bluuebunny/crossref_metadata_2025 huggingface dataset:
Long-Term Health Outcomes of Limb Salvage Compared with Amputation for Combat-Related Trauma
Authors: Tropf Jordan G. , Hoyt Benjamin W. , Walsh Sarah A. , Gibson Jeffery A. , Polfer Elizabeth M. , Souza Jason M. , Potter Benjamin K.
Published: September 2023

Background:

There are little long-term health data, particularly in terms of body composition and development of metabolic syndromes, to help surgeons to guide the decision between limb salvage and amputation in patients with limb-threatening trauma. The purpose of this study was to compare long-term health outcomes after high-energy lower-extremity trauma between patients who underwent attempted flap-based limb salvage or amputation.

Methods:

We performed a retrospective review of servicemembers with a minimum 10-year follow-up who underwent flap-based limb salvage followed by unilateral amputation or continued limb salvage after combat-related, lower-extremity trauma between 2005 and 2011. Patient demographic characteristics, injury characteristics, and health outcomes including body mass index (BMI) and development of metabolic disease (e.g., hyperlipidemia, hypertension, heart disease, and diabetes) were compared between treatment cohorts. Adjusted BMIs were calculated for the amputation cohort to account for lost surface area. We performed multivariable and propensity score analysis to determine the likelihood of developing obesity or metabolic disease.

Results:

In this study, 110 patients had available long-term follow-up (mean, 12.2 years) from the time of the injury. Fifty-six patients underwent limb salvage and 54 patients underwent unilateral amputation. There was no difference in preinjury BMI (p = 0.30). After adjusting for limb loss, the amputation cohort had a trend toward higher BMIs at ≥1 years after the injury, a higher rate of obesity, and a greater increase in BMI from baseline after the injury. The development of metabolic comorbidities was common after both amputation (23 [43%] of 54) and limb salvage (27 [48%] of 56). With the numbers available, we were unable to demonstrate a difference in risk for the development of hypertension, hyperlipidemia, diabetes, heart disease, or any comorbidity other than obesity (p > 0.05).

Conclusions:

Amputations may be medically necessary and may decrease pain, improve mobility, and/or expedite return to activity compared with limb salvage after similar injuries. However, limb loss may negatively impact metabolic regulation and may contribute to a higher risk of obesity despite beneficial effects on mobility.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
A Comparison of the Periprosthetic Fracture Rate of Unicompartmental and Total Knee Replacements
Authors: Mohammad Hasan R. , Barker Karen , Judge Andrew , Murray David W.
Published: September 2023

Background:

Periprosthetic fractures are rare but devastating complications of knee replacement, often requiring complex surgery with substantial morbidity and mortality. It is not known how the fracture rates after total knee replacement (TKR) and unicompartmental knee replacement (UKR) compare. We performed the first matched study comparing TKR and UKR periprosthetic fracture rates.

Methods:

This study involved 54,215 UKRs and 54,215 TKRs, identified in the National Joint Registry and Hospital Episodes Statistics database, which were propensity score-matched on patient and surgical factors. The International Classification of Diseases, Tenth Revision, (ICD-10) code M96.6 was used to identify periprosthetic fractures at ≤3 and >3 months postoperatively, as well as estimate rates at up to 10 years. Subgroup analyses were performed in different age groups (<55, 55 to 64, 65 to 74, and ≥75 years), body mass index (BMI) categories (normal, 18.5 to <25 kg/m2; overweight, 25 to <30 kg/m2; obese, 30 to <40 kg/m2; and morbidly obese, ≥40 kg/m2), and sexes.

Results:

The 3-month fracture rate was 0.09% (n = 50) in the UKR group and 0.05% (n = 25) in the TKR group, with this difference being significant (odds ratio [OR], 2.0; p = 0.004). The rate of fractures occurring at >3 months was 0.32% (n = 171) in the UKR group and 0.61% (n = 329) in the TKR group (OR, 0.51; p < 0.001). At 10 years, the cumulative incidence of fractures was 0.6% after UKR versus 1% after TKR (OR, 0.68; p < 0.001). Fracture rates increased with increasing age, decreasing BMI, and female sex for both UKRs and TKRs.

Conclusions:

The fracture risk was small after both UKR and TKR, with small absolute differences between implant types. During the first 3 postoperative months, the fracture rate after UKR was 0.1% and was about twice as high as that after TKR. However, over the first 10 years, the cumulative fracture rate after TKR was 1% and was almost twice as high as that after UKR. Fracture rates after both UKR and TKR were higher in women, patients ≥75 years of age, and patients with normal weight.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Robotic-Assisted Conversion of a Failed Medial Unicompartmental Knee Arthroplasty to Total Knee Arthroplasty
Authors: Pasqualini Ignacio , Deren Matthew E. , Rullán Pedro J. , Higuera Carlos A. , Molloy Robert M. , Piuzzi Nicolas S.
Published: September 2023

Case:

An 81-year-old man with a history of left medial unicompartmental knee arthroplasty (mUKA) 8 years prior presented to the outpatient clinic with gradually increasing medial left knee pain of 6 years of duration. He underwent left conversion robotic-assisted total knee arthroplasty (RA TKA). At 1-year follow-up, the patient reported satisfactory clinical outcomes and excellent component alignment on x-rays.

Conclusion:

This case highlights using RA TKA for failed mUKA as a viable and promising conversion arthroplasty alternative technique that may improve surgical outcomes by enhancing implant alignment and positioning, protecting the soft tissues, and preserving bone stock.
Hip Abductor Reconstruction with the Use of Mesh and Distal Cerclage Cable Fixation
Authors: Piuzzi Nicolas S. , Deren Matthew E. , Green Adam , Emara Ahmed K. , Pasqualini Ignacio , Surace Peter , McLaughlin John P. , Murray Trevor G. , Bloomfield Michael R. , Krebs Viktor E. , Molloy Robert M.
Published: September 2023

Case:

This is a case of a 71-year-old female patient with recurrent instability and complex hip abductor deficiency after total hip arthroplasty (THA) who was treated successfully with an abductor reconstruction with gluteal transfer with mesh reconstruction. The patient returned to nonassisted ambulation with no further THA dislocations at the 1-year follow-up.

Conclusion:

Abductor deficiencies after THA are complex and have a high potential for long-term disability if not properly diagnosed and treated. A modified gluteal transfer with mesh reconstruction and distal fixation with cerclage cable allowed for sustained restoration of functional hip abduction and stability after revision THA.
Pandemia e desafios metodológicos
Authors: Matthes Daniela , Spiess Maiko , Mattedi Marcos
Published: September 2023

Este artigo apresenta como se deu planejamento, execução e análise dos dados oriundos de um grupo focal online assíncrono via WhatsApp utilizado em uma tese alocada no campo do Desenvolvimento Regional. O referido grupo aconteceu em 2022, período da pandemia de Covid-19. A temática abordada junto aos informantes foi a alimentação tradicional da comunidade da qual são pertencentes. Buscou-se evidências da presença, entre eles, de derivados do Streuselkuchen — uma comida tradicional entre os descendentes de imigrantes germânicos no Brasil. Enquanto ferramenta para obtenção de dados primários, os grupos focais são usuais nas Ciências Sociais. Apesar disso, a forma online e assíncrona dessa técnica ainda é pouco utilizada em geral, tampouco no Desenvolvimento Regional. O grupo foi formado por moradores de Domingos Martins, cidade do estado de Espírito Santo. Foi possível compreender como se dá a dinâmica alimentar entre os informantes, bem como analisar as vantagens e fragilidades desse tipo de ferramenta. Concluiu-se que há presença de ao menos um alimento derivado do Streuselkuchen em seus hábitos alimentares — o Simftbroud. Quanto à prática desse tipo de método, observou-se vantagens, como a possibilidade de distância geográfica entre os participantes. No entanto, o acesso a smartphones e a habilidade no uso desse tipo de tecnologia podem ser entraves importantes. Desta forma, este artigo intenta contribuir na difusão dos grupos focais online assíncronos como ferramenta de pesquisa.
Sarcopenia emerges as a risk factor for cardiac diastolic dysfunction: a new era to focus
Authors: Erdoğan Onur , Erdoğan Tuğba , Cebeci Cemre Tekin , Ataç Hediye , Karan Mehmet , Bahat Gulistan
Published: September 2023

Objectives Cardiac diastolic dysfunction (left ventricular diastolic dysfunction, LVDD) is a well-known predictor of heart failure. We hypothesized that sarcopenia is independently associated with diastolic dysfunction. We aimed to investigate the association of the most recent consensus, definition of sarcopenia with LVDD.Methods We included 121 older participants that admitted to cardiology outpatient clinic. We followed the European Working Group on Sarcopenia in Older People (EWGSOP2) definition of confirmed sarcopenia (presence of low muscle mass + low muscle strength). We estimated skeletal muscle mass with bio-impedance analysis, muscle strength by handgrip strength via Jamar hydraulic hand dynamometer. Skeletal muscle mass was adjusted by body mass index. LVDD was determined by echocardiographic parameters measured per American Society of Echocardiography recommendations. We ran multivariate logistic regression analyses adjusted for well known risk factors of diastolic dysfunction (i.e., age, sex, obesity, smoking, diabetes mellitus, hypertension and ischemic heart disease) to detect if sarcopenia was independently associated with diastolic dysfunction. We gave results in odds ratio(OR) and 95% confidence interval(CI).Results Mean age was 69.9 + 5.8 years; 38.8% was male. Confirmed sarcopenia was detected in 34.7%, diastolic dysfunction in 19.8%. In univariate analyses, S was associated with diastolic dysfunction (OR = 6.7 95%CI:2.4–18.9). Regression analyses showed that two parameters, i.e. sarcopenia (OR = 7.4 95%CI:2.1–26.6, p = 0.002) and obesity (OR:5.0, 95%CI:1.03–24.6, p:0.046) were associated with diastolic dysfunction.Conclusion This study revealed sarcopenia as a new risk factor for the presence of diastolic dysfunction, adding on to its known risk factors. Future longitudinal studies are needed to clarify the factors underlying their co-presence.
The Effects of COVID-19 Restrictions on Portuguese Small-Scale Fisheries: A Regional Analysis
Authors: Zejnilovic Leid , Lavado Susana , Grilo Catarina , Sa Rita , Faias Sergio
Published: September 2023

There is growing evidence of the differential effects the COVID-19 pandemic had on small-scale fisheries across the world, with predominantly decreased landings during the time of restrictions and substantial negative socio-economic impact. We contribute to this evidence with an analysis of a comprehensive dataset of 5 million first sales of seafood transactions by 3,715 small-scale fishers catching 351 species in Portugal from 2017 to the end of 2020. The analysis shows that the patterns observed in other counties, overall, apply to Portugal, with a decline in reported catch and number of fishers during the lockdown. However, there were notable regional differences. Most interestingly, two regions with historically very high tourism activity recorded a statistically significant increase in reported average daily catch volume per fishing operator during the lockdown, often for high-value species. We discuss these regional differences and potential explanations, as well as their policy implications.
Ultra-processed foods consumption is positively associated with the clinical activity of inflammatory bowel diseases
Authors: Sarbagili-Shabat Chen , Sagi Shira Zelber , Isakov Naomi Fliss , Hirsch Ayal , Ron Yulia , Grinsphan Laura , Anbar Ronit , Bromberg Ahuva , Thurm Tamar , Maharshak Nitsan
Published: September 2023

Background
Western diet pattern and its food components have been suggested to impact inflammatory bowel diseases (IBD) clinical course. However, the importance of food processing level is uncertain. We aimed to evaluate whether the intake of foods with varying processing levels is associated with disease activity in IBD patients.
Methods
This cross-sectional study was performed at a tertiary center between August 2019 to June 2022. Consecutive adult IBD patients were recruited. Clinical disease activity was defined using HBI (Crohn's disease) and SCCAI (ulcerative colitis). Dietary intake was assessed using a food frequency questionnaire (FFQ) and a dedicated validated processed food questionnaire (PFQ) that categorizes dietary intake into three groups of processed food levels: unprocessed/minimally processed, processed, and ultra-processed. Adjusted odds ratios for active disease were determined using a multivariable logistic regression.
Results
A total of 242 IBD patients (62.8% Crohn’s disease patients) were enrolled, of whom 73.1% were in clinical remission. A higher (upper tertile vs. lowest tertile) unprocessed/minimally processed foods consumption was negatively associated with active disease (OR = 0.31, 95%CI 0.12–0.80), while high consumption of ultra-processed foods (UPFs) was positively associated with clinically active disease (OR = 4.43, 95%CI 1.77–11.05). Consumption of UPF groups, almost invariably, were positively associated with clinically active disease, while consumption of the ultra-processed meats group, had the strongest association (OR = 5.59, 95%CI 2.63–11.86).
Conclusion
Higher consumption of UPFs is positively associated with clinically active IBD, while higher consumption of unprocessed/minimally processed foods may be protective. Prospective studies are needed to confirm these associations.
Perspectives of physicians treating lung cancer patients on the clinical use of outcomes: A qualitative study
Authors: Abejas Abel García , Gomes João Marques , Makówka Martyna , Canelas Daniel , Andrade Maria Eduarda , Sobral Maria Ana , Costa Fábio Leite , Vergès Àngels Salvador
Published: September 2023

Background
Using patient-reported outcome measures (PROMs) in scales can help personalise patient care pathways, including the frequency and type of clinical review (face-to-face visits, phone calls, or video calls). We aimed to elucidate the perception of the outcomes of physicians who treat lung cancer patients and the impact they have on their quality of life through questionnaires, and to establish relationships (related to the patient, the social and family environment, and the diagnosis and treatment), in addition to relating them to multidimensional aspects of the patient’s experience. Additionally, we also identified barriers and facilitators to using the outcome measures.
Methods
We conducted 16 semi-structured interviews via videoconferencing. The interviews focused on collecting expert opinions on physicians’ perceptions of their patient’s outcomes and the most relevant risk variables. A qualitative thematic analysis was performed.
Results
Three primary groups were identified in the interview analysis: patient-related, social and family environment, and diagnosis and treatment. No direct relationship was discovered between the perception of outcomes by physicians and experiences of patients and caregivers.
Conclusions
PROMs need to be implemented in the daily routine of clinical care because physicians generally focus on clinical outcomes rather than patient-centred outcomes, their experiences, and needs. The digitisation of PROMs can facilitate their use. We conclude that barriers and facilitators are a form of methodological division because, in reality, what we perceive as barriers can also be facilitators, depending on several factors, such as health literacy, digital literacy, and socioeconomic level. The use of PROMs is relevant, provided there is feedback, and the outcomes are subsequently managed with the patient. Digitalising PROMs (ePROMs) and videoconferencing or telemedicine could improve these situations. However, this type of digital instrument cannot address some dimensions that measure the need for a different approach, such as spiritual care for end-of-life patients. Thus, physicians can focus their attention on each patient.
Only Eye Study 5 (OnES 5): A Quantitative Study of Patient Experiences of Undergoing Surgery
Authors: Lee Graham , Ngo Eagle , Girgis Shenouda , Jones Lee , Shah Peter
Published: September 2023

Background/Objectives:
“Only Eye Surgery” can be a stressful experience for both surgeons and patients. Our study aimed to quantitatively explore the patient experience of having eye surgery on their remaining seeing eye.
Subjects/Methods:
A retrospective cohort study comparing monocular and binocular patients recruited from clinics in Brisbane, Australia. 107 patients (43 monocular, 64 binocular) completed a 12-item questionnaire regarding their experience.
Results
Multiple linear regression analysis identified that preoperative anxiety is greater in only eye surgery, (β=-13.99, 95%CI=-25.73 to -2.26, p < 0.05) and there were more worries about losing vision from surgery (β=-18.40, 95%CI=-32.31to -4.49, p < 0.05). The perceived level of support after surgery in binocular patients is influenced by their level of support from family or friends to discuss prior to surgery (r = 0.72), whereas in monocular patients, such level of support is influenced by patients’ level of trust in the surgeon (r = 0.50) and anaesthetist (r = 0.73).
Conclusions
Clinicians can provide support by acknowledging their patients’ anxieties related to loss of vision and its potential impact on lifestyle. By addressing these issues and providing the opportunity to discuss other aspects of the surgery preoperatively, further trust in the surgeon can be achieved. Postoperatively, the patient will feel more supported and enhance the recovery journey. In the advent of adverse outcome, the surgeon who has gained that higher level of trust, the patient will be more likely to feel reassured that everything was performed to the highest possible standard and more likely to accept the resulting level of vision.
The early fossil record of Caturoidea (Halecomorphi: Amiiformes): biogeographic implications
Authors: López-Arbarello Adriana , Concheyro Andrea , Palma Ricardo M , Aguirre-Urreta Beatriz
Published: September 2023

Caturoidea is a clade of Mesozoic predatory ray-finned fishes which lived mainly in the Jurassic. The clade has a few records in the earliest Cretaceous and only two in the Triassic. Among the latter, specimen MPCA 632 Caturus sp. doubtfully from continental Early Triassic of Argentina, i.e. outside Europe, was particularly problematic in the light of the known fossil record of the group, which suggested their origin in the Western Tethys. The micropaleontological and geochemical analysis of bulk-rock samples of MPCA 632 allowed us to correct the provenance of the specimen which corresponds to Tithonian marine outcrops of the Vaca Muerta Formation, Neuquén, Argentina. Specimen MPCA 632 is excluded from Caturus and reclassified as Caturoidea sp. MPCA 632 might be a specimen of Catutoichthys olsacheri, the only caturoid known from the Vaca Muerta Formation (Los Catutos Member), but the fossils are not comparable and, thus, this hypothesis needs further study. Additionally, the first-hand study of the type material of the only other alleged Triassic caturoid, “Caturus” insignis, in the Norian of Seefeld, Austria, led to the exclusion of this taxon from the Caturoidea. Consequently, the clade Caturoidea is restricted to the Jurassic–Lowest Cretaceous. After a modest evolution during the Early Jurassic, the group had its initial radiation and westward dispersion across the Hispanic Corridor during the Middle Jurassic and reached its maximal diversity during the Kimmeridgian and Tithonian.
Using Normalisation Process Theory to understand the likely success of implementing a short educational film within routine antenatal care to reduce the risk of cytomegalovirus infection in pregnancy: An exploratory qualitative study
Authors: Vandrevala Tushna , Montague Amy , Boulton Richard , Coxon Kirstie , Jones Christine. E
Published: September 2023

Background: Congenital cytomegalovirus (CMV) infection is a leading cause of sensorineural hearing loss and neuro-disability in childhood. In the absence of a licensed vaccine, adoption of hygiene-based measures may reduce the risk of CMV infection in pregnancy, however these measures are not routinely discussed with pregnant women as part of National Health Service (NHS) antenatal care in the United Kingdom (UK).
Methods: An exploratory qualitative study was conducted, underpinned by Normalization Process Theory (NPT), to investigate how an educational intervention comprising of a short film about CMV may best be implemented, sustained, and enhanced in real-world routine antenatal care settings. Video, semi-structured interviews were conducted with participants who were recruited using a purposive sample that comprised of midwives providing antenatal care from three NHS hospitals (n=15) and participants from professional colleges and from organisations or charities providing, or with an interest in, antenatal education or health information in the UK (n=15).
Findings: Midwives were reluctant to include CMV as part of early pregnancy discussions about reducing the risk of other infections due to lack of time, knowledge and absence of guidance or policies relating to CMV in antenatal education. However, the educational intervention was perceived to be a useful tool to encourage conversations and empower women to manage risk by all stakeholders, which would overcome some identified barriers. Macro-level challenges such as screening policies and lack of official guidelines to legitimise dissemination were identified.
Discussion: Successful implementation of education about CMV as part of routine NHS care in the UK will require an increase in awareness and knowledge about CMV amongst midwives. NPT revealed that ‘coherence’ and ‘cognitive participation’ between service members are vital to imbed CMV education in routine practice. ‘Collective action’ in and ‘reflexive monitoring’ is required to sustain service changes.
Novel chemical structure discovery named glucosodiene Polymer as an isomer of alkaline glucose compound resulting from the reaction between dextrose and sodium bicarbonate.
Authors: Akl Maher Monir. , Ahmed Amr
Published: September 2023

This research manuscript describes the preparation of a new compound, glucosodiene isomer of alkaline glucose as a Polymer, through the reaction between dextrose and sodium bicarbonate. The resulting Polymer compound, 1-2-O-β-D-Glucopyranosyl-α-D-glucose, was characterized using NMR and LC-MS analysis. This manuscript also presents evidence supporting the formation of this Polymer compound, and its similarity to glucose.
Sex differences in the prevalence and associated factors of cognitive frailty among community dwelling older persons of lower socioeconomic status
Authors: Murukesu Resshaya Roobini , Shahar Suzana , Subramaniam Ponnusamy , Rasdi Hanif Farhan Mohd , Singh Devinder Kaur Ajit
Published: September 2023

Background: Older persons from lower socioeconomic background are more vulnerable to poor health outcomes including susceptibility to higher severity of frailty and cognitive impairment in later life. Hence, the aim of this study was to determine the prevalence of CF and its associated factors among community dwelling older persons of lower socioeconomic status and stratified by sex.
Methods: 255 community dwelling older persons aged 60 years and above (68.58±5.67 years) of lower socioeconomic status participated in this study. CF was operationalized using the Fried’s Frailty Phenotype and Clinical Dementia Rating Scale. Data collected included socio-demographic information, health status, cognitive function, physical and functional status, nutritional status, psychosocial status, and health related quality of life (HRQoL). Prevalence of CF was analyzed descriptively, and associated factors of CF was assessed using hierarchical binary logistic regression (BLR) among total participants and by sex.
Results: Prevalence of CF in this study was 38.4% in total; 41.1% for females and 30.2% for males. The associated factors of cognitive frailty were poorer immediate recall verbal memory (0.816; 95% CI: 0.714, 0.932; p=0.003), poorer attention and working memory (0.722, 95% CI: 0.615, 0.849; p<0.001), poorer functional ability (0.673, 95% CI: 0.477, 0.950; p=0.024) and poorer HRQoL domain of usual activities (1.165; 95% CI: 0.609, 2.227; p=0.025). When stratified by sex, significant factors of CF for males were poorer immediate recall verbal memory (0.719, 95% CI: 0.555, 0.931; p=0.012) and poorer attention, and working memory (1.274, 95% CI: 0.536, 0.980; p=0.036), and for females were lower years of education (0.869, 95% CI: 0.792, 1.011; p=0.017), poorer attention and working memory (0.699, 95% CI: 0.580, 0.844; p<0.001) and HRQoL domain of ‘mental function’ (1.091, 95% CI: 0.916, 1.299; p=0.007).
Conclusion: CF is prevalent among older persons of lower socioeconomic status. Poor verbal memory, attention and working memory, poorer performance of functional and usual activities was identified as associated factors of CF. Although there are some differences in associated factors of CF based on sex, interventions addressing physical and cognitive domains may have the potential for reversal or prevention of CF within the socioeconomically disadvantaged population.
Microplastic Contamination of Packaged Spirulina Products
Authors: Tutaroğlu Serkan , Uslu Leyla , Gündoğdu Sedat
Published: September 2023

Microplastic (MP) contamination in commercially sold Spirulina products has not been previously investigated. In this study, 29 Spirulinasamples in various packaging types were purchased from different brands and origins to assess the presence of MPs. Microplastic analysis was conducted using microscopic and μ-Raman techniques. A total of 251 MP-like particles were observed, with 48 particles subjected to μ-Raman analysis. Out of the 29 examined packaged Spirulina brands, 26 showed potential MPs upon visual inspection, with 35 particles confirmed as MPs (73% of the analyzed particles). The mean abundance of MPs was estimated at 13.77 ± 2.45 MPs/100 g. Powdered Spirulinahad a higher MP abundance (17.34 ± 4.22 MPs/100 g) compared to capsule/tablet forms (10.43 ± 2.45 MPs/100 g). Fragments accounted for 38.3% while fibers constituted 61.7% of the identified MPs, with sizes ranging from 0.07 to 2.15 mm for fragments and 0.19 to 5.691 mm for fibers. The color distribution of MPs in Spirulina samples was predominantly blue (52.8%), followed by black (25.4%), white (10.9%), and others (10.9%). Ten synthetic polymers and cellulose were identified through micro Raman analysis, with polypropylene (31.6%) and polystyrene (8.3%) being the most prevalent. The abundance and composition of MPs were found to be influenced by packaging and processing stages. Identifying potential sources of MPs in Spirulina products and evaluating their risks to human health is crucial.
Impact of the COVID-19 pandemic on the self-care and health condition of the elderly. CUIDAMOS+75. A mixed methods study protocol.
Authors: RICO-BLÁZQUEZ Milagros , ESTEBAN-SEPÚLVEDA Silvia , SÁNCHEZ-RUANO Raquel , ARITZTEGUI-ECHENIQUE Ana María , ARTIGUES-BARBERA Eva María , BRITO-BRITO Pedro Ruymán , CASADO-RAMIREZ  , CIDONCHA-MORENO María Ángeles , FABREGAT-JULVE María Inmaculada , FERIA-RAPOSO Isabel , HERNANDEZ-PASCUAL Montserrat , LOZANO-HERNÁNDEZ Cristina , MORENO-CASBAS María Teresa , OTONES-REYES Pedro , PALMAR-SANTOS Ana María , PEDRAZ-MARCOS Azucena , ROMERO-RODRIGUEZ Esperanza Maria , SOLÉ-AGUSTÍ Maria Cristina , TALTAVULL-APARICIO Joana María , VIDAL-THOMAS María Clara , GONZALEZ-CHORDA Víctor Manuel ,   CUIDAMOS+75 Group CUIDAMOS+75 Group
Published: September 2023

Aims: To assess the impact of the COVID-19 pandemic on the health condition of people ≥75 years of age and on their family caregivers in Spain.
Design: Multicentric, mixed method concurrent study.
Methods: This work, which will be conducted within the primary care setting in 11 administrative regions of Spain, will include three coordinated studies with different methodologies. The first is a population-based cohort study that will use real-life data to analyze the rates and evolution of health needs, care provision, and services utilization before, during, and after the pandemic. The second is a prospective cohort study with eighteen months of follow-up that will evaluate the impact of COVID-19 disease on mortality, frailty, functional and cognitive capacity, and quality of life of the participants. Finally, the third will be a qualitative study with a critical social approach to understand and interpret the social, political, and economic dimensions associated with the use of health services during the pandemic. We have followed the SPIRIT Checklist to address trial protocol and related documents. This research is being funded by the Instituto de Salud Carlos III since 2021 and was approved by its ethics committee (June 2022).
Discussion: The study findings will reveal the long-term impact of the COVID-19 pandemic on the elderly and their caregivers. This information will serve policymakers to adapt health policies to the needs of this population in situations of maximum stress, such as that produced by the COVID-19 pandemic.
Trial registration: Trial registration: Clinicaltrials.gov Identifier: NCT05249868. [https://ClinicalTrials.gov]. Final version (22 February, 2021).
Metamaterial-Based Passive Analog Processor for Wireless Vibration Sensing
Authors: Ma Chu , Zhang Dajun , Polamarasetty Akhil , Shahid Muhammad , Krishnaswamy Bhuvana
Published: September 2023

Real-time, low-cost, and wireless mechanical vibration monitoring is necessary for industrial applications to track the operation status of equipment, environmental applications to proactively predict natural disasters, as well as day-to-day applications such as vital sign monitoring. Despite this urgent need, existing solutions, such as laser vibrometers, commercial Wi-Fi devices, and cameras, lack wide practical deployment due to their limited sensitivity and functionality. In this work, we propose and verify that a fully passive, metamaterial-based vibration processing device attached to the vibrating surface can improve the sensitivity of wireless vibration measurement methods by more than 10 times at designated frequencies. Additionally, the device realizes an analog real-time vibration filtering/labeling effect, and the device also provides a platform for surface editing, which adds more functionalities to the current non-contact sensing systems. Finally, the working frequency of the device is widely adjustable over orders of magnitudes, broadening its applicability to different applications.
Environmental Sustainability: The Attitudes and Experiences of UK Students in the Oral Health Profession
Authors: Durnall Olivia , Durnall Olivia , Mulligan Steven , Dixon Jonathan , Martin Nicolas
Published: September 2023

Objective: This study aims to provide further clarity and detail into the students’ attitudes and review towards Environmental Sustainability in Dentistry (ESD) in the provision of oral healthcare. Also, the manner and extent in which ESD is included in the current undergraduate Oral Healthcare Professional curricula. This study focuses on the perspective of undergraduate dental students [Bachelor of Dental Surgery (BDS)] and dental hygiene and therapy students [Dental Hygiene and Dental Therapy (DH&DT)] from UK dental schools, as a national representative case study.
Methods: A multi-centre study, cross sectional online survey of undergraduate BDS and DH&DT students in UK based dental schools. Data analysis was conducted through descriptive statistics and thematic analysis.
Results: 263 students from thirteen UK schools completed the survey, resulting in a national school response rate of 68.4%, showing a strong representation of this student population across the UK. Key findings are: 97.3% of students believe that the dental profession should be more actively engaged in environmental sustainability, however students currently having very little exposure to ESD at an undergraduate level. 76.8% of students expressed that they are concerned about the impact that oral healthcare provision has on the environment, but only 23% of students have independently researched ESD. 46.4% believe that ‘The provision of oral healthcare is my priority as a clinician and this has unavoidable environmental consequences that we need accept’. Students were clearly concerned about the impact of the addition of ESD into the curricula would have on their studies and progression. There is very little student-reported inclusion of ESD in the school curricula. Notwithstanding, students identified the importance of ESD in the profession and the need for this to be included in their curricula, but were very apprehensive of the effect that this may have on their already congested course.
Conclusions: Students identify that our oral healthcare professions should become more engaged in efforts to mitigate the negative impacts from our activities on the environment. The main way this can be achieved is through education at all levels. The strong insight into student’s level of awareness and concerns for the impact of oral healthcare provision on the environment is a powerful driver for the inclusion of ESD into the undergraduate curriculum in UK based dental schools. There is clearly identified need for schools to include ESD in the curriculum in a seamless and fully integrated manner so that it does not create a further burden to learning and teaching.
Pleistocene-Holocene sedaDNA reconstruction of Southern Doggerland reveals early colonization before inundation consistent with northern refugia.
Authors: Allaby Robin , Ware Roselyn , Cribdon Rebecca , Hansford Teri , Kinnaird Tim , Hamilton W , Kistler Logan , Murgatroyd Philip , Bates Richard , Fitch Simon , Gaffney Vincent
Published: September 2023

Prior to the formation of the North Sea during the mid-Holocene, North-Western Europe was connected through the Doggerland landmass. Whilst it has been known for the past century that forests grew in Doggerland, it has not been clear how this environment compares to the surrounding European areas. Here, we reconstruct the palaeoecology of a river system from the Late Pleistocene to the late Holocene using sedimentary ancient DNA (sedaDNA) from 252 sediment samples from 36 cores spanning the length of the river system and headwater area. We determined that in low kinetic energy environments 95-98% of sedaDNA originates from local deposition and 2-5% is associated with influxed sediments, enabling the identification of secure deposits. High energy environments are insecure with 15-70% of sedaDNA associated with reworked and influxed sediment. Secure sediments reveal the presence of several tree species such as Alnus, Quercus, Ulmus and Corylus over 16000 years ago, and thermal indicator tree species like Tilia several thousand years earlier than has been recorded for surrounding European areas. In this area we also detect the presence of Pterocarya, previously unobserved since the Hoxnian. These observations are consistent with colonization from glacial refugia closer than the classic southern Europe refugia.
Integrated Network Pharmacology Reveals the Mechanism of Action of Xianlinggubao Prescription for inflammation in Osteoarthritis
Authors: Zhu Naiqiang , Hou Jingyi , Si Jingyuan , Ma Guiyun , Yang Ning , Chen Bin , Zhang Yu
Published: September 2023

Background.Osteoarthritis (OA) is a common chronic joint disease characterized by persistent inflammation. This study aimed to explore the potential mechanisms by which Xianlinggubao (XLGB) regulates OA inflammation via network pharmacology andin vitroexperiments.Methods.Data on the bioactive compounds and targets of XLGB were obtained from the TCMSP, ETCM, SymMap, and ChEMBL databases. The targets of XLGB associated with OA inflammation were analyzed using differential expression analysis and OMIM, GeneCards, and PubMed Gene databases. Network pharmacology and bioinformatic analyses were performed to construct compound target and protein-protein interaction (PPI) networks to predict significant targets. Functional enrichment of the targets was performed using the ClusterProfiler package in R. Molecular docking, RT-PCR, and immunofluorescence assays were used to evaluate the ability of the compound to bind to anti-inflammatory targets during OA treatment.Results.Fifty-five bioactive compounds associated with 475 XLGB targets and 125 genes associated with OA inflammation were identified. The constructed PPI network revealed that XLGB may play therapeutic roles in OA inflammation by acting on the hub genes viz. monoclonal antibody to prostaglandin endoperoxide synthase 2, interleukin-1β, tumor necrosis factor, interleukin-6, and matrix metallopeptidase-9. Functional enrichment analysis suggested that XLGB exerted its pharmacological effects against OA inflammation by modulating multiple biological pathways, such as the IL-17, TNF, and NF-κB. The results ofin vitroassays showed that XLGB can treat OA inflammation via hub genes, proteins, and signaling pathways.Conclusions: Using system pharmacology analysis, we systematically revealed the potential mechanisms of action of XLGB in OA inflammation, laying a foundation for its future clinical application.
Factors Affecting the Therapeutic Effects of Multiple Intra-articular Injections of Platelet-Rich-Plasma for Knee Osteoarthritis
Authors: Kamada Kohei , Matsushita Takehiko , Yamashita Takahiro , Matsumoto Tomoyuki , Iwaguro Hideki , Kuroda Ryosuke , Sobajima Satoshi
Published: September 2023

Background Platelet-rich-plasma (PRP) is rapidly spreading as a conservative treatment option for knee osteoarthritis (KOA), however, its therapeutic efficacy is controversial. This study aimed to investigate the factors affecting the therapeutic effect of intra-articular PRP therapy for KOA in patients who received multiple PRP injections (PRP-I).Methods This is a historical cohort study included 1057 knees of 701 patients who received PRP-I during KOA treatment from 2018 to 2020. The difference in visual analog scale (VAS) scores before and after PRP-I was defined as the amount of change in VAS (ΔVAS). Statistical analyses were performed using generalized linear mixed models with ΔVAS from the pre-treatment baseline as dependent variable and sex, age, number of PRP-I, and pre-treatment VAS as independent variables. Evaluations using the Kellgren-Lawrence (KL) classification were added.Results Age and VAS score before treatment and after three, four, and five PRP-I were significantly associated with ΔVAS score. According to KL grade, age was significantly associated with ΔVAS score in the KL grade 4 group. VAS score before treatment was significantly associated with ΔVAS score, regardless of KL grade. Three-time PRP-I were significantly associated with ΔVAS in the KL-grade 1 and 2 groups. For KL grade 4, two or more PRP-I were significantly associated with the high efficacy.Conclusions Age, pain before treatment, and number of injections were associated with pain reduction after intra-articular PRP-I for KOA treatment. Pain reduction can be expected after PRP-I when patients are younger or experience severe pain before treatment. Three-time PRP-I are recommended to reduce pain in early-stage KOA and more than three times in advanced-stage OA.Trial Registration: Retrospectively registration
The Effectiveness of Forensic Outpatient Systemic Therapy in the Treatment of Juvenile Antisocial Behavior: A Study Protocol of a Multiple Case Experimental Design
Authors: Cappellen S. Marjolein van , Creemers Hanneke E. , Hoogsteder Larissa , Horn Joan van , Asscher Jessica J.
Published: September 2023

Background
Juvenile antisocial behavior can have long-lasting and devastating effects for juveniles themselves, victims, and society. Evidence-based treatment is vital. Forensic Outpatient Systemic Therapy (Forensische Ambulante Systeem Therapie; FAST) is a promising treatment for juveniles showing severe antisocial behavior including aggression, (domestic) violence, and delinquent behavior. FAST has a flexible intensity and length, addresses individual and systemic risk and protective factors, and is responsive to the abilities of the client (system), intervention characteristics all considered crucial for effective treatment. The current study will investigate whether FAST is effective in reducing aggression of the juvenile, reaching client formulated subgoals, and improving family functioning. Processes of change will be examined, as well as mediation by reaching client formulated subgoals and improved family functioning.
Methods
A Multiple Case Experimental Design (MCED) with an ABC design will be performed (A = baseline, B = intervention, and C = follow-up). Juveniles with primary aggression and/or anger problems (N = 15) and their caregiver(s) will be recruited. Data collection will consist of self-report questionnaires and case file analysis. Participants fill out frequent short self-report questionnaires (twice a week during phase A, every other week during phase B, and every week during phase C) and two main questionnaires at the start of the intervention and immediately after intervention end, thereby covering a period of 5 to 11 months. Both visual and statistical analyses will be performed.
Discussion
This study will generate robust knowledge and inform clinical practice on the effectiveness, processes of change, and mediating mechanisms of FAST, aiming to improve the treatment of future families within youth forensic care.
Trial registration:
This trial was registered at ClinicalTrials.gov on 28/08/2023, protocol ID 60-63600-98-1138a.
MTGR1 is required to maintain small intestinal stem cell populations
Authors: Short Sarah P. , Brown Rachel E. , Blunt Koral M. , Pilat Jennifer M. , Chen Lucy , Jacobse Justin , Wang Jing , Simmons Alan J. , Xu Yanwen , Yang Yilin , Parang Bobak , Choksi Yash A. , Goettel Jeremy A. , Lau Ken S. , Hiebert Scott W. , Williams Christopher S.
Published: September 2023

Undifferentiated intestinal stem cells (ISCs), particularly those marked by Lgr5, are crucial for maintaining homeostasis and resolving injury. Lgr5+ cells in the crypt base constantly divide, pushing daughter cells upward along the crypt axis, where they differentiate into a variety of specialized cell types. This process requires coordinated execution of complex transcriptional programs, which allow for the maintenance of undifferentiated stem cells while permitting differentiation of the wide array of intestinal cells necessary for homeostasis. Thus, disrupting these programs may negatively impact homeostasis and response to injury. Previously, members of the myeloid translocation gene (MTG) family have been identified as transcriptional co-repressors that regulate stem cell maintenance and differentiation programs in multiple organ systems, including the intestine. One MTG family member, myeloid translocation gene related 1 (MTGR1), has been recognized as a crucial regulator of secretory cell differentiation and response to injury. However, whether MTGR1 contributes to the function of ISCs has not yet been examined. Here, using Mtgr1-/- mice, we have assessed the effects of MTGR1 loss on ISC biology and differentiation programs. Interestingly, loss of MTGR1 increased the total number of cells expressing Lgr5, the canonical marker of cycling ISCs, suggesting higher overall stem cell numbers. However, expanded transcriptomic analyses revealed MTGR1 loss may instead promote stem cell differentiation into transit-amplifying cells at the expense of cycling ISC populations. Furthermore, ex vivo intestinal organoids established from Mtgr1 null were found nearly completely unable to survive and expand, likely due to aberrant ISC differentiation, suggesting that Mtgr1 null ISCs were functionally deficient as compared to WT ISCs. Together, these results identify a novel role for MTGR1 in ISC function and suggest that MTGR1 is required to maintain the undifferentiated state.
Disparities in pediatric obesity during COVID-19: The role of neighborhood social vulnerability and collective efficacy
Authors: Min Jungwon , Tam Vicky , Mayne Stephanie
Published: September 2023

Introduction:
Childhood obesity increased in the first year of Covid-19 with significant disparities across race, ethnicity, and socioeconomic status. Social distancing led to fewer physical activity opportunities but increased screen time and high-calorie food consumption, all co-determined by neighborhood environments. This study aimed to test the moderation effects of neighborhood socioeconomic and built environments on racial/ethnic disparities in obesity change during Covid-19.
Methods
Using electronic health records from a large pediatric primary care network in 2018–2022, we cross-sectionally examined 163,042 well visits of 2–17 year-olds living in Philadelphia county in order to examine (1) the pandemic’s effect on obesity prevalence and (2) moderation by census-tract-level neighborhood socioeconomic disadvantage, crime, food and physical activity-related environments using interrupted-time-series analysis, Poisson regression, and logistic regression.
Results
Weekly obesity prevalence increased by 4.9 percent points (pp) during the pandemic (Jan 2021-Aug 2022) compared to pre-pandemic (Mar 2018- Mar 2020) levels. This increase was pronounced across all age groups, racially/ethnically-minoritized groups, and insurance types (ranging from 2.0 to 6.4 pp) except the Non-Hispanic-white group. The increase in obesity among children racially/ethnically-minoritized groups was significantly larger in the neighborhoods with high social vulnerability (3.3 pp difference between high and low groups), and low collective efficacy (2.0 pp difference between high and low groups) after adjusting for age, sex, and insurance type.
Conclusions
Racially/ethnically-minoritized children experienced larger obesity increases during the pandemic, especially those in socioeconomically disadvantaged neighborhoods. However, the buffering effect of community collective efficacy on the disparities underscores the importance of environments in pediatric health.
Preparation of Mo2@biomass-derived carbon electrocatalysts and performance study of electrocatalytic hydrogen precipitation and degradation of organic pollutants
Authors: Yang Hongxing , Chen Jin , Li Donggang , Zhang Sheng
Published: September 2023

Water electrolysis is a common method for hydrogen production; a catalyst can lower the required voltage, known as electrocatalytic hydrogen production. Pt is an ideal catalyst due to high activity, but limited supply and cost impede use. Thus, we synthesized a novel composite electrocatalyst Mo2C@NC using versatile N-doped mesoporous carbon from camphor leaves, incorporating 7 to 12 nm Mo2C particles into nitrogen-doped mesoporous carbon matrix. This innovative electrocatalyst has unique properties, particularly nitrogen incorporation, making Mo2C@NC highly active in electrocatalytic hydrogen production. Under alkaline conditions, Mo2C@NC needs a low 79 mV overpotential for 10 mA·cm− 2 current density, showing durability after 1000 cycles and remaining stable for 10 hours. Mo2C@NC also efficiently catalyzes the reduction of 4-nitrophenol to 4-aminophenol, requiring only 5 mg to complete the reaction in under 5 minutes. It also degrades methylene blue, a common organic dye, suggesting potential in large-scale H2 production and water purification.