bluuebunny/crossref_metadata_2025 huggingface dataset:
Biocontrol potential of some bacterial and fungal isolates against the terrestrial snail, Monacha obstructa, evaluating their laboratory and field efficiency
Authors: Abo-Elwfa Mohamed M. , Omar Mahmoud M. A. , El-Shamy Emad A. , Ibrahim Hesham A. M.
Published: May 2024

Background

The land snail Monacha obstructa, commonly known as the glassy clover snail, poses a significant threat to crops, causing substantial damage in agriculture and horticulture. It particularly thrives in regions of Egypt, where it can reproduce rapidly, leading to substantial population increases and consequent damage. This study aimed to perform laboratory experiments and field trials to assess the effectiveness of bacterial (Bacillus thuringiensis) and fungal (Metarhizium anisopliae and Trichoderma harzianum) isolates, as well as methomyl, a carbamate compound approved by the Ministry of Agriculture in Egypt against the terrestrial snails. Various methods including contact and leaf dipping as well as baiting techniques were applied under both laboratory and field conditions, using spray and baiting techniques.

Results

Bacillus thuringiensis (Bt) and M. anisopliae isolates showed the most effective results outcomes in comparison with methomyl against M. obstructa. Out of all the application approaches tested, the residual film (contact) technique of these microorganisms proved to be the most potent, with LC50 values of 6.49 × 106 cells/ml Bt (after 14 days), 1.24 × 108 and 1.49 × 108 spores/ml (M. anisopliae, T. harzianum, respectively), after 21 days and 620 ppm, for methomyl after 7 days of treatments. Besides, the findings demonstrated that Bt exhibited the highest success rate in decreasing the number of snails in the field. It was also observed that pathological symptoms increased as the duration of exposure increased, and the snails ceased to feed and showed a noticeable decline in their activity. A slimy, almost tan-like substance coated the exterior of their shells for Bt, and part of the soft body came out of the shell for M. anisopliae. In the case of T. harzianum, fungus hypha growth took on a white color formed inside the shell, and in addition, a black substance formed on the mouth of the shell.

Conclusions

The gathered data revealed that Bt and M. anisopliae effectively combatted the terrestrial snail, making them viable options in integrated pest control as substitutes for pesticides.
Chiari type 1.5 malformation as a cause of secondary trigeminal neuralgia: case report and literature discussion
Authors: Ergün Ahmet Cemil , Ertuğrul Bilal , Yildirim Gökhan , Kaplan Metin
Published: May 2024

Background

Chiari syndrome is a very rare cause of secondary trigeminal neuralgia (TN). There are a few cases of TN associated with Chiari syndrome in the literature, and all of these cases were reported as Chiari type 1. In this report, we present a case of secondary trigeminal neuralgia caused by Chiari type 1.5 for the first time unlike the literature.

Case presentation

A 38-year-old male patient, who had frequent and severe attacks of pain under the orbit, at the chin and rim of the mouth, was evaluated with craniocervical Magnetic Resonance Imaging (MRI) and revealed Chiari type 1.5 malformation and syringomyelia.

Conclusions

The mechanism of TN associated with Chiari malformation is unclear. However, the main concepts emphasized in cases presented in the literature are compression and stretching. The rapid relief of pain after decompression surgery in these cases also supports this situation. It can be predicted that compression and tension forces will become more pronounced in Chiari type 1.5 malformation, in which the brainstem elongation and ventral pressure are more prominent. Decompression of the foramen magnum provides rapid and effective pain control in the treatment of TN accompanying Chiari 1.5 syndrome that does not respond to medical treatment.
Pathobiology of traumatic spinal cord injury: an overview
Authors: Florez-Perdomo William A. , Guillermo Andrés Cardona-Cruz , García-Ballestas Ezequiel , Castilla-Martínez Abigail , Ramos-Villegas Yancarlos , Quintana-Pájaro Loraine , Janjua Tariq , Agrawal Amit , Moscote-Salazar Luis Rafael
Published: May 2024

Traumatic spinal cord injury (SCI) or traumatic myelopathy is a devastating neurological condition and a heavy burden on the health system. There are inflammatory and structural biomarkers with well-defined profiles, and useful for determining the management and prognosis of this pathology. Laboratory studies have shown some utility in confirming the existence of a spinal cord injury. Little knowledge about the molecular processes that occur after a SCI is evident, and it is well known that its understanding is dispensable to establish therapeutic targets that improve the outcomes for this type of patient. Many studies have explored the role of structural and inflammatory markers and some structural and inflammatory biomarkers. In the present article, we review the ongoing research in the field of spinal injury and possible role of biomarkers in the management of these patients.
Metabolomic responses of tea [Camellia sinensis (L.) O. Kuntze] leaves to red spider mite [Oligonychus coffeae (Nietner)] and tea mosquito bug [Helopeltis theivora Waterhouse] infestation: a GC–MS-based study
Authors: Sharma Gopal , Majumder Soumya , Ghosh Arindam , Bhattacharya Malay
Published: May 2024

Background

The tea plant,Camellia sinensis(L.) O. Kuntze, is an evergreen leafy plant whose tender leaves are used in the manufacturing of the world’s second most consumed beverage—tea. The production and consumption of tea worldwide have continually increased over the decades. All parts of the plant—leaf, stem, root, flower and seed, are fed upon by insect pests. This study elucidates the metabolomic changes occurring in tea leaves in response to infestation by two major pests in tea gardens: red spider mites and tea mosquito bugs. These pests significantly impact both the quantity and quality of tea production. The secondary metabolites produced by the tea due to pest attack has been analysed using GC–MS analysis in the laboratory.

Results

Mostly fatty acid derivatives were biosynthesized as secondary metabolites due to pest attack as revealed from the result. In both infestations, methyl stearate was found to be produced along with increased chromatographic peaks of compounds such as caffeine, methyl palmitate, methyl linoleate, and stigmasta-7,25-dien-3-ol. In comparison with respective control samples (leaf with no pest attack), the one attacked by red spider mite showed eighteen exclusive metabolites, whereas tea mosquito bug infested leaf showed six such exclusive metabolites.

Conclusions

Some metabolites were found to be either increased or decreased in their amount in both the samples. The increased compounds were reported with insecticidal and pesticidal properties with respect to respective controls. Some metabolites were markers of pest attacks i.e. plant defense mechanism induced phytochemicals according to the literature as discussed in this research.
Study of smart grid cyber-security, examining architectures, communication networks, cyber-attacks, countermeasure techniques, and challenges
Authors: Achaal Batoul , Adda Mehdi , Berger Maxime , Ibrahim Hussein , Awde Ali
Published: May 2024

Smart Grid (SG) technology utilizes advanced network communication and monitoring technologies to manage and regulate electricity generation and transport. However, this increased reliance on technology and connectivity also introduces new vulnerabilities, making SG communication networks susceptible to large-scale attacks. While previous surveys have mainly provided high-level overviews of SG architecture, our analysis goes further by presenting a comprehensive architectural diagram encompassing key SG components and communication links. This holistic view enhances understanding of potential cyber threats and enables systematic cyber risk assessment for SGs. Additionally, we propose a taxonomy of various cyberattack types based on their targets and methods, offering detailed insights into vulnerabilities. Unlike other reviews focused narrowly on protection and detection, our proposed categorization covers all five functions of the National Institute of Standards and Technology cybersecurity framework. This delivers a broad perspective to help organizations implement balanced and robust security. Consequently, we have identified critical research gaps, especially regarding response and recovery mechanisms. This underscores the need for further investigation to bolster SG cybersecurity. These research needs, among others, are highlighted as open issues in our concluding section.
The potential of undenatured type II collagen against arthritis: a review
Authors: Zhou Yuhao , Zhang Yuer , Dai Hongjie , Zhang Yuhao , Fu Yu
Published: May 2024

The increasing global aging population has led to a continual rise in the prevalence of bone and joint diseases, posing challenges to both the quality of life for patients and healthcare resources. Type II collagen, a pivotal protein for sustaining joint function, has gained substantial attention in recent years. The oral administration of undenatured type II collagen (UC-II) has demonstrated noteworthy advancements in tackling bone and joint diseases. This article presents a comprehensive review of the structure and extraction methods of UC-II, discusses the relationship between UC-II and arthritis, and thoroughly examines its therapeutic role and potential mechanisms in the treatment process. In addition, future perspectives for clinical application of UC-II are discussed. It was found that the oral administration of UC-II, through induction of oral tolerance mechanisms, exhibits promise in alleviating joint inflammation and pain in patients with osteoarthritis (OA) and rheumatoid arthritis (RA). This method can significantly ameliorate joint inflammation and pain, with high patient acceptance and minimal side effects, demonstrating its potential as a well-tolerated treatment option for joint diseases.

Graphical Abstract
Temporal variation in quality characteristics of nutritional constituents and bacterial community during dry salt-fermentation of hilsa (Tenualosa ilisha)
Authors: Sarkar Md. Shirajul Islam , Hossain Md. Shahdat , Hasan Muhammad Mehedi , Khan Murshida , Al Islam Anas , Kamal Md.
Published: May 2024

Nutritional constituents and bacterial community of hilsa (Tenualosa ilisha) at different stages of dry salt-fermentation; namely, F1 (after 2 days of salting), F2 (after 5 days of salting) and F3 (ripe product after 15 days of salting) was studied. Dry salt-fermentation did not negatively affect proximate biochemical composition. Total protein content in F1, F2 and F3 was 10.14, 22.30 and 16.21 mg/ml, respectively. With progression of ripening process, protein solubility gradually decreased. In all stages, about 98% protein digestibility was found. TBARS (Thiobarbituric acid reactive substances) values at F1, F2 and F3 stages was 0.30, 0.41 and 0.95 mg MDA/kg, respectively and within acceptable limit. A total of 3,248 OTUs were found. Of the identified 48 phyla, Proteobacteria (66%), Firmicutes (18%) and Bacteroidota (11%) were abundant at F1 stage but Firmicutes (82%) and Proteobacteria (9%) were dominant at F3 stage. Significant differences in the microbial β-diversity among initial, interim and ripe product were observed. There was no significant α-diversity difference at individual stages of dry salt-fermentation of hilsa. Functional gene profile revealed that, in the final product microbial genes related to organismal systems replaced human disease related genes found in initial and interim product. These findings provide new clues for in-depth characterization of salt-fermented foods from viewpoint of food chemistry and microbiology.

Graphical Abstract
Developing the first Arabic quality of life for parents of children with autism (QoLA) scale: translation, cultural adaptation and psychometric validation
Authors: Alkhatib Razan Numan , Dukmak Samir Jabra , El-Dahiyat Faris , Abojedi Amjed Ahmed
Published: May 2024

Purpose

In this research, the first Arabic quality of life (A-QoLA) measure for the mothers and fathers of children with autism is translated and validated. While there have been several translations of the QoLA scale, to the best of our knowledge, there are no Arabic version of this scale.

Method

To translate and validate the QoLA, 407 family members (mostly parents) participated in this research. Item total correlation and confirmatory factor analysis (CFA) were used for the scale validation process.

Results

The results show that like QoLA, all the items in Part A of the A-QoLA were positively correlated with the total score except items 2, 4, 17, and 22 (which were deleted). In addition, the Part B outcome of the item total correlation showed that all the items had a positive correlation with the overall score. The CFA results show high internal validity and consistency confirmed the two-domain structure for QoLA after it was translated into Arabic.

Conclusion

Our results have very important implications as autism is quite common in the Arab world, and the scale can be used across several Arabic-speaking countries to understand the impact of autism on families.
“Hypertension is such a difficult disease to manage”: federally qualified health center staff- and leadership-perceived readiness to implement a technology-facilitated team-based hypertension model
Authors: Gago Cristina , De Leon Elaine , Mandal Soumik , de la Calle Franze , Garcia Masiel , Colella Doreen , Dapkins Isaac , Schoenthaler Antoinette
Published: May 2024

Background

Despite decades of evidence demonstrating the efficacy of hypertension care delivery in reducing morbidity and mortality, a majority of hypertension cases remain uncontrolled. There is an urgent need to elucidate and address multilevel facilitators and barriers clinical staff face in delivering evidence-based hypertension care, patients face in accessing it, and clinical systems face in sustaining it. Through a rigorous pre-implementation evaluation, we aimed to identify facilitators and barriers bearing the potential to affect the planned implementation of a multilevel technology-facilitated hypertension management trial across six primary care sites in a large federally qualified health center (FQHC) in New York City.

Methods

During a dedicated pre-implementation period (3–9 months/site, 2021–2022), a capacity assessment was conducted by trained practice facilitators, including (1) online anonymous surveys (n = 124; 70.5% of eligible), (2) hypertension training analytics (n = 69; 94.5% of assigned), and (3) audio-recorded semi-structured interviews (n = 67; 48.6% of eligible) with FQHC leadership and staff. Surveys measured staff sociodemographic characteristics, adaptive reserve, evidence-based practice attitudes, and implementation leadership scores via validated scales. Training analytics, derived from end-of-course quizzes, included mean score and number attempts needed to pass. Interviews assessed staff-reported facilitators and barriers to current hypertension care delivery and uptake; following audio transcription, trained qualitative researchers employed a deductive coding approach, informed by the Consolidated Framework for Implementation Research (CFIR).

Results

Most survey respondents reported moderate adaptive reserve (mean = 0.7, range = 0–1), evidence-based practice attitudes (mean = 2.7, range = 0–4), and implementation leadership (mean = 2.5, range = 0–4). Most staff passed training courses on first attempt and demonstrated high scores (means > 80%). Findings from interviews identified potential facilitators and barriers to implementation; specifically, staff reported that complex barriers to hypertension care, control, and clinical communication exist; there is a recognized need to improve hypertension care; in-clinic challenges with digital tool access imposes workflow delays; and despite high patient loads, staff are motivated to provide high-quality cares.

Conclusions

This study serves as one of the first to apply the CFIR to a rigorous pre-implementation evaluation within the understudied context of a FQHC and can serve as a model for similar trials seeking to identify and address contextual factors known to impact implementation success.

Trial registration

ClinicalTrials.gov NCT03713515, date of registration: October 19, 2018.
Improving Access to Care, Patient Costs, and Environmental Impact Through a Community Outreach Lung Cancer Rapid Assessment Clinic
Authors: Golemiec Breanne , Robertson Madison , Poon Vincent , Foley Mary , Parker Christopher M. , McGann Craig , O'Callaghan Nicole , Digby Geneviève C.
Published: May 2024

PURPOSE

In Southeastern Ontario, increased patient distance from the regional lung cancer diagnostic assessment program (LDAP) is associated with a lower likelihood of patient care via LDAP while receiving care via LDAP is associated with improved survival. We implemented an LDAP outreach clinic to provide specialist assessment for patients with suspected lung cancer at a regional community hospital and assessed the impact on timeliness and accessibility of care.

MATERIALS AND METHODS

The Kingston Health Sciences Centre LDAP team engaged with community hospital partners to develop and launch the LDAP outreach clinic. We performed a retrospective chart review of LDAP patients (N = 1,070) before (August-November 2021; n = 234) and after implementation of the outreach clinic (November 2021-October 2022; n = 836). Descriptive data are reported as No. (%). Unpaired t tests and statistical process control charts assess for significance. A cost analysis of out-of-pocket patient costs related to travel and parking is presented in 2022 Canadian dollars (CAD).

RESULTS

Compared with a 3-month matched time period before (August-October 2021) and after outreach clinic (August-October 2022), the mean time from referral to assessment and time from referral to diagnosis decreased from 20.3 to 14.4 days ( P = .0019) and 40.0 to 28.9 days ( P = .0007), respectively. Over 12 months, the total patient travel was reduced by 8,856 km, which combined with parking cost-savings, resulted in patient out-of-pocket savings of CAD $5,755.60 (CAD $47.60/patient). Accounting for physician travel, the total travel saved was 5,688 km, corresponding to reduced CO2 emissions by 1.9 tCO2.

CONCLUSION

Implementation of a lung cancer outreach clinic led to improved timeliness of care, patient cost-savings, and reduced carbon footprint while serving patients in their community.
Survival After Contralateral Axillary Metastasis in Breast Cancer
Authors: Jung Ji-Jung , Cheun Jong-Ho , Kang Eunhye , Shin Ikbeom , Byeon Jinyoung , Lee Hwajeong , Kim Hong-Kyu , Lee Han-Byoel , Han Wonshik , Moon Hyeong-Gon
Published: May 2024

Background

Despite stage IV categorization, survival outcomes for breast cancer patients who experience contralateral axillary lymph node metastasis (CAM) remain uncertain. This study aimed to investigate the clinical outcomes for patients with metachronous CAM to provide insights into its prognosis and treatment recommendations.

Methods

This study retrospectively reviewed medical records of patients who underwent curative surgery for breast cancer and experienced CAM as the first site of distant metastasis (DM) during the follow-up period between January 2001 and April 2023. Survival outcomes of the CAM patients were compared with those of breast cancer patients with other DM via propensity score-matching (PSM).

Results

The study identified 40 breast cancer patients with metachronous CAM. The estimated 5-year overall survival (OS) was 39.6%, and the progression-free survival was 39.4%. The patients with CAM exhibited marginally better OS than the patients with DM (p = 0.071), but survival similar to that of the patients with isolated supraclavicular node recurrence (SCN) (p = 0.509). Moreover, matching of CAM with DM using two PSM models showed a consistently insignificant survival difference (hazard ratio [HR], 1.47; p = 0.124 vs. HR, 1.19; p = 0.542). Ipsilateral breast tumor recurrences (IBTRs) were experienced by 12 patients before or concurrently with the CAM. These patients exhibited significantly better survival than the remaining patients (HR, 0.28; p = 0.024).

Conclusion

The breast cancer patients with CAM showed survival similar to that for the patients with DM, supporting the current stage IV classification of the CAM. However, CAM associated with IBTR exhibited superior survival outcomes, suggesting that this subset of CAM may benefit from treatments with curative intent.
Creative usage of Vivli’s Antimicrobial Resistance Surveillance Open Data through the Re-Use Data Challenge
Authors: Li Rebecca , D'Arcy Catherine V. , Hermsen Elizabeth D. , Serio Alisa W. , Srinivasan Arjun , Bradford Patricia A.
Published: May 2024

The escalation of infections caused by drug-resistant bacteria worldwide poses a formidable challenge to global health, necessitating innovative approaches to combat this issue. In 2022, Vivli launched the Antimicrobial Resistance (AMR) Register, a platform that consolidates antimicrobial susceptibility data from pharmaceutical industry surveillance programs. This register provides a freely available and fully searchable user-friendly repository to facilitate scientific understanding of resistance patterns and support development of innovative strategies to address AMR globally. To promote the register’s utility, raise AMR awareness and encourage further re-use of the available data, Wellcome funded the Vivli AMR Surveillance Open Data Re-Use Data Challenge in 2023. This data challenge successfully fostered diverse, impactful, and innovative solutions that leveraged the AMR Register data to contribute to resolving the AMR crisis. The outcomes of the initiative underscore the importance of access to open data in stimulating collaboration and innovation in the public health domain, particularly in combatting the growing threat of drug-resistant infections.
Introduction to Looking Back, Moving Forward: Celebrating 25 Years of AI Practitioner
Authors: Aitken Shelagh , Tjepkema Saskia
Published: May 2024

In this issue of AI Practitioner, we deviate from our usual format, delving into personal narratives from the minds behind the journal. From Anne Radford’s inception of the journal in 1998 to Tanya Cruz Teller’s interview with Lindsey Godwin, each story explores the intimate relationship between the editorial board members, Appreciative Inquiry, and the AI Practitioner journal. Through reflections, interviews and essays, we invite you to discover the passionate voices shaping our AI community, through helping to shape AI Practitioner.
From Foundations to Flight: SOAR’s Journey from Appreciative Inquiry to the AI Practitioner
Authors: Stavros Jackie
Published: May 2024

This article provides the origin story of SOAR (Strengths, Opportunities, Aspirations and Results). Originating from Appreciative Inquiry, SOAR started as a positive approach to strategic thinking, planning and leading. It has expanded into management and leadership development, fostering an appreciative mindset. SOAR’s adaptability and impact are documented by many contributions in AI Practitioner across various sectors and communities.
A Quarter Century of Appreciative Inquiry Work with Schools and Youth
Authors: Dole Dawn
Published: May 2024

The author, Dawn Dole, delves into AI Practitioner’s quarter-century of support for Appreciative Inquiry in educational realms. From classrooms to communities, Appreciative Inquiry’s transformative power is explored in numerous articles and issues. Reflecting on the pivotal role of pioneers, the text underscores the imperative of nurturing positive educational ecosystems. Through intergenerational dialogues and innovative approaches, AI continues to spark profound change worldwide.
La uniformidad jurisprudencial en las decisiones del Consejo de Estado en los casos de tomas guerrilleras
Authors: Castro Pinto Johan Sebastián
Published: May 2024

En ese orden, el propósito del presente capítulo consiste en soportar la existencia de uniformidad respecto de las decisiones de la jurisprudencia contenciosa administrativa en los temas relacionados con tomas guerrilleras.
Sensitivity Analysis of the Cost Coefficients in Multiobjective Integer Linear Optimization
Authors: Andersen Kim Allan , Boomsma Trine Krogh , Efkes Britta , Forget Nicolas
Published: May 2024

This paper considers sensitivity analysis of the cost coefficients in multiobjective integer linear programming problems. We define the sensitivity region as the set of simultaneous changes to the coefficients for which the efficient set and its structure remain the same. In particular, we require that the component-wise relation between efficient solutions is preserved and that inefficient solutions remain inefficient, and we show that this is sufficient for the efficient set to be the same upon changes. For a single coefficient, we show that a subset of the inefficient solutions can be excluded from consideration. More specifically, we prove that it suffices to inspect the inefficient solutions of a q-objective problem that are efficient in one of two related q + 1-objective problems. Finally, we show that the sensitivity region is a convex set (an interval). Our approach generalizes to simultaneous changes in multiple coefficients. For illustration, we consider mean-variance capital budgeting and determine the region for which the set of efficient portfolios remains the same, despite a misspecification or a change in the net present values of the projects. Further computational experience with multiobjective binary and integer knapsack problems demonstrates the general applicability of our technique. For instance, we obtain all sensitivity intervals for changes to single coefficients of biobjective problems with 500 binary variables in less than half an hour of CPU time by excluding a large number of inefficient solutions. In fact, the number of excluded solutions is above 100 orders of magnitude larger than the number of remaining solutions.

This paper was accepted by Chung Piaw Teo, optimization.

Supplemental Material: The online appendix and data files are available at https://doi.org/10.1287/mnsc.2021.01406 .
The BAR Approach for Multiclass Queueing Networks with SBP Service Policies
Authors: Braverman Anton , Dai J. G. , Miyazawa Masakiyo
Published: May 2024

The basic adjoint relationship (BAR) approach is an analysis technique based on the stationary equation of a Markov process. This approach was introduced to study heavy-traffic, steady-state convergence of generalized Jackson networks in which each service station has a single job class. We extend it to multiclass queueing networks operating under static-buffer-priority (SBP) service disciplines. Our extension makes a connection with Palm distributions that allows one to attack a difficulty arising from queue-length truncation, which appears to be unavoidable in the multiclass setting. For multiclass queueing networks operating under SBP service disciplines, our BAR approach provides an alternative to the “interchange of limits” approach that has dominated the literature in the last twenty years. The BAR approach can produce sharp results and allows one to establish steady-state convergence under three additional conditions: stability, state space collapse (SSC) and a certain matrix being “tight.” These three conditions do not appear to depend on the interarrival and service-time distributions beyond their means, and their verification can be studied as three separate modules. In particular, they can be studied in a simpler, continuous-time Markov chain setting when all distributions are exponential. As an example, these three conditions are shown to hold in reentrant lines operating under last-buffer-first-serve discipline. In a two-station, five-class reentrant line, under the heavy-traffic condition, the tight-matrix condition implies both the stability condition and the SSC condition. Whether such a relationship holds generally is an open problem.
A rare case of biloma after ascending cholangitis and endoscopic retrograde cholangiopancreatography
Authors: Hernandez Perez Laura , Chandra Aishwarya , Ali Ruhma , Sharma Hari , Miller Richard , Hussain Muhammad
Published: May 2024

Introduction: Biloma is an uncommon form of liver abscess composed of bile usually associated with procedures of the biliary tree and gallbladder. Cholangitis can be acute or chronic, can result in partial or complete obstruction of the flow of bile. The infection of the bile is so common, that positive blood cultures are highly characteristic. In the case of a suppurative cholangitis with signs of sepsis treatment alone with antibiotics is usually not sufficient to achieve medical remission. Multiple hepatic abscesses are often present, and the mortality approaches 100% unless prompt endoscopic or surgical relief of the obstruction and drainage of infected bile are carried out. Endoscopic retrograde cholangiopancreatography ERCP with endoscopic sphincterotomy is the preferred initial procedure for both establishing a definitive diagnosis and providing effective therapy. Case description: We present the case of a 69-year-old female patient with complex chronic comorbidities who presented with acute cholangitis initially managed with endoscopically inserted stent and later complicated by sepsis and biloma formation. The bile was drained, and it showed an infection with Candida spp. requiring antifungal therapy. Conclusions: The failure to perform sphincterotomy in patients with suppurative cholangitis can contribute to the backflow of bile and worse outcomes.
The Rationale of Turkish Cypriot Position on Two-State Solution in Cyprus
Authors: Işıksal Hüseyin
Published: May 2024

This article examines the rationale behind the Turkish Cypriot position on the Two-State solution in Cyprus. The analysis consists of three interrelated parts. Initially, the question of whether Turkish Cypriots are entitled to ‘peoplehood’ that can exercise the right of self-determination according to international law is discussed. This is followed by evaluating the reasons driving the Turkish Cypriot side to exercise the right of self-determination and whether Turkish Republic of Northern Cyprus (TRNC) fulfills the criteria for statehood. In accordance with arguments carried out in the previous sections, the final part delves into the reasons for the Turkish Cypriot position on the Two-State solution in Cyprus in detail. It is argued that Turkish Cypriot people possess all of the attributes of statehood and are entitled to the same rights and status as the Greek Cypriot side currently exercises. Therefore, reinstating Turkish Cypriot people’s rights by reaffirming their sovereign equality and equal international status is necessary for a just and sustainable settlement in Cyprus.
Sosyal İnovasyon Politikalarında Üniversitelerin Artan Önemi ve Bilim Mağazaları Konseptinin Türk Üniversitelerine Uyarlanması Üzerine Bir Model Önerisi
Authors: Işık Maden Selen
Published: May 2024

Sosyal inovasyon, yeni bir kavram olmamasına rağmen son yıllarda ulusal/uluslarüstü düzeydeki politika tartışmalarının yeniden merkezi hâline gelmiştir. Gelir ve bilgi eşitsizliğindeki hissedilir artış bu durumun nedenleri arasında değerlendirilebilir. Mevcut büyük toplumsal zorlukların çözümünde, sosyal inovasyonun önemli bir aktörü olan üniversitelere de teknolojik yeniliklerin ötesine geçen yenilikçi çözümler yaratma noktasında önemli roller düşmektedir. Günümüzde artık üniversitelerin geleneksel misyonlarının ötesine geçmeleri ve toplumsal fayda temelli inovasyon süreçlerine yön verecek stratejiler izlemeleri gerekmektedir. Bu kapsamda bu çalışmanın temel amacı üniversitelerin üçüncü misyonu olarak adlandırılan topluma hizmet görevini yerine getirirken kullanabilecekleri yeni bir model önerisinde bulunmaktır. Türk yükseköğrenim sistemi içinde hiç denenmemiş ancak Avrupa üniversitelerinde 70’li yıllarda uygulanmaya başlanan ve günümüzde hem önemi hem de etkisi daha da artmış olan Bilim Mağazası modeli katılımcı, sosyal sorunlara duyarlı, toplumsal odaklı bir model olarak değerlendirilerek Türk üniversitelerine yeni bir yapı olarak sunulmaktadır.
Türkistan Hanlıkları’nda İnayetname Türü (XVI-XIX. yy.) ve İnşa Metodu Üzerine
Authors: Bakırcı Fatih
Published: May 2024

Bu makalenin konusunu Türk diplomatiğinde tıpkı soyurgal, tarhanlık yarlıkları ve bitikler gibi resmî bir yazışma türü olan ve şimdiye kadar alanyazında etraflıca ele alınmayan inayetnameler oluşturmaktadır. Bu çalışmada özellikle XVI-XIX. yüzyıllar arasında Doğu Türklük alanında etkin bir şekilde kullanılan inayetnamelerle ilgili dilsel göstergeler ve tarihî belgeler ışığında inayetname türünün gelişimi, içeriği, veriliş sebepleri, kalıcılığı, muhatabı ve inşa metodu gibi hususların açıklığa kavuşturulması ve bunların Türk resmî yazışma geleneğiyle ilişkilendirilmesi amaçlanmıştır. Bugüne kadar Türkistan hanlıklarından Hive ve Yarkend hanlıklarına ait Arap harfli toplam altı inayetname belgesi Türkoloji çalışmalarına kazandırıldığı için eldeki bu tarihî bulgular etrafında karşılaştırmalı bağlamsal bir metotla bu iç yazışma türünün diplomatik özellikleri ortaya konulmuştur.
Efforts for Energy-Based Regionalisation in the Turkic World: The Organization of Turkic States
Authors: Ağır Osman , Aksu Zehra
Published: May 2024

The main objective of this article is to analyse the energy policies of partner countries of the Organization of Turkic States (OTS), established over two energy regions, within the context of “energy regionalism.” The study, based on the premise that energy is one of the fundamental sources of motivation for the organisation, discusses the contributions of energy to the development and deepening of cooperation among the Turkic States. The paper explores the expectations of member countries from the organisation in terms of energy within the context of energy regionalism analysis criteria and seeks to answer questions regarding the level of fulfillment of these expectations. The findings suggest that the organisation has special importance in energy issues, with energy being a prominent subject in its written materials. The analysis reveals that the union broadly satisfies the criteria of energy regionalism, indicating the potential for implementing concrete cooperation projects related to energy among member countries in the medium term.
Akalın, Şükrü Halûk. Türk İşaret Dili Tarihi. TDK Yayınları, 2023.
Authors: Tözluyurt Zeynep
Published: May 2024

Bu yazıda Türk İşaret Dili Tarihi isimli eserin yayın tanıtımı yapılacaktır.
METASTATIC DISEASE OF THE PROXIMAL FEMUR: MANAGEMENT AND OUTCOMES IN A REGIONAL CANCER CENTRE
Authors: McCabe Patrick , Baxter John , O'Connor Miriam , McKenna Paul , Murphy Terence , Cleary May , Rowan Fiachra
Published: May 2024

The burden of metastatic disease presenting with axial skeleton lesions is exponentially rising predominantly due to advances in oncological therapies. A large proportion is these lesions are located in the proximal femora, which given its unique biomechanical architecture is problematic.

These patients are frequently comorbid and require prompt and concise decision making regarding their orthopaedic care in line with recent British Orthopaedic Association guidelines.

We present data detailing the outcomes for patients with proximal femoral metastatic disease referred and treated over a three year period in an Regional Cancer Centre.

We retrospectively reviewed a prospectively maintained database of all patients referred for discussion at MDT with axial skeletal metastatic disease. From this we isolated patients with femoral disease. Demographic data along with primary tumour and metastatic disease site were assessed. Treatment regimens were analysed and compared. Finally predicted and actual mortality data was collated.

331 patients were referred over the analysed time period, of which 99 had femoral disease. 66% of patients were managed conservatively with serial monitoring while 34% underwent operative treatment. 65% of those received an intramedullary fixation while 35% had arthroplasty performed. There was a 51:49 split male to female with Prostate, Lung and Breast being the predominant primary tumours. Concurrent spinal metastatic disease was noted in 62% of patients while visceral mets were seen in 37%. Mortality rate was 65% with an average prognosis of 388 days (1.06years) while average mortality was noted within 291 days (0.8 years).

Proximal femoral metastatic disease accounts for a large volume of the overall mets burden. There is an overall tendency towards conservative management and of those requiring surgery IM nailing was the treatment of choice. The data would indicate that outcomes for these patients are guarded and on average worse than those predicted.
INTERNATIONAL DELPHI CONSENSUS ON WOUND CLOSURE AND DRESSING MANAGEMENT IN TOTAL HIP ARTHROPLASTY
Authors: Board Tim , Nunley Ryan , Mont Michael A
Published: May 2024

The purpose of this modified Delphi study was to obtain consensus on wound closure (including best practices for each tissue layer of closure) and dressing management in total hip arthroplasty (THA), using an evidence-based approach.

The Delphi panel included 20 orthopedic surgeons from Europe and North America. Eighteen statements were identified (14 specific to THA and 4 relating to both THA and total knee arthroplasty) using a targeted literature review. Consensus was developed on the statements with up to three rounds of anonymous voting per topic. Panelists ranked their agreement with each statement on a five-point Likert scale. An a priori threshold of 75% was required for consensus.

In Round 1, 15 of 18 statements achieved consensus via a structured electronic questionnaire. In Round 2, the 3 statements that did not achieve consensus were revised during a virtual face to face meeting. An additional 2 statements were edited for clarity. In Round 3, the 5 revised statements achieved consensus via a structured electronic questionnaire. Wound closure related interventions that were recommended for use in THA included: 1) barbed sutures over non-barbed sutures (shorter closing times and overall cost savings); 2) subcuticular sutures over skin staples (lower risk of infections and higher patient preference); 3) mesh-adhesives over silver-impregnated dressings (lower rate of wound complications); 4) negative pressure wound therapy over other dressings (lower wound complications and reoperations and fewer dressing changes); 5) triclosan coated sutures (lower risk of surgical site infection).

Using a modified Delphi approach, a panel of 20 orthopedic surgeons achieved consensus on 18 statements pertaining to multi-layer wound closure and dressing management in THA. This study forms the basis for identifying critical evidence gaps within wound management to help reduce variability in outcomes during THA.
EXPERIMENTAL FAILURE OF HIP ARTHROPLASTY UNDER TORSION LOADING
Authors: Dhesi Elinor , Salih Samir , Tomlinson Rachel , Salih Saif
Published: May 2024

Polymethylmethacrylate (PMMA) bone cement is strong in compression, however it tends to fail under torsion. Sufficient pressurisation and subsequent interdigitation between cement and bone are critical for the mechanical interlock of cemented orthopaedic implants, and an irregular surface on the acetabular cup is necessary for reasonable fixation at the cup-cement interface. There is limited literature investigating discrepancies in the failure mechanisms of cemented all-polyethylene acetabular cups with and without cement spacers, under torsional loading.

In vitro experimental comparison of three groups of polyethylene acetabular prosthesis (PAP) cemented into prepared sawbone hemipelvises:

* PAP without PMMA spacers maintaining an equal cement mantle circumferentially. (Group 1 n=3)

* PAP without PMMA spacers cemented deliberately â€˜bottoming-outâ€™ the implant within the acetabulum. (Group 2 n=3)

* PAP with PMMA spacers. (Group 3 n=3)

The constructs were tested to torstional failure on a custom designed setup, and statistical analysis done by a one-way ANOVA and Tukey-Welsh test.

Group 3 demonstrated superior torsional resistance with a statistically significant torque of 145Nm (SD±12Nm) at failure, compared to group 2 (109Nm, SD±7Nm) and group 1 (99Nm, SD±8Nm). Group 3 experienced failure predominantly at the bone-cement interface, in contrast, Groups 1 and 2 exhibited failure predominantly at the cup-cement interface. There was no significant difference between Group 1 and 2. Qualitative analysis of the failure mode indicates the efficient redistribution of stress throughout the cement mantle, consistent with the greater uniformity of cement.

PMMA spacers increase the resistance to torsional failure at the implant-cement interface. Acetabular components without spacers (Groups 1 and 2) failed at the implant-cement interface before the cement-bone interface, at a statistically significantly lower level of torque to failure. Although the PMMA spacers may reduce cement interdigitation at the cement-bone interface the torsional forces required to fail are likely supraphysiological.
SURVIVORSHIP OF CURRENTLY AVAILABLE METAL-ON-METAL HIP RESURFACING IN MALES UNDER 55 YEARS OF AGE: A MATCHED NJR SURVIVORSHIP ANALYSIS
Authors: Dickenson Edward , Griffin James , Wall Peter , McBryde Callum
Published: May 2024

The 22 year survivorship of metal on metal hip resurfacing arthroplasty (RSA) is reported to be 94.3% with expert surgeons, in males with head sizes greater than 48mm. The 2023 National Joint Registry (NJR) report estimates survivorship of all RSA at 19 years to be 85%. This estimate includes all designs, head sizes and females. Our aim was to estimate the survivorship of RSA currently available for implantation (males only, head size >48mm, MatOrtho Adept or Smith and Nephew Birmingham Hip Resurfacing (BHR)) in those under 55 years, performed by all surgeons, compared to conventional THR.

We performed a retrospective analysis of the NJR. We included all males under 55 years who had undergone BHR or Adept RSA with head size greater than 48mm. Propensity score matching was used to produce two comparable groups of patients for RSA or conventional THR. We matched in a 3:1 ratio (THR:RSA) using sex, ASA, BMI group, age at primary procedure, surgeon volume, diagnosis and surgeon grade as covariates. The primary analysis was survivorship at 18 years. Time-to-revision was assessed using Kaplan-Meier curves. Cox's proportional hazard models were used to investigate between group differences.

4839 RSA were available for analysis. After matching the RSA and THR groups were well balanced in terms of covariates. Survivorship at 18 years was 93.7% (95% CI 89.9,96.2) in the RSA group and 93.9% (90.5,96.0) in the THR group. Despite these similar estimates the adjusted hazard ratio was 1.40 (95% CI 1.18, 1.67 p<0.001) in favour of THR.

Survivorship of the currently available RSA in males under 55 was 93.7% at 18 years, however THR survivorship was superior to RSA. These results, generalisable to UK practice, should be set against perceived benefits in functional status offered in RSA when counselling patients.
USE OF NATURAL LANGUAGE PROCESSING TECHNIQUES TO PREDICT PATIENT SELECTION FOR TOTAL HIP ARTHROPLASTY: RESULTS FROM THE AI TO REVOLUTIONISE THE PATIENT CARE PATHWAY IN HIP AND KNEE ARTHROPLASTY (ARCHERY) PROJECT
Authors: Farrow Luke , Zhong Mingjun , Anderson Lesley
Published: May 2024

To examine whether Natural Language Processing (NLP) using a state-of-the-art clinically based Large Language Model (LLM) could predict patient selection for Total Hip Arthroplasty (THA), across a range of routinely available clinical text sources.

Data pre-processing and analyses were conducted according to the Ai to Revolutionise the patient Care pathway in Hip and Knee arthroplasty (ARCHERY) project protocol (https://www.researchprotocols.org/2022/5/e37092/). Three types of deidentified Scottish regional clinical free text data were assessed: Referral letters, radiology reports and clinic letters. NLP algorithms were based on the GatorTron model, a Bidirectional Encoder Representations from Transformers (BERT) based LLM trained on 82 billion words of de-identified clinical text. Three specific inference tasks were performed: assessment of the base GatorTron model, assessment after model-fine tuning, and external validation.

There were 3911, 1621 and 1503 patient text documents included from the sources of referral letters, radiology reports and clinic letters respectively. All letter sources displayed significant class imbalance, with only 15.8%, 24.9%, and 5.9% of patients linked to the respective text source documentation having undergone surgery. Untrained model performance was poor, with F1 scores (harmonic mean of precision and recall) of 0.02, 0.38 and 0.09 respectively. This did however improve with model training, with mean scores (range) of 0.39 (0.31–0.47), 0.57 (0.48–0.63) and 0.32 (0.28–0.39) across the 5 folds of cross-validation. Performance deteriorated on external validation across all three groups but remained highest for the radiology report cohort.

Even with further training on a large cohort of routinely collected free-text data a clinical LLM fails to adequately perform clinical inference in NLP tasks regarding identification of those selected to undergo THA. This likely relates to the complexity and heterogeneity of free-text information and the way that patients are determined to be surgical candidates.
DUAL-MOBILITY IMPLANTS IN PRIMARY AND REVISION TOTAL HIP ARTHROPLASTY: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Saroha Sarup , Raheman Firas , Jaiswal Parag , Patel Akash
Published: May 2024

In this study, we examined the impact of dual-mobility (DM) versus fixed-bearing (FB) implants on outcomes following total hip arthroplasty (THA), a common and successful operation. We examined all-cause revision, revision due to dislocation, postoperative complications and functional scores in patients undergoing primary and revision THA.

A systematic review was performed according to PRISMA guidelines, and was registered in PROSPERO (ID CRD42023403736). The Cochrane Library, Embase, MEDLINE, Web of Science, and Scopus were searched from inception to 12th March 2023. Eligible studies underwent meta-analysis and methodological assessment using the ROBINS-I tool. Data were pooled using a random-effects maximum-likelihood model.

Eight comparative, non-randomised studies involving 2,810 DM implants and 3,188 FB implants were included. In primary THA, the difference in all-cause revision was imprecise (OR 0.82, 95% CI 0.25–2.72), whilst the DM cohort had a statistically significant benefit in revision due to dislocation (OR 0.08, 95% CI 0.02–0.28). In revision THA, the DM cohort showed significant benefit in all-cause revision (OR 0.57, 95% CI 0.31–1.05) and revision due to dislocation (OR 0.14, 95% CI 0.04–0.53). DM implants were associated with a lower incidence of implant dislocation and infection. Functional outcome analysis was limited due to underreporting. No intraprosthetic dislocations were observed.

The results suggest that contemporary DM designs may be advantageous in reducing the risk of all-cause revision, revision due to dislocation, and postoperative complication incidence at mid-term follow-up. Further high-quality prospective studies are needed to evaluate the long-term performance of this design, especially in revision cases.