bluuebunny/crossref_metadata_2025 huggingface dataset:
Enhancing precision of chromatic confocal measurement through linear interpolation based centroid algorithm
Authors: Lu Wenlong , Dai Jiacheng , Zeng Wenhan , Zhong Wenbin , Blunt Liam , Jiang Xiangqian
Published: July 2024

In chromatic confocal measurement (CCM), the accuracy and precision of the results rely on the robustness of the spectral power distribution (SPD) signal resolution. However, traditional centroid algorithms struggle with the inherent discretization of the SPD signal, leading to significant measurement errors. To address this issue, a linear interpolation based centroid algorithm is proposed to improve the robustness of the results. In the precision calibration experiment conducted with the in-house developed chromatic confocal sensors, the proposed algorithm demonstrates good robustness. Moreover, it achieves a 50% enhancement in the accuracy of a 4 mm range, improving from 1 μm to 0.5 μm.
Novel additively manufactured dihedral tiling architected metamaterial conformed with pentagon and rhombus: design and mechanical properties
Authors: Paredes Pureco Paola , Fuentes-Juvera Luis , Olivas-Alanis Luis H , Roman-Flores Armando , Cuan-Urquizo Enrique
Published: July 2024

The design of novel mechanical metamaterials has drawn inspiration from several sources to develop new structures. Additionally, additive manufacturing has widened the possibilities for producing intricate geometries. With this in mind, a novel architected metamaterial based on dihedral tiling is presented here, and its mechanical response is characterized experimentally. The architecture comprises two shapes: a pentagon and rhombuses, arranged in a manner dependent on each other. Three parameters were defined as variables to generate several design variations and analyze the impact of geometry on their effective mechanical properties: pentagon edge length (l), pattern rotation angle (θ), and strut thickness (t). For this purpose, the selected designs were additively manufactured using Thermoplastic Polyurethane (TPU) and tested under compression. It was found that t is directly proportional to relative density, and consequently, to apparent stiffness, while l is inversely proportional to both properties. On the other hand, θ has a minor influence on apparent stiffness and is more related to the deformed shape obtained. Overall, it was observed that the response depends on the combination of all geometrical parameters, meaning the apparent properties cannot be related to the response of only one of the shapes. This behavior differs from lattices based on a singular shape, in which the properties of the whole metamaterial are usually related to those of the unit cell.
Faith and morality
Authors: Trigg Roger
Published: July 2024

Religious faith is often deemed barren without ‘works’. We must, it seems to many, not only see what is true but be prepared to live accordingly. Theologians have often warned against the idea that this can earn God’s favour. Personal faith can degenerate into an idea of merit. Some have also been wary of making it a purely individual matter. The issues of belief and practice, and individual and community cannot be separated. The question of social structures raises the issue of education. Public policy about religious and moral education in a pluralist society will be a vexed matter. Religious faith of its nature should not change to fit different moral assumptions arising from changing social attitudes. Sincere moral disagreements arise from disputes about what is important for humans and they are often rooted in religious faith.
A mixture of grass–legume cover crop species may ameliorate water stress in a changing climate
Authors: Truong Nhu Q , York Larry M , Decker Allyssa , Douglas and Margaret R
Published: July 2024

Climate change models predict increasing precipitation variability in the mid-latitude regions of Earth, generating a need to reduce the negative impacts of these changes on crop production. Despite considerable research on how cover crops support agriculture in a changing climate, understanding is limited of how climate change influences the growth of cover crops. We investigated the early development of two common cover crop species—crimson clover (Trifolium incarnatum) and rye (Secale cereale)—and hypothesized that growing them in the mixture would ameliorate stress from drought or waterlogging. This hypothesis was tested in a 25-day greenhouse experiment, where the two factors (species number and water stress) were fully crossed in randomized blocks, and plant responses were quantified through survival, growth rate, biomass production and root morphology. Water stress negatively influenced the early growth of these two species in contrasting ways: crimson clover was susceptible to drought while rye performed poorly under waterlogging. Per-plant biomass in rye was always greater in mixture than in monoculture, while per-plant biomass of crimson clover was greater in mixture under drought. Both species grew longer roots in mixture than in monoculture under drought, and total biomass of mixtures did not differ significantly from the more-productive monoculture (rye) in any water condition. In the face of increasingly variable precipitation, growing crimson clover and rye together has potential to ameliorate water stress, a possibility that should be further investigated in field experiments.
Finding atomic dynamics in metal and alloy subnanometer clusters
Authors: Imaoka Takane , Yamamoto Kimihisa
Published: July 2024

This highlight review explains advanced structural analysis techniques utilizing electron microscopy to uncover various properties and phenomena in subnanometer clusters that were previously unknown in larger nanoparticles. The discoveries introduced the concept of “subnano alloying,” where different elements mix at the atomic level in arbitrary proportions, leading to enhanced catalytic performance. Additionally, the behavior and dynamics of these clusters were examined to gain insights into their stability and reactivity. These findings have significant implications for the design of advanced materials with tailored properties and improved catalytic applications.
Data set of fraction unbound values in the in vitro incubations for metabolic studies for better prediction of human clearance
Authors: Krumpholz Laura , Klimczyk Aleksandra , Bieniek Wiktoria , Polak Sebastian , Wiśniowska Barbara
Published: July 2024

In vitro–in vivo extrapolation is a commonly applied technique for liver clearance prediction. Various in vitro models are available such as hepatocytes, human liver microsomes, or recombinant cytochromes P450. According to the free drug theory, only the unbound fraction (fu) of a chemical can undergo metabolic changes. Therefore, to ensure the reliability of predictions, both specific and nonspecific binding in the model should be accounted. However, the fraction unbound in the experiment is often not reported. The study aimed to provide a detailed repository of the literature data on the compound’s fu value in various in vitro systems used for drug metabolism evaluation and corresponding human plasma binding levels. Data on the free fraction in plasma and different in vitro models were supplemented with the following information: the experimental method used for the assessment of the degree of drug binding, protein or cell concentration in the incubation, and other experimental conditions, if different from the standard ones, species, reference to the source publication, and the author’s name and date of publication. In total, we collected 129 literature studies on 1425 different compounds. The provided data set can be used as a reference for scientists involved in pharmacokinetic/physiologically based pharmacokinetic modelling as well as researchers interested in Quantitative Structure-Activity Relationship models for the prediction of fraction unbound based on compound structure.

Database URL: https://data.mendeley.com/datasets/3bs5526htd/1
May Measurement Month 2021: an analysis of blood pressure screening results from Bangladesh
Authors: Malik Fazila-Tun-Nesa , Al Mamun Mohammad Abdullah , Choudhury Sohel Reza , Ishraquzzaman Mir , Kalimuddin Mohammad , Huq Tawfiq Shariar , Rahman Mohammad Shamimur , Jubayer Shamim , Bhuiyan Mahfuzur Rahman , Sobhan Sheikh Mohammad Mahbubus , Faruque Mithila , Beaney Thomas , Ahmadi-Abhari Sara , Malik Abdul , Poulter Neil R
Published: July 2024

Previous studies have shown that among Bangladeshi adults, one-fifth have hypertension. The National Heart Foundation of Bangladesh participated in May Measurement Month (MMM) campaigns in 2017, 2018, 2019, as well as in 2021 as a part of a global initiative aimed at raising awareness of high blood pressure (BP) and to act as a temporary solution to the lack of nationwide screening programmes. This opportunistic screening of voluntary participants aged ≥18 years was carried out from May to July 2021. Data were collected from more than 150 screening sites in all 64 districts in Bangladesh. Blood pressure measurement, the definition of hypertension, and statistical analysis followed the MMM protocol. Data on 28 355 individuals were finally analysed. Among the participants, 17 941 (63.3%) were female. After multiple imputation, 11 194 (39.5%) had hypertension. Among the 11 194 participants with hypertension, 78.8% were aware of having hypertension and 65.6% were on antihypertensive medication. Among 11 194 participants with hypertension, 7340 participants (65.6%) were on antihypertensive medication and 43.8% had controlled BP (<140/90 mmHg). Of those on antihypertensive medication, 66.8% had controlled BP. A voluntary BP screening programme can identify significant numbers of people with raised BP and thus contributes importantly to the prevention of cardiovascular diseases.
The Trend of Chronic Diseases Among Older Koreans, 2004–2020: Age–Period–Cohort Analysis
Authors: Namkung Eun Ha , Kang Sung Hye
Published: July 2024

Objectives

This study aimed to examine age, period, and cohort effects contributing to the prevalence of diabetes and hypertension among older Koreans. Additionally, it sought to investigate how sociodemographic characteristics interact with period and cohort effects to influence the disease prevalence.

Methods

Using the 2004–2020 data from the National Survey of Older Koreans, a nationally representative sample of older adults aged 65 or older, hierarchical age–period–cohort cross-classified random effects models (HAPC-CCREMs) were employed to estimate separate age, period, and cohort components of the recent trends in diabetes and hypertension. Sociodemographic characteristics were tested for their interactions with period and cohort effects.

Results

Significant period effects were observed, indicating a steady increase in the likelihood of being diagnosed with diabetes and hypertension over time. Age effects revealed a quadratic trend, with disease risks generally increasing with age, but the rate of increase diminishing at older ages. Cohort effects exhibited an inverted U-shaped pattern, with higher risks observed in the 1930s and early 1940s cohorts compared to earlier and later cohorts. Gender and educational attainment emerged as significant moderators. Women than men born in the early 1930s exhibited higher risks of diabetes and hypertension, whereas individuals with lower educational attainment showed a steadily increasing risk of hypertension over time.

Discussion

The results underscore the complex interplay of age, period, and cohort effects in shaping disease prevalence among older Koreans. Our findings highlight the importance of considering historical context and sociodemographic factors in understanding disease trends and designing targeted interventions to mitigate health disparities.
Research on geothermal-driven single-effect absorption refrigeration systems with different working fluids: energy and exergy analysis
Authors: Zhao Heshan , Xu Haibo , Jin Dan , An Weizheng
Published: July 2024

Geothermal energy is not only environmentally friendly and has low carbon but also represents a nonintermittent technology. It is anticipated that its utilization in human society will experience rapid growth in the coming decades. Absorption refrigeration can be employed for the recovery of geothermal resources. However, the low performance of absorption refrigeration systems has hindered their development. In order to advance absorption refrigeration technology suitable for geothermal energy recovery, this study developed a mathematical model for an absorption refrigeration system using 55% lithium bromide (LiBr) and 35% lithium chloride (LiCl) solutions as working fluids. The impact of various parameters, including cooling water conditions, chilled water conditions, heat source parameters, and working fluid concentration, on the thermodynamic performance, system efficiency, and exergy efficiency of a single-effect absorption refrigeration system was analyzed. The results reveal that the cooling water inlet temperature and flow, chilled water inlet temperature, heat source inlet temperature, and working fluid concentration are the primary factors affecting the thermodynamic performance and exergy efficiency of the absorption refrigeration system. The coefficient of performance (COP) of the system increases with higher cooling water flow, chilled water inlet temperature, and working fluid concentration, but decreases with higher cooling water inlet temperature. Within a certain temperature range, the COP increases with higher heat source temperature. The effective COP (ECOP) increases with higher cooling water inlet temperature, cooling water flow, chilled water inlet temperature, and working fluid concentration, while it decreases with higher heat source temperature. The highest COP values for the LiBr and LiCl solution single-effect absorption refrigeration systems are 0.795 and 0.785, respectively, while the highest ECOP values are 0.694 and 0.684, respectively.
Research on fault diagnosis of industrial materials based on hybrid deep learning model
Authors: Chen Rong
Published: July 2024

Bearing fault detection is becoming more and more important in industrial development, and deep learning image processing technology provides a new solution for this. In this study, ResNet50 is used to replace VGG-16 as the feature extraction network of Faster R-CNN, and feature pyramid network (FPN) and parallel attention module (PAM) are introduced to achieve higher detection accuracy and speed. The experimental validation was conducted with the Case Western Reserve University bearing dataset using a three-fold cross-validation and compared with Yolov5, FPN, and the original Faster R-CNN model. The experimental results show that the accuracy of the proposed bearing image fault detection method is 78.6%, the accuracy is 77.4%, and the recall rate is 76.9%, which can locate and identify bearing faults more accurately. Future work could focus on further optimizing the model structure to enhance detection performance, strengthening the model’s generalization ability to meet the detection requirements of different types of bearing faults.
Techno-economic and environmental analysis of a grid-connected rooftop solar photovoltaic system in three climate zones
Authors: Hai Tao , Jaffar Hussein A , Taher Hameed H , Al-Rubaye Ameer H , Said Esraa Ahmed , Hussein Abbas Hameed Abdul , Alhaidry Wesam Abed A L Hassan , Idan Ameer Hassan , Salehi Abozar
Published: July 2024

This study aims to fill a gap in research on technical-economic and environmental assessments of grid-connected photovoltaic (PV) panels for residential electricity supply. To combat this, a study examines the feasibility of grid-connected rooftop solar PV systems in three cities. Using PVsyst software, technical, economic, and environmental factors were analyzed, including energy injected into the grid, net present value (NPV), internal rate of return (IRR), levelized cost of energy (LCOE), and life cycle emissions. It is concluded from this study that PV power plants are technically, economically, and environmentally feasible for all three climate zones, but cold zone with the highest annual production of 10.66 MWh, the highest NPV ($5449.47), the highest IRR (14.28%), and the lowest LCOE ($0.063/kWh) is the most appropriate place to set up a PV power plant (Scenario 1: No tracking system). Furthermore, using horizontal (Scenario 2), vertical (Scenario 3), and two-axis tracking (Scenario 4) systems instead of the no-tracking system (Scenario 1) increases the amount of electricity injected into the grid by 7.56%, 24.67%, and 36.35%, respectively. According to life cycle emission, the annual production of 10.66 MWh by the 5 kW power plant installed in cold zone will prevent 102.02 tons of carbon dioxide emissions into the atmosphere (Scenario 1: No tracking system). To remove financial obstacles and increase the viability of renewable energy, the government must provide financial incentives, lower the cost of equipment, and enact strong renewable energy legislation.
Application of hybrid renewable energy systems for supplying electricity demand of a water pump station of agricultural plants: a case-based research
Authors: Basem Ali , Fard Habib Forootan , Atamurotov Farruh
Published: July 2024

Employing clean energy production in agricultural purposes has attracted the attention of many researchers. One of the challenges is the flexible nature of irrigation of the plants that need to have a changeable power source of pump stations to supply the load demands. Renewable energies are among the best solutions to supply environmentally-friendly power, especially in remote areas where there is no access to the electricity. This study considers the needed water of five different plants, and according to the calculated hydromodule, the capacity of the pump station as well as its monthly and yearly load demands are determined. Based on the calculated load demand, different configurations of hybrid renewable energy systems (HRES) are considered, and the optimum sizes of equipment are determined. The needed load demand is 1463 kWh/day and peak load is 266.16 kW. Based on the suppositions and inputs of this study, results show that the best economic configuration would be PV/wind turbine/diesel generator/battery the way that cost of energy (COE) and net present cost (NPC are 0.28 ($/kWh) and $2.48 million. Also, the best environmentally friendly system (PV/wind turbine/battery) where CO2 emission is zero and RF is 100%, can be obtained with 647 kW PV panels and 106 wind turbines, the way that COE and NPC values are 0.5 ($/kWh) and 4.41 $ million. To reach the best technical system (PV/generator/battery), 514 kW PV, 100 kW diesel generator, and 1816 batteries would have the least unmeted load and excess electricity where COE and NPC values are 0.34 ($/kWh) and 2.98$ million.
Proof of Specific Intent in the Crime of Genocide
Authors: Pisillo Mazzeschi Riccardo , Carli Eugenio
Published: July 2024

The current dispute between South Africa and Israel before the International Court of Justice has many aspects of great legal interest. This article focuses on the identification and proof of the specific intent of a state in the crime of genocide. On this point, the arguments put forward by the two states in the preliminary phase of the proceedings are very different and raise several issues. The article addresses them especially in light of the International Court of Justice’s previous case law on genocide. The following questions are addressed: Is the genocidal intent of individuals and that of states distinct and separate? Does the finding of individual criminal responsibility for genocide affect, and if so to what extent, state responsibility? What elements/factors are relevant for proving a specific intent? What organs express such an intent? What are the standards of evidence required? The International Court of Justice gave so far unclear answers to these questions. This article seeks to offer some solutions in this regard.
Anal fissure
Authors: Feingold Daniel L.
Published: July 2024

A fissure is a common anal disorder typically treated medically in its acute phase and patients with a chronic fissure often require operative intervention. Patients suffering from anal fissure are commonly referred to surgeons for diagnosis and treatment. The severity of presenting symptoms ranges from minor, annoying pain, or bleeding to severe, consuming, incapacitating pain. The duration of symptoms upon presentation varies, as well, and fissures persisting beyond about 6–8 weeks are typically categorized as chronic. Given the spectrum of presentation related to fissuring as well as the risk of functional deficit related to operative sphincterotomy, clinicians must consider the unique presentation of each patient and individualize their care plan. Sphincterotomy is highly effective at curing chronic fissures but the risk to function must be individualized as some patients will benefit from muscle-sparing treatment.
Fistula in ano
Authors: Patankar Roy
Published: July 2024

Suppurative diseases of the anal canal can be either acute or chronic. A fistula in ano is characterized as an abnormal tract lined with granulation tissue, connecting a primary opening inside the anal canal to an external opening outside, which represents the path through which the abscess has drained. Although a benign condition, suppurative diseases of the anal canal can be highly distressing for patients and lead to significant morbidity. This chapter delves into the various types of fistula in ano, as well as the newer modalities of imaging and treatment. In most cases, fistulas do not resolve spontaneously. Various surgical and minimally invasive procedures, such as LIFT, VAAFT, SLOFT, and FiLac, have been described in this chapter, providing a brief overview of fistula in ano.
Robotic colorectal surgery
Authors: Toh James W.T. , Kim Seon Hahn
Published: July 2024

In this chapter, the authors evaluate the evidence assessing the role of robotic systems in colorectal surgery, comparing the results of robotic and laparoscopic proctectomy for rectal cancer, including a comprehensive review of the outcomes and limitations of the ROLARR study. The role of robotics in performing ventral rectopexy is also assessed. Aside from colorectal surgery within the narrow confines of the pelvis, the role of robotic systems for colectomy is also reviewed in this chapter. Its role in inflammatory bowel disease, endometrioisis as well as performing lateral pelvic lymph node dissection is also discussed. The final part of this chapter evaluates the future of robotic colorectal surgery and provides an in-depth discussion of its future directions, the challenges which exist as well as cost and benefit rationalization of using robotic systems to perform colorectal surgery.
Role of radiation therapy in rectal cancers
Authors: Balogun Onyinye
Published: July 2024

The role of radiation therapy in rectal cancer continues to evolve. Initial studies demonstrated that both short-course preoperative radiotherapy and long-course preoperative chemoradiotherapy improved local control in locally advanced rectal cancer. Head-to-head comparisons of short-course preoperative radiotherapy and long-course preoperative chemoradiotherapy suggest equivalent local control and survival outcomes for both approaches. Trials are ongoing to determine the ideal sequencing of neoadjuvant radiotherapy or chemoradiotherapy with additional neoadjuvant chemotherapy. Omission of radiotherapy may be appropriate in select patients and in the future, MRI-based radiotherapy may become more widespread. Brachytherapy or intraoperative radiation therapy are less frequently used but may be considered in cases of close or positive margins as well as cases of recurrent rectal cancer. Future directions include evaluating the role of the MRI-based linear accelerators for real-time monitoring of tumour response and/or intensifying dose to the primary tumour.
Radiation proctitis
Authors: Thompson Hannah , Ali Fadwa , Widmar Maria
Published: July 2024

Radiation-related rectal injury can result in a wide spectrum of symptoms, such as bleeding, alterations in bowel function, fistulas, strictures, and secondary malignancies. Acute radiation proctitis is typically self-limited and responds to interruption of radiation treatment. The most common presentation of chronic radiation proctitis is bleeding, 8–12 months after initiation of radiation therapy. Management consists of a step-up approach beginning with sucralfate enemas, a topical treatment which can be administered at home. Formalin is an effective topical agent for bleeding from chronic radiation proctitis and is administered by a physician, as an outpatient procedure. Interventional strategies such as argon plasma coagulation and hyperbaric oxygen are effective, but labour-intensive. Surgery is associated with high morbidity and mortality and should be reserved for cases that are refractory to medical management, symptomatic fistulae, and surgical emergencies such as perforation.
Statistics
Authors: Karavadra Babu , Haines Richard A. , Sule Medha
Published: July 2024

This chapter focuses on single best answer questions that test knowledge on the medical statistics that is relevant for the MRCOG part 1 examination. A solid understanding of the principles that underpin medical statistics is vital. The practice of evidence based medicine cannot be underestimated. It is important to understand the principles of screening, the levels of evidence and clinical trial design. Patients will often ask about risk, and therefore an understanding of how risk is quantified is important. The ability to interpret statistical tests is an important part of the MRCOG part 1 examination.
Immunology
Authors: Karavadra Babu , Haines Richard A. , Sule Medha
Published: July 2024

This chapter focuses on single best answer questions that test knowledge on the immunology that is relevant for the MRCOG part 1 examination. An understanding of the basic principles that underpin medical immunology is important for clinical practice that underpins obstetrics and gynaecology. For example, fetal haemolysis is an important consideration within the antenatal context; an understanding of the underlying immunology will help to understand this better and provide safe care. Immune system related medical conditions are not uncommon and therefore an understanding of how and why they develop is important. An understanding of basic immunology is important in the context of stillbirth and any respective investigations that are requested to identify a potential cause.
Biophysics
Authors: Karavadra Babu , Haines Richard A. , Sule Medha
Published: July 2024

This chapter focuses on single best answer questions that test knowledge on the biophysics that is relevant for the MRCOG part 1 examination. An understanding of the basic biophysics that underpin the practice of obstetrics and gynaecology is important. An awareness of when the different imaging modalities should be considered, as well as their beneficial and non-beneficial effects is extremely important. As in any area of medicine, patient safety must always be at the forefront of care, an understanding of basic biophysics is vital to achieve this. Knowledge of the different types of suture material used within the specialty is important; particular considerations include the length of time a particular suture takes to dissolve.
Data interpretation
Authors: Karavadra Babu , Haines Richard A. , Sule Medha
Published: July 2024

This chapter focuses on single best answer questions that tests data management that is relevant for the MRCOG part 1 examination. The ability to correctly interpret data is important for patient safety. There are many examples of data interpretation within obstetrics and some of these include a partogram, cardiotocographs (CTGs) and fetal ultrasound scans. Within the context of gynaecology, examples include common endocrinological tests, imaging results and applying them to the clinical context. A good understanding of physiology and pathology is important when interpreting data within the clinical context.
Pharmacology
Authors: Karavadra Babu , Haines Richard A. , Sule Medha
Published: July 2024

This chapter focuses on single best answer questions that test knowledge on the pharmacology that is relevant for the MRCOG part 1 examination. An understanding of the basic principles of pharmacology is important for the practice of obstetrics and gynaecology. Knowledge of the mechanism of action of the various drugs, their indications and contraindications is important as part of patient safety. It is important to know the common side effects of the drugs used within the specialty and how this can impact on the fetus during pregnancy. The principles of pharmacology should not be seen in isolation; often it is combined with knowledge that underpins physiology and biochemistry.
Clinical management
Authors: Karavadra Babu , Haines Richard A. , Sule Medha
Published: July 2024

This chapter focuses on single best answer questions that test knowledge on the clinical management of scenarios that are relevant for the MRCOG part 1 examination. This aspect of the curriculum focuses on applied knowledge within the clinical context. As with any clinical problem, there may be several approaches that can be taken to explore the issues further. However, through direct clinical experience, an understanding of the common presentations that underpin the practice of obstetrics and gynaecology will become clear. The clinical management aspect of the part 1 examination will test your ability to apply your knowledge of the basic sciences to the given clinical context.
Cellular, Tissue, and Body Fluid Fundamentals
Authors: Morchi Ravi
Published: July 2024

This opening chapter is a review of the cellular and physiologic fundamentals of surgery. It starts with cell structure and function, including growth cycles and organelle activity. This is followed by the molecular and cellular components of inflammation, and phases of wound healing. Thereafter the chapter covers essential surgical facts about nutrition in various stressed states, digestion of carbohydrates, protein, and lipids, body fluid composition with electrolyte balance, and acid–base status. Information in this chapter will guide residents through both examination and clinical environments.
Hematology
Authors: Morchi Ravi
Published: July 2024

A review of clinically relevant hematologic principles for the care of surgical patients. It starts with the coagulation cascade, including the different laboratory measures of coagulative function. Then it covers features of blood product transfusion, transfusion reactions, and medical measures to augment hemostasis. Clinically relevant antiplatelets, anticoagulants, and thrombolytics are described, and commonly tested hypercoagulable states and bleeding disorders are reviewed. The chapter closes with high yield facts on dyshemoglobinemias.
Anorectal
Authors: Morchi Ravi
Published: July 2024

The chapter begins with anorectal anatomy and mechanics for storage and controlled defecation. A brief mention of diagnostic tests is followed by sections on constipation, prolapse, proctitis, and the solitary rectal ulcer. The next portion of the chapter focuses on anal neoplasia, including benign lesions, anal canal malignancies, and anal margin malignancies. The clinical approach to hemorrhoids, abscesses, and various types of fistulae is detailed. The chapter ends with management of incontinence, anal fissure, and highlights of other commonly tested perianal pathology.
Liver
Authors: Morchi Ravi
Published: July 2024

Tissue architecture and cellular structure of the liver, including its dual circulation and excretory pathway, are key to its productive and detoxifying role in the human body. Basic imaging modalities are summarized, from where the majority of hepatic pathology is diagnosed. Clinical features and management of the complications of liver failure, including ascites, encephalopathy, portal hypertension, and varices occupy the central portion of the chapter. A comprehensive review of mass lesions follows: cysts, abscesses, benign masses, liver metastases, hepatocellular carcinoma, and intrahepatic cholangiocarcinoma. Focus is on the specifics of diagnosis and treatment for each entity. The chapter closes with principles and operative steps of hepatectomy and liver transplantation.
Pancreas
Authors: Morchi Ravi
Published: July 2024

Embryology, structure, and function of both the exocrine and endocrine components of the pancreas are outlined initially. The diagnosis and treatment principles for acute and chronic pancreatitis, and management of anatomic complications like peripancreatic fluid collections, walled off necrosis, and pseudocysts follows thereafter. Surgical drainage, debridement, and resection options are detailed. The common malignant pancreatic masses, including adenocarcinoma and neuroendocrine variants are each described. A stepwise guide to pancreaticoduodenectomy is next. Serous and mucinous benign and precancerous masses, and their management algorithms, are also reviewed. The chapter closes with a summary of laparoscopic distal pancreatectomy and pancreas transplantation- both solid organ and islet cell.
Breast
Authors: Morchi Ravi
Published: July 2024

The diagnosis and management of breast pathology represents a large portion of the board examination. The tissue and cellular anatomy, neural innervation, and venous and lymphatic network of the breast and axilla are reviewed in the opening portion of the chapter. Indications and mechanisms of breast screening are detailed with particular focus on high-yield facts for the examination. Imaging and biopsy workup of breast lesions is next. Following this is a listing of pertinent benign breast entities, then invasive ductal and lobular cancer, and inflammatory breast cancer. The information is presented for surgical residents to quickly move through the diagnostic algorithm and staging. Relevant facts about carcinoma in situ (ductal, lobular, and Paget’s disease of the nipple) are outlined thereafter. Next is a succinct description of partial mastectomy (lumpectomy) and the various forms of total mastectomy, as well as breast reconstruction options. A large section of the chapter is focused on management of the axillae for occult or overt nodal involvement. Indications for, and components of, chemotherapy and radiation are reviewed. The final portion of the chapter is focused on recurrence and considerations in pregnancy.
Critical Care
Authors: Morchi Ravi
Published: July 2024

This chapter begins with cardiopulmonary principles of critical care and cardiovascular pharmacology geared toward the surgical resident. Subsequently we have a focused review of the different forms of shock and the sequential organ failure assessment (SOFA) score. Following this, common neurologic, pulmonary, and renal critical care entities are each given their own section. Included are high-yield facts on diagnosis and management of elevated intracranial pressure, brain death, acute respiratory distress syndrome (ARDS), and acute kidney injury.
Burn
Authors: Morchi Ravi
Published: July 2024

This brief review of burns is meant to assist the surgeon in clinical and examination environments. It starts by addressing epidermal and dermal anatomy and function. The different types and degrees of burns are outlined. Principles of treatment include fluid resuscitation, nutritional supplementation, escharotomy, and skin graft coverage for control of the systemic inflammatory response. Commonly tested topical antimicrobials are listed. The chapter closes with a targeted summary of chemical and electrical burns, hypothermia, frostbite, inhalation injury, and immune-mediated epidermal disease.
Urology and Gynecology
Authors: Morchi Ravi
Published: July 2024

This chapter reviews basic renal, ureteral, bladder, and urethral anatomy and pathology for the general surgeon preparing for board examination. The fundamental architecture and pathophysiology of disease of the female genital tract is also described, with a focus on high-yield facts. Commonly tested benign and malignant entities, and their treatment, are briefly summarized.
Vitreoretinal lymphoma
Authors: Steffanoni Sara , Mochizuki Manabu , Batchelor Tracy , Carbonell Denise , Zierhut Manfred , Ferry Judith
Published: July 2024

Primary vitreoretinal lymphoma (PVRL) represents <1% of all intraocular tumours. The diagnosis of PVRL is challenging and clinical symptoms often mimic chronic uveitis. Multimodality ocular imaging is useful when there is a suspicion of PVRL, but pathological confirmation is essential. Ninety-five per cent of PVRL cases are diffuse large B-cell lymphomas. Additional morphological analyses performed on the vitreous and aqueous humour have improved the diagnostic yield. Local radiotherapy or intravitreal injection of steroid and/or low doses of methotrexate results in ocular remission in >80% of cases, but there is a high rate of ocular and/or central nervous system (CNS) relapse within 2 years. High-dose intravenous methotrexate, with or without local treatment, is being investigated in PVRL, with the dual aims of obtaining local disease control and preventing CNS relapse. This chapter covers the epidemiology, pathogenesis, diagnosis, and treatment options for PVRL.
Histiocytic tumours of the central nervous system
Authors: Abla Oussama , Picarsic Jennifer
Published: July 2024

Histiocytoses are heterogeneous neoplasms of the haematopoietic system characterized by the accumulation of histiocytes with variable inflammatory infiltrates. The identification of the crucial role of the mitogen-activated protein kinase (MAPK) pathway has opened the door to new targeted therapies. This chapter reviews the central nervous system (CNS) manifestations and treatment of six histiocytic disorders: Langerhans cell histiocytosis (LCH), juvenile xanthogranuloma (JXG), Erdheim–Chester disease (ECD), Rosai–Dorfman–Destombes disease (RDD), and histiocytic sarcoma (HS). CNS involvement occurs in 10–25% of LCH cases and can manifest in tumorous or neurodegenerative forms, which can have different clinical, radiographic, and prognostic implications. Intracranial JXG accounts for 2% of all JXG cases, is more common in males, and is usually leptomeningeal, with frequent concurrent systemic disease. Almost 40% of ECD patients can present with tumourous or neurodegenerative manifestations, and this can affect the brain parenchyma, leptomeninges, and hypothalamic–pituitary axis. RDD CNS lesions are usually tumourous, with meningeal or parenchymal masses without neurodegenerative lesions. Refractory CNS histiocytic neoplasms should lead to the consideration of targeted kinase inhibitor therapies such as BRAF/MEK or ERK inhibitors.
Neurological complications of cell therapies in haematological malignancies
Authors: Hottinger Andreas F. , Ghesquières Hervé , Touat Mehdi
Published: July 2024

Cell therapies comprising haematological stem cell transplantation (HCT) and adoptive T-cell therapies (ACT) have become an essential part in the treatment of an expanding range haematological and non-haematological conditions. HCT involves the intravenous infusion of haematopoietic progenitor cells from the patient (autologous) or from a human leucocyte antigen (HLA)-matched donor (allogeneic). Prior to HTC, the patient typically undergoes high-dose preparative chemotherapy to eradicate residual malignant cells and suppress the immune system. After allogeneic HCT, it is essential to prevent graft rejection and graft-versus-host disease. Management of neurological complications after HCT is challenging. Complications may result from a wide range of factors, including drug-related toxicities, infections from fungi, bacteria, or viruses, metabolic encephalopathies, and immune-mediated disorders, as well as disease recurrence. Neurotoxicity associated with immune effector cell therapy such as chimeric antigen receptor (CAR)-T-cell and bispecific T-cell engager (BiTE) treatments is classified as immune effector cell-associated neurotoxicity syndrome (ICANS). ICANS may develop days to weeks following immune effector cell therapy. It may present as non-localizing symptoms, such as encephalopathy, memory loss and headaches, as well as with focal neurological deficits, including, hemiparesis, ataxia, weakness, and aphasia. Rapid recognition and timely treatment of these neurological complications are essential to reduce the risk of permanent neurological deficits and death.
Neurological complications of white blood cell disorders
Authors: Grisold Wolfgang , Calimeri Teresa , Santomasso Bianca D.
Published: July 2024

Disorders of white blood cells can cause a variety of neurological complications. Hyperviscosity syndrome is caused by hyperviscous blood, plasma, or serum and occurs in several haematological disorders. Waldenström’s macroglobulinaemia is the most common cause of hyperviscosity syndrome, followed by immunoglobulin A (IgA) and immunoglobulin G3 (IgG3) multiple myeloma, with a serum paraprotein concentration of over 8 g/dl. Symptoms of hyperviscosity syndrome include mucocutaneous bleeding and ophthalmological and neurological symptoms, including headache, vertigo, nystagmus, dizziness, tinnitus, hearing loss, diplopia, and ataxia. Hyperviscosity syndrome rarely causes confusion, dementia, disturbances of consciousness, stroke, and coma. There is no correlation between measured blood or serum viscosity and clinical symptomatology. Management of hyperviscosity syndrome consists of plasmapheresis for symptomatic improvement followed by concurrent initiation of chemotherapy. Bing–Neel syndrome, a rare disease manifestation of Waldenström’s macroglobulinaemia, characterized by infiltration of lymphoplasmacytic cells into the central nervous system, should be considered in the differential diagnosis of hyperviscosity syndrome. Amyloid and amyloidosis comprise a wide range of conditions, affecting the peripheral nervous system and, to a lesser extent, the central nervous system. AL amyloidosis occurs in monoclonal gammopathies, multiple myeloma, plasmacytoma, Waldenström’s macroglobulinaemia, chronic lymphocytic lymphoma, and other low-grade lymphomas. The most frequent peripheral nervous system lesions are generalized neuropathy and carpal tunnel syndrome, often combined with autonomic dysfunction. Other focal lesions can affect cranial nerves, nerve roots, the plexus, and individual nerves. Amyloidoma and muscle involvement are rare. Local amyloidosis can mimic peripheral nerve lesions. Involvement of the musculoskeletal system, including joints and fascia, has been reported. The central nervous system is less frequently affected, although brain and spinal amyloidomas have been described.
Multifunctional 3D matrixes based on flexible bioglass nanofibers for potential application in postoperative therapy of osteosarcoma
Authors: Wang Lihuan , Yuan Liting , Dong Yanbing , Huang Wenli , Zhu Jichang , Du Xuexian , Zhang Chenglin , Liu Pengbi , Mo Jinpeng , Li Bingyan , Liu Zijin , Yu Xi , Yu Hui
Published: July 2024

Postoperative treatment of osteosarcoma is one of the major challenging clinical issues since both elimination of residual tumors and acceleration of bone regeneration should be considered. Photothermal therapy has been widely studied due to its advantages of small side-effect, low-toxicity, high local selectivity and noninversion, and bone tissue engineering is an inevitable trend in postoperative treatment of osteosarcoma. In this study, we combined the tissue engineering and photothermal therapy together, and developed a kind of multifunctional nanofibrous 3D matrixes for postoperative treatment of osteosarcoma. The flexible bioactive glass nanofibers (BGNFs) prepared by sol–gel electrospinning and calcination acted as the basic blocks, and the genipin-crosslinked gelatin (GNP-Gel) acted as the cement to bond the BGNFs forming a stable 3D structure. The stable porous 3D scaffolds were obtained through ice crystal templating method and freeze-drying technology. The obtained GNP-Gel/BGNF 3D matrixes showed a nanofibrous structure that highly biomimetics the extracellular matrix. The excellent compression recovery performance in water of these matrixes made them suitable for minimally invasive surgery. In addition, these 3D matrixes were not only biocompatible in vitro, but also benefit for the formation of mineralized bone in vivo. Furthermore, the dark blue GNP-Gel also acted as the photothermal agent, which endowed the GNP-Gel/BGNF 3D matrixes with efficient photothermal antitumor and photothermal antibacterial performance without addition of other toxic photothermal agents. Therefore, this study provides an ingenious avenue to prepare multifunctional nanofibrous 3D matrixes with photothermal therapy for postoperative treatment of osteosarcoma.
F1ALA: ultrafast and memory-efficient ancestral lineage annotation applied to the huge SARS-CoV-2 phylogeny
Authors: Ye Yongtao , Shum Marcus H , Wu Isaac , Chau Carlos , Zhao Ningqi , Smith David K , Wu Joseph T , Lam Tommy T
Published: July 2024

The unprecedentedly large size of the global SARS-CoV-2 phylogeny makes any computation on the tree difficult. Lineage identification (e.g. the PANGO nomenclature for SARS-CoV-2) and assignment are key to track the virus evolution. It requires annotating clade roots of lineages to unlabeled ancestral nodes in a phylogenetic tree. Then the lineage labels of descendant samples under these clade roots can be inferred to be the corresponding lineages. This is the ancestral lineage annotation problem, and matUtils (a package in pUShER) and PastML are commonly used methods. However, their computational tractability is a challenge and their accuracy needs further exploration in huge SARS-CoV-2 phylogenies. We have developed an efficient and accurate method, called “F1ALA”, that utilizes the F1-score to evaluate the confidence with which a specific ancestral node can be annotated as the clade root of a lineage, given the lineage labels of a set of taxa in a rooted tree. Compared to these methods, F1ALA achieved roughly an order of magnitude faster yet with ∼12% of their memory usage when annotating 2277 PANGO lineages in a phylogeny of 5.26 million taxa. F1ALA allows real-time lineage tracking to be performed on a laptop computer. F1ALA outperformed matUtils (pUShER) with statistical significance, and had comparable accuracy to PastML in tests on empirical and simulated data. F1ALA enables a tree refinement by pruning taxa with inconsistent labels to their closest annotation nodes and re-inserting them back to the pruned tree to improve a SARS-CoV-2 phylogeny with both higher log-likelihood and lower parsimony score. Given the ultrafast speed and high accuracy, we anticipated that F1ALA will also be useful for large phylogenies of other viruses. Codes and benchmark datasets are publicly available at https://github.com/id-bioinfo/F1ALA.