bluuebunny/crossref_metadata_2025 huggingface dataset:
Stress response and virulence factors in bacterial pathogens relevant for Chilean aquaculture: current status and outlook of our knowledge
Authors: Fuentes Derie E. , Acuña Lillian G. , Calderón Iván L.
Published: May 2022

The study of the stress responses in bacteria has given us a wealth of information regarding the mechanisms employed by these bacteria in aggressive or even non-optimal living conditions. This information has been applied by several researchers to identify molecular targets related to pathogeny, virulence, and survival, among others, and to design new prophylactic or therapeutic strategies against them. In this study, our knowledge of these mechanisms has been summarized with emphasis on some aquatic pathogenic bacteria of relevance to the health and productive aspects of Chilean salmon farming (Piscirickettsia salmonis, Tenacibaculum spp., Renibacterium salmoninarum, and Yersinia ruckeri). This study will aid further investigations aimed at shedding more light on possible lines of action for these pathogens in the coming years.
Myelin oligodendrocyte glycoprotein antibody-associated optic neuritis and myelitis in COVID-19: a case report and a review of the literature
Authors: Colantonio Mark A. , Nwafor Divine C. , Jaiswal Shruti , Shrestha Ashish K. , Elkhooly Mahmoud , Rollins Steven , Wen Sijin , Sriwastava Shitiz
Published: May 2022

Background

Our case explored the spectrum of autoimmune and infectious neurological complications of Coronavirus Disease 2019. In addition, we also reviewed and discussed clinical features, neuroimaging, CSF findings, and outcomes in patients with COVID-19-associated Myelin Oligodendrocyte Glycoprotein Antibody Disorder (MOGAD) CNS inflammatory disorder.

Case presentation

Here we presented a case of post-Coronavirus Disease 2019 infection Myelin Oligodendrocyte Glycoprotein Antibody Disorder in a 41-year-old male who presented with gait instability, urinary retention, and confusion. Workup done in hospital showed transverse myelitis in cervical spine region and left optic neuritis. Laboratory findings showed Myelin Oligodendrocyte Glycoprotein-IgG antibodies were positive in serum (1:100), suggestive of post-COVID Myelin Oligodendrocyte Glycoprotein Antibody Disorder.

Conclusion

To our knowledge, this is the first comprehensive case report and the literature review that includes the clinical features, neuroimaging, CSF findings, and outcomes in COVID-19-associated Myelin Oligodendrocyte Glycoprotein Antibody Disorder.
Reasons behind high rate of non-compliance to scheduled office visits in hypertensive patients: results from the Egyptian registry of specialized hypertension clinics
Authors: Youssef Ghada , Mohamed Marwa , Abdel Hamid Magdy , El Remisy Dalia
Published: May 2022

Background

Hypertensive patients’ compliance to the clinic’s follow-up visits is associated with a better blood pressure control. The aim of this study was to detect the reasons of non-compliance to office visits in Egyptian hypertensive patients.

Results

This is an observational, prospective, cross-sectional research study where patients were enrolled from the registry of the specialized hypertension clinics of 9 university hospitals. Those who attended less than 3 office visits, throughout the registry period, were considered non-compliant and were contacted through the phone. A simple questionnaire was prepared, which included questions about the reasons of non-compliance to follow up. There were 3014 patients eligible for inclusion in this study but only 649 patients (21.5%) completed the questionnaire. Patients claimed that the reasons of non-compliance to the follow up visits in the specialized hypertension clinics were as follows: 444 patients (68.4%) preferred to follow up elsewhere mostly in pharmacies, 53 patients (8.2%) claimed that the healthcare service was unsatisfactory, 94 patients (14.5%) were asymptomatic, and 110 patients (16.9%) said that the clinic was far from their homes. Despite non-compliance to office visits, 366 patients (59.2%) were compliant to their antihypertensive medications and 312 (48.1%) patients were compliant to salt restriction. About 34% of patients used herbs, mainly hibiscus, as adjuvant to their antihypertensive medications.

Conclusions

Reasons for non-compliance to office visits in hypertensive patients were either patient-related, or healthcare-related. To improve patients’ compliance, physicians need to educate their patients about hypertension, patients need to follow their doctors’ instructions as regard medications, salt restriction and scheduled office visits, and governments need to provide better and cheaper healthcare services.
A case of Rosai-Dorfman’s disease as isolated mediastinal lymphadenopathy: a diagnostic challenge
Authors: Modi Mahavir , Devi Kaumudi
Published: May 2022

Background

Mediastinal lymphadenopathy is seen in a variety of diseases, like tuberculosis, sarcoidosis, and metastasis. The diagnosis can be confirmed by tissue sampling with endobronchial ultrasound and transbronchial needle aspirate. A middle-aged male presented to us with a history similar to tuberculosis, and was on empirical anti-tuberculosis treatment was evaluated again by EBUS-TBNA and proved to be Rosai-Dorfman’s disease. This case report emphasizes on confirming the cases of mediastinal lymphadenopathy with tissue sampling.

Conclusion

All mediastinal lymphadenopathy should be evaluated in detail as the symptoms of the possible diseases, like tuberculosis, sarcoidosis, Kikuchi’s disease, Rosai-Dorfman’s disease, and malignancy can be similar. Hence, tissue sampling will confirm the diagnosis and help in appropriate management.
Preserving the past or past preserving: sustaining the legacy of postmodern museum architecture
Authors: Armstrong Paul J. , Kapp Paul H.
Published: May 2022

The publication of Complexity and Contradiction in Architecture in 1964 signaled the end of Modernism. The reality was that the modern movement had already jettisoned its ideological underpinnings and had become merely another ‘style.’ The avant garde architects in Europe and in North America were ready to move on and saw Postmodernism as a liberating antidote to the strictures of high Modernism. Historic architectural styles, which had been vilified as antiquated and out of step with modern culture, were revived, reinterpreted, and manipulated. However, Postmodernism, which had burned brightly during the 1970s and 1980s, was superseded by other architectural movements, namely, Deconstructivism, Pluralism, during the waning years of the 12th century.

Even though new building forms and design theory changed during Postmodernism, building technology remained the same. Exterior walls continued to be built as skins, comprised of either glass, masonry, metal, or synthetic cladding, which were hung of steel or concrete framing. Rubberised membranes covered essentially flat roofs. Moisture infiltration was managed in ever complex composite wall assemblies. More important, environmental systems decoupled nature from interiors and were designed to manage ever demanding humidity control requirements. Through the development of new building technology, Modernism severed design style from traditional construction. In re-introducing historical forms back into architecture, Postmodernism complicated constructability. Moreover, Postmodernism and its successors rarely developed new technological ideas by introducing more intricate building forms, which were based on theoretical ideas rather than technical ones, while continuing to employ Modernism building technology into their buildings. This inherent paradox is the most consequential challenge in preserving Postmodernism. Today, approximately 40 years after its inception, we must consider if, in some cases. is it tenable to preserve Postmodern buildings?

This paper reassesses three museums of the Postmodern era through the twin lenses of historic preservation and their legacy as cultural artifacts. It analyses how three iconic Postmodern museums, the Wexner Centre for the Arts in the USA, the Neue Staatsgalerie in Germany, and the Hedmark Museum in Norway, became cultural artifacts and how each of them present technical challenges for their future preservation. These museums represent late 20th century theoretical ideas, which were more a melding of pluralistic influences than design ideology, and the utilisation of Modernist technology. All of which present unique conditions for conservation.
Exploration of mood spectrum symptoms during a major depressive episode: The impact of contrapolarity—Results from a transdiagnostic cluster analysis on an Italian sample of unipolar and bipolar patients
Authors: Mineo Ludovico , Rodolico Alessandro , Spedicato Giorgio Alfredo , Aguglia Andrea , Bolognesi Simone , Concerto Carmen , Cuomo Alessandro , Goracci Arianna , Maina Giuseppe , Fagiolini Andrea , Amore Mario , Aguglia Eugenio
Published: May 2022

Background

Subthreshold hypomania during a major depressive episode challenges the bipolar-unipolar dichotomy. In our study we employed a cross-diagnostic cluster analysis - to identify distinct subgroups within a cohort of depressed patients.

Methods

A k-means cluster analysis— based on the domain scores of the Mood Spectrum Self-Report (MOODS-SR) questionnaire—was performed on a data set of 300 adults with either bipolar or unipolar depression. After identifying groups, between-clusters comparisons were conducted on MOODS-SR domains and factors and on a set of sociodemographic, clinical and psychometric variables.

Results

Three clusters were identified: one with intermediate depressive and poor manic symptomatology (Mild), one with severe depressive and poor manic symptomatology (Moderate), and a third one with severe depressive and intermediate manic symptomatology (Mixed). Across the clusters, bipolar patients were significantly less represented in the Mild one, while the DSM-5 “Mixed features” specifier did not differentiate the groups. When compared to the other patients, those of Mixed cluster exhibited a stronger association with most of the illness-severity, quality of life, and outcomes measures considered. After performing pairwise comparisons significant differences between “Mixed” and “Moderate” clusters were restricted to: current and disease-onset age, psychotic ideation, suicidal attempts, hospitalization numbers, impulsivity levels and comorbidity for Cluster B personality disorder.

Conclusions

In the present study, a clustering approach based on a spectrum exploration of mood symptomatology led to the identification of three transdiagnostic groups of patients. Consistent with our hypothesis, the magnitude of subthreshold (hypo)manic symptoms was related to a greater clinical severity, regardless of the main categorical diagnosis.
Inactivation of AR or ERα in Extrahypothalamic Neurons Does not Affect Osteogenic Response to Loading in Male Mice
Authors: Kim Na Ri , David Karel , Sommers Vera , Schollaert Dieter , Deboel Ludo , Ohlsson Claes , Gustafsson Jan-Åke , Antonio Leen , Decallonne Brigitte , Claessens Frank , Vanderschueren Dirk , Dubois Vanessa
Published: May 2022

Failure of bone mass maintenance in spite of functional loading is an important contributor to osteoporosis and related fractures. While the link between sex steroids and the osteogenic response to loading is well established, the underlying mechanisms are unknown, hampering clinical relevance. Androgens inhibit mechanoresponsiveness in male mice, but the cell type mediating this effect remains unidentified. To evaluate the role of neuronal sex steroid receptor signaling in the male bone’s adaptive capacity, we subjected adult male mice with an extrahypothalamic neuron-specific knockout of the androgen receptor (N-ARKO) or the estrogen receptor alpha (N-ERαKO) to in vivo mechanical stimulation of the tibia. Loading increased cortical thickness in the control animals mainly through periosteal expansion, as total cross-sectional tissue area and cortical bone area but not medullary area were higher in the loaded than the unloaded tibia. Trabecular bone volume fraction also increased upon loading in the control group, mostly due to trabecular thickening. N-ARKO and N-ERαKO males displayed a loading response at both the cortical and trabecular bone compartments that was not different from their control littermates. In conclusion, we show that the presence of androgen receptor or estrogen receptor alpha in extrahypothalamic neurons is dispensable for the osteogenic response to mechanical loading in male mice.
Brown Adipose Tissue—A Translational Perspective
Authors: Carpentier André C , Blondin Denis P , Haman François , Richard Denis
Published: May 2022

Brown adipose tissue (BAT) displays the unique capacity to generate heat through uncoupled oxidative phosphorylation that makes it a very attractive therapeutic target for cardiometabolic diseases. Here, we review BAT cellular metabolism, its regulation by the central nervous and endocrine systems and circulating metabolites, the plausible roles of this tissue in human thermoregulation, energy balance, and cardiometabolic disorders, and the current knowledge on its pharmacological stimulation in humans. The current definition and measurement of BAT in human studies relies almost exclusively on BAT glucose uptake from positron emission tomography with 18F-fluorodeoxiglucose, which can be dissociated from BAT thermogenic activity, as for example in insulin-resistant states. The most important energy substrate for BAT thermogenesis is its intracellular fatty acid content mobilized from sympathetic stimulation of intracellular triglyceride lipolysis. This lipolytic BAT response is intertwined with that of white adipose (WAT) and other metabolic tissues, and cannot be independently stimulated with the drugs tested thus far. BAT is an interesting and biologically plausible target that has yet to be fully and selectively activated to increase the body’s thermogenic response and shift energy balance. The field of human BAT research is in need of methods able to directly, specifically, and reliably measure BAT thermogenic capacity while also tracking the related thermogenic responses in WAT and other tissues. Until this is achieved, uncertainty will remain about the role played by this fascinating tissue in human cardiometabolic diseases.
A Case of a Pregnant Woman With Primary Aldosteronism and Superimposed Preeclampsia Treated With Esaxerenone
Authors: Yamashita Kaoru , Morimoto Satoshi , Inoue Yuko , Hirata Kiyotaka , Kimura Shihori , Seki Yasufumi , Bokuda Kanako , Watanabe Daisuke , Ichihara Atsuhiro
Published: May 2022

During pregnancy, there is no established treatment for idiopathic hyperaldosteronism (IHA), the most common form of primary aldosteronism due to bilateral adrenal hyperplasia. Here, we report the case of a pregnant patient with IHA who was successfully treated with esaxerenone, a nonsteroidal mineralocorticoid receptor (MR) antagonist. A 39-year-old woman was diagnosed with IHA and commenced on nifedipine 20 mg daily because she desired to be pregnant. After 1 year, she became pregnant. Her blood pressure was well controlled until 34 weeks of gestation when her home blood pressure became elevated up to 140/90 mmHg. Although the dose of nifedipine was increased to 80 mg daily, her blood pressure increased to 151/97 mmHg, and urinary test showed proteinuria of 2+ in 35 weeks of gestation. She was diagnosed with superimposed preeclampsia (SPE) and additionally treated with esaxerenone. Her blood pressure decreased to 120-140/98-100 mmHg and the proteinuria improved to ±. A successful cesarean section at 37 weeks resulted in the delivery of a healthy baby boy. Her blood pressure was well controlled although esaxerenone was discontinued 2 weeks after the delivery. This is the first case of a pregnant woman who was safely treated with esaxerenone despite being a female at advanced maternal age who had been diagnosed with IHA and developed SPE. Further studies are needed to investigate the efficacy and safety of nonsteroidal selective MR antagonist in similar pregnant patients with IHA to establish better treatment strategy for these patients.
Aggregating Distributional Treatment Effects: A Bayesian Hierarchical Analysis of the Microcredit Literature
Authors: Meager Rachael
Published: May 2022

Expanding credit access in developing contexts could help some households while harming others. Microcredit studies show different effects at different quantiles of household profit, including some negative effects; yet these findings also differ across studies. I develop new Bayesian hierarchical models to aggregate the evidence on these distributional effects for mixture-type outcomes such as household profit. Applying them to microcredit, I find a precise zero effect from the fifth to seventy-fifth quantiles, and uncertain yet large effects on the upper tails, particularly for households with business experience. These quantile estimates are more reliable than averages because the data are fat tailed. (JEL G21, G51, L25, O16, P34)
Το φαινόμενο του εκφοβισμού στο πλαίσιο του σχολικού πολυπολιτισμικού περιβάλλοντος
Authors: Καλάκου Παναγιώτα
Published: May 2022

Η παρούσα διδακτορική διατριβή μελετά την αλληλοσυσχέτιση δύο σύγχρονων κοινωνικών φαινομένων, αυτά της πολυπολιτισμικότητας και του σχολικού εκφοβισμού. Στο πλαίσιο αυτό, τα φαινόμενα μελετώνται σε θεωρητικό επίπεδο, μέσα από ποικίλους επιστημονικούς χώρους και προσεγγίσεις της υπάρχουσας ελληνικής και ξένης βιβλιογραφίας, ενώ, στη συνέχεια, παρουσιάζεται και αναλύεται η έρευνα που πραγματοποιήθηκε σε ένα αμιγώς ελληνικό σχολείο της Γερμανίας, με συμμετέχοντες μαθητές και μαθήτριες διαφορετικών πολιτισμικών ομάδων που εμπλέκονται σε περιστατικά σχολικού εκφοβισμού, κυρίως ρατσιστικού και κοινωνικού χαρακτήρα. Η πολυπολιτισμικότητα αποτελεί ένα φαινόμενο το οποίο αφορά στην συνύπαρξη ατόμων από διαφορετικά πολιτισμικά περιβάλλοντα και στην μεταξύ τους αλληλεπίδραση στο πλαίσιο μίας κοινωνίας. Πρόκειται για ένα φαινόμενο το οποίο είναι διαχρονικό, καθώς παρατηρείται σε όλες τις εποχές, με διαφορετικές κάθε φορά κοινωνικο – πολιτικές συνθήκες και προεκτάσεις. Στις μέρες μας κάθε κοινωνία θεωρείται πολυπολιτισμική, εξαιτίας των παραγόντων της ύπαρξης μειονοτήτων, τη μεταναστευτική ροή πληθυσμιακών ομάδων και τα προσφυγικά κύματα από τις εμπόλεμες περιοχές. Ως εκ τούτου, η πολυπολιτισμικότητα ως φαινόμενο συναντάται και στο χώρο της σχολικής κοινότητας, δημιουργώντας νέες προκλήσεις για την σύγχρονη διαπολιτισμική εκπαιδευτική πραγματικότητα και το διεθνοποιημένο επιστημονικό κόσμο. Τα προβλήματα και οι προκλήσεις που καλούνται να αντιμετωπίσουν οι σύγχρονες σχολικές κοινωνίες, η εντεινόμενη διεθνοποίηση, η διασπορά των πολιτισμικών στοιχείων σε παγκόσμια κλίμακα και η ενίσχυση της κινητικότητας των ανθρώπων, είναι βασικά χαρακτηριστικά μιας πολυμορφικής, πολυπολιτισμικής κοινωνίας. Δεδομένου ότι το σχολείο αποτελεί μία μικρογραφία της κοινωνίας, εντός της σχολικής κοινότητας εκδηλώνονται φαινόμενα ρατσισμού με τη μορφή της εκφοβιστικής συμπεριφοράς, τα οποία είναι δύσκολα διαχειρίσιμα και είναι σημαντικό να αντιμετωπίζονται μέσα από τη συνεργασία όλων, των εκπαιδευτικών, των διευθυντών, των γονέων και των μαθητών. Το φαινόμενο του εκφοβισμού στα σύγχρονα σχολεία παρατηρείται με εξαιρετικά μεγάλη ένταση εκδήλωσης, ενώ σε συνδυασμό με την πολυπολιτισμικότητα και πολυμορφία των μαθητικών ομάδων αποτελεί έναν από τους παράγοντες που προκαλούν συγκρούσεις. Η έρευνα που πραγματοποιήθηκε για την εκπόνηση της διατριβής επιβεβαιώνει τη σύνδεση που υπάρχει μεταξύ του σχολικού εκφοβισμού και της πολυπολιτισμικότητας, ενώ ανέδειξε τις ελλείψεις και αδυναμίες της διαπολιτισμικής εκπαίδευσης στο σύγχρονο πολυπολιτισμικό σχολείο. Μέσα από τα ευρήματά της, ευελπιστούμε στην εύρεση αποτελεσματικότερων και βιωσιμότερων λύσεων στα προβλήματα αυτά και στην διαμόρφωση ενός ειρηνικού, δημοκρατικού πολυπολιτισμικού σχολείου.
Essays on hedge funds
Authors: Καραγιώργης Αρίστων
Published: May 2022

Η διατριβή περιλαμβάνει τέσσερα κεφάλαια που εξετάζουν διάφορα θέματα των αντισταθμιστικών αμοιβαίων κεφαλαίων υψηλού κινδύνου. Συγκεκριμένα, το πρώτο κεφάλαιο μελετά την αρχιτεκτονική του επιπέδου Ασυμμετρίας-Κύρτωσης, το οποίο είναι γενικώς συμβατό με μια παραβολική μορφή, για τα αντισταθμιστικά αμοιβαία κεφάλαια υψηλού κινδύνου και τις διάφορες επενδυτικές στρατηγικές· τόσο διαγραμματικώς όσο και οικονομετρικώς. Αποδεικνύεται πως υπάρχει μια δομική σχέση τετραγωνικής μορφής που συνδέει τις δύο ανώτερες ροπές, ενώ παρατηρούνται ευδιάκριτες διαφορές μεταξύ των επενδυτικών στρατηγικών. Τα αποτελέσματα μένουν ανεπηρέαστα μετά από ανάλυση ευαισθησίας. Το δεύτερο κεφάλαιο εξετάζει τις ιδιότητες κινητικότητας των ροπών ξεχωριστά και από κοινού. Χρησιμοποιώντας ένα μοντέλο Μαρκοφιανής αλυσίδας, εκτιμώνται οι μήτρες μετάβασης για τον κλάδο και τις επενδυτικές στρατηγικές, περιγράφοντας το πιθανολογικό πλαίσιο μετάβασης για την ασυμμετρία και την κύρτωση κατά μόνας και από κοινού. Τα αποτελέσματα υποδεικνύουν σχεδόν τέλεια κινητικότητα προς τη μη-κανονικότητα. Στο τρίτο κεφάλαιο προτείνεται μια μεθοδολογία εκτίμησης της μόχλευσης στα αντισταθμιστικά αμοιβαία κεφάλαια υψηλού κινδύνου. Αρχικά εφαρμόζεται η μέθοδος κυρίων συνιστωσών σε 49 παράγοντες ρίσκου ώστε να μειωθούν οι διαστάσεις. Αφού επιλεχθούν 10 κύριες συνιστώσες, εφαρμόζεται η παλινδρόμηση ελάχιστης απόλυτης συρρίκνωσης και επιλογής τελεστή, ανά αντισταθμιστικό αμοιβαίο κεφάλαιο και επτά τριετή μηνιαία μη επικαλυπτόμενα μεσοδιαστήματα, ώστε να επιλεχθούν οι κύριες συνιστώσες που επηρεάζουν το κάθε αντισταθμιστικό αμοιβαίο κεφάλαιο. Τέλος, πραγματοποιείται μια παλινδρόμηση ελαχίστων τετραγώνων, ομοιάζοντας το προηγούμενο πλαίσιο, με χρήση μόνο των μη μηδενικών κυρίων συνιστωσών. Αθροίζοντας τους συντελεστές, εκτιμάται μέσο κλαδικό επίπεδο μόχλευσης 3.3, συγκρίσιμο με τα δεδομένα της επιτροπής κεφαλαιαγοράς. Το τέταρτο κεφάλαιο αξιοποιεί ένα εκτενές σετ δεδομένων όπου γίνεται ταίριασμα των αντισταθμιστικών αμοιβαίων κεφαλαίων υψηλού κινδύνου με το βασικό τους μεσίτη. Καταγράφεται μια θετική και στατιστικώς σημαντική σχέση μεταξύ της μόχλευσης των αντισταθμιστικών αμοιβαίων κεφαλαίων και του ρίσκου κατάρρευσης της μετοχής του βασικού μεσίτη. Τα αποτελέσματα παραμένουν ισχυρά μετά από έλεγχο για ενδογένεια και εκτενή ανάλυση ευαισθησίας. Επίσης καταγράφεται ότι επενδυτικές στρατηγικές με μεγαλύτερη αποστροφή στoν κίνδυνο, μειώνουν την κλίση των μέτρων ρίσκου των βασικών μεσιτών και οδηγούν σε χαμηλότερο ρίσκο κατάρρευσης της μετοχής.
Credit Must Be Justifi ed
Authors: Smirnov E.
Published: May 2022

On January 1 this year, Federal Law No. 398-FZ dated December 6, 2021 “On Amendments to the Federal Law “On the Central Bank of the Russian Federation (Bank of Russia)” and Articles 9 and 14 of the Federal Law “On Microfi nance Activities and Microfi nance Organizations” came into force aimed at preventing the accumulation of risks by borrowers and slowing down the excessive growth of unsecured consumer lending.
Comparative Characteristics of the Opinions of Students of Secondary Vocational Education about Distance Learning
Authors: Kandybin A. , Maksimova P.
Published: May 2022

The article analyzes and compares the opinions of students of vocational schools of various courses about distance learning and its impact on the educational process and lifestyle. The results showed that the reaction of different groups of students to distance learning is different, which should be taken into account in the further development and improvement of this form of education.
Nonconvex Piecewise Linear Functions: Advanced Formulations and Simple Modeling Tools
Authors: Huchette Joey , Vielma Juan Pablo
Published: May 2022

Piecewise linear functions are deceptively simple structures that are nonetheless capable of approximating complex nonlinear behavior. As such, they have been adopted throughout operations research and engineering to approximate nonlinear structures in optimization problems which would otherwise render the problem extremely difficult to solve. In “Nonconvex Piecewise Linear Functions: Advanced Formulations and Simple Modeling Tools,” J. Huchette and J. P. Vielma derive new mixed-integer programming (MIP) formulations for embedding low-dimensional nonconvex piecewise linear functions in optimization models. These formulations computationally outperform the crowded field of existing approaches in a number of regimes of interest. As these formulations are derived using recently developed machinery that produce highly performant, but uninterpretable, formulations, the authors showcase the utility of high-level modeling tools by presenting PiecewiseLinearOpt.jl, an extension to the popular JuMP optimization modeling language that implements a host of MIP formulations for piecewise linear function in a single, easy-to-use interface.
Single-stage repair of displaced bucket-handle meniscal tears with anterior cruciate ligament reconstruction leads to good meniscal survivorship
Authors: Robinson James R. , Bruce David , Davies Hywel , Porteous Andrew J. , Murray James R. D. , Howells Nick R.
Published: May 2022

Aims

The best surgical strategy for the management of displaced bucket-handle (BH) meniscal tears in an anterior cruciate ligament (ACL)-deficient knee is unclear. Combining meniscal repair with ACL reconstruction (ACLR) is thought to improve meniscal healing rates; however, patients with displaced BH meniscal tears may lack extension. This leads some to advocate staged surgery to avoid postoperative stiffness and loss of range of motion (ROM) following ACLR.

Methods

We reviewed the data for a consecutive series of 88 patients (mean age 27.1 years (15 to 49); 65 male (74%) and 23 female (26%)) who underwent single-stage repair of a displaced BH meniscal tear (67 medial (76%) and 21 lateral (24%)) with concomitant hamstring autograft ACLR. The patient-reported outcome measures (PROMs) EuroQol visual analogue scale (EQ-VAS), EuroQol five-dimension health questionnaire (EQ-5D), Knee injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee score (IKDC), and Tegner score were recorded at final follow-up. A Kaplan-Meier survival analysis was performed to estimate meniscal repair survivorship. Analyses were performed with different cut-offs for meniscal and ACL injury-to-surgery time (within three weeks, three to ten weeks, and more than ten weeks).

Results

Meniscal repair survivorship at a median final follow-up of 55 months (interquartile range (IQR) 24 to 91) was 82% (95% confidence interval 70 to 89). A total of 13 meniscus repairs failed (12 requiring meniscectomy and one requiring a further meniscal repair). At final follow-up, median PROMs were: EQ-VAS 85 (IQR 75 to 90), EQ-5D Index 0.84 (IQR 0.74 to 1.00), KOOS Pain 89 (IQR 80 to 94), KOOS Symptoms 82 (IQR 71 to 93), KOOS Activities of Daily Living 97 (IQR 91 to 100), KOOS Sport and Recreation 80 (IQR 65 to 90), KOOS Quality of Life 69 (IQR 53 to 86), IKDC 82.8 (IQR 67.8 to 90.8), and Tegner 6 (IQR 4 to 7). Two patients underwent revision ACLR following further injuries. One patient had an arthroscopic washout for infection at 11 days post-BH meniscal repair/ACLR. Four patients (4.5%) required a further procedure for stiffness, reduced ROM, and pain, and all were operated on within three weeks of meniscal injury. There was no difference in the interval between meniscal injury and surgery between repairs that failed and those that survived.

Conclusion

These data suggest that concomitant ACLR with repair of displaced BH meniscal tears, even if they have been displaced for some time, appears to afford satisfactory PROMs and good survivorship. Repairs within three weeks of meniscal injury may be associated with higher rates of postoperative reintervention for stiffness. Cite this article: Bone Joint J 2022;104-B(6):680–686.
Virtual management of clinically suspected scaphoid fractures
Authors: Stirling Paul H. C. , Simpson Cameron J. , Ring David , Duckworth Andrew D. , McEachan Jane E.
Published: May 2022

Aims

The aim of this study was to describe the introduction of a virtual pathway for the management of patients with a suspected fracture of the scaphoid, and to report patient-reported outcome measures (PROMs) and satisfaction following treatment using this service.

Methods

All adult patients who presented with a clinically suspected scaphoid fracture that was not visible on radiographs at the time of presentation during a one-year period were eligible for inclusion in the pathway. Demographic details, findings on examination, and routine four-view radiographs at the time of presentation were collected. All radiographs were reviewed virtually by a single consultant hand surgeon, with patient-initiated follow-up on request. PROMs were assessed at a minimum of one year after presentation and included the abbreviated version of the Disabilities of the Arm, Shoulder and Hand Score (QuickDASH), the EuroQol five-dimension five-level health questionnaire (EQ-5D-5L), the Net Promoter Score (NPS), and return to work.

Results

A total of 221 patients were referred to the virtual pathway. Their mean age was 41 years (range 16 to 87) and there were 99 male patients (45%). A total of 189 patients (86%) were discharged with advice and 19 (9%) were recalled for clinical review: seven with an undisplaced scaphoid fracture, six with another fracture of the hand or wrist, two with a scapholunate ligament injury, and four in whom no abnormality was detected. A total of 13 patients (6%) initiated follow-up with the hand service: no fracture or ligament injury was identified in this group. PROMs were available for 179 patients (81%) at a mean follow-up of 19 months (range 13 to 33). The median QuickDASH score was 2.3 (interquartile range (IQR) 0 to 15.9), the median EQ-5D-5L was 0.85 (IQR 0.73 to 1.00), the NPS was 76, and 173 patients (97%) were satisfied with their treatment. There were no documented cases of symptomatic nonunion one year following injury.

Conclusion

We describe the introduction of a virtual pathway for the management of patients with a suspected scaphoid fracture. We found high levels of patient satisfaction, excellent PROMs, and no detrimental effects in the vast majority of cases. Cite this article: Bone Joint J 2022;104-B(6):709–714.
Elbow hemiarthroplasty with a 3D-printed megaprosthesis for defects of the distal humerus or proximal ulna after tumour resection
Authors: Liang Haijie , Yang Yi , Guo Wei , Yan Liang , Tang Xiaodong , Li Dasen , Qu Huayi , Zang Jie , Du Zhiye
Published: May 2022

Aims

The aim of this study was to investigate the feasibility of application of a 3D-printed megaprosthesis with hemiarthroplasty design for defects of the distal humerus or proximal ulna following tumour resection.

Methods

From June 2018 to January 2020, 13 patients with aggressive or malignant tumours involving the distal humerus (n = 8) or proximal ulna (n = 5) were treated by en bloc resection and reconstruction with a 3D-printed megaprosthesis with hemiarthroplasty, designed in our centre. In this paper, we summarize the baseline and operative data, oncological outcome, complication profiles, and functional status of these patients.

Results

Preparation of the prosthesis was a mean of 8.0 days (SD 1.5), during which time no patients experienced tumour progression. The mean operating time and intraoperative blood loss were 158.1 minutes (SD 67.6) and 176.9 ml (SD 187.8), respectively. All of the prostheses were implanted successfully. During a mean follow-up of 25.7 months (SD 7.8), no patients died, but four had complications (two superficial wound problems, one temporary palsy of radial nerve, and one dislocation). No aseptic loosening, structural failure, infection, heterotopic ossification, or degenerative arthritis was seen in this study. The mean flexion of the elbow was 119.6° (SD 15.9°) and the mean extension lag was 11.9° (SD 13.8°). The mean Musculoskeletal Tumor Society 93 score and Mayo Elbow Performance Score were 28.4 (SD 0.9) and 97.7 (SD 4.4), respectively.

Conclusion

The custom-made, 3D-printed megaprosthesis with hemiarthroplasty is a feasible option for functional reconstruction after resection of a tumour in the distal humerus or proximal ulna. Cite this article: Bone Joint J 2022;104-B(6):747–757.
Projections for primary hip and knee replacement surgery up to the year 2060: an analysis based on data from The National Joint Registry for England, Wales, Northern Ireland and the Isle of Man
Authors: Matharu GS , Culliford DJ , Blom AW , Judge A
Published: May 2022

Introduction

We estimated the number of primary total hip and knee replacements (THR and TKR) that will need to be performed up to the year 2060.

Methods

We used data from The National Joint Registry for England, Wales, Northern Ireland and the Isle of Man on the volume of primary THRs (n=94,936) and TKRs (n=100,547) performed in 2018. We projected future numbers of THR and TKR using a static estimated rate from 2018 applied to population growth forecast data from the UK Office for National Statistics up to 2060.

Results

By 2060, THR and TKR volume would increase from 2018 levels by an estimated 37.7% (n=130,766) and 36.6% (n=137,341), respectively. For both males and females demand for surgery was also higher for patients aged 70 and over, with older patients having the biggest relative increase in volume over time: 70–79 years (44.6% males, 41.2% females); 80–89 years (112.4% males, 85.6% females); 90 years and older (348.0% males, 198.2% females).

Conclusion

By 2060 demand for hip and knee joint replacement is estimated to increase by almost 40%. Demand will be greatest in older patients (70+ years), which will have significant implications for the health service requiring forward planning given that morbidity and resource use is higher in this population. These issues, coupled with two waves of COVID-19, will impact the ability of health services to deliver timely joint replacement to many patients for a number of years, requiring urgent planning.
Are multiple-use bottles of chlorhexidine solutions at risk of contamination in joint replacement surgery?
Authors: Aquilina CO , Aquilina AL , Webb J , Albur M , Whitehouse MR
Published: May 2022

Introduction

Chlorhexidine gluconate 2% w/v in isopropanol 70% solutions in multiple-use bottles is commonly used in surgery as a cost-effective method for skin disinfection. However, multiple-use bottles risk contamination. This study aims to test whether bacterial contamination of multiple-use bottles or their solutions occurs once open and on use between different patients.

Methods

Consecutive samples were taken each time a chlorhexidine bottle was used over a 7-day study period. Samples were tested using blood culture, agar plate and mass spectrometry.

Results

No growth was observed in 52 samples taken from 18 bottles inoculated into blood culture bottles. Four growths on agar plate culture were determined to be contaminants from the sampling process.

Conclusions

This study supports the use of multiple-use bottled chlorhexidine solutions as safe and cost-effective in surgical practice.
Massive intratumoral bleed in renal cell cancer: an unusual life-threatening event
Authors: Parmar K , Thummala Y , Kumar S , Kaundal P , Mandal S
Published: May 2022

Renal cell cancer (RCC) commonly presents as an asymptomatic incidental mass on imaging for other abdominal pathologies. Because of its hypervascular nature, spontaneous haemorrhage, although very rare, can be seen with RCC. Spontaneous haemorrhage may present with flank pain, fever and sudden abdominal distension with or without haemorrhagic shock. Although unusual, spontaneous haemorrhage is potentially serious, and therefore clinicians should be aware of such events. Imaging may be difficult to interpret in view of intratumoral and perinephric haemorrhage. Prompt diagnosis and treatment is essential for a successful outcome. We report a case of massive intratumoral bleed in RCC in a young male and its management by renal artery angioembolisation followed by radical nephrectomy.
Peritoneal mesothelioma presenting with ‘kissing’ liver metastases
Authors: Shaw C , Iype S
Published: May 2022

A 61-year-old woman was diagnosed with an incidental liver lesion with a satellite lesion that had features of a secondary liver metastasis. Investigations for primary sites did not reveal a primary tumour. The lesion was not amenable to biopsy due to location. Intraoperatively, the two lesions were adjacent, but the first was on the diaphragm and the lesion was in segment 7 of the liver. The liver lesion underwent non-anatomical resection and the diaphragmatic lesion was resected separately. The histopathology diagnosed peritoneal mesothelioma in the lesion removed from diaphragm and the liver lesion to be local metastatic spread to an area of liver that was in close contact (a ‘kissing’ lesion). This report portrays a rare occurrence of liver metastases from peritoneal mesothelioma and discusses the current evidence for diagnosis and treatment.
Traction-induced aneurysm of an accessory left hepatic artery: a potentially fatal but synchronously treatable complication of a large hiatus hernia
Authors: Isola D , Jawad ZAR , Chua E , Shorvon P , Martinez-Isla A
Published: May 2022

A 59-year-old man presented to our surgical clinic with a long-standing history of heart burn, and upper abdominal pain. Gastroscopy showed a large sliding hiatus hernia associated with severe reflux oesophagitis. Oesophageal pH manometry revealed a high DeMeester score of 36.03. A computed tomography (CT) scan was performed for preoperative hiatal hernia repair planning. This showed the incidental finding of an accessory left hepatic artery (ALHA) and an aneurysm of this accessory artery. The aneurysm occurred at the point where the ALHA traversed the diaphragmatic crus and was only present in association with the hiatus hernia. These observations suggest that the aetiology of the aneurysm was due to traction during development of the hiatus hernia. The patient went onto have a laparoscopic hiatus hernia repair and Toupet fundoplication with ligation of the accessory left hepatic artery and made an excellent recovery. ALHAs are not uncommon, occurring in around 15% of the general population, with aneurysms of the hepatic arteries accounting for about 20% of cases of visceral artery aneurysms. The case presented herein highlights the importance of performing an arterial phase CT when planning surgery for large hiatus hernias to detect more cases like this one. This would allow early detection and concurrent treatment of an associated aneurysm with repair of the hiatus hernia, to prevent aneurysmal complications later on.
Small bowel obstruction caused by a fibrotic bow-string appendix: a consequence of non-operative management of acute appendicitis
Authors: Banks J , Shuttleworth P , Day N , Guy R
Published: May 2022

A 73-year-old woman presented with small bowel obstruction that failed to settle with conservative management. Over the previous 2 years she had presented twice with computed tomography scan-proven acute appendicitis with localised perforation of the appendix tip. In view of medical comorbidities, she was treated non-operatively with clinical and radiological resolution on each occasion, but on the third presentation laparoscopy was undertaken for non-resolving small bowel obstruction and the non-inflamed appendix itself was identified as a fibrous band causing compression of the distal ileum and complete small bowel obstruction. Following division and appendicectomy, the patient made an uneventful recovery. This case illustrates the potential consequence of repeated appendiceal inflammation and non-operative management and may be seen increasingly as this approach is widely adopted during the COVID-19 pandemic.
Direct Support Professionals: Stress and Resiliency Amidst the COVID-19 Pandemic
Authors: Sheppard-Jones Kathy , Kleinert Harold , Butler Laura , Li Jian , Moseley Emily , Adams Chithra
Published: May 2022

This study reports on the results of an online survey of direct support professionals (DSPs) during the COVID-19 pandemic in June 2020 to measure their perceived quality of life, stressors, coping/resilience skills, and knowledge of health care rights directly related to the pandemic for the persons that they support. Specifically, we examined direct support workers' perceptions of their quality of life, levels of stress, and their self-reported resilience skills. We found that perceived stress was strongly correlated with both self-reported quality of life and resilience, but not with years of DSP experience. Moreover, while DSPs overwhelmingly knew and affirmed health care rights for people with disabilities, they were less knowledgeable about their legal rights during hospital stays.
Improved radar chart for lighting system scheme selection
Authors: Peng Weishi
Published: May 2022

Lighting system scheme selection is an important part of infrastructure construction. This paper proposes an improved radar chart evaluation method for lighting system performance evaluation. First, to solve the problem of other weight scale methods’ inaccurate calculation, Pitman’s closeness measure in exponential form is used to determine the weight of the lighting system performance evaluation index. Second, a comprehensive performance evaluation model, applying the average area, average girth, and average eccentricity of the radar chart, is presented to solve the problem of inconsistent evaluation results due to the different orders of indicators. Finally, an example is given to verify the correctness and rationality of the proposed model. The research work provides scientific guidance for lighting system scheme selection.
Penalized least-squares for imaging with hypertelescopes
Authors: Webb Adam J. , Roggemann Michael C.
Published: May 2022

Practical considerations such
as cost constrain the aperture size of conventional telescopes, which,
combined with atmospheric turbulence effects, even in the presence of
adaptive optics, limit achievable angular resolution. Sparse aperture
telescopes represent a viable alternative for achieving improved
angular resolution by combining light collected from small apertures
distributed over a wide spatial area either using amplitude
interferometry or a direct imaging approach to beam-combining. The
so-called densified hypertelescope imaging concept in particular
provides a methodology for direct image formation from large sparse
aperture arrays. The densification system suppresses wide-angle side
lobes and concentrates that energy in the center of the focal plane,
significantly improving the signal-to-noise ratio of the measurement.
Even with densification, an inevitable consequence of sparse aperture
sampling is that the point-spread function associated with the direct
image contains an additional structure not present in full aperture
imaging systems. Postdetection image reconstruction is performed here
to compute a high-fidelity estimate of the measured object in the
presence of noise. In this paper, we describe a penalized
least-squares object-estimation approach and compare the results with
the classical Richardson–Lucy deconvolution algorithm as it is applied
to hypertelescope image formation. The parameters of the algorithm are
selected based on a comprehensive simulation study using the structure
similarity metric to assess reconstruction performance. We find that
the penalized least-squares formulation with optimized parameters
provides significantly improved reconstructions compared with the
conventional Richardson–Lucy algorithm.
Tunable laser frequency lock based on a temperature-dependent
Fabry–Perot etalon
Authors: Jiang Yuan , Qin Xiateng , Su Dianqiang , Ji Zhonghua , Peng Wenxin , Zhao YanTing
Published: May 2022

A simple method for laser frequency stabilizing by a temperature-tuned Fabry–Perot
etalon is reported. The etalon is a plano–convex lens that permits
tuning the length and refractive index via controlling the temperature
for shifting wavelengths in the region of 852 nm, with a transmission
spectral linewidth of

∼

72.5

M
H
z

and free spectral region of

∼

16

G
H
z

. Using this scheme, arbitrary
frequency locking of a laser with an adjustable frequency resolution
of

2.34

G
H
z

/

∘

C

is realized, and MHz-level long-term
stability is demonstrated.
Generation of multiple solitons with controllable separation assisted by PM fiber
Authors: Ren Hang , Wang Tianshun , Du Lei , Ma Wanzhuo , Li Baoqun , Zhou Jianhong
Published: May 2022

A method of generating multiple solitons with controllable separation is proposed by injecting the dissipative soliton (DS) and conventional soliton (CS) into the polarization-maintaining fiber (PMF), respectively. The soliton separation can be adjusted subjectively from 12 to 28 ps, corresponding to PMF lengths from 10 to 24 m. Multiple solitons consisting of three, four, five, and six solitons can be observed at pump powers of 480, 550, 610, and 700 mW. DS’s average single-pulse energy can increase from 20.4 to 40.7 pJ, while the average single-pulse energy of CS decreases from 29.3 to 13.7 pJ. The experimental results can contribute to the further understanding of the dynamics of multiple solitons.
Tunable mode-locked fiber laser based on nonlinear multimode interference with double offset-splicing step-index few-mode fiber
Authors: Xie Shangzhi , Jin Liang , Zhang He , Li Xiaohui , Zhang Xiaochen , Xu Yingtian , Ma Xiaohui
Published: May 2022

A tunable mode-locked all-fiber Yb-doped laser with a double offset-splicing step-index few-mode fiber (DOS-SIFMF) is demonstrated, to the best of our knowledge, for the first time. The structure of DOS-SIFMF, which constructs a micro Mach–Zehnder interferometer as a consequence of introducing offset splicing, has characteristics of both a saturable absorber and filter and is more accessible to obtain mode-locking operation in an all-normal dispersive region. The results of simulation show that interference with fewer modes is more reliable to acquire mode-locking operation of the fiber laser. The central wavelength, spectrum, and pulse widths are 1032 nm, 6.15 nm, and 28.8 ps, respectively. The output pulse in time and spectrum domains can be tuned in the range of 168.7 ps and 10.7 nm, respectively. This structure has effects of both mode-locking and filtering, showing potential application in communication and sensing. Furthermore, the influence on mode number to interference is generally discussed in the end.
Generation of perfect optical vortex by Laguerre–Gauss beams with a high-order radial index
Authors: Guo Zhenyu , Chang Zehong , Meng Jinglin , An Min , Jia Junliang , Zhao Zidan , Wang Xiaoli , Zhang Pei
Published: May 2022

Perfect optical vortex (POV) beams have attracted extensive attention because they have the advantage of a radial profile that is independent of orbital angular momentum. To date, it is usually obtained by means of the Fourier transform performed by a lens on Bessel beams. We theoretically and experimentally demonstrate that POV can be generated by performing the Fourier transform on Laguerre–Gauss beams with a high-order radial index. Furthermore, we derive an analytical expression for the increase in vortex radius, which is beneficial to compensate for the influence of the radius change in actual experiments. Our results may shed new light for a variety of research utilizing POV.
Biomimetic macroscopic hierarchical moire gratings
Authors: Mazloumi Mahyar , Bdour Yazan , Escobedo Carlos , Sabat Ribal Georges
Published: May 2022

Large-scale hierarchical macroscopic moire gratings resembling the surface structure of Peruvian lily flower petals are fabricated on azobenzene molecular glass thin films using a Lloyd’s mirror interferometer. It is shown that nanostructured linear and crossed moire gratings can be made with pitch values reaching a few millimeters. Also, using atomic force microscopy, scanning electron microscopy, optical microscopy, and surface profilometry techniques, it is shown that the obtained moire gratings have two-fold or three-fold hierarchical structures fabricated using a simple all optical technique.