bluuebunny/crossref_metadata_2025 huggingface dataset:
Laser induced fluorescence spectroscopy analysis of kidney tissues: A pilot study for the identification of renal cell carcinoma
Authors: Pavithran M Sanoop , Lukose Jijo , Barik Bijay Kumar , Periasami Ammasi , Kartha V. B. , Chawla Arun , Chidangil Santhosh
Published: August 2023

The 325 nm‐excited autofluorescence spectra from cancerous and normal renal tissues were collected ex vivo biopsy tissue samples, through an optical fiber probe‐based system. Noticeable changes in intensity/wavelength were observed in the fluorescence emissions from endogenous fluorophores such as collagen, Nicotinamide adenine dinucleotide (NADH), Vitamin A (retinol), and flavin adenine dinucleotide, in pathological conditions with respect to the normal state. The energy metabolism involved in clear cell renal cell carcinoma (ccRCC) and chromophobe renal cell carcinoma (chRCC) are reflected in the fluorescence emission band at 445 nm due to bound NADH attributed to enhanced oxidative phosphorylation in chRCC and emission at 465 nm contributed by free NADH showing higher glycolytic action in ccRCC. The principal component analysis and one‐way ANOVA effectively discriminate ccRCC from chRCC. It is shown that laser induced fluorescence technique with 325 nm excitation can be a suitable technique for optical pathology and in vivo surgical boundary demarcation in renal cell carcinoma.
Pharmacokinetics and Pharmacodynamics of GalNAc‐Conjugated siRNAs
Authors: An Guohua
Published: August 2023

Small interfering RNAs (siRNAs) represent a new class of drugs with tremendous potential for battling previously “undruggable” diseases. After nearly 2 decades of efforts in addressing the problems of the poor drug profile of naked unmodified siRNAs, this new modality has finally come to fruition, with 5 agents (patisiran, givosiran, lumasiran, inclisiran, and vutrisiran) being approved since 2018, and with many others in the different phases of clinical development. Unlike small‐molecule drugs and protein therapeutics, siRNAs have different sizes, distinct mechanisms of action, differing physicochemical and pharmacological properties, and, accordingly, a unique pharmacokinetic/pharmacodynamic (PK/PD) relationship. To support the continuous development of siRNAs, it is important to have a thorough and deep understanding of the PK/PD and clinical pharmacology related features of siRNAs. As most of the current siRNA products are conjugated by N‐acetylgalactosamine (GalNAc), this review focuses on the PK/PD relationships and clinical pharmacology of GalNAc‐conjugated siRNAs, including their absorption, distribution, metabolism, excretion (ADME) properties, PK/PD models, drug–drug interactions, clinical pharmacology in special populations, and safety evaluation. In addition, necessary background information related to the development of siRNAs as a therapeutic modality, including the mechanisms of action, the advantages of siRNAs, the problems of naked siRNAs, as well as the strategies used to enhance the clinical utility of siRNAs, have also been covered. The goal of this review is to serve as a “primer” on siRNA PK/PD, and I hope the readers, especially those who have a limited background on siRNA therapeutics, will have a fundamental understanding of siRNA PK/PD and clinical pharmacology after reading this review.
Incidence of sexually transmitted hepatitis C virus infection among men who have sex with men in Japan from 2009 to 2023
Authors: Adachi Eisuke , Saito Makoto , Kikuchi Tadashi , Ikeuchi Kazuhiko , Koga Michiko , Tsutsumi Takeya , Yotsuyanagi Hiroshi
Published: August 2023

Although the prevalence of hepatitis C virus (HCV) infection has decreased significantly with the advent of direct‐acting antiviral agents, HCV is known to spread as a sexually transmitted disease among men who have sex with men (MSM), and this study aims to provide a perspective on the future prevalence of HCV in Japan. We examined incidence in two groups of MSM with HIV attending our institution in this retrospective cohort study, from 2009 to 2019 and from 2020 to May 2023 and investigated their background factors. Twenty‐two cases were newly confirmed to be HCV infection in 2009–2019 and a total of 9 cases in 2020–2023, with an incidence rate of 5.04 per 1000 person‐years in 2009–2019 and 5.55 per 1000 person‐years in 2020–2023. All of them were diagnosed at routine outpatient visits for HIV, and few cases were considered to have symptoms of suspected hepatitis that led to a visit to the hospital and a diagnosis of HCV. Although HCV is still prevalent among MSM in Japan, it is possible that it would not have been diagnosed without testing at regular visits as in the case of people with HIV, and that the true prevalence rate among MSM, including non‐HIV‐infected persons, may be much higher.
Making journals more international: Language subject differences and impact performance
Authors: Li Jing , Yang Xue , Lu Xiaoli , Wu Dengsheng
Published: August 2023

This study created a comprehensive Country Diversity Score (CDS) index to measure the degree of journal internationality from a diversity perspective, based on publishing authors' affiliation countries. It calculates CDS values and analyses their distribution across countries, publication languages, disciplines, subjects, and journal impact factor (JIF) quartiles for 11,481 journals, and addresses the correlation between CDS and JIF. Empirical studies indicate that journals with authors evenly distributed across more countries are more likely to obtain a higher CDS value. English publications have a relatively high CDS worldwide, and the non‐English publications of a country have a lower CDS than its English‐language publications. In addition, this study found a positive correlation between journal internationality and JIF in terms of the geographical distribution of publishing authors. Implications and recommendations for improving geographical authorship diversity, particularly in the context of internationalization, are discussed.
Design, Synthesis, in Silico and Biological Evaluation of Novel 4‐Aminopyrimidine‐5‐carbonitriles
Authors: Maalej Emna , Abdelmalek Dorra , Msalbi Dhouha , Aifa Sami , Ismaili Lhassane , Marco‐Contelles José , Chabchoub Fakher
Published: August 2023

Herein we report that 4‐aminopyrimidine‐5‐carbonitriles 3 a–i were efficiently synthesized by reacting suitable 2‐(ethoxyalkylene)malononitriles 1 a–c with easily available amidine hydrochlorides 2 a–d, in good yields using a simple synthetic scheme. To predict their pharmacological properties a comprehensive in silico analysis was conducted. Consequently, appropriate compounds 3 a–h were screened for their antiproliferative activity against two colorectal‐cancer‐cell lines and one lung cancer cell line. These analyses revealed that 4‐amino‐6‐methyl‐2‐(p‐tolyl) pyrimidine‐5‐carbonitrile (3 c) and 4‐amino‐2‐(4‐chlorophenyl)‐6‐methyl pyrimidine‐5‐carbonitrile (3 h) exhibited the most potent inhibitory activity against human LoVo and HCT‐116 cancer cells, and that the most potent inhibitory activity against human A549 cells was observed for compound 3 h.
A Larger Lens: Medical Students Benefit from Consciousness-Based Self-Care
Authors: Nader Tony , Carroll Richard J. , Travis Frederick W. , Bray James B. , Gruener Gregory , Rothenberg Stuart , Brown Duncan H. , Brown Carla L.
Published: August 2023

Job burnout is a serious problem in medicine, leading to lost productivity, costly attrition, loss of well-being, and even loss of life through suicide. A major US medical school introduced a 2-credit elective course that featured the Transcendental Meditation® (TM®) technique to try to address this problem. This chapter reports on an 8-year study of medical students’ experiences with this course. The TM technique has been shown to reduce burnout and improve self-care and well-being through the development of consciousness. The authors use qualitative research and a grounded theory approach to assess the effects of this initiative. They report three major benefits. First, the technique addressed their most pressing needs: reducing stress and anxiety. Second, the students reported multiple positive benefits affecting many facets of health, well-being, and learning, including a spontaneous increase in compassion and empathy. Third, TM students reported gaining 2–5 hours of more productive time daily, plus improved relationships and teamwork.
Moduli trapping mechanism in modular flavor symmetric models
Authors: Kikuchi Shota , Kobayashi Tatsuo , Nasu Kaito , Yamada Yusuke
Published: August 2023

Abstract

We discuss how the moduli in modular flavor symmetric models dynamically select enhanced symmetry points at which the residual modular symmetry renders extra matter fields massless. The moduli dynamics non-perturbatively produces the extra matter particles, which gives (time-dependent) effective potential that traps the moduli to enhanced symmetry points. We show analytic estimates of particle production rate consistent with numerical results, and the dynamics of moduli based on the analytic estimates.
A4 modular flavour model of quark mass hierarchies close to the fixed point τ = i∞
Authors: Petcov S. T. , Tanimoto M.
Published: August 2023

Abstract

We study the possibility to generate the quark mass hierarchies as well as the CKM quark mixing and CP violation without fine-tuning in a quark flavour model with modular A4 symmetry. The quark mass hierarchies are considered in the vicinity of the fixed point τ = i∞, τ being the vacuum expectation value of the modulus. We consider first a model in which the up-type and down-type quark mass matrices Mu and Md involve modular forms of level 3 and weights 6, 4 and 2 and each depends on four constant parameters. Two ratios of these parameters, gu and gd, can be sources of the CP violation. If Mu and Md depend on the same τ, it is possible to reproduce the up-type and down-type quark mass hierarchies in the considered model for |gu| ~ $$ \mathcal{O} $$
O
(10) with all other constants being in magnitude of the same order. However, reproducing the CP violation in the quark sector is problematic. A correct description of the quark mass hierarchies, the quark mixing and CP violation is possible close to τ = i∞ with all constant being in magnitude of the same order and complex gu and gd, if there are two different moduli τu and τd in the up-type and down-type quark sectors. We also consider the case of Mu and Md depending on the same τ and involving modular forms of weights 8, 4, 2 and 6, 4, 2, respectively, with Mu receiving a tiny SUSY breaking or higher dimensional operator contribution. Both the mass hierarchies of up-type and down-type quarks as well and the CKM mixing angles and CP violating phase are reproduced successfully with one complex parameter and all parameters being in magnitude of the same order. The relatively large value of Im τ, needed for describing the down-type quark mass hierarchies, is crucial for obtaining the correct up-type quark mass hierarchies.
Cathepsin S activity controls chronic stress-induced muscle atrophy and dysfunction in mice
Authors: Wan Ying , Piao Limei , Xu Shengnan , Meng Xiangkun , Huang Zhe , Inoue Aiko , Wang Hailong , Yue Xueling , Jin Xueying , Nan Yongshan , Shi Guo-Ping , Murohara Toyoaki , Umegaki Hiroyuki , Kuzuya Masafumi , Cheng Xian Wu
Published: August 2023

Exposure to chronic psychological stress (CPS) is an intractable risk factor for inflammatory and metabolic diseases. Lysosomal cysteinyl cathepsins play an important role in human pathobiology. Given that cathepsin S (CTSS) is upregulated in the stressed vascular and adipose tissues, we investigated whether CTSS participates in chronic stress-induced skeletal muscle mass loss and dysfunction, with a special focus on muscle protein metabolic imbalance and apoptosis. Eight-week-old male wildtype (CTSS+/+) and CTSS-knockout (CTSS−/−) mice were randomly assigned to non-stress and variable-stress groups. CTSS+/+ stressed mice showed significant losses of muscle mass, dysfunction, and fiber area, plus significant mitochondrial damage. In this setting, stressed muscle in CTSS+/+ mice presented harmful alterations in the levels of insulin receptor substrate 2 protein content (IRS-2), phospho-phosphatidylinositol 3-kinase, phospho-protein kinase B, and phospho-mammalian target of rapamycin, forkhead box-1, muscle RING-finger protein-1 protein, mitochondrial biogenesis-related peroxisome proliferator-activated receptor-γ coactivator-α, and apoptosis-related B-cell lymphoma 2 and cleaved caspase-3; these alterations were prevented by CTSS deletion. Pharmacological CTSS inhibition mimics its genetic deficiency-mediated muscle benefits. In C2C12 cells, CTSS silencing prevented stressed serum- and oxidative stress-induced IRS-2 protein reduction, loss of the myotube myosin heavy chain content, and apoptosis accompanied by a rectification of investigated molecular harmful changes; these changes were accelerated by CTSS overexpression. These findings demonstrated that CTSS plays a role in IRS-2-related protein anabolism and catabolism and cell apoptosis in stress-induced muscle wasting, suggesting a novel therapeutic strategy for the control of chronic stress-related muscle disease in mice under our experimental conditions by regulating CTSS activity.
Irradiation dose to the swallowing apparatus impacts nutritional status in head and neck cancer patients—results from the prospective randomized HEADNUT trial
Authors: Finger Anna , Grohmann Maximilian , Krause Linda , Krüll Andreas , Petersen Cordula , Thieme Alexander , Rades Dirk , Löser Anastassia
Published: August 2023

Purpose

To investigate the influence of radiation dose to the swallowing muscles on the nutritional status in patients with head and neck cancer undergoing primary or adjuvant (chemo)radiotherapy (C)RT.

Methods

Between 2018 and 2020, 61 patients were prospectively randomized into the so-called HEADNUT trial (head and neck cancer patients undergoing nutritional intervention). Follow-up was continued until 2022. Contouring of the swallowing apparatus included the superior (scm), middle (mcm), and inferior constrictor muscle (icm), the cricopharyngeal muscle (cphm), and the esophageal inlet. Nutritional status was assessed by bioelectrical impedance analysis (BIA) at the beginning and the end of radiotherapy. The posttherapeutic nutritional status was evaluated by the BIA-derived fat-free mass index (FFMI; kg/m2). Malnutrition was assumed at FFMI values of < 15 (women) and < 17 (men) kg/m2. To find differences between dosimetric parameters in well- and malnourished patients, Mann–Whitney U test was used. To model the association between malnutrition and its potentially influencing variables, several logistic regression models were built.

Results

The following parameters differed between well- and malnourished patients at the end of therapy: icm Dmean, V40Gy (%), V50Gy (%), and V60Gy (%), and sphm V40Gy (%). After entering these parameters into a multivariable logistic regression model (dosimetric model), icm Dmean (b = −0.12; Exp(b) = 0.88; 95% CI: 0.78–1.0; p = 0.06) and icm V40Gy (%; b = 0.06; Exp(b) = 1.07; 95% CI: 1–1.13; p = 0.04) proved to be independent dosimetric predictors of malnutrition. We only determined the cut-off value for predicting malnutrition for icm V40Gy (%) since it was the only parameter which met p < 0.05. The optimal cut-off value for the predictor V40Gy (%) based on the Youden Index was 85.6%. Another logistic regression model (dosimetric-clinical model) consisted of icm V40 (%) and the clinical parameters tumor localization, malnutrition before RT, gender, and combined chemotherapy. It was confirmed that both icm V40% (b = −1.9; Exp(b) = −2.7; 95% CI: 0.01–0.8; p = 0.03) and malnutrition at baseline (b = −1.9; Exp(b) = 4.4; 95% CI: 8.4–816.6; p = 0.0002) were independent predictors of subsequent malnutrition the end of RT.

Conclusion

Establishment of a normal nutritional status before the start of RT and adherence to dose constraints for the swallowing apparatus may prevent malnutrition in head and neck cancer patients at the end of therapy. Specifically, we suggest an icm V40Gy (%) of more than 86% to be predictive for nutritional complications.
Vorhersage des postoperativen Sprachverstehens mit dem transkutanen teilimplantierbaren Knochenleitungshörsystem Osia®
Authors: Arndt Susan , Wesarg Thomas , Aschendorff Antje , Speck Iva , Hocke Thomas , Jakob Till Fabian , Rauch Ann-Kathrin
Published: August 2023

Hintergrund

Das aktive transkutane, teilimplantierbare, osseointegrierte Knochenleitungssystem Cochlear™ Osia® (Fa. Cochlear, Sydney, Australien) ist seit April 2021 im deutschsprachigen Raum zugelassen. Das Osia ist für Patienten mit Schallleitungs- (SL-SH) oder kombinierter Schwerhörigkeit (komb-SH) mit einem mittleren Knochenleitungshörverlust von maximal 55 dB HL oder bei einseitiger Taubheit („single-sided deafness“, SSD) indiziert.

Ziel der Arbeit

Ziel dieser retrospektiven Untersuchung war es, die Prädiktion des postoperativen Sprachverstehens mit Osia zu untersuchen sowie die Ergebnisse des Sprachverstehens von Patienten mit komb-SH und einem geringen Dynamikbereich von weniger als 30 dB nach erfolgter Osia-Versorgung zu evaluieren.

Material und Methoden

Zwischen 2017 and 2022 wurden 29 erwachsene Patienten mit dem Osia versorgt, davon 10 Patienten (11 Ohren) mit SL-SH und 19 Patienten (25 Ohren) mit komb-SH. Die Patienten mit komb-SH wurden in 2 Gruppen aufgeteilt: komb-SH‑I mit über 4 Frequenzen gemittelter Hörschwelle in Knochenleitung („four-frequency pure-tone average“,(PTA4-KL)) ≥ 20 dB HL und < 40 dB HL (n = 15 Patienten, 20 Ohren) vs. komb-SH-II mit PTA4-KL ≥ 40 dB HL (n = 4 Patienten, 5 Ohren). Alle Patienten testeten präoperativ ein Knochenleitungsgerät am Softband. Präoperativ wurde das Sprachverstehen im Freiburger Einsilbertest unversorgt und mit Testsystem erfasst. Das maximale Einsilberverstehen (mEV) unversorgt und das Einsilberverstehen (EV) mit Testsystem bei 65 dB SPL wurde mit dem postoperativ erreichten EV mit Osia bei 65 dB SPL korreliert.

Ergebnisse

Die präoperative Vorhersage für das postoperative Ergebnis mit Osia war anhand des mEV mit höherer Varianzaufklärung als mit dem EV bei 65 dB SPL mit KL-Testgerät am Softband möglich. Das postoperative EV war am besten für die Patienten mit SL-SH und am schlechtesten für Patienten mit komb-SH mit einer PTA4-KL ≥ 40 dB HL vorhersagbar. Die Ergebnisse mit dem Testgerät am Softband zeigen eher das minimal erreichbare Ergebnis und das mEV eher das realistisch zu erreichende Ergebnis mit Osia.

Schlussfolgerung

Das Osia kann für die Versorgung von SL-SH und komb-SH unter Beachtung der Indikationsgrenzen eingesetzt werden. Auch die mittlere präoperative Knochenleitungshörschwelle liefert näherungsweise eine Abschätzung des postoperativen EV mit Osia, für das die genaueste Vorhersage anhand des präoperativen mEV erzielt wird. Die Vorhersagegenauigkeit reduziert sich ab einer PTA4-KL von ≥ 40 dB.
Linking MS1 and MS2 signals in positive and negative modes of LC-HRMS in untargeted metabolomics using the ROIMCR approach
Authors: Yamamoto Flávia Yoshie , Pérez-López Carlos , Lopez-Antia Ana , Lacorte Silvia , de Souza Abessa Denis Moledo , Tauler Romà
Published: August 2023

Data-independent acquisition (DIA) mode in liquid chromatography (LC) high-resolution mass spectrometry (HRMS) has emerged as a powerful strategy in untargeted metabolomics for detecting a broad range of metabolites. However, the use of this approach also represents a challenge in the analysis of the large datasets generated. The regions of interest (ROI) multivariate curve resolution (MCR) approach can help in the identification and characterization of unknown metabolites in their mixtures by linking their MS1 and MS2 DIA spectral signals. In this study, it is proposed for the first time the analysis of MS1 and MS2 DIA signals in positive and negative electrospray ionization modes simultaneously to increase the coverage of possible metabolites present in biological systems. In this work, this approach has been tested for the detection and identification of the amino acids present in a standard mixture solution and in fish embryo samples. The ROIMCR analysis allowed for the identification of all amino acids present in the analyzed mixtures in both positive and negative modes. The methodology allowed for the direct linking and correspondence between the MS signals in their different acquisition modes. Overall, this approach confirmed the advantages and possibilities of performing the proposed ROIMCR simultaneous analysis of mass spectrometry signals in their differing acquisition modes in untargeted metabolomics studies.

Graphical Abstract
A Rigorous Derivation of the Functional Renormalisation Group Equation
Authors: Ziebell Jobst
Published: August 2023

The functional renormalisation group equation is derived in a mathematically rigorous fashion in a framework suitable for the Osterwalder–Schrader formulation of quantum field theory. To this end, we devise a very general regularisation scheme which retains reflection positivity as well as the infinite degrees of freedom including smoothness. Furthermore, it is shown how the classical limit is altered by the regularisation process leading to an inevitable breaking of translation invariance. We also give precise conditions for the convergence of the obtained theories upon removal of the regularisation.
Optimal placement of flexible ureteral access sheath in retrograde intrarenal surgery
Authors: Chen Yujun , Cheng Xiaofeng , Yang Heng , Deng Wen , Chen Luyao , Wang Gongxian , Zhou Xiaochen
Published: August 2023

This study aims to explore the optimal location of flexible ureteral access sheath (f-UAS) in retrograde intrarenal lithotripsy (RIRS). RIRS model was built by AutoCAD 2011 software, and imported COMSOL 5.6 software to computer simulation. An RIRS model was constructed in vitro to analyze the distribution pattern of stone fragments and compare the weight of stone fragments carried out by the irrigation fluid when the f-UAS is in different positions. Computer simulation showed that the highest flow of irrigation fluid was in the channel of flexible ureteroscopy (f-URS) and in the lumen of f-UAS. From the f-URS to the renal collection system and then to the f-UAS, the velocity of irrigation fluid changes gradually from high-flow to low-flow and then to high-flow. When the f-URS and the f-UAS are at the same level, the irrigation fluid is always at a state of high flow during the process from f-URS to f-UAS. When the f-URS and the f-UAS are at the same level, it can increase the local intrarenal pressure (IRP) at the front of f-URS. The stone fragments are mainly sediment in the low-flow region of irrigation fluid. More stone fragments could follow the irrigation fluid out of the body when the tip of f-URS and the tip of f-UAS are at the same level (P < 0.001). The f-UAS should be brought closer to the stone in RIRS. And more stone fragments can be taken out of the body by the effect of irrigation fluid.
Bioaccumulation, Bioindication and Health Risk Assessment of Heavy Metals in Cape Horse Mackerel (Trachurus trachurus) and Slinger Seabream (Chrysoblephus puniceus) in the Durban Basin and Cape Vidal, South Africa
Authors: Debipersadh Sanjeev , Ogola Henry Joseph Oduor , Mearns Kevin , Selvarajan Ramganesh
Published: August 2023

The bioaccumulation of heavy metals (HMs) in marine fish is a growing global concern due to potential human health risks. The study analyzed HM in the muscle tissue, gills, and gut of adult male and female cape horse mackerel and slinger seabream caught in the polluted Durban Basin and pristine Cape Vidal from April 2018 to February 2019. Results revealed interspecific, spatial, and organ-specific variability in HM levels. In the Durban Basin, slinger seabream had bioaccumulation (in mg/kg) of As (2.3 ± 0.2), Cr (2.6 ± 0.2), Ni (2.0 ± 0.1), and Pb (4.1 ± 0.3) while cape horse mackerel had Ni (1.6 ± 0.2), Pb (4.7 ± 0.6), and Zn (52 ± 3.01) exceeding World Health Organization (WHO) regulatory limits. Metal pollution index (MPI) values were also higher in Durban Basin (> 5.13) than Cape Vidal (< 3.32) for both species’ muscles. Liver and gills of slinger seabream and gut of cape horse mackerel exhibited higher HM accumulation patterns proportionate to the environmental concentrations, indicating the bioindicative potential of HM pollution by the two species. Risk assessment indicated that both fish species had target hazard quotient > 1 for Cr, and target cancer risk < 10–4 for Pb, implying significant potential non-carcinogenic and carcinogenic health risks associated with fish consumption from the Durban Basin. The study recommends daily consumption limits of 16 g/day for slinger seabream and 14 g/day for cape horse mackerel to ensure health safety. The findings contribute to the understanding of HM pollution in the Durban Basin and provide important information for decision-makers and policymakers in developing effective strategies to mitigate and manage HM contamination in fish populations.
The Ethics and Responsibilities of Social Media Usage by Plastic Surgeons: A Literature Review
Authors: Oregi Paul , Cavale Naveen , Khatib Manaf , Rahman Shakeel M.
Published: August 2023

Background and Objectives

Social media has revolutionised how plastic surgeons advertise their work and promote their services, but concerns have been raised regarding the ethics of these practices. This review aims to identify said concerns and develop measures to address them.

Methods

PubMed, Cochrane and Medline were searched for studies assessing the ethics of social media use by plastic surgeons. Five search terms were used and 23 studies identified. Results were catalogued according to which principle of medical ethics was infringed.

Results

Autonomy: Patients must not be coerced into allowing their operative media to be shared and content anonymised by removing identifiable features and scrubbing metadata. Beneficence: It is difficult to balance the benefit to patients of posting photographs for educational purposes with the risk of identifiable features being present, particularly within craniofacial surgery. Non-maleficence: Taking operative media could be a distraction from the patient and lengthen the procedure which could lead to harm. Any content posted on social media should be adapted to avoid trivialisation or sexualisation. Justice: Surgeons should not entertain their audience to increase their following at the expense of patients.

Conclusions

Greater oversight of social media use by plastic surgeons is required to avoid patient harm and tarnishing of the specialty’s professional standing. Professional bodies should be tasked with devising a course dedicated to the responsible use of these platforms. This should ensure the public’s trust in the specialty does not become eroded and patients are not harmed by unethical social media use.

This review highlights the relevant shortfalls of SoMe use by plastic surgery

Several proposals are made to reduce the incidence of these shortfalls and to ensure SoMe is used in a professional and responsible manner

It also lists areas of the specialty where SoMe is underused and could be of help, such as academia

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266.
12Fr-Pigtail Versus 14Fr-Balloon Percutaneous Radiologic Gastrostomy (PRG), Retrospective Evaluation of Outcomes and Complications; A Maastricht University Medical Centre Study
Authors: Dams Glenn , Knapen Robrecht R. M. M. , Korenblik Remon , van Dam Ronald M. , de Haan Michiel W. , van der Leij Christiaan
Published: August 2023

Purpose

To retrospectively compare tube and placement related results of a 12Fr-pigtail and a 14Fr-balloon gastrostomy tube.

Materials and Methods

All consecutive patients who underwent percutaneous radiologic gastrostomy (PRG) between January 2016 and June 2020 were enrolled in this retrospective single-center analysis. Follow-up for all patients was 180 days. Mortality after 30 days, technical success, days to first complication within 180 days, reason of unexpected visit (tube, anchor or pain related), and tube specific complications (obstruction, pain, luxation, leakage) were taken as outcome measures. Data were obtained from both PACS software and electronic health records.

Results

A total of 247 patients were enrolled (12Fr-pigtail: n = 139 patients and 14Fr-balloon: n = 108 patients). 30-day mortality was very low in both groups and never procedure related. Technical success was 99% in both groups. The average number of complications within 180 days after initial PRG placement was significantly higher in the 12Fr-pigtail group (12Fr-pigtail: 0.93 vs. 14Fr-balloon: 0.64, p = 0.028). Time to first complication within 180 days was significantly longer in the 14Fr-balloon group (12Fr-pigtail: 29 days vs. 14Fr-balloon: 53 days, p = 0.005). In the 14Fr-balloon group, the rate of tube-related complications (luxation and obstruction) was significantly lower compared to 12Fr-pigtail (29% vs. 45%, p = 0.011).

Conclusion

14Fr-balloon gastrostomy tubes have significantly lower (tube-related) complications rates and longer time to first complication compared to 12Fr-pigtail tubes. No procedure-related mortality was observed in either group. Technical success was very high in both groups.

Level of Evidence Level 3, non-controlled retrospective cohort study.
LIF-based quantification of the species transport during droplet impact onto thin liquid films
Authors: Ennayar Hatim , Brockmann Philipp , Hussong Jeanette
Published: August 2023

In the present study, laser-induced fluorescence (LIF) is used to investigate the mixing process of a droplet impacting onto a thin liquid film. A robust multidimensional calibration procedure is developed enabling the extraction of local instantaneous dye concentrations as well as film heights. A series of validation measurements are conducted confirming a low reconstruction error of$$4.53\%$$4.53%. The impact-induced mixing process is thoroughly investigated across various liquid film thicknesses to examine the propagation of the mixing zone and the instantaneous radial concentration gradients within it. It is shown that the maximum extent of the mixing zone scales inversely proportional with the thickness of the liquid film. Within our experiments, we discover the formation of wall-induced vortex ring instabilities subsequent to impact. The disintegration of vortex rings during droplet impact significantly enhances convection-driven mixing, as quantified by the coefficient of variation.

Graphical abstract
Thyroid function and urinary concentrations of iodine, selenium, and arsenic in vegans, lacto-ovo vegetarians and pescatarians
Authors: Henjum Sigrun , Groufh-Jacobsen Synne , Aakre Inger , Gjengedal Elin Lovise Folven , Langfjord Mina Marthinsen , Heen Espen , Sele Veronika , Andersson Maria
Published: August 2023

Purpose

Populations following a plant-based diet may be at particular risk of thyroid dysfunction due to low iodine and selenium intakes. The main purpose was to assess thyroid function and urinary concentration of iodine, selenium, and arsenic, in subjects following a vegan, lacto-ovo vegetarian, or pescatarian diet.

Methods

In Norway, a country without mandatory dietary iodine fortification, 205 adults, following vegan (n = 115), lacto-ovo vegetarian (n = 55) and pescatarian diet (n = 35) were included. Thyroglobulin (Tg), thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), and serum anti-TPO (S-anti-TPO) were measured in a venous blood sample and concentrations of iodine (UIC), creatinine (UCC), selenium, and arsenic were measured from single spot urine samples.

Results

Subclinical hypothyroidism (TSH > 4.0 mU/L) was observed in 3% of subjects. The overall median (p25, p75) Tg was 17 (9, 30) µg/L and vegans had higher Tg compared to pescatarians. Vegans not consuming iodine-containing supplements (n = 43) had higher Tg, than supplement users (n = 72), 27 (11, 44) vs. 16 (8, 25) µg/L and higher fT4, 16 (15, 17) vs. 15 (14, 17) pmol/L, respectively. The overall median UIC was 57 (28, 130) µg/L, all dietary groups had median UIC below WHO thresholds. Median urinary selenium and arsenic concentration was 13 (6, 22) and 3 (2, 8) µg/L, respectively.

Conclusion

The prevalence of subclinical hypothyroidism was low and fT4 and fT3 were within the normal range for all dietary groups. Vegans had significantly increased Tg compared to pescatarians.
Adherence to interdisciplinary tumor board recommendations as an expression of quality-assured patient care: results of a bicentric German analysis
Authors: Braulke Friederike , Kober Kathrin , Rieken Stefan , Brand Tonia , Hartz Tobias , Seipke Stefanie , Asendorf Thomas , Haier Jörg
Published: August 2023

Purpose

Interdisciplinary tumor boards (ITBs) represent a central part of standard cancer care defining a guidelines-guided treatment plan adapted to the patient’s capabilities, comorbidities and wishes in a multi-professional team. The implementation rate of ITB recommendations can be monitored by structured adherence analyses. But (inter)national definitions how to measure the level of implementation are missing. Here, we present results of 4 years of ITB adherence analyses in a bicentric German Comprehensive Cancer Center (CCC).

Methods

Between 2018 and 2021, for at least 1 month, the implementation rate of recommendations of 8 different ITBs of 2 CCC sites was evaluated manually according to harmonized criteria between both sites regarding the degree of implementation of ITB’s recommendations.

Results

In total, 1104 cases were analyzed (65% male, 35% female). Mean distance from patient’s home to the CCC was 57 km (range 0.8–560.6 km). For 949 cases (86%) with known follow-up, the adherence rate was 91.9% (95% CI 0.9; 0.935). In 8.1%, ITB decisions were not implemented due to medical reasons (45.4%), patient’s wish (35.1%) and unknown reasons (19.5%). Logistic regression revealed neither age (OR = 0.998, p = 0.90), nor gender (OR = 0.98, p = 0.92) or the distance from patient’s home to the CCC (OR = 1.001, p = 0.54) were significantly associated with ITB adherence.

Conclusion

ITB adherences analyses can serve as a quality management tool to monitor the implementation rate of ITB recommendations and to stay in contact with practitioners, other hospitals and state cancer registries to share data and resources in accordance with data protection requirements for continuously improvement of quality management and patient care.
Space-time variational material modeling: a new paradigm demonstrated for thermo-mechanically coupled wave propagation, visco-elasticity, elasto-plasticity with hardening, and gradient-enhanced damage
Authors: Junker Philipp , Wick Thomas
Published: August 2023

We formulate variational material modeling in a space-time context. The starting point is the description of the space-time cylinder and the definition of a thermodynamically consistent Hamilton functional which accounts for all boundary conditions on the cylinder surface. From the mechanical perspective, the Hamilton principle then yields thermo-mechanically coupled models by evaluation of the stationarity conditions for all thermodynamic state variables which are displacements, internal variables, and temperature. Exemplary, we investigate in this contribution elastic wave propagation, visco-elasticity, elasto-plasticity with hardening, and gradient-enhanced damage. Therein, one key novel aspect are initial and end time velocity conditions for the wave equation, replacing classical initial conditions for the displacements and the velocities. The motivation is intensively discussed and illustrated with the help of a prototype numerical simulation. From the mathematical perspective, the space-time formulations are formulated within suitable function spaces and convex sets. The unified presentation merges engineering and applied mathematics due to their mutual interactions. Specifically, the chosen models are of high interest in many state-of-the art developments in modeling and we show the impact of this holistic physical description on space-time Galerkin finite element discretization schemes. Finally, we study a specific discrete realization and show that the resulting system using initial and end time conditions is well-posed.
Surgical treatment of spondylodiscitis in critically ill septic patients
Authors: Al-Afif Shadi , Atallah Oday , Scheinichen Dirk , Palmaers Thomas , Cinibulak Zafer , Rollnik Jens D. , Krauss Joachim K.
Published: August 2023

Purpose

Surgical procedures in critically ill patients with spondylodiscitis are challenging and there are several controversies. Here, we present our experience with offering surgical intervention early in critically ill septic patients with spondylodiscitis.

Method

After we introduced a new treatment paradigm offering early but limited surgery, eight patients with spondylodiscitis complicated by severe sepsis and multiple organ failure underwent urgent surgical treatment over a 10-year period. Outcome was assessed according to the Barthel index at 12-month follow-up and at the last available follow-up (mean 89 months).

Results

There were 7 men and 1 woman, with a mean age of 62 years. The preoperative ASA score was 5 in 2 patients, and 4 in 6 patients. Six of them presented with high-grade paresis, and in all of them, spondylodiscitis with intraspinal and/or paravertebral abscesses was evident in MR imaging studies. All patients underwent early surgery (within 24 h after admission). The median time in intensive care was 21 days. Out of the eight patients, seven survived. One year after surgery, five patients had a good outcome (Barthel index: 100 (1); 80 (3); and 70 (1)). At the last follow-up (mean 89 months), 4 patients had a good functional outcome (Barthel index between 60 and 80).

Conclusion

Early surgical treatment in critically ill patients with spondylodiscitis and sepsis may result in rapid control of infection and can provide favorable long-term outcome. A general strategy of performing only limited surgery is a valid option in such patients who have a relatively high risk for surgery.
Machine learning and computational chemistry to improve biochar fertilizers: a review
Authors: Osman Ahmed I. , Zhang Yubing , Lai Zhi Ying , Rashwan Ahmed K. , Farghali Mohamed , Ahmed Ashour A. , Liu Yunfei , Fang Bingbing , Chen Zhonghao , Al-Fatesh Ahmed , Rooney David W. , Yiin Chung Loong , Yap Pow-Seng
Published: August 2023

Traditional fertilizers are highly inefficient, with a major loss of nutrients and associated pollution. Alternatively, biochar loaded with phosphorous is a sustainable fertilizer that improves soil structure, stores carbon in soils, and provides plant nutrients in the long run, yet most biochars are not optimal because mechanisms ruling biochar properties are poorly known. This issue can be solved by recent developments in machine learning and computational chemistry. Here we review phosphorus-loaded biochar with emphasis on computational chemistry, machine learning, organic acids, drawbacks of classical fertilizers, biochar production, phosphorus loading, and mechanisms of phosphorous release. Modeling techniques allow for deciphering the influence of individual variables on biochar, employing various supervised learning models tailored to different biochar types. Computational chemistry provides knowledge on factors that control phosphorus binding, e.g., the type of phosphorus compound, soil constituents, mineral surfaces, binding motifs, water, solution pH, and redox potential. Phosphorus release from biochar is controlled by coexisting anions, pH, adsorbent dosage, initial phosphorus concentration, and temperature. Pyrolysis temperatures below 600 °C enhance functional group retention, while temperatures below 450 °C increase plant-available phosphorus. Lower pH values promote phosphorus release, while higher pH values hinder it. Physical modifications, such as increasing surface area and pore volume, can maximize the adsorption capacity of phosphorus-loaded biochar. Furthermore, the type of organic acid affects phosphorus release, with low molecular weight organic acids being advantageous for soil utilization. Lastly, biochar-based fertilizers release nutrients 2–4 times slower than conventional fertilizers.
Humans as path-finders for mobile robots using teach-by-showing navigation
Authors: Antonucci Alessandro , Bevilacqua Paolo , Leonardi Stefano , Paolopoli Luigi , Fontanelli Daniele
Published: August 2023

One of the most important barriers towards a widespread use of mobile robots in unstructured, human populated and possibly a-priori unknown work environments is the ability to plan a safe path. In this paper, we propose to delegate this activity to a human operator that walks in front of the robot marking with her/his footsteps the path to be followed. The implementation of this approach requires a high degree of robustness in locating the specific person to be followed (the path-finder). We propose a three phases approach to fulfil this goal: 1. Identification and tracking of the person in the image space, 2. Sensor fusion between camera data and laser sensors, 3. Point interpolation with continuous curvature paths. The approach is described in the paper and extensively validated with experimental results.
Moral Case Deliberation in Dutch Prisons: Experienced Outcomes and the Moral Learning of Prison Staff
Authors: Schaap A. I. , Molewijk A. C. , Stolper M. M.
Published: August 2023

We present a study about an ethics support instrument, Moral Case Deliberation (MCD), which is used to support and further professionalize Dutch prison staff. MCD can facilitate prison staff in dealing with moral dilemmas from practice. We present an embedded mixed-methods study on the experienced outcomes of 16 teams participating in both single and in series of MCD sessions. Prison staff and MCD facilitators completed evaluation forms (n = 871 by staff, and n = 122 by facilitators) after participating in a single MCD session (n = 131). Staff filled out another evaluation form (n = 149) after participating in a series of 10 MCD sessions. Our multilevel quantitative analyses show overall positive outcomes, with significant differences between professional disciplines. Prison staff, e.g., reported a better understanding of the discussed moral dilemma and the related perspectives of colleagues. The qualitative thematic content analysis of the experienced outcomes of single MCD sessions resulted in 8 outcome categories, e.g., improved moral awareness, awareness of responsibilities and limitations in decision-making, and feeling empowered to address issues. The experienced outcomes of MCD provide some insights in the process of fostering moral learning of prison staff; staff gained moral awareness, and improved their perspective-taking and the ability to better control their frustrations and emotions. Further research should focus on studying the impact of MCD on moral decision-making in the day-to-day practice of prison staff and on what the organization can learn from the MCD sessions.
Safe Havens, Machine Learning, and the Sources of Geopolitical Risk: A Forecasting Analysis Using Over a Century of Data
Authors: Gupta Rangan , Karmakar Sayar , Pierdzioch Christian
Published: August 2023

We use monthly data covering a century-long sample period (1915–2021) to study whether geopolitical risk helps to forecast subsequent gold volatility. We account not only for geopolitical threats and acts, but also for 39 country-specific sources of geopolitical risk. The response of subsequent volatility is heterogeneous across countries and nonlinear. We find that accounting for geopolitical risk at the country level improves forecast accuracy, especially when we use random forests to estimate our forecasting models. As an extension, we report empirical evidence on the predictive value of the country-level sources of geopolitical risk for two other candidate safe-haven assets, oil and silver, over the sample periods 1900–2021 and 1915–2021, respectively. Our results have important implications for the portfolio and risk-management decisions of investors who seek a safe haven in times of heightened geopolitical tensions.
Correlation factors of translanguaging practices on English as a Foreign Language Contexts: the perception of Teachers
Authors: Alrayes Muhammad
Published: August 2023

Teaching English in second language contexts seems to have succeeded in implementing only target-language policy allowed during class time. However, the problem persists in teaching English in foreign language contexts where English is not the official and/or first language in those countries. Such situations kept the question unanswered; whether the first language of the target learners should be used during class times in the form oftranslanguagingor not. While few studies have investigated this issue thoroughly; however very a few of them examined in depth analysis from different perspectives such as: how different factors paly various roles on this issue, how those factors correlate to each other, and how they relate to translanguaging in particular. This study investigates the correlations between translanguaging practices in English as a foreign language context during class time from teachers’ perspectives. Correlation, Structural Equation Modeling (SEM) and regression analyses showed that there was significant correlation between translanguaging practices and other examined independent variables including gender, same background between teachers and learners’ and first language; whereas no significant correlation was found regarding the teaching experience. The study recommends evaluating learners’ levels even if the focus of the study was on teachers’ perceptions for future research.
Seasonal dynamics of phytoplankton in the northern part of Suez Gulf, Egypt
Authors: El-Sheekh Mostafa , Abu-Faddan Mahmoud , Abo-Shady Atef , Nassar Mohamed Zein Alabdein , Labib Wagdy
Published: August 2023

This study was conducted to evaluate the seasonal variability of phytoplankton in the northern part of the Gulf of Suez (Suez Bay), considering the contribution of physicochemical parameters of bay water in shaping the dynamics, and eutrophication assessment. Water and phytoplankton samples were collected seasonally at nine stations in the Suez Bay during the period from the winter to autumn of 2012. A total of 423 phytoplankton species were identified, comprised mainly of 224 diatoms, 127 dinoflagellates, 33 cyanophytes, 20 chlorophytes, and 9 euglenophytes; the rest of the species (10 species) belong to other six groups. Of these, 28 species were potentially harmful. The total phytoplankton abundance exhibits a significant seasonal variation, with the autumn being the most fertile season, followed by the winter due to the proliferation of diatom species Thalassionema nitzschioides and Proboscia alata f. gracillima, respectively. While the seasonal species richness indicates that the winter attained the highest number of species, followed by summer. Generally, the major diatom genera were Chaetoceros (16 species), Navicula (15 species), Nitzschia (15 species), and Amphora (14 species), while dinoflagellates were principally composed of the genera Protoperidinium (34 species), and Tripos (26 species). Water temperature, pH, salinity, nitrate, and nitrite were the most important explanatory parameters in regard to phytoplankton abundance and chlorophyll a concentration. In addition, the phytoplankton stability exhibited a significant positive relationship with the mean values of dissolved oxygen and biological oxygen demand and the variability of salinity and phosphate, while a negative relationship was observed with ammonia and nitrite and the variability of nitrate. Based on the trophic index (TRIX), the bay water was classified as mesotrophic (moderately polluted) for almost the entire year except in the autumn as it turned eutrophic. The results explored the potential importance of the environmental heterogeneity in the bay as a key structuring mechanism of phytoplankton abundance and biomass, influenced by anthropogenic activities.