bluuebunny/crossref_metadata_2025 huggingface dataset:
Non-target effects of insecticides and herbicides on earwigs
Authors: Hanel Aldo , Nottingham Louis B , Northfield Tobin D , Schmidt-Jeffris Rebecca
Published: February 2025

Conservation biological control in agriculture primarily relies on avoiding pesticides that may harm key natural enemies. In temperate tree fruit crops, the European earwig, Forficula auricularia (L.) has only recently become appreciated as an important predator of economic pests, particularly woolly aphids and pear psylla. Therefore, the non-target effects of orchard pesticides on earwigs are largely understudied. This is particularly true for herbicides, which earwigs are likely to be exposed to due to their foraging behavior moving between the canopy and the ground cover. We tested residues of formulated pesticides (8 insecticides and 7 herbicides) commonly used in tree fruit crops for lethal and sublethal (movement, predation rate) effects on adult female earwigs. Two herbicides, paraquat and glufosinate, and one insecticide, spinetoram, were acutely toxic to earwigs within 72 h. No tested pesticides altered earwigs’ movement or resting behavior compared to the control. The insecticides spinosad and cyantraniliprole and the herbicides 2,4-D, glufosinate, halosulfuron, rimsulfuron, and oxyfluorfen reduced earwig predation on green peach aphids. Therefore, these pesticides may reduce earwig predation on pests in orchards. Our results suggest that some pesticides are of greater risk, and thus, should be carefully considered or better timed when used in tree fruit orchards where earwigs are considered for conservation or augmentative biological control.
Environmental migration during the Great American Drought
Authors: Sichko Christopher
Published: February 2025

From 1930 to 1939, a devastating drought affected the USA. To study environmentally induced migration, I develop datasets of environmental conditions (drought, heat, and precipitation) and census data between 1930 and 1940. My analysis shows that people moved from drought during the early and late 1930s. County-level environmental-related depopulation resulted from increased out-migration and decreased in-migration. At the individual level, all occupational categories (farm labor, farmers, general labor, skilled labor, and white collar) moved from severe environmental conditions, though the response varied depending on rural status. Individuals near cities, but not in the cities themselves, were typically the most mobile in response to shocks. While severe conditions impacted migration across much of the Western USA, the Great Plains states witnessed the most dramatic population declines. My findings provide a detailed view of the environmental forces driving 1930s migration, demonstrate responsiveness across labor sectors, and highlight where people left due to environmental conditions.
Behavioral response of house flies (Diptera: Muscidae) to 3 bittering agents
Authors: Gunathunga Panchalie B , King Bethia H , Geden Christopher J
Published: February 2025

House flies, Musca domestica L., are pests at livestock facilities. House fly numbers are controlled mainly by manure management and chemical controls, like use of toxic baits. Some toxic baits contain denatonium benzoate as a bittering agent, to avoid poisoning of children. House fly behavioral response to denatonium benzoate was examined, using 2 different diluents, sucrose solution or orange juice. Response of flies to quinine and sucrose octaacetate, 2 other bittering agents, was also examined in sucrose. Sucrose is the sweetener in commercially available toxic house fly baits. The proboscis extension response of both male and female flies was significantly reduced by addition of 1,000 ppm of denatonium benzoate to sucrose. Response in males was also reduced at 100 ppm. Consumption of sucrose by both male and female flies was reduced by addition of 100, 500, and 1,000 ppm of denatonium benzoate, but consumption by males was also reduced at 10 ppm. Addition of sucrose octaacetate had no detectable effect on consumption of sucrose at 100, 500, or 1,000 ppm. In contrast, addition of quinine reduced consumption by both male and female flies in all tested concentrations. In orange juice, 10 ppm of denatonium benzoate is often avoided by children. With orange juice, fly proboscis extension response patterns were the same for both sexes, with a reduction at 1,000 ppm of denatonium benzoate. Orange juice consumption by flies was reduced significantly at 1,000 ppm of denatonium benzoate for females but not at any of the concentrations tested for males.
En bloc upper and lower lobe bisegmentectomy for non-small-cell lung cancer invading the fissure
Authors: Kosuge Atsushi , Yoshida Yukihiro , Yotsukura Masaya , Watanabe Shun-ichi
Published: February 2025

Background

The optimal surgical procedure for tumors extending deep into the lung parenchyma of the opposite lobe beyond the fissure remains controversial. The current study aimed to examine whether en bloc upper and lower lobe bisegmentectomy can be an option for such tumors.

Methods

This study included patients who underwent surgery for cN0 non-small-cell lung cancer invading the adjacent lobe beyond the fissure between the upper and lower lobes. The perioperative and long-term outcomes of the bisegmentectomy and extended lobectomy/pneumonectomy groups were compared.

Results

The bisegmentectomy group included five patients who underwent right S2 + S6 segmentectomy and four patients who underwent left S1 + 2 + S6 segmentectomy. The bisegmentectomy and extended lobectomy/pneumonectomy groups had similar perioperative outcomes. The median surgical duration, volume of blood loss and length of hospital stay of the bisegmentectomy group were 175 min, 79 mL and 5 days, respectively. In the bisegmentectomy group, one patient with a tumor without a ground-glass component on computed tomography scan had brain metastasis and died. The remaining eight patients with tumors with ground-glass components on computed tomography scan were alive without recurrence at a median follow-up of 7.2 years. In the extended lobectomy/pneumonectomy group, all patients experienced recurrence and died at a median follow-up of 3.9 years.

Conclusions

En bloc upper and lower lobe bisegmentectomy can be a safe and feasible option for tumors with a ground-glass component on computed tomography scan in patients with non-small-cell lung cancer invading the adjacent lobe beyond the fissure.
Decolonizing Environmental Education: Celebrating Epistemological Diversity Through Integrating Traditional Ecological Knowledge and Scientific Knowledge in Oman
Authors: Alhinai Maryam
Published: February 2025

My goal in this project is to understand how traditional ecological knowledge (TEK) manifests—or fails to manifest—in environmental education policy issued by the Ministry of Education in Oman. I also seek to explore whether there are cultural pressures in Omani society to overlook traditional ecological knowledge in environmental education policy. Specifically, my aim is to understand how forces of globalization interact with traditional ecological knowledge in Oman and whether these forces are behind the tendency to unknowingly ignore traditional ecological knowledge when designing the environmental education policy. Drawing on critical decolonial studies, post-Heideggerian philosophy and environmental education pedagogy, this paper investigates the Policy of Environmental Education for Sustainable Development in Oman, which is a government document issued by the ministry of education in 2012 as a blueprint for designing environmental education curricula in Oman. My analysis of the Policy reveals that there is both a tension with and a potential for a pluriversal approach—one that embraces the coexistence and mutual enrichment of scientific knowledge and traditional ecological knowledge in environmental education. While the focus on scientism has historically marginalized TEK, this paper argues for a pluriversal framework that values multiple ways of knowing. By fostering a dialogue between these knowledge systems, environmental education can become more inclusive, holistic, and ecoculturally sustainable. I argue for honoring indigenous worldviews and celebrating the manifestations of our ecological heritage by integrating traditional ecological knowledge into a land-based pedagogy that works alongside scientific perspectives, promoting a richer understanding of the environment.
Bad stats: A regular series exploring slip-ups, snafus and salutary lessons from the world of statistics
Authors: Prats Jordi
Published: February 2025

Nineteenth-century French mathematician Pierre-Simon Laplace overlooked the effect of errors in his calculations when trying to calculate the mass of Jupiter. Jordi Prats considers how errors can still unavoidably creep into our most careful calculations today
Peritoneal hydatidosis secondary to ruptured hepatic hydatid cyst—a rare presentation: a case report
Authors: Feleke Ashenafi Amsalu , Mekonnen Desiybelew Chanie , Zeneber Meron Berhanu , Zemariam Muluken Assefa , Workneh Gebrehiwot Aderaw , Amare Asratu Getnet
Published: February 2025

Peritoneal hydatidosis (PH) secondary to rupture of hepatic cyst is an exceedingly rare clinical entity. We present a case of a 25-year-old male patient with PH with a hepatic hydatid cyst. The patient underwent laparotomy, total pericystectomy, segmentectomy, and cholecystectomy with a favorable postoperative course. This case highlights the challenges in diagnosing and managing these rare conditions. This is the first reported case in Ethiopia.
Non-coding and epigenetic mechanisms in the regulation of seed germination in Arabidopsis thaliana
Authors: Tremblay Benjamin JM , Qüesta Julia I
Published: February 2025

Seed germination as a developmental process has been extensively studied using the model plant Arabidopsis thaliana. Its seed biology is generally well understood, from the regulation of seed maturation and dormancy to germination and the post-germinative transition. These events require, and are the result of, extensive transcriptional reprogramming which importantly are mediated by essential epigenetic mechanisms such as DNA methylation, different histone variants and modifications, as well as by non-coding regulatory RNAs. Studying these mechanisms therefore is essential for understanding the regulation of gene expression during germination. In this review we summarize our current knowledge of these mechanisms in the context of Arabidopsis thaliana seed biology and discuss aspects requiring further study.
Impact of cigarette smoking on genetic stability, cell division and cytotoxicity in buccal cells of old and young woman
Authors: Nersesyan Armen , Kundi Michael , Muradyan Rafayel , Wultsch Georg , Misik Miroslav , Ferk Franziska , Knasmueller Siegfried
Published: February 2025

We investigated the impact of cigarette smoking, daily exposure to tar and nicotine, and the duration of smoking on genetic instability (chromosomal damage – micronuclei, MN, nuclear buds - gene amplification) as well as on disturbances in mitosis (resulting in binucleated cells). Furthermore, we analyzed markers of cytotoxic effects (such as the formation of condensed chromatin, pyknotic, karyolytic, and karyorrhectic cells) and the mitotic activity of the oral mucosa. These parameters were monitored in groups of old (postmenopausal) and young (premenopausal) smoking and non-smoking women (n= 25/group). We found no differences of the MN frequencies in the non-smoking groups and only a moderate (not significant) increase of MN in both groups of smokers. However, we observed a clear increase of markers of genomic instability in both smoking groups. Furthermore, the mitotic activity of cells in the mucosa and of anomalies caused by acute cytotoxicty was higher in both smoking groups. Nicotine uptake was associated with pronounced acute toxic effects and increased the cell division rate. Chromosomal damage (MN) was higher in individuals which consumed high amounts of tar (this effect was not significant) and caused moderate acute toxicity. Our findings indicate (i) that age and hormonal status have no strong impact on the genotoxic and cytotoxic effects in smoking women, (ii) consumption of up to 30 cigarettes/day does not cause chromosomal damage in buccal cells, however positive results were found in earlier studies in heavy smokers, (iii) smoking increased markers which reflect genetic instability and the division rate of oral mucosa cells. These effects may play a role in neoplastic transformation of cells in the upper respiratory tract in smokers. The duration of smoking was associated with a slight (not significant) increase of the mitotic activity and of chromosomal damage and with moderate acute cytotoxicity.
The reduction of medical resident duty hours for the benefit of patient safety
Authors: Hager Alison
Published: February 2025

Since the case of Libby Zion spurred the first duty hour restrictions placed upon medical residents, the impact of fatigue and the importance of duty hour restrictions have been hotly debated. This paper discusses the history of duty hour restrictions as well as the documented impact of fatigue both on the medical profession and other industries upon which the federal government has imposed hours restrictions due to the danger fatigue has been found to pose. It then takes this information and applies it to the American Medical Association’s ‘Code of Medical Ethics’ to determine if residents can truly adhere to these principles and prioritize patient safety while working hours shaped by current duty hour limits.
Gauge theoretical method in solving zero-curvature equations I — application to the static Einstein-Maxwell equations with magnetic charge—
Authors: Azuma T , Koikawa T
Published: February 2025

The inverse scattering problem is applied to 2-dimensional partial differential equations called soliton equations such as the KdV equation and so on. It is also used to integrate the Einstein equations with axial symmetry. These inverse scattering problems look different. We show that they can be understood in a unified way. As an application to the Einstein equation, we find solutions of the Einstein-Maxwell equations with a magnetic charge.
Generative AI at Work
Authors: Brynjolfsson Erik , Li Danielle , Raymond Lindsey
Published: February 2025

We study the staggered introduction of a generative AI–based conversational assistant using data from 5,172 customer-support agents. Access to AI assistance increases worker productivity, as measured by issues resolved per hour, by 15% on average, with substantial heterogeneity across workers. The effects vary significantly across different agents. Less experienced and lower-skilled workers improve both the speed and quality of their output, while the most experienced and highest-skilled workers see small gains in speed and small declines in quality. We also find evidence that AI assistance facilitates worker learning and improves English fluency, particularly among international agents. While AI systems improve with more training data, we find that the gains from AI adoption are largest for moderately rare problems, where human agents have less baseline experience but the system still has adequate training data. Finally, we provide evidence that AI assistance improves the experience of work along several dimensions: customers are more polite and less likely to ask to speak to a manager.
Race to the Bottom: Competition and Quality in Science
Authors: Hill Ryan , Stein Carolyn
Published: February 2025

This paper investigates how competition to publish first and thereby establish priority impacts the quality of scientific research. We begin by developing a model where scientists decide whether and how long to work on a given project. When deciding how long they should let their projects mature, scientists trade off the marginal benefit of higher quality research against the marginal risk of being preempted. Projects with the highest scientific potential are the most competitive because they induce the most entry. Therefore, the model predicts these projects are also the most rushed and lowest quality. We test the predictions of this model in the field of structural biology using data from the Protein Data Bank (PDB), a repository for structures of large macromolecules. An important feature of the PDB is that it assigns objective measures of scientific quality to each structure. As suggested by the model, we find that structures with higher ex-ante potential generate more competition, are completed faster, and are lower quality. Consistent with the model, and with a causal interpretation of our empirical results, these relationships are mitigated when we focus on structures deposited by scientists who — by nature of their employment position — are less focused on publication and priority. We estimate that the costs associated with improving these low-quality structures are between 1.5 and 8.8 billion dollars since the PDB’s founding in 1971.
Validation of childhood lupus specific targets: ensuring accurate assessment of disease control in younger, lighter paediatric patients
Authors: Sarker Chandni , Jorgensen Andrea L , Tharmaratnam Kukatharmini , Al-Abadi Eslam , Armon Kate , Bailey Kathryn , Bohm Marek , Brennan Mary , Ciurtin Coziana , Gardner-Medwin Janet , Hawley Daniel P , Kinder Alison , Leahy Alice , Malik Gulshan , McLaren Zoe , Moraitis Elena , Mosley Ellen , Ramanan Athimalaipet V , Rangaraj Satyapal , Ratcliffe Annie , Riley Philip , Rostron Heather , Sen Ethan S , Hedrich Christian M , Beresford Michael W , MD Smith Eve
Published: February 2025

Objectives

To validate novel childhood-onset systemic lupus erythematosus (cSLE) T2T targets including Childhood Lupus Low Disease Activity State (cLLDAS), cSLE Clinical Remission on steroids (cCR), and cSLE Clinical Remission off steroids (cCR-0), as compared with adult-onset SLE (aSLE) targets.

Methods

Attainment of the aforementioned cSLE-specific and aSLE-specific targets (LLDAS, DORIS 2021 Remission) was assessed at each visit, in UK JSLE Cohort Study patients. Univariable and multivariable Prentice-Williams-Peterson (PWP) gap-time models investigated the impact of target attainment on new damage and severe flare.

Results

The cohort included 430 cSLE patients. Attainability was comparable between corresponding cSLE and aSLE targets. Achieving cLLDAS (HR 0.18 [0.14, 0.23]), cCR (HR 0.18 [0.13, 0.23]) and cCR-0 (HR 0.17 [0.13, 0.23]) reduced the risk of severe flare (all p < 0.001). Risk of new damage was reduced in those reaching cLLDAS (HR 0.22 [0.11, 0.44]), cCR (HR 0.25 [0.13, 0.49]) and cCR-0 (HR 0.30 [0.15, 0.60]) (all p < 0.001). Inappropriate attainment of LLDAS and DORIS remission occurred at 35 and 52 visits, respectively, in younger (median age 7.3 and 8.8 years) and lighter patients (median weight 26.8 and 37.1 kg) whilst on prednisolone doses that precluded cSLE target attainment (median 0.17 [IQR 0.16–0.24] and 0.13 [IQR 0.11–0.16] mg/kg respectively).

Conclusions

This study validates novel paediatric-specific targets, demonstrating that achieving cLLDAS, cCR, and cCR-0 reduce risks of new damage and severe flare, which is comparable to aSLE targets. Using cSLE-specific targets prevents misclassification of disease activity in paediatric patients, enabling more accurate disease control assessments in younger, lighter patients.
Real-life affective forecasting in young adults with high social anhedonia: An experience sampling study
Authors: Zhang Rui-ting , Gao Yan , Yang Tian-xiao , Yan Chao , Wang Ya , Lui Simon S Y , Chan Raymond C K
Published: February 2025

Background and hypothesis

Affective forecasting (AF), the ability to forecast emotional responses for future events, is critical for optimal decision-making and mental health. Most previous AF studies were conducted using laboratory-based tasks, but overlooked the impacts of real-life situations and social interactions. This study used the experience sampling method to examine real-life AF in young healthy adults and individuals with high social anhedonia.

Study design

In Study 1, 109 young healthy adults reported anticipated and experienced emotions of personal events for 30 days on mobile phones. In Study 2, we examined real-life AF in 28 individuals with high social anhedonia (HSA) and 32 individuals with low social anhedonia (LSA).

Study results

In Study 1 (totaling 8031 real-life events), participants anticipated and experienced social events as more positive and more arousing than non-social events, but also with larger AF discrepancy. In Study 2 (totaling 2066 real-life events), compared with the LSA group, the HSA group anticipated less pleasure and displayed larger valence discrepancy especially for social but not for non-social events. However, the HSA group reported less experienced pleasure for both social and non-social events.

Conclusions

Using an ecological method for assessing real-life AF, we extended the previous laboratory-based findings to real-life situations. These findings demonstrate the effects of sociality on real-life AF and elucidated the deficit in anticipating social pleasure among HSA individuals, which reflects liability to schizophrenia-spectrum disorders. Altered AF may be potential intervention target in people with schizophrenia spectrum disorder.
Punitive Inertia: Anti-Blackness and the Policing of Motion
Authors: Tillman Korey
Published: February 2025

Theories of the U.S. carceral state often treat anti-Blackness as the disproportionate suffering of Black individuals across a range of measures instead of a distinct form of racial oppression that needs investigation. This article examines how anti-Blackness shapes the formal and informal ways that Black individuals are policed in their everyday lives. Drawing on 23 interviews with adults who identify as Black across the United States, I find that their spatial trajectories are altered by mundane forms of policing that extend beyond the criminal legal system. I offer the term punitive inertia to capture how Black spatial trajectories are policed and resisted. In physics, inertia describes how an object resists a force attempting to change its spatial trajectory. Similarly, punitive inertia describes how policing—underpinned by a history of racial slavery and colonialism—is the force Black individuals resist in attempts to control their own spatial trajectories. I argue that Black bodies are moving through an anti-Black modernity generating incessant moments of punitive inertia that call into question our very notions of Human and the Social as coherent categories. I conclude with a call for scholars to contend with anti-Blackness in further examinations of policing.
How Japan’s COVID-19 vaccination policy shapes trust in governance: a relative deprivation approach
Authors: Sudo Naoki
Published: February 2025

This study examines changes in the association between social policy performance and trust in government, focusing on the Coronavirus disease 2019 (COVID-19) vaccination policy implemented by Japan’s central government. Data from the Online Panel Survey of Stratification and Social Psychology (SSPW2021-Panel) were analyzed using two-way fixed effects regression models. The quadratic term of the COVID-19 vaccination rate at the prefecture level had statistically significant effects on the evaluation of the central government’s infection control policies and trust in the central government. This implies that the relative deprivation experienced by unvaccinated individuals weakened trust in the central government in the early stage, and the decline in the number of unvaccinated individuals strengthened trust in the central government in the latter stage. Thus, this paper finds that even if a social policy meets people’s demands, its implementation may temporally damage the government’s reputation through relative deprivation.
Overwintering Capability of Xanthomonas arboricola pv. pruni Strains with Different Bactericidal Sensitivities on Peach Trees
Authors: Panth Milan , Noh Enoch , Sherratt Alec , Schnabel Guido , Anco Daniel J. , Carvalho Renato , Jones Jeffrey B. , Wang Hehe
Published: February 2025

Xanthomonas arboricola pv. pruni (XAP) causes bacterial spot of peach and is primarily managed in commercial South Carolina peach orchards with copper and oxytetracycline applications. The pathogen overwinters in peach twigs and forms spring cankers which generate primary inoculum for early-season leaf and fruitlet infections. Copper-tolerant and oxytetracycline-resistant strains have recently been reported, but their overwintering capability in the absence of selection pressure is unknown. Similarly, the impact of infection during different phenological stages on XAP overwintering is unknown. To investigate these factors, peach twigs were sprayed with strains of XAP with different sensitivities to copper and oxytetracycline in an experimental orchard during bud set (June), after harvest (August), and during leaf drop (October) in the fall. Viable XAP from peach buds was quantified using qPCR with or without propidium monoazide (PMA) treatment. Results indicated that bud cankers were a major inoculum reservoir for XAP, and the overwintered XAP densities in buds were significantly and positively correlated with spring canker ratings (R2 = ~0.6, p < 0.001). Inoculation of peach twigs at all three time points yielded overwintering XAP populations and canker symptoms in spring, with the highest amount of canker and XAP from the leaf drop [42.7% canker incidence, 31,258 CFU/bud] and after harvest [30.4% canker incidence, 8,511 CFU/bud] inoculations. There were no significant differences in overwintering capability of XAP strains in the absence of copper or oxytetracycline sprays, suggesting that these oxytetracycline-resistant and copper-tolerant strains may persist and accumulate in peach orchards across seasons.
Allicin Binds to Cysteine Residues of Fungal Dihydrolipoamide Dehydrogenase to Control Gray Mold (Botrytis cinerea) of Tomato
Authors: Cheng Dan , Liu Fenghua , Li Dongxue , Ma Yue , Zhou Jing-Jiang , Wang Delu , Chen Zhuo
Published: February 2025

Allicin exhibits strong inhibitory activity against phytopathogenic fungi; however, its antifungal mechanism remains unclear. This study assessed allicin's inhibitory effects on several phytopathogenic fungi, revealing a half-maximal effective concentration of 125.47 μg/ml against the hyphal growth of Botrytis cinerea. Micromorphological analysis showed that allicin caused abnormalities in the hyphae, including unclear organelle boundaries and organelle dissolution. Integrated transcriptomic, and proteomic, and metabolomic assays indicated that allicin induced differential gene and protein expression, particularly in the plasma membrane, oxidative stress processes, and energy metabolism pathways. Additionally, differentially expressed metabolites were involved in the inhibition of hyphal growth. Biochemical assays demonstrated that allicin inhibited ATP production and damaged hyphal cell membranes. Molecular docking revealed that allicin could bind to dihydrolipoamide dehydrogenase (DLDH), an enzyme rich in cysteine residues, with a binding free energy of −6.322 kcal/mol. Through antimicrobial activity testing of allicin analogues and molecular docking analysis, the active groups of allicin and its interaction with DLDH were identified. This study shows that allicin interferes with energy metabolism, impacts cell membrane and wall integrity by targeting cysteine-containing proteins, and inhibits the proliferation of plant pathogenic fungi. These insights into the antifungal mechanism will provide valuable data for the development and field application of allicin analogues.
Latest evidence and perspectives of Panax notoginseng extracts and preparations for the treatment of cardiovascular diseases: a review
Authors: Zhao Chenyu , Fu Jiamei , Wang Yingyu , Zhou Yabin
Published: February 2025

Cardiovascular diseases are a major cause of death worldwide, and their high incidence poses a significant threat to human health and public health systems. Panax notoginseng, a traditional Chinese medicinal herb with a long history, has shown promise in treating cardiovascular diseases. This review examines the diverse mechanisms through which Panax notoginseng addresses cardiovascular diseases, including anti-inflammatory, antiplatelet aggregation, anticoagulation, anti-oxidative stress, regulation of angiogenesis, antiatherosclerosis, improvement of microcirculatory disorders and protection against myocardial ischemia-reperfusion injury, highlighting saponins as the principal active components. It also summarizes studies involving Panax notoginseng preparations like Xueshuantong and Xuesaitong in treating coronary heart disease and myocardial infarction, and discusses the safety, limitations, and future research directions of these extracts. In conclusion, the cardiovascular protective mechanism of Panax notoginseng is multi-targeted and multi-pathways, and its clinical application is relatively safe, with rare and mild adverse drug reactions, suggesting a promising therapeutic potential.
Comparison of pharmacological therapies in metabolic dysfunction-associated steatohepatitis for fibrosis regression and MASH resolution: Systematic review and network meta-analysis
Authors: Souza Matheus , Al-Sharif Lubna , Antunes Vanio L J. , Huang Daniel Q. , Loomba Rohit
Published: February 2025

Background and Aims:

Metabolic dysfunction-associated steatohepatitis (MASH) is a leading cause of liver disease. With the advent of multiple therapeutic targets in late-phase clinical drug development for MASH, there is a knowledge gap to better understand the comparative efficacy of various pharmacological agents. We conducted an updated network meta-analysis to evaluate the relative rank-order of the different pharmacological agents for both fibrosis regression and MASH resolution.

Methods:

We searched PubMed and Embase databases from 2020 to December 1, 2024, for published randomized-controlled trials (RCTs) comparing pharmacological interventions in patients with biopsy-proven MASH. The co-primary endpoints were fibrosis improvement ≥1 stage without MASH worsening and MASH resolution without worsening fibrosis. We conducted surface under the cumulative ranking (SUCRA) curve analysis.

Results:

A total of 29 RCTs (n=9324) were included. Pegozafermin, cilofexor + firsocostat, denifanstat, survodutide, obeticholic acid, tirzepatide, resmetirom, and semaglutide were significantly better than placebo in achieving fibrosis regression without worsening MASH. Pegozafermin (SUCRA: 79.92), cilofexor + firsocostat (SUCRA: 71.38), and cilofexor + selonsertib (SUCRA: 69.11) were ranked the most effective interventions. Pegozafermin, survodutide, tirzepatide, efruxifermin, liraglutide, vitamin E + pioglitazone, resmetirom, semaglutide, pioglitazone, denifanstat, semaglutide and lanifibranor were significantly better than placebo in achieving MASH resolution without worsening fibrosis. Pegozafermin (SUCRA: 91.75), survodutide (SUCRA: 90.87), and tirzepatide (SUCRA: 84.70) were ranked the most effective interventions for achieving MASH resolution without worsening fibrosis.

Conclusion:

This study provides updated rank-order efficacy of MASH pharmacological therapies for fibrosis regression and MASH resolution. These data are helpful to inform practice and clinical trial design.
Endophthalmitis Following Delayed Gore-Tex Suture Rotation: A Lesson in Suture Management
Authors: Karadaghy Amin A. , Singh Ajay
Published: February 2025

Purpose:

To highlight occurrence and management of an important surgical complication.

Methods:

Retrospective case review.

Results:

A 35-year-old Caucasian female with a history of crystalline lens dislocation secondary to Marfan Syndrome was referred for management of chronically exposed Gore-Tex suture knots following AKREOS 4-point fixation six years prior. The initial surgery was reportedly complicated by hypotony leading to multiple attempted wound revisions. Ultimately, the patient remained with chronically exposed suture knots. Upon referral to our practice, the knots of the left eye were rotated into the eye, leading to endophthalmitis refractory to two rounds of intravitreal antibiotics. Infection was controlled only after removal of all preexisting hardware, suggesting colonization of the suture material. In the other eye, the decision was made to remove all preexisting sutures and re-fixate the initial lens using new suture. The patient achieved 20/20 vision in both eyes with implantation of a new secondary IOL in one eye and with removal of all preexisting sutures in the other eye.

Conclusion:

This report highlights a case of endophthalmitis following delayed rotation of exposed suture. Based on the outcome of this case, the importance of avoiding suture exposure is highlighted, and options to manage chronically exposed suture are discussed.
Evaluating the Protective Effects of a Dispersive Ophthalmic Viscosurgical Device Versus Balanced Salt Solution on the Cornea During Cataract Surgery
Authors: Hanson Justin , Khorrami Roxana , Kanamoto Kellie , Strawbridge Jason , Miller Kevin M. , Lin Shawn R.
Published: February 2025

Objectives:

To compare intraoperative and postoperative effects of applying a viscosurgical device versus balanced salt solution (BSS) during cataract surgery.

Methods:

Single-center retrospective case–control pilot study. Reviewed 27 patients who received Viscoat (Alcon Laboratories, Inc. Fort Worth, TX) or BSS on the cornea during uncomplicated cataract surgery. Surgeries were analyzed for time when the microscope light reflection was indistinct on the cornea while instruments were in the eye. Postoperative data included patient pain ratings, National Eye Institute score, and Ocular Surface Disease Index (OSDI) scores.

Results:

Compared with BSS, Viscoat application resulted in a significant increase in time with a clear light reflex during surgery (P<0.001). With BSS, average time without a clear light reflex while instruments were in the eye was 82.69±50.14 sec, or 17.56%±12.00% of the surgery, compared with 0% with Viscoat. There was no significant difference in postoperative pain and National Eye Institute score between groups. However, OSDI score two about grittiness was significantly lower with Viscoat application (P=0.01) and approaching significance for OSDI score three, about painful or sore eyes (P=0.09).

Conclusions:

Viscoat provided greater optical clarity during surgery with a single application and was associated with less sensation of grittiness compared with BSS.
Long-Term Study of Biomechanics and Associated Factors of Lenticule Intrastromal Keratoplasty for the Correction of Hyperopia
Authors: Han Xiaosong , Li Meiyan , Xia Fei , Sun Ling , Shen Yang , Xu Haipeng , Lin Feng , Zhou Xingtao
Published: February 2025

Purpose:

To investigate long-term corneal biomechanical changes and influencing factors of lenticule intrastromal keratoplasty (LIKE) in the treatment of hyperopia.

Methods:

9 eyes of 9 patients with a mean age of 34.00 ± 9.34 years were included. Full-scale examinations were conducted on all patients preoperatively and during 2 years of follow-ups. Topographical and biomechanical parameters were evaluated with Pentacam and Corvis ST preoperatively and during all follow-up visits.

Results:

All surgeries were uneventful without complications. The safety index was 1.27 ± 0.64 and the efficacy index was 0.96 ± 0.62 at the last follow-up. The central corneal thickness (CCT) (P < 0.05*) and the thinnest corneal thickness (TCT) (P < 0.05*) significantly increased 2 years postoperatively while the Ambrosio relational thickness horizontal (ARTh) (P < 0.05*) and the Corvis biomechanical index (CBI) (P < 0.05*) decreased. The deformation amplitude ratio (DA ratio), the stiffness parameter at the first applanation (SP-A1), the stress–strain index, and the posterior elevation (PE) remained stable 2 years after LIKE. The DA ratio was negatively correlated with the CCT and the TCT (r = −0.54, P = 0.019*; r = −0.59, P = 0.009*) while the SP-A1 was positively correlated with the CCT and the TCT (r = 0.84, P < 0.001*; r = 0.87, P < 0.001*). The ARTh was positively correlated with the TCT (r = 0.47, P = 0.049*), and the CBI was positively correlated with the PE (r = 0.63, P = 0.005*).

Conclusions:

LIKE for the correction of hyperopia is safe and effective in the long term. The PE remained stable and the CBI improved 2 years postoperatively.
The incidence and outcomes of hyperacute cardiovascular dysfunction following isolated traumatic brain injury: an observational cohort study
Authors: Bird Flora L. , Wilson Mark , Aziz Shadman , Shebl Moustafa , Pickard Alexander , Sims David , Grier Gareth , Lockey David , Davenport Ross
Published: February 2025

Background:

The relationship between early cardiovascular dysfunction (CVD) in isolated traumatic brain injury (iTBI) and outcome has not been fully described. We aimed to (1) determine the prevalence and phenotype of CVD after iTBI in the hyper-acute phase and (2) compare treatment and outcomes in those with CVD vs non-CVD.

Methods:

An observational cohort database study of severe iTBI patients (Head AIS 3+) at a level 1 trauma centre (2008–2019) and physician-led air ambulance service (2019–2020). CV dysfunction was defined as tachycardia or bradycardia, with hypotension. Physiology, laboratory results, 24-hour transfusion, and computer-topography (CT) findings were recorded. Outcomes were 28-day mortality and Glasgow Outcome Score (GOS).

Results:

A total of 168 patients met inclusion criteria, average age 46 years (IQR 30–61), 77% male, median ISS 25 (IQR 17–29) with 51% Head AIS 5. Time from injury to pre-hospital assessment was 31 minutes (IQR 20–42) with 20% demonstrating CVD on initial observations. The CVD group were more shocked (lactate 6.1 (1.7–10.9) vs. 2.4 (1.4–3.3), P < 0.001) and coagulopathic (43% vs. 15%, P = 0.001). There was no difference in Head AIS or CT findings between groups, except frequency of hypoxic ischemic encephalopathy (HIE) (CVD: 21% vs. non-CVD: 1%, P < 0.001). A 24-hour transfusion was higher in CVD patients: 3 (0–8) vs. 0 (0–0) units, P < 0.001. Mortality was greater in CVD vs non-CVD iTBI (61% vs. 31%, P = 0.002), but in patients with AIS 5, there was no difference (P = 0.262). One-third of CVD survivors (13/33) were discharged home, and 4/18 patients with recorded GOS had good neurological outcome.

Conclusion:

One in five patients with severe iTBI develop early CVD, associated with increased mortality, coagulopathy, and HIE. However, mortality and neurological outcome is highly variable in those with CVD across the iTBI severity spectrum. Further research is needed to define the pathophysiology and optimal treatment to improve outcomes for this subgroup of iTBI.
Development, validation, and clinical evaluation of a machine-learning based model for diagnosing early infection after cardiovascular surgery (DEICS): a multi-center cohort study
Authors: Pan Tuo , Zhang Haitao , Wang Chuangshi , Wang Hanghang , Matniyaz Yusanjian , Lv Zhi-Kang , Zhu Tong Tong , Wang Ya-Peng , Song Zhi-Zhao , Tang Yu-Xian , Zhang He , Pan Hao-Dong , Li Chen , Yang Lin-Shan , Guan Shi-Yu , Bian Wen , Hafu Xiateke , Li Xiang , Li Yang , Wu Xiao-Ting , Fan Zhi-Wei , Luo Yuan-Xi , Jiang Yi , Gao Ya-Xuan , Wang Wen-Zhe , Xue Yun-Xing , Fan Fu-Dong , Pan Jun , Zhou Qing , Zhang Bo-Min , Wang Wei , Wang Qiang , Fan Guo-Liang , Wang Dong-Jin
Published: February 2025

Background:

This study addresses the critical need for timely and accurate diagnosis of early postoperative infection (EPI) following cardiac surgery. EPI significantly impacts patient outcomes and healthcare costs, making its early detection vital.

Objectives:

To develop, validate, and clinically implement a machine-learning-based model for diagnosing EPI post-cardiac surgery, enhancing postoperative care.

Methods:

In this multi-center cohort study spanning 2020 to 2022, data from four medical centers involved 2001 participants. Of these, 1400 were used for trainingand 601 for validation. Several machines-learning algorithms, including XGBoost, random forest, support vector machines, least absolute shrinkage and selection operator, and single-layer neural networks, were applied to develop predictive models. These were compared against a traditional logistic regression model. The model with the highest area under the receiver operating characteristic curve (AUROC) was deemed optimal. Implemented across four centers since 1 January 2023, a retrospective real-world study assessed its clinical applicability. Among 400 patients with an estimated EPI risk above 10%, identified by the optimal model, 55 followed its antibiotic upgrade recommendations (DEICS group). The remaining 345 patients upgraded antibiotics empirically, with 55 in the control group, matched 1:1 with the DEICS group. Clinical utility was evaluated through antibiotic use density (AUD), hospital costs, and ICU stay duration.

Results:

The XGBoost model achieved the highest performance with an AUROC of 0.96 (95% CI: 0.93–0.98). The calibration curve exhibited strong agreement with Brier scores of 0.02. According to the XGBoost model, the DEICS group significantly demonstrated reduced AUD (P < 0.01) in the matched cohort, along with decreased ICU stay time (median: 5 vs. 6 days, P = 0.01) and hospital costs (median: ¥150 000 vs. median: ¥200 000, P = 0.01) in the EPI cohort.

Conclusion:

The successful implementation of the XGBoost model facilitates accurate EPI diagnosis, improves postoperative recovery, and lowers hospital costs.
Metabolic myopathies series part 1: What we need to know
Authors: Edmund Sara J. , Heuer Beth Ann
Published: February 2025

Metabolic myopathies, a group of genetic disorders characterized by disruptions in muscle cell pathways, often lead to significant muscle fatigue. The potential underdiagnosis of these conditions is a concern because it can lead to long-term complications. Nurse practitioners are in a prime position to identify and refer these patients, thereby preventing such sequelae. Three genetic disorders affecting muscle metabolism include McArdle disease, Tarui disease, and carnitine palmitoyltransferase II deficiency. McArdle disease is a glycogen storage disease caused by a flaw in the production of a critical muscle enzyme called phosphorylase, leading to the inability to break down glycogen within muscle cells. Muscle pain, fatigue, and sometimes rhabdomyolysis can result. Tarui disease results from insufficient phosphofructokinase, which disrupts glycolysis, leading to exercise intolerance. Carnitine palmitoyltransferase II deficiency affects lipid metabolism, disturbing long-chain fatty acid (LCFA) transport into the mitochondria. The mitochondria use these LCFAs to produce energy. Disruption can lead to exertional muscle pain and myoglobinuria.
Bilateral carotid body tumor management: tips, tricks, strategies, and problems
Authors: Piazza Cesare , Montenegro Claudia , Rampinelli Vittorio
Published: February 2025

Purpose of review

Carotid body tumors (CBTs) are rare neuroendocrine tumors with an annual incidence of 1 : 30 000. Bilateral carotid body tumors (BCBTs) account for 3–5% of all CBTs and are more frequently linked to familial syndromes and potential malignancy. BCBT management is still not universally standardized and depends on multiple factors, including patient's age, risk of malignancy, location, growth rate, size, and related Shamblin and Mehanna classifications.

Recent findings

Options of treatment include active surveillance, external beam radiation, and surgery. Surgery is the first-choice treatment, but it may not always be performed especially in elderly patients. Simultaneous BCBT resection is not suggested due to high intra-operative and postoperative risks. The decision to operate on the larger or smaller tumor first is still debated. Whenever feasible, treatment of the larger tumor first to reduce the tumor burden should be preferred but with higher risks of neurovascular injury. Conversely, starting with the smaller tumor first offers a lower risk at initial surgery but may complicate the management of the larger tumor later.

Surgery for BCBTs, whenever feasible, remains the most indicated treatment but poses a significant risk of neurovascular complications. Resection of the larger, often more symptomatic, and potentially problematic or malignant tumor, reduces the overall disease burden and mitigates risks of rapid progression but involves a higher immediate complication hazard. Multidisciplinary evaluation is essential for balancing surgical risks and long-term outcomes, prioritizing neurovascular preservation and reducing morbidity.
Clinical Outcomes of Gender-Affirming Surgery in Individuals With Connective Tissue Disorders
Authors: Shah Jennifer K. , Camacho Justin M. , Eble Danielle , Hinson Chandler , Najafali Daniel , Patel Heli S. , Shih Pin-Keng , Nazerali Rahim , Morrison Shane D.
Published: February 2025

Introduction

Gender-affirming surgery (GAS) is a complex process that often requires multiple surgical operations and carries a complication risk that could be exacerbated by connective tissue disorders (CTDs). This study aims to investigate the association between CTD diagnosis and GAS outcomes.

Methods

Using the Merative MarketScan Research Databases, patients with gender dysphoria diagnoses who underwent GAS between 2007 and 2022 were identified. Among these, patients with diagnosed CTDs were identified. Demographics, comorbidities, and postoperative complications were recorded. Chi-squared, Shapiro-Wilk, Wilcoxon-Mann-Whitney, and multivariate logistic regression testing was used for statistical analysis.

Results

Of 7575 patients meeting criteria (mean age 29 ±10 years), 300 (4%) had CTD diagnoses. One or more postoperative complications were recorded in 9.8% of patients, without statistically significant difference between CTD and non-CTD patients. Additional simultaneous GAS procedures [odds ratio (OR) 2.02; P < 0.01], Elixhauser index scores of 3+ (OR 1.36; P = 0.010), and age >45 years (OR 1.47; P = 0.02) increased odds of experiencing complications following the index GAS procedure, while CTD diagnoses (P = 0.52) did not affect odds of experiencing complications. However, CTD diagnoses did elevate odds of readmission (OR 1.47; P = 0.046), as did multiple simultaneous GAS procedures (OR 2.66), Elixhauser index scores of 3+ (OR 3.72), and smoking (OR 2.18) (P < 0.01).

Conclusions

These findings suggest CTDs may impact some gender-affirming surgical outcomes, and careful preoperative evaluation and management of comorbidities is necessary to reduce the risk of complications and readmission in this population. Surgeons should continue to exercise caution when performing elective surgery on patients taking immunomodulatory medications.