bluuebunny/crossref_metadata_2025 huggingface dataset:
Laser polarization control of ionization-injected electron beams and x-ray radiation in laser wakefield accelerators
Authors: Mukherjee Arghya , Seipt Daniel
Published: June 2024

In this paper, we have studied the influence of laser polarization on the dynamics of the ionization-injected electron beams, and subsequently, the properties of the emitted betatron radiation in laser wakefield accelerators (LWFAs). While ionizing by strong field laser radiation, the generated photo-electrons carry a residual transverse momentum in excess of the ionization potential via the above threshold ionization (ATI) process. This ATI momentum explicitly depends on the polarization state of the ionizing laser and eventually governs the dynamics of the electron beam trapped inside the wake potential. In order to systematically investigate the effect of the laser polarization, here, we have employed complete three-dimensional particle-in-cell simulations in the nonlinear bubble regime of the LWFAs. We focus, in particular, on the effects the laser polarization has on the ionization injection mechanism, and how these features affect the final beam properties, such as beam charge, energy, energy spread, and transverse emittance. We have also found that as the laser polarization gradually changes from linear to circular, the helicity of the electron trajectory, and hence the angular momentum carried by the beam, increases significantly. Studies have been further extended to reveal the effect of laser polarization on the radiation emitted by the accelerated electrons. The far-field radiation spectra have been calculated for the linear and circular polarization states of the laser. It has been shown that the spatial distributions and the polarization properties (Stokes parameters) of the emitted radiation in the above two cases are substantially different. Therefore, our study provides a facile and efficient alternative to regulate the properties of the accelerated electron beams and x-ray radiation in LWFAs, utilizing ionization injection mechanism.
Understanding the photomechanical effect in organic photoactuators: a comprehensive review of mechanical models and numerical simulations
Authors: Cedeno Madera Rebeca , Arroyo Diaz Ismael , Nait-Abdelaziz Moussa , Aloise Stephane
Published: June 2024

The photomechanical effect (PME), characterized by light-induced mechanical deformation in materials, has gained significant attention across various domains. Photomechanical modeling, integrating photochemistry and mechanical behavior in photoactive materials, is a crucial tool for understanding and optimizing functionality. In this review, we provide an overview of recent developments in mechanical modeling and numerical simulations, focusing on finite element simulations in organic photoactuators. We conducted a systematic literature search from the discovery of the PME, examining progress in modeling diverse organic photoactuators, including polymer-based and liquid crystal elastomer. Integrating light and mechanical constitutive models has enabled the accurate representation of the photomechanical responses of these materials. This review summarizes methods for simulating light-induced deformation, factors influencing photomechanical responses, and current field limitations. Additionally, this review introduces mechanical models as indispensable tools for describing the mechanical behavior of organic photoactuators. In conclusion, developing novel organic photoactuators requires establishing generalized photomechanical couplings to optimize design, enhance light-induced responses, and facilitate cost-effective commercialization. This review serves as a valuable resource for researchers interested in this field, stimulating further exploration of organic photoactuator applications.
Controlling three-dimensional magnetic island appearance with external current drive in the Chinese first quasi-axisymmetric stellarator
Authors: Su X. , Wang X.Q. , Xu Y. , Okamura S. , Shimizu A. , Isobe M. , Cheng J. , Liu H.F. , Huang J. , Zhang X. , Liu H. , Luo Y. , Shen J.F. , Hu J. , Tang C.J.
Published: June 2024

In this study, the impact of a non-inductive current drive, such as electron cyclotron current drive, on three-dimensional (3D) magnetic islands in the high-β equilibrium of the Chinese First Quasi-axisymmetric Stellarator (CFQS) was investigated using the HINT code. In the case of a high-β equilibrium (volume-averaged plasma beta <β> ∼ 0.74% and bootstrap current I
bs∼ 24.5 kA), two m/n = 4/2 rational surfaces with large magnetic islands develop (Wang et al 2021 Nucl. Fusion
61 036021). The islands can be effectively controlled using a constant or a Gaussian current density profile, depending on the direction and amplitude of the current. With a constant current density amounting to a total current of −6 kA, the rotational transform profile can be modified such that the m/n = 4/2 rational surface is eliminated and the island is suppressed. For the Gaussian current density profile, the magnetic island can also be suppressed using a smaller total current of ∼−2 kA to adjust the iota profile. These results suggest that in the CFQS stellarator, the external current drive might be an efficient approach for controlling 3D magnetic islands and consequently improving plasma confinement.
New type of self-sustained divertor oscillation driven by magnetic island dynamics in Large Helical Device
Authors: Kobayashi T. , Kobayashi M. , Narushima Y. , Suzuki Y. , Tanaka K. , Motojima G. , Watanabe K.Y. , Mukai K. , Hayashi Y.
Published: June 2024

A new self-sustained divertor oscillation is discovered in magnetic island induced detached plasmas in the Large Helical Device. The divertor oscillation is found to be a self-regulation of the width of an edge magnetic island accompanied by detachment-attachment transitions. The modified Rutherford equation combined with an ad-hoc bootstrap current equation is introduced to describe the divertor oscillation as a predator–prey model between the magnetic island width and a remnant X-point bootstrap current. The model successfully reproduces the experimental observations in terms of the oscillation frequency, the phase relation between variables, and the oscillation amplitude.
Plasmon-enhanced chiral absorption through electric dipole–electric quadrupole interaction
Authors: Wang Hanwei , Zhao Yang
Published: June 2024

Enantioselective interactions of chiral molecules include distinct absorptions to opposite-handed circularly polarized light, known as chiral absorption. Traditionally, chiral absorption has been primarily attributed to electric dipole (ED) and magnetic dipole (MD) interaction with molecular chirality. However, this approach falls short for large molecules that support high-order multipolar components, such as electric quadrupole (EQ) moment. Here, we introduce a theoretical model to study the chiral absorption of large molecules in the presence of plasmonic nanostructures. This model considers both ED–MD interaction and ED–EQ interaction enhanced by a resonant structure. We numerically study such interactions of the chiral molecular solution in the vicinity of an achiral plasmonic nano-resonator. Our results show the distinct spectral information of the chiral medium on- and off-resonance of the resonator.
The impact of cross-Kerr nonlinearity on rotary photon drag and temporal cloaking in Sagnac interferometry
Authors: Ullah Sana , Ullah Arif , Ahmad Rashid , Javed Muhammad
Published: June 2024

We theoretically explore the impact of cross-Kerr nonlinearity (CKN) on rotary photon drag (RPD) and temporal cloaking in a Sagnac interferometer. With the activation of CKN, significant improvements in RPD and temporal cloaking are observed. Drag angles of

±
1

×

10

−
3

and

±
5

×

10

−
3

radians are attained, similarly, temporal gaps of

10

μ

s,

12

μ

s and

13

μ

s are observed. In addition to the observed electromagnetically induced transparency window, the group refractive index is drastically enhanced, time delay/advance are tuned from pico-radians to micro-radians, and reduced relativistic group velocities are achieved by activating CKN within the system. Additionally, the transmission pulses intensities are observed to be reduced with the dragging phenomenon. The findings may have potential applications in controlled image coding, rotation sensing and secure communication technologies.
Advancements in transfer printing techniques for flexible electronics: adjusting interfaces and promoting versatility
Authors: Chen Zijian , Zhang Chi , Zheng Zijian
Published: June 2024

The burgeoning interest in flexible electronics necessitates the creation of patterning technology specifically tailored for flexible substrates and complex surface morphologies. Among a variety of patterning techniques, transfer printing emerges as one of the most efficient, cost-effective, and scalable methods. It boasts the ability for high-throughput fabrication of 0–3D micro- and nano-structures on flexible substrates, working in tandem with traditional lithography methods. This review highlights the critical issue of transfer printing: the flawless transfer of devices during the pick-up and printing process. We encapsulate recent advancements in numerous transfer printing techniques, with a particular emphasis on strategies to control adhesion forces at the substrate/device/stamp interfaces. These strategies are employed to meet the requirements of competing fractures for successful pick-up and print processes. The mechanism, advantages, disadvantages, and typical applications of each transfer printing technique will be thoroughly discussed. The conclusion section provides design guidelines and probes potential directions for future advancements.
Enhancing defect detection in solid materials using low-duty cycle square wave lock-in thermography: a time-efficient and quantitative approach
Authors: Ma Botao , Ma Xiaolin , Wang Tengfei , Zhang Lin
Published: June 2024

Lock-in thermography has been used to detect material defects but has faced challenges in quantitatively identifying defects. Traditional methods with a sine wave or symmetrical square wave heat source require time-consuming frequency adjustments with multiple experiments. This study introduces a novel technique using a heat source of a low-duty cycle square wave in lock-in thermography. This harmonic-rich heat source provides information on the blind frequency and the depth of defects, significantly reducing testing time. This method was validated by finite element simulations, which generated phase maps and phase difference-frequency curves at multiple frequencies that located defects. The study explored the correlation between thermal diffusion length at the blind frequency and defect depth and the impact of transverse thermal diffusion on depth measurement. The findings indicate that phase maps at the optimal frequency are most suitable for measuring defect edges. This approach offers a promising, time-efficient, and quantitative solution for defect detection.
The Relevance of Belief Outsourcing to Whether Arguments Can Change Minds
Authors: Hill Scott
Published: June 2024

There is a wealth of evidence which indicates that arguments are not very efficient tools for changing minds. Against this scepticism, Dutilh Novaes (2023) presents evidence that, given the right social context, arguments sometimes play a significant role in belief revision. However, drawing on Levy (2021), I argue that the evidence Dutilh Novaes cites is compatible with the view that it is not arguments that change individual minds but instead belief outsourcing that occurs alongside the consideration of arguments.
The pronotum shape of scelimenine grasshoppers (Orthoptera: Tetrigidae) likely represents an exaptation for heterogeneous niche colonization
Authors: Rebrina Fran , Brigić Andreja , Kasalo Niko , Skejo Josip
Published: June 2024

Insects are suitable model organisms for functional morphology research, especially in the context of exaptation, when the same morphological trait represents an advantage in disparate niches. Phylogenetically distant groups of pygmy grasshoppers (Orthoptera: Tetrigidae) have various pronotal projections defining their general appearance and body shape. However, body shape has never been related to niche occupation in these insects, thus the aim of this study is to investigate the relationship between pronotum shape and macrohabitat adaptation in Scelimeninae, a group of Asian and Papuan tetrigids encompassing amphibious and corticolous (bark-dwelling) representatives. With the use of geometric morphometrics and phylogenetic comparative methods, two morphological and functional groups were distinguished, with the body shape exhibiting a significant phylogenetic signal. The first group consists of elongated amphibious taxa (Scelimenini tribe) with highly uniform pronotum morphology, likely due to a strong selection for streamlined body shape. Stouter corticolous taxa (Discotettigini tribe) exhibit more conspicuous body shape variability, possibly increasing camouflage efficiency in tree bark habitats. Ecological divergence associated with macrohabitat adaptation may thus have been the primary driver of speciation in this insect group, but the evolutionary constraints leading to this divergence are still to be identified.
The Grip Strength Loss Rate and the Subsequent Cognitive Decline Rate in Older Adults: The Moderating Role of Social Isolation
Authors: Li Yanzhi , Zhu Liwan , Zhang Caiyun , Zhao Hao , Wang Wanxin , Guo Lan , Lu Ciyong
Published: June 2024

Background and Objectives

Accumulating evidence suggests that low grip strength (GS) is associated with a faster cognitive decline, but most previous studies have measured GS at a single time point, ignoring changes in GS. We aimed to explore the association of the GS loss rate with the sequent cognitive decline, as well as the moderating role of social isolation in older adults.

Research Design and Methods

Data were from the English Longitudinal Study of Ageing. Absolute and relative GS loss rates were calculated as the annual losses from Wave 2 (2004–05) to Wave 4 (2008–09). Participants were divided into 3 groups according to the tertiles of GS loss rates. Linear mixed models were used to assess the association of the GS loss rate during Waves 2–4 with the cognitive decline rate during Waves 4–9 (Wave 9, 2018–19).

Results

Of the 4 356 participants included in analyses, 1 938 (44.5%) were men, with a mean age of 68.4 (SD: 8.4) years. Compared with Tertile 1 of the absolute GS loss rate, Tertile 2 (β = −0.009 [95% CI: −0.018 to −0.001] SD/year) and Tertile 3 (β = −0.018 [95% CI: −0.027 to −0.010] SD/year) were associated with a faster cognitive decline rate. The results of relative GS were similar to those of absolute GS. Social isolation was a significant modifier in the associations of the absolute GS loss rate with decline rates in global cognition and episodic memory, but not in temporal orientation. We did not observe that social isolation moderated the association of the relative GS loss rate with the cognitive decline rate.

Discussion and Implications

Both absolute and relative GS loss rates were positively associated with the cognitive decline rate in older adults. Low social isolation scores attenuated the association of the absolute GS loss rate with the cognitive decline rate.
Relationship between health system quality and racial and ethnic equity in diabetes care
Authors: Wong Michelle S , Tseng Chi-Hong , Moy Ernest , Jones Kenneth T , Kothari Amit J , Washington Donna L
Published: June 2024

Failing to consider disparities in quality measures, such as by race and ethnicity, may obscure inequities in care, which could exist in facilities with overall high-quality ratings. We examined the relationship between overall quality and racial and ethnic disparities in diabetes care quality by health care facility–level performance on a diabetes-related quality measure within a national dataset of veterans using Veterans Health Administration (VA) ambulatory care between March 1, 2020 and Feburary 28, 2021, and were eligible for diabetes quality assessment. We found racial and ethnic disparities in diabetes care quality existed in top-performing VA medical centers (VAMCs) among American Indian or Alaska Native (AIAN) (predicted probability = 30%), Black (predicted probability = 29%), and Hispanic VA-users (predicted probability = 30%) vs White VA-users (predicted probability = 26%). While disparities among Black and Hispanic VA-users were similar relative to White VA-users across VAMCs at all performance levels, disparities were exacerbated for AIAN and Native Hawaiian or Other Pacific Islander VA-users in bottom-performing VAMCs. Equity remains an issue even in facilities providing overall high-quality care. Integrating equity as a component of quality measures can incentivize greater focus on equity in quality improvement.
Perceptions of stimulant and buprenorphine diversion and strategies to address it
Authors: Uscher-Pines Lori , Sousa Jessica , Raja Pushpa , Mehrotra Ateev , Busch Alisa B , Huskamp Haiden A
Published: June 2024

There is ongoing policy debate on the prescribing of controlled substances such as buprenorphine and stimulants via telemedicine. The goal of federal and state policymakers is to ensure access to care while limiting diversion risk. However, there is little evidence on how clinicians view and address diversion and on telemedicine's role in diversion. From December 2023 to January 2024, we conducted semi-structured interviews with 21 psychiatrists and primary care physicians engaged in hybrid (telemedicine and in-person) care models in which we explored perceptions of diversion and strategies used to monitor for diversion. Most physicians reported monitoring for diversion, but there was little consistency on how monitoring was done and reported strategies did not differ between telemedicine vs in-person care. When physicians suspected diversion, there was also wide variation in responses: some clinicians did not immediately take any action while others imposed more requirements on patients (e.g., more frequent visits), no longer prescribed the controlled substance, or terminated the patient from their practice. Few physicians had ever reported a case of suspected diversion to law enforcement. Our findings suggest that the Drug Enforcement Administration could clarify reporting requirements and professional societies could provide additional guidance on how to respond to suspected diversion, given the current variation in practice across clinicians could be exploited by individuals who want to divert.
The Human Right to Land: A Peasant Struggle in the Human Rights System
Authors: Granet Valentine
Published: June 2024

Control and access to land are major concerns for peasants of the global south who face the longstanding consequences of colonialism and recent ‘land-rush’. What is the role of human rights in this peasant struggle? The UNDROP marks the international recognition of the right to land. However, as the very project of human rights is facing criticism and the effectiveness of this recognition remains uncertain, the question of whether using the human rights framework is even desirable arises. Arguing for a broader understanding of the actors and processes involved in the application and evolution of human rights, I explain that the process of obtaining the recognition of the right to land involved the mobilisation and re-modelling of human rights by grassroots organisations. I explore the potential of this mobilisation to transform common understandings of human rights, and its distinctive ability to support the necessary paradigm shift to transform peasants’ lives.
Three-dimensional modelling of aortic leaflet coaptation and load-bearing surfaces: in silico design of aortic valve neocuspidizations
Authors: Macé Loïc Georges , Fringand Tom , Cheylan Isabelle , Sabatier Laurent , Meille Laurent , Lenoir Marien , Favier Julien
Published: June 2024

OBJECTIVES

Three-dimensional (3D) modelling of aortic leaflets remains difficult due to insufficient resolution of medical imaging. We aimed to model the coaptation and load-bearing surfaces of the aortic leaflets and adapt this workflow to aid in the design of aortic valve neocuspidizations.

METHODS

Geometric morphometrics, using landmarks and semilandmarks, was applied to the geometric determinants of the aortic leaflets from computed tomography, followed by an isogeometric analysis using Non-Uniform Rational Basis Splines (NURBS). Ten aortic valve models were generated, measuring determinants of leaflet geometry defined as 3D NURBS curves, and leaflet coaptation and load-bearing surfaces were defined as 3D NURBS surfaces. Neocuspidizations were obtained by either shifting the upper central coaptation landmark towards the sinotubular junction or using parametric neo-landmarks placed on a centreline drawn between the centroid of the aortic root base and centroid of a circle circumscribing the 3 upper commissural landmarks.

RESULTS

The ratio of the leaflet free margin length to the geometric height was 1.83, whereas the ratio of the commissural coaptation height to the central coaptation height was 1.93. The median coaptation surface was 137 mm2 (IQR 58) and the median load-bearing surface was 203 mm2 (60) per leaflet. Neocuspidization multiplied the central coaptation height by 3.7 and the coaptation surfaces by 1.97 and 1.92 using the native coaptation axis and centroid coaptation axis, respectively.

CONCLUSIONS

Geometric morphometrics reliably defined the coaptation and load-bearing surfaces of aortic leaflets, enabling an experimental 3D design for the in silico neocuspidization of aortic valves.
Synovial chondromatosis of the distal radioulnar joint—a rare case
Authors: Mert Sinan , Nuernberger Tim , Hesse Nina , Haas-Lützenberger Elisabeth M
Published: June 2024

Unclear wrist tumors are a common clinical presentation in patients with pain and movement restrictions of the wrist. We report a rare case of a benign tumor of the wrist in a 63-year-old female patient who presented with a ganglion-like swelling of the right hand. After examination and preoperative radiological diagnostics, the indication for an open surgery was indicated for resection of either a typical ganglion cyst or a peripheral nerve sheath tumor was made. Interestingly, the suspected diagnosis was not correct. The intraoperative finding and histological analysis revealed typical findings of synovial chondromatosis of the distal radioulnar joint. Although synovial chondromatosis is a relatively rare, and even rarer in the wrist, it is important to consider it as a differential diagnosis when a patient presents with a ‘simple’ wrist ganglion.
Principles of amyloplast replication in the ovule integuments of Arabidopsis thaliana
Authors: Fujiwara Makoto T , Yoshioka Yasushi , Kazama Yusuke , Hirano Tomonari , Niwa Yasuo , Moriyama Takashi , Sato Naoki , Abe Tomoko , Yoshida Shigeo , Itoh Ryuuichi D
Published: June 2024

Plastids in vascular plants have various differentiated forms, among which amyloplasts are crucial for starch storage and plant productivity. Despite the vast knowledge of the binary-fission mode of chloroplast division, our understanding of the replication of non-photosynthetic plastids, including amyloplasts, remains limited. Recent studies have suggested the involvement of stromules (stroma-filled tubules) in plastid replication when the division apparatus is faulty. However, details of the underlying mechanism(s) and their relevance to normal processes have yet to be elucidated. Here, we developed a live analysis system for studying amyloplast replication using Arabidopsis (Arabidopsis thaliana) ovule integuments. We showed the full sequence of amyloplast development and demonstrated that wild-type amyloplasts adopt three modes of replication, binary fission, multiple fission, and stromule-mediated fission, via multi-way placement of the FtsZ ring. The minE mutant, with severely inhibited chloroplast division, showed marked heterogeneity in amyloplast size, caused by size-dependent but wild-type modes of plastid fission. The dynamic properties of stromules distinguish the wild-type and minE phenotypes. In minE cells, extended stromules from giant amyloplasts acquired stability, allowing FtsZ ring assembly and constriction, as well as the growth of starch grains therein. Despite hyper-stromule formation, amyloplasts did not proliferate in the ftsZ null mutant. These data clarify the differences between amyloplast and chloroplast replication and demonstrate that the structural plasticity of amyloplasts underlies the multiplicity of their replication processes. Furthermore, this study shows that stromules can generate daughter plastids via the assembly of the FtsZ ring.
Transcription factor GmAlfin09 regulates endoplasmic reticulum stress in soybean via peroxidase GmPRDX6
Authors: Chen Kai , Guo Dongdong , Yan Jiji , Zhang Huijuan , He Zhang , Wang Chunxiao , Tang Wensi , Chen Jun , Xu Zhaoshi , Ma Youzhi , Chen Ming
Published: June 2024

Soybean (Glycine max [L.] Merr.) is a valuable oil crop but is also highly susceptible to environmental stress. Thus, developing approaches to enhance soybean stress resistance is vital to soybean yield improvement. In previous studies, transcription factor Alfin has been shown to serve as an epigenetic regulator of plant growth and development. However, no studies on Alfin have yet been reported in soybean. In this study, the endoplasmic reticulum (ER) stress- and reactive oxygen species (ROS)-related GmAlfin09 was identified. Screening of genes co-expressed with GmAlfin09 unexpectedly led to the identification of soybean peroxidase 6 (GmPRDX6). Further analyses revealed that both GmAlfin09 and GmPRDX6 were responsive to ER stress, with GmPRDX6 localizing to the ER under stress. Promoter binding experiments confirmed the ability of GmAlfin09 to bind to the GmPRDX6 promoter directly. When GmAlfin09 and GmPRDX6 were overexpressed in soybean, enhanced ER stress resistance and decreased ROS levels were observed. Together, these findings suggest that GmAlfin09 promotes the upregulation of GmPRDX6, and GmPRDX6 subsequently localizes to the ER, reduces ROS levels, promotes ER homeostasis, and ensures the normal growth of soybean even under ER stress. This study highlights a vital target gene for future molecular breeding of stress-resistant soybean lines.
Comparative time-dependent proteomics reveal the tolerance of cancer cells to magnetic iron oxide nanoparticles
Authors: Liu Yanqing , Meng Yuqing , Zhu Yongping , Gu Liwei , Ma Ang , Liu Rui , Liu Dandan , Shen Shengnan , Zhang Shujie , Xu Chengchao , Zhang Junzhe , Wang Jigang
Published: June 2024

Cancer is one of the most challenging diseases in the world. Recently, iron oxide nanoparticles (IONPs) are emerging materials with rapid development and high application value, and have shown great potential on tumor therapy due to their unique magnetic and biocompatible properties. However, some data hint us that IONPs were toxic to normal cells and vital organs. Thus, more data on biosafety evaluation is urgently needed. In this study, we compared the effects of silicon-coated IONPs (Si-IONPs) on two cell types: the tumor cells (Hela) and the normal cells (HEK293T, as 293 T for short), compared differences of protein composition, allocation and physical characteristics between these two cells. The major findings of our study pointed out that 293 T cells death occurred more significant than that of Hela cells after Si-IONPs treatment, and the rate and content of endocytosis of Si-IONPs in 293 T cells was more prominent than in Hela cells. Our results also showed Si-IONPs significant promoted the production of reactive oxygen species and disturbed pathways related to oxidative stress, iron homeostasis, apoptosis and ferroptosis in both two types of cells, however, Hela cells recovered from these disturbances more easily than 293 T. In conclusion, compared with Hela cells, IONPs are more likely to induce 293 T cells death and Hela cells have their own unique mechanisms to defense invaders, reminding scientists that future in vivo and in vitro studies of nanoparticles need to be cautious, and more safety data are needed for further clinical treatment.
Association of ankylosing spondylitis with the risk of cancer: a meta-analysis of cohort studies
Authors: Yu Lulin , Yan Yici , Liu Wenjing , Huang Siyu , Sun Leitao , Ruan Shanming
Published: June 2024

Objectives

The potential impact of ankylosing spondylitis (AS) on cancer risk remains unclear. This study seeks to investigate the relationship between AS and different types of cancers.

Methods

A literature search on PubMed, EMBASE and Cochrane Library up to 10 July 2023 was conducted. Two investigators selected eligible studies and extracted relevant data. The study used the random-effects model to explore the causality between AS and cancer, utilizing relative risk (RR) as a measure for the study.

Results

A total of 20 cohorts with >330 000 participants were included. The pooling analysis shows AS being associated with a higher risk of cancers (RR = 1.16, 95% CI: 1.07–1.26, P = 0.001, I2 = 70.60%). In the subgroup analysis, AS has a higher cancer risk in Asia, but this association is not significant in Europe. Individual investigations indicate that AS is associated with an increased risk of bone cancer (RR = 3.41, 95% CI: 1.45–7.99, P = 0.005, I2 = 0.00%), thyroid gland cancer (RR = 1.76, 95% CI: 1.29–2.40, P < 0.001, I2 = 13.70%), multiple myeloma (RR = 1.74, 95% CI: 1.42–2.15, P < 0.001, I2 = 27.20%), leukaemia (RR = 1.52, 95% CI: 1.27–1.82, P < 0.001, I2 = 0.00%), kidney cancer (RR = 1.45, 95% CI: 1.08–1.94, P = 0.014, I2 = 0.00%), prostate cancer (RR = 1.43, 95% CI: 1.17–1.74, P < 0.001, I2 = 82.80%) and non-Hodgkin’s lymphoma (RR = 1.42, 95% CI: 1.17–1.73, P < 0.001, I2 = 0.00%). However, there is no significant correlation with connective tissue cancer, brain cancer, testicular and other male cancers, bladder cancer, female cancers, skin cancer, and cancers of the digestive system and respiratory system.

Conclusion

AS appears to be related to cancer development. The results highlighted the necessity for large-scale studies, considering influencing factors such as AS course, medication histories and potential biases when examining cancer risk.
Perceptions in Orthopedic Surgery on the Use of Cannabis in Treating Pain: A Survey of Musculoskeletal Trauma Patients—Results From the Canadian POSIT Study
Authors: Gjorgjievski Marko , Madden Kim , Bullen Conner , Koziarz Frank , Koziarz Alex , Cenic Aleksa , Li Silvia , Bhandari Mohit , Johal Herman
Published: June 2024

OBJECTIVES:

To evaluate the patient-reported expectations regarding cannabis for pain following musculoskeletal (MSK) trauma and patients' perceptions and attitudes regarding its use.

METHODS:

Design:

A cross-sectional retrospective survey-based study.

Setting:

Three orthopaedic clinics in Ontario (Level-1 trauma center, Level-2 trauma center, rehabilitation clinic).

Patients Selection Criteria:

Adult patients presenting to the clinics from January 24, 2018, to March 7, 2018, with traumatic MSK injuries (fractures/dislocations and muscle/tendon/ligament injury) were administered an anonymous questionnaire on cannabis for MSK pain.

Outcome Measures and Comparisons:

Primary outcome measure was the patients' perceived effect of cannabis on MSK pain, reported on a continuous pain scale (0%–100%, 0 being no pain, and 100 unbearable pain). Secondary outcomes included preferences, such as administration route, distribution method, timing, and barriers (lack of knowledge, concerns for side effects/addiction, moral/religious opposition, etc.) regarding cannabis use.

RESULTS:

In total, 440 patients were included in this study, 217 (49.3%) of whom were female and 222 (50.5%) were male, with a mean age of 45.6 years (range 18–92 years, standard deviations 15.6). Patients estimated that cannabis could treat 56.5% (95% CI 54.0%–59.0%) of their pain and replace 46.2% (95% CI 42.8%–49.6%) of their current analgesics. Nearly one-third (131/430, 30.5%) reported that they had used medical cannabis and more than one-quarter (123/430, 28.6%) used it in the previous year. Most felt that cannabis may be beneficial to treat pain (304/334, 91.0%) and reduce opioid use (293/331, 88.5%). Not considering using cannabis for their injury (132/350, 37.7%) was the most common reason for not discussing cannabis with physicians. Higher reported pain severity (β = 0.2/point, 95% CI 0.1–0.3, P = 0.005) and previous medical cannabis use were associated with higher perceived pain reduction (β = 11.1, 95% CI 5.4–16.8, P < 0.001).

CONCLUSIONS:

One in 3 orthopaedic trauma patients used medical cannabis. Patients considered cannabis could potentially be an effective option for managing traumatic MSK pain and believed that cannabis could reduce opioid usage following acute musculoskeletal trauma. These data will help inform clinicians discussing medical cannabis usage with orthopaedic trauma patients moving forward.
Systematic review of swine models for ventricular fibrillation induction in evaluating cardiopulmonary resuscitation methods
Authors: Low Gary Kim Kuan , Azahar Aizad , Samson Emmanuel , Rane Prutha
Published: June 2024

Background and purpose:

Ventricular fibrillation (VF) has been studied using a variety of swine models, historically balloon occlusion of the coronary artery and asphyxiation, and more recently, percutaneous electrical induction. These methods differ in face and construct validity, as well as requirement for expertise, cost, and duration. This study aimed to provide a systematic review these methods and their selection in research.

Methods:

Electronic searches were conducted in PubMed, Scopus, and Google Scholar. The Utstein-Style Guidelines for Uniform Reporting of Laboratory cardiopulmonary resuscitation (CPR) research were used to identify the extracted variables by two independent investigators. Discrepancy was resolved by discussion with the third investigator.

Results:

We included 236 studies published from 1990 to 2024. The most commonly used method was electrical induction using a pacing wire cannulated through the external jugular vein into the right ventricle (n = 112), followed by transthoracic electrical induction (n = 28), asphyxiation (n = 20), electrical induction via two subcutaneous needles (n = 15), and balloon occlusion (n = 10). The mean and standard deviation (SD) of the untreated VF duration were 6.9 and 5.0 minutes, respectively. Female and male pigs were used exclusively in 52 and 45 studies, respectively; both sexes were used in 31 studies; 106 studies not reporting the sex. The mean weight of the pigs was 30.2  ± 12.4 kg in 209 studies, and the number of pigs used in the studies ranged from 2 to 271 with a median of 20 (interquartile range: 15–30) pigs in 223 studies. The four most commonly used drugs for anesthesia/preparation were ketamine (n = 145), propofol (n = 76), isoflurane (n = 68), and pentobarbital (n = 61), either alone or in combination. Higher current and voltage were used for less invasive methods.

Conclusions:

The two most common electric method to induce VF were invasive pacing at the right ventricle and non-invasive transthoracic electrical induction. Asphyxiation was the most common ischemic VF induction. The choice of the VF induction method depends on cost, expertise, feasibility, and the nature of the CPR intervention to be tested.
The impact of MELD exception points for hydrothorax on posttransplant mortality: a propensity score-matched analysis
Authors: Fathma Sawsan , Boateng Sarpong , Amatya Ayesha , Ameyaw Prince , Banini Bubu A.
Published: June 2024

Background

Hepatic hydrothorax is a challenging complication of end-stage liver disease, and.patients with this complication can receive model for end-stage liver disease (MELD) exception points if they meet specific criteria as defined by United Network for Organ Sharing (UNOS). This research aimed to analyze the effect of receiving MELD exception points for hepatic hydrothorax on posttransplant mortality, using a national transplant database.

Methods

Patients >18 years in the UNOS database awaiting liver transplant between 2012 and 2023 were identified based on their petition for MELD exception points. Using a 1: 1 propensity score-matched analysis, 302 patients who received MELD exception points for hepatic hydrothorax were compared with 302 patients who did not receive MELD exception points.Demographic, clinical and laboratory values were compared. The primary outcome was posttransplant mortality. Multivariate logistic regression controlled for potential confounders.

Results

No significant difference was observed in mean age (58.20 vs 57.62 years), mean initial MELD score (16.93 vs 16.54), or mean Child–Pugh score (9.77 vs 9.74) in patients with hepatic hydrothorax receiving MELD exception points versus their matched cohort who did not recieve exception points. The proportion of males was slightly higher among patients who received MELD exception points (57.6% males vs 53.6% males). A majority of patients in both groups had Child–Pugh grade C (>56%). Patients receiving MELD exception points for hepatic hydrothorax had a statistically significant 44% decrease in the odds of posttransplant death compared to those who did not (OR 0.56; 95% CI 0.37–0.88; P = 0.01). Among the combined cohort, each year increase in age resulted in a 3.9% increase in mortality (OR 1.04; 95% CI 1.01–1.07; P = 0.005), and every one-unit increase in serum creatinine resulted in a 40% increase in mortality (OR 1.40; 95% CI 1.03–1.92; P = 0.03).

Conclusion

Receiving MELD exception points for hepatic hydrothorax is associated with a significant reduction in the odds of posttransplant mortality. These findings underscore the importance of MELD exception points for hepatic hydrothorax among patients with decompensated cirrhosis, potentially improving patient prioritization for liver transplantation and influencing clinical decision-making.
The second Irish Helicobacter pylori Working Group consensus for the diagnosis and treatment of Helicobacter pylori infection in adult patients in Ireland
Authors: Smith Sinéad M. , Boyle Breida , Buckley Martin , Costigan Conor , Doyle Maeve , Farrell Richard , Ismail M. Syafiq , Kevans David , Nugent Sean , O’Connor Anthony , O’Morain Colm , Parihar Vikrant , Ryan Cristín , McNamara Deirdre
Published: June 2024

Background

There has been an increase in resistance to many of the antimicrobials used to treat Helicobacter pylori (H. pylori) nationally and internationally. Primary clarithromycin resistance and dual clarithromycin and metronidazole resistance are high in Ireland. These trends call for an evaluation of best-practice management strategies.

Objective

The objective of this study was to revise the recommendations for the management of H. pylori infection in adult patients in the Irish healthcare setting.

Methods

The Irish H. pylori working group (IHPWG) was established in 2016 and reconvened in 2023 to evaluate the most up-to-date literature on H. pylori diagnosis, eradication rates and antimicrobial resistance. The ‘GRADE’ approach was then used to rate the quality of available evidence and grade the resulting recommendations.

Results

The Irish H. pylori working group agreed on 14 consensus statements. Key recommendations include (1) routine antimicrobial susceptibility testing to guide therapy is no longer recommended other than for clarithromycin susceptibility testing for first-line treatment (statements 6 and 9), (2) clarithromycin triple therapy should only be prescribed as first-line therapy in cases where clarithromycin susceptibility has been confirmed (statement 9), (3) bismuth quadruple therapy (proton pump inhibitor, bismuth, metronidazole, tetracycline) is the recommended first-line therapy if clarithromycin resistance is unknown or confirmed (statement 10), (4) bismuth quadruple therapy with a proton pump inhibitor, levofloxacin and amoxicillin is the recommended second-line treatment (statement 11) and (5) rifabutin amoxicillin triple therapy is the recommend rescue therapy (statement 12).

Conclusion

These recommendations are intended to provide the most relevant current best-practice guidelines for the management of H. pylori infection in adults in Ireland.
Pilomatricoma of the calf: a case report and review of literature
Authors: Bourabaa Soukayna , Bourouail Othmane , Arsalan Othman , Elbarkaoui Zakaria , Rguieg Naji , Souadka Amine
Published: June 2024

Introduction and importance:

Pilomatricoma (PMC) is a benign adnexal dermal or subcutaneous tumor, which is derived from immature hair matrix cells. It makes up around 20% of all tumors related to hair follicles in most series and is therefore the most common hair-follicle neoplasm. Nevertheless, diagnosing it remains intricate due to the prevalence of more frequent pathological conditions in soft-tissue. Anatomopathological examination proves to be a valuable asset, offering a definitive and certain diagnosis.

Case presentation:

The authors hereby present a case of a 17-year-old patient with no medical history, who was referred to our medical unit subsequent to the emergence of swelling in the right calf. MRI results highlighted the presence of a subcutaneous nodule situated on the right calf. Following a percutaneous biopsy, the diagnosis of PMC was definitively confirmed. A successful surgical excision of the tumor was performed, and the postoperative progress demonstrated positive outcomes.

Clinical discussion:

PMC usually appears as flesh-colored to white, firm papules or papulonodules that may have an overlying pink to blue hue. MRI plays a crucial role in diagnosis, as it delineates the tumor’s extent in relation to the skin and muscle compartments. Preoperative histological confirmation is essential to rule out other potential diagnoses and precisely establish the required resection margins.

Conclusion:

PMC is an infrequent occurrence in general surgery departments. General surgeons should, however, be well-acquainted with this benign tumor while assessing soft-tissue masses.
Minimally invasive approaches versus conventional sternotomy for aortic valve replacement in patients with aortic valve disease: a systematic review and meta-analysis of 17 269 patients
Authors: Khalid Saad , Hassan Muhammad , Ali Abraish , Anwar Farah , Siddiqui Mishal Shan , Shrestha Sunita
Published: June 2024

Background:

Aortic valve replacement (AVR) is a common procedure for aortic valve pathologies, particularly in the elderly. While traditional open AVR is established, minimally invasive techniques aim to reduce morbidity and enhance treatment outcomes. The authors’ meta-analysis compares these approaches with conventional sternotomy, offering insights into short and long-term mortality and postoperative results. This study provides valuable evidence for informed decision-making between conventional and minimally invasive approaches for AVR.

Materials and methods:

Till August 2023, PubMed, Embase, and MEDLINE databases were searched for randomized controlled trials (RCT) and propensity score matched (PSM) studies comparing minimally invasive approaches [mini-sternotomy (MS) and right mini-thoracotomy (RMT)] with full sternotomy (FS) for AVR. Various outcomes were analyzed, including mortality rates, bypass and clamp times, length of hospital stay, and complications. Risk ratios (RR) and the weighted mean differences (WMD) with corresponding 95% CIs were calculated using Review Manager.

Results:

Forty-eight studies were included having 17 269 patients in total. When compared to FS, there was no statistically significant difference in in-hospital mortality in MS (RR:0.80; 95% CI:0.50–1.27; I2=1%; P=0.42) and RMT (RR:0.70; 95% CI:0.36–1.35; I2=0%; P=0.29). FS was also linked with considerably longer cardiopulmonary bypass duration than MS (MD:8.68; 95% CI:5.81–11.56; I2=92%; P=0.00001). The hospital length of stay was determined to be shorter in MS (MD:−0.58; 95% CI:−1.08 to −0.09; I2=89%; P=0.02) with no statistically significant difference in RMT (MD:−0.67; 95% CI:−1.42 to 0.08; I2=84%; P=0.08) when compared to FS.

Conclusions:

While mortality rates were comparable in minimally invasive approaches and FS, analysis shows that MS, due to fewer respiratory and renal insufficiencies, as well as shorter hospital and ICU stay, may be a safer approach than both RMT and FS.
Percutaneous endocardial septal radiofrequency ablation on syncope in patients with hypertrophic obstructive cardiomyopathy: a short-term safety and efficacy study
Authors: Tian Aiju , Zhang Tianjing , Jia Yuhe , Liu Jun , Guo Xiaogang , Fang Pihua , Tang Min , Chen Keping , Yao Yan
Published: June 2024

Background:

Syncope is a serious consequence in patients with hypertrophic obstructive cardiomyopathy (HOCM). Percutaneous endocardial septal radiofrequency ablation (PESA) has emerged as a promising intervention to alleviate symptoms and enhance the quality of life for HOCM patients. However, little is known about the effects of PESA on syncope in HOCM. The authors aimed to study the effects of PESA on syncope in patients with HOCM.

Materials and methods:

Nineteen patients with HOCM and syncope were enrolled. The left ventricular outflow tract gradient (LVOTG) of the patients was more than 50 mmHg despite medication. The participants underwent PESA under the guidance of intracardiac echocardiography (ICE) combined with a three-dimensional electrophysiological mapping system. The patients were followed for 3 (3-5.5) months.

Results:

The mean age of the patients was 54.8±13.7 years. Out of the 19 participants, 7 (37%) were females. During the follow-up, the syncope was completely alleviated in 14 patients (73.7%) or the syncope episodes were reduced greater than or equal to 80% in 16 patients (84.2%). The mean NYHA functional class significantly improved from 2.2±0.7 at baseline to 1.7±0.6 during follow-up (P=0.002). The LVOTG and septal thickness showed a decreasing trend from baseline to follow-up (LVOTG: P=0.083, septal thickness: P=0.086).

Conclusion:

The authors’ investigation provides evidence supporting the effectiveness of PESA in reducing syncope episodes in patients with HOCM.
Successful Treatment Without Using Dantrolene Sodium on a Child Occurring Malignant Hyperthermia During Induction of General Anesthesia: A Case Report
Authors: Zheng Qiaoyuan , Liu Na , Zeng Yang , Chen Yuan , Zhang Huiwen , Su Xueshang , Zhuang Jun
Published: June 2024

Malignant hyperthermia (MH) is a fatal hyperthermia with a high mortality, which usually occurs during induction of general anesthesia. Dantrolene sodium is a wonder drug currently used for treating malignant hyperthermia. However, preparing, storing, and maintaining dantrolene sodium are crucially expensive, thus making it financially unsatisfactory and difficult for clinicians to acquire in time. Monitoring patients’ condition closely and intervening promptly when early signs of malignant hyperthermia occur can effectively prevent the condition from worsening and win over time for the arrival of dantraline sodium. This article is to report a case in which we successfully rescued a child occurring malignant hyperthermia without using dantrolene sodium.