bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of gel concentration on filter fluxes in microfiltration of Hanford tank wastes and simulants
Authors: Westesen A. M. , Geeting J. G. H. , Brooks K. P. , Shimskey R. W. , Edwards M. K. , Peterson R. A.
Published: February 2023

Treatment processes have been proposed that will utilize crossflow filtration to concentrate sludge waste streams at the Department of Energy's Hanford Site. Challenges associated with solid–liquid separation of the waste streams drive a necessary evaluation of available Hanford high level waste (HLW) filtration data. Limiting flux conditions during crossflow filtration are elucidated with the formation of a cake layer on the membrane surface. A mass transfer coefficient between the gel and bulk concentrations plays a critical role in determining filter flux. A correlation between the gel concentration and mass transfer coefficient is made to assist in determining filter performance of select HLW streams. As a process alternative to crossflow filtration, gravity settling of waste streams may be deployed as a solid–liquid separation technique. However, this results in a contrasting performance with the centrifuged solids concentration. A method was developed to estimate expected filtration and settling performance based on physical characterization data for Hanford tank waste samples. By assessing the estimated processing performance of HLW, technical support can be provided during flowsheet planning.
Life cycle assessment of urban waste management in Rasht, Iran
Authors: Avarand Niloufar , Tavakoli Babak , Mahdiany Bora Khashayar
Published: February 2023

Population growth and industrial development have led to an increase in urban solid waste globally. Collection and disposal of urban waste remain the biggest challenges that countries face at the moment. Proper management in various stages of production, storage, transportation, and disposal of waste can ensure minimal impact to human and environmental health. There are several tools for evaluating a waste management system; among these, life cycle assessment (LCA) is an important one. This article aims to evaluate the life cycle of waste management in the city of Rasht and prioritize decisions to develop its waste management system. To achieve this purpose, four waste management scenarios were designed. In addition, the life cycle cataloging of the scenarios was done using the IWM-1 model in order to calculate the consumption of energy and also obtain the number of pollutant emission sources in each scenario. In the next step, the LCA of the scenarios was performed using the Eco-Indicator 99 index. The results of the study showed that scenario 4 had the most positive effects on the environment, with 40% compost, 25% recycling, 20% sanitary landfill, and 15% waste incineration, based on the index. Therefore, it was chosen as the best option for waste management in the city of Rasht. Integr Environ Assess Manag 2023;19:1385–1393. © 2023 SETAC
Time interval from primary melanoma to first distant recurrence in relation to patient outcomes in advanced melanoma
Authors: van Duin Isabella A. J. , Elias Sjoerd G. , van den Eertwegh Alfonsus J. M. , de Groot Jan Willem B. , Blokx Willeke A. M. , van Diest Paul J. , Leiner Tim , Verhoeff Joost J. C. , Verheijden Rik J. , van Not Olivier J. , Aarts Maureen J. B. , van den Berkmortel Franchette W. P. J. , Blank Christian U. , Haanen John B. A. G. , Hospers Geke A. P. , Kamphuis Anna M. , Piersma Djura , van Rijn Rozemarijn S. , van der Veldt Astrid A. M. , Vreugdenhil Gerard , Wouters Michel W. J. M. , Stevense‐den Boer Marion A. M. , Boers‐Sonderen Marye J. , Kapiteijn Ellen , Suijkerbuijk Karijn P. M.
Published: February 2023

Since the introduction of BRAF(/MEK) inhibition and immune checkpoint inhibition (ICI), the prognosis of advanced melanoma has greatly improved. Melanoma is known for its remarkably long time to first distant recurrence (TFDR), which can be decades in some patients and is partly attributed to immune‐surveillance. We investigated the relationship between TFDR and patient outcomes after systemic treatment for advanced melanoma. We selected patients undergoing first‐line systemic therapy for advanced melanoma from the nationwide Dutch Melanoma Treatment Registry. The association between TFDR and progression‐free survival (PFS) and overall survival (OS) was assessed by Cox proportional hazard regression models. The TFDR was modeled categorically, linearly, and flexibly using restricted cubic splines. Patients received anti‐PD‐1‐based treatment (n = 1844) or BRAF(/MEK) inhibition (n = 1618). For ICI‐treated patients with a TFDR <2 years, median OS was 25.0 months, compared to 37.3 months for a TFDR >5 years (P = .014). Patients treated with BRAF(/MEK) inhibition with a longer TFDR also had a significantly longer median OS (8.6 months for TFDR <2 years compared to 11.1 months for >5 years, P = .004). The hazard of dying rapidly decreased with increasing TFDR until approximately 5 years (HR 0.87), after which the hazard of dying further decreased with increasing TFDR, but less strongly (HR 0.82 for a TFDR of 10 years and HR 0.79 for a TFDR of 15 years). Results were similar when stratifying for type of treatment. Advanced melanoma patients with longer TFDR have a prolonged PFS and OS, irrespective of being treated with first‐line ICI or targeted therapy.
The interplay of oncogenic signaling, oxidative stress and ferroptosis in cancer
Authors: Zeng Wentao , Long Xiaohang , Liu Pu‐Ste , Xie Xin
Published: February 2023

Oncogene‐induced hyper‐proliferation in cancer cells is accompanied by the onset of different stresses, including DNA‐replication stress, metabolic stress and oxidative stress. Excessive accumulation of reactive oxygen species (ROS) plays a pivotal and contradictory role in tumor progression. ROS dictates a multitude of cell signaling pathways to facilitate the malignant transformation of tumor cells. In the meantime, oxidative burden in tumor cells mandates reinforcing antioxidant capacity to mitigate detrimental damages. The addiction to oxidative stress and increased iron demands in cancer cells also impinges on the sensitivity of ferroptosis. Targeting redox homeostasis and ferroptosis to overcome drug resistance in cancer treatment has become an attractive research topic. However, the roles of oncogenic signaling in redox regulation and ferroptosis have not been comprehensively discussed. In this review, we summarize current knowledge regarding the interplay between redox regulation and ferroptosis in the context of cancer biology. We emphasize the implication of oncogenic signaling in redox homeostasis and ferroptosis regulation. We also provide an overview of strategies targeting oxidative stress and ferroptosis in cancer treatment.
Surviving surgery; succumbing to pharmacotherapy: A case report underscoring the importance of PRN order clarification for patient safety
Authors: Nassiri Setare , Karimian Zahra , Tahermanesh Kobra , Farasatinasab Maryam
Published: February 2023

“Pro re nata” (PRN) or “as needed” medicine administration and usage is a relatively neglected area in medication management (pharmacotherapy/pharmaceutical care) which contributes to error‐prone use of medications and is unsafe for patients. In this case, we report the incident of diclofenac toxicity in a 51‐year‐old woman due to a prescription of 100 mg diclofenac suppositories PRN, or as needed, for postoperative pain control without explanation of the maximum daily dose (150 mg daily), which led to arbitrary consumption of 3 g of diclofenac over 5 days (600 mg daily) by the patient, and subsequent development of metabolic acidosis, acute kidney injury, and sudden cardiac arrest. The implementation of practical guidelines and training programs for health care workers to appropriately prescribe, dispense, and administer PRN medicines are necessary, and should at least include providing clarification for their indication, dose and frequency, as well as any cautionary instructions to ensure safe and effective use of such medicines.
Successful invasions to freshwater systems double with climate warming
Authors: Salis Romana K. , Brennan Georgina L. , Hansson Lars‐Anders
Published: February 2023

Although invasive species are recognized as a major threat to freshwaters, little is known about how future climate warming will affect the success of invaders. Ecosystems are also often simultaneously impacted by multiple, potentially interacting, invading species and the management of species invasions can be incredibly difficult. Sensitive methods such as environmental DNA (eDNA) metabarcoding, may be key to the early detection and monitoring of invaders. Therefore, to quantify invader success, we performed an outdoor mesocosm experiment mimicking present and future temperatures (IPCC RPC 8.5) combined with a multispecies invasion of planktonic organisms collected from a region with 3–4°C higher mean temperature. 18S eDNA metabarcoding was used to track invaders and impacts on the established eukaryotic community over 22 weeks. We show that invasion success doubled with climate warming compared to present temperatures, implying a substantial increase in successful establishment of invaders in the future. In addition, after the invasion, species richness increased at warming, but not at present, climate conditions. Our quantification of the establishment of invaders in a climate warming scenario, using advanced eDNA methodologies, provides an important step in understanding and predicting how climate warming may affect the success of invasive species in the future, thereby allowing for more informed management recommendations in adapting society to climate change.
Synchronization for a class of discrete complex dynamical networks in presence of Markov jump topology and actuator saturation
Authors: Natarajan Sakthivel , Subramani Pallavi
Published: February 2023

This work addresses the synchronization problem for discrete complex dynamical networks (CDNs) that are associated with Markov jump outer coupling, parameter uncertainties, actuator saturation, and time delay. Especially, the uncertainties which occur in the inner coupling matrix are categorized with the use of the interval matrix approach. The main purpose of this work is to design an appropriate state feedback controller with a saturation effect that guarantees asymptotic synchronization and also satisfy a prescribed level of mixed and passivity performance for the addressed CDNs. Moreover, a new set of adequate criteria are expressed in the form of linear matrix inequalities to synchronize the considered network plant. The above synchronization criteria are retrieved with the support of an appropriate Lyapunov–Krasovskii functional, Kronecker product properties together with Jensen's inequality and Abel lemma. Eventually, the efficiency and superiority of our proposed synchronization criteria are demonstrated through two numerical examples.
Distribution of potassium, calcium, and magnesium ions from potassium fertilizers in columns of orchard soils
Authors: Yu Chieh , Geisseler Daniel J. , Brown Patrick H. , Khalsa Sat Darshan S.
Published: February 2023

Potassium (K) in fruit and nut orchards affects productivity, water relations, and crop quality; however, information about K, calcium (Ca), and magnesium (Mg) dynamics in orchard soils is limited. This study evaluates the distribution of K, Ca, and Mg in 30‐cm soil columns following four wetting events over 70 days. Soils were a Hillgate sandy loam, a San Ysidro loam, and a Yolo loam applied with muriate of potash (KCl), microfine sulfate of potash (SOP; [K2SO4]), polyhalite (POLY; [K2SO4·MgSO4·2CaSO4·2H2O]), and an unfertilized control. Soil solution K concentrations measured at 5 cm using a porewater sampler were greater than 1400 mg K L−1 in the Hillgate sandy loam POLY treatment after the first two wetting events. Ca and Mg in soil solution were also greater for POLY when averaged across all four wetting events, likely due to greater Ca and Mg inputs. Extractable K using ammonium acetate, significantly increased after the wetting events resulting in 88% and 75% of the extractable K in the top 0–10 cm of the San Ysidro and Yolo loams, respectively. Leached K accounted for 6.2% of the SOP inputs in the Hillgate sandy, whereas only 0.3% and 1.1% in the San Ysidro and Yolo loams, respectively. Higher K leaching as well as Ca and Mg is likely due to higher cation exchange capacity in loam soils and great porosity in sandy loam soils. Our results show differences in the distribution of K, Ca, and Mg and provide insights into K fertilizer availability for orchard soils.
Electromagnetic Response of Multistage‐Helical Nano‐Micro Conducting Polymer Structures and their Enhanced Attenuation Mechanism of Multiscale‐Chiral Synergistic Effect
Authors: Li Tian , Li Jinzhe , Xu Zhengkan , Tian YingRui , Li Jiatong , Du Jiani , Meng Fanbin
Published: February 2023

Nowadays, the rapidly development of advanced antidetection technology raises stringent requirements for microwave absorption materials (MAMs) to focus more attention on wider bandwidth, thinner thickness, and lower density. Adding magnetic medium to realize broadband absorption may usually result in the decline of service performance and accelerating corrosion of MAMs. Chiral MAMs can produce extra magnetic loss without adding magnetic medium due to the unique electromagnetic cross polarization effect. However, more efforts should be taken to furtherly promote efficient bandwidth of chiral MAMs and reveal attenuation mode and modulation method of chiral structure. Herein, a novel superhelical nano‐microstructure based on chiral polyaniline and helical polypyrrole is successfully achieved via in situ polymerization strategy. The enhanced multiscale‐chiral synergistic effect contributes to broaden effective absorption bandwidth, covering 8.6 GHz at the thickness of 3.6 mm, and the minimum reflection loss can reach −51.3 dB simultaneously. Besides, to further explain response modes and loss mechanism of superhelical nano‐microstructures, the electromagnetic simulation and test analysis are applied together to reveal their synergistic enhancement attenuation mechanism. Taken together, this strategy gives a new thought of how to design, prepare, and optimize the hierarchical structure materials to achieving broadband and high‐performance microwave absorption.
Ultrasound‐Activatable g‐C3N4‐Anchored Titania Heterojunction as an Intracellular Redox Homeostasis Perturbator for Augmented Oncotherapy
Authors: He Mengting , Yu Honglian , Zhao Yinmin , Liu Jiahui , Dong Qi , Xu Zhigang , Kang Yuejun , Xue Peng
Published: February 2023

Energy band structure of inorganic nano‐sonosensitizers is usually optimized by surface decoration with noble metals or metal oxide semiconductors, aiming to enhance interfacial charge transfer, augment spin‐flip and promote radical generation. To avoid potential biohazards of metallic elements, herein, metal‐free graphitic carbon nitride quantum dots (g‐C3N4 QDs) are anchored onto hollow mesoporous TiO2 nanostructure to formulate TiO2@g‐C3N4 heterojunction. The direct Z‐scheme charge transfer significantly improves the separation/recombination dynamics of electron/hole (e−/h+) pairs upon ultrasound (US) stimulation, which promotes the yield of singlet oxygen (1O2) and hydroxyl radicals (·OH). The conjugated g‐C3N4 QDs with peroxidase‐mimic activity further react with the elevated endogenous H2O2 and aggravate oxidative stress. After loading prodrug romidepsin (RMD) in TiO2@g‐C3N4, stimulus‐responsive drug delivery can be realized by US irradiation. The disulfide bridge of the released RMD tends to be reduced by glutathione (GSH) into a monocyclic dithiol, which arrests cell cycle in G2/M phase and evokes apoptosis through enhanced histone acetylation. Importantly, reactive oxygen species accumulation accompanied by GSH depletion is devoted to deleterious redox dyshomeostasis, leading to augmented systemic oncotherapy by eliciting antitumor immunity. Collectively, this paradigm provides useful insights in optimizing the performance of TiO2‐based nano‐sonosensitizers for tackling critical diseases.
Goodness‐of‐fit test for semiparametric copula models with bivariate interval‐censored data
Authors: Zhang Ximeng , Zhao Shishun , Hu Tao , Sun Jianguo
Published: February 2023

This paper discusses the goodness‐of‐fit test of semiparametric copula models when one faces bivariate interval‐censored failure time data, which often occur in many areas including epidemiological and medical studies as well as social science experiments. For the problem, three test statistics or procedures are proposed: two based on the pseudo in‐and‐out‐sample approach and one based on the information ratio criterion. The asymptotic properties of the proposed test procedures are established, and in particular, the three methods are shown to be asymptotically equivalent. To assess the empirical performance of the proposed methods, an extensive simulation study is conducted and indicates that they work well in practical situations. An application to a Signal–Tandmobiel study is provided.
An investigation of distributed computing for combinatorial testing
Authors: La Chance Edmond , Hallé Sylvain
Published: February 2023

Combinatorial test generation, also called
‐way testing, is the process of generating sets of input parameters for a system under test, by considering interactions between values of multiple parameters. In order to decrease total testing time, there is an interest in techniques that generate smaller test suites. In our previous work, we used graph techniques to produce high‐quality test suites. However, these techniques require a lot of computing power and memory, which is why this paper investigates distributed computing for
‐way testing. We first introduce our distributed graph colouring method, with new algorithms for building the graph and for colouring it. Second, we present our distributed hypergraph vertex covering method and a new heuristic. Third, we show how to build a distributed IPOG algorithm by leveraging either graph colouring or hypergraph vertex covering as vertical growth algorithms. Finally, we test these new methods on a computer cluster and compare them to existing
‐way testing tools.
Dynamics of forced escape from asymmetric truncated parabolic well
Authors: Genda Attila , Fidlin Alexander , Gendelman Oleg
Published: February 2023

This study presents an analytic method for the estimation of safe basins in the plane of the initial conditions of the escape of a classical particle from an asymmetrically truncated quadratic potential well. For this purpose, an analytic method to estimate the global optimum of the sum of two harmonic functions is proposed. This approach is based on the mapping of the arguments of the two harmonic terms to the surface of the unit torus, where a surrogate optimization problem obtained by the Taylor expansion of the original objective function is solved. Applying the proposed method to the aforementioned escape problem helps predict safe basins for any value of the excitation frequency provided that the exciting force is not too strong, generating essentially non‐linear effects on potential boundaries. Specifically, interesting effects with regard to the shape of safe basins occur when the natural frequency of the potential well and frequency of excitation represent the ratio of two small integers.
K-theory of noncommutative Bernoulli shifts
Authors: Chakraborty Sayan , Echterhoff Siegfried , Kranz Julian , Nishikawa Shintaro
Published: February 2023

For a large class of $$C^*$$

C
∗

-algebras A, we calculate the K-theory of reduced crossed products $$A^{\otimes G}\rtimes _rG$$

A

⊗
G

⋊
r

G

of Bernoulli shifts by groups satisfying the Baum–Connes conjecture. In particular, we give explicit formulas for finite-dimensional $$C^*$$

C
∗

-algebras, UHF-algebras, rotation algebras, and several other examples. As an application, we obtain a formula for the K-theory of reduced $$C^*$$

C
∗

-algebras of wreath products $$H\wr G$$

H
≀
G

for large classes of groups H and G. Our methods use a generalization of techniques developed by the second named author together with Joachim Cuntz and Xin Li, and a trivialization theorem for finite group actions on UHF algebras developed in a companion paper by the third and fourth named authors.
Imaging in rhabdomyosarcoma: a patient journey
Authors: de Vries Isabelle S. A. , van Ewijk Roelof , Adriaansen Laura M. E. , Bohte Anneloes E. , Braat Arthur J. A. T. , Fajardo Raquel Dávila , Hiemcke-Jiwa Laura S. , Hol Marinka L. F. , ter Horst Simone A. J. , de Keizer Bart , Knops Rutger R. G. , Meister Michael T. , Schoot Reineke A. , Smeele Ludi E. , van Scheltinga Sheila Terwisscha , Vaarwerk Bas , Merks Johannes H. M. , van Rijn Rick R.
Published: February 2023

Rhabdomyosarcoma, although rare, is the most frequent soft tissue sarcoma in children and adolescents. It can present as a mass at nearly any site in the body, with most common presentations in the head and neck, genitourinary tract and extremities. The optimal diagnostic approach and management of rhabdomyosarcoma require a multidisciplinary team with multimodal treatment, including chemotherapy and local therapy. Survival has improved over the last decades; however, further improvement in management is essential with current 5-year overall survival ranging from 35% to 100%, depending on disease and patient characteristics. In the full patient journey, from diagnosis, staging, management to follow-up after therapy, the paediatric radiologist and nuclear physician are essential members of the multidisciplinary team. Recently, guidelines of the European paediatric Soft tissue sarcoma Study Group, the Cooperative Weichteilsarkom Studiengruppe and the Oncology Task Force of the European Society of Paediatric Radiology (ESPR), in an ongoing collaboration with the International Soft-Tissue Sarcoma Database Consortium, provided guidance for high-quality imaging. In this educational paper, given as a lecture during the 2022 postgraduate ESPR course, the multi-disciplinary team of our national paediatric oncology centre presents the journey of two patients with rhabdomyosarcoma and discusses the impact on and considerations for the clinical (paediatric) radiologist and nuclear physician. The key learning points of the guidelines and their implementation in clinical practice are highlighted and up-to-date insights provided for all aspects from clinical suspicion of rhabdomyosarcoma and its differential diagnosis, to biopsy, staging, risk stratification, treatment response assessment and follow-up.
DEEP MOVEMENT: Deep learning of movie files for management of endovascular thrombectomy
Authors: Kelly Brendan , Martinez Mesha , Do Huy , Hayden Joel , Huang Yuhao , Yedavalli Vivek , Ho Chang , Keane Pearse A. , Killeen Ronan , Lawlor Aonghus , Moseley Michael E. , Yeom Kristen W. , Lee Edward H.
Published: February 2023

Objectives

Treatment and outcomes of acute stroke have been revolutionised by mechanical thrombectomy. Deep learning has shown great promise in diagnostics but applications in video and interventional radiology lag behind. We aimed to develop a model that takes as input digital subtraction angiography (DSA) videos and classifies the video according to (1) the presence of large vessel occlusion (LVO), (2) the location of the occlusion, and (3) the efficacy of reperfusion.

Methods

All patients who underwent DSA for anterior circulation acute ischaemic stroke between 2012 and 2019 were included. Consecutive normal studies were included to balance classes. An external validation (EV) dataset was collected from another institution. The trained model was also used on DSA videos post mechanical thrombectomy to assess thrombectomy efficacy.

Results

In total, 1024 videos comprising 287 patients were included (44 for EV). Occlusion identification was achieved with 100% sensitivity and 91.67% specificity (EV 91.30% and 81.82%). Accuracy of location classification was 71% for ICA, 84% for M1, and 78% for M2 occlusions (EV 73, 25, and 50%). For post-thrombectomy DSA (n = 194), the model identified successful reperfusion with 100%, 88%, and 35% for ICA, M1, and M2 occlusion (EV 89, 88, and 60%). The model could also perform classification of post-intervention videos as mTICI < 3 with an AUC of 0.71.

Conclusions

Our model can successfully identify normal DSA studies from those with LVO and classify thrombectomy outcome and solve a clinical radiology problem with two temporal elements (dynamic video and pre and post intervention).

Key Points

• DEEP MOVEMENT represents a novel application of a model applied to acute stroke imaging to handle two types of temporal complexity, dynamic video and pre and post intervention.

• The model takes as an input digital subtraction angiograms of the anterior cerebral circulation and classifies according to (1) the presence or absence of large vessel occlusion, (2) the location of the occlusion, and (3) the efficacy of thrombectomy.

• Potential clinical utility lies in providing decision support via rapid interpretation (pre thrombectomy) and automated objective gradation of thrombectomy outcomes (post thrombectomy).
Comparison of laparoscopic and open ileocecal resection for Crohn’s disease in children
Authors: Dotlacil V. , Lerchova T. , Coufal S. , Kucerova B. , Schwarz J. , Hradsky O. , Skaba R. , Rygl M.
Published: February 2023

Purpose

Ileocecal resection (ICR) is the most frequently performed surgery in paediatric Crohn’s disease (CD) patients. The aim of the study was to compare laparoscopic-assisted and open ICR.

Methods

Retrospective review of consecutive CD patients undergoing ICR between March 2014 and December 2021 was performed. The patients were divided into open (OG) and laparoscopic (LG) groups. Compared parameters included patients’ demographics, clinical characteristics, surgery, duration of hospitalisation and follow-up. Complications were classified according to the Clavien–Dindo classification (CDc). Risk factors were identified using multivariable analysis.

Results

Sixty-two patients (29 females, 46.7%) were included in the analysis, forty-two patients in OG. The median duration of surgery was 130 in OG versus 148 in LG (p = 0.065) minutes. Postoperative complications were reported in 4 patients (12.1%). There was no significant difference in postoperative complications according to CDc (OG 7.14 vs LG 5%, p = 1). The median length of hospitalisation was 8 in OG and 7 days in LG (p = 0.0005). The median length of follow-up was 21.5 months.

Conclusion

The laparoscopic-assisted approach had shorter hospital stay and was not associated with increased risk of 30-day postoperative complications. Laparoscopic surgery should be considered the preferred surgical approach for primary ICR.
3D liver model-based surgical education improves preoperative decision-making and patient satisfaction—a randomized pilot trial
Authors: Giehl-Brown Esther , Dennler Sandra , Garcia Sebastián A. , Seppelt Danilo , Oehme Florian , Schweipert Johannes , Weitz Jürgen , Riediger Carina
Published: February 2023

Objective

Hepatobiliary surgery bares obstacles to informed consent for the patients due to its complexity and related risk of postoperative complications. 3D visualization of the liver has been proven to facilitate comprehension of the spatial relationship between anatomical structures and to assist in clinical decision-making. Our objective is to utilize individual 3D-printed liver models to enhance patient satisfaction with surgical education in hepatobiliary surgery.

Design, setting

We conducted a prospective, randomized pilot study comparing 3D liver model-enhanced (3D-LiMo) surgical education against regular patient education during preoperative consultation at the department of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Dresden, Germany.

Participants

Of 97 screened patients, undergoing hepatobiliary surgery, 40 patients were enrolled from July 2020 to January 2022.

Results

The study population (n = 40) was predominantly of male gender (62.5%) with a median age of 65.2 years and a high prevalence of preexisting diseases. Underlying disease, warranting hepatobiliary surgery, was malignancy in the majority of cases (97.5%). Patients in the 3D-LiMo group were more likely to feel very thoroughly educated and exhibited a higher level of satisfaction following surgical education than the control group (80 vs. 55%, n.s.; 90 vs. 65%, n.s.; respectively). Applying 3D models was also associated with enhanced understanding of the underlying disease with regard to amount (100% vs. 70%, p = 0.020) and location of liver masses (95 vs. 65%, p = 0.044). 3D-LiMo patients also demonstrated enhanced understanding of the surgical procedure (80 vs. 55%, n.s.), leading to better awareness for the occurrence of postoperative complications (88.9, vs. 68.4%, p = 0.052). Adverse event profiles were similar.

Conclusion

In conclusion, individual 3D-printed liver models increase patient satisfaction with surgical education and facilitate patients’ understanding of the surgical procedure as well as awareness of postoperative complications. Therefore, the study protocol is feasible to apply to an adequately powered, multicenter, randomized clinical trial with minor modifications.
Sodium-glucose cotransporter 2 inhibitor-associated perioperative ketoacidosis: a systematic review of case reports
Authors: Seki Hiroyuki , Ideno Satoshi , Shiga Toshiya , Watanabe Hidenobu , Ono Motoaki , Motoyasu Akira , Noguchi Hikari , Kondo Kazuya , Yoshikawa Takahiro , Hoshijima Hiroshi , Hyuga Shunsuke , Shishii Miho , Nagai Ai , Higashi Midoriko , Ouchi Takashi , Yasuda Kazuki , Kuratani Norifumi
Published: February 2023

Although the recommended preoperative cessation period for sodium-glucose cotransporter 2 inhibitors (SGLT2is) changed in 2020 (from 24 h to 3–4 days preoperatively) to reduce the risk of SGLT2i-associated perioperative ketoacidosis (SAPKA), the validity of the new recommendation has not been verified. Using case reports, we assessed the new recommendation effectiveness and extrapolated precipitating factors for SAPKA. We searched electronic databases up to June 1, 2022 to assess SAPKA (blood pH < 7.3 and blood or urine ketone positivity within 30 days postoperatively in patients taking SGLT2i). We included 76 publications with 99 cases. The preoperative SGLT2i cessation duration was reported for 59 patients (59.6%). In all cases with available cessation periods, the SGLT2is were interrupted < 3 days preoperatively. No SAPKA cases with > 2-day preoperative cessation periods were found. Many case reports lack important information for estimating precipitating factors, including preoperative SGLT2i cessation period, body mass index, baseline hemoglobin A1c level, details of perioperative fluid management, and type of anesthesia. Our study suggested that preoperative SGLT2i cessation for at least 3 days could prevent SAPKA. Large prospective epidemiologic studies are needed to identify risk factors for SAPKA.
Mental health problems and suicidal behavior from adolescence to young adulthood in college: linking two population-based studies
Authors: Sivertsen Børge , O’Connor Rory C. , Nilsen Sondre Aasen , Heradstveit Ove , Askeland Kristin Gärtner , Bøe Tormod , Hysing Mari
Published: February 2023

It is well established that mental health problems are highly recurrent and persistent from childhood to adolescence, but less is known to what extent mental health problems also persist from adolescence into young adulthood. The aim of the current study was therefore to examine the chronicity and risk of mental health problems and suicidality from adolescence to young adulthood. Data stem from two Norwegian population-based studies conducted 6 years apart; the youth@hordaland study from 2012 (age 16–19) and the SHoT2018 study (age 22–25). These two data sources were linked to produce a longitudinal sample of 1257 individuals. A wide range of self-reported mental health and suicidality instruments (used both continuously and categorically) were analyzed using log-link binomial regression analysis, adjusting for age, sex, parental education, and financial problems. We found that high levels of mental health problems in late adolescence were a significant risk factor for reporting poor mental health 6 years later. Internalizing and externalizing problems in adolescence were associated with a 2.8-fold and 1.9-fold increased risk, respectively, of reporting a mental disorder 6 years later. Similarly, self-harm in adolescence was associated with a 2.1-fold increased risk of suicidal thoughts 6 years later. The magnitudes of the adjusted risk ratios were generally similar across the various mental health and suicidality measures used at the two assessment points. Adjustment for confounders did not, or only slightly, attenuate the risk ratios, and all associations remained statistically significant in the adjusted analyses. This longitudinal study provides new evidence of the chronicity of mental health problems and suicidality from adolescence to adulthood in Norway. The results emphasize the importance of early identification and timely interventions to reduce the prevalence and impact of mental health problems and suicidality.
Treatment of digital ulcers in systemic sclerosis: recent developments and future perspectives
Authors: Sagonas Ioannis , Daoussis Dimitrios
Published: February 2023

Digital ulcers (DUs) comprise the main manifestation of vasculopathy and are a major cause of disability in patients with systemic sclerosis (SSc). A literature search in Web of Science, PubMed and Directory of Open Access Journals was performed in December 2022 to identify articles published in the last decade regarding the management of DUs. Prostacyclin analogues, endothelin antagonists and phosphodiesterase 5 inhibitors have shown promising results both as a stand-alone treatment and in combination for the treatment of existing and prevention of new DUs. Moreover, autologous fat grafting and botulinum toxin injections, although not readily available, can be of use in recalcitrant cases. Many investigational treatments with promising results could pave the way for a paradigm shift in the treatment of DUs in the future. Despite these recent advances, challenges remain. Better-designed trials are of paramount importance to optimise DU treatment in the years to come.

Key Points• DUs are a major cause of pain and reduced quality of life in patients with SSc.• Prostacyclin analogues and endothelin antagonists have shown promising results both as a stand-alone treatment and in combination for the treatment of existing and prevention of new DUs.• In the future, a combination of more powerful vasodilatory drugs, perhaps in conjunction with topical approaches, may improve outcomes.
Last twenty-years activity of cardiovascular tissue banking in Barcelona
Authors: Castells-Sala C. , Pérez M. L. , Agustí E. , Aiti A. , Tarragona E. , Navarro A. , Tabera J. , Fariñas O. , Pomar J. L. , Vilarrodona A.
Published: February 2023

The Barcelona Tissue Bank was established from the merge of two previous multi-tissue banks. Potential donors are screened by Donor Center staff and multi-tissue retrieval is performed by specialized own teams. Tissue processing and preservation is performed in clean room facilities by specialised personnel. After quality control of both donor and all tissues results, the heart valves and vascular segments are stored until medical request. The aim of this report is to present the cardiovascular tissue activity and retrospectively evaluate the outcomes of the changes performed in last 20 years. Cardiovascular tissue from 4088 donors was received, specifically 3115 hearts and 2095 vascular segments were processed and evaluated. A total of 48% of the aortic valves, 68% of the pulmonary valves and 75% of the vascular segments were suitable for transplant. The main reason for discarding tissue was macroscopic morphology followed by microbiological results, for both valves and arteries. Altogether, 4360 tissues were distributed for transplantation: 2032 (47%) vascular segments, 1545 (35%) pulmonary valves and 781 (18%) aortic valves. The most common indication for aortic valve surgery was the treatment of endocarditis, while for pulmonary valves, it was congenital malformation reconstruction. Vascular segments were mainly used for reconstruction after ischemia. During this period, a number of changes were made with the goal of enhancing tissue quality, safety and efficacy. These improvements were achieved through the use of a new antibiotic cocktail, increasing of donor age criteria and changing the microbiological control strategy.
Impact of storage time prior to cryopreservation on mechanical properties of aortic homografts
Authors: Axelsson Ida , Gustafsson Anna , Isaksson Hanna , Nilsson Johan , Malm Torsten
Published: February 2023

Optimal time spans in homograft procurement are still debatable among tissue banks and needs to be further investigated. Cell viability decreases at longer preparation intervals, but the effect on collagen and elastic fibers has not been investigated to the same extent. These fibers are of importance to the homograft elasticity and strength. The objective of this study was to analyze the mechanical properties of homograft tissue at different time spans in the procurement process. Ten aortic homografts were collected at the Tissue Bank in Lund. Twelve samples were obtained from each homograft, cryopreserved in groups of three after 2–4 days, 7–9 days, 28–30 days, and 60–62 days in antibiotic decontamination. Mechanical testing was performed with uniaxial tensile tests, calculating elastic modulus, yield stress and energy at yield stress. Two randomly selected samples were assessed with light microscopy. Procurement generated a total of 120 samples, with 30 samples in each time group. Elastic modulus and yield stress was significantly higher in samples cryopreserved after 2–4 days (2.7 MPa (2.5-5.0) and 0.78 MPa (0.68-1.0)) compared to 7–9 days (2.2 MPa (2.0-2.6) and 0.53 MPa (0.46–0.69)), p = 0.008 and 0.011 respectively. Light microscopy did not show any difference in collagen and elastin at different time spans. There was a significant decrease in elastic modulus and yield stress after 7 days of decontamination at 4 °C compared to 2–4 days. This could indicate some deterioration of elastin and collagen at longer decontamination intervals. Clinical significance of these findings remains to be clarified.
Seasonal and diurnal patterns of littoral microhabitat use by fish in gravel pit lakes, with special reference to supplemented deadwood brush piles
Authors: Maday A. , Matern S. , Monk C. T. , Klefoth T. , Wolter C. , Arlinghaus R.
Published: February 2023

The habitat quality of the littoral zone is of key importance for almost all lentic fish species. In anthropogenically created gravel pit lakes, the littoral zone is often structurally homogenized with limited fish habitats. We supplemented deadwood brush piles in the littoral zone of eight gravel pit lakes and investigated the diurnal and seasonal use of this and other typical microhabitats by six dominant fish species. Shoreline habitats were sampled using point abundance electrofishing during day and night in all four seasons, and patterns of fish abundance were compared amongst unstructured littoral habitats, emerged macrophytes and brush piles. We caught a total of 14,458 specimens from 15 species in the gravel pit lakes. Complex shoreline structures were used by all fish species that we examined, especially during daytime, whilst the use of unstructured habitats was highest during night. The newly added brush piles constituted suitable microhabitats for selected fish species, perch (Perca fluviatilis), roach (Rutilus rutilus) and pike (Esox lucius), particularly during winter. Supplemented deadwood provides suitable fish habitat in gravel pit lakes and may to some degree compensate for the loss of submerged macrophytes in winter by offering refuge and foraging habitat for selected fish species.
Seasonal Differences in the Encounter Rate of the Fat-Tailed Dwarf Lemur (Cheirogaleus medius) in the Transitional Forests of Northwest Madagascar: Implications for Reliable Population Density Assessment
Authors: Hending Daniel , Randrianarison Heriniaina , Andriamavosoloarisoa Niaina Nirina Mahefa , Ranohatra-Hending Christina , Solofondranohatra James Sedera , Tongasoa Haja Roger , Ranarison Herinirina Tahina , Gehrke Victoria , Andrianirina Natacha , Holderied Marc , McCabe Grainne , Cotton Sam
Published: February 2023

Primate encounter rates often vary throughout the year due to seasonal differences in activity, ecology, and behaviour. One notably extreme behaviour is continuous hibernation. Although a rare adaptation in primates, the dwarf lemurs of Madagascar (genusCheirogaleus) enter obligate hibernation each year during the dry season, after spending the wet season consuming high-energy foods. Whilst seasonal changes in activity in someCheirogaleuspopulations are well-known, many species remain little-studied, and there is no specific information on their encounter rates, nor when they enter and emerge from hibernation. This uncertainty critically affects reliable calculation of population density estimates for these highly threatened lemurs. In this study, we assessed how encounter rates of the fat-tailed dwarf lemur (C. medius) vary seasonally in the transitional forests of the Sahamalaza-Iles Radama National Park, northwest Madagascar, during a 4-year period. We established a system of line transects (N = 60) throughout our study area, on which we conducted distance sampling ofC. medius. We then used our distance sampling data to calculate encounter rate and population density data. We found encounter rates ofC. mediusto be significantly higher during the wet season compared with the dry season. Furthermore, encounter rates ofC. mediuswere particularly low from May–August. These results provide some evidence to suggest the time period thatC. mediushibernate in Sahamalaza-Iles Radama National Park. These findings underpin the importance of careful study design when surveying threatened species with seasonal differences in activity, such as those that hibernate. This study also demonstrates the importance of species-specific behavioural data for accurate population density assessment, which is required to inform conservation action.
Integrated Mental Healthcare and Vocational Rehabilitation for People on Sick Leave with Anxiety or Depression: 24-Month Follow-up of the Randomized IBBIS Trial
Authors: Hoff Andreas , Poulsen Rie Mandrup , Fisker Jonas Peter , Hjorthøj Carsten , Nordentoft Merete , Christensen Ulla , Bojesen Anders Bo , Eplov Lene Falgaard
Published: February 2023

Integration of vocational rehabilitation and mental healthcare has shown some effect on work participation at 1-year follow-up after sick leave with depression and anxiety. We aimed to study the effect on work and health outcomes at 2-year follow-up, why we performed a randomized trial was conducted to study the effectiveness of integrated intervention (INT) compared to service as usual (SAU) and best practice mental healthcare (MHC). We included 631 participants, and at 24-month follow-up, we detected no differences in effect between INT and SAU. Compared to MHC, INT showed faster return-to-work (RTW) rates (p = 0.044) and a higher number of weeks in work (p = 0.024). No symptom differences were observed between the groups at 24 months. In conclusion, compared to SAU, INT was associated with a slightly higher work rate reaching borderline statistical significance at 12-month follow-up and lower stress levels at 6-month follow-up. The disappearance of relative effect between 12 and 24 months may be explained by the fact that the intervention lasted less than 12 months or by delayed spontaneous remission in the SAU group after 12 months. Despite the lack of effect at long-term follow-up, INT still performed slightly better than SAU overall. Moderate implementation difficulties, may partly explain the absence of the hypothesized effect. Integrated intervention, as implemented in this trial, showed some positive effects on mid-term vocational status and short-term stress symptom levels. However, these effects were not sustained beyond the duration of the intervention.
Spatial predictions for the distribution of woody plant species under different land-use scenarios in southwestern Ethiopia
Authors: Duguma Dula Wakassa , Law Elizabeth , Shumi Girma , Rodrigues Patrícia , Senbeta Feyera , Schultner Jannik , Abson David J. , Fischer Joern
Published: February 2023

Context

Deforestation, forest degradation and intensification of farming threaten terrestrial biodiversity. As these land-use changes accelerate in many landscapes, especially in the Global South, it is vital to anticipate how future changes might impact specific aspects of biodiversity.

Objectives

The objectives of this study were to model woody plant species richness in southwestern Ethiopia, for the present and for four plausible, spatially explicit scenarios of the future (‘Gain over grain’, ‘Mining green gold’, ‘Coffee and conservation’ and ‘Food first’).

Methods

We used cross-validated generalized linear models for both forest and farmland, to relate empirical data on total and forest-specialist woody plant species richness to indicators of human disturbance and environmental conditions. We projected these across current and future scenario landscapes.

Results

In both farmland and forest, richness peaked at intermediate elevations (except for total species richness in farmland) and decreased with distance to the forest edge (except for forest specialist richness in forest). Our results indicate that the ‘Mining green gold’ and ‘Food first’ scenarios would result in strong losses of biodiversity, whereas the ‘Gain over grain’ scenario largely maintained biodiversity relative to the baseline. Only the ‘Coffee and conservation’ scenario, which incorporates a new biosphere reserve, showed positive changes for biodiversity that are likely viable in the long term.

Conclusions

The creation of a biosphere reserve could maintain and improve woody plant richness in the focal region, by forming a cluster with existing reserves, would be a major step forward for sustainability in southwestern Ethiopia.
“Your struggles are valid, you are worthy of help and you deserve to recover”: narratives of recovery from orthorexia nervosa
Authors: Talbot Catherine V. , Campbell Charleigh E. R. , Greville-Harris Maddy
Published: February 2023

Purpose

Limited research has examined recovery processes and conceptualisations of recovery within orthorexia nervosa (ON). This study harnessed Instagram data to examine how people who self-identify with ON use the hashtag #OrthorexiaRecovery and how recovery is represented within this online space.

Methods

500 textual posts containing #OrthorexiaRecovery were extracted from Instagram. Co-occurring hashtags were analysed descriptively to determine whether this online space is specific to ON, and textual data were analysed using reflexive thematic analysis.

Results

The hashtag analysis indicated that #OrthorexiaRecovery is being used within a wider context of eating disorder recovery and awareness, but also provides deep insights into experiences of recovery from ON. The thematic analysis generated five themes: the invisibility of orthorexia; a turbulent and continuous process; finding food freedom; from compulsive exercise to intuitive movement; a community of support. Our findings suggest that people with self-reported ON experience recovery as a continuous process and the current invisibility of ON within diagnostic criteria and wider society impedes recovery. While working towards recovery, users aimed to be free from diet culture, become more attuned to their bodies, and develop more adaptive relationships with food and fitness. Users noted a general lack of support for people with ON and so used this online space to create a supportive community, though some content was potentially triggering.

Conclusion

Our findings highlight the importance of increased recognition of ON and the potential value of targeting societal norms and harnessing social identity resources within therapeutic interventions for ON.