bluuebunny/crossref_metadata_2025 huggingface dataset:
Symptomatic Complete Discoid Medial Meniscus Completely Coalesced with the Anterior Cruciate Ligament: A Case Report and Literature Review
Authors: Jin Guorong , Xin Tong , Weng Zheng , Zhu Yun , Qiu Hao , Liu Dun , Chen Shimou , Dong Jiangtao , Huang Fang , Chen Yu
Published: August 2022

Background

Complete discoid medial meniscus is an extremely rare abnormality of the knee joint whose meniscus has a discoid shape rather than a normal semilunar one. Several medial meniscus anomalies including anomalous insertion have been reported in the literature. This report presents a rare case of symptomatic complete discoid medial meniscus whose anterolateral (apical) portion was completely coalesced with the ACL. MRI, radiographic, and arthroscopic findings in the medial compartment are to be submitted.

Case Presentation

A 29‐year‐old male presented with intermittent pain and swelling of the right knee for 2 years. Based on radiographic, MRI, and physical examination findings, he was diagnosed with discoid medial meniscus tears. Arthroscopic saucerization was performed for the torn discoid medial meniscus of the right knee. Arthroscopic examination revealed a complete discoid medial meniscus and the anterolateral (apical) portion of which was completely coalesced with the ACL. Careful Probing of the meniscal surface revealed there was a longitudinal tear extending from the tibial spine to the midportion of the meniscus. Arthroscopic saucerization of the discoid meniscus was performed after closely cutting the meniscus around the ACL. The patient reported no symptoms, and he had returned to his daily and sports activities, including football, basketball, and jogging, at the 12‐month follow‐up.

Conclusion

Complete discoid medial meniscus is an extremely rare abnormality, and this case presents the third complete discoid medial meniscus whose anterolateral (apical) portion was completely coalesced with the ACL. The current case we present strongly supports the hypothesis that ACL and meniscus were differentiated from the same mesenchyme.
Loss of 2‐Cys‐Prx affects cellular ultrastructure, disturbs redox poise and impairs photosynthesis in cyanobacteria
Authors: Kalwani Prakash , Rath Devashish , Ballal Anand
Published: August 2022

In a striking similarity to plant chloroplasts, the cyanobacterium Anabaena displays very low catalase activity, but expresses several peroxiredoxins (Prxs), including the typical 2‐Cys‐Prx (annotated as Alr4641), that detoxify H2O2. Due to the presence of multiple Prxs, the precise contribution of Alr4641 to the oxidative stress response of Anabaena is not well‐defined. To unambiguously assess its in vivo function, the Alr4641 protein was knocked down using the CRISPRi approach in Anabaena PCC 7120. The knockdown strain (An‐KD4641), which showed over 85% decrease in the content of Alr4641, was viable, but grew slower than the control strain (An‐dCas9). An‐KD4641 showed elevated levels of reactive oxygen species and the expression of several redox‐responsive genes was analogous to that of An‐dCas9 subjected to oxidative stress. The knockdown strain displayed reduced filament size, altered thylakoid ultrastructure, a marked drop in the ratio of phycocyanin to chlorophyll a and decreased photosynthetic parameters compared to An‐dCas9. In comparison to the control strain, exposure to H2O2 had a more severe effect on the photosynthetic parameters or survival of An‐KD4641. Thus, in the absence of adequate catalase activity, 2‐Cys‐Prx appears to be the principal Prx responsible for maintaining redox homoeostasis in diverse photosynthetic systems ranging from chloroplasts to cyanobacteria.
Influence of epigenetics on periodontitis and peri‐implantitis pathogenesis
Authors: Larsson Lena , Kavanagh Nolan M. , Nguyen Trang V. N. , Castilho Rogerio M. , Berglundh Tord , Giannobile William V.
Published: August 2022

Periodontitis is a disease characterized by tooth‐associated microbial biofilms that drive chronic inflammation and destruction of periodontal‐supporting tissues. In some individuals, disease progression can lead to tooth loss. A similar condition can occur around dental implants in the form of peri‐implantitis. The immune response to bacterial challenges is not only influenced by genetic factors, but also by environmental factors. Epigenetics involves the study of gene function independent of changes to the DNA sequence and its associated proteins, and represents a critical link between genetic and environmental factors. Epigenetic modifications have been shown to contribute to the progression of several diseases, including chronic inflammatory diseases like periodontitis and peri‐implantitis. This review aims to present the latest findings on epigenetic influences on periodontitis and to discuss potential mechanisms that may influence peri‐implantitis, given the paucity of information currently available.
Concise evaluation and therapeutic guidelines for severe periodontitis: A public health perspective
Authors: Slots Jørgen
Published: August 2022

The main goal of periodontology is to prevent and arrest gingivitis and periodontitis to avoid tooth loss and focal infection of periodontal origin. Periodontal scaling or flap surgery of moderate‐to‐severe periodontitis have shortcomings, most likely because removal of herpesviruses and bacterial pathogens in deep periodontal lesions and the adjacent inflamed gingiva requires systemic antimicrobial treatment (or gingivectomy). Valacyclovir (1000 mg twice daily on day 1, and 500 mg twice daily on day 2 and on day 3) is a potent anti‐herpesvirus agent. Antibiotic combinations against bacterial pathogens include amoxicillin‐metronidazole (250 mg of each, thrice daily for 4 days; for systemically healthy adults) and ciprofloxacin‐metronidazole (500 mg of each, twice daily for 4 days; for immunosuppressed individuals and patients exposed to contaminated water and poor sanitation). Supportive antiseptic treatment may consist of 0.1%‐0.2% sodium hypochlorite (regular household bleach) as cooling spray in ultrasonic scalers, flosser fluid in oral irrigators, and mouthrinse in patient self‐care. The anti‐infective treatment described here helps control cases of severe periodontitis and constitutes an exceedingly inexpensive alternative to conventional (mechanical) periodontal therapy.
I'm Not a Scientist, I Just Know What I See: Hurricane experience and climate change acceptance
Authors: Usry Kaye , Husser Jason , Sparks Aaron
Published: August 2022

Objective

Although severe weather events are becoming more frequent and more severe, for many citizens, climate change and its consequences are still a distant concern. In the United States, Republicans, in particular, have expressed skepticism about the threat posed by climate change. Is this skepticism reduced by direct experience with severe weather events?

Methods

Using two surveys of registered voters in North Carolina, we test whether the threat of being hit by Hurricane Florence, or experiencing its effects directly through power loss, flooding, or wind damage, was associated with reduced skepticism about the impact of climate change.

Results

Republican voters who were the most threatened by the storm and who experienced one or more of its impacts were more likely to say climate change poses a threat to the state than their copartisans who were not threatened or impacted. However, among highly educated and motivated Republican voters, experience with Hurricane Florence was associated with increased skepticism about climate change.

Conclusion

Severe weather events have the potential to moderate climate change skepticism in the United States but not among the most engaged, dedicated partisans.
Glutathione degradation activity of γ‐glutamyl peptidase 1 manifests its dual roles in primary and secondary sulfur metabolism in Arabidopsis
Authors: Ito Takehiro , Kitaiwa Taisuke , Nishizono Kosuke , Umahashi Minori , Miyaji Shunsuke , Agake Shin‐ichiro , Kuwahara Kana , Yokoyama Tadashi , Fushinobu Shinya , Maruyama‐Nakashita Akiko , Sugiyama Ryosuke , Sato Muneo , Inaba Jun , Hirai Masami Yokota , Ohkama‐Ohtsu Naoko
Published: August 2022

Glutathione (GSH) functions as a major sulfur repository and hence occupies an important position in primary sulfur metabolism. GSH degradation results in sulfur reallocation and is believed to be carried out mainly by γ‐glutamyl cyclotransferases (GGCT2;1, GGCT2;2, and GGCT2;3), which, however, do not fully explain the rapid GSH turnover. Here, we discovered that γ‐glutamyl peptidase 1 (GGP1) contributes to GSH degradation through a yeast complementation assay. Recombinant proteins of GGP1, as well as GGP3, showed high degradation activity of GSH, but not of oxidized glutathione (GSSG), in vitro. Notably, the GGP1 transcripts were highly abundant in rosette leaves, in agreement with the ggp1 mutants constantly accumulating more GSH regardless of nutritional conditions. Given the lower energy requirements of the GGP‐ than the GGCT‐mediated pathway, the GGP‐mediated pathway could be a more efficient route for GSH degradation than the GGCT‐mediated pathway. Therefore, we propose a model wherein cytosolic GSH is degraded chiefly by GGP1 and likely also by GGP3. Another noteworthy fact is that GGPs are known to process GSH conjugates in glucosinolate and camalexin synthesis; indeed, we confirmed that the ggp1 mutant contained higher levels of O‐acetyl‐l‐Ser, a signaling molecule for sulfur starvation, and lower levels of glucosinolates and their degradation products. The predicted structure of GGP1 further provided a rationale for this hypothesis. In conclusion, we suggest that GGP1 and possibly GGP3 play vital roles in both primary and secondary sulfur metabolism.
Interprofessional Education and Integration with Primary Care: A Systematic Review
Authors: Prado Maria Rosa Machado , Ribeiro Elaine Rossi , Sbolli Kristian , Reis Paula Pontes , Batista Giovana Knapik , Gomar Gabriella Giandotti
Published: August 2022

Interprofessionalism encompasses teamwork, knowledge construction, open dialogue, and respect among the peculiarities related to professional practice. This study consists of a systematic review, structured by the P.V.O. is does Primary Health Care (V - variable), favor the development of interprofessionalism (O - outcomes), during the training of higher education health students (P - population). We used searches of the PubMed (United States National Library of Medicine Service) and SciELO (Scientific Electronic Library Online) databases with descriptors from the DeCS (Descriptors in Health Sciences) and MeSH (Medical Subject Headings) platforms. The Medical Education Research Study Quality Instrument (MERSQI) was used to assess risk of bias and quality. After reading and analyzing the 15 selected articles, three categories emerged: "The dimensions of interprofessionalism in the strengthening of Primary Health Care"; "Interprofessionalism and the teaching-learning process in health"; "Perspectives for interprofessional training in higher education: challenges in implementation and possible solutions". Primary Health Care favors the development of interprofessionalism in many countries, especially in Brazil. However, it is up to the academic staff to use this strategy to advance interprofessional competencies in health education. It is indicated that more didactic-pedagogical resources on interprofessional education be developed and implemented, in such a way that Primary Care is the focal point for the development of interprofessionalism.
The pentagram map, Poncelet polygons, and commuting difference operators
Authors: Izosimov Anton
Published: August 2022

The pentagram map takes a planar polygon $P$ to a polygon $P'$ whose vertices are the intersection points of consecutive shortest diagonals of $P$. This map is known to interact nicely with Poncelet polygons, that is, polygons which are simultaneously inscribed in a conic and circumscribed about a conic. A theorem of Schwartz states that if $P$ is a Poncelet polygon, then the image of $P$ under the pentagram map is projectively equivalent to $P$. In the present paper, we show that in the convex case this property characterizes Poncelet polygons: if a convex polygon is projectively equivalent to its pentagram image, then it is Poncelet. The proof is based on the theory of commuting difference operators, as well as on properties of real elliptic curves and theta functions.
Thin-Film Evaporation in a Mesh Screen Wick
Authors: Remella Karthik S. , Gerner Frank M.
Published: August 2022

Porous capillary wick structures are being employed in two-phase thermal management devices owing to their pumping capabilities and thermal performance enhancement during evaporation of the working fluid. Thin-film evaporation in a porous wick depends primarily on the shape of the liquid–vapor meniscus, especially near the wall. The primary objective of this paper is to study and investigate the thin-film evaporation of the liquid in a unit cell representation (UCR) of a single layer of a metallic wire mesh screen. The volume-of-fluid (VOF) method, which is an interface-capturing technique in multiphase flow modeling, is employed to obtain the steady-state meniscus shape under equilibrium conditions. This paper demonstrates the impact of the equilibrium contact angle (θ) and the initial meniscus height (H) on the steady-state interfacial pressure difference. It outlines a detailed process for estimating 3D interfacial surfaces, obtained from the VOF solution, to generate the final geometry for the thin-film evaporation analysis. A static meniscus heat-transfer model is subsequently solved using the commercial finite volume code, ansysfluent, to obtain the temperature and flow characteristics during evaporation. The relationship of parameters such as the average evaporation mass fluxes and heat transfer coefficients are estimated and presented in this paper. Finally, the relationship between the pressure drop across the liquid–vapor meniscus and the thin-film evaporation rate for screen mesh wicks is discussed.
Physical effects of sound exposure from underwater explosions on Pacific mackerel (Scomber japonicus): Effects on the inner ear
Authors: Smith Michael E. , Accomando Alyssa W. , Bowman Victoria , Casper Brandon M. , Dahl Peter H. , Jenkins A. Keith , Kotecki Sarah , Popper Arthur N.
Published: August 2022

Studies of the effects of sounds from underwater explosions on fishes have not included examination of potential effects on the ear. Caged Pacific mackerel (Scomber japonicus) located at seven distances (between approximately 35 and 800 m) from a single detonation of 4.5 kg of C4 explosives were exposed. After fish were recovered from the cages, the sensory epithelia of the saccular region of the inner ears were prepared and then examined microscopically. The number of hair cell (HC) ciliary bundles was counted at ten preselected 2500 μm2 regions. HCs were significantly reduced in fish exposed to the explosion as compared to the controls. The extent of these differences varied by saccular region, with damage greater in the rostral and caudal ends and minimal in the central region. The extent of effect also varied in animals at different distances from the explosion, with damage occurring in fish as far away as 400 m. While extrapolation to other species and other conditions (e.g., depth, explosive size, and distance) must be performed with extreme caution, the effects of explosive sounds should be considered when environmental impacts are estimated for marine projects.
Explaining and teaching acoustics through comics, interactive web pages, and video games
Authors: Jaouen Luc , Robin Olivier
Published: August 2022

Comics and manga have long been seen as childish literature, even if sometimes referred to as an art. Webpages discussing matters like Mathematics or Science are usually considered popularized content and not as tools with which research can be built. Arcade video games are often not considered serious games that can be used for learning or team building purposes. In this work, we present examples of comics, interactive web pages, and arcade video games that can be used to learn the basics of vibro-acoustics or to focus on more specific topics such as the acoustics of porous media. The reader can experience most of these visual narrative examples following the provided links. An objective of this collection is to make them better known and to stimulate further initiatives on these topics in acoustics education. To this effect, recommendations from various use cases of these visual narratives for different levels of education are also given.
Modelling and simulation of borehole seismoelectric response with an impermeable wall
Authors: Wang Weihao , Gao Wenyang , Liu Jinxia , Cui Zhiwen , Kundu Tribikram
Published: August 2022

In this paper, we construct a borehole model with an impermeable/permeable wall and study the seismoelectric responses. First, we define the boundary conditions at the borehole wall, then the acoustic field and electric field are simulated by the real axis integral method. In order to have a comprehensive analysis of the body wave components, we use the secant integral method to simulate the body waves and give the excitation intensity spectrum in the frequency domain. The results show that the impermeability of the borehole wall significantly increases the amplitude of the acoustic field generated by Stoneley waves. This is because the closed pores at the boundary make Stoneley waves energy leak more slowly and hence attenuating less. The impermeable borehole wall weakens the electromagnetic interface response. Besides, both P wave and S wave and their accompanying electric field properties are affected by boundary connectivity. This investigation provides a theoretical basis for qualitatively judging borehole wall permeability by the seismoelectric signals.
Optimizing distortion product otoacoustic emission recordings in normal-hearing ears by adopting cochlear place-specific stimuli
Authors: Stiepan Samantha , Goodman Shawn S. , Dhar Sumitrajit
Published: August 2022

Distortion product otoacoustic emissions (DPOAEs) provide a window into active cochlear processes and have become a popular clinical and research tool. DPOAEs are commonly recorded using stimulus with fixed presentation levels and frequency ratio irrespective of the test frequency. However, this is inconsistent with the changing mechanical properties of the cochlear partition from the base to the apex that lend specific frequency-dependent spatial properties to the cochlear traveling wave. Therefore, the frequency and level characteristics between the stimulus tones should also need to be adjusted as a function of frequency to maintain optimal interaction between them. The goal of this investigation was to establish a frequency-specific measurement protocol guided by local cochlear mechanics. A broad stimulus parameter space extending up to 20 kHz was explored in a group of normal-hearing individuals. The stimulus frequency ratio yielding the largest 2f1-f2 DPOAE level changed as a function of frequency and stimulus level. Specifically, for a constant stimulus level, the frequency ratio producing the largest DPOAE level decreased with increasing frequency. Similarly, at a given f2 frequency, the stimulus frequency ratio producing the largest DPOAE level became wider as stimulus level increased. These results confirm and strengthen our current understanding of DPOAE generation in the normally functioning cochlea and expand our understanding to previously unexamined higher frequencies. These data support the use of frequency- and level-specific stimulus frequency ratios to maximize DPOAE generation.
Signal detection method using a single vector hydrophone in ocean acoustics
Authors: Yuan Meng , Wang Chao , Da Lianglong , Li Qiang
Published: August 2022

This paper focuses on the problem of transient signal detection using a single vector hydrophone in a horizontal isotropic acoustic field. The covariance matrix of the three sensor output quantities is analyzed in terms of its trace and determinant principal invariants, and the mathematical relationship between the signal-to-noise ratio and these invariants is established. Both the signal power and the ambient-noise power can be accurately estimated directly from the covariance matrix of the received data, and the signal-to-noise ratio can further be obtained. A signal power detector is proposed based on the theoretical analysis, and simulation results show that (i) it can detect signals with low signal-to-noise ratio and (ii) its performance is greatly improved compared with that of an energy detector under the condition of a nonstationary ambient-noise field. An experiment was performed to verify the theoretical analysis and the conclusions of the numerical simulation, and the data-processing results show that this method has good applicability in signal detection.
Conformational Changes in Herpes Simplex Virus Glycoprotein C
Authors: Gianopulos Katrina A. , Komala Sari Tri , Weed Darin J. , Pritchard Suzanne M. , Nicola Anthony V.
Published: August 2022

Herpesviruses are ubiquitous pathogens that cause lifelong latent infections and are characterized by multiple entry pathways. The HSV envelope gC regulates HSV entry by a low-pH entry route.
Structure and Function of BcpE2, the Most Promiscuous GH3-Family Glucose Scavenging Beta-Glucosidase
Authors: Deflandre Benoit , Jadot Cédric , Planckaert Sören , Thiébaut Noémie , Stulanovic Nudzejma , Herman Raphaël , Devreese Bart , Kerff Frédéric , Rigali Sébastien
Published: August 2022

Plant decaying biomass is the most abundant provider of carbon sources for soil-dwelling microorganisms. To optimally evolve in such environmental niches, microorganisms possess an arsenal of hydrolytic enzymatic complexes to feed on the various types of polysaccharides, oligosaccharides, and monosaccharides.
Landscapes of Enteric Virome Signatures in Early-Weaned Piglets
Authors: Tao Shiyu , Zou Huicong , Li Jingjing , Wei Hong
Published: August 2022

This study systematically reveals the biological diversity, structure, and composition of intestinal DNA and RNA virus profiles in early-weaned piglets. Furthermore, characteristics of differences in gut viromes between early-weaned healthy piglets and piglets with diarrhea were also elucidated.
Epidemiological impact and cost-effectiveness analysis of COVID-19 vaccination in Kenya
Authors: Orangi Stacey , Ojal John , Brand Samuel PC , Orlendo Cameline , Kairu Angela , Aziza Rabia , Ogero Morris , Agweyu Ambrose , Warimwe George M , Uyoga Sophie , Otieno Edward , Ochola-Oyier Lynette I , Agoti Charles N , Kasera Kadondi , Amoth Patrick , Mwangangi Mercy , Aman Rashid , Ng'ang'a Wangari , Adetifa Ifedayo MO , Scott J Anthony G , Bejon Philip , Keeling Matt J , Flasche Stefan , Nokes D James , Barasa Edwine
Published: August 2022

Background

A few studies have assessed the epidemiological impact and the cost-effectiveness of COVID-19 vaccines in settings where most of the population had been exposed to SARS-CoV-2 infection.

Methods

We conducted a cost-effectiveness analysis of COVID-19 vaccine in Kenya from a societal perspective over a 1.5-year time frame. An age-structured transmission model assumed at least 80% of the population to have prior natural immunity when an immune escape variant was introduced. We examine the effect of slow (18 months) or rapid (6 months) vaccine roll-out with vaccine coverage of 30%, 50% or 70% of the adult (>18 years) population prioritising roll-out in those over 50-years (80% uptake in all scenarios). Cost data were obtained from primary analyses. We assumed vaccine procurement at US$7 per dose and vaccine delivery costs of US$3.90–US$6.11 per dose. The cost-effectiveness threshold was US$919.11.

Findings

Slow roll-out at 30% coverage largely targets those over 50 years and resulted in 54% fewer deaths (8132 (7914–8373)) than no vaccination and was cost saving (incremental cost-effectiveness ratio, ICER=US$−1343 (US$−1345 to US$−1341) per disability-adjusted life-year, DALY averted). Increasing coverage to 50% and 70%, further reduced deaths by 12% (810 (757–872) and 5% (282 (251–317) but was not cost-effective, using Kenya’s cost-effectiveness threshold (US$919.11). Rapid roll-out with 30% coverage averted 63% more deaths and was more cost-saving (ICER=US$−1607 (US$−1609 to US$−1604) per DALY averted) compared with slow roll-out at the same coverage level, but 50% and 70% coverage scenarios were not cost-effective.

Interpretation

With prior exposure partially protecting much of the Kenyan population, vaccination of young adults may no longer be cost-effective.
Chronic hypercapnic respiratory failure and non-invasive ventilation in people with chronic obstructive pulmonary disease
Authors: Hatipoğlu Umur , Aboussouan Loutfi Sami
Published: August 2022

Chronic obstructive pulmonary disease (COPD) should no longer be seen as a condition for which little can be done. Novel pharmacotherapeutic interventions, surgical and procedural advances, and respiratory assist devices have provided numerous ways to help patients with COPD and treatable traits. For nearly 30 years, non-invasive ventilation, the application of positive pressure through a mask interface placed outside of the airway, has been the cornerstone for treatment of acute hypercapnic respiratory failure due to COPD exacerbation. Clinical trials indicate that this intervention could benefit patients with COPD and chronic hypercapnic respiratory failure in a stable state. This narrative review aims to provide the necessary background for internists to consider this therapeutic option for their COPD patients. We discuss the mechanism of action and implementation, and provide a glimpse into the future of this promising intervention.
Prophylactic surgery plus hyperthermic intraperitoneal chemotherapy (HIPEC CO2) versus standard surgery in colorectal carcinoma at high risk of peritoneal carcinomatosis: short-term and long-term outcomes from the CHECK study – protocol for a randomised, multicentre, phase 3 trial
Authors: Pacelli Fabio , Gerardi Chiara , Rulli Eliana , Abatini Carlo , Rotolo Stefano , Garattini Silvio , Melotti Gianluigi , Torri Valter , Galli Fabio , Rulli Erica , Di Giorgio Andrea
Published: August 2022

Introduction

Up to one-fifth of patients with colorectal cancer will develop peritoneal metastases, frequently without other districts’ involvement. Despite the recent unsuccesses of hyperthermic intraperitoneal chemotherapy (HIPEC) for colorectal cancer peritoneal metastases treatment, the rationale in the prophylactic setting remains strong. Several clinical and pharmacokinetic data suggest that the efficacy of intraperitoneal chemotherapy is highest when the disease is microscopic. However, robust evidence demonstrating whether the addition of HIPEC for high-risk colorectal cancers offers better control of local recurrence is lacking.

Methods and analysis

This is a multicentre randomised phase 3 trial comparing prophylactic surgery plus HIPEC CO2 with mitomycin, over standard surgical excision in patients with colorectal cancer at high risk of peritoneal carcinomatosis; 388 patients will be included in this study. The primary objective is to compare the efficacy of prophylactic surgery (radical colorectal resection, omentectomy, appendectomy, round ligament of the liver resection and bilateral adnexectomy) plus HIPEC CO2 with mitomycin and standard surgery in terms of local recurrence-free survival. The main secondary endpoints are disease-free survival (DFS), overall survival (OS) and safety. The primary endpoint will be described with a cumulative incidence function and will be analysed with Grey test to take account of the competing risks. DFS and OS will be described with the Kaplan-Meier method.

Ethics and dissemination

This trial has been evaluated by the Italian Medicines Agency, local ethics committees and will be submitted to the Ministry of Health to notify the start of the trial according to the regulation of trials on devices with CE mark/certification.

The results will be submitted for presentation at academic meetings and for publication in a peer-reviewed journal, whatever the findings.

Trial registration number

NCT03914820.
Budget impact analysis of providing hospital inpatient care at home virtually, starting with two specific surgical patient groups
Authors: Peters Guido M , Doggen Carine J M , van Harten Wim H
Published: August 2022

Objective

To determine the budget impact of virtual care.

Methods

We conducted a budget impact analysis of virtual care from the perspective of a large teaching hospital in the Netherlands. Virtual care included remote monitoring of vital signs and three daily remote contacts. Net budget impact over 5 years and net costs per patient per day (costs/patient/day) were calculated for different scenarios: implementation in one ward, in two different wards, in the entire hospital, and in multiple hospitals. Sensitivity analyses included best-case and worst-case scenarios, and reducing the frequency of daily remote contacts.

Results

Net budget impact over 5 years was €2 090 000 for implementation in one ward, €410 000 for two wards and €−6 206 000 for the entire hospital. Costs/patient/day in the first year were €303 for implementation in one ward, €94 for two wards and €11 for the entire hospital, decreasing in subsequent years to a mean of €259 (SD=€72), €17 (SD=€10) and €−55 (SD=€44), respectively. Projecting implementation in every Dutch hospital resulted in a net budget impact over 5 years of €−445 698 500. For this scenario, costs/patient/day decreased to €−37 in the first year, and to €54 in subsequent years in the base case.

Conclusions

With present cost levels, virtual care only saves money if it is deployed at sufficient scale or if it can be designed such that the active involvement of health professionals is minimised. Taking a greenfield approach, involving larger numbers of hospitals, further decreases costs compared with implementing virtual care in one hospital alone.
Effectiveness and implementation of SHared decision-making supported by OUTcome information among patients with breast cancer, stroke and advanced kidney disease: SHOUT study protocol of multiple interrupted time series
Authors: Hackert Mariska Quirina Nikita , Ankersmid Jet W , Engels Noel , Prick Janine C M , Teerenstra Steven , Siesling Sabine , Drossaert Constance H C , Strobbe Luc J A , van Riet Yvonne E A , van den Dorpel René M A , Bos Willem Jan W , van der Nat Paul B , van den Berg-Vos Renske M , van Schaik Sander M , Garvelink Mirjam M , van der Wees Philip J , van Uden-Kraan Cornelia F
Published: August 2022

Introduction

Within the value-based healthcare framework, outcome data can be used to inform patients about (treatment) options, and empower them to make shared decisions with their health care professional. To facilitate shared decision-making (SDM) supported by outcome data, a multicomponent intervention has been designed, including patient decision aids on the organisation of post-treatment surveillance (breast cancer); discharge location (stroke) and treatment modality (advanced kidney disease), and training on SDM for health care professionals. The SHared decision-making supported by OUTcome information (SHOUT) study will examine the effectiveness of the intervention and its implementation in clinical practice.

Methods and analysis

Multiple interrupted time series will be used to stepwise implement the intervention. Patients diagnosed with either breast cancer (N=630), stroke (N=630) or advanced kidney disease (N=473) will be included. Measurements will be performed at baseline, three (stroke), six and twelve (breast cancer and advanced kidney disease) months. Trends on outcomes will be measured over a period of 20 months. The primary outcome will be patients’ perceived level of involvement in decision-making. Secondary outcomes regarding effectiveness will include patient-reported SDM, decisional conflict, role in decision-making, knowledge, quality of life, preferred and chosen care, satisfaction with the intervention, healthcare utilisation and health outcomes. Outcomes regarding implementation will include the implementation rate and a questionnaire on the health care professionals’ perspective on the implementation process.

Ethics and dissemination

The Medical research Ethics Committees United in Nieuwegein, the Netherlands, has confirmed that the Medical Research Involving Human Subjects Act does not apply to this study. Bureau Onderzoek & Innovatie of Santeon, the Netherlands, approved this study. The results will contribute to insight in and knowledge on the use of outcome data for SDM, and can stimulate sustainable implementation of SDM.

Trial registration number

NL8374, NL8375 and NL8376.
Creation of objective performance criteria among medical devices
Authors: Gressler Laura Elisabeth , Marinac-Dabic Danica , dosReis Susan , Goodney Philip , Mullins C. Daniel , Shaya Fadia
Published: August 2022

Objectives

Objective performance criteria (OPC) may serve as a tool to expedite the approval process and continue active surveillance of class III medical devices. Thus far, published guidance on the creation of OPC has been clinical area-specific. This study aimed to capture reflections from key stakeholders on the creation of OPC that may serve as a precursor for a formalized conceptual framework within the USA.

Design

Reflections from key stakeholders and guidance from an advisory committee were captured to gain an understanding of the elements that are crucial to the generation of OPC.

Setting

A non-probability sampling method using the purposive sampling strategy was employed to identify relevant stakeholders for engagement in semi-structured, open-ended, concept elicitation discussions.

Participants

Stakeholders involved in the generation of OPC.

Main outcome measures

Elements and themes regarding the priorities of, experiences with, roles within and perceived challenges associated with OPC creation captured through a phenomenological approach.

Results

A total of 27 participants were engaged to represent the following contributors: representatives of registries, health systems, health technology assessment bodies, clinicians, device application reviewers, payers, patients, patient representatives, patient caregivers, device manufacturers, data coordinators, data analysts and data informaticians. Consensus was achieved on the five core elements: (1) identification of medical devices, (2) engagement of key stakeholders, (3) selection of data source, (4) performance of appropriate statistical analyses and (5) reporting of findings. The engagement of key stakeholders (38%) was cited most frequently as the most important core element. Access to meaningful and high-quality data sources (47%) was the most frequently mentioned challenge.

Conclusions

The reflections from the participants identified five elements to be considered when generating an OPC within class III medical devices and may provide the needed foundation for the development of official guidance on OPC generation.
Replenishment Policy with Limited Price Information
Authors: Zhang Xiaoyue , Dai Wenqiang , Cai Xiaoqiang , Zhou Xiaoyu
Published: August 2022

In this paper, we seek to provide real-time replenishment policy for a capacitated company that faces an exogenous demand and has to procure and store sufficient quantities of certain items with uncertain procurement prices. The objective is to minimize the total cost of the procuring cost and inventory holding cost without stock out. Motivated by the fact that a large variability in the price process often makes forecasting difficult, in contrast to the traditional approaches of the stochastic inventory theory, we study this problem from the perspective of competitive analysis who is free of any price distribution assumption. We propose an online replenishment model, which generalizes several previous online models. We give a real-time replenishment policy whose decisions are made based entirely on the past and present prices and the current inventory level. We prove that our policy achieves superior performance, and outperforms all of the previous theoretical results. Furthermore, we present the numerical studies to show that our replenishment policy achieves an even better empirical performance.
New inflationary exact solution from Lie symmetries
Authors: Paliathanasis Andronikos
Published: August 2022

For the inflaton field, we determine a new exact solution by using the Lie symmetry analysis. Specifically, we construct a second-order differential master equation for arbitrary scalar field potential by assuming that the spectral indices for the density perturbations [Formula: see text] and the scalar-to-tensor ratio [Formula: see text] are related as [Formula: see text]. Function [Formula: see text] is classified according to the admitted Lie symmetries for the master equation. The possible admitted Lie symmetries form the [Formula: see text], [Formula: see text], [Formula: see text] and [Formula: see text] Lie algebras. The new inflationary solution is recovered by the Lie symmetries of the [Formula: see text] algebra. Scalar field potential is derived explicitly, while we compare the resulting spectral indices with the observations.
Polynomial and signature invariants for pseudo-links via Goeritz matrices
Authors: Jeong Suhyeon , Kim Jieon , Lee Sang Youl
Published: August 2022

In this paper, we introduce the Goeritz matrix for a pseudo-link whose entries lie in the Laurent polynomial ring [Formula: see text], which generalizes the Goeritz matrix for a classical link. We show that the determinant of a modified Goeritz matrix gives a Laurent polynomial invariant for pseudo-links in one variable u with integer coefficients. We also introduce the notions of the signature, determinant, and nullity of pseudo-links. Further, we discuss some properties of the invariants and compute the polynomials and those numerical invariants for several pseudo-knot families.
Energy Efficient Tri-State CNFET Ternary Logic Gates
Authors: Tabrizchi Sepehr , Sharifi Fazel , Badawy Abdel-Hameed
Published: August 2022

Power consumption and especially leakage power are the main concerns of nano MOSFET technology. On the other hand, binary circuits face a huge number of interconnection wires, which results in power dissipation and area. Researchers introduced emerging nanodevices and multiple-valued logic (MVL) as two feasible solutions to overcome the challenges mentioned above. Carbon nanotube field-effect transistor (CNFET) is one of the emerging technologies that has some unique properties and advantages over MOSFET, such as adjusting the carbon nanotube (CNT) diameters to have the desired threshold voltage and have the same mobility as P-FET and N-FET transistors. In this paper, we present a novel method for designing ternary logic circuits based on CNFETs. Each of our designed logic circuits implements a logic function and its complementary via a control signal. Also, these circuits have a high impedance state, which saves power while the circuits are not in use. Moreover, we designed a two-digit adder/ subtractor and a power-efficient ternary logic arithmetic logic unit (ALU) based on the proposed gates. The proposed ternary circuits are simulated using HSPICE via standard 32 nm CNFET technology. The simulation results indicate the designs’ correct operation under different process, voltage, and temperature (PVT) variations. Also, simulation results show that the two-digit adder/ subtractor using our proposed gates has 12X and 5X lower power consumption and power-delay product (PDP), respectively, compared to previous designs.
Cosmologically viable f(R) model and wormhole solutions
Authors: Godani Nisha , Samanta Gauranga C.
Published: August 2022

In this paper, Morris Thorne wormholes are considered in the context of [Formula: see text] gravity. A shape function is defined as [Formula: see text], where [Formula: see text] is constant. The equation of state is considered as [Formula: see text] and [Formula: see text] function is derived. The wormhole solutions are obtained and energy conditions are examined. Further, the [Formula: see text] model is found to be consistent with local gravity tests and stability of cosmological perturbations and late-time de Sitter point. Cosmological evolution is also explored using Friedman-Robertson-Walker (FRW) metric in [Formula: see text] gravity.
Invariant submanifolds of f-Kenmotsu manifolds
Authors: Khatri Mohan , Chaubey Sudhakar K. , Singh Jay Prakash
Published: August 2022

In the present paper, we study the invariant submanifolds of [Formula: see text]-Kenmotsu manifolds. Firstly, we show that any invariant submanifold of [Formula: see text]-Kenmotsu manifold is again [Formula: see text]-Kenmotsu manifold and minimal. Then, we give some characterizations of totally geodesic submanifolds of [Formula: see text]-Kenmotsu manifolds. We study 3-dimensional submanifold and prove that a 3-dimensional submanifold of [Formula: see text]-Kenmotsu manifold is totally geodesic if and only if it is invariant. Also, [Formula: see text]-Ricci soliton is considered on invariant submanifold of [Formula: see text]-Kenmotsu manifolds. Lastly, the non-trivial examples are constructed to verify some of our obtained results.
Conformal Ricci solitons on generalized (κ,μ)-space forms
Authors: Lone Mehraj Ahmad , Wani Towseef Ali
Published: August 2022

In this paper, we study conformal Ricci solitons and conformal gradient Ricci solitons on generalized [Formula: see text]-space forms. The conditions for the solitons to be shrinking, steady and expanding are derived in terms of conformal pressure [Formula: see text]. We show under what conditions a Ricci semi-symmetric generalized [Formula: see text]-space form equipped with a conformal Ricci soliton forms an Einstein manifold.
Finite Element Approach for Three-Dimensional Linearized Potential Equation with Application to Muffler Acoustic Attenuation Prediction
Authors: Fan Yiliang , Ji Zhenlin
Published: August 2022

In this paper, a three-dimensional finite element method for solving the linearized potential equation (LPE) is implemented to predict the acoustic attenuation performance of mufflers in the presence of nonuniform flow. For accurate physical representations, the porous material is modeled as equivalent fluid with complex speed of sound and density while the background mean flow in fluid domain is captured by solving Reynolds-averaged Navier–Stokes equations. The treatment details for boundary integrals at different boundary conditions and expressions for transmission loss are presented. Good agreements of predicted and measured transmission loss of two reactive and a hybrid mufflers validated the present approach. Finally, the convective effect of nonuniform flow on the acoustic attenuation behavior of the hybrid muffler is examined numerically in detail.
Stretching–buoyancy interplay in the magma-poor rifting process
Authors: Sinha Sudipta Tapan , Nemčok Michal
Published: August 2022

The Cauvery Basin in East India represents a failed rift zone in the west and transform-related termination in the east. The deformation associated with a westward-propagating rift zone involves stretching and necking-related deformation from west to east. The rift axis and the flanks exhibit maximum and minimum deformation.

In this study, we document the increasing role of buoyancy-driven processes and the development of the rift asymmetry during the advanced stages of rifting in a magma-poor setting. We use a series of reflection seismic profiles intersecting the failed rift zone maturing eastward.

The onset of buoyancy-controlled extension correlates with the localized extension. It creates a relatively symmetrical axial dome, and exhibits rift flank rotations and central up-warping. This permanent uplift is associated with lower crustal ductile flow. Notably, the deep-seated syn-rift buoyancy forces progressively operate eastward. We deduce the associated transient dome uplift and its subsequent dissipation using a seismic flattening technique. The axial dome formation is associated with an upwelling asthenosphere and lower lithospheric mantle. This correlates with localized contraction within flat-lying fault blocks at its flanks, concurrently forming the typical hanging-wall and footwall geometry. The multiple shallow- to deep-seated mechanisms promote strain acceleration in the uplifted regions along the rift zone.
Using User-Generated YouTube Videos to Understand Unguided Interactions with Robots in Public Places
Authors: Nielsen Sara , Skov Mikael B. , Hansen Karl Damkjær , Kaszowska Aleksandra
Published: August 2022

Professional service robots are increasingly being deployed in public places, which thus increases user exposure. However, we lack an empirical understanding of complex encounters taking place in dynamic and often crowded environments as well as how people overcome breakdowns during unguided interaction with a robot in a real-world scenario. In this paper, we conducted a covert, digital ethnographic study analyzing 104 user-generated YouTube videos focusing on people’s unguided interactions with robots in several public places. We identified several types of interaction breakdowns pertaining to someone
(person-initiated interaction breakdown, IB)
or something
(environmental disturbances, ED)
having a direct, negative effect on an ongoing unguided interaction. Our findings have implications for the design and development of service robots facing multi-user scenarios entertaining active (primary and secondary) users, inactive (commentators and observers) ‘users’, and
Incidentally Co-present Persons (InCoPs)
. Furthermore, we contribute to and built on the limited prior use of YouTube videos and digital ethnography in HRI research, thereby demonstrating its effectiveness in studying unguided interactions in public places, while supplementing and adding to the existing knowledge base of service robots in public places.
Scalable Color Quantization for Task-centric Image Compression
Authors: Park Jae Hyun , Kim Sanghoon , Lee Joo Chan , Ko Jong Hwan
Published: August 2022

Conventional image compression techniques targeted for the perceptual quality are not generally optimized for classification tasks using deep neural networks (DNNs). To compress images for DNN inference tasks, recent studies have proposed task-centric image compression methods with quantization techniques optimized for DNN inference. Among them, color quantization was proposed to reduce the amount of data per pixel by limiting the number of distinct colors (color space) in an image. However, quantizing images into various color space sizes requires training and inference of multiple DNNs, each of which is dedicated to each color space. To overcome this limitation, we propose a scalable color quantization method, where images with variable color space sizes can be extracted from a master image generated by a single DNN model. This scalability is enabled by weighted color grouping that constructs a color palette using critical color components for the classification task. We also propose an adaptive training method that can jointly optimize images with various color-space sizes. The results show that the proposed method supports dynamic changes of the color space size between 1–6 bit color space per pixel, while even increasing the inference accuracy at a low bit precision up to 20.2% and 46.6% compared to other task- and human-centric color quantizations, respectively.
Dissociation of SH3 and cysteine-rich domain 3 and junctophilin 1 from dihydropyridine receptor in dystrophin-deficient muscles
Authors: Ashida Yuki , Himori Koichi , Tokuda Nao , Naito Azuma , Yamauchi Nao , Takenaka-Ninagawa Nana , Aoki Yoshitsugu , Sakurai Hidetoshi , Yamada Takashi
Published: August 2022

The mechanisms underlying the disruption of excitation-contraction (EC) coupling in dystrophin-deficient muscles are not well understood. Here, using animal models for Duchenne muscular dystrophies (DMD), we show a Ca2+-dependent protease (calpain-1)-mediated proteolysis of SH3 and cysteine-rich domain 3 (STAC3) and junctophilin 1 (JP1), essential EC coupling proteins, in dystrophin-deficient muscle, and highlighting the dissociation of STAC3 and JP1 from dihydropyridine receptor as a causative factor in EC uncoupling of dystrophic muscles.