bluuebunny/crossref_metadata_2025 huggingface dataset:
Poster 377: Patient Perception of Social Media Use by Orthopedic Surgeons
Authors: Wharton Benjamin , Geraghty Elisabeth , Bradsell Hannah , Ishikawa Andrew , McCarty Eric , Bravman Jonathan , Frank Rachel , Johnson Alexander
Published: August 2023

Objectives:

The purpose of this study was to characterize content posted by orthopedic surgeons on social media while investigating patient perceptions of this content and how it may influence their healthcare decisions.

Methods:

Social media posts by orthopedic surgeons from around the country were reviewed and categorized. A patient survey was written to assess perception of these categories and level of patient social media utilization. The survey was administered in the clinic of three separate orthopedic surgeons via QR code.

Results:

There were 250 completed patient surveys. In terms of social media utilization, the 18-24 (87.1%) and 25-34 (86.4%) age groups more likely to report daily use (p=0.002). However, social media utilization was high among all age groups with 78% of all patients and at least 62.5% of patients in each age group reporting weekly or daily usage. 17% of patients reported using social media to see information about their healthcare at least once per month, 21% of patients reported reviewing the social media account of a physician at least once per month, and 19% of patients reported that they were likely or very likely to view the social media account of their own physician. 23% of patients reported that social media content is likely or very likely to influence which physician they see, while only 6% of patients considered a large social media following important or very important. Patients held the most consistently positive view of posts educating patients, discussing sports team coverage, and providing patient testimonials. Patients held consistently neutral views of posts educating colleagues, discussing presentations at national meetings, displaying aspects of surgeons’ personal lives, and supporting marginalized groups. Several post categories elicited negative or highly polarized responses including those discussing research publications, showing surgical technique pictures/videos, showing pictures or videos taken of the surgeon in the operating room, political statements, or showing pictures from a patient’s own surgery.

Conclusions:

Social media is a useful tool to help physicians interact with patients and grow a practice. Physicians should consider posting content that is viewed most positively by patients including post educating patients, discussing sports team coverage, and providing patient testimonials. Content that is viewed less favorably should be posted sparingly or with a sensitive tag so that patients can avoid seeing posts that they may not enjoy. Further study is required to understand the differences between physician social media content focused on interacting with patients compared to content focused on interacting with other physicians.
Poster 388: Gender Diversity of Orthopaedic Sports Medicine Fellowship Trainees, Faculty and Leadership
Authors: Gupta Sanchita , Maginnis Connor , Saraf Shreya , Wong Stephanie , Mulcahey Mary , Lavorgna Tessa
Published: August 2023

Objectives:

Orthopaedic surgery has remained the most male-dominated field in medicine, despite recent efforts to recruit and retain more women. The objective of this study was to determine the gender composition of fellows, faculty, and leaders within orthopaedic sports medicine fellowship programs to provide a more complete analysis of gender diversity within this subspecialty.

Methods:

Official program websites of orthopaedic sports medicine fellowships listed on the Arthroscopy Association of North America (AANA) fellowship directory were examined. Data collected for analysis included the gender of program directors, fellowship faculty, orthopaedic surgery department faculty, current sports medicine fellows and fellows who graduated within the last five years.

Results:

In the academic year 2021-2022, 132 sports medicine fellows were in fellowship training in the United States within 97 programs. Of these, 113 (85.6%) were men and 19 (14.4%) were women (p<0.001). Within the past five years, 419 fellows were listed as completing a sports medicine fellowship, with 375 (89.5%) being men, and 44 (10.5%) being women (p<0.001). There is no significant difference in the gender composition of current fellows compared to the composition of fellows within the last 5 years (p=0.74). When examining gender trends in sports medicine faculty, 639 (86.6%) were men and 99 (13.4%) were women (p<0.001). There are 14 women (14.4%) orthopaedic sports medicine faculty in leadership positions (i.e., program directors or assistant program directors) compared to 83 men in such positions (85.6%) (p<0.001).

Conclusions:

Orthopaedic sports medicine fellowships remain heavily male-dominated in their trainees, faculty, and leadership. There was no significant difference in the gender composition of current fellows when compared to those who graduated in the last five years, suggesting further and novel initiatives are needed to enhance gender diversity in sports medicine. [Table: see text][Table: see text]
Defining operational research priorities to improve malaria control and elimination in sub-Saharan Africa: results from a country-driven research prioritization setting process
Authors: Tine Roger , Herrera Samantha , Badji Mouhamed Ahmed , Daniels Kyle , Ndiaye Pascal , Smith Gueye Cara , Tairou Fassiatou , Slutsker Laurence , Hwang Jimee , Ansah Evelyn , Littrell Megan ,   The Malaria Operational Research Prioritization Partnership, Pratt Abigail , Dicko Alassane , Candrinho Baltazar , Hamainza Busiku , Smith Gueye Cara , Daniels Kyle , Maiteki-Sebuguzi Catherine , Mbogo Charles , Karema Corine , Ngufor Core , Mathanga Don , Achu Dorothy , Juma Elizabeth , Ansah Evelyn , Tadesse Fitsum , Burkybile Frank , Carlson Jenny , Raman Jaishree , Gausi Khoti , Ndiaye Pascal , Uhomoibhi Perpetua , Steketee Richard , Patel Roopal , Leke Rose
Published: July 2023

Background

In order to reignite gains and accelerate progress toward improved malaria control and elimination, policy, strategy, and operational decisions should be derived from high-quality evidence. The U.S. President’s Malaria Initiative (PMI) Insights project together with the Université Cheikh Anta Diop of Dakar, Senegal, conducted a broad stakeholder consultation process to identify pressing evidence gaps in malaria control and elimination across sub-Saharan Africa (SSA), and developed a priority list of country-driven malaria operational research (OR) and programme evaluation (PE) topics to address these gaps.

Methods

Five key stakeholder groups were engaged in the process: national malaria programmes (NMPs), research institutions in SSA, World Health Organization (WHO) representatives in SSA, international funding agencies, and global technical partners who support malaria programme implementation and research. Stakeholders were engaged through individual or small group interviews and an online survey, and asked about key operational challenges faced by NMPs, pressing evidence gaps in current strategy and implementation guidance, and priority OR and PE questions to address the challenges and gaps.

Results

Altogether, 47 interviews were conducted with 82 individuals, and through the online survey, input was provided by 46 global technical partners. A total of 33 emergent OR and PE topics were identified through the consultation process and were subsequently evaluated and prioritized by an external evaluation committee of experts from NMPs, research institutions, and the WHO. The resulting prioritized OR and PE topics predominantly focused on generating evidence needed to close gaps in intervention coverage, address persistent challenges faced by NMPs in the implementation of core strategic interventions, and inform the effective deployment of new tools.

Conclusion

The prioritized research list is intended to serve as a key resource for informing OR and PE investments, thereby ensuring future investments focus on generating the evidence needed to strengthen national strategies and programme implementation and facilitating a more coordinated and impactful approach to malaria operational research.
The role of forests in the EU climate policy: are we on the right track?
Authors: Korosuo Anu , Pilli Roberto , Abad Viñas Raúl , Blujdea Viorel N. B. , Colditz Rene R. , Fiorese Giulia , Rossi Simone , Vizzarri Matteo , Grassi Giacomo
Published: July 2023

Background

The European Union (EU) has committed to achieve climate neutrality by 2050. This requires a rapid reduction of greenhouse gas (GHG) emissions and ensuring that any remaining emissions are balanced through CO2 removals. Forests play a crucial role in this plan: they are currently the main option for removing CO2 from the atmosphere and additionally, wood use can store carbon durably and help reduce fossil emissions. To stop and reverse the decline of the forest carbon sink, the EU has recently revised the regulation on land use, land-use change and forestry (LULUCF), and set a target of − 310 Mt CO2e net removals for the LULUCF sector in 2030.

Results

In this study, we clarify the role of common concepts in forest management – net annual increment, harvest and mortality – in determining the forest sink. We then evaluate to what extent the forest sink is on track to meet the climate goals of the EU. For this assessment we use data from the latest national GHG inventories and a forest model (Carbon Budget Model). Our findings indicate that on the EU level, the recent decrease in increment and the increase in harvest and mortality are causing a rapid drop in the forest sink. Furthermore, continuing the past forest management practices is projected to further decrease the sink. Finally, we discuss options for enhancing the sinks through forest management while taking into account adaptation and resilience.

Conclusions

Our findings show that the EU forest sink is quickly developing away from the EU climate targets. Stopping and reversing this trend requires rapid implementation of climate-smart forest management, with improved and more timely monitoring of GHG fluxes. This enhancement is crucial for tracking progress towards the EU’s climate targets, where the role of forests has become – and is expected to remain – more prominent than ever before.
Deriving GWAS summary estimates for paternal smoking in UK biobank: a GWAS by subtraction
Authors: Woolf Benjamin , Sallis Hannah M. , Munafò Marcus R. , Gill Dipender
Published: July 2023

Objective

To use genome-wide association study (GWAS) by subtraction, a method for deriving novel GWASs from existing summary statistics, to derive genome-wide summary statistics for paternal smoking.

Result

A GWAS by subtraction was implemented using a weighted linear model that defined the child-genotype paternal-phenotype association as the child-genotype child-phenotype association minus the child-genotype maternal-phenotype association. We first use the laws of inherence to derive the weighted linear model. We then implemented the linear model to create a GWAS of paternal smoking by subtracting the summary statistics from a GWAS of maternal smoking from the summary statistics of a GWAS of the index individual’s smoking. We used a Monte-Carlo simulation to validate the model and showed that this approach performed similarly in terms of bias to performing a traditional GWAS of paternal smoking. Finally, we validated the summary statistics in a Mendelian randomisation analysis by demonstrating an association of genetically predicted paternal smoking with paternal lung cancer and emphysema.
A promising resilience parameter for breeding: the use of weight and feed trajectories in growing pigs
Authors: Gorssen Wim , Winters Carmen , Meyermans Roel , Chapard Léa , Hooyberghs Katrijn , Janssens Steven , Huisman Abe , Peeters Katrijn , Mulder Han , Buys Nadine
Published: August 2023

Background

Increasing resilience is a priority in modern pig breeding. Recent research shows that general resilience can be quantified via variability in longitudinal data. The collection of such longitudinal data on weight, feed intake and feeding behaviour in pigs has been facilitated by the development of technologies such as automated feeding stations.

The goal of this study was to investigate resilience traits, which were estimated as deviations from longitudinal weight, feed intake and feeding behaviour data during the finishing phase. A dataset with 324,207 records between the age of 95 and 155 days on 5,939 Piétrain pigs with known pedigree and genomic information was used. We provided guidelines for a rigid quality control of longitudinal body weight data, as we found that outliers can significantly affect results. Gompertz growth curve analysis, linear modelling and trajectory analyses were used for quantifying resilience traits.

Results

To our knowledge, this is the first study comparing resilience traits from longitudinal body weight, feed intake and feeding behaviour data in pigs. We demonstrated that the resilience traits are lowly to moderately heritable for deviations in body weight (h2 = 2.9%–20.2%), in feed intake (9.4%–23.3%) and in feeding behaviour (16.2%–28.3%). Additionally, these traits have good predictive abilities in cross-validation analyses. Deviations in individual body weight and feed intake trajectories are highly correlated (rg = 0.78) with low to moderate favourable genetic correlations with feed conversion ratio (rg = 0.39–0.49). Lastly, we showed that some resilience traits, such as the natural logarithm of variances of observed versus predicted body weights (lnvarweight), are more robust to lower observation frequencies and are repeatable over three different time periods of the finishing phase.

Conclusions

Our results will help future studies investigating resilience traits and resilience-related traits. Moreover, our study provides first results on standardization of quality control and efficient data sampling from automated feeding station data. Our findings will be valuable for breeding organizations as they offer evidence that pigs’ general resilience can be selected on with good accuracy. Moreover, this methodology might be extended to other species to quantify resilience based on longitudinal data.
Inhibition of CDC20 potentiates anti-tumor immunity through facilitating GSDME-mediated pyroptosis in prostate cancer
Authors: Wu Fei , Wang Minglei , Zhong Tao , Xiao Changyan , Chen Xiaozheng , Huang Yiheng , Wu Meng , Yu Jinming , Chen Dawei
Published: August 2023

Background

Increasing evidence suggests that immunotherapy, especially immune checkpoint inhibitors (ICIs), has the potential to facilitate long-term survival in various cancer besides prostate cancer. Emerging evidence indicated that pyroptosis, an immunogenic form of cell death, could trigger an anti-tumor immune microenvironment and enhance the effectiveness of immunotherapy. Nevertheless, the mechanism underlying the regulation of pyroptosis signaling in prostate cancer remains unclear.

Methods

The differential expression of human E3 ligases in prostate cancer was integratedly analyzed from five independent public datasets. Moreover, the immunohistochemistry analysis of a tissue microarray derived from prostate cancer patients confirmed the results from the bioinformatic analysis. Furthermore, prostate cancer cell lines were evaluated via the next-generation RNA sequencing to assess transcriptomic profile upon CDC20 depletion. Next, qRT-PCR, Western blotting, cycloheximide assay, immunoprecipitation, and ubiquitination assay were employed to explore the correlation and interaction between CDC20 and GSDME. Both immune-deficient and immune-competent murine models were utilized to examine the anti-tumor efficacy of CDC20 inhibition with or without the anti-PD1 antibodies, respectively. To analyze the immune microenvironment of the xenografts, the tumor tissues were examined by immunohistochemistry and flow cytometry.

Results

The analysis of multiple prostate cancer cohorts suggested that CDC20 was the most significantly over-expressed E3 ligase. In addition, CDC20 exerted a negative regulatory effect on the pyroptosis pathway by targeting GSDME for ubiquitination-mediated proteolysis in a degron-dependent manner. Knockdown of CDC20 leads to increased GSDME abundance and a transition from apoptosis to pyroptosis in response to death signals. Furthermore, in our syngeneic murine models, we found that depletion of CDC20 significantly enhances the anti-tumor immunity by promoting the infiltration of CD8+ T lymphocytes dependent on the existence of GSDME, as well as reducing myeloid immune cells. More importantly, Apcin, a small molecular inhibitor that targets CDC20, exhibited synergistic effects with anti-PD1-based immunotherapy in murine models of prostate cancer.

Conclusions

Overall, these findings provide new insights into the upstream regulation of GSDME-mediated pyroptosis by CDC20, which specifically interacts with GSDME and facilitates its ubiquitination in a degron-dependent manner. Importantly, our data highlight novel molecular pathways for targeting cellular pyroptosis and enhancing the effectiveness of anti-PD1-based immunotherapy.
Non-invasive imaging and spectroscopy techniques for identifying historical pigments: a case study of Iranian manuscripts from the Qajar era
Authors: Koochakzaei Alireza , Mobasher Maghsoud Elmira , Jelodarian Bidgoli Behrooz
Published: July 2023

In recent years, the expansion of non-invasive methods has been a trend in identifying historical pigments. Accordingly, this study aimed to identify the pigments used in three Iranian historical manuscripts from the Qajar era by utilizing a non-invasive and multi-analytical approach. A combination of various multi-band imaging methods, along with µ-XRF, Raman and FORS spectroscopy, were employed to identify pigments. The results revealed that emerald green, cochineal, ultramarine, orpiment, and red lead were used as pigments for green, red, blue, yellow, and orange colors on a golden leaf made of brass alloy. The study also demonstrated the mixtures of lead-barite white, lead white-ultramarine and lead white-red lead-indigo-cochineal in the white, light blue, and pink sections. While multi-band imaging was found to be a suitable tool for the primary classification of pigments, relying solely on this method without a complete pigment database is not advisable, as differences in underlying paint layers and mixed pigments can affect imaging results. Overall, the combination of imaging and spectroscopic techniques provides a reliable and non-invasive approach to identifying historical pigments and their alterations.
Effect of the mirror force on the collision rate due to energetic electron precipitation: Monte Carlo simulations
Authors: Katoh Yuto , Rosendahl Paul Simon , Ogawa Yasunobu , Hiraki Yasutaka , Tadokoro Hiroyasu
Published: August 2023

We study the effect of the mirror force on the collision rate due to the energetic electron precipitation into the ionosphere. We solve the motion of individual precipitating electrons with the mirror force, where collisions with neutral gas are computed by the Monte Carlo method. By comparing the results with those without the mirror force, we examine the effect of the mirror force on the altitude profile of the ionization rate. First, we carry out simulations of mono-energetic precipitation of 3 keV electrons whose initial pitch angle is 70 degrees at 400 km at L = 6.45. We find that the collision rate peaks at around 120 km altitude and that the duration of the collision is scattered in time with a delay of about 5 ms compared with the result without mirror force. Next, we perform mono-energetic precipitation of the different energy and pitch angle ranges. Simulation results demonstrate that larger kinetic energy lowers the altitude profiles of the collision rate, consistent with previous studies. We also find that the upward motion of electrons bounced back from their mirror points results in the upward broadening of the altitude profile of the collision rate. Simulation results for electrons with kinetic energies above 100 keV show that a secondary peak of the collision rate is formed near the mirror point. The formation of the secondary peak can be explained by the stagnation of electrons around the mirror point at 130 km altitude, because the relatively long duration of staying in neutral gas increases the number of collisions. Simulation results show that under the precipitation of electrons in the kinetic energy range larger than tens of keV with the pitch angle close to the loss cone, the maximum collision rate in the altitude range lower than 100 km becomes one order of the magnitude smaller. The results of the present study suggest the importance of the mirror force for the precise modeling of ionospheric response due to the energetic electron precipitation caused by the pitch angle scattering through wave–particle interactions.

Graphical Abstract
Psychometric properties and cross-cultural comparison of the Arabic version of the Child Behavior Checklist (CBCL), Youth Self Report (YSR), and Teacher’s Report Form (TRF) in a sample of Egyptian children
Authors: Seleem Mohammad A. , Amer Reham A. , Elhosary Mohamed , Saada Sameh , Hamza Eid Abo , Elfert Yomna , Abdo Sanaa Abd El-fatah , Kabbash Ibrahim , Achenbach Thomas M.
Published: July 2023

Background

The Achenbach System of Empirically Based Assessment (ASEBA) forms are among the most studied instruments for assessing behavioral, emotional, social, and thought problems in children and adolescents worldwide. Although ASEBA instruments have been translated into Arabic, fewer studies have investigated their psychometric properties and norms in Arabic speaking societies than in other societies.

Methods

Revisions were made to the Modern Standard Arabic (MSA) translations of the Child Behavior Checklist for Ages 6–18 (CBCL/6–18), the Teacher’s Report Form (TRF), and the Youth Self-Report (YSR). Parents of 6–18-year-olds who came to the general pediatric clinic in Tanta University Hospital during a 2-year period for routine check-ups were invited to fill out the CBCL/6–18 (N = 595), while 11–18-year-olds were invited to fill out the YSR (N = 409). TRFs were filled out by teachers (N = 329).

Results

Confirmatory factor analyses supported the previously reported eight-factor syndrome structure of the forms with good psychometric properties and moderate cross-informant correlations. The mean CBCL/6–18 and YSR Total Problem scores qualified for the previously established ASEBA Multicultural Norm Group 2, while the mean TRF Total Problem score qualified for group 3.

Conclusions

The good psychometric properties and the identification of Multicultural Norm Groups for scores obtained with the Arabic translations of ASEBA forms in Egyptian society support use of the ASEBA for assessment and outcome evaluations of behavioral, emotional, social, and thought problems among Egyptian youth.
Lemierre’s syndrome variant with inferior vena cava and right common iliac vein thrombosis secondary to emphysematous pyelonephritis
Authors: Chandrappa Anupama , Das Sudha Kiran , Shetty Sachin P. , Gurumurthy Balasubramanian , Hiremath Rudresh , Patil Vikram
Published: August 2023

Background

Emphysematous pyelonephritis (EPN) is a potentially life-threatening disease with Escherichia coli (E. coli) being the most common aetiology. Infection can involve the renal parenchyma, collecting system and perinephric tissues, and is commonly encountered in patients with uncontrolled diabetes mellitus. EPN complicated by suppurative thrombophlebitis of the inferior vena cava is a rare occurrence. Our case had thrombosis of the right common iliac vein as well, which is first of its kind reported with EPN.

Case presentation

We describe a case of a 59-year-old male patient, with uncontrolled diabetes mellitus, who presented to the emergency department with a history of high-grade fever and left loin pain. Clinico-laboratory findings were diagnostic for diabetes mellitus, complicated by upper urinary tract infection with sepsis. A preliminary ultrasound of the abdomen was indicative of left hydronephrosis with features of emphysematous pyelonephritis. Abdominal computed tomography (CT) was done to ascertain the cause of hydronephrosis. Left ureteric calculus complicated by emphysematous pyelonephritis (type 3a) with intraluminal air in the left renal vein and inferior vena cava (IVC). Culture grew E. coli. Patient was started on insulin and intravenous (IV) antibiotics, and bilateral DJ stenting was done. Patient was symptomatically better and was discharged. A month later, he was readmitted with relapse of symptoms; repeat CT showed left perinephric abscess, with left renal vein, inferior vena cava and right common iliac vein thrombosis. Repeat culture grew E. coli, stent was replaced, and subsequently he underwent ultrasound-guided aspiration for left perinephric abscess. Haemodialysis along with IV antibiotics and anticoagulant therapy was started.

Conclusion

Suppurative thrombophlebitis of the inferior vena cava in association with EPN is rare; however, the same is associated with higher morbidity and mortality. Prompt diagnosis, drainage procedure, antibiotics coupled with anticoagulants are the mainstay of treatment for deep venous thrombophlebitis.
Thoracoscopic surgery for atrial fibrillation in a patient with persistent left superior vena cava: a case report
Authors: Seimei Go , Shinya Takahashi , Toshiya Ohtsuka , Taiichi Takasaki
Published: August 2023

Background

A persistent left superior vena cava (PLSVC) is an anomaly of the thoracic venous system that flows into the right atrium via an enlarged coronary sinus. When performing pulmonary vein isolation and left atrial appendage closure, the PLSVC can interfere with the procedure. We have performed thoracoscopic surgery on such a patient and would like to share our experience.

Case presentation

The patient is a 70-year-old male with a 1-year history of repeated tachycardia with chest discomfort due to paroxysmal atrial fibrillation. Contrast-enhanced computed tomography revealed the presence of a PLSVC that flows into the right atrium. The hepatic vein flows directly into the right atrium, whereas the inferior vena cava enters the thoracic cavity next to the descending aorta and flows into the parazygous vein and PLSVC. We performed thoracoscopic stapler closure of the left atrial appendage and epicardial clamp-isolation of the pulmonary veins and the PLSVC. There was concern that the PLSVC would interfere with the visual field needed to perform the procedure. We carefully removed the adhesions to the surrounding tissue and provided mobility to the PLSVC and expanded it ventrally. As a result, the procedure could be performed safely and without complications.

Conclusions

Our results demonstrate that in cases where catheter ablation is difficult for anatomical reasons, thoracoscopic stapler closure of the LAA and epicardial clamp-isolation of pulmonary veins may be a viable option.
Esophageal replacement with pedunculated gastric conduit interposition and duodenal transection for refractory anastomotic leakage after esophagectomy
Authors: Hirata Kaiho , Yagi Shusuke , Yamada Kazuhiko , Enomoto Naoki , Nohara Kyoko , Kokudo Norihiro
Published: August 2023

Background

Leakage of cervical esophagogastric anastomosis is a serious complication of esophagectomy. However, there is no established way to treat the anastomosis leakage.

Case presentation

The case is a 69-year-old man with locally advanced esophageal and two early gastric cancers. After induction chemotherapy, we performed minimally invasive esophagectomy, but on postoperative day 11, the anastomotic leakage was observed. Nutritional therapy, negative-pressure wound therapy, and suture closure could not treat it. Therefore, we performed pedunculated gastric conduit interposition with duodenal transection. In this procedure, the main trunk of the right gastroepiploic artery and vein was preserved, and the duodenum and gastric antrum are resected with cutting the branch from the right gastroepiploic artery and vein to gastric antrum, which dramatically improved the flexibility of the gastric conduit, and it is pulled up through the subcutaneous route. Improved blood supply and flexibility of the gastric conduit enabled a tension-free and safe anastomosis.

Conclusions

The flexibility and favorable blood flow of pedunculated gastric conduit interposition with duodenal transection can be an effective treatment option for refractory anastomotic leakage after esophagectomy.
Successful resuscitation from acute coronary syndrome during mediastinoscope-assisted transhiatal esophagectomy: a case report
Authors: Maruyama Kiyotomi , Shimada Kou , Makino Arano , Hisamune Ryo , Kawaguchi Masanori , Ikeno Shigeo , Morita Natsuhiro , Ichioka Ken , Shimizu Tadaaki , Shirota Tomoki , Gomi Kuniyuki , Mihara Motohiro , Kajikawa Shoji
Published: August 2023

Background

Although unexpected cardiac arrest is a very rare intraoperative complication, strategies regarding preoperative screening and procedures to be taken in the event of an emergency need to be well established.

Case presentation

A man in his late 70 s diagnosed with thoracic esophageal cancer, cT3N1M0, and cStage III was admitted. His metabolic equivalents were 4 or more. Electrocardiogram (ECG), ultrasound cardiography, and hematological examinations revealed no severe abnormalities. Computed tomography (CT) showed highly calcified coronary arteries. We performed mediastinoscope-assisted transhiatal esophagectomy. Procedures in the mediastinum involving access from the neck and abdomen were completed uneventfully. Middle mediastinal lymph node dissection and gastrointestinal reconstruction with the patient in the prone position were scheduled for later. However, before the change in position, pulseless nonsustained ventricular tachycardia (VT) suddenly occurred and caused blood pressure to drop sharply to below 30 mmHg. The VT disappeared in approximately 20 s, and there was a return to sinus rhythm after cardiac resuscitation; however, the ECG showed a decrease in the ST segments of leads II, III, and aVF. Immediately thereafter, the patient was transferred to the cardiac catheterization laboratory for percutaneous coronary intervention. Cardiac catheterization revealed diffuse stenosis of 90% in the left anterior descending branch of the coronary artery (segment no. 6). Plain old balloon angioplasty and stent placement were performed. Dual antiplatelet therapy was needed. On the next day, thoracoscopic esophagectomy was performed in the left lateral decubitus position, followed by cervical esophagostomy in the supine position. He developed acute respiratory distress syndrome and thoracic aortic dissection on the 5th postoperative day (POD) and intraperitoneal bleeding on the 16th POD. On the 105th POD, laparoscopic-assisted cervical esophagogastric anastomosis was performed. Parkinson’s disease was diagnosed on the 126th POD. On the 313th POD, the patient was discharged.

Conclusion

Surgeons should be familiar with the guidelines for patient screening and management of intraoperative cardiac arrest. In patients with severe coronary artery calcification, further investigation such as coronary angiography CT may be necessary before esophagectomy. Furthermore, highly invasive surgery should be performed in well-equipped hospitals.
Identification of micro-recurrent lesions using methylene blue for mediastinal ectopic parathyroid adenoma: a case report
Authors: Nomura Shunsuke , Ujiie Hideki , Fujiwara-Kuroda Aki , Kaga Kichizo , Aragaki Masato , Muto Jun , Chiba Ryohei , Yamazaki Gaku , Wakabayashi Kento , Matsuno Yoshihiro , Kato Tatsuya
Published: August 2023

Background

Mediastinal ectopic parathyroid adenomas are rare, and several methods are used to diagnose and localize them preoperatively. Technetium-99m methoxy isobutyl isonitrile scintigraphy has been used to diagnose parathyroid tumors. However, it is difficult to identify tumors buried in adipose tissue during surgery.

Case presentation

We report a case in which methylene blue effectively identified small recurrent lesions in a mediastinal ectopic parathyroid adenoma. After intravenous injection of methylene blue prior to surgery, the stained parathyroid adenoma was easily identifiable. Additionally, we identified other small recurrent lesions that could not be confirmed on preoperative imaging using real-time in vivo imaging guidance during surgery. Using this strategy, complete macroscopic resection can be performed during video-assisted thoracic surgery.

Conclusion

Preoperative intravenous methylene blue injection is useful for identifying small recurrent lesions, even in cases of mediastinal ectopic parathyroid adenoma with suspected recurrence.
Strengthening community midwives to tackle gender-based vulnerabilities during the 2022 floods in Pakistan—lessons learned for future natural disasters
Authors: Kamran Iram , Mir Ali Mohammad
Published: July 2023

Several countries across different continents experienced severe flooding in 2022, including Pakistan. Given the greater frequency and affliction of natural disasters like flooding in an increasing number of countries, we share lessons from the experience of Pakistan in helping the most vulnerable populations through community-based health workers.
Communication strategies to promote vaccination behaviours in sub-Saharan Africa
Authors: West Rebecca L. , Hurst Nisa , Sharma Sunny , Henry Beverley , Vitale-Rogers Shannon , Mutahi William , Salt Frances , Gardner Cassie , Turley Gareth , Ezeanochie Nnamdi , Betik Jason , Panagiotakopoulou Sofia , April Janice , Paige Samantha R.
Published: July 2023

Effective public health communication is needed to increase COVID-19 vaccination uptake in sub-Saharan Africa. We present six best practices: (1) use of collective action/altruism, (2) use of relatable language, (3) tailoring messages, (4) use of gain-framed messages, (5) use of trusted messengers and (6) use of research to test messages.
The barriers to cervical cancer screening for urban and rural populations in Rwanda
Authors: Dau Hallie , Vidler Marianne , AboMoslim Maryam , Mutamba Barbra , Nesbitt Zoey , Deodatha John , Byiringiro Schadrack Danson , Niyotwiringiye Charles , Mithani Nadia , Nair Varun , Smith Laurie , Rulisa Stephen , Ogilvie Gina
Published: July 2023

Background

Cervical cancer is the leading cause of cancer mortality in Rwandan women. There is a limited understanding of the barriers that women face to obtain cervical cancer screening in Rwanda. It is important to understand the barriers in order to implement effective screening programs. The goal of this study is to describe the barriers to cervical cancer screening among women in Rwanda and how they differ among women in rural and urban areas.

Methods

This cross-sectional study recruited women from June 1 to 9, 2022, at Muhima and Nyamata District Hospitals in Rwanda. Women were eligible for the study if they were ≥ 18 years and spoke Kinyarwanda or English. Women completed a 15-min survey which included questions on the participants’ demographics, knowledge of cervical cancer, cervical cancer screening history, and barriers to healthcare. Women were stratified by survey location (urban vs rural). Descriptive statistics were reported.

Results

A total of 374 women completed the survey with 169 participants from Muhima and 205 from Nyamata. Most women were in a relationship and had a primary school or less education. The most common barriers to accessing general healthcare services were long wait times at the facility (Muhima 26%; Nyamata 30%), low quality of care (Muhima 15%; Nyamata 12%), and transportation costs (Muhima 13%; Nyamata 9.3%). However, women from Nyamata were significantly more likely to report distance to the health center as a barrier (p-value < 0.001), and women from Muhima were significantly more likely to report transportation method as a barrier (p-value = 0.004). The primary reason reported for not obtaining cervical cancer screening was that women did not know how or where to get tested (Muhima 57%; Nyamata 51%).

Conclusions

The most common barriers to cervical cancer screening in Rwanda were the quality of clinical care and issues with traveling to the clinic. Implementing a cervical cancer self-collection program could help eliminate many barriers that women face to obtain health services in Rwanda. More research is needed to better understand the acceptability of cervical cancer screening in Rwanda and how it could be integrated into the healthcare system.
Identifying people with tuberculosis and linking to care: finding the missing millions — meet the guest editors
Authors: Burke Rachael M. , McQuaid C. Finn
Published: July 2023

In this Q&A, Rachael Burke and Finn McQuaid answer questions about their research fields and share their experiences of guest-editing the journal’s collection on identifying people with tuberculosis and linking to care.
Meet the editorial board members: Angeline Ferdinand and Michael Murray
Authors: Ferdinand Angeline S. , Murray Michael F.
Published: July 2023

In this Q&A, Angeline Ferdinand and Michael Murray answer questions about their research fields and share insights into their role as editorial board members at the journal.
President's Page: Exploring SEG's future
Authors: Cheng Arthur
Published: August 2023

In September, I will take office as SEG president. This year also happens to be my 50th as an SEG member, and that's a long time. In that time, the world has changed, our lives have changed, the Society's concerns have changed, and, consequently, SEG as a whole needs to change.
Glucocorticoid receptor regulates protein chaperone, circadian clock and affective disorder genes in the zebrafish brain
Authors: Eachus Helen , Oberski Lara , Paveley Jack , Bacila Irina , Ashton John-Paul , Esposito Umberto , Seifuddin Fayaz , Pirooznia Mehdi , Elhaik Eran , Placzek Marysia , Krone Nils P. , Cunliffe Vincent T.
Published: August 2023

Glucocorticoid resistance is commonly observed in depression, and has been linked to reduced expression and/or function of the glucocorticoid receptor (NR3C1 in human, hereafter referred to as GR). Previous studies have shown that GR-mutant zebrafish exhibit behavioural abnormalities that are indicative of an affective disorder, suggesting that GR plays a role in brain function. We compared the brain methylomes and brain transcriptomes of adult wild-type and GR-mutant zebrafish, and identified 249 differentially methylated regions (DMRs) that are regulated by GR. These include a cluster of CpG sites within the first intron of fkbp5, the gene encoding the glucocorticoid-inducible heat shock protein co-chaperone Fkbp5. RNA-sequencing analysis revealed that genes associated with chaperone-mediated protein folding, the regulation of circadian rhythm and the regulation of metabolism are particularly sensitive to loss of GR function. In addition, we identified subsets of genes exhibiting GR-regulated transcription that are known to regulate behaviour, and are linked to unipolar depression and anxiety. Taken together, our results identify key biological processes and novel molecular mechanisms through which the GR is likely to mediate responses to stress in the adult zebrafish brain, and they provide further support for the zebrafish GR mutant as a model for the study of affective disorders.
Immunocytochemical detection of non-histone nuclear antigens in cryosections of developing somatic embryos from Daucus carota L
Authors: Sanchez-Pina M. A. , Kieft H. , Schel J. H. N.
Published: July 2023

The distribution of non-histone nuclear antigens was studied during early somatic embryogenesis of carrot using nuclear antibodies specific for small nuclear RNPs (snRNPs), nuclear matrix proteins and nucleolar proteins. Immunofluorescence showed that in interphase cells snRNPs and nuclear matrix proteins were localized in the nucleus with a speckled pattern. Immunoelectron microscopy indicated that the snRNPs were irregularly distributed while the nuclear matrix proteins showed a distribution preferentially over the condensed chromatin. None were localized in the nucleolus. The nucleolar proteins were localized in both dense fibrillar and granular components while the fibrillar centres were devoid of gold particles.

The localization of these antibodies in plant cell nuclei, in a way comparable to the patterns described in animal cells, indicates the general presence of snRNPs in all eukaryotic nuclei. It further confirms the relation of the nuclear matrix proteins to plant cell proliferation events and the possible role of the nucleolar proteins in both rRNA transcription and preribosome assembly.
Gestational Surrogate’s Autonomy
Authors: Sakellaraki Kalomoira
Published: August 2023

The necessary consent of the surrogate mother is a safeguard of both her autonomy and her self-dispositionand guarantees not only the protection of human value (article 2, paragraph 1 of the GreekConstitution) but also the protection of her personality (article 5 paragraph 1 of the Greek Constitutionand article 57 the Greek Civil Code). It is worth noting, after all, that sometimes it is necessary to restrictthe freedom of some people, in order to ensure the freedom of others. The gestational surrogate expectantis not forced for her act. Autonomy presupposes the possibility of formulating and implementinga decision, as a form of personal freedom, having as a result that pressure opposes the obstructionof the surrogate mother and the future parents to do what they want and therefore feel free and notbe oppressed indirectly. On the other hand, Ronald Dworkin reports on the importance of autonomy inreproduction. According to the liberal view of human value, a behavior is not characterized as inhumanand degrading, nor immoral, in case it is not perceived as such by the subject who participates in it oraccepts it. Otherwise, an objective approach to this principle would be in case that a behavior is consideredto be inhuman by social criteria and regardless of the expression of the individual’s free consentand her possible desire to continue in activities offensive to the individual.
Dance/movement therapy as a holistic approach to diminish health discrepancies and promote wellness for people with schizophrenia: a review of the literature
Authors: Biondo Jacelyn
Published: August 2023

Individuals with a diagnosis of schizophrenia face a myriad of obstacles to wellness, beginning with diagnostic discrepancies including over- and misdiagnoses on the schizophrenia spectrum. People with schizophrenia experience profound amounts of stigmatization from the general population, their healthcare providers, and even themselves. Such stigmatization creates a barrier for wellness, poorer prognoses, and often limits adherence to physical and mental healthcare. Moreover, it can exacerbate the already stifling symptomatology of their diagnoses, including specific bodily-related symptomatology. Oftentimes, a diagnosis of schizophrenia disrupts one’s relationship with their body including a diminished mind-body connection, decreased interoceptive awareness, and thus unsuccessful intra- and interpersonal relationships. Some recent research suggests the use of mind-body therapies, however, if these practices are internalizing, they may not be appropriate for people with schizophrenia experiencing more acute symptomatology excluding them from treatment. Dance/movement therapy (DMT) is an embodied psychotherapeutic treatment option that can support participants in improving mind-body connection, social relationships, and self-regulatory skill development. Research on DMT has shown promising results for people with schizophrenia, however such research is limited and would benefit from increased studies that particularly measure the effects of DMT on mind-body connection and increased interoception for people with schizophrenia. Moreover, integrative and collaborative treatment models that couple DMT and biofeedback may further our understanding of the physiological and neurological effects of DMT interventions for people with schizophrenia and beyond. This review will examine the recent literature on health inequities for people with schizophrenia, their specific body-based disruptions and needs, and DMT as a promising treatment model, particularly when coupled with biofeedback.
Prescriber’s view on anticholinergic deprescribing among older adults with intellectual disability: A qualitative study protocol
Authors: Al Shuhaimi Lamya , Henman Martin C , McCallion Philip , McCarron Mary , O'Dwyer Maire
Published: August 2023

Background: High anticholinergic burden is associated with physical and cognitive functional decline however, these medications are still being prescribed for older adults with intellectual disability. People with intellectual disability exposed to higher anticholinergic burden compared to general population. Additionally, anticholinergic exposure is higher with aging, neurological and psychiatric health conditions, living in nursing homes or community group setting. The long-term exposure to high anticholinergic burden was associated with physical decline, cognitive impairment, higher risk of dementia and Alzheimer disease.

Aim and objectives: The study aimed to explore prescriber views and perspective about prescribing and deprescribing of medication with anticholinergic activity among older adults with intellectual disability. the objectives of this study are:

To explore prescriber’s knowledge on anticholinergic burden, adverse-effects, tools used to measure anticholinergic burden.

To explore barriers and facilitators of anticholinergic deprescribing.

Method and analysis:  this is a qualitative semi-structured interviews study which will be conducted by interviewing prescribers involved in prescribing for older adults with intellectual disabilities. The study aimed to recruit 8 – 10 prescribers or until it reaches data saturation. Interviews will be conducted through MS teams or in person if that’s suits the interviewee. This study will be conducted by based on the Theoretical Domain Framework (TDF).
The genome sequence of a stonefly, Nemoura dubitans (Morton, 1894)
Authors: Farr Andrew , Macadam Craig R. ,   Natural History Museum Genome Acquisition Lab,   Darwin Tree of Life Barcoding collective,   Wellcome Sanger Institute Tree of Life programme,   Wellcome Sanger Institute Scientific Operations: DNA Pipelines collective,   Tree of Life Core Informatics collective,   Darwin Tree of Life Consortium
Published: August 2023

We present a genome assembly from an individual female Nemoura dubitans (a stonefly; Arthropoda; Insecta; Plecoptera; Nemouridae). The genome sequence is 321.0 megabases in span. Most of the assembly is scaffolded into 6 chromosomal pseudomolecules, including the X sex chromosome. The mitochondrial genome has also been assembled and is 15.73 kilobases in length.
Evaluating the Igraph Community Detection Algorithms on Different Real Networks
Authors: Oza Parita Rajiv , Agrawal Smita , Ravaliya Dhruv , Kakkar Riya
Published: July 2023

Complex networks are an essential tool in machine learning and data mining. The underlying information can help understand the system and reveal new information. Community is sub-groups in networks that are densely connected. This community can help us reveal a lot of information. The community detection problem is a method to find communities in the network. The igraph library is used by many researchers due to the utilization of various community detection algorithms implemented in both Python and R language. The algorithms are implemented using various methods showing various performance results. We have evaluated the community detection algorithm and ranked it based on its performance in different scenarios and various performance metrics. The results show that the Multi-level, Leiden community detection algorithm, and Walk trap got the highest performance compared to spin glass and leading eigenvector algorithms. The findings based on these algorithms help researchers to choose algorithms from the igraph library according to their requirements.