bluuebunny/crossref_metadata_2025 huggingface dataset:
The ‘Primeless Pump’: A Novel Technique for Intraoperative Blood Conservation
Authors: Rousou J. A. , Engelman R. M. , Flack J. E. , Deaton D. W. , Garb J. L. , Owen S. G.
Published: September 2024

Purpose:

Hemodilution during cardiopulmonary bypass may lead to anemia requiring intraoperative transfusions. Prime removal from the cardiopulmonary bypass circuit was used to limit dilution and intraoperative transfusions.

Methods:

The technique of prime removal consists of arterial and then venous side evacuation of crystalloid prior to cardiopulmonary bypass. The effectiveness of this technique, to maintain a higher hematocrit and reduce intraoperative transfusions, was studied prospectively in two consecutive groups of patients undergoing coronary revascularization (controls versus primeless).

Results:

Intraoperative hematocrits were significantly higher ( P < 0.0001) and transfusions lower (4%) in the primeless versus the control group (19%) ( P = 0.003). Prime removal is of particular benefit in anemic (hematocrit ≤ 35%) and/or small patients (body surface area ≤ 2 m2).

Conclusion:

The technique of prime removal is simple, safe and cost-effective, reducing intraoperative transfusions, especially in small and/or anemic patients. It could be part of blood conservation strategies in most adult cardiac operations.
Minimally Invasive Thoracoscopic Thoraco-Femoral Bypass: A Case Report
Authors: McMillan W. D. , McCarthy W. J.
Published: September 2024

Thoracoscopic techniques have improved a variety of thoracic surgical procedures. Thoraco-femoral bypass is an exceptional alternative to standard thoracoscopic thoraco-femoral bypass. Herein we report our initial human experience with a thoracoscopic thoraco-femoral bypass.
Inflammatory Pseudotumor of Carotid Artery: A Case Report
Authors: Kim G.-E. , Cho Y.-P. , Chung D.-H. , Kwon T.-W. , Kim O.-J.
Published: September 2024

Inflammatory pseudotumor is an uncommon round and spindle cell proliferative lesion of unknown etiology that occurs most commonly in the lung. But it also occurs in diverse extrapulmonary locations such as the abdomen, retroperitoneum, pelvis, heart, head and neck, upper respiratory tract, trunk, bladder and extremities. The extrapulmonary inflammatory pseudotumor is often larger, less well circumscribed and multinodular. Proximity of the tumor to vital structures or involvement of vital organs compromises the opportunity for complete resection, thus higher recurrence rates are often reported even after surgical treatment.

The authors report a case of inflammatory pseudotumor originating from the common carotid artery in a 42-year-old female patient with a rapidly growing neck mass, treated by en-bloc resection of inflammatory pseudotumor and a long segment of common carotid artery followed by PTFE graft interposition.
The Pharmacokinetics of a Single Dose of Gentamicin (4 mg/kg) as Prophylaxis in Cardiac Surgery Requiring Cardiopulmonary Bypass
Authors: Lewis D. R. , Longman R. J. , Wisheart J. D. , Spencer R. C. , Brown N. M.
Published: September 2024

Background:

Cardiopulmonary bypass has complex effects on drug pharmacokinetics, which is important when considering the use of once-daily aminoglycoside regimens during cardiac surgery.

Aim:

To study the effects of cardiopulmonary bypass on the pharmacokinetics of a single dose of gentamicin (4 mg/kg).

Patients and methods:

Nine patients undergoing valve replacement surgery were given a single dose of gentamicin (4 mg/kg) at induction of anaesthesia and blood was taken for assay at 0, 0.5. 1. 1.5, 2, 2.5, 3, 4, 6, 10, 16, 22 and 24 h following administration. The mean (range) gentamicin Cmax was 18.7 (12.4–26.3) mg/litre. Three patients had concentrations of gentamicin after 24 h of > 1 mg/litre. During cardiopulmonary bypass, the mean (range) gentamicin half-life (tt/2) was 5.1 (2.0–15.1) h and post-bypass the t1/2 was 7.1 (3.0–13.9) h.

Conclusion:

There is significant correlation between the elimination t1/2 and length of cardiopulmonary bypass ( r = 0.89, P < 0.01). These results suggest that gentamicin excretion is delayed following cardiopulmonary bypass so that with dose regimens of < 4 mg/kg there is a risk of toxicity
Multivalvular Surgery for Infective Endocarditis
Authors: Mueller X. M. , Tevaearai H. T. , Stumpe F. , Fischer A. P. , Hurni M. , Ruchat P. , von Segesser L. K.
Published: September 2024

The short and the long-term results of our experience with 25 consecutive patients who underwent multivalvular surgery for infective endocarditis are analysed. Preoperatively, 20/25 (80%) patients were in New York Heart Association (NYHA) stage III or IV, and 2/25 (8%) patients were in cardiogenic shock. All the diseased valves were replaced with mechanical bileaflet prosthesis except seven mitral valves and one tricuspid valve, which could be repaired. Major postoperative complications occurred in 3/25 (12%) patients: a fatal cerebral haemorrhage, a reversible cerebellar syndrome and an intractable heart failure, which required transplantation. During a mean follow-up of 4.7 years (range 6 months to 16.8 years). 7/25 (28%) patients suffered from valve-related complications: five bleedings (one died), one embolic event and one prosthetic valve thrombosis. The actuarial freedom of valve-related event at 10 years was 61.8 ± 12.4%. There was no prosthetic endocarditis. At follow-up. 20/21 (95%) survivors were in NYHA stage 1 or II. Long-term outcome in our patient population operated on for multivalvular endocarditis, is satisfactory with no recurrent infection and excellent functional results.
Surgical Treatment for Aortic Regurgitation Caused by Non-Specific Aortitis
Authors: Ando M. , Kosakai Y. , Okita Y. , Matsukawa R. , Takamoto S.
Published: September 2024

Aortic regurgitation caused by non-specific aortitis is relatively rare, and prosthetic valve detachment after aortic valve replacement has been reported to be one of the most serious complications. The authors investigated the surgical results In patients with aortic regurgitation caused by non-specific aortitis. Between 1978 and 1997.90 patients with aortic regurgitation secondary to non-specific aortitis underwent surgery. There were 28 males and 62 females. The age of these patients ranged from 19 years to 70 years (mean. 48 years). Sixty-five patients were diagnosed to have Takayasu's arteritis. 10 had Behçet's disease and 15 had aortitis of unknown etiology. The surgical procedures for aortic regurgitation were aortic valve replacement in 62 patients. Bentall-type operation in 27 and remodeling in one. Five patients (5.6%) died during the hospital stay. The follow-up duration ranged from 1 month to 224 months (mean. 98 months). Twenty-one patients died during the follow-up period, and the actuarial survival rate was 83% at 5 years and 68% at 10 years. Prosthetic valve detachment occurred in 12 patients (13.3%). Two patients required a re-aortic valve replacement, eight had a composite graft replacement and two patients underwent a homograft reconstruction. Absence of prosthetic valve detachment was noted in 83% of the patients at 5 years and in 75% at 10 years. The incidence of prosthetic valve detachment was 40% (4/10) in patients with Behçet's disease. 33% (5/15) in aortitis of unknown etiology. 4.6% (3/65) in Takayasu's arteritis and 29% (8/28) in male patients. Surgical techniques for treatment of this condition should be modified for further improvement of the surgical outcome in these patients with Behçet's disease and aortitis of unknown etiology.
Incidence and Prognosis of Abdominal Complications after Cardiopulmonary Bypass
Authors: Šimić O. , Strathausen S. , Hess W. , Ostermeyer J.
Published: September 2024

The incidence of abdominal complications after cardiopulmonary bypass is low but associated with a high mortality. From January 1991 to October 1996, 4288 patients, of a mean age of 62.5 years underwent open-heart surgery. Fifty-nine (1 of 4) of these patients developed early abdominal complications. These included 36% with a paralytic ileus, 21% with erosive gastritis, 18% with upper gastrointestinal haemorrhage, 12% with intestinal ischaemia, 5% with pseudo-obstruction of the colon. 6% with acute cholecystitis and 2% with acute pancreatitis. After coronary artery bypass grafting mean cardiopulmonary bypass time was 94.4 min. There were abdominal complications in 1.0% and one hospital death. After valve surgery and combined surgery the mean cardiopulmonary bypass time was 129 min. There were abdominal complications in 2.4% (α = 0.01) and seven deaths. Fourteen patients (24%) underwent abdominal operations: three had caecostomies for pseudo-obstruction of the colon, seven had a hemicolectomy, two had a cholecystectomy and two had resection of the ventricle. The hospital mortality rate was 13.5%. Abdominal complications were significantly more frequent after valve or combined operations of the coronaries and valves in comparison with isolated coronary artery bypass grafting. Cardiac operations with extended cardiovascular bypass time were more likely to produce abdominal complications
Gelseal® Versus Gelweave® Dacron Prosthetic Grafts in the Descending Thoracic Aorta: A Two-Year Computed Tomography Scan Follow-Up Study
Authors: Mattens E. , Engels P. , Hamerlijnck R. , Kelder J. , Schepens M. , de Valois J. , Vermeulen F. , Wijers L.
Published: September 2024

Background:

In the abdominal aorta, the use of knitted rather than woven dacron prostheses has shown an early and slow late dilation. The dilation of woven versus knitted dacron prostheses in the thoracic aortic position has not yet been investigated.

Method:

From 1992, 25 patients entered a prospective study: 13 Gelweave® and 12 Gelseal® prostheses (diameter 18–26 mm) were implanted in the descending thoracic aorta. Computed tomography (CT) scans without contrast-enhancement were performed 2 weeks, and 1 and 2 years postoperatively. The full length of the grafts was scanned and the diameter was measured in mm measured at a level outside the areas of intercostal artery reimplantation. Patient determinants analysed were age, hypertension and implantation diameter of the grafts. The Gelseal group had a mean age of 63.7 years and seven were males. The Gelweave group had a mean age of 67.8 years and seven were males.

Results:

The mean implantation diameters were 19.6 ± 1.7 mm and 22.0 ± 2.7 mm ( P = 0.02) for the Gelseal and Gelweave grafts, respectively. On the CT-scans at 2 weeks postoperatively, the diameter had increased by 18.8 ± 4.8% ( P = 0.0001) in the Gelseal and by 5.7 ± 6.4% ( P = 0.007) in the Gelweave grafts. This difference in diameter at 2 weeks between the two prostheses was significant ( P < 0.00001). At 1 year the diameter had increased by 28.4 ± 5.2% ( P = 0.0001) and by 8.4 ± 4.6% ( P = 0.0003) for the Gelseal and Gelweave grafts, respectively, compared with the implantation diameter. The increase in diameter between the postoperative values at 2 weeks and those at 1 year was statistically significant in the Gelseal grafts ( P = 0.0002) but not in the Gelweave grafts ( P = 0.56). At 2 years an increase in diameter by 31.4 ± 5.2% ( P = 0.0001) and by 7.4 ± 7.1% ( P = 0.014) for the knitted and woven prosthetic grafts, respectively, was noted compared with the initial implantation diameter. The increase in diameter between the CT measurements at 2 weeks and those at 2 years was statistically significant in the Gelseal group ( P = 0.001) but not in the Gelweave group ( P = 0.86). The difference in this late increase in diameter between the two implanted grafts was also significant ( P < 0.005). Age, hypertension and initial diameter did not appear to be significant determinants.

Conclusion:

In contrast to the Gelseal prosthesis in the descending aorta, the Gelweave prosthesis does not show any late dilation.
Thoracoabdominal Aneurysm Repair
Authors: Webb T. H. , Williams G. M.
Published: September 2024

Aneurysms that extend from the descending thoracic aorta into the abdomen and also those that involve the visceral segments of the upper abdominal aorta are traditionally classified as thoracoabdominal. Besides the surgical exposure difficulties associated with repair of these aneurysms, the temporary interruption of renal, splanchnic, and perhaps even spinal cord flow introduces a number of potential complications that makes surgical repair of these aneurysms a daunting task.

The exact incidence of thoracoabdominal aneurysms is unknown, but population studies suggest a prevalence at least a log fold less than the more common infrarenal abdominal aortic aneurysm. The poor prognosis of nonsurgically treated aneurysmal disease of the descending thoracic and abdominal aortas has been reasonably well established. Few patients with thoracoabdominal aneurysms survive beyond five years as a result of not only aneurysm rupture but also death from advanced co-morbid medical disease.

Since the first successful report of thoracoabdominal aneurysm repair over 40 years ago, a number of remarkable contributions have been made in the field. These advances have led to a significant decline in operative mortality as well as procedure related morbidity.

Spinal cord ischemia remains a perplexing and devastating complication following thoracoabdominal aneurysm repair. A number of surgical adjuncts have been developed over the years to reduce the incidence of cord ischemic complications, yet a great deal of controversy still exists with regards to the optimal protective strategy.

A description of the incidence, natural history, and classification of thoracoabdominal aneurysms, along with associated repair techniques centered on reducing spinal cord ischemic complications will form the basis for this review.
Retinoic Acid Suppresses Intimal Hyperplasia and Prevents Vessel Remodeling following Arterial Injury
Authors: DeRose J. J. , Madigan J. , Umana J. P. , Prystowsky J. H. , Nowygrod Ft. , Oz M. C. , Todd G. J.
Published: September 2024

Vitamin A and its derivatives (retinoids) are capable of inhibiting vascular smooth muscle cell proliferation in vitro. The present study examines the effect of two retinoids, all-trans retinoic acid and 13- cis retinoic acid, on intimal hyperplasia following arterial injury. After receiving varying doses of all-trans retinoic acid or 13- cis retinoic acid, 78 male Sprague—Dawley rats underwent standard balloon catheter denudation of the left common carotid artery. Morphometric analysis and immunohistochemistry for proliferating cell nuclear antigen was performed at early and late time points. Intimal/medial ratios were reduced in a dose-dependent fashion for animals treated with all-trans retinoic acid ( P = 0.001) and 13- cis retinoic acid ( P = 0.004). Proliferating cell nuclear antigen labeling indices were reduced after treatment with all- trans retinoic acid and 13- cis retinoic acid at early time points post-injury. At a dose of 10 mg/kg, both all-trans retinoic acid and 13- cis retinoic acid inhibited vessel remodeling as measured by increases in luminal diameter ( P < 0.05) and external elastic lamina ( P < 0.05). Retinoids are an attractive clinical option for the treatment of restenosis following angioplasty and arterial surgery.
Unusual Cause of a Stroke in a Patient with Seronegative Rheumatoid Arthritis
Authors: Chatzis A. , Giannopoulos N. , Baharakakis S. , Saridakis N. , Agapitos E. , Stamatelopoulos S.
Published: September 2024

The case of a patient who suffered a severe cerebrovascular accident caused by an aortic rheumatoid granuloma is presented
Successful One-Stage Resection of Intravenous Leiomyomatosis of the Uterus with Extension into the Heart
Authors: Stolf N. A. G. , Santos G. G. , Haddad V. L. S. , Simões R. M. , Avelar S. F. , Ferreira F. H. , Sobral M. L. P.
Published: September 2024

Intravenous leiomyomatosis of the uterus is a rare neoplasm characterized by nodular masses of benign smooth muscles with intraluminal growth to the inferior vena cava and, in some cases, to the heart. It may cause abdominal and cardiovascular symptoms and is a serious risk of death when it reaches the tricuspid valve. Surgery is the best treatment and must be applied as soon as possible using cardiopulmonary bypass. The authors report a new case that had cardiac involvement and was successfully resected. The symptoms, imaging diagnosis, pathological and histopathological findings, tumors that mismatched the intravenous leiomyomatosis (IVL), and the use of circulatory arrest and deep hypothermia are discussed. A review of the literature is included.
Technical Communication's Fight Against Extractive Large Language Modeling by Applying FAIR and CARE Principles of Data
Authors: Lindgren Chris A. , Yunes Erin , Itchuaqiyaq Cana Uluak
Published: September 2024

This article assesses the data practices of Grammarly, the prominent AI-assisted writing technology, by applying data principles that advocate for empowering Indigenous data sovereignty. The assessment is informed by the authors’ work with an Inuit tribal organization from rural Arctic Alaska that generated data and metadata about potentially sacred tribal activities. Their analysis of Grammarly's large-language modeling practices demonstrates how technical communication can hold businesses to principled data practices created by Indigenous nations and communities that understand how to create more just futures.
2,3,7,8-Tetrachlorodibenzo-p-Dioxin Suppresses Mesenchymal Cell Proliferation and Migration Through miR-214-3p in Cleft Palate
Authors: dong Xiaobo , Chen Qiang , Du Haojuan , Qiu Lin
Published: September 2024

Objective

The aetiology of CL/P is complicated, with both genetic and environmental factors. This study aimed to investigate the association between TCDD (2,3,7,8-tetrachlorodibenzo-p-dioxin) exposure and changes in the expression of miR-214-3p in the context of cleft palate.

Design

In this study, we established a fetal mouse cleft palate model using TCDD and differentially expressed miRNAs were analysed by microarray analysis and verified by qRT-PCR. Finally, we demonstrated the effects of TCDD and microRNAs on the proliferation and migration of mesenchymal cells by using CCK8, EDU, Transwell, and wound-healing assays.

Results

Our findings revealed significant upregulation of miRNAs such as miR-214-3p, miR-296-5p, and miR-33-5p in the TCDD intervention group, while miRNAs like miR-92a-3p, miR-126a-3p, and miR-411-5p were significantly downregulated. Notably, qRT-PCR testing confirmed a significant difference in miR-214-3P expression. Further investigations involved the overexpression of miR-214-3p, reducing cell proliferation and migration in primary mouse embryonic palatal mesenchymal (MEPM) cells.

Conclusions

These results are consistent with the finding that TCDD suppresses palatal mesenchymal cell proliferation and migration through miR-214-3p. In conclusion, miR-214-3p probably plays a role in TCDD-induced cleft palates in mice.
Modeling Sensor-based Vigilance Decrement in the Healthcare Environment
Authors: Li Jiaxin , Kettel Veronika , Higgins Elizabeth A. , Xiao Chaowei , Kwon Younghoon , Meno Michael , Roach Victoria A. , Kim Ji-Eun
Published: September 2024

Vigilance refers to an individual’s ability to maintain attention over time. Vigilance decrement is particularly concerning in clinical environments where shift work and long working hours are common. This study identifies significant factors and indicators for predicting and monitoring individuals’ vigilance decrement. We enrolled 11 participants and measured their vigilance levels by recording their reaction times while completing the Psychomotor Vigilance Test. Additionally, we measured participants’ physiological responses and collected their sleep deprivation data, demographic information, and self-reported anxiety levels. Using repeated-measures correlation analysis, we found that decreased vigilance levels, indicated by longer reaction times, were associated with higher electrodermal activity ( p < .01), lower skin temperature ( p < .001), shorter fixation durations ( p < .05), and increased saccade frequency ( p < .05). Moreover, sleep deprivation significantly affected vigilance decrement ( p < .001). Our findings provide the potential to develop a predictive model of vigilance decrements using physiological signals collected from non-intrusive devices, as an alternative to current behavior-based methods.
Economic Impact of Ambulatory Blood Pressure Monitoring Compared With Clinical Blood Pressure Monitoring: A Simulation Model
Authors: Hayek Michelle A , Catacora Alejandro , Lawley Mark A , Kum Hye-Chung , Ohsfeldt Robert L
Published: September 2024

Background:

Ambulatory blood pressure monitoring (ABPM) is considered the gold standard for proper diagnosis of hypertension. Yet, access to ABPM in the U.S. is limited, and the extent of coverage by commercial health plans remains uncertain, potentially limiting access to ABPM among commercially insured patients.

Objective:

This study aims to assess the net cost impact of using ABPM in comparison to clinical blood pressure monitoring (CBPM) in the U.S. over a 5-year time period.

Design methods:

Using a Markov Model, we estimate the 5-year cumulative cost impact of using ABPM to confirm a prior diagnosis of primary hypertension using CBPM to avoid treatment for white-coat hypertension (WCH) in a hypothetical cohort of 1000 patients from a U.S. healthcare system perspective. The probability and cost inputs for the model were derived from available literature. Base-case model parameters were varied to account for different scenarios.

Results:

Base-case results indicate using ABPM instead of CBPM over 5 years saves a total of $348,028, reflecting an average per-person-per-year (PPPY) cost saving of $70. In sensitivity analyses, almost all cases reveal ABPM as a cost-saving approach compared to CBPM, with cost savings reaching up to $228 PPPY in the highest hypertension treatment cost model. Regression results reveal that ABPM was cost-saving compared to CBPM if ABPM annual payment rates are $100 or less and annual hypertension treatment costs are ⩾$300.

Conclusion:

The potential cost-savings of using ABPM instead of CBPM found in our simulation model underscores the need for confirmatory research using real-world data to support increased use of ABPM as the standard diagnostic approach for hypertension.
Medico-Legal Complaints Against Dermatologists: Data From the Canadian Medical Protective Association, 2013 to 2022
Authors: Ma Bryan , Park Ye-Jean , Han Jing , Gandhi Maharshi , Ramien Michele , Klassen David , Payant Laura , Rose Elaine , Garber Gary , Probst Mireille , Hardin Jori
Published: September 2024

Background:

Medico-legal complaints against physicians are a significant source of anxiety and could be associated with defensive medical practices that may correlate with poor patient outcomes. Little is known about patient concerns brought to regulatory bodies and courts against dermatologists in Canada.

Objective:

To characterize factors contributing to medico-legal complaints brought against dermatologists in Canada.

Methods:

The Canadian Medical Protective Association (CMPA) repository was queried for all closed cases involving dermatologists over the past decade. Aggregate, anonymized data was reviewed and case outcomes, patient harm, and contributing factors were extracted.

Results:

Nearly one-fifth of all dermatologists who are CMPA members have been named in at least one medico-legal case between 2013 to 2022. A total of 396 civil-legal actions or College complaint cases involving dermatologists were closed at the CMPA during this timeframe. The most common patient allegations were deficient assessment (34%), diagnostic error (28%), and unprofessional manner (22%). Nearly half of patients experienced a harmful event, the majority of which were asymptomatic or mild. The most frequently identified contributing factors related to providers were poor clinical decision making (n = 73), lack of situational awareness (n = 67), and conduct and boundary issues (n = 59). Team factors included a breakdown of communication with patients (n = 124).

Conclusions:

Improved communication with patients for informed consent, treatment plans, clinical follow-up, and documentation of thorough clinical patient assessments can improve patient satisfaction and health outcomes, and mitigate dermatologists’ medico-legal risk.
The fall and rise of sovereignty
Authors: El Taki Karim
Published: September 2024

The aftermath of the Cold War signalled a decline of the international norm of sovereignty. The ‘triumph’ of the Liberal International Order during a brief unipolar moment challenged traditional principles of sovereignty, notably non-intervention. However, recent years have seen a resurgence of affirmations of sovereignty in political discourse, coinciding with a broader narrative on the Liberal International Order’s erosion. This article attempts to make sense of this fall and rise of sovereignty. Motivated by genealogical concerns, it historicises political and scholarly conversations on the concept. First, it examines the perceived decline of sovereignty following the Cold War. Second, it traces the proliferation of sovereignty discourses in the European 2000s and 2010s back to debates surrounding the 1992 Maastricht Treaty. Third, it explores the concept of sovereigntism, charting its move from political discourse into academic debates. Finally, the article concludes with a reflection on the trajectory of sovereignty in a post-Liberal International Order world.
‘Burnt out by all the exploitation’: Involuted labour in creative fields
Authors: Scott Michael , Woods Christopher
Published: September 2024

This article develops a neo-Bourdieusian analysis of how creative workers respond to the pressures of freelance, contract and project-based cultural production. Using data from 15 in-depth interviews with independent ‘creatives’ we enrol Bourdieu's fields and Clifford Geertz's account of involution – internal over-elaboration – to investigate the tendencies, nuances and outcomes of creative labour's production practices. To answer the field's piecemeal funding and limited market rewards three broad strategic involution strategies are outlined: ‘hard driving’ of resources; reworking and hybridization of existing cultural forms; and uncodified intricacy within the social relations of production. This theorization illustrates how iterative internal complexity aids the economizing of cultural production oriented to gaining recognition while, due to the social intricacy of creative processes, inducing a tendency towards emotional and physical fatigue. Rather than promote a meritocratic productivity imagined by policy discourses, involuted labour produces burnout and thus contributes to the churn of creative talent.
Characteristics of immune cells and causal relationship with chondromalacia: A two-sample, bidirectional mendelian randomization study
Authors: Chai Weiwei , Zhang Mengwei , He Yan , Chai Weihao
Published: September 2024

Chondromalacia, characterized by the softening of cartilage, is a prevalent condition affecting joint health with complex etiology. The immune system’s role in its pathogenesis has been implicated but remains to be fully elucidated. To address a critical knowledge gap, we conducted a two-sample Mendelian randomization analysis of 731 immune cell phenotypes, assessing parameters like fluorescence, cell count, and morphology. After sensitivity and pleiotropy checks, and applying a false discovery rate correction, our study linked 17 phenotypes to chondromalacia ( p < .05). Among them, seven immune cell phenotypes were found to have a protective effect against chondromalacia (IVW: p < .05, OR <1), while 10 were considered risk factors (IVW: p < .05, OR >1). Despite the constraints of sample size and possible genetic differences among populations, our research has identified a notable genetic correlation between specific immune cell indicators and chondromalacia. This breakthrough sheds light on the pathophysiological mechanisms of the condition. The identification of protective and risk-associated immune cell phenotypes provides a foundation for further exploration of immunological mechanisms in chondromalacia and may pave the way for targeted interventions. Future research is warranted to validate these findings and explore their clinical implications.
Joy as subversive defiance
Authors: Hall Alexander , Steele Brent
Published: September 2024

The argument of this paper is that the experience and performance of joy can be a radical and subversive act of pedagogical agency. Although joy may seem out of place and out of touch in academia given the increased surveillance and policing of what is being taught in the classroom, and neoliberal administrative structuring prioritising uniformity and outcomes at the expense of creativity, it is here, under this oppositional structure, where joy is most subversive precisely because it is this dimension of human emotion that is increasingly being crowded out and disciplined in universities. Joy, as a positive emotion and dimension of wellbeing, has an underappreciated radical dimension only appreciable in contrast to its negative or oppositional dimension. Although joy has been a theme in pedagogy, its subversive possibilities there remain largely unpacked. This paper theorises joy through two themes that express its radical possibilities in and beyond the classroom. Specifically, joy is a relational and publicly embodied affect providing strength for the teacher, inspiration for students, and signalling resistance and defiance to structures of oppression. The paper concludes by acknowledging the risks and limits of joy that nevertheless are outweighed by its sustaining features found in our vocation.
Molecular features of NSCLC patients with liver metastasis
Authors: Zhao Jun , Zhong Jia , Chen Yujie , Chen Zipei , Yin Huan , He Yuange , Chen Rongrong , Guo Renhua
Published: September 2024

Background:

Metastasis is the primary cause of lung cancer-related death. Primary cancer cells invade through the lymphatic or blood vessels to distant sites. Recently, it was proposed that lymphatic metastasis was more a hallmark of tumor aggressiveness or metastatic potential than a gateway to metastases. Therefore, the underlying molecular mechanism of metastasis is not entirely clear.

Objectives:

This study aimed to explore the genetic mechanisms underlying liver metastases from lung cancer and to evaluate the efficacy of different therapies in these patients.

Design:

We retrospectively analyzed the mutation spectrum of different biopsy samples including primary lung tumors, liver, lymph node metastasis, and circulating tumor DNA (ctDNA) from 1090 non-small-cell lung cancer (NSCLC) patients with liver metastasis between the years 2017 and 2022.

Methods:

Demographic and disease characteristics were summarized using descriptive parameters. Time to treatment discontinuation was used to analyze the clinical outcome.

Results:

More liquid biopsies were performed than tissue biopsies, especially in the treated advanced NSCLC patients. Liver metastasis before treatment was associated with poor response to immune checkpoint inhibitors and targeted therapy. Liver and lymph node metastasis had higher levels of single nucleotide variants and copy number variants than primary lung tumors. In paired lung and liver, lymph nodes, and simultaneous ctDNA, we found actionable mutations were always shared, while metastasis samples had multiple private mutations. Serial ctDNA analysis identifies potential resistant mutations and describes the evolution of tumor cells.

Conclusion:

Liver and lymph node metastasis in NSCLC showed shared actionable mutations. Of note, the discrepancy of private mutations in liver and lymph node metastases indicated that liver metastases are mainly seeded by the primary tumor rather than the earlier colonized lymph node metastases.
Clarifying the position of hikikomori in mental health: Is hikikomori a variant of already-known mental health disorders? A review of the literature
Authors: Amendola Simone
Published: September 2024

Hikikomori was included in the chapter “Culture and Psychiatric Diagnosis” of the DSM-5-TR Section III as an example of cultural concepts of distress. However, attempts over time to better define hikikomori emphasized different specific characteristics/criteria. The present study aimed to provide an overview of different criteria and definitions of hikikomori, and to examine whether hikikomori resembles social anxiety/phobia (and avoidant personality), depression, and adjustment and stress disorders. This narrative review followed available recommendations on reporting standards. A structured literature search was conducted in PubMed, MEDLINE, PsycINFO, PsycARTICLES, Web of Science, and Scopus on May 31, 2023. Hikikomori definitions and criteria diverge in their focus on specific criteria such as not working/attending school, avoidance/refusal of and disinterest/unwillingness to participate in social situations and relationships. Hikikomori resembles a (severe) variant of social anxiety disorder, a form of adjustment disorder, or a variant of depressive disorder, depending on the criteria in use. Empirical evidence on the clinical validity of some hikikomori definitions is scarce. If hikikomori criteria do not include indicators of dysfunction, the condition under study may reflect severe/extreme social isolation rather than a different diagnostic category. Updated hikikomori research criteria were proposed to foster future studies addressing diagnostic validity and clinical comorbidity. Alternatively, a “with (social) withdrawal” specifier in the definition of social anxiety, depressive, and adjustment and stress disorders should be considered. Finally, the inclusion of hikikomori in the DSM-5-TR was discussed.
Illness representation in patients with multiple sclerosis: A preliminary narrative medicine study
Authors: Paolucci T , Reho M , Ciacchella C , Veneziani G , Santoro I , Fiorentino G , Galli F , Lai C
Published: September 2024

Background

The development of personalized interventions aimed at coping with multiple sclerosis is enriched by the understanding of patients’ representations of the illness.

Objective

The aim of this study was to investigate the association between patients’ illness representations versus contextual factors (i.e. presence/absence and type of caregiver, engagement, frequency and type of rehabilitation), fatigue, pain, and neurological impairment.

Methods

Interviews of 28 patients were analysed through an automated text analysis procedure. After a systematic labelling procedure four illness representations were identified: daily life, search for meaning of the disease, relationship to people and the diagnosis, coping and physical growth.

Results

Findings showed that the representation of the relational aspects of the illness was associated with the caregiver's presence, while the representation related to coping and growth tended to be associated with participation in rehabilitation programs. Moreover, the representation related to daily life was associated with lower levels of fatigue compared to the representation related to coping and growth, and with higher levels of neurological impairment compared to the representations related to coping and growth and the relational aspects of the illness.

Conclusion

Exploring illness representations is a key step that can help health professionals to get an integrated perspective that could be useful in designing and calibrating interventions according to specific patient needs.
Personality and Crisis Preparedness: The Mediation and Moderation of Narcissistic-Rivalry and Escalation of Commitment
Authors: Asnafy-Hetzrony Dikla , Brender-Ilan Yael
Published: September 2024

Despite extensive research on organizational crises, there is a need for deeper insight into the personalities of managers involved in crisis management and the interplay of personality traits in crisis preparedness. Crisis management (CM) is pivotal in today’s complex and rapidly changing world, involving the strategic process of anticipating, preparing for, and effectively responding to crises that can potentially disrupt an organization. Recent surges in business failures and related corporate crises, along with the varied consequences of COVID-19, emphasize the acute need for effective CM, particularly crisis preparedness (CP). Given that CP in organizations is influenced by various factors, we aimed to develop a model that accurately assesses the impact of individual and situational aspects on CP, drawing on crisis management theory and trait theory as the overarching theoretical basis. Based on a sample of 314 executives and utilizing moderation-mediation analysis, our main findings reveal that narcissistic rivalry fully mediates the positive relationship between conscientiousness and CP. Additionally, Escalation of Commitment (EoC) moderated the relationship between conscientiousness and narcissistic rivalry, such that managers with high conscientiousness disposed to EoC show a desirable low level of rivalry. In conclusion, while EoC is typically viewed as a negative organizational trait, organizations are advised to prioritize hiring conscientious managers who exhibit a propensity for EoC, provided that the organization can effectively manage this tendency. By taking the proper steps, organizations can benefit from the advantages of managers disposed to EoC while reducing crisis risks.
Unusual Case of Fetal Meningocele Mimicking Dacryocystocele
Authors: Mai Phuong Thi , Trinh Cong Thao , Hoang The Huan , Hoang Van Trung
Published: September 2024

Meningocele, a rare subtype of cephalocele, can manifest in various positions and exhibit diverse characteristics. On the other hand, dacryocystocele, also a rare anatomical disorder, typically presents as a cyst located between the nose and the eye. Generally, distinguishing between these 2 lesions is not difficult. The presented case involves a fetus with suspected dacryocystocele, ultimately diagnosed postpartum as meningocele, underscoring the complexities in distinguishing between these conditions. The article details the patient’s prenatal examinations, imaging findings, and the subsequent surgical intervention, highlighting the significance of meticulous diagnosis for effective prenatal management. The case illuminates the potential oversight and misdiagnosis challenges associated with atypical cephaloceles, contributing valuable insights for clinicians involved in prenatal diagnosis and management.
Mid- to long-term outcome of reverse total shoulder arthroplasty as revision procedure for failed hemiarthroplasty after proximal humerus fracture
Authors: Paksoy Alp , Akgün Doruk , Imiolczyk Jan-Philipp , Gebauer Henry , Lacheta Lucca , Scheibel Markus , Hayta Agahan , Moroder Philipp
Published: September 2024

Background

Insufficient tuberosity healing is the most common reason for poor outcome after treatment of proximal humerus fractures (PHFs) using hemiarthroplasty (HA). In these cases, revision to reverse total shoulder arthroplasty (RTSA) can improve function and reduce pain in the short term, however, long-term results remain scarce. Aim of this study was to evaluate the clinical and radiological mid- to long-term results in patients with a revision RTSA after failed HA for PHF.

Methods

In this retrospective study all patients that received a revision to RTSA after failed fracture HA between 2006 and 2018 were included. A total of 49 shoulders in 48 patients (38 female, 10 male; mean age 82 ± 9 years) were identified in our database. A total of 20 patients (17 female, 3 male; mean age was 79 ± 9 years) were available for follow-up examination after a mean time period of approximately eight years (3–14 years) after revision surgery. At final follow-up, patients were assessed using a subjective shoulder value (SSV), range of motion (ROM), visual analogue score (VAS), the Constant Score (CS) and the 12-Item Short Form Survey (SF-12).

Results

At final follow-up, mean CS was 55 ± 19 (19–91), VAS averaged 3 ± 3 (0–8) and mean SSV was 61 ± 18% (18–90%). Mean SF-12 was 44 (28–57) with a mean physical component summary (PCS) of 38 (21–56) and a mean mental component summary (MCS) of 51 (29–67). On average active forward flexion (FF) was 104° (10–170°), active abduction (ABD) was 101° (50–170°), active external rotation (ER) was 19° (10–30°) and active internal rotation (IR) of the lumbosacral transition was reached. Three patients presented with a periprosthetic humeral fracture after RTSA implantation and underwent a reoperation (15%) during follow-up period.

Conclusions

Revision RTSA results in promising clinical results in patients after initial failed HA after PHF. A complication and reoperation rate of 15% is tolerable in consideration of satisfactory functional and psychological outcome.

Trial registration

Retrospectively registered.
Next-generation fertilizers: the impact of bionanofertilizers on sustainable agriculture
Authors: Arora Pankaj Kumar , Tripathi Shivam , Omar Rishabh Anand , Chauhan Prerna , Sinhal Vijay Kumar , Singh Amit , Srivastava Alok , Garg Sanjay Kumar , Singh Vijay Pal
Published: September 2024

Bionanofertilizers are promising eco-friendly alternative to chemical fertilizers, leveraging nanotechnology and biotechnology to enhance nutrient uptake by plants and improve soil health. They consist of nanoscale materials and beneficial microorganisms, offering benefits such as enhanced seed germination, improved soil quality, increased nutrient use efficiency, and pesticide residue degradation, ultimately leading to improved crop productivity. Bionanofertilizers are designed for targeted delivery of nutrients, controlled release, and minimizing environmental pollutants, making them a sustainable option for agriculture. These fertilizers also have the potential to enhance plant growth, provide disease resistance, and contribute to sustainable farming practices. The development of bionanofertilizers addresses the adverse environmental impact of chemical fertilizers, offering a safer and productive means of fertilization for agricultural practices. This review provides substantial evidence supporting the potential of bionanofertilizers in revolutionizing agricultural practices, offering eco-friendly and sustainable solutions for crop management and soil health.
A review of power-to-X and its prospects for integration in Nigeria’s energy transition plan
Authors: Marvin Mahlon Kida , Sarkinbaka Zakiyyu Muhammad
Published: September 2024

Nigeria currently relies on 80% thermal energy generation. However, studies have shown that less than 60% of the population have access to power. To address this issue, Nigeria has developed an energy transition plan to achieve net-zero emissions by utilizing eco-friendly and sustainable renewable energy sources. However, the effectiveness of renewable energy resources is often hampered by seasonal variations, which limit the amount of energy that can be produced to meet growing demand. One effective solution to this challenge is long-term energy storage, particularly during periods of low demand. Power-to-X (PtX) technology offers a promising approach by enabling long-term sustainable energy generation and storage for future use when renewable energy availability decreases during peak demands. This study critically reviews the latest advancements in renewable PtX technology and evaluates its potential application within Nigeria's energy sector. Furthermore, it explores the potential obstacles to the widespread adoption of PtX technology in Nigeria. Despite Nigeria’s significant potential for implementing PtX initiatives, the country currently falls behind in technology deployment and viable production pathways for sustainable PtX implementation. This shortfall is primarily due to lack of policies, frameworks, and financing schemes to support infrastructural development, especially for long-term energy storage. Given the intermittent nature of renewable energy, a transition strategy that includes adequate storage capacity is crucial. Although green hydrogen, a key component of PtX, has substantial potential as an energy carrier in Nigeria, its immediate use is limited by high production costs. Nonetheless, ongoing efforts to diversify Nigeria’s energy mix through infrastructure and policy developments could eventually establish a roadmap for PtX implementation, promoting long-term energy sustainability and distribution efficiency.
Integrating research evidence into virtual healthcare service programming: a quality improvement analysis of healthcare utilization and series of rapid umbrella reviews
Authors: MacPherson Megan , Khaleghi Roshanak , Rourke Sarah , Ramanaidu Rochelle , Montenegro Maria
Published: September 2024

Background

The integration of virtual solutions in healthcare has shown promise in improving access and reducing strain on hospital services. To maximize impact, healthcare authorities should understand what populations to prioritize in virtual healthcare service deployment as well as the research evidence for virtual care services for those populations. This study aims to support the Fraser Health (FH) Authority in prioritizing the implementation of virtual health, focusing on patient populations that would benefit most. “Patient profiles” were created by analyzing admission, readmission rates, and length of stay based on chronic conditions across FH sites. Using the Pabon Lasso Model for visualization, chronic conditions were categorized into zones to identify those with the greatest acute load. Rapid umbrella reviews were conducted for heart failure, COPD, and diabetes to identify evidence-based virtual care solutions for these high-utilization populations. The resulting knowledge products offered user-friendly, high-level overviews of the evidence for decision-making.

Results

Heart failure, COPD, diabetes, schizophrenia, and anxiety disorders were identified as top chronic conditions with highest acute loads. Rapid umbrella reviews indicated potential benefits of the following virtual care interventions for heart failure, COPD, and diabetes: remote patient monitoring (RPM), eLearning, virtual support (via phone calls or video conferencing), tele-rehabilitation, and text messaging.

Conclusion

Integration of virtual care services has the potential to revolutionize healthcare but requires careful planning and consideration of barriers. Patient profiles and rapid umbrella reviews offer a comprehensive approach to inform prioritization and implementation. RPM, eLearning, virtual support, tele-rehab, and text messaging showed promise for specific chronic conditions.
From Crete to London
Authors: Μαραβελάκης Ιωσήφ
Published: September 2024

Ο κεντρικός στόχος της μελέτης είναι η διερεύνηση της εφαρμογής της βρετανικής πολιτικής στην Κρήτη, μέσα από την ανάλυση των προξενικών δραστηριοτήτων. Σε δεύτερο επίπεδο, επιδιώκεται η ανάδειξη των αποκλίσεων και συγκλίσεων μεταξύ της ανεπίσημης βρετανικής πολιτικής στην Κρήτη, όπως αυτή υλοποιούνταν «από τα κάτω», και της επίσημης πολιτικής που καθοριζόταν από την πορεία της ευρωπαϊκής διπλωματίας. Η απόφαση να προσεγγιστεί το ζήτημα της βρετανικής παρουσίας στην Κρήτη τον 19ο αιώνα μέσα από αυτή την οπτική γωνία βασίζεται σε δύο κύριους παράγοντες. Πρώτον, το γεγονός ότι αυτή η κατηγορία υπαλλήλων όφειλε να διαχειριστεί όχι μόνο την προστασία των συμφερόντων της Βρετανίας, αλλά και τα προσωπικά τους συμφέροντα, καθώς οι πρόξενοι συχνά εμπλέκονταν σε πλήθος δραστηριοτήτων. Επιπλέον, το ενδιαφέρον προκαλείται από το ότι οι συγκεκριμένοι υπάλληλοι λειτουργούσαν σε ένα ετερογενές και πολιτισμικά διαφορετικό περιβάλλον από τους ανωτέρους τους, έχοντας ταυτόχρονα ένα ευρύ φάσμα διασυνδέσεων. Αυτή η σύνθετη πραγματικότητα προσφέρει μια ενδιαφέρουσα ευκαιρία να διερευνηθεί η πολυπλοκότητα των ρόλων τους, καθώς και τα όρια της εξουσίας και των δυνατοτήτων δράσης τους.