bluuebunny/crossref_metadata_2025 huggingface dataset:
Prison inmates with court-ordered treatments: are they really different?
Authors: D’Orta Isabella , Herrmann François R. , Giannakopoulos Panteleimon
Published: February 2022

Background

Both the frequency of court-ordered treatments (COT) for offenders and prevalence of mental disorders among regular prison inmates steadily increased in most western countries. Whether there are major sociodemographic and clinical differences between these two populations is still matter of debate.

Methods

We compared the sociodemographic and clinical characteristics in a representative sample of 139 regular prison inmates versus 61 offenders with COT admitted during a 5-year period in an acute psychiatric care unit located in the central prison of the Geneva county. Fisher exact, unpaired Student’s t and Mann–Whitney U tests were used to compare demographic and clinical variables between COT patients and regular inmates. In addition, univariate and multivariable ordered logistic regression models were built to identify the sociodemographic and clinical determinants of COT.

Results

COT patients were significantly older, less frequently married, with better education attainment, predominantly French-speaking, of the Christian religious group and with regular religious practice. History of psychiatric outpatient care was significantly more frequent in this group. Unlike the significantly higher occurrence of adjustment disorders in regular prisoners, psychosis was the main diagnosis in COT patients. When all diagnostic categories were taken into account in multivariable models, the presence of personality and psychotic disorders were the stronger predictors of COT status.

Conclusions

Our data reveal that offenders with COT represent a clinically distinct group with an overrepresentation of personality and psychotic disorders. Moreover, they show that, at least in the Swiss penitentiary system, COT patients are less exposed to acculturation issues compared to regular inmates.
The use of cell salvage during second-stage reimplantation for the treatment of chronic hip periprosthetic joint infection: a retrospective cohort study
Authors: Liu Zunhan , Yang Xuetao , Zhao En-Ze , Wan Xufeng , Cao Guorui , Zhou Zongke
Published: February 2022

Introduction

Given the possibility of inadvertent bacterial contamination of salvaged blood, the use of cell salvage is relatively contraindicated in cases of reimplantation for chronic hip periprosthetic joint infection (PJI). However, there are no published data supporting this assertion. The purpose of the current study was to compare the reinfection rate and rate of postoperative allogeneic blood transfusion (ABT) in second-stage reimplantation for PJI with or without intraoperative cell salvage reinfusion.

Materials and methods

We identified 125 patients who underwent two-stage exchange for chronic hip PJI between November 2012 and April 2019. The groups of patients who had (n = 61) and had not (n = 64) received intraoperative cell salvage reinfusion were compared with respect to the curative infection-free rate. Moreover, we compared the need for postoperative ABT and identified independent factors associated with ABT using multiple regression analysis.

Results

The log-rank survival curve with an endpoint of infection eradication failure was not significantly different between the cell salvage group (98.4%, 95% CI 95.3–99.9%) and the control group (95.3%, 95% CI 90.2–99.9%) at one year (log rank, P = .330). The rates of postoperative ABT in the cell salvage group were significantly lower than those in the control group (11.5% vs 26.6%, P = .041). In multivariable models, patient age, body mass index, preoperative hemoglobin level, and intraoperative cell salvage were independent predictors of ABT exposure (P < .05).

Conclusions

The use of cell salvage during reimplantation in two-stage exchange for chronic hip PJI did not appear to increase the reinfection rate, while it significantly reduced the rate of postoperative allogeneic red blood transfusion. Greater age, lower BMI, lower preoperative hemoglobin, and non-intraoperative cell salvage reinfusion were associated with higher rate of allogeneic red blood transfusion.
Sublobar resection versus ablation for stage I non-small-cell lung cancer: a meta-analysis
Authors: Li Yong , Yang Fang , Huang Ya-Yong , Wang Tao
Published: February 2022

Background

Stage I non-small-cell lung cancer (NSCLC) can be treated by both ablation and sublobar resection (SR). This meta-analysis was therefore designed to better compare the relative safety and efficacy of these two approaches to treating stage I NSCLC.

Materials and methods

Relevant studies published through November 2020 in the Cochrane Library, Embase, and PubMed databases were identified for analyses which were conducted with RevMan v5.3.

Results

In total, 816 potentially relevant articles were identified, of which 8 were ultimately included in the final meta-analysis. Patients in the SR group exhibited a signficantly lower pooled local recurrence (LR) rate (5.0% vs. 25.4%, P < 0.0001), although pooled distant recurrence (DR) rates were similar in both groups (25.7% vs. 23.1%, P = 0.75). The pooled hazard ratio (HR) for overall survival (OS) (HR: 1.23; 95% CI: 1.13–1.33, P < 0.00001), progression-free survival (PFS) (HR: 1.34; 95% CI: 1.15–1.55, P = 0.0002), and cancer-specific survival (HR: 1.39; 95% CI: 1.15–1.70, P = 0.0009) all indicated better survival outcomes among patients that underwent HR treatment, while pooled complication rates were similar in both groups (27.7% vs. 43.8%, P = 0.27). Patients that underwent ablation exhibited significantly shorter pooled post-operative hospitalization relative to those in the SR group (MD: 5.93; 95% CI: 0.78–11.07, P = 0.02). No evidence of publication bias was detected through funnel plot analyses.

Conclusions

SR treatment of stage I NSCLC patients was associated with a lower LR rate and longer survival as compared to ablation.
A validation study of potential prognostic DNA methylation biomarkers in patients with acute myeloid leukemia using a custom DNA methylation sequencing panel
Authors: Šestáková Šárka , Cerovská Ela , Šálek Cyril , Kundrát Dávid , Ježíšková Ivana , Folta Adam , Mayer Jiří , Ráčil Zdeněk , Cetkovský Petr , Remešová Hana
Published: February 2022

Background

Multiple studies have reported the prognostic impact of DNA methylation changes in acute myeloid leukemia (AML). However, these epigenetic markers have not been thoroughly validated and therefore are still not considered in clinical practice. Hence, we aimed to independently verify results of selected studies describing the relationship between DNA methylation of specific genes and their prognostic potential in predicting overall survival (OS) and event-free survival (EFS).

Results

Fourteen studies (published 2011–2019) comprising of 27 genes were subjected to validation by a custom NGS-based sequencing panel in 178 newly diagnosed non-M3 AML patients treated by 3 + 7 induction regimen. The results were considered as successfully validated, if both the log-rank test and multivariate Cox regression analysis had a p-value ≤ 0.05. The predictive role of DNA methylation was confirmed for three studies comprising of four genes: CEBPA (OS: p = 0.02; EFS: p = 0.03), PBX3 (EFS: p = 0.01), LZTS2 (OS: p = 0.05; EFS: p = 0.0003), and NR6A1 (OS: p = 0.004; EFS: p = 0.0003). For all of these genes, higher methylation was an indicator of longer survival. Concurrent higher methylation of both LZTS2 and NR6A1 was highly significant for survival in cytogenetically normal (CN) AML group (OS: p < 0.0001; EFS: p < 0.0001) as well as for the whole AML cohort (OS: p = 0.01; EFS < 0.0001). In contrast, for two studies reporting the poor prognostic effect of higher GPX3 and DLX4 methylation, we found the exact opposite, again linking higher GPX3 (OS: p = 0.006; EFS: p < 0.0001) and DLX4 (OS: p = 0.03; EFS = 0.03) methylation to a favorable treatment outcome. Individual gene significance levels refer to the outcomes of multivariate Cox regression analysis.

Conclusions

Out of twenty-seven genes subjected to DNA methylation validation, a prognostic role was observed for six genes. Therefore, independent validation studies are necessary to reveal truly prognostic DNA methylation changes and to enable the introduction of these promising epigenetic markers into clinical practice.
Allergic rhinitis, allergic contact dermatitis and disease comorbidity belong to separate entities with distinct composition of T-cell subsets, cytokines, immunoglobulins and autoantibodies
Authors: Chai Wenjia , Zhang Xuyi , Lin Meixiong , Chen Zhuo , Wang Xiaolin , Wang Changqing , Chen Aoyan , Wang Caisheng , Wang Hongwu , Yue Honghong , Gui Jingang
Published: February 2022

Background

Allergic rhinitis (AR) and allergic contact dermatitis (ACD) are prevalent allergic diseases and have significant impacts on patients’ daily life. Despite many studies on AR or ACD have been conducted separately, little is known about the immune responses in patients of AR combined with ACD and the interplay between AR and ACD. Our study compared various aspects of immune elements in patients with AR or/and ACD, aiming to characterize the immune responses in AR, ACD, and AR combined with ACD.

Methods

A total of 57 patients diagnosed with AR or/and ACD and 28 healthy volunteers were included. AR patients were further divided into seasonal AR (SAR) and perennial AR (PAR). All subjects’ blood samples were taken to assess the concentration of immunoglobulins, complement C3, C4, autoantibodies and cytokines in serum by immunoturbidimetry, ELISA or Luminex200 platform. Peripheral blood mononuclear cells (PBMCs) were subjected to the analysis of lymphocyte subpopulations by flow cytometry.

Results

It indicated that AR disease caused elevated levels of IgE, IgA, IgG, IgG4, as well as IL-4, IL-15, IL-8 and IL-6 in serum. AR patients possessed a decreased CD4/CD8 ratio and an increased proportion of memory CD4 + T-cell subset, with a skewed Th2 response and an enhanced CD8 + T-cell activation. Compared with patients with sole AR or ACD condition, AR + ACD patients presented with a significantly increased proportion of memory CD8 + T-cell subset and were prone to autoimmune disorders as indicated by the increased autoantibodies. The immune elements in patients with ACD only were least affected compared with those in other conditions. Additionally, seasonal or perennial AR patients exhibited different cytokine profiles and proportions of memory T-cell subsets.

Conclusions

In this study, we illuminated the respective characteristics of immune responses in AR, ACD, and AR combined with ACD. Meanwhile, we discovered that the PAR and SAR patients possessed different cytokine profiles and T-cell compartments. It suggested that these allergic conditions belong to different disease entities. Characterizing the detailed immune changes in these allergic diseases would help to develop proper treatments targeting particular immune elements in different allergic diseases.
Ryanodine receptor RyR1-mediated elevation of Ca2+ concentration is required for the late stage of myogenic differentiation and fusion
Authors: Qiu Kai , Wang Yubo , Xu Doudou , He Linjuan , Zhang Xin , Yan Enfa , Wang Lu , Yin Jingdong
Published: February 2022

Background

Cytosolic Ca2+ plays vital roles in myogenesis and muscle development. As a major Ca2+ release channel of endoplasmic reticulum (ER), ryanodine receptor 1 (RyR1) key mutations are main causes of severe congenital myopathies. The role of RyR1 in myogenic differentiation has attracted intense research interest but remains unclear.

Results

In the present study, both RyR1-knockdown myoblasts and CRISPR/Cas9-based RyR1-knockout myoblasts were employed to explore the role of RyR1 in myogenic differentiation, myotube formation as well as the potential mechanism of RyR1-related myopathies. We observed that RyR1 expression was dramatically increased during the late stage of myogenic differentiation, accompanied by significantly elevated cytoplasmic Ca2+ concentration. Inhibition of RyR1 by siRNA-mediated knockdown or chemical inhibitor, dantrolene, significantly reduced cytosolic Ca2+ and blocked multinucleated myotube formation. The elevation of cytoplasmic Ca2+ concentration can effectively relieve myogenic differentiation stagnation by RyR1 inhibition, demonstrating that RyR1 modulates myogenic differentiation via regulation of Ca2+ release channel. However, RyR1-knockout-induced Ca2+ leakage led to the severe ER stress and excessive unfolded protein response, and drove myoblasts into apoptosis.

Conclusions

Therefore, we concluded that Ca2+ release mediated by dramatic increase in RyR1 expression is required for the late stage of myogenic differentiation and fusion. This study contributes to a novel understanding of the role of RyR1 in myogenic differentiation and related congenital myopathies, and provides a potential target for regulation of muscle characteristics and meat quality.
Podoconiosis instruction at nursing schools in Kenya, Rwanda, and Uganda
Authors: Wampande Lilian Nantume , Nyabuga Lamek Mageto , Fowler Kelly , Okengwu Grace Chinelo , Bayisenge Ursin , Schurer Janna M.
Published: February 2022

Background

Podoconiosis is a preventable, progressive, and non-infectious form of elephantiasis that can contribute to significant disability and economic burden when not treated early. Nurses play a critical role in early detection and response in rural Africa, but it is unclear if they receive adequate training on podoconiosis. We aimed to characterize podoconiosis instruction at all government accredited, post-secondary nursing institutions in three African countries.

Methods

Data for this cross-sectional study was collected through a quantitative survey with several open-answer questions. Through a rigorous online search, we identified all post-secondary institutions in Kenya, Rwanda and Uganda accredited to teach human nursing. A total of 289 accredited programs, including 85 certificate, 56 degree and 148 diploma programs were invited to participate. Respondents completed surveys online or by telephone. Measures focused on podoconiosis knowledge, perceptions of quality/quantity of podoconiosis instruction, and barriers to sufficient podoconiosis education.

Results

We obtained information about 212 curricula across 149 nursing institutions in the three countries (participation rate: 73.4%). Podoconiosis coverage was limited across programs (certificate—24.1%; diploma—55.6%; degree—30.3%). Most respondents felt that the quality and quantity of instruction were insufficient (60.6%, 62.9%), respectively. Exclusion from government curricula, low priority and faculty lack of knowledge were commonly reported barriers to podoconiosis inclusion.

Conclusions

This study demonstrated clear gaps in podoconiosis training for nurses across the three countries and highlights a serious challenge in eliminating podoconiosis as a public health problem. Interventions to improve nurses’ knowledge could include the development and free distribution of podoconiosis teaching materials, designed for integration into pre-existing courses.
Molecular and biochemical basis of softening in tomato
Authors: Wang Duoduo , Seymour Graham B.
Published: February 2022

We review the latest information related to the control of fruit softening in tomato and where relevant compare the events with texture changes in other fleshy fruits. Development of an acceptable texture is essential for consumer acceptance, but also determines the postharvest life of fruits. The complex modern supply chain demands effective control of shelf life in tomato without compromising colour and flavour.

The control of softening and ripening in tomato (Solanum lycopersicum) are discussed with respect to hormonal cues, epigenetic regulation and transcriptional modulation of cell wall structure-related genes. In the last section we focus on the biochemical changes closely linked with softening in tomato including key aspects of cell wall disassembly. Some important elements of the softening process have been identified, but our understanding of the mechanistic basis of the process in tomato and other fruits remains incomplete, especially the precise relationship between changes in cell wall structure and alterations in fruit texture.
Studying driving behavior and risk perception: a road safety perspective in Egypt
Authors: Sayed Islam , Abdelgawad Hossam , Said Dalia
Published: February 2022

Roadway safety research indicates a correlation between drivers’ behavior, the demographics, and the local environment affecting the risk perception and roadway crashes. This research examines these issues in an Egyptian context by addressing three groups: private cars drivers, truck drivers, and public transportation drivers. A Driver Behavior Questionnaire (DBQ) was developed to capture information about drivers’ behavior, personal characteristics, risk perception, and involvement in crashes. The risk perception was captured subjectively by exposing participants to various visual scenarios representing specific local conditions to rank their perception of the situation from a safety perspective.

Results indicated that the human factor, in particular, failure of keeping a safe following distance, was a major cause of crashes. The analyzed data was used to predict expected crash frequency based on personal attributes, such as age, driving experience, personality traits, and driving behavior, using negative binomial models. The study recommends that the DBQ technique, combined with risk perception scenarios, can be used to understand drivers’ characteristics and behaviors and collect information on the crashes they experience.

Practically the study findings could provide series of recommendations to the local authorities about the introduction of the traffic management and noise control act; raising awareness of driving etiquette; setting and enforcing driving hours’ regulations, and consider specific training programs for beginners drivers.
Intron-Retention Neoantigen Load Predicts Favorable Prognosis in Pancreatic Cancer
Authors: Dong Chuanpeng , Reiter Jill L. , Dong Edward , Wang Yue , Lee Kelvin P. , Lu Xiongbin , Liu Yunlong
Published: February 2022

PURPOSE

High tumor mutation burden (TMB) in many cancer types is associated with the production of tumor-specific neoantigens, a favorable outcome and response to immune checkpoint blockade (ICB) therapy. Besides mutation-derived neoantigens, aberrant intron retention also produces tumor neopeptides that could trigger an immune response. The relationship between intron-retention–derived tumor neoantigens (IR-neoAg) and clinical outcomes in pancreatic cancer remains uncertain. Here, we quantify IR-neoAg in pancreatic cancer and evaluate whether IR-neoAg load might serve as a biomarker for selecting patients who may benefit from ICB therapy.

METHODS

We developed a computational approach to estimate patient-specific IR-neoAg load from transcriptome data available in The Cancer Genome Atlas pancreatic cancer cohort. Associations between IR-neoAg load and patient overall survival were evaluated using Kaplan-Meier estimates and Cox regression. Differential expression of immune checkpoint and HLA-I genes was evaluated in tumors with high IR-neoAg load.

RESULTS

High IR-neoAg load predicted better overall survival in pancreatic cancer, although no association was found for TMB. IR-neoAg load remained a significant prognostic factor after adjusting for patient age, sex, tumor stage and grade, and TMB. Moreover, pancreatic tumors with both high IR-neoAg load and high HLA-I gene expression had similar gene expression profiles as other tumor types that showed response to anti–programmed cell death protein 1 therapy.

CONCLUSION

IR-neoAg load is associated with favorable survival in pancreatic cancer. These findings provide strong evidence for considering IR-neoAgs when selecting patients who might benefit from ICB therapy.
Acetaminophen (APAP, Paracetamol) Interferes With the First Trimester Human Fetal Ovary Development in an Ex Vivo Model
Authors: Lecante Laetitia L , Leverrier-Penna Sabrina , Gicquel Thomas , Giton Frank , Costet Nathalie , Desdoits-Lethimonier Christèle , Lesné Laurianne , Fromenty Bernard , Lavoué Vincent , Rolland Antoine D , Mazaud-Guittot Séverine
Published: February 2022

Context

Acetaminophen (APAP, paracetamol) is widely used by pregnant women. Although long considered safe, growing evidence indicates that APAP is an endocrine disruptor since in utero exposure may be associated with a higher risk of male genital tract abnormalities. In rodents, fetal exposure has long-term effects on the reproductive function of female offspring. Human studies have also suggested harmful APAP exposure effects.

Objective

Given that disruption of fetal ovarian development may impact women’s reproductive health, we investigated the effects of APAP on fetal human ovaries in culture.

Design and Setting

Human ovarian fragments from 284 fetuses aged 7 to 12 developmental weeks (DW) were cultivated ex vivo for 7 days in the presence of human-relevant concentrations of APAP (10−8 to 10−3 M) or vehicle control.

Main Outcome Measures

Outcomes included examination of postculture tissue morphology, cell viability, apoptosis, and quantification of hormones, APAP, and APAP metabolites in conditioned culture media.

Results

APAP reduced the total cell number specifically in 10- to 12-DW ovaries, induced cell death, and decreased KI67-positive cell density independently of fetal age. APAP targeted subpopulations of germ cells and disrupted human fetal ovarian steroidogenesis, without affecting prostaglandin or inhibin B production. Human fetal ovaries were able to metabolize APAP.

Conclusions

Our data indicate that APAP can impact first trimester human fetal ovarian development, especially during a 10- to 12-DW window of heightened sensitivity. Overall, APAP behaves as an endocrine disruptor in the fetal human ovary.
Emergency Subglottic Airway Training and Assessment of Skills Retention of Attending Anesthesiologists With Simulation Mastery-Based Learning
Authors: Clark Carlee A. , Mester Robert A. , Redding Amanda T. , Wilson Dulaney A. , Zeiler Lydia L. , Jones Wanda R. , Reves Jerry G. , Reeves Scott T. , Schaefer John J.
Published: February 2022

BACKGROUND:

Although included within the American Society of Anesthesiologists difficult airway algorithm, the use of “invasive airway access” is rarely needed clinically. In conjunction with highly associated morbidity and liability risks, it is a challenge for the average anesthesiologist to develop and maintain competency. The advancement of high-fidelity simulators allows for practice of rarely encountered clinical scenarios, specifically those requiring invasive subglottic airway techniques.

METHODS:

Sixty board-certified academic anesthesiologists were enrolled and trained in dyads in a simulation-based, mastery-based learning (MBL) course directed at 2 emergency airway subglottic techniques: transtracheal jet ventilation (TTJV) and bougie cricothyrotomy (BC). Performance metrics included: pretest, posttest, specific skill step error tracking, and 15-month period retest. All were pretested and trained once on the Melker cricothyrotomy (MC) kit. All pretest assessment, training, posttesting, and 15-month retesting were performed by a single expert clinical and educational airway management faculty member.

RESULTS:

Initial testing showed a success rate of 14.8% for TTJV, 19.7% for BC, and 25% for MC. After mastery-based practice, all anesthesiologists achieved successful invasive airway placement with TTJV, BC, and MC. Repeated performance of each skill improved speed with zero safety breaches. BC was noted to be the fastest performed technique. Fifteen months later, retesting showed that 80.4% and 82.6% performed successful airway securement for TTJV and BC, respectively. For safety, average placement time and costs, MC was discarded after initial training results.

CONCLUSIONS:

We discovered that only ~20% of practicing anesthesiologists were able to successfully place an invasive airway in a simulated life or death clinical setting. Using mobile simulation (training performed in department conference room) during a 2.5-hour session using mastery-based training pedagogy, we increased our success rate of invasive airway placement to 100%, while also increasing the successful speed to ventilation (TTJV, 32 seconds average; BC, 29 seconds average). Finally, we determined that there was a 15-month 80% retention rate of the airway skills learned, indicating that skills last at least a year before retraining is required using this training methodology.
Clinical Experiences of 3-Dimensional Biportal Endoscopic Spine Surgery for Lumbar Degenerative Disease
Authors: Heo Dong Hwa , Kim Ji Yeon , Park Jeong-Yoon , Kim Jin Sung , Kim Hyeun Sung , Roh Jeffrey , Park Choon Keun , Chung Hungtae
Published: February 2022

BACKGROUND:

The lack of stereoscopic vision in endoscopic spine surgery may lead to a risk of neural or vascular injury during endoscopic surgery. Three-dimensional (3D) endoscopy has not yet been attempted in the field of spinal endoscopic surgery.

OBJECTIVE:

To present the technique, clinical efficacy, and safety of the 3D biportal endoscopic approach for the treatment of lumbar degenerative disease.

METHODS:

We attempted 3D biportal endoscopic surgery for lumbar degenerative disease in a series of patients. Clinical outcomes and complications were evaluated postoperatively using a short questionnaire about 3D biportal endoscopic spine surgery that solicited respondents’ opinions on the advantages and disadvantages of 3D biportal endoscopic surgery compared to the conventional 2D biportal endoscopic approach.

RESULTS:

We performed 3D biportal endoscopic spine surgery in 38 patients with lumbar degenerative disease. Optimal neural decompression was revealed by postoperative magnetic resonance imaging in all enrolled patients. The 3D endoscopic vision clearly demonstrated the surgical anatomy starting with the exposure of ligamentum flavum, dura, and nerve root, and 3D endoscopy precisely depicted pathologic lesions such as bony osteophytes and ruptured disc herniation. There were no major complications including neural injury or durotomy.

CONCLUSION:

The 3D endoscope may be able to distinguish between normal structures and lesions. The stereognosis and depth sensation of 3D biportal endoscopic spinal surgery might have a favorable impact on the safety of patients during endoscopic spine surgery.
The “Binder Ring” Bypass: Transection, Rerouting, and Reanastomosis as an Alternative to Macrovascular Decompression of a Dolichoectatic Vertebral Artery
Authors: Srinivasan Visish M. , Labib Mohamed A. , Furey Charuta G. , Catapano Joshua S. , Lawton Michael T.
Published: February 2022

BACKGROUND:

In cases of extreme vertebrobasilar dolichoectasia, padding the cranial nerves (CNs) (microvascular decompression [MVD]) and clip-assisted sling transposition of the tortuous artery (macrovascular decompression [MaVD]) may be ineffective because the sling does not reduce the redundancy. Transposition may not decompress the nerves or may kink the artery. An alternative solution is needed.

OBJECTIVE:

To introduce the “binder ring” bypass as a novel solution to this unusual macrovascular compression problem.

METHODS:

The binder ring denotes the opening and closing of the offending vascular loop with standard bypass techniques with the artery transected, rerouted lateral to the CNs, and reanastomosed. An example case study is presented for a 72-year-old man whose severe vertebral artery tortuosity could not be relieved by MVD or MaVD. His pathology was exposed with an extended retrosigmoid craniotomy, the V4 segment was transected, the free ends were mobilized lateral to CN VII/VIII, and an end-to-end reanastomosis was performed with intraluminal suturing.

RESULTS:

The example binder ring bypass was patent angiographically, and the patient experienced immediate and lasting symptom relief without complications.

CONCLUSION:

The binder ring bypass applies standard bypass techniques to macrovascular compression but represents a significant escalation in technical challenges relative to traditional techniques. Patient tolerance to temporary arterial occlusion during reanastomosis depends on the location of the compressive arterial loop and the anatomy of collateral circulation. The binder ring bypass should be used as a last resort after medical therapy and MaVD techniques fail and performed only by neurosurgeons with advanced bypass skills.
Associating Surgeon Feedback With Material Physical Properties in the Development Process of a Resective Epilepsy Surgery Simulator
Authors: Thiong'o Grace M. , Mayer Haley , Looi Thomas , Kulkarni Abhaya V. , Drake James M.
Published: February 2022

BACKGROUND:

Hands-on neurosurgical simulations, specifically techniques involving white matter disconnection, are underdeveloped owing to the paucity of low indentation materials that can adequately mimic brain dissection.

OBJECTIVE:

To describe the discovery phase of developing a resective epilepsy surgery simulator by quantifying the physical properties of 6 materials and correlating the scores with surgeon feedback data.

METHODS:

Six materials, silicone, TissueMatrix, gel support, Synaptive hydrogel, dry SUP706, and moist SUP706 of equal dimension, were evaluated for hardness by measuring their resistance to indentation. Temporal lobe prototypes, 1 for each material, were dissected by 2 neurosurgeons and ordinal ranking assigned. Two null hypotheses were tested: one is that no differences in the indentation properties of the 6 materials analyzed would be elicited and the other is that there would be no correlation between indentation and surgeon feedback scores. Statistical comparison of the means of the different materials was performed using one-way analysis of variance. Surgeon feedback data and indentation score associations were analyzed using the Kendall rank correlation coefficient.

RESULTS:

A statistically significant effect (P value <.0001; α 0.05) was measured. Gel support and Synaptive hydrogel had the lowest indentation scores and similar physical properties. Moist support material scored lower than dry support (P = .0067). A strong positive correlation (Kendall tau = 0.9333, P < .0001) was ascertained between the surgeon feedback ranking and indentation scores.

CONCLUSION:

Reasonable material options for developing a resective epilepsy surgery are proposed and ranked in this article. Early involvement of surgeons is useful in the discovery phase of simulator invention.
Reliability of slice-encoding for metal artefact correction (SEMAC) MRI to identify prosthesis loosening in patients with painful total hip arthroplasty – a single centre, prospective, surgical validation study
Authors: Takahashi Tsuneari , Thaker Siddharth , Lettieri Giovanni , Redmond Anthony , Backhouse Michael R. , Stone Martin , Pandit Hemant , O'Connor Philip
Published: February 2022

Objectives:

To validate reliability of slice-encoding for metal artefact correction (SEMAC)-MRI findings in prosthesis loosening detection by comparing them to surgical outcomes (gold standard) in symptomatic patients following hip arthroplasties. To evaluate periprosthetic anatomical structures in symptomatic patients to identify an alternative cause of hip symptoms.

Methods:

We prospectively followed 47 symptomatic patients (55 hips, 39 painful hips – group P and 16 control hips – group C) at our institution from 2011 to 2016. We acquired 1.5 T MRI conventional and SEMAC-MRI images for all patients. Two consultants scored MRI for osteolysis and marrow oedema zone-wise using predefined signal characteristics and settled scoring variations by consensus. We used Spearman Rank-Order Correlation for correlation analysis and used OMERACT (Outcome Measures in Rheumatology) filter pillars to validate SEMAC-MRI findings.

Results:

Eleven patients needed revision surgery, all from group P. None from group C required revision surgery. Remaining 28 hips in the group P were managed conservatively pain completely resolved in 21 hips, eight hips had trochanteric bursitis, eight had extraarticular cause and the remaining five hips had spontaneous pain resolution. We found moderate-to-weak correlation between SEMAC-MRI findings for prosthesis loosening and revision surgery outcomes. Sensitivity, Specificity, PPV and NPV in Group P were (72.7, 64.3, 44.4, 85.7%) in T1W-SEMAC, (90.9, 46.4, 40.0, 92.9%) in STIR-SEMAC and (36.3, 78.5, 40.0, 75.8%) in PDW-SEMAC.

Conclusion:

Negative SEMAC-MRI results can effectively exclude prosthesis loosening confirmed on revision surgery and SEMAC-MRI can detect alternative cause of hip pain accurately.

Advances in knowledge:

Negative SEMAC-MRI in painful THA patients can effectively exclude prosthesis loosening as a cause.
Gonad irradiation from fluoroscopy during upper limb orthopaedic procedures in a UK District General Hospital
Authors: Dadabhoy Maria , Waldock Peter , Brammar Timothy , Pryke Steven , Coomber Ross
Published: February 2022

Objectives:

To perform a dose assessment of radiation received to the surgeon’s gonads when performing upper limb fluoroscopy-guided procedures when the C-arm may be positioned in between the surgeon’s legs.

Methods:

A calibrated MDH-Radcal 2025 electrometer was used to read the radiation dose for a single exposure and a 5-s screening radiograph with the C-arm firing up and down. These were performed with and without a lead gown positioned over the ionisation chamber where it would ordinarily lie over gonads during surgery.

Results:

With the tube firing down and lead apron in place the single exposure (SE) recorded<0.01 uSv and screening exposure (SC) recorded 0.01 uSv. With the tube firing up, with lead the SE recorded 0.09 uSv and the SC 0.54 uSv. In the same situation without lead, the recordings were 0.13 uSv SE and 0. 65 uSv SC.

Conclusions:

With the X-ray tube firing up, there is a measurable radiation dose to the area where the surgeons’ gonads lie. The standard lead apron does not provide shielding of the gonads for a surgeon sitting down performing the operation with the tube firing up since the principal source of the radiation is below the edge of the apron and thus scatters up into the unprotected groin.

Advances in knowledge:

Fluoroscopy with conventional C-arm in upper limb procedures can cause scatter irradiation to gonads. The X-ray beam should always be fired from top to bottom otherwise large doses can be emitted and the lead gown is less protective.
Sexual health risk indicators and their associations with caries status and gingival health of adolescents resident in sub-urban South-West Nigeria
Authors: Folayan Morenike Oluwatoyin , El Tantawi Maha , Yassin Randa , Arowolo Olaniyi , Sam-Agudu Nadia A.
Published: February 2022

Background: Adolescents are at high risk of poor sexual and oral health. We investigated for sexual risk factors associated with caries experience and gingival health among adolescents in Nigeria.

Methods: This cross-sectional study collected data from 10-19-year-old adolescents in Ile-Ife, South-West Nigeria through a household survey conducted between December 2018 and January 2019. Information collected included age; sex; socioeconomic status; sexual practices (vaginal, oral, anal sex); sexual (transactional sex, multiple sex partners, condom use at last sexual intercourse) and oral health (frequency of tooth brushing, use of fluoridated toothpaste, dental service utilization in the last 12 months, consumption of refined carbohydrates in-between meals) risk behaviors; caries experience; and gingival health. Logistic regression was used to determine associations between explanatory variables (sexual and oral health risk behaviors) and outcome variables (caries experience and gingivitis).

Results: There were no significant associations between caries experience and history of sexual intercourse (OR:1.00); condom use at last sex act (OR:0.68); and having one (OR:2.27) or more sexual partners. Also, there was no significant association between moderate/severe gingivitis and a history of anal (OR:2.96), oral (OR:2.69), or vaginal (OR:1.40) sex; and a report of having one (OR:1.71) or more (OR:2.57) sex partners.

Conclusions: Some sexual health risk indicators insignificantly increase the risk for caries and moderate/severe gingivitis. Screening for sexual risk behaviors during dental care may be a suitable wellness programs approach for adolescents.
A randomised trial of the effects on recruitment and retention of including a wet-ink signature and photograph in the patient invitation letter for a clinical trial: results from a Study Within a Trial (SWAT 3 and SWAT 53)
Authors: Anand Rohan , Bradley Judy , O'Neill Brenda , McAuley Danny F. , Clarke Mike
Published: February 2022

Background: There is uncertainty about the effects of modifications to trial patient invitation letters on recruitment and retention. However, such documents are important.

Methods: A 2x2 factorial design embedded a pair of randomised Studies Within a Trial (SWAT) within a large host trial (CLEAR), to evaluate the effects of including wet-ink signatures and photographs in the patient invitation letter. Patients were randomised to receive one of four invitation letters: with a wet-ink or generic signature, and with or without a photograph. The primary outcome was the proportion of invited patients who joined the CLEAR trial. The secondary outcome was the proportion of patients retained in the trial.

Results: 368 letters were given to potential participants in the CLEAR trial and 121 (33%) joined. Proportions for each randomised group were generic signature and no photograph: 38% (33/88); generic signature and photograph: 32% (28/88); wet-ink personal signature and no photograph: 29% (26/91); wet-ink personal signature and photograph: 34% (34/101). There was no evidence of a significant difference in recruitment between those receiving the patient invitation letter containing a wet-ink versus generic signature (odds ratio (OR): 0.86, 95% confidence intervals (CI): 0.55 to 1.32, p=0.49) or photograph versus no photograph (OR: 0.99, 95% CI: 0.64 to 1.53, p=0.97). Retention was similar for the wet-ink and generic signature groups (OR: 1.20, 95% CI: 0.35 to 4.16, p=0.77) but significantly better when a photograph was used (OR: 5.40, 95% CI: 1.12 to 26.15, p=0.04, based on 2 withdrawals in the photograph group versus 9 in the no photograph group).

Conclusions: These SWAT add to the evidence base for the effects of modifications to clinical trial documentation on recruitment and retention. We found including a photograph may improve retention. Although these analyses are underpowered, they will contribute to meta-analysis of similar comparisons.

ISRCTN registration: 89040295 (06/07/2018)
INTERNSHIP. PRACTICE FOR OBTAINING PROFESSIONAL SKILLS AND EXPERIENCE IN PROFESSIONAL ACTIVITIES, INCLUDING RESEARCH
Authors:   Kemerovo State University, Solovitskiy A.N. , Tolkacheva T.V. ,   Kemerovo State University
Published: February 2022

Учебное пособие разработано для производственной практики по получению профессиональных умений и опыта профессиональной деятельности, в том числе - научно-исследовательской, в соответствии с требованиями федерального государственного образовательного стандарта высшего образования по направлению подготовки 05.04.01 Геология профиль «Геология полезных ископаемых и недропользование». В пособии изложено формирование основных разделов отчета по производственной практики, включая недропользование, геодинамику, геологическую и экономическую оценки месторождения, интерпретацию геофизических исследований. Предназначено студентам очной форм обучения по направлению подготовки 05.04.01 Геология профиль «Геология полезных ископаемых и недропользование»
Typology of Tasks for Establishing Numerical Patterns in Elementary School
Authors: Vendina Alla , Kirichek Kseniya
Published: February 2022

The article discusses the expediency of forming in elementary school the intellectual ability to recognize patterns in the surrounding world. Based on the analysis of the available literature, the article reveals the concepts of "regularity", "task for establishing patterns", characterizes the features of the methodology for teaching younger schoolchildren to establish graphic and numerical patterns. The subject of the article is primarily numerical patterns, in connection with which cyclic, increasing, decreasing, as well as mixed numerical patterns that underlie tasks for their identification are described. For some types of tasks, examples of the use of numerical patterns are given: when systematizing, generalizing the program material of the initial mathematics course; checking the level of formation of the corresponding computational skills; preparation for the development of new computational techniques.
Palliative decomprression in malignant obstructive jaundice: focus on the liver function
Authors: Khilko Yu.
Published: February 2022

Background and Study Aim: to investigate the impact of endoscopic and laparoscopic palliative decompression of the common bile duct on the liver function of patients with obstructive jaundice caused by tumor growth.  

Materials and Methods. 48 patients were involved in the study with diagnosed incurable tumors and severe mechanical jaundice in the period from 2011 to 2017 years. Palliative decompression of the common bile duct was performed for all of them: endoscopic methods in 30 patients and laparoscopic hepaticojejunostomy – in 18 patients. Every subgroup was randomized by age, sex, duration of jaundice, and major biochemical parameters determined before surgery. Patients were monitored following next 6 months after decompression. Before surgery, 1, 7 and 14 days, as well as 3 and 6 months after decompression liver function markers were checked: prothrombin time, INR index, serum total protein and albumin with routine methods.

Results. Laparoscopic decompression of the common bile duct by hepaticojejunostomy leads to faster recovery of liver function (manifested by a steady decrease in prothrombin time, INR index and an increase in serum total protein and albumin in next 3-6 months) compared to endoscopic methods.

After endoscopic decompression in this period, the prothrombin time and INR index are significantly higher, the content of total protein and albumin in the serum is lower in comparison to laparoscopic decompression. The indicators of hepatodepressive syndrome significantly deteriorate, 3-6 months after the procedure of endoscopic decompression, which is associated with the development of complications in 30.0% of patients.

Conclusions. Laparoscopic decompression of the common bile duct by forming a hepaticojejunoanastomosis is accompanied by faster restoring of liver function markers compared to endoscopic methods in patients with inoperable periampullary tumors.
Risk-Averse Stochastic Programming vs. Adaptive Robust Optimization: A Virtual Power Plant Application
Authors: Lima Ricardo M. , Conejo Antonio J. , Giraldi Loïc , Le Maître Olivier , Hoteit Ibrahim , Knio Omar M.
Published: February 2022

This paper compares risk-averse optimization methods to address the self-scheduling and market involvement of a virtual power plant (VPP). The decision-making problem of the VPP involves uncertainty in the wind speed and electricity price forecast. We focus on two methods: risk-averse two-stage stochastic programming (SP) and two-stage adaptive robust optimization (ARO). We investigate both methods concerning formulations, uncertainty and risk, decomposition algorithms, and their computational performance. To quantify the risk in SP, we use the conditional value at risk (CVaR) because it can resemble a worst-case measure, which naturally links to ARO. We use two efficient implementations of the decomposition algorithms for SP and ARO; we assess (1) the operational results regarding first-stage decision variables, estimate of expected profit, and estimate of the CVaR of the profit and (2) their performance taking into consideration different sample sizes and risk management parameters. The results show that similar first-stage solutions are obtained depending on the risk parameterizations used in each formulation. Computationally, we identified three cases: (1) SP with a sample of 500 elements is competitive with ARO; (2) SP performance degrades comparing to the first case and ARO fails to converge in four out of five risk parameters; (3) SP fails to converge, whereas ARO converges in three out of five risk parameters. Overall, these performance cases depend on the combined effect of deterministic and uncertain data and risk parameters.

Summary of Contribution: The work presented in this manuscript is at the intersection of operations research and computer science, which are intrinsically related with the scope and mission of IJOC. From the operations research perspective, two methodologies for optimization under uncertainty are studied: risk-averse stochastic programming and adaptive robust optimization. These methodologies are illustrated using an energy scheduling problem. The study includes a comparison from the point of view of uncertainty modeling, formulations, decomposition methods, and analysis of solutions. From the computer science perspective, a careful implementation of decomposition methods using parallelization techniques and a sample average approximation methodology was done . A detailed comparison of the computational performance of both methods is performed. Finally, the conclusions allow establishing links between two alternative methodologies in operations research: stochastic programming and robust optimization.
A case study of inspection during Covid
Authors: O'Connell Suzanne
Published: February 2022

Ofsted's inspection schedule is back in full swing but there have been accusations that inspectors are not taking account of the pandemic hardships that schools have faced. Suzanne O'Connell caught up with executive headteacher Joe Roberts following a recent Ofsted
Post-Covid: Building a resilient education system
Authors: O'Connell Suzanne
Published: February 2022

A report into the pandemic experiences of primary schools offers some stern and direct messages which the government should heed if we are to truly Build Back Better. Suzanne O'Connell reports
Remote-facilitated mental simulation to bridge the theory-practice divide
Authors: Corns Paul , Thomas Libby
Published: February 2022

Remote simulation in education predates the COVID-19 pandemic, and its more widespread contemporary use can help inform future teaching practices. This article outlines the development of a remote-facilitated mental simulation (RFMS) delivered to second-year paramedic science students at a UK university. This was created using Sprick et al's simulation design model: preparation, briefing, simulation activity, debriefing, reflection and evaluation. Mental simulation is a teaching modality where participants mentally rehearse processes rather than practical skills. Speaking thoughts aloud helps learners to reflect on their thought processes and decision-making. While studies on remote simulation involve a facilitator viewing participants interacting with a simulation, in this study the participants were observers and the facilitator interacted with the simulation equipment. This arrangement may increase access to simulation for learners who do not have access to such facilities. Participants were engaged through group activities and psychological fidelity was maintained by providing real-time streaming of patient observations. The RFMS was evaluated positively by respondents.