bluuebunny/crossref_metadata_2025 huggingface dataset:
ANKLE PRESERVATION: TWO CASES OF CABLE TRANSPORT FOR BONY DEFECTS FOLLOWING ANEURYSMAL BONE CYST RESECTION
Authors: McCabe Fergus , Wade Anna , Devane Yvonne , O'Brien Chris , McMahon Louise , Donnelly Thomas , Green Connor
Published: July 2023

Introduction

Aneurysmal bone cysts commonly found in lower limbs are locally aggressive masses that can lead to bony erosion, instability and fractures. This has major implications in the lower limbs especially in paediatric patients, with potential growth disturbance and deformity. In this case series we describe radical aneurysmal bone cyst resection and lower limb reconstruction using cable transport and syndesmosis preservation.

Materials & Methods

Case 1 - A 12-year-old boy presented with a two-week history of atraumatic right ankle pain. An X-ray demonstrated a distal tibia metaphyseal cyst confirmed on biopsy as an aneurysmal bone cyst. The cyst expanded on interval X-rays from 5.5cm to 8.5cm in 9 weeks. A wide-margin en-bloc resection was performed leaving a 13.8cm tibial defect. A cable transport hexapod frame and a proximal tibial osteotomy was performed, with syndesmosis screw fixation. The transport phase lasted 11 months. While in frame, the boy sustained a distal femur fracture from a fall. The femur and the docking site were plated at the same sitting and frame removed. At one-year post-frame removal he is pain-free, with full ankle dorsiflexion but plantarflexion limited to 25 degrees. He has begun graduated return to sport.

Results

Case 2 - A 12-year-old girl was referred with a three-month history of lateral left ankle swelling. X-ray demonstrated an aneurysmal bone cyst in the distal fibula metaphysis. The cyst grew from 4.2 × 2.3cm to 5.2 × 3.32cm in 2 months. A distal fibula resection (6.2cm) with syndesmosis fixation and hexapod cable transport frame were undertaken. The frame was in situ for 13 weeks and during this time she required an additional osteotomy for premature consolidation and had one pin site infection. After 13 weeks a second syndesmosis screw was placed, frame removed, and a cast applied. 3 months later she had fibular plating, BMAC and autologous iliac crest bone graft for slow union. At 3 years post-operative she has no evidence of recurrence, is pain-free and has no functional limitation.

Conclusions

We describe two cases of ankle syndesmosis preservation using cable transport for juxta-articular aneurysmal bone cysts. This allows wide resection to prevent recurrence while also preserving primary ankle stability and leg length in children. Both children had a minor complication, but both had an excellent final outcome. Cable bone transport and prophylactic syndesmosis stabilization allows treatment of challenging juxta-articular aneurysmal bone cysts about the ankle. These techniques are especially useful in large bone defects.
CHRONIC OSTEOMYELITIS: BEWARE OF PRE-REFERRAL CULTURES
Authors: Lynch-Wong Matthew , Breen Niall , Ogonda Luke
Published: July 2023

Materials & Methods

Chronic osteomyelitis is a complex and challenging condition the successful treatment of which requires a specialist multidisciplinary approach. Prior to tertiary referral to a specialist Orthoplastic Unit, patients often receive multiple courses of antibiotics, in usually unsuccessful attempts, to eradicate infection. This often results in the development of chronic polymicrobial infection. We reviewed the intra-operative cultures of patients treated in our Orthoplastic unit over a 9-year period from 2012–2021 to determine the spectrum of polymicrobial cultures and the relationship to pre-operative cultures.

Results

We reviewed the electronic care records and laboratory results of all patients referred to or directly admitted to our unit with a diagnosis of chronic osteomyelitis between 2012–2021. We checked all culture results, antibiotic sensitivities and prescription for treatment. We also checked for any recurrence of infection within 1 year.

60 patients were treated over the 9-year period. 9 upper and 51 lower limbs. The most common referral sources were from the surgical specialties of Trauma & Orthopaedics and Plastic Surgery (62%) while an equal amount came from the Emergency Department and other inpatient medical teams, each making up 15%. A small cohort (8%) developed the infection while still being followed up post fixation.

Aetiology of Infection were post fracture fixation 41 (68%), spontaneous osteomyelitis 10 (17%), soft tissue infection 4 (7%). The remaining 5 patients (8%) had a combination failed arthroplasty, arthrodesis and chronic infection from ring sequestrum. 58 patients (97%) had positive cultures with 26 being polymicrobial. 12 cultures were gram negative (G-ve), 11 G+ve 12, 4 anaerobic and 1 Fungal. In 24 patients (40%) the pre-operative cultures and antibiotic sensitivities did not correspond to the intra-operative cultures and sensitivities. 55 patients (92%) required dual or triple therapy with 8% requiring further debridement and extended therapy. 2 (3%) patients had failed treatment requiring amputation.

Conclusions

Chronic osteomyelitis is a complex and challenging condition the successful treatment of which requires early referral to a specialist Orthoplastic unit. Less than half of organisms cultured pre-operatively reflect the causative organisms cultured intra-operatively with 52% of these infections being polymicrobial.

After initial treatment, 8% of patients will require a further combination of extended antibiotic therapy and surgery to eradicate infection.
LEARNING FROM SIMULATION IN HIGHER ORTHOPAEDIC TRAINING: ARE WE ON THE SAME PAGE?
Authors: Al-Hilfi Lena , Afzal Irrum , Radha Sarkhell , Shenouda Michael
Published: July 2023

Simulation use in training is rapidly becoming a mainstay educational tool seen to offer perceived benefits of a safe environment for repeated practice and learning from errors without jeopardising patient safety. However, there is currently little evidence addressing the trainees’ perspectives and attitudes of simulation training, particularly in comparison with trainers and the educational community.

This study investigates orthopaedic trainees’ and trainers’ conceptions of learning from simulation-based training, exploring whether the orthopaedic community are ‘on the same page’, with respect to each other and the educational community. Qualitative research in the form of semi-structured interviews is used to identify commonalities and differences between trainee and trainer conceptions, based on respective experiences and expectations, and suggests ways of enhancing collaboration between stakeholders to achieve better alignment of conceptions.

The research revealed that orthopaedic trainees and trainers conceive key themes in a similar manner: supporting the role of simulation in developing the ‘pre-trained novice’ as opposed to skill refinement or maintenance; attributing greater importance to non-technical rather than technical skills development using simulation; questioning the transferability to practice of learnt skills; and emphasising similar barriers to increased curriculum integration, including financing and scheduling. These conceptions are largely in contrast to those of the educational community, possibly due to differing conceptions of learning between the two communities, along with a lack of a common language in the discourse of simulation.

There was some evidence of changing attitudes and positively emerging conceptions among the orthopaedic community, and capitalising on this by engaging trainers and trainees may help reconcile the differing conceptions and facilitate increasing simulation utilisation and curriculum integration. Developing a common language to make the educational more tangible to surgeons, bringing the educational closer to the surgical, may help maximise the educational benefit and shape the future of simulation use in surgical training.
WHICH IS THE BEST PATIENT-REPORTED OUTCOME MEASURE TO EVALUATE YOUNG PATIENTS UNDERGOING HIP SURGERY?
Authors: Marin-Peña O.
Published: July 2023

Young patients undergoing THA or hip used. HOS and iHOT33 have demonstrated to be useful in hip preservation surgery but never used in THA.

The aim of the study was to evaluate long-term clinical outcomes with HOS and iHOT33 in hip arthroscopy and THA

We conducted a retrospective study with prospective data collection of 118 consecutive young patients (<65 y.o.) between 2008 to 2012 who underwent hip arthroscopy or THA. The mean follow-up was 12.05 years. All surgeries were done by the same senior surgeon. PROMs used were iHOT-33 and HOS preoperatively, at one year and 10 years. SPSS Statistics Grad Pack 28.0 software was used for statistical analysis

Arthroscopy Group (57 patients): Mean age 35.36 years. 55.93% were male. iHOT33 mean differential improvement was 24.43 at 1 year, 70,17% exceed MCID and 49,1% SCB. HOS mean differential improvement was 16.26 at one year. 54,38 % patients exceed MCID and 49,36% SCB. At 10 years, iHOT33 mean differential improvement was 14,36 and 12.56 for HOS. Regarding complications, 3 patients underwent THA (5.26%) and 10 (17.54%) continued with groin pain.

THA Group (61 patients): Mean age 52,54 years. 55.73% were male. Cementless THA was used in all patients with ceramic on ceramic used in 77%. iHOT33 mean differential improvement was 41,57 at 1 year. 95,08% patients exceed MCID and 85,25% SCB. HOS mean differential improvement was 16.57 points at one year. 85,25% patients exceed MCID and 81,97% SCB. At 10 years, iHOT33 mean differential improvement was 20,15 and 14.12 for HOS. Regarding complications, 1 patient underwent DAIR for infection (1.64%) and 1 dislocation with close reduction (1.64%).

iHOT33 or HOS scores should be considered to be used in young active patients after hip preserving surgery or THA, with more predictable results at long-term in THA group.
HIGH ANTIOXIDATION-CAPACITY STEM CELLS ENHANCE CARTILAGE REGENERATION
Authors: Kim Y.J. , Yang H.R. , Bae H.C. , Han H-S.
Published: July 2023

Stem cells are known to have low levels of intracellular reactive oxygen species (ROS) and high levels of glutathione. ROS are thought to interact with several pathways that affect the transcription machinery required for stem cell differentiation, and are critical for maintaining stem cell function. In this study, we are developing a new fluorescent probe that rapidly and reversibly reacts with glutathione (GSH), the most abundant non-protein thiol in living cells that acts as an antioxidant and redox regulator.

Multipotent perivascular progenitor cells derived from human ESCs (hESC-PVPCs): Differentiated ESCs as embryoid bodies in the presence of BMP4 to induce mesoderm differentiation followed by a simple cell selection strategy using attachment of single cells onto collagen-coated dishes. Differential gene expression profiling was performed among H9 hESCs, EBs induced by BMP4 and naturally selected CD140B+CD44+ population at Day 7 (PVPCs). Colony-forming assay: GSHhigh and GSHlow PVPCs were plated on 10-cm tissue culture-treated polystyrene dishes in triplicate in growth medium and cultured for 14 days. Transwell migration assay: GSHhigh and GSHlow PVPCs at passage 4 were resuspended at 1 × 106/mL in the migration medium and seeded in the upper chamber. The following human recombinant SDF-1 and PDGF-AA proteins were used as chemoattractants in the lower compartment.

Probe-GSH conjugate shows shifts in fluorescence excitation and emission spectra that enables ratiometric measurement of GSH levels. Using these properties, stem cells can be purified by FACS-based technology according to intracellular GSH level. We are developing a protocol both for comparing GSH level in stem cell from different culture conditions and for preparing stem cells with high-GSH level . Our results reveal that GSHhigh PVPC purified by FACS show increased colony forming ability compared with that GSHlow PVPC, indicating that intracellular GSH contributes to the maintenance of stemness. Moreover, transplantation of GSHlow PVPC is more effective than that of GSHlow PVPC for cartilage regeneration in osteochondral defect.

This technique enable FACS-based sorting of stem cells according to intracellular GSH levels and thus investigation of functional role of GSH (high antioxidant capacity) in the stem cell maintenance and chondrogenic differentiation.
INTER-RATER AND INTRARATER RELIABILITY OF THREE COMMON CLASSIFICATION SYSTEMS FOR POSTERIOR MALLEOLUS FRACTURES: A MULTICENTRE STUDY
Authors: Rashid M. , Islam R. , Marsden S. , Trompeter A. , Teoh K.H.
Published: July 2023

A number of classification systems exist for posterior malleolus fractures of the ankle. The reliability of these classification systems remains unclear. The primary aim of this study was to evaluate the reliability of three commonly utilised fracture classification systems of the posterior malleolus.

60 patients across 2 hospitals sustaining an unstable ankle fracture with a posterior malleolus fragment were identified. All patients underwent radiographs and computed tomography of their injured ankle. 9 surgeons including pre-ST3 level, ST3-8 level, and consultant level applied the Haraguchi, Rammelt, and Mason & Molloy classifications to these patients, at two timepoints, at least 4 weeks apart. The order was randomised between assessments. Inter-rater reliability was assessed using Fleiss’ kappa and 95% confidence intervals (CI). Intra-rater reliability was assessed using Cohen's Kappa and standard error (SE).

Inter-rater reliability (Fleiss’ Kappa) was calculated for the Haraguchi classification as 0.522 (95% CI 0.490 – 0.553), for the Rammelt classification as 0.626 (95% CI 0.600 – 0.652), and the Mason & Molloy classification as 0.541 (95% CI 0.514 – 0.569). Intra-rater reliability (Cohen's Kappa) was 0.764 (SE 0.034) for the Haraguchi, 0.763 (SE 0.031) for the Rammelt, 0.688 (SE 0.035) for the Mason & Molloy classification.

This study reports the inter-rater and intra-rater reliability for three classification systems for posterior malleolus fractures. Based on definitions by Landis & Koch (1977), inter-rater reliability was rated as ‘moderate’ for the Haraguchi and Mason & Molloy classifications; and ‘substantial’ for the Rammelt classification. Similarly, the intra-rater reliability was rated as ‘substantial’ for all three classifications.
ANKLE FUSION WITH TIBIOTALOCALCANEAL RETROGRADE NAIL FOR FRAGILITY ANKLE FRACTURES: OUTCOMES AT A MAJOR TRAUMA CENTRE
Authors: Lu V. , Tennyson M. , Zhang J. , Zhou A. , Thahir A. , Krkovic M.
Published: July 2023

Fragility ankles fractures in the geriatric population are challenging to manage, due to fracture instability, soft tissue compromise, patient co-morbidities. Traditional management options include open reduction internal fixation, or conservative treatment, both of which are fraught with high complication rates. We aimed to present functional outcomes of elderly patients with fragility ankle fractures treated with tibiotalocalcaneal nails.

171 patients received a tibiotalocalcaneal nail over a six-year period, but only twenty met the inclusion criteria of being over sixty and having poor bone stock, verified by radiological evidence of osteopenia or history of fragility fractures. Primary outcome was mortality risk from co-morbidities, according to the Charlson co-morbidity index (CCI), and patients’ post-operative mobility status compared to pre-operative mobility. Secondary outcomes include intra-operative and post-operative complications, six-month mortality rate, time to mobilisation and union.

The mean age was 77.82 years old, five of whom are type 2 diabetics. The average CCI was 5.05. Thirteen patients returned to their pre-operative mobility state. Patients with low CCI are more likely to return to pre-operative mobility status (p=0.16; OR=4.00).

Average time to bone union and mobilisation were 92.5 days and 7.63 days, respectively. Mean post-operative AOFAS ankle-hindfoot and Olerud-Molander scores were 53.0 (range 17-88) and 50.9 (range 20-85), respectively. There were four cases of broken distal locking screws, and four cases of superficial infection. Patients with high CCI were more likely to acquire superficial infections (p=0.264, OR=3.857). There were no deep infections, periprosthetic fractures, nail breakages, non-unions.

TTC nailing is an effective treatment methodology for low-demand geriatric patients with fragility ankle fractures. This technique leads to low complication rates and early mobilisation. It is not a life-changing procedure, with many able to return to their pre-operative mobility status, which is important for preventing the loss of socioeconomic independence.
DEVELOPMENT OF A HUMAN EX VIVO FEMORAL HEAD MODEL TO ASSESS MESENCHYMAL STROMAL CELL REGENERATION OF ARTICULAR CARTILAGE
Authors: Styczynska-Soczka K. , Cawley W. , Samuel K. , Campbell J. , Amin A. , Hall A.
Published: July 2023

Articular cartilage has poor repair potential and the tissue formed is mechanically incompetent. Mesenchymal stromal cells (MSCs) show chondrogenic properties and the ability to re-grow cartilage, however a viable human model for testing cartilage regeneration and repair is lacking. Here, we describe an ex vivo pre-clinical femoral head model for studying human cartilage repair using MSCs.

Human femoral heads (FHs) were obtained following femoral neck fracture with ethical permission/patient consent and full-depth cartilage wells made using a 3mm biopsy punch. Pancreas-derived mesenchymal stromal cells (P-MSC) were prepared in culture media at ~5000 cells/20µl and added to each well and leakage prevented with fibrin sealant. After 24hrs, the sealant was removed and medium replaced with StemProTM chondrogenesis differentiation medium. The FHs were incubated (37oC;5% CO2) for 3wks, followed by a further 3wks in standard medium with 10% human serum with regular medium changes throughout. Compared to wells with medium only, A-MSCs produced a thin film across the wells which was excised en-block, fixed with 4% paraformaldehyde and frozen for cryo-sectioning.

The cell/tissue films varied in thickness ranging over 20-440µm (82±21µm; mean±SEM; N=3 FHs). The thickness of MSC films abutting the cartilage wells was variable but generally greater (15-1880µm) than across the wells, suggesting an attachment to native articular cartilage. Staining of the films using safranin O (for glycosaminoglycans; quantified using ImageJ) was variable (3±8%; mean±SEM; N=3) but in one experiment reached 20% of the adjacent cartilage. A preliminary assessment of the repair tissue gave an O'Driscoll score of 10/24 (24 is best).

These preliminary results suggest the ex vivo femoral head model has promise for studying the capacity of MSCs to repair cartilage directly in human tissue, although optimising MSCs to produce hyaline-like tissue is essential.

Supported by the CSO (TCS/17/32).
EFFECTS OF TRIPS AND SLIPS ON AGONIST AND ANTAGONIST MUSCLE FORCES POST-PERTURBATION
Authors: Namayeshi T. , Lee P.
Published: July 2023

Falls in adults are a major problem and can lead to injuries and death. In order to better understand falls and successful recoveries, identifying kinematics, kinetics, and muscle forces during recovery from loss of balance is crucial. To obtain reactive gait patterns, participants must be subjected to unexpected perturbations such as trips and slips. Previous researchers have reported kinetics recovery data following stumbling; however, the muscle force recovery patterns remain unknown. To better target exercises to reduce the risk of falls, we must first understand which muscles, their magnitude, and their coordination patterns, play a role in a successful recovery from a trip and a slip. Additionally, knowing the successful patterns of lower limb function can help with the diagnosis of faulty movements.

A total of 20 healthy adults in their twenties with similar athletic backgrounds were perturbed on a split-belt treadmill using Computer-Assisted Rehabilitation Environment (Motkforce Link) at a preset speed of 1.1m/s. Two kinds of perturbations were administered: slip and trip. Slips were simulated by accelerating one belt, whereas trips were simulated by decelerating one belt. Both perturbations had similar intensity and only differed in the direction. Computational modeling was used to obtain lower-limb function during the compensatory step. SPM paired t-test was used to compare differences in recovery strategies between slip and trip through magnitude and patterns of joints.

There were no significant differences in joint angles post tripping vs post-slipping. Results of net joint moments showed that compensating for the loss of balance due to tripping required a higher ankle plantarflexion moment than slipping (at 22-52%; 1.2± 0.3vs0.4±0.2, p<0.001). Additionally, larger gluteus maximus (at 40-50%;8.7±3.8vs2.7±1.1N/kg, p=0.001), gluteus medius (at23~33%; 22.6±5.7vs6.8±3.6N/kg, p<0.001) were generated than post-slipping, respectively.

These findings suggested that greater GMAX and GMED forces are required post-trip recovery than slip. Future analysis of trip recovery showed the importance of ankle joint in recovering from forward and backward fall. These results can be used as references in remote diagnosis of joint and muscle weakness and assessment of the risk of falls with the use of accelerometers.
HOW DOES COVID-19 IMPACT THE HEALTH SYSTEM? A PERSPECTIVE OF HEALTH SERVICE PROVIDERS AND THE HEALTH INDUSTRY
Authors: Reimers N. , Huynh T. , Schulz A.P.
Published: July 2023

The objectives of this study are to evaluate the impact of the CoVID-19 pandemic on the development of relevant emerging digital healthcare trends and to explore which digital healthcare trend does the health industry need most to support HCPs.

A web survey using 39 questions facilitating Five-Point Likert scales was performed from 1.8.2020 – 31.10.2020. Of 260 participants invited, 90 participants answered the questionnaire. The participants were located in the Hospital/HCP sector in 11.9%, in other healthcare sectors in 22.2%, in the pharmaceutical sector in 11.1%, in the medical device and equipment industry in 43.3%. The Five-Point Likert scales were in all cases fashioned as from 1 (strongly disagree) to 5 (strongly agree).

As the top 3 most impacted digital health care trends strongly impacted by CoVID-19, respondents named:

- remote management of patients by telemedicine, mean answer 4.44

- shared data governance under patient control, mean answer 3.80

- new virtual interaction between HCP´s and medical industry, mean answer 3.76

Respondents were asked which level of readiness of the healthcare system currently possess to cope with the current trend impacted by CoVID-19.

- Digital and efficient healthcare logistics, mean answer 1.54

- Integrated health care, mean answer 1.73

- Use of big data and artificial intelligence, mean answer 2.03

Asked if collaborative research in the form of digital data platforms for research data sharing and increasing collaboration with multi-centric consortia would have a positive impact on the healthcare sector, the agreement was high with a value of mean 4.10 on the scale.

We can conclude that the impact of COVID-19 appears to be a high agreement of necessary advances in digitalization in the health care sector and in the collaboration of HCPs with the health care industry. Health care professional are unsure, in how far the national health care sector is capable of transformation in healthcare logistics and integrated health care.
AN INVESTIGATION OF PATELLAR HEIGHT AND KNEE FLEXION ANGLE
Authors: Al-Musawi H. , Sammouelle E. , Manara J. , Clark D. , Eldridge J.
Published: July 2023

The aim is to investigate if there is a relation between patellar height and knee flexion angle. For this purpose we retrospectively evaluated the radiographs of 500 knees presented for a variety of reasons.

We measure knee flexion angle using a computer-generated goniometer. Patellar height was determined using computer generated measurement for the selected ratios, namely, the Insall–Salvati (I/S), Caton–Deschamps (C/D) and Blackburne–Peel (B/P) indices and Modified I/S Ratio.

A search of an NHS hospital database was made to identify the knee x rays for patients who were below the age of forty. A senior knee surgeon (DC) supervised three trainee trauma and orthopaedics doctors (HA, JM, ES) working on this research. Measurements were made on the Insall–Salvati (I/S), Caton–Deschamps (C/D) and Blackburne–Peel (B/P) indices and Modified I/S Ratio. The team leader then categorised the experimental measurement of patients’ knee flexion angle into three groups. This categorisation was according to the extent of knee flexion. The angles were specifically, 10.1 to 20, 20.1 to 30, and 30.1 to 40 degrees of knee flexion.

Out of the five-hundred at the start of the investigation, four hundred and eighteen patients were excluded because they had had either an operation on the knee or traumatic fracture that was treated conservatively.
Unravelling the Norwegian meat reduction controversy: navigating contested sustainabilities and the role of meat
Authors: Loeng Martin , Korsnes Marius
Published: July 2023

Controversy surrounds research reports that promote reduced meat consumption in Norway. By studying these controversies in the media, we ask why meat reduction is polarised seemingly between environmental and agricultural, urban and rural voices. We show how a ‘conventional’ definition of meat reduction in a self-regulating market tends to disconnect consumption habits from agricultural policies. The result is a paradox: Norwegians are urged to eat less meat, but farmers must produce more to stay afloat. In this conventional frame, meat reduction is seen by rural and farmer voices as a further exaggeration of agricultural decline, depopulation and centralisation. To unravel this controversy, we contrast this with a critical ‘post-productivist’ view of conventional agriculture and volume-centred farm subsidies since the 1950s. We show how a different, more interactive understanding of consumption as interrelated with Norwegian food policies, production and distribution emerges, highlighting a path through the controversy. By reimagining a change from subsidies for production volume to production methods, climate, health, environmental and rural issues are brought into conversation with each other. While largely remaining a marginal voice in a heavily polarised debate, we show how alternative notions of meat reduction can help us move past meat reduction controversies. The article stresses that the two concepts of meat reduction are characterised by distinct notions of consumption, suggesting that the popular understanding of what consumption is can be a barrier to, or a part of, a meat-reduced future.
Spherical maximal functions and fractal dimensions of dilation sets
Authors: Roos Joris , Seeger Andreas
Published: July 2023

abstract: For the spherical mean operators $\scr{A}_t$ in $\Bbb{R}^d$, $d\ge 2$, we consider the maximal functions $M_Ef=\sup_{t\in E}|\scr{A}_t f|$, with dilation sets $E\subset [1,2]$. In this paper we give a surprising characterization of the closed convex sets which can occur as closure of the sharp $L^p$ improving region of $M_E$ for some $E$. This region depends on the Minkowski dimension of $E$, but also other properties of the fractal geometry such as the Assouad spectrum of $E$ and subsets of $E$. A key ingredient is an essentially sharp result on $M_E$ for a class of sets called (quasi-)Assouad regular which is new in two dimensions.
Food as Contact Zone: Navigating the Ainu–Wajin Encounter in Golden Kamuy (2014–)
Authors: Spiker Christina M.
Published: July 2023

Abstract: This paper analyzes the role and representation of food in the Japanese manga and anime series Golden Kamuy (Gōruden Kamui, 2014-present) by Satoru Noda. While ostensibly an action-packed narrative about the hunt for indigenous Ainu gold, Golden Kamuy has earned a reputation among fans as a gurume , or gourmet, manga and anime. Cooking scenes of both Ainu and Wajin food feature prominently throughout the series. This paper analyzes the rhetorical role of food in the fictional narrative and its connection to official and unofficial ideologies about ethnic harmony between Ainu and Wajin communities in Japan.
Characteristics of laser-induced steel plasmas generated with different focusing conditions
Authors: Liang Fangyuan , Wang Jingge , Fu Xiaoqing , Wang Hui
Published: July 2023

Laser focusing is an important parameter that affects the characteristics of laser-induced plasma. Focusing lenses with different F-numbers form different energy density distributions near the surface of a sample, thus affecting the characteristics of plasma. In this study, the plasma generated by a nanosecond laser ablation of a micro-alloy steel certified sample at 1 atm of air was investigated. We compare the spectrally integrated plasma images obtained at different defocusing distances for short- and long-focus lenses and investigate the optical emission spectra of laser-induced plasma on steel alloy by using focusing lenses with different F-numbers. With an increase in the defocusing distance, the plasma plume changes from flat to hemispherical and then splitting occurs. The spectral line intensity increases first and then decreases, then increases slightly, and finally decreases gradually. For the long-focus lens, when the focal point is above the sample surface, the laser beam strongly interacts with air over a longer distance, leading to longer air plasma and weaker sample plasma compared with the short-focus lens. Thus, the relative intensity of the second peak in the spectral line intensity, according to the defocusing distance, gradually decreases with increasing F-number. We also obtain two-dimensional spatial distributions of the spectral line intensity according to the F-number and defocusing distance. The optimal defocusing distances for all focusing lenses occur when the focal point is below the sample surface. The relation between the optimal defocusing distance and F-number follows a single- exponential decay function.
Terahertz angle-independent photonic bandgap in a one-dimensional photonic crystal containing InSb-based hyperbolic metamaterials: erratum
Authors: Wu Feng , Yu Xi , Panda Abinash , Liu Dejun
Published: July 2023

This erratum corrects the typing errors in Eq. (6) and the
caption of Fig. 4 of the original paper, Appl. Opt.
61, 7677 (2022).APOPAI0003-693510.1364/AO.470923 The
correction does not affect the results of the original paper.
High-security optical transmission system with multi-dimensional multiplexing based on quaternion chaotic encryption
Authors: Jiang Lei , Liu Bo , Wu Xiangyu , Ren Jianxin , Ullah Rahat , Mao Yaya , Chen Shuaidong , Xia Wenchao , Zhao Lilong , Tian Feng
Published: July 2023

In this paper, we propose a multi-dimensional multiplexing scheme for space division multiplexing optical transmission systems based on quaternion chaotic encryption. A constellation compression shaping mapping method is designed to replace the traditional 2n mapping scheme, which leads to flexible encoding modulation. In order to achieve orthogonality between data symbols and effectively suppress crosstalk, the spectrally superposed transmission of three-dimensional (3D) constellation data is carried out by code division multiplexing and 4D carrier-less amplitude phase joint modulation techniques based on orthogonal basis. The Chen's chaotic model is utilized to generate the rotation angle of the constellation points, which enables data encryption without changing the transmitted power, enhancing system’s security. The feasibility and superiority of the proposed scheme are successfully verified by constructing an experimental platform for a seven-core fiber transmission system.
Maximum likelihood synchronization algorithm correction for photon-counting communications with blocking loss
Authors: Wen Tiancheng , Si Yue , Huang Jun , Zhang Liang , Shu Rong , Wang Jianyu
Published: July 2023

To realize deep space optical communications with high capacity and sensitivity, synchronization of pulse-position modulation (PPM) signals is crucial. In this study, the maximum likelihood synchronization algorithm based on inter-symbol guard times was generalized to the scenario with strong blockage of single-photon detectors, where higher PPM slot frequency and signal-noise ratio could be adopted. Furthermore, a slot frequency offset compensation method was proposed, and simulations and experiments were performed to verify the performance improvement of the proposed corrected synchronization algorithm under blockage. The results indicated that the deadtime-corrected synchronization scheme could effectively overcome the performance degradation of the original model under high photon flux, provide estimation (0.02749 slots @ root-mean-square error) close to the Cramér-Rao Bound, and error rates close to ideal synchronization in the experiment.
Small-sample stacking model for qualitative analysis of aluminum alloys based on femtosecond laser-induced breakdown spectroscopy
Authors: Ma Qing , Liu Ziyuan , Sun Tong , Gao Xun , Dai YuJia
Published: July 2023

Material characterization using laser-induced breakdown spectroscopy (LIBS) often relies on extensive data for effective analysis. However, data acquisition can be challenging, and the high dimensionality of raw spectral data combined with a large-scale sample dataset can strain computational resources. In this study, we propose a small sample size stacking model based on femtosecond LIBS to achieve accurate qualitative analysis of aluminum alloys. The proposed three-layer stacking algorithm performs data reconstruction and feature extraction to enhance the analysis. In the first layer, random forest spectral feature selection and specific spectral line spreading are employed to reconstruct the data. The second layer utilizes three heterogeneous classifiers to extract features from the reconstructed spectra in different feature spaces, generating second-level reconstructed data. Finally, the third layer utilizes the reconstructed dataset for qualitative prediction. Results indicate that the Stacking algorithm outperforms traditional methods such as k-nearest neighbors (KNN), support vector machine (SVM), and random forest (RF), including those combined with principal component analysis (PCA). The Stacking algorithm achieves an impressive 100% recognition rate in classification, with Accuracy, precision, recall, and F1 scores reaching 1.0. Moreover, as the number of samples decreases, the gap between the recognition accuracy of the Stacking algorithm and traditional approaches widens. For instance, using only 15 spectra for training, the Stacking algorithm achieves a recognition accuracy of 96.47%, significantly surpassing the improved RF's accuracy of 71.76%. Notably, the model demonstrates strong robustness compared to traditional modeling approaches, and the qualitative prediction error remains consistently below 5%. These findings underscore the model's enhanced generalization ability and higher prediction accuracy in small sample machine learning. This research contributes significantly to improving the applicability of the LIBS technique for fast detection and analysis of small samples. It provides valuable insights into the development of effective methodologies for material characterization, paving the way for advancements in the field.
Microfluidic integrated D-shaped optical fiber SERS probe with high sensitivity and ability of multi-molecule detection
Authors: Bo Huang , Ke Yang , Yong Zhu , Jie Zhang
Published: July 2023

In order to enhance the sensitivity, integration, and practical application capability of Raman detection systems, we propose a multi-channel microfluidic integrated D-shaped optical fiber SERS (Surface-enhanced Raman scattering) probe structure. Firstly, a microfluidic polydimethylsiloxane (PDMS) channel was fabricated using a self-designed multi-channel microfluidic template. Secondly, a uniform layer of silver nanoparticles was deposited on the D-shaped optical fiber using the liquid-liquid interface method. Finally, the D-shaped optical fiber was plasma-bonded to the multi-channel microfluidic channel and a cover glass, resulting in a microfluidic integrated D-shaped optical fiber SERS probe. The prepared sample exhibited excellent detection performance for R6G (rhodamine 6 G) with a detection limit as low as 10−11 mol/L and an enhancement factor of 1.14 × 109. Moreover, the multi-channel configuration enables simultaneous detection of multiple molecules, demonstrating excellent multi-channel multiplexing capability.
1.7 µm sub-200 fs vortex beams generation from a thulium-doped all-fiber laser
Authors: Xie Yuhua , Long Rufei , Ma Zuhai , Shi Youzhi , Hong Jiahao , Wu Jiadong , Zhao Chujun , Fan Dianyuan , Chen Yu
Published: July 2023

The pulsed 1.7 µm vortex beams (VBs) has significant research prospects in the fields of imaging and material processing. We experimentally demonstrate the generation of sub-200 fs pulsed VBs at 1.7 µm based on a home-made mode-selective coupler (MSC). Through dispersion management technology in a thulium-doped fiber laser, the stable linearly polarized VBs pulse directly emitting from the cavity is measured to be 186 fs with central wavelength of 1721.2 nm. By controlling the linear superposition of LP11 modes, cylindrical vector beams (CVBs) can also be obtained. In addition, a variety of bound states pulsed VBs at 1.7 µm can also be observed. Our finding provides an effective way to generate ultrashort pulsed VBs and CVBs at 1.7 µm waveband.
Detection of acute dengue virus infection, with and without concurrent malaria infection, in a cohort of febrile children in Kenya, 2014–2019, by clinicians or machine learning algorithms
Authors: Vu David M. , Krystosik Amy R. , Ndenga Bryson A. , Mutuku Francis M. , Ripp Kelsey , Liu Elizabeth , Bosire Carren M. , Heath Claire , Chebii Philip , Maina Priscilla Watiri , Jembe Zainab , Malumbo Said Lipi , Amugongo Jael Sagina , Ronga Charles , Okuta Victoria , Mutai Noah , Makenzi Nzaro G. , Litunda Kennedy A. , Mukoko Dunstan , King Charles H. , LaBeaud A. Desiree
Published: July 2023

Poor access to diagnostic testing in resource limited settings restricts surveillance for emerging infections, such as dengue virus (DENV), to clinician suspicion, based on history and exam observations alone. We investigated the ability of machine learning to detect DENV based solely on data available at the clinic visit. We extracted symptom and physical exam data from 6,208 pediatric febrile illness visits to Kenyan public health clinics from 2014–2019 and created a dataset with 113 clinical features. Malaria testing was available at the clinic site. DENV testing was performed afterwards. We randomly sampled 70% of the dataset to develop DENV and malaria prediction models using boosted logistic regression, decision trees and random forests, support vector machines, naïve Bayes, and neural networks with 10-fold cross validation, tuned to maximize accuracy. 30% of the dataset was reserved to validate the models. 485 subjects (7.8%) had DENV, and 3,145 subjects (50.7%) had malaria. 220 (3.5%) subjects had co-infection with both DENV and malaria. In the validation dataset, clinician accuracy for diagnosis of malaria was high (82% accuracy, 85% sensitivity, 80% specificity). Accuracy of the models for predicting malaria diagnosis ranged from 53–69% (35–94% sensitivity, 11–80% specificity). In contrast, clinicians detected only 21 of 145 cases of DENV (80% accuracy, 14% sensitivity, 85% specificity). Of the six models, only logistic regression identified any DENV case (8 cases, 91% accuracy, 5.5% sensitivity, 98% specificity). Without diagnostic testing, interpretation of clinical findings by humans or machines cannot detect DENV at 8% prevalence. Access to point-of-care diagnostic tests must be prioritized to address global inequities in emerging infections surveillance.
Using One Health assessments to leverage endemic disease frameworks for emerging zoonotic disease threats in Libya
Authors: Miller Lauren N. , Elmselati Hatem , Fogarty Alanna S. , Farhat Milad E. , Standley Claire J. , Abuabaid Hanan M. , Zorgani Abdulaziz , Elahmer Omar , Sorrell Erin M.
Published: July 2023

Continued emergence, re-emergence and spread of zoonotic diseases demonstrates the imperative need for multisectoral communication and joint coordination of disease detection and response. While there are existing international frameworks underpinning One Health capacity building for pandemic prevention and response, often guidance does not account for challenges faced by countries undergoing long-term conflict and sociopolitical instability. The purpose of this research was to identify Libya’s laboratory and surveillance networks and routes of inter- and multisectoral communication and coordination for priority zoonotic diseases. The One Health Systems Assessment for Priority Zoonoses (OH-SAPZ) tool is an established methodology that was adapted and applied to the Libyan context to support prioritization of zoonotic diseases, development of systems map schematics outlining networks of communication and coordination, and analysis of operations for targeted capacity building efforts. Five zoonotic diseases were selected to undergo assessment: highly pathogenic avian influenza, brucellosis, Rift Valley fever, leishmaniasis and rabies. Through decisive acknowledgement of Libya’s unique health setting, we mapped how patient and sample information is both communicated within and between the human, animal and environmental health sectors, spanning from local index case identification to international notification. Through our assessment we found strong communication within the public and animal health sectors, as well as existing multisectoral coordination on zoonotic disease response. However, local-level communication between the sectors is currently lacking. Due to the ongoing conflict, resources (financial and human) and access have been severely impacted, resulting in limited laboratory diagnostic capacity and discontinued disease prevention and control measures. We sought to identify opportunities to leverage existing operations for endemic diseases like brucellosis for emerging zoonotic threats, such as Rift Valley fever. Analysis of these operations and capabilities supports the development of targeted recommendations that address gaps and may be used as an implementation guide for future One Health capacity building efforts.
The efficacy and safety of 0.01% atropine alone or combined with orthokeratology for children with myopia: A meta-analysis
Authors: Wang Zengying , Wang Pengfei , Jiang Bohua , Meng Yifei , Qie Sufang , Yan Zhipeng
Published: July 2023

Objective

To evaluate the efficacy and safety of 0.01% atropine alone and in combination with orthokeratology for myopia control using a meta-analysis.

Methods

PubMed, Cochrane Library, and EMBASE were searched. We included eligible randomized controlled trials (RCTs), non-RCTs, and retrospective cohort studies, published up to August 1, 2022. We calculated the weighted mean difference (WMD) and 95% confidence interval (CI) for all outcomes and plotted them in forest plots.

Results

Fourteen studies were included; 4 and 11 in the 0.01% atropine monotherapy and atropine-orthokeratology (AOK) groups, respectively. Compared with orthokeratology (OK) alone, 0.01% atropine alone had similar effects on slowing the axial elongation (WMD: −0.00 mm; 95% CI: −0.05–0.04, p<0.31), while AOK significantly lowered axial growth. Moreover, the baseline myopic degree and duration of treatment were influential for the change in axial elongation (WMD: −0.12 mm; 95% CI: −0.17–−0.07, p = 0.00001 and WMD: −0.11 mm; 95% CI: −0.15–−0.108, p<0.00001, respectively). Additionally, the AOK may reduce the change rate of the spherical equivalent refraction and the accommodation amplitude (WMD: −0.13 D; 95% CI: 0.07–0.19, p<0.001 and WMD: −1.08 mm; 95% CI: −1.73–−0.43, p<0.0001, respectively), and cause a slight increase in the diameter of the pupil (WMD: 0.56 mm; 95% CI: 0.43–0.70, p = 0.007). No significant differences in the uncorrected distant visual acuity, best corrected visual acuity, intraocular pressure, tear film break-up time, lipid layer thickness, and corneal endothelial cell density were found between the OK and AOK groups.

Conclusion

In slowing the axial elongation, 0.01% atropine alone and OK alone have similar effects, while AOK is more effective than OK alone in slowing down the axial elongation. Furthermore, the baseline degree of myopia and treatment duration may affect changes in axial elongation.
Primary health care utilization in the first year after arrival by refugee sponsorship model in Ontario, Canada: A population-based cohort study
Authors: Wanigaratne Susitha , Rayner Jennifer , Glazier Richard H. , Stukel Therese A. , Lu Hong , Gandhi Sima , Saunders Natasha R. , Hynie Michaela , Kilibarda Anja , Guttmann Astrid
Published: July 2023

Background

Canada’s approach to refugee resettlement includes government sponsorship, a pioneering private sponsorship model and a third blended approach. Refugees are selected and supported differently in each approach including healthcare navigation. Little is known about how well private sponsors facilitate primary care navigation and whether this changed during the large-scale 2015 Syrian resettlement initiative characterized by civic and healthcare systems engagement.

Methods and findings

Population-based cohort study of resettled refugees arriving in Ontario between April 1, 2008 and March 31, 2017, with one-year follow-up, using linked health and demographic administrative databases. We evaluated associations of resettlement model (GARs, Privately Sponsored Refugees [PSRs], and Blended-Visa Office Referred [BVORs]) by era of arrival (pre-Syrian and Syrian era) and by country cohort, on measures of primary care (PC) navigation using adjusted Cox proportional hazards and logistic regression. There were 34,591 (pre-Syrian) and 24,757 (Syrian era) resettled refugees, approximately half of whom were GARs. Compared with the reference group pre-Syrian era PSRs, Syrian PSRs had slightly earlier PC visits (mean = 116 days [SD = 90]) (adjusted hazard ratios [aHR] = 1.19, 95% CI 1.14–1.23). Syrian GARs (mean = 72 days [SD = 65]) and BVORs (mean = 73 days [SD = 76]) had their first PC visit sooner than pre-Syrian era PSRs (mean = 149 days [SD = 86]), with respective aHRs 2.27, 95% CI 2.19–2.35 and 1.89, 95% CI 1.79–1.99. Compared to pre-Syrian PSRs, Syrian GARs and BVORs had much greater odds of a CHC visit (adjusted odds ratios 14.69, 95% CI 12.98–16.63 and 14.08, 95% 12.05–16.44 respectively) and Syrian PSRs had twice the odds of a CHC visit.

Conclusions

Less timely primary care and lower odds of a CHC visit among PSRs in the first year may be attributed to selection factors and gaps in sponsors’ knowledge of healthcare navigation. Improved primary care navigation outcomes in the Syrian era suggests successful health systems engagement.