bluuebunny/crossref_metadata_2025 huggingface dataset:
Should Dehydroepiandrosterone Be Administered to Women?
Authors: Wierman Margaret E , Kiseljak-Vassiliades Katja
Published: March 2022

Context

Androgen prohormones such as dehydroepiandrosterone (DHEA) increase in early puberty, peak in the second and third decade, and thereafter decline, independent of menopausal status. Investigators have examined their potential beneficial effects in normal women and those with DHEA-deficient states.

Evidence Acquisition

A review of the literature from 1985 to 2021 on the potential benefits and risks of androgen prohormones in women.

Evidence Synthesis

Studies have examined the potential benefit of DHEA therapy for anti-aging, sexual dysfunction, infertility, metabolic bone health, cognition, and wellbeing in hormone-deficient states such as primary adrenal insufficiency, hypopituitarism, and anorexia as well as administration to normal women across the lifespan.

Conclusions

Data support small benefits in quality of life and mood but not for anxiety or sexual function in women with primary or secondary adrenal insufficiency or anorexia. No consistent beneficial effects of DHEA administration have been observed for menopausal symptoms, sexual function, cognition, or overall wellbeing in normal women. Local administration of DHEA shows benefit in vulvovaginal atrophy. Use of DHEA to improve induction of ovulation response in women with diminished ovarian reserve is not recommended. Risks of high physiologic or pharmacologic use of DHEA include androgenic and estrogenic side effects which are of concern for long-term administration.

Clinical Case

A 49-year-old woman with Addison’s disease who is on low dose estrogen with cyclic progesterone therapy for menopausal symptoms returns for follow-up. She is on a stable glucocorticoid replacement strategy of hydrocortisone 10 mg in the morning and 5 mg in the early afternoon and fludrocortisone 0.05 mg each morning. She has read on the internet that additional therapy with DHEA may help her overall quality of life and libido. She asks whether she should add this therapy to her regimen and at what dose.
Molecular divergence of mammalian astrocyte progenitor cells at early gliogenesis
Authors: Liu Jiancheng , Wu Xiwei , Lu Qiang
Published: March 2022

During mammalian brain development, how different astrocytes are specified from progenitor cells is not well understood. In particular, whether astrocyte progenitor cells (APCs) start as a relatively homogenous population or whether there is early heterogeneity remains unclear. Here, we have dissected subpopulations of embryonic mouse forebrain progenitors using single-cell transcriptome analyses. Our sequencing data revealed two molecularly distinct APC subgroups at the start of gliogenesis from both dorsal and ventral forebrains. The two APC subgroups were marked, respectively, by specific expression of Sparc and Sparcl1, which are known to function in mature astrocytes with opposing activities for regulating synapse formation. Expression analyses showed that SPARC and SPARCL1 mark APC subgroups that display distinct temporal and spatial patterns, correlating with major waves of astrogliogenesis during development. Our results uncover an early molecular divergence of APCs in the mammalian brain and provide a useful transcriptome resource for the study of glial cell specification.
Circulating Lipid- and Inflammation-Based Risk (CLIR) Score: A Promising New Model for Predicting Outcomes in Complete Colorectal Liver Metastases Resection
Authors: Bai Long , Yan Xiao-Luan , Lu Yun-Xin , Meng Qi , Rong Yu-Ming , Ye Liu-Fang , Pan Zhi-Zhong , Xing Bao-Cai , Wang De-Shen
Published: March 2022

Background

Colorectal cancer liver metastasis (CRLM) is a determining factor affecting the survival of colorectal cancer (CRC) patients. This study aims at developing a novel prognostic stratification tool for CRLM resection.

Methods

In this retrospective study, 666 CRC patients who underwent complete CRLM resection from two Chinese medical institutions between 2001 and 2016 were classified into the training (341 patients) and validation (325 patients) cohorts. The primary endpoint was overall survival (OS). Associations between clinicopathological variables, circulating lipid and inflammation biomarkers, and OS were explored. The five most significant prognostic factors were incorporated into the Circulating Lipid- and Inflammation-based Risk (CLIR) score. The predictive ability of the CLIR score and Fong’s Clinical Risk Score (CRS) was compared by time-dependent receiver operating characteristic (ROC) analysis.

Results

Five independent predictors associated with worse OS were identified in the training cohort: number of CRLMs >4, maximum diameter of CRLM >4.4 cm, primary lymph node-positive, serum lactate dehydrogenase (LDH) level >250.5 U/L, and serum low-density lipoprotein-cholesterol (LDL-C)/high-density lipoprotein-cholesterol (HDL-C) ratio >2.9. These predictors were included in the CLIR score and each factor was assigned one point. Median OS for the low (score 0–1)-, intermediate (score 2–3)-, and high (score 4–5)-risk groups was 134.0 months, 39.9 months, and 18.7 months in the pooled cohort. The CLIR score outperformed the Fong score with superior discriminatory capacities for OS and RFS, both in the training and validation cohorts.

Conclusions

The CLIR score demonstrated a promising ability to predict the long-term survival of CRC patients after complete hepatic resection.
Sustained ethical analysis of global dilemmas and country-level decision making during and post the COVID-19 pandemic: A systematic review
Authors: Sarfraz Azza , Sarfraz Zouina , Ashraf Mohammad , Ashraf Huma
Published: March 2022

The COVID-19 pandemic has highlighted the vulnerability of countries worldwide and their abilities to cope with the fast-paced demands of the research and medical community. A key to promoting ethical decision-making frameworks is by calibrating the sustainability at regional, national, and global levels to incorporate coordinated reforms. We performed a sustained ethical analysis and critically reviewed evidence addressing country-level responses to practices during the COVID-19 pandemic using PubMed (MEDLINE), Scopus, and CINAHL. The World Health Organization’s ethical framework proposed for the entire population during the pandemic was applied to thematically delineate findings under equality, best outcomes (utility), prioritizing the worst off, and prioritizing those tasked with helping others. The findings demarcate ethical concerns about the validity of drug and vaccine trials in developing and developed countries, hints of unjust healthcare organizational policies, lack of equal allocation of pertinent resources, miscalculated allocation of resources to essential workers and stratified populations.

doi: https://doi.org/10.12669/pjms.38.4.4755

How to cite this:Sarfraz A, Sarfraz Z, Ashraf M, Ashraf H. Sustained ethical analysis of global dilemmas and country-level decision making during and post the COVID-19 pandemic: A systematic review. Pak J Med Sci. 2022;38(4):---------.  doi: https://doi.org/10.12669/pjms.38.4.4755

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Effectiveness of lever sign test for diagnosing anterior cruciate ligament rupture
Authors: Shair Naveed Ali , Siddiq Umair Abubakar , Tariq Abdullah , Khalid Muhammad
Published: March 2022

Objective: To evaluate the effectiveness of the Lever Sign test (LST) for diagnosing anterior cruciate ligament (ACL) ruptures.

Methods: This prospective trial was conducted from January to December 2020. A total of 73 patients, aged 18 to 65 years, presenting with chief complaint as acute knee pain rated < 7/10 on a verbal numerical rating scale, having a minimum 20 to 1200 range of motion and undergoing magnetic resonance imaging (MRI) were enrolled. Detailed history, physical examination and standard radiographic evaluation were done in all subjects. For the assessment of the integrity of the ACL, the anterior drawer, Lachman, pivot-shift and LST were performed on each symptomatic knee by a senior orthopedic consultant with a minimum five years post-fellowship experience. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of the LST were recorded with respect to standard reference MRI findings.

Results: Out of a total of 73 patients, there were 49 (67.1%) males. Mean age was noted to be 34.5±8.1 years. Area of residence was rural among 42 (57.5%) patients. Mean time since injury was noted to be 11.2±4.6 months. The MRI findings showed ACL intact among 31 (42.4%) patients while it showed ACL torn among 42 (57.5%) patients. The LST showed positive findings for ACL rupture in 39 (53.5%) patients while it was negative in remaining 34 (46.5%). The sensitivity, specificity, PPV, NPV and accuracy of LST with respect to standard reference finding (MRI) was found to be 86%, 90%, 92%, 82% and 88% respectively.

Conclusion: The LST was found to have good specificity, sensitivity, PPV, NPV and accuracy to detect the status of the ACL. The LST is easy to perform can be used along with other standard assessment techniques to further increase the validation of the status of the ACL diagnosis.

doi: https://doi.org/10.12669/pjms.38.4.4993

How to cite this:Shair NA, Siddiq UA, Tariq A, Khalid M. Effectiveness of lever sign test for diagnosing anterior cruciate ligament rupture. Pak J Med Sci. 2022;38(4):---------. doi: https://doi.org/10.12669/pjms.38.4.4993

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
The IC-50-time evolution is a new model to improve drug responses consistency of large scale studies
Authors: ALILECHE ABDELKRIM
Published: March 2022

Abstract: Large-scale studies combining hundreds of cancer cell lines and many cancer drugs, with their promises and challenges, represent a new development in the in vitro screening of cancer drugs. However, drugs sensitivity results of the same cancer cell lines exposed to the same cancer drugs generated different IC50s by these studies as noticed by Haibe-Kains B et al (1). These inconsistencies are due to many factors: the experimental conditions and the use of the Four Parameter Logistic (4PL) regression model to analyze drugs sensitivity results. A new model based on the Levasseur LM et al model, the Gompertzian growth model of in vitro monolayer culture, and the IC-50 time course evolution is more appropriate to improve the accuracy of these large scale studies.
Performance of the T cell senescence markers in predicting the active disease of systemic lupus erythematosus
Authors: Handono Kusworini , Pratama Mirza Zaka , Partan Radiyati Umi , Susianti Hani , Firdaningrum Nimas Eka , Famuji Siti Roziah Ria , Fachry Ade Wildan Rizky , Sumarta Norma Hanifah , Kalim Handono
Published: March 2022

Background: Accelerated immunosenescence has been observed in several autoimmune diseases, including systemic lupus erythematosus (SLE). T cell senescence plays an essential role in the destruction of organs in SLE patients. This study aimed to identify the ability of immunosenescence markers to predict SLE disease activity.

Methods: Overall, 61 SLE patients and 60 healthy subjects were enrolled in this cross-sectional study. The Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score assessed disease activity. Senescence surface markers of CD4 and CD8 T lymphocytes were measured by flow cytometry (CD4/CD8 ratio, CD28null, CD57, CD45 isoforms [CD45RA and CD45RO], and KLRG1). Enzyme-linked immunosorbent assay (ELISA) was used to measure the serum cytokines (IFNγ and IL-2) and cytomegalovirus (CMV) serology. Complement and anti-dsDNA levels were also evaluated as the comparator for predicting active disease in SLE. Logistic regression models were used to identify the independent predictive factors for active SLE status. Performance of the senescence markers in predicting active disease in SLE was analyzed by receiver operating characteristic (ROC) curve as the area under curve (AUC).

Results: SLE patients with active disease had significantly higher CD8+CD28null, CD8+CD57+, CD8+CD45RA+, CD8+CD45RO+, and CD8+KLRG1+ percentages with lower CD4/CD8 ratio than healthy subjects and SLE patients with inactive disease. The highest AUC and sensitivity were seen in CD8+CD28null (AUC 0.801 [0.662-0.940], sensitivity 91.9%, cut off >6.85%) with comparable results to serum complement and anti-dsDNA in predicting active disease. Multivariate analysis showed that CD4/CD8 ratio, CD8+CD28null, and C3 had significantly increased OR for active SLE. Combination models of CD4/CD8 ratio, CD8+CD28null, and C3 yielded the best results for predicting the active SLE (AUC 0.923 [0.848-0.997], sensitivity 81.2%, specificity 84.0%, LR+ 5.08 and LR- 0.22).

Conclusions: Our findings demonstrated that combining immunosenescence markers, including CD4/CD8 ratio and CD8+CD28null with C3 levels could increase the odds of predicting active disease in SLE.
Evaluation of Preclinical Task Based Learning program in Medical Education
Authors: Shenoy Roopashree , Jain Animesh , K Bhagyalaksmi , Shirali Arun , Shetty Sneha , Ramakrishna Anand
Published: March 2022

The conventional curriculum in preclinical medical education has a need for early clinical exposure programs that help in correlation of basic science data with clinical skills. This is helpful to develop clinical reasoning skills, problem-solving abilities, team work, communication skills and overall attitudes and behaviour relevant for a healthcare provider. Preclinical task based learning (TskBL) is an active learning strategy in which the focus for the first year medical student is a real task done by a doctor. In this strategy the student-doctors undergo a standardized patient encounter and discuss the learning issues related to the task in the first year of medical school. The current study is focussed on the student perception of the effectiveness of task based learning module.The TskBL was conducted among first year medical students for nine topics that are commonly encountered in the clinics. After TskBL was planned and implemented the evaluation of the modules was done using focus group discussions. The students highlighted the importance of standardized patients in the TskBL strategy in providing early clinical exposure in preclinical medical education. They reported its usefulness gaining essential knowledge, skills and attitudes for medical learning. They reported positive outcomes of module design and processes and activities in TskBL. Based on the negative aspects of the modules, future improvement was suggested in improving the usefulness of standardized patient encounter. This study showed the novice learners’ outlook of the potency of TskBL for several other topics of clinical relevance to provide early clinical exposure in medical schools.
A visual approach towards forward collision warning for autonomous vehicles on Malaysian public roads
Authors: Wong Man Kiat , Connie Tee , Goh Michael Kah Ong , Wong Li Pei , Teh Pin Shen , Choo Ai Ling
Published: March 2022

Background: Autonomous vehicles are important in smart transportation. Although exciting progress has been made, it remains challenging to design a safety mechanism for autonomous vehicles despite uncertainties and obstacles that occur dynamically on the road. Collision detection and avoidance are indispensable for a reliable decision-making module in autonomous driving.

Methods: This study presents a robust approach for forward collision warning using vision data for autonomous vehicles on Malaysian public roads. The proposed architecture combines environment perception and lane localization to define a safe driving region for the ego vehicle. If potential risks are detected in the safe driving region, a warning will be triggered. The early warning is important to help avoid rear-end collision. Besides, an adaptive lane localization method that considers geometrical structure of the road is presented to deal with different road types.

Results: Precision scores of mean average precision (mAP) 0.5, mAP 0.95 and recall of 0.14, 0.06979 and 0.6356 were found in this study.

Conclusions: Experimental results have validated the effectiveness of the proposed approach under different lighting and environmental conditions.
eTRANSAFE: Building a sustainable framework to share reproducible drug safety knowledge with the public domain
Authors: Sarntivijai Sirarat , Blomberg Niklas , Lauer Katharina B. , Briggs Katharine , Steger-Hartmann Thomas , van der Lei Johan , Sauer John-Michael , Liwski Richard , Mourby Miranda , Camprubi Montse ,   The eTRANSAFE Consortium
Published: March 2022

Integrative drug safety research in translational health informatics has rapidly evolved and included data that are drawn in from many resources, combining diverse data that are either reused from (curated) repositories, or newly generated at source. Each resource is mandated by different sets of metadata rules that are imposed on the incoming data. Combination of the data cannot be readily achieved without interference of data stewardship and the top-down policy guidelines that supervise and inform the process for data combination to aid meaningful interpretation and analysis of such data.

The eTRANSAFE Consortium's effort to drive integrative drug safety research at a large scale hereby present the lessons learnt and the proposal of solution at the guidelines in practice at this Innovative Medicines Initiative (IMI) project. Recommendations in these guidelines were compiled from feedback received from key stakeholders in regulatory agencies, EFPIA companies, and academic partners. The research reproducibility guidelines presented in this study lay the foundation for a comprehensive data sharing and knowledge management plans accounting for research data management in the drug safety space - FAIR data sharing guidelines, and the model verification guidelines as generic deliverables that best practices that can be reused by other scientific community members at large.

FAIR data sharing is a dynamic landscape that rapidly evolves with fast-paced technology advancements. The research reproducibility in drug safety guidelines introduced in this study provides a reusable framework that can be adopted by other research communities that aim to integrate public and private data in biomedical research space.
Quantitative methods for group bibliotherapy research: a pilot study
Authors: Troscianko Emily T. , Holman Emily , Carney James
Published: March 2022

Background: Bibliotherapy is under-theorized and under-tested: its purposes and implementations vary widely, and the idea that ‘reading is good for you’ is often more assumed than demonstrated. One obstacle to developing robust empirical and theoretical foundations for bibliotherapy is the continued absence of analytical methods capable of providing sensitive yet replicable insights into complex textual material. This pilot study offers a proof-of-concept for new quantitative methods including VAD (valence–arousal–dominance) modelling of emotional variance and doc2vec modelling of linguistic similarity.

Methods: VAD and doc2vec modelling were used to analyse transcripts of reading-group discussions plus the literary texts being discussed, from two reading groups each meeting weekly for six weeks (including 9 participants [5 researchers (3 authors, 2 collaborators), 4 others] in Group 1, and 8 participants [2 authors, 6 others] in Group 2).

Results: We found that text–discussion similarity was inversely correlated with emotional volatility in the group discussions (arousal: r = -0.25; p = ns; dominance: r = 0.21; p = ns; valence: r = -0.28; p = ns), and that enjoyment or otherwise of the texts and the discussion was less significant than other factors in shaping the perceived significance and potential benefits of participation. That is, texts with unpleasant or disturbing content that strongly shaped subsequent discussions of these texts were still able to sponsor ‘healthy’ discussions of this content, as evidenced by the combination of low arousal plus high dominance despite low valence in the emotional qualities of the discussion.

Conclusions: Our methods and findings offer for the field of bibliotherapy research both new possibilities for hypotheses to test, and viable ways of testing them. In particular, the use of natural language processing methods and word norm data offer valuable complements to intuitive human judgement and self-report when assessing the impact of literary materials.
Respecting values and perspectives in biobanking and genetic research governance: Outcomes of a qualitative study in Bengaluru, India
Authors: Vaz Manjulika , Warrier Prasanna , Wai-Loon Ho Calvin , Bull Susan
Published: March 2022

Background: The promise of biobanking and genetic research (BGR) in the context of translational research towards improving public health and personalised medicine has been recognised in India. Worldwide experience has shown that incorporating stakeholders’ expectations and values into the governance of BGR is essential to address ethical aspects of BGR.  This paper draws on engagement with various stakeholders in the South Indian city of Bengaluru to understand how incorporating people’s values and beliefs can inform policy making decisions and strengthen BGR governance within India.

Methods: We adopted a qualitative research approach and conducted six focus group discussions with civil society members and seven in-depth interviews with key informants in BGR, identified through a targeted web search and snowballing methods, until data saturation was reached. Data were thematically analysed to identify emergent patterns.

Results: Specific themes relating to the ethics and governance of BGR emerged. Fears and uncertainty about future sample and data use, possibilities of discrimination and exploitation in the use of findings and the lack of comprehensive data protection policies in India along with expectations of enhanced contributor agency, control in future use of samples and data, benefit sharing, enhanced utility of samples, sustained BGR and public good, reflected tensions between different stakeholders’ values and beliefs. Fair governance processes through an independent governance committee for biobanks and a system of ongoing engagement with stakeholders emerged as best practice towards building trust and respecting diversity of views and values.

Conclusions: Ensuring public trust in BGR requires listening to stakeholders’ voices, being open to counter narratives, and a commitment to long term engagement embedded in principles of participatory democracy. This is central to a ‘people-centred governance framework’ involving a negotiated middle ground and an equilibrium of governance which promotes social justice by being inclusive, transparent, equitable, and trustworthy.
Cosmic Proportions and Human Significance
Authors: Slagle Jim
Published: March 2022

A common misperception, both within academia and without, is that the premodern, Judeo-Christian picture of the universe was of a small, cramped one. This allowed people to believe that the Earth and its inhabitants were the most important thing in it. But this misfires in several ways: First, the premodern cosmos is only small in comparison to what contemporary science has discovered, not absolutely. Second, the premoderns felt just as insignificant as we do in light of the universe’s size, but we cannot translate this into a scientific or philosophical argument. Third, it assumes that the Judeo-Christian view is that humanity is the most important thing (rather than God) and that God created the universe for us (rather than himself). Fourth, whatever value human beings have in the Judeo-Christian tradition is derivative, based on being created in God’s image, and the size of the universe has no bearing on it.
Zasięgi polskich grup etnograficznych
Authors: Kamocki Janusz
Published: March 2022

RANGES OF THE POLISH ETHNOGRAPHIC Many authors tried to elaborate a map of the Polish ethnographic groups – the most known is Ugrupowanie etniczne ludu polskiego [“The Ethnic Grouping of the Polish Folk”] of Jan Bystroń, published in 1925. The progress of research in 95 years, publication of many monographs – “Atlas Polskich Strojów Ludowych” [The Atlas of the Polish Folk Costumes] above all – caused that the work of Bystroń is already of archival value. Janusz Kamocki made an effort to elaborate a current range of the Polish ethnographic groups – as he writes at the end of his work “current in 2020”. Among Polish ethnographers, he has probably the greatest experience in research on this issue – he already published his elaborations in 1965 and 1991. Furthermore, he is the author of two issues of Atlas Polskich Strojów Ludowych. In principle, it is accepted that the Polish nation was created due to combining of six basic Lechitic tribes: Małopolanie, Wielkopolanie, Mazowszanie, Sieradzanie, Ślązacy and Pomorzanie. The author determines also the large group of Kresowiacy – created as a result of historical events – and group currently creating on the so-called recovered lands, establishing from settlers of different parts of Poland which he calls tentatively the “settlement group”. He also traces here a chance of creating new ethnographic groups. Moreover, he distinguishes two subgroups: Górale [Highlanders] – separated from Małopolanie and Ślązacy, and Mazurzy Pruscy [Prussian Masurians] – separated from Mazowszanie.
Economics of Ransomware: Risk Interdependence and Large-Scale Attacks
Authors: August Terrence , Dao Duy , Niculescu Marius Florin
Published: March 2022

Recently, the development of ransomware strains and changes in the marketplace for malware have greatly reduced the entry barrier for attackers to conduct large-scale ransomware attacks. In this paper, we examine how this mode of cyberattack impacts software vendors and consumer behavior. When victims face an added option to mitigate losses via a ransom payment, both the equilibrium market size and the vendor’s profit under optimal pricing can actually increase in the ransom demand. Profit can also increase in the scale of residual losses following a ransom payment (which reflect the trustworthiness of the ransomware operator). We show that for intermediate levels of risk, the vendor restricts software adoption by substantially hiking up price. This lies in stark contrast to outcomes in a benchmark case involving traditional malware (non-ransomware) where the vendor decreases price as security risk increases. Social welfare is higher under ransomware compared with the benchmark in both sufficiently low- and high-risk settings. However, for intermediate risk, it is better from a social standpoint if consumers do not have an option to pay ransom. We also show that the expected ransom paid is nonmonotone in risk, increasing when risk is moderate despite a decreasing ransom-paying population. For ransomware attacks on other vectors (beyond patchable vulnerabilities), there can still be an incentive to hike price. However, market size and profits instead weakly decrease in the ransom amount. When studying a generalized model that includes both traditional and ransomware attacks, our results remain robust to a wide range of scenarios, including threat landscapes where ransomware has only a small presence.

This paper was accepted by Kartik Hosanagar, information systems.

Funding: This work has been supported by the Haskayne School of Business' Dean's Research Grant and by an award from the Georgia Institute of Technology Center of International Business Education & Research as part of its funded research program.

Supplemental Material: The online appendix is available at https://doi.org/10.1287/mnsc.2022.4300 .
Refractory Peritonitis and Small Bowel Ileus: A Case of Encapsulating Peritoneal Sclerosis Secondary to Mycobacterium abscessus Peritonitis
Authors: Rouhani Soroush , Adunuri Nikesh
Published: March 2022

Introduction: Complications of peritoneal dialysis (PD) such as exit-site infections and PD peritonitis are common reasons for admission to General Internal Medicine wards. Culprit organisms range from typical skin flora to rarer complicated atypical organisms such as non-tuberculous mycobacteria. Encapsulating peritoneal sclerosis (EPS) is a rarer complication of PD characterized by peritoneal inflammation, ileus and fibrosis with high morbidity, few management options, and poor prognosis. Case Description: We report the case of a patient with a history of end-stage renal disease on peritoneal dialysis who presented with undifferentiated peritonitis and ileus refractory to standard antimicrobial therapy. Subsequent ascitic cultures were positive for Mycobacterium abscessus, and CT imaging was consistent with EPS. To date, EPS secondary to M. abscessus peritonitis has not previously been described. Discussion and Conclusion: This report describes the diagnostic process and treatment offered to this patient and his treatment outcomes over 8 months. It highlights the importance of prompt identification of patients at risk, timely eradication of high-risk pathogens, and transition to haemodialysis to limit morbidity and improve patient prognosis.
Is rationing of total hip arthroplasty justified? Working to optimize patient accessibility to surgery using long-term patient-reported outcome data
Authors: Walker Robert W. , Whitehouse Sarah L. , Howell Jonathan R. , Hubble Matthew J. W. , Timperley A. John , Wilson Matthew J. , Kassam Al-Amin M.
Published: March 2022

Aims

The aim of this study was to assess medium-term improvements following total hip arthroplasty (THA), and to evaluate what effect different preoperative Oxford Hip Score (OHS) thresholds for treatment may have on patients’ access to THA and outcomes.

Methods

Patients undergoing primary THA at our institution with an OHS both preoperatively and at least four years postoperatively were included. Rationing thresholds were explored to identify possible deprivation of OHS improvement.

Results

Overall, 2,341 patients were included. Mean OHS was 19.7 (SD 8.2) preoperatively and 39.7 (SD 9.8) at latest follow-up. An improvement of at least eight-points, the minimally important change (MIC), was seen in 2,072 patients (88.5%). The mean improvement was 20.0 points (SD 10.5). If a rationing threshold of OHS of 20 points had been enforced, 90.8% of those treated would have achieved the MIC, but only 54.3% of our cohort would have had access to surgery; increasing this threshold to 32 would have enabled 89.5% of those treated to achieve the MIC while only depriving 6.5% of our cohort. The ‘rationed’ group of OHS > 20 had significantly better OHS at latest follow-up (42.6 vs 37.3; p < 0.001), while extending the rationing threshold above 32 showed postoperative scores were more significantly affected by the ceiling effect of the OHS.

Conclusion

The OHS was not designed as a tool to ration healthcare, but if it had been used at our institution for this cohort, applying an OHS threshold of 20 to routine THA access would have excluded nearly half of patients from having a THA; a group in which over 85% had a significant improvement in OHS. Where its use for rationing is deemed necessary, use of a higher threshold may be more appropriate to ensure a better balance between patient access to treatment and chances of achieving good to excellent outcomes. Cite this article: Bone Jt Open 2022;3(3):196–204.
Strength Properties of Full-Size Oriented Strand Board Panels Following Submergence in Potable and Salt Water
Authors: Strayhorn Tyler , Mitchell Phil , Tilotta David
Published: March 2022

One of the largest contributors to the economic loss from floods is the complete or partial destruction of residential buildings, and finding ways to eliminate or minimize this loss is important. Oriented strand board (OSB) is a wood product commonly used in home construction, so a better understanding of how flood water affects its mechanical properties is warranted. In this study, the moduli of elasticity and rupture (MOE and MOR, respectively) of representative samples removed from full-size (4 by 8-ft [1.2 by 2.4 m]) OSB panels were examined following the submergence of the panels in potable and salt water (surrogates for flood water) for increasing periods of time (i.e., 8, 24, 48, 72, 168, and 336 h). The results of our study show that after 8 hours of panel submersion in potable water, MOR and MOE is reduced by 15 percent and 16 percent, respectively; no significant change was observed in MOR and MOE for panels soaked in salt water. After 168 hours, the MOR loss was 43 percent for panels soaked in potable water and 38 percent for panels soaked in salt water. For MOE, there was a 35 percent loss regardless of water type. Submersion of panels in either water type for an additional 168 hours resulted in no significant change in MOR or MOE. The MOR and MOE of samples removed from the edges of the submerged panels, for both water types, were lower than those of the interior samples. Finally, the decreases in average MOR and MOE following submergence in either water type were approximately independent of brand.
A Preliminary Assessment of Industry 4.0 and Digitized Manufacturing in the North American Woodworking Industry
Authors: Bumgardner Matthew , Buehlmann Urs
Published: March 2022

Industry 4.0, a term referring to the digitization of manufacturing, enhanced automation, and data-driven production systems, promises to bring rapid change to the secondary woodworking industry. Manufacturers in this sector, many being small in size and scale, may be challenged to remain competitive without understanding how Industry 4.0 principles might affect their operations. A study conducted with subscribers to a major secondary wood industry trade journal found that few North American woodworking companies were familiar with the term “Industry 4.0.” However, that did not mean they were not making decisions about, investing in, and implementing digitization–computerization (digit–comp) in their manufacturing operations. Well over half of study respondents indicated that their firms had made a significant investment in digit–comp over the past 3 years. Several respondents stated that software and technology integration was the most unexpected problem encountered, and that skilled labor was difficult to find. A variety of training types were sought by firms that had made significant Industry 4.0-related investments, especially training related to machine operation. Although a plurality of respondents from both small and large firms indicated that increased digit–comp would not change their number of employees, small firms were more likely to say more employees would be needed and large firms were more likely to perceive a decrease in employees. Perhaps the greatest challenge to successful implementation of Industry 4.0 will be the lack of a strategic plan—just 19 percent of small firms indicated having a vision of how digitization might affect their business.
Formen und Funktionen des Konjunktivs II in historischen ostoberdeutschen Predigten.
Authors: Pickl Simon
Published: March 2022

This article presents a diachronic survey of forms and functions of the subjunctive II grammatical category in historical German. The subjunctive II is historically based on the subjunctive preterit form but has lost its temporal function and become a purely modal category. It has developed a variety of synthetic and analytical forms since Old High German, especially in vernacular varieties, but also in Standard German, and fulfils a range of functions, chiefly that of non-affirmativity. The present study aims to shed light on the historical development of the subjunctive II’s form and function. Its focus is on East Upper German, and its temporal scope spans over a millennium from the 9th to the 19th century. In order to study the usage and development of the subjunctive II in historical East Upper German sermons, the south-eastern part of SermonC, a diachronic corpus of historical German sermons, is analysed. While this (sub‑)corpus is restricted in terms of region and genre, it provides a unique window to written language usage, variation and change in a clearly defined domain over a very long time. The results show that the refunctionalization of the subjunctive preterit as a purely modal category does not date to prehistoric times, as is generally assumed; instead, they point to the 11th century as the likely time for this change, with limited temporal uses persisting into the 15th century. The 15th century is also the time when the synthetic subjunctive II form with -et/-at, a typical feature of Bavarian dialects, seems to have emerged in the spoken register. Analytical forms started to appear from the 13th century, and the periphrasis with würde, today accepted in Standard German, prevailed among several written German analytical variants in the 18th century. While Standard German has preserved the distinction between two subjunctive categories, East Upper German spoken language has in effect reduced a two-way morphological system (tense and mood) to a pure mood system, with tense expressed syntactically, in effect refunctionalizing morphological tense as a mood marker.
Der Konjunktiv II in Salzburger Varietäten: Grammatik, Gebrauch, soziale Faktoren
Authors: Niehaus Konstantin , Kaiser Irmtraud , Mauser Peter
Published: March 2022

If one looks for linguistic information on the past subjunctive (Konjunktiv II) in Salzburg, there is not much to obtain. A few studies have commented on its morphology in dialect (Mauser 1998 und 2021a), the atlases of colloquial German (Eichhoff 1977–2000; Elspaß/Möller 2003–) provide some general insights as to the use of analytical forms, other studies aim at a broader scope on Bavarian dialects (e. g. Wiesinger 1989; Donhauser 1992). This article gives a first more detailed account. We present findings from a traditional dialectological investigation (relying on on-site interviews using a questionnaire) as well as a variationist analysis of online questionnaire data on colloquial Salzburg varieties. The dialectological analysis focuses on language-internal factors such as analytic vs. synthetic construction and variation of endings but also shows strong differences between the northern Flachgau, which surrounds the capital of Salzburg, and the remote and more rural southern Lungau. The online questionnaire allows for a quantitative inspection of the use of Konjunktiv II forms of brauchen, i. e. analytical vs. synthetical, (non-)use of umlaut, inflection with -ert/-at and -te. Statistical analysis shows that the participants’ preferences correlate with their age, region of origin, degree of education, and mobility: Younger speakers indicate the use of analytical forms more frequently, and standard (or near-standard) forms are favoured by participants near or directly from the city of Salzburg and those of higher education and mobility. In the end, we will shortly discuss the comparability of our outcomes and future research avenues, especially with regard to the Salzburg region and its neighbouring dialect areas.
Die Konjunktiv-II-Bildung im Kontext von Partikelverben in den Basisdialekten Salzburgs
Authors: Quehenberger Sonja , Bülow Lars , Vergeiner Philip C.
Published: March 2022

Focusing on phrasal verbs such as einbringen ‘to harvest’ or abbringen ‘to dissuade’, the aim of the present exploratory apparent-time study is to uncover factors affecting the subjunctive II formation in the traditional base dialects of Salzburg (Austria). Depending on whether the subjunctive II formation is synthetic or periphrastic, phrasal verbs are formed in contact position (e. g., würde/täte abbringen ‘would dissuade’) or in distance position (e. g. brächte ab ‘would dissuade’) between particle and verb stem.

In order to examine which subjunctive II variants are used for 15 phrasal verbs in the traditional dialects of Salzburg, an indirect survey was carried out with 25 informants in six rural locations. These villages are spread across the three dialect areas (West-Central Bavarian, South-Central Bavarian, and South Bavarian) cutting through the federal state of Salzburg. Furthermore, the subjunctive II formation of the phrasal verbs is compared to that of the simple verbs (e. g., bringen ‘to bring’) corresponding to the derivational bases of the respective phrasal verbs investigated (e. g., einbringen or abbringen). In addition to linguistic and areal factors, sociolinguistic factors (age and gender) are taken into account.

Results show that the subjunctive II formation of phrasal verbs differs significantly from that of simple verbs: compared to the corresponding simple verbs, the informants used the phrasal verbs significantly more often with periphrastic variants. It is argued that this tendency is related to specific semantic-lexical and morpho-syntactic properties of phrasal verbs. Regarding the areal distribution, there are differences between the individual locations. These differences do not correlate with the traditional dialect regions but can be traced back to the socio-demographic characteristics of the locations (number of inhabitants, transport connections, tourism etc.). Moreover, age proves to be a relevant factor: there is a statistically significant difference in both, simple verbs and phrasal verbs, with the younger informants preferring the periphrastic variants.
Der Konjunktiv II in den ruralen Basisdialekten Österreichs.
Authors: Vergeiner Philip C. , Bülow Lars
Published: March 2022

Until today, variation and change in the use of subjunctive II variants in the dialects of Austria have been poorly studied. Largely neglected by traditional dialectology, even more recent studies neither consider all dialect regions of Austria, nor do they go into detail about intra-linguistic factors. Furthermore, an integration into morpho-syntactic theories of language change is missing.

This paper addresses the above-mentioned desiderata. Using an apparent-time design, it intends to uncover linguistic, geographical, and sociolinguistic factors of variation and change in the use of subjunctive II variants in Austria’s dialects. In order to achieve these goals, a comprehensive corpus of direct dialect recordings is analysed by means of various quantitative methods (cluster analyses, factor analyses, mixed variance analyses). Data are based on the dialect translations of 21 verb forms by 163 speakers from 40 locations (3,430 tokens).

Overall, results show that periphrastic variants spread in the Austrian dialects, in particular periphrastic forms with the täte-auxiliary. Meanwhile, synthetic forms lose importance (both strong and weak synthetic forms). Moreover, results reveal significant verb-related differences which cannot be explained by their belonging to inflectional classes, as previous studies suggested. Instead, the 21 verbs studied can be divided into six clusters reflecting different stages in the spread of periphrastic forms. In terms of linguistic geography, Austria is divided into three parts with regard to subjunctive II variation: an Alemannic region in the west, a north-western Bavarian area, and a south-eastern Bavarian area. With respect to sociolinguistic factors, gender is hardly a relevant factor, whereas age turns out to be decisive. Younger speakers use periphrastic forms more often and synthetic variants less often. Finally, these empirical findings will be discussed against the background of the theory of Natural Morphology.
The Fly-by-Light system for military aircraft
Authors: NICOLIN Ilie , NICOLIN Bogdan Adrian
Published: March 2022

This paper presents the authors’ recent documentary research on the benefits of using the Fly-by-Light system in Military aircraft and the understanding of why Fly-by-Light (FBL) is very promising for the further development of military aircraft. The Fly-by-Light flight system is characterized by the fact that the input control signals from the pilot, motion data, and air data sensors are sent to the flight control computer and from there to the actuators of the control surfaces through a fiber optic cable and the feedback from actuators sensors or other signals is received in the same way, through fiber optic cable connected to the aircraft flight control computer. The first major step in the evolution of flight control systems was the replacement of mechanical flight control systems with a Fly-by-Wire (FBW) flight control system. The next major step is the replacement of Fly-by-Wire (FBW) flight control system with a Fly-by-Light (FBL) flight control system which has some significant advantages such as: reducing the weight of the system, increasing the speed and volume of information transmitted through fiber-optic cable (input and feedback signals), keeping intact the accuracy of the signals along the entire length of the circuit; also, the optical fibers do not present any risk of fire, as they carry only light signals, and the temperature, humidity, and severe weather conditions do not affect the fiber optic cable, which can withstand a pressure of about 0.69 - 1.38 MPa without damaging the cable, unaffected by Electromagnetic Interference (EMI) and the Electromagnetic Pulse (EMP) generated by nuclear blasts. All the advantages listed above provide tactical and safety advantages for the military aircraft and its crew.
Classical and Modern gain estimation approach of PID controller for the pitch control of the RCTA aircraft
Authors: JAISWAL Roli , PRAKASH Om
Published: March 2022

In the current age of globalization, the development of autopilots is superficial as the standard of living is improved through aerial surveillance, defense applications, and door- to-door transportation. To design the PID controller, a mathematical model is created to address the system identification for estimating longitudinal derivatives and to study the handling qualities of aircraft in order to improve piloting performance. This paper exhibits a comparative assessment between the classical closed-loop PID tuning methods like ZN, Modified ZN, Tyreus-luyben, Astrom- Hagglund and the modern control techniques like pole placement, LQR for the pitch controller design. The simulation results are displayed in the time-domain, which demonstrates the effectiveness of the approach used to design a robust controller.
Co-localized line-field confocal optical coherence tomography and confocal Raman microspectroscopy for three-dimensional high-resolution morphological and molecular characterization of skin tissues ex vivo
Authors: Waszczuk Léna , Ogien Jonas , Perrot Jean-Luc , Dubois Arnaud
Published: March 2022

Line-field confocal optical coherence tomography (LC-OCT) is an optical modality that provides three-dimensional (3D) images of the skin at cellular resolution. Confocal Raman microspectroscopy (CRM) is a label-free optical technique that can provide point measurement of the molecular content of the skin. This work presents a method to co-localize LC-OCT and CRM acquisitions for morpho-molecular analysis ofex vivoskin tissues at cellular level. The co-localization method allows acquisition of Raman spectra at specific locations in a sample identified from a 3D LC-OCT image, with an accuracy of ± 20 µm. The method was applied to the characterization of tattooed skin biopsies with adverse tattoo reactions. LC-OCT images allowed to target specific regions in the biopsies where the presence of tattoo ink was revealed by detection of the Raman signature of ink pigments. Micrometer-sized foreign bodies of various materials as well as inflammatory cells were also identified within the biopsies. From these results, we demonstrate the value of the LC-OCT-CRM co-localization method and its potential for futureex vivoanalysis of suspicious skin lesions.