bluuebunny/crossref_metadata_2025 huggingface dataset:
“I Can’t Think of Anything More Fulfilling”: An Interpretative Phenomenological Analysis of Eight Female-Identifying Music Therapists’ Career Longevity
Authors: Silverman Michael J , Segall Lorna E
Published: February 2024

Although there is literature exploring burnout and music therapists who have left the profession, there is a lack of research exploring the lived experience of music therapists who have remained in the profession for their careers. Therefore, the purpose of this study was to understand the lived experience of music therapy clinicians in the United States who remained in the profession for their careers. We individually interviewed eight female-identifying music therapy clinicians who had been in the profession between 25 and 48 (M = 40.63; SD = 8.53) years. We used interpretive phenomenological analysis to analyze the data. Participants reviewed their transcripts and the results to provide credibility to the themes. We identified nine themes that described career longevity: centering service users; other professional opportunities and responsibilities; building a sustainable and thriving program; humility, professional agency, and growth; professional service to support peers and service users; training and supervising music therapists; connecting with the professional community; coping with work-related stressors; and music as a resource for resiliency. On the basis of these results, we developed a model depicting professional resiliency in music therapy that centered and revolved around the service users. In addition to their clinical expertise, there is considerable knowledge to be gained from music therapists regarding professional resiliency and career longevity. Additional scholarship in music therapy career longevity is necessary to grow the profession and increase access to services. Implications, limitations, and suggestions for future research are provided.
Characterization of pediatric non-hematopoietic tumor metastases to the central nervous system: A single institution review
Authors: Newman John , Leelatian Nalin , Liang Jiancong
Published: February 2024

Central nervous system (CNS) metastases represent a small portion of pediatric CNS neoplasms and data surrounding this condition with high morbidity is scarce. Single institutional archival institutional pathology records between 1999 and 2022 were searched for patients over 21 years old and younger with CNS, dura, cranial nerve, CSF, or leptomeningeal metastases; 41 cases were identified. We documented primary tumor types and locations, metastasis locations, types of invasion (direct extension vs distant metastasis), times from imaging or pathologic diagnosis to CNS involvement, and outcomes. Distant metastasis was the most common mechanism of metastasis (n = 32, 78%). Interval times to CNS metastasis varied by both tumor type and primary tumor location. In this cohort, osteosarcoma portended the shortest survival following CNS metastasis. This study highlights the diverse mechanisms and locations of CNS involvement in pediatric CNS metastases and illuminates a need for varied monitoring strategies when considering primary tumor type and anatomic location.
A Century of Change in a Mature Urban Forest: the Thain Family Forest of the New York Botanical Garden, Bronx, New York
Authors: Nagele Eliot , Ashton Mark S , Harris Thomas B , Forrest Todd A , DeLuca Erica A , Martello Maria E , Duguid Marlyse C
Published: February 2024

Urban forests have long been understudied, resulting in a scarcity of long-term data to guide future management. The New York Botanical Garden in New York City has been stewarding the 20 ha Thain Family Forest since 1895. Using inventory data between 1937 and 2021, we document how structure, diversity, and composition of the forest have changed over the past century. Our results show an increase in the proportion and diversity of hardwood species, including oaks, hickories, red maple, black cherry, and American beech, following the loss of a dominant species, eastern hemlock. Despite changes in composition, we find no significant differences in the mean basal area, density, and tree diameter of canopy trees (diameter at breast height [DBH] ≥ 15 cm) from 1937 to 2021. Assessments of small diameter stems (DBH ≥ 2.54 cm) show increasing density, decreasing diameter, and increasing richness from 1985 to 2021, suggesting a period of understory recruitment/regeneration. During this time, native species have been dominant in both overstory and understory strata. These observations mirror trends recorded in hemlock–hardwood and oak–hickory forests region-wide, indicating that, with continued conservation and active management, urban and rural forests may develop in similar patterns and encouraging regional approaches to forest management.

Study Implications: Urban forests have long been understudied, resulting in a scarcity of long-term data to guide future management. Over the past century, the 20 ha Thain Family Forest in New York City has experienced a significant change in species composition, with an increase in the proportion and diversity of hardwood species following the loss of eastern hemlock. Despite these changes, forest canopy structure has remained stable. These observations mirror those observed in hemlock–hardwood and oak–hickory forests regionwide, suggesting that with continued conservation and active management, urban and rural forests may develop in similar patterns. The results of this study support continued investment in the research and management of urban forests as a comprehensive part of regional forest management efforts.
Migration of low-mass planets in inviscid discs: the effect of radiation transport on the dynamical corotation torque
Authors: Ziampras Alexandros , Nelson Richard P , Paardekooper Sijme-Jan
Published: February 2024

Low-mass planets migrate in the type-I regime. In the inviscid limit, the contrast between the vortensity trapped inside the planet’s corotating region and the background disc vortensity leads to a dynamical corotation torque, which is thought to slow down inward migration. We investigate the effect of radiative cooling on low-mass planet migration using inviscid 2D hydrodynamical simulations. We find that cooling induces a baroclinic forcing on material U-turning near the planet, resulting in vortensity growth in the corotating region, which in turn weakens the dynamical corotation torque and leads to 2–3× faster inward migration. This mechanism is most efficient when cooling acts on a time-scale similar to the U-turn time of material inside the corotating region, but is none the less relevant for a substantial radial range in a typical disc (R ∼ 5–50 au). As the planet migrates inwards, the contrast between the vortensity inside and outside the corotating region increases and partially regulates the effect of baroclinic forcing. As a secondary effect, we show that radiative damping can further weaken the vortensity barrier created by the planet’s spiral shocks, supporting inward migration. Finally, we highlight that a self-consistent treatment of radiative diffusion as opposed to local cooling is critical in order to avoid overestimating the vortensity growth and the resulting migration rate.
Exploring the faintest end of mid-infrared luminosity functions up to z ≃ 5 with the JWST CEERS survey
Authors: Ling Chih-Teng , Goto Tomotsugu , Kim Seong Jin , Wu Cossas K -W , Hashimoto Tetsuya , Chien Tom C -C , Lin Yu-Wei , Ho Simon C -C , Kilerci Ece
Published: February 2024

Mid-infrared (MIR) light from galaxies is sensitive to dust-obscured star formation activities because it traces the characteristic emission of dust heated by young, massive stars. By constructing the MIR luminosity functions (LFs), we are able to quantify the overall dusty star formation history and the evolution of galaxies over cosmic time. In this work, we report the first rest-frame MIR LFs at 7.7, 10, 12.8, 15, 18, and 21 μm as well as the total IR LF from the JWST Cosmic Evolution Early Release Science (CEERS) survey. We identify 506 galaxies at z = 0–5.1 in the CEERS survey that also have optical photometry from the Hubble Space Telescope. With the unprecedented sensitivity of the JWST, we probe the faintest end of the LFs at z = 0–1 down to L* ∼ 107L⊙, ∼2 orders of magnitude fainter than those from the previous generation of IR space telescopes. Our findings connect well with and continue the faint end of the MIR LFs from the deepest observations in past works. As a proxy of star formation history, we present the MIR-based luminosity density up to z ≃ 4.0, marking the first probe of the early Universe by JWST Mid-Infrared Instrument.
Effects of heterogeneous data sets and time-lag measurement techniques on cosmological parameter constraints from Mg ii and C iv reverberation-mapped quasar data
Authors: Cao Shulei , Zajaček Michal , Czerny Bożena , Panda Swayamtrupta , Ratra Bharat
Published: February 2024

Previously, we demonstrated that Mg ii and C iv reverberation-mapped quasars (RM QSOs) are standardizable and that the cosmological parameters inferred using the broad-line region radius–luminosity (R–L) relation are consistent with those determined from better-established cosmological probes. With more data expected from ongoing and future spectroscopic and photometric surveys, it is imperative to examine how new QSO data sets of varied quality, with their own specific luminosity and time-delay distributions, can be best used to determine more restrictive cosmological parameter constraints. In this study, we test the effect of adding 25 OzDES Mg ii RM QSOs as well as 25 lower quality SDSS RM C iv QSOs, which increases the previous sample of RM QSOs by $\sim 36{{\ \rm per\ cent}}$. Although cosmological parameter constraints become tighter for some cosmological models after adding these new QSOs, the new combined data sets have increased differences between R–L parameter values obtained in different cosmological models and thus a lower standardizability for the larger Mg ii + C iv compilation. Different time-delay methodologies, particularly the ICCF and CREAM methods used for inferring time delays of SDSS RM QSOs, slightly affect cosmological and R–L relation parameter values, however, the effect is negligible for (smaller) compilations of robust time-delay detections. Our analysis indicates that increasing the sample size is not sufficient for tightening cosmological constraints and a quality cut is necessary to obtain a standardizable RM QSO sample.
RIP-seq reveals RNAs that interact with RNA polymerase and primary sigma factors in bacteria
Authors: Vaňková Hausnerová Viola , Shoman Mahmoud , Kumar Dilip , Schwarz Marek , Modrák Martin , Jirát Matějčková Jitka , Mikesková Eliška , Neva Silvia , Herrmannová Anna , Šiková Michaela , Halada Petr , Novotná Iva , Pajer Petr , Valášek Leoš Shivaya , Převorovský Martin , Krásný Libor , Hnilicová Jarmila
Published: February 2024

Bacteria have evolved structured RNAs that can associate with RNA polymerase (RNAP). Two of them have been known so far—6S RNA and Ms1 RNA but it is unclear if any other types of RNAs binding to RNAP exist in bacteria. To identify all RNAs interacting with RNAP and the primary σ factors, we have established and performed native RIP-seq in Bacillus subtilis, Corynebacterium glutamicum, Streptomyces coelicolor, Mycobacterium smegmatis and the pathogenic Mycobacterium tuberculosis. Besides known 6S RNAs in B. subtilis and Ms1 in M. smegmatis, we detected MTS2823, a homologue of Ms1, on RNAP in M. tuberculosis. In C. glutamicum, we discovered novel types of structured RNAs that associate with RNAP. Furthermore, we identified other species-specific RNAs including full-length mRNAs, revealing a previously unknown landscape of RNAs interacting with the bacterial transcription machinery.
Spinal cord hemangioblastomas in von Hippel–Lindau disease
Authors: Kreatsoulas Daniel C , Lonser Russell R
Published: February 2024

Background

von Hippel-Lindau disease (VHL) is an autosomal dominant familial neoplasia syndrome. The most common manifestation of VHL is central nervous system hemangioblastomas. VHL patients will often develop multiple hemangioblastomas along their craniospinal axis over their lifetime. Spinal cord hemangioblastomas account for nearly half of all nervous system hemangioblastomas in VHL.

Methods

The authors conducted a literature review and summation of available articles on spinal cord hemangioblastomas associated with VHL.

Results

The embryological origins, epidemiology, natural history, surgical outcomes, nonsurgical treatments, and future directions in spinal cord hemangioblastomas are discussed.

Conclusions

Hemangioblastomas in VHL are optimally managed with a multidisciplinary approach that includes surgical resection of symptomatic lesions. Novel treatments are gaining traction, but must be studied further for efficacy and safety.
The effect of oral synbiotics on the gut microbiota and inflammatory biomarkers in healthy adults: a systematic review and meta-analysis
Authors: Cosier Denelle J , Lambert Kelly , Neale Elizabeth P , Probst Yasmine , Charlton Karen
Published: February 2024

Context

Prior research has explored the effect of synbiotics, the combination of probiotics and prebiotics, on the gut microbiota in clinical populations. However, evidence related to the effect of synbiotics on the gut microbiota in healthy adults has not been reviewed to date.

Objective

A systematic review and meta-analysis was conducted to comprehensively investigate the effect of synbiotics on the gut microbiota and inflammatory markers in populations of healthy adults.

Data Sources

Scopus, PubMed, Web of Science, ScienceDirect, MEDLINE, CINAHL, and The Cochrane Library were systematically searched to retrieve randomized controlled trials examining the primary outcome of gut microbiota or intestinal permeability changes after synbiotic consumption in healthy adults. Secondary outcomes of interest were short-chain fatty acids, inflammatory biomarkers, and gut microbiota diversity.

Data Extraction

Weighted (WMD) or standardized mean difference (SMD) outcome data were pooled in restricted maximum likelihood models using random effects. Twenty-seven articles reporting on 26 studies met the eligibility criteria (n = 1319).

Data Analysis

Meta-analyses of 16 studies showed synbiotics resulted in a significant increase in Lactobacillus cell count (SMD, 0.74; 95% confidence interval [CI], 0.15, 1.33; P = 0.01) and propionate concentration (SMD, 0.22; 95% CI, 0.02, 0.43; P = 0.03) compared with controls. A trend for an increase in Bifidobacterium relative abundance (WMD, 0.97; 95% CI, 0.42, 2.52; P = 0.10) and cell count (SMD, 0.82; 95% CI, 0.13, 1.88; P = 0.06) was seen. No significant differences in α-diversity, acetate, butyrate, zonulin, IL-6, CRP, or endotoxins were observed.

Conclusion

This review demonstrates that synbiotics modulate the gut microbiota by increasing Lactobacillus and propionate across various healthy adult populations, and may result in increased Bifidobacterium. Significant variations in synbiotic type, dose, and duration should be considered as limitations when applying findings to clinical practice.

Systematic Review Registration

PROSPERO no. CRD42021284033.
Lost options commitment: how short-term policies affect long-term scope of action
Authors: Martínez Montero Marina , Brede Nuria , Couplet Victor , Crucifix Michel , Botta Nicola , Wieners Claudia
Published: February 2024

We propose to explore the sustainability of climate policies based on a novel commitment metric. This metric allows to quantify how future generations’ scope of action is affected by short-term climate policy. In an example application, we show that following a moderate emission scenario like SSP2-4.5 will commit future generations to heavily rely on carbon dioxide removal or/and solar radiation modification to avoid unmanageable sea level rise.
PTFE as a viable sealing material for lightweight mass spectrometry ovens in dusty extraterrestrial environments
Authors: Abernethy Feargus A J , Chinnery Hannah , Lindner Robert , Barber Simeon J
Published: February 2024

Ever increasing interest in the Moon, not only for scientific but also commercial and prospecting purposes, requires a more streamlined and reproducible approach to issues such as the sealing of sample handling ovens, in contrast to the mission-specific mechanisms which have tended to prevail in the past. A test breadboard has been designed and built in order to evaluate the leak rates of different oven sealing concepts and materials within the context of the PROSPECT Sample Processing and Analysis (ProSPA) instrument being developed for the European Space Agency. Sealing surface geometries based on a simple 90° knife-edge, and two widely used vacuum fitting standards (VCR® and ConFlat®) have been tested using PTFE (polytetrafluoroethylene) gaskets in vacuum across a temperature range of −100 to 320°C, equivalent to a projected −100 to 1000°C sample heating range in the ProSPA ovens. The impact of using glass- and carbon-filled PTFE has also been investigated, as has the effect of dust coverage of JSC-1A lunar simulant up to 9 per cent by area. The best combination of properties appears to be unfilled PTFE, compressed between two 90° knife-edges with a confining force of ∼400 N. This can produce a leak rates within the 10−7 Pa m3 s−1 range or better regardless of the level of dust applied within the experimental constraints. A strong temperature-dependence on the leak rate is identified, meaning that careful oven design will be required to minimize the temperature at the seal interface even within the operational temperature range PTFE itself.
Gall inducer Dasineura sp. alters the polyphenol profile and antioxidant activity of Peumus boldus stems
Authors: Guedes Lubia M , Aguilera Narciso , Torres Solange , Gavilán Elvis , Rosales Natacha
Published: February 2024

Peumus boldus, a tree native to Chile, is extensively used for medicinal purposes due to its richness in alkaloids and antioxidant polyphenols. A species of galling insect, Dasineura sp. induces structural and chemical changes on P. boldus stems while its galls are established and developed. Taking into account the antioxidant properties of P. boldus polyphenols, it would be expected that Dasineura sp. induces changes in the accumulation sites, chemical profile, and antioxidant activity of the P. boldus stem polyphenols, related to different reactive oxygen species (ROS) production levels during gall development. Dasineura sp. induces changes in the accumulation sites of total polyphenols, flavonols, and lignin, redirecting their accumulation toward the sites of greatest production of H2O2 and O2.−. Although changes in total polyphenol content would be expected, this did not vary significantly between non-galled and galled stems. However, the galling insect induced changes in the profile and concentration of soluble polyphenols, leading to the gall extracts’ antioxidant capacity decreasing significantly during the maturation and senescence stages. Additionally, during the maturation stage, lignin deposition increases in the more peripheral gall tissues, which also contributes to ROS dissipation. The differences in the different gall developmental stages’ antioxidant activity could be related to the identity and concentration of phenolic compounds in each gall extract, rather than to the total phenol content. Regardless of the mechanisms involved, the dissipation of the ROS generated by Dasineura sp. activity occurs, restoring the redox balance in galls and guaranteeing the success of the inducer.
Species Diversity of Pectobacterium spp. Causing Potato Aerial Stem Rot in China
Authors: Wu Jian , Zhang Ruofang , Sun Qinghua , Feng Zhiwen , Handique Utpal
Published: February 2024

Pectobacterium spp. are the primary causative agents of aerial stem rot in potatoes in China. A nationwide survey revealed the widespread occurrence of aerial stem rot in the northern, southern, and southwestern cultivation regions, with occurrence rates ranging from 1 to 60%. In total, 36 strains were isolated and identified at the species level using multilocus sequence analysis of six housekeeping genes (rpoS, proA, gapA, icdA, gyrA, and mdh). Genome sequencing was conducted on one representative strain for each species, and further confirmation of their identities was achieved through average nucleotide identity and in silico digital DNA–DNA hybridization analysis. Five Pectobacterium species were identified, namely, P. atrosepticum, P. brasiliense, P. carotovorum, P. polaris, and P. punjabense, with P. atrosepticum and P. brasiliense being the most widely distributed. Pathogenicity tests demonstrated that, among the strains isolated in this study and those obtained from other studies, P. atrosepticum and P. brasiliense are also the most virulent species. To the best of our knowledge, this is the first nationwide study describing the diversity and distribution of Pectobacterium spp. affecting potatoes in China. The information gathered will be utilized for disease diagnosis and the development of pathogen-specific integrated pest management strategies to protect potato production.
Time to Wake Up! The Ongoing Search for General Anesthetic Reversal Agents
Authors: Cylinder Drew M. , van Zundert André A. J. , Solt Ken , van Swinderen Bruno
Published: February 2024

How general anesthetics work remains a topic of ongoing study. A parallel field of research has sought to identify methods to reverse general anesthesia. Reversal agents could shorten patients’ recovery time and potentially reduce the risk of postoperative complications. An incomplete understanding of the mechanisms of general anesthesia has hampered the pursuit for reversal agents. Nevertheless, the search for reversal agents has furthered understanding of the mechanisms underlying general anesthesia. The study of potential reversal agents has highlighted the importance of rigorous criteria to assess recovery from general anesthesia in animal models, and has helped identify key arousal systems (e.g., cholinergic, dopaminergic, and orexinergic systems) relevant to emergence from general anesthesia. Furthermore, the effects of reversal agents have been found to be inconsistent across different general anesthetics, revealing differences in mechanisms among these drugs. The presynapse and glia probably also contribute to general anesthesia recovery alongside postsynaptic receptors. The next stage in the search for reversal agents will have to consider alternate mechanisms encompassing the tripartite synapse.
The association of depressive symptoms and female sexual functioning in the menopause transition: a cross-sectional study
Authors: Stevens Emily B. , Wolfman Wendy , Hernandez-Galan Leticia , Shea Alison K.
Published: February 2024

Objective

Sexual dysfunction is very common among middle-aged females. Several factors are considered to influence sexual functioning, including reproductive aging and associated physiological changes as well as life stressors, mental health, and other socioeconomic influences. The objectives of this study are to evaluate the effect of current depressive symptoms on sexual functioning during menopause and to further analyze whether socioeconomic status, age, and antidepressant usage impact this association.

Methods

Perimenopausal and postmenopausal women aged 40 to 65 years seeking treatment from a specialized menopause clinic completed a self-report survey with the main outcome measure being the 19-item Female Sexual Function Index quantifying sexual dysfunction. We used the 10-item Center for Epidemiological Studies Depression Scale to estimate a major depressive episode. Statistical analyses were completed to assess the potential associations of socioeconomic factors, age, and antidepressant usage.

Results

Of the 269 participants, 61.3% met criteria for a major depressive episode and 67.0% had low sexual function. As predicted, women currently experiencing depressive symptoms had a greater risk of low sexual function during perimenopause and postmenopause. Antidepressant usage, low household income, being postmenopausal, and age also predicted low sexual function.

Conclusions

Among perimenopausal and postmenopausal women, current depressive symptoms were associated with low sexual function. A biopsychosocial approach should be considered when exploring effective treatment strategies for sexual concerns among midlife women.
Propulsive forces and muscle activation during gait: comparisons between premenopausal and postmenopausal midlife women
Authors: Tomaz Giovanni Gondim , Souza Markus Vinicius Campos , Carneiro Marcelo Augusto da Silva , Lima Mariana Luíza de , Assumpção Claudio Oliveira , Orsatti Fábio Lera
Published: February 2024

Objective

The aim of this study was to investigate whether there is a reduction in propulsive force during gait in postmenopausal women compared with premenopausal women.

Methods

Forty-four women (21 premenopausal and 23 postmenopausal women) aged 40 to 55 years were selected. The ability to reach peak propulsive forces was assessed during the step execution test. The test was performed at the usual speed on 2 nonconsecutive days, with two attempts per day, using a force platform. Four temporal parameters were defined and calculated: initiation phase, preparation phase, swing phase, and total time. Peak force (anteroposterior and vertical) and time to reach peak force were obtained in both preparation and swing phases. The rate of force development was defined as peak force divided by time to reach peak force.

Results

The postmenopausal women group presented a longer time in the preparation phase (540.6 ± 77 ms vs 482.5 ± 93 ms, P = 0.024) and consequently a longer total time in the step execution test (1,191 ± 106.4 ms vs 1,129 ± 114.3 ms, P = 0.045). There were differences between the groups for the rate of force development in the anteroposterior (postmenopausal women, 142.5 ± 38.1 N/s vs premenopausal women, 174.7 ± 70.5 N/s; P = 0.022) and vertical directions in the preparation phase (postmenopausal women, 102.7 ± 62.3 N/s vs premenopausal women, 145.3 ± 71 N/s; P = 0.012). No significant differences (P > 0.05) were found in force, time to peak force, and rate of force development during the swing phase. In addition, there were no observed differences in surface electromyography of the medial and lateral gastrocnemius muscles during the preparation phase and swing phase of the step execution test between the two groups.

Conclusions

Postmenopausal women exhibited lower ability to generate propulsive force rapidly (rates of force development) in both the anteroposterior and vertical directions during the preparation phase of gait compared with premenopausal women. This indicates that postmenopausal women experience a reduction in propulsive force during gait.
Comparison of 6 tests for diagnosing minimal hepatic encephalopathy and predicting clinical outcome: A prospective, observational study
Authors: Ehrenbauer Alena F. , Egge Julius F.M. , Gabriel Maria M. , Tiede Anja , Dirks Meike , Witt Jennifer , Wedemeyer Heiner , Maasoumy Benjamin , Weissenborn Karin
Published: February 2024

Background and Aims:

Current guidelines recommend the assessment for minimal HE in patients with liver cirrhosis. Various efforts were made to find tools that simplify the diagnosis. Here, we compare the 6 most frequently used tests for their validity and their predictive value for overt hepatic encephalopathy (oHE), rehospitalization, and death.

Approach and Results:

One hundred thirty-two patients with cirrhosis underwent the Portosystemic Encephalopathy-Syndrome-Test yielding the psychometric hepatic encephalopathy score (PHES), Animal Naming Test (ANT), Critical Flicker Frequency (CFF), Inhibitory Control Test (ICT), EncephalApp (Stroop), and Continuous Reaction Time Test (CRT). Patients were monitored for 365 days regarding oHE development, rehospitalization, and death. Twenty-three patients showed clinical signs of HE grade 1-2 at baseline. Of the remaining 109 neurologically unimpaired patients, 35.8% had abnormal PHES and 44% abnormal CRT. Percentage of abnormal Stroop (79.8% vs. 52.3%), ANT (19.3% vs. 51.4%), ICT (28.4% vs. 36.7%), and CFF results (18.3% vs. 25.7%) changed significantly when adjusted norms were used for evaluation instead of fixed cutoffs. All test results correlated significantly with each other (p<0.05), except for CFF. During follow-up, 24 patients developed oHE, 58 were readmitted to the hospital, and 20 died. Abnormal PHES results were linked to oHE development in the multivariable model. No other adjusted test demonstrated predictive value for any of the investigated endpoints.

Conclusions:

Where applicable, the diagnosis of minimal HE should be made based on adjusted norm values for the tests, exclusively. The minimal HE tests cannot be equated with one another and have an overall limited value in predicting clinical outcomes.
Bowel Perforation Following Sclerotherapy of a Massive Intra-Abdominal Lymphatic Malformation
Authors: Baker Andrew , Wong Kevin , Gonzales-Krellwitz Laura , Kim Elizabeth , Strub Graham M.
Published: February 2024

Lymphatic malformations are vascular anomalies that often arise from congenital defects and can manifest in a variety of locations, including the abdomen. Such lesions are often targeted with sclerotherapy, which has become the first-line treatment due to the limitations of surgical intervention. Sclerotherapy is associated with side effects including local necrosis and edema, with localized tissue destruction seldom reported. Here we describe the case of a neonate female with bowel wall perforation following sclerotherapy with ethanol and doxycycline for macrocystic abdominal lymphatic malformation.
A novel technique of reverse-sequence endoscopic nipple-sparing mastectomy with direct-to-implant breast reconstruction: medium-term oncological safety outcomes and feasibility of 24-hour discharge for breast cancer patients
Authors: Jiao Zhou , Xie Yanyan , Liang Faqing , Feng Yu , Yang Huanzuo , Qiu Mengxue , Zhang Qing , Chung Kawun , Dai Hui , Liu Yang , Liang Peng , Du Zhenggui
Published: February 2024

Background:

Due to the short operation time and no need for special instruments, reverse-sequence endoscopic nipple-sparing mastectomy (R-E-NSM) with direct-to-implant breast reconstruction (DIBR) has been rapidly becoming popular in the last three years. However, there has yet to be an evaluation of its oncologic safety or the feasibility of discharging patients within 24 hours.

Materials and Methods:

In this single-center retrospective cohort study, individuals diagnosed with stage 0–III breast cancer between May 2020 and April 2022 who underwent traditional open mastectomy or R-E-NSM with DIBR were included. Follow-up started on the date of surgery and ended in December 2023. Data, including demographics, tumor characteristics, medium-term oncological outcomes, and postoperative complications, were collected and analyzed. Propensity score matching (PSM) was performed to minimize selection bias.

Results:

This study included 1679 patients (median [IQR] age, 50 [44-57] years). Of these, 344 patients underwent R-E-NSM with DIBR (RE-R group), and 1335 patients underwent traditional open mastectomy (TOM group). The median [IQR] follow-up time was 30 [24-36] months (29 [23-33] months in the RE-R group and 30 [24-36] months in the TOM group). Regarding before or after PSM, the P value of local recurrence-free survival (LRFS, 0.910 and 0.450), regional recurrence-free survival (RRFS, 0.780 and 0.620), distant metastasis-free survival (DMFS, 0.061 and 0.130), overall survival (OS, 0.260 and 0.620), disease-free survival (DFS, 0.120 and 0.330) were not significantly different between the RE-R group and the TOM group. The 3y-LRFS and 3y-DFS rates were 99.0% and 97.1% for the RE-R group and 99.5% and 95.3% for the TOM group, respectively. The rates of any complications and major complications were not significantly different between the RE-R patients who were discharged within 24 hours and the RE-R patients who were not discharged within 24 hours (P=0.290, P=0.665, respectively) or the TOM patients who were discharged within 24 hours (P =0.133, P=0.136, respectively).

Conclusions:

R-E-NSM with DIBR is an innovative oncologic surgical procedure that not only improves cosmetic outcomes but also ensures reliable oncologic safety and fewer complications, enabling patients to be safely discharged within 24 hours. A long-term prospective multicenter assessment will be supporting.
Advancements and current trends in tumor treating fields: a scientometric analysis
Authors: Xing Yang , Yasinjan Feroza , Cui Jiayue , Peng Yizhao , He Minghua , Liu Wenhui , Hong Xinyu
Published: February 2024

Tumor treating fields (TTFields) therapy is a novel and effective non-invasive cancer therapy, and it has been approved by FDA in the treatment of recurrent and newly diagnosed glioblastoma, and malignant pleural mesothelioma. Moreover, TTFields therapy has been widely studied in both clinical trials and preclinical studies in recent years. Based on its high efficacy, research on TTFields therapy has been a hot topic. Thus, we made this scientometric analysis of TTfields to reveal the scientometric distributions such as annual publications and citations, countries and institutions, authors, journals, references, and more importantly, research status and hot topics of the field. In recent years, publication numbers have been stable at high values, and citation numbers have been increasing greatly. The United States and Israel were the top two countries with the highest publication numbers, followed by Germany and Switzerland. Scientometric analyses of keywords indicated that clinical applications and antitumor mechanisms are probably the two main parts of current research on TTfields. Most clinical trials of TTfields focus on the treatment of glioblastoma. And a variety of other cancers such as lung cancer especially non-small cell lung cancer, hepatic cancer, other brain tumors, etc. have also been studied in both clinical trials and preclinical studies.
Distribution of coronal plane alignment of the knee classification in Chinese osteoarthritic and healthy population: a retrospective cross-sectional observational study
Authors: Gao Yu-Hang , Qi Yu-Meng , Huang Pei-Hong , Zhao Xing-Yu , Qi Xin
Published: February 2024

Background:

Few studies have reported the coronal constitutional alignment of the lower limbs in mainland China. This study aimed to analyse the distribution of the coronal plane alignment of the knee (CPAK) classification in the osteoarthritic and healthy Chinese populations.

Materials and Methods:

The CPAK distributions of 246 patients (477 knees) with osteoarthritis (OA) and 107 healthy individuals (214 knees) were retrospectively examined using long-leg radiographs. Radiological measurements and CPAK classification of different Kellgren–Lawrence grades in patients with unilateral total knee arthroplasty (TKA) were compared. The clinical outcomes of patients with CPAK type I who underwent mechanical alignment or restricted kinematic alignment during TKA were examined.

Results:

The most common distributions in the OA and healthy groups were type I and type II, respectively. In patients who underwent unilateral TKA, the most common distribution of knees graded as Kellgren–Lawrence 3–4 was type I. However, the most common distributions of contralateral knees graded as Grade 0–2 were type I and II. For patients with CPAK type I, the mechanical alignment and restricted kinematic alignment groups did not differ significantly concerning postoperative clinical outcomes at three months.

Conclusion:

The most common distributions in Chinese osteoarthritic and healthy populations were types I and II, respectively. In addition, OA progression may lead to changes in the CPAK classification.
A CT-based deep learning model predicts overall survival in patients with muscle invasive bladder cancer after radical cystectomy: a multicenter retrospective cohort study
Authors: Wei Zongjie , Xv Yingjie , Liu Huayun , Li Yang , Yin Siwen , Xie Yongpeng , Chen Yong , Lv Fajin , Jiang Qing , Li Feng , Xiao Mingzhao
Published: February 2024

Background:

Muscle invasive bladder cancer (MIBC) has a poor prognosis even after radical cystectomy (RC). Postoperative survival stratification based on radiomics and deep learning algorithms may be useful for treatment decision-making and follow-up management. This study was aimed to develop and validate a deep learning (DL) model based on preoperative CT for predicting post-cystectomy overall survival in patients with MIBC.

Methods:

MIBC patients who underwent RC were retrospectively included from four centers, and divided into the training, internal validation and external validation sets. A deep learning model incorporated the convolutional block attention module (CBAM) was built for predicting overall survival using preoperative CT images. We assessed the prognostic accuracy of the DL model and compared it with classic handcrafted radiomics model and clinical model. Then, a deep learning radiomics nomogram (DLRN) was developed by combining clinicopathological factors, radiomics score (Rad-score) and deep learning score (DL-score). Model performance was assessed by C-index, KM curve, and time-dependent ROC curve.

Results:

A total of 405 patients with MIBC were included in this study. The DL-score achieved a much higher C-index than Rad-score and clinical model (0.690 vs. 0.652 vs. 0.618 in the internal validation set, and 0.658 vs. 0.601 vs. 0.610 in the external validation set). After adjusting for clinicopathologic variables, the DL-score was identified as a significantly independent risk factor for OS by the multivariate Cox regression analysis in all sets (all P<0.01). The DLRN further improved the performance, with a C-index of 0.713 (95%CI: 0.627-0.798) in the internal validation set and 0.685 (95%CI: 0.586-0.765) in external validation set, respectively.

Conclusions:

A DL model based on preoperative CT can predict survival outcome of patients with MIBC, which may help in risk stratification and guide treatment decision-making and follow-up management.
Performance-Based Outcomes after Revision Ulnar Collateral Ligament Surgery in Professional Pitchers
Authors: Malige Ajith , Uquillas Carlos
Published: February 2024

Objective:

To compare performance in baseball pitchers before and after revision ulnar collateral ligament (UCL) surgery using performance metrics.

Design:

Case series.

Setting:

Public online database.

Patients (or Participants):

Players who underwent revision UCL surgery between 2015 and 2021 were identified. Players were included if they were Minor League (MiLB) or Major League (Major League baseball [MLB]) pitchers. Players were excluded if they were not pitchers, if they underwent their revision surgery as an amateur, or if there is no record of their primary reconstruction surgery.

Interventions:

Revision UCL surgery (repair or reconstruction).

Main Outcome Measures:

Return to sport (RTS) rate, RTS time, pitch velocity, and pitch spin rate.

Results:

Sixty-five pitchers underwent revision UCL surgery. MiLB pitchers had a shorter RTS time after their primary surgery (15.62 vs 20.77 months, P < 0.01) compared with MLB pitchers but similar RTS times after their revision reconstruction (19.64 vs 18.48 months, P = 0.44). There was also no difference in return to play (RTP) rate overall after primary versus revision reconstruction (P = 1.00). Major League baseball pitchers also had decreased RTS time after primary compared with revision reconstruction (15.62 vs 19.64 months, P < 0.01) but similar RTP rates (P = 0.28). Finally, MLB pitchers had similar pitch breakdowns, velocities, and spin rates before and after their primary and revision repair or reconstruction.

Conclusions:

Both revision UCL repair and reconstruction can return pitchers to preinjury performance levels. Pitchers and teams should be properly counseled on realistic RTP times and postsurgery performance when discussing revision UCL surgeries.
Transimpedance Matrix Can Be Used to Estimate Electrode Positions Intraoperatively and to Monitor Their Positional Changes Postoperatively in Cochlear Implant Patients
Authors: Zhang Lichun , Schmidt Florian Herrmann , Oberhoffner Tobias , Ehrt Karsten , Cantré Daniel , Großmann Wilma , Schraven Sebastian P. , Mlynski Robert
Published: February 2024

Objective

Accurate positioning of the electrode array during cochlear implant (CI) surgery is crucial for achieving optimal hearing outcomes. Traditionally, postoperative radiological imaging has been used to assess electrode position. Transimpedance matrix (TIM) measurements have also emerged as a promising method for assessing electrode position. This involves utilizing electric field imaging to create an electric distance matrix by analyzing voltage variations among adjacent electrodes. This study aimed to investigate the feasibility of using intraoperative TIM measurements to estimate electrode position and monitor postoperative changes.

Study Design

Retrospective cohort study.

Setting

University Medical center, tertiary academic referral center.

Patients

Patients undergoing CI (CI622) surgery between January 2019 and June 2022.

Intervention

CI electrode positions and maximal angular insertion depths (maxAID) were determined using X-ray imaging according to Stenvers' projection. The mean gradient phase (MGP) was extracted from the TIM, and a correlation between the MGP and maxAID was examined. A model was then built to estimate the maxAID using the MGP, and changes in electrode location over time were assessed using this model.

Main Outcome Measures

Twenty-four patients were included in this study. A positive correlation between the maxAID and the MGP (R = 0.7, p = 0.0001) was found. The established model was able to predict the maxAID with an accuracy of 27.7 ± 4.4°. Comparing intraoperative and postoperative TIM measurements, a decrease of 24.1° ± 10.7° in maxAID over time was observed.

Conclusion

TIM measurements are useful for estimating the insertion depth of the electrode and monitoring changes in the electrode's position over time.
Navigating The complexity of churg-strauss syndrome presenting as acute abdomen: A comprehensive review and case report
Authors: Boda Subbarayudu , Badipatla Venkata Narayana , Divya Erramelli Nag , Dutta Palak , Ganduboina Rohit
Published: February 2024

Introduction and importance:

Churg-Strauss syndrome (CSS) is a rare multisystemic condition characterized by asthma, blood and tissue eosinophilia, and vasculitis. The purpose of this work is to present a detailed overview of CSS, focusing on its epidemiology, clinical symptoms, histological criteria, gastrointestinal involvement, and therapy.

Case presentation:

We report a case of a 40-year-old woman with CSS who had peripheral eosinophilia, small vessel vasculitis, and bronchial asthma. Diagnosed with symmetric polyarthritis six months ago, experienced abdominal pain, vomiting, and loose feces. Diagnostic tests revealed CSS with systemic involvement. In addition, we undertake a literature analysis to emphasize essential elements of CSS, such as its rarity and the difficulties in diagnosing and managing it.

Clinical discussion:

CSS can cause gastrointestinal symptoms including stomach pain, diarrhea, mucosal ulcers, rectal bleeding, and bowel perforations. Corticosteroids and immunosuppressives are routinely used in treatment, with caution due to the risks of long-term steroid use. The goal of treatment should be to induce remission while minimizing side effects.

Conclusion:

CSS is a rare condition, with an annual incidence of 2.4 per million and a prevalence of 1.3 per 100,000. The illness typically presents with necrotizing vasculitis, extravascular granulomas, and eosinophilic tissue infiltration. CSS is a complex and rare condition that requires high clinical suspicion, especially when patients present with gastrointestinal symptoms in addition to asthma and eosinophilia. This case study adds to our understanding of CSS and emphasizes the significance of a holistic strategy for its management.
Examining the Perspectives of Nurse Managers on Missed Nursing Care in Surgical Units
Authors: Kohanová Dominika , Kirwan Marcia , Bartoníčková Daniela , Gurková Elena , Žiaková Katarína
Published: February 2024

OBJECTIVE

To examine nurse managers' perspectives on missed nursing care (MNC) on surgical units.

BACKGROUND

The phenomenon of MNC is an important concern for nurse researchers. However, the reality of how it is experienced by clinical nurse managers is largely unexplored. Understanding nurse managers' experiences with MNC could help develop useful approaches to reducing levels of MNC.

METHODS

A descriptive qualitative study was conducted between December and June 2020, using face-to-face semistructured interviews with 10 nurse managers.

RESULTS

Five themes were identified: 1) awareness of MNC; 2) rationale for MNC; 3) consequences of MNC; 4) questions of reporting; and 5) management of MNC.

CONCLUSIONS

Nurse managers must use their positions and leadership skills to expect appropriate staffing approaches and material resources for surgical units, effective process for newly hired nurses, and the establishment of a reporting system for MNC to reduce the phenomenon in practice.
Prevalence of Urogenital Mycoplasma genitalium Infection at 2 US Army Medical Facilities
Authors: Romo Matthew L. , Moreland Sarah C. , Yates Adam M. , Crowell Trevor A. , Sevilla Maureen , MacArthur John L. , Faestel Paul , Kunz Anjali , Ake Julie A. , Calvano Tatjana , Colby Donn J.
Published: February 2024

Background

Sexually transmitted infections (STIs) have a high incidence in the US Armed Forces and can adversely impact service members' ability to perform their duties. Better knowledge of Mycoplasma genitalium (MG) epidemiology in the military is needed to understand the potential impact of this emerging pathogen on force readiness.

Methods

We conducted cross-sectional analyses of data from US Army service members and other Military Health System beneficiaries participating in a trial of an STI/HIV behavioral intervention at Fort Liberty, NC, and Joint Base Lewis-McChord, WA. At enrollment, participants completed questionnaires and provided biological specimens for nucleic acid amplification testing for MG, Chlamydia trachomatis (CT), and Neisseria gonorrhoeae (NG). We used principal component analysis and robust Poisson regression to examine associations between participant characteristics and prevalent urogenital MG.

Results

Among 432 participants enrolled between November 2020 and February 2023, 43 had MG (prevalence, 10.0%), of whom 13 had coinfection with another bacterial STI (all 13 were positive for CT, with 1 also positive for NG). The prevalence of MG was significantly higher among female (13.5%) versus male (7.6%; P = 0.048) participants and non-Hispanic Black (14.9%) versus non-Hispanic White participants (6.6%; P = 0.045). Single relationship status and increased number of recent sexual partners were correlated, and their component was associated with higher MG prevalence (adjusted prevalence ratio, 2.11; 95% confidence interval, 1.29–3.48).

Conclusions

The high prevalence of urogenital MG among Military Health System beneficiaries highlights the importance of understanding the potential clinical sequelae of MG and conducting additional epidemiologic research in military settings.