bluuebunny/crossref_metadata_2025 huggingface dataset:
Electrochemical oxidation of Fe (II) using chlorpromazine drug at boron-doped diamond electrode: application to in vivo mechanism study interaction of chlorpromazine on hemoglobin iron and evaluation of some biomolecules
Authors: Amini Nader , Naderi Kazhal , Ahmadi Abbas , Hassanzadeh Kambiz , Menbari Mohammad-Nazir , Abdi Mohammad , Ghaderi Ebrahim , Zarehbin Mohammad-Rezgar
Published: August 2024

In this study, the electrochemical properties of aqueous chlorpromazine hydrochloride (CPZ) in the presence of Fe (II) were investigated by cyclic voltammetry at a boron-doped diamond (BDD) electrode. The results showed that an EC′ reaction mechanism occurs, where electrochemically generated CPZ species (cation radical) are reduced by Fe (II) back to the parent CPZ, and Fe (II) is oxidized to Fe (III). The detection limit, sensitivity, and dynamic concentration ranges were 2.8 μM, 0.0188 μA μM−1 and 10–166 μM. Based on the electrochemical results, the interaction of chlorpromazine (CPZ), a widely used antipsychotic tranquillizer, with the allosteric protein, hemoglobin, has been studied. First, four groups of six female rats weighing 400–450 g were selected. The rats were injected with different concentrations of chlorpromazine over a 3-week period, and the concentrations of hemoglobin, methemoglobin, red blood cells (RBCs), and hematocrit (HCT) were analyzed in the blood of each rat. After injection of different concentrations of the drug, the amount of hemoglobin) as a source of Fe (II)) decreased, but the amount of methemoglobin (as a source of Fe (III) increased. In addition, UV spectroscopic measurements in the range of 200–700 nm indicate the conversion of hemoglobin to methemoglobin in chlorpromazine-treated rats compared to the normal sample, and there was a direct relationship between the increasing methemoglobin concentration of chlorpromazine. Furthermore, the amount of RBC and HCT was measured. The results showed that RBC (21.05%–56.52%) and HCT (10.04%–53.19%) decreased. Finally, this study demonstrates a new mechanism for the effects of CPZ on hemoglobin iron in rat blood based on electrochemical results.
Shell-core structured nanofibers mediate staged anti-inflammatory and pro-neurogenic activities to repair peripheral nerve
Authors: Lin Zhichuan , Zhong Rui , Xu Yong , Wu Yan , Ru Chen
Published: August 2024

The inflammatory reaction significantly impedes the neurogenic process during the restoration of peripheral nerve injury (PNI). Therefore, establishing a non-inflammatory environment is crucial for effective nerve regeneration. This study proposes the use of shell-core structured nanofibers with sequential anti-inflammatory and pro-neurogenic activities to repair PNI. Icariin (ICA), known for its anti-inflammatory effects, was blended with poly(lactic-co-glycolic acid) (PLGA) to form the shell layer’s spinning solution. Concurrently, glial cell-derived neurotrophic factor (GDNF) was combined with graphene oxide (GO) to create the core layer’s spinning solution. These solutions were then subjected to co-axial electrospinning, resulting in shell-core structured GDNF@GO-ICA@PLGA nanofibers. Additionally, a control group of unordered GDNF/GO/ICA/PLGA nanofibers was prepared using conventional electrospinning. The resulting GDNF@GO-ICA@PLGA nanofibers exhibited distinct fibrous structures with a clear shell-core architecture and demonstrated mechanical properties similar to the control group. Notably, the shell-core structured GDNF@GO-ICA@PLGA nanofibers displayed unique staged release kinetics: over 90% ICA was released priorly within the first 0 to 13 days, followed by GDNF release from days 9 to 31. Furthermore, the GDNF@GO-ICA@PLGA nanofibers showed excellent biocompatibility with Schwann cells. In vitro results highlighted the potent anti-inflammatory capabilities of ICA released from the shell layer, while GDNF released from the core layer effectively induced neurogenic differentiation of Schwann cells. The GDNF@GO-ICA@PLGA nanofibers were then processed into a nerve conduit and applied to a 10 mm rat sciatic PNI model. The staged release of ICA and GDNF facilitated by the GDNF@GO-ICA@PLGA nanofibers created a non-inflammatory environment before initiating nerve regeneration, leading to improved PNI restoration. This study underscores the importance of shell-core structured nanofibers in sequentially mediating anti-inflammation and neurogenesis, offering a novel approach for addressing PNI.
Recent advances in encapsulation strategies for flexible transient electronics
Authors: Han Won Bae , Hwang Suk-Won , Yeo Woon-Hong
Published: August 2024

Transient electronics, designed to dissolve, disintegrate, or degrade in a controlled manner after fulfilling their functions without remaining biologically and environmentally harmful byproducts, have emerged as a transformative paradigm with promising applications in temporary biomedical devices, eco-friendly electronics, and security applications. The success of this device development relies significantly on an effective encapsulation to protect their degradable active materials from environmental factors, such as biofluids and water, and secure reliable device functions throughout a desired lifespan. This review article provides an overview of recent advances in various encapsulation strategies for developing flexible, transient electronics. Details include materials selection, key characteristics, water-barrier capabilities, degradation mechanisms, and relevant applications, categorized into inorganic materials, synthetic/natural polymers, and hybrid composites. In addition, our insights into existing challenges and key perspectives for enhancing encapsulation performance are shared.
Characteristics and influencing factors of carbon source/sink variations in the Zoige grassland wetland ecological function zone on the eastern slope of the Tibetan Plateau
Authors: Guo Bin , Chen Chao , Pang Yanmei , Luo Yu
Published: August 2024

Net ecosystem productivity (NEP) refers to the portion of net primary productivity (NPP) that is available for carbon cycling in terrestrial ecosystems after subtracting photosynthetic carbon consumed by heterotrophic respiration. The amount of the NEP reflects the size of carbon sinks/sources in terrestrial ecosystems, holding great significance for the research of climate change and global carbon cycle. In this study, the NEP of the Zoige grassland wetland ecological function zone (ZGW) on the eastern slope of the Tibetan Plateau from 2001 to 2020 is estimated by using the improved Carnegie-Ames-Stanford Approach model for NPP and a statistical model for soil heterotrophic respiration, based on the meteorological data, vegetation data and socioeconomic data. Additionally, the spatio-temporal variations of the NEP are analyzed, and the influences of natural factors and anthropogenic activities on the NEP are investigated. The results indicate that the ZGW overall plays a role as a carbon sink, and the carbon sink area accounts for approximately 99.3% of the whole ZGW. The annual average NEP in the study area is 447.9 g·m−2, showing a gradual increase at a rate of 5.0 g·m−2·a−1, although the increasing trend is not significant. The carbon sink capacity increased in 93.5% of the ZGW, remained relatively stable in 5.9% of the ZGW, and decreased and significantly decreased in 0.6% of the ZGW. Climate warming and humidifying promote the enhancement of carbon sink capacity in the ecosystem of the ZGW, and precipitation is the dominant climatic factor influencing NEP variations. Natural factors are the determinants of NEP variations, while anthropogenic activities play a secondary role. The implementation of ecological restoration and management projects in the areas along the Yellow River, around the main roads and the core area of wetlands, as well as the continuation of green and coordinated development policies of orderly developing grassland resources, is conducive to enhancing vegetation carbon sink capacity of the ZGW.
Smartphone-based diagnostics with coherent and infrared imaging for cultural heritage
Authors: Daffara Claudia , Ambrosini Dario
Published: August 2024

Nondestructive optical techniques are crucial in heritage science for monitoring the condition of artworks in full field. Various imaging methods based on infrared and interferometry techniques have been proposed, but they often require specialized training and expensive equipment. This paper explores the emerging field of smartphone science and its potential to revolutionize artwork diagnostics, especially for cultural institutions with limited budgets. The smartphone science approach is divided into using the device ‘as is’ or enhancing it with add-on sensors. After a concise overview of smartphone sensing in different fields, the paper demonstrates smartphone-based optical diagnostics on traditional wooden painting models, employing coherent techniques like laser speckle imaging and moiré fringe technique, and infrared techniques like reflectography and thermography. The comparison of obtained results with established instrumentation in the field clearly shows that smartphone-based diagnostics have the potential to greatly contribute to cultural heritage preservation and conservation, transforming the field’s accessibility and cost-effectiveness.
Collapse analysis of a masonry arch bridge using the applied element method
Authors: Farneti E , Ávila F , Cavalagli N , Ubertini F
Published: August 2024

Masonry arch bridges constitute a fundamental part of the European transport network. Given their historical relevance and ongoing functional role, often under significantly higher load conditions than originally designed for, a reliable assessment of their load-bearing capacity is essential to understand whether they can guarantee adequate structural performance. To address this need, research efforts have focused on the development of computational methods capable of providing realistic simulations of the structural and collapse behavior of this kind of structures. In this context, the present paper aims to evaluate the application of the recently developed Applied Element Method (AEM) to masonry arch bridges, using the well-known Prestwood bridge (Staffordshire, UK) as a benchmark case study. The bridge was modeled using AEM and loaded until collapse simulating the actual conditions of the in situ test carried out in 1986. Results show consistency, in terms of bearing capacity and collapse mechanism, with the experimental data and previous studies that used other numerical approaches, proving the ability of the Applied Element Method to provide an accurate estimate of the collapse behavior of this kind of structures. AEM’s ability to represent collapse mechanisms involving large displacements, at a reduced computational cost, is especially useful for the design of alert and monitoring systems for structures in a damaged or pre-collapse state.
Dynamic data reconciliation based on elman neural network and particle filter
Authors: Ye Jiaqi , He Yijia , Chen Chong , Zhang Zhengjiang , Zhao Sheng , Wu Guichu , Guo Fengyi
Published: August 2024

In the process of modern industries, complex nonlinear dynamic systems present high requirements for measured data. In the actual industrial process system, the measurement data obtained by sensors will inevitably be subject to noise disturbances from the equipment itself or from the outside environment. These noise disturbances will deteriorate the dynamic performance of the system to a certain extent and affect the industrial production. Particle filter (PF) can be used to infer the accurate outputs of nonlinear dynamic system from the contaminated measurement data, but PF is limited to the pre-known state space model. In the actual industrial process, it is difficult to summarize the internal behavior of the system and obtain the pre-known state space model. Therefore, it is impossible to directly use PF in the nonlinear dynamic system with unknown model. In order to solve the above problems, this paper proposes a dynamic data reconciliation method called ENN-PF, which combines Elman neural network (ENN) data-driven modeling with PF. In this method, ENN is used for data-driven modeling, that is, the system model is dynamically identified by using the input and output data of the system, and then the dynamic data reconciliation is carried out by using PF according to the model identified by ENN. Finally, the proposed ENN-PF method is validated by simulations and practical experiments to effectively reduce the interference of measurement noise and improve the dynamic performance of the system.
Application of integrated entropy-COPRAS and ANN approaches for maximizing wire EDM machinability attributes of Al6082-T6/GNP/TiB2 composites
Authors: Ch Maheswara Rao , Prasad K G Durga , Venkata Subbaiah K
Published: August 2024

Wire Electrical Discharge Machining (WEDM) utilizes electrical sparks to cut conductive materials precisely. It employs a thin, electrically charged wire to erode the material, creating complex shapes with high accuracy, tight tolerance, and minimal material waste. The current study investigates the effect of WEDM process parameters on the various output properties of machining a hybrid Aluminium metal matrix nanocomposite (HAMMNC). A series of experiments were conducted on a composite constructed using Taguchi’s standard L18 Orthogonal Array (OA) design. The acquired responses of Material-Removal-Rate (MRR), Surface-Roughness (SR), and Kerf-Width (KfW) were optimized using integrated Entropy-COPRAS and artificial neural network (ANN) algorithms respectively. The relative significance (

Q

i

)values obtained for the alternatives are analyzed with the Taguchi method. The outcomes showed that the optimal setting of WEDM process variables is achieved at Servo Voltage: high volts; Pulse-on-time: 60 μs; Pulse-off-time: 16 μs; Peak Current: 6 Amp; Variable frequency: 18 Hz; Speed: 50 RPM; Sim Speed: 30 RPM respectively. The models developed from ANN were adequate and accurate from the results of error histogram and regression plots and they are best suited for the prophecy of future responses. The surface morphology studies confirmed the appearance of pockmarks, voids, and globules of debris on the Wire EDMed surfaces.
Learning-assisted specklegram analysis for recognition of simultaneous weights on multimode optical fiber
Authors: Vangety Nikhil , Roy Sourabh
Published: August 2024

A deep learning-based recognition of multimode fiber (MMF) specklegrams for various simultaneous weights is presented in this work. Five different random locations have been considered along the length of MMF and the specklegram images are recorded corresponding to seven different combinations of random simultaneous weights applied at these locations. A popular deep learning convolutional neural network (CNN) model, VGG-16 is employed on these images for the recognition of these seven weight combinations. The impact of acoustic vibrations, laser power, external temperature, and image sizes on the recognition accuracy is examined. A 100% recognition accuracy is attained and a negligible accuracy variation of ∼1.9% for acoustic vibrations as well as for changing laser power is observed, whereas a drastic fall in accuracy is observed in case of change in image sizes less than 80 × 80 pixels. Also, a negligible variation of ∼2% is observed for the applied external temperature. The heart of our work lies in the accumulation of a diverse, large volume of specklegram dataset by virtue of conducting brute force experiments that take care of eradication of model overfitting. The proposed proof-of-concept scheme might be useful for low-cost, efficacious, self-assisted multi-weight analysis in structural health monitoring.
Popular Song and Ethics: Ethical Perspectives and Personal Qualities
Authors: Giovannelli Alessandro
Published: August 2024

Jerrold Levinson has elegantly defended a proposal for the ethical evaluation of popular songs, which looks at the ‘personal qualities’ a song exhibits. I claim that the personal-qualities theory of artistic expression importantly contributes to explaining how songs get to have their meanings, yet that it does not very proﬁtably extend to their ethical evaluation. I propose that the notion of a work’s ethical perspective best generates a central way of ethically evaluating popular songs, by properly linking the ethical evaluation of songs to their meanings. Reference to songs’ ethical perspectives proves able to (a) enjoy broad scope; (b) produce charitable ethical assessments; (c) generate ﬁne-grained and comparative attributions of ethical value; and (d) deal, better than the personal-qualities view, with songs that include multiple characters, manifest despicable personae without explicitly condemning them, or exhibit a persona that eschews ethical evaluation. Investigating the theoretical centrality of this type of ethical judgment also provides us with an opportunity to better understand what construing the meaning of songs—and more generally works of art—involves: when relevant, the proper construal of works’ ethical perspectives’ objects, and of the perspectives themselves as often presenting us with outlooks just for our consideration, not approval. I close by suggesting a possible relationship between our song preferences and our sense of self, via David Hume’s notion of pride: the songs we favour help us with self-perception and -assessment, and perhaps with self-construction.
Vittorio Hösle, Intentionalism, and Understanding Understanding
Authors: Moore Tyler S
Published: August 2024

Vittorio Hösle’s 2018 book, Kritik der Verstehenden Vernunft: Eine Grundlegung der Geisteswissenschaften (“A Critique of Understanding Reason: The Grounding of the Humanities”) provides an ambitious and systematic treatment of human understanding that is important for legal scholars and others. In it, he addresses questions like the nature of mental acts, how they are expressed and grasped, the complex relationship between authorial intention and understanding, what conditions are necessary for understanding to succeed, and more. His account also touches directly on legal interpretation and speaks to a number of contemporary jurisprudential puzzles. Part I of this essay provides a grand tour of Hösle’s theory of understanding, as well as his specific treatment of law. Understanding, as he defines it, is focused on the attempt to indirectly recreate a past mental act though the medium of author’s physical manifestations of meaning (often language). Yet, given his intentionalism, Hösle’s treatment of legal interpretation lands in a surprising place. Though he continues to insist on the importance of the lawmaker’s original mental acts and the difference between questions of meaning and truth, he also recognizes several reasons why it could be undesirable for legal decisions to be strictly bound by the lawmaker. Part II of this essay turns to how Hösle’s theory might inform current debates about legal interpretation by applying it to three recurring puzzles for intentionalist theories: (1) the problem of the inartful author; (2) whether there is anything interpretation (or understanding) “just is”; and (3) the nature of group intentions. As to the first puzzle, Hösle connects “meaning” with the author’s original mental act(s) even if the attempt to communicate this meaning on a specific occasion misfires. Yet Hösle also grants that, from the reader’s or hearer’s perspective, understanding necessarily relies on currently available evidence. Concerning the second puzzle, Hösle suggests the phenomenon of indirectly attempting to recreate the mental acts of another (i.e., “understanding”) just is something that occurs in the process of legal adjudication, whatever you call it. But it does not follow that adjudication should (or can) always be bound by this understanding. For the third puzzle, the manner in which Hösle conceptualizes group intention and “works” suggests that only openly shared aspects of the lawmaking body’s plan count as part of the group’s intention. For this reason, especially in the context of works accomplished by a group, his intentionalism shares at least initial similarities with public meaning originalism.
In Defense of the Common Good
Authors: Barber N W
Published: August 2024

Vermeule argues that law should uphold community morality, and critiques originalists and progressivists for losing sight of this. Though his critique is powerful, the book shares those problems Vermeule diagnoses in the work of others. As with the originalists, Vermeule’s theory of interpretation is not yet able to provide guidance. We need to know more about its content and its moral base to evaluate its attractions. Additionally, Vermeule underplays strong similarities between progressivists and his own scholarship. Acknowledging these similarities draws attention to a pair of shared institutional problems. First, the moral cost in taking decisions away from individuals and passing them to state institutions: using law to regulate an issue runs the risk of error, and may produce morally significant side-effects by coercively limiting people’s options. Secondly, morality speaks to the institutional process by which decisions are produced as well as their substance: the way we decide is important.
When is lethal deceptive pollination maintained? A population dynamics approach
Authors: Nakazawa Takefumi , Matsumoto Tetsuya K , Katsuhara Koki R
Published: August 2024

Background and Aims

Not all plant–pollinator interactions are mutualistic, and in fact deceptive pollination systems are widespread in nature. The genus Arisaema has a pollination system known as lethal deceptive pollination, in which plants not only attract pollinating insects without providing any rewards, but also trap them until they die. Many Arisaema species are endangered from various disturbances, including reduction in forest habitat, modification of the forest understorey owing to increasing deer abundance, and plant theft for horticultural cultivation. We aimed to theoretically investigate how lethal deceptive pollination can be maintained from a demographic perspective and how plant and pollinator populations respond to different types of disturbance.

Methods

We developed and analysed a mathematical model to describe the population dynamics of a deceptive plant species and its victim pollinator. Calibrating the model based on empirical data, we assessed the conditions under which plants and pollinators could coexist, while manipulating relevant key parameters.

Key Results

The model exhibited qualitatively distinct behaviours depending on certain parameters. The plant becomes extinct when it has a low capability for vegetative reproduction and slow transition from male to female, and plant–insect co-extinction occurs especially when the plant is highly attractive to male insects. Increasing deer abundance has both positive and negative effects because of removal of other competitive plants and diminishing pollinators, respectively. Theft for horticultural cultivation can readily threaten plants whether male or female plants are frequently collected. The impact of forest habitat reduction may be limited compared with that of other disturbance types.

Conclusions

Our results have emphasized that the demographic vulnerability of lethal deceptive pollination systems would differ qualitatively from that of general mutualistic pollination systems. It is therefore important to consider the demographics of both victim pollinators and deceptive plants to estimate how endangered Arisaema populations respond to various disturbances.
Evidence that the StlA polyketide synthase is required for the transition of growth to development in Polysphondylium violaceum
Authors: Yamasaki Daiki T , Narita Takaaki B
Published: August 2024

The social amoeba Polysphondylium violaceum uses chemoattractants different from those of Dictyoctelium discoideum for cell aggregation. However, the detailed mechanisms in P. violaceum remain unknown. We have previously reported that the polyketide synthase StlA is involved in inducing aggregation in this species. To elucidate the mechanism of StlA-induced aggregation in P. violaceum, we analyzed the phenotype of P. violaceum stlA− (Pv-stlA−) mutants in more detail. Unlike our previous results, the mutant cells did not exhibit proper chemotaxis toward glorin. Defective aggregation was not restored by glorin pulses, 8Br-cAMP, or deletion of the homologue of PufA that is a translational repressor of protein kinase A, whereas mutant cells grown in the presence of 4-methyl-5-pentylbenzene-1,3-diol (MPBD), the putative Pv-StlA product, aggregated normally without it after starvation. Furthermore, the early developmental marker gene, dscA, was downregulated in the mutant cells. Our data thus suggested that StlA is required for the transition from growth to development in P. violaceum.
71342 - International differences in selection and outcome of minimally invasive and open distal pancreatectomy: a transatlantic analysis
Authors: Johansen Karin , Augustinus Simone , Wellner Ulrich , Andersson Bodil , Beane Joal , Björnsson Bergthor , Busch Olivier , Davis Catherine , Ghadimi Michael , Gleeson Elizabeth , de Graaf Nine , Koerkamp Bas , Pitt Henry , van Santvoort Hjalmar , Tingstedt Bobby , Uhl Waldemar , Werner Jens , Williamsson Caroline , Besselink Marc , Keck Tobias
Published: August 2024

Introduction

The safety and efficacy of minimally invasive distal pancreatectomy (MIDP) has been confirmed within randomized trials. Information regarding differences in patient selection and outcomes of MIDP and open distal pancreatectomy (ODP) among countries is however lacking. This study compared MIDP and ODP in North America (NA), the Netherlands (NL), Germany (GER) and Sweden (SWE).

Method

Patients registered in the four pancreatic registries of the GAPASURG collaboration who underwent MIDP or ODP from 2014 to 2020 were included.

Result

Overall, 20 158 DPs were included; 7316 (36%) MIDP. Use of MIDP varied from 29% to 54% among registries, of which 13-35% were performed robotically (figure 1). Patients undergoing MIDP tended to be younger (GER and SWE), female (NA, GER), have higher body mass index (NA, NL, GER), lower comorbidity classification (NA, GER, SWE), lower performance status (GER), and lower rate of pancreatic ductal adenocarcinoma (all). Patients in the MIDP group had less vascular resections (all) and lower rates of severe complications and mortality (NA and GER). In the multivariable analysis, country was significantly associated with severe complications but not with 30-day mortality.

Discussion

Considerable disparities in the use and outcome of MIDP were shown among four transatlantic registries of pancreatic surgery. The differences in patient selection and outcomes imply that countries are in different stages of their learning curve.
72215 - Percutaneous hepatic perfusion as treatment for liver-dominant metastatic uveal melanoma: the first results from a Nordic referral center
Authors: Wong Andrew , Huibers Anne , Bagge Roger Olofsson
Published: August 2024

Introduction

Uveal melanoma has a high propensity to metastasize to the liver. Percutaneous hepatic perfusion (PHP) is an effective, minimally invasive treatment that allows selective intrahepatic delivery of high dose cytotoxic melphalan while limiting systemic toxicity through filtration of the hepatic venous outflow. The aim of this study was to investigate the response and safety in patients with liver-dominant metastatic uveal melanoma.

Method

Between December 2023 and April 2024, a total of 6 PHP treatments with melphalan were performed in three patients with liver-dominant metastatic uveal melanoma. Procedures were performed at Sahlgrenska University Hospital; the only referral center within the Nordic countries. Peri- and post-procedural adverse events were registered, as well as tumor response.

Result

Adverse events recorded were: periprocedural anaphylaxis (n=1), temporary leukopenia (n=1), temporary thrombocytopenia (n=6) and acute gout exacerbation (n=1). PHP-treatment resulted in stable disease on imaging in all patients after the first treatment session. All three underwent a successful second session of PHP-treatment. Planned additional follow-up imaging after 3 months is currently not yet available.

Discussion

Despite the very small study population and very preliminary data, these results suggest that PHP with melphalan is a safe treatment for selected patients with liver-dominant metastatic uveal melanoma and potentially offers a good intrahepatic disease control. The reported adverse events seem to be directly related to the melphalan instead of the technical aspects of the procedure itself.
72239 - Cholecystectomy for acute cholecystitis during weekend compared to delayed weekday surgery– a nationwide population study
Authors: Edblom Magnus , Enochsson Lars , Nyström Hanna , Sandblom Gabriel , Arnelo Urban , Hemmingsson Oskar , Gkekas Ioannis
Published: August 2024

Introduction

The optimal timing of surgery for acute cholecystitis has been subject for debate, but the predominant view supports early cholecystectomy. This study investigates the safety of early cholecystectomy during weekends compared to delaying until weekdays.

Method

A population-based cohort study based on data from GallRiks (Swedish National Register for Gallstone Surgery and Endoscopic Retrograde Cholangiopancreateatography). Data from cholecystectomies 2006-2020 were analysed. Patients operated on during weekends were compared with patients in hospital during weekends and undergoing surgery on any subsequent weekday. Statistical analyses were conducted using logistic regression analysis.

Result

15 730 patients were included, and a complication was registered in 2 246 patients (14.3%). The proportion of complications was equal in both groups (14.0% vs. 14.5%, p= 0.365) and after adjustment for for confounding factors, there still was no significant difference in complications ratio. The proportion of open surgery was higher in the weekend surgery group (29.1% vs. 26.3%), with an odds ratio of 1.32 in multivariate logistic regression analysis (p<0.001). Meanwhile, duration of surgery exceeding 2 hours was less common when surgery was performed on the weekend (32.7% vs. 46.8%, p=<0.001). No difference were seen in the ratio of bile duct injuries.

Discussion

In this study, procedures carried out during weekends had outcomes that did not substantially differ from those performed during weekdays. More procedures were completed with open surgery during weekends, but less procedures had operating time exceeding two hours. The results of our study support performing early cholecystectomies during the weekend without increasing the patients’ risk of complications.
71465 - Reflex CRC Initiative - Advancing Colorectal Cancer Care through Comprehensive Genetic Testing
Authors: Pappas Christoforos , Olauson Hannes , Haglund Felix , Lindberg Johan , Beergrehn Caroline , Tham Emma , Sjövall Annika
Published: August 2024

Introduction

Colorectal cancer management is evolving towards personalized medicine, with genetic testing playing a crucial role in treatment decisions. The Reflex Testing for Colorectal Cancer initiative aimed to integrate comprehensive genetic testing into routine care. Specifically, the aim was to promptly determine treatment predictive genetic factors and hereditary cancer risk syndromes that would lead to potential prophylactic surgery as well as identify DPYD deficiency that affects oncological treatment.

Method

The study, conducted from October 2021 to December 2023, included 370 patients diagnosed with colorectal cancer. Genetic analysis was performed on DNA extracted from blood and from tumor tissue taken from biopsy during endoscopy, using a gene panel of 385 genes (GMCK panel) designed to identify variants relevant to treatment prediction, prognosis, and heredity for all solid tumors.

Result

In the first 100 cases (48 females, 52 males), 7% were diagnosed before 50 years and 18% between 50 and 60 years of age. The tumor localization varied, with 23% in the right colon, 9% in the transverse colon, 27% in the left colon and 41% in the rectum.15% showed high microsatellite instability. Additionally, four patients (4%) were identified with Lynch syndrome (disease-associated variants in MLH1(x2) or MSH6(x2)). Regarding treatment-predictive biomarkers, pathogenic variants were found in KRAS in 44% and in BRAF in 20%.

Discussion

The analysis of paired tumor and blood data can identify both somatic and germline aberrations that are of clinical significance and thus enable personalized therapeutic decisions at diagnosis.

Grants: Regional Cancer Center Stockholm-Gotland funded this project.
72275 - A retrospective review of palliative rectal cancer with no curative surgical intent – comorbidites, local complications and management
Authors: Kejving Gustav , Sandén Gustav , Ljuslinder Ingrid , Vinnars Petrus , Rutegård Martin
Published: August 2024

Introduction

Palliative rectal cancer patients typically retain their primary tumour, as trials have concluded no survival benefit of tumour resections in non-curative patients. This patient group is understudied regarding the natural course of the remaining tumour, in particular concerning the need of surgical management.

Method

This is a retrospective study on rectal cancer patients diagnosed between 2007–2020 in Region Västerbotten, Sweden.

Data were ascertained from the Swedish Colorectal Cancer Registry and chart review. Exclusion criteria comprised curative intent, primary tumour resection, synchronous other tumour, locally recurrent colorectal cancer, or treatment refusal. Patients were followed up from diagnosis until death or end of followup (2023). Indications for palliative treatment, tumour-related complications, and surgical and oncological management were noted. Stratification for study period and patient age was performed.

Result

Some 150 patients remained after applying exclusion criteria. The majority had a metastasized and incurable disease (74%). Almost half suffered local complications (46%). Some 43% underwent surgical intervention due to the unremoved primary tumour. Tumour perforation occurred in 7% with a significantly higher risk for patients younger than 75 years (p<0.01). Mechanical obstruction afflicted 21.3%, while 33% underwent stoma diversion. Almost half of the patients received chemotherapy (49%) and radiotherapy (44%), respectively.

Discussion

There is a significant risk of local complications and surgical intervention due to the unremoved primary tumour in palliative rectal cancer patients. Therefore, considerations of the benefits of surgical resection should be taken, especially for patients with a longer estimated survival. Further research is required to properly select these patients.
72145 - Mesh versus Suture repair for Small umbilical hernias in adults: Early results from a Randomized Controlled multicenter Trial; The SUMMER Trial
Authors: Bergström Mathias , Widhe Björn , Granåsen Gabriel , Granström Anna Löf , Ohlsson Johan , Schult Simone , Dahlstrand Ursula , Österberg Johanna , Loogna Peter , Bringman Sven , Melkemichel Maria
Published: August 2024

Introduction

Mesh repair is recommended for umbilical hernias larger than 1 cm to reduce recurrence rates, yet evidence remains limited. An important question concerns optimal mesh positioning and surgical site occurrences (SSO). This study investigates early SSO in suture versus mesh repair for small umbilical hernias.

Method

A multicenter, randomized, controlled, double-blind trial across six Swedish surgical units compared a 4x4 cm lightweight onlay mesh to conventional suture repair for umbilical hernias ≤2 cm. Intraoperative centralized web-based randomization ensured allocation concealment. Participants and assessment surgeons were blinded for allocation. Primary outcome will be recurrence at 3 years. Secondary outcome was early SSO at 30 days after surgery, assessed through a physical examination and presented in this study. The trial is registered with Clinicaltrials.gov, NCT04231071.

Result

From February 2020 to January 2024, 290 participants were randomly assigned. After exclusion and loss to follow-up, remaining population for intention to treat analysis were n=144 (suture repair) and n=135 (mesh repair). SSO (Clavien-Dindo ≥1) were in the mesh group n=32 (24%) compared to n=26 (18%) in the suture group, without any significant increase for mesh repairs (OR 1.39, CI 0.78-2.52). BMI and defect size weren't significant risk factors. Clinically relevance SSO (Clavien-Dindo ≥2) were fewer in the mesh group n=2 (1.5%) compared to suture group n=4 (2.8%). No recurrences were detected.

Discussion

This randomized trial provides first high-level evidence for mesh repair in umbilical hernias ≤2 cm. Onlay mesh repair is comparable to suture repair regarding early surgical site occurrences and is safe for small umbilical hernias.
72307 - “Are you curious about studying further?” Undergraduate nurses' attitudes towards specialist training in surgical care
Authors: Ferlin Hanna , Hopf Linnea
Published: August 2024

Introduction

The supply of skills is a major challenge for the Swedish healthcare system, with a shortage of specialist nurses and experienced staff. The lack of competence poses a threat to patient safety. Even though efforts are being made to encourage nurses to specialize, not enough are doing so. The aim of this study is to investigate undergraduate nurses' attitudes towards specialist training in surgical care.

Method

A focus group study with a total of 16 participants employed at surgical wards at a university hospital. A qualitative content analysis supported by Graneheim and Lundman (2004) was conducted.

Result

Four main categories emerged, “Knowledge of the education”, “organizational conditions”, “personal conditions” and “the role of the specialist nurse”. Nurses believe that specialist training in surgical care leads to a diffuse professional role. When the specialist nurse receives more administrative tasks, she disappears from the care close to the patient, which is seen as an obstacle to wanting specialist training. Using research and writing a student thesis was also seen as obstacles. Having nurses with post graduate education in the ward was considered to bring security to both nursing staff and patients.

Discussion

The specialist nurse can have an important role in helping to spread knowledge and new research to the unit. If the nurse specialist gets to work closer to the patient, more would be interested in specializing. Hospital management have an important role in informing about what opportunities for specialist training are available and taking advantage of the interest shown by employees.
Japanese living donor liver transplantation criteria for hepatocellular carcinoma: nationwide cohort study
Authors: Ohira Masahiro , Aoki Gaku , Orihashi Yasushi , Yoshimura Kenichi , Toshima Takeo , Hatano Etsuro , Eguchi Susumu , Hibi Taizo , Hasegawa Kiyoshi , Umeda Yuzo , Hashimoto Takuya , Hasegawa Yasushi , Nobori Shuji , Ogura Yasuhiro , Nitta Hiroyuki , Egawa Hiroto , Eguchi Hidetoshi , Takada Yasutsugu , Ueda Yoshihide , Kasahara Mureo , Kawachi Shigeyuki , Soejima Yuji , Tokushige Katsutoshi , Nagano Hiroaki , Haga Hironori , Fukumoto Takumi , Mochida Satoshi , Umeshita Koji , Ohdan Hideki ,   the Japanese Liver Transplantation Society, Mizuno Shugo , Kuboki Satoshi , Otsuka Masayuki , Kobayashi Takashi , Wakai Toshifumi , Ishigame Teruhide , Marubashi Shigeru , Watanabe Masaaki , Taketomi Akinobu , Nakamuma Shinichi , Yagi Shintaro , Wakiya Taichi , Ishido Keinosuke , Sawada Yu , Endo Itaru , Goto Yuichi , Hisaka Toru , Uryuhara Kenji , Sakuma Yasunari , Ichida Hirofumi , Saiura Akio , Haruki Koichiro , Ikegami Toru , Iso Yukihiro , Aoki Taku , Takahara Takeshi , Yokoo Hideki , Beck Yoshifumi , Miyagi Shigeto , Tokodai Kazuaki
Published: August 2024

Background

Validating the expanded criteria for living donor liver transplantation for hepatocellular carcinoma using national data is highly significant. The aim of this study was to evaluate the validity of the new Japanese criteria for living donor liver transplantation for hepatocellular carcinoma patients and identify factors associated with a poor prognosis using the Japanese national data set.

Methods

The study population comprised patients who underwent living donor liver transplantation for hepatocellular carcinoma at 37 centres in Japan between 2010 and 2018. In a nationwide survey, the overall survival and recurrence-free survival rates were evaluated based on the new Japanese criteria for applying the 5-5-500 rule when extending the indication beyond the Milan criteria. Prognostic factors within the Japanese criteria were determined using the Cox proportional hazards model.

Results

Patients within (485 patients) and beyond (31 patients) the Japanese criteria exhibited 5-year overall survival rates of 81% and 58% and 5-year recurrence-free survival rates of 77% and 48% respectively. Patients who met the Milan criteria, but not the 5-5-500 rule, had poorer outcomes. Multivariate analysis for 474 patients identified a neutrophil-to-lymphocyte ratio greater than or equal to 5 and a history of hepatectomy as independent risk factors.

Conclusion

This nationwide survey confirms the validity of the Japanese criteria. The poor prognostic factors within the Japanese criteria include a neutrophil-to-lymphocyte ratio greater than or equal to 5 and previous hepatectomy.
Dupilumab treatment in paediatric atopic dermatitis (2–18 years): Spanish multicentre retrospective real-world study
Authors: Iznardo Helena , Roé Esther , Vicente Asunción , Prat Carolina , Casals Miquel , Martín-Santiago Ana , Esteve Altea , Viñas Miguel , Munera-Campos Mónica , Corella Francesca , Mollet Jordi , Figueras-Nart Ignasi , Vila Aina , Soria Xavier , Azón-Masoliver Antoni , Marqués-Martín Laura , Nadal-Lladó Cristina , Bel Susana , Pujol-Montcusí Josep , Bertolín-Colilla Marta , Curto-Barredo Laia , Melé-Ninot Gemma , Evole Montserrat , Berbegal Laura , Puig Lluís , Baselga Eulàlia
Published: August 2024

Background

Moderate-to-severe atopic dermatitis (AD) can be difficult to manage in paediatric patients, and there are few licensed treatments available for this age group. Dupilumab is approved for the treatment of AD in children older than 6 months.

Objectives

To assess the effectiveness and safety of dupilumab in a real-world cohort of paediatric patients with AD in Spain.

Methods

A multicentre, retrospective real-world study on the effectiveness and safety of dupilumab in patients aged 2–18 years with moderate-to-severe AD was conducted. Demographic and clinical characteristics were analysed, and effectiveness (Eczema Area and Severity Index, Investigator’s Global Assessment, Dermatology Life Quality Index, Numerical Rating Scale itch), safety and drug survival measures were assessed. A comparison of our results with other real-world outcomes and with clinical trials was made.

Results

Data from 243 patients from 19 centres were collected, with a mean follow-up of 85 weeks. Dupilumab exhibited significant effectiveness, with marked reductions in severity scores from week 4. By week 16, 79.4% of patients achieved ≥ 75% improvement in Eczema Area and Severity Index (EASI) score (EASI 75) and 40.5% achieved ≥ 90% improvement in EASI score (EASI 90). Mean percentage reduction in EASI was 79.7%. Increasing improvements were observed until week 52, with 85.8% and 49.6% of patients achieving EASI 75 and EASI 90, respectively. Forty-three patients developed adverse events (AEs) (43 of 243, 17.7%). The most frequent AEs were ocular surface diseases (20 of 243, 8.2%), injection site reactions (8 of 243, 3.3%) and facial redness (7 of 243, 2.9%). Drug survival was high (96.9% and 93.1% after 1 and 2 years of follow-up, respectively), with only 19 patients (7.8%) interrupting treatment: 7 (2.9%) owing to AEs; 2 (0.82%) owing to secondary failure; 5 (2.1%) were lost to follow-up; and 5 (2.1%) entered remission and stopped treatment.

Conclusions

Real-world use of dupilumab in paediatric AD demonstrated sustained effectiveness, high drug survival and acceptable safety profiles. Longer-term studies are crucial for AE surveillance and understanding how to manage disease remission.
A constellation of cutaneous reactions to chimeric antigen receptor T-cell therapy
Authors: Khoda Fatimah , Ghadiri Sina , Palmer Timothy , Warburton Katharine
Published: August 2024

This case report describes a cascading purpuric eruption progressing to bullae, ulceration and hypergranulation in a 76-year-old patient with diffuse B-cell lymphoma, following chimeric antigen receptor T-cell therapy. It is crucial to document and report these cutaneous reactions to raise awareness, improve management and monitor patient outcomes.
Anion effects on the structure and stability of 3D domain–swapped cytochrome c dimer
Authors: Fujiwara Kodai , Ryuzaki Michiko , Yamanaka Masaru , Mashima Tsuyoshi , Saotome Tomonori , Kidokoro Shun-ichi , Hirota Shun
Published: August 2024

The structure and stability of proteins are affected by ions. We have previously reported that cytochrome c can form a 3D domain–swapped dimer. The structure of the cytochrome c domain–swapped dimer becomes more compact in the presence of kosmotropic anions, whereas the thermal stability of the dimer decreased with addition of chaotropic anions based on the Hofmeister series. Dimers were formed by incubating cytochrome c at 50 °C in the presence of citrate ions.
Clinical Utility of LC-MS/MS for Blood Myo-Inositol in Patients with Acute Kidney Injury and Chronic Kidney Disease
Authors: Omosule Catherine L , Blair Connor J , Herries Elizabeth , Zaydman Mark A , Farnsworth Christopher , Ladenson Jack , Dietzen Dennis J , Gaut Joseph P
Published: August 2024

Background

Diagnosing acute kidney injury (AKI) and chronic kidney disease (CKD) relies on creatinine, which lacks optimal diagnostic sensitivity. The kidney-specific proximal tubular enzyme myo-inositol oxygenase (MIOX) catalyzes the conversion of myo-inositol (MI) to D-glucuronic acid. We hypothesized that proximal tubular damage, which occurs in AKI and CKD, will decrease MIOX activity, causing MI accumulation. To explore this, we developed an LC-MS/MS assay to quantify plasma MI and assessed its potential in identifying AKI and CKD patients.

Methods

MI was quantified in plasma from 3 patient cohorts [normal kidney function (n = 105), CKD (n = 94), and AKI (n = 54)]. The correlations between MI and creatinine were determined using Deming regression and Pearson correlation and the impact of age, sex, and ethnicity on MI concentrations was assessed. Receiver operating characteristic curve analysis was employed to evaluate MI diagnostic performance.

Results

In volunteers with normal kidney function, the central 95th percentile range of plasma MI concentrations was 16.6 to 44.2 µM. Age, ethnicity, and sex showed minimal influence on MI. Patients with AKI and CKD exhibited higher median MI concentrations [71.1 (25th percentile: 38.2, 75th percentile: 115.4) and 102.4 (77, 139.5) µM], respectively. MI exhibited excellent sensitivity (98.9%) and specificity (100%) for diagnosing CKD. In patients with AKI, MI increased 32.9 (SD 16.8) h before creatinine.

Conclusions

This study unveils MI as a potential renal biomarker, notably elevated in plasma during AKI and CKD. Plasma MI rises 33 h prior to serum creatinine, enabling early AKI detection. Further validation and exploration of MI quantitation in kidney disease diagnosis is warranted.