bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating the impact of cultivar selection on carrot weevil (Coleoptera: Curculionidae) damage and foliar insect pest assemblages in carrot
Authors: Justus Emily J , Long Elizabeth Y
Published: October 2023

Knowledge of specialty crop cultivars with resistance against insect pests is limited, and this may serve as a barrier to implementing host-plant resistance as part of an integrated pest management strategy. Carrot (Daucus carota L.) (Apiaels: Apiaceae)is a valuable specialty crop with a diversity of insect pests and cultivars that differ in physical and chemical qualities that influence insect pest preferences. To investigate the role of cultivar as a tool to reduce insect pest damage, we evaluated 7 carrot cultivars in replicated laboratory and field trials in IN and OH, USA in 2021. During June and July, we documented oviposition and feeding damage by the carrot weevil (Listronotus oregonenesis LeConte) (Coleoptera: Curculionidae) and used faunistic analysis to measure the abundance and diversity of foliar insect assemblages on each cultivar. We found no significant differences in oviposition and root damage across cultivars in the field, with mean cumulative egg scars ranging from 1.83 ± 1.40 in “Red Core Chantenay” to 5.17 ± 2.62 in “Cosmic Purple”. However, there was a positive correlation between the cumulative number of egg scars and number of trichomes on petioles. Similarly, no-choice laboratory bioassays revealed no significant differences in mean cumulative egg scars, ranging from 5.00 ± 1.15 in “Red Core Chantenay” to 10.63 ± 1.02 in “Danvers 126”. Predominant insect pests differed across cultivars, but Cicadellidae was common across all cultivars. Interestingly, only 1 beneficial insect family, Pteromalidae, was predominant across cultivars. This research highlights the impact of cultivar selection on the diversity and damage potential of insect pests in carrot production.
The first case of SARS-CoV-2-induced eosinophilic fasciitis
Authors: Boussaa Hiba , Kamoun Mariem , Miladi Saoussen , Makhlouf Yasmine , Abdelghani Kawther Ben , Fazaa Alia , Laatar Ahmed
Published: October 2023

Eosinophilic fasciitis (EF), also known as Shulman syndrome, is a rare auto-immune fibrosing disorder of the fascia. Etiopathogeny of EF is still unclear. Nowadays, it is widely known that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may induce hyper-stimulation of the immune system. Several cases with fasciitis and rhabdomyolysis induced by coronavirus disease 2019 vaccines have been reported in the literature. Herein, we report the first case of EF possibly triggered by SARS-CoV-2 infection. A 45-year-old Tunisian woman, with no medical history, presented to our department with severe widespread muscle pain noticed one month after a SARS-CoV-2 infection. Physical examination showed an induration of the skin and subcutaneous tissue of the arms, forearms and legs with a restricted joint mobility. The level of eosinophils was 430 E/mm3 (6.1%) [1–4%]. Electromyography and creatine kinase levels were normal. Myositis-related antibodies were negative. Magnetic resonance imaging of the left arm showed high-intensity signal and thickness of the fascia without evidence of muscle or bone involvement. A muscular biopsy from the right deltoid showed thickening and inflammation of the fascia. The patient received intraveinous injections of 1000 mg of methylprednisolone for 3 days with an oral relay of 1 mg/kg per day of prednisone equivalent during 4 weeks. At one-month follow-up, a significant improvement of the skin induration and myalgia was observed, with a disappearance of the biological inflammatory syndrome. This brief report suggests a potential link between SARS-CoV-2 infection and new-onset of auto-immune fasciitis.
Dietary approaches for controlling cancer by limiting the Warburg effect: a review
Authors: Shimi Ghazaleh
Published: October 2023

Cancer is a mysterious disease. Among other alterations, tumor cells, importantly, have metabolic modifications. A well-known metabolic modification commonly observed in cancer cells has been termed the Warburg effect. This phenomenon is defined as a high preference for glucose uptake, and increased lactate production from that glucose, even when oxygen is readily available. Some anti-cancer drugs target the proposed Warburg effect, and some dietary regimens can function similarly. However, the most suitable dietary strategies for treating particular cancers are not yet well understood. The aim of this review was to describe findings regarding the impact of various proposed dietary regimens targeting the Warburg effect. The evidence suggests that combining routine cancer therapies with diet-based strategies may improve the outcome in treating cancer. However, designing individualized therapies must be our ultimate goal.
Supplementation with l-arginine and nitrates vs age and individual physiological reactivity
Authors: Kurhaluk Natalia
Published: October 2023

Ageing is a natural ontogenetic phenomenon that entails a decrease in the adaptive capacity of the organism, as a result of which the body becomes less adaptable to stressful conditions. Nitrate and nitrite enter the body from exogenous sources and from nitrification of ammonia nitrogen by intestinal microorganisms. This review considers the mechanisms of action of l-arginine, a known inducer of nitric oxide (NO) biosynthesis, and nitrates as supplements in the processes of ageing and aggravated stress states, in which mechanisms of individual physiological reactivity play an important role. This approach can be used as an element of individual therapy or prevention of premature ageing processes depending on the different levels of initial reactivity of the functional systems. A search was performed of the PubMed, Scopus, and Google Scholar databases (n = 181 articles) and the author’s own research (n = 4) up to May 5, 2023. The review presents analyses of data on targeted treatment of NO generation by supplementation with l-arginine or nitrates, which is a promising means for prevention of hypoxic conditions frequently accompanying pathological processes in an ageing organism. The review clarifies the role of the individual state of physiological reactivity, using the example of individuals with a high predominance of cholinergic regulatory mechanisms who already have a significant reserve of adaptive capacity. In studies of the predominance of adrenergic influences, a poorly trained organism as well as an elderly organism correspond to low resistance, which is an additional factor of damage at increased energy expenditure.

Conclusion

It is suggested that the role of NO synthesis from supplementation of dietary nitrates and nitrites increases with age rather than from oxygen-dependent biosynthetic reactions from l-arginine supplementation.
Frequency of anthropometric implausible values estimated from different methodologies: a systematic review and meta-analysis
Authors: Santana dos Santos Iolanda Karla , Borges dos Santos Pereira Débora , Cumpian Silva Jéssica , de Oliveira Gallo Caroline , de Oliveira Mariane Helen , Pereira de Vasconcelos Luana Cristina , Conde Wolney Lisbôa
Published: October 2023

Context

Poor anthropometric data quality affect the prevalence of malnutrition and could harm public policy planning.

Objective

This systematic review and meta-analysis was designed to identify different methods to evaluate and clean anthropometric data, and to calculate the frequency of implausible values for weight and height obtained from these methodologies.

Data Sources

Studies about anthropometric data quality and/or anthropometric data cleaning were searched for in the MEDLINE, LILACS, SciELO, Embase, Scopus, Web of Science, and Google Scholar databases in October 2020 and updated in January 2023. In addition, references of included studies were searched for the identification of potentially eligible studies.

Data Extraction

Paired researchers selected studies, extracted data, and critically appraised the selected publications.

Data Analysis

Meta-analysis of the frequency of implausible values and 95% confidence interval (CI) was estimated. Heterogeneity (I2) and publication bias were examined by meta-regression and funnel plot, respectively.

Results

In the qualitative synthesis, 123 reports from 104 studies were included, and in the quantitative synthesis, 23 studies of weight and 14 studies of height were included. The study reports were published between 1980 and 2022. The frequency of implausible values for weight was 0.55% (95%CI, 0.29–0.91) and for height was 1.20% (95%CI, 0.44–2.33). Heterogeneity was not affected by the methodological quality score of the studies and publication bias was discarded.

Conclusions

Height had twice the frequency of implausible values compared with weight. Using a set of indicators of quality to evaluate anthropometric data is better than using indicators singly.

Systematic Review Registration

PROSPERO registration no. CRD42020208977.
A Transdiagnostic Study of Effort-Cost Decision-Making in Psychotic and Mood Disorders
Authors: Culbreth Adam J , Moran Erin K , Mahaphanit Wasita , Erickson Molly A , Boudewyn Megan A , Frank Michael J , Barch Deanna M , MacDonald Angus W , Ragland J Daniel , Luck Steven J , Silverstein Steven M , Carter Cameron S , Gold James M
Published: October 2023

Background

Research suggests that effort-cost decision-making (ECDM), the estimation of work required to obtain reward, may be a relevant framework for understanding motivational impairment in psychotic and mood pathology. Specifically, research has suggested that people with psychotic and mood pathology experience effort as more costly than controls, and thus pursue effortful goals less frequently. This study examined ECDM across psychotic and mood pathology.

Hypothesis

We hypothesized that patient groups would show reduced willingness to expend effort compared to controls.

Study Design

People with schizophrenia (N = 33), schizoaffective disorder (N = 28), bipolar disorder (N = 39), major depressive disorder (N = 40), and controls (N = 70) completed a physical ECDM task. Participants decided between completing a low-effort or high-effort option for small or larger rewards, respectively. Reward magnitude, reward probability, and effort magnitude varied trial-by-trial. Data were analyzed using standard and hierarchical logistic regression analyses to assess the subject-specific contribution of various factors to choice. Negative symptoms were measured with a clinician-rated interview.

Study Results

There was a significant effect of group, driven by reduced choice of high-effort options in schizophrenia. Hierarchical logistic regression revealed that reduced choice of high-effort options in schizophrenia was driven by weaker contributions of probability information. Use of reward information was inversely associated with motivational impairment in schizophrenia. Surprisingly, individuals with major depressive disorder and bipolar disorder did not differ from controls.

Conclusions

Our results provide support for ECDM deficits in schizophrenia. Additionally, differences between groups in ECDM suggest a seemingly similar behavioral phenotype, reduced motivation, could arise from disparate mechanisms.
Response of lymphatic endothelial cells to combined spatial and temporal variations in fluid flow
Authors: Michalaki Eleftheria , Surya Vinay N. , Rodríguez‐Hakim Mariana , Fuller Gerald G. , Dunn Alexander R.
Published: October 2023

One‐way valves within lymphatic vessels are required for the efficient drainage of lymphatic fluids. Fluid flow is proposed to be a key cue in regulating both the formation and maintenance of lymphatic valves. However, to our knowledge, no previous study has systematically examined the response of LECs to the complex combination of spatially and temporally varying fluid flows that occur at lymphatic valves in vivo. We built an in vitro microfluidic device that reproduces key aspects of the flow environment found at lymphatic valves. Using this device, we found that a combination of spatially and temporally varying wall shear stresses (WSSs) led to upregulated transcription of PROX1 and FOXC2. In addition, we observed that combined spatial and temporal variations in WSS‐modulated Ca2+ signaling and led to increased cellular levels of NFATc1. These observations suggest that the physical cues generated by the flow environment present within lymphatic valves may act to activate key regulatory pathways that contribute to valve maintenance.
Continuous Renal Replacement Therapy and Mortality in Critically Ill Obese Adults
Authors: Peters Bradley J. , Barreto Erin F. , Mara Kristin C. , Kashani Kianoush B.
Published: October 2023

IMPORTANCE:

The outcomes of critically ill adults with obesity on continuous renal replacement therapy (CRRT) are poorly characterized. The impact of CRRT dose on these outcomes is uncertain.

OBJECTIVES:

This study aimed to determine if obesity conferred a survival advantage for critically ill adults with acute kidney injury (AKI) on CRRT. Secondarily, we evaluated whether the dose of CRRT predicted mortality in this population.

DESIGN, SETTING, AND PARTICIPANTS:

A retrospective, observational cohort study performed at an academic medical center in Minnesota. The study population included critically ill adults with AKI managed with CRRT.

MAIN OUTCOMES AND MEASURES:

The primary outcome of 30-day mortality was compared between obese (body mass index [BMI] ≥ 30 kg/m2) and nonobese (BMI < 30 kg/m2) patients. Multivariable regression assessed was used to assess CRRT dose as a predictor of outcomes. An analysis included dose indexed according to actual body weight (ABW), adjusted body weight (AdjBW), or ideal body weight (IBW).

RESULTS:

Among 1033 included patients, the median (interquartile range) BMI was 26 kg/m2 (23–28 kg/m2) in the nonobese group and 36 kg/m2 (32–41 kg/m2) in the obese group. Mortality was similar between groups at 30 days (54% vs. 48%; p = 0.06) but lower in the obese group at 90 days (62% vs. 55%; p = 0.02). CRRT dose predicted an increase in mortality when indexed according to ABW or AdjBW (hazard ratio [HR], 1.2–1.16) but not IBW (HR, 1.04).

CONCLUSIONS AND RELEVANCE:

In critically ill adults with AKI requiring CRRT, short-term mortality appeared lower in obese patients compared with nonobese patients. Among weight calculations, IBW appears to be preferred to promote safe CRRT dosing in obese patients.
Reducing health disparities in endometrial cancer care in 2024
Authors: Stewart Chelsea E. , Nañez Andrea , Ayoola-Adeola Martins , Chase Dana
Published: October 2023

Purpose of review

To summarize the most recent publications explaining disparities among patients diagnosed with endometrial cancer and identify areas of improvement.

Recent findings

Racial disparities in endometrial cancer care have been identified along the cancer continuum including risk, diagnosis, access to treatment, and overall survival. The mortality gap in endometrial cancer is one of the top five widest Black–White mortality gaps among all cancer diagnoses in the United States. Many publications have demonstrated that the disparities exist, the aim of this review is to identify actionable areas of improvement. To mitigate racial disparities, we must acknowledge that Black patients are at higher risk of high-risk subtypes of endometrial cancer, and their presentation can vary from what is considered typical for the most common type of endometrial cancer. We must address that practice recommendations for diagnosis may not be generalizable to all races and ethnicities, and that racism has an impact on how providers approach a work-up for Black vs. White patients. Finally, we must improve access to appropriate treatment by steadfastly adhering to recommended practice guidelines regardless of race/ethnicity and improving efforts to enroll a diverse patient population to clinical trials.

In this review, we sought to identify specific and actionable areas of improvement to reduce racial disparities in endometrial cancer care.
Sarcopenia is associated with osteopenia and impaired quality of life in children with genetic intrahepatic cholestatic liver disease
Authors: Boster Julia M. , Goodrich Nathan P. , Spino Cathie , Loomes Kathleen M. , Alonso Estella M. , Kamath Binita M. , Sokol Ronald J. , Karpen Saul , Miethke Alexander , Shneider Benjamin L. , Molleston Jean P. , Kohli Rohit , Horslen Simon P. , Rosenthal Philip , Valentino Pamela L. , Teckman Jeffrey H. , Hangartner Thomas N. , Sundaram Shikha S. ,   the Childhood Liver Disease Research Network (ChiLDReN)
Published: October 2023

Background:

Sarcopenia occurs in pediatric chronic liver disease, although the prevalence and contributing factors in genetic intrahepatic cholestasis are not well-described. The objective of this study was to measure muscle mass in school-aged children with genetic intrahepatic cholestasis and assess relationships between sarcopenia, clinical variables, and outcomes.

Methods:

Estimated skeletal muscle mass (eSMM) was calculated on dual-energy x-ray absorptiometry obtained in a Childhood Liver Disease Research Network study of children with bile acid synthesis disorders(BASD) alpha-1 antitrypsin deficiency (a1ATd), chronic intrahepatic cholestasis (CIC), and Alagille syndrome (ALGS). Relationships between eSMM, liver disease, and transplant-free survival were assessed.

Results:

eSMM was calculated in 127 participants (5–18 y): 12 BASD, 41 a1ATd, 33 CIC, and 41 ALGS. eSMM z-score was lower in CIC (−1.6 ± 1.3) and ALGS (−2.1 ± 1.0) than BASD (-0.1 ± 1.1) and a1ATd (−0.5 ± 0.8, p < 0.001). Sarcopenia (defined as eSMM z-score ≤− 2) was present in 33.3% of CIC and 41.5% of ALGS participants. eSMM correlated with bone mineral density in the 4 disease groups (r=0.52–0.55, p < 0.001–0.07), but not serum bile acids, bilirubin, aspartate aminotransferase/platelet ratio index, or clinically evident portal hypertension. Of the 2 patients who died (1 with sarcopenia) and 18 who underwent liver transplant (LT, 4 with sarcopenia), eSMM z-score did not predict transplant-free survival. eSMM z-score correlated with the Physical Pediatric Quality of Life Inventory score (r=0.38–0.53, p = 0.007–0.04) in CIC and a1ATd.

Conclusion:

Severe sarcopenia occurs in some children with ALGS and CIC. The lack of correlation between eSMM and biochemical cholestasis suggests mechanisms beyond cholestasis contribute to sarcopenia. While sarcopenia did not predict transplant-free survival, LT and death were infrequent events. Future studies may define mechanisms of sarcopenia in genetic intrahepatic cholestasis.
Recent Trends in the Cumulative Incidence and Intervention Patterns of Retinopathy of Prematurity in Japan: A Multi-Center Analysis, 2011–2020
Authors: Zhou Han Peng , Hashimoto Yohei , Araki Fumiyuki , Sugimoto Koichiro , Nagahara Masako , Matsui Hiroki , Fushimi Kiyohide , Yasunaga Hideo , Aihara Makoto , Toyama Taku , Ueta Takashi
Published: October 2023

Purpose:

To investigate recent trends in the cumulative incidence and treatment patterns of retinopathy of prematurity (ROP) in Japan.

Methods:

A retrospective multi-center cohort was conducted from 2011 to 2020 using the Diagnosis Procedure Combination inpatient database. Preterm newborns with birth weight <2500g were categorized by birth weight. The cumulative incidence of ROP, treatment patterns, and association between treatment and birth weight was investigated.

Result:

A total of 82,683 preterm infants were identified, of whom 9,335 (11.3%) were diagnosed with ROP. The cumulative incidence of ROP increased by 15% in those with birth weight <500g over the study period. Among the ROP infants, 20.2% received treatment, including laser photocoagulation (94.8%), intravitreal injection (3.8%), or both (1.8%). The proportion receiving laser photocoagulation decreased followed by an increase in intravitreal injection. This shift in intervention pattern was most conspicuous for those with birth weight 750–1249g. The risk ratio of receiving laser and intravitreal injection for those weighing <500g were 24.7 (95% confidence interval, 10.5–58.2) and 28.4 (5.8–138.1), respectively, as compared to infants weighing >1500g.

Conclusion:

The cumulative incidence of ROP increased in infants with birth weight <500g. A shift from laser photocoagulation to intravitreal injection was observed in the more recent years.
Optimum pinhole size determination in pinhole pupilloplasty for higher-order aberrations
Authors: Kumar Dhivya Ashok , Narang Priya , Holladay Jack , Sivagnanam Soundari , Narang Rhea , Agarwal Ashvin , Agarwal Amar
Published: October 2023

Purpose:

To determine optimal pinhole size (OPS) and establish a relationship with visual acuity (VA) and RMS (root mean square) values in cases with higher-order aberrations (HOAs) undergoing pinhole pupilloplasty (PPP).

Setting:

Private practice, India.

Design:

Prospective, interventional study.

Methods:

RMS value for 6-mm–diameter optical zone was determined by Scheimpflug imaging (Pentacam). Patients with RMS value >0.3 μm were included. Preoperatively, a hand-held pinhole gauge with varied apertures determined the OPS, and single-pass four-throw technique was used to perform pupilloplasty with Purkinje-1 reflex as a marker for centration. VA with OPS, correlation of RMS values with OPS and pupil size, and Strehl ratio were the main outcome measures.

Results:

29 eyes with HOAs were analyzed; all patients chose 1.0 or 1.5 mm as OPS. The mean preoperative and postoperative pupil size was 3.25 ± 0.81 mm and 1.8 ± 0.54 mm (P = .000), respectively. Postoperative mean pupil size when compared with OPS denoted that 14 eyes had a difference of <0.1 mm, 8 eyes ranged from 0.2 to 0.45 mm, and 7 eyes had ≥0.6 mm (range from 0.6 to 1.8 mm) difference from OPS. Eyes with higher RMS values needed smaller pupil gauge to achieve better VA. Preoperatively, vision with OPS correlated well with preoperative 6-mm RMS HOAs (r = 0.728; P = .00). Postoperative UDVA correlated well with VA measured with OPS (r = 0.847; P = .00). The preoperative and postoperative mean Strehl ratio was 0.109 ± 0.07 and 0.195 ± 0.11 (P = .001), respectively.

Conclusions:

Higher RMS values required a smaller pupil to achieve optimum VA. PPP can help achieve pinhole size in accordance with patient's optimum pinhole requirement.
Anatomical Compliance of Cavopulmonary Assist Device Designs: A Virtual Fitting Study in Fontan Patients
Authors: Karner Barbara , Escher Andreas , Schorn Therese , Narayanaswamy Krishnaraj , Sachweh Jörg , Laufer Günther , Hübler Michael , Zimpfer Daniel , Granegger Marcus
Published: October 2023

Several device designs for cavopulmonary mechanical circulatory support (MCS) are under investigation, however, challenged by the Fontan population’s heterogeneity in size, cardiovascular and thoracic anatomy. This study aimed to preclinically assess the anatomical compliance of proposed device designs in silico. Representative double- and single-outlet cavopulmonary assist device (CPAD) designs were virtually implanted into CT imaging data of 10 patients previously palliated with total cavopulmonary connection (TCPC) for functionally univentricular hearts. Anatomical device compatibility was characterized concerning pump proximity to cardiovascular, respiratory and thoracic structures, as well as pump in- and outflow graft configuration. In 10 Fontan patients with a median age of 10.4 years (interquartile range [IQR] 5.0–15.3 years) and a median body surface area of 1.09 m2 (IQR 0.76–1.28 m2), implantation of a double-outlet CPAD was feasible in 1 patient (10%). In all other, adverse device intersection with the trachea and (neo-)aorta, or posterior pulmonary artery outflow graft kinking were observed. A single-outlet design permitted enhanced device mobilization adapting to individual anatomical conditions, resulting in device fit in nine of 10 patients (90%). Despite vast anatomical variations among single ventricle patients, a single-outlet device design may provide intracorporeal cavopulmonary MCS to a broad spectrum of failing Fontan patients.
Investigation of the quarter-dose 18F-FDG total-body PET in routine clinical practice and its clinical value
Authors: Zhao Minjie , Zan Keyu , Cui Xiao , Chai Leiying , Ge Min , Cheng Zhaoping , Sun Hongyan , Duan Yanhua
Published: October 2023

Objective

The purpose of the study was to evaluate the routine clinical application of total-body PET with quarter-dose 18F-FDG.

Methods

The contrast recovery coefficient (CRC) and coefficient of variation (COV) were evaluated among full-, half-, and quarter-dose groups with an acquisition duration of 10-, 5-, 3-, and 1-min in the NEMA (IQ) phantom test. Fifty patients undergoing total-body PET/CT with quarter-dose (0.925MBq/kg) of 18F-FDG were included in the prospective study. The acquisition time was 10 min, divided into duration groups of 5-, 3-, and 1-min, referred to as G10, G5, G3, and G1. Visual scores were assessed based on overall visual assessment, noise scoring, and lesion conspicuity. Lesion SUVmax and TBR were evaluated in semi-quantitative analysis. G10 was used as the gold reference to evaluate lesion detectability.

Results

In the phantom study, the COV value of the images with quarter-dose 18F-FDG and 10-min acquisition time was 11.52%. For spheres with 10 mm diameter, the CRC of quarter-dose PET images was relatively stable compared to that of full-dose groups with all acquisition durations. In the human study, the visual score in G10, G5, and G3 was significantly higher than that in G1. The differences in lesion SUVmax and TBR for G1-G10 were significantly higher than that for G5-G10 and G3-G10. All lesions in G10 could be identified in G5 and G3.

Conclusion

The phantom and human findings demonstrated the feasibility of quarter-dose 18F-FDG PET with 3-min acquisition time, which can maintain image quality with reduced radiation dose.
Muscle transposition and free muscle transfer in facial nerve reanimation
Authors: Jones Kia , Taylor S. Mark , AL Afif Ayham
Published: October 2023

Purpose of review

This review highlights recent advances in facial reanimation surgery particularly related to muscle transposition and free functional muscle transfer (FFMT).

Recent findings

FFMT and muscle transposition are mainstays in the treatment of chronic facial paralysis. Recent literature evaluates single versus dual innervated FFMT, reanimation of the periocular region and lower lip depressors, and indications for such methods over gold standard FFMT techniques. New donor sites for muscle transposition and FFMT are also described.

Gracilis FFMT (GFMT) continues to be the gold standard in dynamic facial reanimation for patients with chronic facial paralysis. Muscle transposition should be considered in older patients, those medically unfit for long operative procedures, and individuals who prefer more immediate results. With respect to FFMT, described nerve coaptation patterns, surgical stages, and donor muscle choice vary. Standardization of data reporting and outcome measures is needed in future studies.
Innovative surgical techniques in the intestine and multivisceral transplant
Authors: Abreu Phillipe , Manzi Joao , Vianna Rodrigo
Published: October 2023

Purpose of review

This timely review delves into the evolution of multivisceral transplantation (MVT) over the past six decades underscoring how advancements in surgical techniques and immunosuppression have driven transformation, to provide insight into the historical development of MVT, shedding light on its journey from experimentation to a valuable clinical approach.

Recent findings

The review presents contemporary enhancements in surgical methods within the context of intestinal transplantation. The versatility of MVT is emphasized, accommodating diverse organ combinations and techniques. Both isolated intestinal transplantation (IIT) and MVT have seen expanded indications, driven by improved parenteral nutrition, transplantation outcomes, and surgical innovations. Surgical techniques are tailored based on graft type, with various approaches for isolated transplantation. Preservation strategies and ostomy techniques are also covered, along with graft assessment advancements involving donor-specific antibodies.

This review's findings underscore the remarkable evolution of MVT from experimental origins to a comprehensive clinical practice. The progress in surgical techniques and immunosuppression has broadened the spectrum of patients who can benefit from intestinal transplant, including both IIT and MVT. The expansion of indications offers hope to patients with complex gastrointestinal disorders. The detection of donor-specific antibodies in graft assessment advances diagnostic accuracy, ultimately improving patient outcomes.
Overview of current applications and trends in artificial intelligence for cystoscopy and transurethral resection of bladder tumours
Authors: Ikeda Atsushi , Nosato Hirokazu
Published: October 2023

Purpose of review

Accurate preoperative and intraoperative identification and complete resection of bladder cancer is essential. Adequate postoperative follow-up and observation are important to identify early intravesical recurrence or progression. However, the accuracy of diagnosis and treatment is dependent on the knowledge and experience of the physicians. Artificial intelligence (AI) can be an important tool for physicians performing cystoscopies.

Recent findings

Reports published over the past year and a half have identified an adequate amount of cystoscopy datasets for deep learning, with rich datasets of multiple tumour types including images of flat, carcinoma-in-situ, and elevated lesions, and more diverse applications. In addition to detecting bladder tumours, AI can assist in diagnosing interstitial cystitis. Applications of AI using conventional white-light and also to bladder endoscopy with different image enhancement techniques and manufacturers is underway. A framework has also been proposed to standardise the management of clinical data from cystoscopy to aid education and AI development and to compare with gastrointestinal endoscopic AI. Although real-world clinical applications have lagged, technological developments are progressing.

AI-based cystoscopy is likely to become an important tool and is expected to have real-world clinical applications comprehensively linking AI and imaging, data management systems, and clinicians.

Video abstract

http://links.lww.com/COU/A45
Treatment of hard-to-heal wound after huge scalp tumor resection and reconstruction: a case report
Authors: Wang Lei , Ren Nianjun , Tang Zhi , Zhang Hailin , He Zhengwen
Published: October 2023

Introduction and importance:

Free skin flap transplantation and titanium mesh reconstruction can effectively repair the scalp and skull defects caused by massive scalp tumour resection. Postoperative flap infection is a common complication. Due to the presence of titanium mesh, once infection occurs, a second operation is required to remove the titanium mesh, which brings a great physical and economic burden to the patient.

Case presentation:

In this case of postoperative infection, the authors used a conservative treatment based on dressing change, preserved the titanium mesh and flap, avoided secondary surgery, and successfully controlled the infection.

Clinical discussion:

The treatment strategy is mainly divided into three steps: the first stage is to control infection, the authors use complexed iodine to repeatedly disinfect wounds, subcutaneous dead space, exposed titanium mesh, and antibiotic treatment for bacterial culture results; the second stage is to promote granulation growth, After infection control, the authors remove old granulation after each wound disinfection, and then instill fibroblast growth factor to promote subcutaneous granulation growth to fill dead space, and also provide a base platform for epidermal growth; the third stage is mainly epidermal healing, Change the dressing every day to observe the growth of the epidermis.

Conclusion:

This case suggests that conservative treatment strategy based on dressing change is also a potential treatment option for postoperative infection of the flap with exposure of the titanium plate.
Factors affecting completeness of anaesthetic record: a cross-sectional study
Authors: Limpoon Suwimon , Seangrung Rattaphol , Nimmankiatkul Apichaya
Published: October 2023

Background:

Anaesthesia Information Management Systems (AIMS) are of critical importance for ensuring the comprehensive recording of anaesthesia data. This study aimed to investigate the factors influencing the completeness of anaesthetic records created by various healthcare professionals including anesthesiologists, nurse anaesthetists, residents/fellows, and anaesthetic nurse trainees.

Methods:

Employing an online Google Forms questionnaire, this descriptive research focused on understanding the factors contributing to the completeness of anaesthetic records. The survey was distributed to all anaesthesia personnel in the department, comprising a total of 165 participants. The questionnaire encompassed three primary aspects:(1) personal information, (2) knowledge related to recording anaesthetic records, and (3) concerns related to achieving high-quality record-keeping. To assess completeness, anaesthetic record forms were evaluated based on the 2020 Medical Record Audit Guideline of Thailand’s National Health Security Office, with a completeness rate exceeding 80% deemed acceptable. Spearman’s rank correlation was employed to analyze the connections between the associated factors and completeness of anaesthetic records.

Results:

From August to October 2021, 165 records were examined, indicating a completeness rate of 89.7%. Several factors exhibited significant correlations with the completeness of anaesthetic records. These included age (r = −0.223; P=0.004), job position (r = 0.44; P<0.001), years of anaesthesia experience (r = −0.208; P=0.007), experience in anaesthetic record training/teaching (r = 0.181; P=0.02), and attitude emphasizing high-quality record-keeping (r = 0.167; P=0.032).

Conclusion:

While personal attributes emerged as pivotal factors influencing record completeness, continuous training and a collaborative attitude were identified as critical for maintaining sustainability and achieving record-keeping goals.
Unveiling the potential of galectin-3 as a diagnostic biomarker for pancreatic cancer: a review
Authors: Aderinto Nicholas , Abdulbasit Muili O. , Olatunji Deji , Edun Mariam
Published: October 2023

Early detection of pancreatic cancer is crucial for improving patient outcomes, and identifying reliable biomarkers is a critical research area in this field. Galectin-3 (Gal-3) is a promising candidate for utilisation as a diagnostic biomarker in early-stage pancreatic cancer. This review aims to explore the potential of Gal-3 in pancreatic cancer diagnosis and its implications for precision medicine. Rigorous validation studies are essential to establish the clinical utility of Gal-3, including large-scale investigations to assess its sensitivity, specificity, and predictive value. Combining Gal-3 with existing biomarkers and advanced imaging techniques may enhance the accuracy of early detection. Moreover, Gal-3 holds promise for risk stratification, enabling the identification of high-risk individuals who could benefit from intensified surveillance and early interventions. However, challenges in standardised testing protocols, establishing reference ranges, assay reliability, workflow integration, cost-effectiveness, and healthcare provider education must be addressed for successful implementation. Despite these challenges, Gal-3 presents significant implications for precision medicine in pancreatic cancer management. By unravelling its potential and overcoming the hurdles, Gal-3 could revolutionise early detection, risk stratification, and personalised approaches in pancreatic cancer care. Collaborative efforts and continued research will be crucial in harnessing the full potential of Gal-3 as a diagnostic biomarker for early-stage pancreatic cancer.
Endoscopic Removal of a Recurrent Trichobezoar in an Adolescent: A Case Report
Authors: Tetarbe Shivangi , Dirkhipa Tsering Yangchen , Karkera Parag Janardhan , Dennis Praveen Benjamin , Shah Ira
Published: October 2023

Trichobezoar, a rare condition of intragastric hair accumulation is commonly associated with an underlying psychological condition. Removal of the bezoar either endoscopically or surgically (laparoscopy or laparotomy) with concurrent psychiatric assessment and treatment is the mode of treatment. We present a 10-year-old child with recurrent trichobezoar, who was managed surgically the first time, and subsequently endoscopic removal was done on recurrence of bezoar after 3 months. We also present the difficulties encountered during endoscopic bezoar removal.
Health-Related Quality-of-Life Effects of Rectus Repair during Body Contouring Surgery in Postbariatric Patients: A Prospective Study
Authors: Wilting Roy , Lier Bastiaan , de Vries Claire E. , Dalaei Farima , Poulsen Lotte , Luketina Rosalia , Repo Jussi P. , Paul Marek ,   BODY-Q Network, Hoogbergen Maarten
Published: October 2023

Background:

Massive weight loss after bariatric surgery often leads to psychological and physical dissatisfaction, resulting in an increased demand for body contouring surgery (BCS). As a result of these operations, health-related quality of life (HRQL) is improved. However, little is known about the impact of rectus plication during BCS on HRQL.

Methods:

This multicenter prospective cohort study included postbariatric primary BCS patients with a minimum follow-up period of 12 months between January of 2016 and December of 2019. Patients were divided into 2 groups based on plication status. Using the BODY-Q, a patient-reported outcome measure, HRQL was measured preoperatively and at least 12 months postoperatively. Six HRQL domains were investigated: body image, physical function, psychological function, sexual function, social function, and physical symptoms.

Results:

A total of 305 patients were included in this study: 201 of these patients (66%) did not undergo plication, whereas 104 patients (34%) did. HRQL improved significantly 12 months after BCS in all measured domains, regardless of plication status. Delta scores were significantly higher in the plication group in all HRQL domains. After adjusting for baseline score and other significant variables through multivariate linear regression, 3 scales remained significant: body image (P = 0.001), psychological function (P = 0.035), and sexual function (P = 0.035).

Conclusions:

Three of 6 HRQL domains showed significant improvement after BCS with rectus plication, predominantly body image. Preoperative counseling and surgical planning could benefit from this information. The long-term effects of rectus plication on HRQL should be explored in future research.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, III.
A systematic scoping review protocol to summarise and appraise the use of artificial intelligence in the analysis of digital videos of invasive general surgical procedures
Authors: King Anni , Fowler George , Macefield Rhiannon C. , Quek Fang-Fang , Walker Hamish , Thomas Charlie , Markar Sheraz , Blazeby Jane M. , Blencowe Natalie S.
Published: October 2023

Background:

Intraoperative video recordings are a valuable addition to operative written documentation. However, the review of these videos often requires surgical expertise and takes considerable time. While a large amount of work has been undertaken to understand the role of artificial intelligence (AI) in healthcare more generally, the application of these techniques to automate the analysis of surgical videos is currently unclear. In this systematic scoping review, we sought to give a contemporary overview of the use of AI research in the analysis of digital videos of invasive general surgical procedures. We will describe and summarise the study characteristics, purpose of the applications and stage of development, to ascertain how these techniques might be applied in future research and to identify gaps in current knowledge (e.g. uncertainties about the study methods).

Methods:

Systematic searches will be conducted in OVID Medline and Embase, using terms related to ‘artificial intelligence’, ‘surgery’ and ‘video’ to identify all potentially relevant studies published since 1st January 2012. All primary studies where AI has been applied to the analysis of videos (recorded by conventional digital cameras or laparoscopic or robotic-assisted technology) of general surgical procedures will be included. Data extraction will include study characteristics, governance, details of video datasets and AI models, measures of accuracy, validation and any reported limitations.

Ethics and dissemination:

No ethical approval is required as primary data will not be collected. The results will be disseminated at relevant conferences, on social media and published in a peer-reviewed journal.
Assessment of microbial contamination in laser materials processing laboratories used for prototyping of biomedical devices
Authors: Somorin Yinka M. , O'Connor Gerard M.
Published: October 2023

Microbial contamination of medical devices during pilot production can be a significant barrier as the laboratory environment is a source of contamination. There is limited information on microbial contaminants in laser laboratories and environments involved in the pilot production of medical devices. This study aimed to determine the bioburden and microbial contaminants present in three laser laboratories - an ISO Class 7 clean room, a pilot line facility, and a standard laser laboratory. Microbiological air sampling was by passive air sampling using settle plates and the identity of isolates was confirmed by DNA sequencing. Particulate matter was analysed using a portable optical particle counter. Twenty bacterial and 16 fungal genera were isolated with Staphylococcus and Micrococcus being the predominant genera. Most isolates are associated with skin, mouth, or upper respiratory tract. There was no significant correlation between microbial count and PM2.5 concentration in the three laboratories. There is low level but diverse microbial population in laser-processing environments. Pathogenic bacteria such as Acinetobacter baumannii and Candida parapsilosis were isolated in those environments. These results provide data that will be useful for developing a contamination control plan for controlling microbial contamination and facilitating advanced manufacturing of laser-based pilot production of medical devices.
Phenotypic and genomic characterization of Pseudomonas aeruginosa isolates recovered from catheter-associated urinary tract infections in an Egyptian hospital
Authors: Eladawy Mohamed , Thomas Jonathan C. , Hoyles Lesley
Published: October 2023

Catheter-associated urinary tract infections (CAUTIs) represent one of the major healthcare-associated infections, and

Pseudomonas aeruginosa

is a common Gram-negative bacterium associated with catheter infections in Egyptian clinical settings. The present study describes the phenotypic and genotypic characteristics of 31

P

.

aeruginosa

isolates recovered from CAUTIs in an Egyptian hospital over a 3 month period. Genomes of isolates were of good quality and were confirmed to be

P. aeruginosa

by comparison to the type strain (average nucleotide identity, phylogenetic analysis). Clonal diversity among the isolates was determined; eight different sequence types were found (STs 244, 357, 381, 621, 773, 1430, 1667 and 3765), of which ST357 and ST773 are considered to be high-risk clones. Antimicrobial resistance (AMR) testing according to European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines showed that the isolates were highly resistant to quinolones [ciprofloxacin (12/31, 38.7 %) and levofloxacin (9/31, 29 %) followed by tobramycin (10/31, 32.5 %)] and cephalosporins (7/31, 22.5 %). Genotypic analysis of resistance determinants predicted all isolates to encode a range of AMR genes, including those conferring resistance to aminoglycosides, β-lactamases, fluoroquinolones, fosfomycin, sulfonamides, tetracyclines and chloramphenicol. One isolate was found to carry a 422 938 bp pBT2436-like megaplasmid encoding OXA-520, the first report from Egypt of this emerging family of clinically important mobile genetic elements. All isolates were able to form biofilms and were predicted to encode virulence genes associated with adherence, antimicrobial activity, anti-phagocytosis, phospholipase enzymes, iron uptake, proteases, secretion systems and toxins. The present study shows how phenotypic analysis alongside genomic analysis may help us understand the AMR and virulence profiles of

P. aeruginosa

contributing to CAUTIs in Egypt.
Screening of the Key Genes and Signaling Pathways for Schizophrenia Using Bioinformatics and Next Generation Sequencing Data Analysis
Authors: Vastrad Basavaraj , Vastrad Chanabasayya
Published: October 2023

Schizophrenia is thought to be the most prevalent chronic psychiatric disorder. Numerous proteins have been identified that are associated with the occurrence and development of schizophrenia. This study aimed to identify potential core genes and pathways involved in schizophrenia, through exhaustive bioinformatic and next generation sequencing (NGS) data analyses using GSE20966 NGS data of neural progenitor cells and neurons obtained from healthy controls and patients with schizophrenia. The NGS data were downloaded from the Gene Expression Omnibus database. NGS data was processed by the DESeq2 package in R software and the differentially expressed genes (DEGs) were identified. Gene Ontology (GO) enrichment analysis and REACTOME pathway enrichment analysis were carried out to identify potential biological functions and pathways of the DEGs. Protein-protein interaction (PPI) network, module, miRNA-hub gene regulatory network and TF-hub gene regulatory network analysis were performed to identify the hub genes, miRNA and TFs. Potential hub genes were analyzed using receiver operating characteristic (ROC) curves in the R package (pROC). In this investigation, an overall 955 DEGs were identified: 478 genes were remarkably up regulated and 477 genes were distinctly down regulated. These genes were enriched for GO terms and pathways mainly involved in the multicellular organismal process, GPCR ligand binding, regulation of cellular process and amine ligand-binding receptors. MYC, FN1, CDKN2A, EEF1G, CAV1, ONECUT1, SYK, MAPK13, TFAP2A and BTK were considered the potential hub genes. miRNA-hub gene regulatory network and TF-hub gene regulatory network were constructed successfully. On the whole, the findings of this investigation enhance our understanding of the potential molecular mechanisms of schizophrenia and provide potential targets for further investigation.