bluuebunny/crossref_metadata_2025 huggingface dataset:
Direct Amination of Benzylic Pinacol Boronates by an Aminoazanium
Authors: Liu Chao , Xu Jianeng , Qin Yucheng
Published: February 2023

A practical stereospecific direct amination of benzylic pinacol boronates was achieved by using 4-amino-4-methylmorpholinium iodide as a new amination reagent and cesium carbonate as the base. After amination, an in situ reductive N-alkylation with an aldehyde proceeded well to produce secondary amines.
Giant Coronary Aneurysm with Coronary-Pulmonary Artery Fistula in a Jehovah's Witness
Authors: Hirofuji Aina , Furugen Azusa , Kamada Takeshi , Yamazaki Kenji , Kamiya Hiroyuki , Doi Hirosato
Published: February 2023

With an incidence of 3 in 100 million, giant coronary artery aneurysm (CAA) with coronary artery fistula (CAF) is a very rare condition. To prevent rupture, giant CAA with CAF should be swiftly treated. We present a Jehovah's Witness patient with giant CAA and coronary-pulmonary artery fistula. We resected the giant CAA in one piece, while ligating the CAF, without allogeneic blood transfusion. Due to rarity of these conditions, many thoracic surgeons lack direct experience in its surgical procedures. Herein, we share footage of this surgery as an example of how to safely resect CAA with minimal bleeding.
Smoking Cessation for Preoperative Optimization
Authors: Vu Joceline V. , Lussiez Alisha
Published: February 2023

Cigarette smoking is associated with pulmonary and cardiovascular disease and confers increased postoperative morbidity and mortality. Smoking cessation in the weeks before surgery can mitigate these risks, and surgeons should screen patients for smoking before a scheduled operation so that appropriate smoking cessation education and resources can be given. Interventions that combine nicotine replacement therapy, pharmacotherapy, and counseling are effective to achieve durable smoking cessation. When trying to stop smoking in the preoperative period, surgical patients experience much higher than average cessation rates compared with the general population, indicating that the time around surgery is ripe for motivating and sustaining behavior change. This chapter summarizes the impact of smoking on postoperative outcomes in abdominal and colorectal surgery, the benefits of smoking cessation, and the impact of interventions aimed to reduce smoking before surgery.
Frailty Assessment and Prehabilitation as Part of a PeRioperative Evaluation and Planning (PREP) Program for Patients Undergoing Colorectal Surgery
Authors: Sharon Cimarron E. , Strohl Catherine , Saur Nicole M.
Published: February 2023

Frailty assessment and prehabilitation can be incrementally implemented in a multidisciplinary, multiphase pathway to improve patient care. To start, modifications can be made to a surgeon's practice with existing resources while adapting standard pathways for frail patients. Frailty screening can identify patients in need of additional assessment and optimization. Personalized utilization of frailty data for optimization through prehabilitation can improve postoperative outcomes and identify patients who would benefit from adapted care. Additional utilization of the multidisciplinary team can lead to improved outcomes and a strong business case to add additional members of the team.
Perioperative Assessment and Optimization in Major Colorectal Surgery: Medication Management
Authors: Kane William J. , Berry Puja Shah
Published: February 2023

The colorectal surgeon is often faced with medications that can be challenging to manage in the perioperative period. In the era of novel agents for anticoagulation and immunotherapies for inflammatory bowel disease and malignancy, understanding how to advise patients about these medications has become increasingly complex. Here, we aim to provide clarity regarding the use of these agents and their perioperative management, with a particular focus on when to stop and restart them perioperatively. This review will begin with the management of both nonbiologic and biologic therapies used in the treatment of inflammatory bowel disease and malignancy. Then, discussion will shift to anticoagulant and antiplatelet medications, including their associated reversal agents. Upon finishing this review, the reader will have gained an increased familiarity with the management of common medications requiring modification by colorectal surgeons in the perioperative period.
Evaluation of Two-Dimensional (2D) versus Three-Dimensional (3D) Video Tutorials in Cataract Surgery for New Trainees
Authors: Zheng Yuxi , Hamdan Saif , Siktberg Jonathan , Barnett Jonathan , Groth Sylvia L. , Podoll Nathan , Wayman Laura , Lindsey Jennifer L.
Published: February 2023

Purpose Microscopic ophthalmic surgery requires an understanding of three-dimensional (3D) spaces within the eye. Recently, there has been an increase in 3D video training tools in health care. Studies have evaluated the efficacy of 3D tutorials in general surgery, but little has been published within ophthalmology. We present a randomized study evaluating differences in surgically naïve trainees after watching either a 2D or 3D phacoemulsification tutorial.

Design This was a double-blind, randomized study. A group of third and fourth year medical students at our institution were randomized with stratified randomization based on prior surgical courses to control for differences in baseline surgical skill. The two study arms were watching 2D or 3D instructional videos on phacoemulsification (Richard Mackool).

Methods Participants received a preliminary survey and participated in an hour-long microscopic surgery session. During the session, participants performed tasks evaluating baseline microscopic spatial awareness and surgical skill. The students were then instructed to watch either a 2D or 3D video on phacoemulsification based on their randomized study arm. During the postintervention session, participants performed the biplanar incision and capsulorhexis steps of cataract surgery discussed in the video on model eyes. Students were evaluated on speed and overall capsulorhexis quality.

Results Thirty-one students qualified for the study and completed the microscopic surgery session. Students in both groups had similar baseline speed and quality of preintervention microscopic tasks (p > 0.05 for all tasks). Postintervention, students randomized to the 3D video performed significantly faster than the 2D group for biplanar incision (11.1 ± 5.5 s vs. 20.7 ± 10.5 s, p = 0.001). There were no statistically significant differences found between the groups in capsulorhexis timing (p = 0.12) or quality score (p = 0.60).

Conclusions 3D video surgical training tutorials may improve speed of certain steps of cataract surgery for surgically naïve ophthalmology trainees. Given the limited sample size of this study, further investigation of their effectiveness is warranted.
Combined Resection Approaches: Decision Making for Synchronous Resection, Timing of Staged Intervention to Optimize Outcome
Authors: Asai Megumi , Dobesh Kaitlyn D.
Published: February 2023

Advancement in systemic and regional radiation therapy, surgical technique, and anesthesia has provided a path for increased long-term survival and potential cure for more patients with stage IV rectal cancer in recent years. When patients have resectable disease, the sequence for surgical resection is classified in three strategies: classic, simultaneous, or combined, and reversed. The classic approach consists of rectal cancer resection followed by metastatic disease at a subsequent operation. Simultaneous resection addresses both rectal and metastatic disease in a single surgery. The reversed approach treats metastatic disease first, followed by the primary tumor in several months. Simultaneous resection is appropriate for selected patients to avoid delay of definitive surgery, and reduce number of surgeries, hospital stay, and cost to the health care system. It may also improve patients' psychological effect. Multidisciplinary discussions including colorectal and liver surgeons to review patients' baseline medical conditions, tumor biology and behavior, and disease burden and distribution is imperative to guide proper patient selection for simultaneous resection and perioperative treatments.
Fluctuating characteristics of streamwise wind speed and total saltation mass flux in the near-neutral atmospheric surface layer
Authors: Zhang Xiaobin , Zhang Bowen , Xin Guowei , Han Guowen
Published: February 2023

Eolian sand transport in the atmospheric surface layer (ASL) is a typical kind of gas–solid two-phase flow at a very high Reynolds number that fluctuates over a wide range of spatial and temporal scales. Based on the high-frequency time series of streamwise wind speed (u) and total saltation mass flux (q) measure at three different observation sites, the fluctuating characteristics of u and q in the near-neutral ASL have been analyzed. Our study suggests that the probability density function (PDF) of the normalized streamwise wind speed fluctuations at the height of approximately 0.5 m follows a standard normal distribution, and the PDF of the q presents a lognormal distribution in the near-neutral ASL during strong and steady wind-blown sand. The investigations on the premultiplied spectral of q and u show that, as the energy of very large-scale motions (VLSMs) increases, the influence of the VLSMs on q becomes more significant. In addition, the stochastic couplings between u and q have been analyzed by using space–time correlations and linear coherence spectrum. Our results suggest that the VLSMs have a significant effect on the low-frequency fluctuations of q in the near-neutral ASL.
Tunable oleosome-based oleogels: Effect of polysaccharide architecture on polymer bridging-based structuring
Authors: Zambrano Juan C. , Vilgis Thomas A.
Published: February 2023

A simple method for structuring natural oleosome emulsions by polymer-bridging mechanism is proposed. Polymer bridging of oleosome droplets was induced by the addition of two different adsorbing polymers. Over a range of polymer/oleosome ratios, the mixture results in the formation of a particle gel network of aggregated oleosome droplets. It is found that polymer bridging ability is heavily influenced by the strength of binding between polymer and oleosome surface where sodium alginate interacted stronger to oleosome surface than ι-carrageenan. These effects are associated with the different molecular architecture and physical differences between the two hydrocolloids. Alginate has a co-block arrangement of charged and uncharged units. The polymer promotes stronger adsorption to the oleosome surface, in contrast to ι-carrageenan, where the negative charges are distributed uniformly along its chain. The polymer bridging ability will influence the resulting microstructure and therefore rheological properties. Confocal scanning laser microscopy showed that the difference in microstructure is mainly in the extent of heterogeneity over different length scales where sodium alginate produced the most heterogeneous microstructures. Bridging-flocculated emulsions showed power-law scaling behavior of the storage modulus with the oleosome concentration, which was explained using percolation theory.
Macaroni-type breakup in the primary breakup of discontinuous shear-thickening suspension
Authors: Wang Zi-Yu , Yao Tian-Liang , Zhao Hui , Li Wei-Feng , Xu Jian-Liang , Liu Hai-Feng
Published: February 2023

The primary breakup of discontinuous shear-thickening suspension is studied experimentally. A divergent nozzle was used as the annular passage of a coaxial two-fluid nozzle. The breakup morphology was observed with a DSLR camera and a high-speed camera. According to the experimental results, the discontinuous shear-thickening behavior and the geometry of the annular air nozzle of divergent section significantly affect the breakup morphology of the suspension jet. Under the action of the annular air, the suspension jet near the exit of the nozzle tends to expand radially and becomes hardened and incompressible in the axial direction. For discontinuous shear-thickening suspensions, the axial hardening does not affect the good fluidity in the radial direction because of their anisotropic microstructure. Therefore, a hollow structure appears, and the suspension jet exhibits the macaroni-type breakup. This breakup mode strengthens when the radial expansion increases. Based on the equation of continuity, the force analysis and mechanism of the macaroni-type breakup are discussed.
Experimental study on nonlinear seepage characteristics of coal under true triaxial stress loading
Authors: Luo Yafei , Zhu Yongjian , Huang Fei , Xia Binwei
Published: February 2023

The characteristics of coalbed methane flow are jointly determined by the fracture and stress environment. Previous studies conducted under conventional triaxial or uniaxial stress conditions cannot truly reflect the in situ stress environment and neglected the influence of intermediate principal stress on the nonlinear seepage characteristics of coal. For this study, coal seepage tests were performed under true triaxial stress, allowing the nonlinear seepage characteristics of coal to be analyzed under different principal stresses. This enables the applicability of nonlinear seepage characterization equations and the change laws of relevant parameters to be clarified. The results show that the nonlinear seepage characteristics of coal under true triaxial stress increase as the principal stresses and gas pressure gradient increase. Using the Forchheimer equation for characterization, the nonlinear effect factor, viscous permeability, and inertial permeability gradually decrease with increasing principal stress in all directions. Intermediate principal stress σ2 has the most significant effect on nonlinear effects and inertial permeability, whereas principal stress σ3 has the greatest effect on viscous permeability. Using the Izbash equation for characterization, the fitting coefficients λ, m increase with increasing principal stress. Principal stress σ2 has the most significant effect on m, whereas principal stress σ3 has the greatest influence on λ. Comparative analysis shows that both Forchheimer and Izbash equations accurately characterize the nonlinear seepage characteristics of coal under real triaxial stress. The Forchheimer equation requires more theoretical parameters to measure the degree of nonlinear seepage and thus better describes the evolution process of linear to nonlinear seepage.
Political Identity as Temporal Collapse: Ethiopian Federalism and Contested Ogaden Histories
Authors: Thompson Daniel K , Matshanda Namhla Thando
Published: February 2023

Since the 1980s, analyses of African political identities have emphasized identity manipulation as a governance tool. In the Somali Horn of Africa, however, politicians’ efforts to reinvent identities confront rigid understandings of genealogical clanship as a key component of identity and political mobilization. This article explores how government efforts to construct a new ‘Ethiopian–Somali’ identity within Ethiopia’s ethnic-federal system are entangled with attempts to reinterpret clan genealogies and histories. We focus on efforts to revise the history of clans within the broader Ogaden Somali clan group and trace the possibilities and limits of these revisions in relation to legacies of colonialism as well as popular understandings of Ogaden identity. Drawing on fieldwork and archival research, we show that political struggles over Somalis’ integration with Ethiopia orient around Somali clanship, but that clanship is not a mechanical tool of mobilization, as it is often portrayed. We suggest that genealogical relatedness does not equate to political loyalty, but genealogical discourse provides a framework by which various actors reinterpret contemporary events by collapsing history into the present to imbue clan, ethnic, and national identities with political significance.
A Novel Methodological Approach to Measure Linear Trends in Health Inequalities: Proof of Concept With Adolescent Smoking in Europe
Authors: Kuipers Mirte A G , Kang Kaidi , Dragomir Anca D , Monshouwer Karin , Benedetti Elisa , Lombardi Gabriele , Luta George , Kunst Anton E
Published: February 2023

We describe a new method for presenting and interpreting linear trends in health inequalities, and present a proof-of-concept analysis of inequalities in smoking among adolescents in Europe. We estimated the regression line of the assumed linear relationship between smoking prevalence in low– and high–socioeconomic status (SES) youth over time. Using simulation, we constructed a 95% confidence interval (CI) for the smoking prevalence in low-SES youth for when this would be 0% in high-SES youth, and we calculated the likelihood of eradicating smoking inequality (<5% for both low and high SES). This method was applied to data on adolescents aged 15–16 years (n = 250,326) from 23 European countries, derived from the 2003–2015 European Survey Project on Alcohol and Other Drugs. Smoking prevalence decreased more slowly among low- than among high-SES adolescents. The estimated smoking prevalence was 9.4% (95% CI: 6.1, 12.7) for boys and 5.4% (95% CI: 1.4, 9.2) for girls with low SES when 0% with high SES. The likelihood of eradicating smoking inequality was <1% for boys and 37% for girls. We conclude that this novel methodological approach to trends in health inequalities is feasible in practice. Applying it to trends in smoking inequalities among adolescents in Europe, we found that Europe is currently not on track to eradicate youth smoking across SES groups.
Short-term Satisfaction, Psychosocial Impact, and Complication Profile of Reduction Mammaplasty During Adolescence
Authors: Payne Samuel H , Brown Ciara A , Saad Omar , Neimanis Sara A , Hatcher Kayla , Brady Colin M , Williams Joseph K , Soldanska Magdalena
Published: February 2023

Background

Reduction mammaplasty is an effective and safe treatment option for adults with symptomatic macromastia, but there are few data regarding outcomes in adolescents.

Objectives

The purpose of this study was to determine the short-term psychosocial impact, satisfaction, and safety of reduction mammaplasty when performed during adolescence.

Methods

A retrospective review was performed of a single pediatric plastic surgeon's experience with reduction mammaplasty from 2018 to 2021 in patients aged ≤18 years. Patients completed the preoperative and postoperative “Satisfaction with Breasts” and “Psychosocial Well-being” sections of the BREAST-Q survey. Clinical variables gathered included age, weight, BMI, complication profile, specimen resection weight, and follow-up duration.

Results

In total, 41 patients met inclusion criteria. The mean converted Rasch scores for BREAST-Q “Satisfaction with Breasts” and “Psychosocial Well-being” increased significantly following reduction mammaplasty (“Satisfaction with Breasts”: preoperative, 24.1 vs postoperative, 92.6; “Psychosocial Well-being”: preoperative, 37.7 vs postoperative, 90.4; P < .001). Obesity (BMI ≥ 30 kg/m2) was associated with lower preoperative “Psychosocial Well-being” scores (obese, 29.7 vs nonobese, 43.3; P < .001) but a greater improvement in score following surgery (obese, +63.9 vs nonobese, +44.9; P < .001). Specimen weight ≥1000 grams was also associated with greater improvement in score on the “Psychosocial Well-being” section (≥1000 grams, +58 vs <1000 grams, +49.7; P = .046). Overall complication rate was 31.7% while the major complication rate was 2.4%. Mean specimen resection weight was higher in patients who experienced complications (1141.3 grams vs 836.8 grams, P = .008).

Conclusions

Reduction mammaplasty during adolescence predictably improves both short-term satisfaction with breasts and psychosocial well-being while demonstrating a favorable short-term complication profile.

Level of Evidence: 4
HBV-infected hepatocellular carcinoma can be robustly classified into three clinically relevant subgroups by a novel analytical protocol
Authors: Cheng Zhiwei , Li Leijie , Zhang Yuening , Ren Yongyong , Gu Jianlei , Wang Xinbo , Zhao Hongyu , Lu Hui
Published: February 2023

Liver cancer is the third leading cause of cancer-related death worldwide, and hepatocellular carcinoma (HCC) accounts for a relatively large proportion of all primary liver malignancies. Among the several known risk factors, hepatitis B virus (HBV) infection is one of the important causes of HCC. In this study, we demonstrated that the HBV-infected HCC patients could be robustly classified into three clinically relevant subgroups, i.e. Cluster1, Cluster2 and Cluster3, based on consistent differentially expressed mRNAs and proteins, which showed better generalization. The proposed three subgroups showed different molecular characteristics, immune microenvironment and prognostic survival characteristics. The Cluster1 subgroup had near-normal levels of metabolism-related proteins, low proliferation activity and good immune infiltration, which were associated with its good liver function, smaller tumor size, good prognosis, low alpha-fetoprotein (AFP) levels and lower clinical stage. In contrast, the Cluster3 subgroup had the lowest levels of metabolism-related proteins, which corresponded with its severe liver dysfunction. Also, high proliferation activity and poor immune microenvironment in Cluster3 subgroup were associated with its poor prognosis, larger tumor size, high AFP levels, high incidence of tumor thrombus and higher clinical stage. The characteristics of the Cluster2 subgroup were between the Cluster1 and Cluster3 groups. In addition, MCM2–7, RFC2–5, MSH2, MSH6, SMC2, SMC4, NCPAG and TOP2A proteins were significantly upregulated in the Cluster3 subgroup. Meanwhile, abnormally high phosphorylation levels of these proteins were associated with high levels of DNA repair, telomere maintenance and proliferative features. Therefore, these proteins could be identified as potential diagnostic and prognostic markers. In general, our research provided a novel analytical protocol and insights for the robust classification, treatment and prevention of HBV-infected HCC.
Spatially constrained gene regulation identifies key genetic contributions of preeclampsia, hypertension, and proteinuria
Authors: Boom Genevieve , O’Sullivan Justin M , Schierding William
Published: February 2023

Preeclampsia (PE) is a relatively common but severe pregnancy disorder (with very limited effective treatments) characterized by hypertension (HTN) and usually proteinuria (PRO) or other organ damage. Genome-wide association studies (GWAS) of PE, HTN, and PRO have mostly identified risk loci single nucleotide polymorphisms (SNPs) located in noncoding genomic regions, likely impacting the regulation of distal gene expression. The latest GWAS associated (P < 1 × 10−6) SNPs to PE (n = 25), HTN (n = 1926), and PRO (n = 170). Our algorithmic analysis (CoDeS3D) used chromatin connection data (Hi-C) derived from 70 cell lines followed by analysis of two expression quantitative trail loci (eQTL) cohorts: GTEx (838 donors, 54 tissues, totaling 15 253 samples) and DICE (91 donors, 13 blood tissue types). We identified spatially constrained eQTLs which implicate gene targets in PE (n = 16), HTN (n = 3561), and PRO (n = 335). By overlapping these target genes and their molecular pathways (protein–protein interaction networks), we identified shared functional impacts between PE and HTN, which are significantly enriched for regulatory interactions which target genes intolerant to loss-of-function mutations. While the disease-associated SNP loci mostly do not overlap, the regulatory signals (target genes and pathways) overlap, informing on PE risk mechanisms. This demonstrates a model in which genetic predisposition to HTN and PRO lays a molecular groundwork toward risk for PE pathogenesis. This overlap at the gene regulatory network level identifies possible shared therapeutic targets for future study.
‘The Sane Voice in an Insane Situation’ the Perspective of Arab Social Workers Regarding the Palestinian–Israeli Conflict
Authors: Allassad Alhuzail Nuzha , Mahajne Ibrahim
Published: February 2023

Israel’s Arabs are citizens, but they are an ethnic minority and a national minority (Palestinians) in a Jewish-majority state. The decades-long Palestinian–Israeli conflict has erupted in recent years in violent outbursts between Arab and Jewish citizens. April–May 2021 saw severe violence against individuals and businesses on both sides and damage to holy sites. In this context, a qualitative study using in-depth interviews was conducted amongst 15 Arab social workers in Israel (mean age 45, mean experience twenty years), to examine their perspective regarding the Palestinian–Israeli conflict, particularly the April–May civil dispute. The findings revealed that the social workers wanted to be involved as leaders. The findings also revealed the bind in which they find themselves, caught between local government and the committee that represents the country’s Arab citizens, between the demands of the community and the demands of the employer and between their personal values and their professional values. The study makes a theoretical contribution by addressing the need to create a safe space in the workplace so that social workers can discuss the conflict and its ramifications for them. The study may also contribute to the training of social workers and providing a safe space for another narrative.
The neural correlates of emotional conflict monitoring as an early manifestation of affective and cognitive declines in persons with Type 2 diabetes
Authors: Chen Yu-Hsin , Chen Chenyi , Jian Hong-Yu , Chen Yu-Chun , Fan Yang-Teng , Yang Chih-Yung , Cheng Yawei
Published: February 2023

Patients with Type 2 diabetes are known to be more susceptible to experience dementia and depression/anxiety. The neural circuits of emotional conflict monitoring, as indicated by a Stroop task, might become altered in terms of cognitive and affective impairments in diabetes. This study investigated alterations in the emotional conflict monitoring and associations of corresponding brain activities with metabolic parameters in persons with Type 2 diabetes. Participants with normal cognitive and affective functioning, including 40 persons with Type 2 diabetes and 30 non-diabetes control subjects, underwent a functional MRI paradigm with the face-word emotional Stroop task and detailed cognitive and affective assessments, including the Montreal Cognitive Assessment and Beck Anxiety Inventory. Compared with the controls, people with diabetes exhibited stronger emotional interference, as indicated by differential reaction times between congruent and incongruent trials (Δcon). Δcon was correlated with Montreal Cognitive Assessment test scores and fasting glucose levels. People with diabetes demonstrated altered brain activation and functional connectivity in the neural network for emotional conflict monitoring. The neural network for emotional conflict monitoring mediated the association of pancreatic function with anxiety scores as well as the relationship between Δcon and Montreal Cognitive Assessment scores. Results suggested that alterations in the neural network underlying emotional conflict monitoring might present before clinically measurable cognitive and affective decrements were apparent, thereby bridging the gap between dementia and anxiety/depression in persons with diabetes.
Zn2+-Loaded adhesive bacterial cellulose hydrogel with angiogenic and antibacterial abilities for accelerating wound healing
Authors: Han Zhengzhe , Deng Lili , Chen Shiyan , Wang Huaping , Huang Yinjun
Published: February 2023

Background

Wound healing is a process that requires angiogenesis and antibacterial activities and it remains a challenge for both experimental and clinical research worldwide. Zn2+ has been reported to be widely involved in angiogenesis and exerts antibacterial effects, making it suitable as a treatment to promote wound healing. Therefore Zn2+-loaded adhesive bacterial cellulose hydrogel was designed to observe its angiogenic and antibacterial abilities in the wound healing process.

Methods

The characterization, tensile strength, swelling behaviors and antibacterial activity of bacterial cellulose/polydopamine/zeolitic imidazolate framework-8 (BC/PDA/ZIF8) hydrogels were tested. Cell-Counting-Kit-8 (CCK8), transwell, tube formation and real time qunantitative PCR (qRT-PCR) assays were performed to evaluate the cell compatibility of BC/PDA/ZIF8 hydrogels in vitro. A full-thickness defect wound model and histological assays were used to evaluate the BC/PDA/ZIF8 hydrogels in vivo.

Results

The prepared BC/PDA/ZIF8 hydrogels exhibited suitable mechanical strength, excellent swelling properties, good tissue adhesion, efficient angiogenic and antibacterial effects and good performance as a physical barrier. In vivo experiments showed that the BC/PDA/ZIF8 hydrogels accelerated wound healing in a full-thickness defect wound model by stimulating angiogenesis.

Conclusions

This study proved that BC/PDA/ZIF8 hydrogels possess great potential for promoting satisfactory wound healing in full-thickness wound defects through antibacterial effects and improved cell proliferation, tissue formation, remodeling and re-epithelialization.
‘If Clodia despised Catullus, you can very well, Dionysus, despise Ariadne’: classical receptions and Roman elegy in Hilda Hilst’s Discontinuous and Remote Ode for Flute and Oboe. From Ariadne to Dionysus (1969)
Authors: Gorab Leme Fernando
Published: February 2023

After her depiction in Catullus 64, Ariadne became a model for the relicta, the abandoned woman. The tapestry that ornamented the wedding of Peleus and Thetis told exactly of her dismay and anger upon learning that Theseus left her. As far as the myth goes, following her abandonment, Dionysus took her as a wife. Modernist Brazilian author Hilda Hilst (1930–2004) revisits this portion of the tale in her cycle of ten poems Discontinuous and Remote Ode for Flute and Oboe. From Ariadne to Dionysus (1969). This introduces the poems as works of reception vis-à-vis the ancient figurations of Ariadne, as well as the context of Hilst’s biography, it analyses them as reimaginations of the Roman elegy, and presents their first complete English translation, all original endeavours. On the surface, Hilst’s Ariadne fashions herself as a learned poet who reads Catullus and rejoices in her abandonment. I argue that upon a closer look, however, this endlessly unrequited woman desires instead union and permanence. Hilst, herself an underappreciated and disreputable figure, unveils Ariadne’s labyrinthic mind as she negotiates her devotion to poetry and her desire for the man she loves, revealing the afterlife of the myth of a heroine who found her own voice.
Multidisciplinary diagnostic approach for fulminant myocarditis related to coronavirus disease 2019 messenger RNA vaccines: a case report
Authors: Fujii Masayoshi , Toba Takayoshi , Fukuyama Yusuke , Tjan Lidya Handayani , Mori Yasuko , Hirata Ken-ichi
Published: February 2023

Background

Recent reports have raised serious concerns regarding acute myocarditis related to coronavirus disease 2019 (COVID-19) messenger RNA (mRNA) vaccines. There are only a few reports of fulminant lymphocytic myocarditis that developed after vaccination. Although the diagnostic approach varied among them, no cases with multidisciplinary diagnostic approaches, including cytokine analysis, have been reported.

Case summary

A 59-year-old male with no medical history complained of chest pain a day after receiving the first dose of COVID-19 mRNA (BNT162b2) vaccination. On hospital Day 3, he developed a refractory cardiogenic shock and pulseless ventricular tachycardia, requiring mechanical circulatory support secondary to an exacerbation of myocarditis. Based on the clinical course and examination results, including histologic findings showing a diffuse lymphocytic inflammatory infiltrate with abundant T cells and macrophages in the myocardium, and cardiac magnetic resonance (CMR) findings showing a high-intensity signal on the T2-weighted image and late gadolinium enhancement, he was diagnosed with fulminant myocarditis related to COVID-19 mRNA vaccination. His haemodynamic status gradually improved without immunosuppressive or anti-inflammatory therapy, and he was discharged from hospital on Day 47. To investigate the pathogenesis, we performed cytokine analysis, which showed an increase in serum IP-10, MCP-3, and MIG concentrations, suggesting that Th1-type chemokines preferentially promote cellular immunity.

Discussion

In the present case of a patient with fulminant myocarditis following COVID-19 mRNA vaccination diagnosed through histopathological and CMR findings, additional cytokine analysis revealed that elevated levels of cytokines pertaining to Th1 immune response may be involved in disease pathogenesis. A multidisciplinary diagnostic approach is crucial not only to comprehend an individual patient’s condition but also to clarify the disease pathogenesis.
Diagnostic criteria for the hypothalamic syndrome in childhood
Authors: van Santen Hanneke M , van Schaik Jiska , van Roessel Ichelle M A A , Beckhaus Julia , Boekhoff Svenja , Müller Hermann L
Published: February 2023

Objective

Hypothalamic syndrome (HS) in childhood is a rare condition. Its epidemiology is not well known because incidence and prevalence are related to very rare underlying diseases. In addition, different criteria for the syndrome are used across studies. Recognizing the HS may be difficult, due to its rareness and variety of symptoms. Having diagnostic criteria for signs and symptoms of hypothalamic dysfunction may aid in early recognition and diagnosis, in the reporting and understanding of its etiology, in predicting its course and its management. We aimed to define diagnostic criteria for hypothalamic dysfunction and a score for the presence of HS in childhood.

Methods

Diagnostic criteria for hypothalamic dysfunction were developed and subdivided into hyperphagia, hypophagia, body mass index, behavioral problems, sleep disorders, temperature regulation disorders, pituitary dysfunction, radiological hypothalamic assessment, and presence/suspicion of a hypothalamic genetic syndrome. Subsequently, the scoring system was tested in a retrospective cohort of 120 patients at risk for hypothalamic dysfunction.

Results

A score for presence of HS was developed. Using this new hypothalamic score, in total 52.5% were scored as having HS. Of these patients, 76.7% were diagnosed with pituitary dysfunction, 32.5% with hyperphagia, 40% with sleep disorders, and 14.2% with temperature dysregulation. For several criteria, clinical data was missing in more than 50% of cases.

Conclusions

The here proposed diagnostic criteria for hypothalamic dysfunction and score for presence of HS may be used for care purposes and to aid in early recognition. Also it will be useful for research or registration purposes.
Vascular ageing: moving from bench towards bedside
Authors: Climie Rachel E , Alastruey Jordi , Mayer Christopher C , Schwarz Achim , Laucyte-Cibulskiene Agne , Voicehovska Julija , Bianchini Elisabetta , Bruno Rosa-Maria , Charlton Peter H , Grillo Andrea , Guala Andrea , Hallab Magid , Hametner Bernhard , Jankowski Piotr , Königstein Karsten , Lebedeva Anna , Mozos Ioana , Pucci Giacomo , Puzantian Houry , Terentes-Printzios Dimitrios , Yetik-Anacak Gunay , Park Chloe , Nilsson Peter M , Weber Thomas
Published: February 2023

Prevention of cardiovascular disease (CVD) remains one of the largest public health challenges of our time. Identifying individuals at increased cardiovascular risk at an asymptomatic, sub-clinical stage is of paramount importance for minimizing disease progression as well as the substantial health and economic burden associated with overt CVD. Vascular ageing (VA) involves the deterioration in vascular structure and function over time and ultimately leads to damage in the heart, brain, kidney, and other organs. Vascular ageing encompasses the cumulative effect of all cardiovascular risk factors on the arterial wall over the life course and thus may help identify those at elevated cardiovascular risk, early in disease development. Although the concept of VA is gaining interest clinically, it is seldom measured in routine clinical practice due to lack of consensus on how to characterize VA as physiological vs. pathological and various practical issues. In this state-of-the-art review and as a network of scientists, clinicians, engineers, and industry partners with expertise in VA, we address six questions related to VA in an attempt to increase knowledge among the broader medical community and move the routine measurement of VA a little closer from bench towards bedside.
360° Virtual reality to improve patient education and reduce anxiety towards atrial fibrillation ablation
Authors: Hermans Astrid N L , Betz Konstanze , Verhaert Dominique V M , den Uijl Dennis W , Clerx Kristof , Debie Luuk , Lahaije Marion , Vernooy Kevin , Linz Dominik , Weijs Bob
Published: February 2023

Aims

Evaluation of (i) the effects of a virtual reality (VR) preprocedural patient education video on information provision, procedure-related knowledge, satisfaction, and the level of worries in patients planned for atrial fibrillation (AF) ablation and (ii) the feasibility of a disposable cardboard VR viewer for home use in this setting.

Methods and results

In this prospective observational cohort study, patients were alternatively assigned in a 1:1 ratio to the control or VR group. Controls received standard preprocedural information. VR group received standard information and a VR video (via in-hospital VR headset and disposable cardboard). The Amsterdam Preoperative Anxiety and Information Scale (APAIS) together with additional questions concerning procedural experience and satisfaction was completed pre- and post-ablation. Of 134 patients [38.1% female, aged 66 (58–72) years] included, 49.2% were assigned to the control and 50.7% to the VR group. The number of patients that worried about the ablation procedure was lower in VR than in control patients (19.1% vs. 40.9%, P = 0.006). More VR females than males had worries about the procedure (34.8% vs. 11.1%, P = 0.026). The number of VR patients that were satisfied with the preprocedural information provision was higher post-ablation than pre-ablation (83.3% vs. 60.4%, P = 0.007). In total, 59.4% reported that the disposable cardboard was easy to use and led to a discussion with relatives in 68.8%.

Conclusion

In patients scheduled for AF ablation, a VR preprocedural educational video led to better information provision and procedure-related knowledge, higher satisfaction, and less worries regarding the procedure. The disposable cardboard was feasible for home use.
Pulmonary vein isolation with the radiofrequency balloon catheter: a single centre prospective study
Authors: Del Monte Alvise , Almorad Alexandre , Pannone Luigi , Della Rocca Domenico Giovanni , Bisignani Antonio , Monaco Cinzia , Mouram Sahar , Ramak Robbert , Gauthey Anaïs , Overeinder Ingrid , Bala Gezim , Sorgente Antonio , Ströker Erwin , Sieira Juan , Brugada Pedro , La Meir Mark , Chierchia Gian-Battista , de Asmundis Carlo
Published: February 2023

Aims

The multielectrode radiofrequency balloon catheter (RFB) has been developed to achieve safe and effective pulmonary vein isolation (PVI) for atrial fibrillation (AF) ablation. This single-centre study aimed to evaluate the midterm clinical outcome and predictors of single-shot PVI with the novel RFB.

Methods and results

All consecutive patients with symptomatic paroxysmal or persistent AF undergoing first-time PVI with the RFB were prospectively included. Clinical and procedural parameters were systematically collected. The primary safety endpoint was defined as any major periprocedural complications. The primary efficacy endpoint consisted of freedom from any atrial tachyarrhythmias (ATas) lasting >30 s during the follow-up after a 3-month blanking period. Persistent single-shot PVI was defined as PVI achieved with a single RFB application without acute reconnection. A total of 104 consecutive patients (mean age 64.3 ± 11.4 years, 56.7% males) were included. 15 patients (14.4%) presented with persistent AF. The procedure time was 59.0 min with a dwell time of 20.0 min. One major complication occurred in one patient. At a mean follow-up of 10.1 ± 5.3 months, freedom from ATas was 82.9%. ATas occurred in 14 patients, 11/69 patients (15.9%) with paroxysmal AF and 3/13 (23.1%) with persistent AF. The best cut-offs to predict persistent single-shot PVI were impedance drop >19.2 Ω [area under the receiver operator characteristic curve (AUC) 0.74] and temperature rise >11.1° C (AUC 0.77).

Conclusion

In a large cohort of patients undergoing PVI with the RFB, the complication rate was 1%. At a mid-term follow-up of 10.1 ± 5.3 months, freedom from ATas was 82.9%. Specific cut-offs of impedance drop and temperature rise may be useful to predict persistent single-shot isolation.
Catheter ablation improved ejection fraction in persistent AF patients: a DECAAF-II sub analysis
Authors: Mekhael Mario , Shan Botao , Noujaim Charbel , Chouman Nour , Assaf Alaa , Younes Hadi , El Hajjar Abdel Hadi , Dagher Lilas , Feng Han , He Hua , Zhao Cong , Kreidieh Omar , Lim Chan Ho , Huang Chao , Ayoub Tarek , Kholmovski Eugene , Chelu Mihail , Marrouche Nassir , Donnellan Eoin
Published: February 2023

Aims

The aim of our study was to assess differences in post-ablation atrial fibrillation (AF) recurrence and burden and to quantify the change in LVEF across different congestive heart failure (CHF) subcategories of the DECAAF-II population.

Methods and results

Differences in the primary outcome of AF recurrence between CHF and non-CHF groups was calculated. The same analysis was performed for the three subgroups of CHF and the non-CHF group. Differences in AF burden after the 3-month blanking period between CHF and non-CHF groups was calculated. Improvement in LVEF was calculated and compared across the three CHF groups. Improvement was also calculated across different fibrosis stages. There was no significant differences in AF recurrence and AF burden after catheter ablation between CHF and non-CHF patients and between different CHF subcategories. Patients with heart failure with reduced ejection fraction (HFrEF) experienced the greatest improvement in EF following catheter ablation (CA, 16.66% ± 11.98, P < 0.001) compared to heart failure with moderately reduced LVEF, and heart failure with preserved EF (10.74% ± 8.34 and 2.00 ± 8.34 respectively, P-value < 0.001). Moreover, improvement in LVEF was independent of the four stages of atrial fibrosis (7.71 vs. 9.53 vs. 5.72 vs. 15.88, from Stage I to Stage IV respectively, P = 0.115).

Conclusion

Atrial fibrillation burden and recurrence after CA is similar between non-CHF and CHF patients, independent of the type of CHF. Of all CHF groups, those with HFrEF had the largest improvement in LVEF after CA. Moreover, the improvement in ventricular function seems to be independent of atrial fibrosis in patients with persistent AF.
Occupational Health Literacy Scale (OHLS): development and validation of a domain-specific measuring instrument
Authors: Friedrich Julian , Münch Anne-Kristin , Thiel Ansgar , Voelter-Mahlknecht Susanne , Sudeck Gorden
Published: February 2023

Occupational health literacy (OHL) is a domain-specific approach that can empower people to make health-appropriate decisions in the work environment. OHL comprises the knowledge, skills and willingness of people to access and process health-related information and to apply it in work situations. The aim of this study was to evolve a conceptual model and validate a scale for OHL, that can be used in many sectors in the Western industrial countries, which does not yet exist. After piloting, item selection and alteration were carried out in a pretest with n = 163 working adults in diverse small- and medium-sized enterprises in Germany. The resulting OHL items were validated in a main survey with n = 828 participants working in small- and medium-sized enterprises and among them 47.5% people with migration background. The final 12-item questionnaire had good structural characteristics and is reliable and valid for measuring OHL. Using exploratory structural equation modeling, good fit indices (root mean square error of approximation = 0.063, comparative fit index = 0.940) confirmed a two-factor structure: (i) knowledge and skill-based processing of health information (internal consistency α = 0.88) and (ii) willingness and responsibility for occupational health (α = 0.74). The OHL scale fills the gap regarding domain-specific OHL questionnaires for working adults in diverse sectors in Western industrial countries. The Occupational Health Literacy Scale can be used to identify the needs of employees and companies and then to adapt and evaluate health promotion measures. Further research could include validation and use in other countries and large companies.
El nombramiento de las autoridades independientes. Lecciones a partir de la experiencia española y europea
Authors: Alemán Merlo Sara , Castellá Andreu Josep Mª
Published: February 2023

This analysis focuses on the system of appointments of independent authorities as a key to their proper functioning within the democratic constitutional state, based on the Spanish experience and bearing in mind the particularities of the European constitutional context in which these institutions are rooted. To this end, we first refer to the premises underlying the creation of the various authorities. We then set out the measures used to guarantee the independence regarding the appointment and dismissal of the members of these bodies and, finally, we examine the recent problem concerning the renewal of the heads of the Spanish Data Protection Agency, due to non-compliance with the appointment procedure. Finally, the case of the AEPD allows us to examine the effectiveness of certain remedies arising from the court’s intervention with the help of European law.
The stress, satisfaction and fulfilment of early career pharmacists – a qualitative analysis of a survey on their professional and personal lives
Authors: Chee Pui Ying , Tan Li Vern , Lee Caryn Chuen Wei , Choo Britney Bao Ni , Cheong Mark Wing Loong
Published: February 2023

Objectives

This study aims to examine and develop a better understanding of (1) the factors that affect the stress of both their professional and personal lives, (2) the aspects of professional and personal life that affect their satisfaction and fulfilment and (3) what they need to achieve satisfaction and fulfilment in their professional and personal lives.

Methods

A cross-sectional study using a questionnaire was developed. The questionnaire contained 8 questions designed to collect qualitative data on the factors affecting the stress, satisfaction and fulfilment in the professional and personal lives of early career pharmacists (ECPs). Questionnaire responses were analysed using a qualitative content analysis approach and themes describing influential factors were developed.

Key findings

Some of the factors that contribute to the stress, satisfaction and fulfilment of ECPs were identified. The stressors identified include the workplace environment and relationships with colleagues, the demands of a pharmacist career, the lack of career advancement pathways, job insecurity, relationships and their weaknesses. Factors contributing to satisfaction and fulfilment included supportive work environments and relationships, being appreciated and making a difference, growth, supportive relationships and self-care.

Conclusions

Supporting the well-being of ECPs is important for a resilient, engaged and effective pharmacy workforce. Key interventions include eliminating job insecurity, establishing clear career pathways, improving work environments and relationships and investing in the development of clinical, technical, communication and managerial skills.