bluuebunny/crossref_metadata_2025 huggingface dataset:
Spin-state energetics of metallocenes: How do best wave function and density functional theory results compare with the experimental data?
Authors: Drabik Gabriela , Szklarzewicz Janusz , Radoń Mariusz
Published: November 2020

Benchmarking quantum-chemical methods against experiment-derived spin-state energetics of metallocenes.
The rise of metal–organic polyhedra
Authors: Lee Soochan , Jeong Hyein , Nam Dongsik , Lah Myoung Soo , Choe Wonyoung
Published: November 2020

Metal–organic polyhedra (MOPs) are comprehensively summarized and classified based on topology, providing new directions for MOP design and forthcoming applications.
Strategies and mechanisms of metal–ligand cooperativity in first-row transition metal complex catalysts
Authors: Elsby Matthew R. , Baker R. Tom
Published: November 2020

The use of metal–ligand cooperation (MLC) by transition metal bifunctional catalysts has emerged at the forefront of homogeneous catalysis science.
A biradical oxo-molybdenum complex containing semiquinone ando-aminophenol benzoxazole-based ligands
Authors: Nasibipour Mina , Safaei Elham , Wojtczak Andrzej , Jagličić Zvonko , Galindo Agustín , Masoumpour Marzieh Sadat
Published: November 2020

Biradical molybdenum(iv) complex,MoOLBISLSQ, has been prepared from the reaction of theo-iminosemibenzoquinone form of a tridentate non-innocent benzoxazole ligand,LBIS, and MoO2(acac)2and used as catalyst in oxidation reaction..
Three-dimensional directional nerve guide conduits fabricated by dopamine-functionalized conductive carbon nanofibre-based nanocomposite ink printing
Authors: Houshyar Shadi , Pillai Mamatha M. , Saha Tanushree , Sathish-Kumar G. , Dekiwadia Chaitali , Sarker Satya Ranjan , Sivasubramanian R. , Shanks Robert A. , Bhattacharyya Amitava
Published: November 2020

Directional growth induced by dopamine-functionalized CNF-based nanocomposite ink printing.
Cell-free protein synthesis andin situimmobilization of deGFP-MatB in polymer microgels for malonate-to-malonyl CoA conversion
Authors: Köhler Tony , Heida Thomas , Hoefgen Sandra , Weigel Niclas , Valiante Vito , Thiele Julian
Published: November 2020

We describe a bottom-up approach towards functional enzymes utilizing microgels as carriers for genetic information that enable cell-free protein synthesis,in situimmobilization, and utilization of functional deGFP-MatB.
Use of pyrazoles as ligands greatly enhances the catalytic activity of titanium iso-propoxide for the ring-opening polymerization of l-lactide: a cooperation effect
Authors: Wang Tzu-Fang , Kosuru Someswara Rao , Yu Shu-Chun , Chang Yung-Chi , Lai Hsin-Yu , Chang Yu-Lun , Wu Kuo-Hui , Ding Shangwu , Chen Hsuan-Ying
Published: November 2020

Using TiOiPr4 with a pyrazole ligand for one-pot LA polymerization improved catalytic activity compared with using TiOiPr4 only.
Hydrogenation of CO to olefins over a supported iron catalyst on MgAl2O4 spinel: effects of the spinel synthesis method
Authors: Wang Yu , Li Hou-Xing , Li Xue-Gang , Xiao Wen-De , Chen De
Published: November 2020

In the process of CO hydrogenation to olefins by the Fischer–Tropsch synthesis, the support is a key factor in the activity, selectivity, and thermal and chemical stability of the catalysts, and magnesium aluminate spinel has recently been reported to be very effective.
Selective photocatalytic oxidation of aromatic alcohols to aldehydes with air by magnetic WO3ZnO/Fe3O4. In situ photochemical synthesis of 2-substituted benzimidazoles
Authors: Li Bozhi , Tayebee Reza , Esmaeili Effat , Namaghi Mina S. , Maleki Behrooz
Published: November 2020

WO3ZnO/Fe3O4 is used as a magnetic photocatalyst in the preparation of 2-substituted benzimidazoles in EtOH at RT. The key feature is the in situ photocatalytic oxidation of benzyl alcohols to benzaldehydes under atmospheric air in the absence of further oxidant.
A trifluoromethyl-grafted ultra-stable fluorescent covalent organic framework for adsorption and detection of pesticides
Authors: Zhao Yuxiang , Sui Zhuyin , Chang Zhaosen , Wang Shunli , Liang Ying , Liu Xin , Feng Lijuan , Chen Qi , Wang Ning
Published: November 2020

A fluorine-rich ultra-stable fluorescent covalent organic framework for adsorption and detection of pesticides was designed and prepared via the Povarov reaction in a flask.
The high-yield direct synthesis of dimethyl ether from CO2 and H2 in a dry reaction environment
Authors: Li Huazheng , Ren Shoujie , Zhang Shenxiang , Padinjarekutt Surya , Sengupta Bratin , Liang Xinhua , Li Shiguang , Yu Miao
Published: November 2020

Highly efficient DME synthesis from CO2 and H2 was realized in a dry reaction environment via the incorporation of a water-conduction membrane.
Non-hydrolytic synthesis of caprylate capped cobalt ferrite nanoparticles and their application againstErwinia carotovoraandStenotrophomonas maltophilia
Authors: Johnson Morgan , Gaffney Caitlyn , White Victoria , Bechelli Jeremy , Balaraman Rajesh , Trad Tarek
Published: November 2020

Inhibition of bacterial cells by caprylate capped nanoparticles occursviaphagocytosis of the particles.
The importance of the molecular weight of PEDOT hole transporting materials for efficient organic solar cells
Authors: Fu Qingyao , Li Yuda , Wang Xunchang , Li Qi , Wang Feng , Yang Renqiang
Published: November 2020

We provide a deep insight into the PEDOT molecular weight effect on OSC performance and highlight the importance of optimizing the molecular weight for PEDOT HTLs to help realize the full potential of organic electronic devices.
Magnetic deformation of neutron stars in scalar-tensor theories
Authors: Soldateschi J. , Bucciantini N. , Del Zanna L.
Published: November 2020

Scalar-tensor theories are among the most promising alternatives to general relativity that have been developed to account for some long-standing issues in our understanding of gravity. Some of these theories predict the existence of a non-linear phenomenon that is spontaneous scalarisation, which can lead to the appearance of sizable modifications to general relativity in the presence of compact matter distributions, namely neutron stars. On the one hand, one of the effects of the scalar field is to modify the emission of gravitational waves that are due to both variations in the quadrupolar deformation of the star and the presence of additional modes of emission. On the other hand, neutron stars are known to harbour extremely powerful magnetic fields which can affect their structure and shape, leading, in turn, to the emission of gravitational waves – in this case due to a magnetic quadrupolar deformation. In this work, we investigate how the presence of spontaneous scalarisation can affect the magnetic deformation of neutron stars and their emission of quadrupolar gravitational waves, both of tensor and scalar nature. We show that it is possible to provide simple parametrisations of the magnetic deformation and gravitational wave power of neutron stars in terms of their baryonic mass, circumferential radius, and scalar charge, while also demonstrating that a universal scaling exists independently of the magnetic field geometry and of the parameters of the scalar-tensor theory. Finally, we comment on the observability of the deviations in the strain of gravitational waves from general relativity by current and future observatories.
Reproducing the Fresnel-Arago experiment to illustrate physical optics
Authors: Wenger Jérôme , Rogez Benoît , Chaigne Thomas , Stout Brian
Published: November 2020

Is there a bright spot in the shadow of an opaque disk? Nearly 200 years ago, Augustin Fresnel and François Arago’s remarkable answer to this question validated the wave theory of light and inaugurated the modern theories of diffraction. Today, their renowned experiment can be easily reproduced using lasers and cameras. Far beyond its historical interest, the experiment is a versatile platform to illustrate the main concepts of optical physics, including diffraction, interference, speckle, and Fourier optics.
Micro-lasers for neuromorphic computing
Authors: Pammi Venkata Anirudh , Barbay Sylvain
Published: November 2020

Spiking micro-lasers are interesting neuromorphic building blocks to realize all-optical spiking neural networks. Optical spike-based computing offers speed and parallelism of optical technologies combined with a sparse way of representing information in spikes, thus with a potential for efficient brain-inspired computing. This article reviews some of the latest advances in this field using single and coupled semiconductor excitable micro-lasers.
Expérimentation d’un EVE pour la co-création spatiale et pédagogique
Authors: Varano Sandro , Descamps Nicolas , Touvenot Eric
Published: November 2020

Dans la continuité du projet de recherche Dune-EOLE portant sur la transformation numérique de l’enseignement supérieur, l’ENSA Strasbourg expérimente l’utilisation d’un Environnement Virtuel Éducatif (EVE) pour la co-création spatiale et pédagogique. L’objectif est de réinterroger les modalités et espaces d’apprentissage, les pratiques pédagogiques à l’aide de dispositifs immersifs. Nous supposons que l’utilisation de la réalité virtuelle constitue une entrée à cette problématique et pourrait favoriser une forme d’autodidaxie, de collaboration entre pairs et un séquençage entre espaces physique et virtuel. L’article explicite notre approche expérimentale, menée avec des étudiants et des enseignantschercheurs, ainsi que les réflexions portant sur le rôle de l’enseignant, les modalités d’apprentissage et les systèmes de représentation.
La place des outils numériques dans l’enseignement du projet : comparaison entre une école française et une école américaine
Authors: Lescop Laurent , Chamel Olivier
Published: November 2020

Un quart de siècle est passé depuis la généralisation de l’informatique graphique dans les écoles d’architecture, une generation d’étudiants est passée et pourtant, les mêmes questions animent les equips pédagogiques sur la place à donner aux outils, à leur place et l’influence qu’ils peuvent avoir dans la conception et dans la représentation. Nous proposons ici une grille d’analyse conceptuelle et pédagogique afin de faire un état des lieux et tenter un point d’étape à ce débat.
Bodies need yoga? No plastic surgery! Naturalistic versus instrumental bodies among professions in the Danish healthcare field
Authors: Larsen Kristian , Hindhede Anette Lykke , Larsen Mikkel Haderup , Nicolaisen Mathias Holst , Henriksen Frederik Møller
Published: November 2020

What characterises the similarities and differences in body investments among professions in the Danish healthcare field? This can be important when healthcare professionals relate to each other and to bodies of patients regarding differences in class, gender, age, and disease group. The study takes inspiration from Bourdieu’s sociology and the concept of health capital. We ask whether health capital can explain distinctions in the empirical data? We used the explorative–descriptive method multicorrespondence analysis (MCA) on data from 440 respondents gathered through an online survey. The respondents range from chief physicians to healthcare students. MCA makes it possible to condense frequency statistics and examine patterns of body investments through an examination of variables such as food intake, exercise, and medicine use that are then further related to supplementary variables such as social class and age. The analysis supports the concept of health capital and shows that some groups in the Danish healthcare field have a more instrumental body perception, such as the young age group (e.g. open to surgery, consume medicine, high exercise), while the upper-middle-class and older respondents have a more naturalistic perception of the body (e.g. read often, eat vegetables, practice yoga).
The effect of Ni–Zn ferrite doping on the superconductivity of Y3Ba5Cu8O18 nanocomposite materials
Authors: Arais Ahmed Abo , Shams M. S. , Elbehiry Eslam
Published: November 2020

Nanocomposite materials of the Y3Ba5Cu8O18/(Ni0.5Zn0.5Fe2O4)x type, where x = 0.00 wt. %, 0.03 wt. %, 0.10 wt. %, and 0.50 wt. %, are synthesized by the improvement of the solid-state reaction technique. The prepared samples have been characterized by x-ray diffraction (XRD), scanning electron microscopy, x-ray energy dispersion, infra-red spectroscopy, thermo-gravimetric analysis, four probe DC resistance, and current–voltage (I–V) measurements. It was found that the prepared samples have an orthorhombic structure with unit cell parameters (a = 3.9557 Å, b = 3.8197 Å, and c = 30.2460 Å) for pure Y358, and the unit cell volume decreases by the addition of (Ni0.5Zn0.5Fe2O4) nanoparticles into the Y358 compound. The crystallite size (D) was evaluated from XRD patterns by Scherrer’s method. The crystallite size (D) is decreased from 40 nm for pure Y358 to 18 nm for Y358 doped by the Ni–Zn nanoferrite content of 0.50 wt. %. The critical current density Jc and I–V characteristics for superconductor/nanoferrite (Y358/Ni–Zn) composite materials are explained according to Bean’s critical state model and the charge–vortex duality in the Y358 high-Tc mixed-state.
“Alexa, how are you feeling today?”
Authors: Taylor Jebediah , Weiss Staci Meredith , Marshall Peter J.
Published: November 2020

‘Smart’ devices are becoming increasingly ubiquitous. While these sophisticated machines are useful for various purposes,
they sometimes evoke feelings of eeriness or discomfort that constitute uncanniness, a much-discussed phenomenon in robotics research. Adult
participants (N = 115) rated the uncanniness of a hypothetical future smart speaker that was described as possessing the
mental capacities for experience, agency, neither, or both. The novel condition prompting participants to attribute both agency and
experience to the speaker filled an important theoretical gap in the literature. Consistent with the mind perception hypothesis of
uncanniness (MPH; Gray & Wegner, 2012), participants in the with-experience condition rated
the device significantly higher in uncanniness than those in the control condition and the with-agency condition. Participants in the
with-both (experience and agency) condition also rated the device higher in uncanniness than those in the control condition and the
with-agency condition, although this latter difference only approached statistical significance.
Pleasure and Danger in Pornography
Authors: Tarrant Shira
Published: November 2020

From the figures on revenue and use rates, to considerations about pornography’s impact on viewers, the experts do not quite agree about what is going on with patterns and trends. Research about whether porn causes harm and measures of how much violence appears...
Children and Teens Using Pornography
Authors: Tarrant Shira
Published: November 2020

The issue of children and teens accessing pornography is often fraught with distress and debate. There are those who worry that easy access to porn causes harm among today’s youth. Will children who see porn grow up to be sexist? Will they make...
Transcending the boundaries of punishment: On the nature of citizenship deprivation
Authors: Tripkovic Milena
Published: November 2020

Citizenship deprivation is becoming an increasingly standard response of modern states to criminal and other harmful acts. Current academic attempts to determine the sanction’s legitimacy are, however, frustrated by the inadequate understanding of its nature. Departing from a dominant perspective that considers denationalization as punishment, this article conducts an original study of citizenship policies in 37 European democracies and contrasts them with key principles of punishment. The findings raise serious doubts regarding the penal nature of denationalization: I propose instead that denationalization is better understood as a sui generis sanction, which seeks to relieve the polity of those members who fail to satisfy fundamental citizenship requirements. This position has serious implications for our understanding and justification of modern revocation practices.
The Shortage of Benzathine Penicillin and Its Impact on Congenital Syphilis Incidence: An Ecologic Study in the City of Rio de Janeiro
Authors: Ueleres Braga José , Araujo Rachel Sarmeiro , de Souza Ana Sara Semeão
Published: November 2020

Background

The Pan American Health Organization indicates that increased incidence of congenital syphilis (CS) can be attributed to the lack of penicillin. This study aimed to analyze the relationship between the benzathine penicillin shortage and the significant increase in the incidence of congenital syphilis in the city of Rio de Janeiro from 2013 to 2017.

Methods

We used a mixed ecologic study design (temporal and multiple groups). Analysis units were the neighborhoods (spatial) and quarters (temporal) during those years. The study population consisted of CS patients who were living in the city of Rio de Janeiro. The benzathine penicillin supply measure for use in gestational syphilis considered the ratio between (1) the number of bottles dispensed to health facilities in each neighborhood and (2) the number of bottles necessary to treat pregnant women diagnosed with syphilis and their respective partners residing in each neighborhood. To evaluate the association between shortages and a significant increase in CS incidence, the negative-inflated zero-binomial regression model (longitudinal model) was used.

Results

During the study period, the incidence rate of CS in Rio de Janeiro neighborhoods was on average 19.6 per 1000 live births. In the simple analysis, shortage was associated with a 2.17-fold increase in the risk of a significant increase in CS incidence. After adjustment for the sufficient minimum set, the strength of association increased to 2.23 (95% confidence interval, 1.15–4.30).

Conclusions

We conclude that the benzathine penicillin shortage had an impact on the increase in the incidence of CS in Rio de Janeiro.
An in situ simulation program: a quantitative and qualitative prospective study identifying latent safety threats and examining participant experiences
Authors: Kjaergaard-Andersen Gunhild , Ibsgaard Pernille , Paltved Charlotte , Irene Jensen Hanne
Published: November 2020

Objective

To explore the impact of in situ simulation training in regard to identification of latent safety threats and participant experiences.

Design

A prospective study including quantitative and qualitative measures.

Setting

A Danish hospital shifted from simulation training in centers outside the hospital to training where simulation was conducted where the situations normally took place and with the normal working teams

Participants

A total of 58 local instructors were educated and subsequently conducted in situ simulations in own departments. After each simulation, a log file was completed containing information on location, the scenario, who took part, time, learning points and findings. Furthermore, interviews were conducted with leaders, instructors and simulation participants.

Main outcome measures

Identified latent safety threats and participant experiences.

Results

From June 2017 until December 2018, 323 simulations were conducted representing 35 different wards. They consisted of 40 different scenarios and had both technical and non-technical learning goals. A total of 35 organizational issues were uncovered via the in situ simulation and practice was adjusted accordingly. A total of 11 interviews were conducted. Four themes emerged from the analysis: practice-orientation, endorsement, sense of security and additional impact.

Conclusion

Transferring simulation to in situ training resulted in a substantial number of organizational findings. The subsequent follow-up and changes in practice made awareness of what could be latent safety threats. Leaders, instructors and simulation participants experienced in situ simulation as relevant and profitable.
Respiratory Viruses Associated With Acute Wheezing in Hospitalized Young Children in Jordan
Authors: Fadugba Olajumoke O , Haddadin Zaid , Muhimpundu Sylvie , Faouri Samir , Shehabi Asem , Rahman Herdi , Williams John V , Miller E Kathryn , Khuri-Bulos Najwa , Halasa Natasha B
Published: November 2020

A cross-sectional viral surveillance study of hospitalized children less than 2 years of old in Amman, Jordan, noted that respiratory syncytial virus and human metapneumovirus, but not human rhinovirus, were associated with higher odds of acute wheezing. Future longitudinal studies are needed to evaluate the association between early childhood viral acute respiratory infections and recurrent wheezing later in childhood.
Heterozygous, Polyploid, Giant Bacterium,Achromatium, Possesses an Identical Functional Inventory Worldwide across Drastically Different Ecosystems
Authors: Ionescu Danny , Zoccarato Luca , Zaduryan Artur , Schorn Sina , Bizic Mina , Pinnow Solvig , Cypionka Heribert , Grossart Hans-Peter
Published: November 2020

Achromatium is large, hyperpolyploid and the only known heterozygous bacterium. Single cells contain approximately 300 different chromosomes with allelic diversity far exceeding that typically harbored by single bacteria genera. Surveying all publicly available sediment sequence archives, we show that Achromatium is common worldwide, spanning temperature, salinity, pH, and depth ranges normally resulting in bacterial speciation. Although saline and freshwater Achromatium spp. appear phylogenetically separated, the genus Achromatium contains a globally identical, complete functional inventory regardless of habitat. Achromatium spp. cells from differing ecosystems (e.g., from freshwater to saline) are, unexpectedly, equally functionally equipped but differ in gene expression patterns by transcribing only relevant genes. We suggest that environmental adaptation occurs by increasing the copy number of relevant genes across the cell’s hundreds of chromosomes, without losing irrelevant ones, thus maintaining the ability to survive in any ecosystem type. The functional versatility of Achromatium and its genomic features reveal alternative genetic and evolutionary mechanisms, expanding our understanding of the role and evolution of polyploidy in bacteria while challenging the bacterial species concept and drivers of bacterial speciation.
Congress of Neurological Surgeons Systematic Review and Evidence-Based Guideline on Neuroablative Procedures for Patients With Cancer Pain
Authors: Raslan Ahmed M , Ben-Haim Sharona , Falowski Steven M , Machado André G , Miller Jonathan , Pilitsis Julie G , Rosenberg William S , Rosenow Joshua M , Sweet Jennifer , Viswanathan Ashwin , Winfree Christopher J , Schwalb Jason M
Published: November 2020

BACKGROUND

Managing cancer pain once it is refractory to conventional treatment continues to challenge caregivers committed to serving those who are suffering from a malignancy. Although neuromodulation has a role in the treatment of cancer pain for some patients, these therapies may not be suitable for all patients. Therefore, neuroablative procedures, which were once a mainstay in treating intractable cancer pain, are again on the rise. This guideline serves as a systematic review of the literature of the outcomes following neuroablative procedures.

OBJECTIVE

To establish clinical practice guidelines for the use of neuroablative procedures to treat patients with cancer pain.

METHODS

A systematic review of neuroablative procedures used to treat patients with cancer pain from 1980 to April 2019 was performed using the United States National Library of Medicine PubMed database, EMBASE, and Cochrane CENTRAL. After inclusion criteria were established, full text articles that met the inclusion criteria were reviewed by 2 members of the task force and the quality of the evidence was graded.

RESULTS

In total, 14 646 relevant abstracts were identified by the literature search, from which 189 met initial screening criteria. After full text review, 58 of the 189 articles were included and subdivided into 4 different clinical scenarios. These include unilateral somatic nociceptive/neuropathic body cancer pain, craniofacial cancer pain, midline subdiaphragmatic visceral cancer pain, and disseminated cancer pain. Class II and III evidence was available for these 4 clinical scenarios. Level III recommendations were developed for the use of neuroablative procedures to treat patients with cancer pain.

CONCLUSION

Neuroablative procedures may be an option for treating patients with refractory cancer pain. Serious adverse events were reported in some studies, but were relatively uncommon. Improved imaging, refinements in technique and the availability of new lesioning modalities may minimize the risks of neuroablation even further.

The full guidelines can be accessed at https://www.cns.org/guidelines/browse-guidelines-detail/guidelines-on-neuroablative-procedures-patients-wi.
Perceptions of the Benefits and Risks of Antibiotics Among Adult Patients and Parents With High Antibiotic Utilization
Authors: Spicer Jennifer O , Roberts Rebecca M , Hicks Lauri A
Published: November 2020

Background

Inappropriate antibiotic use is common. Understanding how patients view antibiotic risks and/or benefits could inform development of patient education materials and clinician communication strategies. We explored current knowledge, attitudes, and behaviors related to antibiotics among populations with high antibiotic use.

Methods

We conducted 12 focus groups with adult patients and parents across the United States by telephone in March 2017. Purposive sampling was used to identify participants with high antibiotic use. We transcribed the discussions verbatim and performed thematic analysis.

Results

We identified 4 major themes. First, participants expressed uncertainty regarding which clinical syndromes required antibiotics, and emotion often influenced their desire for antibiotics. Second, they had a limited understanding of antibiotic risks. Antibiotic resistance was viewed as the primary risk but was seen as a “distant, future” issue, whereas immediate adverse events, such as side effects, were minimized; however, patients expressed concern when told about the risk of serious adverse events. Third, they prioritized antibiotic benefits over risks in their decision-making, both due to an inaccurate estimation of antibiotic risks and/or benefits and a tendency to prioritize instant gratification. Fourth, most participants were willing to defer to their clinicians’ decisions about antibiotics, especially if their clinician provided symptomatic treatment and anticipatory guidance.

Conclusions

Patients have a limited understanding of antibiotic risks, potentially explaining why they are willing to try antibiotics even if it is unclear antibiotics will help. Educating patients on the potential antibiotic risks versus benefits, rather than just antibiotic resistance, may have a bigger impact on their decision-making.
Ethical challenges in the treatment of non-refugee migrants with tuberculosis in Canada
Authors: Silva Diego S , Cook Victoria J , Johnston James C , Gardy Jennifer
Published: November 2020

While attention to the ethical issues that migrants face in accessing tuberculosis care has increased in the last few years, most of the attention has focused on challenges that refugees face when emigrating. Less attention has been given to ethical challenges that arise in the context of providing tuberculosis treatment and care to non-refugee migrants in high-income countries (HIC), particularly those that do not face immediate danger or violence. In this paper, we analyze some of the ethical challenges associated with treating migrants with tuberculosis in the Canadian context. In particular, we will discuss (i) inter- and intra-jurisdictional issues that challenge quotidian public health governance structures, and (ii) the ethical imperative for the Canadian government and its provinces to clearly differentiate access to healthcare from a person’s immigration status to help overcome power imbalances that may exist between public health workers and their clients. The arguments presented herein could potentially apply to other HIC with some form of universal health coverage.
Randomized clinical trials of cardiovascular disease in obstructive sleep apnea: understanding and overcoming bias
Authors: Pack Allan I , Magalang Ulysses J , Singh Bhajan , Kuna Samuel T , Keenan Brendan T , Maislin Greg
Published: November 2020

Three recent randomized control trials (RCTs) found that treatment of obstructive sleep apnea (OSA) with continuous positive airway pressure (CPAP) did not reduce rates of future cardiovascular events. This article discusses the biases in these RCTs that may explain their negative results, and how to overcome these biases in future studies.

First, sample selection bias affected each RCT. The subjects recruited were not patients typically presenting for treatment of OSA. In particular, subjects with excessive sleepiness were excluded due to ethical concerns. As recent data indicate that the excessively sleepy OSA subtype has increased cardiovascular risk, subjects most likely to benefit from treatment were excluded. Second, RCTs had low adherence to therapy. Reported adherence is lower than found clinically, suggesting it is in part related to selection bias. Each RCT showed a CPAP benefit consistent with epidemiological studies when restricting to adherent patients, but was underpowered.

Future studies need to include sleepy individuals and maximize adherence. Since it is unethical and impractical to randomize very sleepy subjects to no therapy, alternative designs are required. Observational designs using propensity scores, which are accepted by FDA for studies of medical devices, provide an opportunity. The design needs to ensure covariate balance, including measures assessing healthy user and healthy adherer biases, between regular users of CPAP and non-users. Sensitivity analyses can evaluate the robustness of results to unmeasured confounding, thereby improving confidence in conclusions. Thus, these designs can robustly assess the cardiovascular benefit of CPAP in real-world patients, overcoming biases in RCTs.
4-Hydroxyhalcone effects on cisplatin-induced genotoxicity model
Authors: Nazari Aref , Mirian Mina , Aghaei Mahmoud , Aliomrani Mehdi
Published: November 2020

Background

The genotoxicity of cisplatin (CP) as a platinum-based antineoplastic agent due to its oxidative stress induction was well known. In this research, we examined 4-hydroxychalcone (4-HCH) as a natural food that presents flavonoid effects on reactive oxygen species (ROS) production and CP-induced in vivo genotoxicity.

Method and materials

Cytotoxicity of CP and 4-HCH was measured on human embryonic kidney 293 cells with MTT assay. Then, intracellular ROS content at IC50 concentration of CP was measured with 2′,7′-dichlorofluorescein diacetate (DCFDA) dye. Finally, 4-HCH was administered intraperitoneally at 10 and 40 mg/kg/BW doses as a pre and post-treatment schedule in a mice model of CP genotoxicity (7 mg/kg). Acridine-orange-stained bone marrow cells were quantified for micronucleus presence examination.

Results

The calculated IC50 of CP and 4-HCH were reported around 19.4 and 133.6 μM, respectively, on HEK293 cells. Also, it was observed that 4-HCH at 0.2, 2 and 10 μM concentrations did not show obvious cytotoxicity. The fluorimetry confirmed that pre-treatment with 10 μM and co-treatment with 2 μM of 4-HCH could attenuate the CP-induced ROS production (P < 0.05 and P < 0.01, respectively). Also, the lowest micronucleated cells were seen in 10 mg/kg 4-HCH-treated group after CP exposure (39 ± 7.9, P < 0.0001).

Discussion

Our results demonstrated the antigenotoxic action of 4-HCH in CP-treated mice bone marrow cells for the first time in both concentrations of 10 and 40 mg/kg especially in the form of co-treatment. Further studies required clinical application of this compound in a combination of CP to attenuate the normal cells’ genotoxicity side effects.
A High Psychological and Somatic Symptom Profile and Family Health Factors Predict New or Persistent Pain During Early Adolescence
Authors: Voepel-Lewis Terri , Seng Julia S. , Chen Bingxin , Scott Eric L.
Published: November 2020

Objectives:

Persistent or recurrent pain is common among adolescents and is associated with poor functioning. The purpose of this study was to determine whether preteens who present with pain, and higher, co-occurring psychological and somatic symptoms (PSS) are at higher risk for persistent pain than other children.

Materials and Methods:

We conducted a secondary analysis of the longitudinal Adolescent Brain and Cognitive Development database (version 2.0.1) that includes 11,863 children aged 9 to 12 years. We differentiated children into baseline Pain/PSS profiles using the Child Behavior Checklist assessments of pain, cognitive-fogginess, somatic symptoms, depression, and anxiety and the Sleep Disorder Survey-Children somnolence subscale. We examined whether Pain/PSS profile predicted 1-year new/persistent pain when controlled for child characteristics and intergenerational mental health factors.

Results:

Four profiles were differentiated: No Pain/Low PSS, No Pain/High PSS, Pain/Low PSS, Pain/High PSS. Trauma exposure and family symptoms were associated with increased odds of being in the higher PSS groups. Baseline symptom profile predicted 14% of the variance in new/persistent pain at 1-year. Compared with the No Pain/Low PSS group, an increased odds of 1-year new or persistent pain was found in children with No Pain/High PSS (adjusted odds ratio [OR]: 1.44; [95% confidence interval: 1.14, 1.82]), Pain/Low PSS (adjusted OR: 4.69 [4.01, 5.48]) and Pain/High PSS (adjusted OR: 5.48 [4.35, 6.91]).

Discussion:

Preteen children with higher comorbid Pain/PSS symptomology were at higher risk for new or persistent pain at 1 year when controlled for important child and family characteristics. Findings support the importance of considering co-occurring symptoms when evaluating children with pain.
Hemoglobin Concentration May Influence the Incidence of Postoperative Transient Neurological Events in Patients With Moyamoya After Extracranial-intracranial Arterial Bypass: A Retrospective Single Center Experience
Authors: Mendez Nicholas V. , Chen Catherine , Richardson Angela M. , Morcos Jacques J. , Deepika Krishnaprasad
Published: November 2020

Background:

Moyamoya is a rare condition characterized by cerebral angiographic findings of intracranial carotid artery stenosis with abnormal net-like vessels in the brain, and often presents as transient ischemic attacks or intracranial hemorrhage. Revascularization in the form of extracranial-intracranial (EC-IC) artery bypass has demonstrated efficacy in preventing ischemic attacks and intracranial hemorrhage, although it is associated with a relatively high rate of perioperative ischemic and hemorrhagic stroke. This retrospective analysis aims to evaluate the possible association between postoperative hemoglobin (Hgb) concentration and early postoperative transient neurological events (TNEs) experienced at our center.

Methods:

Consecutive patients undergoing EC-IC bypass between January 1, 2017 and August 31, 2019 were identified, resulting in a study population of 24 patients with 34 individual cases for different cerebral hemispheres. Postoperative Hgb level was evaluated upon arrival to the intensive care unit (ICU) and the primary outcome was the occurrence of TNEs within 24-hours after surgery.

Results:

The incidence of TNEs within 24 hours postoperatively was 12% (n=4). Statistically significant differences were demonstrated between patients who did and did not experience TNEs in the postoperative period: total Hgb value (mean 9.4 vs. 11.3 g/dL, respectively; P=0.012) and percentage of patients with Hgb <10 g/dL (75% vs. 20%, respectively; P=0.048). Patients with a postoperative Hgb value <10 g/dL upon arrival to the ICU were significantly more likely to experience TNEs (odds ratio, 12; 95% confidence interval, 1.053-136.794; P=0.045).

Conclusions:

This study reports a possible association between postoperative Hgb level and the occurrence of TNEs within the first 24 hours after surgery in patients undergoing EC-IC for moyamoya.
Potential benefits, mechanisms, and uncertainties of convalescent plasma therapy for COVID-19
Authors: Dai Weiqian , Gu Haihui , Hao Sha
Published: November 2020

The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in China led to a public health emergency of international concern, putting all health organizations on high alert in the beginning of 2020. Corona virus disease 2019 (COVID-19) is highly infectious and has resulted in thousands of deaths which exceeded that of the SARS coronavirus (SARS-CoV) outbreak back in 2002 and 2003 in China. Besides, the number of diagnosed patients, patients who are suspected to have contracted the disease, and deaths are increasing worldwide. Unfortunately, effective drugs and vaccines to combat SARS-CoV-2 are still lacking. Convalescent plasma, a seemingly successful treatment for COVID-19 patients, proved to be of huge value in terms of saving severely ill patients. This review introduces the reported effects, potential mechanisms, and future uncertainties of convalescent plasma therapy in the treatment of COVID-19 patients, in the hopes that it will provide useful information for relevant physicians and researchers.
SUSPENDED SCATTERING PARTICLES IN MOTION MAY INFLUENCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY VESSEL DENSITY METRICS IN EYES WITH DIABETIC MACULAR EDEMA
Authors: Maltsev Dmitrii S. , Kulikov Alexei N. , Kazak Alina A. , Freund K. Bailey
Published: November 2020

Purpose:

To study the effect of the suspended scattering particles in motion (SSPiM) on optical coherence tomography angiography (OCTA) vessel density metrics in eyes with diabetic macular edema (DME).

Methods:

Thirty-four eyes with DME from 27 patients (16 men and 11 women; 61.4 ± 9.6 years) with DME were included in this retrospective cohort study. Among these eyes, 19 (55.9%) showed the SSPiM artifact on OCTA. All participants received 3-mm and 6-mm optical coherence tomography angiography (OCTA) imaging. Perfusion density and skeletonized vessel density were calculated for the superficial capillary plexus (SCP) and the deep capillary plexus (DCP), and these were compared between eyes with and without SSPiM. Additionally, foveal vessel density in a 300-µm-wide region around the foveal avascular zone (FVD) was evaluated on 3-mm OCTA scans. The main outcome measures were vessel density in the SCP and the DCP.

Results:

Among the 3-mm OCTA images, there was no statistically significant difference in SCP vessel density in eyes with and without SSPiM (P = 0.98). Vessel density in the DCP (P = 0.001 and P = 0.028 for perfusion and skeletonized vessel density, respectively) and FVD (P = 0.03) on 3-mm OCTA scans were significantly higher in DME eyes with SSPiM than in those without SSPiM. There were no statistically significant differences in vessel density in SCP and DCP between eyes with and without SSPiM based on 6-mm OCTA scans.

Conclusion:

The presence of SSPiM may lead to an overestimation of DCP vessel density in eyes with DME when 3-mm OCTA scans are used for analysis.
Coronavirus Surveillance in a Pediatric Population in Jordan From 2010 to 2013
Authors: Haddadin Zaid , Chappell James , McHenry Rendie , Pulido Claudia Guevara , Rahman Herdi , Gu Wenying , Rankin Danielle A. , Talj Rana , Howard Leigh M. , Williams John V. , Faouri Samir , Shehabi Asem , Khuri-Bulos Najwa , Halasa Natasha B.
Published: November 2020

Background:

Human coronaviruses (HCoVs) are a significant cause of acute respiratory illness (ARI) in children; however, the role of HCoVs in ARI among hospitalized children in the Middle East is not well defined.

Methods:

Children under 2 years admitted with fever and/or respiratory symptoms were enrolled from 2010 to 2013 in Amman, Jordan. Nasal/throat swabs were collected and stored for testing. Demographic and clinical characteristics were collected through parent/guardian interviews and medical chart abstractions. Prior stored specimens were tested for HCoVs (HKU1, OC43, 229E and NL63) by qRT-PCR.

Results:

Of the 3168 children enrolled, 6.7% were HCoVs-positive. Among HCoV-positive children, the median age was 3.8 (1.9–8.4) months, 59% were male, 14% were premature, 11% had underlying medical conditions and 76% had viral-codetection. The most common presenting symptoms were cough, fever, wheezing and shortness of breath. HCoVs were detected year-round, peaking in winter-spring months. Overall, 56%, 22%, 13% and 6% were OC43, NL63, HKU1 and 229E, respectively. There was no difference in disease severity between the species, except higher intensive care unit admission frequency in NL63-positive subjects.

Conclusions:

HCoVs were detected in around 7% of children enrolled in our study. Despite HCoV detection in children with ARI with highest peaks in respiratory seasons, the actual burden and pathogenic role of HCoVs in ARI merits further evaluation given the high frequency of viral codetection.
Postbaccalaureate Premedicine Programs: A Path to Diversity in Physician Assistant Education
Authors: Gillum J. Barton
Published: November 2020

The importance of diversity in the physician assistant (PA) profession is well understood. Some of the benefits of diversity include improved patient care and patient satisfaction. In recent times, efforts at increasing diversity in PA education have involved implementing a holistic admissions process and targeted recruitment of applicants who are underrepresented in medicine. Historically, postbaccalaureate programs have been an effective tool for increasing enrollment of both underrepresented and disadvantaged matriculants in medical school. A larger than expected proportion of these students go on to work with underserved patient populations. The authors suggest that similar postbaccalaureate programs could help underrepresented and disadvantaged students be successful in PA education.
Predictors of Attrition Among Accelerated and Traditional Physician Assistant Students
Authors: Wolf Corri , Ahmed Anoma Zehra , Schmidt Gordon , Winter Sara
Published: November 2020

Purpose

Students can be admitted to a physician assistant program via an accelerated bachelor of science/master of science (BS/MS) track or by a postbaccalaureate track. The purpose of this study was to identify predictors of student attrition based on differences in modes of admission.

Methods

Student admissions and retention data were collected for 277 students in the physician assistant program at the New York Institute of Technology from the graduation years 2016 to 2020. A t-test was used to analyze differences among admissions methods for the following variables: age, cumulative grade point average (GPA), science GPA, and patient contact hours.

Results

A total of 10.4% (n = 29) of students from the total enrollment left the program for academic reasons. These students had a significantly lower cumulative GPA (3.54 vs. 3.71) and science GPA (3.45 vs. 3.68), and fewer patient contact hours (951 vs. 1720) at admission (p < .05). Furthermore, 44 students entered via the BS/MS track, and 41% (n = 18) were dismissed for academic reasons. This group of 18 BS/MS students comprised 62% of all students dismissed for academic reasons over the past 5 years. When considering only BS/MS students, those who left for academic reasons had a significantly lower science GPA (3.37 vs. 3.62, p < .05) than those who successfully completed the program.

Conclusions

Having dual tracks of entry resulted in varying degrees of academic preparation and, for our institution, a disproportionate number of students from the accelerated track being dismissed despite meeting published admissions criteria.
The Bony Bankart: Clinical and Technical Considerations
Authors: Nolte Philip-C. , Elrick Bryant P. , Bernholt David L. , Lacheta Lucca , Millett Peter J.
Published: November 2020

Fractures of the anteroinferior aspect of the glenoid rim, known as a bony Bankart lesions, can occur frequently in the setting of traumatic anterior shoulder dislocation. If these lesions are large and are left untreated in active patients, then recurrent glenohumeral instability due to glenoid bone deficiency may occur. Therefore, the clinician must recognize these lesions when they occur and provide appropriate treatment to restore physiological joint stability. This article aims to provide an overview focusing on clinical and technical considerations in the diagnosis and treatment of bony Bankart lesions.
Immunophenotype of Vestibular Schwannomas
Authors: Bi Wenya Linda , Gupta Saksham , Mei Yu , Abdulmohsen Sally Al , Giantini Larsen Alexandra , Unadkat Prashin , Ramkissoon Shakti , Abedalthagafi Malak , Dunn Ian F.
Published: November 2020

Background:

Vestibular schwannomas exhibit a uniquely variable natural history of growth, stability, or even spontaneous regression. We hypothesized that a transitory population of immune cells, or immunomodulation of tumors cells, may influence the growth pattern of schwannomas. We therefore sought to characterize the impact of the immune microenvironment on schwannoma behavior.

Methods:

Forty-eight vestibular schwannomas with preoperative magnetic resonance imaging and 11 with serial imaging were evaluated for presence of immune infiltrates (including the pan-leukocyte marker Cluster of Differentiation (CD)45, CD4 and CD8 T-cell, and CD68 and CD163 macrophages) as well as expression of immunomodulatory regulators (Programmed Death Ligand 1 (PD-L1), Programmed Death Ligand 2 (PD-L2), LAG-3, TIM-3, V-domain Ig Suppressor of T cell Activation). Maximal diameter, volume, and recurrence were annotated.

Results:

Vestibular schwannomas were characterized by diverse signatures of tumor infiltrating leukocytes and immunomodulatory markers. The median tumor volume was 4.7 cm3 (Interquartile Range (IQR) 1.0–13.0) and maximum diameter was 2.3 cm (IQR 1.5–3.2). Among tumors with serial imaging, the median volumetric growth was 0.04 cm3/mo (IQR 0.01–0.18). Tumor volume and maximum diameter demonstrated strong concordance (R2 = 0.90; p < 0.001). Vestibular schwannoma volume was positively associated with CD4, CD68, and CD163, but not CD8, immune infiltration (all p < 0.05). Tumor growth was positively associated with CD163 and PD-L1 (both p < 0.05). Further, CD163 modified this effect: the relationship between PD-L1 and growth strengthened with increasing CD163 infiltration (R2 = 0.81, p = 0.007). No other immune cell types modified this relationship. These associations were inconsistently observed for maximum diameter and linear growth.

Conclusion:

Vestibular schwannomas demonstrate variable expression of immune regulatory markers as well as immune infiltrates. Tumor size is associated with immune infiltrates and tumor growth is associated with PD-L1, especially in the presence of M2-subtype macrophages. Volumetric measures may associate with the biological signature more accurately than linear parameters. Future exploration of the role of immune modulation in select schwannomas will further enhance our understanding of the biology of these tumors and suggest potential therapeutic avenues for control of tumor growth.