bluuebunny/crossref_metadata_2025 huggingface dataset:
Stereotactic radiotherapy for patients with bone metastases: a selected group with low rate of radiation treatment during the last month of life?
Authors: Nieder Carsten , Haukland Ellinor C. , Stanisavljevic Luka , Mannsåker Bård
Published: November 2024

Background

Complex high-precision radiotherapy, such as stereotactic body radiotherapy (SBRT), should only be offered to patients with sufficiently long survival. In the context of bone metastases radiotherapy, low rates of treatment close to the end of life, e.g. last 30 days (RT30), may serve as a quality of care indicator. While traditional, pain-relieving short-course regimens have been studied comprehensively, real-world SBRT results are still limited.

Methods

Retrospective analysis (2010–2023, n = 1117 episodes) of patients with bone metastases treated with traditional single-fraction (8 Gy × 1) or multi-fraction regimens (often 4 Gy × 5 or 3 Gy × 10) compared to stereotactic single-fraction (12–16 Gy × 1) or multi-fraction regimens.

Results

Except for gender, almost all baseline variables were uneven distributed. Failure to complete fractionated radiotherapy was uncommon in the stereotactic (4%) and non-stereotactic group (3%), p = 1.0. With regard to RT30, relevant differences emerged (19% for 8-Gy single-fraction versus 0% for stereotactic single-fraction, p = 0.01). The corresponding figures were 11% for multi-fraction non-stereotactic and 2% for multi-fraction stereotactic, p = 0.08. Median overall survival was shortest after 8-Gy single-fraction irradiation (4.2 months) and longest after stereotactic multi-fraction treatment (13.9 months). Neither stereotactic radiotherapy nor multi-fraction treatment improved survival in multivariate Cox regression analysis. Factors significantly associated with longer survival included better performance status, lower LabBM score (5 standard blood test results), stable disease outside of irradiated area(s), metachronous distant metastases, longer time interval from metastatic disease to bone irradiation, and outpatient status.

Conclusion

The implementation of SBRT for selected patients has resulted in low rates of non-completion and RT30. Optimal selection criteria remain to be determined, but in current clinical practice we exclude patients with poor performance status, unfavorable blood test results (high LabBM score) and progressive disease sites not amenable to SBRT. Established, guideline-endorsed short-course regimens, especially 8-Gy single-fraction treatment, continue to represent an important palliative approach.
Development of a LAMP assay for the rapid visual detection of the emerging tick-borne Songling virus
Authors: Gui Zheng , Ren Yuanning , Guo Qiqi , Yang Weiying , Liu Ziyan , Liu Ning , Peng Yunzhi , Liu Yu , Yu Jingfeng , Sun Lichao , Wang Zedong
Published: November 2024

Background

Songling virus (SGLV) within the genus Orthonairovirus, family Nairoviridae, is an emerging tick-borne virus associated with human febrile illness. However, no rapid detection method for SGLV has been established.

Methods

In this study, four primer sets targeting the nucleocapsid protein gene of SGLV were designed for use in the LAMP assay and evaluated to identify the optimal primer set. Recombinant plasmids were constructed and utilized for assessing the sensitivity of the assay. Tacheng tick virus 1 (TcTV-1)-, Beiji nairovirus (BJNV)-, Yezo virus (YEZV)-, severe fever with thrombocytopenia syndrome virus (SFTSV)-, and tick-borne encephalitis virus (TBEV)-positive tick samples were utilized to assess the specificity. Field-collected ticks were also evaluated as biological specimens to validate the assay.

Results

A SGLV-specific LAMP assay was established with a detection limit of 1 × 10–2 copies/μl and could be visually confirmed by a color change from purple to blue in SGLV-positive samples. No cross-reactivity was observed in the detection of TcTV-1, BJNV, YEZV, SFTSV, and TBEV using the LAMP assay. In addition to the detection of the same seven high-copy numbers of SGLV as the SYBR Green quantitative RT-PCR assay within a reduced timeframe, the developed LAMP method also effectively identified an additional sample with a low copy number in the field-collected tick samples.

Conclusions

We successfully developed a sensitive, specific, and cost-effective visual method for the rapid detection of SGLV using the LAMP assay, which can be applied in pathogenesis and epidemiological surveillance studies of SGLV.

Graphical Abstract
Optimal duration of whole-body cryostimulation exposure to achieve target skin temperature: influence of body mass index—a randomized cross-over controlled trial
Authors: Jdidi Hela , de Bisschop Claire , Dugué Benoit , Bouzigon Romain , Douzi Wafa
Published: November 2024

Background

The efficacy of whole-body cryostimulation (WBC) may be influenced by individual characteristics. The aim of this study is to determine the optimal exposure time required to reach the analgesic threshold of 13.6 °C, which has been proposed to be a target temperature to be reached at skin level. Our objective is also to follow the skin temperature changes during and after WBC considering the participants body mass index (BMI).

Methods

Thirty healthy men were assigned into 2 groups based on their BMI [normal weight (n = 15; BMI = 21.53 ± 1.63 kg·m−2) and overweight (n = 15; BMI = 27.98 ± 1.16 kg·m−2)]. In a random order, each participant experienced a 4-min WBC exposure, as well as a control session with no cold exposure. Skin temperature was measured using a thermal imaging camera during and after cold exposure.

Results

Normal weight participants reached the threshold in 4 min, whereas overweight participants reached it in 3 min 30 s. Following WBC, a rapid mean skin temperature (MsT°) increase was observed for both groups, immediately after exposure. However, after 30 min, MsT° remained significantly lower than at baseline.

Conclusion

Our findings suggest that appropriate WBC dosage may differ according to BMI. Understanding the impact of such variable on cold exposure outcomes can help to optimize WBC treatments and maximize potential benefits.
Multi-parameter MRI radiomics model in predicting postoperative progressive cerebral edema and hemorrhage after resection of meningioma
Authors: Hu Kangjian , Tan Guirong , Liao Xueqing , Liu Weiyin Vivian , Han Wenjing , Hu Lingjing , Jiang Haihui , Yang Lijuan , Guo Ming , Deng Yaohong , Meng Zhihua , Liu Xiang
Published: November 2024

Background

Postoperative progressive cerebral edema and hemorrhage (PPCEH) are major complications after meningioma resection, yet their preoperative predictive studies are limited. The aim is to develop and validate a multiparametric MRI machine learning model to predict PPCEH after meningioma resection.

Methods

This retrospective study included 148 patients with meningioma. A stratified three-fold cross-validation was used to split the dataset into training and validation sets. Radiomics features from the tumor enhancement (TE) and peritumoral brain edema (PTBE) regions were extracted from T1WI, T2WI, and ADC maps. Support vector machine constructed different radiomics models, and logistic regression explored clinical risk factors. Prediction models, integrating clinical and radiomics features, were evaluated using the area under the curve (AUC), visualized in a nomogram.

Results

The radiomics model based on TE and PTBE regions (training set mean AUC: 0.85 (95% CI: 0.78–0.93), validation set mean AUC: 0.77 (95%CI: 0.63–0.90)) outperformed the model with TE region solely (training set mean AUC: 0.83 (95% CI: 0.76–0.91), validation set mean AUC: 0.73 (95% CI: 0.58–0.87)). Furthermore, the combined model incorporating radiomics features, and clinical features of preoperative peritumoral edema and tumor boundary adhesion, had the best predictive performance, with AUC values of 0.87 (95% CI: 0.80–0.94) and 0.84 (95% CI: 0.72–0.95) for the training and validation set.

Conclusions

We developed a novel model based on clinical characteristics and multiparametric radiomics features derived from TE and PTBE regions, which can accurately and non-invasively predict PPCEH after meningioma resection. Additionally, our findings suggest the crucial role of PTBE radiomics features in understanding the potential mechanisms of PPCEH.
Age and blood pressure stratified healthy vascular aging, organ damage and prognosis in the community-dwelling elderly: insights from the North Shanghai Study
Authors: Ren Zhongyuan , Yang Haotian , Zhu Wenqing , Han Jun , Yu Shikai , Zhao Song , Meng Weilun , Xu Yawei , Zhao Yifan , Zhang Yi
Published: November 2024

Background

This study aimed to investigate the prognostic value of age and blood pressure stratified healthy vascular aging (HVA) defined in the North Shanghai Study (NSS), and illustrate its relationship with organ damage (OD).

Methods

This study enrolled 3590 community-dwelling elderly Chinese aged over 65 years and finally 3234 participants were included. 3230 individuals were included in the final analysis, with 4 participants lost to follow-up. NSS HVA was defined as low carotid-femoral pulse wave velocity (PWV) which had a higher cutoff value with advanced age and level of blood pressure. OD was thoroughly assessed and classified into vascular, cardiac and renal OD. Primary endpoints were major adverse cerebrocardiovascular events (MACCE) and all-cause mortality.

Results

Nine hundred seventy-eight participants out of 3234 participants (43.1%) were identified as having NSS HVA. The NSS HVA group exhibited a younger age, lower blood pressure levels, lower body mass index, and milder OD compared to the non-NSS HVA group. Over follow-up of 5.7 ± 1.8 years, 332 MACCE (1.82 per 100 person-year) and 212 all-cause deaths (1.14 per 100 person -year) occurred. NSS HVA was associated with a reduced risk of MACCE (HR [95% CI] = 0.585, 0.454–0.754) and all-cause death (HR [95%CI] = 0.608 [0.445, 0.832]), especially in those subgroups without clinical diagnosed cardiovascular disease (CVD) or diabetes mellitus but with at least one type of OD. Moreover, NSS HVA exhibited improved prognostic value for MACCE, all-cause death and CVD death compared to other definitions of HVA.

Conclusions

Age and blood pressure stratified NSS HVA could serve as an improved indicator against serious adverse events in the community-dwelling elderly Chinese.

Trial registration

Prognosis in the Elderly Chinese: The Northern Shanghai Study (NSS), NCT02368938, https://clinicaltrials.gov/study/NCT02368938?cond=NCT02368938&rank=1.
Engineering collagen-based biomaterials for cardiovascular medicine
Authors: Zuo Xianghao , Xiao Yao , Yang Jing , He Yuanmeng , He Yunxiang , Liu Kai , Chen Xiaoping , Guo Junling
Published: November 2024

Cardiovascular diseases have been the leading cause of global mortality and disability. In addition to traditional drug and surgical treatment, more and more studies investigate tissue engineering therapeutic strategies in cardiovascular medicine. Collagen interweaves in the form of trimeric chains to form the physiological network framework of the extracellular matrix of cardiac and vascular cells, possessing excellent biological properties (such as low immunogenicity and good biocompatibility) and adjustable mechanical properties, which renders it a vital tissue engineering biomaterial for the treatment of cardiovascular diseases. In recent years, promising advances have been made in the application of collagen materials in blood vessel prostheses, injectable cardiac hydrogels, cardiac patches, and hemostatic materials, although their clinical translation still faces some obstacles. Thus, we reviewed these findings and systematically summarizes the application progress as well as problems of clinical translation of collagen biomaterials in the cardiovascular field. The present review contributes to a comprehensive understanding of the application of collagen biomaterials in cardiovascular medicine.

Graphical abstract
Decorin-armed oncolytic adenovirus promotes natural killers (NKs) activation and infiltration to enhance NK therapy in CRC model
Authors: Li Xue , Zhang Yuning , Mao Zhuang , Zhao Huiqiang , Cao Hu , Wang Jingyi , Liu Wei , Dai Shiyun , Yang Yuefeng , Huang Yuanyuan , Wang Hua
Published: November 2024

Colorectal cancer (CRC) is a prevalent malignant tumor of the gastrointestinal system, with the third and second highest incidence and mortality rates globally in 2020, respectively. Immunotherapy has developed rapidly in recent years. Natural killer (NK) cells have received increasing attention in the field of tumor immunotherapy due to their recognition and killing tumor cells without the limitations of major histocompatibility complexes. However, constraints within the tumor microenvironment that impede the infiltration and proliferation of NK cells result in poor efficacy of NK cell therapy for solid tumors. Oncolytic viral therapy is an immunogenic treatment with the potential to enhance anti-tumour immune responses and promote immune cell infiltration. In this study, we synergistically combine NK cells with an oncolytic adenovirus carrying Decorin (rAd.DCN) for the treatment of colorectal cancer (CRC) in a xenograft mouse model. By using Flow cytometry, real-time quantitative PCR and Calcein-AM release assay, we found that rAd.DCN could effectively promote proliferation, activation and degranulation of NK cells, up-regulate expression and secretion of NK cell killing activity-related factors, and enhance their killing activity. The efficacy is better than that of the blank control oncolytic virus rAd.Null. Combined treatment significantly inhibited tumor growth, increased the number of NK cells in peripheral blood, promoted the killing function of NK cells, and increased the expression levels of perforin and IFN-γ. At the same time, more NK cells were recruited to infiltrate tumor tissue. Our study established the feasibility of combination NK cells and oncolytic adenovirus application, thus expanding the scope of potentially curative treatments for NK cells in CRC.
Research on aerodynamic characteristics of high-velocity train bogies
Authors: Yongrong Jin , Xiaoli Chen
Published: November 2024

The bogie is a critical component of high-velocity trains. As train velocity rises, the operational quality is increasingly influenced by aerodynamic forces. The aerodynamic characteristics of bogies significantly impact the safety of train operations. This article examines a real high-velocity train model, constructing a 3-group train model, and developing a mathematical model of high-velocity train operation on open lines. Using three-dimensional steady-state Navier–Stokes equations, the flow field characteristics, pressure spread, aerodynamic forces, and torque characteristics on the bogie and body of high-velocity locomotives operating at velocities of 200 km/h, 250 km/h, 300 km/h, and 350 km/h are calculated, with measurement spots set to study the trend of pressure variation with train velocity. The research findings indicate that pressure at the same location on the body surface rises with vehicle velocity, with a quadratic link between the two. The uneven pressure spread between two bogies of the same vehicle and between two axles of the same bogie indicates that aerodynamic forces can cause axle load transfer in high-velocity trains. The highest values of aerodynamic resistance and lift happen at the front bogie, and the resistance and lift of both a single carriage and the entire vehicle increase with velocity, following a quadratic relationship. The highest nodding torque of the train body occurs on one vehicle, while the highest nodding torque of the bogie occurs on the 6th bogie, with both torques increasing with velocity, also in a quadratic relationship.
Seismic Soundoff: Unveiling the earth's critical zone through a geophysical lens
Authors: Geary Andrew
Published: November 2024

In episode 233 of SEG's Seismic Soundoff podcast, Kamini Singha discusses the earth's critical zone. Listeners will gain a comprehensive understanding of the critical zone's role in addressing major Anthropocene issues such as freshwater supply, groundwater quality, and climate regulation.
Rare Variation in LMNA Underlies Polycystic Ovary Syndrome Pathogenesis in 2 Independent Cohorts
Authors: Bauer Rosemary , Parker Chloe , Gorsic Lidija K , Hayes Michael Geoffrey , Kunselman Allen R , Legro Richard S , Welt Corrine K , Urbanek Margrit
Published: November 2024

Context

Polycystic ovary syndrome (PCOS) is a common, heritable endocrinopathy that is a common cause of anovulatory infertility in reproductive age women. Variants in LMNA cause partial lipodystrophy, a syndrome with overlapping features to PCOS.

Objective

We tested the hypothesis that rare variation in LMNA contributes to PCOS pathogenesis and selects a lipodystrophy-like subtype of PCOS.

Methods

We sequenced LMNA by targeted sequencing a Discovery cohort of 811 PCOS patients and 164 healthy controls. We then analyzed LMNA from whole-exome sequencing of a Replication cohort of 718 PCOS patients and 281 healthy controls. We evaluated variation in the LMNA gene and hormone and lipid profiles of participants

Results

In the Discovery cohort, we identified 8 missense variants in 15/811 cases, and 1 variant in 1/172 reproductively healthy controls. There is strong evidence for association between the variants and PCOS compared to gnomAD non-Finnish European population controls (χ2 = 17, P = 3.7 × 10−5, OR = 2.9). In the Replication cohort, we identified 11 unique variants in 15/718 cases, and 1 variant in 281 reproductively healthy controls. Again, there is strong evidence for association with population controls (χ2 = 30.5, P = 3.4 × 10−8, OR = 4.0). In both the Discovery and Replication cohorts, variants in LMNA identify women with PCOS with high triglycerides and extreme insulin resistance.

Conclusion

Rare missense variation in LMNA is reproducibly associated with PCOS and identifies some individuals with lipodystrophy-like features. The overlap between this PCOS phenotype and genetic partial lipodystrophy syndromes warrants further investigation into additional lipodystrophy genes and their potential in PCOS etiology.
CASRdb: A Publicly Accessible Comprehensive Database for Disease-Associated Calcium-Sensing Receptor Variants
Authors: Charoenngam Nipith , Wattanachayakul Phuuwadith , Mannstadt Michael
Published: November 2024

Context

Genetic testing of the calcium-sensing receptor (CASR) gene is crucial for confirming diagnoses of familial hypocalciuric hypercalcemia type I (FHH1) and autosomal dominant hypocalcemia type I (ADH1). Therefore, we created a publicly accessible comprehensive database of the disease-causing variants of the CASR gene.

Evidence Acquisition

We used 2 sources for variant reports: (1) we conducted a systematic review in the Embase and PubMed databases from inception to March 2023, using search strategies associated with CASR. We identified all articles reporting CASR variants associated with disorders of calcium metabolism. (2) Additionally, data associated with pathogenic (P) or likely pathogenic (LP) variants in the ClinVar and LOVD databases were retrieved. Benign or likely benign variants were excluded. Variants of uncertain significance (VUS) were included only if they were reported in the literature. We generated a library of CASR variants associated with phenotypes, which has been made available on a website.

Evidence Synthesis

We identified a total of 498 variants, of which 121 (24.3%) were associated with ADH1 and 377 (75.7%) with FHH1. Most included variants were identified from the literature (117 activating and 352 inactivating variants), and the majority of these were not documented in ClinVar/LOVD (73/117, 62.4% activating variants; 207/352, 58.8% inactivating variants).

Conclusion

We developed CASRdb, a database that compiles information on all CASR variants associated with disorders of calcium metabolism from existing literature and genomic databases. Our database stands out due to the substantially higher number of disease-associated variants it contains, highlighting its comprehensive nature. The website is available at http://casrdb.mgh.harvard.edu.
Evolution and development of the conduction system in the vertebrate heart: a role for hemodynamics and the epicardium
Authors: Poelmann Robert E.
Published: November 2024

Development of the heart is a very intricate and multiplex process as it involves not only the three spatial dimensions but also the fourth or time dimension. Over time, the heart of an embryo needs to adapt its function to serve the increasing complexity of differentiation and growth towards adulthood. It becomes even more perplexing by expanding time into millions of years, allocating related species in the tree of life. As the evolution of soft tissues can hardly be studied, we have to rely on comparative embryology, supported heavily by genetic and molecular approaches. These techniques provide insight into relationships, not only between species, but also between cell populations, signaling mechanisms, molecular interactions and physical factors such as hemodynamics. Heart development depends on differentiation of a mesodermal cell population that – in more derived taxa – continues in segmentation of the first and second heart field. These fields deliver not only the cardiomyocytes, forming the three-dimensionally looping cardiac tube as a basis for the chambered heart, but also the enveloping epicardium. The synchronized beating of the heart is then organized by the conduction system. In this Review, the epicardium is introduced as an important player in cardiac differentiation, including the conduction system.
Lumpy investment, productivity and quantitative models
Authors: Ζαβέρδας Δημήτριος
Published: November 2024

Οι επιχειρήσεις παίζουν κομβικό ρόλο στην πραγματική οικονομία και αποτελούν θεμελιώδες μέρος των Οικονομικών. Η αξιοπιστία των συμπερασμάτων των οικονομικών υποδειγμάτων εξαρτάται από το πόσο καλά οι υποθέσεις τους αποτυπώνουν την πραγματική φύση των επιχειρήσεων. Επιπλέον, υπό το πρίσμα της αυξανόμενης σημασίας των μικροθεμελιώσεων στη Μακροοικονομική, καθίσταται αναγκαίο να συνεχίσουμε να διευρύνουμε την κατανόηση της πολυπλοκότητας των δυναμικών των επιχειρήσεων και των πηγών ετερογένειας, τα οποία μπορούν να επηρεάσουν τις συνολικές τάσεις και συμπεριφορές. Ως εκ τούτου, επιβάλλεται οι ερευνητές να εξετάζουν συνεχώς τα θεμελιώδη χαρακτηριστικά που σχετίζονται με τις επιχειρήσεις και να προσαρμόζουν αναλόγως τις υποθέσεις των υποδειγμάτων τους. Επί του παρόντος, είναι συνήθης πρακτική να υποθέτουμε ότι η παραγωγικότητα είναι μια διαδικασία εντελώς εξωγενής για την επιχείρηση. Ωστόσο, η υπάρχουσα βιβλιογραφία για τις ανομοιόμορφες επενδύσεις έχει αναδείξει ότι μεγάλα άλματα επενδύσεων σε φυσικό κεφάλαιο συνοδεύονται συχνά από διαταραχές στην παραγωγικότητα. Η διατριβή αυτή καταπιάνεται με αυτή την ασυνέπεια μεταξύ αυτών των ευρημάτων και της συνήθους πρακτικής στην εφαρμοσμένη έρευνα και στοχεύει στη μέτρηση των επιπτώσεών της για τα αποτελέσματα των υποδειγμάτων και στη διόρθωση πιθανών προβλημάτων που διαπιστώνονται. Πρώτα απ' όλα, παρέχουμε πρόσθετες αποδείξεις για διαταραχές της παραγωγικότητας που προκαλούνται από επενδυτικά άλματα, σε νέα δεδομένα. Ενισχύοντας έτσι τα υπάρχοντα ευρήματα της βιβλιογραφίας για τις ανομοιόμορφες επενδύσεις και κινητοποιώντας τις αναλύσεις που ακολουθούν. Στη συνέχεια, επεκτείνουμε το σύνηθες πλαίσιο για την εκτίμηση συναρτήσεων παραγωγής, ώστε να λαμβάνονται υπόψη τα επενδυτικά άλματα και συγκρίνουμε με την αρχική προσέγγιση. Οι ελαστικότητες των εισροών της συνάρτησης παραγωγής και οι αποδόσεις κλίμακας που προκύπτουν είναι σημαντικά διαφορετικές. Επιπλέον, επηρεάζονται και οι εκτιμήσεις και οι αναλύσεις που σχετίζονται με την παραγωγικότητα σε επίπεδο επιχείρησης. Ακόμη πιο σημαντικό, ο αντίκτυπος των επενδυτικών αλμάτων επιδρά και στις μακροοικονομικές αναλύσεις. Κατασκευάζουμε εκτιμήσεις του ρυθμού μεγένθυνσης της συνολικής παραγωγικότητας από τα δεδομένα και τις αποδομούμε στις συνιστώσες της τεχνικής και της αναδιανεμητικής τους αποτελεσματικότητας. Οι συνιστώσες διαφέρουν αισθητά, εξαρτώμενες από τις εξειδικεύσεις του υποδείγματος. Η επίδραση αυτή είναι εντονότερη σε περιόδους με μεγαλύτερη συχνότητα επενδυτικών αλμάτων, επιβεβαιώνοντας έτσι τη σημασία τους για τα ευρήματα αυτής της άσκησης. Τέλος, παρέχουμε στοιχεία βάσει προσομοίωσης που υποστηρίζουν την προτεινόμενη τροποποίησή μας. Προσομοιώνοντας και επανεκτιμώντας ένα διαρθρωτικό υπόδειγμα ετερογενών επιχειρήσεων, δείχνουμε ότι η απόφαση του να συμπεριληφθούν ή να εξαιρεθούν τα επενδυτικά άλματα επηρεάζει σημαντικά τις εκτιμήσεις και τα επακόλουθα συμπεράσματα.
Dynamic stability control and human energetics
Authors: Εκίζος Αντώνης
Published: November 2024

Οι στρατηγικές κινητικού ελέγχου επιλέγονται με τρόπο που εξαρτάται από το πλαίσιο, βασισμένες σε διαφορετικά κριτήρια. Από τη μία πλευρά, η σταθερότητα σε δυναμικές συνθήκες όπως η μετακίνηση, είναι κρίσιμη για την απρόσκοπτη εκτέλεση της δραστηριότητας και απαιτεί αποτελεσματική ρύθμιση από το κεντρικό νευρικό σύστημα. Από την άλλη, η ελαχιστοποίηση του ενεργειακού κόστους μεταφοράς είναι καθοριστική στην επιλογή της στρατηγικής μετακίνησης από το κεντρικό νευρικό σύστημα. Και οι δύο αυτές έννοιες (δηλαδή η διατήρηση της σταθερότητας και η βελτιστοποίηση του ενεργειακού κόστους μετακίνησης) έχουν θεμελιώδη ρόλο στο πώς και γιατί οι άνθρωποι κινούνται με τον τρόπο που το κάνουν. Ωστόσο, το πώς το ανθρώπινο κεντρικό νευρικό σύστημα θέτει προτεραιότητες μεταξύ των διαφορετικών στόχων παραμένει άγνωστο.Τα τελευταία 20 χρόνια, ιδέες από επιστημονικά παραδείγματα όπως η θεωρία του χάους και τα πολύπλοκα συστήματα μας έχουν δώσει νέα εργαλεία για την προσέγγιση αυτών των ερωτημάτων. Η παρούσα διατριβή εξετάζει τη δυναμική σταθερότητα κατά την ανθρώπινη μετακίνηση υπό μια τέτοια προσέγγιση χρησιμοποιώντας την έννοια της ανάλυσης Lyapunov. Αρχικά, πραγματοποιήθηκε μια μεθοδολογική εξέταση της αξιοπιστίας του μέγιστου εκθέτη Lyapunov στο βάδισμα και το τρέξιμο (κεφάλαιο 2). Στη συνέχεια, διεξήχθη μια εξέταση μεταξύ της συνήθους κατάστασης τρεξίματος και μετά την αφαίρεση των υποδημάτων, που έδειξε μείωση της σταθερότητας μετά την οξεία μετάβαση στη νέα κατάσταση (κεφάλαιο 3). Στην τελευταία μελέτη, πραγματοποιήθηκε μια προπονητική παρέμβαση με στόχο τη βελτίωση των ενεργειακών παραμέτρων του τρεξίματος, χρησιμοποιώντας μια ομάδα βραχυπρόθεσμης και μια ομάδα μακροπρόθεσμης παρέμβασης (κεφάλαιο 4). Τα αποτελέσματα αποδεικνύουν ότι τα σφάλματα κινητικού ελέγχου μπορούν να έχουν ρόλο στο ενεργειακό κόστος του τρεξίματος και επομένως, σε μια ευέλικτη ιεράρχηση της εξόδου του κινητικού ελέγχου.
Information Provision from a Platform to Competing Sellers: The Role of Strategic Ambiguity
Authors: Avinadav Tal , Chernonog Tatyana , Shamir Noam
Published: November 2024

Problem definition: With the rapid growth of e-commerce, platforms are able to gather large quantities of data, which can result in high-precision predictions regarding consumer purchasing patterns and future demand. A fundamental question is whether a platform has the incentives and ability to share such nonverifiable information with its sellers. Methodology/results: We show that when information is nonverifiable, sharing the precise value of the platform’s private information by means of cheap-talk cannot result in an equilibrium. This outcome is due to the incentive of the platform to portray a more favorable market condition than that predicted, in order to encourage the sellers to raise their prices and improve market efficiency. In spite of this negative result, we demonstrate that the level of incentives misalignment between the platform and its sellers is bounded; consequently, a region-forecast information-sharing equilibrium can emerge. In this equilibrium, the support of the platform’s private information is divided into several intervals, and the platform strategically chooses to report truthfully the interval containing its private information. The structure of the partition is influenced by two main factors: the incentive of the platform to reduce market uncertainty for the sellers, and the motivation of the platform to soften competition among the sellers. Although both the sellers and the platform benefit from the ability to share some level of information, such an outcome hurts the consumers. Managerial implications: This work explains the observed practice of a platform providing nonverifiable information to its sellers via cheap-talk. The main advantage of this equilibrium is the ability to share information in a costless manner; however, the amount of information that can be shared is limited and is influenced by the level of market competition between the sellers.

Funding: N. Shamir gratefully acknowledges financial support from the Israel Science Foundation [Grant 2358/22] and The Henry Crown Institute of Business Research in Israel. T. Avinadav and T. Chernonog gratefully acknowledge financial support from the Israel Science Foundation [Grant 1571/20].

Supplemental Material: The electronic companion is available at https://doi.org/10.1287/msom.2023.0262 .
Unraveling the Rationality of Genocide: A Comparative Analysis of Khojaly and Srebrenica
Authors: Güven İbrahim Fevzi , Asker Ali
Published: November 2024

Within the scholarly debates in political science and genocide studies, an increasingly prevailing view posits that the most adequate explanation for the occurrence of genocide is the strategic approach. According to this view, the main impetus behind the decision to use violence against civilians is not irrational barbarism but rational choices to realize strategic interests. However, how and under what circumstances genocide becomes a rational choice for aggressors in pursuing their strategic objectives has remained largely unexplored. Through a comparative analysis of the cases of Srebrenica and
Khojaly, this study seeks to uncover the strategic, political, and ideological factors that underpin the rationale for genocide. The findings show that the viability of genocide as a low-risk option is underpinned by three interrelated factors. These are the recognition of the limited capacity of the victims to mount armed resistance, resulting in a reduced or negligible risk of counterattack; the awareness of the international community’s reluctance to intervene; and the expectation that demographic transformation through ethnic cleansing and genocide could be preserved as a beneficial post-conflict resource.
Detection, classification, and characterization of proximal humerus fractures on plain radiographs
Authors: Spek Reinier W. A. , Smith William J. , Sverdlov Marat , Broos Sebastiaan , Zhao Yang , Liao Zhibin , Verjans Johan W. , Prijs Jasper , To Minh-Son , Åberg Henrik , Chiri Wael , IJpma Frank F. A. , Jadav Bhavin , White John , Bain Gregory I. , Jutte Paul C. , van den Bekerom Michel P. J. , Jaarsma Ruurd L. , Doornberg Job N.
Published: November 2024

Aims

The purpose of this study was to develop a convolutional neural network (CNN) for fracture detection, classification, and identification of greater tuberosity displacement ≥ 1 cm, neck-shaft angle (NSA) ≤ 100°, shaft translation, and articular fracture involvement, on plain radiographs.

Methods

The CNN was trained and tested on radiographs sourced from 11 hospitals in Australia and externally validated on radiographs from the Netherlands. Each radiograph was paired with corresponding CT scans to serve as the reference standard based on dual independent evaluation by trained researchers and attending orthopaedic surgeons. Presence of a fracture, classification (non- to minimally displaced; two-part, multipart, and glenohumeral dislocation), and four characteristics were determined on 2D and 3D CT scans and subsequently allocated to each series of radiographs. Fracture characteristics included greater tuberosity displacement ≥ 1 cm, NSA ≤ 100°, shaft translation (0% to < 75%, 75% to 95%, > 95%), and the extent of articular involvement (0% to < 15%, 15% to 35%, or > 35%).

Results

For detection and classification, the algorithm was trained on 1,709 radiographs (n = 803), tested on 567 radiographs (n = 244), and subsequently externally validated on 535 radiographs (n = 227). For characterization, healthy shoulders and glenohumeral dislocation were excluded. The overall accuracy for fracture detection was 94% (area under the receiver operating characteristic curve (AUC) = 0.98) and for classification 78% (AUC 0.68 to 0.93). Accuracy to detect greater tuberosity fracture displacement ≥ 1 cm was 35.0% (AUC 0.57). The CNN did not recognize NSAs ≤ 100° (AUC 0.42), nor fractures with ≥ 75% shaft translation (AUC 0.51 to 0.53), or with ≥ 15% articular involvement (AUC 0.48 to 0.49). For all objectives, the model’s performance on the external dataset showed similar accuracy levels.

Conclusion

CNNs proficiently rule out proximal humerus fractures on plain radiographs. Despite rigorous training methodology based on CT imaging with multi-rater consensus to serve as the reference standard, artificial intelligence-driven classification is insufficient for clinical implementation. The CNN exhibited poor diagnostic ability to detect greater tuberosity displacement ≥ 1 cm and failed to identify NSAs ≤ 100°, shaft translations, or articular fractures.

Cite this article: Bone Joint J 2024;106-B(11):1348–1360.
Hemiarthroplasty in young patients
Authors: Mahmud Hazimah , Wang Dong , Topan-Rat Andra , Bull Anthony M. J. , Heinrichs Christian H. , Reilly Peter , Emery Roger , Amis Andrew A. , Hansen Ulrich N.
Published: November 2024

Aims

The survival of humeral hemiarthroplasties in patients with relatively intact glenoid cartilage could theoretically be extended by minimizing the associated postoperative glenoid erosion. Ceramic has gained attention as an alternative to metal as a material for hemiarthroplasties because of its superior tribological properties. The aim of this study was to assess the in vitro wear performance of ceramic and metal humeral hemiarthroplasties on natural glenoids.

Methods

Intact right cadaveric shoulders from donors aged between 50 and 65 years were assigned to a ceramic group (n = 8, four male cadavers) and a metal group (n = 9, four male cadavers). A dedicated shoulder wear simulator was used to simulate daily activity by replicating the relevant joint motion and loading profiles. During testing, the joint was kept lubricated with diluted calf serum at room temperature. Each test of wear was performed for 500,000 cycles at 1.2 Hz. At intervals of 125,000 cycles, micro-CT scans of each glenoid were taken to characterize and quantify glenoid wear by calculating the change in the thickness of its articular cartilage.

Results

At the completion of the wear test, the total thickness of the cartilage had significantly decreased in both the ceramic and metal groups, by 27% (p = 0.019) and 29% (p = 0.008), respectively. However, the differences between the two were not significant (p = 0.606) and the patterns of wear in the specimens were unpredictable. No significant correlation was found between cartilage wear and various factors, including age, sex, the size of the humeral head, joint mismatch, the thickness of the native cartilage, and the surface roughness (all p > 0.05).

Conclusion

Although ceramic has better tribological properties than metal, we did not find evidence that its use in hemiarthroplasty of the shoulder in patients with healthy cartilage is a better alternative than conventional metal humeral heads.

Cite this article: Bone Joint J 2024;106-B(11):1273–1283.
Understanding the role of machine learning in predicting progression of osteoarthritis
Authors: Castagno Simone , Gompels Benjamin , Strangmark Estelle , Robertson-Waters Eve , Birch Mark , van der Schaar Mihaela , McCaskie Andrew W.
Published: November 2024

Aims

Machine learning (ML), a branch of artificial intelligence that uses algorithms to learn from data and make predictions, offers a pathway towards more personalized and tailored surgical treatments. This approach is particularly relevant to prevalent joint diseases such as osteoarthritis (OA). In contrast to end-stage disease, where joint arthroplasty provides excellent results, early stages of OA currently lack effective therapies to halt or reverse progression. Accurate prediction of OA progression is crucial if timely interventions are to be developed, to enhance patient care and optimize the design of clinical trials.

Methods

A systematic review was conducted in accordance with PRISMA guidelines. We searched MEDLINE and Embase on 5 May 2024 for studies utilizing ML to predict OA progression. Titles and abstracts were independently screened, followed by full-text reviews for studies that met the eligibility criteria. Key information was extracted and synthesized for analysis, including types of data (such as clinical, radiological, or biochemical), definitions of OA progression, ML algorithms, validation methods, and outcome measures.

Results

Out of 1,160 studies initially identified, 39 were included. Most studies (85%) were published between 2020 and 2024, with 82% using publicly available datasets, primarily the Osteoarthritis Initiative. ML methods were predominantly supervised, with significant variability in the definitions of OA progression: most studies focused on structural changes (59%), while fewer addressed pain progression or both. Deep learning was used in 44% of studies, while automated ML was used in 5%. There was a lack of standardization in evaluation metrics and limited external validation. Interpretability was explored in 54% of studies, primarily using SHapley Additive exPlanations.

Conclusion

Our systematic review demonstrates the feasibility of ML models in predicting OA progression, but also uncovers critical limitations that currently restrict their clinical applicability. Future priorities should include diversifying data sources, standardizing outcome measures, enforcing rigorous validation, and integrating more sophisticated algorithms. This paradigm shift from predictive modelling to actionable clinical tools has the potential to transform patient care and disease management in orthopaedic practice.

Cite this article: Bone Joint J 2024;106-B(11):1216–1222.
Tempus fugit: tomorrow’s world is upon us
Authors: Mitchell Tim
Published: November 2024

Innovation is key to improving surgical standards.
Is the NHS broken? Darzi's diagnosis on NHS performance
Authors: Kane Nicola
Published: November 2024

Our Political Editor looks at the results from the Darzi report and what this means for the future of surgery.
Untoward incidents on the technological learning curve: different from those in conventional surgery?
Authors: Wheeler R
Published: November 2024

Do modern technological advancements in theatres affect how surgeons inform patients and seek consent?
A glossary for social-to-biological research
Authors: Robertson Tony , Benzeval Michaela , Betzer Martin , Booker Cara , Castagné Raphaële , Delpierre Cyrille , Gallagher Iain , Kelly-Irving Michelle , McCrory Cathal , Morris Tim , Narimatsu Ethan , Paval Robert
Published: November 2024

Research has shown that our socially structured experiences elicit a biological response, leading to the observation that numerous biomarkers (objective biological measures that are representative of various biological processes) are socially patterned. This ‘social-to-biological’ research is of interest to researchers across multiple disciplines and topics and especially to those with an interest in understanding the biological embodiment of the ‘social environment’. Combining social and biomarker data is also of relevance to those examining the biological determinants of social behaviours (for example, the relationship between genetics and certain behaviours like smoking). However, as much of the research involving biomarkers and social data are multidisciplinary, researchers need to understand why and how to optimally use and combine such data. This article provides a resource for researchers by introducing a range of commonly available biomarkers across studies and countries. Because of the breadth of possible analyses, we do not aim to provide an exhaustive and detailed review of each. Instead, we have structured the glossary to include: an easy-to-understand definition; a description of how it is measured; key considerations when using; and an example of its use in a relevant social-to-biological study. We have limited this glossary to biomarkers that are available in large health and social surveys or population-based cohort studies and focused on biomarkers in adults. We have structured the glossary around the main physiological systems studied in research on social to biological transition and those that go across systems and highlight some basic terms and key theoretical concepts.
Potential ethical frameworks to support professional social care employees who work alongside parents with a learning disability
Authors: Carey Malcolm , Constance Lyndsey
Published: November 2024

Questions continue to be asked about the ability of many parents with a learning disability (PWLD) to support their children. Relatedly, in countries including Australia, the US and the UK, significantly more children are removed from PWLD than children whose parents have no additional needs. This article draws from qualitative interviews with a sample of professional social care employees in the north-west of England to better understand their experiences of and responsibilities in work alongside PWLD. Findings include the exploration of understanding learning disabilities and offering appropriate support, completing assessments, receiving adequate training and support from supervisors, engagements with courts of law, and the removal of children. As a possible challenge to increasingly dominant biomedical and risk-averse discourses, the article also considers the feasibility and limitations of utilising rights-based and communitarian ethical frameworks for understanding the support needs of PWLD from a social work and social care practitioner perspective.
Phase demodulation method for stable long-haul frequency transmission based on the Michelson interferometer
Authors: Liu Qingwei , Gao Hao , Dong Jiameng , Wang Zhaohui , Yu Song , Luo Bin
Published: November 2024

In this Letter, we present a fiber-optic radio frequency (RF) transmission scheme based on phase modulation with an interferometric detection structure. A self-developed Michelson interferometer (MI) is used to demodulate the frequency signal via an electrically controlled optical shifter. The two complementary outputs from the interferometer are detected using a balanced detector, which suppresses the common-mode noise of the fiber link. The structure is tested in the laboratory using a frequency transfer system over a 560 km fiber link. Experimental results show that a stable 2.4 GHz frequency transmission with a fractional frequency instability of 3.9 × 10−14 at 1 s and 6.2 × 10−17 at 10,000 s is achieved. Compared with the frequency transmission system based on intensity modulation and direct detection, the frequency instability is improved from 7.3 × 10−14 to 3.9 × 10−14 at 1 s. We believe that the proposed method will be useful for the construction of time-frequency synchronous fiber networks.
Thermal properties of fluoride fiber Bragg gratings at high to cryogenic temperatures
Authors: Grebnev Kirill , Sultanov Aidar , Oelsner Gregor , Chiamenti Ismael , Chernysheva Maria
Published: November 2024

The thermal sensitivity of fiber Bragg gratings (FBGs) is extensively employed in diverse industrial and scientific applications. FBGs lie at the core of flexible, low-cost, and highly precise sensors, featuring stability in harsh environments and distributed sensing capability. This study assesses the thermal properties of FBGs in fluoride fibers within a temperature range of 4–373 K. Despite having higher thermal expansion coefficients, FBGs in the near-IR wavelength range do not exhibit high sensitivity at room or higher temperatures. However, the pronounced enhancement of their thermal sensitivity at longer Bragg wavelengths shows the potential for sensing applications in the light of the fluoride glass extended transmission range up to 4–5.5 µm. Most importantly, employing FBGs inscribed in fluoride fibers enables the further expansion of fiber-based sensors to cryogenic environments, as they exhibit a detectable sensitivity of 0.5–1.7 pm/K below 50 K. Overall, the exposure to low temperatures provides valuable information on glass stability and physical parameters, which is beneficial for the further development of photonic systems based on fluoride fibers.
Poor perceived oral health is associated with adverse mental health outcomes among Syrian refugees in Canada
Authors: Alghanem Jamil , Haque Salsabil , Ababneh Khansa , Fakhoury Hana M. A. , Zangiabadi Safoura , Tamim Hala
Published: November 2024

While inadequate oral health has been linked to adverse mental health outcomes, there is limited understanding of such implications among refugees who bear a disproportionate burden of oral health disparities. This study aims to examine the effect of self-rated oral health on depression, anxiety, and stress among Syrian refugee parents resettled in Ontario. In this cross-sectional study, a total of 540 Syrian refugee parents who resided in Ontario for an average of 4 years and had at least one child under 18 years old were interviewed between March 2021 and March 2022. Information about self-rated oral health was gathered based on the question “In general, how would you rate the health of your teeth and mouth”. Responses ranged from 1 representing “excellent” and 5 representing “very poor”. The mean score (SD) of self-rated oral health was 3.2 (1.2). Mental health outcomes of depression, anxiety, and stress were measured using the Depression Anxiety Stress Scales (DASS-21). Multiple linear regression analyses were performed to assess the independent relationship between self-rated oral health and depression, anxiety, and stress, adjusting for other variables including, sociodemographic-, migration-, and health-related factors. Among participants, 6.3% rated their oral health as excellent, 26.9% as good, 23.1% as fair, 24.8% as poor, and 18.7% as very poor. Results of the multiple linear regression analyses indicated that poorer self-rated oral health was significantly associated with higher levels of depression (Adjβ = 0.98; p = 0.002; 95% CI = 0.38–1.59), anxiety (Adjβ = 1.03; p< 0.001; 95% CI = 0.54–1.52), and stress (Adjβ = 1.25; p< 0.001; 95% CI = 0.61–1.88). Further efforts and targeted interventions are needed to address the unmet oral health needs of Syrian refugees to improve mental health outcomes within this vulnerable population.