bluuebunny/crossref_metadata_2025 huggingface dataset:
A STUDY OF LIPID PROFILE BEFORE AND AFTER CORONARY ARTERY BYPASS GRAFTING
Authors: Ooi M , Cooper A , Lloyd G , Jackson G
Published: April 2023

SUMMARY This study was undertaken to establish the variability in the levels of total cholesterol (TC), total triglyceride (TG), low‐density lipoprotein (LDL) cholesterol, and high‐density lipoprotein (HDL) cholesterol before and after coronary artery bypass graft (CABG) surgery, in order to determine postoperatively when an accurate assessment can be made of the lipid status. During a prospective study over 4 months, fasting venous samples were taken pre‐ and postoperatively on day 5, and in the 4th, 8th and 12th weeks. Ninety‐six patients admitted to the cardiothoracic and cardiac wards for CABG were recruited to the study. The mean preoperative levels were: TC 5.94 (± 0.1 mmol/l), LDL cholesterol 4.02 (± 0.09mmol/l) and HDL cholesterol 1.00 (± 0.03mmol/l). These were significantly different (p<0.01) from the levels on the 5th postoperative day when the mean level of TC was 4.14 (± 0.084mmol/l), LDL cholesterol was 2.45 (± 0.07mmol/l) and HDL cholesterol was 0.74 (±0.03mmol/l). By the 4th postoperative week, mean TC (5.73±0.13mmol/l), LDL cholesterol (3.79 ±0.14mmol/l) and HDL cholesterol (1.03 ± 0.04mmol/l) did not vary significantly from the mean preoperative values. There was no significant difference in the mean TG levels pre‐ and postoperatively. The mean TC, LDL cholesterol and HDL cholesterol rise to preoperative levels by the 4th week after CABG. Thus, an accurate assessment of patients' lipid status can be made from this period. An earlier postoperative assessment may be falsely reassuring.
THE EPIDEMIOLOGY OF OSTEOPOROSIS
Authors: Dennison E , Cooper C
Published: April 2023

SUMMARY Osteoporosis is a skeletal disorder characterised by low bone mass and an increased susceptibility to fracture. The last two decades have seen an increase in our understanding of the epidemiology of fractures at the three most frequent sites (the hip, wrist and vertebral body). These new insights have led to the delineation of preventive strategies against these fractures for both the general population, and those individuals at highest risk. This review covers these descriptive epidemiological characteristics, as well as approaches to prevention.
SODIUM PICOSULPHATE COMPARED WITH POLYETHYLENE GLYCOL SOLUTION FOR LARGE BOWEL LAVAGE: A PROSPECTIVE RANDOMISED TRIAL
Authors: Hamilton D , Mulcahy D , Walsh D , Farrelly C , Tormey WP , Watson G
Published: April 2023

SUMMARY Mechanical efficiency, patient acceptability and minimal biochemical perturbation are important factors in the choice of lavage solution for bowel preparation. This prospective randomised trial of 59 patients compared a polyethylene glycol bowel lavage solution (Klean Prep) to a sodium picosulphate solution (Picolax) considering their efficacy from both colonoscopists' and radiologists' points of view, patient acceptibility, and plasma biochemical changes. The sodium picosulphate solution was more acceptable to patients than the polyethylene glycol, and resulted in significantly less nausea and vomiting (p=0.0025), and far fewer consumption difficulties (p<0.0001). Mean plasma biochemical changes were significantly different for magnesium (p<0.001), chloride (p<0.01) and potassium (p<0.02). Because neither lavage solution displayed a marked advantage for the colonoscopist or radiologist, and sodium picosulphate was more acceptable to patients, sodium picosulphate is the preferred solution for bowel preparation. The changes in plasma biochemistry values are unlikely to cause clinical problems.
ERECTILE DYSFUNCTION: CARDIOVASCULAR RISK AND THE ROLE OF THE CARDIOLOGIST
Authors: Solomon H , Man J , Wierzbicki AS , O'Brien T , Jackson G
Published: April 2023

Erectile dysfunction (ED) shares the same risk factors as coronary artery disease, so the level of occult cardiovascular risk in men with ED was assessed. A total of 174 men presenting with ED underwent cardiac risk stratification according to the Princeton Consensus Guidelines. Thirty per cent were stratified as intermediate/high cardiovascular risk and had ED treatment deferred until further cardiological assessment; 37% had abnormal lipid profiles; 24% had elevated HbA1C/glucose levels; 17% had uncontrolled hypertension; and 6% were suspected of having significant angina. ED is associated with a high incidence of occult cardiovascular disease. We suggest that cardiologists can significantly contribute to the management of ED.
LEFLUNOMIDE
Authors: Cohen SB , Iqbal I
Published: April 2023

Leflunomide (Arava) was approved for the treatment of rheumatoid arthritis by the regulatory authorities in the US and Europe in 1998. This approval was based on three pivotal randomised clinical trials conducted in the US and Europe. This report will focus on the use of leflunomide in rheumatoid arthritis based on the data from these trials as well information on the efficacy and safety learned from post release clinical experience.
GROWTH CHARTS FOR CHILDREN WITH DOWN'S SYNDROME IN SAUDI ARABIA: BIRTH TO 5 YEARS
Authors: Al Husain M
Published: April 2023

The objective was to construct growth charts for Saudi children under 5 years of age with Down's syndrome (DS). A prospective cross‐sectional survey of anthropometrics standards (weight, height, head circumference and weight for height) of Saudi children with DS, excluding those with associated pathology, and a group of normal children seen at King Khalid University Hospital, Riyadh, Saudi Arabia, during 2001 were studied. Both groups were compared to a reference population of American children documented by the National Center for Health Statistics/Center for Disease Control. A total of 785 children with DS and 989 normal children were studied. Growth charts for the different parameters in both sexes at each age were used to estimate seven centiles. The growth pattern for children with DS differed significantly from normal children and was characterised by short stature at most ages. Data indicated a high proportion of underweight children with DS in the first two years of life, but a clear tendency to be overweight by the age of 3 years; 54.5% of children with DS had a head circumference below −2 SD for age and sex. The results of this study accord with others indicating a genetic effect of DS on growth, and support the use of growth charts in conjunction with charts for normal children for assessing growth in DS in Saudi Arabia.
GALANTAMINE: A REVIEW OF ITS USE IN ALZHEIMER'S DISEASE AND VASCULAR DEMENTIA
Authors: Corey J‐Bloom
Published: April 2023

Dementia has the potential to become a major public health concern during this century due to increasing life expectancy and growth in the ageing population. The commonest types of dementia include Alzheimer's disease (AD), vascular dementia (VaD), and dementia with cerebrovascular components. Galantamine is the only acetylcholinesterase inhibitor that exhibits a dual mechanism of action – inhibition of acetylcholinesterase and nicotinic receptor modulation. Clinical studies demonstrate the efficacy and safety of galantamine in patients with AD, VaD, and AD with cerebrovascular components. Galantamine shows beneficial effects on cognition, global function, activities of daily living and behaviour. Adverse events observed with galantamine use are generally mild to moderate in severity, transient and gastrointestinal in nature. The dose of galantamine should be escalated to 16 and 24 mg/day at four‐week intervals to achieve maximal tolerability. Because of its unique mechanism of action, galantamine may have potential benefits over conventional enzyme‐inhibiting agents.
ANAKINRA: THE FIRST INTERLEUKIN‐1 INHIBITOR IN THE TREATMENT OF RHEUMATOID ARTHRITIS
Authors: Kary S , Burmester GR
Published: April 2023

Rheumatoid arthritis is an immunologically mediated inflammation of joints of unknown aetiology and often leads to disability. This inflammatory process may also involve extra‐articular connective tissue. New therapeutic approaches have been made by inhibition of proinflammatory cytokines, lnterleukin‐1 (IL‐1) is regarded as one of the most important mediators in the development of synovialitis. In this article, anakinra (Kineret®), the first direct antagonist to IL‐1, is discussed, in particular the efficacy and safety data from clinical trials. More than 10,000 patients have been treated with anakinra with significant improvement of inflammation and pain; the rate of radiologically visible progressive joint damage was significantly reduced. Among the adverse events, injection site reactions were most frequent, followed by a mild increase in infections. No activation of tuberculosis, as in tumour necrosis factor‐α antagonist administration, has so far been reported.
LEVOSIMENDAN: A NEW DUAL‐ACTION DRUG IN THE TREATMENT OF ACUTE HEART FAILURE
Authors: Mebazaa A , Erhardt L
Published: April 2023

Levosimendan is a new agent for the treatment of acute heart failure. Levosimendan acts via complementary mechanisms; it enhances contractility by sensitising cardiac myofilaments to calcium and dilates blood vessels by opening ATP‐dependent potassium channels. In contrast to traditional inotropes (β‐agonists or phosphodiesterase inhibitors), levosimendan does not raise myocyte calcium levels and is therefore less likely to elicit arrhythmias or to impair diastolic relaxation. The clinical efficacy of levosimendan is supported by four key clinical studies, including more than 900 patients hospitalised for cardiac decompensation due to acutely worsened chronic heart failure or to heart failure following myocardial infarction. When given as short‐term therapy, levosimendan enhances cardiac output, reduces systemic vascular resistance and lowers pulmonary capillary wedge pressure. At 31 days post‐treatment, mortality rates were halved in decompensated chronic heart failure patients who received levosimendan, compared with those on dobutamine – an advantage sustained at 180 days. Similar survival gains were observed among acute failure patients treated with levosimendan following myocardial infarction. With its substantial haemodynamic and survival benefits, levosimendan is well suited to be part of routine management for patients with acutely decompensated heart failure.
COMPARISON OF ONCE‐DAILY MOMETASONE FUROATE VERSUS ONCE‐DAILY BUDESONIDE IN PATIENTS WITH MODERATE PERSISTENT ASTHMA
Authors: Corren J , Berkowitz R , Murray JJ , Prenner B
Published: April 2023

We conducted this study to compare the efficacy and safety of once‐daily mometasone furoate (MF) administered by dry powder inhaler (DPI) with once‐daily budesonide (BUD)‐DPI and placebo in patients with moderate persistent asthma previously using twice‐daily inhaled corticosteroids. A total of 262 patients (≥12 years of age) with moderate persistent asthma were randomised to once‐daily morning treatment with MF‐DPI 440 μg (metered dose), BUD‐DPI 400 μg (metered dose), or placebo in an eight‐week, multicentre, placebo‐controlled, double‐blind, double‐dummy study. The primary efficacy variable was percent change in FEV1 from baseline to endpoint (last evaluable visit). At endpoint, the percent change in FEV1 was significantly greater (p<0.01) following treatment with MF‐DPI 440 μg (8.9%) than with both BUD‐DPI 400 μg (2.1%) and placebo (−3.9%). Secondary efficacy variables, including morning and evening peak expiratory flow rates, albuterol use, percentage of asthma symptom‐free days, and physician‐evaluated response to therapy were also significantly improved at endpoint in the MF‐DPI group compared with both the placebo and BUD‐DPI groups (p<0.05). Both active treatments were well tolerated. In conclusion, once‐daily treatment in the morning with MF‐DPI 440 μg significantly improved pulmonary function and asthma control compared with morning administration of BUD‐DPI 400 μg and placebo.
PATIENTS WITH MIGRAINE PREFER ZOLMITRIPTAN ORALLY DISINTEGRATING TABLET TO SUMATRIPTAN CONVENTIONAL ORAL TABLET
Authors: Dowson AJ , Charlesworth BR
Published: April 2023

The Zolmitriptan Evaluation versus Sumatriptan Trial (ZEST) assessed patient preference for 2.5 mg zolmitriptan orally disintegrating tablet (ODT) or 50 mg sumatriptan conventional tablet in 218 patients with significant migraine disability. Significantly more patients preferred zolmitriptan ODT to sumatriptan conventional tablet (60.1% vs 39.9%; p=0.0130). In terms of efficacy, significantly more patients considered zolmitriptan ODT to be an effective migraine treatment than sumatriptan conventional tablet (77% vs 63%; p=0.0063). When asked about specific formulation attributes, significantly more patients selected zolmitriptan ODT as the least disruptive therapy (83.6% vs 16.4%), the easiest to take (85.5% vs 14.5%), the most convenient to take (86.1% vs 13.9%), and the one which enabled them to maintain an active lifestyle (65.5% vs 34.5%), compared with the sumatriptan conventional tablet (all comparisons p<0.001). Zolmitriptan ODT is a convenient and beneficial alternative to conventional tablets and is preferred to sumatriptan conventional tablets by migraineurs.
THE POTENTIAL VALUE OF ERECTILE DYSFUNCTION INQUIRY AND MANAGEMENT
Authors: Sadovsky R , Mulhall JP
Published: April 2023

Erectile dysfunction (ED) is a serious condition that becomes more common as men age. Many older men, however, report satisfactory erectile capacity and enjoy satisfying sexual relationships. Physicians have been slow to discuss ED with patients even in the presence of multiple risk factors. New information provides strong reasons for ED inquiry and management in the primary care physician's office. The presence of ED can reveal as yet undiscovered neurovascular and Psychological disorders including diabetes, hypertension, dyslipidaemia, depression and anxiety as well as early neuromuscular disorders. By inquiring about ED, physicians can better decrease iatrogenic sexual dysfunction caused by certain commonly used medications. The successful management of ED, made much easier by the development of phosphodiesterase type 5 inhibitors, has additional potential benefits including improvement of quality of life for both the patient and his Partner; decreasing the symptoms of depression in depressed men who also have ED; improving relationships, a significant factor related to good health; and enhancing overall patient health. Other potential values for the physician include a better clinician‐patient and increased physician work satisfaction. Primary care physicians need to recognise the value of ED inquiry and management and integrate these activities into practice.
THE IMPACT OF IMPLEMENTING THE OTTAWA ANKLE RULES ON ANKLE RADIOGRAPHY REQUESTS IN A&E
Authors: Gwilym SE , Aslam N , Ribbans WJ , Holloway V
Published: April 2023

This audit was set up to quantify the effect of implementing the Ottawa ankle rules in a district general hospital that relies on both medical and nursing radiography requests. Data were collected prospectively on 207 patients who presented with an acute ankle injury between August 2001 and February 2002. The department's activity was recorded before and after a period of teaching on the Ottawa ankle rules. Before teaching, 71% of patients with an acute ankle injury were sent for radiography; teaching reduced this figure to 56% (p<0.05). Auditing the activity of our department enabled us to observe a significant decrease in the number of patients sent for ankle radiography following acute ankle injury. This correlates well with research in other settings. The difficulties of rationalising radiology investigations are discussed.
PLUMMER‐VINSON SYNDROME: A REPORT OF THREE CASES
Authors: Yukselen V , Karaoglu AO , Yasa MH
Published: April 2023

Plummer‐Vinson syndrome is characterised by dysphagia, anaemia, glossitis and oesophageal web. We report our findings in three patients with membranes in the upper oesophagus. All patients underwent endoscopic dilatation and iron replacement therapy, with good results. We review the literature of this syndrome.
BUDESONIDE/FORMOTEROL ADJUSTABLE MAINTENANCE DOSING REDUCES ASTHMA EXACERBATIONS VERSUS FIXED DOSING
Authors: Ställberg B , Olsson P , Jörgensen LA , Lindarck N , Ekström T
Published: April 2023

A guided, adjustable‐dosing regimen with budesonide/formoterol was investigated in asthma patients. In a randomised, open, multicentre study, 1034 patients received budesonide/formoterol (Symbicort®, Turbuhaler®,) 80/4.5 μg or 160/4.5 μg (depending on pre‐study inhaled corticosteroid dose) two inhalations twice daily for four weeks, followed by adjustable or fixed maintenance dosing for six months. Patients receiving adjustable dosing stepped down to one inhalation twice daily if symptoms were controlled and could, if symptoms worsened, step up to four inhalations twice daily for one or two weeks according to a self‐guided management plan. The primary efficacy variable was occurrence of exacerbations. Compared with fixed dosing, adjustable dosing was associated with fewer patients experiencing exacerbations (6.2% vs 9.5%, NNT 30, p<0.05), fewer daily inhalations of budesonide/formoterol (2.35 vs 3.95, p<0.001), lower costs (six‐month saving €98, p<0.001) and was similarly well tolerated. Adjustable maintenance dosing with budesonide/formoterol provides more effective asthma control than fixed dosing, and reduces costs.
EFFICACY OF RADIOFREQUENCY VOLUMETRIC TISSUE REDUCTION OF THE SOFT PALATE IN THE TREATMENT OF SNORING
Authors: Fang TJ , Li HY , Shue CW , Lee LA , Wang PC
Published: April 2023

Traditional surgery for snoring often leads to intolerable postoperative pain. A new surgical treatment radiofrequency volumetric tissue reduction (RVTR) of the soft palate, was carried out and its effect and safety in the management of snoring were evaluated. Thirty‐two patients received a single treatment of RVTR with a mean follow‐up period of 4.5 months. All patients were assessed by a questionnaire using the Snore Outcomes Survey (SOS) and the Epworth Sleepiness Scale (ESS). Postoperative pain, speech and swallowing disturbances were also evaluated. The postoperative scores of SOS and ESS all significantly improved (p<0.05). Postoperative pain, speech and swallowing disturbances were all mild 1–3 days after treatment. With the success of treatment defined as a postoperative snoring index (SI) of <3 or a reduction of the SI by >5 points by the visual analogue scale, the success rate was 81.3% in patients with a respiratory disturbance index (RDI) of <20, and 50% in those with an RDI of >20. We conclude that RVTR of the soft palate is an effective treatment for snoring, resulting in only mild postoperative discomfort. A patient whose RDI was <20 had a higher success rate with a single RVTR treatment.
THERAPEUTIC EFFECTS OF ANGIOTENSIN II INHIBITION OR BLOCKADE ON THE PROGRESSION OF CHRONIC RENAL DISEASE
Authors: Cantarovich F , Rangoonwala B
Published: April 2023

Experimental and clinical research has supported the use of angiotensin‐converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) in diabetic, hypertensive and proteinuric nephropathies. This review will evaluate the role of angiotensin II in the progression of renal damage in kidney diseases; the diagnostic value of microalbuminuria as an early clinical sign of renal damage and the possibility of preventing its further progression; the clinical results obtained with ACE inhibitors and/or ARBs in diabetic and non‐diabetic nephropathies; and the therapeutic possibilities of ACE inhibitors and ARBs in renal transplantation. Based on available clinical data, ACE inhibitors can be considered to be the gold standard in reducing and/or preventing albuminuria, and thereby decreasing the percentage of patients who will progress to end‐stage renal disease and death. Renal transplantation and chronic allograft nephropathy appear to be a promising field for the use of ACE inhibitors and ARBs.
UNINTENTIONAL RECHALLENGE RESULTING IN A CAUSATIVE RELATIONSHIP BETWEEN KETOCONAZOLE AND ACUTE LIVER INJURY
Authors: Chien R‐N , Sheen I‐S , Liaw Y‐F
Published: April 2023

We present the case of a female patient in whom acute overt hepatitis developed after 60 days of ketoconazole administration (200 mg/day). A prompt renewed hepatic injury 48 hours after an unintentional rechallenge 30 months later provided definitive evidence for a causative relationship between ketoconazole and acute liver injury. Histological examination revealed acute hepatitis with bridging hepatic necrosis. Clinicians should be aware of this cause and effect relationship between ketoconazole and acute liver injury, which can result in prompt severe acute liver injury after rechallenge.
SARCOMAS OF THE BREAST
Authors: Alabassi A , Fentiman IS
Published: April 2023

Breast sarcomas are rare lesions that can be derived from any of the mammary stromal cells. A phyllodes tumour may resemble a rapidly growing fibroadenoma but in an older age group. Behaviour ranges from benign to frankly malignant and cannot always be predicted from the histological appearance. For all the sarcomas spread is haematogenous rather than lymphatic and treatment is based on wide surgical clearance without axillary surgery. Angiosarcoma is a rare consequence of skin irradiation as part of breast conservation therapy. Fibrosarcomas have a tendency to relapse locally unless wide surgical margins have been achieved. Radiotherapy is not of value but chemotherapy can be used to palliate women with metastatic disease.
GUILLAIN‐BARRE SYNDROME ASSOCIATED WITH ACUTE NEUROBRUCELLOSIS
Authors: Namiduru M , Karaoglan I , Yilmaz M
Published: April 2023

We report the case of a 14‐year‐old girl with Guillain‐Barré syndrome associated with brucellosis due to Brucella melitensis. The diagnosis was established by the isolation of B. melitensis from her blood and by the determination of high levels of Brucella aglutinins in her sera and cerebrospinal fluid. A combination of rifampin, co‐trimoxazole and physical therapy resulted in complete healing within 30 days. Antibrucellar treatment continued for 12 weeks. This case report suggests that brucellosis should be kept in mind in the aetiology of Guillain‐Barré syndrome in the endemic areas for brucellosis, and bacteriological and serological tests for brucellosis should be performed.
Obstetrical outcomes of pregnant women 50 years and older compared to those aged 45–49 years: A systematic review and meta‐analysis
Authors: Sugai Shunya , Sekizuka Tomoyuki , Haino Kazufumi , Nonaka Taro , Sekine Masayuki , Yoshihara Kosuke , Nishijima Koji
Published: April 2023

Aim

In this review, We compared clinical characteristics of pregnant women aged 50 and older with those aged 45–49. Pregnant women ≥45 years are strongly associated with pregnancy‐related complications, such as cesarean section rate, gestational hypertension, gestational diabetes mellitus, and preterm birth. Although pregnant women ≥50 years are considered more high‐risk, differences in pregnancy outcomes between those over 45 and 50 years of age are unclear.

Methods

Our source strategy included using PubMed, the Cochrane Central Register of Controlled Trials, and Web of Science databases to include studies published between January 1, 2010 and September 30, 2022. The study population was pregnant women 50 years and older; the control group was pregnant women aged 45–49 years. Primary outcomes were cesarean section, gestational hypertension, gestational diabetes mellitus, and preterm birth. The secondary outcomes were small‐for‐gestational age, 5‐min Apgar score < 7, neonatal intensive care unit admission (as neonatal outcomes), nulliparity, assisted reproductive technology (ART), and multifetal pregnancy (as maternal backgrounds).

Results

The incidence of cesarean section, gestational hypertension, and preterm delivery was significantly higher in those 50 years and older; however, significant differences disappeared when pooled analyses were limited to singleton pregnancies. ART was significantly more likely to be used for conception of pregnant women ≥50 years. Infants of women ≥50 years were more likely to be admitted to NICUs.

Conclusions

The differences in outcomes between the two groups are obviously influenced by multiple pregnancies, therefore, reproductive medicine specialists should aim for singleton pregnancies in ART.
Fracture strength of anterior cantilever resin‐bonded fixed partial dentures fabricated from high translucency zirconia with different intaglio surface treatments
Authors: Al‐Wahadni Ahed , Dkmak Mhd Salim Fissal , Almohammed Saleh , Hatamleh Muhanad M. , Tabanjah Abedelmalek
Published: April 2023

Purpose

To compare the fracture resistance and failure modes of anterior cantilever resin‐bonded fixed partial dentures (RBFPDs) fabricated from high translucency zirconia with different intaglio surface treatments.

Materials and methods

Sound‐extracted canines (N = 50) were randomly divided into five groups (n = 10) to be restored with high translucency zirconia RBFBDs of different intaglio surface treatments. The RBFPD was designed using exocad software and fabricated using a CAM milling machine. The RBFPDs were treated differently: abrasion with 50 µm alumina particles (Group 1); abrasion with 30 µm silica‐coated alumina particles (Group 2); abrasion with silica‐coated alumina particles (30 µm) and silane application (Group 3); abrasion with silica‐coated alumina particles (30 µm) and 10‐methacryloyloxydecyl dihydrogen phosphate (10‐MDP) primer application (Group 4); abrasion with silica‐coated alumina particles (30 µm) and silane, and 10‐MDP primer application. All RBFPDs were cemented using dual‐cured resin cement. The RBFPDs underwent 6000 thermal cycles with distilled water at 5/55°C for 2 min per cycle and then mechanical cyclic loading with 1200,000 cycles of 50 N at a 1.7 Hz frequency at an angle of 135° to the abutment's long axis. Then, RBFPDs were loaded to fracture using a universal testing machine at 1 mm/min. Maximum fracture forces and failure modes were recorded. Fractured specimens and uncemented specimens were examined using a scanning electron microscope. Data was analyzed using ANOVA and Games–Howell post hoc tests at p < 0.05.

Results

Mean fracture load results showed a statistically significant difference between the research groups (p < 0.0001) and it ranged from 69.78 to 584 N. Group 4 exhibited the highest fracture load mean (p < 0.0001) which was significantly different from all other groups. Group 2 recorded a significantly higher fracture load mean than Group 3 (p = 0.029). Three modes of failure were observed: prosthesis debonding, prosthesis fracture, and abutment fracture.

Conclusions

Abrasion of zirconia surface with 30 µm silica‐coated alumina particles and application of 10‐MDP primer yielded the highest mean fracture loads of monolithic high translucency zirconia RBFPD. The mode of fracture of the RBFPDs was influenced by the type of surface treatments.
The Association Between Social Exclusion and the Feeling of Hunger
Authors: Kaneko Michihiro , Ueda Yoshiyuki , Ozaki Yuka
Published: April 2023

Social exclusion increases appetitive responses. Whether the feeling of hunger, the preceding phase of the appetitive response, is enhanced by exclusion remains unclear. To better understand the psychological mechanism behind the promotion of appetitive responses, we investigated whether the feeling of hunger is stronger after social exclusion than after inclusion. We manipulated participants' social exclusion status using a computer programmed Cyberball game in which they were either excluded or included by two other players in a ball‐tossing game. We measured hunger as a subjective experience immediately after the game. The results indicated that participants who were socially excluded reported an increased feeling of hunger compared with those who were included. It indicates that when the feeling of hunger is evoked, appetitive responses occur when people are socially excluded.
Effects of antioxidant supplementation on bone mineral density, bone mineral content and bone structure in healthy men during 60 days of 6° head‐down tilt bed rest: Results from a randomised controlled trial
Authors: Austermann Katharina , Baecker Natalie , Zwart Sara R. , Fimmers Rolf , Stehle Peter , Smith Scott M. , Heer Martina
Published: April 2023

Dietary countermeasures to mitigate detrimental spaceflight‐induced effects on bone health would alleviate the requirements and the consequences imposed by other types of countermeasures for this risk. We hypothesised that antioxidant supplementation during 60 days of 6° head‐down tilt bed rest (HDBR), an analogue of spaceflight, would have a protective effect on bone mineral density (BMD), content (BMC) and bone structure parameters. An exploratory, randomised, controlled, single‐blind intervention trial was conducted in a parallel design with 20 healthy male volunteers (age 34 ± 8 y, weight 74 ± 6 kg). The study included 14 days of baseline data collection (BDC) before bed rest, followed by 60 days of HDBR and a 14‐day recovery period. Ten subjects in the antioxidant group received a supplement (741 mg/d polyphenols, 2.1 g/d omega‐3 fatty acids, 168 mg/d vitamin E and 80 μg/d selenium) daily. Ten subjects in the control group received no supplement. The diet was consistent with dietary reference intakes, individually tailored based on the subject's bodyweight and strictly controlled. We measured whole‐body, lumbar spine and femur BMD and BMC, as well as BMD of the cortical and trabecular compartments of the distal radius and tibia, and cortical and trabecular thickness during BDC, HDBR and recovery. Data were analysed using linear mixed models. The supplementation of an antioxidant cocktail did not mitigate the deteriorating effects of HDBR on BMD, BMC and bone structure parameters. Our findings do not support a recommendation for antioxidant supplementation for astronauts.
Technological innovation, natural resources, financial inclusion, and environmental degradation in BRI economies
Authors: Ali Kishwar , Jianguo Du , Kirikkaleli Dervis , Bács Zoltán , Oláh Judit
Published: April 2023

This research aimed to examine the relationship between financial inclusion (FNI), technological innovation (TIN), and natural resources (NRS) and their impact on environmental degradation in the 45‐belt and road initiative (BRI) region from 2001 to 2018. The study utilized advanced econometric techniques, including the generalized method of moments–panel vector autoregressive, as well as traditional methods such as ordinary least squares and dynamic ordinary least squares, to examine the relationship between these factors and environmental degradation, measured by carbon footprint (CFP) and ecological footprint (EFP). The long‐run estimate confirms that NRS and FNI appear to have led to higher regional CFPs and EFP pressure. Meanwhile, the relationship with TIN, economic governance institutions (government effectiveness and regularity quality), and human capital contribute to overcoming environmental degradation and increasing environmental sustainability. The findings of this study have important implications for policymakers and central authorities in the BRI region to address environmental degradation and promote sustainable development.
Relationship between the Depth of Acetabuloplasty and Outcomes of Hip Arthroscopy in Patients with Global Pincer Femoroacetabular Impingement: Study with a Minimum Follow‐Up Period of 2 Years
Authors: Ju Xiao‐Dong , He Zi‐Yi , Dang Han‐Han , Zhang Xin , Zhang Zhu , Xu Yan , Huang Hong‐Jie , Wang Jian‐Quan
Published: April 2023

Objective

There has been no definite consensus on the ideal depth of acetabuloplasty, especially in cases of global pincer femoroacetabular impingement (FAI). This study aims to determine whether the depth of acetabuloplasty influences postoperative outcomes in cases of global pincer FAI.

Methods

Data were retrospectively collected from patients with global pincer FAI who underwent hip arthroscopy with a minimum follow‐up period of 2 years from May 2014 to December 2018. Patients with global pincer FAI were subdivided into low or high resection depth groups based on whether the intraoperative acetabular rim was resected by more than 3 mm. Radiographic measurements; arthroscopic procedures; preoperative and postoperative PROs were recorded. Achievement of MCID and PASS was compared for the VAS, mHHS, HOS‐ADL, and iHOT‐12. A paired Student t‐test was used to evaluate the significance of preoperative and postoperative PROs and two‐tailed unpaired Student t‐test was used to compare demographic data and PROs between different groups. MCID and PASS were evaluated using the chi‐square test or the Fisher's exact test.

Results

A total of 41 hips with global pincer FAI (15 and 26 patients in low or high resection depth groups, respectively) were included in this study. Both groups showed significant postoperative improvements in the scores of all PROs (p < 0.001). Compared to the low resection depth group, the high resection depth group had a lower degree of improvement through hip arthroscopy, which manifested as lower postoperative mHHS scores (94.29 vs. 85.08, p = 0.006), higher VAS scores (0.93 vs. 2.54, p = 0.002), and lower improvements in VAS (−5.00 vs. −3.35, p = 0.028), HOS‐ADL (34.99 vs. 23.90, p = 0.017) and iHOT‐12 (39.89 vs. 29.27, p = 0.036). Patients in high resection depth group were less likely to achieve the MCID for the VAS score compared to low resection depth group in significant (73.3 vs. 26.9%, p = 0.004).

Conclusions

For patients with global pincer, the outcomes in high resection depth group were slightly worse than the the low resection depth group. It is indicated that excessive resection of the acetabular rim during the procedure should be avoided.
Multiple Hemivertebrae: The Natural History and Treatment of 50 Patients
Authors: Hu Bowen , Wang Linnan , Song Yueming , Yang Xi , Liu Limin , Zhou Chunguang
Published: April 2023

Objective

Multiple hemivertebrae (MHV) is defined as three or more hemivertebrae, and is relatively uncommon among patients with congenital scoliosis. This study aimed to compare the natural history of different kinds of MHV and describe the surgical outcome of MHV.

Methods

In this retrospective cohort study, a total of 50 patients diagnosed with MHV were enrolled from June 2007 to June 2018. The medical records and radiographs of these patients were reviewed to summarize the characteristics of MHV. Patients with MHV were divided into the unbalanced (UB) group, partially unbalanced (PUB) group, and completely balanced (CB) group. Medical records and radiographs of MHV patients were reviewed to collect HV position, natural history, coronal and sagittal parameters. A Mann–Whitney U test was used to compare the radiographical data, such as the cobb angle of main curve and secondary curve, and Fisher's exact test was used to compare the patients in different kinds of MHV with surgical indication or not.

Results

The average number of hemivertebrae was 3.6 and the average main curve was 57.5°. Twenty‐four of 50 patients had associated anomalies, including four patients with sacral agenesis, one with tetralogy of Fallot, two with congenital imperforate anus, and 17 with Klippel‐Feil syndrome. In 22 patients who underwent MRI imaging, three patients had mild syringomyelia and three patients had diastematomyelia. The UB and PUB groups had a larger main curve and compensatory curve than the CB group. Of the 25 patients with follow‐up before surgery, the curve progression rate was highest in the UB group (12.1°/year) but similar in the PUB group (4.2°/year) and CB group (3.6°/year). All patients in the UB and PUB group met the criteria for surgery. In contrast, only 10 of 23 patients in the CB group had surgical indications. Eighteen of the 37 patients with surgical indications chose to undergo surgery and the correction rate of the main curve was 51.4%.

Conclusions

Early surgical intervention should be considered for most patients with UB or PUB MHV. For patients with CB MHV, surgical treatment may not be urgently needed at the first visit. Posterior hemivertebrectomy could be used for the treatment of MHV with satisfying radiographic outcome.
COVID‐19 Policy Interventions and Fertility Dynamics in the Context of Pre‐Pandemic Welfare Support
Authors: Plach Samuel , Aassve Arnstein , Cavalli Nicolò , Mencarini Letizia , Sanders Seth
Published: April 2023

This paper focuses on nonpharmaceutical interventions (NPIs) to explain fertility dynamics during the pandemic, while considering countries’ institutional context. We argue that containment policies disrupted people's lives and increased their uncertainty more in countries with weak welfare support systems, while health‐related and economic support NPIs mitigated such disruptions much more there, as they were less expected by citizens. We estimate monthly “excess” crude birth rates (CBRs) and find that countries with low public support—Southern Europe, East Asia, and Eastern Europe—experienced larger decreases and less of a rebound in CBRs than countries with histories of high public spending—Western, Central, and Northern Europe. However, in low support countries, NPIs are much more strongly associated with excess CBRs—containment NPIs more negatively and health and economic support NPIs more positively—with the exception of the one‐month lag of containment NPIs, for which the opposite holds. When putting these coefficients into broader perspective, our findings suggest that the actual implementation of all NPIs taken together mitigated fertility declines. This is especially the case for low public support countries, whereas one might have seen a birth decline even in high support countries if the NPIs were not implemented.
The EU43 genotype of Phytophthora infestans displays resistance to mandipropamid
Authors: Abuley Isaac K. , Lynott James S. , Hansen Jens G. , Cooke David E. L. , Lees Alison K.
Published: April 2023

Mandipropamid is an active ingredient in the carboxylic acid amide group of fungicides and plays a key role in current potato late blight (Phytophthora infestans) management programmes. However, reports from Danish potato growers in 2022 suggested that mandipropamid had lost its efficacy. A study was therefore conducted to investigate the sensitivity of isolates collected from fields in which mandipropamid had been reported to be ineffective. Seventy‐two isolates of P. infestans collected from potato fields in Denmark were genotyped using microsatellite markers, revealing a dominance of the clonal lineage EU43 and fewer isolates of EU41 and ‘other’ genetically distinct genotypes. Isolates belonging to the EU43 and EU41 lineages were selected, in addition to representative isolates of clones EU36 and EU37 from Scotland, and tested for sensitivity to mandipropamid at five concentrations ranging from 0.1 to 10 μg/mL on potato leaf discs (cultivar Maris Piper). The EU43 genotype infected leaf discs at all tested concentrations, and therefore no dose–response curve could be calculated. A dose response was observed for isolates of genotypes EU36, EU37 and EU41 with EC50 values ranging from 0.35 to 0.75 μg/mL. Field experiments confirmed resistance of tested isolates of genotype EU43 to mandipropamid, with no significant difference in the area under the disease curve between the untreated and mandipropamid treatments. Analysis of the Danish population of P. infestans showed that EU43 was widely distributed across the country. To our best knowledge, this is the first report of resistance to mandipropamid in P. infestans.
DNase analysed by a novel competitive assay in patients with complications after ChAdOx1 nCoV‐19 vaccination and in normal unvaccinated blood donors
Authors: Fagerhol Magne Kristoffer , Schultz Nina Haagenrud , Mirlashari Mohammad Reza , Wiedmann Markus Karl Hermann , Nissen‐Meyer Lise Sofie Haug , Søraas Arne Vasli Lund , Hetland Geir
Published: April 2023

Increased levels of neutrophil extracellular traps (NETs) have been detected in individuals with vaccine complications after the ChAdOx1 nCov vaccine with a correlation between the severity of vaccine side effects and the level of NETosis. DNases may disrupt NETs by degrading their content of DNA, and a balance has been reported between NETs and DNases. Because of this and since the inflammatory marker NETs may be used as a confirmatory test in diagnosing VITT, it is of interest to monitor levels of DNase in patients with increased NETs levels. The current novel rapid DNase ELISA was tested in blood samples of patients with known increased levels of NETs with or without VITT after ChAdOx1 nCoV‐19 vaccination. DNase levels in VITT patients were significantly increased compared with normal unvaccinated blood donors and compared with patients with post‐vaccination symptoms but not VITT. However, since EDTA was found to inhibit DNase, serum and not EDTA‐plasma samples should be applied for DNase testing. The novel DNase assay may serve as a supplementary test to the NETs test when analysing samples from patients with suspected increased NETs levels.
Effects of high‐intensity interval training on trajectories of gas‐exchange measures and blood lactate concentrations during cardiopulmonary exercise tests in cardiac rehabilitation—A randomized controlled trial
Authors: Heber Stefan , Gleiss Andreas , Kuzdas‐Sallaberger Marina , Hausharter Maria , Matousek Melanie , Ocenasek Helmuth , Fischer Beatrix , Volf Ivo , Pokan Rochus
Published: April 2023

Background

The optimal allocation of training time to different intensities in cardiac rehabilitation is still under debate. The objective of this study was to explore whether in a 12‐week cardiac rehabilitation program, replacement of two of four usual continuous endurance training (CET) sessions per week with energy expenditure‐matched high‐intensity interval training (HIIT) affects the trajectories of cardiopulmonary exercise test (CPET) variables such as ventilatory equivalents for O2 (EqO2) and CO2 (EqCO2), and blood lactate (BLa) during CPET.

Methods

Eighty‐two male patients undergoing outpatient cardiac rehabilitation after an acute coronary syndrome were randomized to CET (age [mean ± SD] 61.7 ± 9.8 years, body mass index [BMI] 28.1 ± 3.4) or HIIT+CET (60.0 ± 9.4 years, BMI 28.5 ± 3.5). CPET was performed at baseline, after 6 and after 12 weeks. HIIT consisted of ten 60‐s bouts of cycling at an intensity of 100% of the maximal power output (Pmax) achieved in an incremental test to exhaustion, interspersed with 60 s at 20% Pmax. CET was performed at 60% Pmax with equal duration. Training intensities were adjusted after 6 weeks to account for the training‐induced improvement in cardiorespiratory fitness. The entire functions defining the relationship between EqO2, EqCO2, and BLa, with power output were modeled using linear mixed models to assess how these trajectories are affected by HIIT.

Results

After 6 and 12 weeks, Pmax increased to 112.9% and 117.5% of baseline after CET, and to 113.9% and 124.7% after HIIT+CET (means). Twelve weeks of HIIT+CET elicited greater reductions of EqO2 and EqCO2 than CET alone (p < 0.0001 each) in a range above 100% baseline Pmax. Specifically, at 100% of baseline Pmax, least squares arithmetic mean EqO2 values of CET and HIIT+CET patients were 36.2 versus 33.5. At 115% and 130% of baseline Pmax, EqO2 values were 41.2 versus 37.1 and 47.2 versus 41.7. Similarly, corresponding EqCO2 values of CET and HIIT+CET patients were 32.4 versus 31.0, 34.3 versus 32.2, and 37.0 versus 34.0. Conversely, mean BLa levels (mM) were not differently affected (p = 0.64). At 100%, 115%, and 130% of baseline Pmax after 12 weeks, BLa levels did not differ to a relevant extent (least squares geometric means, 3.56 vs. 3.63, 5.59 vs. 5.61, 9.27 vs. 9.10).

Conclusions

While HIIT+CET reduced ventilatory equivalents more effectively than CET alone, specifically when patients were approaching their maximal performance during CPET, both training strategies were equally effective in reducing BLa levels.
Numerical Investigations of Water Column Responses at Different Moonpool Locations Within a Fixed Vessel
Authors: Garad Suraj , Bhattacharyya Anirban , Datta Ranadev
Published: April 2023

The oscillating water column (OWC) responses within forward, central, and aft located moonpools for a fixed rectangular vessel are studied numerically under regular head wave conditions using Reynolds-averaged Navier–Stokes-based computational fluid dynamics calculations. The free surface elevation of the confined water inside the moonpool for the piston mode frequencies is studied independently for the forward, central, and aft moonpools, showing a strong dependence on location, draft, and incident wave frequency. The relative response is largely magnified for wave frequencies around the resonant range. It is observed that the free surface response amplitude is significantly higher in the forward moonpool location, and the results are in well comparison with experiments performed in the towing tank. The variation of dynamic pressure and its influence on the moonpool responses is investigated to understand the position-specific fluctuations, which showed the presence of harmonics. The phase difference between the water column oscillations within the moonpool and the propagating wave in the domain depends on its position. Finally, the effect of the moonpool in modifying the pressure field is studied by comparison with a vessel without moonpool for a common incident wave frequency.
Performance of Modified Conical Solar Still Integrated With Continuous Volume Flowrate
Authors: Abdallah Salah , Aldarabseh Safa M.
Published: April 2023

Solar energy desalination process is the most efficient and cost-effective method for producing fresh water from saline water by employing solar energy from the sun's free source of heat. In the current study, experimental and theoretical methods were used to investigate the performance of a novel design of conical solar still integrated with conical glass cover and conical basin area with continuous volume flowrate at different values of volume flowrate, 80, 60, and 40 mL/s compared to traditional solar still. Experimental results showed that maximum productivity and efficiency can be achieved by utilizing the conical solar still at a lower volume flowrate of saline water. Highest efficiency can be obtained by utilizing traditional single solar still (TSS), conical solar still with a volume flowrate of 80 mL/s (CSSF), conical solar still with a volume flowrate of 60 mL/sec (CSSH), conical solar still with a volume flowrate of 40 mL/sec (CSQ), and conical solar still with volume flowrate of 40 mL/sec with an array of the mirror (CSQM) on average is 28.2, 42.04, 53.78, 63.4, and 69.15%, respectively. Freshwater productivity of CSQ was enhanced by employing the arrays of the mirror. Daily freshwater productivity of CSSF, CSSH, CSQ, and CSQM was enhanced on average by 221.5%, 160.4%, 157%, and 174.7%, respectively, over the freshwater productivity of TSS. Theoretical model is obtained utilizing mathcad software and is validated by comparing it with experimental findings. The theoretical results obtained from the mathematical model are in good agreement with the experimental results.
A Theoretical and Experimental Study on the Power Loss of Gearbox Based on Dimensionless Analysis
Authors: Guo Dong , Wen Guobin , Wang Yawen , Luo Dongyuan
Published: April 2023

A prediction model of gearbox power loss based on dimensionless analysis is proposed. First, the dimensional model of gearbox power loss is established based on similarity criterion, dimensional harmony principle, and fluid mechanics π theorem. Then, the experimental study is carried out on a power loss test bench. Based on the measured data and multiple linear regression method, the coefficients of the influencing factors are calculated, including gear design parameters, lubrication oil parameters, and operating conditions. To validate the prediction model, the gear pairs were tested under various operating conditions, and two new gear sets with different helical angles were also included. The comparison results show good consistency between the measured data and predicted values. The proposed model can be employed to effectively predict the power loss of gearbox and improve the gearbox efficiency.