bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimizing heat transfer in solar air heater ducts through staggered arrangement of discrete V‐ribs
Authors: Dubey Manoj Kumar , Prakash Om
Published: August 2024

This research paper details an experimental study on airflow dynamics in a solar air heater. The heater's design incorporates unique, discrete V‐shaped ribs with staggered elements to enhance thermal performance. The study investigates the influence of various roughness parameters on flow characteristics. These parameters include a relative coarseness pitch (P/e) ratio of 12, a rib inclination angle (α) of 60°, a relative coarseness height (e/Dh) of 0.043, and a staggered element arrangement with a positioning ratio (p′/P) of 0.65. Additionally, the investigation includes scenarios with three gaps (Ng) between elements and a gap‐to‐rib width (g/e) ratio of 4. The research focuses on how changes to the Reynolds number, ranging from 3000 to 14,000, and alterations to the ratio of staggered element positioning to rib height (r/e), from 2 to 5, impact the flow dynamics. The outcomes indicate a significant boost in heat transfer performance, with the Nusselt number rising to 3.76 compared with a conventional smooth duct. The highest thermal efficiency recorded was 86%, at an r/e ratio of 3.5. These results underscore the potential of using discrete V‐ribs with staggered elements in rectangular ducts to improve heat transfer efficiency.
Evolution of evapotranspiration in the context of land cover/climate change in the Han River catchment of China
Authors: Chen Ziying , Nong Xiaomin , Zang Chuanfu , Ou Wentao , Qiu Liya
Published: August 2024

Evapotranspiration (ET) stands as a pivotal element in the terrestrial‐atmospheric energy interchange, modulated by a complex array of factors including land use dynamics and climate change. The elucidation of regional and temporal patterns, alongside the mechanisms underpinning ET and its components, amidst environmental shifts, has emerged as a focal point in contemporary hydrological discourse. The Han River catchment, under the influence of the subtropical monsoon, presents an exemplary case study for hydrological inquiry due to its distinct catchment characteristics. This research probes the evolution and influencing mechanisms of ET within the catchment from 2000 to 2018, employing the improved Shuttleworth–Wallace model (i.e., SWH model), multivariate statistical techniques and additional methodologies. Findings reveal that (1) the annual mean ET, evaporation (E) and vegetation transpiration (T) within the Han River catchment from 2000 to 2018 were quantified at 1156.77, 784.21 and 372.56 mm, respectively. The overall spatial pattern showed a gradual decrease from the Chaoshan Plain area identified as having higher values compared to other regions, which may be attributed to the weakened vegetation cooling effect and the indirect effect of the heat island effect brought about by construction land expansion. (2) The significant decrease of E may be attributed to the optimization of vegetation growth conditions in the catchment, resulting in more solar radiation intercepted by the vegetation canopy. (3) Climatic alterations exerted a notable influence on ET, E and T than land use changes. Temperature, Normalized Difference Vegetation Index (NDVI), net radiation and wind speed were identified as the most consequential factors affecting ET. This study lays a scientific groundwork for subsequent exploration into the spatio‐temporal dynamics and mechanisms influencing evapotranspiration and its elements in the Han River catchment, contributing to a broader understanding of hydrological cycling.
The transcriptional landscape and clinico‐biological characterization of human endogenous retroviruses in esophageal squamous cell carcinoma
Authors: Shi Xinrui , Lu Minyi , Li Xukun , Li Jiaqi , Bao Siqi , Jia Caifeng , Chen Hongyan , Zhou Meng
Published: August 2024

Human endogenous retroviruses (HERVs) are emerging as critical elements in host genomic regulation. Aberrant HERV transcription has been implicated in developmental and tissue‐specific aging and pathological processes. In this study, we presented a comprehensive locus‐specific characterization of the HERV expression landscape in esophageal squamous cell carcinoma (ESCC). We demonstrated the transcriptional diversity among patients and identified 12 clinically relevant HERVs in the SCH cohort, which were experimentally validated by Real‐Time Quantitative Polymerase Chain Reaction (RT‐qPCR) in the CAMS cohort. ESCC patients were stratified into three HERV‐based subtypes (HERVhigh, HERVmedian and HERVlow) with distinct clinical and biological characteristics. The HERVhigh subtype was associated with worse survival, increased CD4+ T cells infiltration and decreased metabolic activity, whereas the HERVlow subtype was characterized by abundant CD8+ T cells, increased metabolic activity, and better survival. The HERV‐based tumor subtyping was further robustly validated by RNA sequencing and RT‐qPCR in two additional external cohorts. Our findings demonstrate the clinical significance of HERVs for tumor subtyping and prognosis, provide insights into the functional role of HERVs and a valuable resource for developing novel biomarkers and therapeutic targets in ESCC.
TCellSI: A novel method for T cell state assessment and its applications in immune environment prediction
Authors: Yang Jing‐Min , Zhang Nan , Luo Tao , Yang Mei , Shen Wen‐Kang , Tan Zhen‐Lin , Xia Yun , Zhang Libin , Zhou Xiaobo , Lei Qian , Guo An‐Yuan
Published: August 2024

T cell is an indispensable component of the immune system and its multifaceted functions are shaped by the distinct T cell types and their various states. Although multiple computational models exist for predicting the abundance of diverse T cell types, tools for assessing their states to characterize their degree of resting, activation, and suppression are lacking. To address this gap, a robust and nuanced scoring tool called T cell state identifier (TCellSI) leveraging Mann–Whitney U statistics is established. The TCellSI methodology enables the evaluation of eight distinct T cell states—Quiescence, Regulating, Proliferation, Helper, Cytotoxicity, Progenitor exhaustion, Terminal exhaustion, and Senescence—from transcriptome data, providing T cell state scores (TCSS) for samples through specific marker gene sets and a compiled reference spectrum. Validated against sizeable pseudo‐bulk and actual bulk RNA‐seq data across a range of T cell types, TCellSI not only accurately characterizes T cell states but also surpasses existing well‐discovered signatures in reflecting the nature of T cells. Significantly, the tool demonstrates predictive value in the immune environment, correlating T cell states with patient prognosis and responses to immunotherapy. For better utilization, the TCellSI is readily accessible through user‐friendly R package and web server (https://guolab.wchscu.cn/TCellSI/). By offering insights into personalized cancer therapies, TCellSI has the potential to improve treatment outcomes and efficacy.
A new dawn? Population baselines of snow leopards and other mammals of the Kishtwar High Altitude National Park, India
Authors: Khanyari Munib , Sanyal Oyndrila , Chandan Pankaj , Bajaj Deepti , Sharma Charu , Rana Manoj , Sharma Neeraj , Bashir Tawqir , Suryawanshi Kulbhushansingh
Published: August 2024

Accurately assessing the status of threatened species requires reliable population estimates. Despite this necessity, only a small proportion of the global distribution range of the vulnerable snow leopard (Panthera uncia) has been systematically sampled. The Indian section of the Greater Himalayas, which includes Kishtwar High Altitude National Park (KHANP), harbours potential snow leopard habitat. Nevertheless, there has been limited ecological and conservation research focusing on species that are specific to KHANP, as well as limited research on the broader biodiversity of the Greater Himalayas. We used Spatially Explicit Capture‐Recapture (SECR) models to provide—to our knowledge—the first robust snow leopard population density and abundance estimates from KHANP. We also provide a Relative Abundance Index (RAI) for non‐volant mammals (excluding small rodents). Our study sampled three catchments within the Dachhan region of KHANP—Kibber, Nanth and Kiyar—using 44 cameras over a 45‐day period between May and June 2023. We identified four unique snow leopard individuals across 15 detections in nine camera locations. SECR analysis estimated a density of 0.50 snow leopards per 100 km2 (95% confidence interval: 0.13–1.86), corresponding to an abundance of four individual (4–9) adults. Camera trapping revealed a total of 16 mammal species, including the endangered Kashmir musk deer (Moschus cupreus). Marmots (Marmota caudata) had the highest RAI of 21.3 (±0.2). Although the estimated density and abundance of snow leopards in our study area had relatively wide 95% confidence intervals, our combined results of snow leopard densities and RAIs of prey species such as ibex and marmots indicate that KHANP is a potentially important area for snow leopards. Given the geopolitical history of Jammu and Kashmir in India, the region where KHANP is located, wildlife research remains a low priority. We hope our study encourages authorities to support further research. This study is an initial step towards evaluating the potential of KHANP as a conservation landscape under the Government of India's Project Snow Leopard.
Mitigating the effect of COVID‐19 in a postemergency phase: The role of sense of community and individual resilience
Authors: Rizzo Marco , Fedi Angela , Brodsky Anne E. , Rochira Alessia , Zhao Jenny , Mannarini Terri
Published: August 2024

To identify and confirm patterns of relationships connecting sense of community (SOC) and individual resilience with psychological well‐being, via the mediation of coronavirus disease 2019 (COVID‐19) impacts on life domains. An online survey was conducted with a sample of adults (n = 650) 1 year after the COVID‐19 outbreak in Italy and the United States (April–December 2021). Utilizing a Structural Equation Model, we tested a mediation model (n = 563) to identify the associations between SOC and individual resilience and the perceived impacts of the emergency situation and psychological well‐being. Results revealed that during the crisis, SOC had an influence on psychological well‐being, but only by mediating the effects of COVID‐19 impacts on life domains. Independently, individual resilience had a direct influence on psychological well‐being. The findings support the importance of the interaction of individual and collective variables that played different roles at different phases of the pandemic. The findings suggest for possible interventions to enhance well‐being during crises.
Identification of novel BCL11A variant in a patient with developmental delay and behavioural differences
Authors: Zha Jian , Chen Yong , Cao Fangfang , Zhong Jianmin , Yu Xiongying , Wu Huaping
Published: August 2024

Background

The BCL11A gene is involved in disorders including intellectual disability syndrome (IDS), encodes a zinc finger protein highly expressed in haematopoietic and brain and acts as a transcriptional repressor of foetal haemoglobin (HbF). De novo variants in BCL11A have been associated with IDS, which is characterized by developmental delays, autism spectrum disorder (ASD) and speech and language delays. The reports of BCL11A gene variants are still limited worldwide, and additional cases are needed to expand the variant and phenotype spectrums.

Methods

The patient is a 5‐year‐old girl who was hospitalized due to developmental delays. After analysing her clinical and pathological characterizations, whole‐exome sequencing (WES) was performed for pathogenic genetic variants of developmental delay and behavioural differences. Candidate variant in BCL11A gene was identified and further validated by Sanger sequencing.

Results

A heterozygous variant, c.1442delA (p.Glu481Glyfs*25), was identified in exon 4 of the BCL11A gene through WES. This variant results in a truncated expression of the encoded protein. This de novo variant was confirmed by Sanger sequencing. The language delay and behavioural differences were prominent in our patient.

Conclusion

Our finding demonstrates that BCL11A variant may cause developmental delay and behavioural differences, expanding the genetic spectrum of the BCL11A gene.
Risk assessment and genetic counseling for hematologic malignancies—Practice resource of the National Society of Genetic Counselors
Authors: Stewart Brittany L. , Helber Hannah , Bannon Sarah A. , Deuitch Natalie T. , Ferguson Meghan , Fiala Elise , Hamilton Kayla V. , Malcolmson Janet , Pencheva Bojana , Smith‐Simmer Kelcy
Published: August 2024

Hematologic malignancies (HMs) are a heterogeneous group of cancers impacting individuals of all ages that have been increasingly recognized in association with various germline predisposition syndromes. Given the myriad of malignancy subtypes, expanding differential diagnoses, and unique sample selection requirements, evaluation for hereditary predisposition to HM presents both challenges as well as exciting opportunities in the ever‐evolving field of genetic counseling. This practice resource has been developed as a foundational resource for genetic counseling approaches to hereditary HMs and aims to empower genetic counselors who encounter individuals and families with HMs in their practice.
Persistent low‐level viraemia is associated with non‐infectious comorbidities in an observational cohort in four African countries
Authors: Esber Allahna L. , Colt Suze , Jian Ningbo , Dear Nicole , Slike Bonnie , Sing'oei Valentine , Maswai Jonah , Iroezindu Michael , Bahemana Emmanuel , Kibuuka Hannah , Polyak Christina S. , Streeck Hendrik , Shah Neha , Crowell Trevor A. , Ake Julie A. ,   the AFRICOS Study Group
Published: August 2024

Introduction

People living with HIV (PLWH) have higher rates of non‐infectious comorbid diseases (NCDs) than individuals without HIV. We characterized the risk of NCDs among PLWH with undetectable viral load and persistent low‐level viraemia (pLLV) in the African Cohort Study (AFRICOS). We secondarily quantified the role of immune activation in the association between LLV and NCDs.

Methods

AFRICOS enrols participants in 12 clinics in Uganda, Kenya, Tanzania and Nigeria. Participants on antiretroviral therapy ≥ 6 months without an NCD at enrolment were included. PLLV was defined as at least two consecutive visits with a detectable viral load <1000 copies/ml. We examined elevated blood pressure, hypercholesterolemia, hyperglycaemia, renal insufficiency and a composite variable of any NCD. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard modelling. Among a subset of participants with biomarker data, we assessed the interaction between viral load and 13 biomarkers in the association with any NCD.

Results

From 23 January 2013 to 1 December 2022, 1755 participants met the inclusion criteria for these analyses. At the first eligible visit, the majority of participants had an undetectable viral load (n = 1375, 78.35%). Participants with pLLV had an increased rate of developing any NCD (aHR: 1.22, 95% CI: 1.02−1.47) compared to participants with an undetectable viral load. There was a statistically significant interaction between LLV and TNF‐α, CCL2/MCP‐1 and TNF‐RII in the association with any NCD.

Conclusions

PLLV was significantly associated with NCDs and immune inflammation in this population. Aggressive management of LLV may positively impact NCDs in PLWH.
The Power of Place: Contextual Considerations for Graduate Leadership Education
Authors: Gleason Michael , Moss Breen Jennifer
Published: August 2024

The current symposium explores graduate leadership education in the higher education learning environment. The collection, authored by scholars from a multitude of higher education institutional types, analyzes the importance of institutional context and programmatic focus in leadership education, and takes into consideration the important role the external environment serves in informing leadership program development. Through this analysis, we focus upon opportunities and challenges faculty and students encounter given their leadership programs' situational placement, or “The Power of Place.” Examining the placement of leadership programs within a systems framework inspires creativity and encourages reframing of what initially appeared to be a challenge as an opportunity for excellence.
Inflammation‐, immunothrombosis,‐ and autoimmune‐feedback loops may lead to persistent neutrophil self‐stimulation in long COVID
Authors: Thierry Alain R. , Salmon Dominique
Published: August 2024

Understanding the pathophysiology of long COVID is one of the most intriguing challenges confronting contemporary medicine. Despite observations recently made in the relevant molecular, cellular, and physiological domains, it is still difficult to say whether the post‐acute sequelae of COVID‐19 directly correspond to the consequences of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection. This work hypothesizes that neutrophils and neutrophil extracellular traps (NETs) production are at the interconnection of three positive feedback loops which are initiated in the acute phase of SARS‐CoV‐2 infection, and which involve inflammation, immunothrombosis, and autoimmunity. This phenomenon could be favored by the fact that SARS‐CoV‐2 may directly bind and penetrate neutrophils. The ensuing strong neutrophil stimulation leads to a progressive amplification of an exacerbated and uncontrolled NETs production, potentially persisting for months beyond the acute phase of infection. This continuous self‐stimulation of neutrophils leads, in turn, to systemic inflammation, micro‐thromboses, and the production of autoantibodies, whose significant consequences include the persistence of endothelial and multiorgan damage, and vascular complications.
Duration of PCR positivity by type of respiratory virus among children using a multiplex PCR test
Authors: Kitano Taito , Kitagawa Daisuke , Murata Masayuki , Onishi Mai , Mori Takahiro , Hachisuka Soshi , Okubo Tenshin , Yamamoto Naohiro , Nishikawa Hiroki , Onaka Masayuki , Suzuki Rika , Sekine Madoka , Suzuki Soma , Nakamura Fumihiko , Yoshida Sayaka
Published: August 2024

Prolonged positive polymerase chain reaction (PCR) results, irrespective of the transmission risk, can lead to prolonged restrictions on daily activities and infection precaution interventions. Studies evaluating the duration of PCR positivity for multiple pathogens in a single patient cohort are scarce. This study aimed to evaluate and compare the durations of PCR positivity for multiple respiratory viruses among children and adolescents. This retrospective study was conducted between April 2018 and March 2024 using a multiplex PCR respiratory panel for symptomatic children and adolescents who had at least two tests within 90 days of study period, with the first PCR test positive. The rate and likelihood of persistent PCR positivity were evaluated for multiple respiratory viruses. For 1325 positive results, repeat tests were conducted within 90 days. The persistent PCR positivity rate at repeat testing decreased over time (60.6%, Days 1–15 and 21.7%, Days 76–90, after the first test). In multivariate logistic regression analysis, an increased likelihood of persistent PCR positivity was observed for rhinovirus/enterovirus and adenovirus, whereas decreased likelihood of persistent positivity was seen in influenza and seasonal coronaviruses, compared with parainfluenza viruses. Persistent PCR positivity is common for multiple respiratory viruses in symptomatic children.
Comparative analysis of uncontrollable angles in direct torque and stator flux control and rotor flux control strategies: A numerical and experimental study
Authors: Alshbib Mussaab , Abdulkerim Sohayb , Ghazal Abdulkader
Published: August 2024

The uncontrollable angles (UAs) in direct torque control (DTC) algorithm is an important issue through which the effects of voltage vectors (VEs) on the magnetic flux and the torque are accurately determined. In this paper, a unique analysis of UAs is performed at different operating conditions, including parameters variations in two different strategies: Direct torque and stator flux control (DTC_SC) and (DTC_RC). Values of Those angles were accurately determined for wide speed, stator and rotor variations, and load changes. In addition, a detailed numerical comparison was performed in terms of these angles in the two strategies mentioned above for each operating condition. The comprehensive comparison showed the superiority of the DTC_RC strategy over its DTC_SC counterpart, being the maximum values of UAs in DTC_RC were 8°, 33°, and 21° versus 15°, 45°, and 38° in DTC_RC strategy for the following operations: Variable speed with variable stator resistance, variable speed with variable stator and rotor resistances, variable speed with variable load, respectively. MATLAB/Simulink results of the contributed analysis and comparisons were accomplished and validated. In addition, DS1103‐based experimental tests supported and verified the theoretical analysis.
Comparison of treatment strategies based on clinical and pathological nodal status in resectable gastric adenocarcinoma
Authors: Ajay Pranay S. , Mavani Parit T. , Sok Caitlin P. , Goyal Subir , Switchenko Jeffery M. , Gillespie Theresa W. , Kooby David A. , Kennedy Timothy J. , Shah Mihir M.
Published: August 2024

Background

To determine the optimal multimodal treatment strategy between perioperative chemotherapy (PEC), postoperative chemoradiation therapy (POCR), and postoperative chemotherapy (POC) in resected gastric cancer (GC) patients based on nodal status.

Methods

In this retrospective analysis, the National Cancer Database was used to identify resected non‐metastatic GC (2006−2016). Patients were stratified by clinical nodal status—negative (cLN−) and positive (cLN+). In patients with cLN− disease who underwent upfront resection and were upstaged to pathological LN+, overall survival (OS) was compared between POC and POCR. In patients with cLN− and cLN+ disease, OS was compared between PEC, POCR, and POC. Kaplan−Meier survival estimate, log‐rank test, and multivariable Cox proportional hazards analysis were performed.

Results

We identified 7827 patients (cLN− 4828; cLN+ 2999). On multivariable analysis in patients with cLN− disease who underwent upfront resection (n = 4314) and were upstaged to pLN+ disease (70%), POCR (n = 2300, aHR 0.78, 95% CI 0.70−0.87, p < 0.001) was associated with improved OS compared to POC (n = 907). No significant difference was noted between POCR (n = 766, aHR 1.11, 95% CI 0.88−1.40, p = 0.39) and POC (n = 341) in patients with pLN− disease. On multivariable analysis in all patients with cLN− disease, POCR (n = 3066) was significantly associated with improved OS (aHR 0.84, 95% CI 0.75−0.92, p < 0.01) compared to POC (n = 1248). No significant difference was noted between POCR (aHR 1.0, 95% CI 0.70−1.01, p = 0.958) and PEC (n = 514). These results remained consistent in patients with cLN+ disease (POCR = 1602, POC = 720, PEC = 677).

Conclusion

Postoperative chemoradiation is associated with improved survival in GC patients upstaged from clinically node‐negative disease to pathologically node‐positive disease. Negative clinical nodal disease status is not a reliable indicator of pathological nodal disease.
Limited Role of MSAFP Screening for Prenatal Omphalocele Detection
Authors: Parobek Christian M. , Shanahan Matthew A. , Burnett Brian A. , Dadoun Simon E. , Adams April D.
Published: August 2024

Objectives

Although serum screening for aneuploidies has become less prevalent, maternal‐serum alpha‐fetoprotein (MSAFP) screening for body‐wall defects remains widespread. We explored whether MSAFP screening is associated with earlier omphalocele detection than ultrasound alone.

Methods

This is a retrospective cohort study of prenatally detected omphalocele cases at our center from 2007 to 2023. We explored the association between MSAFP screening, gestational age at omphalocele detection, and clinical outcomes.

Results

Among 101 pregnancies with prenatally diagnosed omphalocele, 27 (26.7%) had MSAFP screening. The median gestational age at MSAFP screening was 17 weeks 4 days. Of those who received MSAFP screening, 11 (41%) had values ≥2.5 multiples of the median (MoM) and 16 (59%) were not elevated. MSAFP results did not correlate with omphalocele size and were not associated with prenatal or postnatal outcomes. MSAFP screening did not result in earlier suspicion for or confirmation of omphalocele (P = .97 and P = .87, respectively). In contrast, first‐trimester ultrasound screening was associated with earlier suspicion for and confirmation of omphalocele (P < .01 and P = .01, respectively). There were no clinical or demographic differences between those who received MSAFP screening and those who did not (including body mass index or commute distance to an urban center).

Conclusion

MSAFP screening is not associated with earlier omphalocele detection. Furthermore, in pregnancies with prenatally diagnosed omphalocele, the results of MSAFP screening are not predictive of clinical outcomes.
More negative sagittal tibial tuberosity‐trochlear groove distances are correlated with larger patellofemoral chondral lesion size
Authors: Bi Andrew S. , Triana Jairo , Li Zachary I. , Kaplan Daniel J. , Campbell Kirk A. , Alaia Michael J. , Strauss Eric J. , Jazrawi Laith M. , Gonzalez‐Lomas Guillem
Published: August 2024

Purpose

The purpose of this study is to assess the association between sagittal tibial tuberosity‐trochlear groove (sTT‐TG) distance and patellofemoral chondral lesion size in patients undergoing cartilage restoration procedures.

Methods

A retrospective cohort analysis of patients who underwent an osteochondral allograft transplantation or matrix‐induced autologous chondrocyte implantation in the patellofemoral compartment, from 2010 to 2020, were included if they had patellofemoral high‐grade lesions, magnetic resonance imaging (MRI) and minimum 2‐year follow‐up. The preoperative sTT‐TG distance was measured independently on axial T2‐weighted MRI sequences by two authors, each at least two weeks apart. Intraoperative lesion size was reported according to operative report measurements by the attending surgeon. An interclass correlation coefficient (ICC) was calculated to assess intra‐ and inter‐rater reliability, and categorical data analysis and linear regression models were used to assess the relationship between sTT‐TG and lesion size.

Results

A total of 80 patients (50 females) with a mean age of 31.5 ± 10.4 years, body mass index of 27.0 ± 5.9 kg/m2 and follow‐up of 61.5 ± 21.4 months were included. A total of 107 lesions were present: 63 patients with unipolar (patella = 41, trochlea = 22) and 22 with bipolar lesions. The mean MRI defect size was 1.6 ± 1.0 cm2 and the mean intraoperative defect size was 3.8 ± 2.4cm2. Intra‐ (ICC: 0.99,0.98) and inter‐rater reliability (ICC: 0.96) were excellent for both MRI defect size and sTT‐TG measurements. The mean sTT‐TG was −4.8 ± 4.9 mm and was significantly inversely related to MRI defect size (−0.45, p < 0.01), intraoperative patellar lesion size (−0.32, p = 0.01), total lesion area (−0.22, p = 0.04), but not trochlear lesion size (−0.09, p = 0.56). Multivariable regression demonstrated a more negative sTT‐TG remained an independent variable correlated with larger MRI‐measured patellofemoral defect sizes and intraoperative patellar lesions.

Conclusion

A more negative sTT‐TG was an independent variable correlated with larger patellofemoral lesions in patients undergoing patellofemoral cartilage restoration.

Level of Evidence

Level III, Diagnostic.
Shoulder balloon spacer for massive irreparable rotator cuff tears results in significant improvements
Authors: Savarese Eugenio , Aicale Rocco , Romeo Rocco , Maffulli Nicola
Published: August 2024

Purpose

The aim of the present study was to assess the effectiveness of balloon implantation in patients with irreparable supraspinatus tears alone or in combination with other rotator cuff (RC) tendon tears and the effect of several covariables, such as age, gender, status of the long head biceps, with or without tendon repair and regardless the number of tendon involved.

Methods

Patients enrolled from ‘San Carlo’ Hospital of Potenza (Italy, IT), from January 2012 to September 2014, underwent arthroscopic implantation of shoulder balloon by a single surgeon, and followed for 3 years. The American Shoulder and Elbow Surgeons (ASES) and Constant score (CS) were administered pre‐, post‐operatively at 12 months, and then annually. Patients were classified on the basis of the number of tendons involved in the tears and treatment performed, considering the reparability of the tendons themselves. Gleno‐humeral joint osteoarthrosis (OA) was evaluated through shoulder radiographs and classified according to the Samilson–Prieto classification, at the first examination and at the final follow‐up. Statistical improvements were evaluated using a variance model (least‐squares means) and a T distribution test for the evaluation between different treatment groups.

Results

A total of 61 procedures were performed, and eight patients were lost during follow‐up. The mean baseline CS was 30.2 ± 15.4 with statistically significant improvement, respectively, at 1‐, 2‐ and 3‐year follow‐up to 69.3 ± 4.2, 74.6 ± 3.6 and 69.7 ± 5.1 respectively. ASES score at baseline was 22.5 ± 10.9, with a statistically significant improvement to 69.7 ± 9.2, 68 ± 17.8 and 71.2 ± 16.6 at 1‐, 2‐ and 3‐year follow‐up, respectively. Tenotomy or absence of long head biceps at presentation did not influence results (n.s.), with no difference according to gender and age. At final follow‐up, 24 patients (43.9%) showed progression of glenohumeral OA. One patient required secondary surgery for shoulder replacement after 18 months for persistent pain and one patient required implant removal following post‐operative laser treatment.

Conclusion

Arthroscopic rotator cuff tears repair with subacromial spacer balloon implantation showed statistically significant clinical and functional improvement at 3‐year follow‐up. Patients treated with combined partial repair and subacromial spacer balloon implantation experienced good results independent of gender, age, type of tear and long‐head biceps tendon status. The risks related to this procedure appear to be minimal.

Level of Evidence

Level IV.
Subglottic Stenosis After Pediatric Tracheostomy
Authors: Suresh Rishi , Roohani Cheyenne , Wang Cynthia S. , Kou Yann‐Fuu , Johnson Romaine F. , Chorney Stephen R.
Published: August 2024

Objectives

To determine the incidence of subglottic stenosis (SGS) in children after tracheostomy and identify risk factors for development.

Study Design

Retrospective cohort.

Methods

All patients (<18 years) undergoing tracheostomy at a tertiary children's hospital between 2015 and 2020 were included. Patients with a direct laryngoscopy (DL) concurrent with tracheostomy and a subsequent DL were included. Medical records, including operative reports, were reviewed to identify subglottic stenosis and associated risk factors.

Results

A total of 140 patients were included with mean age at tracheostomy of 2.4 years (standard deviation [SD]: 4.3) (median: 0.5 years, interquartile range [IQR]: 0.3–1.5 years) and gestational age of 33.8 weeks (SD: 5.9) (median: 36 weeks, IQR: 28–39 weeks). At initial DL, 24% (N = 34) had subglottic injury and 26% (N = 37) developed SGS. The incidence of SGS after tracheostomy was 11.5 cases per 100 patients per year. At tracheostomy, lower birth weight (1.8 vs. 2.3 kg, p = 0.005), shorter gestational age (31.8 vs. 34.6 weeks, p = 0.01), younger age (0.8 vs. 2.9 years, p = 0.01), lower weight (5.8 vs. 14.7 kg, p = 0.01), and subglottic injury (44% vs. 21%, p = 0.01) were associated with the development of SGS. Multivariable logistic regression analysis associated birth weight (odds ratio [OR]: 0.49, 95% confidence interval [CI]: 0.31–0.75, p = 0.001) and early subglottic injury (OR: 3.22, 95% CI: 1.31–7.88, p = 0.01) with SGS development.

Conclusions

The incidence of SGS after pediatric tracheostomy is estimated at 11.5 cases per 100 patients per year. Low birth weight and subglottic injury at the time of tracheostomy were associated with SGS in this vulnerable population of children.

Level of Evidence

3 Laryngoscope, 2024
Regional spillover effect of 2022 sanctions against Russia on scholarly publications
Authors: Kuzhabekova Aliya
Published: August 2024

This article explores the spillover effects of economic sanctions against Russia on research in neighbouring countries. The assumption of the paper is that such effects should take place given the high level of regional integration in the post‐Soviet area. The study uses bibliometric data retrieved from the Web of Science for analysis; more specifically, the data on publications during 2019, 2021 and 2023 from each of the four countries of interest – Kazakhstan, Belarus, Ukraine and Russia. The data was analysed using descriptive statistics and graphs. The results clearly point to the potential presence of negative externalities of economic sanctions on research systems of neighbouring countries not directly involved in the war. The paper discusses implications of the effects and recommendations, which can be used by policy makers to alleviate the effects on the neighbouring countries and by scholars to further investigate the phenomenon.
Clinical Practices and Opinions toward Gastrostomy Use in Patients with Atypical Parkinsonian Syndromes: A National Survey in the UK
Authors: Kobylecki Christopher , Goh Yee Yen , Mohammad Rahema , Beat Alanna , Michou Emilia , Pavey Samantha , Morris Huw , Houlden Henry , Chelban Viorica
Published: August 2024

Background

Severe dysphagia poses a significant challenge for clinicians regarding feeding tube choices, practices, and timing due to a lack of evidence‐based guidance.

Objectives

To assess national clinical practices and opinions on gastrostomy use in patients with atypical parkinsonian syndromes (APS) across the UK.

Methods

Online survey was administered to clinicians and allied health professionals regarding availability of services, current use, perceived advantages, and problems associated with gastrostomy insertion.

Results

We received responses from 47 respondents across 12 UK centers, including 44 clinicians specialized in APS. Consensus was observed regarding primary indications for gastrostomy insertion and circumstances justifying avoidance of the procedure. Limitations in recommending gastrostomy due to insufficient evidence on safety and outcomes, survival and quality of life were identified. Widespread agreement on delays in gastrostomy discussions was highlighted as a challenge in optimizing patient care, together with variability in current practices and concerns over the lack of a standardized gastrostomy pathway, emphasizing the need for further research to address existing evidence gaps.

Conclusion

This multi‐center survey highlights agreement among clinicians on key aspects of indication, challenges, and limitations such as delayed decision‐making and the absence of standardized pathways regarding the timing, method, and overall approach to gastrostomy insertion in APS. This study identified next steps to facilitate a more structured approach to future research toward a consensus on best practices for gastrostomy in APS. Addressing these challenges is crucial for enhancing patient outcomes and overall care quality in APS.
CineVN: Variational network reconstruction for rapid functional cardiac cine MRI
Authors: Vornehm Marc , Wetzl Jens , Giese Daniel , Fürnrohr Florian , Pang Jianing , Chow Kelvin , Gebker Rolf , Ahmad Rizwan , Knoll Florian
Published: August 2024

Purpose

To develop a reconstruction method for highly accelerated cardiac cine MRI with high spatiotemporal resolution and low temporal blurring, and to demonstrate accurate estimation of ventricular volumes and myocardial strain in healthy subjects and in patients.

Methods

The proposed method, called CineVN, employs a spatiotemporal Variational Network combined with conjugate gradient descent for optimized data consistency and improved image quality. The method is first evaluated on retrospectively undersampled cine MRI data in terms of image quality. Then, prospectively accelerated data are acquired in 18 healthy subjects both segmented over two heartbeats per slice as well as in real time with 1.6 mm isotropic resolution. Ventricular volumes and strain parameters are computed and compared to a compressed sensing reconstruction and to a conventional reference cine MRI acquisition. Lastly, the method is demonstrated in 46 patients and ventricular volumes and strain parameters are evaluated.

Results

CineVN outperformed compressed sensing in image quality metrics on retrospectively undersampled data. Functional parameters and myocardial strain were the most accurate for CineVN compared to two state‐of‐the‐art compressed sensing methods.

Conclusion

Deep learning‐based reconstruction using our proposed method enables accurate evaluation of cardiac function in real‐time cine MRI with high spatiotemporal resolution. This has the potential to improve cardiac imaging particularly for patients with arrhythmia or impaired breath‐hold capability.
Evidence for biexponential glutamate T2 relaxation in human visual cortex at 3T: A functional MRS study
Authors: Emeliyanova Polina , Parkes Laura M. , Williams Stephen R. , Lea‐Carnall Caroline
Published: August 2024

Functional magnetic resonance spectroscopy (fMRS) measures dynamic changes in metabolite concentration in response to neural stimulation. The biophysical basis of these changes remains unclear. One hypothesis suggests that an increase or decrease in the glutamate signal detected by fMRS could be due to neurotransmitter movements between cellular compartments with different T2 relaxation times. Previous studies reporting glutamate (Glu) T2 values have generally sampled at echo times (TEs) within the range of 30–450 ms, which is not adequate to observe a component with short T2 (<20 ms). Here, we acquire MRS measurements for Glu, (t) total creatine (tCr) and total N‐acetylaspartate (tNAA) from the visual cortex in 14 healthy participants at a range of TE values between 9.3–280 ms during short blocks (64 s) of flickering checkerboards and rest to examine both the short‐ and long‐T2 components of the curve. We fit monoexponential and biexponential Glu, tCr and tNAA T2 relaxation curves for rest and stimulation and use Akaike information criterion to assess best model fit. We also include power calculations for detection of a 2% shift of Glu between compartments for each TE. Using pooled data over all participants at rest, we observed a short Glu T2‐component with T2 = 10 ms and volume fraction of 0.35, a short tCr T2‐component with T2 = 26 ms and volume fraction of 0.25 and a short tNAA T2‐component around 15 ms with volume fraction of 0.34. No statistically significant change in Glu, tCr and tNAA signal during stimulation was detected at any TE. The volume fractions of short‐T2 component between rest and active conditions were not statistically different. This study provides evidence for a short T2‐component for Glu, tCr and tNAA but no evidence to support the hypothesis of task‐related changes in glutamate distribution between short and long T2 compartments.
Linear Bloch–Siegert phase‐encoded low‐field MRI: RF coils, pulse sequence, and image reconstruction
Authors: Srinivas Sai Abitha , Martin Jonathan B. , Vaughn Christopher E. , Grissom William A.
Published: August 2024

Conventional
gradient systems have several weaknesses including high cost and bulk. As a step towards addressing these while providing new degrees of freedom for spatial encoding and system design in Magnetic Resonance Imaging (MRI), a radio frequency (RF) gradient encoding system and pulse sequence for phase encoding using the Bloch–Siegert (BS) shift were developed. Optimized BS spatial encoding coils with bucking windings (counter‐wound loops) were designed and constructed, along with compatible homogeneous imaging coils for excitation and signal reception. Two coil systems were developed: one for phantom imaging and a second for human wrist imaging. BS phase‐encoded imaging and BS RF pulse simulations were performed. Pulse sequences were designed for linear stepping in k‐space and implemented on a 47.5‐mT scanner to image resolution phantoms in both coil setups. Reconstructions were performed using both the full
‐based encoding fields for each BS pulse amplitude and using inverse discrete Fourier transforms. A
gradient was used for frequency encoding during signal readout, and the third axis was projected. Specific absorption ratio (SAR) calculations were performed for the wrist coil to determine the safety of BS‐based RF encoding for
fields in the low field MRI regime. The optimized RF spatial encoding coils resulted in higher linearity (
and 0.9921 in the phantom and wrist coils, respectively) than coils used in previous work. The phantom and wrist imaging coils were validated in simulations and experimentally to produce a peak
G and 0.8 G with 12‐W input power, respectively, in the field‐of‐view (length = 11 cm) used for imaging. Nominal imaging resolutions of 5.22 and 7.21 mm were, respectively, achieved by the two‐coil systems in the RF phase‐encoded dimension. Coil systems, pulse sequences, and image reconstructions were developed for linear RF phase encoding using the BS shift and validated using a 47.5‐mT open low field scanner, establishing a key component required for
 gradient‐free imaging at low
 field strengths.
Risk factors for the development of refeeding syndrome in adults: A systematic review
Authors: Zheng Ping , Chen Yilin , Chen Feng , Zhou Min , Xie Caixia
Published: August 2024

Identifying patients with a particularly high risk of refeeding syndrome (RFS) is essential for taking preventive measures. To guide the development of clinical decision‐making and risk prediction models or other screening tools for RFS, increased knowledge of risk factors is needed. Therefore, we conducted a systematic review to identify risk factors for the development of RFS. PubMed, EMBASE, Cochrane Library, and Web of Science were searched from January 1990 until March 2023. Studies investigating demographic, clinical, drug use, laboratory, and/or nutrition factors for RFS were considered. The Newcastle‐Ottawa Scale was used to appraise the methodological quality of included studies. Of 1589 identified records, 30 studies were included. Thirty‐three factors associated with increased risk of RFS after multivariable adjustments were identified. The following factors were reported by two or more studies, with 0–1 study reporting null findings: a previous history of alcohol misuse, cancer, comorbid hypertension, high Acute Physiology and Chronic Health Evaluation II score, high Sequential Organ Failure Assessment score, low Glasgow coma scale score, the use of diuretics before refeeding, low baseline serum prealbumin level, high baseline level of creatinine, and enteral nutrition. The majority of the studies (20, 66.7%) were of high methodological quality. In conclusion, this systematic review informs on several risk factors for RFS in patients. To improve risk stratification and guide development of risk prediction models or other screening tools, further confirmation is needed because there were a small number of studies and a low number of high‐quality studies on each factor.
The mediating role of resilience between caregiver burden and hope among patients with inflammatory bowel disease
Authors: Zhou Meijing , Wang Mi , Luo Dan , Sun Caiyun , Bian Qiugui , Xu Jingjing , Lin Zheng
Published: August 2024

Aim

To investigate whether resilience mediates the connection between caregiver burden and hope among caregivers of patients with inflammatory bowel disease (IBD).

Design

A cross‐sectional study.

Methods

Two hundred patients with IBD were conveniently sampled from two tertiary hospitals in Jiangsu Province, China. The main instruments involved the Zarit Burden Interview, the 10‐item Connor‐Davidson resilience scale, and the Herth Hope Index. We conducted descriptive analysis and Pearson correlations using SPSS 25.0. The PROCESS v3.3 macro analysed the mediating effect. We report the results in line with the STROBE checklist.

Results

Caregiver burden was significantly negatively connected with hope and resilience, whereas resilience positively correlated with hope. The mediation role of resilience was significant in the relationship between caregiver burden and hope, with mediating effects accounting for 47.86% of the overall effect.

Conclusions

Resilience partially mediates the association between caregiver burden and hope among patients with IBD. This finding highlights the protective role of resilience in undermining caregiver burden and strengthening hope.

Implications for Practice

In clinical practice, healthcare providers should perform routine psychological assessments for caregivers of patients with IBD. Furthermore, resilience training should be incorporated into interventions to alleviate caregiver burden and enhance hope.

Patient or Public Contribution

None.
Indicators and factors related to one‐year improved SCImago journal rank in nursing journals: A bibliometric analysis
Authors: Srisawad Sutthisak , Lertsittiphan Kullacha , Saenkla Pennapa , Tunsirirut Sirirut
Published: August 2024

Aims

To analyse the bibliometric data of nursing journals covering general fields, specializations, skills and practices and investigate the influence of selection factors on the one‐year improved SCImago journal rank (SJR).

Design

A bibliometric analysis.

Methods

The study sample included academic journals in the field of nursing indexed in the Scopus and SJR database using data from 2020 to 2022. Quantile regression were performed that investigated the influence factors over the one‐year improved SJR when variables were found to be non‐normally distributed, characterized by extremely high kurtosis.

Results

Results from 539 nursing journals retrieved from the Scopus and SCImago databases revealed that citation index remains the main factor that positively affects differences in SJR, while citable articles only affect the early stages of quantile regression. In addition, an excessively high number of research articles may negatively affect SJR, and the influence of self‐citations can initially be positive but become negative the following year. Citations continue to be the dominant factor, while the rapid growth in the number of articles and self‐citations must be addressed with caution.

No Patient or Public Contribution

No patient or public contribution.