bluuebunny/crossref_metadata_2025 huggingface dataset:
O154 Outcomes of bariatric surgery among patients with obstructive sleep apnoea: a systematic review, meta-analysis and a retrospective database analysis
Authors: Katasani T , Aldafas R , Holt G , Alkhyatt W , Idris I
Published: May 2023

Introduction

Obstructive sleep apnoea (OSA) is highly prevalent among patients undergoing bariatric surgery. Previous studies have reported a higher risk of complications, longer hospital stays and ICU admissions among OSA patients following general surgery but clinical outcomes following bariatric surgery remain unclear. Therefore, we evaluated the risk of adverse outcomes among OSA patients undergoing bariatric surgery.

Methods

We undertook a systematic review and meta-analysis followed by retrospective database analysis. Searches were performed using PubMed and Ovid Medline. Bariatric surgery studies that compared OSA and non-OSA patients that utilised outcome measures that included length of stay, risk of complications, readmission within 30 days and need for ICU admission were selected. Retrospective data analysis of patient records was conducted from the Royal Derby Hospital (RDH) bariatric surgery database by comparing OSA patients (N=49) and non-OSA (N=86) patients using the same outcome measures.

Results

Patients with OSA are at greater risk of complications after bariatric surgery (RR=1.23; CI:1.01,1.5, P=0.04), driven largely by an increased risk of cardiac complications (RR=2.44; CI:1.26,4.76, P=0.009). There were no significant differences between the OSA and non-OSA cohorts in the other outcome variables. Clinical evaluation at RDH showed no significant differences between OSA and non-OSA patients in terms of length of stay, need for ICU admission, risk of complications and 30-day readmission.

Conclusion

Following bariatric surgery, patients with OSA must be managed carefully due to the increased risk of cardiac complications. However, patients with OSA are not more likely to require a longer length of stay or readmission.
O155 Effects of oral feeding on gastric emptying and gastrointestinal hormone secretion in males with obesity compared with those of healthy weight
Authors: Simpson E J , Althubeati S , Cordon S , Bush D , Hoad C , Eldeghaidy S , Gowland P , Macdonald I A , Lobo D N
Published: May 2023

Introduction

Hormones released in response to nutrients in the gastrointestinal (GI) tract, act as physiological signals to regulate appetite and play a role in feeding behaviours. Altered secretion of these ‘appetite’ hormones after feeding in those with obesity (‘Obese’), compared to those with healthy weight (‘Lean’), may drive over-consumption of energy. This study assessed whether gastric emptying rate was implicated in this altered response.

Methods

Twenty healthy males attended the laboratory once in the morning after an overnight fast. Volume of gastric contents (GCV) and small bowel water (SBW) were assessed using MRI (Philips 3T Ingenia and dStream Anterior Coil) pre, immediately post and every 30-minutes for 4-hours after a standard meal (2.5MJ, 78g Carbohydrate, 24g Protein, 21g Fat). Concurrently, arterialised-venous blood was taken for insulin, ghrelin, GLP-1 and PYY evaluation. Gastric emptying (T50) was derived from GCV. Data are presented as the mean (SD) or standardised effect size (ηp2).

Results

10 Lean [38(14)y, 24(2) kg/m2] and 10 Obese [38(13)y, 34(3)kg/m2] were studied. Fasting insulin [12.5(5.8) vs. 17.6(11.3) mIU/l], Ghrelin [3.2(2.1) vs. 2.9(0.9) ng/ml], GLP-1 [7.2(11.5) vs. 13.3(2.5) pmol/l], PYY [102.3(46.7) vs. 88.4(32.4)pg/ml], SBW [121(96) vs. 168(125)ml] and GCV [59(33) vs. 59(30)ml] did not differ between ‘Lean’ and ‘Obese’. Response of Ghrelin (ηp2=0.005), GLP-1 (ηp2=0.103), PYY (ηp2=0.050) and SBWC (ηp2=0.145) to eating, and T50 [148(51) vs. 170(49) min] did not differ between groups. However, postprandial insulin secretion was greater in obese (ηp2=0.286; P<0.05).

Conclusion

Gastric emptying and incretin hormone secretion were not altered in participants with obesity. However, postprandial hyperinsulinemia, associated with insulin resistance, was observed.
O159 Nonselective alpha blockade alone is associated with a significant decrease in ICU/CCU requirement following phaeochromocytoma resection
Authors: Viani Walsh D , Calpin G , O’Reilly M , Hill A , Sherlock M , Thompson C
Published: May 2023

Introduction

Preoperative treatment with alpha blockade is key to optimisation of patients with phaeochromocytoma. Beta blockers may be employed after optimal alpha blockade to prevent reflex tachycardia. The principle of treatment is to avoid severe intraoperative hypertension or hypotension, but the optimal perioperative regimen is unclear. Recent studies have suggested that dual blockade may increase the rate of intraoperative haemodynamic instability We hypothesized that nonselective alpha blockade alone, without addition of beta blockers, would reduce the need for postoperative ICU/CCU supportive care.

Methods

A retrospective study of all patients undergoing pheochromocytoma/paraganglioma resection between 1998 and 2022 was performed. Patients were categorized into two cohorts: Group 1 patients received alpha and beta blockers preoperatively while Group 2 patients received nonselective alpha blockade alone. The primary endpoint was the need for ICU/CCU support.

Results

Of 40 patients identified, adrenalectomy was performed in 36. Median age at resection was similar for both groups (63 v 56 years). Of 22 Group 1 patients 8 (36.4%) required ICU/CCU admission due to haemodynamic instability, (MLS 1.22 days) compared to 3 (21.4%) of the 14 Group 2 (MLS 0.21, p=0.035; one-tailed Two-Sample t-test assuming unequal variance). Median maximum diameter of lesions in Group 1 was 5.4cm, while Group 2 was 4.2cm. In Group 1 59% showed right adrenal disease (n=13), Group 2 43% (n=6).

Conclusion

Our study suggests that nonselective alpha blocker alone, without the addition of beta blockers, is associated with a significantly decreased requirement for post-operative support in the ICU or CCU following pheochromocytoma resection.
O168 A review of oral and oropharyngeal subsite classification and the impact on long-term speech and swallow function of patients with oncological reconstruction
Authors: Awad L , Langridge B , Sinha D , Govender R , Noy D , Butler P , Kalavrezos N
Published: May 2023

Introduction

The oral cavity and oropharynx can be divided into subsites by function or anatomically. The impact on function following reconstruction of one or more subsites with flap surgery is largely unknown. This systematic review aims to assess how subsites are classified, which assessment tools are used to assess speech and swallow, and long-term outcomes following reconstruction.

Methods

A systematic review of PubMed, Web of Science and Embase was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). All types of articles were included which contained speech and swallow follow up for oncological flap reconstruction of the oral cavity and oropharynx, except case reports.

Results

The search resulted in 26 studies with a total of 2,270 patients. Subsites were variably classified ranging from 2-18 per study. Most articles classified subsites anatomically and less commonly functionally grouped subsites. Fewer than half considered the impact of unilateral/bilateral/combination defects. Poorer post-operative function was found for reconstruction of base of tongue, floor of mouth and defects crossing the midline with the best results for lateral reconstruction. The University of Washington Quality of Life Questionnaire (UW-QOL) was the most prevalent measure of function. Subsite was considered impactful for speech and swallow in 76% and 57% of articles respectively.

Conclusion

Subsite categorisation is extremely variable within the current literature. Subsite reconstruction with flap surgery significantly affects swallow and speech. A consistent and formalised approach, risk stratifying for multiple contributing factors would be useful in clinical pre- and post-operative management.
O169 A systematic review on the effect of bone wax application in cardiac surgery
Authors: Shah A , Kuma N S , Raja S , Bhudia S
Published: May 2023

Introduction

Limited and conflicting evidence exists on whether bone wax usage in cardiac surgery increases risk of infection. A systematic review was conducted to examine the cardiac surgery postoperative outcomes following bone wax application.

Method

Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were adhered to in this review. The EMBASE, MEDLINE and Scopus databases were searched for studies evaluating perioperative bone wax usage, excluding non-English papers. All relevant synonyms of Cardiac Surgery, Bone Wax, Infection, and Healing were used for paper identification. Wound infection, sternal dehiscence, postoperative sternal bleeding, postoperative chest drainage and mortality were outcomes of interest.

Results

From the 66 articles identified, 5 were included following full-text screening. No statistically significant difference in infection risk between the bone wax (BW) and comparator groups existed. However, the evidence suggests bone wax significantly increases sternal dehiscence risk. Studies reporting postoperative bleeding showed a significantly greater mean volume in the BW group. All studies reporting postoperative chest drainage (n=3) showed a greater mean volume in the BW group, of which two were significant. Of the three papers reporting mortality, two showed increased risk in the BW group.

Conclusion

Current evidence indicates no significant association between bone wax and wound infection. Bone wax is associated with increased risk of sternal dehiscence, postoperative sternal bleeding, postoperative chest drainage and mortality. Greater emphasis should be placed on bone wax alternatives in clinical practice. Limited data necessitates larger studies, and for clearer guidelines to be established around them.
P02 Surgeon's narcissism, hostility, stress and meaning in life
Authors: El Boghdady M , Ewalds-Kvist B
Published: May 2023

Introduction

Disruptive physician behaviour can affect patients’ safety. If surgical trainees throughout higher education experience disruptive behaviour, impaired work-life may follow. Therefore, we studied if surgeons were prone to disruptive behaviour in form of narcissism (N), hostility, perceived stress and the presence of meaning in life.

Methods

General surgeons in UK National Health Service from 2 hospitals participated with 3 level of training: senior house officer (SHO), specialist registrars (SPR) and consultants (CONS). Participants completed 52 VAS-formed questions plus demographics. Modified questionnaires were used for assessments of ‘Hostility’, ‘Narcissism’, Meaning in life, Quality of work-life and bullying.

Results

Altogether 33% of surgeons displayed narcissism and 22% could exhibit disruptive behaviour. By MANOVA significant differences between low, medium and high N groups was revealed in hostility (p<.01), perceived stress (p=.001), presence of meaning in life (p<.05). Regression analyses explained hostility both by N-scale (p=.000) and ‘being bullied during training’(p=.009) but negatively by ‘presence of meaning in life’(p=.004). Surgeons’ perceived stress was explained both by N-scale (p=.000) followed by ‘seeing others bullied during training (p=.000) and negatively by ‘working extra days beyond schedule’ (p=.007). Presence of meaning in life was explained mostly by ‘(eu)stress’ (p= .000) but negatively both by ‘doing extra work beyond schedule’ (p= .016) and hostility (p= .003).

Conclusion

Surgeons may exhibit disruptive behaviour in a challenging situation. Being bullied during surgical training predicted hostility. Seeing others being bullied during surgical training predicted stress. Eustress explained best surgeons’ experience of presence of meaning in life.
P04 The relationship between air travel and postoperative venous thromboembolism: a systematic review and meta-analysis
Authors: Ghosh A , Shea J , Turner B , Onida S , Davies A
Published: May 2023

Introduction

Surgery is a well-established risk factor for venous thromboembolism (VTE), with fatal pulmonary embolism (PE) remaining the most common preventable death in post-operative patients. Air travel has also been identified as an independent risk factor for VTE, however, there is no guidance on whether air travel in addition to surgery exacerbates this risk. With the increased rates of health tourism, patients increasingly fly to seek surgical intervention. This systematic review and meta-analysis pools published literature to estimate the additional risk of recent air travel after surgery.

Methods

Articles reporting post-operative VTE incidence in adults with recent air travel were included in our review with data pooled using fixed and random effects. Our primary outcome measured the pooled VTE risk.

Results

Seven retrospective studies were included with a total of 24975 patients. The odds ratio (OR) of VTE in the flying plus surgery group was 1.96 (95%CI 0.54-7.08). In subgroup analysis of patients with over 4 hours of air travel, odds of VTE were 2.35 (95%CI 0.29-19.36). The incidence of DVT and PE specifically was 0.67% (95%CI 0.31%-1.51%) and 0.41% (95%CI 0%-1.29%) respectively in the flying and surgery group and 0.45% (95%CI 0.10%-2.00%) and 0.55% (95%CI 0.31%-0.86%) in the surgery alone group.

Conclusion

The meta-analysis demonstrates heterogeneity in studies and a very low certainty of evidence overall considering imprecision and observational study designs. Whilst results did not demonstrate significant increase in VTE risk, further studies should propensity match patients in the cohort to reduce the effect of confounding.
P06 Prediction of surgical-site infection (SSI) in adult patients undergoing gastrointestinal surgery: a systematic review of prognostic risk models
Authors: McLean K , Goel T , Lawday S , Riad A , Simoes J , Knight S , Ghosh D , Glasbey J , Bhangu A , Harrison E
Published: May 2023

Introduction

Surgical site infections (SSI) are among the most common postoperative complications following gastrointestinal surgery. This review aimed to identify and evaluate prognostic tools for prediction of SSI in gastrointestinal surgery.

Methods

Studies describing the development or validation of prognostic models for 30-day SSI after gastrointestinal surgery were identified (PROSPERO: CRD42022311019). An English language restricted search of MEDLINE, EMBASE, and EBSCO was undertaken from 1st January 2000 to 31st December 2021. Studies were excluded if prognostic models included postoperative parameters, or were procedure-specific. Quality assessment was undertaken using TRIPOD and PROBAST guidelines, with narrative synthesis comparing discrimination (area under the curve [AUROC]) and prognostic accuracy between models.

Results

Of 2953 records reviewed, 23 eligible prognostic models were identified. Thirteen (56.5%) reported no internal validation, and only 4 (17.4%) had undergone external validation. Most identified operative contamination (54.5%, n=12) and duration (54.5%, n=12) as important predictors, however, there remained substantial heterogeneity in other predictors identified (range: 2-28). All models demonstrate a high risk of bias due to analytic approaches, with overall low applicability to an undifferentiated gastrointestinal surgical population. Model discrimination was reported in most studies (86.4%, n=19); however, calibration (22.7%, n=5) and prognostic accuracy (18.2%, n=4) was infrequently assessed. Of externally validated scores (n=4), none displayed “good” discrimination (AUROC ≥0·70).

Conclusion

The risk of SSI following gastrointestinal surgery is insufficiently described by existing risk prediction tools, which are not suitable for routine use. Novel risk stratification tools are required to target perioperative interventions and mitigate modifiable risk factors.
P20 An audit of the effectiveness of a prehabilitation programme in patients having surgery for cancer
Authors: Truslove E , James M , Beed M , Lobo D N , Haywood A , Burrows A , Morgan B , Wilson V , Evans D
Published: May 2023

Introduction

Three prehabilitation programmes for patients undergoing surgery for cancer, based around initial physical activity scores, commenced April 2022. An audit of key outcomes was undertaken on patients enrolled onto the main programmes.

Methods

Patients with cancer requiring surgery were initially assessed (April to Oct 2022) and offered 2-3 sessions per week at one of: a community-based gym with registered trainers, a hospital-based gym, or a programme to train at home. Here we report physical activity scores and incremental shuttle walk test at the beginning and end of the programme, in addition to the hospital length of stay (LoS).

Results

The mean (±sem) physical activity score for hospital gym patients (54.4±18.3, n=23) was significantly lower (p<0.001) than for those attending the community gym (180.5±26.5 n=47), but both groups showed a significant improvement (p<0.001) at the end of the programme (216.7±18.3 and 362.0±31.0, respectively). The initial mean (±sem) incremental shuttle walk test score for the hospital gym patients (126.5±19.8, n=17) was significantly lower than for those attending community gyms (415.6±30.1, n=34), but only those at the latter (487.1±29.1) managed a significant increase (p<0.001). Thirty-seven patients requiring colon surgery completed the prehabilitation programme. The median (IQR) LoS [5.2 (3.4-7.3) days] was significantly lower for these patients (p<0.05) compared with those at NUH who did not enter the programme [5.6 days (4.3-8.2) n=567].

Conclusion

The prehabilitation programme increased physical activity for both normal and frail patients with cancer prior to surgery and this was associated with a reduction in LoS.
Healthcare Utilization After Respiratory Tuberculosis: A Controlled Interrupted Time Series Analysis
Authors: Romanowski Kamila , Law Michael R , Karim Mohammad Ehsanul , Campbell Jonathon R , Hossain Md Belal , Gilbert Mark , Cook Victoria J , Johnston James C
Published: May 2023

Background

Despite data suggesting elevated morbidity and mortality among people who have survived tuberculosis disease, the impact of respiratory tuberculosis on healthcare utilization in the years following diagnosis and treatment remains unclear.

Methods

Using linked health administrative data from British Columbia, Canada, we identified foreign-born individuals treated for respiratory tuberculosis between 1990 and 2019. We matched each person with up to four people without a tuberculosis diagnosis from the same source cohort using propensity score matching. Then, using a controlled interrupted time series analysis, we measured outpatient physician encounters and inpatient hospital admissions in the 5 years following respiratory tuberculosis diagnosis and treatment.

Results

We matched 1216 individuals treated for respiratory tuberculosis to 4864 non-tuberculosis controls. Immediately following the tuberculosis diagnostic and treatment period, the monthly rate of outpatient encounters in the tuberculosis group was 34.0% (95% confidence interval [CI]: 30.7%, 37.2%) higher than expected, and this trend was sustained for the duration of the post-tuberculosis period. The excess utilization represented an additional 12.2 (95% CI: 10.6, 14.9) outpatient encounters per person over the post-tuberculosis period, with respiratory morbidity a large contributor to the excess healthcare utilization. Results were similar for hospital admissions, with an additional 0.4 (95% CI: .3, .5) hospital admissions per person over the post-tuberculosis period.

Conclusions

Respiratory tuberculosis appears to have long-term impacts on healthcare utilization beyond treatment. These findings underscore the need for screening, assessment, and treatment of post-tuberculosis sequelae, as it may provide an opportunity to improve health and reduce resource use.
Quantifying changes in umbilicus size to estimate the relative age of neonatal blacktip reef sharks (Carcharhinus melanopterus)
Authors: Debaere Shamil F , Weideli Ornella C , Bouyoucos Ian A , Eustache Kim B , Trujillo José E , De Boeck Gudrun , Planes Serge , Rummer Jodie L
Published: May 2023

Sharks can incur a range of external injuries throughout their lives that originate from various sources, but some of the most notable wounds in viviparous shark neonates are at the umbilicus. Umbilical wounds typically heal within 1 to 2 months post-parturition, depending on the species, and are therefore often used as an indicator of neonatal life stage or as a relative measure of age [e.g. grouping by umbilical wound classes (UWCs), according to the size of their umbilicus]. To improve comparisons of early-life characteristics between studies, species and across populations, studies using UWCs should integrate quantitative changes. To overcome this issue, we set out to quantify changes in umbilicus size of neonatal blacktip reef sharks (Carcharhinus melanopterus) around the island of Moorea, French Polynesia, based on temporal regression relationships of umbilicus size. Here, we provide a detailed description for the construction of similar quantitative umbilical wound classifications, and we subsequently validate the accuracy of our classification and discuss two examples to illustrate its efficacy, depletion rate of maternally provided energy reserves and estimation of parturition period. A significant decrease in body condition in neonatal sharks as early as twelve days post-parturition suggests a rapid depletion of in utero-allocated energy reserves stored in the liver. Back calculations of timing of birth based on the umbilicus size of neonates determine a parturition season from September to January, with most parturitions occurring during October and November. As such, this study contributes valuable data to inform the conservation and management of young-of-the-year blacktip reef sharks, and we therefore encourage the construction and use of similar regression relationships for other viviparous shark species.
OncoCardioDB: a public and curated database of molecular information in onco-cardiology/cardio-oncology
Authors: Riffo-Campos Angela L , Domingo Juan , Dura Esther
Published: May 2023

Numerous studies have been published which, separately, investigate the influence of molecular features on oncological and cardiac pathologies. Nevertheless, the relationship between both families of diseases at the molecular level is an emerging area within onco-cardiology/cardio-oncology. This paper presents a new open-source database that aims to organize the curated information concerning the molecular features validated in patients involved in both cancer and cardiovascular diseases. Entities like gene, variation, drug, study and others are modelled as objects of a database which is populated with curated information from 83 papers identified by systematic literature searched for up to 2021. Researchers will discover new connections among them to validate hypotheses or suggest new ones. Special care has been taken to use standard nomenclature for genes, pathologies and all the objects for which accepted conventions exist. The database can be consulted via the web with a system of simplified queries, but it also accepts any query. It will be updated and refined with the incorporation of new studies as they become available.

Database URL http://biodb.uv.es/oncocardio/
Soil microbial communities are sensitive to differences in fertilization intensity in organic and conventional farming systems
Authors: Lori Martina , Hartmann Martin , Kundel Dominika , Mayer Jochen , Mueller Ralf C , Mäder Paul , Krause Hans-Martin
Published: May 2023

Intensive agriculture has increased global food production, but also impaired ecosystem services and soil biodiversity. Organic fertilization, essential to organic and integrated farming, can provide numerous benefits for soil quality but also compromise the environment by polluting soils and producing greenhouse gases through animal husbandry. The need for reduced stocking density is inevitably accompanied by lower FYM inputs, but little research is available on the impact of these effects on the soil microbiome. We collected soil samples from winter wheat plots of a 42-year-old long-term trial comparing different farming systems receiving farmyard manure at two intensities and measured soil quality parameters and microbial community diversity through DNA metabarcoding. High-input fertilization, corresponding to 1.4 livestock units (LU) improved the soil’s nutritional status and increased soil microbial biomass and respiration when compared to low-input at 0.7 LU. Bacterial and fungal α-diversity was largely unaffected by fertilization intensity, whereas their community structure changed consistently, accompanied by an increase in the bacterial copiotroph-to-oligotroph ratio in high-input systems and by more copiotrophic indicator OTUs associated with high than low-input. This study shows that reduced nutrient availability under low-input selects oligotrophic microbes efficiently obtaining nutrients from various carbon sources; a potentially beneficial trait considering future agroecosystems.
Message fatigue beyond the health message context: a replication and further extension of So et al. (2017)
Authors: Song Hyunjin , So Jiyeon
Published: May 2023

Repeated exposure to similar messages may be counterproductive, yet the majority of the extant research tends to neglect this possibility. Addressing this issue, So et al. (2017) conceptualized and operationalized the message fatigue construct within the health message context. We replicate their study in a climate change message context and extend their work by proposing and validating a shortened message fatigue scale. The results of a preregistered study (N = 620) show that the conceptual structure and correlates of message fatigue are well replicated: Climate change message fatigue retains the original factor structure, and it is positively correlated with counterargument and negatively correlated with attention and message elaboration. Moreover, their relationships with message fatigue are shown to be moderated by political ideology in a theoretically expected manner. The shortened message fatigue scale also exhibits adequate psychometric properties, offering a less cumbersome alternative to the original scale.
CmWRKY6–1–CmWRKY15-like transcriptional cascade negatively regulates the resistance to fusarium oxysporum infection in Chrysanthemum morifolium
Authors: Miao Weihao , Xiao Xiangyu , Wang Yuean , Ge Lijiao , Yang Yanrong , Liu Ye , Liao Yuan , Guan Zhiyong , Chen Sumei , Fang Weimin , Chen Fadi , Zhao Shuang
Published: May 2023

Chrysanthemum Fusarium wilt is a soil-borne disease that causes serious economic losses to the chrysanthemum industry. However, the molecular mechanism underlying the response of chrysanthemum WRKY to Fusarium oxysporum infection remains largely unknown. In this study, we isolated CmWRKY6–1 from chrysanthemum ‘Jinba’ and identified it as a transcriptional repressor localized in the nucleus via subcellular localization and transcriptional activation assays. We found that CmWRKY6–1 negatively regulated resistance to F. oxysporum and affected reactive oxygen species (ROS) and salicylic acid (SA) pathways using transgenic experiments and transcriptomic analysis. Moreover, CmWRKY6–1 bound to the W-box element on the CmWRKY15-like promoter and inhibited its expression. Additionally, we observed that CmWRKY15-like silencing in chrysanthemum reduced its resistance to F. oxysporum via transgenic experiments. In conclusion, we revealed the mechanism underlying the CmWRKY6–1–CmWRKY15-like cascade response to F. oxysporum infection in chrysanthemum and demonstrated that CmWRKY6–1 and CmWRKY15-like regulates the immune system.
Surgical technique for preventing lung torsion after right upper and lower bilobectomy
Authors: Eriguchi Daisuke , Imai Kentaro , Kajiwara Naohiro , Ikeda Norihiko
Published: May 2023

In cases of right upper and lower bilobectomy, careful manipulation is required to avoid lung torsion, as only the right middle lobe remains in the right thoracic cavity. We report a case of successful right upper and lower bilobectomy with no torsion of the middle lobe. Our technique prevents postoperative lung torsion by fixing the lung to the chest wall and pericardial fat with silk threads. In situations where lung torsion is a concern after lung resection, fixing the remaining lungs with silk thread is effective in preventing lung torsion.
Improving thermal performance of a ventilated tiled roof by using phase change materials
Authors: Bottarelli Michele , Baccega Eleonora , Gallero Francisco Javier González , Maestre Ismael Rodríguez , Pei Gang , Su Yuehong
Published: May 2023

The adoption of ventilated roofs and facades, as well as the integration of phase change materials (PCMs) in the building envelope, has proved to be effective as a passive cooling technique in reducing the solar heat gain through the building envelope during the summer period, therefore reducing the energy requirement for cooling. Even though much research focused on each of these strategies individually, their combination has not been deeply studied yet. Preliminary numerical studies were carried out on the application of PCMs on a pitched ventilated tiled roof, and the most effective position turned out to be the one suspended in the middle of the above sheathing ventilation (ASV) channel. Based on this conclusion and exploiting an existing mock-up facility, two equivalent pitched ventilated roofs with an air gap of 4 cm were built as coverage of two identical rooms, each one equipped with a fan coil, one with a 0.007-m PCM layer suspended in the middle of the ASV and the other one without. They were then tested under real conditions at the TekneHub Laboratory at the University of Ferrara. The behaviour of the two configurations were compared in terms of temperature, velocity of the air in the ASV, heat flux and energy requirement for cooling, which were monitored through T-type thermocouples, heat flow metre, anemometers and energy metres, respectively. The aim of the research was to validate the numerical results and confirm that the combination of the two strategies allows further improvement of roof performance.
Euler simulation of interacting particle systems and McKean–Vlasov SDEs with fully super-linear growth drifts in space and interaction
Authors: Chen Xingyuan , dos Reis Gonçalo
Published: May 2023

This work addresses the convergence of a split-step Euler type scheme (SSM) for the numerical simulation of interacting particle Stochastic Differential Equation (SDE) systems and McKean–Vlasov stochastic differential equations (MV-SDEs) with full super-linear growth in the spatial and the interaction component in the drift, and nonconstant Lipschitz diffusion coefficient. Super-linearity is understood in the sense that functions are assumed to behave polynomially, but also satisfy a so-called one-sided Lipschitz condition. The super-linear growth in the interaction (or measure) component stems from convolution operations with super-linear growth functions, allowing in particular application to the granular media equation with multi-well confining potentials. From a methodological point of view, we avoid altogether functional inequality arguments (as we allow for nonconstant nonbounded diffusion maps). The scheme attains, in stepsize, a near-optimal classical (path-space) root mean-square error rate of $1/2-\varepsilon $ for $\varepsilon>0$ and an optimal rate $1/2$ in the nonpath-space (pointwise) mean-square error metric. All findings are illustrated by numerical examples. In particular, the testing raises doubts if taming is a suitable methodology for this type of problem (with convolution terms and nonconstant diffusion coefficients).
Wedge Video: Supporting Remote Participants in a Mixed-Mode Videoconference Meeting
Authors: Rogers Bill , Apperley Mark , Reyes Ervin Delos , Masoodian Masood
Published: May 2023

As global COVID-19 pandemic response has moved from full lockdowns and partial lockdowns in most parts of the world to a post-COVID era, an interesting new phenomenon that has emerged is the increased prevalence of hybrid meetings with a mixture of online and in-person attendees. The opportunity for remote participants to observe the responses and interactions of others in the meeting is generally accepted as being limited. An experimental prototype system, called Wedge Video, has been constructed as an attempt to improve the experience of remote participants in hybrid in-person/remote meetings. Wedge Video uses standard screen and camera equipment with existing video conferencing software (Zoom). An evaluation of the prototype system was conducted based on three simple games that each required players to interact rapidly and with some use of body language or gaze direction. Encouraging results led to the examination of the geometry of screen and camera placement in detail. A system that has a somewhat ‘virtual reality’ feeling to it has now been developed. The remote user is given a view of the in-person part of the meeting with participants at the same scale and location as they would be if the remote user were at the table themselves. Similarly, the local participants see the remote person in place at their table, at a realistic scale and with close to accurate gaze direction. A very preliminary evaluation of these concepts has been promising.
Comparison of methods for the effective evaluation of the energy content of poultry byproduct meal for beagles
Authors: Zhang Qiaoru , Sun Haoran , Gao Zuer , Feng Minshan , Zhang Haihua , Zhang Tietao
Published: May 2023

The objectives of this study were to compare the energy values of poultry byproduct meal (PBM) as feed for adult beagle dogs using the direct, difference, and regression methods to examine dogs’ nitrogen metabolism, energy utilization, gaseous metabolism, and body health. Five groups of six 12 mo old female beagles with an average body weight of 9.67 ± 0.52 kg were tested in a 5 × 6 incomplete Latin square design, with six repetitions in each group. Five experimental diets were tested consisting of 100% PBM; three substitution diets containing either 15%, 30%, or 45% PBM (termed 15PBM, 30PBM, and 45PBM, respectively); and a basal diet (included 6.90% PBM). Each experimental period lasted for 10 d, comprising 4 d of dietary acclimation followed by 6 d of testing (including 3 d feeding period and 3 d fasting period), during which the heat production (HP) was determined and feces and urine were collected. Results showed that, in the feeding state, the nitrogen intake, urinary nitrogen, apparent nitrogen digestibility, retained nitrogen, andHP increased significantly (P < 0.05) as the PBM level increased. The net protein utilization, biological value of protein, and total apparent digestibility of amino acids did not differ between the 30PBM and 45PBM diets (P > 0.05). The O2 consumption and CO2 production of beagles during the fasting period were not influenced by the PBM level (P > 0.05). The digestible energy and metabolizable energy values of the PBM estimated by the regression method were 20.16 and 18.18 MJ/kg dry matter (DM), respectively, and did not differ from those determined by the direct method (P > 0.05). The fecal DM percentages and fecal PBM scores were significantly higher in the PBM diet than in the difference method groups (P < 0.05). The direct method group had a significantly higher fecal score (4.63) than the other groups (P < 0.05), The fecal score of the 45PBM diet (3.50) was significantly higher than the 30PBM diet (2.90; P < 0.05). In summary, the direct and difference methods of determining the effective energy value of PBM for beagles, produce significantly different results. Under the conditions of this test, the best proportion of PBM in beagle feed for optimum energy provision is 30%.
Attrition of Well-Healed Burn Survivors to a 6-Month Community-Based Exercise Program: A Retrospective Evaluation
Authors: Atkins Whitley C , Romero Steven A , Moralez Gilbert , Huang Mu , Cramer Matthew N , Foster Josh , McKenna Zachary J , Crandall Craig G
Published: May 2023

The purpose of this study was to evaluate whether burn survivors have lower adherence compared to non-burned control individuals during a 6-month community-based exercise program. In burn survivors, we sought to answer if there was a relation between the size of the burn injury and dropout frequency. Fifty-two burn survivors and 15 non-burned controls (n = 67) were recruited for a 6-month community-based (ie, non-supervised), progressive, exercise training program. During the exercise program, 27% (ie, 4 of the 15 enrolled) of the non-burned individuals dropped out of the study, while 37% (ie, 19 of the 52) of the burn survivors dropped out from the study. There was no difference in the percentage of individuals who dropped out between groups (P = .552). There was no difference in size of the burn injury, expressed as percent body surface area burned (%BSA) between the burn survivors that dropped out versus those who completed the exercise regimen (P = .951). We did not observe a relation between %BSA burned and dropouts (log odds = −0.15–0.01(%BSA), B = −0.01, SE = 0.015, P = .541). There was no effect of %BSA burned on the probability of dropout [Exp (B) = 0.991, 95% CI (0.961, 1.020)] and there were no differences in the percentage of individuals who dropped out of the study based on %BSA burned (χ2(1) = 0.44, P = .51). These data demonstrate that burn survivors have similar exercise adherence relative to a non-burned group and the extent of a burn injury does not affect exercise program adherence.
Stakeholder engagement in the pooled procurement program in Ghana
Authors: Domfeh Kofi Ameyaw , Appiah-Agyekum Nana Nimo
Published: May 2023

Objective

The article explores stakeholders’ engagement before the implementation of the pooled procurement program (PPP) and the challenges encountered by the National Catholic Health Service (NCHS).

Method

The article used a qualitative research approach and a multiple case study design to solicit the views of healthcare service providers and policymakers within the NCHS.

Key findings

The article revealed that the National Catholic Health Secretariat (the secretariat) advocated through the Ghana Catholic Bishops Conference through the bishop responsible for health. Subsequently, the Diocesan Directors, managers, accountants, suppliers and storekeepers of all health facilities were engaged to understand their respective roles before implementing the PPP. The challenges faced came from all institutions that played a crucial role in the smooth running of the PPP. These institutions were the hospitals, suppliers, Food and Drugs Authority (FDA), National Health Insurance Scheme (NHIS) and the secretariat. The findings indicated that some managers in the hospitals were not committed to the program. Whereas, some suppliers purposely weakened the position of some other suppliers after awarding tenders by carrying their commodities directly to the hospitals and reducing the price marginally. The challenge from the NHIS perspective was the payment delays. The FDA was not proactive with post-market surveillance to check substandard commodities in the hospitals. However, in the secretariat, the deficiency was the weak systems to monitor real-time activities of the PPP at the hospitals.

Conclusion

The article suggests that to ensure the right synergies to meet organizational objectives, the NCHS is advised to increasingly focus on identifying and sustaining the PPP by communicating with other stakeholders to achieve their mutual needs. Such a process would allow the more knowledgeable design of resource needs and allocation of scarce resources to their areas of interest.
Raspberry ketone improves non-alcoholic fatty liver disease induced in rats by modulating sphingosine kinase/sphingosine-1-phosphate and toll-like receptor 4 pathways
Authors: Abdelraheem Kareem M , Younis Nahla N , Shaheen Mohamed A , Elswefy Sahar E , Ali Sousou I
Published: May 2023

Objectives

To investigate the therapeutic role of calorie-restricted diet (CR) and raspberry ketone (RK) in non-alcoholic fatty liver disease (NAFLD) and the implication of sphingosine kinase-1 (SphK1)/sphingosine-1-phosphate (S1P) and toll-like receptor 4 (TLR4) signalling.

Methods

NAFLD was induced by feeding rats high-fat-fructose-diet (HFFD) for 6 weeks. Rats were then randomly assigned to three groups (n = 6 each); NAFLD group continued on HFFD for another 8 weeks. CR group was switched to CR diet (25% calorie restriction) for 8 weeks and RK group was switched to normal diet and received RK (55 mg/kg/day; orally) for 8 weeks. Another six rats were used as normal control.

Key findings

HFFD induced a state of NAFLD indicated by increased fat deposition in liver tissue along with dyslipidemia, elevated liver enzymes, oxidative stress and inflammation. Either CR diet or RK reversed these changes and decreased HFFD-induced elevation of hepatic SphK1, S1P, S1PR1 and TLR4. Of notice, RK along with a normal calorie diet was even better than CR alone in most studied parameters.

Conclusions

SphK1/S1P and TLR4 are interconnected and related to the establishment of HFFD-induced NAFLD and can be modulated by RK. Supplementation of RK without calorie restriction to patients with NAFLD unable to follow CR diet to achieve their treatment goals would be a promising therapeutic modality.
The ARF2–MYB6 module mediates auxin-regulated petal expansion in rose
Authors: Chen Changxi , Hussain Nisar , Ma Yanxing , Zuo Lanxin , Jiang Yunhe , Sun Xiaoming , Gao Junping
Published: May 2023

In cut rose (Rosa hybrida), the flower-opening process is closely associated with vase life. Auxin induces the expression of transcription factor genes that function in petal growth via cell expansion. However, the molecular mechanisms underlying the auxin effect during flower opening are not well understood. Here, we identified the auxin-inducible transcription factor gene RhMYB6, whose expression level is high during the early stages of flower opening. Silencing of RhMYB6 delayed flower opening by controlling petal cell expansion through down-regulation of cell expansion-related genes. Furthermore, we demonstrated that the auxin response factor RhARF2 directly interacts with the promoter of RhMYB6 and represses its transcription. Silencing of RhARF2 resulted in larger petal size and delayed petal movement. We also showed that the expression of genes related to ethylene and petal movement showed substantial differences in RhARF2-silenced petals. Our results indicate that auxin-regulated RhARF2 is a critical player that controls flower opening by governing RhMYB6 expression and mediating the crosstalk between auxin and ethylene signaling.
An effector of ‘Candidatus Liberibacter asiaticus’ manipulates autophagy to promote bacterial infection
Authors: Shi Hongwei , Yang Zuhui , Huang Jie , Wu Haodi , Fu Shimin , Li Weimin , Zou Xiuping , Zhou Changyong , Wang Xuefeng
Published: May 2023

Autophagy functions in plant host immunity responses to pathogen infection. The molecular mechanisms and functions used by the citrus Huanglongbing (HLB)-associated intracellular bacterium ‘Candidatus Liberibacter asiaticus’ (CLas) to manipulate autophagy are unknown. We identified a CLas effector, SDE4405 (CLIBASIA_04405), which contributes to HLB progression. ‘Wanjincheng’ orange (Citrus sinensis) transgenic plants expressing SDE4405 promotes CLas proliferation and symptom expression via suppressing host immunity responses. SDE4405 interacts with the ATG8-family of proteins (ATG8s), and their interactions activate autophagy in Nicotiana benthamiana. The occurrence of autophagy is also significantly enhanced in SDE4405-transgenic citrus plants. Interrupting NbATG8s-SDE4405 interaction by silencing of NbATG8c reduces Pseudomonas syringae pv. tomato strain DC3000ΔhopQ1-1 (Pst DC3000ΔhopQ1-1) proliferation in N. benthamiana, and transient overexpression of CsATG8c and SDE4405 in citrus promotes Xanthomonas citri subsp. citri (Xcc) multiplication, suggesting that SDE4405-ATG8s interaction negatively regulates plant defense. These results demonstrate the role of the CLas effector protein in manipulating autophagy, and provide new molecular insights into the interaction between CLas and citrus hosts.
PEP-FOLD4: a pH-dependent force field for peptide structure prediction in aqueous solution
Authors: Rey Julien , Murail Samuel , de Vries Sjoerd , Derreumaux Philippe , Tuffery Pierre
Published: May 2023

Accurate and fast structure prediction of peptides of less 40 amino acids in aqueous solution has many biological applications, but their conformations are pH- and salt concentration-dependent. In this work, we present PEP-FOLD4 which goes one step beyond many machine-learning approaches, such as AlphaFold2, TrRosetta and RaptorX. Adding the Debye-Hueckel formalism for charged-charged side chain interactions to a Mie formalism for all intramolecular (backbone and side chain) interactions, PEP-FOLD4, based on a coarse-grained representation of the peptides, performs as well as machine-learning methods on well-structured peptides, but displays significant improvements for poly-charged peptides. PEP-FOLD4 is available at http://bioserv.rpbs.univ-paris-diderot.fr/services/PEP-FOLD4. This server is free and there is no login requirement.
Isocitrate dehydrogenase mutations in gliomas: A review of current understanding and trials
Authors: Sharma Nikhil , Mallela Arka N , Shi Diana D , Tang Lilly W , Abou-Al-Shaar Hussam , Gersey Zachary C , Zhang Xiaoran , McBrayer Samuel K , Abdullah Kalil G
Published: May 2023

Isocitrate dehydrogenase (IDH) is a key enzyme in normal metabolism and homeostasis. However, mutant forms of IDH are also defining features of a subset of diffuse gliomas. In this review, we highlight current techniques targeting IDH-mutated gliomas and summarize current and completed clinical trials exploring these strategies. We discuss clinical data from peptide vaccines, mutant IDH (mIDH) inhibitors, and PARP inhibitors. Peptide vaccines have the unique advantage of targeting the specific epitope of a patient’s tumor, inducing a highly tumor-specific CD4+ T-cell response. mIDH-inhibitors, on the other hand, specifically target mutant IDH proteins in cancer cell metabolism and thus help halt gliomagenesis. We also explore PARP inhibitors and their role in treating diffuse gliomas, which exploit IDH-mutant diffuse gliomas by allowing the persistence of unrepaired DNA complexes. We summarize various completed and current trials targeting IDH1 and IDH2 mutations in diffuse gliomas. Therapies targeting mutant IDH have significant promise in treating progressive or recurrent IDH-mutant gliomas and may significantly change treatment paradigms in the next decade.
Institutions, trade, and development: identifying the impact of country-specific characteristics on international trade
Authors: Beverelli Cosimo , Keck Alexander , Larch Mario , Yotov Yoto V
Published: May 2023

We quantify the impact of country-specific institutions on international trade and development in a structural gravity framework. The econometric analysis offers robust evidence that stronger institutions promote trade. A counterfactual analysis reveals that the changes in institutional quality in the poor countries in our sample between 1996 and 2006 have had, via their impact on imports from rich countries, significant and heterogeneous welfare effects, varying between −2% and 5%. Our approach is readily applicable to identifying the impact of any country-specific variable on international trade in the structural gravity framework.