bluuebunny/crossref_metadata_2025 huggingface dataset:
Associations between PM2.5 and its chemical constituents and blood pressure: a cross-sectional study
Authors: Dong Shu , Yu Bin , Yin Chun , Li Yuchen , Zhong Wenling , Feng Chuanteng , Lin Xi , Qiao Xu , Yin Yanrong , Wang Zihang , Chen Tiehui , Liu Hongyun , Jia Peng , Li Xiaoqing , Yang Shujuan
Published: September 2024

Objectives:

To investigate the associations between PM2.5 and its chemical constituents with blood pressure (BP), assess effects across BP quantiles, and identify the key constituent elevating BP.

Methods:

A total of 36 792 adults were included in the cross-sectional study, representing 25 districts/counties of southeast China. Quantile regression models were applied to estimate the associations of PM2.5 and its chemical constituents (ammonium [NH4
+], nitrate [NO3
−], sulfate [SO4
2−], black carbon [BC], organic matter [OM]) with systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean artery pressure (MAP). A weighted quantile sum (WQS) index was used to estimate the relative importance of each PM2.5 chemical constituent to the joint effect on BP.

Results:

The adverse effects of each interquartile range (IQR) increase in PM2.5, NH4
+, NO3
−, SO4
2−, and BC on BP were found to be greater with elevated BP, especially when SBP exceeded 133 mmHg and DBP exceeded 82 mmHg. Each IQR increase in all five PM2.5 chemical constituents was associated with elevated SBP (β [95% CI]: 0.90 [0.75, 1.05]), DBP (β: 0.44 [0.34, 0.53]), and MAP (β: 0.57 [0.45, 0.69]), NH4
+ (for SBP: weight = 99.43%; for DBP: 12.78%; for MAP: 60.73%) and BC (for DBP: 87.06%; for MAP: 39.07%) predominantly influencing these effects. The joint effect of PM2.5 chemical constituents on risks for elevated SBP and DBP exhibited an upward trend from the 70th quantile (SBP exceeded 133 mmHg, DBP exceeded 82 mmHg).

Conclusion:

Long-term exposure to PM2.5 and its chemical constituents was associated with increased risk for elevated BP, with NH4
+ and BC being the main contributors, and such associations were significantly stronger at 70th to 90th quantiles (SBP exceeded 133 mmHg, DBP exceeded 82 mmHg).
Cardiovascular and all-cause mortality outcomes of adrenalectomy versus medical treatment in primary aldosteronism: an umbrella review
Authors: Nayak Sandeep S. , Amini-Salehi Ehsan , Joukar Farahnaz , Biswas Pubali , Nobakht Sara , Letafatkar Negin , Porteghali Parham , Mohammadi-Vajari Erfan , Mansour-ghanaei Fariborz , Javid Mona , Mirdamadi Arian , Ameen Daniyal , Motamed Behrang , Hassanipour Soheil , Keivanlou Mohammad-Hossein
Published: September 2024

Background:

Primary aldosteronism (PA) is now recognized as the most prevalent form of secondary hypertension globally, contributing significantly to cardiovascular morbidity and mortality. This umbrella review aims to systematically compare cardiovascular outcomes and all-cause mortality in PA patients undergoing adrenalectomy versus mineralocorticoid receptor antagonist (MRA) treatment, aiming to inform optimal management strategies.

Method:

Following PRISMA guidelines (Supplemental Digital Content 1, http://links.lww.com/JS9/D386) (Supplemental Digital Content 2, http://links.lww.com/JS9/D387), a comprehensive search strategy was employed across multiple databases. Meta-analyses focusing on cardiovascular outcomes or all-cause mortality, comparing adrenalectomy and MRAs treatment in PA patients, were included. Studies were independently screened and assessed for quality using AMSTAR 2 (Supplemental Digital Content 3, http://links.lww.com/JS9/D388) and GRADE checklists.

Results:

A total of eight studies met the inclusion criteria. Adrenalectomy showed potential benefits over MRAs in reducing the risk of arrhythmias (OR=2.17; 95% CI: 1.25–3.76) and major adverse cardiovascular events (OR=1.81; 95% CI: 1.33–2.46). Patients treated with MRAs exhibited a higher risk of cardiovascular events (OR=1.23; 95% CI: 1.05–1.44), hypertension (OR=3.22; 95% CI: 1.15–8.97), and all-cause mortality (OR=3.03; 95% CI: 1.36–6.70) compared to adrenalectomy.

Conclusion:

Adrenalectomy appears to offer favorable outcomes compared to MRAs treatment in PA patients, particularly in reducing the risk of major adverse cardiovascular events and all-cause mortality. These findings suggest the importance of considering surgical intervention as a primary treatment modality for PA.
Emergency airway management in the post anesthesia care unit
Authors: Spruijt Bart , Huitink Johannes M.
Published: September 2024

Purpose of review

Airway management is one of the most challenging aspects in the field of anesthesia. This is also the case when an emergency airway situation arises in the postoperative patient. These airway procedures are often classified as advanced with high complexity. This article aims to address emergency airway management in the post anesthesia care unit.

Recent findings

The way in which care and supervision are organized in the post anesthesia care unit (PACU) varies between hospitals. Airway management in the PACU has typical challenges related to the team, the location itself, and assembling the necessary equipment for airway rescue. Crew resource management is an important aspect of care in these situations.

This article focuses on emergency airway management in the post anesthesia-care unit. A questionnaire for risk assessment and improvement of quality of care is presented. Different types of emergencies are discussed, i.e., due to medication, medical conditions (e.g., obstructive sleep apnea, pulmonary problems, stridor), procedural related emergencies (e.g., neurosurgery, head and neck surgery) and cardiac arrest. Each specific cause of emergency needs a different approach. A PACU airway rescue flowchart is presented.
Advances in critical care nephrology through artificial intelligence
Authors: Cheungpasitporn Wisit , Thongprayoon Charat , Kashani Kianoush B.
Published: September 2024

Purpose of review

This review explores the transformative advancement, potential application, and impact of artificial intelligence (AI), particularly machine learning (ML) and large language models (LLMs), on critical care nephrology.

Recent findings

AI algorithms have demonstrated the ability to enhance early detection, improve risk prediction, personalize treatment strategies, and support clinical decision-making processes in acute kidney injury (AKI) management. ML models can predict AKI up to 24–48 h before changes in serum creatinine levels, and AI has the potential to identify AKI sub-phenotypes with distinct clinical characteristics and outcomes for targeted interventions. LLMs and generative AI offer opportunities for automated clinical note generation and provide valuable patient education materials, empowering patients to understand their condition and treatment options better. To fully capitalize on its potential in critical care nephrology, it is essential to confront the limitations and challenges of AI implementation, including issues of data quality, ethical considerations, and the necessity for rigorous validation.

The integration of AI in critical care nephrology has the potential to revolutionize the management of AKI and continuous renal replacement therapy. While AI holds immense promise for improving patient outcomes, its successful implementation requires ongoing training, education, and collaboration among nephrologists, intensivists, and AI experts.
Cerebral oximetry in high-risk surgical patients: where are we?
Authors: Navarro-Perez Rosalia , Romero-García Nekane , Paolessi Camilla , Robba Chiara , Badenes Rafael
Published: September 2024

Purpose of review

This review aims to summarize the latest evidence on the role of near-infrared spectroscopy (NIRS) in monitoring cerebral oxygenation in high-risk surgical patients, including both cardiac and noncardiac surgeries, and to present a new algorithm for its application.

Recent findings

NIRS effectively measures brain oxygen saturation noninvasively, proving valuable in cardiac surgeries to reduce neurological complications, though its impact on nonneurological outcomes is less clear. In noncardiac surgeries, NIRS can help prevent complications like postoperative cognitive dysfunction, particularly in high-risk and major surgeries. Studies highlight the variability of cerebral oxygenation impacts based on surgical positions, with mixed results in positions like the beach chair and sitting positions. A structured algorithm for managing cerebral desaturation has been proposed to optimize outcomes by addressing multiple factors contributing to blood oxygen content and delivery.

Despite its limitations, including spatial resolution and interindividual variability, NIRS is a useful tool for intraoperative cerebral monitoring. Further studies are needed to confirm its broader applicability in noncardiac surgeries, but current evidence supports its role in reducing postoperative complications especially in cardiac surgeries.
Re-evaluating intra-cardiac arrest adjunctive medications and routes of drug administration
Authors: Lind Peter C. , Vallentin Mikael F. , Granfeldt Asger , Andersen Lars W.
Published: September 2024

Purpose of review

This narrative review summarizes the evidence for the most commonly used intra-cardiac arrest adjunctive medications and routes of administration and discusses promising new therapies from preclinical animal models.

Recent findings

Large trials on the administration of calcium as well as the combination of vasopressin and glucocorticoids during cardiac arrest have been published. Calcium administration during cardiopulmonary resuscitation does not improve outcomes and might cause harm. Vasopressin and glucocorticoid administration during cardiopulmonary resuscitation improve the chance of return of spontaneous circulation but has uncertain effects on survival. We identified a total of seven ongoing clinical trials investigating the potential role of bicarbonate, of vasopressin and glucocorticoids, and of intravenous versus intraosseous vascular access. Several medications such as levosimendan and inhaled nitric oxide show promise in preclinical studies, and clinical trials are either planned or actively recruiting.

Large trials on intra-cardiac arrest administration of calcium and vasopressin with glucocorticoids have been performed. Several trials are ongoing that will provide valuable insights into the potential benefit of other intra-cardiac arrest medications such as bicarbonate as well as the potential benefit of intravenous or intraosseous vascular access.
Clinical Interventions and Hemodynamic Monitoring in the Setting of Left Ventricular Systolic Heart Failure in Children: Insights From a Physiologic Simulator
Authors: Loomba Rohit S. , Savorgnan Fabio , Acosta Sebastian , Elhoff Justin J. , Farias Juan S. , Villarreal Enrique G. , Flores Saul
Published: September 2024

Background:

In pediatric critical care, vasoactive/inotropic support is widely used in patients with heart failure, but it remains controversial because the influence of multiple medications and the interplay between their inotropic and vasoactive effects on a given patient are hard to predict. Robust evidence supporting their use and quantifying their effects in this group of patients is scarce.

Study Question:

The aim of this study was to characterize the effect of vasoactive medications on various cardiovascular parameters in pediatric patient with decreased ejection fraction.

Study Design:

Clinical-data based physiologic simulator study.

Measure and Outcomes:

We used a physics-based computer simulator for quantifying the response of cardiovascular parameters to the administration of various types of vasoactive/inotropic medications in pediatric patients with decreased ejection fraction. The simulator allowed us to study the impact of increasing medication dosage and the simultaneous administration of some vasoactive agents. Correlation and linear regression analyses yielded the quantified effects on the vasoactive/inotropic support.

Results:

Cardiac output and systemic venous saturation significantly increased with the administration of dobutamine and milrinone in isolation, and combination of milrinone with dobutamine, dopamine, or epinephrine. Both parameters decreased with the administration of epinephrine and norepinephrine in isolation. No significant change in these hemodynamic parameters was observed with the administration of dopamine in isolation.

Conclusions:

Milrinone and dobutamine were the only vasoactive medications that, when used in isolation, improved systemic oxygen delivery. Milrinone in combination with dobutamine, dopamine, or epinephrine also increased systemic oxygen delivery. The induced increment on afterload can negatively affect systemic oxygen delivery.
Alterations in serum levels of calcium, vitamin D, phosphorus, and parathyroid hormone in patients with clinically confirmed familial hypercholesterolemia: a cross-sectional study
Authors: Heshmat-Ghahdarijani Kiyan , Vaseghi Golnaz , Hajian Shabnam , Taheri Marzieh , Haghjooy-Javanmard Shaghayegh , Sarrafzadegan Nizal , Habibi Danial , Babak Anahita , Rabiee Rad Mehrdad
Published: September 2024

Background:

Familial hypercholesterolemia (FH), an autosomal dominant disease, is associated with an increased risk of premature cardiovascular disease (CVD). This study aimed to examine the variations in serum levels of calcium, vitamin D, phosphorus, and parathyroid hormone (PTH) among FH patients, as these factors have been associated with an increased susceptibility to CVD.

Materials and methods:

In this cross-sectional study, the authors used data from Isfahan FH registry. The Dutch Lipid Clinic Network (DLCN) criteria was used for diagnoses of FH patients. Control group included participants with hyperlipidemia and were unlikely FH according to DLCN criteria. All biochemical parameters were measured using standard methods.

Results:

A total of 131 patients (mean age, 53.1 ± 12.2; male, 51.4%) were included in the analysis. Patients with FH had lower serum vitamin D levels compared with control groups in the unadjusted model (P= 0.028). The relationship between serum vitamin D and FH was not significant after adjustment for traditional risk factor (P= 0.184). No significant association was observed between FH and serum calcium (P= 0.886), phosphorus (P= 0.463), and PTH (P= 0.849). Besides, there was no significant association between LDL-C or total cholesterol and serum minerals in FH patients.

Conclusion:

This study found no significant changes in serum calcium, vitamin D, phosphorus, and PTH in patients with FH.
Infiltration and Extravasation Risk with Midline Catheters: A Narrative Literature Review
Authors: Hadaway Lynn , Gorski Lisa A.
Published: September 2024

Midline catheters have recently gained popularity in clinical use, with a common reason being the reduction of central venous catheter use and central line-associated bloodstream infections. At the same time, the number of nononcology vesicant medications has increased, and midline catheters are frequently being used for infusions of vesicant medications. The Infusion Nurses Society (INS) Vesicant Task Force identified midline catheter use as a possible risk factor for extravasation and concluded that a thorough literature review was necessary. This review highlights the variations in catheter terminology and tip locations, the frequency of infiltration and extravasation in published studies, and case reports of infiltration and extravasation from midline catheters. It also examines the many clinical issues requiring evidence-based decision-making for the most appropriate type of vascular access devices. After more than 30 years of clinical practice with midline catheters and what appears to be a significant number of studies, evidence is still insufficient to answer questions about infusion of vesicant and irritant medications through midline catheters. Given the absence of consensus on tip location, inadequate evidence of clinical outcomes, and importance of patient safety, the continuous infusion of vesicants, all parenteral nutrition formulas, and infusates with extremes in pH and osmolarity should be avoided through midline catheters.
The Impact of Frailty on the Toxic Reaction of Chemotherapy in Patients With Cervical Cancer
Authors: Wang Yanhong , Zhang Yaya , Liang Xueping , Liu Jin , Zhao Yanan , Su Qingling
Published: September 2024

Background

Longitudinal research on the impact of frailty on chemotherapy toxicity in patients with cervical cancer is limited.

Objectives

To explore the impact of frailty on chemotherapy toxicity in patients with cervical cancer.

Methods

Two hundred fifty-nine postoperative cervical cancer patients from a hospital located in Northwest China were enrolled between July 2020 and December 2021. Participating patients were followed up for 4 chemotherapy cycles after surgery. Frailty was measured using the Tilburg Frailty Indicator. Chemotherapy toxic reactions were evaluated using the Common Terminology Criteria for Adverse Events 4.0. Repeated-measures analysis of variance and Cox regression analysis were used to analyze the effect of frailty on chemotherapy toxicity.

Results

Cox regression analysis showed that frailty could serve as an independent risk factor for total toxicity (hazard ratio [HR], 5.423; 95% confidence interval [CI], 3.260-9.023;P< .001), nausea (HR, 3.967; 95% CI, 2.446-6.433;P< .001), and vomiting (HR, 3.081; 95% CI, 1.921-4.942;P< .001). Repeated-measures analysis of variance showed that the white blood cell values of the frail group were lower than those of the nonfrail group (Fgroup effect= 4.172,P= .043), and the hemoglobin values of the frail group were lower than those of the nonfrail group (Fgroup effect= 6.589,P= .012).

Conclusions

Frailty can increase the risk of total chemotherapy toxicity, nausea, and vomiting. Frailty can reduce the white blood cell and hemoglobin values of postoperative adjuvant chemotherapy cervical cancer patients.

Implications for Practice

Findings may assist healthcare providers in taking effective measures to reduce the toxicity of chemotherapy.
Charting a Path From the Graduate QSEN Competencies to the New Essentials
Authors: Hays Deana , Hay Brittany , Tassell Barb , Zellefrow Cindy G. , Milner Kerry A.
Published: September 2024

Background:

Graduate nursing programs were encouraged to map their curriculum to the Quality and Safety Education in Nursing (QSEN) graduate knowledge, skills, and attitudes (KSA) competency statements.

Purpose:

Evaluation of the alignment between the 2009 QSEN graduate KSA competency statements and the 2021 American Association of Colleges of Nursing (AACN) Essentials advanced-level (Level 2) subcompetencies is needed to support curricular transition to competency-based education and the Essentials.

Methods:

A team of 5 nursing education experts engaged in multiple rounds of review to seek consensus in determining alignment between the 2009 QSEN graduate KSA competency statements and the 2021 AACN advanced-level subcompetencies.

Results:

A QSEN-AACN graduate crosswalk tool was created, which reflects alignment of 34% of the 196 graduate QSEN KSA competency statements to the AACN Essentials subcompetencies at the advanced level. 36% of the graduate QSEN KSA competency statements were found to align with the AACN subcompetencies at the entry level.

Conclusions:

The 2009 QSEN graduate competencies are embedded within 2021 AACN Essentials at entry and advanced levels. However, a sizable shift toward entry level is noted, which represents an evolution in expectations for contemporary practice. This holds significance for graduate nursing faculty as they work to revise curriculum and assessments to meet new guidelines and standards for the profession.
Fostering Moral Resilience
Authors: Forte Kathy , Higgins Melinda , Pentz Rebecca D.
Published: September 2024

Background:

Despite the high prevalence of moral distress in nursing, empirical evidence is lacking about the best educational approaches to foster moral resilience.

Purpose:

This study evaluates the effectiveness of an ethics simulation in a prelicensure program, 6 months into nursing practice.

Methods:

We used an exploratory design, including 2 instruments and open-ended questions. One instrument measured moral distress, the other measured moral resilience. Alumni who participated in the simulation were compared to alumni who received didactic teaching only.

Results:

Six months into practice, the quantitative data from this study did not show a statistical significance between those who received didactic training only and those who received a simulation, except for one element of the moral resilience scale (relational integrity), in which the control group had a higher score. Open-ended questions confirmed that alumni recognized the positive impact of the simulation in practice.

Conclusions:

Further study is needed to determine the best educational strategies for teaching ethics in prelicensure nursing programs, with a focus on improving retention and resilience in practice.
Using Quality Improvement to Expand and Align State Public Health Long-Term Follow-up Data Collection Across Newborn Screening Conditions
Authors: Bentler Kristi , Barber Lexie , Lintelmann Anna K. , Dierking Darcia M. , Meyer Abby C. , Comer Ashley , Hauser Jennifer
Published: September 2024

Context:

Despite the undeniable success of newborn screening (NBS), numerous barriers exist regarding long-term follow-up (LTFU) of children with conditions included in NBS. Furthermore, there is a focus on condition-specific follow-up with no national guidelines for standard quality measures collected by state public health LTFU programs.

Program:

Minnesota Department of Health (MDH) Longitudinal Follow-up for NBS.

Implementation:

A state public health LTFU for NBS quality improvement (QI) project was carried out with collaboration between MDH project team members and a QI Steering Team who provided clinical, public health, education, caregiver, and community perspectives and expertise to MDH. Relevant measures were selected from existing data elements, and additional measures were developed based on exchange between MDH project team and the QI Steering Team. Potential data sources were explored and prioritized. Processes for querying existing data sources such as death records were refined, new sources such as electronic health records and paper/PDF health records were established, and data collection was piloted. The Minnesota Electronic Disease Surveillance System was modified, and an electronic data form was created to promote consistent data abstraction from sources. Throughout the project, progress was evaluated and shared. At project conclusion, MDH project team and the QI Steering Team reviewed project outcomes and approaches to evolve the project into ongoing surveillance.

Evaluation:

Five common public health LTFU measures were determined. Overall, 77% of attempted measures were successfully collected. Primary and secondary data sources were adopted. In addition, collected data resulted in 7% of cases that were closed to further public health LTFU, often related to a move out of state.

Discussion:

This project established the feasibility of state public health LTFU surveillance of outcomes and health care use by collecting a common data set applicable across NBS conditions.
Brief Report: Genital Microbiome, Inflammation, and Tenofovir Levels in Transgender Men and Cisgender Women Taking Oral PrEP
Authors: Hastie Elizabeth , Srivatsa Megha S. , Gianella Sara , Cottrell Mackenzie , Forsyth Kyra , Porrachia Magali , Burke Leah , Morris Sheldon , Rawlings Stephen A. , Karris Maile , Chaillon Antoine , Blumenthal Jill
Published: September 2024

Background:

Little is known about the efficacy of preexposure prophylaxis (PrEP) or what biologic factors may influence HIV transmission in transgender men (TGM). In this study, we sought to explore the effect of testosterone on the vaginal microbiome, cervicovaginal fluid (CVF) tenofovir concentrations, and levels of CVF inflammatory markers in TGM on PrEP.

Methods:

Cervicovaginal fluid was collected from 13 TGM (7 using testosterone) and 32 cisgender women (CGW) on PrEP. The vaginal microbiome, CVF tenofovir concentrations, and CVF inflammatory markers were determined and compared.

Results:

The proportion of CVF Lactobacillus was significantly higher in CGW than in TGM (78% vs 24%, P < 0.001). Among TGM, the proportion of CVF Lactobacillus was lower, though not statistically significant, in those taking testosterone than in those not taking testosterone (14% vs 35%, P-value = 0.3). Interestingly, mean CVF tenofovir concentrations were the lowest in TGM on testosterone at 884 ng/mL compared with 3150 ng/mL in TGM not on testosterone and 1932 ng/mL in CGW; however, this difference was not statistically significant. There was no statistically significant difference in any of the genital inflammatory markers between groups and no correlation between inflammation and tenofovir levels.

Conclusions:

Our findings suggest a potential correlation between testosterone use, Lactobacillus dominance, and lower TFV concentrations in CVF, which may have implications on HIV acquisition from vaginal sex in TGMT. Future studies with larger sample sizes are needed to further investigate these relationships.
OCT Radiomic Features Used for the Assessment of Activity of Thyroid Eye Disease
Authors: Ma Lan , Zhang Hanqiao , Jiang Xue , Hou Zhijia , Li Dongmei
Published: September 2024

This retrospective study aimed to develop deep-learning radiomics models based on optical coherence tomography (OCT) scans to evaluate the activity of thyroid eye disease. The study included 33 patients (66 orbits) diagnosed with thyroid eye disease at Beijing Tongren Hospital between July 2021 and August 2022. We collected OCT scans, clinical activity score, and medical records of the patients. Patients were divided into active and inactive groups based on the clinical activity score, which were then divided into a training set and a test set at a ratio of ∼7:3. The macula-centered horizontal meridian image was used for the identification of the regions of interest using 3D slicer. Radiomics features were extracted and selected by t test and least absolute shrinkage and selection operator regression algorithm with 10-fold cross-validation. The random forest (RF) model and support vector machine (SVM) model were built based on retinal or choroid features and validated by receiver operating characteristic curves and area under the curve (AUC). For the retinal features, AUC were 0.800 (RF) and 0.840 (SVM) in the test set, and for the choroid features, the AUC were 0.733 and 0.813, for the RF model and SVM model, respectively. For the confusion matrix, the choroid-based SVM model had more balanced parameters compared with the retina-based SVM model. OCT-based deep learning radiomics analysis can be used to evaluate activity, which provide convenience in clinical practice.
Combined Treatment of Ruptured Intracranial Infectious Aneurysm Accompanied by Intracerebral Hemorrhage: Endovascular Treatment and Neuroendoscopy
Authors: Zheng Jiantao , Chen Wanwen , Yang Yong , Chen Guangzhong , Guo Wenlong
Published: September 2024

Intracranial infectious aneurysms (IIAs) are very rare. Most IIAs are associated with infective endocarditis (IE). The treatment of ruptured IIAs with intracerebral hemorrhage (ICH) remains challenging. Here, the authors aimed to describe a minimally invasive approach, combining endovascular treatment (EVT) with endoscopic techniques, for this complex issue. From January 2019 to December 2021, 3 cases of ruptured IIAs with intracerebral hemorrhage treated with EVT and neuroendoscopic hematoma evacuation at Guangdong Provincial People’s Hospital were included in this study. We retrospectively reviewed the clinical and imaging data and postoperative follow-up. All the IIAs were located in the middle cerebral arteries. The IIAs were secured by embolizing the aneurysms and occluding the parent artery. The ICH was evacuated using neuroendoscopy without postoperative rebleeding. After IIAs treatment, 2 patients underwent cardiac surgery, one at 10 days postoperatively and the other at 1 month postoperatively. At the 1-year follow-up, all patients resumed their normal lives. EVT and neuroendoscopic therapy for ruptured IIAs with ICH in patients is a useful complement to current treatment strategies.
A Method of Tumescent Anesthesia Based on Facial and Cervical Nerve Block for Face and Neck Liposuction
Authors: Zhuang Jun , Chen Yi , Wang Cheng , Su Xueshang , Zheng Qiaoyuan , Zhang Ziming , Wei Qingqian , Liu Tun , Hu Jintian
Published: September 2024

Objective:

Liposuction of the face and neck is a common treatment for fat deposition. If conventional methods are used for tumescent anesthesia, patients will experience pain, affecting their surgery experience. Using general anesthesia for liposuction of the face and neck can increase the cost to the patient and cause various adverse effects.

Methods:

The authors selected appropriate parts of the patient's neck, angle of the mandible, and face as needle entry points, and performed nerve block in different directions. Afterward, we performed facial liposuction on these patients and evaluated their level of pain.

Results:

This study included a total of 20 female participants who underwent facial liposuction after a nerve block. The Visual Analog Scale score of the 20 participants was 0.55 (±0.60). There were no significant adverse reactions during the treatment process, and all patients expressed satisfaction with this treatment.

Conclusions:

In this article, the authors present a method of tumescent anesthesia based on facial and cervical nerve block that significantly reduces the pain associated with facial and neck liposuction, eliminating the need for general anesthesia and enhancing the patient’s comfort during the procedure.
Primary Open Reduction and Internal Fixation of Isolated Compound Depressed Nasal Fractures
Authors: Abdelazeem Mohamed Hazem , Nadershah Mohammed
Published: September 2024

The aim of this study was to assess the efficacy of primary open reduction and internal fixation (ORIF) utilizing the existing dorsal wound for the management of isolated nasal fractures characterized by significant depression and to determine its effectiveness in preventing the need for subsequent nasal revisions. A retrospective review was conducted on patients who underwent ORIF of nasal bone for isolated compound depressed nasal fractures from January 2018 to January 2024. The primary outcomes included the assessment of clinical and radiographic results postoperatively, focusing on nasal symmetry, projection, airway patency, and the incidence of secondary surgical interventions. The study included 15 patients, predominantly males (60%), with an average age of 39.33 years. The mechanisms of injury included motor vehicle accidents (40%), falls (26.7%), interpersonal violence (20%), and occupational injuries (13.3%). All patients were treated on the first (73.3%) or second day (26.7%) after the injury. All patients had satisfactory esthetic and functional outcomes and did not require secondary rhinoplasty. The hardware was removed in 4 patients (26.7%). Primary ORIF through an existing dorsal wound for significantly depressed isolated nasal fractures was effective in obviating the necessity for subsequent nasal revisions.
Clinical Characteristics and Underlying Pathophysiology in 4 Subtypes of Dysthyroid Optic Neuropathy Patients
Authors: Yoon EunGyu , Lee Hyunkyu , Baek Sehyun , Lee Hwa
Published: September 2024

Objective:

To analyze different subtypes, clinical characteristics, and pathophysiologies of dysthyroid optic neuropathy (DON) based on orbital fat and extraocular muscle (EOM) volume increases on orbital CT images.

Methods:

The author retrospectively reviewed the medical records of 80 patients (152 eyes) who were diagnosed with DON and treated at Anam, Guro, or Ansan hospitals of the Korea University College of Medicine from February 2006 to December 2023. Clinical features, ophthalmic examination, demographic characteristics, thyroid status, and radiographic findings from computed tomography scans (prevalence of fat or muscle volume increases) were analyzed.

Results:

Four groups were designated based on EOM volume (MV) and orbital fat volume (FV). Group 1 had no increase in MV or FV (5.3%, 8 eyes), group 2 had increased FV only (8.66%, 13 eyes), group 3 had an increase in MV only (52.6%, 80 eyes), while group 4 had both MV and FV increase (33.6%, 51 eyes). Patients in group 1 were younger and had low diplopia scores than patients in the other groups. Decreases in visual acuity, color vision abnormalities, diplopia score, and apical crowding were less frequent in groups 1 and 2 than groups 3 and 4 (P=0.000). Patients in groups 3 and 4 had significantly more apical crowding and higher diplopia scores and CAS scores than patients in groups 1 and 2 (P=0.000 and 0.013, respectively). The number of patients who underwent decompression surgery was significantly higher in groups 3 and 4 than groups 1 and 2 (P=0.000).

Conclusion:

Extraocular muscle enlargement occurred in 86% of DON patients and compression of the optic nerve due to enlargement of EOMs at the orbital apex is the main cause of DON. Optic nerve stretch and vascular insufficiency due to increased orbital pressure are other potential mechanisms underlying DON in groups without an increase in FV or MV. Although decreased visual acuity, color vision abnormalities, and diplopia were less frequent in these groups, greater attention should be paid to the timely diagnosis of DON.
Application of Multimodal Reconstruction Technology and 3D Printing Technology in MVD Surgery
Authors: Liu Jinkai , Zhang Yifei , Tao Xiaowei , Wang Bing
Published: September 2024

Microvascular decompression (MVD) plays a pivotal role in the treatment of cranial neurovascular compression syndromes, yet the safety and precision of the surgery remain a focus of clinical attention. This article delves into the application of multimodal reconstruction and 3D printing technologies in MVD surgeries, evaluating their effectiveness in preoperative planning. Multimodal reconstruction, by integrating various imaging techniques such as magnetic resonance imaging (MRI) and computed tomography (CT), provides high-resolution anatomical information, offering comprehensive data support for preoperative planning and intraoperative navigation. Complementing this, 3D printing technology presents patients’ anatomical structures as individualized physical models, enabling surgeons to fabricate corresponding skin templates for surgical needs, offering intuitive and practical references. Case studies presented in this article demonstrate the application and efficacy of these technologies in actual MVD surgeries. The results suggest that multimodal reconstruction and 3D printing technologies aid surgical teams in better understanding patients’ anatomical structures during preoperative planning, enhancing surgical accuracy, reducing operative time, and shortening hospital stays. Despite notable advancements in MVD surgeries, challenges such as data accuracy, technological complexity, and cost persist. Future research should aim to address these issues, further optimizing the technologies and promoting their widespread application in neurosurgical procedures. Through in-depth investigation and understanding of these advanced technologies, we hope to pave new paths for improving surgical outcomes and patients’ quality of life.
A Patient With Exposed Costal Cartilage After Microtia Surgery Successfully Treated With Perifascial Areolar Tissue Grafting
Authors: Kasai Shogo , Kuba Ryogo , Asato Reiko
Published: September 2024

Postoperative costal cartilage exposure is a troublesome complication following costal cartilage grafting for microtia. The authors report a case of attempted recovery using perifascial areolar tissue (PAT) transplantation that achieved favorable results. The patient was a 13-year-old boy, who developed a 27 × 11 mm2 skin ulcer with a 6 × 3.5 mm2 area of exposed cartilage at the helix 1 month after ear ablation surgery. PAT harvested from above the trapezius muscle was grafted onto the ulcer. The wound was closed 14 days later using a split-thickness skin graft from the head. PAT transplants can be harvested from anywhere in the body, are minimally invasive, and are highly flexible. This case demonstrates that, although factors such as the extent and location of cartilage exposure must be considered, PAT transplants are an option for microtia salvage surgery.
The Peripheral Reduction With Keyhole Tongue Reduction Technique for Macroglossia in Beckwith-Wiedemann Syndrome
Authors: Romeo Dominic J. , Massenburg Benjamin B. , Wilson Alexander T. , George Andrew , Akarapimand Patrick , Lenz Theodor , Wu Meagan , Ng Jinggang J. , Kalish Jennifer M. , Taylor Jesse A.
Published: September 2024

Objective:

Patients with Beckwith-Wiedemann syndrome commonly have macroglossia, which can negatively affect dentoskeletal development, breathing, speaking, and eating. Tongue reduction surgery can improve symptoms, but there is no standardized surgical approach.

Methods:

A video and observational commentary highlighting the effectiveness of a tongue reduction technique for BWS were presented.

Results:

The peripheral resection with a keyhole approach safely reduced tongue volume, maintained the lateral neurovascular pedicles, optimized intraoperative visualization, and limited bleeding.

Conclusions:

The peripheral resection with a keyhole tongue reduction surgical technique is effective for treating symptomatic macroglossia in BWS.
Characterization of Baseline Lung Allograft Dysfunction in Single Lung Transplant Recipients
Authors: Gerckens Michael , Mümmler Carlo , Richard Alexander , Strodel Johannes , Mertsch Pontus , Milger Katrin , Veit Tobias , Gade Nils , Yildirim Ali Önder , Schneider Christian , Kauke Teresa , Michel Sebastian , Irlbeck Michael , Behr Jürgen , Kneidinger Nikolaus
Published: September 2024

Background.

Baseline lung allograft dysfunction (BLAD) is characterized by the failure to achieve normal baseline lung function after double lung transplantation (DLTX) and is associated with a high risk of mortality. In single lung transplant (SLTX) recipients, however, cutoff values and associated factors have not been explored. Here, we aimed to define BLAD in SLTX recipients, investigate its impact on allograft survival, and identify potential risk factors for BLAD in SLTX recipients.

Methods.

We performed a retrospective, single-center analysis of the LTX cohort of LMU Munich between 2010 and 2018. In accordance with DLTX cutoffs, BLAD in SLTX recipients was defined as failure to achieve percentage of forced expiratory volume in 1 s and percentage of forced vital capacity of >60% on 2 consecutive tests >3 wk apart. Survival analysis and regression analysis for potential predictors of BLAD were performed.

Results.

In a cohort of 141 SLTX recipients, 43% of patients met BLAD criteria. SLTX recipients with BLAD demonstrated impaired survival. Native lung hyperinflation was associated with BLAD in obstructive disease, whereas donor/recipient lung size mismatch was associated with BLAD in both obstructive and restrictive underlying diseases. Pulmonary function testing at 3 mo after lung transplantation predicted normal baseline lung function in SLTX recipients with obstructive lung disease.

Conclusions.

BLAD in SLTX recipients is as relevant as in DLTX recipients and should generally be considered in the follow-up of LTX recipients. Risk factors for BLAD differed between underlying obstructive and restrictive lung disease. A better understanding of associated factors may help in the development of preventive strategies.
A revisit to interactions of stimulus quality and semantic context on N400 in visual word recognition
Authors: Xiong Rongmin , Zhang Yong , Hu Wenyi , Zhu Shixue , Huang Zhongxuan , Wang Quanhong
Published: September 2024

Much behavioral research has revealed interactive effects between stimulus quality and semantic priming in visual word recognition, practically in favor of the interactive activation model. However, the limited number of event-related brain potential (ERP) studies have yielded inconsistent results considering this interaction’s impact on N400 amplitude. The current ERP study aimed to examine whether the joint effects of stimulus quality and semantic priming were specific to the lexical decision task. We used both behavioral measures and ERP recordings to evaluate the joint effects of stimulus degradation (i.e. highly vs. slightly degraded) and semantic priming (i.e. semantically related vs. unrelated) in a lexical decision task involving visual recognition of Chinese characters. The results showed significant degradation-by-priming interactions on response times and N400 amplitude (P < 0.05), with larger semantic priming effects on slightly degraded targets. These converging behavioral and electrophysiological findings provide evidence in accordance with the interactive activation models of visual word recognition, in which the early-stage visual processing (i.e. degradation) cascades into the later-stage semantic processing (i.e. priming), thus yielding interactions observed in N400 amplitude.
A theoretical perspective on solid-state ionic interfaces
Authors: Carrasco Javier
Published: September 2024

Solid-state ionic conductors find application across various domains in materials science, particularly showcasing their significance in energy storage and conversion technologies. To effectively utilize these materials in high-performance electrochemical devices, a comprehensive understanding and precise control of charge carriers’ distribution and ionic mobility at interfaces are paramount. A major challenge lies in unravelling the atomic-level processes governing ion dynamics within intricate solid and interfacial structures, such as grain boundaries and heterophases. From a theoretical viewpoint, in this Perspective article, my focus is to offer an overview of the current comprehension of key aspects related to solid-state ionic interfaces, with a particular emphasis on solid electrolytes for batteries, while providing a personal critical assessment of recent research advancements. I begin by introducing fundamental concepts for understanding solid-state conductors, such as the classical diffusion model and chemical potential. Subsequently, I delve into the modelling of space-charge regions, which are pivotal for understanding the physicochemical origins of charge redistribution at electrified interfaces. Finally, I discuss modern computational methods, such as density functional theory and machine-learned potentials, which offer invaluable tools for gaining insights into the atomic-scale behaviour of solid-state ionic interfaces, including both ionic mobility and interfacial reactivity aspects.

This article is part of the theme issue ‘Celebrating the 15th anniversary of the Royal Society Newton International Fellowship’.
Infrasound associated with the eruption of the Hunga volcano
Authors: Guo Quan , Jin Xinxin , Sun Guanwen , Zhang Yuxin , Cui Hanyin , Feng Xiujuan
Published: September 2024

On 13–15 January 2022, the Hunga Tonga–Hunga Ha'apai underwater volcano erupted. This powerful eruption generated infrasonic waves with amplitudes of thousands of Pascals in the near field. The ground infrasonic stations in China, located approximately 10 000 km from the Hunga volcano, also received waves with frequencies from 0.01 to 0.05 Hz. However, the amplitude reached 17 Pa, which is higher than the predicted amplitude using the absorption model without considering the dispersion effect in the thin thermosphere. At high altitudes, dispersion exists and the sound speed depends on the ratio of the molecular mean collision ratio to sound frequency, which is proportional to the ratio (frequency/pressure). And attenuation coefficients are complex to model. We simulate dispersive sound speeds and attenuation coefficients at different frequencies according to theory and our experimental data. In the thermosphere, the dispersion effect causes noticeable changes of sound speed and then affects wave propagation paths in the far field. The abnormal attenuation coefficient has a smaller impact on thermospheric returns than that of the dispersive sound speed, but it is also not negligible. It explains the large amplitude of thermospheric signals received in our infrasound stations.

This article is part of the theme issue ‘Celebrating the 15th anniversary of the Royal Society Newton International Fellowship’.
Unlocking the hidden dimension: power of chirality in scientific exploration
Authors: Kartouzian Aras , Cameron Robert P.
Published: September 2024

In the boundless landscape of scientific exploration, there exists a hidden, yet easily accessible, dimension that has often not only intrigued and puzzled researchers but also provided the key. This dimension is chirality, the property that describes the handedness of objects. The influence of chirality extends across diverse fields of study from the parity violation in electroweak interactions to the extremely large macroscopic systems such as galaxies. In this opinion piece, we will delve into the power of chirality in scientific exploration by examining some examples that, at different scales, demonstrate its role as a key to a better understanding of our world. Our goal is to incite researchers from all fields to seek, implement and utilize chirality in their research. Going this extra mile might be more rewarding than it seems at first glance, in particular with regard to the increasing demand for new functional materials in response to the contemporary scientific and technological challenges we are facing.

This article is part of the theme issue ‘Celebrating the 15th anniversary of the Royal Society Newton International Fellowship’.
Ultra-high-cardinality geometric shaping in the finite SNR regime
Authors: Goossens Sebastiaan , Gültekin Yunus Can , Vassilieva Olga , Kim Inwoong , Palacharla Paparao , Okonkwo Chigo , Alvarado Alex
Published: September 2024

Four-dimensional (4D) constellations with up to 131 072 points (17 bit/4D-sym) are designed for the first time using geometric shaping. The constellations are optimized in terms of mutual information (MI) and generalized MI (GMI) for the additive white Gaussian noise (AWGN) channel, targeting a forward error correction (FEC) rate of 0.8 at finite signal-to-noise ratios. The presented 15–17 bit constellations are currently the highest-performing constellations in the literature, having a gap to the AWGN capacity as low as 0.17 dB (MI) and 0.45 dB (GMI) at 17 bit/4D-sym. For lower cardinalities, our constellations match or closely approach the performance of previously published optimized constellations. We also show that (GMI-)optimized constellations with a symmetry constraint, optimized for a FEC rate of 0.8, perform nearly identical to their unconstrained counterparts for cardinalities above 8 bit/4D-sym. A symmetry constraint for MI-optimized constellations is shown to have a negative impact in general. The proposed procedure relies on a Monte-Carlo-based approach for evaluating performance and is extendable to other (nonlinear) channels. Stochastic gradient descent is used for the optimization algorithm for which the gradients are computed using automatic differentiation.

This article is part of the theme issue ‘Celebrating the 15th anniversary of the Royal Society Newton International Fellowship’.