Linking the humification of organic amendments with size aggregate distribution: Insights into molecular composition using FT-ICR-MS.

Soil organic matter (SOM) plays a pivotal role in enhancing physical and biological characteristics of soil. Humic substances constitute a substantial proportion of SOM and their increase can improve crop yields and promote agricultural sustainability. While previous research has primarily assessed the influence that humic acids (HAs) derived from natural water have on soil structure, our study focuses on the impact of HAs on soil aggregation under different fertilizer regimes. During the summer cropping season, maize was cultivated under organic and synthetic fertilizer treatments. The organic fertilizer treatment utilized barley (Hordeum vulgare L.) and hairy vetch (Vicia villosa R.) as an organic amendment five days prior to maize planting. The synthetic treatment included a synthetic fertilizer (NPK) applied at South Korea's recommended rates. The organic treatment resulted in significant improvements in the soil aggregates and stability (mean weight diameter, MWD; p < 0.05) compared to the synthetic fertilizer application. These improvements could be primarily attributed to the increased quantity and quality of HAs in the soil derived from the organic amendment. The amount of extracted HAs in the organic treatment was nearly twice that of the synthetic treatment. Additionally, the organic treatment had a 140 % larger MWD and a 40 % increase in total phenolic content compared to the synthetic treatment. The organic treatment also had an increased macronutrient uptake (p < 0.001), an 11 % increase in aboveground maize biomass, and a 21 % increase in grain yield relative to the synthetic treatment. Thus, the enhancement of HA properties through the incorporation of fresh organic manure can both directly and indirectly increase crop productivity.

Methane emissions and the microbial community in flooded paddies affected by the application of Fe-stabilized natural organic matter.

Redox chemistry involving the quinone/phenol cycling of natural organic matter (NOM) is known to modulate microbial respiration. Complexation with metals or minerals can also affect NOM solubilization and stability. Inspired by these natural phenomena, a new soil amendment approach was suggested to effectively decrease methane emissions in flooded rice paddies. Structurally stable forms of NOM such as lignin and humic acids (HAs) were shown to decrease methane gas emissions in a vial experiment using different soil types and rice straw as a methanogenic substrate, and this inhibitory behavior was likely enhanced by ferric ion-NOM complexation. A mechanistic study using HAs revealed that complexation facilitated the slow release of the humic components. Interestingly, borohydride-based reduction, which transformed quinone moieties into phenols, caused the HAs to lose their inhibitory capacity, suggesting that the electron-accepting ability of HAs is vital for their inhibitory effect. In rice field tests, the humic-metal complexes were shown to successfully mitigate methane generation, while carbon dioxide emissions were relatively unchanged. Microbial community analysis of the rice fields by season revealed a decrease in specific cellulose-metabolizing and methanogenic genera associated with methane emissions. In contrast, the relative abundance of Thaumarchaeota and Actinomycetota, which are associated with NOM and recalcitrant organics, was higher in the presence of Fe-stabilized HAs. These microbial dynamics suggest that the slow release of humic components is effective in modulating the anoxic soil microbiome, possibly due to their electron-accepting ability. Given the simplicity, cost-effectiveness, and soil-friendly nature of complexation processes, Fe-stabilized NOM represents a promising approach for the mitigation of methane emissions from flooded rice paddies.

Global COVID-19 Policy Engagement With Scientific Research Information: Altmetric Data Study.

BACKGROUND: Previous studies on COVID-19 scholarly articles have primarily focused on bibliometric characteristics, neglecting the identification of institutional actors that cite recent scientific contributions related to COVID-19 in the policy domain, and their locations. OBJECTIVE: The purpose of this study was to assess the online citation network and knowledge structure of COVID-19 research across policy domains over 2 years from January 2020 to January 2022, with a particular emphasis on geographical frequency. Two research questions were addressed. The first question was related to who has been the most active in policy engagement with science and research information sharing during the COVID-19 pandemic, particularly in terms of countries and organization types. The second question was related to whether there are significant differences in the types of coronavirus research shared among countries and continents. METHODS: The Altmetric database was used to collect policy report citations of scientific articles for 3 topic terms (COVID-19, COVID-19 vaccine, and COVID-19 variants). Altmetric provides the URLs of policy agencies that have cited COVID-19 research. The scientific articles used for Altmetric citations are extracted from journals indexed by PubMed. The numbers of COVID-19, COVID-19 vaccine, and COVID-19 variant research outputs between January 1, 2020, and January 31, 2022, were 216,787, 16,748, and 2777, respectively. The study examined the frequency of citations based on policy institutional domains, such as intergovernmental organizations, national and domestic governmental organizations, and nongovernmental organizations (think tanks and academic institutions). RESULTS: The World Health Organization (WHO) stood out as the most notable institution citing COVID-19-related research outputs. The WHO actively sought and disseminated information regarding the COVID-19 pandemic. The COVID-19 vaccine citation network exhibited the most extensive connections in terms of degree centrality, 2-local eigenvector centrality, and eigenvector centrality among the 3 key terms. The Netherlands, the United States, the United Kingdom, and Australia were the countries that sought and shared the most information on COVID-19 vaccines, likely due to their high numbers of COVID-19 cases. Developing nations, although gaining quicker access to COVID-19 vaccine information, appeared to be relatively isolated from the enriched COVID-19 pandemic content in the global network. CONCLUSIONS: The global scientific network ecology during the COVID-19 pandemic revealed distinct types of links primarily centered around the WHO. Western countries demonstrated effective networking practices in constructing these networks. The prominent position of the key term "COVID-19 vaccine" demonstrates that nation-states align with global authority regardless of their national contexts. In summary, the citation networking practices of policy agencies have the potential to uncover the global knowledge distribution structure as a proxy for the networking strategy employed during a pandemic.

Status of Using Complementary and Alternative Medicine among Patients with Cancer in Korea: an Online Survey of Online Cancer Support Groups (KCSG PC21-20).

PURPOSE: An increasing number of patients with cancers are interested in complementary and alternative medicine (CAM), which lacks scientific evidence. This study aimed to determine how CAM was used and how media affected patients in online cancer support groups (OCSG). Materials and Methods: Between August 18 and September 12, 2021, an online survey was conducted among the members of OCSG. The survey consisted of five parts: baseline characteristics, attitudes toward and experience with CAM, source of information and reliabilities, experience with anthelmintics, and online health information literacy and usage. RESULTS: Among the 644 responders, a total of 221 patients with cancer completed the survey, and 78.2% (173/221) used CAM. The users' median age was 52 years; 46.8% were males, and 43.9% had metastatic disease. Fifty-three CAM users (30.6%) discussed their physicians about CAM. In addition, 16.2% (28/173) of CAM users had the experience of anthelmintics. The use of anthelmintics in patients with cancers was associated with younger age (odds ratio [OR], 0.89; 95% confidence interval [CI], 0.84 to 0.95), metastatic disease (OR, 10.88; 95% CI, 3.39 to 34.86), previous exposure to CAM information (OR, 5.57; 95% CI, 1.01 to 30.72), experience with more types of CAM (OR, 1.98; 95% CI, 1.29 to 3.05), and side effects (OR, 5.10; 95% CI 1.46 to 17.75). CONCLUSION: Use of anthelmintics, a CAM of which information is widespread online, is affected by several factors. This study will provide essential information for developing a CAM management strategy in this digital age.

Correction: Understanding the Social Mechanism of Cancer Misinformation Spread on YouTube and Lessons Learned: Infodemiological Study.

[This corrects the article DOI: 10.2196/39571.].

Understanding the Social Mechanism of Cancer Misinformation Spread on YouTube and Lessons Learned: Infodemiological Study.

BACKGROUND: A knowledge gap exists between the list of required actions and the action plan for countering cancer misinformation on social media. Little attention has been paid to a social media strategy for disseminating factual information while also disrupting misinformation on social media networks. OBJECTIVE: The aim of this study was to, first, identify the spread structure of cancer misinformation on YouTube. We asked the question, "How do YouTube videos play an important role in spreading information about the self-administration of anthelmintics for dogs as a cancer medicine for humans?" Second, the study aimed to suggest an action strategy for disrupting misinformation diffusion on YouTube by exploiting the network logic of YouTube information flow and the recommendation system. We asked the question, "What would be a feasible and effective strategy to block cancer misinformation diffusion on YouTube?" METHODS: The study used the YouTube case of the self-administration of anthelmintics for dogs as an alternative cancer medicine in South Korea. We gathered Korean YouTube videos about the self-administration of fenbendazole. Using the YouTube application programming interface for the query "fenbendazole," 702 videos from 227 channels were compiled. Then, videos with at least 50,000 views, uploaded between September 2019 and September 2020, were selected from the collection, resulting in 90 videos. Finally, 10 recommended videos for each of the 90 videos were compiled, totaling 573 videos. Social network visualization for the recommended videos was used to identify three intervention strategies for disrupting the YouTube misinformation network. RESULTS: The study found evidence of complex contagion by human and machine recommendation systems. By exposing stakeholders to multiple information sources on fenbendazole self-administration and by linking them through a recommendation algorithm, YouTube has become the perfect infrastructure for reinforcing the belief that fenbendazole can cure cancer, despite government warnings about the risks and dangers of self-administration. CONCLUSIONS: Health authorities should upload pertinent information through multiple channels and should exploit the existing YouTube recommendation algorithm to disrupt the misinformation network. Considering the viewing habits of patients and caregivers, the direct use of YouTube hospital channels is more effective than the indirect use of YouTube news media channels or government channels that report public announcements and statements. Reinforcing through multiple channels is the key.

Lignin Metabolism by Selected Fungi and Microbial Consortia for Plant Stimulation: Implications for Biologically Active Humus Genesis.

Plant lignin is regarded as an important source for soil humic substances (HSs). Nonetheless, it remains unclear whether microbial metabolism on lignin is related to the genesis of unique HS biological activities (e.g., direct plant stimulation). Here, selected white-rot fungi (i.e., Ganoderma lucidum and Irpex lacteus) and plant litter- or mountain soil-derived microbial consortia were exploited to structurally modify lignin, followed by assessing the plant-stimulatory activity of the lignin-derived products. Parts solubilized by microbial metabolism on lignin were proven to exhibit organic moieties of phenol, carboxylic acid, and aliphatic groups and the enhancement of chromogenic features (i.e., absorbance at 450 nm), total phenolic contents, and radical-scavenging capacities with the cultivation times. In addition, high-resolution mass spectrometry revealed the shift of lignin-like molecules toward those showing either more molar oxygen-to-carbon or more hydrogen-to-carbon ratios. These results support the findings that the microbes involved, solubilize lignin by fragmentation, oxygenation, and/or benzene ring opening. This notion was also substantiated by the detection of related exoenzymes (i.e., peroxidases, copper radical oxidases, and hydrolases) in the selected fungal cultures, while the consortia treated with antibacterial agents showed that the fungal community is a sufficient condition to induce the lignin biotransformation. Major families of fungi (e.g., Nectriaceae, Hypocreaceae, and Saccharomycodaceae) and bacteria (e.g., Burkholderiaceae) were identified in the lignin-enriched cultures. All the microbially solubilized lignin products were likely to stimulate plant root elongation in the order selected white-rot fungi > microbial consortia > antibacterial agent-treated microbial consortia. Overall, this study supports the idea that microbial transformation of lignin can contribute to the formation of biologically active organic matter. IMPORTANCE Structurally stable humic substances (HSs) in soils are tightly associated with soil fertility, and it is thus important to understand how soil HSs are naturally formed. It is believed that microbial metabolism on plant matter contributes to natural humification, but detailed microbial species and their metabolisms inducing humic functionality (e.g., direct plant stimulation) need to be further investigated. Our findings clearly support that microbial metabolites of lignin could contribute to the formation of biologically active humus. This research direction appears to be meaningful not only for figuring out the natural processes, but also for confirming natural microbial resources useful for artificial humification that can be linked to the development of high-quality soil amendments.

Is Crisis and Emergency Risk Communication as Effective as Vaccination for Preventing Virus Diffusion? Measuring the Impacts of Failure in CERC with MERS-CoV Outbreak in South Korea.

This study measured the impacts of failure in Crisis and Emergency Risk Communication (CERC) during the outbreak of a contagious Corona viral disease. The study measured the impacts by the number of individuals and hospitals exposed to the virus. The 2015 Middle East Respiratory Syndrome (MERS) outbreak in South Korea was used to investigate the consequences of CERC failure, where the names of hospitals exposed to MERS-CoV were withheld from the public during the early stage of virus diffusion. Empirical data analyses and simulated model tests were conducted. The findings of analyses and tests show that an early announcement of the hospital names and publicizing the necessary preventive measures could have reduced the rate of infection by approximately 85% and the number of contaminated healthcare facilities by 39% at maximum. This level of reduction is comparable to that of vaccination and of social distancing.

Microbial Volatile Organic Compound (VOC)-Driven Dissolution and Surface Modification of Phosphorus-Containing Soil Minerals for Plant Nutrition: An Indirect Route for VOC-Based Plant-Microbe Communications.

We investigated the ability of microbial volatile organic compounds (MVOCs) emitted by Bacillus megaterium (a well-known MVOC producer) to modify the dissolution kinetics and surface of hydroxyapatite, a natural soil mineral. Facilitated phosphate release was induced by the airborne MVOCs in a time-dependent manner. Use of each standard chemical of the MVOCs then revealed that acetic and oxalic acids are crucial for the phenomenon. In addition, the ability of such MVOCs to engineer the apatite surfaces was evidenced by FT-IR spectra showing the COO- band variation with incubation time and the prolonged acceleration of phosphate release during the negligible acidification of the hydroxyapatite-containing solutions. The formation of calcium oxalate was revealed through SEM-EDS and XRD analyses, suggesting that MVOC oxalic acid interacts with calcium ions, leading to the precipitation of calcium oxalate, thus preventing the recrystallization of calcium phosphates. Gel- and soil-based plant cultivation tests employing Arabidopsis thaliana and solid calcium phosphates (i.e., nano- and microsized hydroxyapatites and calcium phosphate dibasic) demonstrated that these MVOC mechanisms facilitate plant growth by ensuring the prolonged supply of plant-available phosphate. The relationship between the growth enhancement and the particle size of the calcium phosphates also substantiated the MVOC sorption onto soil minerals related to plant growth. Given that most previous studies have assumed that MVOCs are a molecular lexicon directly detected by the dedicated sensing machinery of plants, our approach provides a new mechanistic view of the presence of abiotic mediators in the interaction between plants and microbes via MVOCs.

Effects of Microbes from Coal-Related Commercial Humic Substances on Hydroponic Crop Cultivation: A Microbiological View for Agronomical Use of Humic Substances.

Here, coal-related humic substances (HSs) were examined to confirm whether sterilization treatments induce their inferior ability to stimulate lettuce in hydroponic cultivations. Interestingly, a drastic reduction in both lettuce biomass and microbial colony-forming units of the crop culture solutions was observed when the autoclaved HSs were treated. Some microbial genera (i.e., Bacillus and Aspergillus) identifiable in the bare HS-treated hydroponic systems were able to be isolated by direct inoculation of bare HS powders on conventional microbial nutrients, supporting that flourishing microbes in the hydroponic cultivations derive from bare HSs-treated. Moreover, coincubation of some isolated bacterial and fungal strains (i.e., Bacillus and Aspergillus genera) from HSs with lettuce resulted in a significant increase in plant biomass and enhanced resistance to NaCl-related abiotic stresses. Microbial volatile organic compounds renowned for plant stimulation were detected by using solid-phase microextraction coupled with gas chromatography-mass spectrometry. It was finally confirmed that the isolates are capable of utilizing carbon substrates such as pectin and tween 20 or 40, which are relevant to those of microbes isolated from peat and leonardite (i.e., HS extraction sources). Overall, our results suggest that microbiological factors could be considered when commercial coal-related HSs are applied in hydroponic crop cultivations.

Fungal mycelia functionalization with halloysite nanotubes for hyphal spreading and sorption behavior regulation: A new bio-ceramic hybrid for enhanced water treatment.

Filamentous fungi are believed to remove a wide range of environmental xenobiotics due to their characteristically non-specific catabolic metabolisms. Nonetheless, irregular hyphal spreading can lead to clogging problems in treatment facilities and the dependence of pollutant bioavailability on hyphal surface features severely limits their applicability in water treatment. Here, we propose a scalable and facile methodology to structurally modify fungal hyphae, allowing for both the maximization of pollutant sorption and fungal pellet morphology self-regulation. Halloysite-doped mycelium architectures were efficiently constructed by dipping Aspergillus fumigatus pellets in halloysite nanotube-dispersed water. Ultrastructure analyses using scanning electron microscopy equipped with energy-dispersive X-ray spectroscopy revealed that the nanotubes were mainly attached to the outer surface of the pellets. Fungal viability and exoenzyme production were hardly affected by the halloysites. Notably, nanotube doping appeared to be extremely robust given that detachments rarely occurred even in high concentrations of organic solvents and salt. It was also demonstrated that the doped halloysites weakened hyphal growth-driven gelation, thus maintaining sphere-like pellet structures. The water treatment potential of the hybrid fungal mycelia was assessed through both cationic toxic organic/inorganic-contaminated water and real dye industry wastewater clean-ups. Aided by the mesoporous halloysite sites on their surface, the removal abilities of the hybrid structures were significantly enhanced. Moreover, inherent low sorption ability of HNT for heavy metals was found to be overcome by the aid of fungal mycelia. Finally, universal feature of the dipping-based doping way was confirmed by using different filamentous fungi. Given that traditional approaches to effectively implement fungus-based water treatment are based mostly on polymer-based immobilization techniques, our proposed approach provides a novel and effective alternative via simple doping of living fungi with environmentally-benign clays such as halloysite nanotubes.

Structural variation of humic-like substances and its impact on plant stimulation: Implication for structure-function relationship of soil organic matters.

Here, five aromatic monomers, one bearing a long alkyl chain [3-pentadecylphenol (3-PP)], the second bearing a polycyclic aromatic hydrocarbon [dihydroxynaphthalene (DHN)], the third bearing an organic amine [l-3,4-dihydroxyphenylalanine (l-DOPA)], the fourth bearing a carboxylic acid [vanillic acid (VA)], and the fifth bearing a phenol [catechol (CA)] were oxidatively coupled to produce four humic-like substances (3-PP, DHN, l-DOPA, and CAVA products) to mimic the diverse organic architectures of natural humus. Analysis using several methods, including SEM, EPR, elemental analysis, FT-IR-ATR, 13C NMR and anti-oxidant capability, revealed that each of the monomeric structures was well incorporated into the corresponding humic-like substances. Seed germination acceleration and NaCl-involved abiotic stress resistance of Arabidopsis thaliana were then tested to determine whether the different structures resulted in different levels of plant stimulation. The l-DOPA, CAVA and DHN-based materials showed enhanced stimulatory activities compared with no treatment, whereas the effects of the 3-PP-based materials were meager. Interestingly, high-resolution (15 T) ESI FT-ICR mass spectrometry-based van Krevelen diagrams clearly showed that the presence of molecules with H/C and O/C ratios ranging from 0.5 to 1.0 and 0.2 to 0.4, respectively, could be connected with such biological actions. Here, the l-DOPA sample showed the highest content of such molecules, followed by the CAVA, DHN and 3-PP samples. Next, the ability of l-DOPA and CAVA products to induce resistance in A. thaliana to a pathogen-related biotic stress was tested to confirm whether the proposed molecular features are associated with multi-stimulatory actions on plants. The expression level of pathogenesis-related protein 1 and inspection of plant morphology clearly revealed that both the l-DOPA and CAVA products stimulate plants to respond to biotic stresses. Size-exclusion chromatography together with NMR and IR data of both the materials strongly suggests that lignin-like supramolecular assemblages play an important role in versatile biological activities of humus.

Synergistic Release of Crop Nutrients and Stimulants from Hydroxyapatite Nanoparticles Functionalized with Humic Substances: Toward a Multifunctional Nanofertilizer.

The use of salt- or macro-sized NPK fertilizers is typically associated with low nutrient use efficiency and water eutrophication. Nanotechnology can overcome such drawbacks, but its practical application on a large scale is limited by (i) high costs and difficult scale-up of nanoparticle synthesis, (ii) questionable advantages over traditional methods, and (iii) health hazards related to nanomaterial introduction in the food stream and the environment. Here, we report on a novel biocompatible and multifunctional P nanofertilizer obtained by self-assembling natural or synthetic humic substances and hydroxyapatite nanoparticles using a simple and straightforward dipping process, exploiting the interaction between the polyphenolic groups of humic substances and the surface of nanohydroxyapatite. Pot tests using the as-prepared materials were performed on Zea mays as a model crop, and the results were compared to those obtained using commercial fused superphosphate and bare nanohydroxyapatites. A significant improvement, in terms of early plant growth, corn productivity, rhizosphere bacteria, and the resistance to NaCl-induced abiotic stresses, was achieved using hydroxyapatite nanoparticles assembled with humic substances. These effects were ascribed to the synergistic co-release of phosphate ions and humic substances, which are two types of plant-beneficial agents for crop nutrition and stimulation, respectively. The release patterns were proven to be tunable with the amount of humic substances adsorbed on the nanoparticles, inducing competition between humic-substance-driven phosphorous dissolution and block of water contact. Such positive effects on plant growth in association with its intrinsic biocompatibility, simple synthesis, and multifunctionality qualify this novel nanofertilizer as a promising material for large-scale use in the agronomic field.

Artificial humification of lignin architecture: Top-down and bottom-up approaches.

Humic substances readily identifiable in the environment are involved in several biotic and abiotic reactions affecting carbon turnover, soil fertility, plant nutrition and stimulation, xenobiotic transformation and microbial respiration. Inspired by natural roles of humic substances, several applications of these substances, including crop stimulants, redox mediators, anti-oxidants, human medicines, environmental remediation and fish feeding, have been developed. The annual market for humic substances has grown rapidly for these reasons and due to eco-conscious features, but there is a limited supply of natural coal-related resources such as lignite and leonardite from which humic substances are extracted in bulk. The structural similarity between humic substances and lignin suggests that lignocellulosic refinery resulting in lignin residues as a by-product could be a potential candidate for a bulk source of humic-like substances, but structural differences between the two polymeric materials indicate that additional transformation procedures allowing lignin architecture to fully mimic commercial humic substances are required. In this review, we introduce the emerging concept of artificial humification of lignin-related materials as a promising strategy for lignin valorization. First, the core structural features of humic substances and the relationship between these features and the physicochemical properties, natural functions and versatile applications of the substances are described. In particular, the mechanism by which humic substances stimulate the growth of plants and hence can improve crop productivity is highlighted. Second, top-down and bottom-up transformation pathways for scalable humification of small lignin-derived phenols, technical lignins and lignin-containing plant residues are described in detail. Finally, future directions are suggested for research and development of artificial lignin humification to achieve alternative ways of producing customized analogues of humic substances.

Can Dexmedetomidine Influence Recovery Profiles from General Anesthesia in Nasal Surgery?

Objectives Dexmedetomidine has sympatholytic, sedative, anesthetic, and analgesic effects, as well as vasoconstrictive effects, which may help prevent hypotension under general anesthesia. This meta-analysis aimed to perform a systematic review of the literature and investigate the effect of dexmedetomidine on perioperative morbidity following nasal surgery and its adverse effects. Data Sources MEDLINE, SCOPUS, and the Cochrane database. Review Methods Two authors independently searched the databases from their inception to March 2017. Studies were selected that compared perioperative dexmedetomidine administration (dexmedetomidine groups) with a placebo or remifentanil (control groups) with regard to intraoperative morbidity, including surgical time, bleeding amount, hypotension, and bradycardia during operation, and postoperative morbidity, such as emergence agitation, nausea and vomiting, and sedation after operation. Results Surgical time, intraoperative blood loss, dose of inhaled anesthetic gas, dose of fentanyl, postoperative pain, and incidence of emergence agitation were significantly lower in the dexmedetomidine group versus the placebo group. In contrast, there were no significant differences in intraoperative hemodynamic stability and postoperative residual sedation and nausea and vomiting between groups. Additionally, compared with remifentanil (a currently widely used agent), dexmedetomidine was superior in view of postoperative pain and intraoperative blood pressure control. Conclusion This meta-analysis shows that the systemic administration of dexmedetomidine can decrease surgical time, intraoperative blood loss, and doses of intraoperative inhaled anesthetic gas and fentanyl as compared with placebo. It can also decrease postoperative pain and incidence of the emergence agitation. Due to the small number of studies, further clinical trials are needed to confirm these results.

The safety and efficacy of powered intracapsular tonsillectomy in children: A meta-analysis.

OBJECTIVES: We performed a systemic review and meta-analysis regarding the postoperative pain, perioperative, and postoperative morbidity of powered intracapsular tonsillectomy and adenoidectomy (PITA) using a microdebrider as a method of tonsillectomy. DATA SOURCES: Five databases (PubMed, Scopus, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials) in their entirety through March 2017. REVIEW METHODS: We included studies in which there was a comparison between groups of patients who underwent PITA (PITA group) and those who had extracapsular tonsillectomy (control group). Articles assessing effects of PITA in the pediatric patient were systemically and independently reviewed by two researchers. The outcomes of interest were intraoperative morbidity (operative time and bleeding), postoperative morbidity (postoperative pain, recovery time, tonsil regrowth, and postoperative bleeding rate), and improvement of sleep breath disorder (apnea-hypopnea index [AHI] and symptomatic scores). RESULTS: PITA did not significantly increase operative time or intraoperative blood loss. With PITA, there was significantly decreased postoperative pain, amount of analgesia, time to resumption of normal diet and activity, and incidence of postoperative admissions (due to dehydration or postoperative bleeding control) compared to those of the control group. In contrast, the incidence of postoperative tonsil regrowth was statistically higher in the PITA group than in the control group. The PITA improved AHI and obstructive sleep apnea 18-item questionnaire scores significantly, which were similar with the control group. CONCLUSIONS: With regard to intraoperative morbidity and postoperative morbidity, PITA is a safe procedure. However, there are high levels of heterogeneity with regard to several measured parameters. Therefore, further large, well-designed trials are required to substantiate our findings. Laryngoscope, 128:732-744, 2018.

Efficacy of dexmedetomidine for perioperative morbidities in pediatric tonsillectomy: A metaanalysis.

OBJECTIVES: This study aimed to assess the effects of perioperative dexmedetomidine as an adjuvant to tonsillectomy compared with opioid or sham in children. DATA SOURCE: Five databases (PubMed, SCOPUS, Embase, Web of Science, and Cochrane Central Register of Controlled Trials) were searched from inception of article collections to April 2017. REVIEW METHODS: Prospective, randomized controlled studies that compared outcomes between children who underwent tonsillectomy plus dexmedetomidine administration (intervention) and children who underwent tonsillectomy with placebo or opioid (control) were systemically and independently reviewed by two researchers. The outcomes of interest were emergence agitation, postoperative pain intensity, rescue analgesic consumption, and other morbidities (nausea and vomiting and agitation). RESULTS: Fifteen studies with n = 1,552 met the inclusion criteria. Postoperative pain scores and the need for analgesics in the postanesthesia care unit (PACU) were significantly decreased in the dexmedetomidine group versus the control group. The incidence and degree of agitation and desaturation incidence in the PACU also were significantly lower in the dexmedetomidine group than in the control group. Additionally, there was no significant difference in the duration of staying PACU between both groups. In subgroup analyses by administration method (bolus injection or continuous injection), dexmedetomidine was shown to be effective at reducing postoperative morbidities regardless of administration method. CONCLUSION: Perioperative administration of dexmedetomidine can provide pain and agitation relief without side effects in children undergoing adenotonsillectomy. Considering the high heterogeneity of results within some parameters; however, further clinical trials with robust research methodology should be conducted to confirm the results of this study. Laryngoscope, 128:E184-E193, 2018.

Efficacy of Adjuvant Magnesium for Posttonsillectomy Morbidity in Children: A Meta-analysis.

Objectives The perioperative administration of magnesium is known to reduce postoperative morbidities in adults, such as pain, agitation, and laryngospasm. The objective is to assess the effects of perioperative magnesium as the adjuvant to tonsillectomy as compared with tonsillectomy in children. Data Source Five databases (PubMed, SCOPUS, Embase, Web of Science, Cochrane). Method Two authors independently searched databases up to January 2017. We compared perioperative magnesium administration (magnesium groups) with no administration of magnesium (control group). The following outcomes were measured: postoperative pain intensity, analgesics administration, or other morbidities (laryngospasm, agitation, postoperative bleeding) in the postoperative 24 hours. Additionally, to evaluate the discrepancy of effects according to different administration routes, subgroup analyses regarding effects according to systemic or local administration of magnesium were performed. Results Nine prospective randomized controlled studies (n = 615) that evaluated the effect of magnesium in children having undergone tonsillectomy met inclusion criteria. Compared with control group, the time for first analgesic requirement was significantly delayed in magnesium groups (standardized mean difference = 0.75; 95% CI, 0.20-1.31; P = .0079). Laryngospasm (log odds ratio = -1.09; 95% CI,-2.11 to -0.07; P = .0362) and agitation score (standardized mean difference = -0.67; 95% CI, -0.97 to -0.36; P < .0001) in the recovery room also significantly decreased in magnesium groups. In subgroup analyses regarding pain and laryngospasm-related measurements, local administration of magnesium was shown to be more effective at reducing postoperative morbidities. Conclusions Perioperative magnesium regardless of route may offer pain, agitation, and laryngospasm relief without adverse effects in pediatric tonsillectomy. Based on the high heterogeneity of results within some parameters, further studies need to be performed to affirm these results.

The effectiveness of postoperative intervention in patients after rhinoplasty: a meta-analysis.

Rhinoplasty is the most common facial plastic surgical procedure, and the occurrence of periorbital edema and ecchymosis is normal after rhinoplasty. The goal of this study was to perform a systematic review with meta-analysis of the efficacy of postoperative care of edema and ecchymosis following rhinoplasty. Two authors independently searched the databases (PubMed, SCOPUS, Embase, Web of Science, and the Cochrane database) from inception to September 2016. We included studies that compared postoperative care methods (intervention groups) with no treatment (control group) where the outcomes of interest were edema, ecchymosis, and satisfaction rate of patients on postoperative days. Sufficient data for meta-analysis were retrieved for 11 trials with a total of 627 patients. Eyelid edema and ecchymosis during the first 7 days postoperatively were statistically decreased in the arnica administration groups versus the control group. Eyelid edema and ecchymosis during the first 24 h postoperatively were statistically decreased in the cold compression group versus the control group. The ratio of patient satisfaction was statistically higher in the tapping application group than in the control group. However, the analysis indicated that surgeons had a significant tendency to decrease intranasal packing. The administration of arnica, cold compression, and tape could reduce eyelid edema and ecchymosis. Intranasal packing was associated with more adverse effects in terms of postoperative ecchymosis compared to non-packing. However, additional trials with thorough research methodologies should be conducted to confirm the results of this study.

Gastroesophageal junction adenocarcinoma of young patients who underwent curative surgery: a comparative analysis with older group.

PURPOSE: Adenocarcinoma of the stomach at a young age has a poor prognosis, but there are few reports describing gastroesophageal junction adenocarcinoma. This study aimed to compare the clinicopathological characteristics between the young and old patients who underwent curative surgery. METHODS: One thousand three hundred and sixty-one patients with gastric adenocarcinoma underwent a curative gastrectomy between January 1, 1992 and December 31, 2006. Of these, 141 (10.4%) cases were gastroesophageal junction adenocarcinoma according to the Siewert's classification, and the data were collected prospectively for the analysis of the young age group (under 44 years old), in comparison to the older age group, with factors such as pathological characteristics, recurrence, and survival. RESULTS: The sex ratio was near 1:1 in the younger group while it was predominantly male in the older group. There were no significant differences in the clinicopathological characteristics, such as the recurrence and survival rate, between the two groups. CONCLUSIONS: The factor of young age does not critically affect the clinical course of gastroesophageal junction adenocarcinoma. This may be attributed to curative surgery and multimodality therapy.