bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of bony changes in temporomandibular joint in patients using cone beam computed tomography – a cross sectional study
Authors: Vasegh Zahra , Safi Yaser , azar Maryam Sanaei , Ahsaie Mitra Ghazizadeh , Arianezhad S. Marjan
Published: October 2023

Background and aim

The aim of this study is to evaluate the changes in the temporomandibular joint (TMJ) in patients with temporomandibular disorder (TMD) and the relationship between age, sex, and types of TMJ change using Cone Beam Computed Tomography (CBCT).

Methods and material

CBCT records of 200 patients (123 women and 67 men) were retrieved and assessed. Right and left TMJs were evaluated separately, resulting in a total of 400 TMJs. The images were analyzed using On demand 3D Application The radiographic findings were classified as erosion, proliferative changes mainly, including flattening and osteophytes of the condyle, sclerosis, Ely cyst, hypoplasia and hyperplasia of the condyles, ankylosis, and joint cavity. Data analysis was performed using descriptive statistics, paired T-tests, and repeated measure ANOVA (Analysis of Variance) in SPSS Software.

Results

The most prevalent types of condylar bony changes observed was osteophyte (63.5%) followed by flattening of the articular surface (42%), erosion (40%), ankylosis (10%) and sclerosis (10%). 7.5% of joints showed hyperplastic condyles but only 2% showed hypoplasia. The least prevalent change observed was Ely Cyst (1%). Osteophyte was the most prevalent change observed in all age groups and both sexes except for men aged 31 ~ 50, where flattening was more frequent. A statistically significant difference was found between sex and prevalence of erosion in the age group of 10 ~ 30 (P = 0.001); as well as between sex and condylar hyperplasia in the same age group.

Conclusion

Based on the findings of this research, the prevalence of bony changes of TMJ from highest to lowest is as follows: osteophyte, flattening of the articular surface, erosion, ankylosis, sclerosis, hyperplastic condyles, hypoplastic condyles and Ely Cyst. CBCT is an accurate 3 dimensional imaging modality for assessment of TMJ bony structures.
Application of non-invasive prenatal testing in screening chromosomal aberrations in pregnancies with different nuchal translucency cutoffs
Authors: Xu Yong , Hu Siqi , Chen Liyuan , Hao Ying , Zhang Hu , Xu Zhiyong , Wu Weiqing , Deng Liyanyan
Published: October 2023

Objective

To investigate the efficiency of non-invasive prenatal testing (NIPT) in cases with different cutoffs of nuchal translucency (NT).

Methods

The study retrospectively analyses pregnancies with NT ≥ 2.5 mm who underwent NIPT. Results of NT, NIPT, chromosomal diagnostic and pregnancy outcomes were collected.

Results

Study group was composed of 1470 single pregnancies, including 864 with NT 2.5–2.9 mm, 350 with NT 3.0–3.4 mm and 256 with NT ≥ 3.5 mm. Non-significant differences were found in the positive predictive value (PPV) of NIPT between different cutoffs of NT. There was one false positive case with NT 4.3 mm, screening for 47,XYY in NIPT showed normal in diagnostic testing. For cases with normal NIPT results, the residual risk is 1:20 (5%, 95%CI: 0.1–10.1%) in fetuses with NT 3.0–3.4 mm and 1:15 (6.5%, 95%CI: 1.4%-11.5%) in fetuses with NT ≥ 3.5 mm. These false negative cases included one trisomy 21, seven pathogenic CNVs, one uniparental disomy and one single gene disorders.

Conclusion

Our findings demonstrated that the PPV of NIPT for screening chromosomal aberrations were similarly in different NT cutoffs, while false positive case does exist. After normal in NIPT, risk for chromosomal aberrations remained, especially pathogenic CNV and even common trisomy. Therefore, prenatal diagnosis was recommended and CMA was suggested to apply in pregnancies with NT ≥ 3.0 mm.
CD28/PD1 co-expression: dual impact on CD8+ T cells in peripheral blood and tumor tissue, and its significance in NSCLC patients' survival and ICB response
Authors: Palermo Belinda , Franzese Ornella , Frisullo Giuseppe , D’Ambrosio Lorenzo , Panetta Mariangela , Campo Giulia , D’Andrea Daniel , Sperduti Isabella , De Nicola Francesca , Goeman Frauke , Gallina Filippo , Visca Paolo , Facciolo Francesco , Nisticò Paola
Published: October 2023

Background

Immune checkpoint blockade (ICB) has significantly prolonged survival of non-small cell lung cancer (NSCLC) patients, although most patients develop mechanisms of resistance. Recently single-cell RNA-sequencing (scRNA-Seq) revealed a huge T-cell phenotypic and (dys)functional state variability. Accordingly, T-cell exhaustion is recognized as a functional adaptation, with a dynamic progression from a long-lived “pre-exhausted stem-like progenitor” to a “terminally exhausted” state. In this scenario it is crucial to understand the complex interplay between co-stimulatory and inhibitory molecules in CD8+ T-cell functionality.

Methods

To gain a baseline landscape of the composition, functional states, and transcriptomic signatures predictive of prognosis, we analyzed CD8+ T-cell subsets characterized by the presence/absence of PD1 and CD28 from periphery, adjacent non-tumor tissue and tumor site of a cohort of treatment-naïve NSCLC patients, by integrated multiparametric flow cytometry, targeted multi-omic scRNA-seq analyses, and computational pipelines.

Results

Despite the increased PD1 levels, an improved PD1+CD28+ T-cell polyfunctionality was observed with the transition from periphery to tumor site, associated with lack of TIGIT, TIM-3 and LAG-3, but not with Ag-experienced-marker CD11a. Differently from CD28+ T cells, the increased PD1 levels in the tumor were associated with reduced functionality in PD1+CD28− T cells. CD11ahigh, although expressed only in a small fraction of this subset, still sustained its functionality. Absence of TIGIT, TIM-3 and CTLA-4, alone or combined, was beneficial to CD28− T cells. Notably, we observed distinct TRM phenotypes in the different districts, with CD28+ T cells more capable of producing TGFβ in the periphery, potentially contributing to elevated CD103 levels. In contrast CD28− TRM mainly produced CXCL13 within the tumor.

ScRNA-seq revealed 5 different clusters for each of the two subsets, with distinctive transcriptional profiles in the three districts. By interrogating the TCGA dataset of patients with lung adenocarcinoma (LUAD) and metastatic NSCLC treated with atezolizumab, we found signatures of heterogeneous TRM and "pre-exhausted" long-lived effector memory CD8+ T cells associated with improved response to ICB only in the presence of CD28.

Conclusions

Our findings identify signatures able to stratify survival of LUAD patients and predict ICB response in advanced NSCLC. CD28 is advocated as a key determinant in the signatures identified, in both periphery and tumor site, thus likely providing feasible biomarkers of ICB response.

Graphical Abstract
The effects of aerobic exercises compared to conventional chest physiotherapy on pulmonary function, functional capacity, sputum culture, and quality of life in children and adolescents with cystic fibrosis: a study protocol for randomized controlled trial study
Authors: Hamedi Nadia , Kajbafvala Mehrnaz , ShahAli Shabnam , Pourahmadi MohammadReza , Eshghi Alireza , Estahbanati MohammadReza Modaresi
Published: October 2023

Background

Cystic fibrosis (CF) is an autosomal recessive disorder caused by abnormal function of the chloride ion channels and characterized by pancreatic insufficiency and chronic endobronchial airway infection. Pulmonary dysfunction is very common and could lead to a reduction in the quality of life. Airway clearance techniques (ACT) and physical exercises are introduced as one of the main components of treatment. Therefore, it will be of interest to examine the effect of aerobic exercises compared to conventional chest physiotherapy (CPT) on pulmonary function, functional capacity, sputum culture, and quality of life in patients with CF.

Methods

Thirty patients with CF will participate in a double-blind parallel controlled trial containing 18 sessions of treatment. Group A consists of CPT and placebo aerobic exercise, and group B includes aerobic exercise and placebo CPT. Pulmonary function, functional capacity, sputum culture, and quality of life will be evaluated with a spirometry test, 6-min walk test (6MWT), sputum culture test, and the Cystic Fibrosis Questionnaire-Revised (CFQ-R), respectively, before and after the intervention.

Discussion

We will evaluate and compare the effectiveness of aerobic exercises and conventional chest physiotherapy on pulmonary function, functional capacity, sputum culture, and quality of life. Comparing these two treatment patterns can contribute to a better understanding of the effectiveness. Therefore, if there is a significant difference between the two treatments, the superior treatment will be prioritized clinically.

Trial registration

https://www.irct.ir, IRCT20210505051181N5. Registered on 19 February 2023.
Molecular-phylogenetic analyses of Ixodes species from South Africa suggest an African origin of bird-associated exophilic ticks (subgenus Trichotoixodes)
Authors: Hornok Sándor , Kontschán Jenő , Takács Nóra , Heyne Heloise , Kovács Áron Botond , Plantard Olivier , Keve Gergő , Fedorov Denis , Gyuranecz Miklós , Halajian Ali
Published: October 2023

Background

Among hard ticks (Acari: Ixodidae), the genus Ixodes comprises the highest number of species, which in turn are most numerous in the Afrotropical zoogeographic region. In South Africa extensive morphological studies have been performed on Ixodes species but only few reports included molecular analyses.

Methods

In this study, 58 Ixodes spp. ticks, collected from ten mammalian and eight avian host species in South Africa, were molecularly and phylogenetically analyzed. In addition, a newly collected sample of the Palearctic Ixodes trianguliceps was included in the analyses.

Results

Among the ticks from South Africa, 11 species were identified morphologically. The majority of ticks from mammals represented the Ixodes pilosus group with two species (n = 20), followed by ticks resembling Ixodes rubicundus (n = 18) and Ixodes alluaudi (n = 3). In addition, single specimens of Ixodes rhabdomysae, Ixodes ugandanus, Ixodes nairobiensis and Ixodes simplex were also found. Considering bird-infesting ticks, Ixodes theilerae (n = 7), Ixodes uriae (n = 4) and ticks most similar to Ixodes daveyi (provisionally named I. cf. daveyi, n = 2) were identified. Molecular analyses confirmed two species in the I. pilosus group and a new species (I. cf. rubicundus) closely related to I. rubicundus sensu stricto. Phylogenetic trees based on concatenated mitochondrial or mitochondrial and nuclear gene sequences indicated that the subgenus Afrixodes forms a monophyletic clade with bird-associated exophilic ticks (subgenus Trichotoixodes). Ixodes trianguliceps clustered separately whereas I. alluaudi with their morphologically assigned subgenus, Exopalpiger.

Conclusions

Phylogenetic analyses shed new lights on the relationships of Ixodes subgenera when including multiple sequences from subgenus Afrixodes and African as well as Palearctic species of subgenera Trichotoixodes and Exopalpiger. Subgenera Afrixodes and bird-associated Trichotoixodes share common ancestry, suggesting that the latter might have also originated in Africa. Regarding the subgenus Exopalpiger, I. alluaudi is properly assigned as it clusters among different Australian Ixodes, whereas I. trianguliceps should be excluded.

Graphical Abstract
Acute osteomyelitis, thrombophlebitis, and pulmonary embolism: a case report
Authors: Sheikh Najeeb Mohammad , Alshwaiki Afif , Martini Nafiza , Alsuliman Tamim , Alkharat Banan , Alrstom Ali
Published: October 2023

Background

Septic pulmonary embolism (SPE), deep vein thrombophlebitis (DVT), and acute osteomyelitis (AOM) form a triad that is rarely seen in children and is usually associated with a history of trauma on long bones. Unfortunately, a delay in diagnosis is frequently observed in this syndrome, which places the patient at risk of life-threatening complications. This delay can largely be attributed to the failure to consider osteomyelitis as a potential underlying cause of DVT.

Case presentation

In this case report, we present the case of a 16-year-old Arabian male who presented with limb trauma and fever. The patient had a delayed diagnosis of osteomyelitis, which resulted in the formation of an abscess and subsequent joint destruction. Surgical drainage and joint replacement surgery were deemed necessary for treatment.

Conclusions

persistent fever along with a history of trauma on a long bone with signs of DVT of the limb in a child should raise concern for osteomyelitis and an MRI evaluation of the limb should be obtained.
DNA methylation of insulin signaling pathways is associated with HOMA2-IR in primary myoblasts from older adults
Authors: Burton Mark A. , Garratt Emma S. , Hewitt Matthew O. , Sharkh Hanan Y. , Antoun Elie , Westbury Leo D. , Dennison Elaine M. , Harvey Nicholas C. , Cooper Cyrus , MacIsaac Julia L. , Kobor Michael S. , Patel Harnish P. , Godfrey Keith M. , Lillycrop Karen A.
Published: October 2023

Background

While ageing is associated with increased insulin resistance (IR), the molecular mechanisms underlying increased IR in the muscle, the primary organ for glucose clearance, have yet to be elucidated in older individuals. As epigenetic processes are suggested to contribute to the development of ageing-associated diseases, we investigated whether differential DNA methylation was associated with IR in human primary muscle stem cells (myoblasts) from community-dwelling older individuals.

Methods

We measured DNA methylation (Infinium HumanMethylationEPIC BeadChip) in myoblast cultures from vastus lateralis biopsies (119 males/females, mean age 78.24 years) from the Hertfordshire Sarcopenia Study extension (HSSe) and examined differentially methylated cytosine phosphate guanine (CpG) sites (dmCpG), regions (DMRs) and gene pathways associated with HOMA2-IR, an index for the assessment of insulin resistance, and levels of glycated hemoglobin HbA1c.

Results

Thirty-eight dmCpGs (false discovery rate (FDR) < 0.05) were associated with HOMA2-IR, with dmCpGs enriched in genes linked with JNK, AMPK and insulin signaling. The methylation signal associated with HOMA2-IR was attenuated after the addition of either BMI (6 dmCpGs), appendicular lean mass index (ALMi) (7 dmCpGs), grip strength (15 dmCpGs) or gait speed (23 dmCpGs) as covariates in the model. There were 8 DMRs (Stouffer < 0.05) associated with HOMA2-IR, including DMRs within T-box transcription factor (TBX1) and nuclear receptor subfamily-2 group F member-2 (NR2F2); the DMRs within TBX1 and NR2F2 remained associated with HOMA2-IR after adjustment for BMI, ALMi, grip strength or gait speed. Forty-nine dmCpGs and 21 DMRs were associated with HbA1c, with cg13451048, located within exoribonuclease family member 3 (ERI3) associated with both HOMA2-IR and HbA1c. HOMA2-IR and HbA1c were not associated with accelerated epigenetic ageing.

Conclusions

These findings suggest that insulin resistance is associated with differential DNA methylation in human primary myoblasts with both muscle mass and body composition making a significant contribution to the methylation changes associated with IR.
Forecasting emergency department arrivals using INGARCH models
Authors: Reboredo Juan C. , Barba-Queiruga Jose Ramon , Ojea-Ferreiro Javier , Reyes-Santias Francisco
Published: October 2023

Background

Forecasting patient arrivals to hospital emergency departments is critical to dealing with surges and to efficient planning, management and functioning of hospital emerency departments.

Objective

We explore whether past mean values and past observations are useful to forecast daily patient arrivals in an Emergency Department.

Material and methods

We examine whether an integer-valued generalized autoregressive conditional heteroscedastic (INGARCH) model can yield a better conditional distribution fit and forecast of patient arrivals by using past arrival information and taking into account the dynamics of the volatility of arrivals.

Results

We document that INGARCH models improve both in-sample and out-of-sample forecasts, particularly in the lower and upper quantiles of the distribution of arrivals.

Conclusion

Our results suggest that INGARCH modelling is a useful model for short-term and tactical emergency department planning, e.g., to assign rotas or locate staff for unexpected surges in patient arrivals.
Ris-aided integrated satellite duplex UAV relay terrestrial networks with imperfect hardware and co-channel interference
Authors: Sun Jiu , Guo Kefeng , Zhou Feng , Wang Xueling , Zhu Mingfu
Published: October 2023

Increasing the spectrum and time utilization rate is the goal of the next wireless communication networks. This work studies the outage performance of the reconfigurable intelligent surface (RIS)-aided integrated satellite duplex unmanned-aerial-vehicle relay terrestrial networks. Especially, the RIS is installed in the tall building to enhance the communication. To further increase the time utilization rate, the duplex unmanned aerial vehicle is utilized to enhance the time utilization efficiency. However, owing to the practical reasons, the imperfect hardware and co-channel interference are further researched in this paper. Particularly, the accurate expression for the outage probability (OP) is gotten to confirm the effects of RIS parameters, channel parameters and imperfect hardware on the considered network. To gain more insights of the OP at high signal-to-noise ratios, the asymptotic analysis for the OP is derived. Finally, some Monte Carlo simulations are provided to verify the rightness of the theoretical analysis. The simulations indicate that the OP is mainly judged by the satellite transmission link. The results also indicate that although RIS can enhance the system performance, the system performance is not decided by RIS.
Systematic review and meta-analysis: the efficiency of bacteriophages previously patented against pathogenic bacteria on food
Authors: Romero-Calle Danitza Xiomara , de Santana Vinicius Pereira , Benevides Raquel Guimarães , Aliaga Maria Teresa Alvarez , Billington Craig , Góes-Neto Aristóteles
Published: October 2023

Food-borne diseases are a global public health issue with 1 in 10 people falling ill after eating contaminated food every year. In response, the food industry has implemented several new pathogen control strategies, such as biotechnological tools using the direct application of bacteriophages for biological control. We have undertaken a systematic review and meta-analysis that evaluated the efficiency of patented phages as a biological control for food-borne pathogens and determined the physical–chemical characteristics of the antimicrobial effect. Included and excluded criteria was developed. Included criteria: Phage patent files with an application in biological control on food and scientific articles and book chapters that used phages patented for food biological control. Excluded criteria: Patent documents, scientific articles, and book chapters that included phage therapy in humans, animals, and biological control on plants but did not have an application on food were not considered in our study. The systematic analysis identified 77 documents, 46 scientific articles, and 31 documents of patents and 23 articles was included in the meta-analysis. Listeria monocytogenes and Salmonella sp. comprised most of the targets identified in the screening, so that we focused on these strains to do the meta-analysis. There are a total of 383 and 192 experiments for Listeria and Salmonella phages for quantitative data analysis.

Indexing databases for the bibliographic search (Scopus, Web of Science (WoS) and PubMed (Medline) were addressed by an automated script written in Python 3 Python Core Team (2015) and deposited on GitHub (https://github.com/glenjasper).

A random-effects meta-analysis revealed (i) significant antimicrobial effect of Listeria phages in apple, apple juice, pear, and pear juice, (ii) significant antimicrobial effect of Salmonella phages in eggs, apple, and ready-to-eat chicken, (iii) no heterogeneity was identified in either meta-analysis, (iv) publication bias was detected for Listeria phages but not for Salmonella phages. (v) ListShield and Felix01 phages showed the best result for Listeria and Salmonella biological control, respectively, (vi) concentration of phage and bacteria, time and food had significant effect in the biological control of Listeria, (vii) temperature and time had a significant effect on the antimicrobial activity of Salmonella phages. The systematic review and meta-analyses to determine the efficiency of bacteriophages previously patented against pathogenic bacteria on dairy products, meat, fruits and vegetables. Besides, the discovering of key factors for efficacy, so that future applications of phage biotechnology in foods can be optimally deployed.
Systematic oxidative stress indices predicts prognosis in patients with urothelial carcinoma of the upper urinary tract after radical nephroureterectomy
Authors: Liu Jianyong , Lai Shicong , Wu Pengjie , Wang Jiawen , Wang Jianye , Wang Jianlong , Zhang Yaoguang
Published: October 2023

Background

Oxidative stress plays an important role in the occurrence and development of malignancy. However, the relationship between oxidative stress and upper urinary tract urothelial carcinoma (UTUC) prognosis remains elusive. This study aimed to evaluate the prognostic value of systematic oxidative stress indices as a predictor of patient outcomes in UTUC after radical nephroureterectomy.

Methods

Clinical data for 483 patients with UTUC who underwent radical nephroureterectomy were analyzed. Patients were categorized according to an optimal value of systematic oxidative stress indices (SOSIs), including fibrinogen (Fib), gamma-glutamyl transpeptidase (γ-GGT), creatinine (CRE), lactate dehydrogenase (LDH) and albumin (ALB). Kaplan–Meier analyses were used to investigate associations of SOSIs with overall survival (OS) and progression-free survival (PFS). Moreover, associations between SOSIs and OS and PFS were assessed with univariate and multivariate analyses.

Results

High values of Fib, γ-GGT, CRE, and LDH, and low values of ALB were associated with reduced OS. SOSIs status correlated with age, tumor site, surgical approach, hydronephrosis, tumor size, T stage, and lymph node status. The Kaplan–Meier survival analysis showed a significant discriminatory ability for death and progression risks in the two groups based on SOSIs. Multivariate Cox proportional hazards models showed that SOSIs were an independent prognostic indicator for OS (p = 0.007) and PFS (p = 0.021). SOSIs and clinical variables were selected to establish a nomogram for OS. The 1-, 3-, and 5-year AUC values were 0.77, 0.78, and 0.81, respectively. Calibration curves of the nomogram showed high consistencies between the predicted and observed survival probability. Decision curve analysis curves showed that the nomogram could well predict the 1‐year, 3-year, and 5‐year OS.

Conclusions

SOSIs are an independent unfavorable predictor of OS and PFS in patients diagnosed with UTUC undergoing RNU. Therefore, incorporating SOSIs into currently available clinical parameters may improve clinical decision-making.
The impact of conflict on food security: evidence from household data in Ethiopia and Malawi
Authors: Muriuki James , Hudson Darren , Fuad Syed
Published: October 2023

Background

Violent conflicts threaten food security and household welfare in sub-Saharan Africa. While a more robust understanding of the causal relationship between food security and conflict is vital in mitigating food insecurity and bolstering peace prospects, only limited research exists on this topic, especially at the household level where estimations are more empirically challenging given data constraints and identification issues. Our analysis utilizes a newly developed and novel difference-in-differences model developed by de Chaisemartin and D’Haultfoeuille (2020) to determine the causal relationship between violent conflicts and food security in two sub-Saharan African countries—Malawi and Ethiopia using household-level data from the World Bank’s Household Living Standards Measurement Survey.

Results

Our results suggest that exposure to violent conflict on average decreases the food consumption score (FCS) by 6.84 units, which corresponds to a 16.13% reduction in FCS. With respect to individual countries, Malawi shows the largest effect-size, with the FCS decreasing by 10.54 units (equivalent to a 20.22% reduction in FCS). In Ethiopia, the causal estimate was slightly smaller at − 4.32 (equivalent to a 11.67% reduction in FCS) although the baseline food security status was lower relative to Malawi. Disaggregated analyses show that the effect-size can be several orders of magnitude larger when conflict is experienced simultaneously with natural shocks. Robustness checks using different iterations of propensity score matching generate comparable causal estimates and reinforce the overall findings.

Conclusions

The findings help improve our understanding of a broader issue by providing new direct and granular evidence regarding the relationship between conflict and food security using household data. The results hold implications for aid and humanitarian efforts to help households facing food insecurity stemming from violence and other factors.
ASENN: attention-based selective embedding neural networks for road distress prediction
Authors: Philip Babitha , Xu Zhenyu , AlJassmi Hamad , Zhang Qieshi , Ali Luqman
Published: October 2023

This study proposes an innovative neural network framework, ASENN (Attention-based Selective Embedding Neural Network), for the prediction of pavement deterioration. Considering the complexity and uncertainty associated with the pavement deterioration process, two fundamental frameworks, SEL (Selective Embedding Layer) and MDAL (Multi-Dropout Attention Layer), are combined to enhance feature abstraction and prediction accuracy. This approach is significant while analyzing the pavement deterioration process due to the high variability of the contributing deterioration factors. These factors, represented as tabular data, undergo filtering, embedding, and fusion stages in the SEL, to extract crucial features for an effective representation of pavement deterioration. Further, multiple attention-weighted combinations of raw data are obtained through the MDAL. Several SELs and MDALs were combined as basic cells and layered to form an ASENN. The experimental results demonstrate that the proposed model outperforms existing tabular models on four road distress parameter datasets corresponding to cracking, deflection, international roughness index, and rutting. The optimal number of cells was determined using different ablation settings. The results also show that the feature learning capabilities of the ASENN model improved as the number of cells increased; however, owing to the limited combination space of feature fields, extreme depths were not preferred. Furthermore, the ablation investigation demonstrated that MDAL can improve performance, particularly on the cracking dataset. Notably, compared with mainstream transformer models, ASENN requires significantly less storage and achieves faster execution speed.
Increased ACL direct insertion coverage provided more positive biomechanical effects on graft and bone tunnel during knee flexion: a simulation study
Authors: Xiao Yang , Liang Zhaoxin , Shen Shiwen , Liu Fei , Hu Hai , Chen Bin
Published: October 2023

Purpose

Flattened femoral tunnels were recently applied in anatomical single‐bundle anterior cruciate ligament (ACL) reconstruction. Little is known about the biomechanical effect of such changes during knee flexion. The aim of the present simulation study was to assess the effect of altered ACL direct insertion coverage on the biomechanics of the graft and bone tunnel.

Methods

Five finite element (FE) models, including a round femoral tunnel and four progressively flattened rounded rectangular femoral tunnels, were established to represent the ACL reconstructions. In vivo knee kinematics data obtained from the validated dual fluoroscopic imaging techniques controlled the FE models to simulate lunge motions. The maximal principal stress of the graft and the volume of equivalent strain within 1000–3000 microstrain (V1000‐3000) of the cancellous bone were subsequently calculated at 0°, 30°, 60° and 90° of knee flexion.

Results

A lower stress state on the graft and a more beneficial strain state on the cancellous bone were observed when the femoral tunnel better covered the ACL direct insertion. The average maximal principal stress of each model were 3.93 ± 0.60 MPa, 3.82 ± 0.54 MPa, 3.43 ± 0.44 MPa, 3.45 ± 0.44 MPa and 3.05 ± 0.43 MPa, respectively. The average V1000‐3000 of the cancellous bone of each model were 179.06 ± 89.62 mm3, 221.40 ± 129.83 mm3, 247.57 ± 157.78 mm3, 282.74 ± 178.51 mm3 and 295.71 ± 162.59 mm3, respectively. Both the stress and strain values exhibited two peaks during the flexion simulation. The highest value occurred at 30° of flexion, and the second highest value occurred at 90° of flexion.

Conclusions

Increased ACL direct insertion coverage provided more positive biomechanical effects after anatomical single‐bundle ACL reconstruction during knee flexion.
Qualifications and supports for teaching teams in state-funded preschool in the United States
Authors: Weisenfeld Georgenne G. , Hodges Kate Schellie , Copeman Petig Abby
Published: October 2023

In the United States, state-funded preschool is a critical component of both K-12 public education and the early childhood education and care system. In 2021, 44 states and the District of Columbia operated 63 school/center-based preschool programs serving over 1.3 million children. The vast majority of state-funded preschool programs require two adults in each classroom: typically, a lead teacher and an assistant teacher, with an expectation for team teaching. This paper examines the trends and variations in state policies that address the qualifications requirements, compensation, and professional development supports for preschool lead and assistant teachers in state-funded preschool programs that provide a foundation for supporting a culture of collective success and potential quality of the classroom.
World Cafés as a participatory approach to understanding research agendas in primary care with underserved communities: reflections, challenges and lessons learned
Authors: McGrath Carmel , Kennedy Mari-Rose , Gibson Andy , Musse Samira , Kosar Zahra , Dawson Shoba
Published: October 2023

Background

Certain communities are underserved by research, resulting in lower inclusion rates, under researched health issues and a lack of attention to how different communities respond to health interventions. Minoritised ethnic groups are often underserved by research and services. They experience health inequalities and face significant barriers to accessing health services. It is recognised that new approaches are needed to reach underserved communities and make research more relevant. The purpose of this work was to utilise World Cafés, a participatory method, to explore research agendas with diverse communities.

Methods

Two World Cafés were conducted as research agenda setting activities with individuals from minoritised ethnic communities in Bristol, UK. World Café 1 explored Black and Asian women’s perspectives about supporting mental health. World Café 2 with men from the Somali community, focused on prostate cancer. Community members co-developed the focus and questions of each World Café and were also instrumental in recruiting individuals to the sessions and facilitating discussions, including translation. Audio and written records were made of the discussions and from these key issues about each topic were identified, and a visual representation of the discussion was also generated. These were shared with participants to check for accuracy.

Results

Community members identified a range of issues that are important to them in relation to mental health and prostate cancer, including barriers to help seeking and accessing primary and secondary care, ideas for service improvements and a need for health information that is accessible and culturally relevant.

Conclusions

World Cafés are a flexible method that can be successfully adapted for research agenda setting with individuals from minoritised ethnic communities. The role of community members in co-developing the focus of sessions, recruiting community members and co-facilitating sessions is crucial to this success. The discussions at both World Cafés provided a rich insight into the experiences of participants in relation to the topics mental health and prostate cancer and identified issues that are important to these communities that will be followed-up with communities, researchers and clinicians to co-develop research and service improvement strategies.
Refugee COVID-19 protocol adherence and NGO staff perceptions: paternalism and power in humanitarian assistance
Authors: Karaoglu Ezgi , Nawyn Stephanie J. , Qaji Natalynn , Qaji Natalie , Nashwan Ayat J. , Gasteyer Stephen
Published: October 2023

During the COVID-19 pandemic, humanitarian NGOs have instituted safety protocols intended to reduce the risk of spreading infection during services to refugees. But those protocols are not always followed, and how staff attribute refugee non-adherence reveals underlying power dynamics in humanitarian assistance which can shape how they approach improving adherence in order to enhance effective service provision to the refugees. Using the data from 1466 interviews conducted with 468 different NGO staff in Türkiye, Jordan, and Lebanon, this study exhibits how paternalistic rhetoric operated in humanitarianism during the initial stages of the pandemic. While staff attribute the non-adherence of refugees to essential refugee culture and sometimes “immoral” character, they attribute their own non-adherence to morally neutral situational factors. Some NGO staff even perceived the refugees as incapable of complying with the safety protocols without assistance. While the literature on paternalism focuses on North/South power dynamics between service providers and refugees, our data show that these dynamics also exist in South-South humanitarian interventions where both the service providers and the refugees are from the region and have similar cultural backgrounds.
Economic Evaluation of a Nonmedical Financial Assistance Program on Missed Treatment Appointments Among Adults With Cancer
Authors: Biddell Caitlin B. , Spees Lisa P. , Trogdon Justin G. , Kent Erin E. , Rosenstein Donald L. , Angove Rebekah S.M. , Rogers Cindy D. , Wheeler Stephanie B.
Published: October 2023

PURPOSE

We retrospectively evaluated the clinical and economic impact of a program providing nonmedical financial assistance on missed treatment appointments among patients receiving cancer treatment at a large, Southeastern public hospital system.

MATERIALS AND METHODS

We used patient electronic health records, program records, and cancer registry data to examine the impact of the program on rates of missed (or no-show) radiation therapy and infusion chemotherapy/immunotherapy appointments in the 180 days after treatment initiation. We used propensity weighting to estimate the effect of the program, stratified by treatment appointment type (radiation therapy, infusion chemotherapy/immunotherapy). We developed a decision tree–based economic model to conduct a cost-consequence analysis from the health system perspective in a hypothetical cohort over a 6-month time horizon.

RESULTS

Of 1,347 patients receiving radiation therapy between 2015 and 2019, 53% (n = 715) had ≥1 no-shows and 28% (n = 378) received program assistance. Receipt of any assistance was associated with a 2.1 percentage point (95% CI, 0.6 to 3.5) decrease in the proportion of no-shows, corresponding to a 51% decrease in the overall mean no-show proportion. Under the current funding model, the program is estimated to save the health system $153 in US dollars per missed appointment averted, relative to not providing nonmedical financial assistance. Of the 1,641 patients receiving infusion chemotherapy/immunotherapy, 33% (n = 541) received program assistance, and only 14% (n = 223) had ≥1 no-shows. The financial assistance program did not have a significant effect on no-show proportions among infusion visits.

CONCLUSION

This study used a novel approach to retrospectively evaluate a nonmedical financial assistance program for patients undergoing active cancer treatment. Findings support investment in programs that address patients' nonmedical financial needs, particularly for those undergoing intensive radiation therapy.
Exploring Stakeholders' Perspectives on Implementing Universal Germline Testing for Colorectal Cancer: Findings From a Clinical Practice Survey
Authors: Rodgers-Fouche Linda , Arora Sanjeevani , Ricker Charité , Li Dan , Farooqi Maheen , Balaguer Francesc , Dominguez-Valentin Mev , Guillem Jose G. , Kanth Priyanka , Liska David , Melson Joshua , Mraz Kathryn A. , Shirts Brian H. , Vilar Eduardo , Katona Bryson W. , Hodan Rachel
Published: October 2023

PURPOSE

New guidelines recommend considering germline genetic testing for all patients with colorectal cancer (CRC). However, there is a lack of data on stakeholders' perspectives on the advantages and barriers of implementing universal germline testing (UGT). This study assessed the perspectives of members of the Collaborative Group of the Americas on Inherited Gastrointestinal Cancer (CGA-IGC) regarding the implementation of UGT for patients with CRC, including readiness, logistics, and barriers.

METHODS

A cross-sectional survey was sent to 317 active members of CGA-IGC. The survey included sections on demographics, clinical practice specialty, established institutional practices for testing, and questions pertaining to support of and barriers to implementing UGT for patients with CRC.

RESULTS

Eighty CGA-IGC members (25%) participated, including 42 genetic counselors (53%) and 14 gastroenterologists (18%). Forty-seven (59%) reported an academic medical center as their primary work setting, and most participants (56%) had more than 10 years of clinical practice. Although most participants (73%) supported UGT, 54% indicated that changes in practice would be required before adopting UGT, and 39% indicated that these changes would be challenging to implement. There was support for both genetics and nongenetics providers to order genetic testing, and a majority (57%) supported a standardized multigene panel rather than a customized gene panel. Key barriers to UGT implementation included limited genetics knowledge among nongenetics providers, time-consuming processes for obtaining consent, ordering tests, disclosing results, and lack of insurance coverage.

CONCLUSION

This study demonstrates wide support among hereditary GI cancer experts for implementation of UGT for patients with CRC. However, alternative service delivery models using nongenetics providers should be considered to address the logistical barriers to UGT implementation, particularly the growing demand for genetic testing.
How to be an authentic leader, 1. Understanding authentic leadership
Authors: Thomas Vinice
Published: October 2023

Strong leaders with an approach that supports, empowers and inspires staff are vital to the delivery of quality care and services for patients and service users. Every failing identified in the NHS, and the subsequent reviews examining them have pointed to the failing of leadership to maintain the standards of care, protection and quality required for clinical services eg Mid Staffordshire ( Francis, 2013 ) and the Shipman Inquiries ( Smith, 2003 ). Over the next few months, we will be looking at several leadership styles and how these can impact on patients, staff and health and social care.

In simple terms, a leader influences others (either directly, or by delegating) to carry out a specific action or set of objectives. The essence of followers and followership is considered by authors as an essential aspect of understanding leadership and the importance of the interaction between the two parties ( Winston and Patterson, 2006 ). Authentic leadership is one of the leadership styles that is categorised as relational eg it focuses on building relationships with others, and it is also seen as a positive leadership form (Malila et al, 2017).

Authentic leaders are considered to be key in creating improved nursing and organisational outcomes through promoting a positive emotional wellbeing and such leadership is associated with lower staff turnover ( Laschinger et al, 2016 ; Lee et al, 2019 ). Furthermore, authentic leadership has been linked with improved patient outcomes ( Boamah et al, 2017 ).
The heart of the matter
Authors: Garlo Nina
Published: October 2023

Nina Garlo explores the link between oral health and heart health.
Something to smile about
Authors: Barber Marijka
Published: October 2023

Marijka Barber discusses the great work being done to raise awareness and address children's oral health.
A land of opportunity
Authors: Brown Clementine Rees
Published: October 2023

Clementine Rees Brown speaks with Rochelle Fisher about her journey from NHS dental nurse, to a fully-fledged entrepreneur in Australia.
Surface decontamination in the dental surgery
Authors: Nixon Jenny
Published: October 2023

Jenny Nixon business reviews the important subject of surface decontamination.

Aims & Objectives

Readers will learn how infection spreads via surfaces in the dental environment. Readers will learn about and understand the potential infection control risks in dental practices. Readers will learn about the best practices and strategies to control and mitigate infection risks with effective surface decontamination.
Development of the Watergate Tool to inform levels of care provision needed for people with dementia moving into extra care apartments
Authors: Bainbridge Lesley , Thompson Juliana , Ritchie Julie , Metcalfe Rebekah , McLeod Adelina , Tiplady Sue
Published: October 2023

As rates of dementia rise, there is an increased demand for specialist accommodation for people with dementia. Watergate Court in Gateshead is an extra care facility that provides care and accommodation for residents with different levels of dementia within a wider community of older people. To ensure high-quality, cost-efficient care for these residents, an effective method of assessing their care needs was required. The Watergate Tool was developed to assess the level of care provision that the residents with dementia needed. The authors found that when the Watergate Tool was used regularly within the context of an effective multidisciplinary team, it contributed to consistent care provision assessments, ensuring that the residents with dementia received the care that they needed.
Making reasonable adjustments for employees with mental health issues
Authors: Bernstein Adam
Published: October 2023

Adam Bernstein discusses guidance to help employers make reasonable adjustments for employees that relate to mental health.
#MeToo: A Biography
Authors: Wanzo Rebecca , Stabile Carol A.
Published: October 2023

Abstract: This introduction looks at the difference between Tarana Burke's "me too" and #MeToo. The chronologically distinct origin stories for the forms of activism #MeToo has generated illustrate a distinction between Burke's "me too," grounded in her work with Black girls and created to raise awareness of the collective plight of survivors of sexual violence, and "#MeToo," an example of hashtag feminism that has come to be associated with identifying individual bad actors. We look at various manifestations of #MeToo as well as feminist debates in telling the story about #MeToo's successes and failures.
Reproducing and Resisting Sexual Violence: Narrative, Genre, and Power Structure in Fang Siqi's First Love Paradise
Authors: Huang Rong , Jin Xiaotian
Published: October 2023

Abstract: In her semi-autobiographical novel Fang Siqi's First Love Paradise , Lin Yihan weaves her own traumatic experience of being sexually abused into a powerful narrative that sheds light on the pervasive acquiescence to violence against women in patriarchal cultures. Focusing on the sociocultural factors behind sexual violence, this article examines certain forms of narrative and literary genre, as revealed in the novel, that can be manipulated by male perpetrators and thus play a complicit role in reproducing crimes. But by blurring the divide between fiction and nonfiction, the reception and massive readership of the novel attest to a sort of narrative solidarity against sexual violence, making it an iconic text of the contemporary feminist movement in East Asia.
Sex, Violence, and Memoir: David Wojnarowicz's Close to the Knives
Authors: LaFleur Greta , Seitler Dana
Published: October 2023

Abstract: This article engages David Wojnarowicz's "memoir of disintegration" Close to the Knives (1991), a text that contains numerous and variegated representations of sexual encounters before and during the beginnings of the AIDS crisis in the United States. Wojnarowicz's memoir provides this article with its critical focus because it points us to one iteration of the narratological before-life of the #MeToo movement. In this article, we explore how, in the text, the violence that infuses sex, as well as the sexual intensity that drives violence, is presented as a social and structural problem rather than as an individualized desire, aberration, or impulse. Sexual harm, rather, is primarily a structural reality that in turn informs the way that both sex and violence are practiced—by Wojnarowicz himself, by his lovers and friends, and even by his family. Close to the Knives thus presents the reader with a tension between, on the one hand, Wojnarowicz's playful curiosity surrounding the relationship between sex, violence, and harm, and on the other, formal questions about memoir. In this article, we ask: how can we develop an ethics around sexual violence—without reifying either sex or acts of self-narration?
"If it didn't hurt so bad, I'd kill myself, but I'll let Ed Buck do it for now": #Justice4Gemmel and Black Queer Narratives in the Age and Afterlife of #MeToo
Authors: Wooten Terrance
Published: October 2023

Abstract: Gemmel Moore, a gay Black man, was found dead in the West Hollywood home of Edward Buck, a gay white LGBT rights activist. Gemmel's death was originally classified as an accident until his family published his journal, which was used to ignite both a criminal investigation and a set of Twitter campaigns, #Justice4Gemmel and #StopEdBuck, that have intersected with the #MeToo movement. In this essay, I analyze how Black queer men narrate their experiences of sexual trauma in relation to Black women, and subsequently how Black women have carved space for Black queer survivors by providing a new language for conceptualizing the racialized gendering of sexual violence. In doing so, I examine how Black queer men's autobiographical narratives function not only as evidence of their sexual injury but also as modes of networked connectivity that position Black queer subjects as integral to anti-sexual violence work and #MeToo activism.
Disability and Sexual Assault in Public(s): Performance/Nebula
Authors: Kuppers Petra
Published: October 2023

Abstract: This montage essay investigates elliptical fractured storytelling modes around disabled embodiment, a court case of sexual assault, and the social media aftermath. It tracks how knowledge of perceived sexual vulnerability folds into one's bodymindspirit, and how pain runs through and shifts in these multiple foldings. The essay's earthy, plate-moving tectonics build an autoethnographic star-reaching galaxy that incorporates various modes of storytelling, including social media, poetry, movement, and court discourse. This storytelling montage is hesitant, and creates temporal folds that allow an "I" to slip away into sheltering silences.