bluuebunny/crossref_metadata_2025 huggingface dataset:
Postoperative full leg radiographs exhibit less residual coronal varus deformity compared to intraoperative measurements in robotic arm-assisted total knee arthroplasty with the MAKO™ system
Authors: Glowalla Claudio , Langer Severin , Lenze Ulrich , Lazic Igor , Hirschmann Michael T. , Hinterwimmer Florian , von Eisenhart-Rothe Rüdiger , Pohlig Florian
Published: March 2023

Purpose

Robotic arm-assisted total knee arthroplasty (raTKA), currently a major trend in knee arthroplasty, aims to improve the accuracy of implant positioning and limb alignment. However, it is unclear whether and to what extent manual radiographic and navigation measurements with the MAKO™ system correlate. Nonetheless, a high agreement would be crucial to reliably achieve the desired limb alignment.

Methods

Thirty-six consecutive patients with osteoarthritis and a slight-to-moderate varus deformity undergoing raTKA were prospectively included in this study. Prior to surgery and at follow-up, a full leg radiograph (FLR) under weight-bearing conditions was performed. In addition, a computed tomography (CT) scan was conducted for preoperative planning. The hip–knee–ankle angle (HKA), mechanical lateral distal femur angle (mLDFA), mechanical medial proximal tibial angle (mMPTA) and joint line convergence angle (JLCA) were measured in the preoperative and follow-up FLR as well as in the CT scout (without weight-bearing) by three independent raters. Furthermore, the HKA was intraoperatively assessed with the MAKO™ system before and after raTKA.

Results

Significantly higher HKA values were identified for intraoperative deformity assessment using the MAKO system compared to the preoperative FLR and CT scouts (p = 0.006; p = 0.05). Intraoperative assessment of the HKA with final implants showed a mean residual varus deformity of 3.2° ± 1.9°, whereas a significantly lower residual varus deformity of 1.4° ± 1.9° was identified in the postoperative FLR (p < 0.001). The mMPTA was significantly higher in the preoperative FLR than in the CT scouts (p < 0.001). Intraoperatively, the mMPTA was adjusted to a mean of 87.5° ± 0.9° with final implants, while significantly higher values were measured in postoperative FLRs (p < 0.001). Concerning the mLDFA, no significant differences could be identified.

Conclusion

The clinical importance of this study lies in the finding that there is a difference between residual varus deformity measured intraoperatively with the MAKO™ system and those measured in postoperative FLRs. This has implications for preoperative planning as well as intraoperative fine-tuning of the implant position during raTKA to avoid overcorrection of knees with slight-to-moderate varus osteoarthritis.

Level of evidence

Level IV.
Epidemic modeling with heterogeneity and social diffusion
Authors: Berestycki Henri , Desjardins Benoît , Weitz Joshua S. , Oury Jean-Marc
Published: March 2023

We propose and analyze a family of epidemiological models that extend the classic Susceptible-Infectious-Recovered/Removed (SIR)-like framework to account for dynamic heterogeneity in infection risk. The family of models takes the form of a system of reaction–diffusion equations given populations structured by heterogeneous susceptibility to infection. These models describe the evolution of population-level macroscopic quantities S, I, R as in the classical case coupled with a microscopic variable f, giving the distribution of individual behavior in terms of exposure to contagion in the population of susceptibles. The reaction terms represent the impact of sculpting the distribution of susceptibles by the infection process. The diffusion and drift terms that appear in a Fokker–Planck type equation represent the impact of behavior change both during and in the absence of an epidemic. We first study the mathematical foundations of this system of reaction–diffusion equations and prove a number of its properties. In particular, we show that the system will converge back to the unique equilibrium distribution after an epidemic outbreak. We then derive a simpler system by seeking self-similar solutions to the reaction–diffusion equations in the case of Gaussian profiles. Notably, these self-similar solutions lead to a system of ordinary differential equations including classic SIR-like compartments and a new feature: the average risk level in the remaining susceptible population. We show that the simplified system exhibits a rich dynamical structure during epidemics, including plateaus, shoulders, rebounds and oscillations. Finally, we offer perspectives and caveats on ways that this family of models can help interpret the non-canonical dynamics of emerging infectious diseases, including COVID-19.
Validation of the SSTR-RADS 1.0 for the structured interpretation of SSTR-PET/CT and treatment planning in neuroendocrine tumor (NET) patients
Authors: Grawe Freba , Ebner Ricarda , Geyer Thomas , Beyer Leonie , Winkelmann Michael , Sheikh Gabriel T. , Eschbach Ralf , Schmid-Tannwald Christine , Cyran Clemens C. , Ricke Jens , Bartenstein Peter , Heimer Maurice M. , Faggioni Lorenzo , Spitzweg Christine , Fabritius Matthias P. , Auernhammer Christoph J. , Ruebenthaler Johannes
Published: March 2023

Objectives

The recently proposed standardized reporting and data system for somatostatin receptor (SSTR)–targeted PET/CT SSTR-RADS 1.0 showed promising first results in the assessment of diagnosis and treatment planning with peptide receptor radionuclide therapy (PRRT) in neuroendocrine tumors (NET). This study aimed to determine the intra- and interreader agreement of SSTR-RADS 1.0.

Methods

SSTR-PET/CT scans of 100 patients were independently evaluated by 4 readers with different levels of expertise according to the SSTR-RADS 1.0 criteria at 2 time points within 6 weeks. For each scan, a maximum of five target lesions were freely chosen by each reader (not more than three lesions per organ) and stratified according to the SSTR-RADS 1.0 criteria. Overall scan score and binary decision on PRRT were assessed. Intra- and interreader agreement was determined using the intraclass correlation coefficient (ICC).

Results

Interreader agreement using SSTR-RADS 1.0 for identical target lesions (ICC ≥ 0.91) and overall scan score (ICC ≥ 0.93) was excellent. The decision to state “functional imaging fulfills requirements for PRRT and qualifies patient as potential candidate for PRRT” also demonstrated excellent agreement among all readers (ICC ≥ 0.86). Intrareader agreement was excellent even among different experience levels when comparing target lesion–based scores (ICC ≥ 0.98), overall scan score (ICC ≥ 0.93), and decision for PRRT (ICC ≥ 0.88).

Conclusion

SSTR-RADS 1.0 represents a highly reproducible and accurate system for stratifying SSTR-targeted PET/CT scans with high intra- and interreader agreement. The system is a promising approach to standardize the diagnosis and treatment planning in NET patients.

Key Points

• SSTR-RADS 1.0 offers high reproducibility and accuracy.

• SSTR-RADS 1.0 is a promising method to standardize diagnosis and treatment planning for patients with NET.
Genomic distribution and polymorphism of G-quadruplex motifs occupying ovine promoters and enhancers
Authors: Stefos Georgios C. , Theodorou Georgios , Politis Ioannis
Published: March 2023

G-quadruplexes are non-canonical DNA structures that are formed in regions with short runs of guanines. During the last decade they have gained considerable attention due to their involvement in basic cellular processes, linking them to several physiological processes and pathological conditions. Regulation of gene transcription is among the crucial roles that G-quadruplexes play in the cells. Several ways in which these structures affect transcription have been described, both negatively and positively. Recently, G-quadruplexes have been shown to be implicated in the three-dimensional rearrangement of the chromosomes that enables the interaction of enhancers and gene promoters during regulation of transcription. Sheep is a species for which almost no G-quadruplex-related studies have been conducted and thus research on this species is kept out from the progress that has been made in the G-quadruplex field. In this context, we investigated the DNA sequences with potential to form G-quadruplexes (G4-motifs) in the ovine enhancers and promoters. We describe the distribution of G4-motifs within the regulatory regions which is shown to be enriched in G4-motifs in a way similar to other mammals. Furthermore, our data suggest that G4-motifs promote promoter-enhancer interactions in sheep. The single nucleotide polymorphisms colocalizing with promoter- and enhancer-associated ovine G4-motifs constitute a considerable pool of polymorphism and given the crucial role of these specific G4-motifs on regulation of transcription, we suggest this polymorphism as an interesting target for ovine genetic studies.
Investigation of fluidic thrust vectoring for scramjets
Authors: Hambidge Chris , Ivison William , Steuer David , Neely Andrew , McGilvray Matthew
Published: March 2023

Fluidic thrust vectoring (FTV) offers a novel approach to aerodynamic control, circumventing some of the issues associated with mechanical systems. One method is shock vector control which involves injecting a fluid into the exhaust nozzle of an engine to redirect the gases and thus, produce a control force. An experimental model which incorporated FTV was designed and tested at Mach 6 in the Oxford high density tunnel (HDT). The model was a simplified two-dimensional scramjet geometry with two different configurations to compare an internal and external exhaust nozzle. The FTV injection system consisted of a slot at the rear edge of the exhaust nozzle fed from an internal plenum. In the experimental campaign, a range of gas injection pressures and free stream stagnation pressures were tested to assess the effectiveness of both configurations. Two new measurement methods were successfully implemented in the HDT: pressure sensitive paint and a 6-axis load cell. The FTV system has been shown to be effective with observable increases in lift and pitching moment. A linear relation between the injection pressure ratio and the control forces could be observed for both configurations.

Graphical abstract
Optimal subsampling design for polynomial regression in one covariate
Authors: Reuter Torsten , Schwabe Rainer
Published: March 2023

Improvements in technology lead to increasing availability of large data sets which makes the need for data reduction and informative subsamples ever more important. In this paper we constructD-optimal subsampling designs for polynomial regression in one covariate for invariant distributions of the covariate. We study quadratic regression more closely for specific distributions. In particular we make statements on the shape of the resulting optimal subsampling designs and the effect of the subsample size on the design. To illustrate the advantage of the optimal subsampling designs we examine the efficiency of uniform random subsampling.
Adherence to fast track measures in colorectal surgery—a survey among German and Austrian surgeons
Authors: Willis Maria A. , Keller Peter S. , Sommer Nils , Koch Franziska , Ritz Jörg-Peter , Beyer Katharina , Reißfelder Christoph , Hardt Julia , Herold Alexander , Buhr Heinz J. , Emmanuel Klaus , Kalff Joerg C. , Vilz Tim O.
Published: March 2023

Purpose

The effectiveness of modern perioperative treatment concepts has been demonstrated in several studies and meta-analyses. Despite good evidence, limited implementation of the fast track (FT) concept is still a widespread concern. To assess the status quo in Austrian and German hospitals, a survey on the implementation of FT measures was conducted among members of the German Society of General and Visceralsurgery (DGAV), the German Society of Coloproctology (DGK) and the Austrian Society of Surgery (OEGCH) to analyze where there is potential for improvement.

Methods

Twenty questions on perioperative care of colorectal surgery patients were sent to the members of the DGAV, DGK and OEGCH using the online survey tool SurveyMonkey®. Descriptive data analysis was performed using Microsoft Excel.

Results

While some of the FT measures have already been routinely adopted in clinical practice (e.g. minimally invasive surgical approach, early mobilization and diet buildup), for other components there are discrepancies between current recommendations and present implementation (e.g. the use of local nerve blocks to provide opioid-sparing analgesia or the use of abdominal drains).

Conclusion

The implementation of the FT concept in Austria and Germany is still in need of improvement. Particularly regarding the use of abdominal drains and postoperative analgesia, there is a tendency to stick to traditional structures. To overcome the issues with FT implementation, the development of an evidence-based S3 guideline for perioperative care, followed by the founding of a surgical working group to conduct a structured education and certification process, may lead to significant improvements in perioperative patient care.
Intrarenal Doppler ultrasonography in patients with HFrEF and acute decompensated heart failure undergoing recompensation
Authors: Wallbach M. , Valentova M. , Schroeter M. R. , Alkabariti A. , Iraki I. , Leha A. , Tampe D. , Hasenfuß G. , Zeisberg M. , Hellenkamp K. , Koziolek M. J.
Published: March 2023

Objectives

Renal venous congestion due to backward heart failure leads to disturbance of renal function in acute decompensated heart failure (ADHF). Whether decongestion strategies have an impact on renal venous congestion is unknown. Objective was to evaluate changes in intrarenal hemodynamics using intrarenal Doppler ultrasonography (IRD) in patients with heart failure with reduced ejection fraction (HFrEF) and ADHF undergoing recompensation.

Methods

Prospective observational study in patients with left ventricular ejection fraction (LV-EF) ≤ 35% hospitalized due to ADHF. IRD measurement was performed within the first 48 h of hospitalisation and before discharge. Decongestion strategies were based on clinical judgement according to heart failure guidelines. IRD was used to assess intrarenal venous flow (IRVF) pattern, venous impedance index (VII) and resistance index (RI). Laboratory analyses included plasma creatinine, eGFR and albuminuria.

Results

A number of 35 patients with ADHF and LV-EF ≤ 35% were included into the study. IRD could be performed in 30 patients at inclusion and discharge. At discharge, there was a significant reduction of VII from a median of 1.0 (0.86–1.0) to 0.59 (0.26–1.0) (p < 0.01) as well as improvement of IRVF pattern categories (p < 0.05) compared to inclusion. Albuminuria was significantly reduced from a median of 78 mg/g creatinine (39–238) to 29 mg/g creatinine (16–127) (p = 0.02) and proportion of patients with normoalbuminuria increased (p = 0.01). Plasma creatinine and RI remained unchanged (p = 0.73; p = 0.43).

Discussion

This is the first study showing an effect of standard ADHF therapy on parameters of renal venous congestion in patients with HFrEF and ADHF. Doppler sonographic evaluation of renal venous congestion might provide additional information to guide decongestion strategies in patients with ADHF.

Graphical abstract
TREM2 gene expression associations with Alzheimer’s disease neuropathology are region-specific: implications for cortical versus subcortical microglia
Authors: Winfree Rebecca L. , Seto Mabel , Dumitrescu Logan , Menon Vilas , De Jager Philip , Wang Yanling , Schneider Julie , Bennett David A. , Jefferson Angela L. , Hohman Timothy J.
Published: March 2023

Previous post-mortem assessments of TREM2 expression and its association with brain pathologies have been limited by sample size. This study sought to correlate region-specific TREM2 mRNA expression with diverse neuropathological measures at autopsy using a large sample size (N = 945) of bulk RNA sequencing data from the Religious Orders Study and Rush Memory and Aging Project (ROS/MAP). TREM2 gene expression of the dorsolateral prefrontal cortex, posterior cingulate cortex, and caudate nucleus was assessed with respect to core pathology of Alzheimer’s disease (amyloid-β, and tau), cerebrovascular pathology (cerebral infarcts, arteriolosclerosis, atherosclerosis, and cerebral amyloid angiopathy), microglial activation (proportion of activated microglia), and cognitive performance. We found that cortical TREM2 levels were positively related to AD diagnosis, cognitive decline, and amyloid-β neuropathology but were not related to the proportion of activated microglia. In contrast, caudate TREM2 levels were not related to AD pathology, cognition, or diagnosis, but were positively related to the proportion of activated microglia in the same region. Diagnosis-stratified results revealed caudate TREM2 levels were inversely related to AD neuropathology and positively related to microglial activation and longitudinal cognitive performance in AD cases. These results highlight the notable changes in TREM2 transcript abundance in AD and suggest that its pathological associations are brain-region-dependent.
Expert opinion about laser and intense pulsed light (IPL)-induced leukoderma or vitiligo: a cross-sectional survey study
Authors: Post Nicoline F. , Van Broekhoven Noah X. , Lommerts Annelies , Bae Jung M. , Bekkenk Marcel W. , de Castro Caio C. Silva , Eleftheriadou Viktioria , Esmat Samia , Ezzedine Khaled , van Geel Nanja , Hamzavi Iltefat , Leone Giovanni , Pandya Amit G. , Passeron Thierry , Rodrigues Michelle A. , Seneschal Julien , Th’ng Steven , Wolkerstorfer Albert
Published: March 2023

Vitiligo patients may desire laser hair removal, skin rejuvenation, vascular treatments, and other laser or intense pulsed light (IPL) assisted treatments. However, there is a risk of inducing new depigmented patches (Koebner phenomenon). In absence of guidelines on the safe use of laser or IPL in vitiligo patients, dermatologists tend to be reluctant to administer these treatments. The aim of this survey study was to provide an estimation of the occurrence and related risk factors of laser/IPL-induced leukoderma or vitiligo. A cross-sectional survey study was performed among 15 vitiligo experts from 11 countries, with 14 questions about affected patients, involved laser/IPL treatments and the physicians’ approach. In a total of 11,300 vitiligo patients, laser/IPL-induced leukoderma or vitiligo was reported in 30 patients (0.27%). Of these, 12 (40%) patients had a medical history of vitiligo and seven (58%) of these patients had stable (> 12 months) vitiligo before the treatment. Most frequently reported were hair removal procedures and localization of the face and legs. Side effects like blistering, crusting, and erosions occurred in 56.7% of the cases. These vitiligo experts based their advice on the risk of the laser treatment on stability of the vitiligo (43%) and activity signs (50%), and 50% discuss the risks before starting a laser treatment. Relevant activity signs are the Koebner phenomenon (57.1%), confetti-like lesions (57.1%) and hypochromic borders (50%). Laser-induced leukoderma or vitiligo is an uncommon phenomenon. Remarkably, a minority had a medical history of vitiligo of which 58% were stable. Consequently, most cases could not have been prevented by not treating vitiligo patients. However, a majority had laser/IPL-induced skin damage. Therefore, caution is advised with aggressive settings and test-spots prior to the treatment are recommended. This study showed significant variation in the current recommendations and approach of vitiligo experts regarding laser/IPL-induced leukoderma or vitiligo.
Diagnostic factors for recurrent pregnancy loss: an expanded workup
Authors: Ticconi Carlo , Nicastri Elena , D’Ippolito Silvia , Chiaramonte Carlo , Pietropolli Adalgisa , Scambia Giovanni , Di Simone Nicoletta
Published: March 2023

Purpose

There is limited information on the risk factors for recurrent pregnancy loss (RPL).

Methods

In this study, a patient-based approach was used to investigate the possible involvement and relative relevance of a large number of diagnostic factors in 843 women with RPL who underwent an extensive diagnostic workup including 44 diagnostic factors divided into 7 major categories.

Results

The rates of abnormalities found were: (1) genital infections: 11.74%; (2) uterine anatomic defects: 23.72%; (3) endocrine disorders: 29.42%; (4) thrombophilias: 62%; (5) autoimmune abnormalities: 39.2%; (6) parental karyotype abnormalities 2.25%; (7) clinical factors: 87.78%. Six hundred and fifty-nine out of eight hundred and forty-three women (78.17%) had more than one abnormality. The mean number of pregnancy losses increased by increasing the number of the abnormalities found (r = 0.86949, P < 0.02). The factors associated with the highest mean number of pregnancy losses were cervical isthmic incompetence, anti-beta-2-glycoprotein-1 antibodies, unicornuate uterus, anti-prothrombin A antibodies, protein C deficiency, and lupus anticoagulant. The majority of the considered abnormalities had similar, non-significant prevalence between women with 2 versus ≥ 3 pregnancy losses with the exception of age ≥ 35 years and MTHFR A1298C heterozygote mutation. No difference was found between women with primary and secondary RPL stratified according to the number of abnormalities detected (Chi-square: 8.55, P = 0.07). In these women, the only factors found to be present with statistically different rates were age ≥ 35 years, cigarette smoking, and genital infection by Ureaplasma.

Conclusion

A patient-based diagnostic approach in women with RPL could be clinically useful and could represent a basis for future research.
A longitudinal perspective on the interplay of job demands and destructive leadership on employees’ work ability in Germany
Authors: Kunz Carolin , Millhoff Catrin
Published: March 2023

Purpose

Work ability as a predictor of early retirement or lengthy/frequent sick leaves becomes more and more relevant due to the demographic change. Therefore, factors, which affect employees’ work ability, need to be further examined with a theoretical base. According to Karasek’s job demands–control (JDC) model, high job demands and low control are related to poor employee health. The subsequent job demands–control support (JDCS) model proposed that a lack of support, also from leaders, has a negative impact on health indicators. This article looked at whether destructive leadership reinforces the negative influence of high job demands on employees’ work ability.

Methods

We used the BAuA Working Time Survey waves 2015, 2017, and 2019 (BAuA-WTS), which are representative of employees in Germany. Our data set covers 2448 respondents, who took part in all three waves. Central to the analyses were the variables job demands, control, destructive leadership, and work ability.

Results

Results from pooled ordinary least squares (OLS) and fixed effect (FE) models revealed that job demands influenced work ability negatively, whereas neither control by the employee nor the interaction of job demands and control was significant regarding effecting work ability in the FE models. Destructive leadership exerted a negative effect on work ability and moderated job demands significantly in the FE models meaning a further decrease in work ability.

Conclusion

Leadership behavior should be further examined as an important factor for work ability.
Rhizobia induce SYMRK endocytosis in Phaseolus vulgaris root hair cells
Authors: Dávila-Delgado Raúl , Flores-Canúl Karen , Juárez-Verdayes Marco Adán , Sánchez-López Rosana
Published: March 2023

Main conclusion

PvSYMRK-EGFP undergoes constitutive and rhizobia-induced endocytosis, which rely on the phosphorylation status of T589, the endocytic YXXØ motif and the kinase activity of the receptor.

Legume-rhizobia nodulation is a complex developmental process. It initiates when the rhizobia-produced Nod factors are perceived by specific LysM receptors present in the root hair apical membrane. Consequently, SYMRK (Symbiosis Receptor-like Kinase) becomes active in the root hair and triggers an extensive signaling network essential for the infection process and nodule organogenesis. Despite its relevant functions, the underlying cellular mechanisms involved in SYMRK signaling activity remain poorly characterized. In this study, we demonstrated that PvSYMRK-EGFP undergoes constitutive and rhizobia-induced endocytosis. We found that in uninoculated roots, PvSYMRK-EGFP is mainly associated with the plasma membrane, although intracellular puncta labelled with PvSymRK-EGFP were also observed in root hair and nonhair-epidermal cells. Inoculation with Rhizobium etli producing Nod factors induces in the root hair a redistribution of PvSYMRK-EGFP from the plasma membrane to intracellular puncta. In accordance, deletion of the endocytic motif YXXØ (YKTL) and treatment with the endocytosis inhibitors ikarugamycin (IKA) and tyrphostin A23 (TyrA23), as well as brefeldin A (BFA), drastically reduced the density of intracellular PvSYMRK-EGFP puncta. A similar effect was observed in the phosphorylation-deficient (T589A) and kinase-dead (K618E) mutants of PvSYMRK-EGFP, implying these structural features are positive regulators of PvSYMRK-EGFP endocytosis. Our findings lead us to postulate that rhizobia-induced endocytosis of SYMRK modulates the duration and amplitude of the SYMRK-dependent signaling pathway.
Deletion in Abstract Voronoi Diagrams in Expected Linear Time and Related Problems
Authors: Junginger Kolja , Papadopoulou Evanthia
Published: March 2023

Updating an abstract Voronoi diagram in linear time, after deletion of one site, has been an open problem in a long time; similarly, for any concrete Voronoi diagram of generalized (non-point) sites. In this paper we present a simple, expected linear-time algorithm to update an abstract Voronoi diagram after deletion of one site. To achieve this result, we use the concept of a Voronoi-like diagram, a relaxed Voronoi structure of independent interest. Voronoi-like diagrams serve as intermediate structures, which are considerably simpler to compute, thus, making an expected linear-time construction possible. We formalize the concept and prove that it is robust under insertion, therefore, enabling its use in incremental constructions. The time-complexity analysis introduces a variant to backwards analysis, which is applicable to order-dependent structures. We further extend the technique to compute in expected linear time: the order-$$(k\,{+}\,1)$$

(
k

+

1
)

subdivision within an order-k Voronoi region, and the farthest abstract Voronoi diagram, after the order of its regions at infinity is known.
Endoscopic submucosal dissection training: evaluation of an ex vivo training model with continuous perfusion (ETM-CP) for hands-on teaching and training in China
Authors: Huang Jun , Du Bing-ran , Qiao Wei-guang , Huang Si-lin , Xue Lan-feng , Deng Liang , Liang Jun-ming , Wang Jun , Li Jian-yi , Chen Yu
Published: March 2023

Background

The existing ex vivo models of endoscopic submucosal dissection (ESD) cannot simulate intraoperative hemorrhage well. We aimed to establish an ESD training method by applying an ex vivo training model with continuous perfusion (ETM-CP).

Methods

Four training sessions were conducted for 25 novices under the guidance of 2 experts. Eventually, 10 novices completed ESD operations on a total of 89 patients after the training. The resection effectiveness, resection speed, complication rate, and novice performance before and after the training were compared. The data regarding the effects of the training and the model were gathered through a questionnaire survey.

Results

In terms of the simulation effect of the model, ETM-CP was evaluated as similar to the live pig in all aspects (P > 0.05). The questionnaire analysis revealed that the ESD theoretical knowledge, skill operation, and self-confidence of novices were improved after the training (P < 0.05). The resection time per unit area had a correlation with the number of training periods (rs = – 0.232). For novice performance, the resection time per unit area was shortened (P < 0.05). There was no difference in patient performance between the novice group and the expert group after the training in terms of en bloc resection, R0 resection, complication rate, endoscopic resection bleeding (ERB) score, muscularis propria injury (MPI) score, and resection time per unit area (P > 0.05).

Conclusion

The ETM-CP is effective for ESD training.
Long-term tooth survival and success following primary root canal treatment: a 5- to 37-year retrospective observation
Authors: López-Valverde Isabel , Vignoletti Fabio , Vignoletti Gianfranco , Martin Conchita , Sanz Mariano
Published: March 2023

Objectives

The aims of the present longitudinal retrospective observational case series study were to investigate the survival and success rates of primary non-surgical endodontic therapy.

Materials and methods

Patients with at least one endodontically treated tooth (ETT), with 5 years of follow-up and in compliance with the recall programme of at least 1 time per year in a private practice setting, were recruited. Kaplan-Meier survival analyses were performed considering (a) tooth extraction/survival and (b) endodontic success as the outcome variables. A regression analysis was performed to evaluate prognostic factors associated with tooth survival.

Results

Three hundred twelve patients and 598 teeth were included. The cumulative survival rates showed 97%, 81%, 76% and 68% after 10, 20, 30 and 37 years, respectively. The corresponding values for endodontic success were 93%, 85%, 81% and 81%, respectively.

Conclusions

The study demonstrated high longevity in symptomless function as well as high success rates of ETT. The most significant prognostic factors associated with tooth extraction were the presence of deep (> 6 mm) periodontal pockets, the presence of pre-operative apical radiolucency and the lack of occlusal protection (no use of a night guard).

Clinical relevance

The favourable long-term (> 30 years) prognosis of ETT must encourage clinicians to rely on primary root canal treatment when taking the decision regarding whether a tooth with pulpal and/or periapical diseases should be saved or be extracted and replaced with an implant.
Detection of Merkel cell polyomavirus in multiple primary oral squamous cell carcinomas
Authors: Kitamura Naoya , Hashida Yumiko , Higuchi Tomonori , Ohno Seiji , Sento Shinya , Sasabe Eri , Murakami Ichiro , Yamamoto Tetsuya , Daibata Masanori
Published: March 2023

Oral microbiome studies have mainly focussed on bacteria, with the relationship between viruses and oral cancers remaining poorly understood. Oral cancers can develop even in the absence of any history of daily smoking or drinking. Oral cancer patients frequently have multiple primary cancers in the oral cavity and other organs, such as the upper gastrointestinal tract. Merkel cell polyomavirus (MCPyV) is a novel oncovirus identified from a subtype of skin cancer in 2008. In this study, we investigated the potential involvement of MCPyV in the pathogenesis of oral squamous cell carcinoma (OSCC). Participants comprised 115 Japanese patients with OSCC (single primary: 109 tumours in 109 patients; multiple primaries: 16 tumours in 6 patients) treated in our department between 2014 and 2017. DNA was extracted from formalin-fixed paraffin-embedded specimens of primary lesions. MCPyV DNA copy counts were analysed by quantitative real-time polymerase chain reaction. Twenty-four of the 115 patients (20.9%) were positive for MCPyV DNA. No association was found between presence or absence of MCPyV DNA and clinical characteristics other than number of primary lesions. The MCPyV DNA-positive rate was significantly higher for multiple primary OSCCs (62.5%, 10/16 tumours) than for single primary OSCCs (16.5%, 18/109 tumours; P < 0.001). Furthermore, MCPyV DNA load was significantly higher for patients with multiple primaries (P < 0.05). MCPyV was observed more frequently and DNA load was significantly higher with multiple primary OSCCs than with single primary OSCC. MCPyV may play some role as an oncovirus for multiple primary OSCCs.
An Image Turing Test on Realistic Gastroscopy Images Generated by Using the Progressive Growing of Generative Adversarial Networks
Authors: Shin Keewon , Lee Jung Su , Lee Ji Young , Lee Hyunsu , Kim Jeongseok , Byeon Jeong-Sik , Jung Hwoon-Yong , Kim Do Hoon , Kim Namkug
Published: March 2023

Generative adversarial networks (GAN) in medicine are valuable techniques for augmenting unbalanced rare data, anomaly detection, and avoiding patient privacy issues. However, there were limits to generating high-quality endoscopic images with various characteristics, such as peristalsis, viewpoints, light sources, and mucous patterns. This study used the progressive growing of GAN (PGGAN) within the normal distribution dataset to confirm the ability to generate high-quality gastrointestinal images and investigated what barriers PGGAN has to generate endoscopic images. We trained the PGGAN with 107,060 gastroscopy images from 4165 normal patients to generate highly realistic 5122 pixel-sized images. For the evaluation, visual Turing tests were conducted on 100 real and 100 synthetic images to distinguish the authenticity of images by 19 endoscopists. The endoscopists were divided into three groups based on their years of clinical experience for subgroup analysis. The overall accuracy, sensitivity, and specificity of the 19 endoscopist groups were 61.3%, 70.3%, and 52.4%, respectively. The mean accuracy of the three endoscopist groups was 62.4 [Group I], 59.8 [Group II], and 59.1% [Group III], which was not considered a significant difference. There were no statistically significant differences in the location of the stomach. However, the real images with the anatomical landmark pylorus had higher detection sensitivity. The images generated by PGGAN showed highly realistic depictions that were difficult to distinguish, regardless of their expertise as endoscopists. However, it was necessary to establish GANs that could better represent the rugal folds and mucous membrane texture.
Prediction of motion induced magnetic fields for human brain MRI at 3 T
Authors: Zhou Jiazheng , Hagberg Gisela E. , Aghaeifar Ali , Bause Jonas , Zaitsev Maxim , Scheffler Klaus
Published: March 2023

Objective

Maps of B0 field inhomogeneities are often used to improve MRI image quality, even in a retrospective fashion. These field inhomogeneities depend on the exact head position within the static field but acquiring field maps (FM) at every position is time consuming. Here we propose a forward simulation strategy to obtain B0 predictions at different head-positions.

Methods

FM were predicted by combining (1) a multi-class tissue model for estimation of tissue-induced fields, (2) a linear k-space model for capturing gradient imperfections, (3) a dipole estimation for quantifying lower-body perturbing fields (4) and a position-dependent tissue mask to model FM alterations caused by large motion effects. The performance of the combined simulation strategy was compared with an approach based on a rigid body transformation of the FM measured in the reference position to the new position.

Results

The transformed FM provided inconsistent results for large head movements (> 5° rotation, approximately), while the simulation strategy had a superior prediction accuracy for all positions. The simulated FM was used to optimize B0 shims with up to 22.2% improvement with respect to the transformed FM approach.

Conclusion

The proposed simulation strategy is able to predict movement-induced B0 field inhomogeneities yielding more precise estimates of the ground truth field homogeneity than the transformed FM.
Co-occurrence with Greylag Geese Anser anser and other factors affecting vigilance in White‑fronted Geese Anser albifrons during their spring staging in Central Europe
Authors: Polakowski Michał , Broniszewska Monika , Jankowiak Łukasz , Kasprzykowski Zbigniew
Published: March 2023

Vigilance, a crucial factor affecting the behaviour of birds, is key to the safety of migratory animal flocks against predators and other threats. We examined the vigilance of White-fronted Geese in the Biebrza Basin (NE Poland), one of their major stopover sites in Europe. The study took place during their spring staging, from the end of February until the beginning of April. We found that the vigilance of White-fronted Geese decreased in the centre of mixed flocks with Greylag Geese. This may be associated with the larger size and wider field of view of Greylag Geese, as well as their territorial behaviour, as some of them belong to the local breeding population. White-fronted Geese can benefit from the group-size effect when they form larger flocks. In the presence of a vigilance stimulus, the individuals in the centre of a flock raised their alertness levels. As the probability of detecting danger is higher in large groups, flock size negatively affected the birds’ vigilance. Owing to their different experience and roles (adults care for their broods by being vigilant), adult birds appeared to be vigilant on both grassland and arable land, whereas immatures were vigilant only on arable land, where exposure to predatory pressure was greater. We believe that the lower level of vigilance of White-fronted Geese in large and mixed flocks may give them more time for foraging and, therefore, improve their chances of survival and breeding success during the oncoming spring.
Cognition, attitude, practice toward health checkup and associated factors among urban residents in southwest China, Sichuan province, 2022: a community-based study
Authors: Du Min , Li Pingyang , Tang Ling , Xu Min , Chen Xinzhu , Long Huaicong
Published: March 2023

Aim

Research on the health checkup status of urban residents in Southwest China is limited. In this study, we aimed to investigate the current status of health checkups and explore their influencing factors by analyzing the cognition, attitudes, and practices of urban residents in Southwest China.

Methods

We sampled 1200 urban residents for a questionnaire survey. Statistical analysis was performed using SPSS 23, and logistic regression analysis was used to analyze the factors affecting cognition, attitudes, and practices regarding health checkups. A P value < 0.05 was used to identify variables significantly associated with the outcome variable.

Results

Overall, 29% of the residents understood the importance of health checkups. The main ways urban residents acquire health-related knowledge are through the use of mobile media and medical staff health education. Only 40% of residents had undergone a regular checkup. Health self-assessment, economic reasons, and time are the factors that interfere with urban residents’ health checkups. Logistic regression analysis showed that occupation status, educational background, self-assessed health status, exercise status, and monthly income level were the common influencing factors of health checkup cognition and planning. Whether residents had participated in a medical checkup program was also related to sex and age.

Conclusions

Urban residents in Southwest China generally had a high willingness to undergo physical examinations, but there were differences in knowledge and practice; at the same time, residents lacked understanding of respiratory assessments. Improving the health literacy of medical staff, strengthening urban residents’ health education, and enhancing the utilization rate of health checkups in urban residents are necessary and urgent.
Implementation Science for Eliminating HIV Among Adolescents in High-Burden African Countries: Findings and Lessons Learned from the Adolescent HIV Prevention and Treatment Implementation Science Alliance (AHISA)
Authors: Vorkoper Susan , Sam-Agudu Nadia A. , Bekker Linda-Gail , Sturke Rachel
Published: March 2023

Eliminating adolescent HIV in high-burden African countries depends on the success of implementing evidence-based interventions to reduce transmission and improve treatment outcomes. The Adolescent HIV Prevention and Treatment Implementation Science Alliance (AHISA) takes a collaborative approach to addressing key challenges and identifying and developing new areas of investigation to advance the adolescent HIV agenda. This special supplement represents the collective learning of the Alliance related to implementation science in the context of the adolescent HIV continuum of care from multiple African countries. Specifically, this series describes the current academic landscape of adolescent HIV and implementation science, such as the methodological use and utility of implementation measures and frameworks; addresses timely topics such as the use of innovative technologies for study adaptations in the context of the global COVID-19 pandemic; and explores opportunities to enhance adolescent-responsive approaches to HIV prevention and treatment using implementation science.
Chemsex, Anxiety and Depression Among Gay, Bisexual and Other Men Who have Sex with Men Living with HIV
Authors: Field David James , de Wit John , Davoren Martin P. , O’Reilly Eilis J. , Den Daas Chantal
Published: March 2023

Chemsex is common among gay, bisexual and other men who have sex with men (gbMSM). Although not always categorised as problematic, a link with psychological distress has been reported and might be exacerbated amongst gbMSM living with HIV, as HIV has been associated with anxiety and depression. A cross-sectional online survey of gbMSM living with HIV (n = 359) was performed incorporating the Hospital Anxiety and Depression Scale and sociodemographic variables including, HIV characteristics, chemsex and sexual behaviours. Logistic regression analysis was used to find associations with anxiety or depression. Many participants engaged in chemsex (48.5%, n = 174). Chemsex was associated with lower odds of depression (aOR 0.45, 95% CI 0.23–0.85) and not associated with anxiety (aOR 0.66, CI 0.40–1.09). Although chemsex is a public health concern; we found it was associated with lower levels of depression in gbMSM living with HIV. However, causal inference is not possible, as gbMSM with higher levels of depression might engage in chemsex less.
The establishment and spread of Tamarixia triozae, a parasitoid of the potato psyllid, in New Zealand
Authors: Davidson Melanie , Sachtleben Thalia , MacDonald Frances , Watkins Lisa , Barnes Anna-Marie , Drayton Gabby , Walker Melanie
Published: March 2023

The release of Tamarixia triozae (Burks) (Hymenoptera: Eulophidae), a parasitoid of the potato psyllid, Bactericera cockerelli (Šulc) (Hemiptera: Triozidae), resulted in the successful establishment of the parasitoid in New Zealand. The parasitoid was released at more than 30 sites by the final year of the three-year study throughout New Zealand. Its continued presence over the three-year study was confirmed in two regions (Hawke’s Bay and Canterbury). At one site in Canterbury, the parasitoid was released only in the first summer of this study (Nov. 2017–Feb. 2018). It was recovered from potato psyllid infested African boxthorn (Lycium ferocissimum Miers) foliage in the second and third summers at this site, demonstrating the parasitoid’s ability to survive over successive winters. We found T. triozae parasitized nymphs at 24 sites of the 86 potato psyllid host plant sites surveyed within a 25 km radius of known release sites in Hawke’s Bay. The parasitoid was found up to 24 km from the nearest known release site in Hawke’s Bay. In Canterbury, the parasitoid was found up to 0.6 km from a known release site. Parasitism rates of 13.7–15.6% were estimated based on two post-release survey methods employed in this study. The parasitoid also feeds on psyllid nymphs so its establishment may lead to helping to reduce or delay potato psyllid populations from reaching damaging levels. Long-term monitoring is needed to determine the consequences of importing T. triozae on populations of potato psyllid.
Design and construction of Guayaquil radio speech corpus (CHARG)
Authors: Sawicka-Stępińska Brygida
Published: March 2023

The present paper aims to describe the process of creating CHARG—Corpus de Habla Radiofónica de Guayaquil (the Guayaquil Radiophonic Speech Corpus). It is the first systematized spoken corpus for this rather under-researched variety of Spanish. Guayaquil is the most populated city of Ecuador, while its capital city is Quito. Therefore, Ecuador is a rare case of a Spanish-speaking country with two major urban centers that belong to two separate dialectal zones, offering a very peculiar sociolinguistic context. CHARG is a corpus composed of Guayaquil radio programs. Its structure is organized by non-linguistic criteria (program type) in order to ensure a representative and balanced sample. The paper describes the design of the corpus (defining the study population, sample and stratification) and its construction (recording procedure, speakers and speech style coding, transcription and annotation). As a result, CHARG consists of 24 h of transcriptions and annotations of recordings from 142 speakers. The paper’s potential use is twofold: since it presents a step-by-step procedure of corpus construction that can be replicated, the readers might be interested in both the procedure and the corpus itself as a research material.
Early recognition of CLN3 disease facilitated by visual electrophysiology and multimodal imaging
Authors: Sakti Dhimas H. , Cornish Elisa E. , Fraser Clare L. , Nash Benjamin M. , Sandercoe Trent M. , Jones Michael M. , Rowe Neil A. , Jamieson Robyn V. , Johnson Alexandra M. , Grigg John R.
Published: March 2023

Background

Neuronal ceroid lipofuscinosis is a group of neurodegenerative disorders with varying visual dysfunction.CLN3is a subtype which commonly presents with visual decline. Visual symptomatology can be indistinct making early diagnosis difficult. This study reports ocular biomarkers ofCLN3patients to assist clinicians in early diagnosis, disease monitoring, and future therapy.

Methods

Retrospective review of 5 confirmedCLN3patients in our eye clinic. Best corrected visual acuity (BCVA), electroretinogram (ERG), ultra-widefield (UWF) fundus photography and fundus autofluorescence (FAF), and optical coherence tomography (OCT) studies were undertaken.

Results

Five unrelated children, 4 females and 1 male, with median age of 6.2 years (4.6–11.7) at first assessment were investigated at the clinic from 2016 to 2021. Four homozygous and one heterozygous pathogenicCLN3variants were found. Best corrected visual acuities (BCVAs) ranged from 0.18 to 0.88 logMAR at first presentation. Electronegative ERGs were identified in all patients. Bull’s eye maculopathies found in all patients. Hyper-autofluorescence ring surrounding hypo-autofluorescence fovea on FAF was found. Foveal ellipsoid zone (EZ) disruptions were found in all patients with additional inner and outer retinal microcystic changes in one patient. Neurological problems noted included autism, anxiety, motor dyspraxia, behavioural issue, and psychomotor regression.

Conclusions

CLN3patients presented at median age 6.2 years with visual decline. Early onset maculopathy with an electronegative ERG and variable cognitive and motor decline should prompt further investigations including neuropaediatric evaluation and genetic assessment forCLN3disease. The structural parameters such as EZ and FAF will facilitate ocular monitoring.