bluuebunny/crossref_metadata_2025 huggingface dataset:
(258) Some Erotic Arts and Sexual Therapies Originated from the Ancient Chinese Erotic Health Science
Authors: Wang Q
Published: March 2024

Introduction

Chinese people have created some sexual cultural heritages in 5,000 years, such as the Combined Yin and Yang and The Classic of the Medical Goddess. I have collected more than 5,000 Chinese sexual artifacts, compiled and published The Sexual Life and Health for the Couple: Ancient Wisdom for Modern Use, and hosted the “Forum for Sexual Life and Health” in 2017, to explore ancient Chinese sexual culture, and found that many sexual concepts and sexual therapy or treatment techniques originated from ancient China. 5000, 2017.

Objective

Some Erotic Arts and Sexual Therapies Originated from the Ancient Chinese Erotic Health Science.

Methods

The Han Dynasty's Ten Questions to the Sophist recorded “relaxing one’s hip, contracting one’s pelvic floor muscles, tightening one’s anus are being Keep healthy”, all of the methods mean “A anal lifting therapy in traditional Chinese exercise”. Sun Simiao, a Chinese medicine pharmacist in Tang Dynasty, called them “massage the anus therapy”, and advocated “to do it a hundred times a day for prevention some diseases, and it could extend longevity” in his book Prescriptions for Erotic Techniques of the Couples. This is the therapy that is earlier about 2 thousand years than the Kegel movement, in 1948. In Ming dynasty, The Secret Teachings of the Taoist Nuns, it is written that “nine shallow and one deep while coitus”, and in Northern and southern Dynasties, The Record of Nurturing Life and Extending Longevity there are not only records of the “Ten Movements”, but also explanations of “slow insertion and quick extraction are good for health”, and so on. The recorded “sexual exercises of such kind” are more artistic and practical, predating the “stop-move-stop” while coitus, invented by Helen Singer Kaplan. 194812.

Results

In 1943, James H. Semans, the father of “premature ejaculation”, considered the dysfunction as a physical and mental disease and applied anesthetic cream to treat it, while as early as 1896, Ye Tianshi a doctor of Chinese medicine in the middle of Qing Dynasty, wrote it is, in The Secret Book of Elixir for Progeny, “liking as a cock copulating fast” 1943, 1896.

Conclusions

It is an important sex therapy that was used in ancient China, ie. “to therapy sexual disorders with sexual activities”. For example, The Thousand Golden Remedies is recorded also by Sun Simiao, “the sexual activity is karezza or coitus reservatus rather than administration”, that is to say, it is a form of coitus in which the man tries to avoid ejaculation. This also coincides with the “Sensate Focus Therapy” created by Masters and Johnson.

Disclosure

No.
(265) Self-Image after Breast Cancer
Authors: Sghaier A , Kaabia O , Bouchahda R
Published: March 2024

Introduction

Breast cancer is currently the first cancer diagnosed among women. The impact of its local treatments such as surgery and radiation and its systemic treatments such as chemotherapy, hormone-suppressant therapies and targeted therapies on women's bodies anatomically and physiologically and on their body image and body esteem are the major factors altering their sexual health and the quality of their spousal relationships.

Objective

We aim to evaluate the qualitative impact of breast cancer on its survivors' body-image.

Methods

We ran a prospective qualitative study using semi-structured interviews until saturation of findings. The patients included were women diagnosed, treated for breast cancer, and followed up in our institution. All participants were sexually active and no older than 55. The study enrolled 20 participants over a 6-month period (February 2022-July 2022).

Results

All participants had a history of breast surgery either lumpectomy or mastectomy (70%) with (one case) or without reconstructive surgery. All patients reported a history of radiation and chemotherapy. 60% had received hormone therapy with medically induced menopause. The majority of participants explained how their bodies had changed not only physically and anatomically on the outside but also on the inside especially in relation to the adverse effects of chemotherapy and hormone therapy. They also reported body emotional changes. This required an adaptation to their new body for them and their partners and entourage. The main themes emerging from their discourse were: physical and emotional adaptation to breast cancer per se and its local and systematic treatments, fear of others judgment and comments on their physical changes and loss or gain of self-esteem. Breast reconstruction was also an important theme it the participants verbatim.

Conclusions

The words and themes that characterized the participants' speeches highlighted the impact of cancer diagnosis and oncological therapies on breast cancer survivors. Being part of a psychological intervention focused on self-compassion and body acceptance helps breast cancer survivors develop a better perception and acceptance of their new bodies.

Disclosure

No.
(270) LISWT Before Penile Prosthesis Implantation Might Facilitate Dilation of Fibrotic Corpora
Authors: Feghali J
Published: March 2024

Introduction

Severe corporeal fibrosis presents significant challenges in penile implant insertion. LISWT studies in rats and humans have suggested its ability to rejuvenate cavernous bodies through various mechanisms and growth factors.

Objective

This prompted our evaluation of LISWT's effectiveness in facilitating prosthesis implantation in patients with penile fibrosis, which are typically considered difficult cases.

Methods

A 34-year-old male smoker with a history of sickle cell disease, bilateral hip replacements, and splenectomy due to sickle cell crisis sought penile prosthesis implantation. He presented with severe erectile dysfunction and corporeal fibrosis following two ischemic priapism episodes caused by sickle cell disease, which were treated with distal shunts 4 and 1 years prior, respectively (Fig. 1). After obtaining consent, the patient underwent four cycles of LISWT, spaced one month apart. Each cycle consisted of four weekly sessions using the PiezoWave2 device from Richard WOLF with settings of 0.16mj/mm2 energy flux density, 6Hz frequency, and 10mm wave focus penetration depth. In each session, the patient received a total of 6000 shocks, distributed between the perineum, dorsum penis, and the lateral aspect of the penis.

Results

A month post-LISWT, the patient's Erection Hardness Score (EHS) improved from 0 to 1 following an intracavernous injection of 20 mcg of alprostadil (Fig. 2). Subsequently, he underwent a malleable penile implant procedure through the penoscrotal approach. Cavernosal dilation was successful up to 10mm using a Hegar dilator, with bilateral corporal measurements of 8cm proximally and 9cm distally. A Tactra malleable penile prosthesis (9.5mm girth and 17cm length) from Boston Scientific was implanted without complications (Fig. 3.A.B)

Conclusions

In cases of severe corporeal fibrosis, pre-treatment with LISWT may aid in the dilation of the corpora during penile prosthesis implantation, potentially reducing complications. Randomized studies are warranted to validate this indication

Disclosure

No.
(283) Report of Newly Developed Penile Enhancement Surgery Using Midline Fixation Technique of Dermal Garft, Multi-layer Dissection Method, Multilayer Suture Lengthening and Minimal Skin Incision
Authors: Jang S
Published: March 2024

Introduction

Many physicians have tried to develop the surgical techniques to make safer and more effective results in penile enhancement surgery.

Objective

To accomplish better results of penile enhancement surgery, We aim to introduce newly developed more effective surgical techniques and safer processes in penile enhancement surgery.

Methods

2023 Patients underwent penile enhancement surgeries. All patients adopted pre-pubic minimal skin incision with newly developed retractors. Allogenic dermal graft was fixed for girth enhancement. And midline fixation between penile skin inner surface and midline site of dermal graft was performed with surgifit 3.0. to accelerate the attachment of skin and graft. We use newly developed dissection technique with curved iris scissors and electro-cutting to dissect surgical plain between dartos and buck’s fascias. To perform lengthening procedure, fundiform ligament was dissected and pre-pubic dead space was approximated by multi-layer transverse suturing.

Results

Mean operation time was 46 min and mean incision length was 3.3 cm. Postoperative penile length after 3 months was elongated on average 2.7 cm. postoperative inflammation rate was 1.2% and no garfts failure was observed.

Conclusions

For more effective and safer penile enhancement and lengthening, multi-layer dissection technique, multi-layer suturing lengthening and mid-line fixation technique with minimal pre-pubic incision (4m penile surgery) are very useful.

Disclosure

No.
Female genitourinary schistosomiasis-related symptoms in long-term sub-Saharan African migrants in Europe: a prospective population-based study
Authors: Roure Sílvia , Vallès Xavier , Pérez-Quílez Olga , López-Muñoz Israel , Chamorro Anna , Abad Elena , Valerio Lluís , Soldevila Laura , Gorriz Ester , Herena Dolores , Pedregal Elia Fernández , España Sergio , Serra Cristina , Cera Raquel , Rodríguez Ana Maria , Serrano Lorena , Falguera Gemma , Hegazy Alaa H A , Fernández-Rivas Gema , Miralles Carmen , Conde Carmen , Montero-Alia Juan José , Miranda-Sánchez Jose , Llibre Josep M , Isnard Mar , Bonet Josep Maria , Estrada Oriol , Prat Núria , Clotet Bonaventura ,   The Schisto-Stop study group
Published: March 2024

The involvement of genital women tract of chronic schistosomiasis among African migrant women in non-endemic countries might be more prevalent than expected. A gold standard diagnostic is most needed to determine the true prevalence of this condition and characterize the clinical presentation of female genital schistosomiasis among this particular population.
An Ocean of Becoming: Routed Motherhood in Lisa Ko’sThe Leavers
Authors: Poulsen Melissa , Šmilauerová Tereza
Published: March 2024

In Lisa Ko’s award-winning novel The Leavers (2017), protagonist Polly Guo is a leaver, sometimes by circumstance, sometimes by choice. From the shores of the Minjiang to the bridges of the Harlem River, from the waters of the Atlantic to those of the Pacific, Polly wanders the globe with and without her son but always through and with the water. As such, Polly becomes a rare and pronounced example in Asian American literature of a mother-in-transition—or what we are calling the routed mother. As a routed mother, Polly attempts to use physical movement to escape the containment of heteropatriarchal, capitalist understandings of what it means to be a successful mother. Bringing oceanic studies into conversation with the socioeconomic context of Asian American motherhood, this paper argues that waterways highlight—albeit messily, muddily, shiftingly, much like water itself—the sources and strategies of Polly’s containment as a mother and her resistance to that containment. Simultaneously, water reveals Polly’s failure to do so but recasts that routing in a paradigm beyond the dichotomy of success and failure. Ultimately, this article argues that Polly’s story as a routed mother offers an important oceanic counternarrative of motherly success.
Evidence for adaptive strategies in larval capelin on the northeastern coast of Newfoundland, Canada
Authors: Tripp Ashley , Murphy Hannah M , Davoren Gail K
Published: March 2024

Fish species with high mortality during early life may maximize fitness using adaptive strategies to time hatching to match favorable environmental conditions (match/mismatch) or extending spawning/hatching to disperse risk (bet-hedging). We examined support for these strategies in a collapsed forage fish, capelin (Mallotus villosus), in coastal Newfoundland (2018–2021). Capelin shift from spawning at warm, intertidal to cool, subtidal (15–40 m) habitats in warmer years, with unknown recruitment consequences. We hypothesized that match/mismatch (specifically, Coastal Water Mass Replacement Hypothesis) would be supported if densities of recently hatched larvae showed pulses that overlapped with high prey and low predator densities. Generalized additive models revealed that larval densities increased with zooplankton prey biomass, but were not influenced by predator biomass or temperature, contrasting with pre-collapse studies and providing equivocal support for match/mismatch. Protracted larval emergence and previously documented high variability in larval traits supported a bet-hedging strategy. Larval condition (i.e. length, yolk-sac diameter) did not differ between habitats but varied among years, where the highest proportion of larvae in poor condition was from the intertidal site in the warmest year (2018). Findings suggest that spawning habitat shifts may have limited impact on stock recovery relative to year-specific environmental conditions that influence larval condition.
Seasonal organization of tintinnid community by temperature preference and LOD size-class in a subtropical brackish embayment
Authors: Li Jingyuan , Du Ping , Li Haibo , Zhao Yuan , Mao Ming , Zhao Li , Dong Yi , Xu Yepeng , Grégori Gérald , Zhang Wuchang
Published: March 2024

Most annual studies of tintinnid and phytoplankton in coastal habitats are influenced by alien species introduced by water masses exchange, and therefore cannot be used as direct evidence for exploring the mechanism of annual succession in indigenous community. For brackish communities, very limited annual studies exist because of the difficulty of conducting stable sampling in the transition between freshwater and seawater. The special topography of Xiangshan Bay isolates the external water mass and provides a suitable habitat for exploring the annual succession mechanism of the brackish tintinnid community. In this study, samples were collected from seven stations in Tie Harbor, Xiangshan Bay (East China Sea) during 10 months from 2022 to 2023. A total of 23 tintinnid species of five genera were identified throughout the year. These tintinnid species can be clustered into four seasonal groups, winter, summer, autumn and spring-autumn, with three temperature preferences. The Lorica Oral Diameter (LOD) size-class of each tintinnid species, which determines the food item size of tintinnid, separated their different ecological niches within each seasonal group. The seasonal succession of tintinnid community in Xiangshan Bay was organized by both temperature preference and LOD size of the tintinnid species.
Stripe rust effector Pst03724 modulates host immunity by inhibiting NAD kinase activation by a calmodulin
Authors: Wang Yanfeng , Liu Cong , Qin Yuanyang , Du Yuanyuan , Song Chao , Kang Zhensheng , Guo Jia , Guo Jun
Published: March 2024

Puccinia striiformis f. sp. tritici (Pst) secretes effector proteins that enter plant cells to manipulate host immune processes. In this report, we present an important Pst effector, Pst03724, whose mRNA expression level increases during Pst infection of wheat (Triticum aestivum). Silencing of Pst03724 reduced the growth and development of Pst. Pst03724 targeted the wheat calmodulin TaCaM3-2B, a positive regulator of wheat immunity. Subsequent investigations revealed that Pst03724 interferes with the TaCaM3-2B–NAD kinase (NADK) TaNADK2 association and thus inhibits the enzyme activity of TaNADK2 activated by TaCaM3-2B. Knocking down TaNADK2 expression by virus-mediated gene silencing significantly increased fungal growth and development, suggesting a decrease in resistance against Pst infection. In conclusion, our findings indicate that Pst effector Pst03724 inhibits the activity of NADK by interfering with the TaCaM3-2B–TaNADK2 association, thereby facilitating Pst infection.
Interaction network rewiring and species’ contributions to community-scale flexibility
Authors: Toju Hirokazu , Suzuki Sayaka S , Baba Yuki G
Published: March 2024

The architecture of species interaction networks is a key factor determining the stability of ecological communities. However, the fact that ecological network architecture can change through time is often overlooked in discussions on community-level processes, despite its theoretical importance. By compiling a time-series community dataset involving 50 spider species and 974 Hexapoda prey species/strains, we quantified the extent to which the architecture of predator–prey interaction networks could shift across time points. We then developed a framework for finding species that could increase the flexibility of the interaction network architecture. Those “network coordinator” species are expected to promote the persistence of species-rich ecological communities by buffering perturbations in communities. Although spiders are often considered as generalist predators, their contributions to network flexibility vary greatly among species. We also found that detritivorous prey species can be cores of interaction rewiring, dynamically interlinking below-ground and above-ground community dynamics. We further found that the predator–prey interactions between those network coordinators differed from those highlighted in the standard network-analytical framework assuming static topology. Analyses of network coordinators will add a new dimension to our understanding of species coexistence mechanisms and provide platforms for systematically prioritizing species in terms of their potential contributions in ecosystem conservation and restoration.
Generative artificial intelligence, human creativity, and art
Authors: Zhou Eric , Lee Dokyun
Published: March 2024

Recent artificial intelligence (AI) tools have demonstrated the ability to produce outputs traditionally considered creative. One such system is text-to-image generative AI (e.g. Midjourney, Stable Diffusion, DALL-E), which automates humans’ artistic execution to generate digital artworks. Utilizing a dataset of over 4 million artworks from more than 50,000 unique users, our research shows that over time, text-to-image AI significantly enhances human creative productivity by 25% and increases the value as measured by the likelihood of receiving a favorite per view by 50%. While peak artwork Content Novelty, defined as focal subject matter and relations, increases over time, average Content Novelty declines, suggesting an expanding but inefficient idea space. Additionally, there is a consistent reduction in both peak and average Visual Novelty, captured by pixel-level stylistic elements. Importantly, AI-assisted artists who can successfully explore more novel ideas, regardless of their prior originality, may produce artworks that their peers evaluate more favorably. Lastly, AI adoption decreased value capture (favorites earned) concentration among adopters. The results suggest that ideation and filtering are likely necessary skills in the text-to-image process, thus giving rise to “generative synesthesia”—the harmonious blending of human exploration and AI exploitation to discover new creative workflows.
Route of exposure to veterinary products in bees: Unraveling pasture's impact on avermectin exposure and tolerance in stingless bees
Authors: Obregon Diana , Guerrero Olger , Sossa David , Stashenko Elena , Prada Fausto , Ramirez Beatriz , Duplais Christophe , Poveda Katja
Published: March 2024

Deforestation rapidly increases in tropical regions, primarily driven by converting natural habitats into pastures for extensive cattle ranching. This landscape transformation, coupled with pesticide use, are key drivers of bee population decline. Here, we investigate the impact of pasture-dominated landscapes on colony performance, pesticide exposure, and insecticide sensitivity of the stingless bee Tetragonisca angustula. We monitored 16 colonies located in landscapes with varying proportions of pasture. We collected bee bread for pesticide and palynological analysis. We found a positive correlation between pollen diversity and colony growth, with no effect of the proportion of pasture in the landscape. In contrast, we detected prevalent and hazardous concentrations of the insecticide abamectin (9.6–1,856 µg/kg) in bee bread, which significantly increased with a higher proportion of pasture. Despite the abamectin exposure, the bee colonies displayed no adverse effects on their growth, indicating a potential tolerance response. Further investigations revealed that bees from sites with higher proportions of pasture showed significantly reduced mortality when exposed to a lethal concentration of abamectin (0.021 µg/µL) after 48 h. Since abamectin is scarcely used in the study area, we designed an experiment to track ivermectin, a closely related antiparasitic drug used in cattle. Our findings uncovered a new exposure route of bees to pesticides, wherein ivermectin excreted by cattle is absorbed and biotransformed into abamectin within flowering plants in the pastures. These results highlight that unexplained exposure routes of bees to pesticides remain to be described while also revealing that bees adapt to changing landscapes.
A new type of sulfation reaction: C-sulfonation for α,β-unsaturated carbonyl groups by a novel sulfotransferase SULT7A1
Authors: Kurogi Katsuhisa , Sakakibara Yoichi , Hashiguchi Takuyu , Kakuta Yoshimitsu , Kanekiyo Miho , Teramoto Takamasa , Fukushima Tsuyoshi , Bamba Takeshi , Matsumoto Jin , Fukusaki Eiichiro , Kataoka Hiroaki , Suiko Masahito
Published: March 2024

Cytosolic sulfotransferases (SULTs) are cytosolic enzymes that catalyze the transfer of sulfonate group to key endogenous compounds, altering the physiological functions of their substrates. SULT enzymes catalyze the O-sulfonation of hydroxy groups or N-sulfonation of amino groups of substrate compounds. In this study, we report the discovery of C-sulfonation of α,β-unsaturated carbonyl groups mediated by a new SULT enzyme, SULT7A1, and human SULT1C4. Enzymatic assays revealed that SULT7A1 is capable of transferring the sulfonate group from 3′-phosphoadenosine 5′-phosphosulfate to the α-carbon of α,β-unsaturated carbonyl-containing compounds, including cyclopentenone prostaglandins as representative endogenous substrates. Structural analyses of SULT7A1 suggest that the C-sulfonation reaction is catalyzed by a novel mechanism mediated by His and Cys residues in the active site. Ligand-activity assays demonstrated that sulfonated 15-deoxy prostaglandin J2 exhibits antagonist activity against the prostaglandin receptor EP2 and the prostacyclin receptor IP. Modification of α,β-unsaturated carbonyl groups via the new prostaglandin-sulfonating enzyme, SULT7A1, may regulate the physiological function of prostaglandins in the gut. Discovery of C-sulfonation of α,β-unsaturated carbonyl groups will broaden the spectrum of potential substrates and physiological functions of SULTs.
Evaluation of the toxic potential of Bisphenol-A glycidylmethacrylate (BisGMA) on the third instar larvae of transgenic Drosophila
Authors: Ibrahim Nabeela , Tariq Mohammad , Anjum Arbab , Varshney Himanshi , Gaur Kajal , Subhan Iqra , Jyoti Smita , Siddique Yasir Hasan
Published: March 2024

Introduction

In the present study the cytotoxic and genotoxic effects of Bisphenol-A glycidyl methacrylate (BisGMA) was studied on the third instar larvae of transgenic Drosophila melanogaster (hsp70-lacZ)Bg9.

Materials and methods

The concentration of BisGMA i.e. 0.005, 0.010, 0.015 and 0.020 M were established in diet and the larvae were allowed to feed on it for 24 h.

Results

A dose dependent significant increase in the activity of β-galactosidase was observed compared to control. A significant dose dependent tissue damage was observed in the larvae exposed to 0.010, 0.015 and 0.020 M of BisGMA compared to control. A dose dependent significant increase in the Oxidative stress markers was observed compared to control. BisGMA also exhibit significant DNA damaged in the third instar larvae of transgenic D. melanogaster (hsp70-lacZ)Bg9 at the doses of 0.010, 0.015 and 0.020 M compared to control.

Conclusion

BisGMA at 0.010, 0.015 and 0.020 M was found to be cytotoxic for the third instar larvae of transgenic D. melanogaster (hsp70-lacZ) Bg9.
A radiomics model to predict γδ T‐cell abundance and overall survival in head and neck squamous cell carcinoma
Authors: Fan Binna , Fan Binting , Sun Na , Zou Huawei , Gu Xiao
Published: March 2024

γδ T cells are becoming increasingly popular because of their attractive potential for antitumor immunotherapy. However, the role and assessment of γδ T cells in head and neck squamous cell carcinoma (HNSCC) are not well understood. We aimed to explore the prognostic value of γδ T cell and predict its abundance using a radiomics model. Computer tomography images with corresponding gene expression data and clinicopathological data were obtained from online databases. After outlining the volumes of interest manually, the radiomic features were screened using maximum melevance minimum redundancy and recursive feature elimination algorithms. A radiomics model was developed to predict γδ T‐cell abundance using gradient boosting machine. Kaplan–Meier survival curves and univariate and multivariate Cox regression analyses were used for the survival analysis. In this study, we confirmed that γδ T‐cell abundance was an independent predictor of favorable overall survival (OS) in patients with HNSCC. Moreover, a radiomics model was built to predict the γδ T‐cell abundance level (the areas under the operating characteristic curves of 0.847 and 0.798 in the training and validation sets, respectively). The calibration and decision curves analysis demonstrated the fitness of the model. The high radiomic score was an independent protective factor for OS. Our results indicated that γδ T‐cell abundance was a promising prognostic predictor in HNSCC, and the radiomics model could discriminate its abundance levels and predict OS. The noninvasive radiomics model provided a potentially powerful prediction tool to aid clinical judgment and antitumor immunotherapy.
Rheumatoid arthritis: prediction of future clinically-apparent disease, and prevention
Authors: Deane Kevin D.
Published: March 2024

Purpose of review

This review discusses updates in the prediction and prevention of future rheumatoid arthritis (RA).

Recent findings

In individuals with musculoskeletal symptoms and elevated antibodies to citrullinated proteins (ACPA) without clinical inflammatory arthritis (IA), a ‘simple’ score has a positive predictive value (PPV) of ∼28% for clinical IA/RA within 1 year, and a comprehensive score (including ultrasound) has a PPV of ∼71% for clinical RA within 5 years. Controlled clinical trials in individuals at-risk for future RA have been performed using corticosteroids, rituximab, atorvastatin, methotrexate, hydroxychloroquine and abatacept. Abatacept modestly reduced rates of incident clinical RA and imaging inflammation within the trials, rituximab delayed clinical IA, and methotrexate improved function, symptoms and imaging inflammation. Vitamin D with or without omega 3 fatty acids reduced incidence of autoimmune diseases, including RA. While not proven in controlled clinical trials, observational studies suggest exercise, weight loss and smoking cessation may reduce progression to clinical RA.

Prediction and prevention of RA is advancing although there are no currently approved interventions for prevention. Future studies should include deeper evaluation of the pathophysiology of RA development to improve prediction and identify key pathways to target in future clinical trials, as well as develop infrastructure to support prevention-related research.
The Fragility of Statistical Findings in the Femoral Neck Fracture Literature: A Systematic Review of Randomized Controlled Trials
Authors: Yendluri Avanish , Megafu Michael N. , Wang Anya , Cordero John K. , Podolnick Jeremy D. , Forsh David A. , Tornetta Paul , Parisien Robert L.
Published: March 2024

Objectives:

Randomized controlled trials (RCTs) in the femoral neck fracture literature frequently reportp-values for outcomes which have substantial implications in guiding surgical management. This study utilized the fragility index (FI), reverse fragility index (rFI), and fragility quotient (FQ) to assess the statistical stability of outcomes reported in RCTs evaluating the management and treatment of femoral neck fractures.

Methods:

Data Sources: Pubmed, Emabse, and MEDLINE were queried for RCTs (January 1, 2010 to February 28th, 2023) that evaluated surgical management/treatment of femoral neck fractures. Study Selection: RCTs with two treatment arms reporting categorical dichotomous outcomes were included. Non-RCT studies, RCTs with greater than 2 treatment arms, and RCTs without a femoral neck fracture cohort were excluded.

Data Extraction and Synthesis: The FI and rFI were calculated as the number of outcome event reversals required to alter statistical significance for significant (p<0.05) and non-significant (p≥0.05) outcomes, respectively. The FQ was calculated by dividing the FI by the sample size for the study.

Results:

985 articles were screened with 71 studies included for analysis. The median FI across a total of 197 outcomes was 4 (IQR 2-5) with an associated FQ of 0.033 (IQR 0.017-0.060). 47 outcomes were statistically significant with a median FI of 2 (IQR 1-4) and associated FQ of 0.02 (IQR 0.014-0.043). 150 outcomes were statistically non-significant with a median rFI of 4 (IQR 3-5) and associated FQ of 0.037 (IQR 0.019-0.065).

Conclusion:

Statistical findings in femoral neck fracture RCTs are fragile with reversal of a median 4 outcomes altering significance of study findings. The authors thus recommend standardized reporting ofp-values with FI and FQ metrics to aid in interpreting the robustness of outcomes in femoral neck fracture RCTs.

Level of evidence:

Level I. See Instructions for Authors for a complete description of levels of evidence.
Predictors for Failure to Respond to Erector Spinae Plane Block Following Minimally Invasive Transforaminal Lumbar Interbody Fusion
Authors: Mai Eric , Zhang Joshua , Lu Amy Z. , Bovonratwet Patawut , Kim Eric , Simon Chad Z. , Kwas Cole , Allen Myles , Asada Tomoyuki , Singh Nishtha , Tuma Olivia , Araghi Kasra , Korsun Maximilian , Kim Yeo Eun , Heuer Annika , Vaishnav Avani , Dowdell James , Wetmore Douglas S. , Qureshi Sheeraz A. , Iyer Sravisht
Published: March 2024

Study Design.

Retrospective review of prospectively collected data.

Objective.

To identify the risk factors associated with failure to respond to erector spinae plane (ESP) block following minimally invasive transforaminal lumbar interbody fusion (MI-TLIF).

Summary of Background Data.

ESP block is an emerging opioid-sparing regional anesthetic that has been shown to reduce immediate postoperative pain and opioid demand following MI-TLIF—however, not all patients who receive ESP blocks perioperatively experience a reduction in immediate postoperative pain.

Methods.

This was a retrospective review of consecutive patients undergoing one-level MI-TLIF who received ESP blocks by a single anesthesiologist perioperatively at a single institution. ESP blocks were administered in the OR following induction. Failure to respond to ESP block was defined as patients with a first numerical rating scale (NRS) score postsurgery of >5.7 (mean immediate postoperative NRS score of control cohort undergoing MI TLIF without ESP block). Multivariable logistic regressions were performed to identify predictors for failure to respond to ESP block.

Results.

A total of 134 patients were included (mean age 60.6 yr, 43.3% females). The median and interquartile range (IQR) first pain score postsurgery was 2.5 (0.0–7.5). Forty-nine (36.6%) patients failed to respond to ESP block. In the multivariable regression analysis, several independent predictors for failure to respond to ESP block following MI TLIF were identified: female sex (OR 2.33, 95% CI 1.04-5.98, P=0.040), preoperative opioid use (OR 2.75, 95% CI 1.03-7.30, P=0.043), anxiety requiring medication (OR 3.83, 95% CI 1.27-11.49, P=0.017), and hyperlipidemia (OR 3.15, 95% CI 1.31-7.55, P=0.010).

Conclusions.

Our study identified several predictors for failure to respond to ESP block following MI TLIF, including female gender, preoperative opioid pain medication use, anxiety, and hyperlipidemia. These findings may help inform the approach to counseling patients on perioperative outcomes and pain expectations following MI-TLIF with ESP block.

Level of Evidence.

3
Can we yet use tertiary lymphoid structures as predictive biomarkers for immunotherapy response in melanoma?
Authors: Padonou Francine , Vanhulst Thila , Langouo-Fontsa Mireille D.
Published: March 2024

Purpose of review

In this review, we explore the potential of tertiary lymphoid structures (TLS) as predictive biomarkers in the response to immunotherapy for melanoma patients.

Recent findings

The significance of TLS as indicators predicting immunotherapy response becomes particularly pronounced. Melanoma, renowned for its aggressive characteristics, has undergone revolutionary transformations in treatment through immunotherapeutic interventions. Investigations have unveiled a compelling correlation between the presence of TLS in the melanoma tumor microenvironment and favorable responses to immunotherapy. These responses, characterized by heightened survival rates and improved clinical outcomes, imply that TLS might be pivotal in tailoring more efficient and personalized treatments for individuals with melanoma. The ongoing discourse regarding TLS as a predictive biomarker underscores the need for a meticulous examination of its potential in guiding clinical decisions and optimizing therapeutic strategies.

TLS show great promises as potential biomarkers to melanoma patient's outcomes in ICI treatment; however, more studies are needed to understand their mechanisms of actions and the long-term impact of their functionality.
Towards a Clearer Causal Question Underlying the Association Between Cancer and Dementia
Authors: Rojas-Saunero L. Paloma , van der Willik Kimberly D. , Schagen Sanne B. , Ikram M. Arfan , Swanson Sonja A.
Published: March 2024

Background:

Several observational studies have described an inverse association between cancer diagnosis and subsequent dementia risk. Multiple biologic mechanisms and potential biases have been proposed in attempts to explain this association. One proposed explanation is the opposite expression of Pin1 in cancer and dementia, and we use this explanation and potential drug target to illustrate the required assumptions and potential sources of bias for inferring an effect of Pin1 on dementia risk from analyses measuring cancer diagnosis as a proxy for Pin1 expression.

Methods:

We used data from the Rotterdam Study, a population-based cohort. We estimate the association between cancer diagnosis (as a proxy for Pin1) and subsequent dementia diagnosis using two different proxy methods and with confounding and censoring for death addressed with inverse probability weights. We estimate and compare the complements of a weighted Kaplan–Meier survival estimator at 20 years of follow-up.

Results:

Out of 3634 participants, 899 (25%) were diagnosed with cancer, of whom 53 (6%) had dementia, and 567 (63%) died. Among those without cancer, 15% (411) were diagnosed with dementia, and 667 (24%) died over follow-up. Depending on the confounding and selection bias control, and the way in which cancer was used as a time-varying proxy exposure, the risk ratio for dementia diagnosis ranged from 0.71 (95% confidence interval [CI] = 0.49, 0.95) to 1.1 (95% CI = 0.79, 1.3).

Conclusion:

Being explicit about the underlying mechanism of interest is key to maximizing what we can learn from this cancer-dementia association given available or readily collected data, and to defining, detecting, and preventing potential biases.
Recurrent alcohol-associated hepatitis is common and is associated with increased mortality
Authors: Gratacós-Ginès Jordi , Ruz-Zafra Pilar , Celada-Sendino Miriam , Martí-Carretero Aina , Pujol Clàudia , Martín-Mateos Rosa , Echavarría Víctor , Frisancho Luis E. , García Sonia , Barreales Mónica , Tejedor-Tejada Javier , Vázquez-Rodríguez Sergio , Cañete Nuria , Fernández-Carrillo Carlos , Valenzuela María , Martí-Aguado David , Horta Diana , Quiñones Marta , Bernal-Monterde Vanesa , Acosta Silvia , Artaza Tomás , Pinazo José , Villar-Lucas Carmen , Clemente-Sánchez Ana , Badia-Aranda Ester , Giráldez-Gallego Álvaro , Rodríguez Manuel , Sancho-Bru Pau , Cabezas Joaquín , Ventura-Cots Meritxell , Fernández-Rodríguez Conrado , Aguilera Victoria , Tomé Santiago , Bataller Ramon , Caballería Juan , Pose Elisa ,   REHALC Registry investigators
Published: March 2024

Background and Aims:

Alcohol relapse after surviving an episode of alcohol-associated hepatitis (AH) is common. However, the clinical features, risk factors, and prognostic implications of recurrent alcohol-associated hepatitis (RAH) are not well described.

Approach and Results:

A registry-based study was done of patients admitted to 28 Spanish hospitals for an episode of AH between 2014 and 2021. Baseline demographics and laboratory variables were collected. Risk factors for RAH were investigated using Cox regression analysis. We analyzed the severity of the index episodes of AH and compared it to that of RAH. Long-term survival was assessed by Kaplan-Meier curves and log-rank tests. A total of 1118 patients were included in the analysis, 125 (11%) of whom developed RAH during follow-up (median: 17 [7–36] months). The incidence of RAH in patients resuming alcohol use was 22%. The median time to recurrence was 14 (8–29) months. Patients with RAH had more psychiatric comorbidities. Risk factors for developing RAH included age <50 years, alcohol use >10 U/d, and history of liver decompensation. RAH was clinically more severe compared to the first AH (higher MELD, more frequent ACLF, and HE). Moreover, alcohol abstinence during follow-up was less common after RAH (18% vs. 45%, p<0.001). Most importantly, long-term mortality was higher in patients who developed RAH (39% vs. 21%, p = 0.026), and presenting with RAH independently predicted high mortality (HR: 1.55 [1.11–2.18]).

Conclusions:

RAH is common and has a more aggressive clinical course, including increased mortality. Patients surviving an episode of AH should undergo intense alcohol use disorder therapy to prevent RAH.
Short-duration dynamic power training with elastic bands combined with endurance training: a promising approach to hypertension management in older adults
Authors: Bavaresco Gambassi Bruno , Chaves Luiz Filipe Costa , Sousa Thiago Matheus da Silva , Ribeiro Maria Jacqueline Silva , Souza Thiago Antonio , Schwingel Paulo Adriano
Published: March 2024

Previous studies have investigated the effects of different combined training programs involving traditional resistance training and aerobic exercise on hemodynamic parameters and arterial stiffness in older adults. However, little is known about the impact of power training combined with endurance training on these variables in hypertensive older adults. Therefore, this study aimed to investigate the effects of dynamic power training with elastic bands combined with endurance training on arterial stiffness and hemodynamic parameters in hypertensive older adults. Twenty-six participants were randomly assigned to the control group (CG; n = 13) and the intervention group (n = 13). IG participants performed power training with elastic bands combined with endurance training twice a week for 8 weeks. Pulse pressure, central pulse pressure, pulse wave velocity, SBP, DBP, central SBP, and central DBP were assessed before and after 8 weeks using the triple pulse wave velocity method. Pulse pressure, central pulse pressure, pulse wave velocity, SBP, DBP, central SBP, and central DBP significantly improved after 8 weeks of intervention (P < 0.05). These findings indicate that power training with elastic bands combined with endurance training reduces arterial stiffness and significantly improves hemodynamic parameters in older adults diagnosed with grade 1 hypertension. In addition, underscores the potential of this approach as a promising strategy for the management of hypertension in older adults.
Surgical drainage methods during pars plana vitrectomy for rhegmatogenous retinal detachment: a systematic review and meta-analysis
Authors: Grad Justin R. , Hatamnejad Amin , Huan Peter W. , Popovic Marko M. , McKay Bryon R. , Kertes Peter J. , Muni Rajeev H.
Published: March 2024

Purpose:

To assess efficacy and safety outcomes of subretinal fluid drainage methods during pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD).

Methods:

A systematic search strategy was conducted of studies published between January 2000 and October 2022. Included studies reported on either the safety or efficacy of two or more drainage methods during PPV for RRD patients.

Results:

Two randomized and five observational studies consisting of 1524 eyes were included. Best corrected visual acuity at last study observation and primary reattachment rate were similar across groups. A significantly lower risk of epiretinal membrane formation (ERM) was associated with draining subretinal fluid through pre-existing retinal breaks (PRB) (RR= 0.70, 95% CI=[0.60, 0.83], p=<0.01, I2=0%) or with perfluorocarbon liquid (PFCL) (RR=0.70, 95% CI=[0.59, 0.83], p=<0.01, I2=0%) compared to posterior retinotomy (PR). The risk of an abnormal foveal contour was significantly greater in PFCL-treated eyes relative to PR (RR=1.56, 95% CI=[1.13, 2.17], p=<0.01, I2=0%).

Conclusions:

No significant differences were observed in final BCVA at last study observation and primary reattachment rates across different drainage methods. There remains limited information on the topic and future research is warranted.
Visual Outcomes after Internal Limiting Membrane Peeling vs. Flap in the Closure of Full Thickness Macular Holes
Authors: Suarez Mallory K. , Wang Sean K. , Hayes Bartlett , Greven Margaret A. , Shah Rajiv E. , Greven Craig , Russell Greg , Ong Sally S.
Published: March 2024

Purpose:

To examine postoperative outcomes of internal limiting membrane peeling (ILMP) versus flap (ILMF) in the closure of full thickness macular holes (FTMH).

Methods:

Retrospective chart review of patients who underwent pars plana vitrectomy and gas tamponade with ILMP or ILMF to close FTMH at the Atrium Health Wake Forest Baptist from January 2012 to October 2022 with at least 3 months follow up. Main outcome measures were type 1 primary FTMH closure and postoperative best corrected visual acuity (BCVA) in mean logMAR.

Results:

130 and 30 eyes underwent ILMP and ILMF respectively. There were no significant differences in baseline characteristics between the groups. 96% of ILMP eyes and 90% of ILMF eyes achieved primary hole closure (p=0.29). Among all eyes with primary hole closure, BCVA at 1 year was not different between the groups but when stratified by lens status, was superior in the ILMP versus ILMF group in pseudophakic eyes: the estimated least-squares mean BCVA (Snellen equivalent) [95% confidence interval] was 0.42 (20/50) [0.34, 0.49] in the ILMP group and 0.71 (20/100) [0.50, 0.92] in the ILMF group.

Conclusions:

ILMP and ILMF techniques yielded similarly high FTMH closure rates. In pseudophakic eyes with primary hole closure, ILMF eyes had worse BCVA at 1 year.
Rahnella Aquatilis Endophthalmitis after Intravitreal Injection in an Immunocompetent Patient
Authors: Williams Parker J. , Xue Gilbert , Ross Bing X. , White Erika , Shammas Lisa , Yoganathan Pradeepa , Chapman Christopher , Lin Xihui
Published: March 2024

Purpose:

To present a novel case of exogenous Rahnella aquatilis endophthalmitis following an intravitreal injection.

Methods:

Case report

Results:

A 74-year-old male presented with acute progressive vision loss and pain in the left eye, 5 days after an intravitreal injection for diabetic macular edema. The patient was diagnosed with exogenous endophthalmitis and empirically treated with intravitreal injections of vancomycin and ceftazidime as well as topical and oral ciprofloxacin. In follow up two days later, the patient was treated with preoperative povidone-iodine followed by prompt vitrectomy with additional vancomycin and ceftazidime due to pharmacy sterile hood issues that delayed antibiotic availability. Microbiological cultures and two mass spectrometry identification tests confirmed the diagnosis of exogenous Rahnella aquatilis endophthalmitis. Despite the presence of scattered retinal hemorrhagic infarcts involving the macula and subsequent full-thickness atrophic macular holes seen in follow up, the patient achieved a favorable anatomical and functional outcome of BCVA 20/80 at 1 year of follow-up.

Conclusion:

This case highlights the occurrence of exogenous Rahnella aquatilis endophthalmitis following an intravitreal injection for diabetic macular edema. Prompt diagnosis and treatment produced a favorable outcome relative to other typical Gram-negative Enterobacteriaceae organisms.
Scheimpflug-Based Tomographic Risk Factors for the Development of Acute Corneal Hydrops in Keratoconus
Authors: Yu Sarah N. , Gad Rania , Kutler Rachel , Trief Danielle
Published: March 2024

Purpose:

The purpose of this study was to assess the risk factors that predispose patients with keratoconus to develop acute corneal hydrops (ACH), including both clinical and tomographic risk factors. We additionally describe tomographic changes of the cornea over time after ACH.

Methods:

We retrospectively reviewed patients with keratoconus who were followed at our institution from January 2015 to May 2023. Control eyes, defined as eyes with advanced keratoconus (stage IV Amsler–Krumeich classification on initial examination) were compared with eyes that developed ACH. Demographic, clinical, and tomographic factors were investigated. Visual acuity, keratometry, and corneal thickness were assessed at each follow-up visit to monitor progression over time.

Results:

Twenty-three eyes of 19 patients developed ACH over the follow-up period. The incidence of known clinical associations including seasonal allergies, eye rubbing, snoring, asthma, and eczema was similar between the hydrops and control groups. There was a higher incidence of Down syndrome in the hydrops group (P = 0.04). Eyes that developed hydrops had similar best corrected visual acuity on initial examination, but had steeper keratometry (P = 0.003) and thinner corneas (P < 0.001) than controls at baseline. After hydrops, progressive corneal flattening and reduced maximum keratometry occurred over time. However, final best corrected visual acuity was worse compared with initial examination before hydrops (P = 0.03), as well as compared with control eyes (P < 0.001).

Conclusions:

Risk factors of developing ACH include steep keratometry and thin corneas as well as Down syndrome. Although corneal flattening will occur after resolution of acute corneal edema, visual acuity worsened after ACH.