bluuebunny/crossref_metadata_2025 huggingface dataset:
Uniaxial attitude control of uncrewed aerial vehicle with thrust vectoring under model variations by deep reinforcement learning and domain randomization
Authors: Osedo Atsushi , Wada Daichi , Hisada Shinsaku
Published: August 2023

The application of neural networks for nonlinear control has been actively studied in the field of aeronautics. Successful techniques have been demonstrated to achieve improved control performance in simulation using deep-reinforcement learning. To transfer the controller learnt in the simulation of real systems, domain randomization is an approach that encourages the adaptiveness of neural networks to changing environments through training with randomized parameters in environments. This approach applies to an extended context, with changing working environments, including model configurations. In previous studies, the adaptive performance of the domain-randomization-based controllers was studied in a comparative fashion over the model variations. To understand the practical applicability of this feature, further studies are necessary to quantitatively evaluate the learnt adaptiveness with respect to the training conditions. This study evaluates deep-reinforcement-learning and the domain-randomization-based controller, with a focus on its adaptive performance over the model variations. The model variations were designed to allow quantitative comparisons. The control performances were examined, with a specific highlight of whether the model variation ranges fell within or exceeded the randomization range in training.
Tazobactam/ceftolozane and tobramycin combination therapy in extensively drug-resistant Pseudomonas aeruginosa infections in severe burn injury: a case report
Authors: Ibe Yuta , Kakizaki Ryuichiro , Inamura Hirotoshi , Ishigo Tomoyuki , Fujiya Yoshihiro , Inoue Hiroyuki , Uemura Shuji , Fujii Satoshi , Takahashi Satoshi , Narimatsu Eichi , Fukudo Masahide
Published: August 2023

Background

Combination therapy with tazobactam/ceftolozane (TAZ/CTLZ) and high-dose aminoglycosides has been reported to be efficacious in extensively drug-resistant (XDR)-Pseudomonas aeruginosa infection. However, there are no reports of efficacy in XDR-P. aeruginosa infection for combination therapy with low-dose aminoglycosides and TAZ/CTLZ. Herein, we describe a rare case of severe burn injury patients with persistent bacteremia due to XDR-P. aeruginosa, which was successfully treated with TAZ/CTLZ and low-dose tobramycin (TOB).

Case presentation

A 31-year-old man was admitted to the intensive care unit with severe burn injury involving 52% of the total body surface area and a prognostic burn index of 79.5. The patient had recurrent bacterial infections since admission, and blood cultures collected on the 37th day of admission revealed the presence of P. aeruginosa strains that were resistant to all β-lactams and amikacin (AMK). The results of the antimicrobial synergistic study showed no synergistic effect of low-dose meropenem (MEPM) and AMK combination therapy. The patient had acute renal failure, and it was difficult to increase the dose of MEPM and AMK, respectively. Thus, we initiated TAZ/CTLZ 1.5 g/8 h instead of the AMK and MEPM combination therapy on the 43rd day of hospitalization. Low-dose TAZ/CTLZ was continued because of prolonged renal dysfunction and resulted in a transient clinical improvement. However, the dosage of TAZ/CTLZ could be increased as the renal function improved, but despite an increased TAZ/CTLZ dose, bacteremia persisted, and the blood cultures remained positive. Thus, TOB was added to TAZ/CTLZ at low doses for synergistic effect against Gram-negative bacteria. Blood cultures collected after initiation of combination therapy with TAZ/CTLZ and low-dose TOB were negative on two consecutive follow-up evaluations. Thereafter, although the patient had several episodes of fever and increased inflammatory response, blood cultures consistently tested negative, and all of the wounds healed. On the 93rd day, due to the good healing progress, the patient was transferred to another hospital.

Conclusions

TAZ/CTLZ and low-dose TOB combination therapy showed the potential for synergistic effects. Our present report suggests a novel synergistic treatment strategy for rare cases that are refractory to the treatment of infections, such as XDR-P. aeruginosa infection.
Long-term survival after multidisciplinary treatments for HER2-positive advanced gastric cancer with multiple liver and lung metastases
Authors: Yoshioka Satoshi , Takahashi Naoto , Fujisaki Muneharu , Takeshita Kenji , Takano Yuta , Yano Fumiaki , Toya Naoki , Eto Ken
Published: August 2023

Background

Trastuzumab-based chemotherapy is a standard treatment regimen for human epithelial growth factor 2 (HER2)-positive gastric cancer. This is a case of a patient who has survived 12 years after being diagnosed with advanced gastric cancer with multiple liver and lung metastases.

Case presentation

A woman in her 70s underwent total gastrectomy, cholecystectomy, and left hepatic lobectomy for gastric cancer with liver metastasis. One month after the surgery, multiple liver metastases appeared. After two courses of S-1 + CDDP chemotherapy, the liver metastases disappeared, and new lung metastases occurred. Because the primary tumor was HER2 positive, S-1 + CDDP + trastuzumab chemotherapy was performed. After one course of chemotherapy, the blood test showed pancytopenia, and CDDP was discontinued. S-1 + trastuzumab chemotherapy was then initiated, and as a result, the lung metastases disappeared. The patient is alive without recurrence 12 years after the surgery.

Conclusions

We encountered a case of long-term survival after multidisciplinary treatments for HER2-positive advanced gastric cancer with multiple liver and lung metastases.
Effects of marine sediment as agricultural substrate on soil microbial diversity: an amplicon sequencing study
Authors: Núñez-Gómez Dámaris , Melgarejo Pablo , Martínez-Nicolás Juan José , Hernández Francisca , Martínez-Font Rafael , Lidón Vicente , Legua Pilar
Published: August 2023

Background

The soil microbiota has a direct impact on plant development and other metabolic systems, such as the degradation of organic matter and the availability of microelements and metabolites. In the context of agricultural soils, microbial activity is crucial for maintaining soil health and productivity. Thus, the present study aimed to identify, characterize, and quantify the microbial communities of four types of substrates with varying proportions of marine port sediment used for cultivating lemons. By investigating microbial diversity and relative abundance, the work aimed to highlight the importance of soil microbial communities in agriculture when alternative culture media was used.

Results

The composition and structure of the sampled microbial communities were assessed through the amplification and sequencing of the V3-V4 variable regions of the 16 S rRNA gene The results revealed a diverse microbial community composition in all substrate samples, with a total of 41 phyla, 113 classes, 266 orders, 405 families, 715 genera, and 1513 species identified. Among these, Proteobacteria, Bacteroidota, Planctomycetota, Patescibacteria, Chloroflexi, Actinobacteriota, Acidobacteriota, Verrucomicrobiota, and Gemmatimonadota accounted for over 90% of the bacterial reads, indicating their dominance in the substrates.

Conclusions

The impact of the substrate origin on the diversity and relative abundace of the microbiota was confirmed. The higher content of beneficial bacterial communities for plant development identified in peat could explain why is considered an ideal agricultural substrate. Development of “beneficial for plants” bacterial communities in alternative agricultural substrates, regardless of the edaphic characteristics, opens the possibility of studying the forced and specific inoculation of these culture media aiming to be agriculturally ideals.
Input subsidies, public investments and agricultural productivity in India
Authors: Zafar Shadman , Aarif Mohammad , Tarique Md.
Published: August 2023

The fund allocation in agricultural sector in India is heavily tilted toward input subsidies provision; however, researchers seem to favor investment expenditure instead. The present paper seeks to compare the usefulness of input subsidies as compared to investment with regard to agricultural productivity so that policy makers hit the right tool and avoid less productive state expenditure. We investigated a total of four regression models using autoregressive and distributed lag cointegration in a time series framework covering period from 1983 to 2019. The first model considers all input subsidies in aggregate form, and the rest three models take input subsidies in disaggregate forms, namely fertilizer subsidy, irrigation subsidy and power subsidy, respectively. It is observed from the results that input subsidies still contribute more than what public investment does to agricultural productivity. It is also found that power subsidy is the most effective component of input subsidies followed by fertilizer subsidy. Hence, government expenditure on input subsidies is justified on the ground that it ensures all farmers to have access to affordable agricultural inputs. Targeted subsidies combined with adequate investment in agricultural infrastructure could deliver long-term agricultural development in India.
Reconstruction of the lost colonial architecture in the context of heritage tourism: Dutch Trading Post in Taiwan
Authors: Hsu Ping-hsiang
Published: August 2023

To strengthen brand identity, enrich tourist experiences, and promote heritage education, Taijiang National Park proposed to reconstruct Taiwan’s Dutch Trading Post in a different location from where it was initially erected in the 17th century. This paper is a case study of the reconstruction proposal for a lost colonial architectural complex in the context of heritage tourism. It discusses the practical and academic issues of rebuilding long-lost colonial heritage sites. The author provided a first-hand account of the technical and practical reasoning for reconstructing a bygone complex erected by Dutch settlers. Historical development phases of the Dutch Trading Post of Taiwan were first introduced, and then a reconstruction strategy was proposed to resolve conflicts with legal constraints. Additionally, a site selection process using GIS, a conceptually driven plan for reconstruction, and a 3D simulation were provided. Three specific issues in heritage rebuilding were further discussed, including the decision to reconstruct a heritage building (complex), the authenticity of the reconstructed building if done in a different location from where it was initially situated, and the need to discover more archaeological facts.
Field assessment of elastic full-waveform inversion of combined accelerometer and distributed acoustic sensing data in a vertical seismic profile configuration
Authors: Eaid Matthew V. , Keating Scott D. , Innanen Kristopher A. , Macquet Marie , Lawton Don
Published: August 2023

Seismic data are a significant facilitator for monitoring in carbon capture and sequestration projects, providing high-resolution images of fluid migration, using, for example, full-waveform inversion (FWI). Distributed acoustic sensing (DAS), a relatively novel technology for wavefield sampling, is well suited for this type of monitoring. Using noninvasive optical fibers, DAS allows for dense spatial sampling along the entire length of the wellbore, without disrupting operations. Permanently installed in the wellbore, typically behind casing, DAS offers highly repeatable and dense sampling of the transmitted wave modes crucial to seismic monitoring of injected carbon dioxide ([Formula: see text]). However, the DAS data consist of measurements of strain along the tangent of the fiber and therefore do not transfer directly to conventional FWI algorithms. Incorporation of DAS data in their native strain (or strain-rate) form in standard FWI algorithms, requires changing the definition of the receiver sampling operator to use geometric information about the fiber to supply tangential strain measurements to the FWI residual. The theoretical developments are applied to invert field vertical seismic profile data acquired with DAS fiber and accelerometers at a [Formula: see text] sequestration site in Newell Country, Alberta. Our method incorporates DAS data and accelerometer data in one objective function and allows us to tune the relative importance we wish to place on each data set. This method also transfers to noncollocated sensors, for example, surface-deployed geophones and borehole fiber. The inverted models contain features expected from the geology of the field site, and data modeled in the inverted models compare favorably with the field data for these sensor types. The models are derived from data acquired prior to [Formula: see text] injection, representing baseline models for future time-lapse studies planned at the field research station.
Gemcitabine and Cisplatin Versus Methotrexate, Vinblastine, Doxorubicin, and Cisplatin in Advanced or Metastatic Bladder Cancer: Results of a Large, Randomized, Multinational, Multicenter, Phase III Study
Authors: von der Maase H. , Hansen S.W. , Roberts J.T. , Dogliotti L. , Oliver T. , Moore M.J. , Bodrogi I. , Albers P. , Knuth A. , Lippert C.M. , Kerbrat P. , Sanchez Rovira P. , Wersall P. , Cleall S.P. , Roychowdhury D.F. , Tomlin I. , Visseren-Grul C.M. , Conte P.F.
Published: August 2023

PURPOSE: Gemcitabine plus cisplatin (GC) and methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) were compared in patients with locally advanced or metastatic transitional-cell carcinoma (TCC) of the urothelium.

PATIENTS AND METHODS: Patients with stage IV TCC and no prior systemic chemotherapy were randomized to GC (gemcitabine 1,000 mg/m2 days 1, 8, and 15; cisplatin 70 mg/m2 day 2) or standard MVAC every 28 days for a maximum of six cycles.

RESULTS: Four hundred five patients were randomized (GC, n = 203; MVAC, n = 202). The groups were well-balanced with respect to prognostic factors. Overall survival was similar on both arms (hazards ratio [HR], 1.04; 95% confidence interval [CI], 0.82 to 1.32; P = .75), as were time to progressive disease (HR, 1.05; 95% CI, 0.85 to 1.30), time to treatment failure (HR, 0.89; 95% CI, 0.72 to 1.10), and response rate (GC, 49%; MVAC, 46%). More GC patients completed six cycles of therapy, with fewer dose adjustments. The toxic death rate was 1% on the GC arm and 3% on the MVAC arm. More GC than MVAC patients had grade 3/4 anemia (27% v 18%, respectively) and thrombocytopenia (57% v 21%, respectively). On both arms, the RBC transfusion rate was 13 of 100 cycles and grade 3/4 hemorrhage or hematuria was 2%; the platelet transfusion rate was four patients per 100 cycles and two patients per 100 cycles on GC and MVAC, respectively. More MVAC patients, compared with GC patients, had grade 3/4 neutropenia (82% v 71%, respectively), neutropenic fever (14% v 2%, respectively), neutropenic sepsis (12% v 1%, respectively), and grade 3/4 mucositis (22% v 1%, respectively) and alopecia (55% v 11%, respectively). Quality of life was maintained during treatment on both arms; however, more patients on GC fared better regarding weight, performance status, and fatigue.

CONCLUSION: GC provides a similar survival advantage to MVAC with a better safety profile and tolerability. This better-risk benefit ratio should change the standard of care for patients with locally advanced and metastatic TCC from MVAC to GC.
DNA Encoding Strategy for the Identification and Quantification of Poorly Reactive Target Metabolite Using Phenylboronic Acid-tethered Oligodeoxynucleotides
Authors: Motohashi Yuto , Nishihara Tatsuya , Tanabe Kazuhito
Published: August 2023

Information about poorly reactive metabolites, lactate and glucose could be encoded into DNA sequences. The sequential reaction steps, including H2O2 generation between the target metabolites and their corresponding oxidase, the reaction between phenylboronic acid-tethered oligonucleotide and H2O2, and biotinylation of product DNA allow the DNA encoding strategy to identify and quantify the target metabolites.
Pivot from Pain to Productive: Conversations about Weight Management in Youth with Obesity
Authors: Williams Dominique R. , Fischer Anastasia N.
Published: August 2023

The prevalence of childhood obesity is almost 20% and affects 14.7 million youth. It is not a matter ofifbutwhenandhow oftensports medicine clinicians will care for patients with obesity. Considering the social, emotional, medical, and physical impact of obesity, we need a nuanced approach to communicate with patients and develop effective treatment plans to maintain or encourage physical activity. Neuromusculoskeletal impairments, physical complications, pain, biomechanical differences, and physical deconditioning act as potential barriers to treatment. This article introduces ways to pivot the conversation from musculoskeletal pain to a productive, well-received conversation about a holistic approach to weight management that also promotes physical activity and overall wellness in youth with obesity. Special attention is given to equipping clinicians with recommendations that incorporate the use of inclusive language, health behavior theories, and tenets of motivational interviewing to deliver equitable treatment regardless of body habitus.
Exercise is the Most Important Medicine for COVID-19
Authors: Torres Georgia , Constantinou Demitri , Gradidge Philippe , Patel Deepak , Patricios Jon
Published: August 2023

COVID-19 infection and long COVID affect multiple organ systems, including the respiratory, cardiovascular, renal, digestive, neuroendocrine, musculoskeletal systems, and sensory organs. Exerkines, released during exercise, have a potent crosstalk effect between multiple body systems. This review describes the evidence of how exerkines can mitigate the effects of COVID-19 in each organ system that the virus affects. The evidence presented in the review suggests that exercise should be considered a first-line strategy in the prevention and treatment of COVID-19 infection and long COVID disease.
THE RELATIONSHIP OF MEANING-LIFE ORIENTATIONS AND EDUCATIONAL AND PROFESSIONAL MOTIVATION OF RESIDENTS WITH DIFFERENT LEVELS OF PROFESSIONAL EXPERIENCE
Authors: Zinkevich Elena R. , Korgozha Maria A. , Yatsevich Natalya A.
Published: August 2023

Background. In the modern educational conditions of Russian reality, the pedagogical community of medical universities at the stage of postgraduate education pays great attention to the readiness of doctors for professional activities, which determines the conduct of research involving the study of the relationship between meaning-life orientations and educational and professional motivation of residents with different levels of professional experience. In the 2021-2022 academic year, a study illustrating the stated problems was conducted at the St. Petersburg State Pediatric Medical University at the Faculty of Clinical Psychology.

Purpose. To study the relationship between meaningful life orientations and educational and professional motivation of residents with different levels of professional experience.

Materials and methods. The present study involved 65 residents of 2 years of training in various clinical specialties, their average age is 25.5 years. The entire sample of study participants was divided into two subgroups according to the parameter of involvement in professional activities. This parameter was considered necessary for studying the relationship between meaning-life orientation and educational and professional motivation of residents.

Of the total number of respondents, 69% combined residency training with work in their specialty, 31% mastered the specialty at the stage of postgraduate education. Permission was obtained from the Ethics Committee of the St. Petersburg State Pediatric Medical University to organize the study. Respondents agreed to participate in the study. To evaluate the results, descriptive statistical methods, a comparative analysis using the U-Mann-Whitney criterion for explanatory variables and the Wilcoxon T-test for dependent variables, a correlation analysis of the relationships of indicators using the Spearman criterion, calculated using the STATISTICA 12.0 application package, were used.

Outcomes. The study allowed to form an idea of the relationship between meaning-life orientations and educational and professional motivation of residents with different levels of professional experience.

Conclusions. The results of the study will serve as the basis for rethinking the approaches to the organization of the educational process of students at the stage of residency, the search for ways of education and training that ensured the development of their educational and professional motivation and affect the formation of a system of meaning-life orientations.
Using quality improvement to tackle the triple aim for children and young people with asthma: improving outcomes, experience and costs
Authors: Aurelio Marco , Araujo Rita , Zoetmann Janeke , Moody Julia , Shah Amar
Published: August 2023

Background/Aims

Asthma in children and young people represents a substantial burden to the healthcare system, with these patients requiring frequent emergency care and having poorer health outcomes, leading to high system costs and poor patient experiences. This study used quality improvement methodology to achieve the triple aim of improved outcomes, better experience and reduced costs for those aged 0–16 years with asthma in north east London.

Methods

A multidisciplinary project team used quality improvement methods to implement and assess two interventions: a community high-risk asthma clinic and educational asthma-friendly school groups, both of which were delivered by a specialist asthma nurse. Population-level outcomes included asthma control test scores, accident and emergency department admissions and costs. Intervention-specific outcomes included number of clinic consultations delivered, did-not-attend rates and participant confidence ratings following the school sessions.

Results

Accident and emergency admissions for asthma reduced by 52%, with a 50% reduction in average monthly acute care costs. Asthma control test scores improved significantly, from an average of 18.56 to 22.34 out of a maximum score of 25 (P=0.000) following the interventions. Participants in the asthma-friendly school groups reported increased confidence in both day-to-day and emergency asthma management at the end of their sessions.

Conclusions

Having dedicated specialist asthma nurse input in the community and using school-based interventions can help to improve asthma care for children and young people, reducing the burden of frequent accident and emergency department admissions. Using quality improvement methods in pursuit of triple aim outcomes can help teams to work towards a shared goal.
CHANGES IN THE POSTERIOR TIBIAL SLOPE AND PATELLAR HEIGHT IN MEDIAL OPENING WEDGE HIGH TIBIAL OSTEOTOMIES: ARE THEY INEVITABLE OR SURGICAL ERRORS?
Authors: Mabrouk Ahmed , Ollivier Matthieu
Published: August 2023

Introduction

Changes in posterior tibial slope (PTS) and patellar height (PH) following proximal tibial osteotomies have been a recent focus for knee surgeons. Increased PTS and decreased PH following medial opening wedge high tibial osteotomy (MOWHTO) have been repeatedly reported in the literature. However, this has been disputed in more recent biomechanical studies.

Methodology

A total of 62 cases who underwent MOWHTO were included. Surgery was performed using a dedicated step-by-step protocol focusing on the risks of unintentional slope changes. Clinically, all patients were evaluated preoperatively and at 2 years follow-up with the KOOS scores and UCLA physical activity scale. Preoperative and postoperative radiographic lower limb alignment parameters were measured on full-length lower limb radiographs, including (HKA), (MPTA), (mLDFA), proximal posterior tibial angle (PPTA), (JLCA) and(JLO). PH measurements were assessed on radiographs.

Results

There was a significant change in the coronal plane alignment; the mMPTA changed from 84.38° to 90.39°, and the HKA changed from 172.19° to 180.15° (Both P < 0.0001). There was no significant change in the PTS as evidenced by a postoperative PPTA of 80.56 ° from a preoperative of 80.36°. And no significant change in the PH with all the indices; preoperative Caton Deschamps, Insall Salvati, and Schröter indices measured 0.95, 1.03, and 1.56, respectively. In comparison to postoperative measures of 0.93, 1.03, and 1.54, respectively.

Conclusion

MOWHTO does not change the PTS or PH when accurate preoperative planning and precise intraoperative freehand technique are adopted. Involuntary modification of these anatomic parameters should be considered surgical errors.
PREHABILITATION FOR FRAIL PATIENTS UNDERGOING TOTAL HIP OR KNEE ARTHROPLASTY: PROTOCOL FOR THE JOINT PREP FEASIBILITY RANDOMIZED CONTROLLED TRIAL
Authors: Khalid Tanzeela , Ben-Shlomo Yoav , Bertram Wendy , Culliford Lucy , England Clare , Henderson Emily , Jameson Catherine , Jepson Marcus , Palmer Shea , Whitehouse Michael , Wylde Vikki
Published: August 2023

Introduction

Frailty is associated with poorer outcomes after joint replacement. Targeting frailty pre-operatively via protein supplementation and exercise has the potential to improve outcomes after joint replacement. Before conducting a randomised controlled trial (RCT), a feasibility study is necessary to address key uncertainties and explore how to optimise trial design.

Methodology

Joint PREP is a feasibility study for a multicentre, two-arm, parallel group, pragmatic, RCT to evaluate the clinical and cost-effectiveness of prehabilitation for frail patients undergoing total hip or knee replacement. Sixty people who are ≥65 years of age, frail and scheduled to undergo total hip or knee replacement at 2–3 NHS hospitals will be recruited and randomly allocated on a 1:1 ratio to the intervention or usual care group. The intervention group will be given a daily protein supplement and will be asked to follow a home-based, tailored daily exercise programme for 12 weeks before their operation, supported by fortnightly telephone calls from a physiotherapist. Embedded qualitative research with patients will explore their experiences of participating, reasons for non-participation and/or reasons for withdrawal or treatment discontinuation.

Results

Outcomes to be assessed include eligibility, recruitment and retention rates; intervention adherence; acceptability of the trial and intervention; and data completion. Data collection is ongoing.

Discussion

This study will generate important data regarding the feasibility of a RCT to evaluate a prehabilitation intervention for frail patients undergoing joint replacement. A future RCT will contribute to the evidence on interventions to optimise the benefit that frail patients gain from joint replacement.
COBALT CHROMIUM DEBRIS RELEASE IN CONTEMPORARY TOTAL KNEE ARTHROPLASTY MAY BE AN UNDER-RECOGNIZED CLINICAL ISSUE
Authors: Langton David , Bhalekar Rohan , Wells Stephen , Nargol Matthew , Haston Shona , Natu Sonali , Nargol Antoni
Published: August 2023

Introduction

Several studies have reported significant cobalt(Co) and chromium(Cr) elevations in the blood of patients with total-knee-replacements (TKRs), and histological signs of metal sensitivity have been reported in up to 44% of patients undergoing revision of their TKRs. We carried out this investigation to determine the source and quantity of metal release in TKRs.

Methodology

We identified all TKRs with polished CoCr trays (N=59) [Vanguard=29, Attune=4 and PFC=26]. These were analysed using peer-reviewed [coordinate-measuring-machine (CMM)] methodology to measure the volumetric wear of the polyethylene (PE) bearing surfaces and trays. The trays were analysed using 2D-profilometry (surface roughness-Ra) and 4D-microscopy. Histological and blood metal ion concentration analyses were performed.

Results

The median(IQR) PE wear rate was 10(6to20) mm3/year. Microscopic analysis identified pitting on superior surface of 36(49%) trays. Ra [median (IQR)] of superior surface of pitted trays [0.076 (0.060–0.084) µm] showed a statistically significant increase (p<0.001) compared with unpitted trays [0.057(0.049–0.066) µm]. 4D-microscopy and CMM analysis estimated wear volumes of up to 2mm3 secondary to pitting. The median (range) Co and Cr concentrations were 2.5µg/l (0.2–69.4) and 1.7µg/l (0.5–12.5) respectively in 40 patients. Of the tissue samples examined in 30 patients,6 had at-least “mild”-ALVAL infiltrate. All corresponding “ALVAL” explants were found to be pitted and/or show evidence of loosening of the tray.

Conclusion

This study provides further evidence that CoCr release in TKR appears to be an under-recognised cause of adverse clinical outcomes. Gross metal ion elevations occurred in association with micromotion/loosening of the tray.
DEEP MEDIAL COLLATERAL LIGAMENT RECONSTRUCTION OF THE KNEE RESTORES ROTATIONAL STABILITY THROUGHOUT FULL RANGE OF MOTION WHILE CONTEMPORARY MCL RECONSTRUCTION ONLY DOES IN EXTENSION
Authors: Borque Kyle , Han Shuyang , Gold Jonathan , Sij Ethan , Laughlin Mitzi , Amis Andrew , Williams Andy , Noble Philip , Lowe Walter
Published: August 2023

Introduction

Historic MCL reconstruction techniques focused on the superficial MCL to restore valgus stability while overlooking tibial external rotation and the deep MCL. This study assessed the ability of a contemporary medial collateral ligament (MCL) reconstruction and a deep MCL (dMCL) reconstruction to restore rotational and valgus knee stability.

Methods

Six pairs fresh-frozen cadaveric knee specimens with intact soft tissue were tested in four states: 1) intact 2) after sMCL and dMCL sectioning, 3) contemporary MCL reconstruction (LaPrade et al), and 4) dMCL reconstruction. In each state, four loading conditions were applied at varying flexion angles: 8Nm valgus torque, 5Nm tibial external rotation torque, 90N anterior drawer, and combined 90N anterior drawer plus 5Nm tibial external rotation torque.

Results

Transection of the sMCL and dMCL resulted in increased laxity with valgus torque, external rotation torque, and combined anterior drawer plus external rotation. dMCL reconstruction restored external rotation stability to intact levels throughout all degrees of flexion but did not restore valgus stability at any flexion angle. Contemporary MCL reconstruction restored valgus and external rotation stability at 0° and 20° and valgus stability at 40°. In the combined anterior drawer plus tibial external rotation trial, the dMCL restored stability at 20° and improved stability between 40° and 90° flexion. Conversely, the contemporary MCL reconstruction did not restore stability at any degree of flexion.

Conclusion

Deep MCL reconstruction restored rotational stability to the knee throughout range of motion but not valgus stability. The contemporary MCL reconstruction restored stability only near full extension.
Excitation of surface plasmon resonance with sodium-based photonic crystal fiber for sensing applications
Authors: Yin Zhiyong , Jing Xili
Published: August 2023

Surface plasmon resonance (SPR) sensors using precious metal excitation have encountered bottlenecks in performance enhancement. To address this issue, we propose a photonic crystal fiber (PCF) sensor that utilizes a polymer-protected sodium film to excite the SPR effect. The PCF has hexagonally arranged air holes and a polishing plane. The sodium film is deposited on the polished plane and protected with polymethyl methacrylate or polydimethylsiloxane for refractive index sensing or temperature sensing. We analyzed this structure using the finite element method and found that the sodium-based SPR sensor has greater sensitivity, wider detection range, and higher figure of merit (FOM) than the SPR sensor using precious metal excitation. Numerical results showed that the maximum sensitivity was 35,400 nm/RIU, the widest detection range was 1.22–1.42, and the highest FOM was 3550RIU−1 at different sodium film thicknesses. When applied to temperature sensing, its maximum sensitivity is 20.5 nm/°C, and the temperature detection range is 0°C–100°C. In addition, our proposed sodium-based SPR fiber sensor is compatible with a thermo-assisted spin-coating process, so a good guideline scheme is available for the preparation. Therefore, our proposed sensor shows excellent potential in sensing and expands the application range of sodium-based plasma devices.
Spectrally efficient multi-service fiber-wireless access in low-cost direct-detection THz system at 300 GHz
Authors: Cai Yuancheng , Xiang Shitong , Zhu Min , Luo Wei , Lei Mingzheng , Zhang Jiao , Hua Bingchang , Zou Yucong , Fang Miaomiao , Tian Liang , Chen Xingyu , Yu Jianjun
Published: August 2023

This Letter demonstrates a novel, to the best of knowledge, overlapping single-sideband (OSSB) transmission scheme for spectrally efficient multi-service fiber-wireless (FiWi) access in a low-cost direct-detection (DD) THz system. Utilizing the proposed OSSB scheme, user data from different services can share the same spectrum resource yet can be successfully demodulated via one cost-effective DD THz receiver in conjunction with the Kramers–Kronig (KK) based SSB field reconstruction and look-up table (LUT) enabled signal separation algorithms. A proof-of-principle experiment is conducted. Based on an IQ modulator and a single THz zero-bias diode (ZBD), two independent 10-GBd quadrature phase shift keying (QPSK) signals with an overlapped spectrum are successfully demodulated after 20-km fiber and up to 3-m wireless transmission at the 300-GHz band. To the best of our knowledge, this is the first demonstration of multi-service FiWi access with an OSSB format in a 300-GHz DD THz system.
Photonic topological subspace-induced bound states in the continuum
Authors: Yan Wenchao , Liu Weijie , Cheng Weizhao , Chen Feng
Published: August 2023

Bound states in the continuum (BICs) are intriguing localized states that possess eigenvalues embedded within the continuum of extended states. Recently, a combination of topological band theory and BIC physics has given rise to a novel form of topological matter known as topological BICs. In this work, we experimentally demonstrate the photonic topological subspace-induced BICs. By using femtosecond-laser writing, we experimentally establish a photonic nontrivial three-leg ladder lattice, thereby directly observe the localized propagation of two kinds of topological edge states which exist at different boundaries. Interestingly, such edge states appear in the continuum of the bulk modes, and the topological properties are inherited from its independent subspace Hamiltonian which contains a celebrated Su–Schrieffer–Heeger lattice. This work not only presents a novel, to the best of our knowledge, platform for investigating topological physics in optics, but also unveils exciting prospects for future exploration of other remarkable BICs.
High-repetition-frequency, high-energy mid-infrared ZnGeP2 MOPA system with beam quality improvement
Authors: Fan Yuqing , Qian Chuanpeng , Liu Jing , Sun Jiaxin , Yu Ting , Shi Xiangchun , Ye Xisheng
Published: August 2023

A high-repetition-frequency and high-energy ZnGeP2 master oscillator power amplifier (ZGP-MOPA) system was demonstrated. The pump source was a 2097 nm Ho:YAG laser with average power of about 140 W and repetition frequency of 2 kHz. Using this pump source, the ZGP-MOPA system obtained a mid-wave infrared laser with a maximum power of 58.9 W and pulse width of 20.1 ns, corresponding to the pulse energy of 29.5 mJ. Under the condition of high thermal effect and high gain, the phenomenon of signal and idler beam waist separation was found in the process of measuring OPA beam quality. By adjusting the divergence of OPA seed source to match the divergence of pump source, the beam waist separation of signal and idler was reduced from 400 mm to 200 mm, the beam quality factor M2 of the ZGP-OPA was improved from 5.1 × 4.9 to 3.9 × 3.7(Horizontal directions × Vertical directions), the M2 of the signal was 2.7, and the M2 of the idler was 2.8.
Effective mechanical potential of cell–cell interaction explains three-dimensional morphologies during early embryogenesis
Authors: Koyama Hiroshi , Okumura Hisashi , Ito Atsushi M. , Nakamura Kazuyuki , Otani Tetsuhisa , Kato Kagayaki , Fujimori Toshihiko
Published: August 2023

Mechanical forces are critical for the emergence of diverse three-dimensional morphologies of multicellular systems. However, it remains unclear what kind of mechanical parameters at cellular level substantially contribute to tissue morphologies. This is largely due to technical limitations of live measurements of cellular forces. Here we developed a framework for inferring and modeling mechanical forces of cell–cell interactions. First, by analogy to coarse-grained models in molecular and colloidal sciences, we approximated cells as particles, where mean forces (i.e. effective forces) of pairwise cell–cell interactions are considered. Then, the forces were statistically inferred by fitting the mathematical model to cell tracking data. This method was validated by using synthetic cell tracking data resembling various in vivo situations. Application of our method to the cells in the early embryos of mice and the nematode Caenorhabditis elegans revealed that cell–cell interaction forces can be written as a pairwise potential energy in a manner dependent on cell–cell distances. Importantly, the profiles of the pairwise potentials were quantitatively different among species and embryonic stages, and the quantitative differences correctly described the differences of their morphological features such as spherical vs. distorted cell aggregates, and tightly vs. non-tightly assembled aggregates. We conclude that the effective pairwise potential of cell–cell interactions is a live measurable parameter whose quantitative differences can be a parameter describing three-dimensional tissue morphologies.
The effects of climate change on the ecology of fishes
Authors: Nagelkerken Ivan , Allan Bridie J. M. , Booth David J. , Donelson Jennifer M. , Edgar Graham J. , Ravasi Timothy , Rummer Jodie L. , Vergés Adriana , Mellin Camille
Published: August 2023

Ocean warming and acidification are set to reshuffle life on Earth and alter ecological processes that underpin the biodiversity, health, productivity, and resilience of ecosystems. Fishes contribute significantly to marine, estuarine, and freshwater species diversity and the functioning of marine ecosystems, and are not immune to climate change impacts. Whilst considerable effort has been placed on studying the effects of climate change on fishes, much emphasis has been placed on their (eco)physiology and at the organismal level. Fishes are affected by climate change through impacts at various levels of biological organisation and through a large variety of traits, making it difficult to make generalisations regarding fish responses to climate change. Here, we briefly review the current state of knowledge of climate change effects on fishes across a wide range of subfields of fish ecology and evaluate these effects at various scales of biological organisation (from genes to ecosystems). We argue that a more holistic synthesis of the various interconnected subfields of fish ecology and integration of responses at different levels of biological organisation are needed for a better understanding of how fishes and their populations and communities might respond or adapt to the multi-stressor effects of climate change. We postulate that studies using natural analogues of climate change, meta-analyses, advanced integrative modelling approaches, and lessons learned from past extreme climate events could help reveal some general patterns of climate change impacts on fishes that are valuable for management and conservation approaches. Whilst these might not reveal many of the underlying mechanisms responsible for observed biodiversity and community change, their insights are useful to help create better climate adaptation strategies for their preservation in a rapidly changing ocean.
Knowledge, attitudes, and practices associated with vitamin D supplementation: A cross-sectional online community survey of adults in the UK
Authors: Tanna Nuttan Kantilal , Karki Manisha , Webber Iman , Alaa Aos , El-Costa Austen , Blair Mitch
Published: August 2023

Objective

Assess knowledge, attitudes, and practices (KAPs) of a diverse population. Identify barriers and facilitators that inform routine vitamin D supplementation and self-care in the community setting.

Design

Cross-sectional online voluntary survey. Electronic survey link published on college Qualtrics platform and advertised widely. Study information provided with Participant Information Sheet.

Setting and participants

556 community dwelling adults across the UK.

Methods

The overarching study included two phases, incorporating quantitative and qualitative methodologies. This paper reports findings from the first phase of the FABCOM-D (Facilitators and Barriers to Community (Healthy) Vitamin D status) study. Online survey questions were iteratively developed after background literature searches and piloted to ensure clarity and ease of understanding. Survey responses summarised using frequencies and percentages, and univariable and multivariable logistic regression models explored for any association. A p-value less than 0.05 was considered statistically significant. The Checklist for Reporting Results of Internet E-Surveys guided reporting. Statistical analysis performed using IBM SPSS software.

Main outcome measures

Awareness of vitamin D information sources, health benefits and testing. Attitudes to supplementation, sun exposure and fortification.

Results

Three quarters of the community had some awareness of vitamin D and around half were taking supplements. The two most trusted sources of information included health professionals and the NHS website. Participants were willing to pay for supplements, supporting a self-care agenda. With increasing age, there was significant reduced intake of vitamin D supplements. This aspect needs to be explored further as this could be a concern in deficiency status in the elderly. There was acceptance of food fortification but uncertainty on how to balance food intake with supplementation.

Conclusion

We were successful in eliciting views on KAPs around vitamin D from a community population including a large proportion of Black and Minority Ethnic individuals. The community wanted information and guidance to help manage individual vitamin D status, especially for high-risk groups, and on balancing supplementation, food fortification and sun exposure.
Influence of N6-methyladenosine (m6A) modification on cell phenotype in Alzheimer’s disease
Authors: Ni Pengyun , Pan Kaiting , Zhao Bingbing
Published: August 2023

Objective

Recent research has suggested that m6A modification takes on critical significance to Neurodegeneration. As indicated by the genome-wide map of m6A mRNA, genes in Alzheimer’s disease model achieved significant m6A methylation. This study aimed to investigate the hub gene and pathway of m6A modification in the pathogenesis of AD. Moreover, possible brain regions with higher gene expression levels and compounds exerting potential therapeutic effects were identified. Thus, this study can provide a novel idea to explore the treatment of AD.

Methods

Differential expression genes (DEGs) of GSE5281 and GSE48350 from the Gene Expression Omnibus (GEO) database were screened using the Limma package. Next, the enrichment analysis was conducted on the screened DEGs. Moreover, the functional annotation was given for N6-methyladenosine (m6A) modification gene. The protein-protein interaction network (PPI) analysis and the visualization analysis were conducted using STRING and Cytoscape. The hub gene was identified using CytoHubba. The expression levels of Hub genes in different regions of brain tissue were analyzed based on Human Protein Atlas (HPA) database and Bgee database. Subsequently, the candidate drugs targeting hub genes were screened using cMAP.

Results

A total of 42 m6A modified genes were identified in AD (20 up-regulated and 22 down-regulated genes). The above-described genes played a certain role in biological processes (e.g., retinoic acid, DNA damage response and cysteine-type endopeptidase activity), cellular components (e.g., mitochondrial protein complex), and molecular functions (e.g., RNA methyltransferase activity and ubiquitin protein ligase). KEGG results suggested that the above-mentioned genes were primarily involved in the Hippo signaling pathway of neurodegeneration disease. A total of 10 hub genes were screened using the protein-protein interaction network, and the expression of hub genes in different regions of human brain was studied. Furthermore, 10 compounds with potential therapeutic effects on AD were predicted.

Conclusion

This study revealed the potential role of the m6A modification gene in Alzheimer’s disease through the bioinformatics analysis. The biological changes may be correlated with retinoic acid, DNA damage response and cysteine-type endopeptidase activity, which may occur through Hippo signaling pathway. The hub genes (SOX2, KLF4, ITGB4, CD44, MSX1, YAP1, AQP1, EGR2, YWHAZ and TFAP2C) and potential drugs may provide novel research directions for future prognosis and precise treatment.
The friendships of children and youth with attention-deficit hyperactivity disorder: A systematic review
Authors: Spender Katherine , Chen Yu-Wei Ryan , Wilkes-Gillan Sarah , Parsons Lauren , Cantrill Alycia , Simon Megan , Garcia Abbygale , Cordier Reinie
Published: August 2023

Background

Children with attention-deficit hyperactivity disorder (ADHD) experience substantial difficulty maintaining meaningful friendships, which has implications for social functioning and mental health. No systematic review has investigated their friendship difficulties.

Objectives

To systematically review and methodologically appraise the quality of existing studies reporting on friendships of children with ADHD. To compare their friendships to typically-developing children, and examine associations between friendship and children’s social-emotional wellbeing and mental health.

Method

Six databases were searched. The methodological quality of studies was assessed using the QualSyst appraisal tool and the Appraisal tool for Cross-Sectional Studies. Aspects of friendships measured were charted, along with comparisons between children with ADHD and typically-developing children and the associations between friendships and social-emotional wellbeing and mental health.

Results

Twenty-three cross-sectional studies and one longitudinal follow-up study were included. Studies included 1509 participants with ADHD, with 1197 typically-developing participants used as a companion in 19 of the 24 studies. Friendship quantity was the most investigated aspect of friendship. Children and youth with ADHD had significantly fewer friends, lower quality friendships and poorer friendship interactions. There were mixed findings from studies investigating the role or impact of friendship on social-emotional wellbeing and mental health. Twenty-two had strong methodological quality.

Conclusion

Limited longitudinal studies, small sample sizes and variability in measurement restrict the interpretations of friendship over time and the causal impact of friendship on social and emotional outcomes. Further research should investigate the role and impact of friendships on the social-emotional wellbeing of children and youth with ADHD.