bluuebunny/crossref_metadata_2025 huggingface dataset:
Christian Hebraism
Authors: Burnett Stephen
Published: November 2024

Christian Hebraism was an expression of Renaissance humanism that became an improbable success story during the sixteenth century. It first emerged in fifteenth-century Italy, but it grew far faster in northern Europe under the stimulus of Erasmus’ call for a return to the sources of Christian faith (ad fontes) and the Protestant idea that beliefs and practices had to be based upon Scripture alone (sola Scriptura). To act upon these ideals, Christians had to learn Hebrew, universities had to create teaching positions in it, authors had to write (and printers had to produce) Latin language books on Hebrew-related subjects, and rulers had to provide support for the new activity. Christian Hebraists produced a philological apparatus, created polyglot Bibles, and mediated information and perspectives from the Jewish tradition of biblical study into Christian theological and confessional thinking during the sixteenth century.
Gravitational collapse of white dwarfs to neutron stars: From initial conditions to explosions with neutrino-radiation hydrodynamics simulations
Authors: Mori Masamitsu , Sawada Ryo , Suwa Yudai , Tanikawa Ataru , Kashiyama Kazumi , Murase Kohta
Published: November 2024

Using general relativistic neutrino-radiation hydrodynamics simulations with the multi-group M1 scheme in one dimension, we investigate the collapse of massive, fully convective, and non-rotating white dwarfs (WDs), which are formed by accretion-induced collapse or merger-induced collapse, and the subsequent explosion. We produce initial WDs in hydrostatic equilibrium, which have super-Chandrasekhar mass and are about to collapse. The WDs have masses of $1.6\, M_{\odot }$ with different initial central densities specifically at $1.0\times 10^{10}$, $4.0\times 10^{9}$, $2.0\times 10^{9}$, and $1.0\times 10^{9}\:\mbox{g}\:\mbox{cm}^{-3}$. First, we examine the stability of initial WD in case weak interactions are turned off. Secondly, we calculate the collapse of WDs with weak interactions. We employ hydrodynamics simulations with Newtonian gravity in the first and second steps. Thirdly, we calculate the formation of neutron stars and accompanying explosions with general relativistic simulations. As a result, WDs with the highest density of $10^{10}\:\mbox{g}\:\mbox{cm}^{-3}$ collapse not by weak interactions but by the photodissociation of the iron, and three WDs with low central densities collapse by the electron capture as expected at the second step and succeed in the explosion with a small explosion energy of $\sim\! 10^{48}\:$erg at the third step. By changing the surrounding environment of WDs, we find that there is a minimum value of ejecta masses, which is $\sim\! 10^{-5}\, M_{\odot }$. With the most elaborate simulations of this kind so far, this value is one to two orders of magnitude smaller than previously reported values and is compatible with the estimated ejecta mass from FRB 121102.
Histone modification H3K27me3 is essential during chilling-induced flowering in Litchi chinensis
Authors: Pan Xifen , Lu Xingyu , Huang Lijie , Hu Zhiqun , Zhuo Maogen , Ji Yanchun , Lin Bingqi , Luo Jianqin , Lü Peitao , Zhou Biyan
Published: November 2024

Litchi (Litchi chinensis), a prominent fruit tree in the Sapindaceae, initiates flowering in response to low autumn and winter temperatures. This study investigates the epigenetic regulation of this process, focusing on the marks histone H3 lysine 27 trimethylation (H3K27me3) and its deposition genes during the chilling-induced floral induction (FId) and initiation stages. Our genomic analysis delineated the H3K27me3 deposition landscape across the prefloral induction (PFId), FId, and floral initiation (FIn) stages. We identified 5,635 differentially H3K27me3-modified genes (DHGs) in buds and 4,801 DHGs in leaves. Integration of the RNA-seq and ChIP-seq datasets identified 1,001 differentially regulated genes (DRGs) in buds and 675 DRGs in leaves, offering insights into the genes potentially targeted by H3K27me3. To probe the functional role of H3K27me3, we employed GSK343, a histone H3 lysine methyltransferase inhibitor. Treatment with GSK343 during the chilling-induced flowering process led to reduced H3K27me3 deposition at the TREHALOSE-6-PHOSPHATE SYNTHASE 1 (LcTPS1) and FRIGIDA (LcFRI) loci, resulting in increased gene expression. This manipulation delayed flowering and reduced flowering rates, confirming the pivotal role of H3K27me3 in chilling-induced flowering in litchi. Gene coexpression network analysis identified SHORT VEGETATIVE PHASE 10 (LcSVP10) as a crucial regulator in litchi flowering. Overexpression of LcSVP10 in Arabidopsis thaliana delayed flowering, indicating a conserved function in flowering time control. Our results elucidate the molecular and epigenetic mechanisms that govern FId in litchi and highlight the potential of epigenetic modifications to regulate flowering time in horticultural plants.
On the edge of the social media landscape: associations with adolescent substance use and moderation by parental rules
Authors: Bozhar Hanan , de Rooij Susanne R , Lok Anja , Vrijkotte Tanja , Larsen Helle
Published: November 2024

Background

Adolescent problematic social media use (PSMU) has been increasing. Digital engagement has been associated with substance use, but little is known about the potential protective role of parents. We investigated whether screen and substance-related parental rules moderated the associations between (problematic) SMU and intake of tobacco, alcohol, hashish/marijuana, and laughing gas.

Methods

We used data from the Amsterdam Born Children and Development study (N = 1787; Mage = 15.86 years; SD = 0.36). Both frequent and problematic SMU in relation to tobacco, alcohol, hashish/marijuana, and laughing gas intake levels; and moderation by perceived parental rules (screen/substances), was tested with ordinal logistic regression models.

Results

PSMU was associated with higher chances of higher substance use levels. Hashish/marijuana use and heavy drinking were less prevalent in adolescents reporting the presence of parental rules on alcohol/drugs, compared to adolescents reporting no rules. Although parental rules on alcohol/drugs, but not screen time, moderated the relationship between PSMU and both hashish/marijuana use and heavy drinking, the moderation effect was modest, especially in mitigating substance use at higher PSMU-scores.

Conclusion

PSMU was positively associated with a wide range of substance use behaviours. The potential significant role of parental rules (alcohol/drugs) mitigating these associations are highlighted.
Impact of Enteral and Parenteral Nutrition on Mortality and Morbidity of Mechanically Ventilated Severely Septic Critically Ill Patients
Authors: Kamal Shams Manal Mohammed , Shalaby Alawady Diaa Eldin , Eldin Abd Elaziz Farouk Kamal , Elhusseini Hassan Muhamad Mamdouh
Published: November 2024

Background

Malnutrition is common among critically ill patients and can negatively affect clinical outcomes. Artificial nutrition and hydration support is considered standard care in critical illness. However, there is considerable variation in nutrition support practice in ICUs.

Aim of the Work

The study aims to investigate the clinical outcomes difference of nutritional support TPN and EN in intubated mechanically ventilated severe septic patients over ICU stay.

Patients and Methods

The study involves 80 patients, and APATCHE and SOFA scores were used to assess clinical outcomes such as survival rate, extubation rate, tracheostomy, and complications.

Results

There is no significant difference between TPN and EN in terms of delivered Kcal and delivered proteins, APATCHE, and SOFA scores. Clinical outcomes such as survival rate and extubation rates are also not different between both groups. However, there were significantly more digestive complications in the early EN group, indicating that PN may be the safer route in some patient groups.

Conclusion

The study concludes that there is no difference in mortality and extubation rate between EN and TPN in intubated mechanically ventilated severe septic patients. However, there were significantly more digestive complications in the early EN group, indicating that PN may be the safer route in some patient groups.
Effect of Exosomes Derived from Mesenchymal Stem Cell on Hepatic Regeneration in Carbon Tetrachloride Induced Acute Liver Injury in Adult Male Albino Rats. Histological Study
Authors: Lotfy Ali Ghada , Abd El Salam Nevert Farid , Abunasef Seham Kamel , Ezzat Samar F
Published: November 2024

Background

Acute liver failure (ALF) is one of the emergency conditions. Carbon tetrachloride (CCl4) has been widely used to induce experimental hepatic damage. Bone marrow mesenchymal stem cell derived (BM-MSC) exosomes are broadly applied to regenerative approaches for various disorders serving the therapeutic effects of MSCs.

Aim of the Work

The study analyzed microscopically and biochemically, the regenerative power of the BM-MSC exosomes on the experimentally induced acute hepatic injury.

Materials and Methods

Fifty-five male adult Wistar albino rats were randomly divided into three groups: Group (I) control group, group II [given a single intraperitoneal injection of carbon tetrachloride (CCl4) (3% vol/vol in olive oil) at 0.05 ml/kg body weight] and group III [given a single tail vein injection of 50 μg of BM-MSC exosomes in 100 μl phosphate buffered saline 24 hours post-CCl4]. The rats were sacrificed after seven days. Biochemical analysis of AST and ALT was performed. Histological examination of liver tissue was performed through light microscopy of hematoxylin and eosin and Masson trichrome stained sections. Transmission electron microscopy (TEM) of liver tissue was carried out. Morphometric and statistical studies were done.

Results

By light microscopy, H&E-stained sections of Group II (CCl4 treated) revealed altered hepatic architecture with focal cellular infiltration. Congestion and dilatation of portal veins with periportal cellular infiltration were detected. Widening and endothelial discontinuity of the central veins and disorganization and obliteration of some blood sinusoids were demonstrated. Most hepatocytes appeared with darkly acidophilic cytoplasm and condensed nuclei, while others appeared with pyknotic nuclei with vacuolated cytoplasm. In Masson trichrome stained sections, there was a significant increase in the collagen fibers around the central veins and portal triads, and between hepatic cords. TEM examination, hepatocytes displayed irregular heterochromatic nuclei and rarified cytoplasm with plenty of lipid droplets. Hepatic stellate cells were devoid of lipid droplets. The epithelial cell lining the bile ductules had few short microvilli Inflammatory cells were seen near the ductular basal border. Biochemically, there was a significant increase in both ALT & AST levels in group II. The exosomes treated group (III) revealed marked amelioration of the previously mentioned histopathological and biochemical changes compared to the control group.

Conclusion

The acute CCl4 induced injury was significantly attenuated by BM-MSC exosomes therapy, and is characterized by an increase in hepatocyte proliferation, significant regression of collagen deposition in the liver tissue and marked attenuation of hepatocellular damage, both structurally and biochemically.
Retrospective Analysis of Epidemiology and Clinical Outcomes of Gastric Adenocarcinoma Patients Treated at Ain Shams Clinical Oncology Department
Authors: Elsayed Alaa Mohamed Mohamed Mohamed Ahmed , El-Bassiouny Mohamed Mohamed , Ghany El Khodary Dalia Abd El , Ezz El Din Mai Mohamed Ali , Wahba Christine Reda , Alorabi Mohamed Osama
Published: November 2024

Background

Gastric cancer, a significant health burden in Egypt, has shown a rising trend in recent years. Risk factors include H. pylori infection, smoking, and unhealthy diets. Early detection and improved treatment options are crucial for combating this life-threatening disease

Methods

we conducted a retrospective analysis of the medical records of 70 patients with gastric adenocarcinoma treated at clinical oncology department, faculty of medicine, Ain Shams university in the Period From 2017 till 2020.

Results

our study include 70 patients with male to female ratio of 1: 1 at the median age of 52 years with 84% of the patients presented with advanced stages (stage 3 and stage 4). The median overall survival for stage 2 was the highest it was about 36 months while for stage 4 was the least measuring 7 months. the overall survival for stage 3 was 17 months. There was a highly significant relation between overall survival and surgery (p < 0.001). There was a highly significant relation between overall survival and adjuvant therapy (p < 0.001). Patients who received neoadjuvant therapy had better overall survival but this did not reach the significant level (p > 0.05). Univariate analysis, variables independently associated with overall survival included: higher stage, higher grade and histological type. While in multivariate analysis, it was found that stage and histological type were independent predictors for mortality.

Conclusion

Surgery is the basis of curative treatment for resectable gastric cancer, patients who underwent radical surgery had better overall survival than unresectable ones. presentation with metastatic lymph nodes, and systemic involvement is associated with poor prognosis despite multi-agents systemic treatment. Further research is required regarding the prevalence and causes of gastric cancer in Egypt to improve outcome of systemic treatment.
Functional Outcome after Treatment of Three-Part Proximal Humerus Fractures Using Locking Plate vs. Conservative Treatment in the Elderly
Authors: Ishak Abanob Naguib Aqladious , Bassiony Ayman Abdel-Aziz , ELshabrawy Waleed Elsayed
Published: November 2024

Background

Proximal humeral fractures (PHFs) are among the most common fractures in the elderly. The majority of proximal humeral fractures are treated conservatively, and up to 33% are treated surgically.

Objective

To compare functional outcome and quality of life after treatment of displaced 3-part proximal humerus fractures using the locking plates, as compared to nonoperative treatment in elderly patients.

Methods

This study performed a search for all published articles locking plates or nonoperative treatment in the management of displaced 3-part proximal humerus fractures.

Results

The pooled analysis of the included studies showed no significant difference between conservative treatment and operative treatment regarding the outcome of Constant score (MD = 0.04; 95% CI:[-0.2, 0.29]; P = 0.748). The pooled analysis of the included studies showed no significant difference in postoperative the DASH score between conservative treatment and operative treatment (MD = 0.05; 95% CI:[-0.35, 0.25]; P = 0.48). The pooled analysis of the included studies showed no significant difference in the outcome of VAS score between conservative treatment and operative treatment (MD = 0.38; 95% CI:[0.07, 0.69]; P = 0.748). The pooled analysis of the included studies showed no significant difference in ROM between conservative treatment and operative treatment (MD = 0.39; 95% CI:[-0.15, 0.94]; P = 0.425). The pooled analysis of the included studies showed no significant difference in postoperative complications between conservative treatment and operative treatment (RR = 1.148; 95% CI:[0.369 3.575]; P = 0.507). The pooled analysis of the included studies showed no significant difference in the outcome of non-union rate between conservative treatment and operative treatment (RR = 0.85; 95% CI: [0.72 – 2.28]; P = 0.158).

Conclusion

The results of this meta-analysis revealed no significant differences between conservative treatment and operative treatment as regard constant scores, DASH and VAS scores, range of movement, incidence of complications or non-union.
Impact of COVID19 on Availability of Anti-Epileptic Medications in Pediatric Neurology Clinic
Authors: Hassanein Sahar Mohamed Ahmed , Amin Ghada Essam Aldin , Abdelaziz Asmaa Wafeeq , Zaitoun Raghda Mohamed Hesham , Waseef Aya Mohamed Refaat Mohamed El
Published: November 2024

Background

In epilepsy patients, the pandemic has led to postponement of outpatient visits, cancellation of epilepsy-related tests, such as electroencephalograms (EEG) and magnetic resonance imaging (MRI) studies, and even difficulties in attending emergency situations due to saturation of the healthcare services, which can create life threatening situations for patients who present to the emergency rooms with non-COVID related complaints.

Aim of the Work

To evaluate effect of COVID-19 pandemic on supplying anti-epileptic medications for children following in the Pediatric Neurology Clinic, Ain Shams University.

Patients and Methods

An observational cross-sectional study was carried out at Pediatric Neurology Clinic, Children’s hospital, Ain Shams University. The study included 126 care givers of children with epilepsy who were aged 2 to 18 years, have a diagnosis of Epilepsy (including idiopathic and cryptogenic epilepsy) for at least one year before the onset of the COVID19 pandemic. I.e., Epilepsy diagnosed at or before March 2019 and are following up at the Pediatric Neurology Clinic, Children’s Hospital, Ain Shams University.

Results

Our study showed only 22% of the epileptic children had trouble in obtaining the anti- epileptic drug/drugs; where the most common problem was financial problems followed by drug shortage. Most of the epileptic children didn’t have a change in the treatment regimen during the last year.

Conclusion

Most children with epilepsy did not experience a significant change in their clinical conditions because of healthcare reorganization during the COVID-19 emergency.
Utility of Doppler Ultrasound in Early-Onset Neonatal Sepsis
Authors: Kasim Amr Hasan , Habib Lobna , Mohammad Shaimaa Abdelsattar , Saleh Ghada Ahmed , Salah Shaymaa Hassan Mohamed
Published: November 2024

Background

Early-onset sepsis is one of the leading causes of neonatal morbidity and mortality worldwide and timely diagnosis is, therefore, of paramount importance. There is paucity of literature regarding early alteration of the cerebral blood flow (CBF) in neonatal sepsis.

Purpose

Our study aimed to appraise changes in the CBF velocities and Doppler indices in neonates with early-onset neonatal sepsis (EONS) and to assess its diagnostic accuracy.

Methods

A total of 99 neonates were recruited in the study; 56 neonates with EONS, and the age-matched 43 neonates without any manifestations of sepsis. A Transcranial Doppler examination was performed and the cerebral hemodynamics assessed in neonates during the first seventy-two hours of life. Doppler indices and CBFV were measured in the anterior cerebral artery (ACA), and middle cerebral artery (MCA), of either side for the peak systolic velocity (PSV), end-diastolic velocity (EDV), resistivity index (RI), and pulsatility index (PI). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated for the appropriate diagnostic cut-off points.

Results

A highly significant lower resistance (PI and RI), relatively higher peak systolic velocity, and higher end-diastolic velocity in both ACA, and MCA have been documented within 72 hours of birth in neonates with EONS compared to the control group of neonates without sepsis.

Conclusions

Our Study revealed that assessment of CBF at early hours of birth by Transcranial Doppler examination showed alteration in cerebral hemodynamics in neonates with EONS with an increase in the CBF and a decrease in the resistance. It can be adopted as a bedside and noninvasive tool.
Comparative Study between Chest Radiography and Ultrasound Findings in ICU Patients with Respiratory Distress
Authors: aldin Sayed Moatasem Gamal , Ahmed Amal Ibrahim , Yousry Heba allah Mohammed
Published: November 2024

Background

Lung radiology is regularly done for the patients in intensive care units. Chest x-ray is considered one of the most easy imaging modalities. However, it may be not comfortable for critical patients in addition to the hazards of irradiation. The high variability of quality of the chest x-ray image makes its interpretation difficult. Nowadays bedside lung ultrasound is increasingly used in patients managed in intensive care units (ICUs)

Objective

To compare the diagnostic performance of lung ultrasound and bedside chest radiography for the detection of various pathologic abnormalities in unselected critically ill patients.

Patients and Methods

A prospective study done on 60 patients with respiratory distress admitted to the intensive care unit at our institute over 7 months. Chest X-ray and lung ultrasound were done to all the patients and then compared regarding the clinical diagnosis of pulmonary diseases and further radiological and laboratory methods.

Results

One Hundred Twenty hemithoraces were evaluated. The sensitivity, specificity, and diagnostic accuracy of CXR were 79.2, 94.4 and 88.3% for consolidation, 80, 100 and 98 % for pneumothorax, and 62.8, 96, and 76.7% for pleural effusion, respectively. The corresponding values for lung ultrasound were 87.5, 97, and 93.3% for consolidation, 100, 100, and 100 % for pneumothorax, and 91.4, 100, and 93.3% for pleural effusion, respectively.

Conclusion

Ultrasound is a bed side tool useful for rapid and early diagnosis of acute dyspnea in critical ill patients. It has higher sensitivity and higher specificity of diagnosis of chest diseases as pneumonia, pleural diseases and pneumothorax in comparison to CXR
Hepatic Arterial Anatomy Variations in Patients with Hepatocellular Carcinoma Evaluated by Computed Tomography Angiography
Authors: Kamal Omnia Ahmed , Mohammed Mohammed Yosry , Osman Najwa Mohamed Mahmoud
Published: November 2024

Aim of the Work

To highlight the role of CT angiography in evaluation of hepatic artery variations in patients with hepatocellular carcinoma.

Patients and Methods

The study was conducted from November 2022 to August 2023, 80 patient referred from oncology to radiology department at Ain Shams university hospitals for preoperative evaluation of hepatic artery anatomical variations.

Results

Our study included Egyptian patients who were retrospectively analyzed came for triphasic CT of the liver, the mean age of this study population is 50.06 years. It was identified normal hepatic arterial anatomy in patients (31.3The other 27 patients (42.2%) showed some variation. Regarding Michels classification, the most frequently observed abnormalities were: right hepatic artery branch of the superior mesenteric artery (Type III, n = 10, 15.6 %); left hepatic artery branch of the left gastric artery (Type II, n = 8, 12.5%); Accessory left hepatic artery of the left gastric artery (Type V, n = 5, 7.8%). Accessory right hepatic artery of the superior mesenteric artery (Type VI, n = 2, 3.1%). Replaced right hepatic artery of superior mesenteric artery and Accessory left hepatic artery of the left gastric artery (Type VIII, n = 2, 3.1%).

Conclusion

Hepatic arteries variations are not uncommon findings, with different anatomic variants being reported. Thus, the importance of knowing the possible variations of this structure is emphasized, which may have implications for pre-surgical, pre-laparoscopic, or even pre-interventional and this can be achieved using MSCT to minimize and avoid the major vascular complications and decrease the morbidity of patients.
Pretending Ignorance Is Bliss: Competing Insurers with Heterogeneous Informational Advantages
Authors: Abrardi Laura , Colombo Luca , Tedeschi Piero
Published: November 2024

The availability of big data and analytics expertise provides insurers with informational advantages over policyholders in estimating risk. We study competition between heterogeneously informed insurers, showing that their information may or may not be revealed in equilibrium. We find that all equilibria are profitable and that noninformative equilibria entail risk pooling and possibly efficiency. In informative equilibria, the signaling problem interacts with the screening problem that arises endogenously from insurers’ revelation of information, implying underinsurance. Our main insights are robust to changes in insurers’ information precision and market concentration and to the presence of two-sided asymmetric information and withdrawable contracts.
Entering the mainstream economy? Workplace segregation and immigrant assimilation
Authors: Lillehagen Mats , Hermansen Are Skeie
Published: November 2024

Why do foreign-born immigrant workers often concentrate in low-wage, minority-dense workplaces? Do immigrants’ native-born children—who typically acquire better language skills, education, and country-specific knowledge—experience improved access to workplaces in the mainstream economy? Using economy-wide linked employer–employee administrative data from Norway, we analyze both ethnic and economic workplace segregation across immigrant generations. We find that, on average, 32% of immigrants’ coworkers and 16% of second-generation immigrants’ coworkers have immigrant backgrounds, compared to 7% for natives. In terms of economic segregation, the average percentile rank of coworkers’ salaries is 36, 49, and 52 for immigrants, children of immigrants, and natives, respectively. A formal decomposition analysis shows that differences in employee, workplace, and residential location characteristics collectively explain 54–74% of ethnic and 79–84% of economic workplace segregation for immigrants and their children. Key factors driving this segregation in both immigrant generations include education, occupational attainment, industry of employment, having an immigrant manager, and the concentration of immigrant neighbors. This suggests that both skill-based sorting and network-related processes contribute to immigrant–native workplace segregation. However, children of immigrants’ improved access to less immigrant-dense and higher-paying workplaces, compared to immigrants, is primarily driven by differential skill-based sorting (i.e., higher education and shifts in occupation and industry placement). Our findings reveal a sharp decline in workplace segregation relative to natives as children of immigrants advance into the mainstream economy, highlighting the central role of assimilation in skill profiles for workplace integration across immigrant generations.
Professional Self-Care in Social Work Practice: A New Conceptual Framework
Authors: Cole Rebecca , Fantus Sophia , Hawkins Lataya , Chakraborty Priyanjali
Published: November 2024

Social work practitioners have experienced increased rates of burnout, fatigue, and occupational stress. To combat deteriorating mental health, the National Association of Social Workers’ Code of Ethics has called for a renewed focus on self-care practice. Yet, self-care education often fails to consider how to integrate practices into the workplace, especially with constrained resources and increasing caseloads. The purpose of this study was to examine healthcare social workers’ perceptions of self-care in the workplace. Semistructured virtual interviews were conducted with healthcare social workers (N = 43) across the state of Texas. Interviews were transcribed verbatim and redacted to protect participant confidentiality. Through content analysis, the research team analyzed transcripts by selecting meaningful units of text to create codes and categories. Themes were then developed, and the research team refined codes, discussed inconsistencies, and reached consensus. Findings demonstrate self-care in the workplace includes (a) individual strategies, identified by strong and trustworthy peer support systems and boundary management; (b) intrapersonal strategies, identified by formal supervision and advocacy and activism; and (c) institutional strategies, identified by ethical workplace cultures that invest in mental health and explicitly value social work. These data inform a framework to adapt self-care from an individual necessity to a shared responsibility among organizational leadership.
Testing Relationships between Multiple Regional Features and Biogeographic Processes of Speciation, Extinction, and Dispersal
Authors: Swiston Sarah K , Landis Michael J
Published: November 2024

The spatial and environmental features of regions where clades are evolving are expected to impact biogeographic processes such as speciation, extinction, and dispersal. Any number of regional features (such as elevation, distance, area, etc.) may be directly or indirectly related to these processes. For example, it may be that distances or differences in elevation or both may limit dispersal rates. However, it is difficult to disentangle which features are most strongly related to rates of different processes. Here, we present an extensible Multifeature Feature-Informed GeoSSE (MultiFIG) model that allows for the simultaneous investigation of any number of regional features. MultiFIG provides a conceptual framework for incorporating large numbers of features of different types, including categorical, quantitative, within-region, and between-region features, along with a mathematical framework for translating those features into biogeographic rates for statistical hypothesis testing. Using traditional Bayesian parameter estimation and reversible-jump Markov chain Monte Carlo, MultiFIG allows for the exploration of models with different numbers and combinations of feature-effect parameters and generates estimates for the strengths of relationships between each regional feature and core process. We validate this model with a simulation study covering a range of scenarios with different numbers of regions, tree sizes, and feature values. We also demonstrate the application of MultiFIG with an empirical case study of the South American lizard genus Liolaemus, investigating 16 regional features related to area, distance, and elevation. Our results show two important feature-process relationships: a negative distance/dispersal relationship and a negative area/extinction relationship. Interestingly, although speciation rates were found to be higher in Andean versus non-Andean regions, the model did not assign significance to Andean- or elevation-related parameters. These results highlight the need to consider multiple regional features in biogeographic hypothesis testing.
Assessment of the pattern, severity, and outcomes of acute mood stabilizer drug poisoning
Authors: Abdel-Ghaffar Abdel-Dayem Rania Samir , Elshama Said Said , Maklad Aisha Ibrahim , Elmansy Alshaimma Mahmoud
Published: November 2024

Background: Mood-stabilizer drugs are associated with a considerable incidence of morbidity and mortality. Aim: This study aimed to assess the pattern, severity, and outcomes of poisoning with acute mood stabilizer drugs among admitted patients to Tanta University Poison Control Center, Egypt between January 2021 and September 2023. Patients and methods: This cross-sectional study was conducted in patients with acute mood stabilizer drug poisoning. Data from electronic medical records were observed. The poison severity score (PSS) assessed the severity of the patients. Primary outcomes were the pattern and severity assessment. Secondary outcomes included the incidence of mortality, the need for intensive care unit (ICU) admission, the need for intubation and mechanical ventilation, the incidence of complications, and the duration of hospital stay. Results: A total of 67 patients with acute poisoning of mood stabilizers were included. Poisoning with carbamazepine accounted for 58.2% of all mood stabilizers, followed by valproic acid (29.8%), lithium (7.5%), and lamotrigine (4.5%). The highest proportion of patients were young, females, with intentional poisoning and were classified as mild to moderate poisoning based on PSS. There were significant statistical associations between PSS and the need for ICU admission, development of complications, and length of hospital stay among poisoned patients with carbamazepine or valproic acid. Conclusions: Carbamazepine poisoning and valproic acid poisoning were the most common mood stabilizers compared to lithium and lamotrigine poisoning. In acute carbamazepine and valproic acid poisoning, the PSS is a relevant score that could predict the need for ICU admission, the development of complications, and the duration of hospital stays.
Educational Responses to Local and Migration Destination Shocks: Evidence from China
Authors: Leight Jessica , Pan Yao
Published: November 2024

Over the last 20 years, China has experienced substantial positive shocks to export-oriented industries—especially following its accession to the World Trade Organization—and these shocks have had major implications for human capital investment. One primary channel through which export expansion can shape choices about human capital accumulation is positive labor-demand shocks, and these shocks can be observed both at potential within-country migration destinations and in the locality of birth. Exploiting cross-county variation in the reduction in export tariff uncertainty post-WTO, both locally and at plausible migration destinations, this analysis finds that youth in China reaching matriculation age post-accession in counties experiencing a larger export shock (either locally or at those destinations) show a lower probability of enrolling in high school. This pattern is observed in a sample including both youth who ultimately migrate and youth who do not migrate. For urban youth, the effects of local shocks are larger than the effects of destination shocks, but the opposite pattern is observed for rural youth.
The 2023 Update on Pressure Injuries: A Review of the Literature
Authors: Berlowitz Dan , Konchinski Bianca , Chen Lingming , DeCastro Sheila Sablon
Published: November 2024

More than 700 new articles were added to the pressure injury (PI) literature in 2023, challenging clinicians, educators, and researchers who try to stay current. In this article, the authors summarize six articles published in 2023 that provide important new data or insights about PIs. The articles cover a range of topics, including PI prevention and treatment, management of osteomyelitis, and the role of artificial intelligence in assessment. For each article, the authors provide a description of the study results along with a comment on why the results are important. This information will help the community to remain current with developments in the PI field and incorporate new data into clinical practice.

GENERAL PURPOSE

To provide a summary of six articles published in 2023 that provide important new data or insights about pressure injuries (PIs).

TARGET AUDIENCE

This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and registered nurses with an interest in skin and wound care.

LEARNING OBJECTIVES/OUTCOMES

After participating in this educational activity, the participant will:

1. Summarize selected current evidence addressing the prevention of PIs.

2. Evaluate new studies exploring PI treatment modalities.

3. Identify recent findings concerning the role of artificial intelligence in staging PIs.
Impact of Symptoms on Quality of Life in Patients with Chronic Wounds
Authors: Lin Chen , Ailing Hu , Caifei Li , Yuan Liu
Published: November 2024

OBJECTIVE

To analyze the occurrence of symptoms and quality of life (QoL) among patients with chronic wounds and the impact of chronic wounds on QoL.

METHODS

Researchers evaluated 200 patients with chronic wounds using a general information questionnaire, a modified version of the Memorial Symptom Assessment Scale, and the Chinese version of the Cardiff Wound Impact Questionnaire. They performed correlation and linear regression analyses to explore the impact of symptoms on QoL.

RESULTS

Mean symptoms scores were all moderately severe and ranged as follows: 0 to 7.06 ± 3.85 for mean total symptom, 0 to 2.69 ± 1.33 for mean frequency, 0 to 2.27 ± 1.02 for mean severity, and 0 to 2.29 ± 1.29 for mean distress. Scores on the three dimensions of QoL (daily life, social life, and well-being) were 51.61 ± 14.73, 48.63 ± 17.20, and 47.45 ± 8.65, respectively. Patients’ symptoms on each subscale were negatively correlated with the dimensions of QoL (r = −0.383 to −0.559, P < .01). Multiple linear regression analyses showed that 9 symptoms collectively explained 66.1% of the total variance of daily life (P < .01); 7 symptoms explained 59.0% of the total variance of social life (P < .01); and 10 symptoms explained 59.6% of the total variance of well-being (P < .01).

CONCLUSIONS

Patients with chronic wounds had high levels of psychological symptoms and moderate QoL, scoring lowest on well-being. Sleep disruption, limitations in activity, and scarring were the main symptoms affecting their QoL. Nurses should prioritize managing these symptoms to improve patients’ QoL.
Evaluation of Clinical Outcomes and Quality of Life following the Karydakis Flap Procedure for Pilonidal Sinus Treatment
Authors: Breidung David , Billner Moritz , Buben Philipp , Grieb Gerrit , Sievers Reiner , Reichert Bert , Megas Ioannis-Fivos , Barth André A.
Published: November 2024

OBJECTIVE

To evaluate the clinical outcome of the Karydakis flap procedure performed by a single surgeon for the treatment of pilonidal sinus, focusing on postoperative complications, recurrence rate, wound healing time, and return to daily life.

METHODS

Authors performed a retrospective data analysis of patients who underwent reconstruction of pilonidal sinus using the Karydakis technique at the Department of Plastic, Reconstructive and Hand Surgery, Center for Severe Burn Injuries of Paracelsus Medical University, Klinikum Nürnberg, Germany, between 2014 and 2021. All cases were performed by a single surgeon. Patients were requested to attend a follow-up appointment in person or, if this was not possible, by telephone.

RESULTS

A total of 103 patients were enrolled in the study. The postoperative complication rate was 11.7%. Revision surgery was required in 4.9% of patients because of a complication. Wound healing time was on average 21.4 days postoperatively. A total of seven patients (6.8%) had a recurrence within 59 months postoperatively.

CONCLUSIONS

The Karydakis flap is a robust reconstructive off-midline procedure for the treatment of pilonidal sinus. Relatively few postoperative complications and a low recurrence rate are advantages of the surgical procedure. Based on the results of quality-of-life factors, patients experience early functional return to daily life after the Karydakis flap procedure.
Bagging an Extremity for Negative-Pressure Wound Therapy: A Case Report
Authors: Bulić Krešimir , Gatin Lucija
Published: November 2024

Negative-pressure wound therapy (NPWT) is used to promote wound closure or to prepare a wound for definite coverage. However, the anatomy of the hand makes it difficult to apply dressings that require an airtight seal. In this report, the authors describe the case of a patient with an extensive defect of his right hand and forearm who was treated with a free fibula osteocutaneous flap transfer. The remaining defect was covered with a split-thickness skin graft following NPWT. An airtight seal was achieved by placing the whole extremity in a sterile bag and sealing it proximal to the defect. The authors present a simple and innovative way of treating defects on upper extremities with NPWT with excellent results.
Hidradenitis Suppurativa: Radical Surgical Excisions with Staged Reconstructions: A Single-Surgeon Retrospective Review of 71 Patients
Authors: Judge Abigail C. , Tahernia Amir H.
Published: November 2024

BACKGROUND

Hidradenitis suppurativa is a chronic, inflammatory disease involving the pilosebaceous unit of apocrine gland-bearing skin. Wide surgical excision, wherein margins extend beyond active lesions, is considered curative.

OBJECTIVE

To evaluate the safety and efficacy of wide surgical excision in the treatment of hidradenitis suppurativa.

METHODS

This single-surgeon, single-site analysis included all patients undergoing radical surgical excision of hidradenitis suppurativa between 2015 and 2019. Using paper case notes and electronic health records, researchers identified a total of 71 patients who underwent 262 surgeries.

RESULTS

The mean number of surgeries per patient was 3.7, and the total number of sites addressed was 309. Wound dehiscence, infection, and flap necrosis were the most common complications. Disease recurrence in surgically treated areas was noted in two patients (3%).

CONCLUSIONS

For patients with failed medical management of hidradenitis suppurativa or who have otherwise developed severe disease, wide surgical excision remains a safe, effective treatment with comparatively low recurrence rates. Surgeons should consider staging surgeries, rather than performing a single-stage reconstruction, and anticipate complications.
Redefining Calciphylaxis as a Uniquely Bone Forming Subcutaneous C5b-9–Mediated Microvascular Injury Syndrome Associated With Localized Subcutaneous and Systemic Complement Pathway Activation
Authors: Wolner Zachary , Tello Luna , Kalomeris Taylor , Swerlick Robert , Magro Cynthia M.
Published: November 2024

Background:

Microvascular thrombosis is key to the pathogenesis of calciphylaxis. C5b-9–mediated microvascular injury reflective of complement pathway activation could be a key pathophysiologic event.

Methods:

We conducted a retrospective multicenter study of 24 patients who have had biopsy-supported calciphylaxis from the 2010–2022 data base from Emory where C5b-9 immunohistochemistry (IHC) had not been conducted and the 2019–2023 data base from Cornell where C5b-9 IHC was done as part of the routine calciphylaxis work up. IHC for C5b-9 on lesional biopsy specimens was assessed and correlated with routine light microscopic findings and clinical features.

Results:

Most of the patients in our study had uremic calciphylaxis associated with obesity, diabetes, dialysis, hypertension, hyperparathyroidism and elevated serum phosphorus. Most patients did not have defined procoagulant and/or hyperviscosity states. The vascular pathology was predominantly limited to the subcutaneous fat and ranged from a calcific intimal arteriopathy to microvascular thrombosis with endothelial injury with or without endothelial calcification. In most cases (ie, in excess of 80%), there was prominent deposition of C5b-9 within the vasculature including the microvasculature and arteries of the fat at least localized to injured vessels suggesting a causal association. In about 40% of cases, there was evidence of systemic complement pathway activation revealed by concurrent dermal microvascular C5b-9 deposition.

Conclusions:

Calciphylaxis is characterized by subcuticular vascular changes that reflect an interplay between complement triggered endothelial cell injury, resultant vascular thrombosis, and subsequent abluminal calcification. Complement inhibition therapy defines a potential intervention that should be explored.
Metoidioplasty in Norway: A 13-year Experience from a National Center
Authors: Sundhagen Henriette Pisani , Wæhre Anne , Tønseth Kim Alexander
Published: November 2024

Background:

Genital surgery is often considered the final step in surgical gender-affirming treatment. Metoidioplasty is a variant where the enlarged clitoris is lengthened and straightened. The technique has several advantages but is not without complications. We evaluated the surgical outcomes after metoidioplasty from our national center from 2007 to 2020.

Methods:

All patients who had undergone the metoidioplasty procedure at Oslo University Hospital from January 1, 2007, to December 31, 2020, were identified by the Local Quality Register of Gender Incongruence. Demographic, clinical, and surgical variables were recorded. Statistical analysis was carried out with SPSS.

Results:

A total of 84 patients were identified. The median age at the time of surgery was 27.5 years. Of 84 patients, 48 (57.1%) experienced some kind of complication after the surgery, with an average of 1.7 complications. Complications related to the urethroplasty were the most common, with strictures occurring in 19 (22.6%) patients and urethral fistulas occurring in 11 (13.1%) patients. Forty-one patients (48.8%) needed 1 or more secondary procedures. After the management of strictures and fistulas, a secondary testis implant correction was the most frequent revision procedure performed in 38.1% (32) of patients. With increasing body mass index, the risk of complications and of undergoing secondary procedures also increased significantly (P = 0.045 and 0.019, respectively).

Conclusions:

Metoidioplasty is an operation with a relatively high complication rate, mainly related to urethroplasty. There is an urgent need for future research with a focus on quality of life and long-term follow-up.
OPTICAL COHERENCE TOMOGRAPHY–BASED EPIRETINAL MEMBRANE STAGE CORRELATES WITH TANGENTIAL RETINAL DISPLACEMENT AND METAMORPHOPSIA
Authors: Takano Shun-ichiro , Ishida Masahiro , Ichikawa Yoshikazu , Watanabe Amaka , Shoji Takuhei , Shinoda Kei , Takeyama Asuka , Imamura Yutaka
Published: November 2024

Purpose:

To investigate correlations of the optical coherence tomography–based epiretinal membrane (ERM) classification with metamorphopsia and tangential retinal displacement after ERM surgery.

Methods:

ERM stage (stage 1–4) was defined as originally described. Metamorphopsia scores at baseline, 1 month, 3 months, and 6 months after ERM surgery were measured with M-CHARTS (Inami, Co, Tokyo). Tangential retinal displacement was measured as described previously. Eyes with retinal cysts, lamellar hole with epiretinal proliferation, or retinoschisis were excluded.

Results:

One hundred thirty-five eyes of 135 consecutive patients who underwent ERM surgery at a single academic hospital were enrolled. There were 20 eyes of stage 1, 57 eyes of stage 2, 54 eyes of stage 3, and 4 eyes of stage 4. Epiretinal membrane stage correlated with tangential retinal displacement at 1 month, 3 months, and 6 months postoperatively (Spearman rank correlation coefficient, P < 0.001), which also correlated with both horizontal and vertical preoperative M-CHARTS scores (P < 0.001) and horizontal scores at 1 month (P = 0.001) and 3 months (P = 0.016). Visual acuities did not show any correlations with the stage.

Conclusion:

Optical coherence tomography–based ERM classification correlates strongly with tangential retinal displacement after ERM surgery. This classification is particularly useful to predict pre- and postoperative metamorphopsia, but not for visual acuity.
Contact Lens Regulation: Where Have We Been, Where are We Going?
Authors: Risser Kayleigh M. , Zhou Melody Y. , Koster Karl G. , Tejawinata Felicia I. , Gu Xinyu , Steinemann Thomas L.
Published: November 2024

The Food and Drug Administration and the Federal Trade Commission influence the contact lens (CL) market, with the Food and Drug Administration regulating CLs as medical devices and the Federal Trade Commission dictating how they are prescribed and sold. Legislative oversight came to the forefront in 2004, when the Contact Lens Rule was introduced, drastically changing how CLs are prescribed and distributed. This article examines the evolution of CL regulations over the past two decades and discusses how regulation, such as allowing passive verification, has shaped the current and evolving CL market. We also explore how related products (decorative CLs, artificial tears) are regulated and compare US regulations with those abroad. Finally, we discuss how future technological advancements, including artificial intelligence, promise to change the CL industry and its regulation worldwide.