Quantitative analysis of trabecular bone tissue cryosections via a fully automated neural network-based approach.

Cryosectioning is known as a common and well-established histological method, due to its easy accessibility, speed, and cost efficiency. However, the creation of bone cryosections is especially difficult. In this study, a cryosectioning protocol for trabecular bone that offers a relatively cheap and undemanding alternative to paraffin or resin embedded sectioning was developed. Sections are stainable with common histological dying methods while maintaining sufficient quality to answer a variety of scientific questions. Furthermore, this study introduces an automated protocol for analysing such sections, enabling users to rapidly access a wide range of different stainings. Therefore, an automated 'QuPath' neural network-based image analysis protocol for histochemical analysis of trabecular bone samples was established, and compared to other automated approaches as well as manual analysis regarding scattering, quality, and reliability. This highly automated protocol can handle enormous amounts of image data with no significant differences in its results when compared with a manual method. Even though this method was applied specifically for bone tissue, it works for a wide variety of different tissues and scientific questions.

On the infinite Borwein product raised to a positive real power.

In this paper, we study properties of the coefficients appearing in the q-series expansion of ∏n≥1[(1-qn)/(1-qpn)]δ, the infinite Borwein product for an arbitrary prime p, raised to an arbitrary positive real power δ. We use the Hardy-Ramanujan-Rademacher circle method to give an asymptotic formula for the coefficients. For p=3 we give an estimate of their growth which enables us to partially confirm an earlier conjecture of the first author concerning an observed sign pattern of the coefficients when the exponent δ is within a specified range of positive real numbers. We further establish some vanishing and divisibility properties of the coefficients of the cube of the infinite Borwein product. We conclude with an Appendix presenting several new conjectures on precise sign patterns of infinite products raised to a real power which are similar to the conjecture we made in the p=3 case.

New q-Analogues of Van Hamme's (E.2) Supercongruence and of a Supercongruence by Swisher.

In this paper, a couple of q-supercongruences for truncated basic hypergeometric series are proved, most of them modulo the cube of a cyclotomic polynomial. One of these results is a new q-analogue of the (E.2) supercongruence by Van Hamme, another one is a new q-analogue of a supercongruence by Swisher, while the other results are closely related q-supercongruences. The proofs make use of special cases of a very-well-poised 6 ϕ 5 summation. In addition, the proofs utilize the method of creative microscoping (which is a method recently introduced by the first author in collaboration with Wadim Zudilin), and the Chinese remainder theorem for coprime polynomials.

Islet Autoantibody Standardization Program: interlaboratory comparison of insulin autoantibody assay performance in 2018 and 2020 workshops.

AIMS/HYPOTHESIS: The Islet Autoantibody Standardization Program (IASP) aims to improve the performance of immunoassays measuring autoantibodies in type 1 diabetes and the concordance of results across laboratories. IASP organises international workshops distributing anonymised serum samples to participating laboratories and centralises the collection and analysis of results. In this report, we describe the results of assays measuring IAA submitted to the IASP 2018 and 2020 workshops. METHODS: The IASP distributed uniquely coded sera from individuals with new-onset type 1 diabetes, multiple islet autoantibody-positive individuals, and diabetes-free blood donors in both 2018 and 2020. Serial dilutions of the anti-insulin mouse monoclonal antibody HUI-018 were also included. Sensitivity, specificity, area under the receiver operating characteristic curve (ROC-AUC), partial ROC-AUC at 95% specificity (pAUC95) and concordance of qualitative/quantitative results were compared across assays. RESULTS: Results from 45 IAA assays of seven different formats and from 37 IAA assays of six different formats were submitted to the IASP in 2018 and 2020, respectively. The median ROC-AUC was 0.736 (IQR 0.617-0.803) and 0.790 (IQR 0.730-0.836), while the median pAUC95 was 0.016 (IQR 0.004-0.021) and 0.023 (IQR 0.014-0.026) in the 2018 and 2020 workshops, respectively. Assays largely differed in AUC (IASP 2018 range 0.232-0.874; IASP 2020 range 0.379-0.924) and pAUC95 (IASP 2018 and IASP 2020 range 0-0.032). CONCLUSIONS/INTERPRETATION: Assay formats submitted to this study showed heterogeneous performance. Despite the high variability across laboratories, the in-house radiobinding assay (RBA) remains the gold standard for IAA measurement. However, novel non-radioactive IAA immunoassays showed a good performance and, if further improved, might be considered valid alternatives to RBAs.

Three families of q-supercongruences modulo the square and cube of a cyclotomic polynomial.

In this paper, three parametric q-supercongruences for truncated very-well-poised basic hypergeometric series are proved, one of them modulo the square, the other two modulo the cube of a cyclotomic polynomial. The main ingredients of proof include a basic hypergeometric summation by George Gasper, the method of creative microscoping (a method recently introduced by the first author in collaboration with Wadim Zudilin), and the Chinese remainder theorem for coprime polynomials.

Association of systemic antibody response against polyethylene terephthalate with inflammatory serum cytokine profile following implantation of differently coated vascular prostheses in a rat animal model.

Experimental studies demonstrated antibodies against matrix and coating of polyester-based vascular prostheses. Thus, this study examined associations of these antibodies with serum cytokines (IL-2, IL-4, and IL-10) and local inflammatory reactions. Rats (n = 8/group) intramuscularly received prosthesis segments [PET-C, PET-G, and PET-A groups: polyethylene terephthalate (PET)-based prostheses coated with bovine collagen and gelatin or human serum albumin, respectively; uncoated polytetrafluoroethylene-based (PTFE) prosthesis], with sham-operated controls. Blood was drawn pre-operatively and weekly until day 22. Polymer-specific or coating-specific antibodies and cytokines were detected by enzyme immunoassays, inflammatory reactions were immunohistochemically evaluated on day 23. Polymer-specific antibodies were detected in all PET-groups using uncoated PET as antigenic target, but not for PTFE or controls, coating-specific antibodies only for PET-A. IL-10 was increased in all PET-groups and correlated with polymer-specific antibodies for PET-G and PET-A. IL-2 was increased for PET-A, but overall correlated with PET-specific antibodies. IL-4 remained unchanged in all groups. Intense local inflammatory reactions (ED1+ /ED2+ macrophages and T lymphocytes) were found within all PET-groups, but only minor for PTFE or controls. In conclusion, PET-specific antibodies were associated with increased IL-10 and along with concurrent coating-specific antibodies also with increased IL-2, indicating a specific T cell response. Thus, matrix and/or coating of polymeric vascular prostheses elicit distinct systemic immune reactions, probably influencing local inflammatory reactions.

Some q-supercongruences modulo the square and cube of a cyclotomic polynomial.

Two q-supercongruences of truncated basic hypergeometric series containing two free parameters are established by employing specific identities for basic hypergeometric series. The results partly extend two q-supercongruences that were earlier conjectured by the same authors and involve q-supercongruences modulo the square and the cube of a cyclotomic polynomial. One of the newly proved q-supercongruences is even conjectured to hold modulo the fourth power of a cyclotomic polynomial.

Effect of High Hydrostatic Pressure on Human Trabecular Bone Regarding Cell Death and Matrix Integrity.

The reconstruction of critical size bone defects is still clinically challenging. Even though the transplantation of autologous bone is used as gold standard, this therapy is accompanied by donor site morbidities as well as tissue limitations. The alternatively used allografts, which are devitalized due to thermal, chemical or physical processing, often lose their matrix integrity and have diminished biomechanical properties. High Hydrostatic Pressure (HHP) may represent a gentle alternative to already existing methods since HHP treated human osteoblasts undergo cell death and HHP treated bone cylinders maintain their mechanical properties. The aim of this study was to determine the biological effects caused by HHP treatment regarding protein/matrix integrity and type of cell death in trabecular bone cylinders. Therefore, different pressure protocols (250 and 300 MPa for 10, 20 and 30 min) and end point analysis such as quantification of DNA-fragmentation, gene expression, SDS-PAGE, FESEM analysis and histological staining were performed. While both protein and matrix integrity was preserved, molecular biological methods showed an apoptotic differentiation of cell death for lower pressures and shorter applications (250 MPa for 10 and 20 min) and necrotic differentiation for higher pressures and longer applications (300 MPa for 30 min). This study serves as a basis for further investigation as it shows that HHP successfully devitalizes trabecular bone cylinders.

Local Inflammatory Response after Intramuscularly Implantation of Anti-Adhesive Plasma-Fluorocarbon-Polymer Coated Ti6AI4V Discs in Rats.

Orthopaedic implants and temporary osteosynthesis devices are commonly based on Titanium (Ti). For short-term devices, cell-material contact should be restricted for easy removal after bone healing. This could be achieved with anti-adhesive plasma-fluorocarbon-polymer (PFP) films created by low-temperature plasma processes. Two different PFP thin film deposition techniques, microwave (MW) and radiofrequency (RF) discharge plasma, were applied to receive smooth, hydrophobic surfaces with octafluoropropane (C3F8) or hexafluorohexane (C6F6) as precursors. This study aimed at examining the immunological local tissue reactions after simultaneous intramuscular implantation of four different Ti samples, designated as MW-C3F8, MW-C6F6, RF-C3F8 and Ti-controls, in rats. A differentiated morphometric evaluation of the inflammatory reaction was conducted by immunohistochemical staining of CD68+ macrophages, CD163+ macrophages, MHC class II-positive cells, T lymphocytes, CD25+ regulatory T lymphocytes, NK cells and nestin-positive cells in cryosections of surrounding peri-implant tissue. Tissue samples were obtained on days 7, 14 and 56 for investigating the acute and chronical inflammation (n = 8 rats/group). Implants with a radiofrequency discharge plasma (RF-C3F8) coating exhibited a favorable short- and long-term immune/inflammatory response comparable to Ti-controls. This was also demonstrated by the significant decrease in pro-inflammatory CD68+ macrophages, possibly downregulated by significantly increasing regulatory T lymphocytes.

Universal Protection: Operationalizing Infection Prevention Guidance in the COVID-19 Era.

INTRODUCTION: The COVID-19 pandemic has required facilities to quickly respond to a myriad of infection prevention recommendations, as well as design their own protocols. The varied and changing guidance has been difficult for staff to absorb and has presented challenges for managing compliance. APPROACH: HCA Healthcare recognized the need for a coordinated approach to managing infection prevention guidance during the COVID-19 pandemic and a mechanism for monitoring compliance and responding to implementation challenges remotely. This innovation consisted of a bundle of infection prevention guidance referred to as the Universal Protection Framework that collated existing recommendations into an easy-to-understand structure with four domains: core infection prevention practices, access control, distancing, and patient flow. This was supported by education and clear communication. A remote monitoring program that incorporated a combination of report review and virtual observation via videoconferencing using an on-site leader as a navigator for the discussion assessed 46 survey domains for compliance. RESULTS: This framework was implemented in a large health care system, and to date compliance has been monitored at 15 facilities. Overall, compliance was high (average, 90%). High compliance was seen with oversight and distribution of personal protective equipment, cohorting of COVID-19 patients, facility access controls, and employee exposure monitoring. Challenges were identified in compliance with social distancing and universal masking. CONCLUSION: Complex infection prevention expectations for COVID-19 can be communicated and implemented by bundling into a simple framework. This innovation also demonstrated that compliance can be measured remotely, which may be useful even after the pandemic challenges have passed.

Elliptic Solutions of Dynamical Lucas Sequences.

We study two types of dynamical extensions of Lucas sequences and give elliptic solutions for them. The first type concerns a level-dependent (or discrete time-dependent) version involving commuting variables. We show that a nice solution for this system is given by elliptic numbers. The second type involves a non-commutative version of Lucas sequences which defines the non-commutative (or abstract) Fibonacci polynomials introduced by Johann Cigler. If the non-commuting variables are specialized to be elliptic-commuting variables the abstract Fibonacci polynomials become non-commutative elliptic Fibonacci polynomials. Some properties we derive for these include their explicit expansion in terms of normalized monomials and a non-commutative elliptic Euler-Cassini identity.

A New Family of q-Supercongruences Modulo the Fourth Power of a Cyclotomic Polynomial.

We establish a new family of q-supercongruences modulo the fourth power of a cyclotomic polynomial, and give several related results. Our main ingredients are q-microscoping and the Chinese remainder theorem for polynomials.

Organizational Solutions to the Moral Risks of Policing.

In addition to the physical and emotional challenges faced by law enforcement professionals, the job confronts officers with numerous moral risks. The moral risks include moral distress, moral injury, ethical exhaustion, compassion fatigue, and practices that lead to lapses in ethical decision-making. The paper focuses on what police agencies can do to better address the moral risks of policing. These moral risks are central to officer wellness and, thus, a crucial component of officers' operational readiness. Strategies are presented that will improve prevention efforts, including recruiting and hiring, training, supervision, and promotional practices. Additionally, the paper offers recommendations for effective approaches to intervention with officers who have displayed the effects of these moral risks. Finally, the paper highlights the kind of law enforcement leaders who are best able to implement strategies designed to prevent negative outcomes associated with the moral risks of policing.

Inevitable Loss and Prolonged Grief in Police Work: An Unexplored Topic.

The present manuscript presents foundational constructs related to death and loss (i.e., grief, bereavement, prolonged grief) providing empirical findings from recent research on the impact of death and loss on police officers' health, behavior, and overall functioning. Police officers are routinely exposed to death. In many instances, officers' contact with decedents includes, among others, victims of accidents, catastrophes, or violent crimes and witnessing the intense emotional suffering of relatives of the deceased. Additionally, it is not uncommon for officers to experience the loss of fellow officers from on-duty deaths and permanent, career-ending injuries. Simultaneously, like everyone, police officers have to cope with deaths of loved ones in their personal lives. The result is that officers' health and well-being are likely compromised because of the systematic exposure to on- and off-duty deaths. In this perspective paper, death and loss in law enforcement are explored in an attempt to raise awareness and increase attention to this area of police work. In addition, the authors list a number of prophylactic intervention strategies that would support officers cope with the impact of loss and death and promote their own resilience.

Reduced post-operative opioid use decreases length of stay and readmission rates in patients undergoing hip and knee joint arthroplasty.

BACKGROUND: While adequate pain relief is central to patient recovery and satisfaction, opioid use is associated with side effects, adverse drug events and opioid use disorder and therefore is under increased scrutiny. Enhanced surgical recovery protocols include multimodal pain management as a key process, but the impact of opioid dose as an independent variable has not been examined. METHODS: Retrospective analysis of 51,824 hip and knee arthroplasty encounters in a large healthcare system. RESULTS: Overall, patients receiving treatment with lower doses of opiates had shorter median length of stay (p < 0.001); this earlier discharge had no negative consequences on readmission rates. In particular, patients discharged on day 1 received a lower median morphine milligram equivalent (MME) per day than those who were not discharged (32.5 [IQR: 19.0-50.0] versus 45.0 [26.7-71.2], respectively, p < 0.001). The probability of discharge on day 1 was 41.2% and 19.6% for those patients on lower versus higher MME/day, respectively. Similarly, there was a reduction in odds of readmission of 15.2% (95% CI 5.8-23.6%) for patients on lower doses of MME/day. CONCLUSION: Lower MME/day following joint arthroplasty is linked to the probability of discharge on both days 1 and 2 post-surgery as well as reduced odds of readmission. These findings persisted even when adjusting for all other factors, including participation in the enhanced surgical recovery program, the use of a multi-modal analgesic regimen, the presence of complications, patient demographics, and other baseline characteristics. Efforts to reduce opioid use in the peri- and immediate post-operative period, regardless of the mechanism, demonstrated a significant effect on patient outcomes.

Some New q-Congruences for Truncated Basic Hypergeometric Series: Even Powers.

We provide several new q-congruences for truncated basic hypergeometric series with the base being an even power of q. Our results mainly concern congruences modulo the square or the cube of a cyclotomic polynomial and complement corresponding ones of an earlier paper containing q-congruences for truncated basic hypergeometric series with the base being an odd power of q. We also give a number of related conjectures including q-congruences modulo the fifth power of a cyclotomic polynomial and a congruence for a truncated ordinary hypergeometric series modulo the seventh power of a prime greater than 3.

The Importance of WE in POWER: Integrating Police Wellness and Ethics.

In this article, the authors introduce the POWER perspective of police wellness and ethics. POWER stands for Police Officer Wellness, Ethics, and Resilience. The perspective represents the view that wellness and ethics cannot be discussed separately; they are inextricably connected to each other. Initiatives to address one should always, simultaneously, include the other. Although there is a need for wellness and ethics to be addressed on an organizational level, the present article emphasizes the importance of POWER for individual police officers. The authors make the argument that officers need to expand the way in which they conceptualize their own wellness to include efforts to maintain ethical decision-making. Specifically, officers will remain psychologically healthier when they take active steps to stay steadfastly committed to their ethical principles. Likewise, officers who utilize a comprehensive wellness program, including strategies to boost resilience, will be far less likely to experience lapses in ethical decision-making. Further recommendations for action and implication of this matter in law enforcement are presented and discussed.