bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Oxford Knee Score is a reliable predictor of patients in a health state worse than death and awaiting total knee arthroplasty
Authors: Clement N. D. , Afzal I. , Liu P. , Phoon K. M. , Asopa V. , Sochart D. H. , Kader D. F. 
Published: August 2022

Abstract
Background
The health-related quality of life of patients awaiting a total knee arthroplasty (TKA) deteriorates with increasing time to surgery and identification of those with the worst quality of life may help to prioritize patients. The aims were to identify and validate independent variable(s) associated with a health state worse than death (WTD) in patients awaiting a TKA and whether these variables influenced patients-reported outcome measures.

Methods
A retrospective cohort of 5857 patients undergoing a primary TKA was identified from an established arthroplasty database. Patient demographics, body mass index (BMI), index of multiple deprivation, Oxford Knee Score (OKS), EuroQoL five dimension (EQ-5D) 3 level, and visual analogue scale (EQ-VAS) were collected preoperatively and one year postoperatively. An EQ-5D utility of less than zero was defined as WTD. A randomly selected subset of patients (n = 3076) was used to validate the variable that was most predictive of a state WTD and to assess the influence on patient-reported outcomes.

Results
There were 771 (13.2%) patients with a health state WTD. Increasing social deprivation (P = 0.050), worse preoperative OKS (P < 0.001), or EQ-VAS (P < 0.001) were independently associated with a health state WTD. The OKS was the most reliable predictor (area under curve 88.9%, 95% CI 87.8 to 90.1, P < 0.001) of a health state WTD. A threshold value of 16 or less, 80% sensitive and specific, was validated and confirmed to have a negative predictive value of 97.5%. Patients with an OKS of 16 or less had a significantly greater improvement in their OKS (difference 6.9, P < 0.001) and EQ-5D score (difference 0.257, P < 0.001). When adjusting for confounding factors, a health status WTD was not associated with worse postoperative OKS (difference –0.6, 95% CI –1.4 to 0.3, P = 0.177), EQ-5D (difference –0.016, 95% CI –0.036 to 0.003, P = 0.097) or patient satisfaction (difference –1.8, 95% CI –4.3 to 0.7, P = 0.162).

Conclusion
A threshold score 16 or less in OKS was a reliable predictor of a health status WTD and was associated with a greater improvement in knee-specific and health-related quality of life following TKA.
Multiclass anomaly detection in imbalanced structural health monitoring data using convolutional neural network
Authors: Zhao Mengchen , Sadhu Ayan , Capretz Miriam 
Published: August 2022

AbstractStructural health monitoring (SHM) system aims to monitor the in-service condition of civil infrastructures, incorporate proactive maintenance, and avoid potential safety risks. An SHM system involves the collection of large amounts of data and data transmission. However, due to the normal aging of sensors, exposure to outdoor weather conditions, accidental incidences, and various operational factors, sensors installed on civil infrastructures can get malfunctioned. A malfunctioned sensor induces significant multiclass anomalies in measured SHM data, requiring robust anomaly detection techniques as an essential data cleaning process. Moreover, civil infrastructure often has imbalanced anomaly data where most of the SHM data remain biased to a certain type of anomalies. This imbalanced time-series data causes significant challenges to the existing anomaly detection methods. Without proper data cleaning processes, the SHM technology does not provide useful insights even if advanced damage diagnostic techniques are applied. This paper proposes a hyperparameter-tuned convolutional neural network (CNN) for multiclass imbalanced anomaly detection (CNN-MIAD) modelling. The hyperparameters of the proposed model are tuned through a random search algorithm to optimize the performance. The effect of balancing the database is considered by augmenting the dataset. The proposed CNN-MIAD model is demonstrated with a multiclass time-series of anomaly data obtained from a real-life cable-stayed bridge under various cases of data imbalances. The study concludes that balancing the database with a time shift window to increase the database has generated the optimum results, with an overall accuracy of 97.74%.
Isolated distal esophageal atresia in neonates: a case report and review of the literature
Authors: Keilani Rasem , Badran Eman , Mansour Hanan , Alatout Rasha , Alabadla Abdallah 
Published: August 2022

AbstractEsophageal atresia occurs in 1 out of 2500 to 4500 live births; an isolated variant occurs in 8% of the cases. In this case report and literature review, we present a rare case of isolated distal esophageal atresia happening just 2 cm above the diaphragmatic right leaflet with the connecting band between the two esophageal parts. The location raised the possibility of a direct vascular accident to that segment as a cause of the atresia. Post-operative ambu bagging may facilitate leak at the anastomosis site and should be done carefully, as well as, to introduce contrast with suckling not with jet injection for the same reason. We mentioned that to raise a wariness as this mishap may cause problems.
Environmental Monitoring for Closed Robotic Workcells Used in Aseptic Processing: Data to Support Advanced Environmental Monitoring Strategies
Authors: McCall Joseph , Barnard Nonita , Gadient Kevin , Kasireddy Chandra , Kurtz Adara , Li Yiwei , Page Thomas , Putnam Tadd , Brennan Áine 
Published: August 2022

AbstractThe human operator is acknowledged as the greatest potential source of contamination in aseptic processing. To avoid contamination, barrier systems have progressively reduced the amount of human intervention in the critical zone. This study extends the trajectory of enhanced patient safety through the elimination of human intervention in aseptic filling. Eight companies that are users of closed robotic workcells have aggregated their usage data from 2018 to 2021. The study analyzes the critical design elements and performance of the Cytiva SA25 Aseptic Filling Workcell. The SA25 is a standardized, fully closed robotic system for aseptic filling of vials, syringes, and cartridges that eliminates operator intervention in the critical zone. The standardized design means that the system is not modified to suit a particular application and the same environmental monitoring strategy can be used across different installations. The SA25 provides significantly increased sterility assurance when producing sterile injectables. Users have observed non-viable particle levels well within ISO 5/Grade A air requirements, with extremely low probabilities of entering a dosage container. There have been zero cases of microbial growth in more than 250 media fills and good manufacturing practice (GMP) batches. Across all dosage formats and sizes, the aseptic process is repeatable, with more than 99.3% of units meeting acceptance criteria. These data demonstrate that eliminating risk through design is successful in the SA25, with an improved aseptic process in comparison to filling systems using Restricted Access Barrier Systems (RABS) or isolators with glove ports. One of the contributing companies to this article achieved an industry first. The U.S. FDA-approved commercial production of their biologic drugs without the requirement for routine viable environmental monitoring (EM), requiring viable EM only during process simulations. Based on the data presented and planned future research, new regulatory consideration should be made for closed robotic workcells to ensure that regulations meant for previous technologies with different risk profiles are not inappropriately applied.
Graphical abstract
Ethical dimensions of zoonotic disease research: Perspectives of traditional livestock keepers in Zambia
Authors: Zulu Victor Chisha , Syakalima Michelo , Ali Joseph 
Published: August 2022

Background: With the increase in zoonotic disease research using livestock belonging to traditional livestock keepers (LKs) as research subjects, careful attention to both animal and livestock keeper interests is critically important in Zambia and other similar contexts. Methods: The study aimed to explore ethics-related challenges during zoonotic disease research among LKs where their livestock are included as research subjects. The study was implemented in the Southern province of Zambia in July 2020. Three focus group discussions (FGDs) involving 30 adult male LKs living in livestock-wildlife interface areas where zoonotic diseases are likely to occur, were carried out. The FGDs were done in the local language and audio recorded. Thematic analysis was done using field notes and translated and transcribed recorded interviews. Results: The study found that trust between the researchers and LKs when their livestock are used as research subjects was very cardinal and depended on the continual presence of the local veterinary assistant (VA) during the conduct of research. Conclusions: The LKs could be considered a vulnerable population when their livestock were used as research subjects as, being resource poor, they were looking to researchers to provide benefits yet not fully understanding the research, and thus did not worry so much about consent procedures, bringing into question the validity of the oral consent obtained. The study also found that opportunities to strengthen trust and enhance the research experience could be exploited by researchers conducting research that is locally relevant and desired, being aware of procedural preferences for entering into livestock keeping communities, adequate disclosure of research procedures, respecting conventions and traditional cultural beliefs, and returning results of research. The findings of this study can be used by both researchers as they carry-out zoonotic disease research and by Research Ethics Committees.
The epidemiology and direct healthcare costs of aseptic nonunions in Germany – a descriptive report
Authors: Walter Nike , Hierl Katja , Brochhausen Christoph , Alt Volker , Rupp Markus 
Published: August 2022

Aims This observational cross-sectional study aimed to answer the following questions: 1) how has nonunion incidence developed from 2009 to 2019 in a nationwide cohort; 2) what is the age and sex distribution of nonunions for distinct anatomical nonunion localizations; and 3) how high were the costs for surgical nonunion treatment in a level 1 trauma centre in Germany? Methods Data consisting of annual International Classification of Diseases (ICD)-10 diagnosis codes from German medical institutions from 2009 to 2019, provided by the Federal Statistical Office of Germany (Destatis), were analyzed. Nonunion incidence was calculated for anatomical localization, sex, and age groups. Incidence rate ratios (IRRs) were determined and compared with a two-sample z-test. Diagnosis-related group (DRG)-reimbursement and length of hospital stay were retrospectively retrieved for each anatomical localization, considering 210 patients. Results In 2019, a total of 11,840 nonunion cases (17.4/100,000 inhabitants) were treated. In comparison to 2018, the incidence of nonunion increased by 3% (IRR 1.03, 95% confidence interval (CI) 0.53 to 1.99, p = 0.935). The incidence was higher for male cases (IRR female/male: 0.79, 95% CI 0.76 to 0.82, p = 0.484). Most nonunions occurred at the pelvic and hip region (3.6/100,000 inhabitants, 95% CI 3.5 to 3.8), followed by the ankle and foot as well as the hand (2.9/100,000 inhabitants each). Mean estimated DRG reimbursement for in-hospital treatment of nonunions was highest for nonunions at the pelvic and hip region (€8,319 (SD 2,410), p < 0.001). Conclusion Despite attempts to improve fracture treatment in recent years, nonunions remain a problem for orthopaedic and trauma surgery, with a stable incidence throughout the last decade. Cite this article: Bone Joint Res 2022;11(8):541–547.
Tendon healing: a concise review on cellular and molecular mechanisms with a particular focus on the Achilles tendon
Authors: Schulze-Tanzil Gundula G. , Delgado Cáceres Manuel , Stange Richard , Wildemann Britt , Docheva Denitsa 
Published: August 2022

Tendon is a bradytrophic and hypovascular tissue, hence, healing remains a major challenge. The molecular key events involved in successful repair have to be unravelled to develop novel strategies that reduce the risk of unfavourable outcomes such as non-healing, adhesion formation, and scarring. This review will consider the diverse pathophysiological features of tendon-derived cells that lead to failed healing, including misrouted differentiation (e.g. de- or transdifferentiation) and premature cell senescence, as well as the loss of functional progenitors. Many of these features can be attributed to disturbed cell-extracellular matrix (ECM) or unbalanced soluble mediators involving not only resident tendon cells, but also the cross-talk with immigrating immune cell populations. Unrestrained post-traumatic inflammation could hinder successful healing. Pro-angiogenic mediators trigger hypervascularization and lead to persistence of an immature repair tissue, which does not provide sufficient mechano-competence. Tendon repair tissue needs to achieve an ECM composition, structure, strength, and stiffness that resembles the undamaged highly hierarchically ordered tendon ECM. Adequate mechano-sensation and -transduction by tendon cells orchestrate ECM synthesis, stabilization by cross-linking, and remodelling as a prerequisite for the adaptation to the increased mechanical challenges during healing. Lastly, this review will discuss, from the cell biological point of view, possible optimization strategies for augmenting Achilles tendon (AT) healing outcomes, including adapted mechanostimulation and novel approaches by restraining neoangiogenesis, modifying stem cell niche parameters, tissue engineering, the modulation of the inflammatory cells, and the application of stimulatory factors. Cite this article: Bone Joint Res 2022;11(8):561–574.
Broadband devices for a polarization converter based on optical metasurfaces
Authors: Wu Zhixiang , Zou Yiyang , Deng Hu , Xiong Liang , Liu Quancheng , Shang Liping 
Published: August 2022

Devices employed for optical polarization conversion are widely used in the areas of optical focusing, optical imaging, and microscopy. To circumvent the problems of traditional optical polarization conversion devices, such as a narrow bandwidth, bulky size, and integration difficulties, a linear–radial polarization converter (LRPC) method based on optical metasurfaces is proposed. For a visible wavelength, i.e.,

λ
=

632.8

n
m

, an all-dielectric half-wave plate and a LRPC with a size of

40

λ

(25.312 µm) are designed. The simulated results demonstrate that the LRPC creates a radially polarized wave from a linearly polarized wave in the wavelength range of 620–680 nm. In addition, a cylindrical vectorial wave with different polarizations can be generated via an adjustment of the polarization direction of the incident wave. These types of polarization converters have the important advantage of high transmittance, while also being ultra-thin and easy to integrate. They are expected to be suitable for miniaturized and integrated optical devices.
High range resolution wideband terahertz FMCW radar with a large depth of field
Authors: Hu Weidong , Xu Zhihao , Jiang Huanyu , Liu Yang , Yao Zhiyu , Zhang Kaiqi , Ligthart Leo P. 
Published: August 2022

Terahertz frequency modulation continuous wave (THz FMCW) imaging technology has been widely used in non-destructive testing (NDT) applications of non-metallic materials. However, THz FMCW real-aperture radar usually has a narrow bandwidth and small depth of field, thus restricting the application of THz FMCW NDT. In this paper, a wideband THz signal (220–500 GHz) generation method is proposed by time-division multiplexing. Moreover, a dual-band quasi-optical design with a large depth of field is proposed based on the THz Bessel beam, and a high-quality range profile is obtained. Especially, a signal fusion extended Fourier analysis algorithm without prior knowledge is proposed to further enhance the range profile accuracy, which improves the range resolution to 0.28 mm (

λ

/

3

, center frequency 360 GHz). The effectiveness and advantages of the proposed system are verified by artificially constructing composite materials.
Development and design of the first structured clinic-based program in lower resource settings to transition emerging adults with type 1 diabetes from pediatric to adult care
Authors: Cristello Sarteau Angelica , Peerzada Ariba , Goyal Alpesh , Praveen Pradeep A. , Tandon Nikhil 
Published: August 2022

Introduction
Type 1 diabetes (T1D) is increasing in young people worldwide and more children in resource limited settings are living into adulthood. There is a need for rigorous testing and reporting of evidence-based and stakeholder-informed strategies that transition individuals with T1D from pediatric to adult care. We present the development of and design of the first structured transition program in Delhi, India, to inform similar efforts in India and resource limited settings.

Methods
The intervention development team included clinicians and researchers with expertise in T1D and the implementation context. To select intervention outcomes, establish intervention targets, and design session modules, we drew upon formative research conducted at prospective intervention implementation sites, consensus guidelines, and previous care transition and behavior change research conducted in developed settings. We used the Template for Intervention Description and Replication and GUIDance for the rEporting of intervention Development checklists to report the intervention and development process.

Results
The 15-month program (“PATHWAY”) includes five quarterly ~30 minute sessions delivered predominantly by diabetes educators at pediatric and adult clinics, which coincide with routine care visits. Primary program components include educational and behavioral sessions that address psychosocial drivers of clinic attendance and self-management, diabetes educators as transition coordinators and counselors, and a one-year “overlap period” of alternating visits between pediatric and adult providers.

Conclusions
We followed a systematic and transparent process to develop PATHWAY, which facilitated rich description of intervention context, guiding principles, targets, and components. Dependence on previously published program examples to design PATHWAY may have introduced challenges for program feasibility and effectiveness, underscoring the importance of input gathering from prospective intervention actors at multiple points in the development process. This detailed report in combination with future evaluations of PATHWAY support efforts to increase rigorous development and testing of strategies to improve outcomes among emerging adults with T1D.
Prevalence of bovine tuberculosis and characterization of the members of the Mycobacterium tuberculosis complex from slaughtered cattle in Rwanda
Authors: Ntivuguruzwa Jean Bosco , Michel Anita L. , Kolo Francis Babaman , Mwikarago Ivan Emil , Ngabonziza Jean Claude Semuto , van Heerden Henriette 
Published: August 2022

BackgroundBovine tuberculosis (bTB) is an endemic disease in Rwanda, but little is known about its prevalence and causative mycobacterial species. The disease causes tremendous losses in livestock and wildlife and remains a significant threat to public health.Materials and methodsA cross-sectional study employing a systematic random sampling of cattle (n = 300) with the collection of retropharyngeal lymph nodes and tonsils (n = 300) irrespective of granulomatous lesions was carried out in six abattoirs to investigate the prevalence and identify mycobacterial species using culture, acid-fast bacteria staining, polymerase chain reaction, and GeneXpert assay. Individual risk factors and the origin of samples were analysed for association with the prevalence.FindingsOf the 300 sample pools, six were collected with visible TB-like lesions. Our findings demonstrated the presence ofMycobacterium tuberculosiscomplex (MTBC) in 1.7% (5/300) of sampled slaughtered cattle.Mycobacterium boviswas isolated from 1.3% (4/300) animals while one case was caused by a rifampicin-resistant (RR)M.tuberculosis. Non-tuberculous mycobacteria were identified in 12.0% (36/300) of the sampled cattle. There were no significant associations between the prevalence and abattoir category, age, sex, and breeds of slaughtered cattle.ConclusionsThis study is the first in Rwanda to isolate bothM.bovisand RRM.tuberculosisin slaughtered cattle indicating that bTB is present in Rwanda with a low prevalence. The isolation of RRM.tuberculosisfrom cattle indicates possible zooanthroponotic transmission ofM.tuberculosisand close human-cattle contact. To protect humans against occupational zoonotic diseases, it is essential to control bTB in cattle and raise the awareness among all occupational groups as well as reinforce biosafety at the farm level and in the abattoirs.
Experiences and challenges of parents caring for children with attention-deficit hyperactivity disorder: A qualitative study in Dar es salaam, Tanzania
Authors: Ching’oma Charles Daud , Mkoka Dickson Ally , Ambikile Joel Seme , Iseselo Masunga Kidula 
Published: August 2022

Background
Attention-deficit hyperactivity disorder (ADHD) is the most common neurobehavioral childhood disorder. Children with ADHD are difficult to handle due to the symptoms causing great impairments such as inattention, hyperactivity compared to other childhood mental disorders. Having a child with ADHD is a stressful situation as it impacts the whole family. However, little is known about the experiences and challenges of parents caring for children with ADHD in low and middle-income countries such as Tanzania. Thus, this study explored the experiences and challenges of parents caring for children with ADHD in Dar es Salaam, Tanzania.

Methods
We conducted a qualitative descriptive study involving 16 parents of children with ADHD at Muhimbili National Hospital (MNH). We used the purposive sampling technique to obtain the participants. In-depth interviews, using a semi-structured interview guide, were used to collect data. Audio-recorded data were transcribed, translated, and analysed using qualitative content analysis.

Results
Parents experienced difficulties in handling the children whose level of functioning was impaired due to abnormal and disruptive behaviour such as not being able to follow parental instructions. Psychological problems were also experienced due to caring demands exacerbated by lack of support and stigma from the community. Moreover, there were disruptions in family functioning and social interactions among family members due to the children’s behaviour. Lastly, too much time and family resources spent to fulfil the needs of these children culminated into disruption in economic activities that negatively affected everyday life.

Conclusion
Parents struggle to meet and cope with care demands posed by children with ADHD. The disruptive nature of ADHD symptoms presents a unique caring challenge different from those experienced with other childhood mental illnesses. To address these challenges, a collaborative approach among key stakeholders such as the government, health care professionals, and non-governmental organizations, is needed.