bluuebunny/crossref_metadata_2025 huggingface dataset:
CASTING OF UNSTABLE ANKLE FRACTURES THAT WOULD HAVE BEEN SURGICALLY TREATED: A REVIEW OF RADIOLOGICAL OUTCOMES OF THESE FRACTURES TREATED AT SECONDARY LEVEL HOSPITALS IN CAPE TOWN
Authors: Patterson Britt Cindy , McCaul Jeannie , McCollum G
Published: November 2023

The purpose of this study was to investigate the effectiveness of casting in achieving acceptable radiological parameters for unstable ankle injuries.

This retrospective observational cohort study was conducted involving the retrieval of X-rays of all ankles taken over a 2 year period in an urban setting to investigate the radiological outcomes of cast management for unstable ankle fractures using four acceptable parameters measured on a single X- ray at union. The Picture Archiving and Communication System (PACS) was used, the X-rays were measured by a single observer.

From the 1st of January 2020 to the 31st of December 2021, a total of 1043 ankle fractures were treated at the three hospitals with a male to female ratio of 1:1.7. Of the 628 unstable ankle injuries, 19% of patients were lost to follow up. 190 were managed conservatively with casts, requiring an average of 4 manipulations, with a malunion rate of 23.2%. Unstable ankle injuries that were treated surgically from the outset and those who failed conservative management and subsequently converted to surgery had a malunion rate of 8.1% and 11.0% respectively.

Unstable ankle fractures pose a challenge with a high rate of radiological malunion, regardless of the treatment Casting surgery from the outset or converted to surgery, with rates of 23% and 8% and 11% respectively. In this multivariate analysis we found that conservative management was the only factor influencing the incidence of malunion, age, sex and type of fracture did not have a scientific significant influence.
Dear Omar, Dear Mira: Exploring Zionism Across the Ethnic Divide
Authors: Dajani Omar M. , Sucharov Mira
Published: November 2023

Abstract: What happens to Zionism as an idea when it is encountered through the lens of attachment, loss, and interpersonal connection? This article uses a creative-nonfiction form and a dual autoethnographic lens to examine the question of Jewish Zionist longings and Palestinian memory through the heart and mind of two scholars: a Canadian Jew and a Palestinian American. Mira Sucharov, a professor of political science at Carleton University and a frequent public commentator on Middle East issues, writes to Omar M. Dajani, a former member of the Palestinian negotiating team's legal support unit, who is now a law professor at University of the Pacific's McGeorge School of Law, and Omar writes back. Their correspondence—set both in the present and in a recreated past—suggests avenues for a reexamination of identity and connection to place, and a rediscovery of relationality to one another.
Optically isotropic longitudinal piezoelectric resonant photoelastic modulator for wide angle polarization modulation at megahertz frequencies
Authors: Atalar Okan , Arbabian Amin
Published: November 2023

Polarization modulators have a broad range of applications in optics. The acceptance angle of a free-space polarization modulator is crucial for many applications. Polarization modulators that can achieve a wide acceptance angle are constructed by attaching a piezoelectric transducer to an isotropic material, and utilizing a resonant transverse interaction between light and acoustic waves. Since their demonstration in the 1960s, the design of these modulators has essentially remained the same with minor improvements in the following decades. In this work, we show that a suitable single crystal with the correct crystal orientation, functioning as both the piezoelectric transducer and the acousto-optic interaction medium, could be used for constructing a highly efficient free-space resonant polarization modulator operating at megahertz frequencies and exhibiting a wide acceptance angle. We construct the modulator using gallium arsenide, an optically isotropic and piezoelectric crystal, and demonstrate polarization modulation at 6 MHz with an input aperture of 1 cm in diameter, acceptance angle reaching ±30∘, and modulation efficiency exceeding 50%. Compared to state-of-the-art resonant photoelastic modulators, the modulator reported in this work exhibits greater than 50-fold improvement in modulation frequency for the same input aperture, while simultaneously reducing the thickness by approximately a factor of 80. Increasing the modulation frequency of photoelastic modulators from the kilohertz to the megahertz regime and substantially reducing their thickness lead to significant performance improvements for various use cases. This technological advancement also creates opportunities for utilizing these devices in new applications.
Highly robust performance of a compact, wide-angle, nano-optic capsule endoscopy camera
Authors: Moghaddasi Mojtaba , Hu Bin , Abrinaei Fahimeh
Published: November 2023

The performance of capsule endoscopy, which plays an important role in noninvasive medical diagnostics, has been limited by aberrations and large optical sizes caused by several traditional lenses. We propose a capsule endoscopy camera based on a metalens that distinguishes it from existing technologies in three aspects. First, the camera achieved a high FOV of 160°, enabling a comprehensive examination of internal organs. Second, we achieved a compact design with an optical diameter of 1.6 mm and a length of 1.4 mm to enhance patient comfort. The attainment of exceptional image quality with an MTF of more than 45% at 300 lp/mm is the third advantage of this camera. The theoretical performance of this innovative approach shows great potential to improve diagnostic capabilities.
Strategies for optimizing plasmonic grating couplers with a topology-based inverse design
Authors: Efseaff Michael , Harrison Mark C.
Published: November 2023

Numerical simulations have become a cornerstone technology in the development of nanophotonic devices. Specifically, 3D finite-difference time domain (FDTD) simulations are widely used due to their flexibility and powerful design capabilities. More recently, FDTD simulations in conjunction with a design methodology called inverse design has become a popular way to optimize device topology, reducing a device’s footprint and increasing performance. We implement a commercial inverse design tool to generate complex grating couplers and explore a variety of grating coupler design methodologies. We compare the conventionally designed grating couplers to those generated by the inverse design tool. Finally, we discuss the limitations of the inverse design tool and how different design strategies for grating couplers affect inverse design performance, in terms of both computational cost and performance of the resulting device.
Scalable and robust beam shaping using apodized fish-bone grating couplers
Authors: Ropp Chad , Maurya Dhriti , Yulaev Alexander , Westly Daron , Simelgor Gregory , Aksyuk Vladimir
Published: November 2023

Efficient power coupling between on-chip guided and free-space optical modes requires precision spatial mode matching with apodized grating couplers. Yet, grating apodizations are often limited by the minimum feature size of the fabrication approach. This is especially challenging when small feature sizes are required to fabricate gratings at short wavelengths or to achieve weakly scattered light for large-area gratings. Here, we demonstrate a fish-bone grating coupler for precision beam shaping and the generation of millimeter-scale beams at 461 nm wavelength. Our design decouples the minimum feature size from the minimum achievable optical scattering strength, allowing smooth turn-on and continuous control of the emission. Our approach is compatible with commercial foundry photolithography and has reduced sensitivity to both the resolution and the variability of the fabrication approach compared to subwavelength meta-gratings, which often require electron beam lithography.
Anti-phase pulsation of counter-propagating dissipative solitons in a bidirectional fiber laser
Authors: Yang Kai , Luo Zi-Rui , Zhang Ze-Xian , Zhan Ze-Yu , Wu Dai-Xuan , Liu Meng , Luo Ai-Ping , Xu Wen-Cheng , Luo Zhi-Chao
Published: November 2023

Due to its unique geometric structure, the bidirectional ultrafast fiber laser is an excellent light source for dual-comb applications. However, sharing the same gain between the counter-propagating solitons also gives rise to complex dynamics. Herein, we report the anti-phase pulsation of counter-propagating dissipative solitons in a bidirectional fiber laser. The in-phase and anti-phase soliton pulsation can be manipulated by adjusting the intracavity birefringence. The periodic modulation of polarization-dependent gain (PDG) caused by polarization hole burning (PHB) in the gain fiber can be responsible for anti-phase pulsation of bidirectional dissipative solitons. These findings offer new, to the best of our knowledge, insights into the complex dynamics of solitons in dissipative optical systems and performance improvement of bidirectional ultrafast fiber lasers.
Space–time coupling by a soliton self-mode conversion technique in optical fibers
Authors: Li Ru , Liu Manlin , Hong Weiyi , Luo Aiping
Published: November 2023

Soliton self-mode conversion is a versatile technique that allows for both wavelength changes and mode transformations. This process can be controlled by adjusting the input power, with higher power resulting in a stronger nonlinear effect that facilitates soliton self-mode conversion. Our research has demonstrated that soliton self-mode conversion is a viable method for achieving spatiotemporal coupling. This technique can be applied in optical fibers to link two pulses, resulting in distinct spatial distributions that can be controlled by adjusting the initial time intervals.
Control of vortex orientation of ultrashort optical pulses using a spatial chirp
Authors: Porras Miguel A. , Jolly Spencer W.
Published: November 2023

Introducing a spatial chirp into a pulse with a longitudinal vortex, such as a standard pulsed Laguerre–Gauss beam, results in a vortex pulse with an arbitrary orientation of the phase line singularity between longitudinal and transverse, depending on the amount of chirp. Analytical expressions are given for such pulses with arbitrary topological charge valid at any propagation distance.
Enhanced performances of photonic reservoir computing using a semiconductor laser with random distributed optical feedback
Authors: Cai Deyu , Huang Yu , Yang Yigong , Zhou Pei , Li Nianqiang
Published: November 2023

We propose and experimentally demonstrate a photonic time-delay reservoir computing (TDRC) system with random distributed optical feedback under optical injection. To evaluate the performance, we calculate the memory ability and perform two benchmark tasks, i.e., chaotic time series prediction and nonlinear channel equalization task. Our numerical results show that the proposed TDRC has a superior performance compared with the case with conventional single optical feedback. This is attributed to the fact that the random distributed optical feedback offers multiple external cavity modes, which enhance the nonlinearity of the reservoir laser. Additionally, the experimental result also shows that our proposed TDRC scheme outperforms the computer with single optical feedback in the chaotic time series prediction task. To the best of our knowledge, our work offers a novel path to improve the performance of TDRC by introducing random distributed optical feedback.
Beam search decoder for enhancing sequence decoding speed in single-molecule peptide sequencing data
Authors: Kipen Javier , Jaldén Joakim
Published: November 2023

Next-generation single-molecule protein sequencing technologies have the potential to significantly accelerate biomedical research. These technologies offer sensitivity and scalability for proteomic analysis. One auspicious method is fluorosequencing, which involves: cutting naturalized proteins into peptides, attaching fluorophores to specific amino acids, and observing variations in light intensity as one amino acid is removed at a time. The original peptide is classified from the sequence of light-intensity reads, and proteins can subsequently be recognized with this information. The amino acid step removal is achieved by attaching the peptides to a wall on the C-terminal and using a process called Edman Degradation to remove an amino acid from the N-Terminal. Even though a framework (Whatprot) has been proposed for the peptide classification task, processing times remain restrictive due to the massively parallel data acquisicion system. In this paper, we propose a new beam search decoder with a novel state formulation that obtains considerably lower processing times at the expense of only a slight accuracy drop compared to Whatprot. Furthermore, we explore how our novel state formulation may lead to even faster decoders in the future.
Dominant negative variants in KIF5B cause osteogenesis imperfecta via down regulation of mTOR signaling
Authors: Marom Ronit , Zhang Bo , Washington Megan E. , Song I-Wen , Burrage Lindsay C. , Rossi Vittoria C. , Berrier Ava S. , Lindsey Anika , Lesinski Jacob , Nonet Michael L. , Chen Jian , Baldridge Dustin , Silverman Gary A. , Sutton V. Reid , Rosenfeld Jill A. , Tran Alyssa A. , Hicks M. John , Murdock David R. , Dai Hongzheng , Weis MaryAnn , Jhangiani Shalini N. , Muzny Donna M. , Gibbs Richard A. , Caswell Richard , Pottinger Carrie , Cilliers Deirdre , Stals Karen ,   Undiagnosed Diseases Network, Eyre David , Krakow Deborah , Schedl Tim , Pak Stephen C. , Lee Brendan H.
Published: November 2023

Background

Kinesin motor proteins transport intracellular cargo, including mRNA, proteins, and organelles. Pathogenic variants in kinesin-related genes have been implicated in neurodevelopmental disorders and skeletal dysplasias. We identifiedde novo, heterozygous variants inKIF5B, encoding a kinesin-1 subunit, in four individuals with osteogenesis imperfecta. The variants cluster within the highly conserved kinesin motor domain and are predicted to interfere with nucleotide binding, although the mechanistic consequences on cell signaling and function are unknown.

Methods

To understand thein vivogenetic mechanism ofKIF5Bvariants, we modeled the p.Thr87Ile variant that was found in two patients in theC.elegansortholog,unc-116, at the corresponding position (Thr90Ile) by CRISPR/Cas9 editing and performed functional analysis. Next, we studied the cellular and molecular consequences of the recurrent p.Thr87Ile variant by microscopy, RNA and protein analysis in NIH3T3 cells, primary human fibroblasts and bone biopsy.

Results

C.elegansheterozygous for theunc-116Thr90Ile variant displayed abnormal body length and motility phenotypes that were suppressed by additional copies of the wild type allele, consistent with a dominant negative mechanism. Time-lapse imaging of GFP-tagged mitochondria showed defective mitochondria transport inunc-116Thr90Ile neurons providing strong evidence for disrupted kinesin motor function. Microscopy studies in human cells showed dilated endoplasmic reticulum, multiple intracellular vacuoles, and abnormal distribution of the Golgi complex, supporting an intracellular trafficking defect. RNA sequencing, proteomic analysis, and bone immunohistochemistry demonstrated down regulation of the mTOR signaling pathway that was partially rescued with leucine supplementation in patient cells.

Conclusion

We report dominant negative variants in theKIF5Bkinesin motor domain in individuals with osteogenesis imperfecta. This study expands the spectrum of kinesin-related disorders and identifies dysregulated signaling targets forKIF5Bin skeletal development.
Lineage-specific genes are clustered with HET-domain genes and respond to environmental and genetic manipulations regulating reproduction in Neurospora
Authors: Wang Zheng , Wang Yen-Wen , Kasuga Takao , Lopez-Giraldez Francesc , Zhang Yang , Zhang Zhang , Wang Yaning , Dong Caihong , Sil Anita , Trail Frances , Yarden Oded , Townsend Jeffrey P.
Published: November 2023

Lineage-specific genes (LSGs) have long been postulated to play roles in the establishment of genetic barriers to intercrossing and speciation. In the genome of Neurospora crassa, most of the 670 Neurospora LSGs that are aggregated adjacent to the telomeres are clustered with 61% of the HET-domain genes, some of which regulate self-recognition and define vegetative incompatibility groups. In contrast, the LSG-encoding proteins possess few to no domains that would help to identify potential functional roles. Possible functional roles of LSGs were further assessed by performing transcriptomic profiling in genetic mutants and in response to environmental alterations, as well as examining gene knockouts for phenotypes. Among the 342 LSGs that are dynamically expressed during both asexual and sexual phases, 64% were detectable on unusual carbon sources such as furfural, a wildfire-produced chemical that is a strong inducer of sexual development, and the structurally-related furan 5-hydroxymethyl furfural (HMF). Expression of a significant portion of the LSGs was sensitive to light and temperature, factors that also regulate the switch from asexual to sexual reproduction. Furthermore, expression of the LSGs was significantly affected in the knockouts of adv-1 and pp-1 that regulate hyphal communication, and expression of more than one quarter of the LSGs was affected by perturbation of the mating locus. These observations encouraged further investigation of the roles of clustered lineage-specific and HET-domain genes in ecology and reproduction regulation in Neurospora, especially the regulation of the switch from the asexual growth to sexual reproduction, in response to dramatic environmental conditions changes.
Methods for mediation analysis with high-dimensional DNA methylation data: Possible choices and comparisons
Authors: Clark-Boucher Dylan , Zhou Xiang , Du Jiacong , Liu Yongmei , Needham Belinda L. , Smith Jennifer A. , Mukherjee Bhramar
Published: November 2023

Epigenetic researchers often evaluate DNA methylation as a potential mediator of the effect of social/environmental exposures on a health outcome. Modern statistical methods for jointly evaluating many mediators have not been widely adopted. We compare seven methods for high-dimensional mediation analysis with continuous outcomes through both diverse simulations and analysis of DNAm data from a large multi-ethnic cohort in the United States, while providing an R package for their seamless implementation and adoption. Among the considered choices, the best-performing methods for detecting active mediators in simulations are the Bayesian sparse linear mixed model (BSLMM) and high-dimensional mediation analysis (HDMA); while the preferred methods for estimating the global mediation effect are high-dimensional linear mediation analysis (HILMA) and principal component mediation analysis (PCMA). We provide guidelines for epigenetic researchers on choosing the best method in practice and offer suggestions for future methodological development.
Study on the dynamic distribution of spores of powdery mildew pathogen in wheat by rotor airflow of plant protection UAV
Authors: Qin Weicai , Chen Panyang , He Ruyan
Published: November 2023

Plant protection drones are fast and efficient application machines that are characterised by high application efficiency and no damage to crops. They are particularly suitable for small areas of farmland and mountainous terrain in regions such as Asia and are currently the dominant insecticide application technology in China. The presence of wind is a prerequisite for the spread and dissemination of airborne diseases and it can directly influence the distance and height of ascent of pathogenic spores. This paper investigates the effect of downwash airflow generated by the flight altitude of a plant protection drone on the horizontal distribution, vertical distribution and ground distribution of powdery mildew spores in wheat. Monitoring the changing dynamics of airborne powdery mildew conidia using spore traps. The test results show that: the number of powdery mildew pathogenic spores is related to various factors such as weather, relative humidity and wind speed; the release of spores is greatly influenced by airflow disturbances but has little effect at the early stages of sporulation; the disease is caused by the accumulation process of pathogenic spores and in the control of powdery mildew in wheat, preventive spraying should be carried out within 2–3 days of the germination of pathogenic spores. The study lays the foundation for further in-depth research on the spread of powdery mildew spores and improved pest control, and provides a basis for scientific and rational spraying and control by agricultural drones.
Effects of leaf traits of tropical trees on the abundance and body mass of herbivorous arthropod communities
Authors: Schön Jana E. , Tiede Yvonne , Becker Marcel , Donoso David A. , Homeier Jürgen , Limberger Oliver , Bendix Jörg , Farwig Nina , Brandl Roland
Published: November 2023

In tropical forests, herbivorous arthropods remove between 7% up to 48% of leaf area, which has forced plants to evolve defense strategies. These strategies influence the palatability of leaves. Palatability, which reflects a syndrome of leaf traits, in turn influences both the abundance and the mean body mass not only of particular arthropod taxa but also of the total communities. In this study, we tested two hypotheses: (H1) The abundance of two important chewer guilds (‘leaf chewers’ and ‘rostrum chewers’), dominant components of arthropod communities, is positively related to the palatability of host trees. (H2) Lower palatability leads to an increased mean body mass of chewers (Jarman-Bell principle). Arthropods were collected by fogging the canopies of 90 tropical trees representing 31 species in three plots at 1000 m and three at 2000 m a.s.l. Palatability was assessed by measuring several ‘leaf traits’ of each host tree and by conducting a feeding trial with the generalist herbivore Gryllus assimilis (Orthoptera, Gryllidae). Leaf traits provided partial support for H1, as abundance of leaf chewers but not of rostrum chewers was positively affected by the experimentally estimated palatability. There was no support for H2 as neither leaf traits nor experimentally estimated palatability affected the mean body mass of leaf chewers. The mean body mass of rostrum chewers was positively related to palatability. Thus, leaf traits and experimentally estimated palatability influenced the abundance and mean body mass of chewing arthropods on the community level. However, the data were not consistent with the Jarman-Bell principle. Overall, our results suggest that the palatability of leaves is not among the dominant factors influencing abundance and mean body mass of the community of chewing arthropod herbivores. If other factors, such as the microclimate, predation or further (a-)biotic interactions are more important has to be analyzed in refined studies.
Periodontal disease and visfatin level: A systematic review and meta-analysis
Authors: Bayani Mojtaba , Heidari MohammadTaha , Almasi-Hashiani Amir
Published: November 2023

Visfatin is considered an inflammatory biomarker in periodontal disease (PD). In this meta-analysis, we aimed to evaluate the relationship between Visfatin biomarker level with PD. In this study, Medline, Scopus, Web of Science, and Google Scholar were searched. We included studies that examined visfatin levels in samples from healthy people and periodontal disease until March 2023. The quality of the selected articles was evaluated using the Newcastle-Ottawa assessment scale. Depending on heterogeneity of studies, random-effects or fixed-effect models were used to pool results and report the standardized mean difference (SMD). After screening the retrieved papers, the related data were extracted. A total of 159 studies were identified, and 16 studies were included in the meta-analysis. In 9 studies, the SMD of visfatin level of gingival crevicular fluid (GCF) in patients with chronic periodontitis (CP) and healthy individuals was 4.32 (p<0.001). In 6 studies, the SMD of salivary visfatin level in patients with CP and healthy individuals was 2.95 (p = 0.004). In addition, in five studies, the SMD of serum visfatin level in patients with CP and healthy individuals was 7.87 (p<0.001). Therefore, Visfatin levels in serum, saliva, and GCF of patients with CP were increased in comparison to healthy individuals. Comparison of visfatin levels in saliva of gingivitis patients and healthy individuals showed a significant increase of visfatin in gingivitis patients (SMD:0.57, P = 0.018), but no significant difference was observed in the mean GCF visfatin level of gingivitis patients and healthy individuals (SMD:2.60, P = 0.090). In addition, the results suggested that there is no difference between gingivitis cases compared to CP patients (SMD:3.59, P = 0.217). Visfatin levels in GCF, serum, and saliva have the potential to be used as a diagnostic biomarker of periodontitis.
The effect of mindfulness on decision-making, inhibitory control, and impulsivity of substance use disorder in-treatment patients: A randomized clinical trial
Authors: Donate Ana Paula Gonçalves , de Macedo Elizeu Coutinho , Bedendo André , Félix Júnior Itamar , Gallo Giovanna Gonçalves , Opaleye Emérita Sátiro , Noto Ana Regina
Published: November 2023

This study aimed to investigate the effects of Mindfulness-Based Relapse Prevention (MBRP) in decision-making, inhibitory control and impulsivity compared to Treatment as Usual (TAU) for individuals with Substance Use Disorders (SUD’s) in Brazil. A randomized clinical trial was conducted with participants from a therapeutic community (n = 122). Decision-making (Iowa Gambling Task), impulsivity dimensions (UPPS-P Scale), and inhibitory control (Stroop Color-Word Test) were assessed before and after the MBRP 8-week intervention. GLM Multivariate analysis was used to evaluate the effects of MBRP on different impulsivity measures. The results showed that MBRP+TAU improved the general decision-making score (p = 0,008) compared to TAU. However, no significant effects were found in impulsivity dimensions and inhibitory control in individuals with SUDs in the therapeutic community. This study found improvement in decision-making in the total IGT score; however, no effect for self-reported impulsivity and inhibitory control among middle-aged patients after an 8-weeks intervention of MBRP protocol in an inpatient setting. It adds information to the subject, with implications and possible directions to be followed by the next clinical trials with patients with SUDs in treatment.

Trial registration: EnsaiosClinicos.gov.br: RBR-6c9njc.
Predicting amputation using machine learning: A systematic review
Authors: Yao Patrick Fangping , Diao Yi David , McMullen Eric P. , Manka Marlin , Murphy Jessica , Lin Celina
Published: November 2023

Amputation is an irreversible, last-line treatment indicated for a multitude of medical problems. Delaying amputation in favor of limb-sparing treatment may lead to increased risk of morbidity and mortality. This systematic review aims to synthesize the literature on how ML is being applied to predict amputation as an outcome. OVID Embase, OVID Medline, ACM Digital Library, Scopus, Web of Science, and IEEE Xplore were searched from inception to March 5, 2023. 1376 studies were screened; 15 articles were included. In the diabetic population, models ranged from sub-optimal to excellent performance (AUC: 0.6–0.94). In trauma patients, models had strong to excellent performance (AUC: 0.88–0.95). In patients who received amputation secondary to other etiologies (e.g.: burns and peripheral vascular disease), models had similar performance (AUC: 0.81–1.0). Many studies were found to have a high PROBAST risk of bias, most often due to small sample sizes. In conclusion, multiple machine learning models have been successfully developed that have the potential to be superior to traditional modeling techniques and prospective clinical judgment in predicting amputation. Further research is needed to overcome the limitations of current studies and to bring applicability to a clinical setting.
Stability of hospital quality indicators over time: A multi-year observational study of German hospital data
Authors: Kollmann Nils Patrick , Langenberger Benedikt , Busse Reinhard , Pross Christoph
Published: November 2023

Background

Retrospective hospital quality indicators can only be useful if they are trustworthy signals of current or future quality. Despite extensive longitudinal quality indicator data and many hospital quality public reporting initiatives, research on quality indicator stability over time is scarce and skepticism about their usefulness widespread.

Objective

Based on aggregated, widely available hospital-level quality indicators, this paper sought to determine whether quality indicators are stable over time. Implications for health policy were drawn and the limited methodological foundation for stability assessments of hospital-level quality indicators enhanced.

Methods

Two longitudinal datasets (self-reported and routine data), including all hospitals in Germany and covering the period from 2004 to 2017, were analysed. A logistic regression using Generalized Estimating Equations, a time-dependent, graphic quintile representation of risk-adjusted rates and Spearman’s rank correlation coefficient were used.

Results

For a total of eight German quality indicators significant stability over time was demonstrated. The probability of remaining in the best quality cluster in the future across all hospitals reached from 46.9% (CI: 42.4–51.6%) for hip replacement reoperations to 80.4% (CI: 76.4–83.8%) for decubitus. Furthermore, graphical descriptive analysis showed that the difference in adverse event rates for the 20% top performing compared to the 20% worst performing hospitals in the two following years is on average between 30% for stroke and AMI and 79% for decubitus. Stability over time has been shown to vary strongly between indicators and treatment areas.

Conclusion

Quality indicators were found to have sufficient stability over time for public reporting. Potentially, increasing case volumes per hospital, centralisation of medical services and minimum-quantity regulations may lead to more stable and reliable quality of care indicators. Finally, more robust policy interventions such as outcome-based payment, should only be applied to outcome indicators with a higher level of stability over time. This should be subject to future research.
Spatial coupling relationship between older adults and elderly care resources in the Yangtze River Delta
Authors: Wu Lianxia , Qian Linyi , Li Yinhuan , Huang Zuyu , Guan Weihua
Published: November 2023

The imbalance between supply and demand of elderly care resources in the Yangtze River Delta is increasing. By the older adult agglomeration, spatial cluster analysis, hotspot analysis, and coupling coordination model, this study explores the spatial coupling relationship between older adults and elderly care resources in the Yangtze River Delta in 2020 from the perspective of a supply-and-demand balance. The results demonstrate that: (1) population aging is mainly in the moderate aging stage, followed by the primary aging stage; (2) there are significant spatial differences in elderly care resources on the urban scale in the Yangtze River Delta; and (3) elderly care resources and the older adults in the Yangtze River Delta are mostly highly coupled. However, Nantong, with the highest degree of aging, has a serious mismatch in life service resources and ecological environment resources. The social security resources and medical resources of provincial capital cities with low aging are mismatched. Medical and health resources in underdeveloped areas are seriously mismatched. The social security resources are barely matched in Shanghai. A path for optimizing the spatial allocation of elderly care resources is proposed. This research offers a decision-making reference for coordinating elderly care resources distribution.
Testing biological actions of medicinal plants from northern Vietnam on zebrafish embryos and larvae: Developmental, behavioral, and putative therapeutical effects
Authors: Tran My Hanh , Nguyen Thi Van Anh , Do Hoang Giang , Kieu Trung Kien , Nguyen Thi Kim Thanh , Le Hong Diep , Guerrero-Limon Gustavo , Massoz Laura , Nivelle Renaud , Zappia Jérémie , Pham Hai The , Nguyen Lai Thanh , Muller Marc
Published: November 2023

Evaluating the risks and benefits of using traditional medicinal plants is of utmost importance for a huge fraction of the human population, in particular in Northern Vietnam. Zebrafish are increasingly used as a simple vertebrate model for testing toxic and physiological effects of compounds, especially on development. Here, we tested 12 ethanolic extracts from popular medicinal plants collected in northern Vietnam for their effects on zebrafish survival and development during the first 4 days after fertilization. We characterized more in detail their effects on epiboly, hatching, growth, necrosis, body curvature, angiogenesis, skeletal development and mostly increased movement behavior. Finally, we confirm the effect on epiboly caused by theMahonia bealeiextract by staining the actin filaments and performing whole genome gene expression analysis. Further, we show that this extract also inhibits cell migration of mouse embryo fibroblasts. Finally, we analyzed the chemical composition of theMahonia bealeiextract and test the effects of its major components. In conclusion, we show that traditional medicinal plant extracts are able to affect zebrafish early life stage development to various degrees. In addition, we show that an extract causing delay in epiboly also inhibits mammalian cell migration, suggesting that this effect may serve as a preliminary test for identifying extracts that inhibit cancer metastasis.
KSHV vIL-6 enhances inflammatory responses by epigenetic reprogramming
Authors: Inagaki Tomoki , Wang Kang-Hsin , Kumar Ashish , Izumiya Chie , Miura Hiroki , Komaki Somayeh , Davis Ryan R. , Tepper Clifford G. , Katano Harutaka , Shimoda Michiko , Izumiya Yoshihiro
Published: November 2023

Kaposi sarcoma-associated herpesvirus (KSHV) inflammatory cytokine syndrome (KICS) is a newly described chronic inflammatory disease condition caused by KSHV infection and is characterized by high KSHV viral load and sustained elevations of serum KSHV-encoded IL-6 (vIL-6) and human IL-6 (hIL-6). KICS has significant immortality and greater risks of other complications, including malignancies. Although prolonged inflammatory vIL-6 exposure by persistent KSHV infection is expected to have key roles in subsequent disease development, the biological effects of prolonged vIL-6 exposure remain elusive. Using thiol(SH)-linked alkylation for the metabolic (SLAM) sequencing and Cleavage Under Target & Release Using Nuclease analysis (CUT&RUN), we studied the effect of prolonged vIL-6 exposure in chromatin landscape and resulting cytokine production. The studies showed that prolonged vIL-6 exposure increased Bromodomain containing 4 (BRD4) and histone H3 lysine 27 acetylation co-occupancies on chromatin, and the recruitment sites were frequently co-localized with poised RNA polymerase II with associated enzymes. Increased BRD4 recruitment on promoters was associated with increased and prolonged NF-κB p65 binding after the lipopolysaccharide stimulation. The p65 binding resulted in quicker and sustained transcription bursts from the promoters; this mechanism increased total amounts of hIL-6 and IL-10 in tissue culture. Pretreatment with the BRD4 inhibitors, OTX015 and MZ1, eliminated the enhanced inflammatory cytokine production. These findings suggest that persistent vIL-6 exposure may establish a chromatin landscape favorable for the reactivation of inflammatory responses in monocytes. This epigenetic memory may explain the greater risk of chronic inflammatory disease development in KSHV-infected individuals.
Telaah Perbandingan Panduan Klinis Sindrom Nefrotik Idiopatik Resisten Steroid pada Anak
Authors: Pardede Sudung Oloan , Fahlevi Reza , Kinesya Edwin , Hidayati Eka Laksmi , Puspitasari Henny Adriani , Trihono Partini Pudjiastuti
Published: November 2023

Latar belakang. Sebagai salah satu penyakit ginjal anak tersering di dunia, sindrom nefrotik dapat dibedakan menjadi sensitif dan resisten steroid. Penelitian dan tata laksana sindrom nefrotik resisten steroid pada anak terus berkembang. Panduan klinis yang digunakan seringkali berbeda dan bervariasi antar fasilitas kesehatan ataupun negara di dunia.Tujuan. Membandingkan panduan klinis sindrom nefrotik idiopatik resisten steroid pada anak. Metode. Kami menentukan topik dan lingkup bahasan yang akan dibahas. Sesudah itu, dilakukan telaah dan perbandingan terhadap empat panduan klinis dari Ikatan Dokter Anak Indonesia tahun 2012, Kidney Disease: Improving Global Outcomes tahun 2021, Indian Society of Pediatric Nephrology tahun 2021, dan International Pediatric Nephrology Association tahun 2020. Empat lingkup bahasan kajian antara lain diagnosis, pemeriksaan penunjang, batasan kriteria, dan terapi.Hasil. Didapatkan beberapa perbedaan mendasar yang ditemukan, antara lain, adanya periode konfirmasi, beberapa istilah baru, anjuran pemeriksaan genetik, serta pilihan utama terapi imunosupresan. Kesimpulan. Sesudah menelaah panduan klinis sindrom nefrotik idiopatik resisten steroid dari Ikatan Dokter Anak Indonesia tahun 2012 dan panduan klinis baru lainnya, ditemukan beberapa pebedaan dasar. Oleh karena itu, diperlukan pembaharuan konsensus sindrom nefrotik resisten steroid yang disesuaikan dengan bukti ilmiah terbaru serta ketersediaan fasilitas kesehatan dan obat-obatan di Indonesia.
Peran Puasa Ramadhan pada Anak dengan Epilepsi: Studi Pendahuluan
Authors: Rafli Achmad , Putra Ryan Pramana , Mangunatmadja Irawan , Handryastuti Setyo , Soebadi Amanda
Published: November 2023

Latar belakang. Pada bulan Ramadhan semua umat Muslim diwajibkan untuk berpuasa, menahan diri untuk tidak makan, minum, atau meminum obat dari terbit hingga tenggelamnya fajar. Keadaan ini akan menimbulkan tantangan baru bagi anak dengan epilepsi yang berpuasa, berupa kontrol frekuensi kejang, perubahan jadwal minum obat, dan kepatuhan minum obat. Berpuasa dapat menyebabkan perubahan metabolisme otak yang berdampak pada peningkatan fungsi otak dalam hal kognitif, peningkatan neuroplastisitas dan ketahanan terhadap cedera dan penyakit. Adanya perubahan metabolisme otak pada saat berpuasa dapat membantu dalam mengontrol kejang pada anak dengan epilepsi.Tujuan. Penelitian ini bertujuan untuk menilai frekuensi kejang dan efek samping pada anak dengan epilepsi yang berpuasa di bulan Ramadhan tahun 2023. Metode. Penelitian ini merupakan penelitian observasional prospektif yang dilakukan selama 1 bulan. Sampel pada penelitian ini merupakan semua anak dengan epilepsi yang berpuasa pada bulan Ramadhan, April 2023. Anak dengan epilepsi yang berpuasa dipantau frekuensi kejang, jadwal minum obat dan kepatuhannya (sebelum dan setelah berpuasa). Hasil. Total pasien pada penelitian ini adalah dua belas (6 laki-laki, 6 perempuan, rentang usia 6-17 tahun). Jenis kejang absans merupakan jenis kejang yang paling banyak (50%). Tujuh pasien mendapatkan antiepilepsi monoterapi (58,33%) dengan variasi pemberian antiepilepsi 1-4 jenis. Frekuensi kejang pada seluruh pasien mengalami penurunan selama puasa Ramadhan dibandingkan dengan satu bulan sebelumnya sebesar 27%. Tidak ada efek samping yang timbul akibat berpuasa dan perubahan jadwal minum obat. Kesimpulan. Puasa Ramadhan bermanfaat menurunkan frekuensi kejang bagi anak dengan epilepsi.
Diagnosis dan Tata Laksana Infeksi Virus Hepatitis C pada Anak dengan Penyakit Ginjal Kronik di Indonesia
Authors: Wijaya Ellen , Alatas Fatima Safira , Ambarsari Cahyani Gita
Published: November 2023

Latar belakang. Anak dengan penyakit ginjal kronik yang memerlukan hemodialisis merupakan kelompok risiko tinggi terjadinya infeksi virus hepatitis C. Infeksi virus hepatitis C pada anak dengan penyakit ginjal kronik memerlukan diagnosis dan tata laksana adekuat untuk mencegah progresifitas penyakit dan komplikasi menjadi karsinoma hepatoselular.Tujuan. Menelaah lebih lanjut diagnosis dan tata laksana infeksi virus hepatitis C pada anak dengan penyakit ginjal kronik di Indonesia.Metode. Penelusuran pustaka database elektronik, yaitu instrumen pencari Pubmed®, EBSCOHost®, dan penelusuran manual. Kata kunci yang digunakan adalah (“children” atau “pediatric”) dan “hepatitis C” dan “end stage renal disease” dan “treatment” dengan menggunakan batasan. Penelitian berbentuk kasus-kontrol, kohort, maupun potong lintang, dipublikasikan dalam bahasa Indonesia atau Inggris, dan diterbitkan dalam 20 tahun terakhir (2002-2022).Hasil. Ditemukan enam artikel yang relevan terhadap pertanyaan klinis. Hasil telaah kritis dan telaah berdasarkan validity, importance dan applicability.Kesimpulan. Hepatitis C pada anak seringkali tanpa gejala atau gejala ringan, memerlukan konfirmasi melalui pemeriksaan molekular. Terapi VHC pada anak PGK yang menjalani hemodialisis kontroversial, tetapi dosis disesuaikan interferon dan ribavirin dapat mencegah progresi penyakit. Klinisi harus mendiagnosis dan mengelola infeksi VHC pada anak PGK untuk mendukung eliminasi hepatitis pada 2030 sesuai target WHO
Pengendalian Varisela di Rumah Sakit
Authors: Karyanti Mulya Rahma , Putri Annisa
Published: November 2023

Varisela adalah penyakit menular yang disebabkan oleh virus varisela-zoster. Varisela merupakan penyakit endemik dengan tingkat penularan infeksi mencapai 90% pada kontak dekat. Prevalensi tertinggi terdapat pada kelompok usia 4-10 tahun. Neonatus yang lahir dari ibu yang memiliki varisela dan pasien imunokompromais, seperti keganasan, autoimun, penyakit ginjal kronis, dan pasca transplantasi organ padat (transplantasi hati/ginjal) rentan terhadap varisela-zoster . Kematian akibat varisela sangat jarang terjadi karena adanya program vaksin. Vaksin virus varisela hidup efektif untuk mencegah varisela (86%) dibandingkan dengan pasien yang tidak divaksinasi. Vaksin varisela dapat diberikan sebagai profilaksis sebelum dan setelah paparan. Asiklovir intravena dan Intravenous Immunoglobulin  diindikasikan untuk diberikan pada neonatus yang lahir dari ibu yang memiliki varisela dan pasien imunokompromais.
Prehranski vzorci slovenskih mladostnikov in njihov življenjski slog
Authors: Radivo Manica , Poklar Vatovec Tamara
Published: November 2023

Uvod: Zdravo prehranjevanje, telesna aktivnost in spanje so pomembne določilnice življenjskega sloga mladostnikov. Namen raziskave je bil preučiti povezave prehranskih vzorcev mladostnikov z njihovim življenjskim slogom, analizirati razlike glede na spol in regijo bivanja ter ugotoviti povezave med posameznimi vzorci življenjskega sloga.Metode: Raziskava je bila opravljena spomladi 2019 na populaciji dijakov 3. letnikov (n = 1563) naključno izbranih srednjih šol v Sloveniji. Njihova povprečna starost je bila 18 let. Za namen raziskave je bil uporabljen anonimni anketni vprašalnik, izdelan v spletnem orodju 1KA, ki je vseboval 30 vprašanj. S programom SPSS je bila izvedena opisna in inferenčna statistika. Za testiranje statistično značilnih razlik smo uporabili t-test, statistično značilno povezanost smo preverjali s pomočjo statistike χ2 ter s Spearmanovim korelacijskim koeficientom.Rezultati: Raziskava je pokazala, da je primanjkljaj vnosa zelenjave, stročnic in rib glede na priporočila večji kot pri vnosu sadja; poleg tega je večji v vzhodni regiji. Med regijama smo ugotovili razlike v stanju hranjenosti, ki so statistično značilne (U = 275,597, p = 0,003). Dokazali smo pozitivno povezavo med pogostostjo zajtrkovanja med tednom in količino spanja (rs = 0,177, p = 0,001) ter negativno povezavo med sedentarnim vedenjem in redno telesno aktivnostjo mladostnikov v prostem času (rs = –0,113, p = 0,001). Diskusija in zaključek: Prehranske navade anketiranih mladostnikov niso skladne s priporočili. Prav tako mladostniki ne dosegajo priporočil za telesno aktivnost. Prihodnje raziskave bi se morale bolj osredotočiti na starejše mladostnike (18–24 let) ter na povezanost posameznih dejavnikov življenjskega sloga.
MINIMIZATION OF REPRESENTATIONS OF THE LOGICAL FUNCTION IN SCHAEFFER AND PIERCE BASES
Authors:   Voronezh Institute of the Ministry of Internal Affairs of Russia, Voronezh, Russian Federation, Menshikh V.V. , Nikitenko V.A.
Published: November 2023

The paper studies the representation of arbitrary logical functions in Schaeffer and Pierce bases. For this purpose, recurrent dependencies of the representation of disjunctive and conjunctive monomials in these bases were initially established. Then generalizations were made to the arbitrary logical formulas presented in the form of disjunctive and conjunctive normal forms. Estimates were obtained for the number of operations in logical formulas during the transition to the Schaeffer and Pierce bases.
Violence as a “Generational Experience” of Growing Up in Post-Wall East Germany? Female Experiences of Racist Othering and Assault in East Germany 1989–2000
Authors: Mues Laura
Published: November 2023

As an often-overlooked period of conflict, the era of transformation after German re-unification represents a time of collective and individual identity crisis for East Germans, who experienced a loss of their Lebenswelt (lifeworld; Edmund Husserl) and a devaluation of their life achievements that often led to severe discontent, causing conflict both in and between East and West Germany. During this period, People of Colour experienced a discharge of the general tension through a sharp increase in violence directed against them by radical right-wing actors. Since then, their experiences have gone largely unnoticed in popular media and publications, having only recently found their way into a broader discourse of remembrance. This paper seeks to contribute to a shift away from a discussion about People of Colour and towards a position that focuses on their narratives, experiences and opinions. In doing so, it takes a firmly female-centred perspective, using written and video-recorded material from Women of Colour as a doubly marginalised group.
Lonnie Liston Smith
Authors: Douglass Scott , Smith Lonnie
Published: November 2023

Lonnie Liston Smith is an American pianist and keyboard player from Richmond, Virginia, born in 1940. He earned a bachelor’s degree in Music Education and an honorary doctorate from Morgan State University and has performed with Betty Carter, Art Blakey, and Miles Davis. His original music with the Cosmic Echoes has influenced the genres of smooth jazz, jazz funk, acid jazz, and hip hop. Scott Gray Douglass is a bassist and teacher also from Richmond, born in 1984. He is writing a book based on the oral histories of Richmond’s jazz musician educators. The two spoke by telephone in September of 2021. The following conversation is edited for clarity. Footnotes are provided by the co-author for context.