bluuebunny/crossref_metadata_2025 huggingface dataset:
Whole-body magnetic resonance imaging (WB-MRI) reporting with the METastasis Reporting and Data System for Prostate Cancer (MET-RADS-P): inter-observer agreement between readers of different expertise levels
Authors: Pricolo Paola , Ancona Eleonora , Summers Paul , Abreu-Gomez Jorge , Alessi Sarah , Jereczek-Fossa Barbara Alicja , De Cobelli Ottavio , Nolè Franco , Renne Giuseppe , Bellomi Massimo , Padhani Anwar Roshanali , Petralia Giuseppe
Published: October 2020

Background

The METastasis Reporting and Data System for Prostate Cancer (MET-RADS-P) guidelines are designed to enable reproducible assessment in detecting and quantifying metastatic disease response using whole-body magnetic resonance imaging (WB-MRI) in patients with advanced prostate cancer (APC).

The purpose of our study was to evaluate the inter-observer agreement of WB-MRI examination reports produced by readers of different expertise when using the MET-RADS-P guidelines.

Methods

Fifty consecutive paired WB-MRI examinations, performed from December 2016 to February 2018 on 31 patients, were retrospectively examined to compare reports by a Senior Radiologist (9 years of experience in WB-MRI) and Resident Radiologist (after a 6-months training) using MET-RADS-P guidelines, for detection and for primary/dominant and secondary response assessment categories (RAC) scores assigned to metastatic disease in 14 body regions. Inter-observer agreement regarding RAC score was evaluated for each region by using weighted-Cohen’s Kappa statistics (K).

Results

The number of metastatic regions reported by the Senior Radiologist (249) and Resident Radiologist (251) was comparable. For the primary/dominant RAC pattern, the agreement between readers was excellent for the metastatic findings in cervical, dorsal, and lumbosacral spine, pelvis, limbs, lungs and other sites (K:0.81–1.0), substantial for thorax, retroperitoneal nodes, other nodes and liver (K:0.61–0.80), moderate for pelvic nodes (K:0.56), fair for primary soft tissue and not assessable for skull due to the absence of findings. For the secondary RAC pattern, agreement between readers was excellent for the metastatic findings in cervical spine (K:0.93) and retroperitoneal nodes (K:0.89), substantial for those in dorsal spine, pelvis, thorax, limbs and pelvic nodes (K:0.61–0.80), and moderate for lumbosacral spine (K:0.44).

Conclusions

We found inter-observer agreement between two readers of different expertise levels to be excellent in bone, but mixed in other body regions. Considering the importance of bone metastases in patients with APC, our results favor the use of MET-RADS-P in response to the growing clinical need for monitoring of metastasis in these patients.
Estimation of resistance force at steady-state sinkage for cylindrical wheel-typed lunar/planetary exploration rovers with function of push–pull locomotion
Authors: Fujiwara Daisuke , Tsujikawa Naoki , Oshima Tetsuya , Iizuka Kojiro
Published: October 2020

Planetary exploration rovers have required a high traveling performance to overcome obstacles such as loose soil and rocks. Push-pull locomotion rovers is a unique scheme, like an inchworm, and it has high traveling performance on loose soil. Push-pull locomotion uses the resistance force by keeping a locked-wheel related to the ground, whereas the conventional rotational traveling uses the shear force from loose soil. The locked-wheel is a key factor for traveling in the push-pull scheme. Understanding the sinking behavior and its resistance force is useful information for estimating the rover’s performance. Previous studies have reported the soil motion under the locked-wheel, the traction, and the traveling behavior of the rover. These studies were, however, limited to the investigation of the resistance force and amount of sinkage for the particular condition depending on the rover. Additionally, the locked-wheel sinks into the soil until it obtains the required force for supporting the other wheels’ motion. How the amount of sinkage and resistance forces are generated at different wheel sizes and mass of an individual wheel has remained unclear, and its estimation method hasn’t existed. This study, therefore, addresses the relationship between the sinkage and its resistance force, and we analyze and consider this relationship via the towing experiment and theoretical consideration. The results revealed that the sinkage reached a steady-state value and depended on the contact area and mass of each wheel, and the maximum resistance force also depends on this sinkage. Additionally, the estimation model did not capture the same trend as the experimental results when the wheel width changed, whereas, the model captured a relatively the same trend as the experimental result when the wheel mass and diameter changed.
Novel mechanisms underlying anti-polycystic ovary like syndrome effects of electroacupuncture in rats: suppressing SREBP1 to mitigate insulin resistance, mitochondrial dysfunction and oxidative stress
Authors: Peng Yan , Yang Xinming , Luo Xi , Liu Chunhong , Cao Xia , Wang Hongyan , Guo Liyuan
Published: October 2020

Background

Acupuncture, a therapy of traditional Chinese medicine, is confirmed to exert the therapeutic action on polycystic ovary syndrome (PCOS). However, the detailed therapeutic mechanisms of acupuncture in PCOS remain ambiguous. In this study, we further investigated whether electroacupuncture (EA) alleviated PCOS-like symptoms in rats via regulating a metabolic regulator, sterol regulatory element binding protein-1 (SREBP1).

Methods

The PCOS-like rat model was built by hypodermic injection with dehydroepiandrosterone (DHEA). The rats were subjected to EA intervention (ST29 and SP6 acupuncture points) for 5 weeks. Primary granulosa cells were isolated from control and PCOS-like rats for evaluating insulin resistance, mitochondrial dysfunction and oxidative stress in vitro.

Results

The expression of SREBP1 was increased in PCOS-like rats, which was suppressed by EA treatment. In addition, lentivirus-mediated overexpression of SREBP1 restrained EA treatment-induced improvement in pathological changes, serum hormone levels and insulin resistance in rats. In addition, overexpression of SREBP1 repressed insulin-stimulated phosphorylation of insulin receptor β (IR) and AKT in primary granulosa cells. Moreover, upregulation of SREBP1 further exacerbated mitochondrial dysfunction and oxidative stress in granulosa cells isolated from PCOS-like rats. Mechanically, EA treatment suppressed SREBP1 expression through inducing the activation of AMP-activated protein kinase (AMPK) signaling pathway in PCOS-like rats.

Conclusion

EA intervention alleviated PCOS-like symptoms in rats via improving IR, mitochondrial dysfunction and oxidative stress through regulating SREBP1, a lipid metabolism regulator. Our findings illuminate the novel protective mechanisms of EA in the treatment of PCOS.
Effect of rhG-CSF Combined With Decitabine Prophylaxis on Relapse of Patients With High-Risk MRD-Negative AML After HSCT: An Open-Label, Multicenter, Randomized Controlled Trial
Authors: Gao Lei , Zhang Yanqi , Wang Sanbin , Kong Peiyan , Su Yi , Hu Jiong , Jiang Ming , Bai Hai , Lang Tao , Wang Jishi , Liu Li , Yang Tonghua , Huang Xiaobing , Liu Fang , Lou Shifeng , Liu Yao , Zhang Cheng , Liu Hong , Gao Li , Liu Jia , Zhu Lidan , Wen Qin , Chen Ting , Wang Ping , Rao Jun , Mao Min , Wang Cunbang , Duan Xianlin , Luo Le , Peng Xiangui , Cassady Kaniel , Zhong Jiang F. , Zhang Xi
Published: October 2020

PURPOSE

Relapse is a major cause of treatment failure after allogeneic hematopoietic stem-cell transplantation (allo-HSCT) for high-risk acute myeloid leukemia (HR-AML). The aim of this study was to explore the effect of recombinant human granulocyte colony-stimulating factor (rhG-CSF) combined with minimal-dose decitabine (Dec) on the prevention of HR-AML relapse after allo-HSCT.

PATIENTS AND METHODS

We conducted a phase II, open-label, multicenter, randomized controlled trial. Two hundred four patients with HR-AML who had received allo-HSCT 60-100 days before randomization and who were minimal residual disease negative were randomly assigned 1:1 to either rhG-CSF combined with minimal-dose Dec (G-Dec group: 100 µg/m2 of rhG-CSF on days 0-5 and 5 mg/m2 of Dec on days 1-5) or no intervention (non–G-Dec group). The primary outcome was relapse after transplantation, and the secondary outcomes were chronic graft-versus-host disease (cGVHD), safety of the treatment, and survival.

RESULTS

The estimated 2-year cumulative incidence of relapse in the G-Dec group was 15.0% (95% CI, 8.0% to 22.1%), compared with 38.3% (95% CI, 28.8% to 47.9%) in the non–G-Dec group ( P < .01), with a hazard ratio (HR) of 0.32 (95% CI, 0.18 to 0.57; P < .01). There was no statistically significant difference between the G-Dec and non–G-Dec groups in the 2-year cumulative incidence of cGVHD without relapse (23.0% [95% CI, 14.7% to 31.3%] and 21.7% [95% CI, 13.6% to 29.7%], respectively; P = .82), with an HR of 1.07 (95% CI, 0.60 to 1.92; P = .81). After rhG-CSF combined with minimal-dose Dec maintenance, increasing numbers of natural killer, CD8+ T, and regulatory T cells were observed.

CONCLUSION

Our findings suggest that rhG-CSF combined with minimal-dose Dec maintenance after allo-HSCT can reduce the incidence of relapse, accompanied by changes in the number of lymphocyte subtypes.
Anesthetic Potency of Intravenous Infusion of 20% Emulsified Sevoflurane and Effect on the Blood-Gas Partition Coefficient in Dogs
Authors: Morohashi Toru , Itakura Sayako , Shimokawa Ken-ichi , Ishii Fumiyoshi , Sanjo Yoshimitsu , Kazama Tomiei
Published: October 2020

BACKGROUND:

Intravenous (IV) infusions of volatile anesthetics in lipid emulsion may increase blood lipid concentration, potentially altering the anesthetic agent’s blood solubility and blood-gas partition coefficient (BGPC). We examined the influence of a low-lipid concentration 20% sevoflurane emulsion on BGPC, and the anesthetic potency of this emulsion using dogs.

METHODS:

We compared BGPC and anesthetic characteristics in 6 dogs between the IV anesthesia of emulsion and the sevoflurane inhalation anesthesia in a randomized crossover substudy. Minimum alveolar concentrations (MACs) were determined by tail-clamp stimulation by using the up-and-down method. Blood sevoflurane concentration and partial pressure were measured by gas chromatography; end-tidal sevoflurane concentration was measured using a gas monitor. The primary outcome was BGPC at the end of IV anesthesia and inhalation anesthesia. Secondary outcomes were time to loss/recovery of palpebral reflex, finish intubation and awakening, MAC, blood concentration/partial pressure at MAC and awakening, correlation between blood partial pressure and gas monitor, and the safety of emulsions.

RESULTS:

BGPC showed no difference between IV and inhaled anesthesia (0.859 [0.850–0.887] vs 0.813 [0.791–0.901]; P = .313). Induction and emergence from anesthesia were more rapid in IV anesthesia of emulsion than inhalation anesthesia. MAC of emulsion (1.33% [1.11–1.45]) was lower than that of inhalation (2.40% [2.33–2.48]; P = .031), although there was no significant difference in blood concentration. End-tidal sevoflurane concentration could be estimated using gas monitor during IV anesthesia of emulsion. No major complications were observed.

CONCLUSIONS:

IV anesthesia with emulsion did not increase the BGCP significantly compared to inhalation anesthesia. It was suggested that the anesthetic potency of this emulsion may be equal to or more than that of inhalation.
Anesthesia and Long-term Oncological Outcomes: A Systematic Review and Meta-analysis
Authors: Chang Chun-Yu , Wu Meng-Yu , Chien Yung-Jiun , Su I-Min , Wang Shih-Ching , Kao Ming-Chang
Published: October 2020

BACKGROUND:

Whether propofol elicits a survival benefit over volatile anesthetics during cancer surgery remains inconclusive. The primary aim of this systematic review and meta-analysis is to compare the effects of propofol-based total intravenous anesthesia (TIVA) with any volatile anesthesia on long-term oncological outcomes. The secondary aim is to compare propofol-based TIVA with specific volatile agents on long-term oncological outcomes.

METHODS:

We searched PubMed, Embase, Scopus, Web of Science, and Cochrane Library from inception through March 3, 2020. Randomized control trials and observational studies that compared the effects of propofol-based TIVA and volatile anesthesia on long-term oncological outcomes, which also reported hazard ratios (HR) as effect estimates, were considered eligible for inclusion. Using the inverse variance method with a random-effects model, HR and 95% confidence intervals (CI) were calculated. Trial sequential analysis was incorporated to test if the results were subject to a type I or type II error.

RESULTS:

Nineteen retrospective observational studies were included. Patients who received propofol-based TIVA during cancer surgery were associated with significantly better overall survival than those who received volatile anesthesia (HR = 0.79, 95% CI, 0.66-0.94, P = .008, I
2 = 82%). In contrast, no statistically significant difference was observed in recurrence-free survival between patients who received propofol-based TIVA and volatile anesthesia during cancer surgery (HR = 0.81, 95% CI, 0.61-1.07, P = .137, I
2 = 85%). In the subgroup analysis by different volatile anesthetics, patients who received propofol-based TIVA were associated with better overall survival than those who received desflurane (HR = 0.54, 95% CI, 0.36-0.80, P = .003, I
2 = 80%). In contrast, there was no statistically significant difference in overall survival between patients who received propofol-based TIVA and those who received sevoflurane (HR = 0.92, 95% CI, 0.74-1.14, P = .439, I
2 = 70%). In the trial sequential analysis of overall survival, the cumulative Z curve reached the required heterogeneity-adjusted information size and crossed the traditional significance boundary. In contrast, in the trial sequential analysis of recurrence-free survival, the cumulative Z curve did not cross the traditional significance boundary. However, the required heterogeneity-adjusted information size has not yet been reached.

CONCLUSIONS:

Propofol-based TIVA is generally associated with better overall survival than volatile anesthesia during cancer surgery. Further large-scaled, high-quality randomized control trials are warranted to confirm our findings.
From Monmouth to Madoc to Māori
Authors: Cleaves Wallace
Published: October 2020

This essay examines how Indigenous research methodologies can be usefully applied to medieval texts. It does this by recounting and engaging with personal experience and by interrogating how research is deployed for colonial purpose. The use of medieval English texts by early modern and later colonial proponents and apologists, particularly John Dee, emphasize the inherent colonial purpose of traditional research methodologies. These processes are contrasted with Indigenous research methodologies, particularly those proposed by Linda Tuhiwai Smith, and the author’s own personal experience and that of his tribal nation of how Indigenous memory and inquiry can inform research practices that are relational and not exploitive.
A Decolonizing Medieval Studies?
Authors: Young Helen
Published: October 2020

This article considers how medievalism, particularly in its academic form of medieval studies, might contribute to decolonization through exploration of how the Western “cultural archive” (Smith, Decolonizing Methodologies) draws on the teleological temporality embedded in the idea of the “medieval” to rationalize “white possessive logics” (Moreton-Robinson, White Possessive). It explores medievalisms in legal, mainstream, and academic contexts that focus on Indigenous land rights and law in the Australian settler-colonial state. It examines the High Court of Australia’s ruling in Mabo and Others v. Queensland (2) (1992), a landmark case that challenged the legal doctrine of terra nullius, on which claims to British sovereignty were founded, and on comparisons of Anglo-Saxon and Indigenous law in the post-Mabo era.
Consorting with Stone
Authors: Jackson Sarah-Nelle
Published: October 2020

This essay places Marie de France’s lai “Yonec” (ca. 1150–1200) and the anonymous Middle English romance King Horn (ca. 1250–1300) in conversation with critical Indigenous theories of relational, land-based sovereignty and resurgence. At first, “Yonec” and King Horn appear to reinscribe a Western form of sovereignty based on exclusive territorial control. Both works offer alternative models of sovereignty and self-determination, however, in their depictions of cooperative, lithic alliance between stone and female consorts. Adopting the term lithic sovereignty to describe the works’ relation-based sovereign imaginaries, this essay first follows the King Horn narrator’s depiction of Godhild’s hermetic retreat into stone when Saracens conquer her husband’s realm. Then it turns to the nameless lady of “Yonec” and her implausible escape from her jealous husband’s tower, facilitated by the very stone that had seemed to entrap her. Drawing on critical Indigenous studies, legal studies, and ecomaterialism, this essay concludes that both King Horn and “Yonec” offer a medieval British imaginary of lithic relational sovereignty that runs counter to teleological, naturalizing narratives of Euro-Western origins.
Ghostly Consciousness inThe Book of Margery Kempe
Authors: Duperron Brenna
Published: October 2020

Jill Carter has spearheaded the interpretive practice of “red reading,” wherein a canonical text is read through an Indigenous perspective, and has proven the validity of approaching traditional texts or problems through a decolonized or non-European method. To date, the red reading methodology has been most noticeably used to decentralize a Eurocentric reading of Indigeneity in North American literature, though as this article illustrates, the concepts of red reading can be expanded to analyze texts from across temporal and cultural periodization, which allows us to approach texts from a new perspective. In red reading a text like The Book of Margery Kempe, with its emphasis on holism and fluid consciousness, we can reach past the orality and textuality at the forefront of the text to interrogate and explore the liminality of a third (ghostly) consciousness.
Individual variation and the biomechanics of maneuvering flight in hummingbirds
Authors: Dakin R. , Segre P. S. , Altshuler D. L.
Published: October 2020

An animal's maneuverability will determine the outcome of many of its most important interactions. A common approach to studying maneuverability is to force the animal to perform a specific maneuver or to try to elicit maximal performance. Recently, the availability of wider-field tracking technology has allowed for high-throughput measurements of voluntary behavior, an approach that produces large volumes of data. Here, we show how these data allow for measures of inter-individual variation that are necessary to evaluate how performance depends on other traits, both within and among species. We use simulated data to illustrate best practices when sampling a large number of voluntary maneuvers. Our results show how the sample average can be the best measure of inter-individual variation, whereas the sample maximum is neither repeatable nor a useful metric of the true variation among individuals. Our studies with flying hummingbirds reveal that their maneuvers fall into three major categories: simple translations, simple rotations and complex turns. Simple maneuvers are largely governed by distinct morphological and/or physiological traits. Complex turns involve both translations and rotations, and are more subject to inter-individual differences that are not explained by morphology. This three-part framework suggests that different wingbeat kinematics can be used to maximize specific aspects of maneuverability. Thus, a broad explanatory framework has emerged for interpreting hummingbird maneuverability. This framework is general enough to be applied to other types of locomotion, and informative enough to explain mechanisms of maneuverability that could be applied to both animals and bio-inspired robots.
Information Transmission under the Shadow of the Future: An Experiment
Authors: Wilson Alistair J. , Vespa Emanuel
Published: October 2020

We experimentally examine how information transmission functions in an ongoing relationship. Where the one-shot cheap-talk literature documents substantial overcommunication and preferences for honesty, the outcomes in our repeated setting are more consistent with uninformative babbling outcomes. This is particularly surprising, as honest revelation is supportable as an equilibrium outcome in our repeated setting. We show that inefficient outcomes are driven by a coordination failure on how to distribute the gains from information sharing. However, when agents can coordinate on the payment of an “information rent,” honest revelation emerges. (JEL C92, D83)
Hybrid All-Pay and Winner-Pay Contests
Authors: Lagerlöf Johan N. M.
Published: October 2020

In many contests in economic and political life, both all-pay and winner-pay expenditures matter for winning. This paper studies such hybrid contests under symmetry and asymmetry. The symmetric model assumes very little structure but yields a simple closed-form solution. More contestants tend to lead to substitution toward winner-pay investments, and total expenditures are always lower than in the corresponding all-pay contest. With a biased decision process and two contestants, the favored contestant wins with a higher likelihood, chooses less winner-pay investments, and contributes more to total expenditures. An endogenous bias that maximizes total expenditures disfavors the high-valuation contestant but still makes her the more likely one to win. (JEL C72, D72, D82)
Where have all the parasites gone? Unusual Plasmodium falciparum monoparasitaemia in a cross-sectional malariometric survey in northern Nigeria
Authors: Nakakana Usman Nasir , Onankpa Ben O. , Mohammed Ismaila Ahmed , Jega Ridwan M. , Jiya Nma Muhammad
Published: October 2020

Background: Malaria is caused by one of five currently known Plasmodium parasite species causing disease in humans. While modelling has provided information of the vector, the same is not entirely the case for the parasite. The World Malaria reports of 2014 to 2016 reported 100% of confirmed cases from Nigeria being due to Plasmodium falciparum. Generally, about 98% of cases of uncomplicated malaria in most regions surveyed in Nigeria recently is due to P. falciparum, with the remainder being due to P. malariae. This study aimed to determine the proportions of Plasmodium parasites causing uncomplicated malaria in Wamakko Local Government Area of Sokoto State, north-western Nigeria.

Methods: The study was a descriptive, cross-sectional study conducted during the rainy season and dry season in north-western Nigeria. The area has a ‘local steppe’ climate and Sudanian Savannah vegetation. Sampling was via multistage cluster sampling. Selected participants were examined for pallor, palpable splenomegaly and signs of complicated malaria. Blood samples were also taken for rapid diagnosis of malaria and thick and thin films to identify parasitaemia and the parasite species. Participants found to have malaria were treated with Artemether/Lumefantrine and those with complicated malaria were referred to the nearest hospital.

 Results: We found a parasite prevalence of 34.8% overall, which was higher in the rainy season (49.3%) than in the dry season (20.2%). There was monoparasitaemia of Plasmodium falciparum throughout the study area, irrespective of the clinical status of the participant. Mapping of the parasite was extended throughout the Local Government Area and the State.

Conclusions: Despite the intermediate endemicity in the area. P. falciparum monoparasitaemia affirms theories of disappearance of other parasite species, either due to faltering control of P. falciparum or more efficient control of other species.
SAPHIR: a Shiny application to analyze tissue section images
Authors: Germani Elodie , Lelouard Hugues , Fallet Mathieu
Published: October 2020

Study of cell populations in tissues using immunofluorescence is a powerful method for both basic and medical research. Image acquisitions performed by confocal microscopy notably allow excellent lateral resolution and more than 10 parameter measurement when using spectral or multiplex imaging. Analysis of such complex images can be very challenging and easily lead to bias and misinterpretation. Here, we have developed the Shiny Analytical Plot of Histological Image Results (SAPHIR), an R shiny application for histo-cytometry using scatterplot representation of data extracted by segmentation. It offers many features, such as filtering of spurious data points, selection of cell subsets on scatterplot, visualization of scatterplot selections back into the image, statistics of selected data and data annotation. Our application allows to quickly characterize labeled cells, from their phenotype to their number and location in the tissue, as well as their interaction with other cells. SAPHIR is available from: https://github.com/elodiegermani/SAPHIR
Diseño y validación de un instrumento para la taxonomía de los robots de suelo en Educación Infantil
Authors: Álvarez-Herrero Juan-Francisco
Published: October 2020

La robótica educativa cada vez se encuentra más presente en nuestro sistema educativo. Y la etapa de Educación Infantil en particular no es ajena a ello. Cada vez más, el profesorado recurre a recursos de fácil uso y bajo coste como los robots de suelo, para introducir la robótica en las aulas. Para realizar una implementación planificada y coherente, se hace necesario analizar y escoger razonadamente aquel recurso que mejor se adapte a las necesidades educativas del alumnado. Con la intención de dotar de un instrumento que permitiese esto, se diseñó y validó por 50 expertos en robótica educativa, una ficha, FAREI, resultado de esta investigación, que permite para cada particularidad adentrarse en el mundo de la robótica de suelo y sus potencialidades educativas en el desarrollo de habilidades y competencias del alumnado de Educación Infantil. Con las aportaciones de los expertos se consiguió abarcar todas las posibilidades que este mundo de la robótica puede ofrecer a la educación y ponerlas al servicio del profesorado que vaya a hacer un uso planificado de la misma.
Cadenas agroindustriales y vocación productiva de ciudades intermedias de Uruguay: una aproximación por empleo
Authors: Ackermann Barbero Maria Noel , Cortelezzi Angela
Published: October 2020

Este estudio pretende identificar la vocación productiva (agro) de las ciudades intermedias de Uruguay (ciu), a partir del estudio de la especialización o diversificación del empleo generado para aportar a la comprensión de los procesos de desarrollo registrados en los territorios y las demandas de empleo asociadas. En particular, interesa encontrar patrones de diversificación o concentración de actividades económicas, a partir de datos de empleo en cinco cadenas productivas agroindustriales (cpa): forestal, soja, arroz, carne bovina y leche. Se elaboraron indicadores de especialización y diversificación por empleo, utilizando la Encuesta Continua de Hogares para las ciudades de más de 5 000 habitantes de Uruguay, excluyendo Montevideo y su zona metropolitana. De las 44 localidades analizadas, 32 presentaron una especialización superior al promedio de la economía en las cpa mencionadas, lo que indica que las ciu depen­den significativamente de estas actividades. Finalmente, las ciu se clasificaron en las siguientes categorías: con fuerte presencia de la administración pública y de servicios del Estado; con vocación productiva asociada al manejo intensivo de recursos naturales o a la transformación de materias primas e insumos; con especialización en la provisión de servicios transversales, y con dedicación a los servicios turísticos.
Villavicencio: de nacimiento espontáneo a ciudad intermedia actual
Authors: Cortés Acuña Carlos , Castañeda-Pérez Yonier
Published: October 2020

La ciudad de Villavicencio tiene unas características particulares por su ubicación y condición actual, pero sobre todo por su configuración territorial a partir de una geohistoria de la econo­mía política, relacionada con los llanos orientales de Colombia, su dependencia estrecha con la capital, Bogotá, y con la zona andina del país. Este artículo hace una revisión de los principales hechos territoriales del proceso de formación de la ciudad desde sus orígenes prehispánicos en el territorio Guayupe, hasta la imposición de la cultura llanera en una ciudad poblada de inmigrantes del altiplano cundiboyacense, pasando por las haciendas coloniales, los fenómenos de migración y violencia, y los diferentes factores económicos que impulsaron el surgimiento de una ciudad intermedia con gran influencia en el panorama nacional.
Cidades de porte médio, territórios de conflito e de interesses diversos
Authors: Medeiro Kruger Nino Rafael , Ribeiro Cristine Jaques
Published: October 2020

Este artigo pretende apresentar a dinâmica de uma cidade de porte médio, Pelotas, localizada no Estado do Rio Grande do Sul, no Brasil. Objetiva problematizar a análise sobre os fluxos migratórios, que resultam no impacto ocasionado na morfologia da cidade, resultante das intervenções do Estado com a iniciativa privada. Para evidenciar tal realidade, serão apresen­tados dados da pesquisa vinculada ao Observatório de Conflitos da Cidade, do Programa de Pós-graduação em Política Social e Direitos Humanos da Universidade Católica de Pelotas. As contribuições dos autores Henri Lefebvre, David Harvey e Raquel Rolnik determinaram a perspectiva crítica deste estudo.
Incidence of spinal deformity surgery in a national health service from 2005 to 2018
Authors: Tsirikos Athanasios I. , Roberts Simon B. , Bhatti Emma
Published: October 2020

Aims

Severe spinal deformity in growing patients often requires surgical management. We describe the incidence of spinal deformity surgery in a National Health Service.

Methods

Descriptive study of prospectively collected data. Clinical data of all patients undergoing surgery for spinal deformity between 2005 and 2018 was collected, compared to the demographics of the national population, and analyzed by underlying aetiology.

Results

Our cohort comprised 2,205 patients; this represents an incidence of 14 per 100,000 individuals among the national population aged between zero and 18 years. There was an increase in mean annual incidence of spinal deformity surgery across the study period from 9.6 (7.2 to 11.7) per 100,000 individuals in 2005 to 2008, to 17.9 (16.1 to 21.5) per 100,000 individuals in 2015 to 2018 (p = 0.001). The most common cause of spinal deformity was idiopathic scoliosis accounting for 56.7% of patients. There was an increase in mean incidence of surgery for adolescent idiopathic scoliosis (AIS) (from 4.4 (3.1 to 5.9) to 9.8 (9.1 to 10.8) per 100,000 individuals; p < 0.001), juvenile idiopathic scoliosis (JIS) (from 0.2 (0.1 to 0.4) to one (0.5 to 1.3) per 100,000 individuals; p = 0.009), syndromic scoliosis (from 0.7 (0.3 to 0.9) to 1.7 (1.2 to 2.4) per 100,000 individuals; p = 0.044), Scheuermann’s kyphosis (SK) (from 0.2 (0 to 0.7) to 1.2 (1.1 to 1.3) per 100,000 individuals; p = 0.001), and scoliosis with intraspinal abnormalities (from 0.04 (0 to 0.08) to 0.6 (0.5 to 0.8) per 100,000 individuals; p = 0.008) across the study period. There was an increase in mean number of posterior spinal fusions performed each year from mean 84.5 (51 to 108) in 2005 to 2008 to 182.5 (170 to 210) in 2015 to 2018 (p < 0.001) and a reduction in mean number of growing rod procedures from 45.5 (18 to 66) in 2005 to 2008 to 16.8 (11 to 24) in 2015 to 2018 (p = 0.046).

Conclusion

The incidence of patients with spinal deformity undergoing surgery increased from 2005 to 2018. This was largely attributable to an increase in surgical patients with adolescent idiopathic scoliosis. Paediatric spinal deformity was increasingly treated by posterior spinal fusion, coinciding with a decrease in the number of growing rod procedures. These results can be used to plan paediatric spinal deformity services but also evaluate preventative strategies and research, including population screening.
A protocol for a nationwide multicentre, prospective surveillance cohort and nested-consented cohort to determine the incidence and clinical outcomes of slipped capital femoral epiphysis
Authors: Perry Daniel C , Arch Barbara , Appelbe Duncan , Francis Priya , Spowart Catherine , Knight Marian
Published: October 2020

Aims

Slipped capital femoral epiphysis (SCFE) is one of the most common hip diseases of adolescence that can cause marked disability, yet there is little robust evidence to guide treatment. Fundamental aspects of the disease, such as frequency, are unknown and consequently the desire of clinicians to undertake robust intervention studies is somewhat prohibited by a lack of fundamental knowledge.

Methods

The study is an anonymized nationwide comprehensive cohort study with nested consented within the mechanism of the British Orthopaedic Surgery Surveillance (BOSS) Study. All relevant hospitals treating SCFE in England, Scotland, and Wales will contribute anonymized case details. Potential missing cases will be cross-checked against two independent external sources of data (the national administrative data and independent trainee data). Patients will be invited to enrich the data collected by supplementing anonymized case data with patient-reported outcome measures. In line with recommendations of the IDEAL Collaboration, the study will primarily seek to determine incidence, describe case mix and variations in surgical interventions, and explore the relationships between baseline factors (patients and types of interventions) and two-year outcomes.

Discussion

This is the first disease to be investigated using the BOSS Study infrastructure. It provides a robust method to determine the disease frequency, and a large unbiased sample of cases from which treatment strategies can be investigated. It may form the basis for definitive robust intervention studies or, where these are demonstrated not to be feasible, this may be the most robust cohort study.
Economic evaluation plan of a RCT of hydroxyapatite-coated uncemented hemiarthroplasty versus cemented hemiarthroplasty for the treatment of displaced intracapsular hip fractures
Authors: Png May Ee , Fernandez Miguel A. , Achten Juul , Parsons Nicholas , McGibbon Alwin , Gould Jenny , Griffin Xavier , Costa Matthew L.
Published: October 2020

Aim

This paper describes the methods applied to assess the cost-effectiveness of cemented versus uncemented hemiarthroplasty among hip fracture patients in the World Hip Trauma Evaluation Five (WHiTE5) trial.

Methods

A within-trial cost-utility analysis (CUA) will be conducted at four months postinjury from a health system (National Health Service and personal social services) perspective. Resource use pertaining to healthcare utilization (i.e. inpatient care, physiotherapy, social care, and home adaptations), and utility measures (quality-adjusted life years) will be collected at one and four months (primary outcome endpoint) postinjury; only treatment of complications will be captured at 12 months. Sensitivity analysis will be conducted to assess the robustness of the results.

Conclusion

The planned analysis strategy described here records our intent to conduct a within-trial CUA alongside the WHiTE5 trial.
The BOSS Study. Determining the incidence and clinical outcomes of uncommon conditions and events in orthopaedic surgery
Authors: Perry Daniel C , Arch Barbara , Appelbe Duncan , Francis Priya , Spowart Catherine , Knight Marian
Published: October 2020

Introduction

There is widespread variation in the management of rare orthopaedic disease, in a large part owing to uncertainty. No individual surgeon or hospital is typically equipped to amass sufficient numbers of cases to draw robust conclusions from the information available to them. The programme of research will establish the British Orthopaedic Surgery Surveillance (BOSS) Study; a nationwide reporting structure for rare disease in orthopaedic surgery.

Methods

The BOSS Study is a series of nationwide observational cohort studies of pre-specified orthopaedic disease. All relevant hospitals treating the disease are invited to contribute anonymised case details. Data will be collected digitally through REDCap, with an additional bespoke software solution used to regularly confirm case ascertainment, prompt follow-up reminders and identify potential missing cases from external sources of information (i.e. national administrative data). With their consent, patients will be invited to enrich the data collected by supplementing anonymised case data with patient reported outcomes. The study will primarily seek to calculate the incidence of the rare diseases under investigation, with 95% confidence intervals. Descriptive statistics will be used to describe the case mix, treatment variations and outcomes. Inferential statistical analysis may be used to analyze associations between presentation factors and outcomes. Types of analyses will be contingent on the disease under investigation.

Discussion

This study builds upon other national rare disease supporting structures, particularly those in obstetrics and paediatric surgery. It is particularly focused on addressing the evidence base for quality and safety of surgery, and the design is influenced by the specifications of the IDEAL collaboration for the development of surgical research.
Management of late-detected DDH in children under three years of age
Authors: Terjesen Terje , Horn Joachim
Published: October 2020

Aims

When the present study was initiated, we changed the treatment for late-detected developmental dislocation of the hip (DDH) from several weeks of skin traction to markedly shorter traction time. The aim of this prospective study was to evaluate this change, with special emphasis on the rate of stable closed reduction according to patient age, the development of the acetabulum, and the outcome at skeletal maturity.

Methods

From 1996 to 2005, 49 children (52 hips) were treated for late-detected DDH. Their mean age was 13.3 months (3 to 33) at reduction. Prereduction skin traction was used for a mean of 11 days (0 to 27). Gentle closed reduction under general anaesthesia was attempted in all the hips. Concurrent pelvic osteotomy was not performed. The hips were evaluated at one, three and five years after reduction, at age eight to ten years, and at skeletal maturity. Mean age at the last follow-up was 15.7 years (13 to 21).

Results

Stable closed reduction was obtained in 36 hips (69%). Open reduction was more often necessary in patients ≥ 18 months of age at reduction (50%) compared with those under 18 months (24%). Residual hip dysplasia/subluxation occurred in 12 hips and was significantly associated with avascular necrosis (AVN) and with high acetabular index and low femoral head coverage the first years after reduction. Further surgery, mostly pelvic and femoral osteotomies to correct subluxation, was performed in eight hips (15%). The radiological outcome at skeletal maturity was satisfactory (Severin grades 1 or 2) in 43 hips (83%).

Conclusions

Gentle closed reduction can be attempted in children up to three years of age, but is likely to be less successful in children aged over 18 months. There is a marked trend to spontaneous improvement of the acetabulum after reduction, even in patients aged over 18 months and therefore simultaneous pelvic osteotomy is not always necessary.
Work-related musculoskeletal disorders among Saudi orthopedic surgeons: a cross-sectional study
Authors: Al-Mohrej Omar A. , Elshaer Amani K. , Al-Dakhil Sahar S. , Sayed AlBraa I. , Aljohar Seham , AlFattani Areej A. , Alhussainan Thamer S.
Published: October 2020

Introduction

Studies have addressed the issue of increasing prevalence of work-related musculoskeletal (MSK) pain among different occupations. However, contributing factors to MSK pain have not been fully investigated among orthopaedic surgeons. Thus, this study aimed to approximate the prevalence and predictors of MSK pain among Saudi orthopaedic surgeons working in Riyadh, Saudi Arabia.

Methods

A cross-sectional study using an electronic survey was conducted in Riyadh. The questionnaire was distributed through email among orthopaedic surgeons in Riyadh hospitals. Standardized Nordic questionnaires for the analysis of musculoskeletal symptoms were used. Descriptive measures for categorical and numerical variables were presented. Student’s t-test and Pearson’s χ2 test were used. The level of statistical significance was set at p ≤ 0.05.

Results

The response rate was 80.3%, with a total number of 179 of Saudi orthopaedic surgeons (173 males and six females). Of our sample, 67.0% of the respondents complained of having MSK pain. The most commonly reported MSK pain was lower back (74.0%), followed by neck (58.2%). Age and body mass index were implicated in the development of more than one type of MSK pain. Increased years of experience (≥ 6 years) was linked to shoulder/elbow, lower back, and hip/thigh pain. Smoking is widely associated with lower back pain development, whereas physicians who do not smoke and exercise regularly reported fewer pain incidences. Excessive bending and twisting during daily practice have been correlated with increased neck pain.

Conclusion

MSK pain was found to be common among Saudi orthopaedic surgeons. Further extensive research should be conducted to understand and analyze the risk factors involved and search for possible improvements to avoid further complications. However, ergonomics education during surgical training could be effective at modifying behaviors and reducing MSK pain manifestations.
Design of an endomicroscope including a resonant fiber-based microprobe dedicated to endoscopic polarimetric imaging for medical diagnosis
Authors: Buckley Colman , Fabert Marc , Kinet Damien , Kucikas Vytautas , Pagnoux Dominique
Published: October 2020

We report on a novel endomicroscope, to the best of our knowledge, designed for achieving full 4×4 Mueller polarimetric images of biological tissues through a fiber endoscope for medical diagnosis. The polarimetric technique is based on a previously published two-wavelength differential method (TWDM). A key component of the endomicroscope is a resonant fiber-based microprobe including a highly-selective fiber Bragg grating (FBG), free of detrimental polarimetric effects, photo written in the core of the fiber, near the output face. By means of the TWDM, and using the specially designed microprobe (diameter 2.9 mm, length 30 mm), full Mueller images of 250×250 pixels were produced at the rate of 1 image/2 s through a 2 m single mode fiber, paving the way to in vivo applications in polarimetric endomicroscopy.
Visualizing topical drug uptake with conventional fluorescence microscopy and deep learning
Authors: Evans Conor L. , Hermsmeier Maiko , Yamamoto Akira , Chan Kin F.
Published: October 2020

Mapping the uptake of topical drugs and quantifying dermal pharmacokinetics (PK) presents numerous challenges. Though high resolution and high precision methods such as mass spectrometry offer the means to quantify drug concentration in tissue, these tools are complex and often expensive, limiting their use in routine experiments. For the many topical drugs that are naturally fluorescent, tracking fluorescence emission can be a means to gather critical PK parameters. However, skin autofluorescence can often overwhelm drug fluorescence signatures. Here we demonstrate the combination of standard epi-fluorescence imaging with deep learning for the visualization and quantification of fluorescent drugs in human skin. By training a U-Net convolutional neural network on a dataset of annotated images, drug uptake from both high "infinite" dose and daily clinical dose regimens can be measured and quantified. This approach has the potential to simplify routine topical product development in the laboratory.
Numerical solution to the time-independent inhomogeneous photoacoustic wave equation using the Born series methods
Authors: Saha Ratan K.
Published: October 2020

The traditional Born series (TBS) and convergent Born series (CBS) methods to numerically solve the time-independent inhomogeneous photoacoustic (PA) wave equation are discussed. The performance of these algorithms is examined for a circular PA source (a disk of radius,

a
=
5

µ

m

) in two dimensions. The speed of sound within the source region was gradually decreased from

v
s

=
1950

to 1200 m/s, but the same quantity for the ambient medium was fixed to

v
f

=
1500

m

/

s

. The PA fields were calculated over a large frequency band from

f
=
7.3

to 2000 MHz. Accordingly, the wave number (

k
f

=
2
π
f

/

v
f

) varied from

k
f

=
0.03

to

8.38

µ

m

−
1

. The TBS method does not offer converging solutions when

k
f

a
≥
25

for

v
s

=
1950

m

/

s

and

k
f

a
≥
9

for

v
s

=
1200

m

/

s

. These have been observed in both the near and far fields. However, the solutions for the CBS technique converge in all cases. Both methods facilitate accurate solutions if the computational domain contains a collection of monodisperse/polydisperse disks considered in this study. Our numerical results suggest that the CBS protocol can provide accurate solutions under various test conditions.
Sensing characteristics of a plasmonic Bragg microcavity
Authors: Aray Ayda , Sabouri Saeed Ghavami
Published: October 2020

We represent a detailed design of a plasmonic refractive index sensor based on a metal–insulator–metal Bragg microcavity in which two simultaneous mechanisms boost the sensing performance: high field confinement and resonant assisted multiple-pass of the plasmonic waves. We investigate in detail the effect of structural parameters on the plasmonic spectral properties such as depth of dip and spectral width since these parameters determine the sensor performance such as sensitivity, resolution, and signal-to-noise ratio and thus have a great significance in sensor ability. We explain the physical reasons for all of the observed behavior in the proposed sensing structure.
Two dimensional spacial soliton in atomic gases with PT-symmetry potential
Authors: Xu Wu-xiong , Su Sheng-jie , Xu Bin , Guo Ya-wei , Xu Si-liu , Zhao Yuan , Hu Yong-hong
Published: October 2020

We propose a realistic physical scheme to realize linear Gaussian optical potential with parity-time (PT) symmetry and two dimensional (2D) spacial solitons in a coherent atomic gas. It is shown that the PT-symmetric potential can be created through the spatial modulation of the control and relevant atomic parameters. We find that the Gaussian PT potential parameters, the imaginary part and the width and the position, play crucial roles in the occurrence of the PT phase transition. We demonstrate that the system supports stable 2D dipole solitons and vortex solitons, which can be managed via tuning PT potential. Furthermore, the dynamic characteristics of the symmetric scatter and collision of solitons are shown.