bluuebunny/crossref_metadata_2025 huggingface dataset:
The [1,2,4]Triazolo[4,3‐a]pyridine as a New Player in the Field of IDO1 Catalytic Holo‐Inhibitors
Authors: Fallarini Silvia , Bhela Irene P. , Aprile Silvio , Torre Enza , Ranza Alice , Orecchini Elena , Panfili Eleonora , Pallotta Maria T. , Massarotti Alberto , Serafini Marta , Pirali Tracey
Published: August 2021

Inhibitors of indoleamine 2,3‐dioxygenase 1 (IDO1) are considered a promising strategy in cancer immunotherapy as they are able to boost the immune response and to work in synergy with other immunotherapeutic agents. Despite the fact that no IDO1 inhibitor has been approved so far, recent studies have shed light on the additional roles that IDO1 mediates beyond its catalytic activity, conferring new life to the field. Here we present a novel class of compounds originated from a structure‐based virtual screening made on IDO1 active site. The starting hit compound is a novel chemotype based on a [1,2,4]triazolo[4,3‐a]pyridine scaffold, so far underexploited among the heme binding moieties. Thanks to the rational and in silico‐guided design of analogues, an improvement of the potency to sub‐micromolar levels has been achieved, with excellent in vitro metabolic stability and exquisite selectivity with respect to other heme‐containing enzymes.
Elective neck dissection versus observation in patients with head and neck cutaneous squamous cell carcinoma
Authors: Amit Moran , Liu Chuan , Mansour Jobran , Gleber‐Netto Frederico O. , Tam Samantha , Baruch Erez N. , Aashiq Mohamed , El‐Naggar Adel K. , Moreno Amy C. , Rosenthal David I. , Glisson Bonnie S. , Ferrarotto Renata , Wong Michael K. , Tsai Kenneth , Flores Elsa R. , Migden Michael R. , Silverman Deborah A. , Li Goujun , Khanna Anshu , Goepfert Ryan P. , Nagarajan Priyadharsini , Weber Randal S. , Myers Jeffrey N. , Gross Neil D.
Published: August 2021

Background

The survival benefit of elective neck dissection (END) for patients with cutaneous squamous cell carcinoma (cSCC) of the head and neck and no evidence of regional metastasis (cN0) has never been reported. The aim of this study was to determine the effect of END on patient survival.

Methods

The authors included patients with head and neck cSCC who had undergone primary surgery from 1995 to 2017. The primary end point was survival, and the secondary end points were the incidence of occult regional disease and regional disease control. To assess the impact of END on survival, the authors used multivariable Cox proportional hazards models with propensity score and matching techniques for internal validation.

Results

A total of 1111 patients presented with no evidence of nodal disease; 173 had END, and 938 were observed. Adjuvant radiotherapy to the neck was administered to 101 patients (9%). END resulted in a 5‐year overall survival rate of 52%, whereas the rate was 63% in the observation group (P = .003 [log‐rank]). The 5‐year disease‐free survival rate for patients undergoing END was similar to that for the observation group (73% vs 75%;P = .429). A multivariate regression model showed that the performance of END was not associated with improved rates of overall, disease‐specific, or disease‐free survival; similarly, among patients with advanced disease (T3‐4), those who underwent END did not have improved survival rates.

Conclusions

Among patients with cSCC of the head and neck, observation of the neck nodes resulted in noninferior survival rates in comparison with END at the time of primary surgery. Further studies are required to elucidate the role of END in patients with advanced disease.
Deep belief network and support vector machine fusion for distributed denial of service and economical denial of service attack detection in cloud
Authors: Britto Dennis J. , Shanmuga Priya M.
Published: August 2021

Cloud computing is a progressive technology that offers computing resources as Internet‐based services, revolutionized information, and communication technologies. From an economic standpoint, this transformation is beneficial because it allows them to streamline technology infrastructure and capital costs. However, economical denial of service (EDoS) potential is a crucial impediment to cloud computing success. Several improved ways to detect EDoS and distributed denial of service (DDoS) attacks in the cloud have been presented; nevertheless, these approaches still result in a considerable reduction in detection accuracy when employed in a cloud setting. Because selecting relevant features and precise classifiers for attack detection is a challenge. We recommend using an EDoS and DDoS attack identification framework in the cloud based on optimized deep learning techniques for higher detection accuracy. The experimental results reveal True Positive Rate (TPR) varies from 98.9% to 99.8% when using deep belief network with support vector machine as a learning mechanism, while True Negative Rate (TNR) from 99.6% to 99.9%. TPR and TNR were found to have average values of 99.32% and 99.67%, respectively. At 1600 requests/s, the maximum accuracy achieved and the overall accuracy of the proposed strategy was 99.78%.
Cerebrospinal fluid metabolomics: detection of neuroinflammation in human central nervous system disease
Authors: Yan Jingya , Kuzhiumparambil Unnikrishnan , Bandodkar Sushil , Dale Russell C , Fu Shanlin
Published: August 2021

The high morbidity and mortality of neuroinflammatory diseases drives significant interest in understanding the underlying mechanisms involved in the innate and adaptive immune response of the central nervous system (CNS). Diagnostic biomarkers are important to define treatable neuroinflammation. Metabolomics is a rapidly evolving research area offering novel insights into metabolic pathways, and elucidation of reliable metabolites as biomarkers for diseases. This review focuses on the emerging literature regarding the detection of neuroinflammation using cerebrospinal fluid (CSF) metabolomics in human cohort studies. Studies of classic neuroinflammatory disorders such as encephalitis, CNS infection and multiple sclerosis confirm the utility of CSF metabolomics. Additionally, studies in neurodegeneration and neuropsychiatry support the emerging potential of CSF metabolomics to detect neuroinflammation in common CNS diseases such as Alzheimer's disease and depression. We demonstrate metabolites in the tryptophan–kynurenine pathway, nitric oxide pathway, neopterin and major lipid species show moderately consistent ability to differentiate patients with neuroinflammation from controls. Integration of CSF metabolomics into clinical practice is warranted to improve recognition and treatment of neuroinflammation.
Planar and printed antennas for Internet of Things‐enabled environment: Opportunities and challenges
Authors: Roges Rashmi , Malik Praveen Kumar
Published: August 2021

The Internet of Things (IoT) is the future technology, whose glimpses are already visible in various fields today. IoT promises a connection of about 50 billion devices in the near future to enhance data sharing and analysis between many otherwise independent modules. Smart sensors, smart antennas, and intelligent processors form the backbone of IoT technology. IoT is about remote detection and control of devices which is dependent on the efficient communication system provided. This paper studies the IoT technology, along with its supportive systems, giving an emphasis to the communication module, enabled using microstrip patch antennas. The study takes a walk through the different improvement techniques implemented in patch antennas as DGS, MIMO, and arrays and further pins down the research gaps and objectives that can be taken up in this field with respect to the effective implementation of IoT services. Recent advances in the antenna systems employed in IoT environment are discussed, and the antennas employed in IoT devices and applications are reviewed in detail. Recently evolving technologies like LoRa and NB‐IoT and the ESP8266 module which is widely used in IoT applications are addressed. A good insight is given into the challenges faced in this field along with some recent case studies.
Cavitation‐resistant junipers cease transpiration earlier than cavitation‐vulnerable oaks under summer dry conditions
Authors: Northup Alison P. , Keitt Timothy H. , Farrior Caroline E.
Published: August 2021

Ashe juniper (Juniperus ashei Buchholz) and escarpment live oak (Quercus fusiformis Small) are two of the most common woody species of the Edwards Plateau, an arid‐to‐semi‐arid region of nearly 100,000 km2 in central Texas. They have very different hydraulic strategies, yet they experienced similar mortality rates during an extreme drought in 2011. We measured J. ashei and Q. fusiformis sap flow velocities during summer dry periods of 2016 and 2017 at six micro‐sites. Although these were years with more‐or‐less average summer conditions, both included significant dry periods. To estimate the relative rate of decrease in sap velocity for each species during the dry periods, we fit a Bayesian exponential decay model to the sap velocity time series for each tree. We found that Q. fusiformis trees were better able to maintain transpiration than J. ashei during dry periods at five micro‐sites and were comparable at the sixth micro‐site. We conclude that it is likely that Q. fusiformis can better maintain transpiration during dry periods than J. ashei, on average, and that in the case of these two species, greater cavitation resistance may not translate to greater drought resistance.
Performance‐based optimum tuning of tuned mass dampers on steel moment frames for seismic applications using the endurance time method
Authors: Tavakolinia Majid , Ch. Basim Mohammad
Published: August 2021

A performance‐based framework is presented to investigate the optimum tuning of tuned mass dampers (TMDs) for seismic applications in several steel moment‐resisting frames by single and multi‐objective genetic algorithm. The single objective problems have been developed for a set of given mass ratios so as to meet the best performance, while the multi‐objective problems try to attain a set of Pareto optimal designs so as to find the relation between TMD efficiency and TMD mass. In the proposed approach, nonlinear time history analysis via endurance time (ET) method is utilized to estimate the structural responses at two seismic hazard levels in order to assess the performance of structures, while a new criterion for scaling period of TMD‐equipped structures is proposed to be used in scaling process of seismic excitations. A criterion of interstory drift ratios at BSE‐1N seismic hazard level, as the performance index of the studied frames, is considered to be minimized and finally, detuning effects of the optimum TMD designs are checked at BSE‐2N seismic hazard level. In order to illustrate the superiority of the proposed approach, the robustness of optimal TMD parameters is evaluated under near‐ and far‐field ground motion record sets recommended in FEMA‐P695. Also, the optimum results are compared to those from several analytical methods. The proposed framework, taking the advantage of the ET method, is found to be an efficient and feasible approach for practical and cost‐effective optimum seismic design of TMDs on nonlinear structures with a reasonable accuracy and significantly reduced computational effort.
Towards a practical loss‐based design approach and procedure
Authors: Calvi Gian Michele , O'Reilly Gerard J. , Andreotti Guido
Published: August 2021

Performance‐based design was first envisaged in the early 1990s and has become a mantra in conceptual seismic design. However, practical approaches to be possibly introduced in building codes are not readily available, to say the least, though some can be found in the literature. What is essentially missing is some correlation between structural response parameters and expected monetary losses, at a level of simplicity comparable with the force‐ or displacement‐based approaches applied to design in everyday practice. The purpose of this conceptual paper is to provide the basics of a formulation that may evolve into such a practical loss–based approach.
Investigating the predictive ability of ONS big data‐based indicators
Authors: Kapetanios George , Papailias Fotis
Published: August 2021

This paper investigates the predictive ability of a brand new dataset that is based on big unstructured data published by the UK Office for National Statistics as “Faster Indicators of UK Economic Activity.” We consider some indicative ways for use in macroeconomic nowcasting. Even though the ONS confirms that the newly introduced big data‐based indicators are not constructed with forecasting purposes in mind, and applied researchers should be cautious when using them in this way, a simple out‐of‐sample nowcasting exercise reveals partial evidence that this dataset has some predictive power over GDP growth. Our results, which show a positive and encouraging first step towards the use of this type of data, suggest that national statistics agencies should allocate more resources in constructing big data‐based databases.
Numerical analysis of MHD nanofluid flow over a wedge, including effects of viscous dissipation and heat generation/absorption, using Buongiorno model
Authors: Mishra Ashish , Kumar Manoj
Published: August 2021

The key purpose of this article is to examine magnetohydrodynamics flow, generative/absorptive heat, and mass transfer of nanofluid flow past a wedge in the presence of viscous dissipation through a porous medium. The investigation is completely theoretical, and the present model expresses the influence of Brownian motion and thermophoresis using the nanofluid Buongiorno model. The fundamental model of partial differential equations is reframed into the structure of ordinary differential equations implementing the nondimensional similarity transformation, which are tackled through the fourth–fifth‐order Runge–Kutta–Fehlberg algorithm together with the shooting scheme. The analysis of sundry nondimensional controlling parameters, such as magnetic parameter, Eckert number, heat generation/absorption parameter, porosity parameter, Brownian motion parameter, and thermophoresis parameter on velocity, temperature, and concentration profiles are discussed graphically. The effects of the physical factors on the rate of momentum and heat and mass transfer are also determined with appropriate analysis in terms of skin friction, Nusselt number, and Sherwood number. The outcomes illustrate that the local Nusselt number and local Sherwood number are reduced for higher values of the thermophoresis parameter. Besides, it is found that higher estimations of heat generation/absorption and viscous dissipation parameters increase temperature. Moreover, it is found that the temperature profile increases with the involvement of the Brownian motion parameter, while an opposite trend is observed in the concentration profile. A comparison is also provided for limiting cases to authenticate our obtained results.
Characterizing and classifying urban watersheds with compositional and structural attributes
Authors: Delesantro Joseph M. , Duncan Jonathan M. , Riveros‐Iregui Diego , Blaszczak Joanna R. , Bernhardt Emily S. , Urban Dean L. , Band Lawrence E.
Published: August 2021

Current land‐use classifications used to assess urbanization effects on stream water quality date back to the 1980s when limited information was available to characterize watershed attributes that mediate non‐point source pollution. With high resolution remote sensing and widely used GIS tools, there has been a vast increase in the availability and precision of geospatial data of built environments. In this study, we leverage geospatial data to expand the characterization of developed landscapes and create a typology that allows us to better understand the impact of complex developed landscapes across the rural to urban gradient. We assess the ability of the developed landscape typology to reveal patterns in stream water chemistry previously undetected by traditional land‐cover based classification. We examine the distribution of land‐cover, infrastructure, topography and geology across 3876 National Hydrography Dataset Plus catchments in the Piedmont region of North Carolina, USA. From this dataset, we generate metrics to evaluate the abundance, density and position of landscape features relative to streams, catchment outlets and topographic wetness metrics. While impervious surfaces are a key distinguishing feature of the urban landscape, sanitary infrastructure, population density and geology are better predictors of baseflow stream water chemistry. Unsupervised clustering was used to generate a distinct developed landscape typology based on the expanded, high‐resolution landscape feature information. Using stream chemistry data from 37 developed headwater catchments, we compared the baseflow water chemistry grouped by traditional land‐cover based classes of urbanization (rural, low, medium and high density) to our composition and structure‐based classification (a nine‐class typology). The typology based on 22 metrics of developed landscape composition and structure explained over 50% of the variation in NO3−‐N, TDN, DOC, Cl−, and Br− concentration, while the ISC‐based classification only significantly explained 23% of the variation in TDN. These results demonstrate the importance of infrastructure, population and geology in defining developed landscapes and improving discrete classes for water management.
Evaluating the primary care clinical pharmacist visit transition to telehealth during the COVID‐19 pandemic by comparing medication related problems from telehealth visits and in‐person visits
Authors: McNamara Anusha , Zhao Milly , Lee Shin‐Yu
Published: August 2021

Background

The coronavirus disease 2019 (COVID‐19) pandemic forced healthcare systems to rethink healthcare delivery, and forced primary care pharmacists in our healthcare system to switch all visits that were previously face to face (FTF) to telehealth.

Methods

We conducted a retrospective observational cohort study to examine the association between medication related problems (MRPs) resolved in telehealth vs FTF primary care clinical pharmacist visits. The telehealth visits took place in the context of the COVID‐19 pandemic, which forced health care systems to rethink care delivery. Data was collected for patient visits for 2 weeks in January before the pandemic and 2 weeks in June during the pandemic.

Results

There was significantly more average MRPs resolved per patient encounter in FTF visits compared with telehealth visits, particularly in patient encounters that were previously seen by the pharmacist, who were under 65 years old, identified as Black/African American, had chronic kidney disease but not on dialysis, diabetes with end organ damage, and had uncontrolled blood pressure and uncontrolled A1c.

Conclusion

These results provide a start to establish criteria for which patients should be seen by a clinical pharmacist in person vs over the phone.
Adoption of telepharmacy within a community health center: A focus on clinical pharmacy services
Authors: McCarthy Caitlin , Bateman M. Thomas , Henderson Tyler , Jean Ronald , Evans Rachael
Published: August 2021

Introduction

Due to the current coronavirus disease 2019 (COVID‐19) pandemic, telehealth has shifted from an underutilized service to a medical necessity almost overnight. While guidelines are available regarding implementation of telepharmacy services, there is limited practice‐level evidence demonstrating successful adoption of telepharmacy for the delivery of clinical pharmacy services.

Objectives

The purpose of this article is to provide a description of how telehealth has been utilized to deliver pharmacy services within a Community Health Center (CHC), to discuss the impact of telehealth services, and to provide a framework by which other entities may create successful telehealth programs within the ambulatory care setting.

Methods

Overall CHC productivity, clinical pharmacist productivity, and patient demographics were compared between the 7 months preceding and the 7 months after implementation of telehealth services. Patient satisfaction with telehealth was measured via anonymous surveys administered via Feedtrail XM and provider satisfaction was measured via a survey created by the New Jersey Primary Care Association.

Results

Telepharmacy has caused a shift in the demographics of patients receiving pharmacy services, increasing the proportion of patients with private insurance, who were 65 years or older, and who were non‐English speakers. While overall productivity at the CHC remained stable, the number of clinical pharmacy encounters increased. Patients were satisfied with telepharmacy visits indicating that they were of the same or greater quality than in‐person visits and expressed a preference to continue telepharmacy visits in the future.

CONCLUSIONS

Our results suggest that telepharmacy is an effective way to deliver care particularly around chronic conditions. To be sustainable, telehealth requires ongoing support from local, State, and Federal agencies in terms of maintaining regulations around expanded scopes of practice and in terms of reimbursement.
Insights into lead removal in water using a novel carbonized material derived from the by‐product of oil refining: action mechanism and performance optimization
Authors: Wan Dongjin , Cheng Xiaofan , Shi Yahui , Chen Zhaohui , Liu Yongde , Han Xinze , Liu Yongzhi , Zhang Zhixiang
Published: August 2021

BACKGROUND

Pollution control by the treatment of waste is a hot issue currently being studied that continues to attract more and more attention. In this work, by using the solid by‐products of oil refining (i.e., spent bleaching earth, SBE) as the raw materials, an environmentally‐friendly adsorbent (i.e., spent bleaching earth carbon, SBE@C) was prepared by the pyrolysis of SBE to adsorb Pb(II) from water.

RESULTS

Herein, Pb(II) maximum adsorption capacity of SBE@C (63.30 mg g–1) from the Langmuir model is about twice that of SBE (33.13 mg g–1). This is mainly attributed to the increased surface area and surface hydrophobicity of SBE@C after pyrolysis. The adsorption kinetics indicated that the pseudo‐second‐order kinetic model and the Elovich model can better fit the kinetic process of SBE and SBE@C for Pb(II) adsorption, respectively. Coexisting cations cause the decrease of Pb(II) adsorption capacity by SBE@C to varying degrees, and the order of their inhibition is: Na+ < K+ < Mg2+ < Cu2+ < Al3+ < Fe3+. Increasing the initial pH of the solution (2.20–5.75) can promote Pb(II) adsorption capacity of SBE@C.

CONCLUSION

Based on the results of characterization, Pb(II) adsorption mechanism by SBE@C is proposed, including the surface adsorption, electrostatic attraction, ion exchange, and surface complexation. Meanwhile, SBE@C has an excellent re‐utilization ability, and the adsorption ability of SBE@C was speculated to be lost after nine cycles. Overall, SBE@C is considered an economical and efficient adsorbent with broad application prospects.
Percutaneous ultrasound‐guided resection of a painful osteophyte using novel Tenex‐Bone device in a residual limb: A case report
Authors: Lui Garrett , Sussman Walter I.
Published: August 2021

Residual limb pain is common after amputation. Painful osteophytes are one of many causes of residual limb pain, and cases that fail conservative management may require open surgical resection. Here we present a novel percutaneous ultrasound‐guided approach to remove a painful osteophyte in a transfemoral amputee. This procedure successfully treated this patient's residual limb pain while minimizing the risks associated with open surgical resection.
Basal metabolic rate in free‐ranging tropical birds lacks long‐term repeatability and is influenced by ambient temperature
Authors: Bushuev Andrey , Zubkova Ekaterina , Tolstenkov Oleg , Kerimov Anvar
Published: August 2021

Tropical birds live longer, have smaller clutches and invest more resources into self‐maintenance than temperate species. These “slow” life‐histories in tropical birds are accompanied by low basal metabolic rate (BMR). It has recently been suggested that the low BMR of tropical species may be related not to their slow “pace of life” or high ambient temperatures (Ta) in tropical latitudes, but to the stability of environmental conditions in tropics. Since the repeatability of metabolic traits is higher in stable environments, such as laboratory conditions, we predicted that long‐term repeatability of BMR in a tropical climate should be higher than in a temperate one. Contrary to our predictions, the repeatability of mass‐independent BMR in 64 individuals of free‐living tropical birds from Vietnam was low and insignificant after the species affiliation was taken into account. It indicates that BMR cannot be used as an individual long‐term characteristic of tropical birds. On the other hand, tropical birds showed consistent differences in their mass‐independent BMR at the interspecific level. Using BMR measurements from 1543 individuals of 134 species, we also found that different characteristics ofTawithin the week preceding BMR measurements had a significant impact on the mass‐independent BMR of tropical birds. The most significant effect was the difference between the absolute maximum and minimumTawithin a single week. Our results indicate that the physiology of tropical birds is more subject to changes than would be expected based on the notion of the stability of climatic conditions in the tropics.
Nutrient expert system optimizes fertilizer management to improve potato productivity and tuber quality
Authors: Sha Shanyi , Zhao Xiaohui , Li Yuxi , Li Chunlin , Zhu Lin , Wang Yin , Gao Qiang
Published: August 2021

BACKGROUND

Improving potato productivity and quality plays an important role in enhancing global food security and human health. However, inappropriate fertilizer management negatively affects potato growth and tuber development, especially in developing countries where there are large numbers of smallholders without modern soil testing equipment. Nutrient Expert (NE), a new and convenient fertilization decision system, was evaluated in the present study by conducting four site‐years field experiments in Northeast China, aiming to determine its effectiveness and applicability for potato production relative to local farmers' practice (FP) and fertilizer recommendation based on soil testing (ST).

RESULTS

The excessive fertilization at planting promoted seedling growth for potato plants in FP. Nevertheless, superior plant growth and tuber development were observed in NE at the middle and later growing stages, by optimizing fertilizer input and implementing split fertilization. Overall, compared to FP, the NE system increased total and marketable tuber yields by 12–15% and 16–26%, respectively, at the same time as obtaining 19–31% higher net returns and enhanced fertilizer use efficiencies. Moreover, NE improved tuber quality by increasing the contents of starch, soluble protein and vitamin C and decreasing reducing sugar content relative to FP, as well as increasing starch yields by 23–52%. The ST method also showed comprehensive improvements in potato performances compared to FP, although it did not show any advantages compared to NE system.

CONCLUSION

The NE system improved potato productivity and tuber quality by optimizing fertilization management, which is an effective and promising alternative to the ST method for potato production in China and other developing countries. © 2021 Society of Chemical Industry.
An aqueous extract from Artemisia capillaris inhibits acute gastric injury through mucosal stabilization
Authors: Hwang Su Jung , Yeo Dahee , Song Ye‐Seul , Choi Youngbin , Youn Hyun‐Joo , Lee Hyo‐Jong
Published: August 2021

BACKGROUND

Artemisia capillaris is among the most abundantly used traditional medicines, utilized in East Asia to treat diverse illnesses, including gastrointestinal tract diseases. We previously reported that an aqueous extract of A. capillaris (AEAC) inhibited gastric inflammation induced by HCl/ethanol via reactive oxygen species scavenging and NF‐κB downregulation. To date, the pharmacological potential of AEAC for promoting mucosal integrity has not been studied.

RESULTS

Here, we report that a single treatment with AEAC increased mucus production, and repeated administration of AEAC abolished HCl/ethanol‐induced mucosal injury in vivo. Single‐ and multiple‐dose AEAC treatments measurably increased the expression of mucosal stabilizing factors in vivo, including mucin (MUC) 5 AC, MUC6, and trefoil factor (TFF) 1 and TFF2 (but not TFF3). AEAC also induced mucosal stabilizing factors in both SNU‐601 cells and RGM cells through phosphorylation of extracellular signal‐regulated kinases.

CONCLUSION

Taken together, our results suggest that AEAC protects against HCl/ethanol‐induced gastritis by upregulating MUCs and TFFs and stabilizing the mucosal epithelium. © 2021 Society of Chemical Industry.
Anterolateral Thigh Fascia Lata Rescue Flap: A New Weapon in the Battle Against Osteoradionecrosis
Authors: Meleca Joseph B. , Kerr Rhorie P. , Prendes B. L. , Fritz Michael A.
Published: August 2021

Objectives

To demonstrate that the anterolateral thigh fascia lata (ALTFL) rescue flap may be effectively used for management of osteoradionecrosis (ORN) in selected patients.

Study Design

Retrospective case review.

Methods

Retrospective chart review was performed on patients who underwent ALTFL free flap repair to various sites of ORN in the head and neck between 2011 and 2018. Inclusion criteria were patients with radiographic and clinical evidence of head and neck ORN who either failed previous hyperbaric oxygen (HBO) therapy or with extensive disease, which was unlikely to respond to conservative management.

Results

Twenty‐three patients with average age of 63 years (40–78) who underwent 24 ALTFL free flap procedures were reviewed. ORN sites were the mandible (n = 16), palatomaxilla (n = 4), skull base and cervical spine (n = 3), and calvarium (n = 2). Recipient vessels used were superficial temporal (n = 11), common facial (n = 10), and angular (n = 3). Average hospital stay was 3.0 (1–10) days. Prior HBO therapy was performed in 13 (57%) patients. There were four major complications: flap failure, recurrent mandibular infection resolved with IV antibiotic course, mandibular fracture with malunion requiring occlusal adjustment, and unresolved sequelae of ORN requiring fibular free flap. There were four minor complications: thigh hematoma, thigh seroma, and intraoral scar formation causing trismus (n = 2). The procedure was successful in 22 of 23 (95.7%) patients with radiographic arrest of ORN, resolution of symptoms, and elimination of antibiotic requirements.

Conclusion

The ALTFL rescue flap merits strong consideration in ORN management and appears to prevent progression to more extensive disease, which would require full segmental bone resection and reconstruction.

Level of Evidence

4 Laryngoscope, 131:2688–2693, 2021
Balloon‐Assisted Rib Graft Placement in Endoscopic Posterior Cricoid Split Procedure
Authors: Aldriweesh Bshair , AlAmmar Ahmed
Published: August 2021

View Video S1 Laryngoscope, 132:212–214, 2022
Extended Anterior Ethmoidal Artery Flap: Novel Endoscopic Technique for Large Septal Perforation
Authors: Santamaría‐Gadea Alfonso , Langdon Cristobal , Alobid Isam
Published: August 2021

View Video S1 Laryngoscope, 132:298–300, 2022
The effects of different management interventions on degraded rangelands in Iceland
Authors: Mulloy Tara A. , Barrio Isabel C. , Jónsdóttir Ingibjörg S. , Hik David S.
Published: August 2021

Loss of vegetation and soil erosion are symptoms of widespread rangeland degradation across most of the Icelandic highlands. Areas at different stages of degradation coexist as a mosaic that includes both vegetated heathlands, and exposed gravelly deserts. Revegetation efforts have included fertilizer applications and grazing exclusion to increase plant biomass and reduce bare ground, but their effectiveness is predicted to differ depending on the stage of degradation for a certain area. In this study, we used a 4‐year field experiment to test the predictions of a state‐and‐transition model for the Icelandic highlands. We measured the combined effects of grazing exclusion and factorial applications of nitrogen (N), phosphorus (P), and potassium (K) fertilizers, on plant biomass, species richness, amount of exposed bare ground and plant community composition in a dwarf‐shrub heathland and a gravelly desert habitat. After 4 years: (1) grazing exclusion alone had no effect in either habitat; (2) fertilizers increased biomass in both habitats, especially in plots treated with NP or NK; (3) the combination of fertilizers and grazing exclusion produced the greatest amount of aboveground biomass, predominantly of forb and graminoid species. In the dwarf‐shrub heath, the increase in biomass in fertilized and fenced plots also corresponded to a loss in species richness, whereas in the gravelly desert, increased biomass reduced the amount of bare ground without reducing species richness. Our results reinforce the importance in understanding the effects of different management interventions across ecological conditions to determine the most effective revegetation approach.
Clinical features and hearing prognosis of idiopathic sudden sensorineural hearing loss in patients undergoing hemodialysis: A retrospective study
Authors: Yamamoto Kengo , Kurioka Takaomi , Furuki Shogo , Sano Hajime , Ohashi Kentaro , Ohki Motofumi , Yamashita Taku
Published: August 2021

Background

Patients undergoing hemodialysis (HD) tend to experience hearing loss, including idiopathic sudden sensorineural hearing loss (ISSHL). However, little is known about the relationship between HD and ISSHL.

Objective

To investigate the effects of HD on the hearing level and the treatment prognosis of ISSHL.

Methods

We reviewed the medical records of 23 patients with ISSHL receiving HD treatment (HD group) and 101 patients with ISSHL not receiving HD treatment (non‐HD group), and assessed clinical features, results of audiometric tests and blood examination results.

Results

Statistically significant differences were not observed in pretreatment hearing level and hearing recovery of the ear affected with ISSHL between the two groups (P > .05). Conversely, hearing thresholds in the unaffected ear were statistically different (P < .0001), and the hearing thresholds of the HD groups were significantly increased compared with those of the non‐HD groups, especially at high frequency. In addition, patients with renal dysfunction not receiving HD treatment showed similar hearing thresholds in the unaffected ear when compared with patients receiving HD treatment.

Conclusion

HD itself did not influence the treatment prognosis of ISSHL. Renal dysfunction itself, and not HD treatment, worsened the hearing level. As similar treatment results are expected, standard treatment should be administered to patients undergoing HD.

Level of Evidence

3b.
Multivalent Protein‐Loaded pH‐Stable Polymersomes: First Step toward Protein Targeted Therapeutics
Authors: Moreno Silvia , Boye Susanne , Ajeilat Hane George Al , Michen Susanne , Tietze Stefanie , Voit Brigitte , Lederer Albena , Temme Achim , Appelhans Dietmar
Published: August 2021

Synthetic platforms for mimicking artificial organelles or for designing multivalent protein therapeutics for targeting cell surface, extracellular matrix, and tissues are in the focus of this study. Furthermore, the availability of a multi‐functionalized and stimuli‐responsive carrier system is required that can be used for sequential in situ and/or post loading of different proteins combined with post‐functionalization steps. Until now, polymersomes exhibit excellent key characteristics to fulfill those requirements, which allow specific transport of proteins and the integration of proteins in different locations of polymeric vesicles. Herein, different approaches to fabricate multivalent protein‐loaded, pH‐responsive, and pH‐stable polymersomes are shown, where a combination of therapeutic action and targeting can be achieved, by first choosing two model proteins such as human serum albumin and avidin. Validation of the molecular parameters of the multivalent biohybrids is performed by dynamic light scattering, cryo‐TEM, fluorescence spectroscopy, and asymmetrical flow‐field flow fractionation combined with light scattering techniques. To demonstrate targeting functions of protein‐loaded polymersomes, avidin post‐functionalized polymersomes are used for the molecular recognition of biotinylated cell surface receptors. These versatile protein‐loaded polymersomes present new opportunities for designing sophisticated biomolecular nanoobjects in the field of (extracellular matrix) protein therapeutics.
Boron Nitride Nanosheets Strengthened PVA/Borax Hydrogels with Highly Efficient Self‐Healing and Rapid pH‐Driven Shape Memory Effect
Authors: Xue Shishan , Liu Guanfei , Lai Jingjuan , An Peng , Liu Yang , Wu Yuanpeng , Wang Yu , Ye Zhiyong , Tang Qiao , Zhou Hongwei
Published: August 2021

Self‐healing hydrogels often possess poor mechanical properties which largely limits their applications in many fields. In this work, boron nitride nanosheets are introduced into a network of the poly(vinyl alcohol)/borax (PVA/borax) hydrogels to enhance the mechanical properties of the hydrogel without compromising the self‐healing abilities. The obtained hydrogels exhibit excellent mechanical properties with a tensile strength of 0.410 ± 0.007 MPa, an elongation at break of 1712%, a Young's Modulus of 0.860 ± 0.023 MPa, and a toughness of 3.860 ± 0.075 MJ m−3. In addition, the self‐healing efficiency of the hydrogels is higher than 90% within 10 min at room temperature. Benefiting from the excellent self‐healing properties, the shapeability of the hydrogel fragments is observed using different molds. In addition, the hydrogels display rapid pH‐driven shape memory effects and can recover to their original shape within 260 s. Overall, this work provides a new approach to hydrogels with integrated excellent mechanical properties, self‐healing abilities, and rapid pH‐driven shape memory effects.
A primer on the differential geometry of quaternionic curves
Authors: Giardino Sergio
Published: August 2021

This paper describes the foundations of a differential geometry of a quaternionic curves. The Frenet–Serret equations and the evolutes and evolvents of a particular quaternionic curve are accordingly determined. This new formulation takes benefit of the quaternionic structure, and the results are much simpler than the present formulations of quaternionic curves.
Disease acceptance and social support in patients with peripheral vascular diseases treated in the surgical ward
Authors: Czarnecka Józefa , Kobos Ewa , Sienkiewicz Zofia
Published: August 2021

Aim

The purpose of this study is a comparative analysis of the degree of disease acceptance and social support in patients with peripheral vascular diseases and other medical conditions treated in surgery ward.

Design

A cross‐sectional study.

Methods

This cross‐sectional study compares disease acceptance and social support in a group of 212 patients with peripheral vascular diseases and other conditions treated in surgery ward. A standardized Acceptance of Illness Scale (AIS) and Social Support Scale were used to collect the research data.

Results

Overall, on the AIS, 14% of patients with surgical diseases and 34% of patients with vascular diseases had a low disease acceptance rate. A high level of support was demonstrated in 41% of study participants with surgically treated diseases and in 17% of participants with vascular diseases.
Instrument development and validation of the comprehensive ability of older people assessment scale
Authors: Li Weitong , Wang Qiuqin , Chen Yujing , Pu Yalou , Xu Guihua
Published: August 2021

Aim

The study is aimed to develop and psychometrically test the Comprehensive Ability of Older People Assessment scale and classify the ability grades.

Design

A cross‐sectional design was used for instrument development.

Method

The Comprehensive Ability of Older People Assessment scale was developed by a sample of 971 older people from 4 long‐term care institutions in China. The data were collected between April 2018 and March 2020. One‐way analysis of variance and multiple regression analysis was used to screen scale items, while focus group interviews were used to integrate the subjective and objective items. Confirmative factor analysis and expert judgment were applied to explore construct validity. Reliability was explored through internal consistency estimation using Cronbach's alpha and homogeneity evaluation using corrected item‐total correlations. Cluster analysis and discriminant analysis were used to segment the comprehensive ability assessment scores and discriminant function was established to determine the boundary value of each segment, using correlation analysis to perform reverse verification.

Results

Factor analysis yielded 40 items with six dimensions, including “mentation and cognitive,” “perception and communication,” “emotional problems,” “mental and behavioural problems,” “daily life and social participation,” and “skin and oral status.” The Cronbach's α was 0.951, while the dimensions showed Cronbach's α values ranging from 0.760–0.946. The rationality and scientificity of this scale were proved by the correlation analysis of reverse validation.

Conclusion

The 4‐grade Comprehensive Ability of Older People Assessment scale is proved to be with good validity and reliability and should be considered for institutional assessors.

Impact

Assessors can accurately evaluate older people's health status and nursing needs through this scale in long‐term care institutions, communities and hospitals, so as to provide accurate and high‐quality nursing services. It will become a scientific basis for the government to offer accurate pension subsidies, purchase pension services scientifically for older people and establish third‐party objective evaluation and supervision.
Efficacy of Platinum Rechallenge in Metastatic Urothelial Carcinoma After Previous Platinum-Based Chemotherapy for Metastatic Disease
Authors: Wong Risa L. , Ferris Lorin A. , Do Olivia A. , Holt Sarah K. , Ramos Jorge D. , Crabb Simon J. , Sternberg Cora N. , Bellmunt Joaquim , Ladoire Sylvain , De Giorgi Ugo , Harshman Lauren C. , Vaishampayan Ulka N. , Necchi Andrea , Srinivas Sandy , Pal Sumanta K. , Niegisch Guenter , Dorff Tanya B. , Galsky Matthew D. , Yu Evan Y.
Published: August 2021

Background

Fit patients with metastatic urothelial carcinoma (mUC) receive first-line platinum-based combination chemotherapy (fPBC) as standard of care and may receive additional later-line chemotherapy after progression. Our study compares outcomes with subsequent platinum-based chemotherapy (sPBC) versus subsequent non-platinum-based chemotherapy (sNPBC).

Materials and Methods

Patients from 27 international centers in the Retrospective International Study of Cancers of the Urothelium (RISC) who received fPBC for mUC and at least two cycles of subsequent chemotherapy were included in this study. A multivariable Cox proportional hazards model compared overall survival (OS) and progression-free survival (PFS).

Results

One hundred thirty-five patients received sPBC and 161 received sNPBC. Baseline characteristics were similar between groups, except patients who received sPBC had higher baseline hemoglobin, higher disease control rate with fPBC, and longer time since fPBC. OS was superior in the sPBC group (median 7.9 vs 5.5 months) in a model adjusting for comorbidity burden, performance status, liver metastases, number of fPBC cycles received, best response to fPBC, and time since fPBC (hazard ratio, 0.72; 95% confidence interval, 0.53–0.98; p = .035). There was no difference in PFS. More patients in the sPBC group achieved disease control than in the sNPBC group (57.4% vs 44.8%; p = .041). Factors associated with achieving disease control in the sPBC group but not the sNPBC group included longer time since fPBC, achieving disease control with fPBC, and absence of liver metastases.

Conclusion

After receiving fPBC for mUC, patients who received sPBC had better OS and disease control. This may help inform the choice of subsequent chemotherapy in patients with mUC.

Implications for Practice

Patients with progressive metastatic urothelial carcinoma after first-line platinum-based combination chemotherapy may now receive immuno-oncology agents, erdafitinib, enfortumab vedotin, or sacituzumab govitecan-hziy; however, those ineligible for these later-line therapies or who progress after receiving them may be considered for subsequent chemotherapy. In this retrospective study of 296 patients, survival outcomes and disease control rates were better in those receiving subsequent platinum-based rechallenge compared with non–platinum-based chemotherapy, suggesting that patients should receive platinum rechallenge if clinically able. Disease control with platinum rechallenge was more likely with prior first-line platinum having achieved disease control, longer time since first-line platinum, and absence of liver metastases.
The impact of yoga on components of energy balance in adults with overweight or obesity: A systematic review
Authors: Caldwell Ann E. , Purcell Sarah A. , Gray Bethany , Smieja Hailey , Catenacci Victoria A.
Published: August 2021

Background

Yoga may reduce body weight in individuals with overweight or obesity, but whether this occurs through decreased energy intake (EI) or increased energy expenditure (EE)/physical activity (PA) is unclear.

Methods

A systematic search of PubMed, Web of Science, Embase, and PsychINFO was conducted from inception until April 26, 2021. Eligible studies included randomized controlled trials or single‐arm pre‐post studies with any type and duration of yoga intervention in adults with overweight or obesity. Studies with measures related to EI , EE, or PA were eligible. The review initially identified 1,373 articles.

Results

Of the 10 included studies, one used indirect calorimeter measures of resting EE, while nine used self‐reported measures of EI and PA. Of the seven studies measuring parameters related to EI, only one found greater decreases in EI relative to the control group, although three other investigations reported trends toward improved dietary intake. Of the eight studies measuring PA, two reported greater increases in resting EE or PA in the yoga group relative to the control group. Two reported significant within‐group increases in PA from pre‐post intervention, and four studies reported a trend for increased PA with no p‐values reported.

Conclusions

Limited evidence suggests yoga may reduce EI and increase PA in adults with overweight or obesity. Additional studies that investigate the effects of yoga interventions on energy balance parameters using objective techniques are warranted.