bluuebunny/crossref_metadata_2025 huggingface dataset:
Alltagsmobilität und Erreichbarkeit: Schlüsselfaktoren für Teilhabechancen und Bleibeorientierungen der Geflüchteten in ländlichen Regionen
Authors: Mehl Peter , Kordel Stefan , Meschter Diana , Schneider Hanne , Spenger David , Weidinger Tobias
Published: November 2022

Das Kapitel nimmt die Rolle von Alltagsmobilität in den Blick und bestätigt deren Stellenwert für die Teilhabe von Geflüchteten in ländlichen Regionen. Ein zentraler Faktor hierfür ist der Zugang zum motorisierten Individualverkehr. Geflüchtete nehmen dies wahr, passen sich den lokalen Mobilitätspraktiken an, entwickeln aber auch eigene Strategien im Umgang mit der bestehenden Mobilitätssituation. Werden sie dabei von lokaler Politik und Zivilgesellschaft unterstützt, kann das wesentlich dazu beigetragen, mobilitätsbedingte Exklusion zu verringern.
Geflüchtete in ländlichen Regionen: Zentrale Befunde, konzeptionelle Überlegungen und methodische Reflexionen
Authors: Schammann Hannes , Fick Johanna , Glorius Birgit , Kordel Stefan , Mehl Peter
Published: November 2022

Im Schlusskapitel fassen wir zentrale Ergebnisse des Verbundforschungsprojekts zusammen und reflektieren unsere Erfahrungen im Hinblick auf zukünftige Forschungsbemühungen. Dabei geht es um die Relevanz und Spezifika der Integrationsdimensionen für die Teilhabe von Geflüchteten sowie die Frage, welche Faktoren eine erfolgreiche Verbindung zwischen Maßnahmen zur Teilhabe Geflüchteter und zur Entwicklung ländlicher Regionen begünstigt oder erschwert haben. Ausgehend von unseren Projekterfahrungen diskutieren wir zudem Theorien und Konzepte der Migrationsforschung und reflektieren methodische Herausforderungen.
Standard Model predictions for lepton flavour universality ratios of inclusive semileptonic B decays
Authors: Rahimi Muslem , Vos K. Keri
Published: November 2022

Abstract

We present Standard Model predictions for lepton flavour universality ratios of inclusive B → X(c)$$ \ell {\overline{\nu}}_{\ell } $$
ℓ

ν
¯

ℓ

. For the ℓ = μ, e, these ratios are very close to unity as expected. For the τ mode, we update the SM prediction for the branching ratio including power-corrections in the heavy-quark expansion up to 1/$$ {m}_b^3 $$

m
b
3

. These inclusive ratios serve as an important cross-check of the exclusive B → D(*)$$ \ell {\overline{\nu}}_{\ell } $$
ℓ

ν
¯

ℓ

modes, in which tensions exists between the predictions and measurements in those modes.
The impact of different alignment strategies on bone cuts for neutral knee phenotypes in total knee arthroplasty
Authors: Schelker Benjamin L. , Moret Céline S. , von Eisenhart-Rothe Rüdiger , Graichen Heiko , Arnold Markus P. , Leclercq Vincent , Huegli Rolf W. , Hirschmann Michael T.
Published: November 2022

Purpose

The purpose of this study was to simulate and visualise the influence of the alignment strategy on bone resection in neutral knee phenotypes. It was hypothesised that different amounts of bone resection would be required depending on the alignment strategy chosen. The hypothesis was that by visualising the corresponding bone cuts, it would be possible to assess which of the different alignment strategies required the least change to the soft tissues for the chosen phenotype but still ensured acceptable component alignment and could, therefore, be considered the most ideal alignment strategy.

Methods

Simulations of the different alignment strategies (mechanical, anatomical, restricted kinematic and unrestricted kinematic) regarding their bone resections were performed on four common exemplary neutral knee phenotypes.NEUHKA0° VARFMA90° VALTMA90°, NEUHKA0° NEUFMA93° NEUTMA87°, NEUHKA0° VALFMA96° NEUTMA87° andNEUHKA0°VALFMA99° VARTMA84°.The phenotype system used categorises knees based on overall limb alignment (i.e. hip knee angle) but also considers joint line obliquity (i.e. TKA and FMA) and has been used globally since its introduction in 2019. These simulations are based on long leg weightbearing radiographs. It is assumed that a change of 1° in the alignment of the joint line corresponds to correspond to 1 mm of distal condyle offset.

Results

In the most common neutral phenotypeNEUHKA0° NEUFMA93° NEUTMA87°, with a prevalence of 30%, bone cuts remain below 4 mm regardless of alignment strategy. The greatest changes in the obliquity of the joint line can be expected for the mechanical alignment of the phenotypeNEUHKA0° VALFMA99° VARTMA84°where the medial tibia is raised by 6 mm and the lateral femur is shifted distally by 9 mm. In contrast, theNEUHKA0° VARFMA90° VALTMA90°phenotype requires no change in joint line obliquity if the mechanical alignment strategy is used.

Conclusion

Illustrations of alignment strategies help the treating surgeon to estimate the postoperative joint line obliquity. When considering the alignment strategy, it seems reasonable to prefer a strategy where the joint line obliquity is changed as little as possible. Although for the most common neutral knee phenotype the choice of alignment strategy seems to be of negligible importance, in general, even for neutral phenotypes, large differences in bone cuts can be observed depending on the choice of alignment strategy.
Autologous chondrocyte implantation in the knee is effective in skeletally immature patients: a systematic review
Authors: Migliorini Filippo , Eschweiler Joerg , Prinz Julia , Weber Christian David , Hofmann Ulf Krister , Hildebrand Frank , Maffulli Nicola
Published: November 2022

Purpose

This systematic review evaluated the efficacy and safety of autologous chondrocyte implantation (ACI) for chondral defects of the knee in skeletally immature patients. Current available data from patients reported outcome measures (PROMs) and complications were collected, analyzed, and discussed.

Methods

This systematic review was conducted according to the PRISMA guidelines. The following databases were accessed in May 2022: PubMed, Google scholar, Embase, and Scopus. All the clinical studies investigating the efficacy of ACI to manage chondral defects of the knee in skeletally immature patients were accessed. Articles treating patients with surgical procedures other than ACI were not eligible, nor were studies with a follow-up shorter than 12 months.

Results

Data from 9 studies (251 procedures) were collected. 32% (80 of 251) of patients were females. The mean length of follow-up was 44.2 ± 29.4 (range, 12–115) months. The mean age of the patients was 16.4 ± 0.7 (range, 15–17) years. The Knee injury and Osteoarthritis Outcome Score (KOOS) and International Knee Document Committee (IKDC) increased of + 41.9/100 (P = 0.003) and + 33.2/100 (P =  < 0.0001) points, respectively. The Lysholm Knee Score improved of + 20.6/100 (P = 0.02) points. The Visual Analogue Scale (VAS) for pain reduced of − 3.6/10 (P = 0.004) points. The Tegner scale did not show any statistically significant improvement from baseline to follow-up (P = n.s.). The rate of graft hypertrophy was 12.5% (5 of 40 patients), and the rate of failure 5.6% (8 of 142 patients).

Conclusion

ACI for chondral defects of the knee is effective to improve PROMs in skeletally immature patients. The safety profile of ACI still remains controversial.

Level of evidence

III.
Airborne acoustic emission of an abrasive waterjet cutting system as means for monitoring the jet cutting capability
Authors: Copertaro Edoardo , Annoni Massimiliano
Published: November 2022

Abrasive waterjet cutting is a manufacturing technology making use of a high-speed waterjet with abrasive particles in suspension, for cutting materials with different mechanical properties. Product quality requirements are pushing towards an improvement of tracking and stabilization methods of the relevant process variables. Amongst those, the jet kinetic power defines the cutting capability and has a significant impact on the final cut features. This variable is subject to relevant fluctuations versus time. Besides, the current state of the art does not provide means for its in-line monitoring. The aim of this contribution is to monitor the airborne acoustic emission of an abrasive waterjet cutting head and investigate its correlation with the jet kinetic power. The investigation is carried out by means of factorial studies, in which the jet is fired at various water pressures and abrasive feed rates, providing different kinetic powers. The acoustic emission is synchronously monitored by means of a condenser microphone, installed on the cutting head. Data at frequencies above 40 kHz is found to constitute a robust and selective acoustic signature of the airborne jet. The acoustic signature is proven to be an effective in-line indicator of the jet kinetic power and its pressure-induced variations, whilst abrasive-induced variations remain undetected. A calibration procedure is presented, for translating the acoustic data into a jet kinetic power. The method is validated by means of further experiments that envisage its deployment in a real scenario. Overall, the presented method constitutes a robust tool for monitoring pressure-induced variations of the jet cutting capability.
Feature selection algorithms in generalized additive models under concurvity
Authors: Kovács László
Published: November 2022

In this paper, the properties of 10 different feature selection algorithms for generalized additive models (GAMs) are compared on one simulated and two real-world datasets under concurvity. Concurvity can be interpreted as a redundancy in the feature set of a GAM. Like multicollinearity in linear models, concurvity causes unstable parameter estimates in GAMs and makes the marginal effect of features harder interpret. Feature selection algorithms for GAMs can be separated into four clusters: stepwise, boosting, regularization and concurvity controlled methods. Our numerical results show that algorithms with no constraints on concurvity tend to select a large feature set, without significant improvements in predictive performance compared to a more parsimonious feature set. A large feature set is accompanied by harmful concurvity in the proposed models. To tackle the concurvity phenomenon, recent feature selection algorithms such as the mRMR and the HSIC-Lasso incorporated some constraints on concurvity in their objective function. However, these algorithms interpret concurvity as pairwise non-linear relationship between features, so they do not account for the case when a feature can be accurately estimated as a multivariate function of several other features. This is confirmed by our numerical results. Our own solution to the problem, a hybrid genetic–harmony search algorithm (HA) introduces constrains on multivariate concurvity directly. Due to this constraint, the HA proposes a small and not redundant feature set with predictive performance similar to that of models with far more features.
Perfluoroalkyl substances (PFASs) decrease the expression of recombination-activating genes (RAG1 and RAG2) in human B lymphoma Namalwa cells
Authors: Janssen Aafke W. F. , Louisse Jochem , Rijkers Deborah , Pinckaers Nicole E. T. , Hoekstra Sjoerdtje A. , Hoogenboom Ron L. A. P. , Peijnenburg Ad A. C. M. , Beekmann Karsten
Published: November 2022

Per- and polyfluoroalkyl substances (PFASs) are omnipresent and have been shown to induce a wide range of adverse effects, including hepatotoxicity, developmental toxicity and immunotoxicity. So far, little information is available about the mechanisms underlying the toxicity of PFASs, including those related to their immunotoxicity. Reported immunotoxic effects of PFASs include decreased antibody responses in experimental animals and humans, indicating that PFASs may, among others, affect B cell function. In the present study, we first assessed the effects of PFOA on the transcriptome of the human Namalwa B cell line using RNA seq analysis. Gene expression changes, analyzed using Ingenuity Pathway Analysis, pointed to various cellular processes affected by PFOA, including ‘B cell development’ and ‘Primary immunodeficiency signaling’. Interestingly, PFOA decreased the expression of RAG1 and RAG2, genes involved in immunoglobulin and T cell receptor V(D)J recombination. As a next step, time- and concentration-dependent changes in the expression of RAG1 and RAG2 upon exposure to PFOA, PFNA, PFHxS and PFOS were studied through RT-qPCR analysis. Analysis with the concentration–response modeling software PROAST resulted in the following potency ranking: PFNA > PFOA > PFOS > PFHxS. Altogether, the present in vitro study provides insights into the effects of selected PFASs on B cells, identifying RAG1 and RAG2 expression as possible relevant targets that may play a role in the immunotoxicity of PFASs.
Rapid evaluation of ergosterol to detect yeast contamination in fruit juices
Authors: Vella Filomena Monica , Calandrelli Roberto , Del Barone Alessandra , Guida Marco , Laratta Bruna
Published: November 2022

Foods and beverages are nutrient-rich systems prone to a rapid development of microorganisms that hamper their long-period storage. Particularly, yeasts are strong fermenters of fresh and processed fruits and vegetables; hence, they are often accountable for their spoilage and production of off-flavor. This work provides a quick and easy tool to recognize and count the spoilage of juices with ergosterol as distinctive biomarker of molds and yeasts. Melon juice was reconstituted at natural physical–chemical parameters according to legislation, andSaccharomyces cerevisiaewas selected as yeast to contaminate the juice. Chemical and enzyme tests were performed on the fresh juice to ensure its authentic properties. Ergosterol was then evaluated using a spectrophotometric method that was proven against the official plate count test. The study showed linear and consistent results and, therefore, the ergosterol molecule may be indicated for testing molds and yeasts in contaminated beverages, replacing the common and time-consuming analysis.
Accuracy of automated intracerebral hemorrhage volume measurement on non-contrast computed tomography: a Swedish Stroke Register cohort study
Authors: Hillal Amir , Sultani Gabriella , Ramgren Birgitta , Norrving Bo , Wassélius Johan , Ullberg Teresa
Published: November 2022

Purpose

Hematoma volume is the strongest predictor of patient outcome after intracerebral hemorrhage (ICH). The aim of this study was to validate novel fully automated software for quantification of ICH volume on non-contrast computed tomography (CT).

Methods

The population was defined from the Swedish Stroke Register (RS) and included all patients with an ICH diagnosis during 2016–2019 in Region Skåne. Hemorrhage volume on their initial head CT was measured using ABC/2 and manual segmentation (Sectra IDS7 volume measurement tool) and the automated volume quantification tool (qER–NCCT) by Qure.ai. The first 500 were examined by two independent readers.

Results

A total of 1649 ICH patients were included. The qER–NCCT had 97% sensitivity in identifying ICH. In total, there was excellent agreement between volumetric measurements of ICH volumes by qER–NCCT and manual segmentation by interclass correlation (ICC = 0.96), and good agreement (ICC = 0.86) between qER–NCCT and ABC/2 method. The qER–NCCT showed volume underestimation, mainly in large (> 30 ml) heterogenous hemorrhages. Interrater agreement by (ICC) was 0.996 (95% CI: 0.99–1.00) for manual segmentation.

Conclusion

Our study showed excellent agreement in volume quantification between the fully automated software qER–NCCT and manual segmentation of ICH on NCCT. The qER–NCCT would be an important additive tool by aiding in early diagnostics and prognostication for patients with ICH and in provide volumetry on a population-wide level. Further refinement of the software should address the underestimation of ICH volume seen in a portion of large, heterogenous, irregularly shaped ICHs.
Low Cost Gastroschisis Silo for Sub‐Saharan Africa: Testing in a Porcine Model
Authors: Leraas Harold J. , Biswas Arushi , Eze Anthony , Zadey Siddesh , Wilson Patrick , Theriot Barbara S. , Surana Neeraj K. , Ssekitoleko Robert , Mugaga Julius , Salzman Caroline , Hall Allison , Wesonga Anne , Saterbak Ann , Fitzgerald Tamara N.
Published: November 2022

Background

Gastroschisis mortality in sub‐Saharan Africa (SSA) remains high at 59–100%. Silo inaccessibility contributes to this disparity. Standard of care (SOC) silos cost $240, while median monthly incomes in SSA are < $200. Our multidisciplinary American and Ugandan team designed and bench‐tested a low‐cost (LC) silo that costs < $2 and is constructed from locally available materials. Here we describe in vivo LC silo testing.

Methods

A piglet gastroschisis model was achieved by eviscerating intestines through a midline incision. Eight piglets were randomized to LC or SOC silos. Bowel was placed into the LC or SOC silo, maintained for 1‐h, and reduced. Procedure times for placement, intestinal reduction, and silo removal were recorded. Tissue injury of the abdominal wall and intestine was assessed. Bacterial and fungal growth on silos was also compared.

Results

There were no gross injuries to abdominal wall or intestine in either group or difference in minor bleeding. Times for silo application, bowel reduction, and silo removal between groups were not statistically or clinically different, indicating similar ease of use. Microbiologic analysis revealed growth on all samples, but density was below the standard peritoneal inoculum of 105 CFU/g for both silos. There was no significant difference in bacterial or fungal growth between LC and SOC silos.

Conclusion

LC silos designed for manufacturing and clinical use in SSA demonstrated similar ease of use, absence of tissue injury, and acceptable microbiology profile, similar to SOC silos. The findings will allow our team to proceed with a pilot study in Uganda.
Feasibility of electronic patient-reported outcome monitoring and self-management program in aplastic anemia and paroxysmal nocturnal hemoglobinuria—a pilot study (ePRO-AA-PNH)
Authors: Bänziger Silas , Weisshaar Kimmo , Arokoski Reetta , Gerull Sabine , Halter Jörg , Rovó Alicia , Bargetzi Mario , Goede Jeroen S. , Senft Yuliya , Valenta Sabine , Passweg Jakob R. , Drexler Beatrice
Published: November 2022

Introduction

Electronic patient-reported outcomes (ePRO) are increasingly recognized in health care, as they have been demonstrated to improve patient outcomes in cancer, but have been less studied in rare hematological diseases. The aim of this study was to develop and test the feasibility of an ePRO system specifically customized for aplastic anemia (AA) and paroxysmal nocturnal hemoglobinuria (PNH).

Methods

After performing a user-centered design evaluation an ePRO system for AA and PNH patients could be customized and the application was tested by patients and their medical teams for 6 months. Symptom-reporting triggered self-management advice for patients and prompts them to contact clinicians in case of severe symptoms, while the medical team received alerts of severe symptoms for patient care.

Results

All nine included patients showed a high adherence rate to the weekly symptom-reporting (72%) and reported high satisfaction. The system was rated high for usage, comprehensibility, and integration into daily life. Most patients (78%) would continue and all would recommend the application to other AA/PNH patients. Technical performance was rarely a barrier and healthcare providers saw ePRO-AA-PNH as a useful supplement, but the lacking integration into the hospital information system was identified as a major barrier to usage.

Conclusion

An ePRO system customized for AA and PNH was feasible in terms of adherence, satisfaction, and performance, showing a high potential for these rare conditions in terms of data collection and patient guidance. However, the integration into clinical workflows is crucial for further routine use.

Trial registration

ClinicalTrials.gov NCT04128943.
Der Megatechnische Pharao
Authors: Portmann Edy
Published: November 2022

In seiner Common-Sense Kolumne integriert der Informatiker Edy Portmann, ganz im Sinne der „School of Life“ (einem artistischen Kollektiv von Psychologen, Philosophen und Schriftstellern), westliche und asiatische Paradigmen. Er kommt zum Schluss, dass eine Priese „Wabi-Sabi“ unsere Herausforderungen mit heutigen „Megamaschinen“ (Jochen Kirchhoff) leichter angehen liessen.
Underestimating isolated bilateral hygroma as non-accidental head injury with dramatic consequences: a case presentation
Authors: Cohrs Gesa , Winter Sibylle Maria , Siska Wiebke , Thomale Ulrich-Wilhelm
Published: November 2022

Objective

Abusive head injury (AHI) in infancy is associated with significantly worse outcomes compared to accidental traumatic brain injury. The decision-making of the diagnosis of AHI is challenging especially if the clinical signs are not presenting as a multifactorial pattern.

Method

We present a case of isolated bilateral hygroma in which this differential diagnosis of AHI was evaluated but primarily not seen as such leading subsequently to extensive secondary AHI with fatal brain injury.

Results

The case of an 8-week-old infant with apparently isolated bilateral hygroma without any external signs of abuse and no retinal hemorrhages was interpreted in causative correlation to the perinatal complex course of delivery. At a second readmission of the case, severe brain injury with bilateral cortical hypoxia, subarachnoid and subdural hemorrhages, and skull and extremity fractures led to severe disability of the affected infant.

Conclusion

Any early suspicion of AHI with at least one factor possibly being associated with abusive trauma should be discussed in multidisciplinary team conferences to find the best strategy to protect the child. Beside clinical factors, social factors within the family household may additionally be evaluated to determine stress-related risk for traumatic child abuse. In general, prevention programs will be essential in future perspective.
Evaluation and projections of the East Asian summer monsoon in a perturbed parameter ensemble
Authors: Rostron John W. , Sexton David M. H. , Furtado Kalli , Carvalho Maria João , Milton Sean F. , Rodríguez José M. , Zhang Wenxia
Published: November 2022

The East Asian summer monsoon (EASM) is a dominant driver of East Asian climate, with variations in its strength potentially impacting the livelihoods of millions of people. Understanding, predicting, and assessing uncertainties in these variations are therefore important area of research. Here, we present a study of the projected twenty-first century changes in the EASM using a ‘perturbed parameter ensemble’ (PPE) of HadGEM3-GC3.05 coupled climate models, which samples uncertainties arising from differences in model parameter values. We show that the performance of PPE members for leading order EASM metrics is comparable to CMIP5 and CMIP6 models in many respects. But the PPE also exposes model biases which exist for almost all parameter combinations. These ‘structural’ biases are found mainly to affect metrics for the low-level circulation. We also show that future changes in regional circulation and precipitation are projected consistently across the PPE members. A more detailed moisture budget analysis of the precipitation changes in a region covering the Yangtze River valley shows that the spread of these changes is mainly due to spread in dynamic responses. We also perform parameter sensitivity analyses and find that a parameter controlling the amplitude of deep-level entrainment is the main driver of spread in the PPE’s representation of the EASM circulation. Finally, we discuss how the information provided by the PPE may be used in practice, considering the plausibility of the models, and giving examples of ways to sub-select ensemble members to capture the diversity in the moisture budget changes.
Desmin intermediate filaments and tubulin detyrosination stabilize growing microtubules in the cardiomyocyte
Authors: Salomon Alexander K. , Phyo Sai Aung , Okami Naima , Heffler Julie , Robison Patrick , Bogush Alexey I. , Prosser Benjamin L.
Published: November 2022

In heart failure, an increased abundance of post-translationally detyrosinated microtubules stiffens the cardiomyocyte and impedes its contractile function. Detyrosination promotes interactions between microtubules, desmin intermediate filaments, and the sarcomere to increase cytoskeletal stiffness, yet the mechanism by which this occurs is unknown. We hypothesized that detyrosination may regulate the growth and shrinkage of dynamic microtubules to facilitate interactions with desmin and the sarcomere. Through a combination of biochemical assays and direct observation of growing microtubule plus-ends in adult cardiomyocytes, we find that desmin is required to stabilize growing microtubules at the level of the sarcomere Z-disk, where desmin also rescues shrinking microtubules from continued depolymerization. Further, reducing detyrosination (i.e. tyrosination) below basal levels promotes frequent depolymerization and less efficient growth of microtubules. This is concomitant with tyrosination promoting the interaction of microtubules with the depolymerizing protein complex of end-binding protein 1 (EB1) and CAP-Gly domain-containing linker protein 1 (CLIP1/CLIP170). The dynamic growth and shrinkage of tyrosinated microtubules reduce their opportunity for stabilizing interactions at the Z-disk region, coincident with tyrosination globally reducing microtubule stability. These data provide a model for how intermediate filaments and tubulin detyrosination establish long-lived and physically reinforced microtubules that stiffen the cardiomyocyte and inform both the mechanism of action and therapeutic index for strategies aimed at restoring tyrosination for the treatment of cardiac disease.
Two-stage revision for periprosthetic joint infection in cemented total hip arthroplasty: an increased risk for failure?
Authors: Hipfl Christian , Leopold Vincent , Becker Luis , Pumberger Matthias , Perka Carsten , Hardt Sebastian
Published: November 2022

Background

The impact of the prior fixation mode on the treatment outcome of chronic periprosthetic joint infection (PJI) of the hip is unclear. Removal of cemented total hip arthroplasty (THA) is particularly challenging and residual cement might be associated with reinfection. This study seeks to compare the results of two-stage revision for PJI in cemented and cementless THA.

Methods

We reviewed 143 consecutive patients undergoing two-stage revision THA for PJI between 2013 and 2018. Thirty-six patients with a fully cemented (n = 6), hybrid femur (n = 26) or hybrid acetabulum (n = 4) THA (cemented group) were matched 1:2 with a cohort of 72 patients who underwent removal of a cementless THA (cementless group). Groups were matched by sex, age, number of prior surgeries and history of infection treatment. Outcomes included microbiological results, interim re-debridement, reinfection, all-cause revision, and modified Harris hip scores (mHHS). Minimum follow-up was 2 years.

Results

Compared with PJI in cementless THA, patients undergoing removal of cemented THA had increasingly severe femoral bone loss (p = 0.004). Patients in the cemented group had an increased risk for positive cultures during second-stage reimplantation (22% compared to 8%, p = 0.043), higher rates of reinfection (22% compared to 7%, p = 0.021) and all-cause revision (31% compared to 14%, p = 0.039) compared to patients undergoing two-stage revision of cementless THA. Periprosthetic femoral fractures were more frequent in the group of patients with prior cementation (p = .004). Mean mHHS had been 37.5 in the cemented group and 39.1 in the cementless group, and these scores improved significantly in both groups (p < 0.01).

Conclusion

This study shows that chronic infection in cemented THA might be associated with increased bone loss, higher rates of reinfection and all-cause revision following two-stage revision. This should be useful to clinicians counselling patients with hip PJI and can guide treatment and estimated outcomes.
Association of preoperative conization with recurrences after laparoscopic radical hysterectomy for FIGO 2018 stage IB1 cervical cancer
Authors: Ding Yan , Zhang Xuyin , Qiu Junjun , Li Chunbo , Hua Keqin
Published: November 2022

Objective

To evaluate association of preoperative conization with recurrences after laparoscopic radical hysterectomy (LRH) for FIGO 2018 stage IB1 cervical cancer.

Methods

This is a retrospective single-center study. Patients who underwent LRH for cervical cancer with squamous, adenosquamous and adenocarcinoma subtype from January 2014 to December 2018 were reviewed. All patients were restaged according to the 2018 FIGO staging system. Those who were in FIGO 2018 stage IB1 met the inclusion criteria. General characteristics and oncologic outcomes including recurrence-free survival (RFS) were analyzed.

Results

A total of 1273 patients were included in the analysis. 616 (48.4%) patients underwent preoperative biopsy, and 657 (51.6%) patients underwent conization. Residual disease was observed in 822 (64.6%) patients. During a median follow-up of 50.30 months, 30 (2.4%) patients experienced recurrence. The univariate analysis showed that patients who had larger tumor diameter, the presence of residual tumor at final pathology, and underwent adjuvant treatment had a significant higher risk of recurrence (P < 0.01). Conversely, patients who underwent conization were significantly less likely to experience recurrence (P = 0.001). In the multivariate analysis, the independent risk factor associated with an increased risk of recurrence was resident macroscopic tumor (HR: 38.4, 95% CI 4.20–351.64, P = 0.001). On the contrary, preoperative conization was associated with a significantly lower risk of recurrence (HR: 0.26; 95% CI 0.10–0.63, P = 0.003). The Kaplan–Meier curves showed patients who underwent conization had improved survival over those who underwent biopsy (5 year RFS: 98.6 vs 95.1%, P = 0.001). The 5 year RFS of patients with residual tumor was significantly different (R0: 99.2%, R1: 97.4%, R2: 93.6%, P < 0.001), especially the patients with residual macroscopic tumor after conization (R0: 99.5%, R1: 99.0%, R2:92.4%, P = 0.006).

Conclusion

Preoperative conization and the absence of residual tumor at the time of surgery might play a protective role in patients with FIGO 2018 IB1 cervical cancer following LRH, which support the theory of the influence of intraoperative tumor spread during radical hysterectomy. Further prospective evidence is needed.
Muscle MRI in immune-mediated necrotizing myopathy (IMNM): implications for clinical management and treatment strategies
Authors: Fionda Laura , Lauletta Antonio , Leonardi Luca , Perez Jorge Alonso , Morino Stefania , Merlonghi Gioia , Alfieri Girolamo , Costanzo Rocco , Tufano Laura , Vanoli Fiammetta , Rossini Elena , Vigo Eduard Gallardo , Tartaglione Tommaso , Salvetti Marco , Antonini Giovanni , Diaz-Manera Jordi , Garibaldi Matteo
Published: November 2022

Objectives

Immune-mediated necrotizing myopathy (IMNM) is the most severe idiopathic inflammatory myopathy (IIM) and early aggressive poly-immunotherapy is often required to reduce long-term disability. The aim of this study is to investigate muscle MRI in IMNM as outcome measure for disease activity, severity, progression, response to treatment, and to better characterize the pattern of muscle involvement.

Methods

This is a retrospective, observational, cross-sectional, and longitudinal study including 22 IMNM patients, divided into three groups based on timing of first MRI and if performed before or under treatment. T1 score and percentage of STIR positive muscles (STIR%) were considered and analyzed also in relation to demographic, clinical and laboratory characteristics.

Results

STIR% was higher in untreated patients and in those who performed MRI earlier (p = 0.001). Pelvic girdle and thighs were in general more affected than legs. T1 score was higher in patients with MRI performed later in disease course (p = 0.004) with a prevalent involvement of the lumbar paraspinal muscles, gluteus medius and minimus, adductor magnus and hamstrings. 22% of STIR positive muscles showed fat replacement progression at second MRI. Higher STIR% at baseline correlated with higher risk of fat replacement at follow-up (p = 0.003); higher T1 score correlated with clinical disability at follow-up, with late treatment start and delayed treatment with IVIG (p = 0.03).

Interpretation

Muscle MRI is a sensitive biomarker for monitoring disease activity and therapy response, especially when performed early in disease course and before treatment start, and could represent a supportive outcome measure and early prognostic index in IMNM.
VEGFA rs2010963 GG genotype is associated with superior adaptations to resistance versus endurance training in the same group of healthy, young men
Authors: Boidin Maxime , Dawson Ellen A. , Thijssen Dick H. J. , Erskine Robert M.
Published: November 2022

Purpose

We used a within-subject, cross-over study to determine the relationship between the intra-individual adaptations to four weeks’ resistance (RT)versusfour weeks’ endurance (END) training, and we investigated whether three single nucleotide polymorphisms (SNPs) were associated with these adaptations.

Methods

Thirty untrained, healthy, young men completed a cycling test to exhaustion to determine peak oxygen uptake (V̇O2peak), and a knee extension (KE) maximum voluntary isometric contraction (MVIC) of the right leg before and after four weeks’ supervised RT (four sets of 10 repetitions at 80% single repetition maximum unilateral KE exercise, three times weekly) and four weeks’ supervised END (30 min combined continuous/interval cycling, three times weekly), separated by a three-week washout phase. Participants were genotyped for theACTN3rs1815739,NOS3rs2070744 andVEGFArs2010963 SNPs.

Results

The intra-individual adaptations regarding percentage changes in MVIC force and V̇O2peakfollowing RT and END, respectively, were unrelated (r2 = 0.003;P = 0.79). However, aVEGFAgenotype × training modality interaction (P = 0.007) demonstrated thatVEGFAGG homozygotes increased their MVIC force after RT (+ 20.9 ± 13.2%) more than they increased their V̇O2peakafter END (+ 8.4 ± 9.1%,P = 0.005), and more thanVEGFAC-allele carriers increased their MVIC force after RT (+ 12.2 ± 8.1%,P = 0.04). There were no genotype × training modality interactions for theACTN3orNOS3SNPs.

Conclusion

High/low responders to RT were not consequently high/low responders to END or vice versa. However, preferential adaptation ofVEGFArs2010963 GG homozygotes to RT over END, and their greater adaptation to RT compared toVEGFAC-allele carriers, indicate a novel genetic predisposition for superior RT adaptation.
Effects of exercise interventions on cancer-related fatigue in breast cancer patients: an overview of systematic reviews
Authors: Zhou Hong-Juan , Wang Tao , Xu Yong-Zhi , Chen Yan-Nan , Deng Li-Jing , Wang Chang , Chen Jin-Xiu , Tan Jing-Yu
Published: November 2022

Objective

This overview of systematic reviews aims to critically appraise and consolidate evidence from current systematic reviews (SRs)/meta-analyses on the effects of exercise interventions on cancer-related fatigue (CRF) in breast cancer patients.

Methods

SRs/meta-analyses that explored the effects of exercise interventions on CRF in breast cancer patients compared with the routine methods of treatment and care were retrieved from nine databases. The methodological quality of the included SRs was appraised using A MeaSurement Tool to Assess systematic Reviews II (AMSTAR II). The Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to calculate the grading of outcomes in the included SRs. The exercise type, frequency, duration, and inclusion/absence of supervision were further evaluated with subgroup analyses. The Stata 16.0 software was utilized for data analysis.

Results

Twenty-nine reviews were included. The overall methodological quality and level of evidence of the included reviews were unsatisfactory, with only three reviews rated as high methodological quality and no review identified as high-quality evidence. Moderate certainty evidence indicated that exercise could improve fatigue in breast cancer patients (SMD = − 0.40 [95%CI − 0.58, − 0.22]; P = 0.0001). Subgroup analysis based on the types of exercise showed that yoga (SMD = − 0.30 [95%CI − 0.56, − 0.05]; I2 = 28.7%) and aerobic exercise (SMD = − 0.29 [95%CI − 0.56, − 0.02]; I2 = 16%) had a significantly better effect on CRF in breast cancer patients; exercising for over 6 months (SMD = − 0.88 [95%CI − 1.59, − 0.17]; I2 = 42.7%; P = 0.0001), three times per week (SMD = − 0.77 [95%CI − 1.04, − 0.05]; I2 = 0%; P = 0.0001), and for 30 to 60 min per session (SMD = − 0.81 [95%CI − 1.15, − 0.47]; I2 = 42.3%; P = 0.0001) can contribute to a moderate improvement of CRF. Supervised exercise (SMD = − 0.48 [95%CI − 0.77, − 0.18]; I2 = 87%; P = 0.001) was shown to relieve CRF.

Conclusion

Exercise played a favorable role in alleviating CRF in breast cancer. Yoga was recommended as a promising exercise modality for CRF management in the majority of the included studies. Exercising for at least three times per week with 30 to 60 min per session could be recommended as a suitable dosage for achieving improvement in CRF. Supervised exercise was found to be more effective in alleviating CRF than unsupervised exercise. More rigorously designed clinical studies are needed to specify the exact exercise type, duration, frequency, and intensity to have an optimal effect on CRF in breast cancer patients.

Trial registration

ClinicalTrials.gov Identifier: CRD42020219866.
Loss of bone morphogenetic protein signaling in fibroblasts results in CXCL12-driven serrated polyp development
Authors: Ouahoud Sarah , Westendorp Barbara Florien , Voorneveld Philip Willen , Abudukelimu Subinuer , Koelink Pim Johan , Pascual Garcia Elena , Buuren Jessica Flora Isabella , Harryvan Tom Jacob , Lenos Kristiaan Jan , van Wezel Tom , Offerhaus Johan Arnold , Fariña-Sarasqueta Arantza , Crobach Stijn , Slingerland Marije , Hardwick James Christopher Henry , Hawinkels Lukas Jacobus Antonius Christiaan
Published: November 2022

Mutations in Bone Morphogenetic Protein (BMP) Receptor (BMPR)1A and SMAD4 are detected in 50% of juvenile polyposis syndrome (JPS) patients, who develop stroma-rich hamartomatous polyps. The established role of stromal cells in regulating BMP activity in the intestine implies a role for stromal cells in polyp development. We used conditional Cre-LoxP mice to investigate how specific loss of BMPR1A in endothelial cells, fibroblasts, or myofibroblasts/smooth muscle cells affects intestinal homeostasis. Selective loss of BMPR1A in fibroblasts causes severe histological changes in the intestines with a significant increase in stromal cell content and epithelial cell hyperproliferation, leading to numerous serrated polyps. This phenotype suggests that crucial changes occur in the fibroblast secretome that influences polyp development. Analyses of publicly available RNA expression databases identified CXCL12 as a potential candidate. RNAscope in situ hybridization showed an evident increase of Cxcl12-expressing fibroblasts. In vitro, stimulation of fibroblasts with BMPs resulted in downregulation of CXCL12, while inhibition of the BMP pathway resulted in gradual upregulation of CXCL12 over time. Moreover, neutralization of CXCL12 in vivo in the fibroblast-specific BMPR1A KO mice resulted in a significant decrease in polyp formation. Finally, in CRC patient specimens, mRNA-expression data showed that patients with high GREMLIN1 and CXCL12 expression had a significantly poorer overall survival. Significantly higher GREMLIN1, NOGGIN, and CXCL12 expression were detected in the Consensus Molecular Subtype 4 (CMS4) colorectal cancers, which are thought to arise from serrated polyps. Taken together, these data imply that fibroblast-specific BMP signaling–CXCL12 interaction could have a role in the etiology of serrated polyp formation.
Why do we need to care about transboundary aquifers and how do we solve their issues?
Authors: Rivera Alfonso , Pétré Marie-Amélie , Fraser Christina , Petersen-Perlman Jacob D. , Sanchez Rosario , Movilla Laura , Pietersen Kevin
Published: November 2022

As the reliance on transboundary groundwater is increasing globally, it is important to understand and address the specific issues raised by the assessment and management of transboundary aquifers (TBAs). Building on 20 years of TBA experience and through a three-pillar framework (assessment, cooperation-collaboration, shared management), the key elements to addressing TBA issues are described, including a multidisciplinary approach, identification of hotspot zones, local vs border-wide approaches, appropriate funding models, and an increased recognition of the role and value of each TBA.
Cu2O Nanoparticles Deposited on Y2O3 and CuO: Synthesis and Antimicrobial Properties
Authors: Długosz Olga , Lis Kinga , Matyjasik Wiktoria , Radomski Piotr , Pulit-Prociak Jolanta , Banach Marcin
Published: November 2022

This paper reports the preparation of copper(I) oxide nanoparticles deposited on yttrium oxide and copper(II) oxide in the presence of acerola and white willow extracts. Through the use of natural compounds, it was possible to modify the surface of the Y2O3 and CuO carriers allowing Cu2O to be deposited to a greater extent, thus improving the antibacterial properties of the materials. Cu2O nanoparticles, by being deposited on a carrier, enable an increase in the contact surface of the nanoparticles with microorganisms, which react to form reactive oxygen species. Cu2O nanoparticles with sizes of about 38 nm and 76 nm were obtained for Y2O3- and CuO-deposited nanoparticles, respectively. The Gram-negative bacteria Escherichia coli shown a greater sensitivity to the degree of inhibition compared to Staphylococcus Aureus already at a concentration of 250 mg/L. For almost all materials, the inhibition level remained above 50% after 48 h. Analysis of the effect of the antimicrobial properties of the materials against Candida albicans fungus shown high activity which was obtained only at the highest concentrations of 8000 mg/L, for which the degree of growth inhibition was 100% also after 48 h for both Y2O3–Cu2O and CuO–Cu2O.
Improving Health and Diabetes Self-Management in Immigrants with Type 2 Diabetes Through a Co-Created Diabetes Self-Management Education and Support Intervention
Authors: Hempler Nana Folmann , Fagt Charlotte , Olesen Kasper , Wagner Sabina , Rasmussen Lone Banke , Laursen Ditte Hjorth , Glümer Charlotte , Nygaard Mette , Willaing Ingrid
Published: November 2022

To examine the impact of a co-created culturally sensitive diabetes self-management education and support (DSMES) intervention on the physical and mental health of immigrants with type 2 diabetes (T2D). Pre- and post-test among people with T2D whose primary language was Urdu, Arabic or Turkish (n = 97). Participants were offered a six-week intervention based on a person-centred approach using research-based dialogue tools to facilitate learning and reflection, which was developed in co-creation with immigrants and healthcare professionals. Data were collected at baseline, post-intervention and after 6 months and analysed using paired t-tests, Wilcoxon signed-rank tests, chi-square tests and regression models when appropriate. Several clinical outcomes were improved post-intervention, including HbA1c (P < 0.001), body fat percentage (P = 0.002), self-rated general health (P = 0.05), well-being (P = 0.004) and several self-management behaviours, e.g., physical activity (P < 0.001). Most outcomes remained improved after 6 months, but the effect on HbA1c was no longer statistically significant. Some outcomes were improved only at 6 months, including waist circumference (P < 0.001) and diabetes-related emotional distress (P < 0.001). Fatigue did not change. Attendance at more programme sessions was associated with better outcomes. The DSMES intervention developed in a co-creation process was highly effective in improving the health of immigrants with T2D.
The impact of pharmacist-led medication reconciliation and interprofessional ward rounds on drug-related problems at hospital discharge
Authors: Studer Helene , Imfeld-Isenegger Tamara L. , Beeler Patrick E. , Ceppi Marco G. , Rosen Christoph , Bodmer Michael , Boeni Fabienne , Hersberger Kurt E. , Lampert Markus L.
Published: November 2022

Background

During transitions of care, including hospital discharge, patients are at risk of drug-related problems (DRPs).

Aim

To investigate the impact of pharmacist-led services, specifically medication reconciliation at admission and/or interprofessional ward rounds on the number of DRPs at discharge.

Method

In this retrospective, single-center cohort study, we analyzed routinely collected data of patients discharged from internal medicine wards of a regional Swiss hospital that filled their discharge prescriptions in the hospital’s community pharmacy between June 2016 and May 2019. Patients receiving one of the two or both pharmacist-led services (Study groups: Best Care = both services; MedRec = medication reconciliation at admission; Ward Round = interprofessional ward round), were compared to patients receiving standard care (Standard Care group). Standard care included medication history taken by a physician and regular ward rounds (physicians and nurses). At discharge, pharmacists reviewed discharge prescriptions filled at the hospital’s community pharmacy and documented all DRPs. Multivariable Poisson regression analyzed the independent effects of medication reconciliation and interprofessional ward rounds as single or combined service on the frequency of DRPs.

Results

Overall, 4545 patients with 6072 hospital stays were included in the analysis (Best Care n = 72 hospital stays, MedRec n = 232, Ward Round n = 1262, and Standard Care n = 4506). In 1352 stays (22.3%) one or more DRPs were detected at hospital discharge. The combination of the two pharmacist-led services was associated with statistically significantly less DRPs compared to standard care (relative risk: 0.33; 95% confidence interval: 0.16, 0.65). Pharmacist-led medication reconciliation alone showed a trend towards fewer DRPs (relative risk: 0.75; 95% confidence interval: 0.54, 1.03).

Conclusion

Our results support the implementation of pharmacist-led medication reconciliation at admission in combination with interprofessional ward rounds to reduce the number of DRPs at hospital discharge.
Exposure to persistent organic pollutants alters the serum metabolome in non-obese diabetic mice
Authors: Sinioja Tim , Bodin Johanna , Duberg Daniel , Dirven Hubert , Berntsen Hanne Friis , Zimmer Karin , Nygaard Unni C. , Orešič Matej , Hyötyläinen Tuulia
Published: November 2022

Introduction

Autoimmune disorders such as type 1 diabetes (T1D) are believed to be caused by the interplay between several genetic and environmental factors. Elucidation of the role of environmental factors in metabolic and immune dysfunction leading to autoimmune disease is not yet well characterized.

Objectives

Here we investigated the impact of exposure to a mixture of persistent organic pollutants (POPs) on the metabolome in non-obese diabetic (NOD) mice, an experimental model of T1D. The mixture contained organochlorides, organobromides, and per- and polyfluoroalkyl substances (PFAS).

Methods

Analysis of molecular lipids (lipidomics) and bile acids in serum samples was performed by UPLC-Q-TOF/MS, while polar metabolites were analyzed by GC-Q-TOF/MS.

Results

Experimental exposure to the POP mixture in these mice led to several metabolic changes, which were similar to those previously reported as associated with PFAS exposure, as well as risk of T1D in human studies. This included an increase in the levels of sugar derivatives, triacylglycerols and lithocholic acid, and a decrease in long chain fatty acids and several lipid classes, including phosphatidylcholines, lysophosphatidylcholines and sphingomyelins.

Conclusion

Taken together, our study demonstrates that exposure to POPs results in an altered metabolic signature previously associated with autoimmunity.