bluuebunny/crossref_metadata_2025 huggingface dataset:
Nature‐inspired porous multichannel carbon monolith: Molecular cooperative enables sustainable production and high‐performance capacitive energy storage
Authors: Liu Mingquan , Wu Feng , Zheng Lumin , Feng Xin , Li Ying , Li Yu , Bai Ying , Wu Chuan
Published: July 2021

The advancement of supercapacitors (SCs) is closely bound up with the breakthrough of rational design of energy materials. Freestanding and thick carbon (FTC) materials with well‐organized porous structure is promising SC electrode delivering high areal capacitive performance. However, controllable and sustainable fabrication of such FTC electrode is still of great challenges. Inspired by natural honeycombs with cross‐linked multichannel structure, herein, an innovative molecular‐cooperative‐interaction strategy is elaborately provided to realize honeycomb‐like FTC electrodes. The nitrogen‐doped porous carbon monolith (N‐PCM) is obtained with advantages of interconnect pore structure and abundant nitrogen doping. Such strategy is based on naturally abundant molecular precursors, and free of pore‐templates, expensive polymerization catalyst, and dangerous reaction solvent, rendering it a sustainable and cost‐effective process. Systematic control experiments reveal that strong interactions among molecular precursors promise the structural stability of N‐PCM during carbonization, and rational selection of molecular precursors with chemical blowing features is key step for well‐developed honeycomb‐like pore structure. Interestingly, the optimized sample exhibits hierarchical pore structure with specific surface area of 626.4 m2 g−1 and rational N‐doping of 7.01 wt%. The derived SC electrode with high mass loading of 40.1 mg cm−2 shows an excellent areal capacitance of 3621 mF cm−2 at 1 mA cm−2 and good rate performance with 2920 mF cm−2 at 25 mA cm−2. Moreover, the constructed aqueous symmetric SC and quasi‐solid‐state SC produce high energy densities of 0.32 and 0.27 mWh cm−2, respectively. We believe that such a composition/microstructure controllable method can promote the fabrication and development of other thick electrodes for energy storage devices.

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In situ preparation of gel polymer electrolyte for lithium batteries: Progress and perspectives
Authors: Ma Chao , Cui Wenfeng , Liu Xizheng , Ding Yi , Wang Yonggang
Published: July 2021

The practical applications of Li‐ion batteries (LIBs) are challenged by their safety concerns when using liquid electrolytes (LEs). Solid‐state gel polymer electrolytes (GPEs) can address this challenge and have drawn increased attention recently. Normally, GPEs are prepared separately and then assembled into cells, which undoubtedly result in dissatisfactory solid/solid interfacial compatibility and low ionic conductivity. Fortunately, in situ GPEs are proposed to address the above challenges and simplify the preparation process. Typically, LE precursor is injected into the cells and gradually transformed into a quasi‐solid gel state under the conditions of thermal or chemical initiators. Consequently, the obtained in situ GPEs could fully infiltrate the electrode and better interface contact of gel electrolyte/electrode is thus inherited. In this review, the authors focus on the in situ GPEs used in lithium batteries (LBs), and summarize recent progress of the design, synthesis, and applications of in situ GPEs. Based on the different ways of triggering polymerization, there are mainly three methods: thermochemical gelation, polymerization by additional chemical initiators, and cross‐linking initiated by LiO bond. Composite GPEs based on in situ solidification method are introduced as a promising strategy to improve the electrochemical performances. Finally, up‐to‐date research progresses are discussed, and perspectives are provided on the development and challenges of in situ GPEs to meet the requirements for their practical applications in LBs.

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Effects of temperature and food availability on the filtration and excretion rates of Diplodon parallelopipedon (Hyriidae)
Authors: Marroni Soledad , Mazzeo Néstor , Iglesias Carlos
Published: July 2021

Bivalves can consume detritus, bacteria, phytoplankton, and zooplankton by filtering the water column. Ecological attributes like filtration rate (FR) and excretion rate (ER) are particularly important to better understand the role of bivalves in ecosystem. Here, we aimed to elucidate the FR/ER of Diplodon parallelopipedon in a five‐times replicated laboratory experiment under five levels of temperature (10°C, 15°C, 20°C, 25°C, and 30°C) and three levels of phytoplankton biomass (low, middle, and high). Temperature was the main factor regulating FR and ER in our experimental conditions, as we hypothesized the experimental results showed a nonlinear relationship between FR and water temperature. D. parallelopipedon exerted top‐down control over phytoplankton biomass throughout the temperature gradient tested. Contrarily to our expectation, FR and ER did not vary within the phytoplankton biomass range offered. The experimental evidence suggests D. parallelopipedon might control phytoplankton biomass in different temperature scenarios. Moreover, the excretion of nutrients by D. parallelopipedon, together with a capacity to avoid grazing shown by several phytoplankton species (i.e., buoyance regulation) reveal relevant challenges to our understanding of bivalve‐phytoplankton dynamics, and consequently to the whole ecosystem response, particularly in the presence of more diverse natural phytoplankton communities.
A one covariate at a time, multiple testing approach to variable selection in high‐dimensional linear regression models: A replication in a narrow sense
Authors: Núñez Héctor M. , Otero Jesús
Published: July 2021

Chudik, Kapetanios, & Pesaran (Econometrica 2018, 86, 1479‐1512) propose a one covariate at a time, multiple testing (OCMT) approach to variable selection in high‐dimensional linear regression models as an alternative approach to penalised regression. We offer a narrow replication of their key OCMT results based on the Stata software instead of the original MATLAB routines. Using the new user‐written Stata commands baing and ocmt, we find results that match closely those reported by these authors in their Monte Carlo simulations. In addition, we replicate exactly their findings in the empirical illustration, which relate to top five variables with highest inclusion frequencies based on the OCMT selection method.
Pharmacological inhibition of IRAK1 attenuates colitis‐induced tumorigenesis in mice by inhibiting the inflammatory response and epithelial–mesenchymal transition
Authors: Feng Zeyu , Duan Zhenglan , Shi Guoping , Wang Qiong , Zhou Jinyong , Chen Yugen
Published: July 2021

Colorectal cancer (CRC) is the third most common type of cancer. Here, we studied the inhibitory effect of IRAK1 and IRAK4 as a preventive strategy using a colitis‐induced tumorigenesis mouse model. CRC clinical data were obtained from the Gene Expression Omnibus (GEO). An experimental inflammation‐dependent CRC model was induced by treatment with azoxymethane (AOM) and then dextran sodium sulfate (DSS) in C57BL/6 mice. Mice were administered an IRAK1/4 inhibitor by intraperitoneal injection at 3 mg/kg twice each week for 9 weeks. The IRAK1/4 inhibitor attenuated histological changes and prevented tumor growth. Tumor‐associated proteins, including p65 and Ki‐67, were downregulated by the IRAK1/4 inhibitor in AOM/DSS‐treated mice. Additionally, IRAK1/4 inhibitor administration effectively decreased the expression of inflammatory cytokines. Furthermore, we observed that IRAK1/4 inhibitor treatment attenuated colitis‐induced tumorigenesis by inhibiting epithelial–mesenchymal transition. These observations indicate that inhibition of IRAK1 and IRAK4 may suppress experimental colitis‐induced tumorigenesis by inhibiting inflammatory responses and epithelial–mesenchymal transition.
Effect of regulation of the NRG1/ErbB4 signaling pathway on the visual cortex synaptic plasticity of amblyopic adult rats
Authors: Xu Limin , Li Zhigang , Rong Junbo , Lang Lijuan
Published: July 2021

This study aimed to investigate the effect of the neuregulin‐1/epidermal growth factor 4 (NRG1/ErbB4) signaling pathway on visual cortex synaptic plasticity in adult amblyopic rats with monocular deprivation (MD). Compared with the control group, the P wave latency and amplitude of the MD group were prolonged and low, respectively, with reduced synaptic plasticity‐related protein expression, lower number of visual cortex neurons, and increased apoptosis of visual cortex neurons. Recombinant neuregulin‐1 (rNRG1) administration activated the NRG1/ErbB4 signaling pathway and improved the visual cortex synaptic plasticity in MD amblyopic rats. However, the effects of rNRG1 were reversed by AG1478 (ErbB4 receptor blockers). The NRG1/ErbB4 signaling pathway in the parvalbumin neurons from MD rats was also inactivated. Amblyopic rats had significantly low cell activity and downregulated expression of synaptic plasticity‐related proteins. Thus, exogenous administration of NRG1 can activate ErbB4 signal transduction and improve the damaged synaptic plasticity of the visual cortex among amblyopic rats. Further studies are warranted to explore the potential for clinical management of amblyopia.
Therapeutic plasmapheresis for the treatment of thyrotoxicosis: A retrospective multi‐center study
Authors: Builes‐Montaño Carlos E. , Rodriguez‐Arrieta Luis A. , Román‐González Alejandro , Prieto‐Saldarriaga Carolina , Alvarez‐Payares Jose C. , Builes‐Barrera Carlos A. , Arango‐Toro Clara M.
Published: July 2021

Background and aims

Thyroid storm and severe thyrotoxicosis remain among the most frequent endocrine emergencies, and first‐line hyperthyroidism treatment is not always an option. Since the first report in 1970, plasmapheresis is a second‐line treatment for severe or otherwise untreatable thyrotoxicosis when rapid euthyroidism is desired.

Methods

We present a retrospective study of the experience in treating thyrotoxicosis with plasmapheresis between 2012 and 2020 in two specialized centers in Colombia. We register the demographic and clinical characteristic and compare the thyroid hormones and other biochemical measurements before and after treatment.

Results

Data from 19 patients was obtained, 58% female with a median age of 35 years (IQR 23.5), and most of them with Graves' disease. The most frequent indication for plasmapheresis was thyroid storm. A median of 4 (IQR 2) sessions lead to a significant reduction in FT4 (P .0001) and TT3 (P < .0003) with a nonsignificant decrease in beta‐blocker (P .7353) dose, no change in hepatic enzymes, and no adverse events. After plasmapheresis, thyroidectomy was performed in 10 patients.

Conclusions

Plasmapheresis is an effective and safe treatment option for reducing circulating thyroid hormones in severe thyrotoxicosis when other forms of treatment are contraindicated or in case of urgent thyroid and non‐thyroid surgery. It is limited by its cost and the need for highly specialized resources.
Hsa_circ_0054633 association of C peptide is related to IL‐17 and TNF‐α in patients with diabetes mellitus receiving insulin treatment
Authors: Dai Huixue , Hu Fei , Yang Xiangwei , Hu Peng , Chu Yudong , Bu Shizhong
Published: July 2021

Background

Chronic inflammation damaged the islet and resulted in dysfunction of T2D. Circular RNA is stable and better for biomarker in many diseases. Here, we aimed to identify potential circular RNA hsa_circ_0054633 that can be a biomarkers for the effects of insulin therapy in T2D.

Methods

In this retrospective case‐control study, patients were from Li Huili Hospital, Ningbo, China, from February 10, 2019, to August 15, 2019. We included 47 healthy adults, 46 new‐onset T2D with insulin resistance, and 51 patients with insulin therapy. Serum inflammation factors were tested by ELISA assays. We selected hsa_circ_0054633 as a candidate biomarker and measured its concentration in serum by qRT‐PCR. The Pearson correlation test was used to evaluate the correlation between this circRNA and clinical variables.

Results

Clinical data indicated that serum C peptide was increased in T2D treatment with insulin. Serum hsa_circ_0054633 was decreased in insulin treatment group. Hsa_circ_0054633 was negative correlated with C peptide (r = −0.2841, p = 0.0433,). IL‐1 and IL‐6, IL‐17, and TNF‐α were higher in T2D patients and decreased after insulin treatment, only IL‐17 and TNF‐α showed a positive correlation to hsa_circ_0054633 (r = 0.4825, p < 0.0001, and r = 0.6190, p < 0.0001). The area under ROC curve was 0.7432, 0.5839, and 0.7573 for Hsa_circ_0054633, C peptide, and their combination.

Conclusion

Hsa_circ_0054633 level was lower in T2D with insulin treatment than untreated and was a negative correlation with C peptide, and positively correlated with IL‐17 and TNF‐α, suggesting that hsa_circ_0054633 may be a potential early indicator of insulin treatment effect to improve inflammation condition.
Coinfection with severe acute respiratory syndrome coronavirus‐2 and other respiratory viruses at a tertiary hospital in Korea
Authors: Kim Zehwan , Lee Jong Ho
Published: July 2021

Background

Studies have reported coinfection of severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2), the cause of coronavirus disease‐2019 (COVID‐19), with other viruses that cause respiratory tract infections (RTIs). We investigated the coinfection rate of SARS‐CoV‐2 and other RTI‐causing viruses, and whether the cycle threshold (Ct) value of a real‐time reverse transcriptase PCR (RT‐PCR) differed when the coinfection occurred during the first wave of COVID‐19 in Daegu, Republic of Korea, in 2020.

Methods

After performing PCR for SARS‐CoV‐2, we additionally tested for the presence of RTI‐causing viruses to check for coinfection. Subsequently, we identified the specific coexisting respiratory viruses and calculated the coinfection rate. In addition, based on the coinfection status, we compared the Ct values obtained from RT‐PCR for SARS‐CoV‐2 in patients who tested positive for COVID‐19 PCR.

Results

Of 13,717 patients, 123 had positive results on COVID‐19 PCR testing and six tested positive for an RTI‐causing virus. Thus, the coinfection rate was 4.9%. There were no statistically significant differences in the mean Ct values of SARS‐CoV‐2 RT‐PCR between coinfected and non‐coinfected patients.

Conclusion

This study computed the coinfection rate of SARS‐CoV‐2 and RTI‐causing viruses and revealed that the mean Ct values in SARS‐CoV‐2 real‐time RT‐PCR did not differ according to the coinfection status.
Age‐ and sex‐specific reference intervals for superoxide dismutase enzyme and several minerals in a healthy adult cohort
Authors: Ghazizadeh Hamideh , Kathryn Bohn Mary , Yaghooti‐Khorasani Mahdiyeh , Kamel Khodabandeh Atieh , Zare‐Feyzabadi Reza , Timar Ameneh , Mohammadi‐Bajgiran Maryam , Oladi Mohammad Reza , Rohban Mohadeseh , Esmaily Habibollah , Ferns Gordon A. , Adeli Khosrow , Ghayour‐Mobarhan Majid
Published: July 2021

Introduction

The aim of this study was to establish RIs for clinically important markers including superoxide dismutase (SOD), serum copper, zinc, calcium, magnesium, and phosphate in a cohort of healthy Iranian adults.

Materials

A subsample from MASHAD cohort study was used to assess serum SOD, copper, zinc, calcium, magnesium and phosphate. Serum SOD was measured according to its inhibitory potential of pyrogallol oxidation. Micro‐ and macro‐minerals were measured using flame atomic absorption spectrometry and a BT3000 autoanalyzer, respectively. Sex‐ and age‐specific RIs were then calculated based on CLSI Ep28‐A3 guidelines.

Results

Reference value distributions for studied parameters did not demonstrate any age‐specific differences that were statistically significant. In addition, sex partitioning was not required for all parameters, apart from serum magnesium, which showed a wider range in females (0.81–1.26 mg/dl) compared with males (0.82–1.23 mg/dl).

Conclusion

The RIs established in this study can be expected to improve mineral assessment and clinical decision‐making in the Iranian adult population.
Down‐regulated IL36RN expression based on peripheral blood mononuclear cells and plasma of periodontitis patients and its clinical significance
Authors: Zhou Yue , Liang Yufu
Published: July 2021

Background

The role of IL‐36 receptor antagonist (IL36RN), a mutated gene expression of IL‐36 in periodontitis patients with peripheral blood mononuclear cells (PBMC) and plasma remains to be undetermined.

Materials and methods

Our study discovered the IL36RN expression through GEO public databases and further validated by PBMC and plasma of periodontitis patients and healthy participants. A total of 194 participants of public datasets, consisting of 97 cases of periodontitis and 97 cases of healthy control were retrospectively evaluated and explored the gene enrichment pathways and clinical significance of IL36RN expression accompanied by three different cytokines. Furthermore, the clinical significance of IL36RN was evaluated in mild‐to‐severe patients of periodontitis by the receiver operating curve (ROC) using the area under the curve (AUC).

Results

IL36RN expressions were notably down‐regulated in PBMC and plasma of periodontitis patients. Further, a positive correlation of IL36RN expression was significantly observed between PBMC and plasma of periodontitis patients while IL36RN expression was negatively correlated to serum‐based three different cytokines of periodontitis patients. Meanwhile, the ROC‐AUCs achieved a significantly higher range from 0.80 to 0.87 with PBMC of mild‐to‐severe and moderate‐to‐severe periodontitis patients whereas similar patients with plasma obtained a significant AUC range from 0.73 to 0.83.

Conclusion

IL36RN can distinctively be detectable in periodontitis patients with PBMC and plasma, which can act as a down‐regulated mutated gene that might play an effective role in causing periodontitis. IL36RN may involve by other inflammatory cytokines in the pathogenesis of periodontitis.
Diagnostic value of red blood cell distribution width, platelet distribution width, and red blood cell distribution width to platelet ratio in children with hemophagocytic lymphohistiocytosis
Authors: Xi Ya , Bai Yongying
Published: July 2021

Background

To investigate whether red blood cell distribution width (RDW), platelet distribution width (PDW), and red blood cell distribution width to platelet ratio (RPR) can serve as biomarkers to distinguish hemophagocytic lymphohistiocytosis (HLH) from sepsis in children.

Methods

This is a retrospective study, involving 71 HLH patients, 105 sepsis patients, and 88 normal controls from January 2018 to December 2019. RDW, PDW, and RPR values were obtained from peripheral blood samples before standard treatment. The clinical differential diagnostic values of RDW, PDW, and RPR were analyzed by receiver operating characteristic (ROC) curve. In addition, peripheral blood samples after treatment from HLH patients were also collected for the same analyses.

Results

RDW, PDW, and RPR levels of the HLH patients were significantly higher than those of sepsis and normal controls (p < 0.001). In ROC curve analysis of the RDW, PDW, and RPR for diagnosis of HLH, the area under the curve (AUC) could reach to 0.7799 (95% CI = 0.7113–0.8486), 0.7835 (95% CI = 0.7093–0.8577), and 0.9268 (95% CI = 0.8886–0.9649), respectively. When using the criteria of RDW >13.75, PDW >13.30, and RPR >0.08, the sensitivity was 76.06%, 67.61%, and 84.51%, while the specificity was 68.57%, 85.71%, and 87.62%, respectively. After treatment of HLH patients, PDW and RPR were significantly reduced (p < 0.001).

Conclusions

This study shows that RDW, PDW, and RPR, which can be easily and cheaply detected, are novel indicators for differential diagnosis of HLH. PDW and RPR are useful indices for monitoring the effects of treatment on HLH.
Bridging the science‐practice gap in treatment for posttraumatic stress disorder: Testing strategies to enhance beliefs toward exposure therapy
Authors: Klein Alexandra B. , Kline Alexander C. , Bowling Alexandra R. , Feeny Norah C.
Published: July 2021

Objective

Exposure therapies (e.g., prolonged exposure [PE]), are first‐line interventions for posttraumatic stress disorder but remain underutilized, partially due to providers' negative beliefs about these interventions. We examined two experimental strategies aimed at enhancing beliefs towards PE and subsequent utilization.

Method

Clinicians (N = 155) were randomized to one of three conditions presenting a PE rationale: basic, empirically‐based, or emotionally‐based description. Participants were rerandomized to write or not write arguments for utilizing PE. Before and after PE rationales and 1‐month later, participants completed questions about PE beliefs and utilization.

Results

Participants reported small yet durable belief change across all rationale conditions, with greatest change following the empirically‐based description. Across conditions, belief change was not impacted by writing condition or associated with utilization.

Conclusion

Addressing negative beliefs with empirical information may be a brief, cost‐effective strategy to improve clinicians' beliefs toward PE. Complementary strategies that leverage belief modification to increase utilization are needed.
Be under your own influence: Effectiveness of a Culturally‐Adapted drug prevention campaign targeting Reservation‐Dwelling American Indian youth
Authors: Crabtree Meghan A. , Stanley Linda R. , Kelly Kathleen J. , Swaim Randall C.
Published: July 2021

Be Under Your Own Influence (BUYOI) is a previously validated school‐based intervention designed to delay adolescent substance use (SU) initiation. This study examined the effectiveness of a culturally‐adapted version of BUYOI in delaying SU initiation among reservation‐dwelling American Indian (AI) youth. Five reservation‐based middle schools participated. Three schools were randomly assigned to receive BUYOI‐AI (N = 321), and two schools served as controls (N = 176). Beginning in 7th grade, all participating students completed four assessments over the study period. Discrete time hazard models estimated the effects of BUYOI on students’ risk of initiating alcohol, alcohol intoxication and marijuana before the end of 8th grade. AI students exposed to BUYOI had a lower risk of initiating alcohol use or intoxication, though sex moderated the effect on intoxication. These findings provide preliminary support for the effectiveness of a culturally‐adapted version of BUYOI in delaying AI youth's first‐time alcohol use and intoxication.
The optimization of hydrothermal synthesis of MnxCo3‐xO4/GC catalyst for low temperature NH3‐SCR /using design of experiments
Authors: Ko Songjin , Tang Xiaolong , Gao Fengyu , Zhou Yuansong , Zhang Runcao , Liu Yuanyuan , Liu Hengheng
Published: July 2021

BACKGROUND

In this study, a new catalyst for low‐temperature selective catalytic reduction of NOx with NH3 (NH3‐SCR) were prepared by using glucose and discussed optimization of the synthetic conditions of MnxCo3−xO4/GC (glucose carbon) catalysts by using the design of the experiments. A response surface methodology (RSM) combined with the central composite design (CCD) was applied to model and optimize the synthetic conditions.

RESULTS

As a result, the optimum NOx conversion of 95.6% and N2 selectivity of 81.8% were obtained at Mn/Co 2.1, urea/(Mn + Co) mole ratio 11.5, glucose/(Mn + Co) mole ratio 8.9, preparation temperature 175.4 , and calcination temperature 376.3 . The SEM (Scanning electron microscope) image and EDS (Energy Dispersive Spectroscopy) analysis showed that metal oxides of Mn and Co were uniformly accumulated on the carbon microsphere surface. XRD (X‐ray diffraction) patterns showed that CoCo2O4 content in the catalyst increased with the increase of the glucose/(Mn + Co) mole ratio, which reduced the interaction between Mn and Co, and played a negative impact on catalytic performance. FTIR (Fourier‐transform infrared) spectra showed that the catalyst surface in the optimum preparation conditions had more oxygen‐containing functional groups and that the excessive glucose carbon was unfavourable to catalytic performance. For urea/(Mn + Co), as urea/(Mn + Co) decreased, in addition to the decrease in Mn and Co content in the catalyst due to the decrease in precipitant, CoCo2O4 content in the catalyst also increased and oxygen‐containing functional groups decreased, both of which resulted in the decrease of the catalytic performance.

CONCLUSION

The H2‐TPR and NH3‐TPD results demonstrated that the catalyst prepared in the optimum conditions possessed a stronger reducing ability, more acid sites, and stronger acid strength than the other. © 2021 Society of Chemical Industry
Accumulation of polycyclic aromatic hydrocarbons in the devitalized aquatic moss Fontinalis antipyretica: From laboratory to field conditions
Authors: Carrieri Vittoria , Fernández José Ángel , Aboal Jesús Ramón , Picariello Enrica , De Nicola Flavia
Published: July 2021

This work aims to test the feasibility of a Fontinalis antipyretica devitalized moss clone to uptake and accumulate polycyclic aromatic hydrocarbons (PAHs) from surface waters. To assess the capability of the devitalized clone to accumulate PAHs, in the laboratory, moss was placed in water and spiked with increasing concentrations of 16 PAHs, and under field conditions, the moss was transplanted to 22 sites of Galicia (Spain) rivers. In general, PAH concentrations in water samples were lower than the maximum allowable concentrations from Directive 2013/39/EU, so the sampling sites did not show water PAH contamination. The exponential accumulation kinetic in the laboratory trial highlights a good capability of the devitalized moss clone to accumulate total PAHs. In field experiments, the hydrogeological conditions and the low emission sources caused low concentrations of PAHs in the water system and, consequently, in the transplants, although an enrichment can be observed for several PAHs. Overall, the devitalized clone of F. antipyretica can uptake and accumulate PAHs in water and may be useful in bioremediation strategies.
Perception and handling of breastmilk by childcare staff: A qualitative study of childcare facilities in Japan
Authors: Yabe Chizuru , Yasugi Shiho , Musha Yukiko , Takemura Yousuke C. , Son Daisuke
Published: July 2021

Background

Breastfeeding in infancy has immunological and nutritional benefits. The actual status of breastfeeding in childcare facilities is unclear. However, it is expected to vary in every facility and region. This study aimed to explore what the staff of childcare facilities perceive of breastfeeding and how they feel about handling breast milk.

Methods

The study was conducted from May 2012 to September 2015. A list of childcare facilities in three cities in Japan was compiled. A questionnaire was sent to the facilities by mail asking whether or not they provided breastfeeding care and whether or not they would participate in the study. Semi‐structured interviews were conducted with the staff members of childcare facilities that consented to the study. The transcribed text was analyzed by thematic analysis.

Results

Of the 211 facilities sent, 55 responded, and 21 of these facilities were implementing breastfeeding. Interviews were conducted at four facilities for those who agreed to be interviewed. The researchers extracted three categories of breastfeeding factors at childcare facilities: the value that caregivers see in breastfeeding, difficulties associated with breastfeeding in childcare facilities, and devices and elements for breastfeeding by childcare facilities. Although facility staff acknowledged the nutritional and psychosocial benefits of breast milk, they also felt the administrative difficulties and mental burden of handling expressed breast milk.

Conclusion

This study revealed that for the childcare facility staff, breastfeeding was positioned as a means of communication and reassurance to the mother, and the immunological and nutritional benefits of breast milk.
A single‐center comparative analysis of outpatients with and without COVID‐19 in Sapporo, Japan
Authors: Shimamura Yoshinosuke , Masuda Kaihei , Anbo Yoshiyasu , Sugaya Fumiko , Furuta Yasushi
Published: July 2021

This study aimed to investigate the demographic, clinical, and epidemiological statistics of Japanese patients attending a designated outpatient clinic for COVID‐19 in Sapporo, Japan, and contrast the clinical and epidemiological features between those with and without mild COVID‐19. A total of 27 (8.6%) of 315 patients were diagnosed with COVID‐19. They had higher proportions of myalgia, direct contact with a confirmed COVID‐19 patient, and attendance of social gatherings in close confines. We believe that our study makes a significant contribution to the literature because it provides a clinical picture of mild COVID‐19 in the Japanese population, which has not been studied extensively. It can also assist in optimizing the local preventive measures to reduce the transmission of COVID‐19.
Utility of dedicated bougie dilator for a 0.018‐inch guidewire during EUS‐guided biliary drainage: A multi‐center retrospective cohort study
Authors: Iwashita Takuji , Ogura Takeshi , Ishiwatari Hirotoshi , Nakai Yousuke , Iwata Keisuke , Mukai Tsuyoshi , Shimizu Masahito , Isayama Hiroyuki , Yasuda Ichiro , Itoi Takao
Published: July 2021

Background

During endoscopic ultrasound‐guided biliary drainage (EUS‐BD), a combination of a 19‐gauge needle and a 0.025‐inch guidewire is generally used. However, a 19‐gauge needle has poor maneuverability because of their stiffness and rigidity and might have poor penetrability in non‐dilated bile ducts because of their large bore. In contrast, the application of a 22‐gauge needle is expected to have improved maneuverability. However, only a 0.018‐inch guidewire, which has less supportability, is applicable in the subsequent guidewire selection. This study aimed to evaluate the feasibility and safety of a dedicated bougie dilator for a 0.018‐inch guidewire.

Methods

From September 2019 to May 2020, 26 patients underwent fistula dilation using the dilator after accessing the bile duct using a 22‐gauge needle and a 0.018‐inch guidewire during EUS‐BD. The success and adverse event rates of EUS‐BD were evaluated.

Results

Biliary access with a combination of a 22‐gauge needle and a 0.018‐inch guidewire was successful in all with a median bile duct diameter of 5 mm. Dilation of the fistula using the dedicated dilator was also successful in all cases. Subsequently, the dilator was successfully exchanged to an ERCP catheter that allowed for exchange to a 0.025‐inch guidewire, except in one case where the catheter did not cross the fistula and a dilation balloon was inserted for an exchange to a 0.025‐inch guidewire. The technical success rate of the EUS‐BD was 100%. The adverse event rate was 19%.

Conclusion

The application of the dedicated dilator for a 0.018‐inch guidewire was considered feasible and safe for EUS‐BD.
Development of the nervous system in the early hatching larvae of the ctenophore Mnemiopsis leidyi
Authors: Norekian Tigran P. , Moroz Leonid L.
Published: July 2021

Ctenophores are descendants of an early branching basal metazoan lineage, which may have evolved neurons and muscles independently from other animals. Mnemiopsis is one of the important reference ctenophore species. However, little is known about its neuromuscular organization. Here, we mapped and tracked the development of the neural and muscular elements in the early hatching cydippid larvae, as well as adult Mnemiopsis leidyi. The overall development of the neuromuscular system in Mnemiopsis was very similar to Pleurobrachia bachei, although in Mnemiopsis the entire process occurred significantly faster. The subepithelial neural cells were observed immediately after hatching. This population consisted of a dozen of separated individual neurons with short neurites. In about 2 days, when their neurites grew significantly longer and connected to their neighbors, they began to form a canonical polygonal subepithelial network. Mesogleal neural elements prominent in all studied adult ctenophores were not detectable in Mnemiopsis larvae but were clearly labeled in closely related Lobata species Bolinopsis infundibulum. Hatched larvae also had putative mechanoreceptors with long stereocilia and approximately two dozen muscle cells. In adult Mnemiopsis, the feeding lobes and auricles contained two distinct populations of neurons and neural ensembles that were not observed in other ctenophore lineages and likely represented elaborate neuronal innovations characteristic for the clade Lobata and their lifestyles.
Dexamethasone treatment may mitigate adverse effects of vitamin D deficiency in hospitalized Covid‐19 patients
Authors: Wenban Charlotte , Heer Randeep S. , Baktash Vadir , Kandiah Pirabakaran , Katsanouli Theodora , Pandey Asmita , Goindoo Ryan , Ajaz Afiyah , Van den Abbeele Koenraad , Mandal Amit K. J. , Missouris Constantinos G.
Published: July 2021

Aims

We have previously demonstrated that vitamin D deficiency might be associated with worse outcomes in hospitalized Covid‐19 patients. The aim of our study was to explore this relationship with dexamethasone therapy.

Methods

We prospectively studied two cohorts of hospitalized Covid‐19 patients between March and April and between September and December 2020 (n = 192). Patients were tested for serum 25‐hydroxyvitamin D (25‐OH‐D) levels during admission. The first cohort not treated with dexamethasone (n = 107) was divided into vitamin D deficient (25‐OH‐D ≤ 30 nmol/L) (n = 47) and replete subgroups (25‐OH‐D > 30 nmol/L) (n = 60). The second cohort treated with dexamethasone (n = 85) was similarly divided into deficient (25‐OH‐D ≤ 30 nmol/L) (n = 27) and replete subgroups (25‐OH‐D > 30 nmol/L) (n = 58). Primary outcome was in‐hospital mortality and secondary outcomes were elevation in markers of cytokine storm and ventilatory requirement.

Results

No mortality difference was identified between cohorts and subgroups. The “no dexamethasone” cohort 25‐OH‐D deplete subgroup recorded significantly higher peak D‐Dimer levels (1874 vs. 1233 µgFEU/L) (p = 0.0309), CRP (177 vs. 107.5) (p = 0.0055), and ventilatory support requirement (25.5% vs. 6.67%) (p = 0.007) compared to the replete subgroup. Among the 25‐OH‐D deplete subgroup higher peak neutrophil counts, peak CRP, peak LDH, peak ferritin, and lower trough lymphocyte counts were observed, without statistical significance. In the “dexamethasone” cohort, there was no apparent association between 25‐OH‐D deficiency and markers of cytokine storm or ventilatory requirement.

Conclusion: Vitamin D deficiency is associated with elevated markers of cytokine storm and higher ventilatory requirements in hospitalized Covid‐19 patients. Dexamethasone treatment appears to mitigate adverse effects of vitamin D deficiency.
Association of atrial fibrillation and various cancer subtypes
Authors: Zubair Khan Muhammad , Gupta Ashwani , Patel Kirtenkumar , Abraham Aida , Franklin Sona , Kim Do young , Patel Krunalkumar , Hussian Ishtiaq , Zarak Muhammad Samsoor , Figueredo Vincent , Kutalek Steven
Published: July 2021

Background

Studies have shown that the incidence of atrial fibrillation (AF) in cancer is most likely due to the presence of inflammatory markers. The purpose of our study is to determine the association of AF with different cancer subtypes and its impact on in‐hospital outcomes.

Methods

Data were obtained from the National Inpatient Sample database between 2005 and 2015. Patients with various cancers and AF were studied. ICD‐9‐CM codes were utilized to verify variables. Patients were divided into three age groups: Group 1 (age < 65 years), Group 2 (age 65‐80 years), and Group 3 (age > 80 years). Statistical analysis was performed using Pearson chi‐square and binary logistic regression analysis to determine the association of individual cancers with AF.

Results

The prevalence of AF was 14.6% among total study patients (n = 46 030 380). After adjusting for confounding variables through multivariate regression analysis, AF showed significant association in Group 1 with lung cancer (odds ratio, OR = 1.92), multiple myeloma (OR = 1.59), non‐Hodgkin lymphoma (OR = 1.55), respiratory cancer (OR = 1.55), prostate cancer (OR = 1.20), leukemia (OR = 1.12), and Hodgkin's lymphoma (OR = 1.03). In Group 2, the association of AF with multiple myeloma (1.21), lung cancer (OR = 1.15), Hodgkin lymphoma (OR = 1.15), non‐Hodgkin lymphoma (OR = 1.12), respiratory cancer (OR = 1.08), prostate cancer (OR = 1.06), leukemia (OR = 1.14), and colon cancer (OR = 1.01) were significant. In Group 3, AF showed significant association with non‐Hodgkin lymphoma (OR = 1.06), prostate (OR = 1.03), leukemia (OR = 1.03), Hodgkin's lymphoma (OR = 1.02), multiple myeloma (OR = 1.01), colon cancer (OR = 1.01), and breast cancer (OR = 1.01). The highest mortality was found in lung cancer in age <80 and prostate cancer in age >80.

Conclusion

In patients age <80 years, AF has significant association with lung cancer and multiple myeloma, whereas in patients age >80 years, it has significant association with non‐Hodgkin lymphoma and prostate cancer. In patients age <80 years, increased mortality was seen in AF with lung cancer and in patients age >80 years, increased mortality was seen in those with AF and prostate cancer.

Twitter Abstract

In age <80, lung cancer and multiple myeloma have a strong association with AF while thyroid and pancreatic cancers have no association with AF at any age. In age greater than 80, NHL and prostate cancer have a significant association with AF.
The 2018 classification of periodontal diseases: Its predictive value for tooth loss
Authors: El Sayed Nihad , Rahim‐Wöstefeld Sonja , Stocker Florian , Behnisch Rouven , Eickholz Peter , Pretzl Bernadette
Published: July 2021

Background

Predictive models and assessment tools for disease susceptibility and progression are necessary to enhance personalized medicine. The aim of this study is to assess the predictive accuracy of using the 2018 classification to predict likelihood of tooth loss.

Methods

A total of 134 patients were screened 10 years after periodontal therapy. Data were extracted from 82 patients’ records and periodontal diagnoses were assigned according to the 1999 and 2018 classifications at baseline, whereas patient‐ and tooth‐related parameters were documented at baseline and at reexamination. Statistical analysis included descriptive statistics, hurdle regression with a zero and count model as well as logistic regression.

Results

Significantly more teeth were lost during SPT in patients with Stage IV or Grade C (P < 0.05). Patients’ adherence seems to have an impact on the predictability of the 2018 classification (P < 0.001). In comparison, neither classification system alone (1999 vs 2018) showed a high predictive value for tooth loss (area under the curve [AUC] = 59.2% vs 58.2%).

Conclusion

Class III and IV/Grade C of the 2018 classification of periodontal diseases show similar predictive accuracy for tooth loss as severe cases in the former classification. Patients adherence seems to influence the prognostic value of the classification.
Corticosteroid‐associated hypothalamic–pituitary–adrenal axis suppression in brain tumours: a focus on dosing and tapering
Authors: Elnoby Ahmed S. , Nassar Hend S.
Published: July 2021

Brain tumours are among the most challenging malignancies to treat. The majority of brain tumours are associated with perifocal oedemas and disturbances in the cerebrospinal fluid (CSF) flow. Glucocorticoids (GC) are the mainstay supportive therapy for a variety of disorders associated with brain tumours such as vasogenic oedema, intracranial pressure, headache, and vomiting. In contrast, prolonged exposure to GC has been associated with suppression of the hypothalamic–pituitary–adrenal (HPA) axis. Moreover, abrupt tapering and sudden stopping of GC therapy are the most common causes of HPA axis suppression leading to secondary adrenal insufficiency (SAI). Furthermore, a variety of well‐established dynamic tests have been used to diagnose and assess the integrity of the HPA axis, such as the insulin tolerance test, the metyrapone stimulation test and the adrenocorticotropic hormone stimulation test. Hydrocortisone replacement is the recommended therapy for SAI as it provides the physiological circadian cortisol rhythm. In the context of brain tumours, limited evidence exists to guide clinical practice regarding the optimal dosing of GC with regard to side effects, duration of therapy, withdrawal regimen or quality of life. In this review, we summarise the current status of HPA axis suppression and the SAI associated with GC therapy in brain tumours.
Development of a standardized histopathology scoring system using machine learning algorithms for intervertebral disc degeneration in the mouse model—An ORS spine section initiative
Authors: Melgoza Itzel Paola , Chenna Srish S. , Tessier Steven , Zhang Yejia , Tang Simon Y. , Ohnishi Takashi , Novais Emanuel José , Kerr Geoffrey J. , Mohanty Sarthak , Tam Vivian , Chan Wilson C. W. , Zhou Chao‐Ming , Zhang Ying , Leung Victor Y. , Brice Angela K. , Séguin Cheryle A. , Chan Danny , Vo Nam , Risbud Makarand V. , Dahia Chitra L.
Published: July 2021

Mice have been increasingly used as preclinical model to elucidate mechanisms and test therapeutics for treating intervertebral disc degeneration (IDD). Several intervertebral disc (IVD) histological scoring systems have been proposed, but none exists that reliably quantitate mouse disc pathologies. Here, we report a new robust quantitative mouse IVD histopathological scoring system developed by building consensus from the spine community analyses of previous scoring systems and features noted on different mouse models of IDD. The new scoring system analyzes 14 key histopathological features from nucleus pulposus (NP), annulus fibrosus (AF), endplate (EP), and AF/NP/EP interface regions. Each feature is categorized and scored; hence, the weight for quantifying the disc histopathology is equally distributed and not driven by only a few features. We tested the new histopathological scoring criteria using images of lumbar and coccygeal discs from different IDD models of both sexes, including genetic, needle‐punctured, static compressive models, and natural aging mice spanning neonatal to old age stages. Moreover, disc sections from common histological preparation techniques and stains including H&E, SafraninO/Fast green, and FAST were analyzed to enable better cross‐study comparisons. Fleiss's multi‐rater agreement test shows significant agreement by both experienced and novice multiple raters for all 14 features on several mouse models and sections prepared using various histological techniques. The sensitivity and specificity of the new scoring system was validated using artificial intelligence and supervised and unsupervised machine learning algorithms, including artificial neural networks, k‐means clustering, and principal component analysis. Finally, we applied the new scoring system on established disc degeneration models and demonstrated high sensitivity and specificity of histopathological scoring changes. Overall, the new histopathological scoring system offers the ability to quantify histological changes in mouse models of disc degeneration and regeneration with high sensitivity and specificity.
Long‐Term Outcomes of Olfactory Neuroblastoma: MD Anderson Cancer Center Experience and Review of the Literature
Authors: Abdelmeguid Ahmed S. , Bell Diana , Roberts Diana , Ferrarotto Renata , Phan Jack , Su Shirley Y. , Kupferman Michael , Raza Shaan , DeMonte Franco , Hanna Ehab
Published: July 2021

Objectives/Hypothesis

Olfactory neuroblastoma (ONB) is a rare sinonasal malignant neoplasm that is known to develop late recurrence. The aim of this study is to evaluate the long‐term outcomes of patients with ONB and to determine the factors associated with prognosis.

Study Design

Retrospective study.

Methods

A retrospective review of the medical records of 139 patients diagnosed with ONB at MD Anderson Cancer Center was performed between 1991 and 2016. Descriptive statistics were calculated, and Kaplan–Meier curves were utilized to assess survival.

Results

Median follow‐up time was 75 months. Overall, 129 patients (92.8%) had surgery as part of their treatment and 82 (58.9%) patients received postoperative radiation therapy (PORT) or concurrent chemoradiotherapy. Endoscopic approaches were utilized for 72 patients, 69.4% of whom had pure endoscopic endonasal approaches. Five‐year overall survival and disease‐specific survival were 85.6% and 93.4%, respectively. Recurrence rate was 39.6% with a median time to recurrence of 42 months. Among the 31 patients who received elective nodal irradiation (ENI), two patients developed neck recurrence (6.4%) compared with 20 who developed neck recurrence when ENI was omitted (34.4%) (P = .003). Advanced Kadish stage, orbital invasion, intracranial invasion, and presence of cervical lymphadenopathy at the time of presentation were significantly associated with poor survival.

Conclusion

ONB has an excellent survival. Surgical resection with PORT when indicated is the mainstay of treatment. Endoscopic approaches can be used as a good tool. Elective neck irradiation reduces the risk of nodal recurrence among patients with clinically N0 neck. Despite the excellent survival, recurrence rate remains high and delayed, highlighting the need for long‐term surveillance.

Level of Evidence

Level 4 Laryngoscope, 132:290–297, 2022
Superior Semicircular Canal Dehiscence Syndrome Following Head Trauma: A Multi‐institutional Review
Authors: McCrary Hilary C. , Babajanian Eric , Patel Neil , Yang Sara , Kircher Matthew , Carlson Matthew L. , Gurgel Richard K.
Published: July 2021

Objective

To evaluate patients who become symptomatic from superior semicircular canal dehiscence (SSCD) following head trauma.

Study Design

Case series assessing patients presenting with SSCD after a trauma.

Methods

A case series was completed assessing patients presenting with SSCD after trauma. Data from three academic medical centers were evaluated, including the following: imaging, videonystagmography (VNG)/vestibular evoked myogenic potential (VEMP) testing, audiometric assessment, and surgical repair. Outcome measures included the following: 1) Description of audio‐vestibular symptoms, 2) mean pre‐ and post‐operative pure tone average (PTA), word recognition score (WRS), and air bone gap (ABG).

Results

A total of 14 patients were included; 86% were male. Approximately 43% were found to have bilateral SSCD on imaging, with 57% of patients pursuing surgical management. The most common presenting symptoms included pulsatile tinnitus (93%), autophony (79%), and hearing loss (64%). Approximately 36% of patients underwent VNG/VEMP testing, with 83.3% of those demonstrating abnormal results. The mean audiometric findings on the symptomatic side included an air‐conduction PTA of 38.0 dB, bone‐conduction PTA of 24.3 dB, WRS of 81%, and ABG of 17.9 dB. Among patients who underwent surgery (57%), there was no significant change in the air‐conduction PTA, bone‐conduction PTA, or WRS (P > .05). However, there was an improvement in the ABG (preoperative = 22.8 dB versus postoperative = 9.7 dB; P = .005).

Conclusion

Head trauma may be a potentiating event for SSCD syndrome. This study advances the hypothesis that these patients likely have underlying radiographic SSCD prior to their trauma, and a traumatic event increases in intra‐vestibular or intracranial pressures, unmasking SSCD syndrome.

Level of Evidence

4 Laryngoscope, 131:E2810–E2818, 2021