Evaluating Surgical Accuracy in Bimaxillary Surgery: A Systematic Review and Meta-Analysis of Mandible-First versus Maxilla-First Approaches.

BACKGROUND: Mandible-first surgery (MdFS) has gained attention as an alternative to the traditional maxilla-first surgery (MxFS) in bimaxillary procedures. Given the distinct sequence of operations between these approaches, evaluating the clinical advantages of MdFS compared to MxFS is crucial for optimizing surgical decision-making. This systematic review and meta-analysis examine intraoperative achievability and postoperative stability between these two surgical approaches. METHODS: A thorough literature search was performed using PubMed, Embase, Web of Science, and MEDLINE, covering articles published from 2013 to 2023. Studies included were retrospective, prospective, and randomized trials that compared the accuracy and/or stability of MdFS with MxFS. The primary endpoint for the meta-analysis was the standardized mean difference in surgical accuracy for translational movements, with a secondary focus on rotational accuracy. RESULTS: A total of 11 studies encompassing 712 patients met the inclusion criteria. The analysis suggested that MdFS might reduce accuracy in the sagittal dimension (CI, 0.05 to 0.74) but offered greater achievability in the vertical direction (CI, - 0.47 to - 0.07). Additionally, MdFS was associated with a relatively posterior (CI, - 1.18 to - 0.60) and inferior (CI, - 0.64 to - 0.07) positioning of the maxillomandibular complex. CONCLUSION: Despite certain limitations, our findings indicate that MdFS can achieve clinical outcomes similar to MxFS in terms of both accuracy and stability. However, further researches with larger sample sizes and more rigorous study designs are necessary to validate these conclusions. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of contents or the online Instructions to Authors www.springer.com/00266 .

Efficacy of fidaxomicin versus vancomycin in the treatment of Clostridium difficile infection: A systematic meta-analysis.

PURPOSE: To compare the efficacy, recurrence rate, adverse event rate and mortality of fidaxomicin compared with vancomycin in treating different types of Clostridium difficile infection (CDI). METHODS: A systematic search was conducted on PubMed, Embase, Web of Science, Cochrane Library and clinical trial registration databases for research on fidaxomicin versus vancomycin in the treatment of CDI and the retrieval period extended from the establishment of the database to July 22, 2022. A total of 15 studies were included, including 8 RCTs and 7 retrospective cohort studies. RESULTS: Results showed that there was no significant difference in the overall efficacy of the treatment between fidaxomicin and vancomycin, and results in the subgroups of CDI hypervirulent strains and recurrent CDI were obtained, but vancomycin was more effective than fidaxomicin in the treatment of severe CDI (RR = 0.94, 95% CI: 0.90-0.98, P < .01). Results showed that fidaxomicin is superior to vancomycin in terms of 40-day recurrence rate (RR = 0.52, 95% CI: 0.38-0.70, P < .01), 60-day recurrence rate (RR = 0.38, 95% CI: 0.21-0.69, P < .01) and 90-day recurrence rate (RR = 0.62, 95% CI: 0.50-0.77, P < .01). For the recurrence rate of the treatment in CDI hypervirulent strains, severe CDI and recurrent CDI, there was no significant difference between the 2 groups. In addition, there was no significant difference in the incidence of clinical adverse reactions, and same outcomes appeared in all-cause mortality at 40-day, severe CDI and recurrent CDI, but fidaxomicin was superior to vancomycin in all-cause mortality over 60-day (RR = 0.57, 95% CI: 0.34-0.96, P = .03). CONCLUSION: There were no significant differences between fidaxomicin and vancomycin in the treatment of CDI in therapeutic effectiveness and adverse reactions, while fidaxomicin was superior to vancomycin in terms of recurrence rate and long-term mortality, and vancomycin is more effective in treating severe CDI.

Single-Cell Analysis Reveals Histone Deacetylation Factor Guide Intercellular Communication of Tumor Microenvironment that Contribute to Colorectal Cancer Progression and Immunotherapy.

In this study, single-cell RNA-seq data were collected to analyze the characteristics of Histone deacetylation factor (HDF). The tumor microenvironment (TME) cell clusters related to prognosis and immune response were identified by using CRC tissue transcriptome and immunotherapy cohorts from public repository. We explored the expression characteristics of HDF in stromal cells, macrophages, T lymphocytes, and B lymphocytes of the CRC single-cell dataset TME and further identified 4 to 6 cell subclusters using the expression profiles of HDF-associated genes, respectively. The regulatory role of HDF-associated genes on the CRC tumor microenvironment was explored by using single-cell trajectory analysis, and the cellular subtypes identified by biologically characterized genes were compared with those identified by HDF-associated genes. The interaction of HDF-associated gene-mediated microenvironmental cell subtypes and tumor epithelial cells were explored by using intercellular communication analysis, revealing the molecular regulatory mechanism of tumor epithelial cell heterogeneity. Based on the expression of feature genes mediated by HDF-related genes in the microenvironment T-cell subtypes, enrichment scoring was performed on the feature gene expression in the CRC tumor tissue transcriptome dataset. It was found that the feature gene scoring of microenvironment T-cell subtypes (HDF-TME score) has a certain predictive ability for the prognosis and immunotherapy benefits of CRC tumor patients, providing data support for precise immunotherapy in CRC tumors.

Endoscopic-Assisted Forehead Augmentation with Polyetheretherketone (PEEK) Patient-Specific Implant (PSI) for Aesthetic Considerations.

BACKGROUND: Forehead augmentation have become popular aesthetic procedures among Asians in recent years. However, the use of polyetheretherketone (PEEK) patient-specific implant (PSI) in the facial contouring surgery for aesthetic considerations is not well documented in the existing studies. The purpose of this study was to develop a novel method for forehead augmentation and assess the clinical outcomes and complications in patients who underwent forehead augmentation with PEEK PSI assisted by endoscopy. METHODS: The PEEK PSIs were fabricated using the virtual surgical planning (VSP) and the computer-aided manufacturing (CAM) for each patient, preoperatively. The implant pockets were dissected in the subperiosteal plane, and PEEK PSIs were placed in their designed position and fixed assisting by endoscopy via small incision within the hairline. All patients were asked to complete the FACE-Q questionnaire before and 6 months after the operation. Pre- and postoperative demographics, photographs, and other clinical data of patients were collected and analyzed. RESULTS: 11 patients underwent forehead augmentation were enrolled in this study. All procedures were completed successfully with the help of endoscope. The average patient age was 30.63 ± 2.54 years. The mean thickness and size of PEEK PSI were 4.44 ± 1.77 mm and 38.43 ± 22.66 cm2, respectively. The mean operative time was 83.00 ± 29.44 min, and the mean postoperative follow-up period was 11.00 ± 6.50 months. No implant exposure, extrusion or removal were reported. The FACE-Q scores of patients in satisfaction with the forehead increased from 47.64 ± 7.15 to 78.81 ± 6.35. CONCLUSIONS: PEEK PSIs can be prefabricated to achieve accurate remodeling of the frontal contour with good esthetic outcomes. The endoscope provides direct and magnified vision, which allow easy access to the supraorbital rim and lateral edge of the eyebrow arch and confirming the position of the implants without damaging nerves and vessels. Endoscopic-assisted forehead augmentation with PEEK PSI is safe and effective. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of contents or the online Instructions to Authors www.springer.com/00266 .

A comprehensive review of the development of land use regression approaches for modeling spatiotemporal variations of ambient air pollution: A perspective from 2011 to 2023.

Land use regression (LUR) models are widely used in epidemiological and environmental studies to estimate humans' exposure to air pollution within urban areas. However, the early models, developed using linear regressions and data from fixed monitoring stations and passive sampling, were primarily designed to model traditional and criteria air pollutants and had limitations in capturing high-resolution spatiotemporal variations of air pollution. Over the past decade, there has been a notable development of multi-source observations from low-cost monitors, mobile monitoring, and satellites, in conjunction with the integration of advanced statistical methods and spatially and temporally dynamic predictors, which have facilitated significant expansion and advancement of LUR approaches. This paper reviews and synthesizes the recent advances in LUR approaches from the perspectives of the changes in air quality data acquisition, novel predictor variables, advances in model-developing approaches, improvements in validation methods, model transferability, and modeling software as reported in 155 LUR studies published between 2011 and 2023. We demonstrate that these developments have enabled LUR models to be developed for larger study areas and encompass a wider range of criteria and unregulated air pollutants. LUR models in the conventional spatial structure have been complemented by more complex spatiotemporal structures. Compared with linear models, advanced statistical methods yield better predictions when handling data with complex relationships and interactions. Finally, this study explores new developments, identifies potential pathways for further breakthroughs in LUR methodologies, and proposes future research directions. In this context, LUR approaches have the potential to make a significant contribution to future efforts to model the patterns of long- and short-term exposure of urban populations to air pollution.

Estimate of near-surface NO2 concentrations in Fenwei Plain, China, based on TROPOMI data and random forest model.

Nitrogen dioxide (NO2) concentration is a crucial indicator of ground-level air quality, and elevated concentrations can adversely affect human health and the atmospheric environment. In this study, we utilized Tropospheric Monitoring Instrument (TROPOMI) tropospheric NO2 vertical column density data (VCD) and multi-source geographic data to establish a random forest regression (RF) model that accurately estimates NO2 concentrations near the ground in the Fenwei Plain. The model addresses the inherent limitations of traditional ground-based monitoring and provides data support for analyzing regional pollution spatial and temporal characteristics. (1) The RF model based on TROPOMI and geographic data demonstrates high estimation accuracy, with monthly average RF model fit and validation coefficient of determination (R2) reaching 0.949 and 0.875, respectively. (2) A complex nonlinear relationship exists between near-surface NO2 concentration and multi-source geographic data. The RF model's estimations reveal clear seasonal and regional variations in near-surface NO2 concentration. Concentrations are generally highest in winter, followed by spring and autumn, and lowest in summer. The high NO2 concentrations are primarily mainly distributed in the plains and river valleys with low elevation and dense population density. The model estimation results also indicate that the estimated effect is better when the NO2 concentration fluctuates less and anthropogenic emission reduction measures significantly impact the NO2 concentration near the ground. (3) The population exposure risk results indicate that most cities in the Fenwei Plain face varying exposure risks. These findings offer valuable insights for regional NO2 pollution management.

Potassium hydroxide-modified algae-based biochar for the removal of sulfamethoxazole: Sorption performance and mechanisms.

Biochar has been deemed one of the most promising sorbents for the removal of organic pollutants from aqueous solution. In this study, potassium hydroxide-modified Enteromorpha prolifera biochars (PEBCs) were prepared for the first time and applied for efficient sorption of a typical antibiotic, sulfamethoxazole (SMX). The characteristics of PEBCs, including morphology, pore structure, graphitization degree, surface functional groups, and surface element composition, were investigated. Moreover, sorption kinetic and isotherm experiments were carried out to explore the sorption process, performance, and mechanisms. The maximum sorption capacity for SMX can reach 744 mg g-1, which is much higher than that reported for sorbents. The sorption of SMX onto PEBCs was controlled by both physical and chemical processes. Moreover, pore filling, hydrogen bonding, partitioning, π-π stacking, and electrostatic interactions were possible sorption mechanisms. This study indicated that the structure and properties of algal biochar can be further improved by potassium hydroxide modification at high temperature and applied as an excellent sorbent for the removal of antibiotics from aqueous solution.

One-pot pyrolysis of a typical invasive plant into nitrogen-doped biochars for efficient sorption of phthalate esters from aqueous solution.

Invasive plants pose a significant threat to natural ecosystems because of their high adaptability, rapid propagation and spreading ability in the environment. In this study, a typical aquatic invasive plant, Pistia stratiotes, was chosen as a novel feedstock for the preparation of nitrogen-doped biochars (NBs) for the first time, and the NBs were used as efficient sorbents to remove phthalate esters (PAEs) from aqueous solution. Characterization results showed that NBs possess great pore structure (up to 126.72 m2 g-1), high nitrogen (2.02%-2.66%) and ash (24.7%-34.1%) content, abundant surface functional groups, hydrophobicity and a graphene structure. Batch sorption experiments were performed to investigate the sorption performance, processes and mechanisms. The capacities for PAEs sorption onto NBs were high, especially with NBs pyrolyzed at 700 °C, ranging up to 161.7 mg g-1 for diethyl phthalate and 85.4 mg g-1 for dibutyl phthalate; these levels were better than many reported for other sorbents. With kinetic and isotherm results, Pseudo-second order and Freundlich models fit the sorption data well, and chemical interactions involving hydrogen bonding, Lewis acid-base interaction, functional group interaction, cation-π interaction and π-π stacking interaction were identified as possible rate-limited steps. Moreover, Intra-particle diffusion and Dubinin-Radushkevich models indicated that multiple pore filling and partitioning dominated the process of PAEs sorption onto NBs. This study opens the door for new methods of pollution control with waste treatment, since invasive plant biomass resources were converted into advanced biochars for efficient environmental remediation.

Nitrogen-doped porous biochar derived from marine algae for efficient solid-phase microextraction of chlorobenzenes from aqueous solution.

Nitrogen-doped porous biochar (NPB) with a large specific surface area, wide pore size distribution, graphitized structure, nitrogen doping, and hydrophobicity was fabricated by high-temperature modification of algal biochar with potassium carbonate. This NPB was then uniformly coated on stainless steel wire as a novel solid-phase microextraction (SPME) fiber. The extraction efficiency of NPB-coated fiber for seven chlorobenzenes (CBs) was excellent; it was 1.0-112.2 times higher than that of commercial SPME fibers. A trace determination method was developed for seven CBs in water with the optimized extraction conditions by NPB-coated fiber and gas chromatography-electron capture detector, which showed wide linear ranges (1-1000 ng L-1), low detection limits (0.007-0.079 ng L-1), great repeatability (2.5-6.5% for intra-day, and 3.1-6.8% for inter-day), and excellent reproducibility (3.5-6.3%, n = 5). The practicality of the developed method was evaluated using real water samples and showed great recoveries (89.55-105.19%). This study showed that low-cost biomass wastes could be converted to advanced biochar materials by a facile method, and displayed excellent performance in SPME applications.

Salidroside shows anticonvulsant and neuroprotective effects by activating the Nrf2-ARE pathway in a pentylenetetrazol-kindling epileptic model.

Evidence points towards oxidative stress and neuroinflammation being major processes associated with brain dysfunction in epilepsy. Salidroside reportedly possesses anti-oxidative activity and neuroprotective potential, in addition to exerting an anti-neuroinflammatory response. This study was designed to evaluate the anticonvulsant and neuroprotective role of salidroside in rats with pentylenetetrazole (PTZ) kindling and to explore the underlying mechanism. Male Wistar rats were administered a sub-convulsive dose of PTZ (35 mg/kg) every other day for 15 injections, and salidroside (50 mg/kg) was injected intraperitoneally along with alternate-day PTZ. The seizure degree, cognitive function, and number of hippocampal neurons were investigated. The expression of nuclear factor erythroid 2-related factor- antioxidant response element (Nrf2-ARE) signaling pathways, oxidative stress parameters and inflammatory cytokines were also observed. Our study showed that salidroside treatment suppressed the kindling acquisition process, ameliorated cognitive impairment, and rescued the number of pyramidal neurons in the CA3 regions. Salidroside treatment could activate the Nrf2-ARE signal pathway, and suppressed oxidative stress and neuroinflammation. Our findings demonstrated that salidroside exerted anticonvulsant and neuroprotective effects in epileptic rats by activating the Nrf2-ARE signal pathway.