bluuebunny/crossref_metadata_2025 huggingface dataset:
Breathlessness in hospitalised adult patients
Authors: Rao A B , Gray D
Published: March 2023

Dyspnoea is defined as a sensation of difficult breathing. It is common in hospitalised patients and is often a harbinger of serious and potentially fatal pathology. The pathophysiology of dyspnoea involves complex interactions between peripheral and central receptors and cognition. Given the myriad causes of dyspnoea, a systematic approach to diagnosis is important. A good history and systemic examination are necessary as it is important to quickly identify the cause and treat it promptly. Investigations are numerous but chest radiography and electrocardiography are among the commonest and most useful. It is important to understand the mechanisms underlying dyspnoea to treat breathless patients successfully.
Image guided navigation system—a new technology for complex endoscopic endonasal surgery
Authors: Eliashar R , Sichel J-Y , Gross M , Hocwald E , Dano I , Biron A , Ben-Yaacov A , Goldfarb A , Elidan J
Published: March 2023

Purpose

Endoscopic endonasal surgery (EES) has become the standard practice in sinonasal and anterior skull base surgery. The purpose of this manuscript is to describe experience using a new technology—the image guided navigation system (IGNS)—in complex cases undergoing EES. The advantages and disadvantages of computer aided surgery are discussed.

Patients and methods

A total of 165 endoscopic endonasal procedures were performed between April 2001 and January 2003. IGNS was used in 34 patients in whom it was assumed that the ability to identify surgical sites accurately could be compromised by previous surgery, massive recurrent polyposis, or abnormal anatomy, or when biopsies had to be taken from specific anatomic locations (for example, clivus, wall of sphenoid sinus, orbital apex). The precision of the navigation system, total operating room time, surgeon’s satisfaction and confidence, and intraoperative and postoperative complications were recorded.

Results

In 33 out of 34 patients the surgical procedure was uneventful. One patient with an atelectatic maxillary sinus developed a minor complication of preseptal orbital haematoma. In 94% the IGNS provided accurate anatomical localisation with less than 2 mm localisation error (1.1–2.0 mm, mean 1.6 mm). In all cases the surgical team felt that the system increased the intraoperative safety factor for the patient. The overall operating room time at the end of the study was 15 minutes longer than when regular EES was used.

Conclusions

IGNS enables a new level of efficiency and safety in EES. Nevertheless, it is not advised for surgeons who are not familiar with regular EES. For the experienced endoscopist, however, IGNS is a valuable new tool in complex procedures.
Gastrointestinal stromal tumour in an inguinal hernial sac: an unusual presentation
Authors: Goyal A , Mansel R E , Goyal S
Published: March 2023

Malignancy involving hernial sacs is rare. A 72 year old man is reported who had a right inguinal irreducible mass as an initial presentation of gastrointestinal stromal tumour mimicking irreducible inguinal hernia. The diagnosis was missed at the time of surgery and was revealed only by the histology results of the excised sac.
Effects of stem cell–derived exosome therapy on erectile dysfunction: a systematic review and meta-analysis of preclinical studies
Authors: Zhu Yunpei , Jiang Tiancheng , Yao Chi , Zhang Jiawei , Sun Chao , Chen Shuqiu , Chen Ming
Published: March 2023

Introduction

Erectile dysfunction (ED) is a common disease among elderly men, and novel therapy methods are needed for drug-refractory ED. As an extracellular vesicle, stem cell–derived exosomes displayed erectile function improvement in rat ED models in some preclinical studies. However, the therapeutic efficacy has not been comprehensively evaluated.

Aim

To study the therapeutic effects of stem cell–derived exosomes on ED in preclinical studies and to investigate the potential mechanisms responsible for the efficacy.

Methods

The systematic literature search was conducted in Web of Science, PubMed, and Embase to retrieve studies utilizing stem cell–derived exosomes for ED treatment. We extracted data of intracavernous pressure/mean artery pressure (ICP/MAP), and cavernosum structural changes in rat ED models before and after stem cell-derived exosome therapy. RevMan 5.3 was used to perform meta-analyses of ICP/MAP and cavernosum microstructural changes. Publication bias was assessed with the Egger test and funnel plot by Stata 15.0 (StataCorp).

Main Outcome Measures

Outcomes included ICP/MAP, smooth muscle, and endothelial markers—such as the ratio of smooth muscle to collagen and the expression of α-SMA (alpha smooth muscle actin), CD31 (cluster of differentiation 31), nNOS and eNOS (neuronal and endothelial nitric oxide synthase), TGF-β1 (transforming growth factor β1), and caspase 3 protein-to evaluate erectile function and microstructural changes. Forest plots of effect sizes were performed.

Results

Of 146 studies retrieved, 11 studies were eligible. Pooled analysis showed that stem cell–derived exosomes ameliorated damaged ICP/MAP (standardized mean difference, 3.68; 95% CI, 2.64-4.72; P < .001) and structural changes, including the ratio of smooth muscle to collagen and the expression of α-SMA, CD31, nNOS, eNOS, TGF-β1, and caspase 3 protein. Subgroup analysis indicated that exosome type and ED model type made no difference to curative effects.

Conclusion

This meta-analysis suggests the therapeutic efficacy of stem cell–derived exosomes for ED. Exosomes may restore erectile function by optimizing cavernosum microstructures.
Trajectories of sleep disturbance in cancer survivors during the first 2 years post-treatment
Authors: Chan Julia , Ng Danielle Wing Lam , Liao Qiuyan , Fielding Richard , Soong Inda , Chan Karen Kar Loen , Lee Conrad , Ng Alice Wan Ying , Sze Wing Kin , Chan Wing Lok , Lee Victor Ho Fun , Lam Wendy Wing Tak
Published: March 2023

Study Objectives

To examine the trajectories of sleep disturbance in cancer survivors during the first 2 years post-treatment and to investigate whether psychological, cognitive, and physical factors differentiate trajectories.

Methods

A total of 623 Chinese cancer survivors of diverse cancer types participated in a 2-year-long prospective study after the completion of cancer treatment. Sleep disturbance was measured using Pittsburgh Sleep Quality Index at 3 (T2), 6 (T3), 12 (T4), 18 (T5), and 24 (T6) months after baseline (within 6-months post-treatment; T1). Latent growth mixture modeling identified distinctive sleep disturbance trajectories and tested if these longitudinal patterns were predicted by baseline psychological distress, attentional control, attentional bias and physical symptom distress and T2 cancer-related distress. Fully adjusted multinomial logistic regression then identified whether these factors differentiated trajectories.

Results

Two distinct sleep disturbance trajectories were identified, namely stable good sleepers (69.7%) and persistent high sleep disturbance (30.3%). Compared to those in the stable good sleep group, patients in the persistent high sleep disturbance group were less likely to report avoidant (OR=0.49, 95% CI = 0.26–0.90), while more likely to report intrusive thoughts (OR = 1.76, 95% CI = 1.06–2.92) and cancer-related hyperarousal (OR = 3.37, 95% CI = 1.78–6.38). Higher depression scores also predicted persistent high sleep disturbance group membership (OR = 1.13, 95% CI = 1.03–1.25). Attentional bias, attentional control, anxiety, and physical symptom distress did not predict sleep trajectory membership.

Conclusions

One in three cancer survivors experienced persistent high sleep disturbance. Screening and managing depressive symptoms and cancer-related distress in early cancer rehabilitation may reduce risk of persistent sleep disturbance among cancer survivors.
Restless legs syndrome in patients with epilepsy: risk analysis, polysomnography, and quality of life evaluation
Authors: Li Ying-Sheng , Yeh Wei-Chih , Chang Ya-Hsien , Hsu Chung-Yao
Published: March 2023

Study Objectives

Restless legs syndrome (RLS) is a circadian rhythm related sensorimotor disorder due to brain iron deficiency, with lesion sites at the putamen and substantia nigra. However, epilepsy is a disease with abnormal electric discharge from the cortex and can be triggered with iron disequilibrium. We designed a case–control study to discover the association between epilepsy and RLS.

Methods

A total of 24 patients with epilepsy and RLS and 72 patients with epilepsy without RLS were included. Most of the patients underwent polysomnography and video electroencephalogram tests and took sleep questionnaires. We collected information on seizure characteristics, including general or focal onset, epileptogenic focus, current antiseizure medications, medically responsive epilepsy or refractory epilepsy, and nocturnal attacks. The sleep architectures of the two groups were compared. We analyzed the risk factors for RLS using multivariate logistic regression.

Results

Among the patients with epilepsy, the occurrence of RLS was associated with refractory epilepsy (OR 6.422, p = 0.002) and nocturnal seizures (OR 4.960, p = 0.005). Sleep parameters were not significantly associated with RLS status. Quality of life was significantly impaired in the group with RLS in both the physical and mental domains.

Conclusions

Refractory epilepsy and nocturnal seizures were strongly correlated with RLS in patients with epilepsy. RLS should be considered a predictable comorbidity in patients with epilepsy. The management of RLS not only led to better control of the patient’s epilepsy but also improved their quality of life.
Supporting Medical Student Scholarship: A Novel Case Report Elective to Teach the Writing and Publishing Process
Authors: Bauler Laura , Jones Steven
Published: March 2023

Problem

Successful residency placement requires medical students to pursue activities beyond formal education, including showing their commitment to the specialty. Case reports are a common publication pursued by medical students, which provide trainees with opportunities to show commitment to the specialty, broaden their clinical and scholarly knowledge, improve their ability to find and interpret literature, and gain faculty mentorship. However, case reports can be intimidating to trainees with limited exposure to medical writing and publishing. The authors describe a case report elective designed specifically for medical students.

Approach

Since 2018, Western Michigan University Homer Stryker M.D. School of Medicine has offered a week-long medical student elective designed to teach the process of writing and publishing a case report. Students wrote a first draft of a case report during the elective. Students could pursue publication, including revisions and journal submission, after the elective. An optional, anonymous survey was sent to students who participated in the elective to evaluate their experience with the elective, motivations for taking the elective, and perceived outcomes.

Outcomes

Between 2018 and 2021, the elective was taken by 41 second-year medical students. Five scholarship outcomes of the elective were measured, including conference presentations (35, 85% of students) and publications (20, 49% of students). Students who completed the survey (n = 26) indicated the elective was very valuable with an average score of 85 ± 15.6 (range: minimally valuable [0] to extremely valuable [100]).

Next Steps

Next steps for this elective will be to allocate more faculty time to this curriculum promoting both education and scholarship at the institution, and to curate a list of journals to ease the publication process. Overall, student experiences with this case report elective were positive. This report aims to provide a framework for other schools to implement similar courses for their preclinical students.
A radiation-related second primary gastrointestinal stromal tumor in the bladder
Authors: Hori Mai , Maki Kazuki , Okuno Yumiko , Mikami Koji , Takeuchi Takumi
Published: March 2023

A 69-year-old man underwent 78 Gy/39 Fr of intensity-modulated radiation therapy for prostate cancer. Seven years after radiotherapy, a nonpapillary bladder tumor was identified. Transurethral resection of the bladder tumor was performed, and the pathological diagnosis was spindle cell sarcoma. Immunostaining revealed KIT−, DOG1++, CD34−, Actin++, Cytokeratin−, Desmin−, S100 protein−, and Vimentin++. No tumor recurrence was observed until 17 months after tumor resection. DOG1 is strongly and specifically expressed in gastrointestinal stromal tumors. This was a rare case of bladder gastrointestinal stromal tumor as a radiation-related second primary tumor.
US Racial–Ethnic Mortality Gap Adjusted for Population Structure
Authors: Pifarré i Arolas Héctor , Acosta Enrique , Dudel Christian , Mhairi Hale Jo , Myrskylä Mikko
Published: March 2023

Background:

US racial–ethnic mortality disparities are well documented and central to debates on social inequalities in health. Standard measures, such as life expectancy or years of life lost, are based on synthetic populations and do not account for the real underlying populations experiencing the inequalities.

Methods:

We analyze US mortality disparities comparing Asian Americans, Blacks, Hispanics, and Native Americans/Alaska Natives to Whites using 2019 CDC and NCHS data, using a novel approach that estimates the mortality gap, adjusted for population structure by accounting for real-population exposures. This measure is tailored for analyses where age structures are fundamental, not merely a confounder. We highlight the magnitude of inequalities by comparing the population structure-adjusted mortality gap against standard metrics’ estimates of loss of life due to leading causes.

Results:

Based on the population structure-adjusted mortality gap, Black and Native American mortality disadvantage exceedsmortality from circulatory diseases. The disadvantage is 72% among Blacks (men: 47%, women: 98%) and 65% among Native Americans (men: 45%, women: 92%), larger than life expectancy measured disadvantage. In contrast, estimated advantages for Asian Americans are over three times (men: 176%, women: 283%) and, for Hispanics, two times (men: 123%; women: 190%) larger than those based on life expectancy.

Conclusions:

Mortality inequalities based on standard metrics’ synthetic populations can differ markedly from estimates of the population structure-adjusted mortality gap. We demonstrate that standard metrics underestimate racial–ethnic disparities through disregarding actual population age structures. Exposure-corrected measures of inequality may better inform health policies around allocation of scarce resources.
Improving Biomarker-based HIV Incidence Estimation in the Treatment Era
Authors: Fellows Ian E. , Hladik Wolfgang , Eaton Jeffrey W. , Voetsch Andrew C. , Parekh Bharat S. , Shiraishi Ray W.
Published: March 2023

Background:

Estimating HIV-1 incidence using biomarker assays in cross-sectional surveys is important for understanding the HIV pandemic. However, the utility of these estimates has been limited by uncertainty about what input parameters to use for false recency rate (FRR) and mean duration of recent infection (MDRI) after applying a recent infection testing algorithm (RITA).

Methods:

This article shows how testing and diagnosis reduce both FRR and mean duration of recent infection compared to a treatment-naive population. A new method is proposed for calculating appropriate context-specific estimates of FRR and mean duration of recent infection. The result of this is a new formula for incidence that depends only on reference FRR and mean duration of recent infection parameters derived in an undiagnosed, treatment-naive, nonelite controller, non-AIDS-progressed population.

Results:

Applying the methodology to eleven cross-sectional surveys in Africa results in good agreement with previous incidence estimates, except in 2 countries with very high reported testing rates.

Conclusions:

Incidence estimation equations can be adapted to account for the dynamics of treatment and recent infection testing algorithms. This provides a rigorous mathematical foundation for the application of HIV recency assays in cross-sectional surveys.
Age, Sex, and Comedication Effects on the Steady-State Plasma Concentrations of Amisulpride in Chinese Patients with Schizophrenia
Authors: Yang Shuo , Wang HaiYan , Zheng Gao Feng , Wang Yi
Published: March 2023

Background:

Amisulpride, a second-generation atypical antipsychotic drug, was first marketed in Europe in the 1990s. This study aimed to provide a reference for the clinical application of amisulpride. The effects of age, sex, or specific comedications on amisulpride concentrations in Chinese patients with schizophrenia in the real world were investigated.

Methods:

A retrospective study was conducted of data on amisulpride based on the therapeutic drug monitoring service database at the Zigong Affiliated Hospital of Southwest Medical University.

Results:

Based on the inclusion criteria, 195 plasma samples from 173 patients (67.05% female and 32.95% male patients) were included for in-depth analysis. The median daily dose of amisulpride was 400 mg/d, median plasma concentration was 457.50 ng/mL, and median concentration/dose (C/D) ratio was 1.04 ng/mL/mg/d. The daily dose of amisulpride positively correlated with measured steady-state plasma concentrations. A significant difference was observed in the subgroup analysis of the combination with valproic acid, zopiclone, or aripiprazole on plasma concentrations. Combining amisulpride with these drugs increased the C/D ratios by 0.56-, 2.31-, and 0.77-fold, respectively. After adjusting for age, the median C/D ratio was found to be significantly different between female and male patients. However, no significant differences in daily dose, plasma concentration, and C/D ratio were noted with respect to sex and age of the patients.

Conclusions:

Sex differences were inferred for the first time in this study, with differential effects on daily dose, steady-state plasma concentration, and C/D ratio associated with the population. In the included study samples, blood concentrations were distributed in the range of 223.25–823.55 ng/mL, which perhaps needs to be evaluated in line with the reference range of ammonia–sulfur ratios in the Chinese population.
Relationship between perfusion index and central temperature before and after induction of anesthesia in laparoscopic gastrointestinal surgery: A prospective cohort study
Authors: Hara Kentaro , Kaneko Shohei , Ishioka Taichi , Tobinaga Shohei , Urabe Shigehiko , Nakao Akiha , Hamada Kozue , Nagaoka Kyoko , Taniguchi Miwa , Yamaguchi Michiko , Takeshita Hiroaki , Tanaka Junichi , Kuroda Hiromi , Matsuura Emi , Ishimatsu Yuji , Honda Sumihisa , Sawai Terumitsu
Published: March 2023

The perfusion index (PI) cutoff value before anesthesia induction and the ratio of PI variation after anesthesia induction remain unclear. This study aimed to clarify the relationship between PI and central temperature during anesthesia induction, and the potential of PI in individualized and effective control of redistribution hypothermia. This prospective observational single center study analyzed 100 gastrointestinal surgeries performed under general anesthesia from August 2021 to February 2022. The PI was measured as peripheral perfusion, and the relationship between central and peripheral temperature values was investigated. Receiver operating characteristic curve analysis was performed to identify baseline PI before anesthesia, which predicts a decrease in central temperature 30 minutes after anesthesia induction, and the rate of change in PI that predicts the decrease in central temperature 60 minutes after anesthesia induction. In cases with a central temperature decrease of ≥ 0.6°C after 30 minutes, the area under the curve was 0.744, Youden index was 0.456, and the cutoff value of baseline PI was 2.30. In cases with a central temperature decrease of ≥ 0.6°C after 60 minutes, the area under curve was 0.857, Youden index was 0.693, and the cutoff value of the PI ratio of variation after 30 minutes of anesthesia induction was 1.58. If the baseline PI is ≤ 2.30 and the PI 30 minutes after anesthesia induction is at least 1.58-fold the PI ratio of variation, there is a high probability of a central temperature decrease of at least 0.6°C within 30 minutes after 2 time points.
Phase I cardiac rehabilitation with 5-phase music after emergency percutaneous coronary intervention for acute myocardial infarction: A prospective randomized study
Authors: Yao Xu , Jin Yi , Gao Chunlan , Zhang Yuqin , Lu Yun , Li Xiaoting , Ma Lili
Published: March 2023

Background:

Five-phase music therapy was reported to be effective in the treatment and rehabilitation of several diseases. This study explored the effect of phase I cardiac rehabilitation combined with 5-phase music in acute myocardial infarction (AMI) patients after emergency percutaneous coronary intervention.

Methods:

This prospective pilot study enrolled AMI patients who received percutaneous coronary intervention from the Traditional Chinese Medicine Hospital from July 2018 to December 2019. The participants were randomized in a 1:1:1 ratio to the control, cardiac rehabilitation, and rehabilitation-music groups. The primary endpoint was the hospital anxiety and depression scale. The secondary endpoints were the myocardial infarction dimensional assessment scale, self-rating sleep status, 6-minute walk test, and left ventricular ejection fraction.

Results:

The study included 150 AMI patients (n = 50/group). Hospital anxiety and depression scale showed significant time effects for both anxiety and depression (both P < .05), a treatment effect for depression (P = .02), and an interaction effect for anxiety (P = .02). A time effect was also observed for diet, sleep disorders, 6-minute walk test, and left ventricular ejection fraction (all P < .001). A difference among groups was observed for emotional reaction (P = .001). Interactions effects were observed for diet (P = .01) and sleep disorders (P = .03).

Conclusion:

Phase I cardiac rehabilitation combined with 5-phase music could alleviate anxiety and depression and improve sleep quality.
Circulating protein and lipid markers of early sepsis diagnosis and prognosis: a scoping review
Authors: Barber Gemma , Tanic Jelena , Leligdowicz Aleksandra
Published: March 2023

Purpose of review

Sepsis is the extreme response to infection associated with high mortality, yet reliable biomarkers for its identification and stratification are lacking.

Recent findings

Our scoping review of studies published from January 2017 to September 2022 that investigated circulating protein and lipid markers to inform non-COVID-19 sepsis diagnosis and prognosis identified interleukin (IL)-6, IL-8, heparin-binding protein (HBP), and angiopoietin-2 as having the most evidence. Biomarkers can be grouped according to sepsis pathobiology to inform biological data interpretation and four such physiologic processes include: immune regulation, endothelial injury and coagulopathy, cellular injury, and organ injury. Relative to proteins, the pleiotropic effects of lipid species’ render their categorization more difficult. Circulating lipids are relatively less well studied in sepsis, however, low high-density lipoprotein (HDL) is associated with poor outcome.

There is a lack of robust, large, and multicenter studies to support the routine use of circulating proteins and lipids for sepsis diagnosis or prognosis. Future studies will benefit from standardizing cohort design as well as analytical and reporting strategies. Incorporating biomarker dynamic changes and clinical data in statistical modeling may improve specificity for sepsis diagnosis and prognosis. To guide future clinical decisions at the bedside, point-of-care circulating biomarker quantification is needed.
Exosomes and lipid metabolism in metabolic and cardiovascular disorders
Authors: Zein Abdin Zina , Geng Apple Ziquan , Chandy Mark
Published: March 2023

Purpose of review

Exosomes are lipid-bound particles that carry lipids, protein, and nucleic acid and affect cellular function. This review highlights the current knowledge on the crosstalk between exosomes and lipid metabolism and their impact on cardiometabolic disease.

Recent findings

Recent studies revealed that lipids and lipid metabolizing enzymes are important for exosome biogenesis and internalization and conversely how exosomes affect lipid metabolism, secretion, and degradation. The interplay between exosomes and lipid metabolism affects disease pathophysiology. More importantly, exosomes and lipids might function as biomarkers for diagnosis and prognosis or possibly therapies.

Recent advances in our understanding of exosomes and lipid metabolism have implications for our understanding of normal cellular and physiological functions as well as disease pathogenesis. Exosome and lipid metabolism have implications in novel diagnostic tests and treatments of cardiometabolic disease.
Transperineal vs. transrectal biopsy to reduce postinterventional sepsis
Authors: Stangl-Kremser Judith , Ramaswamy Ashwin , Hu Jim C.
Published: March 2023

Purpose of review

Prostate biopsy is commonly performed in men suspected to have prostate cancer. It has traditionally been performed using a transrectal approach, but transperineal prostate biopsy has been increasingly adopted in part because of its lower associated infectious risk. We review recent studies evaluating the rate of potentially life-threatening post-biopsy sepsis and potential preventive strategies.

Recent findings

After performing a comprehensive literature search, 926 records were screened and 17 studies published in 2021 or 2022 were found to be relevant. Studies varied in periprocedural perineal and transrectal preparation, antibiotic prophylaxis, and definition of sepsis. The sepsis rates after transperineal ultrasound-guided versus transrectal ultrasound-guided biopsy ranged between 0 and 1 versus 0.4 and 9.8%. Mixed efficacy was found for the topical application of antiseptics before transrectal biopsy to decrease postprocedural sepsis. Promising strategies include the use of topical rectal antiseptics before transrectal prostate biopsy and using a rectal swab to guide the antibiotic selection and the route of the biopsy.

The transperineal approach to biopsy is increasingly used because of lower associated sepsis rates. Our review of the recent literature supports this practice pattern change. Hence, transperineal biopsy should be offered as an option to all men.
Evaluating patients’ choice of general and spinal anesthesia for elective cesarean section and associated factors: a descriptive study
Authors: Emadi Seyed A. , Gholipour Baradari Afshin , Khademloo Mohammad , Abotorabi Mehdi , Hassanzadeh Kiabi Farshad
Published: March 2023

Objective:

During an elective cesarean section, the choice of method of anesthesia is critical for maternal and fetal outcomes. However, the anesthesiologist’s decision is dependent on the patient’s desire. This study aimed to determine the choice of general and spinal anesthesia among women undergoing elective cesarean sections and the factors affecting their choice.

Methods:

In this descriptive study, pregnant women who had the ability to undergo both spinal and general anesthesia were referred to public and private hospitals in (Sari Imam Khomeini Hospital, Mazandaran University of Medical Sciences). A questionnaire recorded the patient’s demographic data, education and occupation, history of anesthesia, choice of anesthetic method, and reason for selection.

Results:

A total of 384 women were included in the study, of whom 60% selected general anesthesia and 40% selected spinal anesthesia. Among the reasons for not choosing spinal anesthesia, most common were fear of injury to the spinal cord (64.3%) and fear of seeing and hearing during the surgery (53.3%), and among the reasons for not choosing general anesthesia, most common were fear of not waking (54.3%) and a desire to be alert at the time of infant birth (40.7%). Most of the women with a history of spinal anesthesia selected spinal anesthesia (53%), and 62% of those without a history of spinal anesthesia selected general anesthesia. Factors such as age, nonmedical staff advice, and being employed were significantly correlated with the choice of anesthesia (P<0.005).

Conclusion:

The rate of general anesthesia selection was higher than spinal anesthesia. More attention and efforts are required to educate patients regarding the method of anesthesia prior to the surgery.
Parietal mass caused by a fish bone: case report
Authors: Erguibi Driss , Kamal Khadija , Eddaoudi Yassine , Hajri Amal , Boufettal Rachid , Rifki El Jai Saad , Chehab Farid
Published: March 2023

Introduction:

It is a great challenge to distinguish the parietal inflammation, centered on the foreign body that pierced the digestive tract and remained in the wall before surgery, because of its atypical clinical nature. Ingestion of foreign bodies is not uncommon. Fish bones are particularly notorious culprits; however, most will pass through the gastrointestinal tract uneventfully.

Patients and Methods:

The authors report a case of a patient who presented with periumbilical abdominal pain and a computed tomography (CT) scan that revealed the presence of periumbilical fat infiltration on a foreign body admitted on the Department of Digestive Cancer Surgery and Liver Transplantation, Casablanca, Morocco. An exploratory laparotomy revealed a parietal mass centered by a fish bone.

Results:

Accidental ingestion of foreign bodies is common in clinical practice. However, perforation of the intestine by a foreign body is less common because the majority of foreign bodies pass without incident into the feces and only 1% of them (the sharpest and most elongated objects) will perforate the gastrointestinal tract, usually at the level of the ileum.

CT, especially multidetector CT, is considered the method of choice for preoperative diagnoses of ingested foreign bodies and their complications due to its high-quality multiplanar capabilities and high resolution.

Foreign body ingestion usually goes unnoticed, but the complications of this incident can be severe.

Conclusion:

This case report highlights the fact that intestinal perforation caused by an ingested foreign body is a difficult diagnosis that should always be suspected in an attack of abdominal pain. Frequently, the clinical diagnosis is difficult, and recourse to imaging is sometimes necessary. Most of the time, the treatment is only surgical.
Clinical Nurses' View of Staffing During the Pandemic
Authors: Weaver Susan H. , Fleming Kathryn , Harvey Joan , Marcus-Aiyeku Ulanda , Wurmser Theresa A.
Published: March 2023

The COVID-19 pandemic presented staffing challenges in providing care during the surge of critically ill patients. This qualitative descriptive study was conducted to obtain an understanding of clinical nurses' perspective of staffing in units during the first wave of the pandemic. Eighteen focus groups were conducted with registered nurses who worked on intensive care, telemetry, or medical-surgical units at 9 acute care hospitals. The focus group transcripts were thematically analyzed to identify codes and themes. The overarching theme was staffing, a bit of a mess, which sums up the general perception of nurses during the initial phase of the pandemic. The following additional themes underscore the overarching theme: challenging physical work environment; supplementing the frontline: buddies, helpers, runners, agency, and travel nurses; nurses do everything; getting through as a team; and emotional toll. Nurse leaders can utilize these findings to guide staffing decisions today and in the future, such as ensuring nurses are oriented to their deployed unit, keeping team members together when reassigned, and striving for consistency with staffing. Learning from the experience of clinical nurses who worked during this unprecedented time will assist in improving nurse and patient outcomes.
An Easy Way to Harvest Super-thin SCIP flap with Long Pedicle: Reappraisal of the Inferolateral Branches of SCIA
Authors: Zhang Yuwei , Zeng Ang
Published: March 2023

Despite being the first free flap used in reconstructive surgery in 1973 1, the groin flap slowly fell out of fashion because of its short pedicle length, small vessel diameter, variable vascular anatomy, and bulkiness. In 2004, Dr. Koshima revived the groin flap by applying the concept of perforators and proposed the superior iliac artery perforator (SCIP) flap, which he used successfully to reconstruct limb defects 2. As a workhorse flap, the SCIP flap can be used to reconstruct various body regions 3-15. However, it is still challenging to harvest super-thin SCIP flaps with long pedicles.

Over the years, we have found perforators consistently exist inferolateral to the deep branch of SCIA forming an F configuration with the main branch. The F configuration of the perforators have reliable anatomy and extend directly into the dermal plexus. In this article, we present the anatomy of these perforators of SCIA with F configurations and describe the flap design based on them.
Identification of drug compounds for capsular contracture based on text mining and deep learning
Authors: Lu Yeheng , Chen Zhiwei , Pan Yuyan , Qi Fazhi
Published: March 2023

Background:

Capsular contracture is a common and unpredictable complication after breast implant placement. Currently, the pathogenesis of capsular contracture is unclear and the effectiveness of non-surgical treatment is still doubtful. Our study aimed to investigate new drug therapies for capsular contracture by using computational methods.

Methods:

Genes related to capsular contracture were identified by text mining and GeneCodis. Then the candidate key genes were selected through protein-protein interaction analysis in STRING and Cytoscape. Drugs targeting the candidate genes with relation to capsular contracture were screened out in Pharmaprojects. Based on the drug-target interaction analysis by DeepPurpose, candidate drugs with highest predicted binding affinity were obtained eventually.

Results:

Our study identified 55 genes related to capsular contracture. Gene set enrichment analysis and protein-protein interaction analysis generated 8 candidate genes. 100 drugs targeting the candidate genes were selected. 7 candidate drugs with highest predicted binding affinity were determined by DeepPurpose, including tumor necrosis factor alpha (TNF-α) antagonist, estrogen receptor (ESR) agonist, insulin like growth factor 1 (IGF-1) receptor tyrosine kinase inhibitor and matrix metallopeptidase 1 (MMP1) inhibitor.

Conclusion:

Text mining and DeepPurpose can be used as a promising tool for drug discovery in exploring non-surgical treatment to capsular contracture.
Baseline Characteristics and Clinical Presentation of Biopsy-Proven Giant Cell Arteritis in White Compared with Black Patients
Authors: Sun Emily , Li Ximin , Gruener Anna M. , Chang Jessica R. , Henderson Amanda D. , Carey Andrew R.
Published: March 2023

Background:

Giant cell arteritis (GCA) is the most prevalent systemic vasculitis in the elderly and can lead to permanent vision loss if left untreated. Most earlier studies have evaluated GCA in primarily white populations, and GCA was traditionally thought to occur at nearly negligible frequency in black populations. Our previous study showed that GCA may occur at similar rates in white and black patients, but little is known about the presentation of GCA in black patients. The purpose of this study is to examine baseline presentation of biopsy-proven GCA (BP-GCA) in a tertiary care center–based population with a sizeable proportion of black patients.

Methods:

Retrospective study from a single academic institution of a previously described cohort of BP-GCA. Presenting symptoms, laboratory findings, and GCA Calculator Risk score were compared in black and white patients with BP-GCA.

Results:

Among 85 patients with biopsy-proven GCA, 71 (84%) were white and 12 (14%) were black. White patients had higher rates of elevated platelet count (34% vs 0%, P = 0.04), whereas black patients had higher rates of diabetes mellitus (67% vs 12%, P < 0.001). There were no statistically significant differences in age, gender, biopsy classification (active vs healed arteritis), cranial symptoms, visual symptoms/ophthalmic findings, rates of abnormal erythrocyte sedimentation rate or C-reactive protein, unintentional weight loss, polymyalgia rheumatica, or GCA risk calculator score.

Conclusions:

Presenting features of GCA were similar between white and black patients in our cohort, except for rates of abnormal platelet level and diabetes. Physicians should feel comfortable relying on the usual clinical features for the diagnosis of GCA independent of race.
Genomic evidence for two pathways of formaldehyde oxidation and denitrification capabilities of the species Paracoccus methylovorus sp. nov.
Authors: Timsy Timsy , Behrendt Undine , Ulrich Andreas , Foesel Bärbel U. , Spanner Tobias , Neumann-Schaal Meina , Wolf Jacqueline , Schloter Michael , Horn Marcus A. , Kolb Steffen
Published: March 2023

Three strains (H4-D09T, S2-D11 and S9-F39) of a member of the genus

Paracoccus

attributed to a novel species were isolated from topsoil of temperate grasslands. The genome sequence of the type strain H4-D09T exhibited a complete set of genes required for denitrification as well as methylotrophy. The genome of H4-D09T included genes for two alternative pathways of formaldehyde oxidation. Besides the genes for the canonical glutathione (GSH)-dependent formaldehyde oxidation pathway, all genes for the tetrahydrofolate–formaldehyde oxidation pathway were identified. The strain has the potential to utilize methanol and/or methylamine as a single carbon source as evidenced by the presence of methanol dehydrogenase (mxaFI) and methylamine dehydrogenase (mau) genes. Apart from dissimilatory denitrification genes (narA, nirS, norBC and nosZ), genes for assimilatory nitrate (nasA) and nitrite reductases (nirBD) were also identified. The results of phylogenetic analysis based on 16S rRNA genes coupled with riboprinting revealed that all three strains represented the same species of genus

Paracoccus

. Core genome phylogeny of the type strain H4-D09T indicated that

Paracoccus thiocyanatus

and

Paracoccus denitrificans

are the closest phylogenetic neighbours. The average nucleotide index (ANI) and digital DNA–DNA hybridization (dDDH) with the closest phylogenetic neighbours revealed genetic differences at the species level, which were further substantiated by differences in several physiological characteristics. The major respiratory quinone is Q-10, and the predominant cellular fatty acids are C18 : 1ω7c, C19 : 0cyclo ω7c, and C16 : 0, which correspond to those detected in other members of the genus. The polar lipid profile consists of a diphosphatidylglycerol (DPG), phosphatidylethanolamine (PE), phosphatidylglycerol (PG), phosphatidylcholine (PC), aminolipid (AL), glycolipid (GL) and an unidentified lipid (L).

On the basis of our results, we concluded that the investigated isolates represent a novel species of the genus

Paracoccus

, for which the name Paracoccus methylovorus sp. nov. (type strain H4-D09T=LMG 31941T= DSM 111585T) is proposed.
Substantial viral and bacterial diversity at the bat–tick interface
Authors: Ortiz-Baez Ayda Susana , Jaenson Thomas G. T. , Holmes Edward C. , Pettersson John H.-O. , Wilhelmsson Peter
Published: March 2023

Ticks harbour a high diversity of viruses, bacteria and protozoa. The soft tick Carios vespertilionis (Argasidae) is a common ectoparasite of bats in the Palearctic region and is suspected to be vector and reservoir of viruses and other microbial species in bat populations, some of which may act as zoonotic agents for human disease. The Soprano pipistrelle (Pipistrellus pygmaeus, Vespertilionidae) is widely distributed in Europe, where it can be found inside or close to human habitation. We used meta-transcriptomic sequencing to determine the RNA virome and common microbiota in blood-fed C. vespertilionis ticks collected from a Soprano pipistrelle bat roosting site in south-central Sweden. Our analyses identified 16 viruses from 11 virus families, of which 15 viruses were novel. For the first time in Sweden we identified Issuk-Kul virus, a zoonotic arthropod-borne virus previously associated with outbreaks of acute febrile illness in humans. Probable bat-associated and tick-borne viruses were classified within the families Nairoviridae, Caliciviridae and Hepeviridae, while other invertebrate-associated viruses included members of the Dicistroviridae, Iflaviridae, Nodaviridae, Partitiviridae, Permutotetraviridae, Polycipiviridae and Solemoviridae. Similarly, we found abundant bacteria in C. vespertilionis, including genera with known tick-borne bacteria, such as

Coxiella

spp. and

Rickettsia

spp. These findings demonstrate the remarkable diversity of RNA viruses and bacteria present in C. vespertilionis and highlight the importance of bat-associated ectoparasite surveillance as an effective and non-invasive means to track viruses and bacteria circulating in bats and ticks.
Likelihood-based signal and noise analysis for docking of models into cryo-EM maps
Authors: Read Randy J. , Millán Claudia , McCoy Airlie J. , Terwilliger Thomas C.
Published: March 2023

Fast, reliable docking of models into cryo-EM maps requires understanding of the errors in the maps and the models. Likelihood-based approaches to errors have proven to be powerful and adaptable in experimental structural biology, finding applications in both crystallography and cryo-EM. Indeed, previous crystallographic work on the errors in structural models is directly applicable to likelihood targets in cryo-EM. Likelihood targets in Fourier space are derived here to characterize, based on the comparison of half-maps, the direction- and resolution-dependent variation in the strength of both signal and noise in the data. Because the signal depends on local features, the signal and noise are analysed in local regions of the cryo-EM reconstruction. The likelihood analysis extends to prediction of the signal that will be achieved in any docking calculation for a model of specified quality and completeness. A related calculation generalizes a previous measure of the information gained by making the cryo-EM reconstruction.
A prediction model of users' attention transfer in the context of multitopic competition
Authors: An Lu , Shen Yan , Li Gang , Yu Chuanming
Published: March 2023

Purpose

Multiple topics often exist on social media platforms that compete for users' attention. To explore how users’ attention transfers in the context of multitopic competition can help us understand the development pattern of the public attention.

Design/methodology/approach

This study proposes the prediction model for the attention transfer behavior of social media users in the context of multitopic competition and reveals the important influencing factors of users' attention transfer. Microblogging features are selected from the dimensions of users, time, topics and competitiveness. The microblogging posts on eight topic categories from Sina Weibo, the most popular microblogging platform in China, are used for empirical analysis. A novel indicator named transfer tendency of a feature value is proposed to identify the important factors for attention transfer.

Findings

The accuracy of the prediction model based on Light GBM reaches 91%. It is found that user features are the most important for the attention transfer of microblogging users among all the features. The conditions of attention transfer in all aspects are also revealed.

Originality/value

The findings can help governments and enterprises understand the competition mechanism among multiple topics and improve their ability to cope with public opinions in the complex environment.
DC operating points of nonlinear circuits and generalized Carleman linearization
Authors: Weber Harry , Mathis Wolfgang
Published: March 2023

Purpose

The purpose of this paper is to present a procedure for approximating DC operating points of nonlinear circuits. The presented approach can also be applied in case of multiple DC operating points.

Design/methodology/approach

A generalized Carleman linearization is used, which transforms an algebraic nonlinear equation into an equivalent infinite-dimensional linear system. In general, no close-form solution can be given for the infinite-dimensional linear system. Hence, the infinite-dimensional linear system is approximated by a finite one over a predefined interval using a self-consistent technique. The presented procedure allows to approximate all possible DC operating points within a predefined interval. To isolate all DC operating points, the initial interval is gradually divided into subintervals.

Findings

It is shown that the presented approach is not restricted to the polynomial case and allows to approximate all DC operating points. The presented approach can be applied in case of multiple DC operating points and does not depend on the domain of attraction of the DC operating points.

Originality/value

A new procedure for the approximation of DC operating points of nonlinear circuits based on a generalized Carleman linearization is presented. This approach can be applied in case of multiple DC operating points and is independent of the domain of attraction. Further, this generalized approach is not restricted to the polynomial case and can be applied to a variety of circuits.