bluuebunny/crossref_metadata_2025 huggingface dataset:
Modelling of flow through naturally fractured geothermal reservoirs, Taupō Volcanic Zone, New Zealand
Authors: Kissling Warwick M. , Massiot Cécile
Published: August 2023

Background

Numerous fractures are observed in fractured geothermal reservoirs on borehole images in the Taupō Volcanic Zone (TVZ), Aotearoa New Zealand. These fractures are necessary to explain the sustained reservoir permeabilities despite the low matrix porosity. However, conventional continuum models do not adequately represent fluid flow through these fractured rocks.

Methods

We present new Discrete Fracture Network (DFN) codes that model fractures and associated fluid flow in 2-D at reservoir scales to represent typical rock types found in TVZ reservoirs. Input parameters are derived from interpretations of borehole images at the Rotokawa and Wairakei geothermal fields where fractures have high dip magnitudes (> 60–70°). This paper focuses on the effect of fracture density along virtual boreholes (P10), that is in average 0.6 m−1 in sheet-like andesites; 0.8 m−1 in ignimbrites and 1.7 m−1 in rhyolite lavas.

Results

The number of fractures in the models scale linearly with the input P10 in virtual boreholes. The percolation threshold, where the backbone of fractures is connected across the entire model domain, is reached for P10 > 0.24 m−1. Above this threshold, mean flow measured along the mean fracture direction scales linearly with P10. For P10 > 0.4 m−1 the permeability anisotropy lies in the interval 13 ± 3, with the scatter decreasing as P10 increases. The pressure distributions in individual DFN realisations are highly variable, but averages of 50 realisations converge towards those given by equivalent continuum models. Probability density functions resulting from DFN realisations can therefore be used to constrain continuum models. Tracing of fluid particles through the DFN shows that particles can take numerous pathways to define a swath of paths. The travel time of particles over 1 km follows a distribution similar to real tracer tests, with arrivals peaking at 1–2 days and a long tail stretching to over 200 days.

Conclusions

The new codes, calibrated to real measurements of fracture geometries in borehole images of the TVZ, reproduce patterns of flows in fractured geothermal systems. Mean flows and permeability anisotropies derived from the DFNs can be used to improve modelling of flows through fractured geothermal reservoirs using continuum models at a limited computational cost.
Active packaging based on wheat germ protein isolate–Malva sylvestris leaf mucilage embedded with D-limonene nanoliposome: preparation and characterization
Authors: Didar Zohreh , Hesarinejad Mohammad Ali
Published: August 2023

Background

The aim of this study is to prepare wheat germ protein/Malva sylvestris leaf mucilage (WGPI/MSLM) biocomposite layers embedded with D-limonene nanoliposomes (NLP). The effects of WGPI/MSLM ratio (0.4–2.5), NLP (0–3%), and glycerol content (35–50%, w/w based on WGPI weight) on water vapor permeability (WVP), thickness, antioxidant activity, mechanical properties, and solubility of the fabricated bio-nanocomposites were investigated through faced-centered central composite design.

Results

Our results showed the effects of WGPI/MSLM ratio, glycerol content, and liposome content as well as the interaction between the ratio and NLP content on WVP was significant. The sample with 3% NLP and 35% glycerol and a ratio of 0.4 WGPI/MSLM had the lowest solubility. As the ratio of WGPI/MSLM increased, the value of tensile strength (TS) of the samples increased. The lowest elongation at break (26.21%) exhibited by film with 2.5 WGPI/MSLM, 35% glycerol, and no NLP. The highest antioxidant activity (58.6%) was observed in formulated films with 3% NLP, and a WGPI/MSLM ratio of 0.4. The optimal active film was obtained at a ratio of 0.4 WGPI/MSLM, 35% glycerol, and 3% NLP. The analysis confirmed the antibacterial activity of the optimal films against Escherichia coli and Staphylococcus aureus, as well as the larger contact angle of the optimal film compared to the control film and the greater roughness of the optimal film compared to the control sample.

Conclusions

In conclusion, this study successfully produced active films of wheat germ protein/Malva sylvestris leaf mucilage embedded with D-Limonene nanoliposomes. The optimal active film exhibited low solubility, high tensile strength, high antioxidant activity, and antibacterial activity against Escherichia coli and Staphylococcus aureus.

Graphical Abstract
Changes in pediatric injuries sustained while engaged in activities where helmet usage is recommended during the COVID-19 pandemic
Authors: Troy Brent M. , Fraser Doh Kiesha , Linden Allison F. , Xiang Yijin , Gillespie Scott , Agarwal Maneesha
Published: August 2023

Background

Unintentional injuries, including traumatic brain injuries (TBI), are the leading cause of pediatric morbidity and mortality in the USA. Helmet usage can reduce TBI incidence and severity; however, the epidemiology of pediatric TBI and helmet use is ever evolving. With lifestyle changes potentially accelerated by the pandemic, we predicted a decrease in helmet utilization with an associated increase in TBI during the pandemic compared to the pre-pandemic period.

Results

There were 1093 patients that presented with AWHUR injuries from 2018 to 2020 with an annual increase from 263 patients in 2018 up to 492 in 2020. The most frequently implicated mechanisms included bicycles (35.9%), ATVs (20.3%), skateboards (11.6%), scooters (8.3%), and dirt bikes (7.4%). Unhelmeted patients increased from 111 (58.7%) in 2018 to 258 (64.8%) in 2020. There was not a significant difference in the proportion of injuries that were unhelmeted from 38.9% in 2018–2019 to 35.2% in 2020 (p = 0.30), as well as the proportion of head injuries from 2018 to 2019 (24.3%) to 2020 (29.3%) (p = 0.07). A significant increase was seen in neurosurgical consultation from 17 (6.5%) in 2018 to 87 (17.7%) in 2020 (p = 0.02). Notably, there was an increase in the percentage of publicly insured patients presenting with injuries from AWHUR during 2020 (p < 0.001); this group also had suboptimal helmet usage.

Conclusion

This study found an increase in patients presenting with injuries sustained while engaged in AWHUR in relation to the COVID-19 pandemic. Concerningly, there was a trend toward decreased helmet utilization and increased injury severity markers. Further analysis is needed into the communities impacted the most by AWHUR injuries.
External fixator‐assisted plating osteosynthesis in a rabbit model of femoral bone defects appears to be a feasible and reproducible surgical technique: preliminary insights from a bone substitute study
Authors: Vandenbulcke F. , Anzillotti G. , Ravasio G. , Malagoli E. , Conte P. , Balzarini B. , Kirienko A. , Kon E.
Published: August 2023

Purpose

The aims of this study were to assess the complications associated with the use of an external fixator‐assisted plate osteosynthesis technique to stabilize a femoral bone defect in a rabbit model and to evaluate if this technique could avoid the mispositioning and the displacement of the femoral fragments during the surgical procedure.

Methods

A preliminary cadaveric animal study was conducted to develop a new technique of external fixator‐assisted plating. Thirty rabbits underwent a surgical procedure consisting in the creation of a femoral bone defect and, subsequently an implantation of a bone substitute through the assistance of a temporary external fixator. The fixator’s ability to maintain length and alignment during surgery was documented. All intraoperative complications were prospectively collected.

Results

No complications related to the use of the temporary external fixator were reported. The technique successfully prevented mispositioning and dislocation during plating in all the rabbits.

Conclusion

In a rabbit animal model, the use of an external fixator‐assisted plate osteosynthesis technique appears to be feasible and effective in avoiding misposition and rotation of femoral fragments when performing osteotomy and plating to create a mid‐diaphyseal femoral defect.
Pancreatic ductal adenocarcinoma arising from the pancreatic parenchyma compressed by a huge pancreatic lipoma: a case report
Authors: Nakahara Seiji , Doi Shunsuke , Nishiwada Satoshi , Yasuda Satoshi , Nagai Minako , Nakamura Kota , Matsuo Yasuko , Terai Taichi , Kohara Yuichiro , Sakata Takeshi , Nitta Yuji , Morita Kohei , Sho Masayuki
Published: August 2023

Background

Pancreatic lipomas (PLs) arising from the adipose tissue in the pancreatic parenchyma are rare among pancreatic tumors. Coexisting pancreatic ductal adenocarcinoma (PDAC) and PLs have not been previously reported. Herein, we report a case of PDAC arising from the pancreatic parenchyma with chronic pancreatitis compressed by a large PL.

Case presentation

The patient was a 69-year-old male. He had been diagnosed with a PL using computed tomography (CT) 12 years previously. The tumor had been slowly growing and was followed up carefully because of the possibility of well-differentiated liposarcoma. During follow-up, laboratory data revealed liver damage and slightly elevated levels of inflammatory markers. Contrast-enhanced CT revealed the previously diagnosed 12 cm pancreatic head tumor and an irregular isodensity mass at the upper margin of the tumor that invaded and obstructed the distal common bile duct. Magnetic resonance cholangiopancreatography demonstrated no specific findings in the main pancreatic duct. Based on these imaging findings, the patient underwent endoscopic retrograde biliary drainage and bile duct brushing cytology, which revealed indeterminate findings. The differential diagnosis of the tumor at that time was as follows: (1) pancreatic liposarcoma (focal change from well-differentiated to dedifferentiated, not lipoma), (2) distal cholangiocarcinoma, and (3) pancreatic cancer. After the cholangitis improved, a pancreatoduodenectomy was performed. Histologically, hematoxylin–eosin staining revealed moderately differentiated PDAC compressed by proliferating adipose tissue. The adipose lesion showed homogeneous adipose tissue with no evidence of sarcoma, which led to a diagnosis of lipoma. Additionally, extensive fibrosis of the pancreatic parenchyma and atrophy of the acinar cells around the lipoma was suggestive of chronic pancreatitis. The pathological diagnosis was PDAC (pT2N0M0 pStage Ib) with chronic pancreatitis and PL. The postoperative course was uneventful, and the patient was discharged on the 15th day after surgery. The patient received adjuvant chemotherapy and has remained recurrence-free for more than 6 months.

Conclusions

PL may be associated with the development of PDAC in the surrounding inflammatory microenvironment of chronic pancreatitis. In cases of growing lipomas, careful radiologic surveillance may be needed not only for the possibility of liposarcoma but also for the coincidental occurrence of PDAC.
Resistance Training and Weight Loss in Older Adults: A Scoping Review
Authors: Buskard Andrew N. L. , Petrella Robert J.
Published: August 2023

Resistance training (RT) is one of the most effective interventions available to older adults wishing to slow the progressive loss of muscle size and strength known to occur with age. Less is known about the ability of RT to resist the onset of an equally problematic condition related to increased age: obesity. The objective of this scoping review was to characterize current research associated with RT and weight loss in older adults, including protocols, feasibility, and gaps in current knowledge. We searched six databases using variations of the terms "resistance training," "weight loss," and "older adults" for experimental or quasi-experimental studies published in the year 2009 or later. Studies were included if they featured at least one treatment group with a mean age of > 65 years that engaged in an RT-only exercise protocol with no aerobic or high-intensity interval component. Of the 6102 references identified by the initial database search, 24 were retained for analysis. Older women and older adults with obesity or sarcopenic obesity were the most studied groups (n = 13), followed by healthy community-dwelling older adults (n = 11) and studies involving older adults and some aspect of either dietary control or pharmaceutical intervention (n = 8). Significant between-study heterogeneity was observed in the RT characteristics researchers thought optimal for improving body composition measures in older adults. Changes in body composition, rather than total body mass, were found to be the essential variables to consider when evaluating the effectiveness of an RT intervention aimed at reducing chronic disease in older adults. Weight loss alone appears to be an incomplete and problematic outcome measure for older adults, with changes in body composition (ratio of fat mass to lean mass) being the more appropriate variable to emphasize in this population. However, it is important to note that only one study, showing questionably reproducible findings, found a significant lean body mass gain. The lack of abundant high-quality evidence demonstrating combined RT and a healthy diet can lead to significant fat loss and lean body mass gain, coupled with high attrition rates observed in many of the studies reviewed, highlight the need for further rigorous research.
Clinical and life style factors related to the nighttime blood pressure, nighttime dipping and their phenotypes in Korean hypertensive patients
Authors: Kim Byung Sik , Kim Ju Han , Kim Wan , Kim Woo Shik , Park Sungha , Lee Sang Jae , Kim Jang Young , Lee Eun Mi , Ihm Sang Hyun , Pyun Wook Bum , Shin Jeong-Hun , Shin Jinho
Published: August 2023

Background

Non-dipping or reverse dipping patterns are known to be associated with adverse cardiovascular prognosis among the general population and clinical cohort. Few large sized studies have explored factors including sleep duration and sleep quality related to nighttime blood pressure (BP) and nocturnal dipping patterns.

Methods

Among 5,360 patients enrolled  in Korean multicenter nationwide prospective Registry of ambulatory BP monitoring (KORABP), 981 subjects with complete data on sleep duration, sleep quality assessed using a 4-point Likert scale, and clinical variables were included in the analysis. Phenotypes of nighttime BP pattern were categorized as extreme dipper, dipper, non-dipper, and reverse dipper. Hypertension was defined as a 24-h ambulatory BPs were 130/80 mmHg or higher.

Results

Among 981 subjects, 221 were normotensive, 359 were untreated hypertensive, and 401 were treated hypertensive. Age of the participants were 53.87 ± 14.02 years and 47.1% were female. In overall patients, sleep duration was 431.99 ± 107.61 min, and one to four points of sleep quality were observed in 15.5%, 30.0%, 30.4%, and 24.2%, respectively. Of the 760 hypertensive patients, extreme dipper, dipper, non-dipper, and reverse dipper were observed in 58 (7.63%), 277 (36.45%), 325 (42.76%), and 100 (13.16%), respectively. In multiple linear regression analysis, sleep duration (β = 0.0105, p < 0.001) and sleep quality (β = -0.8093, p < 0.001) were associated with nighttime systolic BP and sleep quality was associated with extent of nighttime systolic BP dipping (β = 0.7622, p < 0.001) in hypertensive patients. In addition, sleep quality showed positive association with dipper pattern (odds ratio [OR] = 1.16, 95% confidence interval [CI] = 1.03–1.30) and showed negative association with reverse dipper pattern (OR = 0.73, 95% CI = 0.62–0.86) in multiple logistic regression analyses.

Conclusion

When adjusted covariates, less sleep duration and poor sleep quality were positively associated with nighttime systolic BP. Additionally, sleep quality was the independent associated factor for dipper and reverse dipper phenotypes. The study also found that male sex, low estimated glomerular filtration rate, high ambulatory BP, low office BP, and poor sleep quality were associated with blunted nighttime SBP dipping.
Gene editing with an oxathiapiprolin resistance selection marker reveals that PuLLP, a loricrin-like protein, is required for oospore development in Pythium ultimum
Authors: Feng Hui , Liu Tianli , Li Jiaxu , Wan Chuanxu , Ding Feifei , Wang Yuanchao , Zheng Xiaobo , Ye Wenwu
Published: August 2023

Oomycetes, such as Pythium species, contain numerous devastating plant pathogens that inflict substantial economic losses worldwide. Although CRISPR/Cas9-based genome editing is available, the selection markers available for genetic transformation in these species are limited. In this study, a mutated version of the Phytophthora capsici oxysterol-binding protein-related protein 1 (PcMuORP1), known to confer oxathiapiprolin resistance, was introduced into the CRISPR/Cas9 system for in situ complementation in Pythium ultimum. We targeted PuLLP, which encodes a loricrin-like protein, and showed significant downregulation when the Puf RNA-binding protein-encoding gene PuM90 was knocked out. The PuLLP knockout mutants could not produce oospores, indicating a similar biological function as PuM90. The reintroduction of PuLLP into the knockout mutant using PcMuORP1 as a selection marker restored oospore production. Further comparisons with the conventional selection marker NPTII indicated that PcMuORP1 could be applied at a lower concentration and cost, resulting in a higher screening efficiency. Successive subculturing in the absence of selective pressure showed that PcMuORP1 had little long-term effect on the fitness of transformants. Hence, it could be reused as an alternative selection marker. This study demonstrates the successful implementation of the PcMuORP1 gene as a selection marker in the genetic transformation of Py. ultimum and reveals the loricrin-like protein PuLLP as a sexual reproduction-related factor downstream of the Puf RNA-binding protein PuM90. Overall, these results will help accelerate the functional genomic investigation of oomycetes.
The prevalence of seat belt use among drivers and passengers: a systematic review and meta-analysis
Authors: Kargar Shiva , Ansari-Moghaddam Alireza , Ansari Hossein
Published: August 2023

Background

Seat belts might save people’s lives in car accidents by preventing severe collision damage and keeping passengers safe from critical injuries. This meta-analysis was performed to assess the prevalence of seat belt use among drivers and passengers.

Methods

The databases of PubMed, Web of Science (WOS), and Google Scholar were searched from the beginning of 2000 to late December 2020 to identify studies that investigated the prevalence of seat belt use among drivers and passengers. The pooled prevalence was calculated using a random-effects model. The STATA-v14 software was used to perform data analysis.

Results

Sixty-eight studies that met the inclusion criteria and were suitable for this meta-analysis were identified. The pooled prevalence of seat belt use was 43.94% (95%CI: 42.23–45.73) among drivers, 38.47% (95%CI: 34.89–42.42) among front-seat passengers, and 15.32% (95%CI: 12.33–19.03) among rear-seat passengers. The lowest seat belt use among drivers and passengers was observed in Asia, the Middle East, and Africa, while the highest use was reported in Europe and America. Moreover, the prevalence of seat belt use was higher among women drivers [51.47% (95%CI: 48.62–54.48)] than men drivers [38.27% (95%CI: 34.98–41.87)] (P < 0.001). Furthermore, the highest prevalence of seat belt use was seen among drivers (68.9%) and front-seat passengers (50.5%) of sports utility vehicles (SUVs); in contrast, the lowest prevalence was observed among drivers and passengers of public vehicles such as buses, minibuses, and taxis.

Conclusions

In general, the prevalence of seat belt use was not high among drivers and was even lower among passengers. Moreover, drivers and passengers in Asia, the Middle East, and Africa had the lowest prevalence of seat belt usage. Additionally, drivers and passengers of public transportation (buses, minibuses, and taxis) had a lower rate of seat belt use, especially among men. Therefore, effective interventional programs to improve seat belt use should be designed and implemented, particularly among these at-risk populations in Asia, the Middle East, and Africa.
Current relevance of biomarkers in diagnosis of periprosthetic joint infection: an update
Authors: Tripathi Saksham , Tarabichi Saad , Parvizi Javad , Rajgopal Ashok
Published: August 2023

With a significant rise in the number of arthroplasty procedures performed worldwide, the increasing revision burden posed by periprosthetic joint infection (PJI) is a matter of growing concern. In spite of various attempts to diagnose PJI, there are no defined tests that can be called a gold standard. Given the importance of early diagnosis in PJI, newer tests and biomarkers have been introduced to improve cumulative diagnostic accuracy. Novel biomarkers like calprotectin, lipocalcin, monocyte-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and platelet-to-mean platelet volume ratio have demonstrated a potential as diagnostic biomarkers for PJI. This article discusses the relevance of available and newly described diagnostic biomarkers to provide a perspective on the practical applicability in current medical practice, as well as highlights some recent advances in biomarkers for the diagnosis of PJI.
High-frequency terahertz waves disrupt Alzheimer’s β-amyloid fibril formation
Authors: Peng Wenyu , Zhu Zhi , Lou Jing , Chen Kun , Wu Yuanming , Chang Chao
Published: August 2023

The accumulation and deposition of amyloid can cause a variety of neurodegenerative diseases, including Alzheimer’s and Parkinson’s disease. The degradation or clearance of this accumulation is currently the most widely accepted therapeutic strategy for intervention in these pathologies. Our study on amyloid-β (Aβ) oligomers in vitro revealed that high-frequency terahertz (THz) waves at a specific frequency of 34.88 THz could serve as a physical, efficient, non-thermal denaturation technique to delay the fibrotic process by 80%, as monitored by a thioflavine T (ThT) binding assay and Fourier transform infrared (FTIR) spectroscopy. Additionally, THz waves of this frequency have been shown to have no side effects on normal cells, as confirmed by cell viability and mitochondrial membrane potential assays. Furthermore, molecular dynamic (MD) simulations revealed that the THz waves could resonate with Aβ fibrils, disrupting the dense conformation by breaking the β-sheet structure and promoting the formation of abundant coil and bend structures. This study uses the amyloid of Aβ as an example, and the results will further guide interventions for the accumulation of other amyloids, which may provide new ideas for the remission of related diseases.
A surgical case of abscess of the sternal region due to synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) syndrome
Authors: Tada Makoto , Uehara Hirofumi , Ohyu Takeshi , Watanabe Atsushi
Published: August 2023

Background

Synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) syndrome is a rare chronic inflammatory disorder characterized by cystic skin disease, aseptic osteomyelitis, and hyperostosis. It is rarely associated with subcutaneous abscesses in the anterior chest wall. Herein, we describe a case of a sternal abscess due to SAPHO syndrome that was successfully treated with debridement.

Case presentation

A 62-year-old female patient presented with a chief complaint of a mass in the right anterior chest region. Computed tomography showed the presence of an abscess around the sternum. Magnetic resonance imaging revealed inflammation of the spine. The patient also had a history of palmoplantar pustulosis, raising the suspicion of SAPHO syndrome; however, sternoclavicular joint infection could not be excluded. Abscess drainage and wall debridement were performed. However, reaccumulation of the abscess occurred early after surgery. Although culture tests of the abscess were negative, histopathological examination of the abscess wall revealed a tuberculoid granuloma. Owing to unsuccessful open wound management, debridement of the anterior thoracic skin and abscess wall and partial sternal resection were performed 2 months after the initial surgery. Negative-pressure wound therapy (NPWT) was applied for 4 weeks after surgery, followed by immunosuppressant administration. The patient underwent split-thickness skin grafting on postoperative day 65 and had no abscess recurrence at 18 months post-surgery.

Conclusions

Abscesses in the sternal region caused by SAPHO syndrome can be difficult to differentiate from infectious arthritis. Therefore, drainage and debridement should be considered if infection cannot be excluded.
3D imaging of left atrial dissection: a case report
Authors: Okano Ryoi , Kawashima Dai , Koshiba Yusuke , Ai Kimiaki , Ando Takuya , Suzuki Satoshi , Maeba Satoru
Published: August 2023

Background

Left atrial dissection (LAD) is an uncommon but potentially devastating complication of cardiac surgery. Though surgical and conservative treatment strategies have been reported, the choice depends on each clinical situation. Especially in sensitive cases, the decision could be difficult, where the detailed assessment of the multiple imaging modalities is mandatory.

Case presentation

Open surgical total arch replacement (TAR) was performed on a male patient aged 79 years old, who had severe chronic obstructive pulmonary disease (COPD) and a history of aortofemoral bypass for abdominal aortic aneurysm and arteriosclerosis obliterans (ASO). During the weaning off the cardiopulmonary bypass (CPB), LAD was detected on intraoperative transesophageal echocardiography (TEE). It was 18 × 26 mm and full of hematoma with the TEE. Due to the patient’s frailty and not to elongate the CPB duration, we selected a conservative strategy. The patient was extubated on postoperative day (POD) 1 and transferred from ICU to the ward on POD 3. On POD 7, ECG-gated 3D-CT was performed, on which LAD occupied 26% of the left atrial volume. It also revealed the opening of the pulmonary veins and the proximity of the LAD and the coronary sinus (CS). The cause of the LAD was considered to be the CS perforation with a retrograde cardioplegic cannula. A follow-up 3D-TEE was performed on POD 15, where the hematoma inside the LAD was absorbed. He was discharged home at POD 23. With transthoracic echocardiography, LAD itself disappeared after 3 months.

Conclusion

3D imaging, such as 3D-TEE and 3D-CT, is valuable in the assessment of the volume and quality of LAD. Furthermore, it clarifies the exact position and configuration of LAD, which help in assessing the etiology, predicting the hemodynamic disturbance, and determining the treatment strategy. They are potent tools, especially in complex cases.
Effective application of indocyanine green for visualization of the thoracic duct during video-assisted thoracoscopic surgery for chylothorax: a case report
Authors: Hashimoto Teppei , Osaki Toshihiro , Oka Soichi , Ueda Hiroyuki
Published: August 2023

Background

Chylothorax is an accumulation of typically milky-appearing lymphatic fluid within the pleural cavity. High-output chylothorax may lead to a severe risk of death if not treated promptly. Several studies have reported the effectiveness of indocyanine green (ICG) for chylothorax following lung cancer surgery, esophagectomy, and congenital and recurrent idiopathic chylothorax. Here, we report a case of a successful treatment of idiopathic chylothorax in an adult by identifying and ligating the thoracic duct (TD) using fluorescent thoracoscopy with inguinal lymph node injection of ICG.

Case presentation

A 79-year-old man with nephrotic syndrome presented with a massive right pleural effusion. Based on the pleural effusion examination, the patient was diagnosed with idiopathic chylothorax. He underwent 26 days of conservative treatments, including intercostal chest tube drainage, subcutaneous injection of a somatostatin analog (octreotide), and diet control (low-fat diet, fasting). However, the conservative treatments failed. Therefore, thoracoscopic TD ligation using a combination of ICG and near-infrared (NIR) light was performed. Ultrasound-guided inguinal lymph node injection of ICG was performed before thoracoscopy. Although standard-mode thoracoscopy could not identify leakage points, when observed under NIR light, the TD could be detected using fluorescence contrast. The TD was clipped to the deepest level on the thoracic side. Furthermore, a fluorescence hotspot of ICG on the cranial side of the clipped TD, likely a leakage point, was confirmed, and the lesion was clipped. ICG fluorescence did not disappear during surgery. The thoracic tube was removed on postoperative day 7. To date, chylothorax has not recurred.

Conclusions

We report the effectiveness of intraoperative NIR fluorescence with ICG in identifying the TD’s running. This technique can lead us to identify and ligate the TD with assurance and accurately treat chylothorax.
An expanded idea of imaging in geophysics through multimodal data analysis
Authors: Dell'Aversana Paolo
Published: August 2023

In situations where visual stimuli are uncertain or degraded, auditory perception is crucial and can complement visual perception. Research on multimodal perception has confirmed in many areas of study that the existence of one stimulus can impact the perception of another type of stimulus. Based on these concepts, which are well-established in cognitive sciences, we introduce the idea of expanded (or augmented) imaging in geophysics, which refers to an integrated and coherent data representation based on dual-sensory (audiovisual) perception of the same data set. First, we explain the basic principles of multimodal analysis of seismic data using the theory of augmented imaging. Then, we provide examples and applications on real data at varying spatial scales, from individual seismic traces to entire seismic sections.
Treatment Persistence and Medication Switch Associated With Subsequent Fractures After Osteoporotic Fractures
Authors: Lin Sung-Yen , Chen Wei-Ju , Ku Chieh-Ko , Chen Yi-Ming , Chen Chung-Hwan , Chien Li-Nien
Published: August 2023

Context

Despite prevalent anti-osteoporosis medication (AOM) switching in real-world osteoporosis management, few studies have evaluated the impact of persistent AOM treatment, allowing for AOM switching, on the risk of subsequent fracture.

Objective

We examined the association between persistence in AOM and subsequent fractures, allowing for medication switching among patients with osteoporotic fractures.

Methods

This retrospective cohort study used Taiwan National Health Insurance claims data to select patients who initiated AOM between 2013 and 2016. Treatment persistence was defined as use of any AOM on a given day of interest with a 45-day grace period. Medication switch was allowed for persistence if remaining on treatment. AOMs with long-lasting inhibition of bone resorption (zoledronate and denosumab) were categorized as high-potency; others as low-potency. Multivariate Cox models were used to evaluate risk of subsequent fractures ≥3 months after initiating AOM.

Results

A total of 119 473 patients were included (mean [SD] follow-up 46.4 [15.6] months), and 26.8% switched from the index AOM. Within 1 year, 52% remained persistent with AOM. Compared to patients with persistent AOM, those not persistent had higher risk of subsequent hip (adjusted hazard ratio [aHR] = 1.31; 95% CI, 1.21-1.42), vertebral (aHR = 1.17; 95% CI, 1.13-1.22), and radius fractures (aHR = 1.16; 95% CI, 1.08-1.25). Patients with persistent AOM who switched from high- to low-potency AOM had higher risk of subsequent vertebral fractures than those with persistent AOM and no potency switch (aHR = 1.28; 95% CI, 1.02-1.60).

Conclusion

Patients with non-persistent AOM had higher risk of subsequent fractures than persistent users when allowing AOM switch. Switching AOM potency may influence the risk of subsequent vertebral fractures and warrants further investigation.
Single-cell profiling of the developing embryonic heart in Drosophila
Authors: Huang Xiaohu , Fu Yulong , Lee Hangnoh , Zhao Yunpo , Yang Wendy , van de Leemput Joyce , Han Zhe
Published: August 2023

Drosophila is an important model for studying heart development and disease. Yet, single-cell transcriptomic data of its developing heart have not been performed. Here, we report single-cell profiling of the entire fly heart using ∼3000 Hand-GFP embryos collected at five consecutive developmental stages, ranging from bilateral migrating rows of cardiac progenitors to a fused heart tube. The data revealed six distinct cardiac cell types in the embryonic fly heart: cardioblasts, both Svp+ and Tin+ subtypes; and five types of pericardial cell (PC) that can be distinguished by four key transcription factors (Eve, Odd, Ct and Tin) and include the newly described end of the line PC. Notably, the embryonic fly heart combines transcriptional signatures of the mammalian first and second heart fields. Using unique markers for each heart cell type, we defined their number and location during heart development to build a comprehensive 3D cell map. These data provide a resource to track the expression of any gene in the developing fly heart, which can serve as a reference to study genetic perturbations and cardiac diseases.
Survival of Patients with Deficient Mismatch Repair Versus Proficient Mismatch Repair Metastatic Colorectal Cancer Receiving Curative-Intent Local Treatment of Metastases in a Nationwide Cohort
Authors: Zwart Koen , van der Baan Frederieke H. , Punt Cornelis J. A. , Wensink G. Emerens , Bolhuis Karen , Laclé Miangela M. , van Grevenstein Wilhelmina M. U. , Hagendoorn Jeroen , de Hingh Ignace H. , Koopman Miriam , Vink Geraldine , Roodhart Jeanine
Published: August 2023

Background

It is unclear whether curative-intent local therapy of metastases is of similar benefit for the biological distinct subgroup of patients with deficient mismatch repair (dMMR) metastatic colorectal cancer (mCRC) compared with proficient mismatch repair (pMMR) mCRC.

Patients and Methods

In this nationwide study, recurrence-free (RFS) and overall survival (OS) were analyzed in patients with dMMR versus pMMR mCRC who underwent curative-intent local treatment of metastases between 2015 and 2018. Subgroup analyses were performed for resection of colorectal liver metastases (CRLM) and cytoreductive surgery ± hyperthermic intraperitoneal chemotherapy (CRS ± HIPEC). Multivariable regression was conducted.

Results

Median RFS was 11.1 months [95% confidence interval (CI) 8.5–41.1 months] for patients with dMMR tumors compared with 8.9 months (95% CI 8.1–9.8 months) for pMMR tumors. Two-year RFS was higher in patients with dMMR versus pMMR (43% vs. 21%). Results were similar within subgroups of local treatment (CRLM and CRS ± HIPEC). Characteristics differed significantly between patients with dMMR and pMMR mCRC; however, multivariable analysis continued to demonstrate dMMR as independent factor for improved RFS [hazard ratio (HR): 0.57, 95% CI 0.38–0.87]. Median OS was 33.3 months for dMMR mCRC compared with 43.5 months for pMMR mCRC, mainly due to poor survival of patients with dMMR in cases of recurrence in the preimmunotherapy era.

Conclusion

Patients with dMMR eligible for curative-intent local treatment of metastases showed a comparable to more favorable RFS compared with patients with pMMR, with a clinically relevant proportion of patients remaining free of recurrence. This supports local treatment as a valuable treatment option in patients with dMMR mCRC and can aid in shared decision-making regarding upfront local therapy versus immunotherapy.
Development of stochastic models and software for marine biodiversity threats
Authors: Σημαντήρης Νικόλαος
Published: August 2023

Oι λιμνθάλασσες Αντινιώτη και Κoρισσίων απoτελoύν πoλύ σημαντικά παράκτια ενδιαιτήματα για την βιoπoικιλoτητα τoυ ζωπλαγκτoύ. Oι φυσικές και χημικές ιδιoτητες των λιμνθαλασσών επηρρεάζoνται απo τις ατμoσφαιρικές συνθήκες και εμφανίζoυν διακυμάνσεις πoυ επιδρoύν στην χωρταξία και την αφθoνία των ζωοπλαγκτoνικών oργανισμών. Η επίδραση της κλιματικής αλλαγής στην λιμνoθάλασσα Αντινιώτη αναμένεται να πρoκαλέσει αλλαγές στην δoμή της ζωoπλαγκτoνικής κoινoτητας και να oδηγήσει σε ανταγωνιστικές σχέσεις μεταξύ των Κωπήπoδων και άλλων oργανισμών. Η παραγωγικoτητα της Αντινιώτη εμφανίζει την δυνατoτητα να επηρεαστεί θετικά απo την κλιματική αλλαγή. Τo εισβoλικo είδoς Callinectes sapidus έχει επoικίσει την λιμνoθάλασσα Αντινιώτη εμφανίζoντας έναν σταθερά εγκατεστημένo πληθυσμo. Η αφθoνία τoυ είδoυς εκτιμήθηκε να είναι 73,000 άτoμα στην λιμνθάλασσα Αντινιώτη, εφαρμoζoντας ένα καινoτόμo πρωτόκoλλo τo οπoίo συνδύασε μετρήσεις πεδίoυ με ένα μαθηματικo μoντέλo βασισμένo στην μέθoδo τoυ τυχαίoυ περίπατoυ. Στη συνέχεια, αναπτύχθηκε ένα εργαλείo λήψης απoφάσεων (BCSIM) για την εκτίμηση της εξέλιξης τoυ πληθυσμoύ τoυ Μπλε καβoυριoύ στην Αντινιώτη και την διαχείρισή τoυ. Η ρύπανση με μικρoπλαστικά έχει επηρεάσει τo ΒΑ Ιoνιo Πέλαγoς και διαφορετικά θαλάσσια ενδιαιτήματα. Η λιμνoθάλασσα Αντινιώτη εμφανίζει μικρoτερη αφθoνία μικρoπλαστικών συγκριτικά με την λιμνoθάλασσα Κoρισσίων. Αυτo είναι απoτέλεσμα της μεταφoράς μικρoπλαστικών σωματιδίων απo γνωστές πηγές (πoλεις, λιμάνια, κ.α.) πρoς την περιoχή της λιμνoθάλασσας Κoρισσίων. Τα επικίνδυνα αυτά σωματίδια τείνoυν να συσσωρεύoνται σε περιοχές πoυ χαρακτηρίζoνται απo χαμηλή υδρoδυναμική δραστηριoτητα, oπoυ η διάχυση γίνεται o κύριoς ρυθμιστής της μεταφoράς μικρoπλαστικών.
A preliminary assessment of Fistularia petimba (Lacepède, 1803) migration in the Mediterranean Sea: historical and new data from Cyprus (Levantine Sea) with biological notes
Authors: PAPAGEORGIOU MARIOS , RESAIKOS VASILIS , PETROU ANTONIS
Published: August 2023

Biological invasions may pose a serious threat to ecosystems and economies. In this study, the presence of the non-indigenous species Fistularia petimba in Cyprus is documented. A total of 76 individuals were collected by bottom trawls and trammel nets in June 2020, March 2021, August 2021, and September 2021. Morphometric measurements, meristic counts, sex, stomach content, and maturity stages were recorded, and notes were made on the length-weight relationship, reproduction, and diet composition. Results from the length-weight relationship indicated a positive allometric growth (b = 3.5127). The preliminary results indicate a prolonged reproductive season, lasting from spring to autumn. The presence of two native and highly commercial fish species, Mullus barbatus and Pagellus sp. in the stomachs of F. petimba highlights the need for further dietary analysis of the species and the study of its impact on local fauna. These findings may confirm the successful establishment of F. petimba in Cyprus and indicate that this species could have similar impacts on local ecosystems as its invasive relative Fistularia commersonii.
Association between the risk perception of contracting COVID-19 and sociodemographic characteristics in a Peruvian population
Authors: Zeladita-Huaman Jhon Alex , Esteban-Espinoza David , Lozada-Urbano Michelle , Franco Chalco Eduardo , Costa Marcelo Fernandes , Castillo-Parra Henry
Published: August 2023

Background: The perception of risk regarding coronavirus disease 2019 (COVID-19) has been widely researched due to its association with the adoption of preventive measures. In addition, since the onset of vaccination, it has been reported that the population perceives a lower risk of getting infected. However, few studies have analyzed the factors associated with risk perception in low- and middle-income countries. The aim of this study was to determine the association between the risk perception of contracting COVID-19 and sociodemographic characteristics in Peruvian population.

Methods: An analytical and cross-sectional study was conducted in four cities in Peru from October to December, 2021. The sample consisted of 821 individuals aged 18 years and older. A virtual questionnaire was used to collect sociodemographic data and assess the risk perception of contracting coronavirus based on the Health Belief Model. The process of back-translation, expert judgment, and reliability analysis using split-half correlation was conducted. Student's t-tests, analysis of variance with post hoc Tukey's test, and Spearman's correlation were employed.

Results: Of the participants, 53.71% were women and 73.3% had a higher education level, 45.55% are self-employed, and 40.44% did not have a family member infected with COVID-19. The risk perception of COVID-19 infection was associated with participants' family antecedent of COVID-19 (p < 0.05). Regarding the factors analyzed, perceived susceptibility to COVID-19 was associated with age (p=0.002), occupation (p<0.05), and a history of COVID-19 (p<0.05), while the perceived benefits of adopting preventive measures against this disease were associated with educational level (p < 0.001).

Conclusions: The risk perception of contracting COVID-19 was higher among those who had multiple infected relatives. Furthermore, the perception of susceptibility and the perceived benefits of using preventive measures were associated with sociodemographic characteristics.
Pilot project on use of social simulation to improve multidisciplinary medical education on health-related social needs
Authors: Rehman Tehreem , Okubanjo Oyinkansola
Published: August 2023

Background:  Competence in system-based practice in medical education must include training on functioning as an interprofessional team member to address health-related social needs (HRSN). This pilot targets the existing gap on teaching residents how to leverage interprofessional expertise and larger context of HRSN in patient care.This pilot applied the principles of social simulation to teach residents how to work with interprofessional partners to effectively address patients’ HRSN.

Methods: We developed simulation cases on HRSN commonly encountered in our Emergency Department. A 9-item instrument using a Likert 5-level scale assessed participants’ knowledge and skills on HRSN before and after the simulation implemented in 2021. Unmatched data largely from missing ID in responses were omitted. The Wilcoxon signed-rank test was used to assess for significant changes pre- and post-intervention.

Results: Thirty-three of forty eligible Emergency Medicine (EM) residents (82.5%) participated in the study. Eighteen of thirty-three participants (response rate 54.5%) were included when matching data based on ID. We found significant differences in self-reported ability to identify patients’ HRSN (p=.0014), differentiate between the roles of interdisciplinary team members (p=.0007), and ability to identify hospital resources patients could be referred to (p=.0018). There was no difference in self-reported sense of empowerment in response to perceived ability in addressing a patient’s HRSN.

Conclusions: Findings from this pilot suggest that social simulation can be an effective tool for teaching residents how to function in interprofessional teams and navigate the dynamic larger healthcare context of social determinants of health (SDOH) in addressing a patient’s HRSN. Competence in system-based practice in multidisciplinary medical education must include training on functioning as an interprofessional team member to address SDOH. This pilot targets the existing gap in teaching residents how to leverage interprofessional expertise and the larger context of SDOH in patient care.
Fixed Point Theorem for Ɓ-type Contraction in Partial Metric Spaces
Authors: Singh Bijender , Sihag Vizender , Ahlawat Anil
Published: August 2023

The objective of this work is to study Ɓ-types of contraction mappings in the settings of partial metric space and establish fixed point results. As a result, a fixed point theorem has been established for a pair of Ɓ-type contraction mappings with a unique common fixed point. The study's main findings, in particular, expand and extend a fixed point theorem first proposed by Bijender et. al. in 2021.
Indian Handicrafts: A Sustainable future of Utilitarian Consumer Goods
Authors: Choudhary Akanksha , Mishra Poonam
Published: August 2023

Utilitarian products are those which are designed to be useful rather than attractive. Handmade products are, thus, one among the wonders of Indian artisans, which are both useful and attractive at the same time. World-renowned Indian handicrafts are imported by several countries, which is highly supporting Indian art and culture. This is a source of livelihood for more than half of the unskilled labours and artisans of the Handicraft Industry. But with high-quality décor, luxurious items being exported to foreign lands, middleman income and trade fairs are sucking up most of the profits. Indian artisans and handicraft workers are therefore left with little income in hand except for the very famous art workers of big businessmen. This is one of the major problems which can be solved by encouraging the supply of handicrafts and domestic consumer demand. Since Indian consumers have been evolving through manufactured products, globalization, industrialization, etc. they are producing harmful effects on the environment and socio-economic conditions. Hence, it is very alarming for the handicraft sector to be able to protect its art and small business during an economic crisis. To address the small businesses and art of poor craftworkers this study intends to focus on the utilitarian aspect of handicrafts as being the sustainable alternative. The research broadly focusses on the socio-economic conditions of rural artisans and the environmental benefits of handicrafts by assessing the demand of domestic consumers and their perspectives. Based on primary data collected through the survey method, the study finds that domestic consumers are aware of the sustainable alternative handicrafts have to offer, while the utilitarian aspect has a vague response when it comes to purchasing handicrafts. However, demand for handicrafts is high because of their utilitarian aspect only. The study applied multiple regression analysis to analyse the results and conclude with suggestions based on qualitative research analysis to support rural handicraft artisans and small businesses. The study initiates a broad scope of research in consumer behaviour towards handicrafts in India as a sustainable alternative to mass production. This is one of the ways of supporting the cultural art forms as well as replenishing sustainability in the three major directions, which are economic, environmental & societal. Based on the empirical findings of this study, it concludes with the suggestions of co-existence with culture and sustainable development in India.
Indian Ethics: Essence, Theory and Praxis
Authors: Kaur Kamalpreet
Published: August 2023

The paper aims at sculpting out the practice of ethics by comparing and contrasting it with morals, religion, metaphysics, among others in turn highlighting the praxis of ethics in India. It also aims to differentiate between the western concept of morals and ethics while drawing out an argument in favour of Indian ethics or Niti. Though ancient, Nitishastra is still as relevant as ever and teaches righteousness by balancing Karma with Dharma where Dharma is the cosmic order that upholds the world. Nitishastra inclines more in favour of ethics which are intuitive than morals which are law-bound. Furthermore, Indian ethics come close to values that are innate, inherent and inclusive; thus, possessing spiritual affinity which one attains only by exploring one’s self or the Self. The awareness of the Self fortifies one by empowering against the vulnerability of emotions and impulses adding further to the tenets of Indian ethics. The value of the paper lies in the use of Indian Folktales to highlight the uniqueness of Indian Ethics.