bluuebunny/crossref_metadata_2025 huggingface dataset:
Temporal Trends in the Incidence and Outcomes of Pacemaker Implantation After Transcatheter Aortic Valve Replacement in the United States (2012–2017)
Authors: Kawsara Akram , Sulaiman Samian , Alqahtani Fahad , Eleid Mackram F. , Deshmukh Abhishek J. , Cha Yong‐Mei , Rihal Charanjit S. , Alkhouli Mohamad
Published: August 2020

Background

Nationwide studies documenting temporal trends in permanent pacemaker implantation (PPMI) following transcatheter aortic valve replacement (TAVR) are limited.

Methods and Results

We selected patients who underwent TAVR between 2012 and 2017 in the National Readmission Database. The primary end point was the 6‐year trend in post‐TAVR PPMI at index hospitalization and at 30, 90, and 180 days after discharge. The secondary end point was the association between PPMI and in‐hospital mortality, stroke, cost, length of stay, and disposition. Among the 89 202 patients who underwent TAVR, 77 405 (86.8%) with no prior pacemaker or defibrillator were included. Patients who required PPMI had a higher prevalence of atrial fibrillation (43.6% versus 38.7%,
P
<0.001) and conduction abnormalities (28.4% versus 15.3%,
P
<0.001). The incidence of PPMI during index admission increased from 8.7% in 2012 to 13.2% in 2015, and then decreased to 9.6% in 2017. The incidence of inpatient PPMI within 30 days after discharge increased from 0.5% in 2012 to 1.25% in 2017 (
P
trend
<0.001). Inpatient PPMI beyond 30 days remained rare (<0.5%) during the study period. After risk adjustment, PPMI was not associated with in‐hospital mortality or stroke but was associated with increased nonhome discharge, longer hospitalization, and higher cost. The incremental expenditure associated with post‐TAVR PPMI during index admission increased from $9.6 million to $72.2 million between 2012 and 2017.

Conclusions

After an upward trend, rates of PPMI after TAVR in the United States stabilized at ~10% in 2016 to 2017, but there was a notable increase in PPMI within 30 days after the index admission. PPMI was not associated with increased in‐hospital morbidity or mortality but led to longer hospitalization, higher cost, and more nonhome discharges.
MerTK Expression and ERK Activation Are Essential for the Functional Maturation of Osteopontin‐Producing Reparative Macrophages After Myocardial Infarction
Authors: Shirakawa Kohsuke , Endo Jin , Kataoka Masaharu , Katsumata Yoshinori , Anzai Atsushi , Moriyama Hidenori , Kitakata Hiroki , Hiraide Takahiro , Ko Seien , Goto Shinichi , Ichihara Genki , Fukuda Keiichi , Minamino Tohru , Sano Motoaki
Published: August 2020

Background

We previously reported that osteopontin plays an essential role in accelerating both reparative fibrosis and clearance of dead cells (efferocytosis) during tissue repair after myocardial infarction (MI) and galectin‐3
hi
CD206
+
macrophages is the main source of osteopontin in post‐MI heart. Interleukin‐10– STAT3 (signal transducer and activator of transcription 3)–galectin‐3 axis is essential for
Spp1
(encoding osteopontin) transcriptional activation in cardiac macrophages after MI. Here, we investigated the more detailed mechanism responsible for functional maturation of osteopontin‐producing macrophages.

Methods and Results

In post‐MI hearts,
Spp1
transcriptional activation occurred almost exclusively in MerTK (Mer tyrosine kinase)
+
galectin‐3
hi
macrophages. The induction of MerTK on galectin‐3
hi
macrophages is essential for their functional maturation including efferocytosis and
Spp1
transcriptional activity. MerTK
+
galectin‐3
hi
macrophages showed a strong activation of both STAT3 and ERK (extracellular signal‐regulated kinase). STAT3 inhibition suppressed the differentiation of osteopontin‐producing MerTK
+
galectin‐3
hi
macrophages, however, STAT3 activation was insufficient at inducing
Spp1
transcriptional activity. ERK inhibition suppressed
Spp1
transcriptional activation without affecting MerTK or galectin‐3 expression. Concomitant activation of ERK is required for transcriptional activation of
Spp1
. In
Il‐10
knockout enhanced green fluorescent protein–
Spp1
knock‐in mice subjected to MI, osteopontin‐producing macrophages decreased but did not disappear entirely. Interleukin‐10 and macrophage colony‐stimulating factor synergistically activated STAT3 and ERK and promoted the differentiation of osteopontin‐producing MerTK
+
galectin‐3
hi
macrophages in bone marrow–derived macrophages. Coadministration of anti‐interleukin‐10 plus anti–macrophage colony‐stimulating factor antibodies substantially reduced the number of osteopontin‐producing macrophages by more than anti–interleukin‐10 antibody alone in post‐MI hearts.

Conclusions

Interleukin‐10 and macrophage colony‐stimulating factor act synergistically to activate STAT3 and ERK in cardiac macrophages, which in turn upregulate the expression of galectin‐3 and MerTK, leading to the functional maturation of osteopontin‐producing macrophages.
Following the Leaders? How to Restore Progress in Global Climate Governance
Authors: Busby Joshua W. , Urpelainen Johannes
Published: August 2020

The Paris Agreement is in trouble. Here we assess the potential for climate leaders to bring the global climate regime back on track by developing a strategic understanding of followership. In other words, leaders need to know how to encourage other actors to follow them. We develop a typology of follower types—Enthusiasts, Pliables, Reluctants, and Hard Nuts—distinguished based on motivation and capacity. We identify the scope for a participation cascade based on the distribution of follower types. We argue that achieving a participation cascade may be more likely if leaders appreciate three insights from theories of collective action. First, break down the climate mitigation problem into smaller, more manageable challenges, such as sectoral approaches. Second, prioritize major emitters and areas with high mitigation potential and politically feasible action. Finally, emphasize benefits to potential followers. Together, the strategies can help reduce the number of Hard Nut cases by making the cost/benefit calculus more attractive to prospective followers.
Ektopicercus Simutnik gen. nov. (Hymenoptera, Chalcidoidea, Encyrtidae) from late Eocene Rovno amber

Authors: SIMUTNIK S.A. , PERKOVSKY E.E.
Published: August 2020

The family Encyrtidae is represented by two subfamilies, Encyrtinae and Tetracneminae, and currently includes over 460 genera and nearly 3,800 described species (Noyes, 2003). All Tetracneminae and the majority of Encyrtinae are reported as parasitoids of mealybugs, whereas some encyrtines are associated with a number of other arthropod hosts (Noyes, 2003; Simutnik & Trjapitzin, 2008).
The first fossil Phloeocharinae Erichson, 1839 (Coleoptera, Staphylinidae) from the Baltic Eocene amber

Authors: SHAVRIN ALEXEY V. , KAIRIŠS KRISTAPS
Published: August 2020

A new species of the genus Charhyphus Sharp, 1887 (Phloeocharinae) from the Eocene Baltic amber is described and illustrated: Ch. balticus Shavrin, sp. nov. The specimen was studied by using X-ray micro-computed tomography (μCT); images of the habitus, body parts and aedeagus were obtained. Based on external morphology, the new species is related to Nearctic Ch. picipennis (LeConte, 1863) and East Palaearctic Ch. paradoxus (Bernhauer, 1933), from which it differs by the smaller body, shape of the head, and other details.
Oxysarcodexia Townsend, 1917 (Diptera: Sarcophagidae)—a centennial conspectus
Authors: DE SOUZA CARINA MARA , PAPE THOMAS , THYSSEN PATRICIA JACQUELINE
Published: August 2020

A taxonomic conspectus is presented for the genus Oxysarcodexia Townsend, 1917, which is one of the most species-rich genera of New World flesh flies. It has its center of diversity in the Neotropical Region, with some species reaching into the Nearctic and a few species introduced to the Australasian and Oceanian Regions. Species within this genus are primarily dung-breeders, but some species have also been bred from vertebrate carcasses. Oxysarcodexia is defined and diagnosed, and a diagnosis, distributional data and known biological data are provided for each species together with figures of the habitus and male terminalia. Oxysarcodexia currently comprises 91 valid species, including six species newly described herein: O. alectoris sp. n. (French Guiana), O. angulosa sp. n. (Costa Rica), O. ariozanoi sp. n. (Brazil), O. graminifolia sp. n. (Colombia and Ecuador), O. maiae sp. n. (Ecuador), and O. rimata sp. n. (Ecuador). Two nominal species based on a male holotype, Oxysarcodexia bomplandi (Hall, 1937) and O subsericans (Walker, 1858), were left unidentified pending examination of their terminalia. Four nominal species, O. aureiceps (Macquart, 1855), O. dorisae Dodge, 1965, O. flavifrons (Macquart, 1846) and O. neivae Mattos, 1919, all described solely based on females, are considered of uncertain status pending a comprehensive study of females of this genus. Asioboettcheria Verves, 2001 is proposed as a junior synonym of Oxysarcodexia Townsend, 1917, syn. n., Oxysarcodexia cuernavaca Dodge, 1966 is proposed as a junior synonym of O. ventricosa (Wulp, 1895), syn. n., and Stackelbergeola papei Nandi, 1994 is proposed as a junior synonym of O. thornax (Walker, 1849), syn. n. A lectotype is designated for Sarcophaga varia Walker, 1836 [= O. varia (Walker, 1836)]. The newly-described O. ariozanoi and O. maiae are included in the “xon group” (former “Xarcophaga group”). New country-level distributional records are provided for O. adunca Lopes, 1975 (Ecuador), O. berlai Lopes, 1975 (Peru), O. cocais Carvalho-Filho, Sousa & Esposito, 2017 (Argentina), O. insolita Lopes, 1946 (Ecuador), O. jamesi Dodge, 1968 (Costa Rica), O. marina (Hall, 1938) (Brazil), O. nitida Soares & Mello-Patiu, 2010 (Ecuador), O. notata Soares & Mello-Patiu, 2010 (Brazil and Ecuador), and O. terminalis (Wiedemann, 1830) (Paraguay).
Preparation of a polymer-modified folate-targeted magnetic nano-delivery system and its inhibitory effect on nasopharyngeal carcinoma
Authors: Yao Shihong , Huang Pu , Liu Fen , Zeng Fanyang , Zeng Wenxuan , He Shifeng
Published: August 2020

The aims of this work were to investigate the effect of a polymer-modified folate-targeted magnetic nano-delivery system on growth inhibition of CNE2 cells and expression of Caspase-3 mRNA, and Caspase-3, Caspase-8, and Caspase-9 proteins, and to explore the mechanism used by this nano-delivery
system to inhibit proliferation and induce apoptosis of human nasopharyngeal carcinoma cells. The MTT method was used to detect the effect of the polymer-modified folate-targeted magnetic nano-delivery system at different concentrations (0, 0.25, 0.50, 0.75, 1.00, 1.50, 2.00 g/mL) on CNE2
cell proliferation; the fluorescence PCR method was used to detect changes in Caspase-3 mRNA at different concentrations (0, 0.75, 1.00, 1.50 g/mL); and western blotting was used to detect Caspase-3, Caspase-8, and Caspase-9 expression. The polymer-modified folate-targeted magnetic nanoparticles
inhibited the expression of Caspase-3 mRNA, and of Caspase-3, Caspase-8, and Caspase-9 in CNE2 cells in a concentration-dependent manner. It may be concluded that the polymer-modified folate-targeted magnetic nano-delivery system can inhibit the growth of CNE2 cells and its effect is closely
related to the upregulation of Caspase-3 mRNA and Caspase-3, Caspase-8, and Caspase-9 protein expression and initiation of the caspase cascade.
Polypyrrole and polypyrrole@MnO2 nanowires grown on graphene foam for asymmetric supercapacitor
Authors: Dong Shuang , Wang Zhengyun , Wang Junlei , Yao Yin , Liu Hongfang
Published: August 2020

The asymmetric supercapacitor with negative electrode by graphene foam loaded Polypyrrole nanowires (PPy NWs/rGOF) and positive electrode by PPy@MnO2 core–shell nanowires on graphene foam (PPy@MnO2 NWs/rGOF) was developed. The negative electrode was further
converted into the positive electrode by one-step redox reaction at room temperature. Graphene foam (rGOF) with unique flexibility, large surface area and high electric conductivity can favor in situ growth of polypyrrole nanowires (PPy NWs) as well as improve cycling stability of the
resultant negative electrode. PPy NWs served as the ideal template for the formation of MnO2 shell gives rise to the as-prepared positive electrode with fast electron transport and enhanced active material utilization. Owing to the rational design, the assembled asymmetric supercapacitor
was able to be repeatedly discharged/charged at 1.6 V, displaying high energy density of 1.04 mWh cm–3 with improved cycling stability.
Study on the antitumor activity and mechanism of novel targeted nanodrugs based on miRNA in cervical cancer
Authors: Chen Xinping , Ma Zhichao , Zhu Juan , Xu Weihua , Hu Junjie , Yin Liyan , Fu Shengmiao
Published: August 2020

The aim of this study was to investigate the effect of different concentrations of novel targeted nanodrugs based on miRNA on the antitumor activity and mechanism in cervical carcinoma A549 cells. The MTT method was used to determine the effect of different concentrations of novel targeted
nanodrugs based on miRNA on A549 cell proliferation, and annexin V FITC/PI double staining flow cytometry was performed to analyze the effect of these nanodrugs on A549 cell apoptosis. Western blotting was performed to observe the effect of these nanodrugs on the expression of Bax, Bcl-2,
and caspase-3-related genes involved in A549 cell apoptosis. Compared with the control group, the novel targeted nanodrugs based on miRNA significantly inhibited the proliferation of A549 cells in a time- and dose-dependent manner. Results of double staining flow cytometry demonstrated that
these nanodrugs could increase the apoptotic rate of A549 cells in a dose-dependent manner 48 h later. Western blotting revealed that these nanodrugs could upregulate the expression of Bax and caspase3 genes and downregulate the expression of Bcl-2 gene. Nanodrugs display an obvious antitumor
activity in vitro, and the underlying mechanism may be associated with the upregulation of Bax and caspase-3 gene expression and the downregulation of Bcl-2 gene expression.
Influence of lattice oxygen on properties of Ce–Fe composite in NO+CO reduction system
Authors: Bai Yuze , Wu Huizhong , Zhu Jinhao , Yang Lichao , Li Na , Luo HuiJuan , Wu Wenfei , Zhang Kai
Published: August 2020

Ce–Fe composite was prepared by hydrothermal method to simulate the ore facies with Ce–Fe coatingembedded structure in rare earth tailings. Fe2O3 is used as the carrier and cerium nitrate is used as active component. We studied the effect of lattice
oxygen on the performance of Ce–Fe composites in the NO+CO reduction system. The results show that the peak of CeO2 in the sample prepared by the hydrothermal method of nitric acid moves at a high angle, the lattice constant becomes smaller, and the diffraction peak corresponding
to CeO2 in Raman is red-shifted. It indicated that the hydrothermal method can form Ce–O–Fe solid solution. In TEM, nanoscale Fe2O3 particles caused by the decomposition of ferric nitrate were observed on the surface of the sample. In the whole
reaction process, a large amount of lattice oxygen provided by Fe2O3 as a carrier, the presence of Ce–O–Fe solid solution and free Fe2O3 fine particles determine the high catalytic activity of the composite catalyst. The presence of CeO2
can improve the surface reduction of Fe2O3, and also promote the conversion of Fe3+ to Fe2+, Ce4+ to Ce3+. The conversion of lattice oxygen to adsorbed oxygen reflects the combined action of the composite catalysts Ce and Fe.
The denitration rate of the Ce–Fe composite NO+CO reduction system exceeded 92.24% at 700 °C. Lattice oxygen can promote the performance of Ce–Fe composites in NO+CO reduction system.
The Effect of Genetic Stability Molecules on the Movement of Human Embryonic Stem Cells
Authors: Zhou Xiaoxiang , Liu Yu
Published: August 2020

Objective: To give full play to the role of human embryonic stem cells (hESCs) in biomedicine, innovate the treatment model of human diseases, and study the effect of genetic stability molecules of hESCs on movement. Methods: hESCs were cultured by mechanical passage,
type IV collagenase passage and 0.25% EDTA trypsin passage respectively to find the best passage way of hESCs culture; hESCs were differentiated into endometrial like cells through embryoid pathway in vitro, and the morphology of endometrial like cells was observed under light microscope;
the genomic DNA of human embryonic stem cells was detected by SNP chip, and its components were analyzed. The SNP analysis of the samples before and after the induction of differentiation were used to extract the DNA of the endometrial epithelioid cells of hESCs, and the DNA microarray results
before and after the induction of hESCs were detected. Results: type IV collagenase passage method took a long time and was not suitable to control the digestion time and inoculation density; 0.25% EDTA trypsin digested hESCs into a single cell state, which was not conducive to continuous
growth after being inoculated in the feeder layer; mechanical passage method could cut into different sizes of clumps according to the needs, and could remove differentiated or deviated cells, which was more suitable for hESCs passage; light microscopically, the cells grow in a single layer
and adhere to the wall, and the cells extending to the surrounding irregularity are spindle shaped. With the extension of differentiation time, the central part of the clone is loose, the cells fall off, and the surrounding cells grow intensively to the outer part of the clone. The mutant
gene involves 1131 mutations and 24 chromosome mutations, of which the mutation rate of chromosome 19 is the largest, and it involves the length of chromosome 5. It is longer than that of other chromosomes, and there are many genes carried by it, which results in the exon mutations on chromosome
5. Conclusion: mechanical subculture is the best way for hESCs culture, and long-term subculture will affect the genetic stability of human embryonic stem cells.
Analysis of Predictive Value and Target Gene Prediction of Serum Micro-RNA-205 in Diagnosis and Prognosis of Prostate Cancer
Authors: Hu Xiangnan , Dou Xiaoliang , Wang He , Sun Jinbo , Zhang Bo , Lin Na , Ma Nan
Published: August 2020

The aim of this study was to explore the predictive value of serum micro-RNA (miRNA)-205 in the diagnosis and prognosis of prostate cancer, and analyze miRNA-205 target genes and functions. Eight patients diagnosed with prostate cancer or benign prostatic hyperplasia (BPH) that were
treated in January 2011 were selected. The serum samples between the two groups were analyzed for miRNA expression profiling, and the differentially expressed miRNA-205 was selected for further analysis. The serum samples of 64 patients with prostate cancer and 20 patients with BPH from March
2011 to March 2013 were collected for qPCR verification. We evaluated the correlation between miRNA-205 expression level and clinicopathological data of 64 patients with prostate cancer and its prognostic value. Finally, through bioinformatic analysis, target genes of miRNA-205 were predicted,
and gene ontology (GO) analysis and signal pathway analysis were performed. A total of 657 differential miRNAs were screened from miRNA expression profiling. Compared with patients with BPH, miRNA-205 showed lower expression in the serum of patients with prostate cancer. Serum miRNA-205 +
PSA combined had the strongest predictive ability, 0.805. The expression level of miRNA-205 in the patients with a Gleason score ≥7 was lower than that in patients with a Gleason score <7, Low miRNA-205 expression was associated with bone metastasis and higher T stage ratings, and the
5-year overall survival rate of the low miRNA-205 expression group was lower than the high miRNA-205 expression group. A total of 27 miRNA-205 target genes were predicted. The target genes of miRNA-205 are mainly enriched in biological functions such as cell adhesion and GTP kinase activity.
The target genes of miRNA-205 are mainly enriched in Axon guidance and signal transduction by L1 and other signal pathways. In this study, serum miRNA-205 was successfully identified as a potential noninvasive serum marker for diagnosis and prognosis of prostate cancer, which will be helpful
for future clinical research and prostate cancer drug target design.
Estimating the Maximum Vertical Velocity at the Leading Edge of a Density Current
Authors: Reif Dylan W. , Bluestein Howard B. , Weckwerth Tammy M. , Wienhoff Zachary B. , Chasteen Manda B.
Published: August 2020

The maximum upward vertical velocity at the leading edge of a density current is commonly <10 m s−1. Studies of the vertical velocity, however, are relatively few, in part owing to the dearth of high-spatiotemporal-resolution observations. During the Plains Elevated Convection At Night (PECAN) field project, a mobile Doppler lidar measured a maximum vertical velocity of 13 m s−1 at the leading edge of a density current created by a mesoscale convective system during the night of 15 July 2015. Two other vertically pointing instruments recorded 8 m s−1 vertical velocities at the leading edge of the density current on the same night. This study describes the structure of the density current and attempts to estimate the maximum vertical velocity at their leading edges using the following properties: the density current depth, the slope of its head, and its perturbation potential temperature. The method is then be applied to estimate the maximum vertical velocity at the leading edge of density currents using idealized numerical simulations conducted in neutral and stable atmospheres with resting base states and in neutral and stable atmospheres with vertical wind shear. After testing this method on idealized simulations, this method is then used to estimate the vertical velocity at the leading edge of density currents documented in several previous studies. It was found that the maximum vertical velocity can be estimated to within 10%–15% of the observed or simulated maximum vertical velocity and indirectly accounts for parameters including environmental wind shear and static stability.
Likelihood of Aortic Valve Preservation During Repair of Acute Type A Aortic Dissection
Authors: Thornhill Rosanne , Shih Wendy , Amen Marvin I. , John Mohan M. , Floridia Rosario , Razzouk Anees J. , Rabkin David G.
Published: August 2020

Background

We sought risk factors for replacement of the aortic valve with or without the root (AVR/root) in the setting of acute type A aortic dissection (ATAD) repair.

Methods

All ATAD repairs at our institution from January 2005 to June 2018 were reviewed. Baseline characteristics were recorded. For patients with aortic valve preservation, we documented the degree of aortic insufficiency (AI) postoperatively and on subsequent echocardiograms when available. Logistic regression was used to determine the association between preoperative characteristics and the odds ratio of AVR/root.

Results

206 patients underwent repair of ATAD. Thirty-four were excluded for no documented AI grading. Forty-six underwent AVR/root during repair of the ATAD (including 40 root replacements). Of 126 that did not undergo AVR/root, 42 (33.33%) had follow-up echocardiograms at a median of 68 months postoperatively, 2 required reintervention for valve insufficiency. An increase in the degree of AI, bicuspid valve morphology, size of the aortic root, and connective tissue disorder was significantly associated with increased risk of AVR/root. Of 130 patients without connective tissue disorder, bicuspid aortic valve, aortic root aneurysm or intimal root tear, the rate of valve preservation was 65/65 (100%), 25/29 (86.2%), and 22/40 (55%) for those presenting with mild, moderate, and severe AI, respectively.

Conclusion

The degree of preoperative AI, bicuspid valve morphology, size of the aortic root, and connective tissue disorder significantly correlate with the failure of aortic valve preservation in patients with ATAD. The vast majority of tricuspid valves in patients without connective tissue disorder or aortic root pathology can be salvaged.
Laryngeal Langerhans Cell Histiocytosis: A Case Report and Literature Review
Authors: Zhou Allen S. , Li Lei , Carroll Thomas L.
Published: August 2020

Objective:

To describe a case of laryngeal Langerhans cell histiocytosis, discuss its characteristic features and management, and provide a review of the available literature.

Methods:

A patient presenting to a tertiary care medical center with dyspnea and hoarseness is described. A literature review of laryngeal Langerhans cell histiocytosis cases was performed through a search of articles indexed in the National Institutes of Health PubMed system.

Results:

We report a case of a 69-year old male, who presented with a laryngeal mass highly suspicious for laryngeal squamous cell carcinoma, was treated with laser excision, and was subsequently found to have laryngeal Langerhans cell histiocytosis upon histological analysis. Including our current case, we found six prior reported cases of laryngeal Langerhans cell histiocytosis in the literature. Of the six cases, four were in adults, while two were in children. Dyspnea is a common presenting complaint present in all cases. Smoking may be a potential risk factor.

Conclusions:

Laryngeal Langerhans cell histiocytosis is a rare condition and an important consideration in the differential diagnosis of patients presenting with a laryngeal mass and symptoms of dyspnea or hoarseness. Biopsy and histopathological analysis are key to the diagnosis. Surgical excision and radiotherapy are successful treatments used in clinical practice.
Modeling Item Revisit Behavior: The Hierarchical Speed–Accuracy–Revisits Model
Authors: Bezirhan Ummugul , von Davier Matthias , Grabovsky Irina
Published: August 2020

This article presents a new approach to the analysis of how students answer tests and how they allocate resources in terms of time on task and revisiting previously answered questions. Previous research has shown that in high-stakes assessments, most test takers do not end the testing session early, but rather spend all of the time they were assigned to take the test. Rather than being an indication of speededness, this was found to be caused by test takers’ tendency to revisit previous items even if they already provided answers to all questions. In accordance with this information, the proposed approach models revisit patterns simultaneously with responses and response times to gain a better understanding of the relationship between speed, ability, and revisit tendency. The empirical data analysis revealed that examinees’ tendency to revisit items was strongly related to their speed and subgroups of examinees displayed different test-taking behaviors.
Off-Label Drug Use in Pediatric Out-Patient Care: A Multi-Center Observational Study
Authors: AlAzmi Aeshah , Alasmari Zahra , Yousef Consuela , Alenazi Ahmed , AlOtaibi Mohammed , AlSaedi Hani , AlShaikh Adnan , AlObathani Amani , Ahmed Omaima , Goronfolah Loie , Alahmari Mousa
Published: August 2020

Objective:

Prescribing a drug for a child is not an easy task and requires using the best available evidence as a guide, especially when a drug is used off-label. The practice of prescribing a drug for off-label use is fairly widespread worldwide. The FDA does not regulate prescribing patterns or practices of individual practitioners and, therefore, allows off-label use. The main objective of this study is to evaluate off-label prescribing among the pediatric population in the Kingdom of Saudi Arabia (KSA).

Method:

This is a retrospective, simple random selection observational study of children (≤15 years) who visited pediatric clinics and had at least 1 drug prescribed over a 12-month period (January to December 2018).

Results:

A total of 865 drugs (mean 1 and SD 0.24) were prescribed to 326 children. Off-label was identified in 39.4% of the drugs with a frequency of 512 (as 1 drug may belong to more than 1 off-label category). The most common reason for off-label prescribing was related to doses that were “higher or lower than the recommended use” (48.6%), and the most frequently identified drug class prescribed for off-label use was anti-infective drugs for systemic use (39.9%). The percentage of off-label drug use was found to be higher in girls and in the age group of 1 month to 2 years ( P = .001) for both variables. In addition, a significant association was found between off label drug use and the total number of drugs prescribed, P < .001.

Conclusion:

The findings of this study showed a high incidence of off-label prescribing mainly related to dosing and indication. The results of this observational study support the need to establish a unified national pediatric dosing formulary guide to ensure safe drug use in pediatrics.
Simultaneous attainment of particle dispersion and surface modification of Al2O3 nanoparticles via wet–jet milling
Authors: Zhang Chaofu , Tominaga Yuichi , Sato Kimiyasu , Imai Yusuke
Published: August 2020

The good dispersion and chemical modification of alumina (Al2O3) nanoparticles as filler were simultaneously performed by a wet–jet milling (WJM) process to disperse the nanoparticles effectively in the polymeric composite. The grafting densities of Al2O3 nanoparticles silane–coupling modified by WJM increased from 0.73 to 1.84 molecules/nm2 in hexyltriethoxysilane, and from 0.65 to 1.09 molecules/nm2 in 3–glycidoxypropyltriethoxysilane. Furthermore, the Al2O3 nanoparticles were dispersed to the primary particle size. In addition, the mechanical properties of the Al2O3/epoxy composite prepared by the in–situ mixing process were higher than those prepared by conventional dry mixing process. As results, the mechanical properties of the Al2O3/epoxy composite could be improved by optimizing the dispersion, chemical modification of the nanoparticles and mixing process of nanoparticles and polymer.
Thermal Imaging of Root Caries In Vivo
Authors: Yang V. , Zhu Y. , Curtis D. , Le O. , Chang N.Y.N. , Fried W.A. , Simon J.C. , Banan P. , Darling C.L. , Fried D.
Published: August 2020

Improved methods are needed to assess the structure and activity of lesions on root surfaces in order to improve clinical decision making. Conventional visual and tactile methods for assessing lesion activity are not reliable, and the clinician is often unable to evaluate if the lesion is progressing or has remineralized. An important marker of an arrested lesion is a highly mineralized surface zone that forms when mineral is deposited in the outer layer of the lesion. In vitro studies have shown that a mineralized surface zone influences the kinetics of water evaporation and the surface temperature while drying. Temperature changes can be monitored by measuring the thermal emission with thermal imaging. Studies have also shown that the depth and severity of demineralization and the thickness of the highly mineralized transparent surface zone on arrested lesions can be measured nondestructively with optical coherence tomography (OCT). Thermal imaging at 8-µm to 13-µm wavelengths was completed on 30 test subjects with a suspected active root caries lesion by monitoring thermal emission from the tooth surfaces during 30 s of air drying. Lesions were also evaluated using cross-polarization OCT (CP-OCT) during lesion dehydration to identify transparent surface zones indicative of arrested lesions and determine if shrinkage occurred during drying. The overall thermal emission recorded during drying was significantly different ( P < 0.001) when comparing sound tooth surfaces, lesion areas identified as arrested, and lesion areas identified as active, demonstrating that thermal imaging is a promising approach for the clinical assessment of lesion activity on root surfaces. Ten of the lesions in this study had distinct areas with transparent surface zones that were visible in CP-OCT images. Shrinkage was detected with CP-OCT during drying for 12 lesions. This study confirms that these novel approaches for assessing lesion activity on root surfaces can be implemented in vivo.
Randomized Clinical Trial on Sodium Fluoride with Tricalcium Phosphate
Authors: Chen K.J. , Gao S.S. , Duangthip D. , Lo E.C.M. , Chu C.H.
Published: August 2020

This 24-mo randomized controlled trial was based on a double-blind parallel design, and it compared the effectiveness of 2 fluoride application protocols in arresting dentine caries in primary teeth. Three-year-old children with active dentine caries were recruited and randomly allocated to 2 treatment groups. Children in group A received a semiannual application of a 25% silver nitrate (AgNO3) solution followed by a commercially available varnish with 5% sodium fluoride (NaF) on the carious tooth surfaces. Children in group B received a semiannual application of a 25% AgNO3 solution followed by another commercially available varnish with 5% NaF containing functionalized tricalcium phosphate (fTCP). Carious tooth surfaces that were hard when probing were classified as arrested. Intention-to-treat analysis and a hierarchical generalized linear model were undertaken. A total of 408 children with 1,831 tooth surfaces with active dentine caries were recruited at baseline, and 356 children (87%) with 1,607 tooth surfaces (88%) were assessed after 24 mo. At the 24-mo evaluation, the mean (SD) number of arrested carious tooth surfaces per child were 1.8 (2.2) and 2.6 (3.3) for group A (without fTCP) and group B (with fTCP), respectively ( P = 0.003). The arrest rates at the tooth surface level were 42% for group A and 57% for group B ( P < 0.001). Results of the hierarchical generalized linear model indicated that protocol B (with fTCP) had a higher predicted probability (PP = 0.656) in arresting dentine caries than protocol A (without fTCP; PP = 0.500) when the carious lesions were on buccal/lingual surfaces, were on anterior teeth, had dental plaque coverage, and were in children from low-income families ( P = 0.046). In conclusion, protocol B, which applied a 25% AgNO3 solution followed by a commercially available 5% NaF varnish with fTCP semiannually, is more effective in arresting dentine caries in primary teeth as compared with protocol A, which applied a 25% AgNO3 solution followed by another commercially available 5% NaF varnish without fTCP semiannually (ClinicalTrials.gov NCT03423797).
Dying, Death and Mourning amid COVID-19 Pandemic in Kashmir: A Qualitative Study
Authors: Hamid Wasia , Jahangir Mohmad Saleem
Published: August 2020

Using a qualitative approach, this study aimed to examine the changing nature of death, dying and mourning among Muslims of Kashmir due to the COVID-19 pandemic. Telephonic Interviews were conducted with 17 participants, whose loved ones died after the outbreak of the COVID-19 in Kashmir. The findings of the study revealed that the deceased mostly died in isolation with no one around. Mourning the loss was also highly challenging with participants receiving less in-person support thus leading to mourning in isolation. The inability to perform last rites added yet another layer of grief which resulted in prolonged grief among the bereaved and impacted their overall wellbeing.
Investigation of multiple-stresses on mechanical and thermal properties of 9000 h Aged RTV-SiR composites for high-voltage insulation
Authors: Mahmood Atif , Amin Muhammad , Khan Hidayatullah , Israrullah  , Muhammad Fazal , Ejaz Tahir
Published: August 2020

Due to many advantages, polymer composite insulators have been extensively used for high-voltage (HV) transmission lines and substation insulations. The in-service operation, various environmental and electrical stresses degrade their mechanical and thermal characteristics. In this study, nine thousand-hour (9000 h) multi-stress (HV, heat, acid rain, salt fog, ultraviolet (UV) radiation, and humidity) accelerated lab-weathering evaluation of alumina-trihydrate (ATH) and silicon dioxide (SiO2) filled silicone rubber (SiR) composites were utilized. Moreover, to quantify the influence of multiple stresses over 9000 h lab-aging, the tensile strength, elongation at break, hardness, and thermal properties were evaluated and compared with the characterization results of neat (un-aged) composites. Winter and summer-aging cycles were designed in accordance with the actual service environment of Islamabad (Pakistan). Mechanical results of SiR blends showed a decrease in the tensile strength and the elongation at break (EAB), whereas the hardness increased over 9000 h lab-aging. The maximum deviation of ∼57.1% in tensile strength was found for hybrid samples (micro-ATH+ nano-Silica blend: SMNC), whereas the minimum change of ∼25.73% was exhibited by micro-silica-filled SiR specimen SMC3. Compared to neat blends, the maximum variation in EAB was ∼61% for a neat sample (SiR), whereas minimum change was noticed for SMC2 (of ∼31%) over 9000 h lab-aging. Additionally, after 9000 h lab-aging, the maximum (of ∼79.6%) and minimum (of ∼24.4%) variation in hardness was found for hybrid and SiR samples, respectively. Moreover, thermogravimetric (TGA) analysis showed that relative to neat samples, the thermal stability of aged specimens was decreased over weathering. Among aged specimens, only ATH filled samples (SMC1, SMC2) exhibited superior performance for a given temperature range (from 0°C to 900°C) by leaving a higher residual weight of ∼68.6% for SMC2. Hence to simulate and quantify the influence of environmental stresses over insulant performance, accelerated lab weathering can be adopted as an efficient tool.
Age effects on the development of stimulus over-selectivity are mediated by cognitive flexibility and selective attention
Authors: Kelly Michelle P. , Reed Phil
Published: August 2020

Stimulus over-selectivity is said to have occurred when only a limited subset of the total number of stimuli present during discrimination learning controls behavior, thus, restricting learning about the range, breadth, or all features of a stimulus. The current study investigated over-selectivity of 100 typically developing children, aged 3–7 (mean = 65.50 ± 17.31 SD months), using a visual discrimination task. Developmental trends in over-selectivity and their relationship to some cognitive variables (i.e., selective attention, sustained attention, and cognitive flexibility) were the target. Over-selectivity decreased with age, but this effect was mediated by the development of cognitive flexibility. Over-selectivity increased when a distractor task was introduced, which was not mediated by the other cognitive variables under investigation. The current results assist in the establishment of the theoretical underpinnings of over-selectivity by offering evidence of its underlying determinants and relating these to developmental trends.
Digital technologies in music subjects on primary teacher training degrees in Spain: Teachers’ habits and profiles
Authors: Calderón-Garrido Diego , Gustems-Carnicer Josep , Carrera Xavier
Published: August 2020

Many recent proposals in music education relate to digital technologies. Technology can act as a mediator in the teaching-learning processes. Educators’ digital competence comprises the knowledge and skills in both instrumental and didactic use and methodological use that each teacher possesses. This work focuses on music education teachers at Spanish universities. It examines their knowledge of different digital resources, use of them to prepare classes, use of them in class and teaching of them, as well as considering how they learned to use these resources and any problems they encounter while teaching them. For this purpose, an ad hoc questionnaire was administered to a total of 93 teachers from 45 different universities. The results show superficial knowledge of technologies, limited use in class preparation, minimal use in class and almost non-existent teaching. They also reflect teaching staff who are largely self-taught and who complain of the limited resources available in the classroom.
Giant gastric bezoar removal from the stomach using combined dual knife–electric snare treatment: a case report
Authors: Huang Zhong , Cheng Fang , Wei Wei
Published: August 2020

Gastric bezoars are foreign bodies that occur when certain drugs or foods aggregate in the stomach. They cannot be digested and most are unable to pass through the pylorus. Here, we describe a giant hard gastric bezoar that was removed by using combined dual knife–electric snare treatment. This strategy has rarely been reported and can eliminate the need for surgery. The patient exhibited a giant hard gastric bezoar and reported a habit of eating persimmons. A giant persimmon bezoar was treated using a combined dual knife–electric snare approach, without any complications. Follow-up endoscopy revealed that the bezoar had been successfully removed. This report also provides a summary of the diagnostic and therapeutic courses of gastric bezoars.
Ophidiomycosis in Red Cornsnakes (Pantherophis guttatus): Potential Roles of Brumation and Temperature on Pathogenesis and Transmission
Authors: McKenzie Christina M. , Oesterle Paul T. , Stevens Brian , Shirose Leonard , Mastromonaco Gabriela F. , Lillie Brandon N. , Davy Christina M. , Jardine Claire M. , Nemeth Nicole M.
Published: August 2020

Ophidiomycosis (snake fungal disease) is caused by the fungus Ophidiomyces ophiodiicola. As ophidiomycosis is difficult to study in free-ranging snakes, a reliable experimental model is needed to investigate transmission, pathogenesis, morbidity, and mortality, and the effects of brumation and temperature on disease development. Our objective was to develop such a model via subcutaneous injection of O. ophiodiicola conidia in red cornsnakes ( Pantherophis guttatus). The model was used to evaluate transmission and the effects of brumation and temperature in co-housed inoculated and noninoculated snakes. All 23 inoculated snakes developed lesions consistent with ophidiomycosis, including heterophilic and granulomatous dermatitis, cellulitis, and myositis, and embolic fungal granulomas throughout the liver and the coelomic connective tissue in 21/23 (91%). In the inoculated snakes, 21% of skin swabs, 37% of exuvia, and all liver samples tested positive by qPCR (quantitative polymerase chain reaction) for O. ophiodiicola. A post brumation skin swab from 1/12 noninoculated snakes that brumated in contact with inoculated snakes tested positive by qPCR, suggesting possible contact transmission. That snake had microscopic skin lesions consistent with ophidiomycosis, but no visible fungal elements. Of the 23 inoculated snakes, 20 (87%) died over the 70-day experiment, with ophidiomycosis considered the primary cause of death; 12 (52%) of the inoculated snakes died during brumation. Overall, this experimental model of ophidiomycosis reproduced skin lesions analogous to those of many natural cases, and internal lesions similar to the most severe natural cases. The study provides tentative experimental evidence for horizontal transmission in brumation, and offers a tool for future studies of this widespread snake disease.
Subjectifying objectivity: Delineating tastes in theoretical quantum gravity research
Authors: Gilbert Thomas Krendl , Loveridge Andrew
Published: August 2020

Research in theoretical quantum gravity has continued expansively even as it has become detached from classic arbiters of research such as direct empirical falsification. This makes it an interesting test case for theories of what motivates and mediates contemporary scientific research and of the nature of scientific objectivity. We conducted 50 semi-structured interviews with researchers in the rival camps of string theory and loop quantum gravity, coded a subset for reoccurring themes, and subjected the resulting data to statistical analysis. To delineate the subjective tastes and the related process of collective consensus-making in contemporary quantum gravity research, we mobilize aspects of Daston and Galison’s depiction of the scientific self and its relation to epistemic virtues, Bourdieu’s field-centered account of social space, and Kantian notions of aesthetics. We make two key contributions. First, our analysis sheds light on the inner workings of the field by connecting its internal epistemic struggles with approaches to understanding scientific fields. Second, our application of theories of social reproduction to the substance of scientific inquiry allows some substantive generalizations of Daston and Galison’s framework.
Driver Reactions to Uphill Grades: Inference from a Stochastic Car-Following Model
Authors: Xu Tu , Laval Jorge
Published: August 2020

This paper analyzes the impact of uphill grades on the acceleration drivers choose to impose on their vehicles. Statistical inference is made based on the maximum likelihood estimation of a two-regime stochastic car-following model using Next Generation SIMulation (NGSIM) data. Previous models assume that the loss in acceleration on uphill grades is given by the effects of gravity. We find evidence that this is not the case for car drivers, who tend to overcome half of the gravitational effects by using more engine power. Truck drivers only compensate for 5% of the loss, possibly because of limited engine power. This indicates not only that current models are severely overestimating the operational impacts that uphill grades have on regular vehicles, but also underestimating their environmental impacts. We also find that car-following model parameters are significantly different among shoulder, median and middle lanes but more data is needed to understand clearly why this happens.
Becoming an Intentional Church Community: Relationships, Security, and Discipleship in Sexual Identity and Faith Development
Authors: Dean Janet B. , Stratton Stephen P. , Yarhouse Mark A.
Published: August 2020

Drawing upon previous research with sexual minority Christian college students, we identify emergent themes important to ministry with sexual minorities integrating religious/spiritual and sexual identities: intrinsic religiosity, social relationships, self-acceptance, and complexity of identity integration. We propose a Trinitarian ministry model wherein the church serves as a holding environment—a discipling community intentionally designed to be relational, secure, and formational thereby creating a synergistic communal climate for identity development related to faith and sexuality.
Dynamic compression and tensile responses of an epoxy matrix composites at high strain rate
Authors: Hu HX , Meng LM , Liu ZW , Chen XY , Qin HL , Wang CJ
Published: August 2020

To study the dynamic compression and tensile mechanical behaviors of a bicomponent epoxy resin matrix composites, which were filled with a semi-crystalline thermoplastic Polyether-ether ketone (PAEK-C) resin, at high strain rate, the dynamic compression and tensile experiments were carried out on a modified split Hopkinson pressure bar (SHPB) and high speed material apparatus, respectively. Stress-strain curves of the epoxy resin matrix composites were obtained and analyzed. Damage mechanism under high strain rate was characterized through the scanning electron microscope (SEM) observation. Results of the dynamic compression tests indicated that, although the effects of strain rate remarkably influenced the variations in stress, the behaviors of the epoxy resin matrix played a more significant role than strain rate in the determination of the high strain rate. It was reflected through increased ductility of the samples and reduced slope of the stress-strain curves. The dynamic impact tensile tests results show that, PAEK-C fillers exhibited dramatic toughening effect. The increase of the volume fraction of PAEK-C rich phase inevitably forces the crack to overcome more tearing deformation of PAEK-C rich phase. At the same time, the enhancement of plastic capacity may also induce a larger range of cooperative deformation at the crack tip.