bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnostic value of Treponema pallidum PCR test in real practice
Authors: Labrandero Hoyos Carolina , Peñuelas Leal Rodrigo , Casanova Esquembre Andrés , Lorca Spröhnle Javier , Echevarría Andrés Grau , Magdaleno Tapial Jorge , Martinez‐Domenech Álvaro , Mochón Maria Dolores Ocete , Hernández Bel Pablo
Published: January 2023

Background

Syphilis is a sexually transmitted infection (STI) caused by the pathogen Treponema pallidum. Its incidence is increasing in our country, especially among men who have sex with men (MSM). Serological tests are still the most widely used technique for diagnosis. The need for an early diagnosis has prompted the introduction of fast techniques, such as Treponema pallidum detection by polymerase chain reaction (PCR) on mucocutaneous samples. The objective of this work is to analyse the sensitivity of this technique in a series of patients diagnosed with syphilis at our centre.

Methods

Retrospective review of all cases diagnosed with syphilis at our centre between May 2017 and May 2021.

Results

A total of 203 cases of syphilis were diagnosed with serologic tests: 33% were primary syphilis and 53.1% secondary syphilis. PCR for Treponema pallidum was performed in 117 (57,6%) cases. The sensitivity was highest (95,2%) when performed on samples from mucocutaneous ulcers in primary syphilis. This value decreased to 69,4% in secondary syphilis, although there were variations between the types of samples.

Conclusions

The PCR test has a high diagnostic value when performed on ulcer exudates in patients with primary syphilis. Its most relevant advantages in clinical practice are the possibility of an early diagnosis before serological tests during the window period, the ability to confirm reinfections in patients with persistent positivity of reaginic antibodies and a history of treated syphilis. Nevertheless, given that a negative PCR test may not rule out infection by Treponema pallidum, serologic tests are still necessary for everyday practice.
The evolving relationship between COVID‐19 and serious bacterial infection evaluation in febrile neonates
Authors: Guernsey David , Kostin Shannon , Silver Michael , Vazquez Hector , Zerzan Jessica
Published: January 2023

Aim

The COVID‐19 omicron variant surge highlighted the evolving impact of COVID‐19. Febrile infants <60 days old are high risk for serious bacterial infections (SBI). This study evaluated the rate of SBI based on COVID‐19 infection.

Methods

We conducted a retrospective chart review at an urban, academic paediatric emergency department. The study enrolled infants 60 days old or less with documented fever. The primary outcome was SBI diagnosed by blood, urine, and/or cerebrospinal fluid cultures. We compared the rate of SBI between COVID‐19 groups with an omicron variant and 29‐ to 60‐day‐old subgroup analyses.

Results

Two hundred and thirty‐three (233) infants meet the criteria. The incidence of SBI was 18.7% in the COVID‐19 negative and 1.7% in the COVID‐19‐positive group which is statistically significant (p < 0.001). Omicron subgroup analysis did not achieve statistical significance (p = 0.62) while COVID‐19‐positive infants 29–60 days old had a statistically significant lower rate of SBI (p = 0.006).

Conclusion

The omicron variant surge provided an additional understanding of the impact of COVID‐19 on these high‐risk infants. These results can lead to decreased invasive testing and exposure to antibiotics as well as examine the utility of viral testing for risk stratification.
The potential of metabolomics as a predictive guide for clinical management in autoimmunity against red blood cells
Authors: Kapur Rick
Published: January 2023

Autoimmune‐responses leading to increased destruction of red blood cells occur in autoimmune haemolytic anaemia (AIHA). The pathophysiology of AIHA is multifactorial and not fully understood, and clinically it remains challenging to manage relapsed and treatment‐refractory cases. Rabelo and colleagues conduct metabolomic profiling in plasma of 26 patients with primary warm AIHA, with consideration of haemolytic activity and relapse occurrence. They identify distinct metabolites to be increased in primary warm AIHA patients, thereby providing an encouraging basis for further validation and exploration of metabolomic profiling as a predictive tool for the management of AIHA.

Commentary on: Rabelo et al. Metabolomic profile in patients with primary warm autoimmune haemolytic anaemia. Br J Haematol 2023;200:140‐149.
The Birth and Death of Hope
Authors: Knox Jean
Published: January 2023

I discuss the origins of the capacity to hope, its roots in the infant's experience of a loving and secure relationship with their caregiver. The infant's awareness of his or her own mental and emotional agency can gradually develop and so the capacity to channel desires and impulses, and to expect an attuned response. I suggest that the failure of this intersubjective developmental process gives rise to an enduring sense of hopelessness, an expectation that emotional needs and desires will never be met. The key role that play has in the development of hope is discussed from psychoanalytic and neuroscientific perspectives. The impact that a patient's persistent hopelessness has for psychoanalytic psychotherapy practice is explored, its function as a defence against any new, spontaneous relational experience which might activate trust and hope. Internal and external change and transference dependence are resisted as the patient fears becoming vulnerable to being abandoned or rejected by the analyst. I explore some socio‐political aspects of hope and hopelessness, such as the belief that people deserve their success in society and the self‐blame, shame and hopelessness that result from an experience of economic or social failure. I discuss the possibility that hope in human relationship and in our humanity can survive in the face of overwhelming catastrophe.
Bone dimensional changes after flapless immediate implant placement with and without bone grafting: Randomized clinical trial
Authors: Fettouh Ahmed Ibrahim Aboul , Ghallab Noha A. , Ghaffar Khaled Abdel , Mina Nael Adel , Abdelmalak Mariam Samy , Abdelrahman Abdelrahman Ali Gamaleldin , Shemais Nesma Mohamed
Published: January 2023

Introduction

Immediate implant in postextraction sockets requires managing the postextraction alveolar resorption. This randomized clinical trial examined vertical and horizontal changes 1‐year following flapless immediate implant with and without xenograft at sites with thin labial plate.

Methods

Forty patients with hopeless teeth in maxillary esthetic zone were randomly assigned to receiving either one immediate implant without bone graft (control) or with bone graft (intervention). Cone beam computed tomography (CBCT) scans were obtained pre‐extraction and 1‐year postoperatively to measure thickness and dimensional changes of the labial bone.

Results

Cone beam computed tomography measurements revealed that a xenograft, when compared to no xenograft, led to 0.2 mm increased fill of the horizontal gap (95% confidence interval (CI): −1.1, 0.7). In both groups, there was a significant reduction in the labio‐palatal bone width after 1 year compared to baseline (P ≤ 0.05). There was no significant difference (P > 0.05) between the xenograft when compared to no xenograft regarding the labio‐palatal bone collapse % at 0 mm (−0.2, 95% CI: −4.8, 4.5) and 2 mm apical to the labial crest (1.9, 95% CI: −1.8, 5.6). While at 5 mm the ridge was significantly reduced (P ≤ 0.05) in the no xenograft when compared to xenograft (4.5, 95% CI: 0.7, 8.2). The xenograft when compared to no xenograft, led to 1.1 mm less vertical bone changes (95% CI: 0.4, 1.9). Both groups revealed significant positive correlation between labio‐palatal socket dimension and bone formed labial to the implant (P ≤ 0.05). [Correction added on 7 February 2023, after first online publication: In the 8th line of this section, the word “collapse” was changed to “ridge” in this version.]

Conclusion

This investigation suggested that immediate implants with or without grafting the labial gap preserved alveolar bone dimension and that bone formation labial to the implant was related to initial labio‐palatal socket dimension.
Risk stratification for post‐operative pulmonary complications following major cardiothoracic or abdominal surgery: Validation of the PPC Risk Prediction Score for physiotherapist's clinical decision‐making
Authors: Salling Sofie Langbo , Jensen Janne Hastrup , Mosegaard Sebastian Breddam , Sørensen Lotte , Mechlenburg Inger
Published: January 2023

Introduction

Patients undergoing major cardiothoracic or abdominal surgery are at increased risk of developing post‐operative pulmonary complications (PPC), but respiratory physiotherapy can prevent PPC. We have previously developed the PPC Risk Prediction Score to allocate physiotherapists' resources and stratify patients into three risk groups. In this study, we performed a temporal external validation of the PPC Risk Prediction Score. Such validation is rare and adds to the originality of this study.

Methods

A cohort of 360 patients, admitted to undergo elective cardiothoracic or abdominal surgery, were included. Performance and clinical usefulness of the PPC Risk Prediction Score were estimated through discrimination, calibration and clinical usefulness, and the score was updated.

Results

The score showed c‐statistics of 0.62. Related to clinical usefulness, a cut point at 8 gave a sensitivity of 0.49 and a specificity of 0.70, whereas a cut point at 12 gave a sensitivity of 0.13 and a specificity of 0.95. Two predictors included in the development sample score, thoraco‐abdominal incision odds ratio (OR) 2.74 (1.12;6.71) and sternotomy OR 2.09 (1.18;3.72), were statistically significantly associated to PPC in the validation sample.

Conclusions

The score was not able to discriminate between patients with and without PPC; neither was the updated score, but the study identified clinically relevant risk factors for developing PPC.
Transboundary conservation hotspots in China and potential impacts of the belt and road initiative
Authors: Shi Kaichong , Yang Li , Zhang Lu , Chapman Colin , Fan Pengfei
Published: January 2023

Aim

Biodiversity hotspots often span international borders, thus conservation efforts must as well. China is one of the most biodiverse countries and the length of its international land borders is the longest in the world; thus, there is a strong need for transboundary conservation. We identify China's transboundary conservation hotspots and analyse the potential effects of the Belt and Road Initiative (BRI) on them to provide recommendations for conservation actions.

Location

China, Asia.

Methods

We compiled a species list of terrestrial vertebrates that span China's borders. Using their distribution, we extracted the top 30% of the area with the highest richness value weighted by Red List category and considered these transboundary hotspots for conservation priority. Then we analysed protected area (PA) coverage and connectivity to identify conservation gaps. To measure potential impact of the BRI, we counted the species whose distribution range is traversed by the BRI, and calculated the aggregation index, proportion of natural land and night light index along its routes.

Results

We identified 1964 terrestrial vertebrate species living in the border region. We identified four transboundary hotspots and found insufficient PA coverage and low connectivity in three of them. The BRI routes intersected all four hotspots and traversed 82.4% (1619/1964) of the transboundary species, half of which (918) are sensitive to the potential risks brought by the BRI. Night light index increased generally along the BRI. However, the proportion of natural land and the aggregation index near the BRI showed different trends in hotspots.

Main Conclusions

There is an urgent need for conservation action in China's transboundary region. The BRI should put biodiversity conservation at the core of its development strategy. Furthermore, we suggest using the planned BRI as a platform for dialogue and consultation, knowledge and data sharing, and joint planning to promote transboundary conservation.
Ant attendance does not necessarily imply protection of aphids from their arthropod natural enemies
Authors: Schifani Enrico , Peri Ezio , Giannetti Daniele , Colazza Stefano , Grasso Donato A.
Published: January 2023

Many ants and hemipterans are bound by a mutualistic relationship (trophobiosis) which represents an ecological keystone: ants receive food (honeydew) providing different kinds of protection. Partner protection against arthropod natural enemies is considered to be frequent and to interfere with biological control strategies of hemipteran pests.

We carried out an ant‐exclusion field experiment in a fava bean (Vicia faba) plantation in Italy to monitor the abundance and behaviour of the ants (Plagiolepis pygmaea, Tetramorium semilaeve and the exotic Nylanderia jaegerskioeldi) and their relationship with facultative mutualist (Aphis fabae) and non‐mutualist (Megoura viciae) aphids, the arthropod natural enemies of the aphids, and extrafloral nectaries.

Ants concentrated their activity on the attendance of facultative mutualist aphids much more than on the extrafloral nectaries. The ant‐exclusion treatment had no effect on the abundance of M. viciae and on the parasitization rate of A. fabae, while it reduced the abundance of A. fabae, aphid predators, and aphid parasitoids.

Our results demonstrate that ant attendance does not imply the protection of aphids from arthropod natural enemies and suggest that the identity of the ant species involved is important for the outcome. As relatively few species have been studied in this regard, extending our knowledge to the role of more ant species is desirable to understand the ecology and evolution of ant‐aphid mutualisms and to refine integrated control strategies of aphid pests.
How patients' psycho‐social profiles contribute to decision‐making in epilepsy surgery: A prospective study
Authors: Hohmann Louisa , Bien Christian G. , Holtkamp Martin , Grewe Philip
Published: January 2023

Objective

Identifying factors associated with surgical decision‐making is important to understand reasons for underutilization of epilepsy surgery. Neurologists' recommendations for surgery and patients' acceptance of these recommendations depend on clinical epilepsy variables, for example, lateralization and localization of seizure onset zones. Moreover, previous research shows associations with demographic factors, for example, age and sex. Here, we investigate the relevance of patients' psycho‐social profile for surgical decision‐making.

Methods

We prospectively studied 296 patients from two large German epilepsy centers. Multiple logistic regression analyses were used to investigate variables linked to neurologists' recommendations for and patients' acceptance of surgery or intracranial video‐electroencephalographic monitoring. Patients' psycho‐social profiles were assessed via self‐reports and controlled for various clinical–demographic variables. Model selection was performed using the Akaike information criterion.

Results

As expected, models for neurologists' surgery recommendations primarily revealed clinical factors such as lateralization and localization of the seizure onset zone, load with antiseizure medication (ASM), and site of the epilepsy‐center. For this outcome, employment was the only relevant psycho‐social aspect (odds ratio [OR] = .38, 95% confidence interval [CI] = .13–1.11). In contrast, three of the five relevant predictors for patients' acceptance were psycho‐social. Higher odds were found for those with more subjective ASM adverse events (OR = 1.04, 95% CI = .99–1.00), more subjective seizure severity (OR = 1.12, 95% CI = 1.01–1.24), and lower subjective cognitive impairment (OR = .98, 95% CI = .96–1.00).

Significance

We demonstrated the relevance of the patients' psycho‐social profile for decision‐making in epilepsy surgery, particularly for patients' decisions. Thus, in addition to clinical–demographic variables, patients' individual psycho‐social characteristics add to the understanding of surgical decision‐making. From a clinical perspective, this calls for individually tailored counseling to assist patients in finding the optimal treatment option.
Text mining applications to support health library practice: A case study on marijuana legalization Twitter analytics
Authors: Kung Janice Y. , Ly Kynan , Shiri Ali
Published: January 2023

Background

Twitter is rich in data for text and data analytics research, with the ability to capture trends.

Objectives

This study examines Canadian tweets on marijuana legalization and terminology used. Presented as a case study, Twitter analytics will demonstrate the varied applications of how this kind of research method may be used to inform library practice.

Methods

Twitter API was used to extract a subset of tweets using seven relevant hashtags. Using open‐source programming tools, the sampled tweets were analysed between September to November 2018, identifying themes, frequently used terms, sentiment, and co‐occurring hashtags.

Results

More than 1,176,000 tweets were collected. The most popular hashtag co‐occurrence, two hashtags appearing together, was #cannabis and #CdnPoli. There was a high variance in the sentiment analysis of all collected tweets but most scores had neutral sentiment.

Discussion

The case study presents text‐mining applications relevant to help make informed decisions in library practice through service analysis, quality analysis, and collection analysis.

Conclusions

Findings from sentiment analysis may determine usage patterns from users. There are several ways in which libraries may use text mining to make evidence‐informed decisions such as examining all possible terminologies used by the public to help inform comprehensive evidence synthesis projects and build taxonomies for digital libraries and repositories.
HETEROGENEITY, FRICTIONAL ASSIGNMENT, AND HOME‐OWNERSHIP
Authors: Head Allen , Lloyd‐Ellis Huw , Stacey Derek
Published: January 2023

We study the composition of the housing stock across ownership and rental markets in a dynamic model of frictional assignment. Houses are rented or sold to heterogeneous households that sort over quality. Due to matching frictions and an increasing ownership surplus, wealthy households tend to own and lower value housing tends to be rented, even without financial frictions or rental supply constraints. When calibrated to match key housing market features of the average U.S. city, the model is consistent with observed empirical relationships across cities. We study the model's implications for affordability, ownership, and the impact of progressive property taxation.
Gut inflammation and adaptive immunity amplify acetaminophen toxicity in bowel and liver
Authors: Alabbas Saleh Y , Giri Rabina , Oancea Iulia , Davies Julie , Schreibner Veronika , Florin Timothy H , Begun Jakob
Published: January 2023

Background and Aim

Prevention of liver failure arising from accidental or deliberate paracetamol (acetaminophen [APAP]) overdose remains a vexed health problem despite well‐publicized guidelines for its early detection and treatment. It is recognized that the gut may aggravate liver pathology, via the gut–liver axis. The main aim of this study was to assess the role of the colon in APAP‐induced liver toxicity.

Methods

Liver necrosis and colitis were studied following sublethal doses of APAP administered intraperitoneally to C57Bl/6 wild‐type (WT) mice, as well as to C57Bl/6 Winnie mice, which develop a spontaneous colitis caused by a SNP in Muc2, and WT mice with acute DSS‐induced colitis. Repeated APAP exposure was studied in WT and Rag1 ko mice that lack mature T and B lymphocytes.

Results

APAP overdose resulted in significant colonic injury in WT mice (P < 0.05), which resolved by 24 h. Underlying colitis was not associated with liver necrosis, but colitis exacerbated APAP‐induced liver injury and extended APAP‐colonic injury. Prior APAP exposure exacerbated both APAP‐liver and APAP‐colonic injury more so in WT than Rag1 ko mice. APAP impaired barrier function with increased intestinal permeability and associated bacterial translocation to the liver and spleen in mice with the Winnie phenotype.

Conclusions

This study identifies novel roles for APAP in causing colitis, the amplification of APAP‐liver toxicity where there is underlying colitis, and involvement of immune memory in APAP‐toxicity. The latter could be key for decoding the poorly understood but important clinical entity of chronic APAP liver failure.
Towards hepatitis C elimination in France: Scanvir, an effective model to test and treat drug users on dedicated days
Authors: Debette‐Gratien Marilyne , François Sandrine , Chevalier Catherine , Alain Sophie , Carrier Paul , Rigaud Céline , Abraham Bruno , Burgevin Anne‐Laure , Courat Laurent , Debenes Bernard , Koffi Joseph , Caux‐Nussbaum Elisabeth , Zattoni‐Leroy Juliette , Feuillet‐Sow Gaëlle , Dumont Quentin , Nubukpo Philippe , Loustaud‐Ratti Véronique
Published: January 2023

According to the French recommendations, the elimination of the hepatitis C virus by 2025 could be a realistic public health goal. Screening policies are being intensified, and access to treatment is promoted for patients who escape the usual care pathway. The ‘Scanvir’ program is an original strategy based on dedicated screening days, as part of the ‘test, treat and cure HCV’ event in addiction care centers in a French region, during which innovative screening technologies (RDTs, FibroScan® and point‐of‐care HCV RNA testing) are brought on site and access to a multidisciplinary team is offered. A total of 392 patients attended the 67 regional Scanvir sessions: 31.6% were HCV Ab‐positive and 66% of them were HCV RNA‐positive. Treatment was initiated in 79.3% of the patients. RDTs were accepted by 62% of the PWIDs (including those who already knew their status) and FibroScan® by 99.5% of the patients. 80% of the viremic patients started their treatment on site and are now cured or still under treatment. Advanced fibrosis evaluated by FibroScan® (LSM > 8 KPa) was suspected in 13.4% and 14.1% of the global and the HCV population, respectively. Scanvir is an efficient strategy for HCV elimination based on dedicated days aimed at increasing cost‐effectiveness and offering a multidisciplinary service while saving human care resources. It is an exportable strategy that also offers comprehensive screening of associated chronic liver diseases via the elastometry device and interviews.
The Effect of Consultation‐Liaison Psychiatry on Postoperative Delirium in Elderly Hip Fracture Patients in the General Hospital
Authors: Xie Qin , Liu Xiao‐Bo , Jing Guang‐Wu , Jiang Xue , Liu Hong , Zhong Bao‐Liang , Li Yi
Published: January 2023

Objective

The low recognition rate of postoperative delirium has gradually aroused clinical attention in China. The present study was to investigate the impact of consultation‐liaison psychiatry on postoperative delirium in elderly hip fracture patients.

Methods

From March 2012 to September 2013, 89 patients with hip fractures hospitalized in Wuhan Mental Health Center were included in this prospective study as the consultation‐liaison group. A total of 81 patients selected from August 2010 to February 2012 were defined as the conventional group. The delirium was evaluated using the confusion assessment method (CAM) recommended by the American Psychiatric Association guidelines.

Results

There was no difference of sex, age, trauma, surgical methods, and anesthesia between two groups (p > 0.05). The consultation rate of consultation‐liaison group was significantly higher than that of conventional group (37.07% vs 17.28%, p < 0.05). After the consultation, there were 26 cases (78%) and nine cases (64%) of delirium in the consultation‐liaison and conventional group, respectively (p > 0.05). In the consultation‐liaison group, three patients (9.09%) were diagnosed with anxiety and three patients (9.09%) were diagnosed with depression, while in the conventional group, three patients (21.42%) were diagnosed with communication and one patient (7.14%) was diagnosed with depression. In addition, this study showed the incidence of delirium in consultation‐liaison group was significantly higher than that of conventional group (29.21% vs 11.11%, p < 0.05). The average hospital stay in consultation‐liaison group was significantly lower than that of conventional group (11.42 ± 2.63 vs. 15.17 ± 2.38 days, p < 0.01).

Conclusion

Consultation‐liaison psychiatry could improve the recognition rate of postoperative delirium in elderly hip fracture patients, shorten hospitalization time. The training of mental health knowledge for non‐psychiatrists could improve the ability of early identification and treatment of delirium.
Comparison of Clinical Outcomes and Muscle Invasiveness between Unilateral Biportal Endoscopic Discectomy and Percutaneous Endoscopic Interlaminar Discectomy for Lumbar Disc Herniation at L5/S1 Level
Authors: Wang Liang , Li Chao , Han Kaifei , Chen Yongqin , Qi Lei , Liu Xinyu
Published: January 2023

Objective

Both unilateral biportal endoscopic discectomy (UBED) and percutaneous endoscopic interlaminar discectomy (PEID) could achieve favorable outcomes for lumbar disc herniation (LDH). There are limited studies comparing the two different methods of endoscopic discectomy. The objective was to comprehensively compare the clinical outcome and muscle invasiveness of UBED and PEID for the treatment of LDH at L5/S1 level with at least 1‐year follow‐up.

Methods

The retrospective cohort study enrolled 106 LDH patients of L5/S1 level from January 2018 to December 2020. There were 51 patients who underwent UBED (22 males and 29 females, 43.8 ± 14.2 years old) and 55 patients underwent PEID (28 males and 27 females, 42.3 ± 13.8 years old). Clinical outcomes and surgical invasiveness were compared between the two groups for at least 1 year follow‐up. Clinical outcomes included visual analogue scale (VAS) scores, Oswestry Disability Index (ODI), complications, recurrence of LDH, intraoperative anesthesia time, operative time, number of intraoperative fluoroscopies, and postoperative length of stay. Surgical invasiveness was evaluated with serum CPK level and change rate of lean multifidus cross‐sectional area (LMCSA). Independent‐sample t test and paired sample t test were used to compare continuous data. Chi‐square test and Fisher's precision probability tests were used to analyze the categorical data.

Results

Both groups achieved favorable clinical outcomes at the last follow‐up, including VAS and ODI (all Ps <0.05). The intraoperative anesthesia time for UBED was longer, but with no difference of operative time. As for intraoperative fluoroscopy times (2.5 vs 2.4), postoperative length of stay (2.1 vs 2.0 days), postoperative complications (5.9% vs 3.6%), there were also no significant difference. The serum CPK level and change rate of LMCSA for UBED was higher than PEID at postoperative 1st day. At the last follow‐up, there was no significant difference in the change rate of LMCSA between the two groups (P = 0.096).

Conclusions

Both UBED and PEID could achieve favorable clinical outcomes for the treatment of L5/S1 LDH. Despite UBED is more invasive, the radiological manifestation of paraspinal muscle invasiveness was equal at last follow‐up with at least 1 year. UBED is a safe and innovative alternative choice for treatment of LDH at L5/S1 level.
Biomechanical Comparison of Anatomic Versus Lower of Anteromedial and Anterolateral Tibial Tunnels in Posterior Cruciate Ligament Reconstruction
Authors: Peng Bo , Tang Yuchen , Jia Gengxin , Geng Bin , Xu Lihu , Xia Yayi , Teng Yuanjun
Published: January 2023

Objective

In order to reduce the “killer turn” effect, various tibial tunnels have been developed. However, few studies investigated the biomechanical effects of different tibial tunnels during PCL reconstruction. This study aims to compare the time‐zero biomechanical properties of anteromedial, anterolateral, lower anteromedial, and lower anterolateral tibial tunnels in transtibial posterior cruciate ligament (PCL) reconstruction under load‐to‐failure loading.

Methods

Porcine tibias and bovine extensor tendons were used to simulate in vitro transtibial PCL reconstruction. Forty bovine extensor tendons and 40 porcine tibias were randomly divided into four experimental groups: anteromedial tunnel group (AM group, n = 10), anterolateral tunnel group (AL group, n = 10), lower anteromedial tunnel group (L‐AM group, n = 10), and lower anterolateral tunnel group (L‐AL group, n = 10). The biomechanical test was then carried out in each group using the load‐to‐failure test. The ultimate load (in newtons), yield load (in newtons), tensile stiffness (in newtons per millimeter), load‐elongation curve, failure mode, and tibial tunnel length (in millimeter) were recorded for each specimen. One‐way analysis of variance (ANOVA) was used to compare the mean differences among the four groups.

Results

The biomechanical outcomes showed that there were no differences in the mean tensile stiffness and failure mode among four groups. The ultimate load and yield load of the L‐AM group were significantly higher than those of other three groups (P < 0.05). For the AM group, its ultimate load is significantly higher than that of the L‐AL group (P < 0.05), and its yield load is higher than that of the AL group and L‐AL group (P < 0.05). However, we found no significant differences in either ultimate load or yield load between AL group and L‐AL group (P > 0.05). There was significant statistical difference in the length of tibial tunnel between anatomic groups (AM and AL) and lower groups (L‐AM and L‐AL) (P < 0.05).

Conclusion

Compared with the anteromedial, anterolateral, and lower anterolateral tibial tunnel, the lower anteromedial tibial tunnel showed better time‐zero biomechanical properties including ultimate load and yield load in transtibial PCL reconstruction.
Successful ABO incompatible heart transplantation after desensitization therapy in an older child
Authors: Krauss Annemarie , West Lori J. , Conway Jennifer , Khoury Michael , Nahirniak Susann , Halpin Anne , Al Aklabi Mohammed , Urschel Simon
Published: January 2023

Background

ABO‐incompatible heart transplantation (HTx) has become a standard procedure for children below 2 years of age due to an immunologically immature immune system and associated low isohemagglutinin titers.

Methods

We report a case of an ABO‐incompatible HTx (recipient blood group O, donor blood group A) at the age of 5 years and 11 months with a fully matured immune system and previously high isohemagglutinin titers that diminished as a result of human leucocyte antigen (HLA) desensitization therapy with rituximab and immunoglobulins.

Results

The anti‐A titer at the time of HTx was 1:16 with post‐transplant isoagglutinin titers never exceeding 1:4 without any signs of rejection with now 3 years of post‐HTx follow‐up.

Conclusions

ABO isohemagglutinin titers should be routinely assessed in children undergoing desensitization therapy since ABOi transplantation can be considered in selected cases to expand the donor pool with the option of crossing the ABO barrier to find a better‐matched allograft.
Addition of ruxolitinib in Graft‐versus‐Host disease prophylaxis for pediatric β‐Thalassemia major patients after allogeneic stem cell transplantation: A retrospective cohort study
Authors: Hong Xiuli , Chen Yamei , Lu Jingyuan , Lu Quanyi
Published: January 2023

Background

To evaluate the effect of addition of ruxolitinib in Graft‐versus‐Host Disease (GVHD) prophylaxis on pediatric patients with β‐thalassemia major after allogeneic hematopoietic stem cell transplantation(HSCT).

Methods

This retrospective study reviewed 49 consecutive β‐thalassemia major pediatric patients who underwent HSCT from unrelated or haploidentical donors from February 2018 to October 2022. All transplantation recipients received cyclosporine A (CsA), mycophenolate mofetil (MMF), and short‐term methotrexate (MTX) as GVHD prophylaxis; while 27 of them in the ruxolitinib group had added ruxolitinib oral to GVHD prophylaxis regimen at 2.5 mg twice daily once successful engraftment after January 2020.

Results

The outcome showed that the ruxolitinib group had a lower cumulative incidence than the control group regardless of acute GVHD (22.2% vs.40.9%; p = .153) or chronic GVHD (18.5% vs.40.9%; p = .072); especially, the incidence of grade III‐IV acute GVHD was reported significantly less frequently in ruxolitinib group than that of the control group (0 vs. 27.3%, p = .005). No significant difference was detected between the two groups in EBV (Epstein–Barr virus)/CMV (cytomegalovirus) reactivation and BKV (BK virus) infection (p = .703, 1.000, and .436, respectively). Twenty‐six patients (96.3%) in the ruxolitinib group were alive, while two patients (9.1%) in the control group died of intestinal acute GVHD. The 2‐year overall survival (OS) and thalassemia‐free survival (TFS) were both 96.296% in the ruxolitinib group, while both 90.909% in the control group.

Conclusion

This study reveals that ruxolitinib prophylaxis is a promising option to decrease the incidence of grade III‐IV acute GVHD in pediatric patients with β‐thalassemia major.
Impact of the COVID‐19 pandemic on pathological autopsy practices in Japan
Authors: Hirata Yuichiro , Iida Shun , Arashiro Takeshi , Nagasawa Sayaka , Saitoh Hisako , Abe Hiroyuki , Ikemura Masako , Makino Yohsuke , Sawa Rintaro , Iwase Hirotaro , Ushiku Tetsuo , Suzuki Tadaki , Akitomi Shinji
Published: January 2023

During the coronavirus disease 2019 (COVID‐19) pandemic, autopsies have provided valuable insights into the pathogenesis of COVID‐19. The precise effect of this pandemic on autopsy procedures in Japan, especially in instances unrelated to COVID‐19, has not yet been established. Therefore, we conducted a questionnaire survey from December 2020 to January 2021 regarding the status of pathological autopsy practices in Japan during the first year of the COVID‐19 pandemic. The questionnaire was sent to 678 medical facilities with pathologists, of which 227 responded. In cases where a confirmed diagnosis of COVID‐19 was not made at the time of autopsy, many facilities counted them as suspected COVID‐19 cases if pneumonia was suspected clinically. At around half of the sites, autopsies were prohibited for suspected COVID‐19 cases. In addition, the number of autopsies of non‐COVID‐19 cases during the pandemic period was also investigated, and a significant decrease was observed compared with the incidence in the pre‐pandemic period. The COVID‐19 pandemic has affected not only the autopsies of COVID‐19 cases but also the entire practice of pathological autopsies. It is necessary to establish a system that supports the implementation of pathological autopsy practices during the pandemic of an emerging infectious disease.
‘Just like I thought’: Street‐level bureaucrats trust AI recommendations if they confirm their professional judgment
Authors: Selten Friso , Robeer Marcel , Grimmelikhuijsen Stephan
Published: January 2023

Artificial Intelligence is increasingly used to support and improve street‐level decision‐making, but empirical evidence on how street‐level bureaucrats' work is affected by AI technologies is scarce. We investigate how AI recommendations affect street‐level bureaucrats' decision‐making and if explainable AI increases trust in such recommendations. We experimentally tested a realistic mock predictive policing system in a sample of Dutch police officers using a 2 × 2 factorial design. We found that police officers trust and follow AI recommendations that are congruent with their intuitive professional judgment. We found no effect of explanations on trust in AI recommendations. We conclude that police officers do not blindly trust AI technologies, but follow AI recommendations that confirm what they already thought. This highlights the potential of street‐level discretion in correcting faulty AI recommendations on the one hand, but, on the other hand, poses serious limits to the hope that fair AI systems can correct human biases.
Intracellular immunoglobulin A (icIgA) in protective immunity and vaccines
Authors: Kok Tuck‐Weng , Izzo Angelo A. , Costabile Maurizio
Published: January 2023

Virus neutralization at respiratory mucosal surfaces is important in the prevention of infection. Mucosal immunity is mediated mainly by extracellular secretory immunoglobulin A (sIgA) and its role has been well studied. However, the protective role of intracellular specific IgA (icIgA) is less well defined. Initially, in vitro studies using epithelial cell lines with surface expressed polymeric immunoglobulin receptor (pIgR) in transwell culture chambers have shown that icIgA can neutralize influenza, parainfluenza, HIV, rotavirus and measles viruses. This effect appears to involve an interaction between polymeric immunoglobulin A (pIgA) and viral particles within an intracellular compartment, since IgA is transported across the polarized cell. Co‐localization of specific icIgA with influenza virus in patients' (virus culture positive) respiratory epithelial cells using well‐characterized antisera was initially reported in 2018. This review provides a summary of in vitro studies with icIgA on colocalization and neutralization of the above five viruses. Two other highly significant respiratory infectious agents with severe global impacts viz. SARS‐2 virus (CoViD pandemic) and the intracellular bacterium—Mycobacterium tuberculosis—are discussed. Further studies will provide more detailed understanding of the mechanisms and kinetics of icIgA neutralization in relation to viral entry and early replication steps with a specific focus on mucosal infections. This will inform the design of more effective vaccines against infectious agents transmitted via the mucosal route.
Image‐based taxonomic classification of bulk insect biodiversity samples using deep learning and domain adaptation
Authors: Fujisawa Tomochika , Noguerales Víctor , Meramveliotakis Emmanouil , Papadopoulou Anna , Vogler Alfried P.
Published: January 2023

Complex bulk samples of insects from biodiversity surveys present a challenge for taxonomic identification, which could be overcome by high‐throughput imaging combined with machine learning for rapid classification of specimens. These procedures require that taxonomic labels from an existing source data set are used for model training and prediction of an unknown target sample. However, such transfer learning may be problematic for the study of new samples not previously encountered in an image set, for example, from unexplored ecosystems, and require methods of domain adaptation that reduce the differences in the feature distribution of the source and target domains (training and test sets). We assessed the efficiency of domain adaptation for family‐level classification of bulk samples of Coleoptera, as a critical first step in the characterization of biodiversity samples. Neural network models trained with images from a global database of Coleoptera were applied to a biodiversity sample from understudied forests in Cyprus as the target. Within‐dataset classification accuracy reached 98% and depended on the number and quality of training images, and on dataset complexity. The accuracy of between‐datasets predictions (across disparate source–target pairs that do not share any species or genera) was at most 82% and depended greatly on the standardization of the imaging procedure. An algorithm for domain adaptation, domain adversarial training of neural networks (DANN), significantly improved the prediction performance of models trained by non‐standardized, low‐quality images. Our findings demonstrate that existing databases can be used to train models and successfully classify images from unexplored biota, but the imaging conditions and classification algorithms need careful consideration.
Digital clinical placements: Student perspectives and preparedness for placements
Authors: Houghton Natasha , Williams Lucy , Baptista Ana , Thakerar Viral , Dharmarajah Aynkaran
Published: January 2023

Background

In May 2020, first‐year students at Imperial College School of Medicine attended a ‘digital hospital placement’. Occurring in the early months of the COVID‐19 pandemic, this replaced their first planned hospital placement. The authors analysed student experiences to understand how a digital hospital placement impacted self‐perceived clinical and professional development and whether it improved preparedness for face‐to‐face hospital placements.

Methods

Three hundred ten students participated in this week‐long digital placement, which integrated clinical skills, communication and professional behaviour domains. It aimed to prepare students for safe participation in clinical environments. Resources included self‐directed and peer learning, virtual simulations (Oxford Medical Simulation) and staff‐led debriefing. Surveys were administered after the digital placement and after students' first face‐to‐face placement to collect quantitative and qualitative data. A reflexive thematic analysis was conducted.

Results

Eighty‐three and twenty‐nine students completed the postdigital and post‐face‐to‐face placement evaluation respectively. Quantitative results indicated a high self‐rated achievement of learning objectives and enthusiasm for digital placements; 83% of respondents supported digital simulations as part of regular medical education. Qualitative analysis identified three superordinate themes: (1) domain integration in digital placements helped students feel better prepared; (2) digital experiential learning is ideally suited to early clinical learning; and (3) virtual placements are a compliment, not an alternative, to face‐to‐face placements.

Conclusion

Digital placements are a promising means of supporting the challenging transition from classroom learner to clinical learner. They provide a feasible and scalable option for building student confidence and improving preparedness.
On double coset separability and the Wilson–Zalesskii property
Authors: Minasyan Ashot
Published: January 2023

A residually finite group has the Wilson–Zalesskii property if for all finitely generated subgroups , one has , where the closures are taken in the profinite completion of . This property played an important role in several papers, and is usually combined with separability of double cosets. In the present note we show that the Wilson–Zalesskii property is actually enjoyed by every double coset separable group. We also construct an example of an subgroup separable (LERF) group that is not double coset separable and does not have the Wilson–Zalesskii property.
Bounded vorticity for the 3D Ginzburg–Landau model and an isoflux problem
Authors: Román Carlos , Sandier Etienne , Serfaty Sylvia
Published: January 2023

We consider the full three‐dimensional Ginzburg–Landau model of superconductivity with applied magnetic field, in the regime where the intensity of the applied field is close to the ‘first critical field’ at which vortex filaments appear, and in the asymptotics of a small inverse Ginzburg–Landau parameter . This onset of vorticity is directly related to an ‘isoflux problem’ on curves (finding a curve that maximizes the ratio of a magnetic flux by its length), whose study was initiated in [22] and which we continue here. By assuming a nondegeneracy condition for this isoflux problem, which we show holds at least for instance in the case of a ball, we prove that if the intensity of the applied field remains below , the total vorticity remains bounded independently of , with vortex lines concentrating near the maximizer of the isoflux problem, thus extending to the three‐dimensional setting a two‐dimensional result of [28]. We finish by showing an improved estimate on the value of in some specific simple geometries.
Barriers and facilitators to vision screening in the U.S. pediatric primary care setting: a mixed methods systematic review protocol
Authors: Killeen Olivia J. , Saylor Kate M. , Hogan Caroline , Jacobson Adam , Collins Megan , Ehrlich Joshua R.
Published: January 2023

Objective:

The objective of this review is to understand the barriers and facilitators to vision screening in the US primary care setting for children ages 3 to 17.

Introduction:

Childhood vision screening is crucial because it detects children at risk for undiagnosed vision problems. Previous studies report low rates of appropriate vision screening in the primary care setting. We aim to identify barriers and facilitators to pediatric primary care vision screening to inform future interventions to improve childhood vision screening.

Inclusion criteria:

Studies of all types that identify barriers and facilitators to vision screening in children aged 3 to 17 years old in the pediatric primary care setting in the US will be considered for inclusion.

Methods:

We will search PubMed, CINAHL Complete (EBSCO), Scopus, Web of Science (SCI-EXPANDED, ESCI, CPCI-S, SSCI), Cochrane Library, and Embase. We will also search gray literature, including conference proceedings, professional organization reports, and clinical trials. We will use supplemental search strategies, including citation tracking and contacting authors for unpublished data. Titles and abstracts will be screened independently by 2 reviewers and selected for full-text screening based on prespecified inclusion criteria. Only studies in English will be considered. Each included study will be appraised using the Mixed Methods Appraisal Tool. Data will be extracted using a modified JBI mixed methods data extraction form. Qualitative and quantitative data will be integrated using a convergent integrated approach.

Review registration:

Open Science Framework https://osf.io/nhf5d/
Psychosocial interventions addressing suicidality in inpatient psychiatry: a scoping review protocol
Authors: Olarte-Godoy Jennifer , Jack Susan M. , Campbell Kaitryn , Halladay Jillian , Cleverley Kristin , McGillion Michael , Links Paul
Published: January 2023

Objective:

The objective of this review is to provide an overview of the existing literature on psychosocial interventions aimed at addressing suicidality among adults in the context of an inpatient psychiatric admission.

Introduction:

For individuals admitted to a psychiatric inpatient unit, their risk of suicide in the period following discharge is significantly higher compared with the prevalence of death by suicide in the general population. During an inpatient admission, there is opportunity for supportive interventions that may lead to reduced risks of suicide. Yet, interventions that directly address suicidality have primarily been studied in outpatient settings. A broader understanding of inpatient interventions will assist clinicians in understanding key considerations when implementing suicide-related interventions in this setting.

Inclusion criteria:

Studies involving adult patients (≥18 years) that describe psychosocial interventions aiming to address suicidality in the context of inpatient psychiatry will be considered. Studies that only describe pharmacological interventions will be excluded, as will studies that describe psychosocial interventions initiated in the context of an outpatient setting.

Methods:

We will search MEDLINE (Ovid), CINAHL (EBSCO), APA PsycINFO (EBSCOhost), the Cochrane Central Register of Controlled Trials (CENTRAL), Embase, and Web of Science for studies in English and Spanish. Gray literature and materials will also be searched for using Google and websites relevant to the review topic. No date limit will be set. Two independent reviewers will screen titles and abstracts from studies that meet the inclusion criteria and review eligible studies at full text. Data will be extracted and synthesized and then presented in tabular and graphical formats accompanied by a narrative summary.

Details of the review available at:

Open Science Framework https://osf.io/5cwhx