bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictors of post-operative pancreatic fistula after pancreaticoduodenectomy: systematic review and meta-analysis protocol
Authors: Adetunji Busayo , Afolabi Samson , Alare Kehinde , Adeleke Oluwatimilehin , Owonikoko Abdulsalam , Adegbesan Abiodun , Damola-Okesiji Adebola , Olakunde Tomilola , Adewumi Adetayo , Adekanmbi Azeezat , Agbama Joseph , Ibiyemi Oluwaseun , Kokogho Eromo , Uwoghiren Ogbemudia
Published: November 2024

Pancreaticoduodenectomy is the standard treatment for resectable pancreatic head and periampullary cancers. Despite advancements, post-operative pancreatic fistula (POPF) remains a significant complication. The pathophysiology of POPF is multifactorial, involving patient-related factors, surgical technique, and postoperative management. Identifying reliable predictors for POPF is crucial for risk stratification and improving patient outcomes. This study aims to systematically review the literature and perform a meta-analysis to identify the most consistent and significant predictors of POPF following pancreaticoduodenectomy. The objectives are to evaluate preoperative, intraoperative, and postoperative factors and determine their relative importance and strength of association with POPF. This systematic review and meta-analysis will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and is registered with PROSPERO. The systematic review and meta-analysis will also follow the Population, Intervention, Comparators and Outcomes framework. A comprehensive literature search will be conducted across PUBMED, SCOPUS, and the Cochrane Library. Studies will be selected based on inclusion criteria, and data will be extracted and assessed for quality using standardized tools. Meta-analysis will be performed using a random-effects model, and the confidence in cumulative evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation approach.
APOE ε4 and Dietary Patterns in Relation to Cognitive Function: An Umbrella Review of Systematic Reviews
Authors: Urich Thomas J , Tsiknia Amaryllis A , Ali Nada , Park Jackson , Mack Wendy J , Cortessis Victoria K , Dinalo Jennifer E , Yassine Hussein N
Published: November 2024

Context

Carrying the apolipoprotein ε4 allele (APOE ε4) is the strongest genetic risk factor for late-onset Alzheimer’s disease. There is some evidence suggesting that APOE ε4 may modulate the influence of diet on cognitive function.

Objective

This umbrella review of systematic reviews evaluates the existing literature on the effect of dietary interventions on cognitive and brain-imaging outcomes by APOE status.

Data Sources

PubMed, EMBASE, Web of Science, and Scopus were searched using terms appropriate to each area of research, from their respective starting dates of coverage until March 2023.

Data Extraction

Two independent reviewers conducted data extraction and performed a quality appraisal using the Measurement Tool to Assess Systematic Reviews (AMSTAR) 2

Data Analysis

Six total reviews were included in the final analysis. Four reviews evaluated randomized controlled trials on individuals aged 50–93 years ranging the entire cognitive continuum. One review combined observational studies and clinical trials conducted on both cognitively healthy and cognitively impaired individuals (age range: 50–90), and 1 review included observational studies of both cognitively healthy and cognitively impaired adults (age range: 50–75).

Results

Both observational studies and clinical trials yielded inconclusive results attributed to both practical limitations associated with longitudinal follow-up and issues of methodological quality. Except for the Mediterranean diet, dietary interventions, such as the ketogenic diet, nutraceuticals, and supplements, were generally not effective in older APOE ε4 carriers. This review considers plausible biological mechanisms that might explain why older and cognitively impaired APOE ε4 carriers were less likely to benefit.

Conclusion

This review identifies notable gaps in the literature, such as a shortage of studies conducted in middle-aged and cognitively healthy APOE ε4 carriers assessing the impact of dietary interventions and provides suggestions for novel trial designs.
Introduction
Authors: Kurzman Charles
Published: November 2024

“Liberal Islam” may sound like a contradiction in terms. For centuries, the West has identified Islam with its most exotic elements. Islamic faith is equated with fanaticism, as in Voltaire’sMahomet, or Fanaticism (1745). Islamic political authority is equated with despotism, as in Montesquieu’s intentionally redundant phrase “Oriental despotism” or Francis Bacon’s definition (1612): “A monarchy, where there is no nobility at all, is ever a pure and absolute tyranny; as that of the Turks.” Islamic military practices are equated with terror and rape, as in Eugene Delacroix’s famous painting “Massacre at Chios” (1824). Islamic tradition is equated with backwardness and primitiveness, as in Ernest Renan ‘s inaugural lecture at the College de France (l 862), one of the founding documents of modem Orientalism: Islam is the complete negation of Europe ... Islam is the disdain of science, the suppression of civil society; it is the appalling simplicity of the Semitic spirit, restricting the human mind, closing it to all delicate ideas, to all refined sentiment, to all rational research, in order to keep it facing an eternal tautology: God is God.
The Indonesian Revolution
Authors: Natsir Muhammad
Published: November 2024

Born in Sumatra, Muhammad Natsir (Indonesia, 1908-1993) was among the first Indonesians to receive a European education. He combined this Western training with his Islamic beliefs to create a modernist interpretation of Islam, which he promoted as leader of the modernist wing of the Consultative Congress of Indonesian Muslims (the Masjumi party) during the 1940s and I 950s.1 After Indonesia regained its independence, Natsir rose to the prime ministership, serving for a year in 1950-1951. Thereafter, through his speeches and interviews, he “became identified as the champion of liberal parliamentary democracy.” In the following essay from 1955, Natsir urges Muslims to accept the secular Indonesian state (analogous to the Kabir and Zafar essays in this volume). In 1958, Natsir appears to have abandoned these views, siding with an Islamic revolutionary movement in Sumatra, serving several years in prison, and emerging with far more rigid theological positions. The younger generation of Indonesian Islamic reformers, represented by Nurcholish Madjid in this volume, viewed Natsir as a recalcitrant member of the old guard.
Rethinking Islam Today
Authors: Arkoun Mohamed
Published: November 2024

Mohamed Arkoun (Algeria-France, born 1928) received his doctorate at the Sorbonne in Paris and joined the faculty there as Professor of Islamic Thought in 1963. In a series of works since the early 1970s, Arkoun has attempted to reshape Islamic interpretation through the use of contemporary social-scientific, particularly linguistic, methods. “One of the most articulate ... liberal Muslims,”1 Arkoun has embarked on “an intellectual cru sade,”2 engaging Islamic radicals in debate and arguing for pluralism within Islam, acceptance of multiple interpretations of the sacred texts, and a more self-conscious attitude toward one’s own interpretation. The following chapter serves as an introduction to and summary of Arkoun’s work: its style is somewhat more accessible than his French work. age and initiate audacious, free, productive thinking on Islam today. The so-called Islamic revivalism has monopolized the discourse on Islam; the social scientists, moreover, do not pay attention to what I call the “silent Islam”-the Islam of true believers who attach more importance to the religious relationship with the absolute of God than to the vehement demonstrations of political movements.
Détermination du domaine d’application du principe dit de l’Or monétaire dans le droit de la Cour internationale de Justice
Authors: Kolb Robert
Published: November 2024

Since 1954, the ICJ has introduced in its jurisprudence the “Monetary Gold” principle. According to this principle, the Court cannot exercise a jurisdiction regularly conferred if it must, in order to decide the dispute having been submitted to it, first decide on the legal position of a third state that has not given its consent to the Court doing so. In an interconnected word where the jurisdiction of the Court is already frustrated by the rarity of required consent or by many reservations engrafted upon the various titles of jurisdiction, it has proven necessary in practice the reduce the potentially toxic scope of a “Monetary Gold” principle writ too large. This contribution considers the stages through which the Court progressively tamed the principle, either by tuning down its reach through well-calibrated carve-outs (e.g., the Nauru jurisprudence) or by affirming that consent had been somehow in effect conferred (the recent Guyana/Venezuela jurisprudence). The true and current scope of the principle is thereby reassessed.
Reparations for Internationally Wrongful Acts Against the Sámi Indigenous People
Authors: Lingaas Carola
Published: November 2024

Interstate reparation aims to amend internationally wrongful acts and restore the situation status quo ante. Yet, in cases of forceful assimilation, the pre-existing situation cannot be restored. This paper explores reparation beyond human rights law for the Sámi Indigenous people in Norway, who were exposed to a century-long forced assimilation. It explores two theoretical strands: (1) traditional reparation for international wrongful acts against the Sámi; and (2) independent sovereign claims to reparation for non-state entities. In the first strand, the paper critically discusses compensation, restitution, and satisfaction by using historical examples from Sápmi. It questions the usefulness and the implications for reparations of the doctrine of intertemporality in cases of past and ongoing colonialism. In the second strand, the elements of statehood are applied to the case of the Sámi, considering their permanent population, defined territory, effective government, and ability to enter into international relations. The paper concludes that the rules of state responsibility and their current interpretation are unsuitable to address historical and systemic injustices that the state inflicted upon its own Indigenous population and calls for decolonial and indigenous perspectives on reparation as well as a re-evaluation of the role of states in granting reparation.
WTO Dispute Settlement System (WTO DSS)
Authors: Gomula Joanna
Published: November 2024

In 2022–2023, the crisis of the WTO dispute settlement continued. The Appellate Body remained dysfunctional, with the pile of appealed panel reports constantly increasing and the number of disputes notified to the WTO Dispute Settlement Body (DSB) falling dramatically. However, despite this situation, two panel reports were adopted in this period, both concerning trade remedies (safeguards and anti-dumping measures). Moreover, the Multi-Party Interim Appeal Arbitration Arrangement (MPIA) was inaugurated by its first completed appeal in a dispute between MPIA participants, the European Union and Colombia. The MPIA arbitration panel upheld most of the WTO panel’s findings and proposed a revised approach to the deferential standard of review in Article 17.6 of the Anti-Dumping Agreement. Thus, despite the ongoing crisis, there were some, albeit small, developments in WTO dispute settlement.
ECOWAS Community Court of Justice (ECCJ)
Authors: Kufuor Kofi Oteng
Published: November 2024

The Economic Community of West African States (ECOWAS) has a human rights mandate. Its constitutive Treaty of 1993 includes as one of its principles the recognition, promotion, and protection of human and peoples’ rights in accordance with the provisions of the African Charter on Human and Peoples’ Rights. The ECOWAS Community Court of Justice was established by Protocol in 1991 and heard its first case in 2001. Through its jurisprudence it has interpreted and clarified the rights of ECOWAS nationals. It has also lowered the barriers to access and has further expanded the range of persons who can come before it. The Court has also clarified its relationship with the national courts of its member states.
Osmotic stress in roots drives lipoxygenase-dependent plastid remodeling through singlet oxygen production
Authors: Cohen-Hoch Dekel , Chen Tomer , Sharabi Lior , Dezorella Nili , Itkin Maxim , Feiguelman Gil , Malitsky Sergey , Fluhr Robert
Published: November 2024

Osmotic stress, caused by the lack of water or by high salinity, is a common problem in plant roots. Osmotic stress can be reproducibly simulated with the application of solutions of the high-molecular-weight and impermeable polyethylene glycol. The accumulation of different reactive oxygen species, such as singlet oxygen, superoxide, and hydrogen peroxide, accompany this stress. Among them, singlet oxygen, produced as a byproduct of lipoxygenase activity, has been associated with limiting root growth. To better understand the source and effect of singlet oxygen, we followed its production at the cellular level in Arabidopsis (Arabidopsis thaliana). Osmotic stress initiated profound changes in plastid and vacuole structure. Confocal and electron microscopy showed that the plastids were a source of singlet oxygen accompanied by the appearance of multiple, small extraplastidic bodies that were also an intense source of singlet oxygen. A marker protein, CRUMPLED LEAF, indicated that these small bodies originated from the plastid outer membrane. Remarkably, LINOLEATE 9S-LIPOXYGENASE 5 (LOX5) was shown to change its distribution from uniformly cytoplasmic to a more clumped distribution together with plastids and the small bodies. In addition, oxylipin products of Type 9 lipoxygenase increased, while products of Type 13 lipoxygenases decreased. Inhibition of lipoxygenase by the salicylhydroxamic acid inhibitor or in downregulated lipoxygenase lines prevented cells from initiating the cellular responses, leading to cell death. In contrast, singlet oxygen scavenging halted terminal cell death. These findings underscore the reversible nature of osmotic stress-induced changes, emphasizing the pivotal roles of lipoxygenases and singlet oxygen in root stress physiology.
Metabolic flux analysis to increase oil in seeds
Authors: Mukherjee Thiya , Kambhampati Shrikaar , Morley Stewart A , Durrett Timothy P , Allen Doug K
Published: November 2024

Ensuring an adequate food supply and enough energy to sustainably support future global populations will require enhanced productivity from plants. Oilseeds can help address these needs; but the fatty acid composition of seed oils is not always optimal, and higher yields are required to meet growing demands. Quantitative approaches including metabolic flux analysis can provide insights on unexpected metabolism (i.e. when metabolism is different than in a textbook) and can be used to guide engineering efforts; however, as metabolism is context specific, it changes with tissue type, local environment, and development. This review describes recent insights from metabolic flux analysis in oilseeds and indicates engineering opportunities based on emerging topics and developing technologies that will aid quantitative understanding of metabolism and enable efforts to produce more oil. We also suggest that investigating the key regulators of fatty acid biosynthesis, such as transcription factors, and exploring metabolic signals like phytohormones in greater depth through flux analysis could open new pathways for advancing genetic engineering and breeding strategies to enhance oil crop production.
Quantum Entanglement to Extract a True Ground State from an Approximate Ground State
Authors: Oshima Kazuto
Published: November 2024

We propose a procedure to extract a true ground state from an approximate ground state by using quantum entanglement. We use plural ancilla qubits with hierarchical structure, intending to gradually improve the precision of the approximation. We demonstrate the procedure for quantum systems with a few qubits that derive from the (1+1)-dimensional Schwinger model by classically emulated digital quantum simulation. Although we use for simplicity an approximate ground state prepared by adiabatic quantum computation, our procedure is applicable to any approximate ground state that is a superposition of a true ground state and excited states. Our procedure is applicable for an $N$-qubits Hamiltonian with a nondegenerate ground state.
Upregulation of ACSL, ND75, Vha26 and sesB genes by antiepileptic drugs resulted in genotoxicity in drosophila
Authors: Shamapari R , Nagaraj K
Published: November 2024

Clobazam (CLB) and Vigabatrin (VGB) are commonly used antiepileptic drugs (AEDs) in the treatment of epilepsy. Here, we have examined the genotoxic effect of these AEDs in Drosophila melanogaster. The Drosophila larvae were exposed to different concentrations of CLB and VGB containing food media. The assessment encompassed oxidative stress, DNA damage, protein levels, and gene expression profiles. In the CLB-treated group, a reduction in reactive oxygen species (ROS) and lipid peroxidation (LPO) levels was observed, alongside increased levels of superoxide dismutase (SOD), catalase (CAT), and nitric oxide (NO). Conversely, the VGB-treated group displayed contrasting results, with increased ROS and LPO and decreased SOD, CAT, and NO levels. However, both CLB and VGB induced DNA damage in Drosophila. Proteomic analysis (SDS-PAGE and OHRLCMS) in the CLB and VGB groups identified numerous proteins, including Acyl-CoA synthetase long-chain, NADH–ubiquinone oxidoreductase 75 kDa subunit, V-type proton ATPase subunit E, ADP/ATP carrier protein, malic enzyme, and DNA-binding protein modulo. These proteins were found to be associated with pathways like growth promotion, notch signaling, Wnt signaling, neuromuscular junction (NMJ) signaling, bone morphogenetic protein (BMP) signaling, and other GABAergic mechanisms. Furthermore, mRNA levels of ACSL, ND75, Vha26, sesB, and Men genes were upregulated in both CLB and VGB-treated groups. These findings suggest that CLB and VGB could have the potential to induce genotoxicity and post-transcriptional modifications in humans, highlighting the importance of monitoring their effects when used as AEDs.
Hippocampal cannabinoid type 2 receptor alleviates chronic neuropathic pain‐induced cognitive impairment via microglial DUSP6 pathway in rats
Authors: Xu Lichi , Zhu Afang , Xu Shuxiang , Zhao Jiale , Song Shujia , Zhu He , Huang Yuguang
Published: November 2024

Approximately 50% of patients with chronic neuropathic pain experience cognitive impairment, which negatively impacts their quality of life. The cannabinoid type 2 receptor (CB2R) may be involved in hippocampal cognitive processes. However, its role in chronic neuropathic pain‐induced cognitive impairment remains elusive. Spared nerve injury (SNI) was used to induce chronic neuropathic pain in rats, while the novel‐object recognition test and the Y‐maze test were employed to assess cognitive function. Immunofluorescence, western blotting, and stereotaxic hippocampal microinjection were utilized to elucidate the potential mechanisms. We observed a reduction in mechanical pain threshold and cognitive impairment in SNI rats. This was accompanied by a tendency for hippocampal microglia to adopt pro‐inflammatory functions. Notably, no changes were detected in CB2R expression. However, downregulation of the endogenous ligands AEA and 2‐AG was evident. Hippocampal microinjection of a CB2R agonist mitigated cognitive impairment in SNI rats, which correlated with a tendency for microglia to adopt anti‐inflammatory functions. Additionally, SNI‐induced activation of the p‐ERK/NFκB pathway in the hippocampus. Activation of CB2R reversed this process by upregulating DUSP6 expression in microglia. The effects elicited by CB2R activation could be inhibited through the downregulation of microglial DUSP6 via hippocampal adeno‐associated virus (AAV) microinjection. Conversely, overexpression of hippocampal DUSP6 using AAV ameliorated the cognitive deficits observed in SNI rats, which remained unaffected by the administration of a CB2R antagonist. Our findings demonstrate that activation of hippocampal CB2R can mitigate chronic neuropathic pain‐induced cognitive impairment through the modulation of the DUSP6/ERK/NFκB pathway.
Complications, Costs, and Health Care Resource Use with Tissue Biopsy Followed by Liquid Biopsy Versus Tissue Re-biopsy in Patients With Newly Diagnosed Metastatic Nonsmall-cell Lung Cancer
Authors: Shah Anne , Apple Jon , Aslam Saad , Engel-Nitz Nicole M. , Le Lisa , Terpenning Marilou
Published: November 2024

Objectives:

We compared complications, costs, and health care resource utilization (HCRU) of patients with newly diagnosed metastatic nonsmall-cell lung cancer (mNSCLC) who had a tissue biopsy followed by either liquid biopsy (TFLB) (identified with a novel algorithm) or tissue re-biopsy (TRB).

Methods:

This claims-based retrospective analysis included commercial and Medicare Advantage members in the Optum Research Database with mNSCLC (January 2017 to June 2021) and ≥2 tissue biopsy claims (7 to 90 d apart) (TRB) or ≥1 tissue and ≥1 liquid biopsy claim within 90 days (TFLB). Patients in the TFLB group were matched 1:1 to patients in the TRB group using propensity score matching. Surgical biopsy-related complications and complication-related and all-cause medical costs and HCRU during the 6-month follow-up were compared.

Results:

Both groups had 235 patients post-match. During the follow-up, the surgical biopsy-related complication rate was lower in the TFLB group than the TRB group (65.1% [153/235] vs. 84.7% [199/235], P<0.001). Mean complication-related medical costs were significantly lower with TFLB ($8494 vs. $19,741, P<0.001) during the follow-up; mean (SD) duration of complication-related inpatient stays was significantly lower with TFLB (3.5 [7.0] vs. 6.6 [13.3] d, P=0.002). Mean all-cause medical costs were not significantly different between the groups; the TFLB group had fewer all-cause inpatient stays, inpatient days, and outpatient visits.

Conclusions:

Multiple tissue biopsy procedures may be associated with significantly higher biopsy complication rates, higher complication-related medical costs, and longer complication-related inpatient stays than TFLB. All-cause medical costs were similar between groups.
Marijuana and Its Implications in Breast Reduction Surgery Outcomes and Quality of Life: A Matched Analysis
Authors: Ewing Jane N. , Amro Chris , Chang Ashley , Gala Zachary , Lemdani Mehdi S. , Broach Robyn B. , Fischer John P. , Serletti Joseph M. , Azoury Saïd C.
Published: November 2024

Background:

With marijuana use on the rise, its influence on surgical outcomes, particularly for breast reduction, warrants investigation. This study aims to clarify marijuana’s effects on breast reduction surgery outcomes, given its limited research focus despite potential perioperative implications.

Methods:

A retrospective review was conducted from 2016 to 2022 of patients with/without marijuana use undergoing breast reduction. Propensity score-matching considered age, body mass index, ptosis, and breast tissue mass. Patient demographics, clinical attributes, and postoperative details were analyzed. Quality-of-life (QoL) changes were gauged using pre- and postoperative BREAST-Q.

Results:

Of 415 patients who underwent breast reduction, 140 patients documented marijuana use. After propensity matching, a total of 108 patients (54 marijuana users versus 54 nonusers) were analyzed. The average age was 39 years ± 12 and body mass index 30.1 kg/m2 ± 5.3. There were no differences between the 2 groups in comorbidities, breast symmetry, excision patterns, pedicle use, or drain count (P > 0.05). Furthermore, surgical outcomes including surgical site occurrences, scarring, pain levels, hypersensitivity, or sensation loss were comparable between the groups (P > 0.05). There were also no differences in number of readmissions, reoperations, or emergency department visits (P > 0.05). Both groups showed enhanced postoperative QoL, regardless of marijuana usage.

Conclusions:

This study indicates that marijuana use does not significantly impact breast reduction surgery outcomes. Comparable surgical results and postoperative QoL improvements were observed in both marijuana users and nonusers. This study provides surgeons with the knowledge to offer more informed patient counseling regarding the implications of marijuana use in relation to breast reduction procedures.
Tranexamic Acid in Rhinoplasty and Septoplasty: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Authors: Khajuria Ankur , Khademi Mansour Hamid Reza , Muhammad Ibrahim , Asare Akua , Tammasse Iin , Suresh Jonathan , Leiberman Christopher , Pacheco-Barrios Niels , Brown Stav , Dogan Teoman , Rohrich Rod
Published: November 2024

Background:

Perioperative bleeding is a challenge in rhinoplasty and septoplasty. Tranexamic acid (TXA) may help reduce this, but its effectiveness is unclear. This systematic review and meta-analysis aimed to evaluate TXA’s impact on bleeding in these procedures.

Methods:

The protocol was registered a priori to PROSPERO (CRD42023393458). PubMed, Embase, Google Scholar, and Web of Science were searched from inception to October 2023. Eligible studies were randomized controlled trials of adult patients undergoing rhinoplasty or septoplasty. Primary outcomes were intraoperative blood loss, surgery duration, and surgeon satisfaction. A random-effects model was used. Methodological quality was assessed using GRADE. The risk of bias was assessed using Cochrane’s RoB 2 tool for randomized studies.

Results:

The search yielded 154 results; 11 randomized controlled trials, with 968 patients, were included. The meta-analysis showed a significant reduction in intraoperative blood loss with TXA (MD −39.67; 95% CI: −15.10 to −64.24; P = 0.002) and superior surgeon satisfaction in favor of TXA use (SMD −2.73; 95% CI: −5.33 to −0.12; P = 0.04). Subgroup analyses for intraoperative blood loss, according to administration routes, were also in favor of intravenous TXA (MD −13.02; 95% CI: −1.65 to −24.38; P = 0.02) and oral TXA (MD −44.98; 95% CI: −83.66 to −6.31; P = 0.02); no statistical difference was noted in surgery duration (MD −0.99; 95% CI: 0.63 to −2.81; P = 0.23). All studies were found to be of high quality, with low bias.

Conclusions:

The findings support TXA’s efficacy in reducing blood loss during rhinoplasty and septoplasty, with high surgeon satisfaction.
Diluted Indocyanine Green Angiography: A Novel Approach to Free Flap Perfusion Evaluation in Reconstructive Microsurgery
Authors: Atmodiwirjo Parintosa , Ramadan Mohamad Rachadian , Wicaksana Aditya , Djohan Michael , Amanda Nadira Fildza , Ralena Nadhira Anindita , Dilogo Ismail Hadisoebroto , Priambodo Purnomo Sidi , Werdhani Retno Asti , Yunir Em , Rachmadi Lisnawati , Harahap Alida Roswita , Yusuf Prasandhya Astagiri , Hasibuan Lisa , Mito Daisuke
Published: November 2024

Background:

Assessing perfusion in free flaps is crucial in clinical practice. Indocyanine green (ICG) angiography offers a more objective and reproducible method, utilizing near-infrared imaging to monitor flap vascularization. This study aims to evaluate the efficacy of diluted ICG as a tool for assessing free flap perfusion.

Methods:

This pilot randomized clinical trial compares the fluorescence concentrations of ICG at 3 different dilutions: 5 mg/mL (standard concentration), 2.5 mg/mL (half the standard concentration), and 0.5 mg/mL (one-tenth of the standard concentration). Inclusion criteria required participants to have serum albumin levels above 3 g/dL, hemoglobin levels over 10 g/dL, and no comorbidities. Participants were randomized into 3 groups based on ICG concentration. Fluorescence analysis was performed using ImageJ software to determine mean gray values. Both surgeons and data analysts were blinded to the ICG concentrations administered, ensuring unbiased evaluation.

Results:

Forty-five patients undergoing free flap surgery, predominantly male (60%) with a mean age of 37.76 ± 19.79 years and a mean body mass index of 21.23 ± 4.49 kg/m², primarily received osteoseptocutaneous fibular free flaps (46.67%), with an average skin flap area of 66.07 ± 46.94 cm². The primary etiology was underlying tumors (84.4%), with the head and neck as the most common reconstruction site (82.2%). The superior thyroid artery was the most frequently used recipient vessel (37.78%). Analysis revealed mean gray values of 64.10 ± 8.27 (5 mg/mL), 79.03 ± 2.7 (2.5 mg/mL), and 33.56 ± 3.47 (0.5 mg/mL), with 2.5 mg/mL yielding the highest value (P < 0.001).

Conclusions:

Findings suggest using 2.5 mg/mL concentration enhances fluorescence emission, offering a dosage alternative in clinical practice.
Retropupillary sulcus gas migration after retinal detachment repair surgery
Authors: Naik Mayuresh , Aslam Sher , Mi Fang Helen
Published: November 2024

PURPOSE:

To elucidate etiology and management of retropupillary sulcus migration of intravitreal gas after uneventful retinal detachment repair surgery

METHODS:

70 year old Caucasian man presented with a temporal macula-off rhegmatogenous retinal detachment. 25-gauge (25G) pars plana vitrectomy was performed with cryopexy to retinal tear and 12% C3F8 gas tamponade under sub-Tenon's anaesthesia. At one week review, there was an elevated IOP of 28mmHg with migration of gas to the retropupillary space. Superiorly, iris was displaced anteriorly causing iridocorneal touch. There was no phacodonesis nor subluxation and retina was attached with a cryopexy scar under a 80% vitreous cavity gas fill.

RESULT:

On treatment with topical IOP-lowering agents until two-week review, IOP had normalised to 18mmHg with persistent 50% gas fill in the retropupillary sulcus and superior iridocorneal touch.

Retropupillary gas resorbed at week four with normalisation of IOP, a localised superior anterior subcapsular cataract with associated posterior synechiae, and no iridocorneal touch. Best-corrected visual acuity was 6/12 Snellen following resorption of vitreous cavity gas.

CONCLUSION:

Medical management may be adequate if there is no complete pupil block and adequate posterior gas fill. With complete pupil block, refractory IOP elevation, or inadequate posterior tamponade resulting in failure of retinal attachment, surgical intervention would be required
Corneal Endothelial Keratoprosthesis EndoArt in Patients with Glaucoma at High Risk of Graft Failure After Keratoplasty
Authors: Wiedemann Johanna , Hos Deniz , Mestanoglu Mert , Cursiefen Claus , Bachmann Björn
Published: November 2024

Purpose:

The novel endothelial keratoprosthesis EndoArt improves corneal edema by reducing the inflow of aqueous humor into the cornea. We assessed the early outcome after EndoArt implantation in patients at a high risk of graft failure after keratoplasty.

Methods:

This retrospective study included 14 patients with high-risk eyes owing to at least one of the following risk factors for graft failure after keratoplasty: multiple previous surgeries (glaucoma surgery, keratoplasty) and recurrent intraocular inflammation because of uveitis, aniridia, or anterior synechia. After descemetorhexis, the EndoArt keratoprosthesis was placed on the posterior stroma, secured with a gas bubble and 1 to 3 transcorneal holding sutures. Best spectacle-corrected visual acuity and central corneal thickness were calculated preoperatively and postoperatively. In addition, detachment of the keratoprosthesis and the need for additional gas injections (rebubbling) were analyzed.

Results:

Octafluoropropane (C3F8) 12% in 11 patients and sulfur hexafluoride 20% in 3 patients were used to attach EndoArt. Detachments requiring at least 1 rebubbling occurred in 8 eyes. Preoperative best spectacle-corrected visual acuity was 1.6 (±0.6) logarithm of the minimal angle of resolution and improved to 1.3 (±0.6) after 12 weeks. Preoperative central corneal thickness (771.8 μm ± 157) significantly decreased postoperatively in all patients (622.1 μm ± 184.7 [P = 0.025] and 562.8 μm ± 183.6 [P = 0.012] after 6 and 12 weeks, respectively).

Conclusions:

EndoArt improved visual acuity and significantly reduced corneal thickness within 3 months postoperatively, subjectively, but not statistically significantly. The rebubbling rates in this cohort with an altered anterior segment anatomy were relatively high. Patients at a high risk of graft failure may benefit from this novel endothelial keratoprosthesis.
Sociodemographic Predictors of Keratoconus (Severity, Treatment, and Progression) in a Tertiary Center in New York City
Authors: Gad Rania E. , Serrano Andres , Dal Col Alexis , Kutler Rachel , Trief Danielle , Lin Weijie V. , Rand Gabriel , Florakis George J. , Suh Leejee H.
Published: November 2024

Purpose:

To identify sociodemographic factors as predictors of keratoconus severity, progression, disease outcomes, and appropriate management in a tertiary care ophthalmology institute in the New York City metropolitan area.

Methods:

This is a retrospective chart review. Patients with keratoconus presenting at a tertiary eye institute in an urban setting seen between 2015 and 2022 were included. Sociodemographic data including age, sex, race, ethnicity, income derived from zip code, insurance coverage, and preferred language were recorded. These sociodemographic factors were analyzed as possible predictors of keratoconus severity at presentation (Amsler–Krumeich grades III and IV): patients presenting with acute hydrops, patients receiving corneal cross-linking or corneal transplant, patients showing 1 or more diopters of increase of Kmax during their follow-up, and patients having longer time between the provider's recommendation of corneal cross-linking and the time of the procedure.

Results:

The retrospective review included 634 patients with a clinical diagnosis of keratoconus. Factors associated with severe keratoconus at presentation in the multivariate analysis were non-White (P < 0.001), lowest income (Q1) (P = 0.018), Q2 income (P = 0.012), and having Medicaid/Medicare coverage (P = 0.021). Medicaid/Medicare coverage was the only factor associated with acute hydrops (P < 0.001), and younger age was the only factor associated with disease progression (P < 0.001). Younger patients and patients with commercial insurance coverage were more likely to receive corneal collagen cross-linking (P < 0.001 and P < 0.001, respectively), whereas patients with Medicaid/Medicare coverage, lowest income, and non-White race were more likely to receive corneal transplantation (P = 0.012, P = 0.062, and P = 0.028, respectively). Medicaid/Medicare was the only factor associated with delay in receiving corneal collagen cross-linking (P = 0.013).

Conclusions:

Our study demonstrates that there are sociodemographic predictors of keratoconus disease severity, progression, and the type and the time of treatment the patients received. This confirms eye health disparities among patients with keratoconus.
Revolutionizing medicine: recent developments and future prospects in stem-cell therapy
Authors: Hussen Bashdar M. , Taheri Mohammad , Yashooa Raya Kh. , Abdullah Gaylany H. , Abdullah Snur R. , Kheder Ramiar Kamal , Mustafa Suhad A.
Published: November 2024

Stem-cell therapy is a revolutionary frontier in modern medicine, offering enormous capacity to transform the treatment landscape of numerous debilitating illnesses and injuries. This review examines the revolutionary frontier of treatments utilizing stem cells, highlighting the distinctive abilities of stem cells to undergo regeneration and specialized cell differentiation into a wide variety of phenotypes. This paper aims to guide researchers, physicians, and stakeholders through the intricate terrain of stem-cell therapy, examining the processes, applications, and challenges inherent in utilizing stem cells across diverse medical disciplines. The historical journey from foundational contributions in the late 19th and early 20th centuries to recent breakthroughs, including ESC isolation and iPSC discovery, has set the stage for monumental leaps in medical science. Stem cells’ regenerative potential spans embryonic, adult, induced pluripotent, and perinatal stages, offering unprecedented therapeutic opportunities in cancer, neurodegenerative disorders, cardiovascular ailments, spinal cord injuries, diabetes, and tissue damage. However, difficulties, such as immunological rejection, tumorigenesis, and precise manipulation of stem-cell behavior, necessitate comprehensive exploration and innovative solutions. This manuscript summarizes recent biotechnological advancements, critical trial evaluations, and emerging technologies, providing a nuanced understanding of the triumphs, difficulties, and future trajectories in stem cell-based regenerative medicine. Future directions, including precision medicine integration, immune modulation strategies, advancements in gene-editing technologies, and bioengineering synergy, offer a roadmap in stem cell treatment. The focus on stem-cell therapy’s potential highlights its significant influence on contemporary medicine and points to a future in which individualized regenerative therapies will alleviate various medical disorders.
Predictive Accuracy of HeartMate 3 Risk Score After the Heart Transplant Allocation Change
Authors: Vincent Justin D. , Ramsay Alyssa , Lambert David S. , Deych Elena , Pico Ana María , Coglianese Erin , Vader Justin M. , Yang Bin Q.
Published: November 2024

The HeartMate 3 risk score (HM3RS) was developed from the Multicenter Study of MagLev Technology in Patients Undergoing Mechanical Circulatory Support Therapy with HeartMate 3 (MOMENTUM 3) clinical trial to predict 1 and 2 year mortality after left ventricular assist device implantation. However, it has not been validated in a real-world population, especially after the heart transplant allocation system change on October 18, 2018. In this multicenter retrospective analysis, we found that HM3RS did not predict 1 and 2 year outcomes in the contemporary era, highlighting the need to revise this risk prediction tool in the real-world setting.
Clinical Utility of Polygenic Risk Scores for Embryo Selection: A Points to Consider Statement of the American College of Medical Genetics and Genomics (ACMG)
Authors: Grebe Theresa A. , Khushf George , Greally John M. , Turley Patrick , Foyouzi Nastaran , Rabin-Havt Sara , Berkman Benjamin E. , Pope Kathleen , Vatta Matteo , Kaur Shagun ,   On Behalf of the ACMG Social, Ethical, and Legal Issues Committee
Published: November 2024

(Abstracted from Genet Med 26:101052)

Polygenic risk scores (PRSs) quantify the combined associations of multiple single nucleotide variations in an individual’s genome to estimate their likelihood of developing certain diseases based on population data. Although PRS availability for adults is currently limited, it is expected to grow.
Impact of Different Progesterone Timings on Live Birth Rates for Blastocyst Frozen Embryo Transfer Cycles
Authors: Zhou Ruiqiong , Dong Mei , Wang Zhaoyi , Huang Li , Wang Songlu , Chen Ye , Zhu Zhenghong , Zhang Xiqian , Liu Fenghua
Published: November 2024

(Abstracted from Reprod Biomed Online 2024;49(4):104307)

Assisted reproductive technology use has been increasing exponentially within the last few decades, with frozen embryo transfer (FET) cycles among them. In preparation for an FET cycle, patients can undergo a natural cycle or an artificial cycle designed to simulate a natural cycle with exogenous estrogen and progesterone.
Digital Health Utilization in Spinal Cord Injury
Authors: Bernard Renaldo M. , Oña Ana , Seijas Vanessa , Diviani Nicola , Sabariego Carla
Published: November 2024

Objective

The objective of this study was to describe the use of digital health tools by people with spinal cord injury and associated factors.

Design

Cross-sectional data from the 2022 Swiss Spinal Cord Injury Cohort Study (SwiSCI) were analyzed. Descriptive statistics summarized data regarding sociodemographic characteristics, self-management, health, and digital health usage. Multiple logistic regression analysis examined the association of digital health use with reasons of use, concerns, confidence, sociodemographic characteristics, self-management, and comorbidities.

Results

Among 961 participants, 69% used digital health tools. Females were 1.79 times more likely to adopt them. People aged 60–70 had 3.84 times higher usage rates than 18–30 yrs old. Longer spinal cord injury duration increased usage by 0.98 times/year. Confidence using digital tools and positive health attitudes predicted usage. Comorbidities were positively correlated with usage. Concerns about digital health utilization had no significant impact.

Conclusions

Our study provides one of the first comprehensive descriptions of digital health utilization in spinal cord injury. Its findings shed light on the intricate factors influencing digital health utilization, contribute to a deeper understanding of this patient population, and pave the way for more targeted and effective digital tools and strategies for their uptake.
Is Home Care Use Associated With Secondary Health Conditions in Persons With Spinal Cord Injury? Findings From a Longitudinal Cohort Study
Authors: Wagner Aylin , Brach Mirjam , Scheel-Sailer Anke , Friedli Manuela , Hund-Georgiadis Margret , Jordan Xavier , Schubert Martin , Gemperli Armin
Published: November 2024

Objective

The aims of the study are to describe the use of professional home care in persons with spinal cord injury over a 10-yr period from 2012 to 2022 and to examine how the use of home care is associated with the future occurrence of secondary health conditions and hospitalizations.

Design

This is a longitudinal questionnaire survey as part of the Swiss Spinal Cord Injury Cohort Study, conducted in 2012, 2017, and 2022.

Results

There were 1549, 1294, and 1158 participants in the three surveys in 2012, 2017, and 2022. The percentage of home care users decreased from 23% in 2012 to 22% in 2017 and 19% in 2022. Fewer home care recipients reported pain (odds ratio 0.52, 95% confidence interval 0.29–0.94), with no reductions in other secondary health conditions, 5 yrs later. Study participants who received home care were more likely to be hospitalized (odds ratio 1.89, 95% confidence interval 1.05–3.42), 5 yrs later.

Conclusions

There is a declining trend in the use of home care services among persons with SCI. While home care is associated with lesser development of pain, it does not generally reduce secondary health conditions. Individuals who receive home care are significantly more likely to report hospitalization 5 yrs later.
177Lu-FAP-2286 Therapy in a Case of Squamous Lung Cancer
Authors: Li Linwei , Chen Lingzhi , Zhang Yanlang , Zhang Yu , Chen Yue
Published: November 2024

We reported a 72-year-old man who was diagnosed with squamous lung cancer and received 2 cycles of 177Lu-FAP-2286 treatment. Radiological remission was observed on follow-up FAP imaging 7 months later with squamous cell carcinoma antigen decreased to normal level. No other abnormality monitored by routine laboratory examination was noted.
Chromosome architecture as a determinant for biosynthetic diversity in Micromonospora
Authors: Mark David R. , Tucker Nicholas P. , Herron Paul R.
Published: November 2024

Natural products – small molecules generated by organisms to facilitate ecological interactions – are of great importance to society and are used as antibacterial, antiviral, antifungal and anticancer drugs. However, the role and evolution of these molecules and the fitness benefits they provide to their hosts in their natural habitat remain an outstanding question. In bacteria, the genes that encode the biosynthetic proteins that generate these molecules are organised into discrete loci termed biosynthetic gene clusters (BGCs). In this work, we asked the following question: How are biosynthetic gene clusters organised at the chromosomal level? We sought to answer this using publicly available high-quality assemblies of Micromonospora, an actinomycete genus with members responsible for biosynthesizing notable natural products, such as gentamicin and calicheamicin. By orienting the Micromonospora chromosome around the origin of replication, we demonstrated that Micromonospora has a conserved origin-proximal region, which becomes progressively more disordered towards the antipodes of the origin. We then demonstrated through genome mining of these organisms that the conserved origin-proximal region and the origin-distal region of Micromonospora have distinct populations of BGCs and, in this regard, parallel the organization of Streptomyces, which possesses linear chromosomes. Specifically, the origin-proximal region contains highly syntenous, conserved BGCs predicted to biosynthesize terpenes and a type III polyketide synthase. In contrast, the ori-distal region contains a highly diverse population of BGCs, with many BGCs belonging to unique gene cluster families. These data highlight that genomic plasticity in Micromonospora is locus-specific, and highlight the importance of using high-quality genome assemblies for natural product discovery and guide future natural product discovery by highlighting that biosynthetic novelty may be enriched in specific chromosomal neighbourhoods.
Genomic diversity of Campylobacter jejuni and Campylobacter coli isolates recovered from human and poultry in Australia and New Zealand, 2017 to 2019
Authors: Cribb Danielle M. , Biggs Patrick J. , McLure Angus T. , Wallace Rhiannon L. , French Nigel P. , Glass Kathryn , Kirk Martyn D.
Published: November 2024

We used genomic and epidemiological data to assess and compare the population structure and origins of Campylobacter, a major foodborne pathogen, in two neighbouring countries with strong trade and cultural links, similar poultry production systems and frequent movement of people and food products. The most common sequence types (STs) differed between Australia and New Zealand, with many unique to each country. Over half of all STs were represented by a single isolate. Multidrug-resistant (MDR) genotypes were detected in 0.8% of all samples, with no MDR isolates detected in poultry. Quinolone and tetracycline resistant ST6964 was prevalent in New Zealand (10.6% of C. jejuni). Closely related isolates suggested some similar food sources or contacts. We have shown that there is little genetic overlap in human and poultry STs of Campylobacter between the countries, which highlights that this common foodborne pathogen has domestic origins in Australia and New Zealand.