bluuebunny/crossref_metadata_2025 huggingface dataset:
What Factors Are Associated With Stem Breakage in Distal Femoral Endoprosthetic Replacements Undertaken for Primary Bone Tumors?
Authors: Carlisle Emma , Steadman Peter , Lowe Martin , Rowell Philip , Sommerville Scott
Published: June 2023

Background

The advantages of distal femoral replacement prostheses for reconstructions after tumors are well known; one such implant, the Global Modular Replacement System (GMRS), has been widely used since 2003. Although implant breakage has been reported, the frequency of this event has varied across different studies.

Questions/purposes

(1) What percentage of patients who underwent distal femur resection and replacement using the GMRS for primary bone tumors at one center experienced stem breakage? (2) At what timepoints did these breakages occur, and what factors were common among the stems that broke?

Methods

We performed a retrospective study of all patients who underwent distal femur resection and replacement using the GMRS for a diagnosis of primary bone sarcoma by the Queensland Bone and Soft-tissue Tumor service from 2003 to 2020 who had a minimum of 2 years of follow-up. Standard follow-up for primary bone sarcoma involves radiographic imaging of the femur at 6 weeks and 3 months postoperatively and yearly thereafter. From a chart review, we identified patients with femoral stem breakage. Patient and implant details were recorded and analyzed. A total of 116 patients had undergone a distal femoral replacement with the GMRS prosthesis for primary bone sarcoma; however, 6.9% (eight of 116 patients) died before completing the 2-year follow-up period and were excluded. Of the remaining 108 patients, 15% (16 patients) had died at the time of this review; however, given that they completed the 2-year follow‐up period and did not experience stem breakage, they were included. Furthermore, 15% (16 patients) were considered lost to follow-up and excluded because they have not been seen in the past 5 years but were not known to have died or experienced stem breakage. This left 92 patients for analysis.

Results

Stem breakages were identified in 5.4% (five of 92) of patients. All stem breakages occurred in stem diameters 11 mm or less with a porous body construct; the percentage of patients with breakage in this group was 16% (five of 31). All patients with stem fracture demonstrated minimal ongrowth to the porous coated body. The median time to stem fracture was 10 years (range 2 to 12 years); however, two of the five stems broke within 3 years.

Conclusion

We recommend the use of a larger-diameter GMRS cemented stem (> 11 mm), and either the line-to-line cementing method or an uncemented stem from an alternative company should be considered in order to achieve this larger stem in smaller canals. If a stem less than 12 mm in diameter must be used or there is evidence of minimal ongrowth, then close follow-up and prompt investigation of new symptoms should occur.

Level of Evidence

Level IV, therapeutic study.
Evaluation of Processed Nerve Allograft in Peripheral Nerve Surgery: A Systematic Review and Critical Appraisal
Authors: Frostadottir Drifa , Chemnitz Anette , Johansson OT Linn J. , Holst Jan , Dahlin Lars B.
Published: June 2023

Background:

Peripheral nerve injuries cause substantial problems when not treated properly. A specific problem is reconstruction of nerve defects, which can be treated in different ways. This study aimed to systematically review whether processed nerve allograft (PNA) is justified in reconstruction of a nerve defect in patients after posttraumatic or iatrogenic peripheral nerve injury and to compare PNA with other established methods.

Methods:

A systematic review with a focused question, PICO (patient, intervention, comparison, outcome) and constraints, was performed. A structured literature search, including several databases, was done to evaluate the existing evidence for outcomes and postoperative complications related to PNA. The certainty of evidence was classified according to Grading of Recommendations, Assessment, Development and Evaluations.

Results:

No conclusions, concerning differences in outcome of nerve reconstruction using PNA compared with the use of nerve autograft or conduits, could be drawn. The level of certainty for all evaluated outcomes was very low (⊕◯◯◯). Most published studies lack a control group to patients treated with PNA; being only descriptive, making it difficult to compare PNA with established methods without substantial risk of bias. For studies including a control group, the scientific evidence was of very low certainty, due to a low number of included patients, and large, undefined loss of patients during follow-up, rendering a high risk of bias. Finally, the authors often had financial disclosures.

Conclusion:

Properly conducted randomized controlled trial studies on the use of PNA in reconstruction of peripheral nerve injuries are needed to establish recommendations in clinical practice.
Mesenchymal Stromal Cells Prevent Blood-induced Degeneration of Chondrocytes in a New Model of Murine Hemarthrosis
Authors: Théron Alexandre , Maumus Marie , Bony-Garayt Claire , Sirvent Nicolas , Biron-Andreani Christine , Jorgensen Christian , Noël Danièle
Published: June 2023

Hemophilia is a rare congenital bleeding disorder caused by deficiency in coagulation factors VIII or IX, which is treated with prophylactic clotting factor concentrates. Nevertheless despite prophylaxis, spontaneous joint bleedings or hemarthroses still occur. The recurrent hemarthroses lead to progressive degradation of the joints and severe hemophilic arthropathy (HA) in patients with moderate and even mild forms of the disease. In absence of disease modifying treatment to stop or even delay HA progression, we aimed at evaluating the therapeutic potential of mesenchymal stromal cells (MSCs)-based therapy. We first developed a relevant and reproducible in vitro model of hemarthrosis relying on blood exposure of primary murine chondrocytes. We found that 30% whole blood for 4 days allowed to induce the characteristic features of hemarthrosis including low survival of chondrocytes, apoptosis induction, and dysregulation of chondrocyte markers in favor of a catabolic and inflammatory phenotype. We then evaluated the potential therapeutic effects of MSCs in this model using different conditions of coculture. Addition of MSCs improved the survival of chondrocytes when added either during the resolution or the acute phases of hemarthrosis and exerted a chondroprotective effect by enhancing the expression of anabolic markers, and reducing the expression of catabolic and inflammatory markers. We here provide the first proof-of-concept that MSCs may exert a therapeutic effect on chondrocytes under hemarthrosis conditions using a relevant in vitro model, thereby confirming a potential therapeutic interest for patients with recurrent joint bleedings.
Day to Day and Environmental Risk Factors for Psychological Distress Among Healthcare Workers
Authors: Atkins Kaitlyn , Cooney Erin E. , Park Soim , Closser Svea , Surkan Pamela J. , Marker Hannah C. , Schneider-Firestone Sarah , Kalb Luther G. , Thrul Johannes , Veenema Tener Goodwin
Published: June 2023

Objective

Despite a growing literature on mental health among clinical staff during COVID-19, factors shaping distress for nonclinical staff are understudied and may be driven by inequalities at work. We aimed to discuss the role of workplace factors in shaping psychological distress for a diverse group of clinical, nonclinical, and other health and hospital workers (HHWs).

Methods

This convergent parallel mixed-methods study with HHWs in a US hospital system included an online survey (n = 1127) and interviews (n = 73) collected from August 2020 to January 2021. We thematically analyzed interviews; findings informed log binomial regression estimating risk factors for severe psychological distress (Patient Health Questionnaire - 4 item version [PHQ-4] scores of 9 or greater).

Results

Qualitatively, day-to-day stressors fostered fear and anxiety, and concerns about work environments manifest as betrayal and frustration with leadership. Distress was associated with burnout, financial concerns, and feeling betrayed or unsupported by the institution and leadership. Staff in service versus clinical roles had higher risk for severe distress (adjusted prevalence ratio = 2.04, 95% confidence interval = 1.13–2.66); HHWs receiving workplace mental health support had lower risk (adjusted prevalence ratio = 0.52, 95% confidence interval = 0.29–0.92.

Conclusions

Our mixed-methods study underscores how the pandemic brought inequalities to the surface to increase distress for vulnerable HHWs. Workplace mental health activities can support HHWs now and during future crises.
A Comprehensive Evaluation of Occupational Epidemiology in Western Iran
Authors: Darbandi Mitra , Rezaeian Shahab , Najafi Farid , Shadmani Fatemeh Khosravi , Ghavi Saeed , Miryan Mahsa , Pasdar Yahya , Barzegar Akbar
Published: June 2023

Objective

The present study aims to evaluate the prevalence of noncommunicable diseases (NCDs), biochemical and anthropometric indicators, and lifestyle among 10 occupational groups.

Method

The sample included 4818 men aged 35 to 65 years. The occupational group is based on the International Standard Classification of Occupations.

Result

The highest prevalence of cardiovascular diseases and type 2 diabetes mellitus was observed in managerial occupational groups (18.62%) and technicians and associate professionals (14%), respectively. Musculoskeletal disorders were more in skilled agricultural, forestry, and fishery workers, as well as craft-related trades workers, and elementary occupations. The highest body mass index was related to the managers.

Conclusions

Noncommunicable diseases were higher in managers, while musculoskeletal disorders belonged to farmers and workers. Finally, lifestyle modification can help reduce NCDs and improve biochemical markers by increasing physical activity.
Stratifying Risk of Future Growth Among Sporadic Vestibular Schwannomas
Authors: Marinelli John P. , Schnurman Zane , Killeen Daniel E. , Nassiri Ashley M. , Hunter Jacob B. , Lees Katherine A. , Lohse Christine M. , Roland J. Thomas , Golfinos John G. , Kondziolka Douglas , Link Michael J. , Carlson Matthew L.
Published: June 2023

Objective

In certain cases, clinicians may consider continued observation of a vestibular schwannoma after initial growth is detected. The aim of the current work was to determine if patients with growing sporadic vestibular schwannomas could be stratified by the likelihood of subsequent growth based on initial growth behavior.

Study Design

Slice-by-slice volumetric tumor measurements from 3,505 serial magnetic resonance imaging studies were analyzed from 952 consecutively treated patients.

Setting

Three tertiary-referral centers.

Patients

Adults with sporadic vestibular schwannoma.

Interventions

Wait-and-scan.

Main Outcome Measures

Composite end point of subsequent growth- or treatment-free survival rates, where growth is defined as an additional increase of at least 20% in tumor volume from the volume at the time of initial growth.

Results

Among 405 patients who elected continued observation despite documented growth, stratification, of volumetric growth rate into less than 25% (reference: n = 107), 25 to less than 50% (hazard ratio [HR], 1.39;p= 0.06; n = 96), 50 to less than 100% (HR, 1.71;p= 0.002; n = 112), and at least 100% (HR, 2.01;p< 0.001; n = 90) change per year predicted the likelihood of future growth or treatment. Subsequent growth- or treatment-free survival rates (95% confidence interval) at year 5 after detection of initial growth were 31% (21–44%) for those with less than 25% growth per year, 18% (10–32%) for those with 25 to less than 50%, 15% (9–26%) for those with 50 to less than 100%, and 6% (2–16%) for those with at least 100%. Neither patient age (p= 0.15) nor tumor volume at diagnosis (p= 0.95) significantly differed across stratification groups.

Conclusions

At the time of diagnosis, clinical features cannot consistently predict which tumors will ultimately display aggressive behavior. Stratification by volumetric growth rate at the time of initial growth results in a stepwise progression of increasing likelihood of subsequent growth. When considering continued observation after initial growth detection, almost 95% of patients who have tumors that double in volume between diagnosis and the first detection of growth demonstrate further tumor growth or undergo treatment if observed to 5 years.
Tobacco Smoking and Pack-Years Are Associated With Frailty Among People With HIV
Authors: Ruderman Stephanie A. , Odden Michelle C , Webel Allison R. , Fitzpatrick Annette L. , Crane Paul K. , Nance Robin M. , Drumright Lydia N. , Whitney Bridget M. , Mixson Lyndsey Sarah , Ma Jimmy , Willig Amanda L. , Haidar Lara , Eltonsy Sherif , Mayer Kenneth H. , O'Cleirigh Conall , Cropsey Karen L. , Eron Joseph J. , Napravnik Sonia , Greene Meredith , McCaul Mary , Chander Geetanjali , Cachay Edward , Lober William B. , Kritchevsky Stephen B. , Austad Steven , Landay Alan , Pandya Chintan , Cartujano-Barrera Francisco , Saag Michael S. , Kamen Charles , Hahn Andrew W. , Kitahata Mari M. , Delaney Joseph A. C. , Crane Heidi M.
Published: June 2023

Background:

Tobacco smoking increases frailty risk among the general population and is common among people with HIV (PWH) who experience higher rates of frailty at younger ages than the general population.

Methods:

We identified 8608 PWH across 6 Centers for AIDS Research Network of Integrated Clinical Systems sites who completed ≥2 patient-reported outcome assessments, including a frailty phenotype measuring unintentional weight loss, poor mobility, fatigue, and inactivity, and scored 0–4. Smoking was measured as baseline pack-years and time-updated never, former, or current use with cigarettes/day. We used Cox models to associate smoking with risk of incident frailty (score ≥3) and deterioration (frailty score increase by ≥2 points), adjusted for demographics, antiretroviral medication, and time-updated CD4 count.

Results:

The mean follow-up of PWH was 5.3 years (median: 5.0), the mean age at baseline was 45 years, 15% were female, and 52% were non-White. At baseline, 60% reported current or former smoking. Current (HR: 1.79; 95% confidence interval: 1.54 to 2.08) and former (HR: 1.31; 95% confidence interval: 1.12 to 1.53) smoking were associated with higher incident frailty risk, as were higher pack-years. Current smoking (among younger PWH) and pack-years, but not former smoking, were associated with higher risk of deterioration.

Conclusions:

Among PWH, smoking status and duration are associated with incident and worsening frailty.
Regulatory T Cell Biomarkers Identify Patients at Risk of Developing Acute Cellular Rejection in the First Year Following Heart Transplantation
Authors: Kim Ji-Young V. , Assadian Sara , Hollander Zsuzsanna , Burns Paloma , Shannon Casey P. , Lam Karen , Toma Mustafa , Ignaszewski Andrew , Davies Ross A. , Delgado Diego , Haddad Haissam , Isaac Debra , Kim Daniel , Mui Alice , Rajda Miroslaw , West Lori , White Michel , Zieroth Shelley , Keown Paul A. , McMaster W. Robert , Ng Raymond T. , McManus Bruce M. , Levings Megan K. , Tebbutt Scott J.
Published: June 2023

Background.

Acute cellular rejection (ACR), an alloimmune response involving CD4+ and CD8+ T cells, occurs in up to 20% of patients within the first year following heart transplantation. The balance between a conventional versus regulatory CD4+ T cell alloimmune response is believed to contribute to developing ACR. Therefore, tracking these cells may elucidate whether changes in these cell populations could signal ACR risk.

Methods.

We used a CD4+ T cell gene signature (TGS) panel that tracks CD4+ conventional T cells (Tconv) and regulatory T cells (Treg) on longitudinal samples from 94 adult heart transplant recipients. We evaluated combined diagnostic performance of the TGS panel with a previously developed biomarker panel for ACR diagnosis, HEARTBiT, while also investigating TGS’ prognostic utility.

Results.

Compared with nonrejection samples, rejection samples showed decreased Treg- and increased Tconv-gene expression. The TGS panel was able to discriminate between ACR and nonrejection samples and, when combined with HEARTBiT, showed improved specificity compared with either model alone. Furthermore, the increased risk of ACR in the TGS model was associated with lower expression of Treg genes in patients who later developed ACR. Reduced Treg gene expression was positively associated with younger recipient age and higher intrapatient tacrolimus variability.

Conclusions.

We demonstrated that expression of genes associated with CD4+ Tconv and Treg could identify patients at risk of ACR. In our post hoc analysis, complementing HEARTBiT with TGS resulted in an improved classification of ACR. Our study suggests that HEARTBiT and TGS may serve as useful tools for further research and test development.
Parkinson's disease – genetic cause
Authors: Cherian Ajith , K.P Divya , Vijayaraghavan Asish
Published: June 2023

Purpose of review

Our knowledge of the genetic architecture underlying Parkinson's disease has vastly improved in the past quarter century. About 5–10% of all patients suffer from a monogenic form of Parkinson's disease.

Recent findings

Mutations in autosomal dominant genes (e.g. SNCA, LRRK2, VPS35) or autosomal recessive genes (e.g. PRKN, PINK1, DJ-1) can cause genetic Parkinson's disease. Recessive DNAJC6 mutations can present predominantly as atypical parkinsonism, but also rarely as typical Parkinson's disease. Majority of Parkinson's disease is genetically complex. Mutation in RIC3, a chaperone of neuronal nicotinic acetylcholine receptor subunit α-7 (CHRNA7), provides strong evidence for the role of cholinergic pathway, for the first time, in cause of Parkinson's disease. X-linked parkinsonism manifests at a young age accompanied by many (atypical) features such as intellectual disability, spasticity, seizures, myoclonus, dystonia, and have poor response to levodopa.

This review article aims to provide a comprehensive overview on Parkinson's disease genetics. MAPT, which encodes the microtubule associated protein tau, TMEM230, LRP10, NUS1 and ARSA are the five new putative disease-causing genes in Parkinson's disease. The validation of novel genes and its association with Parkinson's disease remains extremely challenging, as genetically affected families are sparse and globally widespread. In the near future, genetic discoveries in Parkinson's disease will influence our ability to predict and prognosticate the disease, help in defining etiological subtypes that are critical in implementation of precision medicine.
Improvement Effect of Upper Mediastinal Lymphadenectomy During Minimally Invasive Esophagectomy on the Prognosis in Squamous Cell Carcinoma: Efficacy Index and Propensity Score Matching Analyses
Authors: Oshikiri Taro , Goto Hironobu , Kato Takashi , Hasegawa Hiroshi , Kanaji Shingo , Yamashita Kimihiro , Fujino Yasuhiro , Tominaga Masahiro , Matsuda Takeru , Kakeji Yoshihiro
Published: June 2023

BACKGROUND:

The effect of lymphadenectomy around the recurrent laryngeal nerve (RLN) in open esophagectomy has been demonstrated with the efficacy index (EI). However, it remains unclear whether this effect exists for minimally invasive esophagectomy (MIE) in the prone position. The purpose of this study was to clarify whether the upper mediastinal lymphadenectomy contributed to improved prognosis in patients with esophageal squamous cell carcinoma.

STUDY DESIGN:

This study included 339 patients with esophageal squamous cell carcinoma treated with MIE in the prone position at Kobe University or Hyogo Cancer Center, Japan, from 2010 to 2015. EIs for each station, correlations between metastatic lymph nodes around the left RLN and RLN palsy, and survival of patients with and without upper mediastinal lymphadenectomy were investigated.

RESULTS:

Among 297 patients treated with upper mediastinal lymphadenectomy, Clavien- Dindo grade ≥ II left RLN palsy occurred in 59 patients (20%). Overall, EIs for the right RLN (7.4) and left RLN (6.6) were higher than EIs for other stations. For patients with upper-third or middle-third tumors, the trend was stronger. Left RLN palsy was more likely in patients with metastatic lymph nodes around the left RLN than in those without (44% vs 15%, p < 0.0001). After propensity score-matching, 42 patients were included in each group with and without upper mediastinal lymphadenectomy. In survival analyses, the 5-year overall survival rates were 55% vs 35% and cause-specific survival rates were 61% vs 43% for the patients with and without upper mediastinal lymphadenectomy respectively. Significant differences were confirmed in survival curves (overall survival: p = 0.03; cause-specific survival: p = 0.04, respectively).

CONCLUSIONS:

Upper mediastinal lymphadenectomy contributes to improved prognosis with high EIs in MIE in the prone position.
Transcriptomics Reveals Tumorigenesis and Pathogen Response in Scombrid Puffy Snout Syndrome
Authors: Leidholt Savanah L. , Bistolas Kalia , Pastey Manoj , Dasenko Mark , Miller Emily , Van Houtan Kyle S. , Boustany Andre , Galivn Tatiana , Vega Thurber Rebecca
Published: June 2023

Scombrids represent some of the most economically important fisheries globally. However, increased interest in creating aquaculture systems for these fish has also increased the risk for disease emergence. One such disease, Puffy Snout Syndrome (PSS), causes collagenous tissue growths on the face in numerous scombrid taxa. PSS has mainly been documented in captive-held fish populations and can lead to high mortality rates. Despite this, little is known about the causative agent(s) of PSS and the immune response they elicit. Therefore, we leveraged transcriptomic data of PSS symptomatic-captive, asymptomatic-captive, and healthy-wild Pacific Mackerel (Scomber japonicus) to evaluate the physiological characteristics of PSS infections and identify a potential mechanism of disease. Captive symptomatic and asymptomatic mackerel showed distinct gene expression patterns from their wild counterparts. Genes involved in tumorigenesis, immune response, and tissue remodeling were overexpressed in captive-held fish. WNT9 was the most overexpressed gene in captive groups, and the WNT signaling pathway itself showed a ∼3 fold increase in KEGG pathway enrichment analysis in captive animals. When captive fish were compared, asymptomatic fish showed lower expression of inflammation genes, but high expression of tumor suppressor genes compared to symptomatic-captive fish. Together, these host pathophysiological data and our past visual identification of RNA virus-like particles in afflicted tissues suggest that viral-mediated oncogenesis may be driving PSS in captive mackerel.
Significant factors affecting the New Zealand transportation infrastructure project cost – quantity surveyors' perception
Authors: Atapattu Chinthaka Niroshan , Domingo Niluka , Sutrisna Monty
Published: June 2023

Purpose

Cost overrun is one of the critical issues faced in construction projects, as nine out of ten projects will likely go over the budget. In particular, transportation infrastructure (TI) projects, such as roads and bridges, are vastly affected by cost overruns, which can delay the entire project. This research intends to identify the factors affecting the cost overruns in New Zealand (NZ) TI projects.

Design/methodology/approach

The research was conducted using a questionnaire survey involving ninety-two participants experienced in infrastructure project estimation in NZ. Quantitative methods were used to analyse the data.

Findings

Fifty-three factors were identified through literature under ten categories. Based on the survey, ten significant factors were identified with a high grade of importance. The three most critical factors were “frequent design changes,” “poor planning and scheduling” and “inadequate tender documentation.” It was found that the cost overrun is primarily affected by the pre-contract stage causes.

Research limitations/implications

The data were collected from professionals involved in NZTI projects. Therefore, the implications may be different for other contexts.

Practical implications

The results will improve the current estimation practice by developing a new statistical model considering all the significant variables for NZTI projects.

Originality/value

Although much research is done to identify these factors, they are only considered in a few statistical cost models. These new statistical models mainly focused on technical variable factors similar to the current standard estimation process. However, the results of this research, qualitative and quantitative factors, will be used for the future cost model.
Business process reengineering for designing a knowledge-enabled customer-centric competitiveness strategy
Authors: Al-Shammari Minwir M.
Published: June 2023

Purpose

The study aims to design a holistic multi-stage hierarchical model that leverages the firm's knowledge-enabled distinctive core competencies (DCCs) and builds enduring and profitable customer relationships to achieve sustainable competitive advantage (SCA) in dynamic and challenging environments. It developed a knowledge-enabled customer-centric competitiveness strategy (KCCS) model that integrates four pillars: business process reengineering (BPR), knowledge management (KM), customer relationship management (CRM) and competitiveness strategy. It also proposed a BPR model to enable cross-functional cooperation and coordination for firms dealing with customers, provided a blueprint for KCCS's successful implementation and compared the KCCS model with other customer-centric (CC) approaches.

Design/methodology/approach

This study adopted an exploratory research design based on a literature review of relevant studies. It has systematically analyzed 130 articles and books from Scopus, the Web of Science, Google Scholar and other renowned databases from 1982 to 2022. The analysis involved identifying and selecting relevant literature and conducting thematic research to develop a theoretical KCCS model that integrates BPR, KM, CRM, competitiveness strategy and the firm's SCA into a KCCS model.

Findings

This study developed an integrative KCCS theoretical model rooted in the extant literature in BPR, KM, CRM, competitiveness strategy, DCCs, SCA and other fields. The study proposed a BPR model as a significant component of KCCS that enables cross-functional cooperation and coordination, which are often troublesome for firms in their dealings with customers. The study also provided a blueprint for successfully implementing the KCCS model and compared the KCCS model with other CC approaches.

Originality/value

This study filled many research gaps in the literature in which knowledge-enabled CC frameworks are widely scattered. It offered a conceptual multi-stage hierarchical KCCS model that combines interrelated elements of BPR, KM, CRM, and competitiveness strategy. It proposed a BPR model as a significant component of the KCCS that enables cross-functional cooperation and coordination, which frequently form barriers when dealing with customers. It also provided a blueprint for successfully implementing the KCCS and compared it with other CC approaches.
Target classification using radar cross-section statistics of millimeter-wave scattering
Authors: Coşkun Aysu , Bilicz Sándor
Published: June 2023

Purpose

This paper aims to discuss the classification of targets based on their radar cross-section (RCS). The wavelength, the dimensions of the targets and the distance from the antenna are in the order of 1 mm, 1 m and 10 m, respectively.

Design/methodology/approach

The near-field RCS is considered, and the physical optics approximation is used for its numerical calculation. To model real scenarios, the authors assume that the incident angle is a random variable within a narrow interval, and repeated observations of the RCS are made for its random realizations. Then, the histogram of the RCS is calculated from the samples. The authors use a nearest neighbor rule to classify conducting plates with different shapes based on their RCS histogram.

Findings

This setup is considered as a simple model of traffic road sign classification by millimeter-wavelength radar. The performance and limitations of the algorithm are demonstrated through a set of representative numerical examples.

Originality/value

The proposed method extends the existing tools by using near-field RCS histograms as target features to achieve a classification algorithm.
Investigating crowd logistics platform operations for local food distribution
Authors: Cramer Florian , Fikar Christian
Published: June 2023

Purpose

Short food supply chains have the potential to facilitate the transition to more sustainable food systems. Related distribution processes, however, can be challenging for smallholder and family farmers. To extend the market reach of farmers without the need for extensive investments, crowd logistics (CL) can be used. The purpose of this paper is to explore the benefits and trade-offs of implementing CL platforms in short food supply chains (SFSCs).

Design/methodology/approach

A decision support system (DSS) based on agent-based and discrete event simulation (DES) modelling is developed, which closely approximates the behaviour of customers and distribution processes at outlets. Different scenarios are explored to evaluate the potential of CL in rural and urban settings using the example of regions from Bavaria, Germany.

Findings

Results show that CL can be used to increase the reach of farmers in SFSCs at the cost of minor food quality losses. Moreover, a difference between urban and rural settings is noted: An urban scenario requires less investment in the driver base, whereas the rural scenario shows a higher potential to increase market reach.

Originality/value

Platform-based food delivery services are still mostly unexplored in the context of SFSCs. This research shows that platform services such as CL can be used to support local agriculture and facilitate the distribution of perishable food items, introducing a simulation-based DSS and providing detailed results on various application settings; this research serves as a steppingstone to facilitate successful real-world implementations and encourage further research.
Active community for climate change: a Dynamic Performance Governance analysis of a biodiversity preservation program
Authors: Vignieri Vincenzo
Published: June 2023

Purpose

This study aims to illustrate how collaborative platforms may leverage active community for climate change adaptation to implement biodiversity preservation policies.

Design/methodology/approach

This study adopts the Dynamic Performance Governance methodological framework to analyze the causal relationships affecting biodiversity preservation policy outcomes.

Findings

Active community reduces harmful factors for biodiversity (i.e. biological threats and anthropogenic pressure), limiting the risk of extinction of perennial plants. Stakeholders’ prior knowledge is an enabling condition of climate adaptation processes as it triggers the adoption of prescriptions and cultural changes in a community.

Practical implications

The study provides methodological guidance to define measures to deliver material information to support environmental performance governance. It elaborates an inventory of short- and long-term performance indicators integrating natural-science targets into accounting measures that can support policymakers operating in other contexts to implement climate change adaptation policies.

Social implications

As a response to the study findings, social implications provide insights into how active community in collaborative platforms for climate change may support stakeholders to address natural resources imbalances, define strategies to share the burden among them and intervene on multiple policy domains (e.g. financial, environmental and social).

Originality/value

Climate change adaptation challenges are conceptualized as “super wicked problems,” and the collaborative platforms designed to address them are rendered as complex adaptive systems. This makes the paper go beyond traditional environmental governance, demonstrating that stakeholders’ interactions within collaborative platforms harness active community specialized knowledge.
Rural–urban disparities in pregestational and gestational diabetes in pregnancy: Serial, cross‐sectional analysis of over 12 million pregnancies
Authors: Venkatesh Kartik K. , Huang Xiaoning , Cameron Natalie A. , Petito Lucia C. , Joseph Joshua , Landon Mark B. , Grobman William A. , Khan Sadiya S.
Published: June 2023

Objective

To compare trends in pregestational (DM) and gestational diabetes (GDM) in pregnancy in rural and urban areas in the USA, because pregnant women living in rural areas face unique challenges that contribute to rural–urban disparities in adverse pregnancy outcomes.

Design

Serial, cross‐sectional analysis.

Setting

US National Center for Health Statistics (NCHS) Natality Files from 2011 to 2019.

Population

A total of 12 401 888 singleton live births to nulliparous women aged 15–44 years.

Methods

We calculated the frequency (95% confidence interval [CI]) per 1000 live births, the mean annual percentage change (APC), and unadjusted and age‐adjusted rate ratios (aRR) of DM and GDM in rural compared with urban maternal residence (reference) per the NCHS Urban–Rural Classification Scheme overall, and by delivery year, reported race and ethnicity, and US region (effect measure modification).

Main outcome measures

The outcomes (modelled separately) were diagnoses of DM and GDM.

Results

From 2011 to 2019, there were increases in both the frequency (per 1000 live births; mean APC, 95% CI per year) of DM and GDM in rural areas (DM: 7.6 to 10.4 per 1000 live births; APC 2.8%, 95% CI 2.2%–3.4%; and GDM: 41.4 to 58.7 per 1000 live births; APC 3.1%, 95% CI 2.6%–3.6%) and urban areas (DM: 6.1 to 8.4 per 1000 live births; APC 3.3%, 95% CI 2.2%–4.4%; and GDM: 40.8 to 61.2 per 1000 live births; APC 3.9%, 95% CI 3.3%–4.6%). Individuals living in rural areas were at higher risk of DM (aRR 1.48, 95% CI 1.45%–1.51%) and GDM versus those in urban areas (aRR 1.17, 95% CI 1.16%–1.18%). The increased risk was similar each year for DM (interaction p = 0.8), but widened over time for GDM (interaction p < 0.01). The rural–urban disparity for DM was wider for individuals who identified as Hispanic race/ethnicity and in the South and West (interaction p < 0.01 for all); and for GDM the rural–urban disparity was generally wider for similar factors (i.e. Hispanic race/ethnicity, and in the South; interaction p < 0.05 for all).

Conclusions

The frequency of DM and GDM increased in both rural and urban areas of the USA from 2011 to 2019 among nulliparous pregnant women. Significant rural–urban disparities existed for DM and GDM, and increased over time for GDM. These rural–urban disparities were generally worse among those of Hispanic race/ethnicity and in women who lived in the South. These findings have implications for delivering equitable diabetes care in pregnancy in rural US communities.
Phenological growth stages of Astragalus membranaceus var. mongholicus according to the Biologische Bundesanstalt Bundessortenamt and Chemical Industry (BBCH) scale
Authors: Li Xiaojie , Mu Yingtong , Zhang Xiaoming , Wang Junjie
Published: June 2023

Astragalus membranaceus var. mongholicus (Astragalus) is a perennial medicinal plant belonging to Leguminosae. Its main agronomic and industrial interest is the accumulation of astragaloside IV and calycosin‐7‐O‐β‐D‐glucoside in roots, two components that play crucial pharmacological roles in the finished pharmaceutical products. Phenological research is a prerequisite for improving the yield quality of cultivated medicinal plants. However, there are no standardized phenological studies on Astragalus. To expand phenotyping knowledge on this medicinal plant, researchers and breeders need a universal scale to describe the development of this plant. This study aims to define the phenological growth stages of Astragalus, based on the existing Biologische Bundesanstalt, Bundessortenamt und Chemische Industrie (BBCH) scale to provide a standard scale for Astragalus, and grown under temperate conditions of production and climate, proposes a disease and pest control reference. This study was conducted in Inner Mongolia, North China. The existing BBCH scale with a three‐digit code was used to define Astragalus's phenological growth codes, supplemented with pictures. Phenological observations were performed twice monthly, based on the developmental stages. The chronology and duration of each stage were also observed and described according to the accumulation of degree days during the growing season. Based on the data obtained, the influence of the average temperature and GDD on the phenophases was evaluated. The phenological description is divided into two principal growth stages: five for vegetative growth (perennating bud, leaf development, formation of branches, main stem elongation and root development), four for reproductive growth (reproductive organ development, flowering, fruit development and fruit maturation), and one for senescence according to the BBCH scale. Seventy secondary growth stages were described within the 10 principal growth stages. Under each secondary growth stage, six mesostages are also taken into account, which contains the distinct patterns of the phenological characteristics in Astragalus varieties and the process of transplanting seedlings. A practical management program for disease and pest control was also proposed by using the BBCH code and the phenological data proposed in this work. Our study presents the first BBCH scale established for Astragalus cultivated in temperate conditions and a chronology of phenological stages based on the accumulation of thermal time, through growing degree day calculation. This work provides a general tool that can be widely used by researchers, breeders, and manufacturers of medicinal materials leading to better agricultural production and scientific communication.
Students' experience and perceptions of undergraduate endodontic education in New Zealand
Authors: Friedlander Lara , Hunt Gabrielle , Chandler Nicholas , Daniel Ben
Published: June 2023

This study investigated the clinical experience and perceptions of New Zealand graduating dental students (2019 and 2020) towards endodontic teaching and their clinical learning outcomes using an online survey and clinical scenarios. Quantitative data were analysed using SPSS software, and qualitative data were analysed thematically. Responses were similar for both cohorts (response rates 74%, 2019; 73%, 2020). Endodontic teaching was valuable and interesting but difficult compared with other disciplines. Molar endodontics, finding canals and managing posture were challenging. Students felt more confident and less anxious when supervised by clinicians experienced in endodontics. Time management was the most anxiety‐inducing factor and significantly related to clinical experience (p < 0.001). Overall, students appropriately applied knowledge in most areas of endodontics while holistic problem‐solving in complex scenarios was variable. Maximising clinical experience and supervision from teachers experienced in endodontics are important for learning, improving confidence and reducing anxiety.
Impact of modified‐release opioid use on clinical outcomes following total hip and knee arthroplasty: a propensity score‐matched cohort study
Authors: Liu S. , Patanwala A. E. , Naylor J. M. , Levy N. , Knaggs R. , Stevens J. A. , Bugeja B. , Begley D. , Khor K. E. , Lau E. , Allen R. , Adie S. , Penm J.
Published: June 2023

Modified‐release opioids are often prescribed for the management of moderate to severe acute pain following total hip and knee arthroplasty, despite recommendations against their use due to increasing concerns regarding harm. The primary objective of this multicentre study was to examine the impact of modified‐release opioid use on the incidence of opioid‐related adverse events compared with immediate‐release opioid use, among adult inpatients following total hip or knee arthroplasty. Data for total hip and knee arthroplasty inpatients receiving an opioid analgesic for postoperative analgesia during hospitalisation were collected from electronic medical records of three tertiary metropolitan hospitals in Australia. The primary outcome was the incidence of opioid‐related adverse events during hospital admission. Patients who received modified with or without immediate‐release opioids were matched to those receiving immediate‐release opioids only (1:1) using nearest neighbour propensity score matching with patient and clinical characteristics as covariates. This included total opioid dose received. In the matched cohorts, patients given modified‐release opioids (n = 347) experienced a higher incidence of opioid‐related adverse events overall, compared with those given immediate‐release opioids only (20.5%, 71/347 vs. 12.7%, 44/347; difference in proportions 7.8% [95%CI 2.3–13.3%]). Modified‐release opioid use was associated with an increased risk of harm when used for acute pain during hospitalisation after total hip or knee arthroplasty.
E2F2 modulates cell adhesion through the transcriptional regulation of PECAM1 in multiple myeloma
Authors: Chen Shu‐Na , Mai Zhi‐Ying , Mai Jun‐Na , Liang Weiyao , Dong Zhao‐Xia , Ju Fei‐er , Chan Sze‐Hoi , Fang Zhigang , Xu Yichuan , Uziel Orit , He Chengwei , Zhang Xing‐Ding , Zheng Yongjiang
Published: June 2023

Multiple myeloma (MM) is the second most common haematological malignancy. Despite the development of new drugs and treatments in recent years, the therapeutic outcomes of patients are not satisfactory. It is necessary to further investigate the molecular mechanism underlying MM progression. Herein, we found that high E2F2 expression was correlated with poor overall survival and advanced clinical stages in MM patients. Gain‐ and loss‐of‐function studies showed that E2F2 inhibited cell adhesion and consequently activated cell epithelial‐to‐mesenchymal transition (EMT) and migration. Further experiments revealed that E2F2 interacted with the PECAM1 promoter to suppress its transcriptional activity. The E2F2‐knockdown‐mediated promotion of cell adhesion was significantly reversed by the repression of PECAM1 expression. Finally, we observed that silencing E2F2 significantly inhibited viability and tumour progression in MM cell models and xenograft mouse models respectively. This study demonstrates that E2F2 plays a vital role as a tumour accelerator by inhibiting PECAM1‐dependent cell adhesion and accelerating MM cell proliferation. Therefore, E2F2 may serve as a potential independent prognostic marker and therapeutic target for MM.
The Experience of Women Regarding Chilean Government Measures during the COVID‐19 Pandemic
Authors: Undurraga Rosario , López‐Hornickel Natalia
Published: June 2023

This study explores the experience of ten possible beneficiaries of the measures provided by the Chilean government during the first year of the COVID‐19 pandemic through remote semi‐structured interviews. The results show a scenario of improvisation. Instead of relying on solid gender equity policies, a patchwork of focused measures was implemented, which increased uncertainty and vulnerability. As a result, women experienced sorrow and despair while facing economic constraints and care tasks mostly on their own. This article shows that care remains invisible in politics while overwhelmingly evident at home. Social care policies are urgently needed.
ChemoGraph: Interactive Visual Exploration of the Chemical Space
Authors: Kale Bharat , Clyde Austin , Sun Maoyuan , Ramanathan Arvind , Stevens Rick , Papka Michael E.
Published: June 2023

Exploratory analysis of the chemical space is an important task in the field of cheminformatics. For example, in drug discovery research, chemists investigate sets of thousands of chemical compounds in order to identify novel yet structurally similar synthetic compounds to replace natural products. Manually exploring the chemical space inhabited by all possible molecules and chemical compounds is impractical, and therefore presents a challenge. To fill this gap, we present ChemoGraph, a novel visual analytics technique for interactively exploring related chemicals. In ChemoGraph, we formalize a chemical space as a hypergraph and apply novel machine learning models to compute related chemical compounds. It uses a database to find related compounds from a known space and a machine learning model to generate new ones, which helps enlarge the known space. Moreover, ChemoGraph highlights interactive features that support users in viewing, comparing, and organizing computationally identified related chemicals. With a drug discovery usage scenario and initial expert feedback from a case study, we demonstrate the usefulness of ChemoGraph.
RectEuler: Visualizing Intersecting Sets using Rectangles
Authors: Paetzold Patrick , Kehlbeck Rebecca , Strobelt Hendrik , Xue Yumeng , Storandt Sabine , Deussen Oliver
Published: June 2023

Euler diagrams are a popular technique to visualize set‐typed data. However, creating diagrams using simple shapes remains a challenging problem for many complex, real‐life datasets. To solve this, we propose RectEuler: a flexible, fully‐automatic method using rectangles to create Euler‐like diagrams. We use an efficient mixed‐integer optimization scheme to place set labels and element representatives (e.g., text or images) in conjunction with rectangles describing the sets. By defining appropriate constraints, we adhere to well‐formedness properties and aesthetic considerations. If a dataset cannot be created within a reasonable time or at all, we iteratively split the diagram into multiple components until a drawable solution is found. Redundant encoding of the set membership using dots and set lines improves the readability of the diagram. Our web tool lets users see how the layout changes throughout the optimization process and provides interactive explanations. For evaluation, we perform quantitative and qualitative analysis across different datasets and compare our method to state‐of‐the‐art Euler diagram generation methods.
Exploring Interpersonal Relationships in Historical Voting Records
Authors: Cantareira G. D. , Xing Y. , Cole N. , Borgo R. , Abdul‐Rahman A.
Published: June 2023

Historical records from democratic processes and negotiation of constitutional texts are a complex type of data to navigate due to the many different elements that are constantly interacting with one another: people, timelines, different proposed documents, changes to such documents, and voting to approve or reject those changes. In particular, voting records can offer various insights about relationships between people of note in that historical context, such as alliances that can form and dissolve over time and people with unusual behavior. In this paper, we present a toolset developed to aid users in exploring relationships in voting records from a particular domain of constitutional conventions. The toolset consists of two elements: a dataset visualizer, which shows the entire timeline of a convention and allows users to investigate relationships at different moments in time via dimensionality reduction, and a person visualizer, which shows details of a given person's activity in that convention to aid in understanding the behavior observed in the dataset visualizer. We discuss our design choices and how each tool in those elements works towards our goals, and how they were perceived in an evaluation conducted with domain experts.