bluuebunny/crossref_metadata_2025 huggingface dataset:
Deciphering Anion‐Modulated Solvation Structure for Calcium Intercalation into Graphite for Ca‐Ion Batteries
Authors: Yi Yuyang , Xing Youdong , Wang Hui , Zeng Zhihan , Sun Zhongti , Li Renjie , Lin Huijun , Ma Yiyuan , Pu Xiangjun , Li Molly Meng‐Jung , Park Kyu‐Young , Xu Zheng‐Long
Published: April 2024

Co‐intercalation reactions make graphite a feasible anode in Ca ion batteries, yet the correlation between Ca ion intercalation behaviors and electrolyte structure remains unclear. This study, for the first time, elucidates the pivotal role of anions in modulating the Ca ion solvation structures and their subsequent intercalation into graphite. Specifically, the electrostatic interactions between Ca ion and anions govern the configurations of solvated‐Ca‐ion in dimethylacetamide‐based electrolytes and graphite intercalation compounds. Among the anions considered (BH4−, ClO4−, TFSI− and [B(hfip)4]−), the coordination of four solvent molecules per Ca ion (CN=4) leads to the highest reversible capacities and the fastest reaction kinetics in graphite. Our study illuminates the origins of the distinct Ca ion intercalation behaviors across various anion‐modulated electrolytes, employing a blend of experimental and theoretical approaches. Importantly, the practical viability of graphite anodes in Ca‐ion full cells is confirmed, showing significant promise for advanced energy storage systems.
DOTA‐Based Plectin‐1 Targeted Contrast Agent Enables Detection of Pancreatic Cancer in Human Tissue
Authors: Gazzi Thais , Lesina Marina , Wang Qinghua , Berninger Alexandra , Radetzki Silke , Demir Ihsan Ekin , Kohlmann Larissa , Meiser Waldemar , Wilke Sebastian , von Kries Jens Peter , Algül Hana , Hu Hai‐Yu , Nazare Marc
Published: April 2024

Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive and lethal malignancy with extremely poor patient survival rates. A key reason for the poor prognosis is the lack of effective diagnostic tools to detect the disease at curable, premetastatic stages. Tumor surgical resection is PDAC's first‐line treatment, however distinguishing between cancerous and healthy tissue with current imaging tools remains a challenge. In this work, we report a DOTA‐based fluorescent probe targeting plectin‐1 for imaging PDAC with high specificity. To enable heterogeneous functionalization of the DOTA‐core with multiple targeting peptide units and the fluorophore, a novel, fully clickable synthetic route that proceeds in one pot was developed. Extensive validation of the probe set the stage for PDAC detection in mice and human tissue. Altogether, these findings may pave the way for improved clinical understanding and early detection of PDAC progression as well as more accurate resection criteria.
Cytotoxicity and Biological Activities of Geopopolis Extract from the Stingless bee (Melipona scutellaris) in Isolates of Staphylococcus aureus
Authors: Albuquerque Borges Maria Gabriella da Silva , de Oliveira e Lima Luanna , Veras Ana Caroline Meneses Ferreira , Ferreira Rafael Carlos , da Nóbrega Alves Danielle , de Medeiros Isac Almeida , Magnani Marciane , Sobral Marianna Vieira , Dias de Castro Ricardo , Relison Tintino Saulo , de Morais Oliveira‐Tintino Cícera Datiane , Coutinho Henrique Douglas Melo , Guerra Felipe Queiroga Sarmento , de Barros Daniela Bomfim , de Oliveira Maria Betânia Melo
Published: April 2024

Geopropolis resins are produced by stingless bees (Meliponinae), developed from the collection of resinous materials, waxes and exudates, from the flora of the region where stingless bees are present, in addition to the addition of clay or earth in its composition. Several biological activities are attributed to Ethanol Extracts of Geopropolis (EEGP). The bioactive properties are associated with the complex chemical composition that the samples have. This work aims to evaluate the biological activities of the EEGP, in order to contribute with a natural therapeutic alternative, to face infections, mainly those caused by resistant strains of Staphylococcus aureus. The EEGP MIC tests showed antibacterial activity against two strains of S. aureus, both at concentrations of 550 μg/mL. The MBC performed with the inhibition values showed that the EEGP has bacteriostatic activity in both strains. Biofilm inhibition rates exhibited an average value greater than 65 % at the highest concentration. The EEGP antioxidant potential test showed good antioxidant activity (IC50) of 11.05±1.55 μg/mL. In the cytotoxicity test against HaCat cells, after 24 hours, EEGP induced cell viability at the three tested concentrations (550 μg/mL: 81.68±3.79 %; 1100 μg/mL: 67.10±3.76 %; 2200 μg/mL: 67.40±1.86 %). In view of the above, the safe use of EEGP from the brazilian northeast could be proven by the cytotoxicity test, and its use as an antioxidant and antibacterial agent has proven to be effective, as an alternative in combating oxidative stress and microorganisms such as S. aureus, which, through the spread and ongoing evolution of drug resistance, generates an active search for effective solutions.
Concurrent myocardial infarction in the setting of thrombotic thrombocytopenic purpura secondary to systemic lupus erythematosus: A case report
Authors: Azadbakht Saleh , Amidi Bardia , Naderi Narges , Sharifaskari Anwar , Hatami Mahtab
Published: April 2024

Key Clinical Message

In acute thrombotic thrombocytopenic purpura (TTP), apart from urgent treatment, assessing the patient's medical history, especially conditions like systemic lupus erythematosus that could trigger TTP, is crucial. Rarely, TTP patients may experience cardiac conditions as severe as a myocardial infarction.

A 45‐year‐old woman manifested severe and acute thrombotic thrombocytopenic purpura (TTP) of unknown origin. The patient's symptoms, the laboratory data, the detection of the reduction in ADAMTS13 activity, and the presence of schistocytes on the peripheral smear confirmed the diagnosis. The patient was then planned for therapeutic plasma exchange (TPE). Prior to the scheduled TPE, she suddenly experienced extreme shortness of breath and chest pain. An electrocardiogram was obtained immediately after reporting signs of an inferior myocardial infarction. Further examinations to acquire information about the patient's underlying medical conditions in order to study the secondary causes of TTP, combined with the results of the laboratory tests, resulted in the patient being diagnosed with systemic lupus erythematosus.
Leukocytoclastic vasculitis in a patient with ankylosing spondylitis: A case report
Authors: Khabbazi Alireza , Tekantapeh Sepideh Tahsini , Asadzadeh Cyrus , Vahedi Amir
Published: April 2024

Key Clinical Message

Although the concurrent occurrence of vasculitis with AS is uncommon, when patients diagnosed with AS exhibit symptoms including skin petechiae, purpura, abdominal discomfort, malaise, elevated ESR, and reduced complement levels, vigilant monitoring for vasculitis is advisable following the exclusion of secondary vasculitis triggers such as malignancies, infections, and pharmaceutical agents.

The primary characteristic of ankylosing spondylitis (AS) involves inflammation occurring within the sacroiliac joint and the spine, leading to destruction and eventual ankylosis. A notably infrequent complication associated with AS is vasculitis, with limited reports linking AS to vasculitis. This case study documents a 48‐year‐old male, diagnosed with HLA‐B27‐positive AS for the past 15 years, who developed abdominal pain and skin lesions following the cessation of his medication on his own. Subsequent clinical evaluations identified leukocytoclastic vasculitis (LCV) related to AS after excluding all other potential causes of LCV, including drug‐related sources, cancer, hepatitis B and C viruses, Henoch‐Schönlein purpura (HSP), and IgA nephropathy.
Practical operating flexibility of a bifunctional freestanding membrane for efficient anion exchange membrane water electrolysis across all current ranges
Authors: Son Hong‐Jin , Hwang Jeemin , Choi Min Young , Park Seung Hee , Jang Jae Hyuk , Han Byungchan , Ahn Sung Hoon
Published: April 2024

This study explores a symmetric configuration approach in anion exchange membrane (AEM) water electrolysis, focusing on overcoming adaptability challenges in dynamic conditions. Here, a rapid and mild synthesis technique for fabricating fibrous membrane‐type catalyst electrodes is developed. Our method leverages the contrasting oxidation states between the sulfur‐doped NiFe(OH)2 shell and the metallic Ni core, as revealed by electron energy loss spectroscopy. Theoretical evaluations confirm that the S–NiFe(OH)2 active sites optimize free energy for alkaline water electrolysis intermediates. This technique bypasses traditional energy‐intensive processes, achieving superior bifunctional activity beyond current benchmarks. The symmetric AEM water electrolyzer demonstrates a current density of 2 A cm−2 at 1.78 V at 60°C in 1 M KOH electrolyte and also sustains ampere‐scale water electrolysis below 2.0 V for 140 h even in ambient conditions. These results highlight the system's operational flexibility and structural stability, marking a significant advancement in AEM water electrolysis technology.
Throughput and coverage based Base Station–Relay Station deployment for 5G cellular network
Authors: Ratheesh R. , Nair M. Saranya , Vetrivelan P. , Rajeswari J.
Published: April 2024

Fifth generation cellular networks have high data rates and connectivity demands. The relaying approaches are widely used in cellular networks to improve coverage, user throughput, and capacity at low cost. The increasing data requirements of the mobile network increase energy consumption. Energy efficiency‐based approaches also impact network coverage and throughput. Therefore, developing an energy‐efficient network with optimal coverage and throughput is considered a challenging issue. It can be resolved with optimal deployment of Base Station (BS), Relay Station (RS), and minimizing power consumption. In this research, a joint clustering‐based deployment technique is proposed for BS–RS deployment by considering the network throughput and coverage ratio. After enabling optimal BS–RS deployment, the network traffic is estimated with an On‐demand real‐time traffic estimation framework (ODTE). It estimates user association values using Beacon frames. In addition, the Relay Assisted Base station Power Scheduling (RABPS) approach to minimize power consumption is included. Based on Erlang's probability, the RABPS algorithm is enhanced with sleep mode activation during off‐peak hours. The proposed 5G network ensures uninterrupted connectivity and energy efficiency with varying time slots of power scheduling. The throughput performance of the clustering‐based approach is increased with a coverage ratio of 88%. The simulation results show the superiority of the proposed 5G BS–RS deployment and power scheduling in terms of throughput, coverage ratio, and power consumption.
Synthetic Chemistry in Flow: From Photolysis & Homogeneous Photocatalysis to Heterogeneous Photocatalysis
Authors: Feng Sitong , Su Ren
Published: April 2024

Photocatalytic synthesis of value‐added chemicals has gained increasing attention in recent years owing to its versatility in driving many important reactions under ambient conditions. Selective hydrogenation, oxidation, coupling, and halogenation with a high conversion of the reactants have been realized using designed photocatalysts in batch reactors with small volumes at a laboratory scale; however, scaling‐up remains a critical challenge due to inefficient utilization of incident light and active sites of the photocatalysts, resulting in poor catalytic performance that hinders its practical applications. Flow systems are considered one of the solutions for practical applications of light‐driven reactions and have experienced great success in photolytic and homogeneous photocatalysis, yet their applications in heterogeneous photocatalysis are still under development. In this perspective, we have summarized recent progress in photolytic and photocatalytic synthetic chemistry performed in flow systems from the view of reactor design with a special focus on heterogeneous photocatalysis. The advantages and limitations of different flow systems, as well as some practical considerations of design strategies are discussed.
Roles and interactions of tumor microenvironment components in medulloblastoma with implications for novel therapeutics
Authors: Yang Hanjie , Li Min , Deng Yuhao , Wen Huantao , Luo Minjie , Zhang Wangming
Published: April 2024

Medulloblastomas, the most common malignant pediatric brain tumors, can be classified into the wingless, sonic hedgehog (SHH), group 3, and group 4 subgroups. Among them, the SHH subgroup with the TP53 mutation and group 3 generally present with the worst patient outcomes due to their high rates of recurrence and metastasis. A novel and effective treatment for refractory medulloblastomas is urgently needed. To date, the tumor microenvironment (TME) has been shown to influence tumor growth, recurrence, and metastasis through immunosuppression, angiogenesis, and chronic inflammation. Treatments targeting TME components have emerged as promising approaches to the treatment of solid tumors. In this review, we summarize progress in research on medulloblastoma microenvironment components and their interactions. We also discuss challenges and future research directions for TME‐targeting medulloblastoma therapy.
Engineered oncolytic bacteria for malignant solid tumor treatment
Authors: Wang Minjia , Song Xuejiao , Liu Xianglong , Ma Chuan , Ma Jing , Shi Leilei
Published: April 2024

Bacteria have been explored for their potential in fighting against cancer for decades. Due to their outstanding tumor‐targeting capacity and high biocompatibility, live bacteria can serve as microrobots delivering and producing anti‐tumor agents. In addition, live bacteria have intrinsic immune‐activating functions that aid in the generation of anti‐tumor immunity both systemically and locally in the tumor microenvironment. While bacteria‐based cancer therapy is still facing great challenges, progress in this platform combined with nanobiotechnologies has shown promise in terms of safety and effectiveness. Here, basic development strategies of bacteria‐based delivery systems armed with nanotechnologies, virulence attenuation, and genetic manipulation are summarized and the design of a spatiotemporal selectivity is particularly emphasized. In conclusion, the engineered bacteria platform has a high potentiality in the development of novel cancer therapeutics and holds prospects for future investigation and clinical use.
Transitioning Science to Practice
Authors: Harshbarger Stuart D. , Heckle Rosa R.
Published: April 2024

National security challenges require a new approach to collaborative problem solving to address emergent challenges or opportunities. To effectively address these challenges, development of artificial intelligence (AI) technologies including machine learning (ML) and deep learning (DL), is underway. Advancing AI/ML capabilities requires transdisciplinary research encompassing the fusion of technology and emergent scientific discovery. Achieving this requires a departure from traditional research and development (R&D) methods. New development processes need to support the understanding that research progresses iteratively technology insertion is incremental, and the final capability is evolutionary. We propose a novel systems engineering/research model called the vortical model. The vortical model introduces an iterative framework through which emerging advances in research outcomes are effectively demonstrated and validated for integration, as new capabilities, at varying technology insertion points. Our goal is to facilitate the transfer of knowledge from emerging research for swift, effective integration into the organization's mission capabilities.
A simple method for evaluating the relative water uptake rate of drip‐irrigated crops
Authors: Friedman Shmulik P.
Published: April 2024

Drip irrigation is widely acknowledged for its water use efficiency, yet evaluating relative water uptake rates (RWURs, ratios between the water uptake rates and the irrigation rates) remains pivotal for effective system design and management. This article presents a novel method employing straightforward measurements of wetted soil surfaces around emitters or perpendicular to driplines, both with and without water uptake, emphasizing simplicity and practicality. The proposed method offers valuable insights into agronomic water use efficiency, facilitating the optimization of drip irrigation for both annual and perennial crops. While effective for intensively irrigated crops, the method does have limitations for smaller wetted areas and longer irrigation cycles, depending also upon a reasonable determination of the active root zone depth and the soil capillary length. Despite relying on a simplified water uptake model, the accessibility and cost‐effectiveness of the method render it a valuable tool for assessing RWURs in diverse agricultural settings, contributing to the sustainable utilization of water resources in drip irrigation.
CircBCL2L13 attenuates cardiomyocyte oxidative stress and apoptosis in cardiac ischemia‒reperfusion injury via miR‐1246/PEG3 signaling
Authors: Wu Hua , Li Hairui , Zhang Qian , Song Jia , Chen Yongbin , Wang Ze‐Mu , Jiang Weipeng
Published: April 2024

Ischemia‒reperfusion (I/R) is a common complication in the clinical treatment of acute myocardial infarction (MI), in which cardiomyocytes play a pivotal role in the recovery of cardiac function after reperfusion injury. The expression of numerous circular ribonucleic acids (circRNAs) is disrupted in I/R‐induced cardiac damage, but the potential role of circRNAs in I/R damage has not been fully elucidated. The purpose of the present study was to clarify the biological action and molecular mechanism of circRNA 002166 (also termed circCL2L13) in postmyocardial I/R. Oxygen–glucose deprivation/reoxygenation (OGD/R) in an in vivo model was performed to simulate I/R damage. real‐time polymerase chain reaction analysis was also conducted to evaluate the relationships of the SOD1, SOD2, NRF2, HO1 and GPX4 indicators with oxidative stress injury. TUNEL immunofluorescence was used to evaluate the degree of cardiomyocyte apoptosis in the different treatment groups. The circBCL2L13 level was markedly upregulated in myocardial tissues from a mouse I/R model. Overexpression of circBCL2L13 markedly attenuated the expression of oxidative stress‐related genes and apoptosis in OGD/R‐induced cardiomyocytes. A mechanistic study revealed that circBCL2L13 functions as a ceRNA for miR‐1246 and modulates paternally expressed gene 3 (PEG3). Eventually, circBCL2L13 was proven to regulate PEG3 by targeting miR‐1246, thereby protecting against OGD/R‐induced cardiomyocyte oxidative damage and apoptosis. In conclusion, our study confirmed that the circBCL2L13/miR‐1246/PEG3 axis suppressed the progression of OGD/R injury in cardiomyocytes, which might lead to new therapeutic strategies for cardiac I/R injury.
Ultrasound‐based radiomics for the differential diagnosis of breast masses: A systematic review and meta‐analysis
Authors: Li Xuerong , Zhang Longfang , Ding Manni
Published: April 2024

Objectives

Ultrasound‐based radiomics has demonstrated excellent diagnostic performance in differentiating benign and malignant breast masses. Given a few clinical studies on their diagnostic role, we conducted a meta‐analysis of the potential effects of ultrasound‐based radiomics for the differential diagnosis of breast masses, aiming to provide evidence‐based medical basis for clinical research.

Materials and Methods

We searched Embase, Web of Science, Cochrane Library, and PubMed databases from inception through to February 2023. The methodological quality assessment of the included studies was performed according to Quality Assessment of Diagnostic Accuracy Studies checklist. A diagnostic test accuracy systematic review and meta‐analysis was performed in accordance with PRISMA guidelines. Sensitivity, specificity, and area under curve delineating benign and malignant lesions were recorded. We also used sensitivity analysis and subgroup analysis to explore potential sources of heterogeneity. Deeks' funnel plots was used to examine the publication bias.

Results

A total of 11 studies were included in this meta‐analysis. For the diagnosis of malignant breast masses worldwide, the overall mean rates of sensitivity and specificity of ultrasound‐based radiomics were 0.90 (95% confidence interval [CI], 0.83–0.95) and 0.89 (95% CI, 0.82–0.94), respectively. The summary diagnostic odds ratio was 76 (95% CI, 26–219), and the area under the curve for the summary receiver operating characteristic curve was 0.95 (95% CI, 0.93–0.97).

Conclusion

Ultrasound‐based radiomics has the potential to improve diagnostic accuracy to discriminate between benign and malignant breast masses, and could reduce unnecessary biopsies.
Ramsey numbers for multiple copies of sparse graphs
Authors: Sulser Aurelio , Trujić Miloš
Published: April 2024

For a graph and an integer , we let denote the disjoint union of copies of . In 1975, Burr, Erdős and Spencer initiated the study of Ramsey numbers for , one of few instances for which Ramsey numbers are now known precisely. They showed that there is a constant such that , provided is sufficiently large. Subsequently, Burr gave an implicit way of computing and noted that this long‐term behaviour occurs when is triply exponential in . Very recently, Bucić and Sudakov revived the problem and established an essentially tight bound on by showing follows this behaviour already when the number of copies is just a single exponential. We provide significantly stronger bounds on in case is a sparse graph, most notably of bounded maximum degree. These are relatable to the current state‐of‐the‐art bounds on and (in a way) tight. Our methods rely on a beautiful classic proof of Graham, Rödl and Ruciński, with an emphasis on developing an efficient absorbing method for bounded degree graphs.
Catheter salvage or removal in catheter‐related bloodstream infections with Staphylococcus aureus in children with chronic intestinal failure receiving home parenteral nutrition and the use of prophylactic taurolidine catheter lock solution: A descriptive cohort study
Authors: Demirok Aysenur , Illy David H. C. , Nagelkerke Sietse Q. , Lagerweij Michiel F. , Benninga Marc A. , Tabbers Merit M.
Published: April 2024

Background

Children with chronic IF require long‐term home parenteral nutrition (HPN), administered through a central venous catheter. Catheter‐related bloodstream infection (CRBSI) with Staphylococcus aureus is known to be a serious infection with a high mortality rate and risk of complications. A standardized protocol on the management of S aureus CRBSIs in children receiving HPN is lacking. The aim of this study is to evaluate the effectiveness and safety of the current management in an HPN expertise center in the Netherlands.

Methods

We performed a retrospective descriptive cohort study between 2013 and 2022 on children 0–18 years of age with chronic IF requiring long‐term HPN. Our primary outcomes were the incidence of S aureus CRBSI per 1000 catheter days, catheter salvage attempt rate, and successful catheter salvage rate. Our secondary outcomes included complications and mortality.

Results

A total of 74 patients (39 male; 53%) were included, covering 327.8 catheter years. Twenty‐eight patients (38%) had a total of 52 S aureus CRBSIs, with an incidence rate of 0.4 per 1000 catheter days. The catheter salvage attempt rate was 44% (23/52). The successful catheter salvage rate was 100%. No relapse occurred, and no removal was needed after catheter salvage. All complications that occurred were already present at admission before the decision to remove the catheter or not. No patients died because of an S aureus CRBSI.

Conclusion

Catheter salvage in S aureus CRBSIs in children receiving HPN can be attempted after careful consideration by a multidisciplinary team in an HPN expertise center.
Retrospective analysis of the standardized BARD criteria for acute cholangitis in biliary atresia patients
Authors: Madadi‐Sanjani Omid , Calinescu Ana M. , Rock Nathalie , McLin Valerie A. , Uecker Marie , Kuebler Joachim F. , Petersen Claus , Wildhaber Barbara E.
Published: April 2024

Objectives

In 2022, the Biliary Atresia and Related Diseases (BARD) community reached a consensus for the definition of suspected and confirmed cholangitis for biliary atresia (BA) patients after hepatoportoenterostomy (HPE). This study assessed the new standardized BARD definition in a retrospective, multicenter cohort study.

Methods

We included BA cases managed between 2010 and 2020 at the Hannover Medical School and Geneva University Hospitals' Swiss Pediatric Liver Center. The standardized BARD cholangitis definition assesses four clinical items and four imaging/laboratory items to define cholangitis. The definition was retrospectively applied to all BA cases having presented, according to their physician, cholangitis within the first year after the HPE. The diagnosis defined by the standardized BARD definition was compared with the final clinical diagnosis made by physicians. The Spearman's correlation coefficient was used to test for correlation between diagnoses made by standardized and clinical appreciation.

Results

Of 185 consecutive BA patients, 59 (32%) had at least one episode of cholangitis within the first year after HPE. The correlation between the clinician's impression and the standardized BARD definition was very strong (r = 0.8). Confirmed cholangitis definition coincided with the clinician's impression (2.5 [±0.7]/4 clinical items, 2.6 [±0.5]/4 imaging/laboratory items). For suspected cholangitis, the threshold for diagnosis was lower within the standardized BARD definition (1.1 [±0.3]/4 clinical items, 2.2 [±0.8]/4 laboratory/imaging items).

Conclusions

This first retrospective application of the standardized BARD cholangitis definition reveals a very strong correlation with the physician's assessment before standardization. A prospective study is needed to further refine the standardized definition for cholangitis in BA patients.
What are the short‐ and long‐term abdominal consequences of an omentectomy? A systematic review
Authors: Smit Jan Maerten , Plat Victor D. , Panday Arvind Nannan , Daams Freek , Negenborn Vera L.
Published: April 2024

This review provides an overview regarding the abdominal effects of an omentectomy, with or without extra‐peritoneal reconstructions. In general, reported complication rates were low. Short‐term complications involved ileus, bowel stenosis, abdominal abscess and sepsis (range 0.0%–23%). Donor‐site hernia was mainly reported as long‐term complication (up to 32%) and negligible gastrointestinal complications were observed. However, the level of evidence and methodological quality are quite low with a maximum of 8.5 years follow‐up.
The effect of different alignment strategies on trochlear orientation after total knee arthroplasty
Authors: Klasan Antonio , Anelli‐Monti Victoria , Putnis Sven E. , Neri Thomas , Kammerlander Christian
Published: April 2024

Purpose

When planning and delivering total knee arthroplasty (TKA), there are multiple coronal alignment strategies such as functional alignment (FA), kinematic alignment (KA), mechanical and adjusted mechanical alignment (MA, aMA). Recent three‐dimensional and robotic‐assisted surgery (RAS) studies have demonstrated that KA potentially better restores the trochlear anatomy than MA. The purpose of this study was to compare the restoration of the native trochlear orientation in patients undergoing RAS TKA using four different alignment strategies. It was hypothesised that FA would result in the lowest number of outliers.

Methods

This is a prospective study of 200 patients undergoing RAS‐TKA with a single implant. All patients were analysed for MA and KA prebalancing, and 157 patients received aMA and 43 patients FA with intraoperative balancing. Preoperative transverse computed tomography scans were used to determine the posterior condylar axis (PCA), lateral trochlear inclination (LTI) angle, sulcus angle (SA) and anterior trochlear line (ATL) angle. Implant measurements were obtained using a photographic analysis. Intraoperative software data combined with implant data and preoperative measurements were used to calculate the differences. Outliers were defined as ≥3° of alteration. Trochlea dysplasia was defined as LTI < 12°.

Results

Native transepicondylar PCA had a median of 2°, LTI 18°, SA 137°, ATL 4°. LTI outliers were observed in 47%–60% of cases, with KA < FA < aMA < MA. For ATL, the range of outliers was 40.5%–85%, KA < FA < aMA < MA. SA produced 81% of outliers. Of all median angle values, only LTI when using KA was not significantly altered compared to the native knee.

Conclusion

There is a significant alteration of trochlear orientation after TKA, regardless of the alignment strategy used. KA produced the lowest, but a substantial, number of outliers. The uniform design of implants causes the surgeon to compromise on balance in flexion versus trochlear position. The clinical relevance of this compromise requires further clinical investigations.

Level of Evidence

Level II, prospective cohort study.
Hypomethylation‐associated LINC00987 downregulation induced lung adenocarcinoma progression by inhibiting the phosphorylation‐mediated degradation of SND1
Authors: Lai Qi , Wan Yulin , Zhang Yingqian , Huang Yingzhao , Tang Qiuyue , Chen Mei , Li Qian , Ma Ke , Xiao Ping , Luo Cheng , Zhuang Xiang
Published: April 2024

DNA methylation, an epigenetic regulatory mechanism dictating gene transcription, plays a critical role in the occurrence and development of cancer. However, the molecular underpinnings of LINC00987 methylation in the regulation of lung adenocarcinoma (LUAD) remain elusive. This study investigated LINC00987 expression in LUAD patients through analysis of The Cancer Genome Atlas data sets. Quantitative real‐time polymerase chain reaction (RT‐qPCR) and fluorescence in situ hybridization assays were used to assess LINC00987 expression in LUAD. The bisulfite genomic sequence PCR (BSP) assay was used to determine the methylation levels of the LINC00987 promoter. The interaction between LINC00987 and SND1 was elucidated via immunoprecipitation and RNA pull‐down assays. The functional significance of LINC00987 and SND1 in Calu‐3 and NCI‐H1688 cells was evaluated in vitro through CCK‐8, EdU, Transwell, flow cytometry, and vasculogenic mimicry (VM) tube formation assays. LINC00987 expression decreased in LUAD concomitant with hypermethylation of the promoter region, while hypomethylation of the LINC00987 promoter in LUAD tissues correlated with tumor progression. Treatment with 5‐Aza‐CdR augmented LINC00987 expression and inhibited tumor growth. Mechanistically, LINC00987 overexpression impeded LUAD progression and VM through direct binding with SND1, thereby facilitating its phosphorylation and subsequent degradation. Additionally, overexpression of SND1 counteracted the adverse effects of LINC00987 downregulation on cell proliferation, apoptosis, cell migration, invasion, and VM in LUAD in vitro. In conclusion, this pioneering study focuses on the expression and function of LINC00987 and reveals that hypermethylation of the LINC00987 gene may contribute to LUAD progression. LINC00987 has emerged as a potential tumor suppressor gene in tumorigenesis through its binding with SND1 to facilitate its phosphorylation and subsequent degradation.
Causes of an extremely low visibility event in Northeast China
Authors: Cao Dianbin , Chen Xuelong , Zhang Qiang , Lin Yanluan , Zhang Qinghong , Ma Yaoming
Published: April 2024

An extreme haze‐fog event occurred during October 20–22, 2013, in Harbin, Northeast China, which lasted for nearly 60 h with local visibility as low as 20 m. However, causes of the extreme haze‐fog formation remain unclear. Through the analysis of in situ data and objective weather circulation classification, it is revealed that high pollutant emissions from biomass burning played a very important role in the extreme event. Stable weather conditions under the circulation type 8 (CT8), marked by weak high‐pressure control, strong inversion (6.55°C), shallow boundary layer depth (<300 m), and high relative humidity (>90%), aided in the accumulation of pollutants and hygroscopic aerosol growth. All of these factors collectively contributed to the extreme haze‐fog formation. The insights derived from this study can improve the predictability of extreme haze‐fog events, and indicate that pollution emissions should be tightly controlled in the adverse meteorological circulation type in Northeast China.
Impedance operator of a curved thin layer in linear elasticity with voids
Authors: Abdallaoui Athmane , Berkani Amirouche , Kelleche Abdelkarim
Published: April 2024

We consider a two‐dimensional transmission problem of linear elasticity with voids in a fixed domain
coated by a curved thin layer
. Our aim is to model the effect of the thin layer
on the fixed domain
by an impedance boundary condition. For that, we use the techniques of asymptotic expansion to approximate the transmission problem by an impedance problem set in the fixed domain
, and we prove an error estimate for the approximate impedance problem.
Electroencephalography‐based investigation of the effects of oral desmopressin on improving slow‐wave sleep time in nocturnal polyuria patients (the DISTINCT study): A single‐arm, open‐label, single‐assignment trial
Authors: Torimoto Kazumasa , Gotoh Daisuke , Nakai Yasushi , Miyake Makito , Fujimoto Kiyohide
Published: April 2024

Aims

To investigate changes in subjective and objective sleep quality after desmopressin administration in patients with nocturia due to nocturnal polyuria (NP) using electroencephalography (EEG) and the Pittsburgh sleep quality index (PSQI).

Methods

Twenty male patients (≥65 years old) with NP participated in this study. The inclusion criteria were nocturnal frequency ≥ 2, NP index (NPi) ≥ 0.33, first uninterrupted sleep period (FUSP) ≤ 2.5 h, serum sodium concentration ≥ 135 mEq/L, and estimated glomerular filtration rate ≥ 50 mL/min/1.73 m2. Participants were given 50 μg of desmopressin to be taken orally once daily before bed. The primary endpoint was the change in the duration of slow‐wave sleep (nonrapid eye movement sleep stages 3 and 4), as evaluated by EEG 28 days from the baseline. The visual analog scale (VAS) was used as an additional indicator of sleep quality.

Results

Analysis of data from 15 participants (median age: 74.0 [70.5, 76.0] years) revealed that from before to after desmopressin administration, significant decreases occurred in the median nocturnal frequency (3.0 [2.0, 4.0] to 1.5 [1.0, 2.0]) and NPi (0.445 [0.380, 0.475] to 0.360 [0.250, 0.430]). Furthermore, FUSP was significantly prolonged from 120.0 (94.0, 150.0) min to 210.0 (203.8, 311.3) min. Although the VAS scores improved, slow‐wave sleep duration and the PSQI global score showed no significant differences (68.50 [47.50, 75.50] and 48.00 [38.00, 66.50]; 5.0 [5.0, 10.0] and 7.0 [5.0, 9.0] min, respectively).

Conclusion

Oral administration of 50 μg desmopressin improved nocturnal frequency and FUSP in older individuals with NP but did not significantly enhance sleep quality. In older adults, decreased nighttime urinary frequency may enhance quality of life; however, its influence on objective sleep quality may be limited.
A cognitive task analysis of final year nursing students' situation awareness in simulated deteriorating patient events: A mixed methods study
Authors: Walshe Nuala , Drennan Jonathan , Hegarty Josephine , O'brien Sinéad , Crowley Clare , Ryng Stephanie , O'Connor Paul
Published: April 2024

Aim

The aim of this study was to: (1) use cognitive task analysis to describe final year nursing students situation awareness in recognising, responding and escalating care of deteriorating patients in ward settings; and (2) make recommendations for training and practice.

Design

A mixed methods cognitive task analysis with a convergent triangulation design.

Method

Data collection involved observations of 33 final year nursing students in simulated deteriorating patient scenarios and retrospective cognitive interviews. A process tracing technique was applied to identify the cues to deterioration participants perceived; how cue perception altered as situational demands increased; the extent that participants made connections between perceived cues and reached a situational understanding; and the factors that influenced and constrained participants situation awareness. Qualitative and quantitative findings are woven together and presented using descriptive statistics, illustrative quotations and timeline extractions.

Results

The median cue perception was 65.4% and 57.6% in the medical and surgical scenarios, respectively. Perception was negatively influenced by incomplete vital sign monitoring as situations escalated; limited physical assessments; passive scanning behaviours; poor task automaticity; and excessive cognitive demands. Incomplete perception, poor cue integration and underdeveloped mental models influenced situational understanding. Escalation calls did not always accurately reflect situations and a reporting mindset was evident. Clinical exposure to deteriorating patients was described as variable and opportunistic.

Reporting Method

The study is reported in accordance with the Good Reporting of a Mixed Methods Study (GRAMMS) checklist.

Patient or Public Contribution

Patients and public were not involved in this research.
Psychosocial intervention programme based on the needs of women undergoing termination of pregnancy for foetal anomalies: A modified Delphi study
Authors: Wang Ying , Huang Chi , Xie Jiaying , Zeng Lihong , Wang Yaohan , He Yanjuan , Li Ying , Qin Chunxiang
Published: April 2024

Aim

To construct a psychosocial intervention programme for women diagnosed with foetal anomalies based on their needs in China.

Design

A three round‐modified Delphi survey from September to November 2020.

Methods

In Round 1, based on literature review and qualitative interviews, a face‐to‐face meeting with eight taskforce members was conducted to generate the initial intervention indicators. In Round 2 and 3, 15 experts and three stakeholders (women undergoing termination of pregnancy for foetal anomalies) were invited by email to evaluate the importance of the indicators and built the final psychosocial intervention programme.

Results

The response rate for both two rounds is 100%. The experts' authority coefficient was 0.86. The Kendall W value of the two rounds ranged between 0.191 and 0.339. A needs‐based psychosocial intervention programme was established, including four periods (denial, confirmation, decision‐making and recovery), three needs‐based supports (information, social and acceptance commitment therapy) and 27 intervention indicators. The mean value of the importance of each index was 4.00–5.00. Further research is required to evaluate whether this programme is realistic and effective for the target audiences.
Insurance Status and Access to Otolaryngology Care: National Mystery Caller Study in the United States
Authors: Corbisiero Michaele Francesco , Muffly Tyler M. , Gottman Drew C. , Olson Madeline , Hachicha Yasmine , Garcia‐Creighton Elizabeth , Gallego Natalie , Elsayed Maryam , Ahmed Sophia , Cabrera‐Muffly Cristina
Published: April 2024

Objective

To investigate potential differences in new patient appointment wait times for otolaryngology care based on insurance types and explore factors influencing these wait times.

Study Design

A cross‐sectional audit study, using a “mystery caller” approach, analyzed with a linear mixed Poisson model to adjust for confounding factors.

Setting

A total of 612 physicians across 49 states and the District of Columbia, representing 6 otolaryngology subspecialties, were included.

Methods

Otolaryngology physicians were contacted by mystery callers via telephone with scripted clinical vignettes as patients with either Medicaid or Blue Cross/Blue Shield (BCBS) insurance. Callers requested next available appointment. Wait times for new patient appointments were recorded and analyzed in R using a generalized linear mixed Poisson model.

Results

A total of 1183 of 1224 calls reached a representative. Medicaid patients waited 5.73% longer (P < .001) compared to BCBS patients (IRR: 1.06; confidence interval [CI]: 1.03‐1.09;P < .001), with respective mean wait times of 36.8 days (SE ± 1.6) and 32.4 days (SE ± 1.6). Longer waiting times were also associated with physicians affiliated with universities (P = .001) and certain subspecialties, such as pediatric otolaryngology (P < .001) and neurotology (P = .008). Regional differences were also observed, with specific AAO‐HNS regions showing shorter wait times. The model achieved a conditional R‐squared value of 0.947.

Conclusion

This study reveals disparities in wait times for otolaryngology care based on insurance type, with extended wait times for Medicaid beneficiaries. The findings highlight a potential access to care disparity, which begets the need for strategies that ensure equitable access to otolaryngology care and further research to understand the underlying reasons for these potential disparities.
Identifying Opportunities to Deliver High‐Quality Cancer Care Across a Health System: A Clinical Responsibility
Authors: Shah Hemali P. , Cohen Oded , Bourdillon Alexandra T. , Burtness Barbara A. , Boffa Daniel J. , Young Melissa , Judson Benjamin L. , Mehra Saral
Published: April 2024

Objective

We examined process‐related quality metrics for oral squamous cell carcinoma (OSCC) depending on treating facility type across a health system and region.

Study Design

Retrospective in accordance with Strengthening the Reporting of Observational Studies in Epidemiology guidelines.

Setting

Single health system and region.

Methods

Patients with OSCC diagnosed between 2012 and 2018 were identified from tumor registries of 6 hospitals (1 academic and 5 community) within a single health system. Patients were categorized into 3 care groups: (1) solely at the academic center, (2) solely at community facilities, and (3) combined care at academic and community facilities. Primary outcome measures were process‐related quality metrics: positive surgical margin rate, lymph node yield (LNY), adjuvant treatment initiation ≤6 weeks, National Comprehensive Cancer Network (NCCN)‐guideline adherence.

Results

A total of 499 patients were included: 307 (61.5%) patients in the academic‐only group, 101 (20.2%) in the community‐only group, and 91 (18.2%) in the combined group. Surgery at community hospitals was associated with increased odds of positive surgical margins (11.9% vs 2.5%, odds ratio [OR]: 47.73, 95% confidence interval [CI]: 11.2‐275.86, P < .001) and lower odds of LNY ≥ 18 (52.8% vs 85.9%, OR: 0.15, 95% CI: 0.07‐0.33, P < .001) relative to the academic center. Compared with the academic‐only group, odds of adjuvant treatment initiation ≤6 weeks were lower for the combined group (OR: 0.30, 95% CI: 0.13‐0.64, P = .002) and odds of NCCN guideline‐adherent treatment were lower in the community only group (OR: 0.35, 95% CI: 0.18‐0.70, P = .003).

Conclusion

Quality of oral cancer care across the health system and region is comparable to or better‐than national standards, indicating good baseline quality of care. Differences by facility type and fragmentation of care present an opportunity for bringing best in‐class cancer care across an entire region.
Psychometric Properties and Concurrent Validity of a 10‐Item Questionnaire for Patients With Vestibular Disorders
Authors: Knapstad Mari Kalland , Heggdal Peder O. , Berge Jan Erik , Nordahl Stein Helge Glad , Goplen Frederik Kragerud
Published: April 2024

Objective

This study aimed to investigate the psychometric properties and concurrent validity of the Haukeland Dizziness Questionnaire (HDQ‐10), a 10‐item questionnaire designed for simplified assessment of symptom severity and emotional effects in patients with vestibular disorders.

Study Design

Cross‐sectional study.

Setting

Secondary referral hospital.

Methods

Out of 238 consecutive patients examined for suspected vestibular disease at an otolaryngology clinic, 201 completed the questionnaire. The psychometric properties of the HDQ‐10 were examined by exploratory factor analysis and analysis of internal consistency. Concurrent validity was determined in comparison with the Dizziness Handicap Inventory (DHI), Vertigo Symptom Scale‐Short Form (VSS‐SF), and the Hospital Anxiety and Depression Scale.

Results

The factor analysis revealed 3 subscales of the questionnaire covering “function,” “unsteadiness,” and “emotion.” The examination of the total scale (α = .866) and its subscales indicated satisfactory psychometric properties. The HDQ‐10 correlated highly with both DHI (r = .732. P < .001) and VSS‐SF (r = .720. P < .001) indicating good concurrent validity.

Conclusion

The HDQ‐10 is a 10‐item questionnaire designed for simplified assessment of symptom severity and emotional effects in patients with vestibular disorders. It has satisfactory psychometric properties and good concurrent validity compared to existing dizziness questionnaires.
Study on tensile properties of ultra‐thin‐ply carbon fiber‐reinforced composite laminates under static load
Authors: Ren Mingfa , Liu Yanpeng , Han Yuze , Ren Zhongjie
Published: April 2024

The thinning of carbon fiber‐reinforced composites has been shown to enhance their strength and damage resistance. In this study, cross‐ply and quasi‐isotropic laminate tensile experiments are conducted using composites with ply thicknesses of 24, 55, 75, and 100 μm to investigate the relationship between the strength of laminates and ply thickness. By analyzing the acoustic emission amplitude and energy signals during the loading process of the specimens, the damage evolution of each ply thickness composite under two different stacking methods is studied, revealing the failure mechanisms of the materials. The results show that under both cross‐ply and quasi‐isotropic stacking methods, the ultra‐thin‐ply composites exhibited higher strength. The thickness of ply has a significant influence on the fracture mode of the quasi‐isotropic laminates and the mechanical properties of quasi‐isotropic laminates are more affected by ply thickness than those of cross‐ply laminates.

Highlights

Quasi‐isotropic laminate strength is affected more by ply thickness than cross‐ply.

Reduced ply thickness changes fracture mode in quasi‐isotropic laminates.

Ultra‐thin‐ply composites exhibit flat fractures resulting in higher strength.