bluuebunny/crossref_metadata_2025 huggingface dataset:
Uniportal video-assisted thoracoscopic surgery for lobectomy: the learning curve
Authors: Laven Iris E W G , Daemen Jean H T , Franssen Aimée J P M , Gronenschild Michiel H M , Hulsewé Karel W E , Vissers Yvonne L J , de Loos Erik R
Published: August 2023

OBJECTIVES

Prior reported learning curves for uniportal video-assisted thoracoscopic lobectomy were predominantly based on surgery duration, while reports on complications are limited. Therefore, our study assessed the learning curve based on both technique-related complications and surgery duration.

METHODS

We retrospectively collected data from patients who had undergone uniportal video-assisted thoracoscopic lobectomy between 2015 and 2020. Exclusion criteria were concomitant procedures other than ipsilateral wedge resection, discontinued procedures, or lost to follow-up (less than 30 days). Learning curves were constructed per surgeon who performed over 20 procedures using non-risk adjusted cumulative sum (CUSUM) analysis for technique-related complications and cumulative sum analysis for surgery duration. Based on the literature, an acceptable complication rate was set at 30%, an unacceptable complication rate at 45%, and a mean surgery duration of 145 min.

RESULTS

Learning curves were constructed for three thoracic surgeons and one fellow who performed 324 uniportal video-assisted thoracoscopic lobectomies in total. Each surgeon was experienced in multiportal video-assisted thoracoscopic lobectomy, the fellow was familiar with basic multiportal video-assisted thoracoscopic procedures. Cumulative sum charts of three surgeons reached a statistically significant technique-related complication rate below 30% between 50 and 96 procedures. Regarding surgery duration, typical learning curves were observed for three surgeons with a transition point between 14 and 26 procedures.

CONCLUSIONS

Learning of uniportal video-assisted thoracoscopic surgery for lobectomy is safe without unacceptable complication rates and has a declining surgery duration over time for thoracic surgeons with experience in multiportal video-assisted thoracoscopic lobectomies. However, it remains unknown when the different stages of mastery are completed.
How Useful Are Bilingualized Dictionaries in Discriminating Between Near-Synonyms?
Authors: Kamiński Mariusz Piotr
Published: August 2023

This study investigates the usefulness of a bilingualized dictionary (BLD) against a monolingual one (MD) in a fill-in-the-blank test requiring the ability to discriminate between a set of near-synonyms. 156 participants, all English major undergraduates studying in Poland, were divided into two groups based on the type of dictionary they used. The study compared the two groups with respect to their test scores, learners’ prior receptive vocabulary knowledge, and task completion time. The experiment revealed the limitations of the BLD in this type of task, demonstrating that the dictionary was no more useful than the MD. While the scores were unaffected by dictionary type, they were significantly influenced by the learners’ receptive vocabulary size: the larger the size, the better the performance. The task completion time was not significantly affected by dictionary type, vocabulary size, or scores. The paper discusses learners’ errors and possible reasons for the limitations of the BLD.
Measuring moral development in the pharmacy profession from undergraduate to established practitioner: a decadal longitudinal study
Authors: Gallagher Cathal T , Kareem-Alliu Waseeat O D
Published: August 2023

The aim of this study is to measure and evaluate the moral reasoning of undergraduate pharmacy students as they progress through a British university, and onward through the early years of their professional practice. This study utilizes version 2 of Rest’s Defining Issues Test in a longitudinal design, evaluating a single cohort of future pharmacists, which started a 4-year Master of Pharmacy degree program in 2008–09, completed their preregistration training, and progressed through their early careers. The final dataset was collected in 2019. Both descriptive and inferential statistical analysis was subsequently carried out. The cohort experienced significant moral growth during the 4 years of their undergraduate degree, where they were exposed to an ethical education designed to engage students at the “plus one” level of moral reasoning. There is also evidence for work-based augmentation of moral development between graduation from university and qualification as pharmacists. The subjects underwent a marked increase in moral development as they progressed through their undergraduate studies, followed by another sizeable, though not statistically significant developmental progression during the preregistration year. The retrograde step in moral development observed between newly qualified level and established practitioner level requires further investigation: structured interviews with participants, which focus on changes to their experiences in practice and how these affected their moral agency are already underway.
Grazing activity of Clibanarius corallinus (H. Milne Edwards, 1848) (Decapoda: Anomura: Diogenidae) on epilithic algae in Australian coral reefs
Authors: Bravo Henrique , Tibbetts Ian R
Published: August 2023

Following an incidental observation of captive Clibanarius corallinus (H. Milne Edwards, 1848) supposedly removing algae from each other’s shells, we conducted a feeding experiment over 72 hours to understand its potential role as a mesograzer in coral reef ecosystems. Epiphyte-covered, coral rubble fragments of Acropora spp. were exposed to hermit crab (N = 41) activity for 72 h in a flow-through seawater aquarium system at Heron Island, southern Great Barrier Reef, Australia to understand whether hermit crabs could remove epilithic algae and if so, to what extent. Coral fragments exposed to the hermit crabs had 9.1% less chlorophyll at the end of the experiment. The detritus generated in the experimental set-up had 2.4 times more chlorophyll and 33.4% less organic biomass than the detritus generated in the control environment. The crabs did on average lose 0.11 g of their initial weight, which could have been a consequence of the experimental set-up. These results suggest that C. corallinus has the potential to contribute to the control of epilithic algae in coral reefs, with such effect having hitherto been overlooked as a result of the cryptic behaviour of this hermit crab species.
Do it yourself: fabricating and evaluating a mosquito (Diptera: Culicidae) blood-feeding device to replace a commercial option
Authors: Dewsnup M Andrew , Faraji Ary , White Gregory S , Bibbs Christopher S
Published: August 2023

Tools for rearing hematophagous insects, such as mosquitoes (Diptera: Culicidae), in an insectary are essential for research and operational evaluations in vector biology and control. There is an abundance of low-cost options for practitioners without conventional infrastructure. However, few midrange options exist that provide a balance of efficiency and low material waste. We present here a reproducible design for an electrically powered blood-feeding device that offers long-term reusability, low material waste, and customizability for different species or experiments. The limitation is the requirement for electricity, but the gain is a simple, low-skill device that can be modified as needed. To validate the design, assessments of feeding angle and blood-feeding success were compared between the Salt Lake City Mosquito Abatement District artificial membrane feeder (SLAM) and a commercial system (Hemotek). Engorgement in Aedes aegypti (80–90%), Culex pipiens (50–80%), and Culex tarsalis (30–75%) was similar between the 2 units, resulting in nearly identical fecundity outcomes between devices. Additionally, 45° angles were more successful, generally, than presenting the feeders flat or vertical to the mosquitoes (df3,48, P = 1.014 × 10−15). This angle is simple to present with the SLAM device. Materials for in-house reproduction of the SLAM system are now widely available in regions with access to e-commerce and shipped goods. This results in a device schematic that should fit well into a relatively modular, do-it-yourself paradigm where the practitioner needs only to assemble some materials without complex engineering. This article provides schematics, cost comparison, and validation of the in-house-made SLAM system.
Diagnostic value of pleural effusion Krebs von den Lungen-6 in malignant pleural effusion of patients with non–small cell lung cancer
Authors: Wang Junjun , Ling Liqun , Chen Shuhui , Chou Lunan , Wang Yumin , Hu Lijuan
Published: August 2023

Objective

The aim of this study was to investigate the diagnostic potential of Krebs von den Lungen-6 (KL-6) in differentiating between malignant pleural effusion (MPE) induced by non–small cell lung cancer (NSCLC) and benign pleural effusion (BPE).

Methods

We collected 143 pleural effusion samples from August 2018 to March 2021. The samples included 91 cases of MPE and 52 cases of BPE. The KL-6 and other indicators in pleural effusion were detected.

Results

The level of pleural effusion KL-6 (pKL-6) in the MPE group was significantly higher than in the BPE group (Mann-Whitney U = 442.500, P = .000). The area under the curve (AUC) of pKL-6/pleural effusion adenosine deaminase (pADA) + pleural effusion carcinoembryonic antigen (pCEA)/pADA (AUC = 0.992) in diagnosing MPE was higher than that of pKL-6 alone (AUC = 0.903), with a sensitivity of 93.26% and specificity of 100%.

Conclusion

The measurement of pKL-6 can differentiate NSCLC-induced MPE from BPE. Furthermore, the combined detection of pKL-6/pADA and pCEA/pADA can significantly improve the diagnostic efficiency for distinguishing NSCLC-induced MPE.
Strong Purifying Selection in Haploid Tissue–Specific Genes of Scots Pine Supports the Masking Theory
Authors: Cervantes Sandra , Kesälahti Robert , Kumpula Timo A , Mattila Tiina M , Helanterä Heikki , Pyhäjärvi Tanja
Published: August 2023

The masking theory states that genes expressed in a haploid stage will be under more efficient selection. In contrast, selection will be less efficient in genes expressed in a diploid stage, where the fitness effects of recessive deleterious or beneficial mutations can be hidden from selection in heterozygous form. This difference can influence several evolutionary processes such as the maintenance of genetic variation, adaptation rate, and genetic load. Masking theory expectations have been confirmed in single-cell haploid and diploid organisms. However, in multicellular organisms, such as plants, the effects of haploid selection are not clear-cut. In plants, the great majority of studies indicating haploid selection have been carried out using male haploid tissues in angiosperms. Hence, evidence in these systems is confounded with the effects of sexual selection and intraspecific competition. Evidence from other plant groups is scarce, and results show no support for the masking theory. Here, we have used a gymnosperm Scots pine megagametophyte, a maternally derived seed haploid tissue, and four diploid tissues to test the strength of purifying selection on a set of genes with tissue-specific expression. By using targeted resequencing data of those genes, we obtained estimates of genetic diversity, the site frequency spectrum of 0-fold and 4-fold sites, and inferred the distribution of fitness effects of new mutations in haploid and diploid tissue–specific genes. Our results show that purifying selection is stronger for tissue-specific genes expressed in the haploid megagametophyte tissue and that this signal of strong selection is not an artifact driven by high expression levels.
Menthol and Other Flavor Chemicals in Cigarettes from Vietnam and the Philippines
Authors: Cohen Joanna E , Czaplicki Lauren , Crespi Elizabeth , Brown Jennifer L , Luo Wentai , McWhirter Kevin J , Masanga Braden C , Pankow James F
Published: August 2023

Introduction

Tobacco product flavors can increase product appeal, adolescent initiation and experimentation, and difficulty quitting. Flavored tobacco products are not restricted in Vietnam or the Philippines despite the high smoking prevalence among those 15 years of age and older (24% and 23%, respectively). There are no published reports to our knowledge on the levels of flavor chemicals in the cigarettes sold in these two countries.

Methods

Cigarettes were purchased in Vietnam (32 brand variants) and the Philippines (19 brand variants) during 2020. Chemical analyses gave the mg/filter, mg/rod, and mg/stick (= mg/(filter + rod)) values for 180 individual flavor chemicals. Values were calculated for menthol, clove-related compounds, and “other flavor chemicals” (OFCs).

Results

Five flavor groupings were found among the brand variants purchased in Vietnam: menthol + OFCs (n = 15), OFCs only (n = 8), nonflavored (n = 7), menthol + OFCs with a clove flavorant (n = 1) and menthol only (n = 1). Three flavor groupings were found among the brand variants purchased in the Philippines: menthol + OFCs (n = 10), nonflavored (n = 5), and menthol only (n = 4).

Conclusions

A range of flavored cigarette products are being offered by tobacco companies in Vietnam and the Philippines, presumably to maximize cigarette sales. Regulation of flavor chemicals should be considered in these two countries.

Implications

Article 9 of the WHO Framework Convention on Tobacco Control (FCTC), ratified by both Vietnam and the Philippines, states that “there is no justification for permitting the use of ingredients, such as flavoring agents, which help make tobacco products attractive.” Flavors increase product appeal, adolescent initiation and experimentation, and difficulty quitting. These analyses found that cigarettes purchased in Vietnam and the Philippines contained menthol and other flavor chemicals. Tobacco companies are offering multiple flavor chemical profiles and nominally nonflavored versions in these countries; regulation of flavor chemicals should be considered in these two countries.
Diagnostic Stewardship: A Systematic Review and Meta-analysis of Blood Collection Diversion Devices Used to Reduce Blood Culture Contamination and Improve the Accuracy of Diagnosis in Clinical Settings
Authors: Callado Gustavo Yano , Lin Vivian , Thottacherry Elizabeth , Marins Tássia Aporta , Martino Marinês Dalla Valle , Salinas Jorge L , Marra Alexandre R
Published: August 2023

Background

Blood culture contamination may lead to misdiagnosis, overutilization of antibiotics, and prolonged length of stay. Blood specimen diversion devices can reduce contamination rates during blood culture collection procedures. We performed a systematic literature review and meta-analysis evaluating the influence of blood specimen diversion devices in blood culture contamination rates.

Methods

We searched Medline, Cumulative Index to Nursing and Allied Health Literature, Embase, Cochrane, Scopus, and Web of Science, from database inception to 1 March 2023, for studies evaluating the impact of a diversion device on blood culture contamination. Blood culture contamination was a positive blood culture with microorganisms not representative of true bacteremia, but rather introduced during collection or processing the blood sample. Random-effects models were used to obtain pooled mean differences, and heterogeneity was assessed using the I2 test.

Results

Of 1768 screened studies, 12 met inclusion criteria for this systematic literature review. Of them, 9 studies were included in the meta-analysis. Studies were substantially heterogeneous, but stratified analyses considering only high-quality studies revealed that venipuncture using a diversion device was associated with a significant reduction in blood culture contamination in comparison to the standard procedure of collection (pooled odds ratio [OR], 0.26 [95% confidence interval {CI}, .13–.54]; I2 = 19%). Furthermore, the stratified analysis showed that the adoption of a diversion device did not reduce the detection of true infection (pooled OR, 0.85 [95% CI, .65–1.11]; I2 = 0%).

Conclusions

Blood culture diversion devices was associated with decreased contamination rates and could improve quality of care, reduce costs, and avoid unnecessary antibiotic use.
CALMODULIN6 negatively regulates cold tolerance by attenuating ICE1-dependent stress responses in tomato
Authors: Lin Rui , Song Jianing , Tang Mingjia , Wang Lingyu , Yu Jingquan , Zhou Yanhong
Published: August 2023

Chilling temperatures induce an increase in cytoplasmic calcium (Ca2+) ions to transmit cold signals, but the precise role of Calmodulins (CaMs), a type of Ca2+ sensor, in plant tolerance to cold stress remains elusive. In this study, we characterized a tomato (Solanum lycopersicum) CaM gene, CALMODULIN6 (CaM6), which responds to cold stimulus. Overexpressing CaM6 increased tomato sensitivity to cold stress whereas silencing CaM6 resulted in a cold-insensitive phenotype. We showed that CaM6 interacts with Inducer of CBF expression 1 (ICE1) in a Ca2+-independent process and ICE1 contributes to cold tolerance in tomato plants. By integrating RNA-sequencing (RNA-seq) and chromatin immunoprecipitation-sequencing (ChIP-seq) assays, we revealed that ICE1 directly altered the expression of 76 downstream cold-responsive (COR) genes that potentially confer cold tolerance to tomato plants. Moreover, the physical interaction of CaM6 with ICE1 attenuated ICE1 transcriptional activity during cold stress. These findings reveal that CaM6 attenuates the cold tolerance of tomato plants by suppressing ICE1-dependent COR gene expression. We propose a CaM6/ICE1 module in which ICE1 is epistatic to CaM6 under cold stress. Our study sheds light on the mechanism of plant response to cold stress and reveals CaM6 is involved in the regulation of ICE1.
“I do not consent”: political legitimacy, misinformation, and the compliance challenge in Australia’s Covid-19 policy response
Authors: Dowling Melissa-Ellen , Legrand Tim
Published: August 2023

This paper examines the relationship between policy compliance, the emergence of alternate epistemes and authorities in online spaces, and the decline of trust and legitimacy in democratic institutions. Drawing on insights from public policy, regulation theory, and political theory, the paper critically engages with scholarship on “policy-takers” to illuminate the tensions of compliance and legitimacy in liberal states. It proposes a compliance–legitimacy matrix that identifies the features of policy compliance—including consent, legitimacy, expertise, and trust—and their relationship to the disaggregation of policy knowledge. The article applies this framework to a case study of social media posts that respond to policy information during the management of the Covid-19 pandemic in Australia. Through analysis of these posts, the study reveals the distrust in “the science” and experts advocated by government and the calls from skeptic groups for noncompliance with public health measures. The paper argues that public policy faces an epistemic crisis of public confidence, with significant downstream consequences for compliance with public policy initiatives that has been brought on both by the failures of states to cultivate trust in science and the government. The compliance–legitimacy matrix offers a useful tool for policymakers to anticipate and address objections from policy-takers and to preempt and diffuse their fears.
Shareholder Monitoring through Voting: New Evidence from Proxy Contests
Authors: Brav Alon , Jiang Wei , Li Tao , Pinnington James
Published: August 2023

We present the first comprehensive study of mutual fund voting in proxy contests. Among contests where voting takes place, passive funds are 10 percentage points less likely than active funds to vote for dissidents. The gap shrinks significantly when accounting for votes withheld from management nominees, settled contests, and votes by non-“Big-Three” fund families. Passive and active funds are equally informed about firm fundamentals, although passive funds view contest-related SEC filings more often than active funds during contests, in absolute levels and incrementally relative to noncontest periods. We conclude that passive funds are engaged shareholders in high-stakes voting events.

Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online
Masculinity on the Margins: Boundary Work Among Immobile Fathers in Indonesia’s Transnational Families
Authors: Chang Andy Scott
Published: August 2023

Scholars underline the persistence of gender disparities in the household division of labor. However, it remains understudied how working-class men manage family life amid the physical absence of breadwinning women. Drawing on fifty-four in-depth interviews and over 22 months of fieldwork in Indonesia, this article investigates how non-migrant fathers navigate conjugal and paternal responsibilities in families headed by migrant mothers. I argue that the reproduction of mother-away transnational families hinges on a refashioning of male conduct for the accomplishment of immobile fatherhood—a model of parenthood developed by non-migrant fathers to accommodate the migration of mothers. I examine the boundary work that men engage in to affirm their selfhood when confronted with the diminution of labor market prospects. In response to their status anxieties surrounding the mounting autonomy of transnational mothers, immobile fathers craft moral boundaries around a commitment to the family. Furthermore, immobile fathers reconstitute masculinity away from providership toward an assemblage of waged labor, childrearing, financial management, and housework that comprises the hallmarks of working-class femininities. By positioning themselves as “family men” in contradiction to irresponsible men and women, immobile fathers realize self-respect through their maintenance of transnational families.
A Novel IncX Plasmid Mediates High-Level Oxytetracycline and Streptomycin Resistance in Erwinia amylovora from Commercial Pear Orchards in California
Authors: Sundin George W. , Peng Jingyu , Brown Lindsay E. , Zeng Quan , Förster Helga , Adaskaveg James E.
Published: August 2023

Isolates of the fire blight pathogen Erwinia amylovora with high-level resistance to oxytetracycline (minimal inhibitory concentration [MIC] > 100 μg/ml) and to streptomycin (MIC > 100 μg/ml) were recovered from four commercial pear orchards in California between 2018 and 2020. The two representative oxytetracycline- and streptomycin-resistant (OxyTcR-SmR) strains 32-10 and 33-1 were as virulent as the antibiotic susceptible strain 13-1 in causing blossom blight of pear and were recovered more than 50% of the time 7 days after co-inoculation to pear flowers with strain 13-1. In the field, inoculation of strain 32-10 to pear flowers that were pretreated with oxytetracycline at 200 μg/ml did not reduce disease compared with an untreated control. Four OxyTcR-SmR strains were subjected to draft genome sequencing to identify the genetic determinants of antibiotic resistance and their location. A 43.6-kb IncX plasmid, designated pX11-7, was detected in each of the four strains, and this plasmid encoded the tetracycline-resistance gene tetB and the streptomycin-resistance gene pair strAB within a large putatively mobile genetic element consisting of the transposon Tn 10 that had inserted within the streptomycin-resistance transposon Tn 6082. We also determined that pX11-7 was conjugative and was transferred at a rate that was 104 to 105 higher into an E. amylovora strain isolated in California compared with an E. amylovora strain that was isolated in Michigan. The occurrence of high levels of resistance to both oxytetracycline and streptomycin in E. amylovora strains from commercial pear orchards in California significantly limits the options for blossom blight management in these locations.
Model-Based Community Analyses Identify Fungal Endophytes that May Modulate Symptom Development of Charcoal Rot Disease in Soybean
Authors: Brown Shawn P. , Shahrtash Maryam , Stokes C. Elizabeth , Baird Sonya , Baird Richard , Lu Shien
Published: August 2023

Charcoal rot disease of soybean is a major threat to soybean harvests in the United States. This disease, caused by the fungal pathogen Macrophomina phaseolina (MP), cannot be economically treated in agronomic field conditions, and breeding of resistant cultivars has been largely unsuccessful due to multiple gene resistance. For difficult-to-treat phytopathogens, nascent research has emphasized the potential utility of endophyte modulation of disease symptoms. Most research into biocontrol of MP in soybeans has focused on in vitro or limited greenhouse/pot experiments, which may not emulate field conditions. Here, using a paired framework of diseased and asymptomatic soybeans exposed to MP in a production field setting, coupled with model-based community analyses, we identify several fungal endophytic taxa that apparently modulate disease pathogenicity. We use a multilevel analytical framework to provide evidence of taxa that respond to the disease state by querying plants across years and plant compartments. Additional work is needed to test the mechanisms by which these identified taxa may modulate MP, but this work provides the strongest evidence to date that endophytes may modulate charcoal rot disease levels in production field conditions. We posit that breeding for improved colonization of disease-modulating endophytes is a promising option to manage charcoal rot in soybean.

[Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
CREB‐binding protein and HIF‐1α/β‐catenin to upregulate miR‐322 and alleviate myocardial ischemia‐reperfusion injury
Authors: Dong Wei , Weng Jun‐Fei , Zhu Jian‐Bing , Zheng Yao‐Fu , Liu Lei‐Lei , Dong Chen , Ruan Yang , Fang Xu , Chen Jin , Liu Wen‐Yu , Peng Xiao‐Ping , Chen Xuan‐Ying
Published: August 2023

Myocardial ischemia/reperfusion injury (MIRI) is a prevalent condition associated with numerous critical clinical conditions. miR‐322 has been implicated in MIRI through poorly understood mechanisms. Our preliminary analysis indicated potential interaction of CREB‐binding protein (CBP), a transcriptional coactivator and acetyltransferase, with HIF‐1α/β‐catenin, which might regulate miR‐322 expression. We, therefore, hypothesized that CBP/HIF‐1α/β‐catenin/miR‐322 axis might play a role in MIRI. Rat cardiomyocytes subjected to oxygen‐glucose deprivation /reperfusion (OGD/R) and Langendorff perfused heart model were used to model MIRI in vitro and in vivo, respectively. We used various techniques such as CCK‐8 assay, transferase dUTP nick end labeling staining, western blotting, RT‐qPCR, chromatin immunoprecipitation (ChIP), dual‐luciferase assay, co‐immunoprecipitation (Co‐IP), hematoxylin and eosin staining, and TTC staining to assess cell viability, apoptosis, and the levels of CBP, HIF‐1α, β‐catenin, miR‐322, and acetylation. Our results indicate that OGD/R in cardiomyocytes decreased CBP/HIF‐1α/β‐catenin/miR‐322 expression, increased cell apoptosis and cytokines, and reduced cell viability. However, overexpression of CBP or miR‐322 suppressed OGD/R‐induced cell injury, while knockdown of HIF‐1α/β‐catenin further exacerbated the damage. HIF‐1α/β‐catenin bound to miR‐322 promoter to promote its expression, while CBP acetylated HIF‐1α/β‐catenin for stabilization. Overexpression of CBP attenuated MIRI in rats by acetylating HIF‐1α/β‐catenin to stabilize their expression, resulting in stronger binding of HIF‐1α/β‐catenin with the miR‐322 promoter and subsequent increased miR‐322 levels. Therefore, activating CBP/HIF‐1α/β‐catenin/miR‐322 signaling may be a potential approach to treat MIRI.
“Untying the knot”: The primitive orofacial muscle architecture in the gorilla (Gorilla gorilla) as a key to the evolution of hominin facial movement
Authors: Rotenstreich Liat , Marom Assaf
Published: August 2023

The anatomical underpinnings of primate facial expressions are essential to exploring their evolution. Traditionally, it has been accepted that the primate face exhibits a “scala natura” morphocline, ranging from primitive to derived characteristics. At the primitive end, the face consists of undifferentiated muscular sheets, while at the derived end there is greater complexity with more muscles and insertion points. Among these, the role of the human modiolus (“knoten” in German) has been emphasized. Recent studies have challenged this view by revealing significant complexity in the faces of several non‐human primates, thereby rejecting the linear notion of facial evolution. However, our knowledge of the facial architecture in gorillas, the second closest living relatives to modern humans, remains a significant gap in the literature. Here, we present new findings based on dissection and histological analysis of one gorilla craniofacial specimen, alongside 30 human hemifaces. Our results indicate that while the number and overall arrangement of facial muscles in the gorilla are comparable to those of chimpanzees and modern humans, several orofacial features distinguish the gorilla's anatomy from that of hominins. Among these are the absence of a modiolus, the continuity of muscular fibers over the region of the mouth corner, the flat (uncurving) sheet of the orbicularis oris muscle, and the insertion of direct labial tractors both anterior and posterior to it. Collectively, the anatomical characteristics observed in the gorilla suggest that the complex anatomy of the hominin face should be considered synapomorphic (shared‐derived) within the Pan‐Homo clade.
Telehealth-delivered Psychotherapy for the Treatment of Alcohol Use Disorder: Patient Perspectives in the Age of COVID-19
Authors: Girard Rachel , Foreman Jane , Pinnette Ellen , Bonar Erin E. , Fernandez Anne , Lin Lewei (Allison)
Published: August 2023

Objectives

The COVID-19 pandemic precipitated increases in alcohol use and ushered in virtually delivered health care, creating an opportunity to examine the impacts of telehealth on alcohol use disorder (AUD) treatment. To understand these impacts, we explored perspectives on telehealth-delivered psychotherapy among individuals with AUD.

Methods

This was a qualitative study using semi-structured interviews. Participants (N = 31) were patients with AUD who had received telehealth-delivered AUD psychotherapy in the last 2 years (n = 11) or had never experienced AUD psychotherapy (n = 20), recruited from two large academically-affiliated health care systems in Michigan between July and August 2020. Participants were asked about perceived barriers and facilitators to AUD psychotherapy, benefits and drawbacks of telehealth-delivered AUD psychotherapy, and changes needed to improve psychotherapy delivery. Interviews were transcribed, coded, and analyzed iteratively using thematic analysis.

Results

Participants identified factors relating to perceptions of and experience with telehealth-delivered AUD psychotherapy. Findings reflected four major themes: treatment accessibility, treatment flexibility, treatment engagement, and stigma. Perceptions about telehealth’s impact on treatment accessibility varied widely and included benefits (e.g., eliminating transportation challenges) and barriers (e.g., technology costs). Treatment flexibility and treatment engagement factors included the ability to use phone and video and perceptions of receiving care via telehealth, respectively. Telehealth impacts on treatment stigma were also a key theme.

Conclusions

Overall, perceptions of telehealth treatment for AUD varied. Participants expressed the importance of options, flexibility, and collaborating on decisions with providers to determine treatment modality. Future research should explore who benefits most from telehealth and avenues to enhance implementation.
Laparoscopic versus open liver resection for treatment of liver tumors: Early experience outcomes
Authors: Wongta Kitti , Rattanasakalwong Mati , Nuchanatanon Jantaluck , Charutragulchai Papot , Tangsirapat Vorapatu
Published: August 2023

Background

Although minimally invasive liver surgery has been increasingly practiced worldwide, the lack of experience is a barrier for numerous surgeons to initiate. This study aims to compare the outcome of laparoscopic liver resection (LLR) versus open liver resection (OLR) by surgeons who begin to conduct both procedures through the same period.

Materials and Methods

We retrospectively analyzed the demographic data, the perioperative data, and the surgical outcomes of patients who underwent liver resection for the treatment of liver tumors. All procedures were operated by three hepatopancreatobiliary surgeons.

Results

In total, 56 hepatectomies were performed, 13 patients in the LLR group with an average Iwate score of 5 and 43 patients in the OLR group were included in the study. After propensity score matching, comparing 13 patients each of the LLR and OLR groups, the operative time (316.5 vs 315.4 minutes, P = 0.98) and the amount of blood loss (929 vs 1500 mL, P = 0.23) were not different. The postoperative length of stay was significantly shorter in the LR group (6 vs 12 days, P = 0.009). The LLR group had a lower severity of the complications (P = 0.02), and the mortality rate was zero in both groups. The margin-free status did not differ between the LLR and OLR groups (92.3% vs 76.9%, P = 0.28).

Conclusions

For hepatopancreatobiliary surgeons with limited experience, LLR is safe to meticulously proceed for liver lesions. The advantage of LLR is less severity of the complications, decrease postoperative hospital stays, and most importantly the margin-free status is comparable between both groups.
Ensuring Racial and Ethnic Inclusivity in Facial Vascularized Composite Allotransplantation
Authors: Kauke-Navarro Martin , Knoedler Leonard , Knoedler Samuel , Diatta Fortunay , Huelsboemer Lioba , Stoegner Viola A. , Mookerjee Vikram G. , Panayi Adriana C. , Butler Paris D. , Pomahac Bohdan
Published: August 2023

Background:

Facial vascularized composite allotransplantation (fVCA) represents a valuable surgical option for reconstruction of the most devastating facial defects. There is a mounting body of evidence suggesting that healthcare disparities exist for a variety of other surgical and nonsurgical procedures. We aimed to investigate the potential existence of racial and ethnic disparities in the field of fVCA.

Methods:

A comprehensive literature review was conducted by the authors of this review on PubMed/MEDLINE, and Embase databases from database inception to December 1, 2022 for studies published in the English and French languages. The search terms were (1) “face” OR “facial” AND (2) “transplant” OR “VCA” OR “vascularized composite allotransplantation” OR “vascularized composite allograft” OR “graft.”

Results:

Upon assessment of the racial and ethnic demographics of the 47 global cases of fVCA between 2005 and 2020, 36 were White, 10 were Asian, and one was Black. Sixteen of the 17 fVCA procedures performed in the United States involved White patients. The other patient self-identified as Black, equaling 6% of all US fVCA recipients.

Conclusion:

Our analysis showed that the ethnic and racial distribution of fVCA has not proportionally reflected the racial and ethnic demographics of the general US population, underscoring the risk of such healthcare imbalances. Although large-scale studies are needed before drawing definitive conclusions, leaders in the field should take preventive steps to avoid potential disparities. Further investigations into the factors that facilitate or prohibit access to fVCA referral and surgery will be necessary moving forward.
Hi5 Protocol for the Use of Microfocused Ultrasound with Visualization
Authors: Corduff Niamh , Lowe Stephen
Published: August 2023

Background:

Microfocused ultrasound with visualization (MFU-V) is used for lifting and tightening of facial tissues. Standard protocols are completed in a single session. Despite excellent outcomes, we identified several barriers of entry for a significant number of patients. Therefore, we devised an individualized pan-facial protocol that is delivered as a series of short, intense treatments to address these issues.

Methods:

We enrolled 12 participants with mild-to-moderate skin and fibromuscular laxity to receive one superficial and one deep pass per visit (average 280 lines). Qualitative improvements were rated by both patients and physicians at 6 or 10 months due to COVID-19 delays. Changes in the submentum and eyebrow heights were quantified.

Results:

Ten patients (age range: 31–61 years) underwent an average of four MFU-V treatments. Two patients were excluded after massive weight gain. Skin and fibromuscular ptosis and overall soft tissue laxity improved in all patients. Mean brow height increased by 1.7 mm, whereas the mean submental lift was 78.7 mm2. All patients and treating physicians rated an improvement in appearance, whereas independent physicians rated improvements in 87% of cases. Four patients self-rated as “markedly improved.” Pain was rated at up to 6.2 (out of 10). Although mask-wearing was mandatory, loss of elasticity, wrinkles, and skin roughness all improved. Superficial welts (n = 5), erythema (n = 3), tenderness (n = 3), and mild bruising (n = 2) occurred, but all resolved within a few days and no severe or permanent adverse events occurred.

Conclusion:

The Hi5 protocol was noninferior to standard single-session protocols and improved brow heights and submental lifting.
The Utility of Bone Burring for the Clearance of Locally Advanced Scalp Malignancies: A Scoping Review
Authors: Anthony Ojochonu D. , Hunter-Smith David J. , Rozen Warren M.
Published: August 2023

Background:

The scalp harbors a range of neoplasms occurring at inordinate rates and associated with poorer outcomes. Its unique anatomy poses surgical challenges, including clear deep margins when resecting these lesions. For malignancies extending to the pericranium, removal of outer cortical cranial bone is ideal and routinely achieved with a burr. This review aims to investigate the literature to ascertain the utility and safety of this technique while highlighting evidence gaps.

Methods:

A literature search was conducted systematically using MEDLINE, Embase, and PubMed. Articles were reviewed for inclusion, and eligible studies were analyzed for study design, patient and intervention details, and outcome measures. A formal statistical analysis was not conducted.

Results:

The original search yielded 1506 unique results, and eight studies met the inclusion criteria: four case series, two retrospective analysis of records, two case reports. A number of tumor types were identified, but the burring method used was consistent in all studies. Despite reassuring primary outcome measure results, specifically in terms of local control rates, the overall evidence quality is limited by the nature of the included studies. Few adverse events were reported.

Conclusions:

Evidence for the oncological efficacy of scalp bone burring remains limited. Although the technique seems relatively safe, further investigation is required into its utility and drawbacks. Future studies should aim to report more technical details and more information about outcomes. It may also be worth comparing burring to alternatives such as outer cortical splitting, curettage, and high-dose curative radiotherapy.
Repeated Low-Level Red Light Therapy for the Control of Myopia in Children: A Meta-Analysis of Randomized Controlled Trials
Authors: Wang Fei , Peng Wei , Jiang Zhengxuan
Published: August 2023

Background:

Repeated low-level red light (RLRL) therapy has been suggested to be effective in children with myopia. However, evidence from randomized controlled trials (RCTs) is still limited. We performed a meta-analysis of RCTs to systematically evaluate the efficacy of RLRL on changes of axial length (AL) and cycloplegic spherical equivalent refraction (SER) in children with myopia.

Methods:

Relevant RCTs were obtained through a search of electronic databases including PubMed, Embase, Cochrane Library, Wanfang, and China National Knowledge Infrastructure from inception to September 15, 2022. A random-effects model was used to pool the results after incorporating the influence of potential heterogeneity. Subgroup analyses were performed according to the control treatment and follow-up duration.

Results:

A total of seven RCTs involving 1,031 children with myopia, aged 6 to 16 years, were included in the meta-analysis. Compared with control treatment without RLRL, treatment with RLRL was associated with a significantly reduced AL (mean difference [MD]: −0.25 mm, 95% confidence interval [CI]: −0.32 to −0.17, P<0.001; I2=13%) and a significantly increased cycloplegic SER (MD: 0.60 D, 95% CI: 0.44–0.76, P<0.001; I2=20%). Further subgroup analyses showed consistent results in studies comparing children wearing single vision lenses and those receiving active treatment including orthokeratology or low-dose atropine eye drops, as well as studies of treatment duration of 6 and 12 months.

Conclusions:

Results of the meta-analysis suggested that RLRL treatment is effective for slowing down the progression of myopia in children aged 6 to 16 years.
Twenty-Four-Hour Intraocular Pressure in Chronic Primary Angle-Closure Disease
Authors: Supakontanasan Wasu , Suwan Yanin , Nilphatanakorn Suthaphat , Teekhasaenee Chaiwat , Tantraworasin Apichat , Petpiroon Purit
Published: August 2023

Précis:

Primary angle closure and primary angle closure glaucoma may exhibit normal intraocular pressure. Twenty-four-hour intraocular pressure fluctuation is highest in primary angle closure glaucoma. The degree of peripheral anterior synechiae was associated with a 24-hour intraocular pressure pattern in primary angle-closure disease without laser iridotomy.

Purpose:

The purpose of this study was to study 24-hour intraocular pressure (IOP) patterns in eyes with chronic primary angle-closure disease and evaluate associations between peripheral anterior synechiae (PAS) and 24-hour IOP pattern.

Patients and Methods:

In this prospective cohort study, 59 eyes of 35 Asian patients with chronic primary angle-closure disease underwent complete ocular examinations at Ramathibodi Hospital, Mahidol University. Twenty-four-hour IOP records were obtained using Goldmann applanation tonometry at 2-hour intervals. Peak, mean, and trough 24-hour IOP values and 24-hour IOP fluctuation (difference between peak and trough values) were compared among groups. None of the participants received any treatment before complete data collection.

Results:

Even univariable analysis demonstrated a significant difference in peak, mean, and trough IOP and 24-hour IOP fluctuation between the 3 groups; the magnitude of trough IOP was not higher than 21 mmHg in all groups. In multivariable analysis, PAC and PACG eyes showed significantly higher peak IOP (P=0.020 and 0.006, respectively) and 24-hour IOP fluctuation (P=0.048 and 0.001, respectively) compared with PACS eyes. In comparison between combined PACS and PAC eyes versus PACG eyes, PACG eyes revealed significantly higher 24-hour IOP fluctuation. The degree of PAS was associated with peak and mean IOP values and with 24-hour IOP fluctuation in PAC and PACG eyes.

Conclusions:

Twenty-four-hour IOP fluctuation was highest in PACG eyes. Although PAC and PACG eyes showed higher peak IOP and 24-hour IOP fluctuation values, compared with PACS eyes, trough IOP in PAC and PACG eyes were mostly below 21 mmHg. In addition, the degree of PAS was associated with a 24-hour IOP pattern in either PAC or PACG eyes.
Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022
Authors: Ishiwada Naruhiko , Shinjoh Masayoshi , Kusama Yoshiki , Arakawa Hirokazu , Ohishi Tomohiro , Saitoh Akihiko , Suzuki Akira , Tsutsumi Hiroyuki , Nishi Junichiro , Hoshino Tadashi , Mitsuda Toshihiro , Miyairi Isao , Iwamoto-Kinoshita Noriko , Kobayashi Hisato , Satoh Kouichiro , Shimizu Akihiko , Takeshita Kenichi , Tanaka Takaaki , Tamura Daisuke , Tokunaga Osamu , Tomita Kentaro , Nagasawa Koo , Funaki Takanori , Furuichi Muhehiro , Miyata Ippei , Yaginuma Mizuki , Yamaguchi Yoshio , Yamamoto Shota , Uehara Suzuko , Kurosaki Tomomichi , Okada Kenji , Ouchi Kazunobu
Published: August 2023

The members of the Japanese Society for Pediatric Infectious Diseases and the Japanese Society of Pediatric Pulmonology have developed Guidelines for the Management of Respiratory Infectious Diseases in Children with the objective of facilitating appropriate diagnosis, treatment and prevention of respiratory infections in children. The first edition was published in 2004 and the fifth edition was published in 2022. The Guideline 2022 consists of 2 parts, clinical questions and commentary, and includes general respiratory infections and specific infections in children with underlying diseases and severe infections. This executive summary outlines the clinical questions in the Guidelines 2022, with reference to the Japanese Medical Information Distribution Service Manual. All recommendations are supported by a systematic search for relevant evidence and are followed by the strength of the recommendation and the quality of the evidence statements.
Focus on reuse: reducing waste associated with topical preoperative antiseptics
Authors: Lam Lydia , Dedina Liana , Bacchi Stephen , Lake Stewart R. , Chan WengOnn
Published: August 2023

Purpose:

To outline the environmental and financial costs associated with single-use topical antiseptic (5% povidone–iodine [PVI] solution) in the ophthalmology theatre setting and explore potential methods of repurposing topical antiseptics.

Setting:

Large tertiary referral center (Flinders Medical Centre, Adelaide, Australia).

Design:

Single-center prospective observational study.

Methods:

Dedicated containers placed in the ophthalmology theatre of the participating institution were used to collect the number of disposed PVI bottles over the 3-week study period. Descriptive statistics were employed to determine the associated packaging bottle weight, mean unused quantity (mL) and cost of the single-use topical PVI solution and costs of unused antiseptic.

Results:

The total amount of waste generated from the use of single-use PVI bottles during the surveillance period was 10.823 kg, of which 21.9% was preventable; 72% of unused PVI by weight were discarded during the study period, equating to approximately $21 857.60 in wasted pharmaceutical content per year. 100% of the discarded PVI was successfully redirected and reused at a local wildlife rescue organisation and diverted from landfill.

Conclusions:

This study has demonstrated that the utilization of single-use topical preoperative PVI preparations is associated with significant financial, pharmaceutical and environmental waste. Future studies examining the recyclability of single-use PVI bottles and investigating systematic strategies to recycle and repurpose this waste are required.