bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgical management and final outcomes of chondrosarcoma of the temporomandibular joint: case series and comprehensive literature review
Authors: Oh Hyun Jun , Yoon Hye-Jung , Huh Kyung-Hoe , Kim Bongju , Kwon Ik-Jae , Kim Soung Min , Park Joo Yong , Choi Sung Weon , Lee Jong-Ho
Published: August 2023

Background

Surgical management for chondrosarcoma of the temporomandibular joint (TMJ) is challenging due to the anatomical location involving the facial nerve and the functional joint. The purpose of this case series was to analyze the largest number of TMJ chondrosarcoma cases reported from a single institution and to review the literature about chondrosarcoma involving the TMJ.

Methods

Ten TMJ chondrosarcoma patients at Seoul National University Dental Hospital were included in this study. Radiographic features, surgical approaches, histopathologic subtypes, and treatment modalities were evaluated. All case reports of TMJ chondrosarcoma published in English from 1954 to 2021 were collected under PRISMA guidelines and comprehensively reviewed.

Results

The lesions were surgically resected in all 10 patients with efforts to preserve facial nerve function. Wide excision including margins of normal tissue was performed to ensure adequate resection margins. All TMJs were reconstructed with a metal condyle except one, which was reconstructed with vascularized costal bone. At last follow-up, all patients were still alive, and there had been no recurrence. Among 47 cases (patients from the literature and our cases), recurrence was specified in 43 and occurred in four (9.5%).

Conclusions

For surgical management of TMJ chondrosarcoma, wide excision must consider preservation of the facial nerve. Reconstruction using a metal condyle prosthesis and a vascularized free flap is reliable. A more conservative surgical approach correlates with a favorable prognosis for facial nerve recovery. Nevertheless, wide excision is imperative to prevent tumor recurrence. In cases in which the glenoid fossa is unaffected by the tumor, it is deemed unnecessary to reconstruct the glenoid fossa within an oncological setting.
Influenza A virus infection disrupts oligodendrocyte homeostasis and alters the myelin lipidome in the adult mouse
Authors: Louie Allison Y. , Kim Justin S. , Drnevich Jenny , Dibaeinia Payam , Koito Hisami , Sinha Saurabh , McKim Daniel B. , Soto-Diaz Katiria , Nowak Romana A. , Das Aditi , Steelman Andrew J.
Published: August 2023

Background

Recent data suggest that myelin may be altered by physiological events occurring outside of the central nervous system, which may cause changes to cognition and behavior. Similarly, peripheral infection by non-neurotropic viruses is also known to evoke changes to cognition and behavior.

Methods

Mice were inoculated with saline or influenza A virus. Bulk RNA-seq, lipidomics, RT-qPCR, flow cytometry, immunostaining, and western blots were used to determine the effect of infection on OL viability, protein expression and changes to the lipidome. To determine if microglia mediated infection-induced changes to OL homeostasis, mice were treated with GW2580, an inhibitor of microglia activation. Additionally, conditioned medium experiments using primary glial cell cultures were also used to test whether secreted factors from microglia could suppress OL gene expression.

Results

Transcriptomic and RT-qPCR analyses revealed temporal downregulation of OL-specific transcripts with concurrent upregulation of markers characteristic of cellular stress. OLs isolated from infected mice had reduced cellular expression of myelin proteins compared with those from saline-inoculated controls. In contrast, the expression of these proteins within myelin was not different between groups. Similarly, histological and immunoblotting analysis performed on various brain regions indicated that infection did not alter OL viability, but increased expression of a cellular stress marker. Shot-gun lipidomic analysis revealed that infection altered the lipid profile within the prefrontal cortex as well as in purified brain myelin and that these changes persisted after recovery from infection. Treatment with GW2580 during infection suppressed the expression of genes associated with glial activation and partially restored OL-specific transcripts to baseline levels. Finally, conditioned medium from activated microglia reduced OL-gene expression in primary OLs without altering their viability.

Conclusions

These findings show that peripheral respiratory viral infection with IAV is capable of altering OL homeostasis and indicate that microglia activation is likely involved in the process.
The COVID-19 pandemic and its possible impact on the treatment of odontogenic and intraoral abscesses
Authors: Grill Florian D. , Rothlauf Paulina , Ritschl Lucas M. , Deppe Herbert , Stimmer Herbert , Scheufele Florian , Schwarz Matthias , Wolff Klaus-Dietrich , Fichter Andreas M.
Published: August 2023

Most odontogenic and intraoral abscesses can be treated on an outpatient basis with local anesthesia. However, severe disease progression may require an incision under general anesthesia (GA) with postoperative inpatient treatment. This study aimed to evaluate the first “COVID-19 year” in Germany and compare the first “COVID-19 year” with the two previous years. All consecutive cases with odontogenic or intraoral abscesses treated in an outpatient or inpatient setting between 2018 and 2021 were included in this study. Data were collected, including the type of anesthesia, length of hospital stay, and healthcare costs. Despite the lower total number of abscess treatments in the first year of COVID-19 (n = 298 patients) than that in the two previous years (n = 663 patients), the number of advanced abscesses requiring intervention under GA was significantly higher (p < 0.001). This increased burden of care was also reflected in increased healthcare costs. The measures taken against the COVID-19 pandemic had an impact on the course of other diseases, for example, odontogenic and intraoral abscesses. The results showed an emerging conflict in patient care during the pandemic crisis that should be considered in possible future pandemics.
The relationship of three‐dimensional foot morphology to clinical assessments and postural stability in adolescent male footballers
Authors: Fallon Verbruggen Ferdia , Marenčáková Jitka , Zahálka František
Published: August 2023

Background

Foot morphology is associated with altered loading of the ankle–foot complex in adolescent footballers, predisposing to pain and injury. However, usual singular plane clinical assessments do not accurately capture the 3D nature of foot morphology. A new approach is 3D laser scanning, with statistical shape model techniques creating individual‐to‐group comparison. However, no research exists on the adolescent, football‐playing foot. Furthermore, a link between 3D foot morphology, and usual clinical and performance measures would be beneficial for practical implementation.

Methods

Four hundred forty‐seven 3D foot scans from 224 elite male footballers (U12‐U19) in bilateral stance were collected and further processed with statistical shape model techniques. Weighted shape parameters for individual principal components (Modes) were extracted for each foot. Centre of pressure displacement expressed as total travelled way in millimetres was calculated for bilateral and unilateral postural stability measures. Clinical assessments (Clarke's Angle, Resting Calcaneal Stance Position) were calculated on the 3D foot scans. Differences in weighted shape parameters, postural stability measures, and clinical assessments between age groups were determined by ANOVA. Correlations determined the relationship of Modes and clinical assessments to postural stability measures. Linear regression established if clinical assessments predicted the mode describing foot arch variation.

Results

Age groups significantly differed for Mode 1 (foot length), Mode 2 (foot arch), and Mode 5 (tibial rotation relative to the foot) (p < 0.05). Resting Calcaneal Stance Position (r = .663) and Clarke's Angle (r = ‐.445) were low‐to‐moderately correlated to Mode 2 (both p < 0.001), and linear regression found they were both significant predictors of Mode 2, though only moderately (R2 = .522). There were low correlations of foot morphology to the postural stability tests.

Conclusion

This is the first study to describe the 3D foot morphology of male football‐playing adolescents, and discover the differences between age groups. This will improve understanding and assessment of foot morphology in male adolescents because 2D techniques, as discovered in this study, do not strongly correlate to, nor predict, the 3D foot arch. Foot morphology was only lowly correlated to postural stability, thus a multifaceted program would be required for improvements.
MyKid’sNutrition mobile application trial: a randomized controlled trial to promote mothers’ nutritional knowledge and nutritional status of preschool children with undernutrition—a study protocol
Authors: Hojati Ali , Alesaeidi Sogol , Izadi Saeideh , Nikniaz Alireza , Farhangi Mahdieh Abbasalizad
Published: August 2023

Background

Childhood malnutrition is a crucial public health issue in developing countries. Mothers’ nutritional knowledge significantly affects children’s nutritional status. It also appears that mothers with low health literacy are unable to adequately meet their children’s nutritional needs because they do not clearly understand their children’s nutrition and malnutrition status.

Methods

This randomized controlled trial aims to describe the development and study protocol of the MyKid’sNutrition application, a smartphone-based intervention for mothers of preschool (2–6 years old) children. The application contains several contents on children’s healthy eating, childhood underweight, children’s loss of appetite, and child growth assessment. As part of the MyKid’sNutrition trial, a total of 116 participants will be randomized 1:1 either to (a) treatment as usual and MyKid’sNutrition or (b) treatment as usual alone. The results of this trial will be based on changes in growth indicators and mothers’ nutritional knowledge, attitude, and practice within the groups and the differences between them.

Discussion

Due to their widespread availability throughout society, smartphones can be used to deliver educational content on a large scale at a low cost. In addition, they can provide novel ways for patients to receive support. Hence, it is essential to conduct research studies on these types of interventions. MyKid’sNutrition application offers dietary solutions for such nutritional problems as underweight, loss of appetite, and malnutrition in children. Meanwhile, it provides detailed instructions on how to interact with the child.

Trial registration

IRCT.ir IRCT20140907019082N11. Registered on February 19, 2022.
Effect of postoperative application of esketamine on postoperative depression and postoperative analgesia in patients undergoing pancreatoduodenectomy: a randomized controlled trial protocol
Authors: Yu Kaili , Song Zhenguo , Zhang Bowen , Pan Qian , Gan Shan , Yang Shaoyong , Yang Quanyong , Zuo Xinhua , Yin Yiqing
Published: August 2023

Background

Pancreatoduodenectomy (PD) is traumatic, difficult to perform, and has a high incidence of postoperative complications and perioperative mortality. Postoperative complications and pain occur frequently and seriously affect the psychological status of patients. Esketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, has analgesic and antidepressant effects. In this study, we aim to investigate the effect of esketamine on postoperative depression and pain in patients undergoing PD.

Methods/design

This prospective, single-center, randomized control trial will include 80 patients who will undergo elective PD. The patients will be randomly assigned to two groups: the experimental group that will receive esketamine (n = 40) and the control group (n = 40). In the esketamine group, the analgesic pump will be connected immediately after surgery. A solution of esketamine 1.5 mg/kg + sufentanil 2 µg/kg, diluted to 150 mL, will be administered continuously for 72 h at the background infusion and impact doses of 1 mL/h and 2 mL/time, respectively; the locking time will be 10 min. The control group will receive sufentanil 2 µg/kg that will be administered as per the esketamine group. The primary outcome will be the Hamilton Depression Scale (HAMD-17) score on the third day post-surgery (POD3). Secondary study indicators will include (1) visual analog scale (VAS) score and HAMD-17 score prior to surgery, immediately after entering the postanesthesia care unit (PACU) and 1, 2, 3, 4, and 5 days after surgery; (2) Richmond Agitation-Sedation Scale (RASS) score at 1, 2, 3, 4, and 5 days after surgery; (3) consumed doses of sufentanil and esketamine after surgery; (4) postoperative analgesia pump effective press times, rescue analgesia times, and rescue drug dosage, recording the number of rescue analgesia and rescue drug dosage at 6, 24, 48, and 72 h after the patient enters the PACU; (5) postoperative complications and adverse events; (6) postoperative hospital stay; (7) concentrations of brain-derived neurotrophic factor (BDNP), 5-hydroxytryptamine (5-HT), tumor necrosis factor (TNF-α) and interleukin-6, at 1, 3, and, 5 days post-surgery; and (8) the patient survival rate at 6 and 12 months post-surgery.

Discussion

The study hypothesis is that the postoperative HAMD-17 and VAS scores, incidence of postoperative adverse reactions, and concentration of serum markers BDNP, 5-HT, TNF-α, and IL-6 in the experimental group will be lower than those in the control group.

Trial registration

ClinicalTrials.gov ChiCTR2200066303. Registered on November 30, 2022.

Protocol version: 1.0
Whole lung lavage decreases physiological dead space in patients with pulmonary alveolar proteinosis: two case reports
Authors: Fujihara Tatsuya , Shono Atsuko , Katayama Nozomi , Nikai Tetsuro , Shiratsuki Yohei , Amano Yoshihiro , Saito Yoji
Published: August 2023

Background

Pulmonary alveolar proteinosis (PAP) is a rare disease characterized by progressive accumulation of the alveolar surfactant. Whole lung lavage (WLL) using a high volume of warmed saline remains the standard therapy. However, no established bedside monitoring tool can evaluate the physiological effect of WLL in the perioperative period. Indirect calorimetry, which is generally used to measure resting energy expenditure, can detect carbon dioxide (CO2) production and mixed-expired partial pressure of CO2 breath by breath. In this physiological study, we calculated CO2 elimination per breath (VTCO2,br) and Enghoff’s dead space using indirect calorimetry and measured the extravascular lung water index to reveal the effect of WLL.

Case presentation

We measured VTCO2,br, Enghoff’s dead space, and the extravascular lung water and cardiac indices before and after WLL to assess the reduction in shunt by washing out the surfactant. A total of four WLLs were performed in two PAP patients. The first case involved an Asian 62-year-old man who presented with a 3-month history of dyspnea on exertion. The second case involved an Asian 48-year-old woman with no symptoms. VTCO2,br increased, and the Enghoff’s dead space decreased at 12 h following WLL. An increase in the extravascular lung water was detected immediately following WLL, leading to a transient increase in Enghoff’s dead space.

Conclusion

WLL can increase efficient alveolar ventilation by washing out the accumulated surfactant. However, the lavage fluid may be absorbed into the lung tissues immediately after WLL and result in an increase in the extravascular lung water.
Joint optimization of energy trading and consensus mechanism in blockchain-empowered smart grids: a reinforcement learning approach
Authors: Wang Ruohan , Chen Yunlong , Li Entang , Che Lixuan , Xin Hongwei , Li Jing , Zhang Xueyao
Published: August 2023

Under the trend of green development, the traditional fossil fuel and centralized energy management models are no longer applicable, and distributed energy systems that can efficiently utilize clean energy have become the key to research in the energy field nowadays. However, there are still many problems in distributed energy trading systems, such as user privacy protection and mutual trust in trading, how to ensure the high quality and reliability of energy services, and how to motivate energy suppliers to participate in trading. To solve these problems, this paper proposes a blockchain-based smart grid system that enables efficient energy trading and consensus optimization, enabling electricity consumers to obtain high-quality, reliable energy services and electricity suppliers to receive rich rewards, and motivating all parties to actively participate in trading to maintain the balance of the system. We propose a reputation value assessment algorithm to evaluate the reputation of electricity suppliers to ensure that electricity consumers receive quality energy services. To minimize the cost, maximize the benefit for the electricity suppliers and optimize the system, we present an algorithm based on reinforcement learning DDPG to determine the power supplier, power generation capacity, and consensus mechanism between nodes to obtain power trading rights in each round. Simulation results show that the proposed energy trading scheme has good performance in terms of rewards.
Genomic exploration of coral-associated bacteria: identifying probiotic candidates to increase coral bleaching resilience in Galaxea fascicularis
Authors: Doering Talisa , Tandon Kshitij , Topa Sanjida H. , Pidot Sacha J. , Blackall Linda L. , van Oppen Madeleine J. H.
Published: August 2023

Background

Reef-building corals are acutely threatened by ocean warming, calling for active interventions to reduce coral bleaching and mortality. Corals associate with a wide diversity of bacteria which can influence coral health, but knowledge of specific functions that may be beneficial for corals under thermal stress is scant. Under the oxidative stress theory of coral bleaching, bacteria that scavenge reactive oxygen (ROS) or nitrogen species (RNS) are expected to enhance coral thermal resilience. Further, bacterial carbon export might substitute the carbon supply from algal photosymbionts, enhance thermal resilience and facilitate bleaching recovery. To identify probiotic bacterial candidates, we sequenced the genomes of 82 pure-cultured bacteria that were isolated from the emerging coral model Galaxea fascicularis.

Results

Genomic analyses showed bacterial isolates were affiliated with 37 genera. Isolates such as Ruegeria, Muricauda and Roseovarius were found to encode genes for the synthesis of the antioxidants mannitol, glutathione, dimethylsulfide, dimethylsulfoniopropionate, zeaxanthin and/or β-carotene. Genes involved in RNS-scavenging were found in many G. fascicularis-associated bacteria, which represents a novel finding for several genera (including Pseudophaeobacter). Transporters that are suggested to export carbon (semiSWEET) were detected in seven isolates, including Pseudovibrio and Roseibium. Further, a range of bacterial strains, including strains of Roseibium and Roseovarius, revealed genomic features that may enhance colonisation and association of bacteria with the coral host, such as secretion systems and eukaryote-like repeat proteins.

Conclusions

Our work provides an in-depth genomic analysis of the functional potential of G. fascicularis-associated bacteria and identifies novel combinations of traits that may enhance the coral’s ability to withstand coral bleaching. Identifying and characterising bacteria that are beneficial for corals is critical for the development of effective probiotics that boost coral climate resilience.
BinaRena: a dedicated interactive platform for human-guided exploration and binning of metagenomes
Authors: Pavia Michael J. , Chede Abhinav , Wu Zijun , Cadillo-Quiroz Hinsby , Zhu Qiyun
Published: August 2023

Background

Exploring metagenomic contigs and “binning” them into metagenome-assembled genomes (MAGs) are essential for the delineation of functional and evolutionary guilds within microbial communities. Despite the advances in automated binning algorithms, their capabilities in recovering MAGs with accuracy and biological relevance are so far limited. Researchers often find that human involvement is necessary to achieve representative binning results. This manual process however is expertise demanding and labor intensive, and it deserves to be supported by software infrastructure.

Results

We present BinaRena, a comprehensive and versatile graphic interface dedicated to aiding human operators to explore metagenome assemblies via customizable visualization and to associate contigs with bins. Contigs are rendered as an interactive scatter plot based on various data types, including sequence metrics, coverage profiles, taxonomic assignments, and functional annotations. Various contig-level operations are permitted, such as selection, masking, highlighting, focusing, and searching. Binning plans can be conveniently edited, inspected, and compared visually or using metrics including silhouette coefficient and adjusted Rand index. Completeness and contamination of user-selected contigs can be calculated in real time.

In demonstration of BinaRena’s usability, we show that it facilitated biological pattern discovery, hypothesis generation, and bin refinement in a complex tropical peatland metagenome. It enabled isolation of pathogenic genomes within closely related populations from the gut microbiota of diarrheal human subjects. It significantly improved overall binning quality after curating results of automated binners using a simulated marine dataset.

Conclusions

BinaRena is an installation-free, dependency-free, client-end web application that operates directly in any modern web browser, facilitating ease of deployment and accessibility for researchers of all skill levels. The program is hosted at https://github.com/qiyunlab/binarena, together with documentation, tutorials, example data, and a live demo. It effectively supports human researchers in intuitive interpretation and fine tuning of metagenomic data.
Psychosocial factors and chronic spontaneous urticaria: a systematic review
Authors: Donnelly Jennifer , Ridge Katie , O’Donovan Roisin , Conlon Niall , Dunne Pádraic J.
Published: August 2023

Background

Psychosocial factors have been informally associated with Chronic Spontaneous Urticaria (CSU); however, the relationship between psychosocial factors and CSU remains relatively unexplored in the scientific literature.

Objective

This review aims to provide an evaluation of peer reviewed studies exploring psychosocial factors and CSU.

Methods

A systematic search was performed over four databases identifying studies exploring psychosocial factors in relation to CSU published between the years 1995 and 2022.

Results

Eighteen studies were included for narrative analysis, and 33 psychosocial factors were identified. These were split into two subgroups: psychosocial factors that were associated with CSU symptoms aggravation/onset (n = 20), and psychosocial factors expected to be impacted by CSU symptoms (n = 13).

Conclusion

This review has highlighted a need for more research and interventions to support individuals with psychosocial factors involved in CSU.
Sialendoscopy approach in treating juvenile recurrent parotitis: A systematic review
Authors: Soriano-Martín D. , García-Consuegra L. , Junquera L. , Rodríguez-Santamarta T. , Olay S. , Junquera-Olay S.
Published: August 2023

Background

Juvenile recurrent parotitis (JRP) is characterized by recurrent episodes of painful parotid swelling in children. The purpose of this systematic review was to determine the diagnostic and therapeutic effectiveness of sialendoscopy in children affected by JRP.

Methods

A systematic literature search was performed in PubMed, EMBASE, Scopus and the Cochrane Library until April 2022, without language restrictions or specified start date. Quality assessment was performed using the Newcastle–Ottawa Scale (NOS).

Results

Our review included 524 patients and 646 sialendoscopies. The sample sizes of the different studies ranged from 3 to 77 subjects. Most authors performed sialendoscopy under general anesthesia. The mean percentage of recurrences observed was 25.1% (95% confidence intervals) (CI 23.6–26.6). There was a statistically significant relationship between the number of attacks/year and recurrences ( p < 0.05). The percentage of recurrences according to the type of irrigation/flushing used ranged from 22.2% to 25.2%, with no significant differences between the use of corticosteroids alone (25.2% of recurrences), corticosteroids plus antibiotics (25% of recurrences) or saline alone (22.2% of recurrences). Sialoendoscopy has proved in all cases to be a valid method for the diagnosis of JRP, but it does not allow a reliable differential diagnosis with other autoimmune parotitis such as Sjögren's syndrome.

Conclusion

According to our results, parotid sialoendoscopy was 74.9% effective as a primary treatment in the prevention of recurrent symptoms in JRP. The type of ductal irrigation used did not significantly influence the prognostic outcome.
Caregiver Burden and Its Relationship to Health-Related Quality of Life in Craniopharyngioma Survivors
Authors: Kayadjanian Nathalie , Hsu Eugenie A , Wood Amy M , Carson Dean S
Published: August 2023

Context

Craniopharyngioma (CP) is a rare brain tumor associated with severe comorbidities that reduce survivor health-related quality of life (HRQOL). However, CP impact on caregivers is unknown.

Objective

To measure caregiver burden and examine its relationship to survivor HRQOL and other determinants in CP.

Methods

Eighty-two participants who self-identified as caregivers of CP survivors responded to an online survey including caregiver-reported Pediatric Quality of Life Inventory (PedsQL), and the Zarit Burden Interview (ZBI).

Results

Caregivers reported an average of 13 out of 29 health conditions in survivors following tumor treatment, including excess weight, hypopituitarism, fatigue, mood, cognition, social issues, temperature dysregulation, visual impairment, and sleep problems. Strikingly, 70% of survivors who experienced obesity also experienced hyperphagia. ZBI scores were moderate with a median of 37. PedsQL total scores were poor with a median of 46.2. ZBI scores were independent of caregiver level of education and care duration. Both scores were independent of income, survivor age, gender, age at diagnosis, or tumor recurrence. In contrast, both scores depended on the number (P < .001) and the type of survivor health problems, with significantly worse scores for caregivers or survivors with symptoms of hypothalamic dysfunction (P < .001) including hyperphagia but not obesity. PedsQL total scores significantly predicted ZBI scores (P < .001).

Conclusion

Survivor poly-symptomatology predicted and incurred significant caregiver burden. Our study separated hyperphagia and obesity and identified hyperphagia and other hypothalamic dysfunction symptoms as understudied issues. Altogether, these findings draw particular attention to the unmet needs of CP survivors and their caregivers.
Risk Factors, Management, and Outcome of Gastric Venous Congestion After Total Pancreatectomy: An Underestimated Complication Requiring Standardized Identification, Grading, and Management
Authors: Stoop Thomas F. , von Gohren André , Engstrand Jennie , Sparrelid Ernesto , Gilg Stefan , Del Chiaro Marco , Ghorbani Poya
Published: August 2023

Background

Gastric venous congestion (GVC) after total pancreatectomy (TP) is rarely studied despite its high 5% to 28% incidence and possible association with mortality. This study aimed to provide insight about incidence, risk factors, management, and outcome of GVC after TP.

Methods

This retrospective observational single-center study included all patients undergoing elective TP from 2008 to 2021. The exclusion criteria ruled out a history of gastric resection, concomitant (sub)total gastrectomy for oncologic indication(s) or celiac axis resection, and postoperative (sub)total gastrectomy for indication(s) other than GVC.

Results

The study enrolled 268 patients. The in-hospital major morbidity (Clavien-Dindo grade ≥IIIa) rate was 28%, and the 90-day mortality rate was 3%. GVC was identified in 21% of patients, particularly occurring during index surgery (93%). Intraoperative GVC was managed with (sub)total gastrectomy for 55% of the patients. The major morbidity rate was higher for the patients with GVC (44% vs 24%; p = 0.003), whereas the 90-day mortality did not differ significantly (5% vs 3%; p = 0.406). The predictors for major morbidity were intraoperative GVC (odds ratio [OR], 2.207; 95% confidence interval [CI], 1.142–4.268) and high TP volume (> 20 TPs/year: OR, 0.360; 95% CI, 0.175–0.738). The predictors for GVC were portomesenteric venous resection (PVR) (OR, 2.103; 95% CI, 1.034–4.278) and left coronary vein ligation (OR, 11.858; 95% CI, 5.772–24.362).

Conclusions

After TP, GVC is rather common (in 1 of 5 patients). GVC during index surgery is predictive for major morbidity, although not translating into higher mortality. Left coronary vein ligation and PVR are predictive for GVC, requiring vigilance during and after surgery, although gastric resection is not always necessary. More evidence on prevention, identification, classification, and management of GVC is needed.
Available therapies for the treatment of obesity. Are lifestyle modifications and pharmacotherapy enough to reduce weight? - review of the literature
Authors: Pierzak-Stępień Monika
Published: August 2023

Introduction: The World Health Organization (WHO) defines obesity as "abnormal or excessive accumulation of adipose tissue that poses a health risk". It results from the interdependencies between genetic, cultural, and socio-economic factors. The choice of therapy in the treatment of overweight and obesity depends on body mass index (BMI), individual predispositions, comorbidities and weight history. Among the treatment methods stand out, dietary modification, lifestyle changes, pharmacotherapy, and bariatric surgery. Each of these treatments can be used individually or as a combination treatment using knowledge of physiology.
The aim of the study is to assess the effectiveness of overweight and obesity treatment using pharmacotherapy and lifestyle modification.
Material and Methods: The research material was collected by searching databases with scientific articles about obesity, pharmacotherapy in obesity, the impact of lifestyle modifications, behavioral behavior, and physical activity on the reduction of body fat. The scientific database Pubmed and Web of Science were used. Research articles, systematic reviews and meta-analyses were included.
 Summary Obesity is an epidemic of the 21st century, bringing with it several negative consequences. Prevention of the disease, quick diagnosis, and implementation of appropriate treatment to reduce unnecessary fat and excess weight are extremely important. Lifestyle change including dietary modification, physical activity and pharmacotherapy are promising treatments for overweight and obesity.
A pill full of sunshine. Vitamin D supplementation among polish students
Authors: Gaik Magdalena , Gazda Dawid , Bogacz Rafał , Uram Ewa , Woźniak Justyna , Womperski Karol , Magda Inga , Osuch Magdalena
Published: August 2023

Introduction and purpose of work:

Vitamin D has a significant impact on the functioning of the human body. Vitamin D deficiency is a public health problem worldwide in all age groups including Poland. Supplementation is recommended in the general population with the use of cholecalciferol and should be individualized depending on age, body weight, the sun exposure, diet, and lifestyle.

The aim of study was to analyze vitamin D supplementation habits among polish students in two divided groups: medical students and non-medical students.

Methods:

The tool used to carry out the research was a specially constructed, online questionnaire. The survey was completed by 244 students, 126 of whom supplement vitamin D. Pearson’s χ2 test was used to analyze the survey’s results. The processing of the obtained data, statistical calculation and graphs were made using the R program.

Results and conclusions:

Students of medical faculties are more likely to take vitamin D supplements than students of other faculties. They are significantly more likely to adjust the dose of supplementation to the current guidelines. In 87% of students who tested the level of vitamin D in the blood serum and remember their result, the level of the parameter is ≥30 ng/ml (75 nmol/L), which is below the optimal level for this particular age group. Supplementation improves the quality of life, the benefits of supplementation were noticed by 71.4% of all students. It is necessary to promote the prophylactic habit of vitamin D supplementation.
Improving knowledge of continence care to prevent skin damage associated with incontinence
Authors: Peart Joanna
Published: August 2023

Older people are at an increased risk of developing skin damage related to incontinence, including pressure ulceration and incontinence-associated dermatitis (IAD). Factors exacerbating risk in older people include: a higher rate of faecal and urinary incontinence, reduced mobility, long-term conditions and changes to skin barrier function, as a result of the ageing process. Nurses have a key role to play in the assessment of continence, IAD prevention and management. This article explores nursing knowledge in relation to continence care on six inpatient wards for older people, and describes the implementation of improvement strategies, in order to reduce voidable harm.
The vascular system and associated disorders
Authors: Mitchell Aby , Hill Barry
Published: August 2023

The vascular system, also called the circulatory system, is made up of the vessels that carry blood and lymph fluid through the body. The arteries and veins carry blood all over the body, sending oxygen and nutrients to the body tissues and taking away waste materials. This is a complex system in the body and can be affected by diseases with different pathogenic mechanisms. This article describes the pathophysiology of the main diseases of arteries and the venous system.
Reducing missed medications in surgical patients
Authors: Williams George , Halstead Anna
Published: August 2023

Elective surgical patients need accurate drug charts to reduce missed medication doses, decreasing the chance of peri-operative complications. The quality improvement project described in this article used four interventions to improve the percentage of missed medication doses. A driver diagram was produced to interrogate the current pathway which highlighted multiple interventions, including changes to elective pro formas, the initial clerking process and nurse-based prescribing. Once implemented, a plan-do-study-act (PDSA) cycle was completed as per NHS Improvement guidelines. Overall, missed medication dose percentage decreased from 9.8% to 0% after the interventions. Two of these changes have been deemed sustainable and have been integrated into elective patient pathways, improving both patient safety and streamlining surgical elective patient services. This project highlights the importance of prescribing practice in a multidisciplinary team. Simple changes to established systems allow for better patient care, and the authors' project provides evidence that empowering nursing staff to take the lead in the medication management of patients can reduce the likelihood of negative outcomes in a patient's admission.
Embedding the A-EQUIP model of restorative supervision in a critical care unit by professional nurse advocates
Authors: Wade Rachel
Published: August 2023

The professional nurse advocate (PNA) programme was launched in March 2021, which was towards the end of the third wave of COVID-19 and the start of a critical point of recovery. COVID-19 placed exceptional challenges and pressure on healthcare staff, with many experiencing feelings of stress and burnout. The role of the PNA emerged as a response to the impact this had upon the nursing workforce. PNAs are trained to facilitate restorative clinical supervision and to advocate education for quality improvement, resulting in improvements to patient care and staff wellbeing. The programme started with 400 critical care nurses; since then it has been rolled out to all specialties, with the aim to have 5000 PNAs integrated into the national workforce by April 2022. Criteria for the level 7 PNA training programme requires a registered nurse to be working in a patient-facing role, at band 5 or above, hold a level 6 qualification and have approval from their line manager. The training programme is typically 10 to 12 days in length over a 12-week period. This article explores the implementation of the PNA role in a critical care unit.
Impact of an educational intervention for advanced cancer patients referred for early phase clinical trials
Authors: Hood Ben , Plummer Ruth , Hogarth Linda , Brown Gary , Porteous Helen , Armstrong Alan , Grice Carole , Barron Chris
Published: August 2023

A 2017 service evaluation identified a lack of information and knowledge among patients who were referred on to early phase oncology clinical trials ( Hood, 2020 ). An educational booklet was developed to improve patients' knowledge and experience. To build upon this work, a patient co-designed website was developed. This study examined the impact, if any, of a patient co-designed educational intervention within the clinical pathway for patients who are referred for an early phase oncology clinical trial at an experimental cancer medicine centre (ECMC). Aims: 1. To understand the experiences of patients who have been referred to an ECMC for an early phase clinical trial pre- and post-intervention. 2. To investigate if the intervention reduced anxiety levels in newly referred patients. Method: A convergent mixed-methods design was used in this study, to collect quantitative and qualitative data in parallel. Outcomes: This study examined the experiences of advanced cancer patients who attended their initial research outpatient appointment to discuss the possibility of taking part in an early phase clinical trial and the impact of an educational resource.
Venous and lymphovenous lower limb wound outcomes in specialist UK wound and lymphoedema clinics
Authors: Gray David , Stanton Julie , Rouncivell David , McRobert John
Published: August 2023

This article explores the impact of combining tissue viability and lymphoedema techniques on optimising time to healing. Aim: To investigate the healing rates observed in patients who presented to wound and lymphoedema specialist clinics, located in the south eastern region of England, with venous/lymphovenous ulceration of the lower limb during the COVID-19 pandemic in 2020–2022 (30 months in all). Methodology: A retrospective analysis of patient outcomes. Results: 1041 patients were referred to the service, with a healing rate of 88.5% over 78 days. Discussion: When comparing 2013–2019 healing rates/time to healing vs 2020–2022 there was a decrease of 1.5% in the rate of healing and a mean reduction in time to healing of 40 days. Conclusion: Despite the pandemic the service was able to maintain previous levels of outcomes and observed a decrease in the mean time to healing.
Implementing a new regimen to manage a difficult-to-heal lymphovenous leg ulcer
Authors: Stanton Julie
Published: August 2023

The case study described in this article shows the use of different approaches and techniques that need to be utilised when treating patients presenting with a combination of venous and lymphatic disease (lymphovenous) in order to improve complex wound outcomes. The author highlights how lymphoedema can affect the wound healing process by increasing the risk of recurrent infection and a hardening of the tissues (fibrosis), reducing oxygenation and lymphatic flow to the wound, leading to chronic complex wounds.
Use of a prescribed exercise intervention as an adjunct to improve venous leg ulcer healing
Authors: Quirk Kirstie
Published: August 2023

Background:

The complex healing process of venous leg ulcers (VLUs) is widely documented, yet wound healing outcomes continue to challenge community nurses. Compression therapy remains the ‘gold standard’ to improve healing outcomes. However, the complexities surrounding VLUs demand a holistic and unified approach. Advising patients with VLUs to perform exercises is a widely accepted practice based on the known benefits of lower leg mobility reducing venous hypertension. A lack of standardisation surrounding this subject has generated a rise in academic interest over the past decade, particularly in the benefit of a prescribed exercise intervention (PEI) as an adjunct to compression for VLU patients.

Aim:

This review explored the use of an unsupervised PEI as an adjunct to improve VLU healing in housebound patients wearing compression therapy. The aim was to determine if a PEI is beneficial to VLU healing alongside compression therapy.

Results:

The review identified five randomised controlled trials (RCT) between 2009 and 2022. Although the evidence showed some limitations, statistically and clinically significant results were identified for VLU healing outcomes.

Conclusion:

A PEI designed to engage the calf muscle pump is beneficial to improve VLU healing outcomes, alongside compression therapy, for housebound patients and should be included in the community nursing holistic model of care for VLU management.
Exploring the integration of art and technology
Authors: Nairn Angelique , Matthews Justin
Published: August 2023

The integration of art and technology has emerged as a formidable force in the creative realm, presenting a wide array of opportunities and challenges. With the advent of the internet, collaborative artistic practices have flourished, while financial burdens on artists have been alleviated through democratized production software, reducing their reliance on corporate entities. Technology has empowered artists with increased creative freedom and direct engagement with their fans through social media platforms. Nevertheless, concerns have been raised regarding the authenticity of creative practices, sparking debates about the appropriate extent of technological intervention. The mainstream acceptance of artificial intelligence (AI) and augmentation technologies has further transformed the creative landscape. AI tools now cater to both professionals and amateurs, enabling diverse creative endeavours, ranging from the generation of visual art to assisting in music composition. This Special Issue delves into the profound changes that technology has brought to artistic and creative expression. The articles explore topics such as AI-generated communication, the role of AI in advertising campaigns, AI tools in music composition, technological innovations in art, light augmentation in urban spaces, augmented reality (AR) in literature and the integration of AR in design magazines. The overarching aim is to stimulate critical discussions regarding the future of art, creativity and the implications of technological advancements.
Weizenbaum’s nightmare: The decay of language in AI-generated communication
Authors: McIntyre Andrew
Published: August 2023

Half a century on from the ELIZA program, with the rapid and widespread emergence of generative artificial intelligence (AI) programs, we are now on the cusp of realizing Joseph Weizenbaum’s nightmare: an absurd world that is not only populated by machines that can convincingly simulate human communication in its various forms (e.g. writing, visual art, performance and music) but in which these machines are readily accepted as authentic replacements. Drawing on the existentialist language philosophy of Vilém Flusser, this article argues that to defer cultural communication to generative AI programs is to step outside the ‘great conversation’ of human culture and to be condemned to an unutterable nothingness. To demonstrate this, I analyse several illustrative examples including Google’s Language Model for Dialogue Applications (LaMDA) language model, the text-based roleplaying game AI Dungeon (Latitude 2019), and the art installation UUmwelt (Huyghe 2018). I argue that generative AI programs only appear to ‘speak’ in a language we understand while continuing to ‘think’ in the formal language of mathematics and that their communications are merely transliterations of numbers. As such, these programs are not bound by the same moral and syntactical rules that we observe and abide by in cultural communication, and in using generative AI programs, we may very well bypass these rules to express raw intention. Though mechanized in the form of technical images, such a mode of expression would be akin to the nonsensical cries of animals in that it fulfils a fundamental desire but reveals nothing of a consciousness within. By deferring the labour of communication to an AI program, the human retreats inward and disappears from culture as they ‘speak’ in one language but ‘think’ in another. Thus, the nightmarish future that Weizenbaum envisioned is one filled with illusions of artistic expression, projected by both machines and humans, and yet there is no evidence of humanity in such a culture.
The future of advertising campaigns: The role of AI-generated images in advertising creative
Authors: Matthews Justin , Fastnedge Daniel , Nairn Angelique
Published: August 2023

Computational creativity is a growing component of new artificial intelligence (AI) technologies that allow a machine to render creative constructs such as music, text and images. A rapidly growing area of computational creativity is AI text-to-image engines capable of producing realistic imagery that can now meet the standard of human quality outputs. DALL-E 2, built by OpenAI, is a leader in the field and offers commercial access to AI-produced images. To understand the impact of engines such as DALL-E 2 on advertising agencies and their creative workflows, we conducted a series of focus groups with Aotearoa, New Zealand-based advertising agencies exploring creative practitioners’ considerations on the capability of the DALL-E 2 text-to-image technology. An existing Volkswagen advertising campaign called ‘Small but Ferocious’ that used ‘blended’ animals as a visual metaphor for their economical yet powerful ‘TSI’ engines was expanded in a ‘faux’ continuation of the campaign. Four new images produced by DALL-E 2 were presented to creatives attending the focus groups. Participants were then asked about these new creative-AI assets concerning image quality, creative production and collaborative models. A thematic analysis of the comments from the focus groups was conducted and elicited three themes: aesthetics, creative practice and human vs. machine. Participants’ responses revealed that they were both excited and concerned about DALL-E 2’s capability in image production, its effect on creative workflows and the role of the human vs. machine in generating creative outputs. The result was a clear sense of inevitability for how creative roles will change as computational creativity systems, such as DALL-E 2, advance and are adopted into agency workflows.