bluuebunny/crossref_metadata_2025 huggingface dataset:
High-performance 2D/3D hybrid dimensional p–n heterojunction solar cell with reduced recombination rate by an interfacial layer
Authors: Hegazy H. H. , Afzal Amir Muhammad , Dahshan A. , Iqbal Muhammad Waqas , Kebaili Imen
Published: September 2022

A high-performance 2D/3D hybrid dimensional p–n heterojunction solar cell has been designed with efficiency enhanced by 11.8% using h-BN as an interfacial layer; the improvement is due to interface quality and reduction in recombination rate.
The potential role of ischaemia–reperfusion injury in chronic, relapsing diseases such as rheumatoid arthritis, Long COVID, and ME/CFS: evidence, mechanisms, and therapeutic implications
Authors: Kell Douglas B. , Pretorius Etheresia
Published: September 2022

Ischaemia–reperfusion (I–R) injury, initiated via bursts of reactive oxygen species produced during the reoxygenation phase following hypoxia, is well known in a variety of acute circumstances. We argue here that I–R injury also underpins elements of the pathology of a variety of chronic, inflammatory diseases, including rheumatoid arthritis, ME/CFS and, our chief focus and most proximally, Long COVID. Ischaemia may be initiated via fibrin amyloid microclot blockage of capillaries, for instance as exercise is started; reperfusion is a necessary corollary when it finishes. We rehearse the mechanistic evidence for these occurrences here, in terms of their manifestation as oxidative stress, hyperinflammation, mast cell activation, the production of marker metabolites and related activities. Such microclot-based phenomena can explain both the breathlessness/fatigue and the post-exertional malaise that may be observed in these conditions, as well as many other observables. The recognition of these processes implies, mechanistically, that therapeutic benefit is potentially to be had from antioxidants, from anti-inflammatories, from iron chelators, and via suitable, safe fibrinolytics, and/or anti-clotting agents. We review the considerable existing evidence that is consistent with this, and with the biochemical mechanisms involved.
Insights into the structure and function of the histidine kinase ComP from Bacillus amyloliquefaciens based on molecular modeling
Authors: Wang Lulu , Fan Ruochen , Li Zhuting , Wang Lina , Bai Xue , Bu Tingting , Dong Yuesheng , Xu Yongbin , Quan Chunshan
Published: September 2022

The ComPA two-component signal transduction system (TCS) is essential in Bacillus spp. However, the molecular mechanism of the histidine kinase ComP remains unclear. Here, we predicted the structure of ComP from Bacillus amyloliquefaciens Q-426 (BaComP) using an artificial intelligence approach, analyzed the structural characteristics based on the molecular docking results and compared homologous proteins, and then investigated the biochemical properties of BaComP. We obtained a truncated ComPS protein with high purity and correct folding in solution based on the predicted structures. The expression and purification of BaComP proteins suggested that the subdomains in the cytoplasmic region influenced the expression and stability of the recombinant proteins. ComPS is a bifunctional enzyme that exhibits the activity of both histidine kinase and phosphotransferase. We found that His571 played an obligatory role in the autophosphorylation of BaComP based on the analysis of the structures and mutagenesis studies. The molecular docking results suggested that the HATPase_c domain contained an ATP-binding pocket, and the ATP molecule was coordinated by eight conserved residues from the N, G1, and G2 boxes. Our study provides novel insight into the histidine kinase BaComP and its homologous proteins.
Gr1+ myeloid-derived suppressor cells participate in the regulation of lung–gut axis during mouse emphysema model
Authors: Yang Jing , Zeng Jiajia , Yang Shuaini , Guan Xin , Gao Qiaoying , He Simeng , Wu Xiaoyang , Ge Lixiu , Bai Hong
Published: September 2022

Background: Chronic obstructive pulmonary disease (COPD) is often accompanied by intestinal symptoms. Myeloid-derived suppressor cells (MDSCs) possess immunosuppressive ability in cancer, chronic inflammation, and infection. The aim of this study was to verify the distribution of MDSCs in emphysema mouse model and participation in lung–gut cross-talk.

Methods: Adult male C57BL/6 mice were exposed to cigarette smoke (CS) for 6 months or injected with porcine pancreas elastase to establish emphysema models. Flow cytometry and immunohistochemistry analysis revealed the distribution of MDSCs in tissues. The expression of inflammation and MDSCs-associated genes in the small intestine and colon were analyzed by real-time PCR.

Results: The small intestine and colon of CS-induced emphysematous mice displayed pathological changes, CD4+/CD8+ T cells imbalance, and increased neutrophils, monocytes, and macrophages infiltration. A significant expansion of MDSCs could be seen in CS-affected respiratory and gastrointestinal tract. Importantly, higher expression of MDSCs-related effector molecules inducible nitric oxide synthase (INOS), NADPH oxidase 2 (NOX2), and arginase 1 (ARG-1) suggested the immunosuppressive effect of migrated MDSCs (P<0.05).

Conclusion: These data provide evidence for lung–gut axis in emphysema model and the participants of MDSCs.
Readability of Cochlear Implant Brochures: A Potential Factor in Parent Decision Making
Authors: La Scala Jennifer D. , Zraick Richard I. , Rosa-Lugo Linda I. , Cosby Janel L.
Published: September 2022

Purpose:

The purpose of this study was to examine the ease of reading cochlear implant (CI) brochures provided to parents and caregivers who are making informed decisions about the management of their child's hearing loss.

Method:

CI brochures from three Food and Drug Administration–approved CI manufacturers were examined: Advanced Bionics, Cochlear Americas, and MED-EL. Reading grade levels and ease of reading were analyzed using a commercially available computer software program, applying six readability formulas commonly used to examine hearing-related patient education materials (PEMs).

Results:

The readability of the CI brochures exceeds the fifth- to sixth-grade reading-level guidelines. The CI brochures may be difficult for the average English-speaking adult to read with ease and requires at least a 10th-grade comparable reading level.

Conclusions:

Despite health literacy initiatives, audiology-focused PEMs continue to be created without full consideration of the burden for the reader. Authors of PEMs should consider the average reading level of the reader as a variable potentially influencing the decision-making process. Likewise, clinicians should consider the average reading level needed to understand PEMs when presenting information and resources to parents and caregivers for informed and shared decision making.
Measuring Communicative Congruence and Communicative Dysphoria in a Sample of Individuals Without Voice Disorders
Authors: Welch Brett , Helou Leah B.
Published: September 2022

Purpose:

This study examines communicative congruence and communicative dysphoria in adults who deny having a voice disorder.
Communicative congruence
is the degree to which a person's communication is consistent with their sense of self/identity.
Communicative dysphoria
is the psychological entropy resulting from communicative
in
congruence. We propose that these experiences may influence patients' psychosocial well-being and are thus relevant to the field of speech-language pathology. We hypothesized that both constructs would be normally distributed with an inverse relationship. We also hypothesized that communicative congruence would predict scores on the Center for Epidemiological Studies–Depression (CES-D) scale, subscales of the Big Five Aspect Scales (BFAS; a personality measure), and achieve convergent validity with the Vocal Congruence Scale (VCS).

Method:

Participants (adults 18–70 years) completed the BFAS, CES-D, VCS, and the Voice Handicap Index–10 (VHI-10) before recording a series of speech tasks. Participants' recordings were played back while they responded to questions probing their communicative congruence and communicative dysphoria.

Results:

The 196 participants were predominantly female (67.3%) and cisgender (96.4%). Communicative congruence was negatively skewed, and communicative dysphoria was normally distributed. Both variables significantly related to each other: More
in
congruence was associated with more dysphoria. Communicative congruence was inversely related to CES-D scores. The personality metatrait Plasticity related to communicative congruence, as did the domain of Extraversion and the aspects Withdrawal, Enthusiasm, and Assertiveness. Communicative congruence achieved high convergent validity with the VCS.

Conclusions:

Counter to our hypothesis, participants reported more congruence than incongruence, but all other hypotheses were supported. Participants who reported
in
congruence were more likely to report symptoms of depression. These findings suggest that even in a predominantly cisgender cohort, some individuals' mental well-being might relate to how well their communication aligns with their identity. This work may inform future investigations into these constructs and their effects on voice therapy outcomes.

Supplemental Material:

https://doi.org/10.23641/asha.20739967
EDAfuse: A encoder–decoder with atrous spatial pyramid network for infrared and visible image fusion
Authors: Nie Cairen , Zhou Dongming , Nie Rencan
Published: September 2022

Infrared and visible images come from different sensors, and they have their advantages and disadvantages. In order to make the fused images contain as much salience information as possible, a practical fusion method, termed EDAfuse, is proposed in this paper. In EDAfuse, the authors introduce an encoder–decoder with the atrous spatial pyramid network for infrared and visible image fusion. The authors use the encoding network which includes three convolutional neural network (CNN) layers to extract deep features from input images. Then the proposed atrous spatial pyramid model is utilized to get five different scale features. The same scale features from the two original images are fused by our fusion strategy with the attention model and information quantity model. Finally, the decoding network is utilized to reconstruct the fused image. In the training process, the authors introduce a loss function with saliency loss to improve the ability of the model for extracting salient features from original images. In the experiment process, the authors use the average values of seven metrics for 21 fused images to evaluate the proposed method and the other seven existing methods. The results show that our method has four best values and three second‐best values. The subjective assessment also demonstrates that the proposed method outperforms the state‐of‐the‐art fusion methods.
Real-Time Multiple Input Multiple Output (MIMO) Radar Using Software Defined Radio
Authors: Gilpin Robert , Bray Joey , Hefnawi Mostafa
Published: September 2022

In this paper, commercially-available software-defined radios (SDRs) are used to build a 64-channel, reconfigurable Active Electronically Scanned Arrays (AESA) radar operating in C-band (NATO G-band). The SDRs are used to design and implement a 3-dimensional multi-input and multi-output (MIMO) radar. The flexibility of the SDRs has been harnessed to evaluate the performance of a linear frequency modulated continuous wave (LFMCW) MIMO radar using three different methods of achieving the orthogonality, namely Time Division Multiplexing (TDM), Frequency Division Multiplexing (FDM), and Code Division Multiplexing (CDM). In addition, the radar’s parameters are user-selectable and can be rapidly changed such that the radar can be used in different environments without requiring changes to the hardware. Measurements indicate that the radar is capable of detecting and localizing multiple targets in all 3-dimensions, including bearing, range, and Doppler. The MIMO radar operates in real-time, with a refresh rate of only 3 seconds. Experimental results are generated for the TDM mode of operation with further research reporting on the CDM and FDM modes of operation.
A New Compact and Low loss UHF RFID TAG
Authors: El ahmar Latifa , Errkik Ahmed , Bouzida Ilham , El Mamouni Anass , Er-Rebyiy Ridouane
Published: September 2022

This paper aims to present a new compact and low loss UHF RFID TAG using meander technique to obtain a miniaturized Design validated to operate in Moroccan UHF band. The proposed RFID TAG is designed on PI substrate with a relative dielectric constant of 3.5, tangent loss of 0.0027 and height0.0508mm. Using an EM solver, the proposed design is matched to ALIEN H3 microchip with ZMicrochip=30.39-i*211 Ohm, it’s simulated and confirmed in Moroccan UHF band with a return loss around -20.49dB at 868MHz with a bandwidth of 16.8MHz, a simulated gain 1.82dBi and a good theoretical read range about 2.6m. The global dimension of the structure is 25×70 mm2 which is λ/14×λ/5 mm2, it’s very suitable for RFID applications that required a compact and integrated RFID TAG with a middle-read range.
MIMO Radar Hardware Acceleration with Enhanced Resolution
Authors: Pitre Eric , Roberge Vincent , Bray Joey , Hefnawi Mostafa
Published: September 2022

This paper proposes a method for accelerating an enhanced resolution 3D (range, velocity, and azimuth) Multiple Input Multiple Output (MIMO) radar on a Graphics Processing Unit (GPU). Implementation of MIMO radars and the investigation of their performance are of interest to the research community. However, the MIMO mode of operation increases the computational requirements of the radar system and seldom permits real-time operation without performance compromises. Current methods for achieving reasonable frame rates include reducing the scope of the radar (i.e., limiting the number of dimensions, the field of view, or the ranges of interest), choosing efficient but coarse algorithms (i.e., the FFT for range, velocity, and bearing estimation), or offloading the computation on task specific hardware, DSP, or FPGA. The proposed framework enables real-time operation of the MIMO radar by performing the signal processing on a GPU without compromising the radar coverage, while replacing the widely used 3D FFT with an enhanced resolution alternative. The proposed framework is tested on a Frequency Modulated Continuous Wave (FMCW) MIMO radar using 8 transmitters, 8 receivers, and having a Coherent Processing Interval (CPI) of 256 chirps. The parallel implementation of the enhanced resolution signal processing yields an acceleration of 453.6x when compared to sequential execution on CPU.
Performance metrics for vehicular visible light communication systems
Authors: Raissouni Fatima zahra , Cherkaoui Abdeljabbar , Galilea José Luis Lázaro , Gardel Vicente Alfredo
Published: September 2022

Vehicular Visible Light communication (VVLC) presents a new paradigm for providing vehicle connectivity, increasing road safety, and achieving autonomous driving. It can be chosen as an alternative solution to radio frequency-based inter-vehicle communication systems and/or as a complementary solution to ensure redundancy. Nevertheless, there are still significant challenges in incorporating visible light communication systems into vehicular networks. The main purpose of this paper is to provide an outline of the performance metrics of a VVLC system. Furthermore, the study is performed based on a vehicle-to-vehicle dynamic model close to reality, considering the effect of geometrical changes in the LOS path and the variation of the inter-vehicular distance. The analysis of the proposed system is discussed in terms of Signal to noise (SNR), Field of view (FOV), mobility, and average capacity.
Atmospheric pressure plasma jet based on the dielectric barrier discharge
Authors: Seddaoui Najlae , Ouali Moustapha , Lagmich Youssef
Published: September 2022

The dielectric barrier discharge has attracted the interest of many researchers in several fields since it produces a non-thermal plasma at atmospheric pressure. Its field of application is totally vast and includes medicine, biotechnology, chemistry, and various other fields of science and technology because of the physical and chemical properties that characterize the plasma jet based on the dielectric barrier discharge. These are characterized by different possible configurations and can be powered by radio frequency, alternating current, and even pulsed direct current depending on the application. In this work, we have presented the atmospheric pressure plasma jet as a new micro discharge that can be used in several fields. We have presented the different possible configurations of the plasma jets based on the dielectric barrier discharge that vary according to the targeted application field. In addition, we have presented some fields of study and specialties in the different application areas such as medicine, biotechnology and food preservation, agriculture and combustion domains. Finally, we have presented the results of the simulation with COMSOL Multiphysics of a dielectric barrier discharge at atmospheric pressure for different frequencies and different discharge gaps between the electrodes, since this is the discharge used in the plasma jet.
Kartografische Darstellung regionaler Unterschiede der
Infektionsraten beim Coronavirus (COVID-19): Ergebnisse einer bayesianischen
Glättung über Landkreise Bayerns
Authors: Loidl Verena , Koller Daniela , Mansmann Ulrich , Manz Kirsi Marjaana
Published: September 2022

Ziel der Studie Seit Beginn der aktuellen COVID-19 Pandemie sind
Übersichtskarten zur räumlichen Darstellung des
Infektionsgeschehens von großem öffentlichen Interesse. Aus
methodischer und risikokommunikativer Sicht sind diese Darstellungen nicht
unproblematisch, da zufällige Schwankungen oder Extremwerte auftreten
und tatsächliche regionale Verteilungsmuster überdeckt sein
können. Ein potentieller Lösungsansatz, um diesen
Herausforderungen zu begegnen, besteht in Glättungen durch Bayesianische
Verfahren. Ziel dieser Arbeit ist es, anhand von räumlich
geglätteten Übersichtskarten die Veränderungen der
Inzidenzverhältnisse im zeitlichen Verlauf in den Landkreisen und
kreisfreien Städten in Bayern zu untersuchen.

Methodik Die Daten zu SARS-CoV-2 wurden vom Bayerischen Landesamt
für Gesundheit und Lebensmittelsicherheit am 29.10.2021 und 17.02.2022
zur Verfügung gestellt. Die demographischen Daten pro Kreis sind dem
Statistischen Bericht des Bayerischen Landesamtes für Statistik
für das Jahr 2019 entnommen. Betrachtet wurden vier Altersgruppen pro
Geschlecht (<18, 18–29, 30–64,>64 Jahre)
aufgeteilt in 16 Zeiträume (28.01.2020 bis 31.12.2021). Die Karten
basieren auf standardisierten Inzidenzraten, die räumlich durch
Bayesianische hierarchische Modelle geglättet wurden.

Ergebnisse Das Standardisierte Inzidenzverhältnis (SIR) variierte
deutlich zwischen den Kreisen. Variationen traten für jeden Zeitraum
auf, wobei sich über den zeitlichen Verlauf sich ändernde
regionale Verteilungsmuster zeigten.

Schlussfolgerung Geglättete Gesundheitskarten eignen sich, um
Veränderungen der Inzidenzverhältnisse im zeitlichen Verlauf bei
COVID-19 in Bayern darzustellen und bieten gegenüber traditionellen
Karten den Vorteil, dass sie realitätsnähere Schätzungen
liefern, da sie Nachbarschaftsbeziehungen als erklärenden Faktor
einbeziehen. Der methodische Ansatz kann als erster Schritt gesehen werden, um
wichtige Erklärungsansätze für die beobachtete
Heterogenität zu identifizieren, und eine verbesserte
Risikokommunikation zu unterstützen.
Genes Relating to Biological Processes of Endometriosis: Expression
Changes Common to a Mouse Model and Patients
Authors: Iwasaki Shiho , Kaneda Katsuyuki
Published: September 2022

Endometriosis is one of the most common gynecological diseases in women of
reproductive age. Retrograde menstruation is considered a major reason for the
development of endometriosis. The syngeneic transplantation mouse model is an
endometriosis animal model that is considered to mimic retrograde menstruation.
However, it remains poorly understood which genetic signatures of endometriosis
are reflected in this model. Here, we employed an in vivo syngeneic mouse
endometriosis model and identified differentially expressed genes (DEGs) between
the ectopic and eutopic tissues using microarray analysis. Three gene expression
profile datasets, GSE5108, GSE7305, and GSE11691, were downloaded from the Gene
Expression Omnibus database and DEGs between ectopic and eutopic tissues from
the same patients were identified. Gene ontology analysis of the DEGs revealed
that biological processes including cell adhesion, the inflammatory response,
the response to mechanical stimulus, cell proliferation, and extracellular
matrix organization were enriched in both the model and patients. Of the 195
DEGs common to the model and patients, 154 showed the same expression pattern,
and 28 of these 154 DEGs came up when PubMed was searched for each gene along
with the terms “endometriosis” and
“development”. This is the first comparison of the DEGs of the
mouse syngeneic endometriosis model and those of patients, and we identified the
biological processes common to the model and patients at the transcriptional
level. This model may be useful to evaluate the efficacy of drugs which target
these biological processes.
Individuelle Unterstützung von psychisch beeinträchtigten Jugendlichen im Übergang zwischen den Hilfesystemen
Authors: Gindele Verena , Herzig Meike , Hartl Johann , Neumann Sebastian , Esch Lena-Maria , Hiller Therese , Witt Andreas , Fegert Jörg M. , Böge Isabel
Published: September 2022

Ziel des Teilprojekts „Teilhabeinstrument Dazugehören BaWü Adoleszenz (TiDA)“ im Projekt „Dazugehören BaWü“ ist die Entwicklung eines digitalen Instruments, mit dem (drohende) Teilhabebeeinträchtigungen bei Jugendlichen und jungen Erwachsenen (zwischen 16 und 27 Jahren) zuverlässig eingeschätzt werden können. In enger Zusammenarbeit mit 4 Praxisstandorten entsteht auf Grundlage der gesetzlichen Vorgaben des SGB VIII und des ergänzenden Kinder- und Jugendstärkungsgesetzes (KJSG) und des Bundesteilhabegesetztes (BTHG) sowie aufbauend auf den Desideraten aus der Praxis ein Instrument für die Einschätzung der Teilhabebeeinträchtigung von jungen Menschen. Außerdem soll mit Hilfe dieses Instruments der Übergang von der Jugendhilfe in das Hilfesystem für Erwachsene erleichtert werden. In diesem Artikel wird beschrieben, auf welche Grundlagen bei der Entwicklung des Instruments und der Übergangsplattform zurückgegriffen, wie bei der Entwicklung vorgegangen und wie die Anforderungen aus den gesetzlichen Vorgaben und aus der Praxis umgesetzt wurden.
„Der Bedarf ist oft nicht differenziert aufgeschlüsselt“ Transition junger Erwachsener mit seelischer Beeinträchtigung von der Jugendhilfe in die Eingliederungshilfe
Authors: Esch Lena-Maria , Hiller Therese , Gindele Verena , Herzig Meike , Hartl Johann , Neumann Sebastian , Böge Isabel , Fegert Jörg M. , Witt Andreas
Published: September 2022

Dieser Artikel beschäftigt sich mit der viel diskutierten Übergangsproblematik junger Erwachsener mit seelischer Beeinträchtigung aus der Jugend- in die Eingliederungshilfe und beschreibt die hinderlichen und förderlichen Faktoren in diesem Transitionsprozess. Außerdem werden unterschiedliche Möglichkeiten diskutiert, wie ein Übergabeinstrument von der Jugend- in die Eingliederungshilfe gestaltet werden kann, um den Übergang für die Fachkräfte sowie die Leistungsberechtigen reibungsloser zu gestalten. Dabei wird die „große Lösung“, die im Jahr 2028 gesetzlich verpflichtend werden soll, in den Blick genommen. Hierzu wurden in 11 leitfadengestützten Experteninterviews mit 13 Fachkräften aus der Jugend- und Eingliederungshilfe in 4 Landkreisen in Baden-Württemberg Primärdaten erhoben, deren qualitative Auswertung in diesem Artikel ihre Darstellung findet.

Zusammenfassend fordern die Fachkräfte aus der Praxis ein übersichtliches und einheitliches Bedarfseinschätzungs- und Übergabeinstrument, das sowohl den Fachkräften der Jugendhilfe als auch den Leistungsberechtigten klare Handlungsrichtlinien zum Vorgehen in diesem Transitionsprozess gibt und der Eingliederungshilfe die erforderlichen Informationen liefert.
Hör- und Lebensalter-bezogene Wortproduktion von Kindern mit Cochlea-Implantat
Authors: Glaubitz Cynthia , Geiss Katrin T. , Hoppe Ulrich
Published: September 2022

Hintergrund Eine frühe bilaterale Cochlea-Implantat (CI)-Versorgung stellt für kongenital gehörlose Kinder eine günstige Spracherwerbsbedingung dar.
Die vorliegende Studie fokussiert die Wortproduktion dieser Kinder mit einem Vergleich von
Lebens- und Höralter-bezogenen Leistungen und beleuchtet diese bezüglich
Zusatzbeeinträchtigung, Mehrsprachigkeit und Versorgungsalter.

Methodik Die Daten 62 bilateral versorgter Kinder
(Versorgungsalter M=12,1; SD=6,2 Monate) wurden retrospektiv ausgewertet. Die mit dem Aktiven Wortschatztest für 3–5-jährige Kinder – Revision erhobenen
Leistungen wurden hinsichtlich Lebens- und Höralter verglichen. Gruppenvergleiche und
Korrelationsanalysen zu Mehrsprachigkeit, Zusatzbeeinträchtigungen und Versorgungsalter wurden
durchgeführt.

Ergebnisse Die Leistungen waren signifikant besser in der
Beurteilung nach Höralter. Inner- oder oberhalb der Norm lagen hiernach mehr als 50%, für das
Lebensalter rund 37%. Die beobachteten Leistungsunterschiede bei Mehrsprachigkeit und
Zusatzbeeinträchtigung waren nur für beiderlei betroffene Kinder signifikant. Die Leistungen
einsprachiger Kinder ohne Zusatzbeeinträchtigung waren nicht bedeutsam mit dem
Versorgungsalter assoziiert.

Schlussfolgerung CI-versorgte Kinder können im Alter von 3–5
Jahren über einen angemessenen aktiven Wortschatz verfügen. Besondere Herausforderungen
ergeben sich bei Zusatzbeeinträchtigung und Mehrsprachigkeit, welche in fortführenden Studien
genauerer Definitionen bedürfen. Die Auswertung standardisierter Tests nach Lebens- und
Höralter erlaubt eine differenzierte Beurteilung des Entwicklungsstandes. Therapieplanung und
Elternberatung können davon profitieren.
Learning curve for esophageal peroral endoscopic myotomy: a systematic review and meta-analysis
Authors: Puli Srinivas R. , Wagh Mihir S. , Forcione David , Gopakumar Harishankar
Published: September 2022

Background and study aims Peroral endoscopic myotomy (POEM) is a minimally invasive endoscopic procedure for the treatment of achalasia and certain spastic esophageal motility disorders, delivering excellent results in experienced hands. However, this complex and technically challenging procedure requires advanced endoscopic skills. The aim of this study was to conduct a systematic review and meta-analysis of current data to evaluate the learning curve for POEM in new adopters of this technique.

Methods Electronic databases (PubMed, Embase, and Cochrane Library) from inception to November 2021 were searched for publications addressing the learning curve in POEM. Pooling was conducted by both fixed- and random-effects models. Secondary outcomes reviewed were clinical success defined by Eckardt score ≤ 3 when available and adverse events.

Results Eight studies involving 1904 patients met the inclusion criteria. In the pooled analysis, new adopters of POEM attained proficiency at a mean of 24.67 procedures (95 %CI 23.93 to 25.41). Once proficiency was achieved, the pooled total procedure time plateaued at a mean of 85.38 minutes (95 %CI 81.48 to 89.28), the pooled mean procedure time per centimeter of myotomy was 6.25 minutes (95 %CI 5.69 to 6.82), and the pooled mean length of myotomy was 11.49 cm (95 %CI 10.90 to 12.08).

Conclusions Our analysis showed that new adopters of POEM with previous advanced endoscopy experience required about 25 procedures to attain proficiency. The average time for each procedure once proficiency was attained was about 85 minutes.
Assessment of Alzheimer's Disease Imaging Biomarkers in World Trade Center Responders with Cognitive Impairment at Midlife
Authors: Kritikos Minos , Franceschi Ana M. , Vaska Paul , Clouston Sean A. P. , Huang Chuan , Salerno Michael , Deri Yael , Tang Cheuk , Pellecchia Alison , Santiago-Michels Stephanie , Sano Mary , Bromet Evelyn J. , Lucchini Roberto G. , Gandy Sam , Luft Benjamin J.
Published: September 2022

Purpose Incidence of early onset neurocognitive dysfunction has been reported in World Trade Center (WTC) responders. Ongoing studies are investigating the underlying etiology, as we are concerned that an underlying risk of neurodegenerative dementia may be occurring because of their stressful and neurotoxic exposures to particulate matter when they responded to the search and rescue efforts on September 11, 2001. The purpose of this study is to report preliminary results from two ongoing positron emission tomography (PET)/magnetic resonance imaging (MRI) imaging studies investigating the presence of Alzheimer's disease (AD) biomarkers, such as β-amyloid, tau, and neurodegeneration, and compare our findings to published norms.

Methods We present findings on 12 WTC responders diagnosed with either cognitive impairment (CI) or mild cognitive impairment (MCI), now at midlife, who underwent PET/MRI brain imaging as part of ongoing studies. Six responders with CI received [18F] florbetaben (FBB) to detect β-amyloidosis and six separate responders with MCI received [18F] flortaucipir (FTP) to detect tauopathy. All 12 responders underwent concomitant MRI scans for gray matter volume analysis of neurodegeneration.

Results PET analysis revealed 50% FBB and 50% of FTP scans were clinically read as positive and that 50% of FTP scans identified as consistent with Braak's stage I or II. Furthermore, one responder identified as centiloid positive for AD. Gray matter volumes from MRI analyses were compared with age/sex-matched norms (Neuroquant), identifying abnormally low cortical volumes in the occipital and temporal lobes, as well as the inferior temporal gyri and the entorhinal cortex.

Conclusion These preliminary results suggest that WTC responders with neurocognitive dysfunction may be at increased risk for a neurodegenerative dementia process as a result of their exposures at September 11, 2001.
Onset of Mucormycosis in Patients with COVID-19: A Systematic Review on Patients' Characteristics
Authors: Ghasemi Shohreh , Dashti Mahmood , Fahimipour Amir , Daryakenari Ghazaleh , Mirzaei Fatemeh , Akbari Fatemeh , Khurshid Zohaib
Published: September 2022

Mucormycosis has a significant impact on patients' standard of living and, therefore, a high clinical suspicion, prediagnosis, and rapid treatment are critical in easing patients' suffering and fast recovery. Our focus is to conduct an organized review based on various variables on the patients' characteristics having mucormycosis in severe novel coronavirus disease 2019 (COVID-19). We examined Embase, PubMed-Medline, LitCovid, Web of Science, Scopus, and the reference lists of included case reports up to September 20, 2021, using the Medical Subject Heading (MeSH) phrases and other keywords related to this topic. Subsequently, we investigated associated comorbidities, patient characteristics, position of mucormycosis, steroids use, body involvements, and outcomes. Overall, 77 studies were conducted and among these, 72 studies mentioned that the patients' age to be 48.13±14.33 (mean±standard deviation [SD]) years. Diabetes mellitus (DM) was reported in 77.9% (n=60) of cases. Studies showed that central nervous system (CNS) and bone involvement were reported in 62.3 (n=48) and 53.2% (n=41), respectively. More fatalities were observed in patients with mucormycosis with the active form of COVID-19. Also, men infected with mucormycosis significantly affected by COVID-19. In the end, mortality was higher in males with mucormycosis. As a result, a solid investigation into the root cause of mucormycosis, especially in COVID-19, should be included in the study plan. If the patient is COVID-19-positive and immunosuppressed, this opportunistic pathogen diagnostic test should not be overlooked.
Utility of 99mTechnetium Pertechnetate Thyroid Scan and Uptake in Thyrotoxic Patients: Jordanian Experience
Authors: Al-Muqbel Kusai M.
Published: September 2022

Objective The objective of this study was to assess our local experience with 99mTechnitium thyroid uptake (TcTU) in thyrotoxicosis by examining mean and range of TcTU in both euthyroid patients and thyrotoxic patients. We also wanted to see how well TcTU performed as a substitute for radioiodine thyroid uptake in thyrotoxicosis.

Methods The medical records of thyrotoxic patients were reviewed retrospectively. Inclusion criteria were: (1) thyrotoxicosis was proven biochemically, (2) the patient underwent TcTU at the time of thyrotoxicosis diagnosis, (3) at least 6 months of follow-up, and (4) the final diagnosis was documented. All TcTU of euthyroid patients were also reviewed to determine local normal TcTU mean and range. Patients were divided into three groups: Graves' disease, toxic nodular goiter, and subacute thyroiditis. Each patient group's TcTU mean and range were assessed separately.

Results There were 209 patients in total (54 euthyroid, 112 Graves' disease, 26 toxic nodules, and 17 patients with subacute thyroiditis). TcTU mean±standard deviation and range for euthyroid patients were 1.5±1.1% and 0.17 to 4.8%, 10.6±10% and 0.43 to 40% for Graves' disease, 4.5±4% and 0.6 to 15% for toxic nodules, and 0.5±0.4% and 0.18 to 1% for subacute thyroiditis. Although one-third of thyrotoxic patients' TcTU values overlapped with the normal TcTU range, the diagnosis was made using qualitative image analysis. Subacute thyroiditis was characterized by poor thyroid visualization, whereas Graves'/toxic nodular goiter was well visualized.

Conclusion The mean and range of our local normal TcTU were similar to those previously published. TcTU was a useful alternative to radioiodine in the evaluation of thyrotoxicosis. About two-thirds of the patients had accurate test results. The diagnosis was reached in the remaining one-third of patients by combining quantitative and qualitative image features. This method allowed us to stop giving radioiodine to our patients, resulting in a significant reduction in patient radiation exposure.
External Quality Assessment Data for Investigation of von Willebrand Disease: Focus on Relative Utility of Contemporary Functional von Willebrand Factor Assays. The United Kingdom National External Quality Assessment Scheme (UK NEQAS) Experience
Authors: Jennings Ian , Reilly-Stitt Chris , Lowe Anna , Kitchen Steve , Walker Isobel
Published: September 2022

Von Willebrand disease (VWD) is one of the most common hereditary bleeding disorders. Effective management of patients and their families depends on accurate diagnosis and subtype classification, and quality assurance including participation in proficiency testing programs is essential to ensure the accuracy of the panel of assays required to achieve this diagnosis. We report here findings from recent external quality assessment (EQA) exercises, as well as from a questionnaire about diagnostic practices employed by centers in the United Kingdom National Quality Assessment Scheme (UK NEQAS) performing von Willebrand factor (VWF) assays. Plasma samples from donors with VWD, “normal” donors, the International Society for Thrombosis and Haemostasis Scientific Subcommittee (ISTH SSC) plasma standard, and whole blood samples were sent to participants in the UK NEQAS BC program for VWF investigation. Calibration of lot#5 of the ISTH SSC plasma standard was shown to give improved comparability between the recovered value from an EQA exercise and the assigned potency for VWF activity assays. Diagnostic accuracy and precision amongst UK NEQAS participants was good, with an average 99% of centers reporting the correct interpretation for normal, type 1 and type 2 VWD samples, 100% diagnostic accuracy for centers performing FVIII binding assays, and good agreement amongst centers performing multimeric analysis. Genetic analysis of the VWF gene by specialist centers demonstrated errors in the genotyping process in one center, but also demonstrated failings in the interpretation of results in other centers. Despite evidence of good laboratory accuracy and precision in their assays, a questionnaire identified marked variation in diagnostic criteria employed, underlining the importance of guidelines to support the diagnosis of VWD.
Effect of Poly-L-Lactic Acid Mesh Augmentation on Cyclic Gap Formation in Transosseous Patellar Tendon Repair: A Biomechanical Study
Authors: Gould Heath P. , Rate William R. , Harrell Ryan A. , Abbasi Pooyan , Fillar Allison L.
Published: September 2022

No previous study has investigated poly-L-lactic acid (PLLA) surgical mesh augmentation in the repair of inferior pole patellar tendon rupture. We compared the biomechanical properties of transosseous patellar tendon repair with PLLA surgical mesh augmentation to transosseous repair without augmentation. Ten matched pairs of cadaveric knees were used. Specimens in each pair were randomized to undergo the transosseous technique alone or the transosseous technique augmented with a PLLA surgical mesh. An inferior pole patellar tendon rupture was simulated and the repair procedure was performed. Specimens were cyclically loaded for 500 cycles. Gap formation was measured using two sensors placed medial and lateral to the repair site. After cyclic loading, load to failure was determined by pulling the tendon at a constant rate until a sudden decrease in load occurred. The primary outcome measure was cyclic gap formation at the medial and lateral sensors. Compared with controls, specimens that underwent PLLA mesh-augmented repair had significantly lower medial gap formation at all testing intervals up to 500 cycles (p < 0.05) and significantly lower lateral gap formation at all testing intervals from 10 to 500 cycles (p < 0.05). Transosseous patellar tendon repair augmented with a PLLA woven mesh device provided significantly greater resistance to gap formation compared with transosseous repair alone. These results suggest that PLLA mesh augmentation of the transosseous technique is biomechanically effective for patellar tendon repair.
Patient Perceptions of Wearable and Smartphone Technologies for Remote Outcome Monitoring in Total Knee Arthroplasties
Authors: Kurtz Steven M. , Higgs Genymphas B. , Chen Zhongming , Koshut William J. , Tarazi John M. , Sherman Alain E. , McLean Scott G. , Mont Michael A.
Published: September 2022

While there is enthusiasm for wearables and smartphone technologies in evaluating clinical outcomes among clinicians, less is known about the willingness of patients who have osteoarthritis (OA) to consent for remote outcome monitoring. We developed an Institutional Review Board-approved questionnaire to assess patient perceptions of remote monitoring technologies in a high-volume orthopaedic clinical center. Fifty total knee arthroplasty (TKA) patients (56% female; mean age: 61 years, range: 23–89) and fifty nonoperative OA knee patients (54% female; mean age: 58 years, range: 25–89) routinely consulted in the clinic as part of their OA treatment and consented to participate in the study. Patient perceptions were compared using Pearson's chi-square analyses with a significance threshold of p < 0.05. We found that TKA patients were more receptive to the use of smartphone apps (84 vs. 60%, p = 0.008) and wearable sensors (80 vs. 48%, p < 0.001) and learning to use custom wearables (72 vs. 38%, p = 0.002) than nonoperative OA knee patients as part of their treatment. Likewise, the majority of TKA patients were willing to use the global positioning system in their postoperative technology (54 vs. 18%, p < 0.001), especially if they were only active during certain circumstances (62 vs. 24%, p < 0.001). TKA patients also expressed willingness to have their body movement (68%), balance (70%), sleep (76%), and cardiac output (80%) tracked using remote technologies. Overall, we found that TKA patients were highly receptive to using wearable technology in their treatments, whereas nonoperative OA knee patients were generally unreceptive. Our study challenges the concept that current wearable technology approaches will be generally effective as a tool to remotely monitor all patients across the OA severity landscape.
The Relationship between Sphenoid Sinus, Carotid Canal, and Optical Canal in Paranasal Sinus Computed Tomography in Children
Authors: Tursun Serkan , Bayar Muluk Nuray , Inal Mikail , Göncüoğlu Alper , Şencan Ziya
Published: September 2022

Objectives The authors examined the structural differences in the paranasal sinus region at sphenoid sinus in the pediatric population.

Methods Paranasal sinus computed tomography (PNSCT) images of 86 pediatric subjects (30 males, 56 females) were included. In 13 to 15 years of age group (n=34) and ≥16 years of age group (n=52), sphenoid sinus pneumatization (SSP), optic canal and carotid canal classifications and dehiscence evaluation were performed.

Results In both sexes, type 1 and type 2 SS pneumatization were observed more frequently on both the right and left sides. On the right side, type 2> type 1; on the left side type 1> type 2 optic canals were detected in both gender. Type 3 optic canals were detected in 8.8 to 14.7% of the 13 to 15 years of age group; and 11.5 to 17.3% of ≥16 years of age group. Type 4 optic canals were detected in 2.9% of the 13 to 15 years of age group and 1.9% of the ≥16 years of age group bilaterally. Optic canal dehiscence was detected in 26.5% of the 13 to 15 years of age group and 17.3% of the ≥16 years of age group. Type 1 and type 2 carotid canals are most common in children, the percentages for type 3 carotid canals were 1.8 to 3.6% in children.

Conclusion In pneumatized SS, optic canal classifications got increased values which showed protrusion into the sphenoid sinus wall. Therefore, in children, the surgeons must be very careful for optic canal being nearer to the sphenoid sinus walls.
Advances in Percutaneous Management of Pulmonary Embolism
Authors: Kerrigan Jimmy , Morse Michael , Haddad Elias , Willers Elisabeth , Ramaiah Chand
Published: September 2022

Acute pulmonary embolism (PE) is a leading cause of morbidity and mortality worldwide. Systemic anticoagulation remains the recommended treatment for low-risk PE. Systemic thrombolysis is the recommended treatment for PE with hemodynamic compromise (massive/high-risk PE). A significant number of patients are not candidates for systemic thrombolysis due to the bleeding risk associated with thrombolytics. Historically, surgical pulmonary embolectomy (SPE) was recommended for massive PE with hemodynamic compromise for these patients. In the last decade, catheter-directed thrombolysis (CDT) has largely replaced SPE in the patient population with intermediate risk PE (submassive), defined as right heart strain (as evidenced by right ventricle enlargement on echocardiogram and/or computed tomography, usually along with elevation of troponin or B-type natriuretic peptide). Use of CDT increased in the last few years due to high incidence of PE in hospitalized patients with coronavirus disease 2019 pneumonia, and the use of mechanical thrombectomy (initially reserved for those with contraindications to thrombolysis) has also grown. In this article, we discuss the value of the PE response team, our approach to management of submassive (intermediate risk) and massive (high risk) PE with systemic thrombolytics, CDT, mechanical thrombectomy, and surgical embolectomy.
An Unusual Cause of Biliary Peritonitis on the Background of Acute Pancreatitis: A Case Report
Authors: Symeonidis Dimitrios , Bompou Efrosyni , Samara Athina A. , Kissa Labrini , Tepetes Konstantinos
Published: September 2022

Introduction Acute pancreatitis can cause a wide variety of local complications, sometimes pretty unusual. In the present report, we present a rather unusual cause of biliary peritonitis on the background of acute pancreatitis.

Case Presentation A 41-year-old female patient with biliary acute pancreatitis and concomitant choledocholithiasis required an urgent laparotomy due to signs of sepsis and peritoneal irritation after a trial of conservative management. During laparotomy, the diagnosis of biliary peritonitis was established. Surprisingly, a residual gallstone obstructing the common bile duct at the level of the ampulla was causing bile to reflux, through the common channel, into the main pancreatic duct and subsequently into a partially ruptured acute pancreatic necrotic collection.

Conclusion Dealing with the unexpected is a constant challenge for the surgical team dealing with acute pancreatitis patients. Although deferring surgical intervention during the course of acute pancreatitis, as much as possible, is the ideal strategy, this is not always possible. Deciding the treatment strategy based on the patients' clinical condition represents the most appropriate approach.
The importance of citizenship for deserving COVID-19 treatment
Authors: Helbling Marc , Maxwell Rahsaan , Munzert Simon , Traunmüller Richard
Published: September 2022

Immigrant non-citizens are often considered less deserving than citizens of welfare and other public services. The logic is that valuable and scarce public resources must be limited somehow, and the club of citizens is one way of drawing a boundary. In this paper, we examine how far that boundary extends, by analyzing the extent to which Germans prioritize citizens over non-citizens for access to life-saving healthcare. We implement a conjoint experiment to elicit preferences in the context of the COVID-19 pandemic. The data were collected between April 2020 and March 2021, in 23 waves of an online rolling cross-sectional survey with roughly 17,000 respondents. Our main finding is that citizens are viewed as more deserving of healthcare than non-citizen immigrants, a relationship that is sizeable and robust. Our findings have implications for debates about social boundaries and how to allocate resources in Western Europe.
Superhydrophilic–superhydrophobic patterned surfaces: From simplified fabrication to emerging applications
Authors: Chen Hao , Li Xiaoping , Li Dachao
Published: September 2022

Superhydrophilic–superhydrophobic patterned surfaces constitute a branch of surface chemistry involving the two extreme states of superhydrophilicity and superhydrophobicity combined on the same surface in precise patterns. Such surfaces have many advantages, including controllable wettability, enrichment ability, accessibility, and the ability to manipulate and pattern water droplets, and they offer new functionalities and possibilities for a wide variety of emerging applications, such as microarrays, biomedical assays, microfluidics, and environmental protection. This review presents the basic theory, simplified fabrication, and emerging applications of superhydrophilic–superhydrophobic patterned surfaces. First, the fundamental theories of wettability that explain the spreading of a droplet on a solid surface are described. Then, the fabrication methods for preparing superhydrophilic–superhydrophobic patterned surfaces are introduced, and the emerging applications of such surfaces that are currently being explored are highlighted. Finally, the remaining challenges of constructing such surfaces and future applications that would benefit from their use are discussed.