bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of dextrose prolotherapy for the treatment of chronic plantar fasciitis: A systematic review and meta‐analysis of randomized controlled trials
Authors: Chutumstid Tunchanok , Susantitaphong Paweena , Koonalinthip Nantawan
Published: March 2022

Objective

To systematically investigate the efficacy and safety of dextrose prolotherapy for treating chronic plantar fasciitis.

Literature survey

EMBASE, PubMed, Scopus, and Google Scholar (from inception to December 9, 2021).

Methodology

Comprehensive review of randomized controlled trials investigating dextrose prolotherapy for chronic plantar fasciitis was done. Two investigators independently screened the titles, abstracts, and full texts and extracted data from eligible studies. The changes in visual analog scale (VAS) pain score, foot function index (FFI), American Orthopaedic Foot and Ankle Society (AOFAS) score, and plantar fascia thickness were analyzed. Reports of complications of the procedure were collected.

Synthesis

Eight randomized controlled trials (RCTs) were included in the meta‐analysis, analyzing 444 patients in total. The subgroup analysis showed that at short‐term follow‐up (<6 months) dextrose prolotherapy was more effective in reducing VAS pain score compared to the non‐active treatment control group including exercise and normal saline solution (NSS) injection. However, there was no difference in the change of VAS pain score between dextrose prolotherapy and active treatment control group, which included extracorporeal shock wave therapy (ESWT), steroid injection, and platelet‐rich plasma (PRP) injection. Dextrose prolotherapy was more effective in reducing FFI, increasing AOFAS score, and reducing plantar fascia thickness at short‐term (<6 months) follow‐up compared to other comparators. For long‐term (≥6 months) follow‐up, there was no significant difference in the change in VAS pain score and FFI between the dextrose prolotherapy group and other comparators. No serious complication was reported.

Conclusions

Dextrose prolotherapy is an effective treatment of chronic plantar fasciitis to reduce pain, improve foot functional score, and decrease plantar fascia thickness at short‐term follow‐up. Further studies in larger populations are needed to identify the optimal treatment regimen including dextrose concentration, volume, injection site, injection technique, and the number of injections required. The long‐term effects of these treatments also require further examination.
Can van der Waals constants be used in the chemical reactivity analysis? A new approach as a support to minimum magnetizability principle
Authors: Kaya Savaş , Şimşek Selçuk
Published: March 2022

One of the most important purposes of theoretical chemists is to derive new, useful, and reliable equations to compute the well‐known parameters like hardness, polarizability, magnetizability, and electrophilicity providing enough hints for the reactivity analysis of the chemical systems. In the derivation of such equations, our research team widely considers the popular electronic structure rules like electronegativity equalization, maximum hardness, minimum polarizability, minimum magnetizability, and minimum electrophilicity principles. Recently, in the light of maximum entropy and minimum magnetizability principles, Kaya and Chattaraj (2021) presented a simple way to calculate their standard absolute entropies (S0298) based on molar diamagnetic susceptibilities (χm) of inorganic ionic systems. In the present paper, a new and useful molar diamagnetic susceptibility calculation method including the use of van der Waals constants (a and b) is introduced. Here, we named this method as Kaya–Şimşek approach. Through the relations between molar diamagnetic susceptibility and van der Waals constants, we can easily predict the magnetic susceptibility of molecules that their magnetic susceptibilities are unknown. The results of the equations derived are quite close to experimentally reported data. The analyses made proved that van der Waals constants can be considered as chemical reactivity descriptors. We propose that in stable states, van der Waals constants are minimized. The validity of minimum magnetizability principle is supported with solid evidences.
RNA meets toxicology: efficacy indicators from the experimental design of RNAi studies for insect pest management
Authors: List Fabian , Tarone Aaron M , Zhu‐Salzman Keyan , Vargo Edward L
Published: March 2022

RNA interference (RNAi) selectively targets genes and silences their expression in vivo, causing developmental defects, mortality and altered behavior. Consequently, RNAi has emerged as a promising research area for insect pest management. However, it is not yet a viable alternative over conventional pesticides despite several theoretical advantages in safety and specificity. As a first step toward a more standardized approach, a machine learning algorithm was used to identify factors that predict trial efficacy. Current research on RNAi for pest management is highly variable and relatively unstandardized. The applied random forest model was able to reliably predict mortality ranges based on bioassay parameters with 72.6% accuracy. Response time and target gene were the most important variables in the model, followed by applied dose, double‐stranded RNA (dsRNA) construct size and target species, further supported by generalized linear mixed effect modeling. Our results identified informative trends, supporting the idea that basic principles of toxicology apply to RNAi bioassays and provide initial guidelines standardizing future research similar to studies of traditional insecticides. We advocate for training that integrates genetic, organismal, and toxicological approaches to accelerate the development of RNAi as an effective tool for pest management. © 2022 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.
The impact of the COVID‐19 pandemic on internal migration in Germany: A descriptive analysis
Authors: Stawarz Nico , Rosenbaum‐Feldbrügge Matthias , Sander Nikola , Sulak Harun , Knobloch Vanessa
Published: March 2022

The COVID‐19 pandemic has affected economies, labor markets, health care, education and tourism around the globe in unprecedented ways. However, little research has yet been devoted to the impact that the pandemic might have had on internal migration. This study aims to address this gap by determining how the intensity and spatial patterns of internal migration changed between 2019 and 2020 in Germany. We draw on data from the population register on annual flows between 401 counties. We find that the COVID‐19 pandemic was associated with a 5% drop in the intensity of inter‐county migration in 2020 compared to the previous year, with significant variation across age. The pandemic was also associated with an upsurge in net migration losses for the largest cities, driven by fewer inflows of young adults and continuing outflows of families.
Sustainability of local renewable energy projects: A comprehensive framework and an empirical analysis on two islands
Authors: Tsagkari Marula , Roca Jordi , Stephanides Phedeas
Published: March 2022

Local energy projects have been associated with several benefits for the local community like social cohesion, economic gains, new skills, and environmental awareness. Yet, there is limited research on whether the projects fulfill their sustainability promises, and how the local community perceive the benefits. This research introduces a novel framework to assess the success of a local renewable energy project based on the perceptions of the local population and the initial ambitions of the projects. Using this framework two innovative local renewable energy projects are assessed; one in Tilos island in Greece and the other in El Hierro in Spain. An online questionnaire was used to assess the impact of the project on people's lives, their overall assessment of the project and their willingness to support similar future initiatives. The data show that the economic benefits are not significant when people assess the project, while on the contrary other factors like the environmental benefits, sense of pride, technical parameters institutional seem to have a greater effect. The environmental and institutional factors are also among the ones that influence people's willingness to support and participate in future projects. Overall, we reveal that the two projects are quite successful in the eyes of the local population and offer good case studies with several implications for policymakers and future initiatives.
Multiply robust subgroup analysis based on a single‐index threshold linear marginal model for longitudinal data with dropouts
Authors: Wei Kecheng , Zhu Huichen , Qin Guoyou , Zhu Zhongyi , Tu Dongsheng
Published: March 2022

Identifying subpopulations that may be sensitive to the specific treatment is an important step toward precision medicine. On the other hand, longitudinal data with dropouts is common in medical research, and subgroup analysis for this data type is still limited. In this paper, we consider a single‐index threshold linear marginal model, which can be used simultaneously to identify subgroups with differential treatment effects based on linear combination of the selected biomarkers, estimate the treatment effects in different subgroups based on regression coefficients, and test the significance of the difference in treatment effects based on treatment‐subgroup interaction. The regression parameters are estimated by solving a penalized smoothed generalized estimating equation and the selection bias caused by missingness is corrected by a multiply robust weighting matrix, which allows multiple missingness models to be taken account into estimation. The proposed estimator remains consistent when any model for missingness is correctly specified. Under regularity conditions, the asymptotic normality of the estimator is established. Simulation studies confirm the desirable finite‐sample performance of the proposed method. As an application, we analyze the data from a clinical trial on pancreatic cancer.
Identification of Catalytic Active Sites for Durable Proton Exchange Membrane Fuel Cell: Catalytic Degradation and Poisoning Perspectives
Authors: Shah Syed Shoaib Ahmad , Najam Tayyaba , Bashir Muhammad Sohail , Javed Muhammad Sufyan , Rahman Aziz‐ur , Luque Rafael , Bao Shu‐Juan
Published: March 2022

Recent progress in synthetic strategies, analysis techniques, and computational modeling assist researchers to develop more active catalysts including metallic clusters to single‐atom active sites (SACs). Metal coordinated N‐doped carbons (M‐N‐C) are the most auspicious, with a large number of atomic sites, markedly performing for a series of electrochemical reactions. This perspective sums up the latest innovative and computational comprehension, while giving credit to earlier/pioneering work in carbonaceous assembly materials towards robust electrocatalytic activity for proton exchange membrane fuel cells via inclusive performance assessment of the oxygen reduction reaction (ORR). M‐Nx‐Cy are exclusively defined active sites for ORR, so there is a unique possibility to intellectually design the relatively new catalysts with much improved activity, selectivity, and durability. Moreover, some SACs structures provide better performance in fuel cells testing with long‐term durability. The efforts to understand the connection in SACs based M‐Nx‐Cy moieties and how these relate to catalytic ORR performance are also conveyed. Owing to comprehensive practical application in the field, this study has covered very encouraging aspects to the current durability status of M‐N‐C based catalysts for fuel cells followed by degradation mechanisms such as macro‐, microdegradation, catalytic poisoning, and future challenges.
One stone, many birds: Recent advances in functional nanogels for cancer nanotheranostics
Authors: Wang Huiyi , Picchio Matias L. , Calderón Marcelo
Published: March 2022

Inspired by the development of nanomedicine and nanotechnology, more and more possibilities in cancer theranostic have been provided in the last few years. Emerging therapeutic modalities like starvation therapy, chemodynamic therapy, and tumor oxygenation have been integrated with diagnosis, giving a plethora of theranostic nanoagents. Among all of them, nanogels (NGs) show superiority benefiting from their unique attributes: high stability, high water‐absorption, large specific surface area, mechanical strength, controlled responsiveness, and high encapsulation capacity. There have been a vast number of investigations supporting various NGs combining drug delivery and multiple bioimaging techniques, encompassing photothermal imaging, photoacoustic imaging, fluorescent imaging, ultrasound imaging, magnetic resonance imaging, and computed tomography. This review summarizes recent advances in functional NGs for theranostic nanomedicine and discusses the challenges and future perspectives of this fast‐growing field.

This article is categorized under:

Therapeutic Approaches and Drug Discovery > Emerging Technologies

Therapeutic Approaches and Drug Discovery > Nanomedicine for Oncologic Disease

Nanotechnology Approaches to Biology > Nanoscale Systems in Biology

Diagnostic Tools > In Vivo Nanodiagnostics and Imaging
Enhanced n‐butanol permselective vapor permeation by incorporating ZIF‐8 into a polydimethylsiloxane composite membrane: Effect of filler loading contents
Authors: Su Xing , Zheng Tucai , Zhu Youliang , Tao Xiaohong , Yu Kuangli , Zhao Zhiqing , Wu Zhenghong , Lu Jiale , Gao Chuanhua , Zhao Dian
Published: March 2022

Fabricating high‐performance mixed matrix composite membranes (MMMs) based on the integration of metal‐organic frameworks (MOFs) and hydrophobic polymer matrix are highly sought for the industrial development of vapor permeation (VP) technology. In this work, ZIF‐8@polydimethylsiloxane/polyvinylidene fluoride (ZIF‐8@PDMS/PVDF) MMMs with various ZIF‐8 nanofiller loading contents were prepared via a simple “prime” blending method. The dispersion and agglomeration of ZIF‐8 nanoparticles on both surface and cross‐section of these membranes were characterized by scanning electron microscopy (SEM) and energy‐dispersive X‐ray spectroscopy (EDS), respectively. The hydrophobicity of as‐obtained MMMs was investigated by water contact angle and swelling degree tests. Furthermore, VP experiments were carried out to evaluate the perm‐selection performance of the ZIF‐8@PDMS/PVDF MMMs for the butanol/water mixture separation. Compared to the conventional PDMS membrane, the separation factor and total flux of MMM with ZIF‐8 loading content of 20 wt% increased by 70 % and 23 %, respectively. The mechanism of mass transfer of butanol and water molecules inside the MMMs was also discussed.
The Effects of Lanthanide Ions Doping and Chromophore Anchoring on the Photocurrent Response and Photocatalytic Behaviours of Titanium‐Oxo‐Clusters
Authors: Luo W. , Wu X.‐H. , Cai B. , Zhang H.‐L. , Liu M.‐D. , Huang Y. , Ge G.‐W. , Hu B.
Published: March 2022

Lanthanide‐titanium‐oxo‐clusters (LnTOCs) have been attractive as a rapidly growing class of molecular materials due to their use as molecular models and precursors of nano titanium oxide. Although various applications of LnTOCs with alkoxide/carboxylate ligands have been documented, phenol dyes coordination LnTOCs applications in antibiotics fields have not been reported yet. Herein three LnTOCs formulated as [Ti2Ln2O(OiPr)6(NO3)4(2,3‐DN)2]2 ⋅ 3.5Et3N ⋅ 2HOiPr (Ln=Tb (1), Eu (2) and Yb (3)) were designed and synthesized. Their structures consisted of a Ti2Tb2O subunit and two 2, 3‐DN ligands. Using cluster 1, Ti2(2, 3‐DN)2 and Ti2Tb2, photocurrent response and photocatalytic dye degeneration were examined. The improvements in photocurrent intensity and photocatalytic activity of dye‐degradation could be attributed to the cooperative effect of the Ln3+ doping and 2, 3‐DN coordination. Furthermore, using cluster 1 as a precursor, F1 exhibited high photoactivity for tetracycline. The antibiotics application of LnTOCs was evaluated firstly. The results indicate that clusters 1–3 have potential applications as a molecule based photodegeneration catalyst.
Emergence and Ephemerality of Humour During Live Coverage of Large-Scale eSports Events
Authors: Felczak Mateusz
Published: March 2022

This chapter argues for ephemerality and emergence as key characteristics of humour in the context of large-scale eSports events. The analysis is based on three large-scale venues: the 2019StarCraft IIWorld Championship Series (WCS), Intel Extreme Masters (IEM) Katowice 2020 and DreamHack SC2 Masters 2020: Season Finals tournaments. The assessment is made using examples encompassing commentators, audience and players, and it is argued that the digital and physical space have been crucial in establishing temporary communities based on shared moments of festive humour. Corporeal, accidental and potentially offensive components of comical phenomena are linked to playful engagement with inter- and metatextual frameworks in which humour is facilitated during live broadcasts of eSports venues on the Twitch.tv digital platform.
Assessing the Cost-Effectiveness of Molecular Targeted Therapies and Immune Checkpoint Inhibitors
Authors: Cairns John Alexander
Published: March 2022

Molecular targeted therapies and immune checkpoint inhibitors have in recent years been transforming the care of many cancer patients. This chapter compares twenty-one appraisals of molecular targeted therapies in non-small-cell lung cancer, comprising six EGFR-TK inhibitors (gefitinib, erlotinib, afatinib, necitumumab, osimertinib and dacomitinib), five ALK inhibitors (crizotinib, ceritinib, alectinib, brigatinib and lorlatinib) and two ROS1 inhibitors (crizotinib and entrectinib), with fifteen appraisals of checkpoint inhibitors used in the treatment of non-small-cell lung cancer comprising the anti-PD-1 agents nivolumab and pembrolizumab, and the anti-PD-L1 agents atezolizumab and durvalumab. Differences with respect to economic evaluation, such as, in terms of the clinical evidence underlying the modelling of cost-effectiveness, and differences observed with respect to life-extending end-of-life status and with respect to inclusion in the Cancer Drugs Fund, are highlighted. The differences observed between the appraisal of the two types of therapy derive from the more limited clinical data and the more restricted application of the targeted medicines. This study of decision making with respect to oncology drugs is likely to be increasingly relevant to a much wider range of medicines, as differential weighting of QALYs and the use of managed access schemes are extended beyond oncology drugs.
Real-World Data in Health Technology Assessment: Do We Know It Well Enough?
Authors: Kang Jiyeon
Published: March 2022

Advanced data science leads the fourth revolution. Data are not only contributing to developing new technologies, but also are expected to help provide scientific and systematic evidence to policymakers by combining all available evidence. In health care, big data and real-world data (RWD) are major key concepts. While they share the similarity, two data are different. As the interests in data being increased, the health technology assessment (HTA) agency faces another phase to incorporate these data in appraising new health technology. This chapter focuses on RWD to discuss the opportunities and challenges of using RWD in HTA. RWD is expected to help supplement the information of survival model, comparators, generalisability and rare cancers along with RCTs. However, there are some limitations to use RWD in HTA, such as no consensus on the definition of RWD, the risk of confounder, challenges to assess the relative treatment effects, quality of data and also generalisability issue. In order to use RWD appropriately in HTA, the deliberation based on the understanding of limitation should be accompanied.
Introduction to the Imaginary of Precision Oncology
Authors: Engen Caroline
Published: March 2022

Ideas about precision medicine found its way into cancer research around the turn of the twentieth century and resulted in the imaginary of precision oncology. This chapter presents the emergence of the imaginary as well as its historical background. It furthermore argues that the imaginary is not well suited to take full biological complexity into account. This gives rise to conceptual limitations as well as practical risks as ambitions of precision are translated into practice.
“Reconstruction of Trouble”
Authors: Dillekås Hanna Elisabet
Published: March 2022

This chapter tells the story of how a Norwegian campaign with the noble cause of offering breast reconstruction to breast cancer treated patients, ended up reconstructing trouble both within and outside of this patient group. Some former cancer patients ended up having not only their breast but also their cancer reconstructed. Furthermore, the resource used by the reconstruction campaign also had as a side-effect a certain resurgence of orofacial cleft as a public health issue as the plastic surgeons were instructed to prioritise breast reconstruction.
Lost in Translation
Authors: Gissum Karen Rosnes
Published: March 2022

The era of precision medicine and biomarkers is here. Medical science and research on biomarkers have made enormous improvements in medical care for cancer patients, improvements that are highly valuable to patients and their caregivers as well as prestige for medical scientists and the pharmaceutical industry. But do these improvements lead to “good health” for cancer patients? “Good health” is one of the most important things in life, but what is the meaning of “good health” today, how do we talk about health, who is declaring a status of ‘good health’, do modern medicine have limitations in being able to declare ‘good health’, and by which perspectives are “good health” declared? These are all relevant questions to ask when defining and framing health, disease and illness in the era of precision medicine.

Ovarian cancer is a serious and highly lethal disease. The different perspectives of health, disease and illness affects the physician-patient relationship and eventually the decision-making. The rapid progress in biomedicine demands knowledge and understanding, but are physicians and cancer patients living in the same world, understanding the same language, or are they all lost in the translation when communicating and understanding illness, disease and above all – health?
The Complexity of LTL Rational Synthesis
Authors: Kupferman Orna , Shenwald Noam
Published: March 2022

Inrational synthesis, we automatically construct a reactive system that satisfies its specification in all rational environments, namely environments that have objectives and act to fulfill them. We complete the study of the complexity of LTL rational synthesis. Our contribution is threefold. First, we tighten the known upper bounds for settings that were left open in earlier work. Second, our complexity analysis is parametric, and we describe tight upper and lower bounds in each of the problem parameters: the game graph, the objectives of the system components, and the objectives of the environment components. Third, we generalize the definition of rational synthesis, combining the cooperative and non-cooperative approaches studied in earlier work, and extend our complexity analysis to the general definition.
Automatic Repair for Network Programs
Authors: Shi Lei , Wang Yuepeng , Alur Rajeev , Loo Boon Thau
Published: March 2022

Debugging imperative network programs is a difficult task for operators as it requires understanding various network modules and complicated data structures. For this purpose, this paper presents an automated technique for repairing network programs with respect to unit tests. Given as input a faulty network program and a set of unit tests, our approach localizes the fault through symbolic reasoning, and synthesizes a patch ensuring that the repaired program passes all unit tests. It applies domain-specific abstraction to simplify network data structures and exploits function summary reuse for modular symbolic analysis. We have implemented the proposed techniques in a tool called NetRep and evaluated it on 10 benchmarks adapted from real-world software-defined network controllers. The evaluation results demonstrate the effectiveness and efficiency of NetRep for repairing network programs.
Theoretischer Hintergrund
Authors: Braun Vera
Published: March 2022

Kapitel 2 schafft eine Grundlage für die Entwicklung eines Idealtypus der Beziehung zwischen Meritokratie und beruflicher Bildung. In diesem Sinne setzt es sich allgemein mit Meritokratie auseinander und arbeitet davon ausgehend den Zusammenhang zwischen Leistung, Werten von Akteur/-innen und Strukturen des Bildungssystems heraus.
Digital Information and Library Services in ODDE
Authors: Owusu-Ansah Christopher M. , Rodrigues Antonioda da Silva
Published: March 2022

This chapter is anchored on Collaboration being a new construct in the Digital Library Reference Model proposed by the DELOS Network of Excellence on Digital Libraries. The chapter argues that distance learning library services will be significantly enhanced with a collaboratively implemented digital library service taking into cognizance the role of collaboration in strategic planning and policy development, provision of digital collections and information services, and technological infrastructure and skills development in the distance education context. The study concludes that the collaborative model for implementing digital libraries in open, distance, and digital education (ODDE) can ensure that digital libraries are collaboratively designed leading to wider acceptance and use in ODDE.
miRNA-guided reprogramming of glucose and glutamine metabolism and its impact on cell adhesion/migration during solid tumor progression
Authors: Quirico Lorena , Orso Francesca , Cucinelli Stefania , Paradzik Mladen , Natalini Dora , Centonze Giorgia , Dalmasso Alberto , La Vecchia Sofia , Coco Martina , Audrito Valentina , Riganti Chiara , Defilippi Paola , Taverna Daniela
Published: March 2022

MicroRNAs (miRNAs) are small, non-coding RNAs about 22 nucleotides in length that regulate the expression of target genes post-transcriptionally, and are highly involved in cancer progression. They are able to impact a variety of cell processes such as proliferation, apoptosis and differentiation and can consequently control tumor initiation, tumor progression and metastasis formation. miRNAs can regulate, at the same time, metabolic gene expression which, in turn, influences relevant traits of malignancy such as cell adhesion, migration and invasion. Since the interaction between metabolism and adhesion or cell movement has not, to date, been well understood, in this review, we will specifically focus on miRNA alterations that can interfere with some metabolic processes leading to the modulation of cancer cell movement. In addition, we will analyze the signaling pathways connecting metabolism and adhesion/migration, alterations that often affect cancer cell dissemination and metastasis formation.
One-Dimensional Fokker–Planck Equations and Functional Inequalities for Heavy Tailed Densities
Authors: Furioli Giulia , Pulvirenti Ada , Terraneo Elide , Toscani Giuseppe
Published: March 2022

We present and discuss connections between the problem of trend to equilibrium for one-dimensional Fokker–Planck equations modeling socio-economic problems, and one-dimensional functional inequalities of the type of Poincaré, Wirtinger and logarithmic Sobolev, with weight, for probability densities with polynomial tails. As main examples, we consider inequalities satisfied by inverse Gamma densities, taking values on $$\mathbb R_+$$

R
+

, and Cauchy-type densities, taking values on $$\mathbb R$$
R
.
Evaluation of ankle fracture classification systems in 193 trimalleolar ankle fractures
Authors: Pflüger Patrick , Harder Felix , Müller Karoline , Biberthaler Peter , Crönlein Moritz
Published: March 2022

Purpose

Different classification systems have been developed for ankle fractures. In recent years, the posterior malleolus has gained in importance and led to computed tomography (CT)-based classification systems. The aim of the study was to analyse their reliability, fracture patterns and influence on treatment strategy.

Methods

Patients with a trimalleolar ankle fracture treated between 2011 and 2020 with preoperative radiographs and CT images were included. The blinded images were independently classified by three reviewers according to the AO/OTA, Herscovici, Bartoníček, Mason and Haraguchi classifications. The interobserver reliability was calculated by Fleiss' kappa (κ). CT images were analysed to determine the dimensions of the posterior malleolus fragments. Patient registries were reviewed regarding the treatment data.

Results

A total of 193 patients were included. The AO/OTA classification showed almost perfect inter- and intraobserver reliability (Fleiss’ κ = 0.86, 95% CI 0.82–0.90). Regarding the posterior malleolus, the Bartoníček classification demonstrated the highest reliability (Fleiss’ κ = 0.78, 95% CI 0.73–0.83). The Herscovici classification only reached moderate reliability for medial malleolus fractures (Fleiss' κ = 0.59, 95% CI 0.54–0.65). There was a trend towards direct fixation of the posterior malleolus in the last 3 years of the observation period (OR: 2.49, 95% CI 1.03–5.99).

Conclusion

In trimalleolar ankle fractures, the AO/OTA classification is a reliable system to characterize the type of fracture, but it fails to provide solid information about the posterior malleolus. Nowadays, treatment recommendations for trimalleolar ankle fractures focus on the configuration of the posterior malleolus; therefore, the results of this study advocate the use of the Bartoníček classification as a reliable tool to guide treatment.
Endothelial glycocalyx degradation in multisystem inflammatory syndrome in children related to COVID-19
Authors: Veraldi Noemi , Vivès Romain R. , Blanchard-Rohner Géraldine , L’Huillier Arnaud G. , Wagner Noemie , Rohr Marie , Beghetti Maurice , De Agostini Ariane , Grazioli Serge
Published: March 2022

Multisystem inflammatory syndrome in children (MIS-C) represents a rare but severe complication of severe acute respiratory syndrome coronavirus 2 infection affecting children that can lead to myocardial injury and shock. Vascular endothelial dysfunction has been suggested to be a common complicating factor in patients with coronavirus disease 2019 (COVID-19). This study aims to characterize endothelial glycocalyx degradation in children admitted with MIS-C. We collected blood and urine samples and measured proinflammatory cytokines, myocardial injury markers, and endothelial glycocalyx markers in 17 children admitted with MIS-C, ten of which presented with inflammatory shock requiring intensive care admission and hemodynamic support with vasopressors. All MIS-C patients presented signs of glycocalyx deterioration with elevated levels of syndecan-1 in blood and both heparan sulfate and chondroitin sulfate in the urine. The degree of glycocalyx shedding correlated with tumor necrosis factor-α concentration. Five healthy age-matched children served as controls. Patients with MIS-C presented severe alteration of the endothelial glycocalyx that was associated with disease severity. Future studies should clarify if glycocalyx biomarkers could effectively be predictive indicators for the development of complications in adult patients with severe COVID-19 and children with MIS-C.

Key messages

Children admitted with MIS-C presented signs of endothelial glycocalyx injury with elevated syndecan-1 and heparan sulfate level.

Syndecan-1 levels were associated with MIS-C severity and correlated TNF-α concentration.

Syndecan-1 and heparan sulfate may represent potential biomarkers for patients with severe COVID-19 or MIS-C.
Ökonomische Aspekte der Niederfeld-Magnetresonanztomographie
Authors: Vosshenrich Jan , Breit Hanns-Christian , Bach Michael , Merkle Elmar M.
Published: March 2022

Hintergrund

Niederfeld-Magnetresonanztomographie(MRT)-Geräte bieten aufgrund niedrigerer Herstellungskosten und geringerer baulicher Anforderungen für Installation und Betrieb eine Chance zur Kostenreduktion.

Fragestellung

Mögliche Kostenreduktionen in Anschaffung, Einbringung und Unterhalt durch die Verwendung neuer Niederfeld-MRT-Systeme.

Material und Methoden

Übersicht über die wichtigsten Kostenfaktoren und Evaluierung des Einsparpotenzials eines 0,55-T-Niederfeld-MRT der neuesten Generation im Vergleich zu 1,5‑ und 3‑T-MRT-Systemen in der klinischen Routine.

Ergebnisse

Im Anschaffungspreis liegt das Einsparpotenzial eines 0,55-T- im Vergleich zu einem 1,5-T-MRT-System bei etwa 40–50 %. Das um 25 % niedrigere Gewicht des Systems verringert die Transportkosten, die geringere Größe des Geräts erlaubt bei einem ebenerdigen Betriebsplatz die Einbringung mittels ferngesteuertem fahrbarem Robotersystem ohne Eröffnung der Außenfassade. Eine Quench-Leitung muss nicht installiert werden. Die Kosten für Einbringung und Installation sind insgesamt bis zu 70 % niedriger als bei Hochfeldsystemen. Die Wartungskosten eines 0,55-T-Geräts liegen etwa 45 % unter denen eines 1,5-T-Geräts bei vergleichbarem Servicevertrag. Weitere potenzielle Kostenreduktionen ergeben sich durch die geringere Raumgröße und einen potenziell geringeren Energieverbrauch für Untersuchungen und Kühlung.

Schlussfolgerung

Die Verwendung von MRT-Systemen mit niedrigerer Feldstärke bieten großes ökonomisches und ökologisches Potenzial für Kliniken und Praxisbetreiber.
Fast radio bursts at the dawn of the 2020s
Authors: Petroff E. , Hessels J. W. T. , Lorimer D. R.
Published: March 2022

Since the discovery of the first fast radio burst (FRB) in 2007, and their confirmation as an abundant extragalactic population in 2013, the study of these sources has expanded at an incredible rate. In our 2019 review on the subject, we presented a growing, but still mysterious, population of FRBs—60 unique sources, 2 repeating FRBs, and only 1 identified host galaxy. However, in only a few short years, new observations and discoveries have given us a wealth of information about these sources. The total FRB population now stands at over 600 published sources, 24 repeaters, and 19 host galaxies. Higher time resolution data, sustained monitoring, and precision localisations have given us insight into repeaters, host galaxies, burst morphology, source activity, progenitor models, and the use of FRBs as cosmological probes. The recent detection of a bright FRB-like burst from the Galactic magnetar SGR 1935 + 2154 provides an important link between FRBs and magnetars. There also continue to be surprising discoveries, like periodic modulation of activity from repeaters and the localisation of one FRB source to a relatively nearby globular cluster associated with the M81 galaxy. In this review, we summarise the exciting observational results from the past few years. We also highlight their impact on our understanding of the FRB population and proposed progenitor models. We build on the introduction to FRBs in our earlier review, update our readers on recent results, and discuss interesting avenues for exploration as the field enters a new regime where hundreds to thousands of new FRBs will be discovered and reported each year.
Complete Implant Wrapping with Porcine-Derived Acellular Dermal Matrix for the Treatment of Capsular Contracture in Breast Reconstruction: A Case–Control Study
Authors: Bassetto Franco , Pandis Laura , Azzena Gian Paolo , De Antoni Eleonora , Crema Alberto , Scortecci Leonardo , Brambullo Tito , Pavan Chiara , Marini Massimo , Facchin Federico , Vindigni Vincenzo
Published: March 2022

Background

Capsular contracture (CC) represents one of the most common complications in breast reconstruction surgery, impairing final result and patients’ well-being. The role of acellular dermal matrixes (ADM) has been widely described for the treatment and prevention of contracture. The aim of the study was to evaluate the efficacy and safety of complete implant coverage with porcine-derived ADM in preventing CC limiting complications. In addition, patients’ reported outcomes were evaluated in order to define the role of ADM in improving sexual, physical and psychosocial well-being and satisfaction.

Methods

42 patients who underwent surgical treatment of 46 contracted reconstructed breasts from May 2018th to May 2019th were collected in the two groups (ADM group vs. Control group).

Results

The ADM group showed lower rate of CC recurrence and a higher rate of implant losses and minor complications. A significant difference was observed in red breast syndrome (27.3% in the ADM group vs. absent in control the group) and skin ulceration rates (18.2% in the ADM group vs. 4.18% in the control group). As for patients’ perceived outcomes, the ADM group showed a statistically significant higher postoperative Satisfaction of Breast Scale score compared to the control group. In addition, a significant difference was observed in the improvement of Physical Well-Being of the Chest Scale and the Satisfaction of Breast Scale after surgery, in favor to the ADM group.

Conclusion

Complete implant coverage with ADM may reduce the risk of CC recurrence in breast reconstruction. An accurate patient selection allows minimizing complications improving patient well-being and satisfaction.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Human‐Caused Sound Distractors and their Impact on Operating Room Team Function
Authors: Brommelsiek Margaret , Krishnan Tara , Rudy Paul , Viswanathan Navin , Sutkin Gary
Published: March 2022

Background

Patient safety in the Operating Room (OR) depends on unobstructed team communication. Yet the typical OR is loud, containing numerous sounds from surgical machinery overlayed with human‐caused sounds. Our objective was to compare machine vs human‐caused sounds for their loudness and distraction, and potential impact on team communication.

Methods

After surveying OR staff about sounds that interfere with job performance and team communication, we recorded 19 machine and 48 human‐caused sounds measuring their acoustical intensity. We compared peak measures of machine vs human‐caused sound loudness, using Student's t‐test. We observed the effect of these sounds on OR staff in 59 live surgeries, rating level of interference with team function. We visually depicted competing sounds through a spectral analysis.

Results

The survey response rate was 62.8%. 93% of respondents indicated that OR noise, especially human‐caused sounds such as irrelevant conversations, interfere with team communication, hearing, and focus. OR peak decibel levels ranged from 56.8 dB (surgical packaging) to 105.0 dB (kicked metal stepstool). Human‐caused sounds were comparable to machine‐caused sounds in terms of mean peak dB levels (77.0 versus 73.8 dB, p = 0.32), yet were rated as more interfering with surgical team function. The spectral analysis illustrated both machine and human‐caused sound sources obscuring the surgeon's instructions.

Conclusions

Avoidable human‐caused sounds are a major source of disruption in the OR and interfere with communication and job performance. We recommend surgical team training to minimize these distractions.
CIRSE Standards of Practice on Thermal Ablation of Bone Tumours
Authors: Ryan Anthony , Byrne Caoimhe , Pusceddu Claudio , Buy Xavier , Tsoumakidou Georgia , Filippiadis Dimitrios
Published: March 2022

Background

Percutaneous thermal ablation is an effective, minimally invasive means of treating a variety of focal benign and malignant osseous lesions. To determine the role of ablation in individual cases, multidisciplinary team (MDT) discussion is required to assess the suitability and feasibility of a thermal ablative approach, to select the most appropriate technique and to set the goals of treatment i.e. curative or palliative.

Purpose

This document will presume the indication for treatment is clear and approved by the MDT and will define the standards required for the performance of each modality. CIRSE Standards of Practice documents are not intended to impose a standard of clinical patient care, but recommend a reasonable approach to, and best practices for, the performance of thermal ablation of bone tumours.

Methods

The writing group was established by the CIRSE Standards of Practice Committee and consisted of five clinicians with internationally recognised expertise in thermal ablation of bone tumours. The writing group reviewed the existing literature on thermal ablation of bone tumours, performing a pragmatic evidence search using PubMed to search for publications in English and relating to human subjects from 2009 to 2019. Selected studies published in 2020 and 2021 during the course of writing these standards were subsequently included. The final recommendations were formulated through consensus.

Results

Recommendations were produced for the performance of thermal ablation of bone tumours taking into account the biologic behaviour of the tumour and the therapeutic intent of the procedure. Recommendations are provided based on lesion characteristics and thermal modality, for the use of tissue monitoring and protection, and for the appropriately timed application of adjunctive procedures such as osseus consolidation and transarterial embolisation.

Results

Percutaneous thermal ablation has an established role in the successful management of bone lesions, with both curative and palliative intent. This Standards of Practice document provides up-to-date recommendations for the safe performance of thermal ablation of bone tumours.
Evapotranspiration uncertainty at micrometeorological scales: the impact of the eddy covariance energy imbalance and correction methods
Authors: Bambach N. , Kustas W. , Alfieri J. , Prueger J. , Hipps L. , McKee L. , Castro S. J. , Volk J. , Alsina M. M. , McElrone A. J.
Published: March 2022

Under ideal conditions, evapotranspiration (ET) fluxes derived through the eddy covariance (EC) technique are considered a direct measure of actual ET. Eddy covariance flux measurements provide estimates at a temporal frequency that allows examining sub-daily, daily, and seasonal scale processes and relationships between different surface fluxes. The Grape Remote Sensing Atmospheric Profile and Evapotranspiration eXperiment (GRAPEX) project has collected micrometeorological and biophysical data to ground-truth new remote sensing tools for fine-tuning vineyard irrigation management across numerous sites since 2013. This rich dataset allows us to quantify the impact of different approaches to estimate daily ET fluxes, while accounting for energy imbalance. This imbalance results from the lack of agreement between the total available energy and turbulent fluxes derived by the EC technique. We found that different approaches to deal with this energy imbalance can lead to uncertainty in daily ET estimates of up to 50%. Over the growing season, this uncertainty can lead to considerable biases in crop water use estimates, which in some cases were equivalent to ~ 1/3rd of the total growing season applied irrigation We analyzed ET uncertainty relative to atmospheric meteorological, stability, and advective conditions, and highlight the importance of recognizing limitations of micrometeorological observational techniques, considered state of the art, to quantify ET for model validation and field-scale monitoring. This study provides a framework to quantify daily ET estimates’ uncertainty and expected reliability when using the eddy covariance technique for ground-truthing or model validation purposes.
Million dollar questions: why deliberation is more than information pooling
Authors: Hoek Daniel , Bradley Richard
Published: March 2022

Models of collective deliberation often assume that the chief aim of a deliberative exchange is the sharing of information. In this paper, we argue that an equally important role of deliberation is to draw participants’ attention to pertinent questions, which can aid the assembly and processing of distributed information by drawing deliberators’ attention to new issues. The assumption of logical omniscience renders classical models of agents' informational states unsuitable for modelling this role of deliberation. Building on recent insights from psychology, linguistics and philosophy about the role of questions in speech and thought, we propose a different model in which beliefs are treated as answers directed at specific questions. Here, questions are formally represented as partitions of the space of possibilities and individuals’ information states as sets of questions and corresponding partial answers to them. The state of conversation is then characterised by individuals’ information together with the questions under discussion, which can be steered by various deliberative inputs. Using this model, deliberation is then shown to shape collective decisions in ways that classical models cannot capture, allowing for novel explanations of how group consensus is achieved.
Quantifying the role of the large-scale circulation on European summer precipitation change
Authors: de Vries Hylke , Lenderink Geert , van der Wiel Karin , van Meijgaard Erik
Published: March 2022

Regional climate projections indicate that European summer precipitation may change considerably in the future. Southern Europe can expect substantial drying while Northern Europe could actually become wetter. Model spread and internal variability in these projections are large, however, and unravelling the processes that underlie the changes is essential to get more confidence in these projections. Large-scale circulation change is one of the contributors to model spread. In this paper we quantify the role of future large-scale circulation changes to summer precipitation change, using a 16-member single-model ensemble obtained with the regional climate model RACMO2, forced by the global climate model EC-Earth2.3 and the RCP8.5 emission scenario. Using the method of circulation analogues three contributions to the future precipitation change are distinguished. The first is the precipitation change occurring without circulation change (referred to as the thermodynamic term). This contribution is characterised by a marked drying-to-wetting gradient as one moves north from the Mediterranean. The second contribution measures the effects of changes in the mean circulation. It has a very different spatial pattern and is closely related to the development of a region of high pressure (attaining its maximum west of Ireland) and the associated anti-cyclonic circulation response. For a large area east of Ireland including parts of western Europe, it is the major contributor to the overall drying signal, locally explaining more than 90% of the ensemble-mean change. In regions where the patterns overlap, the signal-to-noise ratio of the total change is either enhanced or reduced depending on their relative signs. Although the second term is expected to be particularly model dependent, the high-pressure region west of Ireland also appears in CMIP5 and CMIP6 ensemble-mean projections. The third contribution records the effects of changes in the circulation variability. This term has the smallest net contribution, but a relatively large uncertainty. The analogues are very good in partitioning the ensemble-mean precipitation change, but describe only up to 40% of the ensemble-spread. This demonstrates that other precipitation-drivers (SST, spring soil moisture etc.) will generally strongly influence trends in single climate realisations. This also re-emphasises the need for large ensembles or using alternative methods like the Pseudo Global Warming approach where signal to noise ratios are higher. Nevertheless, identifying the change mechanisms helps to understand the future uncertainties and differences between models.