bluuebunny/crossref_metadata_2025 huggingface dataset:
Tooth loss and radiographic bone loss in patients without regular supportive care: A retrospective study
Authors: Al‐Harthi Shaima , Barbagallo Giovanni , Psaila Alessandro , d'Urso Umberto , Nibali Luigi
Published: September 2021

Background

Very few studies have investigated the effect of patient and site factors on periodontal progression and long‐term tooth loss in populations with minimal dental care. The aim of this retrospective study was to assess tooth loss and radiographic bone loss over at least 5 years in patients attending a national‐health service primary care practice in Sicily and undergoing no regular care.

Methods

Records of two hundred consecutive patients with at least 5 years follow‐up were screened and demographic, clinical and radiographic data were retrieved. Analyses of associations between patient and site factors and tooth loss were performed.

Results

After excluding not suitable patients, a total of 159 patient records with clinical and radiographic data with average 8.6 years follow‐up were included. One hundred of these patients had no professional mechanical plaque removal (PMPR) carried out throughout the study follow‐up. Nearly 65% of patients lost at least 1 tooth during the follow‐up period, with a total of 400 extracted teeth (for periodontal and non‐periodontal reasons). The annual tooth loss rate was slightly higher for “no PMPR” (untreated) patients (0.30 teeth/patient/year) compared with patients who had PMPR (0.27 teeth/patient/year). On a patient‐level, only reduced frequency of daily tooth brushing was associated with tooth loss at logistic regression, whereas staging, grading and diagnosis of caries were associated with rates of tooth loss/year. At multilevel analysis including patient‐ and tooth‐factors, age, diagnosis of caries and endodontic disease and percentage of bone loss at baseline were associated with tooth loss.

Conclusion

This study confirms the importance of tooth brushing, initial bone loss, caries and endodontic disease in predicting tooth survival in a primary care setting.
Heritability and genome‐wide association study of blood pressure in Chinese adult twins
Authors: Chen Jiahao , Wang Weijing , Li Zhaoying , Xu Chunsheng , Tian Xiaocao , Zhang Dongfeng
Published: September 2021

Background

Blood pressure (BP) is an independent and important factor for chronic diseases such as cardiovascular diseases and diabetes.

Methods

We firstly conducted twin modeling analyses to explore the heritability of BP, including systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP) and mean arterial pressure (MAP), and then performed genome‐wide association studies to explore the associated genomic loci, genes, and pathways.

Results

A total of 380 Chinese twin pairs were included. The AE model containing additive genetic parameter (A) and unique/non‐shared environmental parameter (E) was the best fit model, with A accounting for 53.7%, 50.1%, 48.1%, and 53.3% for SBP, DBP, PP and MAP, respectively. No SNP was found to reach the genome‐wide significance level (p < 5 × 10−8), however, three, four, 14 and nine SNPs were found to exceed suggestive significance level (p < 1 × 10−5) for SBP, DBP, PP, and MAP, respectively. And after imputation, 46, 37, 91 and 61 SNPs were found to exceed the suggestive significance level for SBP, DBP, PP, and MAP, respectively. In gene‐based analysis, 53 common genes were found among SBP, DBP, PP, and MAP. In pathway enrichment analysis, 672, 706, 701, and 596 biological pathways were associated with SBP, DBP, PP, and MAP, respectively (p < 0.05).

Conclusion

Our study suggests that BP is moderately heritable in the Chinese population and could be mediated by a series of genomic loci, genes, and pathways. Future larger‐scale studies are needed to confirm our findings.
Feasibility analysis on simultaneous electron density and attenuation coefficient reconstruction
Authors: Wiedeman Christopher , Cong Wenxiang , Wang Ge
Published: September 2021

Purpose

Creating a viable reconstruction method for Compton scatter tomography remains challenging. Accounting for scatter attenuation when the underlying attenuation map is not known is particularly challenging, and current mathematical approaches to this vary widely. This work explores a novel approach to joint scatter and attenuation image reconstruction, which leverages the underlying structural similarity between the two images and incorporates a deep learning model in an alternating iterative reconstruction scheme.

Methods

A single‐view computed tomography (CT) imaging procedure for recording Compton scatter is first described. A joint reconstruction model, which iterates between algebraically reconstructing scatter images and estimating the attenuation via deep learning, is then proposed. This model is tested on both a generated dataset of 2D phantom images designed to mimic human tissues as well as a realistically simulated dataset based on real CT images.

Results

Testing results yield convergence of the model and decent reconstruction quality to distinguish crucial features such as tumors and lesions, demonstrating the potential principled utilities of this configuration and deep learning approach. The model achieved a structural similarity index measure of at least 0.82 for scatter and 0.88 for attenuation reconstructions with the realistically simulated dataset.

Conclusion

The iterative, deep learning approach outlined in this work shows potential for future efficient medical imaging procedures, reconstructing images with limited scatter information.
Potential increase in radiation‐induced DNA double‐strand breaks with higher doses of iodine contrast during coronary CT angiography
Authors: Van Cauteren Toon , Tanaka Kaoru , Belsack Dries , Van Gompel Gert , Kersemans Veerle , Jochmans Kristin , Droogmans Steven , de Mey Johan , Buls Nico
Published: September 2021

Purpose

To investigate the contrast media iodine dose dependency of radiation‐induced DNA double‐strand breaks (DSBs) during a coronary computed tomography angiography (CCTA) scan.

Methods

This prospective patient study was approved by the ethical committee. Between November 2018 and July 2019, 50 patients (31 males and 19 females, mean age 64 years) were included in the study, 45 CCTA and five noncontrast‐enhanced (NCE) cardiac computed tomography (CT) patients. A single‐heartbeat scan protocol with a patient‐tailored contrast media injection protocol was used, administering a patient‐specific iodine dose. DNA double‐strand breaks were quantified using a γH2AX foci assay on peripheral blood lymphocytes. The net amount of γH2AX/cell was normalized to the individual patient CT dose by the size‐specific dose estimate (SSDE). Correlation between the administered and blood‐iodine dose and the SSDE normalized amount of DNA DSBs was investigated using a Pearson correlation test.

Results

CCTA patients were scanned with a mean CTDIvol of 10.6 ± 5.6 mGy, corresponding to a mean SSDE of 11.3 ± 5.3 mGy while the NCE cardiac CT patients were scanned with a mean CTDIvol of 6.00 ± 1.8 mGy, corresponding to a mean SSDE of 6.6 ± 2.7 mGy. The administered iodine dose ranged from 16.5 to 34.0 gI in the CCTA patients, resulting in a blood‐iodine dose range from 5.1 to 15.0 gI in the exposed blood volume. A significant linear relationship (r = 0.79, p‐value < 0.001) was observed between the blood iodine dose and SSDE normalized radiation‐induced DNA DSBs. A similar significant linear relationship (r = 0.62, p‐value < 0.001) was observed between the administered iodine dose and SSDE normalized radiation‐induced DNA DSBs.

Conclusions

This study shows that contrast media iodine dose increases the level of radiation‐induced DNA DSBs in peripheral blood lymphocytes in a linear dose‐dependent manner with CCTA. Importantly, the level of DNA DSBs can be reduced by lowering the administered iodine dose.
A particle‐continuum coupling method for multiscale simulations of viscoelastic–viscoplastic amorphous glassy polymers
Authors: Zhao Wuyang , Steinmann Paul , Pfaller Sebastian
Published: September 2021

In this contribution, we present a partitioned‐domain method coupling a particle domain and a continuum domain for multiscale simulations of inelastic amorphous polymers under isothermal conditions. In the continuum domain, a viscoelastic–viscoplastic constitutive model calibrated from previous molecular dynamics (MD) simulations is employed to capture the inelastic properties of the polymer. Due to the material's rate‐dependence, a temporal coupling scheme is introduced. The influence of the time‐related parameters on the computational cost and accuracy is discussed. With appropriate parameters, multiscale simulations of glassy polystyrene under various loading conditions are implemented to showcase the method's capabilities to capture the mechanical behavior of polymers with different strain rates and with non‐affine deformations of the MD domain.
Cluster‐based gradient method for stochastic optimal control problems with elliptic partial differential equation constraint
Authors: Xiong Meixin , Chen Liuhong , Ming Ju , Hou Lisheng
Published: September 2021

In this article, we establish a cluster‐based gradient method (CGM) by combining K‐means clustering algorithm and stochastic gradient descent (SGD). By clustering the sampling solutions, we use the cluster centroids to represent sampling data and give an estimate to the full gradient. It is well known that the full gradient descent (FGD) can provide the steepest descent direction for finding a local minimum of the desired stochastic control problems. However, the huge computational requirements, which is proportional to the product of sample size and the numerical cost for each sample, often makes FGD cost prohibitive for large scale optimization problems. To reduce the formidable cost and the risks of getting stuck in a local minimum, SGD is proposed and can be regarded as a stochastic approximation of FGD. This, however, would result in a slow convergence due to the incorrect approximation of the iteratively update parameters. Our study shows that CGM could provide a good stochastic approximation to the full gradient with small sample size while has a more stable and faster convergence than SGD. To verify our algorithm, a stochastic elliptic control problem is selected and tested. The numerical results validate our method as a reliable gradient descent method with great potential applications in optimization problems.
Mucosal melanomas of different anatomic sites share a common global DNA methylation profile with cutaneous melanoma but show location‐dependent patterns of genetic and epigenetic alterations
Authors: Jurmeister Philipp , Wrede Niklas , Hoffmann Inga , Vollbrecht Claudia , Heim Daniel , Hummel Michael , Wolkenstein Peggy , Koch Ines , Heynol Verena , Schmitt Wolfgang Daniel , Thieme Anne , Teichmann Daniel , Sers Christine , von Deimling Andreas , Thierauf Julia Cara , von Laffert Maximilian , Klauschen Frederick , Capper David
Published: September 2021

Cutaneous, ocular, and mucosal melanomas are histologically indistinguishable tumors that are driven by a different spectrum of genetic alterations. With current methods, identification of the site of origin of a melanoma metastasis is challenging. DNA methylation profiling has shown promise for the identification of the site of tumor origin in various settings. Here we explore the DNA methylation landscape of melanomas from different sites and analyze if different melanoma origins can be distinguished by their epigenetic profile. We performed DNA methylation analysis, next generation DNA panel sequencing, and copy number analysis of 82 non‐cutaneous and 25 cutaneous melanoma samples. We further analyzed eight normal melanocyte cell culture preparations. DNA methylation analysis separated uveal melanomas from melanomas of other primary sites. Mucosal, conjunctival, and cutaneous melanomas shared a common global DNA methylation profile. Still, we observed location‐dependent DNA methylation differences in cancer‐related genes, such as low frequencies of RARB (7/63) and CDKN2A promoter methylation (6/63) in mucosal melanomas, or a high frequency of APC promoter methylation in conjunctival melanomas (6/9). Furthermore, all investigated melanomas of the paranasal sinus showed loss of PTEN expression (9/9), mainly caused by promoter methylation. This was less frequently seen in melanomas of other sites (24/98). Copy number analysis revealed recurrent amplifications in mucosal melanomas, including chromosomes 4q, 5p, 11q and 12q. Most melanomas of the oral cavity showed gains of chromosome 5p with TERT amplification (8/10), while 11q amplifications were enriched in melanomas of the nasal cavity (7/16). In summary, mucosal, conjunctival, and cutaneous melanomas show a surprisingly similar global DNA methylation profile and identification of the site of origin by DNA methylation testing is likely not feasible. Still, our study demonstrates tumor location‐dependent differences of promoter methylation frequencies in specific cancer‐related genes together with tumor site‐specific enrichment for specific chromosomal changes and genetic mutations. © 2021 The Authors. The Journal of Pathology published by John Wiley & Sons, Ltd. on behalf of The Pathological Society of Great Britain and Ireland.
Mechanical and nonisothermal cold crystallization behaviors of injection molded surface‐modified chitin whiskers/poly(l‐lactide) composites
Authors: Wen Wei , Li Yizhi , Luo Binghong , Zhou Changren
Published: September 2021

To improve the mechanical, crystallization performances of poly(l‐lactide) (PLLA), pristine and surface grafted chitin whiskers (CWs andg‐CWs) were introduced to PLLA via melt blending. Attributed to the good interfacial compatibility between theg‐CWs and PLLA matrix, the tensile, flexural, and impact performances of theg‐CWs/PLLA composites were better than that of the CWs/PLLA composites with the same whiskers content. The whiskers acted as nucleating agents to promote the crystallization of the PLLA matrix on the one hand, and acted as obstacles to restrict the crystals growth on the other hand. The nonisothermal cold crystallization kinetics revealed that the crystallization rate and crystallinity of the PLLA matrix were improved by the addition of the whiskers, but the promotion effect ofg‐CWs was more obvious than CWs.
Impact of α‐cellulose as a green filler on physico‐mechanical properties of a solution grade styrene‐butadiene rubber based tire‐tread compound
Authors: Pal Koushik , Chowdhury Soumya Ghosh , Mondal Dipankar , Chattopadhyay Dipankar , Bhattacharyya Sanjay Kumar , Mukhopadhyay Rabindra
Published: September 2021

Physico‐mechanical and dynamic mechanical properties of typical solution grade styrene‐butadiene rubber (S‐SBR) and polybutadiene rubber (PBR) based tire‐tread compound were investigated by partially replacing highly dispersible (HD) silica with naturally occurring α‐cellulose. Fourier transform infrared spectrum detected abundance of hydroxyl group in α‐cellulose, which has created keenness to investigate its reinforcement characteristics in an S‐SBR and PBR based compound. Scanning electron microscope and transmission electron microscope were employed to investigate the microstructure and dispersion of α‐cellulose at higher magnification. Thermo‐gravimetric analysis was performed to understand the degradation behavior of α‐cellulose. Differential scanning calorimeter was engaged to detect phase transition and degree of purity of α‐cellulose. An increase in cure rate was observed with partial replacement of HD silica by α‐cellulose. The cure rate index was increased by 13% over control one at 10% replacement of silica with α‐cellulose. It was noticed that at an optimum level of replacement (10%), α‐cellulose containing compounds exhibited lower viscoelastic energy dissipation (both loss modulus [E″] and loss tangent [tan δ]) at the slight expense of tensile moduli. Beside these, substitution of silica with α‐cellulose found to have no effect on wet grip property of the compounds.
Proteomics analysis reveals the correlation of programmed ROS‐autophagy loop and dysregulated G1/S checkpoint with imatinib resistance in chronic myeloid leukemia cells
Authors: Xu Xiucai , Yin Shihong , Ren Yingli , Hu Chaojie , Zhang Aimei , Lin Ya
Published: September 2021

Although tyrosine kinase inhibitors (TKIs), including imatinib, have greatly improved clinical treatment of patients with chronic myeloid leukemia (CML), drug resistance remains a major obstacle. Studies on the mechanisms underlying imatinib resistance and other alternative drugs are urgently needed. Liquid chromatography tandem mass spectrometry was applied to investigate the differences in proteomics and phosphoproteomics between K562 and K562/G (imatinib resistant K562). Multiple bioinformatics analyses were performed to unveil the differential signal pathways. CCK‐8 was used to detect cell proliferation. Flow cytometry was performed to analyze reactive oxygen species (ROS), cell cycle, and cell apoptosis. Western blotting and quantitative real‐time reverse transcription‐polymerase chain reaction (qRT‐PCR) were used to observe the changes of ROS and autophagy associated with imatinib resistance in CML. Our results indicated that ROS‐autophagy formed one negative feedback loop and was associated with imatinib resistance. Additionally, the limited‐rate enzymes of serine synthesis pathway were escalated in K562/G, which could contribute to the increased cyclin‐dependent kinases and cell proliferation index. According to phosphoproteomics data, K562/G cells exhibited abnormal phosphorylation of splicing signals. These results revealed that it could be one useful strategy to correct metabolism shift and oxidative stress, or moderately regulate autophagy. Future research should focus on the discovery of potential targets in ROS‐autophagy loop.
Consumer experience of a flexible exercise participation program (FEPP) for individuals with multiple sclerosis: A mixed‐methods study
Authors: Smith Moira , Neibling Bridee , Williams Gavin , Birks Melanie , Barker Ruth
Published: September 2021

Background and Purpose

The flexible exercise participation program (FEPP) is a novel intervention developed to enable individuals with multiple sclerosis (MS) participate and progress in an exercise or sport of their choice. The FEPP is underpinned by guidelines on aerobic exercise for individuals with MS and is supported by a physiotherapist using behaviour change techniques. As part of a FEPP feasibility trial, the aim of this nested study was to explore the experience of participation in the FEPP from the perspective of individuals with MS. The objectives were to (i) determine the acceptability of the FEPP and (ii) identify recommendations for improvement.

Methods

A mixed methods study using a sequential explanatory design was conducted. Part I consisted of a quantitative participant survey. Survey data were analysed descriptively using SPSS and informed the protocol for part II – qualitative interviews. Interview data were analysed thematically using NVivo. Part III consisted of integration of quantitative and qualitative data to allow greater explanation of survey responses. Individuals with MS who had participated in the FEPP feasibility trial were invited to take part in the study.

Results

The FEPP was highly acceptability to the 10 participants. Five themes emerged to describe the experience of participating in the FEPP: (i) exploring exercise boundaries, (ii) measuring energy, (iii) acknowledging accountability, (iv) adjusting to exercising in a pandemic and (v) sustaining participation. Recommendations for improving the FEPP included changes to energy level monitoring and incorporation of peer support mechanisms.

Discussion

Participants found the FEPP highly acceptable and valued the flexibility to choose their own activity and the health professional support. Based on participant recommendations, future versions of the FEPP will include daily rather than weekly monitoring of exercise and peer support to further enable individuals with MS to find the right balance with exercise and sport.
Eleutheroside B‐loaded poly (lactic‐co‐glycolic acid) nanoparticles protect against renal fibrosis via Smad3‐dependent mechanism
Authors: Chen Xiaohui , Liu Qixia , Yang Jing , Kan Min , Jin Rui , Pu Tian , Yang Yaru , Xing Tian , Meng Xiaoming , Zang Hongmei
Published: September 2021

Although renal fibrosis is a common complication of chronic kidney disease (CKD), effective options for its treatment are currently limited. In this study, we evaluated the renal protective effect and possible mechanism of eleutheroside B. In order to solve the allergic reactions, side effects, and low oral bioavailability of eleutheroside B, we successfully prepared PLGA (poly [lactic‐co‐glycolic acid])–eleutheroside B nanoparticles (NPs) with the diameter of about 128 nm. In vitro and in vivo results showed that eleutheroside B could inhibit expression levels of α‐smooth muscle actin (α‐SMA) and collagen I. Molecular docking results showed that eleutheroside B bound to Smad3 and significantly decreased the expression of phospho‐Smad3 (p‐Smad3). Silencing Smad3 reversed the fibrotic protective effect of eleutheroside B in HK2 cells. Furthermore, small animal imaging showed that NPs can selectively accumulate in the UUO kidneys of mice, and retention time reached as long as 7 days. In conclusion, our results suggested that eleutheroside B is a potential drug to protect renal fibrosis and PLGA–eleutheroside B NPs could facilitate specific targeted therapy for renal fibrosis.
Gradient Architecture‐Enabled Capacitive Tactile Sensor with High Sensitivity and Ultrabroad Linearity Range
Authors: Ji Bing , Zhou Qian , Lei Ming , Ding Sen , Song Qi , Gao Yibo , Li Shunbo , Xu Yi , Zhou Yinning , Zhou Bingpu
Published: September 2021

The sensitivity and linearity are critical parameters that can preserve the high pressure‐resolution across a wide range and simplify the signal processing process of flexible tactile sensors. Although extensive micro‐structured dielectrics have been explored to improve the sensitivity of capacitive sensors, the attenuation of sensitivity with increasing pressure is yet to be fully resolved. Herein, a novel dielectric layer based on the gradient micro‐dome architecture (GDA) is presented to simultaneously realize the high sensitivity and ultrabroad linearity range of capacitive sensors. The gradient micro‐dome pixels with rationally collocated amount and height can effectively regulate the contact area and hence enable the linear variation in effective dielectric constant of the GDA dielectric layer under varying pressures. With systematical optimization, the sensor exhibits the high sensitivity of 0.065 kPa−1 in an ultrabroad linearity range up to 1700 kPa, which is first reported. Based on the excellent sensitivity and linearity, the high pressure‐resolution can be preserved across the full scale of pressure spectrum. Therefore, potential applications such as all‐round physiological signal detection in diverse scenarios, control instruction transmission with combinatorial force inputs, and convenient Morse code communication with non‐overlapping capacitance signals are successfully demonstrated through a single sensor device.
A Pedagogy of Critical Landscape Planning
Authors: Kelly Ashley Scott , Lu Xiaoxuan
Published: September 2021

This chapter, A Pedagogy of critical landscape planning, outlines a form of critical research and practice in landscape architecture that actively engages the global development community. We frame critical landscape planning as produced through three primary struggles: holding cultural-technological positions; ensuring transdisciplinary approaches through culturing and immersion; and maintaining momentum via process-oriented approaches to development. We cover critical landscape planning’s definition as an applied critical research practice, address its primary challenges institutionally, academically, and practically, and describe the aspects of the landscape architecture design discipline that enable it. This is conveyed through reflection on our approaches to project case study selection and design exercises, stakeholder relationships, approaches to fieldwork, capacity for intervention, and association with parallel research efforts. Much of the contents, although supported academically, are structured as suggestions that are equally important as methods for design research and professional practice. These suggestions include replacing “site analysis” with a process of site-specific interdisciplinary socialization and replacing design and planning “concepts” with generative (even if often incommensurable) cultural-technological positions.
From Land-Locked to Land-Linked?
Authors: Kelly Ashley Scott , Lu Xiaoxuan
Published: September 2021

This chapter, From land-locked to land-linked? Laos within a continuum of connectivity in the Mekong region, constructs a history of infrastructure-building in Laos understood through economic connectivity. This chapter challenges the dominant narrative of a de-historicized, often linear progression from land-locked to land-linked or from isolation to integration by contextualizing the contemporary imaginations and developments of Laos within the broader social, economic and political transitions across the Mekong region. We examine the malleable identities of “Laos,” “border” and “infrastructure” in the strategic importance of the Mekong region and the struggles to control and reshape its interconnectivity, especially during the period between colonial-era obscuration and more recent revitalization of the Southern Silk Road. Rather than comprehensive or strictly chronological, this chapter focuses on three loosely defined historical periods: the colonial period from the mid-nineteenth to mid-twentieth century, the Cold War period from the mid-twentieth century to late 1980s, and the post-Cold War period from the late 1980s until the present day. We ground the distinct histories of these periods in discourses specific to their times and places, each with their own geographic conception of the Mekong region and particular combination of socioeconomic and geopolitical imperatives driving investment in large-scale infrastructure projects.
Western Alternative Development and Chinese Development
Authors: Kelly Ashley Scott , Lu Xiaoxuan
Published: September 2021

This chapter, Western alternative development and Chinese development, presents two strategic planning proposals that are generated from frictions between rural development as construed by western aid agencies and forms of Chinese aid, especially regarding the speed of development and their cache of neoliberal ideologies. These programs dominated northern Laos in the 1990s and 2000s and have resulted in a patchwork landscape of development assistance and foreign investment. One featured strategic planning proposal references these earlier programs in Laos’s Muang Sing valley to help guide a strategy for basin-scale agricultural pollution remediation and increased water security, while the other proposal traces the legacies of opium’s replacement, primarily via Chinese investment, with rubber in northern Laos and the how the resultant patchwork of rubber, subsistence and cash crops, and ethnic diversity might deal with increasing rural–urban migration and significant associated strain on the rural agricultural labor force. These proposals exhibit the difficult balancing act between participating in the language and valuation metrics of development but with design concepts and approaches that actively resist easy constitution or reduction. The emphasis of alternative development on livelihood security, environmental sustainability and social development may be commendable, but the building of social capital takes time.
Chinese Mass Nature Tourism and Ecotourism
Authors: Kelly Ashley Scott , Lu Xiaoxuan
Published: September 2021

This chapter features two planning proposals that engage the ideological and practical frictions between Chinese mass nature tourism and ecotourism. Employed by China’s southwestern frontier provinces as a development model since the early 2000s, mass nature tourism is driven by an economic ideology that appropriates an “impoverished” region and its population as resources. In recent years, the Chinese model of mass nature tourism has been introduced into northern Laos. These large-scale tourism programs may arguably prove economically viable but unavoidably raise ethical, cultural and environmental questions that call for urgent attention. Focusing on Boten and Luang Prabang, the two featured planning proposals challenge an economic-driven and object-based mass nature tourism model and investigate the possibility of a site-, culture-, and landscape-sensitive ecotourism approach. Both projects begin with an analysis of the spatial and temporal patterns of key landscape systems that are crucial for enabling the establishment of tourism programs and for sustaining local livelihoods and cultural practices that are indispensable assets of authentic cultural landscape experiences. Based on these analyses, both projects identify site-specific tourism development capacities, guiding the scale and speed of development to minimize conflict between local communities and tourism, while maximizing tourism-related ecological and social benefits.
Infrastructure, logistics and clinical practice management of acute trauma hemorrhage and coagulopathy: a survey across German trauma centers
Authors: Karl Vivien , Schäfer Nadine , Maegele Marc
Published: September 2021

Purpose

Early detection and management of acute trauma hemorrhage and coagulopathy have been associated with improved outcomes, but local infrastructure, logistics and clinical strategies may differ.

Methods

To assess local differences in infrastructure, logistics and clinical management of acute trauma hemorrhage and coagulopathy we have conducted a web-based survey amongst clinicians working in DGU®-certified supraregional, regional and local trauma centers.

Results

137/1875 respondents completed the questionnaire yielding a response rate of 7.3%. The majority specified to work as head of department or senior consultant (95%) in trauma/orthopedic surgery (80%) of supraregional (38%), regional (34%) or local (27%) trauma centers. Conventional coagulation assays are most frequently used to monitor bleeding trauma patients. Only half of the respondents (53%) rely on extended coagulation tests, e.g. viscoelastic hemostatic assays. Tests to assess preinjury use of direct oral anticoagulants and platelet inhibitors are still not widely available and vary according to level of care. Conventional blood products are widely available but there remain differences between trauma centers of different level of care to access other hemostatic therapies, e.g. coagulation factor concentrates. Trauma centers of higher level of care are more likely to implement treatment protocols.

Conclusion

This survey confirms still existing differences in infrastructure, logistics and clinical practice management for the detection of acute trauma hemorrhage and coagulopathy amongst DGU®-certified supraregional, regional and local trauma centers. Further work is recommended to locally implement diagnostics, therapies and treatment algorithms compliant to current guidelines to ensure the best possible outcomes in bleeding trauma patients.
Continuum sensitivity and design optimization of superconducting systems under critical current densities with magnetic field dependence
Authors: Seo Kyungsik , Coombs Tim , Park Il Han
Published: September 2021

This paper presents an approach for deriving the continuum sensitivity of superconducting systems operating at critical current densities and an optimization method based on the continuum sensitivity. In the sensitivity problem, the superconducting systems is represented by a variational state equation, wherein the magnetic permeability depends on the magnetic field, which is transformed from a state equation with a field-dependent source. The design sensitivity is derived using the material derivative concept of continuum mechanics and the adjoint variable method. The adjoint system has a material property represented as a symmetric tensor that contains the sensitivity of the current density with respect to the magnetic field. The design sensitivity is represented in the analytical form of a surface integral on the interface between the superconducting material and its surroundings, which depends on the sensitivity of the current density. The optimization scheme is constructed based on the continuum design sensitivity. In the design optimization, the level set method is used to express the shape variation of the superconducting materials. The numerical example of infinite solenoids demonstrates that the design sensitivity provides an accurate design solution considering the critical current condition. In addition, the design example of a magnetic resonance imaging solenoid shows that the derived design sensitivity has the inherent ability for attaining the compact design by treating the input current of a superconducting system as a critical condition.
Osteoarthritic and non-osteoarthritic patients show comparable coronal knee joint line orientations in a cross-sectional study based on 3D reconstructed CT images
Authors: Hess Silvan , Moser Lukas B. , Robertson Emma L. , Behrend Henrik , Amsler Felix , Iordache Edna , Leclercq Vincent , Hirschmann Michael T.
Published: September 2021

Purpose

Recently introduced total knee arthroplasty (TKA) alignment strategies aim to restore the pre-arthritic alignment of an individual patient. The native alignment of a patient can only be restored with detailed knowledge about the native and osteoarthritic alignment as well as differences between them. The first aim of this study was to assess the alignment of a large series of osteoarthritic (OA) knees and investigate whether femoral and tibial joint lines vary within patients with the same overall lower limb alignment. The secondary aim was to compare the alignment of OA patients to the previously published data of non-OA patients. This information could be useful for surgeons considering implementing one of the new alignment concepts.

Material

Coronal alignment parameters of 2692 knee OA patients were measured based on 3D reconstructed CT data using a validated planning software (Knee-PLAN®, Symbios, Yverdon les Bains, Switzerland). Based on these measurements, patients' coronal alignment was phenotyped according to the functional knee phenotype concept. These phenotypes represent an alignment variation of either the overall alignment, the femoral joint line orientation or the tibial joint line orientation. Each phenotype is defined by a specific mean and covers a range of ± 1.5° from this mean. Mean values and distribution among the phenotypes are presented and compared between two populations (OA patients of this study and non-OA patients of a previously published study) as well as between HKA subgroups (varus, valgus and neutral) using t tests and Chi-square tests (p < 0.05).

Results

Femoral and tibial joint lines varied within patients with the same overall lower limb alignment. A total of 162 functional knee phenotypes were found (119 males, 136 females and 94 mutual phenotypes). Mean values differed between the OA and non-OA population, but differences were small (< 2°) except for the overall alignment (e.g. HKA). The distribution of OA and non-OA patients among the phenotypes differed significantly, especially among the limb phenotypes.

Conclusion

Differences between OA and non-OA knees are small regarding coronal femoral and tibial joint line orientation. Femoral and tibial joint line orientation of osteoarthritic patients can, therefore, be used to estimate their native coronal alignment and plan an individualized knee alignment.

Level of clinical evidence

III.
Phytochemical analysis, antioxidant, antibacterial, and cytotoxic activities of leaves and roots of Rubus hyrcanus Juz.
Authors: Yousefbeyk Fatemeh , Ghasemi Saeed , Evazalipour Mehdi , Dabirian Sara , Schubert Clara , Hekmatnia Sanaz , Habibi Yasamin , Eghbali Koohi Diba , Böhm Volker
Published: September 2021

Rubus hyrcanusJuz. (Rosaceae), known as Caspian blackberry, is wildly distributed around the Caspian Sea. This study focused on antioxidant, cytotoxic, and antibacterial activities of total extracts and different fractions from the roots and leaves of this species. The total phenolics and flavonoid contents were also evaluated. Finally, the phenolic profiles of selected fractions were determined using HPLC–DAD and LC–MS/MS. The results indicated that the total phenolics content (TPC) of root total extract (RTE) was 3.5 times that of leaves (340.4 and 102.7 mg GAE/g, respectively). The TPC of three root fractions ranged from 226.6 to 392.9 mg GAE/g, while in leaves fractions, it ranged between 68.3 and 101.8 mg GAE/g. The total extract of leaves had higher contents of total flavonoids than roots (70.5 and 8.9 mg QE/g, respectively). The methanol fractions of both parts had the highest amounts of flavonoids. The root methanol fraction (RMF) had the best antioxidant effect in both DPPH radical scavenging assay (IC50: 9.16 μg ml−1) and total antioxidant capacity test (1010.5 mg ɑTE/g). The RMF and RTE had potent antibacterial activities againstBacillus subtilisandStaphylococcus aureus(MIC 1.5 mg ml−1). In the MTT assay, ethyl acetate fractions of roots and leaves exhibited the best cytotoxicity (IC50247 and 227 μg ml−1, respectively) and the highest selectivity indexes (4.73 and 5.31, respectively). Phytochemical analysis revealed the presence of gallic acid, p-coumaric acid, and chlorogenic acid in leaves ethyl acetate fraction, chlorogenic acid in leaves methanol fraction, and gallic acid in the root ethyl acetate fraction.
Two Types of Diurnal Variations in Heavy Rainfall during July over Korea
Authors: Park Chang-Kyun , Chang Minhee , Ho Chang-Hoi , Ha Kyung-Ja , Kim Jinwon , Sohn Byung-Ju
Published: September 2021

This study examined the characteristics of the diurnal variations of heavy rainfall (⩾110 mm in 12 hours) in Korea and the related atmospheric circulation for July from 1980–2020. During the analysis period, two dominant pattens of diurnal variation of the heavy rainfall emerged: all-day heavy rainfall (AD) and morning only heavy rainfall (MO) types. For the AD-type, the heavy rainfall is caused by abundant moisture content in conjunction with active convection in the morning (0000–1200, LST; LST = UTC + 9) and the afternoon hours (1200–2400 LST). These systems are related to the enhanced moisture inflow and upward motion induced by the strengthening of the western North Pacific subtropical high and upper-tropospheric jet. For the MO-type, heavy rainfall occurs mostly in the morning hours; the associated atmospheric patterns are similar to the climatology. We find that the atmospheric pattern related to severe heavy rainfalls in 2020 corresponds to a typical AD-type and resembles the 1991 heavy-rainfall system in its overall synoptic/mesoscale circulations. The present results imply that extremely heavy rainfall episodes in Korea during the 2020 summer may occur again in the future associated with the recurring atmospheric phenomenon related to the heavy rainfall.
Deswelling of microfibril bundles in drying wood studied by small-angle neutron scattering and molecular dynamics
Authors: Zitting Aleksi , Paajanen Antti , Rautkari Lauri , Penttilä Paavo A.
Published: September 2021

Structural changes of cellulose microfibrils and microfibril bundles in unmodified spruce cell wall due to drying in air were investigated using time-resolved small-angle neutron scattering (SANS). The scattering analysis was supported with dynamic vapor sorption (DVS) measurements to quantify the macroscopic drying kinetics. Molecular dynamics (MD) simulations were carried out to aid in understanding the molecular-level wood-water interactions during drying. Both SANS experiments and simulations support the notion that individual cellulose microfibrils remain relatively unaffected by drying. There is, however, a significant decrease in fibril-to-fibril distances in microfibril bundles. Both scattering and DVS experiments showed two distinct drying regions: constant-rate drying and falling-rate drying. This was also supported by the MD simulation results. The shrinking of the fibril bundles starts at the boundary of these two regions, which is accompanied by a strong decrease in the diffusivity of water in between the microfibrils.

Graphic abstract
The Long and the Short of It: A Comparison of the Effectiveness of Parent–Child Care (PC–CARE) and Parent–Child Interaction Therapy (PCIT)
Authors: Timmer Susan G. , Hawk Brandi , Usacheva Maria , Armendariz Lindsay , Boys Deanna K. , Urquiza Anthony J.
Published: September 2021

Research shows that parenting interventions struggle with keeping clients in treatment. The purpose of this study was to compare attrition and rates of improvement in caregiver-child dyads participating in either Parent–Child Care (PC–CARE), a brief, 7-session parenting intervention or Parent–Child Interaction Therapy (PCIT) over a 7–week period. Participants were 204 caregiver-child dyads referred to either PC-CARE (N = 69) or PCIT (N = 135) between 2016 and 2019. Children were aged 2–7 years, referred for treatment by county Behavioral Health Services, and Medicaid funded. Findings showed that PC–CARE participants were 2.5 times more likely than PCIT participants to complete 7 sessions, all other things being equal, and showed significantly greater rates of improvement during this timeframe in reported child behavior problems and parenting stress. In conclusion, compared with PCIT, PC–CARE showed greater retention and rate of improvement in child and parent outcomes over a comparable time period.
Development of PBPK model for intra-articular injection in human: methotrexate solution and rheumatoid arthritis case study
Authors: Le Merdy Maxime , Mullin Jim , Lukacova Viera
Published: September 2021

A physiologically based model describing the dissolution, diffusion, and transfer of drug from the intra-articular (IA) space to the plasma, was developed for GastroPlus® v9.8. The model is subdivided into compartments representing the synovial fluid, synovium, and cartilage. The synovium is broken up into two sublayers. The intimal layer acts as a diffusion barrier between the synovial fluid and the subintimal layer. The subintimal layer of the synovium has fenestrated capillaries that allow the free drug to be transported into systemic circulation. The articular cartilage is broken up into 10 diffusion sublayers as it is much thicker than the synovium. The cartilage acts as a depot tissue for the drug to diffuse into from synovial fluid. At later times, the drug will diffuse from the cartilage back into synovial fluid once a portion of the dose enters systemic circulation. In this study, a listing of all relevant details and equations for the model is presented. Methotrexate was chosen as a case study to show the application and utility of the model, based on the availability of intravenous (IV), oral (PO) and IA administration data in patients presenting rheumatoid arthritis (RA) symptoms. Systemic disposition of methotrexate in RA patients was described by compartmental pharmacokinetic (PK) model with PK parameters extracted using the PKPlus™ module in GastroPlus®. The systemic PK parameters were validated by simulating PO administration of methotrexate before being used for simulation of IA administration. For methotrexate, the concentrations of drug in the synovial fluid and plasma were well described after adjustments of physiological parameters to account for RA disease state, and with certain assumptions about binding and diffusion. The results indicate that the model can correctly describe PK profiles resulting from administration in the IA space, however, additional cases studies will be required to evaluate ability of the model to scale between species and/or doses.
Linking Human And Machine Behavior: A New Approach to Evaluate Training Data Quality for Beneficial Machine Learning
Authors: Hagendorff Thilo
Published: September 2021

Machine behavior that is based on learning algorithms can be significantly influenced by the exposure to data of different qualities. Up to now, those qualities are solely measured in technical terms, but not in ethical ones, despite the significant role of training and annotation data in supervised machine learning. This is the first study to fill this gap by describing new dimensions of data quality for supervised machine learning applications. Based on the rationale that different social and psychological backgrounds of individuals correlate in practice with different modes of human–computer-interaction, the paper describes from an ethical perspective how varying qualities of behavioral data that individuals leave behind while using digital technologies have socially relevant ramification for the development of machine learning applications. The specific objective of this study is to describe how training data can be selected according to ethical assessments of the behavior it originates from, establishing an innovative filter regime to transition from the big data rationalen = allto a more selective way of processing data for training sets in machine learning. The overarching aim of this research is to promote methods for achieving beneficial machine learning applications that could be widely useful for industry as well as academia.
On the meaning of EPR’s Reality Criterion
Authors: Gömöri Márton , Hofer-Szabó Gábor
Published: September 2021

This essay has two main claims about EPR’s Reality Criterion. First, we claim that the application of the Reality Criterion makes an essential difference between the EPR argument and Einstein’s later arguments against quantum mechanics. We show that while the EPR argument, making use of the Reality Criterion, does derive that certain interpretations of quantum mechanics are incomplete, Einstein’s later arguments, making no use of the Reality Criterion, do not prove incompleteness, but rather point to the inadequacy of the Copenhagen interpretation. We take this fact as an indication that the Reality Criterion is a crucial, indispensable component of the incompleteness argument(s). The second claim is more substantive. We argue that the Reality Criterion is a special case of the Common Cause Principle. Finally, we relate this proposal to Tim Maudlin’s recent assertion that the Reality Criterion is an analytic truth.
Surgical reconstruction of small and medium rotator cuff tears shows superior long-term results
Authors: Wirth Barbara , Weinhold Leonie , Müller-Rath Ralf
Published: September 2021

Background

Degenerative rotator cuff tears are common in elderly patients. However, the treatment strategies remain controversial. While physiotherapy can lead to pain relief and improved shoulder function, spontaneous tendon healing will not take place and, thus, non-operative management bears the risk of tear progression. Surgical management is the only way to restore the tendon-to-bone interface in spite of a considerable number of retears.

Methods

The present study reviewed the data provided by randomized controlled trials (RCTs) that have compared physiotherapy with surgical rotator cuff repair. Systematic reviews of this kind have been published before; however, this paper re-analyzes the data, given that Moosmayer et al. recently published an RCT with 10-year follow-up. Such long-term data are comparatively rare in the field of musculoskeletal surgery and therefore a reconsideration of treatment recommendations seems necessary.

Results

The results show a mean difference in the Constant and Murley score of 6.2 points (95% confidence interval, 2.6; 9.7,P < 0.001) in favor of the surgical groups. The visual analog scale pain score also improved more in the operatively treated patients with a mean difference of −1.4 (95% confidence interval −2.1; −0.8,P < 0.001).

Conclusion

In summary, this review shows superior clinical results for surgical repair of small- to medium-sized degenerative rotator cuff tears especially in the long term compared to physiotherapy.