bluuebunny/crossref_metadata_2025 huggingface dataset:
Poster 353: Impact of Meniscus and Cartilage Treatment on Return to Sport Following Anterior Cruciate Ligament (ACL) Reconstruction
Authors: McCormick Elle , Maly Connor , Duchman Kyle , An Qiang , Leary Steven , Wolf Brian , Westermann Robert
Published: August 2024

Background:

Anterior cruciate ligament (ACL) tears are a common injury in athletes. ACL tears often occur with other injuries, including cartilaginous injuries. There is a lack of research regarding cartilage treatment on return to sport (RTS) following ACL reconstruction.

Purpose:

To evaluate the impact of meniscus and/or cartilage (meniscus-cartilage) treatment on return to sport (RTS) rates and time to return to sport following ACL reconstruction with hamstring tendon (HT), patellar tendon (BPTB), and quadriceps tendon (QT) grafts.

Methods:

Competitive and recreational athletes between the ages of 13-24 who had an ACL reconstruction between 2010-2022 were included. Activity level, sport, graft type, cartilage treatment, RTS testing result data, and time to RTS were collected. Chi-square statistics and Wilcoxon rank sum tests were used, and statistical significance was set to p<0.05.

Results:

There were 855 total patients with 354 HT, 361 BPTB, and 140 QT grafts of which 275 did not have meniscus-cartilage treatment and 580 received meniscus-cartilage treatment. Females comprised 52% of ACL reconstructions without meniscus-cartilage treatment and 42% of ACL reconstructions with meniscus-cartilage treatment. The median age was 18 and 17 for those receiving meniscus-cartilage treatment and those without treatment, respectively. Median time to RTS was 27.86 weeks for 151 patients without meniscus-cartilage treatment and 30.49 weeks for 299 patients receiving meniscus cartilage-treatment (p=0.0253). The median 6-meter timed hop ratio was 1.01 for 21 athletes with meniscus-cartilage treatment and 0.965 for 12 athletes without meniscus-cartilage treatment (p=0.0492). Median isokinetic quadriceps testing at 300 degrees per second was 85% of the contralateral leg for 170 athletes with meniscus-cartilage treatment and 85% for 67 athletes without meniscus-cartilage treatment (p=0.7181). Return to previous level of play occurred in 91/104 (87.5%) of those without meniscus-cartilage treatment and 196/220 (89%) of those with meniscus-cartilage treatment (p=0.6742). ACL and non-ACL reinjuries occurred in 18% (49/272) of those without and 20% (118/577) of those with meniscus-cartilage treatment (p=0.4047).

Conclusions:

Time to clearance to return to sport occurred more quickly in those without meniscus-cartilage treatment. Six-meter timed hop testing results were superior in those receiving meniscus-cartilage treatment. This study will aid orthopaedic surgeons and their athletes while addressing common concomitant injuries during ACL reconstruction.
Poster 355: A Novel Methodology for Establishing Recommended Threshold Values for MCID, SCB, and PASS for PROMs following ACL Reconstruction
Authors: Yendluri Avanish , Chiang Joshua , Lee Alexander , Parisien Robert
Published: August 2024

Objectives:

An abundance of patient reported outcome measure (PROM) thresholds following ACL reconstruction (ACLR) exist in literature. This frustrates efforts to standardize measures like minimal clinically important difference (MCID), substantial clinical benefit (SCB), and patient acceptable symptom state (PASS). While our earlier study identified the most commonly cited threshold values, this paper examines their underlying methodology. We identify the most robust studies from our systematic review, presenting their International Knee Documentation Committee Subjective Knee Form (IKDC) and Knee injury and Osteoarthritis Outcome Score (KOOS) thresholds and calculation methods.

Methods:

Our systematic review evaluated 42 studies from PubMed, Embase, Medline, Google Scholar, and Cochrane reporting MCID, SCB, and PASS thresholds after ACLR between January 1st, 2000 – June 30th, 2022. We extracted each publication’s methodology, noting if it calculated new thresholds or cited existing values. For studies deriving new values, we determined if they used anchor or distribution-based methods. For studies citing existing thresholds from publications not present in our systematic review, we identified the source texts, assessed them using the same criteria as the systematic review (but allowed non-ACLR studies), and included them in our evaluation. We then ranked the literature according to a predetermined hierarchy, prioritizing anchored studies, receiver operating characteristic (ROC) analyses, and those with higher levels of evidence.

Results:

IKDC and KOOS subscales represented 63% of reported MCID, 70% of SCB, and 94% of PASS thresholds (Table 1). Given their overwhelming representation, we only present threshold recommendations for those PROMs. 32 (76%) of studies in our systematic review referenced thresholds in literature and we included 3 frequently cited publications not originally part of the systematic. Our final ranking of thresholds included 14 studies. 9 studies determined thresholds via anchor-based methodologies and 7 used distribution-based techniques. For anchored studies, 7 calculated thresholds using the Youden Index, 1 used Mean Change, and 1 used Predictive Minimal Important Change (MICpred). 4 studies provided sufficient evidence to recommend their threshold: Irrgang 2006 (MCID: IKDC), Muller 2016 (PASS: IKDC and KOOS), Ingelsrud 2018 (MCID: KOOS), and Forlenza 2020 (MCID: KOOS; SCB: IKDC and KOOS). Their thresholds and derivation methods are found in Table 2.

Conclusions:

This study is the first to present recommended MCID, SCB, and PASS values for commonly reported PROMs following ACLR. We recommend relying on threshold values from studies utilizing anchor-based methodologies and ROC analysis. For studies establishing new thresholds, we recommend this technique along with multiple anchor questions, in order to reduce single-selection bias and better stratify response cohorts.
Woo-Hoo! I’m in the Inner Circle: An Experiential Exercise to Illustrate LMX Theory and In-Group/Out-Group Dynamics
Authors: Zare Mortaza , Stauffer Joseph
Published: August 2024

This article discusses how The Inner Circle, an episode of The Office television series, could be used in the classroom to explain leader-member exchange (LMX) theory and in-group/out-group settings in the workplace. LMX is one of the most important theories in the field of leadership. Its focus on the relationship between leader and followers makes it distinct from many other leadership theories. However, undergraduate students without work experience may struggle to see the practical relevance of this theory, finding it abstract. The Inner Circle episode can help instructors illustrate LMX, in-group/out-group settings, and their associated consequences in the workplace. In this article, we share our experience showing this episode in two management classes and provide a breakdown of scenes for instructors interested in using this episode as a supplementary educational tool in their classes.
A LEGO Teamwork Game to Experience Belbin and Tuckman in Real-Time
Authors: Stewart Ian
Published: August 2024

This article presents a LEGO®1-based experiential exercise where students learn about Tuckman team development and Belbin team role theories. The design allows real-time application of the theories through intense, time-constrained construction activity. Students act in teams of workers or watchers. Workers build the model without the instructions that come with the set. This and a few surprises designed into the task create pressure on the team. Or, students act as watchers, systematically observing the worker teams, using the theories to categorize or predict worker behavior. Directly experiencing the theories helps develop a critique of their utility in helping managers predict and influence team behavior. This activity is intended for synchronous classrooms, ideally with class sizes between 6 and 30. As presented here, the activity requires 2 hours, but can be modified to an hour for a smaller class. Scalability of the task depends on availability of LEGO sets, teaching assistants, and time.
Missing topics for a newly established general practice curriculum for medical students in Hesse – a qualitative study
Authors: Kronemann Bibiane , Joson-Teichert Elisabeth , Michiels-Corsten Matthias , Bösner Stefan , Groth Jana
Published: August 2024

Background

To address the declining numbers of general practitioners (GPs) in rural areas and a lack of medical students pursuing a career in primary care, a general practice-based curriculum coupled with additional university admissions for students has been established at three universities in Hesse, Germany. This study aims to analyze potential topics which students striving to become a GP will benefit from. Teaching such topics will prepare them for their chosen career and working in rural areas. We aimed to explore the views of both specialists and GPs on chief topics and necessary skills in primary care.

Methods

In our study we used semi-structured interviews with outpatient specialists and specialists in clinical practice and semi-structured group interviews with GPs in training. The topic guide addressed contents of the curriculum for medical students with an extracurricular focus (addressing additional topics) on primary care. Data analysis was carried out using qualitative content analysis according to Mayring.

Results

GPs in training and specialists agreed on the importance of knowledge in the fields of medical history, physical examination, communication as well as common diseases in primary care. Essential competences mentioned were: inducing medical treatment, decision-making and triage, conducting structured conversations, having patient knowledge (hard skills) as well as an interest in continuous learning, empathy, personal commitment, listening and down-to-earthness (soft skills). Case reports, symptom-based learning, practical training, lessons with simulated patients and the integration of role models were regarded as useful teaching methods.

Conclusions

General practice-based curriculums should not only focus on the transfer of knowledge. Equally important is the training of soft and hard skills to prepare future GPs for their work in primary care. Special teaching methods as well as practical training should be the heart of a newly established curriculum.
Validity of evaluation scales for post-stroke depression: a systematic review and meta-analysis
Authors: Liu Fang , Gong Lei , Zhao Huan , Li Ying-li , Yan Zhiwen , Mu Jun
Published: August 2024

Background

Post-stroke depression (PSD) is closely associated with poor stroke prognosis. However, there are some challenges in identifying and assessing PSD. This study aimed to identify scales for PSD diagnosis, assessment, and follow-up that are straightforward, accurate, efficient, and reproducible.

Methods

A systematic literature search was conducted in 7 electronic databases from January 1985 to December 2023.

Results

Thirty-two studies were included, the Patient Health Questionnaire-9 (PHQ-9) and Hamilton Depression Scale (HDRS) had higher diagnostic accuracy for PSD. The sensitivity, specificity, and diagnostic odds ratio of PHQ-9 or diagnosing any depression were 0.82, 0.87, and 29 respectively. And for HDRS, used for diagnosing major depression, the scores were 0.92, 0.89, and 94. Furthermore, these two scales also had higher diagnostic accuracy in assessing depressive symptoms during both the acute and chronic phases of stroke. In patients with post-stroke aphasia and cognitive impairment, highly diagnostic scales have not been identified for assessing depressive symptoms yet.

Conclusions

The PHQ-9 and HDRS scales are recommended to assess PSD. HDRS, which demonstrates high diagnostic performance, can replace structured interviews based on diagnostic criteria.
Systemic inflammatory response index as a predictor of stroke-associated pneumonia in patients with acute ischemic stroke treated by thrombectomy: a retrospective study
Authors: Zheng Feng , Gao Wen , Xiao Yinfeng , Guo Xiumei , Xiong Yu , Chen Chunhui , Zheng Hanlin , Pan Zhigang , Wang Lingxing , Zheng Shuni , Ke Chuhan , Liu Qiaoling , Liu Aihua , Huang Xinyue , Hu Weipeng
Published: August 2024

Background

The predictive value of systemic inflammatory response index (SIRI) for stroke-associated pneumonia (SAP) risk in patients with acute ischemic stroke (AIS) treated by thrombectomy remains unclear. This study aimed to investigate the predictive value of SIRI for SAP in patients with AIS treated by thrombectomy.

Methods

We included AIS patients treated by thrombectomy between August 2018 and August 2022 at our institute. We used multivariate logistic regression to construct the prediction model and performed a receiver operating characteristic curve analysis to evaluate the ability of SIRI to predict SAP and constructed a calibration curve to evaluate the prediction accuracy of the model. We evaluated the clinical application value of the nomogram using decision curve analysis.

Results

We included 84 eligible patients with AIS in the analysis, among which 56 (66.7%) had SAP. In the univariate analysis, there were significant differences in sex (p = 0.035), National Institute of Health Stroke Scale score at admission ≥ 20 (p = 0.019) and SIRI (p < 0.001). The results of multivariable logistic analysis showed that the risk of SAP increased with the SIRI value (OR = 1.169, 95% CI = 1.049–1.344, p = 0.014). Age ≥ 60 (OR = 4.076, 95% CI = 1.251–14.841, p = 0.024) was also statistically significant. A nomogram with SIRI showed good prediction accuracy for SAP in AIS patients treated by thrombectomy (C-index value = 0.774).

Conclusions

SIRI is an independent predictor for SAP in patients with AIS treated by thrombectomy. A high SIRI value may allow for the early identification of patients with AIS treated by thrombectomy at high risk for SAP.
Evaluating the impact of a trial of labor after cesarean section on labor duration: a retrospective cohort study
Authors: Ooba Hikaru , Maki Jota , Masuyama Hisashi
Published: August 2024

Background

Cesarean section (C-section) rates are increasing globally, and repeated C-sections are associated with increased maternal morbidity. Trial of labor after C-section (TOLAC) is an approach to reduce the recurrence of C-sections. However, limited research exists on the impact of cesarean scars on labor duration in TOLAC, considering the termination of labor through C-section and selection bias. This study aimed to investigate the impact of cesarean scars on labor duration in TOLAC participants, accounting for potential confounding factors and biases.

Methods

This retrospective cohort study included 2,964 women who attempted vaginal birth at a single center in Japan from 2012 to 2021. The study categorized participants into TOLAC (n = 187) and non-TOLAC (n = 2,777) groups. Propensity scores were calculated based on 14 factors that could influence labor duration, and inverse probability of treatment weighting (IPTW) was applied. Cox proportional hazards regression analysis estimated hazard ratios (HRs) for labor duration, with and without IPTW adjustment. Sensitivity analyses used propensity score matching, bootstrapping, and interval censoring to address potential biases, including recall bias in the reported onset of labor.

Results

The unadjusted HR for labor duration in the TOLAC group compared to the non-TOLAC group was 0.83 (95% CI: 0.70–0.98, P = 0.027), indicating a longer labor duration in the TOLAC group. After adjusting for confounding factors using IPTW, the HR was 0.98 (95% CI: 0.74–1.30, P = 0.91), suggesting no significant difference in labor duration between the groups. Sensitivity analyses using propensity score matching, bootstrapping, and interval censoring yielded consistent results. These findings suggested that the apparent association between TOLAC and longer labor duration was because of confounding factors rather than TOLAC itself.

Conclusions

After adjusting for confounding factors and addressing potential biases, cesarean scars had a limited impact on labor duration in TOLAC participants. Maternal and fetal characteristics may have a more substantial influence on labor duration.
The Spinal Instability Neoplastic Score correlates with epidural spinal cord compression -a retrospective cohort of 256 surgically treated patients with spinal metastases
Authors: Bobinski Lukas , Axelsson Joel , Melhus Jonathan , Åkerstedt Josefin , Wänman Johan
Published: August 2024

Background

Bone metastases can compromise the integrity of the spinal canal and cause epidural spinal cord compression (ESCC). The Spinal Instability Neoplastic Score (SINS) was developed in order to evaluate spinal instability due to a neoplastic process. The SINS has reached wide acceptance among clinicans but its prognostic value is still controversial. The aim was to investigate the correlation between the SINS and ESCC and the association between SINS and ambulation before and survival after surgery.

Methods

Correlations were assessed between SINS and grades of ESCC in patients who underwent spine surgery for spinal metastases. CT and MRI were used to calculate SINS and the grades of ESCC respectively. Correlations were analyzed with the Spearman’s correlation test. Postoperative survival was estimated with Kaplan-Meier analysis and survival curves were compared with the log-rank test. The Cox proportional hazard model was used to assess the effect of prognostic variables including age, ambulation before surgery, SINS, and the Karnofsky Performance Status (KPS) as covariates.

Results

The study included 256 patients (196 men and 60 women) with a median age of 70 (24–88) years. The mean SINS was 10. One hundred fifty-two patients (59%) had lost ambulation before surgery. One hundred and one patients had grades 0–2 and 155 patients had grade 3 according to the ESCC-scale. SINS correlated with the grades of ESCC (p = 0.001). The SINS score was not associated with ambulation before surgery (p = 0.63). The median postoperative survival was 10 months, and there was no difference in postoperative survival between the SINS categories (p = 0.25). The ability to walk before surgery and a high KPS were associated with longer postoperative survival.

Conclusion

SINS correlated with grades of ESCC, which implies that higher SINS may be considered as an indicator of risk for developing ESCC. The SINS was not associated with ambulation before or survival after surgery.
Mandibular biomechanics rehabilitated with different prosthetic restorations under normal and impact loading scenarios
Authors: Shash Yomna H.
Published: August 2024

Background

Restorative treatment options for edentulous patients range from traditional dentures to fixed restorations. The proper selection of materials greatly influences the longevity and stability of fixed restorations. Most prosthetic parts are frequently fabricated from titanium. Ceramics (e.g. zirconia) and polymers (e.g. PEEK and BIOHPP) have recently been included in these fabrications. The mandibular movement produces complex patterns of stress and strain. Mandibular fractures may result from these stresses and strains exceeding the critical limits because of the impact force from falls or accidents. Therefore, it is necessary to evaluate the biomechanical behavior of the edentulous mandible with different restorations under different loading situations.

Objective

This study analyzes the biomechanical behavior of mandibles after four prosthetic restorations for rehabilitation under normal and impact loading scenarios.

Material and Methods

The mandibular model was constructed with a fixed restoration, which was simulated using various materials (e.g. Titanium, Zirconia & BIOHPP), under frontal bite force, maximum intercuspation, and chin impact force. From the extraction of tensile and compressive stresses and strains, as well as the total deformation of mandible segments, the biomechanical behavior and clinical situations were studied.

Results

Under frontal bite, the anterior body exhibited the highest tensile (60.34 MPa) and compressive (108.81 MPa) stresses using restoration 4, while the condyles and angles had the lowest tensile (7.12 MPa) and compressive (12.67 MPa) stresses using restoration 3. Under maximum intercuspation, the highest tensile (40.02 MPa) and compressive (98.87 MPa) stresses were generated on the anterior body of the cortical bone using restoration 4. Additionally, the lowest tensile (7.7 MPa) and compressive (10.08 MPa) stresses were generated on the condyles and angles, respectively, using restoration 3. Under chin impact, the highest tensile (374.57 MPa) and compressive (387.3 MPa) stresses were generated on the anterior body using restoration 4. Additionally, the lowest tensile (0.65 MPa) and compressive (0.57 MPa) stresses were generated on the coronoid processes using restoration 3. For all loading scenarios, the anterior body of the mandible had the highest stress and strain values compared with the other segments. Compared to the traditional titanium restoration.2, restoration.1(zirconia) increases the tensile and compressive stresses and strains on the mandibular segments, in contrast to restoration.3 (BIOHPP). In addition, zirconia implants exhibited higher displacements than the other implants.

Conclusion

In the normal loading scenario, the tensile and compressive stresses and strains on the mandible were within the allowable limits when all restorations were used. Under the chin impact loading scenario, the anterior body of the mandible was damaged by restorations 1 and 4.
Nurturing ethical insight: exploring nursing students’ journey to ethical competence
Authors: Hansen Sylvia , Hessevaagbakke Elisabeth , Lindeflaten Katrin , Elvan Kaja , Lillekroken Daniela
Published: August 2024

Background

Ethical competence is a key competence in nursing and the development of the competence is a central part in nursing education. During clinical studies, nursing students face ethical problems that require them to apply and develop their ethical knowledge and skills. Little is known about how ethical competence evolves during students’ initial clinical placements. This study explored the development of ethical competence in first-year nursing students during their first clinical placements in nursing homes.

Methods

This exploratory-descriptive qualitative study used focus group interviews to collect data and a phenomenological hermeneutical method for analysis. Twenty-eight first-year nursing students participated in six focus groups. The data were collected between March and April 2024 at Oslo Metropolitan University in Norway.

Results

The naïve reading of the data involved an awareness of the students applying their prior knowledge, modifying their prior knowledge and developing skills that allowed them to manoeuvre ethical practices that, in some cases, appeared excellent and, in other cases, grim. The structural analysis identified three themes: (i) ethical competence forges in practice, (ii) ethical competence evolves at the intersection of knowledge and skills and (iii) ethical competence unfolds through meaningful discussions. A comprehensive understanding of the data was formulated as ‘Being on a journey towards ethical competence’. This presents a metaphor illustrating that nursing students embark on a journey towards ethical competence; from their point of departure, their clinical experiences forge the essential waypoints along their path, knowledge and skills fuelling their navigation in rugged terrain towards their destination.

Conclusions

Nursing students’ ethical competence evolved in intricate ways during their initial clinical period. Being informed bystanders or participants in the care of nursing home residents in situations of ethical tension may be a unique position enabling students to evaluate care options differently from those immersed in the ward culture. The findings indicate that organised professional development in nursing homes needs to focus on more reflexively driven ways of supervising students in their first clinical study period. Educational institutions need to continue and further develop reflection-based learning activities and meeting points with students and their peers during their clinical placement periods.
Chronic kidney disease: detect, diagnose, disclose—a UK primary care perspective of barriers and enablers to effective kidney care
Authors: Stewart Stuart , Kalra Philip A. , Blakeman Tom , Kontopantelis Evangelos , Cranmer-Gordon Howard , Sinha Smeeta
Published: August 2024

Chronic kidney disease (CKD) is a global public health problem with major human and economic consequences. Despite advances in clinical guidelines, classification systems and evidence-based treatments, CKD remains underdiagnosed and undertreated and is predicted to be the fifth leading cause of death globally by 2040. This review aims to identify barriers and enablers to the effective detection, diagnosis, disclosure and management of CKD since the introduction of the Kidney Disease Outcomes Quality Initiative (KDOQI) classification in 2002, advocating for a renewed approach in response to updated Kidney Disease: Improving Global Outcomes (KDIGO) 2024 clinical guidelines. The last two decades of improvements in CKD care in the UK are underpinned by international adoption of the KDIGO classification system, mixed adoption of evidence-based treatments and research informed clinical guidelines and policy. Interpretation of evidence within clinical and academic communities has stimulated significant debate of how best to implement such evidence which has frequently fuelled and frustratingly forestalled progress in CKD care. Key enablers of effective CKD care include clinical classification systems (KDIGO), evidence-based treatments, electronic health record tools, financially incentivised care, medical education and policy changes. Barriers to effective CKD care are extensive; key barriers include clinician concerns regarding overdiagnosis, a lack of financially incentivised care in primary care, complex clinical guidelines, managing CKD in the context of multimorbidity, bureaucratic burden in primary care, underutilisation of sodium-glucose co-transporter-2 inhibitor (SGLT2i) medications, insufficient medical education in CKD, and most recently – a sustained disruption to routine CKD care during and after the COVID-19 pandemic. Future CKD care in UK primary care must be informed by lessons of the last two decades. Making step change, over incremental improvements in CKD care at scale requires a renewed approach that addresses key barriers to detection, diagnosis, disclosure and management across traditional boundaries of healthcare, social care, and public health. Improved coding accuracy in primary care, increased use of SGLT2i medications, and risk-based care offer promising, cost-effective avenues to improve patient and population-level kidney health. Financial incentives generally improve achievement of care quality indicators – a review of financial and non-financial incentives in CKD care is urgently needed.
Tree-based ensemble machine learning models in the prediction of acute respiratory distress syndrome following cardiac surgery: a multicenter cohort study
Authors: Zhang Hang , Qian Dewei , Zhang Xiaomiao , Meng Peize , Huang Weiran , Gu Tongtong , Fan Yongliang , Zhang Yi , Wang Yuchen , Yu Min , Yuan Zhongxiang , Chen Xin , Zhao Qingnan , Ruan Zheng
Published: August 2024

Background

Acute respiratory distress syndrome (ARDS) after cardiac surgery is a severe respiratory complication with high mortality and morbidity. Traditional clinical approaches may lead to under recognition of this heterogeneous syndrome, potentially resulting in diagnosis delay. This study aims to develop and external validate seven machine learning (ML) models, trained on electronic health records data, for predicting ARDS after cardiac surgery.

Methods

This multicenter, observational cohort study included patients who underwent cardiac surgery in the training and testing cohorts (data from Nanjing First Hospital), as well as those patients who had cardiac surgery in a validation cohort (data from Shanghai General Hospital). The number of important features was determined using the sliding windows sequential forward feature selection method (SWSFS). We developed a set of tree-based ML models, including Decision Tree, GBDT, AdaBoost, XGBoost, LightGBM, Random Forest, and Deep Forest. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC) and Brier score. The SHapley Additive exPlanation (SHAP) techinque was employed to interpret the ML model. Furthermore, a comparison was made between the ML models and traditional scoring systems. ARDS is defined according to the Berlin definition.

Results

A total of 1996 patients who had cardiac surgery were included in the study. The top five important features identified by the SWSFS were chronic obstructive pulmonary disease, preoperative albumin, central venous pressure_T4, cardiopulmonary bypass time, and left ventricular ejection fraction. Among the seven ML models, Deep Forest demonstrated the best performance, with an AUC of 0.882 and a Brier score of 0.809 in the validation cohort. Notably, the SHAP values effectively illustrated the contribution of the 13 features attributed to the model output and the individual feature's effect on model prediction. In addition, the ensemble ML models demonstrated better performance than the other six traditional scoring systems.

Conclusions

Our study identified 13 important features and provided multiple ML models to enhance the risk stratification for ARDS after cardiac surgery. Using these predictors and ML models might provide a basis for early diagnostic and preventive strategies in the perioperative management of ARDS patients.
In sickness and health - a questionnaire based study regarding immune mediated diseases and neoplasia in Swedish Nova Scotia Duck Tolling Retrievers
Authors: Nilsson Malin , Kozyrev Sergey V. , Lindblad-Toh Kerstin , Rönnberg Henrik , Hansson-Hamlin Helene
Published: August 2024

Background

The Nova Scotia Duck Tolling Retriever (NSDTR) has previously been highlighted as a breed at risk for developing immune mediated diseases and cancer. The immune response is of great importance for the development of neoplastic disease and a dysregulated immune response may predispose to cancer. Two of the commonly seen immune mediated diseases in NSDTRs are immune mediated rheumatic disease (IMRD), which bears similarities to systemic lupus erythematosus (SLE) affecting humans, and steroid-responsive meningitis-arteritis (SRMA), which is a non-infectious inflammation of the meninges and the leptomeningeal vessels. The aim of this survey study was to investigate the lifetime prevalence of immune mediated diseases and tumors among Swedish NSDTRs based on owners’ information. The study design was cross-sectional. A questionnaire was sent to 4102 persons who owned or had previously owned a NSDTR. The questions concerned information about the dog and its overall health status as well as specific diseases.

Results

The response rate was 30%, including 935 live NSDTRs, corresponding to approximately 20% of the current population registered in Sweden (n = 4564), and 177 dead dogs. The surveyed dogs were spread over different ages and sex and corresponded to the typical demographic profile of the general dog population. Of the 935 individuals that were alive, 28 dogs (3%) were reported as previously diagnosed with IMRD and 33 dogs (3.5%) were reported as previously diagnosed with SRMA, one dog was reported to have been diagnosed with both SRMA and IMRD. There were 129 dogs (14%) reported to have or have had a neoplasia of some kind. For the dead dogs (n = 177), almost 40% of the owners reported neoplasia as the main reason for death/euthanasia.

Conclusion

This study reports an estimated lifetime prevalence of IMRD and SRMA, in the studied population of Swedish NSDTRs, of 3.0 and 3.5% respectively. In this study, 14% of the living dogs (n = 935) were reported to have a neoplasia of some kind and almost 40% of the deceased dogs (n = 177) were euthanized due to neoplasia or suspicion of it.
Clinical and preclinical approach in AGA treatment: a review of current and new therapies in the regenerative field
Authors: Pozo-Pérez Lorena , Tornero-Esteban Pilar , López-Bran Eduardo
Published: August 2024

Androgenetic alopecia (AGA) is the most prevalent type of hair loss. Its morbility is mainly psychological although an increased incidence in melanoma has also been observed in affected subjects. Current drug based therapies and physical treatments are either unsuccessful in the long term or have relevant side effects that limit their application. Therefore, a new therapeutic approach is needed to promote regenerative enhancement alternatives. These treatment options, focused on the cellular niche restoration, could be the solution to the impact of dihydrotestosterone in the hair follicle microenvironment. In this context emerging regenerative therapies such as Platelet-rich plasma or Platelet-rich fibrine as well as hair follicle stem cells and mesenchymal stem cell based therapies and their derivatives (conditioned medium CM or exoxomes) are highlighting in the evolving landscape of hair restoration. Nanotechnology is also leading the way in AGA treatment through the design of bioinks and nanobiomaterials whose structures are being configuring in a huge range of cases by means of 3D bioprinting. Due to the increasing number and the rapid creation of new advanced therapies alternatives in the AGA field, an extended review of the current state of art is needed. In addition this review provides a general insight in current and emerging AGA therapies which is intented to be a guidance for researchers highlighting the cutting edge treatments which are recently gaining ground.
Performance of Self-healing Cementitious Mortar with PVA Fiber and SAP
Authors: Kwon Sukmin , Lee Sugyu , Kang Hyunuk , Kim Min Kyoung , Her Sungwun , Bae Sungchul , Kim Dong Joo , Moon Juhyuk
Published: August 2024

Although concrete materials generally exhibit outstanding mechanical properties, it is susceptible against crack formation. It has been reported that narrow cracks (≤ 150 µm) could be naturally sealed in the cement matrix by externally supplied water-induced hydration. However, the crack width of larger than 150 µm is difficult to be sealed without using additional self-healing admixture. In this study, the self-healing cementitious mortar was successfully developed by using a combination of polyvinyl alcohol (PVA) fiber and superabsorbent polymer (SAP), aiming to heal the wide cracks. Although the mechanical properties were slightly reduced, it shows outstanding self-healing performance by using the dual admixtures. A self-healing rate of 60% was observed in the control sample with an initial crack width of 300 µm, while a self-healing rate of nearly 100% was confirmed with suitable SAP and PVA. In addition, it was confirmed that lower hydration degree of self-healing mortar in early stage contributes to the enhanced self-healing performance of developed composite system by internally supplied water from SAP.
Enhancement of the hygrothermal ageing properties of gelatine films by ethylene glycol diglycidyl ether
Authors: Liu Jiaojiao , Dong Wenqiang , Yang Junchang , Chen Zhongwei , Cao Jing , Chen Ran
Published: August 2024

Owing to the instability of gelatine in hygrothermal environments, gelatine-based cultural heritage undergo various deterioration processes, such as cracking, peeling, warping, curling and fracture, posing significant threats to its long-term preservation. Building on previous research, this study investigates the stability of polyol glycidyl ether–gelatine composite films under high-humidity and high-temperature conditions using ethylene glycol diglycidyl ether (EGDE) as a model compound. The hygrothermal ageing properties of EGDE–gelatine composite films are evaluated in terms of macrosize, mesoscopic structure, surface properties and mechanical properties. Results indicate that EGDE enhances the dimensional stability and swelling ratios of the composite films, stabilizes the pore structure and distribution and maintains the hydrophilicity and molecular structural stability under hygrothermal ageing conditions. Furthermore, the incorporation of EGDE leads to superior stress–strain properties of the composite films in such challenging environments. This study provides valuable experimental data for the preparation and conservation applications of gelatine-based cultural heritage materials.
Combining evolutionary computation with machine learning technique for improved short-term prediction of UT1-UTC and length-of-day
Authors: Dhar Sujata , Heinkelmann Robert , Belda Santiago , Modiri Sadegh , Schuh Harald , Guessoum Sonia , Ferrándiz José Manuel , Balasubramanian Nagarajan , Dikshit Onkar
Published: August 2024

Over the years, prediction techniques for the highly variable angular velocity of the Earth represented by Earth's rotation (UT1-UTC) and length-of-day (LOD) have been continuously improved. This is because many applications like navigation, astronomy, space exploration, climate studies, timekeeping, disaster monitoring, and geodynamic studies, all rely on predictions of these Earth rotation parameters. They provide early warning of changes in the Earth's rotation, allowing various industries and scientific fields to operate more precisely and efficiently. Thus, in our study, we focused on short-term prediction for UT1-UTC (dUT1) and LOD. Our prediction approach is to combine machine learning (ML) technique with efficient evolutionary computation (EC) algorithms to achieve reliable and improved predictions. Gaussian process regression (GPR) is used as the ML technique with genetic algorithm (GA) as the EC algorithm. GA is used for hyperparameter optimization of GPR model as selecting appropriate values for hyperparameter are essential to ensure that the prediction model can accurately capture the underlying patterns in the data. We conducted some experiments with our prediction approach to thoroughly test its capabilities. Moreover, two forecasting strategies were used to assess the performance in both hindcast and operational settings. In most of the experiments, the data used are the multi-technique combinations (C04) generated by International Earth Rotation and Reference Systems Service (IERS). In one of the experiments, we also investigated the performance of our prediction model on dUT1 and LOD from four different products obtained from IERS EOP 20 C04, DTRF20, JTRF20 and USNO. The prediction products are evaluated with real estimates of the EOP product with which the model is trained. The combined excitations of the atmosphere, oceans, hydrology, and sea level (AAM + OAM + HAM + SLAM) are used as predictors because they are highly correlated to the input data. The results depict the highest performance of 0.412 ms in dUT1 and 0.092 ms/day in LOD, on day 10 of predictions. It is worth noting that the later predictions were obtained by incorporating the uncertainty of the input data as weights in the prediction model, which was a novel approach tested in this study.

Graphical Abstract
Functional integration of services during the antenatal period can potentially improve childhood growth parameters beyond infancy: findings from a post-interventional follow-up study in West Bengal, India
Authors: Mehta Kayur , Mukherjee Sreeparna Ghosh , Bhattacharjee Ipsita , Fate Kassandra , Kachwaha Shivani , Rajeev Tushara , Kant Aastha , Banerjee Meghendra , Shet Anita
Published: August 2024

Background

Despite progress, the prevalence of childhood undernutrition in India remains amongst the highest globally.

Objective

We aimed to evaluate the impact of a functional integration interventional package during the antenatal period on childhood growth parameters.

Methods

This is a post-interventional follow-up study of a maternal nutrition interventional study conducted between 2018 and 2019 among women in their first trimester of pregnancy from three districts in West Bengal, India. Pregnant women received a package of augmented interventions from study staff which supplemented those provided to them under the state-run programmes, that included body-mass-index measurement at pregnancy registration, monthly weight monitoring, targeted dietary counselling, supervised supplementary nutrition intake and iron-folic acid supplementation during daily anganwadi center visits. In the current follow-up study conducted in 2021, age-matched pregnant women from the same areas who were pregnant during the same period as in the original study and had received standard-of-care under the state-run programmes were recruited into a comparison group. Study staff collected data regarding maternal height and serial weights that were recorded at antenatal visits in 2018-19, and birth and infant characteristics. Child height and weight were measured during the follow-up visit in 2021, which were used to calculate the relative risks of stunting, wasting and underweight using generalized linear models, to understand the sustained impact of the intervention beyond infancy. Eight-hundred-nine mother-child dyads (406 intervention; 403 comparison) were followed.

Results

Median age of women in the intervention and comparison group was 23 (IQR 20–25) and 25 (IQR 24–27) years respectively. Median gestational-weight-gain was higher amongst intervention group women (9 vs. 8 kg, p = 0.04). Low-birth-weight prevalence was 29.3% (119/406) and 32.0% (129/403) in the intervention and comparison group. At 12–35 months of age, children born to women in the intervention group had significantly reduced risk of stunting (RR = 0.65, 95% CI 0.44–0.94), wasting (RR = 0.57, 95% CI 0.33–0.97) and underweight (RR = 0.61, 95% CI 0.42–0.88).

Conclusions

These results indicate that functional integration and strengthening of routine antenatal care services including targeted nutritional counselling to expectant mothers can have distal beneficial effects on childhood undernutrition beyond the immediate post-natal period.
The role of flexible bronchoscope in the evaluation of chronic cough with and without wheeze in children
Authors: M.Elniny Ahmed , Razik Ahmed Mohamed Abdel , A.Abo-Elezz Ahmed , Elmeazawy Rehab , Youssef Amira , Hussein Mahitab Morsy
Published: August 2024

Background

Chronic cough in children is a challenging symptom for clinicians. So, we aimed in this study to evaluate the diagnostic role of flexible bronchoscope in differentiating between the underlying causes of chronic wet cough and chronic cough associated with wheeze.

Methods

This was a prospective cross-sectional study conducted on children referred to Tanta University Hospitals and Ain-Shams University Hospitals between January 2021 and January 2023, presenting with a primary complaint of chronic cough lasting more than 4 weeks. The children were further classified into two groups: the first group included children with chronic wet cough not associated with wheezing (Cohort A) and the second group included children with chronic cough associated with wheezing (Cohort B).

Results

The study enrolled 64 children. During clinical evaluation, 25 (39.1%) children had a chronic cough without wheezing and 39 (60.9%) had a chronic wheezy cough. Bronchoscopic examination findings indicated a notable disparity between the two groups of patients with chronic cough (p=0.006). Among Cohort A patients, the most prevalent bronchoscopic observation was purulent inflammatory secretions in 16 cases (64.0%), followed by congenital airway anomalies in 3 cases (12.0%). Conversely, Cohort B patients exhibited congenital airway anomalies as the primary finding in 14 cases (35.9%), followed by purulent secretions in 7 cases (17.9%).

Conclusion

Flexible bronchoscopy is a valuable and safe tool for diagnosing chronic cough in children. It helped differentiate between the underlying causes of chronic cough in children with and without wheezing.
Unveiling the potential of bacterial isolates from plastic-polluted environments: enhancement of polyhydroxybutyrate biodegradation
Authors: Herrera Diana A. Garza , Mojicevic Marija , Venkatesh Chaitra , Da Silva Pereira E. Henrique , Brennan-Fournet Margaret
Published: August 2024

This study explores the biodegradation potential of microbial isolates focusing on their ability to utilize biopolymers as sole carbon source. Previously described isolates have been investigated through agar-based screen for the ability to degrade plastic-related substrates in powder form, and four strains have been selected for further assessment. Polyhydroxybutyrate (PHB) films degradation was examined through liquid culture, soil burial, and respirometry assays. Structural and chemical alterations in PHB were analysed using scanning electron microscopy (SEM), Fourier-transform infrared spectroscopy (FTIR), and differential scanning calorimetry (DSC). The most successful strains were tested for the ability to degrade PHB/bacterial nanocellulose (BNC) blends. Bacillus sp. DG90 excelled in PHB degradation, achieving 60% weight loss in liquid culture, while Streptomyces sp. DG19 exhibited a notable degradation rate of 51 ± 1.7%. Soil burial assays underscored the impact of environmental factors on degradation rates, emphasizing the role of soil composition and nitrogen availability. In respirometry assay, PHB films were severely defragmented by Streptomyces sp. DG19 with overall weight loss of 83%, while for Bacillus sp. DG90, this percentage reached 39%. FTIR and DSC analyses suggested potential hydrolysis and structural alterations in treated samples. This study observed rapid PHB degradation (83% in 3 weeks) while, considering the complex composition of modern biomaterials, also showcased the potential of examined strains to degrade PHB-BNC blends up to 85%.
SIK2 and SIK3 Differentially Regulate Mouse Granulosa Cell Response to Exogenous Gonadotropins In Vivo
Authors: Hayes Emily T , Hassan Mariam , Lakomy Oliwia , Filzen Rachael , Armouti Marah , Foretz Marc , Tsumaki Noriyuki , Takemori Hiroshi , Stocco Carlos
Published: August 2024

Salt-inducible kinases (SIKs), a family of serine/threonine kinases, were found to be critical determinants of female fertility. SIK2 silencing results in increased ovulatory response to gonadotropins. In contrast, SIK3 knockout results in infertility, gonadotropin insensitivity, and ovaries devoid of antral and preovulatory follicles. This study hypothesizes that SIK2 and SIK3 differentially regulate follicle growth and fertility via contrasting actions in the granulosa cells (GCs), the somatic cells of the follicle. Therefore, SIK2 or SIK3 GC-specific knockdown (SIK2GCKD and SIK3GCKD, respectively) mice were generated by crossing SIK floxed mice with Cyp19a1pII-Cre mice. Fertility studies revealed that pup accumulation over 6 months and the average litter size of SIK2GCKD mice were similar to controls, although in SIK3GCKD mice were significantly lower compared to controls. Compared to controls, gonadotropin stimulation of prepubertal SIK2GCKD mice resulted in significantly higher serum estradiol levels, whereas SIK3GCKD mice produced significantly less estradiol. Cyp11a1, Cyp19a1, and StAR were significantly increased in the GCs of gonadotropin-stimulated SIK2GCKD mice. However, Cyp11a1 and StAR remained significantly lower than controls in SIK3GCKD mice. Interestingly, Cyp19a1 stimulation in SIK3GCKD was not statistically different compared to controls. Superovulation resulted in SIK2GCKD mice ovulating significantly more oocytes, whereas SIK3GCKD mice ovulated significantly fewer oocytes than controls. Remarkably, SIK3GCKD superovulated ovaries contained significantly more preantral follicles than controls. SIK3GCKD ovaries contained significantly more apoptotic cells and fewer proliferating cells than controls. These data point to the differential regulation of GC function and follicle development by SIK2 and SIK3 and supports the therapeutic potential of targeting these kinases for treating infertility or developing new contraceptives.