bluuebunny/crossref_metadata_2025 huggingface dataset:
Enhancement of the anticoagulant capacity of polyvinyl chloride tubing for cardiopulmonary bypass circuit using aluminum oxide nanoscale coating applied through atomic layer deposition
Authors: Wang Chen‐Chie , Wang Li‐Chun , Yang Kai‐Chiang , Chen Miin‐Jang , Lin Hsin‐Chih , Han Yin‐Yi
Published: September 2021

For cardiopulmonary bypass, the polyvinyl chloride (PVC) circuit which can initiate the activation of platelets and the coagulation cascade after blood cell contacting is the possible detrimental effect. Surface coating of the PVC tubing system can be an effective approach to enhance circuit's hemocompatibility. In this study, aluminum oxide (Al2O3) thin films were deposited through thermal atomic layer deposition (T‐ALD) or plasma‐enhanced ALD (PE‐ALD) on PVC samples, and the anticoagulation of the Al2O3‐coated PVC samples was demonstrated. The results revealed that Al2O3 deposition through ALD increased surface roughness, whereas T‐ALD had a relative hydrophilicity compared with blank PVC and PE‐ALD. Whole blood immersion tests showed that blood clots formed on blank PVC and that a large amount of red blood cells was found on PE‐ALD substrates, whereas less blood cells were noted in T‐ALD samples. Both T‐ALD and PE‐ALD Al2O3 films did not cause activation of blood cells, as evidenced in CD3+/CD4+/CD8+, CD61+/CD62P+, and CD45+/CD42b+ populations. Analysis of serum coagulation factors showed that a lower amount of prothrombin was absorbed on T‐ALD Al2O3 samples than that on blank PVC. For albumin and fibrinogen immersion tests, immunostaining and scanning electron microscopy further revealed that a thin albumin layer was absorbed on T‐ALD Al2O3 substrates but not on PVC samples. This study revealed that deposition of Al2O3 films by T‐ALD can improve anticoagulation of the PVC tubing system.
Patterns of Teriparatide and Sequential Antiresorptive Agent Treatment Among Elderly Female Medicare Beneficiaries
Authors: Liu Jiannong , Laster Andrew , Xu Xiaoqing , Guo Haifeng , Oates Mary , Gandra Shravanthi R.
Published: September 2021

The 2020 American Association of Clinical Endocrinologists guidelines for assessing osteoporosis among postmenopausal women stratified postmenopausal women with osteoporosis to “high” and “very-high” fracture risk categories and recommended anabolic agents as initial therapy followed by an antiresorptive agent. Switching the order can blunt the effect of anabolic agents, and failing to follow with an antiresorptive can lead to loss of bone generated by the anabolic agent. It would be helpful to understand the real-world prescribing patterns of anabolic agents. Using the 2010–2015 Medicare 100% osteoporosis database, we assessed patient profiles, teriparatide prescribers, persistence of teriparatide therapy, and antiresorptive agent use after teriparatide discontinuation among elderly women who initiated teriparatide from 2011 to 2013. This study included 14,786 patients. In the year before teriparatide initiation, 30.0% of them had a fracture, 67.6% had a dual energy x-ray absorptiometry scan, 74.4% had a diagnosis of osteoporosis, and 47.9% used antiresorptive agents (non-naïve teriparatide users). Among those who had fractures, 49.4% initiated teriparatide within 3 months postfracture. Teriparatide was prescribed for 37% of users by primary care doctors, 19% by rheumatologists, 13% by endocrinologists, and 7.0% by orthopedists. Median time of teriparatide use was 7.2 months. After teriparatide discontinuation, 40.8% switched to antiresorptive agents (31.9% among naïve teriparatide users, 50.5% among non-naïve users). Among switchers, 42.5% switched within 60 days, 50.5% switched to denosumab, and 31.6% switched to oral bisphosphonates. This study of real-world prescribing data found that about half of teriparatide users switched from an antiresorptive agent, and less than half switched to antiresorptive agents after teriparatide discontinuation. Persistence of teriparatide use was suboptimal. In the management of postmenopausal osteoporosis, increasing the persistence of teriparatide use and improving the appropriate treatment sequence of anabolic and antiresorptive drugs are critical to maximizing gains in bone mass, providing the greatest protection against fractures. © 2021 American Society for Bone and Mineral Research (ASBMR).
Meta‐analysis of the diagnostic value of exosomal miR‐21 as a biomarker for the prediction of cancer
Authors: Liu Fanglan , Mao Haifei , Chai Shiquan , Mao Haifeng
Published: September 2021

Background

Early diagnosis of cancer is still the most effective method to increase survival and therapeutically effective patient management. Accumulating studies had exploited exosomes as an indicator for the diagnosis and prognosis of cancer. In addition to exosomes, exosome‐derived miRs are widely investigated as a novel biomarker for diagnosis in cancer patients. The aim of this study was to clarify the diagnostic value of ex‐miR‐21 in cancer.

Methods

Databases were searched for eligible studies up to June, 2021. Studies included in this meta‐analysis were reviewed and selected independently by two authors. The data of sensitivity, specificity, diagnostic odds ratio (DOR), and summary receiver operating characteristic curves (SROC) of exosomal miR‐21 as a diagnostic biomarker were extracted and calculated. Quality assessment was conducted by using the QUADAS‐2 tool.

Results

A total of 26 studies were included in the systematic analysis and meta‐analysis. The pooled results of sensitivity, specificity, PLR/NLR, DOR, and area under the curve were 76% (95%CI, 0.70–0.81), 82% (0.77–0.87), 4.3 (3.1–6.0), 0.29 (0.22–0.38), 15 (8–26), and 0.86 (0.83–0.89), respectively. Sensitivity analysis and Deeks' funnel plot indicated that results remained unchanged and had no publication bias. For the subgroup analysis, it was showed that ex‐miR‐21 had a superior diagnostic accuracy on identifying PC.

Conclusion

Exosomal microRNA‐21 can serve as an effective and widely used diagnostic biomarker for cancer, especially in PC. The using field of exosomes and exosome‐derived miR can further extend the prognosis and therapeutic management. Standardized isolation of exosomes and miRNA‐21 should be developed.
Evaluation of the serum levels of Mannose binding lectin‐2, tenascin‐C, and total antioxidant capacity in patients with coronary artery disease
Authors: Mehri Hamed , Aslanabadi Naser , Nourazarian Alireza , Shademan Behrouz , khaki‐khatibi Fatemeh
Published: September 2021

Background

Coronary artery disease (CAD) develops as a result of atherosclerosis. Atherosclerosis is a condition that leads to clogged arteries and can be caused by a variety of factors. Several studies have shown that various factors contribute to the development and progression of CAD. The aim of this study was to investigate the serum levels of MBL‐2, TNC and TAC in patients with CAD and the relationship between these biochemical parameters and the progression of CAD.

Methods

In this study, 60 serum samples were obtained from CAD patients as the case group and 20 healthy serum samples as the control group. Serum levels of MBL‐2 and TNC were measured by the ELISA method. Serum TAC level was determined by calorimetry (spectrophotometry). In addition, MDA serum level was measured by reaction with thiobarbituric acid (TBA).

Results

The mean age in the case and control groups was 58.4 ± 9.5 years and 85 ± 9.8 years, respectively. There was no significant difference in age, sex and family history in patients with CAD (p > 0.05), but there was a significant difference in blood pressure and smoking history (p > 0.05). Serum cholesterol, triglyceride, and LDL levels were significantly increased in the case group compared to the control group, while serum HDL‐C levels were significantly decreased in the case group. Serum levels of MBL‐2, TNC, and MDA were significantly increased in the case group compared to the control group. The serum level of TAC was significantly lower in the case group than in the control group.

Conclusion

This study suggests that it is possible to diagnose patients with coronary artery disease (CAD) in the early stages of their disease and take preventive measures by measuring these parameters in serum. However, more research is needed before these serum parameters can be considered diagnostic biomarkers or therapeutic targets.
Adoptability and accuracy of point‐of‐care ultrasound in screening for valvular heart disease in the primary care setting
Authors: Chugh Yashasvi , Lohese Opema , Sorajja Paul , Garberich Ross , Stanberry Larissa , Cavalcante João , Gossl Mario
Published: September 2021

Purpose

Despite continued efforts, a majority of patients with valvular heart disease (VHD) remain undiagnosed and untreated. This study aimed to assess the adoptability and accuracy of point‐of‐care handheld echocardiographic assessments (POCE) in the primary care setting.

Methods

Eleven previously untrained primary care providers were trained to use the Vscan Extend (GE, WI) POCE to assess VHD, left ventricular function (LVEF), and major extra‐cardiac findings. Their assessments were compared to those of three blinded expert readers. A total of 175 patients underwent POCE assessments which were evaluated using Kappa statistics (κ) together with their estimated standard error, p value, and 95% CI bounds.

Results

Each patient had a mean of 3.3 ± 1.1 (±SD) assessments performed. Identical or nearly identical agreement between previously untrained primary providers and expert readers was evident for the diagnosis of tricuspid regurgitation, mitral regurgitation, pericardial effusion, and volume status. These agreements were strongest in apical long axis (κ = 1, p < 0.001) and parasternal long and short axis views (κ > =0.82 p < 0.001), though agreement remained robust in apical 4‐chamber views (κ ≥ 0.76). The agreements in LVEF assessment were identical in the apical long axis view (κ = 1, p < 0.001) and robust in the remaining 3 views (κ > =0.66, p < 0.001). The assessments of aortic stenosis (parasternal/long, κ = 0.42, and parasternal/short, κ = 0.47, both p < 0.001) were weak in their agreement.

Conclusion

Compared to expert echocardiography readers, the untrained providers' use of POCE for VHD shows high user adoptability and diagnostic accuracies in the primary care setting.
Occurrence of COVID‐19 in priority groups receiving ChAdOx1 nCoV‐19 coronavirus vaccine (recombinant): A preliminary analysis from north India
Authors: Kaur Upinder , Bala Sapna , Ojha Bisweswar , Jaiswal Sumit , Kansal Sangeeta , Chakrabarti Sankha S.
Published: September 2021

The ChAdOx1 nCoV‐19 vaccine (Oxford University‐Astra Zeneca) has demonstrated nearly 70% efficacy against symptomatic COVID‐19 in trials and some real‐world studies. The vaccine was the first to be approved in India in early January 2021 and is manufactured by the Serum Institute of India. Favorable short‐term safety data of the vaccine in India in a real‐world setting has been recently demonstrated. Here, we report secondary objective (COVID‐19 occurrence) measures of the same ongoing prospective observational study in prioritized recipients of the vaccine. The findings are based on participants who could complete at least 2 months of follow‐up (n = 1500; female/male: 472/1028; mean age: 38.8 years). Laboratory confirmed SARS‐CoV‐2 infection was observed in 27/65 participants (41%) who received a single dose and 271/1435 (19%) who received both doses. Specifically, among doctors, 18/27 (66.7%) one dose recipients and 131/377 (34.7%) fully vaccinated developed SARS‐CoV‐2 infection. The majority of the cases were mild in all groups, and most were breakthrough infections. The occurrence of “severe” COVID‐19 was 7.7 times lower (0.4%) in fully vaccinated participants compared to partially vaccinated (3.1%). Four deaths were observed in the study. One of the four deaths was due to sepsis, two due to unspecified cardiac events, and one due to unspecified post‐COVID‐19 complications. The results of this preliminary analysis necessitate vigorous research on the performance of vaccines against variants, optimal timing of vaccination, and also optimal timings of effectiveness studies to guide future vaccination policy.
An optimized surrogate model using differential evolution algorithm for computing parameters of antennas
Authors: Ustun Deniz , Toktas Feyza , Toktas Abdurrahim
Published: September 2021

In this study, a method based on surrogate model (SM) for computational analysis of antenna parameters such as the resonant frequency (RF) and bandwidth (BW) is presented. Moreover, it is attempted to optimize the SM using evolutionary optimization algorithms in order to further improve the accuracy of the SM. In the conventional computational approaches, the weighting vectors of the SM have been analytically determined. We have optimally achieved the weighting vectors of the SM through differential evolution (DE) and particle swarm optimization (PSO) algorithms. The capabilities of the algorithms are hereby compared with each other. The methodology is applied to the analysis of rectangular microstrip antenna (RMA), including a number of 33 measured RMAs with different geometrical and electrical parameters. From the total number of RMAs, 27 and 6 RMAs are, respectively, used in the construction and the test of the SM. Furthermore, the SM is verified through a comparison with the literature in terms of total absolute errors (TAEs). The results show that the SM with DE computes the most accurate RF and BW with the TAEs of 0.0099 GHz and 0.131%, respectively. The accuracy of the SM is further raised by 78%, thanks to the optimization of SM with DE. Therefore, a novel computational analysis method based on SM is implemented to computation of an antenna parameter with higher accuracy, and SM is successfully optimized by DE. The proposed method is able to easily implement to the stringent engineering problems based on simulated or measured data for computer‐aided design (CAD).
Detection of sarcopenic obesity and prediction of long‐term survival in patients with gastric cancer using preoperative computed tomography and machine learning
Authors: Kim Jaehyuk , Han Seung Hee , Kim Hyoung‐Il
Published: September 2021

Background

Previous studies evaluating the prognostic value of computed tomography (CT)‐derived body composition data have included few patients. Thus, we assessed the prevalence and prognostic value of sarcopenic obesity in a large population of gastric cancer patients using preoperative CT, as nutritional status is a predictor of long‐term survival after gastric cancer surgery.

Methods

Preoperative CT images were analyzed for 840 gastric cancer patients who underwent gastrectomy between March 2009 and June 2018. Machine learning algorithms were used to automatically detect the third lumbar (L3) vertebral level and segment the body composition. Visceral fat area and skeletal muscle index at L3 were determined and used to classify patients into obesity, sarcopenia, or sarcopenic obesity groups.

Results

Out of 840 patients (mean age = 60.4 years; 526 [62.6%] men), 534 (63.5%) had visceral obesity, 119 (14.2%) had sarcopenia, and 48 (5.7%) patients had sarcopenic obesity. Patients with sarcopenic obesity had a poorer prognosis than those without sarcopenia (hazard ratio [HR] = 3.325; 95% confidence interval [CI] = 1.698–6.508). Multivariate analysis identified sarcopenic obesity as an independent risk factor for increased mortality (HR = 2.608; 95% CI = 1.313–5.179). Other risk factors were greater extent of gastrectomy (HR = 1.928; 95% CI = 1.260–2.950), lower prognostic nutritional index (HR = 0.934; 95% CI = 0.901–0.969), higher neutrophil count (HR = 1.101; 95% CI = 1.031–1.176), lymph node metastasis (HR = 6.291; 95% CI = 3.498–11.314), and R1/2 resection (HR = 4.817; 95% CI = 1.518–9.179).

Conclusion

Body composition analysis automated by machine learning predicted long‐term survival in patients with gastric cancer.
Annual‐Cycle Movements and Phenology of Black Scoters in Eastern North America
Authors: Lamb Juliet S. , Gilliland Scott G. , Savard Jean‐Pierre. L. , Loring Pamela H. , McWilliams Scott R. , Olsen Glenn H , Osenkowski Jason E. , Paton Peter W. C. , Perry Matthew C. , Bowman Timothy D.
Published: September 2021

Sea ducks exhibit complex movement patterns throughout their annual cycle; most species use distinct molting and staging sites during migration and disjunct breeding and wintering sites. Although research on black scoters (Melanitta americana) has investigated movements and habitat selection during winter, little is known about their annual‐cycle movements. We used satellite telemetry to identify individual variation in migratory routes and breeding areas for black scoters wintering along the Atlantic Coast, to assess migratory connectivity among wintering, staging, breeding, and molt sites, and to examine effects of breeding site attendance on movement patterns and phenology. Black scoters occupied wintering areas from Canadian Maritime provinces to the southeastern United States. Males used an average of 2.5 distinct winter areas compared to 1.1 areas for females, and within‐winter movements averaged 1,256 km/individual. Individuals used an average of 2.1 staging sites during the 45‐day pre‐breeding migration period, and almost all were detected in the Gulf of St. Lawrence. Males spent less time at breeding sites and departed them earlier than females. During post‐breeding migration, females took approximately 25 fewer days than males to migrate from breeding sites to molt and staging sites, and then wintering areas. Most individuals used molt sites in James and Hudson bays before migrating directly to coastal wintering sites, which took approximately 11 days and covered 1,524 km. Males tended to arrive at wintering areas 10 days earlier than females. Individuals wintering near one another did not breed closer together than expected by chance, suggesting weak spatial structuring of the Atlantic population. Females exhibited greater fidelity (4.5 km) to previously used breeding sites compared to males (60 km). A substantial number of birds bred west of Hudson Bay in the Barrenlands, suggesting this area is used more widely than believed previously. Hudson and James bays provided key habitat for black scoters that winter along the Atlantic Coast, with most individuals residing for >30% of their annual cycle in these bays. Relative to other species of sea duck along the Atlantic Coast, the Atlantic population of black scoter is more dispersed and mobile during winter but is more concentrated during migration. These results could have implications for future survey efforts designed to assess population trends of black scoters. © 2021 The Wildlife Society.
Representing responses to climate change in spatial land system models
Authors: Malek Žiga , Verburg Peter H.
Published: September 2021

Modelling future change to land use and land cover is done as part of many local and global scenario environmental assessments. Nevertheless, there are still considerable challenges related to simulating land‐use responses to climate change. Mostly, climate change is considered by changing the temperature and precipitation, affecting the spatial distribution and productivity of future land use and land cover as result of differential changes in growing conditions. Other climate change effects, such as changes in the water resources needed to support future cropland expansion and intensification, are often neglected. In this study, we demonstrate how including different types of responses to climate change influences the simulation of future changes to land use and land cover, and land management. We study the influence of including different climate change effects in land system modeling step by step. The results show that land system models need to include numerous simultaneous climate change effects, particularly when looking at adaptation options such as implementing irrigation. Otherwise, there is a risk of biased impact estimates leading either to under‐ or overestimation of the consequences of land use change, including land degradation. Spatial land system models therefore need to be developed accounting for a multitude of climate change impacts, uncertainties related to climate data, and an assessment of the sensitivity of the outcomes toward the decisions of modellers on representing climate change impacts.
Laparoscopic cholecystectomy in a swine model using a novel near‐infrared fluorescent IV dye (BL‐760)
Authors: Cho Yu Jeong , Nam So‐Hyun , Oh Eugene , Luciano Michael P. , Lee Choonghee , Shin Il Hyung , Schnermann Martin J. , Cha Jaepyeong , Kim Kwan Woo
Published: September 2021

Background and Objectives

Bile duct injury during laparoscopic cholecystectomy has an incidence rate of 1%–2% and commonly appears under conditions of severe inflammation, adhesion, or unexpected anatomical variations. Despite the difficulties and rising concerns of identifying bile duct during surgeries, surgeons do not have a specific modality to identify bile duct except intraoperative cholangiography. While no biliary‐specific fluorescent dye exists for clinical use, our team has previously described the development of a preclinical biliary‐specific dye, BL‐760. Here, we present our study of laparoscopic cholecystectomy using the fluorescent dye in a swine model.

Study Design/Materials and Methods

With an approval from Institutional Animal Care and Use Committee, two 20–25 kg swine underwent laparoscopic abdominal surgery using a Food and Drug Administration‐cleared fluorescent laparoscopic system. Images of the liver and gallbladder were taken both before and after intravenous injection of the novel fluorescent dye. The dye was dosed at 60 μg/kg and injected via the ear vein. The amount of time taken to visualize fluorescence in the biliary tract was measured. Fluorescent signal was observed after injection, and target‐to‐background ratio (TBR) of the biliary tract to surrounding cystic artery and liver parenchyma was measured.

Results

Biliary tract visualization under fluorescent laparoscopy was achieved within 5 min after the dye injection without any adverse effects. Cystic duct and extrahepatic duct were clearly visualized and identified with TBR values of 2.19 and 2.32, respectively, whereas no fluorescent signal was detected in liver. Cystic duct and artery were successfully ligated by an endoscopic clip applier with the visual assistance of highlighted biliary tract images. Laparoscopic cholecystectomy was completed within 30 min in each case without any complications.

Conclusions

BL‐760 is a novel preclinical fluorescent dye useful for intraoperative identification and visualization of biliary tract. Such fluorescent dye that is exclusively metabolized by liver and rapidly excreted into biliary tract would be beneficial for all types of hepato‐biliary surgeries. With the validation of additional preclinical data, this novel dye has potential to be a valuable tool to prevent any iatrogenic biliary injuries and/or bile leaks during laparoscopic abdominal and liver surgeries.
Detection of mobile elements insertions for routine clinical diagnostics in targeted sequencing data
Authors: Demidov German , Park Joohyun , Armeanu‐Ebinger Sorin , Roggia Cristiana , Faust Ulrike , Cordts Isabell , Blandfort Maria , Haack Tobias B. , Schroeder Christopher , Ossowski Stephan
Published: September 2021

Background

Targeted sequencing approaches such as gene panel or exome sequencing have become standard of care for the diagnosis of rare and common genetic disease. The detection and interpretation of point mutations, small insertions and deletions, and even exon‐level copy number variants are well established in clinical genetic testing. Other types of genetic variation such as mobile elements insertions (MEIs) are technically difficult to detect. In addition, their downstream clinical interpretation is more complex compared to point mutations due to a larger genomic footprint that can not only predict a clear loss of protein function but might disturb gene regulation and splicing even when located within the non‐coding regions. As a consequence, the contribution of MEIs to disease and tumor development remains largely unexplored in routine diagnostics.

Methods

In this study, we investigated the occurrence of MEIs in 7,693 exome datasets from individuals with rare diseases and healthy relatives as well as 788 cancer patients analyzed by panel sequencing.

Results

We present several exemplary cases highlighting the diagnostic value of MEIs and propose a strategy for the detection, prioritization, and clinical interpretation of MEIs in routine clinical diagnostics.

Conclusion

In this paper, we state that detection and interpretation of MEIs in clinical practice in targeted NGS data can be performed relatively easy despite the fact that MEIs very rarely occur in coding parts of the human genome. Large scale reanalysis of MEIs in existing cohorts may solve otherwise unsolvable cases.
Spectral discretization of the time‐dependent Stokes problem with mixed boundary conditions
Authors: Bousbiat Chaima , Daikh Yasmina , Maarouf Sarra
Published: September 2021

In this paper, we consider the time‐dependent Stokes problem in a three‐dimensional domain with mixed boundary conditions. The discretization relies on spectral methods with respect to the space variables and Euler's implicit scheme with respect to the time variable, then by the second order BDF method. A detailed numerical analysis leads to a priori error estimates for each numerical scheme.
Deuterium solid‐state NMR quadrupolar order rotating frame relaxation with applications to amyloid‐β fibrils
Authors: Vugmeyster Liliya , Ostrovsky Dmitry
Published: September 2021

We describe a new method for measuring molecular dynamics based on the deuterium solid‐state nuclear magnetic resonance (NMR) quadrupolar order rotating frame relaxation rate R1ρ,Q under static conditions. The observed quadrupolar order coherence is created using the broad‐band Jeener–Broekaert excitation and is locked with a weak radio frequency (RF) field. We describe the experimental and theoretical approaches and show applications to a selectively deuterated valine side chain of the phosphorylated amyloid‐β (1–40) fibrils phosphorylated at the serine‐8 position. The R1ρ,Q rate is sensitive to the rotameric exchange mode. For biological samples, the low spin‐lock field in the 5‐ to 10‐kHz range has the advantage of avoiding sample heating and dehydration. Thus, it provides an alternative to approaches based on single‐quantum coherence, which require larger spin‐lock fields.
Single‐center results reporting improved hematopoietic stem cell mobilization success in pediatric and young adult patients with solid tumors and lymphoma
Authors: Koo Jane , Teusink‐Cross Ashley , Davies Stella M. , Jodele Sonata , Dandoy Christopher E.
Published: September 2021

Background

High‐dose chemotherapy with autologous hematopoietic stem cell transplantation (auto‐HSCT) is an established treatment for pediatric and young adult patients with solid tumors and lymphomas. Plerixafor is a CXC chemokine receptor type 4 (CXCR4) antagonist that can be used with granulocyte colony stimulating factor (G‐CSF) to amplify the mobilization of hematopoietic stem cells (HSCs).

Methods

We performed a retrospective analysis of 167 pediatric solid tumor and lymphoma patients from January 2010 to July 2020 in whom HSCs were mobilized using G‐CSF alone or with plerixafor.

Results

Thirteen heavily pretreated patients (33.3%) required twice‐daily dosing of G‐CSF compared to five patients (3.9%) in the not heavily pretreated group (p = .0005). Fourteen heavily pretreated patients (35.9%) required plerixafor compared to four patients (3.1%) in the comparison cohort (p = .0002). The number of mobilization days was similar between both cohorts, with 5 days (range 3–11 days) in the heavily pretreated group and 5 days (range 3–13 days) in the not heavily pretreated group (p = .55). The number of harvest days was 2 days (range 1–5 days) in the heavily pretreated group and 1 day (range 1–4 days) in the not heavily pretreated group (p = .0025). The final cluster of differentiation (CD)34+/kilogram (kg) count was 9.52 × 106/kg among heavily pretreated patients compared to 34.99 × 106/kg CD34+ cells in the comparison group (p < .0001). Three heavily pretreated patients (7.7%) failed HSC mobilization.

Conclusions

Patients at the highest risk for poor HSC mobilization can be successfully treated with more frequent G‐CSF dosing or G‐CSF with plerixafor in a large majority of cases.
Secondary impacts of constipation in acute lymphoblastic leukemia in U.S. children's hospitals
Authors: Belsky Jennifer A. , Batra Sandeep , Stanek Joseph R. , O'Brien Sarah H.
Published: September 2021

Background

Childrenwith acute lymphoblastic leukemia (ALL) suffer a litany of chemotherapy‐induced side effects. Constipation secondary to vinca alkaloids, psychological stressors, and opioid use are common issues for children newly diagnosed with leukemia. This study investigated the morbidity associated with constipation including infections, mucositis, and healthcare utilization in hospitalized children with ALL receiving induction chemotherapy.

Methods

We analyzed data from 48 children's hospitals in the Pediatric Health Information System, extracting patients 1–21 years of age with ALL, hospitalized for induction from October 2015 through December 2019. Data were analyzed using nonparametric statistics, and comparisons of outcomes between those with and without constipation were presented as adjusted odds ratios (aOR).

Results

We identified 2586 (56%) patients with constipation out of a total of 4622 unique ALL patients in induction. Compared to patients without constipation during induction, patients with constipation were significantly more likely to have mucositis (aOR = 2.30; p = 0.0010), perirectal issues (aOR = 3.21; p = 0.0092), or abdominal radiograph exposure (aOR = 2.40; p < 0.0001). The median length of induction hospitalization was significantly greater in those with constipation compared to those without constipation (10 days vs. 8 days; p < 0.0001).

Conclusions

Children with ALL suffering from constipation during induction therapy have increased length of stay, mucositis, imaging, and overall healthcare utilization compared to children without constipation. Further research should explore the causative relationship between constipation and infections. Increased attention should be given to constipation management in patients with ALL at the start of induction therapy, particularly in patients with complications or prolonged hospitalizations.
Multiplex genome editing in Arabidopsis thaliana using Mb3Cas12a
Authors: Jordan William T. , Currie Seth , Schmitz Robert J.
Published: September 2021

The use of CRISPR‐Cas proteins for the creation of multiplex genome engineering represents an important avenue for crop improvement, and further improvements for creation of knock‐in plant lines via CRISPR‐based technologies may enable the high‐throughput creation of designer alleles. To circumvent limitations of the commonly used CRISPR‐Cas9 system for multiplex genome engineering, we explored the use of Moraxella bovoculi 3 Cas12a (Mb3Cas12a) for multiplex genome editing in Arabidopsis thaliana. We identified optimized cis‐regulatory sequences for driving expression of single‐transcript multiplex crRNA arrays in A. thaliana, resulting in stable germline transmission of Mb3Cas12a‐edited alleles at multiple target sites. By utilizing this system, we demonstrate single‐transcript multiplexed genome engineering using of up to 13 crRNA targets. We further show high target specificity of Mb3Cas12a‐based genome editing via whole‐genome sequencing. Taken together, our method provides a simplified platform for efficient multiplex genome engineering in plant‐based systems.
Pediatric MR lung imaging with 3D ultrashort‐TE in free breathing: Are we past the conventional T2 sequence?
Authors: Gräfe Daniel , Anders Rebecca , Prenzel Freerk , Sorge Ina , Roth Christian , Benkert Thomas , Hirsch Franz Wolfgang
Published: September 2021

Objectives

Magnetic resonance imaging (MRI) of the lungs is challenging for several reasons, mainly due to the respiratory motion, low proton density, and rapid T2* decay. Recent MR sequences with ultrashort TE (UTE) coupled with respiratory compensation promise to overcome these obstacles. So far, there are very few studies on the relevance of these sequences in children. The aim of the study was to compare the diagnostic value of a respiratory‐self‐gated three‐dimensional UTE sequence versus a conventional respiratory‐triggered T2‐weighted turbo spin echo (T2‐TSE) sequence in a pediatric collective.

Study Design

Seventy‐one patients between 0 and 18 years of age, who were scheduled for a thoracic MRI based on diverse clinical indications, were examined on a 3T MRI system. The UTE and T2‐TSE sequences were evaluated by two readers regarding quality features and visualization of eight common pathology patterns.

Results

The image quality of both sequences was equally high, with UTE depicting pleural and central bronchi more clearly. In pathologies, UTE was superior to T2‐TSE for so‐called “MR‐negative pathologies”, significant for air trapping, and in tendency for bullae and cysts. In all remaining pathologies, T2‐TSE proved to be at least equivalent to UTE.

Conclusions

At present, UTE cannot serve as a universal replacement for conventional T2‐TSE for all pathologies. It yields, however, a substantial benefit in the context of hyperinflation, emphysema, cysts, or pathologies of the bronchial system.
Making zero a reality: Selecting and measuring the “Right” Zero
Authors: Taube Michael A. , Gardner Frank
Published: September 2021

Since the inception of the process industries (PI), leaders of these organizations have accepted some level of fires, explosions, environmental releases, and other events as the cost of doing business and inevitable. This cultural mindset continues to this day. Real safety performance and behaviors cannot be managed or produced by corporate safety programs, while active and latent hazards go unnoticed and unaddressed. The false sense of security that these “safety programs” encourage is evidenced by the continued occurrences of large‐scale catastrophes. The dichotomy of a “safety culture” versus such events is clearly evident, yet the PI continues to focus on the same indices—all of which have little bearing on the cause of these events. Zero can be a goal, but it needs to be a realistic zero. For many organizations the mistake is not establishing Zero as a goal, the mistake is selecting the wrong Zero and then failing to support the organization in order to make Zero a reality. This paper examines the organizational policies and metrics of the PI with that of the single most reliable and safe organization in the world, which has achieved a safety record of ZERO incidents for its entire 65+ year history.
Physical education teacher motivation: A conceptual review and reconceptualisation
Authors: Zhang Tan
Published: September 2021

Accomplishing the goal of physical education requires a motivated teaching force. The goals of this article are to (a) provide a theoretical perspective that physical education teacher motivation is contextually constructed in close relation with their job demands and recourses, and (b) articulate a reconceptualised theoretical platform for future research based on the theoretical perspectives of extrinsic motivation and the job demand–job resource model. A literature search was conducted and followed by a conceptual review of theory‐driven, data‐based studies on physical education teacher motivation. The review has established a need to reconceptualise and consolidate the theoretical perspectives to enhance future research. The review outcome also suggests that examining the psychological and behavioural processes that influence physical education teacher motivation needs to incorporate an ecological perspective that assists in identifying and clarifying the sources of motivation and the underlying regulatory mechanisms. Based on the review and critique, I further articulate the implications, argue for the need of reconceptualising physical education teacher motivation research, and propose an alternative theoretical framework integrating the external‐regulation motivation and the job demand–job resource model for the future research. The proposed framework provides a conceptual lens that enables researchers to connect physical education teacher motivation to their job environment in future research.

Context and implication

Rationale for this study

By delineating current motivation theoretical perspectives, the study argues that physical education teacher motivation can (and should) be considered extrinsic and the external‐regulation framework (Deci & Ryan, 1985) should be adopted as an effective framework to study teacher motivation.

Why the new findings matter

The study proposes and discusses an alternative conceptual framework that combines external‐regulation and job‐demands/resources perspectives for future research on teacher motivation.

Implications for educational researchers and policy makers

The proposed framework provides a conceptual lens that enables researchers to connect physical education teacher motivation to their job environment in future research.
A controlled clinical trial comparing potent progestins, LNG‐IUS and dienogest, for the treatment of women with adenomyosis
Authors: Ota Ikuko , Taniguchi Fuminori , Ota Yoshiaki , Nagata Hiroki , Wada Ikumi , Nakaso Takaya , Ikebuchi Ai , Sato Eri , Azuma Yukihiro , Harada Tasuku
Published: September 2021

Purpose

To evaluate the efficacy of two progestins, levonorgestrel intrauterine system (LNG‐IUS) and dienogest (DNG), for adenomyosis.

Methods

This study enrolled 157 women with adenomyosis, randomized to either LNG‐IUS (n = 76) or DNG (n = 81) groups as a controlled clinical trial for 72 months. Participants were classified by three different localizations of adenomyosis: diffuse, focal, and extrinsic. VAS (Visual analog scale) score, days, and amount of uterine bleeding were assessed. Uterine volume or bone mineral density (BMD) were measured by three‐dimensional ultrasonography or dual‐energy X‐ray absorptiometry.

Results

LNG‐IUS and DNG comparably reduced pain scores in patients with adenomyosis. With regard to pain control, DNG offered greater efficacy than LNG‐IUS in 3 months of treatment. In all types of adenomyosis, the days of bleeding after 12 months with DNG were significantly decreased compared to those with LNG‐IUS. The decrease of whole uterine body was transient in any subtypes. A comparable decrease in BMD due to age‐related changes in both groups was observed.

Conclusions

LNG‐IUS and DNG could be useful for long‐term management of adenomyosis. In terms of durations of uterine bleeding, DNG was superior to LNG‐IUS for 6 years.
Geographically weighted generalized Farrington algorithm for rapid outbreak detection over short data accumulation periods
Authors: Yoneoka Daisuke , Kawashima Takayuki , Makiyama Koji , Tanoue Yuta , Nomura Shuhei , Eguchi Akifumi
Published: September 2021

The demand for rapid surveillance and early detection of local outbreaks has been growing recently. The rapid surveillance can select timely and appropriate interventions toward controlling the spread of emerging infectious diseases, such as the coronavirus disease 2019 (COVID‐19). The Farrington algorithm was originally proposed by Farrington et al (1996), extended by Noufaily et al (2012), and is commonly used to estimate excess death. However, one of the major challenges in implementing this algorithm is the lack of historical information required to train it, especially for emerging diseases. Without sufficient training data the estimation/prediction accuracy of this algorithm can suffer leading to poor outbreak detection. We propose a new statistical algorithm—the geographically weighted generalized Farrington (GWGF) algorithm—by incorporating both geographically varying and geographically invariant covariates, as well as geographical information to analyze time series count data sampled from a spatially correlated process for estimating excess death. The algorithm is a type of local quasi‐likelihood‐based regression with geographical weights and is designed to achieve a stable detection of outbreaks even when the number of time points is small. We validate the outbreak detection performance by using extensive numerical experiments and real‐data analysis in Japan during COVID‐19 pandemic. We show that the GWGF algorithm succeeds in improving recall without reducing the level of precision compared with the conventional Farrington algorithm.
True Cost of Solar Hydrogen
Authors: Vartiainen Eero , Breyer Christian , Moser David , Román Medina Eduardo , Busto Chiara , Masson Gaëtan , Bosch Elina , Jäger-Waldau Arnulf
Published: September 2021

Green hydrogen will be an essential part of the future 100% sustainable energy and industry system. Up to one‐third of the required solar and wind electricity would eventually be used for water electrolysis to produce hydrogen, increasing the cumulative electrolyzer capacity to about 17 TWel by 2050. The key method applied in this research is a learning curve approach for the key technologies, i.e., solar photovoltaics (PV) and water electrolyzers, and levelized cost of hydrogen (LCOH). Sensitivities for the hydrogen demand and various input parameters are considered. Electrolyzer capital expenditure (CAPEX) for a large utility‐scale system is expected to decrease from the current 400 €/kWel to 240 €/kWel by 2030 and to 80 €/kWel by 2050. With the continuing solar PV cost decrease, this will lead to an LCOH decrease from the current 31–81 €/MWhH2,LHV (1.0–2.7 €/kgH2) to 20–54 €/MWhH2,LHV (0.7–1.8 €/kgH2) by 2030 and 10–27 €/MWhH2,LHV (0.3–0.9 €/kgH2) by 2050, depending on the location. The share of PV electricity cost in the LCOH will increase from the current 63% to 74% by 2050.
Adjusting the Active Layer Morphology via an Amorphous Acceptor Solid Additive for Efficient and Stable Nonfullerene Organic Solar Cells
Authors: You Wen , Zhou Dan , Hu Lin , Xu Haitao , Tong Yongfen , Hu Bin , Xie Yu , Li Zaifang , Li Mingjun , Chen Lie
Published: September 2021

It is incredibly feasible and effective to adopt a solid additive strategy to optimize the active layer blend films morphology for nonfullerene organic solar cells (OSCs) to achieve high efficiency and stable performance. Herein, a novel amorphous small molecule SJ‐IC‐M with a comparatively high molecular weight is first designed and used as an efficient solid additive in the OSCs based on PM6:Y6 to enhance the power conversion efficiency (PCE) and long‐term stability of the device. After the addition of 0.5 wt% SJ‐IC‐M into the active layer blends, the PCE can be increased to 16.2% compared with that of the reference device without additive displaying an inferior PCE of 15.0%. Moreover, the device containing the SJ‐IC‐M additive delivers more excellent long‐term stability. The PCE can remain over 90% of its initial value when the unencapsulated device is preserved in a N2‐filled glovebox for a month. Systematic analysis reveals that the introduction of the relatively high molecular weight amorphous SJ‐IC‐M additive can optimize the crystallinity of Y6. As a result, an improved charge transport, stabilized blend morphology, and enhanced device performance are achieved. Moreover, the current research provides a new strategy which can replace the commonly used solvent additive to fabricate efficient and stable nonfullerene OSCs.
Ersatzneubau Strombrückenzug Magdeburg – Entwurf, Konstruktion und Ausführung (Teil 1)
Authors: Burgard Stefan , Eins Karsten , Anistoroaiei Christian , Hamsch Volker
Published: September 2021

Das Vorhaben „Ersatzneubau Strombrückenzug“ soll die vorhandene Brückenverbindung der bestehenden Anna‐Ebert‐Brücke ersetzen. Diese weist aufgrund des Hochwassers 2013 und gemäß aktueller Gutachten einen irreversiblen und nicht reparablen statischen Totalschaden auf und muss zwingend umgehend und schnellstmöglich durch den Ersatzneubau entlastet werden. Weiterhin haben die Hochwasserereignisse 2002 und 2013 gezeigt, dass der bestehende Verkehrszug über die Anna‐Ebert‐Brücke als Evakuierungsverbindung im Gefahrenfall nicht mehr genutzt werden kann. Insofern ist auch aus diesem Grund die Wiederherstellung einer leistungsfähigen Brückenverbindung im Sinne des Zivilschutzes zwingend und kurzfristig geboten. Herzstück der innerstädtischen Neubauplanung aus zwei Brückenbauwerken und sechs Knotenpunkten ist die Schrägseilbrücke über die Alte Elbe.
Investigation of the strut‐and‐tie model of a two‐plane cable‐stayed bridge tower under vertical component of the cable force
Authors: Li Shengyu , Hong Yu , Huang Shengqian , Pu Qianhui
Published: September 2021

The geometry and mechanical behavior of concrete bridge towers are complex. Hence, it is important to generate a rational mechanical analysis model for structural design. The method of strut‐and‐tie models (STMs) is an effective way to analyze disturbed regions (D‐regions) such as the anchorage zones of cables in bridge towers. This paper provides a detailed analysis of the elastic stress distribution on the bridge tower of a cable‐stayed bridge with two cable planes. The vertical component of the stay cable force was considered for the analysis. Additionally, two different STMs of the bridge tower were developed with the load path method using different horizontal spacings of the stay cables. Based on the minimum energy principle, the optimal STMs of the two different STMs were generated. A detailed calculation method for the configuration of the optimal STMs is presented. In the paper, computational expressions of the internal force for the tie members in the two STMs are also proposed. Overall, this study demonstrated the strong applicability of the proposed STMs for a bridge tower in a cable‐stayed bridge with two cable planes. This can be considered an effective simplified method in the structural design of bridge towers. Furthermore, the study established that the influence of the horizontal distance between stay cables on the mechanical response‐behavior of the structure should be considered in the design of concrete bridge towers.
A radiolucent bronchial foreign body in a two‐ and a half‐month‐old Labrador Retriever with acute onset respiratory distress
Authors: Chang Chee‐Hoon , Patterson Carly
Published: September 2021

A two‐ and a half‐month‐old intact male Labrador Retriever was presented to the Texas A&M University Veterinary Medical Teaching Hospital for acute onset respiratory distress with concern for a potential foreign body. Upon intake by the emergency service, the puppy was exhibiting expiratory dyspnoea. Radiographs revealed marked gas distension of the oesophagus and stomach. No radiopaque foreign bodies were identified. Bronchoscopy revealed a dark brown foreign body in the right middle lobe bronchus. The foreign material was pliable and crumbled upon removal attempts with a snare retrieval device. The majority of the foreign body was removed en masse; it most closely resembled faecal material. Three‐view thoracic radiographs performed 1 day post‐endoscopy revealed aspiration pneumonia. The dog was discharged from the hospital with doxycycline, and the pneumonia was nearly resolved at the 1‐week recheck. The dog was sent home with another 2 weeks of doxycycline and made a full recovery at home.
Fathers and Family Leave Policies: What Public Policy Can Do to Support Families
Authors: Koslowski Alison , O’Brien Margaret
Published: September 2021

There are various types of family leave available to fathers across and within countries. The specific design features of family leave policies are associated with how well used they are by fathers, and the key features associated with higher take up by fathers are presented here. There is an emerging literature on the various impacts of fathers on leave in relation to factors such as family health and well-being and gender equality in the labour market. In particular, fathers and family leave are important for a good quality of infant life. Finally, the chapter considers ways in which employers can support fathers in the workplace to take leave, in light of the range of associated benefits.