bluuebunny/crossref_metadata_2025 huggingface dataset:
Electrochemical and photoluminescence response of laser-induced graphene/electrodeposited ZnO composites
Authors: Santos N. F. , Rodrigues J. , Pereira S. O. , Fernandes A. J. S. , Monteiro T. , Costa F. M.
Published: August 2021

The inherent scalability, low production cost and mechanical flexibility of laser-induced graphene (LIG) combined with its high electrical conductivity, hierarchical porosity and large surface area are appealing characteristics for many applications. Still, other materials can be combined with LIG to provide added functionalities and enhanced performance. This work exploits the most adequate electrodeposition parameters to produce LIG/ZnO nanocomposites. Low-temperature pulsed electrodeposition allowed the conformal and controlled deposition of ZnO rods deep inside the LIG pores whilst maintaining its inherent porosity, which constitute fundamental advances regarding other methods for LIG/ZnO composite production. Compared to bare LIG, the composites more than doubled electrode capacitance up to 1.41 mF cm−2in 1 M KCl, while maintaining long-term cycle stability, low ohmic losses and swift electron transfer. The composites also display a luminescence band peaked at the orange/red spectral region, with the main excitation maxima at ~ 3.33 eV matching the expected for the ZnO bandgap at room temperature. A pronounced sub-bandgap tail of states with an onset absorption near 3.07 eV indicates a high amount of defect states, namely surface-related defects. This work shows that these environmentally sustainable multifunctional nanocomposites are valid alternatives for supercapacitors, electrochemical/optical biosensors and photocatalytic/photoelectrochemical devices.
Low-dose aspirin confers a survival benefit in patients with pathological advanced-stage oral squamous cell carcinoma
Authors: Luo Sheng-Dean , Wu Shao-Chun , Chen Wei-Chih , Wu Ching-Nung , Chiu Tai-Jan , Yang Yao-Hsu , Li Shau-Hsuan , Fang Fu-Min , Huang Tai-Lin , Hsiao Chang-Chun , Chen Chang-Han
Published: August 2021

Oral squamous cell carcinoma (OSCC) remains one of the most challenging clinical problems in the field due to its high rate of locoregional and distant metastases. However, studies that assess the association between aspirin use and survival in patients with OSCC are limited. Moreover, patients that recruited from those studies might have tumors that arose from different anatomic regions of the head and neck, including the oral cavity, oropharynx, etc. Since tumors within these distinct anatomic regions are unique in the context of epidemiology and tumor progression, we sought to evaluate the association of aspirin use with squamous cell carcinomas located within the oral cavity only. In this 10-year cohort study, we evaluated aspirin use and survival rates in relation to clinical characteristics as well as duration of aspirin use in patients with OSCC. Our findings suggest that OSCC patients with aspirin use for more than 180 days showed improved overall and disease-specific survival rates. Aspirin also improves survival in patients across various stages of OSCC. Cox regression models indicated that aspirin use was associated with a good prognosis. In conclusion, this evidence indicates that aspirin may be potentially used as an adjuvant therapy for OSCC.
Was wissen Sie über … den Bewegungsapparat?
Authors: Schmid Eva C.
Published: August 2021

In dieser Ausgabe beschäftigen sich alle Wissensquiz-Fragen mit dem Bewegungsapparat.
Teamplayer: Herz, Magen, Ellenbogen
Authors: Peters Bianca
Published: August 2021

Golfer- und Tennisellenbogen lassen sich über die zugeordneten Segmente, Meridiane und Organe erklären und mittels entsprechender Segment- und Meridian-Tapes behandeln. Insbesondere Herz und Emotionen (Golferellenbogen) sowie der Magen (Tennisellenbogen) stehen über die Segmente C5–Th1 sowie den Herz- und Dickdarmmeridian in enger Wechselbeziehung mit den Strukturen des Ellenbogens. In den beiden vorgestellten Fällen konnte ein chronisch schmerzender Ellenbogen mit den entsprechenden Herz- und Magenbeschwerden in Beziehung gesetzt und durch Schröpfen, Segment- und Meridian-Taping erfolgreich behandelt werden.
Serum 25(OH)D Concentration and Cardiovascular Disease Risk Markers
Among Middle-Aged Healthy and Type 2 Diabetic Subjects
Authors: Dhas Yogita , Banerjee Joyita , Damle Gauri , Mishra Neetu
Published: August 2021

Vitamin D deficiency is a major widespread health concern and is linked to a high
risk of cardiovascular disease (CVD). Thus, we have investigated the association
of vitamin D with various CVD risk markers. The present study comprises 90
control and 90 type 2 diabetes mellitus (T2DM) subjects of both sexes (age
range, 30–50 years). The 25 hydroxyvitamin D [25(OH)D] and CVD risk
markers including high sensitive C-reactive protein (hs-CRP), monocyte
chemoattractant protein-1 (MCP-1), intact parathyroid hormone (I-PTH),
fibroblast growth factor (FGF)-23, erythrocyte sedimentation rate (ESR), and
fibrinogen were measured by using standard assays. Blood viscosity and
atherogenic index of plasma calculated using standard formulae. The ten-year
cardiovascular risk was assessed using the Framingham risk score (FRS). 25(OH)D,
hs-CRP, MCP-1, FGF-23, ESR, fibrinogen, atherogenic index of plasma and FRS were
significantly different between control and T2DM groups (p<0.05).
25(OH)D showed a significant negative correlation with MCP-1, ESR, blood
viscosity, atherogenic index of plasma and FRS among total study subjects.
Further, logistics regression analysis showed an association of 25(OH)D with
MCP-1, hematocrit, fibrinogen, and blood viscosity. The association between
25(OH)D and various CVD risk markers suggests that 25(OH)D might help in the
prediction of CVD risk.
Pricktest als Provokation – schwere anaphylaktische Reaktion auf Hauttests mit Ceftriaxon bei beruflicher Exposition
Authors: Bircher Andreas J. , Parlar Betül , Mateluna Carlos Morales , Heijnen Ingmar , Scherer Hofmeier Kathrin
Published: August 2021

Es werden zwei Patienten vorgestellt, die wegen eines Asthma bronchiale bei beruflichem Kontakt mit Ceftriaxon abgeklärt wurden. Bei beiden trat innerhalb von Minuten nach Anlegen eines Pricktests mit Ceftriaxon eine adrenalinpflichtige, anaphylaktische Reaktion auf. Systemische Reaktionen auf Hauttests mit Betalaktamantibiotika sind relativ selten, sie können auch bei Patienten mit vorausgegangenen milden Symptomen wie Urtikaria oder beruflichen Kontaktallergien auf Betalaktame auftreten. Als Risikofaktoren werden schwere Anaphylaxien in der Anamnese und ein kurzes Reaktionsintervall genannt. Eine korrekte Durchführung der Hauttests mit Titration und eine adäquate Überwachung sind zu beachten.
Triterpenoids from Alisma orientale and their NF-кB Inhibitory Activity
Authors: Yang Qian , Li Yinqing , Liu Xizi , Han Shiyi , Fan Siyang
Published: August 2021

The rhizome of Alisma orientale (sam.) Juz. is used in clinics for eliminating dampness, reducing edema, and promoting diuresis. This study aimed to elucidate the compounds and investigate their nuclear factor-kappa inhibitory activities in human embryonic kidney 293 cells. A new triterpene, alismaketone B (1); a new natural nortriterpene, noralisolic acid A (2); and 13 known protostane-type triterpenes were isolated from the rhizome of A. orientale. The new structures and their absolute configurations were established using HRESIMS, NMR, and electronic circular dichroism experiments. All isolated compounds were evaluated for their inhibitory activity on NF-κB. The compounds 8, 9, 10, and 14 showed moderate NF-κB inhibitory activities with their IC50 values being 64.7, 32.3, 47.3, and 37.3 μM, respectively.
Effects of 12 weeks of high‐intensity interval, moderate‐intensity continuous and self‐selected intensity exercise training protocols on cognitive inhibitory control in overweight/obese adults: A randomized trial
Authors: Amorim Oliveira Gledson Tavares , Elsangedy Hassan Mohamed , Pereira Daniel Carvalho , de Melo Silva Raíssa , Campos Faro Heloiana Karoliny , Bortolotti Henrique , Costa Eduardo Caldas , Fontes Eduardo Bodnariuc
Published: August 2021

Growing evidence shows that aerobic exercise improves cognitive function. However, it is unclear how exercising at different exercise intensities affects cognitive inhibitory control in overweight/obese adults. Herein we compared the effects of 12 weeks of high‐intensity interval training (HIIT), moderate‐intensity continuous training (MICT), and self‐selected intensity training (SSIT) on cognitive inhibitory control in overweight/obese adults. A total of 64 adults (59.4% women, 31.3 ± 7.1 years, 29 ± 2.5 kg/m²) were randomized into three walking/running groups: HIIT, MICT and SSIT. All groups performed three exercise sessions per week on an outdoor running track for 12 weeks. Cognitive inhibitory control was assessed at baseline and after the exercising programs using a computerized version of the Stroop Color‐Words test. The HIIT and SSIT resulted in a faster Stroop effect (i.e. enhanced performance) when compared to MICT (p=.018; p=. 026), however, there were no significant differences between the HIIT and SSIT groups (p>. 05). The enhanced Stroop effect was correlated with increases in cardiorespiratory fitness after HIIT (r= −.521, p=. 018) and decreases in body fat after MICT (r=. 671, p=. 001). These findings may suggest that overweight/obese adults performing exercise interventions at higher intensities or self‐selected intensity may enhance their cognitive ability to inhibit automated behavioral responses.

Highlights

HIIT and/or SSIT are more effective than MICT in improving cognitive inhibitory control after 12‐weeks in overweight/obese adults.

Increases in cardiorespiratory fitness and decreases in body fat after HIIT and MICT were correlated with improvements in cognitive inhibitory control.

Our study highlights the possibility of performing different exercise programs in an outdoor environment to improve cognitive function in overweight/obese adults.
Theoretical study on the improvement of the doping efficiency of Al in 4H-SiC by co-doping group-IVB elements
Authors: Huang Yuanchao , Wang Rong , Qian Yixiao , Zhang Yiqiang , Yang Deren , Pi Xiaodong
Published: August 2021

The p-type doping efficiency of 4H silicon carbide (4H-SiC) is rather low due to the large ionization energies of p-type dopants. Such an issue impedes the exploration of the full advantage of 4H-SiC for semiconductor devices. In this study, we show that co-doping group-IVB elements effectively decreases the ionization energy of the most widely used p-type dopant, i.e., aluminum (Al), through the defect-level repulsion between the energy levels of group-IVB elements and that of Al in 4H-SiC. Among group-IVB elements Ti has the most prominent effectiveness. Ti decreases the ionization energy of Al by nearly 50%, leading to a value as low as ∼ 0.13 eV. As a result, the ionization rate of Al with Ti co-doping is up to ∼ 5 times larger than that without co-doping at room temperature when the doping concentration is up to 1018 cm−3. This work may encourage the experimental co-doping of group-IVB elements such as Ti and Al to significantly improve the p-type doping efficiency of 4H-SiC.
Limiting profile for stationary solutions maximizing the total population of a diffusive logistic equation
Authors: Inoue Jumpei
Published: August 2021

This paper focuses on the stationary problem of the diffusive logistic equation on a bounded interval. We consider the ratio of a population size of a species to a carrying capacity which denotes a spatial heterogeneity of an environment. In one-dimensional case, Wei-Ming Ni proposed a variational conjecture that the supremum of this ratio varying a diffusion coefficient and a carrying function is 3. Recently, Xueli Bai, Xiaoqing He, and Fang Li [Proc. Amer. Math. Soc. 144 (2016), pp. 2161–2170] settled the conjecture by finding a special sequence of diffusion coefficients and carrying functions. Our interest is to derive a profile of the solutions corresponding to this maximizing sequence. Among other things, we obtain the exact order of the maximum and the minimum of solutions of the sequence. The proof is based on separating the stationary problem into two ordinary differential equations and smoothly adjoining each solution.
Manifolds with two projective bundle structures
Authors: Occhetta Gianluca , Romano Eleonora , Solá Conde Luis
Published: August 2021

In this paper we classify varieties of Picard number two having two projective bundle structures of any relative dimension, under the assumption that these structures are mutually uniform. As an application we prove the Campana–Peternell conjecture for varieties of Picard number one admitting

C

∗

\mathbb {C}^*

-actions of a certain kind.
The construction of modular invariants
Authors: Yang Chen
Published: August 2021

We use the

k
[
V
]

k[V]

-module generator of the dual module of the polynomial ring

k
[
V
]

k[V]

over its subring of invariants of a finite group to construct modular invariants and show that it behaves better than the transfer homomorphism.
Limit measures of stochastic Schrödinger lattice systems
Authors: Chen Zhang , Wang Bixiang
Published: August 2021

This paper is devoted to the existence of invariant measures and their limiting behavior of the stochastic Schrödinger lattice systems with respect to noise intensity. We prove the set of all invariant measures of the stochastic systems is weakly compact when the noise intensity varies in a bounded interval. We further show any limit of a sequence of invariant measures of the perturbed systems must be an invariant measure of the limiting system.
The dimension of eigenvariety of nonnegative tensors associated with spectral radius
Authors: Fan Yi-Zheng , Huang Tao , Bao Yan-Hong
Published: August 2021

For a nonnegative weakly irreducible tensor, its spectral radius is an eigenvalue corresponding to a unique positive eigenvector up to a scalar, called Perron vector. But including the Perron vector, it may have more than one eigenvector corresponding to the spectral radius. The projective eigenvariety associated with the spectral radius is the set of the eigenvectors corresponding to the spectral radius considered in the complex projective space. We prove that the dimension of the above projective eigenvariety is zero, i.e. there are finitely many eigenvectors associated with the spectral radius up to a scalar. We characterize a nonnegative combinatorially symmetric tensor for which the dimension of projective eigenvariety associated with spectral radius is greater than zero. Finally we apply those results to the adjacency tensors of uniform hypergraphs.
Asymptotic free independence and entry permutations for Gaussian random matrices
Authors: Popa Mihai
Published: August 2021

The paper presents conditions on entry permutations that induce asymptotic freeness when acting on Gaussian random matrices. The class of permutations described includes the matrix transpose, as well as entry permutations relevant in Quantum Information Theory and Quantum Physics.
Lie automorphisms of incidence algebras
Authors: Fornaroli Érica , Khrypchenko Mykola , Santulo Ednei
Published: August 2021

Let

X
X

be a finite connected poset and

K
K

a field. We give a full description of the Lie automorphisms of the incidence algebra

I
(
X
,
K
)

I(X,K)

. In particular, we show that they are in general not proper.
Total curvature of planar graphs with nonnegative combinatorial curvature
Authors: Hua Bobo , Su Yanhui
Published: August 2021

We prove that the total curvature of any planar graph with nonnegative combinatorial curvature is an integral multiple of

1
12

\frac {1}{12}

. As a corollary, this answers a question proposed by T. Réti.
MRX8, the conserved mitochondrial YihA GTPase family member, is required for de novo Cox1 synthesis at suboptimal temperatures in Saccharomyces cerevisiae
Authors: Verma Yash , Mehra Upasana , Pandey Dharmendra Kumar , Kar Joy , Pérez-Martinez Xochitl , Jana Siddhartha S. , Datta Kaustuv
Published: August 2021

The role of the novel protein Mrx8, a putative GTPase essential for optimal Cox1 translation under cold stress, is reported. Additionally, GTPBP8, the human orthologue, rescues cellular respiration in Δ cells and localizes to the mitochondria in mammalian cells, indicating a universal role of the MRX8 family of proteins.
Cdc7-mediated phosphorylation of Cse4 regulates high-fidelity chromosome segregation in budding yeast
Authors: Mishra Prashant K. , Wood Henry , Stanton John , Au Wei-Chun , Eisenstatt Jessica R. , Boeckmann Lars , Sclafani Robert A. , Weinreich Michael , Bloom Kerry S. , Thorpe Peter H. , Basrai Munira A.
Published: August 2021

This study defined a role for Cdc7-mediated phosphorylation of Cse4 in faithful chromosome segregation.
Blasphemy: A Very Short Introduction
Authors: Sherwood Yvonne
Published: August 2021

Blasphemy: A Very Short Introduction studies the concept of blasphemy. In an increasingly secular world, ‘blasphemy’ is surely a defunct concept; and yet blasphemy (like God and religion) seems to be on the rise. This VSI asks why this should be the case, looking at factors such as the increased visibility of religious and racial minorities, new media, and the legacies of colonial blasphemy laws. Throughout, it uncovers new histories, from the story of accidentally blasphemous cartoons to the close associations between blasphemy, sex, and birth control. This VSI also asks why some ‘blasphemies’ have become infamous, while others have disappeared.
Introduction
Authors: Sherwood Yvonne
Published: August 2021

‘Introduction’ defines blasphemy and assesses what makes a blasphemy. Blasphemy is never purely about content; it needs a social and legal context, and tends to favour the values of the majority. Dictionary definitions of blasphemy as ‘speaking sacrilegiously’ about ‘God or sacred things’ suggest that blasphemy is somehow a purely religious crime. But this seems inaccurate, as many prosecuted crucifixions have targeted politics, nationalism, and the fusion of church and state. By definition, blasphemy seems to be in the eyes and ears of the receiver. But if some seeming ‘blasphemies’ are celebrated and commissioned by religious communities, then trying to guess what might hurt religious communities might be tricky.
Changing our future
Authors: Maslin Mark
Published: August 2021

‘Changing our future’ argues that the challenge of climate change must be seen within the current dominant political and economic landscape. Future policies and international agreements need to provide win-win solutions that deal with the biggest challenges facing humanity in the 21st century, which include climate change, environmental degradation, global inequality, and global security. What we need is a new era of planetary stewardship led by governments and underpinned by new economic theories. Effective carbon emission reductions require a partnership between government, both local and national, corporations, and civil society that is supported and encouraged by individual behaviour change. In addition, we need international organizations fit for the challenges of the 21st century.
Effects of supplemental d-methionine in comparison to l-methionine on nitrogen retention, gut morphology, antioxidant status, and mRNA abundance of amino acid transporters in weanling pigs
Authors: Espinosa Charmaine D , Mathai John K , Blavi Laia , Liu Yanhong , Htoo John K , Caroline Gonzalez-Vega J , Stein Hans H
Published: August 2021

An N-balance experiment was conducted to test the hypothesis that d-Methionine (d-Met) has the same bioavailability and efficacy as l-Methionine (l-Met) when fed to weanling pigs. A Met-deficient basal diet containing 0.24% standardized ileal digestible (SID) Met was formulated. Six additional diets were formulated by adding 0.036%, 0.072%, or 0.108% d-Met or l-Met to the basal diet, and these diets, therefore, contained 77%, 87%, or 97% of the requirement for SID Met. Fifty-six barrows (10.53 ± 1.17 kg) were housed in metabolism crates and allotted to the seven diets with eight replicate pigs per diet. Feces and urine were collected quantitatively with 7-d adaptation and 5-d collection periods. Blood and tissue samples from pigs fed the basal diet and pigs fed diets containing 0.108% supplemental Met were collected on the last day. Results indicated that N retention (%) linearly increased (P < 0.01) as supplemental d-Met or l-Met increased in diets. Based on N retention (%) as a response, the linear slope-ratio regression estimated the bioavailability of d-Met relative to l-Met to be 101% (95% confidence interval: 57%–146%). The villus height and crypt depth in the jejunum were not affected by the Met level or Met source. Total antioxidant capacity or thiobarbituric acid reactive substance concentrations in plasma or tissue samples from pigs fed the control diet or diets containing 0.108% supplemental d-Met or l-Met were not different. Abundance of mRNA for some AA transporters analyzed in intestinal mucosa of pigs also did not differ. Therefore, it is concluded that d-Met and l-Met are equally bioavailable for weanling pigs.
Plant–soil feedback during biological invasions: effect of litter decomposition from an invasive plant (Sphagneticola trilobata) on its native congener (S. calendulacea)
Authors: Sun Jianfan , Rutherford Susan , Saif Ullah Muhammad , Ullah Ikram , Javed Qaiser , Rasool Ghulam , Ajmal Muhammad , Azeem Ahmad , Nazir Muhammad Junaid , Du Daolin
Published: August 2021

Plant invasions can affect soil properties in the invaded habitat by altering the biotic and abiotic nature of soils through positive or negative plant–soil feedback. Litter decomposition from many invasive species enhanced soil nutrients, thereby decreasing native plant diversity and leading to further plant invasions. Here, we examined the impact of litter decomposition from an invasive plant (Sphagneticola trilobata) in a range of soils at varying depths on growth and physiology of its native congener (Sphagneticola calendulacea). We added litter from S. trilobata to each soil type at different depths (0, 2, 4 and 6 cm). Plants of S. calendulacea were grown in each treatment, and morphological and physiological parameters were measured at the end of the growing period. All soils treated with litter displayed increases in soil nutrients at depths of 2 and 4 cm; while most growth traits, leaf chlorophyll and leaf nitrogen of S. calendulacea decreased at the same soil depths. Therefore, litter decomposition from invasive S. trilobata resulted in a positive plant–soil feedback for soil nutrients, and a negative plant–soil feedback for growth in native S. calendulacea. Our findings also suggest that the effects of litter decomposition from an invasive plant on soils and native species can vary significantly depending on the soil depth at which the litter is deposited. Future studies should focus on plant–soil feedback for more native and invasive species in invaded habitats, and the effects of invasive litter in more soil types and at greater soil depths.
Precision Intravenous Immunoglobulin Dosing and Clinical Outcomes: A Retrospective Chart Review
Authors: Nguyen Thy P. , Nguyen Thuy D. , Zhu Liang , Ayish Doha , Karnik Kavitha , Bokhari Hammad , Sheikh Kazim A.
Published: August 2021

Objectives:

Intravenous immunoglobulin (IVIg) is used for treatment of acute neurologic conditions such as Guillain–Barre syndrome, chronic inflammatory demyelinating polyradiculoneuropathy relapse, and myasthenia gravis exacerbation. Precision dosing (adjusted or ideal body weight) is proposed to conserve IVIg. There have been no published studies comparing clinical outcomes in traditional dosing (actual body weight) with precision dosing. In 2014, our institution began dosing patients with precision dosing. This decision was largely performed by administration rather than physicians' preference. We sought to analyze our retrospective data to understand the change in dosing methods with neurologic outcomes.

Methods:

We performed a retrospective review of all patients hospitalized at a single center who received IVIg for myasthenia gravis, Guillain–Barre syndrome, and chronic inflammatory demyelinating polyradiculoneuropathy from January 2010 to October 2017. We collected baseline information and clinical outcomes including mortality, readmission, need for second rescue treatment, length of stay, discharge disposition, treatment-related adverse events, and modified research council posttreatment sum score.

Results:

Length of stay was significantly shorter with precision dosing. There was no statistically significant difference in discharge disposition, readmission, rescue treatment, or modified research council posttreatment sum score with precision dosing.

Conclusion:

Precision dosing did not adversely affect short-term neurologic outcomes.
Routine Hospital-based SARS-CoV-2 Testing Outperforms State-based Data in Predicting Clinical Burden
Authors: Covello Leonard , Gelman Andrew , Si Yajuan , Wang Siquan
Published: August 2021

Throughout the coronavirus disease 2019 (COVID-19) pandemic, government policy and healthcare implementation responses have been guided by reported positivity rates and counts of positive cases in the community. The selection bias of these data calls into question their validity as measures of the actual viral incidence in the community and as predictors of clinical burden. In the absence of any successful public or academic campaign for comprehensive or random testing, we have developed a proxy method for synthetic random sampling, based on viral RNA testing of patients who present for elective procedures within a hospital system. We present here an approach under multilevel regression and poststratification to collecting and analyzing data on viral exposure among patients in a hospital system and performing statistical adjustment that has been made publicly available to estimate true viral incidence and trends in the community. We apply our approach to tracking viral behavior in a mixed urban–suburban–rural setting in Indiana. This method can be easily implemented in a wide variety of hospital settings. Finally, we provide evidence that this model predicts the clinical burden of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) earlier and more accurately than currently accepted metrics. See video abstract at, http://links.lww.com/EDE/B859.
Detecting Heterogeneity of Intervention Effects Using Analysis and Meta-analysis of Differences in Variance Between Trial Arms
Authors: Mills Harriet L. , Higgins Julian P.T. , Morris Richard W. , Kessler David , Heron Jon , Wiles Nicola , Davey Smith George , Tilling Kate
Published: August 2021

Background:

Randomized controlled trials (RCTs) with continuous outcomes usually only examine mean differences in response between trial arms. If the intervention has heterogeneous effects, then outcome variances will also differ between arms. Power of an individual trial to assess heterogeneity is lower than the power to detect the same size of main effect.

Methods:

We describe several methods for assessing differences in variance in trial arms and apply them to a single trial with individual patient data and to meta-analyses using summary data. Where individual data are available, we use regression-based methods to examine the effects of covariates on variation. We present an additional method to meta-analyze differences in variances with summary data.

Results:

In the single trial, there was agreement between methods, and the difference in variance was largely due to differences in prevalence of depression at baseline. In two meta-analyses, most individual trials did not show strong evidence of a difference in variance between arms, with wide confidence intervals. However, both meta-analyses showed evidence of greater variance in the control arm, and in one example, this was perhaps because mean outcome in the control arm was higher.

Conclusions:

Using meta-analysis, we overcame low power of individual trials to examine differences in variance using meta-analysis. Evidence of differences in variance should be followed up to identify potential effect modifiers and explore other possible causes such as varying compliance.
Employee Energy and Engagement: Keys to Clinician and Organization Well-Being in a Crisis
Authors: Singh Harjot
Published: August 2021

Well-being, engagement, and burnout among clinicians are interconnected, and the common denominator is energy. Decades of research show that employees’ energy is a decisive factor in achieving organizational outcomes. Knowing this, healthcare leaders can create well-being programs with measurable outcomes that make a positive impact on the bottom line. Just as important, leaders can avoid wasting money on fruitless efforts. How can clinician well-being be incorporated in organizational culture and strategic and operational plans? What are the special challenges to achieving clinician well-being? What key leadership actions promote and protect the well-being of clinicians? Which approaches are most effective during a crisis such as the COVID-19 pandemic? This article addresses those questions by presenting the rationale and methodology behind well-being programs that also address engagement and burnout so that clinicians can succeed in times of crisis and beyond.
The Efficacy of Orbital Septal Flap in the Treatment of Moderate and Severe Upper Eyelid Retraction
Authors: Vu Que Anh , Nguyen Thu Hien , Bui Van Anh , Pham Khanh Van , Kim Joohyun , Baek Sehyun
Published: August 2021

Purpose:

To assess the long-term effectiveness of the orbital septal flap to lengthen the levator muscle in management of moderate and severe upper eyelid retraction.

Methods:

This study reports 46 eyes of 43 consecutive patients with moderate or severe upper eyelid retraction who were recommended for surgery. The period of the study was between October 2016 and October 2019. All cases were evaluated for eyelid position before and at 3, 6, and 12 months after the operation. Successful outcome was defined as “perfect,” “acceptable,” and “failure”.

Results:

The average age was 33.3 years (range, 16–59 years). The average orbital septal flap height was 5.28 ± 0.77 mm. Before surgery, 78.3% had 1 of 3 central upper eyelid retraction (group 1), and 21.7% had 1 of 3 lateral upper eyelid retraction (group 2). During follow-up postoperatively, all eyelid parameters of upper marginal reflex distance, upper scleral show, and palpebral fissure height significantly decreased compared with preoperative values in both groups. The result was considered “perfect” or “acceptable” in 42 eyes (91.3%). However, at 12 months after surgery, of the 36 middle eyelid retraction cases (group 1), 35 (97.2%) showed a successful outcome (perfect or acceptable results), while the success rate in group 2 was 70% (7 of 10 cases), a significant difference (p = 0.008). No severe complications were seen during follow up.

Conclusions:

Orbital septal flap is a safe and reliable procedure for management of upper eyelid retraction of moderate and severe degree.
Effects of a Case Management Program for Women With Pregnancy-Induced Hypertension
Authors: CHOU Cheng-Chen , LIAW Jen-Jiuan , CHEN Chuan-Chuan , LIOU Yiing-Mei , WANG Chi-Jane
Published: August 2021

Background

Pregnancy-induced hypertension (PIH) is a leading cause of maternal and fetal morbidity and mortality. Although case management programs have been proposed to improve maternal and fetal outcomes in high-risk pregnancies, limited data are available regarding the effect of case management on women with PIH.

Purpose

The aim of this study was to evaluate the effect of an antepartum case management program on stress, anxiety, and pregnancy outcomes in women with PIH.

Methods

A quasi-experimental research design was employed. A convenience sample of women diagnosed with PIH, including preeclampsia, was recruited from outpatient clinics at a medical center in southern Taiwan. Sixty-two women were assigned randomly to either the experimental group (n = 31) or the control group (n = 31). The experimental group received case management for 8 weeks, and the control group received routine clinical care. Descriptive statistics, independent t or Mann–Whitney U tests, chi-square or Fisher's exact tests, paired t test, and generalized estimating equations were used to analyze the data.

Results

The average age of the participants was 35.1 years (SD = 4.5). No significant demographic or clinical differences were found between the control and experimental groups. The results of the generalized estimating equations showed significantly larger decreases in stress and anxiety in the experimental group than in the control group. No significant differences were identified between the two groups with respect to infant birth weeks, infant birth weight, average number of medical visits, or frequency of hospitalization.

Conclusions/Implications for Practice

The nurse-led case management program was shown to have short-term positive effects on the psychosocial outcomes of a population of Taiwanese patients with PIH. These results have important clinical implications for the healthcare administered to pregnant women, particularly in terms of improving the outcomes in those with PIH.
Nontuberculous mycobacteria in cystic fibrosis
Authors: Nick Jerry A. , Daley Charles L. , Lenhart-Pendergrass Patricia M. , Davidson Rebecca M.
Published: August 2021

Purpose of review

Nontuberculous mycobacteria (NTM) are challenging infections among people with cystic fibrosis (pwCF) as the source, modes of transmission, and best practices for diagnosis and treatment are not known. Investigators have defined aspects of NTM infection that are unique to the CF population, as well as features shared with other conditions at risk. This review describes recent advances in our understanding of NTM infection among pwCF.

Recent findings

The presence of dominant circulating clones of Mycobacterium abscessus within the CF community worldwide continue to be described, as well as pathogen phenotypes that could evoke greater environmental fitness and infectivity. The risk of direct or indirect transmission between pwCF remains an active focus of investigation, with divergent findings and conclusions reached in a site-specific fashion. Derived largely from studies in non-CF populations, new clinical guidelines are now available. A wide variety of agents are in preclinical development or early phase trials with promising findings, and new therapeutic targets have been identified as our understanding of the complex biology of NTM continues to expand.

Significant challenges remain in the fight against NTM, however, recent advances in our understanding of the genetics, epidemiology and pathophysiology of pulmonary NTM infection in pwCF are leading efforts to improve clinical care.
COVID-19 outcomes in people with cystic fibrosis
Authors: Burgel Pierre-Régis , Goss Christopher
Published: August 2021

Purpose of review

The COVID-19 global pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has had a dramatic impact that is still ongoing around the world. Cystic fibrosis (CF) has been identified as a possible risk factor of poor outcome.

Recent findings

Data collected by multiple National CF registries around the world have indicated that persons with CF (PwCF) are not more likely to be affected by SARS-CoV-2 than the general population. The course of SARS-CoV-2 is usually mild in PwCF who are relatively young. Severe outcomes have been described in patients with low lung function and in those with immune suppression (i.e. solid organ transplantation). Indirect impact of the pandemic on the CF community has also been observed, including difficulties in the organization of CF care, leading to a dramatic increase in telehealth for PwCF. The pandemic has further affected clinical research by complicating ongoing clinical trials. Vaccination appears important to all PwCF, with special priority on developing adequate vaccination scheme for transplant recipients. Long-term effects of COVID-19 on the CF population remains unknown.

The COVID-19 pandemic has caused significant impacts on PwCF and on healthcare professionals who provide specialized CF care and clinical research.
Incidence of spontaneous bacterial peritonitis among asymptomatic cirrhosis patients undergoing outpatient paracentesis: a systematic review and meta-analysis
Authors: Alotaibi Ammar , Almaghrabi Majed , Ahmed Osman , Rodrigues David , Iansavichene Alla , Puka Klajdi , Gandhi Radhika , Sey Michael , Patel Keyur , Brahmania Mayur
Published: August 2021

Introduction

Spontaneous bacterial peritonitis (SBP) is a common complication of decompensated cirrhosis with high morbidity and mortality rate. There is a paucity of evidence regarding the incidence of SBP in asymptomatic liver cirrhosis patients undergoing routine out-patient large-volume paracentesis (LVP). The aim of this study was to perform a systematic review and meta-analysis to determine the incidence of SBP among asymptomatic decompensated cirrhosis patients undergoing routine outpatient LVP.

Methods

A systematic search of Ovid Medline, Embase, Web of Science and CENTRAL electronic databases was performed in January 2021, along with a manual search of reference lists of retrieved articles. Data were extracted to determine the incidence of SBP [polymorphonuclear cells (PMNs) greater than 250 PMNs/mm3 with or without positive culture] and the incidence of all positive paracentesis (SBP or bacterascites-positive ascitic culture but no elevation in PMNs).

Results

A total of 504 studies were retrieved with 16 studies being included in the review. A total of 1532 patients were included with a total of 4016 paracentesis performed. The incidence of a positive paracentesis (SBP and/or bacterascitis) was 4% [95% confidence interval (CI), 3–6%]. However, the incidence of definite SBP was 2% (95% CI, 1–3%).

Conclusion

The incidence of SBP in asymptomatic outpatients with decompensated cirrhosis requiring LVP is low. The benefit of routine analysis of all paracentesis samples in this population is questionable. Further studies are required to determine the cost-effectiveness of routine analysis and to determine if certain subgroups are at higher risk of SBP that require routine analysis.
Racial Disparities in Avoidable Hospitalizations in Traditional Medicare and Medicare Advantage
Authors: Park Sungchul , Fishman Paul , Coe Norma B.
Published: August 2021

Importance:

Compared with traditional Medicare (TM), Medicare Advantage (MA) has the potential to reduce racial disparities in hospitalizations for ambulatory care sensitive conditions (ACSC). As racial disparities may be partly attributable to unequal treatment based on where people live, this suggests the need of examining geographic variations in racial disparities.

Objective:

The aim of this study was to examine differences in ACSC hospitalizations between White and Black beneficiaries in TM and MA and examine geographic variations in racial differences in ACSC hospitalizations in TM and MA.

Methods:

We analyzed the 2015−2016 Medicare Provider Analysis and Review files. We used propensity score matching to account for differences in characteristics between TM and MA beneficiaries. Then, we conducted linear regression and estimated adjusted outcomes for TM and MA beneficiaries by race. Also, we estimated racial differences in adjusted outcomes by insurance and hospital referral region (HRR).

Results:

While White beneficiaries in TM and MA had similar rates of ACSC hospitalizations (163.7 vs. 162.2/10,000 beneficiaries), Black beneficiaries in MA had higher rates of ACSC hospitalizations than Black beneficiaries in TM (221.2 vs. 209.3/10,000 beneficiaries). However, the racial differences were greater in MA than TM (59.0 vs. 45.6/10,000 beneficiaries). Racial differences in ACSC hospitalizations in MA were prevalent across almost all HRRs. 95.5% of HRRs had higher rates of ACSC hospitalizations among Black beneficiaries than White beneficiaries in MA relative to just 54.2% of HRRs in TM.

Conclusion:

Our findings provide evidence of racial disparities in access to high-quality primary care, especially in MA.
Cathepsin K is Superior to HMB45 for the Diagnosis of Pulmonary Lymphangioleiomyomatosis
Authors: Rolim Ines , Makupson Marquetta , Lovrenski Aleksandra , Farver Carol
Published: August 2021

Pulmonary lymphangioleiomyomatosis (LAM) is a rare cystic lung disease affecting predominantly young women. Classified as a low-grade malignant soft tissue neoplasm from the family of perivascular epithelioid cell (PEC) tumors or PEComas, it is characterized by a proliferation of abnormal smooth muscle-like cells (LAM cells), coexpressing myogenic and melanocytic markers, with HMB45 as the gold-standard immunohistochemical diagnostic marker. Cathepsin K, a papain-like cysteine protease with high matrix degrading activity, is commonly used in the pathologic diagnosis of other PEComa tumors, but there are few data regarding its expression in pulmonary LAM. This study compares the sensitivity of cathepsin K with that of HMB45 as immunohistochemical diagnostic markers for pulmonary LAM. Twenty-one (n=21) specimens of pulmonary LAM were retrieved from the archives of the Department of Pathology of the Cleveland Clinic. All cases were evaluated for protein expression of HMB45 and cathepsin K, on consecutive sections of formalin-fixed, paraffin-embedded tissue. The intensity and the total area of the immunostaining were quantified using an Aperio Scan Scope and analyzed with imaging software (Spectrum). Statistical analysis was performed using GraphPad software. The probability of a positive stained lesion on a transbronchial biopsy for each antibody was calculated. The percentage of LAM cells expressing cathepsin K was significantly higher than for HMB45 and overall expression was statistically significantly higher (P=0.0116). Our findings conclude that cathepsin K is a significantly more sensitive immunohistochemical marker than HMB45 in diagnosing pulmonary LAM.
Cable-Stayed Face Lift: An Innovative Short-Scar Lift for Better Correction of Nasolabial Folds in East Asians
Authors: Qiu Yajing , Gao Wei , Yang Jingyan , Jin Yunbo , Zou Yun , Qiao Congzhen , Chen Hui , Lin Xiaoxi
Published: August 2021

Background:

The improvement of nasolabial folds by either lateral superficial musculoaponeurotic system rhytidectomy or minimal access cranial suspension lift alone is commonly performed, but patient satisfaction is often limited in East Asians. An innovative technique, termed the cable-stayed face lift, which combines the strengths of lateral superficial musculoaponeurotic system rhytidectomy and minimal access cranial suspension lift, was developed for improved results.

Methods:

Between 2016 and 2019, 20 cable-stayed face lifts were performed in a single hospital. Two plastic surgeons independently evaluated postsurgery outcomes using a five-point Likert scale, where 5 = excellent, 4 = good, 3 = fair, 2 = no change, and 1 = worse. Patient satisfaction was assessed by relevant items from the FACE-Q questionnaire.

Results:

Twenty patients with a mean age of 51 years underwent face-lift surgery. The mean follow-up ± SD was 11.3 ± 9.8 months. The five-point Likert scale score evaluated by surgeons was 3.65 ± 1.08. Patient-perceived age visual analogue scale (7.8 ± 4.4) exhibited a difference between preoperative actual age and postoperative apparent age. Patients demonstrated high satisfaction with outcome (67.5 ± 16.2) and satisfaction with lower face and jawline (76.2 ± 14.9). No major complication, hematoma, or seroma was observed.

Conclusion:

The authors’ approach—cable-stayed face lift—offers a good alternative to provide a more effective effacement of nasolabial folds, by lifting the nasolabial folds with parallel vector and lower face and neck with the vertical vector.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
Mandibular Reconstruction with Scapular Systems: A Single-Center Case Series Involving 208 Flaps
Authors: Harada Hiroyuki , Shimamoto Hiroaki , Oikawa Yu , Kuroshima Takeshi , Tomioka Hirofumi , Hirai Hideaki , Tsushima Fumihiko , Michi Yasuyuki
Published: August 2021

Background:

The scapular flap is the most versatile composite flap used for mandibular reconstruction. The purpose of this study was to review and summarize findings of cases of mandibular reconstruction with a scapular flap and describe associated outcomes and complications.

Methods:

A total of 208 microvascular scapular free flaps were performed for mandibular reconstruction in a total of 205 patients from 2003 to 2018. This study involved a retrospective review of all eligible patients’ medical records.

Results:

There were seven cases (3.4 percent) of microvascular thrombosis. Postoperative bone union was achieved by 201 patients, except for five with total flap necrosis and two with partial flap necrosis. There were four cases (1.9 percent) of mandibular condyle dislocation. Two major types of complications were observed at the donor site, including four cases of infection and six cases of scapular body fracture. Postoperative denture prosthesis was introduced to 97 patients (47.3 percent). Implant treatment was performed in 10 patients (4.9 percent). Functional and aesthetic outcomes were good to excellent.

Conclusions:

The scapular composite free flap for mandibular reconstruction was associated with favorable outcomes and demonstrated satisfactory results. Although scapular bone fracture is rare, patients who have undergone mandibular reconstruction using a scapular flap should be monitored for its presence. 

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
Finesse in Mastopexy and Augmentation Mastopexy
Authors: Pferdehirt Rachel , Nahabedian Maurice Y.
Published: August 2021

Learning Objectives:

After studying this article, the participant should be able to: 1. Describe surgical techniques associated with mastopexy and mastopexy augmentation. 2. Understand the evolution of mastopexy and augmentation mastopexy. 3. Address patient goals. 4. Achieve a favorable cosmetic outcome.

The surgical techniques associated with mastopexy and mastopexy augmentation have continued to evolve. Traditional mastopexy techniques have included periareolar, circumvertical, and inverted-T patterns; however, adjuncts to these have included the use of various surgical mesh materials, implants, and fat grafting. This evidence-based article reviews how the techniques of mastopexy and augmentation mastopexy have evolved to best address patient goals and provide a favorable cosmetic outcome.
The first ‘Soviet type’ research institute of the Hungarian Academy of Sciences and its Stalin Prize-awarded director, Imre Szörényi
Authors: Orosz Ferenc , Müller Miklós
Published: August 2021

The Hungarian Academy of Sciences (HAS, established in 1825), similar to the academies of the old Soviet bloc, ran a research network from 1950 until 2019 when it was detached from the Academy. The first research institute of the HAS was the Institute of Biochemistry, which started its operation in 1950. Its first director was Imre Szörényi (1905–1959) who lived in emigration in Kiev until he was called back to Hungary in 1950 by the Secretariat of the Hungarian Workers Party. Initially, for a few years research in the Institute was partly influenced by Lepeshinskaya's ‘New Cell Theory’ and Szörényi himself became the chair of the ‘Living Protein’ Committee of the HAS. He returned for more than two years to Kiev where he received a shared Stalin Prize in 1952 for the development of the antibiotic, Microcid. After his final return to Hungary in 1953, he was able to shape the characteristic image of the Institute of Biochemistry, making it one of the leading workshops of Hungarian biochemistry. From 1956 onwards, ideological considerations no longer interfered with the choice of research topics. The relationship between the chemical structure and the specific biological function of enzymes became the main profile of the Institute. In spite of his untimely death, Szörényi exerted a long-lasting influence on Hungarian biochemistry through his disciples.