bluuebunny/crossref_metadata_2025 huggingface dataset:
Technology as (Dis-)Enchantment. AlphaGo and the Meaning-Making of Artificial Intelligence
Authors: Binder Werner
Published: December 2022

As a social phenomenon, artificial intelligence (AI) is not just technically but also culturally constructed. This article investigates the meaning-making of AI in the case of AlphaGo by employing and refining cultural sociological narrative analysis. Building on Smith’s structural model of genre, whose horizontal axis reflects varying degrees of (dis-)enchantment, I propose an extended model of narrative genre, adding a vertical axis on the theoretical basis of Durkheim’s distinction between pure and impure sacred, to account for the empirical bifurcation between utopian and dystopian AI narratives. While critical approaches to AI, prevalent in sociology, tend to offer disenchanted narratives, my cultural sociological approach allows for the construction of a meta-narrative, which is able to capture not only enchantment as well as disenchantment but also purification and impurification as empirical processes that accompany the emergence and consolidation of new technologies. This approach is exemplified by a case study of AlphaGo, a Go-playing program utilizing machine learning and neural networks, which gained global prominence and cultural significance after beating a human grandmaster in 2016. Drawing on publicly available online data, this article investigates the discourses surrounding AlphaGo, focusing on its cultural construction through storytelling and genre. I not only show how characters and events were emplotted in different stories, which were in turn embedded in broader narratives about technological progress and AI, but also explain how the development of the main storyline was driven by in-game performances, audience expectations and collective representations. The article demonstrates the feasibility of a cultural sociology of AI and the usefulness of my extended model of narrative genre, which is not only applicable to AI discourses but other domains as well.
Modified Mayo score versus Mayo score for evaluation of treatment efficacy in patients with ulcerative colitis: data from the tofacitinib OCTAVE program
Authors: Sandborn William J. , Sands Bruce E. , Vermeire Séverine , Leung Yvette , Guo Xiang , Modesto Irene , Su Chinyu , Wang Wenjin , Panés Julian
Published: December 2022

Objectives:

The subjectivity of the Physician Global Assessment (PGA) is a limitation of the Mayo score in assessing severity of ulcerative colitis (UC). We compared treatment efficacy using endpoint definitions based on modified Mayo (mMayo) score, versus those based on Mayo score, using data from the tofacitinib OCTAVE program.

Design:

This post hoc analysis included data from two 8-week induction studies (OCTAVE Induction 1 and 2) and a 52-week maintenance study (OCTAVE Sustain).

Methods:

Remission and clinical response [with nonresponder imputation (NRI)] were assessed using mMayo (without PGA) and Mayo scores, and further stratified by prior tumor necrosis factor inhibitor (TNFi) failure status.

Results:

At week 8 of OCTAVE Induction 1 and 2, remission rates with placebo and tofacitinib 10 mg twice daily (BID), respectively, were 7.7% and 24.8% (mMayo) and 6.0% and 17.6% (Mayo). At week 52 of OCTAVE Sustain, remission rates with placebo, tofacitinib 5 and 10 mg BID, respectively, were 12.1%, 35.9%, and 42.1% (mMayo) and 11.1%, 34.3%, and 40.6% (Mayo). A statistically significant ( p < 0.05) treatment effect of tofacitinib versus placebo was observed for remission and clinical response at all time points, regardless of scoring definition or prior TNFi failure status.

Conclusions:

A significant effect of tofacitinib versus placebo was demonstrated across efficacy endpoints using mMayo score, consistent with previously reported data using Mayo score. Treatment effect sizes were generally similar regardless of scoring definition. This observation may help contextualize tofacitinib therapy outcomes with those of new UC therapies and support the use of Mayo score-based endpoints in UC clinical trials.

Trail registration:

ClinicalTrials.gov identifiers: NCT01465763; NCT01458951; NCT01458574.
Free Sterol Composition of Deep-Sea Holothurian Orphnurgus cf. glaber
Authors: Ponomarenko Ludmila P , Kapustina Irina I , Dautov Salim S , Dautova Tatiana N , Stonik Valentin A
Published: December 2022

The free sterol fraction from the deep-sea holothurian Orphnurgus cf glaber Walsh, 1891, has been isolated and studied by GC–MS. Sterols containing Δ7, Δ0, Δ5, polyunsaturated and 5,8-epidioxy modified cores were found. A high percentage of compounds with polyunsaturated cores distinguish this composition from those of previously studied holothurians. Almost all identified compounds had saturated side chains, which is also a specific feature of this fraction. Peculiarities of biosynthesis and metabolism of the found sterols are discussed.
Successful peficitinib addition on anti-MDA5 antibody-positive dermatomyositis refractory to triple therapy and glucocorticoid reduction
Authors: Oba Yuki , Yamanouchi Masayuki , Ikuma Daisuke , Mizuno Hiroki , Inoue Noriko , Sekine Akinari , Hasegawa Eiko , Suwabe Tatsuya , Sawa Naoki , Ubara Yoshifumi
Published: December 2022

Anti-melanoma differentiation–associated gene 5 antibody-positive dermatomyositis is the poorest prognosis of all dermatomyositis due to its associated rapidly progressive interstitial lung disease. Intensive treatment is required from the onset and triple therapy with prednisolone, calcineurin inhibitors, and intravenous cyclophosphamide is recommended. However, some patients are refractory or dependent on this treatment and additional immunosuppressive therapy is required. Recently, the efficacy of tofacitinib, a JAK inhibitor, has been reported. Here, we describe a case of a 50-year-old woman with anti-melanoma differentiation–associated gene 5 antibody-positive dermatomyositis who became refractory to triple therapy and prednisolone reduction, and achieved remission with the addition of peficitinib, a JAK inhibitor. This is the first report showing that peficitinib is effective for anti-melanoma differentiation–associated gene 5 antibody-positive dermatomyositis and it may be a potential treatment option.
Finite element analysis and energy recovery calculation of carbon fiber composite based on ANSYS software
Authors: Zheng Jianxiao , Duan Zhishan , Zhou Liming
Published: December 2022

Purpose:

To study the response under impact load of carbon fiber reinforced composite materials that have excellent mechanical properties.

Design/methodology/approach:

Finite element analysis of unidirectional plates was conducted under unsymmetrical impact load based on drop weight impact test. At the macroscopic scale, a finite element model was built on ANSYS/LS-DYNA, which took the impact response of carbon fiber unidirectional plates as unknown quantity. The model considered the macroscopic response of carbon fiber unidirectional plates under different initial conditions, from the aspects of stress, strain, energy change and deformation degree of unidirectional plates. Finally, a mathematical model of energy recovery of carbon fiber composite materials under partial impact load was established, and the energy recovery amount under different fiber orientations was calculated on MATLAB.

Findings:

The impact energy absorbed by the unidirectional plate is the largest when the fiber orientation is 30°. To improve the impact resistance of unidirectional plates under unsymmetrical impact load, laying schemes should be avoided at fiber orientations of 0°, 15° and 60°, and be recommended at 30°, 45°, and 75°. For impact velocity, 4.71 and 7.54 m/s should be avoided, while 2 m/s is recommended. For the impact weight, 50 and 250 kg weights should be avoided, and 150 and 200 kg weights are recommended.

Originality/value:

This model not only provides reference for similar impact resistance research, but also predicts the impact response of unidirectional plates under different initial loads in the future. It can also provide reference for the structure using carbon fiber composite materials to achieve lightweight.
Musical Interval Perception With a Cochlear Implant Alone and With a Contralateral Normal Hearing Ear
Authors: Landsberger David M. , Stupak Natalia , Dahl Cori , Aronoff Justin M.
Published: December 2022

Music through a cochlear implant (CI) is described as out-of-tune, suggesting that musical intervals are not accurately provided by a CI. One potential reason is that pitch may be insufficiently conveyed to provide reliable intervals. Another potential reason is that the size of intervals is distorted through a CI as they would be when produced by a mistuned piano. To measure intervals through a CI, listeners selected prerecorded vowels with different fundamental frequencies to represent each note in Happy Birthday. Each listener had contralateral normal hearing (NH); repeating the experiment with their NH ear allowed for a within-subject control. Additionally, the effect of listening simultaneously to both a CI and NH ear was measured. The resulting versions of Happy Birthday were analyzed in terms of their contours, interval sizes, magnitudes, consistency, and direction. Intervals with NH ears ranged from perfect to uncorrelated with target intervals. Chosen interval size with the CI was poorer than with the NH ear for all subjects. Across listeners, chosen intervals with the CI ranged from highly correlated to uncorrelated with target intervals. That CI intervals were highly correlated with target intervals for some listeners suggests that accurate intervals can be provided through a CI. For some listeners, chosen intervals were larger than target intervals, suggesting that intervals may be perceived as too small. Overall, intervals with the combination of the NH and CI ears were similar to those with the NH ear alone, suggesting that the addition of a CI has little-to-no effect on interval perception.
Sphingosine 1-phosphate has a negative effect on RBC storage quality
Authors: Hay Ariel , Nemkov Travis , Gamboni Fabia , Dzieciatkowska Monika , Key Alicia , Galbraith Matthew , Bartsch Kyle , Sun Kaiqi , Xia Yang , Stone Mars , Busch Michael P. , Norris Philip J. , Zimring James C. , D’Alessandro Angelo
Published: December 2022

Blood storage promotes the rapid depletion of red blood cell (RBC) high-energy adenosine triphosphate (ATP) and 2,3-diphosphoglycerate (DPG), which are critical regulators of erythrocyte physiology and function, as well as oxygen kinetics and posttransfusion survival. Sphingosine-1-phosphate (S1P) promotes fluxes through glycolysis. We hypothesized that S1P supplementation to stored RBC units would improve energy metabolism and posttransfusion recovery. We quantified S1P in 1929 samples (n = 643, storage days 10, 23, and 42) from the REDS RBC Omics study. We then supplemented human and murine RBCs from good storer (C57BL6/J) and poor storer strains (FVB) with S1P (1, 5, and 10 μM) before measurements of metabolism and posttransfusion recovery. Similar experiments were repeated for mice with genetic ablation of the S1P biosynthetic pathway (sphingosine kinase 1 [Sphk1] knockout [KO]). Sample analyses included metabolomics at steady state, tracing experiments with 1,2,3-13C3-glucose, proteomics, and analysis of end-of-storage posttransfusion recovery, under normoxic and hypoxic storage conditions. Storage promoted decreases in S1P levels, which were the highest in units donated by female or older donors. Supplementation of S1P to human and murine RBCs boosted the steady-state levels of glycolytic metabolites and glycolytic fluxes, ie the generation of ATP and DPG, at the expense of the pentose phosphate pathway. Lower posttransfusion recovery was observed upon S1P supplementation. All these phenomena were reversed in Sphk1 KO mice or with hypoxic storage. S1P is a positive regulator of energy metabolism and a negative regulator of antioxidant metabolism in stored RBCs, resulting in lower posttransfusion recoveries in murine models.
Cisplatin-loaded metal–phenolic network with photothermal-triggered ROS generation for chemo-photothermal therapy of cancer
Authors: Chen Xiaoxiao , Wang Lulu , Liu Sijia , Luo Xuezhen , Wang Kai , He Qizhi
Published: December 2022

Developing multifunctional composites has received widespread attention for cancer treatment. Herein, a metal–phenolic network (MPN)-based composite loading with chemotherapy agents (TAFP) exhibits high anti-tumor therapeutic efficacy via photothermal therapy (PTT), chemo-dynamic therapy (CDT), and chemotherapy. The nanocomposite was formed by mixing the chemotherapeutic drugs (cisplatin, DDP) into the tannic acid (TA) and Fe3+ network (TAFe) to integrate the synergistic effect of PTT, CDT, and chemotherapy. Due to the acidic tumor microenvironment, the active substances could be released with the degradation of the metal–phenolic network, and the released DDP would induce the chemotherapy. More importantly, the released TA under the acidic environment could increase iron bioavailability by converting Fe3+ to Fe2+, which converts hydrogen peroxide (H2O2) to highly toxic hydroxyl radical via the Fenton reaction. Meanwhile, the heat generated from TAFP after near-infrared (NIR) laser irradiation could enhance the therapeutic effect of CDT and chemotherapy. Furthermore, the composite exhibited unique anticancer efficacy in vivo with low toxicity. Collectively, this work may facilitate the development of metal–phenolic network-based photothermal agents for clinic anti-tumor applications.
robustica: customizable robust independent component analysis
Authors: Anglada-Girotto Miquel , Miravet-Verde Samuel , Serrano Luis , Head Sarah A.
Published: December 2022

Background

Independent Component Analysis (ICA) allows the dissection of omic datasets into modules that help to interpret global molecular signatures. The inherent randomness of this algorithm can be overcome by clustering many iterations of ICA together to obtain robust components. Existing algorithms for robust ICA are dependent on the choice of clustering method and on computing a potentially biased and large Pearson distance matrix.

Results

We presentrobustica, a Python-based package to compute robust independent components with a fully customizable clustering algorithm and distance metric. Here, we exploited its customizability to revisit and optimize robust ICA systematically. Of the 6 popular clustering algorithms considered,DBSCANperformed the best at clustering independent components across ICA iterations. To enable using Euclidean distances, we created a subroutine that infers and corrects the components’ signs across ICA iterations. Our subroutine increased the resolution, robustness, and computational efficiency of the algorithm. Finally, we show the applicability ofrobusticaby dissecting over 500 tumor samples from low-grade glioma (LGG) patients, where we define two new gene expression modules with key modulators of tumor progression uponIDH1andTP53mutagenesis.

Conclusion

robusticabrings precise, efficient, and customizable robust ICA into the Python toolbox. Through its customizability, we explored how different clustering algorithms and distance metrics can further optimize robust ICA. Then, we showcased howrobusticacan be used to discover gene modules associated with combinations of features of biological interest. Taken together, given the broad applicability of ICA for omic data analysis, we envisionrobusticawill facilitate the seamless computation and integration of robust independent components in large pipelines.
Two-handed facemask technique effectively causes hyperventilation in electroconvulsive therapy: an observational study
Authors: Shimamoto Yoko , Sanuki Michiyoshi , Kurita Shigeaki , Ueki Masaya , Kuwahara Yoshie
Published: December 2022

Background

Electroconvulsive therapy (ECT) remains the mainstay treatment option for patients with psychiatric diseases, such as severe depression. Although various anesthetic techniques provide adequate therapeutic seizures, hyperventilation is a useful adjunct to augment seizure duration and improve seizure quality. We investigated how to efficiently use a facemask to accomplish protocolized hyperventilation and evaluate its effect on ECT seizure.

Methods

We studied 60 patients aged ≥18 years who underwent ECT. The patients were divided into two groups according to the technique of facemask ventilation used: the one-handed (n = 30) and two-handed (n = 30) groups. Following anesthesia induction under preoxygenation conditions, hyperventilation induced hypocapnia in the one-handed facemask group with manual bag ventilation was compared to that in the two-handed facemask group with assisted pressure-controlled ventilation. Ictal and peri-ictal electroencephalogram parameters and cardiovascular responses were monitored and compared between the one-handed and two-handed groups.

Results

The two-handed technique demonstrated better electroencephalogram regularity and minimized cardiovascular stress compared to the one-handed technique. These conclusions come from the fact that the one-handed technique induced a substantial volume of leaks around the facemask (201.7 ± 98.6 mL/breath), whereas minimal leaks (25.8 ± 44.6 mL/breath) with stabler and higher ventilation rate led to greater inhaled minute ventilation in the two-handed group (the one-handed group, 9.52 ± 3.94 L/min; the two-handed group, 11.95 ± 2.29 L/min; p <  0.005). At the end of ECT treatment, all parameters of blood pressure and heart rate increased significantly in both groups equally, with lower SpO2 and more ST-segment depression on the electrocardiogram in the one-handed group. Comparing baseline values before anesthesia, ECT treatment significantly depressed ST-segment in both groups, while the degree of depression in ST-segment increased significantly in the one-handed group compared to that in the two-handed group.

Conclusions

End-tidal carbon dioxide monitoring for hyperventilation can reliably ensure hypocapnia only in the two-handed group. In ECT, the two-handed technique assisted by pressure-controlled ventilation is an effective and practical method for hyperventilation to induce adequate therapeutic seizures. While, the two-handed group with sufficient preoxygenation did not cause more cardiovascular stress than the one-handed group.

Trial registration

UMIN Clinical Trials Registry 000046544, Date of registration 05/01/2022.
Measuring frailty and its association with key outcomes in the ambulance setting: a cross sectional observational study
Authors: Charlton Karl , Sinclair David R , Hanratty Barbara , Burrow Emma , Stow Daniel
Published: December 2022

Background

Little is known about frailty in the ambulance setting, or its association with outcomes relevant to ambulance services. We sought to measure frailty in people aged ≥ 50 attended by an ambulance, and describe the relationship between frailty, odds of conveyance to hospital, and duration at scene.

Methods

An observational study between 01/01/2021-30/06/2021 in North East Ambulance Service, England. Participants were aged ≥ 50 attended by an ambulance, excluding patients requiring immediate treatment for a life-threatening condition or with Glasgow Coma Scale < 15. Paramedics (n = 112) measured patient frailty using the Clinical Frailty Scale (CFS). Additional information was extracted from ambulance care records. Weighted regression models examined associations between frailty, hospital conveyance, and duration at scene.

Results

Three thousand and fifty-six callouts were observed (mean patient age: 78.1 years, 57.2% female). Frailty prevalence (CFS ≥ 5) was 58.7%. Median duration at scene was 47.0 min (interquartile range 34.0–67.0 min). Ambulances spent a median of 8.2 (95%CI:5.4–11.0) minutes longer with frail patients than non-frail patients. Frail patients were less likely to be conveyed to hospital than non-frail patients (OR:0.75, 95%CI:0.60–0.94).

Conclusion

Frailty is common among people aged ≥ 50 attended by an ambulance and an important influence on workload. Ambulance services need a good understanding of frailty to meet patient needs. As populations age, community support should be prioritised to deliver appropriate frailty care and reduce demands on ambulance services.
Comparison of prenatal ultrasound with MRI in the evaluation and prediction of fetal orofacial clefts
Authors: Gai Shuangshuang , Wang Lixiu , Zheng Weizeng
Published: December 2022

Background

Orofacial clefts (OFCs) are common craniofacial abnormalities. This study aimed to compare the diagnostic and predictive values of prenatal ultrasonography (US) and magnetic resonance imaging (MRI).

Methods

We reviewed the newborn physical examinations or fetal autopsy data with OFCs. Between January 2013 and December 2018, the diagnoses resulting from prenatal US and MRI examination were compared retrospectively with the postpartum diagnoses. The diagnostic prediction of prenatal imaging was then determined.

Results

334 infants were identified with OFCs by either newborn physical exam or stillborn autopsy. For detection of OFCs by US, the total accuracy (ACC), true positive rate (TPR), true negative rate (TNR), positive predictive value (PPV), and negative predictive value (NPV) were 99.9% (111,178/110,286), 81.9% (230/281), 99.9% (109,948/110,005), 80.1% (230/287), and 99.9% (109,948/109,999), respectively. For MRI, the ACC, TPR, TNR, PPV, and NPV were 99.8% (4,125/4,132), 89.8% (44/49), 99.9% (4,081/4,083), 95.7% (44/46), and 99.9% (4,081/4,086), respectively. When we compared the predictive values between prenatal US and MRI, there were significant differences in the PPV of OFCs (P < 0.05), NPV of OFCs (P < 0.05), TPR of CLO (P < 0.001), PPV of CLP (P < 0.05), and TPR of CPO (P < 0.05).

Conclusion

Our results suggest that prenatal US could be effective for diagnosing and ruling out fetal OFCs. Diagnostic confidence is significantly improved when fetal MRI is used to assess fetal OFCs as an adjunct to US examination.
A new modified obstetric early warning score for prognostication of severe maternal morbidity
Authors: Xu Yonghui , Zhu Sha , Song Hao , Lian Xiaoyuan , Zeng Maoni , He Ji , Shu Lijuan , Xue XingSheng , Xiao Fei
Published: December 2022

Background

Maternal mortality is still a major challenge for health systems, while severe maternal complications are the primary causes of maternal death. Our study aimed to determine whether severe maternal morbidity is effectively predicted by a newly proposed Modified Obstetric Early Warning Score (MOEWS) in the setting of an obstetric intensive care unit (ICU).

Methods

A retrospective study of pregnant women admitted in the ICU from August 2019 to August 2020 was conducted. MOEWS was calculated 24 h before and 24 h after admission in the ICU, and the highest score was taken as the final value. For women directly admitted from the emergency department, the worst value before admission was collected. The aggregate performance of MOEWS in predicting critical illness in pregnant women was evaluated and finally compared with that of the Acute Physiology and Chronic Health Evaluation II (APACHE II) score.

Results

A total of 352 pregnant women were enrolled; 290 women (82.4%) with severe maternal morbidity were identified and two of them died (0.6%). The MOEWSs of women with serious obstetric complications were significantly higher than those of women without serious obstetric complications [8(6, 10) vs. 4(2, 4.25), z = -10.347, P < 0.001]. MOEWSs of 24 h after ICU admission had higher sensitivity, specificity and AUROC than MOEWSs of 24 h before ICU admission. When combining the two MOEWSs, sensitivity of MOEWS was 99.3% (95% CI: 98–100), specificity 75.8% (95% CI: 63–86), positive predictive value (PPV) 95.1% (95% CI: 92–97) and negative predictive value (NPV) 95.9% (95% CI: 86–100). The areas under the receiver operator characteristic (ROC) curves of MOEWS were 0.92 (95% CI: 0.88–0.96) and 0.70 (95% CI: 0.63–0.76) of the APACHE II score.

Conclusion

The newly proposed MOEWS has an excellent ability to identify critically ill women early and is more effective than APACHE II. It will be a valuable tool for discriminating severe maternal morbidity and ultimately improve maternal health.
Exploring uncertainty and use of real-world data in the National Institute for Health and Care Excellence single technology appraisals of targeted cancer therapy
Authors: Kang Jiyeon , Cairns John
Published: December 2022

Objectives

Dealing with uncertainty is one of the critical topics in health technology assessment. The greater decision uncertainty in appraisals, the less clear the clinical- and cost-effectiveness of the health technology. Although the development of targeted cancer therapies (TCTs) has improved patient health care, additional complexity has been introduced in drug appraisals due to targeting more specific populations. Real-world data (RWD) are expected to provide helpful information to fill the evidence gaps in appraisals. This study compared appraisals of TCTs with those of non-targeted cancer therapies (non-TCTs) regarding sources of uncertainty and reviewed how RWD have been used to supplement the information in these appraisals.

Methods

This study reviews single technology appraisals (STAs) of oncology medicines performed by the National Institute for Health and Care Excellence (NICE) over 11 years up to December 2021. Three key sources of uncertainty were identified for comparison (generalisability of clinical trials, availability of direct treatment comparison, maturity of survival data in clinical trials). To measure the intensity of use of RWD in appraisals, three components were identified (overall survival, volume of treatment, and choice of comparators).

Results

TCTs received more recommendations for provision through the Cancer Drugs Fund (27.7, 23.6% for non-TCT), whereas similar proportions were recommended for routine commissioning. With respect to sources of uncertainty, the external validity of clinical trials was greater in TCT appraisals (p = 0.026), whereas mature survival data were available in fewer TCT appraisals (p = 0.027). Both groups showed similar patterns of use of RWD. There was no clear evidence that RWD have been used more intensively in appraisals of TCT.

Conclusions

Some differences in uncertainty were found between TCT and non-TCT appraisals. The appraisal of TCT is generally challenging, but these challenges are neither new nor distinctive. The same sources of uncertainty were often found in the non-TCT appraisals. The uncertainty when appraising TCT stems from insufficient data rather than the characteristics of the drugs. Although RWD might be expected to play a more active role in appraisals of TCT, the use of RWD has generally been limited.
Long-term complications of cosmetic iris implants
Authors: Queiruga-Piñeiro Juan , Parra-Rodriguez Tomas , Rodriguez-Una Ignacio
Published: December 2022

Background

Additive cosmetic implants (NewColorIris, Kahn Medical Devices, Panama City, Panama) are placed in the anterior chamber, in order to externally change iris color. There is a lack of robust clinical long-term prospective studies regarding the safety of these devices, as they have been related to the early-onset presentation of corneal decompensation, elevated intraocular pressure (IOP), uveitis and hyphema. However, in this case report some mild complications started to manifest unexpectedly late: 15 years after an uneventful procedure.

Case presentation

A 41-year-old Caucasian woman presented with blurred vision in both eyes over the last 6 months. Fifteen years earlier, she had undergone bilateral implantation of additive iris implants for aesthetic purposes, without any complication or ocular trauma during the follow-up. Ocular examination showed bilateral mild corneal edema, iris atrophy, and presence of pigment in the endothelium. Increased IOP (28 mmHg) was identified in the right eye. Anterior segment optical coherence tomography (AS-OCT) confirmed the decentration of the iris implant from the pupillary axis in that eye. Gonioscopy demonstrated pigment dispersion in both eyes, as well as a tendency to bilateral angle closure, that was also illustrated by AS-OCT analysis. Endothelial cell count was 1268 cells/mm2 in the right eye and 1122 cells/mm2 in the left eye.

The presence of both implants was affecting corneal endothelium and anterior chamber angle in both eyes, and additionally, the decentration of the device in the case of the right eye led to secondary ocular hypertension in that eye.

Conclusions

Cosmetic implants in contact to the iris can remain quiescent for years, leading to possible complications that can present even in the long-term. The degree of implant decentration, the stage of angle closure disease and the magnitude of pigment dispersion may be some important factors related to the onset time of complications in these cases.
Effects of the DAGIS randomized controlled trial on home environment and children’s food consumption according to the degree of implementation
Authors: Lehto Reetta , Vepsäläinen Henna , Lehtimäki Aku-Ville , Lehto Elviira , Leppänen Marja H. , Skaffari Essi , Abdollahi Anna M. , Roos Eva , Erkkola Maijaliisa , Ray Carola
Published: December 2022

Background

Combining process evaluation data with effectiveness data and examining the possible mediators of intervention effects elicits valuable knowledge about how and for whom these interventions are effective. The aim of this study was to examine whether the parental degree of implementation (DOI) of a home-involving preschool intervention affected children’s food consumption via home mediators.

Methods

The five-month Increased Health and Wellbeing in Preschools (DAGIS) intervention involved 476 participating children aged 3–6 years and was conducted in 2017–2018. Parents reported children’s food consumption (g/day) outside childcare hours, the availability of foods at home, role modelling of food consumption, and the norms related to food consumption. In addition, parents reported the extent to which they had implemented the intervention program at home. Mediation analyses were conducted to examine the effect of low and high DOI compared to control group on the change in children’s consumption of fruit and vegetables (FV), sugary everyday foods, sugary treats, and sugar-sweetened beverages (SSB) via food availability in the home, parental role modelling and parental norms.

Results

Compared to the control group, there was a direct effect of a high DOI on diminishing consumption of SSB (B -27.71, 95% CI -49.05, -4.80). No indirect effects were detected. In the high DOI group, a change in parental norm was associated with increased FV consumption showing an indirect effect (B 4.31, 95% CI 0.23, 10.59). In the low DOI group, there was an indirect effect via decreased food availability leading to decreased sugary everyday food consumption (B -2.17, 95% CI -5.09,  -0.09).

Conclusions

Combining process evaluation and effectiveness data revealed a decrease in children’s SSB consumption only in the high DOI group, as well as indirect effects on children’s consumption of FV and sugary everyday foods. In order to gain more intervention effects, further studies are required in order to examine parental facilitators and barriers to the implementation of interventions and how to impact effectively the determinants of the targeted behavior.

Trial registration

ISRCTN57165350 (8 January, 2015).
Restoration of hip geometry after total hip arthroplasty: retrospective comparison of two short stems and one straight stem
Authors: Maurer-Ertl Werner , Friesenbichler Joerg , Pfann Michael , Maier Michael , Reinbacher Patrick , Leithner Andreas , Smolle Maria A.
Published: December 2022

Background

The preservation or restoration of hip geometry following total hip arthroplasty (THA) is of importance, considering that alterations in the centrum-collum-diaphysis (CCD)-angle, femoral offset (FO), acetabular offset (AO) and total offset (TO) change hip biomechanics. Therefore, the most suitable implant should be used. The aim of this study was to compare the ability of two short-stem-systems and one straight-stem-system to reconstruct hip geometry.

Methods

Two-hundred-fifty-one patients (mean age: 62.0 ± 10.0 years; 51.8% males) undergoing THA with three different stem types were retrospectively included, after excluding 11 patients with missing radiological follow-up. Pre- and postoperative radiographic images (group I, ANA.NOVA Alpha Schaft Proxy®, ImplanTec, 12 options: n = 99; group II, Optimys® Mathys, 24 options: n = 62; group III: Corail®-System, DePuy-Synthes, 76 options: n = 90) were analyzed. Differences in pre- and postoperative hip geometry (i.e. CCD, FO, AO, TO) were compared between groups with one-way-analysis-of-variance (ANOVA), and post-hoc t-tests.

Results

The CCD-angle increased by a mean of 8.4° ± 7.2° from pre-to postoperative, with no significant difference between groups (p = 0.097). Significantly larger increases in FO were observed for groups II (4.1 mm ± 7.8 mm) and III (4.9 ± 7.2 mm), in comparison to group I (1.6 ± 6.9 mm; p = 0.006). AO decreased by a mean of 2.2 ± 4.5 mm, with the largest decrease observed in group III (-3.3 ± 5.3 mm), and the smallest for group I (-1.4 ± 3.6 mm; p = 0.011). There was no significant difference in change of TO between groups (p = 0.177).

Conclusions

Reconstruction of hip geometry using a single-version novel short-stem-system is achievable with comparable results to stem-systems offering multiple options.
Mid-term results of giant cell tumours with pathologic fractures around the knee: a multicentre retrospective study
Authors: Zhao Liming , Chen Jiapei , Hu Yongcheng , Ye Zhaoming , Tao Kun
Published: December 2022

Objective

The aims of this work are to present a classification of “complex fracture” and “simple fracture”, to compare their features, treatments and prognosis in patients with giant cell tumour with pathologic fractures around the knee, and to determine the best surgical method for patients who have giant cell tumour around the knee with different degrees of fracture.

Methods

Data from 130 patients with pathologic fractures from giant cell tumour around the knee who underwent surgical treatment from March 2000 to November 2015 at 6 institutes around China were collected and analysed. A multicentric study design was used to explore the epidemiological features and to compare differences in the surgical procedures and prognosis of the two fracture groups. The mean age at diagnosis was 37.1 years old (range, 13-77 years). The median follow-up was 126.5 months, ranging from 68 to 370 months.

Results

The general clinical and imaging features of the groups of patients with simple and complex fractures, namely, sex, age, the lesion site, living or working environment, eccentric growth patterns, Campanacci grading system, and duration of symptoms before treatment, showed varying degrees of differences, but with no statistical significance (p > 0.05). The incidence rate of surrounding soft tissue mass was 35.2% (32/91) in the group with simple fractures, whereas it was 87.2% (34/39) in the group with complex fractures, which showed a significant difference (p < 0.05). Wide resection and reconstruction with joint replacement were performed more often in patients with complex fractures (61.5%, 24/39). Intralesional procedures were performed more often in patients with simple fractures (56.0%, 51/91). The difference showed significant differences (p < 0.05). The local recurrence rate was 17.6% (16/91) in the group with simple fractures, whereas it was 10.3% (4/39) in the complex fracture group, showing a significant difference (p < 0.05). A total of 2.3% of patients (n = 3,3/130) developed a skip lesion. The complication rates were 4.6% (4/87) and 14.7% (5/34), respectively, in the two groups with simple or complex fractures, showing a significant difference (p < 0.05). The mean MSTS and TESS scores with simple fractures were 26.6 (range, 13–30) and 84.1 (range, 29-100), respectively, whereas the mean scores in the group with complex fractures were 25.5 (range, 18–30) and 78.3 (range, 30-100), respectively, also showing a significant difference (p < 0.05).

Conclusion

Our classification of “simple fracture” and “complex fracture” could guide decisions regarding the best surgical method for lesions in patients who have giant cell tumour around the knee with different degrees of fracture.
Arthroscopic Rotator Cuff Repair In Patients With Parkinson’s Disease: A Propensity Score Matching Study With Minimum 2-Year Follow-up
Authors: Qian Yufan , Wu Kailun , Zhou Feng , Li Li , Guo Jiong Jiong
Published: December 2022

Background

Although the effectiveness of arthroscopic rotator cuff repair (ARCR) for structural and functional outcomes has been widespread proven, few researchers investigated the impact of ARCR on patients with Parkinson’s Disease (PD), which may have previously been viewed as a relative contraindication to ARCR.

Methods

Data were collected retrospectively for all patients who underwent ARCR for small- to large-sized rotator cuff tears between September 2014 and May 2019. Patients were eligible for the study if they indicated that they diagnosed with rotator cuff repair and had minimum 2-year postoperative outcome scores for the range of motion (ROM), the Western Ontario Rotator Cuff Index (WORC), the Constant-Murley Score (CMS), the University of California, Los Angeles (UCLA), Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale (HADS), and the visual analog scale (VAS) for pain. Propensity score matching (PSM), a statistical method, was used to screen a control group without PD matched 1:1 with similar age, sex, tear size, preoperative stiffness, and fatty infiltration, which have previously been identified as important factors influencing success rates.

Results

Three hundred and eighty-nine patients met all study criteria including required follow-up, of whom 31 and 358 with PD and without PD, respectively. After adjusting for confounders, the propensity score matched indicators were compared, patients with PD experienced significantly more pain (4.45 ± 2.43 vs. 0.52 ± 1.18; P<.001) and had lower WORC (49.10 ± 21.22 vs. 78.90 ± 17.54; P<.001), CMS (46.77 ± 22.24 vs. 79.45 ± 14.74; P<.001) and UCLA (21.11 ± 8.54 vs. 28.16 ± 6.16; P<.001) scores respectively than the matched control group. They also exhibited higher sleep disturbance (10.04 ± 5.36 vs. 5.19 ± 3.28; P<.001), as well as higher anxiety and depression psychological status at 24 months (P<.001; P<.001). Overall clinical outcomes from preoperatively to postoperatively were not improved significantly for patients with PD vs. without PD.

Conclusion

Patients with PD experienced significantly more pain, resulted in worse shoulder functional outcomes, and reported persistently diminished mental and physical health status. Shoulder surgeons should be cognizant of PD as an outcome-modifying variable when treating patients with rotator cuff tears. This finding suggested that the need for ARCR in patients with PD should be carefully considered in the light of personalized needs and physical conditions.
Spatiotemporal distribution and determinants of overweight or obesity among urban women in Ethiopia: a multivariate decomposition analysis
Authors: Azanaw Melkalem Mamuye , Zewde Edgeit Abebe , Gebremariam Alemayehu Digssie , Dagnaw Fentaw Teshome , Asnakew Dessalegn Tesfa , Chanie Ermias Sisay , Feleke Dejen Getaneh , Tiruneh Sofonyas Abebaw
Published: December 2022

Background

Overweight /obesity is a global public health concern. It is higher among women than men in most continents of the world. This study aimed to determine the spatiotemporal distribution and determinants of changes in overweight/obesity over time among urban women in Ethiopia.

Methods

We used data from three consecutive Demographic and Health Surveys in Ethiopia (2005, 2011, and 2016). The total weighted sample of 1112 in 2005, 3569 in 2011, and 3071 in 2016 urban women were included in the analysis. The primary outcome measure of this study was the spatiotemporal distribution and trends over time in overweight/obesity. Factors contributing to change in overweight/obesity were examined using a logit-based multivariate decomposition analysis.

Results

Overweight/obesity increased from 14.2% in 2005 to 21% in 2016. Approximately 61.3% of the overall increase in overweight/obesity among urban women was due to the difference in coefficient (difference in the effect of characteristics) across the surveys. Changes in the composition of women aged 25–49 years (β = 0.012, 95% CI 0.008, 0.015), married women (β = 0.010, 95% CI 0.006, 0.014), women with formal education (primary: β = 0.007, 95% CI 0.003, 0.011, higher education: β = 0.014, 95% CI 0.006, 0.022), women with formal employment (β = 0.006, 95% CI 0.001, 0.011), and women with informal employment (β = − 0.002, 95% CI − 0.003, − 0.0004) were factors contributing to the change in overweight/obesity from 2005 to 2016. The risk difference (RD) in women’s overweight/obesity significantly varied across regions in urban Ethiopia. Furthermore, a high proportion of overweight/obesity was found mainly in Tigray, Oromia, Amhara, and Addis Ababa.

Conclusions

The rate of overweight/obesity among women in urban Ethiopia has shown a significant increase over the last 11 years. This rate change was due to changes in the composition of women’s age, educational status, marital status, and employment status. Therefore, program interventions should be targeted at older (> 25 years), educated, married, Addis Ababa residents, and formally employed women.
Effect of national curriculum reform on medical students’ preparedness for practice: a prospective cohort study from undergraduate to postgraduate periods
Authors: Chaou Chung-Hsien , Yu Shiuan-Ruey , Ma Shou-De , Tseng Hsu-Min , Ou Liang-Shiou , Huang Chien-Da , Fang Ji-Tseng
Published: December 2022

Background

In recent years, a national curriculum reform was implemented in undergraduate medical education in Taiwan to reduce clinical rotation training from 3 years to 2 years. The last generation of the old curriculum and the first generation of the new curriculum both graduated in 2019. This study aimed to compare the learning outcomes of the medical students in these two curriculum groups in terms of preparedness for practice during the transition from undergraduate to postgraduate study.

Methods

This was a 3-year prospective, longitudinal, comparative cohort study between 2017 and 2020. Medical students from both the 7-year and 6-year curriculum groups received biannual questionnaire surveys starting 18 months before graduation and running until 11 months after graduation. The measurement tools were the Preparedness for Hospital Practice Questionnaire (PHPQ) and Copenhagen Burnout Inventory (CBI). Personal demographic information was also collected. Linear mixed models were used to determine the effect of curriculum change on learners’ preparedness and burnout levels.

Results

A total of 130 medical students from the two cohorts provided 563 measurements during the study period. Compared to their counterparts following the old curriculum, the participants following the new curriculum showed a lower level of preparedness when first entering clinical rotation (p = 0.027) and just after graduating (p = 0.049), especially in the domains of clinical confidence (p = 0.021) and patient management p = 0.015). The multivariate linear mixed model revealed gradual increases in preparedness and burnout in serial measurements in both curriculum groups. Students following the new curriculum, which involved a shortened clinical rotation, showed a slightly lower overall preparedness (p = 0.035) and the same level of burnout (p = 0.692) after adjustment. The factor of year of change did not show a significant effect on either preparedness (p = 0.258) or burnout (p = 0.457).

Conclusion

Shortened clinical rotation training for medical undergraduates is associated with a decrease in preparedness for practice during the transition from undergraduate to postgraduate study. Clinical confidence and patient management are the main domains affected.
Videos of demonstration versus text and image-based material for pre-skill conceptualisation in flipped newborn resuscitation training for medical students: a pilot study
Authors: Yoosoof Farah , Liyanage Indika , de Silva Ranjith , Samaraweera Savindra
Published: December 2022

Background

The flipped skills lab is a student-centred approach which incorporates pre-class preparation (pre-skill conceptualization) followed by repeated, hands-on practice for practical skills training. Objective measures of skills acquisition in the flipped literature are few and conflicting. The importance of pre-skill conceptualization in flipped skills training suggests that pedagogically informed pre-skill conceptualization can enhance outcomes.

Methods

A mixed quasi-experimental study was conducted on 41 final year medical students who followed a flipped newborn resuscitation skills lab. Pre-class preparatory material covered conceptual and procedural knowledge. Students in the traditional group (n = 19) and those in the interventionalmental group (n = 22) received identical reading material covering conceptual knowledge. Procedural knowledge was shared with the interventional group as demonstration videos, while the traditional group received a PowerPoint presentation with text and images covering the same material. Knowledge acquisition was assessed by 20 single best answer questions before and after hands-on practice in the skills lab and skill performance was tested post-intervention with a simulated scenario. Students’ perceptions were collected by survey. Quantitative data was analysed using Wilcoxon Signed Ranks test and Mann–Whitney U test as appropriate. Qualitative data was analysed by thematic analysis.

Results

Overall student rating of the intervention was positive with ratings of 4.54 and 4.46 out of 5 by the traditional group and the experimental group respectively. Post-intervention skill performance in the experimental group was significantly better (p < .05) in the interventional group (M = 87.86%, SD = 5.89) than in the traditional group (M = 83.44, SD = 5.30) with a medium effect size (r = .40). While both groups showed significant knowledge gains, only students in the experimental group showed a statistically significant gain in procedural knowledge (p < .05) following the flipped skills lab. Finally, while both groups self-reported feeling more knowledgeable and confident following the intervention, the level of confidence was superior in the experimental group.

Conclusions

Flipping the skills lab with pre-skill conceptualisation combining text-based conceptual knowledge and video-based procedural knowledge followed by simulation-based hands-on practice improves procedural knowledge and skills acquisition in newborn resuscitation training for medical students. This study shows that in addition to temporal benefits, pedagogically informed pre-skill conceptualization can confer procedure-specific cognitive and emotional benefits supporting skills acquisition.