bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of individualized learning plans on nurse learning outcomes and risk mitigation
Authors: Cusanza Sharon A. , Speroni Karen Gabel , Curran Carol A. , Azizi Dawer
Published: September 2020

Introduction

A “Primary Learner Assessment” (PLA) was created to provide an individualized learning plan, offering education as part of a 4‐step computer‐based process. The PLA is intended to improve learner's knowledge, skills, and patient safety perceptions, regarding interpretation of electronic fetal monitoring (EFM) data and administration of appropriate interventions in a timely fashion to mitigate fetal and maternal risks. Research was conducted to determine if learner knowledge, skills, and patient safety perceptions improved after completion of a 4‐step computer‐based, individualized adaptive‐learning process.

Methods

Participants were registered nurses (RNs) responsible for administering and interpreting EFM, from three U.S. hospitals with labor and delivery units. This mixed method pilot study was determined to be exempt by the institutional review board; all participants provided consent. The process included four steps. In step one, RNs completed the baseline PLA. Based on incorrect quantitative and EFM interpretation responses, computer‐based EFM education courses were recommended (step two). After completion of recommended courses weeks or greater of practice (step three), the RNs completed a follow‐up PLA (step four).

Results

Of the 55 RN participants, most (85.5%) were clinical nurses, had a bachelor degree in nursing or higher (80.0%), and 11.2 average years of labor and delivery experience. There was a statistically significant improvement (P < .0001) in overall average percentage of correct PLA scores from baseline (76.7, SD = 9.1) to follow‐up (82.5, SD = 6.9). Practice‐related perceptions showed increased ranking of familiarity with the National Institute of Child Health and Human Development (NICHD) 2008 EFM terminology and guidelines from baseline of 49.0% to follow‐up of 87.4% and of impact to which the participants integrated EFM administration and interpretation of NICHD EFM terminology and guidelines into practice from 52.8% at baseline to 94.5% at follow‐up. In addition, RNs perceived improvement in their oxygen therapy competence and accuracy in interpreting EFM data with implementation of appropriate interventions.

Conclusion

These pilot study findings support a 4‐step, computer‐based individualized adaptive‐learning process as RNs responsible for EFM to potentially mitigate fetal and maternal risk had improved knowledge and skills. Research is warranted in larger samples.
Morphology of the avian yolk sac
Authors: Starck J. Matthias
Published: September 2020

The avian yolk sac is a multifunctional extraembryonic organ that serves not only as a site of nutrient (yolk) absorption, but also for early hemopoiesis, and formation of blood vessels. Although the yolk sac membrane being specialized to function as an extraembryonic absorptive organ, it is neither morphologically nor functionally part of the embryonic gut. Yolk absorption is by the phagocytic activity of the extraembryonic endoderm. I used cryohistology and resin embedding histology of complete developmental series of Japanese quail to document the development of the avian yolk sac and changes of the microscopic anatomy throughout development. This material is complemented by complete series of MRT‐scans of live ostrich embryos from beginning of incubation through hatching. Considerable changes of size and shape of the yolk mass are documented and discussed as resulting from water flux from albumen to yolk associated with the biochemical activation of yolk sac proteins. During embryogenesis, the yolk sac endoderm forms villi that increase the absorptive surface and reach into the yolk ball. The histology of the absorptive epithelium is specialized for phagocytic absorption of yolk. During early developmental stages, the extraembryonic endoderm is single layered, but it eventually becomes several layers thick during later stages. The extraembryonic mesoderm forms an extensive layer of hematopoietic tissue; deep in this tissue lie the yolk sac vessels. During late stages of development, the erythropoietic tissue disappears, blood vessels are obliterated, and the yolk sac epithelium becomes apoptotic. Results are discussed in the light of the evolutionary history and phylogeny of the amniote egg.
Study of the effects of ultrafine carbon black on the structure and function of trypsin
Authors: Li Xiangxiang , Huo Mengling , Zhao Lining , Cao Zhaozhen , Xu Mengchen , Wan Jingqiang , Niu Qigui , Huo Chenqian , Tang Jingchun , Liu Rutao
Published: September 2020

Due to the rapid development of industrial society, air pollution is becoming a serious problem which has being a huge threat to human health. Ultrafine particles (UFPs), one of the major air pollutants, are often the culprits of human diseases. At present, most of the toxicological studies of UFPs focus on their biological effects on lung cells and tissues, but there are less researches taking aim at the negative effects on functional proteins within the body. Therefore, we experimentally explored the effects of ultrafine carbon black (UFCB) on the structure and function of trypsin. After a short‐term exposure to UFCB, the trypsin aromatic amino acid microenvironment, protein backbone and secondary structure were changed significantly, and the enzyme activity showed a trend that rose at first, then dropped. In addition, UFCB interacts with trypsin in the form of a complex. These studies demonstrated the negative effects of UFCB on trypsin, evidencing potential effects on animals and humans.
Systemic lupus erythematosus and varicella‐like rash following COVID‐19 in a previously healthy patient
Authors: Slimani Yasmine , Abbassi Reda , El Fatoiki Fatima‐Zohra , Barrou Lahoucine , Chiheb Soumiya
Published: September 2020

Emerging reports show that coronavirus disease 2019 (COVID‐19) may lead to autoimmune and autoinflammatory diseases. However, COVID‐19 triggered systemic lupus erythematosus (SLE) has never been reported to our knowledge. COVID‐19 also has associated cutaneous manifestations. Here we present a case of SLE with antiphospholipid antibody syndrome in a previously healthy patient with COVID‐19, who subsequently developped a varicella‐like exanthem on the trunk. The disease resulted in death of the patient. The pathophysiological mechanisms resulting in overlapping disorders in our patient remain unknown, adding to the growing mystery of this virus and raising questions about the nature of its link with cutaneous, autoimmune, and autoinflammatory manifestations. Sharing the images of this case may benefit physicians dealing with similar patients during this pandemic.
The effects of internal jugular vein compression for modulating and preserving white matter following a season of American tackle football: A prospective longitudinal evaluation of differential head impact exposure
Authors: Diekfuss Jed A. , Yuan Weihong , Barber Foss Kim D. , Dudley Jonathan A. , DiCesare Christopher A. , Reddington Danielle L. , Zhong Wen , Nissen Katharine S. , Shafer Jessica L. , Leach James L. , Bonnette Scott , Logan Kelsey , Epstein Jeffery N. , Clark Joseph , Altaye Mekibib , Myer Gregory D.
Published: September 2020

The purpose of this clinical trial was to examine whether internal jugular vein compression (JVC)—using an externally worn neck collar—modulated the relationships between differential head impact exposure levels and pre‐ to postseason changes in diffusion tensor imaging (DTI)‐derived diffusivity and anisotropy metrics of white matter following a season of American tackle football. Male high‐school athletes (n = 284) were prospectively assigned to a non‐collar group or a collar group. Magnetic resonance imaging data were collected from participants pre‐ and postseason and head impact exposure was monitored by accelerometers during every practice and game throughout the competitive season. Athletes' accumulated head impact exposure was systematically thresholded based on the frequency of impacts of progressively higher magnitudes (10 g intervals between 20 to 150 g) and modeled with pre‐ to postseason changes in DTI measures of white matter as a function of JVC neck collar wear. The findings revealed that the JVC neck collar modulated the relationships between greater high‐magnitude head impact exposure (110 to 140 g) and longitudinal changes to white matter, with each group showing associations that varied in directionality. Results also revealed that the JVC neck collar group partially preserved longitudinal changes in DTI metrics. Collectively, these data indicate that a JVC neck collar can provide a mechanistic response to the diffusion and anisotropic properties of brain white matter following the highly diverse exposure to repetitive head impacts in American tackle football. Clinicaltrials.gov: NCT# 04068883.
Analysis of spatial changes of extreme precipitation and temperature in Iran over a 50‐year period
Authors: Alavinia Seyed Hassan , Zarei Mahdi
Published: September 2020

This research was carried out to determine whether the changes in precipitation and temperature trend in Iran are attributed to climate change or natural climate variability. The trend and its magnitude with the climatic extremes indices considered by Expert Team on Climate Change Detection and Indices were analysed based on the quality‐controlled daily data of 37 meteorological stations by nonparametric Mann–Kendall test and Sen's slope method from 1966 to 2015. Results indicated that TXx, TNn, the average maximum, and minimum temperature indices have increased with a significant trend in most parts of Iran. The minimum temperatures (TNn and annual Tmin) were increased more rapidly than maximum temperatures (TXx and annual Tmax) and rising temperatures have occurred in northern latitude and western regions more than elsewhere. As a result, the temperature increase leads to changes in seasons and season length; and reduces the growing season of a variety of plants. On the other hand, the MK test detected an insignificant trend of PRCPTOT, R10, R20, and R95p, in most of the stations. The observations showed that CDD had no trend and consecutive wet day had a significant decreasing trend; subsequently, SDII has increased. Besides, RX1day and RX5day indices have gradually decreased, so that Max5‐day has not shown any trend during 1966–2015. Wet day precipitation as well as number of heavy and very heavy precipitation days tend to decrease across the study area. The west and northwest of the country have a more significant trend of precipitation indices. Overall, temperature extreme indices are increasing and precipitation indices are decreasing, which may largely be due to the natural climate variability or urban heat island. Given that climate change is a trans‐regional phenomenon, it is important to examine the climate of neighbouring countries during the same period, as well. Generally, the findings could provide helpful information for agriculture and food security, water, and eco‐social‐environmental planners.
Spatiotemporal freeze–thaw variations over the Qinghai‐Tibet Plateau 1981–2017 from reanalysis
Authors: Qin Yanhui , Wu Tonghua , Zhang Peng , Liu Wenfeng , Xue Shanbin , Guo Zonghe
Published: September 2020

The thawing and freezing conditions on the Qinghai‐Tibet Plateau (QTP) are considered effective indicators that are widely used in ecology, climate change, cold‐region engineering design, and permafrost mapping. The purpose of this study is to utilize reanalysis to detect spatial variations in freeze–thaw conditions across the QTP from 1981–2017. From a comparison of five recent reanalysis models (MERRA2: National Aeronautics and Space Administration Modern‐Era Reanalysis for Research and Applications, Version 2; ERA: European Center for Medium‐Range Weather Forecasts Interim Reanalysis; GLDAS: Global Land Data Assimilation System NOAH; CFS: National Centers for Environmental Prediction Climate Forecast System Reanalysis, Version 2; and CMFD: China Meteorological Forcing Dataset) against existing sparse observations of 2‐m surface air temperature (SAT), we find that NASA MERRA2 dataset is the most applicable to the QTP. Then, the MERRA2 SAT dataset was selected for this study and was corrected and validated by utilizing calibration models built from the observed data. The results revealed that the correlation coefficients between the corrected MERRA2 SAT and meteorological station observed data increased from 0.52 to 0.93, 0.49 to 0.90, 0.56 to 0.93, and 0.69 to 0.93 in spring, summer, autumn, and winter, respectively. The corrected parameters performed better in the southern and southeastern portions of the QTP. Finally, we utilize the corrected MERRA2 dataset to develop freeze–thaw indices and evaluate statistical trends. We find that relatively high air freezing indices are one of the important factors for the presence of permafrost in the central and northeastern portions of the QTP. Trends in the air thawing and freezing indices in the permafrost and seasonally frozen ground regions indicate that, from 1981 to 2017 in the permafrost regions, the warming was more significant in the summer than in the other seasons. However, the winter warming rates in permafrost and seasonally frozen ground regions are almost the same.
Prevention of the rise in plasma cholesterol and glucose levels by kaki‐tannin and characterization of its bile acid binding capacity
Authors: Nishida Saki , Katsumi Naoya , Matsumoto Kenji
Published: September 2020

BACKGROUND

Bile acid‐binding agents, such as cholestyramine and colesevelam, improve both cholesterol and glucose metabolism. Kaki‐tannin, a polymerized condensed tannin derived from persimmon (Diospyros kaki), has been shown to have bile acid‐binding capacity and a hypocholesterolemic effect. However, its effects on glucose metabolism have not been well studied, and the binding selectivity of kaki‐tannin to bile acid molecules has not been reported.

RESULTS

In vivo experiments using mice with high‐fat diet‐induced obesity showed that kaki‐tannin intake (20 g kg−1 of the diet) increased fecal bile acid excretion by 2.3‐fold and prevented a rise in plasma cholesterol levels and fasting plasma glucose levels. Kaki‐tannin also suppressed the development of impaired glucose tolerance. To characterize the bile acid‐binding capacity of kaki‐tannin, we investigated its capacity to bind to eight types of bile acid and cholesterol in vitro. Kaki‐tannin showed strong capacity to bind to lithocholic acid (85.5%), which has one hydroxy group. It also showed moderate capacity to bind to bile acids with two hydroxy groups (53.3%), followed by those with three hydroxy groups (39.0%), but kaki‐tannin did not show binding capacity to cholesterol. These results suggest that the binding capacity of kaki‐tannin to bile acids tends to decrease as the number of hydroxy groups increases. Interestingly, the binding capacity of kaki‐tannin correlated with that of cholestyramine (correlation coefficient: r = 0.900).

CONCLUSION

Our findings indicate that kaki‐tannin binds preferentially to bile acids with fewer hydroxy groups and has beneficial effects on glucose metabolism as well as cholesterol metabolism. © 2020 Society of Chemical Industry
Evaluation of Dianhong black tea quality using near‐infrared hyperspectral imaging technology
Authors: Ren Guangxin , Wang Yujie , Ning Jingming , Zhang Zhengzhu
Published: September 2020

BACKGROUND

Tea (Camellia sinensis L) is a highly nutritious beverage with commercial value globally. However, it is at risk of economic fraud. This study aims to develop a powerful evaluation method to distinguish Chinese official Dianhong tea from various other categories, employing hyperspectral imaging (HSI) technology and chemometric algorithms.

RESULTS

Two matrix statistical algorithms encompassing a gray‐level co‐occurrence matrix (GLCM) and a gradient co‐occurrence matrix (GLGCM) are used to extract HSI texture data. Three novel spectral variable screening methods are utilized to select wavenumbers of near‐infrared (NIR) spectra: iteratively retaining informative variables (IRIV), interval random frog, and variable combination population analysis. Feature fusion of image texture characteristics and spectra data are the eigenvectors for model building. Authentic classification models are constructed using the extreme learning machine approach and the least squares support vector machine (LSSVM) approach, coupling them with features from wavelength extraction techniques for assessing the quality of Dianhong black tea. The results demonstrate that the LSSVM model using fused data (IRIV + GLGCM) provides the best results and achieves a predictive precision of 99.57%.

CONCLUSION

This study confirms that HSI coupled with LSSVM is effective in differentiating authentic Dianhong black tea samples. © 2020 Society of Chemical Industry
Dietary stevioside supplementation increases feed intake by altering the hypothalamic transcriptome profile and gut microbiota in broiler chickens
Authors: Jiang Jingle , Qi Lina , Lv Zengpeng , Wei Quanwei , Shi Fangxiong
Published: September 2020

BACKGROUND

Stevioside (STE) is a widely used sweetener. Despite the fact that chickens are insensitive to sweetness, dietary STE supplementation could increase the feed intake of broiler chickens. Stevioside might regulate the feeding behavior through functional mechanisms other than its high‐potency sweetness. The present study was aimed to elucidate the potential sweetness‐independent mechanism of an STE‐induced orexigenic effect using the broiler chicken and considering the hypothalamic transcriptome profile and gut microbiome.

RESULTS

The analysis of RNA‐Seq identified 398 differently expressed genes (160 up‐regulated and 238 down‐regulated) in the hypothalamus of the STE‐supplemented group compared with the control group. Cluster analysis revealed several appetite‐related genes were differentially expressed, including NPY, NPY5R, TSHB, NMU, TPH2, and DDC. The analysis of 16S rRNA sequencing data also indicated that dietary STE supplementation increased the relative abundance of Lactobacillales, Bacilli, Lactobacillus, and Lactobacillaceae. Meanwhile, the proportion of Ruminococcaceae, Lachnospiraceae, Clostridia, and Clostridiales was decreased after dietary supplementation with STE.

CONCLUSION

Dietary STE supplementation promoted feed intake through the regulation of the hypothalamic neuroactive ligand‐receptor interaction pathway and the alteration of intestinal microbiota composition. This study provides valuable information about the sweetness‐independent mechanism of the STE‐induced orexigenic effect using the broiler chicken (which is insensitive to sweetness) as the animal model. © 2020 Society of Chemical Industry
Utilization of chemoradiation therapy provides strongest protective effect for avoidance of postoperative pancreatic fistula following pancreaticoduodenectomy: A NSQIP analysis
Authors: Mangieri Christopher W. , Strode Matthew A. , Moaven Omeed , Clark Clancy J. , Shen Perry
Published: September 2020

Background

The utilization of neoadjuvant therapy (NAT) before performing pancreaticoduodenectomy for malignancy has been well established as a protective factor for the prevention of postoperative pancreatic fistula (POPF). However, there is a paucity of published data evaluating the specific NAT regimen that is the most protective against POPF development. We evaluated the differences between neoadjuvant chemotherapy (CT) and chemoradiation therapy (CRT) with regard to the effect on POPF rates.

Methods

The main and targeted pancreatectomy American College of Surgeons National Surgical Quality Improvement Program registries for 2014–2016 were retrospectively reviewed. A total of 10,665 pancreaticoduodenectomy cases were present. The primary outcome was POPF development. The factors that have previously been shown to be associated with or suspected to be associated with POPF were evaluated. The factors included NAT, sex, age, body mass index (BMI), diabetes, smoking, steroid therapy, preoperative weight loss, preoperative albumin level, perioperative blood transfusions, wound classification, American Society of Anesthesiologists classification, duct size (<3 mm, 3–6 mm, and >6 mm), gland texture (soft, intermediate, and hard), and anastomotic technique. The factors identified to be statistically significant were then used for propensity score matching to compare POPF development between the cases utilizing CT versus CRT.

Results

A total of 10,117 cases met the inclusion criteria. The development of POPF was significantly associated, on multivariate analysis, with a lack of NAT, male sex, higher BMI, nondiabetic status, nonsmoker status, decreased weight loss, preoperative albumin level, decreased duct size, and soft gland texture. NAT, duct size, and gland texture had the strongest associations with the development of POPF (p < .0001). The overall 1765 cases (17.45%) received NAT and the POPF rate for cases with NAT was 10.20% versus 20.10% for cases without NAT (p < .0001). A total of 1031 cases underwent CT and 734 cases underwent CRT, respectively. A total of 708 paired cases were selected for analysis based on propensity score matching. The POPF rates were 11.20% versus 3.50% for CT and CRT, respectively (p < .0001). There was no difference in the frequencies of specific POPF grades. The decreased POPF rate with CRT correlated with firmer gland texture rates.

Conclusions

To our knowledge, this is the largest analysis of specific NAT regimens with regard to the development of POPF following pancreaticoduodenectomy. CRT provided the strongest protective effect. That protective effect is most likely due to increased fibrosis in the pancreatic parenchyma from radiation therapy. These findings provide additional support to consider CRT over CT alone in the treatment of pancreatic cancer when NAT will be utilized.
Evaluation of Arterial Erectile Dysfunction Using Shear Wave Elastography
Authors: Zhou Wang , Zhang Yuyang , Li Liang , Gao Jingjing , Zheng Hui , Huang Meng , Zhao Sheng , Xie Xinxin , Zhang Chaoxue , Zhang Xiansheng
Published: September 2020

Objectives

To explore the feasibility of shear wave elastography (SWE) in the evaluation of arterial erectile dysfunction (ED).

Methods

From November 2018 to November 2019, 26 patients with arterial ED and 30 patients with non‐vascular ED were prospectively included. SWE values of corpus cavernosum penis (CCP) and the flow velocity of cavernous artery for all patients in both before intracavernous injection (ICI) (flaccid state) and after ICI (erectile state) were measured. Performance of SWE value in assessing arterial ED was studied. Correlation between SWE value of CCP and the age of patients was also investigated.

Results

ICI significantly reduced SWE values in both arterial and non‐vascular group (from 19.57 ± 6.33 KPa to 12.17 ± 3.64 KPa in the first, and from 19.91 ± 6.69 KPa to 8.04 ± 3.13 KPa in the former, both P < .001). SWE values of CCP after ICI in arterial ED were significantly larger than that in non‐vascular ED (P < .001). SWE values of CCP before ICI negatively correlated with age of patients in arterial ED (r = − 0.601, P < .001). With a cutoff value of 7.75 KPa, the area under curve, specificity, sensitivity, PPV, and NPV of SWE values of CCP after ICI in distinguishing arterial ED from non‐vascular ED were 0.810, 63.3%, 96.2%, 96.2%, and 70%, respectively.

Conclusions

SWE was expected to be a potential technique for the noninvasive, simply operated, repeatable and quantitative evaluation of arterial ED.
Kinetics of esterification of the levulinic acid with n‐hexanol, n‐octanol, and 2‐ethylhexanol in the presence of methanesulfonic acid as a catalyst under nonisothermal conditions
Authors: Hamryszak Łukasz , Grzesik Miroslaw
Published: September 2020

The levulinic acid was esterified with alcohol at an alcohol to acid molar ratio of 3:1, 5:1, and 10:1 in the presence of a 0.1 wt% methanesulfonic acid catalyst. During esterification, the temperature was changed linearly from 373 to 428 K and its average change was 4.5 K/min. The authors stated that reactions were of second order and that the activation energy (E) decreased from 61 to 46 kJ/mol in the following alcohol sequence: n‐hexanol > n‐octanol > 2‐ethylhexanol. The fitting errors varied between 3.8% and 6.4%. The time of experiment carried out under nonisothermal condition is five to 15 times shorter than that conducted under isothermal conditions. A smaller number of experimental series also determines a significantly lower cost of such research. The results of such study are the precise form of the kinetic equation, which is indispensable in design and optimization of industrial‐scale chemical reactors.
Voice‐Related Quality of Life in Idiopathic Subglottic Stenosis: Effect of Serial Intralesional Steroid Injections
Authors: Naunheim Matthew R. , Puka Elefteria , Choksawad Kanittha , Franco Ramon A.
Published: September 2020

Objectives

Serial intralesional steroid injection (SILSI) is an emerging treatment for idiopathic subglottic stenosis (ISGS), providing improvement in both subjective symptoms and objective airflow parameters. Little is known about how this airway remodeling affects the voice. This project analyzes subjective voice changes after SILSI and correlates these with airflow parameters.

Methods

An ISGS database containing voice‐related quality of life (V‐RQOL) and spirometry (peak expiratory flow percentage [%PEF]) was retrospectively queried. Included were ISGS patients from 2009 to 2019 who had at least one SILSI treatment. Encounters without complete data were excluded. Differences between preprocedure and postprocedure metrics were calculated. Correlations and nonparametric bivariate analysis were performed.

Results

Six hundred and seventeen steroid injections were performed in 55 patients, with an average of 3.5 years of follow‐up. The average V‐RQOL for all patient encounters, both pre‐ and postprocedure, showed little subjective dysphonia (83.5 of 100, 95% confidence interval [CI] 81.6 to 85.4). Considering SILSI‐only treatments, there were 143 encounters with full data; of these, V‐RQOL improved in 70 (49.0%), did not change in 40 (28.0%), and worsened in 33 (23.0%). Average V‐RQOL improvement for the entire cohort was 1.9 points (95% CI: 0.7 to 3.2), which was small but significant (P = .0003). Across all data, there was a weak but significant correlation between PEF% and V‐RQOL (ρ = 0.22, P = .0043).

Conclusion

SILSI was associated with improvement in subjective voice ratings in about half of patients, and the improvement correlated with improved airflow measurements. This research adds to the growing body of data regarding SILSI and suggests that further work on functional changes to the larynx with airway remodeling is imperative.

Level of Evidence

4 Laryngoscope, 131:366–369, 2021
Blunt Versus Penetrating Neck Trauma: A Retrospective Cohort Study
Authors: Forner David , Noel Christopher W. , Guttman Matthew P. , Haas Barbara , Enepekides Danny , Rigby Matthew H. , Nathens Avery B. , Eskander Antoine
Published: September 2020

Objectives/Hypothesis

Despite being common, neck injuries have received relatively little attention for important quality of care metrics. This study sought to determine the association between blunt and penetrating neck injuries on mortality and length of stay, and to identify additional patient and hospital‐level characteristics that impact these outcomes.

Study Design

Retrospective cohort study utilizing the American College of Surgeons Trauma Quality Improvement Program database.

Methods

Adult patients (≥18) who sustained traumatic injuries involving the soft tissues of the neck between 2012 and 2016 were eligible. Multiple imputation was used to account for missing data. Logistic regression and negative binomial models were used to analyze 1) in‐hospital mortality and 2) length of stay respectively while adjusting for potential confounders and accounting for clustering at the hospital level.

Results

In a cohort of 20,285 patients, the crude mortality rate was lower in those sustaining blunt neck injuries compared to penetrating injuries (4.9% vs. 6.0%, P < .01), while length of hospital stay was similar (median 9.9 vs. 10.2, P = 0.06). In adjusted analysis, blunt neck injuries were associated with a reduced odds of mortality during hospital admission (odds ratio: 0.66, 95% confidence intervals [0.564, 0.788]), as well as significant reductions in length of stay (rate ratio: 0.92, 95% confidence intervals [0.880, 0.954]).

Conclusions

Blunt neck injuries are associated with lower mortality and length of stay compared to penetrating injuries. Areas of future study have been identified, including elucidation of processes of care in specific organs of injury.

Level of Evidence: Level 3 Laryngoscope, 131:E1109–E1116, 2021
Associations between obesity and ocular health in Spanish adults
Authors: Jacob Louis , Smith Lee , Koyanagi Ai , Pardhan Shahina , Allen Peter , Yang Lin , Grabovac Igor , Shin Jae Il , Tully Mark A. , López‐Sánchez Guillermo F.
Published: September 2020

Introduction

Obesity has been associated with poor vascular health, but not in a Spanish population. Therefore, the study aimed to investigate associations between obesity and cataract, wearing glasses or contact lenses, and trouble seeing in a large representative sample of the Spanish adult population.

Methods

Cross‐sectional data from the Spanish National Health Survey 2017 were analyzed. Body mass index (BMI) was calculated and obesity was defined as BMI ≥ 30 kg/m2. Ocular health included three dichotomous variables (presence vs absence): self‐reported cataract, wearing glasses or contact lenses, and trouble seeing. Multivariable logistic regressions were used to assess associations between obesity (independent variable) and ocular health outcomes (dependent variables). Covariates included in the analysis were sex, age, marital status, education, smoking, alcohol, and diabetes.

Results

A total of 23 089 participants were included (54.1% female; mean [SD] age = 53.4 [18.9] years). After adjusting for sex, age, marital status, education, smoking, alcohol, diabetes, and wearing glasses or contact lenses (for the trouble seeing analysis only), obesity was found to be a risk factor for cataract (odds ratio [OR] = 1.22; 95% confidence interval [CI], 1.09‐1.37) and trouble seeing (OR = 1.20; 95% CI, 1.09‐1.32) but not for wearing glasses or contact lenses (OR = 0.99; 95% CI, 0.91‐1.08). These findings were corroborated in participants ≥64 years.

Conclusions

In this large representative sample of Spanish adults, we found that obesity was a risk factor for cataract and trouble seeing. Lifestyle interventions aiming at the reduction of obesity in this population may indirectly improve ocular health. Such lifestyle interventions are important to implement considering the rising trend of obesity in Spain.
Double Yielding in Deformation of Semicrystalline Polymers
Authors: Razavi Masoud , Wang Shi‐Qing
Published: September 2020

Different semicrystalline polymers including poly(l‐lactic acid), poly(ethylene terephthalate), syndiotactic polystyrene, and polyamide 12 are studied in terms of their mechanical response to uniaxial compression deformation. Apparent decoupling of yielding of amorphous and crystalline phases is identified as separate peaks in the stress–strain curve in the vicinity of the glass transition temperature. The same feature is also observed for the uniaxial extension of predrawn semicrystalline poly(ethylene terephthalate). It is indicated that in absence of a strong amorphous phase a semicrystalline polymer is unable to yield and undergo plastic deformation and it fails in a brittle manner in the uniaxial compression. Treating a semicrystalline polymer as a composite of amorphous and crystalline phases, putting emphasis on the crucial role of amorphous phase in acting as connectors between crystalline domains and indicating that the yielding of amorphous phase is a prerequisite for yielding of crystalline phase, work toward a better understanding of the mechanical properties of semicrystalline polymers at the molecular level is done.
Thermally Reversible Diels–Alder Bond‐Containing Acrylate Networks Showing Improved Lifetime
Authors: Maassen Eveline E. L. , Anastasio Rosaria , van Breemen Lambèrt C. A. , Sijbesma Rint P. , Heuts Johan P. A.
Published: September 2020

Photopolymerization of (meth)acrylates into highly crosslinked networks is in general accompanied by volumetric shrinkage, often leading to premature material failure. In this work, thermoreversible Diels–Alder groups are investigated to explore their effect on material lifetime. A difunctional acrylic monomer containing Diels–Alder moieties is synthesized and successfully incorporated in a polymer network by photopolymerization. It is demonstrated that upon heating above 150 °C, the Diels–Alder bonds open, yielding topological rearrangements of the network. The mechanical properties of the material after opening of the Diels–Alder moieties are investigated by tensile testing, showing a high strain‐rate dependence of the yield stress which is indicative of a longer lifetime at the higher strain rates that are prevalent in load‐bearing applications.
Preparation of Diameter‐Controlled Cellulose Aerogel Spheres via Atomization Method and Their Load Performance
Authors: Bian Hongli , Shao Ziqiang , Li Lei , Liu Jianxin , Chen Ken , Zhang Xuan
Published: September 2020

Cellulose aerogel spheres (CASs) are potential carriers due to their low‐cost and large‐scale features. In this paper, uniform CASs with precisely controlled diameters are prepared and their performance is characterized. The results show that the optimum conditions for the preparation of CASs are as follows: coagulation bath composition: Vtrichloromethane: Vethyl acetate: Vacetic acid = 10:10:3, cellulose solution concentration: 2%, and stirring rate: 500 r min−1. The CASs prepared under optimum conditions have smooth spherical surfaces with 3D inner network structures. The diameter of the CASs gradually decreases with increasing air pump pressure and can be controlled between 30 and 1500 µm. Moreover, the loading performance of the CASs with different diameter is investigated. The results show that the load capacity of the CASs for the energetic material cyclotrimethylenetrinitramine (RDX) decreases as the diameter decreases. The diameter of CASs directly determines the balance between energy density, safety performance, and energy output of energetic materials. These CASs with controllable diameters, as well as facile production method give them a series of potential applications in high energy material loading.
Littlewood–Paley–Stein operators on Damek–Ricci spaces
Authors: Fotiadis Anestis , Papageorgiou Effie
Published: September 2020

We obtain pointwise upper bounds on the derivatives of the heat kernel on Damek–Ricci spaces and we study the ‐boundedness of Littlewood–Paley–Stein operators.
The Wide Phenotypic Spectrum of L‐2 Hydroxyglutaric Aciduria in Adults
Authors: Mainka Tina , Ziagaki Athanasia , de Koning Tom J. , Kühn Andrea A. , Ganos Christos
Published: September 2020

View Supplementary Video 1, View Supplementary Video 2
Hollow fibre membrane bioreactor functionalized with GO‐cryogel 3D matrix promotes liver cell anchoring and their functional maintenance
Authors: Verma Surendra Kumar , Modi Akshay , Bellare Jayesh
Published: September 2020

The liver support system (bioartificial liver, BAL) is a potentially efficient treatment during reversible acute liver disease or while waiting for a liver transplant. The main challenge in implementing BAL is a bioreactor, which can fulfil the needs of hepatocyte culture, mass transfer and immunobarriers. In the present study, polymer nanocomposite hollow fibre membranes (HFMs) were fabricated using polyethersulphone (P) as a base polymer, vitamin E TPGS (T) as an additive and carboxylated carbon nanotubes (C) as a filler. These PTC HFMs were functionalized with cryogel (Cr), with or without carboxylated graphene oxide (G), known as PTC‐Cr or PTC‐CrG HFMs, respectively. These HFM substrates were characterized and evaluated for hemocompatibility, cytotoxicity and cellular functionality. Among all the HFM substrates, PTC‐CrG HFMs showed superior hemocompatibility and minimal cytotoxicity. Furthermore, a liver cell bioreactor was developed and studied using PTC‐CrG HFMs. The goat primary liver cells were seeded in a bioreactor and cultured in continuous mode. The cell functionality was better maintained in the continuous mode as compared to that in the batch culture. The three‐dimensional PTC‐CrG HFMs‐based bioreactor can be used for liver cell bioreactor, bioartificial liver system, drug testing/toxicology metabolic study and mass cell culture.
Liquid biopsy technologies for hematological diseases
Authors: Fu Yatian , Zhang Yiyuan , Khoo Bee Luan
Published: September 2020

Since the discovery of circulating tumor cells in 1869, technological advances in studying circulating biomarkers from patients' blood have made the diagnosis of nonhematologic cancers less invasive. Technological advances in the detection and analysis of biomarkers provide new opportunities for the characterization of other disease types. When compared with traditional biopsies, liquid biopsy markers, such as exfoliated bladder cancer cells, circulating cell‐free DNA (cfDNA), and extracellular vesicles (EV), are considered more convenient than conventional biopsies. Liquid biopsy markers undoubtedly have the potential to influence disease management and treatment dynamics. Our main focuses of this review will be the cell‐based, gene‐based, and protein‐based key liquid biopsy markers (including EV and cfDNA) in disease detection, and discuss the research progress of these biomarkers used in conjunction with liquid biopsy. First, we highlighted the key technologies that have been broadly adopted used in hematological diseases. Second, we introduced the latest technological developments for the specific detection of cardiovascular disease, leukemia, and coronavirus disease. Finally, we concluded with perspectives on these research areas, focusing on the role of microfluidic technology and artificial intelligence in point‐of‐care medical applications. We believe that the noninvasive capabilities of these technologies have great potential in the development of diagnostics and can influence treatment options, thereby advancing precision disease management.
Health service experiences among adults with hereditary spastic paraparesis or neurofibromatosis type 1
Authors: Fjermestad Krister W. , Kanavin Øivind , Nyhus Livø , Hoxmark Lise B.
Published: September 2020

Background

Persons with rare disorders may experience poorer health services due to limited knowledge about rare disorders among health professionals. Knowledge about how persons with rare disorders perceive health services can help inform service providers to enhance their practices.

Methods

We conducted a self‐report survey among adults with the rare disorders hereditary spastic paraparesis (HSP; n = 108; mean age 57.7 years; 54.2% females) and neurofibromatosis type 1 (NF1, n = 142; mean age = 50.3 years; 62.0% females). Their responses concerning perceived health experiences were compared to healthy controls from the population study HUNT‐3 (n = 7,312).

Results

Both rare disorder groups reported lower satisfaction, trust, and participation in meetings with their general practitioner and specialist health services. More reported health problems were overall associated with poorer health service experiences.

Conclusion

There is a need to identify predictors of health service experiences at the patient and health service provider levels with the aim to tighten the gap between the health experiences of patients with and without rare disorders.
Quality of life and pain in patients with thalidomide embryopathy in Japan
Authors: Imai Koubun , Sone Hanae , Otomo Ken , Nakano Yuki , Hinoshita Fumihiko
Published: September 2020

Background

The aim of this study was to assess psychological/psychiatric problems and quality of life (QOL) in patients with thalidomide embryopathy (TE), with a specific focus on pain, including pain severity and the effects of coping strategies for pain.

Methods

A questionnaire survey was conducted to evaluate the severity of pain experienced by patients with TE, pain management strategies, time perspective, mental health status, and QOL. Of 67 patients with TE who underwent a health checkup, 51 respondents who gave valid responses were included in analysis.

Results

GHQ‐28 suggested that 41.2% of respondents appeared to potentially have psychiatric disorders. The mean scores of QOL were still within a normal range. There is no significant differences were found between limb disability group and hearing impairment group in QOL or mental health status. About 82.4% of respondents reported that they experience physical pain, and the use of the cognitive coping strategy “catastrophizing” to cope with pain was significantly associated with mental health status and QOL.

Conclusion

This study demonstrate that although some patients with TE have some form of mental health problem, they still maintain a normal range QOL despite their disabilities. In addition, pain was not as strongly associated with mental health problems and QOL as would be expected, and variables such as “catastrophizing” to cope with pain appear to potentially be associated with reduced mental health and QOL.
Propagation of shock waves in a non‐ideal gas under the action of magnetic field
Authors: Singh Deepika , Arora Rajan
Published: September 2020

In this paper, we use power series method to study the propagation of cylindrical shock waves produced on account of a strong explosion in a non‐ideal gas under the influence of azimuthal magnetic field. Here, the density is assumed to be uniform and magnetic pressure is assumed to vary according to power law with distance from the symmetry axis in the undisturbed medium. Using power series method, we obtain approximate analytic solutions in the form of a power series in (a0/V )2, where a0 and V are the velocities of sound in the undisturbed medium and shock front, respectively. The first‐order and second‐order approximate solutions to the considered problem are discussed with the help of the said method. We construct solutions for the first‐order approximation in closed form. Distributions of the flow variables such as fluid velocity, density, pressure, and magnetic pressure for the first‐order approximation are analyzed graphically behind the shock front. Also, the effects of non‐ideal parameter and shock Cowling number on the flow variables are discussed. It is observed that an increase in the value of non‐ideal parameter causes fluid velocity to increase, and density, pressure, and magnetic pressure to decrease. Increase in the shock Cowling number causes decrease in density and pressure, whereas increase in fluid velocity and magnetic pressure behind the shock. Also, it is found that numerical results obtained in the absence of magnetic field recover the existing results in the literature. Further, these results are found to be in good agreement with those obtained by the Runge‐Kutta method of fourth‐order.
Enhanced efficiency of C‐band sheet beam driven backward wave oscillator guided by periodic magnetic field
Authors: Banerjee Tusharika S. , Hadap Arti , Saxena Ayush , Reddy K. T. V.
Published: September 2020

In this article we present the effect of periodic magnetic field on the efficiency of a sheet beam driven C‐band backward wave oscillator (operational in Megawatt power regime) through MAGIC3D PIC simulation. At 90 kV beam energy, 200 A beam current, and 0.6 T average magnetic field, our results depict an efficiency of nearly 70% due to improved electron beam confinement and electron bunching. A qualitative comparison is shown for efficiency through the same slow wave structure, guided by a uniform axial magnetic and the proposed periodic magnetic field. Efficiency enhancement of nearly 20% is observed in case of periodic magnetic field.
Wideband high‐gain multiresonance antenna based on polarization‐dependent metasurface
Authors: Chen Dongxu , Yang Wanchen , Xue Quan , Che Wenquan
Published: September 2020

In this article, a novel polarization‐dependent metasurface (PDMS) structure is presented and applied to realize a wideband high‐gain antenna with multiple resonances. The PDMS element is obtained by cutting slots into the square patch unit cell of conventional metasurface (MS). Very different from the conventional MS structure, the proposed PDMS element exhibits different reflection phases and resonance frequencies, depending on the polarization state of the incident plane wave. By properly tailoring the reflection‐phase curves under different polarizations, a proper PDMS structure is introduced. Then, by arranging the PDMS elements along different orientations, a multiresonance radiator can be realized. When applying the proposed radiator to the slot‐coupled MS antenna, one broadband PDMS‐based antenna with multiple adjacent resonance frequencies can be realized by the combination of coupling slot‐mode and PDMS modes. For verification, a PDMS radiator with 4 × 4 unit cells is designed accordingly and applied to realize one C‐band broadband PDMS‐based antenna in a low profile (0.06 λ0). The measured results of the fabricated prototype PDMS‐based antenna exhibit a large –10 dB impedance bandwidth of 55% (4.31‐7.58 GHz), a maximum available gain of 10.898 dBi, and a 2‐dB gain bandwidth of 30.81% (5.1‐6.96 GHz).