bluuebunny/crossref_metadata_2025 huggingface dataset:
Reduced graphene oxide coating enhances osteogenic differentiation of human mesenchymal stem cells on Ti surfaces
Authors: Kang Moon Sung , Jeong Seung Jo , Lee Seok Hyun , Kim Bongju , Hong Suck Won , Lee Jong Ho , Han Dong-Wook
Published: February 2021

Background

Titanium (Ti) has been utilized as hard tissue replacement owing to its superior mechanical and bioinert property, however, lack in tissue compatibility and biofunctionality has limited its clinical use. Reduced graphene oxide (rGO) is one of the graphene derivatives that possess extraordinary biofunctionality and are known to induce osseointegration in vitro and in vivo. In this study, rGO was uniformly coated by meniscus-dragging deposition (MDD) technique to fabricate rGO-Ti substrate for orthopedic and dental implant application.

Methods

The physicochemical characteristics of rGO-coated Ti (rGO-Ti) substrates were evaluated by atomic force microscopy, water contact angle, and Raman spectroscopy. Furthermore, human mesenchymal stem cells (hMSCs) were cultured on the rGO-Ti substrate, and then their cellular behaviors such as growth and osteogenic differentiation were determined by a cell counting kit-8 assay, alkaline phosphatase (ALP) activity assay, and alizarin red S staining.

Results

rGO was coated uniformly on Ti substrates by MDD process, which allowed a decrease in the surface roughness and contact angle of Ti substrates. While rGO-Ti substrates significantly increased cell proliferation after 7 days of incubation, they significantly promoted ALP activity and matrix mineralization, which are early and late differentiation markers, respectively.

Conclusion

It is suggested that rGO-Ti substrates can be effectively utilized as dental and orthopedic bone substitutes since these graphene derivatives have potent effects on stimulating the osteogenic differentiation of hMSCs and showed superior bioactivity and osteogenic potential.
Dysfunction of natural killer cells in end-stage kidney disease on hemodialysis
Authors: Nagai Kei
Published: February 2021

Natural killer (NK) cells are known to play an important role in defense against infection and tumors. Although there is no clear consensus, most studies have shown that the number and cytotoxicity of NK cells decreases in end-stage kidney disease (ESKD) patients undergoing hemodialysis. Uremic patients chronically suffer from oxidative stress, which could be responsible for downregulation of the activating receptors on NK cells and modulation of ligand expression for activating receptors. Theoretically, the reduced number of NK cells and decreased function might increase susceptibility to viral infections and cancer development in patients with ESKD. There is emerging evidence that NK cell numbers may be an outcome predictor in renal transplantation; however, the clinical significance of NK cell dysfunction in dialysis patients requires clarification. In this review, I describe NK cell number, cytotoxic activity, and activating mechanisms in the context of uremia and oxidative stress, which is anticipated to assist in elucidating the mechanisms underlying immunodeficiency in dialysis patients.
Effect of different dietary protein sources on digestibility and growth performance parameters in lambs
Authors: El-Nomeary Yasser A. A. , Abd El-Rahman Hashem H. H. , Shoukry Mohsen M. , Abedo Abdelmegid A. , Salman Fatma M. , Mohamed Mamdouh I.
Published: February 2021

Background

The aim of this study is a comparison between some different protein sources in sheep rations to identify the best protein source that achieves the highest production performance and the lowest economical feed efficiency. Twenty Farafra male lambs weighed on average 41.39 ± 1.66 kg were divided randomly into four similar groups of 5 animals each. All groups were fed on concentrate feed mixture (CFM) at 3% of their body weight, and wheat straw fed ad lib. to replace 100% of the soybean meal (SBM) as a source of protein, black cumin seed meal (BCSM), cottonseed meal (CSM) and sesame seed meal (SSM) were incorporated into the CFM. The feeding trial extended for 66 days followed by digestibility and nitrogen (N) balance trials.

Results

The results indicated no difference in total feed intake between experimental groups. Digestibility of crude protein, ether extract and crude fiber for animals fed CSM ration was higher (p < 0.05) than those fed the other rations. On the other hand, the CSM ration recorded a higher value of digestible crude protein than SBM and BCSM rations. Lambs gave rations containing CSM was higher (p < 0.05) average daily weight gain compared with those fed the other rations. Lambs that fed CSM ration were better to feed conversion as kg dry matter intake/kg gain than those fed the other rations. Relative economic efficiency was the best for CSM ration as compared to other protein sources. Nitrogen balance value of sheep fed CSM diet had the highest (p < 0.05) value compared with those fed different sources. Rumen fermentation showed that the pH value was the lowest with SSM, NH3-N concentration was higher for BCSM and SSM, and total volatile fatty acids were higher for SBM compared with the other rations.

Conclusion

It could be concluded that cottonseed meal was the best treatment for digestibility coefficient, average daily gain, highest nitrogen balance, better feed conversion ratio and also the best economic efficiency compared to soybean meal, black cumin seed meal and sesame seed meal treatments. It can replace 100% soybean meal by cottonseed meal in sheep ration when economics is to be considered.
MRI CSF flowmetry in evaluation of different neurological diseases
Authors: Ahmad Nermin , Salama Dina , Al-Haggar Mohammad
Published: February 2021

Background

Phase contrast MR imaging is a rapid and non-invasive technique which is sensitive in diagnosis and follow-up of different neurological diseases that cause CSF flow abnormality. MRI CSF flowmetry will be currently assessed in different neurological diseases that may cause CSF flow abnormalities.

Results

This study includes 39 patients with their ages ranging from 1 to 65 years; they were referred from the neurology department, with nine individuals of matched age and sex as a control group. Based on clinical history and conventional MRI, patients were subdivided into five subgroups; normal pressure hydrocephalus (NPH), hydrocephalus, idiopathic intracranial hypertension (IIH), brain atrophy (BA), and Chiari malformation type I (CM-I). All patients and control were subjected to MRI CSF flowmetry evaluation with stress on peak diastolic velocity (PDV), peak systolic velocity (PSV), stroke volume (SV), and maximum velocity (Vmax). PDV, PSV, and SV were found significantly higher in NPH, CM-I, and hydrocephalus compared to control (4.2, 4.96, and 83.23 for NPH; 3.95, 4.93, and 37.38 for CM-I; and 4.2, 5.6, and 125 in hydrocephalus versus 2.11, 2.73, and 75.33 in control, respectively; P = 0.0004, 0.0008, and 0.0009 for NPH; 0.03, 0.003, and 0.06 for CM-I; and 0.0005, 0.0002, and 0.0003, respectively). On the other hand, patients with BA showed significantly lower values (1.37, 1.66, and 1.53, respectively) compared to control (P = 0.001, 0.001, and 0.004, respectively).

Conclusion

MRI CSF flowmetry provides an easy, accurate, and non-invasive method for diagnosis of different neurological diseases that cause CSF flow abnormality. Moreover, this diagnostic modality could be helpful in selecting the therapeutic option.
Understanding constraints on integrated care for people with HIV and multimorbid cardiovascular conditions: an application of the Theoretical Domains Framework
Authors: Schexnayder Julie , Longenecker Chris T. , Muiruri Charles , Bosworth Hayden B. , Gebhardt Daniel , Gonzales Sarah E. , Hanson Jan E. , Hileman Corrilynn O. , Okeke Nwora Lance , Sico Isabelle P. , Vedanthan Rajesh , Webel Allison R.
Published: February 2021

Background

People with HIV (PWH) experience increased cardiovascular disease (CVD) risk. Many PWH in the USA receive their primary medical care from infectious disease specialists in HIV clinics. HIV care teams may not be fully prepared to provide evidence-based CVD care. We sought to describe local context for HIV clinics participating in an NIH-funded implementation trial and to identify facilitators and barriers to integrated CVD preventive care for PWH.

Methods

Data were collected in semi-structured interviews and focus groups with PWH and multidisciplinary healthcare providers at three academic medical centers. We used template analysis to identify barriers and facilitators of CVD preventive care in three HIV specialty clinics using the Theoretical Domains Framework (TDF).

Results

Six focus groups were conducted with 37 PWH. Individual interviews were conducted with 34 healthcare providers and 14 PWH. Major themes were captured in seven TDF domains. Within those themes, we identified nine facilitators and 11 barriers to CVD preventive care. Knowledge gaps contributed to inaccurate CVD risk perceptions and ineffective self-management practices in PWH. Exclusive prioritization of HIV over CVD-related conditions was common in PWH and their providers. HIV care providers assumed inconsistent roles in CVD prevention, including for PWH with primary care providers. HIV providers were knowledgeable of HIV-related CVD risks and co-located health resources were consistently available to support PWH with limited resources in health behavior change. However, infrequent medical visits, perceptions of CVD prevention as a primary care service, and multiple co-location of support programs introduced local challenges to engaging in CVD preventive care.

Conclusions

Barriers to screening and treatment of cardiovascular conditions are common in HIV care settings and highlight a need for greater primary care integration. Improving long-term cardiovascular outcomes of PWH will likely require multi-level interventions supporting HIV providers to expand their scope of practice, addressing patient preferences for co-located CVD preventive care, changing clinic cultures that focus only on HIV to the exclusion of non-AIDS multimorbidity, and managing constraints associated with multiple services co-location.

Trial registration

ClinicalTrials.gov, NCT03643705
Metformin and asarone inhibit HepG2 cell proliferation in a high glucose environment by regulating AMPK and Akt signaling pathway
Authors: Das Bhrigu Kumar , Knott Rachel M. , Gadad Pramod C.
Published: February 2021

Background

Metabolic dysregulation is one of the hallmarks of tumor cell proliferation. Evidence indicates the potential role of the 5′adenosine monophosphate-activated protein kinase (AMPK) and protein kinase B/Akt signaling pathway in regulating cell proliferation, survival, and apoptosis. The present study explores the effect of metformin HCl and the combination of α- and β-asarone on the proliferation of HepG2 cells in the presence of high glucose levels simulating the diabetic-hepatocellular carcinoma (HCC) condition.

Results

The metformin and asarone reduced HepG2 cell viability in a dose-dependent manner and induced morphological changes as indicated by methyl thiazolyl tetrazolium (MTT) assay. The metformin and asarone arrested the cells at the G0/G1 phase, upregulated the expression of AMPK, and downregulated Akt expression in high glucose conditions as identified by the flow cytometry technique. Further, the upregulated AMPK led to a decrease in the expression of phosphoenolpyruvate carboxykinase-2 (PCK-2) and sterol regulatory element-binding protein-1 (SREBP-1).

Conclusion

The anti-proliferative effect of metformin and asarone in the diabetic-HCC condition is mediated via AMPK and Akt pathway.
Simplified Geriatric Assessment in Older Patients With Diffuse Large B-Cell Lymphoma: The Prospective Elderly Project of the Fondazione Italiana Linfomi
Authors: Merli Francesco , Luminari Stefano , Tucci Alessandra , Arcari Annalisa , Rigacci Luigi , Hawkes Eliza , Chiattone Carlos S. , Cavallo Federica , Cabras Giuseppina , Alvarez Isabel , Fabbri Alberto , Re Alessandro , Puccini Benedetta , Barraclough Allison , Delamain Marcia Torresan , Ferrero Simone , Usai Sara Veronica , Ferrari Angela , Cencini Emanuele , Pennese Elsa , Zilioli Vittorio Ruggero , Marino Dario , Balzarotti Monica , Cox Maria Christina , Zanni Manuela , Di Rocco Alice , Lleshi Arben , Botto Barbara , Hohaus Stefan , Merli Michele , Sartori Roberto , Gini Guido , Nassi Luca , Musuraca Gerardo , Tani Monica , Bottelli Chiara , Kovalchuk Sofia , Re Francesca , Flenghi Leonardo , Molinari Annalia , Tarantini Giuseppe , Chimienti Emanuela , Marcheselli Luigi , Mammi Caterina , Spina Michele
Published: February 2021

PURPOSE

To prospectively validate the use of a simplified geriatric assessment (sGA) at diagnosis and to integrate it into a prognostic score for older patients with diffuse large B-cell lymphoma (DLBCL).

METHODS

We conducted the prospective Elderly Project study on patients with DLBCL older than 64 years who underwent our Fondazione Italiana Linfomi original geriatric assessment (oGA) (age, Cumulative Illness Rating Scale for Geriatrics, activities of daily living, and instrumental activities of daily living) before treatment. Treatment choice was left to the physician's discretion. The primary end point was overall survival (OS) (ClinicalTrials.gov identifier: NCT02364050 ).

RESULTS

We analyzed 1,163 patients (median age 76 years), with a 3-year OS of 65% (95% CI, 62 to 68). Because at multivariate analysis on oGA, age > 80 years retained an independent correlation with OS, we also developed a new, simplified version of the GA (sGA) that classifies patients as fit (55%), unfit (28%), and frail (18%) with significantly different 3-year OS of 75%, 58%, and 43%, respectively. The sGA groups, International Prognostic Index, and hemoglobin levels were independent predictors of OS and were used to build the Elderly Prognostic Index (EPI). Three risk groups were identified: low (23%), intermediate (48%), and high (29%), with an estimated 3-year OS of 87% (95% CI, 81 to 91), 69% (95% CI, 63 to 73), and 42% (95% CI, 36 to 49), respectively. The EPI was validated using an independent external series of 328 cases.

CONCLUSION

The Elderly Project validates sGA as an objective tool to assess fitness status and defines the new EPI to predict OS of older patients with DLBCL.
The Society for Obstetric Anesthesia and Perinatology Interdisciplinary Consensus Statement on Neuraxial Procedures in Obstetric Patients With Thrombocytopenia
Authors: Bauer Melissa E , Arendt Katherine , Beilin Yaakov , Gernsheimer Terry , Perez Botero Juliana , James Andra H. , Yaghmour Edward , Toledano Roulhac D. , Turrentine Mark , Houle Timothy , MacEachern Mark , Madden Hannah , Rajasekhar Anita , Segal Scott , Wu Christopher , Cooper Jason P. , Landau Ruth , Leffert Lisa
Published: February 2021

Because up to 12% of obstetric patients meet criteria for the diagnosis of thrombocytopenia in pregnancy, it is not infrequent that the anesthesiologist must decide whether to proceed with a neuraxial procedure in an affected patient. Given the potential morbidity associated with general anesthesia for cesarean delivery, thoughtful consideration of which patients with thrombocytopenia are likely to have an increased risk of spinal epidural hematoma with neuraxial procedures, and when these risks outweigh the relative benefits is important to consider and to inform shared decision making with patients. Because there are substantial risks associated with withholding a neuraxial analgesic/anesthetic procedure in obstetric patients, every effort should be made to perform a bleeding history assessment and determine the thrombocytopenia etiology before admission for delivery. Whereas multiple other professional societies (obstetric, interventional pain, and hematologic) have published guidelines addressing platelet thresholds for safe neuraxial procedures, the US anesthesia professional societies have been silent on this topic. Despite a paucity of high-quality data, there are now meta-analyses that provide better estimations of risks. An interdisciplinary taskforce was convened to unite the relevant professional societies, synthesize the data, and provide a practical decision algorithm to help inform risk-benefit discussions and shared decision making with patients. Through a systematic review and modified Delphi process, the taskforce concluded that the best available evidence indicates the risk of spinal epidural hematoma associated with a platelet count ≥70,000 × 106/L is likely to be very low in obstetric patients with thrombocytopenia secondary to gestational thrombocytopenia, immune thrombocytopenia (ITP), and hypertensive disorders of pregnancy in the absence of other risk factors. Ultimately, the decision of whether to proceed with a neuraxial procedure in an obstetric patient with thrombocytopenia occurs within a clinical context. Potentially relevant factors include, but are not limited to, patient comorbidities, obstetric risk factors, airway examination, available airway equipment, risk of general anesthesia, and patient preference.
Determinants of Work-Related Quality of Life in French Anesthesiologists
Authors: Gafsou Benjamin , Becq Marie-Christine , Michelet Daphné , Julien-Marsollier Florence , Brasher Christopher , Dahmani Souhayl
Published: February 2021

BACKGROUND:

Little evidence is available regarding work-related quality of life (WRQoL) for anesthesiologists. We aimed to explore factors associated with WRQoL among French anesthesiologists.

METHODS:

The study surveyed French anesthesiologists qualified for more than 2 years. The primary objective was the determination of factors associated with WRQoL. Factors analyzed included demographic characteristics, lifestyle, financial status, personality traits, professional relations, management and organization, and occupational tasks when at work. Statistical analyses were performed using a multivariable quantile regression model.

RESULTS:

Overall, 2040 anesthesiologists responded to the survey and 1922 responses were analyzed. The latter represents 19% of practicing French anesthesiologists. The following factors were independently associated with increased WRQoL: family income, long-term employment, organizational and managerial factors (lesser weekly workload, the belief of providing high quality, safe health care services, team management, and operating theatre organization), human relations (satisfaction with workplace ambiance and relations with hospital management and colleagues), and occupational tasks (participation in team activities). Three personality traits were found to be significantly associated with increased WRQoL: extraversion, conscientiousness, and openness. Neuroticism was associated with reduced WRQoL.

CONCLUSIONS:

The current study demonstrates exogenous and endogenous factors associated with increased WRQoL in anesthesiologists. Results should be considered as explorative and provide hypotheses for further research in this domain.
Fiji plugins for qualitative image annotations: routine analysis and application to image classification
Authors: Thomas Laurent S. V. , Schaefer Franz , Gehrig Jochen
Published: February 2021

Quantitative measurements and qualitative description of scientific images are both important to describe the complexity of digital image data. While various software solutions for quantitative measurements in images exist, there is a lack of simple tools for the qualitative description of images in common user-oriented image analysis software. To address this issue, we developed a set of Fiji plugins that facilitate the systematic manual annotation of images or image-regions. From a list of user-defined keywords, these plugins generate an easy-to-use graphical interface with buttons or checkboxes for the assignment of single or multiple pre-defined categories to full images or individual regions of interest. In addition to qualitative annotations, any quantitative measurement from the standard Fiji options can also be automatically reported. Besides the interactive user interface, keyboard shortcuts are available to speed-up the annotation process for larger datasets. The annotations are reported in a Fiji result table that can be exported as a pre-formatted csv file, for further analysis with common spreadsheet software or custom automated pipelines. To illustrate possible use case of the annotations, and facilitate the analysis of the generated annotations, we provide examples of such pipelines, including data-visualization solutions in Fiji and KNIME, as well as a complete workflow for training and application of a deep learning model for image classification in KNIME. Ultimately, the plugins enable standardized routine sample evaluation, classification, or ground-truth category annotation of any digital image data compatible with Fiji.
Cardiometabolic health during early adulthood and risk of miscarriage: a prospective study
Authors: Magnus Maria C. , Ferreira Diana D. S. , Borges Maria Carolina , Tilling Kate , Lawlor Deborah A. , Fraser Abigail
Published: February 2021

Background: Several studies have found that women who are overweight or obese have an increased risk of miscarriage. There is also some evidence of associations of other aspects of cardiometabolic health, including blood pressure and lipids, with miscarriage risk, although these have not been examined to the same extent as body-mass index (BMI).

Methods: Our objective was to investigate the risk of miscarriage according to pre-pregnancy cardiometabolic health. We examined pre-pregnancy levels of BMI, blood pressure, fasting insulin and metabolites profile at age 18 and risk of miscarriage by age 24. The study included adult female offspring in the Avon Longitudinal Study of Parents and Children with a pregnancy between 18 and 24 years of age (n=434 for BMI and blood pressure; n=265 for metabolites). We used log-binomial regression to calculate adjusted associations between cardiometabolic health measures and miscarriage.

Results: The overall risk of miscarriage was 22%.  The adjusted relative risks for miscarriage were 0.96 (95% CI: 0.92-1.00) for BMI (per unit increase), 0.98 (0.96-1.00) for systolic blood pressure, and 1.00 (0.97-1.04) for diastolic blood pressure (per 1 mmHg increase).  Total cholesterol, total lipids and phospholipids in HDL-cholesterol were associated with increased likelihood of miscarriage, but none of the p-values for the metabolites were below the corrected threshold for multiple testing (p-value ≤0.003).

Conclusions: Our findings indicate no strong evidence to support a relationship between pre-pregnancy cardiometabolic health and risk of miscarriage in young, healthy women who became pregnant before age 24. Future studies are necessary that are able to evaluate this question in samples with a wider age range.
Redes férreas y patrimonio industrial en la configuración urbano-territorial de Pereira: ciudad intermedia del Paisaje Cultural Cafetero
Authors: Rivera Pabón Tatiana
Published: February 2021

Este artículo propone la valoración de los doce conjuntos férreos e industriales vinculados a la producción de café en la ciudad intermedia de Pereira, Colombia, como elementos constitutivos de una tipología de patrimonio industrial agroproductivo, hasta ahora inexplorada en la decla­ratoria Unesco del Paisaje Cultural Cafetero (2011). Se plantea la resignificación de estos bienes culturales dentro del contexto del territorio agroproductivo, valorándolos como elementos que consolidaron el papel de la ciudad como mediadora de flujos de bienes y personas entre territorios rurales y urbanos mientras el ferrocarril se mantuvo en funcionamiento (1921-1972). A partir de la consulta de archivos históricos, entrevistas con actores locales, levantamientos urbanos y arquitectónicos, se teje una narrativa territorial y arquitectónica que, recorriendo las antiguas ferrovías desde las áreas de producción rurales hasta las de industrialización urbana, identifica los espacios, actores y temporalidades del proceso productivo cafetero local. Se destaca el potencial de esta nueva lectura histórica del territorio para valorar las configuraciones espaciales propias del proceso de modernización de la región, entender las dinámicas campo-ciudad y fortalecer la memoria social de los espacios industriales cafeteros.
Natural symmetry
Authors: Clarke Jenni
Published: February 2021

When a child is excited by something they identify in the natural world, there is a valuable opportunity to seize the moment and extend learning. Jenni Clarke explains how the adult can prompt and support without taking over.
Lasting impression
Authors: White Hilary
Published: February 2021

Picture books are a mainstay of every setting and also one of the more eco-friendly resources available to us. Hilary White provides a guide to taking children through the steps of choosing and buying books online, and learning to care for what arrives.
Unique closure of Gustilo IIIA fracture with a hard-to-heal lower extremity wound
Authors: Clarke Caroline E , Tettelbach William H
Published: February 2021

Consistently achieving wound closure requires a broad understanding of wound physiology, anatomy and wound healing phases. The multifaceted principles of wound closure are comprised of: perfusion evaluation; diabetes control; nutritional optimisation; infection control; mechanical stress avoidance; oedema management; wound bed preparation; and community care. Optimisation of each element is crucial to timely and durable resolution of acute and hard-to-heal wounds. This objective is realisable only through an interdisciplinary approach to wound healing. The reconstructive ladder represents the graduation of complex wound management as applied by the specialty of plastic surgery. The approach to reconstruction typically begins with the least invasive option, which is considered reliable. However, there are instances when the most reliable option on the reconstructive ladder is not a viable option and creative solutions for wound closure are required. The following case report demonstrates a unique approach to lower extremity salvage in a subacute compound fracture surgical site infection using a limited reconstructive ladder.
The Effects of SCAMPER Technique Activities in the 8th Grade Simple Machines Unit on Students’ Academic Achievement, Motivation and Attitude towards Science Lessons
Authors: Altiparmak Tuba , Eryilmaz-Muştu Özlem
Published: February 2021

This study examines the effects of the SCAMPER technique-based educational activities in the simple machines unit of a science lesson on students' academic achievement, motivation and attitude. The study examines the effects of the simple machines unit activities in the science lesson through a paired quasi-experimental design, which is one of the quantitative research methods. The sample group of the research consists of 33 eighth-grade students studying in a middle school in the Ortaköy district of the Aksaray province in 2018–2019. The research uses simple random sampling method. The experimental group was given SCAMPER-based activities in the simple machines unit for 4 hours a week with a total of 16 hours, and lessons were conducted with the control group in line with the curriculum. To collect data within the framework of the research, the 'attitude scale towards science lesson', scale for 'students' motivation towards science learning' and 'simple machines unit achievement test' were used. As a result, when compared to the control group, there was a significant difference in the academic achievement and motivation of the experimental group who performed SCAMPER-based activities in the simple machines unit of the science lesson. There was no significant difference between the attitude scores of the experimental and control group as a result of the study.
Elective orthopaedic cancellations due to the COVID-19 pandemic: where are we now, and where are we heading?
Authors: Oussedik Sam , MacIntyre Sam , Gray Joanne , McMeekin Peter , Clement Nick D. , Deehan David J.
Published: February 2021

Aims

The primary aim is to estimate the current and potential number of patients on NHS England orthopaedic elective waiting lists by November 2020. The secondary aims are to model recovery strategies; review the deficit of hip and knee arthroplasty from National Joint Registry (NJR) data; and assess the cost of returning to pre-COVID-19 waiting list numbers.

Methods

A model of referral, waiting list, and eventual surgery was created and calibrated using historical data from NHS England (April 2017 to March 2020) and was used to investigate the possible consequences of unmet demand resulting from fewer patients entering the treatment pathway and recovery strategies. NJR data were used to estimate the deficit of hip and knee arthroplasty by August 2020 and NHS tariff costs were used to calculate the financial burden.

Results

By November 2020, the elective waiting list in England is predicted to be between 885,286 and 1,028,733. If reduced hospital capacity is factored into the model, returning to full capacity by November, the waiting list could be as large as 1.4 million. With a 30% increase in productivity, it would take 20 months if there was no hidden burden of unreferred patients, and 48 months if there was a hidden burden, to return to pre-COVID-19 waiting list numbers. By August 2020, the estimated deficits of hip and knee arthroplasties from NJR data were 18,298 (44.8%) and 16,567 (38.6%), respectively, compared to the same time period in 2019. The cost to clear this black log would be £198,811,335.

Conclusion

There will be up to 1.4 million patients on elective orthopaedic waiting lists in England by November 2020, approximate three-times the pre-COVID-19 average. There are various strategies for recovery to return to pre-COVID-19 waiting list numbers reliant on increasing capacity, but these have substantial cost implications. Cite this article: Bone Jt Open 2021;2(2):103–110.
Tuning of the Gouy phase variation for radially polarized laser beams
Authors: Pelchat-Voyer Shanny , Piché Michel
Published: February 2021

We discuss a method to produce a radially polarized laser beam with a tunable on-axis Gouy phase total variation different from the standard value of 2π. It is shown that structuring the derivative of the field near the optical axis of a single-ring-shaped illumination focused by an aplanetic lens or a parabolic mirror, one could obtain any value between 3π/2 and large multiples of π. Our results might prove useful for experiments involving the field pattern of a TM01 beam that requires specific phase matching conditions.
Broadband mid-infrared supercontinuum generation in dispersion-engineered As2S3-silica nanospike waveguides pumped by 2.8  μm femtosecond laser
Authors: Wang Pan , Huang Jiapeng , Xie Shangran , Troles Johann , St.J. Russell Philip
Published: February 2021

Broadband mid-infrared (IR) supercontinuum laser sources are essential for spectroscopy in the molecular fingerprint region. Here, we report generation of octave-spanning and coherent mid-IR supercontinua in

As

2

S
3

-silica nanospike hybrid waveguides pumped by a custom-built 2.8 μm femtosecond fiber laser. The waveguides are formed by pressure-assisted melt-filling of molten

As

2

S
3

into silica capillaries, allowing the dispersion and nonlinearity to be precisely tailored. Continuous coherent spectra spanning from 1.1 μm to 4.8 μm (30 dB level) are observed when the waveguide is designed so that 2.8 μm lies in the anomalous dispersion regime. Moreover, linearly tapered millimeter-scale

As

2

S
3

-silica waveguides are fabricated and investigated for the first time, to the best of our knowledge, showing much broader supercontinua than uniform waveguides, with improved spectral coherence. The waveguides are demonstrated to be long-term stable and water-resistant due to the shielding of the

As

2

S
3

by the fused silica sheath. They offer an alternative route to generating broadband mid-IR supercontinua, with applications in frequency metrology and molecular spectroscopy, especially in humid and aqueous environments.
Cellular Expression and Subcellular Localization of Wwox Protein During Testicular Development and Spermatogenesis in Rats
Authors: Mahmud Md Abdullah Al , Noguchi Maki , Domon Ayaka , Tochigi Yuki , Katayama Kentaro , Suzuki Hiroetsu
Published: February 2021

A well-known putative tumor suppressor WW domain–containing oxidoreductase (Wwox) is highly expressed in hormonally regulated tissues and is considered important for the normal development and function of reproductive organs. In this study, we investigated the cellular and subcellular localization of Wwox in normal testes during postnatal days 0–70 using Western blotting and immunohistochemistry. Wwox is expressed in testes at all ages. Immunohistochemistry showed that fetal-type and adult-type Leydig cells, immature and mature Sertoli cells, and germ cells (from gonocytes to step 17 spermatids) expressed Wwox except peritubular myoid cells, step 18–19 spermatids, and mature sperm. Wwox localized diffusely in the cytoplasm with focal intense signals in all testicular cells. These signals gradually condensed in germ cells with their differentiation and colocalized with giantin for cis-Golgi marker and partially with golgin-97 for trans-Golgi marker. Biochemically, Wwox was detected in isolated Golgi-enriched fractions. But Wwox was undetectable in the nucleus. This subcellular localization pattern of Wwox was also confirmed in single-cell suspension. These findings indicate that Wwox is functional in most cell types of testis and might locate into Golgi apparatus via interaction with Golgi proteins. These unique localizations might be related to the function of Wwox in testicular development and spermatogenesis:
Relationship between serum bilirubin levels, urinary biopyrrin levels, and retinopathy in patients with diabetes
Authors: Kudo Kana , Inoue Tomoaki , Sonoda Noriyuki , Ogawa Yoshihiro , Inoguchi Toyoshi
Published: February 2021

Objective

Previous reports have indicated that serum bilirubin levels may be associated with diabetic retinopathy. However, the detailed mechanism is not fully understood. In this study, we evaluated the relationship between the severity of diabetic retinopathy and various factors including bilirubin levels and factors influencing bilirubin metabolism.

Methods

The study participants consisted of 94 consecutive patients with diabetes mellitus admitted to Kyushu University Hospital from April 2011 to July 2012. The patients were classified into three groups: no retinopathy (NDR), simple retinopathy (SDR), and pre-proliferative or proliferative retinopathy (PDR). The relationship between the severity of retinopathy and various factors was evaluated using univariate and logistic regression analyses. In addition, multivariate regression analysis was performed to evaluate the significant determinants for bilirubin levels.

Results

In univariate analysis, a significant difference was found among NDR, SDR and PDR in bilirubin levels, duration of diabetes, systolic blood pressure, and macroalbuminuria. Logistic regression analysis showed that PDR was significantly associated with bilirubin levels, duration of diabetes, and systolic blood pressure (OR 0.737, 95% CI 0.570–0.952, P = 0.012; OR 1.085, 95% CI 1.024–1.149, P = 0.006; OR 1.036, 95% CI 1.011–1.062, P = 0.005, respectively). In turn, multivariate regression analysis showed that bilirubin levels were negatively associated with high-sensitivity C-reactive protein levels and PDR, but positively correlated with urinary biopyrrin levels, oxidized metabolites of bilirubin.

Conclusion

PDR was negatively associated with bilirubin levels. This negative association may be due to a decreased production of bilirubin rather than its increased consumption considering the positive association between bilirubin and biopyrrin levels.
Protective factors against tobacco and alcohol use among pregnant women from a tribal nation in the Central United States
Authors: Jorda Mariah , Conant Bradley J. , Sandstrom Anne , Klug Marilyn G. , Angal Jyoti , Burd Larry
Published: February 2021

Identifying social determinants of tobacco and alcohol use during pregnancy is critical to improving health outcomes for the next generation. This is especially important on a rural Tribal Nation where influences such as isolation, cultural barriers, and historical trauma have made it uniquely challenging to prevent substance use during pregnancy. The purpose of this study is to identify population-specific factors that are protective against smoking and drinking during pregnancy. We used data from 421 pregnancies collected as a part of the Safe Passages study from a rural Tribal Nation in the central United States. Pregnant women were classified as women who did not smoke (n = 84), women who quit during pregnancy (n = 23), women who smoked during pregnancy (n = 314), and women who both smoked and drank alcohol during pregnancy (n = 149). Demographic data revealed that 28.8% of the mothers were currently employed, and 91.8% of mothers reported a household income of less than $3,000 per year. Substance use rates were higher than national averages: 74.6% smoked during pregnancy and 35.4% of the women both smoked and drank alcohol during pregnancy. Five factors were identified as being protective against substance use during pregnancy: 1) living with someone (81% less likely to smoke and 92% less likely to smoke and drink), 2) having at least 12 years of education (128% less likely to smoke, and 126% less likely to smoke and drink), 3) having over 12 years of education (235% less likely to smoke, and 206% less likely to smoke and drink), 4) being employed (158% less likely to smoke, and 111% less likely to smoke and drink), and 5) not being depressed (214% less likely to smoke, and 229% less likely to smoke and drink). These social determinants should be considered for intervention research to decrease rates of substance use during pregnancy.
Growth performance, physiological parameters, and transcript levels of lipid metabolism-related genes in hybrid yellow catfish (Tachysurus fulvidraco ♀ × Pseudobagrus vachellii ♂) fed diets containing Siberian ginseng
Authors: Li Ming Xiao , Qiang Jun , Bao Jing Wen , Tao Yi Fan , Zhu Hao Jun , Xu Pao
Published: February 2021

In high-density aquaculture, fish health can suffer because of excessive feeding, which causes fatty liver disease. Siberian ginseng (Acanthopanax senticosus) has been used as a feed additive to promote animal growth, immunity, and lipid metabolism. In this study, we explored the effects of A. senticosus on the physiology of hybrid yellow catfish (Tachysurus fulvidraco ♀ × Pseudobagrus vachellii ♂). A control group and five groups fed diets containing A. senticosus (0.5, 1, 2, 4, and 8 g A. senticosus/kg feed) were established and maintained for 8 weeks. Dietary supplementation with A. senticosus at 4 g/kg promoted growth of the hybrid yellow catfish. Serum total cholesterol (TC) and triacylglycerol (TG) levels at 2 g/kg A. senticosus (TC: 1.31 mmol/L; TG: 1.08 mmol/L) were significantly lower than in the control group (TC: 1.51 mmol/L; TG: 1.41 mmol/L), and 4 g/kg A. senticosus (17.20 μmol/g tissue) reduced the liver TG level compared with the control group (21.36 μmol/g tissue) (P <0.05). Comparative transcriptomic analysis of liver tissue between the control group and the group showing optimum growth (4 g/kg A. senticosus) revealed 820 differentially expressed genes and 44 significantly enriched pathways, especially lipid metabolism pathways such as unsaturated fatty acid and fatty acid metabolism. The transcript levels of five lipid metabolism-related genes were determined by quantitative real-time PCR. The results showed that 2–4 g/kg A. senticosus supplementation reduced the FADS2, ELOVL2, CYP24a, and PLPP3 transcript levels and 4 g/kg A. senticosus increased the DIO2 transcript level (P <0.05), leading to altered synthesis of TG and thyroxine and reduced fat deposition in the liver. Our results show that dietary A. senticosus affects the regulation of fat metabolism and promotes the growth of hybrid yellow catfish. A. senticosus is a healthy feed additive, and the appropriate dietary supplementation rate is 2–4 g/kg.
Cell-free DNA in spent culture medium effectively reflects the chromosomal status of embryos following culturing beyond implantation compared to trophectoderm biopsy
Authors: Shitara Akihiro , Takahashi Kazumasa , Goto Mayumi , Takahashi Harunori , Iwasawa Takuya , Onodera Yohei , Makino Kenichi , Miura Hiroshi , Shirasawa Hiromitsu , Sato Wataru , Kumazawa Yukiyo , Terada Yukihiro
Published: February 2021

This prospective study evaluated the accuracy of non-invasive preimplantation genetic testing for aneuploidy (niPGT-A) using cell-free DNA in spent culture medium, as well as that of preimplantation genetic testing for aneuploidy (PGT-A) using trophectoderm (TE) biopsy after culturing beyond implantation. Twenty frozen blastocysts donated by 12 patients who underwent IVF at our institution were investigated. Of these, 10 were frozen on day 5 and 10 on day 6. Spent culture medium and TE cells were collected from each blastocyst after thawing, and the embryos were cultured in vitro for up to 10 days. The outgrowths after culturing beyond implantation were sampled and subjected to chromosome analysis using next-generation sequencing. Chromosomal concordance rate, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), false-positive rate (FPR), and false-negative rate (FNR) of niPGT-A and PGT-A against each outgrowth were analyzed. The concordance rate between the niPGT-A and outgrowth samples was 9/16 (56.3%), and the concordance rate between the PGT-A and outgrowth samples was 7/16 (43.8%). NiPGT-A exhibited 100% sensitivity, 87.5% specificity, 88.9% PPV, 100% NPV, 12.5% FPR, and 0% FNR. PGT-A exhibited 87.5% sensitivity, 77.8% specificity, 87.5% PPV, 75% NPV, 14.3% FPR, and 22.2% FNR. NiPGT-A may be more accurate than PGT-A in terms of ploidy diagnostic accuracy in outgrowths.
Mental health stigma and professional help-seeking attitudes a comparison between Cuba and Germany
Authors: Nohr Laura , Lorenzo Ruiz Alexis , Sandoval Ferrer Juan E. , Buhlmann Ulrike
Published: February 2021

Globally the burden due to mental disorders is continuously increasing. Still, professional help-seeking behavior is not fully understood. To conceive cultural determinants of help-seeking is crucial to reduce personal and social costs of (untreated) mental disorders. The current study investigates mental health stigma and help-seeking attitudes in a Cuban (n = 195) and a German (n = 165) sample. In a questionnaire survey we asked for attitudes towards mental illness and professional help-seeking in the general Cuban and German populations. The cultural context was associated with mental health stigma and professional help-seeking attitudes. Interestingly, Cuban participants reported stronger mental health stigma and more willingness to seek help. In multiple hierarchical regression analyses, community attitudes towards the mentally ill significantly predicted help-seeking attitudes, especially in the Cuban sample. Only in the German sample, more negative individual beliefs about mental illness predicted more self-stigma on help-seeking. Beyond that, cultural context moderated the association between mental health stigma and help-seeking attitudes with a stronger association between the measures in the German sample. However, gender did not predict help-seeking attitudes and self-stigma on help-seeking and no interactions between community attitudes, cultural context, and gender were found in the prediction of help-seeking attitudes. Similarities and differences between the samples are discussed in the light of the cultural contexts and peculiarities of the current samples. Concluding, implications of the current findings are reviewed.
Financial implications of New York City’s weight management initiative
Authors: Agrawal Sagun , Wojtanowski Alexis C. , Tringali Laura , Foster Gary D. , Finkelstein Eric A.
Published: February 2021

Purpose

To estimate potential annual savings in medical expenditures from a subsidized weight management program from the NYC Government perspective.

Design

Longitudinal observational study.

Setting

Employees of New York City (NYC) government and enrolled dependents.

Sample

14,946 participants with overweight and obesity.

Intervention

WW (formerly Weight Watchers®) ‘Workshop’ and ‘Digital’ programs.

Measures

Participation rate, enrollment duration, weight change, and predicted gross and net total and per capita medical expenditure savings and return on investment (ROI).

Analysis

Participation rate, enrollment duration, weight change, and program costs are based on direct observation. Predicted savings are simulated based on published data relating weight loss to medical expenditure reductions.

Results

In total, 47% of participating employees and 50% of participating dependents lost weight during the enrollment period. Mean (median) enrollment duration for employees was 7.1 months (7.0) and for dependents was 6.9 months (6.0). Mean (median) weight losses for the employees in ‘Workshops’ and ‘Digital’ was 6.6 lbs (2.80) and 6.3 lbs (0.0). For dependents, weight losses were 7.4 lbs (3.59) and 11.6 lbs (2.0). Per capita and total predicted net savings to NYC Government from employees was estimated to be $120 and $1,486,102 for an ROI of 143%. Including dependents, predicted net savings increases to $1,963,431 for an ROI of 189%. Over 80% of savings came from participants in the Obese III category.

Conclusion

An evidence-based weight management program has the potential to generate a positive ROI for employers. Future studies should validate these estimates using actual data and more rigorous designs.
Cannabis is associated with clinical but not endoscopic remission in ulcerative colitis: A randomized controlled trial
Authors: Naftali Timna , Bar-Lev Schleider Lihi , Scklerovsky Benjaminov Fabiana , Konikoff Fred Meir , Matalon Shelly Tartakover , Ringel Yehuda
Published: February 2021

Background

Cannabis is often used by patients with ulcerative colitis, but controlled studies are few. We aimed to assess the effect of cannabis in improving clinical and inflammatory outcomes in ulcerative colitis patients.

Methods

In a double-blind, randomized, placebo-controlled trial, patients received either cigarettes containing 0.5 g of dried cannabis flowers with80mgTetrahydrocannabinol (THC)or placebo cigarettes for 8 weeks. Parameters of disease including Lichtiger disease activity index, C reactive protein (CRP), calprotectin, Mayo endoscopic score and quality of life (QOL) were assessed before, during and after treatment.

Results

The study included 32 patients. Mean age was 30 years, 14 (43%) females. Lichtiger index improved in the cannabis group from 10.9 (IQR 9–14) to5 (IQR 1–7), (p<0.000), and in the placebo group from 11 (IQR 9–13) to 8 (IQR 7–10)(p = 0.15, p between groups 0.001). QOL improved in the cannabis group from 77±4 to 98±20 (p = 0.000) but not in the placebo group (78±3 at week 0 and 78±17 at week 8;p = 0.459; p between groups 0.007). Mayo endoscopic score changed in the cannabis group from 2.13±1 to 1.25±2 (p = 0.015) and in the placebo group from 2.15±1to 1.69±1 (p = 0.367, p between groups 0.17).

Conclusion

Short term treatment with THC rich cannabis induced clinical remission and improved quality of life in patients with mild to moderately active ulcerative colitis. However, these beneficial clinical effects were not associated with significant anti-inflammatory improvement in the Mayo endoscopic score or laboratory markers for inflammation.(clinicaltrials.gov NCT01040910).