bluuebunny/crossref_metadata_2025 huggingface dataset:
Science and the Book in Early Modern England
Authors: Johns Adrian
Published: September 2023

This chapter surveys the ways in which practitioners of the sciences engaged with the risks and opportunities presented by printing in early modern England. It argues that to achieve success they had to manage print actively, in a craft environment that was not necessarily sympathetic to their efforts. The chapter uses examples from astrology, medicine, and the mathematical sciences to make this point, showing how in each domain the crafts of the book intersected in complex and ambiguous ways with those of natural knowledge. It then examines how Baconianism came into being via the contested editing of Francis Bacon’s works. Finally, it turns to the Royal Society, the primary institution of Baconian science, to demonstrate the importance of the practices of reading, writing, and publishing that emerged there. These were instantiated above all in the society’s journal, the Philosophical Transactions, which inaugurated a genre still central to science today.
Internationalism and the English Book Trade
Authors: de Lange Hanna , Pettegree Andrew
Published: September 2023

For the first two centuries of print, English collectors relied heavily on books produced in the larger Continental markets. In the seventeenth century, all this began to change. The buoyant Dutch market became an important supplier of books, while domestic production became more ambitious. Increasing numbers of English books made their appearance in the libraries of collectors abroad. English booksellers began to push back against the swamping of their domestic market by cheaper Continental editions supplied by the Dutch. In the second half of the seventeenth century, the works of English scientific writers began to find a wider Continental market. English authors permitted their works to be published in Amsterdam to secure easier access to the European market: books published in England remained too expensive. Yet, by the beginning of the eighteenth century the seeds had been sown for Britain’s later role as a cornerstone of the global book market.
Contexts for Circulation
Authors: O’Callaghan Michelle
Published: September 2023

Books at the universities and the Inns of Court, and within households and professional circles, were transmitted through material and textual exchanges that made up the physical and conceptual fabric of these places. Books have connective properties and a social life. They can be passed hand to hand, sent via others, and read and performed and, as such, bring people together within environments that, in turn, are defined by these social uses of the book. Attention to contexts of circulation allows us to understand how books are not self-contained textual objects; rather their meaning is distributed across time and space and changes as they move through networks of transmission. Within these environments, textual material was put to different uses and connected people and places through reading, performance, and acts of making and remaking in ways which prompt a reconsideration of the media through which texts were transmitted.
Self-Reading Books
Authors: Smith Emma
Published: September 2023

Reviewing the recent interest and excitement in marginalia and readers’ marks, this chapter offers some methodological reflection. Often marginalia are read for their biographical information about the writing reader, with the attendant excitement of human connection across time and place: I discuss the imaginary life-story of the early annotator reverse-engineered from the notes in a copy of Shakespeare’s First Folio. This biographical approach restricts marginalia to self-disclosure. Instead, using reader-response criticism, I suggest the possibility of that the book itself might act as speaking subject, via the much-reproduced sixteenth-century Mannerist painting by Arcimboldo known as The Librarian, and the early modern rhetorical term prosopopeia.
Transience and Loss
Authors: Hill Alexandra
Published: September 2023

Transience and loss play a fundamental role in our perception of the book in early modern England. While a physical copy may be lost, its ideas can survive and thrive in the oral and manuscript world. Conversely a book may be put on a shelf and never have an influence further than the walls of a bookshop or library. Books can be lost through simple use and changing tastes or by more dramatic forms of destruction such as censorship and war. Without addressing what has been lost can we ever truly understand what has survived? This chapter will explore what transience and loss means for the study of the early modern book and the ways in which lost print can be rediscovered. It will also consider how lost books can be recorded and analysed alongside extant counterparts to build a broader picture of the print industry of early modern England.
Broken Books and Fragile Print
Authors: Tomkins Nikki
Published: September 2023

This chapter presents the study of the book from a conservation perspective, focusing on what the material form of a book can tell the reader about its history and how that affects conservation decision-making. Taking the Nicholas Crouch collection of seventeenth-century tract volumes as its focus, the chapter explores theoretical and practical approaches to conserving the ephemeral, balancing both preservation of the object and enabling access. A significant feature of the collection is Crouch’s handwritten contents pages, sometimes listing the cost, date, and name of the binder. Collating and interpreting this information has enabled connections to be made between the binders, the books, and their readers across the collection, revealing how the objects were made and used over the centuries.
The History of the Early Modern Book in the Digital Age
Authors: Trettien Whitney
Published: September 2023

In the middle of the twentieth century, book history and humanities computing both emerged at the peripheries of literary studies. Many decades later, early modern book history, media studies, and digital humanities have become deeply entangled. Taking stock of both where digital book history has been and where it is going, this chapter identifies six research clusters that are currently transforming how early modernists study books as and with media technologies. The first three—forensics, computer vision, and facsimiles—take up the issue of remediation, specifically new digital imaging technologies and machine learning techniques. The last three clusters consider how digital technologies are changing the scale of analysis. Specifically, they turn to how databases are transforming cataloguing practices, what quantification means for studying literary style and printing, and the ways in which networks offer a new perspective on both the internal dynamics of texts and the external exchange of books and letters.
Past, Present, and Future
Authors: Duroselle-Melish Caroline
Published: September 2023

This chapter reflects on the nature of curatorial work with early modern English books. It argues that such work evolves in relation to societal changes and our advancing understanding of books. Curators now engage in a multitude of ways with early modern books through a range of activities in collaboration with other library and book trade professionals, researchers, and increasingly the broader public. This work continues to reshape our understanding of collections and contributes to making visible unexplored parts of collections. To overcome increasing constraints, library professionals in the future may wish to strengthen institutional collaboration in all aspects of their work.
Religion and the History of the Book
Authors: Cummings Brian
Published: September 2023

Religion and the book are inseparably linked. Religion is among the oldest motives for making texts: from the Jewish Torah, made up of a scroll, to the codices of Christian gospel books and the Qur’an in Islam. The history of the book as a discipline has found it harder to acknowledge this centrality of religious texts in the formation of book history. This chapter offers to compensate for this lack by examining, first, liturgical books, from the early printed missals and breviaries to the Book of Common Prayer; and second, Bibles, not only in English translation but also the much larger trade in Latin Bibles. The final section of the chapter considers the ‘confessionalization’ of the book trade, in the proliferating controversy between conformism, Catholics, and puritans. The result is to confirm a sense that early modern religion is yoked to the book as well as vice versa.
What Was a Printing Shop, and What Happened There?
Authors: Nash Paul W.
Published: September 2023

The early modern printing shop, or printing office, was both a building and a workplace, a factory and a place of business, in which printed books and ephemera were manufactured in order to generate income for a master printer. This chapter describes the structure and location of the typical printing shop. It also details the paper, ink, presses, type, woodcuts and ornaments, tools and other equipment and furniture that were used there, as well as examining the personnel, working conditions and practices of the early modern printing industry, and the processes of type-founding, hand-composition and printing with a wooden hand-press.
Conspiracy Theories
Authors: Stubbersfield Joe
Published: September 2023

Conspiracy theories have been part of human culture for hundreds of years, if not millennia, and have been the subject of research in academic fields such as social psychology, political science, and cultural studies. At present, there has been little research examining conspiracy theories from a cultural evolution perspective. This chapter discusses the value of cultural evolution approaches to understanding the diffusion of conspiracy theories. Focusing on the role of biases in cultural transmission, it argues that a key advantage of applying a cultural evolution approach to this phenomenon is that it provides a strong theoretical and methodological framework to bridge the individual-, inter-individual-, and population-level factors that explain the cultural success of conspiracy theories, with potential for producing insights into how to limit their negative influence.
Future of medical research in Sri Lanka: amidst economic chaos
Authors: Perera Nilanka , Gunatilake Saman B
Published: September 2023

Sri Lanka is facing an economic crisis and medical research is significantly affected at present with researchers facing many obstacles. Urgent remedial measures are required to overcome the current situation if medical research is to continue in Sri Lanka.
Burden, trend and determinants of various forms of domestic violence among reproductive age-group women in India: findings from nationally representative surveys
Authors: Ramasubramani Premkumar , Krishnamoorthy Yuvaraj , Vijayakumar Karthiga , Rushender Rajan
Published: September 2023

Background

Violence, a notable human rights concern, has a public health impact across the globe. The study aimed to determine the prevalence and determinants of domestic violence among ever-married women aged 18–49 years in India.

Methods

Secondary data analysis with National Family Health Survey 5, 2019–21 data (NFHS-5) was conducted. The complex sampling design of the survey was accounted-for during analysis. The primary outcome was domestic violence. Prevalence was reported with 95% confidence interval (CI). Prevalence ratio was reported to provide the factors associated with domestic violence using Poisson regression.

Results

About 63 796 ever-married women aged 18–49 years covered under domestic violence module of NFHS-5 survey were included. Prevalence of domestic violence (12 months preceding the survey) was 31.9% (95% CI: 30.9–32.9%). Physical violence (28.3%) was the most common form followed by emotional (14.1%) and sexual violence (6.1%). Women with low education, being employed, husband being uneducated or with coercive behavior had significantly higher prevalence of domestic violence.

Conclusions

One-third of the reproductive age-group women were facing some form of domestic violence. Target group interventions like violence awareness campaigns, women supportive services and stringent law enforcement should be implemented to eliminate domestic violence by year 2030.
Wealth of Two Nations: The U.S. Racial Wealth Gap, 1860–2020
Authors: Derenoncourt Ellora , Kim Chi Hyun , Kuhn Moritz , Schularick Moritz
Published: September 2023

The racial wealth gap is the largest of the economic disparities between Black and white Americans, with a white-to-Black per capita wealth ratio of 6 to 1. It is also among the most persistent. In this article, we construct the first continuous series on white-to-Black per capita wealth ratios from 1860 to 2020, drawing on historical census data, early state tax records, and historical waves of the Survey of Consumer Finances, among other sources. Incorporating these data into a parsimonious model of wealth accumulation for each racial group, we document the role played by initial conditions, income growth, savings behavior, and capital returns in the evolution of the gap. Given vastly different starting conditions under slavery, racial wealth convergence would remain a distant scenario, even if wealth-accumulating conditions had been equal across the two groups since Emancipation. Relative to this equal-conditions benchmark, we find that observed convergence has followed an even slower path over the past 150 years, with convergence stalling after 1950. Since the 1980s, the wealth gap has widened again as capital gains have predominantly benefited white households, and convergence via income growth and savings has come to a halt.
Preliminary study of chromosome aberrations using Giemsa, two-colour fish, and micronucleus assays in lymphocytes of individuals living in elevated radon concentration areas
Authors: Ramadhani Dwi , Purnami Sofiati , Suvifan Viria Agesti , Wanandi Septelia Inawati , Wibowo Heri , Syaifudin Mukh
Published: September 2023

The frequencies of unstable and stable chromosome aberrations and micronuclei were examined in peripheral blood samples from 10 individuals living in elevated radon concentration areas (Takandeang Village, Mamuju, Indonesia). Blood samples from 10 people living in Topoyo Village were used as a control group. For unstable chromosome aberration analysis, a dicentric chromosome assay was conducted using conventional Giemsa staining. Chromosomal painting of chromosomes 1 and 4 using the fluorescence in situ hybridisation technique was also applied to four subjects to assess the stable chromosome aberration. Our study showed no significant increases across all groups in dicentric and other unstable chromosome aberrations, such as rings and acentric fragments. Translocations were found in one person from Takandeang Village and two Topoyo Village inhabitants. The translocations found in the subjects from Takandeang Village were due more to aging factors than to radon exposure. The number of micronuclei per 1000 binucleus cells in Takandeang Village inhabitants was not significantly different than that in the control group (p = 0.943). A more comprehensive analysis should be conducted in a subsequent study by increasing the number of study donors and the number of metaphases to be analysed in both dicentric chromosome assay and fluorescence in situ hybridisation assays. Such research could provide valid information on the cytogenetic effects of elevated indoor radon exposure.
EPR-based uncertainty validation of the calculated external doses for population exposed in the urals region
Authors: Shishkina E A , Degteva M O , Napier B A
Published: September 2023

Tooth enamel Electron Paramagnetic Resonance (EPR) spectroscopy was used as a method for external dosimetry in the territories contaminated in the 1950s by PA ‘Mayak’ (Urals region) to validate the mean dose estimates predicted by the Techa River Dosimetry System (TRDS). The purpose of this study is to validate the uncertainties of TRDS doses. Ninety percent confidence intervals (90% confidence interval, CI) of dose estimated with both methods were compared for 220 people. All data were grouped according to the width of 90%CI, viz.: (1) 90%CI of EPR-based dose ≤  90%CI of TRDS prediction (38 cases); (2) 90%CI of EPR-based dose >  90%CI of TRDS prediction (182 cases). About 91% of 90%CIs overlap. In group 1, 100% cases overlap. In group 2, 80% of the cases were non-contradictive (the calculated 90%CI is completely within the measured one). Interval comparison of doses predicted retrospectively and estimated based on individual measurements are non-contradictory and demonstrate a good agreement.
Twenty-two years later: consistent dose estimation of an accidental overexposure by retrospective biological dosimetry
Authors: Martinez J S , Grégoire E , Fernandez P , Dugué D , Jikia D , Gruel G
Published: September 2023

The goal of this study was to retrospectively estimate the exposure dose of a victim from the Lilo radiological accident in Georgia after 22 y and compare it with the original cytogenetics-based analysis performed in our laboratory. Similar types of studies have been published, notably involving victims of the Chernobyl, Goiânia and Tammiku accidents. Nevertheless, their estimations were done after shorter periods of time post-exposure, and in some cases, the exposure might not have been exclusively of an external nature. In this study, Fluorescence In Situ Hybridization (FISH) was used to score chromosomal translocations in lymphocytes from a recent blood sample of the victim and the dose assessment was performed using our laboratory’s FISH calibration curve. The resulting whole-body exposure dose of 0.35 Gy [0.12, 0.72] was similar to the one obtained when reanalysing the original scoring data from 1997 (0.38 Gy [0.13–0.75]), suggesting that our current calibration curve could be used for relative dose estimations long time after external exposure.
EPR biodosimetry: challenges and opportunities
Authors: Swartz Harold M , Flood Ann Barry
Published: September 2023

This paper briefly examines electron paramagnetic resonance (EPR) techniques to measure dose from exposure to external radiation, assessing their current status, potential future uses and the challenges impacting their progress. We conclude the uses and potential value of different EPR techniques depend on the number of victims and whether they characterize short- or long-term risks from exposure. For large populations, EPR biodosimetry based on in vivo measurements or using co-located inanimate objects offer the greatest promise for assessing acute, life-threatening risk and the magnitude and extent of such risk. To assess long-term risk, ex vivo EPR methods using concentrated enamel from exfoliated teeth are most impactful. For small groups, ex vivo EPR biodosimetry based on available samples of teeth, nails and/or bones are most useful. The most important challenges are common to all approaches: improve the technique’s technical capabilities and advance recognition by planning groups of the relative strengths EPR techniques offer for each population size. The most useful applications are likely to be for triage and medical guidance in large events and for radiation epidemiology to evaluate long-term risks.
The use of double-integral of experimental EPR spectra for tooth enamel EPR dosimetry
Authors: Tuner Hasan
Published: September 2023

The presence of background signal in tooth enamel EPR dosimetry is the most challenging situation to overcome. This becomes even more important because it obscures the radiation-induced signal, especially at radiation doses below 1 Gy. In order to overcome this problem, subtraction of the unirradiated sample signal from the irradiated one and the simulation methods are the most widely used methods in the literature. These methods have their own difficulties. Obtaining the double integral of the experimental EPR spectra (first derivative) of tooth enamel and its advantages are presented in the present work. This method offers the opportunity to handle the whole experimental spectrum, both background, and radiation-induced signals, without performing any subtraction or simulation operations, and to overcome the signal-to-noise effects.
Novel biomarkers for acute radiation injury and countermeasures using large and small animal models and multi-omics approach
Authors: Singh Vijay K , Fatanmi Oluseyi O , Wise Stephen Y , Carpenter Alana D , Janocha Brianna , Seed Thomas M
Published: September 2023

Threats of radiological or nuclear disasters are of serious concern and a top priority for government agencies involved in domestic security and public health preparedness. There is a need for sensitive bioassays for biodosimetric assessments of radiation exposures originating from unanticipated nuclear/radiological events. The Food and Drug Administration Animal Rule approval pathway requires an in-depth understanding of the mechanisms of radiation injury, drug efficacy and biomarkers for radiation medical countermeasure approval. Biomarkers can be helpful for extrapolating the efficacious countermeasure dose in animals to humans. We summarised here our studies to identify candidate biomarkers for the acute radiation injury using various omic platforms (metabolomics/lipidomics, proteomics, microbiome and transcriptomics/microRNA) using murine and non-human primate models conducted in our laboratory. Multi-omic platforms appear to be highly useful in assessing radiation exposure levels and for identifying biomarkers of radiation injury and countermeasure efficacy, which can expedite the regulatory approval of countermeasures.
Transcatheter Aortic Valve Replacement in Patients with Pure Native Aortic Regurgitation: Results from a Multicenter Registry Study
Authors: Gao Xiaofei , Zhang Juan , Kong Xiangquan , Chen Jing , Chen Xiang , Zhang Longyan , Cai Xinyong , Zhu Jiancheng , Tian Nailiang , Ge Zhen , Wang Bin , Zhou Qing , Su Xi , Hong Lang , Wang Yan , Jiang Hong , Zhang Junjie , Chen Shaoliang
Published: September 2023

Objective:

Patients with untreated severe aortic regurgitation (AR) have a high risk of mortality. Transfemoral transcatheter aortic valve replacement (TF-TAVR) is a treatment option for AR; however, the safety and efficacy of this technique have not been sufficiently established. This study aimed to evaluate the clinical and anatomical variables correlating with device success of TF-TAVR using a self-expanding valve system for pure AR.

Methods:

Patients with pure native severe AR who underwent TF-TAVR using a self-expanding valve system were registered at 5 Chinese centers. The primary endpoint was device success at 1 month after TAVR. The secondary endpoint was the composite of major adverse cardiovascular events (MACE) at 6 months, including all-cause death, ischemic stroke, emergency conversion to cardiac surgery, and permanent pacemaker implantation. Echocardiography was used to analyze the left ventricular function before the TAVR procedure and during follow-up. Multivariable logistic regression and Cox regression analyses were performed to find relevant independent risk factors.

Results:

Between September 2019 and February 2022, 79 patients with AR were enrolled in the study. At 1 month, device success was achieved in 60 (75.9%) patients. By 6 months, 29 (36.7%) patients had MACE. Echocardiography revealed improved left ventricular function after TAVR. Multivariate regression analysis demonstrated that the Society of Thoracic Surgeons (STS) risk score (odds ratio (OR) 0.760, 95% confidence interval (CI): 0.584–0.989; P = 0.041) and annulus perimeter (OR 0.888, 95% CI: 0.796–0.992; P = 0.035) were 2 predictors of device success. Moreover, annulus perimeter (<80.2 mm), but not STS risk score, was associated with a significant reduction in MACE at 6 months (hazard ratio (HR) 2.223, 95% CI: 1.060–4.659; P = 0.028).

Conclusions:

TF-TAVR using a self-expanding valve system appears to be a safe and feasible treatment for patients with pure native severe AR, particularly those with a less enlarged annulus.
Epidemiological characteristics of centenarian deaths in China during 2013–2020: A trend and subnational analysis
Authors: Mao Fan , Zhang Weiwei , Yin Peng , Wang Lijun , You Jinling , Liu Jiangmei , Liu Yunning , Zhou Maigeng
Published: September 2023

Background:

Studies that comprehensively address the characteristics of centenarian deaths are rare. The present study aimed to depict the characteristics of centenarian deaths in China and their changing trends.

Methods:

Data on centenarian deaths between 2013 and 2020 were obtained from the national mortality surveillance system of China, including date, place of death (PoD), and underlying cause of death (CoD). Descriptive analyses were performed to understand the epidemiological characteristics, and a joinpoint regression model was adopted to examine the changing trends in the proportions of different PoDs, CoDs among centenarians, and centenarian deaths accounting for all deaths and deaths among people aged 65 years and older.

Results:

There were 46,938 registered centenarian deaths between 2013 and 2020 that included 34,311 females (73.10%) and 12,627 males (26.90%). January (12.05%), February (9.99%), and December (9.74%) were the top three months with the highest number of deaths. The proportions of deaths that occurred in homes, hospitals, and nursing homes were 81.71%, 13.63%, and 2.68%, respectively. The proportion of deaths in nursing homes increased by 9.60% (95% confidence intervals [CIs], 6.4–12.9%) from 2014 to 2020. Heart disease (35.72%) was the leading cause of death, followed by respiratory diseases (17.63%), cerebrovascular disease (15.60%), and old age (11.22%). The proportion of respiratory diseases decreased by 4.8% (95% CI, –8.8 to –0.7%), and the proportion of deaths from old age decreased by 2.3% (95% CI, –4.4 to –0.1%) per year. Shanghai had the highest proportions of deaths in hospitals (39.38%) and nursing homes (14.68%). Sichuan had the highest proportion of deaths attributed to respiratory diseases (32.30%), while Jiangsu (26.58%) and Zhejiang (23.61%) had the highest proportions of deaths from old age.

Conclusion:

Unlike other countries, centenarian deaths in China are characterized by a higher proportion of home and heart disease deaths, and this death pattern differs across provinces.
Impact of Surgical Rejuvenation on Visual Processing and Character Attribution of Faces
Authors: Boonipat Thanapoom , Hebel Nathan S. D. , Shapiro Daniel , Stotland Mitchell A.
Published: September 2023

Background:

This study considers observers’ reflexive responses to the rejuvenated face, and how instinctive responses relate to subjective judgment. We investigated observers’ reflexive perception of faces both pre and post surgical intervention during the early stages of visual processing. Subjective character attribution for all test images was also assessed by the same observers.

Method:

Forty frontal facial images of 20 patients portraying the pre- and postoperative high superficial musculoaponeurotic system facelift along with variable concomitant procedures were studied. Nineteen lookzone regions were mapped post hoc onto each image. Forty observers examined the images, whereas an eye-tracking camera recorded their eye movements. Visual fixation data were recorded and analyzed. Observers also rated each image on the basis of five elemental positive character attributes.

Results:

A statistically coherent but nonsignificant (P > 0.05) trend was identified with the surgical intervention resulting in greater attention being paid to the central triangle region of the face with reduction in attention to the facial periphery. Facial rejuvenation significantly increased the subjective character ratings of all five positively valenced attributes tested. Average age estimate of the photos decreased significantly from 54 to 48.6 years (true average age of 57.4 years).

Conclusions:

We provide data illustrating both reflexive and subjective responses to facial rejuvenation. Observers reported a more favorable impression of the treated faces and evaluated them as being younger than their true age. A trend was detected for increased visual fixation of the central facial region following rejuvenation. Interpretation of these findings and indication for further research is provided.
The Ergonomic FALD Flap for One-stage Total Breast Reconstruction
Authors: Longo Benedetto , D’Orsi Gennaro , Giacalone Martina , Pistoia Angelica , Vanni Gianluca , Buonomo Claudio Oreste , Farcomeni Alessio , Cervelli Valerio
Published: September 2023

Background:

The fat-augmented latissimus dorsi (FALD) flap combines this pedicled flap with immediate intraoperative fat transfer. Very little is described concerning its inset at the mammary site. Our efforts have concentrated on seeking the best flap orientation and skin-adipose paddle shaping, to improve the aesthetic outcome and to obtain a complete breast reconstruction (BR) in one stage.

Methods:

A prospective clinical study was performed in patients who underwent BR with FALD flaps, between December 2020 and March 2022. Patients were randomly enrolled into two groups: ergonomic inset of the FALD flap with vertical orientation of the skin-adipose paddle (group A) and FALD flap with traditional horizontal paddle orientation (group B). The study’s endpoints were the evaluation of the aesthetic outcomes (from patients’ and surgeon’s perspectives) and complications.

Results:

Thirty-two FALD flaps (23 patients) were performed for group A, and 31 FALD flaps (25 patients) for group B. The two groups were homogeneous in terms of demographic and surgical data (P > 0.05). The overall complication rate was homogeneous among the groups, without statistically significant differences (P = 1.00). The surgeon’s assessments showed a statistically significant superior aesthetic outcome in group A regarding volume, symmetry, and shape (P < 0.05). Higher satisfaction was observed in group A patients, in terms of breast size (P < 0.00001), shape (P = 0.0049), and overall satisfaction (P = 0.00061).

Conclusions:

The ergonomic vertical FALD flap technique enables surgeons to perform one-stage total BR, with excellent breast projection and upper pole fullness. These refinements in flap shaping and molding reduced the need for further autologous fat transfer, obtaining a brilliant totally autologous BR without the need for microsurgical experience.
PREDICTIVE ROLES OF QUANTITATIVE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY FEATURES IN PROGNOSIS OF MYOPIC CHOROIDAL NEOVASCULARIZATION
Authors: Liu Jing , Song Shuang , Gu Xiaoya , Yu Xiaobing
Published: September 2023

Purpose:

To explore the predictive roles of the morphologic features of neovascularization in the prognosis of myopic choroidal neovascularization.

Methods:

In this retrospective case series study, quantitative morphologic features of neovascularization were obtained from the optical coherence tomography angiography images. According to the number of anti-vascular endothelial growth factor injections administered within 1 year, the eyes were classified into a stable group (≤2 injections) or an unstable group (>2 injections). Best-corrected visual acuity was recorded before the treatment and at the 1-year follow-up.

Results:

Overall, 50 eyes with treatment-naive myopic choroidal neovascularization were included; 26 in the stable group and 24 in the unstable group. Multivariate analysis showed that the eyes in the unstable group were associated with a larger lesion area (odds ratio = 2.596, P = 0.012), higher junction density (odds ratio = 1.611, P = 0.014), and higher end point density (odds ratio = 1.435, P = 0.023).The area under the receiver operating characteristic curve of the multivariate model was 0.865, with 91.7% sensitivity and 65.4% specificity. The final best-corrected visual acuity was significantly correlated with the lesion area (β = 0.152, P = 0.032) after adjusted for age, sex, and baseline best-corrected visual acuity.

Conclusion:

Lesions with larger areas and higher end point and junction densities tended to have more frequent anti-vascular endothelial growth factor injections and worse visual outcomes in eyes with myopic choroidal neovascularization.
A MULTICENTER STUDY OF RETINOPATHY OF PREMATURITY FOLLOW-UP ADHERENCE
Authors: Mahmud Fahim , Karmouta Reem , Strawbridge Jason C. , Prasad Pradeep , Chu Alison , Khitri Monica , Tsui Irena
Published: September 2023

Purpose:

Characterize clinical and socioeconomic factors that impact follow-up to complete retinal vascularization and subsequent pediatric ophthalmology follow-up in neonates with retinopathy of prematurity.

Methods:

Medical records of 402 neonates diagnosed with retinopathy of prematurity from neonatal intensive care units at the University of California, Los Angeles Mattel Children's Hospital and the University of California, Los Angeles Santa Monica Hospital, both academic medical centers, and the Harbor-University of California, Los Angeles Medical Center, a safety-net county hospital, were reviewed. Primary study outcomes were the rate of follow-up to complete retinal vascularization and adequate pediatric ophthalmology follow-up. Secondary outcome was the rate of nonretinal ocular comorbidity.

Results:

In whole-cohort analysis, 93.6% of neonates were followed to complete retinal vascularization, and 53.5% had adequate pediatric ophthalmology follow-up. Public insurance was associated with lower rates of pediatric ophthalmology follow-up (Odds ratio 0.66, 95% confidence interval 0.45–0.98, P = 0.04). Participants screened at the academic medical center had lower rates of pediatric ophthalmology follow-up compared with the safety-net county hospital (50.7% vs. 63.5%, P = 0.034). In subgroup analysis, academic medical center participants with public insurance were less likely to have pediatric ophthalmology follow-up than safety-net county hospital participants with public insurance (36.5% vs. 63.8%, P < 0.001) or those with private insurance at the academic medical center (36.5% vs. 59.2%, P< 0.001).

Conclusion:

This study identified high follow-up rates to complete retinal vascularization, lower pediatric ophthalmology follow-up rates, and nonretinal ocular comorbidity at all hospitals. Insurance status relative to hospital type was identified as a risk factor for loss to follow-up. This demonstrates a need to further study health care disparities in retinopathy of prematurity infants.
Evaluating the forces involved in bubble management in DMEK surgery: mathematical and computational model with clinical implications
Authors: Lockington David , Brown Gordon , Pearce Chris , Kaczmarczyk Lukasz
Published: September 2023

Purpose:

To model postoperative forces involved in Descemet membrane endothelial keratoplasty (DMEK) tissue adherence and bubble management, including the impact of surface tension on graft support, with a view towards clinical applications.

Setting:

Tennent Institute of Ophthalmology, Glasgow, and James Watt School of Engineering, University of Glasgow, Glasgow, United Kingdom.

Design:

Mathematical modelling and computer simulation.

Methods:

Theoretical modelling of biphasic flow and interaction of gas, liquid and tissue within the anterior chamber for static horizontal scenario A (adherent DMEK with mobile bubble) and dynamic vertical scenario B (release of bubble due to pupil block following DMEK).

Results:

The model assumed incompressibility for both fluids within realistically achievable pressure ranges. Cahn-Hilliard Navier-Stokes equations were discretised through the application of the Finite Element Method. Mathematical modelling and computer simulation showed bubble size, corneal curvature and force intensity influences surface tension support for DMEK tissue in scenario A. Scenario B demonstrated complex, uneven distribution of surface pressure on the DMEK graft during uncontrolled bubble release. Uneven pressure concentration can cause local tissue warping, with air/fluid displacement via capillary waves generated on the fluid-air interface adversely impacting DMEK support.

Conclusions:

We have quantitatively and qualitatively modelled the forces involved in DMEK adherence in normal circumstances. We have shown releasing air/gas can abruptly reduce DMEK tissue support via generation of large pressure gradients at the liquid/bubble/graft interfaces, creating negative local forces. Surgeons should consider these principles to reduce DMEK graft dislocation rates via optimised bubble size to graft size, longer acting bubble support and avoiding rapid decompression where possible.
Deep learning using computed tomography to identify high-risk patients for acute small bowel obstruction: development and validation of a prediction model : A retrospective cohort study
Authors: Oh Seungmin , Ryu Jongbin , Shin Ho-Jung , Song Jeong Ho , Son Sang-Yong , Hur Hoon , Han Sang-Uk
Published: September 2023

Objective:

To build a novel classifier using an optimized 3D-convolutional neural network for predicting high-grade small bowel obstruction (SBO).

Summary Background Data:

Acute SBO (ASBO) is one of the most common acute abdominal diseases requiring urgent surgery. While AI and abdominal CT have been used to determine surgical treatment, differentiating normal cases, high-grade small bowel obstruction (HGSBO) requiring emergency surgery, and low-grade SBO or paralytic ileus (LGSBO) is difficult.

Methods:

A deep learning classifier was used to predict high-risk ASBO patients using CT images at a tertiary hospital. Images from three groups of subjects (normal, nonsurgical, and surgical) were extracted; the dataset used in the study included 578 cases from 250 normal subjects, with 209 HGSBO and 119 LGSBO patients; over 38,000 CT images were used. Data were analyzed from June 1, 2022, to February 5, 2023. The classification performance was assessed based on accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve.

Results:

After 5-fold cross-validation, the WideResNet classifier using dual-branch architecture (DBA) with depth retention pooling (DRP) achieved an accuracy of 72.6%, an area under receiver operating characteristic of 0.90, a sensitivity of 72.6%, a specificity of 86.3%, a positive predictive value of 74.1%, and a negative predictive value of 86.6% on all the test sets.

Conclusions:

These results show the satisfactory performance of the deep learning classifier in predicting HGSBO compared to the previous machine learning model. The novel 3D classifier with DBA and DRP based on AI algorithms could be a reliable screening and decision-support tool for high-risk patients with SBO.
Laparoscopic natural orifice specimen extraction (NOSE) colectomy versus conventional laparoscopic colorectal resection in patients with rectal endometriosis: a randomized, controlled trial
Authors: Dobó Noémi , Márki Gabriella , Hudelist Gernot , Csibi Noémi , Brubel Réka , Ács Nándor , Bokor Attila
Published: September 2023

Background:

The conventional laparoscopic approach for the surgical management of deep endometriosis (DE) infiltrating the rectum appears to ensure improved digestive functional outcomes. The natural orifice specimen extraction (NOSE) technique for the treatment of colorectal DE can significantly accelerate postoperative recovery; however, data on gastrointestinal function following conventional laparoscopic segmental bowel resection (CLR) compared with NOSE-colectomy (NC) for DE are sparse.

Materials and methods:

Between September 30, 2019, and December 31, 2020, a randomized, open-label, two-arm, parallel-group controlled trial with women aged 18–45 years was conducted at University Hospital.

91 patients were randomized to CLR or NC, with DE infiltrating at least the muscular layer, at least 50% of the circumference of the bowel, up to 15 cm from the anal verge, exhibiting pain and bowel symptoms and/or infertility. The primary endpoint was bowel function, represented by Low Anterior Resection Syndrome (LARS). Secondary parameters included the Endometriosis Health Profile 30 (EHP30), Gastrointestinal Quality of Life Index (GIQLI), Visual Analog Scale (VAS) scores preoperatively and at set times (one and six months, one year) following surgery.

Results:

No significant differences were observed in the postoperative LARS scores, VAS, EHP30, and GIQLI between the NC and CLR groups. LARS scores did not reveal significant differences 12 months postoperatively compared to the preoperative values in both groups (CLR-group P=0.93 versus NC-group, P=0.87). GIQLI scores were significantly improved 12 months after the operation compared with baseline values in the CLR-group (P=0.002) and NC-group (P=0.001). Pain symptoms and quality of life scores significantly improved 12 months postoperatively in both groups.

Conclusions:

NC is a feasible surgical approach for treating patients with rectal DE. Our study did not show a statistically significant difference between CLR and NC techniques in mid-term digestive and pain outcomes.
Pregnancy outcomes following self-reported and objective-measured exposure to oral preexposure prophylaxis in South Africa
Authors: Joseph Davey Dvora Leah , Nyemba Dorothy C. , Mvududu Rufaro , Mashele Nyiko , Johnson Leigh , Bekker Linda-Gail , Dean Sarah Schoetz , Bheemraj Kalisha , Coates Thomas J. , Myer Landon
Published: September 2023

Objective:

To compare pregnancy outcomes using self-reported and objective levels of intracellular tenofovir diphosphate (TFV-DP) in pregnant women using preexposure prophylaxis (PrEP).

Design:

We enrolled pregnant women >15 years without HIV at first antenatal care visit in an observational cohort study to compare pregnancy outcomes by PrEP use.

Methods:

Exposure defined as: any PrEP use [tenofovir disoproxil and emtricitabine (TDF/FTC]) prescription + reported taking PrEP], or objectively-measured TFV-DP in dried blood spots in PrEP-using pregnant women. The primary outcome was a composite of pregnancy loss, preterm birth (<37weeks), low birthweight (<2500 g), small for gestational age ([SGA] ≤ tenth percentile), or neonatal death. Multivariable logistic regression models evaluated individual and composite adverse outcomes by self-reported or objectively measured PrEP use adjusting for age, gestational age, gravidity and socio-economic status.

Results:

Between August 19 and February 23, we followed 1195 pregnant women and ascertained 1145 pregnancy outcomes (96%); 72% (n = 826) reported taking PrEP while pregnant, 16% did not take PrEP (n = 178), 12% were unconfirmed (n = 141). Overall, 94.5% (n = 1082) had singleton live births with a median birthweight of 3.2 kg [interquartile range (IQR) = 2.9–3.5], with no difference in pregnancy loss between self-reported PrEP exposed vs. unexposed [4.0 vs. 5.6%; adjusted odds ratio (aOR) = 0.65, 95% confidence interval (CI) = 0.32–1.47]. Composite adverse outcomes did not differ by reported PrEP use (20% for both groups; aOR = 1.07, 95% CI = 0.71–1.63). Comparing objective PrEP use (any TFV-DP vs. no TFV-DP or not on PrEP), adverse outcomes did not differ (aOR = 0.64, 95% CI = 0.39–1.04), nor did other outcomes including preterm birth nor SGA.

Conclusions:

Pregnancy outcomes did not differ by PrEP exposure (self-reported or objective), suggesting real-world efficacy that TDF/FTC as PrEP is safe in pregnancy.
Routine Sterile Glove and Instrument Change at the Time of Abdominal Wound Closure to Prevent Surgical Site Infection: Reviewing the ChEETAh Trial
Authors: Ferreira Julia , Joos Emilie , Bhandari Mohit , Dixon Elijah , Brown Carl J ,   on behalf of the Evidence-Based Reviews in Surgery (EBRS) group
Published: September 2023

“Evidence-Based Reviews in Surgery” (EBRS) was developed to foster critical appraisal skills in practicing surgeons and trainees in order that they may evaluate surgical literature and practice Evidence-based Based Surgery. EBRS virtually connects experts in clinical surgery and evidence-based methodology to collaboratively assess the strengths and weaknesses of current practice compared to the risks and benefits of new approaches to care. Since the inception of EBRS, summaries of each review have been published. The present article is a comprehensive review of the ChEETAh trial, investigating the effectiveness of routine glove and instrument change before abdominal wound closure to prevent surgical site infection (SSI). The trial was conducted in low- and middle-income countries (LMICs) and employed a cluster-randomized design. The results indicate a statistically significant reduction in SSI rates. Although the ChEETAh trial has strengths, caution is advised before implementing the intervention globally. The study's clinical relevance and cost-effectiveness need to be considered, and targeted implementation in specific patient clusters and hospitals with the necessary resources is recommended. Institutions should not only assess their unique circumstances (resources, baseline SSI rates, and use of other effective preventive measures) before implementing glove and instrument changes in their setting but also monitor their outcomes and costs should they choose in favor of implementation. Further research, including long-term effects, is suggested to refine the understanding of the intervention's implications in diverse settings.
Unsaturated intercellular vapor pressure is relevant for leaf water heavy isotope enrichment
Authors: Angove Charlotte , Lehmann Marco M. , Saurer Matthias , Tang Yu , Kilpeläinen Petri , Kahmen Ansgar , Schiestl-Aalto Pauliina P. , Tikkasalo Olli-Pekka , Bäck Jaana K. , Rinne-Garmston Katja T.
Published: September 2023

Leaf intercellular vapor pressure (ei) can be unsaturated, but its effect on leaf water heavy isotope enrichment (LWE) has not yet been quantified. We evaluated the ecological relevance of unsaturatedeifor LWE, i.e., for leaf water oxygen-18 and deuterium enrichment, using data from a boreal forest stand and a large-scale dataset. Unsaturatedeican firstly affect LWE by directly decreasingeiin the Craig Gordon model (Mechanism 1), which leads to an increased influence of atmospheric vapor isotopic enrichment above source water (Δv), and a decreased influence of kinetic fractionation by diffusion through the stomata and boundary layer (εk). Unsaturatedeican secondly affect LWE by changing εk(Mechanism 2). To evaluate the effect of Mechanism 1 to LWE, we employed sensitivity tests on LWE model performance using varying measured intercellular relative humidity (RHcellular), or RHcellularfitted to observed LWE. To explore the effects of Mechanism 2 to LWE, we modified the calculation of εkand observed consequences to LWE predictions. Unsaturatedeiis relevant to LWE by Mechanism 1, since a lowered RHcellularnoticeably changed LWE predictions. It clearly improved deuterium predictions and conditionally improved oxygen-18 predictions. Isotope fractionation by Mechanism 2 is unlikely relevant to oxygen-18 and deuterium enrichment. Unsaturatedeimust now be recognized as a variable that introduces error to heavy isotope enrichment models and reconstructions from organic material, via Mechanism 1. We suggest a correction for unsaturatedeifor both oxygen-18 and deuterium enrichment using a variable RHcellularcalculated from atmospheric relative humidity.