bluuebunny/crossref_metadata_2025 huggingface dataset:
Anatomical pelvic loading of a monoblock polyethylene acetabular component
Authors: Young Peter S. , Macarico Daniela T. , Silverwood Robert K. , Farhan-Alanie Omer M. , Mohammed Aslam , Periasamy Kumar , Nicol Alice , Meek R. M. Dominic
Published: May 2021

Aims

Uncemented metal acetabular components show good osseointegration, but material stiffness causes stress shielding and retroacetabular bone loss. Cemented monoblock polyethylene components load more physiologically; however, the cement bone interface can suffer fibrous encapsulation and loosening. It was hypothesized that an uncemented titanium-sintered monoblock polyethylene component may offer the optimum combination of osseointegration and anatomical loading.

Methods

A total of 38 patients were prospectively enrolled and received an uncemented monoblock polyethylene acetabular (pressfit) component. This single cohort was then retrospectively compared with previously reported randomized cohorts of cemented monoblock (cemented) and trabecular metal (trabecular) acetabular implants. The primary outcome measure was periprosthetic bone density using dual-energy x-ray absorptiometry over two years. Secondary outcomes included radiological and clinical analysis.

Results

Although there were differences in the number of males and females in each group, no significant sex bias was noted (p = 0.080). Furthermore, there was no significant difference in age (p = 0.910) or baseline lumbar bone mineral density (BMD) (p = 0.998) found between any of the groups (pressfit, cemented, or trabecular). The pressfit implant initially behaved like the trabecular component with an immediate fall in BMD in the inferior and medial regions, with preserved BMD laterally, suggesting lateral rim loading. However, the pressfit component subsequently showed a reversal in BMD medially with recovery back towards baseline, and a continued rise in lateral BMD. This would suggest that the pressfit component begins to reload the medial bone over time, more akin to the cemented component. Analysis of postoperative radiographs revealed no pressfit component subsidence or movement up to two years postoperatively (100% interobserver reliability). Medial defects seen immediately postoperatively in five cases had completely resolved by two years in four patients.

Conclusion

Initially, the uncemented monoblock component behaved similarly to the rigid trabecular metal component with lateral rim loading; however, over two years this changed to more closely resemble the loading pattern of a cemented polyethylene component with increasing medial pelvic loading. This indicates that the uncemented monoblock acetabular component may result in optimized fixation and preservation of retroacetabular bone stock. Cite this article: Bone Joint J 2021;103-B(5):872–880.
The impact of Charlson and Elixhauser comorbidities on patient outcomes following shoulder arthroplasty
Authors: Ling Daphne I. , Schneider Brandon , Ode Gabriella , Lai Emily Y. , Gulotta Lawrence V.
Published: May 2021

Aims

To investigate the impact of the Charlson and Elixhauser comorbidity indices on patient-reported outcomes measures (PROMs) following shoulder arthroplasty.

Methods

Patients undergoing total shoulder arthroplasty (TSA), reverse shoulder arthroplasty (RSA), or hemiarthroplasty (HA) from 2016 to 2018 were identified, along with the Charlson and Elixhauser comorbidities listed as their secondary diagnoses in the electronic medical records. Patients were matched to our institution’s registry to obtain their PROMs, including shoulder-specific (American Shoulder and Elbow Society (ASES) and Shoulder Activity Scale (SAS)) and general health scales (12-Item Short Form Survey (SF-12) and Patient-Reported Outcomes Measurement Information System-Pain Interference). Linear regression models adjusting for age and sex were used to evaluate the association between increasing number of comorbidities and PROM scores. A total of 1,817 shoulder arthroplasties were performed: 1,017 (56%) TSA, 726 (40%) RSA, and 74 (4%) HA. The mean age was 67 years (SD 10), and 936 (52%) of the patients were female.

Results

The most common comorbidities were obesity (1,256, 69%) and hypertension (990, 55%). Patients with more comorbidities had lower ASES and SAS scores at baseline (p < 0.001). Elixhauser comorbidities continued to negatively impact ASES and SAS scores at one year (p = 0.002) and two-year follow-up (p = 0.002). Patients with more comorbidities reported greater pain interference on PROMIS at baseline (p = 0.007), but not at two years. Higher number of Charlson comorbidities were associated with lower scores on the SF-12 mental component at baseline (p < 0.001) and two years (p = 0.020). Higher number of Elixhauser comorbidities were associated with lower SF-12 physical component scores at baseline (p < 0.001) and two years (p = 0.004).

Conclusion

Higher number of comorbidities was associated with lower baseline scores and worse outcomes on both shoulder-specific and general health PROMs. The presence of specific comorbidities may be used during shared decision-making to manage expectations for patients undergoing shoulder arthroplasty. Cite this article: Bone Joint J 2021;103-B(5):964–970.
Tübingen hip flexion splint more successful than Pavlik harness for decentred hips after the age of three months
Authors: Lyu XueMin , Chen Tao , Yang Zheng , Fu Gang , Feng Chao , Zhang Tao , Lu Ming
Published: May 2021

Aims

The objective of this study was to evaluate the clinical and radiological outcomes of patients younger than six months of age with developmental dysplasia of the hip (DDH) managed by either a Pavlik harness or Tübingen hip flexion splint.

Methods

Records of 251 consecutive infants with a mean age of 89 days (SD 47), diagnosed with DDH between January 2015 and December 2018, were retrospectively reviewed. Inclusion criteria for patients with DDH were: younger than 180 days at the time of diagnosis; ultrasound Graf classification of IIc or greater; treatment by Pavlik harness or Tübingen splint; and no prior treatment history. All patients underwent hip ultrasound every seven days during the first three weeks of treatment and subsequently every three to four weeks until completion of treatment. If no signs of improvement were found after three weeks, the Pavlik harness or Tübingen splint was discontinued. Statistical analysis was performed.

Results

The study included 251 patients with Graf grades IIc to IV in 18 males and 233 females with DDH. Mean follow-up time was 22 months (SD 10). A total of 116 hips were graded as Graf IIc (39.1%), nine as grade D (3.0%), 100 as grade III (33.7%), and 72 as grade IV (24.2%). There were 109 patients (128 hips) in the Pavlik group and 142 patients (169 hips) in the Tübingen group (p = 0.227). The Tübingen group showed a 69.8% success rate in Graf III and Graf IV hips while the success rate was significantly lower in the Pavlik group, 53.9% (p = 0.033). For infants older than three months of age, the Tübingen group showed a 71.4% success rate, and the Pavlik group a 54.4% success rate (p = 0.047).

Conclusion

The Tübingen splint should be the preferred treatment option for children older than three months, and for those with severe forms of DDH such as Graf grade III and IV, who are younger than six months at time of diagnosis. The Tübingen hip flexion splint is a valid alternative to the Pavlik harness for older infants and those with more severe DDH. Cite this article: Bone Joint J 2021;103-B(5):991–998.
Spectrum allocation scheme considering spectrum slicing in elastic optical networks
Authors: Kitsuwan Nattapong , Akaki Kaito , Pavarangkoon Praphan , Nag Avishek
Published: May 2021

Recent advances in physical layer optics have made slicing of optical bands into multiple subbands with different bandwidths possible. Due to this development, spectrum allocation has become easier in elastic optical networks (EONs). More specifically, owing to the slicing technology, the defragmentation problem in EONs can be addressed easily, i.e., more demands can be fit into empty spectrum slots by breaking the demands as needed using the slicing technology. This paper proposes a spectrum allocation scheme considering the slicing process at any nodes, e.g., source node and intermediate nodes, in EONs. Slicing-and-stitching technology is applied to break the contiguous-spectrum constraint in an EON so that spectrum fragmentation is reduced. While slicing a demand from one node to another, the following questions must be answered: (1) Which parts of the spectrum band should be sliced? (2) In which node(s) along the path of a demand should the slicings be done to reduce the bandwidth blocking rate? To answer the above questions, we formulate a mixed-integer linear programming (MILP) model that jointly addresses the above questions as well as minimizes the total number of slicers in a network. To measure the performance of the MILP, we used the bandwidth blocking ratio (BBR) of the network as a performance metric. Our results from the MILP show that introducing slicing at every node in the network improves the BBR by as much as 68% compared to a conventional case where slicing a demand is allowed only at the source node.
Widely tunable silicon Raman laser
Authors: Ahmadi Mohammad , Shi Wei , LaRochelle Sophie
Published: May 2021

Stimulated Raman scattering is an effective means of wavelength conversion and can largely extend the operating spectral range of an optical source. We demonstrate a high-performance tunable Raman laser on a sub-micrometer-thick silicon on insulator wafer using a standard foundry process. The key feature to this laser is the use of a tunable coupling mechanism to adjust both pump and signal coupling coefficients in the ring cavity, allowing demonstration of laser emission over a large wavelength tuning range of 83 nm. This Raman laser demonstrates efficient (slope of up to 26% and a maximum pump-to-signal power conversion efficiency of 10%) on-chip nonlinear wavelength conversion. Our results indicate great promise for substantially increasing the optical spectral resources available on a silicon chip.
No pre-zygotic isolation mechanisms between Schistosoma haematobium and Schistosoma bovis parasites: From mating interactions to differential gene expression
Authors: Kincaid-Smith Julien , Mathieu-Bégné Eglantine , Chaparro Cristian , Reguera-Gomez Marta , Mulero Stephen , Allienne Jean-Francois , Toulza Eve , Boissier Jérôme
Published: May 2021

Species usually develop reproductive isolation mechanisms allowing them to avoid interbreeding. These preventive barriers can act before reproduction, “pre-zygotic barriers”, or after reproduction, “post-zygotic barriers”. Pre-zygotic barriers prevent unfavourable mating, while post-zygotic barriers determine the viability and selective success of the hybrid offspring. Hybridization in parasites and the underlying reproductive isolation mechanisms maintaining their genetic integrity have been overlooked. Using an integrated approach this work aims to quantify the relative importance of pre-zygotic barriers in Schistosoma haematobium x S. bovis crosses. These two co-endemic species cause schistosomiasis, one of the major debilitating parasitic diseases worldwide, and can hybridize naturally. Using mate choice experiments we first tested if a specific mate recognition system exists between both species. Second, using RNA-sequencing we analysed differential gene expression between homo- and hetero-specific pairing in male and female adult parasites. We show that homo- and hetero-specific pairing occurs randomly between these two species, and few genes in both sexes are affected by hetero-specific pairing. This suggests that i) mate choice is not a reproductive isolating factor, and that ii) no pre-zygotic barrier except spatial isolation “by the final vertebrate host” seems to limit interbreeding between these two species. Interestingly, among the few genes affected by the pairing status of the worms, some can be related to pathways affected during male and female interactions and may also present interesting candidates for species isolation mechanisms and hybridization in schistosome parasites.
Assessing selection procedures and roles of Community Health Volunteers and Community Health Management Committees in Ghana’s Community-based Health Planning and Services program
Authors: Sakeah Evelyn , Aborigo Raymond Akawire , Debpuur Cornelius , Nonterah Engelbert A. , Oduro Abraham Rexford , Awoonor-Williams John Koku
Published: May 2021

Background

Community participation in health care delivery will ensure service availability and accessibility and guarantee community ownership of the program. Community-based strategies such as the involvement of Community Health Volunteers (CHVs) and Community Health Management Committees (CHMCs) are likely to advance primary healthcare in general, but the criteria for selecting CHVs, CHMCs and efforts to sustain these roles are not clear 20 years after implementing the Community-based Health Planning Services program. We examined the process of selecting these cadres of community health workers and their current role within Ghana’s flagship program for primary care–the Community-based Health Planning and Services program.

Methods

This was an exploratory study design using qualitative methods to appraise the health system and stakeholder participation in Community-based Health Planning and Services program implementation in the Upper East region of Ghana. We conducted 51 in-depth interviews and 33 focus group discussions with health professionals and community members.

Results

Community Health Volunteers and Community Health Management Committees are the representatives of the community in the routine implementation of the Community-based Health Planning and Services program. They are selected, appointed, or nominated by their communities. Some inherit the position through apprenticeship and others are recruited through advertisement. The selection is mostly initiated by the health providers and carried out by community members. Community Health Volunteers lead community mobilization efforts, support health providers in health promotion activities, manage minor illnesses, and encourage pregnant women to use maternal health services. Community Health Volunteers also translate health messages delivered by health providers to the people in their local languages. Community Health Management Committees mobilize resources for the development of Community-based Health Planning and Services program compounds. They play a mediatory role between health providers in the health compounds and the community members. Volunteers are sometimes given non-financial incentives but there are suggestions to include financial incentives.

Conclusion

Community Health Volunteers and Community Health Management Committees play a critical role in primary health care. The criteria for selecting Community Health Volunteers and Community Health Management Committees vary but need to be standardized to ensure that only self-motivated individuals are selected. Thus, CHVs and CHMCs should contest for their positions and be endorsed by their community members and assigned roles by health professionals in the CHPS zones. Efforts to sustain them within the health system should include the provision of financial incentives.
The persuasive power of robot touch. Behavioral and evaluative consequences of non-functional touch from a robot
Authors: Hoffmann Laura , Krämer Nicole C.
Published: May 2021

The unique physical embodiment of robots enables physical contact between machines and humans. Since interpersonal touch research has demonstrated that touch has several positive behavioral (e.g., reduced stress, better immune functioning) as well as evaluative consequences (e.g., better evaluation of the initiator of touch), the question arises whether touch from a humanoid robot, the body of which is somewhat similar to that of a human, can evoke similar effects. To answer this question, we conducted a between-subjects experiment in the laboratory withn= 48 students who encountered a humanoid robot (Softbank Robotics’ NAO) that either did or did not touch their hand in a non-functional manner during a counseling conversation. The analyses of participants’ behavior revealed that they mostly reacted by smiling and laughing. Furthermore, participants who were touched by the robot complied significantly more frequently with a request posed by the robot during conversation, and reported better feelings compared to those who were not touched. However, there were no effects of robot touch on subjective evaluations of the robot or on the interaction experience.
A city of cities: Measuring how 15-minutes urban accessibility shapes human mobility in Barcelona
Authors: Graells-Garrido Eduardo , Serra-Burriel Feliu , Rowe Francisco , Cucchietti Fernando M. , Reyes Patricio
Published: May 2021

As cities expand, human mobility has become a central focus of urban planning and policy making to make cities more inclusive and sustainable. Initiatives such as the “15-minutes city” have been put in place to shift the attention from monocentric city configurations to polycentric structures, increasing the availability and diversity of local urban amenities. Ultimately they expect to increase local walkability and increase mobility within residential areas. While we know how urban amenities influence human mobility at the city level, little is known about spatial variations in this relationship. Here, we use mobile phone, census, and volunteered geographical data to measure geographic variations in the relationship between origin-destination flows and local urban accessibility in Barcelona. Using a Negative Binomial Geographically Weighted Regression model, we show that, globally, people tend to visit neighborhoods with better access to education and retail. Locally, these and other features change in sign and magnitude through the different neighborhoods of the city in ways that are not explained by administrative boundaries, and that provide deeper insights regarding urban characteristics such as rental prices. In conclusion, our work suggests that the qualities of a 15-minutes city can be measured at scale, delivering actionable insights on the polycentric structure of cities, and how people use and access this structure.
Telenomus nizwaensis (Hymenoptera: Scelionidae), an important egg parasitoid of the pomegranate butterfly Deudorix livia Klug (Lepidoptera: Lycaenidae) in Oman
Authors: Polaszek A. , Al-Riyami A. , Lahey Z. , Al-Khatri S. A. , Al-Shidi R. H. , Hardy I. C. W.
Published: May 2021

The pomegranate butterfly Deudorix (= Virachola) livia is the major pest of pomegranate, a crop of economic importance, in Oman. A species of parasitoid wasp in the hymenopteran family Scelionidae is responsible for high levels of mortality of its eggs. This wasp is described herein as Telenomus nizwaensis Polaszek sp. n., based on morphology and DNA sequence data. T. nizwaensis is currently known only from D. livia, which is also a pest of economic importance on other crops in North Africa, the Arabian Peninsula, and the Mediterranean. We summarise current knowledge of T. nizwaensis life-history and its potential to provide biological pest control.
A synopsis of Salvatoria McIntosh, 1885 (Annelida: Syllidae: Exogoninae) from Brazilian coastal and oceanic waters
Authors: Nascimento Rodolfo Leandro , Fukuda Marcelo Veronesi , Paresque Karla , Nogueira João Miguel de Matos , Paiva Paulo Cesar de
Published: May 2021

We compiled the records for the genusSalvatoriafrom Brazilian coastal and oceanic habitats, collected by several projects along the years. Here we present 12 species, eight of which already reported–S.breviarticulatacomb. nov.,S.clavata,S.euritmica,S.heterocirra,S.limbata,S.longiarticulatacomb. nov.,S.neapolitanaandS. cf.nitidula–with comments regarding the confidence of some of these records. We also describe three new species,S.marielleaen. sp.andSalvatoria nitiduloidesn. sp., based on material from Fernando de Noronha and Trindade islands, off the Northeastern Brazilian coast, andS.ypsiloidesn. sp., from Fernando de Noronha and also, Campos Basin, off Southeastern Brazilian coast, in depths down to 970 m. Finally, we report a probably undescribed species,Salvatoriasp., represented by only one specimen lacking median antenna, preventing us to proceed with further identification properly. A dichotomous identification key and a comparative table with morphological data of specimens belonging to these species are also provided.
An estimation of the financial consequences of reducing pig aggression
Authors: Peden Rachel S. E. , Turner Simon P. , Camerlink Irene , Akaichi Faical
Published: May 2021

Animal welfare scientists have accumulated knowledge and developed interventions to improve livestock welfare, but these are poorly adopted in commercial practice. Animal welfare interventions are rarely tested for economic viability and this limits their uptake. This study employs Stochastic Partial Budgeting (SPB) to determine the viability of animal welfare improvements. Aggression between pigs is used as an example because there is a large literature base from which to draw interventions, and the problem has persisted for decades without resolution. Costs and benefits of three interventions to control aggression (pre-weaning socialisation, synthetic maternal pheromones and large social groups) were estimated by reviewing the academic and industry literature and by conducting a survey of sixteen pig farmers. The net effects were compared to farmers’ willingness to pay (WTP) for interventions to reduce aggression as identified by recent research. Results are consistent with prior research which indicates that improving animal welfare generally comes at a cost to producers. Nevertheless, pre-weaning socialisation resulted in a neutral or positive net effect 38% of the time and should be central to campaigns promoting the control of aggression in the industry. Exposing pigs to synthetic maternal pheromones did not improve profitability but the net costs were small and within the realms of WTP for a sub-group of farmers with animal welfare goals. The net costs of converting existing buildings in order to house pigs in large social groups were beyond the realms of farmers’ WTP. The approach adopted in this study, of combining SPB with WTP from the sector, should be extended to other animal welfare issues.
Mobile-phone-based e-diary derived patient reported outcomes: Association with clinical disease activity, psychological status and quality of life of patients with multiple sclerosis
Authors: Golan Daniel , Sagiv Smadar , Glass-Marmor Lea , Miller Ariel
Published: May 2021

Background

The applicability of mobile digital technology to promote clinical care of people with multiple sclerosis (pwMS) is gaining increased interest as part of the implementation of patient-centered approaches. We aimed at assessing adherence to a smartphone-based e-diary, which was designed to collect patient-reported outcomes (PROs). Secondary objectives were to evaluate the construct and predictive validity of e-diary derived PROs and to explore the various factors that were associated with changes in PROs over time.

Materials and methods

In this observational cohort study patients downloaded an MS tailored e-diary into their personal smartphones. Report of PROs was enquired once monthly for a period of one year through a smartphone-based application, using previously validated tools. An e-diary derived bodily function summary score (eBF) was defined as the sum of scores depicting vision, limbs function, pain, bowl/ bladder dysfunction, pseudobulbar affect and spasticity. Multiple linear regression and analysis of covariance were used to determine the association between PROs, clinician-reported outcomes (ClinROs) of disease activity and quality of life (QoL). Regression coefficient analysis was used to compare the slope of change in eBF before and after a relapse.

Results

97 pwMS downloaded the e-diary [Female: 64 (66%), EDSS 3.4±2.1]. 76 patients (78%) completed the 12-month study period. 53 patients (55%) submitted ≥75% of requested surveys. Anxiety was negatively associated with adherence to periodic PROs assessments by the e-diary. E-diary derived PROs were significantly correlated with corresponding functional system scores (0.38< r <0.8, P<0.001). eBF score significantly predicted QoL (β = -0.36, P = 0.001) while EDSS did not. Change in eBF score over time was independently associated with the occurrence of an MS relapse (F = 4.4, P = 0.04), anxiety (F = 6.4, P = 0.01) and depression (F = 5.1, P = 0.03). Individual regression slopes of eBF scores were significantly higher pre-relapse than post-relapse (3.0±3.3 vs. -0.8±2.0, P = 0.007).

Conclusion

Adherence of pwMS to recording in an e-diary collecting PROs was high. Changes in e-diary derived PROs over time predict clinical MS relapses on the group level and thus carry the potential of usage in clinical research as well as for improved MS care in real world setting.
How does reorganisation in child and adolescent mental health services affect access to services? An observational study of two services in England
Authors: Fazel Mina , Rocks Stephen , Glogowska Margaret , Stepney Melissa , Tsiachristas Apostolos
Published: May 2021

Background

Child and Adolescent Mental Health Services (CAMHS) in England are making significant changes to improve access and effectiveness. This ‘transformation’ variously involves easier access to services through a Single Point of Access (SPA), more integrated services within CAMHS and enhanced co-provision across education and third sector or non-profit organisations.

Methods

A mixed-methods observational study was conducted to explore the process and impact of transformation over four years in two services. Ethnographic observations and in-depth interviews were conducted and Electronic Patient Records with over one million contacts analysed. Difference-in-differences analysis with propensity score matching to estimate the causal impact of the transformation on patient access was utilised.

Outcomes

Spend and staffing increased across both CAMHS. The SPA had growing rates of self-referral and new care pathways were seeing patients according to expected degree of psychopathology. Third sector partners were providing increasing numbers of low-intensity interventions. Although the majority of staff were supportive of the changes, the process of transformation led to service tensions.

In the first year after transformation there was no change in the rate of new patients accessing services or new spells (episodes of care) in the services. However, by year three, the number of new patients accessing CAMHS was 19% higher (Incidence Rate Ratio: 1·19, CI: 1·16, 1·21) and the rate of new spells was 12% higher (Incidence Rate Ratio: 1·12, CI: 1·05, 1·20).

Interpretation

Transformation investment, both financial and intellectual, can help to increase access to CAMHS in England, but time is needed to realise the benefits of reorganisation.
Exercise-induced Nogo-A influences rodent motor learning in a time-dependent manner
Authors: Stehle Jörg H. , Sheng Zhiyuan , Hausmann Laura , Bechstein Philipp , Weinmann Oliver , Hernesniemi Juha , Neimat Joseph S. , Schwab Martin E. , Zemmar Ajmal
Published: May 2021

The adult, mature central nervous system (CNS) has limited plasticity. Physical exercising can counteract this limitation by inducing plasticity and fostering processes such as learning, memory consolidation and formation. Little is known about the molecular factors that govern these mechanisms, and how they are connected with exercise. In this study, we used immunohistochemical and behavioral analyses to investigate how running wheel exercise affects expression of the neuronal plasticity-inhibiting protein Nogo-A in the rat cortex, and how it influences motor learningin vivo. Following one week of exercise, rats exhibited a decrease in Nogo-A levels, selectively in motor cortex layer 2/3, but not in layer 5. Nogo-A protein levels returned to baseline after two weeks of running wheel exercise. In a skilled motor task (forelimb-reaching), administration of Nogo-A function-blocking antibodies over the course of the first training week led to improved motor learning. By contrast, Nogo-A antibody application over two weeks of training resulted in impaired learning. Our findings imply a bimodal, time-dependent function of Nogo-A in exercise-induced neuronal plasticity: While an activity-induced suppression of the plasticity-inhibiting protein Nogo-A appears initially beneficial for enhanced motor learning, presumably by allowing greater plasticity in establishing novel synaptic connections, this process is not sustained throughout continued exercise. Instead, upregulation of Nogo-A over the course of the second week of running wheel exercise in rats implies that Nogo-A is required for consolidation of acquired motor skills during the delayed memory consolidation process, possibly by inhibiting ongoing neuronal morphological reorganization to stabilize established synaptic pathways. Our findings suggest that Nogo-A downregulation allows leaning to occur, i.e. opens a ‘learning window’, while its later upregulation stabilizes the learnt engrams. These findings underline the importance of appropriately timing of application of Nogo-A antibodies in future clinical trials that aim to foster memory performance while avoiding adverse effects.
Nutritional markers of undiagnosed type 2 diabetes in adults: Findings of a machine learning analysis with external validation and benchmarking
Authors: De Silva Kushan , Lim Siew , Mousa Aya , Teede Helena , Forbes Andrew , Demmer Ryan T. , Jönsson Daniel , Enticott Joanne
Published: May 2021

Objectives

Using a nationally-representative, cross-sectional cohort, we examined nutritional markers of undiagnosed type 2 diabetes in adults via machine learning.

Methods

A total of 16429 men and non-pregnant women ≥ 20 years of age were analysed from five consecutive cycles of the National Health and Nutrition Examination Survey. Cohorts from years 2013–2016 (n = 6673) was used for external validation. Undiagnosed type 2 diabetes was determined by a negative response to the question “Have you ever been told by a doctor that you have diabetes?” and a positive glycaemic response to one or more of the three diagnostic tests (HbA1c > 6.4% or FPG >125 mg/dl or 2-hr post-OGTT glucose > 200mg/dl). Following comprehensive literature search, 114 potential nutritional markers were modelled with 13 behavioural and 12 socio-economic variables. We tested three machine learning algorithms on original and resampled training datasets built using three resampling methods. From this, the derived 12 predictive models were validated on internal- and external validation cohorts. Magnitudes of associations were gauged through odds ratios in logistic models and variable importance in others. Models were benchmarked against the ADA diabetes risk test.

Results

The prevalence of undiagnosed type 2 diabetes was 5.26%. Four best-performing models (AUROC range: 74.9%-75.7%) classified 39 markers of undiagnosed type 2 diabetes; 28 via one or more of the three best-performing non-linear/ensemble models and 11 uniquely by the logistic model. They comprised 14 nutrient-based, 12 anthropometry-based, 9 socio-behavioural, and 4 diet-associated markers. AUROC of all models were on a par with ADA diabetes risk test on both internal and external validation cohorts (p>0.05).

Conclusions

Models performed comparably to the chosen benchmark. Novel behavioural markers such as the number of meals not prepared from home were revealed. This approach may be useful in nutritional epidemiology to unravel new associations with type 2 diabetes.
Perceptions on respectful maternity care in Sri Lanka: Study protocol for a mixed-methods study of patients and providers
Authors: Patabendige Malitha , Agampodi Suneth Buddhika , Jayawardane Asanka , Wickramasooriya Denagamage Jayamini , Agampodi Thilini Chanchala
Published: May 2021

Background

Over the past few decades, interest in providing and measuring Respectful Maternity Care (RMC) has increased markedly. Sri Lanka is reportedly shown to have better maternal health statistics and studies on quality improvement are lacking in this unique population. We aim to describe healthcare providers’ perceptions and women’s expectations, perceptions and their gaps in service provision regarding RMC in Sri Lanka.

Methods

A descriptive cross-sectional study with a mixed-methods approach comprising of qualitative component followed by a quantitative component will be conducted in Castle Street Hospital for Women (CSHW) and De Soysa Hospital for Women (DSHW), Colombo, Sri Lanka. Healthcare providers (HCP- doctors, nurses and midwives) and vaginally delivered postnatal women (in postnatal wards and postnatal well-baby clinics) will be recruited through convenience sampling. In-depth interviews will be conducted with each of the four categories. Thematic analysis will be adopted to analyze qualitative data and the findings will further be used to improve the quantitative phase questionnaires. Self-administered questionnaire will be administered to a 378 vaginally delivered postnatal women [quota sampling across ten wards], exploring demographic details, and maternal opinion on various aspects of RMC. Locally validated Women’s Perceptions of RMC tool (WP-RMC) will also be used to measure the level of RMC among these postnatal women along with the questionnaire 01. Qualitative findings will be used for cognitive validation of the WP-RMC into the Sri Lankan setting.

Discussion

This study will explore HCP’s and women’s expectations, perceptions and their gaps in service provision regarding RMC in two maternity hospitals in Sri Lanka. Assessment of the quality of care with regards to RMC have not been reported previously in this setting.
Transient reprogramming of postnatal cardiomyocytes to a dedifferentiated state
Authors: Kisby Thomas , de Lázaro Irene , Stylianou Maria , Cossu Giulio , Kostarelos Kostas
Published: May 2021

In contrast to mammals, lower vertebrates are capable of extraordinary myocardial regeneration thanks to the ability of their cardiomyocytes to undergo transient dedifferentiation and proliferation. Somatic cells can be temporarily reprogrammed to a proliferative, dedifferentiated state through forced expression of Oct3/4, Sox2, Klf4 and c-Myc (OSKM). Here, we aimed to induce transient reprogramming of mammalian cardiomyocytes in vitro utilising an OSKM-encoding non-integrating vector. Reprogramming factor expression in postnatal rat and mouse cardiomyocytes triggered rapid but limited cell dedifferentiation. Concomitantly, a significant increase in cell viability, cell cycle related gene expression and Ki67 positive cells was observed consistent with an enhanced cell cycle activation. The transient nature of this partial reprogramming was confirmed as cardiomyocyte-specific cell morphology, gene expression and contractile activity were spontaneously recovered by day 15 after viral transduction. This study provides the first evidence that adenoviral OSKM delivery can induce partial reprogramming of postnatal cardiomyocytes. Therefore, adenoviral mediated transient reprogramming could be a novel and feasible strategy to recapitulate the regenerative mechanisms of lower vertebrates.
Structure and species composition of diatom community during the wet season in three floodplain lakes of Brazilian Pantanal
Authors: Nardelli Margaret S. , Bicudo Denise C. , Sampaio Silvio C. , Cordovil Cláudia M. d. S.
Published: May 2021

In order to access environmental conditions, the use of bioindicators that have a close relationship with environmental stressors is a largely common practice, but when evaluating environmental inferences, the individual dominant taxa need to be interpreted. Humid regions such as the marshlands are fragile ecosystems and sustain communities of microalgae, often used as bioindicators, of which diatoms are a good example. Although they provide an excellent response to chemical and physical changes in water, diatom studies in surface sediments in wetlands are scarce worldwide. To determine whether diatom species have the potential to provide unambiguous inferences in the influence of environmental factors, we have evaluated diatom abundance in surface sediment, from three Pantanal lakes, against a set of environmental gradients: pH, dissolved oxygen, turbidity, conductivity, total dissolved solids, water temperature, index of trophic water status, total phosphorus and total nitrogen. The Ferradura lake presented an oligotrophic state and both Burro and Caracará lakes presented mesotrophic state. Diatoms were more abundant in the a mesotrophic conditions, but with higher species richness in the oligotrophic conditions. Depending on the N:P ratio, the nutrients nitrogen and phosphorus can also play the role of pollutants and may have negative and unpredictable effects in the environment, such as biotic homogenization. Despite the spatial variation in species, there was a greater richness of Eunotia Ehrenberg species, with the highest relative density of Eunotia formica Ehrenberg and E. pantropica Glushchenko, Kulikovskiy & Kociolek, due to the environmental acidic conditions, a determining characteristic of this genus. It was also observed that a small increase in the level of phosphorus generated an increase in the abundance of Aulacoseira Thwaites with the highest relative density of A. pusilla (Meister) Tuji & Houki and A. veraluciae Tremarin, Torgan & T.Ludwig. However, A. italica dominated in the moderately acidic environment. The results can help with decisions in impacted areas to solve socioeconomic problems, environmental management and biodiversity.
Clinical evaluation of BCL-2/XL levels pre- and post- HER2-targeted therapy
Authors: Zoeller Jason J. , Press Michael F. , Selfors Laura M. , Dering Judy , Slamon Dennis J. , Hurvitz Sara A. , Brugge Joan S.
Published: May 2021

Our previous pre-clinical work defined BCL-2 induction as a critical component of the adaptive response to lapatinib-mediated inhibition of HER2. To determine whether a similar BCL-2 upregulation occurs in lapatinib-treated patients, we evaluated gene expression within tumor biopsies, collected before and after lapatinib or trastuzumab treatment, from the TRIO-B-07 clinical trial (NCT#00769470). We detected BCL2 mRNA upregulation in both HER2+/ER- as well as HER2+/ER+ patient tumors treated with lapatinib or trastuzumab. To address whether mRNA expression correlated with protein expression, we evaluated pre- and post-treatment tumors for BCL-2 via immunohistochemistry. Despite BCL2 mRNA upregulation within HER2+/ER- tumors, BCL-2 protein levels were undetectable in most of the lapatinib- or trastuzumab-treated HER2+/ER- tumors. BCL-2 upregulation was evident within the majority of lapatinib-treated HER2+/ER+ tumors and was often coupled with increased ER expression and decreased proliferation. Comparable BCL-2 upregulation was not observed within the trastuzumab-treated HER2+/ER+ tumors. Together, these results provide clinical validation of the BCL-2 induction associated with the adaptive response to lapatinib and support evaluation of BCL-2 inhibitors within the context of lapatinib and other HER2-targeted receptor tyrosine kinase inhibitors.
STUDY TO MICROSTRUCTURE AND MECHANICAL PROPERTIES OF Mg-Zn-Fe-Cu-Co AS HIGH ENTROPY ALLOYS FOR URETERAL IMPLANT APPLICATION
Authors: Ashari Andi Mulya
Published: May 2021

Magnesium and its alloys are promising candidates for degradable materials with good biocompatibility. Alloys based on Mg-Zn-Fe-Cu-Co compositions were designed using the equiatomic method of high entropy alloy. This paper discusses the microstructure and mechanical properties of these new high entropy alloys. Pure Magnesium (60 µm), Zinc (45 µm), Fe (10 µm), Cu (63 µm), and Co (1 µm) powder were mixed and milled using a shaker mill at 700 rpm for the 1800s. The resulting milled powders were compacted and sintered at 300 MPa for 180s and 600 MPa for 120s. Sintering was performed at 700oC for 2 hours in a tube vacuum furnace at a 5 °C/min heating rate under a high purity argon atmosphere. Microstructural analyses and mechanical tests were performed based on the American standard of testing and measurement. The alloys were basically multiphase and crystalline. The 20Mg-20Zn-20Fe-20Cu-20Co alloy consisted of the HCP phase and cubic phase. The physical and mechanical properties of Mg-Zn-Fe-Cu-Co were affected by the magnesium content in the matrix alloys. The presence of pores indicated uncomplete compaction and sintering process. The alloys have a medium hardness of between 286.06 HV - 80.98 HV, while the densities of the alloys were relatively moderate in the range of 3.057 g.cm-3 to 1.71 g.cm-3. Solid solution and intermetallic precipitation strengthening were believed the primary strengthening mechanics of the alloys. It is concluded that high entropy is a promising method for the processing of Mg alloys. Alloy with a chemical composition of 20Mg-20Zn-20Fe-20Cu-20Co had optimal mechanical properties that meet the minimum requirements of high entropy alloys as candidates for ureteral implant applications.
Seri Koleksi Kebun Raya Eka Karya Bali Tanaman Berpotensi Penghasil Minyak Atsiri
Authors:   Indonesian Institute Of Sciences, Andila Putri , Warseno Tri ,   Indonesian Institute Of Sciences, Li’aini Arrohmatus ,   Indonesian Institute Of Sciences, Tirta I Gede ,   Indonesian Institute Of Sciences, Wibawa I Putu Agus Hendra ,   Indonesian Institute Of Sciences, Bangun Tuah Malem ,   Indonesian Institute Of Sciences
Published: May 2021

Minyak atsiri, atau yang juga popular dengan nama essential oil, sangat terkenal dengan ciri khas aromatik yang kuat. Manfaatnya pun juga sangat banyak, mulai dari antiseptik, analgesik, antidepresi, hingga antijamur. Oleh karena itu, tidak mengherankan jika minyak yang bersifat volatil ini umum digunakan di berbagai bidang industri dan telah menjadi komoditas yang bernilai ekonomi tinggi. Pada tahun 2014–2015, tim khusus dari Kebun Raya “Eka Karya” Bali telah melakukan eksplorasi ke Gunung Batulanteh di Kabupaten Sumbawa dan Desa Sembalun di Kabupaten Lombok Timur. Melalui eksplorasi tersebut, ratusan aksesi tumbuhan berpotensi penghasil minyak atsiri berhasil dikoleksi. Buku ini merangkum sekaligus mendokumentasikan data-data ilmiah terkait tumbuhan tersebut. Berbeda dengan terbitan lain yang sejenis, buku ini memiliki keunggulan dalam menyajikan informasi ilmiah yang komprehensif, mulai dari deskripsi botani, kandungan senyawa kimia tumbuhan, proses penyulingan, hingga pengembangannya. Buku ini sangat cocok untuk dibaca berbagai kalangan, seperti peneliti, dosen, mahasiswa, serta praktisi dan penghobi minyak atsiri.
Flax Seed and Climacteric Symptoms – A Review
Authors: Rajavi Sri Devi , Samy Kamala Kuppu
Published: May 2021

BACKGROUND Universally every woman faces menopause and feeling of onset of uncomfortable physical, psychological and emotional changes. Many fear about their loss of beauty and sexual life. The word menopause has come from Greek word “Menos” meaning menstruation and “Pause” meaning stopping of the menstrual period. 1 The loss of ovarian follicular activity or the dwindling function of ovaries at the end of reproductive life which leads to permanent cessation of menstruation is known as menopause or climacteric. The period of time when women passes from reproductive to non–reproductive stage is menopause transition. The life after menopause is the stage of postmenopausal period. In majority of women, menopause occurs without any physical or psychological symptoms. But in some of the women there will be marked physical and psychological symptoms. Symptoms of the climacteric are multiple and vague. These climacteric symptoms are due to decrease in oestrogen level and increase in Gonadotrophin level in the body, but the exact mechanism is unknown. The climacteric symptoms are grouped into vasomotor symptoms (hot flushes, night sweats), cardiovascular symptoms and cerebro-vascular effects (hypertension, palpitation, heart disease), neurological & psychological symptoms (anxiety, depression, insomnia, irritability, malaise, loss of libido / lethargy), general symptoms (fatigue, headache, general weakness, vertigo, breast tenderness, skin pigmentation, dyspareunia, indigestion or constipation, obesity), physical symptoms / changes (atrophy of secondary sexual characters, atrophy of internal genital organs, osteoporosis, skin becomes thick and coarse, straggling growth of hair).2 KEY WORDS Flax Seed, Climacteric Symptoms, Menopause
A Distinct Parallel Attachment System for the Rehabilitation of Kennedy’s Class 2 Partially Edentulous Arch – A Case Report
Authors: Peter Meekha , Bembalagi Mahantesh , Kanathila Hema
Published: May 2021

Among the numerous techniques of oral rehabilitation, precision attachments are considered as a good treatment option in removable (RPD) as well as fixed partial dentures (FPD). Precision attachments enhance patient’s self-confidence and selfimage as they help in facilitating aesthetic, functional and retentive replacement of teeth that are missing in the oral cavity. They can improve the aesthetics by eliminating the clasp assembly in cast partial dentures (CPD). This particular case report explains the treatment sequence and approach for the utilisation of attachments in a Kennedy Class 2 situation. A successful removable partial denture includes a precise diagnosis with meticulous treatment planning. However, re-establishment of partially edentulous arch is particularly challenging in distal extension situations classified as Kennedy’s class 1 or 2 conditions.1 In such clinical cases, where a fixed prosthesis cannot be fabricated, a prosthodontist often suggests an implant retained prosthesis that is not routinely possible because of the insufficient available bone width and height.2 Thus to ensure functional and aesthetic substitution of lost teeth, an attachment secured RPD can be considered as a good treatment option in such cases. Attachments are constructed in a ready to place form (pre-fabricated) known as precision attachments. Another one is semi precision attachment where the segments have to be constructed by dentists or dental technicians because it requires casting for incorporating into fixed unit of restoration.3 Hence precision attachments are considered as possible alternatives when patients demand for a fixed restoration in distal extension cases. Various extra coronal attachments are available and used in distal extension cases. Preci-Sagix is considered as an ideal extra coronal attachment for removable partial dentures and also in over denture cases. It is accessible in two sizes, 1.7 mm mini or 2.2 mm standard and is selected according to the permitted space. The male component is available in three varieties, a plastic castable pattern (any hard alloy), cast to no prax (only non-precious alloy) and a threaded male and base ring (2.2 mm size only).4 These attachments produce vertical, horizontal and rotational movements during its function which supports the prosthesis by transferring harmful forces from the abutments to the supporting structures by its passive movement, which helps in the rehabilitation of distal extension cases.5 This case report explains restoration of partially edentulous arch by incorporating a Preci Sagix attachment in mandibular cast partial denture retained by a six-unit FPD and a maxillary conventional cast partial denture.