bluuebunny/crossref_metadata_2025 huggingface dataset:
Global impact of seawater intrusion on coastal agriculture
Authors: Ghirardelli Aurora , Straffelini Eugenio , Park Edward , D’Agostino Vincenzo , Masin Roberta , Tarolli Paolo
Published: December 2024

Coastal agriculture faces escalating threats from seawater intrusion (SWI), jeopardizing global food security through freshwater scarcity, soil salinization and crop damage. However, research on SWI often fails to consider its impact on coastal agriculture. Linking georeferenced SWI data with cropland presence, this review examines SWI’s global distribution and primary drivers. Major attested hotspots include the Mediterranean, South and South-East Asia, and the Bohai Sea region in China. Approximately 87 Mha of cropland globally are vulnerable due to low elevation and coastal proximity, including regions where little to no literature has documented SWI. Main drivers include sea-level rise (SLR), drought, groundwater depletion, river modifications, tidal flooding and subsidence. Projections of SLR indicate cropland of North America, the Indian Subcontinent, and South-East Asia as high-risk for SWI. Additionally, regions like South-East Asia and the Indian Subcontinent are expected to experience significant demographic growth in coastal areas. Understanding present and future SWI dynamics is crucial for designing effective mitigation and adaptation strategies in coastal agriculture to support food supply.
Plant growth promoting properties of Methylobacterium brachiatum B0021T and its influence on the growth and short-term thermal stress resistance of Lactuca sativa L
Authors: Agafonova N V
Published: December 2024

The paper describes the investigation of the effect of inoculation by Methylobacterium brachiatum B0021T on both the growth lettuce plants and their resistance to short-term thermal stress which was made for the first time. The ability of strain B0021T to synthesize indole derivatives, siderophores, to solubilize insoluble phosphates was revealed. It was shown that inoculation of lettuce plants by strain B0021T improved of shoot growth and development, formation of the root system. It had a positive effect on the work of the photosynthetic apparatus, and also increased resistance to short-term temperature stress in vegetation experiments. The obtained results indicate the potential of using the studied strain to improve the yield of agricultural crops, as well as to protect plants from unfavorable environmental conditions.
Current issues in waste management in hot climate conditions
Authors: Shadimetov Yu Sh , Ayrapetov D A
Published: December 2024

The article discusses current issues of waste management in the hot climate of Central Asia. It notes that the development of industry, construction boom, rapid motorization, diversification and growth of agricultural production, combined with a hot climate, along with population growth and its migration to cities, affect the waste situation. At the same time, the region is becoming familiar with the concept of the “green” economy and welcomes the adoption of global experience, modern technologies, and progressive thinking. It emphasizes that waste management is a “complex system” consisting of interconnected parts, each of which can be both a driver and a barrier.
Study of using GIS technologies in forestry cadastre and monitoring for environmental sustainability
Authors: Khafizova Zulfiya , Mukhtarov Uzbekkhon , Nodira Khodjaeva
Published: December 2024

The integration of Geographic Information Systems (GIS) technologies in the forestry cadastre and monitoring practices in Uzbekistan represents a significant advancement in sustainable forest management. This study explores the application of GIS in enhancing the accuracy, efficiency, and comprehensiveness of forestry cadastre, which is crucial for the effective management, conservation, and restoration of forest resources in Uzbekistan. Through spatial analysis, remote sensing, and data integration, GIS technologies offer detailed insights into forest cover, land use changes, and biodiversity, providing a robust framework for decision-making and policy formulation. The research highlights how GIS tools facilitate the precise mapping of forest boundaries, monitoring of illegal logging activities, and assessment of reforestation efforts. Furthermore, the study examines the challenges and opportunities in implementing GIS in Uzbekistan’s forestry sector, considering the country’s unique geographical and ecological context. The findings suggest that adopting GIS technologies can significantly contribute to achieving Uzbekistan’s environmental sustainability goals and improving the management of its forestry resources.
Performance characteristics of rotary lobe pumps for high viscosity food medium
Authors: Akhmedova N A , Levicheva O I , Naumov V A
Published: December 2024

This paper analyses the effects of food media with high viscosity on the performance of rotary lobe pumps. Rotary lobe pumps have long been used in the food industry for pumping highly viscous media and are designed to operate for long periods of time without replacement of any parts. The study utilised publicly available data from factory tests of the PLP 3-4 pump for pumping food media of various viscosities μ (μ above 10,000 cP). The paper presents the results of processing these data, which allow us to draw some conclusions. It is established that the power input of the pump PLP 3-4, due to the viscosity of the food medium, is directly proportional to the rotor speed and increases with its increase. Thus the power spent on overcoming back pressure depends on rotor speed nonlinearly. At the same rotor speed the increase in pressure drop and dynamic viscosity coefficient do not affect the productivity, but lead to a significant increase in power consumption. The obtained results allow to draw a conclusion that it is not necessary to connect the increase of hydraulic efficiency of rotary lobe pump with improvement of energy efficiency of unit utilisation and to take into account the reason of increase of discharge pressure.
Influence of various organomineral biological preparations on the productivity and composition of the chlorophyll complex of spring wheat
Authors: Akhmetzhanov Daniel , Seregina Inga
Published: December 2024

In a field experiment, the influence of various organomineral biological products on the yield and composition of the chlorophyll complex of spring wheat was studied. As a result of research, it was found that organomineral complexes have a positive effect on increasing productivity. Special implementation options using OMC+Zn and OMC+Si. In addition, organomineral biological products have a significant impact on the composition and structure of the chlorophyll complex. To analyze the chlorophyll complex, two indicators were studied: the total content of chlorophylls a and b, and the ratio of chlorophylls a and b. The most optimal and effective in these two indicators was the option using OMC+Zn.
Investigation of operating environments for operating bodies with low tillage
Authors: Sh Primkulov B , Alimova F A , Saidova M T , Allanazarov A A , Khurramov R J
Published: December 2024

The report presents the findings of a feasibility study and provides justification for the Republic of Uzbekistan’s usage of Strip-Till technology. The creating a highly efficient technology issues for bedding fields for planting in one pass, developing a combined aggregate structure that efficiently achieves the procedure, and conducting targeted scientific research to substantiate the parameters of the working parts of the aggregate are considered. The records of investigation on the design of tilling bodies of a combined aggregate with optimal parameters are represented. The theoretical observation to substantiate the parameters of the section of the gangs of the aggregate are presented. A theoretical calculation of the lengthwise spacing across the plate disks of the second row and the spear chisel installed on the beam is given. A program of experimental research has been made to verify the results of theoretical research. The degree of influence of the lengthwise spacing value across the plate disks and the spear chisel on the technological performance indicators of the tilling tools section was determined experimentally. Graphs of variation in the soil loosening gauge and changes in the traction resistance of a tilling tools section depending on the longitudinal spacing across the plate disks and the spear chisel are presented. Concordantly of pilot research events for soil loosening at the level of agrotechnical requirements, the lengthwise spacing value across the plate disks and the spear chisel should not be under 25 cm. Data on the economic efficiency of using an aggregate with experimental tilling tools with well-founded ratings for minimal tillage are presented.
Justification of the operating parameters of the soil mill for the formation of a ridge
Authors: Shaymardanov B P , Berdimuratov P T , Jumatov Y K , Berdimurodov U S , Abdurokhmonov Sh X , Ruziyev D I , Asrorova M K
Published: December 2024

This paper presents the development and justification of operating parameters for a soil milling machine designed to form ridges for the pre-sowing preparation of industrial crops. The study focuses on determining the optimal parameters of the working bodies and operating modes of the cutter, emphasizing the importance of reducing undesirable soil fractions to enhance seed germination. Experimental results demonstrate that the use of organomineral complexes significantly improves soil structure, leading to better moisture retention and reduced vibrations during sowing. The machine’s design incorporates four sections, each equipped with milling drums, ridge formers, and compaction rollers, allowing for efficient soil preparation in a single pass. Key findings indicate that increasing the number of knives on the milling drum enhances soil crumbling efficiency, with optimal configurations yielding significant improvements in grain weight and overall crop quality. The research highlights the effectiveness of the developed machine in achieving high-quality tillage while conserving resources, thereby contributing to more sustainable agricultural practices.
Theoretical study of the threshing process of corn cob under the influence of the rasp bars
Authors: Fozilov G , Akhmedov A , Yuldashev Sh , Akilova U , Juraev K
Published: December 2024

The device described in this scientific article can be used to cut off the unnecessary (top and bottom) part of the corn ears grown for seed, and to thresh and separate the seeds of the precise size. In the course of our research, it was determined that the speed of rotation of the ear corn after impact Ucr
, the radius of the drum Rd
, the angular velocity ωr of the drum at what number of revolutions, the angular speed ωcr of the ear corn after impact, and how it affects the threshing process. According to the physical meaning of the established inequality, the ear corn does not advance from the threshing rasp bar under the impact of the strike of the threshing rasp bar, on the contrary, the threshing rasp bar passes over the corn ear and threshes or removes the seed grains. Also, during the research, Vc
and Vrbr
speeds were analyzed from a theoretical point of view, and their influence on the technological process was studied.
Hydrological analysis using geoelectrics on nickel mine slopes
Authors: Aryanto R , Calvin E , Azizi M A , Marwanza I
Published: December 2024

The sudden emergence of groundwater levels has become a critical issue at PT. Makmur Lestari Primatama, a company operating in the nickel industry. Rainwater seeps into the soil, dominates the groundwater levels, and thus impacting the mining slopes. We conducted a geoelectric study to determine the presence of groundwater and its impact on the mining slopes. The slope safety factors ranged from 0.301 to 0.960, categorized as unstable and therefore, unsafe. Redesigning the slopes as a preventive measure is advised.
Karst groundwater conservation based on hydrochemistry and isotope stable analysis in Obi Island, South Halmahera
Authors: Muchamad A N , Alam Boy Yoseph CSS Syah , Abdurrokhim  , Iskandar I
Published: December 2024

This paper presents an analysis of the hydrogeological characteristics of the Kelo karst area in Obi Island, South Halmahera, focusing on hydrochemistry and isotopic methods to delineate the groundwater recharge zones and propose conservation measures. Despite its natural state, the Kelo karst area has not been previously studied for hydrogeology nor exploited for resources. Unregulated exploitation of karst areas poses significant environmental risks, leading to the degradation of their strategic and hydrological functions. This study investigates spring characteristics through hydrochemistry analysis, stable isotopes (δ18O and δ2H), and groundwater mixing processes. Hydrochemistry and isotopic analyses elucidate the hydrogeological features, including groundwater origin and recharge mechanisms. The predominant groundwater facies in the study area exhibit a Ca-Mg-HCO3
− composition, reflecting the dissolution processes of both limestone and igneous rock formations. Isotopic analysis and local meteoric water line examination indicate a recharge zone elevation ranging from 612 to 945 meters. Geological features such as fracture zones, lineaments, faults, and sinkholes significantly influence the determination of recharge areas. Protection of these recharge zones is imperative for groundwater conservation, ensuring the sustained availability and quality of groundwater amidst the development pressures on karst landscapes.
Integrated vertical mining and processing for Critical Mineral: A case study in Obi Island, North Maluku Province
Authors: Gultom T H
Published: December 2024

Harita Nickel Group in Obi Island, Indonesia pioneered the utilization of limonite nickel ore (Ni <1.5%) for electric car batteries in the country. Nickel mining in Obi Island transitioned from nickel mining in 2010 to integrated mining by establishing downstream processing of raw materials for stainless steel in 2016 and electric car battery in 2018. Pyrometallurgical and hydrometallurgical technologies are employed in factories within Harita Nickel’s mining concession area, notably PT Trimegah Bangun Persada Tbk (PTTBP). This vertically integrated mining and downstream processing in Obi Island, South Halmahera Regency, North Maluku Province, marks a significant advancement in Indonesia’s mining industry. The close proximity (<3km) of mining and factory locations ensures efficiency and low costs. In vertically integrated mining, companies seek to maximize the use of all materials involved in production processes, minimizing waste and optimizing resource utilization. This research focusing on the waste generated during nickel processing of RKEF can be repurposing into new products, reducing environmental impact and increasing sustainability. Nickel, a critical mineral, has garnered global attention, particularly since Indonesia emerged as the world’s largest nickel ore reserve. The extractive industry, employing pyrometallurgy technology, has rapidly produced stainless steel raw materials from nickel mining since 2016. Indonesia’s nickel ore, known as saprolite nickel with high nickel content (>1.7%), has been exploited since the 1970s, while the low-grade limonite nickel layer gained traction only around mid-2018. In the future, Harita Nickel project in western Obi Island will be developed as an Eco Industrial Park for a greater integration, highlighting the comprehensive benefits of vertically integrated mining and providing a more thorough and insightful evaluation of its potential.
Geochemical studies of potential acid-forming classification materials to reduce acid mine drainage formation
Authors: Hadi A L , Arifin Y F , Razie F , Priatmadi B J , Fauzana N A , Noor I
Published: December 2024

Acid mine drainage (AMD) is acidic wastewater produced in coal mining operations due to sulfide mineral oxidation. In compliance with the regulations of good mining practice procedures, each mining operation must conduct a geochemical study of the distribution of material classification categories to identify the potential acid-forming (PAF) or not acid-forming (NAF) materials to mitigate the AMD. This research conducted a field observation at one of the post-mining lakes of a coal mining operation in South Kalimantan. It determined materials or rocks that have the potential for acid formation using static tests with the Net Total Acid Producing Potential (NTAPP) method. The results of coring samples were processed to obtain rock lithology data for four drilling points, demonstrating one layer of low-capacity PAF material in borehole point A, one layer of low-capacity PAF material, and one layer of PAF material in borehole point B. Only one layer of PAF material was in borehole point C and borehole point D. These PAF/NAF data highlighted essential information about PAF/NAF, underscoring the significant role of our work in improving the strength and accuracy of mitigation plans and reducing acid mine drainage.
NTB Province’s commitment to achieve net zero emission by 2050 through energy transition
Authors: Rahmawati D , Hadiyanto  , Adiansyah J S
Published: December 2024

West Nusa Tenggara Province (NTB), Indonesia, is on a dedicated path to achieve Net Zero Emissions (NZE) by 2050. This review evaluated the province’s current policies, strategies, and initiatives aimed at transitioning to renewable energy, enhancing energy efficiency, and reducing carbon emissions. NTB’s significant renewable energy potential—spanning hydro, solar, geothermal, wind, biomass, and waste resources—and the projects underway to harness these resources were examined. Key challenges included the impacts of climate change, economic constraints, and infrastructure limitations, posing significant hurdles to the province’s energy goals. However, opportunities such as international collaborations, innovative financing strategies, and the development of large-scale renewable energy projects provide a strong foundation for progress. NTB’s proactive approach highlighted the critical role of community and private sector involvement in driving the energy transition. The review concludes that NTB’s efforts not only set a benchmark for sustainable development in Indonesia but also offer valuable insights for other regions aiming to achieve similar goals.
Geometric analysis of blasting using C.J. Konya method to get the ideal target fragmentation in pit Main Ridge PT. J Resources Bolaang Mongondow site in Bakan, North Sulawesi
Authors: Mufti S , Matrani B F A , Wijaya A
Published: December 2024

PT J Resources Bolaang Mongondow (JRBM) is a gold mining company located in North Sulawesi Province, Indonesia. The rocks in PT JRBM have high hardness and poor efficiency for direct excavation processes, prompting the company to apply the drilling and blasting method. Problems occur when the size of the blasting fragmentation results in the Pit Main Ridge does not match the PT JRBM fragmentation target of P80 measuring 10 cm. This study aims to provide recommendations for blasting geometry that produces fragmentation according to PT JRBM’s target. The actual blasting data were processed using the Split desktop 4.0 software, and the recommended geometry was calculated using the C.J. Konya and Kuz-Ram methods, then the results of both methods were compared. The results showed that the average size of the actual fragmentation size of P80 was 16.44 cm, which mismatched PT JRBM’s target of 10 cm. In contrast, the recommended geometry using C.J. Konya method resulted in 84.655% of the fragmentation was 10 cm. Therefore, C.J. Konya method was recommended for blasting at the Main Ridge Pit of PT JRBM.
Serologic detection of regenerating protein I alpha by time-resolved fluoroimmunoassay and its clinical value in gastric cancer
Authors: Xiang Zhongyi , Wang Xiaoyan , Zhu Akao , Chen Xindong , Qin Yuan , Zhou Xiumei , Zhao Xueqin , Wang Yigang , Huang Biao , Fang Hongming , Liu Pengfei
Published: December 2024

Background

Regenerating protein I alpha (REG Iα) plays a key role in the progression of gastric cancer (GC). However, the clinical application value of serum REG Iα in GC remains largely unknown.

Methods

Serum REG Iα levels were analyzed through time-resolved fluoroimmunoassay (TRFIA) in healthy controls (HCs) and patients with benign gastric disease (BGD) and GC.

Results

The REG Iα levels of patients with GC were significantly higher than those of HCs and patients with BGD (P < .0001). The REG Iα levels were higher in patients with GC with poor pathological differentiation type; tumor, node, and metastasis stages III-IV; deep tumor invasion (T3–T4); and distant metastasis (P < .05). The diagnostic efficiency of the combined REG Iα, carcinoembryonic antigen (CEA), and carbohydrate antigen 19-9 (CA19-9) tests improved compared with that of the single-indicator test for the diagnosis of patients with GC.

Conclusion

REG Iα-TRFIA may facilitate the ancillary diagnosis of GC and have a monitoring role for further progression of GC. It can also help elucidate the possible diagnostic role of serum REG Iα as a noninvasive tool.
Corneal strain influences keratocyte proliferation and migration through upregulation of ALDH3A1 expression
Authors: Zhang Qian , Zhou Xin , Zhang Wei , Wang Xiaolei , Dou Shengqian , Zhao Leilei , El‐Habta Roine , Zhou Qingjun , Backman Ludvig J. , Danielson Patrik
Published: December 2024

Keratocytes are the primary resident cells in the corneal stroma. They play an essential role in maintaining corneal physiological function. Studying the factors that affect the phenotype and behavior of keratocytes offers meaningful perspectives for improving the understanding and treatment of corneal injuries. In this study, 3% strain was applied to human keratocytes using the Flexcell® Tension Systems. Real‐time quantitative PCR (RT‐qPCR) and western blot were used to investigate the influence of strain on the expression of intracellular aldehyde dehydrogenase 3A1 (ALDH3A1). ALDH3A1 knockdown was achieved using double‐stranded RNA‐mediated interference (RNAi). Immunofluorescence (IF) staining was employed to observe the impact of changes in ALDH3A1 expression on nuclear factor kappa‐light‐chain‐enhancer of activated B cells (NF‐κB) nuclear translocation. Keratocyte proliferation and migration were assessed by bromodeoxyuridine (BrdU) assay and scratch wound healing assay, respectively. Mouse injury models and single‐cell RNA sequencing of keratocytes from keratoconus patients were used to assess how strain influenced ALDH3A1 in vivo. Our results demonstrate that 3% strain suppresses keratocyte proliferation and increases ALDH3A1. Increased ALDH3A1 inhibits NF‐κB nuclear translocation, a key step in the activation of the NF‐κB signaling pathway. Conversely, ALDH3A1 knockdown promotes NF‐κB nuclear translocation, ultimately enhancing keratocyte proliferation and migration. Elevated ALDH3A1 levels were also observed in mouse injury models with increased corneal strain and keratoconus patients. These findings provide valuable insights for further research into the role of corneal strain and its connection to corneal injury repair.
mRNA‐encoded fluorescent proteins enable superior organelle labeling for live cell imaging
Authors: Wang Jiahui , Cao Ziyi , Zhang Qun , Yu Xiang , Lan Zhida , Zhao Leiwen , Wang Jie , Wang Wenjing , Zhang Yu , Zhong Zikan , Hou Yutong , He Xiang , An Zhiyin , Yu Hang , Xu Yingjie , Yang Wen
Published: December 2024

Live cell labeling of various organelles is of great demand in the research field of cell biology. However, current approaches often lack an optimal balance between efficiency and versatility. We took advantage of chemical modified mRNA to express various organelle located fluorescent proteins. This approach facilitated highly efficient multi‐organelle labeling across diverse cell types, both in vitro and in vivo. The application of mRNA‐based organelle markers offers faster and more efficient transfection and expression compared to plasmids. When expressing fluorescent proteins in neuronal cells, it is faster and safer compared to viral vectors. Notably, this approach excels in rapidly labeling organelles, making it highly effective for dynamic live cell imaging applications. By leveraging this tool, we unveiled the unique behaviors of mitochondria and the endoplasmic reticulum during spike protein‐mediated cell fusion, a critical event in SARS‐CoV‐2 viral entry. Thus, our results demonstrate the potency of mRNA‐encoded fluorescent proteins as powerful tools for advancing biological research.
Timing of Surgery for Elbow Fractures (OTA 13 A-C and 21 A-C) and Patient Outcomes
Authors: Linker Jacob A. , Pettit Christopher J. , Ganta Abhishek , Konda Sanjit R. , Egol Kenneth A.
Published: December 2024

OBJECTIVES:

To determine if there is a correlation between time to surgery (TTS) and outcomes after repair of elbow fractures.

METHODS:

Design:

Retrospective comparative study.

Setting:

A single, urban hospital system.

Patient Selection Criteria:

Patients from March 2011 to September 2022 who sustained an isolated fracture about the elbow joint (AO/OTA 13-A, B, and C and 21-A, B, and C), underwent surgical repair, and had at least 6 months of postoperative follow-up identified from an Institutional Review Board–approved database.

Outcome Measures and Comparisons:

TTS, in days, was recorded. Radiographic and clinical follow-up was obtained at all visits, and a Mayo Elbow Performance Index was calculated based on the latest follow-up. Complications recorded include elbow contracture, infection, early hardware failure, reoperation, and fracture nonunion. Multivariable regression and Spearman correlation analysis were used to determine any significant outcome differences based on TTS.

RESULTS:

Three hundred fifty-one patients included with a mean age of 54.8 (range: 18–86) years with 217 females (61.8%) and 134 males (38.2%). Eighty-two patients (23.4%) developed at least 1 complication, whereas 269 patients (76.6%) did not. As a continuous variable, TTS was not correlated with arc of motion at any follow-up visit nor with the latest recorded Mayo Elbow Performance Index score (P > 0.05). Mean TTS for patients who did and did not experience a complication was 6 (range: 0–24) and 10 (range: 0–38) days, respectively, and this was not significantly different (P = 0.217). Complication rate and any of the individual complications were not associated with TTS after a multivariable analysis controlling for age, sex, injury mechanism, open fracture, Charlson Comorbidity Index, and AO/OTA classification (P > 0.05 for all).

CONCLUSIONS:

Timing of surgery after OTA 13 A-C and 21 A-C elbow fractures was not associated with differences in postoperative complications or range of elbow motion.

LEVEL OF EVIDENCE:

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Marijuana Use and Complication Risk After Tibia Shaft Fracture Fixation
Authors: Maxson Ridge , Rapaport Sarah , Covarrubias Oscar , Ghanem Diane , Moreno-Diaz Andres F. , Ross Ryan , Bergstein Victoria E. , O'Sullivan Lucy , Rogers Davis , Mitchell Phillip M. , Shafiq Babar
Published: December 2024

OBJECTIVES:

The aim of this study was to investigate the relationship between preoperative marijuana use and complications after tibia shaft fracture fixation.

METHODS:

Design:

Retrospective cohort study

Setting:

Two academic Level I trauma centers

Patient Selection Criteria:

Adults age ≥18 years who underwent tibia shaft fracture (OTA/AO 42) fixation from 2014 to 2022 and had a minimum 3 months postoperative follow-up were included. Patients were considered marijuana users if they had current self-reported marijuana use or a urine toxicology screen positive for cannabinoids documented at initial presentation.

Outcome Measures and Comparisons:

Bivariate statistics and multivariate regression were used to evaluate the effect of marijuana use on 90-day postoperative thromboembolic and surgical complications, unplanned readmissions, and emergency department visits. Complications related to fracture union were evaluated in patients with ≥6 months follow-up. Multivariate analysis controlled for tobacco use, open fracture, and American Society of Anesthesiologist class ≥3.

RESULTS:

Among 388 patients included in the study, the mean age was 37.6 years (range, 18–90), and most patients were men (66.5%). Ninety-six patients (25%) were identified as marijuana users. Marijuana users were significantly younger (30.5 years vs. 40 years, P < 0.001) and more likely to be men (79% vs. 62%, P = 0.002) and use tobacco currently (73% vs. 31%, P < 0.001) than nonusers. Marijuana users experienced higher rates of 90-day surgical complications (11.5% vs. 4.8%, P = 0.030) and deep infection (8.3% vs. 2.1%, P = 0.008) than nonusers. No significant difference was observed between groups in the rates of thromboembolic complications, nonunion, or delayed union (P > 0.05). On multivariate analysis, marijuana use was not associated with odds of developing any 90-day surgical complication (odds ratios 2.01; 95% confidence intervals 0.83–4.84) or deep infection (odds ratios 2.97; 95% confidence interval 0.95–9.25).

CONCLUSIONS:

Preoperative marijuana use was not found to be associated with risk of thromboembolic, surgical, or fracture union-related complications in patients undergoing tibia shaft fracture fixation.

LEVEL OF EVIDENCE:

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Local Anesthesia With 1% Lidocaine Versus General Anesthesia for Percutaneous Endoscopic Interlaminar Discectomy at L5/S1 Disc Herniation​​​
Authors: Wang Xin , Shen Junjie , Chen Zhiheng , Cai Bin , Chen Yuanyuan , Zhang Guowang , Xu Jianguang , Lian Xiaofeng
Published: December 2024

Study Design:

A prospective randomized clinical trial.

Objective:

In this study, we compared local anesthesia with 1% lidocaine (LA) and general anesthesia (GA) utilized in PEID at L5/S1 disc herniation.

Summary of Background Data:

Given the anatomic characteristics of L5/S1 segment, interlaminar approach was preferred to perform endoscopic discectomy for L5/S1 disc herniation. Typically, general anesthesia was used for interlaminar approach. However, with general anesthesia, nerve damage during surgery due to being unable to monitor patient status is a main concerned for surgeons. As an alternative option, local anesthesia has been developed recently. But, the optimal type of anesthesia for PEID remains controversial.

Methods:

From March 2021 to March 2023, 103 consecutive patients with L5/S1 disc herniation who planned to undergo PEID in our unit were randomized to the LA group (n=53) or GA group (n=50). Both groups were followed up for at least 24 months. Surgical-related parameters, clinical outcomes, and complications were compared between the 2 groups.

Results:

The mean operative time and bed rest time were shorter in the LA group than in the GA group (both P<0.001). The estimated blood loss in the LA group was greater than that in the GA group (P<0.001). The cost of hospitalization in the LA group was significantly lower than that in the GA group (P<0.001). At every time point of follow-up, there was no significant difference between the 2 groups in terms of VAS, ODI, and modified MacNab criteria. The satisfaction surveys showed that more patients in the LA group would choose contrary anesthesia, including 6 patients who were administered extravenously injected sufentanil intraoperatively due to intensive pain. Postoperative neuropathic abnormalities were rarer in the LA group.

Conclusions:

Both local anesthesia using 1% lidocaine and general anesthesia are effective and safe for PEID at the L5/S1 segment. The use of local anesthesia is preferable due to its associated reductions in operative time, bed rest duration, and economic costs.
Crystalloid Liberal or Vasopressors Early Resuscitation in Sepsis-Study of Treatment’s Echocardiographic Mechanisms (CLOVERS-STEM)
Authors: Lanspa Michael J. , Khan Akram , Lyons Patrick G. , Gong Michelle N. , Naqvi Ali A. , Dugar Siddharth , Duggal Abhijit , Johnson Nicholas J. , Schoeneck Jacob H. , Smith Lane , Bose Somnath , Shapiro Nathan I. , Shvilkina Tatyana , Groat Danielle , Jacobs Jason R. , Olsen Troy D. , Cannavina Steven , Knox Daniel B. , Hirshberg Eliotte L. , Self Wesley H. , Brown Samuel M.
Published: December 2024

IMPORTANCE:

Receipt of fluid and vasopressors, common treatments in septic shock, may affect cardiac function.

OBJECTIVES:

We sought to determine whether a liberal or restrictive fluid resuscitation strategy was associated with changes in cardiac function.

DESIGN:

We prospectively studied a subset of patients enrolled in the Crystalloid Liberal or Vasopressors Early Resuscitation in Sepsis (CLOVERS) trial, performing echocardiography at baseline and at 24 hours after randomization. Among patients who had an echocardiogram performed at 24 hours, we measured left ventricular global longitudinal strain (LV GLS) and right ventricular free-wall longitudinal strain (RVFWLS). We performed linear regressions with dependent variables of LV GLS, change in LV GLS (ΔLV GLS), and RVFWLS using treatment assignment as an independent variable. We adjusted for ratio of early diastolic mitral inflow velocity to early diastolic mitral annulus velocity, mean arterial pressure, and history of congestive heart failure and myocardial infarction.

SETTING:

Emergency department and ICUs.

PATIENTS:

Adults with sepsis enrolled in the CLOVERS trial.

MAIN OUTCOMES AND MEASURES:

We enrolled 180 patients. Our analytic cohort comprised 131 patients with an echocardiogram performed at 24 hours. We observed no differences between treatment arms with respect to demographic, clinical, or echocardiographic data at baseline. We observed no association between restrictive fluid assignment and LV GLS (coefficient, 1.22; p = 0.23), ΔLV GLS (–1.97; p = 0.27), or RVFWLS (2.33; p = 0.19).

CONCLUSIONS AND RELEVANCE:

In a subset of patients enrolled in CLOVERS, we observed no association between receipt of fluid and vasopressors and short-term changes in cardiac function. Decreased enrollment may limit inferences.
Per- and poly-fluoroalkyl substances exposure and risk of gastrointestinal cancers: a systematic review and meta-analysis
Authors: Zhang Sirui , Kappil Elizabeth Maria , Zheng Tongzhang , Boffetta Paolo , Seyyedsalehi Monireh Sadat
Published: December 2024

Background

Per- and poly-fluoroalkyl substances (PFASs) are a group of synthetic chemicals used since the 1940s in industrial and consumer applications. These substances are known or suspected to cause cancer, particularly kidney and testicular cancer. However, their association with other types of cancer is not well understood. This review aims to investigate the link between PFAS exposure and the risks of other cancers, including gastrointestinal cancers such as esophageal, gastric, colorectal, and pancreatic cancer.

Methods

We conducted a systematic review of literature from the International Agency for Research on Cancer Monographs, Agency for Toxic Substances and Disease Registry documents, and PubMed (up to January 2024) focusing on the association between PFAS exposure and gastrointestinal cancers. Four independent reviewers screened the studies, extracted the information, and evaluated the quality of the studies using a modified Newcastle-Ottawa Scale. Meta-analyses were performed with random-effects models, including stratified analyses and dose-response assessments.

Results

The meta-analysis included 17 studies. The summary relative risks (RR) of esophageal cancer for perfluorooctanoic acid (PFOA) exposure was 0.75 (95% confidence interval [CI], 0.35–1.60; n = 2), and for perfluorooctane sulfonic acid (PFOS) was 1.76 (95% CI, 0.32–9.68; n = 1). The RR for gastric cancer and PFOA was 0.59 (95% CI, 0.28–1.21; n = 2) and PFAS was 0.96 (95% CI, 0.83–1.12; n = 2). The RR for colorectal cancer and PFOA was 0.83 (95% CI, 0.65–1.06; n = 6) and PFOS was 0.71 (95% CI, 0.22–2.27; n = 4). The RR for pancreatic cancer was 1.02 (95% CI, 0.90–1.15; n = 9) and PFOS was 0.92 (95% CI, 0.76–1.11; n = 2). Stratified analyses by geographical region, study design, quality score, year of publication, gender, and outcome revealed no associations for colorectal and pancreatic cancers. No dose-response trends were identified. Publication bias was suggested for gastric cancer.

Conclusion

Our study suggested no association between PFAS exposure and esophageal, gastric, colorectal, or pancreatic cancer. More rigorous research is needed to investigate this relationship in different settings, with precise PFAS quantification, a wider range of compounds, larger sample sizes for specific cancers, and better control for potential confounders. Our meta-analysis suggests inconclusive evidence, highlighting the need for further research.
Unveiling the molecular and cellular links between obstructive sleep apnea-hypopnea syndrome and vascular aging
Authors: Liu Wei , Zhang Le , Liao Wenhui , Liu Huiguo , Liang Wukaiyang , Yan Jinhua , Huang Yi , Jiang Tao , Wang Qian , Zhang Cuntai
Published: December 2024

Vascular aging (VA) is a common etiology of various chronic diseases and represents a major public health concern. Intermittent hypoxia (IH) associated with obstructive sleep apnea-hypopnea syndrome (OSAHS) is a primary pathological and physiological driver of OSAHS-induced systemic complications. A substantial proportion of OSAHS patients, estimated to be between 40% and 80%, have comorbidities such as hypertension, heart failure, coronary artery disease, pulmonary hypertension, atrial fibrillation, aneurysm, and stroke, all of which are closely associated with VA. This review examines the molecular and cellular features common to both OSAHS and VA, highlighting decreased melatonin secretion, impaired autophagy, increased apoptosis, increased inflammation and pyroptosis, increased oxidative stress, accelerated telomere shortening, accelerated stem cell depletion, metabolic disorders, imbalanced protein homeostasis, epigenetic alterations, and dysregulated neurohormonal signaling. The accumulation and combination of these features may underlie the pathophysiological link between OSAHS and VA, but the exact mechanisms by which OSAHS affects VA may require further investigation. Taken together, these findings suggest that OSAHS may serve as a novel risk factor for VA and related vascular disorders, and that targeting these features may offer therapeutic potential to mitigate the vascular risks associated with OSAHS.
Evaluation of Nursing Program Values in Nursing Course Assignments
Authors: Hostetler Theda
Published: December 2024

Using Burris and Owens' (2024) values-based framework, nursing faculty at a Christian university evaluated curriculum and organizational core values (I-CARE values) to identify how the values were incorporated in nursing program course assignments. The university's I-CARE values are considered a means to develop professionalism in nursing students. The evaluation identified gaps in implementation of the organizational core I-CARE values in assignments at the baccalaureate and graduate levels. Resulting implications for nurse educators provide insights that can be applied to other nursing courses and programs. Applicable Scripture and ethical considerations are discussed.
The Origin of Pediatric Hand Molds and Proof of Concept
Authors: Upton Joseph , Khouri Kimberly S.
Published: December 2024

Background:

The art of casting and creating molds of the hands for teaching anatomy and strategic planning was introduced by Dr. Adrian Flatt and later modified by Dr. Joseph Upton. This article reports on the material and methods of creating low cost and easy to perform 3-dimensional molds that have proven educational for patients, families, residents, and pivotal for surgical planning.

Methods:

Using materials readily available in pediatric operating rooms, the details of the simple, efficient, and cost-effective method of creating hand molds are outlined. Photographs of a small sample size of the mold collection as well as congenital hand deformities are included in this article.

Results:

Over 40 years of molding hands for surgical planning as well as patient and resident education is highlighted. There is also profound public education using these molds as there has been a display of the collection at the Boston Museum of Science for more than 40 years.

Conclusions:

This article provides proof of concept that the use of molds in pediatric hand surgery is low cost, easy to perform, and useful for surgical planning as well as family and resident education.
Foreword: Clinically Focused Insights on the Placenta and Umbilical Cord: An Evidence-based Symposium
Authors: Brandt Justin S. , Oyelese Yinka
Published: December 2024

In this symposium, we introduce a collection of reviews that delve into the diverse clinically relevant aspects of the placenta and umbilical cord. The symposium addresses placenta previa and abruption; pathology, genetics, and imaging of the placenta; infections of the placenta; and ischemic placental disease. The umbilical cord’s essential function as a fetal lifeline is explored, with an emphasis on the clinical repercussions of its dysfunction, including vasa previa and other umbilical cord abnormalities. This curated collection of reviews, which synthesizes the placenta’s and umbilical cord’s fundamental role in maternal-fetal health, underscores the clinical importance of these structures in pregnancy.
Stard1 promotes cholestatic liver injury and disease progression by sensitizing to bile acid hepatotoxicity
Authors: Conde de la Rosa Laura , Fàbrega Laura , Torres Sandra , Nuñez Susana , Ribas Vicent , Segalés Paula , Espinosa-Escudero Ricardo , Solsona Estel , Monte María Jesús , Diaz-Gonzalez Alvaro , Marin José J. G. , García-Ruiz Carmen , Fernandez-Checa Jose C.
Published: December 2024

Background and Aims:

Cholestatic liver diseases are often accompanied by hepatocellular injury, fibrosis, and cirrhosis due to the intracellular accumulation of solutes that cannot be excreted into bile, including bile acids (BAs). These are synthesized in hepatocytes from cholesterol mainly via the classic pathway and in a lower proportion through the mitochondrial acidic pathway. The latter requires STARD1-dependent cholesterol transport to the mitochondrial inner membrane for metabolism, whose contribution to BA-induced hepatotoxicity and cholestatic liver disease is unknown.

Approach and Results:

Here we show that patients with primary biliary cholangitis exhibit increased expression of STARD1 compared to control subjects. Mice with hepatocyte-specific Stard1 deletion (Stard1
Δhep) were more resistant to experimental models of complete (bile duct ligation) and chemical obstructive cholestasis-induced liver injury, inflammation, and fibrosis than Stard1

f/f
mice. Stard1
Δhep mice exhibited reduced hepatic BAs and mitochondrial cholesterol accumulation but increased mitochondrial glutathione levels following bile duct ligation compared to Stard1

f/f
mice. Pharmacological mGSH depletion sensitized primary mouse hepatocytes to a mix of BAs mimicking the profile seen in Stard1
f/f mice after bile duct ligation leading to increased inflammatory response and cytotoxicity.

Conclusions:

These findings highlight a role for STARD1 in cholestatic liver injury and suggest that its targeting may be of relevance for cholestatic liver disease.
=Retinal ischemic perivascular lesions are associated with increased carotid artery stenotic degree
Authors: Wang Hang , Cao Le , Kwapong William Robert , Liu Ruishan , Yan Yuyin , Wan Jincheng , Liu Guina , Hu Fayun , Wu Bo
Published: December 2024

Purpose:

Retinal ischemic perivascular lesions (RIPLs) have been reported as potential biomarkers for cardiovascular diseases and stroke. We aimed to investigate the RIPLs in carotid artery stenosis (CAS) patients and their association with stenotic degree.

Methods:

Patients with unilateral CAS or carotid artery occlusion were recruited. Optical coherence tomography (OCT) was conducted for assessing the presence, number, and distribution of RIPLs. OCT angiography (OCTA) was used for evaluating microvascular density in superficial vascular complex (SVC) and deep vascular complex (DVC).

Results:

Eighty hundred and fifty-four eyes from 474 CAS patients were included. Ipsilateral eyes had more PRILs compared to contralateral eyes (all p < 0.01). CAS patients with cerebral infarction had a higher incidence and broader distribution of RIPLs compared to those without infarction (both p <0.05). The presence, number, and distribution of RIPLs were positively associated with stenotic degree (all p < 0.001). Eyes with RIPLs had lower SVC density (p = 0.020) compared to eyes without RIPLs.

Conclusions:

RIPLs are anatomical markers of ischemia and are suggested to be associated with cerebral infarction and stenotic degree in CAS patients. OCT/OCTA is a noninvasive tool to detect retinal ischemic changes and quantitatively measure retinal microvascular changes in CAS patients.
Novel Multimodal Imaging in Bilateral Diffuse Uveal Melanocytic Proliferation and Change in the Findings During Follow-up and Treatment
Authors: Sezenoz Almila Sarigul , Aykut Aslan , Ayres Bernadete , Beser Buse Guneri , Juntipwong Sarinee , Demirci Hakan
Published: December 2024

Purpose:

To describe the advanced multimodal imaging findings of patients with bilateral diffuse uveal melanocytic proliferation (BDUMP) and the changes in these findings over time.

Methods:

Fundus photography, fundus autofluorescence (FAF), fundus fluorescein angiography (FA), spectral domain optical coherence tomography (OCT), B-scan ultrasonography (US), and ultrasound biomicroscopy (UBM) images of the patients diagnosed with BDUMP at a single institution between years 2006-2023 were evaluated.

Results:

Sixteen eyes of 8 patients with BDUMP were included. The median age was 68 years (Range: 49 – 77 years), and the median follow-up time was 11 months (Range: 1 – 79 months). The most common fundus photography findings were pigmentary changes and diffuse orange pigment patches in the posterior pole. The giraffe/leopard pattern of hyperfluorescence on the posterior pole was the most prominent finding in FAF and FA. Different from previous reports, intraretinal hyperreflective foci, outer retinal tubulations, subretinal fibrosis, and bacillary layer detachment in OCT; optic disc hyperfluorescence, and peripheral vascular leakage in FA; 360° ciliary body thickening, and anterior rotation of the ciliary body in UBM were detected.

Conclusions:

We presented various novel multimodal imaging features of BDUMP that may warrant updating current diagnostic criteria and their changes over time. Our newly defined findings also suggest a possible inflammatory component to BDUMP pathogenesis, which may have implications for treatment.