bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postoperative pain management following laparoscopic cholecystectomy-non-opioid approaches: a review
Authors: Bayoumi Hoda Mohamed , Abdelaziz Doaa Hamed , El Said Nouran Omar , Boraii Sherif , Bendas Ehab Rasmy 
Published: September 2024

Abstract
Background
Gallstone disease with its consequences is a common clinical issue that may necessitate surgical removal. In comparison with traditional open procedures, laparoscopic cholecystectomy (LC) remains the mainstay treatment for symptomatic gallstone disease and can lead to a shorter recovery period, and a shorter hospital stay; yet, severe abdominal and shoulder pain may be experienced.

Main body
Novel drugs and technology for acute and chronic pain management following LC have been studied to improve patient care. The review discusses innovative pain management strategies with non-opioid approaches for laparoscopic surgery, with an emphasis on ensuring speedy and safe recovery.

Conclusion
The key findings state that IV paracetamol is a necessary part of multimodal postoperative pain management. There were several pharmacological interventions found to be effective in pain control: magnesium sulfate and dexamethasone showed anti-inflammatory benefits; ondansetron provided analgesic effects; gabapentinoids and alpha-2-agonists reduced central sensitization; local anesthetics offered targeted pain relief; antidepressants addressed neuropathic pain; NSAIDs proved effective for inflammatory pain. Similarly, non-pharmacological approaches, and emerging technologies, also contributed to the management of post-LC pain underscoring the need for a comprehensive approach to its management. More rigorous research is needed to guide pain management after LC. Future studies should compare multiple treatments simultaneously and involve larger patient groups. This approach will help identify optimal pain control strategies. It will also provide clearer insights into the safety and efficacy of various pain medications under comparable clinical conditions.
Multichannel 3D-printed bionanoparticles-loaded tablet (M3DPBT): designing, development, and in vitro functionality assessment
Authors: Rana Hardik , Pathak Priyanka , Patel Vimal , Thakkar Vaishali , Dholakia Mansi , Dalwadi Saloni , Gandhi Tejal 
Published: September 2024

Abstract
Background
The intersubject variability which was related to the genetic makeup was the major cause of change in pharmacological and pharmacokinetic behavior of same dosage form in varied human being. 3D printing technology will help therapy evolve and eliminate the limitations of conventional technologies. Nebivolol's (NBL)-limited oral bioavailability is mainly due to its poor aqueous solubility. The research aims to combine advanced 3D printing technology and nanotechnology to design customized therapy and enhance the functionality of NBL using a statistical approach.

Results and discussion
The results of the phase solubility indicated that NBL was a poorly aqueous soluble drug. Its solubility was increased by employing nanoparticle drug delivery, which is a promising solubility enhancement technique. The 32 full factorial design was employed to develop and optimize bionanoparticles (BNPs) by solvent evaporation technique using poly (lactic-co-glycolic acid 50:50) (PLGA 50:50) and poloxamer-407 as a surfactant. The BNPs were characterized by % encapsulation efficiency (% EE), Fourier transform infrared spectroscopy (FTIR) and differential scanning calorimeter (DSC), transmission electron microscope (TEM), zeta potential, polydispersity index (PDI), particle size, in vitro drug release, etc. The BNPs loaded of NBL were further incorporated into the multichannel 3D-controlled release tablets made by PVA filaments employing fused deposition modeling (FDM) technology optimized by central composite design (CCD). Multichannel 3D-printed bionanoparticles-loaded tablet (M3DPBT) was optimized using CCD. All designed M3DPBTs were evaluated for post-fabrication parameters. The optimized M3DPBT could release more than 85% NBL within 10 h.

Conclusions
The newly fabricated M3DPBT was found stable. The amount of PLGA 50:50 and Polaxomer was significant for developing BNPs. % infill and layer height were observed as critical for the designing M3DPBT. The combined novel 3D printing and nanotechnology technology will open a new direction for patient compliance and better therapeutic effects.

Graphical abstract
Designing and developing of M3DPBT is substantially improve the patient compliance and therapeutic effectiveness of Nebivolol.
Fourth COVID anniversary: does our practice have changed? The case of ENT outpatient consultations in Cameroon — a national cross-sectional survey
Authors: Mossus Yannick , Ngo Nyeki Adèle-Rose , Mossus Tatiana , Atanga Leonel Christophe , Meva’a Biouélé Roger Christian , Ngaba Mambo Pouka Olive Nicoles , Djomou François , Essi Marie-José , Njock Louis Richard , Ndjolo Alexis 
Published: September 2024

Abstract
Background
In Cameroon, the COVID-19 disease has demonstrated shortcomings in preventing nosocomial infections at both collective and individual levels. This study aimed to identify practice changes in ENT outpatient consultations in Cameroon inducted by the COVID-19 pandemic.

Methods
This was a descriptive cross-sectional study that took place in March 2024. A Google Form was submitted to ENT practitioners online across Cameroon. It consisted of 20 questions grouped into socio-professional and clinical data.

Results
Sixty-four practitioners responded to the questionnaire. The average age of respondents was 36, with extremes of 31 and 70. The sex ratio was 0.35 in favor of women. In terms of experience, 47.7% had been practicing for less than 10 years. A total of 91.3% practiced in public health facilities. Before the COVID-19 outbreak, attitudes towards respiratory diseases were as follows: wearing of masks by suspected patients (4.3%), information posters in waiting rooms (13%), constant use of disinfectant gel (26.1%), wearing of masks by practitioners (0%), wearing of gloves (54.5%), wearing of gowns (87%), constant hand hygiene after each consultation (26.1%), and regular surface hygiene (30.4%). All precautions were improved after 4 years of the pandemic except wearing eye protection.

Conclusion
ENT practice has been strongly impacted by the COVID-19 pandemic, and many measures still need to be taken to improve infection control in hospitals in Cameroon.
Knapsack air assisted electrostatic sprayer for agricultural formulations
Authors: Khatawkar Dipak S. , Dharaneedharan Dhalin , James P. Shaji 
Published: September 2024

Abstract

An experimental prototype of a backpack-type rechargeable battery-powered air-assisted electrostatic sprayer was designed and tested for performance while preserving techno-commercial competence and affordability for India's marginal and small farmer communities. The designed prototype electrostatic sprayer achieved good levels of charge induction on the spray particles at various electrode potentials (1 to 12 kV). At a charging electrode potential of 9 kV and a nozzle discharge rate of 2 mL s
−1
, electrostatically charged spray had a maximum charge to mass ratio (CMR) of 1.79 mC kg
−1
. The Electric Ducted Fan (EDF) used for high velocity air assistance was capable of transporting charged spray droplets onto distant targets such as orchard trees and field crops with a spray throw of up to 5 m. The high-pressure atomization method produced fine droplets within a Volume Median Diameter (VMD) range of 90 to 100 µm, resulting in better charge induction and wrap-around effect. As the prototype features fewer moving mechanical components, reduced total noise and vibrations, it promises operator comfort in the long run while requiring less system maintenance. Environmental contamination can be minimized as the large quantity of harmful chemicals be prevented from drifting into the soil and nearby waterbodies. The competitive performance and lower investment could encourage majority of the Indian famers to upgrade with the developed air assisted electrostatic spraying system contributing to agro-socio-economic welfare.
Hyperinsulinemic Hypoglycemia Due to an Insulinoma in a 2-Year-Old Child
Authors: Mitteer Lauren M , States Lisa , Bhatti Tricia , Adzick N Scott , Lord Katherine , De León Diva D 
Published: September 2024

Abstract
Insulinomas are rare insulin-secreting tumors that most commonly affect adults. A 26-month-old child presented to her local emergency department with severe hypoglycemia. Initial workup was consistent with hyperinsulinemic hypoglycemia. Over the course of 10 months, multiple therapies for hyperinsulinism (HI) were trialed without significant benefit. Genetic testing for genes associated with HI was negative. At age 35 months, the patient was transferred to our center for further treatment. She underwent several imaging tests that revealed a lesion on her pancreas concerning for an insulinoma. The patient underwent surgical intervention to enucleate the lesion. Histopathological review of the specimen confirmed a benign, well-circumscribed insulinoma. A postoperative fasting test proved the patient was cured and she was discharged without the need for further glucose monitoring.
Classifying High-Risk Patients for Persistent Opioid Use After Major Spine Surgery: A Machine-Learning Approach
Authors: Simpson Sierra , Zhong William , Mehdipour Soraya , Armaneous Michael , Sathish Varshini , Walker Natalie , Said Engy T. , Gabriel Rodney A. 
Published: September 2024

BACKGROUND:
Persistent opioid use is a common occurrence after surgery and prolonged exposure to opioids may result in escalation and dependence. The objective of this study was to develop machine-learning–based predictive models for persistent opioid use after major spine surgery.

METHODS:
Five classification models were evaluated to predict persistent opioid use: logistic regression, random forest, neural network, balanced random forest, and balanced bagging. Synthetic Minority Oversampling Technique was used to improve class balance. The primary outcome was persistent opioid use, defined as patient reporting to use opioids after 3 months postoperatively. The data were split into a training and test set. Performance metrics were evaluated on the test set and included the F1 score and the area under the receiver operating characteristics curve (AUC). Feature importance was ranked based on SHapley Additive exPlanations (SHAP).

RESULTS:
After exclusion (patients with missing follow-up data), 2611 patients were included in the analysis, of which 1209 (46.3%) continued to use opioids 3 months after surgery. The balanced random forest classifiers had the highest AUC (0.877, 95% confidence interval [CI], 0.834–0.894) compared to neural networks (0.729, 95% CI, 0.672–0.787), logistic regression (0.709, 95% CI, 0.652–0.767), balanced bagging classifier (0.859, 95% CI, 0.814–0.905), and random forest classifier (0.855, 95% CI, 0.813–0.897). The balanced random forest classifier had the highest F1 (0.758, 95% CI, 0.677–0.839). Furthermore, the specificity, sensitivity, precision, and accuracy were 0.883, 0.700, 0.836, and 0.780, respectively. The features based on SHAP analysis with the highest impact on model performance were age, preoperative opioid use, preoperative pain scores, and body mass index.

CONCLUSIONS:
The balanced random forest classifier was found to be the most effective model for identifying persistent opioid use after spine surgery.
Safety and Efficacy of Balloon-Assisted Kyphoplasty Followed by Stereotactic Body Radiation Therapy for Pathological Fractures
Authors: Adida Samuel , Kann Michael R. , Taori Suchet , Bhatia Shovan , Sefcik Roberta K. , Burton Steven A. , Flickinger John C. , Gerszten Peter C. 
Published: September 2024

BACKGROUND AND OBJECTIVES:
In patients experiencing pain secondary to pathological compression fractures, balloon-assisted kyphoplasty and subsequent stereotactic body radiation therapy (SBRT) may allow for restoration of vertebral height and irradiation of the underlying malignancy to control local disease progression. The aim of this study was to evaluate the safety and efficacy of kyphoplasty treatment before SBRT in patients with spinal metastases and benign tumors.

METHODS:
An analysis of a prospectively collected database of 70 patients and 75 metastatic and benign spinal lesions that underwent kyphoplasty before SBRT at a single institution (2002-2023) was conducted. Patient characteristics were recorded, including treatment history, dosimetry and fractionation schedule, pain outcomes, local control (LC), and overall survival. The Bilsky score and Spinal Instability Neoplastic Score were calculated to assess epidural involvement and spinal stability, respectively.

RESULTS:
The median time from kyphoplasty to SBRT was 29 days (range: 2-159). Seventy-two lesions (96%) were managed with single-fraction SBRT and 3 lesions (4%) with a multifraction regimen. The median single-fraction prescription dose was 20 Gy (range: 12-25) delivered to a median tumor volume of 35.1 cc (range: 2.2-160). After a median follow-up period of 9 months (range: 1-201), 6 lesions (8%) locally progressed. Pain was reported to improve or remain stable for most patients (88%). The LC rate was 88% at 6 months, 1 year, and 2 years. No prognostic factors were significantly associated with LC. The median overall survival was 11 months (range: 1-201) after radiosurgery. There were no reports of cement extravasation or radiation-induced neurological deficit. Two acute pain flares (3%) were reported 1 and 3 months after radiosurgery.

CONCLUSION:
The combined kyphoplasty and SBRT treatment paradigm can be used to treat patients with painful pathological compression fractures. Long-term LC and patient-reported improvement in pain were observed without the morbidity associated with open surgery.
Evaluation of AJCC Nodal Staging for Intraductal Papillary Mucinous Neoplasm-Derived Pancreatic Ductal Adenocarcinoma
Authors: Habib Joseph R. , Rompen Ingmar F. , Javed Ammar A. , Sorrentino Anthony M. , Riachi Mansour E. , Cao Wenqing , Besselink Marc. G. , Molenaar I. Quintus , He Jin , Wolfgang Christopher L. , Daamen Lois A. 
Published: September 2024

Abstract
Background
The American Joint Committee on Cancer (AJCC) eighth edition is based on pancreatic intraepithelial neoplasia-derived pancreatic ductal adenocarcinoma (PDAC), a biologically distinct entity from intraductal papillary mucinous neoplasm (IPMN)-derived pancreatic cancer. The role of nodal disease and the AJCC’s prognostic utility for IPMN-derived pancreatic cancer are unclear. This study aimed to evaluate the prognostic role of nodal disease and the AJCC eighth-edition N-staging for IPMN-derived pancreatic cancer.

Methods
Upfront-surgery patients with IPMN-derived PDAC from four centers were stratified according to the AJCC eighth-edition N stage. Disease characteristics were compared using descriptive statistics, and both overall survival (OS) and recurrence-free survival (RFS) were evaluated using log-rank tests. Multivariable Cox regression was performed to determine the prognostic value of N stage for OS, presented as hazard ratios with 95 % confidence intervals (95 % CIs). A lowest p value log-rank statistic was used to derive the optimal cutoff for node-positive disease.

Results
For 360 patients, advanced N stage was associated with worse T stage, grade, tubular histology, and perineural and lymphovascular invasion (all p < 0.05). The median OS was 98.3 months (95 % CI 82.8–122.0 months) for N0 disease, 27.8 months (95 % CI 24.4–41.7 months) for N1 disease, and 18.1 months (95 % CI 16.2–25.9 months) for N2 disease (p < 0.001). The AJCC N stage was validated and associated with worse OS (N1 [HR 1.64; range, 1.05–2.57], N2 [HR2.42; range, 1.48–3.96]) and RFS (N1 [HR 1.81; range, 1.23–2.68], N2 [HR 3.72; range, 2.40–5.77]). The optimal cutoff for positive nodes was five nodes.

Conclusion
The AJCC eighth-edition N-staging is valid and prognostic for both OS and RFS in IPMN-derived PDAC.
Optimal timing for lithium levels
Authors: Black Kevin J 
Published: September 2024

Reddy and Reddy (2014) discuss the optimal timing for lithium levels in patients taking once-daily extended-release lithium formulations. They argue for blood sampling 24 h after the previous dose rather than the standard 12 h. I interpret the data quite differently. The authors start with the assumption that the clinician wants a trough level. I disagree. What one wants is to be able to compare a patient’s lithium level to the large body of published knowledge about lithium dosing. Almost all of that data comes from standard 12-h blood draws with plain (immediate-release) lithium carbonate or lithium citrate. So, the real question of interest is, with extended-release lithium formulations, at what time point does one draw the lithium level to compare most accurately with a standard 12-h blood draw with plain lithium carbonate? The answer is not obvious because extended-release formulations affect only the absorption and not the excretion of lithium. Their primary benefit is reducing the transient peak lithium serum concentration, not delaying the (already relatively slow) elimination of lithium. Emami and colleagues (2004) provide the needed data. First they show that 90% of the administered dose of a commercial extended-release formulation (Eskalith CR®) is absorbed by 4 h after a dose, and ~100% is absorbed by 8 h (their Figure 2A). Second, they show that at 12 h after a dose, the blood levels for immediate and extended release formulations are essentially identical (their Figure 3). Thus 12 h after the previous dose is the ideal time for drawing blood levels for extended-release lithium tablets.
Snapshot GISC video level 3D imaging based on phase modulation
Authors: Li Meixuan , Wang Meijiao , Guo Naijie , Yang Feng 
Published: September 2024

For traditional point-to-point imaging technology, amplitude modulation intensity correlation imaging technology, and computational imaging technology based on channel coding, there are defects of insufficient channel utilization. To overcome this limitation, this paper proposes a scheme to reconstruct 3D spectral imaging at a video-level imaging rate using a ghost imaging via sparsity constraints (GISC) snapshot spectroscopic camera. The modulation/demodulation process of snapshot video spectral imaging is elaborated based on the imaging principle of a snapshot GISC spectral camera and the design method of DOE in the GISC spectral camera. Experimental results demonstrate that the proposed method successfully captures hyper-spectral reconstructed images of 15 spectral channel wavelengths, including 461–698 nm, while recording three small fish of different colors in motion at a rate of 30 frames/second. The method and result presented will have great application prospects in satellite remote sensing data analysis, air traffic control, animal migration monitoring research, and escaping vehicle tracking in traffic accidents.
Three-parameter sensing characteristics of PCF based on surface plasmon resonance
Authors: Gao Zhijun , Shang Tong , Si Guangyuan , Ying Yu 
Published: September 2024

In this study, a refractive index-temperature sensor based on surface plasmon resonance (SPR) in photonic crystal fiber (PCF) is proposed. Unlike conventional dual-parameter sensing research, this sensor features three sensing channels, offering the advantages of high-sensitivity measurements without cross-interference, utilizing three different plasmonic materials (Au, AZO, Ag), and enabling accurate measurement of temperature and refractive indices of two different analytes simultaneously. The finite element method is employed to investigate the influence of sensor structural parameters on sensing performance and optimize these parameters. In channel 1, analytes within the range of 1.37–1.43 can be detected, with maximum wavelength sensitivity (WS) of 31,500 nm/RIU and maximum amplitude sensitivity (AS) of 5690RIU−1. The range of the SPR sensor in CH-2 is 1.25–1.40, with a max WS value of 5500 nm/RIU and peak AS of 10,845RIU−1. Furthermore, the sensor obtains a higher figure of merit of 2357RIU−1 and a maximum wavelength resolution of 9.2208×10−7. Regarding temperature sensing, the proffered sensor has shown its ability to detect environmental temperature, with a wide detection range from 5°C to 95°C degrees and a maximum WS of 6.3 nm/°C. In summary, the proposed PCF-SPR sensor is capable of precise measurement of solution concentration and environmental temperature over a wide range, exhibiting high sensitivity and possessing potential applications in biosensing, environmental temperature detection, and more.
Lake-wide measurements of primary productivity in Lake Erie
Authors: Lesht Barry M. , Scofield Anne E. , Bockwoldt Katelyn A. 
Published: September 2024

Abstract
Few lake-wide, seasonal primary production measurements have been made in Lake Erie. None more recent than 1997 have been reported in the literature. In 2019 we used 13C uptake to measure production at 11 stations across the lake during three surveys in May, July, and September and at four of these stations during two additional surveys in April and August. Samples were collected at two depths (2 m and 6 m) and incubated on deck using eight levels of irradiance. We fit the resultant photosynthesis-irradiance curves with models that included the initial slope at low light levels, the maximum photosynthesis rate at light saturation, and when warranted, the negative slope at high irradiance. During May, there was little variation in chlorophyll-normalized volumetric productivity with sample depth, and productivity generally was higher nearshore and in the western basin than it was offshore. The distinction between nearshore and offshore stations was less pronounced in July, but nearshore productivity was higher than offshore in September. Using the photosynthesis data from all five surveys, chlorophyll concentration profiles, and estimated clear-sky solar insolation, we calculated time series of vertically integrated daily production at a western basin station, two central basin stations, and an eastern basin station. Central basin production was highest during August, estimated to be 748 mg C m-2 d-1 and 779 mg C m-2 d-1 at our two stations. Production peaked in July in the western basin (510 mg C m-2 d-1) and September in the eastern basin (421 mg C m-2 d-1). Whole-lake seasonal areal phytoplankton photosynthesis was estimated as 1.661E6 tonnes, about half of estimates made in the 1990s using 14C methods. These results inform our understanding of spatial-temporal trends in Lake Erie productivity and highlight the need for continued measurements of Lake Erie primary production.
Rigid stabilizers and local prosolubility for boundary-transitive actions on tree
Authors: Reid Colin D. 
Published: September 2024

Abstract
Let 𝐺 be a group acting 2-transitively on the boundary of a locally finite tree, and exclude the situation (which is a genuine exception) where 𝐺 has both

P
⁢
Γ
⁢

L
3

⁢

(
4
)

\mathrm{P}\Gamma\mathrm{L}_{3}(4)

and

P
⁢
Γ
⁢

L
3

⁢

(
5
)

\mathrm{P}\Gamma\mathrm{L}_{3}(5)

as local actions.
We show that, for each half-tree

T
a

T_{a}

, the local action of the rigid stabilizer of

T
a

T_{a}

at the root of

T
a

T_{a}

contains the soluble residual of the point stabilizer of the local action of 𝐺.
In particular, 𝐺 is locally prosoluble if and only if its local actions have soluble point stabilizers; if 𝐺 is not locally prosoluble, then it has micro-supported action on the boundary.
We also prove some strong restrictions on the local actions of end stabilizers in 𝐺.
These results are partly inspired by Radu’s classification of groups acting boundary-2-transitively on trees with local action containing the alternating group, and partly based on the author’s recent classification of finite permutation groups that preserve an equivalence relation, act faithfully on blocks and act transitively on pairs of points from different blocks.