bluuebunny/crossref_metadata_2025 huggingface dataset:
Airport capacity evaluation based on air traffic activities big data
Authors: Wan Lili , Peng Qiuping , Tian Yong , Gao Lei , Ye Bojia
Published: November 2020

In order to evaluate the airport's comprehensive service capabilities, this paper considers the impact of air quality and noise on the airport environment under the big data of air traffic activities. In this study, the concept of environmental traffic capacity and big data are applied to the air traffic field. Recently, the airport air and noise pollution has been widely investigated and has become one of the major concerns of the potentially exposed people. This study explores the usage of governmental ambient air quality and noise standards to evaluate the airport operation capacities in the context of the era of big data. The first step is to analyze the typical airport operation scenario as the evaluation scenario. The second step is to use the air and noise emission assessment model for calculating the airport maximum air pollutant concentration and noise level. The final step is to establish a complete airport environment traffic capacity (AETC) evaluation process. As a case study, the capacity evaluation of Nanjing Lukou international airport (NKG) is performed using the above steps. In this case, significant associations between the pollutant concentrations/noise level and the air traffic volume were observed. The AETC of NKG was calculated with the established evaluation process successfully. The results show that the NKG maximum hourly air traffic volume is 120, daily air traffic volume is 770, and annual air traffic volume is 365,805, meeting the China Ambient Air Quality and Noise Standards. Although different air pollutants were investigated in this research, only the NOx was found to be the species that approaching the China governmental standards in this case. Thus, the airport NOx concentration was selected as the AETC limitation factor.
Fractional nonlinear Volterra–Fredholm integral equations involving Atangana–Baleanu fractional derivative: framelet applications
Authors: Mohammad Mutaz , Trounev Alexander
Published: November 2020

In this work, we propose a framelet method based on B-spline functions for solving nonlinear Volterra–Fredholm integro-differential equations and by involving Atangana–Baleanu fractional derivative, which can provide a reliable numerical approximation. The framelet systems are generated using the set of B-splines with high vanishing moments. We provide some numerical and graphical evidences to show the efficiency of the proposed method. The obtained numerical results of the proposed method compared with those obtained from CAS wavelets show a great agreement with the exact solution. We confirm that the method achieves accurate, efficient, and robust measurement.
ANZAED practice and training standards for mental health professionals providing eating disorder treatment
Authors: Hurst Kim , Heruc Gabriella , Thornton Chris , Freeman Jeremy , Fursland Anthea , Knight Rachel , Roberts Marion , Shelton Beth , Wallis Andrew , Wade Tracey
Published: November 2020

Introduction

The Australia & New Zealand Academy for Eating Disorders (ANZAED) recently developed general principles and clinical practice standards recommended for mental health clinicians and dietitians providing treatment for people with eating disorders. Separate mental health practice and training standards were then devised as a foundation for strengthening the workforce and providing guidance to professional training programs and service providers on the minimal standards required for practice in the eating disorder field.

Recommendations

The present recommendations for mental health professionals providing eating disorder treatment describe the following practice and training standards: eating disorder treatment foundations (including co-ordination of services, establishing a positive therapeutic alliance, professional responsibility and knowledge of levels of care), assessment, diagnosis, intervention (including evidence-based intervention, managing psychiatric risk and managing co-morbid mental health problems), and monitoring and evaluation.

Conclusions

Further work is required to disseminate these standards to clinicians providing services across Australia to people with eating disorders, and to support adherence in the clinic room where they can translate to improved outcomes for clients. Pathways to supporting adherence include expert supervision of practice, incorporation in training and supervised practice in university settings, and support with checklists that can be used by consumers and referring professionals.
Impact of COVID-19 lockdown measures on a cohort of eating disorders patients
Authors: Machado Paulo P. P. , Pinto-Bastos Ana , Ramos Rita , Rodrigues Tânia F. , Louro Elsa , Gonçalves Sónia , Brandão Isabel , Vaz Ana
Published: November 2020

Background

Lockdown implemented to prevent the COVID-19 spread resulted in marked changes in the lifestyle. The objective of the current study was to assess the impact of lockdown measures on a cohort of eating disorder (ED) patients being followed as part of an ongoing naturalistic treatment study.

Methods

Ninety-nine patients aged 18 or older, currently or previously, in treatment at a Portuguese specialized hospital unit were contacted by phone and invited to participate in the current survey. Fifty-nine agreed to be interviewed by phone, and 43 agreed to respond to a set of self-report measures of ED symptoms, emotion regulation difficulties, clinical impairment, negative urgency, and COVID-19 impact, during the week after the end of the lockdown period.

Results

Data showed that of the 26 patients currently in treatment: 8 remained unchanged (31%), 7 deteriorated (27%), and 11 reliably improved (42%). Of the 17 participants not currently in treatment: 3 deteriorated (18%), 9 remained unchanged (53%), and 5 (29%) improved after the lockdown period. The Coronavirus Impact Scale showed that most patients considered their routines moderately or extremely impacted, experienced stress related to coronavirus, and showed difficulty in maintaining physical exercise and feeding routines. Results suggest that higher impact of COVID-19 lockdown was significantly correlated with eating disorder symptoms and associated psychopathology, impulsivity, difficulties in emotion regulation and clinical impairment measured at post-lockdown. In addition, the impact of COVID-19 and lockdown measures on clinical impairment was mediated by difficulties in emotion regulation.

Conclusions

Findings suggest that some ED patients may experience worsening of their condition, especially if associated with difficulties in emotion regulation, and these difficulties might be exacerbated in the context of a stressful crisis and lockdown measures, highlighting the need for intervention strategies to mitigate its negative impact.
Smartphone-based activity measurements in patients with newly diagnosed bipolar disorder, unaffected relatives and control individuals
Authors: Stanislaus Sharleny , Vinberg Maj , Melbye Sigurd , Frost Mads , Busk Jonas , Bardram Jakob E. , Kessing Lars Vedel , Faurholt-Jepsen Maria
Published: November 2020

Background

In DSM-5 activity is a core criterion for diagnosing hypomania and mania. However, there are no guidelines for quantifying changes in activity. The objectives of the study were (1) to investigate daily smartphone-based self-reported and automatically-generated activity, respectively, against validated measurements of activity; (2) to validate daily smartphone-based self-reported activity and automatically-generated activity against each other; (3) to investigate differences in daily self-reported and automatically-generated smartphone-based activity between patients with bipolar disorder (BD), unaffected relatives (UR) and healthy control individuals (HC).

Methods

A total of 203 patients with BD, 54 UR, and 109 HC were included. On a smartphone-based app, the participants daily reported their activity level on a scale from −3 to + 3. Additionally, participants owning an android smartphone provided automatically-generated data, including step counts, screen on/off logs, and call- and text-logs. Smartphone-based activity was validated against an activity questionnaire the International Physical Activity Questionnaire (IPAQ) and activity items on observer-based rating scales of depression using the Hamilton Depression Rating scale (HAMD), mania using Young Mania Rating scale (YMRS) and functioning using the Functional Assessment Short Test (FAST). In these analyses, we calculated averages of smartphone-based activity measurements reported in the period corresponding to the days assessed by the questionnaires and rating scales.

Results

(1) Smartphone-based self-reported activity was a valid measure according to scores on the IPAQ and activity items on the HAMD and YMRS, and was associated with FAST scores, whereas the majority of automatically-generated smartphone-based activity measurements were not. (2) Daily smartphone-based self-reported and automatically-generated activity correlated with each other with nearly all measurements. (3) Patients with BD had decreased daily self-reported activity compared with HC. Patients with BD had decreased physical (number of steps) and social activity (more missed calls) but a longer call duration compared with HC. UR also had decreased physical activity compared with HC but did not differ on daily self-reported activity or social activity.

Conclusion

Daily self-reported activity measured via smartphone represents overall activity and correlates with measurements of automatically generated smartphone-based activity. Detecting activity levels using smartphones may be clinically helpful in diagnosis and illness monitoring in patients with bipolar disorder.

Trial registration clinicaltrials.gov NCT02888262
PD-L1 chimeric costimulatory receptor improves the efficacy of CAR-T cells for PD-L1-positive solid tumors and reduces toxicity in vivo
Authors: Liao Qibin , Mao Yunyu , He Huan , Ding Xiangqing , Zhang Xiaoyan , Xu Jianqing
Published: November 2020

Background

On-target off-tumor toxicity impedes the clinical application of chimeric antigen receptor-modified T cells (CAR-T cells) in the treatment of solid tumors. Previous reports proved that the combinatorial antigen recognition strategy could improve the safety profile of CAR-T cells by targeting two different tumor-associated antigens (TAAs), one as a CAR-T targeted antigen and the other as a chimeric costimulatory receptor (CCR) ligand. The programmed death-ligand 1 (PD-L1, also known as B7-H1) is preferentially overexpressed on multiple tumors, it will be highly interesting to explore the potential of PD-L1 as a universal target for designing CCR.

Methods

A novel dual-targeted CAR, which is composed of first-generation CD19/HER2 CAR with CD3ζ signaling domain and PD-L1 CCR containing the CD28 costimulatory domain, was constructed and delivered into T cells by pseudotyped lentivirus. The cytokine release, cytotoxicity and proliferation of dual-targeted CAR-T cells were tested in vitro, and their safety and therapeutic efficacy were evaluated using a human tumor xenograft mouse model in vivo.

Results

The dual-targeted CAR-T cells exerted a similar cytotoxic activity against CD19/HER2+tumor cells with or without PD-L1 in vitro, however, enhanced cytokine releases and improved proliferative capacity were only observed in the presence of both CD19/HER2 and PD-L1. Importantly, the dual-targeted CAR-T cells displayed no cytotoxicity against PD-L1+cells alone in the absence of tumor antigen CD19/HER2. In addition, the dual-targeted CAR-T cells preferably destroyed tumor xenografts bearing both CD19/HER2 and PD-L1,but spared only antigen-positive tumor xenografts without PD-L1 in vivo. Furthermore, PD-L1 CCR also improved the antitumor efficacy of the low-affinity HER2 CAR-T cells against PD-L1+tumors expressing high levels of HER2.

Conclusion

Our observations demonstrated that PD-L1 could be used as a universal target antigen for designing CCR, and the dual-targeted CAR-T cells equipped with PD-L1 CCR could be used to reduce the risk of on-target off-tumor toxicity while retaining their potent antitumor efficacy in the treatment of PD-L1+solid tumors.
Evaluation of temperature rise in the pulp during various IPR techniques—an in vivo study
Authors: Banga Kiran , Arora Nitin , Kannan Sridhar , Singh Ashish Kumar , Malhotra Abhita
Published: November 2020

Background

Non-extraction treatment protocol has gained a lot of popularity over extraction for orthodontic treatment. Interproximal enamel reduction is one such method that makes it possible to do orthodontic treatment without extractions. This procedure, which can be done by various techniques, leads to a rise in the temperature of the pulp of the teeth. Previously, studies have been done which have evaluated the temperature changes inside the pulp chamber of extracted teeth, during interproximal enamel reduction. However, no documented literature exists that has evaluated these changes in the live pulp of the teeth whilst interproximal enamel reduction (IPR) is being performed. Therefore, this study aimed to evaluate the temperature changes inside the live pulp of the teeth during various interproximal enamel reduction techniques in vivo.

Aims

Evaluation of temperature rise in the pulp during various interproximal enamel reduction techniques, done in vivo.

Material and method

The study was performed on patients for whom extraction of premolars had been advised for their orthodontic treatment. Fifty-one premolar teeth were randomly divided into three groups of IPR, i.e. using airotor and bur, handheld metal strip and orthodontic IPR kit (oscillating system). IPR was performed on the mesial and distal sides after access opening, temperature change was recorded during IPR and the readings were compared. The Shapiro-Wilk test was utilized for checking whether the data satisfied the requirement of normal distribution.

Results

The highest temperature rise was seen in group 1 in which interproximal enamel reduction was performed using airotor and bur. The minimum temperature rise was observed in group 2 in which interproximal enamel reduction was done using the handheld metal strip, whereas the temperature rise observed in group 3, in which interproximal enamel reduction was done using IPR kit, was between the range of group 1 and group 3. The temperature change was in the following order—group 1 (2.08 °C) > group 3 (1.22 °C) > group 2 (0.52 °C).

Conclusion

None of the methods used to perform interproximal enamel reduction caused a temperature increase more than 5.5 °C, beyond which pulp necrosis may occur. Therefore, all three methods used in the study for IPR were found to be safe.
3D printing technology and internet of things prototyping in family practice: building pulse oximeters during COVID-19 pandemic
Authors: Capobussi Matteo , Moja Lorenzo
Published: November 2020

Family doctors can have an active role in identifying significant population needs and solutions. During the COVID-19 epidemic, patient home monitoring with pulse oximetry has been a key aspect of care of patients. However, pandemics bring shortage of medical equipment such as pulse oximeters. Through the local maker community, in a matter of days four “smart” pulse oximeters were built. Following Internet of Things principles, the prototypes were programmed to transmit real-time data through Wi-Fi directly to the doctors. Each pulse oximeter served a family doctor during the pandemic. In this article we describe the process that led to the production of the technology and provide detailed instructions, which have also been shared in maker-oriented websites. Dissemination can potentially lead to additional small-scale productions, limiting future shortages.
Intravital imaging of orthotopic and ectopic bone
Authors: Hashimoto Kunihiko , Kaito Takashi , Kikuta Junichi , Ishii Masaru
Published: November 2020

Bone homeostasis is dynamically regulated by a balance between bone resorption by osteoclasts and bone formation by osteoblasts. Visualizing and evaluating the dynamics of bone cells in vivo remain difficult using conventional technologies, including histomorphometry and imaging analysis. Over the past two decades, multiphoton microscopy, which can penetrate thick specimens, has been utilized in the field of biological imaging. Using this innovative technique, the in vivo dynamic motion of bone metabolism-related cells and their interactions has been revealed. In this review, we summarize previous approaches used for bone imaging and provide an overview of current bone tissue imaging methods using multiphoton excitation microscopy.
Radiofrequency catheter ablation of ventricular tachycardia in pediatric patients
Authors: Park Woo Young , Song Mi Kyoung , Kim Gi Beom , Lee Sang Yun , Kwon Hye Won , Bae Eun Jung
Published: November 2020

Background

Radiofrequency catheter ablation (RFCA) has been accepted as an efficient therapy for tachycardia, and substantial improvement in the outcomes of RFCA in pediatric patients has been seen. However, there is not enough data on the clinical outcomes of RFCA for ventricular tachycardia (VT) in pediatric patients. The objective of this study was to elucidate the efficacy and safety of RFCA for VT in pediatric patients.

Methods

We performed a retrospective study involving 35 consecutive pediatric VT ablation procedures in 28 patients at a single institution.

Results

The median age at ablation was 14.0 years (range 6.9–19.2 years). There were 24 patients with a structurally normal heart and four patients with congenital heart disease (CHD). The left ventricular posteroseptal area was the most common site of VT origin (22/28, 78.6%). However, there was an unusual case of VT which involved a papillary muscle as its origin. Acute success was achieved in 30 (85.7%) of 35 procedures. The recurrence rate after successful RFCA was 14.2% (5/35) at a median follow-up of 6.7 years (range 1.0–16.7 years). There were five procedural failures due to the inability to induce VT for complete mapping. Ultimately, long-term success was achieved in 27 patients (96.4%) after repeated procedures and no major complications occurred. Long-term success was associated with VT inducibility (p =  < 0.001).

Conclusions

Difficulty in inducing VT for precise mapping was a significant obstacle to successful RFCA. RFCA was identified as safe and effective therapy to eliminate VT in the selected pediatric VT patients.
Disease modifying treatment trials in Parkinson’s disease: how to balance expectations and interests of patients, physicians and industry partners?
Authors: Berg D. , Eggert K. , Haslinger B. , Kassubek J. , Mollenhauer B. , Reetz K. , Rogge A. , Schaeffer E. , Tönges L. , Zeuner K. E.
Published: November 2020

Background

The advent of therapeutic strategies designed to modify the disease course in Parkinson’s disease has raised great expectations in the currently conducted clinical trials. However, we see ethical challenges in the cooperation of industry and clinical partners, specifically evident in the way recruitment is performed.

We here discuss the different positions and challenges of all involved to set the stage for a study and recruitment culture taking into account the expectations of all: (i) patients and their caregivers, ready to take the considerable burden of clinical trials in hope for the development of disease-modifying treatments; (ii) physicians and study nurses, obligated to the patients’ well-being and benefit who accompany and supervise patients closely as basis for the performance of elaborate clinical trials (iii) industrial partners, investing years of efforts and finances to develop new treatments.

Conclusions

We conclude that the current competitive race for enrollment in clinical studies in PD is challenging the primary goal to ensure patients’ benefit and formulate requests to the industrial partners to encounter these concerns.
Executive Perspectives
Authors: Bhatia Yogaani
Published: November 2020

On a global scale, the changes that the pandemic has brought to the workplace have been neither subtle nor temporary. There has been a massive shift from physical to digital processes as more and more companies work to close the digital gap and bring technology to the forefront. From intimate birthday parties to busy conferences, events have made the leap to digital faster than the world ever could have anticipated or prepared for. However, the advantages have been significant. These new digital experiences prioritize flexibility and accessibility and bring noteworthy information to the comfort of people’s couches.
Telomere dynamics from hatching to sexual maturity and maternal effects in the “multivariate egg”
Authors: Criscuolo F. , Torres R. , Zahn S. , Williams T. D.
Published: November 2020

Avian eggs contain a large number of molecules deposited by the mother that provide the embryo with energy but also potentially influence its development via the effects of maternally-derived hormones and antibodies: the avian egg is “multivariate”. Multivariate effects on offspring phenotype were evaluated in a sister study on captive zebra finches, by simultaneously manipulating maternally derived antibodies after LPS-treatment of mothers and egg-treatment using yolk testosterone injection. LPS-treatment had a positive effect on body mass growth at 30 days after hatching and immune response at sexual maturity, while egg-testosterone positively influenced immune response at fledging and courtship behaviour in sexually mature male offspring. Maternal effects are known to modulate offspring telomere length. Still, the multivariate effects of egg-derived maternal components on offspring telomere dynamics from hatching to sexual maturity are undefined. Here, using the data of the sister study completed with telomere measurements, we tested a) the effects of LPS and T treatments on telomere length (TL) from hatching to sexual maturity (day 82), b) how LPS treatment modulated telomere length over reproduction in adult females, and c) the relationship between maternal and offspring TL. We predicted, a) TL would be shorter in LPS fledglings (as a cost of faster growth), and b) TL would be longer in sexually mature adults from T-treated (as a proxy of individual quality). In adult females, there was an overall negative relationship between laying and rearing investments and telomere length, this relationship being weaker in LPS treated females. In chicks, there was an overall negative effect of LPS treatment on telomere length measured at fledging and sexual maturity (day 25 – 82). In addition, at fledging, there was a sex x LPS x T-treatment interaction, suggesting the existence of antagonistic effects of our treatments. Our data partially support the hypothesis of telomeres are proxies of individual quality and that individual differences in telomere length are set-up very early in life.
Targeted Next-Generation Sequencing Analysis for Recurrence in Early-Stage Lung Adenocarcinoma
Authors: Kim In Ae , Hur Jae Young , Kim Hee Joung , Park Jung Hoon , Hwang Jae Joon , Lee Song Am , Lee Seung Eun , Kim Wan Seop , Lee Kye Young
Published: November 2020

Background

Despite surgical resection, early lung adenocarcinoma has a recurrence rate of 20–50%. No clear predictive markers for recurrence of early lung adenocarcinoma are available. Targeted next-generation sequencing (NGS) is rarely used to identify recurrence-related genes. We aimed to identify genetic alterations that can predict recurrence, by comparing the molecular profiles of patient groups with and without recurrence.

Methods

Tissues from 230 patients with resected stage I–II lung adenocarcinoma (median follow-up: 49 months) were analyzed via targeted NGS for 207 cancer-related genes. The recurrence-free survival according to the number and type of mutation was estimated using the Kaplan–Meier method. Independent predictive biomarkers related to recurrence were identified using the Cox proportional hazards model.

Results

Recurrence was observed in 64 patients (27.8%). In multivariate analysis adjusted for age, sex, smoking history, stage, surgical mode, and visceral pleural invasion, the CTNNB1 mutation and fusion genes (ALK, ROS1, RET) were negative prognostic factors for recurrence in early-stage lung adenocarcinoma (HR 4.47, p = 0.001; HR 2.73, p = 0.009). EGFR mutation was a favorable factor (HR 0.51, p = 0.016), but the CTNNB1/EGFR co-mutations were negative predictors (HR 19.2, p < 0.001). TP53 mutation was a negative predictor compared with EGFR mutation for recurrence (HR 5.24, p = 0.02). Conclusions: Targeted NGS can provide valuable information to predict recurrence and identify patients at high recurrence risk, facilitating selection of the treatment strategy among close monitoring and adjuvant-targeted therapy. Larger datasets are required to validate these findings.
Effect of Carbon Dots on Supercapacitor Performance of Carbon Nanohorn/Conducting Polymer Composites
Authors: Chang Chia Chi , Geleta Tesfaye Abebe , Imae Toyoko
Published: November 2020

Conducting composites consisting of carbon nanohorn (CNH), carbon dots (C-dots) and polyaniline (PA) or polypyrrole (PP) have been synthesized via in-situ polymerization and evaluated for performance as electrode materials for supercapacitors. The addition of C-dots to composites of CNH and conducting polymer showed a superior influence on supercapacitance properties in comparison with composites without C-dots. Incidentally, the specific capacitance was 1206 F/g and 538 F/g at a scan rate of 5 mV/s for composites of CNH with PA and PP, respectively, with addition of C-dots. These values were 1.6 and 2.3 times higher than values for composites without C-dots. Moreover, composites with C-dots exhibited high capacitance retention (94 and 93%, respectively). Thus, these results indicate that the addition of C-dots to composites of CNH with conducting polymers provides a significant enhancing effect as promising electrode materials for energy storage devices with high capacitance and stability.
The varying openness of digital open science tools
Authors: Bezuidenhout Louise , Havemann Johanna
Published: November 2020

Background: Digital tools that support open science practices play a key role in the seamless accumulation, archiving and dissemination of scholarly data, outcomes and conclusions. Despite their integration into open science practices, the providence and design of these digital tools are rarely explicitly scrutinized. This means that influential factors, such as the funding models of the parent organizations, their geographic location, and the dependency on digital infrastructures are rarely considered. Suggestions from literature and anecdotal evidence already draw attention to the impact of these factors, and raise the question of whether the open science ecosystem can realise the aspiration to become a truly “unlimited digital commons” in its current structure.

Methods: In an online research approach, we compiled and analysed the geolocation, terms and conditions as well as funding models of 242 digital tools increasingly being used by researchers in various disciplines.

Results: Our findings indicate that design decisions and restrictions are biased towards researchers in North American and European scholarly communities. In order to make the future open science ecosystem inclusive and operable for researchers in all world regions including Africa, Latin America, Asia and Oceania, those should be actively included in design decision processes.

Conclusions: Digital open science tools carry the promise of enabling collaboration across disciplines, world regions and language groups through responsive design. We therefore encourage long term funding mechanisms and ethnically as well as culturally inclusive approaches serving local prerequisites and conditions to tool design and construction allowing a globally connected digital research infrastructure to evolve in a regionally balanced manner.
Skin-to-skin contact following caesarean section: a narrative review
Authors: Vilinsky-Redmond Aliona , Brenner Maria , McCaul Conan , McCann Margaret
Published: November 2020

Skin-to-skin contact (SSC) is commonly performed after normal vaginal delivery and there is an increased demand by mothers to perform SSC after caesarean section (CS). However, there are still many obstacles that inhibit the initiation of SSC after CS, especially the risk of neonatal hypothermia. Although the evidence suggests that SSC promotes neonatal normothermia, this evidence is based on studies after vaginal birth and not after CS. Current literature suggests that both mothers and newborns may become hypothermic during or after a CS in the absence of active preventative measures. Suboptimal neonatal and maternal temperatures could have adverse physiological effects in both newborns and mothers. This narrative review predominantly focuses on the available evidence for SSC after CS. It also synopsises the adverse effects of hypothermia in neonates and mothers, and explains the physiology of peripartum thermoregulation, the mechanisms of heat loss and their prevention.
Insulin safety: what is all the fuss about?
Authors: Cartwright Anne
Published: November 2020

Errors in the prescribing, dispensing and administration of insulin can cause serious harm. Anne Cartwright raises awareness of the risks

In 2010 National Patient Safety Alerts produced a rapid response report ‘Safer Use of Insulin’ in response to an increasing number of medication incidents leading to severe harm or death as a result of errors with insulin therapy. In 2017 the World Health Organization launched a global initiative to reduce avoidable medication error by 50% over 5 years. This article aims to raise awareness of the risks of insulin therapy, the common mistakes that can be made in the prescribing, dispensing and administration of insulin, and to inform health professionals who are involved in caring for people on insulin therapy how to reduce the risk of potential harm.
Newly qualified nurse: choosing to work as a GPN
Authors: Gourlay Mark
Published: November 2020

In this new column, newly qualified nurse Mark Gourlay explains what attracted him to a career in general practice
Analysing the variation in volume and nature of trauma presentations during COVID-19 lockdown in Ireland
Authors: Fahy Stephen , Moore Joss , Kelly Michael , Flannery Olivia , Kenny Paddy
Published: November 2020

Aims

Europe has found itself at the epicentre of the COVID-19 pandemic. Naturally, this has placed added strain onto healthcare systems internationally. It was feared that the impact of the COVID-19 pandemic could overrun the Irish healthcare system. As such, the Irish government opted to introduce a national lockdown on the 27 March 2020 in an attempt to stem the flow of admissions to hospitals. Similar lockdowns in the UK and New Zealand have resulted in reduced emergency department presentations and trauma admissions. The aim of this study is to assess the effect of the national lockdown on trauma presentations to a model-3 hospital in Dublin, Ireland.

Methods

A retrospective study was conducted. All emergency department presentations between 27 March 2019 to 27 April 2020 and 27 March 2020 to 27 April 2020 were cross-referenced against the National Integrated Medical Imaging System-Picture Archiving Communication System (NIMIS-PACS) radiology system to identify those with radiologically proven skeletal trauma. These patients were grouped according to sex, age, discharge outcome, mechanism of injury, and injury location.

Results

A 21% decrease in radiologically proven trauma was observed on comparison with the same time-period last year. Additionally, a 40% reduction in trauma admissions was observed during the COVID-19 lockdown. A 60% reduction in sports-related injuries and road traffic accident-related injuries was noted during the national lockdown. However, a 17% increase was observed in patients sustaining trauma because of domestic accidents.

Conclusion

Variation was observed in both the volume and nature of trauma presentations during the COVID-19 lockdown. As would be expected, a reduction was seen in the number of injuries resulting from outdoor activities. Interestingly, increased rates of domestic injuries were seen during this period which could represent an unintended consequence of the prolonged period of lockdown. Cite this article: Bone Joint Open 2020;1-6:261–266.
Trauma and orthopaedic team members’ mental health during the COVID-19 pandemic
Authors: Thakrar Amit , Raheem Ali , Chui Karen , Karam Edward , Wickramarachchi Lilanthi , Chin Kuen
Published: November 2020

Aims

Healthcare systems have been rapidly restructured to meet COVID-19 demand. Clinicians are working to novel clinical guidelines, treating new patient cohorts and working in unfamiliar environments. Trauma and orthopaedics (T&O) has experienced cancellation of routine clinics and operating, with redistribution of the workload and human resources. To date, no studies have evaluated the mental health impact of these changes on the T&O workforce. We report the results of a novel survey on the impact of the pandemic on the mental health of our orthopaedic workforce and the contributory factors.

Methods

A 20-question survey-based cross-sectional study of orthopaedic team members was conducted during the COVID-19 pandemic. The primary objective was to identify the impact of the pandemic on mental health in the form of major depressive disorder (MDD) and general anxiety disorder (GAD). The survey incorporated the patient health questionnaire (PHQ-2), which is validated for screening of MDD, and the generalized anxiety disorder questionnaire (GAD-2), which is validated for screening of GAD.

Results

There were 62 respondents (18 females and 44 males). As compared to the general population, we noted a greater estimated prevalence of GAD (17.7% vs 5.9%, p = 0.0009297) and MDD (19.4% vs 3.3%, p = 0.0000007731). The prevalence of MDD symptoms was greatest among senior house officers (SHOs) (p = 0.02216). Female respondents scored higher for symptoms of MDD (p = 0.03583) and GAD (p = 0.0001086). Those identifying as ‘Black, African, Caribbean or Black British’ displayed a higher prevalence of GAD symptoms (p = 0.001575) and felt least supported at work (p = 0.001341).

Conclusion

Our study, in the first of its kind, shows a significant prevalence of GAD and MDD in the workforce. We found that SHOs, females and those of Black, African, Caribbean, or Black British origin were disproportionately affected. Action should be taken to help prevent adverse mental health outcomes for our colleagues during the pandemic. Cite this article: Bone Joint Open 2020;1-6:316–325.
The arithmetic HKA (aHKA) predicts the constitutional alignment of the arthritic knee compared to the normal contralateral knee
Authors: MacDessi Samuel J , Griffiths-Jones William , Harris Ian A , Bellemans Johan , Chen Darren B
Published: November 2020

Aims

An algorithm to determine the constitutional alignment of the lower limb once arthritic deformity has occurred would be of value when undertaking kinematically aligned total knee arthroplasty (TKA). The purpose of this study was to determine if the arithmetic hip-knee-ankle angle (aHKA) algorithm could estimate the constitutional alignment of the lower limb following development of significant arthritis.

Methods

A matched-pairs radiological study was undertaken comparing the aHKA of an osteoarthritic knee (aHKA-OA) with the mechanical HKA of the contralateral normal knee (mHKA-N). Patients with Grade 3 or 4 Kellgren-Lawrence tibiofemoral osteoarthritis in an arthritic knee undergoing TKA and Grade 0 or 1 osteoarthritis in the contralateral normal knee were included. The aHKA algorithm subtracts the lateral distal femoral angle (LDFA) from the medial proximal tibial angle (MPTA) measured on standing long leg radiographs. The primary outcome was the mean of the paired differences in the aHKA-OA and mHKA-N. Secondary outcomes included comparison of sex-based differences and capacity of the aHKA to determine the constitutional alignment based on degree of deformity.

Results

A total of 51 radiographs met the inclusion criteria. There was no significant difference between aHKA-OA and mHKA-N, with a mean angular difference of −0.4° (95% SE −0.8° to 0.1°; p = 0.16). There was no significant sex-based difference when comparing aHKA-OA and mHKA-N (mean difference 0.8°; p = 0.11). Knees with deformities of more than 8° had a greater mean difference between aHKA-OA and mHKA-N (1.3°) than those with lesser deformities (-0.1°; p = 0.009).

Conclusion

This study supports the arithmetic HKA algorithm for prediction of the constitutional alignment once arthritis has developed. The algorithm has similar accuracy between sexes and greater accuracy with lesser degrees of deformity. Cite this article: Bone Joint Open 2020;1-7:339–345.
Utility of a high-definition 3D digital exoscope for spinal surgery during the COVID-19 pandemic
Authors: Teo Terry Hong Lee , Tan Beatrice Jun-Nian , Loo Wee Lim , Yeo Andy Kuei Siong , Dinesh Shree Kumar
Published: November 2020

The COVID-19 pandemic creates unique challenges in the practice of spinal surgery. We aim to show how the use of a high-definition 3D digital exoscope can help streamline workflows, and protect both patients and healthcare staff.
Better functional results of opening wedge HTO for varus knees with medial osteoarthritis than opening wedge LFO for valgus knees with lateral osteoarthritis
Authors: Ekeland Arne , Nerhus Tor Kjetil , Dimmen Sigbjørn , Heir Stig
Published: November 2020

Aims

To compare time dependent functional improvement for patients with medial, respectively lateral knee osteoarthritis (OA) after treatment with opening wedge osteotomy relieving the pressure on the osteoarthritic part of the knee.

Methods

In all, 49 patients (52 knees) with a mean age of 47 years (31 to 64) underwent high tibial osteotomies (HTO), and 24 patients with a mean age of 48 years (31 to 62) low femoral osteotomies (LFO) with opening wedge technique due to medial, respectively lateral knee OA with malalignment. All osteotomies were stabilized with a Puddu plate and bone grafting performed in the same time period (2000 to 2008). The patients were evaluated by the Knee Injury and Osteoarthritis Outcome Score (KOOS) pre-operatively and at six months, and at one, two, five, and ten years postoperatively. The knee OA was graded according to the Ahlbäck and Kellgren-Lawrence radiological scoring systems.

Results

The mean angular corrections were 8.0° (4° to 12°) for the HTO and 9.6° (4° to 20°) for the LFO. Both the pre-operative KOOS and the osteoarthritic gradings were similar for the two patient groups. The five subscores of KOOS increased significantly during the postoperative period (p < 0.001 to 0.029) levelling out after one year in both groups. The KOOS subscore symptoms was significantly higher for patients with HTO than those with LFO at all follow-up times, for sport and recreation in the period one to five years, and for pain and quality of life at two to five years (p < 0.001 to 0.009). Eight HTOs (15%) and five LFOs (21%) were converted to total knee arthroplasty after mean 6.7 years (2.0 to 9.8) and 5.4 years (4.0 to 8.0) respectively. The ten-year osteotomy survival rates were 88% for the HTO and 79% for the LFO (p = 0.745).

Conclusion

Patients with unicompartmental knee OA improved after a corrective opening wedge osteotomy, but four of the five subscores of KOOS were significantly higher for those with medial than those with lateral OA in most of the ten-year follow-up period. Cite this article: Bone Joint Open 2020;1-7:346–354.
Medical Image of the Month: Buffalo Chest Identified at the Time of Lung Nodule Biopsy
Authors:   University of Arizona, Tucson, AZ USA, Belone Phillip , Lee Jason , Larson Michael
Published: November 2020

No abstract available. Manuscript truncated after 150 words. A gentleman in his late 50s with a past medical history of squamous cell carcinoma at the base of the tongue had numerous slowly-growing pneumocyst-like lesions despite clinical remission status post surgery and chemoradiation. Biopsy of one of these lesions was recommended by a multidisciplinary tumor board. An outpatient pre-procedural supine chest CT revealed a right pneumothorax above the lesion targeted for biopsy. A subsequent pre-procedural right lateral decubitus chest CT three weeks later demonstrated a left-sided pneumothorax, raising concern for buffalo chest. (A less likely possibility would be spontaneous resolution of the right pneumothorax and development of a new left pneumothorax in the less than 4-week interval.) Intraprocedural imaging continued to demonstrate the left-sided pneumothorax. A biopsy touch preparation of the first sample obtained did not demonstrate malignancy. Therefore, an attempt was made at obtaining another sample. However, the patient developed a brief but forceful coughing fit, resulting in …
Highly flexible fiber delivery of a high peak power nanosecond Nd:YAG laser beam for flexiscopic applications
Authors: Abbasi Hamed , Canbaz Ferda , Guzman Raphael , Cattin Philippe C. , Zam Azhar
Published: November 2020

Minimally invasive laser surgeries that require the use of a flexible endoscope (flexiscope) could benefit from high-energy nanosecond laser pulses delivered through fibers for real-time tissue characterization and phenotyping. The damage threshold of the fiber’s glass material limits the maximum amount of deliverable peak power. To transmit high-energy pulses without damaging the fiber material, large-diameter fibers are typically used, leading to a limited bending radius. Moreover, in a large-core fiber, self-focusing can damage the fiber even if the tip remains intact. In this work, we tested a fused-end fiber bundle combined with a beam shaper capable of delivering more than 20 MW (>100 mJ/5 ns). The fiber bundle was tested over more than eight hours of operation, with different bending radiuses down to 15 mm. The results demonstrate, to the best of our knowledge, the highest peak power delivered through a flexible fiber, for a frequency-doubled Q-switched Nd:YAG laser.
Wearable device for remote monitoring of transcutaneous tissue oxygenation
Authors: Cascales Juan Pedro , Roussakis Emmanuel , Witthauer Lilian , Goss Avery , Li Xiaolei , Chen Yenyu , Marks Haley L. , Evans Conor L.
Published: November 2020

Wearable devices have found widespread applications in recent years as both medical devices as well as consumer electronics for sports and health tracking. A metric of health that is often overlooked in currently available technology is the direct measurement of molecular oxygen in living tissue, a key component in cellular energy production. Here, we report on the development of a wireless wearable prototype for transcutaneous oxygenation monitoring based on quantifying the oxygen-dependent phosphorescence of a metalloporphyrin embedded within a highly breathable oxygen sensing film. The device is completely self-contained, weighs under 30 grams, performs on-board signal analysis, and can communicate with computers or smartphones. The wearable measures tissue oxygenation at the skin surface by detecting the lifetime and intensity of phosphorescence, which undergoes quenching in the presence of oxygen. As well as being insensitive to motion artifacts, it offers robust and reliable measurements even in variable atmospheric conditions related to temperature and humidity. Preliminary in vivo testing in a porcine ischemia model shows that the wearable is highly sensitive to changes in tissue oxygenation in the physiological range upon inducing a decrease in limb perfusion.
Non-interferometric technique to realize vector beams embedded with polarization singularities: publisher’s note
Authors: Kumar Praveen , Pal Sushanta Kumar , Nishchal Naveen K. , Senthilkumaran P.
Published: November 2020

This publisher’s note corrects the contents of references in
J. Opt. Soc. Am.
A 37, 1043
(2020)JOAOD60740-323210.1364/JOSAA.393027.
Non-diffracting nature of truncated Hermite–Gaussian beams: publisher’s note
Authors: Bencheikh Abdelhalim , Forbes Andrew
Published: November 2020

This publisher’s note corrects the Fig. 6 caption in J. Opt. Soc. Am. A
37, C1 (2020)JOAOD60740-323210.1364/JOSAA.385913.
Long-distance distributed acoustic sensing utilizing negative frequency band
Authors: Xiong Ji , Wang Zinan , Wu Yue , Wu Han , Rao Yunjiang
Published: November 2020

Wider bandwidth always means better overall performance for an information system. Naturally, this criterion can also be applied to phase-sensitive optical time domain reflectometry (Φ-OTDR), which is a typical distributed optical fiber sensing (DOFS) system. Thus, an indispensable way to enhance the performance of Φ-OTDR is to increase the available system bandwidth, which is usually limited by the electrical components. As a kind of frequency resources, the negative frequency band (NFB) has been used in communication systems based on coherent receivers and high-order modulation, but is still rarely used in DOFS. In this paper, we make a comprehensive study on how to utilize NFB in Φ-OTDR and thus double the available system bandwidth. Moreover, the related improvement of sensing performance is experimentally demonstrated. The positive and negative frequency multiplexing is utilized together with frequency division multiplexing to break the inherent trade-off between sensing distance and scan-rate. As a result, 21.6 kHz scan-rate is experimentally achieved on a 103 km fiber, with

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z

strain resolution and 9.3 m spatial resolution. To the best of our knowledge, this is the best sensing performance in long distance Φ-OTDR > 100 km. The proposed scheme can also be applied to other DOFS systems with heterodyne-detection, opening up new possibilities for performance enhancement in DOFS systems.
Laser pointing and characterization parameter determination methods based on laser profile arrays of ICESat/GALS
Authors: Yang Xiong Dan , Li Guo Yuan , Yao Jia Qi
Published: November 2020

Satellite laser altimeter data are used for polar ice sheet elevation mapping, vegetation mapping, etc. Data quality mainly depends on complex relationships among several factors in the path of laser transmission and on illuminated surfaces, including clouds, atmospheric aerosol, satellite pointing, laser energy, topography, footprint size, shape and orientation. The precise pointing of the transmitted laser pulse is critical for improving the horizontal accuracy of the footprint on the ground. Thus, we extracted the centroid of the laser profile array (LPA) image of ICESat/GLAS by 1/e2 maximum energy distribution method. The results show that the accuracy of extraction of the LPA’s centroid improved by 0.3 pixel, and the relative positioning accuracy improved by 0.11 pixel. The fast Fourier transform and Fourier series fitting of the LPA centroid has been implemented to detect the periodic change and analyze the model regularity. The results show that the centroid of the LPA undergoes four periodic changes: 1.83 × 10−4, 3.36 × 10−4, 5.19 × 10−4, and 6.71 × 10−4Hz. The correlation of fit is a good indicator (R2=0.86) and accurate up to 0.4 arcsec (approximately 0.13 pixel). Finally, we extract and estimate the LPA characteristic parameters (eccentricity, orientation, total intensity, and major axis) in different campaigns. We observe that the results obtained by the 1/e2maximum energy distribution are only approximate.