CI: −30.8 to −40.3]. The overall pooled change in excess volume across 12 studies including 587 patients was −32.7% [95% CI: −19.8 to −45.6], and the overall pooled change in the number of cutaneous infections episodes per year across 8 studies including 248 patients was −1.9 [95% CI: −1.4 to −2.3]. The vast majority of the studies included were case series and cohorts, which were intrinsically exposed to a risk of selection bias.

Conclusion:

The currently available evidence supports LVA and vascularized lymph node transfers as effective treatments to reduce the severity of secondary lymphedema. Standardization of staging method, outcomes measurements, and reporting is paramount in future research in order to allow comparability across studies and pooling of results.
Quantization of extraoral free flap monitoring for venous congestion with deep learning integrated iOS applications on smartphones: a diagnostic study
Authors: Hsu Shao-Yun , Chen Li-Wei , Huang Ren-Wen , Tsai Tzong Yueh , Hung Shao-Yu , Cheong David Chon-Fok , Lu Johnny Chuieng-Yi , Chang Tommy Nai-Jen , Huang Jung-Ju , Tsao Chung-Kan , Lin Chih-Hung , Chuang David Chwei-Chin , Wei Fu-Chan , Kao Huang-Kai
Published: April 2023

Background:

Free flap monitoring is essential for postmicrosurgical management and outcomes but traditionally relies on human observers; the process is subjective and qualitative and imposes a heavy burden on staffing. To scientifically monitor and quantify the condition of free flaps in a clinical scenario, we developed and validated a successful clinical transitional deep learning (DL) model integrated application.

Material and Methods:

Patients from a single microsurgical intensive care unit between 1 April 2021 and 31 March 2022, were retrospectively analyzed for DL model development, validation, clinical transition, and quantification of free flap monitoring. An iOS application that predicted the probability of flap congestion based on computer vision was developed. The application calculated probability distribution that indicates the flap congestion risks. Accuracy, discrimination, and calibration tests were assessed for model performance evaluations.

Results:

From a total of 1761 photographs of 642 patients, 122 patients were included during the clinical application period. Development (photographs =328), external validation (photographs =512), and clinical application (photographs =921) cohorts were assigned to corresponding time periods. The performance measurements of the DL model indicate a 92.2% training and a 92.3% validation accuracy. The discrimination (area under the receiver operating characteristic curve) was 0.99 (95% CI: 0.98–1.0) during internal validation and 0.98 (95% CI: 0.97–0.99) under external validation. Among clinical application periods, the application demonstrates 95.3% accuracy, 95.2% sensitivity, and 95.3% specificity. The probabilities of flap congestion were significantly higher in the congested group than in the normal group (78.3 (17.1)% versus 13.2 (18.1)%; 0.8%; 95% CI, P<0.001).

Conclusion:

The DL integrated smartphone application can accurately reflect and quantify flap condition; it is a convenient, accurate, and economical device that can improve patient safety and management and assist in monitoring flap physiology.
“The First Documented Experience of Qi and an Account of Healing Failure: 4th Century BCE”
Authors: Cook Constance A.
Published: April 2023

This essay will review the earliest case that documents a patient’s experience of qi, one found on a bamboo text buried with the patient who died in the 318 BCE. Details of the healing encounter and of concepts of illness show how non-transmitted documents hidden from later editors in tombs preserve an older layer of medical understanding than that in transmitted canons, such as the Huang Di Nei Jing (Inner Canon of the Yellow Emperor).The 4th-century BCE case record described below is the longest early medical record concerning the treatment of a specific individual. It is also an account of failure formally recorded for the sake of the survivors and buried with the dead to be transmitted to the world of the spirits. The essay begins with a reevaluation of ancient concept of qi and then moves on to the individual case record.
Effect of Ginseng Extract Ginsenoside Rg1 on Mice with Intracerebral Injury
Authors: Zhuang Zixin , Chen Jinman , Xu Hao , Wang Yongjun , Liang Qianqian
Published: April 2023

Background:

Traditional Chinese medicine has a long history of treating intracerebral injury. The aim of this research is to test the hypothesis that Ginsenoside Rg1 can alleviate brain injury in subarachnoid hemorrhage (SAH) mice.

Methods:

SAH mice were induced by autologous blood injection into cisterna magna, the mortality and neurological function were assessed. Ginsenoside Rg1 was administered continuously for 7 days after SAH. Then, Y-maze test was used to detect the neurological deficits. Brains were harvested to evaluate the neuroinflammation of SAH by immunofluorescence staining and flow cytometry. Cerebral vasospasm was evaluated by hematoxylin-eosin (HE) staining, and neuronal apoptosis was evaluated by TdT-mediated dUTP Nick-End Labeling (TUNEL) staining and HE staining.

Results:

We demonstrate that Ginsenoside Rg1 reduced mortality and improved neurological deficits, reduced inflammatory response, ameliorated cerebral vasospasm, and neuronal apoptosis after SAH.

Conclusion:

Ginsenoside Rg1 can alleviate brain damage after SAH in mice.
Idiopathic calcinosis cutis of the buttocks: A case report and review of the literature
Authors: E Tian-Yu , Yang Xin-Jun , Bi Chen , Xue Feng , Cao Yong-Qian
Published: April 2023

Rationale:

Calcinosis cutis is a rare skin disease, and idiopathic cases are rarely reported. It is characterized by the deposition of insoluble calcium salts in the skin, subcutaneous tissue, superficial muscles, and tendon sheaths. However, no abnormal changes were found in the bone. In this article, we introduce a case of idiopathic calcinosis cutis of the buttocks with a long course and large lesion area.

Patient concerns:

A 51-year-old male patient was admitted to the hospital with a chief complaint of ‘Due to the discovery of hard nodules with pruritus in the buttocks for 32 years. The patient was a male who was 51 years old. He has been in good health and reported no history of surgery, trauma, infection, metabolic disease, tumor, or other diseases. There was no family history. It is worth noting that the patient has the occupation of driving trucks, which keeps him sedentary.

Diagnoses:

The accurate diagnosis of calcinosis cutis was confirmed by postoperative histopathological examination with many local calcifications and multinucleated giant cells in subcutaneous tissue.

Interventions:

The patient underwent skin lesion excision and autologous skin grafting under general anesthesia. A medium-thickness skin graft from the left lateral thigh was transplanted into the hip operation area, and a bolus tie-over pressure dressing was applied. After the operation, the patient received anti-infection treatment and was advised to rest in the prone position to prevent extrusion of the operation area.

Outcomes:

The postoperative recovery was good, and there was no recurrence after 4 months of follow-up.

Lessons:

The incidence rate of cutaneous calcinosis is not clear. This patient had a large lesion area, long onset time, an invasion of the fat layer, and the onset site was located in the sacrococcygeal region. It is necessary to choose appropriate treatment methods.
Banded versus non-banded sleeve gastrectomy: A systematic review and meta-analysis
Authors: Chaouch Mohamed Ali , Yang Wah , Gouader Amine , Krimi Bassem , Carneiro da Costa Adriano , Pourcher Guillaume , Oweira Hani
Published: April 2023

Background:

Laparoscopic banded sleeve gastrectomy (LBSG) has been compared to laparoscopic sleeve gastrectomy (LSG) in terms of anthropometric results and postoperative complications, which are controversial. This systematic review and meta-analysis aimed to compare the safety and efficacy of LBSG and LSG.

Methods:

We performed a systematic review with meta-analysis according to preferred reporting items for systematic review and meta-analysis 2020 and assessing the methodological quality of systematic review 2 guidelines. We included studies that systematically searched electronic databases and compared LBSG with LSG conducted until August 10, 2021.

Results:

The literature search yielded 8 comparative studies. Seven hundred forty-three patients were included: 352 in the LBSG group and 391 in the LSG group. LBSG group allowed greater anthropometric parameters (body mass index [BMI] after 1 year (mean difference [MD] = −3.18; 95% CI [−5.45, −0.92], P = .006), %EWL after 1 year (MD = 8.02; 95% CI [1.22, 14.81], P = .02), and %EWL after 3 years (MD = 10.60; 95% CI [5.60, 15.69], P < .001) and similar results with LSG group in terms of operative time (MD = 1.23; 95% CI [−4.71, 7.17], P = .69), food intolerance (OR = 1.72; 95% CI [0.84, 3.49], P = .14), postoperative vomiting (OR = 2.10; 95% CI [0.69, 6.35], P = .19), and De novo GERD (OR = 0.65; 95% CI [0.34, 1.26], P = .2). Nevertheless, major postoperative complications did not differ between the 2 groups.

Conclusions:

This systematic review and meta-analysis comparing LBSG and LSG concluded that banding sleeve gastrectomy (SG) may ensure a lower BMI and %EWL after 1 year of follow-up, and a significant reduction in %EWL after 3 years of follow-up. There is no evidence to support LBSG in vomiting, de novo GERD, food intolerance, or operative time.
Efficacy and safety of acupuncture in the treatment of stroke complicated with sleep apnea syndrome: A systematic review and meta-analysis of randomized controlled trials
Authors: Gao Huanyu , Kan Zunqi , Fang Yuqing , Wang Ning , Yan Wenli , Yang Mengqi , Song Yongmei
Published: April 2023

Background:

stroke patients often have a combination of sleep apnea syndrome, which is an important and modifiable risk factor for stroke prognosis. Acupuncture is one of the measures for sleep apnea syndrome, and it is also widely used in stroke. However, we are concerned that its efficacy and safety in the treatment of stroke with sleep apnea syndrome are not yet clear.

Methods:

This systematic review and meta-analysis was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses schema and was registered with INPLASY (registration number: INPLASY202250113). The following 8 databases were searched: PubMed, Cochrane Library (CENTRAL), Embase, Web of Science, China National Knowledge Infrastructure, Chongqing VIP Information, WanFang Data, and China Biomedical Literature Database limited from the establishment of each database to May 4, 2022. Subject headings, free words, and keywords were used for retrieval. Relevant literature was supplemented by consulting other resources. We assessed the risk of bias in the included studies using the Cochrane risk of bias tool. RevMan 5.4 software (The Cochrane Collaboration, 2020) was used to perform the meta-analysis.

Results:

Six records were included, including a total of 513 participants: 256 in the experimental group and 257 in the control group. The results showed that the total effective rate (relative risk = 1.23, 95% confidence interval (CI): 1.13, 1.34, P < .00001), apnea-hypopnea index (mean difference (MD) = −8.39, 95% CI: −9.19, −7.59, P < .00001), Epworth Sleepiness Scale score (MD = −1.59, 95% CI: −2.66, −0.52, P = .004), minimal oxygen saturation (MD = 4.99, 95% CI: 3.5, 6.47, P < .00001), longest duration of apnea (MD = −7.47, 95% CI: −8.97, −5.97, P < .00001), longest duration of apnea (MD = −6.48, 95% CI: −8.60, −4.35, P < .00001), and S100β levels (standard mean difference = −1.52, 95% CI: −1.87, −1.18, P < .00001) were better in the experimental group than in the control group. Simultaneously, the effect of reducing the neuron-specific enolase level in the experimental group was comparable to that in the control group (MD = -3.40, 95% CI: −9.08, 2.29, P = .24).

Conclusions:

Acupuncture can improve the clinical symptoms and related laboratory indicators for sleep apnea syndrome in patients with stroke. More high-quality trials remain urgently needed.
Impact of sentinel lymph node assessment on the outcomes of patients with advanced endometrial cancer: A meta-analysis
Authors: Yao Huiyi , Luo Ruiwen , Tong Ruoyi , Wei Yanwen , Zheng Kaiteng , Hu Xiangdan
Published: April 2023

Background:

Sentinel lymph node (SLN) assessment is used to treat early endometrial cancer; however, its application in advanced endometrial cancer remains controversial. Therefore, we assessed the effects of SLN assessment and lymphadenectomy (LND) on the prognosis (survival rate and primary outcome) of patients with advanced endometrial cancer.

Methods:

Pertinent studies were selected from PubMed, Embase, Web of Science, and the Cochrane Library until March 19, 2022. Relevant studies were strictly screened according to the inclusion and exclusion criteria. Data from the included studies were extracted and their quality was evaluated. Then RevMan5.4 software was used for the meta-analysis.

Results:

Four retrospective studies were included, which enrolled 7181 patients; 492 were treated with SLN and 6689 with LND. In terms of overall survival, there was no significant difference between the 2 groups (odds ratio = 1.14, 95% confidence interval: 0.92–1.41, I
2 = 0%, P = .39).

Conclusions:

SLN assessment is an alternative to LND as a treatment modality for advanced endometrial cancer.
Endocrine characteristics and risk factors of type 2 diabetes complicated with gastrointestinal autonomic neuropathy: A single-center retrospective study
Authors: Guan Wei , Li Shan , Sun Wenzao , Kang Yuqin , Li Xiaoqin
Published: April 2023

To analyze endocrine characteristics and risk factors of type 2 diabetes mellitus (T2DM) gastrointestinal autonomic neuropathy. A total of 202 patients with T2DM with obesity who were hospitalized at our institute between January 2019 and June 2021 were selected. Based on adrenocorticotropic hormone (ACTH) levels, 102 patients were placed in the ACTH abnormal group and 100 patients were placed in the non-ACTH abnormal group. Ninety-five healthy adults without diabetes, hyperlipidemia, osteoporosis, or endocrine system abnormalities who were examined at our hospital during the same period were selected as the control group. Fasting plasma glucose (FPG), fasting insulin (FINS), triglycerides (TG), total cholesterol (TC), homeostasis model assessment of insulin resistance (HOMA-IR), ACTH level, body mass index (BMI), and bone mineral density (BMD) were measured to evaluate endocrine characteristics and risk factors. BMI, FPG, FINS, HOMA-IR, TG, TC, and ACTH levels in the abnormal ACTH group were significantly higher than those in the other 2 groups, while BMD was significantly lower than that in the other 2 groups (all P < .05). BMI, FPG, FINS, HOMA-IR, TG, TC, and ACTH in the non-ACTH abnormal group were significantly higher than those in the control group, whereas BMD was significantly lower than that in the control group (all P < .05). The plasma ACTH level in patients with abnormal ACTH levels was significantly positively correlated with BMI, FPG, FINS, HOMA-IR, TG, and TC and negatively correlated with BMD (all P < .05). Multivariate regression analysis showed that BMI, advanced age, FINS, TG, and FPG were risk factors for ACTH abnormalities in patients with diabetes (odds ratio > 1, all P < .05). BMI, advanced age, FINS, TG and FPG are the risk factors of abnormal ACTH in T2DM patients with gastrointestinal autonomic neuropathy.
Malignancy diseases and kidneys: A nephrologist prospect and updated review
Authors: Habas Elmukhtar , Akbar Raza , Farfar Kalifa , Arrayes Nada , Habas Aml , Rayani Amnna , Alfitori Gamal , Habas Eshrak , Magassabi Yaqeen , Ghazouani Hafidh , Aladab Aisha , Elzouki Abdel-Naser
Published: April 2023

Acute kidney injury (AKI), chronic renal failure, and tubular abnormalities represent the kidney disease spectrum of malignancy. Prompt diagnosis and treatment may prevent or reverse these complications. The pathogenesis of AKI in cancer is multifactorial. AKI affects outcomes in cancer, oncological therapy withdrawal, increased hospitalization rate, and hospital stay. Renal function derangement can be recovered with early detection and targeted therapy of cancers. Identifying patients at higher risk of renal damage and implementing preventive measures without sacrificing the benefits of oncological therapy improve survival. Multidisciplinary approaches, such as relieving obstruction, hydration, etc., are required to minimize the kidney injury rate. Different keywords, texts, and phrases were used to search Google, EMBASE, PubMed, Scopus, and Google Scholar for related original and review articles that serve the article’s aim well. In this nonsystematic article, we aimed to review the published data on cancer-associated kidney complications, their pathogenesis, management, prevention, and the latest updates. Kidney involvement in cancer occurs due to tumor therapy, direct kidney invasion by tumor, or tumor complications. Early diagnosis and therapy improve the survival rate. Pathogenesis of cancer-related kidney involvement is different and complicated. Clinicians’ awareness of all the potential causes of cancer-related complications is essential, and a kidney biopsy should be conducted to confirm the kidney pathologies. Chronic kidney disease is a known complication in malignancy and therapies. Hence, avoiding nephrotoxic drugs, dose standardization, and early cancer detection are mandatory measures to prevent renal involvement.
A leading author of meta-analysis does not have a dominant contribution to research based on the CJAL score: Bibliometric analysis
Authors: Chow Julie Chi , Ho Sam Yu-Chieh , Chien Tsair-Wei , Chou Willy
Published: April 2023

Background:

There have been nearly 200 thousand meta-analysis articles indexed by web of science (WoS) since 2013. To date, a bibliometric analysis of leading authors of meta-analyses that contribute to the field has not been conducted. Analyzing trend patterns in article citations and comparing individual research achievements (IRAs) are required following the extraction of meta-analysis articles. Using trend analysis, this study aims to verify the hypotheses that; The leading author has a dominant research achievement and; Recent articles that deserve worth reading can be identified.

Methods:

In the WoS collection, we identified the top 20 authors with the most articles related to meta-analysis. Using coword analysis, 2882 articles were collected to cluster author collaborations and identify the top 3 authors with the highest weighted centrality degrees. Based on the CJAL (category, journal raking by impact factor, authorship, and L-index on article citation) score and absolute advantage coefficient (AAC), we compared the IRAs and identified the author who dominated the field significantly beyond the next 2 authors. In WoS collection, coword analysis was used to highlight the characteristics of research domains for the top authors contributing to meta-analyses. The selection of articles that deserve reading is based on a temporal heatmap.

Results:

The top 2 authors were Young–Ho Lee (South Korea), Patompong Ungprasert (U.S.), and Brendon Stubbs (US) with CJAL scores of 240.71, 230.99, and 240.71, respectively. Based on the weak dominance coefficient (AAC = 0.49 < 0.50), it is evident that the leading meta-analysis author does not possess a significant dominant position over the next 2 leading authors in IRAs. Coword analysis was used to illustrate the characteristics of the 3 authors research domains. The 3 articles worth reading were selected based on a trend analysis of the last 4 years using the temporal heatmap.

Conclusion:

A coword analysis of meta-analysis studies identified 3 leading authors. There was no evidence that 1 author possessed a dominant position due to the lower AAC (=0.49 < 0.50) for the leading author. As we have demonstrated in this study, the CJAL score and the AAC can be applied to many bibliographical studies in the future.