bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterization of regional differences in cerebral vascular response to breath holding usingBOLD fMRI
Authors: Chen Chun‐Ming , Yang Hui‐Chieh , Hsieh Hsin‐Hua , Liao Tsai‐Ying , Huang Yen‐Chih , Peng Shin‐Lei
Published: August 2020

Cerebrovascular reactivity (CVR) is a specific indicator of autoregulatory efficiency. Studies have demonstrated that CVR depends on the baseline vascular dilation status between groups. Within the brain, there also exist spatial variations in both the resting cerebral blood flow (CBF) and CVR across different cerebral regions. However, the relationship between the regional CBF and CVR remains unclear. Hence, the primary goal of this study was to investigate the relationship between the resting CBF using pseudocontinuous arterial spin labeling (pCASL) technique and CVR using blood oxygenation level‐dependent (BOLD) technique across different cerebral regions. Eleven male and 14 female young volunteers were recruited in this study. Each subject was asked to perform the breath‐holding challenge to evaluate CVR at 3 T. The resting CBF was measured using pCASL in each subject. The relationships between CBF and CVR across the lobes were evaluated using the Spearman's rank test. The results showed that, for both sexes, the frontal lobe had the maximal resting perfusion but minimal vascular response to hypercapnia, whereas the occipital lobe had the lowest baseline CBF but maximal reactivity to hypercapnia, suggesting low and high autoregulatory efficiencies at high and low resting CBF in the brain, respectively. Sex‐related differences were observed in CBF but not in CVR. These findings may be of clinical interest in the assessment of cerebrovascular reserve and regional‐dependent vascular diseases.
Mining database for the clinical significance and prognostic value of CBX family in skin cutaneous melanoma
Authors: Li Ding , Liu YiRan , Hao Shuai , Chen Bo , Li AnHai
Published: August 2020

Background

Skin cutaneous melanoma (SKCM) is one of the most aggressive malignancies with high invasiveness. Chromobox (CBX) family are involved in the regulation of the tumorigenesis, progression, invasion, and apoptosis of many malignancies.

Methods

The clinical significance and prognostic value of CBX family in SKCM were analyzed via a series of databases, including ONCOMINE, GEPIA, UALCAN, TIMER, GSCALite, DAVID 6.8, GeneMANIA, and LinkedOmics.

Results

We found that the level of CBX2, CBX3, CBX5, and CBX6 was upregulated while the level of CBX7 and CBX8 was downregulated in tumor tissues in SKCM. Moreover, the mRNA expression of CBX1 and CBX2 was significantly associated with the pathological stage in SKCM. Prognosis analysis revealed that SKCM patients with high CBX5 level and low CBX7 level had a poor prognosis. Immune infiltrations analysis revealed that the expression of CBX family was associated with the abundance of certain immune cells in SKCM. We also found that CBX family were associated with the activation of cell cycle pathway and DNA damage response, and the inhibition of apoptosis pathway. Moreover, enrichment analysis revealed that CBX family and correlated genes were enriched in chromatin modification, PcG protein complex, transcription coactivator activity, protein binding, and RNA splicing. Several Kinase targets (ATM, CDK1, and PLK1) and miRNA targets (MIR‐331, MIR‐296, and MIR‐496) of CBX family were also identified.

Conclusion

Our study may uncover CBX family–associated molecular mechanisms involved in the tumorigenesis and progression of SKCM and provide additional choice for the prognosis and therapy biomarker for SKCM.
Development and validation of a predictive model for the prognosis in aneurysmal subarachnoid hemorrhage
Authors: Lai Xiang , Zhang Wenbo , Ye Min , Liu Xiaoping , Luo Xingda
Published: August 2020

Background

This study was to conduct a predictive model for the prognosis of aneurysmal subarachnoid hemorrhage (aSAH) and validate the clinical data.

Methods

A total of 235 aSAH patients were enrolled in this study, dividing into the favorable or poor prognosis groups based on Modified Rankin Scale (mRS) at 3 months postoperatively. Multivariate analysis was assessed using binary Logistic regression and Fisher discriminant analysis. The receiver operating characteristic (ROC) curve was used to determine the cut‐off value.

Results

Our findings showed that the high Glasgow Coma Scale (GCS) score 24‐hour after surgery reduced the risk of poor prognosis, and the surgical clipping and elevated neutrophil‐lymphocyte ratio (NLR) increased the risk of poor prognosis. The discriminant function was V = 0.881 × GCS score − 0.523 × NLR − 0.422 × therapeutic approach, and V = −0.689 served as a cut‐off value. When V ≥ −0.689, the good prognosis was considered among these patients with aSAH. The correctness for predicting the prognostic outcomes by self‐validation was 85.11%.

Conclusion

This predictive model established by a discriminant analysis is a useful tool for predicting the prognostic outcomes of aSAH patients, which may help clinicians identify patients at high risk for poor prognosis and optimize treatment after surgery.
Daily change patterns in mindfulness and psychological health: A pilot intervention
Authors: Kim Shin Ye , Suh Hanna , Oh Wonjung , Daheim Jacob
Published: August 2020

Objective

This study examined the differences in first‐year college students' daily change trajectories in subjective happiness, depression, anxiety, stress, and state mindfulness.

Method

A 5‐day, online mindfulness‐based intervention (MI) condition and stress management (SM) condition were employed in 247 first‐year college students.

Results

Students in both the MI and SM conditions displayed similar significant linear declines in anxiety and stress, but there were significant differences between the two conditions, including: (1) the MI condition showing a significant linear increase in subjective happiness compared with no change in the SM condition and (2) the SM condition showed a significant linear decrease in depression compared to no significant change in the MI condition.

Conclusion

Brief online interventions—whether MI or SM—can promote better mental health and reduce psychological distress. The results also lend support for MI's differential influence on first‐year college students' happiness and SM's differential influence on their depression.
Struggling with perfectionism: When good enough is not good enough
Authors: Overholser James , Dimaggio Giancarlo
Published: August 2020

Perfectionism includes a tendency for high standards for self and others with a clear goal of successful performance in a variety of areas. A perfectionist often reacts with critical evaluations whenever performance falls below these standards. Moreover, perfectionists emphasize personal goals to gauge their worth, neglecting intimate bonds or openness to new experience. At the core of perfectionism lies a view of self as weak, flawed, and easily rejected. Perfectionism can result in chronic tendencies for emotional distress and interpersonal conflict. Treatment aims to explore personal views of self and others, viewing perfectionism as a form of maladaptive coping. When clients understand the role of perfectionism, they can discontinue striving to meet their extreme goals and unrealistic standards. The authors of the papers in the issue present their views on how to treat these maladaptive tendencies according to their preferred therapeutic orientation.
A fern frond‐like peripheral portal vein thrombosis in a neonate: A case report
Authors: Seber Turgut
Published: September 2020

Although the ultrasonographic (US) features of portal vein thrombosis in premature newborns have been described, there are very few reports on thrombosis of the peripheral branches of the portal vein. Here, I describe a case of peripheral portal vein branch thrombosis in a neonate, appearing on US imaging with a fern frond pattern.
Scanning electron microscopic and histological studies of the buccal cavity of a phytoplanktivorous small freshwater fish, Amblypharyngodon mola
Authors: Nandi Sudarshana , Saikia Surjya Kumar
Published: August 2020

The electron microscopic and histological studies of the buccal‐cavity of herbivorous fish Mola (Amblypharyngodon mola) were performed. The studies revealed that the architectures of the buccal cavity of A. mola support the herbivory nature of the fish. Both the upper and lower jaws of the fish are rich in mucus glands, unculi, and microridges. The presence of papillae like taste buds in the lower jaw of A. mola indicates the mechanosensory role of the lower jaw during gustation. These features directly support a gustatory feeding behavior associated with filter feeding in this small freshwater fish.
Multiwalled carbon nanotubes crowned with nickel‐ferrite magnetic nanoparticles assisted heterogeneous catalytic strategy for the synthesis of benzo[d]imidazo[2,1‐b]thiazole scaffolds
Authors: Geedkar Deepika , Kumar Ashok , Sharma Pratibha
Published: August 2020

Present manuscript elicits an account of the sonication promoted multicomponent reactions strategy assisted by multiwalled carbon nanotubes embraced with nickel‐ferrite (NiFe2O4‐CNTs) magnetic nanoparticles, as a heterogeneous catalyst to synthesize a novel series of pharmacologically active benzo[d]imidazo[2,1‐b]thiazole scaffolds. The synthesis of these biologically active derivatives was achieved via. A3 coupling involving 2‐aminobenzothiazole, pertinent aryl aldehydes and phenyl acetylene derivatives, proceeded in PEG 400 as green solvent under aerobic conditions to afford the products in good to excellent yields. The higher environmental compatibility and sustainability factors such as higher ecoscale score, smaller E‐factor and appreciable atom economy put this etiquette under the parasol of green chemistry precepts. The characterization of synthesized catalysts was attained through varied techniques viz. powder X‐ray diffraction, field emission scanning electron microscopy with energy‐dispersive X‐ray spectroscopy, Raman, FT‐IR, VSM and TGA‐DTA‐DTG analyses, dispersion studies, and nitrogen porosimetry analyses. The structures of the synthesized compounds were also endorsed by extensive spectroscopic studies (FT‐IR, 1H and 13C NMR, Mass) and elemental analyses.
Tocilizumab use in COVID‐19‐associated pneumonia
Authors: Okoh Alexis K. , Bishburg Eliahu , Grinberg Sagy , Nagarakanti Sandhya
Published: August 2020

Background

We sought to evaluate the effect of tocilizumab (TCB), a recombinant humanized monoclonal antibody against soluble interleukin‐6 receptors, in patients hospitalized for coronavirus disease 2019 (COVID‐19).

Methods

We included all patients with laboratory‐confirmed COVID‐19 who had completed hospitalization between March 10, 2020 and April 10, 2020 with follow‐up through April 20, 2020. Patients who received TCB in addition to standard of care within 48 h of admission were matched in a 1:2 fashion to a similar cohort who received standard of care alone. Clinical outcomes were compared between matched groups. The primary outcome was de‐escalation in oxygen therapy. Secondary outcomes were in‐hospital death, septic shock, and acute kidney injury (AKI) requiring hemodialysis.

Results

Out of 77 patients who received TCB in addition to standard of care, 34% (n = 26) received TCB within 48 h of admission. One‐to‐two propensity matching identified 20 versus 40 patients in the TCB and no‐TCB treatment arms. In the TCB group, an improvement in oxygenation was observed in 80% (n = 16) of the patients by 7 days post TCB administration. After matching, there was no difference in clinical outcomes between TCB and no‐TCB patients. In‐hospital death: 10% versus 8%; p = .823, septic shock: 10% versus 11%, p = .912, AKI requiring hemodialysis (10% vs. 13%; p = .734).

Conclusions

Early treatment with TCB in patients admitted for COVID‐19 led to an improvement in their oxygen status during hospitalization. This change however did not translate into improved survival when compared to a matched cohort with a similar clinical profile.
The prognostic role of neopterin in COVID‐19 patients
Authors: Ozger Hasan Selcuk , Dizbay Murat , Corbacioglu Seref Kerem , Aysert Pinar , Demirbas Zehra , Tunccan Ozlem Guzel , Hizel Kenan , Bozdayi Gulendam , Caglar Kayhan
Published: August 2020

In Coronavirus disease‐2019 (COVID‐19) cases, hyper inflammation is associated with the severity of the disease. High levels of circulating cytokines were reported in severe COVID‐19 patients. Neopterin produced by macrophages on stimulation with interferon‐gamma, which is an important cytokine in the antiviral immune response, hence it can be used to predict the severity of disease in COVID‐19 cases. In this study, it was aimed to determine the prognostic value of the neopterin for the prediction of severe disease in patients with COVID‐19. This single‐center, prospective study was conducted in hospitalized COVID‐19 patients and healthy volunteers. Severe and mild COVID‐19 cases were compared in terms of clinical and laboratory findings as well as serum neopterin levels on hospital admission. To assess the prognostic utility of neopterin between the severe and mild COVID‐19 groups, a receiver‐operating characteristic (ROC) curve was generated, and the area under the curve (AUC) was calculated. The median serum neopterin level was four times higher in COVID‐19 patients than the healthy controls (46 vs. 12 nmol/L; p < .001). The AUC value of serum neopterin was 0.914 (95% confidence interval, 0.85–0.97). The sensitivity and specificity of serum neopterin for the cut‐off value of 90 nmol/L to identify severe COVID‐19 cases were 100% and 76%, respectively. Serum neopterin levels on hospitalization were significantly higher in severe COVID‐19 disease than mild COVID‐19 patients. Neopterin levels can be used as an early prognostic biomarker for COVID‐19 on admission.
Changes of extreme climate events and related risk exposures in Huang‐Huai‐Hai river basin under 1.5–2°C global warming targets based on high resolution combined dynamical and statistical downscaling dataset
Authors: Wu Jia , Han Zhenyu , Li Rouke , Xu Ying , Shi Ying
Published: September 2020

Extreme climate events and related risk exposures in Huang‐Huai‐Hai (HHH) river basin were projected under global warming of 1.5–2°C using the high‐resolution combined dynamical and statistical downscaling dataset. Firstly, evaluation indicated that the dataset can well reproduce the spatial distribution of all temperature extremes and most of the precipitation extremes, providing a reliable ability for future projections. Then, projections showed that the hot events were projected to increase, while the cold events were projected to decrease substantially in the whole HHH river basin for 1.5°C and 2°C global warming. The additional 0.5°C of warming roughly accelerated the increase of extreme temperatures by 0.6°C, and increased the number of heat days by 2.7 days. In addition, the rainfall events and the precipitation intensity were projected to increase while the drought events were projected to decrease, with the slight changes due to the additional 0.5°C warming. The gross domestic product (GDP) exposures to heat events and heavy rainfall increased more than nine fold for 1.5°C and 2°C global warming, while the growing population (POP) exposures to that increased by more than 100% and 20%, respectively. For the increased exposures to heat events, the changes in GDP (POP) were as important as changes in interaction effect between climate and GDP (POP), while the exposures to heavy rainfall events was mainly dominated by GDP (POP). In addition, the enhanced interaction effect was the most important factor to the increase of exposures due to additional 0.5°C of warming. Notably, the largest increases of heat events and heavy rainfall events were projected in Huaihe river basin due to the additional 0.5°C warming, accompanied by greatest increase of exposures, implying larger risk in the future.
Hypophosphatemia as an Early Metabolic Bone Disease Marker in Extremely Low‐Birth‐Weight Infants After Prolonged Parenteral Nutrition Exposure
Authors: Tan Yin‐Ling , Tsao Po‐Nien , Chou Hung‐Chieh , Yen Ting‐An , Chen Chien‐Yi
Published: August 2020

Background

Early metabolic bone disease (MBD) detection is important in preterm infants to decrease long‐term consequence. We aim to explore the early MBD biochemical marker in extremely low‐birth‐weight (ELBW) infants.

Methods

Retrospective cohort study of 95 preterm infants born in a tertiary care–level neonatal intensive care unit between January 2015 and June 2018, with birth weight <1000 g. Thirty‐five infants were “nothing by mouth” for >14 days and categorized as the high‐risk group; the remaining 60 were categorized as the control group. Mineral intake in the first 14 days and the trend of serum calcium (Ca), phosphorus (P), and alkaline phosphatase (ALP) levels were compared in both groups.

Results

The Ca and P supplementation in the first 2 weeks of life were inadequate in both groups. Compared with the control group, significantly lower serum P (mg/dL) levels were noted in the high‐risk group on weeks 2 (3.65 ± 1.2 vs 4.67 ± 1.45; P < .001), 4 (3.21 ± 0.95 vs 5.83 ± 1.18; P < .0001), and 6 (3.94 ± 1.1 vs 6.22 ± 0.78; P <.0001). There was no significant difference in the serum Ca level, and significantly higher ALP (U/L) levels were found up until 2 months of life in the high‐risk group (458.36 ± 189.02 vs 335.7 ± 111.51; P < .014).

Conclusion

Hypophosphatemia developed as early as 2 weeks old in high‐risk preterm infants because of inadequate supplementation. Neither the serum Ca or ALP levels were affected. Thus, the routine monitoring of serum P level should be started 2 weeks after birth for early MBD detection in extremely ELBW infants.
Peru's emerging craft‐brewing industry and its implications for tourism
Authors: Duarte Alonso Abel , Kok Seng , O'Shea Michelle
Published: August 2020

While the body of research on craft beer production, consumption, and tourism is growing, some regions, such as Latin America, where beer products are also popular, have received much less attention. This study addresses this knowledge gap, exploring craft breweries in Peru, where in recent years gastronomy has gained significant momentum. In doing so, Porter's three generic competitive strategies and the resource‐based view frameworks are considered. Differentiation and focus strategies, coupled with firm resources, including symbiotic relationships between restaurateurs and craft breweries, camaraderie, and continuous partnership development emerged as key competitive factors, with key implications for tourism development.
White‐Tailed Deer Population Dynamics Following Louisiana Black Bear Recovery
Authors: Peters Rebecca M. , Cherry Michael J. , Kilgo John C. , Chamberlain Michael J. , Miller Karl V.
Published: August 2020

Changing predator communities have been implicated in reduced survival of white‐tailed deer (Odocoileus virginianus) fawns. Few studies, however, have used field‐based age‐specific estimates for survival and fecundity to assess the relative importance of low fawn survival on population growth and harvest potential. We studied white‐tailed deer population dynamics on Tensas River National Wildlife Refuge (TRNWR) in Louisiana, USA, where the predator community included bobcats (Lynx rufus), coyotes (Canis latrans), and a restored population of Louisiana black bear (Ursus americanus luteolus). During 2013–2015, we radio‐collared and monitored 70 adult (≥2.5 yrs) and 21 yearling (1.5‐yr‐old) female deer. Annual survival averaged 0.815 (95% CI = 0.734–0.904) for adults and 0.857 (95% CI = 0.720–1.00) for yearlings. We combined these estimates with concurrently collected fawn survival estimates (0.27; 95% CI = 0.185–0.398) to model population trajectories and elasticities. We used estimates of nonhunting survival (annual survival estimated excluding harvest mortality) to project population growth (λ) relative to 4 levels of harvest (0, 10%, 20%, 30%). Finally, we investigated effects of reduced fawn survival on population growth under current management and with elimination of female harvest. Despite substantial fawn predation, the deer population on TRNWR was increasing (λ = 1.06) and could sustain additional female harvest; however, the population was expected to decline at 20% (λ = 0.98) and 30% (λ = 0.94) female harvest. With no female harvest, the population was projected to increase with observed (λ = 1.15) and reduced fawn survival (λ = 1.02), but the population could not sustain current female harvest (10%) if fawn survival declined (λ = 0.90). For all scenarios, adult female survival was the most elastic parameter. Given the importance of adult female survival, the relative predictability in response of adult survival to harvest management, and the difficulty in altering fawn survival, reducing female harvest is likely the most efficient approach to compensate for low fawn survival. On highly productive sites such as ours, reduction, but not necessarily elimination, of harvest can mitigate effects of low fawn survival on population growth. © 2020 The Wildlife Society.
Development and evaluation of an EHR‐based computable phenotype for identification of pediatric Crohn's disease patients in a National Pediatric Learning Health System
Authors: Khare Ritu , Kappelman Michael D. , Samson Charles , Pyrzanowski Jennifer , Darwar Rahul A. , Forrest Christopher B. , Bailey Charles C. , Margolis Peter , Dempsey Amanda ,   And the PEDSnet Computable Phenotype Working Group
Published: August 2020

Objectives

To develop and evaluate the classification accuracy of a computable phenotype for pediatric Crohn's disease using electronic health record data from PEDSnet, a large, multi‐institutional research network and Learning Health System.

Study Design

Using clinician and informatician input, algorithms were developed using combinations of diagnostic and medication data drawn from the PEDSnet clinical dataset which is comprised of 5.6 million children from eight U.S. academic children's health systems. Six test algorithms (four cases, two non‐cases) that combined use of specific medications for Crohn's disease plus the presence of Crohn's diagnosis were initially tested against the entire PEDSnet dataset. From these, three were selected for performance assessment using manual chart review (primary case algorithm, n = 360, primary non‐case algorithm, n = 360, and alternative case algorithm, n = 80). Non‐cases were patients having gastrointestinal diagnoses other than inflammatory bowel disease. Sensitivity, specificity, and positive predictive value (PPV) were assessed for the primary case and primary non‐case algorithms.

Results

Of the six algorithms tested, the least restrictive algorithm requiring just ≥1 Crohn's diagnosis code yielded 11 950 cases across PEDSnet (prevalence 21/10 000). The most restrictive algorithm requiring ≥3 Crohn's disease diagnoses plus at least one medication yielded 7868 patients (prevalence 14/10 000). The most restrictive algorithm had the highest PPV (95%) and high sensitivity (91%) and specificity (94%). False positives were due primarily to a diagnosis reversal (from Crohn's disease to ulcerative colitis) or having a diagnosis of “indeterminate colitis.” False negatives were rare.

Conclusions

Using diagnosis codes and medications available from PEDSnet, we developed a computable phenotype for pediatric Crohn's disease that had high specificity, sensitivity and predictive value. This process will be of use for developing computable phenotypes for other pediatric diseases, to facilitate cohort identification for retrospective and prospective studies, and to optimize clinical care through the PEDSnet Learning Health System.
Mobilizing health district management teams through digital tools: Lessons from the District.Team initiative in Benin and Guinea using an action research methodology
Authors: Keugoung Basile , Bello Kéfilath Olatoyossi Akankè , Millimouno Tamba Mina , Sidibé Sidikiba , Dossou Jean Paul , Delamou Alexandre , Legrand Antoine , Massat Pierre , Gutierrez Nimer Ortuno , Meessen Bruno
Published: August 2020

Background

Improving capacities of health systems to quickly respond to emerging health issues, requires a health information system (HIS) that facilitates evidence‐informed decision‐making at the operational level. In many sub‐Saharan African countries, HIS are mostly designed to feed decision‐making purposes at the central level with limited feedback and capabilities to take action from data at the operational level. This article presents the case of an eHealth innovation designed to capacitate health district management teams (HDMTs) through participatory evidence production and peer‐to‐peer exchange.

Methods

We used an action research design to develop the eHealth initiative called “District.Team,” a web‐based and facilitated platform targeting HDMTs that was tested in Benin and Guinea from January 2016 to September 2017. On District.Team, rounds of knowledge sharing processes were organized into cycles of five steps. Quantitative and qualitative data were collected to assess the participation of HDMTs and identify enablers and barriers of using District.Team.

Results

Participation of HDMTs in District.Team varied between cycles and steps. In Benin, 79% to 94% of HDMTs filled in the online questionnaire per cycle compared to 61% to 100% in Guinea per cycle. In Benin, 26% to 41% of HDMTs shared a commentary on the results published on the platform while 21% to 47% participated in the online discussion forum. In Guinea, only 3% to 8% of HDMTs shared a commentary on the results published on the platform while 8% to 74% participated in the online discussion forum. Five groups of factors affected the participation: characteristics of the digital tools, the quality of the facilitation, profile of participants, shared content and data, and finally support from health authorities.

Conclusion

District.Team has shown that knowledge management platforms and processes valuing horizontal knowledge sharing among peers at the decentralized level of health systems are feasible in limited resource settings.
Complex Liver Transplantation Using Venovenous Bypass With an Atypical Placement of the Portal Vein Cannula
Authors: Rocco Giuseppe , Siniscalchi Antonio , Serenari Matteo , Fallani Guido , Germinario Giuliana , Maroni Lorenzo , Prosperi Enrico , Del Gaudio Massimo , Odaldi Federica , Cescon Matteo , Ravaioli Matteo
Published: August 2020

In liver transplantation (LT) medical literature, venovenous bypass (VVB) with the interposition of a venous graft attached to the inferior mesenteric vein (IMV) or to the splenic vein (SV) has not been reported previously. Here, we report the decompression of the portomesenteric compartment in 2 patients with complex cases of orthotopic LT. A femoroaxillary percutaneous VVB was installed prior to abdominal opening to decompress massive collateral veins in the abdominal wall. In the first patient, the IMV was connected to a donor vein graft with a lateroterminal anastomosis, and the distal part of the vein graft was cannulated and connected to the VVB. In the second patient, because of the excessive size of the spleen, it was necessary to perform a splenectomy to gain sufficient space in the abdomen to implant the new liver. The SV was connected to a donor vein graft with a terminoterminal anastomosis, and the distal part of the vein graft was cannulated and connected to the VVB. In both patients, the decompression of the portomesenteric compartment was crucial to reduce portal hypertension and to access the hepatic hilum, where the dissection was very complex due to previous major surgeries. In conclusion, VVB with the interposition of a venous graft attached to the IMV or to the SV during LT is a safe and simple technique, and it may be useful for patients needing VVB with no standard access to the portal compartment, particularly in the case of severe portal hypertension and re‐LTs.
Development of a Clinical Rating Scale for the Severity of Apraxia of Eyelid Opening, Either Isolated or Associated with Blepharospasm
Authors: Ferrazzano Gina , Muroni Antonella , Conte Antonella , Ercoli Tommaso , Tamburini Giorgio , Fabbrini Giovanni , Berardelli Alfredo , Defazio Giovanni
Published: August 2020

Background

Apraxia of eyelid opening is a movement disorder characterized by an inability to raise the eyelids without any overt contractions of the orbicularis oculi muscle. There is currently no clinical scale to rate the severity of this condition.

Objectives

To develop and validate a novel scale that considers phenomenological aspects relevant to the severity of the condition.

Methods

The study sample included 20 patients with apraxia of eyelid opening, either isolated (9 patients) or associated with blepharospasm (11 patients). To validate the scale, selected features were checked for reliability, reliable items were combined to generate the scale, and clinimetric properties were evaluated.

Results

The novel severity scale yielded acceptable reliability, scaling assumptions, internal consistency, and sensitivity to change; a lack of floor and ceiling effects; and no correlation with the blepharospasm severity rating scale.

Conclusions

We propose a severity scale that considers the most relevant apraxia of eyelid opening motor abnormalities based on objective criteria. This scale can be reliably administered by general neurologists after a brief training.
Genome‐wide pathogenesis interpretation using a heat diffusion‐based systems genetics method and implications for gene function annotation
Authors: Quan Yuan , Zhang Qing‐Ye , Lv Bo‐Min , Xu Rui‐Feng , Zhang Hong‐Yu
Published: September 2020

Background

Genetics is best dedicated to interpreting pathogenesis and revealing gene functions. The past decade has witnessed unprecedented progress in genetics, particularly in genome‐wide identification of disorder variants through Genome‐Wide Association Studies (GWAS) and Phenome‐Wide Association Studies (PheWAS). However, it is still a great challenge to use GWAS/PheWAS‐derived data to elucidate pathogenesis.

Methods

In this study, we used HotNet2, a heat diffusion‐based systems genetics algorithm, to calculate the networks for disease genes obtained from GWAS and PheWAS, with an attempt to get deeper insights into disease pathogenesis at a molecular level.

Results

Through HotNet2 calculation, significant networks for 202 (for GWAS) and 167 (for PheWAS) types of diseases were identified and evaluated, respectively. The GWAS‐derived disease networks exhibit a stronger biomedical relevance than PheWAS counterparts. Therefore, the GWAS‐derived networks were used for pathogenesis interpretation by integrating the accumulated biomedical information. As a result, the pathogenesis for 64 diseases was elucidated in terms of mutation‐caused abnormal transcriptional regulation, and 47 diseases were preliminarily interpreted in terms of mutation‐caused varied protein‐protein interactions. In addition, 3,802 genes (including 46 function‐unknown genes) were assigned with new functions by disease network information, some of which were validated through mice gene knockout experiments.

Conclusions

Systems genetics algorithm HotNet2 can efficiently establish genotype‐phenotype links at the level of biological networks. Compared with original GWAS/PheWAS results, HotNet2‐calculated disease‐gene associations have stronger biomedical significance, hence provide better interpretations for the pathogenesis of genome‐wide variants, and offer new insights into gene functions as well. These results are also helpful in drug development.
AMHCA: Growing numbers of mental health distress point to looming crisis
Authors: Canady Valerie A.
Published: August 2020

Systemic racism, the COVID‐19 health crisis and an economic meltdown are the cataclysmic events that have caused significant increases in mental health and substance‐related disorders in the United States this year, according to a new report released Aug. 24 by the American Mental Health Counselors Association (AMHCA). Unless Congress, states and local communities act, the country faces an imminent national mental health crisis, say the authors.
School mental health bills in New Jersey seek to bolster partnerships
Authors: Enos Gary
Published: August 2020

As school districts across the country navigate all the uncertainties surrounding this year's return to instruction, many are anticipating what is often referred to as an expected tsunami of mental health need in the school‐age population. New Jersey state legislators soon are expected to vote on a package of bills designed to enhance the support mechanisms available for students who are struggling.
Stability analysis of a fractional‐order delay dynamical model on oncolytic virotherapy
Authors: Singh Hitesh K. , Pandey Dwijendra N.
Published: August 2020

In this manuscript, the main objective is to introduce the derivatives of fractional‐order into a delayed dynamical model of oncolytic virotherapy. The system consists of populations of infected cells, uninfected cells, and virus particles. The local asymptotic stability of all the equilibrium points is discussed by analyzing the corresponding characteristic polynomials. The existence of Hopf bifurcation is shown due to the effect of delay. The fractional‐order dynamical system is compared with the integer order counterpart. Numerical simulations are also carried out to verify how the fractional‐order model is more stable than its integer‐order counterpart and fractional‐order parameter can be used to pacify the effect of delay.
Tolerance analysis of 3D printed patch antennas based on interval arithmetic
Authors: Wang Chao , Li Peng , Xu Wanye , Song Liwei , Huang Jin
Published: August 2020

A tolerance analysis approach based on interval arithmetic (IA) is proposed for heterogeneous three‐dimensional (3D) printed patch antennas. Four key parameters—patch length, width, substrate thickness, and material properties—are considered that can introduce errors in the analysis results. Investigating the comprehensive effect of these parameters on resonant frequency and the E/H pattern of the patch is difficult and time‐consuming when classical numerical simulations are employed. Thus, in this work, the four parameters are modeled as interval variables, and the equations between error and resonant frequency and the E/H pattern are derived using IA. Then, for the given tolerances (error intervals), the corresponding resonant frequency interval and E/H pattern interval are calculated using the proposed approach and compared with HFSS simulation results. Some samples of the patch antenna are fabricated via a self‐developed heterogeneous 3D printer, which employs ink injection and laser sintering to fabricate the patch and the microstrip; furthermore, ultraviolet (UV) resin injection and curing are used to fabricate the substrate. The transmission performance of the samples is evaluated by comparing simulation and measurement results to verify the effectiveness of the proposed IA‐based approach.
Unequally spaced resonant slotted‐waveguide antenna array with low side lobe level based on an open‐ended substrate integrated waveguide resonator
Authors: Taheri Meqdad , Majedi Mohammad Saeed
Published: August 2020

In this article, an unequally spaced resonant slotted‐waveguide antenna array with low side lobe level (SLL) is presented. In the conventional resonant arrays with longitudinal slots on the waveguide broad wall, slots must be separated one half guided wavelength (λg/2) from each other and be on opposite sides of the center line to have an in‐phase excitation. The open‐ended substrate integrated waveguide (SIW) resonator can support a resonance mode with the infinite wavelength. Hence using this kind of resonator, distances between slots in the resonant array are free parameters and can be optimized to achieve a low SLL. Based on the mentioned resonator, a 10‐element resonant slotted‐waveguide antenna array at 10 GHz with 10° beam‐width is designed and simulated. The distances between slots are determined by using genetic algorithm (GA). This antenna has been fabricated and measured. The measurement results show that the SLL of the presented antenna is 16 dB.
Channel configuration in a complementary market under different power structures
Authors: Yuan Mao , Ma Shi‐hua , Guan Xu , Chen Ying‐Ju
Published: August 2020

This paper investigates the impact of channel selection power on the firms' channel configuration strategies in a market with two upstream manufacturers providing complementary products and one downstream retailer who can resell the products. Each manufacturer can sell its product either directly by incurring a selling cost or indirectly via the retailer, in which the decision is further dependent on the relative channel selection powers between itself and the retailer. We investigate three scenarios depending on the possible power structures among the firms and show that the equilibrium channel configuration strategy hinges highly on the channel selection power, the direct selling cost and the degree of complementarity between the two products. The manufacturer may prefer direct selling when it is more powerful than the retailer and both the direct selling cost and the degree of complementarity are relatively low. However, when the degree of products' complementarity is sufficiently high, a manufacturer would not choose direct selling even though there is no direct selling cost. We also show that a stronger channel selection power does not necessarily benefit but may occasionally hurt a manufacturer's profitability. For the manufacturer who does not have channel selection power before, the enhanced channel selection power endows it with more selling options but also encourages the leading manufacturer (who already has the channel power) to design a more aggressive channel configuration strategy that only benefits itself but hurts the others.
Well‐being of nurses and working conditions—Are polish nurses different from doctors and midwives in terms of professional quality of life?
Authors: Bąk‐Sosnowska Monika , Gruszczyńska Magdalena , Tokarz Aleksandra
Published: August 2020

Aim

The aim of the study is to assess the differences in the professional quality of life between nurses, midwives and doctors.

Design

Cross‐sectional study.

Methods

A total of 297 participants were surveyed: 165 nurses, 101 doctors and 31 midwives. We used ProQol questionnaire with three subscales (compassion satisfaction ‐CS, burnout‐ B, compassion fatigue‐CF and own questionnaire (social‐demographics data).

Results

Burnout and CF were average in a group of nurse and midwives, low in group of doctors. In group of nurses, a relationship was observed between compassion satisfaction and: job seniority (p < .01), basic place of work (p < .01), self‐assessment of work situation (p < .01), as well as between burnout and: job seniority (p < .05), form of employment (p = .03), basic place of work (p = .002), self‐assessment of work situation (p < .01). In group of midwives was only the relationship between the self‐assessment of work situation and: CS (p < .01) and burnout (p < .01) were shown.
The element‐free Galerkin method for a quasistatic contact problem with the Tresca friction in elastic materials
Authors: Ding Rui , Shen Quan , Huo Yuebin
Published: August 2020

This paper is proposed for the error estimates of the element‐free Galerkin method for a quasistatic contact problem with the Tresca friction. The penalty method is used to impose the clamped boundary conditions. The duality algorithm is also given to deal with the non‐differentiable term in the quasistatic contact problem with the Tresca friction. The error estimates indicate that the convergence order is dependent on the nodal spacing, the time step, the largest degree of basis functions in the moving least‐squares approximation, and the penalty factor. Numerical examples demonstrate the effectiveness of the element‐free Galerkin method and verify the theoretical analysis.
Defining the impact of prognostic factors at the time of relapse for nonmetastatic rhabdomyosarcoma
Authors: Affinita Maria Carmen , Ferrari Andrea , Chiaravalli Stefano , Melchionda Fraia , Quaglietta Lucia , Casanova Michela , Zanetti Ilaria , Scarzello Giovanni , Di Pasquale Luisa , Di Cataldo Andrea , Bisogno Gianni
Published: August 2020

Background

The prognosis for patients with relapsed rhabdomyosarcoma (RMS) depends on a number of variables, including tumor characteristics, type of relapse, and treatment received. All published studies have considered tumor characteristics at initial diagnosis, but not at the time of recurrence. In this study, we compared tumor characteristics at diagnosis and at the moment of local relapse to better define the chance of cure in this group of patients.

Methods

We first analyzed 92 children with localized RMS treated according to the RMS96 and RMS2005 protocols who developed relapse after achieving complete remission at the end of treatment. Then we restricted our analysis to 51 patients with local recurrence to compare their initial tumor characteristics with those at relapse. All characteristics were studied using univariate and multivariate analyses.

Results

The 10‐year progression‐free survival (PFS) and overall survival (OS) rates for the whole group were 23.5% (15.4‐32.6) and 34.4% (24.8‐44.1), respectively. On multivariate analysis, only primary tumor site appeared to have a strong impact on prognosis (P = .0010). The 10‐year PFS and OS rates of patients with locoregional recurrences were 22.7% (12.3‐35.0) and 34.9% (22.1‐47.9), respectively. Multivariate analysis showed that tumors at unfavorable sites (P = .0044), and tumor size > 5 cm at recurrence (P = .0088) were associated with the poorest prognosis.

Conclusion

Our study demonstrates that to estimate the chance of cure in patients with relapsed RMS, we should also consider tumor characteristics at the time of relapse, and tumor size in particular.
The use of imaging to identify immunocompromised children requiring biopsy for invasive fungal rhinosinusitis
Authors: Harreld Julie H. , Kaufman Robert A. , Kang Guolian , Maron Gabriela , Mitchell William , Thompson Jerome W. , Srinivasan Ashok
Published: August 2020

Background and purpose

Children with severe immunocompromise due to cancer therapy or hematopoietic cell transplant are at risk both for potentially lethal invasive fungal rhinosinusitis (IFRS), and for complications associated with gold‐standard biopsy diagnosis. We investigated whether early imaging could reliably identify or exclude IFRS in this population, thereby reducing unnecessary biopsy.

Methods

We reviewed clinical/laboratory data and cross‐sectional imaging from 31 pediatric patients evaluated for suspicion of IFRS, 19 without (age 11.8 ± 5.4 years) and 12 with proven IFRS (age 11.9 ± 4.6 years). Imaging examinations were graded for mucosal thickening (Lund score), for fungal‐specific signs (FSS) of bone destruction, extra‐sinus inflammation, and nasal mucosal ulceration. Loss of contrast enhancement (LoCE) was assessed separately where possible. Clinical and imaging findings were compared with parametric or nonparametric tests as appropriate. Diagnostic accuracy was assessed by receiver operating characteristic (ROC) analysis. Positive (+LR) and negative likelihood ratios (−LR) and probabilities were calculated.

Results

Ten of 12 patients with IFRS and one of 19 without IFRS had at least one FSS on early imaging (83% sensitive, 95% specific, +LR = 15.83, −LR = 0.18; P < .001). Absolute neutrophil count (ANC) ≤ 200/mm3 was 100% sensitive and 58% specific for IFRS (+LR = 2.38, −LR = 0; P = .001). Facial pain was the only discriminating symptom of IFRS (P < .001). In a symptomatic child with ANC ≤ 200/m3, the presence of at least one FSS indicated high (79%) probability of IFRS; absence of FSS suggested low (<4%) probability.

Conclusion

In symptomatic, severely immunocompromised children, the presence or absence of fungal‐specific imaging findings may effectively rule in or rule out early IFRS, potentially sparing some patients the risks associated with biopsy.
Crystallization kinetics, structure, and rheological behavior of poly(ethylene terephthalate)/multilayer graphene oxide nanocomposites
Authors: Pinto Gabriel M. , Silva Giovanna da C. , Santillo Chiara , Lavorgna Marino , Maia João M. , Fechine Guilhermino J. M.
Published: August 2020

This work aims to produce poly(ethylene terephthalate)/multilayer graphene oxide (mGO) nanocomposites via continuous melt mixing in twin‐screw extrusion, and to study the changes in crystallization and melt flow behavior. Three mGO contents (0.05, 0.1, and 0.3 wt%) were used. Differential scanning calorimetry analyses showed that at 0.1 wt%, mGO acted best as nucleating agent, increasing the crystallization kinetics as well as the melt crystallization temperature (Tmc) by more than 20%. It was also observed that mGO increases the crystals perfection. The nucleating behavior was confirmed by X‐ray diffraction and small angle X‐ray scattering analyses, which showed a decrease in the composites' crystalline lamella thickness (lc) and long period. X‐ray microtomography data confirms that this behavior is significantly affected by the mGO agglomerates distribution and specific surface area inside the polymer matrix. The rheological behavior was studied under two different conditions. It was noticed that under lower shear stresses the mGO particles hinder the polymer flow, increasing the composites viscosity and the pseudo‐solid character. However, under higher shear stresses, for example, when flowing through a die, the nanomaterial enters its “superlubricity state,” acting as a lubricant to the flow. This is industrially interesting, because it may allow the use of less severe processing parameters to produce the nanocomposites.
Beyond transplant: Roles of atrial septostomy and Potts shunt in pediatric pulmonary hypertension
Authors: Grady Ronald Mark
Published: August 2020

Despite significant successes in treating children with pulmonary hypertension, many still die from their disease. Death most often results from right ventricular failure. Bilateral lung transplantation has historically been the ultimate palliation for children who develop heart failure despite maximal medical therapy. Creating an atrial level shunt has been advocated as a pre‐transplant intervention to help reduce symptoms and perhaps serve as a bridge to transplant. More recently, the utilization of a pulmonary‐to‐systemic anastomosis, that is, Potts shunt, has demonstrated efficacy in ameliorating symptoms in children with severe, progressive disease. This improvement is often coincident with a reduction in expensive and onerous pulmonary hypertension specific medications. Improvement has been sustained over the years in some children, delaying the need for transplant consideration. Research is ongoing to determine more specific risks/benefits of using the Potts shunt in children with pulmonary hypertension both in the short term and long.
Theoretical investigation on the rhodium‐catalyzed coupling reaction of ketoxime with 1,3‐enynes: [4 + 1] vs [4 + 2] annulation
Authors: Yun Xiao , Yu Zhangyu , Liu Tao
Published: August 2020

The mechanisms of rhodium‐catalyzed coupling reaction of ketoxime and 1,3‐enynes were investigated by using density functional theory calculations. Different 1,3‐enynes would lead to different annulation products. Reaction A undergoes five sequential steps (CH activation, 1,3‐enyne migratory insertion, 1,4‐Rh migration, cyclization, and deprotonation) to lead to the [4 + 1] annulation product, whereas due to the electronic effect, the process generating the [4 + 2] product in reaction A is restricted. In contrast, the electron‐withdrawing group of the N(Me)2 group in 1,3‐enyne would bring about the [4 + 2] annulation product in reaction B. Our calculated results indicate that no [4 + 1] annulation product could be obtained in reaction C, in agreement with the experimental observation that the cis‐allyl hydrogen in 1,3‐enyne is crucial for the [4 + 1] annulation reaction.