bluuebunny/crossref_metadata_2025 huggingface dataset:
Medial Patellofemoral Ligament Reconstruction Using Suture Tape for Patellofemoral Joint Instability
Authors: Xu Jun‐cai , Zhang Bo‐xuan , Jia Yan‐feng , Wang Xiao‐feng , Shen Ke , Ren Wei‐bin , Sun Ran
Published: March 2021

Objective

To describe a surgical technique using suture tape for reconstruction of the medial patellofemoral ligament (MPFL). This technique restores the stability of the reconstructed ligament and has excellent postoperative outcomes.

Method

This is a retrospective analysis. From January 2016 to June 2018, 17 patients underwent MPFL reconstruction using high‐strength suture (FiberTape; Arthrex) augmentation, with at least 12 months of follow up. There were 11 female and 6 male patients. The mean age at the time of MPFL reconstruction was 22.1 years (range 13–34 years). Clinical outcomes included pain level, knee range of motion, passive patellar hypermobility, and maltracking at follow‐up. The lateral patellofemoral angles, congruence angles, and patellar tilt angles were measured in a skyline view by CT at 30° of knee flexion at 12 months. Functional outcomes were assessed using the Lysholm knee scoring scale, the SF‐12 score, the Tegner score, and the Crosby and Insall grading system at yearly follow‐up.

Result

No patients were lost at the last follow up. One patient had recurrence of patellar dislocation and none of the others had serious complications. The success rate of MPFL repair for preventing recurrent dislocations was 94.1% (16 of 17 knees). Fifteen knees had full range of motion of more than 130°. At follow‐up, 2 knees were judged to have mild hypermobility and none had severe hypermobility or maltracking. Using the Crosby and Insall grading system, 12 knees (70.6%) were graded as excellent, 4 knees (23.5%) as good, 1 knee (5.9%) as fair to poor, and none as worse at the last follow‐up assessment. In all patients, the Lysholm knee score (55.12 ± 13.52 vs 79.88 ± 7.50, P < 0.01), the SF‐12 score (47 ± 9.53 vs 65.24 ± 12.82, P < 0.01), and the Tegner score (2.76 ± 1.39 vs 6.53 ± 1.70, P < 0.01) had improved at their 12‐month follow up. Compared with preoperative radiological findings, there was a significant improvement in lateral patellofemoral angle (−10.24 ± 7.10 vs 6 ± 5.43, P < 0.01), patellar tilt angle (26.53 ± 7.23 vs 9.88 ± 4.24, P < 0.01), and congruence angle (29.59 ± 11.95 vs −8.65 ± 4.86, P < 0.01).

Conclusion

The use of FiberTape in MPFL reconstruction can improve the stability of the knee following surgery and has good midterm clinical results and low complication rates.
Community engagement and linkage to care efforts by peer community‐health workers to increase PrEP uptake among sexual minority men
Authors: Farley Jason E. , Dangerfield Derek T. , LaRicci Jessica , Sacamano Paul , Heidari Omeid , Lowensen Kelly , Jennings Jacky M. , Tobin Karin E.
Published: March 2021

Purpose

Pre‐exposure prophylaxis (PrEP) prevents HIV yet uptake remains suboptimal across the United States. This paper evaluates the impact of outreach activities led by nurse supervised community healthcare workers (CHWs) on the PrEP care cascade.

Methods

This is an observational programmatic evaluation of LGBTQ + community outreach between March 1, 2016, to March 31, 2020, as part of a public health initiative. Descriptive statistics are used to characterize the data by outreach type.

Results

2,465 participants were reached. Overall, a PrEP appointment was scheduled for 94 (3.8%) with 70 (2.8%) confirmed to have completed a PrEP visit. Success for each type of community outreach activity was evaluated with virtual models outperforming face‐to‐face. Face‐to‐face outreach identified nine persons among 2,188 contacts (0.41%) completing an initial PrEP visit. The website prepmaryland.org identified 4 among 24 contacts (16.7%) and the PrEP telephone/text warm‐line identified 18 among 60 contacts (30%). The PrEPme smartphone application identified 39 among 168 contacts (23.2%).

Conclusions

Face‐to‐face community outreach efforts reached a large number of participants, yet had a lower yield in follow‐up and confirmed PrEP visits. All virtual platforms reached lower total numbers, but had greater success in attendance at PrEP visits, suggesting enhanced linkage to care.
Childhood patterns of overweight and wheeze and subsequent risk of current asthma and obesity in adolescence
Authors: Aris Izzuddin M. , Sordillo Joanne E. , Rifas‐Shiman Sheryl L. , Young Jessica G. , Gold Diane R. , Camargo Carlos A. , Hivert Marie‐France , Oken Emily
Published: March 2021

Background

Obesity and asthma in childhood often co‐occur. Few studies have examined this relationship using repeated measures of body mass index (BMI) or asthma symptoms (such as wheeze).

Objective

We compared two analytic approaches for repeated measures data to investigate this relationship.

Methods

Our baseline sample consisted of 1277 children enrolled in a Boston‐area cohort with BMI or wheeze at age 1 year and no missing covariates. We used latent class growth models (LCGM) and inverse probability weighting (IPW) of marginal structural models to examine the extent to which presence of overweight across childhood was associated with early adolescent current asthma, and conversely of repeated measures of wheeze across childhood with early adolescent obesity.

Results

Using LCGM, a “persistent” childhood overweight class (vs “never”) was associated with higher risk of asthma in early adolescence (RR 1.9; 95% CI 1.1, 3.0), while “persistent” childhood wheeze (vs “never”) was associated with higher risk of obesity in early adolescence (RR 2.7; 95% CI 1.0, 6.4) after adjusting for baseline covariates. An IPW analysis treating childhood overweight and wheeze as time‐varying exposures and adjusting for baseline and time‐varying covariates resulted in weaker and less precise associations of “persistent” (vs “never”) overweight with adolescent asthma (RR 1.3; 95% CI 0.3, 3.0), and of “persistent” (vs “never”) wheeze with adolescent obesity (RR 2.3; 95% CI 0.4, 5.3).

Conclusion

Our point estimates from both approaches suggest an association between “persistent” childhood overweight and adolescent asthma, and between “persistent” childhood wheeze and adolescent obesity. LCGM results were stronger and more precise, whereas IPW results were less conclusive with wider 95% confidence intervals containing the null. The precision gained from LCGM may be at the expense of bias, and the use of both approaches helps to shed some light on this tradeoff.
Hematologic and clinical characteristics of dogs with circulating macrophage‐like cells
Authors: Mochizuki Hiroyuki , Stowe Devorah M.
Published: March 2021

Background

Macrophage‐like (ML) cells are rarely observed on blood smear examinations, and the significance of these cells has been poorly described.

Objective

The objective of this study was to retrospectively describe selected hematologic and clinical characteristics of dogs with ML cells in peripheral blood.

Materials and Methods

Complete blood count (CBC) reports with blood smear evaluations from the clinical pathology laboratory records at North Carolina University College of Veterinary Medicine were retrospectively reviewed. Data were collected over a 10‐year‐period. Dogs were defined as having circulating ML cells if three or more ML cells were present on a single blood smear. Hematologic and clinical data of dogs with circulating ML cells were compared with age‐matched hospital‐derived control dogs.

Results

Of 61,631 CBC records, 87 reports (0.14%) described the presence of ML cells. Thirty‐nine dogs met the inclusion criteria. The hemogram of dogs with circulating ML cells was characterized by a pronounced inflammatory and stress leukogram, anemia, and thrombocytopenia. Of the 39 dogs, 19 (49%) had systemic or severe localized inflammatory/necrotic diseases. Eighteen (46%) dogs were diagnosed with neoplasia of histiocytic (5) and non‐histiocytic origins (13). Dogs with circulating ML cells had a shorter median survival time (34 days) than the control dogs (595 days, P < .0001), with an increased occurrence of death/euthanasia within 1 month (3.89‐fold). However, the presence of circulating ML cells was not found to be an independent prognostic factor in a multivariable model.

Conclusions

The hemograms and diagnoses of dogs with ML cells suggest that severe inflammatory conditions or histiocytic and non‐histiocytic neoplasia are common causes for circulating ML cells.
An in vitro study of canine cryopoor plasma to correct vitamin K–dependent coagulopathy in dogs
Authors: Cheung Hilvy , Jandrey Karl E. , Burges Julie , Brooks Marjory , Kent Michael S.
Published: March 2021

Objective

To compare the efficacy of fresh frozen plasma (FFP) with cryopoor plasma (CPP) to treat vitamin K–dependent factor deficiency in a canine in vitro setting.

Design

In vitro laboratory study.

Setting

University veterinary medical teaching hospital.

Animals

Seven units of FFP and 6 units of CPP from unique canine donors from the university veterinary blood bank.

Interventions

Canine FFP was adsorbed by oral barium sulfate suspension to mimic vitamin K–dependent coagulopathy. A sequential mixing study was completed by adding FPP or CPP to the adsorbed plasma. Measurements of prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen, and factor activities of factors II, VII, and IX (FII, FVII, and FIX) were compared between the 2 treatment groups.

Measurements and main results

When comparing the sequential addition of CPP or FPP to adsorbed plasma, the following had no statistical significance: PT (P = 0.94), aPTT (P = 0.66), FII (P = 0.05), and FIX (P = 0.90). There was a dose‐dependent decrease with PT and aPTT and a dose‐dependent increase with FII and FIX. In contrast, after the addition of either CPP or FFP, there was a significant difference between the treatment groups for the concentration of fibrinogen (P = 0.005) and activity of FVII (P = 0.044), with FFP resulting in a greater concentration of fibrinogen and CPP resulting in a greater concentration of FVII. Measurements of factor X (FX) were initially included in the study but were later excluded because FX appeared to be continually adsorbed even after the addition of CPP or FFP.

Conclusions

CPP partially corrected the coagulation times and concentration of vitamin K–dependent coagulation factors to the same degree as FFP. CPP, generally less expensive than FFP, may provide an alternative treatment option for vitamin K–dependent coagulopathies, although in vivo testing is needed.
Instantons and Bar-Natan homology
Authors: Kronheimer P. B. , Mrowka T. S.
Published: March 2021

A spectral sequence is established whose $E_{2}$ page is Bar-Natan's variant of Khovanov homology and which abuts to a deformation of instanton homology for knots and links. This spectral sequence arises as a specialization of a spectral sequence whose $E_{2}$ page is a characteristic-2 version of $F_{5}$ homology in Khovanov's classification.
Synthesis of Flow and Thermal Transport in Porous Media as Applied to Biological Applications
Authors: Kosari Erfan , Vafai Kambiz
Published: March 2021

The biological systems are tied to the molecular transport across the living tissues which in turn highly depend on kinetic and thermal energy exchanges. For various applications ranging from artery modeling to very sensitive tissue modeling such as the brain, porous media modeling accurately predicts biological behavior. This article elaborately addresses the fundamentals of porous media and provides a comprehensive synthesis of the theory development from the primary methods available in the literature to the modern mathematical formulations. Specifically, this paper concentrates on two remarkable biological applications including (1) blood flow interactions with the porous tissue and (2) hydrodynamic impacts of particle-particle interactions in the microscale modeling that requires a Lagrangian frame.
Advances in secondary ion mass spectrometry for N-doped niobium
Authors: Angle Jonathan W. , Palczewski Ari D. , Reece Charles E. , Stevie Fred A. , Kelley Michael J.
Published: March 2021

Accurate secondary ion mass spectroscopy measurement of nitrogen in niobium relies on the use of closely equivalent standards, made by ion implantation, to convert nitrogen signal intensity to nitrogen content by determination of relative sensitivity factors (RSFs). Accurate RSF values for ppm-range nitrogen contents are increasingly critical, as more precision is sought in processes for next-generation superconducting radiofrequency (SRF) accelerator cavities. Factors influencing RSF value measurements were investigated with the aim of reliably attaining better than 10% accuracy in nitrogen concentrations at various depths into the bulk. This has been accomplished for materials typical of SRF cavities at the cost of increased attention to all aspects.
Plasma generation by household microwave oven for surface modification and other emerging applications
Authors: Barnes Benjamin K , Ouro-Koura Habilou , Derickson Justin , Lebarty Samuel , Omidokun Jesudara , Bane Nathan , Suleiman Othman , Omagamre Eguono , Fotouhi Mahdi J. , Ogunmolasuyi Ayobami , Dominguez Arturo , Gonick Larry , Das Kausik S.
Published: March 2021

A simple and inexpensive method to generate plasma using a kitchen microwave oven is described in this paper. The microwave-generated plasma is characterized by spectroscopic analysis and compared with the absorption spectra of a gas discharge tube. A Paschen-like curve is observed as the microwave plasma initiation time is plotted as a function of the pressure of the plasma chamber. We have also demonstrated that this microwave-generated air plasma can be used in a multitude of applications such as: (a) surface modification of a substrate to change its wettability; (b) surface modification to change electrical/optical properties of a substrate; and (c) enhancement of adhesive forces for improved bonding of polymeric microfluidic molds, such as bonding polydimethylsiloxane (PDMS) chips to glass covers. These simple techniques of plasma generation and subsequent surface treatment and modification applications may bring new opportunities leading to new innovations not only in advanced labs, but also in undergraduate and even high school research labs.
Flawed interferon response spurs severe illness
Authors: Wadman Meredith
Published: March 2021

Antibodies or mutations that cripple key antivirus protein underlie 14% of severe cases.
Fighting to be counted
Authors: Wade Lizzie
Published: March 2021

The pandemic has fueled Abigail Echo-Hawk's quest for health data on Indigenous people in the United States.
A tropical research treasure faces difficult times
Authors: Kaiser Jocelyn
Published: March 2021

Nonprofit known for its training programs and field stations is undergoing financial challenges compounded by pandemic.
Internet voting remains insecure, says AAAS EPI Center
Authors: Korte Andrea
Published: March 2021

The center has worked with U.S. policy-makers to suggest scientifically sound alternatives
Synthetic connectivity, emergence, and self-regeneration in the network of prebiotic chemistry
Authors: Wołos Agnieszka , Roszak Rafał , Żądło-Dobrowolska Anna , Beker Wiktor , Mikulak-Klucznik Barbara , Spólnik Grzegorz , Dygas Mirosław , Szymkuć Sara , Grzybowski Bartosz A.
Published: March 2021

Mapping primordial reaction networks

Chemists seeking to understand the origins of life have published a wide range of reactions that may have yielded the building blocks of proteins, nucleic acids, and lipids from simple precursors. Wołos
et al.
scoured the literature to document each such reaction class and then wrote software that applied the reactions first to the simplest compounds such as cyanide, water, and ammonia, and then iteratively to each successive generation of products. The resulting network predicted a variety of previously unappreciated routes to biochemically relevant compounds, several of which the authors validated experimentally.

Science
, this issue p.
eaaw1955
In Vitro
Susceptibility of Kinetoplastids to Celastroloids from Maytenus chiapensis
Authors: Núñez Marvin J. , Martínez Morena L. , López-Arencibia Atteneri , Bethencourt-Estrella Carlos J. , San Nicolás-Hernández Desirée , Jiménez Ignacio A. , Lorenzo-Morales Jacob , Piñero José E. , Bazzocchi Isabel L.
Published: March 2021

Leishmaniasis and Chagas are among the most significant neglected tropical diseases. Due to several drawbacks with the current chemotherapy, developing new antikinetoplastid drugs has become an urgent issue.
Assessing the Bioactive Profile of Antifungal-Loaded Calcium Sulfate against Fungal Biofilms
Authors: Butcher Mark C. , Brown Jason L. , Hansom Donald , Wilson-van Os Rebecca , Delury Craig , Laycock Phillip A. , Ramage Gordon
Published: March 2021

Calcium sulfate (CS) has been used clinically as a bone- or void-filling biomaterial, and its resorptive properties have provided the prospect for its use as a release mechanism for local antibiotics to control biofilms. Here, we aimed to test CS beads loaded with three antifungal drugs against planktonic and sessile fungal species to assess whether these antifungal beads could be harnessed to provide consistent release of antifungals at biofilm-inhibitory doses.
Antioxidant Molecules as a Source of Mitigation of Antibiotic Resistance Gene Dissemination
Authors: Ortiz de la Rosa José Manuel , Nordmann Patrice , Poirel Laurent
Published: March 2021

Escherichia coli
is the most commonly identified human pathogen and a prominent microorganism of the gut microbiota. Acquired resistance to antibiotics in this species is driven mainly by horizontal gene transfer and plasmid acquisition.
A
Mycoplasma gallisepticum
Glycerol ABC Transporter Involved in Pathogenicity
Authors: Mahdizadeh Sara , Masukagami Yumiko , Tseng Chi-Wen , Markham Philip F. , De Souza David P. , Nijagal Brunda , Tull Dedreia , Tatarczuch Liliana , Browning Glenn F. , Sansom Fiona M.
Published: March 2021

Many mycoplasmas are pathogenic and cause disease in human and animals.
M. gallisepticum
causes chronic respiratory disease in chickens and infectious sinusitis in turkeys, resulting in economic losses in poultry industries throughout the world. Expanding our knowledge about the pathogenesis of mycoplasma infections requires better understanding of the specific gene functions of these bacteria.
Transmission of the Human Relapsing Fever Spirochete Borrelia persica by the Argasid Tick Ornithodoros tholozani Involves Blood Meals from Wildlife Animal Reservoirs and Mainly Transstadial Transfer
Authors: Kleinerman Gabriela , Eshed Tom , Nachum-Biala Yaarit , King Roni , Baneth Gad
Published: March 2021

Borrelia persica
is a spirochete that causes tick-borne relapsing fever in humans in an area that spans from India to the Mediterranean. Until now, it was thought that the soft tick vector of this infection,
Ornithodoros tholozani
, is also its main reservoir and it transmits
B. persica
mostly transovarially between tick generations.
Roles of OmpX, an Outer Membrane Protein, on Virulence and Flagellar Expression in Uropathogenic Escherichia coli
Authors: Hirakawa Hidetada , Suzue Kazutomo , Takita Ayako , Kamitani Wataru , Tomita Haruyoshi
Published: March 2021

Uropathogenic
Escherichia coli
(UPEC) is a major pathogen that causes urinary tract infection (UTI). This bacterium adheres to and internalizes within urinary tract cells, where it aggregates and subsequently forms biofilm-like multicellular colonies that protect UPEC from antimicrobial agents and the host’s immune system.
The Novel P
II
-Interacting Protein PirA Controls Flux into the Cyanobacterial Ornithine-Ammonia Cycle
Authors: Bolay Paul , Rozbeh Rokhsareh , Muro-Pastor M. Isabel , Timm Stefan , Hagemann Martin , Florencio Francisco J. , Forchhammer Karl , Klähn Stephan
Published: March 2021

Cyanobacteria contribute a significant portion to the annual oxygen yield and play important roles in biogeochemical cycles, e.g., as major primary producers. Due to their photosynthetic lifestyle, cyanobacteria also arouse interest as hosts for the sustainable production of fuel components and high-value chemicals.
Molecular Basis for Bordetella pertussis Interference with Complement, Coagulation, Fibrinolytic, and Contact Activation Systems: the Cryo-EM Structure of the Vag8-C1 Inhibitor Complex
Authors: Dhillon Arun , Deme Justin C. , Furlong Emily , Roem Dorina , Jongerius Ilse , Johnson Steven , Lea Susan M.
Published: March 2021

The structure of a 10-kDa protein complex is one of the smallest to be determined using cryo-electron microscopy at high resolution. The structure reveals that C1-INH is sequestered in an inactivated state by burial of the reactive center loop in Vag8.
A Small Cysteine-Free Protein Acts as a Novel Regulator of Fungal Insect-Pathogenic Lifecycle and Genomic Expression
Authors: Mou Ya-Ni , Fu Bo , Ren Kang , Ying Sheng-Hua , Feng Ming-Guang
Published: March 2021

Small cysteine-rich proteins secreted during plant-pathogenic fungal infection comprise virulence effectors. Our study confirms that only a cysteine-free protein (CFP) is determinant to insect-pathogenic fungal virulence among 10 small putatively secreted proteins containing 0 to 12 Cys residues.
High-Fiber, Whole-Food Dietary Intervention Alters the Human Gut Microbiome but Not Fecal Short-Chain Fatty Acids
Authors: Oliver Andrew , Chase Alexander B. , Weihe Claudia , Orchanian Stephanie B. , Riedel Stefan F. , Hendrickson Clark L. , Lay Mi , Sewall Julia Massimelli , Martiny Jennifer B. H. , Whiteson Katrine
Published: March 2021

A profound decrease in the consumption of dietary fiber in many parts of the world in the last century may be associated with the increasing prevalence of type II diabetes, colon cancer, and other health problems. A typical U.S. diet includes about ∼15 g of fiber per day, far less fiber than the daily recommended allowance.
Integrating clinical pharmacists within general practice: protocol for a pilot cluster randomised controlled trial
Authors: Croke Aisling , Moriarty Frank , Boland Fiona , McCullagh Laura , Cardwell Karen , Smith Susan M , Clyne Barbara
Published: March 2021

Introduction

Managing patients with multiple conditions (multimorbidity) is a major challenge for healthcare systems internationally, particularly in older patients. Multimorbidity and subsequent polypharmacy increase treatment burden and the risk of potentially inappropriate prescribing, and both are complex to manage in primary care. Limited evidence suggests integration of pharmacists into general practice teams could improve medication management for patients with multimorbidity and polypharmacy. Building on findings from a non-randomised, uncontrolled General Practice Pharmacist (GPP) feasibility study conducted in Irish primary care, the aim of this study is to conduct a pilot cluster randomised controlled trial (cRCT) of the GPP study, to assess feasibility, intervention impact, costs and appropriateness of continuing to a definitive cRCT.

Methods and analysis

This pilot cRCT will involve 8 general practitioner (GP) practices and 120 patients. Practices will identify and recruit patients aged ≥65 years, who are taking ≥10 regular medications. Practices will be allocated to intervention or control after baseline data collection. Intervention practices will have a pharmacist integrated within their service, working with GPs, patients and practice staff to optimise prescribing and other medication-related activities. Control practices will provide standard GP care. The primary feasibility outcomes will include recruitment rate, uptake of medication reviews and study retention. For the primary clinical outcome, the number of potentially inappropriate prescribing incidences per patient will be collected. Secondary outcomes will include medication-related outcomes, patient-reported outcome measures, and data pertaining to the role and impact of the pharmacist on prescribing. In addition, economic and process evaluations will be conducted.

Ethics and dissemination

This trial has been approved by the Irish College of General Practitioners Research Ethics Committee and will be performed in accordance with the Declaration of Helsinki. The results will be reported in peer-reviewed journals and be presented at national and international conferences.

Trial registration number

ISRCTN Registry (https://doi.org/10.1186/ISRCTN18752158).
Comorbidities and functional impairments in children with attention deficit hyperactivity disorder in China: a hospital-based retrospective cross-sectional study
Authors: Shi Xiaoyan , Ji Yiting , Cai Shizhong , Wu Ying , Zhang Lijun , Shen Ling , Jiang Zhiying , Chen Yan
Published: March 2021

Objectives

The aim of this study was to assess comorbidity patterns and functional impairment in children with and without attention deficit hyperactivity disorder (ADHD).

Design

Hospital-based retrospective cross-sectional study; data collection occurred between 2016 and 2019.

Settings and patients

A total of 8256 children and adolescents, 6–17 years of age, with suspected ADHD agreed to participate in this hospital-based cross-sectional study over a 4-year period in China. Comorbidities and social functions were assessed according to the scales Vanderbilt ADHD Diagnostic Parent Rating Scale and Weiss Functional Impairment Rating Scale-Parent Form, which were completed by the parents of the study participants.

Results

Of the 8256 children, 5640 were diagnosed with ADHD. Other 2616 children who did not meet the ADHD diagnostic criteria were classified as the N-ADHD group . The proportion of comorbidities (47.4%) and functional impairments (84.5%) in the ADHD group were higher than the N-ADHD group (p≤0.001). The functional impairment scores in all of the six domains, including family, academic, life skills, self-concept, social activities and risky activities, were significantly higher in the ADHD group than the N-ADHD group (p≤0.001). The functional impairment in ADHD group with comorbidities was more severe than those without comorbidities (p≤0.001). Comorbidities and core symptoms both can affect the functions of children with ADHD. Logistics regression analysis indicated that in all of the six functional domains, the effect of comorbidities on functional impairment exceeded the effects of ADHD core symptoms.

Conclusions

Comorbidities had the greatest influence on different areas of adaptive functioning in children with ADHD. Clinical management of children suspected to have ADHD should address multiple comorbidities and functional impairments assessment, as well as core symptom analysis.
Stakeholders’ views on the organisational factors affecting application of artificial intelligence in healthcare: a scoping review protocol
Authors: Lebcir Reda , Hill Tetiana , Atun Rifat , Cubric Marija
Published: March 2021

Introduction

Artificial intelligence (AI) offers great potential for transforming healthcare delivery leading to better patient-outcomes and more efficient care delivery. However, despite these advantages, integration of AI in healthcare has not kept pace with technological advancements. Previous research indicates the importance of understanding various organisational factors that shape integration of new technologies in healthcare. Therefore, the aim of this study is to provide an overview of the existing organisational factors influencing adoption of AI in healthcare from the perspectives of different relevant stakeholders. By conducting this review, the various organisational factors that facilitate or hinder AI implementation in healthcare could be identified.

Methods and analysis

This study will follow the Joanna Briggs Institute framework, which includes the following stages: (1) defining and aligning objectives and questions, (2) developing and aligning the inclusions criteria with objectives and questions, (3) describing the planned approach to evidence searching and selection, (4) searching for the evidence, (5) selecting the evidence, (6) extracting the evidence, (7) charting the evidence, and summarising the evidence with regard to the objectives and questions.

The databases searched will be MEDLINE (Ovid), CINAHL (Plus), PubMed, Cohrane Library, Scopus, MathSciNet, NICE Evidence, OpenGrey, O’REILLY and Social Care Online from January 2000 to June 2021. Search results will be reported based on The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews guidelines. The review will adopt diffusion of innovations theory, technology acceptance model and stakeholder theory as guiding conceptual models. Narrative synthesis will be used to integrate the findings.

Ethics and dissemination

Ethics approval will not be sought for this scoping review as it only includes information from previously published studies. The results will be disseminated through publication in a peer-reviewed journal. In addition, to ensure its findings reach relevant stakeholders, they will be presented at relevant conferences.
Efficacy and safety of anti-epidermal growth factor receptor agents for the treatment of oesophageal cancer: a systematic review and meta-analysis
Authors: Zhang Lijuan , Song Yanli , Jiang Nan , Huang Yaqi , Dong Bo , Li Wei , He Yanze , Chen Yun , Liu Haibin , Yu Rui
Published: March 2021

Objectives

Despite remarkable advances in the treatment of oesophageal cancer (OC), the role of antiepidermal growth factor receptor (anti-EGFR) agents in treating OC remains controversial. Herein, a systematic review and meta-analysis were conducted to elucidate the efficacy and safety of anti-EGFR agents in patients with OC.

Design

Meta-analysis of randomised controlled trials (RCTs) identified by searching the PubMed, Embase, Web of Science, ClinicalTrials.gov, Cochrane Library, Chinese Biology Medicine, China National Knowledge Infrastructure and Wanfang Data Knowledge Service Platform databases from inception to December 2019. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Setting

RCTs from any country and healthcare setting.

Participants

Patients with OC.

Interventions

Combination therapy with anti-EGFR agents and conventional treatments versus conventional treatments alone in patients with OC.

Primary and secondary outcome measures

Overall survival (OS) and progression-free survival (PFS) were primary outcome measures, and objective response rate (ORR), disease control rate (DCR) and treatment toxicities were secondary outcome measures.

Results

In total, 25 RCTs comprising 3406 patients with OC were included. Overall, anti-EGFR treatment significantly improved the OS (HR: 0.81, 95% CI 0.74 to 0.89, p<0.00001), ORR (relative risk (RR): 1.33, 95% CI 1.16 to 1.52, p<0.0001) and DCR (RR: 1.22, 95% CI 1.11 to 1.34, p<0.0001) but not PFS (HR: 0.91, 95% CI 0.76 to 1.08, p=0.26). Anti-EGFR treatment was significantly associated with higher incidences of myelosuppression, diarrhoea, acne-like rash and hypomagnesaemia.

Conclusions

Overall, anti-EGFR agents have positive effects on OS, the ORR and DCR in OC. However, considering the high incidence of adverse effects, such as myelosuppression, diarrhoea, acne-like rashes and hypomagnesaemia, careful monitoring of patients with OC is recommended during anti-EGFR treatment.

Trial registration number

CRD42020169230.
Risk factors for SARS-CoV-2 infection and course of COVID-19 disease in patients with IBD in the Veterans Affair Healthcare System
Authors: Khan Nabeel , Mahmud Nadim , Trivedi Chinmay , Reinisch Walter , Lewis James D
Published: March 2021

Objective

Our aim was to explore the risk of infection with all classes of inflammatory bowel disease (IBD) medications and the impact of these medications on the disease course in a nationwide cohort of patients with IBD.

Design

This was a retrospective national cohort study of patients with IBD in the Veterans Affairs Healthcare System. We categorised IBD medication use immediately prior to the COVID-19 pandemic and used survival analysis methods to study associations with SARS-CoV-2 infection, as well as a combined secondary outcome of COVID-19 hospitalisation or COVID-19-related mortality.

Results

The analytical cohort of 30 911 patients was primarily male (90.9%), white (78.6%) and with ulcerative colitis (58.8%). Over a median follow-up of 10.7 months, 649 patients (2.1%) were diagnosed with SARS-CoV-2 infection and 149 (0.5%) met the combined secondary outcome. In adjusted models, vedolizumab (VDZ) use was significantly associated with infection relative to mesalazine alone (HR 1.70, 95% CI 1.16 to 2.48, p=0.006). Patients on no IBD medications had increased risk of the combined secondary outcome relative to mesalazine alone (sub-HR 1.64, 95% CI 1.12 to 2.42, p=0.01), however, no other IBD medication categories were significantly associated with this outcome, relative to mesalazine alone (each p>0.05). Corticosteroid use was independently associated with both SARS-CoV-2 infection (HR 1.60, 95% CI 1.23 to 2.09, p=0.001) and the combined secondary outcome (sub-HR 1.90, 95% CI 1.14 to 3.17, p=0.01).

Conclusion

VDZ and corticosteroid were associated with an increased risk of SARS-CoV-2 infection. Except for corticosteroids no medications including mesalazine were associated with an increased risk of severe COVID-19.
Thoughtful Selection and Use of Scientific Terms in Clinical Research: The Case of ‘Pragmatic’ Trials
Authors: Dal-Ré Rafael , Mentz Robert J , Rosendaal Frits R
Published: March 2021

Clinical research is a discipline prone to the use of technical terms that may be particularly at risk for misunderstanding given the complex interpretation that is required. In this century, what is happening with the word ‘pragmatic’ when describing a randomized controlled trial (RCT) with medicines deserves a public reflection. Explanatory trials are conducted in ideal conditions to assess the comparative efficacy of interventions and are useful to explain whether interventions work. Pragmatic trials are those conducted in a way that resembles usual clinical practice conditions to assess the comparative effectiveness of interventions in a manner directly applicable for decision-makers. This, however, did not prevent 36% of authors of placebo-controlled, or prelicensing trials to identify their medicines RCTs as pragmatic in the title of their articles. The current situation is such that scientific literature has accepted that ‘pragmatic’ can convey the original meaning—that obtained in trials mimicking usual clinical practice—and a distorted one—that is focused on streamlining any trial procedure. Those involved in clinical trials should emphasize the importance of precision in the use of terms when describing RCTs through standardized solutions when possible. Unless clinical trial stakeholders agree when it would be correct to label an RCT as pragmatic, in a short period of time the term will be in danger of becoming meaningless. It is suggested that the Enhancing the Quality and Transparency of Health Research (EQUATOR) network, the Consolidated Standards of Reporting Trials (CONSORT) group and the International Committee of Medical Journal Editors (ICMJE) could address this topic and provide a consensus way forward.
Rising of LOXHD1 as a signature causative gene of down-sloping hearing loss in people in their teens and 20s
Authors: Kim Bong Jik , Jeon Hyoung Won , Jeon Woosung , Han Jin Hee , Oh Jayoung , Yi Nayoung , Kim Min Young , Kim Minah , Kim Justin Namju , Kim Bo Hye , Hyon Joon Young , Kim Dongsup , Koo Ja-Won , Oh Doo-Yi , Choi Byung Yoon
Published: March 2021

Background

Down-sloping sensorineural hearing loss (SNHL) in people in their teens and 20s hampers efficient learning and communication and in-depth social interactions. Nonetheless, its aetiology remains largely unclear, with the exception of some potential causative genes, none of which stands out especially in people in their teens and 20s. Here, we examined the role and genotype–phenotype correlation of lipoxygenase homology domain 1 (LOXHD1) in down-sloping SNHL through a cohort study.

Methods

Based on the Seoul National University Bundang Hospital (SNUBH) genetic deafness cohort, in which the patients show varying degrees of deafness and different onset ages (n=1055), we have established the ‘SNUBH Teenager–Young Adult Down-sloping SNHL’ cohort (10–35 years old) (n=47), all of whom underwent exome sequencing. Three-dimensional molecular modelling, minigene splicing assay and short tandem repeat marker genotyping were performed, and medical records were reviewed.

Results

LOXHD1 accounted for 33.3% of all genetically diagnosed cases of down-sloping SNHL (n=18) and 12.8% of cases in the whole down-sloping SNHL cohort (n=47) of young adults. We identified a potential common founder allele, as well as an interesting genotype–phenotype correlation. We also showed that transcript 6 is necessary and probably sufficient for normal hearing.

Conclusions

LOXHD1 exceeds other genes in its contribution to down-sloping SNHL in young adults, rising as a signature causative gene, and shows a potential but interesting genotype–phenotype correlation.
Wood density variation in naturally regenerated stands of Pinus ponderosa in northern Arizona, USA
Authors: Vaughan Damon , Auty David , Kolb Thomas , Dahlen Joseph , Sánchez Meador Andrew J. , Mackes Kurt H.
Published: March 2021

In the southwestern United States, land managers are implementing large-scale forest restoration projects involving treatments designed to improve forest health, protect ecosystem services, and reduce the risk of catastrophic wildfire in overstocked ponderosa pine (Pinus ponderosa Dougl. ex P. & C. Laws.) forests. A better understanding of wood properties is necessary to improve the currently limited markets for the woody byproducts generated by these treatments. Therefore, our objective was to investigate variations in ponderosa pine wood density across the northern Arizona landscape. We sampled trees from 18 naturally regenerated stands and used X-ray densitometry to quantify the radial and axial variation within and among trees. We modeled within-stem wood density patterns using generalized additive models, and investigated the effects of climatic variation using response function analyses. Additionally, we tested the effects of site-level predictors on whole-tree wood density. We found high variability in radial wood density profiles among trees in our stands compared with that observed in studies of other species grown in plantations — perhaps due to high genetic variation within naturally regenerated stands. Wood density was negatively correlated with precipitation at annual and most quarterly intervals, except for a positive correlation with late-summer monsoon precipitation. The high wood density variation we found among trees highlights the need for further investigation of controls over wood properties in natural nonplantation forests.
Improvement of root morphological characteristics on water percolation rate in grassland soils of Yellow River riparian buffer strips
Authors: Yang Xiaoyan , Gu Haiping , Fan Zihao , Guo Erhui
Published: March 2021

Soil water percolation is an important process required to meet plant water needs, determine soil water storage, and affect soil water quality in riparian buffer strips. However, the effects of plant roots on soil percolation in riparian buffer strips are not totally understood, and contradictory results have been carried out on the effects of the root system on soil percolation rates. This study aimed to investigate soil percolation in natural grasslands and evaluate the relationships between root morphological characteristics and percolation rates. Path analysis was used to provide information on the relative contribution of root characteristics on soil percolation rates. Three mixed grasslands (Imperata cylindrica + Phragmites australis, I. cylindrica + Cynodon dactylon, and I. cylindrica + Juncellus serotinus) were selected in the Yellow River wetland natural reserves of Zhengzhou. Soil percolation rates (initial, average, and steady infiltration rates) were measured by using double-ring methods, and plant root morphological characteristics were analyzed. Soil percolation rates and plant root characteristic parameters of I. cylindrica + P. australis and I. cylindrica + C. dactylon were higher than those of I. cylindrica + J. serotinus. Initial percolation rate of I. cylindrica + P. australis and I. cylindrica + C. dactylon at 0–10 cm depth was 58.06% and 95.55% higher than that of I. cylindrica + J. serotinus, respectively. Percolation rates had a significant positive correlation with root characteristic parameters, and the main factor controlling soil percolation rates was root volume density (RVD). Mixed natural grasslands with more RVD improved soil infiltration and percolation rates.
Probing nuclear cluster symmetries through the harmonic oscillator
Authors: Freer Martin , Canavan Rhiann , Marsh Thomas , Souter James
Published: March 2021

The present contribution explores the symmetries of the deformed harmonic oscillator for both prolate and oblate deformations. It demonstrates the emergence of clustering from the degeneracies of the deformed harmonic oscillator and the appearance of the cluster structures in the associated densities. The universality of molecular structures is presented, demonstrating that molecular-like exchange of protons and neutrons is encoded into the mean-field. The nature of oblate-like structures is also explored.
CPTM symmetry, closed time paths and cosmological constant problem in the formalism of extended manifold
Authors: Bondarenko S.
Published: March 2021

The problem of the cosmological constant is considered in the formalism of an extended space-time consisting of the extended classical solution of Einstein equations. The different regions of the extended manifold are proposed to be related by the charge, parity, time and mass (CPTM) reversal symmetry applied with respect to the metric fields of the manifolds. There are interactions between the points of the extended manifold provided by scalar fields present separately in the different patches of the extended solution. The value of the constant is obtained equal to zero at the classical level due the mutual contribution of the fields in the vacuum energy, it’s non-zero value is due the quantum interactions between the fields. There are few possible scenario for the actions of the fields are discussed. Each from the obtained variants is similar to the closed time path approach of non-equilibrium condensed matter physics and among these possibilities for the closed paths, there is a variant of the action equivalent to the formalism of Keldysh. Accordingly, we consider and shortly discuss the application of the proposed formalism to the problem of smallness of the cosmological constant and singularities problem.
Development of a probabilistic model for quantitative risk assessment of COVID-19 in Brazil
Authors: de Siqueira Paulo Gabriel Santos Campos , de Oliveira Alexandre Calumbi Antunes , Duarte Heitor Oliveira , das Chagas Moura Márcio
Published: March 2021

We have developed a probabilistic model to quantify the risks of COVID-19 explosion in Brazil, the epicenter of COVID-19 in Latin America. By explosion, we mean an excessive number of new infections that would overload the public health system. We made predictions from July 12th to Oct 10th, 2020 for various containment strategies, including business as usual, stay at home (SAH) for young and elderly, flight restrictions among regions, gradual resumption of business and the compulsory wearing of masks. They indicate that: if a SAH strategy were sustained, there would be a negligible risk of explosion and the public health system would not be overloaded. For the other containment strategies, the scenario that combines the gradual resumption of business with the mandatory wearing of masks would be the most effective, reducing risk to considerable category. Should this strategy is applied together with the investment in more Intensive Care Unit beds, risk could be reduced to negligible levels. A sensitivity analysis sustained that risks would be negligible if SAH measures were adopted thoroughly.
SURVIVAL OF THE FITTEST: A NATURAL EXPERIMENT FROM CRYPTO EXCHANGES
Authors: AYSAN AHMET FARUK , KHAN ASAD UL ISLAM , TOPUZ HUMEYRA , TUNALI AHMET SEMIH
Published: March 2021

This paper explores the applicability of universal cryptocurrency exchange by analyzing crypto exchanges of Binance, Latoken, Kucoin and Qash, which also have their own cryptocurrencies in the crypto market. Results of the recursive Johansen cointegration test proved that even though all of the cryptocurrencies have cointegration among each other, Binance positively disassociated itself from the others after it moved to Malta on 23 March 2018. Based on the daily prices of cryptocurrencies over the period from 6 November 2017 to 10 November 2019, taken from coinmarketcap, we conclude that Binance can be considered as a survival of the fittest among all of the crypto exchanges in this natural experiment.
Nonlinear Phenomena in Axially Moving Beams with Speed-Dependent Tension and Tension-Dependent Speed
Authors: Chen Ling , Tang You-Qi , Liu Shuang , Zhou Yuan , Liu Xing-Guang
Published: March 2021

This paper investigates some nonlinear dynamical behaviors about domains of attraction, bifurcations, and chaos in an axially accelerating viscoelastic beam under a time-dependent tension and a time-dependent speed. The axial speed and the axial tension are coupled to each other on the basis of a harmonic variation over constant initial values. The transverse motion of the moving beam is governed by nonlinear integro-partial-differential equations with the rheological model of the Kelvin–Voigt energy dissipation mechanism, in which the material derivative is applied to the viscoelastic constitutive relation. The fourth-order Galerkin truncation is employed to transform the governing equation to a set of nonlinear ordinary differential equations. The nonlinear phenomena of the system are numerically determined by applying the fourth-order Runge–Kutta algorithm. The tristable and bistable domains of attraction on the stable steady state solution with a three-to-one internal resonance are analyzed emphatically by means of the fourth-order Galerkin truncation and the differential quadrature method, respectively. The system parameters on the bifurcation diagrams and the maximum Lyapunov exponent diagram are demonstrated by some numerical results of the displacement and speed of the moving beam. Furthermore, chaotic motion is identified in the forms of time histories, phase-plane portraits, fast Fourier transforms, and Poincaré sections.
Stationary Patterns of a Predator–Prey Model with Prey-Stage Structure and Prey-Taxis
Authors: Chen Meijun , Cao Huaihuo , Fu Shengmao
Published: March 2021

In this paper, a predator–prey model with prey-stage structure and prey-taxis is proposed and studied. Firstly, the local stability of non-negative constant equilibria is analyzed. It is shown that non-negative equilibria have the same stability between ODE system and self-diffusion system, and self-diffusion does not have a destabilization effect. We find that there exists a threshold value [Formula: see text] such that the positive equilibrium point of the model becomes unstable when the prey-taxis rate [Formula: see text], hence the taxis-driven Turing instability occurs. Furthermore, by applying Crandall–Rabinowitz bifurcation theory, the existence, the stability and instability, and the turning direction of bifurcating steady state are investigated in detail. Finally, numerical simulations are provided to support the mathematical analysis.