bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analgesic Effect of Ultrasound-Guided Anterior Quadratus Lumborum Block at the L2 Level in Patients Undergoing Laparoscopic Partial Nephrectomy: A Single-Center, Randomized Controlled Trial
Authors: He Ying , Huang Mingying , Zhong Qiangui , Ni Huijuan , Yu Zenggui , Zhang Xinjian 
Published: December 2022

Objectives. This study aimed to evaluate the effect of ultrasound-guided anterior quadratus lumborum block (QLB) at the L2 level in patients undergoing laparoscopic partial nephrectomy. Methods. Patients who were 18–70 years old with an American Society of Anesthesiologists (ASA) physical status of 1-2 and were scheduled for elective laparoscopic partial nephrectomy were recruited into the cluster randomized controlled trial. Sixty-three patients were randomly allocated to receive QLB (group Q, n = 32) or no block (group C, n = 31). The patients were not masked to the group allocations. The postoperative follower was blinded to the group allocations. All patients received total intravenous anesthesia, the same multimodal analgesic regimen, and rescue analgesia when needed. The primary outcome was perioperative cumulative sufentanil consumption. Results. 30 patients in group Q and 29 patients in group C were included in the statistical analysis. Block-related complications were not found in this study. Sufentanil consumption during the perioperative period (155.41 [19.58] vs 119.37 [12.41] μg,

p

< 0.001) and sufentanil dosage during surgery and 0–6 h, 6–12 h, and 12–24 h after surgery were lower in group Q than in group C, while 24–48 h after surgery was similar between both groups. The median sensory blockade area in group Q was T9-L1. Comparison of invasive blood pressure (BP) and heart rate (HR) before and after skin incision in group C was statistically significant, but there was no significant difference in group Q. Both at rest and during activity, numerical rating scale (NRS) scores and the incidence of rescue analgesia were lower in group Q at any time point after surgery. The incidences of postoperative nausea and vomiting (PONV), time from postoperative to discharge, postoperative recovery quality, or anesthesia satisfaction were similar between the two groups. Conclusions. Anterior QLB at the L2 level can reduce the perioperative dosage of sufentanil and the degree of postoperative pain in patients undergoing laparoscopic partial nephrectomy, but it did not improve postoperative recovery quality and anesthesia satisfaction.
Hydrogen Sulfide Creates a Favorable Immune Microenvironment for Colon Cancer
Authors: Yue Taohua , Li Jichang , Zhu Jing , Zuo Shuai , Wang Xin , Liu Yucun , Liu Jia , Liu Xiaoyun , Wang Pengyuan , Chen Shanwen 
Published: December 2022

AbstractImmunotherapy can elicit robust anticancer responses in the clinic. However, a large proportion of patients with colorectal cancer do not benefit from treatment. Although previous studies have shown that hydrogen sulfide (H2S) is involved in colorectal cancer development and immune escape, further insights into the mechanisms and related molecules are needed to identify approaches to reverse the tumor-supportive functions of H2S. Here, we observed significantly increased H2S levels in colorectal cancer tissues. Decreasing H2S levels by using CBS+/− mice or feeding mice a sulfur amino acid-restricted diet (SARD) led to a marked decrease in differentiated CD4+CD25+Foxp3+ Tregs and an increase in the CD8+ T-cell/Treg ratio. Endogenous or exogenous H2S depletion enhanced the efficacy of anti–PD-L1 and anti–CTLA4 treatment. H2S promoted Treg activation through the persulfidation of ENO1 at cysteine 119. Furthermore, H2S inhibited the migration of CD8+ T cells by increasing the expression of AAK-1 via ELK4 persulfidation at cysteine 25. Overall, reducing H2S levels engenders a favorable immune microenvironment in colorectal cancer by decreasing the persulfidation of ENO1 in Tregs and ELK4 in CD8+ T cells. SARD represents a potential dietary approach to promote responses to immunotherapies in colorectal cancer.Significance:H2S depletion increases the CD8+ T-cell/Treg ratio and enhances the efficacy of anti–PD-L1 and anti–CTLA4 treatment in colon cancer, identifying H2S as an anticancer immunotherapy target.
Unintended Consequences of Antibiotic Therapy on the Microbiome Delivers a Gut Punch in Ovarian Cancer
Authors: Hawkins Shannon M. , Nephew Kenneth P. 
Published: December 2022

AbstractWhile the early use of antibiotics during chemotherapy may be lifesaving, antibiotic therapy is associated with worse outcomes in patients with ovarian cancer during platinum chemotherapy. The study by Chambers and colleagues in this issue of Cancer Research provides mechanistic insights into how disrupting the gut microbiome with broad-spectrum antibiotics negatively influences the survival of patients with ovarian cancer and highlights the impact of the gut microbiome on tumor progression and response to therapy. Treatment of ovarian cancer models with a broad-spectrum antibiotic cocktail (ABX, vancomycin, neomycin sulfate, metronidazole, ampicillin) changed the gut microbiome and increased tumor growth and development of cisplatin resistance. Stem cells, reported to drive resistance to chemotherapy and disease recurrence in ovarian cancer, were enriched as a surprising consequence of ABX-induced microbiome disruption. Immune-competent and immune-deficient mice revealed that ABX treatment enhanced the cisplatin-induced stemness and provided evidence for immune surveillance of ovarian cancer stem cells through the gut microbiome. Two gut-derived metabolites, indole-3-propionic acid and indoxyl sulfate, suppressed by ABX treatment and reestablished with cecal microbial transplantation colonization of ABX-treated mice, were identified as potential effectors connecting the gut microbiome to ovarian cancer growth. This clinically relevant study opens new therapeutic opportunities for patients—one aimed at interventions to increase platinum sensitivity and another aimed at preventing the potential adverse effects of broad-spectrum antibiotic treatment. Both represent paradigm changes to standard care.See related article by Chambers et al., p. 4654
Coronary Artery Lesion Lipid Content and Plaque Burden in Diabetic and Nondiabetic Patients: PROSPECT II
Authors: Gyldenkerne Christine , Maeng Michael , Kjøller-Hansen Lars , Maehara Akiko , Zhou Zhipeng , Ben-Yehuda Ori , Erik Bøtker Hans , Engstrøm Thomas , Matsumura Mitsuaki , Mintz Gary S. , Fröbert Ole , Persson Jonas , Wiseth Rune , Larsen Alf I. , Jensen Lisette O. , Nordrehaug Jan E. , Bleie Øyvind , Omerovic Elmir , Held Claes , James Stefan K. , Ali Ziad A. , Rosen Hans C. , Stone Gregg W. , Erlinge David 
Published: December 2022

Background:
Patients with diabetes have increased rates of major adverse cardiac events (MACEs). We hypothesized that this is explained by diabetes-associated differences in coronary plaque morphology and lipid content.

Methods:
In PROSPECT II (Providing Regional Observations to Study Predictors of Events in the Coronary Tree), 898 patients with acute myocardial infarction with or without ST-segment elevation underwent 3-vessel quantitative coronary angiography and coregistered near-infrared spectroscopy and intravascular ultrasound imaging after successful percutaneous coronary intervention. Subsequent MACEs were adjudicated to either treated culprit lesions or untreated nonculprit lesions. This substudy stratified patients by diabetes status and assessed baseline culprit and nonculprit prevalence of high-risk plaque characteristics defined as maximum plaque burden ≥70% and maximum lipid core burden index ≥324.7. Separate covariate-adjusted multivariable models were performed to identify whether diabetes was associated with nonculprit lesion–related MACEs and high-risk plaque characteristics.

Results:

Diabetes was present in 109 of 898 patients (12.1%). During a median 3.7-year follow-up, MACEs occurred more frequently in patients with versus without diabetes (20.1% versus 13.5% [odds ratio (OR), 1.94 (95% CI, 1.14–3.30)]), primarily attributable to increased risk of myocardial infarction related to culprit lesion restenosis (4.3% versus 1.1% [OR, 3.78 (95% CI, 1.12–12.77)]) and nonculprit lesion–related spontaneous myocardial infarction (9.3% versus 3.8% [OR, 2.74 (95% CI, 1.25–6.04)]). However, baseline prevalence of high-risk plaque characteristics was similar for patients with versus without diabetes concerning culprit (maximum plaque burden ≥70%: 90% versus 93%,
P
=0.34; maximum lipid core burden index ≥324.7: 66% versus 70%,
P
=0.49) and nonculprit lesions (maximum plaque burden ≥70%: 23% versus 22%,
P
=0.37; maximum lipid core burden index ≥324.7: 26% versus 24%,
P
=0.47). In multivariable models, diabetes was associated with MACEs in nonculprit lesions (adjusted OR, 2.47 [95% CI, 1.21–5.04]) but not with prevalence of high-risk plaque characteristics (adjusted OR, 1.21 [95% CI, 0.86–1.69]).

Conclusions:
Among patients with recent myocardial infarction, both treated and untreated lesions contributed to the diabetes-associated ≈2-fold increased MACE rate during the 3.7-year follow-up. Diabetes-related plaque characteristics that might underlie this increased risk were not identified by multimodality imaging.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02171065.
Direct Simulation of the Surface Manifestation of Internal Gravity Waves with a Wave–Current Interaction Model
Authors: Yue Liangyi , Hao Xuanting , Shen Lian , Fringer Oliver B. 
Published: December 2022

Abstract
Internal solitary waves in the ocean are characterized by the surface roughness signature of smooth and rough bands that are observable in synthetic aperture radar satellite imagery, which is caused by the interaction between surface gravity waves and internal wave–induced surface currents. In this work, we study the surface signature of an internal wave packet in deep water over a large range of spatial scales using an improved wave–current interaction model that supports a moving surface current corresponding to a propagating internal gravity wave. After validating the model by comparison to previously published numerical results by Hao and Shen, we investigate a realistic case based on a recent comprehensive field campaign conducted by Lenain and Pizzo. Distinct surface manifestation caused by internal waves can be directly observed from the surface waves and the associated surface wave steepness. Consistent with observations, the surface is relatively rough where the internal wave–induced surface current is convergent (∂U/∂x < 0), while it is relatively smooth where the surface current is divergent (∂U/∂x > 0). The spatial modulation of the surface wave spectrum is rapid as a function of along-propagation distance, showing a remarkable redistribution of energy under the influence of the propagating internal wave packet. The directional wavenumber spectra computed in the smooth and rough regions show that the directional properties of the surface wave spectra are also rapidly modulated through strong wave–current interactions. Good agreement is found between the model results and the field observations, demonstrating the robustness of the present model in studying the impact of internal waves on surface gravity waves.

Significance Statement
The purpose of this study is to better understand the physical processes leading to the bands of rough and smooth surface waves arising from internal gravity waves. The surface manifestation of internal gravity waves allows them to be measured remotely via surface imagery, which can provide insight into their nonlinear behavior and sources and fate and which can ultimately inform the local stratification for assimilation into larger-scale models. Our results highlight the application of wave–current interaction models to the study of the interaction of surface waves with internal gravity waves and indicate strong modulation of the surface wave spectra over relatively short time scales despite the long time scales associated with the internal wave propagation.
Assessing the Extent of Rural Development in Punjab
Authors: Singh Jagmohan , Kumar Gulshan 
Published: December 2022

Rural development is widely acclaimed as a tool for economic development of any region by the policy makers. Being a multi-level and multi-faceted process, the actual status of rural development is insuperable to assess through the individual scrutiny of either one or a few development indicators. Therefore, the present study endeavours to reckon district level rural development and its disparities in Punjab through the formulation of a composite rural development index (RDI) encompassing four dimensions, namely rural economy, rural social transformation, rural health and education and rural infrastructure at five points in time, that is, 1981, 1991, 2001, 2011 and 2018 based on 29 development indicators. The findings of the study revealed a lopsided picture of rural development with a concentration of frontrunner districts mainly in the Doaba belt, while mediocre and laggard categories are dominated by the districts of the Malwa belt. Further, reduction in the level of inter-district disparities in rural development has also been observed over the study period. It is suggested that mediocre as well as laggard districts should be prioritised in resource allocation to curtail the extent of rural development disparities in the state. JEL Codes: C38, H54, O10, R10
Effect of extracorporeal shock wave therapy on pain and function in patients with knee osteoarthritis: a systematic review with meta-analysis and grade recommendations
Authors: Silva AC , Almeida VS , Veras PM , Carnaúba FRN , Filho JE , Garcia MAC , Fonseca DS 
Published: December 2022

ObjectiveTo investigate extracorporeal shock wave therapy effect on knee osteoarthritis compared to a sham or kinesiotherapy by a systematic review and meta-analysis of randomized clinical trials.Data SourcesThe search was performed in: Cochrane Library, PubMed, PEDro, Web of Science, EMBASE, Scopus, LILACS, and Scielo.Review methodsWe performed the online search until October, 2022. The following terms were used (Osteoarthritis) AND (“knee joint”) AND (“Extracorporeal Shockwave Therapy”). Eligibility criteria: (1) randomized clinical trials; (2) effects comparison of shockwave therapy to a sham or kinesiotherapy in individuals with knee osteoarthritis; (3) pain and physical function as outcome variables. Risk of bias assessed using the PEDro scale. PROSPERO registration (CRD42021235597).ResultsWe identified 4217 studies, and 12 were included in the qualitative synthesis and the meta-analysis, totaling 403 individuals submitted to the intervention and 331 control individuals. Compared to sham, shockwave was favored in short-term for the function outcome (SMD = −1.93; 95%CI: [−2.77; −1.09]; I² = 83%; P < 0.01). For the pain outcome, the shockwave was favored in the short (MD = −2.05; 95%CI: [−2.59; −1.51]; I² = 84%; P < 0.01), medium (MD = −3.46; 95%CI: [−4.03; −2.89]; I² = 0%; P < 0.01) and long-term (MD = −2.01; 95%CI: [−3.36; −0.65]; I² = 98%; P < 0.01). The association with kinesiotherapy was favored in the short term for the function outcome (SMD = -1.88; 95%CI: [−2.98; −0.78]; I² = 94%; P < 0.01) and favored for the pain outcome in the short (MD = −1.44; 95%CI: [−1.81; −1.07]; I² = 37%; P = 0.14), medium (MD = −1,31; 95%CI: [−1.76; −0,85]; I² = 0%; P = 0.41), and long terms (MD = −1.63; 95%CI: [−1.73; −1.52]; I² = 0%; P = 0.43).ConclusionShockwave therapy may improve functionality in patients with knee osteoarthritis in the short term and pain in all follow-up moments, compared with sham. When associated to kinesiotherapy, it may improve function in the short term and pain in all follow-up time points, although improvement in pain may not be clinically significant.
Comparison of the onset and offset times of two available formulations of rocuronium bromide in an animal model
Authors: Speedy Louise M , O’Beirn Sean , Hopgood Gary , Harvey Martyn G , Cave Grant 
Published: December 2022

Rocuronium bromide is a neuromuscular blocker in widespread use in anaesthesia, emergency and intensive care. Reports of reduced efficacy of a new different formulation of rocuronium bromide were submitted to Medsafe, the New Zealand Medicines and Medical Devices Safety Authority, in 2020. Given the requirement for rapid and predictable paralysis for patient safety the efficacy of the two available formulations of rocuronium bromide was investigated in an animal model. After ethics committee approval, 19 rats were anaesthetised and paralysis, defined as loss of tibialis anterior flexion on direct electrical stimulation of the sciatic nerve, was assessed by mechanomyography in response to ED90 doses of rocuronium. Paralysis was observed at a median of 12 seconds for the new different formulation: A, Hameln Pharma (interquartile range (IQR) 6–106 seconds) and 28 seconds for formulation B: Pfizer (IQR 12–68 seconds) P = 0.48. Offset of paralysis was observed after 293 seconds for formulation A (IQR 250–372 seconds) and 241 seconds for formulation B (IQR 220–263 seconds). While the differences observed were substantial, they were not statistically significant. Moreover, the direction of observed difference was towards a shorter median onset and longer offset for the newer formulation, a finding in the opposite direction to the initial clinical concern. Relevance to the clinical situation is indeterminate given the study was stopped at low numbers for futility and limitations around the clinical applicability of animal pharmacokinetics and dynamics. Nevertheless our findings provide some reassurance that the newly available different formulation of this critical use medication does not exhibit a substantial increase in time to onset.
Perioperative outcomes in intermediate and high-risk patients after major surgery following introduction of a dedicated perioperative medicine team: A single centre cohort study
Authors: Nicholson Jonathan J , Reilly Jennifer , Shulman Mark A , Ferguson Marissa , Burke Justin A , Lehane Daragh N , Liaw Chen-Mei , Mahoney Adam , Stark Peter , Myles Paul S 
Published: December 2022

Intermediate and high-risk patients undergoing surgery are often managed on a surgical ward in the absence of haemodynamic or ventilatory support requirements necessitating intensive care unit or high dependency unit admission. We describe a model of care for the multidisciplinary management of selected postoperative patients and the epidemiology of patients managed using this model at a tertiary Australian hospital. Of 25,139 patients undergoing inpatient surgery at our institution over a two-year period, 506 (2%) were referred to the Perioperative Medicine team. The median age of patients referred was 74 years; 85% had an American Society of Anesthesiologists physical status ≥3, and 44% underwent emergency surgery. Major complication or death within 30 days was 44.2% (213/482). The most common complications, as defined by the American College of Surgeons National Surgical Quality Improvement Program were transfusion within 72 h (17.4%), pneumonia/aspiration pneumonitis (11.3%), and acute renal failure (10.6%); median time to Medical Emergency Team call was 146 (interquartile range 77–279) h. Sixty-six percent of referred patients (280/423) required an intervention during their time under the service. This high incidence indicates that this population of patients merits closer attention, including routine measurement and reporting of postoperative outcomes to monitor and improve quality of care at our institution as part of an integrated perioperative service. We believe that with so much current focus on perioperative medicine, it is important we translate this to clinical care by evolving traditional models of management into more innovative strategies to meet the complex demands of today’s surgical patients.
Early Clinical Outcomes and Complications of Transfibular Total Ankle Arthroplasty: The Australian Experience
Authors: Clugston Ellery , Ektas Nalan , Scholes Corey , Symes Michael , Wilton Alex , Wines Andrew , Mittal Rajat 
Published: December 2022

Background: We report the short-term outcomes of a retrospective cohort of Trabecular Metal total ankle arthroplasties (TAAs) via a transfibular approach from a single, nondesigner surgeon in Australia. Methods: This was a retrospective cohort study. Demographic, clinical, and patient-reported outcome measures (PROMs) were collected. The primary outcome was the Foot and Ankle Outcome Score (FAOS), and secondary outcomes included patient satisfaction, the EuroQol-5 Dimension (EQ5D), and complications including revision rates. Results: Between 2016 and 2019, 84 trabecular metal prostheses were implanted in 84 patients. Mean age (SD) at time of surgery was 68 (7.8) years, and 46 (55%) were male. Mean follow-up (SD) was 26.1 (13) months. There were significant ( P < .001) improvements in the FAOS in the subscales of pain (47.9 to 79.1), activities of daily living (59.5 to 83.7), and quality of life (25.5 to 60.2) and EQ-5D (0.55 to 0.75) ( P < .001), and overall satisfaction was 69.6%. The commonest complications were wound infection or breakdown (11.9%, n=10), fibular nonunion (3.5%), plate irritation (3.5%), and tibial nerve neuropathy (3.5%). There were no thromboembolic complications. Implant survivorship was 100%, with Trabecular Metal components retained in all patients. Two patients developed deep infection, with 1 requiring debridement and polyethylene exchange. No patients experienced implant loosening. Conclusion: Our results demonstrate that the trabecular metal survival rates are comparable with other total ankle implants in the Australian Orthopaedic Association National Joint Replacement Registry and as published in other international literature. Overall patient satisfaction was high, as were PROMs. However, the data highlight potential complications uniquely associated with this implant. The authors believe that these figures support TAA via a transfibular approach as a viable option in the treatment of ankle arthritis. Level of Evidence: Level IV, retrospective cohort study.
MiR-197-3p inhibits the malignant progression of atherosclerosis by targeting WDR5
Authors: Yang Kai , Yu Chunjun , Ruan Lin , Hu Shengpeng , Zhu Wenjie , Xia Feng 
Published: December 2022

Background The aberrantly increased proliferation and migration of vascular smooth muscle cells (VSMCs) was critically associated with atherosclerosis (AS) progression. MiR-197-3p has been confirmed to regulate various biological processes, such as tumorigenesis; however, whether miR-197-3p is involved with the pathological development of AS remains largely unknown. Methods The serum levels of miR-197-3p in AS patients and healthy donors were determined by polymerase chain reaction (PCR) assay. The transfection efficacies of miR-197-3p mimic or inhibitor in VSMCs were evaluated by PCR assay. The effects of miR-197-3p on VSMC proliferation and migration were determined by EdU cell proliferation and Traswell migration assays. Western blotting was conducted to evaluate the effect of miR-197-3p on WDR5 expression in VSMCs. Results In the present study, we found that the expression of miR-197-3p was decreased in the serum of AS patients compared to healthy donors. Overexpression of miR-197-3p inhibited the proliferation and migration of VSMCs, while silencing miR-197-3p showed opposite effects. Mechanistical study revealed that WD Repeat Domain 5 (WDR5) was a target of miR-197-3p. Moreover, miR-197-3p was downregulated in VSMCs upon IL6 treatment and inhibited IL6-induced proliferation and migration in VSMCs. Conclusions These findings indicate that miR-197-3p could serve as a promising diagnostic marker for AS and that targeting IL6/miR-197-3p/WDR5 axis might be a potential approach to treat AS.