bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of MRE11 and Mortality Among Adults With Muscle-Invasive Bladder Cancer Managed With Trimodality Therapy
Authors: Magliocco Anthony M. , Moughan Jennifer , Miyamoto David T. , Simko Jeff , Shipley William U. , Gray Phillip J. , Hagan Michael P. , Parliament Matthew , Tester William J. , Zietman Anthony L. , McCarthy Susan , Saeed-Vafa Daryoush , Xiong Yin , Ayral Taylor , Hartford Alan C. , Patel Ashish , Rosenthal Seth A. , Chafe Susan , Greenberg Richard , Schwartz Michael A. , Augspurger Mark E. , Keech John A. , Winter Kathryn A. , Feng Felix Y. , Efstathiou Jason A.
Published: November 2022

Importance

Bladder-preserving trimodality therapy can be an effective alternative to radical cystectomy for treatment of muscle-invasive bladder cancer (MIBC), but biomarkers are needed to guide optimal patient selection. The DNA repair protein MRE11 is a candidate response biomarker that has not been validated in prospective cohorts using standardized measurement approaches.

Objective

To evaluate MRE11 expression as a prognostic biomarker in MIBC patients receiving trimodality therapy using automated quantitative image analysis.

Design, Setting, and Participants

This prognostic study analyzed patients with MIBC pooled from 6 prospective phase I/II, II, or III trials of trimodality therapy (Radiation Therapy Oncology Group [RTOG] 8802, 8903, 9506, 9706, 9906, and 0233) across 37 participating institutions in North America from 1988 to 2007. Eligible patients had nonmetastatic MIBC and were enrolled in 1 of the 6 trimodality therapy clinical trials. Analyses were completed August 2020.

Exposures

Trimodality therapy with transurethral bladder tumor resection and cisplatin-based chemoradiation therapy.

Main Outcomes and Measures

MRE11 expression and association with disease-specific (bladder cancer) mortality (DSM), defined as death from bladder cancer. Pretreatment tumor tissues were processed for immunofluorescence with anti-MRE11 antibody and analyzed using automated quantitative image analysis to calculate a normalized score for MRE11 based on nuclear-to-cytoplasmic (NC) signal ratio.

Results

Of 465 patients from 6 trials, 168 patients had available tissue, of which 135 were analyzable for MRE11 expression (median age of 65 years [minimum-maximum, 34-90 years]; 111 [82.2%] men). Median (minimum-maximum) follow-up for alive patients was 5.0 (0.6-11.7) years. Median (Q1-Q3) MRE11 NC signal ratio was 2.41 (1.49-3.34). Patients with an MRE11 NC ratio above 1.49 (ie, above first quartile) had a significantly lower DSM (HR, 0.50; 95% CI, 0.26-0.93;P = .03). The 4-year DSM was 41.0% (95% CI, 23.2%-58.0%) for patients with an MRE11 NC signal ratio of 1.49 or lower vs 21.0% (95% CI, 13.4%-29.8%) for a ratio above 1.49. MRE11 NC signal ratio was not significantly associated with overall survival (HR, 0.84; 95% CI, 0.49-1.44).

Conclusions and Relevance

Higher MRE11 NC signal ratios were associated with better DSM after trimodality therapy. Lower MRE11 NC signal ratios identified a poor prognosis subgroup that may benefit from intensification of therapy.
KRAS inhibitors: going noncovalent
Authors: Drosten Matthias , Barbacid Mariano
Published: November 2022

KRASG12D is the most frequent KRAS mutation in human cancer with particularly high frequencies in pancreatic and colorectal cancer. Informed by the structure of the KRASG12C inhibitor adagrasib, Hallin et al. have now, through multiple rounds of structure‐based drug design, identified and validated a potent, selective, and noncovalent KRASG12D inhibitor, MRTX1133. This study demonstrated that MRTX1133 inhibited both the inactive and active state of KRASG12D and showed potent antitumor activity in several preclinical models of pancreatic and colorectal cancer, especially when combined with cetuximab, a monoclonal antibody against the EGFR, or BYL‐719, a potent PI3Kα inhibitor.
Tensile Response Characterization and Constitutive Modeling of LPBF Ti6Al4V Thin Struts
Authors: Hosseini Ehsan , Robmann Serjosha , Lüthi Thomas , Affolter Christian , Mazza Edoardo
Published: November 2022

Additive manufacturing enables the fabrication of orthopedic implants with lattice materials whose topology is tailored to mimic the mechanical response of native bone. Detailed analysis of such lattice structures for optimizing their mechanical biocompatibility requires an understanding of the mechanical response of their constituent components, that is, “struts”. The present study conducts a series of miniature‐specimen mechanical experiments to analyze the apparent stress–strain response of additive manufacturing Ti6Al4V struts. The “true” geometries of the struts are then derived based on observations from microcomputed tomography to discuss the size and orientation dependence of the “geometrical mismatch” as well as the “true” stress–strain response of the struts. It is however argued that considering the “true” mechanical response of struts in the design and topology optimization of lattice‐based implants is not practically feasible, since it requires information regarding the “true” geometry of each strut within the implant that is not accessible at the design stage. As an alternative, consideration of a representative “apparent” constitutive model in finite‐element simulations representing the “nominal” geometry of the lattices provides acceptable approximations of their experimentally observed mechanical response and, therefore might be employed for design analysis and topology optimization of lattice‐based implants.
Synergistic Engineering of Doping and Vacancy in Ni(OH)2 to Boost Urea Electrooxidation
Authors: Qin Hongye , Ye Yukun , Li Jinhong , Jia Wenqi , Zheng Siyu , Cao Xuejie , Lin Guangliang , Jiao Lifang
Published: November 2022

Nickel hydroxide (Ni(OH)2) has been identified as one of the best promising electrocatalyst candidates for urea oxidation reaction (UOR) due to its flexible structures, wide compositions, and abundant 3d electrons under alkaline conditions. However, its layered structure with limited exposed edge sites severely hinders further improvement of the UOR activity. Herein, oxygen‐vacancy rich and vanadium doped Ni(OH)2 (Ovac‐V‐Ni(OH)2) catalysts are prepared and synergistically boost the urea electrooxidation. Vanadium doping contributes more exposed active sites, and simultaneously generates oxygen vacancies, switching the rate‐determining step of UOR from *COOH deprotonation to the N–H bond cleavage process and lowering the thermodynamic barrier by around 1.13 eV. The novel Ovac‐V‐Ni(OH)2 demonstrates good electrocatalytic performances with a working potential of 1.47 V at a high current density of 100 mA cm−2. Synergistic engineering of doping and oxygen vacancy is a promising strategy for designing efficient UOR electrocatalysts.
High Entropy Approach to Engineer Strongly Correlated Functionalities in Manganites
Authors: Sarkar Abhishek , Wang Di , Kante Mohana V. , Eiselt Luis , Trouillet Vanessa , Iankevich Gleb , Zhao Zhibo , Bhattacharya Subramshu S. , Hahn Horst , Kruk Robert
Published: November 2022

Technologically relevant strongly correlated phenomena such as colossal magnetoresistance (CMR) and metal‐insulator transitions (MIT) exhibited by perovskite manganites are driven and enhanced by the coexistence of multiple competing magneto‐electronic phases. Such magneto‐electronic inhomogeneity is governed by the intrinsic lattice‐charge‐spin‐orbital correlations, which, in turn, are conventionally tailored in manganites via chemical substitution, charge doping, or strain engineering. Alternately, the recently discovered high entropy oxides (HEOs), owing to the presence of multiple‐principal cations on a given sub‐lattice, exhibit indications of an inherent magneto‐electronic phase separation encapsulated in a single crystallographic phase. Here, the high entropy (HE) concept is combined with standard property control by hole doping in a series of single‐phase orthorhombic HE‐manganites (HE‐Mn), (Gd0.25La0.25Nd0.25Sm0.25)1‐xSrxMnO3 (x = 0–0.5). High‐resolution transmission microscopy reveals hitherto‐unknown lattice imperfections in HEOs: twins, stacking faults, and missing planes. Magnetometry and electrical measurements infer three distinct ground states—insulating antiferromagnetic, unpercolated metallic ferromagnetic, and long‐range metallic ferromagnetic—coexisting or/and competing as a result of hole doping and multi‐cation complexity. Consequently, CMR ≈1550% stemming from an MIT is observed in polycrystalline pellets, matching the best‐known values for bulk conventional manganites. Hence, this initial case study highlights the potential for a synergetic development of strongly correlated oxides offered by the high entropy design approach.
New Method for Preparing ZnO Layer for Efficient and Stable Organic Solar Cells
Authors: Wang Yafei , Zheng Zhong , Wang Jianqiu , Liu Xiaoyu , Ren Junzhen , An Cunbin , Zhang Shaoqing , Hou Jianhui
Published: November 2022

Owing to outstanding optoelectronic properties and simple preparation, zinc oxide (ZnO) has widely been used in organic solar cells (OSCs). Although versatile cathode interface materials have been designed in past, ZnO remains indispensable owing to its excellent overall performance. Therefore, solving the persistent problem of residual amine reacting with non‐fullerene acceptors will make ZnO superior over other materials, and thus improve the performance and energy budget of OSCs. Herein, a simple, effective, and economical method for removing residual amine in ZnO without distorting ZnO is reported. By accurately comparing the alkalinities of ZnO and residual amine, boric acid (BA) is selected as the amine‐removing agent because of its suitable acidic dissociation constant. Moreover, the high water solubility of BA ensures that the post‐cleaning process can be easily performed. The work function, electron extraction, and stability of cathode interface layer are optimized through rinsing them with BA. Consequently, the power conversion efficiency (PCE) and stability of OSCs under long‐term illumination are significantly improved. The optimal 0.04 and 1.00 cm2 single‐junction OSCs are based on PBDB‐TF:HDO‐4Cl:BTP‐eC9 bulk heterojunction output 18.40% and 17.42% efficiencies, respectively. Furthermore, tandem OSCs based on the BA‐treated ZnO exhibit a 19.56% PCE, demonstrating the reliability of this method.
Curved Nanofiber Network Induces Cellular Bridge Formation to Promote Stem Cell Mechanotransduction
Authors: Sun Qian , Pei Fang , Zhang Man , Zhang Bo , Jin Ying , Zhao Zhihe , Wei Qiang
Published: November 2022

Remarkable exertions are directed to reveal and understand topographic cues that induce cell mechanical sensitive responses including lineage determination. Extracellular matrix (ECM) is the sophisticated ensemble of diverse factors offering the complicated cellular microenvironment to regulate cell behaviors. However, the functions of only a few of these factors are revealed; most of them are still poorly understood. Herein, the focus is on understanding the curved structure in ECM network for regulating stem cell mechanotransduction. A curved nanofiber network mimicking the curved structure in ECM is fabricated by an improved electrospinning technology. Compared with the straight fibers, the curved fibers promote cell bridge formation because of the cytoskeleton tension. The actomyosin filaments are condensed near the curved edge of the non‐adhesive bridge in the bridging cells, which generates higher myosin‐II‐based intracellular force. This force drives cell lineage commitment toward osteogenic differentiation. This study enriches and perfects the knowledge of the effects of topographic cues on cell behaviors and guides the development of novel biomaterials.
Precursor Chemistry Enables the Surface Ligand Control of PbS Quantum Dots for Efficient Photovoltaics
Authors: Wang Chao , Wang Yinglin , Jia Yuwen , Wang Hai , Li Xiaofei , Liu Shuai , Liu Xinlu , Zhu Hongbo , Wang Haiyu , Liu Yichun , Zhang Xintong
Published: November 2022

The surface ligand environment plays a dominant role in determining the physicochemical, optical, and electronic properties of colloidal quantum dots (CQDs). Specifically, the ligand‐related electronic traps are the main reason for the carrier nonradiative recombination and the energetic losses in colloidal quantum dot solar cells (CQDSCs), which are usually solved with numerous advanced ligand exchange reactions. However, the synthesis process, as the essential initial step to control the surface ligand environment of CQDs, has lagged behind these post‐synthesis ligand exchange reactions. The current PbS CQDs synthesis tactic generally uses lead oxide (PbO) as lead precursor, and thus suffers from the water byproducts issue increasing the surface‐hydroxyl ligands and aggravating trap‐induced recombination in the PbS CQDSCs. Herein, an organic‐Pb precursor, lead (II) acetylacetonate (Pb(acac)2), is used instead of a PbO precursor to avoid the adverse impact of water byproducts. Consequently, the Pb(acac)2 precursor successfully optimizes the surface ligands of PbS CQDs by reducing the hydroxyl ligands and increasing the iodine ligands with trap‐passivation ability. Finally, the Pb(acac)2‐based CQDSCs possess remarkably reduced trap states and suppressed nonradiative recombination, generating a certified record Voc of 0.652 V and a champion power conversion efficiency (PCE) of 11.48% with long‐term stability in planar heterojunction‐structure CQDSCs.
Farmer field school participation and exit decisions in hog production: A case study from Beijing
Authors: Cai Jinyang , Hong Yu , Zhou Meifang , Hu Ruifa , Ding Fengxiang
Published: November 2022

The worsening volatility in the domestic and global hog and pork markets is a cause of concern for China's producers and government, as well as the global market. Cyclical price fluctuations have been caused by domestic small‐ and medium‐scale farmers' frequent exits and re‐entries into the hog market, which may have been partly driven by information asymmetry and risk resistance. This study examines the impact of a farmer field school (FFS) program aiming to deliver information and services that may facilitate hog farmers' decision‐making. Using survey data collected from 226 hog farms in Beijing, we employ probit models to examine the exit decisions of hog farmers based on their FFS participation and its effect on hog farm size. We find evidence that FFS participation significantly reduces hog farmers' exit rates, and that this effect increases as farm scale decreases. The findings suggest that such a program may be an effective policy tool to support and improve the resilience of small‐ and medium‐scale hog farms, thereby alleviating the volatility in China's hog industry and those of other developing countries where small‐ and medium‐scale hog farms play an important role. [EconLit Citations: C21, D13, Q16, Q18].
Exploring links between pathogen avoidance motivation, COVID‐19 case counts, and immune function
Authors: Muehlenbein Michael P. , Gassen Jeffrey , Nowak Tomasz J. , Henderson Alexandria D. , Thum Edward , Weaver Sally P. , Baker Erich J.
Published: November 2022

Objectives

The selection pressures exerted by pathogens have played important roles in shaping the biology and behavior of animals, including humans. Immune systems recognize and respond to cues of infection or damage by coordinating cellular, humoral, and metabolic shifts that promote recovery. Moreover, animals also possess a repertoire of behavioral tools to help combat the threat of pathogens, often referred to as the behavioral immune system. Recently, researchers have begun to examine how cognitive, affective, and behavioral disease avoidance mechanisms interact with the biological immune system.

Methods

The present study explored relationships among individual differences in behavioral immune system activity (e.g., pathogen disgust), shifts in SARS‐CoV‐2 infection risk (i.e., 7‐day case averages), and immune function in a community cohort from McLennan County, Texas, USA (n = 387).

Results

Levels of disease concern were not consistently associated with immune markers. However, serum levels of IFN‐γ, TNF‐α, IL‐2, and IL‐8, as well as serum killing ability of Escherichia coli, each varied with case counts. Additional analyses found that case counts also predicted changes in stress physiology, but not subjective measures of distress. However, follow‐up mediation models did not provide evidence that relationships between case counts and immunological outcomes were mediated through levels of stress.

Conclusions

The present project provides initial evidence that markers of immune function may be sensitive to changes in infection risk during the COVID‐19 pandemic. This adds to the growing body of research finding relationships among behavioral and biological pathogen management mechanisms.
Multivariate analyses of molecular genetic associations between childhood psychopathology and adult mood disorders and related traits
Authors: Akingbuwa Wonuola A. , Hammerschlag Anke R. , Allegrini Andrea G. , Sallis Hannah , Kuja‐Halkola Ralf , Rimfeld Kaili , Lichtenstein Paul , Lundstrom Sebastian , Munafò Marcus R. , Plomin Robert , Nivard Michel G. , Bartels Meike , Middeldorp Christel M.
Published: November 2022

Ubiquitous associations have been detected between different types of childhood psychopathology and polygenic risk scores based on adult psychiatric disorders and related adult outcomes, indicating that genetic factors partly explain the association between childhood psychopathology and adult outcomes. However, these analyses in general do not take into account the correlations between the adult trait and disorder polygenic risk scores. This study aimed to further clarify the influence of genetic factors on associations between childhood psychopathology and adult outcomes by accounting for these correlations. Using a multivariate multivariable regression, we analyzed associations of childhood attention‐deficit/hyperactivity disorder (ADHD), internalizing, and social problems, with polygenic scores (PGS) of adult disorders and traits including major depression, bipolar disorder, subjective well‐being, neuroticism, insomnia, educational attainment, and body mass index (BMI), derived for 20,539 children aged 8.5–10.5 years. After correcting for correlations between the adult phenotypes, major depression PGS were associated with all three childhood traits, that is, ADHD, internalizing, and social problems. In addition, BMI PGS were associated with ADHD symptoms and social problems, while neuroticism PGS were only associated with internalizing problems and educational attainment PGS were only associated with ADHD symptoms. PGS of bipolar disorder, subjective well‐being, and insomnia were not associated with any childhood traits. Our findings suggest that associations between childhood psychopathology and adult traits like insomnia and subjective well‐being may be primarily driven by genetic factors that influence adult major depression. Additionally, specific childhood phenotypes are genetically associated with educational attainment, BMI and neuroticism.
Reduction of Na+ within a {Mg2Na2} Assembly
Authors: Liu Han‐Ying , Neale Samuel E. , Hill Michael S. , Mahon Mary F. , McMullin Claire L. , Richards Emma
Published: November 2022

Ionic compounds containing sodium cations are notable for their stability and resistance to redox reactivity unless highly reducing electrical potentials are applied. Here we report that treatment of a low oxidation state {Mg2Na2} species with non‐reducible organic bases induces the spontaneous and completely selective extrusion of sodium metal and oxidation of the MgI centers to the more conventional MgII state. Although these processes are also characterized by a structural reorganisation of the initially chelated diamide spectator ligand, computational quantum chemical studies indicate that intramolecular electron transfer is abetted by the frontier molecular orbitals (HOMO/LUMO) of the {Mg2Na2} ensemble, which arise exclusively from the 3s valence atomic orbitals of the constituent sodium and magnesium atoms.
An Enzymatically Gated Catalytic Hairpin Assembly Delivered by Lipid Nanoparticles for the Tumor‐Specific Activation of Signal Amplification in miRNA Imaging
Authors: Liu Qing , Huang Yuanyu , Li Zhengping , Li Lele , Zhao Yuliang , Li Mengyuan
Published: November 2022

MicroRNA (miRNA) imaging in disease sites is vital to elucidate their role in cancer progression. However, limited tumor specificity remains a major barrier for traditional amplification approaches due to associated background signal leakage. Here, we report a generalizable approach via the combination of enzymatically triggered catalytic hairpin assembly with lipid nanoparticles (LNPs)‐based delivery strategy for tumor‐specific activation of signal amplification and therefore sensitive miRNA imaging. The signal amplification is established via engineering of traditional catalytic hairpin assembly with enzymatically activated motifs to achieve triggable miRNA imaging in cancer cells. Furthermore, by the introduction of LNPs to combat biological barriers, we demonstrate that the system enables amplified miRNA imaging in vivo with reduced off‐tumor signal, leading to enhanced tumor‐to‐background contrast compared with traditional methods. This approach that relies on specific triggers and controlled delivery to distinguish miRNA in cancer cells from normal cells should be useful in tumor diagnosis.
Aggregation of Electrochemically Active Conjugated Organic Molecules and Its Impact on Aqueous Organic Redox Flow Batteries
Authors: Xiang Zhipeng , Li Wenjin , Wan Kai , Fu Zhiyong , Liang Zhenxing
Published: November 2022

Molecule aggregation in solution is acknowledged to be universal and can regulate the molecule's physiochemical properties, which however has been rarely investigated in electrochemistry. Herein, an electrochemical method is developed to quantitatively study the aggregation behavior of the target molecule methyl viologen dichloride. It is found that the oxidation state dicationic ions stay discrete, while the singly‐reduced state monoradicals yield a concentration‐dependent aggregation behavior. As a result, the molecule's energy level and its redox potential can be effectively regulated. This work does not only provide a method to investigate the molecular aggregation, but also demonstrates the feasibility to tune redox flow battery's performance by regulating the aggregation behavior.
Jet cooking dramatically improves the wet strength of soy adhesives
Authors: Hunt Christopher G. , Lorenz Linda F. , Houtman Carl J. , Valle Eder , Coolidge Thomas , Mock Chera , Frihart Charles R.
Published: November 2022

The impact of jet cooking on shear strength of soy‐and‐water adhesives was investigated to understand the higher shear strength of commercial soy protein isolates compared to soy flours. Soy flour‐based wood adhesives are appealing because of their bio‐based content, low formaldehyde emission, and low cost, but their commercial application is limited by low wet cohesive strength. Previous researchers proposed that the process of jet cooking (steam injection with high turbulence followed by rapid cooling) was responsible for the high (~3 MPa) wet shear strength of adhesives made with commercially produced soy protein isolate, using the ASTM D 7998 test. In this work, we show that jet cooking did dramatically increase the wet strength of laboratory‐produced, native‐state soy protein isolate from 0.6 to 3 MPa, a strength similar to many commercial isolates. Jet cooking was far less effective at developing wet strength of soy flours, but greatly increased the viscosity of virtually all our soy materials. We hypothesize that the benefits of jet cooking are primarily a result of nonequilibrium protein aggregation states because subsequent wet autoclaving of jet cooked soy proteins dramatically decreased wet strength. The dramatic differences in adhesive properties between commercial soy protein isolates and soy flours suggests that the common practice of using results obtained with commercial isolates to predict the performance of soy flour adhesives is inappropriate.
A void surface flame retardant strategy for polymericpolyHIPEs
Authors: Zhang Chen , Cai Ruiyun , Xu Chuanbang , Xia Hongwei , Zhu Yun , Zhang Shengmiao
Published: November 2022

Effective flame retardant strategy for open‐cell foam (e.g., polyHIPE) remains of a great challenge. Herein, a void surface flame retardant strategy for polyHIPE was presented. An open‐cell polystyrene (PS) polyHIPE was fabricated through an emulsion‐templating technique. Polyphosphazene (PSZ), a highly efficient flame retardant polymer, was then in situ fabricated and covalently attached to the void surface of the foam to be a uniform flame retardant protective layer, while the open‐cell structure of the foam was perfectly preserved. Compared with the pristine PS polyHIPE, the PSZ modified one had significantly improved thermal stability (char residues yield at 800°C increased from 3.36 to 16.53 wt%) and mechanical properties (Young's modulus increased by 2.6 times); the values of average heat release rate and total heat release of combustion were reduced by 62.36% and 41.57%, respectively. While, the value of limiting oxygen index was increased from 17.39% to 19.75%, owing to the combined action of condensed phase flame retardant and gas phase flame retardant. These results indicate that the in situ surface modification strategy is effective for improving the flame retardancy of highly interconnected polymer foams.
Evaluation of the antimicrobial activity of silver nanoparticles biosynthesized from the aqueous extract of Schinus terebinthifolius Raddi leaves
Authors: Ferreira Milene Dias , Neta Lourdes Cardoso de Souza , Brandão Geovani Cardoso , dos Santos Walter Nei Lopes
Published: November 2022

Silver nanoparticles (AgNPs) synthesized from green synthesis using medicinal plants are presented as an option for the development of new antimicrobial agents. In this context, this study aims to evaluate the antimicrobial activity of silver nanoparticles synthesized from the aqueous extract of Schinus terebinthifolius Raddi leaves, popularly known as “aroeira.” A 23 factorial design was used to assess the statistical significance of the studied factors, and Box–Behnken design was used to define the optimal conditions for the green synthesis of AgNPs. The studied factors were significant for the synthesis of nanoparticles, and the optimal conditions were pH 9.5, reaction time of 180 min, and 10 g of S. terebinthifolius Raddi leaves. The samples were characterized using UV–Vis spectroscopy, Fourier transform infrared spectroscopy, X‐ray diffraction, scanning electron microscopy, transmission electron microscopy, and dynamic light scattering. Antimicrobial activity was evaluated using the broth microdilution method and through the minimum microbicidal concentration. AgNPs showed greater antimicrobial efficacy compared to the extract, both for bacteria and fungi: bacteriostatic activity against all tested bacteria and bactericidal against Pseudomonas aeruginosa, besides fungistatic action against Candida albicans and Candida glabrata. Finally, the aqueous extract of “aroeira” leaves was effective in the synthesis of AgNPs, with greater antimicrobial potential than the extract.
Volume–outcome relationships in open and endovascular repair of abdominal aortic aneurysm: administrative data 2006–2018
Authors: Tong T , Aber A , Chilcott J , Thokala P , Walters S J , Maheswaran R , Nawaz S , Thomas S , Michaels J
Published: November 2022

Background

The aim of this study was to use recent evidence to investigate and update volume–outcome relationships after open surgical repair (OSR) and endovascular repair (EVAR) of abdominal aortic aneurysm in England.

Methods

Hospital Episode Statistics (HES) data from April 2006 to March 2018 were obtained. The primary outcome was in-hospital death. Other outcomes included duration of hospital stay, readmissions within 30 days, and critical care requirements. Case-mix adjustment included age, sex, HES year, deprivation index, weekend admission, mode of admission, type of procedure and co-morbidities.

Results

Annual volume of all repairs combined appeared to be an appropriate measure of volume. After case-mix adjustment, a significant relationship between volume and in-hospital mortality was seen for OSR (P < 0·001) but not for EVAR (P = 0·169 for emergency and P = 0·363 for elective). The effect appeared to extend beyond 60 repairs per year to volumes above 100 repairs per year. There was no significant relationship between volume and duration of hospital stay or 30-day readmissions. In patients receiving emergency OSR, higher volume was associated with longer stay in critical care.

Conclusion

Higher annual all-procedure volumes were associated with significantly lower in-hospital mortality for OSR, but such a relationship was not significant for EVAR. There was not enough evidence for a volume effect on other outcomes.
Comparison of peak wall stress and peak wall rupture index in ruptured and asymptomatic intact abdominal aortic aneurysms
Authors: Singh T P , Moxon J V , Iyer V , Gasser T C , Jenkins J , Golledge J
Published: November 2022

Background

Previous studies have suggested that finite element analysis (FEA) can estimate the rupture risk of an abdominal aortic aneurysm (AAA); however, the value of biomechanical estimates over measurement of AAA diameter alone remains unclear. This study aimed to compare peak wall stress (PWS) and peak wall rupture index (PWRI) in participants with ruptured and asymptomatic intact AAAs.

Methods

The reproducibility of semiautomated methods for estimating aortic PWS and PWRI from CT images was assessed. PWS and PWRI were estimated in people with ruptured AAAs and those with asymptomatic intact AAAs matched by orthogonal diameter on a 1 : 2 basis. Spearman's correlation coefficient was used to assess the association between PWS or PWRI and AAA diameter. Independent associations between PWS or PWRI and AAA rupture were identified by means of logistic regression analyses.

Results

Twenty individuals were included in the analysis of reproducibility. The main analysis included 50 patients with an intact AAA and 25 with a ruptured AAA. Median orthogonal diameter was similar in ruptured and intact AAAs (82·3 (i.q.r. 73·5–92·0) versus 81·0 (73·2–92·4) mm respectively; P = 0·906). Median PWS values were 286·8 (220·2–329·6) and 245·8 (215·2–302·3) kPa respectively (P = 0·192). There was no significant difference in PWRI between the two groups (P = 0·982). PWS and PWRI correlated positively with orthogonal diameter (both P < 0·001). Participants with high PWS, but not PWRI, were more likely to have a ruptured AAA after adjusting for potential confounders (odds ratio 5·84, 95 per cent c.i. 1·22 to 27·95; P = 0·027). This association was not maintained in all sensitivity analyses.

Conclusion

High aortic PWS had an inconsistent association with greater odds of aneurysm rupture in patients with a large AAA.
Clean Cut (adaptive, multimodal surgical infection prevention programme) for low-resource settings: a prospective quality improvement study
Authors: Forrester J A , Starr N , Negussie T , Schaps D , Adem M , Alemu S , Amenu D , Gebeyehu N , Habteyohannes T , Jiru F , Tesfaye A , Wayessa E , Chen R , Trickey A , Bitew S , Bekele A , Weiser T G
Published: November 2022

Background

Clean Cut is an adaptive, multimodal programme to identify improvement opportunities and safety changes in surgery by enhancing outcomes surveillance, closing gaps in surgical infection prevention standards, and strengthening underlying processes of care. Surgical-site infections (SSIs) are common in low-income countries, so this study assessed a simple intervention to improve perioperative infection prevention practices in one.

Methods

Clean Cut was implemented in five hospitals in Ethiopia from August 2016 to October 2018. Compliance data were collected from the operating room focused on six key perioperative infection prevention standards. Process-mapping exercises were employed to understand barriers to compliance and identify locally driven improvement opportunities. Thirty-day outcomes were recorded on patients for whom intraoperative compliance information had been collected.

Results

Compliance data were collected from 2213 operations (374 at baseline and 1839 following process improvements) in 2202 patients. Follow-up was completed in 2159 patients (98·0 per cent). At baseline, perioperative teams complied with a mean of only 2·9 of the six critical perioperative infection prevention standards; following process improvement changes, compliance rose to a mean of 4·5 (P < 0·001). The relative risk of surgical infections after Clean Cut implementation was 0·65 (95 per cent c.i. 0·43 to 0·99; P = 0·043). Improved compliance with standards reduced the risk of postoperative infection by 46 per cent (relative risk 0·54, 95 per cent c.i. 0·30 to 0·97, for adherence score 3–6 versus 0–2; P = 0·038).

Conclusion

The Clean Cut programme improved infection prevention standards to reduce SSI without infrastructure expenses or resource investments.
Global attitudes in the management of acute appendicitis during COVID-19 pandemic: ACIE Appy Study
Authors: Ielpo B , Podda M , Pellino G , Pata F , Caruso R , Gravante G , Di Saverio S ,   ACIE Appy Study Collaborative
Published: November 2022

Background

Surgical strategies are being adapted to face the COVID-19 pandemic. Recommendations on the management of acute appendicitis have been based on expert opinion, but very little evidence is available. This study addressed that dearth with a snapshot of worldwide approaches to appendicitis.

Methods

The Association of Italian Surgeons in Europe designed an online survey to assess the current attitude of surgeons globally regarding the management of patients with acute appendicitis during the pandemic. Questions were divided into baseline information, hospital organization and screening, personal protective equipment, management and surgical approach, and patient presentation before versus during the pandemic.

Results

Of 744 answers, 709 (from 66 countries) were complete and were included in the analysis. Most hospitals were treating both patients with and those without COVID. There was variation in screening indications and modality used, with chest X-ray plus molecular testing (PCR) being the commonest (19·8 per cent). Conservative management of complicated and uncomplicated appendicitis was used by 6·6 and 2·4 per cent respectively before, but 23·7 and 5·3 per cent, during the pandemic (both P < 0·001). One-third changed their approach from laparoscopic to open surgery owing to the popular (but evidence-lacking) advice from expert groups during the initial phase of the pandemic. No agreement on how to filter surgical smoke plume during laparoscopy was identified. There was an overall reduction in the number of patients admitted with appendicitis and one-third felt that patients who did present had more severe appendicitis than they usually observe.

Conclusion

Conservative management of mild appendicitis has been possible during the pandemic. The fact that some surgeons switched to open appendicectomy may reflect the poor guidelines that emanated in the early phase of SARS-CoV-2.
Central lymph node dissection and permanent hypoparathyroidism after total thyroidectomy for papillary thyroid cancer: population-based study
Authors: Salem F A , Bergenfelz A , Nordenström E , Almquist M
Published: November 2022

Background

Papillary thyroid cancer is treated with total/near-total thyroidectomy (TT) with or without central lymph node dissection (CLND), depending on risk factors and tumour size. Balancing the risk of disease recurrence and surgical morbidity remains a challenge. A population-based nationwide study was undertaken to evaluate the risk of permanent hypoparathyroidism associated with CLND.

Method

Data on patients with stage pT1–3 papillary thyroid cancer, who underwent TT with or without CLND between 1 July 2004 and 30 June 2014 were retrieved from the Scandinavian Quality Register for Thyroid, Parathyroid and Adrenal Surgery. Drug use was ascertained by cross-linking with the Swedish Prescribed Drug Register. Permanent hypoparathyroidism was defined as treatment with active D vitamin or oral calcium drugs for more than 6 months after surgery. Data were analysed separately for all patients and those who underwent TT + CLND. Univariable and multivariable logistic regression analyses were done, yielding odds ratios (ORs) with 95 per cent confidence intervals.

Results

A total of 722 patients were included in the study. Permanent hypoparathyroidism was more common in the TT + CLND group than the TT group: 30 of 265 patients (6·6 per cent) versus six of 457 (2·3 per cent) (P = 0·011). In multivariable logistic regression analysis, CLND was a risk factor for permanent hypoparathyroidism (OR 3·74, 95 per cent c.i. 1·46 to 9·59, based on use of combined therapy 6 months after surgery). In patients who had TT + CLND, node negativity was associated with a risk of permanent hypoparathyroidism (OR 3·08, 1·31 to 7·25).

Conclusion

CLND is an independent risk factor for permanent hypoparathyroidism. Node negativity is associated with a higher risk of permanent hypoparathyroidism.
Predicting outcomes in older patients undergoing vascular surgery using the Hospital Frailty Risk Score
Authors: Aitken S J , Lujic S , Randall D A , Noguchi N , Naganathan V , Blyth F M
Published: November 2022

Background

Frailty may explain why some older patients having vascular surgery are at high risk of adverse outcomes. The Hospital Frailty Risk Score (HFRS) has been designed specifically for use with administrative data and has three categories of frailty risk (low, intermediate and high). The aim of this study was to evaluate the HFRS in predicting mortality, and hospital use in older patients undergoing vascular surgery.

Methods

Routinely collected hospital data linked to death records were analysed for all patients aged 75 years or older who had undergone either endovascular or open vascular surgery between 2010 and 2012 in New South Wales, Australia. Multilevel logistic regression models were used to compare outcomes adjusted for patient and procedural factors, with and without frailty.

Results

Some 9752 patients were identified, of whom 1719 (17·6 per cent) had a high-risk HFRS. Patients in the high-risk frailty category had an adjusted odds ratio for death by 30 days after surgery of 4·15 (95 per cent c.i. 2·99 to 5·76) compared with those in the low-risk frailty category, and a similarly increased odds of death by 2 years (odds ratio 4·27, 3·69 to 4·95). Adding the HFRS to a model adjusted for age, sex, co-morbidity score, socioeconomic status, previous hospitalization and vascular procedure type improved the prediction of 2-year mortality and prolonged hospital stay, but there was minimal improvement for 30-day mortality and readmission.

Conclusion

Adjusting for the HFRS in addition to other patient and procedural risk factors provided greater discrimination of outcomes in this cohort of older patients undergoing vascular surgery.
Multistimuli‐Responsive Chromism of Vinylene‐Linked Bisflavin Based on the Aggregation and Redox Properties
Authors: Kawamorita Soichiro , Li Zimeng , Okamoto Koyo , Naota Takeshi
Published: November 2022

Multistimuli‐responsive chromism was observed for vinylene‐linked bisflavin 1 a with an extended π‐conjugated platform. The yellow emission of a dilute solution of 1 a in CHCl3 (0.2 mM) observed at 298 K under UV excitation was changed to orange or red emission upon (1) an increase of concentration, (2) a decrease of temperature, and (3) variation of the solvent. This is in contrast to the almost non stimuli‐responsive chromism of the N‐methylated bisflavin analogue 1 b and monoflavin 2 a. Mechanistic investigation by 1H NMR analysis under various conditions revealed that the extended π‐conjugation platform and imide moiety of 1 a generate controllability in the formation of lower‐ and higher‐ordered aggregates, which induce variation of the emission color upon change. Bisflavin 1 a also exhibited redox‐induced chromism, where the orange emission of 1 a was quenched by the addition of hydrazine under anaerobic conditions, and changed back to the original emission upon subsequent bubbling of O2 gas.
Di‐Iron(II) [2+2] Helicates of Bis‐(Dipyrazolylpyridine) Ligands: The Influence of the Ligand Linker Group on Spin State Properties
Authors: Kulmaczewski Rafal , Armstrong Isaac T. , Catchpole Pip , Ratcliffe Emily S. J. , Vasili Hari Babu , Warriner Stuart L. , Cespedes Oscar , Halcrow Malcolm A.
Published: November 2022

Four bis[2‐{pyrazol‐1‐yl}‐6‐{pyrazol‐3‐yl}pyridine] ligands have been synthesized, with butane‐1,4‐diyl (L1), pyrid‐2,6‐diyl (L2), benzene‐1,2‐dimethylenyl (L3) and propane‐1,3‐diyl (L4) linkers between the tridentate metal‐binding domains.L1andL2form [Fe2(μ−L)2]X4(X−=BF4−or ClO4−) helicate complexes when treated with the appropriate iron(II) precursor. Solvate crystals of [Fe2(μ−L1)2][BF4]4exhibit three different helicate conformations, which differ in the torsions of their butanediyl linker groups. The solvates exhibit gradual thermal spin‐crossover, with examples of stepwise switching and partial spin‐crossover to a low‐temperature mixed‐spin form. Salts of [Fe2(μ−L2)2]4+are high‐spin, which reflects their highly twisted iron coordination geometry. The composition and dynamics of assembly structures formed by iron(II) withL1−L3vary with the ligand linker group, by mass spectrometry and1H NMR spectroscopy. Gas‐phase DFT calculations imply the butanediyl linker conformation in [Fe2(μ−L1)2]4+influences its spin state properties, but show anomalies attributed to intramolecular electrostatic repulsion between the iron atoms.
Structure Determination of the Crystalline LiPON Model Structure Li5+xP2O6−xN1+x with x≈0.9
Authors: Schneider Stefanie , Balzat Lucas G. , Lotsch Bettina V. , Schnick Wolfgang
Published: November 2022

Non‐crystalline lithium oxonitridophosphate (LiPON) is used as solid electrolyte in all‐solid‐state batteries. Crystalline lithium oxonitridophosphates are important model structures to retrieve analytical information that can be used to understand amorphous phases better. The new crystalline lithium oxonitridophosphate Li5+xP2O6−xN1+x was synthesized as an off‐white powder by ampoule synthesis at 750–800 °C under Ar atmosphere. It crystallizes in the monoclinic space group P21/c with a=15.13087(11) Å, b=9.70682(9) Å, c=8.88681(7) Å, and β=106.8653(8)°. Two P(O,N)4 tetrahedra connected by an N atom form the structural motif [P2O6−xN1+x](5+x)−. The structure was elucidated from X‐ray diffraction data and the model corroborated by NMR and infrared spectroscopy, and elemental analyses. Measurements of ionic conductivity show a total ionic conductivity of 6.8×10−7 S cm−1 at 75 °C with an activation energy of 0.52±0.01 eV.
Dichromic Allophycocyanin Trimer Covering a Broad Spectral Range (550–660 nm)
Authors: Guo Rui , Wang Si , Niu Nan‐Nan , Xu Ya‐Li , Zhu Jun‐Xun , Scheer Hugo , Noy Dror , Zhao Kai‐Hong
Published: November 2022

Phycobilisomes, the light‐harvesting complexes of cyanobacteria and red algae, are a resource for photosynthetic, photonic and fluorescence labeling elements. They cover an exceptionally broad spectral range, but the complex superstructure and assembly have been an obstacle. By replacing in Synechocystis sp. PCC 6803 the biliverdin reductases, we studied the role of chromophores in the assembly of the phycobilisome core. Introduction of the green‐absorbing phycoerythrobilin instead of the red‐absorbing phycocyanobilin inhibited aggregation. A novel, trimeric allophycocyanin (Dic‐APC) was obtained. In the small (110 kDa) unit, the two chromophores, phycoerythrobilin and phytochromobilin, cover a wide spectral range (550 to 660 nm). Due to efficient energy transfer, it provides an efficient artificial light‐harvesting element. Dic‐APC was generated in vitro by using the contained core‐linker, LC, for template‐assisted purification and assembly. Labeling the linker provides a method for targeting Dic‐APC.
Boron‐Mediated Regioselective Aromatic C−H Functionalization via an Aryl BF2Complex
Authors: Shinde Ganesh H. , Sundén Henrik
Published: November 2022

An efficient regioselective functionalization of 2‐aryl‐heteroarenes and aryl aldehydes via an azaaryl BF2complex has been developed. Mechanistically the reaction comprises fluoride to bromide ligand exchange on an aryl boron species and consecutive C−B bond cleavage to deliver a broad range of functionalized products. The reaction is high yielding, has a broad substrate scope where several different heteroarenes can be functionalized with chloro, bromo, iodo, hydroxyl, amine and BF2in a highly regioselective fashion. The method can be applied for late‐stage functionalization or for rapid skeleton remodeling with for instance cross‐couplings.
An LSTM‐based mixed‐integer model predictive control for irrigation scheduling
Authors: Agyeman Bernard T. , Sahoo Soumya R. , Liu Jinfeng , Shah Sirish L.
Published: November 2022

The development of well‐devised irrigation scheduling methods is desirable from the perspectives of plant quality and water conservation. Accordingly, in this article, a mixed‐integer model predictive control system is proposed to address the daily irrigation scheduling problem. In this framework, a long short‐term memory (LSTM) model of the soil–crop–atmosphere system is employed to evaluate the objective of ensuring optimal water uptake in crops while minimizing total water consumption and irrigation costs. To enhance the computational efficiency of the proposed method, a heuristic method involving the logistic sigmoid function is used to approximate the binary variable that arises in the mixed‐integer formulation. Through computer simulations, the proposed scheduler is applied to homogeneous and spatially variable fields. The results of these simulation experiments reveal that the proposed method can prescribe optimal/near‐optimal irrigation schedules that are typical of irrigation practice within practical computational budgets.
CO2 capture enhancement by forming tetra‐n‐butyl ammonium bromide semiclathrate in graphite nanofluids
Authors: Ge Bin‐Bin , Yan Jin , Zhong Dong‐Liang , Lu Yi‐Yu , Li Xi‐Yue
Published: November 2022

In this work, CO2 capture was experimentally investigated by forming tetra‐n‐butyl ammonium bromide (TBAB) semiclathrate in a new system of TBAB + graphite nanofluids. The experiments were carried out at 3.5 MPa and 277.15 K. Compared to the TBAB solution and the TBAB + sodium dodecyl sulphate (SDS) solution, it was found that the system of TBAB + graphite nanofluids was preferable for CO2 capture, and 0.2 wt.% graphite nanoparticles (GNP) was an optimal concentration for the enhancement of hydrate growth in TBAB + graphite nanofluids. At this GNP concentration, CO2 consumption gained at 0.29 mol% TBAB is greater than that acquired at 0.62 and 2.57 mol% TBAB. CO2 consumption obtained in TBAB + graphite nanofluids is larger than other systems containing GNP. Moreover, the morphologies of TBAB + CO2 semiclathrate formed in TBAB solution, TBAB + SDS solution, and TBAB + graphite nanofluids were presented, and the mechanism of CO2 capture using TBAB semiclathrate formation in graphite nanofluids was presented. Therefore, it is an efficient way to capture CO2 by forming TBAB semiclathrate in graphite nanofluids.