bluuebunny/crossref_metadata_2025 huggingface dataset:
Death zone minimizes the impact of fipronil-treated soils on subterranean termite colonies by negating transfer effects
Authors: Chouvenc Thomas
Published: July 2024

The use of nonrepellent liquid termiticides against subterranean termites has long relied on the assumption that foraging termites in soils could transfer toxicants to nestmates to achieve population control. However, their dose-dependent lethal time can lead to rapid termite mortality in proximity of the treatment, triggering secondary repellency. The current study characterizes the dynamic nature of the “death zone,” i.e., the area adjacent to soil termiticides that termites would avoid owing the accumulation of cadavers. Using whole subterranean termite laboratory colonies of Coptotermes gestroi (Wasmann) with 3 × 15 m foraging distances, fipronil was implemented at 1.5 m, 7.5 m, or 12.5 m away from colony central nests, emulating a corrective action against an termite structural infestation. For treatments at 7.5 m and 12.5 m, the death zone stabilized at an average of ~2.56 m away from the treatment after 40 d post-treatment, and colonies suffered as little as 1.5% mortality by 200 d post-treatment. Colonies located 1.5 m away from the treatment minimized the death zone to ~1.1 m and suffered as little as 23.5% mortality. Mortality only occurred within the first few days of treatment from initial exposure, as the rapid emergence of the death zone negated further transfer effects among nestmates over time. In some cases, foraging termites were trapped within the infested structure. While technically nonrepellent, fipronil becomes functionally repellent from the rapid mortality onset near the treatment. Even if diligently implemented to successfully protect structures, surrounding termite colonies are minimally impacted by fipronil soil treatments.
Sustainable production of 2,3,5,6-Tetramethylpyrazine at high titer in engineered Corynebacterium glutamicum
Authors: Srinivasan Aparajitha , Chen-Xiao Kevin , Banerjee Deepanwita , Oka Asun , Pidatala Venkataramana R , Eudes Aymerick , Simmons Blake A , Eng Thomas , Mukhopadhyay Aindrila
Published: July 2024

The industrial amino acid production workhorse, Corynebacterium glutamicum naturally produces low levels of 2,3,5,6-tetramethylpyrazine (TMP), a valuable flavor, fragrance, and commodity chemical. Here, we demonstrate TMP production (∼0.8 g L−1) in C. glutamicum type strain ATCC13032 via overexpression of acetolactate synthase and/or α-acetolactate decarboxylase from Lactococcus lactis in CGXII minimal medium supplemented with 40 g L−1 glucose. This engineered strain also demonstrated growth and TMP production when the minimal medium was supplemented with up to 40% (v v−1) hydrolysates derived from ionic liquid-pretreated sorghum biomass. A key objective was to take the fully engineered strain developed in this study and interrogate medium parameters that influence the production of TMP, a critical post-strain engineering optimization. Design of experiments in a high-throughput plate format identified glucose, urea, and their ratio as significant components affecting TMP production. These two components were further optimized using response surface methodology. In the optimized CGXII medium, the engineered strain could produce up to 3.56 g L−1 TMP (4-fold enhancement in titers and 2-fold enhancement in yield, mol mol−1) from 80 g L−1 glucose and 11.9 g L−1 urea in shake flask batch cultivation.

One-Sentence Summary

Corynebacterium glutamicum was metabolically engineered to produce 2,3,5,6-tetramethylpyrazine followed by a design of experiments approach to optimize medium components for high-titer production.
Effects of cold and hot temperatures on the renal function of people with chronic disease
Authors: Park Min Young , Ahn Joonho , Bae S , Chung B H , Myong Jun-Pyo , Lee Jongin , Kang Mo-Yeol
Published: July 2024

Objectives

This study investigated the effects of hot and cold temperature on the renal function of people with chronic diseases, such as diabetes, hypertension, and chronic kidney disease, using large-scale clinical data.

Methods

We used retrospective cohort data from the Clinical Data Warehouse of the Seoul St Mary’s Hospital, which contains clinical, diagnostic, laboratory, and other information about all patients who have visited the hospital since 1997. We obtained climate data from the Automated Synoptic Observing System of the Korea Meteorological Administration. The heat index was used as a measuring tool to evaluate heat exposure by indexing the actual heat that individuals feel according to temperature and humidity. The estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. To investigate changes in renal function trends with heat index, this study used generalized additive mixed models.

Results

Renal function decreased linearly with increasing heat index after approximately 25°C, which was considered the flexion point of temperature. A linear decrease in the eGFR was observed with the effects of 0 to 5 lag days. Although there was a correlation observed between the decrease in eGFR and temperatures below −10°C, the results did not indicate statistical significance.

Conclusions

The results of our study provide scientific evidence that high temperatures affect the renal function of people with chronic diseases. These results can help prevent heat-related morbidity by identifying those who are more likely to develop renal disease and experience worsening renal function.
Remitting through crisis: Looking beyond resilience in UK migrant and diaspora communities
Authors: Lindley Anna , Datta Kavita , Chase Elaine , Fadal Kaltun , Hammond Laura , Loureiro Gabriela , Majeed-Hajaj Saliha
Published: July 2024

Migrants’ remittances have often been understood to operate as a form of insurance for families, communities and countries of origin, increasing in times of downturn and disaster. But what happens when the same crisis hits both destination and origin countries simultaneously? During the Covid-19 pandemic, despite early expectations of a dramatic contraction, official recorded remittances were characterized as remarkably a ‘resilient’ financial flow. This article investigates the people and processes behind remittances through the crisis. Drawing on micro-level mixed-methods primary research in the UK, we investigate indications of community-level resilience in migrants’ remittance practices, highlighting that perceptions of rising needs abroad added fuel to people’s desire to remit, while diverse economic capacities also mediated remittance sending. Both a strong sense of meaning and connection, and the stresses of managing multiple needs at home and abroad, were apparent in diaspora accounts of sending remittances. While money ultimately continued to flow, through this as through many other crises, the discourse of remittance resilience risks eclipsing the major challenges navigated by migrant communities. The relevance to research and policy in the context of the contemporary cost-of-living crisis is explored.
Robustness of direct measurements of the mean free path of ionizing photons in the epoch of reionization
Authors: Satyavolu Sindhu , Kulkarni Girish , Keating Laura C , Haehnelt Martin G
Published: July 2024

Measurements of the mean free path of Lyman-continuum photons in the intergalactic medium during the epoch of reionization can help constrain the nature of the sources as well as sinks of hydrogen-ionizing radiation. A recent approach to this measurement has been to utilize composite spectra of multiple quasars at $z\sim 6$, and infer the mean free path after correcting the spectra for the presence of quasar proximity zones. This has revealed not only a steep drop in the mean free path from $z=5$ to $z=6$, but also potentially a mild tension with reionization simulations. We critically examine such direct measurements of the mean free path for biases due to quasar environment, incomplete reionization, and quasar proximity zones. Using cosmological radiative transfer simulations of reionization combined with one-dimensional radiative transfer calculations of quasar proximity zones, we find that the bias in the mean free path due to overdensities around quasars is minimal at $z\sim 6$. Patchiness of reionization at this redshift also does not affect the measurements significantly. Fitting our model to the data results in a mean free path of $\lambda _{\mathrm{mfp}}=1.49^{+0.47}_{-0.52}$ pMpc at $z=6$, which is consistent with the recent measurements in the literature, indicating robustness with respect to the modelling of quasar proximity zones. We also compare various ways in which the mean free path has been defined in simulations before the end of reionization. Overall, our finding is that recent measurements of the mean free path appear to be robust relative to several sources of potential bias.
Metasomatic Interaction of Ultramafic Mantle Xenoliths with their Felsic HP–UHT Granulite Host (Moldanubian Domain, Bohemian Massif in Lower Austria)
Authors: ZelinkovÁ Tereza , Racek Martin , JanouŠek VojtĚch , ŠtÍpskÁ Pavla , Abart Rainer , Asenbaum Rene
Published: July 2024

The St. Leonhard granulite massif in Lower Austria, dominantly formed by kyanite-bearing felsic granulite, encloses countless up to 5 cm sized mantle xenoliths of garnet clinopyroxenite and peridotite. The mineralogical, textural and chemical consequences of a mutual metasomatic interaction at the contact between these xenoliths and the host orthopyroxene-bearing felsic granulite are described. Movement of Mg, Al and, especially, Ca from the garnet clinopyroxenite to the granulite and migration of K and Na in the opposite direction, caused the breakdown of clinopyroxene and formation of orthopyroxene–plagioclase symplectite coronae at the expense of the garnet clinopyroxenite xenoliths. Around the peridotite xenoliths, monomineralic orthopyroxene coronae have developed due to the supply of Si from the host granulite. The P–T conditions of this interaction were established to 900°C to 1000°C and 1.0 to 1.2 GPa by thermodynamic modelling. The duration of coronae growth was constrained to 13 to 532 ka based on modelling of Fe–Mg interdiffusion underlying secondary compositional zoning of garnet from the garnet clinopyroxenite xenolith extending to the coronae. The most significant change in the host granulite was caused by the supply of Ca from the garnet clinopyroxenite xenolith, which led to the breakdown of the Al2SiO5 phase—probably kyanite—and stabilization of orthopyroxene. K-feldspar-poor haloes surrounding mantle xenoliths formed due to the depletion of K in the granulite adjacent to the garnet clinopyroxenite. The observed origin of felsic–intermediate orthopyroxene-bearing granulite by transformation of felsic kyanite-bearing granulite through the metasomatic interaction with mantle xenoliths implies that the deep crustal chemical exchange between mantle- and crust-derived lithologies may have an important consequences on composition, thermal structure and geodynamic evolution of orogenic lower crust especially in hot collisional orogens, such as the European Variscides.
A national survey of rheumatology telephone advice line support in the United Kingdom: frontline perspectives
Authors: Ryan Sarah , Hider Samantha , Tavernor Jay , Hassell Andrew
Published: July 2024

Objectives

Telephone advice lines are a key component of rheumatology services. A national survey of telephone advice line providers was undertaken to explore how this service is currently delivered and the impact on those delivering it to inform providers, policymakers and patients.

Methods

We conducted an online survey between March and September 2023 collecting data on demographics, how advice lines function, governance and the impact on nurses’ well-being. Data were analysed using descriptive statistics.

Results

A total of 123 health professionals completed the survey. The majority were rheumatology nurses [n = 118 (96%)], >45 years of age [n = 112 (91%)], band ≥7 [n = 92 (76%)], with 77 (65%) reporting >10 years of experience within rheumatology. Most advice lines operated weekdays only [n = 93 (79%)], with most calls returned within 2 days [n = 81 (66%)], although some callers waited >7 days [n = 19 (15%)]. The number of calls received monthly ranged from 100 to >800, with 46 (37%) responders reporting >500 calls/month. The most common reasons for contacting advice lines were disease activity, pain and medication concerns. For most responders, governance arrangements were unclear [n = 72 (61%)]. Providing advice lines impacted on the well-being of nurses providing the service: 89 (72%) felt anxious ‘sometimes to mostly’ and 79 (64%) found it ‘mostly–always’ stressful. A total of 85 (69%) nurses had not received any training to manage advice lines.

Conclusion

Although telephone advice lines are provided by experienced rheumatology nurses, high demand is impacting on well-being. Having designated training could equip nurses with additional skills to manage increased capacity and monitor their own well-being.
On the uncertainty in numerical modeling of wireless communication devices operating at frequencies of 900 MHz, 1800 MHz, and 28 GHz
Authors: Christ Andreas , Keshvari Jafar
Published: July 2024

Some of the difficulties in numerical modeling of wireless communication devices for dosimetric evaluations arise from, e.g. incomplete documentation available for the numerical model, such as missing information on dielectric materials or the antenna matching circuitry. This study investigates the impact of these difficulties on the dosimetric results, such as the peak spatial average specific absorption rate at 900 and 1800 MHz and the peak spatial average power density at 28 GHz. The impact of dielectric losses, detuning, and mesh resolution is quantified using different generic and Computer Aided Design (CAD) based models of wireless transmitters. The findings show that the uncertainties of the numerical results due to detuning and mesh resolution can be reduced by normalization to the antenna feedpoint power instead of the feedpoint current. Uncertainties due to variations in dielectric losses can largely be compensated by normalization to the radiated power.
Making Sense of Recovery From First Psychosis With Antipsychotic Medication: A Qualitative Phenomenological Study
Authors: Dijkstra Stéphanie Astrid , Rijkeboer Jennifer , Noordhof Arjen , Boyette Lindy-Lou , Berendsen Steven , de Koning Mariken , Bennen Romy Liza Japien , Hofman Tim , de Haan Lieuwe
Published: July 2024

Background and Hypothesis

Recovering from a first psychosis is a highly individual process and requires the person to make sense of their experiences. Clinicians, in turn, need to comprehend these first-person perspectives, creating a mutual sense-making dynamic. Antipsychotic medication is a substantial part of psychosis treatment. Providing insight in the lived experience of recovery with antipsychotics could improve the mutual understanding and help bridge the gap between the perspective of the clinician and that of the person recovering from psychosis.

Study Design

14 persons in recovery from a first psychosis with the use of antipsychotics were interviewed. Their narratives were analyzed using Interpretative Phenomenological Analysis (IPA).

Study Results

Five overarching themes were found, representing important and meaningful experiences in recovering with antipsychotic medication. Theme 1: antipsychotics as external dampening (4 subthemes); Theme 2: shifting of realities; Theme 3: pace of recovery; Theme 4: antipsychotics’ influence on identity; and Theme 5: is it truly the antipsychotics?

Conclusions

Our findings show that recovery from psychosis with antipsychotics is an all-encompassing, multi-faceted, and ambivalent experience. The themes found in this research could inspire clinicians to discuss less obvious aspects of the experience of recovering with antipsychotics. Even more so, paying attention to the first-person perspective could lead to a more thorough understanding and benefit therapeutic relationships.
Amentoflavone regulates the miR-124-3p/CAPN2 axis to promote mitochondrial autophagy in HCC cells
Authors: Zhu Fengting , Jiang Jingwen , Chen Xuewu , Fu Lei , Liu Hui , Zhang Hui
Published: July 2024

Background: Hepatocellular carcinoma (HCC) is a disease with poor prognosis and high mortality. Amentoflavone (AF) possesses the characteristics of marginal toxicity, stable curative effect, and good anti-HCC activity. This study aimed to evaluate the molecular mechanism of AF inhibiting HCC and provide a new idea for HCC treatment. Methods: Clinical tissue of HCC was collected. AF was given with HCC cells, and transfected with corresponding vectors. MiR-124-3p expression in HCC clinical samples and cells was ascertained by qRT-PCR assay. HCC cells viability was identified by CCK-8 assay. LC3 protein expression was ascertained by immunofluorescence assay. The expressions of CAPN2, β-catenin and mitochondrial autophagy-related proteins were detected by western blot. Dual-luciferase reporter gene assay confirmed the targeting relationship of miR-124-3p and CAPN2. Results: MiR-124-3p expression was inhibited and CAPN2 expression was increased in HCC tissues and cells. AF decreased HCC cell viability, up-regulated miR-124-3p expression, and inhibited CAPN2 expression and β-catenin nuclear transcription. Moreover, AF could activate the mitochondrial autophagy of HCC cells. MiR-124-3p specifically regulated CAPN2 expression. This study found that CAPN2 could promote β-catenin nuclear translocation, thus activating wnt/β-catenin pathway to inhibit mitochondrial autophagy in HCC cells. MiR-124-3p mimics enhanced AF function in promoting mitochondrial autophagy in HCC cells. However, CAPN2 overexpression, miR-124-3p inhibitor and SKL2001 attenuated the effectiveness of AF. Conclusion: This study confirmed that AF regulated miR-124-3p/CAPN2 axis to restraint β-catenin nuclear translocation and then inhibit the wnt/β-catenin pathway, thereby promoting mitochondrial autophagy in HCC.
Predictors of Alcohol Use, Alcohol-Related Problems, and Substance Use Following Adolescent Metabolic and Bariatric Surgery
Authors: White Gretchen E. , Boles Richard E. , Courcoulas Anita P. , Inge Thomas H. , Yanovski Susan Z. , Jenkins Todd M. , Zeller Meg H.
Published: July 2024

Objective:

To identify factors associated with incident alcohol consumption, hazardous drinking, alcohol-related problems, and substance use up to 8 years following metabolic and bariatric surgery (MBS) during adolescence.

Background:

In this cohort, nearly half of those who underwent MBS as adolescents screened positive for alcohol use disorder, symptoms of alcohol-related harm, or alcohol-related problems within 8 years post-surgery. Moreover, persistent or heavy marijuana use following MBS during adolescence is higher than national data.

Methods:

This study includes 217 adolescents (aged 13–19 years) enrolled in a 5-center prospective cohort study who underwent Roux-en-Y gastric bypass or vertical sleeve gastrectomy between 2007 and 2011 and were followed for up to 8 years. Participants self-reported alcohol use via the Alcohol Use Disorders Identification Test and substance use for up to 8 years.

Results:

Female sex, pre-surgery lower body mass index, and pre-surgery substance use were independently associated with increased risk of incident post-surgery hazardous drinking. Pre-surgery psychiatric counseling was significantly associated with increased risk for new-onset substance use post-surgery. Starting substance use post-surgery or continuing pre- to post-surgery was independently associated with a higher risk of post-surgery hazardous drinking. Greater percent weight loss, starting post-surgery or continuing pre- to post-surgery psychiatric counseling, using alcohol, and hazardous drinking were independently associated with a higher risk of post-surgery substance use.

Conclusions:

Future research with a nonsurgical control group should be examined to further elucidate the relationships between MBS and alcohol and substance use following surgery during adolescence.
Evaluating the Accuracy, Quality, and Readability of Online Breast Cancer Information
Authors: Valencia Elsie A. , Cortina Chandler S. , Cobb Adrienne N. , Chaudhary Lubna N. , Kelly Tracy , Kong Amanda L.
Published: July 2024

Objective:

To assess the accuracy, quality, and readability of patient-focused breast cancer websites using expert evaluation and validated tools.

Background:

Ensuring access to accurate, high-quality, and readable online health information supports informed decision-making and health equity but has not been recently evaluated.

Methods:

A qualitative analysis on 50 websites was conducted; the first 10 eligible websites for the following search terms were included: “breast cancer,” “breast surgery,” “breast reconstructive surgery,” “breast chemotherapy,” and “breast radiation therapy.” Websites were required to be in English and not intended for healthcare professionals. Accuracy was evaluated by 5 breast cancer specialists. Quality was evaluated through the DISCERN questionnaire. Readability was measured using 9 standardized tests. Mean readability was compared with the American Medical Association and National Institutes of Health 6th grade recommendation.

Results:

Nonprofit hospital websites had the highest accuracy (mean = 4.06, SD = 0.42); however, no statistical differences were observed in accuracy by website affiliation (P = 0.08). The overall mean quality score was 50.8 (“fair”/“good” quality) with no significant differences among website affiliations (P = 0.10). Mean readability was at the 10th grade reading level, the lowest being for commercial websites with a mean 9th grade reading level (SD = 2.38). All websites exceeded the American Medical Association- and National Institutes of Health-recommended reading level by 4.4 levels (P < 0.001). Websites with higher accuracy tended to have lower readability levels, whereas those with lower accuracy had higher readability levels.

Conclusion:

As breast cancer treatment has become increasingly complex, improving online quality and readability while maintaining high accuracy is essential to promote health equity and empower patients to make informed decisions about their care.
Near-Peer Coaching to Enhance Operative Learning: An Educational Innovation for Surgical Training
Authors: Papachristos Alexander J. , Molloy Elizabeth , Chui Juanita N. , Ghidinelli Monica , Kitto Simon , Nestel Debra , Loveday Benjamin P. T.
Published: July 2024

Objective:

To design, implement, and evaluate a near-peer coaching model to enhance operative learning in general surgery training.

Background:

There is an urgent need to maximize operative learning in surgical education. Trainees find barriers to operative learning difficult to navigate and often sacrifice educational opportunities for the sake of impression management.

Methods:

A prospective cohort study was conducted over a 6-month period following design and implementation of a trainee-led near-peer coaching model; “SPICE” (Set goals, Plan, Imagine, Comment and feedback, Evaluate and reflect). Semistructured interviews were conducted to explore trainees’ experiences of the model.

Results:

Twelve trainees participated in the study. The near-peer coaching encounters provided trainees with the psychological safety to be honest about learning needs, validated insecurities, and mitigated the pressures associated with impression management that consistently shaped consultant–trainee relationships. Trainees described improved operative performance, increased self-confidence, and a greater ability to adapt to the unexpected. Trainees adapted the use of the SPICE model to conventional consultant–trainee dynamics, which facilitated learning conversations and negotiation of operative opportunities. On a broader scale, trainees noticed an improvement in the teaching culture of the unit, describing that the use of the model legitimized the importance of perioperative learning conversations and increased consultant enthusiasm for teaching.

Conclusions:

Near-peer coaching created a unique psychological safety that facilitated authentic reflection and goal setting and improved trainee confidence. The benefits of the SPICE model were translated to other contexts and facilitated entrustment in conventional consultant–trainee relationships.
Lisfranc Open Reduction and Internal Fixation
Authors: DeGenova Daniel T. , Mennona Steven , Jones Travis J. , Hoffman Adam , Davis Trent , Cantor Nikki , Taylor Benjamin C.
Published: July 2024

Lisfranc injuries are an uncommon injury of the midfoot that can occur after a low-energy or high-energy mechanisms. There often a wide spectrum of injury ranging from a sprain to a sever fracture dislocation. Treatment of displaced Lisfranc injuries is often operative with the mainstays of treatment being open reduction and internal fixation versus arthrodesis. We describe a stepwise and reproducible approach of open reduction and internal fixation in a 20-year-old man with a severe Lisfranc fracture dislocation injury.

Video available at:

https://ota.org/education/ota-online-resources/video-library-procedures-techniques/lisfranc-open-reduction-and.
Distal Clavicle Fracture Repair Utilizing Plate and Suture-Button Fixation: Optimizing Intraoperative Fluoroscopy
Authors: Ghanem Diane , Marrache Majd , Rogers Davis , Shafiq Babar
Published: July 2024

This is the case of a 44-year-old healthy right-hand–dominant man who fell off his mountain bike and sustained a right distal third clavicle fracture, classified as a type IIB (modified Neer Classification), with rupture of the coracoclavicular ligaments and vertical instability of the medial segment. The report demonstrates open reduction and internal fixation of the distal clavicle with a superior plate and coracoclavicular suture–button placement with a focus on optimizing intraoperative fluoroscopy. The use of optimal fluoroscopic views provides reproducible visualization of the coracoid base, greatly facilitating optimal suture-button placement to reduce the risk of coracoid fracture.

Video available at:

https://ota.org/education/ota-online-resources/video-library-procedures-techniques/distal-clavicle-fracture-repair
Operative Management of Atypical Femur Fractures
Authors: Coscia Atticus , Wilson Jenna , Muscatelli Stefano , Hake Mark
Published: July 2024

Atypical femur fractures represent a distinct clinical entity from other geriatric and fragility fractures. Cephalomedullary nailing is the preferred means of fixation. Anatomic reduction is key to avoiding delayed healing and nonunion.

Video available at:

https://ota.org/education/ota-online-resources/video-library-procedures-techniques/operative-management-atypical#/+/0/score,date_na_dt/desc/
Social Vulnerability Index Provides Greater Granularity Compared With the Area Deprivation Index When Assessing Outcomes Following Elective Lumbar Fusion
Authors: Yang Phillip T. , Shaikh Hashim , Akoto Alexander , Menga Emmanuel N. , Molinari Robert W. , Rubery Paul T. , Puvanesarajah Varun
Published: July 2024

Study Design.

Retrospective review of a single institution cohort.

Objective.

To determine whether area deprivation index (ADI) or social vulnerability index (SVI) is more suitable for evaluating minimum clinically important difference (MCID) achievement following elective lumbar fusion as captured by the Patient-Reported Outcomes Measurement Information System (PROMIS).

Summary of Background Data.

A total of 182 patients who underwent elective one-level to two-level posterior lumbar fusion between January 2015 and September 2021.

Materials and Methods.

ADI and SVI values were calculated from patient-supplied addresses. Patients were grouped into quartiles based on values; higher quartiles represented greater disadvantage. MCID thresholds for Pain Interference (PI) and Physical Function (PF) were determined through a distribution-based method. Multivariable logistic regression was performed to identify factors impacting MCID attainment. Univariate logistic regression was performed to determine which themes comprising SVI values affected MCID achievement. Statistical significance was set at P<0.05.

Results.

Multivariable logistic regression demonstrated that ADI and SVI quartile assignment significantly impacted achievement of MCID for PI (P=0.04 and 0.01, respectively) and PF (P=0.03 and 0.02, respectively). Specifically, assignment to the third ADI and SVI quartiles were significant for PI (OR: 0.39 and 0.23, respectively), and PF (OR: 0.24 and 0.22, respectively). Race was not a significant predictor of MCID for either PI or PF. Univariate logistic regression demonstrated that among SVI themes, the socioeconomic status theme significantly affected achievement of MCID for PI (P=0.01), while the housing type and transportation theme significantly affected achievement of MCID for PF (P=0.01).

Conclusion.

ADI and SVI quartile assignment were predictors of MCID achievement. While ADI and SVI may both identify patients at risk for adverse outcomes following lumbar fusion, SVI offers greater granularity in terms of isolating themes of disadvantage impacting MCID achievement.
Impact of sentinel node use in lymphedema formation among gynecologic cancer patients
Authors: Gracia Myriam , Alonso-Espías María , Zapardiel Ignacio
Published: July 2024

Purpose of review

The most common surgical procedure associated with lymphedema formation is the regional lymphadenectomy. One of the advantages of sentinel node biopsy is the reduction of the risk of lymphedema formation. The purpose of this review is to collect and analyze the most relevant and recent evidence of the use of sentinel node biopsy and its implication on the development of postoperative lymphedema in gynecological cancer.

Recent findings

The current evidence of the use of sentinel node biopsy in cervical cancer to reduce lymphedema is heterogeneous and more data is needed to establish its role.

Sentinel lymph node biopsy in endometrial cancer is a staging procedure with lower surgical complications, as well as lymphedema formation; while the results of prospective trials evaluating its impact on quality of life are still lacking.

Sentinel lymph node biopsy in vulvar cancer minimizes the need for extensive dissection and reduces the incidence of complications associated with overharvesting of lymph nodes such as lymphedema without compromising oncological outcomes.

The prevalence of lymphedema in gynecological cancer varies based on the surgical treatment or additional therapies applied. Over the past years, one of the most important surgical modifications to decrease lymphedema formation has been implementation of sentinel lymph node technique mainly in vulvar cancer patients.
Benefits of sentinel node detection in cervical cancer
Authors: Alonso-Espías María , Gracia Myriam , Zapardiel Ignacio
Published: July 2024

Purpose of review

Sentinel lymph node biopsy (SLNB) is a widely used technique in other gynaecological tumours but has not yet been implemented as the gold standard technique for nodal staging in cervical cancer. Since the majority of evidence is derived from retrospective studies, this review aims to summarize the most recent evidence on this relevant topic.

Recent findings

SLNB has demonstrated to be a well tolerated technique for lymph node staging in early-stage cervical cancer patients with promising future as exclusive lymph node assessment method avoiding full lymphadenectomy. Moreover, it allows ultrastaging and unfrequent drainage identification, which enables the detection of patients at a high risk of recurrence who would otherwise remain unnoticed. When compared with pelvic lymphadenectomy, SLNB is also associated with less intraoperative and postoperative complications, especially in terms of lymphedema formation.

The available evidence suggests that SLNB offers numerous advantages over the standard pelvic lymphadenectomy reducing morbidity rates and increasing diagnostic accuracy. Three ongoing prospective trials will likely answer the controversies over these questions.
What is the best salvage therapy for Hodgkin lymphoma?
Authors: Luttwak Efrat , Moskowitz Alison J.
Published: July 2024

Purpose of review

Historically, salvage chemotherapy followed by high-dose chemotherapy and autologous stem cell transplant (HDT/ASCT) was the mainstay approach for relapsed or refractory classic HL. The emergence of novel agents for HL, such as brentuximab vedotin and programmed death-1 (PD-1) blockade has revolutionized therapeutic strategies, yielding excellent results. This review aims to provide a comprehensive overview of new salvage therapies and offer insights into forthcoming therapeutic options.

Recent findings

The incorporation of brentuximab vedotin and PD-1 blockade into salvage therapy before HDT/ASCT has led to markedly improved outcomes. Notably, PD-1 based salvage studies yield posttransplant 2-year progression-free survival rates approaching 90%, marking a significant advancement in the treatment of Hodgkin lymphoma (HL). Studies are beginning to explore nontransplant treatment approaches following front-line treatment failure and may identify certain risk groups eligible for these strategies.

The landscape of HL treatment is rapidly evolving, leading to significant changes in the standard of care. Novel agents are now administered earlier in the disease course, resulting in higher cure rates. The focus of treatment is shifting towards achieving cure with minimal toxicity, reducing exposure to various agents, and advancing research in optimizing treatment sequencing and patient selection for less intensive therapies.
How to treat localized Hodgkin lymphoma?
Authors: Bernard Wivine , André M. , Crochet G.
Published: July 2024

Purpose of review

We aim to summarize the current knowledge on the management of early-stage classical Hodgkin lymphoma, with a focus on conventional strategies, incorporation of immunotherapies and exploration of novel prognostic markers.

Recent findings

Long-term data on combined modalities (associating chemotherapy and radiotherapy) still supports their benefit in terms of progression free survival compared to chemotherapy alone in both early favourable and early unfavourable interim PET-negative classical Hodgkin Lymphoma. Novel agents, such as Brentuximab Vedotin and checkpoints inhibitors show promising and impressive results when added to first-line treatment. Various strategies have been used, mainly in phase 2 non randomized clinical trials. Interim PET-scan has limited prognostic value and its role in regimens incorporating immunotherapies is yet unknown. Other prognosis markers emerge, such as metabolic tumour volume and circulating tumour DNA. By reflecting tumour burden pretreatment and minimal residual disease on treatment, they might be useful tools guiding treatment decisions.

Novel immunotherapy agents are likely to change the landscape in front-line management of classical early-stage Hodgkin lymphoma by combined modality treatment. Despite encouraging recent data, proof of their efficacy and safety on the longer term are still needed. Treatment decisions might be guided by new promising prognosis markers but their use in clinical practice is still to be determined.
Validation of the DBP-8278B Wrist-type Fully Automatic Blood Pressure Monitor in the general population according to the ISO 81060-2:2018/AMD 1:2020 protocol
Authors: Zhou Qi
Published: July 2024

The aim of this study was to evaluate the accuracy of the DBP-8278B Wrist-type Fully Automatic Blood Pressure Monitor in the general population according to the AAMI/ESH/ISO Universal Standard (ISO 81060-2 : 2018/AMD 1 : 2020). The test monitor was used to measure SBP and DBP and pulse rate in the wrists using the oscillometric method. According to this protocol using the same-arm sequential blood pressure measurement method, subjects were recruited to fulfill the age, sex, blood pressure, and cuff distribution criteria of the Universal Standard. A single cuff for wrist sizes of 13.5–21.5 cm was used. A total of 85 subjects were included in this study. According to Criterion 1, the mean difference in SBP between the test device and the reference device was 0.89 mmHg, with a SD of 7.76 mmHg. The mean difference of DBP was −1.44 mmHg, with a SD of 6.23 mmHg. The mean difference between SBP and DBP was less than 5.0 mmHg, and the SD was less than 8.0 mmHg, which met the requirements. According to Criterion 2, the SD of the mean differences of SBP between the test device and the reference device per subject was 5.65 mmHg, which was less than 6.88 mmHg and met the requirements. The SD of the mean differences of DBP between the test device and the reference device per subject was 5.61 mmHg, which was less than 6.78 mmHg and met the requirements. The DBP-8278B Wrist-type Fully Automatic Blood Pressure Monitor met the requirements of the AAMI/ESH/ISO Universal Standard (ISO 81060-2 : 2018/AMD 1 : 2020). It can be recommended for home and clinical use.
Drugs Effective for Nonsteroidal Anti-inflammatory Drugs or Aspirin-induced Small Bowel Injuries
Authors: Choe Younghee , Park Jae Myung , Kim Joon Sung , Cho Yu Kyung , Kim Byung-Wook , Choi Myung-Gyu , Kim Na Jin
Published: July 2024

Objective:

The frequency of small bowel (SB) injuries has increased due to the increased use of nonsteroidal anti-inflammatory drugs (NSAIDs) or aspirin. This study was a systematic review and meta-analysis to compare drugs effective for SB injuries caused by NSAIDs or aspirin use.

Methods:

We searched MEDLINE, Embase, and Cochrane registries for randomized controlled trials through February 2023. The extracted data included changes in the number of erosions or ulcers in the jejunum or ileum observed through capsule endoscopy in patients taking NSAIDs or aspirin and administration of various mucoprotectants. We investigated the therapeutic or preventive efficacy of these drugs. The methodological bias was evaluated using Risk of Bias 2.0.

Results:

Eighteen randomized controlled trials of drugs effective for NSAIDs or aspirin-induced SB injuries were included and analyzed. The agents used to treat or prevent SB injuries were rebamipide, misoprostol, geranylgeranylacetone, and probiotics. In the meta-analysis, the mucoprotectants that showed a significant effect in treating NSAID users, who developed SB injuries, were misoprostol (mean difference: −9.88; 95% CI: −13.26 to −6.50). Meanwhile, the mucoprotectant that can prevent SB injuries caused by NSAIDs or aspirin in the general population was rebamipide (mean difference: −1.85; 95% CI: −2.74 to −0.96).

Conclusions:

Misoprostol was effective in treating SB injuries caused by NSAIDs or aspirin (CRD42023410946).
Treatment of the Buried Bumper Syndrome​​​​​
Authors: Steinbrück Ingo , Pohl Jürgen , Friesicke Matthias , Grothaus Johannes , von Hahn Thomas , Drews Jan , Faiss Siegbert , Kuellmer Armin , Otto Helge , Allgaier Hans-Peter
Published: July 2024

Background and Goals:

The therapy of buried bumper syndrome (BBS) is difficult. The aim of this retrospective multicenter study was to analyze the treatment methods with focus on effectiveness and safety of endoscopic techniques.

Methods:

The analysis of all therapies and a comparison of the papillotome technique (PT) and needle knife–based nonpapillotome technique (NPT) were performed. Primary endpoint was technical success in one session, secondary endpoints overall technical success, number and duration of treatment sessions, SAE, and mortality.

Results:

The primary treatment of 160 BBS cases, diagnosed between 2003 and 2021, was NPT in 60 (37.5%), PT in 43 (26.9%), push/pull technique (PPT) in 40 (25.0%), no removal in 9 (5.6%), laparotomy in 7 (4.4%) cases, and external incision in 1 (0.6%) case. For PT and NPT rates of technical success in one session were 95.5% and 45.0% (P<0.01), rates of overall technical success 100% and 88.3% (P=0.02), and mean number and duration of treatment sessions 1.05 (±0.21) versus 1.70 (±0.91) (P<0.01) and 32.17 (±21.73) versus 98,00 (±62.28) minutes (P<0.01), respectively. No significant differences between PT and NPT were found for SAE (15.9% vs. 25.0%) and mortality (2.3% vs. 1.7%). For PPT, laparotomy and external incision rates of technical success in one session and overall technical success were 100%, rates of SAE 2.5%, 50.0%, and 0% and mortality 0%, 10.0%, and 0%.

Conclusions:

Endoscopic therapy of BBS is treatment of choice in most cases with removal of incomplete BB by PPT. In case of complete BB PT appears more effective than NPT.
Psychosocial Factors Associated With Long-Term Cognitive Impairment Among COVID-19 Survivors
Authors: Dang Wen , Li Wenjing , Liu Haotian , Li Chunyang , Zhu Tingxi , Bai Lin , Yang Runnan , Wang Jingyi , Liao Xiao , Liu Bo , Zhang Simai , Yuan Minlan , Zhang Wei
Published: July 2024

COVID-19 survivors complained of the experience of cognitive impairments, which also called “brain fog” even recovered. The study aimed to describe long-term cognitive change and determine psychosocial factors in COVID-19 survivors. A cross-sectional study was recruited 285 participants from February 2020 to April 2020 in 17 hospitals in Sichuan Province. Cognitive function, variables indicative of the virus infection itself, and psychosocial variables were collected by telephone interview. Univariate logistic regression and Lasso logistic regression models were used for variable selection which plugged into a multiple logistics model. Overall prevalence of moderate or severe cognitive impairment was 6.3%. Logistic regression showed that sex, religion, smoking status, occupation, self-perceived severity of illness, sleep quality, perceived mental distress after COVID-19, perceived discrimination from relatives and friends, and suffered abuse were associated with cognitive impairment. The long-term consequences of cognitive function are related to multiple domains, in which psychosocial factors should be taken into consideration.
Establishing Criteria for Tumor Necrosis as Prognostic Indicator in Colorectal Cancer
Authors: Kastinen Meeri , Sirniö Päivi , Elomaa Hanna , Äijälä Ville K. , Karjalainen Henna , Tapiainen Vilja V. , Pohjanen Vesa-Matti , Kemppainen Janette , Sliashynskaya Katja , Ahtiainen Maarit , Rintala Jukka , Meriläinen Sanna , Rautio Tero , Saarnio Juha , Mattila Taneli T. , Lindgren Outi , Wirta Erkki-Ville , Helminen Olli , Seppälä Toni T. , Böhm Jan , Mecklin Jukka-Pekka , Tuomisto Anne , Mäkinen Markus J. , Väyrynen Juha P.
Published: July 2024

Tumor necrosis has been reported to represent an independent prognostic factor in colorectal cancer, but its evaluation methods have not been described in sufficient detail to introduce tumor necrosis evaluation into clinical use. To study the potential of tumor necrosis as a prognostic indicator in colorectal cancer, criteria for 3 methods for its evaluation were defined: the average percentage method (tumor necrosis percentage of the whole tumor), the hotspot method (tumor necrosis percentage in a single hotspot), and the linear method (the diameter of the single largest necrotic focus). Cox regression models were used to calculate cancer-specific mortality hazard ratios (HRs) for tumor necrosis categories in 2 colorectal cancer cohorts with more than 1800 cases. For reproducibility assessment, 30 cases were evaluated by 9 investigators, and Spearman’s rank correlation coefficients and Cohen’s kappa coefficients were calculated. We found that all 3 methods predicted colorectal cancer-specific survival independent of other prognostic parameters, including disease stage, lymphovascular invasion, and tumor budding. The greatest multivariable HRs were observed for the average percentage method (cohort 1: HR for ≥ 40% vs. <3% 3.03, 95% CI, 1.93-4.78; cohort 2: HR for ≥ 40% vs. < 3% 2.97; 95% CI, 1.63-5.40). All 3 methods had high reproducibility, with the linear method showing the highest mean Spearman’s correlation coefficient (0.91) and Cohen’s kappa (0.70). In conclusion, detailed criteria for tumor necrosis evaluation were established. All 3 methods showed good reproducibility and predictive ability. The findings pave the way for the use of tumor necrosis as a prognostic factor in colorectal cancer.
KLF10: a point of convergence in cancer cachexia
Authors: Epstein Savannah A. , Doles Jason D. , Dasgupta Aneesha
Published: July 2024

Purpose of the review

Cancer-associated cachexia is a wasting syndrome entailing loss in body mass and a shortened life expectancy. There is currently no effective treatment to abrogate this syndrome, which leads to 20–30% of deaths in patients with cancer. While there have been advancements in defining signaling factors/pathways in cancer-induced muscle wasting, targeting the same in the clinic has not been as successful. Krüppel-like factor 10 (KLF10), a transcription factor implicated in muscle regulation, is regulated by the transforming growth factor-beta signaling pathway. This review proposes KLF10 as a potential convergence point of diverse signaling pathways involved in muscle wasting.

Recent findings

KLF10 was discovered as a target of transforming growth factor-beta decades ago but more recently it has been shown that deletion of KLF10 rescues cancer-induced muscle wasting. Moreover, KLF10 has also been shown to bind key atrophy genes associated with muscle atrophy in vitro.

There is an elevated need to explore targets in cachexia, which will successfully translate into the clinic. Investigating a convergence point downstream of multiple signaling pathways might hold promise in developing effective therapies for cachexia.
Forward and inverse problems for creep models in viscoelasticity
Authors: Itou H. , Kovtunenko V. A. , Nakamura G.
Published: July 2024

This study examines a class of time-dependent constitutive equations used to describe viscoelastic materials under creep in solid mechanics. In nonlinear elasticity, the strain response to the applied stress is expressed via an implicit graph allowing multi-valued functions. For coercive and maximal monotone graphs, the existence of a solution to the quasi-static viscoelastic problem is proven by applying the Browder–Minty fixed point theorem. Moreover, for quasi-linear viscoelastic problems, the solution is constructed as a semi-analytic formula. The inverse viscoelastic problem is represented by identification of a design variable from non-smooth measurements. A non-empty set of optimal variables is obtained based on the compactness argument by applying Tikhonov regularization in the space of bounded measures and deformations. Furthermore, an illustrative example is given for the inverse problem of isotropic kernel identification.

This article is part of the theme issue 'Non-smooth variational problems with applications in mechanics'.
What is the physical origin of the gradient flow structure of variational fracture models?
Authors: Kimura Masato , Takaishi Takeshi , Tanaka Yoshimi
Published: July 2024

We investigate a physical characterization of the gradient flow structure of variational fracture models for brittle materials: a Griffith-type fracture model and an irreversible fracture phase field model. We derive the Griffith-type fracture model by assuming that the fracture energy in Griffith’s theory is an increasing function of the crack tip velocity. Such a velocity dependence of the fracture energy is typically observed in polymers. We also prove an energy dissipation identity of the Griffith-type fracture model, in other words, its gradient flow structure. On the other hand, the irreversible fracture phase field model is derived as a unidirectional gradient flow of a regularized total energy. We have considered the time relaxation parameter a mathematical approximation parameter, which we should choose as small as possible. In this research, however, we reveal the physical origin of the gradient flow structure of the fracture phase field model (F-PFM) and show that the small time relaxation parameter is characterized as the rate of velocity dependence of the fracture energy. It is verified by comparing the energy dissipation properties of those two models and by analysing a travelling wave solution of the irreversible F-PFM.

This article is part of the theme issue ‘Non-smooth variational problems with applications in mechanics’.