bluuebunny/crossref_metadata_2025 huggingface dataset:
Astragalus mongholicus Bunge and Curcuma aromatica Salisb. inhibits liver metastasis of colon cancer by regulating EMT via the CXCL8/CXCR2 axis and PI3K/AKT/mTOR signaling pathway
Authors: Liu Fuyan , Liang Yan , Sun Ruolan , Yang Weicheng , Liang Zhongqing , Gu Junfei , Zhao Fan , Tang Decai
Published: August 2022

Background

One of the most challenging aspects of colon cancer (CC) prognosis and treatment is liver-tropic metastasis. Astragalus mongholicus Bunge—Curcuma aromatica Salisb. (AC) is a typical medication combination for the therapy of many malignancies. Our previous studies found that AC intervention inhibits liver metastasis of colon cancer (LMCC). Nevertheless, the comprehensive anti-metastasis mechanisms of AC have not been uncovered.

Methods

In bioinformatics analysis, RNA-seq data of CC and LMCC patients were collected from TCGA and GEO databases, and differentially expressed genes (DEGs) were identified. The biological processes and signaling pathways involved in DEGs were enriched by GO and KEGG. The protein–protein interaction (PPI) network of DEGs was established and visualized using the Cytocape software, followed by screening Hub genes in the PPI network using Degree value as the criterion. Subsequently, the expression and survival relevance of Hub gene in COAD patients were verified. In the experimental study, the effects of AC on the inhibition of colon cancer growth and liver metastasis were comprehensively evaluated by cellular and animal models. Finally, based on the results of bioinformatics analysis, the possible mechanisms of AC inhibition of colon cancer EMT and liver metastasis were explored by in vivo and in vitro pharmacological experiments.

Results

In this study, we obtained 2386 DEGs relevant to LMCC from the COAD (colon adenocarcinoma) and GSE38174 datasets. Results of GO gene function and KEGG signaling pathway enrichment analysis suggested that cellular EMT (Epithelial-mesenchymal transition) biological processes, Cytokine-cytokine receptor interaction and PI3K/Akt signaling pathways might be closely related to LMCC mechanism. We then screened for CXCL8, the core hub gene with the highest centrality within the PPI network of DEGs, and discovered that CXCL8 expression was negatively correlated with the prognosis of COAD patients. In vitro and in vivo experimental evidence presented that AC significantly inhibited colon cancer cell proliferation, migration and invasion ability, and suppressed tumor growth and liver metastasis in colon cancer orthotopic transplantation mice models. Concomitantly, AC significantly reduced CXCL8 expression levels in cell supernatants and serum. Moreover, AC reduced the expression and transcription of genes related to the PI3K/AKT pathway while suppressing the EMT process in colon cancer cells and model mice.

Conclusions

In summary, our research predicted the potential targets and pathways of LMCC, and experimentally demonstrated that AC might inhibit the growth and liver metastasis in colon cancer by regulating EMT via the CXCL8/CXCR2 axis and PI3K/AKT/mTOR signaling pathway, which may facilitate the discovery of mechanisms and new therapeutic strategies for LMCC.
Incidence of oncogenic HPV and HPV-related dysplasia five years after a negative HPV test by self-sampling in elderly women
Authors: Hermansson Ruth S. , Olovsson Matts , Gustavsson Inger , Gyllensten Ulf , Lindkvist Olga , Lindberg Julia Hedlund , Lillsunde-Larsson Gabriella , Lindström Annika K.
Published: August 2022

Purpose

Cervical cancer prevention for older women can be challenging since there are no specific guidelines for this group. This study aimed to determine the incidence of oncogenic HPV and HPV-related dysplasia in elderly women 5 years after being HPV negative.

Methods

Invited women participated five years earlier in a study where self-sampling for HPV testing was applied, at this time, they were all HPV negative. The women were now, five years later invited to perform self-sampling for HPV testing. Women with a positive result performed a repeat HPV test. Those with a positive repeat HPV test were examined by colposcopy, biopsy and cytology.

Results

Of the 804 invited women, 634 (76.9%) agreed to participate in the study and a self-sampling kit was sent to them. Of these, 99.6% (632/634) sent a sample to the HPV laboratory. The participation rate in each age group was 93.3% at age 65, 74.0% at age 70, 80.7% at age 75 and 64.6% at age 80. Overall 18 women (2.8%, 95% CI 3.2 to 6.0) were HPV positive in the first test and 8 (1.3%, 95% CI 0.6 to 2.6) in the second test. Sampling for the second test was done on average 5.4 months after the first test. Fifty per cent (4/8) of the women with a positive repeat test had dysplasia in histology.

Conclusion

The incidence of HPV in previously HPV-negative elderly women was low. Among women who were HPV positive in a repeat test, there was a high prevalence of low grade dysplasia.
Post-exposure prophylaxis with sotrovimab for Omicron (B.1.1.529) SARS-CoV-2 variant during the aplastic phase of autologous stem cell transplantation
Authors: Marcacci Gianpaolo , Coppola Nicola , Madonna Emanuela , Becchimanzi Cristina , De Pascalis Stefania , D’Ovidio Silvia , Crisci Stefania , Maiolino Piera , De Filippi Rosaria , Pinto Antonio
Published: August 2022

Background

To date, there is no information on the safety and efficacy of the novel anti-sarbecoviruses monoclonal antibody sotrovimab administered, as a post-exposure prophylactic measure, during the aplastic phase of autologous stem cell transplantation (ASCT).

Methods

We describe the outcomes of a Multiple Myeloma (MM) patient, who was threateningly exposed to the Omicron (B.1.1.529) SARS-CoV-2 variant, two days after having received a myeloablative regimen of high-dose melphalan. The patient fulfilled all CDC criteria for prolonged close contacts with an index patient who tested positive for a molecular nasopharyngeal swab (Omicron; B.1.1.529) soon after admission to the ward. Given the high risks of morbidity and mortality in the case of COVID-19 developing during the aplastic phase of transplantation, we adopted a post-exposure prophylaxis intervention based on intravenous (i.v.) sotrovimab.

Results

Sotrovimab (500 mg i.v.) was administered at day + 2 from stem cells reinfusion, i.e. 4 days after myeloablative chemotherapy, and at day + 5 from the last close contact with the Omicron-positive index case. The patient was fully protected from SARS-CoV-2 infection throughout his clinical course and remained molecularly negative at the day + 30 from the transplant. We compared times to engraftment and transplant-related toxicities of the sotrovimab-treated patient with the last 15 MM patients transplanted at our Centre, evidencing no unexpected safety signals, infusion-related reactions, or alarming effects on engraftment kinetics.

Conclusions

We have shown here for the first time that administration of sotrovimab during the pre-engraftment phase of ASCT is effective, safe, and not associated with delays in hemopoietic recovery. As compared to MM patients who received the same myeloablative conditioning regimen, the patient given sotrovimab during the aplastic phase did not show any significant differences in engraftment kinetics and toxicity outcomes. Post-exposure prophylaxis with sotrovimab may represent a valuable approach in the stem cell transplantation setting for patients with high-risk exposure to a confirmed COVID-19 case sustained by highly infectious SARS-CoV-2 variants escaping the vaccine-derived immunity due to antigenic shifts in the spike proteins.
Artificial intelligence enhanced ultrasound (AI-US) in a severe obese parturient: a case report
Authors: Compagnone Christian , Borrini Giulia , Calabrese Alberto , Taddei Mario , Bellini Valentina , Bignami Elena
Published: August 2022

Background

Neuraxial anesthesia in obese parturients can be challenging due to anatomical and physiological modifications secondary to pregnancy; this led to growing popularity of spine ultrasound in this population for easing landmark identification and procedure execution.

Integration of Artificial Intelligence with ultrasound (AI-US) for image enhancement and analysis has increased clinicians' ability to localize vertebral structures in patients with challenging anatomical conformation.

Case presentation

We present the case of a parturient with extremely severe obesity, with a Body Mass Index (BMI) = 64.5 kg/m2, in which the AI-Enabled Image Recognition allowed a successful placing of an epidural catheter.

Conclusions

Benefits gained from AI-US implementation are multiple: immediate recognition of anatomical structures leads to increased first-attempt success rate, making easier the process of spinal anesthesia execution compared to traditional palpation methods, reducing needle placement time for spinal anesthesia and predicting best needle direction and target structure depth in peridural anesthesia.
The relationship between external and internal load parameters in 3 × 3 basketball tournaments
Authors: Willberg C. , Wieland B. , Rettenmaier L. , Behringer M. , Zentgraf K.
Published: August 2022

Purpose

3 × 3 basketball games are characterized by high-intensity accelerations and decelerations, and a high number of changes of direction and jumps. It is played in tournament form with multiple games per day. Therefore, optimal regeneration is crucial for maintaining a high performance level over the course of the tournament. To elucidate how load of a match affects the athletes' bodies (i.e., internal load), muscular responses to the load of 3 × 3 games were analyzed. We aimed to investigate changes in contractility of the m. rectus femoris (RF) and m. gastrocnemius medialis (GC) in response to the load of single 3 × 3 games and a 3 × 3 tournament.

Methods

Inertial movement analysis was conducted to capture game load in 3 × 3. Changes in contractility were measured using tensiomyography (TMG). During a two-day tournament, TMG measurements were conducted in the morning and after each game. Additionally, off-game performance analysis consisting of jump and change-of-direction (COD) tests was conducted the day before the tournament.

Results

Significant changes of the muscle contractility were found for GC with TMG values being higher in the baseline than in the post-game measurements. In contrast to athletes of the GC group, athletes of the RF group responded with either decreased or increased muscle contractility after a single 3 × 3 game. A significant correlation between external and internal load parameters could not be shown. Concerning off-game performance, significant correlations can be reported for COD test duration, CMJ height and ∆Vc as well as COD test duration and ∆Dm. No systematic changes in muscle contractility were found over the course of the tournament in RF and GC.

Conclusion

The athletes' external 3 × 3 game load and their performance level did not seem to affect muscular contractility after a single 3 × 3 game or a complete 3 × 3 tournament within this investigation. This might indicate that elite athletes can resist external load without relevant local muscular fatigue. With respect to the course of the tournament, it can therefore be concluded that the breaks between games seem to be sufficient to return to the initial level of muscle contractility.
Early diagnosis of Alzheimer’s disease using machine learning: a multi-diagnostic, generalizable approach
Authors: Diogo Vasco Sá , Ferreira Hugo Alexandre , Prata Diana ,   for the Alzheimer’s Disease Neuroimaging Initiative
Published: August 2022

Background

Early and accurate diagnosis of Alzheimer’s disease (AD) is essential for disease management and therapeutic choices that can delay disease progression. Machine learning (ML) approaches have been extensively used in attempts to develop algorithms for reliable early diagnosis of AD, although clinical usefulness, interpretability, and generalizability of the classifiers across datasets and MRI protocols remain limited.

Methods

We report a multi-diagnostic and generalizable approach for mild cognitive impairment (MCI) and AD diagnosis using structural MRI and ML. Classifiers were trained and tested using subjects from the AD Neuroimaging Initiative (ADNI) database (n = 570) and the Open Access Series of Imaging Studies (OASIS) project database (n = 531). Several classifiers are compared and combined using voting for a decision. Additionally, we report tests of generalizability across datasets and protocols (IR-SPGR and MPRAGE), the impact of using graph theory measures on diagnostic classification performance, the relative importance of different brain regions on classification for better interpretability, and an evaluation of the potential for clinical applicability of the classifier.

Results

Our “healthy controls (HC) vs. AD” classifier trained and tested on the combination of ADNI and OASIS datasets obtained a balanced accuracy (BAC) of 90.6% and a Matthew’s correlation coefficient (MCC) of 0.811. Our “HC vs. MCI vs. AD” classifier trained and tested on the ADNI dataset obtained a 62.1% BAC (33.3% being the by-chance cut-off) and 0.438 MCC. Hippocampal features were the strongest contributors to the classification decisions (approx. 25–45%), followed by temporal (approx. 13%), cingulate, and frontal regions (approx. 8–13% each), which is consistent with our current understanding of AD and its progression. Classifiers generalized well across both datasets and protocols. Finally, using graph theory measures did not improve classification performance.

Conclusions

In sum, we present a diagnostic tool for MCI and AD trained using baseline scans and a follow-up diagnosis regardless of progression, which is multi-diagnostic, generalizable across independent data sources and acquisition protocols, and with transparently reported performance. Rated as potentially clinically applicable, our tool may be clinically useful to inform diagnostic decisions in dementia, if successful in real-world prospective clinical trials.
Harmonization issues in unit costing of service use for multi-country, multi-sectoral health economic evaluations: a scoping review
Authors: Fischer Claudia , Mayer Susanne , Perić Nataša , Simon Judit
Published: August 2022

Background

Valuation is a critical part of the costing process in health economic evaluations. However, an overview of specific issues relevant to the European context on harmonizing methodological requirements for the valuation of costs to be used in health economic evaluation is lacking. We aimed to inform the development of an international, harmonized and multi-sectoral costing framework, as sought in the European PECUNIA (ProgrammE in Costing, resource use measurement and outcome valuation for Use in multi-sectoral National and International health economic evaluAtions) project.

Methods

We conducted a scoping review (information extraction 2008–2021) to a) to demonstrate the degree of heterogeneity that currently exists in the literature regarding central terminology, b) to generate an overview of the most relevant areas for harmonization in multi-sectoral and multi-national costing processes for health economic evaluations, and c) to provide insights into country level variation regarding economic evaluation guidance. A complex search strategy was applied covering key publications on costing methods, glossaries, and international costing recommendations augmented by a targeted author and reference search as well as snowballing. Six European countries served as case studies to describe country-specific harmonization issues. Identified information was qualitatively synthesized and cross-checked using a newly developed, pilot-tested data extraction form.

Results

Costing methods for services were found to be heterogeneous between sectors and country guidelines and may, in practice, be often driven by data availability and reimbursement systems in place. The lack of detailed guidance regarding specific costing methods, recommended data sources, double-counting of costs between sectors, adjustment of unit costs for inflation, transparent handling of overhead costs as well as the unavailability of standardized unit costing estimates in most countries were identified as main drivers of country specific differences in costing methods with a major impact on valuation and cost-effectiveness evidence.

Conclusion

This review provides a basic summary of existing costing practices for evaluative purposes across sectors and countries and highlights several common methodological factors influencing divergence in cost valuation methods that would need to be systematically incorporated and addressed in future costing practices to achieve more comparable, harmonized health economic evaluation evidence.
An electrochemical sensor based on [Ru(bpy)2dpp]2+/SMWCNTs/Au modified glassy carbon electrode for the detection of 5ʹ-GMP
Authors: Yu Ying , Huan Siqi , Wang Xiaodan , Yang Cong , Liu Dengyong
Published: August 2022

A sensitive electrochemical sensor for the selective detection of 5ʹ-guanylic acid (5ʹ-GMP) was prepared by combining sulfonated-multiwalled carbon nanotubes (SMWCNTs) and [Ru(bpy)2dpp]Cl2, which were dripped on the surface of a glass carbon electrode (GCE) immobilized with gold nanoparticles. The 5ʹ-GMP electrochemical biosensor was fabricated using [Ru(bpy)2dpp]2+/SMWCNTs/Au/GCE as working, Ag/AgCl as reference and Pt as auxiliary electrode connected by an electrochemical workstation. The modified electrode was characterized by cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS). The results showed the sensor’s response current had the best peak shape and maximum peak when the pH of electrolyte was 3, scan speed of CV was in the range of 100 to 180 mV/s, and the enrichment time was in the range of 200 to 300 s. Under the optimum conditions, a linear analytical curve was obtained for 5ʹ-GMP concentrations in the range of 0.01 to 0.5 mmol L−1, with a detection limit of 0.0014 mmol L−1. The analytical results of the 5ʹ-GMP sensor were exhibited good consistent with the data from liquid chromatography. The sensor has good reproducibility, long-term stability and strong immunity to interference, and may be a powerful device for 5ʹ-GMP detection, with great advantages such as simple preparation and operation, low equipment cost.
Differences between bipolar disorder types 1 and 2 support the DSM two-syndrome concept
Authors: Tondo Leonardo , Miola Alessandro , Pinna Marco , Contu Martina , Baldessarini Ross J.
Published: August 2022

Objective

To compare characteristics of bipolar disorder patients diagnosed as DSM-5 types I (BD-1) vs. II (BD-2).

Methods

We compared descriptive, psychopathological, and treatment characteristics in a sample of 1377 consenting, closely and repeatedly evaluated adult BD patient-subjects from a specialty clinic, using bivariate methods and logistic multivariable modeling.

Results

Factors found more among BD-2 > BD-1 cases included: [a] descriptors (more familial affective disorder, older at onset, diagnosis and first-treatment, more education, employment and higher socioeconomic status, more marriage and children, and less obesity); [b] morbidity (more general medical diagnoses, less drug abuse and smoking, more initial depression and less [hypo]mania or psychosis, longer episodes, higher intake depression and anxiety ratings, less mood-switching with antidepressants, less seasonal mood-change, greater %-time depressed and less [hypo]manic, fewer hospitalizations, more depression-predominant polarity, DMI > MDI course-pattern, and less violent suicidal behavior); [c] specific item-scores with initial HDRS21 (higher scores for depression, guilt, suicidality, insomnia, anxiety, agitation, gastrointestinal symptoms, hypochondriasis and weight-loss, with less psychomotor retardation, depersonalization, or paranoia); and [d] treatment (less use of lithium or antipsychotics, more antidepressant and benzodiazepine treatment).

Conclusions

BD-2 was characterized by more prominent and longer depressions with some hypomania and mixed-features but not mania and rarely psychosis. BD-2 subjects had higher socioeconomic and functional status but also high levels of long-term morbidity and suicidal risk. Accordingly, BD-2 is dissimilar to, but not necessarily less severe than BD-1, consistent with being distinct syndromes.
Do immigrants experience labor market mismatch? New evidence from the US PIAAC
Authors: Pivovarova Margarita , Powers Jeanne M.
Published: August 2022

Background

One way of evaluating immigrants’ labor market outcomes is to assess the extent to which immigrants are able to enter into jobs that are commensurate with their education and experience. An imperfect alignment between workers’ educational qualifications and these required for their current job, or education-job mismatch, has implications for both the broader economy and individual workers. In this study, we investigate the factors associated with education-job mismatches among US workers by immigrant generation.

Methods

We analyzed the data from the US sample of the Program for the International Assessment of Adult Competencies (PIAAC) 2012/2014. Our analytic sample included 4022 employed (full and part-time) individuals between the ages of 20–65 years. We documented the distribution of education-job mismatches across selected independent variables and estimated the relationship between the individual characteristics of workers such as race, gender, presence of children, location, time in the country and knowledge of English for first-generation immigrant workers, and education-job mismatch using multinomial logistic regressions for the full sample and for the sample of first- and second-generation workers.

Results

We found that on average, immigrant workers in the US labor market were more likely to hold jobs which required less education that they had (being overmatched for the job), with first-generation workers being overmatched more frequently than second-generation workers. The probability of being overmatched for immigrant workers declines with the length of stay, and workers who are proficient in English are less likely to be overmatched. Our results also suggest that there may be labor market disadvantages to immigrant status that persist beyond the first-generation.

Conclusions

Previous research demonstrated that over-education depresses wages and lowers workers’ standards of living and their abilities to accumulate wealth. Our findings confirm that this dynamic may be particularly acute for first- and second-generation workers who are finding it difficult to become fully integrated into US labor markets, even though the factors behind the mismatch differs between the two immigrant generations.
Investigation of heavy metalloid pollutants in the south of Tehran using kriging method and HYDRUS model
Authors: Mirzaei Farhad , Abbasi Yasser , Sohrabi Teymour , Mirhashemi Seyed Hassan
Published: August 2022

Due to the high cost of the large-scale measurement of heavy metals, the use of statistical land models and techniques is one of the proper ways to study their distribution and level of pollution. The study area, is agricultural lands of south Tehran in Iran. Municipal wastewater is often used for irrigation agricultural lands under surface irrigation method. To study the distribution of heavy metals including copper, nickel, and lead, the ordinary kriging method in the GIS environment was used. In addition, one-dimensional HYDRUS modeling of water flow and heavy metals in the soil environment was simulated up to a depth of 50 cm for 210 days and the concentration of heavy metals in the depth was simulated. Distribution of lead element in soil surface with spherical model showed that its variation was in the range of 20–70 mg/kg. These values were 50–60 mg/kg for copper and 30 mg/kg for nickel. Investigation of heavy metal concentrations in soil profiles using the HYDRUS-1D model showed that the major accumulation of heavy metals occurred in the surface layer of soil at a depth of 0–15 cm that was higher than the permissible level.
An eye for an ‘I:’ a critical assessment of artificial intelligence tools in migration and asylum management
Authors: Nalbandian Lucia
Published: August 2022

The promise of artificial intelligence has been originally to put technology at the service of people utilizing powerful information processors and ‘smart’ algorithms to quickly perform time-consuming data analysis. It soon though became apparent that the capacity of artificial intelligence to scrape and analyze big data would be particularly useful in surveillance policies. In the wider areas of migration and asylum management, increasingly sophisticated artificial intelligence tools have been used to register and manage vulnerable populations without much concern about the potential misuses of the data collected and the overall ethical and legal underpinnings of these operations. This article examines three cases in point. The first case investigates the United Nations High Commissioner for Refugees’ decision to deploy a biometric matching engine engaging artificial intelligence to make accessing identification documents easier for both refugees and asylum seekers and the states and organizations they interact with. The second case focuses on the New Zealand government’s introduction of artificial intelligence to improve border security and streamline immigration. The third case looks at data scraping and biometric recognition tools implemented by the United States government to track (and eventually deport) undocumented migrants. The article first shows how states and international organizations are increasingly turning to artificial intelligence tools to support the implementation of their immigration policies and programs. Subsequently, the article also outlines how even despite well-intentioned efforts, the decision to use artificial intelligence tools to increase efficiency and support the implementation of migration or asylum management policies and programs often involves jeopardizing or altogether sacrificing individuals’ human rights, including privacy and security, and raises concerns about vulnerability and transparency.
ABC/2 formula for “bedside” postoperative pneumocephalus volume measurement
Authors: Chan David Yuen Chung , Cheung Eric Yuk Hong , Hui Ka Ho , Leung Cecelia Mei Sze , Ng Stephanie Chi Ping , Mak Wai Kit , Wong George Kwok Chu , Chan Tat Ming Danny , Poon Wai Sang
Published: August 2022

Background

Postoperative pneumocephalus is associated with a higher risk of recurrence of chronic subdural hematoma (cSDH). However, there is no verified simple way to measure the pneumocephalus volume at the bedside for daily clinical use. The ABC/2 method was shown to be a simple and reliable technique to estimate volumes of intracranial lesions, such as intracranial hematomas. This study aims to evaluate the accuracy of the ABC/2 formula in estimating volumes of pneumocephalus, as compared to the gold standard with computer-assisted volumetric analysis.

Methods

A total of 141 postoperative computed tomographic (CT) brain scans of cSDH patients with burr-hole drainage were analysed. Pneumocephalus volume was measured independently by both the ABC/2 formula and the computer-assisted volumetric measurement. For the computer-assisted measurement, the volume of the air was semiautomatically segmented and calculated by computer software. Linear regression was used to determine the correlation between the ABC/2 method and computer-assisted measurement.

Results

The postoperative pneumocephalus volume after bilateral burr-hole drainage was significantly larger than that of unilateral burr-hole drainage (29.34 ml versus 12.21 ml, p < 0.001). The estimated volumes by the formula ABC/2 significantly correlated to the volumes as measured by the computer-assisted volumetric technique, with r = 0.992 (p < 0.001). The Pearson correlation coefficient is very close to 1, which signifies a very strong positive correlation, and it is statistically significant.

Conclusions

An excellent correlation is observed between the ABC/2 method and the computer-assisted measurement. This study verified that the ABC/2 method is an accurate and simple “bedside” technique to estimate pneumocephalus volume.
A phase I/II study of adoptive immunotherapy using donor liver graft-derived natural killer cells to prevent bloodstream infection after liver transplantation: a study protocol
Authors: Ohira Masahiro , Imaoka Yuki , Sato Koki , Imaoka Koki , Nakano Ryosuke , Tanimine Naoki , Tahara Hiroyuki , Ide Kentaro , Kobayashi Tsuyoshi , Tanaka Yuka , Ohdan Hideki
Published: August 2022

Background

Bloodstream infections (BSIs) are among the most lethal complications of liver transplantation (LT). Natural killer (NK) cells are an important component of innate immunity and play an essential role in infection and cancer. Adoptive transfer of activated NK cells has the potential to decrease post-LT infections, including BSIs.

Methods

In this prospective, single-center, interventional, single-arm, historical control, phase I/II study, 37 LT recipients will enroll. The patient will receive a single infusion of donor liver-derived NK cells 3−5 days after LT.

Discussion

The primary endpoint is the incidence of BSIs during the first month after LT. Secondary endpoints include overall survival, adverse events, immunological responses, hepatocellular or de novo malignancy, and incidence of infectious disease.

Trial registration

This study was prospectively registered with UMIN000019183 (https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000022074) on November 1, 2015 and jRCTa060190036 on February 27, 2020.
The Oxford Knee Score is a reliable predictor of patients in a health state worse than death and awaiting total knee arthroplasty
Authors: Clement N. D. , Afzal I. , Liu P. , Phoon K. M. , Asopa V. , Sochart D. H. , Kader D. F.
Published: August 2022

Background

The health-related quality of life of patients awaiting a total knee arthroplasty (TKA) deteriorates with increasing time to surgery and identification of those with the worst quality of life may help to prioritize patients. The aims were to identify and validate independent variable(s) associated with a health state worse than death (WTD) in patients awaiting a TKA and whether these variables influenced patients-reported outcome measures.

Methods

A retrospective cohort of 5857 patients undergoing a primary TKA was identified from an established arthroplasty database. Patient demographics, body mass index (BMI), index of multiple deprivation, Oxford Knee Score (OKS), EuroQoL five dimension (EQ-5D) 3 level, and visual analogue scale (EQ-VAS) were collected preoperatively and one year postoperatively. An EQ-5D utility of less than zero was defined as WTD. A randomly selected subset of patients (n = 3076) was used to validate the variable that was most predictive of a state WTD and to assess the influence on patient-reported outcomes.

Results

There were 771 (13.2%) patients with a health state WTD. Increasing social deprivation (P = 0.050), worse preoperative OKS (P < 0.001), or EQ-VAS (P < 0.001) were independently associated with a health state WTD. The OKS was the most reliable predictor (area under curve 88.9%, 95% CI 87.8 to 90.1, P < 0.001) of a health state WTD. A threshold value of 16 or less, 80% sensitive and specific, was validated and confirmed to have a negative predictive value of 97.5%. Patients with an OKS of 16 or less had a significantly greater improvement in their OKS (difference 6.9, P < 0.001) and EQ-5D score (difference 0.257, P < 0.001). When adjusting for confounding factors, a health status WTD was not associated with worse postoperative OKS (difference –0.6, 95% CI –1.4 to 0.3, P = 0.177), EQ-5D (difference –0.016, 95% CI –0.036 to 0.003, P = 0.097) or patient satisfaction (difference –1.8, 95% CI –4.3 to 0.7, P = 0.162).

Conclusion

A threshold score 16 or less in OKS was a reliable predictor of a health status WTD and was associated with a greater improvement in knee-specific and health-related quality of life following TKA.
Multiclass anomaly detection in imbalanced structural health monitoring data using convolutional neural network
Authors: Zhao Mengchen , Sadhu Ayan , Capretz Miriam
Published: August 2022

Structural health monitoring (SHM) system aims to monitor the in-service condition of civil infrastructures, incorporate proactive maintenance, and avoid potential safety risks. An SHM system involves the collection of large amounts of data and data transmission. However, due to the normal aging of sensors, exposure to outdoor weather conditions, accidental incidences, and various operational factors, sensors installed on civil infrastructures can get malfunctioned. A malfunctioned sensor induces significant multiclass anomalies in measured SHM data, requiring robust anomaly detection techniques as an essential data cleaning process. Moreover, civil infrastructure often has imbalanced anomaly data where most of the SHM data remain biased to a certain type of anomalies. This imbalanced time-series data causes significant challenges to the existing anomaly detection methods. Without proper data cleaning processes, the SHM technology does not provide useful insights even if advanced damage diagnostic techniques are applied. This paper proposes a hyperparameter-tuned convolutional neural network (CNN) for multiclass imbalanced anomaly detection (CNN-MIAD) modelling. The hyperparameters of the proposed model are tuned through a random search algorithm to optimize the performance. The effect of balancing the database is considered by augmenting the dataset. The proposed CNN-MIAD model is demonstrated with a multiclass time-series of anomaly data obtained from a real-life cable-stayed bridge under various cases of data imbalances. The study concludes that balancing the database with a time shift window to increase the database has generated the optimum results, with an overall accuracy of 97.74%.
Isolated distal esophageal atresia in neonates: a case report and review of the literature
Authors: Keilani Rasem , Badran Eman , Mansour Hanan , Alatout Rasha , Alabadla Abdallah
Published: August 2022

Esophageal atresia occurs in 1 out of 2500 to 4500 live births; an isolated variant occurs in 8% of the cases. In this case report and literature review, we present a rare case of isolated distal esophageal atresia happening just 2 cm above the diaphragmatic right leaflet with the connecting band between the two esophageal parts. The location raised the possibility of a direct vascular accident to that segment as a cause of the atresia. Post-operative ambu bagging may facilitate leak at the anastomosis site and should be done carefully, as well as, to introduce contrast with suckling not with jet injection for the same reason. We mentioned that to raise a wariness as this mishap may cause problems.
Environmental Monitoring for Closed Robotic Workcells Used in Aseptic Processing: Data to Support Advanced Environmental Monitoring Strategies
Authors: McCall Joseph , Barnard Nonita , Gadient Kevin , Kasireddy Chandra , Kurtz Adara , Li Yiwei , Page Thomas , Putnam Tadd , Brennan Áine
Published: August 2022

The human operator is acknowledged as the greatest potential source of contamination in aseptic processing. To avoid contamination, barrier systems have progressively reduced the amount of human intervention in the critical zone. This study extends the trajectory of enhanced patient safety through the elimination of human intervention in aseptic filling. Eight companies that are users of closed robotic workcells have aggregated their usage data from 2018 to 2021. The study analyzes the critical design elements and performance of the Cytiva SA25 Aseptic Filling Workcell. The SA25 is a standardized, fully closed robotic system for aseptic filling of vials, syringes, and cartridges that eliminates operator intervention in the critical zone. The standardized design means that the system is not modified to suit a particular application and the same environmental monitoring strategy can be used across different installations. The SA25 provides significantly increased sterility assurance when producing sterile injectables. Users have observed non-viable particle levels well within ISO 5/Grade A air requirements, with extremely low probabilities of entering a dosage container. There have been zero cases of microbial growth in more than 250 media fills and good manufacturing practice (GMP) batches. Across all dosage formats and sizes, the aseptic process is repeatable, with more than 99.3% of units meeting acceptance criteria. These data demonstrate that eliminating risk through design is successful in the SA25, with an improved aseptic process in comparison to filling systems using Restricted Access Barrier Systems (RABS) or isolators with glove ports. One of the contributing companies to this article achieved an industry first. The U.S. FDA-approved commercial production of their biologic drugs without the requirement for routine viable environmental monitoring (EM), requiring viable EM only during process simulations. Based on the data presented and planned future research, new regulatory consideration should be made for closed robotic workcells to ensure that regulations meant for previous technologies with different risk profiles are not inappropriately applied.

Graphical abstract
Ethical dimensions of zoonotic disease research: Perspectives of traditional livestock keepers in Zambia
Authors: Zulu Victor Chisha , Syakalima Michelo , Ali Joseph
Published: August 2022

Background: With the increase in zoonotic disease research using livestock belonging to traditional livestock keepers (LKs) as research subjects, careful attention to both animal and livestock keeper interests is critically important in Zambia and other similar contexts.

Methods: The study aimed to explore ethics-related challenges during zoonotic disease research among LKs where their livestock are included as research subjects. The study was implemented in the Southern province of Zambia in July 2020.  Three focus group discussions  (FGDs) involving 30 adult male LKs living in livestock-wildlife interface areas where zoonotic diseases are likely to occur, were carried out. The FGDs were done in the local language and audio recorded. Thematic analysis was done using field notes and translated and transcribed recorded interviews. 

Results: The study found that trust between the researchers and LKs when their livestock are used as research subjects was very cardinal and depended on the continual presence of the local veterinary assistant (VA) during the conduct of research. 

Conclusions: The LKs could be considered a vulnerable population when their livestock were used as research subjects as, being resource poor, they were looking to researchers to provide benefits yet not fully understanding the research, and thus did not worry so much about consent procedures, bringing into question the validity of the oral consent obtained. The study also found that opportunities to strengthen trust and enhance the research experience could be exploited by researchers conducting research that is locally relevant and desired, being aware of procedural preferences for entering into livestock keeping communities, adequate disclosure of research procedures, respecting conventions and traditional cultural beliefs, and returning results of research. The findings of this study can be used by both researchers as they carry-out zoonotic disease research and by Research Ethics Committees.
Swedish People's Party of the Grand Duchy of Finland in the Revolution of 1905-1907
Authors: Postnikov Nikolay
Published: August 2022

The activities of the Swedish People's Party, its predecessor, the Swedish Party and the Svekomans movement as a whole, their role in the social and political life of the Grand Duchy of Finland remains a subject that has not previously fallen into the sphere of interests of domestic researchers, therefore it has not been studied and is a "blank spot" in history national political parties of Russia. Based on the above message, the purpose of this article is to analyze the activities of the Swedish People's Party during the revolution of 1905-1907. The article used historical, systemic, retrospective, comparative research methods. The article examines socio-political and state-legal, as well as interethnic relations between the Finns and the Swedish-speaking population, as prerequisites for the emergence of the Svekomans movement and the genesis of the Swedish People's Party, analyzes the ideological principles and theoretical provisions on the basis of which the Swedish People's Party was formed and its activities were built. To understand the stages of partogenesis of the Swedish People's Party, the article tells about the emergence of the Svekomans movement in the 60-70s of the 19th century and the activities of the Swedish Party, which emerged from the Svekomans and in 1906 was institutionalized into the Swedish People's Party. The article gives a description of the program provisions of the party, tells about the relationship of the Swedish People's Party in the internal party field of Finland with the ethnically Finnish political parties - the Old Finnish and Young Finnish parties. Considerable attention is paid to the relationship of the party with the Russian administration and the imperial government, the party's struggle against the integration of Finland into the Russian political space and the preservation of the dominance of the Swedish-speaking elite in the political life of the principality.
Prevalência dos níveis de atividade física e fatores associados entre adolescentes escolares
Authors: Silva Nayra Suze Souza e , Silva Rosângela Ramos Veloso , Santos Bruna Nathália , Silveira Marise Fagundes , Brito Maria Fernanda Santos Figueiredo , Pinho Lucinéia de , Cangussu Camila Katheryne Santos , Silva Carla Silvana de Oliveira e
Published: August 2022

Este estudo objetivou estimar a prevalência dos níveis insuficientes de atividade física e fatores associados entre adolescentes. Trata-se de um estudo transversal e analítico, realizado em 2017/2018 com estudantes do ensino médio das escolas públicas de Montes Claros, Minas Gerais, Brasil. Utilizou-se o autopreenchimento do IPAQ, versão curta, para avaliar o nível de atividade física, categorizando os adolescentes em ativos, insuficientemente ativos e fisicamente inativos. Variáveis de exposição foram organizadas em blocos: perfil sociodemográfico, consumo alimentar, uso de álcool/drogas, condições de saúde e aulas de educação física escolar. A Regressão Logística Multinomial permitiu estimar odds ratio (OR) e seus respectivos intervalos de confiança (IC) de 95%, com análises corrigidas pelo efeito do desenho. Participaram do estudo 2.040 adolescentes distribuídos em 21 escolas. No total, 21,3% eram insuficientemente ativos e 23,7% fisicamente inativos. As chances de ser insuficientemente ativo foram maiores entre as meninas (OR = 1,39; IC95%: 1,01 – 1,91), que consumiam frutas raramente (OR = 1,54; IC95%: 1,00 – 2,37), que não estavam fazendo nada em relação ao peso corporal (OR = 1,78; IC95%: 1,34 – 2,37) e com autopercepção de saúde regular (OR = 1,75; IC95%: 1,27 – 2,42). Houve maior chance de ser fisicamente inativo entre aqueles com menor renda (OR = 1,44; IC95%: 1,09 – 1,92), que consumiam frutas raramente (OR = 1,76; IC95%: 1,22 – 2,55), com boa autopercepção de saúde (OR = 1,54; IC95%: 1,15 – 2,07) e sem interesse pelas aulas de educação física (OR = 1,69; IC95%: 1,02 – 2,81). O estudo apontou que quase metade dos adolescentes não eram ativos fisicamente, indicando a necessidade de implementações de programas relacionados à promoção da prática de atividade física na adolescência.
Handling the heatwave
Authors: Chander Tina
Published: August 2022

Tina Chander explores the rules around temperature in the workplace.
What? Where? When? How?
Authors: Fitzsimons Rebecca
Published: August 2022

Rebecca Fitzsimons on how the dental team's communication skills play a vital role in improving outcomes.
Are you a genuine asset?
Authors: Deeming Guy
Published: August 2022

Where does the role of the dental nurse stand in the modern practice – and how can they add value? Guy Deeming offers a snapshot of what works for him and his team.
Teaching a fellow dental nurse
Authors: Wake Charlotte
Published: August 2022

Charlotte Wake explains why taking on the responsibility is a great opportunity.
Behind the camera
Authors: Warwick Josh
Published: August 2022

Dental Nursing speaks to Josh Warwick about fusing dentistry and photography.
A team approach
Authors: Jackson Josie
Published: August 2022

Josie Jackson speaks to Sarah Hussain about her practice's approach to social media and the roles dental nurses can play.
The epidemiology and direct healthcare costs of aseptic nonunions in Germany – a descriptive report
Authors: Walter Nike , Hierl Katja , Brochhausen Christoph , Alt Volker , Rupp Markus
Published: August 2022

Aims

This observational cross-sectional study aimed to answer the following questions: 1) how has nonunion incidence developed from 2009 to 2019 in a nationwide cohort; 2) what is the age and sex distribution of nonunions for distinct anatomical nonunion localizations; and 3) how high were the costs for surgical nonunion treatment in a level 1 trauma centre in Germany?

Methods

Data consisting of annual International Classification of Diseases (ICD)-10 diagnosis codes from German medical institutions from 2009 to 2019, provided by the Federal Statistical Office of Germany (Destatis), were analyzed. Nonunion incidence was calculated for anatomical localization, sex, and age groups. Incidence rate ratios (IRRs) were determined and compared with a two-sample z-test. Diagnosis-related group (DRG)-reimbursement and length of hospital stay were retrospectively retrieved for each anatomical localization, considering 210 patients.

Results

In 2019, a total of 11,840 nonunion cases (17.4/100,000 inhabitants) were treated. In comparison to 2018, the incidence of nonunion increased by 3% (IRR 1.03, 95% confidence interval (CI) 0.53 to 1.99, p = 0.935). The incidence was higher for male cases (IRR female/male: 0.79, 95% CI 0.76 to 0.82, p = 0.484). Most nonunions occurred at the pelvic and hip region (3.6/100,000 inhabitants, 95% CI 3.5 to 3.8), followed by the ankle and foot as well as the hand (2.9/100,000 inhabitants each). Mean estimated DRG reimbursement for in-hospital treatment of nonunions was highest for nonunions at the pelvic and hip region (€8,319 (SD 2,410), p < 0.001).

Conclusion

Despite attempts to improve fracture treatment in recent years, nonunions remain a problem for orthopaedic and trauma surgery, with a stable incidence throughout the last decade. Cite this article: Bone Joint Res 2022;11(8):541–547.