bluuebunny/crossref_metadata_2025 huggingface dataset:
Variability and changes in Pearl River Delta water level: oceanic and atmospheric forcing perspectives
Authors: Feng Xiangbo , Zhang Wei , Zhu Zhenglei , Chevuturi Amulya , Chen Wenlong
Published: July 2021

Understanding water level (WL) fluctuations in river deltas is of importance for managing water resources and minimizing the impacts of floods and droughts. Here, we demonstrate the competing effects of atmospheric and oceanic forcing on multi-timescale variability and changes in the Pearl River Delta (PRD) WLs in southern China, using 52 years (1961–2012) of in-situ observations at 13 hydrological stations. PRD WL presents significant seasonal to decadal variations, with large amplitudes upstream related to strong variability of southern China rainfall, and with relatively small amplitudes at the coastal stations determined by sea level (SL) fluctuations of the northern South China Sea. We find that the strengths of atmospheric and oceanic forcing in PRD are not mutually independent, leading to a distinct contrast of WL–forcing relationships at upstream and coastal stations. In the transition zone, because of counteracts of atmospheric and oceanic forcing, no robust relationships are identified between WL and either of the forcing. We further show that in the drought season of the warm ENSO and PDO epochs, the effect of atmospheric (oceanic) forcing on PRD WL is largely enhanced (weakened), due to increased southern China rainfall and negative SL anomalies. Over the observation period, WL significantly decreased at upstream stations, by up to 28–42 mm/year for flood season, contrasting with the upward trends of <4.3 mm/year at coastal stations across all seasons. Southern China rainfall explains little of the observed WL trends, whilst SL rise is mostly responsible for the WL trends at coastal stations.
Immobilizing Bactericides on Dental Resins via Electron Beam Irradiation
Authors: Thongthai P. , Kitagawa H. , Iwasaki Y. , Noree S. , Kitagawa R. , Imazato S.
Published: July 2021

Polymerizable bactericides, such as quaternary ammonium compound–based monomers, have been intensively studied as candidates for immobilizing antibacterial components on dental resin. However, they predominantly exhibit a bacteriostatic behavior, rather than bactericidal, as the immobilized components are left with insufficient molecular movement to disrupt the bacterial surface structure through contact-mediated action. In this study, we developed a novel strategy to increase the density of the immobilized bactericide and enhance its antibacterial/antibiofilm properties by combining a surface-grafting technique with electron beam irradiation. A solution of the quaternary ammonium compound–based monomer, 12-methacryloyloxydodecylpyridinium bromide (MDPB), was coated on polymethyl methacrylate (PMMA) resin specimens at the concentrations of 30, 50, and 80 wt%. The coated resins were subsequently exposed to 10 MeV of electron beam irradiation at 50 and 100 kGy, followed by thermal stabilization at 60 °C. The antibacterial effect was evaluated by inoculating a Streptococcus mutans suspension on the coated PMMA resin samples, which exhibited bactericidal effects even after 28 d of aging ( P < 0.05, Tukey’s honestly significant difference test). Transmission electron microscopy and bacteriolytic activity evaluation revealed that the S. mutans cells had sustained membrane depolarization. Furthermore, the antibiofilm effects against S. mutans and bacteria collected from human saliva were assessed. The thickness and the percentage of membrane-intact cells of the S. mutans and multispecies biofilms formed on the MDPB-immobilized surfaces were significantly lower than the uncoated PMMA specimens, even after 28-d aging ( P < 0.05, Tukey’s honestly significant difference test). Thus, the immobilization of antibacterial MDPB via electron beam irradiation induced rapid membrane depolarization, increasing membrane permeability and eventually causing cell death. Our strategy substantially enhances the antibacterial properties of the resinous materials and inhibits biofilm formation, therefore demonstrating significant potential for preventing infectious diseases in the oral environment.
Research Governance in Public University: Proposal of a Composite Index
Authors: El Kadiri Boutchich Driss
Published: July 2021

This work aims to elaborate a governance composite index for research laboratories in public university. This index is composed by an indicator of responsible liberalism associating effectiveness and ethics, to which are added an organizational management indicator and a strategic management indicator. To achieve the above aim, several methods are used, such as adjusted data envelopment analysis and geometric mean to aggregate indicators to calculate the composite index, Vigier index to compute responsible liberalism indicator, and tools to measure the validity and the reliability of indicators. The findings show that the developed index can be applied in any context.
The impact of deep learning–based equipment usage detection on building energy demand estimation
Authors: Wei Shuangyu , Tien Paige Wenbin , Wu Yupeng , Calautit John Kaiser
Published: July 2021

As external temperatures and internal gains from equipment rise, office buildings’ cooling demand and issues are likely to increase. Solutions such as demand-driven controls can help minimise energy consumption and maintain thermal comfort in buildings by coordinating the real-time heating, ventilation and air-conditioning (HVAC) use to the requirements of the conditioned spaces. The present study introduces a real-time equipment usage detection and recognition approach for demand-driven controls using a deep learning method. A Faster R-CNN model was trained and deployed to a camera. The performance of this model was assessed through different evaluation metrics. Based on the initial field experiment results, a detection accuracy of 76.21% was achieved. To investigate the impact of the proposed approach on building heating and cooling energy demand, the case study building was modelled and simulated. The results showed that the deep learning–based method predicted up to 35.95% lower internal heat gains compared to static or ‘fixed’ schedules based on the set conditions.

Practical Application: As the appliances and equipment in building spaces contribute to the internal heat gains, their usage can influence the building energy demand and indoor thermal environment. Linking equipment usage with occupants’ presence in space may not be fully accurate and may lead to the over- or under-estimation of heat emissions, especially when the space is unoccupied, and the equipment is powered ON or the opposite. This approach can be integrated with demand-driven controls for HVAC systems, which can minimise unnecessary building energy consumption while maintaining a comfortable indoor environment using computer vision and deep learning detection and recognition methods.
Construct Validity of the EuroQoL–5 Dimension and the Health Utilities Index in Head and Neck Cancer
Authors: Noel Christopher W. , Keshavarzi Sareh , Forner David , Stephens Robert F. , Watson Erin , Monteiro Eric , Hosni Ali , Hansen Aaron , Goldstein David P. , de Almeida John R.
Published: July 2021

Objective

The objective of this study was to evaluate the construct validity of 2 health utility instruments—the EuroQoL–5 Dimension (EQ‐5D) and the Health Utilities Index–Mark 3 (HUI‐3)—and to compare them with disease‐specific measures in patients with head and neck cancer.

Study Design

Prospective cross‐sectional analysis.

Setting

Princess Margaret Cancer Centre.

Methods

Patients were administered the EQ‐5D, HUI‐3, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ‐C30) and its head and neck cancer module (EORTC QLQ‐H&N35), and the University of Washington Quality of Life Questionnaire (UWQoL). Several a priori expected relations were examined. The correlative and discriminative properties of the various instruments were examined.

Results

A total of 209 patients completed the 4 questionnaires. A significant ceiling effect was observed among EQ‐5D responses (23% reported a maximum score of 1). The EQ‐5D (rho = 0.79) and HUI‐3 (rho = 0.60) had a strong correlation with the social‐emotional domain of the UWQoL. The EQ‐5D had a moderate correlation with the physical domain of the UWQoL (rho = 0.42), whereas the HUI‐3 had a weak correlation (rho = 0.29). The EQ‐5D and HUI‐3 were able to distinguish among levels of health severity measured on the EORTC QLQ‐C30 though not the QLQ‐H&N35. Comparatively, the UWQoL was able to distinguish levels of disease severity on the EORTC QLQ‐C30 and QLQ‐H&N35.

Conclusion

The results of this study demonstrate that disease‐specific domains from head and neck quality‐of‐life instruments are not strongly correlated with the EQ‐5D and HUI‐3. Consideration should be put toward development of a disease‐specific preference‐based measure for health economic evaluation.

Level of evidence

4.
Alignment and Identification of the Relationships between Key Performance Indicators in a Multilevel Tree Structure to Support Transportation Agency Decisions
Authors: Mata Hector Donaldo , Hadi Mohammed , Hale David
Published: July 2021

Transportation agencies utilize key performance indicators (KPIs) to measure the performance of their traffic networks and business processes. To make effective decisions based on these KPIs, there is a need to align the KPIs at the strategic, tactical, and operational decision levels and to set targets for these KPIs. However, there has been no known effort to develop methods to ensure this alignment producing a correlative model to explore the relationships to support the derivation of the KPI targets. Such development will lead to more realistic target setting and effective decisions based on these targets, ensuring that agency goals are met subject to the available resources. This paper presents a methodology in which the KPIs are represented in a tree-like structure that can be used to depict the association between metrics at the strategic, tactical, and operational levels. Utilizing a combination of business intelligence and machine learning tools, this paper demonstrates that it is possible not only to identify such relationships but also to quantify them. The proposed methodology compares the effectiveness and accuracy of multiple machine learning models including ordinary least squares regression (OLS), least absolute shrinkage and selection operator (LASSO), and ridge regression, for the identification and quantification of interlevel relationships. The output of the model allows the identification of which metrics have more influence on the upper-level KPI targets. The analysis can be performed at the system, facility, and segment levels, providing important insights on what investments are needed to improve system performance.
A review on fire suppression by fire sprinklers
Authors: Abdulrahman Shehu A , Chetehouna Khaled , Cablé Axel , Skreiberg Øyvind , Kadoche Maurice
Published: July 2021

Water spray remains the most effective, environment-friendly and economical way of fighting accidental or unwanted fires, and this is largely due to its thermal characteristics. The mechanism of fire suppression by sprinkler water sprays is influenced by numerous factors, which have been the focus of years’-long and on-going research studies to improve its extinguishing performances. A comprehensive review study was carried out in this study to assess the level of technological know-how and current state of research in the field. A total of 2473 published articles spanning 50 years (i.e. 1970–2020) were systematically collected and analysed, whereby more than 100 relevant articles were selected and integrated in the discussion. In particular, the review focuses on research relating to the interactions of sprinkler sprays with flame, fire plume and hot surfaces, aiming to provide a better understanding of the phenomena involved in fire suppression.
Rejection-Identification: An Examination of Group-Level and Individual-Level Discrimination Among Hispanic Immigrants
Authors: Brugger Laura J.
Published: July 2021

This study investigates the Rejection-Identification Model (RIM) by examining impacts of group-level and personal experiences with discrimination on different measures of ethnic identity and cultural importance among Hispanic immigrants. The RIM is used to describe associations between discrimination and increased ethnic identity and the mediating role of ethnicity on negative outcomes of discrimination. Growing empirical support for the RIM has prompted inquiry into its application among different populations, including immigrants who face numerous types of discrimination. Using the Latino Immigrant National Election Survey, the study found that the perception of group-level discrimination was associated with a higher likelihood of reporting Hispanic identity importance, however, personal experiences with discrimination were not. Further, results showed that neither type of discrimination impacted cultural or Spanish language maintenance importance. This paper discusses the implications of these findings and how the protective factors presented by the RIM may vary among populations and when considering personal and group-level discrimination.
Deeply Tailoring Adaptive Interventions: Enhancing Knowledge Generation of SMARTs in Special Education
Authors: Hampton Lauren H. , Chow Jason C.
Published: July 2021

Special educators serve a diverse population of students with unique strengths and needs, and adaptive interventions that account for individual differences before and during the intervention are an important tool to moving the field toward more individualized practices. The purpose of this article is to detail the conceptualization and application of tailoring the sequential multiple assignment randomized trial (SMART) design approach to developing and evaluating deeply tailored adaptive interventions through the application of secondary analyses to account for individual differences at multiple time points. This conceptual paper provides an overview beyond the basic SMART design components by describing the tactics, design options, and analyses currently available to further refine a SMART study into a more personalized intervention to account for individual differences at multiple points throughout the intervention and individual response to treatment.
Prevalence of Prejudice-Denoting Words in News Media Discourse: A Chronological Analysis
Authors: Rozado David , Al-Gharbi Musa , Halberstadt Jamin
Published: July 2021

This work analyzes the prevalence of words denoting prejudice in 27 million news and opinion articles written between 1970 and 2019 and published in 47 of the most popular news media outlets in the United States. Our results show that the frequency of words that denote specific prejudice types related to ethnicity, gender, sexual, and religious orientation has markedly increased within the 2010–2019 decade across most news media outlets. This phenomenon starts prior to, but appears to accelerate after, 2015. The frequency of prejudice-denoting words in news articles is not synchronous across all outlets, with the yearly prevalence of such words in some influential news media outlets being predictive of those words’ usage frequency in other outlets the following year. Increasing prevalence of prejudice-denoting words in news media discourse is often substantially correlated with U.S. public opinion survey data on growing perceptions of minorities’ mistreatment. Granger tests suggest that the prevalence of prejudice-denoting terms in news outlets might be predictive of shifts in public perceptions of prejudice severity in society for some, but not all, types of prejudice.
Fidelity, Rigor, and Relevance: How SEAs are Approaching the ESSA Evidence Requirements
Authors: Yoshizawa Lauren
Published: July 2021

The Every Student Succeeds Act’s evidence requirements mandate the use of research in the selection of school improvement interventions, with the aim of ensuring that schools and districts invest their efforts and funding more wisely. This study of eight states presents three different approaches to the evidence requirements: using lists of pre-sanctioned evidence-based interventions, training schools and districts to evaluate the research supporting potential interventions, and building local evidence of effectiveness. Through interviews with state administrators, I show how each approach relied on different understandings and prioritizations of research rigor and local relevance.
Phenotypic characterisation of paroxysmal dyskinesia in Sphynx cats
Authors: James Matthew , Garosi Laurent , Bessant Claire , Lowrie Mark
Published: July 2021

Objectives

The aim of this study was to identify the phenotypic features of a paroxysmal dyskinesia observed in Sphynx cats.

Methods

The owners of affected Sphynx cats were invited to provide video footage of abnormal episodes for review. Those that demonstrated episodes consistent with paroxysmal dyskinesia were then invited to complete an online questionnaire designed to allow further characterisation.

Results

Ten Sphynx cats were included in the study. All affected cats were <4 years of age at the onset of the episodes (range 0.5–4.0). The episodes had a duration of <5 mins in 9/10 cats (range 0.5–10), while episode frequency was variable between and within individual cats. The episodes were characterised by impaired ambulation due to muscle hypertonicity, most commonly affecting the hips and pelvic limbs (9/10) and shoulders and thoracic limbs (8/10). The head and neck (6/10), tail (5/10), and back and abdomen (3/10) were also involved in some cats. Sudden movement, excitement and stress were identified as possible triggers for the episodes in three cats. Therapeutic intervention was not attempted in 7/10 cases, although two cats were reported to become free of the episodes while receiving acetazolamide. The two cats that were followed beyond 2 years from onset entered spontaneous remission. None of the owners believed that the abnormal episodes had affected the quality of life of their cat.

Conclusions and relevance

The phenotype of paroxysmal dyskinesia in Sphynx cats presented in this study appears to share similarities with paroxysmal kinesigenic dyskinesia described in human classification systems. Some cats appear to achieve episode freedom spontaneously. Subsequent research should focus on evaluating response to treatment and determining an underlying genetic cause.
Long-term retinal changes in progressive geographic atrophy
Authors: Gallagher Denise , Kalra Gagan , Rasheed Mohammed Abdul , Vupparaboina Kiran Kumar , Singh Sumit Randhir , Chhablani Jay
Published: July 2021

Background:

Age-related macular degeneration (AMD) is one of the leading causes of blindness with loss of retinal layers over long term. We aim to evaluate these changes in eyes with progressive non-exudative AMD with geographic atrophy (GA).

Methods:

This retrospective study included patients with GA with a minimum of 4 years follow up. Retinal layers on spectral domain optical coherence tomography (SD-OCT) were segmented based on their reflectivity patterns using validated semi-automated segmentation algorithm. The thickness of the segmented retinal layers was measured. Horizontal length of GA at baseline and last follow-up were also measured. Regression analysis was performed to correlate changes in RPE layer thickness with other retinal layers and the length of GA on OCT.

Results:

A total of 351-line scans including 17 foveal scans showing presence of GA at final visit that is, a total of 2457 retinal layer bands were analyzed. Outer nuclear layer (ONL) ( p = 0.02), outer segment layers (OSL) ( p = 0.01), and retinal pigment epithelium (RPE) ( p = 0.01) showed a statistically significant variation between baseline and final visit. Regression analysis showed the change in ONL ( r = 0.72; p = 0.01) and OSL ( r = 0.93, p < 0.01) correlated significantly with change in RPE thickness whereas rest of the layers failed to show significant correlation.

Conclusion:

Outer retinal layers (ONL and OSL) show more significant and widespread changes in retinal thickness and correlated most significantly with RPE thickness changes in eyes with GA due to AMD. Assessment of various retinal layer bands can be used as surrogate quantitative parameters to study eyes with GA.
The Bottom-up Place Branding of a Neighborhood: Analyzing a Case of Selective Empowerment
Authors: Gerosa Alessandro , Tartari Maria
Published: July 2021

This article analyzes the entanglement of social impacts of bottom-up urban branding processes on local hyperdiverse communities, through an ethnography of a neighborhood of Milan recently named by a group of residents as “NoLo.” Indeed, existing literature has broadly investigated urban rebranding as a tool used by policy makers to foster social change and economic capital, imposing top-down transformations. Nevertheless, a gap in the bottom-up place rebranding processes exists. We inspect it through the aforementioned case study and by combining place branding literature, the loss of place identity and theories on empowerment. Empirically, we analyze the socioeconomic processes and the actors that enabled the rebranding, discussing the positive externalities and the criticalities in terms of marginalization of weaker social groups and cultural hegemony. As for the theory, we contribute to the literature arguing that a bottom-up process is not enough to avoid a loss of place identity, as it can lead to selective empowerment.
Health outcomes in young adulthood among former child refugees in Denmark, Norway and Sweden: A cross-country comparative study
Authors: Dunlavy Andrea , Gauffin Karl , Berg Lisa , De Montgomery Christopher Jamil , Europa Ryan , Eide Ketil , Ascher Henry , Hjern Anders
Published: July 2021

Aims:

This study aimed at comparing several health outcomes in young adulthood among child refugees who settled in the different immigration and integration policy contexts of Denmark, Norway and Sweden.

Methods:

The study population included refugees born between 1972 and 1997 who immigrated before the age of 18 and settled in the three Nordic countries during 1986–2005. This population was followed up in national registers during 2006–2015 at ages 18–43 years and was compared with native-born majority populations in the same birth cohorts using sex-stratified and age-adjusted regression analyses.

Results:

Refugee men in Denmark stood out with a consistent pattern of higher risks for mortality, disability/illness pension, psychiatric care and substance misuse relative to native-born majority Danish men, with risk estimates being higher than comparable estimates observed among refugee men in Norway and Sweden. Refugee men in Sweden and Norway also demonstrated increased risks relative to native-born majority population men for inpatient psychiatric care, and in Sweden also for disability/illness pension. With the exception of increased risk for psychotic disorders, outcomes among refugee women were largely similar to or better than those of native-born majority women in all countries.

Conclusions:

The observed cross-country differences in health indicators among refugees, and the poorer health outcomes of refugee men in Denmark in particular, may be understood in terms of marked differences in Nordic integration policies. However, female refugees in all three countries had better relative health outcomes than refugee men did, suggesting possible sex differentials that warrant further investigation.
Ameliorative effect of allicin on vascular calcification via inhibiting endoplasmic reticulum stress
Authors: Wang Qin , Lin Ping , Feng Li , Ren Qian , Xie Xiaofeng , Zhang Bin
Published: July 2021

Objectives

Vascular calcification (VC) is an independent predictor for cardiovascular events and mortality. However, there are currently no effective methods to reverse or prevent it. The present study aimed to determine the ameliorative effect of allicin on VC.

Methods

VC model of rats was induced by high-dose vitamin D3, which was valued by Alizarin Red staining, calcium contents, and alkaline phosphatase in the aorta. Systolic blood pressure, pulse pressure, and pulse wave velocity were measured to determine aortic stiffness. Protein levels were detected by Western blot.

Results

Allicin treatment rescued aortic VC and stiffness. The increased protein levels of RUNX2 and BMP2, two markers of osteoblastic phenotype of vascular smooth muscle cells, in the calcified aorta were attenuated by allicin, whereas the decreased levels of calponin and SM22α induced by calcification were improved. Allicin treatment significantly attenuated the increased protein levels of GRP78, GRP94, and CHOP, which are key markers of endoplasmic reticulum stress, in the calcified aorta. The activation of PERK/eIF2α/ATF4 cascades was also prevented by allicin.

Conclusions

Allicin could ameliorate aortic VC and stiffness. The ameliorative effect of allicin on VC might be mediated by inhibiting PERK/eIF2α/ATF4 cascades. Our results might provide a new proof for VC treatment.
Comparative chloroplast genome analysis of Impatiens species (Balsaminaceae) in the karst area of China: insights into genome evolution and phylogenomic implications
Authors: Luo Chao , Huang Wulue , Sun Huayu , Yer Huseyin , Li Xinyi , Li Yang , Yan Bo , Wang Qiong , Wen Yonghui , Huang Meijuan , Huang Haiquan
Published: July 2021

Background

Impatiens L. is a genus of complex taxonomy that belongs to the family Balsaminaceae (Ericales) and contains approximately 1000 species. The genus is well known for its economic, medicinal, ornamental, and horticultural value. However, knowledge about its germplasm identification, molecular phylogeny, and chloroplast genomics is limited, and taxonomic uncertainties still exist due to overlapping morphological features and insufficient genomic resources.

Results

We sequenced the chloroplast genomes of six different species (Impatiens chlorosepala, Impatiens fanjingshanica, Impatiens guizhouensis, Impatiens linearisepala, Impatiens loulanensis, and Impatiens stenosepala) in the karst area of China and compared them with those of six previously published Balsaminaceae species. We contrasted genomic features and repeat sequences, assessed sequence divergence and constructed phylogenetic relationships. Except for those of I. alpicola, I. pritzelii and I. glandulifera, the complete chloroplast genomes ranging in size from 151,366 bp (I. alpicola) to 154,189 bp (Hydrocera triflora) encoded 115 distinct genes [81 protein-coding, 30 transfer RNA (tRNA), and 4 ribosomal RNA (rRNA) genes]. Moreover, the characteristics of the long repeat sequences and simple sequence repeats (SSRs) were determined. psbK-psbI, trnT-GGU-psbD, rpl36-rps8, rpoB-trnC-GCA, trnK-UUU-rps16, trnQ-UUG, trnP-UGG-psaJ, trnT-UGU-trnL-UAA, and ycf4-cemA were identified as divergence hotspot regions and thus might be suitable for species identification and phylogenetic studies. Additionally, the phylogenetic relationships based on Maximum likelihood (ML) and Bayesian inference (BI) of the whole chloroplast genomes showed that the chloroplast genome structure of I. guizhouensis represents the ancestral state of the Balsaminaceae family.

Conclusion

Our study provided detailed information about nucleotide diversity hotspots and the types of repeats, which can be used to develop molecular markers applicable to Balsaminaceae species. We also reconstructed and analyzed the relationships of some Impatiens species and assessed their taxonomic statuses based on the complete chloroplast genomes. Together, the findings of the current study might provide valuable genomic resources for systematic evolution of the Balsaminaceae species.
Optimizing telemedical care in neurological outpatients by characterizing the patients’ needs in the physician–patient relationship—content analysis of guideline-based interviews
Authors: Hamann Till , Lemke Stella , Kropp Peter , Rimmele Florian , Jürgens Tim P. , Frielitz Fabian
Published: July 2021

Background

The use of new concepts in patient care, such as video-consultations, reminder systems, and online evaluation portals, is becoming increasingly important in the physician–patient relationship and outpatient care. This study examines the acceptance of these approaches in a neurological setting and determines the patients’ preferences.

Methods

We analyzed 16 guideline-based qualitative interviews with neurological patients using qualitative content analysis (inductive category formation).

Results

The patients commented on the benefits and challenges of integrating new concepts of medical care. They identified advantages of telemedical care, including time savings (7 of 16; 43,8%) for both the patient and the physician, the prospect of more intensive (4 of 16; 25%) care, and the possibility for a quick response in case of urgent needs (3 of 16; 18.8%). Several challenges were reported, such as the limitations for patients with psychiatric (2 of 16; 12.5%) or complex diseases (4 of 16; 25%) and limited options for diagnostic procedures (such as physical examination (4 of 16; 25%)).

For individual neurological patients' needs, telemedical and telecommunication structures could be discussed, which support the patients' specific requirements, such as answering questions while having a recall (2 of 16; 12.5%) and avoiding the journey (8 of 16; 50%). Also, patients are rejecting evaluation portals and are skeptical of telecare in the treatment of neurological diseases.

Discussion

The perception of telemedical care and the successful integration of new medical care concepts depend on fulfilling the individual patient’s needs. Regardless of the preferred nature of physician–patient interactions, there are specific instruments that can intensify the relationship. These individual needs of the patients must be inquired about and accommodated for.

Conclusions

For the first time, we could characterize the properties of optimal telemedical care for neurological patients. Interviews like the ones we conducted should be repeated during and after the pandemic, referring to our results and compare.
AMIC for traumatic focal osteochondral defect of the talar shoulder: a 5 years follow-up prospective cohort study
Authors: Götze Christian , Nieder Christian , Felder Hanna , Peterlein Christian Dominik , Migliorini Filippo
Published: July 2021

Background

Autologous Matrix-Induced Chondrogenesis (AMIC) is addressed to osteochondral defects of the talus. However, evidence concerning the midterm efficacy and safety of AMIC are limited. This study assessed reliability and feasibility of AMIC at 60 months follow-up. We hypothesize that AMIC leads to good clinical outcome at midterm follow-up.

Methods

Surgeries were approached with an arthrotomy via malleolar osteotomy. A resorbable porcine I/III collagen membrane (Chondro-Gide®, Geistlich Pharma AG, Wolhusen, Switzerland) was used. Patients were followed at 24 and 60 months. The primary outcome of interest was to analyse the Foot Function Index (FFI), and the subscale hindfoot of the American Orthopaedic Foot and Ankle Score (AOFAS). Complications such as failure, revision surgeries, graft delamination, and hypertrophy were also recorded. The secondary outcome of interest was to investigate the association between the clinical outcome and patient characteristics at admission.

Results

Data from 19 patients were included. The mean age at admission was 47.3 ± 13.2 years, and the mean BMI 24.1 ± 4.9 kg/m2. 53% (10 of 19 patients) were female. At a mean of 66.2 ± 11.6 months, the FFI decreased at 24-months follow-up of 22.5% (P = 0.003) and of further 1.3% (P = 0.8) at 60-months follow-up. AOFAS increased at 24-months follow-up of 17.2% (P = 0.003) and of further 3.4 (P = 0.2) at 60-months follow-up. There were two symptomatic recurrences within the follow-up in two patients. There was evidence of a strong positive association between FFI and AOFAS at baseline and the same scores last follow-up (P = 0.001 andP = 0.0002, respectively).

Conclusion

AMIC enhanced with cancellous bone graft demonstrated efficacy and feasibility for osteochondral defects of the talus at five years follow-up. The greatest improvement was evidenced within the first two years. These results suggest that clinical outcome is influenced by the preoperative status of the ankle. High quality studies involving a larger sample size are required to detect seldom complications and identify prognostic factors leading to better clinical outcome.

Level of evidence

II, prospective cohort study.
Management of chronic lung diseases in Sudan and Tanzania: how ready are the country health systems?
Authors: Egere Uzochukwu , Shayo Elizabeth , Ntinginya Nyanda , Osman Rashid , Noory Bandar , Mpagama Stella , Hussein ElHafiz , Tolhurst Rachel , Obasi Angela , Mortimer Kevin , Sony Asma El , Taegtmeyer Miriam ,   The IMPALA Consortium, Addo-Yobo Emmanuel , Allwood Brian , Banda Hastings , Bates Imelda , Binegdie Amsalu , Falade Adegoke , Khan Jahangir , Lesosky Maia , Mbatchou Bertrand , Meme Hellen , Mutayoba Beatrice , Niessen Louis , Rylance Jamie , Worodria William , Zar Heather , Zulu Eliya , Zurba Lindsay , Squire S Bertel
Published: July 2021

Background

Chronic lung diseases (CLDs), responsible for 4 million deaths globally every year, are increasingly important in low- and middle-income countries where most of the global mortality due to CLDs currently occurs. As existing health systems in resource-poor contexts, especially sub-Saharan Africa (SSA), are not generally oriented to provide quality care for chronic diseases, a first step in re-imagining them is to critically consider readiness for service delivery across all aspects of the existing system.

Methods

We conducted a mixed-methods assessment of CLD service readiness in 18 purposively selected health facilities in two differing SSA health system contexts, Tanzania and Sudan. We used the World Health Organization’s (WHO) Service Availability and Readiness Assessment checklist, qualitative interviews of key health system stakeholders, health facility registers review and assessed clinicians’ capacity to manage CLD using patient vignettes. CLD service readiness was scored as a composite of availability of service-specific tracer items from the WHO service availability checklist in three domains: staff training and guidelines, diagnostics and equipment, and basic medicines. Qualitative data were analysed using the same domains.

Results

One health facility in Tanzania and five in Sudan, attained a CLD readiness score of ≥ 50 % for CLD care. Scores ranged from 14.9 % in a dispensary to 53.3 % in a health center in Tanzania, and from 36.4 to 86.4 % in Sudan. The least available tracer items across both countries were trained human resources and guidelines, and peak flow meters. Only two facilities had COPD guidelines. Patient vignette analysis revealed significant gaps in clinicians’ capacity to manage CLD. Key informants identified low prioritization as key barrier to CLD care.

Conclusions

Gaps in service availability and readiness for CLD care in Tanzania and Sudan threaten attainment of universal health coverage in these settings. Detailed assessments by health systems researchers in discussion with stakeholders at all levels of the health system can identify critical blockages to reimagining CLD service provision with people-centered, integrated approaches at its heart.
Developing and implementing a model of equitable distribution of mentorship in districts with spatial inequities and maldistribution of human resources for maternal and newborn care in Rwanda
Authors: Ngabonzima Anaclet , Kenyon Cynthia , Kpienbaareh Daniel , Luginaah Isaac , Mukunde Gisele , Hategeka Celestin , Cechetto David F.
Published: July 2021

Background

The shortage of health care providers (HCPs) and inequity in their distribution along with the lack of sufficient and equal professional development opportunities in low-income countries contribute to the high mortality and morbidity of women and newborns. Strengthening skills and building the capacity of all HCPs involved in Maternal and Newborn Health (MNH) is essential to ensuring that mothers and newborns receive the required care in the period around birth. The Training, Support, and Access Model (TSAM) project identified onsite mentorship at primary care Health Centers (HCs) as an approach that could help reduce mortality and morbidity through capacity building of HCPs in Rwanda. This paper presents the results and lessons learnt through the design and implementation of a mentorship model and highlights some implications for future research.

Methods

The design phase started with an assessment of the status of training in HCs to inform the selection of Hospital-Based Mentors (HBMs). These HBMs took different courses to become mentors. A clear process was established for engaging all stakeholders and to ensure ownership of the model. Then the HBMs conducted monthly visits to all 68 TSAM assigned HCs for 18 months and were extended later in 43 HCs of South. Upon completion of 6 visits, mentees were requested to assist their peers who are not participating in the mentoring programme through a process of peer mentoring to ensure sustainability after the project ends.

Results

The onsite mentorship in HCs by the HBMs led to equal training of HCPs across all HCs regardless of the location of the HC. Research on this mentorship showed that the training improved the knowledge and self-efficacy of HCPs in managing postpartum haemorrhage (PPH) and newborn resuscitation. The lessons learned include that well trained midwives can conduct successful mentorships at lower levels in the healthcare system. The key challenge was the inconsistency of mentees due to a shortage of HCPs at the HC level.

Conclusions

The initiation of onsite mentorship in HCs by HBMs with the support of the district health leaders resulted in consistent and equal mentoring at all HCs including those located in remote areas.
HOXB7 acts as an oncogenic biomarker in head and neck squamous cell carcinoma
Authors: Wu Xiang , Li Jin , Yan Tingyuan , Ke Xueping , Li Xin , Zhu Yumin , Yang Jianrong , Li Zhongwu
Published: July 2021

Background

The homeobox gene Homeobox B7 (HOXB7) is overexpressed across a range of cancers and promotes tumorigenesis through varying effects on proliferation, survival, migration and invasion. However, its expression pattern and oncogenic role of HOXB7 in head and neck squamous cell carcinoma (HNSCC) remain largely unexplored. Here, we aimed to explore the expression pattern of HOXB7, its clinical significance as well as functional roles in HNSCC.

Methods

HOXB7 mRNA expression in HNSCC was determined by data mining and analyses from TCGA (The Cancer Genome Atlas) and GEO (Gene Expression Omnibus) datasets. The protein abundance of HOXB7 was measured by immunohistochemistry in 119 primary HNSCC samples and associations between its expression and clinicopathological parameters and patient survival were evaluated. The pro-tumorigenic roles of HOXB7 in HNSCC were further delineated in vitro by loss-of-function assay. And a xenograft tumor model was established in nude mice to assess the role of HOXB7 in tumor growth. Connectivity Map (CMap) analysis was performed to identify bioactive small molecules which might be potential inhibitors for HOXB7.

Results

Bioinformatics analyses showed that HOXB7 mRNA was significantly overexpressed in 8 independent HNSCC datasets from TCGA and GEO databases. HOXB7 protein was markedly upregulated in HNSCC samples as compared to normal counterparts and its overexpression significantly associated with high pathological grade, advanced clinical stage, cervical node metastasis (P = 0.0195, 0.0152, 0.0300) and reduced overall and disease-free survival (P = 0.0014, 0.0007). Univariate and multivariate Cox regression analyses further revealed HOXB7 as an independent prognostic factor for patients’ overall survival. Moreover, HOXB7 knockdown significantly inhibited cell proliferation, migration and invasion and induced cell apoptosis in HNSCC cells, and resulted in compromised tumour growth in vivo. Furthermore, CMap (Connectivity map) analysis has identified three potential bioactive small molecule inhibitors (NU-1025, thiamine, vinburnine) for HOXB7 targeted therapy in HNSCC.

Conclusions

Our findings revealed that overexpression of HOXB7 was associates with tumour aggressiveness and unfavourable prognosis by serving a novel prognostic biomarker in HNSCC. Moreover, HOXB7 might be involved in the development and progression of HNSCC as an oncogene, and thereby might be a potential therapeutic target for HNSCC.
Modified pedicle screw-rod versus anterior subcutaneous internal pelvic fixation for unstable anterior pelvic ring fracture: a retrospective study and finite element analysis
Authors: Pan Zhi-Hong , Chen Fan-Cheng , Huang Jun-Ming , Sun Cheng-Yi , Ding Sheng-Long
Published: July 2021

Objectives

This study compared the stability and clinical outcomes of modified pedicle screw-rod fixation (MPSRF) and anterior subcutaneous internal pelvic fixation (INFIX) for the treatment of anterior pelvic ring fractures using the Tornetta and Matta grading system and finite element analyses (FEA).

Methods

In a retrospective review of a consecutive patient series, 63 patients with Orthopaedic Trauma Association (OTA)/Arbeitsgemeinschaft für Osteosynthesefragen (AO) type B or C pelvic ring fractures were treated by MPRSF (n = 30) or INFIX (n = 33). The main outcome measures were the Majeed score, incidence of complications, and adverse outcomes, and fixation stability as evaluated by finite element analysis.

Results

Sixty-three patients were included in the study, with an average age of 34.4 and 36.2 in modified group and conventional group, respectively. Two groups did not differ in terms of the injury severity score, OTA classification, cause of injury, and time to pelvic surgery. However, the MPSRF group had a rate of higher satisfactory results according to the Tornetta and Matta grading system than the conventional group (73.33% vs 63.63%) as well as a higher Majeed score (81.5 ± 10.4 vs 76.3 ± 11.2), and these differences were statistically significant at 6 months post-surgery. FEA showed that MPSRF was stiffer and more stable than INFIX and had a lower risk of implant failure.

Conclusions

Both MPSRF and INFIX provide acceptable biomechanical stability for the treatment of unstable anterior pelvic ring fractures. However, MPSRF provides better fixation stability and a lower risk of implant failure, and can thus lead to better clinical outcomes. Therefore, MPSRF should be more widely applied to anterior pelvic ring fractures
Value of preoperative computed tomography for meso-Rex bypass in children with extrahepatic portal vein obstruction
Authors: Wu Huiying , Zhou Ning , Lu Lianwei , Chen Xiwen , Liu Tao , Zhang Binbin , Liu Hongsheng , Wen Zhe
Published: July 2021

Background

Extrahepatic portal vein obstruction (EHPVO) is the most important cause of hematemesis in children. Intrahepatic left portal vein and superior mesenteric vein anastomosis, also known as meso-Rex bypass (MRB), is becoming the gold standard treatment for EHPVO. We analyzed the value of preoperative computed tomography (CT) in determining whether MRB is feasible in children with EHPVO.

Results

We retrieved data on 76 children with EHPVO (50 male, 26 female; median age, 5.9 years) who underwent MRB (n = 68) or the Warren procedure (n = 8) from 2013 to 2019 and retrospectively analyzed their clinical and CT characteristics. The Rex recess was categorized into four subtypes (types 1–4) depending on its diameter in CT images. Of all 76 children, 7.9% had a history of umbilical catheterization and 1.3% had leukemia. Sixteen patients (20 lesions) had associated malformations. A total of 72.4% of Rex recesses could be measured by CT, and their mean diameter was 3.5 ± 1.8 mm (range 0.6–10.5 mm). A type 1, 2, 3, and 4 Rex recess was present in 9.2%, 53.9%, 11.8%, and 25.0% of patients, respectively. MRB could be performed in patients with types 1, 2, and 3, but those with type 4 required further evaluation. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of CT were 100%, 83.8%, 42.1%, 100%, and 85.5%, respectively.

Conclusions

Among the four types of Rex recesses on CT angiography, types 1–3 allow for the performance of MRB.
Fish otoliths from the early Miocene of Chile: a window into the evolution of marine bony fishes in the Southeast Pacific
Authors: Schwarzhans Werner W. , Nielsen Sven N.
Published: July 2021

Few fossil fish otolith associations have been described from the Pacific side of the Americas and, except for a single species (Steindachneria svennielseni), none have been described from Pacific South America south of the Central American tropical region. Here, we describe a rich otolith assemblage obtained from fifteen early Miocene outcrop locations along the Chilean coast from about 33°S to about 45°S. More than 2,000 specimens were studied resulting in the recognition of 67 species, with 27 being new to science. This assemblage represents an important new data point distant from any previously known otolith-based fish fauna, with the nearest coeval associations being from the Caribbean Province in Venezuela, which lies about 5000 km to the north, and New Zealand, which is about 9000 km to the west. The fauna represents a mixture of offshore and shallow water fishes and is rich in myctophids, paralichthyids (Citharichthys), ophidiids (Lepophidium), steindachneriids, and macrourids. Typical tropical American fishes are nearly completely absent, with the exception of Steindachneria and certain anguilliforms. The mesopelagic faunal component, chiefly Myctophidae, shows a striking resemblance to the well-known coeval fish fauna from New Zealand, and both are interpreted as representing an early South Pacific mesopelagic bioprovince. The strong correlation with the mesopelagic otolith-based fish fauna from New Zealand constricts the time interval of the sampled sediments to the middle Burdigalian (approximately 17.5 to 18.5 Ma). All otoliths obtained from the early Miocene of Chile relate to extant fish groups of the area and few exotic components not currently present in the East Pacific. The sole exception is a morpho-type described as Navidadichthys which has an unresolved relationship, possibly with the Prototroctidae, a family that is today endemic to the freshwater and nearshore marine environments of Australia and New Zealand. The new taxa are in the sequence of taxonomic description: Pterothrissus transpacificus n. sp., Pythonichthys panulus n. sp., Chiloconger chilensis n. sp., Gnathophis quinzoi n.sp., Rhynchoconger chiloensis n. sp., Navidadichthys mirus n. gen. et n. sp., Maurolicus brevirostris n. sp., Polyipnus bandeli n. sp., Lampanyctus ipunensis n. sp., Physiculus pichi n. sp., Coelorinchus fidelis n. sp., Coelorinchus rapelanus n. sp., Nezumia epuge n. sp., Paracarapus chilensis n. gen. et n. sp., Lepophidium chonorum n. sp., Lepophidium mapucheorum n. sp., Sirembola supersa n. sp., Spectrunculus sparsus n. sp., Pseudonus humilis n. sp., Capromimus undulatus n. sp., Agonopsis cume n. sp., Cottunculus primaevus n. sp., Kuhlia orientalis n. sp., Citharichthys parvisulcus n. sp., Citharichthys vergens n. sp., Achirus australis n. sp., Achirus chungkuz n. sp.

ZooBank LSID: urn:lsid:zoobank.org:pub:38A10A21-ECAA-4BBE-BF9B-3D9204B69CA4 https://zoobank.org/B0213E37-6E6F-445B-9B2B-B03494659964.