bluuebunny/crossref_metadata_2025 huggingface dataset:
The effects of personalized gamification on students’ flow experience, motivation, and enjoyment
Authors: Oliveira Wilk , Hamari Juho , Joaquim Sivaldo , Toda Armando M. , Palomino Paula T. , Vassileva Julita , Isotani Seiji
Published: March 2022

Gamification refers to the attempt to transform different kinds of systems to be able to better invoke positive experiences such as the flow state. However, the ability of such intervention to invoke flow state is commonly believed to depend on several moderating factors including the user’s traits. Currently, there is a dearth of research on the effect of user traits on the results of gamification. Gamer types (personality traits related to gaming styles and preferences) are considered some of the most relevant factors affecting the individual’s susceptibility to gamification. Therefore, in this study we investigate how gamer types from the BrainHex taxonomy (achiever, conqueror, daredevil, mastermind, seeker, socializer and survivor) moderate the effects of personalized/non-personalized gamification on users’ flow experience (challenge-skill balance, merging of action and awareness, clear goals, feedback, concentration, control, loss of self-consciousness andautotelicexperience), enjoyment, perception of gamification and motivation. We conducted a mixed factorial within-subject experiment involving 121 elementary school students comparing a personalized version against a non-personalized version of a gamified education system. There were no main effects between personalization and students’ flow experience, perception of gamification and motivation, and enjoyment. Our results also indicate patterns of characteristics that can lead students to the high flow experience (e.g., those who prefer to play multiplayer have a high flow experience in both personalized and non-personalized versions). Based on our results, we provided recommendations to advance the design of gamifed educational systems.
Emerging trends of online assessment systems in the emergency remote teaching period
Authors: Topuz Arif Cem , Saka Eda , Fatsa Ömer Faruk , Kurşun Engin
Published: March 2022

The COVID-19 pandemic caused many educational institutions in the world to switch to the distance education process, and this process was called "Emergency Remote Teaching". This urgent transition process has caused many problems in educational environments. One of the problems is the subject of measurement and evaluation. Along with the pandemic, many institutions have used various online assessment systems to make measurements and evaluations online, and researchers have conducted research on these online assessment systems. This research focus on the features of the online assessment systems and aims to examine the trends towards the prominent features of the online assessment systems in the Emergency Remote Teaching period. For this purpose, the prominent online assessment systems have been determined by systematically analyzing academic studies published in 2020, and answers have been sought to the following research questions: (1) which platforms they support, (2) which security features they have, and (3) what common features they have. Identifying trends in the characteristics of online assessment systems is expected to guide practitioners, decision-makers, researchers, and system developers in the process of selecting and/or developing an online assessment system for use in online measurement and evaluation.
Peridotites with back-arc basin affinity exposed at the southwestern tip of the Mariana forearc
Authors: Oya Shoma , Michibayashi Katsuyoshi , Ohara Yasuhiko , Martinez Fernando , Kourim Fatma , Lee Hao-Yang , Nimura Kohei
Published: March 2022

Peridotites at water depths of 3430 to 5999 m have been discovered using the submersible Shinkai6500 (dives 6K-1397 and 6K-1398) on the southwestern slope of the 139°E Ridge (11°12′N, 139°15′E), a small ridge at the southwesternmost tip of the Mariana forearc near the junction with the Yap Trench and Parece Vela Basin. The peridotites studied consist of 17 residual harzburgites and one dunite and show various textures with respect to their depths. Peridotites with coarse-grained (> 1 mm) textures were sampled from the shallowest part (3705–4042 m) of the dive area, and peridotites with fine-grained (< 0.5 mm) textures were sampled deeper (5996 m). Olivine crystal-fabrics vary with grain size, with (010)[100] A-type patterns for the coarse-grained peridotites, {0kl}[100] D-type patterns for the fine-grained peridotites, and various indistinct patterns in samples of variable grain sizes. Fine-grained peridotites with D-type olivine crystal-fabrics could result from deformation under relatively higher flow stresses, suggesting that a ductile shear zone in the lithospheric mantle could occur in the deepest part of 139°E Ridge. Spinel Cr# range from relatively low (0.36) to moderately high (up to 0.57), and correlate with Ti contents (0.07–0.45 wt.%). The trace element patterns of clinopyroxene similarly exhibit steepening slopes from the middle to the light REEs regardless of textural variations. These mineralogical and geochemical features would result from melt-rock interactions under conditions of relatively shallow lithospheric mantle, which are much more comparable with the Parece Vela Basin peridotites than the Mariana forearc peridotites. Consequently, the Parece Vela Basin mantle is more likely exposed on the inner slope of the westernmost Mariana Trench, presumably due to the collision of the Caroline Ridge.
Impact of cyclic changes in pharmacokinetics and absorbed dose in pediatric neuroblastoma patients receiving [177Lu]Lu-DOTATATE
Authors: Malcolm Javian C. , Falzone Nadia , Gains Jennifer E. , Aldridge Matthew D. , Mirando David , Lee Boon Q. , Gaze Mark N. , Vallis Katherine A.
Published: March 2022

Purpose

Recent reports personalizing the administered activity (AA) of each cycle of peptide receptor radionuclide therapy based on the predicted absorbed dose (AD) to the kidneys (dose-limiting organ) have been promising. Assuming identical renal pharmacokinetics for each cycle is pragmatic, however it may lead to over- or under-estimation of the optimal AA. Here, we investigate the influence that earlier cycles of [177Lu]Lu-DOTATATE had on the biokinetics and AD of subsequent cycles in a recent clinical trial that evaluated the safety and activity of [177Lu]Lu-DOTATATE in pediatric neuroblastoma (NBL). We investigated whether predictions based on an assumption of unchanging AD per unit AA (Gy/GBq) prove robust to cyclical changes in biokinetics.

Methods

A simulation study, based on dosimetry data from six children with NBL who received four-cycles of [177Lu]Lu-DOTATATE in the LuDO trial (ISRCTN98918118), was performed to explore the effect of variable biokinetics on AD. In the LuDO trial, AA was adapted to the patient’s weight and SPECT/CT-based dosimetry was performed for the kidneys and tumour after each cycle. The largest tumour mass was selected for dosimetric analysis in each case.

Results

The median tumour AD per cycle was found to decrease from 15.6 Gy (range 8.12–26.4) in cycle 1 to 11.4 Gy (range 9.67–28.8), 11.3 Gy (range 2.73–32.9) and 4.3 Gy (range 0.72–20.1) in cycles 2, 3 and 4, respectively. By the fourth cycle, the median of the ratios of the delivered AD (ADD) and the predicted (or “expected”) AD (ADE) (which was based on an assumption of stable biokinetics from the first cycle onwards) were 0.16 (range 0.02–0.92, p = 0.013) for the tumour and 1.08 (range 0.84–1.76, p > 0.05) for kidney. None of the patients had an objective response at 1 month follow up.

Conclusion

This study demonstrates variability in Gy/GBq and tumour AD per cycle in children receiving four administrations of [177Lu]Lu-DOTATATE treatment for NBL. NBL is deemed a radiation sensitive tumour; therefore, dose-adaptive treatment planning schemes may be appropriate for some patients to compensate for decreasing tumour uptake as treatment progresses.

Trial registration ISRCTN ISRCTN98918118. Registered 20 December 2013 (retrospectively registered).
Small lesion depiction and quantification accuracy of oncological 18F-FDG PET/CT with small voxel and Bayesian penalized likelihood reconstruction
Authors: Xu Lei , Li Ru-Shuai , Wu Run-Ze , Yang Rui , You Qin-Qin , Yao Xiao-Chen , Xie Hui-Fang , Lv Yang , Dong Yun , Wang Feng , Meng Qing-Le
Published: March 2022

Background

To investigate the influence of small voxel Bayesian penalized likelihood (SVB) reconstruction on small lesion detection compared to ordered subset expectation maximization (OSEM) reconstruction using a clinical trials network (CTN) chest phantom and the patients with 18F-FDG-avid small lung tumors, and determine the optimal penalty factor for the lesion depiction and quantification.

Methods

The CTN phantom was filled with 18F solution with a sphere-to-background ratio of 3.81:1. Twenty-four patients with 18F-FDG-avid lung lesions (diameter < 2 cm) were enrolled. Six groups of PET images were reconstructed: routine voxel OSEM (RVOSEM), small voxel OSEM (SVOSEM), and SVB reconstructions with four penalty factors: 0.6, 0.8, 0.9, and 1.0 (SVB0.6, SVB0.8, SVB0.9, and SVB1.0). The routine and small voxel sizes are 4 × 4 × 4 and 2 × 2 × 2 mm3. The recovery coefficient (RC) was calculated by dividing the measured activity by the injected activity of the hot spheres in the phantom study. The SUVmax, target-to-liver ratio (TLR), contrast-to-noise ratio (CNR), the volume of the lesions, and the image noise of the liver were measured and calculated in the patient study. Visual image quality of the patient image was scored by two radiologists using a 5-point scale.

Results

In the phantom study, SVB0.6, SVB0.8, and SVB0.9 achieved higher RCs than SVOSEM. The RC was higher in SVOSEM than RVOSEM and SVB1.0. In the patient study, the SUVmax, TLR, and visual image quality scores of SVB0.6 to SVB0.9 were higher than those of RVOSEM, while the image noise of SVB0.8 to SVB1.0 was equivalent to or lower than that of RVOSEM. All SVB groups had higher CNRs than RVOSEM, but there was no difference between RVOSEM and SVOSEM. The lesion volumes derived from SVB0.6 to SVB0.9 were accurate, but over-estimated by RVOSEM, SVOSEM, and SVB1.0, using the CT measurement as the standard reference.

Conclusions

The SVB reconstruction improved lesion contrast, TLR, CNR, and volumetric quantification accuracy for small lesions compared to RVOSEM reconstruction without image noise degradation or the need of longer emission time. A penalty factor of 0.8–0.9 was optimal for SVB reconstruction for the small tumor detection with 18F-FDG PET/CT.
Single pile in cohesionless soil in sloping ground under lateral loading
Authors: Perumalsamy Kavitha , Ranganathan Sundaravadivelu
Published: March 2022

Pile foundations are adopted if a soil of low bearing capacity extends to a considerable depth or if the structure is heavy or the settlement due to the structure is large. It transfers the load to a strong, stable stratum of soil. The behaviour of soil in slope and piles embedded in it is an elaborated soil-structure interaction problem. This paper presents the results of experimental investigations on a single pile subjected to lateral load by varying relative density of soil in the horizontal and sloping ground with three different slopes of 1V: 2H, 1V: 2.5H and 1V: 3H. The lateral load carrying capacity of the pile is considerably decreased when the lateral load is applied in the direction of the slope. It is found that the lateral load carrying capacity of the pile is increased for higher relative density of sand and the lateral capacity of the pile is greater in flatter slope than in steeper slope. The effect of different slopes on normalized lateral load versus displacement for the lateral load applied in the direction along and against slope is quantified. A set of empirical equations are formulated to determine the deflection, fixity depth and moment for the pile in sloping ground.
Soil microbial communities following 20 years of fertilization and crop rotation practices in the Czech Republic
Authors: Kracmarova Martina , Uhlik Ondrej , Strejcek Michal , Szakova Jirina , Cerny Jindrich , Balik Jiri , Tlustos Pavel , Kohout Petr , Demnerova Katerina , Stiborova Hana
Published: March 2022

Background

Although fertilization and crop rotation practices are commonly used worldwide in agriculture to maximize crop yields, their long-term effect on the structures of soil microorganisms is still poorly understood. This study investigated the long-term impact of fertilization and crop rotation on soil microbial diversity and the microbial community structure in four different locations with three soil types. Since 1996, manure (MF; 330 kg N/ha), sewage sludge (SF; 330 and SF3x; 990 kg N/ha), and NPK (NPK; 330 kg N/ha) fertilizers were periodically applied to the soils classified as chernozem, luvisol and cambisol, which are among the most abundant or fertile soils used for agricultural purposes in the world. In these soils, potato (Solanum tuberosum L.), winter wheat (Triticum aestivum L.), and spring barley (Hordeum vulgare L.) were rotated every three years.

Results

Soil chemistry, which was significantly associated with location, fertilization, crop rotation, and the interaction of fertilization and location, was the dominant driver of soil microbial communities, both prokaryotic and fungal. A direct effect of long-term crop rotation and fertilization on the structure of their communities was confirmed, although there was no evidence of their influence on microbial diversity. Fungal and bacterial communities responded differently to fertilization treatments; prokaryotic communities were only significantly different from the control soil (CF) in soils treated with MF and SF3x, while fungal communities differed across all treatments. Indicator genera were identified for different treatments. These taxa were either specific for their decomposition activities or fungal plant pathogens. Sequential rotation of the three crops restricted the growth of several of the indicator plant pathogens.

Conclusions

Long-term fertilization and crop rotation significantly altered microbial community structure in the soil. While fertilization affected soil microorganisms mainly through changes in nutrient profile, crop rotations lead to the attraction and repulsion of specific plant pathogens. Such changes in soil microbial communities need to be considered when planning soil management.
Influence and Mechanisms of Action of Environmental Stimuli on Work Near and Above the Severe Domain Boundary (Critical Power)
Authors: Richard Normand A. , Koehle Michael S.
Published: March 2022

The critical power (CP) concept represents the uppermost rate of steady state aerobic metabolism during work. Work above CP is limited by a fixed capacity (W′) with exercise intensity being an accelerant of its depletion rate. Exercise at CP is a considerable insult to homeostasis and any work done above it will rapidly become intolerable. Humans live and exercise in situations of hypoxia, heat, cold and air pollution all of which impose a new environmental stress in addition to that of exercise. Hypoxia disrupts the oxygen cascade and consequently aerobic energy production, whereas heat impacts the circulatory system’s ability to solely support exercise performance. Cold lowers efficiency and increases the metabolic cost of exercise, whereas air pollution negatively impacts the respiratory system. This review will examine the effects imposed by environmental conditions on CP and W′ and describe the key physiological mechanisms which are affected by the environment.

Graphical Abstract
Effect of pneumatic vitreolysis in management of patients with symptomatic focal vitreomacular traction
Authors: Fouad Ahmed N. , Eissa Iman M. , Nassar Ghada A. , Leila Mahmoud , Fathy Adel M.
Published: March 2022

Purpose

To evaluate the efficacy of single intravitreal injection of an expansile concentration of sulphur hexafluoride gas (SF6) in treating patients with symptomatic focal vitreomacular traction (VMT) documented by spectral domain optical coherence tomography (SD-OCT) preoperatively.

Methods

This is a prospective interventional case series including 30 eyes of 29 patients with symptomatic focal VMT evident on SD-OCT. Pre-operatively, mean best corrected visual acuity (BCVA) was 20/125 (range 20/400–20/40). Mean central foveal thickness (CFT) was 382 μm (range 149–576 μm; SD ± 91.88). All eyes received single intravitreal injection of 0.3 mL of 100% SF6 gas. Postoperatively, we performed SD-OCT at one week, one month, and three months for all eyes. Primary outcome measure was release of VMT. Secondary outcome measures were changes in postoperative BCVA andCFT.

Results

Overall, VMT release occurred in 24 of 30 eyes by the final follow-up visit (80% final release rate); furthermore, 76.9% of eyes with diabetic maculopathy and 25% of eyes with concurrent epiretinal membrane (ERM) had successful VMT release. VMT release was documented on SD-OCT at an average of 3 weeks (range, 1–12 weeks). The rate of release in phakic eyes was 90% (18 of 20 eyes) versus 60% in pseudophakic eyes (6 of 10 eyes). One patient developed a retinal break at upper nasal retina after two weeks of injection.

Conclusion

Pneumatic vitreolysis (PVL) with limited face-down position is a viable option for treating focal VMT with few adverse events. Further studies are needed to evaluate its indications, benefits, and risks.
Promises of eukaryotic ribonucleases for cancer treatment: a systematic review
Authors: Siraj Yesuf Adem
Published: March 2022

Background

Following an increasing interest in exploration of anticancer chemotherapeutic agents, ribonucleases are currently under investigations for alternative anticancer chemotherapy.

Objective

The current review scrutinizes information on the potential capability of eukaryotic ribonucleases for cancer treatment.

Methods

Predefined searching terms were applied to PubMed, Scopus, eLibrary databases and other search engines such as Google Scholar and bioRvix preprints. Twenty four research articles on eukaryotic ribonuclease were included in the review. Qualitative and quantitative information of these studies were extracted, analyzed and explained in text, tables and figures.

Results

Majority of eukaryotic ribonucleases (46%, 11/24) included in the review were extracted from various species of frogs, 21% (5/24) were from bovine sources and others were from human bodies, edible mushrooms, fungal and plant species. Molecular characteristics of eukaryotic ribonucleases were illustrated in tables and figures. According to the reports, ranpirnase with a trademark of Onconase® is the sole ribonuclease granted with an orphan and fast-track drug status by FDA, USA. Most other eukaryotic ribonucleases are undergoing various preclinical stages of research for their potential anticancer effect. Hence, the mean of half – maximal inhibitory concentrations (IC50) of eukaryotic ribonucleases of several research outcomes showed their selective cytotoxicity towards cancerous cells. In some reports, pre-tumor-xenografted animals treated with ribonucleases also demonstrated diminished tumor volume, lower tumor metastasis and increased survival rates. In addition, overall safety and toxicity parameters were also indicated as tolerable by the experimental hosts. However, a single study indicated degeneration of spermatogenic epithelia in wheat leave RNase treated animals.

Conclusions

Though several clinical trials on eukaryotic ribonucleases are expected, existing results from in vitro and in vivo preclinical studies showed promising alternative chemotherapy to treat cancer diseases. Hence, further human safety and efficacy studies are still necessary to explore well established applications of eukaryotic ribonucleases in clinical medicine.
Bergenia ciliata as a future candidate for liver diseases: a concise review
Authors: Latief Uzma , Tung Gurleen Kaur , Singh Harjeet , Per Tasir Sharief , Jain Subheet Kumar
Published: March 2022

Liver cirrhosis, alcoholic liver diseases, non-alcoholic fatty liver and steatohepatitis are the major risk factors for liver damage leading to hepatocellular carcinoma. Oxidative stress and insulin resistance are the main pathogenetic mechanisms leading the hepatic cell injury and damage in these patients. The present review is the first attempt which focuses on the biological activities ofBergenia ciliatato explore its benefits and possible applications in the treatment of liver ailments.Bergenia ciliatais an evergreen herb belonging to the family saxifragaceae and is regarded as a miracle herb due to its wide medicinal applications. The data published in India and other nations are methodically reviewed and summarized in this article. It covers the facts collected from scientific journals, theses and online bibliographical databases: PubMed, Scopus, Google Scholar and Web of Science from year 1995–2020. The phytochemical studies onB. ciliatahave shown the presence of many phytochemicals belonging to phenols, flavonoids, fatty acid, glycosides, terpenoids, etc. Due to the presence of a multitude of these bioactives, the whole plant ofB. ciliatahas numerous medicinal applications such as diuretic, antipyretic, α-glucosidase, antiviral, antibacterial, anti-inflammatory and insecticidal activity. Therefore in the present study, we invite the attention of scientists and researchers to carry out further clinical and toxicological studies on this valuable plant in order to discover and develop novel hepatoprotective medicine with fewer side effects on human beings.
Effect of temperature and soil moisture on the efficacy of indigenous and imported strains of the entomopathogenic nematode, Heterorhabditis sp. against the black cutworm, Agrotis ipsilon (Hufnagel) (Lepidoptera/Noctuidae)
Authors: Nouh Gehan M.
Published: March 2022

Background

Biotic and abiotic factors influence survival, infectivity, development, reproduction, and activity of the entomopathogenic nematodes (EPNs). EPNs have been used to suppress the soil-inhabitant insects, which applied as a successful biological control agent against the black cutworm, Agrotis ipsilon (Hufnagel) (Lepidoptera/Noctuidae) larvae, and pupae.

Results

Studying the effect of different temperatures 20, 25, and 30°C ± 2, and the soil moisture content at 10, 15, and 25% on the susceptibility of two Heterorhabditis sp. strains, Egyptian strain (TAN5) and imported strain (Hb88) against the A. ipsilon 4th and 6th larval instars and 3-day-old pupae was carried out under laboratory conditions. The tested concentrations of the two strains were 30, 60, 120, 240, and 480 IJs/cm2 of soil surface. The mortality rate of 4th instar A. ipsilon larvae was high after Heterorhabditis strain TAN5 treatments at all concentrations, which ranged between (24 and 100%) and (6–100%) at 25°C and 30°C, respectively. At 20°C, Heterorhabditis strain Hb88 recorded higher mortality percentages for A. ipsilon 4th and 6th larval instars and pupae than the indigenous strain TAN5. The soil moisture content of 25% gave the highest mortality rates for the 4th instar larvae of A. ipsilon after treatments of the two strains. The Egyptian Heterorhabditis strain TAN5 was tolerant to the increase in temperature and more tolerant to the change in the water content of the soil than the imported strain Hb88 at all concentrations tested. In a semi-field experiment, Heterorhabditis strain TAN5 at concentrations between (1000–8000 IJs/cm2 of soil surface) showed mortality rates (27–95%) for 4th instar A. ipsilon larvae and (19–81%) for the 3-day-old pupae, respectively.

Conclusions

Heterorhabditis strains TAN5 can was utilized against the black cutworm of A. ipsilon at the temperatures 25 and 30°C. Heterorhabditis strains TAN5 and Hb88 can be utilized against the black cutworm of A. ipsilon at the soil moisture content from 15 to 25%. In the semi-field experiment, Heterorhabditis TAN5 and Hb88 strains were effective against larvae and pupae of A. ipsilon at high concentrations of the nematodes.
Biological evaluation of the efficacy of two different anesthetic solutions in pain control during extraction of mandibular second primary molars
Authors: Sharaf Rasha F. , Kabel Nihal
Published: March 2022

Background

The most critical part in management of children in the dental clinic is control of pain and this can be achieved through local anesthesia. When the treatment plan includes extraction of mandibular primary molars, the nerve block technique is the technique of choice for administration of local anesthesia. However, this technique is accompanied with discomfort due to deep penetration of the needle, possibility of nerve injury, hematoma as well as risk of self-inflicted trauma. Therefore, researchers have searched for an alternative technique to facilitate providing painless dental treatment for the child with avoidance of the possible complications of the nerve block technique, and this can be achieved by using a strong and deeply penetrating type of local anesthesia like articaine 4% that can be effective when administered with infiltration technique. The aim of the current study was to compare the efficacy of infiltration anesthesia using alexadricaine 4% and Mepecaine-L 2% in control of pain during extraction of lower 2nd primary molars in children and to compare the change in the heart rate that occurs as a consequence of pain during extraction. A total of 50 children were included in the current study, pain assessment was performed through measuring physiological parameter (pulse rate), subjective parameter (Wong–Baker Facial Pain Scale) and objective parameter (Sound Eye Motor scale). Results showed that there was significant increase in the pulse rate in both groups, while extraction using alexadricaine showed significantly lower pain scores either with Wong–Baker Facial Pain Scale (WBFPS) or with Sound Eye Motor scale (SEM).

Conclusions

Using a potent anesthetic solution like alexadricaine 4% facilitates extraction of mandibular primary molars, and achieves efficient pain control, with infiltration technique only without any need for the invasive nerve block technique.
Nonparametric Test for a class of Lifetime Distribution UBAC(2) Based on the Laplace Transform
Authors: Abu-Youssef S. E. , Ali N. S. A. , El-Toony A. A.
Published: March 2022

Testing various classes of life distributions have been considered a very important problem in the literature during the last decades, and many authors tried to solve it. In this paper, a new statistic technique for testing exponentiality versus the class of life distribution used better than aged in increasing concave ordering (UBAC(2)) is introduced based on the Laplace transform. For this proposed test, the critical values, the pitman’s asymptotic efficiency and the power of the test are calculated via simulation to assess the performance of the test. A new nonparametric test statistic for testing exponentiality versus UBAC(2) for right censored data is proposed, and the critical values are tabulated. Finally, real data are used for complete and censored data by using our proposed test.
A proposed framework for holding intensive 3Rs workshops in laboratory animal science
Authors: Ahmadi-Noorbakhsh Siavash , Sadighi Jila , Hatami Zahra , Shamsi Gooshki Ehsan
Published: March 2022

Principles of 3Rs are the backbone of today’s animal research. Applying 3Rs in practice requires proper education and training. Although this could be achieved via long-term courses ranging from several weeks to years, in some circumstances a short-term course may be the only viable option. In this paper we define scientific and ethical objectives for running short-term 3Rs workshops. To meet these objectives, we propose a 2-day workshop curriculum and an ethical framework. The curriculum comprises theoretical and practical sessions and covers Replacement, Reduction, and Refinement strategies. The ethical framework defines the responsibilities of lecturers and attendees, and proposes the animals and facilities requirements to run the proposed workshop curriculum. The attendees will be assessed at the end of the workshop and they receive certificates for working under supervision until they are deemed competent at their intended functions. The proposed curriculum and framework are not subscriptive, instead they share the experience gained through running more than 60 laboratory animal 3Rs workshops.
Outside-in technique versus inside-out semitendinosus graft harvest technique in ACLR: a randomised control trial
Authors: Sundararajan Silvampatti Ramasamy , Ramakanth Rajagopalakrishnan , Jha Amit Kumar , Rajasekaran Shanmuganathan
Published: March 2022

Background

Paraesthesia after hamstring graft harvest is a ubiquitous complication in the early post-operative period, and its correlation with vertical versus horizontal skin incision are well documented. The purpose of the study is to evaluate the incidence and extent/area of sensory loss of saphenous nerve branches occurring with the outside-in (OI) versus inside-out technique (IO) of semitendinosus graft harvest from the sartorius fascia and to determine a better method of graft harvest.

Methods

Sixty patients who underwent isolated semitendinosus graft harvest during anterior cruciate ligament reconstruction (ACLR) between 2016 and 2017. Patients were randomised into two groups depending on the graft harvest technique: 30 in the OI group and 30 in the IO group. The area of sensory loss was mapped on the patients’ skin using tactile feedback from the patients at each follow-up (10 days, 1 month, 3 months, 6 months and 1 year). Then, the area of sensory changes for the infrapatellar branch (IPBSN) and sartorial branch (SBSN) of the saphenous nerve, incision length, graft harvest duration, and graft length were analysed statistically between the groups.

Results

In groups 1 and 2, 18/30 (60%) and 19/30 (63%) of patients, respectively, developed sensory changes, with no significant difference between the groups (p = 0.79). Isolated SBSN and IPBSN paraesthesia occurred in 2/60 (3%) and 19/60 (32%), respectively. Combined SBSN and IPBSN paraesthesia was present in 16/60 (27%) of patients. There was no significant difference in the area of the sensory deficit between OI and IO groups on the 10th post-operative day or at 1-month, 3-month or 1-year follow-up (p = 0.723, p = 0.308, p = 0.478, p = 0.128, respectively). However, at 6-month follow-up, the area of paraesthesia was significantly higher in the IO group (p = 0.009). The length of incision and duration of graft harvest was higher in the OI group than in the IO group (p = 0.002 and p = 0.007, respectively), and the total length of the graft was greater in the IO group (p = 0.04).

Conclusion

Incidence is equally distributed, area of iatrogenic saphenous nerve injury gradually decreases, and recovery is seen in the majority of the patients in both graft harvest techniques. IO graft harvesting technique is better in terms of graft harvest time and cosmetics and yields longer graft; however, area of paraesthesia, though not significant, was two-fold higher than the OI technique at 1-year follow-up.

Clinical relevance

IO graft harvest technique would enable the surgeon to adopt quicker graft harvest, smaller surgical scar and lengthier graft than the OI technique.

Level of evidence

Therapeutic randomised controlled prospective study, Level II.
Contemporary results of transcatheter mitral valve procedures: bi-centric retrospective analysis
Authors: Owais Tamer , El Garhy Mohammad , Elvinger Sebastian , Harmel Eva , Gross Tatiana Maria Sequeria , Lapp Harald , Kuntze Thomas , Von Scheidt Wolfgang , Girdauskas Evaldas , Al-Jassem Mahmoud , Lauten Philipp
Published: March 2022

Background

Transcatheter mitral valve-in-valve (TMVIV) or valve-in-ring (TMVIR) replacement offer an alternative therapy for high risk patients. We aimed to highlight the operative and postoperative results of TMVIV and TMVIR procedures.

Results

We included all patients underwent TMVIV and TMVIR procedures between 2017 and 2020 at two heart centers in Germany. We included a total of 36 high risk patients in our study where 12 received TMVIV and 24 received TMVIR. All patients underwent TMVIV or TMVIR with Edwards Sapien XT or S3 transcatheter valves (Edwards Lifesciences). The mean age was 79 (75–83 years old). The median (IQR) preoperative STS score was 9 (7–13)% and EuroSCORE II was 14.5% (12–16). The majority of our patients were operated via transapical approach (n = 26) and the minority via transseptal approach (n = 10). Out of our records, none of our patients required reopening for bleeding or any other surgical complications. None of our patients required reintervention during the 6 months follow-up period. One mortality was recorded on fifth postoperative day due to low cardiac output syndrome (obviously because of LVOT obstruction by the anterior mitral leaflet). The average blood loss was 200 ml in the first 24 h in patients underwent transapical approach. Average operative time was 93 min and all patients were immediately extubated after the procedure in the operating room (even the patient with echocardiographically documented LVOT obstruction who died on the fifth postoperative day). Length of Intensive Care Unit stay was 2 ± 1.2 days and length of hospital stay was 4.1 ± 1.2 days. In the follow up period, echocardiograms showed normal prosthetic valve function with low transvalvular gradients, no LVOT obstruction in TMVIR cases and no evidence of valve migration or thrombosis (except in one patient). Concerning 6 months readmission, it was recorded in 2 patients due to right sided heart failure symptoms due to preexisting high degree of tricuspid valve regurge which did not disappear or even decrease after the operation and the other patient due to gastrointestinal bleeding.

Conclusions

TMVIV and TMVIR offer an efficient, safe and less invasive alternative in high surgical risk patients.
Switching from warfarin to direct-acting oral anticoagulants: it is time to move forward!
Authors: Abdelnabi Mahmoud , Benjanuwattra Juthipong , Okasha Osama , Almaghraby Abdallah , Saleh Yehia , Gerges Fady
Published: March 2022

Oral vitamin K antagonists (VKAs), warfarin, have been in routine clinical use for almost 70 years for various cardiovascular conditions. Direct-Acting Oral Anticoagulants (DOACs) have emerged as competitive alternatives for VKAs to prevent stroke in patients with non-valvular atrial fibrillation (AF) and have become the preferred choice in several clinical indications for anticoagulation. Recent guidelines have limited the use of DOACs to patients with non-valvular AF to reduce the risk of cardioembolic complications and to treat venous thromboembolism (VTE). Although emerging evidence is suggestive of its high efficacy, there was a lack of data to support DOACs safety profile in patients with mechanical valve prosthesis, intracardiac thrombi, or other conditions such as cardiac device implantation or catheter ablation. Therefore, several clinical trials have been conducted to assess the beneficial effects of using DOACs, instead of VKAs, for various non-guideline-approved indications. This review aimed to discuss the current guideline-approved indications for DOACs, advantages, and limitations of DOACs use in various clinical indications highlighting the potential emerging indications and remaining challenges for DOACs use. Several considerations are in favour of switching from warfarin to DOACs including superior efficacy, better adverse effect profile, fewer drug-drug interactions, and they do not require frequent international normalized ratio (INR) monitoring. Large randomized controlled trials are required to determine the safety and efficacy of their use in various clinical indications.
Correlation of qanadli obstruction index (QOI) and atrial size on CT pulmonary angiography (CTPA) in patients with pulmonary thromboembolism
Authors: Dakshin Vishnu , Hiremath Rudresh
Published: March 2022

Background

Pulmonary thromboembolism (PTE) is a potentially fatal and life-threatening variation of venous thromboembolism (Faghihi Langroudi et al. in Radiol Res Pract 2:1–6, 2019). Computed Tomography Pulmonary Angiography (CTPA) has been proven to be an invaluable first-line diagnostic tool in the early identification of pulmonary thromboembolism (Aviram et al. J Thromb Haemost 9(2):293–299, 2011; Ghaye et al. in RadioGraphics. 26 1 23 39, 2006). Preliminary studies have suggested the correlation between atrial size and clot burden in the pulmonary arteries in patients with pulmonary thromboembolism (Faghihi Langroudi et al. in Radiol Res Pract 2:1–6, 2019; Aviram et al. J Thromb Haemost 9(2):293–299, 2011). Clot burden is calculated by applying the CTPA dependent score—Qanadli Obstruction Index (QOI)/Pulmonary Arterial Obstruction Index (PAOI) in the pulmonary arteries.

Results

There was a significant negative correlation between left atrial/right atrial area, left atrial/right atrial short axis and left atrial/right atrial long axis with the PAOI, especially the left atrial/right atrial area ratio and left atrial/right atrial short axis ratio, which showed the most significant negative correlation. Additionally, an LA/RA area of ≤ 0.60 correlated with a PAOI of > 20 and an obstruction percentage of > 50%, which can serve as a predictor of right ventricular dysfunction.

Conclusions

These atrial dimensions can serve as additional early parameters that reflect changes in the cardiac morphology in response to the clot load within the pulmonary arteries, and can thus contribute towards a more comprehensive risk assessment in patients with acute pulmonary thrombo-embolism.
Shoulder adhesive capsulitis: can clinical data correlate with fat-suppressed T2 weighted MRI findings?
Authors: Mohammed Mariam Hussein , Fahmi Fady Micheal , Shehata Khaled Ali , Elia Remon Zaher
Published: March 2022

Background

Adhesive capsulitis (AC) of the shoulder or frozen shoulder is a debilitating condition characterized by progressive pain, stiffness and limited range of motion about the glenohumeral joint, the term (adhesive capsulitis) to describe the findings of chronic inflammation and fibrosis of the joint capsule, characterized by significant restriction of both active and passive shoulder motion that occurs in the absence of a known intrinsic shoulder disorder. The goal of the trial was to examine the association between clinical features (stages) and magnetic resonance imaging (MRI) findings in adhesive capsulitis of the shoulder.

Results

In our study, Regarding the diagnostic performance of shoulder MRI there is a statistically significant difference between degree of pain intensity according to Capsular thickening regarding humeral “mm” with p-value (p < 0.05). The highest value was found moderate and severe pain group (5.67 ± 1.39) compared to absent, minimal and mild pain group (4.42 ± 1.29), there was a statistically significant difference between two groups according to axillary recess regarding height “mm” with p-value (p < 0.05). The highest value was found absent, minimal and mild pain group (7.02 ± 2.68) compared to moderate and severe pain group (5.73 ± 2.25). There is no statistically significant association between pain intensity and MRI finding regarding capsular edema, extra capsular edema, obliteration of subcoracoid fat triangle, effusion of biceps tendon sheath, capsular thickening of glenoid (mm) and humeral portions of axillary recess and axillary recess width and height (mm), with p-value (p > 0.05 NS).

Conclusions

MRI is useful for assessing clinical impairment and predicting the clinical stage of adhesive capsulitis.
A framework to guide storytelling as a knowledge translation intervention for health-promoting behaviour change
Authors: Brooks Stephanie P. , Zimmermann Gabrielle L. , Lang Michael , Scott Shannon D. , Thomson Denise , Wilkes Gil , Hartling Lisa
Published: March 2022

Background

Stories can be a powerful tool to increase uptake of health information, a key goal of knowledge translation (KT). Systematic reviews demonstrate that storytelling (i.e. sharing stories) can be effective in changing health-promoting behaviours. Though an attractive KT strategy, storytelling is a complex approach requiring careful planning and consideration of multiple factors. We sought to develop a framework to assist KT researchers and practitioners in health contexts to consider and develop effective KT interventions that include stories or storytelling.

Methods

We conducted a broad search of the literature to identify studies that used storytelling as a KT intervention across different disciplines: health research, education, policy development, anthropology, organizational development, technology research, and media. We extracted purposes, theories, models, mechanisms, and outcomes and then mapped the theoretical and practical considerations from the literature onto the Medical Research Council guidance for complex interventions. The theoretical and practical considerations uncovered comprised the basis of the storytelling framework development. Through discussion and consensus, methodological experts refined and revised the framework for completeness, accuracy, nuance, and usability.

Results

We used a complex intervention lens paired with existing behaviour change techniques to guide appropriate theory-based intervention planning and practical choices. An intentional approach to the development of story-based KT interventions should involve three phases. The theory phase specifies the goal of the intervention, mechanisms of action, and behaviour change techniques that will achieve the intended effects. The modelling phase involves development and testing using an iterative approach, multiple methods and engagement of end-users. Finally, formal evaluation using multiple methods helps determine whether the intervention is having its intended effects and value added.

Conclusions

This framework provides practical guidance for designing story-based KT interventions. The framework was designed to make explicit the requisite considerations when determining the appropriateness and/or feasibility of storytelling KT, clarify intervention goals and audience, and subsequently, support the development and testing of storytelling interventions. The framework presents considerations as opposed to being prescriptive. The framework also offers an opportunity to further develop theory and the KT community’s understanding of effectiveness and mechanisms of action in storytelling interventions.
Costus root extract improves testicular toxicity of Bisphenol A in adult male albino rats: histopathological, ultrastructural and biochemical studies
Authors: Osman Hosam-Eldin Hussein , ELSahra Doaa Galal , Alamin Amin A. , El-Kenawy Ayman El-Meghawry , Salem Rasha R.
Published: March 2022

Background

Bisphenol A (BPA) causes environmental pollution and is used as a natural antioxidant to protect against chemical side-effects. Costus is a well-known medicinal plant containing several biologically active compounds. We investigated the protective effects of costus extract against the toxic effects of BPA in the rat testes.

Results

Biochemical and immunohistochemical investigations revealed that bisphenol reduced the activity of antioxidant enzymes and plasma testosterone levels and significantly increased P53. Co-administration of costus root extract with BPA improved the depletion of antioxidant enzymes, returned testosterone to normal levels, and improved P53 alternations. Histological and ultrastructural examinations showed that BPA reduced body and testicular weights, and the degeneration of seminiferous tubule germ cells, and the use of costus root extract with BPA attenuated these toxic effects.

Conclusions

Costus protects rat testes against the toxic effects of BPA.
Relationship between nasal polyposis and Eustachian tube function
Authors: El-Anwar Mohammad Waheed , Elnabtity Nadia Mohamed , Nada Ebtessam , Abdelmonem Said
Published: March 2022

Background

No previous study investigated the relationship between different stages and duration of nasal polyposis (NP) and Eustachian tube (ET) functions. Thus, the aim of the current study was to assess the relationship between the NP and ET functions by studying different staging and duration of the NP. The study included adult patients with bilateral NP. The tridimensional endoscopic staging of the NP was performed to provide information on the location of the NP within the nasal cavity in the three dimensions; horizontal, vertical, and anteroposterior planes. Tympanometry was performed 1 day before endoscopic staging, and the tympanometric results were distinguished into 3 grades; type A, normal curve; type C; and type B.

Results

Within 40 patients (80 nasal cavities, 80 ears), tympanometry showed type A curve in 48 ears (60%), type B curve in 14 ears (17.5%), and type C in 18 ears (22.5%). So, NP was associated with 40% ET affection with non-significant differences with different NP stages at the horizontal plan (P=0.989567), at the vertical plan (P=0.666), and at the anteroposterior plane (P=0.628). While ET affection (ET dysfunction or OME) was reported significantly more with NP of longer duration (P<0.0001).

Conclusion

NP is associated with a high ET dysfunction rate that is significantly higher with NP of longer duration, while different NP stages did not significantly differ in affecting the ET function.
Integrated detection and investigation of bad borehole section in the Wolfcamp Formation in the Midland Basin using machine learning, petrophysics, and core characterization
Authors: Bhattacharya Shuvajit , Ambrose William , Ko Lucy Tingwei , Casey Brian
Published: March 2022

The quality of formation evaluation and reservoir estimates depends a lot on the quality of open hole logs, which is intricately tied to the borehole geometry and stand-offs. Bad borehole sections cause interesting patterns on wireline logs that can result in multiple interpretations. We have conducted an automated identification of bad borehole sections (>50 ft [15 m] thick) in multiple wells in the Wolfcamp Formation in the Midland Basin of the United States and investigated the causalities behind the unstable borehole section. The wells impacted by bad hole conditions appear to be within a particular region of the northern Midland Basin, and the bad hole condition impacts a specific zone in the Wolfcamp D. We consider well logs as multivariate time series (or depth series), where they share interdependencies to a large extent. We use this concept and unsupervised multivariate time series clustering to automatically identify bad borehole sections. Our proposed workflow simultaneously clusters the wireline logs, resulting in a large labeled regional-scale data set that can be further used for log quality assurance, processing, and petrophysical modeling. More importantly, we investigate the reasons behind the borehole washout, integrating sedimentology and geochemical data. Thick borehole washout sections are related to the presence of a significant amount of clay (>73 wt%, a mixture of smectite and illite) in the Wolfcamp D. The results also indicate that the manual editing of wireline logs and even supervised machine learning-based log reconstruction (commonly known as a missing log prediction problem) can lead to erroneous and inconsistent interpretation of subsurface characteristics. Such exercise can be meaningless if derived models are not validated with the ground truth (preserved subsurface rocks).

Geologic feature: Clay-rich unstable borehole section Log appearance: Large-to-small caliper response associated with erratic density and neutron porosity logs Features with similar appearance: Gypsum, siderite nodules, and tool failure Formation: Wolfcamp Formation Age: Wolfcampian Location: Northern Midland Basin, Texas, USA Well data: Obtained from the IHS Analysis tools: Unsupervised machine learning, core description, geochemistry, and petrophysical inversion modeling