bluuebunny/crossref_metadata_2025 huggingface dataset:
Sexual Behaviour and STI Incidence in Sexually Active MSM Living With HIV in Times of COVID-19
Authors: Mugglin Catrina , Hamusonde Kalongo , Salazar-Vizcaya Luisa , Kusejko Katharina , Nicca Dunja , Haerry David , Braun Dominique L , Stoeckle Marcel , Kouyos Roger , Calmy Alexandra , Cavassini Matthias , Cipriani Michela , Bernasconi Enos , Rauch Andri , Hachfeld Anna ,   the Swiss HIV Cohort Study (SHCS), Abela I , Aebi-Popp K , Anagnostopoulos A , Battegay M , Bernasconi E , Braun D L , Bucher H C , Calmy A , Cavassini M , Ciuffi A , Dollenmaier G , Egger M , Elzi L , Fehr J , Fellay J , Furrer H , Fux C A , Günthard H F , Hachfeld A , Haerry D , Hasse B , Hirsch H H , Hoffmann M , Hösli I , Huber M , Jackson-Perry D , Kahlert C R , Kaiser L , Keiser O , Klimkait T , Kouyos R D , Kovari H , Kusejko K , Labhardt N , Leuzinger K , Martinez de Tejada B , Marzolini C , Metzner K J , Müller N , Nemeth J , Nicca D , Notter J , Paioni P , Pantaleo G , Perreau M , Rauch A , Salazar-Vizcaya L , Schmid P , Speck R , Stöckle M , Tarr P , Trkola A , Wandeler G , Weisser M , Yerly S
Published: July 2023

Despite decreased numbers of sexual partners, the COVID-19 pandemic had limited impact on the prevalence of attending private sex parties, traveling for sex within Switzerland, and practicing chemsex in men with HIV who have sex with men. COVID-19 risk perception was low, and STI-diagnosis incidence rates remained stable over time.
Can Geographically Targeted Vaccinations Be Ethically Justified? The Case of Norway During the COVID-19 Pandemic
Authors: Amdam Håkon , Norheim Ole Frithjof , Solberg Carl Tollef , Littmann Jasper R
Published: July 2023

This article discusses the fairness of geographically targeted vaccinations (GTVs). During the initial period of local and global vaccine scarcity, health authorities had to enact priority-setting strategies for mass vaccination campaigns against COVID-19. These strategies have in common that priority setting was based on personal characteristics, such as age, health status or profession. However, in 2021, an alternative to this strategy was employed in some countries, particularly Norway. In these countries, vaccine allocation was also based on the epidemiological situations in different regions, and vaccines were assigned based on local incidence rates. The aim of this article is to describe and examine how a geographical allocation mechanism may work by considering Norway as a case study and discuss what ethical issues may arise in this type of priority setting. We explain three core concepts: priority setting, geographical priority setting and GTVs. With a particular focus on Norway, we discuss the potential effects of GTV, the public perception of such a strategy, and if GTV can be considered a fair strategy. We conclude that the most reasonable defence of GTV seems to be through a consequentialist account that values both total health outcomes and more equal outcomes.
Solvation thermodynamics from cavity shapes of amino acids
Authors: Azizi Khatereh , Laio Alessandro , Hassanali Ali
Published: July 2023

According to common physical chemistry wisdom, the solvent cavities hosting a solute are tightly sewn around it, practically coinciding with its van der Waals surface. Solvation entropy is primarily determined by the surface and the volume of the cavity while enthalpy is determined by the solute–solvent interaction. In this work, we challenge this picture, demonstrating by molecular dynamics simulations that the cavities surrounding the 20 amino acids deviate significantly from the molecular surface. Strikingly, the shape of the cavity alone can be used to predict the solvation free energy, entropy, enthalpy, and hydrophobicity. Solute–solvent interactions involving the different chemical moieties of the amino acid, determine indirectly the cavity shape, and the properties of the branches but do not have to be taken explicitly into account in the prediction model.
Metacontexts and Cross-Contextual Communication: Stabilizing the Content of Documents Across Contexts
Authors: Davies Alex
Published: July 2023

Context-sensitive expressions appear ill suited to the purpose of sharing content across contexts. Yet we regularly use them to that end (in regulations, textbooks, memos, guidelines, laws, minutes, etc.). This paper describes the utility of the concept of a metacontext for understanding cross-contextual content-sharing with context-sensitive expressions. A metacontext is the context of a group of contexts: an infrastructure that can channel non-linguistic incentives on content ascription so as to homogenize the content ascribed to context-sensitive expressions in each context in the group. Documents composed of context-sensitive expressions can share content across contexts when supported by an appropriate metacontext. The bible has its church, the textbook its education system, the form its bureaucracy, and the manifesto its social movement. Some metacontexts support cross-contextual content-sharing. Some don’t. A promising research programme (one with practical importance) would take metacontexts as its unit of analysis.
Construction of a radiation beam scanner and investigation of volume averaging correction factor effects on beam-profile
Authors: Tikkanen Joonas , Morelius Jan , Siiskonen Teemu
Published: July 2023

In radiation beam-profile measurements, an accurate positioning of the detector with high position resolution is essential. For this purpose, we built a scanning device capable of moving a detector in three dimensions (3D) using mainly parts from a commercial 3D-printer. The accuracy and repeatability of movement was tested with caliper, laser displacement sensor and repeated 60Co beam-profile measurements in a water phantom. The results from the caliper and the sensor showed position accuracy for the scanner to be better than $\pm$150 μm. The standard deviation of the error in position from laser sensor measurements was approximately 30 μm, and the beam profile scans showed a maximum deviation from the mean position of 50 μm. The effect of volume averaging correction factors on 60Co beam-profile was investigated with two different sized ionization chambers. The differences in the profiles were reduced significantly after applying the correction factors.
Heavy-ions shielding data for hadrontherapy application with Monte Carlo methods
Authors: Bonforte Francesco , Ferrarini Michele , D’Angola Antonio , Giroletti Elio , Introini Daniele
Published: July 2023

In hadrontherapy centers, ion beams are accelerated by a cyclotron or synchrotron through electric and magnetic fields and, once the treatment energy is reached, ions interact with the patient. The interaction of the beam with magnets, other elements of particle accelerator or with the patient generates secondary radiation and the calculation for the design of the shielding is required. A first assessment of the shielding, generally made by concrete, can be performed by using Monte Carlo simulations, in which neutron yields and the ambient dose equivalent, H*(10), spatial distribution are obtained. The aim of this work is to evaluate, with a Monte Carlo approach, ambient dose equivalent values at various concrete depths generated by the secondary radiation. Simulations are performed considering helium, lithium, carbon, oxygen and iron primary beams. For existing facilities that already accelerates carbon ion, an equivalent carbon ratio is introduced to estimate the ion currents to get, in a given point, the same ambient dose equivalent as a carbon ion. Numerical results have been obtained simulating an ion beam that impinges on a thick iron or international commission on radiation units and measurements (ICRU) tissue, respectively, representing magnets and patient. The secondary radiation is transported through a large concrete shielding where ambient dose equivalent values are calculated as function of concrete thickness.
The association of various physical activities with erectile dysfunction: NHANES 2001-2004
Authors: Zhou Hang , Xu Mingming , Xu Zhunan , Li Muwei , Ren Congzhe , Chen Xiangyu , Liu Xiaoqiang
Published: July 2023

Background

The relationship between erectile dysfunction (ED) and physical activity has been established in several previous studies, but there is little information on the specific forms of activity that affect ED.

Aim

The objective of this study was to evaluate the relationship of 4 exercise categories and 2 activity intensities with ED in US men.

Methods

We used data sets from the National Health and Nutrition Examination Survey, 2001-2004. We used odds ratios (ORs) and multivariate logistic regression models to investigate the relationship between physical activity and ED. We also conducted subgroup analyses by age and controlled for potential confounder variables using propensity score matching analyses.

Outcomes

The primary outcome was ED as assessed through self-reporting.

Results

An overall 4094 adult men were included in the study. Adjusted multivariate regression models indicated that men who participated in monthly muscle-strengthening activities (OR = 0.75, P = .031), leisure activities (OR = 0.76, P = .024), or vigorous activities (OR = 0.64, P = .001) had a lower risk of ED. The subgroup analysis showed that among those ≥40 years old, muscle-strengthening activity (OR = 0.67, P = .005), leisure activity (OR = 0.72, P = .006), and vigorous activity (OR = 0.50, P < .001) were negatively associated with ED. After adjustment of propensity score matching, leisure activity and vigorous activity were also associated with a lower risk of ED, and muscle-strengthening activity was not significantly associated with ED.

Clinical Implications

Our findings could provide guidance to clinicians in helping patients with ED develop exercise programs.

Strengths and Limitations

We explored the relationship of 4 types and 2 intensities of exercise with ED, using a large sample size and sampling weights to produce representative data. However, this is only a cross-sectional study.

Conclusion

Active monthly participation in leisure and vigorous activity is associated with the maintenance of erectile function, while the relevance of muscle-strengthening activities needs further study.
The impact of essential fatty acid ratios and unsaturated to saturated fat ratio on growth performance of grow-finish pigs and estrus detection of gilts
Authors: Becker Spenser L , Greiner Laura L
Published: July 2023

The objective of this study was to investigate the effects of dietary unsaturated and saturated fat ratio (U:S) and the ratio of linoleic and linolenic acid (LA:ALA) on the growth performance of grow-finish pigs and estrus detection of gilts. A total of 240 pigs with initial body weight (BW) 54.4 ± 5.5 kg were randomly assigned to a high (>1.8; HUS) or low (<1.0; LUS) U:S in combination with a high (20:1), moderate (12:1), or low (4:1) LA:ALA in a 3 × 2 factorial arrangement. Dietary ratios were achieved using blends of choice white grease, beef tallow, corn oil, flaxseed oil, or palm kernel oil. Diets were fed across three phases and balanced for energy and LA. Pigs were housed across 60 pens with either four gilts or four barrows per pen. On day 49, 1 gilt per pen was moved to individual housing at approximately 154 d of age for evaluation of reproductive characteristics. Data were analyzed as repeated measures using PROC MIXED (SAS 9.4; SAS Inst., Cary, NC) with pen as the experimental unit and U:S, LA:ALA, sex, and their interactions as fixed effects. Initial BW was fit as a covariate. Within each phase, there were no differences in BW, daily gain (ADG), feed intake (ADFI), or feed efficiency (G:F) for U:S, LA:ALA, or their interaction when averaged across sex (P ≥0.128). Gilt feed efficiency was improved during the second phase compared to barrows; however, feed efficiency was not different between barrows and gilts during the first and third phases; resulting in a similar feed efficiency between sexes for the overall period (P = 0.523). Compared to HUS, gilts receiving LUS had higher ADFI overall (P = 0.018), which translated into improved G:F for HUS gilts (P = 0.011). Overall, gilts receiving the 20:1 diet tended to have improved G:F compared to 12:1 (P = 0.086). ADG was improved in pigs fed diets formulated with unsaturated fat sources to a 20:1 LA:ALA, regardless of sex. Detection of first estrus by 235 d of age in gilts was not impacted by U:S or LA:ALA (P ≥ 0.356). In conclusion, feeding differing dietary U:S and LA:ALA ratios impacts growth of growing pigs, particularly improving feed efficiency of gilts fed diets with unsaturated fat sources or a 20:1 LA:ALA. Further investigation into the physiological mechanisms differentially affecting gilt growth when fed varying dietary LA:ALA is warranted to understand the impact on reproductive outcomes.
The Impact of Single-Dose Debriefing for Meaningful Learning Training on Debriefer Quality, Time, and Outcomes: Early Evidence to Inform Debriefing Training and Frequency
Authors: Bradley Cynthia Sherraden , Johnson Brandon Kyle , Woda Aimee , Hansen Jamie , Loomis Ann , Dreifuerst Kristina Thomas
Published: July 2023

AIM

This study evaluated the impact of a single dose of training in Debriefing for Meaningful Learning (DML) on learner knowledge outcomes and time spent in debriefing.

BACKGROUND

Regulatory bodies recommend that faculty who debrief receive training and competence assessment to ensure positive student learning outcomes, yet there is little literature describing the training needed. There is also little understanding of the impact of a single training on the length of debriefing, debriefer skill, and learner outcomes.

METHOD

Following training, debriefers submitted a recorded debriefing for assessment by experts; their learners completed knowledge assessment tests at three time points.

RESULTS

Longer debriefing time led to higher DML Evaluation Scale scores. Learner knowledge scores improved and later decayed.

CONCLUSION

The results of this study contribute to the evidence about the importance of training to debrief well, the impact of training on the length of debriefing time, and subsequent learner outcomes.
Growth hormone and nonalcoholic fatty liver disease
Authors: Ma Ingrid L. , Stanley Takara L.
Published: July 2023

Nonalcoholic fatty liver disease (NAFLD) is a prevalent cause of liver disease and metabolic comorbidities. Obesity is strongly associated with NAFLD and is also a state of relative deficiency of growth hormone (GH). Evidence supports a role of reduced GH and insulin-like growth factor-1 (IGF-1) in NAFLD pathogenesis. Physiological actions of GH in the liver include suppression of de novo lipogenesis (DNL) and promotion of lipid beta-oxidation, and GH also appears to have anti-inflammatory actions. Physiologic actions of IGF-1 include suppression of inflammatory and fibrogenic pathways important in the evolution from steatosis to steatohepatitis and fibrosis. Rodent models of impaired hepatic GH signaling show the development of steatosis, sometimes accompanied by inflammation, hepatocellular damage, and fibrosis, and these changes are ameliorated by treatment with GH and/or IGF-1. In humans, individuals with GH deficiency and GH resistance demonstrate an increased prevalence of NAFLD compared to controls, with improvement in hepatic lipid, steatohepatitis, and fibrosis following GH replacement. As a corollary, individuals with GH excess demonstrate lower hepatic lipid compared to controls along with increased hepatic lipid following treatment to normalize GH levels. Clinical trials demonstrate that augmentation of GH reduces hepatic lipid content in individuals with NAFLD and may also ameliorate steatohepatitis and fibrosis. Taken together, evidence supports an important role for perturbations in the GH/IGF-1 axis as one of the pathogenic mechanisms of NAFLD and suggests that further study is needed to assess whether augmentation of GH and/or IGF-1 may be a safe and effective therapeutic strategy for NAFLD.
Absolute Monocyte Count as Early and Safe Marker for Antibiotic Cessation in Febrile Neutropenia Without Etiology in Pediatric Oncology Patients
Authors: Alali Muayad , Prather Cassandra , Danziger-Isakov Lara A. , Kussin Michelle L. , Khalifeh Malak , Al Othman Nashwan , Bartlett Allison H.
Published: July 2023

Background:

There is no practice standard regarding antibiotic duration in children with cancer and unexplained febrile neutropenia (FN). We hypothesized that absolute monocyte count (AMC) and absolute phagocyte count (APC= ANC + AMC + bands) are more sensitive, earlier, and safe markers of antibiotic cessation compared with absolute neutrophil count (ANC).

Methods:

A retrospective review of FN episodes (FNEs) in pediatric oncology patients was conducted between 2009 and 2016. Included patients were afebrile for 24 hours and without an identified infectious source at antibiotic cessation. Primary endpoints, including recurrent fever, readmission, bloodstream infection, microbiologically documented infection, and adverse outcomes, were assessed 10 days after antibiotic cessation and compared among different bone marrow recovery parameters (ANC, AMC, APC). Secondary endpoints included length of FN stay, antibiotic-free days, and cost.

Results:

Three hundred ninety-one FNEs in 235 patients were included. Three groups were compared based on ANC (cells/μL) at the time of antibiotic cessation: < 200 in 102 (26%), 200 to 500 in 111 (28%), and >500 in 178 (46%). No statistically significant differences in primary endpoints were identified among the 3 ANC groups; however, a trend toward unfavorable outcomes in the ANC ≤200 cells/μL group compared with the ANC >200 cells/μL was observed. Primary endpoints based on AMC >100 cells/μL at the time of antibiotic cessation showed statistically significant favorable outcomes compared AMC ≤100 cells/μL (80%, 88%, 90%, 89%, and 93% risk reduction in recurrent fever, readmission, new bloodstream infection, new microbiologically documented infection, and adverse events, respectively). Similar favorable results were seen when APC >300 cells/μL was used as a threshold for antibiotic cessation. The median length of stay for FN if discharged when AMC >100 cells/μL was 3 days shorter and associated with fewer unfavorable outcomes, thus resulting in fewer hospital days, fewer antibiotic days, and decreased cost.

Conclusion:

Our results suggest that AMC >100 cells/μL (regardless of ANC) or APC >300 cells/μL may be safe thresholds for empiric antibiotic cessation and result in reduced unfavorable clinical outcomes within 10 days postdischarge, reduced antibiotic days of therapy and reduced health care costs. Further prospective studies are needed to validate AMC as an accurate surrogate marker for antibiotic cessation in FNEs in children with cancer.
Prognostic Factors and Treatment Outcome of Relapsing and Refractory Pediatric Mature B-cell Non-Hodgkin Lymphoma, Children’s Cancer Hospital Egypt Experience
Authors: Semary Samah F. , Abdel Rahman Hany , Elkinaai Naglaa , Zaky Iman , Nagy Nouran , Salem Sherine , Hamoda Asmaa
Published: July 2023

Background:

Relapsed non-Hodgkin lymphoma treated by chemotherapy and hematopoietic stem cell transplantation (HSCT) has a dismal prognosis.

Patients:

It is a retrospective study, including pediatric patients diagnosed as mature B-cell non-Hodgkin lymphoma who were primarily refractory or relapsed over 8 years at CCHE. The aim of the study was to analyze the prognostic factors and outcomes of this group of patients. Our result is, 53 of 750 (7%) patients were included. Thirty-four (64.2%) patients had Burkitt lymphoma. Forty-eight (90.6%) patients received LMB 96 protocol initially. The median delay of duration between chemotherapy cycles in first-line treatment was 37 days. Thirty-five (66%) patients relapsed, 23 (65.7%) of them relapsed early, whereas 18 (34%) had tumor progression. Thirty-one (58.5%) patients presented with stage IV at the time of relapse. rituximab, ifosfamide, carboplatin, etoposide was the second line of treatment in 42 (79.24%) patients, and complete second remission was achieved only in 13 (24.3%) patients. Allogeneic HSCT was done for 4 (7.5%) patients, and auto HSCT was done for 3 (5.7%) patients. Three years of overall survival for relapsed and progressed patients were 35.3% and 11.1%, respectively, with a P-value of 0.009. Three years overall survival for patients who underwent HSCT was 85.7% compared with 18.1% for no HSCT with a P-value of 0.007.

Conclusions:

The relapse rate is higher than literatures because of the delay of duration between chemotherapy cycles in first-line treatment and more advanced stage at time of relapse. Progression of the disease had a worse outcome than relapse. HSCT in patients with the second remission markedly improved the outcome.
Temporal Changes in Metabolic Syndrome Indices and Factors of Metabolic Syndrome Development in Patients With Rheumatic Disease
Authors: Oh HyunSoo , Park JiSuk , Kim JiYoung , Jang SungKyung , Ryu Yeona , Jeong YeoJu , Kwon SuYeon , Suh SoHyun , Lee HaYoung , Choi DaHee , Lee HanNa , Cho GaWon , Seo WhaSook
Published: July 2023

Patients with rheumatic disease have a high prevalence of metabolic syndrome. The purpose of this study was to investigate temporal changes in metabolic syndrome indices and to identify factors influencing metabolic syndrome development. A prospective cohort study design was adopted. The study participants were 68 outpatients with a rheumatic disease at an outpatient clinic of a university hospital. Data on demographics, health-related characteristics, steroid use, serum C-reactive protein levels, and metabolic syndrome indices were collected between December 2017 and March 2021. Temporal changes in body mass indices, serum triglyceride, and cholesterol levels were significant. Body mass indices, diastolic blood pressure, serum triglyceride, high-density lipoprotein, and fasting blood glucose levels at time of diagnosis were found to influence metabolic syndrome development. Temporal changes in serum triglyceride, cholesterol, and fasting blood glucose levels were significantly influenced by inflammatory status. The findings demonstrate the importance of controlling inflammatory activities in the context of inhibiting the progression of metabolic syndrome and rheumatic diseases.
Pathogenesis of Gastrointestinal Follicular Lymphomas
Authors: Takahashi Yuka , Taniguchi Hirokazu , Haruhi Furukawa , Hattori Daiki , Sasaki Hirokazu , Makita Shinichi , Iwaki Noriko , Fukuhara Suguru , Munakata Wataru , Saito Yutaka , Izutsu Koji , Maeshima Akiko M.
Published: July 2023

Gastrointestinal (GI) follicular lymphoma (FL) is the most frequently diagnosed extranodal FL; however, its pathogenesis is debatable. We investigated the distribution, endoscopic, and histopathologic findings of 366 GI FL samples obtained from 298 patients. FLs were most frequently observed in the small intestine (71%), including the duodenum (52%), but were also commonly found in the stomach (15%) and colon (12%). The proportion of granular lesions in the duodenum, terminal ileum, colon, and stomach was 74%, 39%, 24%, and 0%, respectively. Submucosal or ulcerated tumors were frequently observed in the stomach (48%) and colon (52%). Most GI FL showed grade 1 to 2 histology (89%) as well as CD10+ (93%) and BCL2+ (98%) positivity. There were no significant differences in the endoscopic or histologic findings between primary and secondary GI FLs. As known, the mucosa of the small intestine is thin and villous, while the mucosa of the stomach and colon is thicker and has a smooth surface. Granular lesions corresponding to very small FL were detected in the former but rarely in the latter. Nine (7%) patients with primary GI FL developed histologic transformation to diffuse large B-cell lymphoma (n=8) or high-grade B-cell lymphoma (n=1) 10 months to 14 years after the diagnosis of FL. Two patients died of lymphoma. In conclusion, the incidence and endoscopic findings differed, but the histopathology was similar in FLs in each site. These differences might be attributed to variations in each GI site’s mucosal structure and the neoplastic follicles’ size. Due to its characteristic structure, very small classic FLs might be detectable mainly in the small intestine.
Rapid Response System Components and In-Hospital Cardiac Arrests Rates 21 Years After Introduction Into an Australian Teaching Hospital
Authors: Jones Daryl , Pearsell James , Wadeson Emma , See Emily , Bellomo Rinaldo ,   on behalf of The Austin Health DPC investigators
Published: July 2023

Objectives

The aims of the study are: (1) to evaluate the epidemiology of in-hospital cardiac arrests (IHCAs) 21 years after implementing a rapid response teams (RRTs); and (2) to summarize policies, procedures, and guidelines related to a national standard pertaining to recognition of and response to clinical deterioration in hospital.

Methods

The study used a prospective audit of IHCA (commencement of external cardiac compressions) in ward areas between February 1, 2021, and January 31, 2022. Collation, summary, and presentation of material related to 8 “essential elements” of the Australian Commission for Safety and Quality in Health Care consensus statement on clinical deterioration.

Results

There were 3739 RRT calls and 244 respond blue calls. There were 20 IHCAs in clinical areas, with only 10 occurring in general wards (0.36/1000 admissions). The median (interquartile range) age was 69.5 years (60–77 y), 90% were male, and comorbidities were relatively uncommon. Only 5 patients had a shockable rhythm. Survival was 65% overall, and 80% and 50% in patients on the cardiac and general wards, respectively. Only 4 patients had RRT criteria in the 24 hours before IHCA. A detailed summary is provided on policies and guidelines pertaining to measurement and documentation of vital signs, escalation of care, staffing and oversight of RRTs, communication for safety, education and training, as well as evaluation, audit, and feedback, which underpinned such findings.

Conclusions

In our mature RRT, IHCAs are very uncommon, and few are preventable. Many of the published barriers encountered in successful RRT use have been addressed by our policies and guidelines.
Deciphering the potential of plasma cell-free metagenomic next-generation sequencing using the Karius test
Authors: Bell Drew T.
Published: July 2023

Purpose of review

Plasma cell-free metagenomic next-generation sequencing (cf-mNGS) is increasingly employed for the diagnosis of infection, but a consensus for optimal use has not been established. This minireview focuses on the commercially available Karius Test and is aimed at local leaders seeking to understand the complexities of cf-mNGS to make informed test utilization policies and better interpret results.

Recent findings

Recent retrospective studies have reported how the Karius Test was applied at their institutions and identified areas of potential patient benefit. In addition, substantive studies have reported how this test performs in specific indications, particularly invasive fungal disease, endovascular infection and lower respiratory infection.

Successfully integrating plasma cf-mNGS requires careful assessment of performance in the specific applications and patient populations in which it is used. Individual institutions must independently evaluate implementation strategies and determine where diagnostic yields outweigh the potential pitfalls.
Clinical Utility of Diffusion-Weighted Imaging in Gynecological Imaging
Authors: Fujii Shinya , Gonda Takuro , Yunaga Hiroto
Published: July 2023

Diffusion-weighted imaging (DWI) is an increasingly valuable sequence in daily clinical practice, providing both functional and morphological information. The use of DWI can help quantify diffusion using the apparent diffusion coefficient, which reflects the physiological features of the tissue and tumor microcirculation. This knowledge is crucial for understanding and interpreting gynecological imaging. This article reviews the clinical utility of DWI for gynecological imaging, highlighting its ability to aid in the detection of endometrial and cervical cancers, as well as tumor extension and metastasis. In addition, DWI can easily detect the solid components of ovarian cancer (including dissemination), assist in the diagnosis of adnexal torsion, and potentially show bone marrow status. Apparent diffusion coefficient measurement is useful for differentiating between endometrial lesions, uterine leiomyomas, and sarcomas, and may provide important information for predicting the prognosis of gynecological cancers.
MRI of Temporomandibular Joint Disorders: A Comparative Study of 0.55 T and 1.5 T MRI
Authors: Kopp Markus , Wiesmueller Marco , Buchbender Mayte , Kesting Marco , Nagel Armin M. , May Matthias S. , Uder Michael , Roemer Frank W. , Heiss Rafael
Published: July 2023

Objectives

Temporomandibular disorders (TMDs) are common and may cause persistent functional limitations and pain. Magnetic resonance imaging (MRI) at 1.5 and 3 T is commonly applied for the evaluation of the temporomandibular joint (TMJ). No evidence is available regarding the feasibility of modern low-field MRI for the assessment of TMDs. The objective of this prospective study was to evaluate the image quality (IQ) of 0.55 T MRI in direct comparison with 1.5 T MRI.

Materials and Methods

Seventeen patients (34 TMJs) with suspected intraarticular TMDs were enrolled, and both 0.55 and 1.5 T MRI were performed on the same day. Two senior readers independently evaluated the IQ focusing on the conspicuity of disc morphology (DM), disc position (DP), and osseous joint morphology (OJM) for each joint. We analyzed the IQ and degree of artifacts using a 4-point Likert scale (LS) at both field strengths. A fully sufficient IQ was defined as an LS score of ≥3. Nonparametric Wilcoxon test for related samples was used for statistical comparison.

Results

The median IQ for the DM and OJM at 0.55 T was inferior to that at 1.5 T (DM: 3 [interquartile range {IQR}, 3–4] vs 4 [IQR, 4–4]; OJM: 3 [IQR, 3–4] vs 4 [IQR 4–4]; each P < 0.001). For DP, the IQ was comparable (4 [IQR 3–4] vs 4 [IQR 4–4]; P > 0.05). A sufficient diagnostic IQ was maintained for the DM, DP, and OJM in 92% of the cases at 0.55 T and 100% at 1.5 T. Minor image artifacts (LS score of ≥3) were more prevalent at 0.55 T (29%) than at 1.5 T (12%).

Conclusions

Magnetic resonance imaging of the TMJ at 0.55 T yields a lower IQ than does MRI at 1.5 T but maintains sufficient diagnostic confidence in the majority of patients. Further improvements are needed for reliable clinical application.
Low-Cost Task Trainer for In Utero Fetal Stent Placement
Authors: Codsi Elisabeth , Brost Brian C. , Nitsche Joshua F.
Published: July 2023

Introduction

Some fetal procedures such as intrauterine fetal stent placement remain rare, and simulation is needed to help learners and specialists in attaining and maintaining technical competence. We sought to design and assess a low-cost, easily assembled yet clinically relevant task trainer for fetal stent placement.

Method

The simulator was constructed using 2 quart-sized freezer bags filled with ultrasound gel and sealed with clear packing tape. The bags were stacked vertically in a transparent plastic container with ultrasound gel applied between the bags when ultrasound was used. This task trainer was used to deploy in utero stents with or without the use of ultrasound. It has been used at the annual meeting of the Society for Maternal-Fetal Medicine since 2015, the annual meeting of the International Society of Ultrasound in Obstetrics and Gynecology in 2015 and 2016, and at regional Maternal-Fetal Medicine Fellow simulation workshops since 2016. Participants were asked to complete a 5-point Likert scale survey regarding the model's realism and usefulness in training.

Results

One hundred thirty-three course participants evaluated the task trainer. The median rating for realism of the ultrasound images, haptic feel of stent deployment, and usefulness in training was 5 (interquartile range, 4–5). Seven physicians participated in the timed assessment of model assembly, stent deployment, and model reassembly. The average times required for the freezer bag task trainer were 2.3 minutes (2.20–2.35), 1.0 minutes (0.70–1.93), and 0.1 minutes (0.08–0.10), respectively. For the porcine tissue-based model tested in parallel, the average times were 6.0 minutes (5.00–7.06), 3.7 minutes (3.63–3.75), and 3.3 minutes (3.00–3.70), respectively.

Conclusions

This low-cost simulator was rated highly when used to practice in utero stent deployment and allows for numerous repetitions in each training session. It could be a valuable tool in training novice providers and allow more experienced providers to maintain competence in this low-volume procedure.
Cost-Utility Analysis of Midurethral Sling Timing Among Women Undergoing Prolapse Surgery
Authors: Sassani Jessica C. , Giugale Lauren E. , Lavelle Erin Seifert , Shepherd Jonathan P.
Published: July 2023

Importance

There are no guidelines regarding the ideal timing of midurethral sling (MUS) placement following prolapse repair.

Objective

The objective of this study was to estimate the cost-utility of concomitant MUS versus staged MUS among women undergoing apical suspension surgery for pelvic organ prolapse.

Study Design

Cost-utility modeling using a decision analysis tree compared concomitant MUS with staged MUS over a 1-year time horizon. The primary outcome was the incremental cost-effectiveness ratio (ICER). Six scenarios were modeled to estimate cost-utilities for women with preoperative overt, occult, or no stress urinary incontinence (SUI) who underwent either minimally invasive sacrocolpopexy or vaginal native tissue apical suspension. Possible complications of de novo overactive bladder, urinary retention requiring sling lysis, mesh exposure, and persistent SUI were included. Costs from a third-party payer perspective were derived from Medicare 2022 reimbursements. One-way sensitivity analyses were performed.

Results

Among women without preoperative SUI, staged MUS was the dominant strategy for both surgical routes with higher utility and lower costs. For women with either occult or overt SUI undergoing sacrocolpopexy or vaginal repair, concomitant MUS was cost-effective (ICER = $21,114–$96,536 per quality-adjusted life-year). Therefore, concomitant MUS is preferred for patients with preoperative SUI as higher costs were offset by higher effectiveness. One-way sensitivity analyses demonstrated that ICERs were most affected by probability of cure following MUS.

Conclusions

A staged MUS procedure is the dominant strategy for women undergoing apical prolapse repair without preoperative SUI. In women with either overt or occult SUI, the ICER was below the willingness-to-pay threshold of $100,000 per quality-adjusted life-year, suggesting that concomitant MUS surgery is cost-effective.
Early Detection of Optic Nerve Changes on Optical Coherence Tomography Using Deep Learning for Risk-Stratification of Papilledema and Glaucoma
Authors: Li Anfei , Tandon Anika K. , Sun Grace , Dinkin Marc J. , Oliveira Cristiano
Published: July 2023

Background:

The use of artificial intelligence is becoming more prevalence in medicine with numerous successful examples in ophthalmology. However, much of the work has been focused on replicating the works of ophthalmologists. Given the analytical potentials of artificial intelligence, it is plausible that artificial intelligence can detect microfeatures not readily distinguished by humans. In this study, we tested the potential for artificial intelligence to detect early optic coherence tomography changes to predict progression toward papilledema or glaucoma when no significant changes are detected on optical coherence tomography by clinicians.

Methods:

Prediagnostic optical coherence tomography of patients who developed papilledema (n = 93, eyes = 166) and glaucoma (n = 187, eyes = 327) were collected. Given discrepancy in average cup-to-disc ratios of the experimental groups, control groups for papilledema (n = 254, eyes = 379) and glaucoma (n = 441, eyes = 739) are matched by cup-to-disc ratio. Publicly available Visual Geometry Group-19 model is retrained using each experimental group and its respective control group to predict progression to papilledema or glaucoma. Images used for training include retinal nerve fiber layer thickness map, extracted vertical tomogram, ganglion cell thickness map, and ILM-RPE thickness map.

Results:

Trained model was able to predict progression to papilledema with a precision of 0.714 and a recall of 0.769 when trained with retinal nerve fiber layer thickness map, but not other image types. However, trained model was able to predict progression to glaucoma with a precision of 0.682 and recall of 0.857 when trained with extracted vertical tomogram, but not other image types. Area under precision–recall curve of 0.826 and 0.785 were achieved for papilledema and glaucoma models, respectively.

Conclusions:

Computational and analytical power of computers have become an invaluable part of our lives and research endeavors. Our proof-of-concept study showed that artificial intelligence (AI) algorithms have the potential to detect early changes on optical coherence tomography for prediction of progression that is not readily observed by clinicians. Further research may help establish possible AI models that can assist with early diagnosis or risk stratification in ophthalmology.
Robert Ramage. 4 October 1935—16 October 2019
Authors: Muir FRS Tom W.
Published: July 2023

Robert (Bob) Ramage was an innovative and versatile organic chemist who made pioneering contributions to the fields of target-oriented synthesis and synthetic methodology. His research programme was initially focused on the (bio)synthesis of natural products, but later expanded to include peptides and proteins, where he became a key figure in the development of that field in the UK and beyond. As a PhD student in Glasgow, he developed a synthesis of the sesquiterpene cuparene, an achievement that earned him a Fulbright scholarship to Harvard, where he worked under the guidance of R. B. Woodward ForMemRS. With Woodward he participated in the now classic synthesis of the beta-lactam antibiotic cephalosporin C. His independent career began in Liverpool, where he continued his interests in sesquiterpene synthesis, devising several notable syntheses. This period also saw him forge important collaborations with Alan Battersby (FRS 1966) and George Kenner FRS, with whom he worked on the biosynthesis of the alkaloid colchicine and the chemical synthesis of several polypeptides, respectively. In Manchester, and later in Edinburgh, he continued his work in peptide synthesis methodology, a multi-pronged effort that culminated in the successful chemical synthesis of crystalline ubiquitin, widely considered a landmark achievement in the field. His scientific impact reached beyond academia through various consultancies with the pharmaceutical industry and the founding of a successful biotech company. He also assumed various academic leadership roles throughout his career. Bob will be remembered for his exacting standards and resolve to tackle big problems, attributes that he instilled in the many young scientists he mentored. He is dearly missed by all who knew him, by his colleagues around the world and most of all by his family.
Casein fibres for wound healing
Authors: Ahmed Jubair , Guler Ece , Sinemcan Ozcan Gul , Emin Cam Muhammet , Homer-Vanniasinkam Shervanthi , Edirisinghe Mohan
Published: July 2023

The name casein is given to a family of phosphoproteins which is commonly found in milk. Until recently, this was a constituent of milk that was commonly discarded; however today, it is widely used in health supplements all over the world. In this work, a high loading (50 wt%) of casein is mixed with a solution of polycaprolactone (PCL) to produce bandage-like fibres with an average fibre diameter of 1.4 ± 0.5 µm, which would be used to cover wounds in a series of tests with diabetic rats. Mouse fibroblast cell viability tests show that the casein-loaded fibres had little cytotoxicity with over 90% observed viability. A 14-day
in vivo
trial involving three groups of rats, used as control (no treatment), pure PCL fibres and casein-loaded fibres, showed that the casein within the fibres contributed to a significantly more extensive healing process. Histological analysis showed increased development of granulation tissue and follicle regrowth for the casein-loaded fibres. Further analysis showed that casein-loaded fibres have significantly lower levels of TNF-α, TGF-β IL-1β, NF-κB and IL-6, contributing to superior healing. The results presented here show an economical and simple approach to advanced wound healing.
Investigation of biphenyl enamines for applications as p-type semiconductors
Authors: Steponaitis Matas , Jankauskas Vygintas , Kamarauskas Egidijus , Malinauskienė Vida , Karazhanov Smagul , Malinauskas Tadas , Getautis Vytautas
Published: July 2023

Due to the ease of synthesis and the ability to easily tune properties, organic semiconductors are widely researched and used in many optoelectronic applications. Requirements such as thermal stability, appropriate energy levels and charge-carrier mobility have to be met in order to consider the suitability of an organic semiconductor for a specific application. Balancing of said properties is not a trivial task; often one characteristic is sacrificed to improve the other and therefore a search for well-balanced materials is necessary. Herein, seven new charge-transporting biphenyl-based enamine molecules are reported. The new materials were synthesized using a simple one-step reaction without the use of expensive transition metal catalysts. It was observed that subtle variations in the structure lead to notable changes in the properties. Materials exhibited high thermal stability and relatively high carrier drift mobility, reaching 2 × 10
−2
cm
2
V
−1
s
−1
(for
BE3
) at strong electric fields. Based on the results, three materials show the potential to be applied in organic light emitting diodes and solar cells.
Prolonged baleen hormone cycles suggest atypical reproductive endocrinology of female bowhead whales
Authors: Lysiak N. S. J. , Ferguson S. H. , Hornby C. A. , Heide-Jørgensen M. P. , Matthews C. J. D.
Published: July 2023

Serial measurements of hormone concentrations along baleen plates allow for reconstructions of mysticete whale reproductive histories. We assessed gestation and calving interval in bowhead whales (
Balaena mysticetus
) by measuring progesterone, oestradiol, corticosterone and nitrogen stable isotope ratios (δ
15
N) along baleen of 10 females from the eastern Canada-west Greenland population. Three immature females (body size < 14.32 m) had uniformly low progesterone concentrations across their baleen, while seven mature females (body size ≥ 14.35 m) had repeated, sustained elevations of progesterone indicative of pregnancies. The mean duration of progesterone elevations (23.6 ± 1.50 months) was considerably longer than the approximately 14 month gestation previously estimated for this species. We consider several possible explanations for this observation, including delayed implantation or sequential ovulations prior to gestation, strategies that would allow females to maximize their fitness in variable Arctic conditions, as well as suggest modified criteria defining gestation as a shorter component of the entire progesterone peak. Calving intervals varied within and among individuals (mean = 3.7 years; range = range 2.8–5.7 years), providing population-specific reproductive estimates for growth models used in bowhead whale management and conservation.
Investigation of airborne spread of COVID-19 using a hybrid agent-based model: a case study of the UK
Authors: Rahaman Hafijur , Barik Debashis
Published: July 2023

Agent-based models have been proven to be quite useful in understanding and predicting the SARS-CoV-2 virus-originated COVID-19 infection. Person-to-person contact was considered as the main mechanism of viral transmission in these models. However, recent understanding has confirmed that airborne transmission is the main route to infection spread of COVID-19. We have developed a computationally efficient agent-based hybrid model to study the aerial propagation of the virus and subsequent spread of infection. We considered virus, a continuous variable, spreads diffusively in air and members of populations as discrete agents possessing one of the eight different states at a particular time. The transition from one state to another is probabilistic and age linked. Recognizing that population movement is a key aspect of infection spread, the model allows unbiased movement of agents. We benchmarked the model to recapture the temporal stochastic infection count data of the UK. The model investigates various key factors such as movement, infection susceptibility, new variants, recovery rate and duration, incubation period and vaccination on the infection propagation over time. Furthermore, the model was applied to capture the infection spread in Italy and France.
Triggering of electro-elastic anti-superhydrophobicity during non-Newtonian droplet collision
Authors: V V S Vara Prasad Gudlavalleti , Dhar Purbarun , Samanta Devranjan
Published: July 2023

The present article discusses the electrohydro-dynamics of impacting non-Newtonian dielectric droplets on superhydrophobic (SH) surfaces. The role of important parameters like electric Eotvos number (

Eo
e

), Weber number (
We
), dielectric particle concentration (

TiO
2

) and polymer concentration (
PEG-400
) were elucidated in this experimental study. Due to the interplay of non-Newtonian effects and electric field, we had observed the suppression of drop rebound on SH surfaces at much lower

Eo
e

compared to its Newtonian counterpart. It has been observed that with an increase in both polymer concentration or dielectric particle concentration, the suppression of drop rebounds was observed at lower

Eo
e.

In order to encapsulate the combined effects of electric field and non-Newtonian dynamics on drop rebound suppression, we have introduced the ‘electro-elastic effect’. Contrary to the common observations of drop rebound on SH surfaces, this electro-elastic effect induces inhibition of drop rebound, thereby resulting in anti-superhydrophobicity. Subsequently, we also established a scaling relationship to show that the rebound suppression is observed as a manifestation of the onset of electro-elastic instability, when a proposed electric Weissenberg number (

Wi
e

) exceeds unity. Finally, we demarcated the rebound and rebound suppression regimes of droplet dynamics through a detailed phase map.
Heteroclinic bifurcation analysis of the tippedisk through the use of Melnikov theory
Authors: Sailer Simon , Leine Remco I.
Published: July 2023

The tippedisk is a mechanical–mathematical archetype for friction-induced instabilities caused by geometry and interaction with a frictional support. The instability leads to a counterintuitive rise of the centre of gravity when an unbalanced disc is spun rapidly about an in-plane axis. To understand the qualitative behaviour of the tippedisk, a nonlinear analysis is performed, revealing the singularly perturbed structure of the system equations. Application of singular perturbation theory shows that the long-term behaviour is dominated by a two-dimensional slow manifold, on which the asymptotic dynamics takes place. Moreover, Melnikov theory is used to derive a closed-form approximation of a heteroclinic bifurcation, which allows general statements to be made about the dynamic behaviour of the tippedisk.