bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterization of luminescent road markings
Authors: Villa C , Brémond R , Eymond F , Saint-Jacques E
Published: August 2022

Photoluminescent paints for road marking application have been evaluated through laboratory measurements and visibility computations. The luminance decay in the dark was measured after constant excitation during at least 6 hours. To study the effect of night-time lighting conditions, luminance was measured under a constant low illumination (simulating moon and light pollution), and a periodic lighting, simulating automotive traffic. Measurements were also carried out on luminescent road marking applied on real pavement in a full-scale mock-up. Then, possible uses and limits of photoluminescent road markings were investigated through visibility computations based on the COST 331 model. Findings suggest luminescent road markings could strengthen the visual guidance of drivers on the road with traffic by increasing the visibility distance beyond the headlamp beams during the first few hours of the night, and in unlit areas such as bicycle paths, but the performance depends on the night-time illumination level.
Measures of fidelity of delivery and engagement in self-management interventions: A systematic review of measures
Authors: Rookes Tasmin A , Schrag Anette , Walters Kate , Armstrong Megan
Published: August 2022

Background/Aims:

Self-management interventions are increasingly being developed and researched to improve long-term condition outcomes. To understand and interpret findings, it is essential that fidelity of intervention delivery and participant engagement are measured and reported. Before developing fidelity checklists to assess treatment fidelity of interventions, current recommendations suggest that a synthesis of fidelity measures reported in the literature is completed. Therefore, here we aim to identify what the current measures of fidelity of intervention delivery and engagement for self-management interventions for long-term conditions are and whether there is treatment fidelity.

Methods:

Four databases (MEDLINE, PubMed, CINAHL Plus and ScienceDirect) and the journal implementation science were systematically searched to identify published reports from inception to December 2020 for experimental studies measuring fidelity of intervention delivery and/or participant engagement in self-management interventions for long-term conditions. Data on fidelity of delivery and engagement measures and the findings were extracted and synthesised.

Results:

Thirty-nine articles were identified as eligible, with 25 studies measuring fidelity of delivery, 19 reporting engagement and 5 measuring both. For fidelity of delivery, measures included structured checklists, participant completed measures and researcher observations/notes. These were completed by researchers, participants and intervention leaders. Often there was little information around the development of these measures, particularly when the measure had been developed by the researchers, rather than building on others work. Eighteen of 25 studies reported there was fidelity of intervention delivery. For engagement, measures included data analytics, participant completed measures and researcher observations. Ten out of 19 studies reported participants were engaged with the intervention.

Conclusion:

In complex self-management interventions, it is essential to assess whether treatment fidelity of each core component of interventions is delivered, as outlined in the protocol, to understand which components are having an effect. Treatment fidelity checklists comparing what was planned to be delivered, with what was delivered should be developed with pre-defined cut-offs for when fidelity has been achieved. Similarly, when measuring engagement, while data analytics continue to rise with the increase in digital interventions, clear cut-offs for participant use and content engaged with to be considered an engagement participant need to be pre-determined.
Teacher leadership for professional development in a networked learning community: A Chinese case study
Authors: Zheng Xin , Ye Juyan
Published: August 2022

Educators worldwide are engaged in efforts to improve teaching and learning through teachers’ collaborations in learning communities and networks. Teacher leadership has played a crucial role in such communities or networks. This study focused on a teacher professional development program in mainland China, the Master Teacher Studio, in which a group of teachers from different schools learn from a master teacher. The study explored how the master teacher enacted leadership strategies to facilitate participants’ professional development and how the community can develop sustainably. Through a qualitative case study analysis, the study summarizes five major strategies, namely, establishing a shared value and specific goals, structuring through rules and collaboration, developing people by scaffolding and allocating resources, bridging internal and external social capital, and sustaining the community through leadership virtues and role modeling. The results show that teacher leaders in Chinese contexts adopt a combination of multiple strategies to achieve a dynamic balance depending on the developmental stage of the community and members’ dynamic needs. Teachers lead the community through an integration of their administrative, professional, and moral leadership. Implications for teacher leadership in communities are further discussed.
Joint Consideration of Means and Variances Might Change the Understanding of Etiology
Authors: Burt S. Alexandra , Johnson Wendy
Published: August 2022

Twin and adoption studies compare the similarities of people with differing degrees of relatedness to estimate genetic and environmental contributions to trait population variance. The analytic workhorse of these kinds of variance-focused designs is the intraclass correlation, which estimates similarity between pairs of individuals. Group means, by contrast, play no overt role in estimating genetic and environmental influences. Although this focus on variance has made very important contributions to understanding psychological characteristics, we contend that the exclusion of mean effects from behavioral genetic designs may have obscured key environmental influences and impeded full appreciation of the ubiquity and nature of gene–environment interplay in human outcomes. We provide empirical examples already in the literature and a theoretical framework for thinking through the incorporation of mean effects using largely forgotten, non-Mendelian theory regarding how genes influence human outcomes. We conclude that the field needs to develop models capable of fully incorporating mean effects into twin and adoption studies.
Infectious hepatitis
Authors: Downes Thomas J , Manship Thomas A , Bathgate Andrew
Published: August 2022

Infectious hepatitis describes inflammation of the liver due to transmissible viruses. The five most common viruses recognised are classed alphabetically as A, B, C, D and E. These different viruses cannot be differentiated clinically, but a focused history and examination can provide clues towards aetiology, guide appropriate investigations and allow for identification of complications. Hepatitis A and E are typically enterically transmitted and generally follow a mild and self-limiting course. Hepatitis B, C and D are parenterally transmitted and collectively account for a large burden of chronic liver disease globally. This article will cover clinical assessment and management of patients with viral hepatitis A–E. Although there are numerous other types of infectious hepatitis, labelled ‘non-A–E hepatitis’, they are rare and not routinely tested for in clinical practice so are not covered in this article. We will also not cover viruses with more systemic effects which can cause hepatitis but are not specific to the liver, such as Epstein– Barr virus and cytomegalovirus.
Implementation of the Nurse Professional Competence Scale in the Republic of Croatia
Authors: Ivanišević Kata , Kosić Radoslav , Bošković Sandra , Bukvić Marija
Published: August 2022

The purpose of this study was to evaluate the psychometric properties of the Nurse Professional Competence Scale in Croatia in order to use it as a valid and reliable instrument for assessing nurses’ competence. Methodological study. Content and construct validity as well as internal consistency and confirmatory factor analysis (CFA) was conducted. The six-factor structure of the Nurse Professional Competence Scale in the Republic of Croatia was confirmed by CFA. The six-factor model showed a satisfactory fit to the data (RMSEA = 0.085, CFI = 0.84). All factor loadings were significant at p < 0.05. Cronbach’s alpha for each scale ranged from 0.76 to 0.92. The psychometric properties of the Nurse Professional Competence Scale in the Republic of Croatia show that the scale is a reliable and valid measurement tool and as such can be used in research to assess the quality of professional competencies of nurses. The Scale consists of 35 items distributed in six competence areas.
Establishment of Malawi Institute of Procurement and Supply Library and Learning Resources Center: Challenges and Opportunities
Authors: Phiri Austine , Mwale Gladys
Published: August 2022

The objectives of the project of establishing the library and learning resources center at Malawi Institute of Procurement and Supply (MIPS) were to draft recommendations on the kind of infrastructure in terms of hardware, software, and networking required to establish the library systems; Koha and DSpace, to develop user training manual for e-library systems, to develop a user manual for a recommendation for additional training resources for the library, to install e-library systems, link the elibrary systems to Members Management Information System (MMIS), to create catalog records for information resources and to conduct training on the functionality of the e-library system. The study was a descriptive account of the processes of establishing a library and learning resources center in an organization. Monitoring and reporting of the project activities were done which led to the development of reports, library manuals, and deliverables for the project. The scope of the work involved the establishment of the library currently operational. The period for the entire project was 6 months. Some of the major achievements for the project were the installation of Closed Circuit Television (CCTV) system for the resource center, installation of e-library systems, purchase of new textbooks and subscription to electronic journals, training of MIPS management and users on the functionalities of e-library systems, and recruitment of a qualified Librarian to manage the resource center.
Synchronous Recto-Sigmoid Colorectal Carcinomas With Microsatellite Instability and an Activating PIK3CA Mutation
Authors: Mathavan Mohit , Mathavan Akash , Mathavan Akshay , Altshuler Ellery
Published: August 2022

Synchronous colorectal cancer is a rare subtype of colorectal carcinoma defined by the presence of 2 or more primary tumors simultaneously or within 6 months of initial detection. The overall impact of a synchronous presentation on prognosis is not yet clear. Surgical resection is the primary treatment. However, higher rates of local recurrence and metastasis in synchronous colorectal cancer demand greater exploration of the role of adjuvant therapy. The increased frequency of microsatellite instability observed in synchronous colorectal cancer also affects therapy selection. Similarly, activating PIK3CA mutations are regularly noted in colorectal cancer, but their role in a synchronous presentation has not yet been described. We report a case of a young patient with a synchronous recto-sigmoid colorectal carcinoma complicated by microsatellite instability and an activating PIK3CA mutation—a presentation as of yet unreported in literature. We also review the impact of these molecular events on the efficacy of several chemotherapies and targeted therapies.
Cross-cultural Adaptation and Validation of the Japanese Version of the Hospital for Special Surgery Pediatric Functional Activity Brief Scale (HSS Pedi-FABS)
Authors: Hozumi Takashi , Akagi Ryuichiro , Fabricant Peter D. , Teratani Toshiyasu , Kimura Seiji , Yamaguchi Satoshi , Ohtori Seiji
Published: August 2022

Background:

The Hospital for Special Surgery Pediatric Functional Activity Brief Scale (HSS Pedi-FABS) is a specifically designed scoring system for children and has been translated into several languages. However, to date, no validated Japanese version of this scoring system is available.

Purpose:

To translate the HSS Pedi-FABS into Japanese and assess its reliability and validity.

Study Design:

Cohort study (diagnosis); Level of evidence, 2.

Methods:

The HSS Pedi-FABS was translated into Japanese and back-translated into English to confirm the appropriateness of the translation. A total of 764 children aged 9 to 15 years participated in the validation study. The participants answered the Japanese version of the HSS Pedi-FABS along with 2 other questionnaires in Japanese (the Physical Activity Questionnaire for Older Children [PAQ-C] and the physical activity questionnaire of the World Health Organization’s Health Behavior in School-aged Children [HBSC PAQ]). At 1 month after the first assessment, the children answered the Japanese version of the HSS Pedi-FABS again. We evaluated reliability using the Cronbach alpha and the intraclass correlation coefficient. Validity was evaluated by quantifying floor and ceiling effects, correlations between the HSS Pedi-FABS and the PAQ-C, the HSS Pedi-FABS discrepancy between active and inactive groups divided by the HBSC PAQ, and correlation between the HSS Pedi-FABS and body mass index.

Results:

HSS Pedi-FABS scores were slightly but significantly higher in male participants (mean = 16.7) than in female participants (mean = 13.2). The Cronbach alpha coefficient was .90, and the intraclass correlation coefficient value was 0.90, indicating excellent internal consistency and test-retest reliability, respectively. No floor (2.6%) or ceiling effect (1.0%) was observed. The HSS Pedi-FABS was significantly correlated with the PAQ-C ( r = 0.70). The active group demonstrated a significantly higher score on the HSS Pedi-FABS (mean = 18.9) than did the inactive group (mean = 11.2). In terms of discriminative validity, the HSS Pedi-FABS was not correlated with body mass index ( r = –0.15).

Conclusion:

The Japanese version of the HSS Pedi-FABS demonstrated appropriate reliability and validity, indicating that it is a useful tool to assess physical activity levels in Japanese children.
Factors Associated With Pain and Function Before Medial Patellofemoral Ligament Reconstruction
Authors: Corey Robert M. , Rabe Joseph , Yalcin Sercan , Saluan Paul , Farrow Lutul D.
Published: August 2022

Background:

Medial patellofemoral ligament (MPFL) reconstruction is performed to treat recurrent patellar instability. Measurement of joint pain and function at the time of surgery has been demonstrated to be a predictor of the final outcomes in many surgical procedures.

Purpose/Hypothesis:

The purpose of this study was to evaluate the relationship between baseline patient characteristics, mental health, and intraoperative findings and patient-reported knee pain and function at the time of MPFL reconstruction. We hypothesized that patient characteristics and associated pathology would be associated with the degree of pain and dysfunction.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Included were skeletally mature patients who underwent unilateral open MPFL reconstruction between 2015 and 2020 at a single institution. Baseline descriptive information was collected, and the following outcome measures were administered preoperatively: the Veterans RAND 12-Item Health Survey Mental Component Score (VR-12 MCS) and the Knee injury and Osteoarthritis Outcome Score (KOOS) Pain, Physical Function Short Form (PS), and Quality of Life (QoL) subscales. Intraoperative findings were collected in a standardized format. Patient characteristics, preoperative variables, intraoperative findings, and VR-12 MCS were used as risk factors, and multivariate analysis was conducted to assess for relationships with the KOOS subscale scores.

Results:

In total, 201 patients with patella dislocations were included in this analysis. Intraoperatively, 122 patients (60.7%) had either normal cartilage or grade 1 or 2 cartilage injury, 79 patients (39.3%) had grade 3 or 4 cartilage injury, 35 patients (17.4%) had a loose body, and 3 patients (1.49%) had evidence of synovitis. Younger age ( P = .012), male sex ( P < .001), never having smoked ( P = .029), and lower baseline VR-MCS ( P < .001) were significantly associated with higher baseline KOOS Pain scores. Older age ( P = .035), female sex ( P = .003), higher body mass index ( P = .005), and lower baseline VR-12 MCS ( P < .001) were significantly associated with higher baseline KOOS PS scores. Younger age ( P = .003), male sex ( P < .001), lower baseline VR-12 MCS ( P < .001), and no dysplasia ( P = .023) were significantly associated with higher baseline KOOS QoL scores.

Conclusion:

Patient age, sex, and baseline VR-12 MCS were associated with all 3 baseline KOOS subscale scores, whereas intraoperative findings outside of trochlear dysplasia were not associated with any of the KOOS subscale scores.
Effect of Desizing Treatment on the Bagging Behavior of Denim Fabrics
Authors: Ben Fraj Abir , Jaouachi Boubaker
Published: August 2022

This research aims to study the impact of desizing treatment on the bagging behavior of denim garments. Therefore, six denim fabrics with the same weaves and different characteristics were desized under different conditions. Then, the bagging behavior properties of the treated and untreated denim fabric were analyzed and investigated. Thanks to analysis of variance and the main effects plots, the influencing factors were found. The obtained results showed that the most important factors are the characteristics of the samples like the percentage of elastane and polyester fibers, and weight. In addition, it can be concluded that the concentration of desizing agents affects widely the bagging fatigue percentage.
Environmentally Friendly Reactive Washing Process: A Case Study
Authors: Toprak-Cavdur Tuba , Anis Pervin , Çalışkan Naime
Published: August 2022

Available and clean water resources in the world are decreasing day by day. Textiles is one of the industries that are consuming the highest volumes of water. For this reason, it is necessary to develop environmentally friendly textile processes within the scope of sustainability. Reactive dyeing is followed by a washing process consisting of many steps to remove unfixed/hydrolyzed dyes, which is the most preferred dyeing in the coloring of cotton products. A high amount of water is consumed in these processes. In this study, an alternative washing process was developed instead of the conventional reactive washing process. The baths, which were decided to be used according to the transmittance values of the washing baths after dyeing in light, medium, and dark shades, were used again as the first two baths of the next washings. Alternative washing did not have a negative effect on the quality parameters, namely washing and rubbing fastnesses. As a result, it was observed that the last two baths of the washing cycle could be used as the first two baths of the next washing cycle. In this case, it was predicted that approximately 40%−50% water savings could be achieved.
Development of a companion questionnaire for “Did You Feel It?”: Assessing response in earthquakes where an earthquake early warning may have been received
Authors: Goltz James D , Wald David J , McBride Sara K , DeGroot Robert , Breeden Jolie K , Bostrom Ann
Published: August 2022

Earthquake early warning (EEW) systems are relatively new technologies having first emerged as regional systems in the 1990s. Japan was the first nation to develop and implement a nationwide system in October 2007, and in the United States, ShakeAlert® became available on the entire length of the US West Coast in May 2021. Assessing how EEW is perceived and utilized by alert recipients is considered essential. Such assessments are necessary to evaluate whether alert recipients are taking advantage of alert messages to initiate protective actions upon receipt of an alert, how they regard the usefulness of alerts, desirable thresholds for issuing alerts, and other aspects of these systems. Having information from users will also facilitate assessments of the success of earthquake preparedness educational programs such as the ShakeOut and whether annual drills which include information on EEW systems are resulting in behavioral response consistent with the content of these programs. Finally, information on EEW utilization will provide data useful to social scientists who study hazards to advance our understanding of behavioral response to warnings. Survey research in the aftermath of a significant earthquake in which an EEW has been issued is one obvious method of achieving these objectives and there already exist a number of survey instruments for this purpose. A related strategy and the goal of the present research is to develop a brief questionnaire, consistent with those already developed, as a supplement to the United States Geological Survey’s “Did You Feel It?” questionnaire that has provided earthquake intensities and information on behavioral response in earthquakes, both domestic and international, since 2004. Having the intensity level at each respondent’s location is essential for relating their perspectives and actions to the shaking they experienced.
Sequencing T-cell redirection therapies leads to deep and durable responses in patients with relapsed/refractory myeloma
Authors: Mouhieddine Tarek H. , Van Oekelen Oliver , Melnekoff David T. , Li Jeanne , Ghodke-Puranik Yogita , Lancman Guido , Thibaud Santiago , Pan Darren , Rajeeve Sridevi , Agte Sarita , Aleman Adolfo , Sanchez Larysa , Richard Shambavi , Rossi Adriana , Richter Joshua , Cho Hearn Jay , Rodriguez Cesar , Lagana Alessandro , Moshier Erin , Chari Ajai , Jagannath Sundar , Parekh Samir
Published: August 2022

T-cell redirection therapy using chimeric antigen receptor (CAR) T cells and bispecific antibodies (BiAbs) has shown promising efficacy in heavily pretreated patients with relapsed/refractory multiple myeloma (RRMM), leading to the approval of 2 CAR T-cell products and numerous BiAb trials. Data on the outcomes after relapse following BiAbs are urgently required to develop strategies for sequencing salvage therapies. We identified 58 patients progressing after a BiAb trial at Mount Sinai Hospital. Progression-free survival (PFS) to the first salvage (PFS1), second salvage therapy (PFS2), and overall survival (OS) were estimated using the Kaplan-Meier method. The median age of the patients was 67 years, and 78% had high-risk cytogenetics. They had a median of 6 prior therapy lines, 89% were triple-class refractory, and 44% were penta-drug refractory. After the BiAb trial, patients were followed for a median of 30.5 months and received a median of 2 additional salvage therapies (range, 1-9). The most common first salvage was T-cell redirection in 19 patients (10 BiAb and 9 CAR T cells). Ten patients underwent T-cell redirection as a second salvage treatment. T-cell redirection therapy as first or second salvage was feasible and associated with a median PFS1 of 28.9 months, PFS2 of 30.9 months, and an OS of 62% at 2 years. The sequential use of different T-cell redirection therapies is possible and may lead to deep and durable responses following the relapse after BiAb therapy in RRMM.
Gut microbiota mediate vascular dysfunction in a murine model of sleep apnoea: effect of probiotics
Authors: Badran Mohammad , Khalyfa Abdelnaby , Ericsson Aaron C. , Puech Clementine , McAdams Zachary , Bender Shawn B. , Gozal David
Published: August 2022

Background

Obstructive sleep apnoea (OSA) is a chronic prevalent condition characterised by intermittent hypoxia (IH), and is associated with endothelial dysfunction and coronary artery disease (CAD). OSA can induce major changes in gut microbiome diversity and composition, which in turn may induce the emergence of OSA-associated morbidities. However, the causal effects of IH-induced gut microbiome changes on the vasculature remain unexplored. Our objective was to assess if vascular dysfunction induced by IH is mediated through gut microbiome changes.

Methods

Faecal microbiota transplantation (FMT) was conducted on C57BL/6J naïve mice for 6 weeks to receive either IH or room air (RA) faecal slurry with or without probiotics (VSL#3). In addition to 16S rRNA amplicon sequencing of their gut microbiome, FMT recipients underwent arterial blood pressure and coronary artery and aorta function testing, and their trimethylamineN-oxide (TMAO) and plasma acetate levels were determined. Finally, C57BL/6J mice were exposed to IH, IH treated with VSL#3 or RA for 6 weeks, and arterial blood pressure and coronary artery function assessed.

Results

Gut microbiome taxonomic profiles correctly segregated IH from RA in FMT mice and the normalising effect of probiotics emerged. Furthermore, IH-FMT mice exhibited increased arterial blood pressure and TMAO levels, and impairments in aortic and coronary artery function (p<0.05) that were abrogated by probiotic administration. Lastly, treatment with VSL#3 under IH conditions did not attenuate elevations in arterial blood pressure or CAD.

Conclusions

Gut microbiome alterations induced by chronic IH underlie, at least partially, the typical cardiovascular disturbances of sleep apnoea and can be mitigated by concurrent administration of probiotics.
Research on imbalance machine learning methods for MR$$T_1$$WI soft tissue sarcoma data
Authors: Liu Xuanxuan , Guo Li , Wang Hexiang , Guo Jia , Yang Shifeng , Duan Lisha
Published: August 2022

Background

Soft tissue sarcoma is a rare and highly heterogeneous tumor in clinical practice. Pathological grading of the soft tissue sarcoma is a key factor in patient prognosis and treatment planning while the clinical data of soft tissue sarcoma are imbalanced. In this paper, we propose an effective solution to find the optimal imbalance machine learning model for predicting the classification of soft tissue sarcoma data.

Methods

In this paper, a large number of features are first obtained based on $$T_1$$

T
1

WI images using the radiomics methods.Then, we explore the methods of feature selection, sampling and classification, get 17 imbalance machine learning models based on the above features and performed extensive experiments to classify imbalanced soft tissue sarcoma data. Meanwhile, we used another dataset splitting method as well, which could improve the classification performance and verify the validity of the models.

Results

The experimental results show that the combination of extremely randomized trees (ERT) classification algorithm using SMOTETomek and the recursive feature elimination technique (RFE) performs best compared to other methods. The accuracy of RFE+STT+ERT is 81.57% , which is close to the accuracy of biopsy, and the accuracy is 95.69% when using another dataset splitting method.

Conclusion

Preoperative predicting pathological grade of soft tissue sarcoma in an accurate and noninvasive manner is essential. Our proposed machine learning method (RFE+STT+ERT) can make a positive contribution to solving the imbalanced data classification problem, which can favorably support the development of personalized treatment plans for soft tissue sarcoma patients.
How structural changes in online gambling are shaping the contemporary experiences and behaviours of online gamblers: an interview study
Authors: Hing Nerilee , Smith Michele , Rockloff Matthew , Thorne Hannah , Russell Alex M. T. , Dowling Nicki A. , Breen Helen
Published: August 2022

Background

Over the last decade, the provision of online gambling has intensified with increased access, enhanced betting markets, a broader product range, and prolific marketing. However, little research has explored how this intensification is influencing contemporary gambling experiences. This study focused on two research questions: 1) What changes in online gambling have online gamblers observed over the past decade? 2) How have these changes influenced the online gambling experiences and behaviours reported by treatment-seeking and non-treatment-seeking gamblers?

Methods

Two samples of Australian adults were interviewed: 1) 19 people who had been gambling online for at least a decade and with no history of treatment-seeking for online gambling, and 2) 10 people who had recently sought professional help for an online gambling problem. Telephone interviews were semi-structured, with questions that encouraged participants to consider how their online gambling, including any harmful gambling, had been influenced by changes in operator practices and online gambling environments. Data were analysed using thematic analysis.

Results

Both treatment- and non-treatment-seekers noted the increased speed and ease of online gambling, which now enables instant access from anywhere at any time and increased their gambling opportunities. Both groups highlighted the continued proliferation of advertising and inducements for online gambling, particularly during televised sports and racing events, in social media, and through targeted push marketing. Many treatment- and non-treatment-seekers were aware of the vast range of recently introduced bet types, particularly multi-bets. Treatment-seekers disproportionately reported negative effects from these changes, and described how and why they fostered their increased gambling, impulsive gambling, persistence and loss-chasing. They reported limited uptake and effectiveness of current harm minimisation tools.

Conclusions

Counter to stated policy and practice objectives to minimise gambling harm, industry changes that have made online gambling easier, faster, and more heavily incentivised, and increased the array of complex bets with poorer odds, unduly affect addicted and harmed individuals – who are also the most profitable customers. Further consideration is needed to ensure gambling policy, industry practices and public health measures more effectively reduce gambling harm in contemporary settings. Inducements and the poor pricing of complex bets such as multi-bets, and their outsized attraction to players with problems, should be a key focus.
Finite element analysis after rod fracture of the spinal hybrid elastic rod system
Authors: Hsieh Jui-Yang , Chen Chen-Sheng , Chuang Shao-Ming , Wang Jyh-Horng , Chen Po-Quang , Huang Yi-You
Published: August 2022

Background

The spinal hybrid elastic (SHE) rod dynamic stabilization system can provide sufficient spine support and less adjacent segment stress. This study aimed to investigate the biomechanical effects after the internal fracture of SHE rods using finite element analysis.

Methods

A three-dimensional nonlinear finite element model was developed. The SHE rod comprises an inner nitinol stick (NS) and an outer polycarbonate urethane (PCU) shell (PS). The fracture was set at the caudal third portion of the NS, where the maximum stress occurred. The resultant intervertebral range of motion (ROM), intervertebral disc stress, facet joint contact force, screw stress, NS stress, and PCU stress were analyzed.

Results

When compared with the intact spine model, the overall trend was that the ROM, intervertebral disc stress, and facet joint force decreased in the implanted level and increased in the adjacent level. When compared with the Ns-I, the trend in the Ns-F decreased and remained nearly half effect. Except for torsion, the PS stress of the Ns-F increased because of the sharing of NS stress after the NS fracture.

Conclusions

The study concluded the biomechanical effects still afford nearly sufficient spine support and gentle adjacent segment stress after rod fracture in a worst-case scenario of the thinnest PS of the SHE rod system.
Treatment of ankylosing spondylitis complicated with a thoracolumbar Andersson lesion by posterior closed osteotomy, debridement and fusion through the fracture line
Authors: Guo Chaofeng , Li Tao , Zhang Hongqi , Gao Qile , Zhang Gengming , Liu Jinyang , Wang Yuxiang , Deng Ang , Liu Shaohua , Sun Yang , Tang Mingxing
Published: August 2022

Background

An Andersson lesion (AL) is a fatigue fracture occurring across three columns in ankylosing spondylitis (AS), resulting in spinal pseudarthrosis (SP) formation, most commonly in the thoracolumbar segment. However, there is still great controversy and few reports on the best surgical method for the treatment of AS combined with thoracolumbar AL. The purpose of this study was to investigate the efficacy of posterior closed osteotomy, debridement and fusion through the fracture line for the treatment of this disease.

Methods

The clinical data of 13 patients (male 8, female 5, mean age 50.6 years) with AS combined with thoracolumbar AL treated with posterior closed osteotomy, debridement and fusion through the fracture line were retrospectively analysed. The following parameters of the full-length lateral spine radiographs were measured preoperatively and at the last follow-up: cervical 7 tilt (C7T), global kyphosis (GK), thoracic kyphosis (TK), thoracolumbar kyphosis (TLK), local kyphosis (LK), angle of the fusion levels (AFL), lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS) and sagittal vertical axis (SVA). The visual analog scale (VAS), Oswestry disability index (ODI) and Scoliosis Research Society-22 (SRS-22) scores were recorded preoperatively and at the last follow-up.

Results

The mean operation time was 345 min, the mean blood loss was 673 mL, and the mean follow-up time was 21.9 months. Compared with the preoperative values, the C7T, GK, TK, TLK, LK, AFL, PT, SS and SVA values of all patients were significantly improved at the last follow-up (P < 0.05); GK improved from 81.62 ± 16.11 to 50.15 ± 8.55, with an average of 31° of correction (F = 75.945, P<0.001). The VAS, ODI and SRS-22 scores also significantly improved (P < 0.05). At the last follow-up, bone fusion was found in all fracture ends. One patient developed numbness in the lower limbs after surgery and recovered after 3 months of rehabilitation; none of the remaining patients experienced postoperative complications.

Conclusions

Posterior closed osteotomy, debridement and fusion through the fracture line completely removes the necrotic tissue around the SP, relieves symptoms, and corrects kyphosis simultaneously. It reduces the tension behind the fracture line or changes the tension into compressive stress, enabling stable repair of the fracture and avoiding anterior surgery. It is a safe and effective operation.
Comparison of a dichotomous versus trichotomous checklist for neonatal intubation
Authors: Johnston Lindsay , Sawyer Taylor , Nishisaki Akira , Whitfill Travis , Ades Anne , French Heather , Glass Kristen , Dadiz Rita , Bruno Christie , Levit Orly , Auerbach Marc
Published: August 2022

Background

To compare validity evidence for dichotomous and trichotomous versions of a neonatal intubation (NI) procedural skills checklist.

Methods

NI skills checklists were developed utilizing an existing framework. Experts were trained on scoring using dichotomous and trichotomous checklists, and rated recordings of 23 providers performing simulated NI. Videolaryngoscope recordings of glottic exposure were evaluated using Cormack-Lehane (CL) and Percent of Glottic Opening scales. Internal consistency and reliability of both checklists were analyzed, and correlations between checklist scores, airway visualization, entrustable professional activities (EPA), and global skills assessment (GSA) were calculated.

Results

During rater training, raters gave significantly higher scores on better provider performance in standardized videos (both p < 0.001). When utilized to evaluate study participants’ simulated NI attempts, both dichotomous and trichotomous checklist scores demonstrated very good internal consistency (Cronbach’s alpha 0.868 and 0.840, respectively). Inter-rater reliability was higher for dichotomous than trichotomous checklists [Fleiss kappa of 0.642 and 0.576, respectively (p < 0.001)]. Sum checklist scores were significantly different among providers in different disciplines (p < 0.001, dichotomous and trichotomous). Sum dichotomous checklist scores correlated more strongly than trichotomous scores with GSA and CL grades. Sum dichotomous and trichotomous checklist scores correlated similarly well with EPA.

Conclusions

Neither dichotomous or trichotomous checklist was superior in discriminating provider NI skill when compared to GSA, EPA, or airway visualization assessment. Sum scores from dichotomous checklists may provide sufficient information to assess procedural competence, but trichotomous checklists may permit more granular feedback to learners and educators. The checklist selected may vary with assessment needs.
Reducing disease and death from Artisanal and Small-Scale Mining (ASM) - the urgent need for responsible mining in the context of growing global demand for minerals and metals for climate change mitigation
Authors: Landrigan Philip , Bose-O’Reilly Stephan , Elbel Johanna , Nordberg Gunnar , Lucchini Roberto , Bartrem Casey , Grandjean Philippe , Mergler Donna , Moyo Dingani , Nemery Benoit , von Braun Margrit , Nowak Dennis ,   on behalf of the Collegium Ramazzini
Published: August 2022

Artisanal and small-scale mining (ASM) takes place under extreme conditions with a lack of occupational health and safety. As the demand for metals is increasing due in part to their extensive use in ‘green technologies’ for climate change mitigation, the negative environmental and occupational consequences of mining practices are disproportionately felt in low- and middle-income countries. The Collegium Ramazzini statement on ASM presents updated information on its neglected health hazards that include multiple toxic hazards, most notably mercury, lead, cyanide, arsenic, cadmium, and cobalt, as well as physical hazards, most notably airborne dust and noise, and the high risk of infectious diseases. These hazards affect both miners and mining communities as working and living spaces are rarely separated. The impact on children and women is often severe, including hazardous exposures during the child-bearing age and pregnancies, and the risk of child labor. We suggest strategies for the mitigation of these hazards and classify those according to primordial, primary, secondary, and tertiary prevention. Further, we identify knowledge gaps and issue recommendations for international, national, and local governments, metal purchasers, and employers are given. With this statement, the Collegium Ramazzini calls for the extension of efforts to minimize all hazards that confront ASM miners and their families.
Patient perspectives on naloxone receipt in the emergency department: a qualitative exploration
Authors: Lowenstein Margaret , Sangha Hareena K. , Spadaro Anthony , Perrone Jeanmarie , Delgado M. Kit , Agarwal Anish K.
Published: August 2022

Background

Emergency departments (EDs) are important venues for the distribution of naloxone to patients at high risk of opioid overdose, but less is known about patient perceptions on naloxone or best practices for patient education and communication. Our aim was to conduct an in-depth exploration of knowledge and attitudes toward ED naloxone distribution among patients who received a naloxone prescription.

Methods

We conducted semi-structured telephone interviews with 25 adult participants seen and discharged from three urban, academic EDs in Philadelphia, PA, with a naloxone prescription between November 2020 and February 2021. Interviews focused on awareness of naloxone as well as attitudes and experiences receiving naloxone in the ED. We used thematic content analysis to identify key themes reflecting patient attitudes and experiences.

Results

Of the 25 participants, 72% had previously witnessed an overdose and 48% had personally experienced a non-fatal overdose. Nineteen participants (76%) self-disclosed a history of substance use or overdose, and one reported receiving an opioid prescription during their ED visit and no history of substance use. In interviews, we identified wide variability in participant levels of knowledge about overdose risk, the role of naloxone in reducing risk, and naloxone access. A subset of participants was highly engaged with community harm reduction resources and well versed in naloxone access and use. A second subset was familiar with naloxone, but largely obtained it through healthcare settings such as the ED, while a final group was largely unfamiliar with naloxone. While most participants expressed positive attitudes about receiving naloxone from the ED, the quality of discussions with ED providers was variable, with some participants not even aware they were receiving a naloxone prescription until discharge.

Conclusions

Naloxone prescribing in the ED was acceptable and valued by most participants, but there are missed opportunities for communication and education. These findings underscore the critical role that EDs play in mitigating risks for patients who are not engaged with other healthcare or community health providers and can inform future work about the effective implementation of harm reduction strategies in ED settings.
Accreditation as a driver of interprofessional education: the Canadian experience
Authors: Azzam Mohammad B. , Girard Marie-Andrée , Andrews Cynthia , Bilinski Hope , Connelly Denise M. , Gilbert John H. V. , Newton Christie , Grymonpre Ruby E.
Published: August 2022

Background

The purpose of this study was to (1) explore evidence provided by Canadian health and social care (HASC) academic programs in meeting their profession-specific interprofessional education (IPE)-relevant accreditation standards; (2) share successes, exemplars, and challenges experienced by HASC academic programs in meeting their IPE-relevant accreditation standards; and (3) articulate the impacts of IPE-relevant accreditation standards on enabling interprofessional learning to the global HASC academic community.

Methods

Profession-specific (bilingual, if requested) surveys were developed and emailed to the Deans/Academic Program Directors of eligible academic programs with a request to forward to the individual who oversees IPE accreditation. Responses were collated collectively and by profession. Open-ended responses associated with our first objective were deductively categorized to align with the five Accreditation of Interprofessional Health Education (AIPHE) standards domains. Responses to our additional questions associated with our second and third objectives were inductively categorized into themes.

Results/discussion

Of the 270 HASC academic programs surveyed, 30% (n = 24) partially or completely responded to our questions. Of the 106 IPE-relevant standards where evidence was provided, 62% (n = 66) focused on the Educational Program, 88% of which (n = 58) were either met or partially met, and 47% (n = 31) of which focused on practice-based IPE. Respondents cited various exemplars and challenges in meeting IPE-relevant standards.

Conclusions

The overall sentiment was that IPE accreditation was a significant driver of the IPE curriculum and its continuous improvement. The array of exemplars described in this paper may be of relevance in advancing IPE implementation and accreditation across Canada and perhaps, more importantly, in countries where these processes are yet emerging.
Computational analysis of 4-1BB-induced NFκB signaling suggests improvements to CAR cell design
Authors: Tserunyan Vardges , Finley Stacey D.
Published: August 2022

Background

Chimeric antigen receptor (CAR)-expressing cells are a powerful modality of adoptive cell therapy against cancer. The potency of signaling events initiated upon antigen binding depends on the costimulatory domain within the structure of the CAR. One such costimulatory domain is 4-1BB, which affects cellular response via the NFκB pathway. However, the quantitative aspects of 4-1BB-induced NFκB signaling are not fully understood.

Methods

We developed an ordinary differential equation-based mathematical model representing canonical NFκB signaling activated by CD19scFv-4-1BB. After a global sensitivity analysis on model parameters, we ran Monte Carlo simulations of cell population-wide variability in NFκB signaling and quantified the mutual information between the extracellular signal and different levels of the NFκB signal transduction pathway.

Results

In response to a wide range of antigen concentrations, the magnitude of the transient peak in NFκB nuclear concentration varies significantly, while the timing of this peak is relatively consistent. Global sensitivity analysis showed that the model is robust to variations in parameters, and thus, its quantitative predictions would remain applicable to a broad range of parameter values. The model predicts that overexpressing NEMO and disabling IKKβ deactivation can increase the mutual information between antigen levels and NFκB activation.

Conclusions

Our modeling predictions provide actionable insights to guide CAR development. Particularly, we propose specific manipulations to the NFκB signal transduction pathway that can fine-tune the response of CD19scFv-4-1BB cells to the antigen concentrations they are likely to encounter.
ALKBH5-mediated m6A modification of circCCDC134 facilitates cervical cancer metastasis by enhancing HIF1A transcription
Authors: Liang Leilei , Zhu Yunshu , Li Jian , Zeng Jia , Wu Lingying
Published: August 2022

Background

Metastasis is the main cause of mortality in cervical cancer (CC). Circular RNAs (circRNAs) have been demonstrated to play a crucial role in carcinoma biology. However, the expression and function of circRNAs in cervical cancer metastasis are still unclear.

Methods

In the present study, we identified a circRNA with an N6-methyladenosine (m6A) modification, circCCDC134, whose expression was increased in CC tissues by circRNA-Seq and qPCR. CircCCDC134 upregulation in CC was fine-tuned by ALKBH5-mediated m6A modification, which enhanced its stability in a YTHDF2-dependent manner. The functional experiments illustrated that circCCDC134 enhanced tumour proliferation and metastasis in vitro and in vivo. For the comprehensive identification of RNA-binding proteins, circRNA pull-down and mass spectrometry (ChIRP-MS), chromatin immunoprecipitation-seq (Chip-seq), RNA binding protein immunoprecipitation (RIP) and luciferase reporter assays were used to perform mechanistic investigations.

Results

The results revealed that circCCDC134 recruited p65 in the nucleus and acted as a miR-503-5p sponge to regulate the expression of MYB in the cytoplasm, ultimately stimulating HIF1A transcription and facilitating CC growth and metastasis. Conclusion: These findings indicate that circCCDC134 is an important therapeutic target and provide new regulatory model insights for exploring the carcinogenic mechanism of circCCDC134 in CC.