bluuebunny/crossref_metadata_2025 huggingface dataset:
Texture, color, and sensory changes occurring in chocolate bars with filling during storage
Authors: Hřivna Luděk , Machálková Lenka , Burešová Iva , Nedomová Šárka , Gregor Tomáš
Published: July 2021

The impact of storage temperature (6, 12, 20, 30℃) and period (2, 6, 10, 18, 26 weeks) on the texture, color, and sensory characteristics of dark and milk‐filled chocolate bars was studied. Temperatures of 6 and 12℃ were the most suitable for bar storage; these samples were evaluated not to be significantly deteriorated by the storage period. The condition of samples stored at 20℃ started to deteriorate after 10 weeks in storage; the decline was observed mainly in meltdown rate and off‐flavors, resulting in low overall acceptability. This effect was more evident in dark chocolate bars. Keeping the bars at 24℃ for 24h immediately after production (retemperation) improved the bar resistance to fat bloom, even if the decrease in the sensory quality was observed at the beginning of the storage period.
Gastrointestinal transit tolerance, cell surface hydrophobicity, and functional attributes of Lactobacillus Acidophilus strains isolated from Indigenous Dahi
Authors: Farid Wajiha , Masud Tariq , Sohail Asma , Ahmad Nazir , Naqvi S. M. Saqlan , Khan Sipper , Ali Amjad , Khalifa Salah A. , Hussain Abid , Ali Sartaj , Saghir Maryum , Siddeeg Azhari , Manzoor Muhammad Faisal
Published: July 2021

Strains of Lactobacillus acidophilus WFA1 (KU877440), WFA2 (KU877441), and WFA3 (KU877442) were isolated from indigenous Dahi (yogurt), screened, and selected based on acid and bile tolerance along with the antimicrobial activity. These selected strains were further assessed for their probiotic and functional attributes. Results for simulated gastric and intestinal tolerance/ resistance revealed that all three strains can resist and survive under the following mentioned conditions. To access cell surface hydrophobicity, bacterial adhesion to hydrocarbons (BATH), cellular auto‐aggregation, and salt aggregation were performed. In BATH, adhesion of strains against three hydrocarbons namely xylene, dichloromethane, and hexadecane was conducted. The results show that strains showed the least adhesion to xylene (54.25%) as compared to dichloromethane (55.25%) and hexadecane (56.65%). WFA1 showed maximum adherence percentage (55.48%) followed WFA2 (55.48%) and WFA3 (51.38%). Cellular auto‐aggregation varied from 21.72% to 30.73% for WFA3 and WFA1, respectively. In the salt aggregation test (SAT), WFA1, WFA2, and WFA3 aggregated at 0.6, 1.0, and 2.0 molar concentrations of ammonium sulfate, respectively. PCR amplification of bile salt hydrolase gene (bsh) was performed and sequences were submitted to the public database of NCBI and Gene bank under accession numbers, KY689139, KY689140, and KY689141. Additionally, a cholesterol‐lowering assay was conducted and up to 26% reduction in cholesterol was observed by the strains. Regarding functional properties, exopolysaccharide (EPS) production, and antioxidant potential, strain WFA1 showed promising results EPS (1.027mg/ml), DPPH (80.66%), ABTS (81.97%), and reducing power (1.787). It can be concluded from the present study that the mentioned strains of L. acidophilus (WFA1, WFA2, and WFA3) are strongly hydrophobic; thus having an ability to survive and colonize under the gastrointestinal tract which confirms their probiotic nature. Regarding their functional properties, L. acidophilus WFA1 (KU877440) showed excellent properties of antioxidants and EPS production.
CARMN‐NOTCH2 fusion transcript drives high NOTCH2 expression in glomus tumors of the upper digestive tract
Authors: Girard Nicolas , Marin Cristi , Hélias‐Rodzewicz Zofia , Villa Chiara , Julié Catherine , de Lajarte‐Thirouard Anne‐Sophie , de Beauce Simon Martin , Lagorce‐Pages Christine , Renaud Florence , Cazals‐Hatem Dominique , Guedj Nathalie , Cros Jérome , Raffin‐Sanson Marie‐Laure , Selves Janick , Terris Benoit , Fléjou Jean‐François , Garchon Henri‐Jean , Coindre Jean‐Michel , Emile Jean‐François
Published: July 2021

Glomus tumors (GTs) are perivascular tumors mostly occurring in the distal extremities. Rare cases arise in the digestive tract and may be misdiagnosed with neuroendocrine or gastrointestinal stromal tumors. We aimed to specify the features of GT of the upper digestive tract. Clinical, histological, phenotypic, and molecular features of 16 digestive GTs were analyzed, of whom two underwent whole exome and RNA sequencing to search for gene alterations. RNA‐sequencing disclosed a t(1:5)(p13;q32) translocation, which resulted in the fusion of CARMN and NOTCH2 in two GTs. The fusion gene encoded a protein sequence corresponding to the NOTCH2 intracellular domain that functions as transcription factor. These finding was supported by high expression of genes targeted by NOTCH. The CARMN‐NOTCH2 translocation was detected in 14 out of 16 (88%) GTs of the upper digestive tract; but in only in two out of six cutaneous GTs (33%). Most digestive GT arose from the stomach (n = 13), and the others from duodenal (2) or oesophagous (1). Nuclear expression of NOTCH2 was detected in the 14 cases containing the fusion transcripts. The CARMN‐NOTCH2 fusion transcript may contribute to activation of the NOTCH2 pathway in GT and drive tumor development. The high frequency of this translocation in GT of the upper digestive track suggest that detection of nuclear NOTCH2 expression may be useful diagnostic biomarker of these tumors.
Ethicists and Activists
Authors: Kaebnick Gregory E.
Published: July 2021

In some sense, argues Christopher Meyers in the lead article in this, the July‐August 2021, issue of the Hastings Center Report, to be a good ethicist is to be an activist. The question for the ethicist, and for Meyers, is about how hard and far to push: how much personal risk to shoulder, how much to tick off colleagues, how much institutional disruption to create, how much to look like an angry protester. Meyers argues for aiming at the middle, in two senses. In a time of anger and activism about relentless, pervasive, overwhelming wrongs, the question of balance is increasingly front of mind. A set of commentaries we solicited both welcome Meyers's call for activism and push for more.
Functional neuroanatomy of arithmetic in monolingual and bilingual adults and children
Authors: Brignoni‐Pérez Edith , Matejko Anna A. , Jamal Nasheed I. , Eden Guinevere F.
Published: July 2021

Prior studies on the brain bases of arithmetic have not focused on (or even described) their participants' language backgrounds. Yet, unlike monolinguals, early bilinguals have the capacity to solve arithmetic problems in both of their two languages. This raises the question whether this ability, or any other experience that comes with being bilingual, affects brain activity for arithmetic in bilinguals relative to monolinguals. Here, we used functional magnetic resonance imaging to compare brain activity in 44 English monolinguals and 44 Spanish‐English early bilinguals, during the solving of arithmetic problems in English. We used a factorial design to test for a main effect of bilingual Language Experience. Based on the known modulating roles of arithmetic operation and age, we used two arithmetic tasks (addition and subtraction) and studied two age groups (adults and children). When collapsing across operations and age, we found broad bilateral activation for arithmetic in both the monolingual group and the bilingual group. However, an analysis of variance revealed that there was no effect of Language Experience, nor an interaction of Language Experience with Operation or Age Group. Bayesian analyses within regions of interest chosen for their role in arithmetic further supported the finding of no effect of Language Experience on brain activity underlying arithmetic. We conclude that early bilingualism does not influence the functional neuroanatomy of simple arithmetic.
Assessing fine fescue mixtures and plant growth regulator applications to determine their effect on traffic tolerance and divot recovery
Authors: Reiter Maggie , Mihelich Nicole T. , Qiu Yinjie , Horgan Brian P. , Watkins Eric
Published: July 2021

There has been some transition to using low‐input fine fescues on golf courses, but these species have poor traffic tolerance and divot recovery, making them impractical for playable areas on golf courses. The objectives of this study were to determine the effect of the plant growth regulator (PGR) trinexapac‐ethyl on the performance of fine fescue mixtures when managed as a golf course fairway and to identify fine fescue mixtures that perform well under traffic stress. Twenty‐five mixtures were tested that combined ‘Treazure II’ chewings fescue (Festuca rubraL. ssp.commutataGaudin), ‘Beacon’ hard fescue (Festuca brevipilaTracey), ‘Navigator II’ strong creeping red fescue (Festuca rubraL. ssp.rubraGaudin), ‘Shoreline’ slender creeping red fescue [Festuca rubraL. ssp.littoralis(G. Mey.) Auquier], and ‘Quatro’ sheep fescue (Festuca ovinaL.). Field experiments were conducted in St. Paul, MN, with PGR, mixture, and traffic treatments. The benefits of the PGR trinexapac‐ethyl on fine fescue fairway quality was relatively small compared with the benefits of traffic management and mixture selection. Hard fescue, slender creeping red fescue, strong creeping red fescue, and sheep fescue had the greatest impact on increasing visual turfgrass quality after traffic treatments. There was no significant difference in divot recovery with any mixtures, and no divots had recovered after 12 mo.
Approaches for setting occupational exposure limits in the pharmaceutical industry
Authors: Ahuja Varun , Krishnappa Mohan
Published: July 2021

The use of pharmaceutical drugs has provided a cure for many diseases. However, unintended exposure to drugs in the manufacturing workplace can cause significant health hazards to workers. It is important to protect the workforce from these deleterious effects by limiting exposure to an acceptable level, the occupational exposure limit (OEL). OEL is defined as airborne concentrations (expressed as a time‐weighted average for a conventional 8‐h workday and a 40‐h work week) of a substance to which nearly all workers may be repeatedly exposed (for a working lifetime) without adverse effects. Determination of OELs has become very challenging over time, requiring an overall assessment of the preclinical and clinical data of the drug being manufactured. Previously, to derive OEL values, toxicologists used animal no‐observed‐adverse‐effect level (NOAEL) data, which have been replaced with the overall assessment of animal and human data, placing a higher emphasis on human health‐based data. A major advantage of working with human pharmaceuticals is that sufficient clinical data are available for them in most cases. The present manuscript reviews the latest knowledge regarding the derivation of occupational exposure limits as health‐based exposure limits (HBELs) for pharmaceuticals. We have provided examples of OEL calculations for various drugs including levofloxacin (CAS No. 100986‐85‐4), dienogest (CAS no. 65928‐58‐7), and acetylsalicylic acid (ASA, CAS no. 50–78‐2) using human data. This report will benefit professionals in the OEL domain in understanding this highly important, growing, and challenging field.
Toward optical spectroscopy‐guided lung biopsy: Demonstration of tissue‐type classification
Authors: Rodriguez‐Diaz Eladio , Kaanan Samer , Vanley Christopher , Qureshi Tauseef , Bigio Irving J
Published: July 2021

The diagnostic yield of standard tissue‐sampling modalities of suspected lung cancers, whether by bronchoscopy or interventional radiology, can be nonoptimal, varying with the size and location of lesions. What is needed is an insitu sensor, integrated in the biopsy tool, to objectively distinguish among tissue types in real time, not to replace biopsy with an optical diagnostic, but to verify that the sampling tool is properly located within the target lesion. We investigated the feasibility of elastic scattering spectroscopy (ESS), coupled with machine learning, to distinguish lung lesions from the various nearby tissue types, in a study with freshly‐excised lung tissues from surgical resections. Optical spectra were recorded with an ESS fiberoptic probe in different areas of the resected pulmonary tissues, including benign‐margin tissue sites as well as the periphery and core of the lesion. An artificial‐intelligence model was used to analyze, retrospectively, 2032 measurements from excised tissues of 35 patients. With high accuracy, ESS was able to distinguish alveolar tissue from bronchi, alveolar tissue from lesions, and bronchi from lesions. This ex vivo study indicates promise for ESS fiberoptic probes to be integrated with surgical intervention tools, to improve reliability of pulmonary lesion targeting.
Nanophase surface arrays on poly (lactic‐co‐glycolic acid) upregulate neural cell functions
Authors: Mimiroglu Didem , Yanik Tulin , Ercan Batur
Published: July 2021

Nerve guidance channels (NGCs) promote cell‐extracellular matrix (ECM) interactions occurring within the nanoscale. However, studies focusing on the effects of nanophase topography on neural cell functions are limited, and mostly concentrated on the sub‐micron level (>100 nm) surface topography. Therefore, the aim of this study was to fabricate <100 nm sized structures on poly lactic‐co‐glycolic acid (PLGA) films used in NGC applications to assess the effects of nanophase topography on neural cell functions. For this purpose, nanopit surface arrays were fabricated on PLGA surfaces via replica molding method. The results showed that neural cell proliferation increased up to 65% and c‐fos protein expression increased up to 76% on PLGA surfaces having nanophase surface arrays compared to the control samples. It was observed that neural cells spread to a greater extend and formed more neurite extensions on the nanoarrayed surfaces compared to the control samples. These results were correlated with increased hydrophilicity and roughness of the nanophase PLGA surfaces, and point toward the promise of using nanoarrayed surfaces in NGC applications.
Graphene oxide incorporated amino‐functionalized iron terephthalate composite as a heterogeneous Fenton‐like catalyst
Authors: Liew Aaron Shun Yao , Nguang Sing Yew , Minggu Lorna Jeffrey , Tahir Norini , Moh Pak Yan
Published: July 2021

Amino‐functionalized iron terephthalate metal–organic framework (NH2‐MIL‐88B) has been studied for its adsorption and catalytic properties due to its high surface area and unique topological architecture. Functionality of the material can be improved through surface modification to increase active sites for the targeted applications. In this study, graphene oxide (GO) was incorporated to the NH2‐MIL‐88B material to obtain composite with improved adsorption and catalytic properties. The results showed that GO/NH2‐MIL‐88B in dark (as GO/NH2‐MIL‐88B/Dark system) was capable to adsorb 28.1% of methylene blue (MB) in water, which is about twice the adsorption of MB by the NH2‐MIL‐88B material in dark (as NH2‐MIL‐88B/Dark system). Furthermore, with the presence of hydrogen peroxide (H2O2), the GO/NH2‐MIL‐88B composite in dark condition (as GO/NH2‐MIL‐88B/H2O2/Dark) and the GO/NH2‐MIL‐88B composite under ultraviolet‐A (UV‐A) irradiation (as GO/NH2‐MIL‐88B/H2O2/UV‐A) have shown promising Fenton‐like behavior, which have removed 72.2% and 92.3% of MB in water, respectively. The removal of MB was well fitted to the Langmuir–Hinshelwood pseudo‐first order kinetics model with the reaction rate constant, k1 = 0.0221 min−1 and k1 = 0.0426 min−1 for GO/NH2‐MIL‐88B/H2O2/Dark and GO/NH2‐MIL‐88B/H2O2/UV‐A system, respectively. This study implies that the GO/NH2‐MIL‐88B composite can be a good catalyst for the heterogeneous Fenton‐like degradation of cationic pollutants in water.
B‐lines beyond the thoracic cavity ‐ ultrasound identification of intercostal pulmonary hernia
Authors: Gordon Richard , Karfunkle Benjamin , Smith Hannah , Larimore Katheryn , Turgiss Krystal , Najeemuddin Syed
Published: July 2021

Intercostal pulmonary hernia is a rare condition that may present to the emergency department spontaneously, following blunt trauma or as a complication of thoracic surgery. With the evolution of minimally invasive thoracic surgery pulmonary hernia may become more common. In this case of postoperative chest pain, incisional swelling, and shortness of breath, we present the ultrasound characteristics of a postoperative intercostal pulmonary hernia and its resemblance to subcutaneous emphysema.
Bilateral axillary pseudoangiomatous stromal hyperplasia in a premenopausal woman: A case report with imaging findings
Authors: Jung Hyun Kyung , Kim Woogyeong
Published: July 2021

Pseudoangiomatous stromal hyperplasia is a benign proliferative mesenchymal lesion of the breast. To date, only a few cases of axillary pseudoangiomatous stromal hyperplasia with imaging findings have been reported in the literature. Herein, we report a rare case of pseudoangiomatous stromal hyperplasia in both axillae in a previously healthy 46‐year‐old woman and describe the imaging findings, including ultrasonography and computed tomography findings.
Microplastics interaction with terrestrial plants and their impacts on agriculture
Authors: Ullah Raza , Tsui Martin Tsz‐Ki , Chen Huan , Chow Alex , Williams Clinton , Ligaba‐Osena Ayalew
Published: July 2021

Microplastics (MPs) are widespread in natural ecosystems and have attracted considerable attention from scientists all over the world because they are believed to threaten every life form. In addition to their potential physical and chemical effects on organisms, MPs may act as a carrier for many micropollutants, including antibiotics, heavy metals, and others. Over the last 10–15 yr, extensive research has been carried out on MPs in marine environments regarding their sources, fate, and toxicity. However, studies concerning their accumulation in the soil ecosystem, uptake, internalization, and impacts on photosynthetic components of the terrestrial ecosystem and risk assessments have been scanty. Thus, there is a large knowledge gap on the extent to which terrestrial environments, especially agroecosystems, are affected by MPs and their subsequent risks to human health. This review summarizes up‐to‐date findings about MPs on terrestrial environments and provides guidelines for future studies regarding the phytotoxic effects of MPs on plants; the mechanism of uptake and translocation in plant tissues; detection tools for MPs in plants; impacts on plant growth, plant development, and agricultural productivity; and, most important, the future prospects of MPs interaction and accumulation in plants.
Estimating dissolved phosphorus losses from legacy sources in pastures: The limits of soil tests and small‐scale rainfall simulators
Authors: Nash David M. , Weatherley A. J. , Kleinman Peter J. A. , Sharpley Andrew N.
Published: July 2021

A legacy of using P fertilizers on grazed pastures has been enhanced soil fertility and an associated increased risk of P loss in runoff. Rainfall simulation has been extensively used to develop relationships between soil test P (STP) and dissolved P (DP) in runoff as part of modeling efforts scrutinizing the impact of legacy P. This review examines the applicability of rainfall simulation to draw inferences related to legacy P. Using available literature, we propose a mixing layer model with chemical transfer to describe DP mobilization from pasture soils where readily available P in the mixing layer is rapidly exhausted and contact time controls DP concentrations responsible for subsequent DP mobilization. That conceptual model was shown to be consistent with field monitoring data and then used to assess the likely effect of rainfall simulation protocols on DP mobilization, highlighting the influence of soil preparation, scale and measurement duration, and, most important, hydrology that can facilitate the physical transport of P into and out of surface flow. We conclude that rainfall simulation experimental protocols can have severe limitations for developing relationships between DP in runoff and STP that are subsequently used to estimate legacy P contributions to downstream water resources.
Widespread cis‐ and trans‐regulatory evolution underlies the origin, diversification, and loss of a sexually dimorphic fruit fly pigmentation trait
Authors: Hughes Jesse T. , Williams Melissa E. , Rebeiz Mark , Williams Thomas M.
Published: July 2021

Changes in gene expression are a prominent feature of morphological evolution. These changes occur to hierarchical gene regulatory networks (GRNs) of transcription factor genes that regulate the expression of trait‐building differentiation genes. While changes in the expression of differentiation genes are essential to phenotypic evolution, they can be caused by mutations within cis‐regulatory elements (CREs) that drive their expression (cis‐evolution) or within genes for CRE‐interacting transcription factors (trans‐evolution). Locating these mutations remains a challenge, especially when experiments are limited to one species that possesses the ancestral or derived phenotype. We investigated CREs that control the expression of the differentiation genes tan and yellow, the expression of which evolved during the gain, modification, and loss of dimorphic pigmentation among Sophophora fruit flies. We show these CREs to be necessary components of a pigmentation GRN, as deletion from Drosophila melanogaster (derived dimorphic phenotype) resulted in lost expression and lost male‐specific pigmentation. We evaluated the ability of orthologous CRE sequences to drive reporter gene expression in species with modified (Drosophila auraria), secondarily lost (Drosophila ananassae), and ancestrally absent (Drosophila willistoni) pigmentation. We show that the transgene host frequently determines CRE activity, implicating trans‐evolution as a significant factor for this trait's diversity. We validated the gain of dimorphic Bab transcription factor expression as a trans‐change contributing to the dimorphic trait. Our findings suggest an amenability to change for the landscape of trans‐regulators and begs for an explanation as to why this is so common compared to the evolution of differentiation gene CREs.
Adaptive evolvability through direct selection instead of indirect, second‐order selection
Authors: Wagner Andreas
Published: July 2021

Can evolvability itself be the product of adaptive evolution? To answer this question is challenging, because any DNA mutation that alters only evolvability is subject to indirect, “second order” selection on the future effects of this mutation. Such indirect selection is weaker than “first‐order” selection on mutations that alter fitness, in the sense that it can operate only under restrictive conditions. Here I discuss a route to adaptive evolvability that overcomes this challenge. Specifically, a recent evolution experiment showed that some mutations can enhance both fitness and evolvability through a combination of direct and indirect selection. Unrelated evidence from gene duplication and the evolution of gene regulation suggests that mutations with such dual effects may not be rare. Through such mutations, evolvability may increase at least in part because it provides an adaptive advantage. These observations suggest a research program on the adaptive evolution of evolvability, which aims to identify such mutations and to disentangle their direct fitness effects from their indirect effects on evolvability. If evolvability is itself adaptive, Darwinian evolution may have created more than life's diversity. It may also have helped create the very conditions that made the success of Darwinian evolution possible.
Feasibility of IntestinalMRElastography in Inflammatory Bowel Disease
Authors: Reiter Rolf , Loch Florian N. , Kamphues Carsten , Bayerl Christian , Marticorena Garcia Stephan R. , Siegmund Britta , Kühl Anja A. , Hamm Bernd , Braun Jürgen , Sack Ingolf , Asbach Patrick
Published: July 2021

Background

While MR enterography allows detection of inflammatory bowel disease (IBD), the findings continue to be of limited use in guiding treatment—medication vs. surgery.

Purpose

To test the feasibility of MR elastography of the gut in healthy volunteers and IBD patients.

Study Type

Prospective pilot.

Population

Forty subjects (healthy volunteers:n = 20, 37 ± 14 years, 10 women; IBD patients:n = 20 (ulcerative colitisn = 9, Crohn's diseasen = 11), 41 ± 15 years, 11 women).

Field Strength/Sequence

Multifrequency MR elastography using a single‐shot spin‐echo echo planar imaging sequence at 1.5 T with drive frequencies of 40, 50, 60, and 70 Hz.

Assessment

Maps of shear‐wave speed (SWS, in m/s) and loss angle (φ, in rad), representing stiffness and solid–fluid behavior, respectively, were generated using tomoelastography data processing. Histopathological analysis of surgical specimens was used as reference standard in patients.

Statistical Tests

Unpaired t‐test, one‐way analysis of variance followed by Tukey post hoc analysis, Pearson's correlation coefficient and area under the receiver operating characteristic curve (AUC) with 95%‐confidence interval (CI). Significance level of 5%.

Results

MR elastography was feasible in all 40 subjects (100% technical success rate). SWS andφwere significantly increased in IBD by 21% and 20% (IBD: 1.45 ± 0.14 m/s and 0.78 ± 0.12 rad; healthy volunteers: 1.20 ± 0.14 m/s and 0.65 ± 0.06 rad), whereas no significant differences were found between ulcerative colitis and Crohn's disease (P = 0.74 and 0.90, respectively). In a preliminary assessment, a high diagnostic accuracy in detecting IBD was suggested by an AUC of 0.90 (CI: 0.81–0.96) for SWS and 0.84 (CI: 0.71–0.95) forφ.

Data Conclusion

In this pilot study, our results demonstrated the feasibility of MR elastography of the gut and showed an excellent diagnostic performance in predicting IBD.

Evidence Level

1

Technical Efficacy

Stage 1
Changes in anticoagulant prescription patterns over time for patients with atrial fibrillation around the world
Authors: Kozieł Monika , Teutsch Christine , Bayer Valentina , Lu Shihai , Gurusamy Venkatesh K. , Halperin Jonathan L. , Rothman Kenneth J. , Diener Hans‐Christoph , Ma Chang‐Sheng , Huisman Menno V. , Lip Gregory Y. H. ,   the GLORIA‐AF Investigators
Published: July 2021

Background

Prescribing patterns for stroke prevention in atrial fibrillation (AF) patients evolved with approval of non‐Vitamin K antagonist oral anticoagulants (NOACs) over time.

Objectives

To assess changes in anticoagulant prescription patterns in various geographical regions upon first approval of a NOAC and to analyze the evolution of oral anticoagulants (OACs) use over time in relation to CHA2DS2‐VASc and HAS‐BLED risk profiles.

Methods

Global Registry on Long‐Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation (GLORIA‐AF) Phases II and III reported data on antithrombotic therapy for patients with newly diagnosed AF and ≥1 stroke risk factor. We focused on sites enrolling patients in both phases and reported treatment patterns for the first 4 years after initial NOAC approval.

Results

From GLORIA‐AF Phases II and III, 27 432 patients were eligible for this analysis. When contrasting the first year with the fourth year of enrolment, the proportion of NOAC prescriptions increased in Asia from 29.2% to 60.8%, in Europe from 53.4% to 75.8%, in North America from 49.0% to 73.9% and in Latin America from 55.7% to 71.1%. The proportion of Vitamin K antagonists (VKAs) use decreased across all regions over time, in Asia from 26.0% to 9.8%, in Europe from 35.5% to 16.8%, in North America from 28.9% to 12.1%, and in Latin America from 32.4% to 17.8%. In the multivariable analysis, factors associated with NOAC prescription were as follows: enrolment year, type of site, region, stroke and bleeding risk scores, and type and categorization of AF.

Conclusions

During 4 years after the approval of the first NOAC, NOAC use increased, while VKA use decreased, across all regions.
Performance assessment using sensor technology
Authors: Mohamadipanah Hossein , Wise Brett , Witt Anna , Goll Cassidi , Yang Su , Perumalla Calvin , Huemer Kayla , Kearse LaDonna , Pugh Carla
Published: July 2021

Over the past 30 years, there have been numerous, noteworthy successes in the development, validation, and implementation of clinical skills assessments. Despite this progress, the medical profession has barely scratched the surface towards developing assessments that capture the true complexity of hands‐on skills in procedural medicine. This paper highlights the development implementation and new discoveries in performance metrics when using sensor technology to assess cognitive and technical aspects of hands‐on skills.
Dedifferentiation within well‐differentiated liposarcoma of the extremity or trunk: Implications for clinical management
Authors: Tseng William W. , Barretta Francesco , Baia Marco , Barisella Marta , Radaelli Stefano , Callegaro Dario , Yoon Dong Hum , Fiore Marco , Gronchi Alessandro
Published: July 2021

Background

In extremity or trunk liposarcoma, the implications of a dedifferentiated (DD) component within a well‐differentiated (WD) tumor are unclear. We evaluated outcomes after surgery and identified potential predictors of survival in these patients compared to those with an entirely WD tumor.

Methods

Retrospective data were collected for patients who underwent complete resection from 2009 to 2019. Cumulative incidences of local recurrence (LR) and distant metastasis (DM) were calculated, and overall survival (OS) was estimated. Associations between OS and clinicopathologic variables were evaluated by univariable models.

Results

A total of 210 patients with MDM2‐verified tumors were studied, including 58 (27.6%) with DD. In primary disease, LR occurred only in DD and worse OS was observed versus WD (p < 0.001). In recurrent disease, the LR incidences were similar between WD and DD (p = 0.559); however, worse OS persisted in DD (p = 0.004). The incidence of DM was extremely low (3.8%) and limited to DD. Higher grade (p < 0.001) and DD size (p = 0.043), but not overall tumor size were associated with worse OS.

Conclusions

In extremity or trunk liposarcoma, the presence of DD leads to significantly worse outcomes in both primary and recurrence diseases. Further study is needed to determine if these patients benefit from adjunct therapies (e.g., radiation).
Mass spectrometry imaging for direct visualization of components in plants tissues
Authors: Hu Wenya , Han Yehua , Sheng Yiqi , Wang Yinghao , Pan Qiong , Nie Honggang
Published: July 2021

Mass spectrometry is considered the most informative technique for components identification and has been widely adopted in plant sciences. However, the spatial distribution of compounds in the plant, which is vital for the exploration of plant physiological mechanisms, is missed in MS analysis. In recent years, mass spectrometry imaging has brought a great breakthrough in plant analysis because it can determine both the molecular compositions and spatial distributions, which is conducive to understand functions and regulation pathways of specific components in plants. Mass spectrometry imaging analysis of plant tissue is toward high sensitivity, high spatial resolution, and even single‐cell analysis. Despite many challenges and technical barriers, such as difficulties of sample pretreatment caused by morphological diversity of plant tissues, obstacles for high spatial resolution imaging, and so on, lots of researches have contributed to remarkable progress, including improvement in tissue preparation, matrix innovation, and ionization mode development. This review focuses on the advances of mass spectrometry imaging analysis of plants in the last 5 years, including commonly used ionization techniques, technical advances, and recent applications of mass spectrometry imaging in plants.
Online preconcentration of lysozyme in hen egg white using responsive polymer coating in CE
Authors: Wang Yuchen , Li Mengqin , Hu Fei , Wang Yanmei
Published: July 2021

A mixed polymer brushes material based on poly (2‐methyl‐2‐oxazoline)‐ and poly (acrylic acid)‐coated capillary with switchable protein adsorption/desorption properties was applied for online preconcentration of lysozyme in hen egg white during capillary electrophoresis performance. First, lysozyme in simulated egg white was successfully online preconcentrated and the detection signal of lysozyme was amplified. Ovalbumin, ovomucoid, and conalbumin in egg white were verified show negligible interference on the online preconcentration of lysozyme according to the study on electroosmotic flow mobility. Second, a series validation procedure was carried out to evaluate the proposed method performance. There was a good linearity behavior range from 0.1 to 5.0 ng/mL, limit of detection was 20 pg/mL, and limit of quantity was 50 pg/mL, the accuracy and robustness of this method were also excellent. Last, the proposed method has been successfully used to detect and analyze lysozyme in hen egg white, the determined amounts of lysozyme in hen egg white were consistent with reported normal levels and recoveries were in the range of 96.0‐99.2%. After 75 consecutive runs, this prepared capillary was still stable for online preconcentration and determination of lysozyme in hen egg white without being affected by complex matrix.
Chronic Rhinosinusitis Disease Disparity in the South Florida Hispanic Population
Authors: Levine Corinna G. , Casiano Roy R. , Lee David J. , Mantero Alejandro , Liu Xue Zhong , Palacio Ana M.
Published: July 2021

Objectives/Hypothesis

The role of social determinants of health in chronic rhinosinusitis (CRS) is poorly characterized. Limited research examining CRS health disparities indicates that minority status is associated with worse CRS. However, many of these studies are retrospective or performed in populations without substantial ethnic minorities. Rhinologists need to characterize existing CRS disease disparities to develop targeted strategies for improving care in these populations. This prospective study assesses preoperative CRS disease burden in South Florida (SFL) Hispanic and non‐Hispanic patients and examines potential factors contributing CRS disease disparities.

Study Design

Prospective cohort study.

Methods

The prospective cohort study included consecutive patients having primary endoscopic sinus surgery (ESS) for CRS between September 2019 and February 2020 with complete preoperative data. Data were collected in clinic and surgery. Descriptive statistics compare Hispanic and non‐Hispanic cohorts. Linear regression adjusts for confounders. Relative risk (RR) compared CRS severity markers.

Results

Thirty‐eight Hispanic and 56 non‐Hispanic patients met inclusion criteria. Age, sex, CT scores, insurance payer, and comorbidities were similar between cohorts. Hispanics presented with worse 22‐item Sinonasal Outcome Test (SNOT‐22) (55; SD = 18) compared to non‐Hispanics (37; SD = 22) (P < .001). Hispanics tended to have a higher risk of severe CRS markers, including nasal polyps RR = 2.5 (95% CI: 1.0–5.9), neo‐osteogenesis RR = 1.6 (95% CI: 0.5–4.7), extended procedures (i.e., draft III) RR = 2.97 (95% CI: 1.0–9.1), and tissue eosinophilia RR = 1.46 (95% CI: 0.6–3.5). Hispanics reported longer sinonasal symptom duration.

Conclusions

SFL hispanic patients presenting for primary ESS have worse sinonasal disease burden. SFL Hispanics have markers of greater CRS severity and report longer delays before receiving CRS care. These factors may contribute to increased sinonasal disease burden in Hispanic patients.

Level of Evidence

3Laryngoscope, 131:2659–2665, 2021
Postoperative Radiation Therapy Refusal in Human Papillomavirus‐Associated Oropharyngeal Squamous Cell Carcinoma
Authors: Prasad Aman , Carey Ryan M. , Brody Robert M. , Bur Andrés M. , Cannady Steven B. , Ojerholm Eric , Newman Jason G. , Ibrahim Said , Brant Jason A. , Rajasekaran Karthik
Published: July 2021

Objectives/Hypothesis

Human papillomavirus (HPV)‐associated oropharyngeal squamous cell carcinoma (OPSCC) is a distinct clinical entity with good prognosis, unique demographics, and a trend toward treatment deintensification. Patients with this disease may opt out of recommended postoperative radiation therapy (PORT) for a variety of reasons. The aim of this paper was to examine factors that predict patient refusal of recommended PORT in HPV‐associated OPSCC, and the association of refusal with overall survival.

Study Design

Retrospective population‐based cohort study of patients in the National Cancer Database.

Methods

We conducted a retrospective cohort study of patients in the National Cancer Database diagnosed with OPSCC between January 2010 and December 2015. We primarily assessed overall survival and the odds of refusing PORT based on demographic, socioeconomic, and clinical factors. Analysis was conducted using multivariable logistic regression and multivariable Cox proportional hazards model.

Results

A total of 4229 patients were included in the final analysis, with 156 (3.7%) patients opting out of recommended PORT. On multivariable analysis, patient refusal of PORT was independently associated with a variety of socioeconomic factors such as race, insurance status, comorbidity, treatment at a single facility, and margin status. Lastly, PORT refusal was associated with significantly lower overall survival compared to receipt of recommended PORT (hazard ratio 1.69, confidence interval 1.02–2.82).

Conclusions

Patient refusal of recommended PORT in HPV‐associated OPSCC is rare and associated with variety of disease and socioeconomic factors. PORT refusal may decrease overall survival in this population. Our findings may help clinicians when counseling patients and identifying those who may be more likely to opt out of recommended adjuvant therapy.

Level of Evidence

3 Laryngoscope, 132:339–348, 2022
Turnover in a small Canadian shield lake
Authors: Ghane Alireza , Boegman Leon
Published: July 2021

In dimictic lakes, the stable density stratification during summer and winter inhibits vertical mixing of nutrients and oxygen. This favors the development of hypolimnetic hypoxia, which degrades cool‐water fish habitat and enhances nutrient mineralization from the sediments. Fall and spring turnover events, therefore, provide a crucial biannual link between surface and bottom waters. However, the physical processes occurring to mix lakes during turnover events remain comparatively uninvestigated. In this study, long‐term field observations were supplemented with output from a three‐dimensional numerical model, to better understand turnover events within a small temperate lake during 2011–2017. Mid‐basin penetrative convection, sidearm convection, and wind‐induced mixing were identified, with mid‐basin convection likely contributing the most to turnover events; a typical side‐arm convective plume had 2% (spring) to 4% (fall) of the mass flux compared to those at mid‐basin. During fall turnover, wind shear only mixed the upper 35% of the surface mixed layer, with convection acting to deepen below. During spring turnover, ice‐cover sheltered the lake from wind, causing convection to be the only process occurring and lengthening the turnover duration (~ 51 d) compared to fall (~ 13 d).
Compact, High‐resolution Inverse‐Designed On‐Chip Spectrometer Based on Tailored Disorder Modes
Authors: Hadibrata Wisnu , Noh Heeso , Wei Heming , Krishnaswamy Sridhar , Aydin Koray
Published: July 2021

Integrated optical sensors have garnered much interest for lab‐on‐chip applications such as chemical and biological sensing and detection. Among various ways for detection schemes, spectral analysis performed by a spectrometer has shown great promise. Typically, such spectrometry is carried out in a relatively large device, owing to the fact that spectral resolution is often dictated by large optical path length. Here, a high‐resolution compact spectrometer utilizing random scattering events in a disordered medium is demonstrated. The spectrometer is inverse designed by objective‐first method and fabricated using two‐photon polymerization technique. The compact spectrometer consists of a disordered photonic structure and an inversed‐designed mode decomposer. A spectral resolution of 0.25 nm with a bandwidth of 30 nm in the near‐infrared regime is realized from a spectrometer occupying a relatively small footprint of 30 × 12.8 µm2. The proposed platform has a great potential to be used as a versatile lightweight and compact spectrometer for various applications including on‐chip spectrometer and sensing.
New Jersey study examines consumer telehealth experience
Authors: Canady Valerie A.
Published: July 2021

While the majority of consumers of mental health services in New Jersey who participated in a survey and weighed in on the use of telehealth services during the pandemic had favorable responses to those services, less than half indicated a preference for virtual telehealth services. The survey was conducted by the Mental Health Association in New Jersey Inc. (MHANJ).
Design of super compact ultrathin perfect wide‐angle polarization independent metamaterial absorber for C, X, and Ku band applications
Authors: Puri Vishal , Singh Hari Shankar
Published: July 2021

This article focuses on the design of super compact, polarization insensitive with wide angular stability, ultrathin triple‐band metamaterial absorber. The unit cell comprising patches achieves almost perfect absorption (close to 100%) at C, X, and Ku band thereby justifying the term perfect metamaterial absorber. The structure provides 99.96%, 99.98%, and 99.62% absorptivity at the 4.75 GHz (C‐band), 9.47 GHz (X‐band), and 14.40 GHz (Ku‐band), respectively. The dimension of the structure is super compact of the order of 7.2 × 7.2 × 0.8 mm3 along with the ultrathin profile. The unit cell thickness is 0.012 λlowest (where λlowest is at a lowest cut‐off frequency). The proposed absorber comprises an outermost ring, split ring, innermost ring and square line with triangle patches at the boundary. The combinational effect of rings and internal patch provides perfect absorption at designated frequencies. Further, equivalent circuit is explained for the proposed design. The absorptivity remains insensitive towards transverse electric and transverse magnetic polarized wave and exhibits matched absorption. Moreover, the stability of the proposed design is validated with the different incident (for TE and TM modes) and polarization angles. The results are found close to perfect absorption. Finally, the simulated results are validated with measured results and found in close agreement.
Prescription stimulant brand name recognition among a national sample of 10‐ to 18‐year‐old youth
Authors: Cottler Linda B. , Lasopa Sonam O. , Striley Catherine W. , Cicero Theodore J. , Fitzgerald Nicole D. , Ben Abdallah Arbi
Published: July 2021

Objective

The majority of prescription drugs, including prescription stimulants, are marketed using multiple brand names, doses, and formulations. There is limited research on the extent to which individuals correctly identify medication by brand name or packaging, but such identification is important for epidemiological studies especially among youth. Testing the ability of youth to identify medications was one aim of the National Monitoring of Prescription Stimulants Study, which focused on the prevalence of prescription stimulant use among youth.

Methods

Using the entertainment venue intercept method, youth 10 to 18 years of age (n = 11,048) were recruited across 10 metropolitan areas throughout the United States, shown pictures of eight formulations of prescription stimulants, and asked to identify them by name, dosage, and formulation.

Results

Overall, 27% of youth reported having seen one of the eight stimulant formulations and between 2% and 70% correctly identified name, dose, and formulation. Youths' reports of having seen and correctly identifying medication increased with age except for Daytrana®. Specifically, while 2.8% of youth reported using Adderall® in the past 30 days, only 71.4% correctly identified it.

Conclusions

These results provide strong evidence of the need for more stringent methods for youth to report drug use.
Mapping of the World Health Organization's Disability Assessment Schedule 2.0 to disability weights using the Multi‐Country Survey Study on Health and Responsiveness
Authors: Lokkerbol Joran , Wijnen Ben F. M. , Chatterji Somnath , Kessler Ronald C. , Chisholm Dan
Published: July 2021

Objectives

To develop and test an internationally applicable mapping function for converting WHODAS‐2.0 scores to disability weights, thereby enabling WHODAS‐2.0 to be used in cost‐utility analyses and sectoral decision‐making.

Methods

Data from 14 countries were used from the WHO Multi‐Country Survey Study on Health and Responsiveness, administered among nationally representative samples of respondents aged 18+ years who were non‐institutionalized and living in private households. For the combined total of 92,006 respondents, available WHODAS‐2.0 items (for both 36‐item and 12‐item versions) were mapped onto disability weight estimates using a machine learning approach, whereby data were split into separate training and test sets; cross‐validation was used to compare the performance of different regression and penalized regression models. Sensitivity analyses considered different imputation strategies and compared overall model performance with that of country‐specific models.

Results

Mapping functions converted WHODAS‐2.0 scores into disability weights; R‐squared values of 0.700–0.754 were obtained for the test data set. Penalized regression models reached comparable performance to standard regression models but with fewer predictors. Imputation had little impact on model performance. Model performance of the generic model on country‐specific test sets was comparable to model performance of country‐specific models.

Conclusions

Disability weights can be generated with good accuracy using WHODAS 2.0 scores, including in national settings where health state valuations are not directly available, which signifies the utility of WHODAS as an outcome measure in evaluative studies that express intervention benefits in terms of QALYs gained.
Preconditioned water‐fat total field inversion: Application to spine quantitative susceptibility mapping
Authors: Boehm Christof , Sollmann Nico , Meineke Jakob , Ruschke Stefan , Dieckmeyer Michael , Weiss Kilian , Zimmer Claus , Makowski Marcus R. , Baum Thomas , Karampinos Dimitrios C.
Published: July 2021

Purpose

To (a) develop a preconditioned water‐fat total field inversion (wfTFI) algorithm that directly estimates the susceptibility map from complex multi‐echo gradient echo data for water‐fat regions and to (b) evaluate the performance of the proposed wfTFI quantitative susceptibility mapping (QSM) method in comparison with a local field inversion (LFI) method and a linear total field inversion (TFI) method in the spine.

Methods

Numerical simulations and in vivo spine multi‐echo gradient echo measurements were performed to compare wfTFI to an algorithm based on disjoint background field removal (BFR) and LFI and to a formerly proposed TFI algorithm. The data from 1 healthy volunteer and 10 patients with metastatic bone disease were included in the analysis. Clinical routine computed tomography (CT) images were used as a reference standard to distinguish osteoblastic from osteolytic changes. The ability of the QSM methods to distinguish osteoblastic from osteolytic changes was evaluated.

Results

The proposed wfTFI method was able to decrease the normalized root mean square error compared to the LFI and TFI methods in the simulation. The in vivo wfTFI susceptibility maps showed reduced BFR artifacts, noise amplification, and streaking artifacts compared to the LFI and TFI maps. wfTFI provided a significantly higher diagnostic confidence in differentiating osteolytic and osteoblastic lesions in the spine compared to the LFI method (p = .012).

Conclusion

The proposed wfTFI method can minimize BFR artifacts, noise amplification, and streaking artifacts in water‐fat regions and can thus better differentiate between osteoblastic and osteolytic changes in patients with metastatic disease compared to LFI and the original TFI method.