Hasil untuk "Surgery"

Adzick Ns, E. Thom, C. Spong et al.

N. A. van der Gaag, E. A. Rauws, C. V. van Eijck et al.

Y. L. Chee, J. C. Crawford, H. Watson et al.

Wanyu Deng, Zhen Luo, Haifei Yu et al.

IntroductionChronic hepatitis B virus (HBV) infection continues to pose a significant global health burden, and current therapies rarely target the viral covalently closed circular DNA reservoir. Kaempferol (KP), a major flavonoid found in various herbs and plants, exhibits diverse bioactivities, but its potential anti-HBV activity remains unclear. This study aims to investigate the anti-HBV potential of KP and to elucidate its underlying mechanisms.MethodsThe HBV-infected Huh7DhNTCP cell, viral stable transfection cell HepG2.2.15, as well as a hydrodynamic injection-based chronic HBV infection mouse model, were established to evaluate the antiviral effects of KP. The levels of HBV RNAs, DNA and proteins were detected using ELISA, western blot, qPCR, immunofluorescence and immunohistochemistry. To investigate the mechanisms, viral promoter activities were assessed via dual-luciferase reporter assays, and relevant transcription factors were validated through qPCR and western blot analysis.ResultsKP dose- and time-dependently reduced the levels of viral antigens, RNA, and DNA in vitro, and also significantly lowered viral markers and attenuated HBV-induced hepatic pro-inflammatory cytokines expression in vivo. Furthermore, KP acted in combination with the nucleoside analog entecavir to suppress HBV replication. Mechanistically, KP strongly inhibited the transcriptional activity of the HBV core promoter (Cp), and enhanced the phosphorylation of both extracellular signal-regulated kinase (ERK) and its downstream target forkhead box protein O1 (FOXO1). Importantly, the ERK-specific inhibitor U0126 completely abolished the antiviral effects of KP, confirming that its antiviral activity depended on the ERK/FOXO1 pathway.DiscussionCollectively, our results indicate that KP activates ERK-dependent FOXO1 phosphorylation, leading to transcriptional repression of the HBV Cp and thereby suppression of viral replication. These findings identify KP as a potential candidate for developing novel therapeutics against chronic HBV infection.

Lavinia Ghiani, Simona Citro, Alessandro Medda et al.

Abstract Background Head and Neck Squamous Cell Carcinoma (HNSCC) are classified in two main subtypes: HPV-positive (HPV+), driven by human papillomavirus (HPV) infections, and HPV-negative (HPV-), associated with environmental risk factors. Despite molecular and clinicopathological differences, neither subtype has effective tailored therapies. Since high-risk HPV oncoproteins E6/E7 affect several epigenetic regulators, characterizing the epigenetic landscape of HPV+ and HPV- HNSCC may uncover novel subtype-specific biomarkers and therapeutic targets. Methods Histone post-translational modifications were profiled in HPV+ and HPV- HNSCC tissues and cell lines using super-SILAC mass spectrometry. The same analysis was performed and combined with RNA-sequencing on E6/E7-transduced human primary keratinocytes (HKs) to identify relevant histone modifiers affected by HPV oncoproteins. Candidate gene was validated via E6/E7-mediated-siRNA knockdown in HPV + cell lines. Western Blot, RT-qPCR and Immunohistochemistry assessed gene expression. NSD2 expression was examined in patients’ tissue samples, TCGA data and 14 HNSCC cell lines. shRNA-mediated NSD2 knockdown followed by RNA-seq, cell proliferation and migration assays evaluated its oncogenic role in HNSCC. CaCl2 treatments were used to investigate NSD2’s role in epithelial differentiation, while ALDH-positive cells were quantified by flow-cytometry. NSD2 overexpression was used to confirm results. Results HPV+ HNSCC exhibited elevated H3K36me2 levels, compared to HPV-. This alteration is driven by E6/E7-induced NSD2 upregulation. NSD2, a histone methyltransferase specific for H3K36 di-methylation is overexpressed in HPV+ relative to HPV- HNSCC and in both subtypes compared to normal tissue, suggesting crucial implications in HNSCC. Functional assays revealed that NSD2 promotes cell proliferation and migration in both the subtypes. Notably, we identified a novel role for NSD2 in inhibiting epithelial cell differentiation, particularly in HPV+ HNSCC, where its upregulation mediates the E6/E7-induced differentiation blockade. Conclusions We identified a novel HPV-driven epigenetic signature in HNSCC marked by increased H3K36me2 and its writer, NSD2. Our study highlights H3K36me2 as a potential biomarker for patient stratification and positions NSD2 as a promising therapeutic target across HNSCC subtypes, modulating both common and subtype-specific oncogenic pathways. Specifically, NSD2 inhibition in HPV+ tumors restores epithelial differentiation, offering a potential strategy to arrest tumor progression.

Ha Na Cho, Seungmin Jeong, Yawen Guo et al.

Objective: Predicting length of stay after elective spine surgery is essential for optimizing patient outcomes and hospital resource use. This systematic review synthesizes computational methods used to predict length of stay in this patient population, highlighting model performance and key predictors. Methods: Following PRISMA guidelines, we systematically searched PubMed, Google Scholar, and ACM Digital Library for studies published between December 1st, 2015, and December 1st, 2024. Eligible studies applied statistical or machine learning models to predict length of stay for elective spine surgery patients. Three reviewers independently screened studies and extracted data. Results: Out of 1,263 screened studies, 29 studies met inclusion criteria. Length of stay was predicted as a continuous, binary, or percentile-based outcome. Models included logistic regression, random forest, boosting algorithms, and neural networks. Machine learning models consistently outperformed traditional statistical models, with AUCs ranging from 0.94 to 0.99. K-Nearest Neighbors and Naive Bayes achieved top performance in some studies. Common predictors included age, comorbidities (notably hypertension and diabetes), BMI, type and duration of surgery, and number of spinal levels. However, external validation and reporting practices varied widely across studies. Discussion: There is growing interest in artificial intelligence and machine learning in length of stay prediction, but lack of standardization and external validation limits clinical utility. Future studies should prioritize standardized outcome definitions and transparent reporting needed to advance real-world deployment. Conclusion: Machine learning models offer strong potential for length of stay prediction after elective spine surgery, highlighting their potential for improving discharge planning and hospital resource management.

Sabrina Erriyanti, Amiliana M Soesanto, Indriwanto Sakidjan et al.

In “The Impact of Tricuspid Annular Plane Systolic Excursion (TAPSE) After Mitral Valve Surgery on Long Term Mortality” (Indonesian Journal of Cardiology, 43(1), 1-8. https://doi.org/10.30701/ijc.1196), there is an error noted. An error has been found in the PDF version of this article. The DOI printed in the PDF is incorrect. The correct DOI is https://doi.org/10.30701/ijc.1196. The error occurs only in the PDF; the DOI listed in the article metadata is already correct. The publisher apologizes for any inconvenience caused by this error. DOI of original article: https://doi.org/10.30701/ijc.1196

Almabadi ES, Felemban D, Alekhmimi RK et al.

Eman S Almabadi,1 Doaa Felemban,2 Razan Khalid Alekhmimi,3,4 Muntasir Adnan Aynusah,4 Alla Alsharif,1 Nebras Althagafi,1 Saba Kassim1 1Department of Preventive Dental Sciences, Taibah University, College of Dentistry, Al-Madinah Al-Munawwrah, 42353, Saudi Arabia; 2Department of Oral and Maxillofacial Diagnostic Sciences, Taibah University, College of Dentistry, Al-Madinah Al-Munawwarah, 42353, Saudi Arabia; 3Medical Administration Department,Taibah University, College of Dentistry, Al-Madinah Al-Munawwarah, 42353, Saudi Arabia; 4Department of Dental Surgery, Healthcare Quality and Patient Safety, Ministry of Health, Al-Madinah Al-Munawwarah, 42394, Saudi ArabiaCorrespondence: Eman S Almabadi, Department of Preventive Dental Sciences, Taibah University, College of Dentistry, Prince, Naif Ibn Abdulaziz, Al-Madinah Al-Munawwrah, 42353, Saudi Arabia, Email emabadi@taibahu.edu.saObjective: This study aimed to assess the association between sleep bruxism (SB) among children and parental sociodemographic characteristics and SB risk factors (eg, nose obstruction).Methods: A cross-sectional survey was conducted with 250 parents of children under the age of 13 who visited pediatric dental clinics. Data were collected through a questionnaire completed by parents. Sociodemographic characteristics, the child’s medical history, sleep patterns and parents’ awareness of bruxism and its symptoms were investigated. Descriptive, bivariate and binary logistic regression analyses were performed.Results: The response rate was 85.2% (55% females, 45% males) and 25.8% of the parents self-reported that their children had bruxism. The regression analysis revealed that parents reporting SB among their children were significantly more likely to have SB themselves (8.62 [3.68– 20.16], p = 0.001). While children whose mothers had lower education level and were unaware of bruxism-related symptoms (such as teeth, jaw, or face pain) were less likely to be reported as having SB (0.35 [0.16– 0.75], p = 0.007; 0.36 [0.14– 0.97], p = 0.043, respectively). Parents who identified nose obstruction as a cause of bruxism also had children with a higher likelihood of having SB (5.49 [1.04– 29.08], p = 0.045).Conclusion: The findings highlighted that parental sociodemographic characteristic and SB risk factors associated signficantly with the prevalence of childhood SB.Keywords: sleep bruxism, children, parental sociodemographic factors, Saudi Arabia

Alexander Cowtan

This thesis is a study of quantum error-correction codes from an algebraic perspective. We concern ourselves not only with quantum codes but also protocols to perform logical quantum computation using such codes. We derive new methods of performing fault-tolerant quantum computation, rooted in abstract algebra and category theory. We also generalise known constructions of quantum codes and rigorously formalise existing constructions. At its core, this thesis asks: what is lattice surgery?

Jiajun Cheng, Xianwu Zhao, Sainan Liu et al.

Innovations in digital intelligence are transforming robotic surgery with more informed decision-making. Real-time awareness of surgical instrument presence and actions (e.g., cutting tissue) is essential for such systems. Yet, despite decades of research, most machine learning models for this task are trained on small datasets and still struggle to generalize. Recently, vision-Language Models (VLMs) have brought transformative advances in reasoning across visual and textual modalities. Their unprecedented generalization capabilities suggest great potential for advancing intelligent robotic surgery. However, surgical VLMs remain under-explored, and existing models show limited performance, highlighting the need for benchmark studies to assess their capabilities and limitations and to inform future development. To this end, we benchmark the zero-shot performance of several advanced VLMs on two public robotic-assisted laparoscopic datasets for instrument and action classification. Beyond standard evaluation, we integrate explainable AI to visualize VLM attention and uncover causal explanations behind their predictions. This provides a previously underexplored perspective in this field for evaluating the reliability of model predictions. We also propose several explainability analysis-based metrics to complement standard evaluations. Our analysis reveals that surgical VLMs, despite domain-specific training, often rely on weak contextual cues rather than clinically relevant visual evidence, highlighting the need for stronger visual and reasoning supervision in surgical applications.

Nathan Darjana, Ryo Fujii, Hideo Saito et al.

Egocentric open-surgery videos capture rich, fine-grained details essential for accurately modeling surgical procedures and human behavior in the operating room. A detailed, pixel-level understanding of hands and surgical tools is crucial for interpreting a surgeon's actions and intentions. We introduce EgoSurgery-HTS, a new dataset with pixel-wise annotations and a benchmark suite for segmenting surgical tools, hands, and interacting tools in egocentric open-surgery videos. Specifically, we provide a labeled dataset for (1) tool instance segmentation of 14 distinct surgical tools, (2) hand instance segmentation, and (3) hand-tool segmentation to label hands and the tools they manipulate. Using EgoSurgery-HTS, we conduct extensive evaluations of state-of-the-art segmentation methods and demonstrate significant improvements in the accuracy of hand and hand-tool segmentation in egocentric open-surgery videos compared to existing datasets. The dataset will be released at https://github.com/Fujiry0/EgoSurgery.

Mary Noory, Caitlin Anne Fitzgerald, Sejul Chaudhary

.

Takashi Ikeda, Kazunari Ninomiya, Koji Suzuki et al.

Purpose: Frailty and sarcopenia may progressively worsen physical function, and studies have noted the frequent presence of sarcopenia in patients who undergo total hip arthroplasty (THA). This study aimed to examine the prevalence of comorbid frailty and sarcopenia in older patients undergoing THA and to determine the impact of these conditions on lower limb strength and hip function. Methods: Patients aged ≥65 years who had undergone THA at least 1 year previously were divided into five groups according to the presence and severity of frailty and sarcopenia. Lower limb strength [hip abductor (HA) and knee extensor (KE)], balance, and hip function were compared. Results: Sarcopenia and frailty affected lower limb muscle strength and hip function in a staircase-like manner, with mean ​± ​standard deviation values for the five groups as follows: HA muscle strength (in Nm/body weight), robust 0.80 ​± ​0.23, pre-frail ​+ ​non-sarcopenia 0.69 ​± ​0.17, pre-frail ​+ ​sarcopenia 0.58 ​± ​0.20, frail ​+ ​non-sarcopenia 0.54 ​± ​0.16, frail ​+ ​sarcopenia 0.50 ​± ​0.16; KE muscle strength (in kgf/body weight), robust 1.17 ​± ​0.23, pre-frail ​+ ​non-sarcopenia 1.03 ​± ​0.32, pre-frail ​+ ​sarcopenia 0.90 ​± ​0.31, frail ​+ ​non-sarcopenia 0.84 ​± ​0.27, frail ​+ ​sarcopenia 0.74 ​± ​0.21; and Harris Hip Score, robust 96.8 ​± ​4.6, pre-frail ​+ ​non-sarcopenia 94.3 ​± ​7.9, pre-frail ​+ ​sarcopenia 88.6 ​± ​9.6, frail ​+ ​non-sarcopenia 87.5 ​± ​10.3, frail ​+ ​sarcopenia 83.5 ​± ​8.6. Conclusion: Progression of sarcopenia and frailty affects lower limb muscle strength and physical function in a staircase-like fashion, suggesting the need to assess the cumulative effects of the two. Among this population, rather than interventions to improve muscle strength and balance in specific areas, interventions to maintain a comprehensive level of physical fitness and muscle mass (including nutrition and lifestyle changes) may be necessary.

Kenichiro Kikuchi, Satoshi Kazuma, Yoshiki Masuda

Background/Objectives: Hyperlactatemia is a common predictive factor for poor post-cardiovascular surgery outcomes. However, it is not well understood whether the rapid postoperative lactate level elevation in a short period of time is associated with patient outcomes. Herein, we investigated the relationship between the degree of change in serum lactate levels and postoperative serious adverse events (PSAEs), including mortality, within 24 h of cardiovascular surgery. Methods: In this retrospective study, we evaluated the relationship between a rapid serum lactate level increase and PSAEs after open-heart and major vascular surgery. We divided the patients into those with and without PSAEs. Univariate and multivariate analyses were performed to evaluate the association between PSAEs and rapid lactate level increases. Results: We enrolled 445 patients; 16% (n = 71) had PSAEs. The peak lactate levels during the first 24 h of intensive care unit (ICU) stay were higher in patients with PSAEs than in those without. The maximum change in lactate levels between two consecutive lactate measurements during the first 24 h after ICU admission was higher in patients with PSAEs than in those without. A multivariate logistic regression analysis revealed that changes in lactate levels of 2 mmol/L or more between two consecutive lactate measurements were associated with PSAEs. ICU peak lactate levels of 3 mmol/L or more were not associated with PSAEs. Conclusions: Rapid serum lactate level increases of 2 mmol/L or more during the first 24 h of ICU admission post-cardiovascular surgery are associated with PSAEs.

Yuqi Xiao, Leah Edelstein-Keshet, Alain Goriely et al.

Capsular contracture is a pathological response to implant-based reconstructive breast surgery, where the ``capsule'' (tissue surrounding an implant) painfully thickens, contracts and deforms. It is known to affect breast-cancer survivors at higher rates than healthy women opting for cosmetic cosmetic breast augmentation with implants. We model the early stages of capsular contracture based on stress-dependent recruitment of contractile and mechanosensitive cells to the implant site. We derive a one-dimensional continuum spatial model for the spatio-temporal evolution of cells and collagen densities away from the implant surface. Various mechanistic assumptions are investigated for linear versus saturating mechanical cell responses and cell traction forces. Our results point to specific risk factors for capsular contracture, and indicate how physiological parameters, as well as initial states (such as inflammation after surgery) contribute to patient susceptibility.

Lim Zheng Jie, Kian Meng Yap

Traditional medical training faces challenges like ethical concerns, safety risks, and high costs. VR technology offers a promising solution but is limited by low complexity and lack of tactile feedback. This paper presents a cost-effective haptic VR surgery simulation which simulates realistic Kidney Transplant using commercial devices to enhance training authenticity and immersion. Trainees can conduct incision and anastomosis procedures using a haptic stylus device that provides tactile sensations. Results from the test with medical participants showed that haptic feedback positively enhances the VR medical training experience.

Junbo Shen, Bing Xue, Thomas Kannampallil et al.

Early detection of surgical complications allows for timely therapy and proactive risk mitigation. Machine learning (ML) can be leveraged to identify and predict patient risks for postoperative complications. We developed and validated the effectiveness of predicting postoperative complications using a novel surgical Variational Autoencoder (surgVAE) that uncovers intrinsic patterns via cross-task and cross-cohort presentation learning. This retrospective cohort study used data from the electronic health records of adult surgical patients over four years (2018 - 2021). Six key postoperative complications for cardiac surgery were assessed: acute kidney injury, atrial fibrillation, cardiac arrest, deep vein thrombosis or pulmonary embolism, blood transfusion, and other intraoperative cardiac events. We compared prediction performances of surgVAE against widely-used ML models and advanced representation learning and generative models under 5-fold cross-validation. 89,246 surgeries (49% male, median (IQR) age: 57 (45-69)) were included, with 6,502 in the targeted cardiac surgery cohort (61% male, median (IQR) age: 60 (53-70)). surgVAE demonstrated superior performance over existing ML solutions across all postoperative complications of cardiac surgery patients, achieving macro-averaged AUPRC of 0.409 and macro-averaged AUROC of 0.831, which were 3.4% and 3.7% higher, respectively, than the best alternative method (by AUPRC scores). Model interpretation using Integrated Gradients highlighted key risk factors based on preoperative variable importance. surgVAE showed excellent discriminatory performance for predicting postoperative complications and addressing the challenges of data complexity, small cohort sizes, and low-frequency positive events. surgVAE enables data-driven predictions of patient risks and prognosis while enhancing the interpretability of patient risk profiles.

Arndt Michael, Lippert Hans, Croner Roland S. et al.

In the surgical treatment of colorectal carcinoma (CRC), 1 in 10 patients has a peritumorous adhesion or tumor infiltration in the adjacent tissue or organs. Accordingly, multivisceral resection (MVR) must be performed in these patients. This prospective multicenter observational study aimed to analyze the possible differences between non-multivisceral resection (nMVR) and MVR in terms of early postoperative and long-term oncological treatment outcomes. We also aimed to determine the factors influencing overall survival.

Shuning Ding, Niu Qiao, Qingchen Zhu et al.

Abstract Background Characterizing the unique immune microenvironment of each tumor is of great importance for better predicting prognosis and guiding cancer immunotherapy. However, the unique features of the immune microenvironment of triple negative breast cancer (TNBC) compared with other subtypes of breast cancer remain elusive. Therefore, we aimed to depict and compare the immune landscape among TNBC, human epidermal growth factor receptor 2‐positive (HER2+) breast cancer, and luminal‐like breast cancer. Methods Single‐cell RNA sequencing (scRNA‐seq) was performed on CD45+ immune cells isolated from human normal breast tissues and primary breast tumors of various subtypes. By analyzing the scRNA‐seq data, immune cell clusters were identified and their proportions as well as transcriptome features were compared among TNBC, human HER2+ breast cancer, and luminal‐like breast cancer. Pseudotime and cell‐cell communication analyses were also conducted to characterize the immune microenvironment. Results ScRNA‐seq data of 117,958 immune cells were obtained and 31 immune clusters were identified. A unique immunosuppressive microenvironment in TNBC was decoded as compared to that in HER2+ or luminal‐like breast cancer, which was characterized by higher proportions of regulatory T cells (Tregs) and exhausted CD8+ T cells and accompanied by more abundant plasma cells. Tregs and exhausted CD8+T cells in TNBC exhibited increased immunosuppression signature and dysfunctional scores. Pseudotime analyses showed that B cells tended to differentiate to plasma cells in TNBC. Cell‐cell communication analyses indicated that these unique features are fostered by the diversified T cell‐B cell crosstalk in TNBC. Based on the T cell‐B cell crosstalk, a prognostic signature was established that could effectively predict the prognosis status for patients with TNBC. Additionally, it was found that TNBC had a higher proportion of cytotoxic natural killer (NK) cells, whereas HER2+ or luminal‐like breast cancer lost this feature, suggesting that HER2+ or luminal‐like breast cancer, but not TNBC, may benefit from NK‐based immunotherapy. Conclusions This study identified a distinct immune feature fostered by T cell‐B cell crosstalk in TNBC, which provides better prognostic information and effective therapeutic targets for breast cancer.