bluuebunny/crossref_metadata_2025 huggingface dataset:
Non‐surgical therapy of peri‐implant mucositis—Mechanical/physical approaches: A systematic review
Authors: Verket Anders , Koldsland Odd Carsten , Bunæs Dagmar , Lie Stein Atle , Romandini Mario
Published: February 2023

Aim

To study in humans with peri‐implant mucositis the efficacy of (Q1) mechanical/physical instrumentation over oral hygiene instructions alone; (Q2) any single mode of mechanical/physical instrumentation over others; (Q3) combinations of mechanical/physical instrumentation over single modes; and (Q4) repetitions of mechanical/physical instrumentation over single administration.

Materials and Methods

Randomized clinical trials (RCTs) fulfilling specific inclusion criteria established to answer the four PICOS questions were included. A single search strategy encompassing the four questions was applied to four electronic databases. Two review authors independently screened the titles and abstracts, carried out full‐text analysis, extracted the data from the published reports and performed the risk of bias assessment through the RoB2 tool of the Cochrane Collaboration. In case of disagreement, a third review author took the final decision. Treatment success (i.e., absence of bleeding on probing [BoP]), BoP extent and BoP severity were considered as the implant‐level outcomes of critical importance for the present review.

Results

A total of five papers reporting on five RCTs, involving 364 participants and 383 implants, were included. Overall, treatment success rates after mechanical/physical instrumentation ranged from 30.9% to 34.5% at 3 months and from 8.3% to 16.7% at 6 months. Reduction in BoP extent was 19.4%–28.6% at 3 months, 27.2%–30.5% at 6 months and 31.8%–35.1% at 12 months. Reduction in BoP severity was 0.3–0.5 at 3 months and 0.6–0.8 at 6 months. Q2 was addressed in two RCTs, which reported no differences between glycine powder air‐polishing and ultrasonic cleaning, as well as between chitosan rotating brush and titanium curettes. Q3 was addressed by three RCTs, which showed no added effect of glycine powder air‐polishing over the use of ultrasonic and of diode laser over ultrasonic/curettes. No RCTs were identified that answered Q1 and Q4.

Conclusions

Several mechanical/physical instrumentation procedures including curettes, ultrasonics, lasers, rotating brushes and air‐polishing are documented; however, a beneficial effect over oral hygiene instructions alone or superiority over other procedures could not be demonstrated. Moreover, it remains unclear whether combinations of different procedures or their repetition over time may provide additional benefits.

(CRD42022324382)
The adjunctive effect of a resorbable membrane to a xenogeneic bone replacement graft in the reconstructive surgical therapy of peri‐implantitis: A randomized clinical trial
Authors: Regidor Erik , Ortiz‐Vigón Alberto , Romandini Mario , Dionigi Carlotta , Derks Jan , Sanz Mariano
Published: February 2023

Aim

To evaluate the potential adjunctive effect of a resorbable collagen membrane covering a xenogeneic bone replacement graft in the reconstructive surgical therapy of peri‐implantitis.

Materials and Methods

Forty‐three patients (43 implants) diagnosed with peri‐implantitis associated with intra‐bony defects were treated with a surgical reconstructive approach that included a xenogeneic bone substitute material. Additionally, resorbable collagen membranes were placed over the grafting material at sites randomly allocated to the test group; conversely, no membranes were placed in the control group. Clinical outcomes, namely probing pocket depth (PPD), bleeding and suppuration on probing (BoP and SoP), marginal mucosal level (REC) and keratinized mucosa width (KMW), were recorded at baseline and 6 and 12 months after surgery. Radiographic marginal bone levels (MBLs) and patient‐reported outcomes (PROs) were assessed at baseline and 12 months. A composite outcome (success) was evaluated at 12 months, which included the absence of BoP/SoP, PPD ≤5 mm and reduction of buccal marginal mucosal level (buccal REC) of ≤1 mm.

Results

At 12 months, no implants were lost and treatment success was observed at 36.8% and 45.0% of implants in the test and control groups, respectively (p = .61). Similarly, there were no significant differences between groups in terms of changes of PPD, BoP/SoP, KMW, MBL or buccal REC. Post‐surgical complications were observed in the test group only (e.g., soft tissue dehiscence, exposure of particulate bone graft and/or resorbable membrane). Longer surgical times (~10 min; p < .05) and higher levels of self‐reported pain at 2 weeks (p < .01) were observed in the test group.

Conclusions

This study failed to demonstrate the presence of added clinical or radiographic benefits of the use of a resorbable membrane to cover a bone substitute material within the reconstructive surgical therapy of peri‐implantitis associated with intra‐bony defects.
Novel alternative pretreatment approaches for production of quality raisins from grapes: Opportunities and future prospects
Authors: Pawar Dilip A. , Giri Saroj K. , Sharma Ajay K.
Published: February 2023

Raisins are high‐value products obtained by drying grape berries. Natural drying of grapes is difficult because a hydrophobic waxy cuticle is present on the berry surface. Pretreatment is an important operation in raisin production in which the waxy layer is dissolved or removed for enhancing the drying rate of grapes. Chemical pretreatment consisting of dipping grape bunches in a solution of alkali and oil emulsion is commonly followed for raisin production. However, the threat of chemicals to human health, the environment, and longer processing time lead to the development of an alternative to chemical pretreatment. Various alternative methods have been explored including the abrasive pretreatment and some novel thermal and nonthermal techniques. The potential of these alternative pretreatments has been discussed in this review along with a critical analysis of literature on grape drying. The fundamentals of grape drying and unit operations of the chemical and abrasive process of raisin production have also been narrated. An abrasive process as the best alternative to chemicals in raisin production has been described in detail along with future prospects of different physical pretreatments. This review provides comprehensive information on raisin production with a focus on chemical‐free processing of grape for raisin production.

Practical applications

Raisins are dried grapes rich in nutritional and functional ingredients that are beneficial for human health. A predrying treatment to remove or to dissolve the waxy layer from surface of grapes is an important operation in raisin production. The chemical method of pretreatment is prevalent among raisin processors. However, a chemical method has some limitations like longer processing time, intense use of chemicals, food safety issues, and so forth. Many novel pretreatments like superficial abrasion, thermal, and nonthermal techniques have been explored by researchers and it has the potential to produce safe raisins without use of any chemicals. These alternative techniques can be adopted for industrial‐scale processing of raisins. A lot of literature is available on the grape drying process, modeling, and quality aspects of raisins. All this information has been summarized in this comprehensive review with a comparison of unit operations, analysis of findings, and future aspects for the production of safe raisins. This review will be very useful for industrial‐scale processing of raisins adopting novel processes and it will also provide in‐depth knowledge to the academician and research scholars.
Reliability of 3D freehand ultrasound to assess lower limb muscles in children with spastic cerebral palsy and typical development
Authors: Hanssen Britta , Peeters Nicky , Dewit Tijl , Huyghe Ester , Dan Bernard , Molenaers Guy , Van Campenhout Anja , Bar‐On Lynn , Van den Broeck Christine , Calders Patrick , Desloovere Kaat
Published: February 2023

This study investigated the reliability of 3‐dimensional freehand ultrasound (3DfUS) to quantify the size (muscle volume [MV] and anatomical cross‐sectional area [aCSA]), length (muscle length [ML], tendon length [TL], and muscle tendon unit length [MTUL]), and echo‐intensity (EI, whole muscle and 50% aCSA), of lower limb muscles in children with spastic cerebral palsy (SCP) and typical development (TD). In total, 13 children with SCP (median age 14.3 (7.3) years) and 13 TD children (median age 11.1 (1.7) years) participated. 3DfUS scans of rectus femoris, semitendinosus, medial gastrocnemius, and tibialis anterior were performed by two raters in two sessions. The intra‐ and inter‐rater and intra‐ and inter‐session reliability were defined with relative and absolute reliability measures, that is, intra‐class correlation coefficients (ICCs) and absolute and relative standard error of measurement (SEM and SEM%), respectively. Over all conditions, ICCs for muscle size measures ranged from 0.818 to 0.999 with SEM%s of 12.6%–1.6%. For EI measures, ICCs varied from 0.233 to 0.967 with SEM%s of 15.6%–1.7%. Length measure ICCs ranged from 0.642 to 0.999 with SEM%s of 16.0%–0.5%. In general, reliability did not differ between the TD and SCP cohort but the influence of different muscles, raters, and sessions was not constant for all 3DfUS parameters. Muscle length and muscle tendon unit length were the most reliable length parameters in all conditions. MV and aCSA showed comparable SEM%s over all muscles, where tibialis anterior MV was most reliable. EI had low‐relative reliability, but absolute reliability was better, with better reliability for the distal muscles in comparison to the proximal muscles. Combining these results with earlier studies describing muscle morphology assessed in children with SCP, 3DfUS seems sufficiently reliable to determine differences between cohorts and functional levels. The applicability on an individual level, for longitudinal follow‐up and after interventions is dependent on the investigated muscle and parameter. Moreover, the semitendinosus, the acquisition, and processing of multiple sweeps, and the definition of EI and TL require further investigation. In general, it is recommended, especially for longitudinal follow‐up studies, to keep the rater the same, while standardizing acquisition settings and positioning of the subject.
Association of physical restraint duration and undesirable outcomes amongst inpatients comorbid with dementia and pneumonia in acute care settings
Authors: Okumura Yasuyuki , Sakata Nobuo , Ogawa Asao
Published: February 2023

Aims and Objectives

This study aimed to examine the association between physical restraint duration and undesirable outcomes amongst inpatients comorbid with dementia and pneumonia in acute care hospitals.

Background

Physical restraints are frequently used in the management of patients, especially amongst patients with dementia. No previous study investigated the potential undesirable effects of physical restraints in patients with dementia.

Methods

This was a cohort study using a nationwide discharge abstract database in Japan. Patients aged ≥65 years with dementia hospitalised for pneumonia or aspiration pneumonia between April 1, 2016 and March 31, 2019 were identified. The exposure was physical restraint. The primary outcome was hospital discharge to the community. Secondary outcomes included hospitalisation costs, functional decline, in‐hospital mortality, and institutionalisation for long‐term care.

Results

A total of 18,255 inpatients with pneumonia and dementia in 307 hospitals were included in this study. Of them, 21.5% and 23.7% had physical restraint during full and partial days of hospital stays, respectively. Discharge to the community incidence rates was lower in the full‐restraint vs. the no‐restraint group (27 vs. 29 per 1000 person‐days; HR, 1.05 [95% CI, 1.01–1.10]) and the partial‐restraint vs. the no‐restraint group (17 vs. 29 per 1000 person‐days; HR, 1.79 [95% CI, 1.71–1.87]). The risks of functional decline were higher in the full‐restraint vs. the no‐restraint group (27.8% vs. 20.8%; RR, 1.33 [95% CI, 1.22, 1.46]) and the partial‐restraint vs. the no‐restraint group (29.2% vs. 20.8%; RR, 1.40 [95% CI, 1.29, 1.53]).

Conclusions

The use of physical restraints was associated with a lower incidence rate of discharge to the community and an increased risk of functional decline at discharge. Further research is needed to judge the benefit–risk balance of physical restraints in acute care settings.

Relevance to Clinical Practice

Understanding the risk of physical restraints allows medical staff to improve the process of decision making in everyday practice.

No Patient or Public Contribution.

Reporting Methods

The reporting of this article conforms to the STROBE statement.
Negative experiences of patients using medicinal cannabis: A systematic review of qualitative studies
Authors: Gliksberg Or , Kushnir Talma , Sznitman Sharon R. , Lev‐Ran Shaul , Brill Silviu , Amit Ben H. , Feingold Daniel
Published: February 2023

Aims and Objectives

In this study, we systematically reviewed qualitative studies concerning patients' experience with medicinal cannabis (MC) use, to gain insight into the negative effects of MC.

Background

Over the past decades, the use of MC for therapeutic purposes has increased. However, there is conflicting and insufficient data on possible negative physiological and psychological effects of MC treatment.

Design

A systematic review was conducted and the PRISMA guidelines were adopted. Literature searches were conducted using PubMed, PsycINFO and EMBASE. Critical Appraisal Skills Programme (CASP) qualitative checklist used to assess risk of bias in the included studies.

Methods

We included studies focusing on conventional medical treatment using cannabis‐based products, approved by a physician for a particular health issue.

Results

Of the 1230 articles identified in the initial search, eight articles were included in the review. Following the compilation of themes in the eligible studies, six themes were identified: (1) MC approval; (2) administrative barriers; (3) social perception; (4) MC misuse/widespread effect; (5) adverse effects; and (6) dependence or addiction. These were grouped into two meta‐themes: (1) administrative and social aspects of MC use; and (2) experiences of the effects of medicinal cannabis.

Conclusions

Our findings call for specific attention to unique consequences associated with MC use. Further research is needed in order to assess the degree to which negative experiences associated with MC use may affect various aspects of patients' medical condition.

Relevance to clinical practice

Describing the complex experience of MC treatment and its spectrum of consequences for patients may enable physicians, therapists and researchers to provide more attentive and accurate MC treatment to their patients.

Patient or public contribution

In this review, patients' narratives were explored, yet the research methods did not directly involve patients or the public.
‘I'm having jelly because you've been bad!’: A grounded theory study of mealtimes with siblings in Australian families
Authors: Ayre Susannah K. , White Melanie J. , Harris Holly A. , Byrne Rebecca A.
Published: February 2023

Obesity prevention interventions have been designed to promote responsive feeding in early childhood. However, existing interventions primarily target first‐time mothers without considering the complexities of feeding multiple children within a family unit. By applying principles of Constructivist Grounded Theory (CGT), this study aimed to explore how mealtimes are enacted in families with more than one child. A mixed‐methods study was conducted with parent–sibling triads (n = 18 families) in South East Queensland, Australia. Data included direct mealtime observations, semistructured interviews, field notes, and memos. Data were analysed using open and focused coding, during which constant comparative analysis was applied. The sample comprised of two‐parent families with children ranging in age from 12 to 70 months (median sibling age difference = 24 months). A conceptual model was developed to map sibling‐related processes integral to the enactment of mealtimes in families. Notably, this model captured feeding practices used by siblings, such as pressure to eat and overt restriction, that previously had only been described in parents. It also documented feeding practices used by parents that may occur only in the presence of a sibling, such as leveraging sibling competitiveness and rewarding a child to vicariously condition their sibling's behaviour. The conceptual model demonstrates complexities in feeding that give shape to the overall family food environment. Findings from this study can inform the design of early feeding interventions that support parents to remain responsive, particularly when their perceptions and expectations of siblings differ.
An artificial intelligence platform provides an accurate interpretation of esophageal motility from Functional Lumen Imaging Probe Panometry studies
Authors: Kou Wenjun , Soni Priyanka , Klug Matthew W. , Etemadi Mozziyar , Kahrilas Peter J. , Pandolfino John E. , Carlson Dustin A.
Published: February 2023

Background

Functional lumen imaging probe (FLIP) Panometry is performed at the time of sedated endoscopy and evaluates esophageal motility in response to distension. This study aimed to develop and test an automated artificial intelligence (AI) platform that could interpret FLIP Panometry studies.

Methods

The study cohort included 678 consecutive patients and 35 asymptomatic controls that completed FLIP Panometry during endoscopy and high‐resolution manometry (HRM). “True” study labels for model training and testing were assigned by experienced esophagologists per a hierarchical classification scheme. The supervised, deep learning, AI model generated FLIP Panometry heatmaps from raw FLIP data and based on convolutional neural networks assigned esophageal motility labels using a two‐stage prediction model. Model performance was tested on a 15% held‐out test set (n = 103); the remainder of the studies were utilized for model training (n = 610).

Key Results

“True” FLIP labels across the entire cohort included 190 (27%) “normal,” 265 (37%) “not normal/not achalasia,” and 258 (36%) “achalasia.” On the test set, both the Normal/Not normal and the achalasia/not achalasia models achieved an accuracy of 89% (with 89%/88% recall, 90%/89% precision, respectively). Of 28 patients with achalasia (per HRM) in the test set, 0 were predicted as “normal” and 93% as “achalasia” by the AI model.

Conclusions

An AI platform provided accurate interpretation of FLIP Panometry esophageal motility studies from a single center compared with the impression of experienced FLIP Panometry interpreters. This platform may provide useful clinical decision support for esophageal motility diagnosis from FLIP Panometry studies performed at the time of endoscopy.
Prospects for rice in 2050
Authors: Shi Jianxin , An Gynheung , Weber Andreas P. M. , Zhang Dabing
Published: February 2023

A key to achieve the goals put forward in the UN's 2030 Agenda for Sustainable Development, it will need transformative change to our agrifood systems. We must mount to the global challenge to achieve food security in a sustainable manner in the context of climate change, population growth, urbanization, and depletion of natural resources. Rice is one of the major staple cereal crops that has contributed, is contributing, and will still contribute to the global food security. To date, rice yield has held pace with increasing demands, due to advances in both fundamental and biological studies, as well as genomic and molecular breeding practices. However, future rice production depends largely on the planting of resilient cultivars that can acclimate and adapt to changing environmental conditions. This Special Issue highlight with reviews and original research articles the exciting and growing field of rice‐environment interactions that could benefit future rice breeding. We also outline open questions and propose future directions of 2050 rice research, calling for more attentions to develop environment‐resilient rice especially hybrid rice, upland rice and perennial rice.
Long‐pulsed neodymium‐doped yttrium aluminum garnet for hair reduction in pediatric microtia repair
Authors: Braun Mitchell , Pomerantz Jason H. , Hoffman William Y. , Mathes Erin F.
Published: February 2023

Microtia is the term for congenital malformation of the ear in which the external and internal ear are absent or malformed. Surgical reconstruction is a common management approach and occasionally requires hair reduction of the newly constructed auricle. Few studies have investigated lasers for this purpose. We conducted a retrospective chart review of patients seen at a single institution between 2012 and 2021 who underwent laser hair reduction with long‐pulsed neodymium‐doped yttrium aluminum garnet laser (Nd:YAG). Efficacy ratings were done through review of clinical photographs. Twelve patients were identified with 14 total ears treated. The number of laser treatments varied from 1 to 9 sessions with an average of 5.1 treatments. The majority (8/12) had an “excellent” or “very good” response, one patient had a “good” response, and three were lost to follow‐up. Other than pain, there were no side effects documented. Nd:YAG laser was both effective and safe in our pediatric cohort, without any cutaneous side effects in patients with darker skin.
Understanding of the dynamics of mobile reading: An HMM model of user engagement and content consumption
Authors: Zhao Xia , Huang Lu , Wang Lei , Yazdani Elham , Zhang Cheng
Published: February 2023

Understanding consumers’ engagement and subsequent content consumption behavior in the mobile context is critical to mobile app providers. In this paper, we develop a Hidden Markov Model (HMM) to capture the dynamics of users’ engagement states and consumption decisions on the number of books/chapters read and the amount of money spent. Our method allows us to simultaneously capture three interdependent usage behaviors using a single integrated model and identify the impact of content loading time and previous reading behavior on users’ engagement dynamics and content consumption. We calibrate the model using a tap stream data set of individual users’ reading activities on a mobile app. Our analysis reveals three distinct engagement states, a low state with inactive users, a medium state with users sampling books, and a high state with users reading intensively. Furthermore, we find that content loading time has higher negative impacts on high‐state users in state transitioning than medium‐state users. In contrast, the days that elapsed since the last visit has a similar negative impact on the users in the high and medium states. The effect of usage frequency on users in state transitioning is always positive. We have also identified the weekend effect and social influence on users’ reading outcomes. Finally, our simulations quantify the shortened content loading time and the days elapsed since the last visit on users’ engagement dynamics and content consumption decisions, which generate important managerial implications for app providers.
Assessment of semen quality and anti‐oxidative enzyme activity between bovine sex‐sorted and non‐sex‐sorted frozen–thawed semen
Authors: Guo Yanmin , Fan Zhaobin , Zhao Fuwei , Ge Shihao , Chu Hanping , Wei Zhongfeng , Khan Rajwali , Faisal Muhammad , Ayari‐Akkari Amel , Yassin Habab M. , Zhao Xianlin
Published: February 2023

In the current study, the difference between the sex‐sorted and non‐sex‐sorted frozen semen of Holstein Friesian breed cattle was investigated. Significant variation (p < .05) was found in the semen quality parameters such as motility; vitality; acrosome integrity rate; the anti‐oxidative enzyme activity including GSH (glutathione); SOD (superoxide dismutase); CAT (catalase); GSH‐Px (glutathione peroxidase) and the rate of fertilization. The results showed that the sperm acrosome integrity and motility of the non‐sorted sperm were higher compared to sex‐sorted sperm (p < .05). The linearity index and mean coefficient analysis revealed that the percentage of ‘grade a’ in sex‐sorted sperm were significantly (p < .05) lower than non‐sorted sperm. Interestingly, low SOD level and high CAT level was found in the non‐sexed semen than in the sexed semen (p < .05). Furthermore, the GSH and GSH‐Px activity in the sexed semen was found lower than the non‐sexed semen (p < .05). In conclusion, sperm motility characteristics were lower in sex‐sorted semen than in non‐sex‐sorted semen. This might be related to the complex process of sexed semen production, which could reduce sperm motility and movement characteristics, acrosomal integrity, CAT, SOD, GSH and GSH‐Px, and finally lead to the decline in the fertilization rate.
Moving from one state to another among patients experiencing unexplained chest pain during physical activity: A secondary qualitative analysis by Meleis transition theory
Authors: Røysland Ingrid Ølfarnes
Published: February 2023

Background

Unexplained chest pain is a common condition in medical settings. Nurses usually coordinate the rehabilitation of patients. Physical activity is recommended; however, it is one of the major avoidance behaviours in patients with coronary heart disease. There is a need for a deeper understanding of the transition that patients with unexplained chest pain undergo during physical activity.

Aim

To develop deeper understanding about experiences of transition in patients with unexplained chest pain during physical activity.

Design

Secondary qualitative analysis of data from three exploratory studies.

Method

Meleis et al.'s transition theory was used as a framework for the secondary analysis.

Findings

The transition was complex and multidimensional. The participants experienced personal processes of change toward health within the illness, corresponding to indicators of healthy transitions.

Conclusion

The process can be identified as a transition from an uncertain and often sick role to a healthy role. Knowledge regarding transition promotes a person‐centred approach in which patients' perspectives are included. Nurses and other health professionals can better direct and plan the caring and rehabilitation of patients with unexplained chest pain by deepening their knowledge of the transition process based on physical activity.
Characterization of two new HLA alleles, HLA‐B*18:01:01:74 and HLA‐C*06:02:01:93 in Russian individuals
Authors: Kuzminova Elena P. , Leonov Evgeny A. , Abdrakhimova Alena R. , Khizhinskiy Stanislav P. , Khamaganova Ekaterina G.
Published: February 2023

Two new alleles B*18:01:01:74 and C*06:02:01:93 identified in Russian individuals.
Canine melanocytes: Immunohistochemical expression of melanocytic markers in different somatic areas
Authors: Porcellato Ilaria , Orlandi Margherita , Lo Giudice Adriana , Sforna Monica , Mechelli Luca , Brachelente Chiara
Published: February 2023

Background

Melanoblasts originate in the neural crest from where they migrate to peripheral tissues and differentiate into melanocytes. Alteration during melanocyte development and life can cause different diseases, ranging from pigmentary disorders and decreased visual and auditory functions, to tumours such as melanoma. Location and phenotypical features of melanocytes have been characterised in different species, yet data on dogs are lacking.

Objective

This study investigates the expression of melanocytic markers Melan A, PNL2, TRP1, TRP2, SOX‐10 and MITF in melanocytes of selected cutaneous and mucosal surfaces of dogs.

Animals

At necropsy, samples from five dogs were harvested from oral mucosa, mucocutaneous junction, eyelid, nose and haired skin (abdomen, back, pinna, head).

Materials and Methods

Immunohistochemical and immunofluorescence analyses were performed to assess marker expression.

Results

Results showed variable expression of melanocytic markers in different anatomical sites, particularly within epidermis of haired skin and dermal melanocytes. Melan A and SOX‐10 were the most specific and sensitive melanocytic markers. PNL2 was less sensitive, while TRP1 and TRP2 were seldomly expressed by intraepidermal melanocytes in haired skin. MITF had a good sensitivity, yet the expression often was weak.

Conclusions and Clinical Relevance

Our results indicate a variable expression of melanocytic markers in different sites, suggesting the presence of subpopulations of melanocytes. These preliminary results pave the way to understanding the pathogenetic mechanisms involved in degenerative melanocytic disorders and melanoma. Furthermore, the possible different expression of melanocyte markers in different anatomical sites could influence their sensitivity and specificity when used for diagnostic purposes.
Existence of the detS2$det^{S^2}$ map
Authors: Staic Mihai D.
Published: February 2023

In this paper we show that for a vector space of dimension there exists a linear map with the property that if there exists such that . The existence of such a map was conjectured by Staic [The exterior graded Swiss‐Cheese Operad (with an appendix by Ana Lorena Gherman and Mihai D. Staic), to appear in Comm. Algebra.]. We present applications of the map to geometry and combinatorics.
Plasma biomarkers of endothelial function, inflammation and oxidative stress in individuals with non‐freezing cold injury
Authors: Eglin Clare M. , Wright Jennifer , Shepherd Anthony I. , Massey Heather , Hollis Sarah , Towse Jonathan , Young John S. , Maley Matthew J. , Bailey Stephen J. , Wilkinson Chris , Montgomery Hugh , Tipton Michael J.
Published: February 2023

Plasma biomarkers of inflammation, oxidative stress, endothelial function and damage were examined in 16 individuals with chronic NFCI (NFCI) and matched control participants with (COLD, n = 17) or without (CON, n = 14) previous cold exposure. Venous blood samples were collected at baseline to assess plasma biomarkers of endothelial function (nitrate, nitrite and endothelin‐1), inflammation [interleukin‐6 (IL‐6), interleukin‐10 (IL‐10), tumour necrosis factor alpha and E‐selectin], oxidative stress [protein carbonyl, 4‐hydroxy‐2‐nonenal (4‐HNE), superoxide dismutase and nitrotyrosine) and endothelial damage [von Willebrand factor, syndecan‐1 and tissue type plasminogen activator (TTPA)]. Immediately after whole‐body heating and separately, foot cooling, blood samples were taken for measurement of plasma [nitrate], [nitrite], [endothelin‐1], [IL‐6], [4‐HNE] and [TTPA]. At baseline, [IL‐10] and [syndecan‐1] were increased in NFCI (P < 0.001 and P = 0.015, respectively) and COLD (P = 0.033 and P = 0.030, respectively) compared with CON participants. The [4‐HNE] was elevated in CON compared with both NFCI (P = 0.002) and COLD (P < 0.001). [Endothelin‐1] was elevated in NFCI compared with COLD (P < 0.001) post‐heating. The [4‐HNE] was lower in NFCI compared with CON post‐heating (P = 0.032) and lower than both COLD (P = 0.02) and CON (P = 0.015) post‐cooling. No between‐group differences were seen for the other biomarkers. Mild to moderate chronic NFCI does not appear to be associated with a pro‐inflammatory state or oxidative stress. Baseline [IL‐10] and [syndecan‐1] and post‐heating [endothelin‐1] are the most promising candidates for diagnosing NFCI, but it is likely that a combination of tests will be required.
Assessing Fatigue Damage in the Reuse of a Decommissioned Offshore Jacket Platform to Support a Wind Turbine
Authors: Heo Taemin , Liu Ding Peng , Manuel Lance , Correia José A.F.O. , Mendes Paulo
Published: February 2023

An offshore energy transition, even if only a gradual one, from carbon-emitting fossil fuel extraction to cleaner sources is recommended, if we are to slow the harmful impacts of climate change. The potential for sustainable reuse of decommissioned offshore jacket platforms to support wind turbines is being considered as an attractive proposition in such a transition. To maximize the benefits of such reuse of assets, what is needed is a rational optimization strategy that considers the remaining life of a repurposed platform, associated retrofit and construction costs, and a future period of gross renewable energy generation following installation of the wind turbine. We outline a study that employs a fatigue reliability-based framework, based on the global fatigue approach and Palmgren–Miner’s rule, to aid in such sustainable reuse planning and optimization. The framework proposed identifies an optimized reuse plan that incorporates metocean data analysis, structural analysis, life cycle evaluation, and revenue optimization. We employ a case study and sustainable reuse scenario for a site in the vicinity of Porto (Leixões), Portugal.
The Körperkoordinations Test Für Kinder for Iranian Youth: Factor Structure, Measurement Invariance, and Covariates
Authors: Salami Sedigheh , Ribeiro Bandeira Paulo Felipe , Martins Clarice , Hardy Louise L. , Shams Amir , Dehkordi Parvaneh Shamsipour
Published: February 2023

Purpose: To examine the factor structure and measurement invariance of the Körperkoordinations Test Für Kinder (KTK) and covariates of motor competence in a sample of Iranian children aged 5–14 years. Methods: Participants were children aged 5–14 years (N = 432, 61% boys). Age, sex, and body mass index were collected. Confirmatory factor analysis (CFA) was conducted to investigate the factorial structure of KTK and multigroup CFA carried out to test measurement invariance across sexes and age groups. In addition, we calculated a model with covariates to identify the association between KTK items with age, sex, and body mass index z score. Results: CFA supported the construct validity of a one-factor model with an appropriate fit indices that the four subtests loaded on the same factor namely motor competence. Furthermore, according to the magnitude of changes in root mean square error of approximation and comparative fit index between nested models, the assumption of KTK measurement invariance across age-groups and sex were valid. Finally, adequate fit indices were found for the multigroup CFA path model of KTK with the covariates sex, age, and body mass index z score. Conclusion: The KTK is a valid, reliable, and valuable instrument for assessing motor competence of Iranian children and adolescents.
Accuracy of UK Rapid Test Consortium (UK-RTC) “AbC-19 Rapid Test” for
detection of previous SARS-CoV-2 infection in key workers: test accuracy
study
Authors: Mulchandani Ranya , Jones Hayley E , Taylor-Phillips Sian , Shute Justin , Perry Keith , Jamarani Shabnam , Brooks Tim , Charlett Andre , Hickman Matthew , Oliver Isabel , Kaptoge Stephen , Danesh John , Di Angelantonio Emanuele , Ades Anthony E , Wyllie David H
Published: February 2023

Objective

To assess the accuracy of the AbC-19 Rapid Test lateral flow
immunoassay for the detection of previous severe acute respiratory
syndrome coronavirus 2 (SARS-CoV-2) infection.

Design

Test accuracy study.

Setting

Laboratory based evaluation.

Participants

2847 key workers (healthcare staff, fire and rescue officers, and
police officers) in England in June 2020 (268 with a previous polymerase
chain reaction (PCR) positive result (median 63 days previously), 2579
with unknown previous infection status); and 1995 pre-pandemic blood
donors.

Main outcome measures

AbC-19 sensitivity and specificity, estimated using known negative
(pre-pandemic) and known positive (PCR confirmed) samples as reference
standards and secondly using the Roche Elecsys anti-nucleoprotein assay,
a highly sensitive laboratory immunoassay, as a reference standard in
samples from key workers.

Results

Test result bands were often weak, with positive/negative
discordance by three trained laboratory staff for 3.9% of devices. Using
consensus readings, for known positive and negative samples sensitivity
was 92.5% (95% confidence interval 88.8% to 95.1%) and specificity was
97.9% (97.2% to 98.4%). Using an immunoassay reference standard,
sensitivity was 94.2% (90.7% to 96.5%) among PCR confirmed cases but
84.7% (80.6% to 88.1%) among other people with antibodies. This is
consistent with AbC-19 being more sensitive when antibody concentrations
are higher, as people with PCR confirmation tended to have more severe
disease whereas only 62% (218/354) of seropositive participants had had
symptoms. If 1 million key workers were tested with AbC-19 and 10% had
actually been previously infected, 84 700 true positive and 18 900 false
positive results would be projected. The probability that a positive
result was correct would be 81.7% (76.8% to 85.8%).

Conclusions

AbC-19 sensitivity was lower among unselected populations than among
PCR confirmed cases of SARS-CoV-2, highlighting the scope for
overestimation of assay performance in studies involving only PCR
confirmed cases, owing to “spectrum bias.” Assuming that 10% of the
tested population have had SARS-CoV-2 infection, around one in five key
workers testing positive with AbC-19 would be false positives.

Study registration

ISRCTN 56609224.
The role of community pharmacies in early detection of suspected COVID-19 cases in 2020: lessons from Dar es Salaam, Tanzania
Authors: Mohamed Hussein , Faini Diana , Ngailo Lusungu , Munishi Castory , Mutayoba Rita , Mmbuji Peter , Mponela Marcelina , Subi Leonard , Kwesi Elias , Mpembeni Rose , Jalloh Mohamed F , Gatei Wangeci , Bakari Muhammad , Mghamba Janneth
Published: February 2023

Tanzania reported its first COVID-19 case on 16 March 2020. We conducted event-based surveillance of COVID-19 suspect cases among pharmacy clients presenting with respiratory symptoms and influenza-like illness to increase early and rapid detection of COVID-19 cases and mitigate transmission. We conveniently sampled 103 pharmacies from Dar es Salaam, the epicentre for the COVID-19 pandemic in Tanzania at the time. Between 23 April 2020 and 18 May 2020, 67% of the pharmacies (69/103) reported an observed increase in the number of clients presenting with respiratory symptoms and influenza-like illness compared with the 1 month before the COVID-19 outbreak. In the 1-month surveillance period, the participating pharmacies recorded 75 alerts of COVID-19 suspect cases and referred all suspected COVID-19 cases to rapid response teams for additional symptomatic screening and SARS-CoV-2 testing. A key implementation challenge was that some clients identified as COVID-19 suspected cases were hesitant to provide follow-up information for linkage to rapid response teams. Addressing concerns among drug dispensers in the participating pharmacies and informing them of the benefits of the surveillance activity were important implementation components. Our approach demonstrates the overall feasibility of rapidly implementing an event-based surveillance system for an emerging health threat through an existing network of pharmacies within the community. The approach and tools used in this surveillance activity could be adapted in similar settings to detect and generate alerts of disease outbreaks in the community that other surveillance systems may otherwise miss.
Early discontinuation and results reporting of robot-assisted surgery studies registered on ClinicalTrials.gov: a research on research study
Authors: Long Youlin , Hu Tengyue , Yang Zixin , Liu Liqin , Lin Yifei , Huang Jin , Du Liang
Published: February 2023

Objectives

In this study, we aimed to investigate the characteristics of robot-assisted surgery studies registered on ClinicalTrials.gov and identify factors associated with early trial discontinuation and timely results reporting.

Design

We searched ClinicalTrials.gov to identify interventional studies on robot-assisted surgery on 24 May 2021. All structured information of the potential studies was downloaded and reviewed. A descriptive analysis was performed. Logistic and Cox regression analyses were respectively performed to determine the significance of the association of study characteristics with results reporting and early discontinuation.

Results

A total of 529 interventional studies on robot-assisted surgery were included, with 45 studies reporting results and 54 studies being stopped early. Of the 289 due studies, only 45 (16%) had submitted their results, and only 6 (2%) had submitted their results within the 1-year deadline. Funding source was associated with results reporting: academic funded were 63% less likely than industry to report results (OR=0.37, 95% CI: 0.16 to 0.83, p=0.02). Studies related to device feasibility were associated with greater risk of early discontinuation compared to treatment-related studies (HR=2.30, 95% CI: 1.08 to 4.89, p=0.03). Surprisingly, National Institutes of Health-funded studies were at greater hazard of discontinuation compared to industry-funded studies (HR=3.30, 95% CI: 1.09 to 10.00, p=0.04).

Conclusions

There was poor compliance with results reporting requirements for robot-assisted surgical studies. It is important that investigators remain informed about the regulatory requirements, and should be helped to develop a sense of responsibility for reporting results. Also, they need to ensure the careful design of the study protocol and adequate resources to reduce the risk of early discontinuation.
Screening tools for predicting mortality of adults with suspected sepsis: an international sepsis cohort validation study
Authors: Blair Paul W , Mehta Rittal , Oppong Chris Kwaku , Tin Som , Ko Emily , Tsalik Ephraim L , Chenoweth Josh , Rozo Michelle , Adams Nehkonti , Beckett Charmagne , Woods Christopher W , Striegel Deborah A , Salvador Mark G , Brandsma Joost , McKean Lauren , Mahle Rachael E , Hulsey William R , Krishnan Subramaniam , Prouty Michael , Letizia Andrew , Fox Anne , Faix Dennis , Lawler James V , Duplessis Chris , Gregory Michael G , Vantha Te , Owusu-Ofori Alex Kwame , Ansong Daniel , Oduro George , Schully Kevin L , Clark Danielle V
Published: February 2023

Objectives

We evaluated the performance of commonly used sepsis screening tools across prospective sepsis cohorts in the USA, Cambodia and Ghana.

Design

Prospective cohort studies.

Setting and participants

From 2014 to 2021, participants with two or more SIRS (Systemic Inflammatory Response Syndrome) criteria and suspected infection were enrolled in emergency departments and medical wards at hospitals in Cambodia and Ghana and hospitalised participants with suspected infection were enrolled in the USA. Cox proportional hazards regression was performed, and Harrell’s C-statistic calculated to determine 28-day mortality prediction performance of the quick Sequential Organ Failure Assessment (qSOFA) score ≥2, SIRS score ≥3, National Early Warning Score (NEWS) ≥5, Modified Early Warning Score (MEWS) ≥5 or Universal Vital Assessment (UVA) score ≥2. Screening tools were compared with baseline risk (age and sex) with the Wald test.

Results

The cohorts included 567 participants (42.9% women) including 187 participants from Kumasi, Ghana, 200 participants from Takeo, Cambodia and 180 participants from Durham, North Carolina in the USA. The pooled mortality was 16.4% at 28 days. The mortality prediction accuracy increased from baseline risk with the MEWS (C-statistic: 0.63, 95% CI 0.58 to 0.68; p=0.002), NEWS (C-statistic: 0.68; 95% CI 0.64 to 0.73; p<0.001), qSOFA (C-statistic: 0.70, 95% CI 0.64 to 0.75; p<0.001), UVA score (C-statistic: 0.73, 95% CI 0.69 to 0.78; p<0.001), but not with SIRS (0.60; 95% CI 0.54 to 0.65; p=0.13). Within individual cohorts, only the UVA score in Ghana performed better than baseline risk (C-statistic: 0.77; 95% CI 0.71 to 0.83; p<0.001).

Conclusions

Among the cohorts, MEWS, NEWS, qSOFA and UVA scores performed better than baseline risk, largely driven by accuracy improvements in Ghana, while SIRS scores did not improve prognostication accuracy. Prognostication scores should be validated within the target population prior to clinical use.
Cohort study assessing the impact of COVID-19 on venous leg ulcer management and associated clinical outcomes in clinical practice in the UK
Authors: Guest Julian F , Fuller Graham W
Published: February 2023

Objective

To assess the impact of the COVID-19 pandemic on venous leg ulcer (VLU) management by the UK’s health services and associated outcomes.

Design

Retrospective cohort analysis of the electronic records of patients from The Health Improvement Network database.

Setting

Clinical practice in primary and secondary care.

Participants

A cohort of 1946 patients of whom 1263, 1153 and 733 had a VLU in 2019, 2020 and 2021, respectively.

Primary and secondary outcome measures

Clinical outcomes and wound-related healthcare resource use.

Results

VLU healing rate in 2020 and 2021 decreased by 16% and 42%, respectively, compared with 2019 and time to heal increased by >85%. An estimated 3% of patients in 2020 and 2021 had a COVID-19 infection. Also, 1% of patients in both years had VLU-related sepsis, 0.1%–0.2% developed gangrene and 0.3% and 0.6% underwent an amputation on part of the foot or lower limb in 2020 and 2021 (of whom 57% had diabetes), respectively. The number of community-based face-to-face clinician visits decreased by >50% in both years and >35% fewer patients were referred to a hospital specialist. In 2020 and 2021, up to 20% of patients were prescribed dressings without compression compared with 5% in 2019. The total number of wound care products prescribed in 2020 and 2021 was >50% less than that prescribed in 2019, possibly due to the decreased frequency of dressing change from a mean of once every 11 days in 2019 to once every 21 days in 2020 and 2021.

Conclusions

There was a significant trend towards decreasing care during 2020 and 2021, which was outside the boundaries considered to be good care. This led to poorer outcomes including lower VLU healing rates and increased risk of amputation. Hence, the COVID-19 pandemic appears to have had a deleterious impact on the health of patients with a VLU.