bluuebunny/crossref_metadata_2025 huggingface dataset:
Ventral femoral head and neck ostectomy: Standard versus novel K‐wire guided technique using a premeasured ostectomy angle in canine cadavers
Authors: Sapora Joseph A. , Palmer Ross H. , Goh Clara S. S.
Published: July 2021

Objective

To assess the accuracy and efficiency of performing ventral FHO (vFHO) after measuring the ideal femoral head and neck ostectomy angle (iFHOA), with and without guidance of a K‐wire. To compare the iFHOA to the previously accepted 45° angle to guide vFHOs.

Study Design

Randomized, controlled, ex vivo study.

Animals

Ten mixed‐breed canine cadavers.

Methods

A routine un‐guided and guided vFHO was performed on each cadaver. A single unmodified ostectomy was performed on all hips. The pre‐ and postoperative iFHOA and postoperative residual femoral neck were radiographically assessed. Subjective intraoperative palpation and postoperative radiographic ostectomy completeness (OC) scores were assigned.

Results

Subjective OC scores (p > .63) did not differ between techniques, and guided vFHOs were as good or better for 7/10 dogs assessed via intraoperative palpation, and 9/10 dogs assessed radiographically. Residual femoral neck measurements were similar in both groups (p > .75). The average iFHOA in this study was 38.5°, with no significant difference between limbs of the same cadaver (p = .34). Guided vFHO took longer (294.5 s, p = .002) than unguided vFHO (166.7 s).

Conclusion

The mean iFHOA of 38.5° was less than the previously published 45° angulation for vFHOs. Subjectively, use of a K‐wire guide improved soft tissue retraction, neck visualization, and confidence in cut angulation.

Clinical Significance

Preoperative iFHOA measurement may minimize the risk of inappropriate vFHO angles.
Intermittent cold exposure improves glucose homeostasis despite exacerbating diet‐induced obesity in mice housed at thermoneutrality
Authors: McKie Greg L. , Shamshoum Hesham , Hunt Kristin L. , Thorpe Hayley H. A. , Dibe Hana A. , Khokhar Jibran Y. , Doucette Christine A. , Wright David C.
Published: July 2021

Key points

Ambient cold exposure is often regarded as a promising anti‐obesity treatment in mice.

However, most preclinical studies aimed at treating obesity via cold‐induced thermogenesis have been confounded by subthermoneutral housing temperatures. Therefore, the ability of ambient cold to combat diet‐induced obesity in mice housed under humanized thermoneutral conditions is currently unknown.

Moreover, mammals such as mice are rarely exposed to chronic ambient cold without reprieve, yet mice are often subjected to experimental conditions of chronic rather than intermittent cold exposure (ICE), despite ICE being more physiologically relevant.

In the present study, we provide novel evidence that thermoneutral housing uncouples the effects of ICE on glucose and energy homeostasis suggesting that ICE, despite improving glucose tolerance, is not an effective obesity treatment when mice are housed under humanized thermoneutral conditions.

The present study examines whether a physiologically relevant model of ambient cold exposure, intermittent cold exposure (ICE), could ameliorate the metabolic impairments of diet‐induced obesity in male and female mice housed under humanized thermoneutral conditions. Male and female C57BL/6J mice housed at thermoneutrality (29°C) were fed a low‐fat diet or high‐fat diet for 6 weeks before being weight matched into groups that remained unperturbed or underwent ICE for 4 weeks (4°C for 60 min day–1; 5 days week–1) when being maintained on their respective diets. ICE induced rapid and persistent hyperphagia exacerbating rather than attenuating high‐fat diet‐induced obesity over time. These ICE‐induced increases in adiposity were found to be energy intake‐dependent via pair‐feeding. Despite exacerbating high‐fat diet‐induced obesity, ICE improved glucose tolerance, independent of diet, in a sex‐specific manner. The effects of ICE on glucose tolerance were not attributed to improvements in whole‐body insulin tolerance, tissue specific insulin action, nor differences in markers of hepatic insulin clearance or pancreatic beta cell proliferation. Instead, ICE increased serum concentrations of insulin and C‐peptide in response to glucose, suggesting that ICE may improve glucose tolerance by potentiating pancreatic glucose‐stimulated insulin secretion. These data suggest that ICE, despite improving glucose tolerance, is not an effective obesity treatment in mice housed under humanized conditions.
Application of Visual MODFLOW to the Analysis of Boundary Conditions for a Phreatic Porous Aquifer Using Limited Available Information: A Case Study
Authors: Almeida Milena Stefany Lage , Gonçalves José Augusto Costa
Published: July 2021

The increasing water demand, especially in developing regions, continuously puts pressure on groundwater resources both quantitatively and qualitatively. Hydrogeological modeling is a tool used in planning and management of groundwater resources. The factors that interfere in groundwater flow dynamics can be determined by developing a conceptual model and they can be validated via a numerical model. The objective of the manuscript is the hydrogeological groundwater flow modeling of the phreatic porous aquifer of the Ribeirão Candidópolis catchment in the Itabira municipality, State of Minas Gerais (Brazil). The software used in this study is GMS: MODFLOW, which enabled a steady state flow regime modeling by means of the Finite Difference Method (FDM) and the parameters calibration from a semi-transient approach. To assess the performance of the model, the Mean Error (ME), the Mean Absolute Error (MAE), and the Root Mean Square Error (RMSE) were calculated. The results proved to be compatible with the values observed in the field. After several adjustments of the boundary conditions, a Normalized Root Mean Square (NRMS) of 9.648% and a correlation coefficient of 0.993 were obtained. Despite the economic importance of the study area, studies made available on groundwater flow behavior are rare. The results obtained via modeling are in accordance with the data observed in the field and consequently our model can be used in the study of water level changes.
An Energy-Efficient Method for Controlling Hydraulic Actuators Using Counterbalance Valves With Adjustable Pilot
Authors: Sciancalepore Annalisa , Vacca Andrea , Weber Steven
Published: July 2021

Counterbalance valves (CBVs) are widely used in hydraulic machines handling gravitational loads. They are usually adopted in hydraulic circuits that set the flow to the actuator with either metering control strategies or primary control strategies. In these circuits, the CBV does not determine the actuator velocity, but it establishes a proper counterpressure that balances the actuator during overrunning loads. A well-known problem of CBVs is the excessive power consumption introduced into the circuit, which is due to an excessive pressurization of the flow supply. This paper presents a solution for using CBVs to control the actuator velocity while also reducing energy consumption. The method consists in controlling the pilot port of the CBV through an external pressure source (adjustable pilot). The solution is first studied analytically, considering all the possible loading conditions at the actuator. Two different control strategies are presented: the “Smart CBV,” where the CBV does not control the actuator velocity but it minimizes the system pressure; and the “Smart System” that uses the CBV to efficiently control the actuator velocity during overrunning load conditions. An experimental validation of the proposed solutions is also provided, taking as reference a truck-mounted hydraulic crane. The results of the proposed solutions are compared to those achieved by the traditional circuit of the reference hydraulic crane which uses standard CBVs. For both cases of smart CBV and smart system, a remarkable power saving, respectively, up to 75% and up to 90% is observed.
Performance improvement of an oil-lubricated journal bearing using bionic-textures fused micro-pockets
Authors: Pattnayak Manas Ranjan , Pandey R. K. , Dutt Jayanta kumar
Published: July 2021

This article investigates the static and dynamic performances of bionic-textures fused micro-pocketed journal bearing considering cavitation. The new bionic textures placed inside the micro-pocket towards the trailing side has been conceived inspired from the skins of freshwater fish. The mass conservation satisfying partial differential lubrication equations for the static and dynamic pressures are discretized using finite volume method (FVM) followed by simultaneous solution of the system equations using the Fischer-Burmeister-Newton-Schur (FBNS) and the Broyden's method with Sherman-Morrison formula. The minimum film thickness, friction force, temperature rise, dynamic coefficients, effective damping and stiffness, critical mass and system characteristic roots have been explored with new conceived bores and the numerical results have also been compared with conventional plain and conventional pocketed bore bearings. Significant static and dynamic performance improvements have been found in presence of bionic textures fused micro-pocketed bores in comparison to conventional bores.
Effects of local anaesthetic dilution on the characteristics of ultrasound guided axillary brachial plexus block: a randomised controlled study
Authors: Ranganath Anil , Ahmed Osman , Iohom Gabriella
Published: July 2021

Aims: Ultrasound guidance has led to marked improvement in the success rate and characteristics of peripheral nerve blocks. However, effects of varying the volume or concentration of a fixed local anaesthetic dose on nerve block remains unclear. The purpose of our study was to evaluate whether at a fixed dose of lidocaine, altering the volume and concentration will have any effect on the onset time of ultrasound-guided axillary brachial plexus block.Material and methods: Twenty patients were randomised to receive an ultrasound-guided axillary brachial plexus block with either lidocaine 2% with epinephrine (20 ml, Group 2%) or lidocaine 1% with epinephrine (40 ml, Group 1%). The primary endpoint was block onset time. Secondary outcomes included duration of the block, performance time, number of needle passes, incidence of paraesthesia and vascular puncture.Results: The median [IQR] onset time of surgical anaesthesia was shorter in Group 1% when compared to Group 2% (6.25 [5-7.5] min vs 8.75 [7.5-10] min; p=0.03). The mean (SD) overall duration of surgical anaesthesia was significantly shorter in Group 1% compared to Group 2% (150.9±17.2 min vs 165.1±5.9 min; p=0.02). Group 1% had a shorter performance time with fewer needle passes. The incidence of vascular puncture and paraesthesia was similar in the two groups.Conclusion: Ultrasound-guided axillary brachial plexus blocks performed using a higher volume of lower concentration lidocaine was associated with shorter onset time and duration of surgical anaesthesia.
Diagnosis of parotid gland tumours with Contrast-Enhanced Ultrasound: a systematic review and meta-analysis
Authors: Sultan Salahaden R , AlKharaiji Mohammed , Rajab Shahad H
Published: July 2021

Aim: Contrast-enhanced ultrasound (CEUS) appears to be a promising application for the diagnosis of parotid gland tumours. We aimed to systematically review and meta-analyse the ability of CEUS in distinguishing benign from malignant parotid gland tumours.Material and methods: PubMed was searched for relevant studies. Data on area under time intensity curve (AUC) in arbitrary unit (AU), and mean transit time (MTT) in seconds (sec) were analysed using the Cochrane Review Manager Software.Results: Nine studies met the eligibility criteria comprising a total number of 498 parotid gland tumours (benign, number (n)=423; malignant, n=75). Descriptive evaluation of parotid gland tumours following CEUS administration showed overlap characteristics in benign and malignancies. Two publications assessed AUC and MTT in 72 and 60 parotid gland tumours, respectively. AUC was significantly lower in benign compared to malignant tumours following contrast administration (AUC, mean difference (MD) -266.77 AU, 95% confidence intervals (CI) -433.22, -100.33, p=0.002). No significant different in MTT between benign and malignant tumours (p=0.12). Heterogeneity was statistically significant in AUC (p=0.04) and MTT (p<0.00001).Conclusion: Descriptive evaluation of parotid gland tumours showed overlap CEUS characteristics. Perfusion related CEUS parameters analysis is promising in differentiating benign parotid tumours from malignancies.
Costs of dynamic cocktail party listening: Investigating the effects of cognitive abilities and hearing impairment
Authors: Wächtler Moritz , Kessler Josef , Walger Martin , Meister Hartmut
Published: July 2021

Situations with multiple competing talkers are especially challenging for listeners with hearing impairment. These “cocktail party” situations can either be static (fixed target talker) or dynamic (changing target talker). Relative to static situations, dynamic listening is typically associated with increased cognitive load and decreased speech recognition (“costs”). This study addressed the role of hearing impairment and cognition in two groups of older listeners with and without hearing loss. In most of the dynamic situations, the costs did not differ between the listener groups. There was no clear evidence that overall costs show an association with the individuals' cognitive abilities.
Longitudinal Associations Between Neighborhood Park and Open Space Access and Children’s Accelerometer-Assessed Measured Physical Activity: The Evidence From the MATCH Study
Authors: Yi Li , Mason Tyler B. , Yang Chih-Hsiang , Chu Daniel , Dunton Genevieve F.
Published: July 2021

Background: Cross-sectional studies have shown positive associations between neighborhood park access and children’s physical activity (PA); however, research that examines the relationship longitudinally is lacking. This study investigates how neighborhood park access affects the longitudinal trajectory of PA in 192 children across 3 years. Methods: Accelerometer-assessed PA data of children (N = 202) were collected across 6 semi-annual waves (7 d each) between 2014 and 2018. Geographical information systems was used to measure neighborhood park access (ie, coverage, density, and proximity) at baseline. Mixed-effects models examined the associations of park access with children’s baseline and trajectory of moderate to vigorous PA (MVPA) minutes across 3 years and whether the associations differed by sex or weekends versus weekdays. Results: Higher neighborhood park density, coverage, and proximity were positively associated with children’s baseline MVPA minutes per day. Longitudinally, higher park coverage was associated with smaller decreases in children’s MVPA minutes per day, but only during weekends. Park density and proximity were not associated with change in MVPA minutes per day. The above associations did not differ by sex. Conclusions: Having access to more neighborhood parklands protected against age-related declines in children’s PA. These findings suggest that neighborhood park coverage should be considered by urban planners when evaluating the health impacts of their policies.
Physical Education and Sport Pedagogy: The Application of the Academic Discipline of Kinesiology
Authors: Solmon Melinda A.
Published: July 2021

Scholarship related to physical education and sport pedagogy is rigorous and should be central to the academic discipline of kinesiology. The goal of this article is to situate physical education and sport pedagogy as an applied field in kinesiology, grounded in the assumption that physical education, as the professional or technical application of the broader academic discipline, is of critical importance to the success of kinesiology. A brief overview of the history of research on teaching physical education is followed by an overview of the streams of research that have evolved. Major tenets of research on effective teaching and curricular reform are discussed. The status of physical education teacher education and school physical education programs is considered, and a rationale for a broader view of pedagogy that has the potential not only to promote physical education and sport pedagogy but also to enrich the academic discipline is offered.
Perspectives on the Academic Discipline of Kinesiology
Authors: Anderson David I. , van Emmerik Richard E.A.
Published: July 2021

This special issue of Kinesiology Review celebrates the 40th anniversary of the publication of George Brooks’s Perspectives on the Academic Discipline of Physical Education: A Tribute to G. Lawrence Rarick (1981). Written by many of the luminaries within kinesiology, the papers in this special issue highlight the tremendous growth of knowledge that has occurred in the subdisciplines of kinesiology over the last 40 years and the breadth of contexts in which new knowledge is now being applied. Kinesiology has rapidly become an influential discipline, and its breadth, depth, and influence continue to grow. Though not without challenges, there is much to be optimistic about concerning kinesiology’s future.
Gene editor injected into the body treats disease
Authors: Kaiser Jocelyn
Published: July 2021

In a first, CRISPR components infused into patients' blood shut down mutant gene in liver.
The peopling of the Pacific
Voyagers: The Settlement of the Pacific
Nicholas Thomas
Basic Books, 2021. 224 pp.
Authors: Bae Christopher J.
Published: July 2021

An anthropologist traces the emergence of the rich and varied cultures of the Pacific islands
The myth of historical bio-based plastics
Authors: Altman Rebecca
Published: July 2021

Early bio-based plastics, which were neither clean nor green, offer lessons for today
Achieving a circular bioeconomy for plastics
Authors: Kakadellis Sarah , Rosetto Gloria
Published: July 2021

Designing plastics for assembly and disassembly is essential to closing the resource loop
Reengineering protein-phosphorylation switches
Authors: Kholodenko Boris N. , Okada Mariko
Published: July 2021

Phosphorylation circuits operate as logic gates that rapidly toggle a system between two stable states
An anti-obesity immunotherapy?
Authors: O'Brien Conan J. O. , Domingos Ana I.
Published: July 2021

Adipose tissue–resident macrophages promote lipid storage in mice but can be stopped with antibody treatment
Astrocytes control the critical period of circuit wiring
Authors: Kofuji Paulo , Araque Alfonso
Published: July 2021

Astrocytes regulate the experience-dependent remodeling of brain circuits during development
Shared blame for the opioid crisis
Authors: Thorp H. Holden
Published: July 2021

As the COVID-19 pandemic recedes, it's time to turn attention back to the slow-moving and devastating epidemic caused by America's opioid crisis. For the last 10 years, around 15,000 annual deaths have been ascribed to prescription opioid overdoses. Add in deaths from all opioids, whether obtained by prescription or on the black market, and the total reaches almost 50,000. Black market fentanyl has played a big role, as well as a now notorious pharmaceutical called OxyContin, which is manufactured and sold by Purdue Pharma. The company's dysfunctional culture combined with complacent oversight by the US Food and Drug Administration (FDA), the research community, and the medical community led to this perfect storm—one we must learn from so that we can avoid a similar tragedy in the future.
CD8
+
T cells specific for conserved coronavirus epitopes correlate with milder disease in patients with COVID-19
Authors: Mallajosyula Vamsee , Ganjavi Conner , Chakraborty Saborni , McSween Alana M. , Pavlovitch-Bedzyk Ana Jimena , Wilhelmy Julie , Nau Allison , Manohar Monali , Nadeau Kari C. , Davis Mark M.
Published: July 2021

T cells specific for conserved coronavirus antigens are preferentially expanded in patients with mild COVID-19.
Complete Genome Sequence of an
mcr-9
-Possessing Enterobacter asburiae Strain Isolated from a Cat in Japan
Authors: Sato Toyotaka , Usui Masaru , Harada Kazuki , Fukushima Yukari , Nakajima Chie , Suzuki Yasuhiko , Yokota Shin-ichi
Published: July 2021

We report the complete genome sequence of the
mcr-9
-possessing strain
Enterobacter asburiae
En30, isolated from a cat in Japan. The genome sequence was obtained by using long- and short-read sequencing.
Klebsiella variicola Reference Strain F2R9 (ATCC BAA-830) Genome Sequence
Authors: Garza-Ramos Ulises , Rodriguez-Medina Nadia , Lozano-Aguirre Luis , Silva-Sanchez Jesús , Sanchez-Arias Margarita , Rodriguez-Olguin Jeannet , Martínez-Romero Esperanza
Published: July 2021

Klebsiella variicola
F2R9 was isolated from banana root, and its sequence has been deposited as ATCC BAA-830. It corresponds to sequence type 11 (ST11) and KL16 and contains no identifiable plasmids. The genome showed few antimicrobial resistance and virulence genes and several plant-association genes. The strain showed susceptibility to most antimicrobials and avirulent behavior.
First-Time Presence of African Swine Fever Virus Genotype II in Nigeria
Authors: Adedeji Adeyinka J. , Luka Pam D. , Atai Rebecca B. , Olubade Toyin A. , Hambolu Dupe A. , Ogunleye Mary A. , Muwanika Vincent B. , Masembe Charles
Published: July 2021

A confirmed African swine fever (ASF) outbreak in Nigeria was further investigated by partial sequencing of
B464L
and
E183L
genes of the ASF virus (ASFV). Results revealed the first-time presence of ASFV genotype II in Nigeria and West Africa. This finding has serious implications for control measures and food security.
Complete Genome Sequence of
Rhynchophorus ferrugineus
Endocytobiont “
Candidatus
Nardonella dryophthoridicola” Strain NardRF
Authors: Chouaia Bessem , Montagna Matteo , Suma Pompeo , Faoro Franco
Published: July 2021

We report the complete genome sequence and annotation of “
Candidatus
Nardonella dryophthoridicola” strain NardRF, obtained by sequencing its host bacteriome,
Rhynchophorus ferrugineus
, using Oxford Nanopore technology.
Complete Genome Sequence of Pasteurella multocida HuN001, a Capsular Type A Strain from a Human
Authors: Lin Lin , Li Chunhui , Wang Fei , Wang Xueying , Zhang Yue , Liu Songtao , Liang Wan , Hua Lin , Peng Zhong , Wu Bin
Published: July 2021

Here, we report the complete genome sequence of clinical
Pasteurella multocida
strain HuN001, which was cultured from a sputum sample from a patient with pneumonia. Oxford Nanopore Technologies sequencing provided a complete genome sequence of
P. multocida
HuN001, which contains a 2,287,216-bp circular chromosome with an average G+C content of 40.33%.
Sympathetic ophthalmia following blunt injury to phthisical eye
Authors: Patil Vinay S , Surve Abhidnya , Banerjee Mousumi , Kumar Vinod
Published: July 2021

Sympathetic ophthalmia is a severe sight-threatening disorder that can lead to blindness if not diagnosed and managed appropriately. It occurs most commonly following penetrating ocular injury and less commonly following surgery. Herein, we report a case of sympathetic ophthalmia following blunt trauma to the phthisical eye along with the pathophysiology and management of such cases.
Maturity assessment of Kenya’s health information system interoperability readiness
Authors: Nyangena Job , Rajgopal Rohini , Ombech Elizabeth Adhiambo , Oloo Enock , Luchetu Humphrey , Wambugu Sam , Kamau Onesmus , Nzioka Charles , Gwer Samson , Ndiritu Ndirangu Moses
Published: July 2021

Background

The use of digital technology in healthcare promises to improve quality of care and reduce costs over time. This promise will be difficult to attain without interoperability: facilitating seamless health information exchange between the deployed digital health information systems (HIS).

Objective

To determine the maturity readiness of the interoperability capacity of Kenya’s HIS.

Methods

We used the HIS Interoperability Maturity Toolkit, developed by MEASURE Evaluation and the Health Data Collaborative’s Digital Health and Interoperability Working Group. The assessment was undertaken by eHealth stakeholder representatives primarily from the Ministry of Health’s Digital Health Technical Working Group. The toolkit focused on three major domains: leadership and governance, human resources and technology.

Results

Most domains are at the lowest two levels of maturity: nascent or emerging. At the nascent level, HIS activities happen by chance or represent isolated, ad hoc efforts. An emerging maturity level characterises a system with defined HIS processes and structures. However, such processes are not systematically documented and lack ongoing monitoring mechanisms.

Conclusion

None of the domains had a maturity level greater than level 2 (emerging). The subdomains of governance structures for HIS, defined national enterprise architecture for HIS, defined technical standards for data exchange, nationwide communication network infrastructure, and capacity for operations and maintenance of hardware attained higher maturity levels. These findings are similar to those from interoperability maturity assessments done in Ghana and Uganda.
Simulation study on the validity of the average risk approach in estimating population attributable fractions for continuous exposures
Authors: Ruan Yibing , Walter Stephen D , Gogna Priyanka , Friedenreich Christine M , Brenner Darren R
Published: July 2021

Background

The population attributable fraction (PAF) is an important metric for estimating disease burden associated with causal risk factors. In an International Agency for Research on Cancer working group report, an approach was introduced to estimate the PAF using the average of a continuous exposure and the incremental relative risk (RR) per unit. This ‘average risk’ approach has been subsequently applied in several studies conducted worldwide. However, no investigation of the validity of this method has been done.

Objective

To examine the validity and the potential magnitude of bias of the average risk approach.

Methods

We established analytically that the direction of the bias is determined by the shape of the RR function. We then used simulation models based on a variety of risk exposure distributions and a range of RR per unit. We estimated the unbiased PAF from integrating the exposure distribution and RR, and the PAF using the average risk approach. We examined the absolute and relative bias as the direct and relative difference in PAF estimated from the two approaches. We also examined the bias of the average risk approach using real-world data from the Canadian Population Attributable Risk of Cancer study.

Results

The average risk approach involves bias, which is underestimation or overestimation with a convex or concave RR function (a risk profile that increases more/less rapidly at higher levels of exposure). The magnitude of the bias is affected by the exposure distribution as well as the value of RR. This approach is approximately valid when the RR per unit is small or the RR function is approximately linear. The absolute and relative bias can both be large when RR is not small and the exposure distribution is skewed.

Conclusions

We recommend that caution be taken when using the average risk approach to estimate PAF.
Regional and hospital variation in commonly performed paediatric otolaryngology procedures in the Netherlands: a population-based study of healthcare utilisation between 2016 and 2019
Authors: van Munster Juliëtte J C M , Wammes Joost J G , Bremmer Rolf H , Zamanipoor Najafabadi Amir H , Hemler Raphael J , Peul Wilco C , van den Hout Wilbert B , van Benthem Peter Paul G
Published: July 2021

Objective

In the past few decades, there has been an increase in high-quality studies providing evidence on the effectiveness of commonly performed procedures in paediatric otolaryngology. We believe that now is the time to re-evaluate the care process. We aimed to analyse (1) the regional variation in incidence and referrals of adenoidectomies, tonsillectomies and ventilation tube insertions in children in the Netherlands between 2016 and 2019, (2) whether regional surgical rates, referral rates and in-hospital surgical rates were associated with one another, and (3) the hospital variation in healthcare costs, which indicates the utilisation of resources.

Design

Repeated cross-sectional analysis.

Setting

Four neighbouring Dutch provinces comprising 2.8 million inhabitants and 14 hospitals.

Participants

Children aged 0–15 years.

Outcome measures

We analysed variation in regional surgical rates and referral rates per 1000 inhabitants and in-hospital surgical rates per 1000 clinic visitors, adjusted for age and socioeconomic status. Furthermore, the relationships between referral rates, regional surgical rates and in-hospital surgical rates were estimated. Lastly, variation in resource utilisation between hospitals was estimated.

Results

Adenoidectomy rates differed sixfold between regions. Twofold differences were observed for adenotonsillectomy rates, ventilation tube insertion rates and referral rates. Referral rates were negatively associated with in-hospital surgical rates for adenotonsillectomies, but not for adenoidectomies and ventilation tube insertions. In-hospital surgical rates were positively associated with regional rates for adenoidectomies and adenotonsillectomies. Significant variation between hospitals was observed in costs for all resources.

Conclusions

We observed low variation in tonsillectomies and ventilation tube insertion and high variation in adenoidectomies. Indications for a tonsillectomy and ventilation tube insertion are well defined in Dutch guidelines, whereas this is not the case for an adenoidectomy. Lack of agreement on indications can be expected and high-quality effectiveness research is required to improve evidence-based guidelines on this topic.
DECRYPT trial: study protocol for a phase II randomised controlled trial of cognitive therapy for post-traumatic stress disorder (PTSD) in youth exposed to multiple traumatic stressors
Authors: Allen Leila , Ashford Polly-Anna , Beeson Ella , Byford Sarah , Chow Jessica , Dalgleish Tim , Danese Andrea , Finn Jack , Goodall Ben , Grainger Lauren , Hammond Matthew , Humphrey Ayla , Mahoney-Davies Gerwyn , Morant Nicola , Shepstone Lee , Sims Erika , Smith Patrick , Stallard Paul , Swanepoel Annie , Trickey David , Trigg Katie , Wilson Jon , Meiser-Stedman Richard
Published: July 2021

Background

Post-traumatic stress disorder (PTSD) is a distressing and disabling condition that affects significant numbers of children and adolescents. Youth exposed to multiple traumas (eg, abuse, domestic violence) are at particular risk of developing PTSD. Cognitive therapy for PTSD (CT-PTSD), derived from adult work, is a theoretically informed, disorder-specific form of trauma-focused cognitive–behavioural therapy. While efficacious for child and adolescent single-event trauma samples, its effectiveness in routine settings with more complex, multiple trauma-exposed youth has not been established. The Delivery of Cognitive Therapy for Young People after Trauma randomised controlled trial (RCT) examines the effectiveness of CT-PTSD for treating PTSD following multiple trauma exposure in children and young people in comparison with treatment as usual (TAU).

Methods/design

This protocol describes a two-arm, patient-level, single blind, superiority RCT comparing CT-PTSD (n=60) with TAU (n=60) in children and young people aged 8–17 years with a diagnosis of PTSD following multiple trauma exposure. The primary outcome is PTSD severity assessed using the Children’s Revised Impact of Event Scale (8-item version) at post-treatment (ie, approximately 5 months post-randomisation). Secondary outcomes include structured interview assessment for PTSD, complex PTSD symptoms, depression and anxiety, overall functioning and parent-rated mental health. Mid-treatment and 11-month and 29-month post-randomisation assessments will also be completed. Process–outcome evaluation will consider which mechanisms underpin or moderate recovery. Qualitative interviews with the young people, their families and their therapists will be undertaken. Cost-effectiveness of CT-PTSD relative to TAU will be also be assessed.

Ethics and dissemination

This trial protocol has been approved by a UK Health Research Authority Research Ethics Committee (East of England–Cambridge South, 16/EE/0233). Findings will be disseminated broadly via peer-reviewed empirical journal articles, conference presentations and clinical workshops.

Trial registration

ISRCTN12077707. Registered 24 October 2016 (http://www.isrctn.com/ISRCTN12077707). Trial recruitment commenced on 1 February 2017. It is anticipated that recruitment will continue until June 2021, with 11-month assessments being concluded in May 2022.
COVID-19 international border surveillance at Toronto’s Pearson Airport: a cohort study
Authors: Goel Vivek , Bulir David , De Prophetis Eric , Jamil Munaza , Rosella Laura C , Mertz Dominik , Regehr Cheryl , Smieja Marek
Published: July 2021

Objectives

The primary objective was to estimate the positivity rate of air travellers coming to Toronto, Canada in September and October 2020, on arrival and on day 7 and day 14. The secondary objectives were to estimate the degree of risk based on country of origin and to assess knowledge and attitudes towards COVID-19 control measures and subjective well-being during the quarantine period.

Design

Prospective cohort of arriving international travellers.

Setting

Toronto Pearson Airport Terminal 1, Toronto, Canada.

Participants

Participants of this study were passengers arriving on international flights. Inclusion criteria were those aged 18 or older who had a final destination within 100 km of the airport, spoke English or French, and provided consent. Excluded were those taking a connecting flight, had no internet access, exhibited symptoms of COVID-19 on arrival or were exempted from quarantine.

Main outcome measures

Positive for SARS-CoV-2 virus on reverse transcription PCR with self-administered oral-nasal swab and general well-being using the WHO-5 Well-being Index.

Results

Of 16 361 passengers enrolled, 248 (1.5%, 95% CI 1.3% to 1.7%) tested positive. Of these, 167 (67%) were identified on arrival, 67 (27%) on day 7, and 14 (6%) on day 14. The positivity rate increased from 1% in September to 2% in October. Average well-being score declined from 19.8 (out of a maximum of 25) to 15.5 between arrival and day 7 (p<0.001).

Conclusions

A single arrival test will pick up two-thirds of individuals who will become positive by day 14, with most of the rest detected on the second test on day 7. These results support strategies identified through mathematical models that a reduced quarantine combined with testing can be as effective as a 14-day quarantine.
Does admission order form design really matter? A reduction in urea blood test ordering
Authors: Mathura Pamela , Boettger Cole , Hagtvedt Reidar , Suranyi Yvonne , Kassam Narmin
Published: July 2021

Introduction

Laboratory blood testing is one of the most high-volume medical procedures and continues to increase steadily with instances of inappropriate testing resulting in significant financial implications. Studies have suggested that the design of a standard hospital admission order form and laboratory request forms influence physician test ordering behaviour, reducing inappropriate ordering and promoting resource stewardship.

Aim/method

To redesign the standard medicine admission order form-laboratory request section to reduce inappropriate blood urea nitrogen (BUN) testing.

Results

A redesign of the standard admission order form used by general internal medicine physicians and residents in two large teaching hospitals in one health zone in Alberta, Canada led to a significant step reduction in the ordering of the BUN test on hospital admission.

Conclusions

Redesigning the standard medicine admission order form-laboratory request section can have a beneficial effect on the reduction in BUN ordering altering physician ordering patterns and behaviour.
New insight on the role of liraglutide in alleviating dexamethasone-induced pancreatic cytotoxicity via improving redox status, autophagy flux, and PI3K/Akt/Nrf2 signaling
Authors: Elseady Walaa S. , Abd Ellatif Rasha A. , Estfanous Remon S. , Emam Marwa N. , Keshk Walaa A.
Published: July 2021

Chronic glucocorticoids therapy is commonly complicated by steroid diabetes, although the underlying mechanisms are still elusive. Liraglutide, a glucagon-like peptide-1, was initially found to induce glycemic control and recently it was found to have many pleotropic effects; however, its role in pancreas remains unknown. The present study aims to estimate the protective role of liraglutide on dexamethasone-induced pancreatic cytotoxicity and hyperglycemia, highlighting the possible underlying biochemical, molecular, and cellular mechanisms. Twenty-eight male Wistar rats were involved in this study and were randomly divided into four groups. Group III and IV were treated with 1 mg/kg dexamethasone daily for 10 days. Group II and IV were treated with liraglutide in a dose of 0.8 mg/kg per day for 2 weeks. Pancreatic caspase-9, nuclear factor erythroid 2–related factor 2 (Nrf2), phospho-protein kinase-B (pAkt), and sequestrome 1 (p62) levels were assessed by immunoassay. Moreover, phosphoinositide 3-kinase (PI3K) expression by real-time PCR, microtubule-associated protein light chain 3 (LC3B) expression by immunohistochemistry, glycemic status, β-cell function by homoeostasis model assessment (HOMA) β index, and pancreatic redox status were assessed. Liraglutide improved blood glucose level, β-cell function, pancreatic caspase-9 level, redox status, and autophagy. Additionally, it increased pancreatic PI3K, pAkt, and Nrf2 levels. Moreover, preservation of pancreatic histological and the ultrastructural morphological features of β- and α-cells were observed. In conclusion, liraglutide protected against dexamethasone-induced pancreatic injury and hyperglycemia and decelerated the progression towards steroid diabetes via activating PI3K/Akt/Nrf2 signaling and autophagy flux pathways.
Nonlinear mixed convective Williamson nanofluid flow with the suspension of gyrotactic microorganisms
Authors: Zhou Shuang-Shuang , Khan M. Ijaz , Qayyum Sumaira , Prasannakumara B. C. , Kumar R. Naveen , Khan Sami Ullah , Gowda R. J. Punith , Chu Yu-Ming
Published: July 2021

This investigation aims to present the thermally developed bioconvection flow of Williamson nanoliquid over an inclined stretching cylinder in presence of linear mixed convection and nonuniform heat source/sink. The activation energy and suspension of gyrotactic microorganisms are accounted with applications of bioconvection phenomenon. Appropriate nondimensional variables are opted to attain the dimensionless form of flow equations. The resulting momentum, energy, concentration and motile density equations are abridged to highly coupled and nonlinear in nature. The numerical treatment is followed for the solution procedure by employing the shooting method. The influence of some relevant dimensionless parameters is discoursed graphically along with physical justifications. Moreover, the impact of several dimensionless parameters on skin friction and Nusselt number is obtained and listed in tables. It is observed that the velocity of fluid shows a decreasing variation for Williamson fluid parameter. The change in unsteadiness parameter and heat source parameter enhanced the nanofluid temperature. The motile microorganisms profile declines with bioconvection constant and bio-convection Lewis number.
Liquid phase stratification induced by large temperature gradient during spinodal decomposition in Fe–Cr alloys: A phase-field study
Authors: Du Lifei , Tian Runbo , Shi Tiantian , Cao Youqi
Published: July 2021

The spinodal decomposition in Fe-40at.%Cr binary alloy is numerically studied by implementing the phase-field model based on Cahn–Hilliard equation. Effects of different temperature gradients on the solute distributing characteristics during the spinodal decomposition are investigated. In the system with a temperature gradient, the phase decomposition happens gradually from low temperature to high temperature, and a metastable stratification is achieved with specified temperature distribution. The critical temperature and corresponding temperature gradient are specified for the obvious solute stratification in the binary Fe–Cr alloy. The kinetics of the solute diffusion during the spinodal decomposition is discussed to reveal the liquid phase stratification induced by the anisotropic diffusion with the nonuniform temperature field. Therefore, tailoring the heat treatment during the spinodal decomposition in Fe–Cr binary alloys might be an efficient way to obtain nanometer coherent microstructures with specified solute distribution.
Ontological Modeling for Excavation Documentation and Virtual Reconstruction of an Ancient Egyptian Site
Authors: Hiebel Gerald , Aspöck Edeltraud , Kopetzky Karin
Published: July 2021

In this article we introduce our semantic modeling approach for data from over 50 years of excavations at Tell el-Daba in Egypt. The CIDOC CRM with some of its extensions is used as an ontological framework to provide the semantics for creating a knowledge graph containing material remains, excavated areas, and documentation resources. An objective of the project A Puzzle in 4D is to digitize the documentation and create metadata for analog and digital resources in order to provide the data to the research community and facilitate future work for this important archaeological site. Using an example of 3D reconstruction of a tomb, we show how the knowledge graph linked to digital resources can be exploited for a specific task to encounter available information that is essential for a virtual reconstruction. Moreover, we show an approach of modeling to represent the interpretations supporting reconstructions as well as relate them to the sources used, thus providing transparency for the model and provenance data. Modeling for excavation documentation as well as virtual reconstruction has been tailored to the large amount of data processed from the project. The goal is to propose a semantic modeling feasible even on a large scale while still preserving the basic underlying ontological structures.
Computer Vision Tagging the Metropolitan Museum of Art's Collection
Authors: Villaespesa Elena , Crider Seth
Published: July 2021

Computer vision algorithms are increasingly being applied to museum collections to identify patterns, colors, and subjects by generating tags for each object image. There are multiple off-the-shelf systems that offer an accessible and rapid way to undertake this process. Based on the highlights of the Metropolitan Museum of Art's collection, this article examines the similarities and differences between the tags generated by three well-known computer vision systems (Google Cloud Vision, Amazon Rekognition, and IBM Watson). The results provide insights into the characteristics of these taxonomies in terms of the volume of tags generated for each object, their diversity, typology, and accuracy. In consequence, this article discusses the need for museums to define their own subject tagging strategy and selection criteria of computer vision tools based on their type of collection and tags needed to complement their metadata.
Cross-collection Linking of Botanical Imagery in Ghent Altarpiece to Learn More about Van Eyck’s Masterpiece and to Explore a Region’s Plant Richness and Diversity over Time
Authors: Chandrasekar Krishna Kumar Thirukokaranam , Deman Emile , Verstockt Steven
Published: July 2021

As people on average only spent 20 seconds(s) observing an artwork, they mostly miss a lot of informative details that are contained within it. As an example, the 75 different plants that can be found in the Ghent Altarpiece is something not a lot of people are aware of. Within this article, we present a methodology, based on cross-collection linking, to create awareness about the botanical imagery in Van Eyck’s masterpiece and to inform people about their region’s plant richness and diversity over time. As such, this article is a nice example of how the interdisciplinary fields of cultural heritage and botany can go hand in hand to facilitate its dissemination to the general public. The plants in the painting can be queried by their name or by a picture taken with a mobile device—a plant recognition app is used to evaluate the pictures taken from the plants. A study has also been performed to evaluate these apps and to select the most appropriate one for the collection of plants in the Ghent Alterpiece. Currently, we link the detected plants to herbaria, observation data, Global Biodiversity Information Facility plantinfo, and recent wikimedia commons pictures, but other links can also be easily integrated with the platform. Finally, we also studied nowadays plant observations (volunteered geographic information) in more detail and reveal which region currently has most of Van Eyck’s plants/flowers.
Use of Tools
Authors: Green Daniel , Hargood Charlie , Charles Fred
Published: July 2021

The technology supporting Interactive Digital Narrative (IDN) is of particular significance to cultural heritage research. IDN technology provides a means of engagement in cultural heritage sites, a medium for culturally significant stories, and culturally significant story-centric games. While previous work in this space has numerous examples of user experience (UX) evaluations of the interactive narrative works themselves, there is significantly less in terms of evaluation of technology for authoring IDN, creating a UX research space in this area that is focused on the audience and not authors. We propose to balance this focus by considering the UX of authoring tools more closely. In this work, we undertake a review of the state of the art of authoring tools for IDN, such as story-centric games, and report on a rigorous UX evaluation of representative technologies (n = 21). We also address the challenges of UX research for these tools through an original evaluation methodology where authors complete a story composed of representative story features. Our study leads us to conclude seven UX principles for IDN authoring tools that explore both how authors use tools to create story-focused games and how the interface for these tools impacts the creative process.