bluuebunny/crossref_metadata_2025 huggingface dataset:
Meta-Analysis on the Efficacy of Indocyanine Green Fluorescence Angiography for Reduction of Anastomotic Leakage After Rectal Cancer Surgery
Authors: Li Zonglin , Zhou Yejiang , Tian Gang , Liu Yi , Jiang Yifan , Li Xin , Song Min
Published: December 2020

Background

Indocyanine green (ICG) fluorescence angiography is a new technique that help surgeons to assess the blood perfusion of the anastomotic intestine. The aim of this study is to evaluate whether ICG fluorescence angiography can reduce the anastomotic leakage (AL) rate after colorectal anastomoses for rectal cancer (RC) patients.

Methods

Studies comparing AL rates between use and nonuse of ICG fluorescence angiography up to April 2020 were systematically searched from PubMed, Embase, Web of Science, Cochrane Library, and China National Knowledge Infrastructure. A pooled analysis was performed for the available data regarding the baseline features, AL rate, and other surgical outcomes. ReMan 5.3 software was used to perform the statistical analysis. Quality evaluation and publication bias were also conducted.

Results

Thirteen studies with a total of 2593 patients (1121 in the ICG group and 1472 in the control group) undergoing colorectal anastomoses after RC surgery were included. In the pooled analysis, the baseline data, operation time, and intraoperative blood loss in 2 groups were all comparable and without significant heterogeneity. However, the AL rate in the ICG group was significantly lower (OR .31; 95% CI .22-.44; P < .00001) than that in the control group. Additionally, ICG fluorescence angiography was associated with a decreased overall complication rate (OR .60; 95% CI .47-.76; P < .0001) in patients who undergo RC surgery.

Conclusions

The present study revealed that ICG fluorescence angiography reduced AL rate after colorectal anastomoses for RC patients. However, more high-quality randomized controlled trials are needed to confirm this benefit.
Exploring Cost Savings with Specialty Biologic Drugs Administered to Adult Inpatients with Inflammatory Bowel Disease
Authors: Pitman Stuart , Jones Carey , Polyak Steven , Taylor Alexandria , Cerven-Jenn Diane , Reist Diane
Published: December 2020

Background: Specialty infusion and self-injectable biologic drugs for the treatment of inflammatory bowel disease (IBD) are high-cost medications. When administered to hospital-admitted patients, these medications are not reimbursed on an individual basis but rolled into a per diem payment by most payers in the United States (US). Therefore, choosing to administer these medications in the inpatient setting may reveal negative financial implications for some health care institutions. Selecting an alternative site of care to administer these medications during the clinical management process may lead to cost savings. Objective: Review the clinical necessity of inpatient specialty biologic administrations for the treatment of IBD to identify and quantify potential cost saving opportunities. Methods: Using patient medical records at a US academic medical center, we retrospectively identified inpatient administrations of specialty infusion and self-injectable biologic medications for IBD treatment from June 1, 2016 to May 31, 2017. Guided by a standardized form, an evaluation team consisting of 3 of the investigators determined the clinical necessity of each specialty biologic medication administration within the inpatient setting. Costs and reimbursement rates for administration in both the inpatient and outpatient settings were procured and tabulated. Results: Seventeen inpatient specialty biologic administrations for IBD during the 12 month study period were identified. Of these, 11 administrations were given for the treatment of Crohn’s disease (CD) and 6 for ulcerative colitis (UC). The evaluation team determined that 65% of these administrations were clinically necessary as inpatient administrations, and that 35% were not. The sum of the wholesale acquisition costs (WAC) for clinically necessary inpatient biologic administrations totaled $54 737, and the WAC for those administrations deemed not clinically necessary totaled $43 702. Further analysis of administration events revealed that the institution could have realized an estimated $13 817 in additional revenue above the cost of the drug if eligible inpatient biologic administrations had been received in the institution’s outpatient clinic setting instead. Conclusion: Administering specialty biologic drugs for the treatment of IBD in the care setting best aligned with existing reimbursement structures may lead to institutional cost savings.
Staff Knowledge Enhancement Program in Hospital Pharmacy: One-Year Experience
Authors: Abulezz Rayf , Khoshhal Sahal
Published: December 2020

Purpose: To assess the effectiveness of Staff Knowledge Enhancement Program (SKEP) among staff, in improving staff knowledge, and awareness of policies and procedures. Methods: After 1 year of implementing SKEP, a survey was conducted among pharmacy staff that participated in SKEP during June 2019 ( n = 38). The survey included 7 questions and the answers were on a scale of 1 to 5 (1 = strongly disagree and 5 = strongly agree). The investigators also obtained the average monthly time used to solve SKEP test, and the number of therapeutic intervention documentations (TID). Results: Sixty-one percent of the pharmacists and 80% of the technicians were satisfied with the educational content of SKEP; 35% of pharmacists and 93% of technicians felt that their learning needs were met with the SKEP; 83% of pharmacists and 93 % of technicians found SKEP is an effective tool in improving their knowledge; 48% of pharmacists and 34% of technicians felt that SKEP made staff evaluations fair; 38% of pharmacists felt that SKEP is a burden and takes a lot from their free time, while 40% of technicians did not have this feeling; 83% of pharmacist and 93% of the technicians found that the knowledge gained from SKEP applicable in their daily practice; 73% and 74% of the pharmacists and technicians who completed the survey felt that their familiarity with policies and procedures improved after SKEP respectively. The total number of TID increased by 30% and the average duration for the test was 5 hours/month and 68 minutes/month per pharmacist and technician respectively. Conclusion: SKEP is innovative tool which may enhance the knowledge and policy awareness among pharmacy staff.
Development and delivery of a work experience week programme for mechanical engineering
Authors: Gonzalez-Buelga A , Renaud-Assemat I , Selwyn B , Ross J , Lazar I
Published: December 2020

This paper focuses on the development, delivery and preliminary impact analysis of an engineering Work Experience Week (WEW) programme for KS4 students in the School of Civil, Aerospace and Mechanical Engineering (CAME) at the University of Bristol, UK. Key stage 4, is the legal term for the two years of school education which incorporate GCSEs in England, age 15–16. The programme aims to promote the engineering profession among secondary school pupils. During the WEW, participants worked as engineering researchers: working in teams, they had to tackle a challenging engineering design problem. The experience included hands-on activities and the use of state-of-the-art rapid prototyping and advanced testing equipment. The students were supervised by a group of team leaders, a diverse group of undergraduate and postgraduate engineering students, technical staff, and academics at the School of CAME. The vision of the WEW programme is to transmit the message that everybody can be an engineer, that there are plenty of different routes into engineering that can be taken depending on pupils’ strengths and interests and that there are a vast amount of different engineering careers and challenges to be tackled by the engineers of the future. Feedback from the participants in the scheme has been overwhelmingly positive.
The Effect of the Crow Hop on Elbow Stress During an Interval Throwing Program
Authors: Lizzio Vincent A. , Smith D. Grace , Guo Eric W. , Cross Austin G. , Gulledge Caleb M. , Koolmees Dylan S. , Chalmers Peter N. , Makhni Eric C.
Published: December 2020

Background:

Postoperative rehabilitation protocols after ulnar collateral ligament (UCL) reconstruction typically involve a structured interval throwing program. In an effort to minimize torque placed on the UCL, athletes are often instructed to throw with a crow hop, even at short throwing distances. However, the effect of the crow hop on medial elbow stress is unknown.

Purpose/Hypothesis:

The purpose was to determine whether elbow stress differs with and without a crow hop across the throwing distances of a typical interval throwing program. We hypothesized that crow hop throws would generate lower torque on the elbow than standing throws at each distance of the interval throwing program.

Study Design:

Controlled laboratory study.

Methods:

Healthy high school and collegiate pitchers and position players were recruited from the surrounding area. Each player was outfitted with a wearable athletic sleeve and device that recorded elbow torque (Newton-meters), arm slot (degrees), arm speed (revolutions per minute), and shoulder rotation (degrees). Ball velocity (miles per hour) was measured using a radar gun. Players were instructed to perform 3 crow hop throws and 3 standing throws at distances of 30, 45, 60, 90, 120, 150, and 180 feet. A repeated measures analysis of variance was used to compare ball velocity, elbow torque, arm slot, arm speed, and shoulder rotation between crow hop and standing throws at each throwing distance.

Results:

Twenty athletes participated in this study (average age, 17.8 years; range, 15-25 years). The average medial elbow torque increased at each distance for both crow hop and standing throws at distances of 30, 45, 60, and 90 feet ( P < .05), after which there were no significant increases in elbow torque ( P > .05). The average torque was higher for crow hop throws than standing throws at distances of 30 feet (13.9 N·m vs 12.0 N·m; P = .002), 45 feet (21.8 N·m vs 19.3 N·m; P = .005), and 60 feet (28.0 N·m vs 24.5 N·m; P = .02).

Conclusion:

Crow hop throws generated greater medial elbow torque than standing throws at distances up to 60 feet; however, there were no differences in elbow torque at distances greater than 60 feet between the 2 throw types. For both crow hop and standing throws, elbow stress increased at each distance interval up to 90 feet before plateauing at distances greater than 90 feet. The crow hop throwing technique does not reduce medial elbow stress during a simulated interval throwing program, and it may actually increase torque at shorter throwing distances.

Clinical Relevance:

The results of our study indicate that it would be prudent for players to initially perform standing throws at shorter distances and only later be allowed to employ a natural crow hop at greater distances to minimize torque placed on the medial elbow during UCL rehabilitation protocols.
Compassion-Focused Therapy: Proof of Concept Trial on Suicidal Ideation and Cognitive Distortions in Female Survivors of Intimate Partner Violence With PTSD
Authors: Daneshvar Somayeh , Shafiei Masumeh , Basharpoor Sajjad
Published: December 2020

This proof of concept trial aimed to assess the pre–post differences in suicidal ideation and cognitive distortions in the compassion-focused therapy (CFT), and to compare the psychological improvement in the experimental group to a control group. A total of 42 women suffering from PTSD due to exposure to intimate partner violence (IPV) were randomized to the experimental and control groups (21 per group). All participants completed the questionnaires of suicidal ideation and cognitive distortions as pretest measures. Subjects of the experimental group received 8 CFT sessions, while the controls did not receive any therapy. Then, all subjects responded to the questionnaires of suicidal ideation and cognitive distortions as the posttest measures. Data were analyzed using one-way repeated measures MANOVA. Subjects of the experimental group indicated a greater reduction in post-test scores of suicidal ideation and its subscales including passive suicidal ideation, preparation for suicide, and active suicidal ideation when compared to the controls. Moreover, the subjects of the experimental group indicated a greater reduction in the post-test scores of cognitive distortions than controls. These results provide support for a larger trial focusing on the efficacy of CFT on psychological outcomes of PTSD following exposure to IPV. This intervention has the potential to be deployed at higher scales for IPV-affected women with PTSD.
Research on S-gear design, manufacturing and measuring based on NC machining center
Authors: Ren Shao-ying , Wang Yan-zhong , Li Yuan
Published: December 2020

This article presents a method of design, manufacturing, and measuring S-gear. S-gear is a kind of gear whose tooth profile is an S-shaped curve. The sine (cosine) gear, cycloid gear, polynomial gear, and circular arc gear are all S-gears in essence. In the S-gear transmission, the concave surface of one gear and the convex surface of the other gear contact each other. Therefore, the power transmitted by S-gear is much larger than that of the convex-convex-contact involute gear. Some scholars have studied the characteristics of S-gear, but few have explored its manufacturing. In this article, the Numerical Control (NC) machining technology of S-gear is studied in detail for its industrial application. The polynomial curve is used to construct the tooth profile of the S-gear based on the Gear Meshing Theory. The mathematical model of polynomial S-gear is established, by which involute gear can be represented as a special S-gear. The steps of generating NC codes are described. Then, the S-gear sample is processed with an NC machining center. Finally, the sample is measured with a Coordinate Measuring Machine (CMM), and the measurement results show that the accuracy of the S-gear processed by the NC machining center reaches ISO6. This research provides a feasible approach for the design, manufacturing, and measuring of S-gear.
Exploring Parents’ Intentions to Monitor and Mediate Adolescent Social Media Use and Implications for School Nurses
Authors: Douglas Kimberly D. , Smith Kandy K. , Stewart Mary W. , Walker Jean , Mena Leandro , Zhang Lei
Published: December 2020

Social media may promote health and social connectedness, but its misuse and frequency of use may pose risks. Social media use during adolescence requires parental monitoring and mediation to mitigate potentially harmful effects such as depression, anxiety, and risk-taking behaviors. While parents and health care professionals convey concern surrounding exposure to inappropriate content, prolonged screen time, and cyberbullying, appropriate social media monitoring remains challenging. The purpose of this study was to explore parental monitoring and mediation of social media use in adolescents. Online recruitment yielded a nationwide sample ( n = 836) of parents of adolescents. The results of the online survey indicated that parents are concerned about adolescent social media use and endorse positive attitudes toward monitoring. Yet parents perceived little control over monitoring. Findings from this study support the school nurse in promoting healthy social media use, media literacy among parents and adolescents, and the use of screening tools.
Association of infrapopliteal medial arterial calcification with lower-limb amputations in high-risk patients: A systematic review and meta-analysis
Authors: Losurdo Fabrizio , Ferraresi Roberto , Ucci Alessandro , Zanetti Anna , Clerici Giacomo , Zambon Antonella
Published: December 2020

Medial arterial calcification (MAC) is a known risk factor for cardiovascular morbidity. The association between vascular calcifications and poor outcome in several vascular districts suggest that infrapopliteal MAC could be a risk factor for lower-limb amputation (LLA). This study’s objective is to review the available literature focusing on the association between infrapopliteal MAC and LLA in high-risk patients. The PubMed and Embase databases were systematically searched. We selected original studies reporting the association between infrapopliteal MAC and LLAs in patients with diabetes and/or peripheral artery disease (PAD). Estimates were pooled using either a fixed-effects or a random-effects model meta-analysis. Heterogeneity was evaluated using the Q and I2 statistics. Publication bias was investigated with a funnel plot and Egger test. The trim-and-fill method was designed to estimate the possibly missing studies. Influence analysis was conducted to search studies influencing the final result. Test of moderators was used to compare estimates in good versus non-good-quality studies. Fifteen articles satisfied the selection criteria ( n = 6489; median follow-up: 36 months). MAC was significantly associated with LLAs (pooled adjusted risk ratio (RR): 2.27; 95% CI: 1.89–2.74; I2 = 25.3%, Q-test: p = 0.17). This association was kept in the subgroup of patients with diabetes (RR: 2.37; 95% CI: 1.76–3.20) and patients with PAD (RR: 2.48; 95% CI: 1.72–3.58). The association was maintained if considering as outcome only major amputations (RR: 2.11; 95% CI: 1.46–3.06). Our results show that infrapopliteal MAC is associated with LLAs, thus suggesting MAC as a possible new marker of the at-risk limb.
Medicine in Motion: Addressing Physician Burnout Through Fitness, Philanthropy, and Interdisciplinary Community Building
Authors: Seward Michael W. , Marso Chase C. , Soled Derek R. , Briggs Logan G.
Published: December 2020

Physician burnout is a public health crisis. Although recent studies underscore its prevalence, there are few rigorous studies examining its prevention, especially among medical students and residents. Prior interventions have centered on mindfulness techniques and flexible workload scheduling, yielding limited success. However, interventions that combine fitness with philanthropy and community building may be more effective. The purpose of this report is 2-fold: first, to provide a review of physician burnout and potential prevention mechanisms and, second, to present a case study of how Medicine in Motion (MiM) addresses these issues. MiM facilitates various athletic workouts, competitions, and other events for students and professionals in medicine, dentistry, nursing, and physical therapy to support wellness and charitable initiatives. This analysis identifies 4 barriers to physicians and those in the health care profession from participating in wellness activities: (1) insufficient awareness, (2) logistical challenges, (3) lack of purpose, and (4) absence of perceived support. To overcome these barriers, MiM provides a model toolkit for starting a grassroots movement against physician burnout that other health care institutions may emulate. Institutions should provide financial support for these wellness programs. Future research is needed to evaluate these combined exercise, philanthropic, and community building efforts.
ACE2: the molecular doorway to SARS-CoV-2
Authors: Medina-Enríquez Miriam Marlene , Lopez-León Sandra , Carlos-Escalante José Alberto , Aponte-Torres Zuleika , Cuapio Angelica , Wegman-Ostrosky Talia
Published: December 2020

The angiotensin-converting enzyme 2 (ACE2) is the host functional receptor for the new virus SARS-CoV-2 causing Coronavirus Disease 2019. ACE2 is expressed in 72 different cell types. Some factors that can affect the expression of the ACE2 are: sex, environment, comorbidities, medications (e.g. anti-hypertensives) and its interaction with other genes of the renin-angiotensin system and other pathways. Different factors can affect the risk of infection of SARS-CoV-2 and determine the severity of the symptoms. The ACE2 enzyme is a negative regulator of RAS expressed in various organ systems. It is with immunity, inflammation, increased coagulopathy, and cardiovascular disease. In this review, we describe the genetic and molecular functions of the ACE2 receptor and its relation with the physiological and pathological conditions to better understand how this receptor is involved in the pathogenesis of COVID-19. In addition, it reviews the different comorbidities that interact with SARS-CoV-2 in which also ACE2 plays an important role. It also describes the different factors that interact with the virus that have an influence in the expression and functional activities of the receptor. The goal is to provide the reader with an understanding of the complexity and importance of this receptor.
Student Zone
Authors: Mwanzia Dorothy Kanini , Zowa Peace , Achoki Dennis , Ogochukwu Ozotta , Onwumelu Chioma , Mwangi Antony Hiuhu
Published: December 2020

More than 80 young professionals and students from around the world attended the 1st Virtual African Young Professionals and Students Geoscience Week, which took place 21–26 September 2020. Participants were from Argentina, Brazil, Congo, Germany, Ghana, Indonesia, Kenya, Malawi, Mexico, Nigeria, Rwanda, South Africa, Tanzania, Uganda, Ukraine, the United States, and Zimbabwe. Figure 1 shows a distribution map of the represented locations. A total of 12 speakers presented on a variety of interesting topics throughout the week.
Relaxation of the order-parameter statistics and dynamical confinement
Authors: Javier Valencia Tortora Riccardo , Calabrese Pasquale , Collura Mario
Published: December 2020

We study the relaxation of the local ferromagnetic order in the quantum Ising chain in a slant field with both longitudinal and transverse components. After preparing the system in a fully polarised state, we analyse the time evolution of the entire probability distribution function (PDF) of the magnetisation within a block of ℓ spins. We first analyse the effect of confinement on the Gaussification of the PDF for large ℓ, showing that the melting of initial order is suppressed when the longitudinal field is aligned to initial magnetisation while it is speed up when it is in the opposite direction. Then we study the thermalisation dynamics. In the paramagnetic region, the PDF quickly shows thermal features. Conversely, in the ferromagnetic phase, when confinement takes place, the relaxation suffers a typical slowing down which depends on the interplay between the strength of the longitudinal field, the density of excitations, and the direction of the initial polarisation. Even when the initial magnetisation is aligned oppositely to the longitudinal field, confinement prevents thermalisation in the accessible timescale, as it is neatly bared by the PDF.
Stochastic resetting antiviral therapies prevent drug resistance development
Authors: Ramoso A. M. , Magalang J. A. , Sánchez-Taltavull D. , Esguerra J. P. , Roldán É.
Published: December 2020

We study minimal mean-field models of viral drug resistance development in which the efficacy of a therapy is described by a one-dimensional stochastic resetting process with mixed reflecting-absorbing boundary conditions. We derive analytical expressions for the mean survival time for the virus to develop complete resistance to the drug. We show that the optimal therapy resetting rates that achieve a minimum and maximum mean survival times undergo a second- and first-order phase transition-like behaviour as a function of the therapy efficacy drift. We illustrate our results with simulations of a population dynamics model of HIV-1 infection.
Families of people with Marfan syndrome. The relationship between the functioning of the family system and the life quality of the affected persons
Authors: Lewandowska- Walter Aleksandra , Trawicka Agnieszka , Bogdanowicz Marta , Sabiniewicz Robert , Woźniak-Mielczarek Lidia
Published: December 2020

Cel pracy

Celem badania była analiza funkcjonowania rodziny w percpecji osoby z zespołem Marfana oraz poszukiwanie zależności między cechami systemu a ogólną jakością życia chorych.

Metoda

W badaniu uczesniczyły 33 osoby z zespołem Marfana oraz 33 osoby bez diagnozy choroby przewlekłej. Wykorzystano Skale Oceny Rodziny – polską adaptację FACES-IV D. H. Olsona oraz SWLS (Satisfaction with Life Scale) autorstwa Dienera, Emmonsa, Larsona i Griffina.

Wyniki

Osoby z zespołem Marfana postrzegają swoje rodziny jako znacznie mniej spójne i znacznie bardziej niezwiązane od osób bez diagnozy przewlekłej choroby. System rodzinny osób z zespołem Marfana charakteryzuje się niskimi wynikami w zakresie spójności i elastyczności oraz wysokimi wynikami w pozostałych czterech skalach, co wskazuje na profil rodziny podobny do "niezrównoważonego" systemu. Satysfakcja z życia osób z zespołem Marfana korelowała pozytywnie ze Spójnością, Elastycznością i Satysfakcją z Życia Rodzinnego jako cechami postrzeganego przez nich system rodzinnego.

Wnioski

Uzyskane wyniki potwierdzają znaczenie wspierania rodziny osób z zespołem Marfana jako oraz udzielania im specjalistycznej pomocy w radzeniu sobie z obciążeniem emocjonalnym związanym ze zdrowiem pacjenta.
Biochemical Alterations Accompanied to Zoledronic Acid Treatment after High Doses of Vitamin D in Experimental Model
Authors: H.A Abdel Maksoud , Elharrif Mohamed G. , K. R Anwar , M.H Abdullah , Alotaibi Nemer A.
Published: December 2020

Zoledronic acid is a long-acting compound of bisphosphonate class, and it has many health and medical benefits, among which are its effects in treatment of bone disorders and accordingly decrease the incidence of osteoporosis. Besides, vitamin D is recognized as one of the fat-soluble vitamins that affect the absorption of major minerals in the digestive system. The aim of this study was to verify the influence of vitamin D on the biochemical effect of zoledronic acid. To achieve the aim of the study, the experiment was conducted on ninety-six male Wistar rats that were divided into the following groups; control group, vitamin D treated groups and zoledronic acid treated groups. The results of the study found that, taking high doses of vitamin D before treatment with zoledronic acid results in significant changes (P < 0.05) in the levels of calcium, magnesium and phosphorus, as well as levels of thyroid hormone, cortisol and levels of immunoglobulin E in the blood. Which means that treatment with zoledronic acid in high levels of vitamin D promote worsening of such biochemical parameters.
Current and novel non-invasive imaging modalities in vascular neurosurgical practice
Authors: Bautista Melissa , Saleem Nayyar , Anderson Ian A
Published: December 2020

Radiological investigations are a powerful tool in the assessment of patients with intracranial vascular anomalies. ‘Visual’ assessment of neurovascular lesions is central to their diagnosis, monitoring, prognostication and management. Computed tomography and magnetic resonance imaging are the two principal non-invasive imaging modalities used in clinical practice for the assessment of the cerebral vasculature, but these techniques continue to evolve, enabling clinicians to gain greater insights into neurovascular pathology and pathophysiology. This review outlines both established and novel imaging modalities used in modern neurovascular practice and their clinical applications.
What is the best choice for postoperative analgesia after major gynaecological oncology surgery?
Authors: Griffiths Megan , Zhang Sheldon , Kotsopoulos Ioannis C , Mandour Yasser
Published: December 2020

Major gynaecological oncology surgery can be complex and extensive, with correspondingly high requirements for postoperative analgesia. Multiple options are available including intravenous, neuraxial and regional techniques. This article discusses the pros and cons of different anaesthetic modalities for postoperative analgesia.
What is the performance of novel synovial biomarkers for detecting periprosthetic joint infection in the presence of inflammatory joint disease?
Authors: Li Rui , Li Xiang , Ni Ming , Fu Jun , Xu Chi , Chai Wei , Chen Ji-Ying
Published: December 2020

Aims

The aim of this study was to further evaluate the accuracy of ten promising synovial biomarkers (bactericidal/permeability-increasing protein (BPI), lactoferrin (LTF), neutrophil gelatinase-associated lipocalin (NGAL), neutrophil elastase 2 (ELA-2), α-defensin, cathelicidin LL-37 (LL-37), human β-defensin (HBD-2), human β-defensin 3 (HBD-3), D-dimer, and procalcitonin (PCT)) for the diagnosis of periprosthetic joint infection (PJI), and to investigate whether inflammatory joint disease (IJD) activity affects their concentration in synovial fluid.

Methods

We included 50 synovial fluid samples from patients with (n = 25) and without (n = 25) confirmed PJI from an institutional tissue bank collected between May 2015 and December 2016. We also included 22 synovial fluid samples aspirated from patients with active IJD presenting to Department of Rheumatology, the first Medical Centre, Chinese PLA General Hospital. Concentrations of the ten candidate biomarkers were measured in the synovial fluid samples using standard enzyme-linked immunosorbent assays (ELISA). The diagnostic accuracy was evaluated by receiver operating characteristic (ROC) curves.

Results

BPI, LTF, NGAL, ELA-2, and α-defensin were well-performing biomarkers for detecting PJI, with areas under the curve (AUCs) of 1.000 (95% confidence interval, 1.000 to 1.000), 1.000 (1.000 to 1.000), 1.000 (1.000 to 1.000), 1.000 (1.000 to 1.000), and 0.998 (0.994 to 1.000), respectively. The other markers (LL-37, HBD-2, D-dimer, PCT, and HBD-3) had limited diagnostic value. For the five well-performing biomarkers, elevated concentrations were observed in patients with active IJD. The original best thresholds determined by the Youden index, which discriminated PJI cases from non-PJI cases could not discriminate PJI cases from active IJD cases, while elevated thresholds resulted in good performance.

Conclusion

BPI, LTF, NGAL, ELA-2, and α-defensin demonstrated excellent performance for diagnosing PJI. However, all five markers showed elevated concentrations in patients with IJD activity. For patients with IJD, elevated thresholds should be considered to accurately diagnose PJI. Cite this article: Bone Joint J 2021;103-B(1):32–38.
Assessment of malreduction standards for the syndesmosis in bilateral CT scans of uninjured ankles
Authors: Kubik Jeremy F. , Rollick Natalie C. , Bear Jessica , Diamond Owen , Nguyen Joseph T. , Kleeblad Laura J. , Helfet David L. , Wellman David S.
Published: December 2020

Aims

Malreduction of the syndesmosis has been reported in up to 52% of patients after fixation of ankle fractures. Multiple radiological parameters are used to define malreduction; there has been limited investigation of the accuracy of these measurements in differentiating malreduction from inherent anatomical asymmetry. The purpose of this study was to identify the prevalence of positive malreduction standards within the syndesmosis of native, uninjured ankles.

Methods

Three observers reviewed 213 bilateral lower limb CT scans of uninjured ankles. Multiple measurements were recorded on the axial CT 1 cm above the plafond: anterior syndesmotic distance; posterior syndesmotic distance; central syndesmotic distance; fibular rotation; and sagittal fibular translation. Previously studied malreduction standards were evaluated on bilateral CT, including differences in: anterior, central and posterior syndesmotic distance; mean syndesmotic distance; fibular rotation; sagittal translational distance; and syndesmotic area. Unilateral CT was used to compare the anterior to posterior syndesmotic distances.

Results

A difference of anterior to posterior syndesmotic distance > 2 mm was observed in 89% of ankles (n = 190) on unilateral CT assessment. Using bilateral CT, we found that 35% (n = 75) of normal ankles would be considered malreduced by current malreduction parameters. In 50 patients (23%), only one parameter was anomalous, 18 patients (8%) had two positive parameters and seven patients (3%) had three. Difference in fibular rotation had the lowest false positive rate of all parameters at 6%, whereas posterior syndesmotic distance difference had the highest at 15%.

Conclusion

In this study, 35% of native, uninjured syndesmoses (n = 75) would be classified as malreduced by current diagnostic standards on bilateral CT and 89% had an asymmetric incisura on unilateral CT (n = 190). Current radiological parameters are insufficient to differentiate mild inherent anatomical asymmetry from malreduction of the syndesmosis. Cite this article: Bone Joint J 2021;103-B(1):178–183.
Zero GVD slow-light originating from a strong coupling of one-way modes in double-channel magneto-optical photonic crystal waveguides
Authors: Zhuang Suna , Chen Jianfeng , Liang Wenyao , Li Zhi-Yuan
Published: December 2020

We have studied the coupling effect of topological photonic states in a double-channel magneto-optical photonic crystal waveguide by introducing a two-stranded ordinary Al2O3 photonic crystal as the coupling layer. There exist both M1 (odd) and M2 (even) one-way modes simultaneously in the bandgap. Interestingly, M1 mode is always a fast-light mode with large group velocity (vg) and large group velocity dispersion (GVD) regardless what the radius (RA) of Al2O3 rods is. However, when RA is appropriate, M2 mode becomes a very slow-light mode exhibiting near-zero vg and zero GVD simultaneously. The physical reason of such slow-light is attributed to the strong coupling effect between the one-way edge modes in both sub-waveguides. Furthermore, the simulation results show that the robustness of both the fast- and slow-light modes are extremely strong against perfect electric conductor defect and the one-way transmittance is close to 100%. Besides, the PEC defect can cause significant phase delay. These results hold promise for many fields such as signal processing, optical modulation, and the design of various topological devices.
Home-EEG assessment of possible compensatory mechanisms for sleep disruption in highly irregular shift workers – The ANCHOR study
Authors: Mentink Lara J. , Thomas Jana , Melis René J. F. , Olde Rikkert Marcel G. M. , Overeem Sebastiaan , Claassen Jurgen A. H. R.
Published: December 2020

Study objectives

While poor sleep quality has been related to increased risk of Alzheimer’s disease, long-time shift workers (maritime pilots) did not manifest evidence of early Alzheimer’s disease in a recent study. We explored two hypotheses of possible compensatory mechanisms for sleep disruption: Increased efficiency in generating deep sleep during workweeks (model 1) and rebound sleep during rest weeks (model 2).

Methods

We used data from ten male maritime pilots (mean age: 51.6±2.4 years) with a history of approximately 18 years of irregular shift work. Subjective sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI). A single lead EEG-device was used to investigate sleep in the home/work environment, quantifying total sleep time (TST), deep sleep time (DST), and deep sleep time percentage (DST%). Using multilevel models, we studied the sleep architecture of maritime pilots over time, at the transition of a workweek to a rest week.

Results

Maritime pilots reported worse sleep quality in workweeks compared to rest weeks (PSQI = 8.2±2.2 vs. 3.9±2.0; p<0.001). Model 1 showed a trend towards an increase in DST% of 0.6% per day during the workweek (p = 0.08). Model 2 did not display an increase in DST% in the rest week (p = 0.87).

Conclusions

Our findings indicated that increased efficiency in generating deep sleep during workweeks is a more likely compensatory mechanism for sleep disruption in the maritime pilot cohort than rebound sleep during rest weeks. Compensatory mechanisms for poor sleep quality might mitigate sleep disruption-related risk of developing Alzheimer’s disease. These results should be used as a starting point for future studies including larger, more diverse populations of shift workers.
Assessing the low complexity of protein sequences via the low complexity triangle
Authors: Mier Pablo , Andrade-Navarro Miguel A.
Published: December 2020

Background

Proteins with low complexity regions (LCRs) have atypical sequence and structural features. Their amino acid composition varies from the expected, determined proteome-wise, and they do not follow the rules of structural folding that prevail in globular regions. One way to characterize these regions is by assessing the repeatability of a sequence, that is, calculating the local propensity of a region to be part of a repeat.

Results

We combine two local measures of low complexity, repeatability (using the RES algorithm) and fraction of the most frequent amino acid, to evaluate different proteomes, datasets of protein regions with specific features, and individual cases of proteins with extreme compositions. We apply a representation called ‘low complexity triangle’ as a proof-of-concept to represent the low complexity measured values. Results show that proteomes have distinct signatures in the low complexity triangle, and that these signatures are associated to complexity features of the sequences. We developed a web tool called LCT (http://cbdm-01.zdv.uni-mainz.de/~munoz/lct/) to allow users to calculate the low complexity triangle of a given protein or region of interest.

Conclusions

The low complexity triangle proves to be a suitable procedure to represent the general low complexity of a sequence or protein dataset. Homorepeats, direpeats, compositionally biased regions and globular regions occupy characteristic positions in the triangle. The described pipeline can be used to characterize LCRs and may help in quantifying the content of degenerated tandem repeats in proteins and proteomes.
Study protocol for COvid-19 Vascular sERvice (COVER) study: The impact of the COVID-19 pandemic on the provision, practice and outcomes of vascular surgery
Authors: Benson Ruth A. , Nandhra Sandip ,   on behalf of the Vascular and Endovascular Research Network
Published: December 2020

Background

The novel Coronavirus Disease 2019 (COVID-19) pandemic is having a profound impact on global healthcare. Shortages in staff, operating theatre space and intensive care beds has led to a significant reduction in the provision of surgical care. Even vascular surgery, often insulated from resource scarcity due to its status as an urgent specialty, has limited capacity due to the pandemic. Furthermore, many vascular surgical patients are elderly with multiple comorbidities putting them at increased risk of COVID-19 and its complications. There is an urgent need to investigate the impact on patients presenting to vascular surgeons during the COVID-19 pandemic.

Methods and analysis

The COvid-19 Vascular sERvice (COVER) study has been designed to investigate the worldwide impact of the COVID-19 pandemic on vascular surgery, at both service provision and individual patient level. COVER is running as a collaborative study through the Vascular and Endovascular Research Network (VERN), an independent, international vascular research collaborative with the support of numerous national and international organisations). The study has 3 ‘Tiers’: Tier 1 is a survey of vascular surgeons to capture longitudinal changes to the provision of vascular services within their hospital; Tier 2 captures data on vascular and endovascular procedures performed during the pandemic; and Tier 3 will capture any deviations to patient management strategies from pre-pandemic best practice. Data submission and collection will be electronic using online survey tools (Tier 1: SurveyMonkey® for service provision data) and encrypted data capture forms (Tiers 2 and 3: REDCap® for patient level data). Tier 1 data will undergo real-time serial analysis to determine longitudinal changes in practice, with country-specific analyses also performed. The analysis of Tier 2 and Tier 3 data will occur on completion of the study as per the pre-specified statistical analysis plan.
The association between HIV tri-therapy with the development of Type-2 Diabetes Mellitus in a rural South African District: A case-control study
Authors: Bam Nokwanda E. , Mabunda Sikhumbuzo A. , Ntsaba Jafta , Apalata Teke , Nomatshila Sibusiso C. , Chitha Wezile
Published: December 2020

Background

Combination antiretroviral drugs (cARVs) prolong patients’ lives but are unfortunately thought to increase complications related to metabolic disorders including type-2 Diabetes Mellitus (DM). We sought to confirm the association of cARVs with type-2 DM and ascertain the extent of this association in a rural South African setting.

Methods

A case-control study of 177 (33.33%) cases with HIV/AIDS and type-2 DM were selected and compared with 354 (66.67%) non-DM HIV/AIDS unmatched controls from a rural district of South Africa’s third most populous province (Eastern Cape). Cases were identified from community health centres using the district health information system, and controls were identified using simple random sampling from the same health facilities. Odds Ratios (OR), together with 95% confidence intervals, were calculated for all the univariable and multivariable logistic analyses.

Results

This study found that cARVs significantly increased the occurrence of type-2 DM among HIV patients. Patients on protease inhibitors (PIs) were at least 21 times significantly (p<0.0001) more likely to be diabetic than those on the fixed dose combination (FDC); those on stavudine (D4T) and zidovudine (AZT) were 2.45 times and 9.44 times respectively more likely to be diabetic than those on FDC (p<0.05). The odds of diabetes increased by more than three-folds for those who had been on antiretroviral drugs for more than 6 years (p<0.005).

Conclusion

This study has been able to establish the association between cARVs and type-2 DM. It therefore proposes consideration of the usage of AZT, D4T, lopivavir and ritonavir for the treatment of HIV. The study further proposes more prospective research to test these findings further.
A comparison between internal protein nanoenvironments of α-helices and β-sheets
Authors: Mazoni Ivan , Salim Jose Augusto , de Moraes Fabio Rogerio , Borro Luiz , Neshich Goran
Published: December 2020

Secondary structure elements are generally found in almost all protein structures revealed so far. In general, there are more β-sheets than α helices found inside the protein structures. For example, considering the PDB, DSSP and Stride definitions for secondary structure elements and by using the consensus among those, we found 60,727 helices in 4,376 chains identified in all-α structures and 129,440 helices in 7,898 chains identified in all-α and α + β structures. For β-sheets, we identified 837,345 strands in 184,925 β-sheets located within 50,803 chains of all-β structures and 1,541,961 strands in 355,431 β-sheets located within 86,939 chains in all-β and α + β structures (data extracted on February 1, 2019). In this paper we would first like to address a full characterization of the nanoenvironment found at beta sheet locations and then compare those characteristics with the ones we already published for alpha helical secondary structure elements. For such characterization, we use here, as in our previous work about alpha helical nanoenvironments, set of STING protein structure descriptors. As in the previous work, we assume that we will be able to prove that there is a set of protein structure parameters/attributes/descriptors, which could fully describe the nanoenvironment around beta sheets and that appropriate statistically analysis will point out to significant changes in values for those parameters when compared for loci considered inside and outside defined secondary structure element. Clearly, while the univariate analysis is straightforward and intuitively understood, it is severely limited in coverage: it could be successfully applied at best in up to 25% of studied cases. The indication of the main descriptors for the specific secondary structure element (SSE) by means of the multivariate MANOVA test is the strong statistical tool for complete discrimination among the SSEs, and it revealed itself as the one with the highest coverage. The complete description of the nanoenvironment, by analogy, might be understood in terms of describing a key lock system, where all lock mini cylinders need to combine their elevation (controlled by a matching key) to open the lock. The main idea is as follows: a set of descriptors (cylinders in the key-lock example) must precisely combine their values (elevation) to form and maintain a specific secondary structure element nanoenvironment (a required condition for a key being able to open a lock).
A methodology and theoretical taxonomy for centrality measures: What are the best centrality indicators for student networks?
Authors: Vignery Kristel , Laurier Wim
Published: December 2020

In order to understand and represent the importance of nodes within networks better, most of the studies that investigate graphs compute the nodes’ centrality within their network(s) of interest. In the literature, the most frequent measures used are degree, closeness and/or betweenness centrality, even if other measures might be valid candidates for representing the importance of nodes within networks. The main contribution of this paper is the development of a methodology that allows one to understand, compare and validate centrality indices when studying a particular network of interest. The proposed methodology integrates the following steps: choosing the centrality measures for the network of interest; developing a theoretical taxonomy of these measures; identifying, by means of Principal Component Analysis (PCA), latent dimensions of centrality within the network of interest; verifying the proposed taxonomy of centrality measures; and identifying the centrality measures that best represent the network of interest. Also, we applied the proposed methodology to an existing graph of interest, in our case a real friendship student network. We chose eighteen centrality measures that were developed in SNA and are available and computed in a specific library (CINNA), defined them thoroughly, and proposed a theoretical taxonomy of these eighteen measures. PCA showed the emergence of six latent dimensions of centrality within the student network and saturation of most of the centrality indices on the same categories as those proposed by the theoretical taxonomy. Additionally, the results suggest that indices other than the ones most frequently applied might be more relevant for research on friendship student networks. Finally, the integrated methodology that we propose can be applied to other centrality indices and/or other network types than student graphs.