bluuebunny/crossref_metadata_2025 huggingface dataset:
Flow Disruptions as A Result of Personal Electronic Devices in Orthopedic Surgery
Authors: Tooker McKenna , Lawton Paige , Rosado Gabriela , Ehrenfort Sabrina , Boquet Albert
Published: November 2023

The operating room (OR) is a complex environment in which highly trained individuals perform cognitively demanding tasks. Distractions in this environment may lead to deleterious effects, as a loss of situational awareness can interfere with surgical procedures. The present study aims to quantify the frequency and nature of distracting events associated with personal electronic devices (PEDs) during twenty elective orthopedic surgery cases. PED use was coded using a real-time, custom data collection tool beginning in the pre-operative area and terminating at the time of handoff with the post-anesthesia care team. PED use accounted for 242 flow disruptions in the OR. The vendor showed the highest frequency of flow disruptions (73), followed by the circulating nurse (52) and the certified registered nurse anesthetist (CRNA) (52). Thus, taking a proactive safety approach to account for intraoperative distractions associated with PEDs among OR team members will be critical to ensure high-quality patient care.
Efficacy and Outcome Measurement of iFactor/ABM/P-15 in Lumbar Spine Surgery: A Systematic Review
Authors: Hasan Sazid , Al-Jamal Malik , Miller Alex , Higginbotham Devan O. , Cavazos Daniel R. , Waheed Muhammad , Saleh Ehab , McCarty Scott A.
Published: November 2023

Study Design

Systematic Review.

Objectives

To determine the efficacy and overall outcomes of iFactor/ABM/P-15 following lumbar spine surgery.

Methods

We performed a search of the Cochrane Library, Medline Ovid, PubMed, and SCOPUS databases from inception until August 2023. Eligible studies included outcomes of patients receiving iFactor following lumbar spine surgery. The primary outcomes of interest were fusion rates and iFactor efficacy after lumbar surgery in patients who received iFactor. Secondary outcomes included patient-reported outcomes and complication rates.

Results

A total of 766 titles were initially screened. After inclusion criteria were applied, 5 studies (388 patients) were included, which measured overall outcomes of iFactor/ABM/P-15 following lumbar spine surgery. These studies showed acceptable reliability for inclusion based on the Methodical Index for Non-Randomized studies and Critical Appraisal Skills Programme assessment tools. iFactor/ABM/P-15 facilitated significantly faster bone development in various procedures while maintaining favorable clinical outcomes compared to traditional grafts.

Conclusions

This systematic review found that iFactor/ABM/P-15 use for lumbar spine surgery maintains similar managing patient-reported outcomes relative to other grafting methods. In regard to rates of fusion, iFactor/ABM/P-15 showed a significantly faster rate of fusion when compared to traditional grafts including allograft, autograft, demineralized bone matrix (DBM), and recombinant human bone morphogenetic protein-2 (rhBMP-2). Future multicenter randomized control trials with larger sample sizes are recommended to further assess iFactor/ABM/P-15 efficacy in lumbar spine surgery.
SNP heterozygosity, relatedness and inbreeding of whole genomes from the isolated population of the Faroe Islands
Authors: Gislason Hannes
Published: November 2023

Background

The population of the Faroe Islands is an isolated population but very little is known about it from whole genome sequencing. The population of about 50000 people has a high incidence of rare diseases e.g., 1:300 for Primary Carnitine Deficiency. A screening programme was implemented, and eleven persons were also whole genome sequenced at x37 coverage for diagnostic purposes of those cases that were not affected by the known mutations. The purpose of our study is to utilize the high coverage data to explore the genomic variation and the ancestral history of the population. We study the SNP heterozygosity, the pairwise relatedness from kinship, the inbreeding from runs of homozygosity ROH, and we find the minor allele frequency distribution. We estimate the population ancestry and the timing of the founding event by using the whole genomes from eight consenting individuals.

Results

We find the number of SNPs and the heterozygosity for the eight individual samples, and for merged samples, for which we also study the relatedness. We find close relatedness between the supposedly unrelated individuals. From ROH, we interpret the high relatedness as an ancient property of the isolated population. A bottleneck event is estimated starting between years $$\sim 50-300$$

∼
50
-
300

with a maximum consanguineous population in year $$\sim 600$$

∼
600

and similarly consanguineous between years $$500-700$$

500
-
700

. The ancestry analysis shows the population descends from founders of $$>99\%$$

>
99
%

European and $$<1\%$$

<
1
%

Admixed American ancestry. A distinct clustering near the central European and British populations of the 1000 Genome Project is likely the result of the population isolation and genetic drift. The minor allele frequency distribution suggests many rare variants.

Conclusions

The ancestry is mainly European while the inbreeding is higher compared to European populations and population isolates. The Faroese population has inbreeding more like ancient Europeans. We discovered a bottlenecked and consanguineous population event and estimated it starting in the 1st-4th century as compared to the oldest archaeological findings from the 4th-6th century.
Identification of gene modules and hub genes associated with Colletotrichum siamense infection in mango using weighted gene co-expression network analysis
Authors: Liu Zongling , Zhu Zhengjie , Huang Yuanhe , Nong Song , Jiang Minli , Yi Sangui , Xie Delong , Hu Hongliu
Published: November 2023

Colletotrichum siamense is a hemibiotrophic ascomycetous fungus responsible for mango anthracnose. The key genes involved in C. siamense infection remained largely unknown. In this study, we conducted weighted gene co-expression network analysis (WGCNA) of RNA-seq data to mine key genes involved in Colletotrichum siamense-mango interactions. Gene modules of Turquoise and Salmon, containing 1039 and 139 respectively, were associated with C. siamense infection, which were conducted for further analysis. GO enrichment analysis revealed that protein synthesis, organonitrogen compound biosynthetic and metabolic process, and endoplasmic reticulum-related genes were associated with C. siamense infection. A total of 568 proteins had homologs in the PHI database, 370 of which were related to virulence. The hub genes in each module were identified, which were annotated as O-methyltransferase (Salmon) and Clock-controlled protein 6 (Turquoise). A total of 24 proteins exhibited characteristics of SCRPs. By using transient expression in Nicotiana benthamiana, the SCRPs of XM_036637681.1 could inhibit programmed cell death (PCD) that induced by BAX (BCL-2-associated X protein), suggesting that it may play important roles in C. siamense infection. A mango-C. siamense co-expression network was constructed, and the mango gene of XM_044632979.1 (auxin-induced protein 15A-like) was positively associated with 5 SCRPs. These findings help to deepen the current understanding of necrotrophic stage in C. siamense infection.
Ultrasound-guided pericapsular nerve group (PENG) block for early analgesia in elderly patients with hip fractures: a single-center prospective randomized controlled study
Authors: Tang Yan , Zhang Xinlei , Yi Shuai , Li Dan , Guo Hui , Liu Yunqing , Liu Jindong , Kong Mingjian
Published: November 2023

Background

The aim of this study was to compare the efficacy of ultrasound-guided PENG (pericapsular nerve group) block and drug therapy with intravenous flurbiprofen for early analgesia in elderly patients with hip fractures after hospitalization.

Methods

This is a single-center, observer-blinded, prospective, randomized, controlled trial. A total of 41 elderly patients (aged 60 or older) with hip fractures were enrolled in the current study. Patients were randomly assigned to two groups: Group P (ultrasound-guided PENG block, 20 mL of 0.375% ropivacaine) and Group F (intravenous flurbiprofen 50 mg). The primary outcome measure was the dynamic (passive straight leg raising 15°) NRS (numerical rating scale 0 to 10) pain scores at different time points. The secondary outcomes were the static NRS scores at different time points, the number of rescue analgesia sessions, patient satisfaction, and the incidence of complications.

Results

Patients in the two groups had comparable baseline characteristics. The group P had lower dynamic and static NRS scores at 15 min, 30 min, 6 h, and 12 h after intervention (P<0.05) than the group F. The highest NRS pain scores in the group P were still lower than the NRS scores in the group F at 30 min-12 h (Group F: 5.57±1.54 vs. Group P: 3.00±1.12, P<0.001), and there was no significant difference between the two groups at 12-24 h (Group F: 6.35±1.79 vs. Group P: 5.90±1.83, P>0.05). The group P had higher satisfaction scores (Group P: 9 (9,9) vs. Group F: 8 (7,8), P<0.001). There was no statistically significant difference in the number of rescue analgesics at 0-12 h or 12-24 h or the incidence of complications between the groups.

Conclusions

Compared with intravenous flurbiprofen, ultrasound-guided PENG block provides better early analgesic effects in elderly patients with hip fractures, and a PENG block is safe for elderly patients with hip fractures after hospitalization.

Trial registration

This study was registered in the Chinese Clinical Trial Testing Center (ID: ChiCTR2200062400).
Analysis of controlled ovarian hyperstimulation protocols in women over 35 years old with poor ovarian response: a real-world study
Authors: Duan Xiaoyan , Li Zhan , Li Mingming , Ma Xing
Published: November 2023

The objective of this study was to investigate the optimal controlled ovarian hyperstimulation (COH) protocol for patients aged 35 and above with poor ovarian response (POR), utilizing real-world data. This retrospective cohort study examined clinical information from a total of 4256 patients between January 2017 and November 2022. The patients were categorized into three groups: modified GnRH agonist protocol (2116 patients), GnRH antagonist protocol (1628 patients), and Mild stimulation protocol (512 patients). Comparative analysis was conducted on clinical variables and pregnancy outcomes across the three groups. The GnRH agonist protocol was associated with a higher number of oocyte number (4.02 ± 2.25 vs. 3.15 ± 1.52 vs. 2.40 ± 1.26, p < 0.001), higher number of transferable embryos (1.73 ± 1.02 vs. 1.35 ± 1.22 vs. 1.10 ± 0.86, p = 0.016), higher cumulative live birth rate 28.50(603/2116) vs. 24.94(406/1628) vs. 20.51(105/512), p < 0.001) than GnRH antagonist protocol and Mild stimulation protocol, the Mild stimulation protocol was associated with a higher miscarriage rates 16.27(62/381) vs. 16.61(48/289) vs. 32.22(29/90), p = 0.001) than the other two groups. Therefore, it can be concluded that all three protocols can be used in patients over 35 years old with poor ovarian response. However, if patients require more frozen-thawed embryo transfers to achieve better cumulative live birth rates, the modified GnRH agonist protocol may be the preferable option.
Two-way adjustable double-knots intrascleral fixation and single sclerotomy looping technique: a novel minimal invasive adjustable intraocular lens fixation technique
Authors: Chen Lulu , Wang Zaowen , Sun Lu , Tang Yongxiang , Sui Wenda , Bian Ailing , Zhang Xia , Zhong Yong , Zhang Shunhua
Published: November 2023

Background

IOL fixation without capsular support presents challenges for surgeons. Although innovative techniques were developed to address subluxated IOLs, adjustable IOL fixation methods are seldom reported. We introduce a novel two-way adjustable double-knots intrascleral fixation combined with single sclerotomy looping technique for fixing intraocular lenses (IOL) or IOL-capsular bags.

Methods

A bent 30-gauge needle threaded with 8 − 0 polypropylene was introduced into the eye. A gripping forceps assisted the haptic looping. Two overhand knots were made with 8 − 0 polypropylene thread. The knots were incarcerated into a scleral tunnel made by a 30-gauge needle, with two ends of the thread left at each side of the tunnel. The IOL was adjusted to the premium position with adequate tension by pulling either end of the threads. The study included 19 eyes with aphakia, subluxated IOL-capsular bags, or subluxated crystalline lenses. The mean followed up period was 18.9 ± 7.1 months with evaluations of uncorrected visual acuity (UCVA), intraocular pressure, slit-lamp examination, and swept-source optical coherence tomography of the anterior segment.

Results

UCVA increased from 1.28 ± 0.74 at baseline to 0.44 ± 0.51 (logMAR) at final visit (P < 0.001). All IOLs were fixed well-centered. The mean IOL tilt was 3.5°±1.1°. Postoperative complications included transient IOP elevation (15.8%), hypotony (10.5%), and cystoid edema (5.3%) which resolved within 4 weeks.

Conclusions

We presented a novel adjustable technique for IOL fixation, which stabilize IOLs by using an intrascleral double-knots structure. This technique minimized surgical manipulations by using a single sclerotomy looping technique without large conjunctival dissection and scleral flap creation. The technique offers a reliable and optimal IOL positioning and improved visual outcomes in patients undergoing scleral fixed IOL implantation.
“Multivariate analysis of the impact of sleep and working hours on medical errors: a MICE approach"
Authors: Mul Fedele Malena Lis , López Gabeiras María del Pilar , Simonelli Guido , Diez Joaquín José , Bellone Giannina Julieta , Cagliani Joaquín , Larrateguy Luis , Eiguchi Kumiko , Golombek Diego Andrés , Cardinali Daniel Pedro , Pérez-Chada Daniel , Vigo Daniel Eduardo
Published: November 2023

Background

The main objective of this study was to describe the relationship between working conditions, sleep and psycho-affective variables and medical errors.

Methods

This was an observational, analytical and cross-sectional study in which 661 medical residents answered questionnaires about working conditions, sleep and psycho-affective variables. Actigraphic sleep parameters and peripheral temperature circadian rhythm were measured in a subgroup of 38 subjects. Bivariate and multivariate predictors of medical errors were assessed.

Results

Medical residents reported working 66.2 ± 21.9 weekly hours. The longest continuous shift was of 28.4 ± 10.9 h. They reported sleeping 6.1 ± 1.6 h per day, with a sleep debt of 94 ± 129 min in workdays. A high percentage of them reported symptoms related to psycho-affective disorders. The longest continuous shift duration (OR = 1.03 [95% CI, 1.00–1.05], p = 0.01), working more than six monthly on-call shifts (OR = 1.87 [95% CI, 1.16–3.02], p = 0.01) and sleeping less than six hours per working day (OR = 1.66 [95% CI, 1.10–2.51], p = 0.02) were independently associated with self-reported medical errors. The report of medical errors was associated with an increase in the percentage of diurnal sleep (2.2% [95% CI, 0.1–4.3] vs 14.5% [95% CI, 5.9–23.0]; p = 0.01) in the actigraphic recording.

Conclusions

Medical residents have a high working hour load that affect their sleep opportunities, circadian rhythms and psycho-affective health, which are also related to the report of medical errors. These results highlight the importance of implementing multidimensional strategies to improve medical trainees’ sleep and wellbeing, increasing in turn their own and patients’ safety.
Pulmonary manifestations of POEM syndrome: a retrospective analysis of 282 cases
Authors: Huang Yilin , Luo Yang , Hou Huan , Gao Jinming
Published: November 2023

Background

Polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome is a rare multisystemic clonal plasma cell disorder. Pulmonary involvement is frequently found in patients with POEMS syndrome, manifesting various clinical features. Therefore, to improve diagnostic accuracy and provide treatment strategies, a comprehensive analysis of pulmonary manifestations of POEMS syndrome is needed.

Methods

This retrospective study included patients with POEMS syndrome at Peking Union Medical College Hospital, a major referral medical center in China, between June 1, 2013, and June 1, 2023. Demographic data, laboratory findings, pulmonary function test results, echocardiograms, and chest imaging data were extracted. Continuous variables were compared using the t-test or Mann–Whitney method. Pearson’s chi-square test or Fisher’s exact test was conducted to compare categorical data.

Results

Overall, 282 individuals diagnosed with POEMS syndrome were included in this study, of which 56% were male with an average age of 48.7 years. Respiratory symptoms were found in 40.1% of the patients, with dyspnea as the most common symptom (34.4%). Chest computed tomography and echocardiography findings showed that 56.4% of patients exhibited pleural effusion, 62.8% displayed mediastinal or hilar lymphadenopathy, 46.5% presented pleural thickening, 27.3% demonstrated bone lesions of the ribs or thoracic vertebra, 7.8% showed lung interstitial abnormalities, and 35.5% had pulmonary hypertension. Decreased diffuse capacity and restrictive ventilatory patterns were identified in 85.2% (115 cases) and 47.4% (64 cases) of patients, respectively. Patients with respiratory symptoms exhibited higher declined lung function measures than those having no respiratory symptoms. High-risk patients with poor prognosis showed more pulmonary function abnormalities.

Conclusion

Abnormalities in pulmonary manifestations constitute the significant features of POEMS syndrome. Several patients with POEMS syndrome presented with respiratory symptoms at the initial evaluation. These findings underscore the importance of early identification and accurate diagnosis of POEMS syndrome by clinicians, particularly in cases involving lung and multisystem.
Temporomandibular treatments are significantly efficient in improving otologic symptoms
Authors: Naderi Yeganeh , Karami Elaheh , Chamani Goli , Amizadeh Maryam , Rad Maryam , Shabani Mohammad
Published: November 2023

Symptoms of temporomandibular disorders (TMD) could be present as otologic symptoms like earache and dizziness in some patients. In most cases, these symptoms are not recognized because otolaryngologists fail to diagnose TMD as a source of the problem. This investigation was conducted to evaluate the effect of TMD treatments on the otologic symptoms which after taking history and clinical examinations seemed to be related to TMD. In the present study, the patients who were complaining of otalgia, ear fullness, tinnitus, hearing loss, and dizziness were evaluated by an ear fellow. Forty patients who had no known otologic or other primary causes to explain their symptoms, were referred to the orofacial pain clinic with the possible diagnosis of TMD. If the diagnosis was confirmed by an orofacial pain specialist, a combination of TMD treatments was administered to each case and the patients were followed up. The results showed that following implementation of treatment protocols for TMD, more than 50% of the patients reported complete or partial recovery in the second follow-up (p < 0.05). The most common otologic symptom of the referred cases was earache, and the most common associated complaint was neck pain. All the patients had one or more parafunctional habits. This study showed that TMD treatments were significantly efficient in improving otologic symptoms partially or completely and the authors concluded that for the patients with otolaryngologic unexplained symptoms, an overhaul examination is needed to assess TMD as a possible cause of the patient complaint. It is recommended that in cases with unexplained otologic symptoms, otolaryngologists care more about the neck trigger points (TP) and ask about the patient’s parafunctional habits. Otolaryngologists and dentists need to be aware of the risk of developing otologic symptoms caused by these habits or cervical TPs.
Variations in wait times for imaging services: a register-based study of self-reported wait times for specific examinations in Norway
Authors: Hofmann Bjørn , Brandsaeter Ingrid Øfsti , Kjelle Elin
Published: November 2023

Background

While the number of medical images has increased substantially, the demand has outpaced access, resulting in long wait times in many countries. Long wait times are a key problem for patient safety and quality of care as they can result in prolonged suffering, delayed diagnosis and treatment, as well as poorer prognosis and loss of lives. Surprisingly, little is known about wait times for imaging services.

Objective

Investigate wait times for specific imaging services in Norway and to compare wait times with the total number of examinations and their development over time.

Methods

Data from the wait time registry at the Norwegian Directorate of Health from 2018 to 2021 as well as data on outpatient imaging provided by the Norwegian Health Economics Administration (HELFO) and in-patient data afforded by fourteen hospital trusts and hospitals in Norway were analysed. Data include the total number of imaging examinations according to the Norwegian Classification of Radiological Procedures (NCRP). Analyses were performed with descriptive statistics.

Results

Wait times vary through the months of the year. Conventional X-ray (XR) had the shortest wait times (3.0-4.4 weeks), and Magnetic Resonance Imaging (MRI) and ultrasound (US) had the lengthiest (8.7–12.0 and 7.9–11.4 weeks respectively). The wait times were lengthiest during the summer and winter holidays. Variations in wait times were also found for specific examination types between Norway’s four public health regions. In addition, there was variation over time within the health regions. The wait times with the private health providers were substantially lower than with the public health providers. From 2018 to 2021, the wait time for MRIs increased by 6.6%, while the number of examinations (per 10,000) increased by 8.6%. Those regions with the highest number of examinations per 1,000 inhabitants per year had the lowest wait times.

Conclusion

Wait times for diagnostic imaging procedures varied with time, region, and modality in Norway from 2018 to 2021. Long wait times may entail many negative consequences for patients, professionals, and the healthcare system. Reducing long wait times is an obvious way to improve the quality, safety, and efficiency of care.
Detection of monkeypox virus using helicase dependent amplification and recombinase polymerase amplification combined with lateral flow test
Authors: Gulinaizhaer Abudushalamu , Yang Chuankun , Zou Mingyuan , Ma Shuo , Fan Xiaobo , Wu Guoqiu
Published: November 2023

The monkeypox virus (MPXV) is a zoonotic DNA virus that belongs to the poxvirus family. Conventional laboratory methods for detecting MPXV are complex and expensive, making them unsuitable for detecting the virus in regions with limited resources. In this study, we using the Helicase dependent amplification (HDA) method and the Recombinase polymerase amplification (RPA) technique in combination with the lateral flow test (LFT), together with a self-designed qPCR technique for the detection of the MPXV specific conserved fragment F3L, to compare the sensitivity and specificity of the three assays. By analyzing the sensitivity detection results using Probit, it can be seen that the limit of detection (LOD) of the HDA-LFT detection target is 9.86 copies/µL (95% confidence interval, CI 7.52 copies/µL lower bound), the RPA-LFT detection target is 6.97 copies/µL (95% CI 3.90 copies/µL lower bound), and the qPCR detection target is 479.24 copies/mL (95% CI 273.81 copies/mL lower bound). The specificity test results showed that the specificity of the three methods mentioned above was higher than 90% in detecting pseudoviruses of the same genus of MPXV. The simple, highly sensitive, and specific MPXV assay developed in this study is anticipated to provide a solid foundation for future applications in the early screening, diagnosis, and evaluation of the efficacy of MPXV. This is the first time the HDA-LFT assay has been utilized to detect MPXV infection.
Effect of adding hip exercises to general rehabilitation treatment of knee osteoarthritis on patients’ physical functions: a randomized clinical trial
Authors: Qiu Jie , Zhou Tiantian , Jin Huihong , Pan Yujian , Qian Tingting , Xue Chuan , Xia Wen , Shi Haitao , An Bingchen
Published: November 2023

Background

Hip adductor and abductor strength were both reduced in KOA patients. But to date, most of the researches have only focused on quadriceps combined with hip abductor strengthening versus quadriceps strengthening.

Objective

The aim of the study is to evaluate the effect of adding hip abductor and adductor strengthening to quadriceps strengthening on lower limb strength, knee pain and physical function in patients with medial compartmental knee osteoarthritis.

Methods

In this study, 42 participants, were randomly divided into two groups: the general treatment group (GT group) and the added-hip-exercise group (AH group). All participants were given a general rehabilitation treatment. The AH group performed hip abductor and adductor strengthening in addition to the general rehabilitation treatment. Knee and hip muscle strength, Five Times Sit-to-Stand Test (FTSST), the Timed Up and Go Test (TUGT), Numerical Rating Scale (NRS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were assessed at baseline and 6 weeks. A two-sided 2-sample unpaired t test was performed to compare the difference in mean change scores between AH and GT groups.

Results

Finally, 36 participants completed the study: both groups consist of 18 participants. In the per-protocol analysis, the AH group had a greater improvement in knee extension strength (mean changes, 7.84 versus 36.48; P < 0.001) and hip abduction strength (mean changes, 5.05 versus 26.62; P = 0.001) than the control group. Similarly, the AH group had a greater improvement in the FTSST time (mean changes, 0.40 s versus 3.57 s; P < 0.001) and the TUFT time (mean changes, 0.18 s versus 1.67 s; P = 0.002) than the GH group. No statistical difference was found in the change of WOMAC pain scores and NRS between the 2 groups.

Conclusions

Older adults with knee OA in the AH group had superior muscle strength, symptoms and daily activity performance at the 6th week than those in the GT group. And adding hip exercises could expedite improvement of pain at the 2th week, but not at the 6th week.

Trial registration

Clinical trial registration numbers and date of registration: ChiCTR-IOR-16009124, Registered 30 August 2016.
ESR paper on structured reporting in radiology—update 2023
Authors:   European Society of Radiology (ESR), dos Santos Daniel Pinto , Kotter Elmar , Mildenberger Peter , Martí-Bonmatí Luis
Published: November 2023

Structured reporting in radiology continues to hold substantial potential to improve the quality of service provided to patients and referring physicians. Despite many physicians’ preference for structured reports and various efforts by radiological societies and some vendors, structured reporting has still not been widely adopted in clinical routine.

While in many countries national radiological societies have launched initiatives to further promote structured reporting, cross-institutional applications of report templates and incentives for usage of structured reporting are lacking. Various legislative measures have been taken in the USA and the European Union to promote interoperable data formats such as Fast Healthcare Interoperability Resources (FHIR) in the context of the EU Health Data Space (EHDS) which will certainly be relevant for the future of structured reporting. Lastly, recent advances in artificial intelligence and large language models may provide innovative and efficient approaches to integrate structured reporting more seamlessly into the radiologists’ workflow.

The ESR will remain committed to advancing structured reporting as a key component towards more value-based radiology. Practical solutions for structured reporting need to be provided by vendors. Policy makers should incentivize the usage of structured radiological reporting, especially in cross-institutional setting.

Critical relevance statement Over the past years, the benefits of structured reporting in radiology have been widely discussed and agreed upon; however, implementation in clinical routine is lacking due—policy makers should incentivize the usage of structured radiological reporting, especially in cross-institutional setting.

Key points

1. Various national societies have established initiatives for structured reporting in radiology.

2. Almost no monetary or structural incentives exist that favor structured reporting.

3. A consensus on technical standards for structured reporting is still missing.

4. The application of large language models may help structuring radiological reports.

5. Policy makers should incentivize the usage of structured radiological reporting.

Graphical Abstract
Biological efficacy of simulated radiolabeled Lipiodol® ultra-fluid and microspheres for various beta emitters: study based on VX2 tumors
Authors: Dieudonné Arnaud , Becker Stéphanie , Soares Miguel , Hollenbeck Claire , De Goltstein Marie-Christine , Vera Pierre , Santus Robin
Published: November 2023

Background

Radioembolization is one therapeutic option for the treatment of locally early-stage hepatocellular carcinoma. The aim of this study was to evaluate the distribution of Lipiodol® ultra-fluid and microspheres and to simulate their effectiveness with different beta emitters (90Y, 188Re, 32P, 166Ho, 131I, and 177Lu) on VX2 tumors implanted in the liver of 30 New Zealand rabbits.

Results

Twenty-three out of 30 rabbits had exploitable data: 14 in the group that received Lipiodol® ultra-fluid (group L), 6 in the group that received microspheres (group M), and 3 in the control group (group C). The histologic analysis showed that the Lipiodol® ultra-fluid distributes homogeneously in the tumor up to 12 days after injection. The X-ray μCT images showed that Lipiodol® ultra-fluid has a more distal penetration in the tumor than microspheres. The entropy (disorder of the system) in the L group was significantly higher than in the M group (4.06 vs 2.67, p = 0.01). Equivalent uniform biological effective doses (EUBED) for a tumor-absorbed dose of 100 Gy were greater in the L group but without statistical significance except for 177Lu (p = 0.03). The radionuclides ranking by EUBED (from high to low) was 90Y, 188Re, 32P, 166Ho, 131I, and 177Lu.

Conclusions

This study showed a higher ability of Lipiodol® ultra-fluid to penetrate the tumor that translated into a higher EUBED. This study confirms 90Y as a good candidate for radioembolization, although 32P, 166Ho, and 188Re can achieve similar results.
Efficacy and safety of perioperative use of non-steroidal anti-inflammatory drugs for preemptive analgesia in lumbar spine surgery: a systematic review and meta-analysis
Authors: Ma Nanshan , Yi Ping , Xiong Zhencheng , Ma Haoning , Tan Mingsheng , Tang Xiangsheng
Published: November 2023

Objective

Lumbar spine disorders have become an increasingly common health problem in recent years. Modern clinical studies have shown that perioperative analgesia at certain doses can reduce postoperative pain by inhibiting the process of peripheral sensitization and central sensitization, which is also known as “preemptive analgesia,” Non-steroidal anti-inflammatory drugs (NSAIDs) are a class of drugs that achieve antipyretic and analgesic effects by inhibiting cyclooxygenase (COX) and affecting the production of prostaglandins. Our meta-analysis aimed to assess the efficacy and safety of perioperative preemptive analgesia with non-steroidal anti-inflammatory drugs in patients with lumbar spine surgery.

Methods

We searched PubMed, ScienceDirect, the Cochrane Library, and the Web of Science for randomized controlled trials (RCTs) that met the inclusion criteria. A total of 12 clinical studies were included to assess the efficacy and safety of perioperative NSAIDs preemptive analgesia for lumbar spine surgery.

Result

Twelve studies, including 845 patients, met the inclusion criteria. The results showed that perioperative receipt of NSAIDs for preemptive analgesia was effective and safe. Patient’s postoperative morphine consumption (P < 0.05), visual analog scale (P < 0.05), and numerical rating scale (P < 0.05) were not statistically associated with postoperative complications (P > 0.05).

Conclusion

Our findings suggest that NSAIDs are effective and safe for preemptive analgesia in the perioperative period of lumbar spine surgery and that more and better quality RCTs and more in-depth studies of pain mechanics are still needed.
Molecular characterization of the CXCR4 / CXCR7 axis in germ cell tumors and its targetability using nanobody-drug-conjugates
Authors: Wakileh Gamal A. , Bierholz Philipp , Kotthoff Mara , Skowron Margaretha A. , Bremmer Felix , Stephan Alexa , Anbuhl Stephanie M. , Heukers Raimond , Smit Martine J. , Ströbel Philipp , Nettersheim Daniel
Published: November 2023

Being stimulated by the chemokine CXCL12, the CXCR4 / CXCR7 cascade is involved in tumor proliferation, migration, and metastasis. The interaction between CXCL12, secreted by cells from the microenvironment, and its receptors is complex and has been ascribed to promote chemotherapy resistance. However, the role of this signaling axis and its targetability in germ cell tumors (GCT) is not fully understood. Thus, this study investigated the therapeutic efficacy of a nanobody-drug-conjugate targeting CXCR4 (CXCR4-NDC) and functionally characterized this signaling pathway in GCT using small molecule inhibitors and nanobodies. As shown by diminished cell viability, enhanced apoptosis induction, and detection of mitotic catastrophes, we confirmed the cytotoxic efficacy of the CXCR4-NDC in CXCR4+-GCT cells (i.e. seminoma and yolk-sac tumor), while non-malignant CXCR4−-fibroblasts, remained largely unaffected. Stimulation of CXCR4+ / CXCR7+-GCT cells with CXCL12 resulted in an enhanced proliferative and migratory capacity, while this effect could be reverted using CXCR4 inhibitors or a CXCR7-nanobody. Molecularly, the CXCR4 / CXCR7-signaling cascade could be activated independently of MAPK (ERK1 / 2)-phosphorylation. Although, in CXCR4− / CXCR7−-embryonal carcinoma cells, CXCR7-expression was re-induced upon inhibition of ERK1 / 2-signaling. This study identified a nanobody-drug-conjugate targeting CXCR4 as a putative therapeutic option for GCT, i.e. seminoma and yolk-sac tumors. Furthermore, this study shed light on the functional role of the CXCR4 / CXCR7 / CXCL12-signaling cascade in GCT, demonstrating an important influence on proliferation and migration.
Perfectionism, test anxiety, and neuroticism determines high academic performance: a cross-sectional study
Authors: Shin Jiyoon , Lee Hyung Jun , Park Hyungyou , Hong Yoontae , Song Yong Keun , Yoon Dong Uk , Oh Sanghoon
Published: November 2023

Background

Academic performance is an important issue for Korean students. Various psychological factors contribute to academic performance. We aimed to evaluate the psychological factors that affect academic performance integratively.

Methods

A total of 102 academic high achievers and 120 comparison participants were recruited. We evaluated psychological factors (test anxiety, perfectionism, personality traits, resilience, and self-efficacy) and measured academic performance using the College Scholastic Ability Test and the current college grade. We compared psychological factors and academic performance between the academic high achiever and comparison groups. Multiple linear regression was then conducted to identify the significant psychological factors for high academic performance. Further, we used cluster analysis to classify the comparison group by the significant psychological factors and compared them among clusters and academic high achievers to determine the psychological characteristics of academic high achievers.

Results

The academic high achiever group showed lower test anxiety (p = .002), less neuroticism (p = .001), higher self-efficacy (p = .028), and less socially prescribed perfectionism (p < .001) than the comparison group. Multiple linear regression results (p = .020) clarified that neuroticism (p = .020), test anxiety level (p = .047), and perfectionism (p = .035) were important factors predicting better academic performance. Academic high achievers had moderate test anxiety and perfectionism levels, with the best performance on the College Scholastic Ability Test.

Conclusions

Neuroticism, test anxiety levels, and perfectionism are important psychological factors for high academic performance. Interventions targeting these factors may help to improve academic accomplishments.
Preliminary validity testing of the eHealth Literacy Questionnaire (eHLQ): a Confirmatory Factor Analysis (CFA) in Norwegian hospitalized patients
Authors: Hermansen Å. , Andersen M. H. , Borge C. R. , Dahl K. G. , Larsen M. H. , Lønning K. , Meyer K. B. , Vidnes T. K. , Wahl A. K.
Published: November 2023

Aims

To perform the first psychometric analysis of the Norwegian version of the eHLQ using confirmative factor analysis (CFA) procedures in a population of patients admitted to hospital using a cross-sectional design. The eHLQ consists of 35 items capturing the 7-dimensional eHealth Literacy Framework (eHLF) which describes users' attributes, user's interaction with technologies and user's experience with digital health systems.

Methods

The 7 independent scales of the eHLQ was translated from Danish and culturally adapted into the Norwegian language following a standardised protocol. Assessment of construct validity of the eHLQ was undertaken using data from a cross-sectional survey of 260 patients hospitalized at a Norwegian University Hospital in the Oslo area during a two-week period in June 2021. The analysis included using correlation analysis (Pearsons R), internal consistency (Cronbach’s alpha) and confirmatory factor analysis (CFA).

Results

All factor loadings were high to acceptable (i.e. > 0.6), except for five items which had somewhat lower loadings. Regarding internal consistency, alpha ranged from 0.73 to 0.90. For optimal CFA fit for the different scale models, correlated residuals were required for five of the seven scales. Overall our analysis shows an intermediate fit of the orginal construct. Scale intercorrelations were all below 0.8, indicating an overall acceptable discriminant validity between the 7 dimensions.

Conclusions

The results from the CFA analysis indicate that for almost all 7 eHLQ scales, an acceptable model fit was achieved. The 260 hospitalized patients included in this study represented a variety of diagnoses, recruited from a geographically limited area. Further studies on psychometric properties of the Norwegian version of eHLQ in larger samples, diverse settings and by using more comprehensive approaches are warranted.
Improving the prediction of Spreading Through Air Spaces (STAS) in primary lung cancer with a dynamic dual-delta hybrid machine learning model: a multicenter cohort study
Authors: Jin Weiqiu , Shen Leilei , Tian Yu , Zhu Hongda , Zou Ningyuan , Zhang Mengwei , Chen Qian , Dong Changzi , Yang Qisheng , Jiang Long , Huang Jia , Yuan Zheng , Ye Xiaodan , Luo Qingquan
Published: November 2023

Background

Reliable pre-surgical prediction of spreading through air spaces (STAS) in primary lung cancer is essential for precision treatment and surgical decision-making. We aimed to develop and validate a dual-delta deep-learning and radiomics model based on pretreatment computed tomography (CT) image series to predict the STAS in patients with lung cancer.

Method

Six hundred seventy-four patients with pre-surgery CT follow-up scans (with a minimum interval of two weeks) and primary lung cancer diagnosed by surgery were retrospectively recruited from three Chinese hospitals. The training cohort and internal validation cohort, comprising 509 and 76 patients respectively, were selected from Shanghai Chest Hospital; the external validation cohorts comprised 36 and 53 patients from two other centers, respectively. Four imaging signatures (classic radiomics features and deep learning [DL] features, delta-radiomics and delta-DL features) reflecting the STAS status were constructed from the pretreatment CT images by comprehensive methods including handcrafting, 3D views extraction, image registration and subtraction. A stepwise optimized three-step procedure, including feature extraction (by DL and time-base radiomics slope), feature selection (by reproducibility check and 45 selection algorithms), and classification (32 classifiers considered), was applied for signature building and methodology optimization. The interpretability of the proposed model was further assessed with Grad-CAM for DL-features and feature ranking for radiomics features.

Results

The dual-delta model showed satisfactory discrimination between STAS and non-STAS and yielded the areas under the receiver operating curve (AUCs) of 0.94 (95% CI, 0.92–0.96), 0.84 (95% CI, 0.82–0.86), and 0.84 (95% CI, 0.83–0.85) in the internal and two external validation cohorts, respectively, with interpretable core feature sets and feature maps.

Conclusion

The coupling of delta-DL model with delta-radiomics features enriches information such as anisotropy of tumor growth and heterogeneous changes within the tumor during the radiological follow-up, which could provide valuable information for STAS prediction in primary lung cancer.
Silicon nanoparticles: fabrication, characterization, application and perspectives
Authors: Kim Taeyeong , Lee Jungchul
Published: November 2023

Silicon nanoparticles have emerged as pivotal components in nanoscience and nanoengineering due to their inherent characteristics such as high energy capacity and outstanding optical properties. Numerous fabrication and characterization techniques have been researched so far, while a range of applications utilizing them have been developed. In this review, we aim to provide a brief overview of the distinct and representative fabrication methods of silicon nanoparticles, including top-down, bottom-up, and reduction approaches. Then, we look into various characterization techniques essential for assessing and ensuring quality and performance of fabricated silicon nanoparticles. In addition, we provide insights for silicon nanoparticle technology towards further advancements.
Microfluidic thrombosis analysis system: possibilities and limitations
Authors: Ham Dong-Hwi , Choi Ji-Seob , Choi Jin-Ho , Park Woo-Tae
Published: November 2023

Thrombosis is a double-edged sword. Normal thrombus formation within injured blood vessel is an important natural defensive mechanism to prevent excessive bleeding, whereas abnormal thrombus formation leads to critical disease such as stroke or myocardial infarction. One of keys in the pathophysiology mechanism involved in the thrombus formation is acute hemodynamic changes within the vessel lumen, which has been investigated mostly in pre-clinical and clinical studies. However, studies involving animal or human subjects are frequently limited by technical difficulties and requirement of substantial blood volume. Microfluidic systems have emerged as a valuable tool owing to their inherent advantages including minimal sample requirements and rapid analysis capabilities. In this mini review, we present a summary of microfluidic systems designed for thrombosis analysis, encompassing fabrication processes, design, and analysis methods. We also discuss both the potentials and limitations of microfluidic platform for the analysis of thrombus mechanisms.
Associations of dietary methyl donor nutrients with common psychological conditions (depression, anxiety and stress) among reproductive-aged women in Kabul, Afghanistan
Authors: Zahidi Fawzia , Abbasi Hanieh , Surkan Pamela J , Azadbakht Leila
Published: November 2023

Background

Higher levels of methyl donor nutrients may be associated with better psychological conditions. Little is known about the association of methyl donor nutrients with psychological conditions among women especially in Asian countries such as Afghanistan.

Method

This cross-sectional study was conducted in Kabul, Afghanistan to assess the association of methyl donor nutrients with common psychological conditions (depression, anxiety and stress) among reproductive-aged women using multistage random sampling to choose one health center from each municipality out of four cardinal directions. Finally a sample of 421 reproductive-aged women with a mean BMI of 23.3 ± 5.0 kg/m2 and an age range of 15–45 years were collected. All women’s dietary intakes were obtained using a 24-recall questionnaire. Depression, Anxiety and Stress Scale − 21 Items (DASS-21) was used to assess psychological conditions. Chi-square tests and one-way ANOVAs were performed to assess general characteristics. Residual model test while adjusting for energy intake was used to assess nutrient intake of methyl donor nutrients and food groups. We fitted logistic regression models to assess risk for Common mental health problems (CMHPs) based on methyl donor tertiles.

Result

We observed that there is no significant association between methyl donor nutrients and psychological disorders in both crude and adjusted models (depression, OR = 0.95, CI: 0.48; 1.88; anxiety, OR = 0.88, CI: 0.43, 1.79; stress, OR = 0.73, CI: 0.38, 1.40), (p > 0.05).

Conclusion

Overall, we did not find any significant association between methyl donor nutrients and depression, anxiety and stress.
An update on visual prosthesis
Authors: Ramirez Kailyn A. , Drew-Bear Laura E. , Vega-Garces Maria , Betancourt-Belandria Henry , Arevalo J. Fernando
Published: November 2023

Purpose

To review the available evidence on the different retinal and visual prostheses for patients with retinitis pigmentosa and new implants for other indications including dry age-related macular degeneration.

Methods

The PubMed, GoogleScholar, ScienceDirect, and ClinicalTrials databases were the main resources used to conduct the medical literature search. An extensive search was performed to identify relevant articles concerning the worldwide advances in retinal prosthesis, clinical trials, status of devices and potential future directions up to December 2022.

Results

Thirteen devices were found to be current and were ordered by stimulation location. Six have active clinical trials. Four have been discontinued, including the Alpha IMS, Alpha AMS, IRIS II, and ARGUS II which had FDA and CE mark approval. Future directions will be presented in the review.

Conclusion

This review provides an update of retinal prosthetic devices, both current and discontinued. While some devices have achieved visual perception in animals and/or humans, the main issues impeding the commercialization of these devices include: increased length of time to observe outcomes, difficulties in finding validated meaures for use in studies, unknown long-term effects, lack of funding, and a low amount of patients simultaneously diagnosed with RP lacking other comorbid conditions. The ARGUS II did get FDA and CE mark approval so it was deemed safe and also effective. However, the company became more focused on a visual cortical implant. Future efforts are headed towards more biocompatible, safe, and efficacious devices.
Cerebral sparganosis: rare parasitic infection of the brain
Authors: Chougule Meghana V. , Mohite Aniruddha , Joshi Vijay P. , Agrawal Amit
Published: November 2023

Spirometra is larval cestode that involve humans as accidental intermediate hosts. Although the incidence of central nervous system infestation with sparganum is low, the diagnosis of the disease can cause delayed with an increased possibility of severe brain damage and neurological deficits. The present case reports a case of a 19-year male student and describes the imaging findings, histopathological characteristics, and management of this rare disease. The patient was treated surgically with good outcome.