bluuebunny/crossref_metadata_2025 huggingface dataset:
Adipose Stem Cell-Derived Exosomes As a Macrophage-Based Treatment for Chronic Rotator Cuff Tendinopathy: From a Mouse Model to a Study in Human Tissue
Authors: Yu Weilin , song wei , Liu Xudong , He Yaohua , Wang Chongyang
Published: July 2021

Objectives:

Chronic rotator cuff tendinopathy is one of the most prevalent causes of shoulder pain. Growing evidence suggests that macrophages play a significant role in the pathogenesis of tendinopathy. Therefore, a treatment that targets macrophages would be useful for patients with this common musculoskeletal disorder. To investigate whether adipose stem cell-derived exosomes (ASC-Exos) mediate polarization of macrophages and contribute to the healing of chronic rotator cuff tendinopathy.

Methods:

First, we compared the effects of ASC-Exos on polarization of mouse bone marrow-derived macrophages between a classically activated phenotype (M1φ) and an alternatively activated phenotype (M2φ) in vitro. Seventy-two C57Bl/6 mice were assigned to normal cage activity (n=24) or 5 weeks of treadmill overuse (n=48). The enthesis of supraspinatus in each mouse was then injected with ASC-Exos (ASC-Exos group, n=24) or saline (saline group, n=24). Histological and biomechanical outcomes were assessed 4 weeks after treatment. Finally, tissue samples from human patients with rotator cuff tendinopathy were obtained to determine the effect of ASC-Exos on the M1φ/M2φ balance in tissue-resident macrophages.

Results:

ASC-Exos inhibited M1φ polarization and augmented M2φ polarization both in mouse bone marrow-derived macrophages, mouse in vivo model and human tissue-resident macrophages. Mice in the ASC-Exos group showed less severe pathological changes than the saline group, including less cellular infiltration, disorganization of collagen, and ground substance deposition. The mean modified Bonar score was significantly lower in the ASC-Exos group than in the saline group (9.81 ± 0.96 vs 7.69 ± 1.03; P<.05). Furthermore, the maximum failure load was significantly higher in the ASC-Exos group than in the saline group (4.23 ± 0.66 N vs 3.86 ± 0.65 N; P<.05) as was stiffness (3.38 ± 0.34 N/m vs. 2.68 ± 0.49 N/m; P<.05).

Conclusions:

ASC-Exos-mediated balance of M1φ/M2φ contributes to healing of tendinopathy. Regulation of the M1φ/M2φ balance could be a new target for treatment of chronic rotator cuff tendinopathy.
Introducing the Impingement Index: A study of the combined effect of alpha angle and femoral version on outcomes after hip arthroscopy for femoral acetabular impingement
Authors: Swensen Stephanie , Marom Niv , Nwachukwu Benedict , Ranawat Anil , Kelly Bryan , Nawabi Danyal
Published: July 2021

Objectives:

Many studies within the recent literature have sought to identify the effect of femoral version and other morphologic characteristics on outcomes after primary hip arthroscopy for femoral acetabular impingement (FAI). In addition to femoral version and combined version, our group has recently begun to use the impingement index to stratify patients undergoing this procedure. We define the impingement index as the alpha angle minus the femoral version. The purpose of the current study is to determine the impact of femoral version, combined version and impingement index on patient reported outcomes after primary hip arthroscopy for FAI.

Methods:

A retrospective chart review of a prospectively collected data was conducted from 2010-2016 to identify consecutive patients who underwent primary hip arthroscopy for treatment of FAI. Inclusion criteria are pre-operative CT scan,

Results:

A total of 456 hips (200 males, 256 females) met the inclusion criteria. The mean age at time of surgery was 28.2 (+/- 10). Average follow-up was 2.6 years (range 23-59 months). The cohort experienced clinical improvement (p<0.001) in all patient-reported outcome measures. The mean improvement was 21.4 points for HHS, 17.4 for HOS ADL, 29.5 for HOS Sport, and 34.3 for QOL. There was no significant difference in outcomes scores when stratified by femoral version (<5°, 5-20°, >20°), including at the extremes of femoral version (<-5°, >30°). There was also no significant difference in outcomes scores when patients were stratified by Mckibbin Index (<25°, 25-40, >40°). The net change in mean HOS Sport for impingement index >75 was significantly lower than any other category (14.5 (>75°) vs. 28.1 (45°-75°) vs. 25.7 (<45°).

Conclusions:

Clinically significant improvements can be expected for all femoral version values when a thoughtful algorithm is employed for indicating patients for hip arthroscopy with version abnormalities. However, patients with significant femoral retroversion and large cam lesions may experience less overall improvement compared with normal or increased version. The impingement index may be a valuable tool for predicting outcomes of primary hip arthroscopy for FAI. An elevated impingement index in the setting of femoral retroversion may portend less improvement in patient reported outcomes. This finding warrants further investigation and informs the preoperative decision-making process when indicating a patient for hip arthroscopy for FAI.
Post vs. Post-less Hip Arthroscopy: A Comparison of Traction Force and Patient Specific Parameters
Authors: Dowdle Spencer , Adeyemi Temitope , Cassidy Benjamin , Craig Matthew , Aoki Stephen , Maak Travis
Published: July 2021

Objectives:

Hip distraction during arthroscopic surgery has typically utilized a peroneal post, which has known complications; post-less distraction has thus recently gained favor. This study quantified the traction force required for adequate hip distraction during post-less arthroscopic surgery and compared the data to a previous post cohort including the relationship between force and patient-specific factors.

Methods:

One-hundred thirty-four patients undergoing primary hip arthroscopy were prospectively enrolled. Twenty-nine patients underwent post-less primary hip arthroscopy. A load-cell attached to the traction boot measured traction force. Fluoroscopic images were obtained to measure joint displacement. The stiffness coefficient was calculated as the force of traction divided by joint displacement. Relationships between the stiffness coefficient and patient specific factors were investigated using a univariable regression model. Variables significant at P<0.05 were included in a multivariable regression model.

Results:

The mean age for the combined cohort was 31.9 ± 8.6 years, 42.5% (57/134) were male, and mean BMI was 24.8 ± 4.3kg/m2. There was no significant difference in age (32.5 ± 8.4 vs. 29.7 ± 9.0; p=0.12), sex (43.8% male vs 37.9% male; p=0.57), or BMI (24.6 ± 4.1 vs. 25.2 ± 5.1; p=0.51) between the posted and post-less cohorts. Both maximum and final traction force and hip distraction were statistically significantly smaller in the post-less traction group (Table 1). In univariable regression analysis for maximum traction force (K-max), post-less traction, male sex, BMI, alpha angle, Beighton score greater than zero, and hamstring flexibility were significant. For final traction force (K-hold), male sex, BMI, alpha angle, Beighton score greater than zero and hamstring flexibility were significant (Tables 2 and 3). In the multi-variate analysis for (1) K-max, five variables remained significant including, posted vs. post-less, sex, hamstring flexibility, alpha angle and Beighton score, and (2) K-hold, three variables remained significant including, posted vs. post-less, sex, and alpha angle (Tables 2 and 3).

Conclusions:

Maximal and maintained holding distraction forces were significantly lower in the post-less cohort. Female gender, hamstring flexibility lower alpha angle and Beighton score were found to decrease the maximal force needed for hip distraction. Female gender and lower alpha angle were found to decrease the force needed to maintain distraction. The presence of a labral tear did not correlate with distraction force. These data may be used to identify patients in whom a specific focus on capsular repair and/or plication may be warranted. Moreover, post-less traction may reduce post-related complications by reducing maximal and holding traction forces and perineal pressure.
Increased Posterior Tibial Slope is Associated with Revision Anterior Cruciate Ligament Reconstruction Graft Re-Rupture
Authors: Ormseth Benjamin , DiBartola Alex , Flanigan David , Siston Robert , Geers Katie , Dorweiler Matthew , Kaeding Christopher , Magnussen Robert , Duerr Robert
Published: July 2021

Objectives:

Anterior cruciate ligament reconstruction (ACLR) graft failure continues to be a problem with failure rates reported up to 11%. Following revision ACLR, 3.3 – 4.3% of these patients suffer re-tear of the revision ACL graft. The purpose of this study was to evaluate the influence of posterior tibial slope (PTS) on ACL graft re-tear after revision ACLR. It was hypothesized that increased posterior tibial slope (PTS) is associated with an increased risk of ACL graft re-tear following revision ACLR.

Methods:

Retrospective chart review identified patients who underwent revision ACLR between 2005 and 2016 at a single institution. Patients who suffered an ACL re-tear following revision surgery were matched by age, sex, and graft type to controls who had intact revision ACLR grafts at a minimum of 2 years follow-up. Medial posterior tibial slope (MPTS) and lateral posterior tibial slope (LPTS) were measured on lateral radiographs and sagittal magnetic resonance imaging (MRI). Tibial slope was then compared between groups using independent sample t-tests.

Results:

Twenty-nine patients with a graft failure after revision ACLR were included and compared to 29 matched controls with a mean follow-up of 5.8 years (range: 2 to 11.3 years). Each group included 16 males and 13 females. Average age was 26 +/- 8.3 years at time of revision ACLR. Both x-ray and MRI demonstrated increased LPTS in the failure group versus controls (12.7 ± 3.2 degrees vs. 10.6 ± 3.6 degrees, p = 0.02 and 8.1 ± 3.4 degrees vs. 5.0 ± 3.5 degrees, p = 0.001, respectively). There was no significant difference in MPTS between the failure and control groups on x-ray (11.9 ± 2.9 degrees vs. 11.1 ± 3.6 degrees, p = 0.3772) nor MRI (4.3 ± 3.5 degrees vs. 3.3 ± 3.0 degrees, p = 0.2486).

Conclusions:

Matching for age, sex, and graft type, increased LPTS measured on both x-ray and MRI is associated with increased risk of a subsequent ACL injury following revision ACLR. Identification of at-risk patients may guide pre-operative discussions regarding revision ACL graft failure risk.
Isolated ACL Reconstruction Versus Combined ACL and Anterolateral Ligament Reconstruction: A Matched Case Series with Mean Follow Up of 9 Years
Authors: Haidar Ibrahim , FRADIN Thomas , Rayes Johnny , Vieira Thais , Cédric Ngbilo , Sonnery-Cottet Bertrand , Saithna Adnan
Published: July 2021

Objectives:

The aim of this study was to report long term comparative clinical outcomes of isolated Anterior Cruciate Ligament (ACL) reconstruction versus combined ACL and Anterolateral Ligament (ALL) reconstruction in a matched pair analysis.

Methods:

A retrospective analysis of prospectively collected data was undertaken. Patients who underwent combined ACL and ALL reconstruction were matched 1:1 to patients who had undergone isolated ACL reconstruction using a propensity score. Matching was based upon age, BMI, side to side laxity difference, duration of time between injury and surgery, type of sports participation (e.g pivoting, contact), presence of concomitant meniscal injuries and their treatment. At the end of the study period all patients completed Lysholm, Tegner, IKDC and KOOS scores, and underwent telephone interview and medical notes review to determine whether they had experienced any complications or re-operations after the index procedure. Kaplan-Meier analysis was used to determine survivorship with respect to graft rupture rates in each group

Results:

90 patients who underwent combined ACL and ALL reconstruction were matched to 90 patients who underwent isolated ACL reconstruction. The mean duration of follow up was 108.09±9.43 months (range 97-182). The combined ACLR and ALLR group had significant lower graft rupture rate (3.5%) than the isolated ACLR group (16%) (OR=5.306 ; CI =1.46-19.19 ; p=0.007) (Fig 1). There was no significant difference between groups with respect to non-graft rupture related reoperation rates (secondary meniscectomy, cyclops excision, arthroscopic lavage for infection or hemarthrosis). Contralateral ACL rupture rates were comparable between combined ACL and ALL reconstruction (16.27%) and isolated ACL reconstruction (19.5%) groups. The KOOS score was significantly higher in the combined group with respect to subdomains of pain (p=0.007) and quality of life (p=0.007). There was no significant difference in other KOOS domains, Tegner, Lysholm, or IKDC

Conclusions:

This study reports the first long-term results of combined ACL and ALL reconstruction. The results demonstrate a significantly lower graft failure rate when compared to isolated ACL reconstruction in a matched pair series with a minimum follow-up of 9 years.
TMJ Replacement Following Pseudoarthrosis of Condylar Neck Fracture With Dislocation of the Condylar Neck Within the Infra-Temporal Fossa
Authors: Olate Sergio , Huentequeo-Molina Claudio , Unibazo Alejandro , Alister Juan Pablo
Published: July 2021

Study Design:

Case Report

Objective:

To present a patient with long-standing TMJ dislocation and pseudoarthrosis in the temporal bone treated with orthognathic surgery and unilateral joint replacement.

Method:

The patient, a 52-year-old female, came to our department to treat facial asymmetry and oral rehabilitation. The patient reported early facial trauma at 7 years old showing partial edentoulism, dental occlusion class III and a 19 mm mandibular midline deviation. Cone beam computed tomography showed the left TMJ in long-standing dislocation into the fossa temporalis, creating a new articular fossa in the temporal bone and adaptation of the hard and soft tissue.

Results:

Orthognathic surgery and TMJ replacement using a patient-specific implant and dental rehabilitation were planned; surgery was performed with no complications, and the 1-year follow-up showed that this treatment was a good option for long-standing TMJ dislocation.

Conclusion:

The long-term TMJ dislocation can be successfully treated by TMJ replacement using a patient-specific implant to obtain facial balance and oral function and avoid relapse.
Design and bulletproof performance investigation on the ceramic/metal laminated composite
Authors: Li Bianhong , Deng Hongbin , Gao Xiangsheng , Gao Hanjun
Published: July 2021

In the current study, seven types of laminated composites are designed to replace the existing 616 steel plate with 5 mm thickness for the bulletproof. An explicit dynamic finite element model is developed to simulate the bullet penetration process using ANSYS Workbench software. And a specific bulletproof coefficient, which considers the ultimate bulletproof speed and area density of the target plate, is proposed and calculated, and the overall bulletproof performances of the composites and 616 steel plate are compared. The specific bulletproof coefficients of seven composites are increased by 12.53%, 14.77%, 13.28%, 12.20%, 19.59%, 23.81%, and 20.67%, respectively. The type F is the optimal type among all the structures. Eventually, the optimal composites are validated under different bullet hit positions and double-bullet situations. Results show that all the seven composites and 616 steel with 5 mm thickness can effectively defend 5.62 mm bullets, and no damage or failure is observed. Although the impact stiffness and ultimate bulletproof speed are both decreased, the area density and density are also significantly decreased.
Decline and Pronounced Regional Disparities in Medical Cocaine Usage in the United States
Authors: Armbuster Youngeun C. , Banas Brian N. , Feickert Kristen D. , England Stephanie E. , Moyer Erik J. , Christie Emily L. , Chughtai Sana , Giuliani Tanya J. , Halden Rolf U. , Graham Jove H. , McCall Kenneth L. , Piper Brian J.
Published: July 2021

Background: Cocaine is a stimulant and Schedule II drug used as a local anesthetic and vasoconstrictor. Objective: This descriptive study characterized medical cocaine use in the United States. Methods: Retail drug distribution data from 2002 to 2017 were extracted for each state from the Drug Enforcement Administration, which reports on medical, research, and analytical chemistry use. The percentage of buyers (pharmacies, hospitals, and providers) was obtained. Use per state, corrected for population, was determined. Available cross-sectional data on cocaine use as reported by the Medicare and Medicaid programs for 2013-2017 and electronic medical records were examined. Results: Medical cocaine use decreased by −62.5% from 2002 to 2017. Hospitals accounted for 84.9% and practitioners for 9.9% of cocaine distribution in 2017. The number of pharmacies carrying cocaine dropped by −69.4%. The percentages of hospitals, practitioners, and pharmacies that carried cocaine in 2017 were 38.4%, 2.3%, and 0.3%, respectively. There was a 7-fold difference in 2002 (South Dakota, 76.1 mg/100 persons; Delaware, 10.1 mg/100 persons). Relative to the average state in 2017, those reporting the highest values (Montana, 20.1; North Dakota, 24.1 mg/100 persons) were significantly elevated. Cocaine use within the Medicare and Medicaid programs was negligible. Cocaine use within the Geisinger system was rare from 2002 to 2007 (<4 orders/100 000 patients per year) but increased to 48.7 in 2018. Conclusion and Relevance: If these pharmacoepidemiological patterns continue, licit cocaine may soon become a historical relic. The pharmacology and pharmacotherapeutics education of health care providers may need to be adjusted accordingly.
Emerging Technology: Ultrasound Vector Flow Imaging—A Novel Approach to Arterial Hemodynamic Quantification
Authors: Baun Jim
Published: July 2021

Accurate, reliable, and easily obtainable quantification of peripheral arterial hemodynamic states has long been a holy grail of vascular ultrasound. While conventional Doppler modalities have been relied upon for decades to provide velocity, directionality, and flow volume data for integration into patient management schema, they carry limitations in accurately and reproducibly quantifying complex arterial hemodynamic patterns. Advances in ultrasound imaging architecture, such as virtual beamforming, integration of “big data” capabilities, and the use of enhanced digital signal processing methods have opened the door for a novel approach to arterial hemodynamic mapping and quantification—ultrasound vector flow imaging (VFI). This article presents an overview of the technological underpinnings of VFI, compares it with conventional pulsed wave and color Doppler methods, and describes the potential clinical benefits of this emerging vascular ultrasound modality.
Association of frailty with health service utilisation and health care expenditure in sub-Saharan Africa: evidence from Côte d’Ivoire
Authors: Ambagtsheer Rachel C. , Moussa Richard K.
Published: July 2021

Background

Frailty, a syndrome resulting in heightened risk of negative outcomes for older adults, is increasing across the globe. However, little is known about the health service impacts of frailty in low-income countries (LICs), and in particular, sub-Saharan Africa (SSA). This study explores the relationship between frailty and health service 1) utilisation and 2) expenditure within Côte d’Ivoire.

Methods

Participants aged 50 years and over participated in the Living Condition, Health and Resilience among the Elderly study. Frailty was assessed using a 30-item Frailty Index (FI). The association between frailty and self-reported health service utilisation was analysed for general practitioners (GPs), specialists, overnight hospitalisations, traditional practitioners and self-medication. Expenditure over the previous month included consulting, medications, hospitalisations and total expenditure.

Results

Among participants [n = 860, mean age (SD) = 61.8 (9.7) years, 42.9% female], 60.0% were frail, 22.8% pre-frail and 17.2% robust. The mean (SD) FI was 0.28 (0.17). Increased health service utilisation was associated with frailty for GP attendance, traditional practitioners and self-medication but not specialists or overnight hospitalisation. Pre-frailty and frailty were associated with increased total health service expenditure, with frailty also associated with aggregate consulting costs and medications.

Conclusions

Although frailty is associated with health service utilisation and expenditure in a variety of contexts, the study results suggest that such impacts may vary across the globe. The experience of frailty in LICs is likely to differ from that experienced elsewhere due to cultural traditions, attitudes to the health system, and accessibility, with more research needed.
Clinical and genetic factors associated with anxiety and depression in breast cancer patients: a cross-sectional study
Authors: HAJJ Aline , HACHEM Roula , KHOURY Rita , HALLIT Souheil , ElJEBBAWI Bashar , NASR Fady , EL KARAK Fadi , CHAHINE Georges , KATTAN Joseph , RABBAA KHABBAZ Lydia
Published: July 2021

Background

Despite the progress in assessment and treatment of breast cancer, being diagnosed with it or receiving chemotherapy treatment is still conceived as a traumatic experience. Women develop negative thoughts about life and death with detrimental effects on their daily physical functioning/activities, emotional state and overall quality of life. The aim of our study was to evaluate the level of anxiety and depression among breast cancer patients receiving chemotherapy and explore the correlation between these psychological disorders, clinical, sociodemographic and genetic factors.

Methods

A cross-sectional study was conducted among breast cancer patients undergoing intravenous chemotherapy at the oncology outpatient unit of Hôtel-Dieu de France hospital (November 2017–June 2019; Ethical approval number: CEHDF1016). All patients gave their written informed consent and completed several validated scales, including the Hospital Anxiety and Depression scale (HADS) for the assessment of anxiety and depression. Sleep quality, insomnia, cognitive function, fatigue and pain were also evaluated. Genotyping for certain gene polymorphisms (CLOCK, PER2, CRY2, OPRM1, ABCB1, COMT, DRD2) was performed using the Lightcycler® (Roche).

Results

A total of 112 women was included. The prevalence of depression was 43.4%, and 56.2% of the patients reported anxiety (based on the HADS classification). Multivariable analysis showed that higher cognitive scores and taking fosaprepitant were significantly associated with lower depression and anxiety scores. Moreover, being married compared to single was also associated with lower depression scores, whereas higher PSQI scores (worse sleep quality) and having the PER2 AA variant genotype compared to GG were significantly associated with higher depression scores. Finally, reporting a more severe insomnia and having the COMT Met/Met genotype were significantly associated with a higher anxiety score.

Conclusions

Our study demonstrated a strong relationship between depression scores and cognitive impairment, sleep quality, marital status, fosaprepitant intake, and PER2 polymorphism, while anxiety scores were correlated to cognitive impairment, insomnia severity, fosaprepitant intake, and COMT polymorphism. The association with PER polymorphism was not previously reported. Identification of genetic and clinical risk factors for anxiety and depression would help clinicians implement an individualized management therapy aiming at preventing and alleviating the burden of these symptoms in breast cancer patients, hence improving their overall quality of life.
Feasibility study of early prediction of postoperative MRI findings for knee stability after anterior cruciate ligament reconstruction
Authors: Zhang Jianqiang , Ma Jiyao , Huang Juan , Wang Guoliang , Huang Yilong , Li Zhenhui , Yan Jun , Zeng Xiaomin , Zhu Hongli , Zhao Wei , Li Yanlin , He Bo
Published: July 2021

Background

At present, the most effective and mature treatment after ACL injury and tear is ACL reconstruction, but the rehabilitation process after ACL reconstruction that is very long, so it is very important to find early MRI positive findings of knee instability.

Methods

We retrospectively collected the clinical and imaging data of 70 patients who underwent ACL reconstruction from January 2016 to December 2019; Based on clinical criteria, the patients were divided into a stable group (n = 57) and an unstable group (n = 13); We measured the MRI imaging evaluation indexes, including the position of the bone tunnel, graft status, and the anatomical factors; Statistical methods were used to compare the differences of imaging evaluation indexes between the two groups; The prediction equation was constructed and ROC curve was used to compare the prediction efficiency of independent prediction factors and prediction equation.

Results

There were significant differences in the abnormal position of tibial tunnel entrance, percentage of the position of tibial tunnel entrance, position of tibial tunnel exit, lateral tibial posterior slope (LTPS), width of intercondylar notch between stable knee joint group and unstable knee joint group after ACL reconstruction (P < 0.05); The position of tibial tunnel exits and the lateral tibial posterior slope (LTPS) and the sagittal obliquity of the graft were independent predictors among surgical factors and self-anatomical factors (P < 0.05); The prediction equation of postoperative knee stability was established: Logit(P) = -1.067–0.231*position of tibial tunnel exit + 0.509*lateral tibial posterior slope (LTPS)-2.105*sagittal obliquity of the graft; The prediction equation predicted that the AUC of knee instability was 0.915, the sensitivity was 84.6%, and the specificity was 91.2%.

Conclusions

We found that abnormalities of the position of the exit of the bone tunnel, lateral tibial posterior slope (LTPS) and sagittal obliquity of the graft were the early MRI positive findings of knee instability after ACL reconstruction. It is helpful for clinicians to predict the stability of knee joint after ACL reconstruction.
Predicting temperature-dependent transmission suitability of bluetongue virus in livestock
Authors: El Moustaid Fadoua , Thornton Zorian , Slamani Hani , Ryan Sadie J. , Johnson Leah R.
Published: July 2021

The transmission of vector-borne diseases is governed by complex factors including pathogen characteristics, vector–host interactions, and environmental conditions. Temperature is a major driver for many vector-borne diseases including Bluetongue viral (BTV) disease, a midge-borne febrile disease of ruminants, notably livestock, whose etiology ranges from mild or asymptomatic to rapidly fatal, thus threatening animal agriculture and the economy of affected countries. Using modeling tools, we seek to predict where the transmission can occur based on suitable temperatures for BTV. We fit thermal performance curves to temperature-sensitive midge life-history traits, using a Bayesian approach. We incorporate these curves intoS(T), a transmission suitability metric derived from the disease’s basic reproductive number,$$R_0.$$R0.This suitability metric encompasses all components that are known to be temperature-dependent. We use trait responses for two species of key midge vectors,Culicoides sonorensisandCulicoides variipennispresent in North America. Our results show that outbreaks of BTV are more likely between 15$$^{\circ }$$∘C and$$34^{\circ }\hbox { C}$$34∘C, with predicted peak transmission risk at 26$$^\circ$$∘ C. The greatest uncertainty inS(T) is associated with the following: the uncertainty in mortality and fecundity of midges near optimal temperature for transmission; midges’ probability of becoming infectious post-infection at the lower edge of the thermal range; and the biting rate together with vector competence at the higher edge of the thermal range. We compare three model formulations and show that incorporating thermal curves into all three leads to similar BTV risk predictions. To demonstrate the utility of this modeling approach, we created global suitability maps indicating the areas at high and long-term risk of BTV transmission, to assess risk and to anticipate potential locations of disease establishment.
Superresolution reconstruction method for ancient murals based on the stable enhanced generative adversarial network
Authors: Cao Jianfang , Jia Yiming , Yan Minmin , Tian Xiaodong
Published: July 2021

A stable enhanced superresolution generative adversarial network (SESRGAN) algorithm was proposed in this study to address the low-resolution and blurred texture details in ancient murals. This algorithm makes improvements on the basis of GANs, which use dense residual blocks to extract image features. After two upsampling steps, the feature information of the image is input into the high-resolution (HR) image space to realize an improvement in resolution, and the reconstructed HR image is finally generated. The discriminator network uses VGG as its basic framework to judge the authenticity of the input image. This study further optimized the details of the network model. In addition, three loss optimization models, i.e., the perceptual loss, content loss, and adversarial loss models, were integrated into the proposed algorithm. The Wasserstein GAN-gradient penalty (WGAN-GP) theory was used to optimize the adversarial loss of the model when calculating the perceptual loss and when using the preactivation feature information for calculation purposes. In addition, public data sets were used to pretrain the generative network model to achieve a high-quality initialization. The simulation experiment results showed that the proposed algorithm outperforms other related superresolution algorithms in terms of both objective and subjective evaluation indicators. A subjective perception evaluation was also conducted, and the reconstructed images produced by our algorithm were more in line with the general public’s visual perception than those produced by the other compared algorithms.
Protecting patients and staff in residential treatment centers during exposure to COVID-19: commentary
Authors: Johnson Kimberly A. , Keough Carolyn , Hills Holly , Vermeer Wouter , Lengnick-Hall Rebecca , McNulty Moira , McGovern Mark , Brown Hendricks
Published: July 2021

Background

The COVID-19 pandemic has created a crisis in access to addiction treatment. Programs with residential components have been particularly impacted as they try to keep infection from spreading in facilities and contributing to further community spread of the virus. This crisis highlights the ongoing daily trade-offs that organizations must weigh as they balance the risks and benefits of individual patients with those of the group of patients, staff and the community they serve.

Main body

The COVID-19 pandemic has forced provider organizations to make individual facility level decisions about how to manage patients who are COVID-19 positive while protecting other patients, staff and the community. While guidance documents from federal, state, and trade groups aimed to support such decision making, they often lagged pandemic dynamics, and provided too little detail to translate into front line decision making. In the context of incomplete knowledge to make informed decisions, we present a way to integrate guidelines and local data into the decision process and discuss the ethical dilemmas faced by provider organizations in preventing infections and responding to COVID positive patients or staff.

Conclusion and commentary

Provider organizations need decision support on managing the risk of COVID-19 positive patients in their milieu. While useful, guidance documents may not be capable of providing support with the nuance that local data and simulation modeling may be able to provide.
Determinants of self-management behaviors among pulmonary tuberculosis patients: a path analysis
Authors: Li Jin , Pu Jie , Liu Jiaqing , Wang Qingya , Zhang Rui , Zhang Ting , Zhou Jiani , Xing Wei , Liang Shengxiang , Hu Daiyu , Li Ying
Published: July 2021

Background

Tuberculosis (TB) is one of the top 10 causes of death in the world. Since Directly Observed Therapy (DOT) as a core strategy for the global TB control are not applicable to all types of TB patients, and self-management of TB patients (SMTP) as a patient-centered supervision type is a supplement to DOT and can improve TB case management. However, the factors related to SMTP are complex and need more study. This study aimed at identifying the determinants of SMTP and examining the direct/indirect effects of these determinants.

Methods

The purposive sampling technique was used to select study sites and participants were recruited from the study sites by the consecutive sampling method. The PRECEDE model was used as the framework to analyze the determinants of SMTP. The responses of TB patients were acquired via a questionnaire survey for data collection. A Pearson correlation analysis was used to define the relationship between the predisposing, enabling, reinforcing factors with SMTP behaviors. A regression-based path analysis was used to determine the action paths of the predisposing, enabling, and reinforcing factors on SMTP behaviors.

Results

The predisposing (TB knowledge), enabling [health education and healthcare workers (HCWs) support], reinforcing factors (family support) had significant positive correlations with SMTP behaviors (P < 0.05). The predisposing, enabling, reinforcing factors were positively correlated with each other (r = 0.123‒0.918,P < 0.05), except for family support and HCWs support. The predisposing factors (TB knowledge, β = 0.330) and the enabling factors (HCWs support, β = 0.437) had direct effects on SMTP behaviors. The enabling factors (health education and HCWs support) and the reinforcing factors (family support) had indirect effects on SMTP behaviors.

Conclusions

This study revealed the effects and action path of TB knowledge, health education, HCWs support, and family support on SMTP behaviors via a path analysis. Assessing patient’s needs for SMTP along with promoting effective TB health education and providing firm support from HCWs and family members are potential strategies to promote SMTP behaviors.

Graphic abstract
Long-term survival in thymic carcinoma with postoperative pleural dissemination
Authors: Kimura Toru , Higashiyama Masahiko , Honma Keiichiro , Nakamura Harumi , Maniwa Tomohiro , Okami Jiro
Published: July 2021

Background

We report a patient with thymic squamous cell carcinoma who underwent multiple rounds of surgical resection and definitive radiotherapy for both primary tumor and postoperative recurrence. However, the patient remains well and healthy 18 years after initial diagnosis. Since long-term survival after postoperative recurrence of thymic carcinoma is extremely rare, we also present her immunohistochemical staining results, which suggested indolent disease.

Case presentation

A 42-year-old woman with thymic squamous cell carcinoma underwent en bloc resection of the tumor and thymus gland. Pleural dissemination was noted in the right thoracic cavity 3, 10, and 16 years postoperatively. Where possible, the nodules were resected surgically: during the postoperative 3rd and 16th years. Definitive radiotherapy was administered for all nodules that could not be excised during the postoperative 3rd and 10th years. Disease-free survival is 25 months.

Conclusions

Local control of pleural dissemination may be beneficial in the treatment of postoperative recurrence of thymic carcinoma in limited cases of indolent disease.
Practical considerations of dietary therapies for epilepsy in adults
Authors: Kaul Neha , Nicolo John-Paul , O’Brien Terence J. , Kwan Patrick
Published: July 2021

Despite the increasing number of anti-seizure medications becoming available, the proportion of patients with drug-resistant epilepsy remains unchanged. Dietary therapy for epilepsy is well-established practice in paediatric care, but relatively underutilised in adults. Recently, international recommendations have been published to guide the treatment of adults receiving dietary therapy for epilepsy.

This review focuses on the specific aspects of care unique to the management of adults receiving dietary therapy for epilepsy, including patient selection, diet composition, initiation, monitoring and cessation of dietary treatment. We emphasise the need for a multidisciplinary team approach with appropriately trained neurologists and dietitians to provide holistic care while the patients are receiving dietary therapy. Future research should focus on the optimal diet composition and meeting the psychosocial needs of adults with epilepsy to maximise efficacy and adherence to dietary treatment.
Racial Differences in Patient Portal Activation and Research Enrollment Among Patients With Prostate Cancer
Authors: Halbert Chanita Hughes , Jefferson Melanie , Allen Caitlin G. , Babatunde Oluwole A. , Drake Richard , Angel Peggi , Savage Stephen J. , Frey Lewis , Lilly Michael , Obi Ted , Obeid Jihad
Published: July 2021

PURPOSE

The purpose of this study was to examine racial differences in patient portal activation and research participation among patients with prostate cancer.

MATERIALS AND METHODS

Participants were African American and White patients with prostate cancer who were treated with radical prostatectomy (n = 218). Patient portal activation was determined using electronic health records, and research participation was measured based on completion of a social determinants survey.

RESULTS

Thirty-one percent of patients completed the social determinants survey and enrolled in the study and 66% activated a patient portal. The likelihood of enrolling in the study was reduced with greater levels of social deprivation (odds ratio [OR], 0.70; 95% CI, 0.50 to 0.98; P = .04). Social deprivation also had a signification independent association with patient portal activation along with racial background. African American patients (OR, 0.48; 95% CI, 0.23 to 0.91; P = .02) and those with greater social deprivation (OR, 0.58; 95% CI, 0.42 to 0.82; P = .002) had a lower likelihood of activating a patient portal compared with White patients and those with lower social deprivation.

CONCLUSION

Although the majority of patients with prostate cancer activated their patient portal, rates of patient portal activation were lower among African American patients and those who lived in areas with greater social deprivation. Greater efforts are needed to promote patient portal activation among African American patients with prostate cancer and address access to health information technology among those who live in socially disadvantaged geographic areas.
Word, Image, Sound
Authors: Engelke Matthew
Published: July 2021

This essay introduces the special section “Word, Image, Sound,” a collection of essays on public religion and religious publicities in Africa and South Asia. The essays cover case studies in Myanmar, Zambia, Senegal, Rwanda, and Egypt. The introduction situates the essays in relation to the broader fields of work on the public sphere and publics, especially as they relate to recent work in the human sciences that focus on materiality, the senses, and media.
Drowning in Context
Authors: Edwards Michael
Published: July 2021

Recent reforms in Myanmar afforded local Christians new opportunities to more actively share the gospel with Buddhists. In doing so they entered into a public sphere tentatively emerging from five decades of censorship and other restrictions on expression. This article explores the place of misunderstanding and translation in encounters between evangelists and Buddhist audiences. For evangelists, to go public was to open oneself to the possibility, even the likelihood, of being misunderstood. Such misunderstandings emerged in part from the negotiation of similarity and difference entailed by translation practices. Edwards situates these practices in a conceptual and linguistic space partly shaped by nineteenth-century missionary efforts, and also by state attempts to regulate the public use of Buddhist language.
Inter-Islamic Modernity at the End of Empire
Authors: Amzi-Erdoǧdular Leyla
Published: July 2021

This review essay of Faiz Ahmed's Afghanistan Rising: Islamic Law and Statecraft between the Ottoman and British Empires focuses on the late imperial and the postimperial context of inter-Islamic networks. It emphasizes the Ottoman, Balkan, and Eurasian exchanges within the historiographical framework of the changing global order characterized by novel deliberations among Muslims across geographic and political boundaries. Situating Afghanistan Rising within these networks reveals the complexity of the inter-Islamic region and the consequence of Muslim agency.
rmcorrShiny: A web and standalone application for repeated measures correlation
Authors: Marusich Laura R. , Bakdash Jonathan Z.
Published: July 2021

We describe a web and standalone Shiny app for calculating the common, linear within-individual association for repeated assessments of paired measures with multiple individuals: repeated measures correlation (rmcorr). This tool makes rmcorr more widely accessible, providing a graphical interface for performing and visualizing the output of analysis with rmcorr. In contrast to rmcorr, most widely used correlation techniques assume paired data are independent. Incorrectly analyzing repeated measures data as independent will likely produce misleading results. Using aggregation or separate models to address the issue of independence may obscure meaningful patterns and will also tend to reduce statistical power. rmcorrShiny (repeated measures correlation Shiny) provides a simple and accessible solution for computing the repeated measures correlation. It is available at: https://lmarusich.shinyapps.io/shiny_rmcorr/.
DARLENE – Improving situational awareness of European law enforcement agents through a combination of augmented reality and artificial intelligence solutions
Authors: Apostolakis Konstantinos C. , Dimitriou Nikolaos , Margetis George , Ntoa Stavroula , Tzovaras Dimitrios , Stephanidis Constantine
Published: July 2021

Background: Augmented reality (AR) and artificial intelligence (AI) are highly disruptive technologies that have revolutionised practices in a wide range of domains. Their potential has not gone unnoticed in the security sector with several law enforcement agencies (LEAs) employing AI applications in their daily operations for forensics and surveillance. In this paper, we present the DARLENE ecosystem, which aims to bridge existing gaps in applying AR and AI technologies for rapid tactical decision-making in situ with minimal error margin, thus enhancing LEAs’ efficiency and Situational Awareness (SA).

Methods: DARLENE incorporates novel AI techniques for computer vision tasks such as activity recognition and pose estimation, while also building an AR framework for visualization of the inferenced results via dynamic content adaptation according to each individual officer’s stress level and current context. The concept has been validated with end-users through co-creation workshops, while the decision-making mechanism for enhancing LEAs’ SA has been assessed with experts. Regarding computer vision components, preliminary tests of the instance segmentation method for humans’ and objects’ detection have been conducted on a subset of videos from the RWF-2000 dataset for violence detection, which have also been used to test a human pose estimation method that has so far exhibited impressive results and will constitute the basis of further developments in DARLENE.

Results: Evaluation results highlight that target users are positive towards the adoption of the proposed solution in field operations, and that the SA decision-making mechanism produces highly acceptable outcomes. Evaluation of the computer vision components yielded promising results and identified opportunities for improvement.

Conclusions: This work provides the context of the DARLENE ecosystem and presents the DARLENE architecture, analyses its individual technologies, and demonstrates preliminary results, which are positive both in terms of technological achievements and user acceptance of the proposed solution.
Against the Current
Authors: Klever Emma
Published: July 2021

The political reality of the European Union is not reflected in the general discourse on the relationship between Western Europe and Central and Eastern Europe, which is characterized by an adverse attitude towards the latter. This impacts identity construction on the European level, where Central and Eastern Europe has long been regarded as the “Other” against which the European “self ” was defined. However, a new discourse on this relationship has emerged in literary works written by scholars and journalists that are able to take an overarching perspective. The present study analyses four publications to see how the relationship between Western Europe and Central and Eastern Europe is portrayed in terms of the self and the Other, employing the Discourse Historical Approach and a spectrum of the self and the Other perspectives. It emerges that the discussed authors share a discourse which respects differences, focuses on similarities as well as differences and shows an awareness of the interwovenness of the narratives of the self and the Other. This new, shared discourse holds directions for the further development of a European-wide discourse that includes the same notions of respect and the interwovenness of narratives, and which could in turn influence European identity construction.
Reviewing Media Literacy Intervention Studies for Validity
Authors:   University of California at Santa Barbara, Potter W. James , Thai Chan L. ,   Santa Clara University
Published: July 2021

This study is an examination of validity in published articles that have provided tests of the effectiveness of media literacy interventions. We identified 88 published tests of media literacy interventions then analyzed their content using five coding variables that indicated the degree to which authors of those studies established basic validity. We first conducted a meaning analysis to identify the definitions that authors of those studies presented for media literacy. Then we used those definitions to determine the extent to which those authors provided a complete (content validity) and accurate (face validity) operationalization in the design of their measures.