bluuebunny/crossref_metadata_2025 huggingface dataset:
A comprehensive study of orbital evolution of LMC X-4: existence of a second derivative of the orbital period
Authors: Jain Chetana , Sharma Rahul , Paul Biswajit
Published: March 2024

We report here results from pulse arrival time delay analysis of the eclipsing high-mass X-ray binary (HMXB) pulsar LMC X-4 using observations made with the Rossi X-ray Timing Explorer, XMM–Newton, NuSTAR (Nuclear Spectroscopic Telescope ARray), and AstroSat. Combining the orbital parameters determined from these observations with the historical measurements dating back to 1998, we have extended the Tπ/2 epoch history of LMC X-4 by about 4600 binary orbits spanning about 18 yr. We also report mid-eclipse time measurements (Tecl) using data obtained from wide-field X-ray monitors of MAXI-GSC (Monitor of All-sky X-ray Image – Gas Slit Camera) and Swift-BAT (Burst Alert Telescope). Combining the new Tπ/2 and Tecl estimates with all the previously reported values, we have significantly improved the orbital evolution measurement, which indicates that the orbital period is evolving at a time-scale ($P_{\rm orb}/\dot{P}_{\rm orb}$) of about 0.8 Myr. For the first time in an accreting X-ray pulsar system, we confirm the existence of a second derivative of the orbital period, having an evolution time-scale ($\dot{P}_{\mathrm{ orb}}/\ddot{P}_{\mathrm{ orb}}$) of about 55 yr. Detection of a second derivative of the orbital period in LMC X-4 makes its orbital evolution time-scale more uncertain, which may also be true for other HMXBs. Independent solutions for the orbital evolution measurement using the mid-eclipse data and the pulse timing data are consistent with each other, and help us put an upper limit of 0.009 on the eccentricity of the binary system.
The white dwarf binary pathways survey – X. Gaia orbits for known UV excess binaries
Authors: Garbutt J A , Parsons S G , Toloza O , Gänsicke B T , Hernandez M S , Koester D , Lagos F , Raddi R , Rebassa-Mansergas A , Ren J J , Schreiber M R , Zorotovic M
Published: March 2024

White dwarfs with an F, G, or K type companion represent the last common ancestor for a plethora of exotic systems throughout the galaxy, though to this point very few of them have been fully characterized in terms of orbital period and component masses, despite the fact several thousand have been identified. Gaia data release 3 has examined many hundreds of thousands of systems, and as such we can use this, in conjunction with our previous UV excess catalogues, to perform spectral energy distribution fitting in order to obtain a sample of 206 binaries likely to contain a white dwarf, complete with orbital periods, and either a direct measurement of the component masses for astrometric systems, or a lower limit on the component masses for spectroscopic systems. Of this sample of 206, four have previously been observed with Hubble Space Telescope spectroscopically in the ultraviolet, which has confirmed the presence of a white dwarf, and we find excellent agreement between the dynamical and spectroscopic masses of the white dwarfs in these systems. We find that white dwarf plus F, G, or K binaries can have a wide range of orbital periods, from less than a day to many hundreds of days. A large number of our systems are likely post-stable mass transfer systems based on their mass/period relationships, while others are difficult to explain either via stable mass transfer or standard common envelope evolution.
Formation of lower mass-gap black hole–neutron star binary mergers through super-Eddington stable mass transfer
Authors: Zhu Jin-Ping , Qin Ying , Wang Zhen-Han-Tao , Hu Rui-Chong , Zhang Bing , Wu Shichao
Published: March 2024

Super-Eddington accretion of neutron stars (NSs) has been suggested both observationally and theoretically. In this paper, we propose that NSs in close-orbit binary systems with companions of helium (He) stars, most of which systems form after the common-envelope phase, could experience super-Eddington stable Case BB/BC mass transfer (MT), and can sometimes undergo accretion-induced collapse (AIC), resulting in the formation of lower mass-gap black holes (mgBHs). Our detailed binary evolution simulations reveal that AIC events tend to happen if the primary NSs have an initial mass ${\gtrsim} 1.7\, {\rm M}_\odot$ with a critical accretion rate of ≳300 times the Eddington limit. These mgBHs would have a mass nearly equal to or slightly higher than the NS maximum mass. The remnant mgBH–NS binaries after the core collapses of He stars are potential progenitors of gravitational-wave (GW) sources. Multimessenger observations between GW and kilonova signals from a population of high-mass binary NS and mgBH–NS mergers formed through super-Eddington stable MT are helpful in constraining the maximum mass and equation of state of NSs.
Probiotics supplementation during pregnancy or infancy on multiple food allergies and gut microbiota: a systematic review and meta-analysis
Authors: Jiang Lan , Zhang Lili , Xia Jiayue , Cheng Lei , Chen Guoxun , Wang Jin , Raghavan Vijaya
Published: March 2024

Context

Probiotics show promise in preventing and managing food allergies, but the impact of supplementation during pregnancy or infancy on children's allergies and gut microbiota remains unclear.

Objective

This study aimed to assess the effects of maternal or infant probiotic supplementation on food allergy risk and explore the role of gut microbiota.

Data Sources

A systematic search of databases (PubMed, Cochrane Library, Embase, and Medline) identified 37 relevant studies until May 20, 2023.

Data Extraction

Two independent reviewers extracted data, including probiotics intervention details, gut microbiota analysis, and food allergy information.

Data Analysis

Probiotics supplementation during pregnancy and infancy reduced the risk of total food allergy (relative risk [RR], 0.79; 95% CI, 0.63-0.99), cow-milk allergy (RR, 0.51; 95% CI, 0.29-0.88), and egg allergy (RR, 0.57; 95% CI, 0.39-0.84). Infancy-only supplementation lowered cow-milk allergy risk (RR, 0.69; 95% CI, 0.49-0.96), while pregnancy-only had no discernible effect. Benefits were observed with over 2 probiotic species, and a daily increase of 1.8 × 109 colony-forming units during pregnancy and infancy correlated with a 4% reduction in food allergy risk. Children with food allergies had distinct gut microbiota profiles, evolving with age.

Conclusions

Probiotics supplementation during pregnancy and infancy reduces food allergy risk and correlates with age-related changes in gut microbial composition in children.

Systematic Review Registration

PROSPERO registration no. CRD42023425988.
Foreign Travelers’ Accounts and Fanny Calderón de la Barca’s Life in Mexico
Authors: Parra Lazcano Lourdes
Published: March 2024

Foreign travelers arrived in large numbers in Mexico, especially after Mexican War of Independence, to see the country and access its commercial potential. Each of them talked about the Valley of Mexico, its richness and human diversity. The way these travelers wrote about their “gazes” over this valley—in particular Fanny Calderón de la Barca—is key to understanding the politics of their trips. After their initial viewing, foreign travelers described the Mexican social and political situation as ripe for exploitation and improvement. The chapter presents anecdotes and accounts of foreign travelers in Mexico during the nineteenth century. It primarily focuses on Fanny Calderón de la Barca and her work, Life in Mexico: Residence of Two Years in That Country. Calderón de la Barca’s work is relevant because she was the wife of the first Spanish minister of independent Mexico and had the opportunity to travel extensively throughout the country. Moreover, the work is considered to be a crucial text in terms of history, politics, and literature, despite her tendency to disseminate gender stereotypes and racist and classist assumptions. The work of Fanny Calderón de la Barca, and her gaze as it falls upon the Valley of Mexico, reflect the politics of mid-19th-century Mexico.
Taíno Religion
Authors: Stevens-Arroyo Anthony
Published: March 2024

This chapter introduces the Taíno religion, which is the first religion known in the Caribbean. It details the intricacy of the Taínos’ religious system, which integrated social behavior and nature. In contrast to scriptural religions, the Taínos trusted instead their own unspoiled and immediate response to the world around them. Religious wonder at the manifestation of spiritual forces in nature is a primordial human experience that exceeded the boundaries of earth religion and found its way into many scriptures. However, the focus on nature did not rob the Taíno belief system of the moral arc that all religions use to define right and wrong in social behavior.
Gender in Caribbean Religion
Authors: Otero Solimar
Published: March 2024

This chapter focuses on Afro-Caribbean expressions of gender, power, and place in traditions like Lukumí, Vodou, Palo, and Espiritismo. Gender is the focal point where race, colonialization, and sexuality come together to illuminate the intersectionality and fissures of creolized cultural life. The ways that gender is performed, produced, and circumscribed in Afro-Caribbean religious expression situate the nature of heated debates about authenticity, modernity, and nation-building in the Caribbean. This analysis of gender in Caribbean religion explores ritual, ethnography, and narrative. It will pay special attention to sites of reinvention and vernacular expressions coming from especially women and LGBTQ practitioners of Afro-Caribbean religions.
Rituals
Authors: Clark Mary Ann
Published: March 2024

This chapter focuses on rituals within the Yoruba religious complex variously known as Santería, Lukumí, and Regla de Ocha. It explains that rituals performed by participants in African-based religions in the Americas are the most important aspects of the religion. Rituals are intended to make the life or lives of the participants better, and more in line with each individual’s destiny for this lifetime. In the Caribbean and parts of Central and South America, groups of the enslaved and the formerly enslaved worked together to recreate the religious practices of their homelands. The chapter reveals that rituals allow individuals to be brought into the religious complex while also making connections with deities and other members of the community.
Wholeness by Every Means
Authors: Wood Funlayo E.
Published: March 2024

This chapter discusses the practice of religiomedical healing in the Caribbean. It highlights how healing is a centrifugal force in Caribbean religious practice. In the Caribbean, people of all kinds, regardless of affiliation or status, may employ spiritual healers or religiomedical healing modalities at some point in their lives, especially for African and Indian descendants whose healthcare was largely ignored, as they were considered expendable and replaceable labor. The chapter then provides an overview of case studies of the most prominent religiomedical healing traditions and modalities from around the region. It also explains how Caribbean religious traditions will continue to make important contributions to the health and well-being of Caribbean peoples.
Possession
Authors: Johnson Paul Christopher
Published: March 2024

This chapter explores the issues surrounding spirit possession within Caribbean religions. It cites how the notion of possession questioned the idea of the autonomous, rational, free agent. While slavery was the Caribbean’s foundational institution and system of exchange, spirit possession provided a key category that helped affix the great ontological and social divide that separated those capable of ownership from those who could by right be owned. The question of the colonial occupation of territory or enslaved persons raised the issues of the economic value of land and spirits’ presence in the bodies of the enslaved. The chapter explains how the history of slavery hovers and chains the tropes of spirit possession, material possessions, and possessable persons.
Protestant Christianity
Authors: Cardoza-Orlandi Carlos F.
Published: March 2024

This chapter explores the history of Colonial Protestant Christianity in the Caribbean. It elaborates on the diversity of Protestant expression across Europe. The region became a geopolitical and religious location of violent encounters, imperial tensions and alliances, and human accounts of exploitation and survival due to the religious and political turmoil and the power struggle between Roman Catholicism and Protestant traditions in Europe. Thus, the narrative of Protestantism in the Caribbean primarily revolves around several key contexts of colonial structure, plantation economy, conquest, exploitation of indigenous and mixed-race people, and slavery. The chapter also considers the tensions concerning traditions, uncertainties and unexpected alliances, rebellions, and Caribbean missionary work.
The Lukumí in Cyberspace
Authors: Gonzalez Jeffery M.
Published: March 2024

The advent of cyberspace contributed significantly to the development and impact of globalization on religious traditions. For the Lukumí, the Internet with its numerous social media applications provides new methods of communication between geographically dispersed Lukumí communities. The diffusion of the Lukumí worldview, driven by the migration of practitioners, has acquired new characteristics during the past decades with the expansion of the Internet. A survey conducted with Facebook users attempted to explore some of the dynamics involved in the relationship between new communication technologies and the Lukumí tradition. Throughout the chapter the concepts of Orisha diaspora, Orisha capital, and Orisha marketplace are discussed as guideposts in the expanding conversation of technology and religious practices. The changing nature of the Lukumí tradition in Cuba and around the globe is explored as a growing global Lukumí community that continues to question the fundamental concepts of authenticity and sacredness as encounters with other Orisha traditions. Moreover, the expansion of social media has created hybridized traditions, commercialization of sacred icons, and the presence of unscrupulous priests using the Internet to prey on unknowing novices. In summary, this chapter provides a framework to understand how technology has created a new frontier in the expansion, maintenance, and development of the Lukumí tradition.
Santería
Authors: Rauhut Claudia
Published: March 2024

This chapter elaborates on the Afro-Cuban religion Santería, which is one of the most popular religions of African origin in the Americas. It explores a Cuban example of such a “renewal” or appropriation of the African past and present in Cuban Santería. African-based religions in the Americas are more of a product of a transatlantic religious agency that actively reformed and renewed those traditions until the present day. The chapter then discusses the processes of religious globalization and transnationalization after the 1990s before considering strategies of re-Africanization in translocal religious settings. It considers a version of Lúkúmí that offers a more differentiated perspective on the construction and appropriation of the Yoruba religion.
Mapping and writing as a co-creative therapeutic process
Authors: Potter Steve
Published: March 2024

Cognitive analytic therapy’s (CAT’s) conceptual tools and methods offer a scaffolding for a co-creative therapeutic partnership. CAT emphasizes doing therapy with rather than for, or to, the client. It combines personal problem solving with attention to a sense of self and in the process a more general relational and conversational awareness is developed. Whilst CAT centres on the written and diagrammatic reformulation with the client, it is important to not neglect the additional and continuous task of establishing and maintaining a healing narrative. The shared, in-session process of mapping the conversations, stories, and relationships as they develop depends on an open story approach and the sensitive exploration of words and the patterns they relate to. The approach to CAT described is one of several ways of using the CAT framework and it is a tribute to Ryle’s openness and pragmatism that the approach has not become model bound.
Theoretical underpinnings of CAT
Authors: Burns-Lundgren Eva
Published: March 2024

This chapter describes the development of cognitive analytic therapy (CAT) from its early origins in Anthony Ryle’s efforts to create a common language for the psychotherapies, through the provision of a solid object relations base to more cognitive aspects of the model. CAT is an integrative and relational model of therapy, which also draws on the ideas of Lev Vygotsky and Mikhail Bakhtin on the continuous social and dialogic formation of mind and the self—‘we interact and communicate, therefore I become’. CAT views participants in therapy as whole human beings within their interpersonal context, and focuses on how we construe the world around us and choose to interact in it. CAT is time-limited and in the early stages of therapy sequences of problem procedures are jointly identified, which become the main focus throughout the work. Ryle’s interest in why we don’t revise these procedures, even though they come at high personal cost, lead to the development of the core CAT concept of reciprocal roles and their resultant reciprocal role procedures. The chapter describes the development of these interpersonal roles and procedures, both from a theoretical perspective, and through their demonstration in observational studies. CAT uses written and diagrammatic tools to describe these patterns, and the diagram in particular, the sequential diagrammatic reformulation, is a powerful aid for addressing these as they emerge within the therapy relationship. The chapter gives clinical illustrations and examples of diagrams.
CAT for people with a diagnosis of bipolar disorder
Authors: Evans Mark
Published: March 2024

This chapter makes reference to the current evidence for psychological approaches for people with bipolar disorder (BD) before describing the cognitive analytic therapy (CAT) for bipolar disorder (CATBiD) study. Insights from both clients and therapists in the study will be discussed and some hypotheses suggested for how to formulate BD using a CAT perspective. CAT appears to be a promising treatment for people living with BD, reflections are offered on what it can bring over and above what other more standard (cognitive behavioural and psychoeducational) approaches can offer. Three case studies are described and made reference to together with examples of CAT diagrams that may be helpful. CAT can be a useful therapy for clients with BD but there are some key differences in the approach compared to when working with people who experience difficulties with emotionally unstable or narcissistic personality traits.
‘Struggling well’
Authors: Walsh Sue , Freshwater Kate
Published: March 2024

Feeling and holding onto your self-worth when organizational change is constant; trying to implement a change process that you have not been consulted about; not knowing what is going on and feeling too insignificant to ask; watching effective systems be dismantled in the face of a new National Health Service (NHS) target or reorganization; being overwhelmed at work and feeling unsure how to cope; knowing when to get out when work has become too difficult or coping proactively when you feel you no longer have a valued place; making good decisions about whistleblowing when it all feels, and is, frightening. These are examples of emotional experiences embedded into the everyday psychosocial context of mental health work. Maintaining self-worth and self-efficacy in the face of service demands is key to well-being at work and is an enabling factor in supporting organizational change. The interrelationship between self and organization is therefore key to the delivery of effective and compassionate help-giving relationships. Drawing upon the mentalization literature cognitive analytic therapy (CAT) can help us maintain the focus on our primary work task of enabling and supporting positive change in the well-being and life chances of services users. This chapter explores using CAT organizationally to maintain the reflective capacities of the individual and the system through clinical and organizational supervision and by embedding CAT in wider system change.
Revision
Authors: Lloyd Julie
Published: March 2024

This chapter describes the process of change, or revision, within cognitive analytic therapy (CAT). Client and therapist work together within this active phase, to notice and develop new ways of relating to oneself and others, through exits, or ways out of familiar target problem procedures that have maintained the individual’s target problems. Positive change in CAT initially involves developing an understanding of these target problems in their historical and relational context, which in turn allows for the development of an ‘observing eye/I’, scaffolded by the therapist. New reciprocal role procedures become explicitly described and through the process of recognition and revision new possibilities emerge. Knowledge and experiences within the therapeutic relationship offer rich opportunities for client and therapist to practice exits together, or new ways of relating, which are then built on in-between sessions using tools to reinforce and reflect on new learning.
Ubiquitous filter feeders shape open ocean microbial community structure and function
Authors: Thompson Anne W , Nyerges Györgyi , Lamberson Kylee M , Sutherland Kelly R
Published: March 2024

The mechanism of mortality plays a large role in how microorganisms in the open ocean contribute to global energy and nutrient cycling. Salps are ubiquitous pelagic tunicates that are a well-known mortality source for large phototrophic microorganisms in coastal and high-latitude systems, but their impact on the immense populations of smaller prokaryotes in the tropical and subtropical open ocean gyres is not well quantified. We used robustly quantitative techniques to measure salp clearance and enrichment of specific microbial functional groups in the North Pacific Subtropical Gyre, one of the largest ecosystems on Earth. We discovered that salps are a previously unknown predator of the globally abundant nitrogen fixer Crocosphaera; thus, salps restrain new nitrogen delivery to the marine ecosystem. We show that the ocean's two numerically dominant cells, Prochlorococcus and SAR11, are not consumed by salps, which offers a new explanation for the dominance of small cells in open ocean systems. We also identified a double bonus for Prochlorococcus, wherein it not only escapes salp predation but the salps also remove one of its major mixotrophic predators, the prymnesiophyte Chrysochromulina. When we modeled the interaction between salp mesh and particles, we found that cell size alone could not account for these prey selection patterns. Instead, the results suggest that alternative mechanisms, such as surface property, shape, nutritional quality, or even prey behavior, determine which microbial cells are consumed by salps. Together, these results identify salps as a major factor in shaping the structure, function, and ecology of open ocean microbial communities.
Laccase-induced decontamination and humification mechanisms of estrogen in water–crop matrices
Authors: Sun Kai , Dai Ling-Zhi , Chen Mei-Hua , Si You-Bin , Fang Guo-Dong , Li Shun-Yao , Yu Han-Qing
Published: March 2024

Enzymatic humification plays a crucial biogeochemical role in eliminating steroidal estrogens and expanding organic carbon stocks. Estrogenic contaminants in agroecosystems can be taken up and acropetally translocated by crops, but the roles of laccase-triggered rhizospheric humification (L-TRH) in pollutant dissipation and plant uptake remain poorly understood. In this study, the laccase-induced decontamination and humification mechanisms of 17β-estradiol (E2) in water–crop media were investigated by performing greenhouse pot experiments with maize seedlings (Zea mays L.). The results demonstrated that L-TRH effectively dissipated E2 in the rhizosphere solution and achieved the kinetic constants of E2 dissipation at 10 and 50 μM by 8.05 and 2.75 times as much as the treatments without laccase addition, respectively. The copolymerization of E2 and root exudates (i.e. phenols and amino acids) consolidated by L-TRH produced a larger amount of humified precipitates with the richly functional carbon architectures. The growth parameters and photosynthetic pigment levels of maize seedlings were greatly impeded after a 120-h exposure to 50 μM E2, but L-TRH motivated the detoxication process and thus mitigated the phytotoxicity and bioavailability of E2. The tested E2 contents in the maize tissues initially increased sharply with the cultivation time but decreased steadily. Compared with the treatment without laccase addition, the uptake and accumulation of E2 in the maize tissues were obviously diminished by L-TRH. E2 oligomers such as dimer, trimer, and tetramer recognized in the rhizosphere solution were also detected in the root tissues but not in the shoots, demonstrating that the acropetal translocation of E2 oligomers was interrupted. These results highlight a promising strategy for decontaminating estrogenic pollutants, boosting rhizospheric humification, and realizing low-carbon emissions, which would be beneficial for agroenvironmental bioremediation and sustainability.
Stability versus flexibility in projectified science–policy context: what is the role of science advisors?
Authors: Vihma Peeter
Published: March 2024

Science–policy interaction is frequently organized through projects, lauded as flexible and focused administrative solutions for policy learning. However, there is a risk of stifling projects with overly rigid interfaces or, controversially, losing project results amidst the cracks of inter- and intra-organizational cleavages when interfaces are excessively flexible. This article examines how science advisors in Estonian ministries contributed to resolving this controversy through an in-depth case study of an agenda-setting bioeconomy project. The results suggest that the potential of science advisors to provide necessary flexibility is contingent on their position relative to bureaucratic hierarchies and boundary objects.
Waqf—The Muslim endowments in India: ideological and legal intricacies
Authors: Rasool Tabasum
Published: March 2024

Waqf is the permanent dedication by any person, of any movable or immovable property for any purpose recognised by the Muslim law as pious, religious or charitable. Making waqf is considered a virtuous act in Islam. As a result, Muslims established auqaf wherever they lived. Apart from agricultural, commercial and residential properties, waqf in India includes functional/non-functional mosques, darghās (tomb or shrine of Muslim saint), khanqahās (building or space for Sufi brotherhood), maqbaras (tombs), ashoor-khanās (mourning place for Shias), qabristāns (graveyards), idghās (space to offer Eid Prayer), imam-baras (space for prayers and gatherings for Shias), etc. With the passage of time, waqf endowments started playing an important role in shaping the religious, social, educational, cultural, economic and political aspects/institutions of Muslim societies. This voluntary institution of waqf supplemented the State in fulfilment of its obligations towards the provisions of public good. This interaction between the state and the waqf created ideological and legal intricacies that have shaped the present-day waqf legislations.
Transcriptional Activator UvXlnR Is Required for Conidiation and Pathogenicity of Rice False Smut Fungus Ustilaginoidea virens
Authors: Yan Jiali , Wang Rui , Wu Mengyao , Cai Minzheng , Qu Jinsong , Liu Lianmeng , Xie Jiatao , Yin Weixiao , Luo Chaoxi
Published: March 2024

Transcription factors play critical roles in diverse biological processes in fungi. XlnR, identified as a transcriptional activator that regulates the expression of the extracellular xylanase genes in fungi, has not been extensively studied for its function in fungal development and pathogenicity in rice false smut fungus Ustilaginoidea virens. In this study, we characterized UvXlnR in U. virens and established that the full-length, N-terminal, and C-terminal forms have the ability to activate transcription. The study further demonstrated that UvXlnR plays crucial roles in various aspects of U. virens biology. Deletion of UvXlnR affected growth, conidiation, and stress response. UvXlnR mutants also exhibited reduced pathogenicity, which could be partially attributed to the reduced expression of xylanolytic genes and extracellular xylanase activity of U. virens during the infection process. Our results indicate that UvXlnR is involved in regulating growth, conidiation, stress response, and pathogenicity.
Should New Data on Rehabilitation Interventions in Critically Ill Patients Change Clinical Practice? Updated Meta-Analysis of Randomized Controlled Trials
Authors: Jiroutková Kateřina , Duška František , Waldauf Petr
Published: March 2024

Objectives:

We published a meta-analysis in March 2020 to assess the impact of rehabilitation in the ICU on clinical outcomes. Since then, 15 new randomized controlled trials (RCTs) have been published; we updated the meta-analysis to show how the recent studies have tipped the scale.

Design:

Systematic review and meta-analysis.

Setting:

An update of secondary data analysis of RCTs published between January 1998 and July 2023 performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Patients:

Critically ill adults.

Interventions:

Cycling exercises or neuromuscular electrical stimulation (NMES) or protocolized physical rehabilitation (PPR) or functional electrical stimulation-assisted cycle ergometry (FESCE) compared with standard of care.

Measurements and Main Results:

Days on a mechanical ventilator, length of stay in ICU and at the hospital, and mortality. We found 15 RCTs (one on cycling, eight on NMES alone, four on PPR, and two on FESCE) into which 2116 patients were randomized. The updated meta-analysis encompasses a total of 5664 patients. The exercise interventions did not influence mortality (odds ratio, 1.00 [0.87–1.14]; n = 53 RCTs) but reduced the duration of mechanical ventilation (mean difference, –1.76 d [–2.8 to –0.8 d]; n = 46) and length of stay in ICU (–1.16 d [–2.3 to 0.0 d]; n = 45). The effects on the length of mechanical ventilation and ICU stay were only significant for the PPR subgroup by a median of –1.7 days (95% CI, –3.2 to –0.2 d) and –1.9 days (95% CI, –3.5 to –0.2 d), respectively. Notably, newly published trials provided consistent results and reduced the overall heterogeneity of these results.

Conclusions:

None of the rehabilitation intervention strategies being studied influence mortality. Both mechanical ventilation and ICU stay were shortened by PPR, this strengthens the earlier findings as all new RCTs yielded very consistent results. However, no early rehabilitation interventions in passive patients seem to have clinical benefits. Regarding long-term functional outcomes, the results remain inconclusive.
Laser Test Spots: A Scoping Review
Authors: Chong Derrick , Shi Jincheng , Richer Vincent
Published: March 2024

BACKGROUND

Laser test spots are commonly suggested for the assessment of clinical response and adverse effects, but use by laser operators is not well described.

OBJECTIVE

To describe the use of laser test spots in the existing published literature regarding methodology (location, treatment parameters) and objective (clinical efficacy, safety, other).

MATERIALS AND METHODS

This scoping review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines and included indexed studies performing test spots in human subjects for dermatologic conditions with clinical reassessment at a subsequent visit.

RESULTS

Among 5,261 identified publications, 103 studies with 959 test spots were selected for inclusion. Test spots conducted were mostly on lesional skin (89.3%) assessing both clinical response and adverse effects (76.9%). Most test spots used multiple laser parameters with a single wavelength (48.3%). Fluence was most frequently adjusted either alone (30.1%) or in combination with pulse duration or spot size. Other described test spots examined single set of laser parameters, multiple wavelengths with various parameters, or were left unspecified.

CONCLUSION

Laser test spot methodology was diverse and performed for dual objectives of efficacy and safety. The authors have compiled clinical considerations to assist laser operators in deciding whether performing a test spot may be beneficial to their patient.
Variable Energy and Ultrasound–based Liposculpture of the Arms: Multicenter and Multidevice Study
Authors: Cala Uribe Laura C. , Perez Pachon Mauricio E. , Babaitis Ricardo , Zannin Ferrero Andreina , Aljure Diaz Manuel F.
Published: March 2024

Incorporation of new technologies to assist the liposuction procedure is becoming increasingly common. These technologies allow for a softer technique, balanced shaping, elimination of excess adipose tissue, and skin tightening. Some of these technologies include ultrasound (US; US-assisted liposculpture, VASER-assisted liposuction), power suction (power-assisted liposuction), radiofrequency (RF; RF-assisted lipolysis), and laser (laser-assisted liposuction). In addition, some of these devices have been shown to reduce the incidence of hematomas/inflammation and shorten recovery time. We report our experience in high-definition liposculpture of the arms in addition to new technologies to improve skin retraction, comparing their results in terms of complications, satisfaction score, and aesthetic outcomes. We included patients with mild-to-moderate arm dermatochalasis (Duncan classification) fat deposits in the upper extremities who were considered candidates for third-generation US-assisted liposculpture, power-assisted liposuction, RF-assisted lipolysis/skin tightening, and laser-assisted liposuction. A total of 683 consecutive patients met the inclusion criteria for the study. Most of them were women (n = 605, 88%). Fat grafting was performed in 80 patients (11.7%). A significant portion of the patients were secondary cases (n = 223, 33%). Age ranged from 18 to 70 years (median = 38 years). BMI ranged from 17.8 to 34.8 kg/m2 (mean = 24.3 kg/m2). RF-assisted and laser-assisted high-definition liposculpture of the arms are both effective and reproducible techniques for patients who seek an athletic and slim arm contour. A low rate of complications and high satisfaction index support our findings.
T-line Hernia Mesh Repairs of Large Umbilical Hernias: Technique and Short-term Outcomes
Authors: Naga Hani I. , Emovon Emmanuel , Kim Joshua K. , Hernandez Jorge Andres , Yoo Jin S.
Published: March 2024

Background:

The T-line hernia mesh is a synthetic, polypropylene mesh specifically designed to prevent anchor point failure by evenly distributing tension through mesh suture extensions. This case series illustrates the first clinical application of the T-line mesh for umbilical hernia repair (UHR).

Methods:

This study is a retrospective, consecutive cases series of all adult patients presenting to a single surgeon with symptomatic umbilical hernia requiring surgical repair using the T-line hernia mesh. Patient demographics, surgical details, and 30-day postoperative complications were collected. Descriptive statistics were computed in Microsoft Excel (Redmond, Va.).

Results:

Three patients presented for UHR. All three patients were obese with mean body mass index of 37.5 ± 6.6. Two patients were former smokers, and two had presented after hernia recurrence. The average defect size was 80.1 cm2 ± 94.0 cm2. Two patients had UHR with onlay mesh placement, whereas one had a transversus abdominus release followed by retrorectus mesh placement. The average mesh size was 192.3 cm2 ± 82.5 cm2. All three cases were classified as clean. There were no intraoperative complications. No patients experienced 30-day postoperative complications or recurrence.

Conclusions:

We present a case series of three patients presenting with large, symptomatic umbilical hernias who underwent UHR with T-line hernia mesh reinforcement without short term complications or hernia recurrence at last follow-up.
Continuous Wave Transscleral Cyclophotocoagulation and Endoscopic Cyclophotocoagulation in Childhood Glaucoma: A Meta-Analysis
Authors: Elhusseiny Abdelrahman M. , Hassan Amr K. , Elsaman Ahmed S. , Azhari Jamal O. , VanderVeen Deborah K. , Abdelnaem Salah , Pakravan Mohammad , Chang Ta C. , Khodeiry Mohamed M. , Khouri Albert S. , Sayed Mohamed S. , Lee Richard K. , Sallam Ahmed B.
Published: March 2024

Précis:

Transscleral cyclophotocoagulation (TS-CPC) and endoscopic cyclophotocoagulation (ECP) were effective in reducing intraocular pressure (IOP) and glaucoma medications in childhood glaucoma.

Objective:

To report the outcomes of continuous wave TS-CPC and ECP in childhood glaucoma.

Materials and Methods:

We performed a systematic search of relevant databases. We collected data on age, follow-up duration, type of glaucoma, previous surgical interventions, preoperative and postoperative IOP, preoperative and postoperative number of glaucoma medications, adverse events, number of sessions, and success rates at different time points. The main outcome measures are the amount of IOP and glaucoma medication reduction.

Results:

We included 17 studies studying 526 patients (658 eyes); 11 evaluated the effectiveness of TS-CPC (268 patients, 337 eyes), 5 evaluated ECP (159 patients, 197 eyes), and one study compared both techniques (56 patients, 72 eyes for TS-CPC vs 43 patients, 52 eyes for ECP). The median duration of follow-up was 28 months in the TS-CPC group and 34.4 months in the ECP group. The mean number of treatment sessions was 1.7 in the TS-CPC and 1.3 in the ECP. In the TS-CPC group, the mean IOP was significantly reduced from 31.2 ± 8 to 20.8 ± 8 mm Hg at the last follow-up (P < 0.001). The mean number of glaucoma medications was reduced from 2.3 ± 1.3 to 2.2 ± 1.3 (P = 0.37). In the ECP group, there was also a significant reduction in the mean IOP from 32.9 ± 8 mm Hg with a mean of 1.7 ± 0.7 glaucoma medications to 22.6 ± 9.8 mm Hg (P < 0.0001) on 1.2 ± 1.1 medications (P = 0.009) at the last follow-up.

Conclusion:

Both TS-CPC and ECP were effective in reducing the IOP and glaucoma medications in childhood glaucoma. Multiple treatment sessions were required.
Erector spinae plane block reduces opioid consumption and improves incentive spirometry volume after cardiac surgery: A retrospective cohort study
Authors: Liang Ting-Wei , Shen Ching-Hui , Wu Yung-Szu , Chang Yi-Ting
Published: March 2024

Background:

Effective postoperative pain management is vital in cardiac surgery to prevent opioid dependency and respiratory complications. Previous studies on the erector spinae plane (ESP) block have focused on single-shot applications or immediate postoperative outcomes. This study evaluates the efficacy of continuous ESP block vs conventional care in reducing opioid consumption and enhancing respiratory function recovery postcardiac surgery over 72 hours.

Methods:

A retrospective study at a tertiary hospital (January 2021–July 2022) included 262 elective cardiac surgery patients. Fifty-three received a preoperative ESP block, matched 1:1 with a control group (n = 53). The ESP group received 0.5% ropivacaine intraoperatively and 0.16% ropivacaine every 4 hours postoperatively. Outcomes measured were cumulative oral morphine equivalent (OME) dose within 72 hours postextubation, daily maximum numerical rating scale (NRS) ≥3, incentive spirometry volume, and %baseline performance, stratified by surgery type (sternotomy or thoracotomy).

Results:

Significant OME reduction was observed in the ESP group (sternotomy: median decrease of 113 mg, 95% CI: 60–157.5 mg, p < 0.001; thoracotomy: 172.5 mg, 95% CI: 45–285 mg, p = 0.010). The ESP group also had a lower risk of daily maximum NRS ≥3 (adjusted OR sternotomy: 0.22, p < 0.001; thoracotomy: 0.07, p < 0.001), a higher incentive spirometry volumes (sternotomy: mean increase of 149 mL, p = 0.019; thoracotomy: 521 mL, p = 0.017), and enhanced spirometry %baseline (sternotomy: mean increase of 11.5%, p = 0.014; thoracotomy: 26.5%, p < 0.001).

Conclusion:

Continuous ESP block was associated with a reduction of postoperative opioid requirements, lower instances of pain scores ≥3, and improve incentive spirometry performance following cardiac surgery. These benefits appear particularly prominent in thoracotomy patients. Further prospective studies with larger sample size are required to validate these findings.
Current perspectives and trend of computer-aided drug design: a review and bibliometric analysis
Authors: Wu Zhenhui , Chen Shupeng , Wang Yihao , Li Fangyang , Xu Huanhua , Li Maoxing , Zeng Yingjian , Wu Zhenfeng , Gao Yue
Published: March 2024

Aim:

Computer-aided drug design (CADD) is a drug design technique for computing ligand–receptor interactions and is involved in various stages of drug development. To better grasp the frontiers and hotspots of CADD, we conducted a review analysis through bibliometrics.

Methods:

A systematic review of studies published between 2000 and 20 July 2023 was conducted following the PRISMA guidelines. Literature on CADD was selected from the Web of Science Core Collection. General information, publications, output trends, countries/regions, institutions, journals, keywords, and influential authors were visually analyzed using software such as Excel, VOSviewer, RStudio, and CiteSpace.

Results:

A total of 2031 publications were included. These publications primarily originated from 99 countries or regions led by the U.S. and China. Among the contributors, MacKerell AD had the highest number of articles and the greatest influence. The Journal of Medicinal Chemistry was the most cited journal, whereas the Journal of Chemical Information and Modeling had the highest number of publications.

Conclusions:

Influential authors in the field were identified. Current research shows active collaboration between countries, institutions, and companies. CADD technologies such as homology modeling, pharmacophore modeling, quantitative conformational relationships, molecular docking, molecular dynamics simulation, binding free energy prediction, and high-throughput virtual screening can effectively improve the efficiency of new drug discovery. Artificial intelligence-assisted drug design and screening based on CADD represent key topics that will influence future development. Furthermore, this paper will be helpful in better understanding the frontiers and hotspots of CADD.
ChatGPT in medicine: prospects and challenges: a review article
Authors: Tan Songtao , Xin Xin , Wu Di
Published: March 2024

It has been a year since the launch of Chat Generator Pre-Trained Transformer (ChatGPT), a generative artificial intelligence (AI) program. The introduction of this cross-generational product initially brought a huge shock to people with its incredible potential and then aroused increasing concerns among people. In the field of medicine, researchers have extensively explored the possible applications of ChatGPT and achieved numerous satisfactory results. However, opportunities and issues always come together. Problems have also been exposed during the applications of ChatGPT, requiring cautious handling, thorough consideration, and further guidelines for safe use. Here, the authors summarized the potential applications of ChatGPT in the medical field, including revolutionizing healthcare consultation, assisting patient management and treatment, transforming medical education, and facilitating clinical research. Meanwhile, the authors also enumerated researchers’ concerns arising along with its broad and satisfactory applications. As it is irreversible that AI will gradually permeate every aspect of modern life, the authors hope that this review can not only promote people’s understanding of the potential applications of ChatGPT in the future but also remind them to be more cautious about this “Pandora’s Box” in the medical field. It is necessary to establish normative guidelines for its safe use in the medical field as soon as possible.
Testing the validity of three acute care assessment tools for assessing residents’ performance during in situ simulation: the ACAT-SimSit study
Authors: Philippon Anne-Laure , Lefevre-Scelles Antoine , Eyer Xavier , Zumstein Carine , Ghazali Aiham , Audibert Simon , Le Borgne Pierrick , Triby Emmanuel , Truchot Jennifer
Published: March 2024

Background

The assessment of technical and nontechnical skills in emergency medicine requires reliable and usable tools. Three Acute Care Assessment Tools (ACATs) have been developed to assess medical learners in their management of cardiac arrest (ACAT-CA), coma (ACAT-coma) and acute respiratory failure (ACAT-ARF).

Objective

This study aims to analyze the reliability and usability of the three ACATs when used for in situ (bedside) simulation.

Methods

This prospective multicenter validation study tested ACATs using interprofessional in situ simulations in seven emergency departments and invited training residents to participate in them. Each session was rated by two independent raters using ACAT. Intraclass correlation coefficients (ICC) were used to assess interrater reliability, and Cronbach’s alpha coefficient was used to assess internal consistency for each ACAT. The correlation between ACATs’ scores and the learners’ level of performance was also assessed. Finally, a questionnaire and two focus groups were used to assess the usability of the ACATs.

Results

A total of 104 in situ simulation sessions, including 85 residents, were evaluated by 37 raters. The ICC for ACAT-CA, ACAT-coma and ACAT-ARF were 0.95 [95% confidence interval (CI), 0.93–0.98], 0.89 (95% CI, 0.77–0.95) and 0.92 (95%CI 0.83–0.96), respectively. The Cronbach’s alphas were 0.79, 0.80 and 0.73, respectively. The ACAT-CA and ARF showed good construct validity, as third-year residents obtained significantly higher scores than first-year residents (P < 0.001; P < 0.019). The raters supported the usability of the tools, even though they expressed concerns regarding the use of simulations in a summative way.

Conclusion

This study reported that the three ACATs showed good external validity and usability.