bluuebunny/crossref_metadata_2025 huggingface dataset:
The potential benefits of assessing post-cardiopulmonary exercise testing (CPET) in aging: a narrative review
Authors: Lim Zi Xiang , Gyanwali Bibek , Soh Janjira , Koh Angela S. , Goh Jorming
Published: May 2023

Cardiopulmonary exercise testing (CPET) is an important tool to measure the cardiopulmonary fitness of an individual and has been widely used in athletic, clinical and research settings. Most CPET focus on analyzing physiological responses during exercise. We contend that the post-CPET recovery physiological responses offer further diagnostic and prognostic information about the health of the cardiopulmonary and metabolic systems, especially when testing apparently healthy middle-aged and older adults. However, there are limited studies that investigate physiological responses during the post-CPET recovery, and even less so in middle-aged and older adults. Therefore, this current review is aimed at discussing the contribution of post-CPET recovery parameters to cardiopulmonary health and their potential applications in aging populations. In addition to the existing methods, we propose to examine the aerobic and anaerobic recovery threshold post-CPET as novel potential diagnostic and/or prognostic tools.
Handling unexpected inputs: incorporating source-wise out-of-distribution detection into SAR-optical data fusion for scene classification
Authors: Gawlikowski Jakob , Saha Sudipan , Niebling Julia , Zhu Xiao Xiang
Published: May 2023

The fusion of synthetic aperture radar (SAR) and optical satellite data is widely used for deep learning based scene classification. Counter-intuitively such neural networks are still sensitive to changes in single data sources, which can lead to unexpected behavior and a significant drop in performance when individual sensors fail or when clouds obscure the optical image. In this paper we incorporate source-wise out-of-distribution (OOD) detection into the fusion process at test time in order to not consider unuseful or even harmful information for the prediction. As a result, we propose a modified training procedure together with an adaptive fusion approach that weights the extracted information based on the source-wise in-distribution probabilities. We evaluate the proposed approach on the BigEarthNet multilabel scene classification data set and several additional OOD test cases as missing or damaged data, clouds, unknown classes, and coverage by snow and ice. The results show a significant improvement in robustness to different types of OOD data affecting only individual data sources. At the same time the approach maintains the classification performance of the baseline approaches compared. The code for the experiments of this paper is available on GitHub: https://github.com/JakobCode/OOD_DataFusion
A hierarchically sampling global sparse transformer in data stream mining for lightweight image restoration
Authors: Shi Mingzhu , Zao Bin , Wang Chao , Tan Muxian , Kong Siqi , Liu Shouju
Published: May 2023

With the rapid development of information technology, mining valuable information from multi-source data stream is essential for redundant data, particularly in image processing; the image is degraded when the image sensor acquires information. Recently, transformer has been applied to the image restoration (IR) and shown significant performance. However, its computational complexity grows quadratically with increasing spatial resolution, especially in IR tasks to obtain long-range dependencies between global elements through attention computation. To resolve this problem, we present a novel hierarchical sparse transformer (HST) network with two key strategies. Firstly, a coordinating local and global information mapping mechanism is proposed to perceive and feedback image texture information effectively. Secondly, we propose a global sparse sampler that reduces the computational complexity of feature maps while effectively capturing the association information of global pixels. We have conducted numerous experiments to verify the single/double layer structure and sampling method by analyzing computational cost and parameters. Experimental results on image deraining and motion deblurring show that the proposed HST performs better in recovering details compared to the baseline methods, achieving an average improvement of 1.10 dB PSNR on five image deraining datasets and excellent detail reconstruction performance in visualization.
A neural network-supported two-stage algorithm for lightweight dereverberation on hearing devices
Authors: Lemercier Jean-Marie , Thiemann Joachim , Koning Raphael , Gerkmann Timo
Published: May 2023

A two-stage lightweight online dereverberation algorithm for hearing devices is presented in this paper. The approach combines a multi-channel multi-frame linear filter with a single-channel single-frame post-filter. Both components rely on power spectral density (PSD) estimates provided by deep neural networks (DNNs). By deriving new metrics analyzing the dereverberation performance in various time ranges, we confirm that directly optimizing for a criterion at the output of the multi-channel linear filtering stage results in a more efficient dereverberation as compared to placing the criterion at the output of the DNN to optimize the PSD estimation. More concretely, we show that training this stage end-to-end helps further remove the reverberation in the range accessible to the filter, thus increasing the early-to-moderate reverberation ratio. We argue and demonstrate that it can then be well combined with a post-filtering stage to efficiently suppress the residual late reverberation, thereby increasing the early-to-final reverberation ratio. This proposed two-stage procedure is shown to be both very effective in terms of dereverberation performance and computational demands, as compared to, e.g., recent state-of-the-art DNN approaches. Furthermore, the proposed two-stage system can be adapted to the needs of different types of hearing-device users by controlling the amount of reduction of early reflections.
The effect of fear of missing out on mental health: differences in different solitude behaviors
Authors: Liu Xinyang , Liu Tour , Zhou Zhao , Wan Fuyu
Published: May 2023

Background

Depression, anxiety, and stress are the main issues that affect the mental health of individuals. Solitude behavior, fear of missing out, and mental health are all closely related.

Objective

This study was intended to investigate the relationship between solitude behavior, fear of missing out, and mental health.

Methods

Short Form of Solitude Behavior Scale, Fear of Missing Out scale, and Depression Anxiety Stress Scale-21 were employed in this study to investigate 616 college students. The collected data were analyzed using SPSS 26.0 for basic data organization, and Mplus 8.3 was used to complete the analysis of the mediation model.

Results

(1) Positive solitude was positively associated with eccentricity and negatively related to loneliness; social avoidance positively correlated with eccentricity and loneliness. (2) Social avoidance and loneliness affected mental health through the mediating effect of fear of missing out, whereas positive solitude and eccentricity did not affect mental health through fear of missing out. Moreover, the results still held in the model with depression, anxiety, and stress as dependent variables.

Conclusion

The roles of different solitude behavior in the relationship between fear of missing out and mental health differed. Social avoidance and loneliness as not self-determined solitude could activate the fear of missing out, which could affect mental health.
Cine MR feature tracking analysis for diagnosing thymic epithelial tumors: a feasibility study
Authors: Takumi Koji , Nagano Hiroaki , Mukai Akie , Ueda Kazuhiro , Tabata Kazuhiro , Yoshiura Takashi
Published: May 2023

Background

To assess the feasibility of the cine MR feature tracking technique for the evaluation of cardiovascular-induced morphological deformation in the diagnosis of thymic epithelial tumors (TETs).

Methods

Our study population consisted of 43 patients with pathologically proven TETs including 10 low-grade thymomas, 23 high-grade thymomas, and 10 thymic carcinomas. Cine MR images were acquired using a balanced steady-state free precession sequence with short periods of breath-hold in the axial and oblique planes in the slice with the largest lesion cross-sectional area. The tumor margin was manually delineated in the diastolic phase and was automatically tracked for all other cardiac phases. The change rates of the long-to-short diameter ratio (∆LSR) and tumor area (∆area) associated with pulsation were compared between the three pathological groups using the Kruskal–Wallis H test and the Mann–Whitney U test. A receiver-operating characteristic (ROC) curve analysis was performed to assess the ability of each parameter to differentiate thymic carcinomas from thymomas.

Results

∆LSR and ∆area were significantly different among the three groups in the axial plane (p = 0.028 and 0.006, respectively) and in the oblique plane (p = 0.034 and 0.043, respectively). ∆LSR and ∆area values were significantly lower in thymic carcinomas than in thymomas in the axial plane (for both, p = 0.012) and in the oblique plane (p = 0.015 and 0.011, respectively). The area under the ROC curves for ∆LSR and ∆area for the diagnosis of thymic carcinoma ranged from 0.755 to 0.764.

Conclusions

Evaluation of morphological deformation using cine-MR feature tracking analysis can help diagnose histopathological subtypes of TETs and identify thymic carcinomas preoperatively.
Taking high-stakes venture to make ends meet? Determinants and impacts of international migration of Ethiopians to the Middle East
Authors: Wondimagegnhu Beneberu A. , Fantahun Lemlem
Published: May 2023

Ethiopia is one of the major origins for international migrants to the Middle East in Africa regardless of the risks and the abuses that migrants face. The study aims to analyse the determinants of international migration of Ethiopians to the Middle East and its impact on the income of households staying behind particularly in the Dessie Zuria district of the Amhara region in Ethiopia. Data were randomly collected from 346 households and analysed using descriptive statistics, logit regression, and Propensity Score Matching (PSM) models. The logit regression analysis indicates that bigger family size, network with migrants/returnees, and the presence of peer/family pressure influence the probability of international migration positively. On the contrary, being a male household head, ownership of larger farmland and livestock, and participation in additional non-farm activities determine international migration negatively. The findings from the PSM model revealed that international migration increased the annual income of migrant-sending households by 13,079.51 ETB per year over non-migrant sending households. However, the benefits enjoyed by the families staying behind have been at the expense of migrants, whose income is hard-earned and they often take a risky route to reach the destination regions. The findings call for an integrated policy approach to control population pressure that depletes the key financial and physical assets of households in the origin and thus forces individuals to look for alternative livelihood strategies such as migration. Location-specific policy interventions are needed to create non-farm and alternative livelihoods, improve agricultural productivity, and access information to reduce exaggerated and misleading information about the destination areas.
Suboptimal control status of young hypertensive population
Authors: Shin Donghun , Choi JungMin , Lee Hae-Young
Published: May 2023

The prevalence of hypertension (HT) among young adults aged 18 to 39 years is estimated to be 3.7% to 8.6% worldwide. Although the prevalence of HT in young adults is lower than that of the overall population, those with HT are at substantially increased risk of cardiovascular events compared to those without HT. HT in young adults should be taken with even more caution as longer exposure to higher blood pressure leads to a higher lifetime risk of HT-mediated organ damage. However, young patients with HT show low awareness of HT compared to older patients. Also, they are more prone to show low treatment adherence despite the good efficacy of the treatment. Other risk factors that hinder HT control among young adults include alcohol intake, smoking, low physical activity, emotional stress, job stress, metabolic syndrome, and obesity. This review aimed to illustrate the suboptimal control status of the young hypertensive population and to propose strategies for improvement.
Stability considerations for drug-device combination products-21 CFR part 4 update
Authors: Latoz Christopher , Larkin Laure , Huynh-Ba Kim
Published: May 2023

Combination products are therapeutic and diagnostic products that include two or more of the following: drug, biologic, and device. These products are needed for enhanced clinical outcomes and have more than one Mode of Action (MOA). Therefore, they require a more complex regulatory pathway and compliance with a minimum of two (2) sets of regulatory standards. In 2013, the 21 Code of Federal Regulations (CFR) Part 4 was published to clarify the applicable GMP regulations when drugs, devices, or biological products are included. The FDA (U.S. Food and Drug Administration) released additional guidance in 2017 to streamline the regulatory framework and provide transparency about demonstrating GMP compliance when multiple regulatory standards overlap. This paper summarizes the Current Good Manufacturing Practice (CGMP) requirements for drug-device combination products (Biologic combinations are not discussed in this paper). Emphasis is placed on considerations for structuring a compliant drug-device stability program, including the use of bracketing and matrixing the test schedule to support the establishment of the product expiry date and how legacy products can be evaluated to meet current standards.
Improved visualization of the bone-implant interface and osseointegration in ex vivo acetabular cup implants using photon-counting detector CT
Authors: Woisetschläger Mischa , Booij Ronald , Tesselaar Erik , Oei Edwin H. G. , Schilcher Jörg
Published: May 2023

Background

Successful osseointegration of joint replacement implants is required for long-term implant survival. Accurate assessment of osseointegration could enable clinical discrimination of failed implants from other sources of pain avoiding unnecessary surgeries. Photon-counting detector computed tomography (PCD-CT) provides improvements in image resolution compared to conventional energy-integrating detector CT (EID-CT), possibly allowing better visualization of bone-implant-interfaces and osseointegration. The aim of this study was to assess the quality of visualization of bone-implant-interfaces and osseointegration in acetabular cup implants, using PCD-CT compared with EID-CT.

Methods

Two acetabular implants (one cemented, one uncemented) retrieved during revision surgery were scanned using PCD-CT and EID-CT at equal radiation dose. Images were reconstructed using different reconstruction kernels and iterative strengths. Delineation of the bone-implant and bone-cement-interface as an indicator of osseointegration was scored subjectively for image quality by four radiologists on a Likert scale and assessed quantitatively.

Results

Delineation of bone-implant and bone-cement-interfaces was better with PCD-CT compared with EID-CT (p ≤ 0.030). The highest ratings were given for PCD-CT at sharper kernels for the cemented cup (PCD-CT, median 5, interquartile range 4.25–5.00 versus EID-CT, 3, 2.00–3.75, p < 0.001) and the uncemented cup (5, 4.00–5.00 versus 2, 2–2, respectively, p < 0.001). The bone-implant-interface was 35–42% sharper and the bone-cement-interface was 28–43% sharper with PCD-CT compared with EID-CT, depending on the reconstruction kernel.

Conclusions

PCD-CT might enable a more accurate assessment of osseointegration of orthopedic joint replacement implants.

Key points

• The bone-implant interface ex vivo showed superior visualization using photon-counting detector computed tomography (PCD-CT) compared to energy-integrating detector computed tomography.

• Harder reconstruction kernels in PCD-CT provide sharper images with lower noise levels.

• These improvements in imaging might make it possible to visualize osseointegration in vivo.
The foramen ovale: a keyhole to the brain? Computer simulations of percutaneous FO punctures
Authors: Brandstetter Maximilian , Mallouhi Ammar , Alesch François
Published: May 2023

Background

The percutaneous cannulation of the foramen ovale (FO) is implemented in treating trigeminal neuralgia, diagnosing temporal lobe epilepsy and biopsy petroclival lesions. This study dealt with the question whether it is possible to reach intracerebral structures with a puncture beyond the Gasserian Ganglion (GG) without bone destruction or perforating vascularity.

Methods

We considered the FO a natural keyhole and performed computer-simulated punctures through the right and left FO to eight intracerebral structures. Therefore, we took the Hartel and Submandibular (SM) approach as a starting point and planned trajectories with stereotactic planning software by using brain scans of ten patients.

Results

The simulated punctures with the Hartel approach directly reached the hippocampus (20 out of 20 trajectories), the lateral ventricle (15/20) and the amygdala (2/20). The pons was reached (20/20); however, the pontine vascularity was within the course. The trajectories to the thalamus (13/20) ran through the hippocampus or the mesencephalon. The simulated punctures with the SM approach directly reached the amygdala (18/20), the lateral ventricle (5/20) and the putamen (20/20). The trajectories to the nucleus caudatus (20/20) pierced the hippocampus, the putamen or the maxillary artery. The courses to the thalamus (7/20) ran through the hippocampus or the mesencephalon. The sinus cavernosus could not be reached with the Hartel or SM approach.

Conclusions

This study indicates that a percutaneous approach to the hippocampus, the lateral ventricle, the amygdala and the putamen is possible without harming major vessels or bone destruction. For a possible implementation of these trajectories in a clinical setting, it is necessary to prove these simulated punctures in cadaveric studies.
Influence of the traditional food culture of Ancient Egypt on the transition of cuisine and food culture of contemporary Egypt
Authors: Halawa Abdelhadi
Published: May 2023

Because of the largely arid desert landscape of Egypt, for millennia, Egyptians have been closely connected to living alongside the narrow fertile banks of the Nile River. Annually, melting snow cascading from the mountains in the highlands of the south triggers the Nile River to flood on its journey northbound toward Egypt. As the flood water recedes, it leaves in its wake a rich layer of fertile, volcanic dark soil deposits. The Egyptians mainly rely on this annual natural event to grow various staple food crops, including emmer wheat for making bread, vegetables for cooking molokhia, fruits, and legumes for making koshary. Further, the Nile River provides a source of drinking water, fishing, and raising livestock for meat and dairy products for making halloumi and kariesh cheeses. Ancient Egyptians devoted a sizable portion of Pharaonic history to food, both as nourishment and for the preparation for the mythical religious experience on the journey into eternal life. Food played an essential role in performing religious rites, mummification, coronation and wedding banquets, burial ceremonies, and particularly in preparation for entering eternal life in the afterlife. Because the ancient Egyptians meticulously kept descriptive records, there is a considerable body of archaeological evidence and hieroglyphic accounts regarding ancient Egyptian tangible food history and culture. However, ancient Egyptian food culture has not received adequate scholarly investigations as did the Pharaohs, Pyramids, and mummies. This article aims to examine the under-researched area of the influence of the traditional food culture of Ancient Egypt on the transition of the cuisine and food culture of contemporary Egypt, and how the Pharaohs employed food to achieve longevity during their life and prepare for successful admission into their afterlife. Three factors have contributed to the development and continuation of the 5000-year Egyptian food culture. First, the existence of the Nile River provides reliable, rich silted soil for growing various staple crops. Second, the annual inundation of the Nile River transports fresh layers of silt-rich fertile soil, which provides stable agriculture and supports cultivating various food crops and raising livestock. Third, as a result, of the first two factors, Egypt has been experiencing abundantly diverse staple food sources for millennia.
Noninvasive identification of molecular biomarkers of hepatocellular carcinoma in HCV-Egyptian patients
Authors: Daif Ahmed , Al-Azzawi Mahmood A. , Sakr Moustafa A. , Ismail Hisham A. , Gadallah Mahmoud
Published: May 2023

Background

This study was performed to investigate the expression of different biomarkers in patients with hepatocellular carcinoma and its connection with detective biomarkers. To achieve this objective, seventy subjects were examined in this study, sub-grouped to forty HCC patients and thirty HCV-affected patients with matched thirty healthy individuals. The study involved several groups of participants who were matched based on their age and gender.

Methods

The expression pattern of biomarkers was monitored by quantitative polymerase chain reaction (qRT-PCR). Finally, we utilized a ROC curve to investigate the predictive accurateness of those distinct biomarkers as well as a traditional tumor marker, AFP, in detecting HCC cases.

Results

The baseline biomarker expression levels were markedly greater in HCC patients than in those affected by HCV or healthy subjects. We stated that the sensitivity and the specificity of the different biomarkers alone did not improve than that of AFP alone. When comparing AFP with different biomarkers, the diagnostic validity improves only when combining with CK-1.

Conclusions

Overall, our results indicate that CK-1 mRNA expression could help as a noninvasive tumor biomarker for HCC prognosis and diagnosis when combining with AFP.
To be well or not to be well: compositional associations of physical activity, sedentary behaviour and sleep with mental well-being in Flemish adults aged 55+ years
Authors: Vanderlinden Julie , Biddle Gregory J. H. , Boen Filip , van Uffelen Jannique G. Z.
Published: May 2023

Background

Well-being is a key aspect for healthy ageing and there is an established association between physical activity and well-being in ageing adults. Despite the recent interest in physical activity as part of a 24-h continuum also including sedentary behaviour and sleep, there is a lack of studies examining the link between these 24-h behaviours and well-being in older adults. Therefore, the aim of this study was twofold: (1) to describe 24-h behaviours and their associations with mental well-being in community dwelling adults aged 55+ years; and (2) to examine the theoretical changes in mental well-being if time were reallocated from one behaviour to another.

Methods

This was a cross-sectional study (n = 410). Daily time spent in sedentary behaviour, light and moderate-vigorous physical activity, and sleep was assessed using wrist-worn accelerometers during 6 days. Mental well-being was assessed using the 14-item Warwick-Edinburgh Mental Well-being Scale (WEMWBS). The association of 24-h behaviours and well-being was examined using crude and adjusted linear regression models with compositional data analysis procedures (aim 1). Associations between reallocations of five-minute intervals from five to 60 min between these behaviours and well-being were modelled using compositional isotemporal substitutions (aim 2).

Results

Mean age (SD) was 71.3 (6.3) years and 71% were female. In 24-h, participants spent 5.66 h asleep, 13.88 h sedentary, 2.58 h in light intensity and 1,89 h in moderate-vigorous intensity physical activity. There were no statistically significant associations between 24-h behaviours and mental well-being in fully adjusted models (aim 1). Reallocations up to 30 min were not significantly associated with changes in well-being (aim 2). There were some statistically significant theoretical changes of up to 2 points on the WEMWBS with substitutions larger than 30 min.

Discussion

24-h behaviours and time reallocations between behaviours were not associated with better or worse well-being in community dwelling adults aged 55+ years. Considering well-being as a key aspect for healthy ageing, future public health research should continue to examine physical activity (both light and moderate-to-vigorous), sedentary behaviour, as well as sleep as a part of the 24-h continuum and its associations with mental health outcomes in older adults.

Trial registrationThis trial was registered at ClinicalTrials.gov on 3th July, 2018 (Trial registration NCT03576209)
Automated target detection methodology for drill head sensor systems
Authors: Haddad Waleed S. , Hanson David R. , Ryerson Kenneth R. , Sjostrom Keith J.
Published: May 2023

A stepped-frequency continuous-wave radar system has been designed and integrated into a drill head for use on midrange horizontal directional drills. Data from the forward-looking radar are acquired, processed, and displayed in near real time. A unique, computationally efficient target detection algorithm has been developed and tested to predict the position of potential obstacles in front of the drill head. This method is called derivative imaging, and it provides distance to target and radial offset information such that the drill operator may respond accordingly. Application to traditional ground-penetrating radar systems is also demonstrated.
Lateral thinking in syndromic congenital cardiovascular disease
Authors: Kocere Agnese , Lalonde Robert L. , Mosimann Christian , Burger Alexa
Published: May 2023

Syndromic birth defects are rare diseases that can present with seemingly pleiotropic comorbidities. Prime examples are rare congenital heart and cardiovascular anomalies that can be accompanied by forelimb defects, kidney disorders and more. Whether such multi-organ defects share a developmental link remains a key question with relevance to the diagnosis, therapeutic intervention and long-term care of affected patients. The heart, endothelial and blood lineages develop together from the lateral plate mesoderm (LPM), which also harbors the progenitor cells for limb connective tissue, kidneys, mesothelia and smooth muscle. This developmental plasticity of the LPM, which founds on multi-lineage progenitor cells and shared transcription factor expression across different descendant lineages, has the potential to explain the seemingly disparate syndromic defects in rare congenital diseases. Combining patient genome-sequencing data with model organism studies has already provided a wealth of insights into complex LPM-associated birth defects, such as heart-hand syndromes. Here, we summarize developmental and known disease-causing mechanisms in early LPM patterning, address how defects in these processes drive multi-organ comorbidities, and outline how several cardiovascular and hematopoietic birth defects with complex comorbidities may be LPM-associated diseases. We also discuss strategies to integrate patient sequencing, data-aggregating resources and model organism studies to mechanistically decode congenital defects, including potentially LPM-associated orphan diseases. Eventually, linking complex congenital phenotypes to a common LPM origin provides a framework to discover developmental mechanisms and to anticipate comorbidities in congenital diseases affecting the cardiovascular system and beyond.
A Systematic Review of Methods Used to Determine the Work of Breathing during Exercise
Authors: Cross Troy J. , Isautier Jennifer Mj , Kelley Eli F. , Hubbard Colin D. , Morris Sarah J. , Smith Joshua R. , Duke Joseph W.
Published: May 2023

Introduction

Measurement of the work of breathing (Wb) during exercise provides useful insights into the energetics and mechanics of the respiratory muscles across a wide range of minute ventilations. The methods and analytical procedures used to calculate the Wb during exercise have yet to be critically appraised in the literature.

Purpose

The aim of this systematic review was to evaluate the quality of methods used to measure the Wb during exercise in the available literature.

Methods

We conducted an extensive search of 3 databases for studies that measured the Wb during exercise in adult humans. Data were extracted on participant characteristics, flow/volume and pressure devices, oesophageal pressure (Poes) catheters, and methods of Wb analysis.

Results

A total of 120 articles were included. Flow/volume sensors used were primarily pneumotachographs (n = 85, 70.8%), whereas the most common pressure transducer was of the variable reluctance type (n = 63, 52.5%). Oesophageal pressure was frequently obtained via balloon-tipped catheters (n = 114, 95.0%). Few studies mentioned calibration, frequency responses and dynamic compensation of their measurement devices. The most popular method of measuring the Wb was pressure-volume integration (n = 51, 42.5%), followed by the modified Campbell (n = 28, 23.3%) and Dean & Visscher diagrams (n = 26, 21.7%). Over one-third of studies did not report the methods used to process their pressure-volume data, and the majority (60.8%) of studies used the incorrect Wb units and/or failed to discuss the limitations of their Wb measurements.

Conclusions

The findings of this systematic review highlight the need for the development of a standardized approach for measuring Wb which is informative, practical, and accessible for future researchers.
Physical Activity and Nonalcoholic Fatty Liver Disease: A Roundtable Statement from the American College of Sports Medicine
Authors: STINE JONATHAN G. , LONG MICHELLE T. , COREY KATHLEEN E. , SALLIS ROBERT E. , ALLEN ALINA M. , ARMSTRONG MATTHEW J. , CONROY DAVID E. , CUTHBERTSON DANIEL J. , DUARTE-ROJO ANDRES , HALLSWORTH KATE , HICKMAN INGRID J. , KAPPUS MATTHEW R. , KEATING SHELLEY E. , PUGH CHRISTOPHER J. A. , ROTMAN YARON , SIMON TRACEY L. , VILAR-GOMEZ EDUARDO , WONG VINCENT WAI-SUN , SCHMITZ KATHRYN H.
Published: May 2023

Although physical activity (PA) is crucial in the prevention and clinical management of nonalcoholic fatty liver disease, most individuals with this chronic disease are inactive and do not achieve recommended amounts of PA. There is a robust and consistent body of evidence highlighting the benefit of participating in regular PA, including a reduction in liver fat and improvement in body composition, cardiorespiratory fitness, vascular biology, and health-related quality of life. Importantly, the benefits of regular PA can be seen without clinically significant weight loss. At least 150 min of moderate or 75 min of vigorous intensity PA are recommended weekly for all patients with nonalcoholic fatty liver disease, including those with compensated cirrhosis. If a formal exercise training program is prescribed, aerobic exercise with the addition of resistance training is preferred. In this roundtable document, the benefits of PA are discussed, along with recommendations for 1) PA assessment and screening; 2) how best to advise, counsel, and prescribe regular PA; and 3) when to refer to an exercise specialist.
Indocyanine green fluorescence imaging may detect tumour residuals during surgery for bone and soft-tissue tumours
Authors: Wang Han , Ji Tao , Qu Huayi , Yan Taiqiang , Li Dasen , Yang Rongli , Tang Xiaodong , Guo Wei
Published: May 2023

Aims

The aim of this study was to determine the rate of indocyanine green (ICG) staining of bone and soft-tissue tumours, as well as the stability and accuracy of ICG fluorescence imaging in detecting tumour residuals during surgery for bone and soft-tissue tumours.

Methods

ICG fluorescence imaging was performed during surgery in 34 patients with bone and soft-tissue tumours. ICG was administered intravenously at a dose of 2 mg/kg over a period of 60 minutes on the day prior to surgery. The tumour stain rate and signal-to-background ratio of each tumour were post hoc analyzed. After tumour resection, the tumour bed was scanned to locate sites with fluorescence residuals, which were subsequently inspected and biopsied.

Results

The overall tumour stain rate was 88% (30/34 patients), and specific stain rates included 90% for osteosarcomas and 92% for giant cell tumours. For malignant tumours, the overall stain rate was 94%, while it was 82% for benign tumours. The ICG tumour stain was not influenced by different pathologies, such as malignant versus benign pathology, the reception (or lack thereof) of neoadjuvant chemotherapies, the length of time between drug administration and surgery, the number of doses of denosumab for patients with giant cell tumours, or the tumour response to neoadjuvant chemotherapy. The overall accuracy rate of successfully predicting tumour residuals using fluorescence was 49% (23/47 pieces of tissue). The accuracy rate after en bloc resection was significantly lower than that after piecemeal resection (16% vs 71%; p < 0.001).

Conclusion

A high percentage of bone and soft-tissue tumours can be stained by ICG and the tumour staining with ICG was stable. This approach can be used in both benign and malignant tumours, regardless of whether neoadjuvant chemotherapy is adopted. The technique is also useful to detect tumour residuals in the wound, especially in patients undergoing piecemeal resection.

Cite this article: Bone Joint J 2023;105-B(5):551–558.
Metastasectomy of spinal lesions from thyroid carcinomas
Authors: Kato Satoshi , Demura Satoru , Yokogawa Noriaki , Shimizu Takaki , Kobayashi Motoya , Yamada Yohei , Murakami Hideki , Tsuchiya Hiroyuki
Published: May 2023

Aims

Patients with differentiated thyroid carcinomas (DTCs) have a favourable long-term survival. Spinal metastases (SMs) cause a decline in performance status (PS), directly affecting mortality and indirectly preventing the use of systemic therapies. Metastasectomy is indicated, if feasible, as it yields the best local tumour control. Our study aimed to examine the long-term clinical outcomes of metastasectomy for SMs of thyroid carcinomas.

Methods

We collected data on 22 patients with DTC (16 follicular and six papillary carcinomas) and one patient with medullary carcinoma who underwent complete surgical resection of SMs at our institution between July 1992 and July 2017, with a minimum postoperative follow-up of five years. The cancer-specific survival (CSS) from the first spinal metastasectomy to death or the last follow-up was determined using Kaplan-Meier analysis. Potential factors associated with survival were evaluated using the log-rank test. We analyzed the clinical parameters and outcome data, including pre- and postoperative disability (Eastern Cooperative Oncology Group PS 3), lung and non-spinal bone metastases, and history of radioiodine and kinase inhibitor therapies.

Results

Lung and other bone metastases at the time of surgery were observed in ten and eight patients, respectively. Three patients experienced local tumour recurrences at the operated site. The five- and ten-year CSS rates in the 22 patients with DTC were 77% and 52%, respectively. Pre- and postoperative disability and operative site tumour recurrence were identified as risk factors for short postoperative survival.

Conclusion

Metastasectomy for resectable SM from DTC yielded favourable results and has the potential to improve survival.

Cite this article: Bone Joint J 2023;105-B(5):575–582.
Survival of the Exeter V40 short revision (44/00/125) stem when used in primary total hip arthroplasty
Authors: Evans Jonathan T. , Salar Omer , Whitehouse Sarah L. , Sayers Adrian , Whitehouse Michael R. , Wilton Timothy , Hubble Matthew J. W.
Published: May 2023

Aims

The Exeter V40 femoral stem is the most implanted stem in the National Joint Registry (NJR) for primary total hip arthroplasty (THA). In 2004, the 44/00/125 stem was released for use in ‘cement-in-cement’ revision cases. It has, however, been used ‘off-label’ as a primary stem when patient anatomy requires a smaller stem with a 44 mm offset. We aimed to investigate survival of this implant in comparison to others in the range when used in primary THAs recorded in the NJR.

Methods

We analyzed 328,737 primary THAs using the Exeter V40 stem, comprising 34.3% of the 958,869 from the start of the NJR to December 2018. Our exposure was the stem, and the outcome was all-cause construct revision. We stratified analyses into four groups: constructs using the 44/00/125 stem, those using the 44/0/150 stem, those including a 35.5/125 stem, and constructs using any other Exeter V40 stem.

Results

In all 328,737 THAs using an Exeter V40 stem, the revision estimate was 2.8% (95% confidence interval (CI) 2.7 to 2.8). The 44/00/125 stem was implanted in 2,158 primary THAs, and the ten-year revision estimate was 4.9% (95% CI 3.6 to 6.8). Controlling for age, sex, year of operation, indication, and American Society of Anesthesiologists grade demonstrated an increased overall hazard of revision for constructs using the 44/00/125 stem compared to constructs using other Exeter V40 femoral stems (hazard ratio 1.8 (95% CI 1.4 to 2.3)).

Conclusion

Although the revision estimate is within the National Institute for Health and Care Excellence ten-year benchmark, survivorship of constructs using the 44/00/125 stem appears to be lower than the rest of the range. Adjusted analyses will not take into account ‘confounding by indication’, e.g. patients with complex anatomy who may have a higher risk of revision. Surgeons and patients should be reassured but be aware of the observed increased revision estimate, and only use this stem when other implants are not suitable.

Cite this article: Bone Joint J 2023;105-B(5):504–510.
Patterns of symptoms and insufficiency fractures in patients with tumour-induced osteomalacia
Authors: Kobayashi Hiroshi , Ito Nobuaki , Nakai Yudai , Katoh Hajime , Okajima Koichi , Zhang Liuzhe , Tsuda Yusuke , Tanaka Sakae
Published: May 2023

Aims

The aim of this study was to report the patterns of symptoms and insufficiency fractures in patients with tumour-induced osteomalacia (TIO) to allow the early diagnosis of this rare condition.

Methods

The study included 33 patients with TIO who were treated between January 2000 and June 2022. The causative tumour was detected in all patients. We investigated the symptoms and evaluated the radiological patterns of insufficiency fractures of the rib, spine, and limbs.

Results

The mean age of the patients was 57 years (24 to 87), and the mean duration of pain from onset to time of presentation was 3.9 years (0.75 to 23). The primary symptoms were low back pain (ten patients), chest wall pain (eight patients), and hip pain (eight patients). There were symptoms at more sites at the time of presentation compared with that at the time of the onset of symptoms. Bone scans showed the uptake of tracer in the rib (100%), thoracic and lumbar vertebrae (83%), proximal femur (62%), distal femur (66%), and proximal tibia (72%). Plain radiographs or MRI scans identified femoral neck fractures in 14 patients, subchondral insufficiency fractures of the femoral head and knee in ten and six patients, respectively, distal femoral fractures in nine patients, and proximal tibial fractures in 12 patients. Thoracic or lumbar vertebral fractures were identified in 23 of 29 patients (79.3%) when using any imaging study, and a biconcave deformity was the most common type of fracture.

Conclusion

Insufficiency fractures in patients with TIO caused spinal pain, chest wall pain, and periarticular pain in the lower limbs. Vertebral fractures tended to be biconcave deformities, and periarticular fractures of the hips and knees included subchondral insufficiency fractures and epiphyseal or metaphyseal fractures. In patients with a tumour, the presence of one or more of these symptoms and an insufficiency fracture should suggest the diagnosis of TIO.

Cite this article: Bone Joint J 2023;105-B(5):568–574.
Which Unified Classification System type B periprosthetic fractures around cemented polished tapered stems should not be fixed?
Authors: Scott Chloe E. H. , Jain Sameer , Moran Matt , Haddad Fares S.
Published: May 2023

The Unified Classification System (UCS), or Vancouver system, is a validated and widely used classification system to guide the management of periprosthetic femoral fractures. It suggests that well-fixed stems (type B1) can be treated with fixation but that loose stems (types B2 and B3) should be revised. Determining whether a stem is loose can be difficult and some authors have questioned how to apply this classification system to polished taper slip stems which are, by definition, loose within their cement mantle. Recent evidence has challenged the common perception that revision surgery is preferable to fixation surgery for UCS-B periprosthetic fractures around cemented polished taper slip stems. Indications for fixation include an anatomically reducible fracture and cement mantle, a well-fixed femoral bone-cement interface, and a well-functioning acetabular component. However, not all type B fractures can or should be managed with fixation due to the risk of early failure. This annotation details specific fracture patterns that should not be managed with fixation alone.

Cite this article: Bone Joint J 2023;105-B(5):481–486.
The complexity of decision-making for total hip arthroplasty in early osteoarthritis
Authors: Sharrock Martin , Board Tim
Published: May 2023

Cite this article: Bone Joint Res 2023;12(5):306–308.
Comparative Effect of Biofillers in pMDI Resin Performance
Authors: Alawode Abiodun , Owofadeju Femi Kehinde , Musah Munkaila , Asafu-Adjaye Osei , Via Brian
Published: May 2023

This study investigated the feasibility of using wood flour (WF) as a partial substitute in polymeric methylene diphenyl diisocyanate (pMDI) resin and compared its performance with soy flour (SF) substituted in pMDI resin. The physical and mechanical properties of experimental particleboards made with WF and SF substituted in pMDI resin at different substitution percentages were evaluated. The viscosity for the WF at different substitution ratios (5%, 10%, 20%, and 30%) ranged from 314.7 to 6,256.3 cP, whereas SF-substituted resin ranged from 249.7 to 1,291.8 cP. During the production of the boards, it was observed that because of the high viscosity of WF substituted in pMDI resin above 10 percent, it was exceedingly difficult to apply it through spraying and brushing, either to wood particles or veneers. Dimensional stability test results established that the incorporation of SF assisted in mitigating board thickness swelling. The results from the study showed that panels made with SF substituted in pMDI resin at 5 and 10 percent exhibited the overall best performance in all the properties considered compared with panels made with WF substituted in pMDI resin.
Nonresonant cavity for multipass laser intensity buildup
Authors: Zeng Yi , Hutzler Nicholas R.
Published: May 2023

A nonresonant cavity to build up laser intensity is modeled, developed,
and tested. It can be used for overlapping multiple lasers of
different wavelengths, increasing their intensities by more than an
order of magnitude while maintaining good uniformity. It is simple to
set up, has flexible optical characteristics, and is robust against
perturbations. The intensity buildup requires no resonances, and the
wavelength dependence of the performance is limited only by the mirror
coatings. The cavity can be used, for example, in applications
requiring a spatially constrained intensity buildup, such as in atomic
and molecular traps.
Plasmon-induced quantum interference near an L-shaped nanostructure
Authors: Pei Yanan , Li Zhichao , Liu Qi , Shan Lingxiao , Gu Ying , Yang Rongcao
Published: May 2023

In the near-field region of a metallic slab or metallic nanosphere, quantum interference caused by anisotropic spontaneous emission in a multilevel quantum system is a hot research topic. The research on the influence of an anisotropic plasmon nanostructure on quantum interference is expected to open the door for tunability of quantum interference. In this paper, we study an L-shaped plasmon nanostructure, which can provide a high degree of quantum interference for a three-level V-type atom. The research shows that the degree of quantum interference greatly depends on the atomic position and the separation between the atom and the nanostructure. By adjusting the atomic position, tunable peak positions and linewidths of the Mollow triplet can be achieved caused by quantum interference. The proposed system is highly versatile and has potential application in quantum single photon source and some active nanodevices.
Effects of primary aberrations on a dark-field microscopy imaging system with the sharper focusing lens
Authors: Wang Yuqin , Chen Dan , Yong Kangle , Zhou Xin , Bai Xing , Zhang Rongzhu
Published: May 2023

The effects of primary aberrations of the sharper focusing lens on the image quality is analyzed for a dark-field microscopy imaging system, which is illuminated by a left-circularly (LC) polarized Laguerre–Gaussian (LG) vortex beam. To confirm the aberration tolerance range of the sharper focusing lens for precise measurement, the analytical expression of the field distribution on the image plane is deduced. Then the dark-field image results corresponding to a defect with a scale of 6µm×6µm are simulated. The influence of the spherical error, coma, and astigmatism on the imaging quality is compared in detail. Then the verification test has been carried out to show the effects of different primary aberrations. Finally, both the simulation and experiment results help us to identify that the tolerance range of spherical aberration, astigmatism, and coma should be less than 1.5λ, 1λ, and 1.25λ, respectively.
(3+1)D printed adiabatic 1-to-M broadband couplers and fractal splitter networks
Authors: Grabulosa Adrià , Porte Xavier , Jung Erik , Moughames Johnny , Kadic Muamer , Brunner Daniel
Published: May 2023

We experimentally demonstrate, based on a generic concept for creating 1-to-M couplers, single-mode 3D optical splitters leveraging adiabatic power transfer towards up to 4 output ports. We use the CMOS compatible additive (3+1)D flash-two-photon polymerization (TPP) printing for fast and scalable fabrication. Optical coupling losses of our splitters are reduced below our measurement sensitivity of 0.06 dB by tailoring the coupling and waveguides geometry, and we demonstrate almost octave-spanning broadband functionality from 520 nm to 980 nm during which losses remain below 2 dB. Finally, based on a fractal, hence self-similar topology of cascaded splitters, we show the efficient scalability of optical interconnects up to 16 single-mode outputs with optical coupling losses of only 1 dB.
Machine-learning-based method for fiber-bending eavesdropping detection
Authors: Song Haokun , Lin Rui , Li Yajie , Lei Qing , Zhao Yongli , Wosinska Lena , Monti Paolo , Zhang Jie
Published: May 2023

In this Letter, we present a scheme for detecting fiber-bending eavesdropping based on feature extraction and machine learning (ML). First, 5-dimensional features from the time-domain signal are extracted from the optical signal, and then a long short-term memory (LSTM) network is applied for eavesdropping and normal event classification. Experimental data are collected from a 60 km single-mode fiber transmission link with eavesdropping implemented by a clip-on coupler. Results show that the proposed scheme achieves a 95.83% detection accuracy. Furthermore, since the scheme focuses on the time-domain waveform of the received optical signal, additional devices and a special link design are not required.