bluuebunny/crossref_metadata_2025 huggingface dataset:
A questionnaire survey on radiation protection among 282 medical staff from 26 endoscopy‐fluoroscopy departments in Japan
Authors: Hayashi Shiro , Takenaka Mamoru , Kogure Hirofumi , Yakushijin Takayuki , Maruyama Hirotsugu , Hori Yasuki , Yoshio Toshiyuki , Ikezawa Kenji , Takagi Tadayuki , Asai Satoshi , Matsunaga Kazuhiro , Matsumoto Kengo , Tsumura Hidetaka , Yamaguchi Shinjiro , Sumiyoshi Tetsuya , Nagaike Koji , Tamaru Yuzuru , Hara Kazuo , Fujisawa Toshio , Oda Ichiro , Ohnita Ken , Kato Motohiko , Nebiki Hiroko , Mikami Tatsuya , Nishihara Akihiro , Egawa Satoshi , Minami Ryuki , Hosono Makoto , Nishida Tsutomu
Published: April 2021

Background and aims

It is essential for endoscopists, technologists, and nurses to understand radiation protection. However, protective equipment usage is still low, and there is little awareness of radiation protection in practice.

Methods

We conducted a questionnaire survey on radiation protection from January to February 2020. The participants were medical staff, including medical doctors, nurses, and radiological and endoscopy technician in endoscopy‐fluoroscopy departments. The questionnaire included 14 multiple‐choice questions divided among three parts: background, equipment, and knowledge.

Results

We surveyed a total of 282 subjects from 26 institutions. There were 168 medical doctors (60%), 90 nurses (32%), and 24 technologists (9%). Although almost all staff members (99%) always wore a lead apron, only a few wore a thyroid collar (32%) and lead glasses (21%). The rate of wearing a radiation dosimeter was insufficient (69%), especially among doctors (52%). A few subjects knew the radiation exposure dose of each procedure (15%), and slightly over half had attended lectures on radiation protection (64%) and knew about the three principles of radiation protection (59%). Protection adherence did not differ by years of experience, knowledge of fluoroscopy, awareness of radiation exposure doses, or attendance at basic lectures on radiation protection. However, medical doctors who were aware of the radiation exposure dose of each procedure were significantly more likely to wear dosimeters than those who were not (p = 0.0008).

Conclusion

Medical staff in endoscopy departments in Japan do not have enough radiation protection equipment or education.
Vitamin D insufficiency is associated with metabolic syndrome independent of insulin resistance and obesity in young adults ‐ The Berlin Aging Study II
Authors: Buchmann Nikolaus , Eckstein Nils , Spira Dominik , Demuth Ilja , Steinhagen‐Thiessen Elisabeth , Norman Kristina
Published: April 2021

Purpose

Age‐related changes affect vitamin D absorption and metabolism. Low 25‐hydroxyvitamin D concentrations have been reported as risk factor for the development of metabolic syndrome (MetS). However, recent evaluations suggest this association might be explained by obesity or insulin resistance (IR) in subjects with MetS. Our aim was to analyze associations between vitamin D insufficiency and MetS in a young cohort without diabetes and two senior cohorts with and without diabetes.

Methods

Four hundred sixteen young and 1357 older BASE‐II participants were analyzed. Type 2 diabetes (T2D) was defined according to European Society of Cardiology (ESC) guidelines, MetS as suggested by International Diabetes Federation/American Heart Association/National Heart, Lung and Blood Institute (IDF/AHA/NHLBI 2009). Vitamin D insufficiency was defined as 25‐hydroxyvitamin D concentrations <50 nmol/L. Among other confounders, BMI and IR were taken into account.

Results

MetS was prevalent in 7.7% of the young and in 35.6% of the older BASE‐II participants and T2D occurred in 12.7% of the older participants. In young subjects without diabetes, vitamin D insufficiency was associated with an independent 3.2‐fold increased odds of having MetS (OR: 3.2 CI: 1.0–8.7; p = 0.042). However, in the older participants, this association was lost once BMI was taken into account among those with diabetes, and once IR was taken into account among those without diabetes.

Conclusion

Independent associations between vitamin D insufficiency and MetS were only found among young subjects without diabetes. In the older adults, BMI annihilated these associations among subjects without diabetes as did HOMA‐IR among subjects with diabetes.
Two‐Photon Absorption Properties in “Push‐Pull” Ruthenium Nitrosyl Complexes with various Fluorenylterpyridine‐Based Ligands
Authors: Bukhanko Valerii , León‐Rojas Andrés Felipe , Lacroix Pascal G. , Tassé Marine , Ramos‐Ortiz Gabriel , Barba‐Barba Rodrigo M. , Farfán Norberto , Santillan Rosa , Malfant Isabelle
Published: April 2021

Using the compound [RuII(FT)(bipy)(NO)](PF6)3 (FT is the electron‐rich 4’‐(2‐fluorenyl)‐2,2’:6’,2’’‐terpyridine ligand and bipy is 2–2’bipyridine) as a reference, two new compounds are presented in which carbon‐carbon double and triple bonds are inserted between the fluorenyl substituent and the terpyridine to provide an extended conjugation path. The electronic properties of the three complexes are compared experimentally by UV‐visible spectroscopy and computationally by means of the density functional theory. All of them exhibit a capability for NO release under irradiation on their low‐energy transition located in the 400–500 nm range, with a quantum yield around 0.01. Their two‐photon absorption (TPA) cross sections are investigated by the Z‐scan technique at λ=800 nm. While the reference compound exhibits a cross‐section equal to 108 GM, the introduction of double and triple bonds leads to increased cross‐sections equal to 131 GM and 150 GM, respectively. These values are discussed in reference to the two‐level model in use for “push‐pull” dipolar TPA chromophores.
Selective Bromination of β‐Positions of Porphyrin by Self‐Catalytic Behaviour of VOTPP: Facile Synthesis, Electrochemical Redox Properties and Catalytic Application
Authors: Maurya Mannar R. , Prakash Ved , Avecilla Fernando , Sankar Muniappan
Published: April 2021

Oxidovanadium(IV) complex of β‐octabromo‐meso‐tetraphenylporphyrin, {[VIVO(TPPBr8)], 2} was synthesized by self‐catalytic oxidative bromination of meso‐tetraphenylporphyrinatooxidovanadium(IV) {[VIVO(TPP), 1} in excellent yield under mild conditions at 25 °C and its structure was confirmed by single crystal X‐ray study. UV‐Vis and 1H NMR spectra further confirmed that the meso‐phenyl rings are not brominated and thus emphasizes on the selectivity as well as synthetic importance of this catalytic method. In the presence of substrates e. g. phenol derivatives, 1 biomimics the vanadium bromoperoxidase (VBPO) enzyme and catalyses the oxidative bromination of substrates in water at 25 °C. Remarkably, 2 also catalyses the oxidative bromination of phenol derivatives under similar reaction conditions with very high turnover frequency (TOF) values (ca. 29 s−1) along with its recyclability. It was found that 2 showed superior catalytic performance as compared to 1 because of its electron deficient nature due to electron withdrawing bromo substituents and robust saddle shaped nonplanar structure (further supported by DFT studies).
Conjugated Bis‐Guanidines (CBGs) as β‐Diketimine Analogues: Synthesis, Characterization of CBGs/Their Lithium Salts and CBG Li Catalyzed Addition of B−H and TMSCN to Carbonyls
Authors: Peddarao Thota , Baishya Ashim , Sarkar Nabin , Acharya Rudresh , Nembenna Sharanappa
Published: April 2021

Herein, we report a range of conjugated bis‐guanidines (CBGs) L [L={(ArHN)(ArHN)C=N−C=(NAr)(NHAr)}; Ar=2, 6‐Me2 ‐ C6H3, (1), 2, 4, 6‐Me3−C6H2, (2), 2, 6‐Et2−C6H3, (3), 2, 6‐iPr2−C6H3, (4)]. These compounds can be easily accessed by the reaction between N,N′‐diaryl carbodiimide, and aq. ammonia in acetonitrile. Deprotonation of 1 with n‐BuLi in a 1 : 1 ratio in THF resulted in the formation of four coordinate lithium complex, [1Li ⋅ (THF)2] (5), while at the same reaction conditions, ligands 3 and 4 gave three coordinate lithium complexes, [3Li⋅THF] (6) and [4Li⋅THF] (7), respectively. However, both compounds 1 and 4 upon deprotonation with n‐BuLi in diethyl ether allowed [1Li⋅Et2O] (8) and [4Li⋅Et2O] (9), respectively, while compounds 1 and 3 in toluene afforded un‐solvated lithium complexes [1Li] (10) and [3Li] (11), respectively. Significantly, a reaction between compound 4 and n‐BuLi in a 1 : 1 ratio in toluene yielded sandwich lithium complex [4Li] (12). All new CBGs 1–4 and lithium salts of CBG, 5, 8, and 12 were characterized by single‐crystal X‐ray structural analysis. The compounds 5–12 were characterized by multinuclear magnetic resonance spectroscopy. Moreover, we have investigated the catalytic application of lithium salts of CBGs for the addition of B−H and TMSCN to carbonyls.
Synthesis and Characterization of Poly‐NHC‐Derived Silver(I) Assemblies and Their Transformation into Poly‐Imidazolium Macrocycles
Authors: Gutiérrez‐Blanco Ana , Dobbe Christian , Hepp Alexander , Daniliuc Constantin G. , Poyatos Macarena , Hahn F. Ekkehardt , Peris Eduardo
Published: April 2021

Three metallosupramolecular assemblies composed of two bis‐NHCs and two silver atoms, [4](PF6)2, two tetra‐NHCs and four silver atoms, [7](PF6)4, and two tri‐NHCs and three silver atoms [8](BF4)3, have been prepared. Assemblies [4](PF6)2 and [7](PF6)4 feature NHC ligands decorated with terminal olefin groups. Irradiation of [4](PF6)2 yielded complex [5](PF6)2 with two terminal cyclobutane rings linking the two bis‐NHC ligands. Liberation of the macrocyclic tetrakisimidazolium salt H4‐6(PF6)4 was achieved by reaction of [5](PF6)2 with NH4Cl/NH4PF6. No [2+2] cycloaddition was observed upon irradiation of [7](PF6)4, apparently due to an unfavorable orientation of the olefin groups. Irradiation of complex [8](BF4)3 with three internal pairs of olefin groups leads to [9](BF4)3 as a mixture of two isomers that differ on the relative orientation of the internal cyclobutane rings. Reaction of [9](BF4)3 with NH4Cl/NH4BF4 yields an isomer mixture of the novel cage‐line hexakisimidazolium salt H6‐10(BF4)6.
A Conformer‐Dependent, Quantitative Quadrant Model
Authors: Zahrt Andrew F. , Rinehart N. Ian , Denmark Scott E.
Published: April 2021

This study reports the development and application of a conformer‐dependent quantitative quadrant descriptor for generating models that relate catalyst performance to catalyst structure in enantioselective transformations. The generality of these descriptors is demonstrated by using them for three different reactions: (1) copper‐catalyzed, enantioselective cyclopropanation of alkenes, (2) rhodium‐catalyzed enantioselective hydrogenation ofα‐substitutedN‐acyl‐enamides, and (3) enantioselective addition of thiols toN‐acyl imines. This work will provide researchers an interpretable steric descriptor that merges the heuristic value of quadrant models with a quantitative tool that can be used to create statistically meaningful correlations between the steric occupancy of catalyst quadrants and stereoselectivity. The low dimensionality of this descriptor, its ability to capture conformational effects and stereostructure, and its direct relationship to intuitive structural properties make it particularly well‐suited for creating Quantitative Structure‐Selectivity Relationships (QSSR) with smaller datasets of asymmetric reactions.
Harnessing the power of intersection for pattern recognition: a novel unsupervised learning method and its application to financial engineering
Authors: Haddad Michel Ferreira Cardia
Published: April 2021

In the present paper a data‐driven hard cluster analysis derived from a novel similarity measure is proposed to support financial investors in their portfolio management decision‐making process. The main objective of the proposed method is to provide a less arbitrary learning procedure to quantify similarity levels between investment alternatives (pairwise) as well as revealing clustering patterns (whole sample). This is especially useful during periods of high volatility, when investment alternatives tend to become more similar and, therefore, harder to distinguish between themselves. The method dynamics may be readily interpreted through a clear data visualisation. The advantages and caveats of the proposed method is compared to the most popular class of cluster analysis, applied to the well‐known Fisher's Iris dataset. Such results show a slightly superior performance of the proposed method but, most importantly, through remarkably different clustering allocation approaches. Moreover, further empirical results applied to daily data reflecting a period of 15 years of time series of economies/stock markets of the Group of Seven (G7) illustrate the potential practical usefulness of the proposed unsupervised learning method, particularly, for portfolio strategy, asset allocation, and investment diversification.
Ficus hispida leaf paste for goatskin preservation: Pollution reduction in tannery wastewater
Authors: Hashem Md. Abul , Hasan Md. Anik , Islam Md. Mazharul , Arman Md. Navid , Sheikh Md. Hasibur Rahman
Published: April 2021

Wet salting preservation is commonly practiced to preserve raw hide/skin which discharges high salinity wastewater during soaking operation of hide/skin processing. The saline wastewater significantly pollutes the environment. In this study, a novel plant‐based approach has been made to preserve the goatskin to reduce pollution in tannery wastewater. The Ficus hispida plant leaf paste with a minimal amount of common salt was applied on the flesh side of raw goatskin. Efficacy of the method was evaluated by scrutinizing thermal stability, hair slip, odor, moistness percentage, Total Kjeldahl Nitrogen, and bacterial count in comparison with the conventional wet salting preservation method for 28 days. Pollution load in the wastewater, for example, total dissolved solids (TDS), total suspended solids (TSS), chloride (Cl−), biochemical oxygen demand (BOD), and chemical oxygen demand (COD) was measured following the APHA method. Results indicate that the novel plant‐based method has decreased the pollution load of Cl−, TDS, TSS, BOD, and COD in the tannery wastewater by 51.02%, 41.6%, 37.1%, 2.9%, and 14.6%, respectively. Leather produced from the experimentally preserved goatskin illustrates similar physical properties in comparison to the leather produced from conventionally preserved goatskin. The proposed preservation technique of goatskin in combination with lower salt might be an ecological alternative that could decrease the pollution load especially in soaking operation.
Lower leptin level at discharge in acute anorexia nervosa is associated with early weight‐loss
Authors: Dardennes Roland , Tolle Virginie , Lavoisy Guillaume , Grouselle Dominique , Alanbar Nebal , Duriez Philibert , Gorwood Philip , Ramoz Nicolas , Epelbaum Jacques
Published: April 2021

Objective

Predictive values of acute phase metabolic abnormalities of anorexia nervosa (AN) have seldom been studied. As early postrestoration weight loss is associated with poor outcome, discharge biologic parameters were assessed to detect an association with 2‐month follow‐up weight loss as a proxy to poor outcome.

Method

Fasting plasma levels of leptin, acyl‐ghrelin, obestatin, PYY, oxytocin and BDNF were measured in 26 inpatients, at inclusion, at discharge and 2 months later. A body mass index less than 18 2‐month postdischarge was considered a poor outcome.

Results

Nineteen patients (73%) had a fair outcome and seven (27%) had a poor one with a mean loss of 0.69 versus 4.54 kg, respectively. Only discharge leptin levels were significantly higher in fair versus poor outcome patients (14.1 vs. 7.0 ng/ml, p = 0.006). The logistic regression model using discharge leptin, acyl‐ghrelin, obestatin, oxytocin, PYY and BDNF levels as predictors of outcome disclosed a nearly significant effect of leptin (p < 0.10). Receiver operating characteristic analysis showed 11.9 ng/ml was the best value of threshold. Neither clinical variables differed according to outcome.

Conclusion

Leptin level may be a biomarker of early weight relapse after acute inpatient treatment of AN. Its clinical usefulness in monitoring care in AN should further be determined.
The thrombin receptor modulates astroglia‐neuron trophic coupling and neural repair after spinal cord injury
Authors: Kim Ha Neui , Triplet Erin M. , Radulovic Maja , Bouchal Samantha , Kleppe Laurel S. , Simon Whitney L. , Yoon Hyesook , Scarisbrick Isobel A.
Published: April 2021

Excessive activation of the thrombin receptor, protease activated receptor 1 (PAR1) is implicated in diverse neuropathologies from neurodegenerative conditions to neurotrauma. PAR1 knockout mice show improved outcomes after experimental spinal cord injury (SCI), however information regarding the underpinning cellular and molecular mechanisms is lacking. Here we demonstrate that genetic blockade of PAR1 in female mice results in improvements in sensorimotor co‐ordination after thoracic spinal cord lateral compression injury. We document improved neuron preservation with increases in Synapsin‐1 presynaptic proteins and GAP43, a growth cone marker, after a 30 days recovery period. These improvements were coupled to signs of enhanced myelin resiliency and repair, including increases in the number of mature oligodendrocytes, their progenitors and the abundance of myelin basic protein. These significant increases in substrates for neural recovery were accompanied by reduced astrocyte (Serp1) and microglial/monocyte (CD68 and iNOS) pro‐inflammatory markers, with coordinate increases in astrocyte (S100A10 and Emp1) and microglial (Arg1) markers reflective of pro‐repair activities. Complementary astrocyte‐neuron co‐culture bioassays suggest astrocytes with PAR1 loss‐of‐function promote both neuron survival and neurite outgrowth. Additionally, the pro‐neurite outgrowth effects of switching off astrocyte PAR1 were blocked by inhibiting TrkB, the high affinity receptor for brain derived neurotrophic factor. Altogether, these studies demonstrate unique modulatory roles for PAR1 in regulating glial‐neuron interactions, including the capacity for neurotrophic factor signaling, and underscore its position at neurobiological intersections critical for the response of the CNS to injury and the capacity for regenerative repair and restoration of function.
Variations on Consent
Authors: Kaebnick Gregory E.
Published: April 2021

Two articles in the March‐April 2021 issue of the Hastings Center Report consider alterations to traditional informed consent. In “The Consent Continuum: A New Model of Consent, Assent, and Nondissent for Primary Care,” Marc Tunzi and colleagues argue that, in primary care settings, patient consent should be understood as taking a range of forms depending on the procedure, the patient, and the patient‐care context. Traditional informed consent is at the ceremonious end; for many things done in these settings, the authors assert, assent or even nondissent is fine. In the lead article, health policy scholars Stephanie Morain and Emily Largent consider another continuum for informed consent, this one occurring with pragmatic research, at the intersection of clinical care with research.
Public Attitudes toward Consent When Research Is Integrated into Care—Any “Ought” from All the “Is”?
Authors: Morain Stephanie R. , Largent Emily A.
Published: April 2021

Research that is integrated into ongoing clinical activities holds the potential to accelerate the generation of knowledge to improve the health of individuals and populations. Yet integrating research into clinical care presents difficult ethical and regulatory challenges, including how or whether to obtain informed consent. Multiple empirical studies have explored patients' and the public's attitudes toward approaches to consent for pragmatic research. Questions remain, however, about how to use the resulting empirical data in resolving normative and policy debates and what kind of data warrants the most consideration. We recommend prioritizing data about what people consider acceptable with respect to consent for pragmatic research and data about people's informed, rather than initial, preferences on this subject. In addition, we advise caution regarding the weight given to majority viewpoints and identify circumstances when empirical data can be overridden. We argue that empirical data bolster normative arguments that alterations of consent should be the default in pragmatic research; waivers are appropriate only when the pragmatic research would otherwise be impracticable and has sufficiently high social value.
Estimating optimal willingness to pay thresholds for cost‐effectiveness analysis: A generalized method
Authors: Phelps Charles E , Cinatl Chris
Published: April 2021

Operationalizing cost‐effectiveness analysis (CEA) requires that decisionmakers select maximum willingness to pay thresholds (K). We generalize previous methods used to estimate K using highly flexible hyperbolic absolute risk aversion (HARA) utility functions that encompass a wide range of risk behavior. For HARA utility, we calculate formulas for relative risk aversion (r*) and relative prudence (π∗), using literature‐based estimates to calibrate our HARA model. We then assess optimal WTP thresholds (K) in absolute value and relative to income (K/M). Across the most‐plausible range of risk preference parameters (r* and π∗), optimal K/M ratios sit (approximately) in the range of 1 to 3, although we cannot readily rule out larger K/M values. The optimal K always increases with income, while K/M falls with income if utility has increasing relative risk aversion. Results of this more‐general model of economic utility are broadly consistent with previous work using more‐restrictive Weibull functions. More precision in measuring the key parameters—particularly relative prudence (π∗) will narrow down the range of K/M estimates. The highly general HARA structure illuminates why and how optimal CEA thresholds change with income. An appendix illuminates how relative risk aversion and relative prudence relate to each other.
A study on financial sustainability of healthcare indicators for Turkey under the health transformation program
Authors: Kilci Esra N.
Published: April 2021

This paper attempts to assess the financial sustainability of the healthcare system in Turkey by providing an empirical evaluation by concentrating on Turkey’s healthcare system as a single country case after presenting the main developments with the transition to the Health Transformation Program (HTP) which was mainly carried out from 2003 through 2013. The analysis covers the period from 1999 through 2018 in which Turkey has undergone a significant transformation process in terms of the healthcare system. In the analysis, we employ a recent empirical approach which uses the Residual Augmented Least Squares procedure to examine the financial sustainability of healthcare indicators. Our findings suggest that healthcare indicators do not have a financially consistent pattern in the analysis period.
Chief executive officer positive framing and employee ownership
Authors: Li Jiangyan , Shi Wei , Dasborough Marie T.
Published: April 2021

Employee ownership is an important governance tool used to encourage employee participation and enhance employee productivity, but we know little about what encourages employee ownership. This study investigates the influence of chief executive officer (CEO) positive framing in public speeches on employee ownership. We propose that CEO positive framing can increase employee ownership when employees internalize CEOs' positive beliefs about firms' accomplishments and prospects. Using a sample of 664 U.S. listed firms from 2002 to 2018, we find that CEO positive framing increases employee ownership. In addition, the stock purchasing behaviors of top executives, analyst recommendations, and positive media coverage strengthen the effectiveness of CEOs' positive framing on employee ownership. Findings from this study advance employee ownership research by highlighting the vital role of CEOs' public language use in promoting employee ownership.
Minding the maps: Using visual mapping methodology and installation art to understand differences in client service accessibility among nonprofit organizations in Los Angeles
Authors: Capous‐Desyllas Moshoula , Bogumil Elizabeth , Lara Patricia , Reshetnikov Aleksey
Published: April 2021

This study highlights the pathways of clients' social service usage through qualitative interviews and visual mapping methodology. Undergraduate students interviewed clients at diverse social service agencies in Los Angeles that include homeless shelters, child welfare organizations, domestic violence organizations, LGBTQIA youth‐oriented agencies, nonprofits serving older adults, schools, and organizations serving low‐income families. Students used the information gathered from the interviews to visually map their clients' environmental and structural barriers, as well as their pathways to service. The research team then analyzed the students' visual maps to create one cohesive, complex, and multilayered visual map representing clients' overall barriers and pathways to social services in Los Angeles.
Recent advances in integrated process analytical techniques, modeling, and control strategies to enable continuous biomanufacturing of monoclonal antibodies
Authors: Chopda Viki , Gyorgypal Aron , Yang Ou , Singh Ravendra , Ramachandran Rohit , Zhang Haoran , Tsilomelekis George , Chundawat Shishir P S , Ierapetritou Marianthi G
Published: April 2021

Continuous bioprocessing is significantly changing the biological drugs (or biologics) manufacturing landscape by potentially improving product quality, process stability, and overall profitability, as was similarly seen during the adoption of advanced manufacturing processes for small molecule drugs in the past decade. However, the implementation of continuous manufacturing for biological processes producing protein‐based drug molecules, such as monoclonal antibodies (mAbs), is facing several new hurdles. The barriers to continuous bioprocessing can be overcome through improved process understanding via better predictive capabilities enabled by hybrid modeling that can also lead to robust process control. This review article summarizes the recent advances and ongoing obstacles faced during the use of advanced process analytical technologies (PAT), process modeling, and control strategies to enable continuous manufacturing of mAbs. In addition, this review also discusses the process strategies and future directions of advanced continuous manufacturing approaches that have been adapted by other industries and that could be implemented for mAbs production soon. © 2021 Society of Chemical Industry (SCI).
Structural adaption of the nasal conchae of Eurasian common moorhen (Gallinula chloropus chloropus, Linnaeus, 1758)—Histomorphological study
Authors: Hanafy Basma G.
Published: April 2021

In the current study, the nasal conchae of the Eurasian common moorhen were grossly and histologically examined for 20 healthy adult birds. Rostral (RC), middle (MC), and caudal (CC) conchae in each side of the nasal cavity were observed. The anatomical cross sections revealed that, the RC was noncurved in its rostral and middle parts, and one half turn in its caudal part. The MC was one half turn in its rostral part, one turn in its middle part, and one and one half turns in its caudal part. The CC was like a pouch from the lateral wall of the nasal cavity. Histologically, the distribution of the mucous glands was different among the three conchae; In RC, the ducts of these glands were intraepithelial, while the acini were located in the propria–submucosa toward the convex surface of the concha and absent toward its concave surface. In MC, they were intraepithelial and opened directly on the surface epithelium of the convex and concave surfaces. In CC, they were intraepithelial in few number near the convex surface of the concha and with abundant number in the propria–submucosa and absent near the concave surface. The RC was richer in the vascularity than the other two conchae. The nasal conchae were functioning for conditioning of the inspired air and entrapping the antigens presented in it.
Comparative palynology and taxonomic implication of Jasminum L. (Oleaceae) species from Pakistan on the bases of scanning electron microscopy
Authors: Akhtar Naeem , Hayat Muhammad Qasim , Hafiz Ishfaq Ahmed , Abbasi Nadeem Akhtar , Malik Saad Imran , Habib Umer , Hussain Adil , Potter Daniel
Published: April 2021

Jasminum L. is the largest genus containing ~200 species found wild mostly in the tropical regions of the world. The comparative palynological study of nine Pakistani Jasminum species with SEM showed zonocolpus, trilobate, and tricolpus pollen types with simple endocolpus apertures which are plesiomorphic and conserved in the Jasminum species. The equatorial pollen view was prolate, subprolate, and perprolate with elliptic, lobate, subcircular whereas polar view was subtriangular in all species. Few characters were specific to some species like heteropolarity in Jasminum grandiflorum and foveolate exine ornamentation with rounded heterobrochate in Jasminum angulare whereas reticulate and angular homobrochate character was common in other species. The UPGMA dendrogram based on qualitative characters did not support the phylogenetic classification of the genus Jasminum as these are highly conserved. The quantitative data showed more variation in some characters whereas few characters showed little or no variation. A greater variation in pollen size was observed among the variants of same species, for example, Jasminum humile showed highly variable polar length and equatorial diameter as compared to other species. Minimum variation was observed in colpus length which divided all species in to two groups. The large lumina were specific to Jasminum nitidum and broader muri was the prominent characteristic of Jasminum angulare. Some species like Jasminum sambac and Jasminum azoricum were unable to develop true pollen due to structural or functional disabilities. So, the quantitative characters of pollen are only suitable for palynological based grouping of Jasminum species but less suitable to infer their evolutionary relationship.
Realization of noncontact confocal optical microsphere imaging microscope
Authors: Zhou Yan , Hong Minghui
Published: April 2021

A novel noncontact confocal optical microsphere imaging microscope (COMIM) is proposed to achieve high contrast optical nano‐imaging at a high scanning speed. The developed setup obtains images with significantly higher contrast when compared with conventional bright‐field microsphere nano‐imaging, as well as with a commercial confocal laser scanning microscope (CLSM). With the image‐by‐image scanning scheme, COMIM takes only 11% time to complete a three‐dimensional (3D) scanning image than using a commercial CLSM, while still offers an outstanding resolving power for the nano‐features on the sample.
Pharmacogenomic education among genetic counseling training programs in North America
Authors: Loudon Elizabeth , Scott Stuart A. , Rigobello Robert , Scott Erick R. , Zinberg Randi , Naik Hetanshi
Published: April 2021

The increasing number of genetic counselors participating directly in clinical pharmacogenomic post‐test counseling prompted our evaluation of pharmacogenomic education across genetic counseling training programs in North America. Thirty‐one program leadership participants from both the United States (U.S.) and Canada responded to a survey assessing pharmacogenomics education and the role of genetic counselors. Eighty‐five percent of respondents agreed pharmacogenomics is currently within the scope of genetic counseling practice, and 96.3% indicated their training programs currently provide education on pharmacogenomics, with the majority reporting < 7 hr of education. Lectures on pharmacogenomics were the most common method for didactics; however, some programs also included practical modalities (e.g., case studies, clinical rotations) and online resources. Barriers to expanding pharmacogenomic education included the constrained timeline of training, and lack of resources and local expertise. Moreover, participants suggested that genetic counselors ideally should be able to order pharmacogenomic tests and counsel patients on pharmacogenomics, including result interpretation, as they believe pharmacogenomics does fall within the scope of practice of genetic counseling. Our novel results also confirm that training program leadership support a pharmacogenomic service delivery model that includes a combined effort between genetic counselors and pharmacists to utilize their synergistic expertise. However, this model likely still necessitates expanding pharmacogenomic didactics in genetic counseling training programs through more practical training and/or by leveraging online pharmacogenomic courses dedicated to supporting clinical implementation.
LINC00958 promotes endometrial cancer cell proliferation and metastasis by regulating the miR‐145‐3p/TCF4 axis
Authors: Jiang Ying , Qiao Zhiwei , Jiang Jing , Zhang Jingru
Published: April 2021

Background

Long noncoding RNAs (lncRNAs) exert an essential regulatory role in cancer progression. This work focuses on the role of LINC00958 in endometrial cancer (EC).

Methods

LINC00958 expression in EC tissues was examined by GEPIA database and TCGA‐UCEC dataset. LINC00958, miR‐145‐3p, and TCF4 mRNA expression levels in EC tissues and cells were examined by qRT‐PCR. Western blot was employed to determine TCF4, E‐cadherin, and N‐cadherin protein expression levels. After LINC00958 was overexpressed or silenced, cell proliferation was determined using Cell Counting Kit 8 (CCK‐8) and bromodeoxyuridine (BrdU) incorporation experiments. Cell migration and invasion were examined by Transwell experiment. Dual‐luciferase reporter gene or RNA immunoprecipitation (RIP) experiments were executed to validate the targeting relationships among LINC00958 and miR‐145‐3p and TCF4. The effects of LINC00958 on EC cell proliferation and metastasis were investigated in vivo using a nude mouse subcutaneous graft model and a caudal vein injection model.

Results

LINC00958 was remarkably upmodulated in EC. Moreover, its overexpression was strongly linked to unfavorable overall survival of the patients. Functional experiments confirmed that in vitro knockdown of LINC00958 suppressed EC cell proliferation and metastasis. LINC00958 was validated to decoy miR‐145‐3p and repressed its expression, and TCF4 was uncovered to be a target gene of miR‐145‐3p and negatively modulated by miR‐145‐3p. Furthermore, the function of LINC00958 was dependent on its regulation of miR‐145‐3p and TCF4.

Conclusions

LINC00958 acts as an oncogenic lncRNA to regulate EC progression by modulating the miR‐145‐3p/TCF4 axis. Knockdown of LINC00958 impedes tumor growth and metastasis in vitro and in vivo, opening a new avenue for therapeutic intervention.
ATR kinase activity promotes antibody class switch recombination in B cells through cell cycle regulation without suppressing DSB resection and microhomology usage
Authors: Sun Xikui , Liu Meiling , Bai Jingning , Xu Jiejie , Zhu Chengming , Dong Junchao , Chen Chun
Published: April 2021

Class switch recombination (CSR) changes the effector functions of antibodies and is carried out by classical and alternative nonhomologous end joining (c-NHEJ and A-EJ) of repetitive switch (S) region double-strand breaks (DSBs). The master DNA damage response (DDR) kinase ataxia-telangiectasia mutated (ATM) is critical for CSR in part by suppressing S region DSB resection. However, whether another related DDR kinase ATM- and Rad3-related (ATR) plays similar role in CSR remains elusive. In this study, we investigated the requirement for ATR kinase activity on CSR in both c-NHEJ competent and deficient B cell lines with high-throughput sequencing of S-S junctions. We found that ATR kinase inhibition efficiently blocked both c-NHEJ- and A-EJ-mediated CSR without affecting germline transcription and activation-induced cytosine deaminase expression. In contrast to ATM, ATR does not suppress S region DSB resection and microhomology usage. In addition, ATR kinase inhibition did not affect Cas9-generated DSB end joining by either c-NHEJ and A-EJ. ATR kinase-inhibited stimulated B cells proliferate much slower than controls and exhibited altered cell cycle profile with increased G1 and G2/M phase cells. In summary, our data revealed a role for ATR in promoting both c-NHEJ- and A-EJ-mediated CSR through regulating cell proliferation upon damage without negatively influencing DSB end-joining features.
The lymphatic drainage system of the CNS plays a role in lymphatic drainage, immunity, and neuroinflammation in stroke
Authors: Chen Jinman , Wang Linmei , Xu Hao , Wang Yongjun , Liang Qianqian
Published: April 2021

The lymphatic drainage system of the central nervous system (CNS) plays an important role in maintaining interstitial fluid balance and regulating immune responses and immune surveillance. The impaired lymphatic drainage system of the CNS might be involved in the onset and progression of various neurodegenerative diseases, neuroinflammation, and cerebrovascular diseases. A significant immune response and brain edema are observed after stroke, resulting from disrupted homeostasis in the brain. Thus, understanding the lymphatic drainage system of the CNS in stroke may lead to the development of new approaches for therapeutic interventions in the future. Here, we review recent evidence implicating the lymphatic drainage system of the CNS in stroke.
Artificial intelligence–based design optimization of nonuniform microstrip line band pass filter
Authors: Mahouti Tarlan , Yıldırım Tülay , Kuşkonmaz Nilgün
Published: April 2021

Design optimization of many electromagnetic and multiphysics problems have multiscale issues that require a fast, efficient, and accurate surrogate‐based model to be used. Recently, in microwave engineering field, artificial intelligence–based models are being used for modeling of complex microwave stages. In all the studies, the main aim is to form models inner structure parameters, by using the given data to predict the linear/nonlinear relationships between given inputs and outputs. Herein, a surrogate‐based model of a nonuniform microstrip transmission line (NTL) with a typical application of design optimization of a band‐pass filter for ISM band application using deep learning (DL) and meta‐heuristic optimization has been presented. In order to have a computationally efficient and accurate optimization process, firstly a 3D EM unit element model of NTL has been designed. The training and test data sets are created based on different sampling methods. A DL regression model modified multilayer perceptron M2LP have been used for prediction of scattering parameters (S) of the NTL, with respect to the variation of geometrical design parameters. The proposed S‐parameters will then be used to calculate the equivalent S‐parameters of the cascading NTL to be used to calculate the NTL‐based microstrip band‐pass filter S‐parameter response. The optimal design parameters of each line used in the filter design have been determined using a fast and powerful optimization algorithm differential evolutionary algorithm.
Improved multi‐model ensemble forecasts of Iran's precipitation and temperature using a hybrid dynamical‐statistical approach during fall and winter seasons
Authors: Najafi Husain , Robertson Andrew W. , Massah Bavani Ali R. , Irannejad Parviz , Wanders Niko , Wood Eric F.
Published: April 2021

Skillful seasonal climate forecasts can support decision making in water resources management and agricultural planning. In arid and semi‐arid regions, tailoring reliable forecasts has the potential to improve water management by using key hydroclimate variables months in advance. This article analyses and compares the performance of two common approaches (empirical and hybrid dynamical‐statistical) in seasonal climate forecasting over a drought‐prone area located in Southwest Asia including Iran. Empirical models are framed as a baseline skill that hybrid models need to outperform. Both approaches provide probabilistic forecasts of precipitation and temperature using canonical correlation analysis to provide forecasts at 0.25° resolution. Empirical models are developed based on the large‐scale observed atmosphere–ocean patterns for forecasting using antecedent climate anomalies as predictors, while the hybrid approach makes use of model output statistics to correct systematic errors in dynamical climate model forecast outputs. Eight state‐of‐the‐art dynamical models from the North American Multi‐Model Ensemble project are analysed. Individual models with the highest goodness index are weighted to develop seven different hybrid dynamical‐statistical Multi‐model Ensembles. In this study, (October–December) and (January–February) are considered as target seasons which are the most important periods within the water year for water resource allocation to the agriculture sector. The results show that the hybrid approach has improved performance compared to the raw general circulation models and purely empirical models, and that the performance of the hybrid models is season‐dependent. Seasonal forecasts of precipitation (temperature) have a higher skill in OND (JFM). In addition, in most cases, Multi‐model Ensemble (MME) is more skillful than the empirical models and outperforms individual dynamical models. However, the best individual model might be as skillful as the MME given the target season and region of interest.
The first case with FBXL4 mutation successfully treated with a parenteral ketogenic diet for lactic acidosis
Authors: İnci Aslı , Aktaş Emine , Cengiz Ergin Filiz Başak , Okur İlyas , Biberoğlu Gürsel , Ezgü Fatih Süheyl , Tümer Leyla
Published: April 2021

Background

The ketogenic diet (KD) is a low‐carbohydrate, high‐fat diet that has been used as an effective nonpharmacological treatment in many neurological and metabolic disorders for a long time. The effectiveness of the KD is revealed in mitochondrial disorders, mainly in pyruvate dehydrogenase deficiency.

Case report: A 4‐year‐old girl who was diagnosed with an F‐box and leucine‐rich repeat protein 4 (FBXL4) gene mutation was hospitalized with sepsis. She was first given standard parenteral nutrition (PN) because of gastrointestinal problems. During the disease course, lactic acidosis became prominent and did not respond to pharmacological treatment; standard PN was gradually switched to parenteral KD, and lactate levels decreased after parenteral KD. The patient was discharged with an enteral KD.

Conclusion

This is the first case of mitochondrial depletion syndrome effectively treated with parenteral KD for lactic acidosis.
Improved Detection of Gallbladder Perforation Using Ultrasound Small Vessel Slow Flow “Perfusion” Imaging
Authors: Aziz Muhammad U , Robbin Michelle L.
Published: April 2021

Gallbladder (GB) perforation is a potentially fatal cause of acute abdomen. Higher morbidity and mortality are associated with this entity due to delayed diagnosis and treatment. Ultrasound with color/power Doppler and contrast sonography can detect wall discontinuity; however, sometimes it can be subtle or unavailable. Small vessel slow flow “perfusion” imaging allows improved microvascular perfusion detection using different filters, which result in increased spatial resolution and vessel visualization. Noncontrast perfusion imaging was of immense clinical value in the diagnosis of GB perforation in the six cases presented here. To the best of our knowledge, this is the first case report describing efficacy of noncontrast “perfusion” imaging in detection of GB perforation.
Paper Patching Versus Watchful Waiting of Traumatic Tympanic Membrane Perforations: A Meta‐Analysis
Authors: Simani Liam , Oron Yahav , Handzel Ophir , Eta Rani Abu , Warshavsky Anton , Horowitz Gilad , Muhanna Nidal , Ungar Omer J.
Published: April 2021

Objectives/Hypothesis

The aim of the study was to investigate the healing rates, the restoration of hearing, and the time for complete healing of paper patching versus watchful waiting for traumatic tympanic membrane perforations (TTMPs).

Study Design

Systematic review with meta analysis.

Methods

Publications were selected by a search on “PubMed,” “Embase,” and “Web of Science.” A meta‐analysis of risk ratios for paper patching (intervention arm) and watchful waiting (control arm) was performed.

Results

Five studies describing 393 TTMPs were included in the quantitative meta‐analysis. TTMP healing rates ranged between 84.2% and 95.2% in the intervention arm and between 76.7% and 84.8% in the control arm. The pooled risk ratio of healed TTMPs was significantly higher in the intervention arm than in the control arm (risk ratio: 1.12, 95% confidence interval: 1.04–1.21).

Conclusions

TTMPs have high healing potential with and without intervention. The healing rate of paper patching was superior to that of watchful waiting alone.

Level of Evidence

NA Laryngoscope, 131:2091–2097, 2021
The Prevalence of Incidental Mastoid Opacification and the Need for Intervention: A Meta‐Analysis
Authors: Mughal Zahir , Charlton Alexander Rowan , Clark Matthew
Published: April 2021

Objectives/Hypothesis

The increasing use of cross‐sectional imaging has led to the predicament of incidental mastoid opacification (IMO). We investigated the prevalence of IMO and the clinical need for ENT assessment or intervention when identified.

Study Design

Systematic review and meta‐analysis.

Methods

The PRISMA statement standards were used to search electronic databases including Medline, Embase, PubMed, and Web of Science. The selection criteria were mastoid opacification found on computed tomography (CT) or magnetic resonance imaging (MRI) as incidental findings.

Results

A total of 16 studies were identified for qualitative analysis and 15 for quantitative analysis, mainly retrospective. The pooled prevalence of IMO in 246,288 patients was 8.4% (95% CI 5.5–12.0). The prevalence of IMO was significantly higher in studies with children (17.2%, 95% CI 10.9–24.6) than those with adults (6.1%, 95% CI 3.3–9.6); smaller sample size studies (12.4%, 95% CI 8.1–17.3) compared to larger sample size studies (4.1%, 95% CI 1.5–7.8); and when IMO was detected by viewing images (14.5%, 95% CI 9.9–19.8) compared to reading reports (3.5%, 95% CI 1.3–6.6). Imaging modality was not a significant moderator due to similar IMO rate on CT (8.6%, 95% CI 1.8–19.7) and MRI (10.4%, 95% CI 4.9–17.6). Nine studies reported on clinical outcomes of patients with IMO, and none reliably reported any cases of clinical mastoiditis.

Conclusions

The term “mastoiditis” on radiology reports based on IMO does not indicate a clinical diagnosis of mastoiditis, although the current body of evidence is limited. Otolaryngology review is suggested if clinical correlation detects otological signs or symptoms.

Level of Evidence

NA Laryngoscope, 132:422–432, 2022
Modified Cyclodextrin Microparticles to Improve PMMA Drug Delivery Without Mechanical Loss
Authors: Lu Chao‐Yi , Church Derek C. , Learn Greg D. , Pokorski Jonathan K. , von Recum Horst A.
Published: April 2021

Antibiotic‐loaded poly(methyl methacrylate) (PMMA) cement is commonly used as a local delivery system to treat and prevent orthopedic infections associated with arthroplasties in load‐bearing applications. However, these delivery systems are inefficient as release rate sharply declines to subinhibitory levels. Prior studies have shown that by adding in drug‐filled cyclodextrin (CD) microparticles into PMMA cement, a more consistent release is observed, and antibiotic refilling through simulated implantation can be achieved. However, the mechanical strengths of PMMA is reduced. In order to decrease the mechanical loss, modified CD microparticles (PMMA‐CD) are synthesized that contain covalently appended PMMA chains. The compressive strengths, handling characteristics, and refilling ability of PMMA cement with PMMA‐CD are evaluated. Specifically, up to a 13.7% increase in compressive strength is observed when unmodified CD is substituted with PMMA‐CD in PMMA samples with 10 wt% CD microparticles. Additionally, a 13.3% increase in working time, a 7.5% decrease in maximum polymerization temperature, and up to a 32.1% increase in amount of drug refilled are observed with the addition of 10 wt% CD PMMA‐CD into PMMA in comparison to plain PMMA without CD microparticles.