bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing provider performance of intrapartum care using simulated encounters and clinical vignettes: A comparison study from Tanzania
Authors: Young Anna Marie P. , Marx Melissa A. , Frost Emily , Hazel Elizabeth , Kabanywanyi Abdunoor M. , Mohan Diwakar
Published: September 2021

Objective

To compare clinical vignettes and objective structured clinical examinations (OSCE) as methods for assessing the quality of intrapartum care among skilled providers in rural primary‐level health facilities in Tanzania.

Methods

Cross‐sectional study conducted at six health facilities in the Simiyu region of Tanzania. Providers were assessed using OSCE and clinical vignettes in spontaneous delivery, neonatal resuscitation, and management of postpartum hemorrhage. Trained researchers used a structured clinical checklist. The frequencies of items are presented as percentages and the agreement of the methods of assessment are reported using kappa statistics (high: kappa > 0.80, moderate: kappa = 0.60–0.80, low: kappa < 0.60).

Results

Most healthcare providers were female (60.7%), registered nurses by training (29.0%), and worked in a dispensary (56.1%), with an average age of 33 years and an average of 7.4 years of experience in their respective professions. Five items had high agreement between OSCE and clinical vignettes: postpartum vital signs every 15 min, oxytocin within 1 min of birth, diagnosis of postpartum hemorrhage, elevating legs of the mother, and deciding on manual compression of the uterus.

Conclusion

OSCE and clinical vignettes should be viewed as complimentary to one another in the assessment of provider knowledge and skill, with priority given to OSCE, particularly in intrapartum care.
Risk factors for obstetric anal sphincter injury recurrence: A systematic review and meta‐analysis
Authors: Barba Marta , Bernasconi Davide P. , Manodoro Stefano , Frigerio Matteo
Published: September 2021

Background

Women with previous obstetric anal sphincter injuries (OASIs) are at a higher risk of recurrence in the subsequent pregnancy, which may lead to the development or worsening of anal incontinence. Due to a lack of evidence, few recommendations can be made about the factors that may affect the risk of OASI recurrence.

Objective

We sought to conduct a systematic review and meta‐analysis to investigate potential risk factors for recurrent OASIs.

Search strategy

Studies up to May 2019 were identified from PubMed, Scopus, Cochrane Library, and ISI Web of Science.

Selection criteria

Studies assessing the impact of risk factors on OASI recurrence in subsequent pregnancies were included. Reviews, letters to the editor, conference abstracts, book chapters, guidelines, Cochrane reviews, and expert opinions were excluded.

Data collection and analysis

Data were extracted by two independent reviewers. Odds ratio and standardized mean difference were chosen as effect measures. Pooled estimates were calculated using the random‐effects model.

Main results

The meta‐analysis showed that maternal age, gestational age, occiput posterior presentation, oxytocin augmentation, operative delivery, and shoulder dystocia were associated with the risk of recurrent OASIs in the subsequent delivery.

Conclusion

Prenatal and intrapartum risk factors are associated with recurrence of OASI.

PROSPERO registration no. CRD42020178125.
The lethal effect of the second wave of COVID‐19 on pregnant women: a matter of concern
Authors: Khoiwal Kavita , Agarwal Anchal , Mittal Anmol , Gaurav Amrita , Chawla Latika , Mundhra Rajlaxmi , Bahadur Anupama , Chaturvedi Jaya
Published: September 2021

Synopsis

The lethal second wave of COVID‐19 hit pregnant women terribly with regards to disease severity, requirement of invasive ventilation, and maternal mortality.
Edge computing and AIoT based network intrusion detection mechanism
Authors: Sui Qingru , Liu Xiaoyan
Published: September 2021

Edge computing technology solves the shortcomings of high latency, mobility and location awareness in remote cloud computing, but it also brings many security challenges to the AIoT. In view of the open and heterogeneous characteristics of edge network, a more secure edge computing intrusion detection method is studied in this paper. The main idea is to combine edge computing with AIoT to realize edge smart interconnection. This method optimizes the weight value in machine learning by increasing the screening and mitigation of cloud server training samples, so as to provide efficient and accurate edge intrusion detection behavior. The experimental results show that the proposed method can more effectively improve the detection accuracy and reduce the detection time.
The role of hydrogen‐based power systems in the energy transition of the residential sector
Authors: Maestre Víctor M , Ortiz Alfredo , Ortiz Inmaculada
Published: September 2021

The unsustainable and continuous growth of anthropogenic emissions of greenhouse gases (GHG) has pushed governments, private companies and stakeholders to adopt measures and policies to fight against climate change. Within this framework, increasing the contribution of renewable energy sources (RES) to final consumed energy plays a key role in the planned energy transition. Regarding the residential sector in Europe, 92% of GHG emissions comes from 75% of the building stock that is over 25 years old, and highly inefficient. Thus, this sector must raise RES penetration from the current 36% to 77% by 2050 to comply with emissions targets. In this regard, the hybridization of hydrogen‐based technologies and RES represents a reliable and versatile solution to facilitate decarbonization of the residential sector. This study provides an overview and analysis of standalone renewable hydrogen‐based systems (RHS) focusing on the residential and buildings sector, as well as critical infrastructures like telecom stations, data servers, etc. For detailed evaluation of RHS, several pilot plants and real demonstration plants implemented worldwide are reviewed. To this end, a techno‐economic assessment of relevant parameters like self‐sufficiency ratio, levelized cost of energy and hydrogen roundtrip efficiency is provided. Moreover, the performance of the different configurations is evaluated by comparing the installed power of each component and their energy contribution to cover the load over a defined period of time. Challenges ahead are identified for the wider deployment of RHS in the residential and buildings sector. © 2021 The Authors. Journal of Chemical Technology and Biotechnology published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry (SCI).
Prediction models for child and adolescent mental health: A systematic review of methodology and reporting in recent research
Authors: Senior Morwenna , Fanshawe Thomas , Fazel Mina , Fazel Seena
Published: September 2021

Background

There has been a rapid growth in the publication of new prediction models relevant to child and adolescent mental health. However, before their implementation into clinical services, it is necessary to appraise the quality of their methods and reporting. We conducted a systematic review of new prediction models in child and adolescent mental health, and examined their development and validation.

Method

We searched five databases for studies developing or validating multivariable prediction models for individuals aged 18 years old or younger from 1 January 2018 to 18 February 2021. Quality of reporting was assessed using the Transparent Reporting of a multivariable prediction models for Individual Prognosis Or Diagnosis checklist, and quality of methodology using items based on expert guidance and the PROBAST tool.

Results

We identified 100 eligible studies: 41 developing a new prediction model, 48 validating an existing model and 11 that included both development and validation. Most publications (k = 75) reported a model discrimination measure, while 26 investigations reported calibration. Of 52 new prediction models, six (12%) were for suicidal outcomes, 18 (35%) for future diagnosis, five (10%) for child maltreatment. Other outcomes included violence, crime, and functional outcomes. Eleven new models (21%) were developed for use in high‐risk populations. Of development studies, around a third were sufficiently statistically powered (k = 16%, 31%), while this was lower for validation investigations (k = 12, 25%). In terms of performance, the discrimination (as measured by the C‐statistic) for new models ranged from 0.57 for a tool predicting ADHD diagnosis in an external validation sample to 0.99 for a machine learning model predicting foster care permanency.

Conclusions

Although some tools have recently been developed for child and adolescent mental health for prognosis and child maltreatment, none can be currently recommended for clinical practice due to a combination of methodological limitations and poor model performance. New work needs to use ensure sufficient sample sizes, representative samples, and testing of model calibration.
Antimicrobial and antiproliferative study of chalcone clubbed 2,4‐dimethylpyrrole‐3‐carboxamide derivatives: Synthesis and in vitro evaluation
Authors: Rasal Nishant Kisan , Jagtap Sangeeta Vijay , Bhange Dattatraya Soma
Published: September 2021

The presented study explores the anticancer potency of a novel series of chalcone clubbed 2,4‐dimethyl‐1H‐pyrrole‐3‐carboxamide derivatives. In vitro antimicrobial screening concluded that five compounds are potential against Candida albicans having inhibition of growth in the range of 46.38%–73.05% against at the concentration of 32 μg/mL. The antiproliferative screening against 60 cancer cell lines revealed that seven compounds have great potential against the various types of cancer cell lines with inhibition of growth in the range of 41%–71%. The structure–activity relationship study concluded that the hydrazide bond is more significant than the carboxamide bond. In silico study of highly potential derivatives obeys each parameter of Lipinski rule of five and qualified drug‐likeness behavior. The presented pyrrole‐chalcone template delivered various candidates as anticancer agents, and those could be a potential scaffold to develop the new anticancer drug.
Total synthesis of xylapeptide B [Cyclo‐(L‐Leu‐L‐Pro‐N‐Me‐Phe‐L‐Val‐D‐Ala)]
Authors: Kurnia Dessy Yulyani , Maharani Rani , Hidayat Ace Tatang , Al‐Anshori Jamaludin , Wiani Ika , Mayanti Tri , Nurlelasari  , Harneti Desi , Supratman Unang
Published: September 2021

Xylapeptide B is a cyclopentapeptide isolated from Xylaria sp. derived from the Chinese medicinal plant Sophora tonkinensis. Xylapeptide B was successfully synthesized by a combination of solid‐ and solution‐phase, using the Fmoc strategy, and 2‐chlorotrityl chloride resin. The coupling reagent used is a combination of HBTU/HOBt to assist in the formation of amide bonds. D‐Ala was chosen as the C‐terminal because it has a small residue and can facilitate the cyclization process. Linear peptide was cleaved from the resin using a dilute acid concentration of 20% TFA in DCM because the peptide has no protecting group at the side chain. Crude linear peptide was purified by semi‐preparative RP‐HPLC using 0%–100% ACN eluent for 35 min and obtained a pure mass of 22.4 mg (18.83%). Cyclization was carried out in solution phase using HBTU (3 eq.) and DIPEA (1% v/v) in diluted concentration (1.25 mM) for 72 h at room temperature. The cyclization stage was monitored by thin‐layer chromatography (TLC). Crude xylapeptide B was purified by semi‐preparative RP‐HPLC using 30%–80% ACN eluent for 40 min, to result in 6 mg (8.91%) of the desired xylapeptide B. All synthesized products were characterized by HR‐TOFMS, 1H‐, and 13C‐NMR.
Differentiation of Diffuse Infiltration Pattern in Multiple Myeloma From Hyperplastic Hematopoietic Bone Marrow: Qualitative and Quantitative Analysis Using Whole‐BodyMRI
Authors: Sun Mengtian , Cheng Jingliang , Ren Cuiping , Zhang Yong , Li Yinhua , Wang Linlin , Liu Yu
Published: September 2021

Background

The visual assessment used for diffuse infiltration of multiple myeloma (MM) is inadequate. It can be difficult to differentiate MM from hyperplastic hematopoietic bone marrow (HHBM) because the MRI signal characteristics overlap.

Purpose

To analyze the bone marrow diffuse signal changes on whole‐body MRI caused by MM and HHBM.

Study type

Retrospective.

Subjects

Thirty Four patients with MM (21 men and 13 women), 22 patients with HHBM (9 men and 13 women), and 15 healthy controls (9 men and 6 women).

Field strength/sequence

A 3.0 T MRI; diffusion‐weighted whole‐body imaging with background body signal suppression (DWIBS), modified Dixon T1 fast field echo, and T2 STIR.

Assessment

Three radiologists analyzed the whole‐body MRI alone and in combination with apparent diffusion coefficient (ADC) and fat fraction (FF) with qualitative and quantitative analysis. Normalized T1 and T2 signal intensities (nT1 and nT2) and signal‐to‐noise ratio (SNR) were obtained.

Statistical tests

Kruskal–Wallis and chi‐square tests.

Results

The MM group had significantly higher ADC and significantly lower FF than HHBM and control groups. There was no significant difference in nT1, nT2 or SNR between MM and HHBM (P = 0.932,P = 0.097, andP = 0.110, respectively). Receiver operating characteristic (ROC) analysis using ADC and FF cut‐off values of 0.47 × 10−3 mm2/sec and 20.63%, respectively. The AUC was 0.866 for ADC and 0.886 for FF. The quantitative analysis yielded better specificity (observer 1: 81.8% vs. 27.3%; observer 2: 68.2% vs. 22.7%; and observer 3: 72.7% vs. 18.2%) and a higher diagnostic accuracy (observer 1: 82.1% vs. 51.8%; observer 2: 80.4% vs. 50.0%; observer 3: 76.8% vs. 44.6%) than the qualitative analysis.

Data conclusion

Whole‐body MRI combined with DWIBS and mDIXON could be used to differentiate between MM and HHBM. Combining the quantitative ADC and FF with the whole‐body MRI improved the specificity and accuracy in differentiating these conditions.

Evidence Level

3

Technical Efficacy

Stage 2
Phenotype stability, expansion potential, and senescence of embryonic tendon cells in vitro
Authors: Nguyen Phong K. , Deng Feiyang , Assi Sereen , Paco Paolo , Fink Spencer , Stockwell Caroline , Kuo Catherine K.
Published: September 2021

Embryonic tendon cells have been studied in vitro to better understand mechanisms of tendon development. Outcomes of in vitro cell culture studies are easily affected by phenotype instability of embryonic tendon cells during expansion in vitro to achieve desired cell numbers, yet this has not been characterized. In the present study, we characterized phenotype stability, expansion potential, and onset of senescence in chick embryo tendon cells from low to high cell doublings. We focused on cells of Hamburger‐Hamilton stages (HH) 40 and HH42, where HH40 is the earliest stage associated with substantial increases in extracellular matrix and mechanical properties during embryonic tendon development. HH40 and HH42 cells both downregulated expression levels of tendon phenotype markers, scleraxis and tenomodulin, and exhibited onset of senescence, based on p16 and p21 expression levels, cell surface area, and percentage of β‐galactosidase positive cells, before significant decreases in proliferation rates were detected. These findings showed that embryonic tendon cells destabilize phenotype and become senescent earlier than they begin to decline in proliferation rates in vitro. Additionally, embryonic stage of isolation appears to have no effect on proliferation rates, whereas later stage HH42 cells downregulate phenotype and become susceptible to senescence sooner than earlier stage HH40 cells. Based on our data, we recommend chick embryo tendon cells be used before a maximum cumulative doubling level of 12 (passage 4 in this study) to avoid phenotype destabilization and onset of senescence.
A single base change at exon of Wx‐A1 caused gene inactivation and starch properties modified in a wheat EMS mutant line
Authors: Zhang Xuteng , Karim Hassan , Feng Xiuqin , Lan Jingyu , Tang Huaping , Guzmán Carlos , Xu Qiang , Zhang Yazhou , Qi Pengfei , Deng Mei , Ma Jian , Wang Jirui , Chen Guoyue , Lan Xiujin , Wei Yuming , Zheng Youliang , Jiang Qiantao
Published: September 2021

BACKGROUND

Wheat is an essential source of starch. The GBSS or waxy genes are responsible for synthesizing amylose in cereals. The present study identified a novel Wx‐A1 null mutant line from an ethyl methanesulfonate (EMS)‐mutagenized population of common wheat cv. SM126 using sodium dodecyl sulfate‐polyacrylamide gel electrophoresis and agarose gel analyses.

RESULTS

The alignment of the Wx‐A1 gene sequences from the mutant and parental SM126 lines showed only one single nucleotide polymorphism causing the appearance of a premature stop codon and Wx‐A1 inactivation. The lack of Wx‐A1 protein resulted in decreased amylose, total starch and resistant starch. The starch morphology assessment revealed that starch from mutant seeds was more wrinkled, increasing its susceptibility to digestion. Regarding the starch thermodynamic properties, the gelatinization temperature was remarkably reduced in the mutant compared to parental line SM126. The digestibility of native, gelatinized, and retrograded starches was analyzed for mutant M4‐627 and the parental SM126 line. In the M4‐627 line, rapidly digestible starch contents were increased, whereas resistant starch was decreased in the three types of starch.

CONCLUSION

Waxy protein is essential for starch synthesis. The thermodynamic characteristics were decreased in the Wx‐A1 mutant line. The digestibility properties of starch were also affected. Therefore, the partial waxy mutant M3‐627 might play a significant role in food improvement. Furthermore, it might also be used to produce high‐quality noodles. © 2021 Society of Chemical Industry.
Preparation of core‐shell microporous organic polymer‐coated silica microspheres for chromatographic separation and N‐glycopeptides enrichment
Authors: Wang Chenyang , Tang Ruizhi , Pan Lei , Wu Wenrui , Ma Shujuan , Wei Yinmao , Ou Junjie
Published: September 2021

Through a “one‐pot” strategy, a layer of microporous organic polymer was coated onto the surface of monodisperse amino‐functionalized silica microsphere via amino‐aldehyde condensation reaction with core‐shell structure. The change in chemical structure of material before and after modification was determined by Fourier‐transform infrared spectroscopy and X‐ray photoelectron spectroscopy. Due to existence of a large number of amino and aldehyde groups in microporous organic polymer shell, the water contact angle decreased from 56.8° (silica microspheres) to 34.7° (microporous organic polymer‐coated silica microspheres). Based on these properties, microporous organic polymer‐coated silica microspheres were employed as the stationary phase for capillary liquid chromatography and successfully offered baseline separation of polar small molecules. Additionally, the material could also be served as the sorbent of hydrophilic interaction chromatography to enrich glycopeptides from human serum digest. A total of 470 unique N‐glycopeptides and 342 N‐glycosylation sites mapped to 112 N‐glycosylated proteins were unambiguously identified from 2 μL of human serum, exhibiting a promising application prospect of microporous organic polymer‐coated silica microspheres in the pretreatment of proteomics samples.
Dephosphorylation of pyridoxal 5′‐phosphate‐derived Schiff bases in the presence of bovine alkaline phosphatase
Authors: Gamov George , Murekhina Anastasia , Aleksandriiskii Viktor
Published: September 2021

The present paper reports on the study of the dephosphorylation of pyridoxal 5′‐phosphate and four derived hydrazones (containing the residues of pyrazine, 2‐furan, 2‐thiophene, 3‐pyridine carboxylic acids) induced by bovine alkaline phosphatase from intestinal mucosa at 298.2 K and pH 10 (0.05 m Tris–HCl buffer). We observed and discussed characteristic changes in the UV–vis and fluorescent spectra of substrates. Michaelis–Menten parameters of the enzymatic dephosphorylation are calculated. The stability of alkaline phosphatase in the presence of hydrazones is confirmed. The dephosphorylation of the Zn(II) complex with pyridoxal 5′‐phosphate‐derived hydrazone is analyzed.
Development of N,O‐Carboxymethyl Chitosan‐Starch Biomaterial Inks for 3D Printed Wound Dressing Applications
Authors: Naseri Emad , Cartmell Christopher , Saab Matthew , Kerr Russell G. , Ahmadi Ali
Published: September 2021

In this paper, a novel hybrid biomaterial ink consisting of two water‐soluble polymers is investigated: starch and N,O‐carboxymethyl chitosan (NOCC). The biomaterial ink is used to fabricate controlled release biodegradable wound dressing scaffolds via a novel low‐temperature solvent (organic)‐free 3D printing technique. NOCC is a variant of chitosan with a high degradation rate that can lead to an immediate release of the drugs, and starch, on the other hand, is used to alter degradation and drug release characteristics of the biomaterial. Mupirocin, a topical anti‐infective, is incorporated into the biomaterial inks. Different biomaterial inks in terms of NOCC to starch ratio are prepared and characterized. Printability and rheology of the samples are investigated, and the release of mupirocin over time is quantified. The efficacy of the developed 3D printed wound dressings against Staphylococcus aureus is examined through disk diffusion assays. Increasing NOCC accelerated the release of the drug from the scaffold and led to larger zones of inhibition in the early hours of the in vitro tests; this phenomenon is correlated to the enhanced hydrophilicity of NOCC‐dominated scaffolds. The drug release and the zone of inhibition are controlled by altering starch to NOCC ratio in the biomaterial ink.
Solvated Ionic‐Liquid Incorporated Soft Flexible Cross‐Linked Network Polymer Electrolytes for Safer Lithium Ion Secondary Batteries
Authors: Grewal Manjit Singh , Tanaka Manabu , Kawakami Hiroyoshi
Published: September 2021

The present work demonstrates the solvent‐free, highly flexible, self‐supporting crosslinked network polymer electrolyte membranes with decent ion conductivities and stable battery performance (in terms of rate capability and cycle stability) at ambient temperatures. The network polymer electrolyte membranes are prepared by “thiol‐epoxy” and “thiol‐ene” (co)polymerization using pentaerythritol tetrakis(3‐mercaptopropionate) (PEMP) and terminal‐functionalized poly(ethylene glycol) (PEG). The network polymer electrolyte membranes contain small amounts of solvated ionic liquids (equimolar mixture of tetraglyme and lithium salt) at different lithium salt molar concentrations. The obtained membranes display remarkable homogeneity and high amorphous characteristics, good mechanical robustness, high thermal stability, wide electrochemical stability (>4.20 V vs Li/Li+), and superior lithium ion transference number (tLi+ = 0.20–0.50). The electrochemical and spectroscopic study of the network polymer electrolyte membranes reveals the influence of solvated ionic liquid on the ion conduction, mechanical, thermal, and electrochemical properties. The overall performance of the present crosslinked polymer network electrolyte containing solvated ionic liquid systems postulates the possibility of their practical implementation in the construction of safe and durable alternative electrolytes for high‐performance lithium ion batteries working at wide temperatures.
Recent advances in mass spectrometry analysis of neuropeptides
Authors: Phetsanthad Ashley , Vu Nhu Q. , Yu Qing , Buchberger Amanda R. , Chen Zhengwei , Keller Caitlin , Li Lingjun
Published: September 2021

Due to their involvement in numerous biochemical pathways, neuropeptides have been the focus of many recent research studies. Unfortunately, classic analytical methods, such as western blots and enzyme‐linked immunosorbent assays, are extremely limited in terms of global investigations, leading researchers to search for more advanced techniques capable of probing the entire neuropeptidome of an organism. With recent technological advances, mass spectrometry (MS) has provided methodology to gain global knowledge of a neuropeptidome on a spatial, temporal, and quantitative level. This review will cover key considerations for the analysis of neuropeptides by MS, including sample preparation strategies, instrumental advances for identification, structural characterization, and imaging; insightful functional studies; and newly developed absolute and relative quantitation strategies. While many discoveries have been made with MS, the methodology is still in its infancy. Many of the current challenges and areas that need development will also be highlighted in this review.
Faecalibacterium prausnitzii Attenuates DSS‐Induced Colitis by Inhibiting the Colonization and Pathogenicity of Candida albicans
Authors: Mao Xiaqiong , Ma Jingjing , Jiao Chunhua , Tang Nana , Zhao Xiaojing , Wang Di , Zhang Yue , Ye Ziping , Xu Chenjing , Jiang Jingyue , Wu Shasha , Cui Xiufang , Zhang Hongjie , Qiu Xinyun
Published: September 2021

Scope

Intestinal commensal microbiota interactions play critical roles in the inflammatory bowel disease (IBD) development. Candida albicans (CA) can aggravate intestinal inflammation; however, whether Faecalibacterium prausnitzii (FP) can antagonize CA is unknown.

Methods and Results

CA are co‐cultured with bacteria (FP and Escherichia coli (EC)), bacterial supernatant, and bacterial medium, respectively. Then, the CA hyphae‐specific genes’ expression and CA cells’ morphology are investigated. The Nod‐like receptor pyrin‐containing protein 6 (NLRP6) inflammasome, inflammatory cytokines, and antimicrobial peptides (AMPs) production are evaluated in intestinal epithelial cells pre‐treated with bacteria, bacterial med, and bacterial supernatant and exposed without or with CA. Both bacteria significantly prohibit CA numbers, while only FP and FP supernatant prohibit the transformation and virulence factors (extracellular phospholipase, secreted aspartyl proteinase, and hemolysin) secretion of CA in a co‐culture system compared with media controls. Further, FP and FP supernatant promote the production of the NLRP6 inflammasome, interleukin (IL)‐1β, IL‐18, and antibacterial peptides (β‐defensin (BD)‐2 and BD‐3) and inhibit in vitro and in vivo CA growth and pathogenicity, and alleviate DSS‐colitis in mice, while EC do not show the similar effect.

Conclusion

FP improve intestinal inflammation by inhibiting CA reproduction, colonization, and pathogenicity and inducing AMP secretion in the gut. This study uncovers new relationships between intestinal microbes and fungi in IBD patients.
International Continence Society white paper on ethical considerations in older adults with urinary incontinence
Authors: Suskind Anne M. , Vaittinen Tiina , Gibson William , Hajebrahimi Sakineh , Ostaszkiewicz Joan , Davis Nina , Dickinson Tamara , Spencer Martha , Wagg Adrian
Published: September 2021

Urinary incontinence is a common problem among older adults that is often complicated by many nuanced ethical considerations. Unfortunately, there is a lack of guidance for healthcare professionals on how to navigate such concerns. This International Continence Society white paper aims to provide healthcare professionals with an ethical framework to promote best care practices in the care of older adults with urinary incontinence.
Comparison of linear combination modeling strategies for edited magnetic resonance spectroscopy at 3 T
Authors: Zöllner Helge J. , Tapper Sofie , Hui Steve C. N. , Barker Peter B. , Edden Richard A. E. , Oeltzschner Georg
Published: September 2021

J‐difference‐edited spectroscopy is a valuable approach for the in vivo detection of γ‐aminobutyric‐acid (GABA) with magnetic resonance spectroscopy (MRS). A recent expert consensus article recommends linear combination modeling (LCM) of edited MRS but does not give specific details regarding implementation. This study explores different modeling strategies to adapt LCM for GABA‐edited MRS. Sixty‐one medial parietal lobe GABA‐edited MEGA‐PRESS spectra from a recent 3‐T multisite study were modeled using 102 different strategies combining six different approaches to account for co‐edited macromolecules (MMs), three modeling ranges, three baseline knot spacings, and the use of basis sets with or without homocarnosine. The resulting GABA and GABA+ estimates (quantified relative to total creatine), the residuals at different ranges, standard deviations and coefficients of variation (CVs), and Akaike information criteria, were used to evaluate the models' performance. Significantly different GABA+ and GABA estimates were found when a well‐parameterized MM3cobasis function was included in the model. The mean GABA estimates were significantly lower when modeling MM3co, while the CVs were similar. A sparser spline knot spacing led to lower variation in the GABA and GABA+ estimates, and a narrower modeling range—only including the signals of interest—did not substantially improve or degrade modeling performance. Additionally, the results suggest that LCM can separate GABA and the underlying co‐edited MM3co. Incorporating homocarnosine into the modeling did not significantly improve variance in GABA+ estimates. In conclusion, GABA‐edited MRS is most appropriately quantified by LCM with a well‐parameterized co‐edited MM3cobasis function with a constraint to the nonoverlapped MM0.93, in combination with a sparse spline knot spacing (0.55 ppm) and a modeling range of 0.5–4 ppm.
The use of uncertain exposure—A method to define switching and add‐on in pharmacoepidemiology
Authors: Pazzagli Laura , Linder Marie , Reutfors Johan , Brandt Lena
Published: September 2021

Purpose

When defining exposure to pharmacological treatments in pharmacoepidemiology, register data often do not provide information regarding if a pharmacological treatment is a switch or an add‐on. This study aims to compare two methods defining switching and add‐on therapies and their impact on exposure‐outcome associations. Additionally, to guide bias reduction, it aims to describe how the methods relate to immortal time bias and selection bias.

Methods

Cohort study using Swedish population‐based health registers to identify antidepressant (AD) prescriptions as exposures while hospitalizations for psychiatric reasons were used as an empirical outcome example. The first method for exposure definition used conditioning on future exposure (FE), the second used the concept of uncertain exposure (UE). To estimate associations between outcome and exposure categories “Use of one AD,” “Use of two or more ADs”, and “UE” compared to “Unexposed,” hazard ratios (HRs) and 95% confidence intervals were estimated using Cox regression adjusted for age and sex.

Results

Using the UE method, 7.2% of time periods were classified as “UE” with a notable proportion of psychiatric hospitalizations (7.7%) occurring during this time, while when using the FE method these hospitalizations were distributed over unexposed time and AD use time. The FE method resulted in slightly higher associations than the UE method. The highest HR was found during “UE”: HR (95% CI) 5.54 (5.06–6.07).

Conclusions

This study suggests that to reduce the potential immortal time bias, selection bias, and exposure misclassification inherent to the FE method, the UE method could be used for identifying switching and add‐on therapies. If not used as a main exposure definition, the UE method may be used to investigate the impact of UE time in a sensitivity analysis.
Use of oral tetracyclines in the treatment of adult outpatients with skin and skin structure infections: Focus on doxycycline, minocycline, and omadacycline
Authors: Bidell Monique R. , Lodise Thomas P.
Published: September 2021

Oral tetracyclines have been used in clinical practice for over 60 years. One of the most common indications for use of oral tetracyclines is for treatment of adult outpatients with skin and soft infections (SSTIs), including acute bacterial skin and skin structure infections (ABSSSIs). The 2014 Infectious Diseases Society of America (IDSA) skin and soft tissue guideline strongly recommends sulfamethoxazole/trimethoprim, clindamycin, and tetracyclines as oral treatment options for patients with purulent SSTIs, especially when methicillin‐resistant Staphylococcus aureus is of clinical concern. Despite the long‐standing use of tetracyclines, practice patterns indicate that they are often considered after other guideline‐concordant oral options for the treatment of patients with SSTIs. Clinicians may therefore be less familiar with the clinical data associated with use of commercially available tetracycline agents for treatment of patients with SSTI. This review summarizes the literature on the use of oral tetracyclines (ie, doxycycline, minocycline, and omadacycline) for the treatment of adult patients with SSTIs. As part of this review, we describe their common mechanisms of resistance, susceptibility profiles against common SSTI pathogens, pharmacokinetics and pharmacodynamics, and comparative clinical data.
A consensus statement on the use of botulinum toxin in pediatric patients
Authors: Vova Joshua A. , Green Michael M. , Brandenburg Joline E. , Davidson Loren , Paulson Andrea , Deshpande Supreet , Oleszek Joyce L. , Inanoglu Didem , McLaughlin Matthew J.
Published: September 2021

Botulinum toxin has been used in medicine for the past 30 years. However, there continues to be controversy about the appropriate uses and dosing, especially in the pediatric population. A panel of nine pediatric physiatrists from different regions and previous training programs in the United States were nominated based on institutional reputation and botulinum toxin (BoNT) experience. Based on a review of the current literature, the goal was to provide the rationale for recommendations on the administration of BoNT in the pediatric population. The goal was not only to review safety, dosing, and injection techniques but also to develop a consensus on the appropriate uses in the pediatric population. In addition to upper and lower limb spasticity, the consensus also provides recommendations for congenital muscular torticollis, cervical dystonia, sialorrhea, and brachial plexus palsies.
Shock Initiation Investigation of a Pressed Trinitrotoluene Explosive
Authors: Du Lixiaosong , Jin Shaohua , Liu Zhiyue , Li Lijie , Wang Mengxia , Nie Pengsong , Wang Junfeng
Published: September 2021

The shock initiation process of a pressed trinitrotoluene (TNT) at density of 1.563 g cm−3 was studied by manganese‐copper gauge measurement experiments as well as numerical simulation for assessing the performance and detonation growth characteristics in such pressed samples. Through gap test, the shock pressure histories at different inner positions of the target TNT charges were measured. The parameterization on shock initiation model proposed by Lee & Tarver for numerical simulation were accomplished. The equation of state for unreacted explosive in the model was obtained by fitting Hugoniot data calculated from molecular dynamic simulation and shock temperature based on Walsh's solution. The equation of state for the detonation products was theoretically predicted by EXPLO5. Combining those procedures, the ignition and growth model for a pressed TNT was accurately parameterized together with experimental pressure history data. Experiment and simulation indicate that when the input pressures are 6.13 GPa and 8.67 GPa, respectively, the corresponding run distances to detonation are >9 mm and 6 mm. The calculated pressure growth histories at different inner positions of the pressed TNT sample can well reproduce the correspondingly measured values. The determined ignition and growth model will be expected to put in use in subsequent simulation analysis with complex geometrical scenarios.
Destabilization of polar interactions in the prion protein triggers misfolding and oligomerization
Authors: Bhate Suhas H. , Udgaonkar Jayant B. , Das Ranabir
Published: September 2021

The prion protein (PrP) misfolds and oligomerizes at pH 4 in the presence of physiological salt concentrations. Low pH and salt cause structural perturbations in the monomeric prion protein that lead to misfolding and oligomerization. However, the changes in stability within different regions of the PrP prior to oligomerization are poorly understood. In this study, we have characterized the local stability in PrP at high resolution using amide temperature coefficients (TC) measured by nuclear magnetic resonance (NMR) spectroscopy. The local stability of PrP was investigated under native as well as oligomerizing conditions. We have also studied the rapidly oligomerizing PrP variant (Q216R) and the protective PrP variant (A6). We report that at low pH, salt destabilizes PrP at several polar residues, and the hydrogen bonds in helices α2 and α3 are weakened. In addition, salt changes the curvature of the α3 helix, which likely disrupts α2–α3 contacts and leads to oligomerization. These results are corroborated by the TC values of rapidly oligomerizing Q216R‐PrP. The poly‐alanine substitution in A6‐PrP stabilizes α2, which prevents oligomerization. Altogether, these results highlight the importance of native polar interactions in determining the stability of PrP and reveal the structural disruptions in PrP that lead to misfolding and oligomerization.
Has the risk of a 1976 north‐west European summer drought and heatwave event increased since the 1970s because of climate change?
Authors: Baker Laura , Shaffrey Len , Hawkins Ed
Published: September 2021

In the summer of 1976, north‐west Europe experienced an exceptional heatwave and drought, which impacted agriculture and public water supply. This study aims to assess how the likelihood of the event in the present‐day climate has changed since 1976 because of climate change. The analysis focuses on the England and Wales region, which was particularly badly impacted. Three key factors contributing to the extreme summer were identified: the dry preceding winter–spring period, the dry summer and the hot summer. Following the principles of event attribution, three methods are used to evaluate the change in event risk: one using observational data, a second using CMIP5 coupled climate models and a third using HadGEM3‐A atmosphere‐only simulations. This is the first time that this method has been used to evaluate how the risk of a historical extreme event has changed since it originally occurred. The results from the three methods agree qualitatively. The probability of a summer at least as hot as 1976 has increased significantly between the 1970s and the present‐day climate (estimated risk ratios 11 (5–95% confidence interval (CI) [7,14]), 9 (CI [4,28]) and 19 (CI [5,25]) based on the three respective methods). In contrast, no significant change in the probability of an extreme dry winter–spring or an extreme dry summer was found. However, the joint probability of an extreme dry winter–spring followed by an extreme hot summer and the probability of an extreme hot and dry summer have both increased significantly between the 1970s and the present day (estimated risk ratios between 5 and 79, and between 3 and 39, respectively). Water resource systems should therefore be robust enough to cope with more frequent occurrences of summers as extreme as 1976.
Robustness of the one‐class Peeling method to the Gaussian Kernel Bandwidth
Authors: Lee Lina , Weese Maria L. , Martinez Waldyn G. , Jones‐Farmer L. Allison
Published: September 2021

The One Class Peeling (OCP) method is an outlier detection method for Phase I analysis of large multivariate samples. The two stage OCP method is based on support vector data description and employs the Gaussian kernel function to create sequential flexible boundaries to peel away observations to estimate the center of a data set. Subsequently the distance from that estimated center is used as the monitoring statistic. In this work we study the effect of the bandwidth parameter for the Gaussian Kernel on the performance of the OCP method. We find that the OCP method is robust to the value of the bandwidth parameter in terms of in‐control and out‐of‐control simulation performance. We verify these results on example data. The result is a recommendation for a small value of the bandwidth value, providing a computational advantage to the OCP method.
Notably small bronchial carcinoid accompanied by peripheral squamous cell carcinoma
Authors: Miura Hiroyuki , Miura Jun , Goto Shinichi , Tachibana Keisei , Yamamoto Tomoko
Published: September 2021

Our report presents the smallest bronchial carcinoid thus far associated with peripheral squamous cell carcinoma. A 79‐year‐old Japanese man presented with an abnormal shadow on chest radiography. Chest computed tomography revealed an ill‐defined nodule at the left S9a area without lymph node involvement. At the time of bronchoscopy, a nodule of ~1 mm in diameter with a smooth surface was observed at the orifice of the left B8. Left lower lobectomy was performed. Pathologically, the S9a tumour was keratinizing squamous cell carcinoma with surgical stage IA3, and the left B8 tumour was a typical bronchial carcinoid. The patient was alive without recurrence 2 years after the surgery. Cases of combined carcinoid and lung cancer are rare. It may be possible to identify bronchial carcinoids early by careful observation of the bronchi during bronchoscopy for peripheral neoplastic lesions.
Efficacy and secondary infection risk of tocilizumab, sarilumab and anakinra in COVID‐19 patients: A systematic review and meta‐analysis
Authors: Peng Jingwen , Fu Meihua , Mei Huan , Zheng Hailin , Liang Guanzhao , She Xiaodong , Wang Qiong , Liu Weida
Published: September 2021

As the pandemic progresses, the pathophysiology of coronavirus disease 2019 (COVID‐19) is becoming clearer and the potential for immunotherapy is increasing. However, clinical efficacy and safety of immunosuppressants (including tocilizumab, sarilumab and anakinra) treatment in COVID‐19 patients are not yet known. We searched PubMed, Embase Medline, Web of Science and MedRxiv using specific search terms in studies published from 1 January 2020 to 20 December 2020. In total, 33 studies, including 3073 cases and 6502 controls, were selected for meta‐analysis. We found that immunosuppressant therapy significantly decreased mortality in COVID‐19 patients on overall analysis (odds ratio = 0.71, 95% confidence interval = 0.57–0.89, p = 0.004). We also found that tocilizumab and anakinra significantly decreased mortality in patients without any increased risk of secondary infection. In addition, we found similar results in several subgroups. However, we found that tocilizumab therapy significantly increased the risk of fungal co‐infections in COVID‐19 patients. This represents the only systematic review and meta‐analysis to investigate the efficacy and secondary infection risk of immunosuppressant treatment in COVID‐19 patients. Overall, immunosuppressants significantly decreased mortality but had no effect on increased risk of secondary infections. Our analysis of tocilizumab therapy showed a significantly increased risk of fungal co‐infections in these patients.
Proportional‐derivative controller design of continuous‐time positive linear systems
Authors: Liu Jason J. R. , Yang Nachuan , Kwok Ka‐Wai , Lam James
Published: September 2021

This article focuses on the design of proportional‐derivative (PD) controllers for positive linear systems in the continuous‐time domain, which is a well‐known open problem in positive systems theory. The main objective is to design a PD controller subject to interval gain variations, which simultaneously preserves the closed‐loop system stability and positivity. The provided results fill the literature gap by considering both the PD controller structure and positivity. Although various feedback control strategies of positive systems have been developed recently, the work provides, for the first time, a systematic and tractable framework for finding nonfragile PD controller gains for positive stabilization. Finally, the theory and algorithm performance are evaluated and illustrated by numerical examples.
Significantly Enhanced Photocatalytic CO2 Reduction by Surface Amorphization of Cocatalysts
Authors: Chen Qin , Mo Weihao , Yang Guodong , Zhong Shuxian , Lin Hongjun , Chen Jianrong , Bai Song
Published: September 2021

Rational phase engineering of reduction cocatalyst offers a promising route to modulate the photocatalytic activity and selectivity in the conversion of CO2 to chemical feedstocks. However, it remains a great challenge to choose a suitable phase given that high‐crystallinity phase is more conducive to the charge transfer and separation, while amorphous phase is more favorable for the adsorption and activation of CO2 molecules. To resolve this dilemma, herein, with Pd as a well‐defined model, a surface amorphization strategy has been developed to fabricate crystalline@amorphous semi‐core‐shell cocatalysts based on the transformation of outer layer atoms of crystalline cocatalysts to disorder phase. According to the theoretical and experimental analysis, in the heterostructured cocatalysts, crystalline core shuttles the photoexcited electrons from light‐harvesting semiconductor to amorphous shell due to its strong electronic coupling with both components. Meanwhile, amorphous shell provides efficient active sites for preferential activation and conversion of CO2 and suppression of undesirable proton reduction. Benefiting from the synergistic effects between crystalline core and amorphous shell, the optimized heterophase cocatalyst with suitable thickness of amorphous shell achieves superior CO (22.2 µmol gcat−1 h−1) and CH4 (38.1 µmol gcat−1 h−1) formation rates with considerable selectivity and high stability in comparison with crystalline and amorphous counterparts.
Multifunctional Thermoresponsive Microcarriers for High‐Throughput Cell Culture and Enzyme‐Free Cell Harvesting
Authors: Dabiri Seyed Mohammad Hossein , Samiei Ehsan , Shojaei Shahla , Karperien Lucas , Khun Jush Bardia , Walsh Tavia , Jahanshahi Maryam , Hassanpour Sadegh , Hamdi David , Seyfoori Amir , Ahadian Samad , Khademhosseini Ali , Akbari Mohsen
Published: September 2021

An effective treatment of human diseases using regenerative medicine and cell therapy approaches requires a large number of cells. Cultivation of cells on microcarriers is a promising approach due to the high surface‐to‐volume ratios that these microcarriers offer. Here, multifunctional temperature‐responsive microcarriers (cytoGel) made of an interpenetrating hydrogel network composed of poly(N‐isopropylacrylamide) (PNIPAM), poly(ethylene glycol) diacrylate (PEGDA), and gelatin methacryloyl (GelMA) are developed. A flow‐focusing microfluidic chip is used to produce microcarriers with diameters in the range of 100–300 μm and uniform size distribution (polydispersity index of ≈0.08). The mechanical properties and cells adhesion properties of cytoGel are adjusted by changing the composition hydrogel composition. Notably, GelMA regulates the temperature response and enhances microcarrier stiffness. Human‐derived glioma cells (U87) are grown on cytoGel in static and dynamic culture conditions with cell viabilities greater than 90%. Enzyme‐free cell detachment is achieved at room temperature with up to 70% detachment efficiency. Controlled release of bioactive molecules from cytoGel is accomplished for over a week to showcase the potential use of microcarriers for localized delivery of growth factors to cell surfaces. These microcarriers hold great promise for the efficient expansion of cells for the industrial‐scale culture of therapeutic cells.