bluuebunny/crossref_metadata_2025 huggingface dataset:
S100B predicts neurological injury and 30-day mortality following surgery for acute type A aortic dissection: an observational cohort study
Authors: Teurneau-Hermansson Karl , Ede Jacob , Larsson Mårten , Moseby-Knappe Marion , Bjursten Henrik , Nozohoor Shahab , Sjögren Johan , Zindovic Igor
Published: February 2023

Background

Neurological injuries are frequent following Acute Type A Aortic Dissection (ATAAD) repair occurring in 4–30% of all patients. Our objective was to study whether S100B can predict neurological injury following ATAAD repair.

Methods

This was a single-center, retrospective, observational study. The study included all patients that underwent ATAAD repair at our institution between Jan 1998 and Dec 2021 and had recorded S100B-values. The primary outcome measure was neurological injury, defined as focal neurological deficit or coma diagnosed by clinical assessment with or without radiological confirmation and with a symptom duration of more than 24 h. Secondary outcome measure was 30-day mortality.

Results

538 patients underwent surgery during the study period and 393 patients, had recorded S100B-values. The patients had a mean age of 64.4 ± 11.1 years and 34% were female. Receiver operating characteristic curve for S100B 24 h postoperatively yielded area under the curve 0.687 (95% CI 0.615–0.759) and best Youden’s index corresponded to S100B 0.225 which gave a sensitivity of 60% and specificity of 75%. Multivariable logistic regression identified S100B ≥ 0.23 μg/l at 24 h as an independent predictor for neurological injury (OR 4.71, 95% CI 2.59–8.57; p < 0.01) along with preoperative cerebral malperfusion (OR 4.23, 95% CI 2.03–8.84; p < 0.01) as well as an independent predictor for 30-day mortality (OR 4.57, 95% CI 1.18–11.70; p < 0.01).

Conclusions

We demonstrated that S100B, 24 h after surgery is a strong independent predictor for neurological injury and 30-day mortality after ATAAD repair.

Trial registration: As this was a retrospective observational study it was not registered.
Complete uni-port video-assisted thoracoscopic surgery for surgical stabilization of rib fractures: a case report
Authors: Yang Zhen , Wen Ming , Kong Weiqing , Li Xu , Liu Zhuan , Liu Xin
Published: February 2023

Background

Rib fractures are a common injury in trauma. Potential complications include pain, pneumonia, respiratory failure, disability, and death. Surgical stabilization of rib fractures (SSRF) has become an available treatment option, and complete video-assisted thoracoscopic surgery (VATS) for SSRF is gradually accepted because of minimally invasive and pain relief. To our knowledge, complete uni-port VATS for SSRF has not yet been reported.

Case presentation

A 53-year-old man accidentally fell off a three-meter high scaffolding while working resulting in severe chest pain and shortness of breath. He was found with left 7th through 11th rib fractures with a pulmonary contusion from computed tomography (CT). A 4 cm incision was made in the 7th intercostal space in the midaxillary line, and complete uni-port VATS for SSRF were operated. The patient's pain was significantly relieved after the operation, and the scar was tiny and unapparent.

Conclusions

Complete uni-port VATS for SSRF is a novel and modificatory method of operation with the benefit of minimal invasion, meanwhile, intrathoracic injuries could be treated at the same time. Further study is warranted.
Exploring the active components and potential mechanisms of Rosa roxburghii Tratt in treating type 2 diabetes mellitus based on UPLC-Q-exactive Orbitrap/MS and network pharmacology
Authors: Shen Chenxiao , Wang Yu , Zhang Hui , Li Wei , Chen Wenyue , Kuang Mingqing , Song Yuelin , Zhong Zhangfeng
Published: February 2023

Background

Type 2 diabetes mellitus (T2DM) is a global disease with growing prevalence that is difficult to cure.Rosa roxburghii Tratt is an edible and medicinal plant, and modern pharmacological studies have shown that it has potential anti-diabetic activity. This is the first study to explore the active components and potential mechanisms of Rosa roxburghii Tratt fruit for treating T2DM based on UPLC-Q-Exactive Orbitrap/MS and network pharmacology.

Methods

The active components of Rosa roxburghii Tratt fruit were obtained from UPLC-Q-Exactive Orbitrap/MS analysis and retrieval in the SciFinder, PubMed, Web of Science, and CNKI databases. The potential targets of the active components were obtained from the SwissTargetPrediction and PharmMapper databases. The disease targets for T2DM were obtained from GeneCards, OMIM, TTD, DisGENent, and GEO databases. The intersection of the two datasets was used to obtain the potential targets of Rosa roxburghii Tratt fruit against T2DM. The target protein interaction network was constructed using the String database and Cytoscape software. The R software ClusterProfiler package was used for target enrichment analysis and the Cytoscape CytoNCA plug-in was used to screen core targets. Molecular docking and result visualization were performed using PyMOL and Autodock Vina software.

Results

We obtained 20 bioactive ingredients, including alphitolic acid, quercetin, and ellagic acid, as well as 13 core targets, such as AKT1, TNF, SRC, and VEGFA. All bioactive ingredients in Rosa roxburghii Tratt fruit were active against T2DM-related therapeutic targets. Rosa roxburghii Tratt fruit may play a therapeutic role in T2DM by regulating the PI3K/AKT, RAS, AGE-RAGE, and other signaling pathways.

Conclusions

This study explored the active components and potential mechanisms of Rosa roxburghii Tratt fruit in the treatment of T2DM, laying the foundation for a further experimental study based on pharmacodynamic substances and their mechanisms of action.

Graphical Abstract
Factors associated with recruitment to randomised controlled trials in general practice: a systematic mixed studies review
Authors: Moffat Keith R. , Shi Wen , Cannon Paul , Sullivan Frank
Published: February 2023

Background

A common challenge for randomised controlled trials (RCTs) is recruiting enough participants to be adequately powered to answer the research question. Recruitment has been set as a priority research area in trials to improve recruitment and thereby reduce wasted resources in conducted trials that fail to recruit sufficiently.

Methods

We conducted a systematic mixed studies review to identify the factors associated with recruitment to RCTs in general practice. On September 8, 2020, English language studies were identified from MEDLINE, EMBASE, Cochrane Database of Systematic Reviews and CENTRAL databases for published studies. NTIS and OpenGrey were searched for grey literature, and BMC Trials was hand searched. A narrative synthesis was conducted for qualitative studies and a thematic synthesis for qualitative studies.

Results

Thirty-seven studies met the inclusion criteria. These were of different study types (10 cross-sectional, 5 non-randomised studies of interventions, 2 RCTs, 10 qualitative and 10 mixed methods). The highest proportion was conducted in the UK (48%). The study quality was generally poor with 24 (65%) studies having major concerns. A complex combination of patient, practitioner or practice factors, and patient, practitioner or practice recruitment were assessed to determine the possible associations. There were more studies of patients than of practices or practitioners.

Conclusions

For practitioners and patients alike, a trial that is clinically relevant is critical in influencing participation. Competing demands are given as an important reason for declining participation. There are concerns about randomisation relating to its impact on shared decision-making and not knowing which treatment will be assigned. Patients make decisions about whether they are a candidate for the trial even when they objectively fulfil the eligibility criteria. General practice processes, such as difficulties arranging appointments, can hinder recruitment, and a strong pre-existing doctor-patient relationship can improve recruitment. For clinicians, the wish to contribute to the research enterprise itself is seldom an important reason for participating, though clinicians reported being motivated to participate when the research could improve their clinical practice. One of the few experimental findings was that opportunistic recruitment resulted in significantly faster recruitment compared to systematic recruitment. These factors have clear implications for trial design. Methodologically, recruitment research of practices and practitioners should have increased priority. Higher quality studies of recruitment are required to find out what actually works rather than what might work.

Trial registration

PROSPERO CRD42018100695. Registered on 03 July 2018.
The impact of parent treatment preference and other factors on recruitment: lessons learned from a paediatric epilepsy randomised controlled trial
Authors: Carter Bernie , Bray Lucy , al-Najjar Nadia , Piella Agnès Tort , Tudur-Smith Catrin , Spowart Catherine , Collingwood Amber , Crudgington Holly , Currier Janet , Hughes Dyfrig A. , Wood Eifiona , Martin Rachael , Morris Christopher , Roberts Deborah , Rouncefield-Swales Alison , Sutherland Heather , Watson Victoria , Cook Georgia , Wiggs Luci , Gringras Paul , Pal Deb
Published: February 2023

Background

In paediatric epilepsy, the evidence of effectiveness of antiseizure treatment is inconclusive for some types of epilepsy. As with other paediatric clinical trials, researchers undertaking paediatric epilepsy clinical trials face a range of challenges that may compromise external validity

Main body

In this paper, we critically reflect upon the factors which impacted recruitment to the pilot phase of a phase IV unblinded, randomised controlled 3×2 factorial trial examining the effectiveness of two antiseizure medications (ASMs) and a sleep behaviour intervention in children with Rolandic epilepsy. We consider the processes established to support recruitment, public and patient involvement and engagement (PPIE), site induction, our oversight of recruitment targets and figures, and the actions we took to help us understand why we failed to recruit sufficient children to continue to the substantive trial phase.

The key lessons learned were about parent preference, children’s involvement and collaboration in decision-making, potential and alternative trial designs, and elicitation of stated preferences pre-trial design.

Despite pre-funding PPIE during the trial design phase, we failed to anticipate the scale of parental treatment preference for or against antiseizure medication (ASMs) and consequent unwillingness to be randomised. Future studies should ensure more detailed and in-depth consultation to ascertain parent and/or patient preferences.More intense engagement with parents and children exploring their ideas about treatment preferences could, perhaps, have helped predict some recruitment issues. Infrequent seizures or screening children close to natural remission were possible explanations for non-consent. It is possible some clinicians were unintentionally unable to convey clinical equipoise influencing parental decision against participation. We wanted children to be involved in decisions about trial participation. However, despite having tailored written and video information to explain the trial to children we do not know whether these materials were viewed in each consent conversation or how much input children had towards parents’ decisions to participate. Novel methods such as parent/patient preference trials and/or discrete choice experiments may be the way forward.

Conclusion

The importance of diligent consultation, the consideration of novel methods such as parent/patient preference trials and/or discrete choice experiments in studies examining the effectiveness of ASMs versus no-ASMs cannot be overemphasised even in the presence of widespread clinician equipoise.
Can multisite clinical trial results change clinical practice? Use of long-acting injectable risperidone nationally in the Veterans Health Administration
Authors: Rosenheck Robert , Anand Sonia T. , Kurtz Stephen G. , Hau Cynthia , Smedberg Diane , Pontzer James F. , Ferguson Ryan E. , Davis Cynthia R.
Published: February 2023

Background

Multisite practical clinical trials evaluate treatments in real-world practice. A multisite randomized Veterans Health Administration (VHA) cooperative study (CSP#555) published in 2011 compared the first long-acting injectable (LAI) second-generation antipsychotic (SGA), Risperidone Consta®, in veterans with a diagnosis of schizophrenia or schizoaffective disorder, to oral antipsychotics, with unexpected null results for effectiveness and cost-effectiveness. Whether null results of this type could change VHA practice has not been studied.

Methods

A longitudinal observational analysis was used to evaluate the impact of the trial findings on VHA clinical practices. National administrative data compared new starts on LAI risperidone during the 4 years before the publication of CSP#555 in 2011 to new starts on LAI risperidone during the 4 years after.

Results

Among 119,565 Veterans with the indicated diagnoses treated with antipsychotics from 2007 to 2015, the number and proportion of new starts on LAI risperidone declined significantly following the study publication, as did the total number of annual users and drug expenditures. However, data from 2007 to 2010 showed the decline in new starts actually preceded the publication of CSP#555. This change was likely explained by the increase in new starts, total use, and expenditures on a newer medicine, LAI paliperidone, a 4-week LAI treatment, in the 2 years prior to the publication of CSP#555.

Conclusions

The declining use of LAI risperidone likely primarily reflects the substitution of a longer-acting LAI SGA, paliperidone, that came to market 2 years before the study publication, a substitution that may have been reinforced by null CSP#555 study results for LAI risperidone.
Advanced practice physiotherapy care in emergency departments for patients with musculoskeletal disorders: a pragmatic cluster randomized controlled trial and cost analysis
Authors: Matifat E. , Berger Pelletier E. , Brison R. , Hébert L. J. , Roy J.-S. , Woodhouse L. , Berthelot S. , Daoust R. , Sirois M.-J. , Booth R. , Gagnon R. , Miller J. , Tousignant-Laflamme Y. , Emond M. , Perreault K. , Desmeules F.
Published: February 2023

Background

Advanced practice physiotherapy (APP) models of care where physiotherapists are primary contact emergency department (ED) providers are promising models of care to improve access, alleviate physicians’ burden, and offer efficient centered patient care for patients with minor musculoskeletal disorders (MSKD).

Objectives

To compare the effectiveness of an advanced practice physiotherapist (APPT)-led model of care with usual ED physician care for persons presenting with a minor MSKD, in terms of patient-related outcomes, health care resources utilization, and health care costs.

Methods

This trial is a multicenter stepped-wedge cluster randomized controlled trial (RCT) with a cost analysis. Six Canadian EDs (clusters) will be randomized to a treatment sequence where patients will either be managed by an ED APPT or receive usual ED physician care. Seven hundred forty-four adults with a minor MSKD will be recruited. The main outcome measure will be the Brief Pain Inventory Questionnaire. Secondary measures will include validated self-reported disability questionnaires, the EQ-5D-5L, and other health care utilization outcomes such as prescription of imaging tests and medication. Adverse events and re-visits to the ED for the same complaint will also be monitored. Health care costs will be measured from the perspective of the public health care system using time-driven activity-based costing. Outcomes will be collected at inclusion, at ED discharge, and at 4, 12, and 26 weeks following the initial ED visit. Per-protocol and intention-to-treat analyses will be performed using linear mixed models with a random effect for cluster and fixed effect for time.

Discussion

MSKD have a significant impact on health care systems. By providing innovative efficient pathways to access care, APP models of care could help relieve pressure in EDs while providing efficient care for adults with MSKD.

Trial registration

ClinicalTrials.govNCT05545917. Registered on September 19, 2022
Internet-based self-help intervention for procrastination: randomized control group trial protocol
Authors: Zhou Ying , Wang Jianhua
Published: February 2023

Background

Procrastination or “postponing until later” is a common phenomenon defined as the intentional delay in partaking in and finishing important activities despite negative outcomes potentially outweighing the positive. Procrastination adversely affects mental health, academic performance, and career achievement. Although studies on procrastination intervention methods and effectiveness exist, utility and cost-effectiveness are limited by various factors, including practitioner availability and skills, barriers to participant participation, and the time investment required by participants. Thus, internet-based interventions could increase the availability of evidence-based treatments for adult procrastination.

Methods

This study explored the efficacy of an online-based self-help intervention in the context of voluntary procrastination among undergraduate psychology students. The study design is a randomized controlled trial. Participants who self-reported procrastination-related problems and behaviours were included in the trial consisting of two groups; specifically, one group undergoing a self-directed internet-based intervention for coping with procrastination (N=160) and (2) another group with delayed access to the intervention programmes (waitlist control group; N=160). Follow-up assessments were scheduled 6 and 12 weeks after baseline, and the control group received the intervention after 12 weeks. Procrastination, measured by the Irrational Procrastination Scale and the Simple Procrastination Scale, was examined as the primary outcome. Meanwhile, secondary outcomes included susceptibility, stress, depression, anxiety, well-being, self-efficacy, time management strategies, self-control, cognition, and emotion regulation. Other measures comprised acceptability (e.g., intervention satisfaction, potential side effects, and expectations) and learning behaviour analysis to reflect adherence.

Discussion

This randomized controlled trial will provide data on the effectiveness of online interventions for adult procrastination. If deemed effective, this low-cost, high-coverage internet-based intervention could aid more people who seek to address their procrastination.

Trial registration

Chinese Clinical Trial Registry. https://www.chictr.org.cn/showproj.aspx?proj=171246.
Zoonotic parasites associated with predation by dogs and cats
Authors: Mendoza Roldan Jairo Alfonso , Otranto Domenico
Published: February 2023

One of the most common behaviors of cats that have an indoor/outdoor lifestyle is to bring hunted “gifts” to their owners, represented by small mammals, reptiles and birds. Access to the outdoors by dogs and cats may represent a problematic issue, since they may be at risk of diseases, traffic accidents and ingestion of toxins. Yet, the impact of this population of roaming dogs and cats predating wildlife is another concerning issue that receives less attention. Despite these risks, most owners still prefer to give outdoor access to their pets to allow them to express their “natural instincts,” such as hunting. Therefore, with a growing population of > 470 million dogs and 373 million cats worldwide, predation not only represents a threat to wildlife, but also a door of transmission for parasitic diseases, some of them of zoonotic concern. In this review, the role played by dogs, and especially cats, in the perpetuation of the biological life cycle of zoonotic parasites through the predation of rodents, reptiles and birds is discussed. Feral and domestics dogs and cats have contributed to the population collapse or extinction of > 63 species of reptiles, mammals and birds. Although the ecological impact of predation on wild populations is well documented, the zoonotic risk of transmission of parasitic diseases has not received significant attention. The parasitic diseases associated to predation vary from protozoan agents, such as toxoplasmosis, to cestodes like sparganosis and even nematodes such as toxocariasis. Raising awareness about predation as a risk of zoonotic parasitic infections in dogs and cats will aid to create responsible ownership and proper actions for controlling feral and free-roaming cat and dog populations worldwide.

Graphical Abstract
High-intensity circuit training change serum myostatin but not myogenin in adolescents’ soccer players: a quasi-experimental study
Authors: Ziyaiyan Amirhosein , Kordi Mohammadreza , Hofmeister Martin , Chamari Karim , Moalla Wassim , Gaeini Abbas Ali
Published: February 2023

Background

Skeletal muscle contractions due to exercise lead to the secretion of many proteins and proteoglycan peptides called myokines. Myostatin (MSTN) and Myogenin (MyoG) are two of the most important skeletal muscle growth regulatory factors related to myoblast differentiation and muscle hypertrophy. The present study aims at investigating the effects over eight weeks of high-intensity circuit training (HICT) on serum MyoG and MSTN in male soccer players.

Method

The present study is a quasi-experimental study on 21 male soccer players (Experimental group: n = 11, Control group: n = 10) (ages 15.0 ± 3.4 years, body mass 55.7 ± 7.8 kg, height 173.3 ± 8.0 cm, Body mass index 18.4 ± 1.9 kg m−2, maximum oxygen uptake 61.89 ± 3.01 ml kg−1and the peak height velocity 14.5 ± 0.3 years). Participants were randomly divided into two groups: training group and a control group. The first resting blood samples were obtained in the morning-fasting state, and the second blood samples were obtained after the maximum aerobic test at pre- and post-HICT.

Results

There were non-significant differences in resting serum values of MyoG (p = 0.309,p > 0.05) but significant differences in resting serum values of MSTN between the training and control groups after eight weeks of HICT (p = 0.003,p < 0.05). No significant differences were observed between groups in the acute response of serum values of MyoG (p = 0.413,p < 0.05) and MSTN (p = 0.465,p < 0.05) to the maximum aerobic test after eight weeks of HICT.

Conclusion

These results suggest that eight weeks of HICT can decrease the resting serum values of MSTN but not change the resting serum values of MyoG in male adolescent soccer players. Also, eight weeks of HICT does not affect the acute response of MSTN and MyoG after a maximum aerobic test.
The use of low-value imaging: the role of referral practice and access to imaging services in a representative area of Norway
Authors: Andersen Eivind Richter , Brandsæter Ingrid Øfsti , Hofmann Bjørn Morten , Kjelle Elin
Published: February 2023

Background

Even though imaging is essential to modern medicine, some examinations are of low value as they do not lead to any change in the management of the patient. The Choosing Wisely (CW) campaign aims to reduce the use of such services. In the Norwegian version of CW, specific magnetic resonance imaging (MRI) of the head, lower back, and knee are amongst others identified as potential low-value examinations. However, referral practice and access to imaging may drive low-value utilisation. By using registry data from 2019 and descriptive analysis, this study aimed to examine the role of referral practice and access to imaging on the use of specific CW-examinations in one representative area in Norway.

Results

A total of 237,554 examinations were performed by four public and two private imaging facilities located within the area. Forty-two percent (19,210/45,289) of all MRI examinations were related to CW. Private imaging centres performed most of the CW-imaging. A total of 3700 referrers were identified, and 2.3% were identified as “high-referrers,” accounting for 33% of all CW-examinations. Referrers’ experience did not influence imaging utilisation. A subset of referrers (“super-referrers,” 0.5%) accounted for 10% of CW-examinations. Distance to service had no impact on the use of CW-examinations.

Conclusions

This study provides valuable insight into the use of imaging and referral practice in one representative area in Norway. A great variation in referral practice was observed. Therefore, targeting referrers with high referral rates may be a promising strategy for reducing the use of low-value imaging.
The oxidative balance and stopover departure decisions in a medium- and a long-distance migrant
Authors: Eikenaar Cas , Ostolani Alessia , Brust Vera , Karwinkel Thiemo , Schmaljohann Heiko , Isaksson Caroline
Published: February 2023

Background

Birds have extremely elevated metabolic rates during migratory endurance flight and consequently can become physiologically exhausted. One feature of exhaustion is oxidative damage, which occurs when the antioxidant defense system is overwhelmed by the production of damaging reactive oxygen species (ROS). Migrating birds have been shown to decrease the amount of oxidative lipid damage during stopovers, relatively stationary periods in between migratory flights. It has therefore been argued that, in addition to accumulating fuel, one of the functions of stopover is to restore the oxidative balance. If this is so, we would expect that migrating birds are unlikely to resume migration from stopover when they still have high amounts of lipid damage.

Methods

To test this hypothesis, we measured parameters of the oxidative balance and related these to stopover departure decisions of song thrushes (Turdus philomelos) and northern wheatears (Oenanthe oenanthe), a medium- and long-distance songbird migrant, respectively. We measured malondialdehyde (MDA) concentration, a biomarker for oxidative lipid damage, and total non-enzymatic antioxidant capacity (AOX), an overall biomarker of protection against ROS. Stopover departure decisions were determined using a fully automated telemetry system set-up on our small island study site.

Results

The decision to resume migration was not related with MDA concentration in either study species, also not when this was corrected for circulating fatty acid concentrations. Similarly, AOX did not affect this decision, also not when corrected for uric-acid concentration. The time within the night when birds departed also was not affected by MDA concentration or AOX. However, confirming earlier observations, we found that in both species, fat individuals were more likely to depart than lean individuals, and fat northern wheatears departed earlier within the night than lean conspecifics. Northern wheatears additionally departed earlier in spring with more southerly winds.

Conclusions

We found no support for the idea that stopovers departure decisions are influenced by parameters of the oxidative balance. We discuss possible reasons for this unexpected finding.
Constraints in employing learning-oriented assessment in EFL classrooms: teachers’ perceptions
Authors: Jalilzadeh Kaveh , Coombe Christine
Published: February 2023

Learning-oriented assessment has been called a practice that can be employed to increase the power of assessment practices in the classroom and one that has been said to promote efficient student learning. However, it is not always easy to employ learning-oriented assessment in English classes, because of a number of constraints. This study aimed at investigating the constraints which hinder teachers’ use of learning-oriented assessment in EFL classes. A phenomenological research method was used to explore the constraints associated with learning-oriented assessment. EFL teachers were selected through purposive sampling. The interviews were thematically coded into three main categories: teacher-related, institute-related, and learner-related constraints. It can be inferred that coordination among the different components of the curriculum is a necessary step that teachers need to take before attempting to employ LOA principles in their classes. Findings are theoretically and practically significant to EFL teachers and teacher educators as assessment instructors.
Hygromechanical behaviour of wooden panel paintings: classification of their deformation tendencies based on numerical modelling and experimental results
Authors: Riparbelli Lorenzo , Mazzanti Paola , Manfriani Chiara , Uzielli Luca , Castelli Ciro , Gualdani Giovanni , Ricciardi Luciano , Santacesaria Andrea , Rossi Sandra , Fioravanti Marco
Published: February 2023

Wooden panel paintings are among the most important historical and artistic artworks from the Middle Ages and the Renaissance period. Currently, they represent a challenge for conservators and scientists who face complex issues related to their conservation. Panel paintings can be considered multilayer objects, that for brevity can be considered to consist of a wooden support and various paint layers. The wooden support is known to be hygroscopic and is continuously seeking hygroscopic equilibrium with the humidity of the environment, thus it tends to deform. Based on various hygroscopic tests carried out on 6 real panel paintings chosen by expert restorers to represent different periods and construction techniques, this paper describes the deformation tendencies of the selected panel paintings. Among possible variables, three most important variables were identified: (a) tree ring orientation of the wooden support, (b) stiffness and (c) emissivity of the paint layers. The internal equilibrium of the forces, governed by the moisture gradients across the thickness of the wood, changes drastically according to the varying characterisation of these factors. To observe their individual contributions, the 6 panel paintings underwent various humidity cycles, were completely free to deform and were always in complete safety. To characterise the stiffness and emissivity of the paint layers, the 6 panel paintings underwent a few humidity cycles with the front face totally waterproofed; thus, the moisture exchange was forced from the back only, and one of the three variables was eliminated. A complex system emerges where the tree ring orientation of the wooden support, the stiffness and emissivity of the paint layers are strongly coupled and determine the deformation modes of the panel paintings. A numerical analysis was conducted to classify the various general deformation modes of panel paintings and the specific classification of the 6 real panel paintings analysed experimentally. The complexity of the interaction of the variables studied suggests that experimental procedures must be conducted in preparation for numerical analyses of real panel paintings.
The effect of orthodontic treatment on smile attractiveness: a systematic review
Authors: Coppola G. , Christopoulou I. , Gkantidis N. , Verna C. , Pandis N. , Kanavakis G.
Published: February 2023

Background

Smile attractiveness is a primary factor for patients to seek orthodontic treatment, however, there is yet no systematic evaluation of this topic in the literature.

Objectives

To assess the current evidence on the effect of orthodontic treatment on smile attractiveness.

Search methods

Seven electronic databases (MEDLINE, Cochrane Library, Virtual Health Library, SCOPUS, Web of Science, Google Scholar and Embase) were searched on 14 September 2022.

Selection criteria

Studies evaluating smile attractiveness before and after orthodontic treatment or only after completion of orthodontic treatment.

Data collection and analysis

Extracted data included study design and setting, sample size and demographics, malocclusion type, treatment modality and method for outcome assessment. Risk of bias was assessed with the ROBINS-I tool for non-randomised studies. Random-effects meta-analyses of mean differences and their 95% confidence intervals (CIs) were planned a priori.

Methods

After elimination of duplicate studies, data extraction and risk of bias assessment according to the Cochrane guidelines, an evaluation of the overall evidence was performed. The included studies were evaluated based on the characteristics of their study and control groups and based on their main research question. Also, all outcome measures were standardized into a common assessment scale (0–100), in order to obtain more easily interpretable results.

Results

Ten studies were included in this review, nine of which were assessed as being at serious risk of bias and one at moderate risk of bias. The large heterogeneity between the included studies did not allow for a meta-analysis. Orthodontic treatment has a moderately positive effect on smile attractiveness. When compared to no treatment, orthodontic treatment with premolar extractions improves smile attractiveness by 22%. Also, surgical correction of Class III cases increases smile attractiveness by 7.5% more than camouflage treatment. No other significant differences were shown between different types of treatment.

Conclusion

Based on the available data, orthodontic treatment seems to moderately improve the attractiveness of the smile. There is significant bias in the current literature assessing the effect of orthodontics on smile attractiveness; therefore, the results cannot be accepted with certainty.
Effectiveness of systemic thrombolysis on clinical outcomes in high-risk pulmonary embolism patients with venoarterial extracorporeal membrane oxygenation: a nationwide inpatient database study
Authors: Nishimoto Yuji , Ohbe Hiroyuki , Matsui Hiroki , Nakajima Mikio , Sasabuchi Yusuke , Sato Yukihito , Watanabe Tetsuya , Yamada Takahisa , Fukunami Masatake , Yasunaga Hideo
Published: February 2023

Background

Current guidelines recommend systemic thrombolysis as the first-line reperfusion treatment for patients with high-risk pulmonary embolism (PE) who present with cardiogenic shock but do not require venoarterial extracorporeal membrane oxygenation (VA-ECMO). However, little is known about the optimal reperfusion treatment in high-risk PE patients requiring VA-ECMO. We aimed to evaluate whether systemic thrombolysis improved high-risk PE patients’ outcomes who received VA-ECMO.

Methods

This was a retrospective cohort study using the Japanese Diagnosis Procedure Combination inpatient database from July 2010 to March 2021. We identified patients who were diagnosed with PE and received VA-ECMO on the day of admission. Patients who received systemic thrombolysis with monteplase or urokinase within two days of initiating VA-ECMO were defined as the thrombolysis group and the remaining patients as the control group. The primary outcome was in-hospital mortality and secondary outcomes were favorable neurological outcomes, length of hospital stay, VA-ECMO duration, total hospitalization cost, major bleeding, and blood transfusion volume. Propensity-score inverse probability of treatment weighting (IPTW) was performed to compare the outcomes between the groups.

Results

Of 1220 eligible patients, 432 (35%) received systemic thrombolysis within two days of initiating VA-ECMO. Among the unweighted cohort, patients in the thrombolysis group were less likely to have poor consciousness at admission, out-of-hospital cardiac arrest, and left heart catheterization. After IPTW, the patient characteristics were well-balanced between the two groups The crude in-hospital mortality was 52% in the thrombolysis group and 61% in the control group. After IPTW, in-hospital mortality did not differ significantly between the two groups (risk difference: − 3.0%, 95% confidence interval: − 9.6% to 3.5%). There were also no significant differences in the secondary outcomes. Sensitivity analyses showed a significant difference in major bleeding between the monteplase and control groups (risk difference: 6.9%, 95% confidence interval: 1.7% to 12.1%), excluding patients who received urokinase. There were no significant differences in the other sensitivity and subgroup analyses except for the total hospitalization cost.

Conclusions

Systemic thrombolysis was not associated with reduced in-hospital mortality or increased major bleeding in the high-risk PE patients receiving VA-ECMO. However, systemic thrombolysis with monteplase was associated with increased major bleeding.
Maximum tumor-absorbed dose measured by voxel-based multicompartmental dosimetry as a response predictor in yttrium-90 radiation segmentectomy for hepatocellular carcinoma
Authors: Orcajo Rincón Javier , Regi Amanda Rotger , Peña Ana Matilla , Berenguer Laura Reguera , Leyte Manuel González , Martín Laura Carrión , Atance García De La Santa Jaime , Boyra Miguel Echenagusia , Ruiz Cristina González , Rodríguez Arturo Colón , Farto Juan Carlos Alonso
Published: February 2023

Objective

Advances in hepatic radioembolization are based on a selective approach with radical intent and the use of multicompartment dosimetric analysis. The objective of this study is to assess the utility of voxel-based dosimetry in the quantification of actual absorbed doses in radiation segmentectomy procedures and to establish cutoff values predictive of response.

Methods

Ambispective study in hepatocarcinoma patients treated with radiation segmentectomy. Calculated dosimetric parameters were mean tumor-absorbed dose, maximum tumor AD, minimal tumor AD in 30, 50, and 70% of tumor volume and mean AD in non-tumor liver. The actual absorbed dose (aAD) was calculated on the Y-90-PET/CT image using 3D voxel-based dosimetry software. To assess radiological response, localized mRECIST criteria were used. The objective response rate (ORR) was defined as CR or PR.

Results

Twenty-four HCC patients, BCLC 0 (5), A (17) and B (2) were included. The mean yttrium-90 administered activity was 1.38 GBq in a mean angiosome volume of 206.9 cc and tumor volume 56.01 cc. The mean theoretical AD was 306.3 Gy and aAD 352 Gy. A very low concordance was observed between both parameters (rho_c 0.027). ORR at 3 and 6 m was 84.21% and 92.31%, respectively. Statistically significant relationship was observed between the maximum tumor-absorbed dose and complete radiological response at 3 m (p 0.022).

Conclusion

A segmental approach with radical intention leads to response rates greater than 90%, being the tumor maximum absorbed dose the dosimetric parameter that best predicts radiological response in voxel-based dosimetry.
Quality of death after elective surgery: a questionnaire survey for the bereaved family
Authors: Sato Mariko , Ida Mitsuru , Naito Yusuke , Kawaguchi Masahiko
Published: February 2023

Purpose

Postoperative death is the third leading cause of death in the world, but the quality of death after surgery has been poorly documented. This study aimed to evaluate the feasibility of a questionnaire survey for the bereaved family regarding the postoperative quality of death and the impact of preoperative functional disability on the quality of death.

Methods

Patients aged ≥55 years who underwent scheduled surgery under general anesthesia in a tertiary-care hospital in Japan between April 2016 and December 2018 were enrolled. Patients’ functional disability was assessed using the 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) before surgery and scored based on the sum of the 12 items (0–48). Postoperative deaths were detected in medical records 3 months and 1 year after surgery. When death had occurred, a questionnaire on the quality of death using the short version of the Good Death Inventory (GDI) was sent to the bereaved family, which was scored as the sum of the 10 domains (10–70).

Results

Of 4020 eligible patients, 148 patients (3.6 %) died within 1 year after surgery. A hundred and twenty-nine bereaved families were sent the questionnaire, and 83 of them (64.3%) submitted valid responses suggesting the high feasibility of this questionnaire survey. There were no differences between the GDI and WHODAS 2.0 scores (median 49 [interquartile range 41–55] vs. 49 [43–54], respectively, p = 0.90). In addition, multiple regression analysis of related factors using the short version of the GDI as a continuous variable showed that age and death in a facility other than that in which the surgery was performed were associated with lower GDI scores (p = 0.004 and p = 0.04, respectively).

Conclusion

The completion rate was 64.3%. There was no association between the quality of death and preoperative functional disability; however, older age was associated with a higher quality of death, while death in a facility other than that in which the surgery was performed was associated with lower quality of death.
A nonsense germline mutation in the LPL gene in a 1-month-old infant: case report with review of literature
Authors: Pawal Pratibha , Aute Tukaram
Published: February 2023

Background

Primary hypertriglyceridemia (HTG) is a very rare autosomal recessive disorder caused by the mutations of the genes related with triglyceride metabolism, including apolipoproteins and lipoprotein lipase (LPL) among others. Germline mutations in the LPL gene cause familial LPL deficiency with an incidence of about 1:1,000,000. It is often diagnosed in childhood and consanguinity is common.

Case presentation

We present here a LPL nonsense variant in an infant with heterozygous carriers (parents) of one of each variation detected in the infant. The infant presented with recurrent vomiting, diarrhoea, and haematochezia at 1 month of age. A diagnosis of familial HTG in the infant was made from the clinical manifestations and observation of a lipemic blood sample. Next-generation sequencing identified two pairs of variants in the LPL gene in the patient: chr8:g.19961024G>A; c.1263G>A; p.Trp421Ter and chr8:g.19962221T>G; c.1427+2T>G which were confirmed and validated by Sanger sequencing. The nonsense variant in exon 8 (chr8:g.19961024G>A (HET); c.1263G>AC; p.Trp421Ter) of the LPL gene was detected only in the father, while the 5ʹ splice site variant in intron 9 (chr8:g.19962221T>G (HET); c.1427+2T>G) was detected only in the mother. Thus, the infant manifesting HTG inherited one recessive gene from each of the carrier parents. There were no de novo mutations in the index patient. Based on the clinical findings and genetic test results, it was concluded that the infant suffers from compound heterozygous familial HTG.

Conclusions

The current case of the infant with germline mutations in the LPL gene resulting in very severe HTG highlights the importance of genetic counseling. Genetic identification of the pathogenic variants is essential to strategize genetic therapy whenever feasible. The consanguineous nature of the parents is the most probable identified risk factor for the germline mutation in the LPL gene.
Nicotinamide Adenine Dinucleotide Augmentation in Overweight or Obese Middle-Aged and Older Adults: A Physiologic Study
Authors: Pencina Karol Mateusz , Valderrabano Rodrigo , Wipper Benjamin , Orkaby Ariela R , Reid Kieran F , Storer Thomas , Lin Alexander P , Merugumala Sai , Wilson Lauren , Latham Nancy , Ghattas-Puylara Catherine , Ozimek Noelle E , Cheng Ming , Bhargava Avantika , Memish-Beleva Yusnie , Lawney Brian , Lavu Siva , Swain Pamela M , Apte Rajendra S , Sinclair David A , Livingston David , Bhasin Shalender
Published: February 2023

Context

Nicotinamide adenine dinucleotide (NAD) levels decline with aging and age-related decline in NAD has been postulated to contribute to age-related diseases.

Objective

We evaluated the safety and physiologic effects of NAD augmentation by administering its precursor, β-nicotinamide mononucleotide (MIB-626, Metro International Biotech, Worcester, MA), in adults at risk for age-related conditions.

Methods

Thirty overweight or obese adults, ≥ 45 years, were randomized in a 2:1 ratio to 2 MIB-626 tablets each containing 500 mg of microcrystalline β-nicotinamide mononucleotide or placebo twice daily for 28 days. Study outcomes included safety; NAD and its metabolome; body weight; liver, muscle, and intra-abdominal fat; insulin sensitivity; blood pressure; lipids; physical performance, and muscle bioenergetics.

Results

Adverse events were similar between groups. MIB-626 treatment substantially increased circulating concentrations of NAD and its metabolites. Body weight (difference −1.9 [−3.3, −0.5] kg, P = .008); diastolic blood pressure (difference −7.01 [−13.44, −0.59] mmHg, P = .034); total cholesterol (difference −26.89 [−44.34, −9.44] mg/dL, P = .004), low-density lipoprotein (LDL) cholesterol (−18.73 [−31.85, −5.60] mg/dL, P = .007), and nonhigh-density lipoprotein cholesterol decreased significantly more in the MIB-626 group than placebo. Changes in muscle strength, muscle fatigability, aerobic capacity, and stair-climbing power did not differ significantly between groups. Insulin sensitivity and hepatic and intra-abdominal fat did not change in either group.

Conclusions

MIB-626 administration in overweight or obese, middle-aged and older adults safely increased circulating NAD levels, and significantly reduced total LDL and non-HDL cholesterol, body weight, and diastolic blood pressure. These data provide the rationale for larger trials to assess the efficacy of NAD augmentation in improving cardiometabolic outcomes in older adults.
The Williamsburg Avant-Garde
Authors: Bradley Cisco
Published: February 2023

In The Williamsburg Avant-Garde Cisco Bradley chronicles the rise and fall of the underground music and art scene in the Williamsburg neighborhood of Brooklyn between the late 1980s and the early 2010s. Drawing on interviews, archival collections, musical recordings, videos, photos, and other ephemera, Bradley explores the scene’s social, cultural, and economic dynamics. Building on the neighborhood’s punk DIY approach and aesthetic, Williamsburg's free jazz, postpunk, and noise musicians and groups---from Mary Halvorson, Zs, and Nate Wooley to Matana Roberts, Peter Evans, and Darius Jones---produced shows in a variety of unlicensed venues as well as in clubs and cafes. At the same time, pirate radio station free103point9 and music festivals made Williamsburg an epicenter of New York’s experimental culture. In 2005, New York’s rezoning act devastated the community as gentrification displaced its participants farther afield in Brooklyn and in Queens. With this portrait of Williamsburg, Bradley not only documents some of the most vital music of the late twentieth and early twenty-first centuries; he helps readers better understand the formation, vibrancy, and life span of experimental music and art scenes everywhere.
Composing Violence
Authors: Chatterjee Moyukh
Published: February 2023

In 2002, armed Hindu mobs attacked Muslims in broad daylight in the west Indian state of Gujarat. The pogrom, which was widely seen over television, left more than one thousand dead. In Composing Violence Moyukh Chatterjee examines how highly visible political violence against minorities acts as a catalyst for radical changes in law, public culture, and power. He shows that, far from being quashed through its exposure by activists, media, and politicians, state-sanctioned anti-Muslim violence set the stage for transforming India into a Hindu supremacist state. The state's and civil society’s responses to the violence, Chatterjee contends, reveal the constitutive features of modern democracy in which riots and pogroms are techniques to produce a form of society based on a killable minority and a triumphant majority. Focusing on courtroom procedures, police archives, legal activism, and mainstream media coverage, Chatterjee theorizes violence as a form of governance that creates minority populations. By tracing the composition of anti-Muslim violence and the legal structures that transform that violence into the making of minorities and majorities, Chatterjee demonstrates that violence is intrinsic to liberal democracy.