bluuebunny/crossref_metadata_2025 huggingface dataset:
Geographic accessibility to public dental practices in the Jazan region of Saudi Arabia
Authors: Shubayr Mosa Ali , Kruger Estie , Tennant Marc
Published: June 2022

Background

It is impossible to attain good general health without maintaining oral health and this becomes problematic when dental services are located far from the population that needs to utilise them. This study aimed to assess the geographic accessibility of dental clinics located in public primary healthcare clinics (PHCs) and hospitals in the Jazan region of Saudi Arabia and how long it takes to reach them by car and on foot.

Methods

The location of clinics and hospitals, maps of road systems, and the governorates' borders (administrative areas) within the Jazan region were downloaded using the QGIS mapping tool. The time taken to travel to the clinics and hospitals, either by driving or walking, was assessed. If the time was 30 min or less, residents in the area were classified as ‘serviced’. It was more than 30 min, they were ‘underserved’.

Results

Only 31% of Jazan residents were found to live in a serviced area if they drove to clinics and hospitals. Residents of Jazan's seven mountainous governorates were more likely to require services. Only 40% could drive less than 30 min to a primary health dental clinic. Only 19% of people could walk to a hospital in less than 30 min. Only two governorates had a majority of residents who lived in serviced areas.

Conclusion

The study demonstrates an accessibility issue, as many Jazan inhabitants must drive or walk for an extended period (> 30 min) to reach a healthcare facility, whether a primary health care centre or a hospital. This issue may result in many people not receiving necessary health care, compromising their oral health status. Additional research is needed to identify public, private and other health facilities in the region and the prevalence of oral disease.
Knowledge, perception, and clinical experiences on molar incisor hypomineralization amongst Portuguese dentists
Authors: Delgado Rita Maria , Botelho João , Machado Vanessa , Mendes José João , Lopes Luísa Bandeira
Published: June 2022

Aim

Molar incisor hypomineralization (MIH) is a prevalent oral health condition whose knowledge by dentists is key to the best clinical outcome. This study aimed to evaluate the knowledge, perceptions and clinical experiences of MIH among Portuguese dentists.

Methods

A cross-sectional structured questionnaire was distributed nationally through a web-based survey platform. Data concerning demographic variables, years of experience, dental specialty, MIH prevalence, diagnosis, severity, training demands and clinical management of MIH were collected. We calculated a knowledge score (KS), and compared data between Pediatric Dentists (PDs), General Dental Practitioners (GDPs) and other dental specialties (ODS).

Results

Overall, 2.2% of Portuguese dentists (n = 257) answered the questionnaire. Most participants reported having identified MIH in their practice (82.5%), with PD reporting the prevalence appeared to have increased, and practically all (91.7%) considered it a public health problem. Resin composite was often the used material to restore MIH teeth (56.0%), however PDs indicated glass ionomer cements as the preferred and preformed crowns a better option. The average KS on MIH was 41.3 (± 5.7), with GDPs having a similar score than PDs. Most respondents (94.9%) reported a lack of information about MIH and were willing to receive appropriate clinical training.

Conclusions

The average knowledge on MIH was considered low among Portuguese dentists. Respondents perceived an increased incidence of MIH, despite the lack of prevalence data in Portugal. The material of choice was Glass Ionomer and performed crowns, by PDs, while GDPs and ODS reported poor confidence to manage MIH. These results may serve future programs to increase knowledge, perceptions and clinical experiences towards MIH.
Opportunities and challenges for advance care planning in strongly religious family-centric societies: a Focus group study of Indonesian cancer-care professionals
Authors: Martina Diah , Kustanti Christina Yeni , Dewantari Rahajeng , Sutandyo Noorwati , Putranto Rudi , Shatri Hamzah , Effendy Christantie , van der Heide Agnes , Rietjens Judith A. C. , van der Rijt Carin
Published: June 2022

Background

Most studies on advance care planning in Asia originate in high-income Asian countries. Indonesia is a middle-income Asian country characterized by its religious devoutness and strong family ties. This study aims to explore the perspectives and experiences of Indonesian healthcare professionals on advance care planning for cancer patients.

Methods

Focus-group discussions were conducted in July and August 2019 and were analysed using thematic content analysis enhanced by dual coding and exploration of divergent views. Purposive sampling of physicians and nurses actively engaged in cancer care in a national cancer centre and a national general hospital.

Results

We included 16 physicians and 16 nurses. These participants were open to the idea of advance care planning. We further identified four aspects of this planning that the participants considered to be important: 1) the family’s role in medical decision-making; 2) sensitivity to communication norms; 3) patients’ and families’ religious beliefs regarding the control and sanctity of life; and 4) the availability of a support system for advance care planning (healthcare professionals’ education and training, public education, resource allocation, and formal regulation). Participants believed that, although family hierarchical structure and certain religious beliefs may complicate patients’ engagement in advance care planning, a considerate approach to involving family and patients’ religious perspectives in advance care planning may actually facilitate their engagement in it.

Conclusion

Indonesian healthcare professionals believed that, for culturally congruent advance care planning in Indonesia, it was essential to respect the cultural aspects of collectivism, communication norms, and patients’ religious beliefs.
Probiotics and their beneficial effects on alcohol-induced liver injury in a rat model: the role of fecal microbiota
Authors: Chayanupatkul Maneerat , Somanawat Kanjana , Chuaypen Natthaya , Klaikeaw Naruemon , Wanpiyarat Natcha , Siriviriyakul Prasong , Tumwasorn Somying , Werawatganon Duangporn
Published: June 2022

Background

Current therapies for alcohol-induced liver injury are of limited efficacy and associated with significant side effects. With the proposed pathophysiology of alcohol-induced liver injury to be related to deranged gut microbiota, we hypothesized that probiotics would have beneficial effects in attenuating alcohol-induced liver injury.

Methods

Twenty-four male Sprague-Dawley rats were divided into 4 groups: control group, alcohol group, Lactobacillus plantarum group, and mixed-strain probiotics group. After 4 weeks, all rats were sacrificed, and blood samples were analyzed for ALT, lipopolysaccharide level (LPS), interleukin 6 (IL-6), and tumor necrosis factor-alpha (TNF-α). Liver tissues were processed for histopathology, malondialdehyde (MDA) level and immunohistochemistry for toll-like receptors 4 (TLR-4). Stool samples were collected, and 16S rRNA sequencing was used to analyze the fecal microbiota.

Results

Liver histopathology showed the presence of significant hepatocyte ballooning in the alcohol group as compared with the control group, and the treatment with L. plantarum or mixed-strain probiotics alleviated these changes. Significant elevation of serum ALT, LPS, IL-6, and TNF-α, hepatic MDA levels, and hepatic TLR-4 expression were observed in alcohol-fed rats as compared with control rats. The administration of L. plantarum or mixed-strain probiotics restored these changes to the levels of control rats. The relative abundance of fecal bacteria at genus level showed a significant reduction in Allobaculum, Romboutsia, Bifidobacterium, and Akkermansia in the alcohol group as compared with the control group. In probiotics-treated rats, significant increases in Allobaculum and Bifidobacterium were observed, while the relative abundance of Romboutsia and Akkermansia was unchanged compared to the alcohol group. A reduction in alpha diversity was observed in alcohol-treated rats, whereas the improvement was noted after probiotic treatment.

Conclusions

The treatment with Lactobacillus, whether as single-, or mixed-strain probiotics, was beneficial in reducing the severity of alcohol-induced liver injury likely through the increase in beneficial bacteria, and the reduction of inflammatory responses, and oxidative stress.
Fabrication of methylene blue-loaded ovalbumin/polypyrrole nanoparticles for enhanced phototherapy-triggered antitumour immune activation
Authors: Xu Xiao , Mao Huafen , Wu Yunchao , Liu Suwan , Liu Jingjin , Li Qianzhe , Yang Mengyu , Zhu Jinqian , Zou Shengqiang , Du Fengyi
Published: June 2022

Background

Phototherapy-triggered immunogenic cell death (ICD) rarely elicits a robust antitumour immune response, partially due to low antigen exposure and inefficient antigen presentation. To address these issues, we developed novel methylene blue-loaded ovalbumin/polypyrrole nanoparticles (MB@OVA/PPY NPs) via oxidative polymerization and π–π stacking interactions.

Results

The as-prepared MB@OVA/PPY NPs with outstanding photothermal conversion efficiency (38%) and photodynamic properties were readily internalized into the cytoplasm and accumulated in the lysosomes and mitochondria. Upon 808 nm and 660 nm laser irradiation, the MB@OVA/PPY NPs not only ablated tumour cells by inducing local hyperthermia but also damaged residual tumour cells by generating a large amount of reactive oxygen species (ROS), finally triggering the release of many damage-associated molecular patterns (DAMPs). Moreover, the MB@OVA/PPY NPs synergized with DAMPs to promote the maturation and improve the antigen presentation ability of DCs in vitro and in vivo.

Conclusions

This work reported a PPY NPs-based nanoplatform to encapsulate the therepeutic proteins and absorb the functional molecules for combination therapy of tumours. The results demonstrated that the prepared MB@OVA/PPY NPs could be used as effective nanotherapeutic agents to eliminate solid tumours and trigger a powerful antitumour immune response.
Potential biomarkers of spinal dural arteriovenous fistula: C4BPA and C1QA
Authors: Wang Yinqing , Ma Yongjie , Yang Chengbin , Huang Xiahe , Yang Kun , Lan Fei , Fu Jingxuan , Song Zihao , Tian An , Feng Yueshan , Tu Tianqi , Li Haifeng , Hong Tao , Wang Yingchun , Zhang Hongqi
Published: June 2022

Background and purpose

A major challenge in spinal dural arteriovenous fistula (SDAVF) is timely diagnosis, but no specific predictive biomarkers are known.

Methods

In the discovery cohort (case, n = 8 vs. control, n = 8), we used cerebrospinal fluid (CSF) and paired plasma samples to identify differentially expressed proteins by label-free quantitative proteomics. Further bioinformatics enrichment analyses were performed to screen target proteins. Finally, it was validated by ELISA in two of the new cohorts (case, n = 17 vs. control, n = 9), and univariate analysis, simple linear regression, and receiver operator characteristic (ROC) curve analysis were performed to evaluate the diagnostic potential.

Results

In the discovery cohort, the most overexpressed proteins were APOB and C4BPA in CSF samples of patients. The GO/KEGG enrichment analysis indicated that the upregulated proteins were mainly involved in the acute inflammatory response and complement activation. Hub-gene analysis revealed that APP might be the key protein in the molecular interaction network. In the validation cohort, C4BPA and C1QA were significantly overexpressed in the CSF of patients, averaging 3046.9 ng/ml and 2167.2 ng/ml, respectively. Simple linear regression demonstrated that levels of C1QA and C4 were positively correlated with total protein in CSF (R2 = 0.8021, p = 0.0005; R2 = 0.7447, p = 0.0013). The areas under the ROC curves of C4BPA and C1QA were 0.86 and 1.00, respectively.

Conclusions

This study was the first to identify C4BPA and C1QA as potential biomarkers for the diagnosis of SDAVF and revealed that complement pathway activation might be one of the molecular mechanisms for venous hypertension myelopathy.
Repression of HIV-1 reactivation mediated by CRISPR/dCas9-KRAB in lymphoid and myeloid cell models
Authors: da Costa Lendel Correia , Bomfim Larissa Maciel , Dittz Uilla Victoria Torres , Velozo Camila de Almeida , da Cunha Rodrigo Delvecchio , Tanuri Amilcar
Published: June 2022

Background

Despite antiretroviral treatment efficacy, it does not lead to the complete eradication of HIV infection. Consequently, reactivation of the virus from latently infected cell reservoirs is a major challenge toward cure efforts. Two strategies targeting viral latency are currently under investigation: the “shock and kill” and the “block and lock.” The “Block and Lock” methodology aims to control HIV-1 latency reactivation, promoting a functional cure. We utilized the CRISPR/dCas9-KRAB platform, which was initially developed to suppress cellular genes transcription, to block drug-induced HIV-1 reactivation in latently infected T cells and myeloid cells.

Results

We identified a set of five sgRNAs targeting the HIV-1 proviral genome (LTR1-LTR5), having the lowest nominated off-target activity, and transduced them into the latently infected lymphoid (J-Lat 10.6) and myeloid (U1) cell lines. One of the sgRNAs (LTR5), which binds specifically in the HIV-1 LTR NFκB binding site, was able to promote robust repression of HIV-1 reactivation in latently infected T cells stimulated with Phorbol 12-Myristate 13-Acetate (PMA) and Ingenol B (IngB), both potent protein kinase C (PKC) stimulators. Reactivation with HDAC inhibitors, such as SAHA and Panobinostat, showed the same strong inhibition of reactivation. Additionally, we observed a hundred times reduction of HIV-1 RNA expression levels in the latently infected myeloid cell line, U1 induced with IngB.

Conclusion

Taken together, our results show that the KRAB fused CRISPR/dCas9 system can robustly prevent the HIV-1 latency reactivation process, mediated by PMA or IngB and SAHA or Panobinostat, both in myeloid and lymphoid HIV-1 latently infected cells. In addition, we demonstrated that KRAB repressor protein is crucial to reactivation resistance phenotype, and we have identified some useful hotspots sequences in HIV-1 LTR for the design sgRNAs.
Patient tilt improves efficacy of CO2 field-flooding in minimally invasive cardiac surgery
Authors: Vandenberghe Stijn , Singjeli Geni , Demertzis Stefanos
Published: June 2022

Objective

Space limitations during minimally invasive cardiac surgery impede consistent use of CO2field-flooding. We compared different gas delivery methods, flow rates and the effect of patient inclination.

Methods

A gastight model of MICS surgery with internal organs and right thoracotomy wound was created from a mannequin and equipped with a CO2concentration sensor in the left ventricle. Maximum achievable CO2concentration was compared for gas delivery via three commercial CO2diffusors (CarbonMini, Temed, Andocor) and also via a trocar with side port. Gas flow rates of 1, 3, 5 and 8 L per minute were tested. The model was placed either in supine position or with 20° oblique tilt. A simplified transparent model was also created and placed in an optical test bench to evaluate the gas cloud motions via real-time visualization.

Results

The trocar consistently achieved higher CO2concentrations inside the left ventricle. At 1 l/min, approximately 2.5 min were needed to fill the supine model to its maximum CO2concentration, which was limited to a range of 48–82% in the left ventricle. At higher flow rates, filling time and concentration were significantly improved. In a tilted model, all devices and all flow rates generated on average 99% CO2in the ventricle. Imaging revealed constant gas exchange via the main incision, with CO2outflow via bottom and air inflow via the top of the incision.

Conclusions

CO2field flooding in minimally invasive cardiac surgery is highly effective if the patient is tilted. Else a flow rate of 5 l/min is recommended to achieve the same protection.
Innominate artery direct cannulation provides brain protection during total arch replacement for acute type A aortic dissection
Authors: Kong Xiang , Ruan Peng , Yu Jiquan , Jiang Hui , Chu Tianshu , Ge Jianjun
Published: June 2022

Background

This study aimed to investigate the safety of direct innominate arterial (IA) cannulation using a pediatric arterial cannula to establish selective antegrade cerebral perfusion (ACP) during total arch replacement (TAR) for acute Stanford type A aortic dissection (ATAAD).

Methods

This retrospective study included patients with ATAAD who underwent TAR with the frozen elephant trunk (FET) technique between October 2020 and November 2021. Patients treated with direct IA cannulation using a pediatric arterial cannula for selective anterograde cerebral perfusion were included in the study.

Results

Of the 29 patients, 24 (82.8%) were male. The average age was 50.9 ± 9.47 years. Proximal repair included aortic root plasty (27 patients, [93.1%]) and Bentall surgery (2 patients, [6.9%]). Perioperative mortality and stroke rates were 3.4% and 6.9%, respectively. The mean lowest core temperature was 23.8 ± 0.74 °C and the mean ACP time was 25 ± 6.4 min. The aortic cross-clamp and cardiopulmonary bypass times were 141 ± 28 and 202 ± 29 min, respectively. There were no cases of IA injuries.

Conclusion

Direct IA cannulation using a pediatric arterial cannula is a simple, safe, and effective technique for establishing ACP during TAR with the FET technique for ATAAD and can avoid the potential complications of axillary artery cannulation.
Bilateral upper extremity motor priming (BUMP) plus task-specific training for severe, chronic upper limb hemiparesis: study protocol for a randomized clinical trial
Authors: Stoykov Mary Ellen , Biller Olivia M. , Wax Alexandra , King Erin , Schauer Jacob M. , Fogg Louis F. , Corcos Daniel M.
Published: June 2022

Background

Various priming techniques to enhance neuroplasticity have been examined in stroke rehabilitation research. Most priming techniques are costly and approved only for research. Here, we describe a priming technique that is cost-effective and has potential to significantly change clinical practice. Bilateral motor priming uses the Exsurgo priming device (Exsurgo Rehabilitation, Auckland, NZ) so that the less affected limb drives the more affected limb in bilateral symmetrical wrist flexion and extension. The aim of this study is to determine the effects of a 5-week protocol of bilateral motor priming in combination with task-specific training on motor impairment of the affected limb, bimanual motor function, and interhemispheric inhibition in moderate to severely impaired people with stroke.

Methods

Seventy-six participants will be randomized to receive either 15, 2-h sessions, 3 times per week for 5 weeks (30 h of intervention) of bilateral motor priming and task-specific training (experimental group) or the same dose of control priming plus the task-specific training protocol. The experimental group performs bilateral symmetrical arm movements via the Exsurgo priming device which allows both wrists to move in rhythmic, symmetrical wrist flexion and extension for 15 min. The goal is one cycle (wrist flexion and wrist extension) per second. The control priming group receives transcutaneous electrical stimulation below sensory threshold for 15 min prior to the same 45 min of task-specific training. Outcome measures are collected at pre-intervention, post-intervention, and follow-up (8 weeks post-intervention). The primary outcome measure is the Fugl-Meyer Test of Upper Extremity Function. The secondary outcome is the Chedoke Arm and Hand Activity Index-Nine, an assessment of bimanual functional tasks.

Discussion

To date, there are only 6 studies documenting the efficacy of priming using bilateral movements, 4 of which are pilot or feasibility studies. This is the first large-scale clinical trial of bilateral priming plus task-specific training. We have previously completed a feasibility intervention study of bilateral motor priming plus task-specific training and have considerable experience using this protocol.

Trial registration

ClinicalTrials.govNCT03517657. Retrospectively registered on May 7, 2018.
Drugs and convalescent plasma therapy for COVID-19: a survey of the interventional clinical studies in Italy after 1 year of pandemic
Authors: Puopolo Maria , Morciano Cristina , Buoncervello Maria , De Nuccio Chiara , Potenza Rosa Luisa , Toschi Elena , Palmisano Lucia
Published: June 2022

Background

The 2019 novel coronavirus disease (COVID-19) pandemic has highlighted the importance of health research and fostered clinical research as never before. A huge number of clinical trials for potential COVID-19 interventions have been launched worldwide. Therefore, the effort of monitoring and characterizing the ongoing research portfolio of COVID-19 clinical trials has become crucial in order to fill evidence gaps that can arise, define research priorities and methodological issues, and eventually, formulate valuable recommendations for investigators and sponsors. The main purpose of the present work was to analyze the landscape of COVID-19 clinical research in Italy, by mapping and describing the characteristics of planned clinical trials investigating the role of drugs and convalescent plasma for treatment or prevention of COVID-19 disease.

Methods

During an 11-month period between May 2020 and April 2021, we performed a survey of the Italian COVID-19 clinical trials on therapeutic and prophylactic drugs and convalescent plasma. Clinical trials registered in the Italian Medicines Agency (AIFA) and ClinicalTrials.gov websites were regularly monitored. In the present paper, we report an analysis of study design characteristics and other trial features at 6 April 2021.

Results

Ninety-four clinical trials planned to be carried out in Italy were identified. Almost all of them (91%) had a therapeutic purpose; as for the study design, the majority of them adopted a parallel group (74%) and randomized (76%) design. Few of them were blinded (33%). Eight multiarm studies were identified, and two of them were multinational platform trials. Many therapeutic strategies were investigated, mostly following a drug repositioning therapeutic approach.

Conclusions

Our study describes the characteristics of COVID-19 clinical trials planned to be carried out in Italy over about 1 year of pandemic emergency.

High level quality clinical trials were identified, although some weaknesses in study design and replications of experimental interventions were observed, particularly in the early phase of the pandemic.

Our findings provide a critical view of the clinical research strategies adopted for COVID-19 in Italy during the early phase of the pandemic. Further actions could include monitoring and follow-up of trial results and publications and focus on non-pharmacological research areas.
Effect of a single-dose denosumab on semen quality in infertile men (the FITMI study): study protocol for a randomized controlled trial
Authors: Yahyavi Sam Kafai , Holt Rune , Juel Mortensen Li , Petersen Jørgen Holm , Jørgensen Niels , Juul Anders , Blomberg Jensen Martin
Published: June 2022

Background

Infertility is a common problem globally and impaired semen quality is responsible for up to 40% of all cases. Almost all infertile couples are treated with either insemination or assisted reproductive techniques (ARTs) independent of the etiology of infertility because no medical treatment exists. Denosumab is an antibody that blocks RANKL signaling and inhibition of testicular RANKL signaling has been suggested to improve semen quality in a pilot study. This RCT aims to assess whether treatment with denosumab can improve spermatogenesis in infertile men selected by serum AMH as a positive predictive biomarker. This paper describes the design of the study.

Methods/design

FITMI is a sponsor-investigator-initiated, double-blinded, placebo-controlled 1:1, single-center, randomized clinical trial. Subjects will be randomized to receive either a single-dose denosumab 60 mg subcutaneous injection or placebo. The study will be carried out at the Department of Growth and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen. The primary outcome of the study is defined as the difference in sperm concentration (millions pr. mL) one spermatogenesis (80 days) after inclusion.

Discussion

We describe a protocol for a planned RCT aimed at evaluating whether treatment with denosumab can improve the semen quality in infertile men selected by using serum AMH as a positive predictive biomarker. The results will provide evidence crucial for future treatment in a patient group where there is a huge unmet need.

Trial registration

Clinical Trials.gov NCT05212337. Registered on 14 January 2022.

EudraCT 2021–003,451-42. Registered on 23 June 2021.

Ethical committee H-21040145. Registered on 23 December 2021.
Maternal epigenetic clocks measured during pregnancy do not predict gestational age at delivery or offspring birth outcomes: a replication study in metropolitan Cebu, Philippines
Authors: Ryan Calen P. , Rege Raviraj J. , Lee Nanette R. , Carba Delia B. , Kobor Michael S. , MacIsaac Julie L. , Lin David S. , Atashzay Parmida , Kuzawa Christopher W.
Published: June 2022

Adverse birth outcomes, such as early gestational age and low birth weight, can have lasting effects on morbidity and mortality, with impacts that persist into adulthood. Identifying the maternal factors that contribute to adverse birth outcomes in the next generation is thus a priority. Epigenetic clocks, which have emerged as powerful tools for quantifying biological aging and various dimensions of physiological dysregulation, hold promise for clarifying relationships between maternal biology and infant health, including the maternal factors or states that predict birth outcomes. Nevertheless, studies exploring the relationship between maternal epigenetic age and birth outcomes remain few. Here, we attempt to replicate a series of analyses previously reported in a US-based sample, using a larger similarly aged sample (n = 296) of participants of a long-running study in the Philippines. New pregnancies were identified prospectively, dried blood spot samples were collected during the third trimester, and information was obtained on gestational age at delivery and offspring weight after birth. Genome-wide DNA methylation was assessed with the Infinium EPIC array. Using a suite of 15 epigenetic clocks, we only found one significant relationship: advanced age on the epigenetic clock trained on leptin predicted a significantly earlier gestational age at delivery (β = − 0.15, p = 0.009). Of the other 29 relationships tested predicting gestational age and offspring birth weight, none were statistically significant. In this sample of Filipino women, epigenetic clocks capturing multiple dimensions of biology and health do not predict birth outcomes in offspring.
Evaluating a pre-surgical health optimisation programme: a feasibility study
Authors: McLaughlin Joanna , Scott Lauren J. , Owens Lucie , McLeod Hugh , Sillero-Rejon Carlos , Reynolds Rebecca , Owen-Smith Amanda , Hill Elizabeth M. , Jago Russell , Donovan Jenny L. , Redwood Sabi , Kipping Ruth
Published: June 2022

Background

Health optimisation programmes are increasingly popular and aim to support patients to lose weight or stop smoking ahead of surgery, yet there is little published evidence about their impact. This study aimed to assess the feasibility of evaluating a programme introduced by a National Health Service (NHS) clinical commissioning group offering support to smokers/obese patients in an extra 3 months prior to the elective hip/knee surgery pathway.

Methods

Feasibility study mapping routinely collected data sources, availability and completeness for 502 patients referred to the hip/knee pathway in February–July 2018.

Results

Data collation across seven sources was complex. Data completeness for smoking and ethnicity was poor. While 37% (184) of patients were eligible for health optimisation, only 28% of this comparatively deprived patient group accepted referral to the support offered. Patients who accepted referral to support and completed the programme had a larger median reduction in BMI than those who did not accept referral (− 1.8 BMI points vs. − 0.5). Forty-nine per cent of patients who accepted support were subsequently referred to surgery, compared to 61% who did not accept referral to support.

Conclusions

Use of routinely collected data to evaluate health optimisation programmes is feasible though demanding. Indications of the positive effects of health optimisation interventions from this study and existing literature suggest that the challenge of programme evaluation should be prioritised; longer-term evaluation of costs and outcomes is warranted to inform health optimisation policy development.
Islamic copper-based metal artefacts from the Garb al-Andalus. A multidisciplinary approach on the Alcáçova of Mārtulah (Mértola, South of Portugal)
Authors: Bottaini Carlo , Martínez Susana Gómez , Bordalo Rui , Beltrame Massimo , Mirão José , Rafael Lígia , Schiavon Nick
Published: June 2022

A multidisciplinary approach has been applied to investigate the production technology of a collection of copper-based artefacts found during archaeological excavation campaigns carried out in the Almohad neighbourhood of Mārtulah, the Islamic name of modern Mértola (South of Portugal). In stark contrast to other Islamic materials found in the same site such as common and finely decorated pottery, glass, and bone artefacts, metal objects have received less attention despite the high number of artefacts recovered.

This study focuses on the chemical characterisation of 171 copper-based artefacts dating back to the 12th and the first half of the thirteenth centuries. The artefacts are daily use objects and consist of personal ornaments (earrings, rings, and casket ornaments), tools (spindles, spatulas, and oil lamp sticks) and artefacts with unknown functions. The analytical results by X-ray fluorescence Spectroscopy (XRF) provided information not only about technological issues but infer as well on the socio-economic implications of metal consumption in Islamic Mértola. Results revealed that metals were produced using a variety of Cu-based alloys, namely unalloyed copper, brasses (Cu + Zn), bronzes (Cu + Sn), and red brasses (Cu + Sn + Zn), with a variable concentration of Pb, without any apparent consistency, as a likely result of recurrent recycling and mixing scrap metals practices or use of mineral raw materials available locally.
Noninvasive identification of Benign and malignant eyelid tumors using clinical images via deep learning system
Authors: Hui Shiqi , Dong Li , Zhang Kai , Nie Zihan , Jiang Xue , Li Heyan , Hou Zhijia , Ding Jingwen , Wang Yue , Li Dongmei
Published: June 2022

Eyelid tumors accounts for 5–10% of skin tumors. It is important but difficult to identify malignant eyelid tumors from benign lesions in a cost-effective way. Traditional screening methods for malignancy in eyelid tumors require laborious and time-consuming histopathological process. Therefore, we aimed to develop a deep learning (DL)-based image analysis system for automatic identification of benign and malignant eyelid tumors. Using a common digital camera, we collected clinical images from patients who were histopathologically diagnosed with eyelid tumors. We trained 8 convolutional neural network (CNN) models to identify benign and malignant eyelid tumors, including ResNet-50, ResNet-101, InceptionV3, and InceptionResNetV2. Another group of patients with eyelid tumors were also collected as the prospective validation dataset. Performance of DL models and human clinicians in prospective validation dataset were evaluated and compared. A total of 309 images from 209 patients were used for training DL system, all eight models reached an average accuracy greater than 0.958 in the internal cross-validation. 36 images from 36 patients were included for the prospective validation, the models reached the best performance in accuracy, sensitivity, specificity, and area under curve (AUC) of 0.889 (95% CI 0.747–0.956), 0.933 (95% CI 0.702–0.988), 0.857 (95% CI 0.654–0.950), and 0.966 (95% CI 0.850–0.993), respectively. DL system had a similar performance as the senior ophthalmologists, and outreached the performance of junior ophthalmologists and medical students. DL system can identify benign and malignant tumors through common clinical images, with a better performance than most ophthalmologists. Combining DL system with smartphone may enable patients’ self-monitoring for eyelid tumors and assist in doctors’ clinical decision making.
Geotechnical modelling and subsurface analysis of complex underground structures using PLAXIS 3D
Authors: Hemeda Sayed
Published: June 2022

In this study, analysis of complicated underground structure of Horemheb tomb (KV57) at Luxor, Egypt by using the software PLAXIS 3D is adopted and the deformation that occurs in the body of the underground structure after applied the failure load detected; the failure loads are obtained from the series of laboratory tests. Then, the structure is modelled by using finite element code to perform accurate three-dimensional analysis of deformation and stability in complex geotechnical engineering and rock mechanics. These underground monumental structures have been analyzed by finite element method FEM to obtain the deformation that accrued into the structure and so beneath of the surface and calculated the effective stress, shear stress and horizontal displacements. In order to modeling requires the soil parameters obtained from laboratorial tests. In the analysis elastic–plastic Mohr–Coulomb model is used as material model. It involves five parameters namely, Young’s Modulus (E) and poison’s ratio (ν) for soil elasticity, friction angle (φ) and cohesion (c) for soil plasticity. To set up the boundary condition, the standard fixities option is used. As a result a full fixity at the base and free condition at the horizontal side of geometry are generated. Numerical Engineering analysis for Horemheb tomb (KV57) in the valley of kings at the west bank of Luxor was carried out through the following four main steps: (1) Evaluation of surrounding rocks (marl limestone and marl shale) by experimental research and Roclab program to obtain the Hoek Brown and Mohr- Coulomb fit classification criterion and rock mass standards in particular the global strength and deformation coefficient. Also to specify the main characteristics of the Esna Shale using different methods such as swelling test, swelling potential, swelling pressure, in addition, discussion of the role of the expansive Esna Shale in the deterioration of archaeological buildings and sites. (2) Quantitative and qualitative estimates of the relevant factors affecting the stability of the tomb, especially overloading, fixed, geographic, and dynamic. (3) Integrated 3D geotechnical modeling of the cemetery environment for stress and displacement analysis and identification of volumetric strains and plastic points using advanced symbols and programs such as PLAXIS 3D. (4) The rapeutic and retrofit policies and techniques and the fixed monitoring and control systems needed to strengthen and stabilize the cemetery, where the rock mass classification refers to the rock mass where KV57 is excavated and it is poor rocks. The mechanical behavior of the rocks is simulated by assuming a foundational model to soften the elastic stress of the flexible plastic that captures fragile failure and the mechanisms of progressive substrate failure. In addition, rock pillar treatments and ground support strategies are discussed. This article represents the second phase of the numerical analysis of KV57 using PLAXIS 3D.
Emergency open drainage of massive hemoperitoneum and early stage left hepatectomy for abdominal compartment syndrome due to hepatocellular carcinoma rupture: a case report
Authors: Kurimoto Makoto , Yamanaka Kenya , Hirata Masaaki , Umeda Makoto , Yamashita Tokuyuki , Aoki Hikaru , Hanabata Yusuke , Shinkura Akina , Tamura Jun
Published: June 2022

Background

Spontaneous rupture is one of the most life-threatening complications of hepatocellular carcinoma (HCC). Transcatheter arterial embolization (TAE) effectively achieves hemostasis in patients with hemodynamic instability. However, there have been no reports of abdominal compartment syndrome (ACS) caused by massive intra-abdominal hematoma after TAE. We report emergency open drainage of a massive hematoma for abdominal decompression and early stage left hepatectomy at the same time.

Case presentation

A 75-year-old woman was transported to our emergency department with hypovolemic shock. Dynamic contrast-enhanced computed tomography revealed extravasation of contrast medium from a HCC lesion in the medial segment of the liver and a large amount of high-density ascites. TAE was immediately performed to achieve hemostasis. Three hours after the first TAE, we decided to perform a second TAE for recurrent bleeding. After the second TAE, the patient’s intra-abdominal pressure increased to 35 mmHg, her blood pressure gradually decreased, and she had anuria. Thus, she was diagnosed with ACS due to spontaneous HCC rupture. Twenty-seven hours after her arrival to the hospital, we decided to perform open drainage of the massive hematoma and left hepatectomy for ACS relief, prevention of re-bleeding, tumor resection, and intraperitoneal lavage. The operative duration was 225 min, and the blood loss volume was 4626 g. Postoperative complications included pleural effusion and grade B liver failure. She was discharged on postoperative day 33. The patient survived for more than 3 years without functional deterioration.

Conclusions

Even after hemostasis is achieved by TAE for hemorrhagic shock due to spontaneous rupture of HCC, massive hemoperitoneum may lead to ACS, particularly in cases of re-bleeding. Considering the subsequent possibility of ACS and the recurrence of bleeding, early stage hepatectomy and removal of intra-abdominal hematoma after hemodynamic stabilization could be a treatment option for HCC rupture.
Mechanical behavior of stretchable conductive materials based on elastomeric core: experimental and theoretical simulation
Authors: Bar Avia J. , Mead Joey , Dodiuk Hanna , Kenig Samuel
Published: June 2022

The mechanical behavior of braided carbon nanotube yarns (CNTYs) on an elastomeric core to produce stretchable conductive materials were theoretically modeled and experimentally studied under tension. The elastomeric core served as the stretchable spring and the CNTYs braiding, with shape changing capabilities, as the conductive shell. A variety of samples were produced having various braiding angles on an elastomeric core and subsequently loaded in tension, and their stress–strain behavior was characterized. The model predicts the stress–strain behavior of the composite as a function of the initial braiding angle and the number of pitches. The innovative aspect was included in the model related to the friction between the braid and the core. Results indicated good agreement between the theoretical simulations and the experimental results which was not discussed in previous studies. Since the rate of the diameter decrease of the CNTYs braid was higher than that of the elastomeric core diameter, squeezing out of the core through the braid inter yarn space occurred. This limited the maximum potential extension of the braid. Thus, a critical strain was defined where the braid came into contact with the core. The addition of the friction stresses made a significant contribution to the overall stresses and the accuracy of the theoretical simulation, and its agreement with the experimental results. An apparent friction coefficient was proposed to account for the effect of the elastomer core/braid interactive restriction and squeezing out of the elastomer through the braiding, as observed in experimental results. As the CNTYs are conductive, a stretchable conductive composite was obtained having a resistivity of 9.05 × 10–4 Ohm*cm, which remained constant throughout the tensile loading until failure and under cyclic loading.
Curve intersection based on cubic hybrid clipping
Authors: Wu Yaqiong , Li Xin
Published: June 2022

This study presents a novel approach to computing all intersections between two Bézier curves using cubic hybrid clipping. Each intersection is represented by two strip intervals that contain an intersection. In each step, one curve is bounded by two fat lines, and the other is bounded by two cubic Bézier curves, clipping away the domain that does not contain the intersections. By selecting the moving control points of the cubic hybrid curves, better cubic polynomial bounds are obtained to make the proposed method more efficient. It was proved that the two strip intervals have second- and fourth-order convergence rates for transversal intersections. Experimental results show that the new algorithm is the most efficient among all existing curve/curve intersection approaches.
Mental disorders into adulthood among adolescents placed in residential care: A prospective 10-year follow-up study
Authors: Seker Süheyla , Boonmann Cyril , d’Huart Delfine , Bürgin David , Schmeck Klaus , Jenkel Nils , Steppan Martin , Grob Alexander , Forsman Hilma , Fegert Jörg M. , Schmid Marc
Published: June 2022

Background

Child welfare and juvenile justice placed youths show high levels of psychosocial burden and high rates of mental disorders. It remains unclear how mental disorders develop into adulthood in these populations. The aim was to present the rates of mental disorders in adolescence and adulthood in child welfare and juvenile justice samples and to examine their mental health trajectories from adolescence into adulthood.

Methods

Seventy adolescents in shared residential care, placed by child welfare (n = 52, mean age = 15 years) or juvenile justice (n = 18, mean age = 17 years) authorities, were followed up into adulthood (child welfare: mean age = 25 years; juvenile justice: mean age = 27 years). Mental disorders were assessed based on the International Classification of Diseases 10th Revision diagnoses at baseline and at follow-up. Epidemiological information on mental disorders was presented for each group. Bivariate correlations and structural equation modeling for the relationship of mental disorders were performed.

Results

In the total sample, prevalence rates of 73% and 86% for any mental disorder were found in adolescence (child welfare: 70%; juvenile justice: 83%) and adulthood (child welfare: 83%; juvenile justice: 94%) respectively. General psychopathology was found to be stable from adolescence into adulthood in both samples.

Conclusions

Our findings showed high prevalence rates and a high stability of general psychopathology into adulthood among child welfare and juvenile justice adolescents in Swiss residential care. Therefore, continuity of mental health care and well-prepared transitions into adulthood for such individuals is highly warranted.
Burden of Long-Term Morbidity Borne by Survivors of Acute Myeloid Leukemia Treated With Blood or Marrow Transplantation: The Results of the BMT Survivor Study
Authors: Armenian Saro H. , Chen Yanjun , Hageman Lindsay , Wu Jessica , Landier Wendy , Bosworth Alysia , Francisco Liton , Schlichting Elizabeth , Bhatia Ravi , Salzman Donna , Wong F. Lennie , Weisdorf Daniel J. , Forman Stephen J. , Arora Mukta , Bhatia Smita
Published: June 2022

PURPOSE

Blood or marrow transplantation (BMT) is an integral part of consolidation and/or salvage therapy for patients with acute myeloid leukemia (AML). With the growing population of AML survivors, there is a need to understand the quality of their survival.

MATERIALS AND METHODS

This multisite study included 1,369 2-year survivors who underwent BMT for AML between 1974 and 2014 at age ≥ 21 years and 1,310 siblings. Using Common Terminology Criteria for Adverse Events, severe/life-threatening and fatal chronic health conditions were identified. Multivariable regression analysis was used to compare the risk of severe/life-threatening conditions and health status between survivors and siblings, and to identify risk factors for health conditions among BMT survivors.

RESULTS

The prevalence of severe/life-threatening conditions was 54.9% in BMT survivors compared with 28.5% in siblings ( P < .001), yielding 3.8-fold higher odds of severe/life-threatening conditions (95% CI, 3.1 to 4.7) among the BMT survivors. The most prevalent conditions included subsequent neoplasms, diabetes, cataracts, venous thromboembolism, and joint replacement. Survivors were more likely to report poor general health (odds ratio [OR], 3.8; 95% CI, 2.8 to 5.1), activity limitation (OR, 3.7; 95% CI, 3.0 to 4.5), and functional impairment (OR, 2.9; 95% CI, 2.3 to 3.6). Among BMT recipients, the 20-year cumulative incidence of severe/life-threatening/fatal conditions was 68%. History of chronic graft-versus-host disease was associated with a higher risk of pulmonary disease (hazard ratio [HR], 3.1; 95% CI, 1.0 to 9.3), cataract (HR, 2.6; 95% CI, 1.4 to 3.8), and venous thromboembolism (HR, 2.3; 95% CI, 1.3 to 4.7). Relapse-related mortality (RRM) plateaued at 30%, whereas non-RRM increased to 50% at 30 years.

CONCLUSION

The burden of severe/life-threatening conditions is substantially higher in BMT recipients when compared with an unaffected comparison group, contributing to an increasing incidence of non-RRM over time. Chronic graft-versus-host disease was an important risk factor for severe/life-threatening/fatal conditions among BMT recipients, informing the need for close monitoring to anticipate and manage morbidity.
Reconfiguring the Chronotope
Authors: Shao Xuesong , Lu Sheldon
Published: June 2022

This article adopts Mikhail Bakhtin's conception of the chronotope to analyze the 2015 film Laopaoer 老炮兒 (Mr. Six), directed by Guan Hu 管虎 and starring Feng Xiaogang 馮小剛, exploring its representation and reconfiguration of the real as well as the imagined time-spaces of Beijing. Revolving around generational conflicts against the grain of a globalized and gentrified Beijing, Mr. Six creates a strong nostalgic appeal and laments the withering of mores from the past. The film not only attends to the physiognomic remapping of contemporary Beijing but also incorporates topographical imaginaries from the culture of the martial arts. By invoking hybrid sites of memory, Guan Hu mobilizes cultural legacies associated with Beijing and creates a palimpsestic urban chronotope. Furthermore, this article compares Mr. Six to its literary and filmic predecessors, probing its insights and oversights in restoring cultural memories and in capturing the zeitgeist of contemporary China. With gaps and conflicts on textual, contextual, and intertextual levels calling into question the efficacy of Mr. Six's exposé of China's social stratification and urban gentrification, the stories in, of, and around Mr. Six reiterate the coordination between cultural elites and consumer culture.
Take the Elevator to Tomorrow
Authors: Møller-Olsen Astrid
Published: June 2022

What if, in the encounter between the subject and the city, it is the buildings, the streets, the rooms that are moving and the human beings who are at a standstill? Inspired by the efforts of literary scholars and human geographers to apply a unified understanding of space and time to the study of the (fictional) city, this article employs an analysis centered on the figure of the elevator to explore how literary narratives can help expand our understanding of space-time as an intuitive and quotidian fact of existence. In a comparative study of Taiwanese author Wu Mingyi's short story “The Ninety-Ninth Floor” and Hong Kong writer Dorothy Tse's “Mute Doors,” this article proposes the term time-space as a suitable concept for dealing with discrete sections of space-time in literature and goes on to explore the elevator as a prime example of such an explicitly temporal, and spatially confined, time-space.