bluuebunny/crossref_metadata_2025 huggingface dataset:
The use of meshes in male groin hernia repairs
Authors: Banerjee Abhirup , Bhattacharya Satyajit
Published: July 2021

The use of a mesh is standard practice in the surgical repair of groin hernias. No one type of mesh or surgical technique appears to be superior to another. Here the authors discuss the evolution of groin hernia repair, the different types of mesh, as well as the investigation and management of complications that can occur, albeit in a minority of patients.
Five common urological problems affecting adolescent men
Authors: Tregunna Rebecca , Wood Dan
Published: July 2021

Young men can be a challenging group and may resist engagement with health care. It is important that then when they do attend their problem is managed appropriately. This paper gives a background to five common adolescent problems, including tips on how to manage them.
Preventing abdominal aortic aneurysm in men
Authors: Kirby Mike
Published: July 2021

Abdominal aortic aneurysm causes significant mortality and morbidity, particularly in older men. Primary prevention and early detection via screening with ultrasound are important interventions to reduce the high mortality rates.
Marek Miller, 1960–2021
Authors: Noble Jeremy
Published: July 2021

Marek Miller, a recently retired Consultant Urological Surgeon in Northampton, died peacefully on 10th June 2021 at the tender age of only 61.
Explaining (g − 2)μ with multi-TeV sleptons
Authors: Altmannshofer Wolfgang , Gadam Sri Aditya , Gori Stefania , Hamer Nick
Published: July 2021

Abstract

We present a supersymmetric extension of the Standard Model in which the new physics contributions to the anomalous magnetic moment of the muon can be more than an order of magnitude larger than in the minimal supersymmetric Standard Model. The extended electroweak symmetry breaking sector of the model can consistently accommodate Higgs bosons and Higgsinos with O(1) couplings to muons. We find that sleptons with masses in the multi-TeV range can comfortably explain the recently confirmed discrepancy in the anomalous magnetic moment of the muon. We discuss additional phenomenological aspects of the model, including its effects on tau flavor changing decays.
Holographic phonons by gauge-axion coupling
Authors: Wang Xi-Jing , Li Wei-Jia
Published: July 2021

Abstract

In this paper, we show that a simple generalization of the holographic axion model can realize spontaneous breaking of translational symmetry by considering a special gauge-axion higher derivative term. The finite real part and imaginary part of the stress tensor imply that the dual boundary system is a viscoelastic solid. By calculating quasi-normal modes and making a comparison with predictions from the elasticity theory, we verify the existence of phonons and pseudo-phonons, where the latter is realized by introducing a weak explicit breaking of translational symmetry, in the transverse channel. Finally, we discuss how the phonon dynamics affects the charge transport.
From black holes to baby universes in CGHS gravity
Authors: Godet Victor , Marteau Charles
Published: July 2021

Abstract

We study $$ \hat{\mathrm{CGHS}} $$

CGHS
̂

gravity, a variant of the matterless Callan-Giddings-Harvey-Strominger model. We show that it describes a universal sector of the near horizon perturbations of non-extremal black holes in higher dimensions. In many respects this theory can be viewed as a flat space analog of Jackiw-Teitelboim gravity. The result for the Euclidean path integral implies that $$ \hat{\mathrm{CGHS}} $$

CGHS
̂

is dual to a Gaussian ensemble that we describe in detail. The simplicity of this theory allows us to compute exact quantities such as the quenched free energy and provides a useful playground to study baby universes, averages and factorization. In particular we derive a “wormhole = diagonal” identity. We also give evidence for the existence of a non-perturbative completion in terms of a matrix model. Finally, flat wormhole solutions in this model are discussed.
Toward simulating superstring/M-theory on a quantum computer
Authors: Gharibyan Hrant , Hanada Masanori , Honda Masazumi , Liu Junyu
Published: July 2021

Abstract

We present a novel framework for simulating matrix models on a quantum computer. Supersymmetric matrix models have natural applications to superstring/M-theory and gravitational physics, in an appropriate limit of parameters. Furthermore, for certain states in the Berenstein-Maldacena-Nastase (BMN) matrix model, several supersymmetric quantum field theories dual to superstring/M-theory can be realized on a quantum device. Our prescription consists of four steps: regularization of the Hilbert space, adiabatic state preparation, simulation of real-time dynamics, and measurements. Regularization is performed for the BMN matrix model with the introduction of energy cut-off via the truncation in the Fock space. We use the Wan-Kim algorithm for fast digital adiabatic state preparation to prepare the low-energy eigenstates of this model as well as thermofield double state. Then, we provide an explicit construction for simulating real-time dynamics utilizing techniques of block-encoding, qubitization, and quantum signal processing. Lastly, we present a set of measurements and experiments that can be carried out on a quantum computer to further our understanding of superstring/M-theory beyond analytic results.
Soft-drop grooming for hadronic event shapes
Authors: Baron Jeremy , Reichelt Daniel , Schumann Steffen , Schwanemann Niklas , Theeuwes Vincent
Published: July 2021

Abstract

Soft-drop grooming of hadron-collision final states has the potential to significantly reduce the impact of non-perturbative corrections, and in particular the underlying-event contribution. This eventually will enable a more direct comparison of accurate perturbative predictions with experimental measurements. In this study we consider soft-drop groomed dijet event shapes. We derive general results needed to perform the resummation of suitable event-shape variables to next-to-leading logarithmic (NLL) accuracy matched to exact next-to-leading order (NLO) QCD matrix elements. We compile predictions for the transverse-thrust shape accurate to NLO + NLL′ using the implementation of the Caesar formalism in the Sherpa event generator framework. We complement this by state-of-the-art parton- and hadron-level predictions based on NLO QCD matrix elements matched with parton showers. We explore the potential to mitigate non-perturbative corrections for particle-level and track-based measurements of transverse thrust by considering a wide range of soft-drop parameters. We find that soft-drop grooming indeed is very efficient in removing the underlying event. This motivates future experimental measurements to be compared to precise QCD predictions and employed to constrain non-perturbative models in Monte-Carlo simulations.
Noether-Wald charges in six-dimensional Critical Gravity
Authors: Anastasiou Giorgos , Araya Ignacio J. , Corral Cristóbal , Olea Rodrigo
Published: July 2021

Abstract

It has been recently shown that there is a particular combination of conformal invariants in six dimensions which accepts a generic Einstein space as a solution. The Lagrangian of this Conformal Gravity theory — originally found by Lu, Pang and Pope (LPP) — can be conveniently rewritten in terms of products and covariant derivatives of the Weyl tensor. This allows one to derive the corresponding Noether prepotential and Noether-Wald charges in a compact form. Based on this expression, we calculate the Noether-Wald charges of six-dimensional Critical Gravity at the bicritical point, which is defined by the difference of the actions for Einstein-AdS gravity and the LPP Conformal Gravity. When considering Einstein manifolds, we show the vanishing of the Noether prepotential of Critical Gravity explicitly, which implies the triviality of the Noether-Wald charges. This result shows the equivalence between Einstein-AdS gravity and Conformal Gravity within its Einstein sector not only at the level of the action but also at the level of the charges.
The trochlear sulcus of the native knee is consistently orientated close to the sagittal plane despite variation in distal condylar anatomy
Authors: Borukhov Ilya , Esposito Christina I. , Ismailidis Petros , LiArno Sally , Lyon Jenna P. , McCarthy Thomas F. , McEwen Peter
Published: July 2021

Purpose

The aim of this study was to describe the native trochlear orientation of non-arthritic knees in three planes and to quantify the relationship between trochlear and distal condylar anatomy across race and sex.

Methods

Computed tomography scans of 1578 femora were included in this study. The mediolateral position of the trochlear sulcus, the distal trochlear sulcus angle (DTSA) the medial sulcus angle (MSA) and the lateral sulcus angle (LSA) as well as the mechanical lateral distal femoral angle (mLDFA) were measured relative to a standard reference coordinate system. Multiple linear regression analyses were performed to account for potential confounding variables.

Results

The mediolateral position of the trochlear sulcus had minimal mean deviation of the sagittal femoral plane. The mean DTSA was 86.1° (SD 2.2°). Multilinear regression analysis found mLDFA, sex, and age all influence DTSA (p < 0.05), with mLDFA having by far the greatest influence (r2 = 0.55). The medial facet of the trochlear sulcus was found to be flat proximally and more prominent distally. The lateral facet was relatively uniform throughout the arc.

Conclusion

In non-arthritic knees, due to a strong positive correlation between the DTSA and the mLDFA, the trochlear sulcus is consistently orientated in the sagittal femoral plane regardless of distal condylar anatomy. Minor deviations from the sagittal plane occur in a lateral direction in the middle part and in a medial direction at the proximal and distal part of the trochlea. These findings have relevance regarding the biomimetic design of total knee implants.
Genotoxicity and inflammatory potential of stainless steel welding fume particles: an in vitro study on standard vs Cr(VI)-reduced flux-cored wires and the role of released metals
Authors: McCarrick Sarah , Romanovski Valentin , Wei Zheng , Westin Elin M. , Persson Kjell-Arne , Trydell Klara , Wagner Richard , Odnevall Inger , Hedberg Yolanda S. , Karlsson Hanna L.
Published: July 2021

Welders are daily exposed to various levels of welding fumes containing several metals. This exposure can lead to an increased risk for different health effects which serves as a driving force to develop new methods that generate less toxic fumes. The aim of this study was to explore the role of released metals for welding particle-induced toxicity and to test the hypothesis that a reduction of Cr(VI) in welding fumes results in less toxicity by comparing the welding fume particles of optimized Cr(VI)-reduced flux-cored wires (FCWs) to standard FCWs. The welding particles were thoroughly characterized, and toxicity (cell viability, DNA damage and inflammation) was assessed following exposure to welding particles as well as their released metal fraction using cultured human bronchial epithelial cells (HBEC-3kt, 5–100 µg/mL) and human monocyte-derived macrophages (THP-1, 10–50 µg/mL). The results showed that all Cr was released as Cr(VI) for welding particles generated using standard FCWs whereas only minor levels (< 3% of total Cr) were released from the newly developed FCWs. Furthermore, the new FCWs were considerably less cytotoxic and did not cause any DNA damage in the doses tested. For the standard FCWs, the Cr(VI) released in cell media seemed to explain a large part of the cytotoxicity and DNA damage. In contrast, all particles caused rather similar inflammatory effects suggesting different underlying mechanisms. Taken together, this study suggests a potential benefit of substituting standard FCWs with Cr(VI)-reduced wires to achieve less toxic welding fumes and thus reduced risks for welders.
RETRACTED ARTICLE: Curves with prescribed symmetry and associated representations of mapping class groups
Authors: Boggi Marco , Looijenga Eduard
Published: July 2021

Let C be a complex smooth projective algebraic curve endowed with an action of a finite group G such that the quotient curve has genus at least 3. We prove that if the G-curve C is very general for these properties, then the natural map from the group algebra $${{\mathbb {Q}}}G$$

Q
G

to the algebra of $${{\mathbb {Q}}}$$
Q
-endomorphisms of its Jacobian is an isomorphism. We use this to obtain (topological) properties regarding certain virtual linear representations of a mapping class group. For example, we show that the connected component of the Zariski closure of such a representation often acts $${{\mathbb {Q}}}$$
Q
-irreducibly in a G-isogeny space of $$H^1(C; {{\mathbb {Q}}})$$

H
1

(
C
;
Q
)

and with image a $${{\mathbb {Q}}}$$
Q
-almost simple group.
An anthropometric evaluation of the augmented breast: differences between cis-and transgender women and possible clinical implications
Authors: Wilhelmus Timmermans Floyd , Elisabeth Mokken Sterre , Scheffers Brian , Bouman Mark-Bram , Mullender Margriet , van de Grift Tim
Published: July 2021

Background

The morphometric results after breast augmentations are generally understood to be clinically different between trans(gender) and cis(gender) women. The objective of this study was to establish these morphometric differences between the augmented breasts of trans and cis women and their implications for preoperative planning and expectation management of trans women.

Methods

A single-center, observational cross-sectional study was conducted. Three-dimensional images (VECTRA) of the chest were taken and used to measure preset morphometric parameters. Subsequently, several proportional morphometric outcome variables were calculated. We compared body, breast, and nipple dimensions and their interdependence between trans and cis women. The main outcome sets were (1) the relative dimensions of the chest, (2) the position of the breasts relative to the chest, (3) and the position of the nipple relative to the breast and nipple size.

Results

A total of 22 transgender and 22 cisgender women were included. The results showed that the breasts of the trans women were positioned more cranial. Furthermore, the nipple-areola complexes (NAC) were significantly smaller and positioned relatively more latero-cranial on the breasts.

Conclusions

Morphological characteristics of augmented breasts differ significantly between trans and cis women. The results of this study identified distinct differences between the augmented breasts of trans and cis women. Because of the apparent differences in results, surgical considerations, expectation management, and shared decision-making should play an even more pronounced role in breast augmentations in trans women.

Level of evidence: Level III, risk/prognostic study.
Dietary fat intake and risk of disabling hearing impairment: a prospective population-based cohort study
Authors: Yévenes-Briones Humberto , Caballero Francisco Félix , Struijk Ellen A. , Lana Alberto , Rodríguez-Artalejo Fernando , Lopez-Garcia Esther
Published: July 2021

Purpose

To examine the associations of specific dietary fats with the risk of disabling hearing impairment in the UK Biobank study.

Methods

This cohort study investigated 105,592 participants (47,308 men and 58,284 women) aged ≥ 40 years. Participants completed a minimum of one valid 24-h recall (Oxford Web-Q). Dietary intake of total fatty acids, polyunsaturated fatty acids (PUFA), saturated fatty acids (SFA), and monounsaturated fatty acids (MUFA) was assessed at baseline. Functional auditory capacity was measured with a digit triplet test (DTT), and disabling hearing impairment was defined as a speech reception threshold in noise > − 3.5 dB in any physical exam performed during the follow-up.

Results

Over a median follow-up of 3.2 (SD: 2.1) years, 832 men and 872 women developed disabling hearing impairment. After adjustment for potential confounders, including lifestyles, exposure to high-intensity sounds, ototoxic medication and comorbidity, the hazard ratios (HRs), and 95% confidence interval (CI) of disabling hearing function, comparing extreme quintiles of intakes were 0.91 (0.71–1.17) for total fat, 1.09 (0.83–1.44) for PUFA, 0.85 (0.64–1.13) for SFA and 1.01 (0.74–1.36) for MUFA among men. Among women, HRs comparing extreme intakes were 0.98 (0.78–1.24) for total fat, 0.69 (0.53–0.91) for PUFA, 1.26 (0.96–1.65) for SFA, and 0.91 (0.68–1.23) for MUFA. Replacing 5% of energy intake from SFA with an equivalent energy from PUFA was associated with 25% risk reduction (HR: 0.75; 95% CI: 0.74–0.77) among women.

Conclusions

PUFA intake was associated with decreased risk of disabling hearing function in women, but not in men.
The categorical use of a continuous time representation
Authors: Beracci Alessia , Santiago Julio , Fabbri Marco
Published: July 2021

The abstract concept of time is mentally represented as a spatially oriented line, with the past associated with the left space and the future associated with the right. Although the line is supposed to be continuous, most available evidence is also consistent with a categorical representation that only discriminates between past and future. The aim of the present study was to test the continuous or categorical nature of the mental timeline. Italian participants judged the temporal reference of 20 temporal expressions by pressing keys on either the left or the right. In Experiment 1 (N = 32), all words were presented at the center of the screen. In Experiment 2 (N = 32), each word was presented on the screen in a central, left, or right position. In Experiment 3 (N = 32), all text was mirror-reversed. In all experiments, participants were asked to place the 20 temporal expressions on a 10-cm line. The results showed a clear Spatial–TEmporal Association of Response Codes (STEARC) effect which did not vary in strength depending on the location of the temporal expressions on the line. However, there was also a clear Distance effect: latencies were slower for words that were closer to the present than further away. We conclude that the mental timeline is a continuous representation that can be used in a categorical way when an explicit past vs. future discrimination is required by the task.
Patterns of airway obstruction of non-acquired origin in children with and without major congenital anomalies
Authors: Dias Rodrigo Gonçalves , Giger Roland , Latzin Philipp , Riva Thomas , Casaulta Carmen , Ulmer Francis , Jaquet Yves , Nisa Lluís
Published: July 2021

Major congenital anomalies are known to play a role in the management and prognosis of airway obstruction. Most studies assess acquired forms of airway obstruction. Data on congenital or otherwise non-acquired forms of airway obstruction is sparse. In this retrospective, single-institution cohort study, we sought to evaluate and compare the patterns of airway obstruction in children with and without major congenital anomalies, and to assess the impact of management and outcome, irrespective of aetiology. Fifty-five patients were included, 23 with and 32 without underlying major congenital anomalies. Multilevel airway obstruction (usually affecting the nasopharynx, oropharynx, and the trachea) was more common in children with congenital anomalies (91% vs. 41%, p < .001). Consequently, these children required more frequent and earlier surgical management, especially tracheostomy and adenotonsillar surgery.

Conclusions: Major congenital anomalies are associated with multilevel airway obstruction and poor functional prognosis. A simple clinical definition considering impact of major congenital anomalies on development and growth may help guide management plans following endoscopic evaluation of the entire airway and flanked by multidisciplinary discussions.

What is Known:• Children with major comorbidities display increased disease severity and more prevalent multilevel airway obstruction• Previous studies include both children with acquired and non-acquired forms of airway obstruction; therefore, the actual impact major comorbidities in children with non-acquired causes of airway obstruction remain unclear.

What is New:• A total of 42% children in this study population had major comorbidities with and impact on growth and/or psychomotor development, with a higher prevalence of multilevel airway obstruction and worse rates of functional improvement/recovery.• Children with major comorbidities require tracheostomy more often and earlier than those without major comorbidities, and remain tracheostomy-dependent for a longer time.
Anti-tumour effect of neo-antigen-reactive T cells induced by RNA mutanome vaccine in mouse lung cancer
Authors: Sun Jiaxing , Zhang Jing , Hu Haiyan , Qin Huan , Liao Ximing , Wang Feilong , Zhang Wei , Yin Qi , Su Xiaoping , He Yanan , Li Wenfeng , Wang Kun , Li Qiang
Published: July 2021

Purpose

Mutation-specific T-cell response to epithelial cancers and T-cell-based immunotherapy has been successfully used to treat several human solid cancers. We aimed to investigate the anti-tumour effect of neo-antigen-reactive T(NRT) cells induced by RNA mutanome vaccine, which may serve as a feasible and effective therapeutic approach for lung cancer.

Methods

We predicted candidate neo-antigens according to the mutant gene analysis by sequencing the mouse Lewis cells and C57BL/6 mouse tail tissue. RNA vaccine was prepared with the neo-antigens as the template. We assessed antitumor efficacy, cytokine secretion and pathological changes after adoptive transfer of NRT cells in vitro and vivo experiments.

Results

We identified 10 non-synonymous somatic mutations and successfully generated NRT cells. The percentage of T-cell activation proportion was increased from 0.072% in conventional T cells to 9.96% in NRT cells. Interferon-γ secretion augmented from 17.8 to 24.2% as well. As an in vivo model, adoptive NRT cell infusion could promote active T-cell infiltration into the tumour tissue and could delay tumour progression.

Conclusion

NRT cells induced by RNA mutanome vaccine exert a significant anti-tumour effect in mouse lung cancer, and adoptive NRT cell therapy might be considered a feasible, effective therapeutic approach for lung cancer.
Correction to: A local input-to-state stability result w.r.t. attractors of nonlinear reaction–diffusion equations
Authors: Dashkovskiy Sergey , Kapustyan Oleksiy , Schmid Jochen
Published: July 2021

The article “A local input-to-state stability result w.r.t. attractors of nonlinear reaction–diffusion equations” written by Sergey Dashkovskiy, Oleksiy Kapustyan, and Jochen Schmid, was originally published online on 6 May 2020, without Open Access.
Correction to: Temporary materials: comparison of in vivo and in vitro performance
Authors: Sari Tuğrul , Usumez Aslihan , Strasser Thomas , Şahinbas Abdurrahman , Rosentritt Martin
Published: July 2021

A Correction to this paper has been published: https://doi.org/10.1007/s00784-021-04067-4
Greenhouse Gas Balance of Sphagnum Farming on Highly Decomposed Peat at Former Peat Extraction Sites
Authors: Oestmann Jan , Tiemeyer Bärbel , Düvel Dominik , Grobe Amanda , Dettmann Ullrich
Published: July 2021

For two years, we quantified the exchange of carbon dioxide (CO2), methane (CH4) and nitrous oxide (N2O) at two different large-scale Sphagnum farming sites. At both, peat extraction left a shallow layer of highly decomposed peat and low hydraulic conductivities. One site was characterized by preceding multi-annual inundation and irrigated by ditches, while the other one was inoculated directly after peat extraction and irrigated by ditches and drip irrigation. Further, GHG emissions from an irrigation polder and the effect of harvesting Sphagnum donor material at a near-natural reference site were determined. GHG mitigation potentials lag behind the results of less decomposed sites, although our results were also affected by the extraordinary hot and dry summer 2018. CO2 exchanges ranged between -0.6 and 2.2 t CO2-C ha−1 y−1 and were mainly influenced by low water table depths. CH4 emissions were low with the exception of plots with higher Eriophorum covers, while fluctuating water tables and poorly developing plant covers led to considerable N2O emissions at the ditch irrigation site. The removal of the upper vegetation at the near-natural site resulted in increased CH4 emissions and, on average, lowered CO2 emissions. Overall, best plant growth and lowest GHG emissions were measured at the previously inundated site. At the other site, drip irrigation provided more favourable conditions than ditch irrigation. The size of the area needed for water management (ditches, polders) strongly affected the areal GHG balances. We conclude that Sphagnum farming on highly decomposed peat is possible but requires elaborate water management.
Corticosteroid injections in the temporomandibular joint temporarily alleviate pain and improve function in rheumatoid arthritis
Authors: Kroese Johanna Margaretha , Kopp Sigvard , Lobbezoo Frank , Alstergren Per
Published: July 2021

Objectives

To evaluate the effect of corticosteroid injections in the painful temporomandibular joint (TMJ) of patients with rheumatoid arthritis (RA) in relation to systemic inflammatory activity.

Method

Examination of 35 patients (median age 54 years; 89% female) included maximum mouth opening capacity, degree of anterior open bite (AOB), TMJ pain intensity at rest, and crepitus. Serum levels of rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), serotonin, and plasma levels of interleukine-1β (IL-1β) were determined. Out of the 70 examined joints, 53 joints received a corticosteroid (methylprednisolone) injection after the clinical examination at baseline (T0). The examination was repeated for all patients at T1 (median 3.1 weeks after T0), and for 21 patients at T2 (median 6.3 weeks after T1), of whom 20 patients received a second injection at T1.

Results

Maximum mouth opening capacity significantly increased, and TMJ pain intensity significantly decreased between T0 and T1, but these improvements were no longer present at T2. No differences were found in AOB between the time points. Of the joints that received an injection at T0, 19 joints had pretreatment crepitus, which resolved in eight joints at T1. No correlations were found between the change in mouth opening capacity or TMJ pain intensity and ESR, CRP, serotonin, or IL-1β.

Conclusions

Methylprednisolone injections in the TMJ alleviate pain and improve mouth opening capacity for approximately 3 weeks, allowing patients to perform jaw exercises during this timeframe of temporary relief. It thus seems useful for the short-term management of TMJ involvement in RA.Key Points•In rheumatoid arthritis, corticosteroid injection in the temporomandibular joint alleviates pain and improves function.•The clinical improvement achieved with methylprednisolone injections lasts for approximately 3 weeks.•Corticosteroid injections could be used to facilitate and support additional noninvasive, conservative treatment options.
Saving energy in residential buildings: the role of energy pricing
Authors: Ewald Jens , Sterner Thomas , Ó Broin Eoin , Mata Érika
Published: July 2021

A zero-carbon society requires dramatic change everywhere including in buildings, a large and politically sensitive sector. Technical possibilities exist but implementation is slow. Policies include many hard-to-evaluate regulations and may suffer from rebound mechanisms. We use dynamic econometric analysis of European macro data for the period 1990–2018 to systematically examine the importance of changes in energy prices and income on residential energy demand. We find a long-run price elasticity of −0.5. The total long-run income elasticity is around 0.9, but if we control for the increase in income that goes towards larger homes and other factors, the income elasticity is 0.2. These findings have practical implications for climate policy and the EU buildings and energy policy framework.
Paraneoplastic myelitis associated with durvalumab treatment for extensive-stage small cell lung cancer
Authors: Wang Lan , Lou Haiyan , Li Bo , Li Jun , Yang Yun-Mei
Published: July 2021

Paraneoplastic neurologic syndromes(PNSs) caused by immune checkpoint inhibitors(ICIs) is rare and requires clinicians to differentiate between disease progression and immune-related adverse effects(irAEs). We hereby report the case of immune-related myelitis accompanied by positive paraneoplastic autoantibodies following durvalumab treatment for extensive-stage small cell lung cancer (ES-SCLC). A 70-year-old Chinese woman with ES-SCLC was administered durvalumab with etoposid-platinum(EP) as first-line treatment. Four cycles after treatment with EP plus ICI, she developed immune-related myelitis with positive paraneoplastic autoantibodies (CV2, SOX1, ZIC4). Spinal MRI showed diffuse abnormal signal shadow in the cervicothoracic spinal cord. She was discontinued for chemotherapy, and treated with high-dose steroids, intravenous immunoglobulin and plasmapheresis, maintenance therapy with steroids resulted in a favorable neurologic outcome. This is the first report of durvalumab-related PNSs. We supposed that the development of paraneoplastic myelitis was causally related to immune activation by durvalumab. Prompt diagnosis and therapeutic intervention are essential for the effective treatment of paraneoplastic myelitis.
Transcatheter therapies for secondary mitral regurgitation in advanced heart failure: what are we aiming for?
Authors: Scotti Andrea , Munafò Andrea , Margonato Alberto , Godino Cosmo
Published: July 2021

A severe secondary mitral regurgitation (SMR) can be found in a significant portion of patients affected by advanced heart failure (AHF). Conventional therapies (optimal medical therapy, devices, surgery) present restricted clinical efficacy in this stage of the left ventricle disease which is burdened by high mortality and morbidity rates. Although the treatment of choice is represented by heart transplantation (HTx), there is an unmet need related to the limited supply of donor hearts (as opposed to the growing prevalence of AHF) and the low eligibility of highly symptomatic patients. In case of concomitant severe SMR, transcatheter mitral valve therapies (repair and replacement) may play a crucial role in this setting. While a direct prognostic improvement after correction of SMR has yet to be proved, AHF patients can benefit from the following: hemodynamic stabilization, symptomatic relief, normalization of pulmonary arterial pressures, and reduction in hospitalizations for acute heart failure. Obtaining these results may lead to the clinical consequences of reaching the HTx in good enough clinical status (bridge to heart transplantation), becoming eligible for the HTx (bridge to HTx candidacy), and being delisted for clinical improvement (bridge to recovery). Therefore, achieving traditional secondary endpoints in patients with AHF and SMR can translate into significant clinical implications.
Multimodal Wearable Intelligence for Dementia Care in Healthcare 4.0: a Survey
Authors: Yang Po , Bi Gaoshan , Qi Jun , Wang Xulong , Yang Yun , Xu Lida
Published: July 2021

As a new revolution of Ubiquitous Computing and Internet of Things, multimodal wearable intelligence technique is rapidly becoming a new research topic in both academic and industrial fields. Owning to the rapid spread of wearable and mobile devices, this technique is evolving healthcare from traditional hub-based systems to more personalised healthcare systems. This trend is well-aligned with recent “Healthcare 4.0” which is a continuous process of transforming the entire healthcare value chain to be preventive, precise, predictive and personalised, with significant benefits to elder care. But empowering the utility of multimodal wearable intelligence technique for elderly care like people with dementia is significantly challenging considering many issues, such as shortage of cost-effective wearable sensors, heterogeneity of wearable devices connected, high demand for interoperability, etc. Focusing on these challenges, this paper gives a systematic review of advanced multimodal wearable intelligence technologies for dementia care in Healthcare 4.0. One framework is proposed for reviewing the current research of wearable intelligence, and key enabling technologies, major applications, and successful case studies in dementia care, and finally points out future research trends and challenges in Healthcare 4.0.
Adverse Selection, Heterogeneous Beliefs, and Evolutionary Learning
Authors: Buchen Clemens , Palermo Alberto
Published: July 2021

We relax the common assumption of homogeneous beliefs in principal-agent relationships with adverse selection. Principals are competitors in the product market and write contracts also on the base of an expected aggregate. The model is a version of a cobweb model. In an evolutionary learning set-up, which is imitative, principals can have different beliefs about the distribution of agents’ types in the population. The resulting nonlinear dynamic system is studied. Convergence to a uniform belief depends on the relative size of the bias in beliefs.
Osteonecrosis of the jaw: a rare but possible side effect in thyroid cancer patients treated with tyrosine-kinase inhibitors and bisphosphonates
Authors: Lorusso L. , Pieruzzi L. , Gabriele M. , Nisi M. , Viola D. , Molinaro E. , Bottici V. , Elisei R. , Agate L.
Published: July 2021

Osteonecrosis of the jaw (ONJ) is a rare but very serious disease that can affect both jaws. It is defined as exposed bone in the maxillofacial region that does not heal within 8 weeks after a health care provider identification. ONJ can occur spontaneously or can be due to drugs like bisphosphonates (BPS) and anti-RANK agents, in patients with no history of external radiation therapy in the craniofacial region. Although in phase 3 trials of tyrosine kinase inhibitors (TKIs) used in thyroid cancer (TC) the ONJ was not reported among the most common side effects, several papers reported the association between ONJ and TKIs, both when they are used alone and in combination with a bisphosphonate. The appearance of an ONJ in a patient with metastatic radio-iodine refractory differentiated TC, treated with zoledronic acid and sorafenib, has put us in front of an important clinical challenge: when a ONJ occurred during TKIs treatment, it really worsens the patients’ quality of life. We should consider that in the case of ONJ a TKI discontinuation becomes necessary, and this could lead to a progression of neoplastic disease. The most important aim of this review is to aware the endocrinologists/oncologists dealing with TC to pay attention to this possible side effect of BPS and TKIs, especially when they are used in association. To significantly reduced the risk of ONJ, both preventive measures before initiating not only antiresorptive therapy but also antiangiogenic agents, and regular dental examinations during the treatment should always be proposed.
HatchEnsemble: an efficient and practical uncertainty quantification method for deep neural networks
Authors: Xia Yufeng , Zhang Jun , Jiang Tingsong , Gong Zhiqiang , Yao Wen , Feng Ling
Published: July 2021

Quantifying predictive uncertainty in deep neural networks is a challenging and yet unsolved problem. Existing quantification approaches can be categorized into two lines. Bayesian methods provide a complete uncertainty quantification theory but are often not scalable to large-scale models. Along another line, non-Bayesian methods have good scalability and can quantify uncertainty with high quality. The most remarkable idea in this line is Deep Ensemble, but it is limited in practice due to its expensive computational cost. Thus, we propose HatchEnsemble to improve the efficiency and practicality of Deep Ensemble. The main idea is to use function-preserving transformations, ensuring HatchNets to inherit the knowledge learned by a single model called SeedNet. This process is called hatching, and HatchNet can be obtained by continuously widening the SeedNet. Based on our method, two different hatches are proposed, respectively, for ensembling the same and different architecture networks. To ensure the diversity of models, we also add random noises to parameters during hatching. Experiments on both clean and corrupted datasets show that HatchEnsemble can give a competitive prediction performance and better-calibrated uncertainty quantification in a shorter time compared with baselines.
A weighted least squares optimisation strategy for medical image super resolution via multiscale convolutional neural networks for healthcare applications
Authors: Goyal Bhawna , Lepcha Dawa Chyophel , Dogra Ayush , Wang Shui-Hua
Published: July 2021

Medical imaging is an essential medical diagnosis system subsequently integrated with artificial intelligence for assistance in clinical diagnosis. The actual medical images acquired during the image capturing procedures generate poor quality images as a result of numerous physical restrictions of the imaging equipment and time constraints. Recently, medical image super-resolution (SR) has emerged as an indispensable research subject in the community of image processing to address such limitations. SR is a classical computer vision operation that attempts to restore a visually sharp high-resolution images from the degraded low-resolution images. In this study, an effective medical super-resolution approach based on weighted least squares optimisation via multiscale convolutional neural networks (CNNs) has been proposed for lesion localisation. The weighted least squares optimisation strategy that particularly is well-suited for progressively coarsening the original images and simultaneously extract multiscale information has been executed. Subsequently, a SR model by training CNNs based on wavelet analysis has been designed by carrying out wavelet decomposition of optimized images for multiscale representations. Then multiple CNNs have been trained separately to approximate the wavelet multiscale representations. The trained multiple convolutional neural networks characterize medical images in many directions and multiscale frequency bands, and thus facilitate image restoration subject to increased number of variations depicted in different dimensions and orientations. Finally, the trained CNNs regress wavelet multiscale representations from a LR medical images, followed by wavelet synthesis that forms a reconstructed HR medical image. The experimental performance indicates that the proposed model SR restoration approach achieve superior SR efficiency over existing comparative methods
Correction to: Betwixt and Between: Adolescent Transitions and Social Policy Lacunae in Ethiopia
Authors: Devonald Megan , Jones Nicola , Hamory Joan , Yadete Workneh
Published: July 2021

A Correction to this paper has been published: 10.1007/s41255-021–00019-y
Laboratory-Developed Tests: Design of a Regulatory Strategy in Compliance with the International State-of-the-Art and the Regulation (EU) 2017/746 (EU IVDR [In Vitro Diagnostic Medical Device Regulation])
Authors: Spitzenberger Folker , Patel Jaimin , Gebuhr Inga , Kruttwig Klaus , Safi Abdulrahim , Meisel Christian
Published: July 2021

Purpose

This study aimed at the development of a regulatory strategy for compliance of laboratory-developed tests (LDTs) with requirements of the Regulation (EU) 2017/746 (“EU-IVDR”) under consideration of international requirements for LDTs as established in major regulatory regions. Furthermore, it was analysed in how far elements of current LDT regulation could qualify for an internationally harmonised concept ensuring quality, safety and performance of LDTs.

Methods

A review of regulatory literature including legislation as well as guidance documents was performed. The regulatory strategy was adapted from international guidance concepts used for commercially marketed IVD. It was then applied to the example of a large medical laboratory in the EU. A high-level comparison was conducted to identify gaps and matches between the different international regulatory requirements for LDTs.

Results

A four-step strategy for compliance of LDTs with the EU IVDR was implemented in an exemplary medical laboratory. On the basis of an internationally used LDT definition, LDTs constitute nearly 50% of the total IVD devices used in the laboratory. While an ISO 15189-compliant QMS is a major component, it should be accompanied by the application of appropriate processes for risk management, performance evaluation and continuous monitoring of LDTs. At least six criteria represent common characteristics of a potential, internationally convergent concept for the regulation/standardization of LDTs.

Conclusions

This study confirms the impact of LDTs for individualized and innovative medical laboratory testing. Prerequisites for LDT use as especially given by the IVDR and missing interpretation in the EU with regard to the scope of LDT definition, the application of standards and the extent of documentation for LDTs currently lead to uncertainties for both laboratories and regulatory bodies responsible for LDT oversight. The characteristics identified as common criteria for ensuring quality, safety and performance of LDTs may be considered as central elements of future international consensus guidance.
Child maltreatment and protective assets in the development of internalising and externalising problems: A study of youth offenders
Authors: Li Dongdong , Ng Nyx , Chu Chi Meng , Oei Adam , Chng Grace , Ruby Kala
Published: July 2021

Introduction

An emerging trend in child maltreatment research focuses on identifying protective assets that contribute to youth resilience. Extending the trend, this study examines not just whether but also how protective assets in various domains (e.g., the individual, family, and schools) are associated with internalising and externalising problems among youth offenders, which is a population that typically reports a high prevalence of child maltreatment experiences.

Methods

This study used the baseline data of 790 youth offenders (85% male) aged between 12 and 19 years old from the EPYC project, a national longitudinal study in Singapore. Structural equation modelling was conducted to test the direct effects and interactive effects of protective assets and child maltreatment on internalising and externalising problems.

Results

For direct effects, maltreated youth offenders reported higher levels of internalising and externalising problems than their non‐maltreated counterparts. Higher levels of peer assets were directly related to lower levels of externalising, but not internalising problems. For interactive effects, overall protective assets, school/work assets and internal assets had significant buffering effects against physical/emotional abuse on externalising problems, whereas peer assets showed significant buffering effects against sexual abuse on internalising problems.

Conclusion

An overall level of protective assets, as well as assets from specific domains (peer, school/work, and internal assets) could provide protective effects on problematic behaviours among youth offenders. Interventions seeking to address youth internalising and externalising problems should focus on reducing child maltreatment incidence and enhancing protective assets within these domains.
Neurological and Head/Eyes/Ears/Nose/Throat Manifestations of COVID-19: A Systematic Review and Meta-Analysis
Authors: Ganesh Aravind , Reis Isabella R. , Varma Malavika , Patry David G. , Cooke Lara J.
Published: July 2021

Background/Objective:

Coronavirus disease 2019 (COVID-19) has been associated with various neurological and atypical head/eyes/ears/nose/throat (HEENT) manifestations. We sought to review the evidence for these manifestations.

Methods:

In this systematic review and meta-analysis, we compiled studies published until March 31, 2021 that examined non-respiratory HEENT, central, and peripheral nervous system presentations in COVID-19 patients. We included 477 studies for qualitative synthesis and 59 studies for meta-analyses.

Results:

Anosmia, ageusia, and conjunctivitis may precede typical upper/lower respiratory symptoms. Central nervous system (CNS) manifestations include stroke and encephalopathy, potentially with brainstem or cranial nerve involvement. MRI studies support CNS para-/postinfectious etiologies, but direct neuroinvasion seems very rare, with few cases detecting Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in the CNS. Peripheral nervous system (PNS) manifestations include muscle damage, Guillain–Barre syndrome (GBS), and its variants. There was moderate-to-high study heterogeneity and risk of bias. In random-effects meta-analyses, anosmia/ageusia was estimated to occur in 56% of COVID-19 patients (95% CI: 0.41–0.71, I2:99.9%), more commonly than in patients without COVID-19 (OR: 14.28, 95% CI: 8.39–24.29, I2: 49.0%). Neurological symptoms were estimated to occur in 36% of hospitalized patients (95% CI: 0.31–0.42, I2: 99.8%); ischemic stroke in 3% (95% CI: 0.03–0.04, I2: 99.2%), and GBS in 0.04% (0.033%–0.047%), more commonly than in patients without COVID-19 (OR[stroke]: 2.53, 95% CI: 1.16–5.50, I2: 76.4%; OR[GBS]: 3.43,1.15–10.25, I2: 89.1%).

Conclusions:

Current evidence is mostly from retrospective cohorts or series, largely in hospitalized or critically ill patients, not representative of typical community-dwelling patients. There remains a paucity of systematically gathered prospective data on neurological manifestations. Nevertheless, these findings support a high index of suspicion to identify HEENT/neurological presentations in patients with known COVID-19, and to test for COVID-19 in patients with such presentations at risk of infection.
Optimization of Man Power Deployment for Covid-19 Screening in a Tertiary Care Hospital: A Study of Utility of Queuing Analysis
Authors: Yadav Shakti Kumar , Singh Garima , Sarin Namrata , Singh Sompal , Gupta Ruchika
Published: July 2021

Objectives:

The recent Covid-19 pandemic has burdened the healthcare facilities, especially in the presence of limited infrastructure. We aimed at applying a queuing model to the Covid-19 screening area so as to optimize the screening services and ensuring that no patient is refused the service.

Methods:

The mean arrival time of patients, number of physicians, mean screening time and queue characteristics were observed and entered in the M/M/c/K queuing model using R programming to optimize the number of physicians required in the screening area.

Results:

Considering the mean arrival of 7 patients in 10 minutes and screening of 3 patients in 10 minutes by 1 physician, 2 physicians were assigned. At this capacity, the probability of saturation of the system was 15% with patient loss rate of 1.05 per 10 minutes. Queuing simulation with 3 physicians reduced the patient loss rate to 0.013 per 10 minutes and a saturation probability of 0.2%. However, an increase of arrival rate from 10 to 20 led to an early saturation of the system.

Conclusion:

Queuing models offer an opportunity for the healthcare providers and hospital administrators to optimize patient care services, especially in critical areas with an ever-changing situation such as the current pandemic.