bluuebunny/crossref_metadata_2025 huggingface dataset:
The Law and the Profits: Lewis Granom and the Royal Licence as a Form of Music Copyright Protection
Authors: Duncan Cheryll
Published: May 2023

In 1753 the composer Lewis Granom instigated proceedings against several London music sellers, led by John Cox, for breach of copyright. The complaint unravelled because the royal licence/privilege he had acquired to protect his XII New Songs and Ballads against piracy post-dated their publication. After explaining why most composers relied on the licence for protection, and not the 1710 Copyright Act, a survey of its use c.1720–c.1765 leads to a re-examination of three test cases that corrects previous misconceptions about its efficacy. Detailed discussion of the litigation exposes weaknesses in Granom’s case, identifies the engraver Cox employed to copy the songs, shows that the outcome was consistent with evolving legal thinking about privileges, and reveals that an unwritten convention bound composers to notify music sellers if their publications were licensed. This study is an antidote to prevailing scholarly claims that the licence was a toothless instrument that did little to discourage piracy.
Neoadjuvant Versus Adjuvant Systemic Therapy for Early-Stage Non-Small Cell Lung Cancer: The Changing Landscape Due to Immunotherapy
Authors: John Ajoy Oommen , Ramnath Nithya
Published: May 2023

Non-small cell lung cancer (NSCLC) remains a major cause of morbidity and mortality worldwide. One-third of NSCLC patients present with surgically resectable, non-metastatic disease; however, many of these patients will recur despite curative surgery and adjuvant therapy. The recent publication of randomized trials incorporating immune check-point inhibitors (ICI) to the standard neo-adjuvant and adjuvant treatment regimens has reported improved survival with manageable toxicity profiles. The IMpower 010 studied the use of adjuvant atezolizumab after standard surgery and adjuvant chemotherapy. They demonstrated an improvement in 3-year disease-free survival (DFS) prompting a change in treatment guidelines. The Checkmate 816 and NADIM II studies evaluated the addition of pembrolizumab and nivolumab, respectively, to standard neo-adjuvant chemotherapy. The results from both trials showed an improvement in 2-year event-free survival (EFS) and 2-year PFS (PFS), respectively. In this review, we summarize the prior data regarding adjuvant and neo-adjuvant chemotherapy in NSCLC and elaborate on results from the newer trials incorporating ICIs. We briefly discuss the pros and cons of each treatment approach along with areas that need further clarity to inform clinical practice and future directions for research in this disease.
Heat induces multiomic and phenotypic stress propagation in zebrafish embryos
Authors: Feugere Lauric , Bates Adam , Emagbetere Timothy , Chapman Emma , Malcolm Linsey E , Bulmer Kathleen , Hardege Jörg , Beltran-Alvarez Pedro , Wollenberg Valero Katharina C
Published: May 2023

Heat alters biology from molecular to ecological levels, but may also have unknown indirect effects. This includes the concept that animals exposed to abiotic stress can induce stress in naive receivers. Here, we provide a comprehensive picture of the molecular signatures of this process, by integrating multiomic and phenotypic data. In individual zebrafish embryos, repeated heat peaks elicited both a molecular response and a burst of accelerated growth followed by a growth slowdown in concert with reduced responses to novel stimuli. Metabolomes of the media of heat treated vs. untreated embryos revealed candidate stress metabolites including sulfur-containing compounds and lipids. These stress metabolites elicited transcriptomic changes in naive receivers related to immune response, extracellular signaling, glycosaminoglycan/keratan sulfate, and lipid metabolism. Consequently, non-heat-exposed receivers (exposed to stress metabolites only) experienced accelerated catch-up growth in concert with reduced swimming performance. The combination of heat and stress metabolites accelerated development the most, mediated by apelin signaling. Our results prove the concept of indirect heat-induced stress propagation toward naive receivers, inducing phenotypes comparable with those resulting from direct heat exposure, but utilizing distinct molecular pathways. Group-exposing a nonlaboratory zebrafish line, we independently confirm that the glycosaminoglycan biosynthesis-related gene chs1 and the mucus glycoprotein gene prg4a, functionally connected to the candidate stress metabolite classes sugars and phosphocholine, are differentially expressed in receivers. This hints at the production of Schreckstoff-like cues in receivers, leading to further stress propagation within groups, which may have ecological and animal welfare implications for aquatic populations in a changing climate.
Student close contact behavior and COVID-19 transmission in China's classrooms
Authors: Guo Yong , Dou Zhiyang , Zhang Nan , Liu Xiyue , Su Boni , Li Yuguo , Zhang Yinping
Published: May 2023

Classrooms are high-risk indoor environments, so analysis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission in classrooms is important for determining optimal interventions. Due to the absence of human behavior data, it is challenging to accurately determine virus exposure in classrooms. A wearable device for close contact behavior detection was developed, and we recorded >250,000 data points of close contact behaviors of students from grades 1 to 12. Combined with a survey on students' behaviors, we analyzed virus transmission in classrooms. Close contact rates for students were 37 ± 11% during classes and 48 ± 13% during breaks. Students in lower grades had higher close contact rates and virus transmission potential. The long-range airborne transmission route is dominant, accounting for 90 ± 3.6% and 75 ± 7.7% with and without mask wearing, respectively. During breaks, the short-range airborne route became more important, contributing 48 ± 3.1% in grades 1 to 9 (without wearing masks). Ventilation alone cannot always meet the demands of COVID-19 control; 30 m3/h/person is suggested as the threshold outdoor air ventilation rate in a classroom. This study provides scientific support for COVID-19 prevention and control in classrooms, and our proposed human behavior detection and analysis methods offer a powerful tool to understand virus transmission characteristics and can be employed in various indoor environments.
Neutrino propagation in the neutron star with uncertainties from nuclear, hadron, and particle physics
Authors: Hutauruk Parada T P , Gil Hana , Nam Seung-il , Hyun Chang Ho
Published: May 2023

In the present work, we investigate the neutral-current neutrino-nucleon scattering in the nuclear medium using various energy-density functional models such as KIDS (Korea-IBS-Daegu-SKKU) and SLy4, together with the quark-meson coupling model for the nucleon form factors at finite density. The differential cross-section and neutrino mean free path are computed numerically, considering the density-dependent nucleon form factors (DDFF) and neutrino structural properties such as the neutrino magnetic moment (NMM) and its electric charge radius (NCR). It turns out that the DDFF decreases the scattering cross-section, whereas the NCR increases it considerably. The effect of the NMM turns out to be almost negligible. We also observe that the value of the neutron effective mass is of importance in the neutron-star cooling process, indicating that for a neutron effective mass larger than the mass in free space, the neutrino can interact with matter at densities ρ ≳ 1.5ρ0 in a neutron star with radius 13 km.
Postirradiation temperature influences DSB repair and dicentric chromosome formation—potential impact for dicentric chromosome analysis in interlaboratory comparisons
Authors: Beinke Christina , Port Matthias , Scherthan Harry
Published: May 2023

The objective was to investigate the influence of different pre-storage temperatures in the dicentric chromosome analysis (DCA) protocol (22°C vs. 37°C) by using γ-H2AX + 53BP1 foci as a marker for deoxyribonucleic acid (DNA) double-strand break (DSB) damage induction and repair and the formation of dicentric chromosomes as a result of mis-repair. Repair of γ-H2AX + 53BP1 DSB foci was absent in samples that were incubated for 2 h at 22°C after exposure of 0.5 and 1.2 Gy. When 0.5- and 1.2-Gy-exposed samples were incubated at 37°C for 2 h, there was an average decline of 31 and 52% of DSB foci, respectively. This indicated that DNA repair occurred. There was a 27% decrease in dicentric chromosome yield at 1.2 Gy and a 15% decrease at 3.5 Gy after post-irradiation incubation for 2 h at 37°C relative to the observed dicentric frequencies at 22°C. Recommended to re-phase: our data suggested that there were more open DSBs after a 2-h incubation at 22°C, which contributed to more mis-repair and dicentric formation from the start of culture. Our findings are corroborated by publications showing that lesion interaction based on enzymatic activity is suppressed below 21°C. As such temperature variations can be a source of variation in DCA during interlaboratory comparison studies, we propose to establish a common guide for the standardisation of pre-culture conditions in cytogenetic dosimetry proficiency testing.
Marking Race: Empire, Social Democracy, Deindustrialization
Authors: Matera Marc , Natarajan Radhika , Perry Kennetta Hammond , Schofield Camilla , Waters Rob
Published: May 2023

This joint-authored essay concludes the thematic issue ‘Marking Race’. Drawing on the authors’ individual essays and reviewing the wider literatures in the field of race and immigration, imperialism and decolonization, social democracy and the welfare state, and deindustrialization, the essay makes a series of proposals about what an analytical focus on race adds to our understanding of modern British history.
The African Grounds of Race Relations in Britain
Authors: Matera Marc
Published: May 2023

‘Race relations’ became the most common way of conceptualizing the ‘integration’ of Commonwealth migrants and various obstacles to it in post-war Britain. However, interest in race relations did not centre initially on Afro-Caribbeans and other non-white migrants to metropolitan Britain as is commonly assumed. Before the 1960s, efforts to study and manage them centred primarily on British settler colonies in Africa. This article demonstrates how colonial Africa provided institutional models and much of the personnel and start-up capital for a race relations industry in Britain that depoliticized racism and delegitimated anticolonial and Black Power politics by attributing them to racial identification. Studies of and policies directed towards race relations in 1960s Britain emerged alongside and in connection with efforts to manage, co-opt, or divert the transformative potential of African liberation movements and to shape post-colonial futures with neoliberal solutions.
Assessing the effect of N-oxidation on the mutagenicity of 1-pyrazolines using the Ames assay
Authors: Inami Keiko , Miura Motofumi , Yoshida Masafumi , Mochizuki Masataka
Published: May 2023

N-Nitrosamines are well known as environmental carcinogens. We have reported that N-nitroso-N-methylbutylamine was oxidized by Fe2+-Cu2+-H2O2 to 5-methyl-5-nitro-1-pyrazoline, a direct-acting N-oxide. 1-Pyrazolines have not been reported to exhibit genotoxicity. In this study, we investigated the effect of N-oxidation on the mutagenicity of 1-pyrazolines using the Ames assay. The mutagenicity of 5-alkyl-5-nitro-1-pyrazoline 1-oxide (1a; methyl, 1b; ethyl), the N-oxide isomer (3-alkyl-3-nitro-1-pyrazoline 1-oxide; 2a; methyl, 2b; ethyl), and the corresponding nonoxides (3-alkyl-3-nitro-1-pyrazoline; 3a; methyl, 3b; ethyl) was assayed in Salmonella typhimurium TA1535 and Escherichia coli WP2uvrA. The ratios of mutagenic potency in S. typhimurium TA1535 versus E. coli WP2uvrA were compared with those of N-alkylnitrosoureas. To predict the reaction site on the pyrazolines with nucleophiles, the electron density of the pyrazolines was obtained by theoretical calculations. The pyrazolines were mutagenic in S. typhimurium TA1535 and E. coli WP2uvrA. The ratio of S. typhimurium TA1535 to E. coli WP2uvrA 1a (87:13) or 1b (90:10) was similar to that of N-ethyl-N-nitrosourea (70:30). In contrast, the mutagenic ratio of 2a (22:78) or 2b (52:48) was similar to that of N-propyl-N-nitrosourea (48:52) or N-butyl-N-nitrosourea (14:86). The ratio of 3a (53:47) or 3b (54:46) was similar to that of N-propyl-N-nitrosourea or N-butyl-N-nitrosourea. The pyrazolines exhibit genotoxicity, and the mutagenic potency of the 1-pyrazolines is influenced by N-oxidation. We estimated that the mutagenicity of 1a or 1b was caused by DNA ethylation, and the isomers or the nonoxides were mutagenic via formation of alkylated DNA, which contains an alkyl chain longer than the propyl.
Review of the zebrafish as a model to investigate per- and polyfluoroalkyl substance toxicity
Authors: Rericha Yvonne , Simonich Michael T , Truong Lisa , Tanguay Robyn L
Published: May 2023

The existence of thousands of per- and polyfluoroalkyl substances (PFAS) and evidence that some cause adverse health effects has created immense need to better understand PFAS toxicity and to move beyond one-chemical-at-a-time approaches to hazard assessment for this chemical class. The zebrafish model enables rapid assessment of large libraries of PFAS, powerful comparison of compounds in a single in vivo system, and evaluation across life stages and generations, and has led to significant advances in PFAS research in recent years. The focus of this review is to assess contemporary findings regarding PFAS toxicokinetics, toxicity and apical adverse health outcomes, and potential modes of action using the zebrafish model. Much of the peer-reviewed literature has focused on a small subset of PFAS structural subclasses, such as the perfluoroalkyl sulfonic acids and perfluoroalkyl carboxylic acids. However, recent data on more diverse PFAS structures are enabling prioritization of compounds of concern. Structure-activity comparisons and the utilization of modeling and ‘omics technologies in zebrafish have greatly contributed to our understanding of the hazard potential for a growing number of PFAS and will surely inform our understanding and predictive capabilities for many more PFAS in the future.
Mental Health Implications of Abortion Restrictions for Historically Marginalized Populations
Authors: Ogbu-Nwobodo L. , Shim R.S. , Vinson S.Y. , Mangurian C.
Published: May 2023

(N Engl J Med. 2022;387:1613–1617)

With the dismantling of nationwide legal abortion in the United States by the Supreme Court ruling on Dobbs v. Jackson Women’s Health, it is expected that there are far-reaching effects that will disproportionately affect historically marginalized populations. Access to equitable health care is met with many barriers for these groups, which include racial and sexual minorities, and people with mental health conditions, substance abuse disorders and trauma. Disparity in pregnancy outcomes currently occur in these groups and the Dobbs decision is expected to exacerbate this.
Planned Cesarean Section Versus Planned Vaginal Delivery Among Women Without Formal Medical Indication for Planned Cesarean Section: A Retrospective Cohort Study of Maternal Short-term Complications
Authors: Dahlquist K. , Stuart A. , Kallen K.
Published: May 2023

(Acta Obstet Gynecol Scand. 2022;101:1026–1032)

The rates of cesarean delivery (CD) have climbed worldwide over the past 3 decades. While the increased risks of serious complications associated with CD compared with vaginal delivery (VD) have been well described, there is a lack of information on the risks and benefits of CD without medical indication, or “CD on maternal request.” This study compared the rates of short-term complications, including postpartum thromboembolism and infections, with planned, requested CD compared with planned VD.
Carbetocin Versus Oxytocin at Elective Caesarean Delivery: A Double-blind, Randomized, Controlled, Noninferiority Trial of Low-dose and High-dose Regimens
Authors: McDonagh F. , Carvalho J.C.A. , Abdulla S. , Downey K. , Ye X.Y. , Farine D. , Morais M. , Balki M.
Published: May 2023

(Anaesthesia. 2022;77:892–900)

Oxytocin and carbetocin are both uterotonics, and are recommended for prophylactically combatting postpartum uterine atony. They are currently used at high doses but some advocate for lower doses that would carry less risk for adverse effects. This double-blind, randomized, controlled non-inferiority study compared carbetocin and oxytocin at low and high doses during elective cesarean delivery (CD).
Clean Cooking Fuels to Improve Health During Pregnancy
Authors: Wylie B.J. , Asante K.P.
Published: May 2023

(N Engl J Med. 2022;387:1805–1807)

Three billion people worldwide depend on solid biomass fuels for cooking or heating, leading to millions of adverse health outcomes and deaths. Neonates are no exception with pollution from biomass fuel cookstoves causing low birth weight and pneumonia.
Preventing Spinal Hypotension During Cesarean Birth With 2 Initial Boluses of Norepinephrine in Chinese Parturients: A Randomized, Double-blind, Controlled Trial
Authors: Lyu W. , Wei P. , Tang W. , Ma X. , Zheng Q. , Zhou H. , Zhou J. , Li J.
Published: May 2023

(Anesth Analg. 2023;136:94–100)

Spinal hypotension is a common adverse outcome during cesarean delivery and impacts 70% to 80% of mothers. Norepinephrine has proven effective in preventing spinal hypotension, however, the optimal regimen of norepinephrine has yet to be determined. This study hypothesized an initial norepinephrine bolus helps prevent spinal hypotension compared with continuous norepinephrine alone. The aim of this study was to compare 2 loading boluses of norepinephrine (0.05 and 0.10 μg/kg) followed by regular 0.05 μg/kg/min infusion during cesarean delivery in ability to prevent spinal hypotension using noninvasive blood pressure measurements.
Adapting Contingency Management for Hospitalized Patients with Stimulant Use Disorder
Authors: Peng Linda , Titus Hope , Roellich Provo , Englander Honora
Published: May 2023

Background

Hospitals struggle to engage patients with stimulant use disorders, and little is known about how to adapt evidence-based behavioral interventions, such as contingency management (CM), for hospital settings. Our study is the first step in informing the design of a hospital CM intervention.

Methods

We performed a qualitative study at a quaternary referral academic medical center in Portland, Oregon. We conducted semistructured qualitative interviews with CM experts, hospital staff, and hospitalized patients, eliciting input about hospital CM adaptations, anticipated challenges, and potential opportunities. We performed a reflexive thematic analysis at a semantic level and shared results for respondent validation.

Results

We interviewed 8 CM experts (researchers and clinicians), 5 hospital staff, and 8 patients. Participants felt CM could benefit hospitalized patients by supporting patient substance use disorder and physical health goals, especially by addressing the boredom, sadness, and loneliness of hospitalization. Participants emphasized that in-person interactions could improve patient-staff relationships by using “super positive” experiences to improve rapport. For successful hospital CM, participants emphasized CM core concepts and potential hospital adaptations, including identifying hospital-specific high-yield target behaviors, ensuring staff training, and using CM to support the hospital discharge transition. Participants also encouraged considering novel mobile app interventions, which may offer more flexibility in the hospital, recommending that such interventions include an in-person CM facilitator.

Conclusions

Contingency management has potential to support hospitalized patients and improve patient and staff experience. Our findings can inform CM interventions for hospital systems seeking to expand access to CM and stimulant use disorder treatment.
Developing Surgical Skill Level Classification Model Using Visual Metrics and a Gradient Boosting Algorithm
Authors: Shafiei Somayeh B. , Shadpour Saeed , Mohler James L. , Attwood Kristopher , Liu Qian , Gutierrez Camille , Toussi Mehdi Seilanian
Published: May 2023

Objective:

Assessment of surgical skills is crucial for improving training standards and ensuring the quality of primary care. This study aimed to develop a gradient-boosting classification model to classify surgical expertise into inexperienced, competent, and experienced levels in robot-assisted surgery (RAS) using visual metrics.

Methods:

Eye gaze data were recorded from 11 participants performing 4 subtasks; blunt dissection, retraction, cold dissection, and hot dissection using live pigs and the da Vinci robot. Eye gaze data were used to extract the visual metrics. One expert RAS surgeon evaluated each participant’s performance and expertise level using the modified Global Evaluative Assessment of Robotic Skills (GEARS) assessment tool. The extracted visual metrics were used to classify surgical skill levels and to evaluate individual GEARS metrics. Analysis of Variance (ANOVA) was used to test the differences for each feature across skill levels.

Results:

Classification accuracies for blunt dissection, retraction, cold dissection, and burn dissection were 95%, 96%, 96%, and 96%, respectively. The time to complete only the retraction was significantly different among the 3 skill levels (P value = 0.04). Performance was significantly different for 3 categories of surgical skill level for all subtasks (P values < 0.01). The extracted visual metrics were strongly associated with GEARS metrics (R2 > 0.7 for GEARS metrics evaluation models).

Conclusions:

Machine learning algorithms trained by visual metrics of RAS surgeons can classify surgical skill levels and evaluate GEARS measures. The time to complete a surgical subtask may not be considered a stand-alone factor for skill level assessment.
Next questions in the management of retroperitoneal sarcoma
Authors: Drohan Ashley , Gronchi Alessandro
Published: May 2023

Purpose of review

Retroperitoneal soft-tissue sarcomas (RPS) are a group of rare, histologically distinct tumours with variable recurrence patterns depending on histological type. This review will discuss the growing body of evidence supporting histology-specific, multidisciplinary management and highlight areas of future research for patients with RPS.

Recent findings

Histology-tailored surgery is the cornerstone of management in patients with localized RPS. Further efforts to develop resectability criteria and identify patients who will benefit from neoadjuvant treatment strategies will help standardize the treatment of patients with localized RPS. Surgery for local recurrence is well tolerated in selected patients and re-iterative surgery in liposarcoma (LPS) may be beneficial at the time of local recurrence. The management of advanced RPS holds promise with several trials currently investigating systemic treatment beyond conventional chemotherapy.

The management of RPS has made significant progress over the past decade owing to international collaboration. Ongoing efforts to identify patients who will derive the most benefit from all treatment strategies will continue to advance the field of RPS.
Immunotherapies in non-metastatic gastrointestinal cancers
Authors: Saúde-Conde Rita , Nguyen Dan , Hendlisz Alain
Published: May 2023

Purpose

Over the last decade, immune checkpoint inhibitors (ICI) have emerged as cornerstone in the treatment of many metastatic tumour types, including gastrointestinal cancers. In many solid tumours, the effective therapies in the metastatic field are progressively brought into the curative setting. Consequently, earlier tumoural settings have become a field of experiment for immunotherapies. In melanoma, lung, and bladder cancers, excellent results were recorded, possibly explained by differences in the tumour microenvironment between metastatic and non-metastatic settings. In gastrointestinal (GI) Oncology, nivolumab is the first immune checkpoint inhibitor to become a standard-of-care adjuvant treatment after curative surgery for oesophagal or gastroesophageal junction cancer.

Recent findings

We herein discuss the results of a selection of the most relevant studies presented/published over the last 18 months testing immunotherapies in non-metastatic GI cancers. Among immunotherapies, ICI have been investigated in pre-, peri- and postoperative setting across tumour types, alone or in combination with chemo- and/or radiotherapy. Vaccines are also a new field of investigation.

Promising results from two studies (NCT04165772 and NICHE-2 study) demonstrating never-seen-before responses to neoadjuvant immunotherapy in MMR deficient (dMMR) colorectal cancers raise hope for improving the patients’ outcome and developing organ-sparing strategies in this situation.
Selection Bias in Avoiding Vein Graft in Replantation/Revascularization May Exist in Distal and Proximal Amputations, Respectively
Authors: Kobayashi Koichi , Shinoura Susumu , Nishimura Ken , Sugawara Runa
Published: May 2023

Background:

No difference in the success rate has been reported between the vein graft and non–vein graft groups in replantation/revascularization. However, this depends on a wide range of indications in difficult cases. This study aimed to investigate the selection bias in avoiding vein grafts.

Methods:

This is a single-center, noninterventional, retrospective cohort study comprising 229 patients (277 digits) who underwent replantation/revascularization between January 2000 and December 2020 at our institution. Sex, age, smoking history, comorbidities, affected side, level of amputation, complete or incomplete amputation, type of fracture and mechanism, diameter of the artery, needle, warm ischemic time, and results were investigated and compared between the subgroups with and without vein graft. Results were investigated between the subgroups with and without a vein graft in the distal and proximal groups.

Results:

In the distal group, the mean arterial diameter of the vein graft subgroup was larger than that of the non–vein graft subgroup [0.7 (0.1) mm and 0.6 (0.2) mm, respectively, P < 0.05]. In the proximal group, the vein graft subgroup had higher severity than the non–vein graft subgroup (comminuted fracture, 31.1% versus 13.4%; and avulsion or crush amputation, 57.8% versus 37.1%, respectively, P < 0.05). However, the success rate was not significantly different between the aforementioned subgroups.

Conclusion:

There was no significant difference between the vein graft and non–vein graft subgroups owing to the selection bias avoiding small arteries in the distal amputation and the absence of said bias in the proximal amputation.
Lumbar Sympathetic Ganglion Block Facilitates Wound Healing in a Rat Ischemic Hindquarter Model
Authors: Shoji Mami , Kuwahara Hiroaki , Osumi Makoto , Akaishi Satoshi , Ogawa Rei
Published: May 2023

Background:

Lumbar sympathetic nerve block (LSNB) improves blood flow in the lower limbs and relieves pain involving the sympathetic afferents. This study examines the use of LSNB, but there are no reports of its use for the purpose of wound healing. Therefore, the authors planned the following study.

Methods:

An ischemic limb ulcer was created on both lower limbs using a rat model (N = 18). The rats were divided into three groups, namely, A, B, and C. Group A received LSNB on one side (N = 6). Group B was sprayed with basic fibroblast growth factor preparation (trafermin/fiblast) on one side (N = 6). Group C was used as a control (N = 6). Lower limb temperature and the ulcer area were measured over time in each group. Furthermore, the correlation between the ulcer temperature and the ulcer area reduction rate was analyzed.

Results:

Group A had higher skin temperature on the LSNB-treated side than on the nontreated side (P = 0.0022 < 0.05). Regarding the correlation between the average temperature and the ulcer area reduction rate, the correlation coefficient was as high as 0.691 in group A.

Conclusions:

In the LSNB group, the skin temperature increased and the ulcer area decreased significantly. Conventionally, LSNB has been used for pain relief purposes, although the authors consider that it will be useful in the treatment of ischemic ulcers and that it is a potential treatment option for future chronic limb ischemia/chronic limb-threatening ischemia cases.
An integrated analysis of fecal microbiome and metabolomic features distinguish non-cirrhotic NASH from healthy control populations
Authors: Carr Rotonya M. , Li Yun , Chau Lillian , Friedman Elliot S. , Lee Jung-Jin , Adorini Luciano , Erickson Mary , Zaru Luna , Shringarpure Reshma , MacConell Leigh , Bittinger Kyle , Li Hongzhe , Wu Gary D.
Published: May 2023

Background and Aims:

There is great interest in identifying microbiome features as reliable noninvasive diagnostic and/or prognostic biomarkers for non-cirrhotic NASH fibrosis. Several cross-sectional studies have reported gut microbiome features associated with advanced NASH fibrosis and cirrhosis, where the most prominent features are associated with cirrhosis. However, no large, prospectively collected data exist establishing microbiome features that discern non-cirrhotic NASH fibrosis, integrate the fecal metabolome as disease biomarkers, and are unconfounded by BMI and age.

Approach and Results:

Results from shotgun metagenomic sequencing performed on fecal samples prospectively collected from 279 US patients with biopsy-proven NASH (F1–F3 fibrosis) enrolled in the REGENERATE I303 study were compared to those from 3 healthy control cohorts and integrated with the absolute quantification of fecal bile acids. Microbiota beta-diversity was different, and BMI- and age-adjusted logistic regression identified 12 NASH-associated species. Random forest prediction models resulted in an AUC of 0.75–0.81 in a receiver operator characteristic analysis. In addition, specific fecal bile acids were significantly lower in NASH and correlated with plasma C4 levels. Microbial gene abundance analysis revealed 127 genes increased in controls, many involving protein synthesis, whereas 362 genes were increased in NASH many involving bacterial environmental responses (false discovery rate < 0.01). Finally, we provide evidence that fecal bile acid levels may be a better discriminator of non-cirrhotic NASH versus health than either plasma bile acids or gut microbiome features.

Conclusions:

These results may have value as a set of baseline characteristics of non-cirrhotic NASH against which therapeutic interventions to prevent cirrhosis can be compared and microbiome-based diagnostic biomarkers identified.
MACULAR SLING: A CUSTOMIZABLE METHOD FOR MACULAR BUCKLING USING AVAILABLE ELEMENTS
Authors: Clark Andrew , Souverein Erik A. , Rootman Daniel B. , Yang Dong , Kreiger Allan E. , Nagiel Aaron
Published: May 2023

Purpose:

Macular buckling surgery is used to treat certain cases of myopic traction maculopathy but is rarely performed in the United States. One of the main factors limiting its use is the lack of commercially available buckling elements. Here, we describe a novel technique for creating an effective macular buckle using readily obtainable buckling materials.

Methods:

By using a traditional circumferential 41 band as the anchoring point around the globe, a 240 band can then be attached and oriented posteriorly along the superonasal–inferotemporal axis. This posterior 240 band is then used to guide a grooved sponge (509G) under the macula to create a customizable and titratable tamponade effect along the posterior pole. This approach was used to provide external support in the case of a recurrent, complex tractional retinal detachment which had failed multiple prior vitrectomy-based repairs.

Results:

Placement of the macular sling resolved the patient's recurrent retinal detachment with return of the visual acuity to her preoperative baseline. There have been no adverse effects related to the surgery aside from a large hyperopic shift due to the buckle effect on the macula. We believe the technical and material complexity of this technique is comparable with that of more common scleral buckling techniques.

Conclusion:

This macular sling technique can be used to create an effective posterior buckle without requiring specialized materials.
Effects of Footbath on Postoperative Pain and Sleep Quality in Patients With Lumbar Degenerative Disc Disease: A Randomized Controlled Study
Authors: Ünver Seher , Çolakoğlu Ülkü , Akıncı Ahmet Tolgay
Published: May 2023

BACKGROUND: Pain management and good sleep are essential for patients after surgical procedures. This study aimed to evaluate the effects of footbath on postoperative pain severity and sleep quality levels of patients who have undergone degenerative lumbar spine surgery. METHODS: Sixty patients were randomly assigned to the footbath intervention group or the control group. The intervention was a 20-minute footbath in 42°C water before patients fell asleep on the evening of the surgery day. On the morning of the surgery day and the morning of postoperative day, the patient's pain severity and sleep quality scores were obtained using the visual analog scale and the Visual Analog Sleep Scale. RESULTS: There was no significant difference between the pain severity scores of the study groups (P > .05). The sleep quality level of the intervention group was statistically significantly higher than that of the control group (P < .05). CONCLUSION: Consequently, a footbath is effective in increasing sleep quality levels of patients who have undergone degenerative lumbar spine surgery. It may be used as a simple and practical nonpharmacological nursing strategy for improving patients' sleep quality.
Acquired vulvar lymphangioma: risk factors, disease associations, and management considerations: a systematic review
Authors: Duong Amber , Balfour Alex , Kraus Christina N.
Published: May 2023

Background:

Acquired vulvar lymphangioma (AVL) is not well-characterized. Diagnosis is delayed and the condition is often refractory to therapy.

Objective:

The objective of this study was to provide a systematic review of AVL including risk factors, disease associations, and management options.

Methods:

A primary literature search was conducted using 3 databases: PubMed, CINAHL, and OVID, from all years to 2022.

Results:

In total, 78 publications with 133 patients (48 ± 17 years) were included. Most studies were case reports/series. The most common disease association was prior malignancy (70 patients, 53% of cases) and inflammatory bowel disease (6 patients, 5% of cases). The most common malignancy was cervical cancer (57 patients, 43% of cases). Most patients had prior radiation or surgery, with 36% (n = 48) treated with radiation, 30% (n = 40) with lymph node dissection, and 27% (n = 36) with surgical resection. Common presenting symptoms included discharge/oozing, pain, and pruritus. Most patients underwent surgical treatment for AVL with 39% treated with excision, 12% with laser therapy (the majority used CO2), and 11% with medical therapies. Most patients had failed prior therapies and there was a diagnostic delay.

Limitations:

Retrospective nature. Most studies were limited to case reports and case series, with interstudy variability and result heterogeneity.

Conclusion:

AVL is an underrecognized entity and should be considered in patients with a history of malignancy or radiation to the urogenital area. Treatment should include multidisciplinary care and address underlying lymphatic changes, manage any existing inflammatory conditions, and utilize skin-directed therapies and barrier agents while addressing symptoms of pruritus and pain. Prospective studies are needed to further characterize AVL and develop treatment guidelines.
The Impact of Social Determinants of Health on Vestibular Schwannoma Management: A Single Institution Review
Authors: Ellsperman Susan E. , Bellile Emily , Fryatt Rachel , Hoi Karen , Wang JiCi , Fayson Shannon , Banakis Hartl Renee M. , Stucken Emily Z.
Published: May 2023

Objective

To evaluate social determinants of health and their effect on the management of vestibular schwannoma (VS).

Study Design

Retrospective chart review.

Setting

Tertiary referral center.

Patients

Patients >18 years old with sporadic VS newly diagnosed between January 1, 2010, and December 31, 2020.

Intervention(s)

Magnetic resonance imaging; audiogram; treatment recommendations.

Main Outcome Measure(s)

Differences in treatment recommendations for patients based on their social determinants of health, including race, ethnicity, and socioeconomic status.

Results

A total of 811 patients were included in analysis. Patients with a higher area deprivation index (ADI) presented with larger tumors. A higher ADI was associated with a higher likelihood of recommending radiation (or the option of surgery or radiation) compared with a recommendation of surgery alone. Tumor grade and patient age were significantly associated with treatment recommendation. Older age was associated with a recommendation of observation alone or a recommendation of radiation. Higher tumor grade was associated with a recommendation of surgery. There was a trend for higher hearing class to be associated with a recommendation of surgery, but this did not reach statistical significance. Race, ethnicity, and gender were not significantly associated with treatment recommendation.

Conclusions

Patients with higher levels of disadvantage presented with higher tumor grade, suggesting that access to care influences diagnosis. Factors including age, ADI, and tumor grade were associated with treatment recommendation.
Predictive value of metabolic score for insulin resistance and triglyceride glucose-BMI among patients with acute myocardial infarction in 1-year follow-up
Authors: Drwiła-Stec Dominika , Rostoff Paweł , Gajos Grzegorz , Nessler Jadwiga , Konduracka Ewa
Published: May 2023

Background

Recently two indicators – metabolic score for insulin resistance (METS-IR) and triglyceride glucose-BMI (TyG-BMI) have been proposed as surrogate markers of IR and potential cardiovascular risk factors. The aim of the study was to assess the predictive value of METS-IR and TyG-BMI concerning the incidence of major adverse cardiovascular events (MACE) and all-cause mortality in 1-year follow-up among patients admitted with acute myocardial infarction (AMI).

Methods

Two thousand one hundred fifty-three patients with a median age of 68 years were enrolled in the study. Patients were divided into two groups according to the type of AMI.

Results

MACE occurred in 7.9% of the patients in the ST-segment elevation myocardial infarction (STEMI) group and in 10.9% of the non-STEMI (NSTEMI) group. No significant difference in median MACE-IR and TyG-BMI between patients with and without incidence of MACE was found in both groups. None of the examined indices were predictors of MACE in the STEMI and NSTEMI groups. Moreover, both of them did not predict MACE in subgroups of patients classified according to the presence of diabetes. Finally, METS-IR and TyG-BMI were significant predictors of 1-year morality, however with low prognostic value and only in univariate regression analysis.

Conclusion

METS-IR and TyG-BMI should not be used in predicting MACE among patients with AMI.
Systemic immune-inflammation index associated with contrast-induced nephropathy after elective percutaneous coronary intervention in a case-control study
Authors: Ma Xiao , Mo Changhua , Li Yujuan , Gui Chun
Published: May 2023

Elevated systemic immune-inflammation index (SII) has associated with coronary heart disease and poor clinical outcomes. However, the relationship between SII and contrast-induced nephropathy (CIN) in patients who underwent elective percutaneous coronary intervention (PCI) is still unclear. We aimed to investigate the association of SII with the development of CIN in elective PCI patients. A retrospective study with 241 participants was performed from March 2018 to July 2020. CIN was defined as any of the following: increase in serum creatinine (SCr) level by ≥0.5 mg/dl (≥44.2 mol/L) or increase in SCr to ≥25% over the baseline value within 48–72 h after PCI. The SII levels in patients with CIN (n = 40) were significantly higher than those without. In correlation analysis, SII positively correlated to uric acid but negatively with the estimated glomerular filtration rate. Increased log2(SII) levels were independent risk factors for patients with CIN [odds ratio (OR) = 2.686; 95% confidence interval (CI), 1.457–4.953]. In the subgroup analysis, increased log2(SII) was strongly associated with the presence of CIN in male participants (OR = 3.669; 95% CI, 1.925–6.992; P < 0.05), whereas no association was found in females (OR = 1.552; 95% CI, 0.533–4.515; P > 0.05). Receiver operating characteristic analysis demonstrated that in a cutoff of 586.19, SII showed 75% sensitivity and 54.2% specificity for predicting CIN in patients undergoing elective PCI, respectively. In conclusion, elevated SII was an independent risk factor of CIN development in patients undergoing elective PCI, particularly in male people.
Progression of coronary artery calcification after radiation therapy for esophageal cancer
Authors: Matsuo Keisuke , Fukushima Kenji , Abe Takanori , Saito Satoshi , Kato Shingo , Arai Takahide , Nakano Shintaro
Published: May 2023

Background

Advances in cancer treatment have resulted in increased attention toward potential cardiac complications, especially following treatment for esophageal cancer, which is associated with a risk of coronary artery disease. As the heart is directly irradiated during radiotherapy, coronary artery calcification (CAC) may progress in the short term. Therefore, we aimed to investigate the characteristics of patients with esophageal cancer that predispose them to coronary artery disease, CAC progression on PET-computed tomography and the associated factors, and the impact of CAC progression on clinical outcomes.

Methods

We retrospectively screened 517 consecutive patients who received radiation therapy for esophageal cancer from our institutional cancer treatment database between May 2007 and August 2019. CAC scores were analyzed clinically for 187 patients who remained by exclusion criteria.

Results

A significant increase in the Agatston score was observed in all patients (1 year: P = 0.001*, 2 years: P < 0.001*). Specifically for patients receiving middle-lower chest irradiation (1 year: P = 0.001*, 2 years: P < 0.001*) and those with CAC at baseline (1 year: P = 0.001*, 2 years: P < 0.001*), a significant increase in the Agatston score was observed. There was a trend for a difference in all-cause mortality between patients who had irradiation of the middle-lower chest (P = 0.053) and those who did not.

Conclusion

CAC can progress within 2 years after the initiation of radiotherapy to the middle or lower chest for esophageal cancer, particularly in patients with detectable CAC before radiotherapy initiation.
Postoperative Crohn’s Disease
Authors: Bernstein Charles N. , Regueiro Miguel
Published: May 2023

Although surgery rates in Crohn's disease are declining in the past twenty years, bowel resection remains an important and still commonly used therapeutic option in Crohn's disease. Preoperatively, patients clinical status must be optimized including preparation for perioperative recovery including with nutrition optimization and preparation for postoperative pharmacotherapy. Postoperatively a medical therapy is often required and in recent years it has often been a biological therapy. One randomized controlled study suggested that infliximab is more likely to prevent endoscopic recurrence than placebo. But other biologicals have been used as well. Ileocolonoscopy should be undertaken by 6 months after an ileal or ileocecal resection especially. Adjunctive imaging such as transabdominal ultrasound, capsule endoscopy or cross sectional imaging may be required. Biomarker measurement with fecal calprotectin especially, or C-reactive protein, serum ferritin, serum albumin and serum hemoglobin will also be helpful.
Beyond Alar Base Resection – Contouring of the Alar Rim and Base
Authors: Rohrich Rod J. , Novak Matthew , Chiodo Michael , Lisiecki Jeffrey , Savetsky Ira , Cason Roger
Published: May 2023

Alar base surgery is approached with hesitancy and is often avoided by many surgeons because of inexperience and a lack of understanding. However, with a thorough knowledge of the anatomy and dynamic nature of the lower third of the nose, alar base resection can achieve favorable and reproducible results. Beyond correcting alar flare, an appropriately diagnosed and performed alar base procedure serves to contour both the alar rim and the alar base. The following article presents a case series of 436 consecutive rhinoplasties from a single surgeon, 214 of which underwent alar base surgery. The outcomes demonstrate that the procedure is safe and yields desirable results without a single revision being required. As the third in a series of three articles on alar base surgery by the senior author, this article unifies the management of the alar base. An intuitive approach to the classification and management of alar flare and the implications of alar base surgery on contouring of the alar base and alar rim is presented.
Mind the Gap
Authors: Dushnicky Molly J. , Fine Claire , Cellucci Tania , Garner Stephanie , Heale Liane , Matsos Mark , Beattie Karen A. , Batthish Michelle
Published: May 2023

Background

The transition from pediatric to adult care is a critical time when adolescent patients and their families face many challenges. This period can be associated with an increase in disease-related morbidity and mortality. The aim of our study is to identify gaps in transition-related care to help guide areas for improvement.

Methods

Patients (14–19 years) with juvenile idiopathic arthritis or systemic lupus erythematosus and one of their parents were recruited from the McMaster Rheumatology Transition Clinic. Both were asked to complete the Mind the Gap questionnaire, a validated tool to assess experience and satisfaction with transition care in a clinic setting. The questionnaire, addressing 3 important domains of care: management of the environment, provider characteristics, and process issues, was completed twice—once based on their current clinical experience and again based on their ideal clinical encounter. Positive scores suggest current care is less than ideal; negative scores suggest current care exceeds the ideal experience

Results

Most patients (n = 65, 68% female) had a diagnosis of juvenile idiopathic arthritis (87%). Patients identified mean gap scores between 0.2 and 0.3 for each domain of Mind the Gap, with female patients having higher gap scores compared with male patients. Parents (n = 51) identified gap scores between 0.0 and 0.3. Patients identified process issues as having the largest gap, whereas parents identified management of the environment as having the largest gap.

Conclusions

We identified several gaps in transition clinic care relative to what patients and parents identify as ideal. These can be used to improve the rheumatology transition care that is currently being provided.