bluuebunny/crossref_metadata_2025 huggingface dataset:
Study of pulmonary hypertension in post-COVID-19 patients by transthoracic echocardiography
Authors: Taha Heba Abdelhady , Elshafey Basem Ibrahim , Abdullah Taimor Mostafa , Salem Heba Ahmed
Published: June 2023

Background

A devastating medical disorder, the coronavirus pandemic infection (COVID-19), produced by the coronavirus 2 (SARSCoV-2), is primarily characterized by severe pneumonia. Pulmonary hypertension (PH), which may cause right ventricular (RV) involvement and dysfunction, can occur as a result of lung parenchymal injury and disturbed pulmonary circulation. Transthoracic echocardiography (TTE) is a very reliable noninvasive approach to determining the severity of PH. Similar to that, thorax computer tomography (TCT) can effectively detect the severity of lung damage during the acute phase of a COVID-19 infection.

Aims

The goal of this research is to examine PH and altered right ventricular function by TTE in post-COVID-19 cases.

Patients and methods

This retrospective case–control study was conducted at Tanta Chest University Hospital, Tanta, Egypt. The study started from October 2021 to September 2022 on 50 post-COVID-19 cases with one or more clinical manifestations of PH. These cases underwent TTE (group I showed normal PAP “control group,” groups II & III with PH further subdivided according to PaO2).

Results

Risk factors of age, BMI, diabetes mellitus, and smoking were substantially raised in group III, but sex and hypertension were insignificant. Symptoms of chest pain, dyspnea, and palpitation were worse in group III. Levels of LDH, d-dimer, ESR, and serum bilirubin were substantially increased in group III in comparison to the other groups. Post-COVID-19-associated lung fibrosis and embolism were higher in group III. Mean values of estimated systolic pulmonary artery pressure (esPAP) and right atrial and right ventricular diameters were substantially increased in groups III and II in comparison to group I. Mean values of RV-GLS and TAPSE were lower in groups III and II in comparison to group I. FEV1, FVC, PEFR, and FEF25–75% percentage of the predicted were significantly low in groups II and III. FEV1/FVC ratio was substantially lower in group II in comparison to groups I and III.

Conclusions

The incidence of pulmonary hypertension in post-COVID-19 patients with suspected manifestations of PH is 70%. Increased age, BMI, DM, smoking, decreased PaO2, increased CORADS score, and abnormal spirometry are risk factors for PH in post-COVID-19 patients. Patients with post-COVID-19 PH stay more either in ICU or ward.
African agri-entrepreneurship in the face of the COVID-19 pandemic
Authors: Kadzamira Mariam A. T. J. , Ogunmodede Adewale , Duah Solomon , Romney Dannie , Clottey Victor Attuquaye , Williams Frances
Published: June 2023

Background

The African continent is known for high entrepreneurial activity, especially in the agricultural sector. Despite this, the continent's economic development is below expectations, due to numerous factors constraining the growth and sustainability of agricultural SMEs. These constraints have been exacerbated by the COVID-19 pandemic. The purpose of this study was to understand the pathways through which the pandemic affected agri-SMEs, with specific focus on assessing the differentiated effects arising from the size of the agri-SME and the gender of the owner-manager.

Methods

Data was collected from over 100 agri-SMEs, ranging in size from sole proprietorships with one employee to agri-SMEs employing up to 100 people, in six African countries. Mixed methods were used to analyse the data with changes in business operations arising from changing market access, regimented health and safety guidelines and constrained labour supply assessed using visualisations and descriptive statistics. Logistic regression modelling was employed to determine the set of variables contributing to agri-SME business downturn during the COVID-19 pandemic.

Results

All surveyed agri-SMEs were negatively affected by COVID-19-associated restrictions with the size of the firm and gender of the owner-managers resulting in differentiated impacts. The smallest agri-SMEs, mainly owner-managed by women, were more likely to experience disruptions in marketing their goods and maintaining their labour supply. Larger agri-SMEs made changes to their business operations to comply with government guidelines during the pandemic and made investments to manage their labour supply, thus sustaining their business operations. In addition, logistic regression modelling results show that financing prior to the pandemic, engaging in primary agricultural production, and being further from urban centres significantly influenced the likelihood of a firm incurring business losses.

Conclusions

These findings necessitate engendered multi-faceted agri-SME support packages that are tailored for smaller-sized agri-SMEs. Any such support package should include support for agri-SMEs to develop sustainable marketing strategies and help them secure flexible financing that considers payment deferrals and debt moratorium during bona fide market shocks such as the COVID-19 pandemic.
Solving Mad Dog subsalt imaging in two decades: From WATS to OBN to elastic FWI
Authors: Liu Hui , Rollins Fran , Pratt Kevin , Da Silva Elizabeth , Mootoo Nathalie , Yang Tongning , Ren Dorothy , Gao Fei , Mei Jiawei
Published: June 2023

The Gulf of Mexico (GoM) is one of the most prolific oil and gas producing provinces in the world. The Mad Dog Field, like many large deepwater fields in the GoM, is subsalt. The geometric complexity of the overlying salt causes extremely variable image quality of the strata beneath the salt. Improving the seismic image has been critical for field development, and a tremendous amount of effort has been expended over the years to solve this problem. Over the past two decades, data acquisition has evolved from narrow-azimuth towed streamer to wide-azimuth streamer, and finally to ocean-bottom nodes. Processing methods such as using different anisotropic velocity models of increasing complexity, exhaustive iterations of salt modeling, acoustic full-waveform inversion, and most recently elastic full-waveform inversion have been applied. Dozens of wells have been drilled at Mad Dog guided by the resulting seismic images, and many acquisition and processing learnings have been acquired and implemented over this period to optimize the imaging. This paper explores the techniques that have caused major uplift to subsalt imaging and some techniques that were of only minor impact, while giving a glimpse into the imaging history of one of the GoM's giant fields.
Atlantis — 20 years of seismic innovation finally removes the shroud of mystery
Authors: Buist Sam , Jiang Li , Egbue Obi , Tebo Daniel , Lopez Luis , Wei Zhiyuan , Hao Alex , Chen Chi
Published: June 2023

The Atlantis Field has gone through more than two decades of continuous seismic imaging efforts, during which time many innovative technologies were incubated, the most recent one being the successful application of full-waveform inversion (FWI) in salt environments. This technique led to a significant improvement in the subsalt image. However, imaging challenges remain for the Atlantis reservoirs, primarily due to the complex overburden salt geometries and the highly compartmentalized reservoir. Even with an improved velocity model from FWI, the conventional reverse time migration (RTM) images still suffer from illumination issues and contain strong migration swings that hinder the subsalt imaging and subsequent interpretations. Furthermore, early versions of FWI employed an acoustic assumption, leading to visible salt halos at the salt boundaries in the velocity model, which adversely impacted the reservoir imaging. In the last 12 months, elastic time-lag FWI (TLFWI) and FWI-derived reflectivity (FDR) imaging using long-offset ocean-bottom node data have minimized these imaging issues at Atlantis, providing another step change in subsalt understanding. Although the 3D RTM images using the elastic FWI velocity model are similar overall to their acoustic counterparts, the 4D time-lapse RTM images at Atlantis show noticeable improvements. Furthermore, FDR images derived from elastic FWI velocities show obvious benefits over the acoustic ones. With a more accurate modeling engine that allows for better match between synthetic and real data, FDR imaging shows improved illumination, higher signal-to-noise ratio, and better reservoir details over acoustic FDR imaging. This recent advancement in using elastic TLFWI has had immediate positive effects in facilitating the Atlantis Field's current and future development.
Effects of strict COVID-19 lockdown on patients with obsessive-compulsive disorder compared to a clinical and a nonclinical sample
Authors: D’Urso Giordano , Magliacano Alfonso , Dell’Osso Bernardo , Lamberti Hekla , Luciani Adalgisa , Mariniello Teresa S. , Pomes Mattia V. , Rifici Lorenza M. ,   The COVID in OCD Study Group, Iasevoli Felice , de Bartolomeis Andrea
Published: June 2023

Background

Symptoms of obsessive-compulsive disorder (OCD) have been reported to increase during the COVID-19 lockdowns because of the hygiene requirements related to the pandemic. Patients with adjustment disorder (AD) may, in turn, represent a vulnerable population for identifiable stressors. In this study, we aimed at assessing potential symptoms changes in OCD patients during the lockdown in comparison with AD patients as well as versus healthy controls (HC).

Methods

During the COVID-related lockdown, we enrolled 65 patients and 29 HC. Participants were tested with four clinical rating scales (Yale–Brown obsessive-compulsive scale and Brown Assessment of Beliefs Scale for OCD patients; Beck Depression Inventory-II and State–Trait Anxiety Inventory-Y for each group) that had been also administered just before the Italian lockdown.

Results

Our results showed that during the lockdown: (i) the symptoms of depression and anxiety increased in all groups, but this increase was most pronounced in HC (p < 0.001); (ii) OCD symptoms severity did not increase, but the insight worsened (p = 0.028); (iii) the proportion of OCD patients showing hygiene-related symptoms increased (p = 0.031 for obsessions of contamination), whereas that of patients with checking-related symptoms decreased.

Conclusions

The lockdown-induced psychological distress apparently changed the characteristics and the pattern of OCD symptoms expression but not their overall severity. This evidence confirms the heterogeneity and changing nature of OCD symptoms, strongly depending on the environmental circumstances.
Disparities in Diagnosis, Treatment Access, and Time to Treatment Among Hispanic Men With Metastatic Prostate Cancer
Authors: Hougen Helen Y. , Swami Nishwant , Dee Edward Christopher , Alshalalfa Mohammed , Meiyappan Karthik , Florez Narjust , Penedo Frank J. , Nguyen Paul L. , Punnen Sanoj , Mahal Brandon A.
Published: June 2023

PURPOSE

Reporting racial/ethnic disparities in aggregate obscures within-group heterogeneity. We sought to identify disparities in diagnosis and treatment in Hispanic subpopulations with metastatic prostate cancer (mPCa).

METHODS

We disaggregated men with prostate adenocarcinoma from the National Cancer Database from 2004 to 2017 by racial subgroup and Hispanic background. We assessed (1) presenting with mPCa, (2) receiving any treatment, and (3) receiving delayed treatment beyond 90 days. Logistic regression and adjusted odds ratios (aOR) were reported.

RESULTS

Hispanic men had greater odds of presenting with mPCa (aOR, 1.54; 95% CI, 1.50 to 1.58; P < .001) compared with non-Hispanic White (NHW) men. All Hispanic racial subgroups were more likely to present with mPCa, with the highest risk in Hispanic Black (HB) men (aOR, 1.68; 95% CI, 1.46 to 1.93; P < .01). Men from all Hispanic backgrounds had higher odds of presenting with mPCa, especially Mexican men (aOR, 1.99; 95% CI, 1.86 to 2.12; P < .01). Hispanic men were less likely to receive any treatment (aOR, 0.60; 95% CI, 0.53 to 0.67; P < .001), and this effect was particularly strong for Hispanic White patients (aOR, 0.58; 95% CI, 0.52 to 0.66; P < .001) and Dominican men (aOR, 0.52; 95% CI, 0.28 to 0.98; P = .044). Hispanic men were more likely to experience treatment delays compared with NHW men (aOR, 1.38; 95% CI, 1.26 to 1.52; P < .001) and in particular HB (aOR, 1.83; 95% CI, 1.22 to 2.75; P = .002) and South/Central American men (aOR, 1.48; 95% CI, 1.07 to 2.04; P = .018).

CONCLUSION

Differences exist in stage at presentation, treatment receipt, and delays in treatment on disaggregation by racial subgroup and Hispanic heritage. We need to study the potential mechanisms of the observed variations to help develop targeted interventions.
Diurnal Range and Intra-patient Variability of ACTH Is Restored With Remission in Cushing's Disease
Authors: Alvarez Reinier , Hogan Elizabeth , Asuzu David T , Wu Tianxia , Oshegbo Gloria , McGlotten Raven , Cortes Michaela , Hayes Christina , Stratakis Constantine A , Tatsi Christina , Nieman Lynnette K , Chittiboina Prashant
Published: June 2023

Context

Single ACTH measurements have limited ability to distinguish patients with Cushing's disease (CD) from those in remission or with other conditions.

Objective

To investigate the changes in ACTH levels before and after transsphenoidal surgery (TSS) to identify trends that could confirm remission from CD and help establish ACTH cutoffs for targeted clinical trials in CD.

Design

Retrospective analysis of CD patients who underwent TSS from 2005 to -2019.

Setting

Referral center.

Patients

CD patients (n = 253) with ACTH measurements before and after TSS.

Interventions

TSS for CD.

Main Outcome Measures

Remission after TSS.

Results

Remission was observed in 223 patients after TSS. Those in remission had higher ACTH variability at AM (P = .02) and PM (P < .001) time points compared to nonremission. The nonremission group had a significantly narrower diurnal range compared to the remission group (P = <.0001). A decrease in plasma ACTH of ≥50% from mean preoperative levels predicted CD remission after TSS, especially when using PM values. The absolute plasma ACTH concentration and ratio of preoperative to postoperative values were significantly associated with nonremission after multivariable logistic regression (adj P < .001 and .001, respectively).

Conclusions

Our findings suggest that ACTH variability is suppressed in CD, and remission from CD is associated with the restoration of this variability. Furthermore, a decrease in plasma ACTH by 50% or more may serve as a predictor of remission post-TSS. These insights could guide clinicians in developing rational outcome measures for interventions targeting CD adenomas.
Reevaluating the Role of Progesterone in Ovarian Cancer: Is Progesterone Always Protective?
Authors: Mauro Laura J , Spartz Angela , Austin Julia R , Lange Carol A
Published: June 2023

Ovarian cancer (OC) represents a collection of rare but lethal gynecologic cancers where the difficulty of early detection due to an often-subtle range of abdominal symptoms contributes to high fatality rates. With the exception of BRCA1/2 mutation carriers, OC most often manifests as a post-menopausal disease, a time in which the ovaries regress and circulating reproductive hormones diminish. Progesterone is thought to be a “protective” hormone that counters the proliferative actions of estrogen, as can be observed in the uterus or breast. Like other steroid hormone receptor family members, the transcriptional activity of the nuclear progesterone receptor (nPR) may be ligand dependent or independent and is fully integrated with other ubiquitous cell signaling pathways often altered in cancers. Emerging evidence in OC models challenges the singular protective role of progesterone/nPR. Herein, we integrate the historical perspective of progesterone on OC development and progression with exciting new research findings and critical interpretations to help paint a broader picture of the role of progesterone and nPR signaling in OC. We hope to alleviate some of the controversy around the role of progesterone and give insight into the importance of nPR actions in disease progression. A new perspective on the role of progesterone and nPR signaling integration will raise awareness to the complexity of nPRs and nPR-driven gene regulation in OC, help to reveal novel biomarkers, and lend critical knowledge for the development of better therapeutic strategies.
Loss of flrt2 gene leads to microphthalmia in zebrafish
Authors: Yang Siyu , Huang Lianggui , Liang Huiling , Guo Jingyi , Liu Liyue , Chen Shuyi , Cao Mingzhe
Published: June 2023

As a member of the fibronectin leucine-rich transmembrane (flrt) gene family, fibronectin leucine-rich transmembrane 2 (flrt2) is strongly expressed in a subset of sclerotome cells, and the resultant protein interacts with FGFR1 in the FGF signaling pathway during development. Studies on flrt2 have focused mainly on its roles in the brain, heart and chondrogenesis. However, reports on its expression and function in the zebrafish retina are lacking. Here, we detected the high expression of flrt2 in zebrafish retina using in situ hybridization technique and developed an flrt2-knockout (KO) zebrafish line using CRISPR/Cas9 genome editing. Quantitative real-time PCR was used to measure the expression levels of flrt2, which results in an approximately 60% mRNA reduction. The flrt2-KO zebrafish eyes’ altered morphological, cellular, and molecular events were identified using BrdU labeling, TUNEL assay, immunofluorescent staining, fluorescent dye injection and RNA sequencing. Abnormal eye development, known as microphthalmia, was found in flrt2-KO larvae, and the retinal progenitor cells exhibited increased apoptosis, perhaps owing to the combined effects of crx, neurod4, atoh7, and pcdh8 downregulation and Casp3a and Caspbl upregulation. In contrast, the retinal neural development, as well as retinal progenitor cell differentiation and proliferation, were not affected by the flrt2 deletion. Thus, flrt2 appears to play important roles in retinal development and function, which may provide the basis for further investigations into the molecular mechanisms of retinal development and evolution.
Immature human engineered heart tissues engraft in a guinea pig chronic injury model
Authors: von Bibra Constantin , Shibamiya Aya , Bähr Andrea , Geertz Birgit , Köhne Maria , Stuedemann Tim , Starbatty Jutta , Horneffer-van der Sluis Verena , Klostermeier Ulrich C. , Hornaschewitz Nadja , Li Xinghai , Wolf Eckhard , Klymiuk Nikolai , Krane Markus , Kupatt Christian , Hiebl Bernhard , Eschenhagen Thomas , Weinberger Florian
Published: June 2023

Engineered heart tissue (EHT) transplantation represents an innovative, regenerative approach for heart failure patients. Late preclinical trials are underway, and a first clinical trial started recently. Preceding studies revealed functional recovery after implantation of in vitro-matured EHT in the subacute stage, whereas transplantation in a chronic injury setting was less efficient. When transplanting matured EHTs, we noticed that cardiomyocytes undergo a dedifferentiation step before eventually forming structured grafts. Therefore, we wanted to evaluate whether immature EHT (EHTIm) patches can be used for transplantation. Chronic myocardial injury was induced in a guinea pig model. EHTIm (15×106 cells) were transplanted within hours after casting. Cryo-injury led to large transmural scars amounting to 26% of the left ventricle. Grafts remuscularized 9% of the scar area on average. Echocardiographic analysis showed some evidence of improvement of left-ventricular function after EHTIm transplantation. In a small translational proof-of-concept study, human scale EHTIm patches (4.5×108 cells) were epicardially implanted on healthy pig hearts (n=2). In summary, we provide evidence that transplantation of EHTIm patches, i.e. without precultivation, is feasible, with similar engraftment results to those obtained using matured EHT.
NR2F1 shapes mitochondria in the mouse brain, providing new insights into Bosch-Boonstra-Schaaf optic atrophy syndrome
Authors: Bonzano Sara , Dallorto Eleonora , Molineris Ivan , Michelon Filippo , Crisci Isabella , Gambarotta Giovanna , Neri Francesco , Oliviero Salvatore , Beckervordersandforth Ruth , Lie Dieter Chichung , Peretto Paolo , Bovetti Serena , Studer Michèle , Marchis Silvia De
Published: June 2023

The nuclear receptor NR2F1 acts as a strong transcriptional regulator in embryonic and postnatal neural cells. In humans, mutations in the NR2F1 gene cause Bosch-Boonstra-Schaaf optic atrophy syndrome (BBSOAS), a rare neurodevelopmental disorder characterized by multiple clinical features including vision impairment, intellectual disability and autistic traits. In this study, we identified, by genome-wide and in silico analyses, a set of nuclear-encoded mitochondrial genes as potential genomic targets under direct NR2F1 transcriptional control in neurons. By combining mouse genetic, neuroanatomical and imaging approaches, we demonstrated that conditional NR2F1 loss of function within the adult mouse hippocampal neurogenic niche results in a reduced mitochondrial mass associated with mitochondrial fragmentation and downregulation of key mitochondrial proteins in newborn neurons, the genesis, survival and functional integration of which are impaired. Importantly, we also found dysregulation of several nuclear-encoded mitochondrial genes and downregulation of key mitochondrial proteins in the brain of Nr2f1-heterozygous mice, a validated BBSOAS model. Our data point to an active role for NR2F1 in the mitochondrial gene expression regulatory network in neurons and support the involvement of mitochondrial dysfunction in BBSOAS pathogenesis.
Fertility-Sparing Treatment for Early-Stage Cervical Cancer ≥ 2 cm: Can One Still Effectively Become a Mother? A Systematic Review of Fertility Outcomes
Authors: Ronsini Carlo , Solazzo M. C. , Molitierno R. , De Franciscis P. , Pasanisi F. , Cobellis L. , Colacurci N.
Published: June 2023

Background

Fertility-sparing treatments (FSTs) have played a crucial role in the management of early-stage cervical cancer (ECC); however, there is currently no standard of care for women with ECC ≥ 2 cm who wish to preserve their fertility. The current orientation of the scientific community comprises upfront surgical techniques and neoadjuvant chemotherapy (NACT) followed by minor surgery such us conization. However these approaches are not standardized. This systematic review aimed to collect the evidence in the literature regarding the obstetric outcomes of the different techniques for applying FSTs in ECC ≥ 2 cm.

Methods

A systematic review was performed in September 2022 using the Pubmed and Scopus databases, from the date of the first publication. We included all studies containing data regarding pregnancy, birth, and preterm rates.

Results

Fifteen studies fulfilled the inclusion criteria, and 352 patients were analyzed regarding fertility outcomes. Surgery-based FST showed the pregnancy rate (22%), birth rate (11%), and preterm rate (10%). Papers regarding FST using the NACT approach showed a pregnancy rate of 44%, with a birth rate of 45% in patients who managed to get pregnant. The preterm rate amounted to 44%, and pregnancy rates and birth rates were significantly different between the two groups (p < 0.001).

Conclusion

Fertility preservation in patients with ECC > 2 cm is challenging. The endpoint for evaluating the best treatment should include oncological and fertility outcomes together. From this prospective, NACT followed by less radical surgery could be a reasonable compromise.
Exogenous Ketosis Improves Sleep Efficiency and Counteracts the Decline in REM Sleep after Strenuous Exercise
Authors: ROBBERECHTS RUBEN , ALBOUY GENEVIÈVE , HESPEL PETER , POFFÉ CHIEL
Published: June 2023

Introduction

Available evidence indicates that ketone bodies may improve sleep quality. Therefore, we determined whether ketone ester (KE) intake could counteract sleep disruptions induced by strenuous exercise.

Methods

Ten well-trained cyclists with good sleep quality participated in a randomized crossover design consisting of two experimental sessions each involving a morning endurance training and an evening high-intensity interval training ending 1 h before sleep, after which polysomnography was performed overnight. Postexercise and 30 min before sleeping time, subjects received either 25 g of KE (EXKE) or a placebo drink (EXCON). A third session without exercise but with placebo supplements (RCON) was added to evaluate the effect of exercise per se on sleep.

Results

Blood d-β-hydroxybutyrate concentrations transiently increased to ~3 mM postexercise and during the first part of the night in EXKE but not in EXCON or RCON. Exercise significantly reduced rapid eye movement sleep by 26% (P = 0.001 vs RCON) and increased wakefulness after sleep onset by 95% (P = 0.004 vs RCON). Interestingly, KE improved sleep efficiency by 3% (P = 0.040 vs EXCON) and counteracted the exercise-induced decrease in rapid eye movement sleep (P = 0.011 vs EXCON) and the increase in wakefulness after sleep onset (P = 0.009 vs EXCON). This was accompanied by a KE-induced increase in dopamine excretion (P = 0.033 vs EXCON), which plays a pivotal role in sleep regulation. In addition, exercise increased sleep spindle density by 36% (P = 0.005 vs RCON), suggesting an effect on neural plasticity processes during sleep.

Conclusions

These data indicate that KE ingestion improves sleep efficiency and quality after high-intensity exercise. We provide preliminary evidence that this might result from KE-induced increases in dopamine signaling.
Development of Cycling Performance Variables and Durability in Female and Male National Team Cyclists: From Junior to Senior
Authors: ALMQUIST NICKI WINFIELD , HANSEN JOAR , RØNNESTAD BENT R.
Published: June 2023

Aim

This study investigated the development of power profiles and performance-related measures from the junior level (<19 yr) via U23 (19–23 yr) to senior level (>23 yr) in 19 female and 100 male Norwegian national team cyclists.

Methods

A total of 285 tests were performed in a 3-d laboratory-standardized testing regime. The tests included power profiles with shorter duration (6–60 s) and longer durations (12–30 min) together with performance-related measures: critical power (CP), work capacity above CP (W′), power output at 4 and 2 mmol·L−1 [BLa−] (L4 and L2), maximal aerobic power (Wmax), and maximal oxygen uptake (V̇O2max), gross efficiency (GE), and pedaling efficiency.

Results

Females and males evolve similarly when maturing from junior via U23 to senior categories (all P > 0.07), except for V̇O2max, which increased in females (but not males) from junior to senior level (534 ± 436 mL·min−1, P = 0.013). In general, only performances of longer durations improved with age (12 and 30 min, P = 0.028 and P = 0.042, respectively). Performance-related measures like Wmax, V̇O2max, CP, L4, L2, and pedaling efficiency in the fresh state improved with age (all P ≤ 0.025). Importantly, performance in the semifatigued state during a 5-min maximal test was also improved with age (P = 0.045) despite a higher external energy expenditure before the test (P = 0.026).

Conclusions

Junior cyclists show highly developed sprint abilities, and the primary improvements of absolute power outputs and performance-related measures are seen for durations >60 s when maturing to U23 and senior categories. However, the durability, i.e., the capacity to maintain performance in a semifatigued state, is improved with age.
Addressing post-COVID-19 musculoskeletal symptoms through telemedicine: A study protocol
Authors: Sánchez Romero Eleuterio A. , Fernández Carnero Josué , Alonso Pérez José Luis , Martínez Rolando Lidia , Villafañe Jorge Hugo
Published: June 2023

Objective: The purpose of the study will be to evaluate the effect of a rehabilitation program on the improvement of patients with post-COVID-19 musculoskeletal symptoms, as well as to quantify the impact of telemedicine that evaluates the evolution of pain, functionality, and quality of life. Methods: We will carry out a case-control study in post-COVID-19 musculoskeletal symptoms patients who will undergo a multicomponent rehabilitation program, together with an intervention and a follow-up using programmed telemedicine sessions. Data will be collected on the improvement of functional capacity and quality of life, in addition to assessing the evolution of musculoskeletal symptomatology, as well as pain and psychological variables. The telemedicine sessions will improve user adherence and follow-up, and the results are expected to be disseminated to the scientific community during and after the end of the study.
Przygotowanie kandydatów do chrztu w kontekście ich funkcjonowania w świecie na podstawie wybranych pouczeń chrzcielnych oraz pism katechetycznych (IV–V w.)
Authors: Grzywa Anna
Published: June 2023

Artykuł przedstawia charakterystykę sylwetki katechumena w kulturze pierwszych wieków chrześcijaństwa na podstawie katechez chrzcielnych (przedchrzcielnych i mistagogicznych). Dzięki wykorzystaniu pouczeń katechetów pochodzących z IV w. i pocz. V w. z różnych środowisk ukazano miejsce kandydatów do chrztu w świecie, ich relacje społeczne w kontekście specyficznej pozycji, jaką zajmowali, przygotowując się do przyjęcia sakramentu chrztu, a tym samym oczekując przyjęcia w sposób pełny do wspólnoty Kościoła.
Wybrane przykłady realiów biblijnych ze świata flory i fauny wprowadzone do przekładu Pisma Świętego przez św. Hieronima
Authors: Wajda Anna Maria
Published: June 2023

W artykule przedstawiono problemy związane z oddaniem realiów biblijnych (realia biblica). Przedmiotem analizy jest kwestia przekładu przez św. Hieronima hebrajskiej nazwy rośliny קִיקָיוֹן (qîqājôn – rącznik pospolity) oraz hebrajskich nazw zwierząt ליִַשׁ (layiš – lew) i שָׁפןָ (šāpān – góralek). W przypadku terminu קִיקָיוֹן (qîqājôn), który użyty jest w Księdze Jonasza (4,6), św. Hieronim wybrał dla swego łacińskiego tłumaczenia nazwę hedera (bluszcz), co wywołało spore zamieszanie. Hebrajskie słowo ליִַשׁ (layiš), występujące w Księdze Hioba (4,11) przetłumaczył jako tygrys. Natomiast, jeśli chodzi o góralka, małe stworzenie biblijne (zob. Kpł 11,5; Pwt 14,7; Ps 104,18; Prz 30,26), które prawdopodobnie spotkał podczas pobytu w Ziemi Świętej, wprowadził kilka różnych identyfikacji: jako zająca, jeża, a nawet świnię. Przykłady te bardzo dobrze obrazują problemy, z jakimi św. Hieronim spotkał się przy doborze realiów biblijnych. Niniejszy artykuł jest próbą uporządkowania wszystkich istotnych informacji dotyczących identyfikacji wymienionych roślin i zwierząt. Autor artykułu po pierwsze analizuje teksty, w których Hieronim bronił swoich wyborów i odpowiadał na krytykę, a po drugie konfrontuje jego rozwiązania translatorskie z podejściem tłumaczy Septuaginty, informacjami o florze i faunie zawartymi w innych starożytnych źródłach oraz dorobkiem nauk przyrodniczych.
A qualitative study of patients' experiences of living with hard-to-heal leg ulcers
Authors: Olsson Malin , Wadin Lisa , Åhlén Jenny , Friman Anne
Published: June 2023

Background:

Patients with hard-to-heal leg ulcers are often older and have underlying conditions that contribute to making wound healing more difficult. Hard-to-heal leg ulcers are often treated in primary care and form a large part of the district nurse's work.

Aim:

To describe patients' experiences of living with hard-to-heal leg ulcers.

Methods:

This qualitative study undertook 18 interviews with patients in primary care with hard-to-heal leg ulcers.

Findings:

A total of three categories were identified: ‘Living with changes in everyday life’, ‘Being dependent on care’, and ‘Experiencing and dealing with suffering’. The patients described limitations in physical activity and changes in social interaction. Suffering was described in different ways and also resulted in coping strategies.

Conclusions:

Living with hard-to-heal leg ulcers affects the patient's everyday life physically and mentally. Knowledge about the complexity of patients' experiences can contribute to better care and increased quality of life in a difficult situation.
Children's oral health: what's your role?
Authors: Brown Clementine Rees
Published: June 2023

Clementine Rees Brown speaks to Leigh Ann Randell about the challenges and rewards of paediatric dentistry.
High rate of radiolucent lines following the cemented original design of the ATTUNE total knee arthroplasty
Authors: Prodromidis Apostolos D. , Chloros George D. , Thivaios Georgios C. , Sutton Paul M. , Pandit Hemant , Giannoudis Peter V. , Charalambous Charalambos P.
Published: June 2023

Aims

Loosening of components after total knee arthroplasty (TKA) can be associated with the development of radiolucent lines (RLLs). The aim of this study was to assess the rate of formation of RLLs in the cemented original design of the ATTUNE TKA and their relationship to loosening.

Methods

A systematic search was undertaken using the Cochrane methodology in three online databases: MEDLINE, Embase, and CINAHL. Studies were screened against predetermined criteria, and data were extracted. Available National Joint Registries in the Network of Orthopaedic Registries of Europe were also screened. A random effects model meta-analysis was undertaken.

Results

Of 263 studies, 12 were included with a total of 3,861 TKAs. Meta-analysis of ten studies showed high rates of overall tibial or femoral RLLs for the cemented original design of the ATTUNE TKA. The overall rate was 21.4% (95% confidence interval (CI) 12.7% to 33.7%) for all types of design but was higher for certain subgroups: 27.4% (95% CI 13.4% to 47.9%) for the cruciate-retaining type, and 29.9% (95% CI 15.6% to 49.6%) for the fixed-bearing type. Meta-analysis of five studies comparing the ATTUNE TKA with other implants showed a significantly higher risk of overall tibial or femoral RLLs (odds ratio (OR) 2.841 (95% CI 1.219 to 6.623); p = 0.016) for the ATTUNE. The rates of loosening or revision for loosening were lower, at 1.2% and 0.9% respectively, but the rates varied from 0% to 16.3%. The registry data did not report specifically on the original ATTUNE TKA or on revision due to loosening, but ‘all-cause’ five-year revision rates for the cemented ATTUNE varied from 2.6% to 5.9%.

Conclusion

The original cemented ATTUNE TKA has high rates of RLLs, but their clinical significance is uncertain given the overall low associated rates of loosening and revision. However, in view of the high rates of RLLs and the variation in the rates of loosening and revision between studies and registries, close surveillance of patients who have undergone TKA with the original ATTUNE system is recommended.

Cite this article: Bone Joint J 2023;105-B(6):610–621.
The relationship between exposure to noise and hearing loss in orthopaedics
Authors: Mistry Dylan , Ahmed Usman , Aujla Randeep , Aslam Nadim , D’Alessandro Peter , Malik Shahbaz
Published: June 2023

Aims

In the UK, the agricultural, military, and construction sectors have stringent rules about the use of hearing protection due to the risk of noise-induced hearing loss. Orthopaedic staff may also be at risk due to the use of power tools. The UK Health and Safety Executive (HSE) have clear standards as to what are deemed acceptable occupational levels of noise on A-weighted and C-weighted scales. The aims of this review were to assess the current evidence on the testing of exposure to noise in orthopaedic operating theatres to see if it exceeds these regulations.

Methods

A search of PubMed and EMBASE databases was conducted using PRISMA guidelines. The review was registered prospectively in PROSPERO. Studies which assessed the exposure to noise for orthopaedic staff in operating theatres were included. Data about the exposure to noise were extracted from these studies and compared with the A-weighted and C-weighted acceptable levels described in the HSE regulations.

Results

A total of 15 studies were deemed eligible. These included a total of 386 orthopaedic operations and the use of 64 orthopaedic instruments. A total of 294 operations (76%) and 45 instruments (70%) exceeded the regulations on an A-weighted scale, and 22% (10 of 46) of operations exceeded the maximum C-weighted peak acceptable level of noise. Noise-induced hearing loss was reported in 28 of 55 orthopaedic staff members (50.9%).

Conclusion

Safe levels of noise can be exceeded in orthopaedic operations, and when using orthopaedic instruments. Employers have clear policies about exposure to noise in the workplace but have yet to identify orthopaedic theatres as a potential at-risk area. Orthopaedic staff need education, monitoring, and protection, while employers should consider regular assessments of staff in orthopaedic theatres and offer methods to prevent noise-induced hearing loss.

Cite this article: Bone Joint J 2023;105-B(6):602–609.
Patellar resurfacing versus retention in cruciate-retaining and posterior-stabilized total knee arthroplasty
Authors: Simpson Cameron J. R. W. , Wright Evan , Ng Nathan , Yap Ngee J. , Ndou Solomon , Scott Chloe E. H. , Clement Nick D.
Published: June 2023

Aims

This systematic review and meta-analysis aimed to compare the influence of patellar resurfacing following cruciate-retaining (CR) and posterior-stabilized (PS) total knee arthroplasty (TKA) on the incidence of anterior knee pain, knee-specific patient-reported outcome measures, complication rates, and reoperation rates.

Methods

A systematic review of MEDLINE, PubMed, and Google Scholar was performed to identify randomized controlled trials (RCTs) according to search criteria. Search terms used included: arthroplasty, replacement, knee (Mesh), TKA, prosthesis, patella, patellar resurfacing, and patellar retaining. RCTs that compared patellar resurfacing versus unresurfaced in primary TKA were included for further analysis. Studies were evaluated using the Scottish Intercollegiate Guidelines Network assessment tool for quality and minimization of bias. Data were synthesized and meta-analysis performed.

Results

There were 4,135 TKAs (2,068 resurfaced and 2,027 unresurfaced) identified in 35 separate cohorts from 33 peer-reviewed studies. Anterior knee pain rates were significantly higher in unresurfaced knees overall (odds ratio (OR) 1.84; 95% confidence interval (CI) 1.20 to 2.83; p = 0.006) but more specifically associated with CR implants (OR 1.95; 95% CI 1.0 to 3.52; p = 0.030). There was a significantly better Knee Society function score (mean difference (MD) -1.98; 95% CI -1.1 to -2.84; p < 0.001) and Oxford Knee Score (MD -2.24; 95% CI -0.07 to -4.41; p = 0.040) for PS implants when patellar resurfacing was performed, but these differences did not exceed the minimal clinically important difference for these scores. There were no significant differences in complication rates or infection rates according to implant design. There was an overall significantly higher reoperation rate for unresurfaced TKA (OR 1.46 (95% CI 1.04 to 2.06); p = 0.030) but there was no difference between PS or CR TKA.

Conclusion

Patellar resurfacing, when performed with CR implants, resulted in lower rates of anterior knee pain and, when used with a PS implant, yielded better knee-specific functional outcomes. Patellar resurfacing was associated with a lower risk of reoperation overall, but implant type did not influence this.

Cite this article:Bone Joint J 2023;105-B(6):622–634.
Predicting five-year mortality in soft-tissue sarcoma patients
Authors: Yeramosu Teja , Ahmad Waleed , Bashir Azhar , Wait Jacob , Bassett James , Domson Gregory
Published: June 2023

Aims

The aim of this study was to identify factors associated with five-year cancer-related mortality in patients with limb and trunk soft-tissue sarcoma (STS) and develop and validate machine learning algorithms in order to predict five-year cancer-related mortality in these patients.

Methods

Demographic, clinicopathological, and treatment variables of limb and trunk STS patients in the Surveillance, Epidemiology, and End Results Program (SEER) database from 2004 to 2017 were analyzed. Multivariable logistic regression was used to determine factors significantly associated with five-year cancer-related mortality. Various machine learning models were developed and compared using area under the curve (AUC), calibration, and decision curve analysis. The model that performed best on the SEER testing data was further assessed to determine the variables most important in its predictive capacity. This model was externally validated using our institutional dataset.

Results

A total of 13,646 patients with STS from the SEER database were included, of whom 35.9% experienced five-year cancer-related mortality. The random forest model performed the best overall and identified tumour size as the most important variable when predicting mortality in patients with STS, followed by M stage, histological subtype, age, and surgical excision. Each variable was significant in logistic regression. External validation yielded an AUC of 0.752.

Conclusion

This study identified clinically important variables associated with five-year cancer-related mortality in patients with limb and trunk STS, and developed a predictive model that demonstrated good accuracy and predictability. Orthopaedic oncologists may use these findings to further risk-stratify their patients and recommend an optimal course of treatment.

Cite this article: Bone Joint J 2023;105-B(6):702–710.
Comparison of long-term clinical and radiological outcomes for cemented keel, cemented peg, and hybrid cage glenoids with anatomical total shoulder arthroplasty using the same humeral component
Authors: Friedman Richard J. , Boettcher Marissa L. , Grey Sean , Flurin Pierre-Henri , Wright Thomas W. , Zuckerman Joseph D. , Eichinger Josef K. , Roche Christopher
Published: June 2023

Aims

The aim of this study was to longitudinally compare the clinical and radiological outcomes of anatomical total shoulder arthroplasty (aTSA) up to long-term follow-up, when using cemented keel, cemented peg, and hybrid cage peg glenoid components and the same humeral system.

Methods

We retrospectively analyzed a multicentre, international clinical database of a single platform shoulder system to compare the short-, mid-, and long-term clinical outcomes associated with three designs of aTSA glenoid components: 294 cemented keel, 527 cemented peg, and 981 hybrid cage glenoids. Outcomes were evaluated at 4,746 postoperative timepoints for 1,802 primary aTSA, with a mean follow-up of 65 months (24 to 217).

Results

Relative to their preoperative condition, each glenoid cohort had significant improvements in clinical outcomes from two years to ten years after surgery. Patients with cage glenoids had significantly better clinical outcomes, with higher patient-reported outcome scores and significantly increased active range of motion, compared with those with keel and peg glenoids. Those with cage glenoids also had significantly fewer complications (keel: 13.3%, peg: 13.1%, cage: 7.4%), revisions (keel: 7.1%, peg 9.7%, cage 3.5%), and aseptic glenoid loosening and failure (keel: 4.7%, peg: 5.8%, cage: 2.5%). Regarding radiological outcomes, 70 patients (11.2%) with cage glenoids had glenoid radiolucent lines (RLLs). The cage glenoid RLL rate was 3.3-times (p < 0.001) less than those with keel glenoids (37.3%) and 4.6-times (p < 0.001) less than those with peg glenoids (51.2%).

Conclusion

These findings show that good long-term clinical and radiological outcomes can be achieved with each of the three aTSA designs of glenoid component analyzed in this study. However, there were some differences in clinical and radiological outcomes: generally, cage glenoids performed best, followed by cemented keel glenoids, and finally cemented peg glenoids.

Cite this article: Bone Joint J 2023;105-B(6):668–678.
Coronal translation of the forearm, proximal capitate, and ulnar styloid predict radial inclination in distal radius fractures in older female patients
Authors: Johnston Geoffrey H. F. , Mastel Matthew , Sims Laura A. , Cheng Yanzhao
Published: June 2023

Aims

The aims of this study were to identify means to quantify coronal plane displacement associated with distal radius fractures (DRFs), and to understand their relationship to radial inclination (RI).

Methods

From posteroanterior digital radiographs of healed DRFs in 398 female patients aged 70 years or older, and 32 unfractured control wrists, the relationships of RI, quantifiably, to four linear measurements made perpendicular to reference distal radial shaft (DRS) and ulnar shaft (DUS) axes were analyzed: 1) DRS to radial aspect of ulnar head (DRS-U); 2) DUS to volar-ulnar corner of distal radius (DUS-R); 3) DRS to proximal capitate (DRS-PC); and 4) DRS to DUS (interaxis distance, IAD); and, qualitatively, to the distal ulnar fracture, and its intersection with the DUS axis.

Results

In the study (fracture) and control groups, respectively, the mean values were: RI, 17.2° (SD 7.2°; -7° to 35°) and 25.6° (SD 2.6°; 21° to 30°); DRS-U, 13.5 mm (SD 1.7; 4.9 to 20.8) and 15.3 mm (SD 0.72; 13.8 to 16.3); DUS-R, 13.4 mm (SD 2.1; 4.8 to 18.5) and 12.0 mm (SD 0.99; 9.7 to 13.9); DRS-PC (positive value radial to DRS, negative value ulnar), 0.14 mm (SD 5.4; -10.9 to 22.7) and -6.1 mm (SD 1.6; -10.6 to -2.3); and IAD, 25.3 mm (SD 2.5; 17.6 to 31.1) and 27.1 mm (SD 1.5; 24.5 to 31.0). All means were significantly different between the study and control groups. RI correlated strongly with DRS-PC. Ulnar styloid fracture intersection with the DUS axis, reflective of ulnar translation of both radial and ulnar shafts, was associated with significantly lower RI.

Conclusion

After DRF, the relationship of the proximal capitate to the DRS axis in the coronal plane correlates with the final radial inclination. Additionally, ulnar styloid intersection with the DUS axis is associated with even lower radial inclination. DRF reduction should seek to restore the normal coronal relationship of both radial and ulnar shafts to their distal counterparts.

Cite this article: Bone Joint J 2023;105-B(6):688–695.