bluuebunny/crossref_metadata_2025 huggingface dataset:
ANN-based damage detection with two-stage approach and model reduction
Authors: Lu Xuandong , Zou Yunfeng , Cai Chenzhi , He Xuhui
Published: October 2024

The implementation of artificial neural network (ANN) is limited in model-based damage detection of large-scale structures. A large potential damaged area impairs the convergence performance of ANN training, and numerous structural DOFs decrease computational efficiency. This article proposes a novel strategy of ANN-based damage detection with two-stage approach and model reduction. To reduce computation DOFs and narrow down the detected area, the original finite element model is divided into manageable substructures and transferred into a super-element model through substructural reduction and integration. Then, damage localization is first performed to search for suspicious damaged substructure by the constructed ANN, which is trained by the defined modal group strain energy analytically calculated from the reduced model. Then, element-stage damage detection is conducted by minimizing the defined reconstructed modal group, and more detailed damage information is desired. The proposed methods could be performed conveniently as traditional modal-based damage detection methods, while it further overcome the difficulty of deal with closely spaced modes. Furthermore, the incorporated ANN provides better timeliness for health monitoring. Numerical and experimental cases are performed for verification. Analysis for the neural network and adjustment are studied.
Multi-objective optimization algorithms for building performance assessment – A benchmark
Authors: da Silva Mario Alves , Garcia Rafael de Paula , Carlo Joyce Correna
Published: October 2024

The increasing development in the computational field that allowed software and hardware advances enables more refined building performance analysis. Simulation-based optimization (SBO) methods allow high standards to be achieved by combining parametric modeling, simulation, and optimization methods. However, SBO methods still need development, especially regarding the correct choice of the optimization algorithm based on the specific characteristics of each problem. This study proposes a multi-objective optimization algorithms benchmark by comparing seven multi-objective optimization algorithms: RBFMOpt, NSGA2, MHACO, NSPSO, MOEA/D, HypE, and SPEA2, across nine building-related problems, including thermal, energy, and daylight simulation. The problems varied from 5 to 18 discrete, continuous, and mixed parameters. The objective functions varied between two and three. We used the hypervolume indicator, IGD+, GD+, and EPS + to compare algorithms’ performance and assess the tendency to reduce computational costs. We also performed the Kruskal-Wallis non-parametric test to analyze the impact of multiple runs on the hypervolume indicator. The results showed that RBFMOpt and HypE perform best across all problems. However, RBFMOpt tends to reduce computational costs since the algorithm requires fewer simulations to obtain the best results.
Tubulotrabecular adenocarcinoma of the nasopharynx operated by transoral and transpalatal approach in a cat
Authors: Ferenczi Estelle , Ragetly Chantal
Published: October 2024

Case summary

A 10-year-old castrated male crossbreed Birman cat was presented for respiratory difficulties, nasal discharge, dysphagia and wheezing. An obstructive nasopharyngeal mass invading the caudoventral nasal cavity and the left sphenoid sinus was observed on a CT scan. Surgical treatment via a ventral rhinotomy and curettage was performed. Histopathology revealed an adenocarcinoma with tubulotrabecular architecture. The cat’s clinical signs significantly improved postoperatively. After 10 months, a recurrence was documented and a second surgical procedure was performed that allowed the patient to live an additional 6 months without clinical signs and an overall survival time of 19 months after first presentation.

Relevance and novel information

This case report describes a nasopharyngeal adenocarcinoma treated by ventral rhinotomy in a cat. To our knowledge, there is only one other report describing this surgery on a nasal adenocarcinoma in a cat. The tomodensitometric, endoscopic and unusual histological appearance of the mass are reported. The prognosis after surgical removal of nasal adenocarcinomas in cats is only sparsely documented. This case demonstrates that ventral rhinotomy might be considered if first-line treatment is declined.
Towards a self-applied, mobile-based geolocated exposure therapy software for anxiety disorders: SyMptOMS-ET app
Authors: González-Pérez Alberto , Diaz-Sanahuja Laura , Matey-Sanz Miguel , Osma Jorge , Granell Carlos , Bretón-López Juana , Casteleyn Sven
Published: October 2024

Objective

While exposure therapy (ET) has the potential to help people tolerate intense situation-specific emotions and change avoidance behaviours, no smartphone solution exists to guide the process of in-vivo ET. A geolocation-based smartphone software component was designed and developed to instrumentalize patient guidance in in-vivo ET and its psychological validity was assessed by a group of independent psychology experts.

Methods

A team of computer scientists and psychologists developed the ET Component for in-vivo ET using geolocation-based technology, following the process-centred design methodology. The ET Component was integrated into the SyMptOMS-ET Android application, which was developed following the co-design methodology. Next, nine independent psychology experts tested and evaluated the ET Component and the SyMptOMS-ET app in the field, following the think-aloud methodology. Participants also completed the Mobile Application Rating Scale (MARS) instrument to quantitatively evaluate the solutions.

Results

We present the SyMptOMS-ET app’s main features and the ET Component exposure workflow. Next, we discuss the feedback obtained and the results of the MARS instrument. Participants who tested the app were satisfied with the ET Component during exposure scenarios (score of [Formula: see text]4.32 out of 5 [[Formula: see text]0.28] on MARS quality aspects), agreed on the soundness of the theoretical foundations of the solutions developed (score of [Formula: see text]4.57 [[Formula: see text]0.48] on MARS treatment support aspects), and provided minor think-a-loud comments to improve them.

Conclusions

The results of the expert evaluation demonstrate the psychological validity of the ET Component and the SyMptOMS-ET app. However, further studies are needed to discern the acceptability and efficacy of the mHealth tool in the target population.
Transmigration Stressors, Parent Mental Health, Resource Utilisation and Family Functioning Among Sri Lankan Camp Refugees in India
Authors: Sahoo Indranil , Kuttikat Miriam , Chan David , Murphy Jennifer , Saleh Muna , Lund Marianne B.
Published: October 2024

This study explores the relationships between resource utilisation, transmigration stressors, physical and mental health problems, and family dysfunction of Sri Lankan Tamil camp refugees during their transmigration period. The study aims to (a) describe the types of stressors experienced by Sri Lankan Tamil refugees, and their levels of adjustment and family functioning; (b) conduct a preliminary assessment of associations between parental daily stressors, mental well-being and family functioning; and (c) analyse the extent to which refugees rely on formal and informal resources and their impact on adjustment and family functioning. A quantitative longitudinal study was conducted over 4 years with a systematic random sample of 120 camp refugee parents. Statistical analyses examined the effects of transmigration stress on mental well-being and family functioning. Findings from Phase I indicated significant associations between transmigration stress and somatic complaints, depressive symptoms, hostility and family functioning. Improved family functioning was reported in Phase II, which could be attributed to a reduction in overall transmigration stress. Refugees who accessed informal support from friends in Phase I reported better family functioning, and those using formal support from non-governmental organisations and informal support from families showed improved family functioning in Phase II. Our findings underscore the importance of emphasising transmigration stressors in understanding health outcomes, family dynamics and resource utilisation among transmigratory refugees.
10 Years of Communication & Sport: A Review of Theory, Method, and Authorship
Authors: Cummins R. Glenn , Hahn Dustin
Published: October 2024

Inspired by the regular reflections and suggestions for the future that regularly appear within Communication & Sport, this paper reports the result of a systematic review of a sample of articles from the first 10 vol of the journal to document the most common methods, forms of data employed, theoretical frameworks (and how they are applied), and nationality of author affiliation. Results reflect that the analysis of media texts, either qualitative or quantitative in nature, is the most common methodological approach. Moreover, qualitative approaches dominate the journal. With respect to theories or organizing frameworks, a select few theories appear most frequently, and frameworks related to gender are most common (i.e., hegemonic masculinity, heteronormativity, etc.). Furthermore, most references to theories or framework are just that—mere references. Only a minority of references offered theories as the guiding framework for the articles in which they appeared. To further advance legitimacy of the field, we offer suggestions for expanding the methodological approaches employed within the field, as well as suggestions for the explicit treatment of theory.
Return to Sports after Rotator Cuff Repair
Authors: Marsetio Aldo Fransiskus
Published: October 2024

Rotator cuff tear (RCT) is one of the most common shoulder disorders in orthopaedic surgery. When conservative treatment fails, arthroscopic rotator cuff repair (RCR) has become the most common procedure to achieve a functional shoulder. Success of rotator cuff repair on athletes is measured by their capability to return to sports (RTS) and return to play (RTP).

Most athletes were able to return to the state of preinjury level of play after arthroscopic RCR. Arthroscopic rotator cuff repair has rate of RTS in 75% of patients within an average of 6.4 months. Recreational sports participants was associated with higher rate of RTS, up to more than 90%, even on the patients aged >40 years old. On the contrary, competitive sports and overhead sports athletes were associated with lower rate of RTS. Of all athletes who RTS, only around half of them returned to the equivalent or a higher level of competition. Professional overhead athletes are at higher risk of not returning to their prior level of play. The trends can be observed on performance decline among professional baseball players who underwent RTS. Study on professional football players found no significance difference in RTP rates, performance score, or career longevity between operative and nonoperative group.

There are some criteria for RTP after RTS following RCR, namely: time from surgery, pain, range of motion, functional recovery, proprioception, strength and muscular balance, patient perception, psychological readiness, sport-specific training program. Customized rehab protocols for large to massive rotator cuff repairs and patients at increased risk of stiffness should be considered.
Effects of Posterior Tibial Slope on Posterior Cruciate Ligament Injury: A Systematic Review
Authors: Nugroho Johanes Jethro , Konstantino Roy Edward , Anggi Paramitha Dewa Ayu
Published: October 2024

Introduction and Objective:

Posterior cruciate ligament (PCL) injuries occur in an estimated 3% to 37% of all knee injuries. The PCL is the largest and strongest ligament of the knee joint and the primary restraint to posterior tibial translation (PTT) at all flexion angles. Posterior tibial slope (PTS) is an important radiographic measurement defined as the angle between a line perpendicular to the mid-diaphysis of tibia and the posterior inclination of the tibial plateau. Increase of PTS was reported to alter the knee joint kinematics by anteriorly shifting the resting position of tibia and increasing in situ forces on the ACL and counteracts the PTT and reduces force on PCL. In contrast, a decrease of PTS is correlated to significantly higher residual PTT and lower reduction of PTT and increased force on PCL. The literature regarding the effects of decreased PTS on PCL injury is still limited. This study aims to evaluate effects of posterior tibial slope on primary cruciate ligament injury.

Material and Method:

A comprehensive literature search was conducted in 3 databases, including PubMed, ScienceDirect, and Cochrane Library. Last search was conducted on 17th July 2023. We included prospective and retrospective studies. We presented our results according to PRISMA guidelines.

Results:

A total of 400 participants from 3 different studies were included in this review. All three studies were retrospective case-control. One study concluded a decrease of PTS was associated with patients with PCL tears. Other studies evaluated further by dividing PTS into lateral PTS and medial PTS. One study found decreased lateral PTS were underlying anatomic risk factors for PCL injury, the other concluded a decreased medial PTS and an increased lateral PTS/medial PTS are associated with increased risk of primary PCL injury.

Conclusion:

Decrease of PTS is associated with higher risk of PCL injury. Further studies should elaborate and study the effects of PTS including medial PTS and lateral PTS in posterior knee stability.
Posterior cruciate ligament tears in monozygotic twins: A case report
Authors: Tua Lubis Andri Maruli , Canintika Anissa Feby , Prasetyo Joseph
Published: October 2024

Introduction:

Posterior cruciate ligament (PCL) tears are not as frequent as anterior cruciate ligament (ACL) tears. They are rare as an isolated injury and more commonly occur in a multi-ligament-injured knee. We reported a case of rupture of PCL in monozygotic twins.

Case Presentation:

A 19-year-old female presented with giving away of her left knee since 4 months ago. She fell from stairs previously. Physical examination demonstrated positive posterior drawer test. Magnetic resonance imaging showed ruptured PCL and lateral meniscal tear. Two months later, her identical twin, also a 19-year old-female, fell from the stairs and complained of giving away. Physical examination showed positive posterior drawer test. Magnetic resonance imaging demonstrated ruptured PCL and lateral meniscal tear. Both patients underwent arthroscopic-assisted PCL reconstruction using gracilis, semitendinosus, and peroneus tendon graft. At one year of follow-up, there were no graft failures. Both patients were athletes prior to their injury and they returned to sport.

Discussion:

Although it has never been reported before, this report shows that patients may have genetic predisposition to the incidence of PCL rupture. This is likely because of heritable factors, such as biomechanical, anatomic, anthropometric, and neuromuscular traits.

Conclusions:

A family history of PCL tear may increase the risk of a PCL tear. Further studies are recommended to examine genetic variants as a risk factor for PCL tears and other knee disorders.
Surgical Showdown: Comparative Evaluation of Functional Outcomes and Complications in Isolated Tibial Avulsion: A Comprehensive Analysis of Open and Arthroscopic Fixation over a 2-Year Period: A Systematic Review
Authors: Kuswara Leonardus William , Wien Aryana I Gusti Ngurah
Published: October 2024

Introduction:

Tibia avulsion fractures of the posterior cruciate ligament (PCL) can be treated surgically with arthroscopic repair or open reduction and internal fixation. The approach is simpler but risks soft tissue and neurovascular injury due to the difficulty of accessing the ligament's tibial attachment. Open surgery is effective and provides direct visualization. Meanwhile, arthroscopy is less invasive and promotes fast recovery.

Method:

Using predetermined criteria, the authors conducted a search to identify relevant studies. After reaching a consensus among the authors, Retrospective Case Series, Retrospective Comparative Series, Prospective Randomized Controlled Trials were included. Utilizing the Coleman methodology score, the analytical quality of each study presented was assessed in terms of its methodology. The outcome measures included the comparison of Lysholm score and the complications between open versus arthroscopic fixation in Isolated Tibial Avulsions.

Result:

The initial electronic search found 1,470 articles. Rigid inclusion and exclusion criteria reduced the initial number of studies to 12. This included 7 studies on the open posterior approach, 7 on arthroscopic fixation, and 2 on direct comparison. The study found that arthroscopic PCL avulsion in knee outcomes had better Lysholm scores than open surgery. Arthroscopy yielded better results with fewer complications, but the mini open technique was sometimes comparable.

Conclusion:

The results of the study indicate that arthroscopic approach yielded more favorable postoperative Lysholm scores compared to the open approach in cases of PCL avulsion. The utilization of arthroscopy resulted in superior outcomes with a reduced incidence of complications, although in certain instances, the mini open technique demonstrated comparable efficacy to arthroscopy.
An overview of the management of injury and illness along with referral pattern in Indonesian Football Clubs
Authors: Wijaya Pratama Wicaksana , Kurniarobbi Chikih Jull
Published: October 2024

Introduction and Objectives:

The injury rate in professional men's soccer match is around 8.1/1000 hours of exposure, almost 10 times higher than the rate in training session approximately in 3.7/1000 hours of exposure. Sixty-five percent of injuries causing time loss and impairing athlete performance. Therefore, the better understanding of professional soccer athletes’ management is essential in order to formulate comprehensive treatment of injuries and illnesses. The purpose of this research is to describe injury, illness, and referral pattern in Indonesian football clubs.

Material and Methods:

This descriptive study was conducted on injury and illness data from two Indonesian Football Clubs through 2018-2023. Many incidences, referral to another specialist, and collaboration care has been evaluated to describe the injury and illness characteristic. This study excluded Covid-19 pandemic data.

Results:

There were 159 cases over five years of data collection on injuries and illnesses from two Indonesian Football Clubs (Club X: 2018-2022, Club Y: 2022-2023). From the data, 149 players were registered in the Indonesian League 1 for 5 seasons. The number of injury case recorded was 137 cases with a ratio of 0.91 injured cases per number of players while the ratio of illnesses was 0.14 per number of players (n = 22). The characteristics case of injuries was divided into acute injuries (n = 105) and overuse injuries (n = 32). The referral process was carried out in 44% of the total case of injuries (n=61) and 18% of illnesses (n=4), with the most specialists receiving referrals were orthopaedics (n=28), followed by radiologist (n=26), emergency department (n=4), ophthalmology (n=3) and anaesthesia, plastic surgery, internal medicine, and medical rehabilitation. Monitoring and evaluation of referral cases were carried out by club doctors directly (n = 45) or in outpatient care by the specialist (n = 20)

Conclusions:

Management of injuries and illnesses in football clubs involved several medical specialties therefore comprehensive teamwork is mandatory for effective care. Most referral cases can be evaluated directly by the team doctor or additionally by medical doctor specialist.
The role of iPACK (interspace between the popliteal artery and the posterior knee capsule) radiofrequency for pain management following meniscus repair- a case report
Authors: Deviandri Romy , KH M.Pramana , Yuliana Viet , Irawan Dino
Published: October 2024

Introduction:

Adequate postoperative pain control is essential for successful rehabilitation programs after meniscus repair (MR). The pulsed radiofrequency of the interspace between the popliteal artery and the posterior knee capsule (PRF-iPACK) is a recently developed method.

Objectives:

This study aimed to evaluate the use of PRF-iPACK in patients who underwent MR.

Materials & Methods:

We performed PRF-iPACK guided by ultrasonography for patients who underwent MR with aggravated pain four weeks after surgery. The pain was evaluated using the visual analogue scale (VAS), Lysholm score, and the Euroqol- 5 Dimension (EQ-5D).

Results:

In this study, two patients participated. For the results, a week after treatment, the mean VAS score, Lysholm score, and EQ5D improved from 7 to 1, 42 to 86, and 0.48 to 0.82, respectively.

Conclusion:

PRF-iPACK is an adequate and safe procedure for managing postoperative pain after MR. It may enhance the postoperative rehabilitation program.
Psychometric properties analysis of the Indonesian ACL-RSI scale in patients with ACL injury
Authors: Deviandri R , van der Veen HC , Lubis AMT , Postma MJ , van den Akker-Scheek I
Published: October 2024

Introduction:

The Anterior Cruciate Ligament–Return to Sport After Injury scale (ACL-RSI) measures athletes’ emotion, confidence, and risk appraisal when returning to sports after an anterior cruciate ligament (ACL) injury and/or ACL reconstruction (ACLR).

Objectives:

To assess the validity, reliability, and responsiveness of the Indonesian version of ACL-RSI scale for use in the Indonesian-speaking ACL population.

Material & Methods:

After a forward-and-backward translation procedure, validity and reliability of the (I-ACL-RSI were investigated. Patients who had undergone ACLR at a single hospital were asked to complete four questionnaires: the Indonesian version of the ACL-RSI (I-ACL-RSI), Injury–Psychological Readiness to Return to Sport scale, Tampa Scale of Kinesiophobia, and International Knee Documentation Committee Scale. After a two-week interval, patients were asked to complete the I-ACL-RSI a second time. Following COSMIN (Consensus-based Standards for the selection of health Measurement Instruments) reporting guidelines, construct validity using hypothesis testing, test-retest reliability, internal consistency, floor and ceiling effects, and measurement error were determined. The Bland and Altman method was used to explore absolute agreement. The responsiveness was determined using the logistic regression-based method.

Results:

Of 200 eligible patients, 102 (51%) were included in the analysis. All predefined hypotheses on correlations between the I-ACL-RSI and the other questionnaires were confirmed, indicating good construct validity. An intraclass correlation coefficient (2-way random, type agreement) of 0.90 was found for the first and second I-ACL-RSI scores, indicating good test-retest reliability. A Cronbach α of .95 indicated good internal consistency, and no floor or ceiling effects were found. The standard error of measurement was 3.9, with the minimal detectable change calculated as 10.9 points at the individual level and 1.1 points at the group level. Responsiveness was considered good, especially at the group level.

Conclusion:

The ACL-RSI is a good evaluation instrument for Indonesian patients with anterior cruciate ligament injuries.
Safety and efficacy of intravitreal dexamethasone implantation along with phacoemulsification and intraocular lens implantation in children with uveitis
Authors: Feng Hui , Chen Weixin , Yang Jianzhu , Kong Haorong , Li Hongyu , Tian Meng , Mo Jing , He Yuan , Wang Hong
Published: October 2024

Purpose

To evaluate the safety and efficacy of intravitreal dexamethasone implantation during phacoemulsification and intraocular lens implantation in pediatric uveitis.

Methods

A retrospective analysis was conducted on pediatric uveitis patients undergoing phacoemulsification and intraocular lens implantation with intravitreal dexamethasone implantation. Patients with a minimum follow-up of 6 months were included. Primary outcome measures included ocular inflammation, intraocular pressure (IOP), best-corrected visual acuity (BCVA), and worsening of uveitis.

Results

36 eyes of 28 patients were ultimately included in this study. The mean preoperative BCVA was 1.00 (0.40–1.50) LogMAR. BCVA significantly improved to 0.40 (0.20–0.54) LogMAR at 1 month postoperatively (P = 0.006), further improving to 0.30 (0.20–0.40) LogMAR at 3 months postoperatively (P = 0.001). BCVA remained stable at 0.30 (0.20–0.70) LogMAR at 6 months postoperatively (P = 0.005). Mean IOP showed no statistically significant difference during the follow-up period of three to six months after surgery. Eight children experienced recurrence of ocular inflammation during the 6-month follow-up period. No cases of worsening macular edema, glaucoma, or elevated IOP were observed in any patient.

Conclusion

Intravitreal dexamethasone implantation during phacoemulsification and intraocular lens implantation is a safe and effective method for preventing and treating postoperative inflammation in children with uveitis.
DNA-protein quasi-mapping for rapid differential gene expression analysis in non-model organisms
Authors: Santiago Kyle Christian L. , Shrestha Anish M. S.
Published: October 2024

Background

Conventional differential gene expression analysis pipelines for non-model organisms require computationally expensive transcriptome assembly. We recently proposed an alternative strategy of directly aligning RNA-seq reads to a protein database, and demonstrated drastic improvements in speed, memory usage, and accuracy in identifying differentially expressed genes.

Result

Here we report a further speed-up by replacing DNA-protein alignment by quasi-mapping, making our pipeline > 1000× faster than assembly-based approach, and still more accurate. We also compare quasi-mapping to other mapping techniques, and show that it is faster but at the cost of sensitivity.

Conclusion

We provide a quick-and-dirty differential gene expression analysis pipeline for non-model organisms without a reference transcriptome, which directly quasi-maps RNA-seq reads to a reference protein database, avoiding computationally expensive transcriptome assembly.
Data-driven discovery of chemotactic migration of bacteria via coordinate-invariant machine learning
Authors: Psarellis Yorgos M. , Lee Seungjoon , Bhattacharjee Tapomoy , Datta Sujit S. , Bello-Rivas Juan M. , Kevrekidis Ioannis G.
Published: October 2024

Background

E. coli chemotactic motion in the presence of a chemonutrient field can be studied using wet laboratory experiments or macroscale-level partial differential equations (PDEs) (among others). Bridging experimental measurements and chemotactic Partial Differential Equations requires knowledge of the evolution of all underlying fields, initial and boundary conditions, and often necessitates strong assumptions. In this work, we propose machine learning approaches, along with ideas from the Whitney and Takens embedding theorems, to circumvent these challenges.

Results

Machine learning approaches for identifying underlying PDEs were (a) validated through the use of simulation data from established continuum models and (b) used to infer chemotactic PDEs from experimental data. Such data-driven models were surrogates either for the entire chemotactic PDE right-hand-side (black box models), or, in a more targeted fashion, just for the chemotactic term (gray box models). Furthermore, it was demonstrated that a short history of bacterial density may compensate for the missing measurements of the field of chemonutrient concentration. In fact, given reasonable conditions, such a short history of bacterial density measurements could even be used to infer chemonutrient concentration.

Conclusion

Data-driven PDEs are an important modeling tool when studying Chemotaxis at the macroscale, as they can learn bacterial motility from various data sources, fidelities (here, computational models, experiments) or coordinate systems. The resulting data-driven PDEs can then be simulated to reproduce/predict computational or experimental bacterial density profile data independent of the coordinate system, approximate meaningful parameters or functional terms, and even possibly estimate the underlying (unmeasured) chemonutrient field evolution.
Insomnia symptoms in children and adolescents: screening for sleep problems with the two-item Sleep Condition Indicator (SCI-02)
Authors: Illingworth Gaby , Mansfield Karen L. , Skripkauskaite Simona , Fazel Mina , Waite Felicity
Published: October 2024

Background

Sleep problems are common in young people. Yet brief screening measures to identify those most in need of an intervention are lacking. This study investigated the potential of the two-item Sleep Condition Indicator (SCI-02) for screening insomnia symptoms in children and adolescents. We sought to establish whether there are distinct subgroups with different sleep profiles and whether subgroup membership varied with gender and school year group.

Methods

Students (school years 5–13; typical age 9–18 years) in England completed the OxWell Student Survey in 2021. Sleep measures included: SCI-02, sleep onset latency (SOL), sleep duration, daytime sleepiness, and worry disrupting sleep. Latent profile analysis and multinomial logistic regression explored sleep profiles and predicted class membership.

Results

In total, 29,304 participants answered sleep items. Of these, 95% provided binary gender (n = 27,802, 55% female) for analyses. Five sleep profiles emerged. The profiles, labelled “good”, “moderate”, or “poor” sleepers, vary by sleep quality – which includes time taken to fall asleep (SOL), amount of sleep (sleep duration), and the disruption of sleep due to worry. The profiles are then further differentiated by high levels of daytime sleepiness – labelled “sleepy”. “Good Sleepers” (18,355, 66%), “Moderate Sleepers” (4825, 17.4%), “Moderate Sleepy Sleepers” (1250, 4.5%), “Poor Sleepers” (1037, 3.7%) and “Poor Sleepy Sleepers” (2335, 8.4%). Probable insomnia rates (SCI-02 ≤ 2) were high in both poor sleeper profiles (70–80%) compared with other profiles (0%) and the sample overall (9%). Compared with “Good Sleepers”, all other profiles were mostly female. Daytime sleepiness – the defining characteristic of the sleepy sleeper profiles – was more common in secondary school participants than primary school.

Conclusions

The SCI-02 is an efficient, two-question measure to screen for potential sleep problems in young people. Sleep disruption was high: one in ten were experiencing poor sleep. Females and adolescents appeared more vulnerable to poor sleep and daytime sleepiness. The SCI-02 has the potential for use in school and community contexts to identify children and adolescents who may benefit from support managing their sleep.
ECMO support may be associated with improved survival in tuberculosis associated severe ARDS
Authors: Nalbant Bahar , Buhlmann Alix , Wild Lennart , Bode Christian , David Sascha , Seeliger Benjamin , Stahl Klaus ,   for the BonHanZA study group, Pape Thorben , Ruwisch Jannik , Hoeper Marius M. , Wendel-Garcia Pedro David , Hofmaenner Daniel A. , Erlebach Rolf , Mueller Mattia , Andermatt Rea , Peukert Konrad , Sauer Andrea
Published: October 2024

Background

Data describing outcome of extracorporeal membrane oxygenation (ECMO) support in Tuberculosis (Tbc)-associated acute respiratory distress syndrome (ARDS) remain sparce and are mostly confined to singular case reports. The aim of this case series was to analyze intensive care unit (ICU) survival in patients with Tbc-associated ARDS receiving veno-venous (vv-) ECMO support and to compare those to patients not receiving ECMO.

Case presentation

ICU survival was analyzed retrospectively in 14 patients treated for Tbc-associated ARDS at three ECMO-referral university hospitals (Hannover Medical School, University Hospital Bonn (both Germany) and University Hospital Zurich (Switzerland)) during the last 14 years, of which eight patients received additional vv-ECMO support and six standard care only.

ICU survival was significantly higher in patients receiving additional vv-ECMO support (62.5%, n = 5/8) compared to those that did not (16.7%, n = 1/6) (p = 0.021). ECMO support was associated with reduced ICU mortality (Hazard ratio adjusted for baseline SOFA score [adj. HR] 0.125 (95% confidence interval (CI): 0.023–0.689), p = 0.017). Median (IQR) time on ECMO and invasive ventilation in the vv-ECMO group were 20 (11–26) and 37 (27–53) days, respectively. Major bleeding defined as transfusion requirement of 4 units of blood or more or surgical and/or radiologic intervention occurred only in one patient, in whom pulmonary bleeding was fatal. Thromboembolic events occurred in none of the vv-ECMO patients.

Discussion and conclusions

This retrospective analysis from three large ECMO centers with similar SOPs suggests vv-ECMO support as a feasible approach in patients with severe Tbc-associated ARDS. Although affiliated with extended runtimes, vv-ECMO might be associated with improved survival in those patients. Vv-ECMO support should thus be considered in Tbc-associated ARDS to enable lung protective strategies during prolonged lung recovery.
The effect of autoclave cycles on the mechanical properties and surface roughness of NiTi archwires: ex-vivo study
Authors: Shahawi Amal Magdi El , Aboalnaga Amira Ahmed
Published: October 2024

Objectives

To evaluate the effect of the universal and rapid autoclave cycles on the mechanical properties and surface roughness of nickel-titanium archwires following clinical use.

Material and methods

Thirty-six NiTi archwires (0.016 × 0.022 inch) were equally divided into a control group (Group A) and 2 experimental groups (Group B & C). Wires in group A were tested in the “as-received” form. Wires in the two other groups were installed in patients mouth for 4 weeks, and then autoclaved using the rapid-cycle (Group B) or the universal-cycle (Group C). All wires were subjected to 3-point bending test to calculate the elastic limit, modulus of elasticity, spring-back, yield strength, resilience and toughness. Atomic force microscopy (AFM) was used for surface roughness qualitative and quantitative analysis.

Results

Group B showed significantly higher values of elastic limit, modulus of elasticity, resilience, yield strength and toughness than the other two groups. No significant differences were detected between groups A and C (P > 0.05). Group B showed significantly lower average surface roughness than the other two groups, but no significant differences were detected between groups A and C (P > 0.05).

Conclusions

The mechanical properties and surface roughness of clinically used NiTi wires were less affected by the universal-cycle than the rapid-cycle autoclaving. However, the difference between the effect of both autoclave cycles was diminutive.

Clinical relevance

The mechanical properties and surface roughness of the tested NiTi wires were not notably altered by clinical use and autoclaving.
Deep learning assisted cancer disease prediction from gene expression data using WT-GAN
Authors: Ravindran U. , Gunavathi C.
Published: October 2024

Several diverse fields including the healthcare system and drug development sectors have benefited immensely through the adoption of deep learning (DL), which is a subset of artificial intelligence (AI) and machine learning (ML). Cancer makes up a significant percentage of the illnesses that cause early human mortality across the globe, and this situation is likely to rise in the coming years, especially when non-communicable illnesses are not considered. As a result, cancer patients would greatly benefit from precise and timely diagnosis and prediction. Deep learning (DL) has become a common technique in healthcare due to the abundance of computational power. Gene expression datasets are frequently used in major DL-based applications for illness detection, notably in cancer therapy. The quantity of medical data, on the other hand, is often insufficient to fulfill deep learning requirements. Microarray gene expression datasets are used for training procedures despite their extreme dimensionality, limited volume of data samples, and sparsely available information. Data augmentation is commonly used to expand the training sample size for gene data. The Wasserstein Tabular Generative Adversarial Network (WT-GAN) model is used for the data augmentation process for generating synthetic data in this proposed work. The correlation-based feature selection technique selects the most relevant characteristics based on threshold values. Deep FNN and ML algorithms train and classify the gene expression samples. The augmented data give better classification results (> 97%) when using WT-GAN for cancer diagnosis.
Metabolic and lifestyle factors accelerate disease onset and alter gut microbiome in inflammatory non-communicable diseases
Authors: Rohmann Nathalie , Geese Theresa , Nestel Samantha , Schlicht Kristina , Geisler Corinna , Türk Kathrin , Brix Fynn , Jensen-Kroll Julia , Demetrowitsch Tobias , Bang Corinna , Franke Andre , Lieb Wolfgang , Schulte Dominik M. , Schwarz Karin , Ruß Anne-Kathrin , Sharma Arunabh , Schreiber Stefan , Dempfle Astrid , Laudes Matthias
Published: October 2024

Background

Biomedical and lifestyle factors in Western populations have significantly shifted in recent decades, influencing public health and contributing to the increasing prevalence of non-communicable diseases (NCDs) that share inflammation as common pathology.

Methods

We investigated the relationship between these factors and 11 NCDs in the cross-sectional FoCus cohort (n = 1220), using logistic regression models. Associations with age-at-disease-onset were specifically analyzed for type 2 diabetes (T2D, low-grade chronic inflammation) and inflammatory bowel disease (IBD, high-grade chronic inflammation) in disease-specific cohorts (FoCus-T2D, n = 514; IBD-KC, n = 1110). Important factors for disease risk were identified using Cox-PH-regression models and time-to-event analysis. We further explored the interaction between identified risk factors and gut microbiome composition using linear models.

Results

Lifestyle factors were clearly linked to disease phenotypes, particularly in T2D and IBD. Still, some factors affected only the age-at-onset, but not disease prevalence. High-quality nutrition significantly delayed onset for both IBD and T2D (IBD: HR = 0.81 [0.66; 0.98]; T2D: HR = 0.45 [0.28; 0.72]). Smoking accelerated T2D onset (HR = 1.82 [1.25; 2.65]) but delayed onset in ulcerative colitis (UC: HR = 0.47 [0.28; 0.79]). Higher microbiota diversity delayed IBD onset (Shannon: HR = 0.58 [0.49; 0.71]) but had no effect on T2D. The abundance of specific microbial genera was strongly associated with various biomedical and lifestyle factors in T2D and IBD. In unaffected controls, these effects were smaller or reversed, potentially indicating a greater susceptibility of the gut microbiome to negative influences in T2D and IBD.

Conclusions

The dual insights into age-at-disease-onset and gut microbiota composition in disease emphasize the role of certain biomedical and lifestyle factors, e.g., nutrition quality, in disease prevention and management. Understanding these relationships provides a foundation for developing targeted strategies to mitigate the impact of metabolic and inflammatory diseases through lifestyle modifications and gut health management.
Assessing the role of non-state actors in health service delivery and health system resilience in Myanmar
Authors: Than K. , Bertone Maria Paola , La T. , Witter Sophie
Published: October 2024

Background

Due to the weaknesses of the public health system and its low reach, especially in border areas, provision of health services by non-state actors (NSAs) has historically played an important role in Myanmar. NSAs include local and international NGOs and civil society organisations (CSOs), but also Ethnic Health Organisations (EHOs) in the border areas, as well as the private (for profit) sector. This study aims to understand the changing role of NSAs in the shifting political environment of Myanmar between 2010 and 2022, and to explore their contribution to health system resilience.

Methods

Our study includes three main components: a documentary review (n = 22), key informant interviews (KIIs) at central level (n = 14) and two township-level case studies (13 KIIs, 4 FGDs). Mostly qualitative data were collected in 2022 and synthesized, using a health system resilience framework to structure the analysis.

Results

During the transition period (2010–2014) and the new political era (2015–2020), while the country gradually transitioned to a democratic system, the government increasingly recognized NSAs. Initially, engagement with NSAs remained focused on disease-specific activities and government oversight was limited, but later it expanded to health system strengthening, including the start of a “convergence” with ethnic health systems. Progress was relatively slow, but defined by a clear vision and plans. The military coup of February 2021 brought a halt to this progress. Collaboration between government and NSAs was interrupted, and NSAs restored previous practices and parallel systems. Initially, most health service provision stopped, but with time coping strategies emerged, which showed the capacity of NSAs to absorb the shocks (focusing on basic services; using informal communication channels; maintaining buffer stocks of supplies) and adapt (changing modes of delivery and supply chains, and adjusting HRH training).

Conclusions

The study highlights the role of NSAs during crises, and provides insights on how the resilience capacities built over time by NSAs to provide services in adverse circumstances have informed the response to the latest crisis. While strategies of absorption and adaptation are noted in the study, we did not identify any transformation strategy – which might indicate the difficulty of NSAs to introduce radical changes when subjected to multiple shocks and a hostile political environment.
Genetic analysis using next-generation sequencing and multiplex ligation probe amplification in Chinese aniridia patients
Authors: Wang Li , Xu Qingdan , Wang Wentao , Sun Xinghuai , Chen Yuhong
Published: October 2024

Background

Congenital aniridia is a rare pan-ocular disease characterized by complete irideremia, partial iridocoloboma. The progressive nature of aniridia is frequently accompanied by secondary ocular complications such as glaucoma and aniridia-associated keratopathy, which can lead to severely impaired vision or blindness. The genetic basis of aniridia has been the subject of numerous studies, leading to the development of innovative therapeutic options based on PAX6 nonsense mutations. Specific knowledge of the genetics of aniridia has become increasingly important. To report the clinical features, elucidate the genetic etiology, and reveal the mutational spectrum of congenital aniridia in the Chinese population, sixty patients with congenital aniridia from 51 families were recruited. Candidate genes associated with developmental eye diseases were identified and analyzed using panel-based next-generation sequencing (NGS), and mutations were confirmed through polymerase chain reaction and Sanger sequencing. Multiplex ligation probe amplification (MLPA) of PAX6 and FOXC1 was performed to detect copy number variations in the patients without intragenic mutations.

Results

Clinical examination revealed complete iris hypoplasia in 58 patients and partial iris hypoplasia in two patients. Additionally, two patients were diagnosed with Wilms’ tumor-aniridia-genital anomalies-retardation syndrome and nephroblastoma. By combining panel-based NGS and MLPA, 43 intragenic mutations or deletions of PAX6, FOXC1, and BCOR were identified in 59 patients, including 33 point mutations (76.7%) in 43 patients and 10 deletions (23.3%) in 16 patients. The total detection rate was 98.3%. Phenotypic variation was observed between and within families.

Conclusions

Variations in PAX6 and its adjacent regions were the predominant causes of aniridia in China. In addition to intragenic point mutations in PAX6, deletion of PAX6 or its adjacent genes is a common cause of congenital aniridia. Furthermore, FOXC1 is an important gene associated with congenital aniridia. The combination of panel-based NGS and MLPA significantly enhanced the detection rate of gene mutations in patients with congenital aniridia.
Safety and adherence of early oral immunotherapy for peanut allergy in a primary care setting: a retrospective cross-sectional study
Authors: Landry Victoria , Lewis Rachel , Lewis William , MacDonald Lyndsey , Carson Beth , Chandra Kavish , Fraser Jacqueline , Flewelling Andrew J. , Atkinson Paul , Vaillancourt Chris
Published: October 2024

Background

Peanut allergy is a common food allergy with potentially life-threatening implications. Early oral immunotherapy for peanut allergy (P-EOIT) has been shown to be effective and safe in research and specialty clinic settings. Provision of P-EOIT in primary care would make it available to more patients. We sought to assess the safety of P-EOIT in a primary care setting by documenting the rates of peanut-related allergic reactions leading to emergency department (ED) visits and use of epinephrine. We also examined adherence by assessing the percentage of patients reaching maintenance phase and continuing ingestion after one year of P-EOIT.

Methods

This retrospective study included all patients aged less than 36 months who started P-EOIT at a primary care allergy clinic in New Brunswick, Canada, from 2016 to 2020. The population included patients who (1) had a history of an allergic reaction to peanuts with a positive skin prick test or positive peanut specific IgE level (ps-IgE) or (2) no history of ingestion and a baseline ps-IgE ≥5 kU/L. Patients had biweekly clinic visits with graded increases in peanut protein up to a maintenance dose of 300 mg of peanut protein daily. A blinded retrospective review of paper charts and electronic medical records was conducted along with phone interviews regarding ED visits and epinephrine use.

Results

All 69 consented patients reached maintenance dose over a median of 29 weeks, and 66 patients (95.7%) were still regularly consuming peanut protein after 1 year of maintenance. One patient had a peanut ingestion-related ED visit requiring epinephrine during the escalation phase of peanut protein dosing (1.4%). During the first year of maintenance phase, no patients had peanut ingestion-related ED visits nor required epinephrine.

Conclusion

Early oral immunotherapy for peanut allergy in a primary care setting appears to be safe and our findings suggest that it does not lead to an increased burden of emergency department visits. Our population had high adherence rates, with the majority achieving maintenance dose and staying on this dose for one year.