bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterization of slightly acidic electrolyzed water (SAEW) on effective disinfection against microbial safety and retention of phenolic compound in SAEW treated fresh romaine lettuce
Authors: Shi John , Xue Sophia Jun , Tang Joshua
Published: May 2024

Objectives

This study investigated the effects of processing parameters, specifically the flow rate and the combination of diluted HCl and salt (NaCl) at different concentrations, on the properties of slightly acidic electrolyzed water (SAEW) that was produced.

Materials and Methods

The properties of the SAEW that were analyzed included pH, oxidation–reduction potential (ORP), available chlorine concentration (ACC), and generated hypochlorous acid (HClO) concentration. Meanwhile, the total aerobic bacteria and total phenolic content retention were determined.

Results

NaCl alone resulted in the lowest pH (<4) and the highest ORP values (>1000 mV). Increasing the HCl concentration significantly raised the pH to greater than 5 and lowered the ORP values of SAEW, with the highest pH (5.7) observed with 1.5% HCl and 5% NaCl. The highest HClO concentration of 19.65±1.03 mg/L was obtained with 1.5% HCl:5% NaCl. Interestingly, the concentration of NaCl had no significant effect on the production of HClO. Furthermore, different concentrations of combined NaCl and HCl significantly influenced the inactivation efficiency on total aerobic bacteria count and changes in phenolic compound content. Increasing HCl concentrations from 0.5% to 2.0% led to an increase in the reduction of aerobic bacteria counts from 2.51 to 4.22 log colony-forming units (CFU)/g with 5% NaCl and from 2.49 to 3.52 log CFU/g with 10% NaCl. Flow rates significantly contributed to the change in HClO formation and altered the properties of the produced SAEW. The results indicated that SAEW treatment significantly reduced total aerobic bacteria counts. A lower flow rate (0.3 L/min) produced the highest log reduction. Additionally, SAEW treatment led to a reduction in phenolic content, even though a considerable amount was retained at lower HClO concentrations.

Conclusions

These findings offer valuable information on optimizing SAEW treatment protocols for enhancing microbial safety and extending the shelf life of fresh produce, while considering the impact on the content of phenolic compounds.
Building Tomorrow's Transport Systems
Authors: Cooper Martin
Published: May 2024

Safe, reliable, affordable and equitable transport is critically important for communities. Myra Blanco from VTTI tells Martin Cooper MBCS how using data is the key to enabling people and goods to move more effectively.
Will the AI Do Everything?
Authors: Runciman Brian
Published: May 2024

Are humans destined for mass redundancy? If Elon Musk is right, we may well be. Brian Runciman MBCS and ChatGPT team up to analyse the latest BCS research about AI's capabilities and find a very different story.
Announcing the BCS Wales Hub
Authors: Cooper Martin
Published: May 2024

By drawing on BCS' role as a convener, the first BCS Hub will bring professionals, industry and academia together to make IT good for society in Wales. More BCS hubs will follow. Martin Cooper MBCS reports.
Creativity and Tech Innovation
Authors:   BCS Early Careers Executive
Published: May 2024

The BCS Early Careers Executive explores how new technologies are changing the way content is made and consumed, and the ethical responsibility we all have to ensure that everybody can participate.
Greening Digital
Authors: Nind Andrew , Pearson Siani
Published: May 2024

Interest in sustainable IT is growing. Andrew Nind, MMaths, MSc, and Siani Pearson, PhD, from Just Algorithms Action Group (JAAG), explain how the assessment of digital technologies from a climate perspective can be misleading, and why the use of smaller systems should be considered.
What it Can Learn from Aviation Safety
Authors: Whitby Blay
Published: May 2024

Blay Whitby FBCS explores how air crashes are investigated and discusses how lessons from that industry might be applicable when IT and AI projects experience disastrous outcomes.
My favourite flowering image: the remarkable inside-out flowers of Lacandonia
Authors: Rudall Paula J
Published: May 2024

Flowers are deceptively simple structures, characterized by a determinate primary axis that bears organs in condensed concentric zones in a strict structural and temporal sequence. Few species have escaped these constraints, but those that have can provide insights into the evolutionary history of flowers if placed in the appropriate phylogenetic and developmental context. For my flowering image, I selected a longitudinal section of a Lacandonia flower, which breaks a fundamental rule of spatial arrangement: the flowers are ‘inside-out’, with the carpels surrounding the stamens—a pattern that is almost unique among angiosperms. When viewed in the context of the family and order to which it belongs, this species has led me into many fascinating areas of comparative and evolutionary plant morphology.
Description of the feeding rhythm of cone snails in French Polynesia
Authors: Teillard Valentin , Gache Camille , Dutertre Sebastien , Bambridge Tamatoa , Salvat Bernard , Planes Serge
Published: May 2024

The Conidae is a family of marine gastropod molluscs that includes carnivorous and venomous species. The venom they produce is remarkably diverse and has recently drawn much interest from a pharmacological perspective. To respond to this growing interest, a better understanding of the ecology and biology of the species is required. Only a few studies have examined the feeding behaviour and the trophic specialization of these species in detail. In this study, we investigated diet through hunger and satiety experiments of eight species of cones that occur in French Polynesia and that present different feeding modes (piscivorous, molluscivorous or vermivorous). Monitoring behaviour of cones during fasting periods demonstrated a correlation between increased hunger and nocturnal cone activity, mainly for piscivorous species, while the molluscivores did not show this correlation. In the study on satiety, we defined an average frequency of feeding for cone species that were fed prey ad libitum. Finally, this study provided indications that will help to define an equilibrium feeding frequency in further studies involving the cultivation of cones.
Is it better to bring digital health tools together? Where Burkina Faso is going with a minimal digital ecosystem (MDE)
Authors: Kiendrébéogo Joël Arthur , Tapsoba Charlemagne , Sory Orokia , Kaboré Issa , Kafando Yamba , Tiendrébéogo Simon , Zombré David , Kaboré Rémi , Konsebo Noellie , Relwendé Nacanabo , Ouattara Jean Serge Dimitri , Foutry Guillaume , Hyde Sara , Green Dylan , Chaitkin Michael , Ouédraogo André Lin , Yaméogo S Pierre
Published: May 2024

Digital health technologies are proliferating in low-income countries. However, they are not always optimally integrated and focused on health system priorities. To improve the performance of primary health care and accelerate progress toward universal health coverage, Burkina Faso aims to bring together eight digital health tools in two health districts as a pilot project, an initiative known as the ‘Minimal Digital Ecosystem’. A co-creation approach is used to develop and implement these tools, involving the Ministry of Health, international nongovernmental organizations that promote the tools, donors and researchers. Despite the many challenges in developing and deploying it, the minimal digital ecosystem (MDE) is a promising experiment that deserves special attention to reap its full benefits.
Spain: Boom, Bust, and Breakup
Authors: Hopkin Jonathan
Published: May 2024

This chapter discusses the evolution of anti-system politics in Spain. Spain provides an eloquent illustration of the direct impact of economic distress on anti-system politics. The country suffered one of the deepest financial crises and most severe hits to the wealth and incomes of large numbers of people. This was followed by a surge of political instability, voter volatility, and electoral shifts away from the establishment parties to anti-system forces. The political discourses of the anti-system parties, and the kinds of voters they appealed to, confirm that economic factors were the driving force behind this transformation. However, Spain also reveals the complexity of anti-system politics, with anti-austerity politics contributing to the intensification of the conflict between Catalan nationalism and its opponents, both within Catalonia and across the rest of Spain.
Extra-articular Osteotomy for the Management of Intra-articular Tibial Plateau Valgus Malunion
Authors: Page Brian Joseph , Greenstein Michael D. , Sheridan Gerard A. , Fragomen Austin T. , Rozbruch S. Robert
Published: May 2024

OBJECTIVES:

To report a case series of extra-articular osteotomies for the management of intra-articular tibial plateau malunions and to assess the ability to correct deformity and improve knee range of motion (ROM).

METHODS:

 

Design:

Retrospective case series.

Setting:

Academic, tertiary, referral center.

Patient Selection Criteria:

Adult patients with tibial plateau fracture malunion treated with extra-articular osteotomy of the femur and/or tibia between 2014 and 2023.

Outcome Measures and Comparison:

Mechanical axis deviation (MAD), medial proximal tibia angle (MPTA), lateral distal femoral angle (LDFA), and posterior proximal tibia angle (PPTA) correction; knee ROM; and time to weight bearing.

RESULTS:

There were 7 patients included, 6 (85.7%) were female and 1 (14.3%) were male. The median age was 43.5 years (IQR 38.5–51, range 32–62). Four (57.1%) patients were treated with a high tibial osteotomy (HTO), and 3 (42.9%) patients were treated with an HTO and distal femoral osteotomy. One patient had concomitant supramalleolar osteotomy with HTO to address distal tibia procurvatum and valgus. Four were treated with hexapod frames, and 3 were treated with plates and screws. Median follow-up was 22.5 months (IQR 10.5–107 months, range 7–148 months). Surgical intervention corrected median radiographic measures of valgus malalignment preoperatively relative to postoperative values. This included MAD (42.5 mm–0 mm), valgus angle (12.5 degrees–1.5 degrees), MPTA (95 degrees–88.0°), and LDFA (86.0°–87.3 degrees). Surgical intervention increased maximal knee range of motion preoperatively to postoperatively. Median time to full weight bearing was 81.5 days (IQR 46–57 days, range 41–184 days). Two patients were converted to total knee arthroplasty after 5 and 10 years following HTO with hexapod frame.

CONCLUSIONS:

Extra-articular osteotomy is an effective treatment for addressing intra-articular malunion after tibia plateau fractures. It is effective in correcting the MAD, valgus deformity, MPTA, LDFA, PPTA, and improving knee ROM (measured through knee extension and flexion).

LEVEL OF EVIDENCE:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Complete Treatment of Hallux Valgus With Minimally Invasive Surgery: Lapidus Procedure
Authors: Purnell Jennifer , Johnson A. Holly
Published: May 2024

The use of minimally invasive techniques for managing hallux valgus in foot and ankle surgery is expanding. Hallux valgus management would not be complete without a discussion of the Lapidus procedure. This chapter focuses on indications, contraindications, patient selection, and surgical techniques for the application of the percutaneous Lapidus procedure. In this chapter, the senior author details the pearls and pitfalls of the technique and discusses patient outcomes.

Level of Evidence:

Level V.
Cytomegalovirus gastritis as a rare adverse event during combined ipilimumab and nivolumab in a patient with melanoma
Authors: Indini Alice , Gueli Rossana , Cerati Michele , Rijavec Erika , Parravicini Marco , Casagrande Sabrina , Rovelli Cristina , Grossi Paolo Antonio , Grossi Francesco
Published: May 2024

Immunotherapy has improvedsurvival outcomes of patients with advanced melanoma. Lower gastrointestinal tract immune-related adverse events (irAEs) are common during treatment; however, gastritis is not frequently observed. Herein, we report a case of severe cytomegalovirus (CMV)-related gastritis in a patient treated with ipilimumab and nivolumab for metastatic melanoma. This report presents a 60-year-old woman with stage IV BRAF wild-type melanoma. t. After the second course of ipilimumab-nivolumab, the patient reported epigastric discomfort after meals, anorexia, and subsequent nausea, vomiting, epigastric pain, and weight loss. Disease staging with PET/CT scan showed very good partial response and diffuse gastroduodenitis. The patient underwent esophagogastroduodenoscopy, showing severe esophageal candidiasis and diffuse hemorrhagic, edematous, and ulcerative mucosa in the whole gastric wall. Biopsies of the gastric wall were obtained. Before receipt of the final pathology report, the patient was empirically started on corticosteroids based on the clinical suspicion of immune-related gastritis, without improvement of symptoms. The hematoxylin-eosin staining demonstrated active gastritis with diffuse nuclear cytopathic viral inclusions in epithelial and interstitial cells; CMV infection was confirmed with immunohistochemical staining. The patient startedganciclovir and fluconazole, with rapid improvement of symptoms. This case presents a rare instance of CMV gastritis in a patient receiving combined anti-PD1 and anti-CTLA4 , in the absence of immune-suppression to manage an irAE. In the case of suggestive symptoms of irAEs, a high index of clinical suspicion is required to rule out concomitant or isolated infective disease. Guidelines for prophylaxis and treatment of these patients are needed, to optimize treatment results.
Hypofractionated Radiotherapy-Related Lymphopenia Is Associated With Worse Survival in Unresectable Intrahepatic Cholangiocarcinoma
Authors: Lee Grace , Kim Daniel W. , Smart Alicia C. , Horick Nora K. , Eyler Christine E. , Roberts Hannah J. , Pathak Priyadarshini , Goyal Lipika , Franses Joseph , Heather James M. , Hwang William L. , Grassberger Clemens , Klempner Samuel J. , Drapek Lorraine C. , Allen Jill N. , Blaszkowsky Lawrence S. , Parikh Aparna R. , Ryan David P. , Clark Jeffrey W. , Hong Theodore S. , Wo Jennifer Y.
Published: May 2024

Objective:

The aim of this study was to evaluate the incidence of radiotherapy (RT)-related lymphopenia, its predictors, and association with survival in unresectable intrahepatic cholangiocarcinoma (ICC) treated with hypofractionated-RT (HF-RT).

Methods:

Retrospective analysis of 96 patients with unresectable ICC who underwent HF-RT (median 58.05 Gy in 15 fractions) between 2009 and 2022 was performed. Absolute lymphocyte count (ALC) nadir within 12 weeks of RT was analyzed. Primary variable of interest was severe lymphopenia, defined as Grade 3+ (ALC <0.5 k/μL) per CTCAE v5.0. Primary outcome of interest was overall survival (OS) from RT.

Results:

Median follow-up was 16 months. Fifty-two percent of patients had chemotherapy pre-RT, 23% during RT, and 40% post-RT. Pre-RT, median ALC was 1.1 k/μL and 5% had severe lymphopenia. Post-RT, 68% developed RT-related severe lymphopenia. Patients who developed severe lymphopenia had a significantly lower pre-RT ALC (median 1.1 vs. 1.5 k/μL, P=0.01) and larger target tumor volume (median 125 vs. 62 cm3, P=0.02). In our multivariable Cox model, severe lymphopenia was associated with a 1.7-fold increased risk of death (P=0.04); 1-year OS rates were 63% vs 77% (P=0.03). Receipt of photon versus proton-based RT (OR=3.50, P=0.02), higher mean liver dose (OR=1.19, P<0.01), and longer RT duration (OR=1.49, P=0.02) predicted severe lymphopenia.

Conclusions:

HF-RT-related lymphopenia is an independent prognostic factor for survival in patients with unresectable ICC. Patients with lower baseline ALC and larger tumor volume may be at increased risk, and use of proton therapy, minimizing mean liver dose, and avoiding treatment breaks may reduce RT-related lymphopenia.
Hurricane Harvey and the risk of spontaneous preterm and early-term birth
Authors: Liu Xinyue , Berberian Alique G. , Wang Sophia , Cushing Lara J.
Published: May 2024

Background:

Hurricane Harvey made landfall in August 2017 and resulted in catastrophic flooding in Houston, Texas. Prior studies of hurricanes and preterm birth have found conflicting results. We tested the hypotheses that exposure to Hurricane Harvey was associated with a higher risk of spontaneous pre- and early-term birth and assessed vulnerable subpopulations.

Methods:

We conducted a retrospective study of singleton births using administrative birth records in the nine-county greater Houston area from 2015 to 2019. We estimated the likelihood of pre- and early-term births using logistic regression, comparing births occurring during or within 1, 2, or 4 weeks of Hurricane Harvey to unexposed reference periods encompassing the same dates 2 years prior and after. Stratified models assessed effect modification by degree of flooding, birth parent age, high- vs. low-risk pregnancy, race/ethnicity, and prenatal care.

Results:

Among 15,564 births, we found no association between exposure to Hurricane Harvey and spontaneous preterm birth within 1 week adjusted (odds ratio [OR], 1.06; 95% confidence interval [CI] = 0.91, 1.25) but a 14% higher odds of spontaneous early-term birth (OR, 1.14; 95% CI = 1.04, 1.25). The odds of early-term birth were even higher in neighborhoods with severe flooding (OR, 1.21; 95% CI = 1.05, 1.38), segregated neighborhoods (OR, 1.23; 95% CI = 1.03, 1.47), and among foreign-born Hispanics (OR, 1.21; 95% CI = 1.04, 1.53) and pregnant people receiving no prenatal care (OR, 1.37; 95% CI = 1.03, 1.82). Effect estimates were attenuated or null when considering 2-week or 4-week lags to define exposure.

Conclusions:

Hurricane Harvey was associated with higher odds of spontaneous early-term birth up to 1 week later, especially among socially marginalized populations.
Oncologic Staging Computed Tomography with IV Contrast Has Similar Efficacy to Dedicated Computed Tomography Angiography for Preoperative DIEP Flap Planning
Authors: Brown Meghan S. , Mirhaidari Cyrus , Johnson Jordan , Larson Brandon M. , Cook Chad , Shue Robert , Ventimiglia Anthony J. , Cody Derek G.
Published: May 2024

Background:

Due to variations in perforator vasculature, deep inferior epigastric artery perforator (DIEP) flap preoperative imaging can minimize operative time required to locate the most suitable perforators. Dedicated computed tomography angiography (CTA) has been the gold standard; however, many patients have already undergone a staging computed tomography (CT) per oncologic workup. The benefits from CTA may also be realized with a staging CT or CT with IV contrast.

Methods:

Ten patients who underwent DIEP flap reconstruction with staging CT and CTA within 3 years of one another were included in this study. Reviewers evaluated axial views of both imaging modalities separately to identify each visible perforator in reference to the pubic symphysis from the xiphoid to the pubic symphysis. An intraclass correlation coefficient (ICC) was used to determine agreement in location of perforators between the two imaging studies. Statistical analysis was performed using an ICC and Wilcoxon signed rank-tests.

Results:

The identified perforators within the patient cohort had an excellent correlation between their location on CT and CTA based upon ICC. The mean number of perforators identified in the CT group was 15.3 (SD 4.9) and in the CTA group was 18.8 (SD 6.4), which was not statistically different (P = 0.247).

Conclusions:

CT has similar efficacy in identifying number of perforators and perforator location to dedicated CTA for preoperative planning in DIEP flaps. This has the potential for decreased patient contrast and ionizing radiation exposure as well as improved patient and healthcare resource utilization.
Dorso Proximal Interphalangeal Island Flap
Authors: Pereira Osvaldo J. , Ely Jorge B. , Bertelli Jaime A. , Vasconcellos Zulmar A. , Granemann Alfredo S.
Published: May 2024

Background:

This study aimed to demonstrate the clinical application of the dorsoproximal interphalangeal island flap as an alternative approach to skin graft or cross-finger flap to repair lesions at the ventral site at the proximal interphalangeal (PIP) finger joint.

Methods:

Fifteen patients received flaps (11 men and four women, n = 25 flaps). The repair of volar contracture in finger sequelae after burn injuries was the main indication. Five patients underwent two or more flaps during the same surgical session. The mean patient age was 18 years (range, 7–56 years). Most patients presented with palmar finger contractures of the PIP joint. In three patients, six flaps were rotated to the lateral radial and ulnar proximal surfaces of the finger to treat syndactyly.

Results:

Most flaps survived and provided satisfactory functional and aesthetic improvement of palmar scar contracture in the PIP region. Postoperative donor site follow-up was normal. The color and pliability of the skin are similar to those of the surrounding area. The follow-up period ranged from 6 months to 12 years.

Conclusions:

Dorsoproximal interphalangeal island flaps are an option for repairing lesions that lack soft tissue and range in size from 10 × 15 to 12 × 18 mm at the volar site and around the PIP joint. The arch of rotation of this flap allows for lateral, ulnar, and radial rotations around the joint. The indication of six flaps in three patients to repair a proximal lack of tissue caused by syndactyly demonstrated its potential use in this anomaly.
Evaluation of Platelet-rich Plasma and Microneedling for Facial Skin Rejuvenation
Authors: Pincelli Thais P. , Zawawi Suha , Shapiro Shane A. , Heckman Michael G. , Hochwald Alexander P. , Arthurs Jennifer , Tolaymat Leila , Bruce Alison
Published: May 2024

Background:

The regenerative properties of platelet growth factors make platelet-rich-plasma (PRP) an attractive modality for treatment of aging skin. The main objective of this study was to determine efficacy and safety of PRP injections and microneedling compared with saline injections in women with aging skin of the face.

Methods:

In this prospective, randomized clinical trial, 18 women with facial aging were randomized to receive either PRP injections to the unilateral face and saline injections to the contralateral side, or vice versa. Microneedling was performed after injections on the entire face. Physician assessment, photographs, and treatment satisfaction questionnaires were used for outcome assessment at baseline and 16- and 24-week follow-ups.

Results:

There was no evidence of improvement and suggestion of worsening in skin laxity and rhytides from baseline to weeks 4, 16, and 24 for PRP and saline (all P ≤ 0.004) and no notable difference in skin roughness between baseline and follow-up time points for PRP or saline (all P ≥ 0.19). The degree of change in skin laxity, rhytides, and skin roughness from baseline to follow-up time points was similar for PRP and saline. All patients experienced some degree of pain/discomfort and burning/stinging sensation at treatment weeks 4, 8, and 12 for both saline and PRP.

Conclusions:

PRP injections did not seem to be effective for treatment of aging skin of the face in women, with no notable macroscopic improvement in appearance when compared with baseline or saline injections. Advanced age of study participants (>45 years) and less-sensitive methods of evaluation may be potential contributing factors to the lack of detected response.
Fat-augmented Temporal Fascia Flap for Defect Coverage following External Auditory Canal Cancer Resection
Authors: Shikano Yusuke , Tashima Hiroki , Kuroda Kazuya , Otani Naoya , Seike Shien , Kubo Tateki
Published: May 2024

Malignant tumors of the external auditory canal are rare and require surgical interventions such as lateral temporal bone resection (LTBR) for localized cases. This study introduces a novel approach, the lipofilling fascia flap technique, for external auditory canal reconstruction following LTBR or modified LTBR. The technique involves augmenting the temporal fascia flap with autologous fat grafting, aiming to enhance volume and improve outcomes. Two cases are presented, demonstrating successful reconstruction with minimal complications.
A Qualitative Study of Patients’ Lived Experiences of Free Tissue Transfer for Diabetic Foot Disease
Authors: Goodall Richard J. , Borsky Kim L. , Harrison Conrad J. , Mavromatidou Galini , Shirley Rebecca A. , Ellard David R. , Rodrigues Jeremy N. , Chan James KK.
Published: May 2024

Background:

Free tissue transfer (FTT) for reconstruction of diabetic foot disease (DFD) is an emerging field to preserve the lower limb within this patient group. The design of future quantitative research and clinical services in this area must consider the needs, expectations and concerns of patients. This qualitative study explores patient experiences of FTT for reconstruction of DFD.

Methods:

Semistructured interviews were conducted to explore patients’ lived experiences of FTT for DFD. A purposive sampling strategy identified six patients who underwent FTT for recalcitrant DFD between September 2019 and December 2021 in a single center in the United Kingdom.

Results:

Three experiential themes emerged. Theme 1: “negative lived experiences of living with DFD” included frustration with the chronic management of nonhealing ulcers and fear regarding limb amputation. Theme 2: “surgery related concerns” included fears of reconstructive failure and subsequent amputation, as well as foot cosmesis and donor-site morbidity. Theme 3: “positive lived experiences following reconstruction” included the positive impact the reconstruction had on their overall life and diabetic control. All patients would repeat the process to obtain their current results.

Conclusions:

This qualitative study provides first-hand insight into the lived experience of FTT for DFD, exploring both the negative and positive experiences and reasons for these. We found that FTT for DFD can be positively life-changing for affected individuals.
Intraocular Pressure Before and After Corneal Refractive Surgery: A Prospective Comparison of Corvis ST and Ocular Response Analyzer
Authors: Salouti Ramin , Azimi Ali , Meshksar Aidin , Takapouy Ramin , Ghoreyshi Maryam , Salouti Kia , Razeghinejad Reza , Nowroozzadeh Mohammad Hossein
Published: May 2024

Précis:

The study showed that Corvis ST’s biomechanical intraocular pressure (bIOP) and ocular response analyzer's (ORA) cornea-compensated intraocular pressure (IOPcc) do not agree well, before or after photorefractive keratectomy (PRK), and may not be used interchangeably. bIOP remained unchanged after PRK.

Objective:

To evaluate the agreement between the biomechanically corrected intraocular pressure (bIOP) measured by the Corvis ST and the IOPcc measured by the ORA before and after PRK.

Patients and Methods:

In this prospective interventional study, a total of 53 patients (53 eyes) were included. Measurements were acquired using both the Corvis ST and ORA devices before and 3 months post-PRK. The agreement between the 2 devices was evaluated using limits of agreement (LoA) and Bland-Altman plots.

Results:

The participants had a mean age of 29.6 ± 5.21 years (range: 21 to 40), with 41 (77.4%) of them being females. After the surgery, the average change in intraocular pressure (IOP) was 0.3 ± 1.7 mm Hg for bIOP and −1.6 ± 4.0 mm Hg for IOPcc. The corresponding 95% LoA were −3.5 to 4.2 mm Hg and −9.5 to 6.3 mm Hg, respectively. The 95% LoA between bIOP and IOPcc after PRK was −2.3 to 8.5 mm Hg. Notably, the bIOP values were higher for IOPs <20 mm Hg and lower for IOPs >20 mm Hg compared with IOPcc.

Conclusions:

The findings indicate a weak agreement between the Corvis ST-bIOP and the ORA-IOPcc both before and after PRK. These devices may not be used interchangeably for IOP measurement. bIOP exhibited less variation compared with the IOPcc, suggesting that the bIOP may be a better option for IOP reading after PRK.
Five-Year Treatment Outcomes of Resident-Performed Ahmed Valve Implantation for Glaucoma
Authors: Corzo-Camberos Fernanda , Hernandez-Oteyza Alejandra , Alvarez-Ascencio Daniela , Neaves-Mendez Jorge , Navarro-Arregui Diego , Garcia-Huerta Magdalena
Published: May 2024

Précis:

Ahmed glaucoma valve implantation by residents showed similar complications, success, and failure rates, regardless of their level of expertise. Training programs must encourage ophthalmologists to perform this surgery to enhance competence in their future practices.

Purpose:

To describe outcomes of resident-performed Ahmed valve implantation over a 5-year period.

Methods:

In this cross-sectional observational study we retrospectively reviewed the medical records of patients who underwent resident-performed Ahmed glaucoma valve implantation over a 5-year period. The main outcomes were the number of surgeries performed by first-year, second-year, and third-year residents, intraoperative, and postoperative complications, and the association of level of training with outcomes and complications.

Results:

Totally, 160 eyes were included, with a mean age of 53.8±15.4 years, 63% were men. The most frequent type of glaucoma was neovascular glaucoma (67.5%). Mean follow-up was 23.2±19.6 months. Residents of higher years performed more surgeries and no relationship was found between the surgeon’s level of training and type of glaucoma operated on. After the surgical procedure, significant changes in best-corrected visual acuity were noted in surgeries performed by third-year residents (P=0.04). Intraocular pressure and number of medications were significantly reduced in all groups (P=0.01). Complications were registered in 60 eyes; the most frequent being the presence of a transient flat anterior chamber (27.45%).

Conclusions:

There were no significant differences in terms of IOP control and the number of complications in the 3 groups. There was no significant association between the resident’s experience and the outcomes of the surgery. The Ahmed valve implant is a procedure that appears to have similar results in surgeons with different levels of training.
Central Venopulmonary Extracorporeal Membrane Oxygenation: Background and Standardized Nomenclature
Authors: Brewer J. Michael , Lorusso Roberto , Broman L. Mikael , Conrad Steven A. , Swol Justyna , Maybauer Marc O.
Published: May 2024

This review highlights advancements in extracorporeal life support (ECLS), emphasizing the critical role of standardized terminology, particularly for extracorporeal membrane oxygenation (ECMO) in treating right ventricular and respiratory failure. Advocating for the adoption of the Extracorporeal Life Support Organization (ELSO) Maastricht Treaty for ECLS Nomenclature guidelines, it aims to resolve communication barriers in the ECMO field. Focusing on venopulmonary (VP) ECMO utilizing central pulmonary artery (PA) access, this review details surgical approaches and introduces a terminology guide to support effective knowledge exchange and advancements in patient care.
The effect and mechanism of inulin on atherosclerosis is mediated by the characteristic intestinal flora and metabolites
Authors: Li Zhenwei , Xu Qingqing , Huangfu Ning , Cui Hanbin
Published: May 2024

Background

Inflammation and hyperlipidemia can cause atherosclerosis. Prebiotic inulin has been proven to effectively reduce inflammation and blood lipid levels. Utilizing a mouse model induced by a high-fat diet, this study aimed to explore whether the characteristic intestinal flora and its metabolites mediate the effects of inulin intervention on atherosclerosis and to clarify the specific mechanism.

Methods

Thirty apolipoprotein E-deficient (ApoE−/−) mice were randomly divided into three groups. They were fed with a normal diet, a high-fat diet or an inulin+high-fat diet for 16 weeks. The total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) in the three groups were compared. The gross aorta and aortic sinus of mice were stained with oil red O, and the area of atherosclerotic plaque was observed and compared. The diversity and structure of the mouse fecal flora were detected by sequencing the V3–V4 region of the 16S rRNA gene, and the levels of metabolites in mouse feces were assessed by gas chromatography-mass spectrometry. The plasma lipopolysaccharide (LPS) levels and aortic inflammatory factors were measured by multi-index flow cytometry (CBA).

Results

ApoE−/− mice fed with the high-fat diet exhibited an increase of approximately 46% in the area of atherosclerotic lesions, and the levels of TC, TG and LDL-C were significantly increased (P < 0.05) compared with levels in the normal diet group. After inulin was added to the high-fat group, the area of atherosclerotic lesions, the level of serum LPS and aortic inflammation were reduced, and the levels of TC, TG and LDL-C were decreased (P < 0.05). Based on 16S rRNA gene detection, we found that the composition of the intestinal microbiota, such as Prevotella, and metabolites, such as L-arginine, changed significantly due to hyperlipidemia, and the dietary inulin intervention partially reversed the relevant changes.

Conclusion

Inulin can inhibit the formation of atherosclerotic plaques, which may be related to the changes in lipid metabolism, the composition of the intestinal microbial community and its metabolites, and the inhibition of the expression of related inflammatory factors. Our study identified the relationships among the characteristic intestinal microbiota, metabolites and atherosclerosis, aiming to provide a new direction for future research to delay or treat atherosclerosis by changing the composition and function of the host intestinal microbiota and metabolites.
A novel radiomics-based technique for identifying vulnerable coronary plaques: a follow-up study
Authors: Zheng Yan-li , Cai Ping-yu , Li Jun , Huang De-hong , Wang Wan-da , Li Mei-mei , Du Jing-ru , Wang Yao-guo , Cai Yin-lian , Zhang Rong-cheng , Wu Chun-chun , Lin Shu , Lin Hui-li
Published: May 2024

Background

Previous reports have suggested that coronary computed tomography angiography (CCTA)-based radiomics analysis is a potentially helpful tool for assessing vulnerable plaques. We aimed to investigate whether coronary radiomic analysis of CCTA images could identify vulnerable plaques in patients with stable angina pectoris.

Methods

This retrospective study included patients initially diagnosed with stable angina pectoris. Patients were randomly divided into either the training or test dataset at an 8 : 2 ratio. Radiomics features were extracted from CCTA images. Radiomics models for predicting vulnerable plaques were developed using the support vector machine (SVM) algorithm. The model performance was assessed using the area under the curve (AUC); the accuracy, sensitivity, and specificity were calculated to compare the diagnostic performance using the two cohorts.

Results

A total of 158 patients were included in the analysis. The SVM radiomics model performed well in predicting vulnerable plaques, with AUC values of 0.977 and 0.875 for the training and test cohorts, respectively. With optimal cutoff values, the radiomics model showed accuracies of 0.91 and 0.882 in the training and test cohorts, respectively.

Conclusion

Although further larger population studies are necessary, this novel CCTA radiomics model may identify vulnerable plaques in patients with stable angina pectoris.
Hypoparathyroidism update
Authors: Chiang Cherie
Published: May 2024

Purpose of review

Since the release of the 2022 Second International Workshop Evaluation and Management of Hypoparathyroidism Summary Statement and Guidelines, updates and advances are now available in the cause, complications, and treatment of adult chronic hypoparathyroidism (hypoPTH). This review aims to highlight these new findings and implications to patient care.

Recent findings

Postsurgical hypoparathyroidism remains the most common cause, immune-related hypoparathyroidism from checkpoint inhibitors is an emerging autoimmune cause. In a large retrospective cohort study of thyroidectomies, incident fracture was lower, particularly in the vertebra, in the hypoPTH cohort, compared with postthyroidectomy control group. Hypercalciuria increases risk for renal calculi in hypoPTH independent of disease duration and treatment dose. Quality of life is impaired in hypoPTH patients on conventional therapy, improvement was noted post-PTH replacement. TranCon PTH phase 3 RCT reported eucalcemia with reduced renal calcium excretion, normalization of bone turn-over markers, stable BMD and improved quality of life.

HypoPTH is a chronic disease associated with significant morbidity and poor Quality of Life. Awareness of treatment targets and follow-up investigations can alleviate patient anxiety regarding over-treatment and under-treatment. Progress in long-acting PTH replacement strategies might provide accessible, feasible alternatives to conventional therapy in brittle hypoPTH patients.
Viability assessment of the liver during ex-situ machine perfusion prior to transplantation
Authors: Groen Puck C. , van Leeuwen Otto B. , de Jonge Jeroen , Porte Robert J.
Published: May 2024

Purpose of review

In an attempt to reduce waiting list mortality in liver transplantation, less-than-ideal quality donor livers from extended criteria donors are increasingly accepted. Predicting the outcome of these organs remains a challenge. Machine perfusion provides the unique possibility to assess donor liver viability pretransplantation and predict postreperfusion organ function.

Recent findings

Assessing liver viability during hypothermic machine perfusion remains challenging, as the liver is not metabolically active. Nevertheless, the levels of flavin mononucleotide, transaminases, lactate dehydrogenase, glucose and pH in the perfusate have proven to be predictors of liver viability. During normothermic machine perfusion, the liver is metabolically active and in addition to the perfusate levels of pH, transaminases, glucose and lactate, the production of bile is a crucial criterion for hepatocyte viability. Cholangiocyte viability can be determined by analyzing bile composition. The differences between perfusate and bile levels of pH, bicarbonate and glucose are good predictors of freedom from ischemic cholangiopathy.

Although consensus is lacking regarding precise cut-off values during machine perfusion, there is general consensus on the importance of evaluating both hepatocyte and cholangiocyte compartments. The challenge is to reach consensus for increased organ utilization, while at the same time pushing the boundaries by expanding the possibilities for viability testing.
Evaluation of the Treatment Duration of Japanese Patients With Pancreatic Cancer in a Real-World Setting Using a Large Hospital Claims Database
Authors: Ueno Hideki , Shimizu Kyoko , Fukui Ayako , Nii Masahiro , Koto Ryo , Unno Michiaki
Published: May 2024

Objectives

To clarify the treatment reality of pancreatic cancer in Japan, focusing on treatment duration and time to death.

Materials and Methods

We retrospectively analyzed Japanese hospital claims data for patients diagnosed with pancreatic cancer between April 2009 and October 2018 to investigate treatment patterns, duration of first-line chemotherapy, and time to death.

Results

Of 81,185 eligible patients, 54.2% were male, the mean age was 71.7 years, and 23.3% (n = 18,884) received chemotherapy as primary treatment. The median treatment duration was 14.1 weeks for the 6.7% of patients who received oxaliplatin, irinotecan, fluorouracil, and leucovorin (FOLFIRINOX; recommended first-line regimen) and 16.9 weeks for the 30.2% of patients who received gemcitabine plus nab-paclitaxel (GEM + nab-PTX). Time to death for patients who received FOLFIRINOX or GEM + nab-PTX was similar (15.4 and 14.8 months, respectively). The duration of first-line chemotherapy regimens tended to increase annually for both regimens. The time to death for all first-line chemotherapy regimens also increased annually.

Conclusions

This study revealed the treatment reality of pancreatic cancer in the real-world Japanese setting. Treatment duration and time to death tended to increase over time and did not differ numerically between FOLFIRINOX and GEM + nab-PTX.
Exploring the Synergies Between the Magnet Recognition Program® and the International Council of Nurses' Charter for Change
Authors: Bryant Tiffany , Work Monica P.
Published: May 2024

Healthcare organizations across the globe apply the Magnet® Model framework to achieve excellence in nursing practice, thriving work environments, and improved patient, nursing, and organizational outcomes. The International Council of Nurses' (ICN) Charter for Change (2023) commissioned actionable measures for change to advance the nursing profession into the future. This article explores the synergies between the Magnet Recognition Program® and the ICN Charter for Change, aiming to demonstrate that integrating the principles of both models can provide a roadmap for healthcare organizations to enhance nursing professional development, foster a culture of innovation and evidence-based practice, and ultimately improve healthcare outcomes for patients and communities globally.
Comparison of Task-Layered Clinical Orientation to Traditional Orientation in a RN Residency Program
Authors: Cantrell Faith , Shah Jinal , Hessler Karen , Dunn Kelli , Skroch Alisa , Hochheimer Camille
Published: May 2024

OBJECTIVE

The purpose of this study was to compare outcomes of using a task-layered clinical orientation when compared with the original patient-layering approach.

BACKGROUND

Use of task-layering to orient new graduate nurses to the clinical world of nursing has been theorized to provide a decrease in cognitive load and allow for more streamlined clinical orientation.

METHODS

The method of this study was a nonrandomized, comparative design to measure the outcomes of length of orientation, new graduate perceptions about level of confidence/comfort with professional nurse responsibilities/skills, stress, satisfaction, and perceptions about orientation.

RESULTS

Analysis revealed no statistical significance between the 2 groups. However, the task-layered clinical orientation group completed orientation earlier than the traditional patient-layered group.

CONCLUSIONS

The task-layered approach to clinical orientation provided as good of outcomes as traditional orientation strategy and may result in cost savings due to decrease in total clinical orientation days.
Exploring the Roles, Functions, and Work Experiences of Nurse Scientists in the Veterans Health Administration
Authors: Mu Qiyan , Guzman-Clark Jenice , Etchin Anna G. , Sullivan Sheila Cox , Battaglia Catherine
Published: May 2024

OBJECTIVE

The aim of this project was to describe nurse scientists' roles, functions, and work experiences in the Veterans Health Administration (VHA).

BACKGROUND

Nurse scientists play a critical role in shaping the culture of clinical inquiry and closing the gap between knowledge and practice.

METHODS

A cross-sectional survey was used to collect information on sociodemographics, workload, research, clinical practice, education, and time/effort. Data were examined using descriptive statistics and χ2 analyses.

RESULTS

One hundred forty-four nurse scientists completed the survey. These nurse scientists serve dynamic and critical roles in conducting research, implementing evidence-based practice, and reforming policy. Research effort was limited due to workload and infrastructure constraints. Better research infrastructure was associated with higher research productivity and funding.

CONCLUSIONS

This survey highlights the needs and challenges nurse scientists experience in conducting research and advancing VHA's mission. Given the national shortage of PhD-prepared nurses, long-term strategies are needed to attract, hire, and retain nurse scientists in healthcare systems.
Examining Sex Differences in Relationships Between Subjective and Objective Measures of Upper Extremity Motor Impairment in a Sample of Stroke Survivors
Authors: Dahlby Julia , Larssen Beverley C. , Boyd Lara A.
Published: May 2024

Background and Purpose:

Rehabilitation professionals use subjective and objective outcome measures to assess stroke-related impact and impairment. Understanding if subjective and objective findings correlate among stroke survivors, especially if these associations differ between females and males, can inform care decisions.

Methods:

A retrospective cross-sectional design was used, with data selected from subacute to chronic stroke survivors on age, time since stroke, the hand domain from the Stroke Impact Scale version 3.0 (SIS-H), and the Fugl-Meyer Upper Extremity (FMUE) Assessment. Group differences were assessed for all outcomes based on sex and time poststroke. Separate correlations for females and males were performed between the subjective (SIS-H) and objective measures (FMUE) of upper limb function and impairment.

Results:

Data from 148 participants (44 females) were included in this study. SIS-H was significantly correlated with FMUE in both females and males (Ps ≤ 0.001). No significant differences were found between the groups’ mean SIS-H or FMUE scores based on sex or time poststroke.

Discussion and Conclusions:

Subjective and objective measures of physical functioning were correlated in both females and males. Although we found no sex differences in our primary outcomes, the sample size of females was disproportionately lower than the males. This is consistent with an ongoing problem in the stroke recovery research field, where females are often underrepresented and understudied, and where females who experience higher levels of impairment are less likely to participate in research.
Safety and Efficacy of Intensive Blood Pressure–Lowering After Successful Endovascular Therapy in AIS
Authors: Liao Zhouzan , Tian Li , Wen Ming , Wang Bing , Ding Kai , Song Qionglin
Published: May 2024

Objectives:

Higher blood pressure has been proven to be associated with poorer functional outcomes after successful reperfusion by EVT. However, the effect of intensive blood pressure–lowering regimens in these patients remains controversial and ambiguous in clinical practice. We propose further analysis aimed at determining the effect of an intensive blood pressure–lowering regimen after EVT in AIS.

Methods:

The protocol registered in PROSPERO CRD42023360989. We performed a systematic search that was comprehensively executed in online databases for studies published up to June 2022. Eligibility criteria were established based on the PICOS model. The Cochrane risk of bias algorithm was used to evaluate the risk of bias. The effect models were applied to calculate the pooled ORs and CIs via Review Manager 5.4 software.

Results:

A total of 1582 citations were identified, 3 randomized clinical trials and 2 retrospective cohort studies were included. Data from 3211 patients were analyzed. We revealed that intensive blood pressure–lowering interventions could significantly reduce symptomatic intraparenchymal hemorrhage compared with standard blood pressure lowering. Nevertheless, favorable functional outcome, poor outcome, all-cause mortality within 3 months and intraparenchymal hemorrhage in 24 hours showed no significant differences. Subgroup analysis revealed the variability of systolic blood pressure within 24 hours after EVT was not associated with odds of poor outcome and intraparenchymal hemorrhage.

Conclusions:

Based on the current evidence, intensive blood pressure–lowering regimen was superior to standard blood pressure–lowering regimen for a reduced risk of symptomatic intraparenchymal hemorrhage in AIS patients treated with EVT, but there was no statistically significant difference found between the 2 regimens for the other outcomes.