bluuebunny/crossref_metadata_2025 huggingface dataset:
A review of the co‐liquefaction of biomass feedstocks and plastic wastes for biofuel production
Authors: Baloyi Hope , Patel Bilal
Published: May 2024

Interest has emerged recently in addressing the long‐standing issue of waste plastic disposal and environmental challenges through the co‐liquefaction of waste plastics with eco‐friendly renewable biomass resources, including microalgae biomass and lignocellulosic biomass, to produce biofuels. Co‐liquefaction provides a viable alternative for managing plastic waste while contributing to biofuel production. The purpose of this article is to provide a comprehensive review of the advances in the co‐liquefaction of various mixtures of plastic waste and different types of biomass feedstocks (lignocellulosic and algal) for the production of biofuels.

The influence of various reaction parameters, such as feedstock composition (blending ratio), temperature, catalyst type and loading, solvents, and reaction time on the product yield are explored. The synergistic interaction during the co‐liquefaction of biomass and plastic and the distribution and properties of biofuel products are also discussed.

The findings demonstrate that maximum product yields vary depending on the final temperature, and the blending ratio plays a crucial role in determining the distribution of liquefaction products. Of particular interest is biocrude oil, the components of which are influenced by the composition of the feedstock material. The distribution of organic elements in the biochar is contingent upon the type of plastic used. Although the analysis of gas‐phase components is often overlooked, the reaction medium's composition is shown to impact the resulting gas composition.

Finally, based on the insights gleaned from the literature, this review presents future perspectives on the subject matter. In general, the co‐liquefaction process offers a viable option for sustainable biofuel production and is a promising approach to address the waste plastics disposal challenges effectively, contributing to the valorization of plastic waste to achieve a circular bioeconomy in the future.
Stent dislodgement during withdrawal attempt into the guiding‐catheter: A step‐by‐step retrieval technique
Authors: Spînu Radu , Mangin Lionel , Pilichowski Hugo , Belle Loïc , Bonnet Marc
Published: May 2024

Catheter‐induced stent dislodgement may occur when attempting to withdraw the stent into the guide‐catheter particularly in cases of guiding‐catheter co‐axiality issues. We present the management of a catheter‐induced stent dislodgement with simultaneous loss of wire position.
Multimodal imaging assessment for feasibility of endovascular reconstruction in cases of inferior vena cava atresia
Authors: Kisling Adam , Basile Sean , Dagher Adelle , Sexton Jonathan , Twerdahl Eric
Published: May 2024

Key Clinical Message

Inferior vena cava atresia is a rare condition with highly variable anatomy due to the complexity of caval embryology. When endovascular venovenous reconstruction is considered for severe persistent sequelae, multimodality imaging with CT and invasive venography is used to determine the appropriateness of intervention and for procedural planning.
Primary extraperitoneal hydatid cyst, a rare differential diagnosis of subdiaphragmatic mass: A case report
Authors: Ghandhari Maryam , Mehri Amirhossein , Doostparast Armin , Gharib Masoumeh , Rezaei Reza
Published: May 2024

Key Clinical Message

Hydatid cyst is a sly disease that can manifest with a spectrum of symptoms in almost every part of the human body, so it is crucial to be familiar with different scenarios that a patient may present.

The echinococcus granulosus parasite causes hydatid disease and is common in areas with animal husbandry and agriculture. Here, we report a middle age woman who presented with abdominal pain that further investigation revealed a cyst in subdiaphragmatic area.
Uncommon manifestation of Ebstein anomaly: A case report of apical displacement involving all tricuspid valve leaflets
Authors: Jalali Amirhossein , Khajali Zahra , Parsaee Mozhgan , Behrooj Soudabe , Salehi Pegah , Akbarian Mahsa , Shemshadi Sara , Hooshyar Dariush
Published: May 2024

Key Clinical Message

This case report presents an uncommon variant of Ebstein anomaly, where all three tricuspid valve leaflets exhibited apical displacement—a rare finding. It illustrates the complexities in diagnosing and managing such atypical presentations, with successful surgical correction through annuloplasty. The report adds valuable insights to the limited literature on this congenital heart disease.

Ebstein anomaly (EA), a rare congenital heart disorder, presents with diverse clinical spectrums. This case report explores a distinctive manifestation of EA, where all three tricuspid valve (TV) leaflets exhibited apical displacement, highlighting a novel aspect in the presentation of this condition. A 44‐year‐old woman, under long‐term medical surveillance for EA, showcased an atypical clinical trajectory marked by the apical displacement of all TV leaflets, which is uncommon in EA. Despite a predominantly asymptomatic course, recent exacerbation of symptoms prompted further evaluation. Diagnostic modalities, including echocardiography and cardiac magnetic resonance imaging, revealed severe tricuspid regurgitation concomitant with unprecedented apical displacement of the anterior, septal, and posterior tricuspid leaflets. The displacement of the anterior leaflet was contrary to typical embryonic valvular formation expectations, indicating a unique presentation within EA. The patient underwent annuloplasty surgery, which successfully rectified the anomalous TV architecture. Postoperative evaluation demonstrated mild residual tricuspid regurgitation, and the patient was discharged in stable condition. This case underscores the variability in EA presentations and accentuates the significance of tailored surgical interventions. The observation of apical displacement involving all TV leaflets adds a unique dimension to the existing EA literature, reinforcing the need for careful diagnosis and personalized treatment approaches.
Functional neurological disorder mimicking stroke: A case report
Authors: Venturini G. , Sarti C.
Published: May 2024

KEY CLINICAL MESSAGE

Even in the era of technology‐guided medicine, the clinician must integrate into his daily practice a careful anamnesis and physical examination to be conducted within a close doctor–patient relationship. All these elements, together with tools such as teleconsultation and digitalized medical records, are able to significantly increase the effectiveness of health care action.
Monitoring plant growth by analyzing their morphology using microfocus X‐ray CT
Authors: Kunieda Tadashi , Hayashi Maika M. , Kumagai Ryo , Matsuura Noriaki , Haruta Makito , Ohta Jun , Demura Taku
Published: May 2024

The growth and development of embryophytes is deeply influenced by environmental stimuli, such as light, temperature, and soil nutrients. Understanding the mechanisms underlying the growth response of plants to environmental stimuli is crucial for agriculture. In this study, we examined the morphology of a flowering plant, Arabidopsis thaliana, using microfocus X‐ray computed tomography (µCT), which enables non‐destructive analysis of the external and internal structures of plants. Three‐dimensional (3D) images of the plant, which were reconstructed from X‐ray scanned data, clearly showed the shapes of its leaves, stems, and buds from any angle. At a higher magnification, the µCT also revealed the small hair‐like structures called trichomes on the Arabidopsis leaf epidermis. However, motion artifacts found in the 3D‐reconstructed images indicated that plant's growth rate was faster than scanning speed. Thus, scan parameters must be accordingly optimized. Additionally, CT‐based 3D printing can be used to design micro devices that can be further used to monitor plant growth. These results suggest that µCT is a useful technique for analyzing morphology of growing plants.
Gas classification by an electronic‐nose prototype based on a single gas sensor with novel temperature modulation
Authors: Saeki Maaki , Okura Yuki , Yoshikawa Takefumi , Iwata Tatsuya
Published: May 2024

An electronic nose prototype based on the novel temperature‐modulation technique is developed, where the heater voltage changes its amplitude and frequency periodically. The system comprises a sensor analog front end and a digital processing part including a heater voltage generator and a sensor data transmitter, where the digital part was implemented by a field programmable gate array. The fabricated prototype successfully generated the modulated heater waveform and synchronously acquired sensor responses at a sampling rate of 10 kHz. Whereby, sensor responses to the test gases of volatile organic compounds were collected. Gas classification was achieved with an accuracy of 99.6% based on the data obtained by the prototype, demonstrating the promising properties of the prototype as a compact and highly precise electronic nose.
Risk of COVID‐19 infection and seizure exacerbation among patients with epilepsy during the peak of Omicron wave
Authors: Leng Xiuxiu , Hu Gengyao , Wang Xuan , Zhang Yingchi , Guo Yaomin , Song Changgeng , Yang Fang , Jiang Wen , Wang Yuanyuan , Wang Xiaomu
Published: May 2024

Objectives

Existing data regarding the risk of COVID‐19 infection and its effects on seizure control in patients with epilepsy (PWE) are inconclusive. Our research aims to investigate the PWE who are susceptible to COVID‐19 and what factors contribute to seizure exacerbation.

Methods

From Dec 28, 2022 to Feb 19, 2023, a cross‐sectional questionnaire survey among adult PWE was conducted. The demographics, epilepsy‐related information, COVID‐19‐related variables, and seizure outcomes after COVID‐19 infection were collected. Multivariate logistic analyses were performed to determine the risk factors associated with COVID‐19 infection and exacerbated seizures.

Results

Of 1557 PWE, 829 (53.2%) were infected with COVID‐19 and 136 (16.4%) developed seizure exacerbation after COVID‐19 infection. Overweight/obesity (OR 1.372, 95% CI 1.075–1.753, p = 0.011), immunocompromised (OR 3.301, 95% CI 1.093–9.974, p = 0.031), active epilepsy (OR 1.700, 95% CI 1.378–2.097, p < 0.001), and antiseizure medication (ASM) polytherapy (OR 1.314, 95% CI 1.065–1.621, p = 0.011) were associated with COVID‐19 infection. Active epilepsy (OR 4.696, 95% CI 2.568–8.586, p < 0.001) and fever‐associated seizures (OR 4.298, 95%CI 2.659–6.946, p < 0.001) were associated with seizure exacerbation.

Significance

PWE with overweight/obesity, immunocompromised, active epilepsy, and ASM polytherapy were at higher risk of COVID‐19 infection. Once infected with COVID‐19, seizures were exacerbated in PWE with active epilepsy and fever‐associated seizures.

Plain language summary

Patients with epilepsy (PWE) do not appear to be more susceptible to COVID‐19 infection than general population. Once infected with COVID‐19, 16.4% of PWE had seizure exacerbation. The PWE who have experienced seizures within the past 12 months before infection tend to contract COVID‐19 more often, and are more likely to experience seizure exacerbations following COVID‐19 infection.
The how, when, and why of an abandoned bedrock meander of the Colorado River, Utah (U.S.)
Authors: Pederson Joel L. , Young Sherman C. , Turley Michael , Tanski Natalie , Rittenour Tammy M. , Harris Ron A.
Published: May 2024

River meanders entrenched into bedrock are found worldwide, and they are famously well represented in the Colorado Plateau of the southwestern U.S. Meandering of bedrock streams can eventually lead to cutting off canyon loops, and these abandoned “rincons” are locations with high preservation of fluvial deposits and landforms. We document and luminescence date the fluvial terraces in and around the Jackson Hole rincon along the Colorado River downstream of Moab, Utah. Results indicate cutoff and abandonment of the rincon at ~200 ka and also record the rapid and unsteady incision in this region over the past 300 ky. A convergence of conditions contributed to the cutoff of the rincon, including alluvial‐channel conditions at the onset of MIS 6 glacial‐climate, which provided channel‐bed cover and enhanced lateral erosion of weak strata. Also, a contemporaneous rock‐avalanche partially obstructed the paleochannel just downstream of the breach, potentially creating a backwater that further enabled a flood to avulse across the neck. Although other studies show that bedrock‐channel meandering and cutoff can generate unpaired strath terraces and short‐term increases in incision rates, these are not evident in the record at the Jackson Hole rincon. This novel case study leverages the high preservation potential within abandoned bedrock meanders to illuminate the processes and controls of rincon formation during landscape evolution.
Effects of the Coronavirus disease 2019 pandemic on mortality in patients with lung cancer: A multiple mediation analysis in Japan
Authors: Miyamori Daisuke , Kamitani Tsukasa , Yoshida Shuhei , Kikuchi Yuka , Shigenobu Yuya , Ikeda Kotaro , Yamamoto Yosuke , Ito Masanori
Published: May 2024

COVID‐19 pandemic has had a substantial effect on healthcare systems worldwide, including the care of patients with lung cancer. The impact of healthcare disruptions and behavioral changes on lung cancer mortality is unclear. Patients newly diagnosed with lung cancer during the pandemic period 2020–2021 were compared with those diagnosed in the pre‐pandemic 2018–2019. The primary outcome was all‐cause mortality within 1 year. Cox proportional hazards regression analyses were conducted to estimate the changes in mortality between pandemic and pre‐pandemic. Multiple mediation analyses were performed to determine the factors that accounted for the changes in mortality. In total, 5785 patients with lung cancer were included in this study. The overall mortality rate was significantly higher during the pandemic compared with the pre‐pandemic (crude hazard ratio [HR]: 1.19, 95% confidence interval [CI]: 1.05, 1.29). Mediation analyses showed that not receiving tumor‐directed treatment, diagnosis at an older age, and decreased diagnosis through cancer screening significantly accounted for 17.5% (95%CI: 4.2, 30.7), 13.9% (95%CI: 0.8, 27.0), and 12.4% (95%CI: 3.0, 21.8) of the increased mortality, respectively. This study revealed a significant increase in mortality risk in patients with lung cancer who have not received tumor‐directed treatment or cancer screening, despite potential selection bias for follow‐up status. Efforts should be focused on ensuring timely access to healthcare services, optimizing treatment delivery, and addressing the unique challenges faced by patients with lung cancer during the pandemic to mitigate the impact of the pandemic on lung cancer outcomes and provide clinical care to vulnerable populations.
International validation of meaningfulness of postural sway and gait to assess myeloneuropathy in adults with adrenoleukodystrophy
Authors: Yska Hemmo A. F. , Turk Bela R. , Fatemi Ali , Goodman Jordan , Voermans Marije , Amos Dan , Amanat Man , van de Stadt Stephanie , Engelen Marc , Smith‐Fine Amena , Keller Jennifer
Published: May 2024

Background

The most common manifestation of X‐linked adrenoleukodystrophy (ALD) is a slowly progressive myeloneuropathy, which leads to imbalance and gait disturbances. The variable progression of the disease complicates evaluation of its progression rate. Wearable sensors allow for easy and frequent balance and gait collection. This study reports baseline data from a longitudinal study on the quantitative assessment of balance and gait with wearable sensors and their clinical relevance.

Methods

Data were collected from adult patients in two institutions. Postural body sway and gait parameters were measured using accelerometers. Disease severity was measured by the Expanded Disability Severity Scale (EDSS). Falling frequency and quality of life (QOL) were collected in men. The relationship between sway and gait variables and EDSS score, participants' use of a walking aid, and falling frequency was evaluated.

Results

One hundred twenty individuals with ALD were included. Sway variables significantly differentiate participants' assistive device use. Sway and gait variables were correlated to the EDSS in both sexes. Both gait speed and sway were correlated with falling frequency in men from one institution. Select QOL subscores were correlated with the EDSS in males from one institution. Accelerometry generated comparable results across sites.

Discussion

This study confirms the clinical correlation between spinal cord disease and imbalance and gait in ALD. For the first time, this study shows clinically meaningful relationships for sway and gait with use of an assistive device, falling frequency and QOL. Wearable accelerometers are a valid means to measure sway and gait in ALD. These measures are promising outcomes for clinical trial designs to assess myeloneuropathy in ALD and to monitor disease progression in individuals.
Duration of cefazolin prophylaxis did not impact infection risk in a murine model of joint arthroplasty
Authors: Karau Melissa J. , Alarcon Perico Diego , Guarin Perez Serigo F. , Koscianski Christina , Abdel Matthew P. , Patel Robin , Bedard Nicholas A.
Published: May 2024

To minimize periprosthetic joint infection (PJI) risk, some clinicians prescribe extended antibiotic prophylaxis (EAP) following total joint arthroplasty (TJA). Given the limited evidence supporting EAP, we sought to evaluate impact of prophylactic antibiotic duration on PJI risk in a murine TJA model. A titanium prosthesis was implanted into the proximal tibia of 89 mice and inoculated with 102 colony forming units (cfu) of Staphylococcus aureus Xen36. Control mice (n = 20) did not receive antibiotics. Treated mice received either 24 h (n = 35) or 4 days (n = 34) of cefazolin prophylaxis. Cultures were obtained from the prostheses, tibia, femur, and knee tissues 3 weeks after surgery. All mice in the control group developed PJI. Both prophylaxis regimens reduced the rate of PJI relative to the control, with only 2/35 mice in the 24‐h cohort (p < 0.0001) and 1/34 in 4‐day cohort developing PJI (p < 0.0001). CFU counts from the prostheses, bone and knee tissues were reduced for the 24‐h and 4‐day prophylaxis cohorts relative to the control (p < 0.0001 for both). There was no difference in rates of PJI or CFU counts between the two prophylaxis cohorts (p = 0.58). Prophylactic cefazolin profoundly reduced rates of PJI in a murine model of TJA in which all control animals developed PJI. Extending cefazolin prophylaxis duration from 24 h to 4 days did not result in improved PJI rates or decreased bacterial loads in infected cases. While these results strongly support use of antibiotic prophylaxis for TJA, EAP did not appear to add benefit in the described mouse model.
Exploring shopping tourism as an adjunct therapy to improve mental health: Evidence from PLS‐SEM and NCA
Authors: Xu Jing Bill , Lee Stephanie W. , Choi H. S. Chris , Wong Shun‐mun
Published: May 2024

While previous tourism studies have examined mental health, additional research is necessary. Drawing on Rogers' theory of person‐centered therapy and self‐determination theory, this study explores shopping tourism as an adjunct therapy to improve mental health. 309 residents from Hong Kong who had shopping tourism experiences were surveyed. Partial Least Squares‐Structural Equation Modeling (PLS‐SEM) and Necessary Condition Analysis (NCA) were adopted. The results showed that shopping hedonism, consisting of memorable and fashion shopping, and tourism escapism had specific effects on tourists' self‐congruence and eventually enhanced mental health. While tourism escapism was shown through PLS‐SEM to be non‐significant in driving shopping tourists' self‐congruence, it proved to be a necessary condition of such self‐congruence in NCA. This study recommends that government agencies promote shopping tourism as a non‐conventional way of enhancing people's mental health. Destinations can also attract shopping tourists from the perspective of promoting their mental health.
Optimal intersurface stability for unicompartmental femoral component design with two pegs placed on the distal resection surface: 5 mm peg length increment and 10° peg inclination
Authors: Sun Yandong , Li Zhongyao , Zhao Kaiyu , Dimitriou Dimitris , Yang Biao , Cao Zhangyi , Ma Xin , Cheng Rongshan , Li Pingyue , Tsai Tsung‐Yuan
Published: May 2024

Purpose

The present study aimed to identify the optimal design of the unicompartmental femoral component through parameter analysis and stability evaluation.

Methods

A finite element (FE) analysis was applied to analyse and adjust the parameter combinations of the anterior tilt angle of the posterior condyle resection surface, the position of the peg, the length of the peg and the inclination angle of the peg, resulting in 10 different FE models. Setting three knee flexion angles of 8.4° (maximum load state during walking), 40° (maximum load state during stair climbing) and 90° (maximum load state during squatting exercise), quantitatively analysing the micromotion values of the bone–prosthesis interface and defining a weighted scoring formula to evaluate the stability of different FE models. The validity of the FE analysis was verified using the Digital Image Correlation (DIC) device.

Results

The errors between the FE analysis and the DIC test at three flexion angles were 5.6%, 1.7% and 11.1%. The 10 different femoral component design models were measured separately. The FE analysis demonstrated that the design with a 0° anterior tilt angle of the posterior condyle resection surface, both pegs placed on the distal resection surface, lengthened 5 mm pegs and a 10° peg inclination angle provided the best stability.

Conclusion

The current study proposed a method for evaluating the stability of the femoral component design. The optimal intersurface stability design of the unicompartmental femoral component was achieved with two pegs placed on the distal resection surface, a 5‐mm peg length increment and a 10° peg inclination. These results might provide a reference for the selection of unicompartmental femoral components in clinical practice and therefore improve the survival rate of future unicompartmental knee arthroplasty.

Level of Evidence

Level III.
Enhanced reliability and time efficiency of deep learning‐based posterior tibial slope measurement over manual techniques
Authors: Yao Shang‐Yu , Zhang Xue‐Zhi , Podder Soumyajit , Wu Chen‐Te , Chan Yi‐Shen , Berco Dan , Yang Cheng‐Pang
Published: May 2024

Purpose

Multifaceted factors contribute to inferior outcomes following anterior cruciate ligament (ACL) reconstruction surgery. A particular focus is placed on the posterior tibial slope (PTS). This study introduces the integration of machine learning and artificial intelligence (AI) for efficient measurements of tibial slopes on magnetic resonance imaging images as a promising solution. This advancement aims to enhance risk stratification, diagnostic insights, intervention prognosis and surgical planning for ACL injuries.

Methods

Images and demographic information from 120 patients who underwent ACL reconstruction surgery were used for this study. An AI‐driven model was developed to measure the posterior lateral tibial slope using the YOLOv8 algorithm. The accuracy of the lateral tibial slope, medial tibial slope and tibial longitudinal axis measurements was assessed, and the results reached high levels of reliability. This study employed machine learning and AI techniques to provide objective, consistent and efficient measurements of tibial slopes on MR images.

Results

Three distinct models were developed to derive AI‐based measurements. The study results revealed a substantial correlation between the measurements obtained from the AI models and those obtained by the orthopaedic surgeon across three parameters: lateral tibial slope, medial tibial slope and tibial longitudinal axis. Specifically, the Pearson correlation coefficients were 0.673, 0.850 and 0.839, respectively. The Spearman rank correlation coefficients were 0.736, 0.861 and 0.738, respectively. Additionally, the interclass correlation coefficients were 0.63, 0.84 and 0.84, respectively.

Conclusion

This study establishes that the deep learning‐based method for measuring posterior tibial slopes strongly correlates with the evaluations of expert orthopaedic surgeons. The time efficiency and consistency of this technique suggest its utility in clinical practice, promising to enhance workflow, risk assessment and the customization of patient treatment plans.

Level of Evidence

Level III, cross‐sectional diagnostic study.
Reduced physiological extrusion of the medial meniscus in axial load‐bearing condition in anterior cruciate ligament deficiency
Authors: Lee JiHwan , Lee Gyu Hwan , Zakaryaei Farima , Choi Jae Sung , Kim Jin Goo
Published: May 2024

Purpose

In this study, ultrasonography was used to measure medial meniscus (MM) extrusion under weight‐bearing and nonweight‐bearing conditions in both anterior cruciate ligament (ACL)‐deficient and ACL‐intact knee groups. This study aimed to determine the possible differences between these groups with an eventual impact on meniscal tears in ACL‐deficient knees.

Methods

A total of 107 patients who underwent ACL reconstructive surgery between June 2022 and April 2023 were enroled. After applying exclusion criteria, 37 patients met the conditions for inclusion in the study and formed the ACL deficiency group (Group D). Of the 141 patients presenting to an outpatient clinic who agreed to have ultrasonography conducted on their nondiscomforting contralateral knee, 37 patients matched for age, sex, hip–knee–ankle angle and body mass index with Group D patients were selected for the ACL intact group (Group I). Ultrasonography was used to measure MM extrusion in weight‐bearing and nonweight‐bearing conditions for all participants.

Results

Seventy‐four patients were included in the study (n = 37 per group). The supine position showed an MM extrusion of 1.2 ± 0.7 mm in Group I and 1.2 ± 0.7 mm in Group D (not significant). In the standing position, MM extrusion measured 2.0 ± 0.6 mm in Group I and 1.3 ± 0.8 mm in Group D. The difference in extrusion (Δextrusion) between the two positions was 0.8 ± 0.6 in Group I and 0.1 ± 0.2 in Group D, with statistical significance (p < 0.01). A consistent reduction in MM extrusion during weight‐bearing was observed in patients with ACL deficiency, irrespective of the duration of ACL deficiency, age, sex and BMI.

Conclusion

ACL deficiency did not significantly impact MM extrusion during nonweight‐bearing conditions; however, less MM extrusion was observed in response to axial loading conditions. These findings indicate altered MM biomechanics due to increased anterior‐posterior meniscal motion and rotational instability after ACL injury.

Level of Evidence

Level III.
Deltoid ligament injuries: A review of the anatomy, diagnosis and treatments
Authors: Koris Jacob , Calder James D. F. , Dalmau‐Pastor Miki , Fernandez Miguel A. , Ramasamy Arul
Published: May 2024

Purpose

Ankle sprains remain the most common soft tissue injury presenting to Emergency Departments. Recently, there has been increased awareness and reporting of deltoid ligament injuries in association with injuries to the lateral ligament complex as well as with fibula fractures. This article reviews the currently available literature on the anatomy of the deltoid ligament, clinical and radiological diagnosis of injuries to the deltoid ligament and treatment recommendations.

Methods

A literature review was conducted for keywords associated with deltoid ligament injuries. MEDLINE, PubMed and Embase databases were utilised for this search. Articles were included if involving an adult population, were English‐language, were related to deltoid ligament injuries (with or without associated injuries) and reported on patho‐anatomy, clinical or radiological diagnosis or treatment methods.

Results

A total of 93 articles were assessed for relevance from the database search, and 47 were included after the removal of irrelevant articles and duplicates. Several studies reported on the clinical findings of deltoid ligament injury, as well as the radiographic analysis. Arthroscopy was considered the gold standard of diagnosis, with authors reporting on the potential benefit of performing arthroscopic repair or reconstruction at the same time. There were no studies that provided a system for the classification of deltoid ligament injury or larger studies of treatment pathways. Long‐term studies of the incidence of instability in deltoid ligament injuries were not available.

Conclusion

There is limited evidence available regarding deltoid ligament injuries, particularly in terms of treatment options, either in isolation or with concomitant injuries. Long‐term follow‐up studies are needed to obtain more accurate data on the number of complications.

Level of Evidence

Level IV.
The mind matters: Psychological factors influence subjective outcomes following unicompartmental knee arthroplasty—A prospective study
Authors: ten Noever de Brauw Gaby V. , Aalders Margot B. , Kerkhoffs Gino M. M. J. , Zuiderbaan Hendrik A. , Keijser Lucien C. M. , Benner Joyce L.
Published: May 2024

Purpose

This study aimed to investigate how psychological factors, including pain catastrophizing (PC), anxiety and depression affect preoperative and postoperative subjective outcomes in patients undergoing unicompartmental knee arthroplasty (UKA).

Methods

A prospective comparative study was performed among 150 patients undergoing medial or lateral UKA for isolated unicompartmental osteoarthritis. Patients were categorized based on their preoperative PC and Hospital Anxiety and Depression Scale, stratifying them into groups with PC, anxiety or depression, and those without these psychological factors. Patient‐reported outcomes, including the Knee Injury and Osteoarthritis Outcome Score‐Physical function Short form (KOOS‐PS), 5‐level EQ5D Visual Analogue Scale (EQ5D‐VAS), Forgotten Joint Score (FJS) and Numeric Rating Scale for pain (NRS‐pain) were compared between groups preoperatively and at 6‐, 12‐, and 24‐month follow‐up.

Results

At 24 months, PC patients had inferior outcomes in KOOS‐PS (66.9 ± 16.5 vs. 77.6 ± 14.7, p = .008), EQ5D‐VAS (63.5 ± 19.9 vs. 78.9 ± 20.1, p = .003) and FJS (73.7 ± 14.3 vs. 84.6 ± 13.8, p = .003). Anxiety was associated with inferior KOOS‐PS (65.4 ± 15.2 vs. 78.2 ± 14.5, p = <.001), EQ5D‐VAS (64.2 ± 23.2 vs. 79.3 ± 19.4, p = .002), FJS (75.7 ± 16.8 vs. 84.6 ± 13.4, p = .008) and NRS‐pain (27.4 ± 24.6 vs. 13.7 ± 19.3, p = .023) at 24 months. Depression consistently resulted in inferior outcomes in KOOS‐PS, EQ5D‐VAS, FJS and NRS‐pain across all follow‐up assessments (p = <.05). Additionally, patients with anxiety and depression experienced longer length of hospital stay compared to those without these psychological factors (anxiety: 2.3 ± 2.3 vs. 0.8 ± 0.8 days, p = .006; depression: 2.3 ± 2.4 vs. 0.8 ± 0.8 days, p = .017).

Conclusions

Preoperative PC, anxiety and depression are associated with inferior subjective outcomes both prior to and following UKA. Among these factors, depression seemed to exert the most substantial adverse impact on outcomes following UKA. Patients with anxiety and depression had an extended duration of hospitalization lasting over twice as long as patients without these psychological factors. It seems that inferior outcomes primarily stem from the suboptimal preoperative condition rather than an inherent inability to benefit from UKA.

Level of Evidence

Level II, prospective study.
A clinical risk score enables early prediction of dissatisfaction 1 year after total knee arthroplasty
Authors: Strahl André , Delsmann Maximilian M. , Simon Alexander , Ries Christian , Rolvien Tim , Beil Frank Timo
Published: May 2024

Purpose

Dissatisfaction after total knee arthroplasty (TKA) is a prevalent and clinically relevant problem that affects approximately 10%–20% of patients. The aim of this study is to identify factors associated with dissatisfaction 1 year after TKA.

Methods

A total of 236 patients undergoing TKA were included in this prospective cohort study. Demographic data, preoperative clinical parameters (e.g., axial alignment, osteoarthritis severity) and patient‐reported outcome measures (PROMs) were collected preoperatively, at 1 month and 1 year after TKA, encompassing the Knee Society Score (KSS) and Knee injury and Osteoarthritis Outcome Score (KOOS). The primary outcome was dissatisfaction 1 year after TKA, defined as ≤20 points on the KSS satisfaction scale. A risk score based on multiple regression and area under the curve (AUC) analyses was calculated to predict dissatisfaction.

Results

One year after TKA, 16% of the patients were dissatisfied. Dissatisfied patients were significantly younger (p = 0.023) and had a higher body mass index (BMI) (p = 0.007). No differences were observed in preoperative objective (p = 0.903) and functional KSS (p = 0.346), pain (p = 0.306), osteoarthritis severity (p = 0.358), axial knee alignment (p = 0.984) or psychological distress (p = 0.138). The likelihood of dissatisfaction at 1 year was 3.0, 4.0, 7.4, 4.3 and 2.8 times higher amongst patients aged <63.5 years, with a BMI > 30.1 kg/m2, a KOOSPain < 50%, a KSSFunction < 42 points and a KSSExpectation < 9 points (all at 1 month), respectively. Using these variables, a risk score with a maximum of 7 points was developed, demonstrating a high predictive value for dissatisfaction (AUC: 0.792 [95% confidence interval: 0.700–0.884], p < 0.001).

Conclusion

Dissatisfaction 1 year after TKA can be predicted by a weighted risk score that includes patient age, BMI, pain, subjective functionality and unmet expectation 1 month postoperatively. Using the risk score, early detection of dissatisfaction has the potential to enable targeted interventions and improve patients' quality of life.

Level of Evidence

Level II, Prognostic study.
Meniscal allograft transplantation (MAT) combined with revision ACL reconstruction and lateral extra‐articular tenodesis results in significantly improved outcomes, but patient‐reported knee function is inferior compared to an isolated MAT
Authors: Mitrousias Vasileios , Chalatsis Georgios , Mylonas Theodoros , Siouras Athanasios , Panteliadou Freideriki , Stergiadou Stella , Hantes Michael
Published: May 2024

Purpose

Meniscal allograft transplantation (MAT) is a valuable option for postmeniscectomy syndrome in young and active patients, which can successfully improve symptoms, function and quality of life. This study aimed to report outcomes and complications in patients treated with isolated MAT or MAT combined with revision anterior cruciate ligament reconstruction (ACLR) and lateral extra‐articular tenodesis (LET).

Methods

In total, 18 patients who were treated with MAT using a soft tissue fixation technique were retrospectively analysed. Patients were allocated into two groups, the isolated MAT group and the MAT plus revision ACLR + LET group (MAT+ group). Both groups were assessed using the following Patient‐Reported Outcome Measures (PROMs): Knee Injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC), Tegner Activity Scale, Lysholm score, EuroQol 5‐Dimension 5‐level (EQ‐5D‐5L) questionnaire and a patient acceptable symptom state (PASS) statement.

Results

The mean follow‐up was 3.2 years and the mean age of patients was 29 (±7.6) years. Ten patients were treated with isolated MAT and eight patients were treated with MAT combined with revision ACLR and LET. No complications and no reoperations were reported. In both groups, all PROMs significantly improved postoperatively (p < 0.05), except for the Tegner score in the MAT+ group, which did not reach statistical significance (not significant [n.s.]). No significant difference was found postoperatively in PROMs between the MAT and the MAT+ group; however, differences in the KOOS Symptoms, Sports and Quality‐of‐life subscales reached the minimal clinically important threshold. Mean values were: IKDC 61.2 (±13.9) versus 64.7 (±23.2), KOOS Total 72.8 (±14.9) versus 68.0 (±16.7), Lysholm score 83.2 (±11) versus 84.2 (±8.7) and EQ‐5D‐5L 71.8 (±14.9) versus 72.2 (±22.4). Median values for the Tegner Activity Scale were 4 versus 3. PASS statement was negative in 37.5% of the MAT+ group in comparison to 20% of the MAT group (n.s.).

Conclusion

In terms of patient‐reported outcomes, MAT is an effective and safe procedure, even when combined with revision ACLR + LET. Compared to the preoperative assessment, a significant improvement of the postoperative PROMs can be expected either when MAT is performed isolated or in combination with ACLR + LET. However, clinically important differences between the two groups can be noted in favour of the isolated MAT procedure, especially regarding symptoms and sporting activity.

Level of Evidence

Level III.
Datacubes as enabler for advanced decision support systems in land management
Authors: Baumann Peter , Merticariu Vlad , Misev Dimitar , Pham Huu Bang , Langella Giuliano
Published: May 2024

Informed, wise, land management has been a challenge since a long time, but has gained extra importance through the need for responding to climate change effects. The European Green Deal is one example of a concertation effort in a world where data availability, sharing options, and just‐in‐time exploitation are not entirely solved. The LandSupport service responds to this challenge through a combination of a Spatial Decision Support System on top of a datacube management and analytics engine. In this paper, we specifically focus on this datacube engine and how it can contribute to a better decision making through an ordered multidimensional data management paired with strictly standards‐compliant interfaces. Further, the approach described shows a remedy against the current fragmentation of services: through a location‐transparent federation a single common pool of information is established, including distributed fusion allowing an unlimited mix‐and‐match of data regardless of their location.
Remote 3D Imaging and Classification of Pelagic Microorganisms with A Short‐Range Multispectral Confocal LiDAR
Authors: Santos Joaquim , Jakobsen Hans H. , Petersen Paul M. , Pedersen Christian
Published: May 2024

Plankton is essential to maintain healthy aquatic ecosystems since it influences the biological carbon pump globally. However, climate change‐induced alterations to oceanic properties threaten planktonic communities. It is therefore crucial to monitor their abundance to assess the health status of marine ecosystems. In situ optical tools unlock high‐resolution measurements of sub‐millimeter specimens, but state‐of‐the‐art underwater imaging techniques are limited to fixed and small close‐range volumes, requiring the instruments to be vertically dived. Here, a novel scanning multispectral confocal light detection and ranging (LiDAR) system for short‐range volumetric sensing in aquatic media is introduced. The system expands the inelastic confocal principle to multiple wavelength channels, allowing the acquisition of 4D point clouds combining near‐diffraction limited morphological and spectroscopic data that is used to train artificial intelligence (AI) models. Volumetric mapping and classification of microplastics is demonstrated to sort them by color and size. Furthermore, in vivo autofluorescence is resolved from a community of free‐swimming zooplankton and microalgae, and accurate spectral identification of different genera is accomplished. The deployment of this photonic platform alongside AI models overcomes the complex and subjective task of manual plankton identification and enables non‐intrusive sensing from fixed vantage points, thus constituting a unique tool for underwater environmental monitoring.
Enhancing X‐Ray Excited Persistent Luminescence in Lanthanide‐Doped Fluoride Nanoparticles via a Versatile Acid Pickling Strategy
Authors: Zhang Shuning , Wang Yubin , Deng Degang , Zhou Su , Xu Shiqing , Lei Lei
Published: May 2024

X‐ray excited persistent luminescence (XEPL) of lanthanide‐doped fluoride nanoparticles (NPs) holds promise for applications in back‐ground free bio‐medicine and flexible 3D imaging. However, it remains a daunting challenge to develop a universal and convenient route to greatly improve the XEPL performance of most fluoride nanosystems. Herein, for the first time, a versatile acid pickling strategy is proposed to greatly enhance the XEPL intensity of lanthanide‐doped fluoride NPs with different chemical compositions and activator types. Especially, after treatment with diluted HCl, the XEPL intensity of the NaYF4: Tb NPs with a mean particle size of ≈ 7 nm is enhanced ≈17.4 times. Mechanistic studies indicate the trap density in the NPs upon X‐ray irradiation is greatly enhanced after HCl treatment, contributing to the enhanced XEPL intensity. By integrating the HCl‐treated NPs into a scintillation film, the X‐ray image resolution is significantly increased from 6.3 to 11 lp mm−1, and the quality of delayed X‐ray images improved, particularly at low‐dose irradiation rates. These findings are expected to advance the development of high‐performance X‐ray‐activated persistent fluoride NPs and their applications for low‐dose high‐resolution X‐ray imaging.
From ugly to attractive: Leveraging anthropomorphism to increase demand for irregular‐appearing produce
Authors: Kim Kacy , Ryoo Yuhosua , Manika Danae , Yoon Nathan , Yoon Sukki
Published: May 2024

Recognizing that the waste of imperfect produce contributes to the global environmental crisis, the authors conduct three studies examining whether retailers can use anthropomorphizing marketing techniques to make irregular‐appearing produce more attractive and increase purchase intentions. Based on the exemplar model theory, Study 1 shows that when retailers place googly eyes on pictures of irregular‐appearing produce, consumers judge the product according to multiple exemplars as they do when they evaluate humans. The multiple esthetic cues cause them to perceive irregular produce as more attractive. Study 2 replicates Study 1 by using human names as the anthropomorphic cues, demonstrating that anthropomorphism can increase purchase intentions toward irregular‐appearing produce. Study 3 further shows that the anthropomorphism effects hold for irregular‐appearing produce from corporate farms and not from local farms. The differences occur because consumers expect corporate farms to conform to standardized esthetic norms but expect local farms to market irregular‐appearing produce. When expectations are aligned, anthropomorphism is more likely to cause consumers to diversify esthetic cues, but not when expectations are disassociated. The article concludes with suggestions for promotion strategies that use anthropomorphizing to change attitudes and increase purchase intentions toward irregular‐appearing produce.
Cholecystitis following the initiation of glucagon‐like peptide‐2 analogue for short bowel syndrome: A case report
Authors: Goto Yudai , Masumoto Kouji , Jimbo Takahiro , Sasaki Takato , Tanaka Yasunari , Shirane Kazuki
Published: May 2024

Patients with short bowel syndrome (SBS) have a risk for cholelithiasis and cholecystitis, particularly those who have received long‐term parenteral nutrition (PN). Teduglutide (Revestive), a glucagon‐like peptide‐2 (GLP‐2) analogue, is the first effective therapy approved for treating patients with SBS via self‐subcutaneous injection. It also pharmacologically inhibits gallbladder contraction, which may increase the risks for cholelithiasis and cholecystitis. Here, we report a case of cholecystitis occurring after the introduction of a GLP‐2 analogue in a patient with SBS and cholelithiasis. A 16‐year‐old girl, with a residual intestinal anatomy of 5 cm jejunum and left colon, was referred to our hospital for further treatment of SBS. She underwent jejunocolic anastomosis 2 months later. After that, she received PN for 2.5 years. Teduglutide treatment was initiated to reduce PN dependence. Several asymptomatic gallbladder stones were found during a routine ultrasound examination before drug initiation. On day 31 of teduglutide treatment, right subcostal pain with fever occurred, and the patient was diagnosed with acute cholecystitis. GLP‐2 analogue treatment was temporarily discontinued. The patient underwent gallbladder drainage followed by cholecystectomy 3 weeks later. Histopathological findings illustrated mucosal hyperplasia of the gallbladder. Her postoperative course was uneventful, and teduglutide was restarted 2 weeks postoperatively. GLP‐2 analogues promote gallbladder refilling and epithelial hyperplasia, which may be a risk factor for cholecystitis in patients with cholelithiasis, as observed in our patient. Based on our experience, patients with SBS and established asymptomatic cholelithiasis may be considered for prophylactic cholecystectomy before the administration of GLP‐2 analogues.
Predisposing, Enabling, and Need Factors Driving Palliative Care Use in Head and Neck Cancer
Authors: Fereydooni Soraya , Valdez Caroline , Williams Lauren , Malik Devesh , Mehra Saral , Judson Benjamin
Published: May 2024

Objective

Characterizing factors associated with palliative care (PC) use in patients with stage III and VI head and neck cancer using Anderson's behavioral model of health service use.

Study Design

A retrospective study of the 2004 to 2020 National Cancer Database.gg

Methods

We used multivariate logistic regression to assess the association of predisposing, enabling, and need factors with PC use. We also investigated the association of these factors with interventional PC type (chemotherapy, radiotherapy, surgery) and refusal of curative treatment in the last 6 months of life.

Results

Five percent of patients received PC. “Predisposing factors” associated with less PC use include Hispanic ethnicity (adjusted odds ratio [aOR], 086; 95% confidence interval [CI], 0.76‐0.97) and white and black race (vs white: aOR, 1.14; 95% CI, 1.07‐1.22). “Enabling factors” associated with lower PC include private insurance (vs uninsured: aOR, 064; 95% CI, 0.53‐0.77) and high‐income (aOR, 078; 95% CI, 0.71‐0.85). “Need factors” associated with higher PC use include stage IV (vs stage III cancer: aOR, 2.25; 95% CI, 2.11‐2.40) and higher comorbidity index (vs Index 1: aOR, 1.58; 95% CI, 1.42‐1.75). High‐income (aOR, 0.78; 95% CI, 0.71‐0.85) and private insurance (aOR, 0.6; 95% CI, 0.53, 0.77) were associated with higher interventional PC use and lower curative treatment refusal (insurance: aOR, 0.82; 95% CI, 0.55, 0.67; income aOR, 0.48; 95% CI, 0.44, 0.52).

Conclusion

Low PC uptake is attributed to patients' race/culture, financial capabilities, and disease severity. Culturally informed counseling, clear guidelines on PC indication, and increasing financial accessibility of PC may increase timely and appropriate use of this service.