bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnostic and surgical approaches to congenital uterine anomalies for the minimally invasive gynecologic surgeon
Authors: Murphy Colleen , Wilcox Annemieke , Vash-Margita Alla
Published: June 2023

Purpose of review

Congenital uterine anomalies (CUAs) impact the physical and psychosocial wellbeing of affected patients. Managing these conditions depends on the clinical scenario, and in some cases, can involve the use of minimally invasive surgical techniques. The purpose of this review is to provide an update of the diagnosis, perioperative considerations, and treatment of CUAs.

Recent findings

The American Society for Reproductive Medicine (ASRM) updated the guidelines for classification of CUAs to provide practitioners with a standardized classification system and have created an interactive tool designed for provider use.

Gynecologic surgeons are likely to encounter CUAs during their career. This review provides updated guidance for the workup and treatment of CUAs.
Changes in Teleworking and Physical Activity Behaviors in the United States Before and After Emergence of COVID-19
Authors: Webber Bryant J. , Soto Graycie W. , Smith Akimi , Whitfield Geoffrey P.
Published: June 2023

Objective

The aim of the study is to determine the prevalence of perceived decreases in three physical activity (PA) behaviors and meeting the PA guideline, by changes in telework.

Methods

US workers (N = 2393) reported teleworking and PA behaviors before and after COVID-19 emergence. Those reporting more and less telework were compared with those reporting stable telework on prevalence of (1) decreasing behaviors and (2) meeting the aerobic guideline (≥150 min/wk of moderate-intensity PA).

Results

Compared with workers with stable telework, those with increased telework were more likely to report decreases in any PA (by 61%), active transportation (65%), and park use (52%). Workers who deceased telework were also more likely to report decreases in these behaviors. Groups were equally likely to meet the guideline.

Conclusions

Changes in teleworking status—either more or less—may be associated with decreased participation in PA behaviors.
Physical activity and nutrition in chronic kidney disease
Authors: Wang Angela Yee-Moon , March Daniel S. , Burton James O.
Published: June 2023

Purpose of review

Lifestyle intervention is considered a cornerstone in chronic kidney disease management and has been recommended in different international or regional clinical practice guidelines in chronic kidney disease. However, evidence was largely based on the general population. Here we summarized the latest evidence supporting lifestyle intervention in chronic kidney disease.

Recent findings

Both observational cohort studies as well as randomized controlled trials have demonstrated health benefits with more physical activity in chronic kidney disease. There are compelling observational data supporting different health and kidney benefits with a healthy dietary pattern rich in fruits and vegetables, whole grains, plant-based foods and low in salt, low in sugar, saturated fat, red meat and ultraprocessed foods, a plant-based diet or Mediterranean diet in chronic kidney disease population. Clinical and epidemiologic studies also showed that higher 24 h urine potassium excretion (as proxy of higher dietary potassium intake) may be associated with lower blood pressure, better kidney outcomes and lower mortality in chronic kidney disease population. Randomized controlled trials also suggested that salt substitutes improved blood pressure control, reduced all-cause death and cardiovascular event risk in the general population compared with regular salt.

Accumulating evidence supports the current recommendation of encouraging physical activity and promoting a healthy dietary pattern in chronic kidney disease patients. Whether potassium needs restriction in chronic kidney disease diet requires further review. The safety versus benefits of salt substitutes in patients with moderate and advanced chronic kidney disease warrants further investigation.
Atypical thymic carcinoid tumor with ectopic ACTH syndrome in a 33-year-old male patient: A rare case report and literature review
Authors: Li Le-Yao , Zhao Huan-Yu , Tong Hai-Chao , Li Ying-Chun , Xu Hong-Tao , Ma Shuang , Yang Lian-He , Zhang Wan-Lin , Wildes Tyler , Wang Endi
Published: June 2023

Rationale:

Atypical thymic carcinoid tumor is an exceedingly rare thymic neuroendocrine tumor derived from the cells of neuroendocrine system. Misdiagnosis or delayed diagnosis may result in disease progression to advanced stages and eventually leads to a poor prognosis. It is therefore necessary to make a correct diagnosis and provide an adequate treatment.

Patient concerns:

A 33-year-old Chinese male presented with numbness in bilateral lower extremities and general fatigue for a month. Chest computed tomography revealed a superior anterior mediastinal mass. Thymoma was initially considered, given the location of the mass and radiographic presentation.

Diagnosis:

Microscopic findings showed that the tumor cells are arranged in pseudoepitheliomatous growth or irregular nested growth pattern in a background of fibroconnective tissue, with focal infiltration into adipose tissue. The chrysanthemum-like structure or beam-like structure seen often in typical carcinoid tumor was not identified in this case. The tumor cells are spindled or oval, with focal active mitosis. The immunohistochemical staining showed strong positivity for CD56, CgA and Syn, positivity for CK, ACTH, and TTF-1, negativity for Vimentin, and ki67 labeled proliferation index was up to 10% in focal areas. According to the radiological and pathological findings, the diagnosis of atypical thymic carcinoid was made.

Interventions:

The patient underwent surgical resection of the mass.

Outcome:

No recurrence or metastasis was identified during the follow up.

Lessons:

Because of its low incidencen, onspecific clinical symptoms, tissue location, and radiological findings, atypical thymic carcinoid tumor may sometimes be misdiagnosed as thymoma. Attention should be paid to avoid misdiagnosis.
ECG-gated MR angiography at 3T for follow-up after surgery involving the ascending aorta
Authors: Busse Anke , Neßelmann Catharina , Streckenbach Felix , Beller Ebba , Klemenz Ann-Christin , Dohmen Pascal , Öner Alper , Weber Marc-André , Meinel Felix G.
Published: June 2023

We aimed to evaluate electrocardiogram (ECG)-gated MR angiography (MRA) in the follow-up after surgery involving the ascending aorta regarding technical feasibility, image quality, spectrum of findings, and their implications for clinical management. We retrospectively analyzed a cohort of 19 patients (median age 59 years, range 38–79 years), who underwent MRA for follow-up imaging after surgery involving the ascending aorta. Our magnetic resonance imaging protocol consisted of a time-resolved, non-ECG-gated MRA and an ECG-gated MRA performed at 3T. Median examination duration was 25 minutes (range 11–41 minutes). All examinations were assessed by 2 readers in consensus for image quality on a 5-point scale ranging from 1 (non-diagnostic) to 5 (excellent). MRA examinations and patient charts were analyzed for diagnostic findings and their consequences for further management. Subjective image quality was rated as “sufficient” (score 3.1 ± 1.1) for the aortic root and as “good” to “excellent” for the ascending aorta (score 4.5 ± 0.7), aortic arch (4.5 ± 0.7), supra-aortic branches (4.5 ± 0.6) and descending aorta (4.6 ± 0.7). Abnormal findings were seen in 6 patients (32%) including progressive diameter of remaining aneurysm or dissection (3 patients, 16%) and suture aneurysms (3 patients, 16%). In all 6 of these patients, abnormal findings at MRA had consequences for clinical management. ECG-gated MR angiography at 3T yields good image quality for post-operative surveillance after aortic surgery involving the ascending aorta. This technique may serve as an alternative to computed tomography particularly in younger patients with repeated follow-up.
Effect of intraoperative mild hyperventilation on the incidence of shoulder pain after laparoscopic sleeve gastrectomy: A randomized, controlled trial
Authors: Yang Chaojie , Rong Peng , Zhang Jian , Fan Chaotao , Ling Bin , Wang Wei
Published: June 2023

Backgrounds:

To observe the effect of using mild intraoperative hyperventilation on the incidence of postlaparoscopic shoulder pain (PLSP) in patients undergoing laparoscopic sleeve gastrectomy.

Methods:

Eighty patients undergoing laparoscopic sleeve gastrectomy, aged 22 to 36 years, with American Society of Anesthesiologists grade I or II, were divided into 2 groups according to method of random number table. A mild hyperventilation was used in group A with controlling pressure of end-tidal carbon dioxide (PETCO2) of 30 to 33 mm Hg, while conventional ventilation was used in group B with PETCO2 35 to 40 mm Hg during the operation. The incidence and severity of PLSP, dosage of remedial analgesia and adverse reactions such as nausea and vomiting at 12, 24, 48, 72 hours and 1 week after surgery were recorded. Arterial blood gas was recorded before anesthesia induction, 20 minutes after pneumoperitoneum, during suture skin, and 24 hours after surgery.

Results:

Compared with 12, 24, 48, and 72 hours after operation, the incidence of PLSP at 1 week decreased significantly (P < .01). Compared with group B, the incidence of PLSP, pain score, and dosage of remedial analgesic at 12, 24,48, 72 hours, and 1 week after surgery were significantly decreased (P < .01). There was no significant difference between the 2 groups in arterial blood gas analysis before anesthesia induction, 20 minutes after pneumoperitoneum, during suture skin, and 24 hours after surgery (P > .05). There were no significant difference of the occurrence of adverse reactions such as nausea and vomiting between the 2 groups within 1 week after surgery (P > .05).

Conclusion:

Mild hyperventilation can reduce the incidence and severity of PLSP after laparoscopic sleeve gastrectomy without increasing the associated adverse effects.
Efficacy and safety of treatment with or without pertuzumab for HER2-positive breast cancer: A meta-analysis
Authors: Chen Xuan , Li Yuqing , Lin Mingfei , Lu Yufu
Published: June 2023

Background:

We conducted a meta-analysis to systematically evaluate the efficacy and safety of treatment with or without pertuzumab for human epidermal growth factor receptor-2 -positive (HER2)-positive breast cancer and provided evidence-based reference for clinical use.

Methods:

The Cochrane Library, PubMed, EMbase, Clinical Trials and Web of Science databases were searched for studies published up to July 2022, which reported clinical randomized controlled trials of treatment in combination with pertuzumab (experimental group) and without pertuzumab (control group) for HER2-positive breast cancer. Meta-analysis was performed using R 4.2.1 based on the extraction of the data and the risk of bias assessment under the supervision of the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0.

Results:

The results from this study showed that, the patients in the experimental group showed prolonged progression-free survival [hazard ratio = 0.72, 95% confidence interval (CI) (0.65,0.80), P < .01] and overall survival [hazard ratio = 0.80, 95% CI (0.66,0.96), P = .02] than those in the control group. In terms of safety, the incidence of grade ≥ 3 adverse events including diarrhea [risk ratio (RR) = 2.36, 95% CI (1.98,2.81), P < .01] and anemia [RR = 1.43, 95% CI (1.17,1.75), P < .01] in the experimental group were significantly higher than those in the control group. The incidence of common adverse events, that is rash in the experimental group was significantly higher than that in the control group [RR = 1.62, 95% CI (1.38,1.90), P < .01].

Conclusion:

These results support that the treatment in combination with pertuzumab is superior to the treatment in combination without pertuzumab in the treatment of HER2-positive breast cancer, but there are some adverse effects such as diarrhea, anemia, and rash, which should be carefully monitored in clinical practice.
Detection rate and shunt grading with synchronous testing of contrast transcranial Doppler and contrast transthoracic echocardiography: Preliminary findings
Authors: Li Rong-bin , Cao Liming , Fu Maolin , Cai Xu-dong
Published: June 2023

Patent foramen ovale, a common congenital atrial septal defect, may lead to cardiac right-to-left shunting (RLS), which has been associated with various diseases. Reliable techniques for detecting RLS are essential for diagnosis and assist with treatment decision-making. Contrast transcranial Doppler (c-TCD), contrast transthoracic echocardiography (c-TTE), and contrast transesophageal echocardiography can be used to detect RLS. However, it is still unclear which ultrasound modalities are the most practical and cost-effective. To evaluate the efficacy of synchronous c-TCD and c-TTE in detecting cardiac RLS. We prospectively designed and continuously recruited 100 patients with cryptogenic stroke, migraines, transient ischemic attack, unexplained syncope, or dizziness admitted at the First Affiliated Hospital of Shenzhen University between February 2020 and August 2020. Ninety-five patients underwent synchronous c-TCD and c-TTE (during a single contrast-enhanced ultrasound session). We compared synchronous test results with the results of c-TCD alone and c-TTE alone. Ninety-five patients successfully underwent synchronous c-TCD and c-TTE, with the data analyzed for each individual. The positive detection rates of Grade I, II, and III shunts with synchronous c-TCD and c-TTE were higher than those with c-TTE or c-TCD alone (P = .047, P = .002, and P = .024, respectively). Overall, the positive detection rates of synchronous tests, c-TCD alone, and c-TTE were 69.5%, 51.6%, and 31.6%, respectively (P = .000, and P = .012). Among the 66 patients who were double-RLS-positive (both c-TTE and c-TCD showed positive results), as detected by the synchronous test, 26 (39.3%) patients who underwent c-TTE alone had higher shunt grades detected than those who underwent c-TCD alone. Conversely, 5 (7.6%) patients who underwent c-TCD alone had higher shunt grades detected than those who underwent c-TTE alone (P = .000). Synchronous c-TCD and c-TTE testing can significantly improve the detection rate, accuracy, and test process efficacy for quantifying RLS, and reduce the testing risk, workload, and medical costs.
Are dietary intake parameters of vitamin A, carotene, retinol appropriate factors to evaluate the risk of diabetic retinopathy?
Authors: Choi Yu-Jin , Kwon Jin-Woo , Jee Donghyun
Published: June 2023

The purpose of this study is to investigate whether dietary parameters of vitamin A, carotene, and retinol are sufficient for assessing the risk of diabetic retinopathy (DR). This was a population-based cross sectional study using systematic stratified, multilevel, nationwide, clustered sampling methods. From 2008 to 2012, 1948 subjects aged ≥ 40 years who participated in the Korean National Health and Nutrition Examination Survey were included. Participants underwent standardized interviews, dietary vitamin A estimation, carotene and retinol level evaluation, and eye examination. Daily dietary intake was evaluated using data in the form of a single 24-hour recall. The odds ratio (OR) of dietary vitamin A between extreme quartiles for DR was 0.72 (95% confidence interval [CI], 0.45–1.16, P for trend = .462) after adjusting for covariates such as age, sex, hypertension, hemoglobin A1c levels, and diabetes duration. The adjusted OR of dietary carotene between extreme quartiles for DR was 0.65 (95% CI, 0.39–1.09, P for trend = .220). The adjusted OR of dietary retinol between extreme quartiles for DR was 1.05 (95% CI, 0.62–1.80, P for trend = .279). There was no statistical significance in proliferative DR and Vision-threatening Dr Our study did not find evidence that the risk of DR is correlated with dietary vitamin A levels. Dietary intake parameters of vitamin A, carotene, and retinol might be insufficient to determine the association between the risk of Dr To demonstrate an association for the risk of DR, the use of serum information and not dietary information is needed.
LncRNA HEIH expression in cancer prognosis: A review and meta-analysis
Authors: Wang Xuhua , Chen Zhaoyuan , Zhou Huaqiang , Liu Wuyang , Luo Jiaquan
Published: June 2023

Background:

As a newly discovered lncRNA, lncRNA High expression in hepatocellular carcinoma (HEIH) has been reported to correlate with poor clinical outcomes in several different cancers, In addition, studies have shown that HEIH is overexpressed in a variety of cancers and plays an oncogenic role. The present meta-analysis aims to elucidate the relationship between HEIH expression and prognosis and clinicopathological features among cancer patients.

Methods:

PubMed, Web of Science, Cochrane Library, and EMBASE database were comprehensively and systematically searched. pooled odds ratios (ORs) and hazard ratios (HRs) with 95% confidence interval (CI) were employed to assess the relationship between HEIH expression and clinical outcomes and clinicopathological features in cancer patients.

Conclusion:

The present study finally enrolled 11 studies which included 1227 cancer patients. The combined results indicated that HEIH overexpression was significantly associated with shorter overall survival (OS) (pooled HR = 2.03, 95% CI 1.74–2.38, P < .00001).Meanwhile, regarding clinicopathology of cancer patients, upregulated HEIH expression was closely related to larger tumor size (OR = 2.65, 95% CI: 1.52–4.65, P = .0006), advanced tumor T stage (OR = 2.41, 95 % CI: 1.54–3.77, P = .0001), advanced TNM stage (OR = 4.76, 95% CI: 2.73–8.29, P < .00001), distant metastasis (OR = 2.94, 95% CI: 1.75–4.96, P < .0001) and lymph node metastasis (OR = 2.07, 95% CI: 1.05–4.07, P = .04), respectively.

Conclusions:

High expression of HEIH in some cancers predicts shorter overall survival and higher clinical stage as well as larger tumor size. HEIH has great potential to become a prognostic marker for cancer patients.
Moyamoya disease with distal anterior choroidal artery aneurysm resected via transcallosal approach: A case report and review
Authors: Ding Wei , Zhao Yunfei , Liu Lei , Wang Peng , Qiu Wenchuan , Ren Hongwei , Jin Shengxi
Published: June 2023

Rationale:

Moyamoya disease (MMD) is a cerebrovascular structural disorder characterized by bilateral stenosis and obstruction of the internal carotid artery, anterior cerebral artery, and initial segment of a middle cerebral artery, as well as the aberrant formation of collateral arteries at the base of the brain. Moyamoya disease with distal anterior choroidal artery (AChA) aneurysm is extremely uncommon. At present, the treatment of Moyamoya disease with aneurysm mainly includes conservative treatment and surgical treatment, including revascularization, endovascular therapy and microsurgical clipping or resection. Interventional therapy is the first treatment of choice. For those whose paths are tortuous and inaccessible and intervention fails, I successfully excised them through craniotomy.

Patient concerns:

The 38-year-old male patient, diagnosed with Moyamoya disease 11 years ago and was hospitalized for multiple intraventricular hemorrhages throughout that time. During the 11 years, the patient was hospitalized for intra ventricular hemorrhage for several times. The patient was diagnosed as moyamoya disease for many times by digital subtraction angiography, but he was recommended to come to our hospital for cerebrovascular bypass surgery 3 months after each hemorrhage, but he did not come to our hospital until the next intraventricular hemorrhages.

Diagnoses:

This recurrent intraventricular bleeding was suspected to be caused by MMD, and a digital subtraction angiography of the brain revealed an aneurysm of the distal AChA.

Interventions:

Interventional therapy was the first choice. During the operation, transcatheter aneurysm embolization was tried. Finally, interventional therapy was abandoned because the vessels were too thin and tortuous and the guide wire could not pass through. After detecting the aneurysm using computerized tomography angiography, the distal AChA aneurysm was resected through the lateral interventricular foramen of the corpus callosum, and the corpus callosum was parted along the interhemispheric fissure to access the third ventricle.

Outcomes:

On the 21st postoperative day, the patient improved, recovered to a Glasgow Coma Scale score of 15.

Lessons:

We conclude that craniotomy is a satisfying alternative in patients with MMD complicated by perforated distal AChA aneurysm hemorrhage if the vascular prerequisites for endovascular treatment are not accessible and the patient has a favorable prognosis.
Is low phase angle a risk indicator for frailty and pre-frailty among community-dwelling older adults?
Authors: Araújo Adrielle Cavalcanti de Pontes , Cabral Poliana Coelho , Lira Rita de Cássia da Silva Almeida , Viana Amanda Carla Corrêa , Silva Rodrigo Luis da Silveira , Diniz Alcides da Silva , dos Santos Ana Célia Oliveira
Published: June 2023

Studies investigating the association between the phase angle (PA) and frailty are scarce. The PA is considered a practical, low-cost, noninvasive measure for the early identification of this clinical condition. To investigate the association between PA and frailty/pre-frailty, nutritional and clinical aspects in older people. A cross-sectional study was conducted with 51 older people (≥ 60 years). PA was determined using bioelectrical impedance analysis. Frailty profile was determined using the criteria of unintentional weight loss, self-reported fatigue, slow gait speed, low grip strength and insufficient physical activity. Nutritional status was evaluated based on the body mass index and appendicular skeletal muscle mass index (ASMMI). Sarcopenia and sarcopenic obesity were also investigated. Sociodemographic data were collected through interviews. Prevalence of frailty/pre-frailty was 84.3%, with no difference between the sexes. The first tercile of the sample had a PA lower than 6º, which was considered low. No significant difference in PA was found between older people with or without frailty/pre-frailty. In the multiple linear regression analysis, age and ASMMI were shown to be potential independent predictors for PA. Age showed an inverse correlation with PA, while ASMMI showed a direct correlation. No association was found between PA and frailty or pre-frailty.
The status of endoscopic therapies for gastroesophageal reflux disease
Authors: Kolb Jennifer M. , Chang Kenneth J.
Published: June 2023

Purpose of review

Gastroesophageal reflux disease (GERD) is exceedingly common and can significantly impact quality of life through heartburn, troublesome regurgitation, or atypical symptoms. The initial approach is conservative lifestyle changes followed by medications with escalation to antireflux surgery as needed. Endoscopic therapy may represent a bridge between pharmacotherapy and surgery and represents an appropriate option for select individuals.

Recent findings

Appropriate patient selection for endoscopic antireflux therapies is critical to the success of the intervention. Candidates for endoscopic treatment with trans-oral incisionless fundoplication (TIF) include those with a small (<2 cm) or no hiatal hernia and a Hill valve grade 1 or 2. Transoral incisionless fundoplication with concomitant hiatal hernia repair (cTIF) is a safe and effective option that addresses both the crural diaphragm and gastroesophageal flap valve (GEFV).

Endoscopic interventions for GERD continue to evolve and are not all created equal. Given our current understanding of the mechanisms of GERD, the TIF procedure stands out in its ability to re-create the optimal GEFV. In those patients with altered anatomy, endoscopic approaches may offer at least partial benefit.
In-hospital management of inflammatory bowel disease
Authors: Berinstein Jeffrey A. , Aintabi Daniel , Higgins Peter D.R.
Published: June 2023

Purpose of review

The management of hospitalized patients with inflammatory bowel disease (IBD) is complex. Despite considerable therapeutic advancements in outpatient ulcerative colitis and Crohn's disease management, the in-hospital management continues to lag with suboptimal outcomes. The purpose of this review is to provide a brief overview of our approach to managing patients hospitalized with acute severe ulcerative colitis (ASUC) and Crohn's disease-related complications, followed by a summary of emerging evidence for new management approaches.

Recent findings

ASUC has seen the emergence of well validated prognostic models for colectomy as well as the development of novel treatment strategies such as accelerated infliximab dosing, Janus kinase inhibitor therapy, and sequential therapy, yet the rate of colectomy for steroid-refractory ASUC has not meaningfully improved. Crohn's disease has seen the development of better diagnostic tools, early Crohn's disease-related complication stratification and identification, as well as better surgical techniques, yet the rates of hospitalization and development of Crohn's disease-related complications remain high.

Significant progress has been made in the in-hospital IBD management; however, both the management of ASUC and hospitalized Crohn's disease remain a challenge with suboptimal outcomes. Critical knowledge gaps still exist, and dedicated studies in hospitalized patients with IBD are needed to address them.
Evidence-based perioperative opioid-sparing techniques during the United States opioid crisis
Authors: Warinner Chloe , Parker Lois F. , Shapiro Fred , Jowett Nate
Published: June 2023

Purpose of review

The current United States opioid epidemic resulted from the overprescribing of opioids by physicians and surgeons in response to deceptive and unlawful marketing campaigns by pharmaceutical companies seeking to profit from opioid sales. Surgeons have a moral obligation to employ evidence-based opioid-sparing analgesia protocols for management of perioperative pain.

Recent findings

Recent evidence strongly supports the use of NSAIDs in perioperative pain management, with large studies demonstrating no increased risk of postoperative hemorrhage or renal insult.

We present an evidence-based approach for opioid-sparing perioperative pain management, including multimodal analgesia guidelines used at our center for patients undergoing free flap facial reanimation procedures.
Meniere's disease is a manifestation of migraine
Authors: Frank Madelyn , Abouzari Mehdi , Djalilian Hamid R.
Published: June 2023

Purpose of review

To discuss the theory that Meniere's disease (MD) is a variation of otologic migraine rather than an isolated inner ear condition.

Recent findings

In contrast to the approximately 12% of the general population suffering from migraine headaches, 51–60% of patients with MD experience migraine headaches. While pathognomonic for MD, endolymphatic hydrops has also been identified in patients with vestibular migraine. Treatment with the integrative neurosensory rehabilitation approach (diet and lifestyle changes, magnesium and riboflavin supplementation, and when needed, prophylactic medication) to treat the underlying migraine process has been highly effective in patients with MD.

MD can be understood as a manifestation of migraine such that patients with MD can be effectively treated with migraine therapies.
Postoperative Relapse Prediction in Patients With Ewing Sarcoma Using Computed Tomography–Based Radiomics Models Covering Tumor Per Se and Peritumoral Signatures
Authors: Liu Ying , Yin Ping , Cui Jingjing , Sun Chao , Chen Lei , Hong Nan
Published: June 2023

Objective

We aimed to develop and validate a computed tomography (CT)–based radiomics model for early relapse prediction in patients with Ewing sarcoma (ES).

Methods

We recruited 104 patients in this study. Tumor areas and areas with a tumor expansion of 3 mm were used as regions of interest for radiomics analysis. Six different models were constructed: Pre-CT, CT enhancement (CTE), Pre-CT+3 mm, CTE+3 mm, Pre-CT and CTE combined (ComB), and Pre-CT+3 mm and CTE+3 mm combined (ComB+3 mm). All 3 classifiers used a grid search with 5-fold cross-validation to identify their optimal parameters, followed by repeat 5-fold cross-validation to evaluate the model performance based on these parameters. The average performance of the 5-fold cross-validation and the best one-fold performance of each model were evaluated. The AUC (area under the receiver operating characteristic curve) and accuracy were calculated to evaluate the models.

Results

The 6 radiomics models performed well in predicting relapse in patients with ES using the 3 classifiers; the ComB and ComB+3 mm models performed better than the other models (AUC-best: 0.820–0.922/0.823–0.833 and 0.799–0.873/0.759–0.880 in the training and validation cohorts, respectively). Although the Pre-CT+3 mm, CTE+3 mm, and ComB+3 mm models covering tumor per se and peritumoral CT features preoperatively forecasted ES relapse, the model was not significantly improved.

Conclusions

The radiomics model performed well for early recurrence prediction in patients with ES, and the ComB and ComB+3 mm models may be superior to the other models.
Prediction of Anemia From Cerebral Venous Sinus Attenuation on Deep-Learning Reconstructed Brain Computed Tomography Images
Authors: Yamakuni Ryo , Sekino Hirofumi , Saito Masaki , Kakamu Takeyasu , Takahashi Katsuhiro , Hara Junko , Suenaga Hiroki , Ishii Shiro , Fukushima Kenji , Ito Hiroshi
Published: June 2023

Objective

The aim of the study is to evaluate whether the prediction of anemia is possible using quantitative analyses of unenhanced cranial computed tomography (CT) with deep learning reconstruction (DLR) compared with conventional methods.

Methods

This cross-sectional retrospective study included 116 participants (76 males; mean age, 66.7) who had hemoglobin (Hb) levels obtained within 24 hours of unenhanced cranial CT, which included 2 reconstruction methods: DLR and hybrid iterative reconstruction. Regions of interest were the confluence of sinuses (CoS) and the right and left transverse sinuses. In addition, edge rise distance of cerebrospinal fluid and venous was measured.

Results

Spearman rank correlation coefficient demonstrated a positive association between Hb levels and sinus attenuation values. Among these, the CoS in DLR had the best correlation (r = 0.703, P < 0.001). For the prediction of anemia (Hb < 11 g/dL), the area under the curve of CoS in DLR (area under the curve = 0.874; 95% confidence interval, 0.798–0.949; P < 0.001) was the highest; however, there were no significant differences among reconstruction method and sinus. The attenuation values of DLR were significantly higher than those of hybrid iterative reconstruction (P < 0.001, paired t test), and the differences between the 2 methods were 4.1 (standard deviation [SD], 1.6) for CoS, 5.2 (SD, 2.2) for right transverse sinuses, and 5.8 (SD, 2.4) for left transverse sinuses. The signal-to-noise ratio (P < 0.001, paired t test) and edge rise distance (P < 0.001, Wilcoxon signed rank test) of DLR was significantly higher.

Conclusions

Higher CT attenuation values should be considered for predicting anemia based on brain DLR images.
Evaluation of Research Diagnostic Criteria in Craniofacial Microsomia
Authors: Renkema Ruben W. , de Vreugt V. , Heike Carrie L. , Padwa Bonnie L. , Forrest Christopher R. , Dunaway David J. , Wolvius E.B. , Caron Cornelia J.J.M. , Koudstaal Maarten J.
Published: June 2023

Characteristics of patients with craniofacial microsomia (CFM) vary in type and severity. The diagnosis is based on phenotypical assessment and no consensus on standardized clinical diagnostic criteria is available. The use of diagnostic criteria could improve research and communication among patients and healthcare professionals. Two sets of phenotypic criteria for research were independently developed and based on multidisciplinary consensus: the FACIAL and ICHOM criteria. This study aimed to assess the sensitivity of both criteria with an existing global multicenter database of patients with CFM and study the characteristics of patients that do not meet the criteria. A total of 730 patients with CFM from were included. Characteristics of the patients were extracted, and severity was graded using the O.M.E.N.S. and Pruzansky-Kaban classification. The sensitivity of the FACIAL and ICHOM was respectively 99.6% and 94.4%. The Cohen’s kappa of 0.38 indicated a fair agreement between both criteria. Patients that did not fulfill the FACIAL criteria had facial asymmetry without additional features. It can be concluded that the FACIAL and ICHOM criteria are accurate criteria to describe patients with CFM. Both criteria could be useful for future studies on CFM to create comparable and reproducible outcomes.
Age and sex dependent effects of metabolic response to muscle contraction
Authors: Campbell Matthew D , Djukovic Danijel , Raftery Daniel , Marcinek David
Published: June 2023

Sarcopenia, the age-related loss of muscle mass and function, contributes to decreased quality of life in the elderly and increased healthcare costs. Decreased skeletal muscle mass, specific force, increased overall fatty depositions in the skeletal muscle, frailty and depressed energy maintenance are all associated with increased oxidative stress and the decline in mitochondrial function with age. We hypothesized that elevated mitochondrial stress with age alters the capacity of mitochondria to utilize different substrates following muscle contraction. To test this hypothesis, we designed two in vivo muscle-stimulation protocols to simulate high-intensity intervals (HII) or low intensity steady-state (LISS) exercise to characterize the effect of age and sex on mitochondrial substrate utilization in skeletal muscle following muscle contraction. Following HII stimulation, mitochondria from young skeletal muscle increased fatty acid oxidation compared to non-stimulated control muscle; however, mitochondria from aged muscle decreased fatty acid oxidation. In contrast, following LISS, mitochondrial from young skeletal muscle decreased fatty acid oxidation, whereas aged mitochondria increased fatty acid oxidation. We also found that HII can inhibit mitochondrial oxidation of glutamate in both stimulated and non-stimulated aged muscle, suggesting HII initiates circulation of an exerkine capable of altering whole-body metabolism. Analyses of the muscle metabolome indicates that changes in metabolic pathways induced by HII and LISS contractions in young muscle are absent in aged muscle. Treatment with elamipretide, a mitochondrially targeted peptide, restored glutamate oxidation and metabolic pathway changes following HII suggesting rescuing redox status and improving mitochondrial function in aged muscle enhances the metabolic response to muscle contraction.
Effect of Aging, Sex, and Gene (Fbln5) on Arterial Stiffness of Mice: 20 Weeks Adult Fbln5-knockout Mice Have Older Arteries than 100 Weeks Wild-Type Mice
Authors: Dong Hai , Ferruzzi Jacopo , Liu Minliang , Brewster Luke P. , Leshnower Bradley G. , Gleason Rudolph L.
Published: June 2023

The arterial stiffening is a strong independent predictor of cardiovascular risk and has been used to characterize the biological age of arteries (‘arterial age’). Here we revealed that the Fbln5 gene knockout (Fbln5-/-) significantly increases the arterial stiffening for both male and female mice. We also showed that the arterial stiffening increases with natural aging, but the stiffening effect of Fbln5-/-is much more severe than aging. The arterial stiffening of 20 weeks old mice with Fbln5-/-is much higher than that at 100 weeks in wild-type (Fbln5+/+) mice, which indicates that 20 weeks mice (equivalent to ∼26 years old humans) with Fbln5-/-have older arteries than 100 weeks wild-type mice (equivalent to ∼77 years humans). Histological microstructure changes of elastic fibers in the arterial tissue elucidate the underlying mechanism of the increase of arterial stiffening due to Fbln5-knockout and aging. These findings provide new insights to reverse ‘arterial age’ due to abnormal mutations of Fbln5 gene and natural aging.

This work is based on a total of 128 biaxial testing samples of mouse arteries and our recently developed unified-fiber-distribution (UFD) model. The UFD model considers the fibers in the arterial tissue as a unified distribution, which is more physically consistent with the real fiber distribution of arterial tissues than the popular fiber-family-based models (e.g., the well-know Gasser-Ogden-Holzapfel [GOH] model) that separate the fiber distribution into several fiber families. Thus, the UFD model achieves better accuracies with less material parameters. To our best knowledge, the UFD model is the only existing accurate model that could capture the property/stiffness differences between different groups of the experimental data discussed here.
Breaking boundaries and creating inclusion-based organization through critical performativity and dialogical accountability: the case of FC United Manchester
Authors: Torchia Daniel , Scagnelli Simone Domenico , Corazza Laura
Published: June 2023

Purpose

The purpose of this paper is to extend research on boundary making and breaking through alternative football clubs. These entities have borne out of the disappointment caused by the neoliberal turn of the football industry, which excluded traditional fans from being active actors and therefore call for study and generalization of specific forms of alternative accountability.

Design/methodology/approach

The study looks at emerging trends in the accounting and sport literature by drawing on two concepts that emerged in critical scholarship: critical performativity and critical dialogical accountability, with the aim of better understanding how these elements are developed and shaped within an alternative form of football organization. The focus on Football Club United of Manchester drives the ethnographic approach with data collected via participant observation, field-notes, documental analysis and semi-structured interviews.

Findings

The research shows that the pillars of the club's ethos, pushing its critical performative interventions toward setting new boundaries, are democratic governance and accountability, favoring participation and inclusion, and strictly linked to this, a responsibility to local communities. However, the study also highlights the difficulties of maintaining these boundaries when core values are threatened by degeneration.

Originality/value

The study makes a novel contribution to the field of accounting and sport, showing how an alternative football club adopts inclusive accountability systems that go beyond mainstream neoliberal practices. Such an inclusive approach can stimulate critical performativity, moving away from means-end rationality.
Job crafting-job embeddedness linkage of construction professionals: moderating effect of career stages
Authors: AlMemari Mustafa , Khalid Khalizani , Osman Abdullah
Published: June 2023

Purpose

Construction managers must focus on effective job design to develop and harness employee talent and achieve organizational goals. Because psychological needs and key motivators vary by career stage, a differentiated employee value proposition is crucial for a firm’s retention strategy. This study aims to examine how job crafting (JC) affects job embeddedness (JE) at different career stages.

Design/methodology/approach

In this investigation, a quantitative methodology was used. In total, 272 construction industry professionals from 25 construction firms in Abu Dhabi, United Arab Emirates, provided the data. Through the use of structural equation modeling, hypotheses were evaluated.

Findings

The results show that JC enhances construction professionals’ JE (β = 0.60, p < 0.000). Moreover, the relationship between JC and JE is moderated by career stages. The impact of JC on JE is greater among longer tenured (late-career stages, β = 0.61, p < 0.000) than shorter tenured construction professionals (early-career stages, β = 0.60, p < 0.000 and mid-career stages, β = 0.58, p < 0.000).

Originality/value

Limited research shows how JC can improve JE. At the time of this research, there was no published work on JC and JE relationship in the construction industry. This research found that JC has a positive impact on JE and JC behavior applies at both individual and team levels. This could imply that construction professionals with longer organizational tenure are more likely to challenge the status quo and identify problems or opportunities for improvement, hence contributes to JE theory.
Insights into UK investment firms’ efforts to comply with MiFID II RTS 6 that governs the conduct of algorithmic trading
Authors: Culley Alexander Conrad
Published: June 2023

Purpose

The purpose of this paper is to examine the effectiveness of UK investment firms’ implementation of the requirements in Commission Delegated Regulation 2017/589 (more commonly known as “Regulatory Technical Standard 6” or “RTS 6”) that govern the conduct of algorithmic trading activities.

Design/methodology/approach

A qualitative examination of 19 semi-structured interviews with practitioners working for, or with, UK investment firms engaged in algorithmic trading activities.

Findings

The paper finds that practitioners generally have a good understanding of the requirements in RTS 6. Some lack knowledge of algorithms, coding and algorithmic strategies but have used best efforts to implement RTS 6. However, regulatory fatigue, complacency, cost pressures, governance in international groups, overreliance on external knowledge and generous risk parameter calibration threaten to undermine these efforts.

Research limitations/implications

The study’s findings are limited to the participants’ insights. Some areas of the RTS 6 regime attracted little comment from participants.

Practical implications

The paper proposes the introduction of mandatory algorithmic trading qualification requirements for key staff; the lessening of the requirements in RTS 6 for automated executors; and the introduction of a recognised software vendor regime to reduce duplication and improve coordination between market participants that deploy algorithmic trading systems.

Originality/value

To the best of the author’s knowledge, the study represents the first qualitative examination of firms’ implementation of the algorithmic trading regime in the second Markets in Financial Instruments Directive 2014/65/EU.
COVID-19 pandemic and comfort food consumption based on gender in a Brazilian sample: which variables are related to this behavior?
Authors: Souza Tamires Cássia de Melo , Anastácio. Lucilene Rezende , Oliveira Lívya Alves , Daniel Marina Martins , Penaforte Fernanda Rodrigues de Oliveira , Liboredo Juliana Costa , Della Lucia Ceres Mattos , Ferreira Lívia Garcia
Published: June 2023

Purpose

This study aims to identify comfort food (CF) consumption and its associated factors during the pandemic period. The study also involves an online survey conducted five months after the quarantine started in Brazil.

Design/methodology/approach

Data on lifestyle, eating habits and anthropometric data were collected before and during the pandemic, and the differences in these habits were analyzed. Univariate and multivariate logistic regression models were performed to identify predictors of CF consumption by gender.

Findings

A total of 1,363 individuals were included in the sample, with a median age of 31 years old, of whom 80.3% were women. Since individuals were free to respond about the food consumed without predetermined categories, it was possible to carry out a faithful assessment of the occurrence of this behavior. At the same time, allowing the subjectivity and symbolism inherent to the concept of CF to be embraced. CF consumption was present for 54%, with “sweets” being the most mentioned group by both genders. The factors associated with CF consumption in women during the pandemic were increased snacking, increased bread, candies and alcoholic beverage intake, increased time spent at work, worsened sleep quality, reduced meals, perceived stress (PS), emotional eating (EE), age and increased frequency of meat intake. In men, the predictors for CF consumption were remote full-time work/study, PS, EE and early waking time. For both genders, CF consumption during the pandemic period was associated with PS and EE.

Originality/value

This study provides an important overview of the possible contributions of the pandemic on behaviors and food choices related to the consumption of CF in Brazilians. This information is valuable to support further studies to investigate and treat the impacts of the pandemic on lifestyle, eating habits and behavior, mental health and other factors in the postpandemic period.
Digital Platform Complementors and the Number of Product Features: Evidence from the Apple iOS App Store
Authors: Kang Hye Young
Published: June 2023

This paper explores the understudied question of how the number of product features that a digital platform complementor adds to a product is associated with its performance. Specifically, by integrating consumer behaviour literature into platform research, this paper focuses on three key performance dimensions considered as important for digital platform complementors. Considering the distinctive characteristics of digital platforms, this paper conceptualizes how additional features affect consumer acquisition, consumer retention, and product monetization of a digital platform complementor. This research question is empirically examined in the context of a health and fitness mobile platform in the US Apple iOS App Store, and the panel data analyses are complemented with a randomized online experiment to mitigate endogeneity concerns and lend further credence to the findings. This paper enhances platform research by unravelling an underexplored yet essential topic—how many features a digital platform complementor should include to achieve superior performance and by distinguishing among various key performance measurements on digital platforms.
A Public Value Strategy for Sustainable Development Goals: Transforming an Existing Organization?
Authors: van Gestel Nicolette , Ferlie Ewan , Grotenbreg Sanne
Published: June 2023

The Public Value model is widely discussed in the contemporary public management literature. Despite the growing discourse, few associated publications reflect empirical research. The important question of how public organizations, originally based on traditional public administration models, change to become public value‐orientated is underexplored. We first review the literature on public value, given alternative models of Traditional Public Administration, New Public Management, and Network Governance. We apply a core analytical framework in the public value literature (the ‘strategic triangle’) to an intensive case study of a large national agency that chose a public value strategy. Although staff support for public value (in the form of sustainable development goals) is significant, constraining factors inherited from prior public management models interfere with realizing public value ambitions ‘purely’. The study enhances an understanding of applying the Public Value model in practice by producing insights about barriers and pre‐conditions to such an organizational transition, notably from a wider institutional context. Theoretically, we suggest that the Public Value model has the potential to move to a synergy of elements of existing models in a new configuration. The implications for future research and practice are discussed.