bluuebunny/crossref_metadata_2025 huggingface dataset:
Cost‐effectiveness of treating all hepatitis B–positive individuals in the United States
Authors: Razavi‐Shearer Devin , Estes Chris , Gamkrelidze Ivane , Razavi Homie
Published: June 2023

Chronic hepatitis B virus (HBV) infection is a leading cause of liver disease and related mortality globally. However, most of the infected individuals in the United States remain undiagnosed and untreated. There is a need to understand more completely the economic and disease burden impact of removing treatment restrictions and increasing diagnosis and treatment. The PRoGReSs model, a dynamic HBV model that tracks the infected population by year, disease stage, and gender, was used to quantify the disease and economic burden of chronic HBV infection in the United States from 2020 to 2050 based on four scenarios: a status quo (base) scenario and three treat‐all scenarios, in which screening, diagnosis, and treatment were maximized at different annual treatment price levels of $5382, $2000 and $750. Compared to the base scenario, the treat‐all scenarios would avert 71,100 acute and 11,100 chronic incident cases of HBV, and 169,000 liver‐related deaths from 2020 to 2050. At an annual treatment cost of $2000, treating all HBV infections would be highly cost‐effective, and at $750 would be cost saving and would achieve a positive return on investment before 2050. Maximizing the diagnosed and treated HBV population in the United States would avert a significant number of cases of advanced liver disease and related mortality. Such interventions can also be cost‐effective compared to the status quo strategy, and cost saving at a treatment price threshold of $750 annually, above the current lowest annual treatment cost of $362.
Peeking under the canopy: anomalously short fire‐return intervals alter subalpine forest understory plant communities
Authors: Kiel Nathan G. , Braziunas Kristin H. , Turner Monica G.
Published: June 2023

Climate change is driving changes in disturbance regimes world‐wide. In forests adapted to infrequent, high‐severity fires, recent anomalously short fire‐return intervals (FRIs) have resulted in greatly reduced postfire tree regeneration. However, effects on understory plant communities remain unexplored.

Understory plant communities were sampled in 31 plot pairs across Greater Yellowstone (Wyoming, USA). Each pair included one plot burned at high severity twice in < 30 yr and one plot burned in the same most recent fire but not burned previously for > 125 yr. Understory communities following short‐interval fires were also compared with those following the previous long‐interval fire.

Species capable of growing in drier conditions and in lower vegetation zones became more abundant and regional differences in plant communities declined following short‐interval fire. Dissimilarity between plot pairs increased in mesic settings and decreased with time since fire and postfire winter snowfall. Reduced postfire tree density following short‐interval fire rather than FRI per se affected the occurrence of most plant species.

Anomalously short FRIs altered understory plant communities in space and time, with some indications of community thermophilization and regional homogenization. These and other shifts in understory plant communities may continue with ongoing changes in climate and fire across temperate forests.
The Reliability and Accuracy of the Medial Malleolar Fracture Classification Based on 3D CT Reconstruction
Authors: Lu Hao , Liu Yijun , Xie Wenyong , Liang Hui , Guo Hao , Quan Yuan , Zhang Boyu , Zeng Canjun , Xu Hailin
Published: June 2023

Objective

There is a new medial malleolar fracture classification based on 3D CT reconstruction. However, there is no study assessing the reliability and accuracy of the new classification system and comparison between the new and the classic classification. This study aimed to compare the reliability and accuracy of the medial malleolar fracture classification based on 3D CT reconstruction and the Herscovici classification system.

Methods

We retrospectively analyzed the consecutive ankle fractures in our hospital from January 2013 to September 2020. Five inexperienced and five experienced orthopedic surgeons were included as observers to assess 68 cases with medial malleolar fractures. Ten evaluators classified the cases according to the two classification systems. The reference results of each case were made by the consensus of three senior trauma surgeons. The interobserver reliability, intraobserver reliability, and accuracy were evaluated at an interval of 6 weeks using Fleiss's kappa (κ) statistics.

Results

We found substantial interobserver and intraobserver reliability and 81.4% accuracy for the new classification, which was statistically superior to the Herscovici classification (P < 0.05). The reliability and accuracy of both classifications were similar in inexperienced and experienced groups, except for type III in the new classification. The interobserver reliability of type II was the best (P < 0.05), and the intraobserver reliability of IVc ranked the worst (P < 0.05) in the new classification.

Conclusion

The reliability and accuracy of the new classification are superior to the Herscovici classification. Clinical experiences will not affect the assessment of both classification systems in most instances.
Technical Notes and Clinical Outcomes of Full‐Endoscopic Interbody Fusion Via Transforaminal Approach for Hard Disc Herniations in Thoracolumbar Junction
Authors: Cao Zheng , Li Zhen‐Zhou , Zhao Hong‐Liang , Zhu Jia‐Liang , Hou Shu‐Xun
Published: June 2023

Objective

Obtaining sufficient decompression and solid fusion and avoiding approach‐related injuries simultaneously are still challenging for the treatment of hard disc herniation in thoracolumbar junction. A combined full‐endoscopic decompression and interbody fusion via a transforaminal approach was used to achieve this goal. The purpose of this study was to introduce the technical notes and clinical outcomes of this novel technique.

Methods

Twenty segments of hard disc herniations in the thoracolumbar junction of 14 patients treated with full‐endoscopic interbody fusion via the transforaminal approach between January 2018 and September 2021 were analyzed. The patients were an average age of 43.3 years. Full‐endoscopic interbody fusion and discectomy via the transforaminal approach were performed under local anesthesia, followed by percutaneous pedicle screw system fixation under general anesthesia. Imaging, including magnetic resonance imaging (MRI), computed tomography (CT), and X‐ray, was carried out. MRI was performed on the second day and 3 months postoperatively. CT was performed on the second day, 6 months, and 1 year (as needed) postoperatively. Back and radicular pain, neurological function, and thoracic spine function were scored using a visual analog scale, the Nurick scale, and modified Japanese Orthopaedic Association (mJOA) scale, and the Oswestry disability index at 1 week, 3 months, 6 months, and 1 year postoperatively.

Results

All the operations were successfully completed, and no intraoperative conversion of the surgical methods occurred. Postoperative thoracolumbar junction MRI and CT examinations of all the patients revealed a sufficiently decompressed spinal cord or cauda equina, without any residual compression. At the 1‐year follow‐up, all the surgical segments were fused. Back and radicular pain was relieved in all the patients, and neurological function was restored. The average recovery rate of the mJOA was 72.5%, including seven excellent, five good, and two fair cases. Although dural tears occurred in two cases during the operation, no cerebrospinal fluid leakage or pseudomeningocele occurred during follow‐up. No other surgical complications were noted.

Conclusions

A combined full‐endoscopic decompression and interbody fusion via a transforaminal approach can achieve complete spinal canal decompression and solid interbody fusion with fewer approach‐related injuries. It is a safe and effective minimally invasive spine surgery for treating hard disc herniation in the thoracolumbar junction.
Dorsal root ganglion stimulation for chemotherapy‐induced peripheral neuropathy
Authors: Ege Eliana , Briggi Daniel , Mach Steven , Huh Billy K. , Javed Saba
Published: June 2023

Background

Chemotherapy‐induced peripheral neuropathy (CIPN) is a common consequence of cancer treatment that can be persistent and difficult to manage. Dorsal root ganglion stimulation (DRG‐S) is a recently introduced but understudied treatment modality. This study explored the effect of DRG‐S on pain and symptom burden associated with CIPN.

Methods

Patients with CIPN who underwent a DRG‐S trial between January 2017 and August 2022 were identified through chart review after IRB approval was obtained. Demographic data, procedure details, pre‐and postoperative scores, including the Numerical Rating Scale (NRS) and Edmonton Symptom Assessment System (ESAS), and duration of follow‐up were recorded. Statistical analysis included descriptive statistics and paired t‐tests to compare pre‐and postoperative scores.

Results

Nine patients with an even mix of solid and hematologic malignancies underwent DRG‐S trial and had a statistically significant decrease in NRS scores, with a mean reduction of 2.3 in their average pain (p = 0.014), 2.6 in worst pain (p = 0.023), and 2.1 in least pain (p = 0.018). Eight patients (88.9%) underwent permanent DRG‐S implantation. Mean NRS scores remained lower than preoperative baselines through the first year of follow‐up. Statistically significant reductions were noted at 3 months in average (2.1, p = 0.006) and least pain scores (1.9, p = 0.045), which further decreased after 6–12 months (average: 3.6, p = 0.049; least: 3.4, p = 0.023). Only the pain component of ESAS scores showed a significant reduction with DRG‐S (2.0, p = 0.021). All patients endorsed improved sensation, 75% decreased their pain medication usage, and 37.5% reported complete pain relief by 2 years.

Conclusion

Dorsal root ganglion stimulation can be an effective treatment for pain related to CIPN and deserves further investigation.
Risk tolerance as a complementary concept to risk perception of natural hazards: A conceptual review and application
Authors: Anderson Carl C. , Moure Mar , Demski Christina , Renaud Fabrice G.
Published: June 2023

There is a longstanding assumption that if people perceive a risk as high, they will act to reduce it. In fact, research has shown a lack of consistently strong causal relations between risk perception (RP) and mitigative behavior—the so‐called “risk perception paradox.” Despite a recent increase in research on RP, individuals’ risk tolerance (RT; or demand for risk reduction) only rarely appears as a consideration for explaining behavioral response to natural hazards. To address this research gap, we first systematically review relevant literature and find that RT has been directly assessed or operationalized using perceived thresholds related to costs and benefits of risk reduction measures, risk consequences, hazard characteristics, behavioral responses, or affective reactions. It is either considered a component or a result of RP. We then use survey data of individuals’ RP, RT, and behavioral intention to assess relations among these variables. Comparing across three European study sites, “behavioral intention” is assessed as the public's willingness to actively support the implementation of nature‐based solutions to reduce disaster risk. A series of tests using regression models shows RT significantly explains variance in behavioral intention and significantly contributes additional explanatory power beyond RP in all three sites. In two sites, RT is also a significant partial mediator of the relation between RP and behavior. Taken together, our findings demand further conceptual and empirical research on individuals’ RT and its systematic consideration as a determinant for (in)action in response to natural hazards.
Hematopoietic stem‐cell transplantation in a zoo of multidrug‐resistant organisms: Data from a cancer center in eastern India
Authors: Ghosh Shouriyo , Bhattacharya Sanjay , Goel Gaurav , Deshmukh Rasika Avinash , Javed Rizwan , Roychowdhury Mita , Sinha Subir , De Maitrayee Sarkar , Nag Arijit , Kumar Jeevan , Bhave Saurabh Jayant , Nair Reena , Chandy Mammen
Published: June 2023

Background

Infections by multidrug‐resistant organisms (MDRO) are a major hurdle in hematopoietic stem‐cell transplants (HSCTs). Conditioning regimens lead to mucosal barrier injury, which in‐turn leads to transmigration of gut bacteria and sepsis. Pre‐transplant stool and throat surveillance cultures can guide empirical antibiotic policy during the neutropenic period. In this paper, we document colonization with MDRO in pre‐transplant surveillance cultures and the correlation with bloodstream infections in HSCT patients and analyze transplant outcomes with respect to these infections.

Methods

A single‐center, retrospective study on HSCT was performed between January 2021 and December 2021. The incidence of bacterial infections, percentage of MDROs, correlation with pre‐transplant stool/throat surveillance cultures, and their impact on overall 100‐day and post‐100‐day to 6‐month post‐transplant survival were analyzed.

Results

Sixty‐four patients were included in the study. Pre‐transplant stool surveillance cultures were positive for MDRO in 85.9% of patients. Almost half (48.5%) of the isolates were positive for carbapenemase‐producing genes (mainly New Delhi metallo‐beta‐lactamase‐1 [NDM‐1] and oxacillinase‐48 [OXA‐48]). Eighteen patients (18/64, 28%) had a positive blood culture for MDRO in the peri‐engraftment neutropenic period. Correlation between surveillance and blood cultures was seen in 61% (11/18) of patients. All‐cause mortality was 14.1% (9/64) and 25% (16/64) in patients at 100 days and 6 months post‐HSCT, respectively. The 100‐day and post‐100‐day all‐cause mortality rates were higher in patients with Gram‐negative MDRO bloodstream infections (p < .012 and <.008, respectively).

Conclusion

MDRO infections can adversely affect HSCT outcomes. Pre‐transplant stool and throat surveillance cultures may guide empirical antibiotic policy and lead to favorable transplant outcomes.

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Serological screening for tick‐borne encephalitis virus in eight Norwegian herds of semi‐domesticated reindeer (Rangifer tarandus tarandus)
Authors: Lamsal Alaka , Tryland Morten , Paulsen Katrine M. , Romano Javier Sánchez , Nymo Ingebjørg H. , Stiasny Karin , Soleng Arnulf , Vikse Rose , Andreassen Åshild K.
Published: June 2023

Tick‐borne encephalitis virus (TBEV) is found in Ixodes ricinus ticks throughout the area where viable tick populations exist. In Norway, TBEV is found in I. ricinus from the south coast until Brønnøy municipality in Nordland County and the range of the vector is expanding due to changes in climate, vegetation, host animals and environmental conditions. TBEV might thus have the potential to establish in new areas when I. ricinus expand its geographical distribution. At present, there is little knowledge on the status of the virus in high‐altitude areas of inland regions in Norway. It has previously been indicated that reindeer may be an important sentinel species and indicator of the spread of ticks and TBEV in high‐altitude regions. In this study, 408 semi‐domesticated Eurasian tundra reindeer (Rangifer tarandus tarandus) from eight herds, from Tana in Troms and Finnmark County in northern Norway to Filefjell in Innlandet and Viken Counties in southern Norway, were screened for TBEV antibodies using a commercial enzyme‐linked immunosorbent assay (ELISA). We found 16 TBEV reactive reindeer samples by ELISA; however, these results could not be confirmed by the serum neutralization test (SNT). This could indicate that a flavivirusand not necessarily TBEV, may be circulating among Norwegian semi‐domesticated reindeer. The results also indicate that TBEV was not enzootic in Norwegian semi‐domesticated reindeer in 2013–2015. This knowledge is important as an information base for future TBEV and flavivirus surveillance in Norway.
EXPLORING HUMAN-ERROR FACTORS CONTRIBUTING TO MOTORCYCLE ACCIDENTS IN HANOI CITY USING GREY RELATIONAL ANALYSIS
Authors: Trung Nguyen Chi , Xuan Can Vuong , Trong Thuat Vu
Published: June 2023

Along with the development of the economy and society and the speedy increasing number of personal vehicles, especially motorcycles, many cities in developing countries like Hanoi (Vietnam) are facing many transportation problems, notably traffic accidents involving motorcyclists.  Motorcycle accidents are caused by main human-error factors, and could be considered as the typical grey system with the features of complexity and imperfect information. In this study, a grey relational analysis (GRA) model of the human-error factors is presented to quickly explore the main human-error factors contributing to traffic accidents caused by motorcycles. In this model, the grey relational degree and the grey relational order of each human-error factor also are determined to rank the main contributing human-error factors. Taking the data of road traffic accidents caused by motorcycles in Hanoi, the capital of Vietnam between 2015 and 2017 as experimental data, the grey relational degrees of human-error factors have been analyzed quantitatively through the GRA model. The experimental results show the first three human-error factors include wrong lane shifting, poor road observation, and speeding, respectively. The results also help to conduct effective countermeasures for controlling human errors and reducing road traffic accidents.
ROC CURVE ANALYSIS OF DIFFERENT HYBRID FEATURE DESCRIPTORS USING MULTI CLASSIFIERS
Authors: Kailasam S. Piramu , Sankari E. Siva , Kumuthini R.
Published: June 2023

Tremendous success of machine learning algorithms at pattern recognition creates interest in new inventions. Machine learning in an era of big data is that significant hierarchical relationships within the data can be discovered algorithmically than other handcraft like features. In this study, Convolutional Neural Network (CNN) is used as feature descriptors in pulmonary malignancy prediction. Various feature descriptors such as Histogram of Oriented Gradient (HOG), Extended Histogram of Oriented Gradient (EXHOG) and Linear Binary Pattern (LBP) descriptors are analyzed with classifiers such as Random Forest (RF), Decision Tree (DT), K-Nearest Neighbour (KNN) and Support Vector Machine (SVM) for Computed Tomography (CT) The phenotype features of pulmonary nodules are important cues for identification. The nodule solidity is an important cue for white blob area identification. The method is analyzed in Lung Image Database Consortium (LIDC) dataset. Receivers Operating Characteristics (ROC) curves show the graphical summaries of detectors performance. It is proved that CNN based feature extraction with SVM classifier works well in pulmonary malignancy prediction.
EVALUATING THE PHYSICAL VULNERABILITY OF PUBLIC SCHOOL BUILDINGS AGAINST FLOODING IN METRO MANILA, PHILIPPINES
Authors: Macuha Richmark
Published: June 2023

Vulnerability analysis has always been an integral part of disaster risk assessment. This study aims to assess the physical vulnerability of public school buildings against flooding. It discusses the vulnerable elements or attributes, the extent of damages incurred during flood events, the damage response, and the future steps that must be taken to increase flood resiliency. The study used empirical data collection using semi-structured interviews to characterize the common types of public schools and to collate the damage responses. Quantity surveying was performed to measure the amount of damages related to different flood depths. Structural damages to public school buildings are not expected for flood heights ranging from ground level up to ten (10) m. However, damages are incurred by building finishes and fixtures. Floors, walls, and septic system are cosmetically damaged. Vulnerable components include wooden elements like doors, cabinets, blackboards and ceiling, and electrical fixtures such as wiring, lighting, outlets, switches, and fire alarm system. Comprehensive vulnerability description of public school buildings were represented as curves of flood depth vs. damage index. The damage ratio decreases as the number of floors increase. Maximum damage to one-story building is 23.6% while at 15.02% for four-story school building. This study is an attempt to promote further research of the subject matter in developing countries towards flood resiliency in the built environment.
COST-BENEFIT ANALYSIS OF USING BIM COMPARED TO TRADITIONAL METHODS IN IRAQ'S PUBLIC CONSTRUCTION PROJECTS
Authors: M. Alsamarraie Mundher , Ghazali Farid
Published: June 2023

The construction procurement process generates significant cost-related issues, such as project delivery delays, budget overruns, and poor quality. Public projects were suffering from bureaucracy and separation in work activities. Building Information Modeling (BIM) has demonstrated the potential for solving these issues. The study aims to investigate and analyze the cost-benefit analysis of using BIM compared to traditional methods in public construction projects in Iraq. Therefore, the study evaluated Multiple case studies of two projects quantitatively and conducted several interviews with 15 experts to determine the cost-benefit of adopting BIM compared to conventional methods. The study investigated the benefits of BIM in construction projects due to the remarkable difference between the two methods. The quantitative data of study findings revealed a significant cost improvement using BIM rather than the traditional method in public projects. To conclude, multi-cultural studies need to assess the projects' performance of large and small entities. Furthermore, this research suggested incorporating BIM adoption in government organizations in a wide range.
PHYSICAL AND MORPHOLOGICAL INVESTIGATION OF THE UTILIZATION OF EXPANDED PERLITE AS FINE AGGREGATE FOR TYPE M STRUCTURAL LIGHTWEIGHT MORTAR
Authors: Guanzon Clarence Rosario , Torrecampo Librea Jesha Faye , Valencia Paolo Sarmiento , Jeresano Camposano Jomar Christian , Abad Caram Rosabelle Louise , Quizon Colegio Karlo Daniel , Tongol Peralta Mathew Harvey
Published: June 2023

The study examined the influence of expanded perlite aggregates (EPA) on mortar properties and whether EPA could replace sand to produce mortar that meets the compressive strength requirement of ASTM Type M mortar. The study involved fabricating mortars wherein sand was substituted by volumes of 20%, 40%, 60%, 80%, and 100% with three types of EPA (EPA A, EPA B, and EPA Coarse). Results showed that EPA-mortars can meet the ASTM compressive strength requirement of 17.2 MPa. The sample attained its greatest compressive strength of 29.19 MPa, which is nearly equal to the control sample strength of 29.42 MPa, upon replacing sand with 60% by volume of EPA A. In comparison to the control mortar density of 2055 kg/m3, Type M EPA mortar density can drop as low as 1422 kg/m3, which is a 30.8% decrease. Additionally, it was observed that EPA microstructure played a role in the resulting mortar compressive strength. Mortars with the highly absorbent EPA Coarse were found to have less compressive strength than mortars that used EPA A, which has a lower capacity for absorption and more intact microstructure.
Massey products and elliptic curves
Authors: Bleher Frauke M. , Chinburg Ted , Gillibert Jean
Published: June 2023

We study the vanishing of Massey products of order at least 3 for absolutely irreducible smooth projective curves over a field with coefficients in . We mainly focus on elliptic curves, for which we obtain a complete characterization of when triple Massey products do not vanish.
Reducing Capital Flight in Africa: Does Regional Financial Integration Matter?
Authors: Mekongo Celestin Balla , Ondoa Henri Atangana , Kenkouo Guy Albert
Published: June 2023

Capital flight continues to be an issue of paramount importance for developing economies, as it deprives them of the funds required for economic takeoff. Hence, this paper aims to analyze the effect of regional financial integration (RFI) on capital flight in Africa. Based on a sample of 23 countries, we specify and estimate an asset demand model of capital flight using a portfolio choice analysis by the system-generalized method of moments for the period 1996-2015. We find two important results. First, the RFI reduces capital flight. This result becomes even more interesting when the quality of governance is considered. Second, structural breaks in the RFI-capital flight relationship explain why the RFI has had a mixed effect on the capital flight over the study period. We recommend that the attractiveness of regional financial services be enhanced concurrently with the standardization of banking and financial regulation in Africa.
Seated-Shot-Put Equipment in Para Athletics—A Review and Presentation of Data From the Tokyo 2020 Paralympic Games
Authors: Holdback Connor J.M. , Ibrahim Rony , Haydon David S. , Pinder Ross A. , Grimshaw Paul N. , Kelso Richard M.
Published: June 2023

This research provides a review of seated shot put alongside new data from the Tokyo 2020 Paralympic Games with the aim to understand the latest trends in equipment within a recently established rule set and how key equipment variables may impact performance for athletes in different classifications. First, a review of the literature found that the throwing pole is a key equipment aid that is not well understood, in part due to limitations in testing design. New data from the 2020 Paralympic Games showed inconsistent trends for the use of the throwing pole among athletes, particularly in transitionary classes (F33–34 and F54–55). A two-way analysis of variance found a main effect of classification on performance (p < .001), as well as an interaction effect between pole use and classification on performance (p < .05). Notably, pole users are seen to perform better than non–pole users in Class F32 (p < .05).
Use of Dual-Task Timed-Up-and-Go Tests for Predicting Falls in Physically Active, Community-Dwelling Older Adults—A Prospective Study
Authors: Tong Yujie , Rong Jifeng , Tian Xiaochun , Wang Yejun , Chen Zhengquan , Adams Roger , Witchalls Jeremy , Waddington Gordon , El-Ansary Doa , Wu Sam , Tirosh Oren , Wu Tao , Han Jia
Published: June 2023

This prospective study aimed to determine which specific mobility tests were the most accurate for predicting falls in physically active older adults living in the community. Seventy-nine physically active older adults who met the American College of Sports Medicine physical activity guidelines volunteered. Participants were assessed and followed up for 12 months. Mobility assessments included the 30-s sit-to-stand test, five times sit-to-stand test, single-task timed-up-and-go test (TUG), motor dual-task TUG (Mot-TUG), and cognitive dual-task TUG (Cog-TUG). Mot-TUG and Cog-TUG performances were moderately correlated with number of falls (r = .359, p < .01 and r = .372, p < .01, respectively). When Mot-TUG, Cog-TUG, or Age were included as fall predictors, discrimination scores represented by the area under the receiver operating characteristic curve (AUC) were AUC (Mot-TUG) = 0.843 (p < .01), AUC (Cog-TUG) = 0.856 (p < .01), and AUC (Age) = 0.734 (p < .05). The cutoff point for Cog-TUG was 10.98 s, with test sensitivity of 1.00 and specificity of 0.66. Fall predictors for different populations may be based on different test methods. Here, the dual-task TUG test more accurately predicted falls in older adults who met American College of Sports Medicine’s physical activity guidelines.
What Is Known From the Published Literature About Yoga Interventions Delivered in Community Settings for Older Adults? A Systematic Scoping Review
Authors: Lee Janet Lok Chun , Xing Jianli , Ho Rainbow Tin Hung
Published: June 2023

In recent years, mind–body exercises have arisen as a popular type of physical exercise among older adults in both Eastern and Western countries. In the last 10 years, yoga has been established as a key physical activity intervention for older adults. Thus, the literature on yoga interventions delivered in community settings for older adults warrants a formal appraisal. This scoping review synthesized information on intervention contents and outcomes and summarized data on attrition, adherence, and adverse events for community health practitioners. In addition, this review used the Template for Intervention Description and Replication and the Population, Intervention, Comparator, Outcome checklist to identify areas of depth and gaps in the literature on yoga interventions.
Effects of Sport Participation on Gait Coordination, Symmetry, and Variability in Older Adults
Authors: Shafizadeh Mohsen , Bonner Stuart , Fraser Jonathan , Parvinpour Shahab , Shabani Mohsen , Barnes Andrew
Published: June 2023

The aim of this study was to compare the interlimb coordination, asymmetry, and variability between older adults who participated in sports (n = 25; age = 72.6 ± 6.46 years) and sedentary older adults (n = 20; age = 70.85 ± 3.82 years). The sport participants were selected from tennis and badminton clubs, whereas the sedentary participants were recruited from local community centers. The participants walked at their preferred speed in a 10-m walkway for 2 min. The interlimb coordination was measured by the phase coordination index. Other walking metrics were speed, cadence, swing time, stance time, double-support time, stride time, and swing time asymmetry. The results showed that the sport participants relative to the sedentary group had better interlimb coordination, higher walking speed and cadence, and less swing time variability. Young older adults also had a better interlimb coordination. In conclusion, the findings of this study showed that long-term participation in sports has some antiaging benefits on gait coordination and symmetry in older adults.
Heart-brain connections: Phenotypic and genetic insights from magnetic resonance images
Authors: Zhao Bingxin , Li Tengfei , Fan Zirui , Yang Yue , Shu Juan , Yang Xiaochen , Wang Xifeng , Luo Tianyou , Tang Jiarui , Xiong Di , Wu Zhenyi , Li Bingxuan , Chen Jie , Shan Yue , Tomlinson Chalmer , Zhu Ziliang , Li Yun , Stein Jason L. , Zhu Hongtu
Published: June 2023

Cardiovascular health interacts with cognitive and mental health in complex ways, yet little is known about the phenotypic and genetic links of heart-brain systems. We quantified heart-brain connections using multiorgan magnetic resonance imaging (MRI) data from more than 40,000 subjects. Heart MRI traits displayed numerous association patterns with brain gray matter morphometry, white matter microstructure, and functional networks. We identified 80 associated genomic loci (
P
< 6.09 × 10
−10
) for heart MRI traits, which shared genetic influences with cardiovascular and brain diseases. Genetic correlations were observed between heart MRI traits and brain-related traits and disorders. Mendelian randomization suggests that heart conditions may causally contribute to brain disorders. Our results advance a multiorgan perspective on human health by revealing heart-brain connections and shared genetic influences.
Phylogenomic analyses provide insights into primate evolution
Authors: Shao Yong , Zhou Long , Li Fang , Zhao Lan , Zhang Bao-Lin , Shao Feng , Chen Jia-Wei , Chen Chun-Yan , Bi Xupeng , Zhuang Xiao-Lin , Zhu Hong-Liang , Hu Jiang , Sun Zongyi , Li Xin , Wang Depeng , Rivas-González Iker , Wang Sheng , Wang Yun-Mei , Chen Wu , Li Gang , Lu Hui-Meng , Liu Yang , Kuderna Lukas F. K. , Farh Kyle Kai-How , Fan Peng-Fei , Yu Li , Li Ming , Liu Zhi-Jin , Tiley George P. , Yoder Anne D. , Roos Christian , Hayakawa Takashi , Marques-Bonet Tomas , Rogers Jeffrey , Stenson Peter D. , Cooper David N. , Schierup Mikkel Heide , Yao Yong-Gang , Zhang Ya-Ping , Wang Wen , Qi Xiao-Guang , Zhang Guojie , Wu Dong-Dong
Published: June 2023

Comparative analysis of primate genomes within a phylogenetic context is essential for understanding the evolution of human genetic architecture and primate diversity. We present such a study of 50 primate species spanning 38 genera and 14 families, including 27 genomes first reported here, with many from previously less well represented groups, the New World monkeys and the Strepsirrhini. Our analyses reveal heterogeneous rates of genomic rearrangement and gene evolution across primate lineages. Thousands of genes under positive selection in different lineages play roles in the nervous, skeletal, and digestive systems and may have contributed to primate innovations and adaptations. Our study reveals that many key genomic innovations occurred in the Simiiformes ancestral node and may have had an impact on the adaptive radiation of the Simiiformes and human evolution.
A functional group–guided approach to aptamers for small molecules
Authors: Yang Kyungae , Mitchell Noelle M. , Banerjee Saswata , Cheng Zhenzhuang , Taylor Steven , Kostic Aleksandra M. , Wong Isabel , Sajjath Sairaj , Zhang Yameng , Stevens Jacob , Mohan Sumit , Landry Donald W. , Worgall Tilla S. , Andrews Anne M. , Stojanovic Milan N.
Published: June 2023

Aptameric receptors are important biosensor components, yet our ability to identify them depends on the target structures. We analyzed the contributions of individual functional groups on small molecules to binding within 27 target-aptamer pairs, identifying potential hindrances to receptor isolation—for example, negative cooperativity between sterically hindered functional groups. To increase the probability of aptamer isolation for important targets, such as leucine and voriconazole, for which multiple previous selection attempts failed, we designed tailored strategies focused on overcoming individual structural barriers to successful selections. This approach enables us to move beyond standardized protocols into functional group–guided searches, relying on sequences common to receptors for targets and their analogs to serve as anchors in regions of vast oligonucleotide spaces wherein useful reagents are likely to be found.
A sinterless, low-temperature route to 3D print nanoscale optical-grade glass
Authors: Bauer J. , Crook C. , Baldacchini T.
Published: June 2023

Three-dimensional (3D) printing of silica glass is dominated by techniques that rely on traditional particle sintering. At the nanoscale, this limits their adoption within microsystem technology, which prevents technological breakthroughs. We introduce the sinterless, two-photon polymerization 3D printing of free-form fused silica nanostructures from a polyhedral oligomeric silsesquioxane (POSS) resin. Contrary to particle-loaded sacrificial binders, our POSS resin itself constitutes a continuous silicon-oxygen molecular network that forms transparent fused silica at only 650°C. This temperature is 500°C lower than the sintering temperatures for fusing discrete silica particles to a continuum, which brings silica 3D printing below the melting points of essential microsystem materials. Simultaneously, we achieve a fourfold resolution enhancement, which enables visible light nanophotonics. By demonstrating excellent optical quality, mechanical resilience, ease of processing, and coverable size scale, our material sets a benchmark for micro– and nano–3D printing of inorganic solids.
Trails to Research: an Inquiry-Based Course Using Zebrafish To Provide Research Experience to Tribal College Students
Authors: Forecki Jennifer , Morales Chelsea , Merzdorf Christa
Published: June 2023

Embryonic development is fascinating to follow and highly engaging and, therefore, lends itself for undergraduate students’ first steps in experimental science. We developed the “Trails to Research” inquiry-based course, which exposes students to life science research using zebrafish as model organism.
A DNA phosphorothioation-based Dnd defense system provides resistance against various phages and is compatible with the Ssp defense system
Authors: Jiang Susu , Chen Ke , Wang Yingying , Zhang Yueying , Tang Yaru , Huang Wanqiu , Xiong Xiaolin , Chen Shi , Chen Chao , Wang Lianrong
Published: June 2023

DndABCDE-catalyzed DNA phosphorothioation (PT), in which the nonbridging oxygen is swapped with a sulfur atom, was first identified in the bacterial genome. Usually, this modification gene cluster is paired with a restriction module consisting of DndF, DndG, and DndH. Although the mechanisms for the antiphage activity conferred by this Dnd-related restriction and modification (R-M) system have been well characterized, several features remain unclear, including the antiphage spectrum and potential interference with DNA methylation. Recently, a novel PT-related R-M system, composed of the modification module SspABCD paired with a single restriction enzyme, SspE, was revealed to be widespread in the bacterial kingdom, which aroused our interest in the interaction between Dnd- and Ssp-based R-M systems. In this study, we discussed the action of Dnd-related R-M systems against phages and demonstrated that the host could benefit from the protection provided by Dnd-related R-M systems against infection by various lytic phages as well as temperate phages. However, this defense barrier would fail against lysogenic phages. Interestingly, DNA methylation, even in the consensus sequence recognized by the Dnd system, could not weaken the restriction efficiency. Finally, we explored the interaction between Dnd- and Ssp-based R-M systems and found that these two systems were compatible. This study not only expands our knowledge of Dnd-associated R-M systems but also reveals a complex interaction between different defense barriers that coexist in the cell.

IMPORTANCE

Recently, we decoded the mechanism of Dnd-related R-M systems against genetic parasites. In the presence of exogenous DNA that lacks PT, the macromolecular machine consisting of DndF, DndG, and DndH undergoes conformational changes to perform DNA binding, translocation, and DNA nicking activities and scavenge the foreign DNA. However, several questions remain unanswered, including questions regarding the antiphage spectrum, potential interference by DNA methylation, and interplay with other PT-dependent R-M systems. Here, we revealed that the host could benefit from Dnd-related R-M systems for a broad range of antiphage activities, regardless of the presence of DNA methylation. Furthermore, we demonstrated that the convergence of Dnd- and Ssp-related R-M systems could confer to the host a stronger antiphage ability through the additive suppression of phage replication. This study not only deepens our understanding of PT-related defense barriers but also expands our knowledge of the arms race between bacteria and their predators.
Tailing growth, neonatal jaundice and anaemia
Authors: Jefferson Lucy , Ramanan Athimalaipet V , Cummins Michelle , Roderick Marion
Published: June 2023

At medical school, there is a phrase to help us remember that common things are common: ‘If you hear hooves think horses, not zebras’. However, zebras do exist, and from time to time in general paediatric and neonatal practice, we will encounter these rare diagnoses, more of which we can now accurately diagnose through the ever-expanding field of genomics. Our case demonstrates how a rare diagnosis can present with common features of growth restriction, jaundice and anaemia. Paediatricians therefore require a high index of suspicion and increasing knowledge of the logistics of genetic testing.
Using coaching skills in paediatric practice: a summary of use and benefits
Authors: Nahabedian Lucine , Nahabedian Noushig
Published: June 2023

This paper sets out the use and benefits of adopting a coaching style of conversation within our everyday practice. Here, we present two case examples within a paediatric setting which applies coaching skills to different contexts to help progress meaningful conversations.
Prevention of venous thromboembolism in patients with cancer
Authors: Guntupalli Saketh R , Spinosa Daniel , Wethington Stephanie , Eskander Ramez , Khorana Alok A
Published: June 2023

Venous thromboembolism (VTE) is a major cause of both morbidity and mortality in patients with cancer. Venous thromboembolism, which includes both deep vein thrombosis and pulmonary embolism, affects a sizable portion of patients with malignancy and can have potentially life threatening complications. Accurate assessment of risk as well as diagnosis and treatment of this process is paramount to preventing death in this high risk population. Various risk models predictive of venous thromboembolism in patients with cancer have been developed, and knowledge of these rubrics is essential for the treating oncologist. Subgroups of particular interest are inpatients receiving chemotherapy, postoperative patients after surgical debulking, and patients undergoing radiotherapy. Numerous newer drugs have become available for the prevention of venous thromboembolism in patients with cancer who are at high risk of developing the disease. These include the class of drugs called direct oral anticoagulants, (DOACs) which do not require the same monitoring that other modalities have previously required and are taken by mouth, preventing the discomfort associated with subcutaneous strategies. The appropriate risk stratification and intervention to prevent venous thromboembolism are vital to the treatment of patients with cancer.
One-stage hip revisions are as good as two-stage surgery to replace infected artificial hips
Authors: Saul Helen , Deeney Brendan , Cassidy Samantha , Kwint Jemma , Blom Ashley
Published: June 2023

The study

Blom AW, Lenguerrand, Strange S, et al. Clinical and cost effectiveness of single stage compared with two stage revision for hip prosthetic joint infection (INFORM): pragmatic, parallel group, open label, randomised controlled trial.
BMJ
2022;379:e071281.

To read the full NIHR Alert, go to:
https://evidence.nihr.ac.uk/alert/one-stage-hip-revisions-are-as-good-as-2-stage-surgery-to-replace-infected-artificial-hips/
Implementation and evaluation of a pilot Match-A-Nurse programme to provide home-based care in Singapore
Authors: Ang Seng Bin , Neo Sylvia , Koh Benedix , Cheng Shu Juan , Tan Irene , Thumboo Julian , Goh Louise Gek Huang , Dhaliwal Satvinder Singh
Published: June 2023

Background

To enable our seniors to age in place and at home, healthcare needs to shift towards delivering care in the community while taking advantage of technology, to enhance the productivity and effectiveness of home-based nursing care. Home-based nursing care is also less expensive, more convenient and as effective as care received in a hospital.

Methods

The pilot Match-A-Nurse programme linked discharged patients from two public hospitals in Singapore requiring home-based nursing care to nurses living or working close to them through a mobile application. Patients’ requests are listed in the application which was developed by adopting a ‘hybrid agile’ framework for nurses to ‘bid’ for jobs. The concept is similar to a taxi booking application. Information on demographics, skills competency, services required, bidding frequency and patient and nurse satisfaction were collected and analysed.

Results

The Match-A-Nurse programme was successfully implemented and was received positively by patients and nurses. Patients were satisfied with the time taken to confirm the visit, the quality of care and would recommend the programme to others. Nurses were also satisfied with the usability of the application and the level of support provided to them. In addition, patient’s information can be readily accessed through the application.

Conclusions

The technical feasibility and practical potential of this programme is evidenced by the nurses’ and patients’ willingness to participate, their satisfaction with the programme and the ability of the prototype mobile application to secure patient documentation, and the adherence of programme to the legal and insurance employment regulations in Singapore.
Cost of surgical treatment for ulnar nerve entrapment in Finland, 2011–2015: a registry-based cost description study
Authors: Hannula Aarni , Miettinen Laura , Lampainen Kaisa , Ryhänen Jorma , Torkki Paulus , Hulkkonen Sina
Published: June 2023

Objectives

The aim of this study was to evaluate the cost of surgical treatment for primary ulnar nerve entrapment (UNE) borne by the public sector in Finland.

Design

Registry-based cost description study.

Setting

Primary and secondary care throughout Finland.

Participants

We identified all the patients diagnosed with primary UNE in the whole population of Finland from 2011 to 2015 from the Care Register for Health Care. From these patients, we identified those who had undergone ulnar nerve release during the year they were diagnosed or the following year.

Interventions

Open ulnar nerve release.

Outcome measures

The primary outcome measure was cost borne by the public sector in 2015 euros. The cost of surgery was based on the diagnosis-related group prices. We calculated the cost of a single visit to a primary care physician, an electroneuromyography examination, a preoperative visit to a hand surgeon and a follow-up appointment by telephone in specialised care for each patient. These unit costs were provided by the Finnish Institute for Health and Welfare and the same costs were used for each patient. We obtained the number of reimbursed sick days and the total amount reimbursed to each patient in euros within the 2 years after diagnosis from the Social Insurance Institution of Finland.

Results

During our study period, approximately 1786 primary UNE diagnoses were made yearly, and on average, 876 (49%) of patients received surgical treatment annually. The surgery-related cost per patient averaged at EUR 1341 (43%) and reimbursed sick leaves at EUR 952 (30%) during this period. The annual cost of surgical treatment for UNE borne by the public sector in Finland varied between EUR 3082 and EUR 3213 per patient.

Conclusions

The average cost of surgical treatment for UNE in Finland was EUR 3140 per patient between 2011 and 2015.
Consideration of sex and gender in European clinical practice guidelines in internal medicine: a systematic review protocol
Authors: Naghipour Awa , Gemander Marcel , Becher Eva , Oertelt-Prigione Sabine
Published: June 2023

Introduction

Clinical practice guidelines (CPGs) are a powerful instrument to ensure evidence-based practice in clinical diagnostics and disease management. As knowledge about the impact of sex and gender on health and disease is emerging, the need for its transfer into clinical practice is becoming more urgent. However, a systematic evaluation of the incorporation of sex-related and gender-related knowledge into CPGs in Europe is currently not available. This systematic review will fill this gap. We will analyse the operationalisation of sex and gender in internal medicine CPGs in Europe and the translation of this information into tailored recommendations. The results will offer a baseline assessment to inform prospective sex-sensitive and gender-sensitive guideline development.

Methods and analysis

CPGs published by European internal medicine guidelines will be analysed according to a pre-established analysis framework. CPGs will be identified by a two-step approach, that is, through direct contact with the organisations and by a PubMed search, to ensure capture of all relevant guidelines. Prespecified keywords will be employed to identify the representation of sex-related and gender-related content throughout the CPGs. Structured data will be collected through machine-assisted text mining. Identified texts will then be manually reviewed by two independent coders using a specifically developed checklist.

Ethics and dissemination

This study does not require approval by an ethics board. It will provide an overview of sex and gender considerations in European CPGs in the field of internal medicine regarding the time frame 2012–2022.