bluuebunny/crossref_metadata_2025 huggingface dataset:
Urbanization Effects on Rainfall Processes Induced by Landfalling Typhoon Lekima (2019) over the Shanghai Metropolitan Area
Authors: Ao Xiangyu , Yue Caijun , Yang Xuchao , Deng Lin , Huang Wei
Published: April 2022

Urbanization effects on rainfall induced by landfalling tropical cyclones have rarely been studied. Here high-resolution numerical simulations with the Weather Research and Forecasting/Noah/Single-layer urban canopy model system (WRF/SLUCM) are conducted to investigate impacts of urban land cover and building heights on heavy rainfall induced by landfalling Typhoon Lekima (2019) over the Megacity Shanghai. The default single urban category in WRF was updated to a new land cover data with three urban categories. Results indicate that WRF/SLUCM captures the typhoon intensity, track and total rainfall amount quite well. Urbanization has a small positive effect on rainfall amount for this event. However, urbanization has a significant impact on the spatial distribution of the accumulated rainfall with enhancement not confined over the urban area but mainly to the southwest of Shanghai possibly due to the changes of the typhoon tracks. With the impact of typhoon Lekima, the urban heat island disappears, indicating that the thermal effect of urbanization has limited influence on the rainfall processes. The model performance is very sensitive to the building height. More realistic building height values can noticeably improve simulations of the diurnal patterns of rainfall, urban heat island and the urban wind speed stilling effect. With the rising of building heights, the surface frictional dynamic effect and vertical uplift is enhanced, but seems not enough to evidently intensify the rainfall. The simulated lower level large moisture flux convergence corresponds well to rainfall peaks. This study has important scientific significance for the accuracy of rainfall forecast of landfalling typhoons and disaster mitigation in cities.
Improving station-based ensemble surface meteorological analyses using numerical weather prediction: A case study of the Oroville Dam crisis precipitation event
Authors: Bunn Patrick T.W. , Wood Andrew W. , Newman Andrew J. , Chang Hsin-I , Castro Christopher L. , Clark Martyn P. , Arnold Jeffrey R.
Published: April 2022

Surface meteorological analyses serve a wide range of research and applications, including forcing inputs for hydrological and ecological models, climate analysis, and resource and emergency management. Quantifying uncertainty in such analyses would extend their utility for probabilistic hydrologic prediction and climate risk applications. With this motivation, we enhance and evaluate an approach for generating ensemble analyses of precipitation and temperature through the fusion of station observations, terrain information, and numerical weather prediction simulations of surface climate fields. In particular, we expand a spatial regression in which static terrain attributes serve as predictors for spatially distributed 1/16th degree daily surface precipitation and temperature by including forecast outputs from the High-Resolution Rapid Refresh (HRRR) numerical weather prediction model as additional predictors. We demonstrate the approach for a case study domain of California, focusing on the meteorological conditions leading to the 2017 flood and spillway failure event at Lake Oroville. The approach extends the spatial regression capability of the Gridded Meteorological Ensemble Tool (GMET) and also adds cross-validation to the uncertainty estimation component, enabling the use of predictive rather than calibration uncertainty. In evaluation against out-of-sample station observations, the HRRR-based predictors alone are found to be skillful for the study setting, leading to overall improvements in the enhanced GMET meteorological analyses. The methodology and associated tool represent a promising method for generating meteorological surface analyses for both research-oriented and operational applications, as well as a general strategy for merging in situ and gridded observations.
Selection Optimal Method of Evaporation Duct Model Based on Sensitivity Analysis
Authors: Qiu Zhijin , Hu Tong , Wang Bo , Zou Jing , Li Zhiqian
Published: April 2022

The evaporation duct is an abnormal refractive phenomenon with wide distribution and frequency occurrence at the boundary between the atmosphere and the ocean, which directly affects electromagnetic wave propagation. In recent years, the use of meteorological and hydrological data to predict the evaporation duct height has become an emerging and promising approach. There are some evaporation duct models that have been proposed based on the Monin–Obukhov similarity theory. However, each model adopts different stability functions and roughness length parameterization methods, so the prediction accuracies are different under different environmental conditions. To improve the prediction accuracy of the evaporation duct under different environmental conditions, a model selection optimization method (MSOM) of the evaporation duct model is proposed based on sensitivity analysis. According to the sensitivity of each model to input parameters analyzed by the sensor observation accuracy, curve graph, and Sobol sensitivity, the model input parameters are divided into several intervals. Then the optimization model is selected in different intervals. The model was established using numerical simulation data from local areas in the South China Sea, and its accuracy was verified by the observational data from the offshore observation platform located in the South China Sea. The results show that the MSOM can effectively improve the prediction accuracy of the evaporation duct height. Under unstable conditions, the maximum relative error is reduced by 7.1%, and under stable conditions, the relative error is reduced by 10.7%.

Significance Statement

The evaporation duct height has a significant effect on marine radar or wireless apparatus applications. To obtain the evaporation duct height, there are some evaporation duct models that have been proposed. However, different evaporation duct models are applicable to different meteorological and hydrological environments. A single model cannot achieve accurate evaporation duct height predictions in all environments. We propose a model selection optimization method of the evaporation duct model based on sensitivity analysis. This method can dynamically select the optimal model according to different meteorological and hydrological environment, and improve the prediction accuracy of the evaporation duct height. Under unstable conditions, the maximum relative error is reduced by 7.1%, and under stable conditions, the relative error is reduced by 10.7%.
Turbulent Fluxes and Surface Meteorology during the Landfall of Four Typhoons in the South China Sea
Authors: Huang Huijun , Huang Jian , Liao Fei , Mao Weikang , Liu Chunxia , Wen Guanhuan , Huang Ling , Zhou Mingsen
Published: April 2022

We examine landfall of four typhoons in the South China Sea to better understand their air–land and air–sea energy exchanges at both an inland site and a nearby oversea observational site, comparing the exchanges to those during the monsoon period. We found the following: 1) Counter-gradient sensible heat fluxes could occur for all wind directions. For the latent heat, counter-gradient flux occurred at the inland site mainly with onshore winds. At the oversea site, such flux regularly occurred during the typhoons as well as during rainy periods in the monsoon. 2) Monin–Obukhov similarity theory (MOST) fits the inland and oversea cases well for only the vertical and horizontal wind speeds. Also, the nondimensional vertical gradient of wind speed had larger MOST parameter values over sea than inland. 3) Inland, when the wind speed increased, the downward heat flux from air to ground increased. 4) When the typhoon center was distant, the oversea latent heat flux was larger than that during the monsoon period. However, when the typhoon center was nearby, the latent heat flux was smaller. We suggest that the observed heat flux behavior over sea may arise from boundary layer rolls and sea spray during a typhoon with rainfall, but significant gaps exist in the latent heat flux data from the two stronger typhoons. 5) Detailed measurements of Typhoons Vicente and Kai-tak suggest two mechanisms for their SST decrease: Vicente had a wind-driven upwelling and mixing of the sea’s upper layer, whereas Kai-tak had a much stronger wind-driven vertical turbulent mixing, resulting in whole-layer mixing and less cooling than Vicente.

Significance Statement

The energy exchanges of air–land and air–sea during a typhoon landfall remain unclear. To investigate these exchanges, we studied four typhoons using two coastal observational sites (inland and over sea). When the site has no rainfall and is far away from the typhoon center, the latent heat flux is much larger than that in the monsoon period. However, when a typhoon is closer and has high winds and rainfall, a greater variation in heat fluxes occurs with larger negative and positive values. The variation results in a small average sensible heat flux and more uncertainty in the latent heat flux. Such complex heat flux transfer over sea may be due to boundary layer rolls and sea spray during a typhoon with rainfall.
Real-Time Simulated Storm Surge Predictions during Hurricane Michael (2018)
Authors: Bilskie M. V. , Asher T. G. , Miller P. W. , Fleming J. G. , Hagen S. C. , Luettich Jr. R. A.
Published: April 2022

Storm surge caused by tropical cyclones can cause overland flooding and lead to loss of life while damaging homes, businesses, and critical infrastructure. In 2018, Hurricane Michael made landfall near Mexico Beach, Florida, on 10 October with peak wind speeds near 71.9 m s−1 (161 mph) and storm surge over 4.5 m NAVD88. During Hurricane Michael, water levels and waves were predicted near–real time using a deterministic, depth-averaged, high-resolution ADCIRC+SWAN model of the northern Gulf of Mexico. The model was forced with an asymmetrical parametric vortex model [generalized asymmetric Holland model (GAHM)] based on Michael’s National Hurricane Center (NHC) forecast track and strength. The authors report errors between simulated and observed water level time series, peak water level, and timing of peak for NHC advisories. Forecasts of water levels were within 0.5 m of observations, and the timing of peak water levels was within 1 h as early as 48 h before Michael’s eventual landfall. We also examined the effect of adding far-field meteorology in our TC vortex model for use in real-time forecasts. In general, we found that including far-field meteorology by blending the TC vortex with a basin-scale NWP product improved water level forecasts. However, we note that divergence between the NHC forecast track and the forecast track of the meteorological model supplying the far-field winds represents a potential limitation to operationalizing a blended wind field surge product. The approaches and data reported herein provide a transparent assessment of water level forecasts during Hurricane Michael and highlight potential future improvements for more accurate predictions.
Development and Validation of the Secondary Victimization Scale
Authors: Tavares Suiane M. , Pimentel Carlos E. , Paiva Tamyres T. , Pereira Cicero R.
Published: April 2022

Sexual violence is ubiquitous in the history of human relationships, with the victim being perceived as responsible for their own misfortune. This phenomenon is labelled secondary victimization and is manifested in blaming, minimizing the suffering, and avoiding the victim. This article presents evidence of the validity of a scale that measures individual differences in these three types of secondary victimization of rape victims. In Study 1, we developed the scale items and analyzed their content validity. In Study 2, we carried out an exploratory analysis of its factorial structure and verified the set-up of the items in three theoretically predicted factors (blaming, minimizing the suffering, and avoiding the victim), which had convergent validity with the Rape Myth Acceptance Scale, and discriminant validity with the Big Five Personality Traits, in addition to having concurrent validity with the Belief in a Just World Scale (BJWS). In Study 3, we confirmed this tri-factor structure using confirmatory analysis. In Study 4, we analyzed the predictive validity of the Secondary Victimization Scale (SVS), proposing the hypothesis that secondary victimization mediates the effect of BJWS on the participants' behavior towards a rape victim. The summary of the results shows consistent evidence of the SVS’s validity.
New and effective method to develop primary hepatocytes from liver cancer patients
Authors: Li Jia-yan , Wang Li-li , Fan Jing , Liu Du-xian , Han Jian-bo , Zhang Yu-feng , Yin Dan-dan , Yi Yong-xiang
Published: April 2022

Liver cancer (LC) is one of the most common malignant tumors worldwide. Since the mechanism of LC pathogenesis and metastasis cannot be carried out directly on the human body, it is particularly important to establish human liver cancer cell lines for research in vitro. In this study, tissue block adherence method combined with cell clumps digestion method was used to establish primary human hepatocytes (PHHs) with a successful rate of 60% (45/75). Short tandem repeat (STR) analysis proved the cells were derived from its paired tissues. These cells from hepatocellular carcinoma (HCC) expressed NTCP and secreted ALB and AAT as detected by western blot, and expressed hepatocyte-specific membrane protein ASGR1 as detected by flow cytometry. Liver cancer biomarkers like CK7 in ICC (intrahepatic cholangiocarcinoma), AFP, and GPC3 in HCC expressed of different degree as detected by immunohistochemical analysis. These cells displayed typical liver cancer cell morphological characteristics and can passage stably. In conclusion, we developed an effective method to establish PHHs. Further studies are necessary to study if these cells maintaining other liver function and reproduce the physiology of the tumors and how these cells behavior in the drug development.
Near Total/Total Lower Lip Reconstruction—Chin Rotation Advancement Flap
Authors: Abu-Jabal Amin , Joachim Michael V. , Bitterman Nir , El Naaj Imad Abu
Published: April 2022

Summary: Total lower lip reconstruction is a challenging reconstruction procedure. Its main role is to restore lip function, maintain the proper relationship between the upper and lower lips and optimize cosmesis. Various techniques ranging from local flaps to free tissue transfer have been developed. For patients who are not candidates for microsurgical techniques or for those who do not want complex procedures, the local flap technique is a good solution. Most of the reported techniques, based on cheek advancement and nasolabial flaps, lead to scars located in the midface and therefore to unaesthetic results. We hereby present a novel technique for total lower lip reconstruction using a rotation advancement flap based on the excess tissue of the lower face. To our knowledge, this method has not been described previously in the literature.
Risk of vaso-occlusive episode after exposure to corticosteroids in patients with sickle cell disease
Authors: Walter Ondine , Cougoul Pierre , Maquet Julien , Bartolucci Pablo , Lapeyre-Mestre Maryse , Lafaurie Margaux , Moulis Guillaume
Published: April 2022

Vaso-occlusive episodes (VOEs) are a major concern in patients with sickle cell disease (SCD). Exposure to systemic corticosteroids has been suspected to increase the occurrence of VOEs in case reports or series. No comparative study has been conducted to investigate this risk, which is still debated. Several clinical trials demonstrated the effectiveness of corticosteroids for the treatment of VOEs, but with increased rates of readmission. The aim of the study was to assess the risk of hospitalization for VOE associated with exposure to systemic corticosteroids in patients with SCD. We used a case-case-time-control design in a nationwide population-based cohort built in the French national health insurance database between 2010 and 2018. The population included all patients with SCD with at least 1 hospitalization for VOE. Corticosteroids were identified using out-of-hospital dispensing data. The outcome was the first hospitalization for VOE. The case-case-time-control design induces self-adjustment for time-invariant confounders, including genotype. Analyses were adjusted for time-dependent confounders (infections, red blood transfusions) and stratified by exposure to hydroxyurea. Overall, 5151 patients were included in the main analysis. Corticosteroid exposure was significantly associated with the occurrence of hospitalizations for VOEs: adjusted odds ratio, 3.8; 95% confidence interval [CI], 2.4-5.6). In patients exposed to hydroxyurea, the adjusted odds ratio was 2.6 (95% CI, 1.1-6.4); it was 4.0 (95% CI, 2.5-6.3) in unexposed patients. These results were consistent in children and adults. In conclusion, systemic corticosteroids were associated to an increased risk of hospitalization for VOEs and should be limited in patients with SCD.
Cardiopulmonary ultrasound correlates of pleural effusions in patients with congestive heart failure
Authors: Li Hong , Chen Jian , Hu Ping-xiang
Published: April 2022

Background

Pleural effusions are common in patients with congestive heart failure. However, there is a need to assess systematically the correlation between effusion volume, extravascular lung water and echocardiographic parameters. We used combined cardiopulmonary ultrasound to evaluate the relationship between effusion volume, extravascular lung water, and echocardiographic parameters in patients with congestive heart failure.

Methods

Patients who were hospitalized for congestive heart failure underwent combined cardiopulmonary ultrasound. A semiquantitative score of pleural effusions was derived by pulmonary ultrasound and extravascular lung water was estimated by ultrasound lung comets. The measurements were compared with echocardiographic and clinical results.

Results

Among 168 patients (median age 66 years, 69.6% men), 102 (60.7%) had pleural effusions, 84.3% bilateral, 10.8% right-sided, and 4.9% left-sided. High pleural effusion scores were associated with high ultrasound lung comet scores (P < 0.0001). Compared with patients without pleural effusions, patients with pleural effusions were significantly older and had higher systolic pulmonary artery pressure (SPAP), NT-proBNP, New York Heart Association scale, larger left atrium, larger right ventricle, more severe mitral regurgitation, and worse left and right heart function. Adjusted for age, multiple logistic regression analysis showed that SPAP (OR 5.688,P = 0.006) and E/A (OR 3.941,P = 0.043) were the significant variables and risk factors associated with pleural effusions in heart failure.

Conclusion

For patients with left heart failure, the degree of pleural effusions was associated with pulmonary congestion. Elevated SPAP and E/A were the main risk factors for the formation of pleural effusions in patients with congestive heart failure.
Association of physical activity with the incidence of atrial fibrillation in persons > 65 years old: the Atherosclerosis Risk in Communities (ARIC) study
Authors: Fletcher Grace , Alam Aniqa B. , Li Linzi , Norby Faye L. , Chen Lin Y. , Soliman Elsayed Z. , Alonso Alvaro
Published: April 2022

Aims

To evaluate the association of physical activity (PA) with atrial fibrillation (AF) incidence in an elderly population.

Methods

We studied 5166 participants of the Atherosclerosis Risk in Communities cohort examined in 2011–2013 free of AF. Self-reported PA was evaluated with a validated questionnaire. Weekly minutes of leisure-time moderate to vigorous physical activity (MVPA) were calculated and categorized using the 2018 Physical Activity Guidelines for Americans (no activity [0 min/week], low [> 0– < 150 min/week], adequate [150– < 300 min/week], high [≥ 300 min/week]). Incident AF through 2019 was ascertained from hospital discharges and death certificates. Cox models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for AF by levels of physical activity adjusting for potential confounders.

Results

The mean (SD) age for the sample was 75 (5) years (59% female, 22% Black). During a mean (SD) follow-up time of 6.3 (2.0) years, 703 AF events were identified. The association of MVPA with AF incidence showed a U-shaped relationship. Compared to those not engaging in MVPA, individuals with low MVPA had a 23% lower hazard of AF (HR = 0.77; 95% CI 0.61, 0.96), while those with adequate MVPA had a 14% lower hazard (HR 0.86; 95% CI 0.69, 1.06). High levels of MVPA were not associated with AF risk (HR 0.97; 95% CI 0.78, 1.20).

Conclusion

This study suggests that being involved in low to moderate levels of MVPA is associated with lower AF risk, with no evidence of increased risk of AF in those with higher levels of MVPA.
The reporting and handling of missing data in longitudinal studies of older adults is suboptimal: a methodological survey of geriatric journals
Authors: Okpara Chinenye , Edokwe Chidozie , Ioannidis George , Papaioannou Alexandra , Adachi Jonathan D. , Thabane Lehana
Published: April 2022

Background

Missing data are common in longitudinal studies, and more so, in studies of older adults, who are susceptible to health and functional decline that limit completion of assessments. We assessed the extent, current reporting, and handling of missing data in longitudinal studies of older adults.

Methods

Medline and Embase databases were searched from 2015 to 2019 for publications on longitudinal observational studies conducted among persons ≥55 years old. The search was restricted to 10 general geriatric journals published in English. Reporting and handling of missing data were assessed using questions developed from the recommended standards. Data were summarised descriptively as frequencies and proportions.

Results

A total of 165 studies were included in the review from 7032 identified records. In approximately half of the studies 97 (62.5%), there was either no comment on missing data or unclear descriptions. The percentage of missing data varied from 0.1 to 55%, with a 14% average among the studies that reported having missing data. Complete case analysis was the most common method for handling missing data with nearly 75% of the studies (n = 52) excluding individual observations due to missing data, at the initial phase of study inclusion or at the analysis stage. Of the 10 studies where multiple imputation was used, only 1 (10.0%) study followed the guideline for reporting the procedure fully using online supplementary documents.

Conclusion

The current reporting and handling of missing data in longitudinal observational studies of older adults are inadequate. Journal endorsement and implementation of guidelines may potentially improve the quality of missing data reporting. Further, authors should be encouraged to use online supplementary files to provide additional details on how missing data were addressed, to allow for more transparency and comprehensive appraisal of studies.
Integrating BRAFV600E mutation, ultrasonic and clinicopathologic characteristics for predicting the risk of cervical central lymph node metastasis in papillary thyroid carcinoma
Authors: Zhang Zheng , Zhang Xin , Yin Yifei , Zhao Shuangshuang , Wang Keke , Shang Mengyuan , Chen Baoding , Wu Xincai
Published: April 2022

Background

The advantages of prophylactic central lymph node dissection (CLND) for clinically node-negative patients remained a great deal of controversies. Our research was aimed to analyze the relationship between cervical central lymph node metastasis (CLNM) and BRAFV600E mutation, ultrasonic and clinicopathologic characterizes in papillary thyroid carcinoma (PTC).

Methods and materials

In current study, a total of 112 consecutive PTC patients who experienced thyroidectomy plus cervical central neck dissection were included in our research. All PTC were pre-operatively analyzed by ultrasonic features, including tumor size, multifocality or not, tumor location, internal components, echogenicity, microcalcification, margins, orientation, taller than wide shape, and internal vascularity. The presence of clinicopathologic factors, including age, sex, T stage, Hashimoto’s thyroiditis, and BRAFV600E mutation was then investigated. Univariate and multivariate analysis were conducted to check into the relationship between predictive factors and cervical CLNM in PTC patients, and then a predictive model was also established.

Results

Pathologically, 58.0% (65/112) of the PTC patients harbored cervical CLNM. Univariate and multivariate analysis were conducted to identify age < 55 years, tumor size > 10 mm, microcalcification, non-concomitant Hashimoto’s thyroiditis and BRAFV600E mutation were predictive factors for cervical CLNM in PTC. The risk score for cervical CLNM in PTC patients was calculated: risk score = 1.284 × (if age < 55 years) + 1.241 × (if tumor size > 10 mm) + 1.143 × (if microcalcification) – 2.097 × (if concomitant Hashimoto’s thyroiditis) + 1.628 × (if BRAFV600E mutation).

Conclusion

Age < 55 years old, PTC > 10 mm, microcalcification, non-concomitant Hashimoto’s thyroiditis and BRAFV600E mutation are predictive factors for cervical CLNM. BRAFV600E mutation by pre-operative US-FNA technology synergized with clinicopathologic and ultrasonic features is expected to guide the appropriate surgical management for PTC patients.
Can upfront DPYD extended variant testing reduce toxicity and associated hospital costs of fluoropyrimidine chemotherapy? A propensity score matched analysis of 2022 UK patients
Authors: Tsiachristas Apostolos , Vallance Grant , Koleva-Kolarova Rositsa , Taylor Harriet , Solomons Luke , Rizzo Giovanni , Chaytor Catherine , Miah Junel , Wordsworth Sarah , Hassan A. Bassim
Published: April 2022

Aim

To independently assess the impact of mandatory testing using an extended DPYD variant panel (ToxNav®) and consequent dose adjustment of Capecitabine/5-FU on recorded quantitative toxicity, symptoms of depression, and hospital costs.

Methods

We used propensity score matching (PSM) to match 466 patients tested with ToxNav® with 1556 patients from a historical cohort, and performed regression analysis to estimate the impact of ToxNav®on toxicity, depression, and hospital costs.

Results

ToxNav® appeared to reduce the likelihood of experiencing moderate (OR: 0.59; 95%CI: 0.45–0.77) and severe anaemia (OR: 0.55; 95%CI: 0.33–0.90), and experience of pain for more than 4 days a week (OR: 0.50; 95%CI: 0.30–0.83), while it increased the likelihood of mild neutropenia (OR: 1.73; 95%CI: 1.27–2.35). It also reduced the cost of chemotherapy by 12% (95%CI: 3–31) or £9765, the cost of non-elective hospitalisation by 23% (95%CI: 8–36) or £2331, and the cost of critical care by 21% (95%CI: 2–36) or £1219 per patient. For the DPYD variant associated with critical risk of toxicity (rs3918290), the improved non-elective hospital costs were > £20,000, whereas variants associated with hand-foot syndrome toxicity had no detectable cost improvement.

Conclusion

Upfront testing of DPYD variants appears to reduce the toxicity burden of Capecitabine and 5-FU in cancer patients and can lead to substantial hospital cost savings, only if the dose management of the drugs in response to variants detected is standardised and regulated.
Optical coherence tomography biomarkers in patients with macular edema secondary to retinal vein occlusion treated with dexamethasone implant
Authors: Castro-Navarro Verónica , Monferrer-Adsuara Clara , Navarro-Palop Catalina , Montero-Hernández Javier , Cervera-Taulet Enrique
Published: April 2022

Purpose

To evaluate the impact of optical coherence tomography (OCT) biomarkers on intravitreal dexamethasone (DEX) implant clinical outcomes in patients with macular edema secondary to retinal vein occlusion (RVO-ME).

Methods

Retrospective study conducted on a cohort of patients with RVO-ME, either naïve or previously treated, who underwent treatment with DEX implant and had a follow-up of 6 months. Anatomic success was defined as a central retinal thickness (CRT) < 250 μm or a relative reduction of CRT ≥10% from baseline. The primary endpoint was the mean change in CRT from baseline to month-6. Secondary end-points included changes in BCVA, the impact of baseline OCT biomarkers on functional and anatomic outcomes; and the impact of treatment on the different OCT biomarkers. OCT biomarkers associated with functional and anatomic outcomes were estimated using a logistic regression model.

Results

Fifty-seven eyes were included in the study. Baseline CRT was significantly decreased from 567.6 ± 226.2 μm to 326.9 ± 141.0 μm at month-6 (p < 0.0001). Baseline BCVA was significantly lower in the eyes with disrupted external limiting membrane (ELM) (mean 40.3 ± 21.3 letters) than in those with non-disrupted (mean 68.6 ± 10.7 letters) or partially-disrupted ELM (mean 59.6 ± 13.2 letters),p = 0.0001 andp = 0.0011, respectively. Baseline BCVA was significantly lower in eyes with > 20 hyperreflective foci (HRF) than in those with < 10 HRF (p = 0.0388). The eyes with disorganization of the retinal inner layers (DRIL) had lower baseline BCVA than those without DRIL (Hodges-Lehmann median difference: − 12.0 letters, 95% CI: − 25.0 to − 5.0 letters,p = 0.0042). At month-6, 26 (45.6%); 24 (42.1%), and 20 (35.1%) eyes achieved a BCVA improvement ≥5, ≥10, and ≥ 15 letters respectively. Forty (70.2%) eyes were classified as anatomic success at month-6. Logistic regression analysis found none factor significantly associated with success in the multivariate analysis.

Conclusions

The results of this study suggested a positive impact of DEX on CRT and BCVA in eyes with RVO-ME. No OCT-biomarkers were identified as predictors of clinical-outcomes. Additionally, presence of DRIL, presence of HRF (> 20), or disrupted ELM were significantly associated with worse baseline BCVA.
Bone quality effect on short implants in the edentulous mandible: a finite element study
Authors: Liu Chaowei , Xing Yifeng , Li Yan , Lin Yanjun , Xu Jianghan , Wu Dong
Published: April 2022

Introduction

The aim of this study was to verify whether the use of short implants could optimize stress distribution of bone surrounding implants in atrophic mandibles with different bone qualities.

Methods

A three-dimensional model of the atrophic mandible with three levels of bone quality was made using computer software. Short implants (6 mm) and standard implants (10 mm) were used in four designs: Design 1 "All-On four", Design 2 "All-On-four" with two short implants, Design 3 four vertical implants with two short implants, and Design 4 six short implants. The distal short implants were placed at the first molar position. All twelve models were imported into finite element analysis software, and 110 N oblique force was loaded on the left second premolar. Maximum principal stress values of peri-implant bone and the volumes of bone with over 3000 microstrians (overload)were analyzed.

Result

Stress values and volumes of overload bone increased in all four groups with the decline of bone quality. The highest stress values were found in the cortical bone surrounding the Design 1 inclined implant in two lower bone quality mandibles, and the lowest in Design 3. However, Design 1 had less overload bone tissue than all three designs with short implants.

Conclusion

Short implants placed posteriorly helped decrease stress values in peri-implant bone, while bone surrounding short implants had a high resorption risk in low bone quality mandible.
Knowledge, attitudes and professional practices of ortho-periodontal care of adults: a cross-sectional survey in France
Authors: Saloux Apolline , Couatarmanach Antoine , Chauvel Brice , Jeanne Sylvie , Brezulier Damien
Published: April 2022

Background

Due to increasing numbers of adult patients, orthodontists are being confronted more and more with periodontal problems. Coordination amongst orthodontists, periodontists and general dentists is useful in preventing and stopping periodontal disease. The main objectives of this survey were to evaluate the technical knowledge, techniques and attitudes employed by French orthodontists, periodontists and general dentists in adult dental care.

Methods

A cross-sectional online survey was distributed to French dentists. The questionnaire, consisting of 30 questions, was divided into six sections covering treatment programs and the forensic environment.

Results

One thousand one hundred twenty-two complete answers were recorded. Adults undergoing orthodontic treatment represented 19.9% of the orthodontists' patients, but only 2.67% of the general dentists' patients. Communication between clinicians was rated as good, greater than 3 out of 5. Before treatment, orthodontists were less alarmed than generalists regarding bleeding, recessions, increased probing depths, halitosis and hyperplasia. During treatment, orthodontists never or only occasionally performed palpation or probing in 54.2% and 84.6% of cases. Gingivitis and recessions were the main reasons for consultations for 22.0% and 20.1% of general dentists and periodontists after orthodontic treatment. Of the practitioners surveyed, 43% felt that they experienced a setback in the ortho-periodontal treatment.

Conclusions

This study revealed discrepancies in the knowledge and attitudes of practitioners. Therapeutic management remains one of the major challenges of multidisciplinary treatments. Continuing education needs to be further developed in this field.
Effect of aqueous environment on wear resistance of dental glass–ceramics
Authors: Zhang Zhenzhen , Wang Qi , Wang Fu , Li Ding , Meng Meng , Zhang Yaming , Zhang Shaofeng
Published: April 2022

Background

Wear resistance affects dental ceramics longevity and the functions of the opposing teeth. However, data for the effect of aqueous environment on wear resistance of dental ceramics are lacking. This study evaluated the effect of aqueous environment on wear resistance of typical dental glass–ceramics.

Methods

Disk specimens were prepared from lithium disilicate glass–ceramics (LD) and leucite reinforced glass–ceramics (LEU). The disk specimens paired with steatite antagonists were tested in a pin-on-disk tribometer under both wet and dry conditions with 10 N up to 500,000 wear cycles. The wear analysis of glass–ceramics was performed using a 3D profilometer after 100,000, 300,000 and 500,000 wear cycles. Wear morphologies were analyzed by employing scanning electron microscopy (SEM). The crystalline compositions of specimens stored in a dry environment and subsequently immersed in distilled water for 40 h were separately determined using X-ray diffraction (XRD). The chemical states of the wear surfaces for LD were analyzed by X-ray photoelectron spectroscopy (XPS). The data analysis and multiple pair-wise comparisons of means were performed by using one-way analysis of variance (ANOVA) and Tukey’s post-hoc test.

Results

LEU in a wet environment exhibited less wear volume loss than that in a dry environment (p < 0.05). The volume loss of LD in a wet environment was higher than that in a dry environment (p < 0.05). The wear volumes of steatite antagonists paired with two glass–ceramics under dry conditions were higher than under wet conditions.

Conclusions

XPS spectra of LD under wet conditions indicated that high wear loss might result from the effect of stress corrosion by water and reaction of water with the ionic-covalent bonds at the crack tip. XPS spectra and SEM images of LD under dry conditions showed a possible formation of tribofilm. Within the limitations of this in vitro study, water was wear-friendly to LEU and all opposing steatites but aggravated wear for LD.
Foot-related diabetes complications: care pathways, patient profiles and costs
Authors: Kurkela Olli , Nevalainen Jaakko , Arffman Martti , Lahtela Jorma , Forma Leena
Published: April 2022

Background

Foot-related diabetes complications reduce individual well-being, increase mortality and results in increased healthcare costs. Despite their notable stress on health services, studies examining the foot complication care pathways, especially from the viewpoint of health services, are limited. We aimed to identify the most typical care pathways following an initial foot-related diabetes complication, to characterize the patients on each pathway and calculate the related healthcare costs.

Methods

The identification of pathways was based on population-wide register-based data including all persons diagnosed with diabetes in Finland from 1964 to 2017. For each patient, initial foot-related complication from 2011–2016 was identified using the ICD-10 codes and related healthcare episodes were followed for two years until the end of 2017 or death. A sequence analysis was conducted on care episodes resulting in groups of typical care pathways, as well as their patient profiles. The costs of pathways resulting from the care episodes were calculated based on the data and the reported national unit costs and analyzed using linear models.

Results

We identified six groups of typical pathways each comprising mainly single type of care episodes. Three of the groups comprised over 10 000 patients while the remaining groups ranged from a few hundred to a few thousand. Majority of pathways consisted only single care episode. However, among the rest of the care pathways variability in length of care pathways was observed between and within group of pathways. On average, the patients were over 65 years of age and were diagnosed with diabetes for over a decade. The pathways resulted in an annual cost of EUR 13 million. The mean costs were nearly 20-fold higher in the group with the highest costs (EUR 11 917) compared to the group with the lowest costs (EUR 609).

Conclusions

We identified groups of typical care pathways for diabetic foot and discovered notable heterogeneity in the resource use within the groups. This information is valuable in guiding the development of diabetes care to meet the growing need. Nevertheless, reasons underlying the observed heterogeneity requires further examination. Since foot complications are largely preventable, substantial savings could be achieved using cost-effective technologies and more efficient organization of care.
A proof of concept for continuous, non-invasive, free-living vital signs monitoring to predict readmission following an acute exacerbation of COPD: a prospective cohort study
Authors: Hawthorne Grace , Richardson Matthew , Greening Neil J. , Esliger Dale , Briggs-Price Samuel , Chaplin Emma J. , Clinch Lisa , Steiner Michael C. , Singh Sally J. , Orme Mark W.
Published: April 2022

Background

The use of vital signs monitoring in the early recognition of an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) post-hospital discharge is limited. This study investigated whether continuous vital signs monitoring could predict an AECOPD and readmission.

Methods

35 people were recruited at discharge following hospitalisation for an AECOPD. Participants were asked to wear an Equivital LifeMonitor during waking hours for 6 weeks and to complete the Exacerbations of Chronic Pulmonary Disease Tool (EXACT), a 14-item symptom diary, daily. The Equivital LifeMonitor recorded respiratory rate (RR), heart rate (HR), skin temperature (ST) and physical activity (PA) every 15-s. An AECOPD was classified as mild (by EXACT score), moderate (prescribed oral steroids/antibiotics) or severe (hospitalisation).

Results

Over the 6-week period, 31 participants provided vital signs and symptom data and 14 participants experienced an exacerbation, of which, 11 had sufficient data to predict an AECOPD. HR and PA were associated with EXACT score (p < 0.001). Three days prior to an exacerbation, RR increased by mean ± SD 2.0 ± 0.2 breaths/min for seven out of 11 exacerbations and HR increased by 8.1 ± 0.7 bpm for nine of these 11 exacerbations.

Conclusions

Increased heart rate and reduced physical activity were associated with worsening symptoms. Even with high-resolution data, the variation in vital signs data remains a challenge for predicting AECOPDs. Respiratory rate and heart rate should be further explored as potential predictors of an impending AECOPD.

Trial registration: ISRCTN registry; ISRCTN12855961. Registered 07 November 2018—Retrospectively registered, https://www.isrctn.com/ISRCTN12855961
Successful use of dalbavancin in the treatment of gram positive blood stream infections: a case series
Authors: Evins Connor , Lancaster Harrison , Schnee Amanda E.
Published: April 2022

Background

Dalbavancin is a semisynthetic antibiotic used as an alternative to vancomycin for skin infections and osteomyelitis. Its long half-life decreases length of hospitalizations. This study analyzes the effectiveness of Dalbavancin for bacteremia and infective endocarditis.

Methods

The authors performed a retrospective chart analysis on patients who received Dalbavancin due to being poor candidates for PICC placement, poor candidates for prolonged hospitalization, or who were leaving against medical advice. Their hospitalizations were analyzed and results were compiled using descriptive statistics.

Results

Our cohort had 22 patients treated with Dalbavancin for bacteremia and 1 for endocarditis. They were treated with IV antibiotics, typically a regimen of at least vancomycin and a cephalosporin, for a median of 6.5 days prior to receiving Dalbavancin. 20 received one dose, while three received two doses. 22 had confirmed culture clearance and one denied repeat culture. There were no reported side effects from the medication, no readmissions for worsened infection, and no deaths from the infection. 15 patients had follow-up visits within 90 days.

Conclusions

Overall, patients responded well. The lack of readmission to the hospital indicates possible outpatient treatment. This would help decrease cost and comorbidities of long-term hospital stays. These positive results are limited by small sample size and treatment of other antibiotics prior to receiving Dalbavancin. Further research is required to accurately estimate the efficacy of Dalbavancin on bloodstream infections and endocarditis, but these results are promising especially for patients who are not candidates for long term hospitalization or outpatient IV access.
Knowledge and experience of Kazakhstan athletes in anti-doping and the impact of past educational intervention
Authors: Zhumabayeva Galiya , Kapanova Gulnara , Vinnikov Denis , Bakasheva Maira , Abdulla Venera , Grjibovski Andrej
Published: April 2022

Background

Although Kazakhstan National Anti-Doping Organization (KazNADO) exists since 2013, but little is yet known about anti-doping (AD) knowledge of Kazakhstan athletes. The aim of this study was to assess the AD education knowledge level and experience among Kazakhstan athletes, as well as the impact of any past AD educational program on them.

Methods

Altogether, 590 athletes (the median was age 17 years (interquartile range 8)), representing various sports, participated in the web-based study and completed the questionnaire, which consisted of socio-demographic part and ALPHA test. We assessed the association of any past AD education and experience with anti-doping knowledge using adjusted regression models.

Results

A total of 54.6% participants underwent doping control and 82,7% of athletes received AD education at least once. More than 300 participants (50.8%) provided correct answers for 10 questions. Age and years in sports (competition duration) were significantly associated with the ALPHA scores of athletes. Athletes who received AD education more than once in the past had significantly higher ALPHA scores than non-AD educated athletes in most questions.

Conclusion

AD education was associated with AD knowledge. Further research is needed to identify the adherence to anti-doping knowledge.
Large-scale discovery of novel neurodevelopmental disorder-related genes through a unified analysis of single-nucleotide and copy number variants
Authors: Hamanaka Kohei , Miyake Noriko , Mizuguchi Takeshi , Miyatake Satoko , Uchiyama Yuri , Tsuchida Naomi , Sekiguchi Futoshi , Mitsuhashi Satomi , Tsurusaki Yoshinori , Nakashima Mitsuko , Saitsu Hirotomo , Yamada Kohei , Sakamoto Masamune , Fukuda Hiromi , Ohori Sachiko , Saida Ken , Itai Toshiyuki , Azuma Yoshiteru , Koshimizu Eriko , Fujita Atsushi , Erturk Biray , Hiraki Yoko , Ch’ng Gaik-Siew , Kato Mitsuhiro , Okamoto Nobuhiko , Takata Atsushi , Matsumoto Naomichi
Published: April 2022

Background

Previous large-scale studies of de novo variants identified a number of genes associated with neurodevelopmental disorders (NDDs); however, it was also predicted that many NDD-associated genes await discovery. Such genes can be discovered by integrating copy number variants (CNVs), which have not been fully considered in previous studies, and increasing the sample size.

Methods

We first constructed a model estimating the rates of de novo CNVs per gene from several factors such as gene length and number of exons. Second, we compiled a comprehensive list of de novo single-nucleotide variants (SNVs) in 41,165 individuals and de novo CNVs in 3675 individuals with NDDs by aggregating our own and publicly available datasets, including denovo-db and the Deciphering Developmental Disorders study data. Third, summing up the de novo CNV rates that we estimated and SNV rates previously established, gene-based enrichment of de novo deleterious SNVs and CNVs were assessed in the 41,165 cases. Significantly enriched genes were further prioritized according to their similarity to known NDD genes using a deep learning model that considers functional characteristics (e.g., gene ontology and expression patterns).

Results

We identified a total of 380 genes achieving statistical significance (5% false discovery rate), including 31 genes affected by de novo CNVs. Of the 380 genes, 52 have not previously been reported as NDD genes, and the data of de novo CNVs contributed to the significance of three genes (GLTSCR1, MARK2, and UBR3). Among the 52 genes, we reasonably excluded 18 genes [a number almost identical to the theoretically expected false positives (i.e., 380 × 0.05 = 19)] given their constraints against deleterious variants and extracted 34 “plausible” candidate genes. Their validity as NDD genes was consistently supported by their similarity in function and gene expression patterns to known NDD genes. Quantifying the overall similarity using deep learning, we identified 11 high-confidence (> 90% true-positive probabilities) candidate genes: HDAC2, SUPT16H, HECTD4, CHD5, XPO1, GSK3B, NLGN2, ADGRB1, CTR9, BRD3, and MARK2.

Conclusions

We identified dozens of new candidates for NDD genes. Both the methods and the resources developed here will contribute to the further identification of novel NDD-associated genes.
Virulence and phylogenetic groups of Escherichia coli cultured from raw sewage in Kuwait
Authors: Redha Mahdi A. , Al Sweih Noura , Albert M. John
Published: April 2022

In Kuwait, some untreated sewage is discharged into the sea which poses health risks. Therefore, we determined the virulence traits and the phylogenetic groups of E. coli cultured from raw sewage. Sewage was collected once every month for 12 months with culturing of a total of 140 E. coli isolates. E. coli was typed by the methods of Clermont. The five pathotypes of diarrheagenic E. coli (DEC), and extra-intestinal pathogenic E. coli (ExPEC) were detected by specific PCR assays. Four virulence genes which correlate with pathogenicity in animal models, were used for the first time for detection of ExPEC—vat (vacuolating auto-transporter toxin), fyuA (yersiniabactin receptor), chuA (heme-binding protein), and yfcV (major subunit of putative chaperon-usher fimbria). Most E. coli belonged to phylogenetic groups A (65[45%]) and B1 (34[24.3%]). Three (2.1%) isolates were DEC, while 14 (10%) isolates were ExPEC mostly in group B2 (57.1%). A relatively high prevalence of ExPEC in sewage has public health implications.