bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of construction defects on construction and demolition waste management in building construction: a systematic literature review
Authors: Karunasena Gayani , Gurmu Argaw , Shooshtarian Salman , Udawatta Nilupa , Ranthika Perera C Savindi , Maqsood Tayyab
Published: January 2025

The occurrence of defects in building construction projects is a significant issue, leading to increased construction waste and negatively affecting sustainability and overall project performance. Despite its critical nature, the specific relationship between construction defects and waste generation has been underexplored in the literature. This study seeks to address this gap by conducting a systematic literature review of relevant publications. The research followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, conducting an extensive search across databases like Scopus and Web of Science, which resulted in the identification and content analysis of 59 pertinent articles. The findings reveal that poor workmanship, inadequate planning and scheduling, and frequent design changes are the primary causes of defect-related waste. Additionally, the study identified 12 themes, noting that the quantification of the cost of quality and the association between defect, rework and waste have not been thoroughly analyzed. The study's implications are twofold: Theoretically, it contributes to the academic understanding of the link between construction defects and waste generation, laying a foundation for future research in this area. Practically, it underscores the need for improved industry practices, such as enhanced training for construction workers, more rigorous project planning, and stricter adherence to design and specifications, to mitigate defect-related waste and promote sustainable construction practices.
Evaluation process for matching population models to regulatory decisions regarding threatened or endangered species by considering model risk
Authors: Spromberg Julann A , Hecht Scott A , Laetz Cathy A , Hawkes Tony , Baldwin David H
Published: January 2025

Population models can be an important tool in regulatory decision-making processes regarding natural resources, such as fisheries and rare species. Regulators presented with population models for their use often do not have the specific expertise to gauge the appropriateness of the model to their specific regulatory situation and decline their use in an abundance of caution. In other cases, regulators want to be involved with model development but may lack confidence in the utility of the models and their contribution to model development. The proposed process aims to address these concerns about using population models. The utility of population models depends on the available species data and the alignment of the model structure with regulatory needs. Importantly, the confidence in the available data and the model rigor need to match the types of decisions to be made, the time frame for reassessment, and the level of risk the regulator/agency deems appropriate. Model risk, defined as the possibility that the model is wrong or the output is misapplied, may stem from data limitations, parameter estimation uncertainty, model misspecification, or inappropriate use of a model. Here, we recommend a decision framework for considering the use of population models as a line of evidence in various regulatory contexts. The framework will assist regulators as they either work with modelers to construct new models or as they select from existing models to inform their decisions. Acknowledging and managing model risk increases the confidence of using models in regulatory contexts. As we move forward with utilizing models in regulatory decision-making, use of this process will ensure models fit the regulatory question, reduce model risk, and increase user confidence in applying models.
Life cycle assessment of copper concentrate production and improvement potentials for tailing management
Authors: Keykha Mahla , Einollahipeer Fatemeh , Abyar Hajar , Erfani Malihe
Published: January 2025

Due to the widespread application and development of copper, there is growing concern about increasing pressure on available resources and significant environmental repercussions. To support improvements in copper mining, this study addressed the life cycle assessment of copper concentrate production from cradle to gate, along with the feasibility of tailings reuse, which has received less attention. To fill a critical gap, the alternative use of tailings in building and landfilling disposal was also conducted. Sodium hydroxide (36.63%-95.22%), copper concentrate (4.73%-99.4%), and carboxymethyl cellulose (0.06%-46.35%) were identified as the main contributors. Marine ecotoxicity was prioritized in terms of environmental burdens (31.28%) followed by human toxicity and freshwater ecotoxicity potential. It is interesting to note that photovoltaic systems and treated wastewater provided the required energy and water for copper concentrate production, which alleviated the final impacts. For tailings management, it was initially found that landfilling intensified the environmental impacts by 1.67–65.15 times higher than copper production processing. However, the utilization of tailings in cement production and road construction provided environmental benefits and conserved resources. Summing up, this study provided additional insights into environmental indicators of the copper industry and tailings efficiency for future applications.
Operationalization of the safe and sustainable by design framework for chemicals and materials: challenges and proposed actions
Authors: Abbate Elisabetta , Ragas Ad M J , Caldeira Carla , Posthuma Leo , Garmendia Aguirre Irantzu , Devic Anne Chloe , Soeteman-Hernández Lya G , Huijbregts Mark A J , Sala Serenella
Published: January 2025

The production and use of chemicals and materials have both advantages and drawbacks for human and ecosystem health. This has led to a demand for carefully guided, safe, and sustainable innovation in the production of chemicals and materials, taking into consideration their entire life cycle. The European Commission's Joint Research Centre (JRC) has released the Safe and Sustainable by Design (SSbD) framework, which aims to support this objective. The SSbD framework consists of two components that are intended to be iteratively implemented throughout the innovation process: (1) the application of design principles phase, and (2) the safety and sustainability assessment phase. However, the operationalization of the framework is currently challenging. This article maps the challenges and proposes ways to address them effectively. The mapping, which is based on a literature review and stakeholder opinions, resulted in 35 challenges. The highest priority challenge is “integration of SSbD framework into the innovation process.” To begin addressing this issue, this article recommends conducting a scoping analysis to define the SSbD study. This can be achieved through implementing a tiered approach that aligns with the objectives of the innovation and the growing expertise that comes with it. The second priority challenge is “data availability, quality and uncertainty.” This can be supported by using Findability, Accessibility, Interoperability, and Reuse (FAIR) principles and by optimizing in silico methods at early stages of the innovation process. An infrastructure for data and communication is necessary to effectively engage with the entire value chain. The third priority challenge is “integration of safety and sustainability aspects,” which requires a clear definition of how to integrate those aspects in the SSbD context, and harmonization, as far as possible, of input data, assumptions, and scenario construction. This review is the first step in accelerating the operationalization of the novel SSbD concept and framework into industrial practice.
Why do labor regimes change? Worker power, the supplier squeeze, and structural transformation in the global apparel industry
Authors: Marslev Kristoffer , Whitfield Lindsay
Published: January 2025

Debates on labor regimes situate worker outcomes at the intersection of globalized production and specific social formations, but they do not specify how and why labor regimes change over time. This article presents a new approach to explaining how labor regimes change in the global apparel industry, the labor-led profit squeeze approach, combining insights from global production networks (GPN), development economics and labor studies. This approach argues that workers’ bargaining power is largely conditional upon processes of structural transformation. The article demonstrates this conceptual approach through a comparative analysis of the apparel export industries in Madagascar, Cambodia, and Vietnam.
A three-parameter high-resolution 3D fast Radon Transform
Authors: Ma Jitao , Zhao Kaige , Liao Zhen
Published: January 2025

When the underground medium exhibits anisotropy, the time slices of seismic data after normal moveout correction exhibit non-standard elliptical shapes. This complexity hinders the accurate representation by the traditional two-parameter 3D Radon transforms. To address this limitation, we introduced an additional parameter to describe ellipse rotation and integrated the frequency and curvature together, resulting in a frequency-independent transform operator, which can enhance both accuracy and computational efficiency of the algorithm. However, the algorithm suffers from low resolution in the transform domain, which limits its effectiveness in suppressing multiples with small moveouts. Existing high-resolution fast Radon transform algorithms typically adopt an iterative approach to obtain respective regularization terms for each frequency, which improves resolution but at the cost of sacrificing the frequency-independent advantage of the fast algorithm. This significantly increases computational costs. In response, we propose a novel three-parameter high-resolution 3D fast Radon transform algorithm based on the constraints derived from dominant frequency calculation. This algorithm utilizes calculation results from dominant frequency seismic data as the regularization term for all frequency calculations. By pre-computing high-resolution transform operator and its inversion, and calling them in all frequency calculations, the algorithm can effectively enhance the suppression of multiples with small moveouts while avoiding a significant increase in computational costs. To further enhance computational efficiency, we also implement a GPU-based strategy for the algorithm, which significantly improves the practicality of the approach. Both synthetic and real data tests have verified the feasibility and effectiveness of this new method.
Exploring the mechanism of pachymic acid intervention in myocardial ischemia based on network pharmacology and experimental validation
Authors: Yin Nengpin , Zhao Xuan , Yang Jin , Liu Zongjun
Published: January 2025

Objectives

To deeply explore the mechanism of pachymic acid (PA) intervention in myocardial ischemia, providing new ideas and methods for the treatment of myocardial ischemia.

Methods

Predict the targets of PA for improving myocardial ischemia, and conduct functional enrichment analysis using databases, such as Gene Ontology, Kyoto Encyclopedia of Genes and Genomes, and Reactome. To verify these findings, PPI network topology analysis and molecular docking were used to screen key targets and main mechanisms of action and further validated through in vitro experiments on the H9C2 cell line.

Key findings

PA can significantly alleviate myocardial damage caused by hypoxia/reoxygenation, effectively reversing the abnormalities of oxidative stress indicators such as LDH, MDA, SOD, and ROS. PA may exert its effects through 39 targets, particularly by regulating the downregulation of autophagy-related proteins LC3-II and Beclin-1 expression via MTOR, thereby inhibiting excessive autophagy in cardiomyocytes.

Conclusions

PA protects myocardial cells during myocardial ischemia through various pathways, particularly by regulating mTOR to inhibit excessive autophagy.
Modernist Synagogues for Modern Jews: Architecture and Jewish Identity in Weimar-Era Germany
Authors: Geller Jay Howard
Published: January 2025

As Jewish communities in Germany constructed new synagogues in the 1920s and early 1930s, both the architectural style of the buildings and their use signaled a change in German–Jewish identity compared to German Jewry before the First World War. Architects wanted an aesthetic unencumbered by overtly un-Jewish associations and rejected historicism, especially “Oriental” neo-Moorish style and Christian-inspired neo-Romanesque architecture, which had characterized previous German synagogues. They opted for the aesthetic of the modernist Neues Bauen (New Building) movement, which was contemporary and regarded as not religiously didactic. In addition, the new buildings were purposely designed and built to serve as centers for Jewish cultural and social life rather than solely or almost solely as houses of worship, in contrast to nineteenth-century synagogues.
Hierarchical Bayesian inference on an analytical toy model of the LISA MBHB population
Authors: Langen Vivienne , Tamanini Nicola , Marsat Sylvain , Bortolas Elisa
Published: January 2025

Massive black hole binary (MBHB) mergers detected by the Laser Interferometer Space Antenna (LISA) will provide insights on their formation via dark matter (DM) halo and galaxy mergers. We present a novel Bayesian inference pipeline to infer the properties of an analytical model describing the MBHB population. The flexibility of our approach allows for exploring the uncertain range of MBH seeding and growth, as well as the interplay between MBH and galactic astrophysics. This flexibility is fundamental for the successful implementation and optimization of hierarchical Bayesian parameter estimation that we apply to the LISA MBHB population for the first time. Our inferred population hyper-parameters are chosen as proxies to characterize the MBH–DM halo mass scaling relation, the occupation fraction of MBHs in DM haloes and the delay between halo and MBHB mergers. We find that LISA will provide tight constraints at the lower-end of the mass scaling relation, complementing EM observations which are biased towards large masses. Furthermore, our results suggest that LISA will constrain features of the MBH occupation fraction at high redshift, as well as time delays around a few hundreds of Myr. Although our analysis clearly shows that results are affected by a degeneracy between the efficiency of time delays and the overall abundance of MBH that can potentially merge, they open the possibility to constrain dynamical evolution times such as the dynamical friction. Our analysis is a first attempt at developing hierarchical Bayesian inference to the LISA MBHB population, opening the way for further investigations.
Nuances in Visual Rehabilitation After Pituitary Surgery
Authors: Gupta Saksham , Bi Wenya Linda
Published: January 2025

Patients with pituitary lesions often present with visual deficits attributable to mass effect along the optic pathway or on the cranial nerves controlling extraocular muscles. While symptoms often improve after treatment, persistent symptoms negatively impact quality of life. We reviewed the literature on emerging concepts in visual monitoring and recovery during and after pituitary surgery. Rigorous preoperative laboratory testing, neuro-ophthalmologic examination, and imaging abets planning of safe surgery. Intraoperative visual evoked potentials may provide an adjunct to monitor impending damage to vision during surgery, particularly for recurrent tumors that may have scarred onto visual structures. Treatment of persistent visual deficits depends on the physiological cause of the deficit, the duration of symptoms, and the degree and pace of spontaneous recovery. Management ranges from observation to corrective oculoplastic surgery, often in the context of a multidisciplinary team. There are several gaps in knowledge on the reasons why visual deficits remain after adequate decompression during surgery, and further study will reveal new therapies and devices. Postoperative visual deficits following pituitary surgery can cause a considerable reduction in quality of life. Multidisciplinary neurosurgery, neuro-ophthalmologic, and neuro-endocrine teams should work in concert to provide an individualized approach for each patient.
Adjunctive nivolumab in combination with antibiotic therapy for the management of refractory melioidosis in a patient with metastatic breast cancer and chemotherapy-induced pancytopenia
Authors: Tirlangi Praveen Kumar , Kiran Swathi , KE Vandana , Mukhopadhyay C , Kundu Ramit , Pai Ananth , PS Priya , Saravu Kavitha
Published: January 2025

Burkholderia pseudomallei, the causative agent of melioidosis, is intrinsically resistant to multiple classes of antibiotics and primarily affects immunocompromised individuals, such as those with poorly controlled diabetes or malignancies. In this case, a 58-y-old female farmer with poorly controlled diabetes (HbA1c of 11.4%), metastatic breast cancer with chemotherapy-induced pancytopenia and disseminated melioidosis showed no improvement despite receiving antibiotics and supportive care. However, the introduction of adjunctive nivolumab, combined with an antibiotic regimen, resulted in significant therapeutic benefit, suggesting a promising new approach for managing severe and refractory melioidosis.
A Sorghum BAK1/SERK4 Homolog Functions in PAMP-Triggered Immunity and Cell Death in Response to Colletotrichum sublineola Infection
Authors: Vela Saddie , Wolf Emily S. A. , Zhou Mingxi , Davis Alyssa , Mou Zhonglin , Cuevas Hugo E. , Vermerris Wilfred
Published: January 2025

Sorghum bicolor (L.) Moench is the fifth most important cereal crop and expected to gain prominence due to its versatility, low input requirements, and tolerance to hot and dry conditions. In warm and humid environments the productivity of sorghum is severely limited by the hemibiotrophic fungal pathogen Colletotrichum sublineola, the causal agent of anthracnose. Cultivating anthracnose-resistant accessions is the most effective ane environmentally benign way to safeguard yield. A previous genome-wide association study for anthracnose resistance in the sorghum association panel (SAP) uncovered single nucleotide polymorphisms on chromosome 5 associated with resistance to anthracnose, including one located within the coding region of gene Sobic.005G182400. In this study, we investigated the molecular function of Sobic.005G182400 in response to C. sublineola infection. Conserved domain, phylogenetic, and structural analyses revealed that the protein encoded by Sobic.005G182400 shares significant structural similarity with the Arabidopsis BRASSINOSTEROID INSENSITIVE 1-ASSOCIATED RECEPTOR KINASE 1 (BAK1) / SOMATIC EMBRYOGENESIS RECEPTOR-LIKE KINASE 4 (SERK4). Even though sequence analysis of four sorghum accessions showed no substantial variation in the coding region, accession SC1330, which carries the resistance allele, exhibited significantly higher expression of Sobic.005G182400 during early infection (≤24 hours). Co-expression network analysis identified the module associated with Sobic.005G182400 was enriched in genes involved in endocytosis, autophagy, and vesicle transport. Gene regulatory network analysis further suggested that Sobic.005G182400 regulates genes required for BAK1/SERK4-mediated cell death via protein glycosylation. Together, these findings indicate that Sobic.005G182400 encodes a protein with similarity to Arabidopsis BAK1/SERK4 that enables PAMP-triggered immunity and regulates cell death.
Extracellular vimentin amplifies inflammation: Perspectives for immune injury and therapeutics for periodontitis
Authors: Yuan Zhiyao , Smith Patricio , McCulloch Christopher A.
Published: January 2025

Periodontitis is an inflammatory disease triggered by microbial biofilms that promote immune dysfunction and tissue destruction of tooth‐supporting tissues. The search for soluble mediators that amplify inflammatory responses and matrix degradation in periodontal tissues has implicated extracellular vimentin (ECV) as a signaling ligand and damage‐associated molecular pattern in the pathogenesis of periodontitis. Intracellular vimentin filaments are essential for the structural integrity of cells and the preservation of matrix homeostasis. These are important determinants of health in the periodontium and many other organs. But in inflamed tissues, intracellular vimentin filaments are disassembled. Vimentin is subsequently released from cells into the extracellular space in a soluble form where it drives immune signaling and tissue destruction. We discuss the role of ECV as a signaling molecule in several tissues. We apply these data to understand how in inflammatory diseases like periodontitis, ECV amplifies immune responses that contribute to disease progression. Arising from these data, we consider novel therapeutic opportunities for limiting tissue destruction by targeting ECV for treatment of inflammatory disorders like periodontitis.
Artificial Intelligence Anxiety in Nursing Students
Authors: Varol Belgin
Published: January 2025

As in many other sectors, artificial intelligence has an impact on health. Artificial intelligence anxiety may occur because of a lack of knowledge about the effects of artificial intelligence, its outcomes, and how it will be used, as well as potential labor concerns. This study aims to determine the artificial intelligence anxiety levels of nursing students and examine whether there is a relationship with their self-efficacy levels. This cross-sectional study, conducted at a public nursing school in Turkey, involved 317 nursing students. Data were collected using a personal information form, the General Self-efficacy Scale, and the Artificial Intelligence Anxiety Scale. There was a negative, moderately strong correlation between the General Self-efficacy Scale and the learning subdimension (r = −0.369) and the Artificial Intelligence Anxiety Scale (r = −0.313) and a weak negative correlation between the job replacement subdimension (r = −0.215), sociotechnical blindness subdimension (r = −0.232), and artificial intelligence configuration subdimension (r = −0.211). The General Self-efficacy Scale has a significant negative effect on the Artificial Intelligence Anxiety Scale (β = −.313, t = −5.845, P < .05). These findings suggest that higher self-efficacy is associated with lower artificial intelligence anxiety. It is recommended to enhance technical competence and self-efficacy in nursing education.
Development and psychometric properties of a quality of life assessment tool for Chinese patients undergoing intravitreal injection (IVI-QoL-23)
Authors: Tan Liangzhang , Linghu Wenrui , Xu Meiqi , Liu Shoukuan , Li Yongtao , Ke Yifeng , Pazo Emmanuel Eric , Ren Xinjun
Published: January 2025

Purpose:

To develop and assess the psychometric properties of a quality of life (QoL) assessment tool for Chinese patients treated with intravitreal injection (IVI) of anti-vascular endothelial growth factor (anti-VEGF).

Methods:

We developed a 31-item IVI-QoL questionnaire using semi- structured patient interviews and expert panel consultation, drawing on a study of the literature. After pretesting on a subset of patients undergoing IVI, the questionnaire was pared down to 23 items. In total, 364 completed questionnaires were received. The IVI-QoL was further developed and evaluated using Rasch analysis.

Results:

The final IVI-QoL version was constructed with 23 items in four dimensions: visual function, emotional subscale, social function, and healthy behavior, based on item reduction and exploratory factor analysis. The person separation indices for the four subscales ranged from 2.05 to 2.60. No items had a differential item functioning (DIF) contrast greater than 0.5 logits. The IVI-QoL-23 scale showed satisfactory internal consistency (Cronbach’s alpha > 0.9).

Conclusions:

The IVI-QoL-23 is reliable and valid for evaluating the QoL of Chinese patients treated with intravitreal injection of anti-VEGF drugs.
Longitudinal changes of macular neurodegenerative and vascular abnormalities on OCTA in sickle cell disease
Authors: Brandsen Rajani P. , Biemond Bart J. , Nur Erfan , Chang-Wolf Jennifer M. , Schlingemann Reinier O. , Diederen Roselie M.H.
Published: January 2025

Purpose:

To evaluate the presence and progression of maculopathy in patients with sickle cell disease (SCD) using Optical Coherence Tomography (OCT) and OCT-Angiography (OCTA), and to identify clinical/laboratory risk factors for progression during follow-up.

Methods:

Complete ophthalmic examination, including fundoscopy and macular SD-OCT/OCTA scans, was performed in consecutive SCD-patients (HbSS/HbSβ0/HbSβ+/HbSC genotype) during baseline and follow-up visits. SCR stage was based on fundoscopy instead of the Goldberg classification, since fluorescein angiography was not routinely used. Medical/ophthalmological history and hematologic characteristics were retrieved from medical records.

Results:

106 eyes of 60 patients were analyzed. The median follow-up period was 34.5 months (range 8-70, IQR 25-55). Macular thinning was present in 41 eyes (38.7%) at baseline and in 52 eyes (49.1%) at follow-up. Progression of macular thinning was observed in 25.5% (27/106) of the eyes and SCR progression in 15.1% (16/106) of the eyes. Predictors for progression of macular thinning were proliferative retinopathy (adjusted OR (aOR) 3.40, p=0.024), lower vessel density in the superior capillary plexus of the inferior parafoveal subfield (aOR 0.88, p=0.003) and higher vessel density in the deep capillary plexus of the inferior parafoveal subfield (aOR 1.17, p=0.001). No association was found between progression of macular thinning and worsening of other organ damage, SCR progression, ocular complications or laser treatment.

Conclusions:

SCD-related maculopathy progresses in many patients without impairing visual acuity during short-term follow-up. Progression of maculopathy is correlated with proliferative retinopathy and vessel densities in inferior parafoveal subfields. Further research is needed to elucidate functional consequences of macular changes.
Removal of Subretinal Gas After Pneumatic Retinopexy Under Air Using External Manipulation
Authors: Cobbs Lucy , Rodriguez Linnet , Hinkle John , Hsu Jason , Mehta Sonia
Published: January 2025

Purpose:

To illustrate a technique for the removal of subretinal gas via pars plana vitrectomy (PPV) with air-fluid exchange and simultaneous manipulation with scleral depression.

Methods:

PPV to remove subretinal gas causing persistent macula-off retinal detachment was performed in one eye, and the results were evaluated in this case report. Ports were carefully placed to avoid puncturing the retina, which was significantly displaced anteriorly past the ora serrata due to the buoyancy of the subretinal gas with the patient in a supine position. After vitrectomy was performed, an air-fluid exchange was initiated to flatten the anterior retina and assist in stabilizing the subretinal gas bubble. Simultaneously, a scleral depressor was used to apply external pressure in a sweeping motion to direct the subretinal gas toward the pre-existing retinal break where it was aspirated or moved into the vitreous cavity.

Results:

The one-year postoperative visual acuity without correction was 20/25 with normal intraocular pressure and attached retina. There were no intraoperative or postoperative complications.

Conclusion:

Our technique used a partial air-fluid exchange to stabilize the subretinal gas and external manipulation with a scleral depressor to manually extrude subretinal gas. This maneuver was previously described in the 1980s, and we include a surgical video of its execution with modern vitrectomy equipment and the benefit of excellent control of the subretinal gas without the need to create a retinotomy.
Comparison of “Lung and Large Intestine being Exterior-Interior” and “Gut-Lung Crosstalk” Based on COVID-19
Authors: Wang Yunliang , Zhang Yan
Published: January 2025

The infection of SARS-CoV-2 has triggered Covid-19 pandemic. In addition to the fever and respiratory symptoms in the process of coronavirus infections, gastrointestinal symptoms, especially diarrhea, are prominent features of its acute infection and long COVID. The associations between lung and large intestine have been demonstrated by Western medicine at the aspects such as tissue origin, microflora homeostasis, mucosal immunity, renin-angiotensin system (RAS) and autonomic nervous system as well, which are considered as the evidence of material basis and potential regulatory mechanisms for “gut-lung crosstalk” in COVID-19. We have noticed that probiotics and other preparations can regulate the intestines, and further treat COVID-19 with effective and gratifying results. In the system of traditional Chinese medicine (TCM), there’s a term of “lung and large intestine standing in exterior-interior relationship (肺与大肠相表里)”, showing an interconnection of lung and bowel. “lung and large intestine standing in exterior-interior relationship” is an important part of the theory of visceral activities proposed by ancient physicians through a long-term observation and practice. It’s considered that "lung" and "large intestine" are interconnected and mutually exterior-interior in the normal physical activities and the disease development, providing a theoretical basis for treating lung diseases and bowel diseases from the perspective of overall concept. Here, we intend to compare the term of “lung and large intestine standing in exterior-interior relationship” in TCM and “gut-lung crosstalk” in Western medicine regarding the development of COVID-19 and its intestinal symptoms, and provide more ideas for diagnosing and treating lung and bowel related diseases.
Traditional Chinese Medicine Recorded by Missionaries (1887-1932): A Study Centered on the China Medical Missionary Journal
Authors: LI YanRan , YAN Na
Published: January 2025

It was in The China Medical Missionary Journal (CMMJ) that traditional Chinese medicine (TCM) made her academic international debut, which was first published in Shanghai in 1887. Originally, It integrated medical evangelism, hospital reports and world medical development, and it was transformed into a purely academic journal in 1907. There are many records related to TCM in it, such TCM diagnosis, treatment methods and clinical practices. These records show the process of how the missionaries observed, understood, learned, and used TCM. They also reflect the attitudes of medical missionaries towards TCM after experiencing it in its homeland - China at that time. The writings of missionaries on TCM represent a confluence of Eastern and Western medical research and cultural interactions, contributing significantly to the study of modern Chinese medical advancements and Sino-Western cultural exchanges.
Performance of Ulcer Features in Predicting Malignancy Among Gastric Ulcers Diagnosed on Upper Endoscopy
Authors: Patel Ankur P. , Gandle Cassandra , Baerman Elliot , Lill Isaac , Pecha Robert L. , Nguyen Wenker Theresa H. , El-Serag Hashem B. , Ketwaroo Gyanprakash A. , Tan Mimi C.
Published: January 2025

Objective:

Even though the prevalence of malignancy within gastric ulcers is low, surveillance endoscopy is routinely performed after gastric ulcer diagnosis resulting in unnecessary costs and risks. Endoscopic appearance may be used to identify ulcers with malignant features and guide decisions regarding the need for surveillance endoscopy. Our aim was to assess the predictive value of several endoscopic ulcer features with the risk of prevalent malignancy in patients diagnosed with gastric ulcers.

Methods:

Patients with gastric ulcers were identified using endoscopic reporting software in 2 hospitals in Houston, TX, from February 2019 to July 2021. Malignant and benign gastric ulcers were defined using ulcer biopsy histopathology, and ulcers that had healed on surveillance endoscopy were also classified as benign ulcers. Potential endoscopy-related predictors of malignant ulcers included: Forrest classification, location, size, elevated border, irregular border, and background gastric atrophy.

Results:

We identified 338 patients with gastric ulcers, and 150 (44%) had at least one surveillance endoscopy. Malignant ulcers were found in 41 patients (12%). The strongest predictors of malignancy were irregular border [area under receiver operating characteristic (AUROC): 0.89, 95% CI: 0.80-0.97], gastric atrophy on histopathology (AUROC: 0.87, 95% CI: 0.78-0.96), and elevated border (AUROC: 0.84, 95% CI: 0.73-0.95). A multivariate model including corpus/cardia location, irregular border, elevated border, and gastric atrophy on histopathology had the best discrimination for predicting malignant ulcers (AUROC: 0.96, 95% CI: 0.93-0.98) with low false negatives (0.4%).

Conclusions:

A model combining corpus/cardia location, irregular border, elevated border, and gastric atrophy on histopathology best-predicted malignancy in gastric ulcers and may identify patients with the most benefit from surveillance endoscopy.
A Systematic Critical Appraisal of Clinical Practice Guidelines in Barrett’s Esophagus Using the AGREE II Tool
Authors: Dayto Denisse C. , Sephien Andrew , Reljic Tea , Klocksieben Farina , Slone Samuel , Kumar Ambuj , Blonski Wojciech
Published: January 2025

Background:

Several clinical practice guidelines (CPGs) exist for managing Barrett’s esophagus (BE). However, the methodological quality of these CPGs is not known. To summarize the methodological quality of CPGs, we performed a critical appraisal of all available CPGs for the management of BE published from January 2018 to February 2023.

Methods:

A comprehensive search of EMBASE and PubMed was conducted to identify eligible CPGs published from January 1, 2018, until February 24, 2023, addressing the management of BE. The Canadian Agency for Drugs and Technologies broad filter was also utilized in the search. The quality of the CPGs was independently assessed and evaluated by 2 reviewers using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) instrument, with domain scores showing good quality being >80% and sufficient quality being >60%. The search yielded 652 citations, of which 5 CPGs met eligibility.

Results:

Three CPGs were published by gastroenterology societies in the United States and 2 in Europe. The overall median score for the AGREE II domain was 100% for scope and purpose, 93% for stakeholder involvement, 93% for rigor of development, 93% for clarity of presentation, 75% for applicability, and 75% for editorial independence.

Conclusion:

The findings from our study show that there is significant variability in the methodological quality of the CPGs for the management of BE across different domains. The application of the AGREE II tool can help CPG developers in improving the methodological rigor and applicability of CPGs.
Complete mesocolic excision versus D2 lymphadenectomy in right hemicolectomy: a meta-analysis of propensity score matched studies and randomized controlled trials
Authors: Pompeu Bernardo Fontel , Pasqualotto Eric , Marcolin Patrícia , Delgado Lucas Monteiro , Pigossi Beatriz D’Andrea , Figueiredo Sergio Mazzola Poli de , Formiga Fernanda Bellotti
Published: January 2025

Introduction:

The complete mesocolic excision (CME) in right-sided hemicolectomy could result in higher lymph node yield and decreased local recurrence. However, this approach could increase intraoperative and postoperative complications. Therefore, our meta-analysis aims to demonstrate the outcomes of CME versus D2 conventional lymphadenectomy in right-side colon cancer.

Methods:

We searched MEDLINE, Cochrane Central Register of Clinical Trials, and Scopus for studies published until April 2024. Odds ratios (OR) with 95% confidence intervals (CIs) were pooled using a random-effects model. Heterogeneity was assessed using the Cochran Q test and I
2 statistics, with P values <0.10 and I
2 >25% considered significant. Statistical analysis was performed using R Software, version 4.1.2.

Results:

Three randomized controlled trials and four observational studies comprising 2296 patients were included, of whom 1138 (49.6%) were submitted to the CME and 1158 (50.4%) to the conventional D2 lymphadenectomy. CME was associated with decreased local recurrence rates (OR 0.07; 95% CI 0.001 to 0.36; P = 0.002). There were no significant differences between groups in overall complications, severe complications, intraoperative complications, blood loss, and 30-day mortality. No difference between groups was observed in distance metastasis and 3-year disease-free survival.

Conclusion:

In this meta-analysis, CME significantly decreases local recurrence rates compared with D2 conventional lymphadenectomy in patients with right-side colon cancer. No significant difference was observed between groups in rates of overall complications, severe complications, intraoperative complications, blood loss, and 30-day mortality.
A bleeding sword: Scimitar syndrome in a child with hematemesis due to esophageal varices – a case report
Authors: Elawad Aida , Arabi Ali M. E. , Yousif Rayan , Ganim Mohammed , Rafei Ahmed , Bedab Rawan A. , Salah Reem , Abdo Abdelmounem E.
Published: January 2025

Introduction:

Scimitar syndrome, or congenital venolobar syndrome, is a rare congenital heart condition that typically involves partial anomalous pulmonary venous drainage (PAPVD) of the right lung, right lung hypoplasia, and dextroposition of the heart. The incidence is estimated to be between 1 and 3 cases per 100 000 live births. Most patients present with cardiopulmonary symptoms, though rare cases may involve gastrointestinal (GI) complications. We report a unique case of Scimitar syndrome in a 10-year-old boy presenting with hematemesis due to esophageal varices.

Case Presentation:

A 10-year-old boy presented with massive hematemesis, losing approximately 1 liter of fresh blood. After stabilization, an upper GI endoscopy revealed grade IV esophageal varices, which were ligated successfully. Abdominal ultrasound showed mild portal hypertension, and a unique vessel, identified as the Scimitar vein, was found draining into the left portal vein. Subsequent imaging confirmed right lung hypoplasia, dextroposition of the heart, and PAPVD, leading to the diagnosis of Scimitar syndrome. The patient was transferred abroad for specialized care due to limited medical facilities in Sudan.

Clinical Discussion:

Scimitar syndrome is often associated with severe symptoms in children, such as respiratory failure and pulmonary hypertension. Upper GI bleeding in this syndrome is rare, likely resulting from portal hypertension caused by the anomalous drainage of the Scimitar vein into the left portal vein.

Conclusion:

This case underscores the importance of recognizing the diverse complications of Scimitar syndrome, including its rare association with upper GI bleeding. Timely diagnosis and intervention, especially in resource-limited settings, are critical to managing complex congenital conditions.
Mad (wild) honey poisoning: a case series of eleven cases
Authors: Subedi Bhusan Kumar , Homagain Sushan , Ghimire Jeevan , Subedi Shova , Paudel Suruchi , Pandeya Govinda , Jha Saroj Kumar , Shrestha Nishan , Twanabasu Sajal , Devkota Sadina
Published: January 2025

Introduction:

Mad (Wild) honey, used as alternative medicine in some countries where cases of poisoning are reported, got its name due to its intoxicating effects. Poisoning due to mad honey mostly presents as bradycardia and hypotension.

Case reports:

We report 11 cases involving 6 females and 5 males, of mad honey poisoning used for medicinal purposes. All patients were young adults (average age 43.9 years) except for one. Lightheadedness, dizziness and nausea were the most common complaints. All presented in bradycardia ranging from 35 to 60 beats per minute. All cases were managed conservatively while one required vasopressors support. All patients improved with a couple of days of supportive care.

Discussion:

Mad honey poisoning seems to be a geographically restricted entity as the majority of cases are reported from a particular region. Because of its use as an alternative medicine for various purposes, cases of intoxication occur year around. Although the signs and symptoms of mad honey can be life threatening including nausea, dizziness, bradycardia, and hypotension, the prognosis is generally good

Conclusion:

Although the prognosis is fairly good, mad honey intoxication has significant morbidity. Lack of awareness about the potential complications of consuming mad honey seems to be the cause of cases of poisoning seen annually.
Factors affecting maternal health and antenatal care services of working mothers in Southwestern Coastal Bangladesh: a cross-sectional study
Authors: Al-Mamun Md. , Kalam Abul , Uzzal Nurul Islam
Published: January 2025

Background and aims:

Maternal health is a crucial component of public health, with antenatal care (ANC) services essential for positive pregnancy outcomes. However, many women in low-income, marginalized populations face barriers to accessing this care. This cross-sectional study aims to investigate the factors affecting maternal health and ANC utilization among working mothers in southwestern coastal regions of Bangladesh.

Methods:

Utilizing a structured questionnaire, data were collected from 220 working mothers from coastal regions, ages 16–45, who participated in the study. Reliability statistics and multivariate logistic regression analyses were used to identify the factors contributing to utilizing ANC. Adjusted odds ratio and 95% confidence interval were computed to show the strength of the association more clearly.

Results:

Many pregnant working women in coastal Bangladesh encounter problems with their maternal health, such as an insufficient proper ANC system (23.2%) and insufficient healthcare facilities (13.6%). In spite of the government’s best efforts, inaccessibility (20%) is still a major barrier to ANC utilization, especially in outlying coastal regions. Ordinal logistic regression was used to find the association between socioeconomic characteristics and the ANC system. Cultural beliefs restricted pregnant women to healthcare access to 2.73 times more than other factors. In addition, distance to healthcare access was found to be 1.22 times more than other factors. We hope that the results of this study highlight the critical need for immediate, focused initiatives to improve maternal health outcomes and increase the use of ANC in coastal areas of Bangladesh. Findings highlight significant associations between socioeconomic factors and healthcare-seeking behavior, emphasizing the need for targeted interventions to improve maternal health outcomes in similar settings.

Conclusions:

Strategies to increase community awareness, expand access to ANC services, and improve accessibility should consider the unique requirements of coastal women.
Leukocyte dynamics in female reproductive health: roles and mechanisms
Authors: Obeagu Emmanuel Ifeanyi , Obeagu Getrude Uzoma
Published: January 2025

Leukocytes are critical mediators of immune responses and play multifaceted roles in female reproductive health, influencing processes such as menstruation, ovulation, implantation, pregnancy, and parturition. This review examines the dynamic involvement of key leukocyte populations, including neutrophils, macrophages, T lymphocytes, natural killer (NK) cells, and dendritic cells, across reproductive processes. Leukocytes contribute to tissue remodeling, hormonal regulation, immune tolerance, and pathogen defense. Dysregulation in their functions is implicated in reproductive disorders such as endometriosis, recurrent pregnancy loss (RPL), and complications arising from infections. The review integrates emerging insights into the molecular mechanisms governing leukocyte behavior, emphasizing the roles of cytokines, hormones, and chemokines in guiding their recruitment and activity. Key findings underscore the significance of leukocyte-mediated cytokine networks in maintaining immune homeostasis during pregnancy and their critical roles in spiral artery remodeling for fetal-maternal exchange. Neutrophils and macrophages support menstrual shedding and repair, while NK cells facilitate trophoblast invasion and placental development. Dysregulated leukocyte activity contributes to chronic inflammation in endometriosis and impaired immune tolerance in RPL. Additionally, leukocytes are central to immune defenses against infections, but excessive inflammation can lead to infertility or adverse pregnancy outcomes. Therapeutic strategies targeting these immune cells hold promise for managing reproductive health disorders by modulating inflammation, enhancing immune tolerance, and developing biomarkers for early diagnosis. In conclusion, leukocyte dynamics are integral to reproductive physiology and pathology, with significant potential for translational research to optimize reproductive health outcomes.
Single-Double-Single Barrel (1-2-1) Fibula Free Flap Design for Functional and Esthetic Brown Class III Mandibular Reconstruction
Authors: PU Jane J. , YU Xingna , POW Edmond H. N. , LAM Walter Y. H. , SU Yu-xiong
Published: January 2025

This novel hybrid single-double-single barrel (1-2-1) design for fibula free flap reconstruction addresses the unique challenges presented by Brown Class III mandibular defects, which involve long-span defects at both bodies of the mandible and the chin. The importance of this design lies in its ability to overcome the limitations of traditional approaches in terms of mandible height and pedicle length, while optimizing both functional and esthetic outcomes.

The technique utilizes a combination of single-double-single barrel fibula segments to achieve ideal esthetics and support for dental prosthesis across different areas of the mandible. At the chin, a double barrel design provides proper chin and lower lip projection and supports dental prosthesis at the alveolus, while single barrel segments are used for the mandibular bodies to allow adequate restorative space for dental rehabilitation and save the pedicle length.

Favorable outcomes were demonstrated in terms of flap survival, dental implant osseointegration, bony healing, facial aesthetics, and occlusal rehabilitation. By addressing both functional and aesthetic requirements, this technique represents an important advancement in mandibular reconstruction for complex Brown Class III defects. The approach showcases the potential of computer-assisted surgery and innovative flap designs to improve patient outcomes in challenging reconstructive scenarios.