bluuebunny/crossref_metadata_2025 huggingface dataset:
Receptor of advanced glycation end product (RAGE) polymorphism and oxidative status in Hashimoto’s thyroiditis in Egyptian female patients: case control study
Authors: Mohamed Noura Mostafa , elfatah Azza H. Abd
Published: May 2022

Background

Hashimoto's thyroiditis is the most widespread autoimmune illness targeting a specific organ. "Redox homeostasis" is achieved when the production of Reactive Oxygen Species and their elimination are in balance. Advanced glycation end products (AGEs) are formed when glucose and/or α-oxaloaldehydes react non-enzymatically with the amino groups of lipids, proteins, and DNA. Nowadays, many studies are concerned with AGEs, the polymorphisms of their receptors, and their association with increased risk of HT. However, few studies investigated the role of receptors of advanced glycation end product (RAGE) SNP in Egyptian females.

Objective

The goals of this investigation were to ascertain whether oxidative stress plasma malondialdehyde (MDA) and total antioxidant capacity (TAC) were associated with HT, in addition, to assess the association of RAGE polymorphisms (− 374 T > A and the − 429 T > C and Gly82Ser) with HT.

Subject and methods.

Our case–control study has 80 patients enrolled who have newly been diagnosed with HT and 80 age and sex-matched healthy female controls. Each participant underwent a thorough medical history, physical examination, and laboratory investigations, which included Genotyping of RAGE Gly82Ser, − 374 T > A and − 429 T > C using polymerase chain reaction-restriction fragment length polymorphisms (PCR–RFLP).

Results

Chi-square revealed a significant association regarding the distribution of RAGE (− 374 T < C) genotypes TT and CC between patients and control (P = 0.04). Non-significant associations regarding the distribution of Gly82Ser genotypes Gly/Gly, Gly/Ser, Ser/Ser were found between patients and control (P = 0.5), and non-significant associations related to − 429 T > C gene polymorphism were revealed. In addition, patients with HT had higher MDA and lower TCA compared with controls.

Conclusion

The elevated MDA and decreased TAC as an antioxidant may be one of several risk factors associated with the prevalence of HT in individuals with the − 429 T > C RAGE mutation polymorphism that is associated with an increased risk of HT in Egyptian females.
COVID-19-induced silent myocarditis and newly developed hypertension in a 3-year-old boy
Authors: Malakan Rad Elaheh , Momtazmanesh Sara
Published: May 2022

Background

COVID-19 myocarditis occurs in 7–28% of patients admitted in the hospital with or without multisystem inflammatory syndrome. It may present as fulminant myocarditis. Dilated cardiomyopathy as a sequela of COVID-19 myocarditis has been reported in the pediatric population. However, to date, no case of silent COVID-19 myocarditis progressing to dilated cardiomyopathy has been reported in children. Furthermore, although newly developed hypertension as a sequela of COVID-19 infection has been reported in adults, there is no report of newly developed COVID-induced hypertension in children. We report a 3-year-old boy with silent COVID-19 myocarditis progressing to dilated cardiomyopathy and newly developed systemic hypertension.

Case presentation

A 3-year-old boy was referred to the emergency department because of respiratory distress. The parents gave a history of SARS-CoV-2 infection in the child 5 months ago that was manifested as fever and cough, for which he was treated as an outpatient. Echocardiographic examination revealed a severe decrease in left ventricular systolic function in favor of dilated cardiomyopathy. Cardiac magnetic resonance imaging established the diagnosis of myocarditis. The patient left ventricular systolic function did not improve after 2 weeks of intravenous inotropic support. Therefore, the child was transferred to another tertiary center with extracorporeal membrane oxygenation and pediatric cardiac transplantation facilities.

Conclusions

COVID-19 can induce silent myocarditis with progression to dilated cardiomyopathy and newly developed systemic hypertension. Thus, a thorough examination of the heart and measurement of blood pressure are mandatory in every child with COVID-19 infection. Cardiac MR is an indispensable tool in the diagnosis, follow-up, and prognostication of COVID-19 myocarditis. Moreover, four-chamber speckle tracking strain imaging showed apical rocking in all the four heart chambers in this child with opposite direction in the failed left ventricle compared with other cardiac chambers. Lastly, the presence of septal flash on M-mode echocardiography, apical rocking and prestretch–rebound stretch patterns on longitudinal strain imaging of the failed left ventricle in this child may be of predictive value for response to cardiac resynchronization therapy.
Biotechnological potentials of halophilic microorganisms and their impact on mankind
Authors: Dutta Bhramar , Bandopadhyay Rajib
Published: May 2022

Background

Halophiles are extremophilic organisms represented by archaea, bacteria and eukaryotes that thrive in hypersaline environment. They apply different osmoadaptation strategies to survive in hostile conditions. Habitat diversity of halophilic microorganisms in hypersaline system provides information pertaining the evolution of life on Earth.

Main body

The microbiome-gut-brain axis interaction contributes greatly to the neurodegenerative diseases. Gut resident halophilic bacteria are used as alternative medication for chronic brain diseases. Halophiles can be used in pharmaceuticals, drug delivery, agriculture, saline waste water treatment, biodegradable plastic production, metal recovery, biofuel energy generation, concrete crack repair and other sectors. Furthermore, versatile biomolecules, mainly enzymes characterized by broad range of pH and thermostability, are suitable candidate for industrial purposes. Reflectance pattern of halophilic archaeal pigment rhodopsin is considered as potential biosignature for Earth-like planets.

Short conclusions

This review represents important osmoadaptation strategies acquired by halophilic archaea and bacteria and their potential biotechnological applications to resolve present day challenges.

Graphical Abstract
Systemic Therapy for Advanced Human Epidermal Growth Factor Receptor 2–Positive Breast Cancer: ASCO Guideline Update
Authors: Giordano Sharon H. , Franzoi Maria Alice B. , Temin Sarah , Anders Carey K. , Chandarlapaty Sarat , Crews Jennie R. , Kirshner Jeffrey J. , Krop Ian E. , Lin Nancy U. , Morikawa Aki , Patt Debra A. , Perlmutter Jane , Ramakrishna Naren , Davidson Nancy E.
Published: May 2022

PURPOSE

To update evidence-based guideline recommendations to practicing oncologists and others on systemic therapy for patients with human epidermal growth factor receptor 2 (HER2)–positive advanced breast cancer.

METHODS

An Expert Panel conducted a targeted systematic literature review (for both systemic treatment and CNS metastases) and identified 545 articles. Outcomes of interest included efficacy and safety.

RESULTS

Of the 545 publications identified and reviewed, 14 were identified to form the evidentiary basis for the guideline recommendations.

RECOMMENDATIONS

HER2-targeted therapy is recommended for patients with HER2-positive advanced breast cancer, except for those with clinical congestive heart failure or significantly compromised left ventricular ejection fraction, who should be evaluated on a case-by-case basis. Trastuzumab, pertuzumab, and taxane for first-line treatment and trastuzumab deruxtecan for second-line treatment are recommended. In the third-line setting, clinicians should offer other HER2-targeted therapy combinations. There is a lack of head-to-head trials; therefore, there is insufficient evidence to recommend one regimen over another. The patient and the clinician should discuss differences in treatment schedule, route, toxicities, etc during the decision-making process. Options include regimens with tucatinib, trastuzumab emtansine, trastuzumab deruxtecan (if either not previously administered), neratinib, lapatinib, chemotherapy, margetuximab, hormonal therapy, and abemaciclib plus trastuzumab plus fulvestrant, and may offer pertuzumab if the patient has not previously received it. Optimal duration of chemotherapy is at least 4-6 months or until maximum response, depending on toxicity and in the absence of progression. HER2-targeted therapy can continue until time of progression or unacceptable toxicities. For patients with HER2-positive and estrogen receptor–positive or progesterone receptor–positive breast cancer, clinicians may recommend either standard first-line therapy or, for selected patients, endocrine therapy plus HER2-targeted therapy or endocrine therapy alone. Additional information is available at www.asco.org/breast-cancer-guidelines .
Management of Advanced Human Epidermal Growth Factor Receptor 2–Positive Breast Cancer and Brain Metastases: ASCO Guideline Update
Authors: Ramakrishna Naren , Anders Carey K. , Lin Nancy U. , Morikawa Aki , Temin Sarah , Chandarlapaty Sarat , Crews Jennie R. , Davidson Nancy E. , Franzoi Maria Alice B. , Kirshner Jeffrey J. , Krop Ian E. , Patt Debra A. , Perlmutter Jane , Giordano Sharon H.
Published: May 2022

PURPOSE

To provide updated evidence- and consensus-based guideline recommendations to practicing oncologists and others on the management of brain metastases for patients with human epidermal growth factor receptor 2 (HER2)–positive advanced breast cancer up to 2021.

METHODS

An Expert Panel conducted a targeted systematic literature review (for both systemic therapy for non-CNS metastases and for CNS metastases of HER2+ guideline updates) that identified 545 articles. Outcomes of interest included overall survival, progression-free survival, and adverse events.

RESULTS

Of the 545 publications identified and reviewed, six on systemic therapy were identified to form the evidentiary basis for the systemic therapy for CNS metastases guideline recommendations.

RECOMMENDATIONS

Patients with brain metastases should receive appropriate local therapy and systemic therapy, if indicated. Local therapies include surgery, whole-brain radiotherapy, and stereotactic radiosurgery. Memantine and hippocampal avoidance should be added to whole-brain radiotherapy when possible. Treatments depend on factors such as patient prognosis, presence of symptoms, resectability, number and size of metastases, prior therapy, and whether metastases are diffuse. Other options include systemic therapy, best supportive care, enrollment onto a clinical trial, and/or palliative care. There are insufficient data to recommend for or against performing routine magnetic resonance imaging to screen for brain metastases; clinicians should have a low threshold for magnetic resonance imaging of the brain because of the high incidence of brain metastases among patients with HER2-positive advanced breast cancer. Additional information is available at www.asco.org/breast-cancer-guidelines .
Constant-roll inflation from a fermionic field
Authors: Shokri Mehdi , Sadeghi Jafar , Reza Setare Mohammad
Published: May 2022

We study the inflationary period driven by a fermionic field which is non-minimally coupled to gravity in the context of the constant-roll approach. We consider the model for a specific form of coupling and perform the corresponding inflationary analysis. By comparing the result with the Planck observations coming from CMB anisotropies, we find the observational constraints on the parameters space of the model and also the predictions of the model. We find that the values of r and n

s
for

are in good agreement with the observations when

and N = 60.
Offshore Profit Shifting and Aggregate Measurement: Balance of Payments, Foreign Investment, Productivity, and the Labor Share
Authors: Guvenen Fatih , Mataloni Raymond J. , Rassier Dylan G. , Ruhl Kim J.
Published: May 2022

We show how offshore profit shifting by US multinational enterprises affects several key measures of the US economy. Profits shifted out of the United States grew rapidly from the mid-1990s to 2010 and have since waned. From 1982–2016, on average, 38 percent of income attributed to US direct investment abroad is reattributable to the United States. We find that adjusting for profit shifting shrinks the trade deficit, decreases the return on US foreign direct investment abroad, boosts productivity growth rates in the late 1990s and early 2000s, and lowers labor’s share of income. (JEL E23, E25, F14, F23, H25, H87, L25)
Migrants and Firms: Evidence from China
Authors: Imbert Clement , Seror Marlon , Zhang Yifan , Zylberberg Yanos
Published: May 2022

How does rural-urban migration shape urban production in developing countries? We use longitudinal data on Chinese manufacturing firms between 2000 and 2006, and exploit exogenous variation in rural-urban migration induced by agricultural income shocks for identification. We find that, when immigration increases, manufacturing production becomes more labor intensive and productivity declines. We investigate the reorganization of production using patent applications and product information. We show that rural-urban migration induces both labor-oriented technological change and the adoption of labor intensive product varieties. (JEL D24, L23, L60, O33, P25, P31, R23)
FAIR4Health: Findable, Accessible, Interoperable and Reusable data to foster Health Research
Authors: Alvarez-Romero Celia , Martínez-García Alicia , Sinaci A. Anil , Gencturk Mert , Méndez Eva , Hernández-Pérez Tony , Liperoti Rosa , Angioletti Carmen , Löbe Matthias , Ganapathy Nagarajan , Deserno Thomas M. , Almada Marta , Costa Elisio , Chronaki Catherine , Cangioli Giorgio , Cornet Ronald , Poblador-Plou Beatriz , Carmona-Pírez Jonás , Gimeno-Miguel Antonio , Poncel-Falcó Antonio , Prados-Torres Alexandra , Kovacevic Tomi , Zaric Bojan , Bokan Darijo , Hromis Sanja , Djekic Malbasa Jelena , Rapallo Fernández Carlos , Velázquez Fernández Teresa , Rochat Jessica , Gaudet-Blavignac Christophe , Lovis Christian , Weber Patrick , Quintero Miriam , Perez-Perez Manuel M. , Ashley Kevin , Horton Laurence , Parra Calderón Carlos Luis
Published: May 2022

Due to the nature of health data, its sharing and reuse for research are limited by ethical, legal and technical barriers. The FAIR4Health project facilitated and promoted the application of FAIR principles in health research data, derived from the publicly funded health research initiatives to make them Findable, Accessible, Interoperable, and Reusable (FAIR). To confirm the feasibility of the FAIR4Health solution, we performed two pathfinder case studies to carry out federated machine learning algorithms on FAIRified datasets from five health research organizations. The case studies demonstrated the potential impact of the developed FAIR4Health solution on health outcomes and social care research. Finally, we promoted the FAIRified data to share and reuse in the European Union Health Research community, defining an effective EU-wide strategy for the use of FAIR principles in health research and preparing the ground for a roadmap for health research institutions.

This scientific report presents a general overview of the FAIR4Health solution: from the FAIRification workflow design to translate raw data/metadata to FAIR data/metadata in the health research domain to the FAIR4Health demonstrators’ performance.
API-based evidence acquisition in the cloud - a survey
Authors: Pawlaszczyk Dr. Dirk , Bochmann Martin , Engler Philipp , Klaver Coert , Hummert Christian
Published: May 2022

Cloud services and cloud storage solutions are special challenges in digital forensic investigations. Cloud services allow their users, with relatively little technical knowledge, store, manage and share content with others. At the same time investigators are faced with a wide range of technical, legal and organizational issues. Unfortunately, evidence acquisition for such services still follows the traditional way of collecting artefacts on a client device. In this article, first, an overview of the state of research is given. Next, technical and legal challenges related to the forensically sound acquisition of cloud data are presented. Since accessing these data is highly challenging, basic techniques for acquiring data from the cloud are discussed and compared, using the example of 30 cloud storage services. We introduce the concept of an API-based evidence acquisition for cloud services that utilize the officially supported API of the service. We show how well this approach applies to most current cloud drive services in the survey context. We present the first glance of a proof-of-concept acquisition framework called CLOUDxTRACT, which can acquire evidence from selected cloud service providers.
Data assimilation with agent-based models using Markov chain sampling
Authors: Tang Daniel , Malleson Nick
Published: May 2022

Every day, weather forecasting centres around the world make use of noisy, incomplete observations of the atmosphere to update their weather forecasts. This process is known as data assimilation, data fusion or state estimation and is best expressed as Bayesian inference: given a set of observations, some prior beliefs and a model of the target system, what is the probability distribution of some set of unobserved quantities or latent variables at some time, possibly in the future?

While data assimilation has developed rapidly in some areas, relatively little progress has been made in performing data assimilation with agent-based models. This has hampered the use of agent-based models to make quantitative claims about real-world systems.

Here we present an algorithm that uses Markov-Chain-Monte-Carlo (MCMC) methods to generate samples of the parameters and trajectories of an agent-based model over a window of time given a set of possibly noisy, aggregated and incomplete observations of the system. This can be used as-is, or as part of a data assimilation cycle or sequential-MCMC algorithm.

Our algorithm is applicable to time-stepping, agent-based models whose agents have a finite set of states and a finite number of ways of acting on the world. As presented, the algorithm is only practical for agents with a few bytes of internal state although we discuss ways of removing this restriction. We demonstrate the algorithm by performing data assimilation with an agent-based, spatial predator-prey model.
Business Continuity Assessment in Accordance with International Auditing Standards and National Standards of the Russian Federation
Authors: Egorova I.
Published: May 2022

Th e article discusses proposals for the inclusion of an assessment based on the provisions of the national standards of the Russian Federation on the formation of a business continuity management system in order to prevent threats of business termination and their leveling in the methodology of assessing the continuity of an audited entity by an external auditor.
Pedagogical Support of Students’ Vocational Self-Determination Under Conditions of an Advanced Vocational Training Center
Authors: Lysenko V.
Published: May 2022

The article substantiates the relevance of the idea that career guidance is a significant factor of students’ pedagogical support in a changing labor market and demanding requirements of society and employers for professional's background.

The paper displays the author's approaches to changing priorities, identifying new meanings in the career guidance, focused on a vision of the future, the "professions (occupations) of the future" and the formation of such meta-professional personal qualities that will allow learners and students to become competitive and sought-after specialists on the labor market throughout their lives.

The article describes some particular forms of career guidance performed for learners, students and adults under conditions of an advanced (proactive) professional training center and educational and technological cluster, based on close interaction and cooperation with enterprises and social partners.
Psychiatric manifestations of rheumatic diseases
Authors: Wróblewski Hubert , Chojęta Dariusz , Zimna Aleksandra , Zygmunt Ewelina , Kozłowska Anna , Mierzwa Monika , Wróblewska Kinga
Published: May 2022

Introduction and purpose of the work: Rheumatic diseases are chronic diseases that cause symptoms in many systems of the human body. Their most common symptoms include pain and symptoms of arthritis, their deformities, fatigue, and malaise. The aim of the article is to present the symptoms and mental disorders occurring in the course of selected rheumatic diseases.

State of knowledge: The psychological symptoms are characteristic of systemic lupus erythematosus. Specified is a form of lupus called NSPLE (neuropsychiatric systemic lupus erythematosus), which includes neuropsychiatric symptoms in the course of systemic lupus erythematosus. Psychiatric symptoms are also present in the course of other rheumatic diseases. Neuropsychiatric symptoms may affect up to 80% of patients with primary Sjogren's syndrome, with 50% to 80% ahead of diagnosis. It has been proven that systemic slcerosis causes microvascular damage, which may cause neuropsychiatric symptoms in the form of mood disorders, anxiety and cognitive disorders. In one study, 59% of patients with fibromyalgia experienced mania, which was more than twice as high as in the control group.

Summary: In the course of all rheumatic diseases presented by us, there are symptoms and mental disorders. They are often mood, cognitive and sleep disturbances. It should be emphasized that the etiology of psychiatric symptoms is multifactorial.
What’s in a Face? An Experiment on Facial Information and Loan-Approval Decision
Authors: Chen Zeyang , Liu Yu-Jane , Meng Juanjuan , Wang Zeng
Published: May 2022

Facial information is essential in daily life, but relatively little is known about whether seeing a face improves people’s decision quality. This experimental paper studies the loan-approval decisions based on the historical cash-loan data with real repayment outcomes and exogenously varies whether and how a borrower’s facial information is provided. We find that facial information does not improve subjects’ decisions, despite the fact that it can predict repayment behavior in a machine-learning algorithm. This is because subjects have various biases in evaluating facial photos, and they rely excessively on facial information in making the loan-approval decisions.

This paper was accepted by Yan Chen, behavioral economics and decision analysis.

Funding: J. Meng received financial support from the National Natural Science Foundation of China [Grants 71103003, 71471004, and 71822301].

Supplemental Material: Data files and the online appendix are available at https://doi.org/10.1287/mnsc.2022.4436 .
Network Centralization and Collective Adaptability to a Shifting Environment
Authors: Bernstein Ethan S. , Shore Jesse C. , Jang Alice J.
Published: May 2022

We study the connection between communication network structure and an organization’s collective adaptability to a shifting environment. Research has shown that network centralization—the degree to which communication flows disproportionately through one or more members of the organization rather than being more equally distributed—interferes with collective problem-solving by obstructing the integration of existing ideas, information, and solutions in the network. We hypothesize that the mechanisms responsible for that poor integration of ideas, information, and solutions would nevertheless prove beneficial for problems requiring adaptation to a shifting environment. We conducted a 1,620-subject randomized online laboratory experiment, testing the effect of seven network structures on problem-solving success. To simulate a shifting environment, we designed a murder mystery task and manipulated when each piece of information could be found: early information encouraged an inferior consensus, requiring a collective shift of solution after more information emerged. We find that when the communication network within an organization is more centralized, it achieves the benefits of connectivity (spread of novel better solutions) without the costs (getting stuck on an existing inferior solution). We also find, however, that these benefits of centralization only materialize in networks with two-way flow of information and not when information only flows from the center of the network outward (as can occur in hierarchical structures or digitally mediated communication). We draw on these findings to reconceptualize theory on the impact of centralization—and how it affects conformity pressure (lock-in) and awareness of diverse ideas (learning)—on collective problem-solving that demands adaptation.

History: This paper has been accepted for the Organization Science Special Issue on Experiments in Organizational Theory.

Funding: The authors acknowledge financial support from the Division of Research at the Harvard Business School for making this research possible.
Patient-reported outcome and survival following meniscal allograft transplantation: an international case series
Authors: Barlow Timothy , Coco Vito , Shivji Faiz , Grassi Alberto , Asplin Laura , Thompson Peter , Metcalfe Andrew , Zaffagnini Stefano , Spalding Tim
Published: May 2022

Aims

Meniscal allograft transplantation (MAT) for patients with symptomatic meniscal loss has demonstrated good clinical results and survivorship. Factors that affect both functional outcome and survivorship have been reported in the literature. These are typically single-centre case series with relatively small numbers and conflicting results. Our aim was to describe an international, two-centre case series, and identify factors that affect both functional outcome and survival.

Methods

We report factors that affect outcome on 526 patients undergoing MAT across two sites (one in the UK and one in Italy). Outcomes of interest were the Knee injury and Osteoarthritis Outcome Score four (KOOS4) at two years and failure rates. We performed multiple regression analysis to examine for factors affecting KOOS, and Cox proportional hazards models for survivorship.

Results

Our results indicate that baseline KOOS4 score affects functional outcome at two years, but no other included factors were significantly related to functional outcome. The only factor that affected failure rate was the presence of cartilage lesions down to bone on both the femur and tibia, decreasing the five-year survivorship from 95% (95% confidence interval (CI) 91 to 99) to 84% (95% CI 74 to 94).

Conclusion

To our knowledge, this is the largest international cohort reporting on MAT. Our results indicate that factors such as age, BMI, and cartilage lesions down to bone on both the femur and tibia of the affected compartment should not present barriers to offering MAT. Baseline KOOS4 score and the presence of bone-on-bone arthritis can be used to help counsel patients regarding the expected risks and rewards of surgery. Cite this article: Bone Joint J 2022;104-B(6):657–662.
Electrochemically applied hydroxyapatite on the cementless porous surface of Bi-Metric stems reduces early migration and has a lasting effect
Authors: Knudsen Martin B. , Thillemann Janni K. , Jørgensen Peter B. , Jakobsen Stig S. , Daugaard Henrik , Søballe Kjeld , Stilling Maiken
Published: May 2022

Aims

BoneMaster is a thin electrochemically applied hydroxyapatite (HA) coating for orthopaedic implants that is quickly resorbed during osseointegration. Early stabilization is a surrogacy marker of good survival of femoral stems. The hypothesis of this study was that a BoneMaster coating yields a fast early and lasting fixation of stems.

Methods

A total of 53 patients were randomized to be treated using Bi-Metric cementless femoral stems with either only a porous titanium plasma-sprayed coating (P group) or a porous titanium plasma-sprayed coating with an additional BoneMaster coating (PBM group). The patients were examined with radiostereometry until five years after surgery.

Results

At three months, the mean total translation (TT) was 0.95 mm (95% confidence interval (CI) 0.68 to 1.22) in the P group and 0.57 mm (95% CI 0.31 to 0.83) in the PBM group (p = 0.047). From two to five years, the TT increased by a mean of 0.14 mm (95% CI 0.03 to 0.25) more in the P group than in the PBM group (p = 0.021). In osteopenic patients (n = 20), the mean TT after three months was 1.61 mm (95% CI 1.03 to 2.20) in the P group and 0.73 mm (95% CI 0.25 to 1.21) in the PBM group (p = 0.023). After 60 months, the mean TT in osteopenic patients was 1.87 mm (95% CI 1.24 to 2.50) in the P group and 0.82 mm (95% CI 0.30 to 1.33) in the PBM group (p = 0.011).

Conclusion

There was less early and midterm migration of cementless stems with BoneMaster coating compared with those with only a porous titanium plasma-sprayed coating. Although a BoneMaster coating seems to be important for stem fixation, especially in osteopenic patients, further research is warranted . Cite this article: Bone Joint J 2022;104-B(6):647–656.
Early patient-reported outcomes from primary hip and knee arthroplasty have improved over the past seven years
Authors: Sabah Shiraz A. , Knight Ruth , Alvand Abtin , Beard David J. , Price Andrew J.
Published: May 2022

Aims

Routinely collected patient-reported outcome measures (PROMs) have been useful to quantify and quality-assess provision of total hip arthroplasty (THA) and total knee arthroplasty (TKA) in the UK for the past decade. This study aimed to explore whether the outcome following primary THA and TKA had improved over the past seven years.

Methods

Secondary data analysis of 277,430 primary THAs and 308,007 primary TKAs from the NHS PROMs programme was undertaken. Outcome measures were: postoperative Oxford Hip/Knee Score (OHS/OKS); proportion of patients achieving a clinically important improvement in joint function (responders); quality of life; patient satisfaction; perceived success; and complication rates. Outcome measures were compared based on year of surgery using multiple linear and logistic regression models.

Results

For primary THA, multiple linear regression modelling found that more recent year of surgery was associated with higher postoperative OHS (unstandardized coefficient (B) 0.15 points (95% confidence interval (CI) 0.14 to 0.17); p < 0.001) and higher EuroQol five-dimension index (EQ-5D) utility (B 0.002 (95% CI 0.001 to 0.002); p < 0.001). The odds of being a responder (odds ratio (OR) 1.02 (95% CI 1.02 to 1.03); p < 0.001) and patient satisfaction (OR 1.02 (95% CI 1.01 to 1.03); p < 0.001) increased with year of surgery, while the odds of any complication reduced (OR 0.97 (95% CI 0.97 to 0.98); p < 0.001). No trend was found for perceived success (p = 0.555). For primary TKA, multiple linear regression modelling found that more recent year of surgery was associated with higher postoperative OKS (B 0.21 points (95% CI 0.19 to 0.22); p < 0.001) and higher EQ-5D utility (B 0.002 (95% CI 0.002 to 0.003); p < 0.001). The odds of being a responder (OR 1.04 (95% CI 1.03 to 1.04); p < 0.001), perceived success (OR 1.02 (95% CI 1.01 to 1.02); p < 0.001), and patient satisfaction (OR 1.02 (95% CI 1.01 to 1.02); p < 0.001) all increased with year of surgery, while the odds of any complication reduced (OR 0.97 (95% CI 0.97 to 0.97); p < 0.001).

Conclusion

Nearly all patient-reported outcomes following primary THA/TKA improved by a small amount over the past seven years. Due to the high proportion of patients achieving good outcomes, PROMs following THA and TKA may need to focus on better discrimination of patients achieving high scores to be able to continue to measure improvement in outcomes. Cite this article: Bone Joint J 2022;104-B(6):687–695.
A quantitative study to explore functional outcomes following laparoscopic ventral mesh rectopexy for rectal prolapse
Authors: Olatunbode O , Rangarajan S , Russell V , Viswanath YKS , Reddy A
Published: May 2022

Introduction

Rectal prolapse is a life-altering problem and laparoscopic ventral mesh rectopexy (LVMR) is emerging as the surgical intervention of choice. However, the literature is ambiguous on its effect on bowel function and sparse as regards bladder and sexual function. This study assesses short-term functional outcomes following LVMR.

Materials and methods

This quantitative retrospective study with a pretest–post-test design included 130 adults who had undergone LVMR from October 2010 to December 2018 in a tertiary centre. Analysis with paired-samples t-test and Wilcoxon matched pairs test was done using SPSS (v26).

Results

The median age was 58 years (interquartile range, 48–74 years); 123 (94.6%) were female. The median length of stay was two days (interquartile range, 1–2 days). A total of 104 (80%) sets of medical notes were reviewed. One patient had recurrence of rectal prolapse. Synthetic mesh was used in 24 patients (23.1%) and biological mesh in 80 (76.9%). One patient had extrusion of a synthetic mesh and required surgery; 31(23.8%) completed the Electronic Patient Assessment Questionnaire for Pelvic Floor. Overall, the improvement in bladder function was not statistically significant (p = 0.670). A statistically significant improvement was seen for all bowel symptoms (p = 0.002) excluding constipation (p = 0.295). Irritable bowel symptoms associated with rectal prolapse improved significantly following LVMR (p = 0.001). Vaginal prolapse (p < 0.0005), dyspareunia (p = 0.001) and bowel symptoms affecting sexual intercourse (p = 0.01) improved, but improvement in overall sexual function was not statistically significant (p = 0.081).

Conclusions

LVMR improves bowel function overall, although it can worsen constipation. It has the potential to improve sexual function but makes negligible difference to bladder function.
Safe provision of elective endocrine surgery operations amid the COVID-19 crisis
Authors: Christakis I , Parsons S , Chadwick D
Published: May 2022

Introduction

The aim of this study was to determine the impact of the COVID-19 pandemic on the provision of clinical services (perioperative clinical outcomes and productivity) of the department of endocrine and general surgery at a teaching hospital in the UK.

Methods

A retrospective chart review was conducted of all patients who were operated in our department during two periods: 1 April to 31 October 2019 (pre-COVID-19 period) and 1 April to 31 October 2020 (COVID-19 period). The perioperative clinical outcomes and productivity of our department for the two time periods were compared.

Results

In the pre-COVID-19 period, 130 operations were carried out, whereas in the COVID-19 group, this reduced to 89. The baseline characteristics between the two groups did not significantly differ. Parathyroid operations decreased significantly by 68% between the two study periods. Overall, during the COVID-19 phase, the department maintained 68% of its operating workload compared with the respective 2019 time period. The clinical outcomes for the patients who had a thyroid/parathyroid/adrenal operation were not statistically different for the two study periods. There were no COVID-19 related perioperative complications for any of the operated patients and no patient tested positive for COVID-19 while an inpatient. For the COVID-19 group, the department maintained 67% of its outpatient appointments for endocrine surgery and 26% for general surgery pathologies.

Conclusions

The COVID-19 pandemic significantly reduced the clinical activity of our department. However, it is possible to continue providing clinical services for urgent/cancer cases with the appropriate safety measures in place.
Surgical training during the COVID-19 pandemic at a designated ‘cold’ site: are we meeting the challenge?
Authors: Hamid M , Naumann DN , Digne-Malcolm H , Kanwal A , Puventhiranathan P , Phelan L , Dilworth M
Published: May 2022

Introduction

There has been a marked reduction in surgical operative training opportunities during the COVID-19 pandemic. This may be improved by the establishment of ‘cold’ sites for NHS elective surgery. We investigated the training opportunities at a newly designated elective surgery cold site in the West Midlands, UK.

Methods

An observational retrospective study was undertaken to include all gastrointestinal and urological elective surgery at a single ‘cold’ site during the first peak of the COVID-19 pandemic. Patient demographics, details of surgery and data relating to surgical training such as primary surgeon and portfolio index procedure were collected. Factors affecting the likelihood of trainees being the primary surgeon were analysed using logistic regression models.

Results

There were 880 patients, with a median (interquartile range) age of 62 (48–74). Some 658 (74.8%) procedures were defined as ‘index procedures’ for specialty training year 4 (ST4) level: 409/509 (80.4%) for urology, 155/235 (66%) for colorectal and 94/136 (69.1%) for upper gastrointestinal (GI). Only 253/880 (28.8%) procedures were performed by a trainee as the primary surgeon: 201/509 (39.4%) for urology, 21/235 (8.9%) for colorectal and 31/136 (22.8%) for upper GI. The likelihood of a trainee being the primary surgeon was reduced for major surgery (p<0.001) and for GI surgery when compared with urology (p<0.001).

Conclusions

Surgical training was facilitated at an elective surgery ‘cold’ site during the COVID-19 pandemic, but at lower levels than anticipated. Type of surgery influenced trainee participation. Surgical training should be incorporated into ‘cold’ site elective surgical services if trainees are to be prepared for the future.
Hashimoto’s thyroiditis on outcomes in papillary thyroid cancer revisited: experience from South East Asia
Authors: Lau J , Lee J , Mahipal M , Yang SP , Tan WB , Yuan NK , Parameswaran R
Published: May 2022

Introduction

The association between Hashimoto Thyroiditis (HT) and papillary thyroid cancer (PTC) remains uncertain. HT, the most common inflammatory condition of the thyroid, is postulated to increase the risk of PTC and yet confer cancer-retarding effects. In this study, we aim to evaluate the prevalence of HT in patients surgically treated for PTC and evaluate the long-term prognostic implications.

Methods

This is a retrospective study of 521 patients with PTC who underwent hemi- or total thyroidectomy between January 2000 and December 2018 at a tertiary referral centre. Patients were categorised into two group: group A (n=402) consists of patients with PTC without HT, whereas group B (n=119) consists of patients with PTC and HT. Demographic and clinicopathological details, recurrence rates and overall survival were collected. Univariate and multivariate analyses were performed to evaluate for clinical factors associated with HT.

Results

A total of 521 patients with a mean age of 46.7 years were evaluated. HT was detected in 22.8% of patients with PTC. On multivariate analysis, presence of HT was associated with a lower incidence of extrathyroidal extension (hazard ratio: 0.59, 95%confidence interval 0.37–0.95). Also, patients with HT tend to have fewer cycles of radioactive iodine and correspondingly have excellent response to treatment. However, no differences in recurrence rates and overall survival were detected.

Conclusions

One-fifth of patients with PTC have coexisting HT. These patients tend to have less-aggressive tumour features such as extrathyroidal extension. However, the effect of HT on recurrence and overall survival appears to be inconsequential clinically.
One-year follow-up of conservative management of appendicitis: results from a single centre during extended lockdown in the COVID-19 pandemic
Authors: West H , Garcea G
Published: May 2022

Introduction

Conservative management with antibiotics was recommended by the UK Surgical Royal Colleges early in the COVID-19 pandemic as the first-line treatment for acute uncomplicated appendicitis.

Methods

This is a prospective single-centre cohort study of patients aged 16 years or over, diagnosed clinically and confirmed radiologically with acute appendicitis in a secondary care setting who were initially treated conservatively with antibiotics. The primary outcome was the response to conservative management with antibiotics. Secondary outcomes were: antibiotic duration; operative rates; surgical approach (open, laparoscopic or conversion to open); complication rates; COVID-19 positive rate; rates of readmission within 12 months; and length of hospital stay.

Results

A total of 109 patients were included in the study, 67 of whom were male. Median age was 37 (range 17–93) years. A further 28 patients were excluded because of a decision to manage operatively on the index admission or because of other diagnoses. Thirty-three patients (30.3%) had surgery on the index admission after failed conservative management and 15 (13.8%) had surgery on readmission. On histology, 32/48 patients (66.7%) had a diagnosis of complicated appendicitis and 18/48 (37.5%) had a confirmed appendicolith.

Conclusions

There was a high readmission rate (47/109; 43.1%) for surgery, a radiological drain or conservative management within the first year following initial conservative management. There is a significant risk of recurrence of symptoms, particularly in the presence of an appendicolith. Laparoscopic appendicectomy should be the first-line treatment, with conservative management reserved for patients with acute uncomplicated appendicitis who are COVID-19 positive or have comorbidities.
Peripartum haemorrhage from an intramedullary conus medullaris cavernous malformation: a rare but serious complication
Authors: Abougamil AB , Ashkan K , Rayan T
Published: May 2022

Cavernous malformations (CMs) represent about 5% of all spinal intramedullary lesions in adults. There is growing evidence to suggest that pregnancy may increase the risk of haemorrhage from CMs. We report the case of a 28-year-old woman who presented with bilateral lower limb paraparesis following an intramedullary haemorrhage from conus medullaris CM during the peripartum period. To the best of our knowledge, this is the first such case. We also review a handful of other reported cases of peripartum symptomatic spinal intramedullary CMs from the literature highlighting the pathogenesis of such cases and the best timing for intervention.
Leisure Participation Opportunities for Adults With Intellectual Disability With Moderate Levels of Impairment Residing in Community Apartments
Authors: Keller Aviva , Weintraub Naomi
Published: May 2022

The purpose of this study was to examine the leisure and recreation opportunities available in community apartments for adults with intellectual disability (ID), and their association with leisure participation. The study included 38 adults with ID with moderate levels of impairment residing in 19 apartments. Apartment coordinators reported on apartment characteristics, as well as leisure and recreation schedule and opportunities. Findings revealed diverse leisure and recreation activities. We found correlation between the number of activities (rs = .392 , p = .015; rs = .433, p = .007, respectively) as well as a visible daily schedule (Z = 2.143, p = .035) and leisure participation. Findings suggest that diverse leisure activities and a visible schedule may be associated with improved leisure participation.
Three-dimensional measurement method based on a three-step phase-shifting fringe and a binary fringe
Authors: Wang Lin , Wang Wei , Wang Xiaofang , Wang Xiangjun
Published: May 2022

Gray-code plus phase-shifting is currently a commonly used method for structured light three-dimensional (3D) measurement that is able to measure complex surfaces. However, the Gray-code fringe patterns tend to be complicated, making the measurement process time-consuming. To solve this problem and to obtain faster speed without sacrificing accuracy, a 3D measurement method based on three-step phase-shifting and a binary fringe is proposed; the method contains three phase-shifting fringe patterns and an additional binary fringe pattern. The period of the binary fringe is designed to be the same as the three-step phase-shifting fringe. Because of the specific pattern design strategy, the three-step phase-shifting algorithm is used to obtain the wrapped phase, and the connected region labeling theorem is used to calculate the fringe order. A theoretical analysis, simulation, and experiments validate the efficiency and robustness of the proposed method. It can achieve high-precision 3D measurement, which performs almost the same as the Gray-code plus phase-shifting method. Since only one additional binary fringe pattern is required, it has the potential to achieve higher measurement speed.
3D-printed actuator-based beam-steering approach for improved physical layer security in visible light communication
Authors: Erdem Mehmet Can , Gürcüoğlu Oğuz , Panayirci Erdal , Kurt Güneş Karabulut , Ferhanoğlu Onur
Published: May 2022

In this study, we present the design, manufacture, and implementation of a 3D-printed lens scanner-based beam steering for use in visible light communication (VLC) applications. The5cm×5cmscanner is designed for low-cost 3D printing with fused deposition modeling using polylactic acid. Scanning is facilitated through electromagnetic actuation of the lens frame, carrying a conventional 25 mm lens, from two nearly orthogonal directions. The serpentine spring that connects the lens frame to the external frame is tailored to offer similar spring constants in the directions of actuation and has minimal (<1.5mm) sag due to the mass of the lens. The manufactured actuator was integrated on a miniaturized VLC test bed (70cm×40cm×40cm). Using the test bed, we characterized the applied voltage versus beam displacement behavior of the actuator in the lateral plane and demonstrated beam steering on a moving target with face-recognition feedback. The proposed scheme was targeted to offer an improved security measure in VLC through tracking the legitimate receiver (i.e., via face recognition) and uses the feedback to steer the focused light onto the targeted device. The joint use of focusing and steering features allows for the legitimate receiver to roam within the room while enjoying the improved secrecy due to the focused light. We calculate the secrecy capacity for the demonstrated approach, which compares favorably with a number of jamming, spatial modulation, and beam-forming counterparts. The presented actuator can be used with larger room dimensions, yet upscaling to larger illumination units will require the use of a lens having smaller focus to address a larger total steering angle.