bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation and management of aortic stenosis in chronic kidney disease
Authors: Mallick Sanjoyita , Ogugua Fredrick M , Chedid Maroun , Mathew Roy O , Shroff Gautam R
Published: December 2024

The combination of aortic stenosis (AS) and chronic kidney disease (CKD) represents a formidable clinical challenge commonly encountered in practice. Specific guidelines addressing the management of AS in CKD/end-stage kidney disease (ESKD) patients are lacking. This review addresses the unique epidemiological features, caveats relevant to diagnostic modalities and specific management considerations pertinent for AS in patients with CKD/ESKD. Transthoracic echocardiography remains the imaging modality of choice for establishing an accurate diagnosis and assessing severity of AS in this population. However, the presence of anatomical and hemodynamic alterations along with co-prevalent valve disease often necessitates complementary imaging including dobutamine stress echocardiography, cardiac computed tomography and magnetic resonance imaging. Management includes blood pressure control, addressing CKD-related metabolic bone disease, and the selection of optimal dialysis modality. For aortic valve replacement (AVR), the choice between mechanical versus biological prosthesis, as well as between surgical versus transcatheter approaches requires careful consideration of patient-specific factors, including life expectancy, bleeding risk, risk of acute kidney injury; as well as prosthesis specific considerations including durability and need for long-term anticoagulation. Patients with CKD/ESKD encounter higher periprocedural risks as well as worse long-term outcomes; yet AVR is associated with improved survival compared to conservative management. Shared-decision making with the patient is essential regarding choice of prosthesis. A multidisciplinary heart-kidney team is recommended for optimizing perioperative planning, hemodynamic/volume status and preventing acute kidney injury to ensure a balanced and comprehensive patient-centered strategy for managing AS in the context of CKD/ESKD.
BCMA-directed CAR T-cell Therapy in patients with multiple myeloma and CNS involvement
Authors: Gaballa Mahmoud R. , Castaneda Puglianini Omar , Cohen Adam D. , Vogl Dan T , Chung Alfred , Ferreri Christopher J , Voorhees Peter M , Hansen Doris K , Patel Krina K.
Published: December 2024

We investigated BCMA-directed CART in patients with relapsed or refractory multiple myeloma (RRMM) and CNS involvement. Ten patients who received either ide-cel (n=6) or cilta-cel (n=4) were included in this analysis. Patients had brain/cranial nerve and/or spinal cord involvement/leptomeningeal disease evident on either MRI (100%) and/or CSF (40%). The time between CNS diagnosis and CART was 60 days or less in 50% of patients, >300 days in 30%, and 20% were diagnosed within 14 days after CART infusion. Seven (70%) received CNS-directed therapy during bridging in the form of different combinations of radiotherapy, intrathecal chemotherapy, and surgery. There were no excess toxicities: no CRS grade (G) 3 or more, ICANS G3 10% (n=1), and none had ICANS G4. Two patients experienced delayed but treatable neurotoxicity with no reported Parkinsonian side effects. The best overall response rate was 80%, with 70% VGPR or better, and a 100% CNS response. For patients with CNS myeloma diagnosed pre-CART (n=8), with a median follow-up of 381 days, the median OS and PFS were 13.3 and 6.3 months, respectively. Best outcomes were observed in 4 patients who had a response to bridging therapy, suggesting that optimizing pre-CART therapy may be key for improved outcomes. Our study suggests that CART in patients with CNS MM is safe and feasible and that screening for CNS involvement before CART therapy could be warranted in high-risk patients. The excellent initial response but relatively short PFS suggests consideration for post-CART maintenance. Larger studies are needed to confirm these findings.
Deciphering the dynamics of a Younger Dryas rock avalanche in the Bernese Alps
Authors: Bucher Giacomina , Dieleman Catharina , Ivy-Ochs Susan , Aaron Jordan , Vockenhuber Christof , Akçar Naki
Published: December 2024

Large rock avalanches play a key role in shaping alpine landscapes. However, the complex interplay between mass movement and other surface processes poses challenges in identifying these deposits and understanding the underlying process controls. Here, we focus on the rock avalanche deposit of the Lurnigalp valley in the Bernese Alps (Switzerland), originally mapped as till. The Lurnigalp valley is a U-shaped tributary valley located in the southwest of Adelboden, Canton Bern. To explore the timing and dynamics of the rock avalanche event, we employed detailed remote and field mapping, sedimentary petrology, surface exposure dating with cosmogenic 36Cl, and runout modelling with DAN3D®. For the reconstruction of the chronology, we analyzed cosmogenic 36Cl in surface samples from 15 boulders of the rock avalanche deposit. We developed three distinct scenarios to investigate the dynamics and contextual conditions of the rock avalanche event. In the first scenario, we consider a rock avalanche depositing 1 Mm3 of sediment in a valley devoid of ice. The second scenario uses the same deposit volume but introduces a hypothetical glacier occupying the uppermost part of the valley. Finally, the third scenario, similar to the first scenario with a glacier-free valley, assumes a substantially larger volume of collapsed rock mass. We consider the third scenario the most plausible, in which approximately 6 Mm3 of rock mass, composed of limestone and sandstone, was released from a limestone cliff around 12 ± 2 ka during the Younger Dryas. The collapsed rock mass fell into the ice-free valley floor, ran up the opposite valley side and was deflected towards the northeast following the valley orientation. The rock mass stopped after 2.2 km leaving approximately 6.4 Mm3 deposits spread across the entire valley floor. Subsequently, most of the rock avalanche deposit have been reworked by periglacial activity. We suggest that structural features, lithology and glacial erosion and debuttressing were involved in the weakening of the in-situ bedrock that finally led to the collapse. Our study not only enhances the understanding of rock avalanche mechanisms and their profound impact on Alpine landscape evolution but also elucidates the complex interplay of geological processes that led to the collapse and altered the rock avalanche deposit afterwards.
Performance of A-DROP, NEWS2, and REMS in predicting in-hospital mortality and mechanical ventilation in pneumonia patients in the emergency department: a retrospective cohort study
Authors: Thirawattanasoot Netiporn , Chongthanadon Brandon , Ruangsomboon Onlak
Published: December 2024

Background

Pneumonia is a potentially life-threatening respiratory tract infection. Many Early Warning Scores (EWS) were developed to detect patients with high risk for adverse clinical outcomes, but few have explored the utility of these EWS for pneumonia patients in the Emergency Department (ED) setting. We aimed to compare the prognostic utility of A-DROP, NEWS2, and REMS in predicting in-hospital mortality and the requirement for mechanical ventilation among ED patients with pneumonia.

Methods

A retrospective study was conducted at the ED of Siriraj Hospital, Thailand. Adult patients diagnosed with non-COVID-19 pneumonia between June 1, 2021, and May 31, 2022, were included. We calculated and analyzed their EWS at ED arrival. The primary outcome was all-cause in-hospital mortality. The secondary outcome was mechanical ventilation.

Results

We enrolled 735 patients; 272 (37%) died at hospital discharge, and 75 (10.2%) required mechanical ventilation. A-DROP had the highest discrimination capacity for in-hospital mortality (AUROC: 0.698, 95% CI 0.659–0.737) compared to NEWS2 (AUROC 0.657; 95%CI 0.617, 0.698) and REMS (AUROC 0.637; 95%CI 0.596, 0.678). A-DROP also had superior performances than NEWS2 and REMS in terms of calibration, overall model performance, and balanced diagnostic accuracy indices at its optimal cut point (A-DROP ≥ 2). No EWS could perform well in predicting mechanical ventilation.

Conclusion

A-DROP had the highest prognostic utility for predicting in-hospital mortality in non-COVID-19 pneumonia patients in the ED compared to NEWS2 and REMS.
Gene expression profiling for the diagnosis of male breast cancer
Authors: Liu Jing , Sun Yifeng , Qi Peng , Wo Yixin , Pang Yue , Xu Qinghua , Xu Midie , Huang Shenglin , Wang Qifeng
Published: December 2024

Background

Male breast cancer (MBC) is a rare malignancy, but its global incidence has shown a notable increase in recent decades. Factors such as limited health literacy, inadequate health education, and reluctance to seek medical attention contribute to the late-stage diagnosis of most MBC patients. Consequently, there is an urgent need for a highly specific and sensitive diagnostic approach to MBC.

Methods

This retrospective study enrolled 20 patients with 30 surgical or biopsy MBC specimens from August 2020 to August 2023. The 90-gene expression assay was performed to determine the tissue of origin. Predicted tumor types were then compared to the reference diagnosis for accuracy calculation. The differentially expressed genes were identified between male and female breast cancer.

Result

The 90-gene expression assay demonstrated an overall accuracy of 96.7% (29/30) when compared with the pathological diagnosis. For primary, lymph node metastatic, and distant metastatic tumors, the accuracies were 100% (15/15), 90.9% (10/11), and 100% (4/4), respectively. Five genes (RPS4Y1, PI15, AZGP1, PRRX1, and AGR2) were up-regulated, and six (XIST, PIGR, SFRP1, PLA2G2A, S100A2, and CHI3L1) were down-regulated in MBC.

Conclusion

Our findings highlight the promising performance of the 90-gene expression assay in accurately identifying the tumor origin in MBC. Incorporating this assay into pathological diagnoses has the potential to empower oncologists with precision treatment options, ultimately enhancing the care and outcomes for patients with MBC.
Assessment of the safety and gut microbiota modulation ability of an infant formula containing Bifidobacterium animalis ssp. lactis CP-9 or Lactobacillus salivarius AP-32 and the effects of the formula on infant growth outcomes: insights from a four-month clinical study in infants under two months old
Authors: Shen Shang-Po , Lin Hung-Chih , Chen Jui-Fen , Wang Hui-Shan , Huang Yen-Yu , Hsia Ko-Chiang , Lin Jia-Hung , Kuo Yi-Wei , Li Ching-Min , Hsu Yu-Chieh , Tsai Shin-Yu , Ho Hsieh-Hsun
Published: December 2024

Background

Breast milk is a natural treasure for infants, and its microbiota contains a rich array of bacterial species. When breastfeeding is not possible, infant formula with probiotics can be used as a sole source or as a breast milk supplement. The main aim of this study was to evaluate the growth outcomes and tolerance of infants consuming an infant formula containing Bifidobacterium animalis ssp. lactis CP-9 (B. animalis CP-9) or Lactobacillus salivarius AP-32 (L. salivarius AP-32), which were isolated from breast milk and the guts of healthy infants. The safety of these strains in terms of antibiotic resistance and their ability to modulate the gut microbiota were also evaluated.

Methods

One hundred eighty healthy infants were included in this study and separated into three groups: the control group, the L. salivarius AP-32 group, and the B. animalis CP-9 group. In this clinical study, adverse events, growth effects, and the incidence of allergies and gastrointestinal disorders in infants consuming infant formula containing B. animalis CP-9 or L. salivarius AP-32 were evaluated. Finally, the impact of the probiotic infant formula on the gut microbiota was elucidated via next-generation sequencing (NGS) analysis.

Results

The 4-month interventional study revealed that body weight, recumbent length, and head circumference were similar among the three groups. No adverse events related to the intervention were observed. The microbiota composition was more diverse on day 0 and became more uniform by month 4. B. animalis CP-9 and L. salivarius AP-32 were found to be susceptible to streptomycin, tetracycline, erythromycin, clindamycin, chloramphenicol, and ampicillin.

Conclusions

The use of infant formula containing B. animalis CP-9 and L. salivarius AP-32 was considered safe and well tolerated, with no adverse events observed during the study. While these strains showed low antibiotic resistance and no immediate concerns related to antibiotic resistance genes, further research is needed to comprehensively assess their long-term safety and efficacy and the potential risk of horizontal gene transfer in broader contexts.

Trial registration

The trial was registered with the US Library of Medicine (clinicaltrials.gov) with the number NCT03993301 on 20/06/2019.
Unveiling the mechanical performance of partially replaced coronal restorations in root canal-treated teeth: an in-vitro study
Authors: Turky Mohammed , Plotino Gianluca , Mahmoud Nermin Alsayed
Published: December 2024

Objectives

To compare the mechanical performance of partially replaced (repaired) intra-coronal restorations to totally replaced ones in root canal-treated teeth.

Methods

Thirty maxillary second premolars were selected according to strict criteria, mounted on moulds, and had mesio-occluso-distal (MOD) cavities prepared. Resin composite restorative material was used to perform the initial restoration, followed by aging procedures using thermo-mechanical cycling fatigue to replicate six months of intraoral aging. The specimens were then randomly divided into two groups: a totally replaced restoration (TR) group (n = 15), which involved the preparation of a traditional endodontic access cavity after the complete removal of the pre-existing coronal filling; and a partially replaced restoration (PR) group (n = 15), which involved accessing the tooth through the pre-existing restoration without completely removing it. Root canal preparation and filling procedures were conducted, and the access cavity was sealed with a new resin composite restoration, followed by a new thermo-mechanical cycling aging procedure. Finally, the specimens were submitted to a static fracture test to measure specimen fracture strength and determine the failure mode pattern (repairable fracture or irreparable fracture). Chi-square and t-tests were used for statistical analysis.

Results

Significant differences between the groups regarding their mechanical resistance were found. The average failure load of the TR group was 1115.13 N and 1330.23 N in the PR group (p = 0.002). Regarding the failure modes, the TR group exhibited eight irreparable fractures, while the PR group had four (p = 0.136).

Conclusions

Partially replaced restorations presented higher fracture strength and led to fewer irreparable fractures when compared to totally replaced restorations in root canal-treated teeth.
Hazard assessment of nanomaterials: how to meet the requirements for (next generation) risk assessment
Authors: Longhin Eleonora Marta , Rios-Mondragon Ivan , Mariussen Espen , Zheng Congying , Busquets Martí , Gajewicz-Skretna Agnieszka , Hofshagen Ole-Bendik , Bastus Neus Gómez , Puntes Victor Franco , Cimpan Mihaela Roxana , Shaposhnikov Sergey , Dusinska Maria , Rundén-Pran Elise
Published: December 2024

Background

Hazard and risk assessment of nanomaterials (NMs) face challenges due to, among others, the numerous existing nanoforms, discordant data and conflicting results found in the literature, and specific challenges in the application of strategies such as grouping and read-across, emphasizing the need for New Approach Methodologies (NAMs) to support Next Generation Risk Assessment (NGRA). Here these challenges are addressed in a study that couples physico-chemical characterization with in vitro investigations and in silico similarity analyses for nine nanoforms, having different chemical composition, sizes, aggregation states and shapes. For cytotoxicity assessment, three methods (Alamar Blue, Colony Forming Efficiency, and Electric Cell-Substrate Impedance Sensing) are applied in a cross-validation approach to support NAMs implementation into NGRA.

Results

The results highlight the role of physico-chemical properties in eliciting biological responses. Uptake studies reveal distinct cellular morphological changes. The cytotoxicity assessment shows varying responses among NMs, consistent among the three methods used, while only one nanoform gave a positive response in the genotoxicity assessment performed by comet assay.

Conclusions

The study highlights the potential of in silico models to effectively identify biologically active nanoforms based on their physico-chemical properties, reinforcing previous knowledge on the relevance of certain properties, such as aspect ratio. The potential of implementing in vitro methods into NGRA is underlined, cross-validating three cytotoxicity assessment methods, and showcasing their strength in terms of sensitivity and suitability for the testing of NMs.

Graphical abstract

Created with BioRender.com (publication license obtained)
Standard: Human gastric cancer organoids
Authors: Tan Ronghui , Hong Fan , Wang Ting , Zhong Nanshan , Zhao Hongling , Xu Rui-hua , Shen Lin , Liu Yingbin , Yao Xuebiao , Xiang Dongxi , Gao Dong , Xiong Jianping , Hui Lijian , Zhao Bing , Miao Zhifeng , Hao Jie , Li Yong , Hu Shijun , Fu Boqiang , Hua Guoqiang , Wang Lei , Zeng Zhao-Lei , Chen Chong , Wu Jianmin , Wang Changlin , Wang Chunnian , Zhan Xianbao , Song Chen , Sun Zhijian , Yu Chunping , Yang Yingying , Niu Gengming , Wang Yalong , Zhao Tongbiao , Chen Ye-Guang
Published: December 2024

Gastric cancer is one of the most common malignancies with poor prognosis. The use of organoids to simulate gastric cancer has rapidly developed over the past several years. Patient-derived gastric cancer organoids serve as in vitro models that closely mimics donor characteristics, offering new opportunities for both basic and applied research. The “Human Gastric Cancer Organoid” is part of a series of guidelines for human gastric cancer organoids in China, jointly drafted by experts from the Chinese Society for Cell Biology and its branches, and initially released on October 29, 2024. This standard outlines terminology, technical requirements, assessment protocols, and applies to production, evaluation procedures, and quality control for human gastric cancer organoids. The publication of this guideline aims to assist institutions in endorsing, establishing, and applying best practices, advancing the international standardization of human gastric cancer organoids for clinical development and therapeutic application.
A hands-free carotid Doppler can identify spontaneous circulation without interrupting cardiopulmonary resuscitation: an animal study
Authors: Faldaas Bjørn Ove , Storm Benjamin Stage , Lappegård Knut Tore , How Ole-Jakob , Nilsen Bent Aksel , Kiss Gabriel , Skogvoll Eirik , Nielsen Erik Waage , Torp Hans , Ingul Charlotte Björk
Published: December 2024

Background

Identifying spontaneous circulation during cardiopulmonary resuscitation (CPR) is challenging. Current methods, which involve intermittent and time-consuming pulse checks, necessitate pauses in chest compressions. This issue is problematic in both in-hospital cardiac arrest and out-of-hospital cardiac arrest situations, where resources for identifying circulation during CPR may be limited. The fraction of chest compression plays a pivotal role in improving survival rates. To address this challenge, we evaluated a newly developed hands-free, continuous carotid Doppler system (RescueDoppler), designed to identify spontaneous circulation during chest compressions. In our study, we utilized a porcine model of cardiac arrest to investigate sequences of ventricular fibrillation, followed by defibrillation, and monitoring for the return of spontaneous circulation during chest compressions with the carotid Doppler system. We explored both manual compressions at 100 and 50 compressions per minute and mechanical compressions. To estimate the detection rate (i.e., sensitivity), we employed a logistic mixed model with animal identity as random effect.

Results

Offline analysis of Doppler color M-mode and spectral display successfully identified spontaneous circulation during chest compressions in all compression models. Spontaneous circulation was detected in 51 of 59 sequences, yielding an expected sensitivity of 98% with a 95% confidence interval of 59% to 99%.

Conclusion

The RescueDoppler, a continuous hands-free carotid Doppler system, demonstrates an expected sensitivity of 98% for identifying spontaneous circulation during both manual and mechanical chest compressions. Clinical studies are needed to further validate these findings.
The Scottish Simulation ‘KSDP’ Design Framework: a sense-making and ordered approach for building aligned simulation programmes
Authors: Oliver Nathan , Edgar Simon , Mellanby Edward , May Alistair
Published: December 2024

Impactful learning through simulation-based education involves effective planning and design. This can be a complex process requiring educators to master a varied toolkit of analysis tools, learning methodologies, and evaluative strategies; all to ensure engagement of learners in a meaningful and impactful way. Where there is a lack of thoughtful design, simulation-based education programmes may be inefficiently deployed at best, and completely ineffective or even harmful to learning and learners at worst. This paper presents a useful sense-making framework, designed to support simulation educators in designing their learning activities in a systematic, stepwise, and learner centred way.
Ca2+ signaling in vascular smooth muscle and endothelial cells in blood vessel remodeling: a review
Authors: Suzuki Yoshiaki , Giles Wayne R. , Zamponi Gerald W. , Kondo Rubii , Imaizumi Yuji , Yamamura Hisao
Published: December 2024

Vascular smooth muscle cells (VSMCs) and endothelial cells (ECs) act together to regulate blood pressure and systemic blood flow by appropriately adjusting blood vessel diameter in response to biochemical or biomechanical stimuli. Ion channels that are expressed in these cells regulate membrane potential and cytosolic Ca2+ concentration ([Ca2+]cyt) in response to such stimuli. The subsets of these ion channels involved in Ca2+ signaling often form molecular complexes with intracellular molecules via scaffolding proteins. This allows Ca2+ signaling to be tightly controlled in localized areas within the cell, resulting in a balanced vascular tone. When hypertensive stimuli are applied to blood vessels for extended periods, gene expression in these vascular cells can change dramatically. For example, alteration in ion channel expression often induces electrical remodeling that produces a depolarization of the membrane potential and elevated [Ca2+]cyt. Coupled with endothelial dysfunction blood vessels undergo functional remodeling characterized by enhanced vasoconstriction. In addition, pathological challenges to vascular cells can induce inflammatory gene products that may promote leukocyte infiltration, in part through Ca2+-dependent pathways. Macrophages accumulating in the vascular adventitia promote fibrosis through extracellular matrix turnover, and cause structural remodeling of blood vessels. This functional and structural remodeling often leads to chronic hypertension affecting not only blood vessels, but also multiple organs including the brain, kidneys, and heart, thus increasing the risk of severe cardiovascular events. In this review, we outline recent advances in multidisciplinary research concerning Ca2+ signaling in VSMCs and ECs, with an emphasis on the mechanisms underlying functional and structural vascular remodeling.
Analysis of high-temperature exposure to physical changes in Valplast®-based denture with acrylic element for human identification purpose
Authors: Apriyono Dwi Kartika , Shita Amandia Dewi Permana , Wandanti Cheija
Published: December 2024

Background

Identification of victims will be difficult due to exposure to high temperatures when fires occur. In some cases of fire, small pieces, such as teeth, can be detached and ignored as necessary evidence. Destroyed body parts or the number of victims in a disaster makes the identification of victims more complicated, and forensic odontology is hoped to help the identification process. In a fire disaster, it is possible that a victim used dentures. One of them is a Valplast®-based denture with an acrylic element. If a victim wearing dentures caught fire and was exposed to high-temperature flames, there may be remains of dentures that can be identified. This study aimed to determine the physical changes in Valplast®-based dentures with acrylic elements in shape, color, and weight due to high exposure temperature. In this article, Valplast®-based dentures with acrylic element samples of four groups (P1: 32–288 °C; P2: 32–319 °C; P3: 32–412 °C; P4: 32–800 °C) were observed in shape, weight, and color measurements before and after heating using an oven.

Results

The result is a change in shape and weight after heating that is shown by the results of the Kruskal–Wallis and Mann–Whitney tests with a p-value < 0.05, that is, the results of the one-way ANOVA test show that the average color change is not significantly different (p > 0.05).

Conclusion

Valplast®-based dentures with acrylic elements experience changes in shape and weight after being heated at high temperatures. So, these results can be used as a reference in the forensic identification process for burn victims who use dentures.
From apoplexy in antiquities to cerebrovascular stroke in modernity: a narrative timeline and tale
Authors: Roushdy Tamer
Published: December 2024

Background

Stroke is one of the commonest encountered brain and neurological disorders worldwide. Stroke management has had a major shift in the last 50 years and precisely since the discovery and approval of thrombolysis as an acute management followed by multiple trials on mechanical thrombectomy and its approval. Yet, Stroke is as old as the history of mankind. Historically stroke symptoms’ description is older than the descriptions of the Greco-Roman civilization (500 BC – 800 AD). Before Stroke, the term apoplexy was described in ancient civilizations and evidence of suffering and managing it is preserved within the mummies, inscriptions, and papyri of the Egyptian civilization, clay tablets of the Mesopotamian civilization, medical books of the Chinese civilization, and although physicians and scientists consider the Greco-Roman civilization the base for modern medicine, yet the golden age of Islam (800 – 1200 AD) might have shared more in identifying bases of stroke. The European Renaissance beginning from 1400 AD with its famous anatomists and physicians greatly contributed too to stroke localization and vascular supply.

Conclusions

As medicine and science are in a continuous chain from the past to the future through the present, the
current comprehensive review highlights the major important and documented shifts in the history of stroke over
more than 4500 years starting from ancient civilizations BC up to 2024 AD.
Minimally invasive tubular versus conventional open microsurgery of the lumbar spine for degenerative disorders
Authors: Ziga Michal , El-Garci Ahmed , Mahler Julia , Kogias Evangelos , Schlichtherle Rainer , Bozinov Oliver , Stienen Martin N. , Naseri Yashar
Published: December 2024

Background

The aim of this study was to investigate patient-related variables, hospital-related variables and surgeon-related variables of minimally invasive tubular microsurgery (MITM) compared to conventional open microsurgery (COMS) in patients undergoing microsurgery for lumbar degenerative disorders (LDD).

Results

403 included patients were treated microsurgically for LDD between 09/2018 and 09/2021. Mean blood loss (44 vs. 72 ml), surgery time (76.2 vs. 85.7 min) and mean Rx-Dosis (1.1 mGy vs. 1.6 mGy) were lower in the MITM group (all p < 0.05). The Macnab criteria and VAS pain scale (VAS Leg/VAS Back) of the MITM group were better at 6 weeks as well as 1 year postoperatively (Macnab at 6W: 1.5 vs. 1.7 (p = 0.02), at 1y: 1.2 vs. 1.4 (p = 0.002); VAS Leg at 6W: 1.4 vs. 1.9 (p = 0.005), at 1y: 0.4 vs. 0.9 (p < 0.001), VAS Back at 6W 1.4 vs. 3.2 (p < 0.001), at 1y: 1.2 vs. 1.4 (p < 0.001)).

Conclusion

The patient-related variables, hospital-related variables and surgeon-related variables are equivalent or better in MITM compared to COMS. MITM showed more favourable clinical outcomes in both short- and long-term follow-up, albeit small between-group differences in our single-center study and can be considered for various microsurgical indications for LDD.
Assessment of peripheral nerve affection of the lower limbs in type 2 diabetic patients using neuromuscular ultrasound and electrodiagnostic studies
Authors: Hana Mary Fayez Francis , El Naby Mona Mansour Hasab , Saied Ola Abdulnaser Abdulaziez , Gergius Youssy Saeed Eshak
Published: December 2024

Background

Diabetic peripheral neuropathy is regarded as one of the most common microvascular sequalae of type 2 diabetes mellitus which leads to lower limb complications. Lately, the focus has shifted to early detection of diabetic neuropathy in the subclinical stage. While nerve conduction studies are considered non-invasive, sensitive and objective procedures for diagnosis of neuropathies, the missed diagnosis rate is high in early neuropathy. Recently, ultrasonography use has been regarded as an alternative method for detecting neuropathies, being an inexpensive and a more comfortable tool. The aim of this study was to define the pattern of affection of lower limb peripheral nerves in type 2 diabetic patients using neuromuscular ultrasound and to assess its utility in evaluation of diabetic peripheral neuropathy in asymptomatic diabetic patients.

Methods

This cross-sectional study included 40 type 2 diabetic patients and 20 healthy age- and sex-matched controls. All patients were subjected to full history taking, clinical examination, electrodiagnostic studies and neuromuscular ultrasound. Neuromuscular ultrasound was performed for tibial, fibular and sural nerves bilaterally for all patients and controls. Nerve cross-sectional area was measured at multiple sites for each nerve.

Results

Diabetic patients had statistically significant higher mean cross-sectional area values than controls in nearly all examined sites of all nerves. Furthermore, patients with electrophysiological diabetic peripheral neuropathy (EDPN) had higher statistically significant mean sural cross-sectional area values than patients without EDPN. There were no statistically significant differences in mean cross-sectional area values between symptomatic and asymptomatic patients with EDPN in all measured nerves. ROC analysis showed that sural nerve cross-sectional area cut off value of > 5 mm2 was predictive for diagnosis of EDPN.

Conclusions

Diabetic cases, even asymptomatic ones, had statistically significant higher mean cross-sectional area values than controls on neuromuscular ultrasound. In addition, patients with EDPN showed higher cross-sectional area values of lower limbs peripheral nerves. Thus, neuromuscular ultrasound could be used as a screening tool for diabetic peripheral neuropathy using sural nerve cross-sectional area measurement at the ankle even in asymptomatic diabetic patients.
Immediate effects of exercise snacking on physical fatigue, mood, and pain in elderly adults with knee osteoarthritis
Authors: Aiyegbusi Ayoola Ibifubara , Kolawole Francis Oluwatosin , Oke Israel Kayode , Fawole Henrietta O.
Published: December 2024

Background

Exercise has been reported to be beneficial in reducing pain and fatigue, as well as improving mood, in patients with knee osteoarthritis (KOA). However, long bouts of exercise have been linked to an increase in fatigue and pain level in elderly adults. Currently, there are very few investigations into the immediate effects of breaking exercise into shorter and frequent bouts, otherwise known as exercise snacking on physical fatigue, mood, and pain in elderly adults with KOA. The aim of this study was to investigate the immediate impact of exercise snacking versus continuous exercise on physical fatigue, mood, and pain level in elderly adults with KOA.

Methods

This was a randomized experimental study, with 37 participants aged 60 years and above with KOA. Participants were recruited and randomly assigned into a five bouts of 2-min exercise snacking and 10-min continuous exercise groups, with the bicycle ergometer as the exercise mode. Physical fatigue, mood, and pain of participants were assessed at baseline and immediately after the exercise using Numerical Fatigue Rating Scale (NFRS), Visual Analog Mood Scale (VAMS), and Numerical Pain Rating Scale (NPRS) respectively. Descriptive statistics and inferential statistics of Wilcoxon Rank test, Mann–Whitney U, and ANCOVA were used to analyze the data with p value set at 0.05.

Results

There were significant differences (p < 0.001) in physical fatigue, mood, and pain between baseline and post-intervention values within groups. Between-group comparisons revealed significant reductions in physical fatigue (p < 0.001) and pain levels (p = 0.048) in the exercise snacking group compared to the continuous exercise group. However, no significant between-group differences were found for mood.

Conclusion

Exercise snacking yielded significant improvements in physical fatigue and pain in elderly with KOA. However, both exercise snacking and continuous aerobic exercise were comparable in their immediate effects on mood in elderly adults with KOA.

Trial registration

PACTR202308724795310 Registered 28th September 2023, https://www.edctp.org/pan-african-clinical-trials-registry/.
Numerical investigation of aerodynamic performance in a morphing wing with flexible leading edge using computational fluid dynamics
Authors: Shi Junjie , Han Fei , Li Taorui , Liu Chao
Published: December 2024

In this study, a numerical investigation into the sustained aerodynamic performance of a morphing wing equipped with a flexible leading edge, employing a 2-dimensional NACA0012 airfoil configuration, is conducted. The compressible governing equations of the flow are employed, simulating 2 distinct states: the airfoil without motion and the airfoil featuring a flexible leading edge with a chord length of 0.856 m, assessing various angles of attack utilizing the k-ω SST turbulence approach within Fluent software. Dynamic mesh, facilitated by a user-defined function, is utilized in Fluent software to simulate the movement of the airfoil wall at the leading edge. The study thoroughly analyzes the flow behavior concerning diverse angles of attack and deviations, evaluating their impact on aerodynamic coefficients, velocity, and pressure fields under steady-state settings. Validation of the chosen numerical approach demonstrates close alignment of the front and back coefficients with experimental settings. Outcomes from the steady-state flow simulation of the morphing wing reveal that positive deflection angles correspond to increased lift coefficients and decreased drag coefficients, with lift coefficient increases of up to 15% and drag coefficient reductions of up to 10% at specific angles. Meanwhile, the negative deflection angles have shown a decline in lift coefficients, with the drag coefficients increasing with the decrease in deflection angle. All these observations show that at the flexible leading edge, there is a considerable improvement in aerodynamic efficiency. Hence, it should find more applications in different regimes of flight.
Edukacja domowa szansą na rozwój metauczenia się. Biograficzna perspektywa mamy-edukatorki
Authors: Kądziołka Danuta
Published: December 2024

Celem badania było jest zrozumienie, w jaki sposób edukacja domowa wpływa na rozwój kompetencji metauczenia się u dzieci, z perspektywy matki, która prowadzi taki sposób nauczania. Badanie koncentrowało się na zidentyfikowaniu motywacji, które skłoniły matkę do podjęcia edukacji domowej, analizie sposobu organizacji tego procesu oraz strategii stosowanych przez matkę-edukatorkę. Przeprowadzono badania jakościowe w oparciu o metodę biograficzną, wykorzystując wywiad narracyjny i analizę proksemiczną.
Wyniki badań wskazują, że edukacja domowa sprzyja rozwojowi metauczenia się, umożliwiając dzieciom lepsze zrozumienie własnych procesów poznawczych oraz rozwój takich umiejętności, jak krytyczne myślenie i refleksja nad własnym uczeniem się. Na podstawie analizy doświadczeń matki-edukatorki zaproponowano praktyczne rekomendacje dla rodziców i edukatorów.
Dziecko i dzieciństwo w myśli pedagogicznej Marii Montessori
Authors: Surma Barbara
Published: December 2024

Maria Montessori, włoska lekarka i pedagog, żyjąca na przełomie XIX i XX wieku, stworzyła koncepcję pedagogiczną opartą na podmiotowym podejściu do dziecka. Zwracała uwagę, że dzieciństwo jest ważnym etapem w rozwoju człowieka. W związku z tym postulowała, że należy prowadzić badania, aby odkryć jego wartość. Na podstawie eksperymentu przeprowadzonego z dziećmi z deficytami rozwojowymi, a następnie z dziećmi w wieku przedszkolnym w tak zwanym „Casa dei Bambini”, opracowała innowacyjną metodę wspierającą rozwój dziecka. Jej rozumienie dziecka i dzieciństwa wpisuje się w nurt Nowego Wychowania rozwijającego się na początku XX wieku.
Celem artykułu jest odczytanie na nowo znaczenia treści pojęć „dziecko” i „dzieciństwo” w antropologicznej i filozoficznej perspektywie badań w myśli pedagogicznej Montessori. Problemy badawcze zostały sformułowane w formie pytań: Kim jest dziecko i jakie znaczenie Montessori nadaje dzieciństwu? Metodą badawczą, która została zastosowana, był narracyjny przegląd literatury, w tym przypadku dzieł Montessori. Badania wykazały, że według Montessori dziecko jest „konstruktorem” własnego bytu, a nie tylko skutkiem działań reprodukcyjnych swoich rodziców. Nie jest też pustym naczyniem, które należy napełnić wiedzą. Dziecko pozostaje w centrum metody Montessori, która uwzględnia specyficzne właściwości poznawania przez dziecko swego otoczenia w okresie dzieciństwa.
Practical challenges to addressing age discrimination in Spain.
Authors: McKenzie Shelagh
Published: December 2024

The 2023 Eurobarometer 2023 on Discrimination in the European Union listed
age (being too old or too young) as being perceived amongst citizens of the
European Union as being the top potential barrier to the labour market. This
is despite specific European Union laws being in place for almost twenty-one
years to tackle age discrimination in the labour market (Directive 2000/78/
EC). In an evaluation of the implementation of Directive 2000/78/EC in the EU
Member States in 2021, the European Commission found some stakeholders
had a ‘limited awareness and application’ of the concept of indirect
discrimination in domestic judicial practice. Despite Spain introducing a new
comprehensive law on Equality of Treatment and Non-Discrimination in 2022
and a new Whistleblowing Law in 2023, practical difficulties to addressing age
discrimination and particularly indirect age discrimination continue to exist.
Descarbonización en el sector marítimo: una mirada desde el Derecho del Trabajo.
Authors: Menoya Zayas Sandys
Published: December 2024

El trabajo analiza de manera crítica las posibles implicaciones, efectos y retos
que el proceso de descarbonización del sector marítimo representa para el
trabajo y la empleabilidad desde una perspectiva jurídica laboral. Por una
parte, se tiene en cuenta el contexto actual que exige la implementación
de políticas, estrategias y acciones que contribuyan a la descarbonización,
tanto a nivel mundial como en el ámbito europeo y español, así como de
cara a las particularidades de cada sector de la economía; y de otra parte,
se identifican los aspectos claves que se deben tomar en consideración en
el sector marítimo para garantizar una transición justa, equitativa y tuitiva
para sus colectivos de trabajadores, teniendo en cuenta que dicho sector
constituye uno de los mayores contaminantes a escala global, dado su
impacto en la economía, las características tecnológicas de la industria y su
marcado carácter internacional.
La Gran Dimisión: algunos datos y primeras conclusiones en relación con el mercado de trabajo español.
Authors: Calvo Gallego Francisco Javier , Gómez Domínguez Dolores , Sánchez López Celia
Published: December 2024

Este artículo explora la tendencia de la «Gran Dimisión» en el contexto del mercado laboral español, centrándose en el aumento de renuncias laborales
desde 2013. Analiza los datos de bajas voluntarias proporcionados por la Seguridad
Social, destacando el impacto de la pandemia y factores estructurales como la insatisfacción laboral y la falta de conciliación. Además, el estudio identifica cambios en la propensión a la dimisión, especialmente entre trabajadores con contratos indefinidos tras la reforma laboral de 2021
Penalty Decomposition Methods for Second-Best Congestion Pricing Problems on Large-Scale Networks
Authors: Guo Lei , Zhou Wenxin , Wang Xiaolei , Yang Hai , Fan Tijun
Published: December 2024

The second-best congestion pricing (SBCP) problem is one of the most challenging problems in transportation because of its two-level hierarchical structure. In spite of various intriguing attempts at solving SBCP, existing solution methods are either heuristic without a convergence guarantee or suitable for solving SBCP on small networks only. In this paper, we first reveal some convexity-based structural properties of the marginal value function reformation of SBCP, and then, by effectively exploiting these structural properties, we propose two dedicated decomposition methods for solving SBCP on large-scale networks, which are different from existing methods in that they avoid linearizing nonconvex functions. We establish the convergence of the two decomposition methods under commonly used conditions and provide the maximum number of iterations for deriving an approximate stationary solution. The computational experiments based on a collection of real road networks show that in comparison with three existing popular methods, the two proposed methods are capable of solving SBCP on larger-scale networks, and for instances that can be solved by existing methods, the two proposed methods are substantially faster.

History: Accepted by Pascal Van Hentenryck, Area Editor for Computational Modeling: Methods and Analysis.

Funding: This work was supported by the National Natural Science Foundation of China [Grants 72032001, 72431007, 72131007, 72021002, and 12271161]. L. Guo was also supported by the Natural Science Foundation of Shanghai [Grant 22ZR1415900]. X. Wang was also supported by the Fundamental Research Funds for the Central Universities and CCF-DiDi GAIA Collaborative Research Funds for Young Scholars.

Supplemental Material: The software that supports the findings of this study is available within the paper and its Supplemental Information ( https://pubsonline.informs.org/doi/suppl/10.1287/ijoc.2023.0144 ) as well as from the IJOC GitHub software repository ( https://github.com/INFORMSJoC/2023.0144 ). The complete IJOC Software and Data Repository is available at https://informsjoc.github.io/ .
Planning Bike Lanes with Data: Ridership, Congestion, and Path Selection
Authors: Liu Sheng , Siddiq Auyon , Zhang Jingwei
Published: December 2024

Urban infrastructure is vital for sustainable cities. In recent years, municipal governments have invested heavily in the expansion of bike lane networks to meet growing demand, promote ridership, and reduce emissions. However, reallocating road capacity to cycling is often contentious because of the risk of amplifying traffic congestion. In this paper, we develop a method for planning bike lanes that accounts for ridership and congestion effects. We first present a procedure for estimating parameters of a traffic equilibrium model, which combines an inverse optimization method for predicting driving times with an instrumental variables method for estimating a commuter mode choice model. We then formulate a prescriptive model that selects paths in a road network for bike lane installation while endogenizing cycling demand and driving travel times. We conduct an empirical study on the City of Chicago that brings together several data sets that describe the urban environment—including the road and bike lane networks, vehicle flows, commuter mode choices, bike share trips, driving and cycling routes, demographic features, and points of interest—with the goal of estimating the impact of expanding Chicago’s bike lane network. We estimate that adding 25 miles of bike lanes as prescribed by our model can lift cycling ridership from 3.6% to 6.1%, with at most a 9.4% increase in driving times. We also find that three intuitive heuristics for bike lane planning can lead to lower ridership and worse congestion outcomes, highlighting the value of a holistic and data-driven approach to urban infrastructure planning.

This paper was accepted by Karan Girotra, operations management.

Funding: Funding: The authors acknowledge funding from the UCLA Anderson Easton Technology Management Center (Siddiq & Zhang) and the Natural Sciences and Engineering Research Council of Canada [Grant RGPIN-2022-04950] and TD-MDAL Research Grant from the Rotman School of Management (Liu).

Supplemental Material: The online appendix and data files are available at https://doi.org/10.1287/mnsc.2022.00775 .
On Simple Mechanisms for Dependent Items
Authors: Cai Yang , Oikonomou Argyris
Published: December 2024

In “On Simple Mechanisms for Dependent Items,” the authors study the performance of simple mechanisms—such as item pricing or bundling—in settings where a buyer’s valuations for items are dependent. Previous research has largely focused on the setting with independent item valuations, which, although theoretically appealing, is unrealistic. Other studies have either examined limited forms of dependency or allowed arbitrary dependencies, but in the latter case, the resulting approximation ratios are exponential in the number of items, making them too weak to be practical for real-world applications. To bridge this gap, the authors use Markov random fields (MRFs), a graphical model well suited for representing complex dependencies among random variables, to capture correlations among items. They establish a parametric approximation, showing that the performance of simple mechanisms is independent of the number of items and degrades gracefully with the degree of dependency among items, as characterized by the MRF. This framework extends to general valuation functions, enabling it to account for practical constraints faced by practitioners, such as cardinality constraints.
Flexible working
Authors: Dunckley Joe
Published: December 2024

With flexible working becoming more popular, organisations should embrace the potential for such arrangements to enhance recruitment and retention as well as staff wellbeing and productivity