bluuebunny/crossref_metadata_2025_split huggingface dataset:
Competitive tenders on analogue hospital pharmaceuticals in Denmark 2017–2020
Authors: Ehlers Lars Holger , Jensen Morten B. , Schack Henrik 
Published: October 2022

Abstract
Background
Competitive tenders on pharmaceuticals are one of the most effective cost-containment instruments in healthcare systems. Its effectiveness has been demonstrated, among other things, in markets for generic medicine and biosimilars. In Denmark, an internationally unique model for competitive tenders on analogue substitutable pharmaceuticals has been developed and implemented for all public hospitals.

Methods
We obtained data on all analogue competitive tenders carried out by the Danish Medicines Council from its foundation on January 1, 2017, to October 9, 2020. We calculated univariate descriptive statistics, pairwise correlations and made a multiple regression analysis on tender savings.

Results
Average annual saving on hospital pharmaceutical purchase prices was 44.1% ranging from 0.4% to 92.8% between therapeutic areas and areas of indication. There was a significant positive correlation between tender savings and the number of competitors participating in the tender, and a significant negative correlation between tender savings and the number of days since market authorization.

Conclusions
This study finds analogue tenders to be similar in effect and mechanism to competitive tenders in markets for generic medicine and biosimilars. It supports the increasing number of empirical findings that competitive tendering has a high potential to generate substantial savings on healthcare budgets.
Minimally invasive anatomic reconstruction of the anterolateral ligament with ipsilateral gracilis tendon: a kinematic in-vitro study
Authors: Muccioli Giulio Maria Marcheggiani , Rinaldi Vito Gaetano , Zappia Marcello , Lullini Giada , Bignozzi Simone , Zaffagnini Stefano , Trinchese Giovanni Felice 
Published: October 2022

Abstract
Purpose
The anterolateral ligament (ALL) has been defined as a key stabilizer of internal tibial rotation at 35° or more of knee flexion, with a minimal primary or secondary stabilizing role in the AP direction. This study aimed to demonstrate that anatomical reconstruction of the ALL confers rotational stability equal to that of the uninjured knee. Hypothesis: anteroposterior (AP) and rotatory laxity will significantly vary after ALL tenotomy and ALL reconstruction with the author’s previously described technique.

Methods
After ultrasound (US) ALL identification, different kinematic measurements were performed with an image-less Computer-Assisted Navigation System with dedicated software for Laxity Analysis in 5 knee specimens. Anteroposterior (AP) translations and varus/valgus (VV) and Internal-External (IE) rotations were evaluated by two trained orthopedic surgeons before ALL section, after ALL section, and after ALL anatomical reconstruction with doubled ipsilateral autologous gracilis tendon.

Results
ALL resection significantly increased laxity in IE rotations with knee 90° flexed (IE90) and AP translation with tibia internally rotated and the knee 30° flexed (APlat) (p < 0.05). ALL reconstruction significantly reduced laxity in IE90 and APlat (p < 0.05) and reduced VV rotations at 30° of flexion (VV30) (p < 0.05).
There were no statistically significant elongation differences between native ALL and reconstructed ALL (graft) during laxity tests. The inter-operator repeatability of the tests was excellent for each measurement.

Conclusions
ALL acted as an important internal tibial rotation restrain at 90° and a significant (secondary) AP stabilizer at 30° of knee flexion. The presented ALL reconstruction technique significantly restored the increase of knee laxity produced by the ALL section.

Scientific level
Case-Controlled Laboratory Study, Level III.
Combinatorial strategies for production improvement of anti-tuberculosis antibiotics ilamycins E1/E2 from deep sea-derived Streptomyces atratus SCSIO ZH16 ΔilaR
Authors: Zhu Yunfei , Zheng Gaofan , Xin Xiujuan , Ma Junying , Ju Jianhua , An Faliang 
Published: October 2022

AbstractIlamycins E1/E2 are novel cyclic heptapeptides from Streptomyces atratus SCSIO ZH16, which have the MIC value of 9.8 nM against Mycobacterium tuberculosis H37Rv. However, the lower fermentative titer of ilamycins E1/E2 cut off further development for novel anti-TB lead drugs. In order to break the obstacle, the combinatorial strategy of medium optimization, fermentative parameters optimization, exogenous addition of metal ions, precursors, and surfactants was developed to promoted the production of ilamycins E1/E2. Addition of 1 mM ZnCl2 at 0 h, 1 g/L tyrosine at 96 h, and 2 g/L shikimic acid at 48 h increased the production of ilamycins E1/E2 from 13.51 to 762.50 ± 23.15, 721.39 ± 19.13, and 693.83 ± 16.86 mg/L, respectively. qRT-PCR results showed that the transcription levels of key genes in Embden–Meyerhof–Parnas pathway, hexose phosphate shunt pathway, and shikimic acid pathway were upregulated. In addition, the production of ilamycins E1/E2 reached 790.34 mg/L in a 5-L bioreactor by combinatorial strategy. Combinatorial strategies were used for improving ilamycins E1/E2 production in S. atratus ΔilaR and provided a sufficient basis on further clinic development.
Graphical Abstract
Dynamic changes in community structure and degradation performance of a bacterial consortium MMBC-1 during the subculturing revival reveal the potential decomposers of lignocellulose
Authors: Zhu Jingrong , Liu Jiawen , Li Weilin , Ru Yunrui , Sun Di , Liu Cong , Li Zongyun , Liu Weijie 
Published: October 2022

AbstractBacterial consortium is an important source of lignocellulolytic strains, but it is still a challenge to distinguish the direct decomposers of lignocellulose from other bacteria in such a complex community. This study aims at addressing this issue by focusing on the dynamic changes in community structure and degradation activity of MMBC-1, an established and stable lignocellulolytic bacterial consortium, during its subculturing revival. MMBC-1 was cryopreserved with glycerol as a protective agent and then inoculated for revival. Its enzyme activities for degradation recovered to the maximum level after two rounds of subculturing. Correspondingly, the cellulose and hemicellulose in lignocellulosic carbon source were gradually decomposed during the revival. Meanwhile, the initial dominant bacteria represented by genus Clostridium were replaced by the bacteria belonging to Lachnospira, Enterococcus, Bacillus, Haloimpatiens genera and family Lachnospiraceae. However, only three high-abundance (> 1%) operational taxonomic units (OTUs) (Lachnospira, Enterococcus and Haloimpatiens genera) were suggested to directly engage in lignocellulose degradation according to correlation analysis. By comparison, many low-abundance OTUs, such as the ones belonging to Flavonifractor and Anaerotruncus genera, may play an important role in degradation. These findings showed the dramatic changes in community structure that occurred during the subculturing revival, and paved the way for the discovery of direct decomposers in a stable consortium.
Graphical Abstract
Deep-sea bottom-water environment change caused by sediment resuspension on the continental slope off Sanriku, Japan, before and after the 2011 Tohoku Earthquake
Authors: Wakita Masahide , Watanabe Shuichi , Yoshino Jun , Oguri Kazumasa , Nomaki Hidetaka , Kawagucci Shinsuke , Ariyoshi Keisuke , Nagano Akira , Fujikura Katsunori 
Published: October 2022

Abstract
The 2011 off the Pacific coast of Tohoku Earthquake occurred off southern Sanriku, Japan, on March 11 and generated strong shaking and huge tsunami along the entire eastern coast of Tohoku. The mainshock and numerous large aftershocks caused mass-wasting sedimentation events on the continental shelf, slope, and trench bottom. To investigate the impacts of the 2011 Tohoku Earthquake on the deep-sea bottom-water environment off Sanriku, we conducted shipboard surveys up to ~ 2000 dbar during 2011–2018 and long-term monitoring of the seafloor on the continental slope using a deep-sea station (~ 1000 dbar) off Otsuchi Bay during 2012–2018. The high turbidity (maximum ~ 6%) was observed for the bottom water deeper than 500 dbar on the continental slope of the entire area off Sanriku during 2012–2018. This high turbidity was caused by sporadic sediment resuspension induced by frequent large aftershocks. Furthermore, dissolved oxygen concentrations in the bottom layer from 1000 to 1500 dbar dropped significantly by about 10% after the earthquake, while nutrients and dissolved inorganic carbon showed no significant changes but exhibited wide variations. The high turbidity was associated with the increase in the concentrations of phosphate, dissolved inorganic carbon, and methane, as well as the decrease in those of dissolved oxygen and nitrate. This suggests that remineralization of suspended organic matter resulting from the respiration and denitrification of microbial communities after the earthquake caused the chemical properties of the deep-sea bottom-water. The deep-sea bottom-water environment change was maintained by sporadic sediment resuspension due to continued large aftershocks and was likely caused by variations in dissolved inorganic carbon and phosphate. There are two peaks in the concentration and carbon isotope ratio of methane on the deeper slope from 1000 to 2000 dbar near the hypocenter, which were advected along isopycnal surfaces of 27.38σθ (1000 dbar) and 27.56σθ (1500 dbar). The source of the shallower peak of chemical input is considered to be the sediment resuspension from the shallow sediment on the continental slope induced by the mainshock and large aftershocks.

Graphical abstract
Soft Tissue Vibrations in Running: A Narrative Review
Authors: Play Marie-Caroline , Trama Robin , Millet Guillaume Y. , Hautier Christophe , Giandolini Marlène , Rossi Jérémy 
Published: October 2022

AbstractDuring running, the human body is subjected to impacts generating repetitive soft tissue vibrations (STV). They have been frequently discussed to be harmful for the musculoskeletal system and may alter running gait. The aims of this narrative review were to: (1) provide a comprehensive overview of the literature on STV during running, especially why and how STV occurs; (2) present the various approaches and output parameters used for quantifying STV with their strengths and limitations; (3) summarise the factors that affect STV. A wide set of parameters are employed in the literature to characterise STV. Amplitude of STV used to quantify the mechanical stress should be completed by time–frequency approaches to better characterise neuromuscular adaptations. Regarding sports gear, compression apparels seem to be effective in reducing STV. In contrast, the effects of footwear are heterogeneous and responses to footwear interventions are highly individual. The creation of functional groups has recently been suggested as a promising way to better adapt the characteristics of the shoes to the runners’ anthropometrics. Finally, fatigue was found to increase vibration amplitude but should be investigated for prolonged running exercises and completed by an evaluation of neuromuscular fatigue. Future research needs to examine the individual responses, particularly in fatigued conditions, in order to better characterise neuromuscular adaptations to STV.
Seeing Effort: Assessing Coaches' Prediction of the Number of Repetitions in Reserve Before Task-Failure
Authors: Emanuel Aviv , Har-Nir Itai , Obolski Uri , Halperin Israel 
Published: October 2022

AbstractBackgroundA key role of resistance training (RT) coaches is to personalize programs based on their trainees’ abilities and goals. Specifically, coaches often assess how many repetitions in reserve (RIR) their trainees have until task-failure. Coaches can then modify the number of repetitions assigned per set accordingly. However, coaches’ ability to predict the number of RIR is unknown.MethodsCertified RT coaches (n = 259) were randomly assigned to watch a video of one of eight trainees. The trainees performed two sets of barbell squats and preacher biceps-curls, using 70% or 80% of their 1RM, to task-failure. The coaches predicted trainees’ RIR at 33%, 66%, and 90% of the total number of repetitions the trainees completed in each set. We fitted a linear mixed model with various predictors to the prediction errors as the outcomes (i.e., signed and unsigned values of the predicted minus actual repetitions to task-failure).ResultsThe overall average number of repetitions completed by the trainees was 13.9. The average absolute errors were 4.8, 2.0, and 1.2 repetitions for the 33%, 66%, and 90% time-points, respectively. The absolute prediction error increased for the biceps-curl compared to the squat (1.43, 95% CI [1.13, 1.74]), but decreased for heavier loads (− 1.17, 95% CI [− 2.16, − 0.19]), and in the second set of each exercise (− 1.20, 95% CI [− 1.38, − 1.02]). Surprisingly, coaches’ years of experience had a negligible effect on the absolute error (− 0.020, 95% CI [− 0.039, − 0.0007]). Finally, coaches underpredicted the RIR at early time-points but reverted to slight overprediction at later time-points.ConclusionsPrior coaching experience seems to play a minor role in RIR predictions. However, even short-term exposures to new trainees performing different exercises can substantially improve coaches’ RIR predictions.
Spectral domain oct for screening of macular diseases prior to multifocal intraocular lens implantation
Authors: Hinnig Rodrigo Braz , Martins Luiz Felipe Silva , Penha Fernando Marcondes 
Published: October 2022

Abstract
Background
Cataract surgery with multifocal IOLs could give patients good vision and great satisfaction, at the same time generating high expectations; therefore, its precise indication is essential if we are to reach our goal. The use of optical coherence tomography may be a valuable tool in the screening of macular diseases, which often cannot be detected in routine clinical examinations. This study evaluates the benefit of including spectral domain optical coherence tomography (SD-OCT) in routine preoperative cataract surgery protocols for better case selection in multifocal IOLs.

Methods
Observational and retrospective clinical study that includes patients with an indication for multifocal IOL implantation who underwent retinal fundus exam and SD-OCT examination between 2018 and 2019. The clinical examination with ophthalmoscopy and SD-OCT imaging results were evaluated to observe their influence on the final choice of the lens implanted lens in cataract surgery.

Results
405 eyes from 207 patients with multifocal IOL indication were included. It was found that 220 (54.2%) of all indicated multifocal or trifocal IOLs were in fact implanted. The most important reason for not implanting the indicated IOL was financial, in 116 (59.46%) eyes. The second cause were retinal abnormalities detected by SD-OCT, 63 eyes (15.6%). Those abnormalities included dry age-related macular degeneration (AMD) (50.7%), neovascular AMD (3.1%), vitreomacular adhesion (11.1%), diabetic macular edema (3.1%), epiretinal membrane (ERM) (25.3%) and other macular abnormalities (6.3%). Of the 63 eyes with an abnormal SD-OCT result, 44 (69.8%) were also identified by fundus examination. Nineteen (30.2%) eyes had abnormalities detected only by SD-OCT imaging with a normal clinical exam.

Conclusions
Routine use of SD-OCT imaging may help diagnose pre-existing macular pathologies not identified by clinical exam, helping both physicians and patients choose the ideal IOL individually and has the potential to prevent unsatisfactory functional results.
Simulation-based skills training: a qualitative interview study exploring surgical trainees’ experience of stress
Authors: Tjønnås Maria Suong , Das Anita , Våpenstad Cecilie , Ose Solveig Osborg 
Published: October 2022

Abstract
Introduction
Stress can affect the ability to acquire technical skills. Simulation-based training (SBT) courses allow surgical trainees to train their technical skills away from stressful clinical environments. Trainees’ subjective experiences of stress during SBT courses on laparoscopic surgery remains understudied. Here, we explored the subjective stress experiences of surgical trainees during mandatory laparoscopic SBT courses. We aimed to obtain a broader understanding of which factors of the simulation training the trainees perceived as eliciting stress.

Methods
A qualitative study with semistructured individual interviews was undertaken to explore trainees’ subjective experiences of stress. Twenty surgical trainees participated while attending courses at a national training center for advanced laparoscopic surgery. Questions explored trainees’ stress experiences during the SBT courses with a focus on perceived stressors related to laparoscopic simulation training on two box-trainers and one virtual reality simulator. Interview data were analyzed using inductive, qualitative content analysis methods to identify codes, categories, and themes.

Results
Findings indicated that trainees have a variety of stress experiences during laparoscopic SBT. Three main themes were identified to be related to stress experiences: simulation task requirements, psychomotor skill levels and internal pressures, with subcategories such as task difficulty and time requirements, unrealistic haptic feedback and realism of graphics, inconsistent and poor technical performance, and self-imposed pressures and socio-evaluative threats.

Conclusions
Insights into surgical trainees’ experience of stress during laparoscopic SBT courses showed that some stress experiences were directly related to simulation training, while others were of psychological nature. The technical and efficiency requirements of simulation tasks elicited stress experiences among trainees with less laparoscopic experience and lower levels of psychomotor skills. Self-imposed pressures played an integral part in how trainees mobilized and performed during the courses, suggesting that levels of stress might enhance laparoscopic simulation performance. For course facilitators aiming at optimizing future laparoscopic SBT courses, attending to the realism, providing clarity about learning objectives, and having awareness of individual differences among trainees’ technical level when designing the simulation tasks, would be beneficial. Equally important to the laparoscopic SBT is to create a psychological safe learning space in order to reduce the internal pressures of trainees.
Patient and public involvement in implementation of evidence-based guidance for musculoskeletal conditions: a scoping review of current advances and gaps
Authors: Babatunde Opeyemi O. , Dawson Shoba , Brammar June , Parton Linda , Dziedzic Krysia , Adebajo Adewale O. 
Published: October 2022

AbstractAdvances in musculoskeletal (MSK) research have been successfully curated into widely endorsed evidence-based recommendations and guidelines. However, there continues to exist significant variations in care and quality of care, and the global health and socio-economic burdens associated with MSK conditions continues to increase. Limited accessibility, and applicability of guideline recommendations have been suggested as contributory factors to less than adequate guideline implementation. Since patient and public involvement (PPI) is being credited with increasing relevance, dissemination and uptake of MSK research, the success of guidelines implementation strategies may also be maximised through increasing opportunities for PPI input. We therefore conducted a scoping review of literature to explore PPI in implementation of evidence-based guidance for MSK conditions. A comprehensive search was used to identify relevant literature in three databases (Medline, Embase, Cinahl) and two large repositories (WHO, G-IN), supplemented by grey literature search. Eligibility was determined with criteria established a priori and narrative synthesis was used to summarise PPI activities, contexts, and impact on implementation of MSK related evidence-based guidance across ten eligible studies (one from a low-and middle-income country LMIC). A prevalence of low-level PPI (mainly consultative activities) was found in the current literature and may partly account for current experiences of significant variations and quality of care for MSK patients. The success of PPI in MSK research may be lessened by the oversight of PPI in implementation. This has implications for both high- and low-resource healthcare systems, especially in LMICs where evidence is limited. Patient and public partnership for mobilising knowledge, maximising guideline uptake, and bridging the research-practice gap particularly in low resource settings remain important and should extend beyond PPI in research and guideline dissemination activities only. This review is a clarion call to stakeholders, and all involved, to transform PPI in MSK research into real world benefits through implementation approaches underpinned by patient and public partnerships. We anticipate that this will enhance and drive quality improvements in MSK care with patients and for patients across health and care settings.
Patient and public involvement in an international rheumatology translational research project: an evaluation
Authors: de Souza Savia , Johansson Eva C. , Karlfeldt Susanne , Raza Karim , Williams Ruth 
Published: October 2022

Abstract
Background
Rheuma Tolerance for Cure (RTCure) is a five-year international collaboration between academia, industry and patients/members of the public. It focuses on developing approaches to predict the onset of rheumatoid arthritis (RA) and designing clinical trials to reduce the risk of disease development through immune-tolerising and other treatments. We conducted a mid-term evaluation of patient and public involvement (PPI) within the project.

Methods
Two surveys on PPI were co-designed by the PPI Coordinator, Patient/Public Research Partners (PRPs) and a researcher. Both anonymous, electronic surveys were distributed to 61 researchers and 9 PRPs. Quantitative survey data were analysed using descriptive statistics and free text responses underwent inductive thematic analysis.

Results
Researcher and Patient response rates were 33% and 78%, respectively. Quantitative Researcher Survey data highlighted that (i) responding researchers represented all seven Work Packages (WPs), (ii) 40% thought PRPs had made a large or extremely large contribution to their own WPs, (iii) 55% thought PPI has had a moderate or large impact on RTCure, (iv) 75% worked with PRPs in RTCure, and (v) 60% said PRPs had affected their research thinking. Quantitative PRP Survey data highlighted that (i) PRPs were most involved in four WPs, (ii) 43% thought they had made a minor contribution to their main WP, (iii) 57% thought PPI has had a small impact on RTCure, and (iv) 57% thought they received too little feedback on the outcome of their contribution to different tasks. Four main themes were identified in both surveys: ‘PRP contributions’, ‘Experiences of PPI’, ‘Impact of PPI on RTCure’, and ‘How PPI can be improved’. Two additional themes from the Researcher Survey were ‘Impact of PPI on researchers’ and ‘Influence on Future Projects’, and from the PRP Survey were ‘Impact of PPI on PRPs’ and ‘Engagement with PRPs’.

Conclusion
PPI seemed to have a significant impact on RTCure, however, PRPs were less aware. A focus on improving communication between PRPs and researchers (facilitated by the PPI Coordinator), and providing PPI training for researchers is likely to improve involvement. Complex legal agreements for PRPs should be avoided and careful attention paid to appropriate PRP compensation.