bluuebunny/crossref_metadata_2025 huggingface dataset:
The Handmaids’ Tale
Authors: Bourne Claire M. L.
Published: September 2023

This chapter argues that the long history of the early modern book has been enabled by a shadow history of ‘service scholarship’—collecting, cataloguing, editing, and the creation of reference works—dating back to at least the eighteenth century. The labour of gathering, organizing, and making information available in digested form has been performed disproportionately—and often uncredited—by women. When credited, the women responsible have been frequently written out of the historical record or eclipsed by male colleagues and collaborators. Charlotte Lennox was the first to produce a consolidated study of Shakespeare’s sources, but her name has been displaced by Richard Farmer, James Orchard Halliwell, and Geoffrey Bullough. Henrietta C. Bartlett’s census of Shakespeare quartos, a revision of her earlier collaboration with Pollard, was overshadowed by W. W. Greg’s subsequent Bibliography of the Early Printed Drama. And the name most associated with compositor studies, a branch of scholarship that Alice Walker helped establish, is not Walker but rather Charlton Hinman.
The Cultural Evolution of Science
Authors: Wu Jingyi , O’Connor Cailin , Smaldino Paul E.
Published: September 2023

This chapter offers a brief review of formal models in which science is treated as a cultural evolutionary system. The models reviewed are divided into three categories. First, ‘selective’ models are considered in which scientific practices are transmitted preferentially by successful individuals. The chapter then looks at models that focus on the dynamics of scientific beliefs rather than on the methods used to produce them. Third, models tracking how social identity can impact the norms and structures of science are studied. The discussion concludes with consideration of the role of cultural evolutionary models in our understanding of science. Throughout, the discussion is connected to empirical research on the workings of science.
Evolutionary Archaeology
Authors: O'Brien Michael J.
Published: September 2023

Evolution, or descent with modification, involves three principles: variation is present in a population, the variants are heritable, and there is a sorting mechanism (or mechanisms) that causes differential survival and reproduction among variants. Evolution works mainly on individuals, occasionally on groups, but what is visible in most cases is not change in individual variants but rather cumulative change in populations of variants over time. In archaeology, evolution is measured in terms of changes in populations of artefacts, which are viewed as phenotypic expressions of human behaviour, which itself is phenotypic. Archaeologists use artefacts to construct historical lineages, or temporal lines of change owing their existence to heritability. They then use those lineages to construct arguments as to which evolutionary process or processes created and later modified them. Asking and answering questions that are historical in nature is the ultimate goal of evolutionary archaeology.
The role of policy design in policy continuation and ratcheting-up of policy ambition
Authors: Sewerin Sebastian , Fesenfeld Lukas P , Schmidt Tobias S
Published: September 2023

Effectively addressing grand societal challenges like climate change and environmental degradation requires policy intervention that is not only continuous but also increasing in ambition over time. However, negative feedback could lead to policies being weakened or even discontinued after a while. An important but unresolved policy question, therefore, is whether policies can be deliberately designed to survive (i.e., to “stick”) and, ideally, be replaced with more ambitious ones over time (i.e., to “ratchet up”). We bridge policy feedback and policy design scholarship to derive hypotheses on the effects of two policy design features—“intensity” (i.e., a measure of policies’ overall design) and “specificity” (i.e., a measure of policies’ targeted focus)—on policy (dis-)continuation and ratcheting-up (-down) of ambition. Focusing on policy design, we contribute to the theorization and empirical understanding of endogenous factors behind policy change. We test our hypotheses with an event history dataset of 627 low-carbon energy policies in eight developed countries. Conducting a multilevel survival analysis, we find statistically significant evidence of more intense policies being replaced with less intense ones, i.e., more intense policies lead to ratcheting-down of ambition. We also find that more specific policies are more likely to be replaced with more intense policies, i.e., more specific policies lead to ratcheting-up of ambition. Based on these novel insights, we discuss how policy design can navigate these complex dynamics. In this sense, our approach also contributes to the discussion about the “forward-looking” potential of the policy sciences.
Morality, Modality, and Humans with Deep Cognitive Impairments
Authors: Gildea William
Published: September 2023

Philosophers struggle to explain why human beings with deep cognitive impairments have a higher moral status than certain non-human animals. Modal personism promises to solve this problem. It claims that humans who lack the capacities of “personhood” and the potential to develop them nonetheless could have been persons. I argue that modal personism has poor prospects because it's hard to see how we could offer a plausible account of modal personhood. I search for an adequate understanding of modal personhood by considering existing accounts and sketching new ones. But each account fails, either because it objectionably excludes some deeply cognitively impaired humans from the class of modal persons or because it makes modal personhood doubtfully relevant to moral status. And the modal personist cannot solve this problem by appealing to the misfortune suffered by modal persons.
Experiences of implementing the ‘Making Every Contact Count’ initiative into a UK integrated care system: an interview study
Authors: Turner Rebecca , Byrne-Davis Lucie , Michael Panayiotis , Coupe Nia , Holtom Caroline , Smith Cheryl , Hart Jo
Published: September 2023

Background

The ‘Making Every Contact Count’ (MECC) approach is in line with the current National Health Service (NHS) strategy to improve and prevent health conditions in England. Despite its importance and value for preventative healthcare, implementation of MECC varies. The aim of this study was to explore the barriers and facilitators of implementing MECC and MECC training into an integrated care system (ICS).

Methods

Remote semi-structured interviews were conducted with staff across an ICS in the North West of England who were involved in implementing and delivering MECC across the region. Data were analysed initially using an inductive thematic analysis approach and then interpreted using the ‘Capability, Opportunity, Motivation = Behaviour’ (COM-B) model of behaviour change.

Results

We interviewed nine stakeholders and identified three superordinate themes: (1) macro-level barriers and facilitators, e.g. funding; (2) organizational level barriers and facilitators, e.g. time and resource; and (3) individual-level barriers/facilitators for both MECC trainers and MECC agents.

Conclusions

MECC has potential to meet the needs of the public’s health, but barriers to its implementation exist. MECC must be successfully embedded into organizations and regions in which it is implemented, which relies on further development of an appropriate infrastructure including sustainable funding and a shift in culture to value preventative healthcare.
Inference on Winners
Authors: Andrews Isaiah , Kitagawa Toru , McCloskey Adam
Published: September 2023

Policy makers, firms, and researchers often choose among multiple options based on estimates. Sampling error in the estimates used to guide choice leads to a winner’s curse, since we are more likely to select a given option precisely when we overestimate its effectiveness. This winner’s curse biases our estimates for selected options upward and can invalidate conventional confidence intervals. This article develops estimators and confidence intervals that eliminate this winner’s curse. We illustrate our results by studying selection of job-training programs based on estimated earnings effects and selection of neighborhoods based on estimated economic opportunity. We find that our winner’s curse corrections can make an economically significant difference to conclusions but still allow informative inference.
Violence against Women at Work
Authors: Adams-Prassl Abi , Huttunen Kristiina , Nix Emily , Zhang Ning
Published: September 2023

We link every police report in Finland to administrative data to identify violence between colleagues and the economic consequences for victims, perpetrators, and firms. This new approach to observe when one colleague attacks another overcomes previous data constraints limiting evidence on this phenomenon to self-reported surveys that do not identify perpetrators. We document large, persistent labor market effects of between-colleague violence on victims and perpetrators. Male perpetrators experience substantially weaker consequences after attacking female colleagues. Perpetrators’ relative economic power in male-female violence partly explains this asymmetry. Turning to broader implications for firm recruitment and retention, we find that male-female violence causes a decline in the proportion of women at the firm, both because fewer new women are hired and current female employees leave. Management plays a key role in mediating the effects on the wider workforce. Only male-managed firms lose women. Female-managed firms exhibit a key difference relative to male-managed firms: male perpetrators are less likely to remain employed after attacking their female colleagues.
The Evolution of Market Power in the U.S. Automobile Industry
Authors: Grieco Paul L E , Murry Charles , Yurukoglu Ali
Published: September 2023

We construct measures of industry performance and welfare in the U.S. automobile market from 1980 to 2018. We estimate a demand model using product-level data on market shares, prices, and attributes, and consumer-level data on demographics, purchases, and stated second choices. We estimate marginal costs assuming Nash-Bertrand pricing. We relate trends in consumer welfare and markups to trends in market structure and the composition of products. Although real prices rose, we find that markups decreased substantially, and the fraction of total surplus accruing to consumers increased. Consumer welfare increased over time due to improved product quality and improved production technology.
Dosimetry of a self-shielded gamma irradiator small animal whole-body irradiations: comparisons between ionisation chamber and alanine
Authors: Ménard Véronique , Ristic Yoann , Trompier François
Published: September 2023

Because of reproducibility and repeatability problems with reference measurements made with an ionisation chamber in a self-protected GSRD1 irradiator, a comparison was made with alanine dosimetry for a whole-body mouse irradiation setup in a sterile box. The twisting of the cables in the cable duct and in the irradiator cell and the irradiation of the ionisation chamber connector are likely to have caused the problems encountered. These problems are not observed on other types of irradiators with more suitable cable passages. A difference up to 8.4% was observed between the alanine dosimetry and ionisation chamber. The influence of the number of animals in the sterile box on the whole-body dose of the animals was also evaluated with alanine and found to be <2%.
Benefits and challenges of in vivo EPR nail biodosimetry in a second tier of medical triage in response to a large radiation event
Authors: Flood Ann Barry , Sidabras Jason W , Swarts Steven G , Buehler Paul W , Schreiber Wilson , Grinberg Oleg , Swartz Harold M
Published: September 2023

Following large-scale radiation events, an overwhelming number of people will potentially need mitigators or treatment for radiation-induced injuries. This necessitates having methods to triage people based on their dose and its likely distribution, so life-saving treatment is directed only to people who can benefit from such care. Using estimates of victims following an improvised nuclear device striking a major city, we illustrate a two-tier approach to triage. At the second tier, after first removing most who would not benefit from care, biodosimetry should provide accurate dose estimates and determine whether the dose was heterogeneous. We illustrate the value of using in vivo electron paramagnetic resonance nail biodosimetry to rapidly assess dose and determine its heterogeneity using independent measurements of nails from the hands and feet. Having previously established its feasibility, we review the benefits and challenges of potential improvements of this method that would make it particularly suitable for tier 2 triage. Improvements, guided by a user-centered approach to design and development, include expanding its capability to make simultaneous, independent measurements and improving its precision and universality.
EPR investigation of gamma-irradiated FAMOSER drug for DOSIMETRIC purposes
Authors: Babayeva Nazrin , Ece Emel , Biyik Recep , Ozmen Ayhan , Sayin Ulku
Published: September 2023

Exposure to ionizing radiation can also lead to the formation of stable or unstable radicals in the structures of drugs, as in many materials. The concentrations of these radicals may show a linear dependence on the radiation dose exposed. Since drugs are materials that can be found next to or on radiation victims during a possible nuclear or radiological accident, it is very meaningful to determine the Electron Paramagnetic Resonance (EPR) dosimetric properties of stable radicals in their structures. In this study, the dosimetric properties of Famoser, which is one of the stomach-relieving drugs that people often have with them in their daily life, in the dose range of 10–800 Gy were investigated by EPR technique.
Development of high-throughput systems for biodosimetry
Authors: Wilkins Ruth C , Beaton-Green Lindsay A
Published: September 2023

Biomarkers for ionising radiation exposure have great utility in scenarios where there has been a potential exposure and physical dosimetry is missing or in dispute, such as for occupational and accidental exposures. Biomarkers that respond as a function of dose are particularly useful as biodosemeters to determine the dose of radiation to which an individual has been exposed. These dose measurements can also be used in medical scenarios to track doses from medical exposures and even have the potential to identify an individual’s response to radiation exposure that could help tailor treatments. The measurement of biomarkers of exposure in medicine and for accidents, where a larger number of samples would be required, is limited by the throughput of analysis (i.e. the number of samples that could be processed and analysed), particularly for microscope-based methods, which tend to be labour-intensive. Rapid analysis in an emergency scenario, such as a large-scale accident, would provide dose estimates to medical practitioners, allowing timely administration of the appropriate medical countermeasures to help mitigate the effects of radiation exposure. In order to improve sample throughput for biomarker analysis, much effort has been devoted to automating the process from sample preparation through automated image analysis. This paper will focus mainly on biological endpoints traditionally analysed by microscopy, specifically dicentric chromosomes, micronuclei and gamma-H2AX. These endpoints provide examples where sample throughput has been improved through automated image acquisition, analysis of images acquired by microscopy, as well as methods that have been developed for analysis using imaging flow cytometry.
Electron paramagnetic resonance spectroscopy for the detection of radiation exposure in dreissenid mussels
Authors: Tzivaki Margarita , Hassan Amna , Waller Edward
Published: September 2023

Electron paramagnetic resonance (EPR) spectroscopy, established for radiation measurements in calcified tissues, was identified as a methodology that merits investigation for the purpose of environmental radiation measurements using dreissenid mussels from the Great Lakes. With the refinement of sample preparation and measurement protocols, a linear relationship of dose with the peak-to-peak height of the radiation-induced signal at g = 2.0034 was established. A dedicated analysis algorithm was developed to process batches of samples, eliminating the need for manual peak-to-peak height measurement. Varying background EPR signals were identified in different sampling groups, with samples gathered in winter having a markedly lower background signal. Through optimisation of spectrum acquisition normalisation methods, it was possible to resolve doses as low as 0.2 Gy. This work provides further validation that EPR dosimetry of shelled species has the potential to contribute to better characterisation of absorbed doses in aquatic environments.
Paramagnetic characterization of fossil mollusc shells at eastern part of the old Konya lake: its importance for EPR dating
Authors: Ekici Gamze , Sayin Ulku , Isik Mesut , Kapan Sevinc , Demir Ahmet , Aydin Karaaslan Hulya , Delikan Arif , Biyik Recep , Orhan Hukmu , Engin Birol , Tapramaz Recep , Ozmen Ayhan
Published: September 2023

Fossil mollusc shells are used for dating geological materials because they are well preserved throughout geological time. In this study, the radicals in the structure of fossil mollusc shells (Dreissena iconica, Valvata piscinalis, Bithynia tentaculate, Unio pictorum) collected from the Eastern Part of Old Konya Lake in Türkiye were investigated by EPR technique. For all fossil shells, microwave and temperature dependence of the signals were examined, and the signals suitable for dating are discussed. Characteristic features of intrinsic and impurity-related radicals were identified and the importance of paleontological evaluation of molluscs to get a reliable equivalent dose in EPR dating studies was emphasised.
Monte Carlo modelling of experimental setup used for biodosimetry intercomparison
Authors: Gunasekara Dinindu , Wilkins Ruth , Tessier Frédéric , Beaton-Green Lindsay
Published: September 2023

When using biodosimetry techniques to assess absorbed dose from an ionising radiation exposure, a calibration curve is required. At Health Canada (HC), these curves are generated for a variety of radiation qualities and assays to translate biological damage into absorbed dose. They are produced by irradiating biological samples in custom-designed water-equivalent phantoms inside a cabinet X-ray machine. In the HC lab, two different phantoms can be used for irradiation that differs in material composition and internal geometry. To ensure consistency, the impact of using the phantoms interchangeably was investigated. This was done through lab measurements and the development of a Monte Carlo (MC) model. Differences up to 6.7% were found between the two experimental setups, indicating the need for careful consideration if using these setups interchangeably in the laboratory. Once validated, the MC model can be used to investigate different aspects of the experimental setup without the need for laboratory measurements.
Biopsychosocial approach to male chronic pelvic pain syndrome: recent treatments and trials
Authors: Sandler Max D , Ledesma Braian , Thomas Jamie , Ben-Ezra Logan , Lokeshwar Soum D , Paz Lisa A , White Joshua , Ramasamy Ranjith , Masterson Thomas A
Published: September 2023

Introduction

Chronic pelvic pain syndrome (CPPS) is a common urologic condition that can cause significant disability in affected individuals. Physiologic explanations of chronic pain are often incomplete; appropriate management of CPPS includes recognition of biological, psychological, and social elements, known as the biopsychosocial model.

Objective

The aim of this narrative review is to investigate treatments for men with CPPS, with a special focus on those utilizing the biopsychosocial model of care.

Methods

A comprehensive literature search was conducted on the electronic databases PubMed, Embase, and Cochrane Library, using relevant Medical Subject Heading terms and keywords related to CPPS treatments. The search was limited to studies published in English from inception to January 2023. Additionally, reference lists of selected studies were manually reviewed to find studies not identified by the initial search. Studies were included if they investigated pharmacologic or nonpharmacologic treatments for men with CPPS.

Results

A total of 30 studies met the inclusion criteria. Antibiotics, α-blockers, nonsteroidal anti-inflammatory drugs, gabapentinoids, antidepressants, and phosphodiesterase type 5 inhibitors were among the pharmacologic agents included in trials attempting to reduce symptoms of male CPPS. Studies that focused on treating CPPS without medication included interventions such as shockwave therapy, acupuncture, physical therapy, botulinum toxin, cryotherapy, electrotherapy, exercise, and cognitive behavioral therapy.

Conclusion

α-Blockers and nonsteroidal anti-inflammatory drugs have shown promising results in treating CPPS in men, while the effectiveness of antibiotics remains controversial. Antidepressants and phosphodiesterase type 5 inhibitors may also be useful in decreasing symptoms in patients with CPPS. Treatments such as pelvic floor muscle therapy, acupuncture, shockwave therapy, and cognitive behavioral therapy must be considered effective complements to medical management in men with CPPS. While these interventions demonstrate benefits as monotherapies, the individualization and combination of treatment modalities are likely to result in reduced pain and improved quality of life.
The high burden of pediatric cystic echinococcosis in Kazakhstan: epidemiological and clinical consequences
Authors: Doszhanova Gaukhar , Colpani Agnese , Duisenova Amangul , De Vito Andrea , Zholdybay Zhamilya , Juszkiewicz Konrad , Brunetti Enrico , Katarbayev Adyl , Kaniyev Shokan , Zhakenova Zhanar , Manciulli Tommaso , Mustapayeva Aigerim
Published: September 2023

Background

Cystic echinococcosis (CE) is attributable to Echinococcus granulosus metacestodes. Ultrasound examinations enable a stage-specific approach to CE management. However, this approach is not often applied in endemic areas, which include Kazakhstan.

Methods

We collected clinical and ultrasound data on CE pediatric patients seen at a national referral surgical center in Almaty, Kazakhstan, during 2015–2020.

Results

We included 49 patients, and 79 cysts that were all surgically treated. All but one patient carried active cysts (CE1-CE3 stages). Twenty-six (53.2%) did not receive albendazole postsurgery. Children with CE1 and CE3a cysts underwent surgery, while the use of albendazole and percutaneous drainage were advised upon by experts.

Conclusions

A stage-specific approach to CE management in Kazakhstan is urgent, especially in the pediatric population. The rate of active cysts suggests continuing transmission of CE.
Virulence Characterization of Puccinia striiformis f. sp. tritici in China Using the Chinese and Yr Single-Gene Differentials
Authors: Zhou Aihong , Wang Jie , Chen Xianming , Xia Minghao , Feng Yaoxuan , Ji Fan , Huang Lili , Kang Zhensheng , Zhan Gangming
Published: September 2023

Stripe rust, caused by Puccinia striiformis f. sp. tritici (Pst), is one of the most important diseases of wheat. Identifying Pst races is essential for developing resistant cultivars and managing the disease. In this study, 608 isolates collected from China in 2021 were tested with the Chinese set of 19 wheat variety differentials and the set of 18 Yr single-gene differentials. Of the 119 races detected with the Chinese set of differentials, 94 were new. A higher number (149) of races were identified using the Yr single-gene differentials. The frequencies of virulence factors to 17 of the 19 Chinese differential varieties and to 10 of the 18 Yr single-gene differentials were high (>60%). None of the isolates were virulent to the differentials Zhong 4 (Yr genes unknown) and Triticum spelta Album (Yr5) in the Chinese set and the Yr5 and Yr15 lines in the single-gene set of differentials, indicating that these genes or varieties are effective against the Pst population detected in 2021. Using Nei’s genetic distance, the 16 provincial Pst populations were clustered into six groups based on the Chinese set and eight groups based on the Yr single-gene set of differentials. In addition, we found that the same races identified using the Chinese differentials could be further differentiated into different races using the Yr single-gene differentials, suggesting a higher differential capability than the Chinese set of differentials. The results provide a scientific basis for monitoring Pst populations and guiding resistance breeding in China.
RNA‐binding protein‐regulated fibronectin is essential for EGFR‐activated metastasis of head and neck squamous cell carcinoma
Authors: Shieh Jiunn‐Min , Chang Ting‐Wei , Wang Jing‐He , Liang Song‐Ping , Kao Pei‐Lu , Chen Liang‐Yi , Yen Chia‐Jui , Chen Yun‐Ju , Chang Wen‐Chang , Chen Ben‐Kuen
Published: September 2023

There is a higher expression level of epidermal growth factor receptor (EGFR) in up to 90% of advanced head and neck squamous cell carcinoma (HNSCC) tissue than in normal surrounding tissues. However, the role of RNA‐binding proteins (RBPs) in EGFR‐associated metastasis of HNSCC remains unclear. In this study, we reveal that RBPs, specifically nucleolin (NCL) and heterogeneous nuclear ribonucleoprotein A2/B1 (hnRNPA2B1), correlated with the mesenchymal phenotype of HNSCC. The depletion of RBPs significantly attenuated EGF‐induced HNSCC metastasis. Intriguingly, the EGF‐induced EMT markers, such as fibronectin, were regulated by RBPs through the ERK and NF‐κB pathway, followed by the enhancement of mRNA stability of fibronectin through the 5′ untranslated region (5′‐UTR) of the gene. The upregulation of fibronectin triggered the integrin signaling activation to enhance tumor cells’ attachment to endothelial cells and increase endothelial permeability. In addition, the concurrence of EGFR and RBPs or EGFR and fibronectin was associated with overall survival and disease‐free survival of HNSCC. The in vivo study showed that depletion of NCL, hnRNPA2B1, and fibronectin significantly inhibited EGF‐promoted extravasation of tumor cells into lung tissues. The depletion of fibronectin or treatment with integrin inhibitors dramatically attenuated EGF‐induced HNSCC metastatic nodules in the lung. Our data suggest that the RBPs/fibronectin axis is essential for EGF‐induced tumor‐endothelial cell interactions to enhance HNSCC cell metastasis.
Recurrent Cystitis Associated With 2 Programmed Death 1 Inhibitors
Authors: Fan Yong , Zhao Juan , Mi Yue , Zhang Zhening , Geng Yan , Zhou Liqun , Shen Lin , Zhang Zhuoli
Published: September 2023

Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of advanced cancer, however, often with immune-related adverse events (irAEs). Adverse events involving the bladder were extremely rare with only few cases. Herein, we described a rare, recurrent cystitis associated with 2 programmed death 1 inhibitors (pembrolizumab and toripalimab) in 1 patient with advanced liver cancer. Cystitis associated with toripalimab, a novel humanized programmed death 1 monoclonal antibody, was first presented in our case. Cystitis is an extremely rare irAE associated with ICIs, especially anti–programmed death 1 antibodies. With widening indications of ICIs in clinical practice, physicians should be also aware of this rare irAE.
Prognostic and clinical value of circPRKCI expression in diverse human cancers
Authors: Liu Zhongyue , Ren Xiaolei , Yang Zhimin , Mei Lin , Li Wenyi , Tu Chao , Li Zhihong
Published: September 2023

Background:

Highly expressed in various human cancers, circular RNA Protein Kinase C Iota (circPRKCI) has been reported to play an important role in cancer development and progression. Herein, we sought to reveal the prognostic and clinical value of circPRKCI expression in diverse human cancers.

Methods:

We searched the Pubmed, Web of Science, and the Cochrane Library databases from inception until May 16, 2021. The relationship between circPRKCI expression and cancer patients' survival, including overall survival (OS) and disease-free survival (DFS), was assessed by pooled hazard ratios (HR) with corresponding 95% confidence interval (CI). The correlation between circPRKCI expression and clinical outcomes was evaluated using odds ratios (OR) with corresponding 95% CI. The data were analyzed by STATA software (version 12.0) or Review Manager (RevMan 5.3).

Results:

A total of 15 studies with 1109 patients were incorporated into our meta-analysis. The results demonstrated that high circPRKCI expression was significantly related to poor OS (HR = 1.96, 95% CI: 1.61, 2.39, P <0.001) when compared with low circPRKCI expression in diverse human cancers. However, elevated circPRKCI expression was not associated with DFS (HR = 1.34, 95% CI: 0.93, 1.95, P = 0.121). Furthermore, the patient with a higher circPRKCI expression was prone to have a larger tumor size, advanced clinical stage, and lymph node metastasis, but it was not significantly correlated with age, gender, and distant metastasis.

Conclusion:

Elevated circPRKCI expression was correlated with worse OS and unfavorable clinical features, suggesting a novel prognostic and predictive role of circPRKCI in diverse human cancers.
Transoral Septoplasty before Le Fort I Downfracture: A Novel Functional Rhinoplasty Technique
Authors: Godbe Kerilyn N. , DeWitt Jason , Garg Ravi K.
Published: September 2023

Individuals with maxillary dentofacial deformities commonly have preexisting nasal airway obstruction with associated nasal septal deviation. Combination bimaxillary procedures with intraoral septoplasty after maxillary downfracture have been demonstrated to address dentofacial deformities and nasal obstruction simultaneously. Although effective, current transoral septoplasty techniques offer limited visualization of the superior septum and are challenging to perform due to septal mobility after Le Fort I downfracture. Here, we describe a novel approach in which a transoral septoplasty is performed before completion of the Le Fort I maxillary downfracture, improving septal stability during the dissection and affording better visualization of the septal L-strut for precise cartilage resection.
Orbital Liposarcoma Progression From a Well-Differentiated to a Dedifferentiated Type in a Young Patient
Authors: Lucero Kate Angelli J. , Woo Kyung In
Published: September 2023

A young male patient presented with unilateral proptosis of the left eye. Laboratory tests and an initial computed tomography scan of the orbit were compatible with euthyroid orbitopathy. He subsequently underwent decompression surgery for unfavorable cosmesis and corneal exposure symptoms with good results, but returned 1 year later for recurrence of proptosis. There was a superomedial fatty density extraconal mass on computed tomography scan. A biopsy done a year later confirmed the diagnosis of well-differentiated liposarcoma from the previously noted mass and a dedifferentiated component in the newly appeared mass in the intraconal space. Orbital exenteration with radial forearm free flap was performed followed by orbital radiotherapy. No disease recurrence or metastasis was seen on follow-ups for 7 years since undergoing treatment.
Predictors for postoperative cranial nerve complications in carotid body tumor resection. a retrospective cohort study
Authors: Alimohamad Hoda , Yilmaz Dilek , Marang-van de Mheen Perla J. , Jansen Jeroen , Hamming Jaap F. , Schepers Abbey
Published: September 2023

Introduction:

Carotid Body Tumors (CBTs) are slow-growing benign tumors. Therefore, surgical resection is considered in case of tumor growth. Timing of surgery is of the utmost importance as the risk of iatrogenic surgical complications increases when resecting larger tumors, whereas on the other hand resections for asymptomatic small CBT should be prevented. The primary aim of this study was to identify which tumor size or dimension is most accurate to predict nerve injury in patients undergoing resection of a CBT.

Material and methods:

This retrospective cohort study included patients who underwent surgical resection of CBT at the university hospital in South-Holland. Baseline patient characteristics and tumor measurements were retrieved from the medical records. We assessed how the different methods of measuring the size of the tumor were interrelated using Pearson correlation. Logistic regression was used to assess which variables were independently associated with nerve injury, including age at surgery, Shamblin classification and those dimensions that captured different aspects of tumor size (rather than measuring the same as shown by high correlations) as possible independent variables.

Results:

In 125 patients, 143 CBT were resected whereof in 35 cases cranial nerve injury occurred, (transient in 16 cases and permanent in 19 cases). The risks for nerve injury increased with larger tumor size and Shamblin classification. Logistic regression analysis showed that the anterior-posterior (AP) diameter significantly increased the odds of a nerve injury, a doubling for every 1 cm increase in AP diameter (odds ratio [95%CI] 2.12[1.29-3.48], P-value=0.003.

Conclusion:

This study shows that measured tumor size in AP plane is a strong predictor for postoperative nerve injury of a CBT resection. This predictor can be used in daily clinic to give insight in operative risks. More research is needed in order to select the most appropriate time window for CBT resection.
Nationwide analysis of pre-hospital tranexamic acid for trauma demonstrates systematic bias in adherence to treatment guidelines: a retrospective cohort study
Authors: Almuwallad Ateeq , Cole Elaine , Rossetto Andrea , Brohi Karim , Perkins Zane , Davenport Ross
Published: September 2023

Background:

Prehospital (PH) tranexamic acid (TXA) improves survival from trauma haemorrhage. Injury mechanism, physiology and sex demographics vary with patient age. We hypothesised that these factors influence TXA guideline compliance and examined national trends in PH use to identify any systematic biases in bleeding management.

Materials & Methods:

UK Trauma Audit & Research Network data for TXA eligible patients admitted to Major Trauma Centres were divided into cohorts: 2013-2015 (n=32,072) and 2017-2019 (n=14,974). Patients were stratified by PH, Emergency Department (ED) or no TXA use. Logistic regression models explored interaction between PH variables and TXA administration. Results are presented as Odds Ratios (OR) with 95% Confidence Intervals (CI).

Results:

PH TXA use increased from eight percent to 27% over time (P<0.001). Only three percent of eligible patients who fell <2 m received PH TXA vs. 63% with penetrating injuries (P<0.001). Older patients eligible for pre-hospital TXA were less likely to receive it compared to younger patients (≥65 y old: 590 [13%] vs <65 y old: 3361 [33%], P<0.001). There was significant interaction between age and sex with fewer older women receiving PH TXA. In shocked patients, one third of females compared to a fifth of men did not receive TXA (P<0.001). There was a decrease in pre-hospital TXA use as age increased (P<0.001).

Conclusions:

Despite a three-fold increase in use, treatment guidance for PH TXA is not universally applied. Older people, women and patients with low energy injury mechanisms appear to be systematically under-treated. Training and education for pre-hospital providers should address these potential treatment biases.
Hyperglycemia and insulin infusion in pancreatoduodenectomy: A prospective cohort study on feasibility and impact on complications
Authors: Ekström Eva , Fagher Katarina , Tingstedt Bobby , Rystedt Jenny , Nilsson Johan , Löndahl Magnus , Andersson Bodil
Published: September 2023

Background:

Hyperglycemia is a risk factor for postoperative complications but its impact on outcome after pancreatoduodenectomy (PD) is scarcely studied. This prospective cohort study aimed to assess the effect of continuous insulin infusion on postoperative complications and blood glucose, as well as to evaluate the impact of hyperglycemia on complications, after PD.

Materials and methods:

One hundred patients planned for PD were prospectively included for perioperative continuous insulin infusion and a historic cohort of 100 patients was included retrospectively. Median blood glucose levels were calculated and data on complications were analyzed and compared between the historic cohort and the intervention group as well as between normo- and hyperglycemic patients.

Results:

Median glucose levels were significantly lower in the intervention group compared to the historic cohort up to 30 days postoperatively (median glucose 8.5 mmol/l (IQR 6.4 – 11) vs. 9.1 mmol/l (IQR 6.8 – 17) (P=0.007)). No significant differences in complication rates were recorded between these two groups. The incidence of complications classified as Clavien ≥3 was higher in hyperglycemic patients (100% vs. 27%, P=0.024). Among hyperglycemic patients the prevalence of preoperative diabetes was higher compared to normoglycemic patients (52% vs.12%, P<0.001). In patients with a known diagnosis of diabetes, a trend, although not statistically significant, towards a lower incidence of postoperative pancreatic fistula (POPF) grade B and C, as well as postpancreatectomy hemorrhage (PPH) grade B and C, was seen compared to those without preoperative diabetes (6.8% vs. 14%, P=0.231 and 2.3% vs. 7.0%, P=0.238 respectively).

Conclusion:

Insulin infusion in the early postoperative phase after PD is feasible in a non-ICU setting and significantly decreased blood glucose levels. The influence on complications was limited. Preoperative diabetes was a significant predictor of postoperative hyperglycemia and was associated with a lower incidence of clinically significant POPF.
Preoperative prognostic predictors and treatment strategies for surgical procedure focused on the Sequential Organ Failure Assessment score in nonocclusive mesenteric ischemia: A multicenter retrospective cohort study
Authors: Murata Takaaki , Yamaguchi Nobuo , Shimomoto Yutaro , Mikajiri Yumi , Sasaki Yuki , Konagaya Kensuke , Igarashi Yuto , Sawamura Naoki , Yamamoto Kota , Kume Nao , Suno Yuma , Kurata Shuji , Kasetani Tetsuya , Kato Ichiro , Nishida Tomoki , Hirata Hirohisa , Miyake Katsunori , Oonishi Takahisa , Isogai Naoko , Fukai Ryuta , Kanomata Hiroyuki , Shimoyama Rai , Kashiwagi Hiroyuki , Takenoue Tomohiro , Terashima Takahiro , Murayama Hiroyuki , Kohriki Shunsaku , Morita Takeshi , Takaki Mutsuo , Ogino Hidemitsu , Kanemaru Takayuki , Sano Ken , Kurogi Norimitsu , Watanabe Kazunao , Hirata Masahiro , Kawachi Jun
Published: September 2023

Background:

Several large-scale studies have assessed endovascular and surgical treatment methods for nonocclusive mesenteric ischemia (NOMI); however, the prognostic factors for NOMI remain unclear. Therefore, this study aimed to evaluate risk factors for in-hospital mortality among patients with NOMI who underwent laparotomy and to examine therapeutic strategies that may improve the prognosis.

Materials and Methods:

In this multicenter retrospective study, we reviewed the electronic medical records retrieved from the inpatient database of patients with NOMI at eight district general hospitals between January 2011 and January 2021. A total of 88 patients who underwent laparotomies were divided into survivor and non-survivor groups, and statistical analysis was performed to determine clinical physiological factors.

Results:

Exploratory laparotomy based on second-look surgery was the first treatment choice. The overall mortality rate was 48.8%, with a male-to-female ratio of 1.1:1. The median Sequential Organ Failure Assessment (SOFA) score was 8 [interquartile range: 3.75–14.2], and the median SOFA scores were 5 [3–7] in the survivor group and 13 [9–17.5] in the non-survivor group. Univariate analysis revealed a significant difference in body mass index (P<0.001), hypoglycemia (P=0.0012), previous cardiovascular surgery (P=0.0019), catecholamine use (P<0.001), SOFA score (P<0.001), platelet count (P=0.0023), and lactate level (P<0.001). Logistic regression analysis using the factors with significant differences revealed that SOFA score ≥10 (odds ratio 23.3; 95% confidence interval 1.94–280.00; P=0.013) was an independent prognostic factor. In addition, catecholamine use was suggested as a factor with a SOFA score ≥10.

Conclusion:

This study confirmed that a SOFA score of ≥10 may be associated with increased mortality. While closely monitoring low blood pressure and renal dysfunction, survival rates may be improved if surgical intervention is performed before the SOFA score reaches ≥10.
Comparison of safety and effectiveness between robotic and laparoscopic major hepatectomy: A systematic review and meta-analysis
Authors: Mao Benliang , Zhu Shanfei , Li Dan , Xiao Junhao , Wang Bailin , Yan Yong
Published: September 2023

Background:

Robotic platform has been increasingly applied in major hepatectomy. However, the role or advantage of robotic approach comparing with laparoscopic approach in major hepatectomy remains controversial. This meta-analysis compares perioperative outcomes of robotic major hepatectomy (RMH) to laparoscopic major hepatectomy (LMH) for hepatic neoplasms.

Methods:

PubMed, Web of Science, EMBASE, and Cochrane Library were searched to identify comparative studies compared RMH versus LMH for hepatic neoplasms. The search timeframe was set before May 2023. Main outcomes were mortality, overall morbidities, serious complications, and conversion to open surgery. Secondary outcomes were operative time, intraoperative blood loss, blood transfusion, postoperative length of hospital stay, R0 resection, reoperation, and readmission. Studies were evaluated for quality by Cochrane risk of bias tool or Newcastle-Ottawa scale. Data were pooled as odds ratio (OR) or mean difference (MD). This study was registered at PROSPERO (CRD#).

Results:

Twelve retrospective cohort studies concerning total 1657 patients (796 RMH, 861 LMH) were included. Meta-analyses showed no significant differences in mortality (OR=1.23, 95% CI=0.50–2.98, P=0.65), overall postoperative complications (OR=0.83, 95% CI=0.65–1.06, P=0.14), operative time (MD=6.47, 95% CI=−14.72 to 27.65, P=0.55), blood transfusion (OR=0.77, 95% CI=0.55–1.08, P=0.13), R0 resection (OR=1.45, 95% CI=0.91–2.31, P=0.12), reoperation (OR=0.76, 95% CI=0.31–1.88, P=0.56), and readmission (OR=0.63, 95% CI=0.28–1.44, P=0.27) between RMH and LMH. Incidence of serious complications (OR=0.60, 95% CI=0.40–0.90, P=0.01), conversion to open surgery (OR=0.41, 95% CI=0.27–0.63, P<0.0001), blood loss (MD=−91.42, 95% CI=−142.18 to −40.66, P=0.0004), and postoperative hospital stay (MD=−0.64, 95% CI=−0.78 to −0.49, P<0.00001) were reduced for RMH versus LMH.

Conclusions:

RMH is associated with comparable short-term surgical outcomes and oncologic adequacy compared to LMH when performed by experienced surgeons at large centers. RMH may result in reduced major morbidities, conversion rate, blood loss, and hospital stay, but these results were volatile. Further randomized studies should address the potential advantages of RMH over LMH.
Living alone predicts poor prognosis among patients with acute myocardial infarction
Authors: Fukumoto Daichi , Kanda Daisuke , Takumi Takuro , Ikeda Yoshiyuki , Tokushige Akihiro , Ohmure Kenta , Sonoda Takeshi , Arikawa Ryo , Anzaki Kazuhiro , Ohishi Mitsuru
Published: September 2023

Background

Living alone as a proxy for social isolation has been considered to increase the risk of cardiovascular disease. We thus investigated the impact of living alone on mortality in acute myocardial infarction (AMI) patients.

Methods

Subjects comprised 277 AMI patients who underwent percutaneous coronary intervention (PCI). Associations between all-cause and cardiac deaths after PCI and baseline characteristics including living alone and Global Registry of Acute Coronary Events (GRACE) risk score were assessed.

Results

Eighty-three patients (30%) were living alone. Thirty patients died after PCI, including 20 cardiac deaths. Patients living alone showed higher incidences of both all-cause and cardiac deaths compared with patients not living alone (18% vs. 8%, P = 0.019 and 14% vs. 4%, P = 0.004). Multivariate Cox proportional hazards regression analysis models showed living alone [hazard ratio (HR), 2.60; 95% confidence interval (CI), 1.20–5.62; P = 0.016 and HR, 4.17; 95% CI, 1.60–10.84; P = 0.003] and GRACE risk score (HR, 1.02; 95% CI, 1.01–1.03; P = 0.003 and HR, 1.03; 95% CI, 1.01–1.04; P < 0.001) correlated significantly with all-cause and cardiac deaths. Cox proportional hazards modeling revealed that patients living alone with GRACE risk score ≥162 derived from the receiver-operating characteristic curve showed a significantly greater risk of all-cause death than patients not living alone with GRACE risk score <162 (HR 16.57; 95% CI 6.67–41.21; P < 0.001).

Conclusion

Among AMI patients, living alone represents an independent risk factor for all-cause and cardiac deaths after PCI, separate from GRACE risk score. Furthermore, AMI patients living alone with high GRACE risk scores may experience an additively increased risk of mortality after PCI.
Long-term clinical outcomes of drug-coated balloon for the management of chronic total occlusions
Authors: Qin Qing , Chen Lu , Ge Lei , Qian Juying , Ma Jianying , Ge Junbo
Published: September 2023

Objectives

This study aims to compare the clinical outcomes of patients with de novo chronic total occlusion (CTO) lesions treated by hybrid strategy and drug-coated balloons (DCB)-only strategy.

Backgrounds

DCBs have been used as an alternative to or in combination with drug-eluting stents in CTO lesions. However, the clinical impact of DCB treatment on CTO lesion remains uncertain.

Methods

We retrospectively enrolled 154 patients with de novo CTO lesions treated by DCB, including 57 cases in hybrid group and 97 cases in DCB-only group.

Results

The lesions in hybrid group were more complicated than those in DCB-only group as shown by higher J-CTO score, and therefore higher percentage of retrograde approach, more IVUS guidance, more CTO guidewires, and longer procedural time were demonstrated. Although the percentage of non-flow-limiting dissection and residual stenosis of more than 30% were lower in hybrid group, TIMI flow grade, satisfactory and acceptable recanalization rate were not significantly different between two groups. During a median follow-up was 470 days, the incidence of target lesion revascularization (TLR), myocardial infarction and cardiac death was 11.0%, 1.3% and 1.9%, respectively. The long-term TLR-free survival was comparable between hybrid and DCB-only groups. By multivariate analysis, DCB length and age were predictors of TLR.

Conclusion

DCB treatment appears effective and safe in selected de novo CTO lesions during long-term follow up. The recanalization results and long-term outcomes are comparable between hybrid and DCB-only group despite more complicated lesions in hybrid group.