bluuebunny/crossref_metadata_2025 huggingface dataset:
PIM-COVID study: protocol for a multicentre, longitudinal study measuring the psychological impact of surviving an intensive care admission due to COVID-19 on patients in the UK
Authors: Waite Alicia A C , Johnston Brian W , Boyle Andrew J , Cherry Mary Gemma , Fisher Peter , Brown Stephen L , Jones Christina , Williams Karen , Welters Ingeborg D
Published: September 2023

Introduction

Psychological distress is common in intensive care unit (ICU) survivors and is anticipated in those who were treated for severe COVID-19 infection. This trainee-led, multicentre, observational, longitudinal study aims to assess the psychological outcomes of ICU survivors treated for COVID-19 infection in the UK at 3, 6 and/or 12 months after ICU discharge and explore whether there are demographic, psychosocial and clinical risk factors for psychological distress.

Methods and analysis

Questionnaires will be provided to study participants 3, 6 and/or 12 months after discharge from intensive care, assessing for anxiety, depression, post-traumatic stress symptoms, health-related quality of life and physical symptoms. Demographic, psychosocial and clinical data will also be collected to explore risk factors for psychological distress using latent growth curve modelling. Study participants will be eligible to complete questionnaires at any of the three time points online, by telephone or by post.

Ethics and dissemination

The PIM-COVID study was approved by the Health Research Authority (East Midlands - Derby Research and Ethics Committee, reference: 20/EM/0247).

Trial registration number

NCT05092529.
Identification of neoepitope reactive T-cell receptors guided by HLA-A*03:01 and HLA-A*11:01 immunopeptidomics
Authors: Ade Catherine M , Sporn Matthew J , Das Sudipto , Yu Zhiya , Hanada Ken-ichi , Qi Yue A , Maity Tapan , Zhang Xu , Guha Udayan , Andresson Thorkell , Yang James C
Published: September 2023

Background

Tumor-specific mutated proteins can create immunogenic non-self, mutation-containing ‘neoepitopes’ that are attractive targets for adoptive T-cell therapies. To avoid the complexity of defining patient-specific, private neoepitopes, there has been major interest in targeting common shared mutations in driver genes using off-the-shelf T-cell receptors (TCRs) engineered into autologous lymphocytes. However, identifying the precise naturally processed neoepitopes to pursue is a complex and challenging process. One method to definitively demonstrate whether an epitope is presented at the cell surface is to elute peptides bound to a specific major histocompatibility complex (MHC) allele and analyze them by mass spectrometry (MS). These MS data can then be prospectively applied to isolate TCRs specific to the neoepitope.

Methods

We created mono-allelic cell lines expressing one class I HLA allele and one common mutated oncogene in order to eliminate HLA deconvolution requirements and increase the signal of recovered peptides. MHC-bound peptides on the surface of these cell lines were immunoprecipitated, purified, and analyzed using liquid chromatography-tandem mass spectrometry, producing a list of mutation-containing minimal epitopes. To validate the immunogenicity of these neoepitopes, HLA-transgenic mice were vaccinated using the minimal peptides identified by MS in order to generate neoepitope-reactive TCRs. Specificity of these candidate TCRs was confirmed by peptide titration and recognition of transduced targets.

Results

We identified precise neoepitopes derived from mutated isoforms of KRAS, EGFR, BRAF, and PIK3CA presented by HLA-A*03:01 and/or HLA-A*11:01 across multiple biological replicates. From our MS data, we were able to successfully isolate murine TCRs that specifically recognize four HLA-A*11:01 restricted neoepitopes (KRAS G13D, PIK3CA E545K, EGFR L858R and BRAF V600E) and three HLA-A*03:01 restricted neoepitopes (KRAS G12V, EGFR L858R and BRAF V600E).

Conclusions

Our data show that an MS approach can be used to demonstrate which shared oncogene-derived neoepitopes are processed and presented by common HLA alleles, and those MS data can rapidly be used to develop TCRs against these common tumor-specific antigens. Although further characterization of these neoepitope-specific murine TCRs is required, ultimately, they have the potential to be used clinically for adoptive cell therapy.
RIG-I promotes immune evasion of colon cancer by modulating PD-L1 ubiquitination
Authors: Zhang Yangyang , Zeng Lingxiu , Wang Meng , Yang Zhenwei , Zhang Hailin , Gao Liping , Zhang Ranran , Liu Jialong , Shan Wenqing , Chang Ying , Liu Lan , Zhao Qiu , Li Yong , Liu Jing
Published: September 2023

Colon cancer is one of the most prevalent cancers and exhibits high mortality worldwide. Despite the certain success in the immunotherapy of many tumor types, the limited response of colon cancer to immunotherapy remains a difficult problem. Retinoic acid-inducible gene-I (RIG-I) is a crucial component in innate antiviral immunity, but its role in antitumor immunity remains unclear. Here, in this report, we found that silencing RIG-I decreased resistance to tumor cells killed by T cells and attenuated colon tumor growth in immunocompetent mice. Meanwhile, overexpressing RIG-I promoted tumor progression, and high expression of RIG-I sensitized cells to anti-programmed cell death protein-1 (PD-1) therapy in vivo. Interestingly, we found that RIG-I influenced programmed cell death ligand 1 (PD-L1) expression to promote colon cancer immune evasion without relying on type I interferon stimulation. Mechanistically, RIG-I could compete with Speckle Type POZ protein (SPOP) to bind PD-L1, leading to attenuation of the polyubiquitination and proteasomal degradation of PD-L1. Collectively, our work reveals new insights into the contribution of RIG-I to driving immune evasion by maintaining the stability of PD-L1 through post-translational modification and provides a promising biomarker of the efficacy of immunotherapy in colon cancer.
Risk factors, outcomes and healthcare utilisation in individuals with multimorbidity including heart failure, chronic kidney disease and type 2 diabetes mellitus: a national electronic health record study
Authors: Pasea Laura , Dashtban Ashkan , Mizani Mehrdad , Bhuva Anish , Morris Tamsin , Mamza Jil Billy , Banerjee Amitava
Published: September 2023

Background

Heart failure (HF), type 2 diabetes (T2D) and chronic kidney disease (CKD) commonly coexist. We studied characteristics, prognosis and healthcare utilisation of individuals with two of these conditions.

Methods

We performed a retrospective, population-based linked electronic health records study from 1998 to 2020 in England to identify individuals diagnosed with two of: HF, T2D or CKD. We described cohort characteristics at time of second diagnosis and estimated risk of developing the third condition and mortality using Kaplan-Meier and Cox regression models. We also estimated rates of healthcare utilisation in primary care and hospital settings in follow-up.

Findings

We identified cohorts of 64 226 with CKD and HF, 82 431 with CKD and T2D, and 13 872 with HF and T2D. Compared with CKD and T2D, those with CKD and HF and HF and T2D had more severe risk factor profile. At 5 years, incidence of the third condition and all-cause mortality occurred in 37% (95% CI: 35.9%, 38.1%%) and 31.3% (30.4%, 32.3%) in HF+T2D, 8.7% (8.4%, 9.0%) and 51.6% (51.1%, 52.1%) in HF+CKD, and 6.8% (6.6%, 7.0%) and 17.9% (17.6%, 18.2%) in CKD+T2D, respectively. In each of the three multimorbid groups, the order of the first two diagnoses was also associated with prognosis. In multivariable analyses, we identified risk factors for developing the third condition and mortality, such as age, sex, medical history and the order of disease diagnosis. Inpatient and outpatient healthcare utilisation rates were highest in CKD and HF, and lowest in CKD and T2D.

Interpretation

HF, CKD and T2D carry significant mortality and healthcare burden in combination. Compared with other disease pairs, individuals with CKD and HF had the most severe risk factor profile, prognosis and healthcare utilisation. Service planning, policy and prevention must take into account and monitor data across conditions.
Future prospects of biocleaning application in textile conservation
Authors: Jedrusik Aldona , Krasnan Vladimir , Rehakova Milena , Rebros Martin
Published: September 2023

Studies of sustainable preservation methods are an important element of ongoing research into minimising the environmental impact of conservation treatment. Of these methods, the cleaning of antique surfaces using selected microbial cultures is attracting attention in the field of heritage conservation. Due to the highly specific nature of the action of these microorganisms, which is similar to enzymatic cleaning, it is generally assumed that individual cultures can remove dirt without endangering the complex structures of textiles. The emphasis is placed on the use of nonpathogenic microbial cultures that have proven to be effective in the cleaning of other historical materials, and which are active in a neutral environment and show relevant metabolic activity. The aims of this work were to study the application of Pseudomonas putida to clean iron gall ink staining and the feasibility of using a selected bacterial strain to clean historic textiles. A relevant procedure for the application of this method to the controlled biocleaning of textiles was also developed. The use of water-based gel systems as a matrix for microorganisms seems to be optimal in terms of providing suitable living conditions for the bacteria and maintaining controlled contact with the surface of the object while simultaneously ensuring efficiency. Tests were carried out on appropriately prepared model samples consisting of cotton and silk. The changes emerging on the surface were evaluated using optical microscopy, and the rate of cleaning was assessed using FTIR and colorimetric methods. In addition, FTIR spectroscopy was employed for microbial control after biocleaning. The research demonstrates the feasibility of cleaning iron gall ink from textiles with viable microbial cells. The selected microorganism was able to reduce undesired discolouration from iron gall ink on model textiles. The results indicate that P. putida has a profound impact on silk samples, and prove that microbial cleaning can achieve a high level of efficiency in the removal of concentrated dirt.
Named Entity Recognition of Tunisian Arabic Using the Bi-LSTM-CRF Model
Authors: Mekki Asma , Zribi Inès , Ellouze Mariem , Belguith Lamia Hadrich
Published: September 2023

Named Entity Recognition (NER) is an NLP field that deals with recognizing and classifying entities in written text. Most Arabic NER research studies discuss the Arabic NER challenge for the Modern Standard Arabic (MSA) language. However, the presence of dialectal Arabic textual resources in social media, blogs, TV shows, etc. is increasingly progressive. Therefore, the treatment of named entities is rapidly becoming a necessity, particularly for dialectal Arabic. In this paper, we are interested in the collection and annotation of a corpus as well as the realization of a NER system for Tunisian Arabic (TA), named TUNER. To the best of the researchers’ knowledge, this is the first study that uses the suggested method for this purpose. In the present study, we adopt a hybrid method based on a Bi-LSTM-CRF model and a rule-based method. The proposed TUNER system yields an F-measure of 91.43%. This is an interesting improvement over comparable related work dialectal Arabic NER systems.
MSA-UNet: A Multiscale Lightweight U-Net Lung CT Image Segmentation Algorithm Under Attention Mechanism
Authors: Wang Chuantao , Shao Shuo , Yin Jiajun , Wang Xiumin , Li Baoxia
Published: September 2023

Automatic and precise segmentation of lung images can assist doctors in locating and diagnosing lung lesions. However, current traditional lung CT image lesion segmentation algorithms suffer from the problem of low segmentation accuracy, while deep learning-based segmentation algorithms struggle to strike a better balance between lightweight and high accuracy. In response to this issue, a multi-scale and lightweight U-Net lung image segmentation algorithm with an attention mechanism is proposed. This algorithm introduces CA convolution after the convolution in the encoding stage to extract channel relationships and positional information from the feature maps. Furthermore, the RFB module is employed to extract features from different perspectives. Lastly, upward residual connections are introduced between the RFB modules in the encoder and decoder to enhance inter-network information interaction. Experiments conducted on the LUNA (lung nodule analysis) dataset and the COVID-QU-Ex dataset for COVID-19 pneumonia demonstrate that the proposed MSA-UNet algorithm achieves the best results in terms of Precision and Dice metrics. It outperforms mainstream models such as U-Net++ and DeeplabV3+ in terms of segmentation effectiveness and segmentation generality. The model has a floating-point operation count (FLOPs) of 18.15 G, a network parameter counts of 8.83×106, and achieves a Precision of 99.37%. The algorithm achieves a good balance between computational efficiency, model size, and segmentation accuracy.
Preparation of novel azobenzene derivatives/potassium niobate nanocomposite and its application in electrochemical sensors
Authors: Zhou Yicheng , Dong Li , Cao Tongtong , Wang Haoran , Zhang Jiazheng , Zhang Xiaobo , Liu Lin , Tong Zhiwei
Published: September 2023

The guest molecule trans-[2-(2,2,3,3,4,4,4-heptafluorobutylamino) ethyl]-{2-[4-(4-hexanobenzazo)-phenoxy] ethyl} -dimethylammonium (abbreviated as C3F7-azo[Formula: see text]Br[Formula: see text]) were inserted into the K 4Nb6O[Formula: see text]laminated by the guest–guest exchange method to synthesize C3 F7-azo[Formula: see text]/Nb6 O[Formula: see text]type-A nanocomposite with excellent electrochemical properties. X-ray diffraction (XRD), scanning electron microscopy (SEM), transmission electron microscopy (TEM), Fourier Transform infrared (FTIR) spectrometer and energy dispersive spectroscopy (EDS) were used to characterize the structure and morphology of nanocomposite C3F7-azo[Formula: see text]/Nb 6O[Formula: see text]. C3F7-azo[Formula: see text]ions were speculated to form bilayer between the [Nb6O[Formula: see text] ][Formula: see text]lamellar at an angle of [Formula: see text] by morphology analysis and lamellar spacing calculation. This nanocomposite was used to fabricate an electrochemical sensor for simultaneous detection of dopamine (DA) and ascorbic acid (AA). Differential pulse voltammetry, cyclic voltammetry and electrochemical impedance spectroscopy in N2-saturated phosphate buffered solution (0.1 M, pH = 5) demonstrated excellent electrocatalytic activity. The sensor achieved detection limits of 1.74 [Formula: see text]M for DA and 1.57 [Formula: see text]M for AA.
A Cadaveric Feasibility Study of an Automatic Multi-Degrees of Freedom Surgical Robot for Percutaneous Scaphoid Guide Pin Insertion
Authors: WANG Qiao , SHUAI Mei , XIONG Ge , JIA Hongye
Published: September 2023

Background: Percutaneous fixation of scaphoid fractures need accurate guide pin insertion. The emergence of computer-assisted navigation and robotic surgery may provide a promising solution to this problem.

Methods: This study presents the development of an automatic multi-degrees of freedom (DOF) surgical robot with computer-assisted navigation system, focusing on percutaneous scaphoid guide pin insertion. Using this device, along with a 3D fluoroscopy unit, we have conducted an experimental study on 10 cadavers for percutaneous scaphoid guide pin insertion to verify the feasibility and reliability of the system.

Results: The mean operative duration was 29.1 (SD 4.3) minutes. The cadavers required no more than two attempts to achieve desired wire placement, with the mean positioning-error being 2.0 (SD 0.3) mm and the mean angle-deviation 3.6 (SD 0.7)°. Throughout the study, a mean of 2.2 full-cycle fluoroscopy attempts was required for each cadaver during surgery, and no preoperative CT scan was needed.

Conclusions: The outcomes show that using the automatic surgical robot to perform the percutaneous scaphoid guide pin insertion is feasible and desired results can be achieved.
Ulnar-Sided Upper Extremity Traumatic Wounds: What Should We Expect to Find?
Authors: COSTA João Q. , LEITE Maria J. , RELVAS Miguel , VIEIRA Paula , NEGRÃO Pedro , VIDINHA Vitor
Published: September 2023

Background: Upper limb traumatic injuries have a significant impact on social and professional life; however, there is still a paucity of studies focusing on the injuries of the ulnar border of the forearm, wrist and hand.

Methods: We designed a retrospective single-blinded study, including all patients with deep traumatic wounds affecting the ulnar side of the forearm, wrist or hand, that received surgical treatment from 2006 until 2016. A characterisation of the sample, assessment of concomitant injuries and clinical outcomes, as well as neurological and functional evaluation were performed.

Results: We obtained a sample of 61 patients, 69% with injuries affecting the wrist and 90% of patients with a neurological lesion, most frequently of the ulnar nerve lesion (UNL). Concomitant injuries included tendinous lesions, more frequently of the flexor carpi ulnaris (64%) and fractures (13%). And 39% of patients presented an ulnar artery lesion, without significant differences in outcomes regarding the completion of arteriorrhaphy or not. At the end of the 8.6 years follow-up, 34% of patients had no deficits; however, patients with UNL showed worse functional scores and greater risk of sequelae. Besides motor function compromise, sensory deficits were also associated with worst functional outcomes.

Conclusions: The UNL subgroup showed important impairment of the first ray, probably related to the level of UNL. Furthermore, besides the implications of the motor sequelae, sensory deficits were also associated with worst functional scores. Due to the high percentage of neurovascular and tendinous lesions in ulnar-sided upper extremity wounds, the authors recommend surgical exploration of these lesions.

Level of Evidence: Level IV (Therapeutic)
Case Series: Wide-Awake Local Anaesthesia Without Tourniquet (WALANT) for Camitz Transfer
Authors: NIEMPOOG Sunyarn , JAROENPORN Woraphon
Published: September 2023

Background: Wide-Awake Local Anaesthesia Without Tourniquet (WALANT), with the benefit of simplicity and a low complication rate, is a well-recognised procedure in orthopaedic surgery. To date, there is no report using WALANT technique with the Camitz transfer procedure. The aim of this study is to determine the early outcomes of using WALANT for Camitz transfer and compare these with outcomes of similar procedures in literature.

Methods: Between January 2012 and January 2018, all patients with severe carpal tunnel syndrome (CTS) with thenar muscle atrophy who underwent the Camitz transfer procedure as day surgery under the WALANT technique at the Thammasat University Hospital were included. With the WALANT technique, the 10 mL of prepared anaesthesia was injected into the area around the palmaris longus tendon from 5-cm proximal to the distal wrist crease to the distal palmar crease, while an additional 10 mL was injected from the radial side of the metacarpophalangeal joint of the thumb to the distal wrist crease before the operation. Upon completion of the operation, the patients’ hand was placed in a thumb spica splint. Patient demographic data, visual analogue scale (VAS) during injection and during procedure, operative time, blood lost and complications were recorded.

Results: Thirty-six patients (8 males and 28 females) were included. The average age of the patients was 65.9 (37–87) years old. The average VAS score during the anaesthetic injection was 6.22 (5–8). The average VAS pain score during the operation was 0.52 (0–3). The average operative time was 27.06 (17–47) minutes. The mean intraoperative blood loss was 3 (2.4–6.8) mL. All patients underwent the procedure without any complications.

Conclusions: The WALANT technique is safe and can be used as alternative anaesthesia for the Camitz transfer.

Level of Evidence: Level IV (Therapeutic)
A Comparison of Distal Nerve Blocks and Brachial Plexus Blocks in Terms of Block Success, Block-related Characteristics, Time to Discharge and Patient Satisfaction
Authors: CAKMAK Hamiyet Şenol , ERTAS Gamze , AKDENİZ Sevda , POLAT Ebru , SONMEZ Ayhan , GUMUS Murat
Published: September 2023

Background: Ultrasound-guided brachial plexus blocks (BPB) are used as an anaesthetic method in hand and wrist surgeries. The radial, median and ulnar nerves can also be selectively blocked. The objective of this retrospective cohort study was to compare distal nerve blocks (DNB) and BPB in terms of block success, block-related characteristics, time to discharge and patient satisfaction.

Methods: The data of patients who underwent elective hand and wrist surgery under regional anaesthetic procedures between 01.01.2022 and 01.09.2022 were analysed. Standard multimodal analgesia was performed in all groups, in addition to either ultrasound-guided BPB or DNB. Demographic characteristics, American Society of Anaesthesiology (ASA) classes, presence of additional diseases, block and volume applied, block-related data such as block performance time, onset time, initial analgesia times, perioperative additional anaesthetic or analgesic requirement, surgery times, types of surgery, discharge times and the presence of additional complaints were recorded. In addition, the anaesthesia quality score were determined using a 5-point Likert scale.

Results: There was no difference between demographic data. Average surgical time was similar between the DNB and BPB groups (46.0 ± 8.92 vs. 59.95 ± 22.04 min, p < 0.05). Block onset time was significantly lower in the DNB group (26.4 ± 2.73 vs. 32.17 ± 2.94 min, p < 0.001). When patients discharged before and after 12 hours were compared, 11/22 of the patients in the DNB group and 4/23 of the patients in the BPB group were discharged in the first 12 hours (p < 0.05). Patient satisfaction scores were similar between groups (14.22 ± 0.86 vs. 13.65 ± 1.11, p > 0.05).

Conclusions: In surgeries of the hand and wrist, the radial, median and ulnar nerves can be used individually or in combination as an alternative to proximal BPB.

Level of Evidence: Level III (Therapeutic)
Distal Interphalangeal Joint Arthroplasty: A Narrative Review
Authors: MODI Devam , SLEVIN Omer , BHALLA Hargun , MCCOMBE David B. , BERGER Anthony C. , THAM Stephan K. Y.
Published: September 2023

Background: Symptomatic distal interphalangeal (DIP) joint arthritis is frequently treated by arthrodesis, though DIP arthroplasty has been reported as a treatment option since 1977. This study reviews the current evidence on DIP joint arthroplasty for the treatment of arthritis refractory to non-operative management.

Methods: A systematic search of PubMed, MEDLINE and Embase databases was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Risk of bias was assessed using the ROBINS-I tool.

Results: The search yielded 55 records, of which six studies were included in the narrative review. All the included studies were of level IV evidence (case series or cohort studies). DIP arthroplasty was effective in relieving pain and reducing subsequent dysfunction. The average total arc of motion was 30°–40° but with an extension lag of 10°–15°. The overall complication rate was 15% with a re-operation rate of 8%. Joint instability (incidence of 2.5%) and infection (incidence of 2.1%) were the most common complications, while implant fracture was seen in 1% of cases. Joints that failed after DIP arthroplasty were salvaged by DIP arthrodesis.

Conclusions: DIP arthroplasty is an effective treatment for painful arthritis but with a complication rate of 15%. Its main advantage over arthrodesis is the preservation of DIP motion. However, due to the limited high-quality evidence available, its use should be limited to circumstances where there is a desire or vocational need to maintain motion at the DIP joint.

Level of Evidence: Level V (Therapeutic)
Lunate Pseudarthrosis: Our Clinical Experience
Authors: TEODONNO Francesca , ARNAOUT Ahlam , MERLINI Lorenzo , GRAS Mathilde
Published: September 2023

Background: Lunate pseudarthrosis is a complication of lunate fractures and few cases are described in the literature. We designed a case series of lunate pseudarthrosis, to acknowledge this topic and to show our clinical experience.

Methods: Four patients were included in this study. Three went through surgical treatment of lunate nonunion.

Results: At 2 years’ follow-up, patients had slight improvement of range of motion (ROM) and Quick-DASH score compared to preoperative measures, though two patients developed scaphocapitate, radiolunate or midcarpal osteoarthritis. The fourth patient is asymptomatic and is being followed up.

Conclusions: Surgical options depend on the localization of the pseudarthrosis in the lunate. Fragment excision can be a good option when the fragment is small, preserving scapholunate (SL) stability. Caution must be taken with dorsal pole pseudarthrosis, regarding midcarpal osteoarthritis.

Level of Evidence: Level IV (Therapeutic)
The Incidence of Heterotopic Ossification in Surgically and Non-surgically Treated Elbow Fractures at a Municipal Hospital in Japan
Authors: HIRAKAWA Akihiro , KOMURA Shingo , KURAMITSU Norishige , OHNO Yoshiyuki , AKIYAMA Haruhiko
Published: September 2023

Background: Heterotopic ossification (HO) is a well-recognised complication of after elbow trauma. The prevalence and risk factors of HO have been previously reported. However, these reports were based on elbow trauma that had undergone surgical treatment and most of them were from Western countries. This study aimed to assess the incidence of HO in patients with elbow fractures who were treated surgically and non-surgically in Japan.

Methods: We retrospectively identified consecutive patients who were treated of elbow fractures and fracture–dislocations at our institution in recent consecutive 3-year periods. We extracted patient demographics, injury mechanisms and treatment details from the medical records. Furthermore, we reviewed radiographs to classify the fracture pattern and identify the presence or absence of HO.

Results: HO was identified in 6/97 (6%) patients. Fracture–dislocation was noted in 4/6 patients. The fracture types with HO included terrible triad injury (n = 2), isolated coronoid process fractures (n = 2), distal humerus A-type fractures (n = 1) and radial head fracture (n = 1). According to the Hastings and Graham classification, HO was classified as Class I in five patients and Class II B in one patient who underwent additional surgery for HO resection.

Conclusions: The incidence of HO was relatively low in our patients. However, of the 20 conservatively treated elbows, one patient developed clinically relevant HO and required excision of HO. Even patients with elbow fractures treated conservatively should be informed of the potential risk of developing severe HO requiring surgical excision. In addition, surgeons in this region could use these data to inform patients about the risk of HO development after an elbow injury.

Level of Evidence: Level IV (Therapeutic)
Swan-Neck Correction by FDS Tenodesis and Dynamic Lateral Band Volar Relocation in the Setting of Cerebral Palsy
Authors: ALEXANDER William , THOMAS Damon , ATKINS Sara , JOHNSTONE Bruce
Published: September 2023

While there are many proposed surgical treatment options for the correction of swan-neck deformities, none are perfect. We describe a partial flexor digitorum superficialis tenodesis that combines both a static volar plate with a dynamic oblique retinacular ligament vector reconstruction. This is performed through a single, short mid-lateral incision and requires no tendon grafts. The protected early active exercises are encouraged postoperatively, and our long-term results have been promising. The technique was designed for children with cerebral palsy, but the indications have since expanded.

Level of Evidence: Level V (Therapeutic)
Pectoralis Major Reinnervation by Retrograde Nerve Regeneration after Complete Paralysis of the Brachial Plexus
Authors: BERTELLI Jayme A. , SHAH Harsh R. , LANZARIN Leonardo D.
Published: September 2023

Spontaneous neuronal recovery is an expected phenomenon in brachial plexus palsy patients. However, the spontaneous recovery owing to retrograde regeneration is an evolving phenomenon with dearth of adequate research on it. Pectoralis major contraction on stimulation of median nerve (in the arm) is an unexpected phenomenon, in the absence of any anomalous communication and with distal coaptation site of intraplexal nerve repair. We presumably attribute it to the retrograde regrowth of axons. The case described supports our hypothesis.

Level of Evidence: Level V (Therapeutic)
XAutoML: A Visual Analytics Tool for Understanding and Validating Automated Machine Learning
Authors: Zöller Marc-André , Titov Waldemar , Schlegel Thomas , Huber Marco F.
Published: September 2023

In the last 10 years, various automated machine learning (AutoML) systems have been proposed to build end-to-end machine learning (ML) pipelines with minimal human interaction. Even though such automatically synthesized ML pipelines are able to achieve competitive performance, recent studies have shown that users do not trust models constructed by AutoML due to missing transparency of AutoML systems and missing explanations for the constructed ML pipelines. In a requirements analysis study with 36 domain experts, data scientists, and AutoML researchers from different professions with vastly different expertise in ML, we collect detailed informational needs for AutoML. We propose
XAutoML
, an interactive visual analytics tool for explaining arbitrary AutoML optimization procedures and ML pipelines constructed by AutoML.
XAutoML
combines interactive visualizations with established techniques from explainable artificial intelligence (XAI) to make the complete AutoML procedure transparent and explainable. By integrating
XAutoML
with
JupyterLab
, experienced users can extend the visual analytics with ad-hoc visualizations based on information extracted from
XAutoML
. We validate our approach in a user study with the same diverse user group from the requirements analysis. All participants were able to extract useful information from
XAutoML
, leading to a significantly increased understanding of ML pipelines produced by AutoML and the AutoML optimization itself.
Evaluation of an 8-week high school science communication course designed to read, write, and present scientific research
Authors: Radyk Megan D. , Spatz Lillian B. , Adkins-Threats Mahliyah L. , Cates Kitra , St Pierre Celine L.
Published: September 2023

Strong communication skills are necessary for a successful scientific career. Here, we describe the curriculum for a science communication course designed to accompany high school students participating in a summer biomedical research program. The course aims to improve their scientific literacy and communication skills. Students learn to read and understand scientific literature, write a paper about their summer research project, present their results, and provide feedback to peers. We found significant improvements in students’ self-confidence in reading, interpreting, and communicating scientific data after completing the course. This successful model serves as a guide for students participating in their first research experience and provides the skills for success in future science, technology, engineering, and mathematics education and careers. The curriculum presented here can be easily adapted for any research program, including undergraduate summer research experiences and graduate student laboratory rotations.
A muscarinic, GIRK channel-mediated inhibition of inspiratory-related XII nerve motor output emerges in early postnatal development in mice
Authors: Rudy Samantha L. , Wealing Jesse C. , Banayat Tatum , Black Chody , Funk Gregory D. , Revill Ann L.
Published: September 2023

Muscarinic modulation of inspiratory bursting at hypoglossal motoneurons has a net excitatory effect in neonatal rhythmic medullary slice preparations and a net inhibitory effect in adult animals. We demonstrate that muscarinic modulation of inspiratory bursting undergoes maturational changes from postnatal days 0 to 5 that include emergence of an inhibitory component mediated by G-protein-coupled inwardly rectifying potassium channels after postnatal day 3 in neonatal mouse rhythmic medullary slice preparations.
Fabrication of Graphene Oxide Reinforced Biocomposite: Recycling of Postconsumed Footwear Leather
Authors: Islam Rashedul , Noyon Md Ashikur Rahaman , Dey Thuhin Kumar , Jamal Mamun , Rathanasamy Rajasekar , Chinnasamy Moganapriya , Uddin Md. Elias
Published: September 2023

The increasing concerns about solid waste disposal have led to the development of innovative strategies for repurposing waste materials. This paper describes a simple solution casting process for recycling postconsumed footwear leather fiber (PCF) into a biocomposite film reinforced with graphene oxide (GO) and polyvinylpyrrolidone (PVP). PVP was utilized as a compatibilizer to strengthen the interfacial bonding of GO and leather fiber via π–π interactions. UV–visible spectroscopy, Fourier transform infrared spectroscopy, X-ray diffraction, thermogravimetric analysis, and scanning electron microscopy were used to examine the material dispersibility bonding between GO and PCF, structural properties, thermal properties, and surface morphology of the biocomposite films, respectively. Compared to pure PCF film, the oxygen transmission rate of the prepared biocomposite films is elevated by 64% as well as the biodegradability rate is intensified up to 60%. In addition, the film’s tensile strengths are raised by 216%, while their elongation at break is increased by 164.64% as compared with PCF. The versatility of these eco-friendly and biodegradable composite films extends to its possible applications in packaging and interior design. The outcomes of the research reveal the viability of manufacturing affordable and sustainable biocomposites through the utilization of waste leather from consumed footwear.
Exploring Teachers’ Attitudes toward the Management of Type 1 Diabetes: A Qualitative Study
Authors: Horvath Maria Dora , Papp-Zipernovszky Orsolya , Tesch Zsanett , Buzas Norbert
Published: September 2023

This study aimed to explore the attitudes of teachers toward type 1 diabetes (T1D) and its management. Teachers working in kindergartens and schools (N = 30) participated in audio-recorded, semi-structured interviews (three focus groups and 20 individual interviews) that were transcribed and analyzed using thematic analysis. We used the theory of the three components of attitude as a framework for the analysis. The three components of attitude emerged during the analysis: knowledge, positive and negative emotions, approaches, and opinions toward diabetes and its management and behavior. The main theme of knowledge included knowledge about diabetes in general and its management. Besides medical treatment, alternative treatment possibilities were mentioned by the participants. The affective component revealed empathy, integrating, and segregating approaches toward children living with diabetes. The behavior component revealed how teachers contribute to the care and integration of children with diabetes in schools. They support children with diabetes by the virtue of their profession. For example, they teach them health awareness and support their integration through peer education and sensitization. The findings indicated that, in addition to diabetes management tasks, teachers could help children with T1D by tutoring them and their peers about health awareness and T1D acceptance.
Investigating the Antagonistic Effect of Indigenous Probiotics on Carbapenem‐Resistant Pseudomonas aeruginosa Strains
Authors: Ghiaei Azita , Ghasemi Seyed Mahdi , Shokri Dariush
Published: September 2023

Introduction. With the increase of hospital infections due to the indiscriminate use of antibiotics, multidrug resistance has increased, decreasing the effectiveness of antibiotics against these infections. For this reason, the identification of alternative agents such as probiotics has been considered. The aim of this study was to isolate and identify effective probiotics against carbapenem‐resistant Pseudomonas aeruginosa strains. Material and Methods. During a period of eight months, isolates of P. aeruginosa were collected from patients in three hospitals in Isfahan. The presence of metallo‐beta‐lactamase enzymes was determined by the combination disc test (CDT). The inhibitory and antimicrobial activities of 20 probiotic bacteria isolated from local dairy products against these strains were investigated by agar dilution. Two probiotic strains that showed broader inhibition results were selected, and the values of the lowest inhibitory concentration (MIC) and the lowest lethal concentration (MBC) and their antibiofilm effect were determined using the microtiter plate method. The concentration of organic acids was done by HPLC. Findings. Of the 100 samples isolated and identified, 61 samples (61%) exhibited multiple drug resistance (MDR) and were selected for further investigation. Phenotypic diagnosis of the presence of metallo‐beta‐lactamase enzymes revealed that 74.5% of the strains were positive. The results showed that these two probiotics killed P. aeruginosa strains after only one hour, and the inhibition mechanism was due to the presence of lactic acid and acetic acid. The antibiofilm effect of these two probiotics was at concentrations of 1/2 and 1/4. Conclusion. The two Lactobacillus isolates had potential antimicrobial and antibiofilm properties against all carbapenem‐resistant P. aeruginosa strains, even at thinner dilutions. Considering the broad activity of this strain, it can potentially be used for biocontrol of these strains.
Characterization of Key Odorants in Soy Sauce and Their Concentration Changes during Storage
Authors: Wang Rui , Chang Shiyu , Liang Miao , Wu Yajian , Xin Runhu , Liu Yuping , Chen Liang , Zhou Shangting
Published: September 2023

To explore the key odorants and their concentration changes in high-salt liquid-state fermentation soy sauce (HLFSS) during storage, solvent extraction coupled with solvent-assisted flavor evaporation was applied to isolate the volatiles in HLFSS, and the volatiles were analyzed by gas chromatograph-mass spectrometry-olfactory and gas chromatograph-flame ionization detector-olfactometry combined with the aroma extract dilution assay. A total of 37 odor-active compounds with flavor dilution (FD) factors ranging from 1 to 1024 were identified, and 23 aroma components with odor activity values ≥1 were considered as key odorants. Methional, 3-methylbutanoic acid, phenethyl alcohol, sotolon, 4-hydroxy-2-methyl-5-ethyl-3(2H)-furanone (HEMF), and 4-hydroxy-2,5-dimethylfuran-3(2H)-one (HDMF) had the highest FD factors of 1024. The results of quantitative analysis through the internal standard curve showed that the concentrations of HEMF, HDMF, acetic acid, 1-hydroxy-2-butanone, acetol, and furfuryl alcohol varied greatly during storage, so these compounds might be used as the indicators to determine the shelf life of HLFSS. The recombination experiment also confirmed the important contribution of these compounds. This result will provide valuable information for understanding the flavor changes of HLFSS.
Missed Opportunity of Antenatal Care Services Utilization and Associated Factors among Reproductive Age Women in Eastern Hararghe Zone, Eastern Ethiopia: Mixed Methods Study
Authors: Mussa Ibsa , Makhubela-Nkondo On , Maruta Melat B. , Debella Adera
Published: September 2023

Background. Despite the enormous advantages of early pregnancy-related problem diagnosis and therapy during prenatal care visits, not all pregnant women begin antenatal care at the proper time. Thus, this study aims to identify factors associated with missed opportunities for antenatal care service utilization among reproductive-age women in Eastern Ethiopia. Methods. A mixed methods study design (quantitative and qualitative) was conducted in Grawa, Meta, and Haramaya woredas from September 5 to December 5, 2019. The quantitative data were analyzed using SPSS version 25. A multivariable logistic regression analysis model was used to identify the predictors. Statistical software programs based on ATLAS.ti version 8.2 was were used to conduct the thematic analysis of the qualitative data. Results. Overall, missed opportunities for antenatal care were 15.4% of 95% (12.1, 19.1%). Factors such as maternal age being 15–24 (

AOR
=
6.9

, 95% CI: 2.89–8.81); having a college education (

AOR
=
0.02

, 95% CI: 0.001, 0.42), elementary (

AOR
=
0.05

, 95% CI: 0.002, 0.98), and secondary education (

AOR
=
0.04

, 95% CI: 0.001, 0.88); having five and more parity (

AOR
=
0.08

, 95% CI: 0.01, 0.75); three visits (

AOR
=
0.10

, 95% CI: 0.02, 0.71); those in the first trimester (

AOR
=
0.02

, 95% CI: 0.001, 0.35) and the second trimester (

AOR
=
0.01

, 95% CI: 0.001, 0.26); and get information from a health facility (AOR =0.09, 95% CI: 0.01, 0.67) and traditional birth attendance (

AOR
=
0.02

, 95% CI: 0.001, 0.74) were factors statistically associated with outcome variables. Conclusions. According to this report, relatively high proportions of pregnant women experienced missed opportunities in antenatal care follow-up. Factors such as maternal age, education, parity, frequency, timing, and media access were statistically significantly correlated with missed antenatal care follow-up. Therefore, all stakeholders should emphasize advocating for and enhancing the benefits of antenatal care; this in turn plays a crucial role in increasing the follow-up of clients for these crucial services. Moreover, health policy implementers need to coordinate their tracking of pregnant women who missed their antenatal care session.
Porcine Circovirus Type 3: Diagnostics, Genotyping, and Challenges in Vaccine Development
Authors: Pranoto Stella , Wu Hsing-Chieh , Chu Chun-Yen
Published: September 2023

Porcine circovirus (PCV) comprises four distinct species, namely, PCV1–4, with considerable differences between them, resulting in limited crossprotection. PCV2 inflicts substantial economic losses on the swine industry. PCV3 was found to have been circulating before its discovery in 2015. PCV3 is suspected of having a comparable impact to PCV2; however, its characterization studies are still underway. The symptoms of PCV3 infection are similar to those of PCV2 infection. However, PCV2 and PCV3 share a maximum amino acid identity of only 37%, which partially explains the inadequacy of the PCV2 vaccine in protecting against PCV3 infection. Swift measures must be taken to control PCV3, including vaccine development, as it also poses a threat to swine populations. This review synthesizes the recent findings on PCV3 in comparison with PCV2 and highlights the prevailing challenges encountered in vaccine development. Various strategies and innovative approaches to producing PCV3 vaccines, such as using RNA particle technology and baculovirus vectors, are also discussed. Addressing research gaps in diagnostic methods, viral isolation, and vaccine development is crucial to controlling this virus, which poses a threat to swine populations.
Dual-Wavelength Passively Q-Switched Erbium-Doped Fiber Laser Incorporating Calcium Carbonate Nanoparticles as Saturable Absorber
Authors: Jasem Iman N. , Abdullah Hiba H. , Jalal Abdulrazzaq Mohammed
Published: September 2023

This study experimentally demonstrates the operation of a dual-wavelength passively Q-switched erbium-doped fiber laser that incorporates CaCO3 nanoparticles as a saturable absorber (SA). The SA was prepared by using the drop-casting method, wherein CaCO3 nanoparticles were embedded in a polyvinyl alcohol (PVA) polymer to form a CaCO3/PVA film SA. The film was integrated into a ring laser cavity with a 976 nm pump to generate Q-switched pulses. The properties of the SA were examined experimentally, and its modulation depth is approximately 47%. As the pump power increased from 180 mW to 270 mW and the pulse repetition rate increased from 12.67 kHz to 21.3 kHz, the corresponding pulse width decreased from 35.27 μs to 18.74 μs. The signal-to-noise ratio was approximately 25 dB, highlighting the laser’s stability. The results indicate that the proposed CaCO3/PVA SA is suitable for realizing portable Q-switched lasers.
Supplementary Figures, Tables, Notes from Whole Slide Imaging-Based Prediction of TP53 Mutations Identifies an Aggressive Disease Phenotype in Prostate Cancer
Authors: Pizurica Marija , Larmuseau Maarten , Van der Eecken Kim , de Schaetzen van Brienen Louise , Carrillo-Perez Francisco , Isphording Simon , Lumen Nicolaas , Van Dorpe Jo , Ost Piet , Verbeke Sofie , Gevaert Olivier , Marchal Kathleen
Published: September 2023

Supplementary Figures, Tables and Notes
Suppl Data 2 from Whole Slide Imaging-Based Prediction of TP53 Mutations Identifies an Aggressive Disease Phenotype in Prostate Cancer
Authors: Pizurica Marija , Larmuseau Maarten , Van der Eecken Kim , de Schaetzen van Brienen Louise , Carrillo-Perez Francisco , Isphording Simon , Lumen Nicolaas , Van Dorpe Jo , Ost Piet , Verbeke Sofie , Gevaert Olivier , Marchal Kathleen
Published: September 2023

Contains
1. significantly differentially expressed genes between samples with high and low gleason grade ("Gleason_high_low"),
2. the pathway overrepresentations for these genes ("MSigDB_Gleason_HL", "Reactome_Gleason_HL"),
3. the overlapping genes between "Gleason_high_low" and "TP TN" from Suppl. Data 1 ("Gleason_HL_overlap TP_TN"),
4. the pathway overrepresentations for genes from (3) ("reactome_GLHL_TP_TN", "MSigDB_GLHL_TP_TN")
Supplementary Methods. MS1 from A Phase I/II Trial of Oral SRA737 (a Chk1 Inhibitor) Given in Combination with Low-Dose Gemcitabine in Patients with Advanced Cancer
Authors: Jones Robert , Plummer Ruth , Moreno Victor , Carter Louise , Roda Desamparados , Garralda Elena , Kristeleit Rebecca , Sarker Debashis , Arkenau Tobias , Roxburgh Patricia , Walter Harriet S. , Blagden Sarah , Anthoney Alan , Klencke Barbara J. , Kowalski Mark M. , Banerji Udai
Published: September 2023

Study inclusion and exclusion criteria.
Mean exposure (AUC0–12) by dose level from A Phase I/II Trial of Oral SRA737 (a Chk1 Inhibitor) Given in Combination with Low-Dose Gemcitabine in Patients with Advanced Cancer
Authors: Jones Robert , Plummer Ruth , Moreno Victor , Carter Louise , Roda Desamparados , Garralda Elena , Kristeleit Rebecca , Sarker Debashis , Arkenau Tobias , Roxburgh Patricia , Walter Harriet S. , Blagden Sarah , Anthoney Alan , Klencke Barbara J. , Kowalski Mark M. , Banerji Udai
Published: September 2023

This figure displays the mean area under the SRA737 plasma concentration-time curve from 0 to 12 hours (AUC0–12) following a single oral dose of SRA737 at doses of 150, 300, 500 and 600 mg. Error bars represent standard deviation.