bluuebunny/crossref_metadata_2025 huggingface dataset:
End‐ischemic hypothermic oxygenated machine perfusion does not improve renal outcome following liver transplantation from aged donors: A single‐center retrospective report
Authors: Norén Åsa , Mölne Johan , Bennet William , Sörensen Gustaf , Herlenius Gustaf , Lindnér Per , Oltean Mihai
Published: September 2023

Background

Organ transplantation using grafts from elderly donors entails a higher risk for severe ischemia‐reperfusion injury (IRI). Advanced IRI after liver transplantation (LT) seems to be associated with the development of acute kidney injury (AKI). We studied if end‐ischemic hypothermic oxygenated machine perfusion (HOPE) of liver grafts, aimed at mitigating liver IRI, impacts on the frequency and severity of AKI after LT.

Methods

LTs performed at our center between January 2017 and December 2022 using organs from deceased brain‐dead donors aged 70 or older were reviewed. From November 2020 on, HOPE was performed routinely in this donor category. The frequency and severity of AKI (KDIGO criteria) within 48 hours of graft reperfusion and the model of early allograft function (MEAF) were compared between HOPE‐LTs (n = 30) and control LTs (n = 71).

Results

AKI developed in 23/30 (77%) HOPE‐LTs and in 40/71 (56%) control LTs (p = n.s.), with no difference in severity and timing between groups. Renal replacement therapy was required in 3/30 (10%) HOPE‐LTs and 6/71 (8%) control LTs. In addition, transaminase leak during the first week (marker of IRI) and MEAF were similar between groups. These findings persisted after propensity matching. Histology showed more hepatocyte vacuolization and higher Suzuki score in HOPE‐LTs. Although this analysis could have been underpowered, no trends supporting the benefit of HOPE on liver and renal injury after LT were ever identified.

Conclusions

In conclusion, HOPE in this group of older donors does not seem to improve either graft IRI, or the incidence of early AKI after LT.
Pathogenesis of refractory ITP: Overview
Authors: Cines Douglas B.
Published: September 2023

A subset of individuals with ‘primary’ or ‘idiopathic’ immune thrombocytopenia (ITP) who fail to respond to conventional first‐ and second‐line agents or who lose responsiveness are considered to have ‘refractory’ disease (rITP), placing them at increased risk of bleeding and complications of intensive treatment. However, the criteria used to define the refractory state vary among studies, which complicates research and clinical investigation. Moreover, it is unclear whether rITP is simply ‘more severe’ ITP, or if there are specific pathogenic pathways that are more likely to result in refractory disease, and whether the presence or development of rITP can be established or anticipated based on these differences. This paper reviews potential biological features that may be associated with rITP, including genetic and epigenetic risk factors, dysregulation of T cells and cytokine networks, antibody affinity and specificity, activation of complement, impaired platelet production and alterations in platelet viability and clearance. These findings indicate the need for longitudinal studies using novel clinically available methodologies to identify and monitor pathogenic T cells, platelet antibodies and other clues to the development of refractory disease.
Dose selection for biological enzyme replacement therapy indicated for inborn errors of metabolism
Authors: Hon Yuen Yi , Wang Jie , Abodakpi Henrietta , Balakrishnan Anand , Pacanowski Michael , Chakder Sushanta , Smpokou Patroula , Donohue Kathleen , Wang Yow‐Ming C.
Published: September 2023

This paper summarizes key features of the dose‐finding strategies used in the development of 11 approved new molecular entities that are first‐in‐class enzyme replacement therapy (ERT), with a goal to gain insight into the dose exploration approaches to inform efficient dose‐finding in future development of biological products for Inborn Errors of Metabolism (IEM). Dose exploration should preferably begin in in vitro studies, followed by testing multiple doses in an appropriate animal disease model, when available, which can provide important information for dose assessment in humans. Performing adequate dose‐finding in early phase clinical studies in a well‐defined study population, including pediatric subjects, is generally critical to inform dose selection for pivotal trials; alternatively, additional dose exploration can be incorporated as part of a pivotal trial. Two important considerations for successful dose selection include (1) identifying appropriate disease‐specific endpoints, including pharmacodynamic (PD) end points and intermediate clinical end points or clinical end points, and (2) designing a study with adequate treatment durations for evaluating these end points. Appropriately selected PD biomarkers is useful for dose selection, and early development of these biomarkers can facilitate the overall clinical development program. Optimization of ERT doses, as well as evaluations of patient intrinsic factors and/or immune tolerance strategies may be necessary to overcome antibody responses or increase efficacy in IEM.
The Myth of Counter‐modern Ontologies: Indigenous People and the Modern Politics of Extractivism in Ecuador
Authors: Tym Christian
Published: September 2023

Anti‐extractivist critique still positions Indigenous people as protagonists of counter‐modern political sentiment, whether as opponents of modernity's processes of productive rationalization and economic integration, or as embodying ontologies that reject modernity's conceptual separation of humanity from natural resources. Indigenous anti‐extractivism is thus said to represent a rupture of modern politics in that it exceeds politics as we know it. Yet the calculus of modern politics remains central to Indigenous responses to resource extraction, even in social contexts where non‐modern ontological suppositions are widely adhered to. This is illustrated through an ethnography of Indigenous mining in the southern Ecuadorean Amazon and national‐level electoral data showing the sweeping support of Indigenous people for former leftist President Rafael Correa's ‘neo‐extractivist’ programme. This persistent modernity of Indigenous resource politics exposes the fallacy of projecting counter‐modern sentiments onto Indigenous peoples.
Equality of competition: A consistent approach to equality of opportunity in sport
Authors: Doomen Jasper
Published: September 2023

Accepting the principles of equal treatment and equality of opportunity as standards means that individuals should have the same chances and receive the same rewards. If there is no reason to maintain that these principles should not be decisive in the domain of sport, the consequences of accepting them must be accepted. Equality of opportunity, in particular, which may with respect to sport be termed ‘equality of competition’, raises some issues that are examined.
The regulation of liquid‐liquid phase separated condensates containing nucleic acids
Authors: Dai Zhuojun , Yang Xiaorong
Published: September 2023

Liquid–liquid phase separation (LLPS) has been recognized as a universal biological phenomenon. It plays an important role in life activities. LLPS is induced by weak interactions between intrinsically disordered regions or low complex domains. Nucleic acids are widely present in cells, and shown to be closely related to LLPS. Their structure and electronegativity provide the excellent platforms for the formation of phase‐separated condensates. In this review, we summarize the interconnected regulation between nucleic acids and LLPS demonstrated in in vivo and in vitro studies. Beside homogeneous and single‐phase condensates, complicated and multicompartment LLPS induced by nucleic acids is discussed as well. Recent advances about nucleic‐acid‐induced LLPS as a new pathogenic mechanism and drug design direction are highlighted, especially virus‐mediated disease treatment and prevention.
Functional and structural properties of pyridoxal reductase (PdxI) from Escherichia coli: a pivotal enzyme in the vitamin B6 salvage pathway
Authors: Tramonti Angela , Donkor Akua K. , Parroni Alessia , Musayev Faik N. , Barile Anna , Ghatge Mohini S. , Graziani Claudio , Alkhairi Mona , AlAwadh Mohammed , di Salvo Martino Luigi , Safo Martin K. , Contestabile Roberto
Published: September 2023

Pyridoxine 4‐dehydrogenase (PdxI), a NADPH‐dependent pyridoxal reductase, is one of the key players in the Escherichia coli pyridoxal 5′‐phosphate (PLP) salvage pathway. This enzyme, which catalyses the reduction of pyridoxal into pyridoxine, causes pyridoxal to be converted into PLP via the formation of pyridoxine and pyridoxine phosphate. The structural and functional properties of PdxI were hitherto unknown, preventing a rational explanation of how and why this longer, detoured pathway occurs, given that, in E. coli, two pyridoxal kinases (PdxK and PdxY) exist that could convert pyridoxal directly into PLP. Here, we report a detailed characterisation of E. coli PdxI that explains this behaviour. The enzyme efficiently catalyses the reversible transformation of pyridoxal into pyridoxine, although the reduction direction is thermodynamically strongly favoured, following a compulsory‐order ternary‐complex mechanism. In vitro, the enzyme is also able to catalyse PLP reduction and use NADH as an electron donor, although with lower efficiency. As with all members of the aldo‐keto reductase (AKR) superfamily, the enzyme has a TIM barrel fold; however, it shows some specific features, the most important of which is the presence of an Arg residue that replaces the catalytic tetrad His residue that is present in all AKRs and appears to be involved in substrate specificity. The above results, in conjunction with kinetic and static measurements of vitamins B6 in cell extracts of E. coli wild‐type and knockout strains, shed light on the role of PdxI and both kinases in determining the pathway followed by pyridoxal in its conversion to PLP, which has a precise regulatory function.
Mobilization under anaesthesia for correction of knee flexion deformity in haemophilia
Authors: Thakkar Prince , John Judy Ann , Thomas Raji , Tilak Merlyn , Kandagaddala Madhavi , Poonnoose Pradeep , Fouzia Nambiathayil Abubacker , Abrahm Aby , Srivastava Alok
Published: September 2023

Introduction

Haemophilia patients not treated with primary or secondary prophylaxis, often present with recurrent haemarthrosis. Knee is the most frequently involved joint leading to disabling knee flexion deformity (KFD). Here, we present a retrospective study of our experience on the role of mobilization under general anaesthesia in the correction of KFD.

Aim

To study the effectiveness of mobilization under anaesthesia (MUA) for correction of knee flexion deformity (KFD) in persons with haemophilia (PWH).

Methods

Outcome of all patients managed with MUA in our multidisciplinary haemophilia clinic from 2008 to 2019 were included for analysis. PWH with KFD > 20 degree who underwent MUA were included in the study. Under general anaesthesia and cover of clotting factor replacement, gentle joint mobilization was done to achieve maximal correction in flexion deformity, followed by above knee casting in this position. The outcome measures assessed were reduction in knee flexion deformity following MUA and complications, if any.

Results

Thirty patients (34 knees) with knee flexion deformity were included in the study. Mean age of the study population was 14.23 years ± 8.3. Study population was analysed in two groups, Group 1 included patients who underwent single MUA and Group 2, patients who underwent two or more MUA. There was significant improvement in KFD correction in both groups. [Group 1; Mean difference: 22 ± 13.7, p value ‐0.01, 95% CI (16.4–27.5) and Group 2; Mean difference 48.8 ± 19.8, p value ‐0.00, 95% CI (34.2–64.5)].

Conclusion

MUA can be effective in the short‐term correction of KFD in PWH particularly those below 15 years of age. It should be done judiciously when target correction is not achieved with other physical methods.
Simulation of methane hydrate formation in coarse‐ to fine‐grained sediments in the Nankai Trough, Japan
Authors: Xu Chao , Tomaru Hitoshi
Published: September 2023

The properties of host sediments and pore water considerably affect both the occurrence and formation processes of methane hydrate. In coarse‐grained layers, hydrates are generally concentrated preferentially in the pore space, and their formation is influenced by pore water salinity. To understand how geophysical and geochemical factors control the distribution of methane hydrates, we conducted numerical simulations using a one‐dimensional flow model under different reservoir and fluid conditions in the Kumano Forearc Basin, Nankai Trough, Japan. Assuming an estimated range of methane flux between 0.002 and 1.9 kg m−2 year−1, three flow scenarios were considered. When the methane flux was relatively small, the results coincided with the observed hydrate distribution. In general, a low‐methane flux decreases the hydrate saturation upward from the bottom of the methane hydrate stability, whereas a high‐methane flux increases the saturation downward. These results also suggest that the sediment structure, such as the fracture distribution, influences the sediment stress conditions and constrains the flow regime. We further examined the effects of permeability changes in the heterogeneous lithological units on the simulation results using typical permeabilities of 10−13 m2 for sand and 10−15 m2 for mud. The results showed that hydrate saturation sharply increased and decreased in adjacent high‐ and low‐permeability units, respectively. The consideration of complex stratigraphic conditions and variable fluid configurations provides an understanding of the environmental factors controlling hydrate generation and distribution, which is important for hydrate resource extraction and geohazard prevention.
Real‐time audit of public agencies: Utility, controversy and lessons for an emerging practice
Authors: Rabin Yoram , Peled Roy
Published: September 2023

Real‐time audit is the auditing of actions as they occur and the publishing of findings before the audited action was completed. It is an emerging practice of Supreme Audit Institutions (SAIs) in many countries, and it marks a stark departure from the traditional ‘after‐the‐fact’ auditing practice. Real‐time audits have been widely used in the auditing of COVID‐19 relief programmes in many countries. Whereas in the United States and many other countries, this practice became popular only in recent years, Israel's SAI in Israel has been conducting real‐time audits since the 1970s. The article surveys SAI practices in various countries regarding the timeliness of the auditing of public agencies and presents the pros and cons of real‐time audits based on an analysis of the Israeli experience. We conclude by outlining several issues that SAIs should consider before choosing to conduct a real‐time audit.
A digital cohort analysis of consumers' mobile banking app experience
Authors: Sharma Neeru
Published: September 2023

The literature on mobile banking has extensively explored various mechanisms underlying service acceptance and continuation. However, there is a lack of research on how the service experience and outcomes differ between digital natives (users born after the digital age) and digital immigrants (users born before the digital age). This study aims to fill this gap by investigating how mobile banking application experience, satisfaction and continued use intention interrelationships differ between digital natives and digital immigrants. The study posits that four components of mobile banking application experience (pragmatic, ease of use, emotional and sensorial) drive continued use intention directly and indirectly through satisfaction. The hypothesized relationships are analysed using a sample of 215 digital natives and 203 digital immigrants and employing the multi‐group analysis in the partial least squares structural equation modelling technique. The study finds that while pragmatic, ease of use and emotional experiences significantly predict satisfaction and continued use, the pattern of associations varies across the digital cohorts. Sensorial experience was consistently found to be insignificant. Satisfaction mediated between the experience dimensions and continued use. The findings suggest that bank managers should recognize the relevant experiences to achieve the satisfaction and continued use of the digital cohorts.
What specific investments are critical in fostering buyer‐supplier relationships: Evidence from MSMEs in emerging economies
Authors: Sanyal Priyavrat , Jain Nikunj Kumar , Choudhury Dibyendu
Published: September 2023

MSMEs (Micro, Small and Medium enterprises) play a vital role in the development of emerging economies, and their interactions with state‐owned enterprises can generate significant economic value for both parties. However, the dependency asymmetry between MSMEs and state‐owned enterprises can hinder their growth and overall relationship performance. This research explores the impact of various dimensions of relationship‐specific investments (RSIs) on fostering trust and satisfaction in these relationships. Additionally, the study investigates the moderating role of bilateral communication in the relationship between RSIs and satisfaction through trust. The conceptual model was assessed using a sample of 157 MSMEs, employing partial least squares structural equation modelling and necessary conditions analysis. The findings suggest that communication is crucial in building trust and satisfaction within these relationships. The literature has not extensively explored the context of these relationships and the application of necessary condition analysis, making this study valuable for policymakers. By understanding the factors that contribute to successful relationships between MSMEs and state‐owned enterprises, policymakers can create targeted strategies to support and enhance these interactions, ultimately fostering the growth and development of emerging economies.
Enhanced piezoelectric and optical properties of tetragonal Sm‐doped Pb(In1/2Nb1/2)–Pb(Mg1/3Nb2/3)–PbTiO3 crystals
Authors: Zhou Kai , He Chongjun , Wen Yiyang , Xu Guisheng , Deng Chenguang , He Yiyang , Lu Yuangang , Li Qian
Published: September 2023

Relaxor ferroelectric single crystal Pb(In1/2Nb1/2)O3–Pb(Mg1/3Nb2/3)O3–PbTiO3 (PIN–PMN–PT) has received extensive research and attention due to its excellent piezoelectric, electromechanical, and other properties. In particular, tetragonal relaxor ferroelectric single crystals have shown greater application potential in high‐temperature devices due to their higher Curie temperature and better stability. However, the low piezoelectric performance of tetragonal crystals also greatly limits its application, and research on its optical properties is not sufficient. In this paper, the tetragonal phase Sm–PIN–PMN–PT single crystal was obtained by the Bridgman method, and its piezoelectric and electro‐optical properties are studied. At the same time, we gave a complete set of piezoelectric, dielectric, and elastic coefficient matrices. The results show that the crystal has excellent piezoelectric and electromechanical properties. The piezoelectric coefficient can reach 905pC/N, the electromechanical coupling coefficient k33 is 85%, and the kt is 72%. The transmittance of the sample polarized along [001] direction can reach 66%. The effective electro‐optical coefficient γc is 60 pm/V at room temperature and can reach 86 pm/V at 70°C. It has a wide operating temperature range and stable performance with frequency variation, which has certain reference significance for application in new electro‐optical devices.
Antidromic and orthodromic reciprocating tachycardias over a novel left‐sided accessory pathway involving the vein of Marshall and coronary sinus musculature
Authors: Kanzaki Yasunori , Morishima Itsuro , Miyazawa Hiroyuki , Shimojo Kazuki
Published: September 2023

Introduction

Herein, we present a rare case of the successful ablation of an accessory pathway (AP) involving the Marshall Bundle (MB) and coronary sinus musculature (CSM) in a 40‐year‐old man with Wolff−Parkinson−White syndrome.

Methods and Results

An orthodromic reciprocating tachycardia (ORT) was inducible with the earliest atrial activation site located at the posterolateral mitral annulus. The local conduction and the cycle length of ORT was prolonged by peri‐mitral ablation; however, it failed to block the AP. The atrial insertion of the AP was identified by remapping during ORT at the left atrial ridge, which was away from the mitral annulus, where ablation was successful. Together with the electrophysiological findings in CSM potentials, we conclude that the epicardial MB‐CSM connection functioned as the AP in this patient.

Conclusion

The novel variant form of AP comprised of MB and CSM should be noted. The atrial insertion of the MB may be the target of catheter ablation.
Visceral adipose tissue increases the risk of periodontal disease: Results from the 2011–2014 National Health and Nutrition Examination Survey and Mendelian randomization analysis
Authors: Qu Xiaoying , Wang Xiaolin , Shen Danfeng
Published: September 2023

Aim

This study aimed to investigate the relationship and potential causal effect of visceral adipose tissue (VAT) on periodontal disease (PD). Despite prior research on this, there has been no definitive conclusion. Therefore, this study aimed to provide additional insight into these associations.

Materials and Methods

This study used data from the National Health and Nutrition Examination Survey 2011–2014 to examine the association between VAT and PD in a cross‐sectional study design. Various analytical methods were employed, such as multivariable logistic regression, restricted cubic spline analysis, and p‐value for trend. Additionally, two‐sample Mendelian randomization (MR) analysis was performed to evaluate the potential causal effect of VAT on PD risk. These methods enabled us to evaluate the association between VAT and PD and to establish whether VAT could be a causal factor in PD development.

Results

The study examined a sample of 3535 participants, and the findings suggested that higher VAT levels were associated with an increased risk of PD. In addition, multivariable regression analysis conducted in six models revealed a statistically significant association between VAT and PD risk. Restricted cubic spline analysis showed an inverted U‐shaped association between VAT and PD, with a turning point at 733 g of VAT. Finally, a two‐sample MR analysis provided evidence for a potential causal relationship between VAT and PD risk, with an odds ratio of 1.16 (95% confidence interval: 1.02–1.33, p = .027) per kg increase in genetically predicted VAT.

Conclusions

The results of this study suggest that there is a significant association between VAT and PD and that VAT could be a potential causal factor in PD risk. Our results also suggest that although there is a potential link between VAT levels and PD risk, the effect size is modest. Therefore, interventions designed to reduce VAT levels should not be considered a primary strategy for PD risk reduction but could be one of many strategies used in a comprehensive approach to PD risk management.
Computational fluid dynamics analysis of the effects of total weight and food on the water temperature distribution and flow in a pot during cooking
Authors: Arata Risa , Nagata Yusaku , Sato Yoko
Published: September 2023

Uniform quality of cooked foods regardless of its position in the pot is desirable. However, there are no research about the effect of cooking scale on the flow and water temperature distribution. This study investigated the effects of the weight and the presence of food on the water temperature distribution and flow during cooking. Using nylon cylinders with thermophysical properties similar to those of root vegetables, the water temperature near the inner surface of the pot was measured. The water temperature and flow were simulated with 2D models based on the finite element method. The water temperature was highly uniform at a total weight of 20 kg than at 3 kg due to the greater convection and faster flow velocity. The water flow velocity was lower with nylon cylinders than in its absence and decreases with decreasing sample size. This study demonstrates the usefulness of combining simulations with nylon cylinders.

Practical applications

The evaluation of temperature distribution and water flow during cooking is important for ensuring uniform quality of products in a pot. Particularly, it is important to evaluate the effect of cooking scale, presence of food and ingredient size. However, the experimental verification of large‐scale cooking is costly and time‐consuming. This study shows the usefulness of combining computational fluid dynamics (CFD) simulation with the nylon cylinders having thermophysical properties similar to those of root vegetables as food analogs. The CFD analysis revealed that increasing cooking scale increases the water flow velocity and uniformity of water temperature. This result should be considered in the actual large‐scale cooking of prototypes, which are tested at small scale, for example, in laboratories. Furthermore, small‐sized foods hinder the flow and cause uneven water temperature distribution. The findings suggest that sample size affects the temperature and uniformity in quality of cooked products in a pot.
Identification of natural allelic variation in TTL1 controlling thermotolerance and grain size by a rice super pan‐genome
Authors: Lin Yarong , Zhu Yiwang , Cui Yuchao , Qian Hongge , Yuan Qiaoling , Chen Rui , Lin Yan , Chen Jianmin , Zhou Xishi , Shi Chuanlin , He Huiying , Hu Taijiao , Gu Chenbo , Yu Xiaoman , Zhu Xiying , Wang Yuexing , Qian Qian , Zhang Cuijun , Wang Feng , Shang Lianguang
Published: September 2023

Continuously increasing global temperatures present great challenges to food security. Grain size, one of the critical components determining grain yield in rice (Oryza sativa L.), is a prime target for genetic breeding. Thus, there is an immediate need for genetic improvement in rice to maintain grain yield under heat stress. However, quantitative trait loci (QTLs) endowing heat stress tolerance and grain size in rice are extremely rare. Here, we identified a novel negative regulator with pleiotropic effects, Thermo‐Tolerance and grain Length 1 (TTL1), from the super pan‐genomic and transcriptomic data. Loss‐of‐function mutations in TTL1 enhanced heat tolerance, and caused an increase in grain size by coordinating cell expansion and proliferation. TTL1 was shown to function as a transcriptional regulator and localized to the nucleus and cell membrane. Furthermore, haplotype analysis showed that hapL and hapS of TTL1 were obviously correlated with variations of thermotolerance and grain size in a core collection of cultivars. Genome evolution analysis of available rice germplasms suggested that TTL1 was selected during domestication of the indica and japonica rice subspecies, but still had much breeding potential for increasing grain length and thermotolerance. These findings provide insights into TTL1 as a novel potential target for the development of high‐yield and thermotolerant rice varieties.
An audit of post‐operative complications following oral surgery procedures over a 3‐month period at the Eastman dental hospital, London
Authors: Tayara Samira , Gunaseelan Amy , Devine Maria , Koshal Sonita
Published: September 2023

Objective

The objective of this paper was to evaluate the rate of post‐operative complications following Oral Surgery procedures at the Eastman Dental Hospital. Dento‐alveolar surgery procedures can lead to complications including pain, swelling, bleeding, infection and numbness amongst others. Although many are considered minor and resolve swiftly, it is important as clinicians to have an understanding of the incidence of complications prior to undertaking surgical treatment to allow evaluation of the risks and benefits.

Materials and Methods

Electronic patient records were reviewed across a 3‐month period from February to April 2022 for every patient receiving treatment under local or general anaesthetic and intravenous sedation. Patients returning for an unplanned appointment with a problem related to their treatment was classified as a “post‐operative complication”. Information was recorded regarding patient demographics, treatment type and modality, complications, management and outcome. Results were analysed using Microsoft Excel.

Results

Nine hundred and ninety four patients received treatment in total. The overall complication rate was 6.33%. The treatment modality with the highest incidence of complications was general anaesthetic. Third molar extractions resulted in the highest proportion of complications out of the procedures considered. The complication with the highest incidence was post‐operative pain and swelling (2%), followed by dry socket (1.5%) and post‐operative infection (1.4%).

Conclusion

Post‐operative complications can occur following a range of procedures and can lead to significant morbidity. Clinicians should consider the likelihood of complications occurring when planning treatment as well as early recognition. Future auditing could consider medical co‐morbidities of patients and potential influences of this on developing complications.
Spine Surgery with Electronic Conductivity Device: A Prospectively Multicenter Randomized Clinical Trial and Literature Review
Authors: Zhai Xiao , Li Bo , Chen Kai , Chen Ziqiang , Shao Jie , Chen Kai , Xu Qintong , Meng Dehua , Fei Qinming , Jiang Leisheng , Bai Yushu , Li Ming
Published: September 2023

Objective

Improving accuracy and safety of pedicle screw placement is of great clinical importance. Electronic conductivity device (ECD) can be a promising technique with features of affordability, portability, and real‐time detection capabilities. This study aimed to validate the safety and effectiveness of a modified ECD.

Methods

The ECD underwent a modification where six lamps of various colors, and it was utilized in a prospectively multicenter randomized controlled clinical trial involving 96 patients across three hospitals from June 2018 to December 2018. The trial incorporated a self‐control randomization with an equal distribution of left or right side of vertebral pedicle among two groups: the free‐hand group and the ECD group. A total of 496 pedicle screws were inserted, with 248 inserted in each group. The primary outcomes focused on the accuracy of pedicle screw placement and the frequency of intraoperative X‐rays. Meanwhile, the secondary indicator measured the time required for pedicle screw placement. Results were presented as means ± SD. Paired samples t‐test and χ2‐test were used for comparison. Furthermore, an updated review was conducted, which included studies published from 2006 onwards.

Results

Baseline patient characteristics were recorded. The primary accuracy outcome revealed a 96.77% accuracy rate in the ECD group, compared to a 95.16% accuracy rate in the free‐hand group, with no significant differences noted. In contrast, ECD demonstrated a significant reduction in radiation exposure frequency when compared to the free‐hand group (1.11 ± 0.32 vs. 1.30 ± 0.53; p < 0.001), resulting in a 14.6% reduction. Moreover, ECD displayed a decrease of 30.38% in insertion time (70.88 ± 30.51 vs. 101.82 ± 54.00 s; p < 0.001). According to the results of the 21 studies, ECD has been utilized in various areas of the spine such as the atlas, thoracic and lumbar spine, as well as sacral 2‐alar‐iliac. The accuracy of ECD ranged from 85% to 100%.

Conclusion

The prospectively randomized trial and the review indicate that the use of ECD presents a secure and precise approach to the placement of pedicle screws, with the added benefit of reducing both procedure time and radiation exposure.
Identification of atrial fibrillation phenotypes at low risk of stroke in patients with CHA2DS2‐VASc ≥2: Insight from the China‐AF study
Authors: Jiang Chao , Li Mingxiao , Hu Yiying , Du Xin , Li Xiang , He Liu , Lai Yiwei , Chen Tiange , Li Yingxue , Guo Xueyuan , Jiang Chenxi , Tang Ribo , Sang Caihua , Long Deyong , Xie Guotong , Dong Jianzeng , Ma Changsheng
Published: September 2023

Objective

Patients with atrial fibrillation (AF) are highly heterogeneous, and current risk stratification scores are only modestly good at predicting an individual's stroke risk. We aim to identify distinct AF clinical phenotypes with cluster analysis to optimize stroke prevention practices.

Methods

From the prospective Chinese Atrial Fibrillation Registry cohort study, we included 4337 AF patients with CHA2DS2‐VASc≥2 for males and 3 for females who were not treated with oral anticoagulation. We randomly split the patients into derivation and validation sets by a ratio of 7:3. In the derivation set, we used outcome‐driven patient clustering with metric learning to group patients into clusters with different risk levels of ischemic stroke and systemic embolism, and identify clusters of patients with low risks. Then we tested the results in the validation set, using the clustering rules generated from the derivation set. Finally, the survival decision tree was applied as a sensitivity analysis to confirm the results.

Results

Up to the follow‐up of 1 year, 140 thromboembolic events (ischemic stroke or systemic embolism) occurred. After supervised metric learning from six variables involved in CHA2DS2‐VASc scheme, we identified a cluster of patients (255/3035, 8.4%) at an annual thromboembolism risk of 0.8% in the derivation set. None of the patients in the low‐risk cluster had prior thromboembolism, heart failure, diabetes, or age older than 70 years. After applying the regularities from metric learning on the validation set, we also identified a cluster of patients (137/1302, 10.5%) with an incident thromboembolism rate of 0.7%. Sensitivity analysis based on the survival decision tree approach selected a subgroup of patients with the same phenotypes as the metric‐learning algorithm.

Conclusions

Cluster analysis identified a distinct clinical phenotype at low risk of stroke among high‐risk [CHA2DS2‐VASc≥2 (3 for females)] patients with AF. The use of the novel analytic approach has the potential to prevent a subset of AF patients from unnecessary anticoagulation and avoid the associated risk of major bleeding.
Dental extractions do not predict further use of dental general anesthesia in people with disabilities: A longitudinal analysis
Authors: McGeown Danielle , Mac Giolla Phadraig Caoimhin , Van Harten Maria , Stapleton Siobhan , Nunn June
Published: September 2023

Objectives

This paper describes treatments completed under dental general anesthesia (DGA) for a cohort of adults with disabilities. This patient cohort was followed up a number of years later to determine outcomes and identify factors that predict further use of DGA.

Methods

A retrospective patient record review and cross‐sectional survey was carried out on a convenience sample of 64 patients who had previously received dental treatment under general anesthesia. Patient record review extracted data on patient demographics and treatment provided under DGA. Cross‐sectional survey a number of years post‐DGA collected data on oral care habits and current oral health based on a standardized clinical examination. Statistical analysis was carried out to identify predictors of repeat DGA.

Results

Participants received extensive treatment under DGA including preventive care, restorations, extractions, and root canal treatment. At follow‐up 89.1% of participants had gingival disease and 56.3% had active dental caries. The mean number of teeth present was 21.2 (SD 6.9, range 6–32). Only caries risk status was found to be a significant predictor (p = 0.03) with those with a high caries risk status 6.9 times (95%CI 1.2–39.3) more likely to receive a second DGA.

Conclusions

Dentists extract teeth for people with disabilities under DGA in the mistaken belief that this will avoid the need for further DGA. This study found that extraction of teeth does not prevent the need for repeated episodes of DGA. Therefore, dentists should stop extracting teeth for this reason. Rather, if dentists want to avoid further DGA, they should do the basics well: consistent, evidence‐based caries risk assessment and risk reduction.
Comparison of young and old patients on peritoneal dialysis: A retrospective observational study
Authors: Çankaya Erdem , Altunok Murat
Published: September 2023

Background

With a global increase in life expectancy around the world, the burden of chronic kidney disease in the elderly is increasing. The number of elderly patients undergoing peritoneal dialysis (PD) is also increasing. There is still a perception that PD may be associated with an increased risk of complications in these elderly patients.

Methods

A total of 311 patients, of which 103 PD patients aged 65 and over and 208 PD patients under 65 years of age, were followed in a single center and evaluated, retrospectively. Demographic data of these patients, albumin values at first PD and during PD time, residual urine amount, number of peritonitis, time to the first peritonitis attack, PD endpoints, and mortality were compared.

Results

Peritonitis and technique failure rates were lower in patients aged 65 and over who applied PD (0.61–0.75, 6.8%–23.1%, respectively). There was no difference in peritonitis‐free survival (p = 0.931). Need for help HR 2.569 [95%CI 1.564–4.219] (p < 0.05), time to first peritonitis attack HR 0.983 [95%CI 0.974–0.992] (p < 0.05), mean albumin value HR 0.191 [95%CI 0.088–0.413] (p < 0.05), urine output level HR 1.154 [95%CI 1.010–1.318] (p < 0.05) were factors affecting mortality.

Conclusion

Peritonitis and technical survival evaluations of elderly PD patients, other than mortality, were lower than younger PD patients. However, the need for help is one of the biggest obstacles to this method for the elderly. We believe that incentives in this regard will increase the number of elderly PD patients.
Global practitioner assessment and management of mental fatigue and mental recovery in high‐performance sport: A need for evidence‐based best‐practice guidelines
Authors: Russell S. , Johnston R. D. , Stanimirovic R. , Halson S. L.
Published: September 2023

Background

Mental fatigue and mental recovery have gained scientific attention in relation to sporting performance, yet best practice assessment and management methods are lacking. A greater understanding of current knowledge and practices in high‐performance sport are necessary.

Objective

To understand the contemporary knowledge, beliefs, monitoring processes, management strategies, perceived responsibility, sources of evidence, and challenges, when assessing the mental fatigue and mental recovery of athletes in high‐performance sport.

Methods

A mixed‐methods survey approach obtained information from 156 multi‐disciplinary high‐performance sport practitioners. Descriptive outputs were reported and potential differences between key concepts were detected using Wilcoxon‐signed rank analysis. Thematic analysis interpreted open‐text responses.

Results

Only 11.5% and 5.1% of respondents indicated they were “very” knowledgeable about mental fatigue and mental recovery, respectively. Knowledge (p < 0.001) and confidence in application (p = 0.001) were significantly greater for mental fatigue than mental recovery. Nearly all respondents perceived mental fatigue and mental recovery impacted training and competition performance, with a greater negative impact during competition (p < 0.001). A limited number of respondents reported deliberate assessment (31.1%) or management (51.2%) of mental fatigue and mental recovery. A combination of sources of evidence were used to inform practice, with common challenges to implementation including staff knowledge, athlete‐buy in, time‐availability, and a lack of evidence. Practitioners reported that assessing and managing mental fatigue and mental recovery was multi‐disciplinary in nature.

Conclusion

Practitioners reported that mental fatigue and mental recovery did impact performance, yet this was not reflected in the implementation of evidence‐based assessment and management practices in high‐performance sport.
Identification of genomic alterations with clinical impact in canine splenic hemangiosarcoma
Authors: Estabrooks Timothy , Gurinovich Anastasia , Pietruska Jodie , Lewis Benjamin , Harvey Garrett , Post Gerald , Lambert Lindsay , Miller Aubrey , Rodrigues Lucas , White Michelle E. , Lopes Christina , London Cheryl A. , Megquier Kate
Published: September 2023

Canine hemangiosarcoma (HSA) is an aggressive cancer of endothelial cells with short survival times. Understanding the genomic landscape of HSA may aid in developing therapeutic strategies for dogs and may also inform therapies for the rare and aggressive human cancer angiosarcoma. The objectives of this study were to build a framework for leveraging real‐world genomic and clinical data that could provide the foundation for precision medicine in veterinary oncology, and to determine the relationships between genomic and clinical features in canine splenic HSA. One hundred and nine dogs with primary splenic HSA treated by splenectomy that had tumour sequencing via the FidoCure® Precision Medicine Platform targeted sequencing panel were enrolled. Patient signalment, weight, metastasis at diagnosis and overall survival time were retrospectively evaluated. The incidence of genomic alterations in individual genes and their relationship to patient variables including outcome were assessed. Somatic mutations in TP53 (n = 44), NRAS (n = 20) and PIK3CA (n = 19) were most common. Survival was associated with presence of metastases at diagnosis and germline variants in SETD2 and NOTCH1. Age at diagnosis was associated with somatic NRAS mutations and breed. TP53 and PIK3CA somatic mutations were found in larger dogs, while germline SETD2 variants were found in smaller dogs. We identified both somatic mutations and germline variants associated with clinical variables including age, breed and overall survival. These genetic changes may be useful prognostic factors and provide insight into the genomic landscape of hemangiosarcoma.
Modeling and Analysis of the Bending Moment in a Subsea Shuttle Tanker Under the Effect of Waves Using a Multi-Body Approach
Authors: Patel Karan Sandipkumar , Ma Yucong , Xing Yihan , Li Lin
Published: September 2023

The Subsea Shuttle Tanker (SST) is a cost-effective, novel sizeable autonomous vehicle designed to transport liquid CO2 between land facilities and smaller marginal fields. The SST travels underwater at a nominal diving depth of 70 m, allowing it to carry out freight operations in all weather conditions. Accurate structural assessment of large submarines is an essential part of structural reliability. In many practical cases, finite element methods (FEM) are used to predict the structural performance of the hull, but they come with significant computational expenses and time. This paper aims to present a reliable and efficient multi-body approach based on the discrete-module-beam bending-based hydroelectricity method to study the hydro-elastic behavior of SST hull at 40 and 70 m water depth. First, the continuous hull of the SST is discretized into several multi-body rigid modules. Then, a planar multi-body seakeeping model is presented to study the bending moment response of an interconnected multi-body rigid module under wave loads. The bending moment results are first measured using simplified multi-body geometry to ensure the use of the optimal number of model fidelity. The bending moment time series and power spectral density (PSD) have been analyzed in this paper. Numerical results also show that the mean bending moment at 40 m water depth is approximately 3 to 40 % greater than at 70 m water depth.
Analytical Model of Non-Linear Load Reduction Devices for Catenary Moorings
Authors: Festa Oscar , Gourvenec Susan , Sobey Adam
Published: September 2023

Load reduction devices are extensible components installed along mooring lines to provide peak and mean mooring load reduction, and are of articular interest for floating offshore wind. Various concepts exist, including ballasted pendulums, thermoplastic springs and hydraulic dampers, all of which provide compliance to environmental loads. This enables lighter mooring lines, smaller anchors and increased fatigue life of mooring lines — contributing to higher reliability and lower cost. Load reduction devices are designed to exhibit a non-linear load-extension behaviour: lower stiffness in the operational strain range to reduce loads, and higher stiffness at high strain. These devices are becoming an increasingly common consideration for FOWTs, and are pushing traditional analysis/design to readily incorporate nonlinearity. Well-established static catenary equations, used to define mooring tension-offset profiles, only account for linear elasticity such that capturing non-linear response typically requires finite element modelling. This paper presents an alternative through parameterising equations for three different non-linear load-extension curves and incorporating them into the existing catenary equations. For a given non-linear load-extension curve and length of load reduction device, the resulting analytical model can be solved quasi-instantaneously using Newton-Raphson or Newton-Krylov iterations to give vertical and horizontal mooring line tensions and thus strain of the device. Results from the new analytical model are compared with finite element predictions showing agreement to within 1%. The analytical model can be solved for any two unknowns, such that optimal load reduction device length and stiffness can be determined instantaneously given maximum environmental load and allowable surge. The new analytical equations are implemented into a graphical app, which allows the user to input any load reduction device parameters and visualise the resulting mooring system’s geometry and tension-offset profile.
Study on Large Particle Slurry Transport in Inclined Pipes With Pulsating Flow for Subsea Mining
Authors: Masanobu Sotaro , Takano Satoru , Yamamoto Marcio , Murai Yuichi , Tasaka Yuji , Park Hyun Jin
Published: September 2023

For subsea mining, it is important to predict the pressure loss in oscillating pipes with pulsating slurry flow for the safe and reliable operation of ore lifting. The configuration of pipe is expected to have not only vertical but also inclined parts. In the present paper, the authors focused on the pulsating internal slurry flow in static inclined pipes and derived the mathematical model to predict the pressure loss in such conditions. The slurry transport experiment was carried out to investigate the effects of pulsating slurry flow on the pressure loss in inclined pipes. In the experiment, the data related to slurry flow was measured by the differential pressure gauges, the electromagnetic flowmeter and the ultrasound monitoring. The model derived was validated by a comparison with measured data. The measured pressure loss has an outstanding component with pulsating period of water flow with relatively small higher order harmonic components. Although the prediction model derived in the present study has a tendency to overestimate the pressure loss for larger inclination angles, the calculated pressure loss is within the acceptable range given the simplicity of the model.