bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of osteoprotegerin rs3102735 gene polymorphism in acute ischemic stroke patients
Authors: Monir Dina , Osama Ahmed , Saad Alaa Eldin , Negm Mohamed , Abd El-Razek Reda
Published: April 2023

Background

Ischemic stroke ranks third among leading causes of death and disability. Both endothelial and vascular smooth muscle cells generate osteoprotegerin (OPG). Ischemic stroke and its severity may be enhanced by the OPG rs3102735 gene polymorphism. Our research aims to investigate OPG rs3102735 gene polymorphism role in ischemic stroke risk and to assess its association with stroke severity at presentation and degree of vascular stenosis and evaluate its potential as a predictor of stroke severity. Fifty people with acute ischemic stroke as well as fifty controls were studied. The NIHSS and ASPECTS were utilized to evaluate stroke severity and the infarction size, respectively. All subjects underwent extracranial carotid duplex study and molecular assessment for genotyping of OPG rs3102735) gene polymorphism.

Results

Stroke patients had markedly higher concentrations of OPG in the plasma than controls (311.60 ± 109.48 versus 240.20 ± 75.96 mmol/ml, p = 0.001). The optimal plasma OPG cutoff value for the predicting the occurrence of stroke was determined to be > 250 mmol/ml, the 95% confidence interval (CI) was (0.625–0.843), sensitivity was 68% and specificity was 72%. Ischemic stroke had a significantly different genotype distribution for the OPG rs3102735 gene polymorphism than did controls (36 CC, 13 CT, and 1 TT) versus (28 CC, 15 CT, and 7 TT) respectively. Stroke patients had a significantly greater CC + CT genotype than controls did (P = 0.041), also they had a higher propensity for carrying the C allele than the T allele (P = 0.017). Carotid intima medium thickness and the NIHSS both had positive correlations with OPG serum level (r = 0.39, p = 0.02 and r = 0.4, p = 0.02, respectively), whereas ASPECTS had an inversed correlation (r = − 0.65, p = 0.001).

Conclusions

The current study shows that as an independent risk factor, increased plasma OPG level, may participate in the atherothrombotic ischemic stroke pathophysiology, in addition, genetic variants in the OPG gene (rs3102735) are a separate risk factor for large artery atherosclerosis and plasma OPG level can serve as a biomarker to determine the severity of a stroke.
Case report of coexisting transposition of the great arteries with supracardiac total anomalous pulmonary venous connection: focus on computed tomography features
Authors: Nawawi Yusuf Syaeful , Sari Indah Purnama , Maryetty Ida Prista , Rahayu Rachmi Fauziah , Widjaja Sri Lilijanti
Published: April 2023

Background

The coexisting of transposition of the great arteries (TGA) with total anomalous pulmonary venous connection (TAPVC) is one of the rare anomalies. The incidence of coexisting TAPVC and TGA is unknown with very few cases ever reported.

Case presentation

We reported a case of a 13-month-old female toddler with history of cyanosis. Echocardiography revealed atrioventricular ambiguity with pulmonary atresia, all PVs drain into the innominate vein via vertical vein (VV), ostium secundum atrial septal defect (ASD) and ventricular septal defect (VSD) were observed. The CT scan confirmed co-occurrence of TGA and TAPVC. All four confluence PVs behind the small left atrium (LA), drains into an ascending lateral large VV, coursing to innominate vein without any PV access into LA. The superior vena cava, right atrium and right ventricle (RV) were dilated. The RV is the origin of the aortic root. The aorta continues on the right side, with an arterial connection to the right pulmonary aberrant artery at the level of the aortic arch. Main pulmonary artery originates from LV and appears atretic with only connection to the left pulmonary artery. Large ASD and VSD were identified.

Conclusions

TGA and TAPVC are a rare combination and should be suspected in mild-cyanotic cases with levocardia with situs solitus. CT angiography is one of the modalities of choice to characterize the vasculature anomalies.
Autoregulation: mediators and renin–angiotensin system in diseases and treatments
Authors: Mansour Antony Sameh
Published: April 2023

Background

Hemodynamic regulation is a substantial part of the physiological integrity of the human body. It is based on the delivery of proper blood perfusion to every organ. Five primary vasoactive substances are nearly located throughout the human body, either released from the endothelium, prostanoids, nitric oxide (NO), and endothelin-1 (ET-1); or considered as hormones, bradykinin (BK) and natriuretic peptides (NPs).

Main body

The circulating mediators are in synchronization with the renin–angiotensin system (RAS) during the pathogenesis of the main vital organs, heart, kidney, lung, liver, and brain. The RAS system has been an extensive therapeutic approach for cardiovascular and renal diseases for decades, but more recently became a crucial regulator of hemodynamics in other organs after the actions of its components were detected in other organs. All the mentioned disorders here begin with the initiation of abnormal imbalance between vasoactive mediators which causes vascular dysfunction and histopathological situations that may induce oxidative stress which exaggerates the disorder if there is no clinical intervention.

Conclusion

We will review the currently identified signaling pathways and the possible relationships between those compounds elucidating how they interfere with serious diseases including cardiovascular diseases (CVDs), chronic kidney disease (CKD), pulmonary arterial hypertension (PAH), portal hypertension (PHT), and Alzheimer's disease (AD). Thus, this updated review summarizes years of work that aims to define the contribution of each mediator in both normal and pathological states, besides the drugs based on their activity and their places in either preclinical or clinical trials.
Ultrasensitive Circulating Tumor DNA Pilot Study Distinguishes Complete Response and Partial Response With Immunotherapy in Patients With Metastatic Renal Cell Carcinoma
Authors: Chehrazi-Raffle Alexander , Muddasani Ramya , Dizman Nazli , Hsu JoAnn , Meza Luis , Zengin Zeynep B. , Malhotra Jasnoor , Chawla Neal , Dorff Tanya , Contente-Cuomo Tania , Dinwiddie Devin , McDonald Bradon R. , McDaniel Timothy , Trent Jeffrey M. , Baehner Frederick L. , Murtaza Muhammed , Pal Sumanta K.
Published: April 2023

PURPOSE

Circulating tumor DNA (ctDNA) has been validated across multiple indications in the adjuvant and surveillance settings. We evaluated whether targeted digital sequencing (TARDIS) may distinguish a partial response (PR) from a complete response (CR) among patients with metastatic renal cell carcinoma (mRCC) receiving immune checkpoint inhibitor (ICI) therapy.

MATERIALS AND METHODS

Eligible patients had mRCC that yielded a PR or CR to ICI therapy. Peripheral blood was obtained at a single time point for ctDNA analysis. TARDIS was used for quantification of average variant allele fractions (VAFs). Our primary objective was to determine the association between VAFs and depth of response (PR v CR). A secondary objective was to determine whether VAFs were associated with disease progression.

RESULTS

Twelve patients were analyzed, nine of whom achieved a PR (75%). Patients received either nivolumab monotherapy (50%) or nivolumab plus ipilimumab (50%). ctDNA analysis incorporated an average of 30 patient-specific mutations (range, 19-35); average coverage depth was 103,342 reads per target. TARDIS quantified a significant difference in VAFs between PR and CR (median, 0.181% [IQR, 0.077%-0.420%] v 0.007% [IQR, 0.0%-0.028%], respectively [ P = .014]). Of the 12 patients in the series, six patients demonstrated radiographic progression subsequent to ctDNA assessment. Patients who progressed on subsequent scans had significantly higher ctDNA than those who maintained their response (median, 0.362% [IQR, 0.181%-2.71%] v 0.033% [IQR, 0.007%-0.077%], respectively [ P = .026]).

CONCLUSION

In this pilot study, TARDIS accurately differentiated PR from CR among patients with mRCC receiving immunotherapy, and also prospectively identified patients at risk for subsequent progression. Given these findings, we envision subsequent studies that validate these results and investigate the utility of this assay to discern appropriate candidates for discontinuation of immunotherapy.
Pertuzumab Plus Trastuzumab in Patients With Endometrial Cancer With ERBB2/3 Amplification, Overexpression, or Mutation: Results From the TAPUR Study
Authors: Ahn Eugene R. , Rothe Michael , Mangat Pam K. , Garrett-Mayer Elizabeth , Ali-Ahmad Hussein M. , Chan John , Maitland Michael L. , Patel Sapna R. , Reese Zachary , Balmanoukian Ani S. , Drescher Charles W. , Li Rui , Tsimberidou Apostolia M. , Leath Charles A. , O'Lone Raegan , Grantham Gina N. , Halabi Susan , Schilsky Richard L.
Published: April 2023

PURPOSE

The TAPUR Study is a pragmatic basket trial evaluating antitumor activity of commercially available targeted agents in patients with advanced cancers harboring potentially actionable genomic alterations. Data from a cohort of patients with endometrial cancer (EC) with ERBB2 or ERBB3 (ERBB2/3) amplification, overexpression, or mutation treated with pertuzumab plus trastuzumab (P + T) are reported.

METHODS

Eligible patients had advanced EC, no standard treatment options, measurable disease (RECIST v1.1), Eastern Cooperative Oncology Group performance status 0-2, adequate organ function, and tumors with ERBB2/3 amplification, overexpression, or mutation. Simon's two-stage design was used with a primary end point of disease control (DC), defined as objective response (OR) or stable disease (SD) of at least 16 weeks (SD16+) duration. Secondary end points include safety, duration of response, duration of SD, progression-free survival (PFS), and overall survival (OS).

RESULTS

Twenty-eight patients were enrolled from March 2017 to November 2019; all patients were evaluable for efficacy and toxicity. Seventeen patients had tumors with ERBB2/3 amplification and/or overexpression, eight with both ERBB2 amplification and ERBB2/3 mutations, and three with only ERBB2 mutations. Ten patients had DC (two partial response and eight SD16+); all 10 had ERBB2 amplification, and 6 of the 10 patients with DC had >1 ERBB2/3 alteration. DC and OR rates were 37% (95% CI, 21 to 50) and 7% (95% CI, 1 to 24), respectively; the median PFS and median OS were 16 weeks (95% CI, 10-28) and 61 weeks (95% CI, 24-105), respectively. One patient experienced a grade 3 serious adverse event (muscle weakness) at least possibly related to P + T.

CONCLUSION

P + T has antitumor activity in heavily pretreated patients with EC with ERBB2 amplification and warrants additional study.
Consistent Exercise Timing as a Strategy to Increase Physical Activity: A Feasibility Study
Authors: Schumacher Leah M. , Kalala Siddhartha , Thomas J. Graham , Raynor Hollie A. , Rhodes Ryan E. , Bond Dale S.
Published: April 2023

Introduction/Purpose

Observational research suggests that consistent exercise timing could be leveraged to promote moderate to vigorous physical activity (MVPA) among adults with obesity. However, the feasibility and acceptability of prescribed consistent exercise timing in a free-living setting is unknown. The purpose of this study was to assess the feasibility and acceptability of prescribed consistent exercise timing in a free-living setting among inactive adults with obesity (primary) and to compare MVPA timing prescription and characterize barriers/facilitators (secondary).

Methods

Using a within-subjects design, inactive adults with obesity (n = 15) were randomized in a counterbalanced order to three 3-wk exercise timing conditions separated by 2-wk washout periods: 1) consistent morning, 2) consistent evening, and 3) choice timing (control). Feasibility was assessed using prespecified benchmarks. Acceptability and preferred timing were assessed with questionnaires postintervention. Secondarily, exercise timing and MVPA were assessed via accelerometry, and nightly surveys and barriers/facilitators were assessed with nightly surveys.

Results

All feasibility benchmarks were achieved (e.g., timing adherence = 69.9% via accelerometry and 87.4% via self-report; target, ≥60%). Consistent exercise timing was acceptable (mean rating = 3.7 of 5; target, ≥3.5). Choice was the most popular prescription. There were medium- to large-sized effects (partial η
2 of 0.09–0.16) of condition on MVPA; MVPA was higher during the morning and the evening conditions versus choice condition. Facilitators were similar across conditions, whereas some barriers were time specific.

Conclusion

Prescribed exercise timing in a free-living setting appears feasible and acceptable. Although choice timing was most preferred, consistent timing appeared most effective for increasing MVPA. Data warrant larger trials to test the efficacy and mechanisms of consistent exercise timing as a translational strategy for promoting MVPA. Pending findings from a fully powered randomized trial, practitioners interested in promoting MVPA among their patients or clients could consider encouraging exercise at a consistent time day to day.
THE MEMORY OF THE BODY AS TRANSPERSONAL ARCHETYPE
Authors: Lucaciu Adriana
Published: April 2023

The paper proposes a perspective based on a research through art at the crossroads between personal memory, corporeality, transpersonal archetypes and drawing. If art can be admitted as a way of ‘writing’ through images, self-reflexive art can be considered a self-description, as well as an ‘autograph’, which is not reduced to affectivity. From here it is only a step to notice that the ‘disguised’ revelation of the self as our memory archived it, by artistic works, turns out to be a symbolic narrative, expressed through metaphors with autobiographical overtones. The artistic act placed outside of creation in relation to the evaluative factors, is exempt from gratuity because it responds to at least one existential need – that of self-expression, which becomes paramount in historical, social and private history contexts. It plays a main role in documenting actual life and preserving it for the future, like reveries of dissolution and permanence.
RENEWAL OF THE GREEK ILLUSTRATED CHILDREN’S BOOK DURING THE METAPOLITEFSI
Authors: Delfino Ioanna
Published: April 2023

With the restoration of democracy in Greece in 1974 a period of transition began, known as metapolitefsi, which saw deep political, social and economic changes. Progressive developments also occurred in art, culture and education. The rules of the new pedagogy affected the field of literature and more specifically children’s illustrated books. Thus, writers departed from the old conservative models, dominated by protectionism and superficial idealism. Instead, they introduced political, social and environmental concerns, while the language became friendlier and modern. At the same time, illustrators such as Kyritsopoulos, Zarampouka, Fakinou, Maroulakis, Psaraki a.s.o., begin to move away from the dry literalness and naive realism of most of their predecessors. They draw on a wide range of sources, from cartoons to abstraction and from Art Nouveau to Pop Art, they experiment with techniques never before used in Greek book illustration, and use innovative symbolism to convey textual meanings. Their style becomes intimate, imaginative and humorous. Pictures are no longer a merely decorative accompaniment to the text which is particularly important. They often cover the entire surface of the page, and play a decisive role in the development of the story. In short, they become central to the experience of the book. It is no coincidence that the young illustrators of the 70s and 80s often wrote their own texts. Typography, too, escapes from strict rules. Handwritten lettering, previously unheard of in Greek books, is often used on covers and title pages. Overall, during the early years of the Greek metapolitefsi, children’s illustrated books changed radically and caught up with international developments. The predictable layout and obvious didacticism of previous decades, especially during the military junta (1967-1974), gave way to sophistication, sensitivity and wit, fresh and intelligent ways of introducing children to real-life social and ethical issues.
Μουσειακή Μάθηση στη μετά-covid εποχή:
Authors: Τράντα Αλεξάνδρα , Λαπούρτας Ανδρέας
Published: April 2023

Η εκπαιδευτική διάσταση, παράμετρος ανέκαθεν συνυφασμένη με τη λειτουργία του μουσείου, τροποποιείται βάσει των επιστημονικών δεδομένων κάθε εποχής, των σχετικών με τη γνώση και τη μάθηση. Στο πλαίσιο του εκδημοκρατισμού του μουσείου, έχει καλλιεργηθεί η συμπερίληψη, δηλαδή η μέριμνα για όλους τους επισκέπτες και η διασύνδεση με ποικίλες ομάδες κοινού. Το άρθρο πραγματεύεται τον σχεδιασμό, την περιγραφή και την αξιολόγηση ενός εκπαιδευτικού προγράμματος για παιδιά, το οποίο σχεδιάστηκε με αφορμή την περιοδική έκθεση «Αδάμαστη φύση», της Αφροδίτης Λίτη, στο Μουσείο Περιβάλλοντος Στυμφαλίας, το οποίο ανήκει στο Δίκτυο Μουσείων του Πολιτιστικού Ιδρύματος Ομίλου Πειραιώς. Το πρόγραμμα σχεδιάστηκε με βάση τις σύγχρονες θεωρίες για τη μουσειακή μάθηση, και κυρίως τη μάθηση μέσω αντικειμένων, τη θεωρία των πολλαπλών τύπων νοημοσύνης και τα αποτελέσματα της γενικής μάθησης. Το προαναφερθέν πρόγραμμα αποτελεί ολοκληρωμένη, διεπιστημονική προσέγγιση για την ενίσχυση της κατανόησης της πολιτιστικής κληρονομιάς από τους νέους, η οποία βασίζεται στη βιωματική μάθηση και σε σύγχρονες παιδαγωγικές προσεγγίσεις που δίνουν προτεραιότητα στα υποκείμενα (τους εκπαιδευόμενους) και όχι στο αντικείμενο της μάθησης. Το πρόγραμμα, διαφοροποιημένο, απευθύναμε σε δύο ομάδες που υποεκπροσωπούνται στη Μουσειακή Μάθηση, σε νήπια και εφήβους, ομάδες με κοινά χαρακτηριστικά την αυξημένη ανάγκη για ενεργό συμμετοχή, ιδιαίτερα μετά την πανδημία, την κοινωνικοποίηση και την ελευθερία στην έκφραση. Στα παιδιά του Νηπιαγωγείου, η αξιολόγηση έγινε μέσω συμμετοχικής παρατήρησης και διανομής των ερωτηματολογίων στους εκπαιδευτικούς. Στους μαθητές του Γυμνασίου, η αξιολόγηση έγινε μέσω συμμετοχικής παρατήρησης και διανομής ερωτηματολογίων σε μαθητές και καθηγητές. Το ενδιαφέρον σημείο έγκειται στο ότι, βάσει της αξιολόγησης, προκύπτει ότι η Μουσειακή Μάθηση θα πρέπει να επικεντρωθεί λιγότερο στο εύρος των γνώσεων και περισσότερο στην καλλιέργεια της ενσυναίσθησης. Και βέβαια, να προσπαθήσουμε να λέμε λιγότερα και να ακούμε περισσότερο τους επισκέπτες των μουσείων, και ιδιαίτερα αυτούς νεαρής και πολύ νεαρής ηλικίας, καθώς στο σύγχρονο, «επανεφευρημένο» μουσείο, καθώς και στη Μουσειακή Μάθηση, με τον ανθρωποκεντρικό χαρακτήρα, προτεραιότητα έχουν οι επισκέπτες και τα υποκείμενα της μάθησης.
Long-COVID, neurological and cardiovascular disorders
Authors: Saienko Oleksandr , Chemych Mykola , Svitailo Vladyslav
Published: April 2023

Introduction. After the disease COVID-19 caused by the SARS-CoV-2 virus, many people recover completely, but others have symptoms that persist for weeks, months or even years after the illness, with the number of patients who are worried about the signs of Long-COVID constantly growing.

The aim. Study of the features of the epidemiological and clinical course, pathophysiological mechanisms of long-COVID development, based on the study and analysis  of modern scientific data and the establishment of causal relationships of damage to the nervous and cardiovascular systems.  

Materials and methods. The electronic databases Scopus, PubMed, Web of Science, using modern technologies (Obsidian), key terms and words related to Long COVID, distant neurological and cardio-vascular complications have been studied and analyzed.

Conclusions. "Long COVID" is conceptualized as a multiorgan disorder with a wide range of clinical signs that may indicate primarily damage to the nervous and cardiovascular systems. Central or peripheral nervous system lesions occur in more than one-third of patients. Cardiovascular complications, including stroke, are the predominant causes of death of people with "long COVID" (40 %). The most frequent neurological signs of "Long COVID" (>70 %) are fatigue, headache, sleep disorders, emotional disorders and sensorimotor disorders. The processes of neuroinflammatory and oxidative stress predominate in the spread of neurological consequences of "Long COVID".
The Design and Targeting of Compliance Promotions
Authors: Daljord Øystein , Mela Carl F. , Roos Jason M. T. , Sprigg Jim , Yao Song
Published: April 2023

This paper addresses how and when to extrapolate experimental results for normative policy analysis, particularly in the context of compliance promotions in which consumers can self-select into treatment.
Tax Planning Knowledge Diffusion via the Labor Market
Authors: Barrios John M. , Gallemore John
Published: April 2023

We examine the extent to which the labor market facilitates the diffusion of tax-planning knowledge across firms. Using a novel data set of tax department employee movements between S&P 1500 firms, we find that firms experience an increase in their tax planning after hiring a tax employee from a tax-aggressive firm. This finding is robust to various research designs and specifications. Consistent with tax-planning knowledge driving the result, we find that the tax-planning benefits are more substantial when the employee is involved in a director-level role and has more experience. Further tests suggest that tax-planning knowledge is highly specific in nature: the increase in tax avoidance is larger when the hiring and former firms are similar (i.e., operating in the same sector or having similar foreign operations), and firms are more likely to hire tax department employees from firms with similar characteristics. Finally, we do not find that the prior firm’s tax planning changes after the employee leaves the firm, suggesting that the tax-planning knowledge simply spreads to the hiring firm and does not leave the prior firm. Our study documents the first order role of the labor market in the diffusion of tax-planning knowledge across firms, and our findings suggest that tax department human capital is a central determinant of tax-planning outcomes.

This paper was accepted by Suraj Srinivasan, accounting.

Supplemental Material: The online appendix and data are available at https://doi.org/10.1287/mnsc.2023.4741 .
Vascular access device type for systemic anti-cancer therapies: a scoping review protocol
Authors: Duggan Caitriona , Hernon Orlaith , Dunne Rosie , McInerney Veronica , Walsh Stewart R , Carr Peter J
Published: April 2023

Introduction: Vascular access devices (VADs) are the most common invasive procedure performed in acute medicine and cancer patients undergo multiple invasive vascular access procedures. Our aim is to identify the type of evidence available regarding the best choice of VAD for cancer patients undergoing systemic anti-cancer therapy (SACT). In this article, the authors frame the scoping review protocol used, which will systematically report all published and unpublished literature around the use of VADs for the infusion of SACT in oncology. Inclusion criteria: For studies to be included, they must focus on people or populations aged 18 years or older and report on vascular access in cancer patients. The concept is the variety of VAD use in cancer and reported insertion and post-insertion complications. The context surrounds the intravenous treatment of SACT whether in a cancer centre or non-cancer setting. Methods: The JBI scoping review methodology framework will guide the conduct of this scoping review. Electronic databases (CINAHL, Cochrane, Medline and Embase) will be searched. Grey literature sources and the reference lists of key studies will be reviewed to identify those appropriate for inclusion. No date limits will be used in the searches and studies will be limited to the English language. Two reviewers will independently screen all titles and abstracts and full-text studies for inclusion, and a third reviewer will arbitrate disagreements. All bibliographic data, study characteristics and indicators will be collected and charted using a data extraction tool.
Implementation of a midline catheter service in a regional setting
Authors: Jones Paul
Published: April 2023

Introduction: Midline catheters have been reported to be an effective and safe means of providing patients with intravenous access within the hospital and community setting. With minimal experience in the introduction of a midline service across the local health network, a regional hospital pursued this task. This observational study assesses the provision of a safe clinical framework for midline insertion, and the improvement of patient care and experiences by avoiding treatment interruptions and unnecessary cannulation attempts from failed traditional peripheral vascular access devices.

Methods: From the introduction of the midline service in June 2018, outcome measures of all patients who received a midline over the following two-year period were documented including rate of line success, complication rates, dwell time, and the number of insertion attempts.

Results: The midline service provided 207 lines over a two-year period with a total dwell time of 1,585 days. Project goals were achieved with 85% (Aim > 85%) of all lines completing treatment prior to removal. First attempt insertion was 86% (Aim > 80%) with a maximum insertion attempt of two. Rates of line-related complications were less than 8%, with five documented cases of phlebitis (2.5%) and one deep vein thrombosis with no infections documented.

Conclusion: Despite limited resources, a successful midline service was introduced. Future expansion will see an increase in insertor numbers providing improved access to the service.
An A to Z of Enhancements: H is for Home
Authors: Jackson Amy
Published: April 2023

Enhancements that link to home can help children to feel safe – especially important when they first start at nursery. By Amy Jackson
Prevalence and Clinical Spectrum of Mycoplasma pneumoniae in Community-acquired Pneumonia
Authors: Ali Mohd Kashif , Khan Diwan Israr , Mittal Akansha , Khan Samreen , Akhtar Swaleha
Published: April 2023

ABSTRACT: Introduction Community-acquired pneumonia has been a serious health issue, particularly among the pediatric age group, and is considered to be one of the major causes responsible for hospital admissions [1]. It is a substantial cause of respiratory illness and mortality in children in developing countries. It is a widespread bacterial pathogen that has been associated with a variety of clinical features, including pulmonary and extrapulmonary manifestations. But as diagnostic testing is typically based on serology or non-standardized molecular techniques, the prevalence and epidemiology of hospitalized community-acquired pneumonia (CAP) owing to Mycoplasma pneumoniae are poorly recognized [6]. Because of its ample prevalence and fatal complications, there is a need to identify cases of Mycoplasma pneumonia and treat them optimally to minimize the long-term consequences. Material and Method This study aims to recruit the cases of community-acquired pneumonia from the OPD and IPD of Jawahar Lal Nehru Medical College Hospital, AMU, Aligarh, for one year (October 2019–October 2020) in patients within 1–14 years of age and assess the prevalence of Mycoplasma pneumonia among them. Result Five (15.62%) of the total of thirty-two (100%) patients with community-acquired pneumonia had Mycoplasma pneumoniae infection diagnosed based on serology, with the majority of patients in the 1–5 year age group and variable clinical characteristics, with tachypnea, fever, and cough being the most prominent symptoms and diffuse reticular pattern and lobar consolidation being the most common radiological findings. Conclusions It has been concluded from the above study that the prevalence of Mycoplasma pneumoniae in community-acquired pneumonia cases based on serology is low. However, because serology is not 100% sensitive and specific, and titers can range from complete absence for the first 7 days to highly detectable after one week of illness, the diagnosis should not be ruled out solely based on serology. Owing to the severity of the disease, a differential diagnosis of M. pneumoniae must always be kept in mind.
Isolation and Characterization of L-Asparaginase Producing Endophytic Fungi from Medicinal Plants of Rutaceae Family
Authors: Udayan Elangovan , Gnanadoss John Joel
Published: April 2023

Endophytic fungi synthesize a diverse set of enzymes and biomolecules with wide array of bioactivities. Thirty-five distinct fungal endophytes have been isolated from medicinal plants of Rutaceae and screened for their ability to produce various industrially important enzymes. Primary enzyme screening revealed that 65% of isolates produced L-Asparaginase, 62% of isolates produced cellulase, 60% of isolates produced amylase, 48% of isolates produced both lipase and pectinase, 45% of isolates produced laccase and 42% of isolates produced protease. Among the different enzymes screened, L-Asparaginase producing isolates were dominant and subjected to quantification using the nesslerization method. The endophytic isolates LCJ315, LCJ324, LCJ326 and LCJ335 were capable of producing high L-Asparaginase activity and their enzyme activity ranged between 7.58 U/ml to 8.84 U/ml. The four isolates were further subjected to molecular identification using 18S rRNA sequencing. The results were then subjected to BLAST analysis. The phylogenetic tree was created by MEGA software. The isolated endophytic fungal strains were identified as LCJ315 (Aspergillus sp.), LCJ326 (Colletotrichum sp.), LCJ324 and LCJ335 (Fusarium sp.). The fungal source of L-Asparaginase is preferred over other microbial sources of L-Asparaginase due to reduced side effects. Given the fact that L-Asparaginase is a crucial anticancer enzyme that is used as the initial therapy for acute lymphoblastic leukemia. Hence, the present study reveals that these endophytic fungal strains isolated from Rutaceae members can be used as an alternate source for L-Asparaginase production.
Diversity and Distribution of Potential Biosurfactant Producing Bacillus Sp MN 243657, GC-MS Analysis and its Antimicrobial Study
Authors: Brinda C.M. , R. Ragunathan R. Ragunathan , Johney Jesteena
Published: April 2023

Biosurfactants are microbially produced surface-active compounds. They are amphiphilic molecules with hydrophilic and hydrophobic regions. The demand for biosurfactants has been exponentially growing as they are nontoxic and biodegradable. They have different applications in several industrial sectors. The objective of this study was to isolate and characterize the native bacteria which produce biosurfactants from oil contaminated soil of different places in Kerala and Tamil Nadu, India. The soil samples were collected from petrol pumps and workshops where the soil is contaminated with petrol, diesel and oil. The bacteria were isolated from contaminated soil samples and confirmed as Bacillus sp.The cultures were screened for biosurfactant production by different screening techniques such as blood hemolysis, oil spreading assay, emulsification ability assay, bacterial adherence to hydrocarbons activity. The potential biosurfactant producing culture was selected and identified using molecular techniques and submitted to NCBI Gene Bank (MN 243657 – Bacillus sp). The selected bacterial culture was used for biosurfactant production and these were characterized by UV, TLC, FTIR and GC -MS analysis. The derived biosurfactant's Rf value was 0.68 as determined by a TLC chromatogram. In a UV-visible spectroscopy study, the isolated biosurfactant displayed a highest peak at 415 nm. According to FTIR analysis, the isolated biosurfactant displayed an intense peak at 3340 cm -1. The large peaks of the biosurfactant were observed at various retention times of 12.75, 10.22, 4.98, and 3.87, respectively, after GC-MS analysis. Antibacterial and antifungal activity of the biosurfactant was identified against pathogenic bacteria such as P.aeruginosa, E. coli, K. pneumoniae, S. aureus and fungi Aspergillus niger, Aspergillus terreus, Aspergillus flavus.
Near-infrared spectroscopy for structural bone assessment
Authors: Sharma Varun J. , Adegoke John A. , Afara Isaac O. , Stok Kathryn , Poon Eric , Gordon Claire L. , Wood Bayden R. , Raman Jaishankar
Published: April 2023

Aims

Disorders of bone integrity carry a high global disease burden, frequently requiring intervention, but there is a paucity of methods capable of noninvasive real-time assessment. Here we show that miniaturized handheld near-infrared spectroscopy (NIRS) scans, operated via a smartphone, can assess structural human bone properties in under three seconds.

Methods

A hand-held NIR spectrometer was used to scan bone samples from 20 patients and predict: bone volume fraction (BV/TV); and trabecular (Tb) and cortical (Ct) thickness (Th), porosity (Po), and spacing (Sp).

Results

NIRS scans on both the inner (trabecular) surface or outer (cortical) surface accurately identified variations in bone collagen, water, mineral, and fat content, which then accurately predicted bone volume fraction (BV/TV, inner R2= 0.91, outer R2= 0.83), thickness (Tb.Th, inner R2= 0.9, outer R2= 0.79), and cortical thickness (Ct.Th, inner and outer both R2= 0.90). NIRS scans also had 100% classification accuracy in grading the quartile of bone thickness and quality.

Conclusion

We believe this is a fundamental step forward in creating an instrument capable of intraoperative real-time use.

Cite this article:Bone Jt Open 2023;4(4):250–261.
Clinical frailty is independently associated with joint-specific function and health-related quality of life in patients awaiting a total hip or knee arthroplasty
Authors: Bayram John M. , Wickramasinghe Neil R. , Scott Chloe E. H. , Clement Nick D.
Published: April 2023

Aims

The aims were to assess whether preoperative joint-specific function (JSF) and health-related quality of life (HRQoL) were associated with level of clinical frailty in patients waiting for a primary total hip arthroplasty (THA) or knee arthroplasty (KA).

Methods

Patients waiting for a THA (n = 100) or KA (n = 100) for more than six months were prospectively recruited from the study centre. Overall,162 patients responded to the questionnaire (81 THA; 81 KA). Patient demographics, Oxford score, EuroQol five-dimension (EQ-5D) score, EuroQol visual analogue score (EQ-VAS), Rockwood Clinical Frailty Score (CFS), and time spent on the waiting list were collected.

Results

There was a significant correlation between CFS and the Oxford score (THA r = −0.838; p < 0.001, KA r = −0.867; p < 0.001), EQ-5D index (THA r = −0.663, p =< 0.001; KA r = −0.681; p =< 0.001), and EQ-VAS (THA r = −0.414; p < 0.001, KA r = −0.386; p < 0.001). Confounding variables (demographics and waiting time) where adjusted for using multiple regression analysis. For each 8.5 (THA, 95% CI 7.1 to 10.0; p < 0.001) and 9.9 (KA, 95% CI 8.4 to 11.4; p < 0.001) point change in the Oxford score, there was an associated change in level of the CFS. For each 0.16 (THA, 95% CI 0.10 to 0.22; p < 0.001) and 0.20 (KA, 95% CI 0.12 to 0.27; p < 0.001) utility change in EQ-5D, there was an associated change in level of the CFS. EQ-VAS (THA, B = −11.5; p < 0.001, KA B = −7.9; p = 0.005) was also associated with CFS.

Conclusion

JSF and HRQoL in patients awaiting THA or KA for more than six months, were independently associated with level of clinical frailty. With further prospective studies, clinical frailty may prove to be a useful metric to assist in the prioritization of arthroplasty waiting lists.

Cite this article: Bone Jt Open 2023;4(4):241–249.
Reliability Index of Simply Supported Beam Based on HL Method
Authors: Devi M. Tirumala , Maheshwari T. Sumathi Uma , Satyanarayana A.
Published: April 2023

In this paper, reliability of simply supported I-beam is studied under point load at the mid-point of span. Reliability index has been obtained by using Hasofer-Lind method. In the analysis, yield strength of material, depth of the section and load are considered as basic random variables and those are assumed to follow normal distribution. Non-linear limit state surface function has been considered. Derived design point in each case and found the reliability.
STABLE INTRAOPERATIVE PULSE OXIMETRY VALUES DO NOT PROTECT AGAINST A DECREASE IN REGIONAL CEREBRAL OXYGEN SATURATION IN PATIENTS UNDERGOING PRIMARY HIP ARTHROPLASTY. A PILOT STUDY
Authors:   Military Institute of Aviation Medicine, Warsaw, Poland, Tomaszewski Dariusz , Bałkota Mariusz ,   Military Institute of Medicine, Warsaw, Poland, Rybicki Zbigniew ,   Military Institute of Medicine, Warsaw, Poland, Waśko Marcin
Published: April 2023

Background and Study objective: Continuous perioperative monitoring of blood oxygen saturation via pulse oximetry is an established standard of care. The incidence of postoperative cognitive dysfunction (POCD) in orthopedic patients is higher when compared to any other group of hospitalized patients. Although its etiology remains unclear, factors such as thromboembolic complications may play a role. Thromboembolic material, including that released from the surgery site, enters the bloodstream and then travels to the brain. The decrease in blood flow in the involved cerebral vessels may decrease cerebral oxygen saturation. Considering this, we decided to determine if the regional cerebral saturation monitored by near-infrared spectroscopy corresponds with readings of blood oxygen saturation monitored by pulse oximetry in patients who underwent primary total hip arthroplasty. Methods: A total of 20 patients scheduled for elective total hip arthroplasty were enrolled in the study. All orthopedic procedures were performed under spinal anesthesia and intravenous sedation. Monitoring of regional cerebral oxygen saturation (rSO2) was carried out from the time of the initiation of spinal anesthesia until the end of the surgery, using the near-infrared spectroscopy method. In all, 15 patients were analyzed. Results and Conclusions: We found the following: (1) rSO2 values decreased continuously over the surgery, and (2) rSO2 value changes were not related to mean arterial pressure variations or to hemoglobin saturation as analyzed by pulse oximetry.
Balancing words, balancing lives: framing vulnerability in times of crisis
Authors: de Ruiter Adrienne , Dekking Sara , Leget Carlo , Dronkers Pieter
Published: April 2023

Words matter, especially in times of crisis. This article analyses the complexities of political discourse on vulnerability by considering the case of the Dutch COVID-19 response. Our study finds that the framing of vulnerability as a predetermined and naturalised condition, linked to old age and pre-existing medical conditions, draws attention away from aspects of precarisation tied to economic position, social class, cultural background and living conditions. This rhetorical strategy can be understood as a practice of de-responsibilisation through which attention is rhetorically diverted from the way(s) in which political authorities are implicated in producing, exacerbating or failing to mitigate vulnerabilities.
Maximizing atmospheric-disturbed fiber coupling efficiency with speckle-based phase retrieval and a single-pixel camera
Authors: Pashazanoosi Mohamadreza , Taylor Michael , Pitts Oliver , Flueraru Costel , Orth Antony , Hranilovic Steve
Published: April 2023

An approach to adaptive optics utilizing a single-pixel camera (SPC) is proposed to maximize fiber coupling efficiency at the receiver side of an optical satellite-to-ground link perturbed by atmospheric turbulence. Using a single-pixel wavefront sensor enables operation at longer optical wavelengths, such as near and far infrared, which have advantageous propagation characteristics for free space optical communication. In this approach, a focal plane intensity image of the atmospheric-disturbed wavefront is taken via an SPC using a compressed sensing technique. An iterative speckle-based phase retrieval algorithm is then applied to infer the phase distortion corrected by a deformable mirror in a feedback loop. This computational approach to inferring the phase of the wavefront overcomes the limitations of traditional Shack–Hartman-based approaches, which are difficult to implement at high speed and at the long infrared wavelengths proposed for future optical satellite communication downlinks. It has been shown that fiber coupling efficiency is increased from less than 5% to 40%–50% in medium-to-strong turbulence scenarios with the phase retrieval algorithm proposed in this work.
Scale-adaptive three-dimensional imaging using Risley-prism-based coherent lidar
Authors: Liu Xingsheng , Li Anhu , Chen Hao , Sun Jianfeng , Lu Zhiyong
Published: April 2023

We present a scale-adaptive three-dimensional (3D) imaging architecture for coherent light detection and ranging (lidar) that incorporates Risley-prism-based beam scanning. An inverse design paradigm from beam steering to prism rotation is developed for demand-oriented beam scan pattern generation and prism motion law formulation, which allows the lidar to perform 3D imaging with adaptive scale and configurable resolution. By combining flexible beam manipulation with simultaneous distance and velocity measurement, the proposed architecture can achieve both large-scale scene reconstruction for situational awareness and small-scale object identification against long range. The experiment results demonstrate that our architecture enables the lidar to recover a 3D scene in a ±30° field of view and also focus on distant objects at over 500 m with spatial resolution up to 1.1 cm.
Perfect linear polarization wave generator based on quasi-bound states in the continuum
Authors: Cai Haocheng , Li Jitao , Mao Luhong
Published: April 2023

Quasi-bound states in the continuum (q-BICs) in optical metasurfaces have been found to carry special radiation polarization properties. Herein, we have studied the relationship between the radiation polarization state of a q-BIC and the polarization state of the output wave, and theoretically proposed a perfect linear polarization wave generator controlled by the q-BIC. The proposed q-BIC has an x-polarized radiation state, and the y co-polarized output wave is completely eliminated by introducing additional resonance at the q-BIC frequency. Finally, a perfect x-polarized transmission wave with very low background scattering is obtained, and the transmission polarization state is not limited by the incident polarization state. The device can be used to efficiently obtain narrowband linearly polarized waves from non-polarized waves, and can also be used for polarization-sensitive high-performance spatial filtering.
Recovery of a highly reflective Bragg grating in DPDS-doped polymer optical fiber by thermal annealing
Authors: Hu Xuehao , Xu Ning , Cheng Xin , Tan Linyao , Tam Hwa-Yaw , Min Rui , Qu Hang , Caucheteur Christophe
Published: April 2023

We report fiber Bragg grating manufacturing in poly(methyl methacrylate) (PMMA)-based polymer optical fibers (POFs) with a diphenyl disulfide (DPDS)-doped core by means of a 266 nm pulsed laser and the phase mask technique. Gratings were inscribed with different pulse energies ranging from 2.2 mJ to 2.7 mJ. For the latter, the grating reflectivity reached 91% upon 18-pulse illumination. Though the as-fabricated gratings decayed, they were recovered by post-annealing at 80°C for 1 day, after which they showed an even higher reflectivity of up to 98%. This methodology for the fabrication of highly reflective gratings could be applied for the production of high-quality tilted fiber Bragg gratings (TFBGs) in POFs for biochemical applications.
Atmospheric effects on the laser-driven avalanche-based remote detection of radiation
Authors: Zingale A. , Waczynski S. , Sears J. , Lakis R. E. , Milchberg H. M.
Published: April 2023

The effect of realistic atmospheric conditions on mid-IR (λ = 3.9 µm) and long-wave-IR (λ = 10 µm) laser-induced avalanche breakdown for the remote detection of radioactive material is examined experimentally and with propagation simulations. Our short-range in-lab mid-IR laser experiments show a correlation between increasing turbulence level and a reduced number of breakdown sites associated with a reduction in the portion of the focal volume above the breakdown threshold. Simulations of propagation through turbulence are in excellent agreement with these measurements and provide code validation. We then simulate propagation through realistic atmospheric turbulence over a long range (0.1–1 km) in the long-wave-IR regime (λ = 10 µm). The avalanche threshold focal volume is found to be robust even in the presence of strong turbulence, only dropping by ∼50% over a propagation length of ∼0.6 km. We also experimentally assess the impact of aerosols on avalanche-based detection, finding that, while background counts increase, a useful signal is extractable even at aerosol concentrations 105 times greater than what is typically observed in atmospheric conditions. Our results show promise for the long-range detection of radioactive sources under realistic atmospheric conditions.
408  Gbit/s PAM-8 sidewall-doped germanium–silicon photodetector
Authors: Hu Xiao , Wu Dingyi , Liu Ye , Chen Daigao , Wang Lei , Xiao Xi , Yu Shaohua
Published: April 2023

Based on the 90 nm silicon photonics commercial foundry, sidewall-doped germanium–silicon photodetectors (PDs) are designed and fabricated. The large designed overlap between the optical field and electric field achieves high responsivity while retaining high-speed performance. Even including the loss due to optical fiber coupling, the PD demonstrates an external responsivity greater than 0.55 A/W for transverse magnetic (TM) polarization and 0.65 A/W for transverse electric (TE) polarization at 1530 nm. A flat responsivity spectrum of >0.5  A/W is achieved up to 1580 nm for both polarizations. Their internal responsivities can exceed 1 A/W in the C+L optical communication bands. Furthermore, with the aid of a 200 mm wafer-level test and analysis, the overall PDs of 26 reticles have a 3 dB optoelectrical bandwidth >50  GHz and a dark current <10  nA at a −3  V bias voltage. Finally, the eye diagram performances under TE and TM polarizations, various modulation formats, and different input wavelengths are comprehensively investigated. The clear open electrical eye diagrams up to 120, 130, 140, and 150 Gbit/s nonreturn-to-zero are experimentally attained at a photocurrent of 1 mA. To the best of our knowledge, this is the first time that single-lane direct detection of record-high-speed 200, 224, 256, and 290 Gbit/s four-level pulse amplitude modulation (PAM) and 300, 336, 384, and 408 Gbit/s eight-level PAM optical signals has been experimentally achieved.
Photonics Research 10th anniversary: editorial
Authors: Yang Lan
Published: April 2023

The editor-in-chief of Photonics Research announces the journal’s 10-year anniversary, which takes place in 2023 and reports on new initiatives for the journal.