bluuebunny/crossref_metadata_2025 huggingface dataset:
Quality Assessment of Licorice Based on Quantitative Analysis of Multicomponents by Single Marker Combined with HPLC Fingerprint
Authors: Li Tingting , Zhou Hao , Ma Jiahua , Dong Lin , Xu Fang , Fu Xueyan
Published: January 2021

Licorice is a commonly used traditional Chinese medicine and natural sweetening agent, rich in numerous bioactive compounds. Moreover, it is one of the oldest and most frequently employed folk medicines in both eastern and western countries. It is prescribed for the treatment of asthma, fever, and cough. However, with the increasing demand of licorice, its quality and safety become the important issue. The content in licorice varies significantly in materials from different geographical origins. In this study, a reasonable and feasible evaluation method for the quality assessment of licorice was developed based on the analysis of high-performance liquid chromatography (HPLC) fingerprint, combined with the quantitative analysis of multicomponents by single marker (QAMS) method. Glycyrrhizic acid was selected as the internal reference substance, and ten components were simultaneously determined based on relative correction factors. The contents of eleven components in 21 batches of licorice were determined by the QAMS and the ESM (external standard method); there was no significant difference by comparison of the quantitative results between the QAMS and the ESM method; the cosine value (Cir > 0.9999) confirmed the consistency of the two methods. According to the outcomes of 21 batches of licorice samples, the contents of the eleven components were used for further chemometric analysis. All of the samples of licorice from various geographical origins were divided into five categories based on hierarchical cluster analysis, which indicated the crucial influence of geographical origins on licorice. This study showed that QAMS combined with HPLC fingerprint and chemometrics methods could effectively control the quality of licorice. Hence, QAMS is a feasible and promising method for promoting the quality control standardization process of herbal medicines.
Sociodemographic Factors Associated with Request for Labor Epidural Analgesia in a Tertiary Obstetric Hospital in Vietnam
Authors: Nguyen Lam D. , Nguyen Anh D. , Farber Michaela K. , Phan Chi T. , Khuat Luong T. , Nguyen Ha T. , Dang Tuan M. , Doan Ha T. Ngoc
Published: January 2021

This study is aimed at examining the sociodemographic factors associated with the utilization of labor epidural analgesia at a large obstetric and gynecology hospital in Vietnam. This was a cross‐sectional study of women who underwent vaginal delivery in September 2018 at the Hanoi Obstetrics and Gynecology Hospital. The utilization of epidural analgesia during labor was determined. Univariate and multivariate regression models were applied to evaluate the association between patient demographic and socioeconomic factors and request for labor epidural analgesia. A total of 417 women had vaginal deliveries during the study period. 207 women utilized epidural analgesia for pain relief during labor, and 210 did not. Parturients older than 35 years of age (OR 2.84, 95% CI 1.11‐8.17), multiparous women (OR 2.8 95% CI 1.85‐4.25), women living from an urban area, women with higher income (OR 6.47, 95% CI 2.59‐19.23), and women with higher level of education were more likely to utilize labor epidurals. Factors related to a parturient request for epidural analgesia during labor at our tertiary obstetric hospital included age greater than 35 years, multiparity, and high income and education levels. Educational outreach to women about the benefits of epidural analgesia can target women who do not share these demographic characteristics.
A Centrifuge Model Test of the Ground Motion Response in a Moderately Stiff Soil
Authors: Lan Jing-Yan , Wang Ting , Khatri Chhetri Diwakar , Naqvi Mohammad Wasif , Hu Liang-Bo
Published: January 2021

The ground motion response in a moderately stiff soil in seismic events has been traditionally studied based on the actual field records which, however, have yet to offer consistent results regarding the amplification effect of the ground motion. In the present study, a centrifuge model of the moderately stiff soil field is designed to study the amplification effect of the ground motion in response to seismic loads. Four El Centro waves of different strengths are used as the input wave at the base under a gravitational field of 75 g. Ground motion data at different depths are collected via a number of sensors to study the acceleration peak, time history, and response spectrum of the ground motion. The measured amplitude and energy of seismic waves are found to gradually increase from the bottom to the surface during the propagation of seismic waves, and the peak acceleration at the surface is significantly magnified. The response spectrum analysis shows that the acceleration response spectrum gradually moves to the high‐frequency direction from the base to the surface and the value of the response spectrum decreases with the increase of the depth in the present study.
The Effect of Vitamin D Supplementation on Blood Lipids in Patients with Polycystic Ovary Syndrome: A Meta-Analysis of Randomized Controlled Trials
Authors: Gao Hong , Li YanTao , Yan WenNan , Gao Fei
Published: January 2021

Purpose. Studies have found that vitamin D supplementation may improve blood lipids in patients with polycystic ovary syndrome, but the results are controversial, so this study will further analyze the effect of vitamin D supplementation on blood lipids in patients with polycystic ovary syndrome. Methods. PubMed, Embase, Cochrane Library, CNKI, and Wanfang databases were searched up to May 2020, to identify randomized controlled trials of the effect of vitamin D supplementation on blood lipids in patients with polycystic ovary syndrome. The Cochrane risk of bias tool was applied to assess the risk of bias, and RevMan5.3 software was used for statistical analysis. Results. Ten studies were included in this study, including 543 subjects. The results of the meta-analysis showed that, compared with placebo, vitamin D supplementation can significantly reduce total cholesterol level (WMD = –11.32, 95% CI = [–14.51, –8.41],

P
<
0.00001

), low-density lipoprotein cholesterol level (WMD = –4.83, 95% CI = [–7.52, –2.14],

P
=
0.0004

), and triglyceride level (WMD = –8.23, 95% CI = [–13.08, –3.38],

P
=
0.0009

, but the effect on high-density lipoprotein cholesterol level is not statistically significant (WMD = –0.32, 95%CI = [–1.24, 0.60],

P
=
0.50

). Conclusion. Vitamin D supplementation can significantly reduce total cholesterol, low-density lipoprotein cholesterol, and triglycerides in patients with polycystic ovary syndrome. However, it has no significant effect on high-density lipoprotein cholesterol.
Anesthesia Management for Pediatrics with Congenital Heart Diseases Who Undergo Cardiac Catheterization in China
Authors: Xie Chun-Mei , Yao Yun-Tai
Published: January 2021

Objectives. The goal of this study was to summarize anesthesia management for pediatrics with congenital heart diseases who undergo cardiac catheterization procedure in China. Methods. The relevant articles were identified through computerized searches in the CNKI, Wanfang, VIP, and PubMed databases through May 2020, using different combinations of keywords: “congenital heart diseases,” “pediatric,” “children,” “anesthesia,” “cardiac catheterization,” “interventional therapy,” “interventional treatment,” “interventional examination,” and “computed tomography.” Results. The database searches identified 48 potentially qualified articles, of which 25 (9,738 patients in total) were determined to be eligible and included. The authors collect data from the article information. Anesthesia methods included endotracheal intubation or laryngeal mask ventilation general anesthesia, monitored anesthesia care, and combined with sacral canal block. Anesthesia-related complications occurred in 7.41% of the patients and included dysphoria, respiratory depression, nausea, vomiting, cough, increased respiratory secretion, and airway obstruction. The incidence of procedure-related complications was 12.14%, of which the most common were arrhythmia and hypotension. Conclusions. For pediatric patients with congenital heart diseases who undergo cardiac catheterization procedures in China, arrhythmia and hypotension are the most common procedure-related complications. Monitored anesthesia care is the commonly used anesthesia methods, and dysphoria, cough, nausea, vomiting, and respiratory depression are frequent complications associated with anesthesia.
A Method for Determining the Thicknesses of the Reserved Protective Layers in Complex Goafs Using a Joint‐Modeling Method of GTS and Flac3D
Authors: Zhao Xin , Liu Dianshu , Li Shenglin , Wang Meng , Tian Shuaikang , Niu Xiaoming , Mo Lin
Published: January 2021

In this study, a C‐ALS underground cavity scanner was used to detect the shapes of mining goafs. In addition, GTS software was adopted to establish a three‐dimensional geological model based on the status of the stopes, geological data, and mechanical parameters of each rock mass and to analyze the roof areas of the goafs. In regard to the morphology of the study area, based on a thin plate theory and the obtained field sampling data, a formula was established for the thicknesses of the reserved protective layers in the goafs. In addition, a formula for the thicknesses of the protective layers in the curved gobs was obtained. The thickness formula of the protective layers was then successfully verified. The detection results showed that the roof shapes of the goafs in the Yuanjiacun Iron Mine were mainly arc‐shaped, and the spans of the goafs were generally less than 20 m. The stability of the arc‐shaped roofs was found to be greater than that of the plate‐shaped roofs. Therefore, by reducing the thicknesses of the protective layers in mining goafs, the ore recovery rates can be increased on the basis of safe production conditions. The formula of the thickness of the security layers obtained through the thin plate theory was revised based on the statistical results of the roof shapes of the goafs and then combined using GTS and FLAC3D. The modeling method successfully verified the stability of the mined‐out areas. It was found that the verification results were good, and the revised formula was able to improve the recovery rate of the ore under the conditions of meeting safe production standards. Also, it was found that the revised formula could be used in the present situation. At the same time, it was also determined that the complexity of the rock masses obstructed the full identification of the joints and fissures in the present orebodies. Therefore, it is necessary to incorporate C‐ALS underground cavity scanners to regularly observe the shapes of the goafs in order to ensure that stability and safety standards are maintained.
Postoperative COVID-19 Pneumonia following Resection of a Large Thoracic Chondrosarcoma
Authors: Kaidi Austin C. , Held Michael B. , Park Paul J. , Tyler Wakenda K.
Published: January 2021

Case. A 57-year-old man presenting with two months of insidious shoulder pain was found to have a large thoracic chondrosarcoma invading the spinal canal. The patient’s orthopedic oncologist organized an interdisciplinary team including interventional radiology, thoracic surgery, neurosurgery, and plastic surgery. This allowed safe, en bloc tumor resection. The patient’s postoperative course was complicated by COVID-19 pneumonia, which was rapidly identified and medically managed with full recovery. Conclusion. Postoperative COVID-19 pneumonia can present insidiously and mimic other postoperative complications. Early identification and testing can promote rapid isolation, proper personal protective equipment use, and guide outcome-improving treatments.
M-Matrix-Based Robust Stability and Stabilization Criteria for Uncertain Switched Nonlinear Systems with Multiple Time-Varying Delays
Authors: Kermani Marwen , Sakly Anis
Published: January 2021

This paper focuses on the robust stability and the memory feedback stabilization problems for a class of uncertain switched nonlinear systems with multiple time-varying delays. Especially, the considered time delays depend on the subsystem number. Based on a novel common Lyapunov functional, the aggregation techniques, and the Borne and Gentina criterion, new sufficient robust stability and stabilization conditions under arbitrary switching are established. Compared with existing results, the proposed criteria are explicit, simple to use, and obtained without finding a common Lyapunov function for all subsystems through linear matrix inequalities, considered very difficult in this situation. Moreover, compared with the memoryless one, the developed controller guarantees the robust stability of the corresponding closed-loop system with more performance by minimizing the effect of the delays in the system dynamics. Finally, two numerical simulation examples are shown to prove the practical utility and the effectiveness of the proposed theories.
On the Approximate Solutions of the Constant Forced (Un)Damping Helmholtz Equation for Arbitrary Initial Conditions
Authors: Salas Alvaro H. , Jairo E Castillo H. , Alharthi M. R.
Published: January 2021

This paper presents some novel solutions to the family of the Helmholtz equations (including the constant forced undamping Helmholtz equation (equation (1)) and the constant forced damping Helmholtz equation (equation (2))) which have been reported. In the beginning, equation (1) is solved analytically using two different techniques (direct and indirect solutions): in the first technique (direct solution), a new assumption is introduced to find the analytical solution of equation (1) in the form of the Weierstrass elliptic function with arbitrary initial conditions. In the second case (indirect solution), the solution of the undamping (standard) Duffing equation is devoted to determine the analytical solution to equation (1) in the form of Jacobian elliptic function with arbitrary initial conditions. Moreover, equation (2) is solved using a new ansatz and with the help of equation (1) solutions. Also, the evolution equations (equations (1) and (2)) are solved numerically via the Adomian decomposition method (ADM). Furthermore, a comparison between the approximate analytical solution and approximate numerical solutions using the fourth-order Runge–Kutta method (RK4) and ADM is reported. Furthermore, the maximum distance error for the obtained solutions is estimated. As a practical application, the Helmholtz-type equation will be derived from the fluid governing equations of quantum plasma particles with(out) taking the ionic kinematic viscosity into account for investigating the characteristics of (un)damping oscillations in a degenerate quantum plasma model.
NR3C2‐Related Transcriptome Profile and Clinical Outcome in Invasive Breast Carcinoma
Authors: Lu Jianjun , Hu Fang , Zhou Yingling
Published: January 2021

Background. Increasing evidence has indicated that the nuclear receptor subfamily 3 group C member 2 (NR3C2) may be associated with tumorigenesis and patient prognosis for certain types of tumors. However, the clinical significance of NR3C2 is unclear in invasive breast carcinoma (BRCA). Methods. We used bioinformatics to broadly investigate and obtain a deeper understanding of the prognostic significance between NR3C2 and BRCA. RNA‐sequencing data and clinical information of patients with BRCA from the Cancer Genome Atlas database were collected for subsequent analysis. The diagnostic efficacy of NR3C2 was evaluated by calculating the receiver operating characteristic curve. The prognostic value of NR3C2 was evaluated by Kaplan‐Meier analysis and Cox regression analysis for patients with BRCA. Moreover, the OSbrca database was used to validate NR3C2 as a prognostic biomarker for BRCA. Gene set enrichment analysis (GSEA) and tumor immune infiltration analysis were conducted to explore the molecular mechanism of NR3C2 in BRCA. Results. The expression level of NR3C2 in BRCA tissues decreased compared to that in normal breast tissues (P < 0.001). NR3C2 presented good diagnostic efficacy (AUC = 0.908). Moreover, the expression of NR3C2 was verified using the Oncomine database. High expression of NR3C2 was statistically associated with prolonged overall survival (HR = 0.65, 95% CI: 0.47‐0.91, and P = 0.012), progression‐free interval (HR = 0.68, 95% CI: 0.49‐0.95, and P = 0.024), and disease‐specific survival (HR = 0.57, 95% CI: 0.36‐0.89, and P = 0.015) for patients with BRCA. Besides, the prognostic value of NR3C2 was verified by the OSbrca database. GSEA results suggested that enriched pathways included neuroactive ligand‐receptor interaction, focal adhesion, and ECM‐receptor interaction. NR3C2 expression was moderately correlated with mast cells and some T cell subsets in BRCA. Conclusion. NR3C2 is a potential prognostic biomarker that could help clinicians develop more appropriate treatment plans for individual patients with BRCA.
A First Reading of the Anhui University Bamboo-Slip Shi Jing
Authors: Shaughnessy (夏含夷) Edward L.
Published: January 2021

In September, 2019, Anhui University published the first volume of Warring States bamboo-slip manuscripts in its collection. The bamboo slips were purchased by the university in 2015 on the antique market. This volume contains ninety-three slips that correspond with all of or portions of fifty-seven poems in the Guo feng 國風 (Airs of the States) section of the Shi jing 詩經 (Classic of Poetry). The manuscript is written in the script of the ancient state of Chu 楚, and thus presumably was robbed from a tomb somewhere in the territory of that state. This preliminary study of the manuscript presents close readings of six representative poems, comparing the versions in the manuscript with those of the received text. It concludes with consideration of how to understand the textual variants apparent in the manuscript, and also the significance of the manuscript for the composition and especially the transmission of the Shi jing in the pre-Qin period.
Misplacement, Re-Edition or Funerary Object: On the Textual Features of the Anhui Shijing Manuscript and Its Value
Authors: Cao (曹建國) Jianguo
Published: January 2021

There are numerous discrepancies between the Anhui University Shijing Manuscript and Mao Shi 毛詩. These discrepancies are not due to misplacement or re-editing, but result from the use of the Anda Shijing as a funerary object. However, this is not to discredit the significance of the Anda Shijing, which still has exegetical, philological, hermeneutical and paleographical value.
A Re-examination of the Controversy over the Oral and Written Nature of the Classic of Poetry’s Early Transmission, Based on the Anhui University Manuscript
Authors: Jiang (蔣文) Wen
Published: January 2021

Based on the newly discovered Anhui University manuscript, the paper re-examines the controversy over the oral and written nature of the Classic of Poetry’s early transmission. The paper argues that the Anda Shi jing serves to prove, first, that at the time of the manuscript (mid-Warring States period), or even earlier, the Shi jing was already not only an independent text, but had already been written down, and second, that the Anda Shi jing is a “manuscript,” and what is more there are various traces showing that it was a “copy,” such that it could not have been produced in an oral context.
Some Minor Insights from Reading the Anhui University Warring States Bamboo Slips of the Classic of Poetry
Authors: Chen (陳鴻森) Hung-sen
Published: January 2021

This article discusses three topics. First, it discusses the line “I could not fill my slanting basket” 不盈頃筐 in the poem “Juan er” 卷耳. The Anhui University Bamboo Slip version’s qing 頃 (slanting) is written . This, as with the Chu Silk Manuscript character, should be explained as qi 攲 (lopsided). Second, regarding the line “Do you not understand me?” 不諒人只 in the poem “Bai zhou” 柏舟 of the Yong Airs 鄘風 section, the Anhui University Bamboo Slip version of liang 諒 (understanding) is written jing 京. This character should be understood as qiang 強 in the sense of “coerce/force” 強迫. In the line “Supporting King Wu” 涼彼武王 in the poem “Da ming” 大明 of the Major Elegantiae 大雅, liang 涼 is similarly explained as 強 in the sense of “coerce” 威強. These two characters have always been traditionally glossed as either “trust” 信 or “assist” 佐. Third, regarding the line “… it cannot be recited” 不可讀也 of the poem “Qiang you ci” 牆有茨, du 讀 (reciting) in the Han Poetry 韓詩 is glossed in the sense of “record and narrate” 記述, which is superior to the traditional gloss.
A Reconstruction of the Text of the Poem “You Bi” of the Liturgies of Lu Section of the Classic of Poetry
Authors: Liu (劉剛) Gang
Published: January 2021

When ancient texts copied repeated words, they commonly used the notation = to represent it; successive repeated words written as A=B= could be read as either AABB or as ABAB. In Pre-Qin manuscripts unearthed in recent years, there have been examples in which these duplication marks can also be read multiple times. Referring to this usage of duplication marks, I raise several hypotheses regarding the poem “You bi” 有駜 (There are Stout Steeds) in the Liturgies of Lu section of the Classic of Poetry, suggesting that the lines 振振鷺，鷺于下 and 振振鷺，鷺于飛 in the first two stanzas of the poem would have been written in early manuscripts as 振=鷺=于下 and 振=鷺=于飛. 振= 鷺=于下 should be read as 振鷺振鷺，振鷺于下 “Flapping egrets, flapping egrets, Flapping egrets are there below,” and 振=鷺=于飛 should be read as 振鷺振鷺，  振鷺于飛 “Flapping egrets, flapping egrets, Flapping egrets are taking flight.” On the basis of this, I attempt a reconstruction of the original text of “You bi.”
The Shortage of Trauma Surgeons in the US
Authors: Elkbuli Adel , Sutherland Mason , Sanchez Carol , Liu Huazhi , Ang Darwin , McKenney Mark
Published: January 2021

Background

As the United States (US) population increases, the demand for more trauma surgeons (TSs) will increase. There are no recent studies comparing the TS density temporally and geographically. We aim to evaluate the density and distribution of TSs by state and region and its impact on trauma patient mortality.

Methods

A retrospective cohort analysis of the American Medical Association Physician Masterfile (PM), 2016 US Census Bureau, and Centers for Disease Control and Prevention (CDC’s) Web-based Injury Statistics Query and Reporting System (WISQARS) to determine TS density. TS density was calculated by dividing the number of TSs per 1 000 000 population at the state level, and divided by 500 admissions at the regional level. Trauma-related mortality by state was obtained through the CDC’s WISQARS database, which allowed us to estimate trauma mortality per 100 000 population.

Results

From 2007 to 2014, the net increase of TS was 3160 but only a net increase of 124 TSs from 2014 to 2020. Overall, the US has 12.58 TSs/1 000 000 population. TS density plateaued from 2014 to 2020. 33% of states have a TS density of 6-10/1 000 000 population, 43% have a density of 10-15, 12% have 15-20, and 12% have a density >20. The Northeast has the highest density of TSs per region (2.95/500 admissions), while the Midwest had the lowest (1.93/500 admissions).

Conclusion

The density of TSs in the US varies geographically, has plateaued nationally, and has implications on trauma patient mortality. Future studies should further investigate causes of the TS shortage and implement institutional and educational interventions to properly distribute TSs across the US and reduce geographic disparities.
Readmission After Surgical Resection for Colon and Rectal Cancers: A Retrospective Cohort Study
Authors: Khan Sidrah , Kaltenmeier Christof , Hrebinko Katherine , Nassour Ibrahim , Hoehn Richard S , Medich David S , Zureikat Amer , Tohme Samer
Published: January 2021

Background

Colorectal adenocarcinoma is a leading cause of cancer mortality worldwide, often requiring patients to undergo anatomy-altering surgical interventions leading to increased postoperative readmission. Hospital readmission rates have been correlated with increased mortality. Therefore, it is important to understand the association between 30-day readmission rates and mortality as well as the factors associated with increased readmission rates.

Study Design

This is a retrospective review utilizing data from the National Cancer Database. Our primary outcomes of interest were 30- and 90-day mortality rates. Our primary independent variable of interest was 30-day readmission.

Results

Between 2010 and 2016, 207 299 patients underwent surgery for rectal cancer and 754 895 for colon cancer. The readmission rates within 30 days of discharge were 5.4% and 5.5% for patients after surgery for rectal or colon cancer, respectively. 30-day readmission was not associated with 30-day mortality, but it was independently associated with increased 90-day mortality and inferior long-term survival for both cohorts ( P = .001). Independent risk factors significantly associated with increased readmission included race, non-private insurance, and low income.

Conclusion

This study provides a large, up-to-date, and comprehensive analysis of readmission rates for colon and rectal cancers. We demonstrate that socioeconomic factors are associated with increased 30-day readmission. 30-day readmission is also independently associated with increased 90-day mortality as well as lower overall survival rates. Our study supports the need for implementation of programs that support patients of lower socioeconomic status undergoing surgery to further decrease readmission rates and mortality.
REBOA Use, Practices, Characteristics, and Implementations Across Various US Trauma Centers
Authors: Sutherland Mason , Shepherd Aaron , Kinslow Kyle , McKenney Mark , Elkbuli Adel
Published: January 2021

Background

Hemorrhage accounts for >30% of trauma-related mortalities. Use of resuscitative endovascular balloon occlusion of the aorta (REBOA) for temporary hemostasis in the civilian population remains controversial. We aim to investigate REBOA practices through analysis of surgeon and trauma center characteristics, implementation, patient characteristics, and overall opinions.

Methods

An anonymous 30-question standardized online survey on REBOA use was administered to active trauma surgeon members of the Eastern Association for the Surgery of Trauma.

Results

A total of 345 responses were received, and 130/345 (37.7%) reported REBOA being favorable, 42 (12.2%) reported REBOA unfavorably, and 173 (50.1%) were undecided. The majority of respondents (87.6%) reported REBOA performance in the trauma bay. 170 (49.3%) of respondents reported having deployed REBOA at least once over the past 2 years. 80.0% reported blunt trauma being the most common mechanism of injury in REBOA patients. Resuscitative endovascular balloon occlusion of the aorta deployment in zone 3 of the aorta was significantly higher in patients reported to suffer a pelvic fracture or pelvic hemorrhage, whereas REBOA deployment in zone 1 was significantly higher among patients reported to suffer hepatic, splenic, or other intra-abdominal hemorrhage ( P < .05).

Conclusion

Among survey respondents, frequency of REBOA use was low along with knowledge of clear indications for use. While current REBOA usage among respondents appeared to model current guidelines, additional research regarding REBOA indications, ideal patient populations, and outcomes is needed in order to improve REBOA perception in trauma surgeons and increase frequency of use.
Comparative Analysis of Patients with Robotic Hiatal Hernia Repairs with and without Collis Gastroplasty
Authors: Perrone John A. , Yee Stephanie , Guerrero Manrique , Wang Antai , Hanley Brian , Zuberi Jamshed , Damani Tanuja
Published: January 2021

Introduction

After extensive mediastinal dissection fails to achieve adequate intra-abdominal esophageal length, a Collis gastroplasty(CG) is recommended to decrease axial tension and reduce hiatal hernia recurrence. However, concerns exist about staple line leak, and long-term symptoms of heartburn and dysphagia due to the acid-producing neoesophagus which lacks peristaltic activity. This study aimed to assess long-term satisfaction and GERD-related quality of life after robotic fundoplication with CG (wedge fundectomy technique) and to compare outcomes to patients who underwent fundoplication without CG. Outcomes studied included patient satisfaction, resumption of proton pump inhibitors (PPI), length of surgery (LOS), hospital stay, and reintervention.

Methods

This was a single-center retrospective analysis of patients from January 2017 through December 2018 undergoing elective robotic hiatal hernia repair and fundoplication. 61 patients were contacted for follow-up, of which 20 responded. Of those 20 patients, 7 had a CG performed during surgery while 13 did not. There was no significant difference in size and type of hiatal hernias in the 2 groups. These patients agreed to give their feedback via a GERD health-related quality of life (GERD HRQL) questionnaire. Their medical records were reviewed for LOS, length of hospital stay (LOH), and reintervention needed. Statistical analysis was performed using SPSS v 25. Satisfaction and need for PPIs were compared between the treatment and control groups using the chi-square test of independence.

Results

Statistical analysis showed that satisfaction with outcome and PPI resumption was not significantly different between both groups ( P > .05). There was a significant difference in the average ranks between the 2 groups for the question on postoperative dysphagia on the follow-up GERD HRQL questionnaire, with the group with CG reporting no dysphagia. There were no significant differences in the average ranks between the 2 groups for the remaining 15 questions ( P > .05). The median LOS was longer in patients who had a CG compared to patients who did not (250 vs. 148 min) ( P = .01). The LOH stay was not significantly different ( P > .05) with a median length of stay of 2 days observed in both groups. There were no leaks in the Collis group and no reoperations, conversions, or blood transfusions needed in either group.

Conclusion

Collis gastroplasty is a safe option to utilize for short esophagus noted despite extensive mediastinal mobilization and does not adversely affect the LOH stay, need for reoperation, or patient long-term satisfaction.
Intraoperative Nerve Monitoring in Thyroidectomies for Malignancy: Does It Matter?
Authors: Leonard-Murali Shravan , Ivanics Tommy , Nasser Hassan , Tang Amy , Singer Michael C.
Published: January 2021

Background

Recurrent laryngeal nerve (RLN) injury and postoperative hypocalcemia are potential complications of thyroidectomy, particularly in malignancy. Intraoperative nerve monitoring (IONM) remains controversial. We sought to evaluate the impact of IONM on these complications using a national data set.

Methods

The American College of Surgeons National Surgical Quality Improvement Program thyroidectomy-targeted data set was queried for patients who underwent thyroidectomies from 2016 to 2017. Patients were grouped according to IONM use. Logistic regression models were constructed to evaluate associations of variables with 30-day hypocalcemic events (HCEs) and RLN injury. Associations were expressed as odds ratios (ORs) with 95% confidence intervals (95% CIs). A subgroup analysis was performed of patients with malignancy.

Results

A total of 9527 patients were identified; 5969 (62.7%) underwent thyroidectomy with IONM and 3558 (37.3%) without. By multivariable analysis, IONM had protective associations with HCE (OR = .81, 95% CI = .68-.96; P = .013) and RLN injury (OR = .83, 95% CI = .69-.98; P = .033). Malignancy increased risk of HCE (OR = 1.21, 95% CI=1.01-1.45; P = .038) and RLN injury (OR = 1.22, 95% CI = 1.02-1.46; P = .034). A large proportion (5943/9527, 62.4%) of patients had malignancy; 3646 (61.3%) underwent thyroidectomy with IONM and 2297 (38.7%) without. In the subgroup analysis, IONM had stronger protective associations with HCE (OR = .73, 95% CI = .60-.90; P = .003) and RLN injury (OR = .76, 95% CI = .62-.94; P = .012).

Discussion

Malignancy was associated with increased risk of HCE and RLN injury. Intraoperative nerve monitoring had a protective association with HCE and RLN injury, both overall, and in the malignant subgroup. Intraoperative nerve monitoring was correlated with improved thyroidectomy outcomes, especially if the indication was malignancy. This warrants further study to clarify cause and effect.
Is It Necessary to Perform a Histopathological Examination of Pilonidal Sinus Excision Material?
Authors: Akin Tezcan , Akin Merve , Ocakli Serhat , Birben Birkan , Er Sadettin , Tez Mesut
Published: January 2021

Background

Although pilonidal sinus disease is common, development of associated malignancy is very rare. After surgical treatment, most surgeons send the excision material for a histopathological examination. The aim of this study was to examine whether it is necessary to routinely send the pilonidal sinus surgical excision material for this examination.

Method

The data of 3146 patients were retrospectively screened, and 2486 patients with available histopathological reports of the excision material were included in the study.

Results

Of the 2486 patients included in the study, 2165 were men and 321 were women, and 94.7% of the patients were under the age of 50 years while 5.3% were 50 years or above. The rate of patients who underwent surgery due to recurrence was 1.2%. No malignancy was detected in any patient after the histopathological examination.

Discussion

In this study, none of the pathology results was reported as malignant. This confirms that it is necessary to ask the question whether we should routinely send the surgical excision material for a histopathological examination.
Safety of Bariatric Surgery in Patients With Congestive Heart Failure: Results of an 11-Year Retrospective Study
Authors: Brathwaite Barbara M. , Howell Raelina S. , Petrone Patrizio , Brathwaite Collin E. M.
Published: January 2021

Introduction

Congestive heart failure (CHF) is a known risk factor for increased postoperative morbidity. However, the safety in patients with CHF has not been well established. The objective of this study was to assess the safety of surgery in patients with a history of CHF undergoing bariatric surgical procedures.

Methods

Retrospective review of a prospectively maintained Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) Center of Excellence database. Patients with known CHF undergoing bariatric procedures over an 11-year period were reviewed.

Results

Over the 11-year period, 4470 total bariatric surgeries were performed, of which 41 (.92%) patients had known CHF. Twenty-one patients were men (51.2%) with a mean age of 55.8 years and mean body mass index (BMI) of 51.9. Comorbidities included hypertension (87.8%), obstructive sleep apnea (80.5%), osteoarthritis (63.4%), gastroesophageal reflux disease (56%), and diabetes (53.7%). Surgical procedures included 16 sleeve gastrectomies (SGs) (39%), 11 Roux-en-Y gastric bypasses (RYGBs) (26.8%), 10 laparoscopic adjustable gastric bands (LAGBs) (24.4%), 1 removal of a gastric band and conversion to SG (2.4%), 1 removal of a gastric band to RYGB (2.4%), 1 gastric band over RYGB pouch (2.4%), and 1 gastric band replacement (2.4%). All cases were performed minimally invasively (73.2% laparoscopic and 26.8% robotic). Mean LOS was 2.53 days. Thirty-day complications included 2 readmissions (4.9% [1 small bowel obstruction and 1 pulmonary edema]), 1 reoperation (2.4% [small bowel obstruction]), and 1 mortality (2.4%) on postoperative day 30 unrelated to the surgery.

Conclusions

Bariatric surgery can be performed safely in patients with CHF.
Concomitant Sternal Fractures: Harbinger of Worse Pulmonary Complications and Mortality in Patients With Rib Fractures
Authors: Choi Jeff , Mulaney Bianca , Sun Beatrice , Trimble Richard , Tennakoon Lakshika , Spain David A , Forrester Joseph D
Published: January 2021

Background

Sternal and rib fractures are common concomitant injuries. However, the impact of concurrent sternal fractures on clinical outcomes of patients with rib fractures is unclear. We aimed to unveil the pulmonary morbidity and mortality impact of concomitant sternal fractures among patients with rib fractures.

Methods

We identified adult patients admitted with traumatic rib fractures with vs. without concomitant sternal fractures using the 2012-2014 National Inpatient Sample (NIS). After 2:1 propensity score matching and adjustment for residual imbalances, we compared risk of pulmonary morbidity and mortality between patients with vs. without concomitant sternal fractures. Subgroup analysis in patients with flail chest assessed whether sternal fractures modify the association between undergoing surgical stabilization of rib fractures (SSRF) and pulmonary morbidity or mortality.

Results

Of 475 710 encounters of adults admitted with rib fractures, 24 594 (5%) had concomitant sternal fractures. After 2:1 propensity score matching, patients with concomitant sternal fractures had 70% higher risk (95% CI: 50-90% higher, P < 0.001) of undergoing tracheostomy, 40% higher risk (30-50% higher, P <.001) of undergoing intubation, and 20% higher risk of respiratory failure (10-30% higher, P <.001) and mortality (10-40% higher, P =.007). Subgroup analysis of 8600 patients with flail chest showed concomitant sternal fractures did not impact the association between undergoing SSRF and any pulmonary morbidity or mortality.

Conclusion

Concomitant sternal fractures are associated with increased risk for pulmonary morbidity and mortality among patients with rib fractures. However, our findings are limited by a binary definition of sternal fractures, which encompasses heterogeneous injury patterns with likely variable clinical relevance.
Nighttime Calls, Pages, and Interruptions to the On-Call Surgery Resident
Authors: Parrado Raphael H. , Notrica David M , Molitor Mark S.
Published: January 2021

Background

Communication is a keystone to good medical practice. At night, as physician numbers decrease, frequent, nonurgent interruptions have shown to disrupt patient care and impact resident/physician wellness. Potentially, interruptions can lead to an increase in medical errors. The frequency and activities interrupted during night calls have not been fully described.

Methods

For a period of 44 days (August through September), all calls and pages received during the 12-hour night call session were documented. Calls were analyzed by caller, urgency, need for intervention, and resident interrupted by the communication.

Results

A total of 494 communications were identified with a mean of 10 calls per shift (IQR 7-14). Communications lasted a mean of 2.7 +/− 2.9 minutes. Direct calls occurred in 78% and pages in 22% of the cases. From the non-ED calls (n = 335), most of them came from nursing staff (85%), followed by other specialties (12%). Five percent of the calls were directed to the wrong service. Communications occurred during charting (41%), patient assessment (33%), interrupted resident’s sleep (12%), or during a surgical procedure (6%). Communication required no action in 47% of the cases. A physician order was needed in 41%, while bedside clinical assessment was required in 12% of the calls.

Conclusions

Communications are common at night, but most did not require clinical assessment. A large portion of communications interrupted direct patient care. An opportunity exists to eliminate nonproductive communications and improve the quality of medical education.
Routine Use of Preoperative Neck Ultrasound in Primary Hyperparathyroidism Identifies Coexisting Thyroid Disease and Improves Parathyroid Localization
Authors: Foster Trenton , Dy Benzon , Rocco Raffaele , Mckenzie Travis , Thompson Geoffrey , Wermers Robert , Lyden Melanie
Published: January 2021

Background

In Jan 2018, we began routinely obtaining neck ultrasound (US) with 123I/99Tc-sestamibi (MIBI) for parathyroid gland localization and to identify thyroid pathology in the setting of primary hyperparathyroidism (1HPT). The aim of this study is to assess if routine neck US is a useful adjunct to 123I/99Tc-MIBI in 1HPT.

Methods

Patients undergoing surgery for 1HPT with both 123I/99Tc-MIBI and US at our institution after implementation of routine US were reviewed. Biopsy and surgical management of thyroid pathology was evaluated. 123I/99Tc-MIBI and US results were compared to intraoperative findings to determine sensitivity and positive predictive value (PPV) for parathyroid localization.

Results

From January 2018 to September 2019, there were 423 patients (mean, 61 years) that met inclusion criteria (80% women). Thyroid nodules were found on US in 57%, mean size 1.3 + 0.8 cm. Fine needle aspiration (FNA) was performed in 87 patients with nodules (36%). 35 patients (8.5%) required total or partial thyroidectomy for diagnoses/treatment. Papillary thyroid cancer (PTC) was found in 3.5% of the cohort with micro-PTC 53% and PTC 1-2 cm 40%. A successful parathyroid operation for 1HPT was achieved in 98.6% of patients. Positive predictive value for localization of abnormal parathyroid glands was 97% when US and 123I/99Tc-MIBI had concordant findings.

Discussion

Routine use of US in 1HPT commonly identifies nodules that are benign or low-risk PTC. Ultrasound is less sensitive for parathyroid localization but when used with 123I/99Tc-MIBI, concordant imaging has a high PPV.
The time of the Prophet and the future of the community: Temporalities in nineteenth and twentieth century Muslim India
Authors: Pernau Margrit
Published: January 2021

The comparison of the present to the time of the Prophet could mean very different things at different times and for different people, in spite of the finite authoritative sources, the Quran and the traditions of the Prophet. The article argues that the time of the Prophet and the comparative standard it offered not only changed depending on the concerns of the present from which the authors wrote and the future they imagined, but also affected the present and the future of each community referring to it. In the colonial contexts of the nineteenth and twentieth century, this temporal comparison met with and integrated the model of the stages of development. Comparisons with Europe, standing in for modernity, became central for the location of the community on a scale of progress, but also for attempts to change this position by catching up, educationally, economically, and politically. They went hand in hand with a strong appeal to the emotions: The successful reform of the community or nation was what would make the difference between honor, hope, and pride on the one hand and despair, humiliation, and shame on the other, and it was the responsibility of the present generation to gain or lose the future. The article investigates two comparisons of the present with the early Islamic past, Altaf Husain Hali’s Musaddas, a long poem on the Ebb and Flow of Islam (1879), and the speeches Bahadur Yar Jang delivered in Hyderabad in the 1930s and 1940s. Both, though in a noticeably different way, show a Prophetic time, which is not only situated in the past, but also the age of the most perfect form of progress ( taraqqi). Reverting to the past thus also means advancing toward the future; comparing the present to the Prophetic times is an indication how far the community is ready to face the challenges of the future.
Chronemic urgency in everyday digital communication
Authors: Kalman Yoram M , Ballard Dawna I , Aguilar Ana M
Published: January 2021

The experience of a lack of time due to an increasing burden of urgent tasks is one of the more common challenges created by digital communication media in the network society. This study develops the concept of chronemic urgency to explore urgent messaging using digital media. Chronemic urgency is the urgency users assign to messages received via a specific communication medium. Consistent with a communication perspective, the urgency is a function of both the relationship and the media. This study uses social entrainment theory and expectancy violations theory to conceptualize the chronemic urgency construct. This construct is then examined in a pilot study of the chronemic urgency 773 US-based participants assign to the communication media they use at least on a weekly basis. High chronemic urgency is assigned to messages received through media that (1) are used for urgent communication, (2) are checked more often, (3) are likely to be used by others who wish to contact the user urgently, and (4) are likely to lead to a quicker response. Despite the increasing centrality of urgency in everyday communication in the digital age, researchers and practitioners lack reliable methods to measure chronemic urgency in populations. The findings provide initial indications of levels of chronemic urgency in the US population’s everyday digital communication and create a foundation to better understand contemporary temporal phenomena.
The pace of “the good life”: Connecting past, present, and future in the context of a housing affordability crisis
Authors: Kubala Petr , Hoření Samec Tomáš
Published: January 2021

This article focuses on the topic of the young adult’s cleft habitus influenced by a housing affordability crisis in the Czech Republic and examines how this situation affects the young adult’s relation to the imagination of a temporally structured life course and synchronization of life spheres (housing, family, and work). This article is based on qualitative in-depth interviews conducted in the four cities most affected by the house and rent price increase. The general question addresses if and how social inequalities, sharpened by the current housing affordability crisis, affect the process of narrative life course coherence creation (the connection of past, present, and future) in relation to an orientation toward a vision of “the good life.” We furthermore complement the already existing ideal types of the young adult’s relation toward time— confident continuity and cautious contingency—with two other two types— cautious continuity and total contingency—defined on the basis of our data. We argue that the ability of young adults to envision a coherent future is related to the feeling of secured housing and that the idea of the good life is depicted to a large extent through the ideal of homeownership, although the precarity of the housing market makes homeownership harder to reach for those from unprivileged backgrounds.