bluuebunny/crossref_metadata_2025 huggingface dataset:
Compressive and Flexural Strength of Concrete with Different Nanomaterials: A Critical Review
Authors: Ashwini R. M. , Potharaju M. , Srinivas V. , Kanaka Durga S. , Rathnamala G. V. , Paudel Anish
Published: January 2023

With recent technological advances, adding nanomaterials as a reinforcement material in concrete has gained immense attention. This review paper aims to report advances in the form of a one-stop shop catering to methods that focus on improving the quality of traditional concrete. Nanoparticles—the elementary form of nanomaterials—are proven to enhance the strength and longevity of concrete. Nanosilica, nanoalumina, nanometakaolin, carbon nanotubes, and nanotitanium oxide are modern nanomaterials that have demonstrated strong evidence of enhancing concrete quality, which supports infrastructure building and long-term monitoring. Nanoconcrete—an exciting prospect extending the boundaries of traditional civil engineering—exhibited increased compressive and flexural strength using elementary compounds. In particular, the rigorous research survey of many articles reveals an increase in compressive strength from 20% to 63% by replacing the cement with different nanomaterials in different percentages and flexural strength from 16% to 47%.
Assessment of Anatomy Education Teaching Modalities before and during COVID-19 in US Medical Schools
Authors: Cicerchia Gaia , Lumpkins Kimberly , Puche Adam C.
Published: January 2023

Medical schools in the United States, as well as across the world, have undergone curriculum reform in the delivery of anatomy courses, which recently required social distancing during the COVID-19 pandemic. The aim of this study was to compare total teaching time across three major types of anatomy curricular formats in preclerkship and clerkship phases of US medical education, and quantitatively describe which tools/teaching modalities are used within different curricula structures across preclinical and clinical anatomy courses as well as evaluate the relative percent of the curricular time their use comprised prior to and during the pandemic. An optional survey instrument (with skip patterns), developed using Qualtrics Software and approved by the author’s home Institutional Review Board, was sent to anatomy course directors at 152 allopathic medical schools, from all four geographic and size categories delineated by the Association of American Medical Colleges. Data were analyzed using Qualtrics XM Stats iQ software. Thirty allopathic US medical institutions were represented in this survey, among which there existed an even distribution across the three integration formats with the majority of instruction occurring in the first-year curriculum. Total anatomy teaching time varied widely, but cadaveric dissection and lectures were the predominant teaching modalities, even during the pandemic. Traditional dissection comprised the majority of contact time compared to alternative modalities, but less than half of respondents currently incorporate new modalities. Approximately half of the schools changed to an all-virtual format for 2020–2021. Among those that were fully virtual, time using 3D anatomy significantly increased. Our results demonstrate that traditional anatomic educational practices remain the mainstay of medical education. Surprisingly, total contact hours in anatomic education varied widely, but there were striking similarities in the use of traditional tools.
Anesthetic Management of Laparoscopic Adrenalectomy for a Patient with Concomitant Pheochromocytoma and Bilateral Carotid Artery Stenosis
Authors: Michaud Kristina L. , Thiele Robert H. , Forkin Katherine T.
Published: January 2023

Symptomatic carotid stenosis and pheochromocytoma both require timely surgical intervention. Following a transient ischemic attack (TIA), a 46-year-old man was diagnosed with bilateral carotid artery stenosis and scheduled for carotid endarterectomy. He was a poor candidate for minimally invasive options due to prior neck radiation. Simultaneously, he began experiencing difficulty with diabetes management and elevated blood pressures and was ultimately diagnosed with pheochromocytoma. This unique situation required coordination to determine the appropriate timing of the two interventions. This case highlights the importance of communication and coordination amongst medical specialists and consideration for anesthetic management of patients with concomitant pheochromocytoma and carotid stenosis.
Protective Efficiency Comparison of Direct and Remote Ischemic Preconditioning on Ischemia Reperfusion Injury of the Liver in Patients Undergoing Partial Hepatectomy
Authors: Kong Erliang , Yuan Chang , Li Yongchang , Tian Tian , He Yan , Feng Xudong
Published: January 2023

Objective. Ischemia reperfusion injury greatly damages liver function and deteriorates the prognosis of patients undergoing partial hepatectomy. This study is to compare the protective efficiency of direct and remote ischemic preconditioning (DIPC and RIPC) on ischemia reperfusion injury of the liver in patients undergoing partial hepatectomy. Methods. 90 patients scheduled for partial hepatectomy were enrolled and randomly divided into control (n = 30), DIPC (n = 30), and RIPC (n = 30) groups. Baseline and surgery characteristics were collected, and ischemic preconditioning methods were carried out. Intraoperative hemodynamics, liver function and liver reserve capacity, oxidative stress, and inflammatory responses were measured, and the incidence of postoperative adverse reactions was calculated finally. Results. 10 patients were excluded from the study, and finally, the eligible patients in three groups were 27, 28, and 25, separately. No significant differences were observed in baseline and surgery characteristics among the three groups. SBP and DBP were significantly higher after hepatic portal vein occlusion while they were significantly lower after surgery in the DIPC and RIPC groups compared with that in the control group, SBP and DBP were of great fluctuation at different time points in the control group while they showed much more stabilization in the DIPC and RIPC groups. ALT, AST, and TBIL were significantly decreased on days 1, 3, and 5 after surgery, and ICG R15 was significantly decreased while ICG K value and EHBF were significantly increased on day 1 after surgery in the DIPC and RIPC groups compared with that in the control group. Moreover, antioxidant enzyme SOD was increased, and inflammatory factors TNF‐α and IL‐1β were decreased 24 hours after surgery in the DIPC and RIPC groups compared with that in the control group. DIPC and RIPC also decreased hospital stays and the incidence of nausea, vomiting, and hypertension. Conclusion. DIPC and RIPC both alleviated ischemia reperfusion injury of the liver and reduced perioperative complications with similar protective efficiency in patients undergoing partial hepatectomy.
Psoraleae Fructus Ethanol Extract Induced Hepatotoxicity via Impaired Lipid Metabolism Caused by Disruption of Fatty Acid β-Oxidation
Authors: Guo Zhaojuan , Shi Yuanyuan , Jiang Bingqian , Peng Xiyi , Zhang Lin , Tu Can , Wang Ting
Published: January 2023

Herb-induced liver injury (HILI) is gradually increasing, and Psoraleae Fructus (PF) has been reported to induce hepatotoxicity. However, its underlying toxicity mechanism has been only poorly revealed. In this paper, we attempted to explore the liver injury and mechanism caused by Psoraleae Fructus ethanol extract (PFE). First, we administered PFE to mice for 4 weeks and evaluated their serum liver function indices. H&E staining was performed to observe the pathological changes of the livers. Oil red O staining was used to visualize hepatic lipids. Serum-untargeted metabolomics and liver proteomics were used to explore the mechanism of PF hepatotoxicity, and transmission electron microscopy was determined to assess mitochondria and western blot to determine potential target proteins expression. The results showed that PFE caused abnormal liver biochemical indicators and liver tissue injury in mice, and there was substantial fat accumulation in liver tissue in this group. Furthermore, metabolomic analysis showed that PFE changed bile acid synthesis, lipid metabolism, etc., and eight metabolites, including linoleic acid, which could be used as potential biomarkers of PFE hepatotoxicity. Proteomic analysis revealed that differential proteins were clustered in the mitochondrial transmembrane transport, the long-chain fatty acid metabolic process and purine ribonucleotide metabolic process. Multiomics analysis showed that eight pathways were enriched in both metabolomics and proteomics, such as bile secretion, unsaturated fatty acid biosynthesis, and linoleic acid metabolism. The downregulation of SLC27A5, CPT1A, NDUFB5, and COX6A1 and upregulation of cytochrome C and ABCC3 expressions also confirmed the impaired fatty acid oxidative catabolism. Altogether, this study revealed that PFE induced hepatotoxicity by damaging mitochondria, reducing fatty acid β-oxidation levels, and inhibiting fatty acids ingested by bile acids.
Pathological Detection of Micro and Fuzzy Gastric Cancer Cells Based on Deep Learning
Authors: Guo Qiuxia , Yu Weiwei , Song Shasha , Wang Wenlin , Xie Yufei , Huang Lihua , Wang Jing , Jia Ying , Wang Sen
Published: January 2023

In recent years, with the increasing incidence of cancer, regular physical examination is an important way to find cancer. Nuclear screening is an important method for the diagnosis of gastrointestinal diseases, but it is challenging in the face of small and fuzzy gastrointestinal images. Different from traditional medical objects, pathological slice images are mostly blurry and tiny, which is somewhat difficult to detect and segment. The traditional diagnostic method lacks rapid quantitative analysis and has a certain delay in medical diagnosis, and traditional image processing uses morphological features and pixel distribution to extract features; it is often difficult to achieve the desired effect on small blurry images. This paper proposes a small, microfuzzy pathology detection algorithm based on the attention mechanism; the YOLOv5 is improved under small and micro fuzzy scenarios of the detection of cancer cells in the full field of digital pathology and tests it in the gastric cancer slice dataset. The network structure is improved, and the ability to learn features on small and micro targets is enhanced according to the law of feature distribution. Spatial and channel changes in network attention and attention weight distribution. In the deep blur scenario, the attention mechanism is added to optimize its recognition ability, and the test result shows F1_score is 0.616, and the mAP is 0.611, which can provide the decision support for clinical judgment.
Diplomats on the Frontlines: Knowing and Ordering in Crisis
Authors: Hofius Maren
Published: January 2023

How do diplomatic practices change under crisis conditions? To explore the possible effects of crisis on diplomatic standards of competence, the article zooms in on the modes of knowledge production of frontline diplomats in crisis. An illustrative case study of European Union (EU) diplomatic practice in Ukraine during the Euromaidan revolution reveals two different modes of knowledge production among members of the local EU diplomatic ‘community of practice’: a rule-following and reflexive mode. The article finds that the reflexive mode of knowledge production surfaces in times of crisis and reflects a heretofore under-acknowledged standard of excellence, the ‘ethics of care’ towards the host state’s citizens. Foregrounding the ‘ethics of care’ as a standard of competence sheds new light on diplomatic ethics and advances International Practice Theory’s (IPT) discussion about the normativity of practices and the contested nature of diplomatic competence.
Faunistic and diagnostic notes on some species of the genus Omalium Gravenhorst, 1802 of Caucasus, Turkey and Iran (Coleoptera: Staphylinidae: Omaliinae, Omaliini)
Authors: SHAVRIN ALEXEY V. , KHACHIKOV EDUARD A.
Published: January 2023

Faunistic and diagnostic notes on eleven species of the genus Omalium Gravenhorst, 1802 of Caucasus, Turkey and Iran are presented. Faunistic data of all species are summarized, and distributional maps for O. falsum Eppelsheim, 1889, O. turcicum Smetana, 1967 and O. wunderlei Zanetti, 2002 are given. Several new records are provided for the first time from certain areas: O. caesum Gravenhorst, 1806 from several regions of Russia (Stavropol Territory, Karachay-Cherkessia, North Ossetia-Alania) and Armenia, O. falsum from Russia and Iran, O. excavatum Stephens, 1834 from Krasnodar Territory and Karachay-Cherkessia, O. littorale Kraatz, 1857 from Kabardino-Balkaria and Dagestan, O. rivulare (Paykull, 1789) from Kabardino-Balkaria and Iran, O. rugatum Mulsant & Rey, 1880 from south-western region of Russia, Georgia and Iran, and O. turcicum from Russia.
Pseudophilautus pardus, a junior synonym of P. viridis (Amphibia: Anura: Rhacophoridae)
Authors: WIJAYATHILAKA NAYANA , PERERA USHANI , MANAMENDRA-ARACHCHI KELUM , ELLEPOLA GAJABA , ADHIKARI HIMASH , WIJAYASEKARA SANOJ , WICKRAMASINGHE MENDIS , PRATHAP VIMUKTHI , MEEGASKUMBURA MADHAVA
Published: January 2023

Pseudophilautus pardus, was first described in 2007, based on a single specimen collected in Sri Lanka during the 19th century. Its absence in recent surveys suggested that the species was extinct. The distinctive spotted dorsal coloration, together with other morphological features, was used to distinguish it from congeners. In 2013, we discovered a specimen resembling the holotype of P. pardus in Samanala Strict Nature Reserve. A DNA analysis based on the 16S rRNA mt-DNA locus recovered a low uncorrected pairwise genetic distance of 0.77–0.96% between the recent example of ‘P. pardus’ and a congener, P. viridis. Molecular species delimitation methods suggest P. pardus and P. virids to be a single operational taxonomic unit. Morphological analyses using the freshly collected specimen, together with numerous photographic records show P. viridis to be a highly polychromatic species within which the coloration observed in P. pardus too occurs, though rarely. We conclude that P. pardus is a junior synonym of P. viridis.
Kovalius—a new genus of cave-dwelling harvestmen from the Caucasus (Opiliones: Sclerosomatidae: Leiobuninae)
Authors: TCHEMERIS ALEKSEY N.
Published: January 2023

A new genus Kovalius gen. nov. and species K. logunovi sp. nov., are described from the Sokolova Cave of NW Caucasus, Russia. This is the second genus and third species within Leiobuninae recorded from caves in the NW Caucasus, Sochi Region. A close relationship between Kovalius and Nelima Roewer, 1910 is discussed based on presence in Kovalius of a distinctly developed and pronounced inner patellar apophysis exceeding half of the length on the patellae on the pedipalps and unusual structure of the penis. In this paper, Kovalius is diagnosed, the male K. logunovi sp. nov. is described and illustrated, and the only known locality of the species is mapped.
About some Indonesian Pachyrhynchus Germar 1824 with description of a new species (Coleoptera, Curculionidae, Entiminae, Pachyrhynchini)
Authors: BOLLINO MAURIZIO
Published: January 2023

Pachyrhynchus faisali Bollino, sp. nov. is described from Teminabuan, West Papua, Indonesia. Pachyrhynchus forsteni Snellen van Vollenhoven is reported for the first time from Morotai Island and a second specimen of Pachyrhynchus viridis (Chevrolat) from Manokwari district is illustrated. In addition, the endophallus of three species of Papuan Pachyrhynchus and one Pantorhytes are illustrated.
Role of Perception in Differentiating Subtypes of Alcoholism
Authors: Fuller Gerald B. , Lunney Gerald H. , Naylor William M.
Published: January 2023

Summary.—A perceptual and a personality test were administered to 694 alcoholic patients to establish whether there were perceptual differences and, if so, to see what personality variables accompany perceptual differences. Three separate groups of alcoholics were identified along what might be called an intact-deteriorated continuum of perception. However, the groups differed on only three MMPI personality variables (L, F, and Hs). Differences between groups for age, IQ, and education were significant. When these variables were controlled, groups were still significantly different on the perceptual task and the three MMPI scales. Characteristics of the groups were discussed in relation to Witkin's work. It was clear that perceptual variability among alcoholics is appreciable.
A fatigue reliability assessment model for welded structures based on the structural stress method
Authors: Zhou Shaoze , Hao Siqi , Liang Longyin , Chen Bingzhi , Li Yonghua
Published: January 2023

Since many factors affect the fatigue life of welded structures and the relationships between them are complex, finding effective ways to improve the fatigue reliability of welded structures has always been a challenge for the industry. A fatigue reliability assessment model and design method for welded structures based on the structural stress method is proposed. According to the limit state equation of the model, the design-life fatigue reliability and the service fatigue reliability assessment approaches are presented. Then, a first-order second-moment method is employed to reveal quantitative fatigue reliability for welded joints and structures. The relationships between the fatigue reliability and the influence variables are used to analyze and improve the welded structure design. Fatigue reliability of T-joint examples was assessed by accounting for weld leg sizes, plate thicknesses, penetration depths, and single-sided and double-sided forms. Furthermore, the assessment model was verified with a welded bogie frame. The fatigue reliability of the frame was improved based on the evaluation results. The model and method can be applied to other types of welded joints and welded structures.
An Experimental Design on Coffee Extraction Factors Impacting the Measurable Percent of Total Dissolved Solids in Solution
Authors: Walston Jonathan D. , Short Daniel L. , Badar M. Affan
Published: January 2023

There are numerous techniques and technologies used in the brewing of coffee today. This study is aimed to design an umbrella experiment to examine the impacting key factors consistent across all methods of extraction. These factors were identified as: grind size, roast type, steep time, grind to water as a mass-to-mass ratio and temperature. Samples were prepared by grinding the beans, weighing the beans and adding the appropriate amount to a rectangular glass vessel. Distilled water was used. French press was selected as the brewing technique. No agitation after the addition of grind was allowed. Water was heated to initial temperature and added to the vessel and a timer was started. Upon time completion aliquots were taken and analysed using a prism-based automatic temperature compensation (ATC) refractometer. Minitab 19.2020.1 (64-bit) was used for analysis of variance and optimisation. In the initial design of experiments, the five factors were considered at different levels. Three factors found significant in impacting %TDS (total dissolved solids) were: total steep time, grind-to-water ratio and roast type. To further refine the experiments, 23 full-factorial design was conducted for these three factors. Finally, optimisation was done to determine the factor levels to produce a cup of coffee for the target %TDS of 1.26. This research found that it is best to use medium roast coffee that is ground fine with a 0.08 grind-to-water ratio, with an initial temperature of 195 Fahrenheit in a French press, and the ideal steep time is 7 min. Previous studies have focused on the extraction methods. In this study, the method of extraction has been removed as a variable. Hence, the findings are very useful for food industry.
Perpetuating Perceptions: Understanding the “Chaining” of a Common Training Narrative Beyond the Classroom
Authors: Mathis Robin Smith , Aust Philip J.
Published: January 2023

Workplace learning initiatives are influenced by perceptions, and negative perceptions hinder organizational innovation and productivity. This exploratory study presents an argument that messages shared among trainees regarding their training experiences shape such perceptions. The application of Symbolic Convergence Theory reveals two discursive narratives explaining trainees’ perceptions that are foundational for a desired rhetorical vision of training efforts. The findings reveal practical implications for teaching applied communication and instruction in the workplace training classroom. Further, exploring “backstage” workplace communication such as gossip, opinions, and perceptions sheds light on the intersection of communication, human resource development, and vision construction.
The effect of preoperative sleep quality on the target plasma concentration of propofol and postoperative sleep in patients undergoing painless gastroscopy
Authors: Qiu Yuxue , Hou Haitao , Zhang Junxia , Wang Xiaomei , Wang Lu , Wu Yanan , Deng Liqin
Published: January 2023

Background

This study aims to investigate the effect of preoperative sleep quality on the target plasma concentration of propofol and postoperative sleep in patients undergoing painless gastroscopy.

Methods

Ninety-three outpatients aged 45 to 64 years with body mass index (BMI) of 18.5–30 kg/m2 and ASA grades of I or II, who underwent painless gastroscopy, were selected. All patients were evaluated by the Athens insomnia scale (AIS) before the painless gastroscopy. The patients were divided into two groups according to the AIS score evaluated before painless gastroscopy: normal sleep group (group N, AIS score < 4 points, 47 cases) and sleep disorder group (group D, AIS score > 6 points, 46 cases). The target-controlled infusion (TCI) of propofol (Marsh model) was used for general anesthesia, the Bispectral index (BIS) was used to monitor the depth of anesthesia, and the BIS was maintained between 50 and 65 during the painless gastroscopy. The target plasma concentration (Cp) of propofol was recorded when the patient’s eyelash reflex disappeared (T1), before the painless gastroscopy (T2), at the time of advancing the gastroscope (T3) and during the painless gastroscopy (T4), and the infusion rate per body surface area of propofol was calculated. The patient’s AIS score was followed up by telephone at day 1, day 3, 1 week, and 1 month after the painless gastroscopy to assess the postoperative sleep of the patient. The occurrence of adverse reactions during the painless gastroscopy was recorded; the patient’s satisfaction and the endoscopist’s satisfaction with the anesthesia effect were compared between the two groups.

Results

Compared with group N, the Cp at each time point and the infusion rate per body surface area of propofol in group D was increased significantly (P < 0.05); compared with the AIS scores before the painless gastroscopy, the AIS scores of the two groups of patients were significantly increased day 1 after the painless gastroscopy (P < 0.05); there were no significant differences in the AIS scores of the two groups at day 3, 1 week, and 1 month after the painless gastroscopy (P > 0.05). There were no statistically significant differences in the occurrence of adverse reactions and the patient’s satisfaction and the endoscopist’s satisfaction with the anesthesia effect between the two groups (P > 0.05).

Conclusion

The preoperative sleep disturbance will increase the Cp and the infusion rate per body surface area of propofol in patients undergoing painless gastroscopy. Propofol only affects the patients’ sleep for day 1 after the painless gastroscopy.

Trial registration

Chinese Clinical Trial Registry (ChiCTR2100045332) on 12/04/2021.
Errors in pressure measurements due to changes in pressure transducer levels during adult cardiac surgery: a prospective observational study
Authors: Oh Chahyun , Lee Soomin , Jeon Seungbin , Park Hanmi , Chung Woosuk , Shim Man-Shik , Yoon Seok-Hwa , Kim Yoon-Hee , Lee Sun Yeul , Hong Boohwi
Published: January 2023

Background

Blood pressure measurement is an essential element during intraoperative patient management. However, errors caused by changes in transducer levels can occur during surgery.

Methods

This single center, prospective, observational study enrolled 25 consecutive patients scheduled for elective cardiac surgery with invasive arterial and central venous pressure (CVP) monitoring. Hydrostatic pressures caused by level differences (leveling pressure) between a reference point (on the center of the left biceps brachii muscle) and the transducers (fixed on the right side of the operating table) for arterial and central lines were continuously measured using a leveling transducer. Adjusted pressures were calculated as measured pressure – leveling pressure. Hypotension (mean arterial pressure < 80, <70, and < 60 mmHg), and CVP (< 6, ≥6 and < 15, or ≥ 15 mmHg) and pulmonary artery pressure (PAP, mean > 20 mmHg) levels were determined using unadjusted and adjusted pressures.

Results

Twenty-two patients were included in the analysis. Leveling pressure ≥ 3 mmHg and ≥ 5 mmHg observed at 46.0 and 18.7% of pooled data points, respectively. Determinations of hypotension using unadjusted and adjusted pressures showed disagreements ranging from 3.3 to 9.4% depending on the cutoffs. Disagreements in defined levels of CVP and PAP were observed at 23.0 and 17.2% of the data points, respectively.

Conclusions

The errors in pressure measurement due to changes in transducer level were not trivial and caused variable disagreements in the determination of MAP, CVP, and PAP levels. To prevent distortions in intraoperative hemodynamic management, strategies should be sought to minimize or adjust for these errors in clinical practice.

Trial registration

cris.nih.go.kr (KCT0006510).
Exploring the impact of mental health conditions on vaccine uptake in high-income countries: a systematic review
Authors: Suffel Anne M. , Ojo-Aromokudu Oyinkansola , Carreira Helena , Mounier-Jack Sandra , Osborn David , Warren-Gash Charlotte , McDonald Helen I.
Published: January 2023

Background

Vaccination is an essential public health intervention to reduce morbidity and mortality from infectious diseases. Despite being at higher at risk of infectious diseases, health inequalities towards vaccine uptake in people with mental health issues have not been systematically appraised.

Methods

We searched 7 databases from 1994 to 26/03/2021. We included all studies with a relative measure of effect comparing a group with a mental health issue to a control group. All studies covering any mental health issue were eligible with no constraints to study population, vaccine type or region, provided in a high-income country for comparability of health care systems. The study outcomes were synthesised by study population, mental health issue and type of vaccine.

Results

From 4,069 titles, 23 eligible studies from 12 different countries were identified, focusing on adults (n = 13) or children (n = 4) with mental health issues, siblings of children with mental health issues (n = 2), and mothers with mental health issue and vaccine uptake in their children (n = 6). Most studies focused on depression (n = 12), autism, anxiety, or alcoholism (n = 4 respectively). Many studies were at high risk of selection bias.

Discussion

Mental health issues were associated with considerably lower vaccine uptake in some contexts such as substance use disorder, but findings were heterogeneous overall and by age, mental health issue or types of vaccine. Only individuals with mental health issues and physical comorbidities had consistently higher uptake in comparison to other adults.

Mental health should be considered as a health inequality for vaccine uptake but more context specific research is needed focusing more on specific mental health issues and subgroups of the population to understand who misses vaccination and why.
Does the anteromedial plate position affect proximal screw length and worsen the clinical outcomes in medial opening wedge high tibial osteotomy?
Authors: Ryu Dong Jin , Park Sang Jun , Lee Dae Hee , Kwon Kyeu-Back , Choi Geun Hong , Kim Il Su , Wang Joon Ho
Published: January 2023

Background

During medial opening wedge high tibial osteotomy (MOWHTO), sometimes the plate tends to be positioned anteromedially. The plate position can affect the length of the proximal screw, which significantly affects stability after osteotomy. Therefore, research on the correlation among plate position, screw length, and clinical outcomes is needed.

Methods

This retrospective review examines 196 knees in 175 patients who underwent MOWHTO from May 2012 to December 2018, for symptomatic medial compartment osteoarthritis with a varus alignment of > 5°. We evaluated the anteroposterior plate position, length of proximal screw, and postoperative computed tomography (CT). We reviewed patients’ clinical outcome scores, presence of lateral hinge fracture, neurovascular complications, and infection. The correlation among proximal plate position, proximal screw length, and clinical outcomes was evaluated using Pearson’s correlation analysis. A subgroup analysis by screw angle (> 48 ° or < 48 °) was also performed using chi-square test and Student t-test.

Results

The mean proximal plate position was 16.28% (range, 5.17–44.74) of the proximal tibia’s anterior-to-posterior distance ratio, and the proximal screw length averaged 63.8 mm (range, 44–80 mm). Proximal posteromedial plate position and proximal screw length were significantly correlated (r2 = 0.667, P < .001), as were screw angle and length (r2 = 0.746, P < .001). Medial plating (< 48°) can use a longer proximal screw; nevertheless, no significant difference occurred in clinical outcomes between the two groups. Also, no differences occurred in complication rate, including hinge fracture.

Conclusion

With more medially positioned plating during MOWHTO, we can use longer proximal screws. However, there was no significant difference in clinical outcomes and the incidence of lateral hinge fractures regardless of plate position and screw length.
Honesty in signalling games is maintained by trade-offs rather than costs
Authors: Számadó Szabolcs , Zachar István , Czégel Dániel , Penn Dustin J.
Published: January 2023

Background

Signal reliability poses a central problem for explaining the evolution of communication. According to Zahavi’s Handicap Principle, signals are honest only if they are costly at the evolutionary equilibrium; otherwise, deception becomes common and communication breaks down. Theoretical signalling games have proved to be useful for understanding the logic of signalling interactions. Theoretical evaluations of the Handicap Principle are difficult, however, because finding the equilibrium cost function in such signalling games is notoriously complicated. Here, we provide a general solution to this problem and show how cost functions can be calculated for any arbitrary, pairwise asymmetric signalling game at the evolutionary equilibrium.

Results

Our model clarifies the relationship between signalling costs at equilibrium and the conditions for reliable signalling. It shows that these two terms are independent in both additive and multiplicative models, and that the cost of signalling at honest equilibrium has no effect on the stability of communication. Moreover, it demonstrates that honest signals at the equilibrium can have any cost value, even negative, being beneficial for the signaller independently of the receiver’s response at equilibrium and without requiring further constraints. Our results are general and we show how they apply to seminal signalling models, including Grafen’s model of sexual selection and Godfray’s model of parent-offspring communication.

Conclusions

Our results refute the claim that signals must be costly at the evolutionary equilibrium to be reliable, as predicted by the Handicap Principle and so-called ‘costly signalling’ theory. Thus, our results raise serious concerns about the handicap paradigm. We argue that the evolution of reliable signalling is better understood within a Darwinian life-history framework, and that the conditions for honest signalling are more clearly stated and understood by evaluating their trade-offs rather than their costs per se. We discuss potential shortcomings of equilibrium models and we provide testable predictions to help advance the field and establish a better explanation for honest signals. Last but not least, our results highlight why signals are expected to be efficient rather than wasteful.
Results of the phase IIa study to evaluate the efficacy and safety of rezivertinib (BPI-7711) for the first-line treatment of locally advanced or metastatic/recurrent NSCLC patients with EGFR mutation from a phase I/IIa study
Authors: Shi Yuankai , Zhou Jianying , Zhao Yanqiu , Zhu Bo , Zhang Liangming , Li Xingya , Fang Jian , Shi Jianhua , Zhuang Zhixiang , Yang Sheng , Wang Donglin , Yu Huiqing , Zhang Longzhen , Zheng Rongsheng , Greco Michael , Wang Tingting
Published: January 2023

Background

Rezivertinib (BPI-7711) is a novel third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI). This phase IIa study was part of a phase I/IIa study (NCT03386955), aimed to evaluate the efficacy and safety of rezivertinib as the first-line treatment for patients with locally advanced or metastatic/recurrent EGFR mutated non-small cell lung cancer (NSCLC).

Methods

Patients received the first-line treatment of 180 mg rezivertinib orally once daily until disease progression, unacceptable toxicity, or withdrawal of consent. The primary endpoint was the objective response rate (ORR) assessed by blinded independent central review (BICR). Secondary endpoints included disease control rate (DCR), duration of response (DoR), progression-free survival (PFS), overall survival (OS), and safety.

Results

From Jun 12, 2019, to Oct 17, 2019, 43 patients were enrolled. At the data cutoff date on Dec 23, 2021, the ORR by BICR was 83.7% (95% CI: 69.3–93.2%). The median DoR was 19.3 (95% CI: 15.8–25.0) months. The median PFS by BICR was 20.7 (95% CI: 13.8–24.8) months and 22.0 (95% CI: 16.8–26.3) months by investigators. Data on OS was immature. Totally, 40 (93.0%) patients had at least one treatment-related adverse event while 4 (9.3%) of them were grade ≥ 3.

Conclusions

Rezivertinib (BPI-7711) showed promising efficacy and a favorable safety profile for the treatment among the locally advanced or metastatic/recurrent NSCLC patients with EGFR mutation in the first-line setting.

Trial registration

ClinicalTrials.gov, NCT03386955.
Prenatal social support in low-risk pregnancy shapes placental epigenome
Authors: Tesfaye Markos , Wu Jing , Biedrzycki Richard J. , Grantz Katherine L. , Joseph Paule , Tekola-Ayele Fasil
Published: January 2023

Background

Poor social support during pregnancy has been linked to inflammation and adverse pregnancy and childhood health outcomes. Placental epigenetic alterations may underlie these links but are still unknown in humans.

Methods

In a cohort of low-risk pregnant women (n = 301) from diverse ethnic backgrounds, social support was measured using the ENRICHD Social Support Inventory (ESSI) during the first trimester. Placental samples collected at delivery were analyzed for DNA methylation and gene expression using Illumina 450K Beadchip Array and RNA-seq, respectively. We examined association between maternal prenatal social support and DNA methylation in placenta. Associated cytosine-(phosphate)-guanine sites (CpGs) were further assessed for correlation with nearby gene expression in placenta.

Results

The mean age (SD) of the women was 27.7 (5.3) years. The median (interquartile range) of ESSI scores was 24 (22–25). Prenatal social support was significantly associated with methylation level at seven CpGs (PFDR < 0.05). The methylation levels at two of the seven CpGs correlated with placental expression of VGF and ILVBL (PFDR < 0.05), genes known to be involved in neurodevelopment and energy metabolism. The genes annotated with the top 100 CpGs were enriched for pathways related to fetal growth, coagulation system, energy metabolism, and neurodevelopment. Sex-stratified analysis identified additional significant associations at nine CpGs in male-bearing pregnancies and 35 CpGs in female-bearing pregnancies.

Conclusions

The findings suggest that prenatal social support is linked to placental DNA methylation changes in a low-stress setting, including fetal sex-dependent epigenetic changes. Given the relevance of some of these changes in fetal neurodevelopmental outcomes, the findings signal important methylation targets for future research on molecular mechanisms of effect of the broader social environment on pregnancy and fetal outcomes.

Trial registration

NCT00912132 (ClinicalTrials.gov).
Ethnic differences in COVID-19 mortality in the second and third waves of the pandemic in England during the vaccine rollout: a retrospective, population-based cohort study
Authors: Bosworth Matthew L. , Ahmed Tamanna , Larsen Tim , Lorenzi Luke , Morgan Jasper , Ali Raghib , Goldblatt Peter , Islam Nazrul , Khunti Kamlesh , Raleigh Veena , Ayoubkhani Daniel , Bannister Neil , Glickman Myer , Nafilyan Vahé
Published: January 2023

Background

Ethnic minority groups in England have been disproportionately affected by the COVID-19 pandemic and have lower vaccination rates than the White British population. We examined whether ethnic differences in COVID-19 mortality in England have continued since the vaccine rollout and to what extent differences in vaccination rates contributed to excess COVID-19 mortality after accounting for other risk factors.

Methods

We conducted a retrospective, population-based cohort study of 28.8 million adults aged 30–100 years in England. Self-reported ethnicity was obtained from the 2011 Census. The outcome was death involving COVID-19 during the second (8 December 2020 to 12 June 2021) and third wave (13 June 2021 to 1 December 2021). We calculated hazard ratios (HRs) for death involving COVID-19, sequentially adjusting for age, residence type, geographical factors, sociodemographic characteristics, pre-pandemic health, and vaccination status.

Results

Age-adjusted HRs of death involving COVID-19 were elevated for most ethnic minority groups during both waves, particularly for groups with lowest vaccination rates (Bangladeshi, Pakistani, Black African, and Black Caribbean). HRs were attenuated after adjusting for geographical factors, sociodemographic characteristics, and pre-pandemic health. Further adjusting for vaccination status substantially reduced residual HRs for Black African, Black Caribbean, and Pakistani groups in the third wave. Fully adjusted HRs only remained elevated for the Bangladeshi group (men: 2.19 [95% CI 1.72–2.78]; women: 2.12 [1.58–2.86]) and Pakistani men (1.24 [1.06–1.46]).

Conclusions

Lower COVID-19 vaccination uptake in several ethnic minority groups may drive some of the differences in COVID-19 mortality compared to White British. Public health strategies to increase vaccination uptake in ethnic minority groups would help reduce inequalities in COVID-19 mortality, which have remained substantial since the start of the vaccination campaign.
Remote harm reduction services are key solutions to reduce the impact of COVID-19-like crises on people who use drugs: evidence from two independent structures in France and in the USA
Authors: Torres-Leguizamon Magally , Favaro Jamie , Coello Dan , Reynaud Emmanuel G. , Néfau Thomas , Duplessy Catherine
Published: January 2023

Background

Harm Reduction (HR) policies for People Who Use Drugs (PWUD) have a significant positive impact on their health. Such approaches limit the spread of infections and reduce opioid overdose mortality. These policies have led to the opening of specialized structures located mainly in big cities and urbanized zones. The COVID-19 pandemic reduced access to HR structures in locations undergoing lockdown. Before the pandemic, HR services in France and in the USA were complemented by the development of remote HR programs: HaRePo (Harm Reduction by Post) for France, implemented in 2011, and NEXT Distro for the USA founded in 2017. These programs are free and specifically designed for people who have difficulties accessing HR tools and counseling in-person. PWUD can access HaRePo program by phone and/or email. NEXT Distro users can access the program through its dedicated website. The aim of the study is to test if and possibly how COVID-19 pandemic and the associated lockdowns have impacted the HR services in both countries.

Methods

By using t-test comparing the year 2019 with the year 2020, we analyzed how lockdowns impacted the number of new users entering the programs, as well as the numbers of parcels sent and naloxone distributed, by using records of both structures.

Results

We showed that the activity of both programs was significantly impacted by the pandemic. Both show an increase in the number of new users joining the programs (+ 77.6% for HaRePo and + 247.7% for NEXT Distro) as well as for the number of parcels sent per month (+ 42.7% for HaRePo and + 211.3% for NEXT Distro). It shows that remote HR was able to partially compensate for the reduced HR activities due to COVID-19. We also observed that the distribution of naloxone per parcel tends to increase for both structures.

Conclusion

With the ability to reach PWUD remotely, HaRePo and NEXT Distro were particularly effective at maintaining service continuity and scaling up services to meet the needs of PWUD during the COVID-19 pandemic. By studying two independent structures in France and in the USA sharing similar objectives (remote HR), we showed that this approach can be a key solution to crises that impact classical HR structures despite various differences in operating procedures between countries.
Clinical application of PARP inhibitors in ovarian cancer: from molecular mechanisms to the current status
Authors: Wu Yongsong , Xu Shilin , Cheng Shanshan , Yang Jiani , Wang Yu
Published: January 2023

As a kind of gynecological tumor, ovarian cancer is not as common as cervical cancer and breast cancer, but its malignant degree is higher. Despite the increasingly mature treatment of ovarian cancer, the five-year survival rate of patients is still less than 50%. Based on the concept of synthetic lethality, poly (ADP- ribose) polymerase (PARP) inhibitors target tumor cells with defects in homologous recombination repair(HRR), the most significant being the target gene Breast cancer susceptibility genes(BRCA). PARP inhibitors capture PARP-1 protein at the site of DNA damage to destroy the original reaction, causing the accumulation of PARP-DNA nucleoprotein complexes, resulting in DNA double-strand breaks(DSBs) and cell death. PARP inhibitors have been approved for the treatment of ovarian cancer for several years and achieved good results. However, with the widespread use of PARP inhibitors, more and more attention has been paid to drug resistance and side effects. Therefore, further research is needed to understand the mechanism of PARP inhibitors, to be familiar with the adverse reactions of the drug, to explore the markers of its efficacy and prognosis, and to deal with its drug resistance. This review elaborates the use of PARP inhibitors in ovarian cancer.
The serum oestradiol/progesterone ratio on the day of OPU + 7, but not the day of OPU + 5, affects the rates of live birth in fresh blastocyst embryo transfer cycles
Authors: Zhao Wenxian , Diao Honglu , Chen Xin , Xu Shaoyuan , Jiang Shengfang , Cao Hong , Zhang Changjun , Zhang Ying
Published: January 2023

Background

In an in vitro fertilization (IVF) cycle, the embryo ends its wandering time and begins the process of implantation into the uterine cavity on the seventh day after oocyte pick-up (OPU + 7), which is closer than OPU + 5 to the time of nidation. Therefore, measuring the oestradiol (E2)/progesterone (P) ratio on OPU + 7 may be helpful for predicting pregnancy outcomes.

Methods

This is a retrospective cohort study of 2,257 women undergoing a follicular-phase depot gonadotropin-releasing hormone agonist (GnRH-a) protocol for in vitro fertilization /intracytoplasmic sperm injection (IVF/ICSI) treatment and fresh blastocyst embryo transfer cycles at a university-affiliated fertility center between January 2016 and April 2021. First, 2,257 women were split into two groups based on clinical pregnancy for analyzing the levels of E2 and P and the E2/P ratio on the day of OPU + 2, OPU + 5 and OPU + 7. And then 2,257 cycles were stratified into three groups based on E2/P ratio tertiles on OPU + 7: the low group (1.3–15.7 pg/ng), middle group (15.7–28.8 pg/ng), and high group (28.8–487.2 pg/ng). The threshold effect of the E2/P ratio on OPU + 7 on live birth was investigated using a two-piecewise linear regression model and a smoothing function curve.

Results

The level of P in the clinical pregnancy group were lower than that in the nonclinical pregnancy group on both OPU + 2 and OPU + 7 (201.9 ± 71.6 ng/ml vs 213.1 ± 77.6 ng/ml, 89.5 ± 88.5 ng/ml vs 99.5 ± 94.9 ng/ml, P < 0.05). The E2/P ratio in the clinical pregnancy group were higher than that in the nonclinical pregnancy group on both OPU + 2 and OPU + 7 (8.4 ± 6.5 pg/ng vs 8.0 ± 6.8 pg/ng, 32.3 ± 38.5 pg/ng vs 25.2 ± 31.0 pg/ng, P < 0.01). The E2/P ratio on OPU + 7 was positively associated with positive hCG (adjusted OR = 1.01; 95% CI, 1.01–1.02; P < 0.0001), clinical pregnancy (adjusted OR = 1.01; 95% CI, 1.00–1.01; P = 0.0067) and live birth (adjusted OR = 1.01; 95% CI, 1.00–1.01; P < 0.001), and a nonlinear correlation was observed between the E2/P ratio and LBR on OPU + 7.

Conclusions

A higher E2/P ratio is associated with a higher LBR, but the E2/P ratio should be maintained within a suitable range.
MRI of acute neck infections: evidence summary and pictorial review
Authors: Hirvonen Jussi , Heikkinen Jaakko , Nyman Mikko , Happonen Tatu , Velhonoja Jarno , Irjala Heikki , Soukka Tero , Mattila Kimmo , Nurminen Janne
Published: January 2023

Infection of the deep neck spaces is a life-threatening acute illness that requires prompt diagnosis and treatment. Magnetic resonance imaging (MRI) offers unsurpassed soft tissue discrimination and is therefore well suited for imaging neck infections. Recently, the feasibility, diagnostic accuracy, and clinical significance of this method have been documented in patients with acute neck infections. This review article summarizes the scientific evidence, provides a practical guide to image acquisition and interpretation, reviews the most common imaging findings, and discusses some difficult diagnoses and pitfalls in acute neck infections, to help both radiologists and clinicians in managing these critically ill patients.