bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness and safety of same day discharge after left atrial appendage closure under moderate conscious sedation
Authors: Marmagkiolis Konstantinos , Ates Ismail , Kose Gulcan , Iliescu Cezar , Cilingiroglu Mehmet
Published: November 2020

Background

Left atrial appendage occlusion (LAAO) using Watchman device has become a world‐wide, well‐established therapeutic alternative to chronic systemic oral anticoagulation in patient who are at high‐risk of bleeding with paroxysmal (PAF) or chronic atrial fibrillation (Afib). Currently, LAAO procedures are performed under general anesthesia (GA) and patients stay overnight post procedure in the United States. We aimed to present the effectiveness and safety of same day discharge following LAAO under moderate conscious sedation (MCS) in patients without procedural complications.

Methods

A total of 112 patients between August 2019 and May 2020 with elevated CHA2DS2VASc (median score of 3) underwent transesophageal echocardiography (TEE)‐guided LAAO with FDA approved Watchman (Boston Scientific, MN) under MCS and discharged home on the same day 6 hr following their post procedural transthoracic echocardiogram (TTE) evaluations. All patients had next day TTE and follow up at the cardiology clinic. We prospectively evaluated clinical and procedural outcomes using medical records of these patients.

Results

Among all the patients, the mean age was 83.5 ± 8.5 years, 45 (40%) were women. Procedural duration, device implant time and fluoroscopic times were 45 ± 8.6, 14.5 ± 7.8 and 10.2 ± 1.2 min, respectively. The median required dosage of propofol was 105 ± 2.8 mg. No complications arose from MCS. There was no need for conversion to GA in any of the patients during the procedure. All patients were able to be discharged 6 hr following their TTE evaluation post procedure. There were no procedural complications.

Conclusions

Same day discharge following LAAO closure seems to be safe and effective in patients without procedural complications. LAAO can also be performed safely and effectively under moderate conscious sedation. Applying moderate conscious sedation may simplify the LAAO procedure, reduce procedural time, procedural costs and hospital stay while increasing overall patient satisfaction.
Mortality and functional outcomes of endovascular stroke therapy in the United States
Authors: Alqahtani Fahad , Osman Mohammed , Harris Alyssa Hartsell , Hohmann Samuel F. , Alkhouli Mohamad
Published: November 2020

Background

We sought to evaluate the nationwide trends in the characteristics and outcomes of for endovascular stroke therapy in contemporary practice.

Methods

We selected patients with acute ischemic stroke who underwent endovascular stroke therapy between 01 October 2015 and 30 September 2019 in a large academic consortium database. The end points of this study were (a) in‐hospital mortality and functional outcomes and, (b) predictors of poor functional outcome, defined as death or discharge to hospice, or to a long‐term nursing facility.

Results

Among the 22,193 included patients; 50.3% were females, and 66.5% were white. Mean age was 68±15 years. Poor functional outcomes occurred in 8,274 patients (37.4%), of whom 2,741 (12.4%) died in the hospital, 1,345 (6.1%) were discharged to hospice, and 4,188 (18.9%) were discharged to other long‐term facilities. Most common in‐hospital complications were mechanical ventilation (32.3%), intracranial hemorrhage (18.9%), and acute kidney injury (15.6%). Median total and intensive‐care length‐of‐stay were 7 days (IQR = 4–9), and 2 days (IQR = 1–4), respectively. Median cost was $36,609 (IQR = $26,034–$54,313). In a multi‐logistic regression analysis; age, hypertension, diabetes, anemia, heart failure, vascular disease, chronic pulmonary disease, renal insufficiency, Medicare/medicaid insurance, transfer from nonendovascular capable hospital, and low procedural volume independently predicted poor functional outcomes. Tissue plasminogen activator use was associated with better functional outcomes.

Conclusion

There is a substantial growth in the performance of endovascular stroke interventions in the United States in recent years, and those were associated with favorable short‐term outcomes.
Determinants of visual‐functional mismatches as assessed by coronary angiography and quantitative flow ratio
Authors: Sugiyama Tomoyo , Kanno Yoshinori , Hamaya Rikuta , Kanaji Yoshihisa , Hoshino Masahiro , Murai Tadashi , Lee Tetsumin , Yonetsu Taishi , Sasano Tetsuo , Kakuta Tsunekazu
Published: November 2020

Objective

We aimed to evaluate the determinants of visual‐functional mismatches between quantitative coronary angiography (QCA) and the quantitative flow ratio (QFR).

Background

The fractional flow reserve (FFR) has been established as a method to estimate the functional stenosis severity of coronary artery disease and to optimize decision‐making for revascularization. The QFR is a novel angiography‐derived computational index that can estimate the FFR without pharmacologically induced hyperemia or the use of pressure wire.

Methods

A total of 504 de novo intermediate‐to‐severe stable lesions that underwent angiographic and physiological assessments were analyzed. All lesions were divided into four groups based on the significance of visual (QCA‐diameter stenosis [DS] > 50% and ≤ 50%) and functional (QFR ≤ 0.80 and > 0.80) stenosis severity. Patient characteristics, angiographic findings, and physiological indices were compared.

Results

One‐hundred seventy‐eight lesions (35.3%) showed discordant visual‐functional assessments; mismatch (QCA‐DS > 50% and QFR > 0.80) in 75 lesions (14.9%) and reverse mismatch (QCA‐DS ≤ 50% and QFR ≤ 0.80) in 103 lesions (20.4%), respectively. Reverse mismatch was associated with non‐diabetes, lower ejection fraction, higher Duke jeopardy score, and lower coronary flow reserve (CFR). Mismatch was associated with smaller QCA‐DS, larger reference diameter, shorter lesion length, lower Duke jeopardy score, and higher CFR. Lesion location and microcirculatory resistance was not associated with the prevalence of mismatches. Reverse mismatch group had the higher prevalence of discordant decision‐makings between QFR and FFR than the other three groups.

Conclusions

The CFR and subtended myocardial mass were predictors of visual‐functional mismatches between QCA‐DS and the QFR. Caution should be exercised in lesions showing QCA‐DS/QFR reverse mismatch.
Gingival bleeding associated with COVID‐19 infection
Authors: Manzalawi Rahaf , Alhmamey Khulud , Abdelrasoul Mohamed
Published: November 2020

Gingival bleeding, which was not previously present, may be a preceding symptom associated with COVID‐19 infections, preceding or coincidental with fever, other clinical signs, and positive testing.
Boosting Visible‐Light‐Driven H2 Evolution of Covalent Triazine Framework from Water by Modifying Ni(II) Pyrimidine‐2‐thiolate Cocatalyst
Authors: Xu Ze , Cui Yao , Guo Bin , Li Hai‐Yan , Li Hong‐Xi
Published: November 2020

Covalent triazine frameworks (CTFs) have recently emerged as prospective photoactive materials coupled with Pt or Pd cocatalyst for the hydrogen evolution. Herein, we report visible‐light driven hydrogen generation catalyzed by heterogeneous systems combining CTF photosensitizers and a noble‐metal‐free cocatalyst for the first time. CTF‐HC2 was doped with two‐dimensional Ni(II) pyrimidine‐2‐thiolate ([Ni(pymt)2]n) to yield a series of x‐[Ni(pymt)2]n/CTF‐HC2 (x=3, 6, 9, 12, 15, 18 and 24 wt %) composites. Illuminated with λ>420 nm, [Ni(pymt)2]n/CTF‐HC2 materials display excellent photocatalytic performance for H2 generation from water. The highest hydrogen evolution rate is up to 3472 μmol h−1 g−1, which is 68 times of bare CTF‐HC2 (51 μmol h−1 g−1) and 1.16 times of CTF‐HC2 doped 2.0 wt % Pt (2991 μmol h−1 g−1). The efficient and recyclable heterogeneous photocatalytic H2 production from water under visible light has been established.
A Novel CeO2/Cu2O/CuO Nanocomposite Designed from a CeAlCu Glass Precursor as an Excellent Dual Function Catalyst in Dye Wastewater Remediation
Authors: Song Jingjing , Zhang Fabao , Hu Qingzhuo , Jiang Wei , Li Dongdong , Zhang Bo
Published: November 2020

A novel dual functional CeO2/Cu2O/CuO nanocomposite was synthesized by a facile chemical method using Ce‐based Ce‐Al‐Cu glass ribbons as a precursor. The nanocomposite can rapidly degrade azo dyes including orange II (OII), methyl orange (MO), and congo red (CR) under dark conditions with no chemical and energy input. Under visible light irradiation, the composite also showed high efficiency for the decomposition azo‐free dyes such as methylene blue (MB) and rhodamine B (RhB). The excellent performances of the nanocomposite in both dark and light conditions are attributed to the synergistic effects of its composition and the nanoparticle structure that have large surface areas and contain many active sites, and to the formation of heterojunctions in the Ce/Cu Oxide. The high performance of this bi‐functional catalyst made from industrially‐prepared atomically homogenous amorphous metallic demonstrates the promise of high‐performance catalysts based on multi‐component metallic glass materials.
Restraining Polysulfide with High‐Entropy Metal Nitride towards Long Cycle Life and High Capacity Li−S Batteries
Authors: Fang Binren , Tian Xiaolu , Wang Te , Wang Tao , Qu Long , Li Mingtao
Published: November 2020

Lithium−sulfur (Li−S) batteries with ultrahigh theoretical specific capacity (1675 mAh g−1) have become a research hotpot, which focuses on the solution of shuttle effect of soluble lithium polysulfides (LIPS). Chemical immobilization of LIPS and encapsulation structure of the sulfur cathode are effective strategies to suppress the shuttle effect. Herein, high entropy metal nitride (HEMN) was prepared by mechanochemical‐assisted synthesis as an innovative anchor to restrain LIPS via the chemical bonding interaction between HEMN and LIPS. Furthermore, the composite of HEMN and S was encased by graphene (GR) through electrostatic attraction caused by opposite zeta potential, thus as the effective cathode (HEMN/S@GR) of Li−S batteries. HEMN has plentiful active metal sites which can chemically adsorb LIPS, enhancing the cycle life of Li−S batteries. Graphene can accelerate surface charge transfer of sulfur cathode to reduce the interface resistance because of its high conductivity. The initial specific capacity of HEMN/S@GR cathode is 1193 mAh g−1 and still maintains 695 mAh g−1 after 100 cycles at 0.1 C. When increased to 1.0 C, the initial specific capacity is 556 mAh g−1 and exhibits remarkable stability in long cycles. This study presents the synergetic effect of HEMN and graphene on LIPS in Li−S batteries, which introduces a new application way of high entropy materials in the field of energy storage devices.
Polymerization‐Driven Photoluminescence in Alkanolamine‐Based C‐Dots
Authors: Ludmerczki Robert , Malfatti Luca , Stagi Luigi , Meloni Manuela , Carbonaro Carlo Maria , Casula Maria Francesca , Bogdán Dóra , Mura Stefania , Mándity István M. , Innocenzi Plinio
Published: November 2020

Carbonized polymer dots (CPDs), a peculiar type of carbon dots, show extremely high quantum yields, making them very attractive nanostructures for application in optics and biophotonics. The origin of the strong photoluminescence of CPDs resides in a complicated interplay of several radiative mechanisms. To understand the correlation between CPD processing and properties, the early stage formation of carbonized polymer dots has been studied. In the synthesis, citric acid monohydrate and 2‐amino‐2‐(hydroxymethyl)propane‐1,3‐diol have been thermally degraded at 180 °C. The use of an oil bath instead of a more traditional hydrothermal reactor has allowed the CPD properties to be monitored at different reactions times. Transmission electron microscopy, time‐resolved photoluminescence, nuclear magnetic resonance, infrared, and Raman spectroscopy have revealed the formation of polymeric species with amide and ester bonds. Quantum chemistry calculations have been employed to investigate the origin of CPD electronic transitions. At short reaction times, amorphous C‐dots with 80 % quantum yield, have been obtained.
The Young Scientists Network: How the European Federation for Medicinal Chemistry (EFMC) Became Young Again
Authors: Goncharenko Kristina , Mari Michele , Auberson Yves P. , Matagne Brieuc
Published: November 2020

The European Federation for Medicinal Chemistry (EFMC) created the Young Scientists Network (YSN) to support early‐career medicinal chemists and chemical biologists. By doing this, it addressed the rapid changes taking place in the scientific community and in our society, such as the rise of social media, the evolution of the gender balance in the scientific population, and educational needs. Creating the YSN was also a way to ensure that the next generation of scientists would contribute to shaping EFMC's strategy, while recognizing and addressing their needs. The YSN was set up as a very dynamic concept, and has now developed to the point where its impact is evident. The activities it promotes complement EFMC's community support and scientific opportunities, rejuvenating the Federation and preparing it for the future. It also provides opportunities for many brilliant young scientists, who do not hesitate to invest time and energy in supporting our community and shaping their own future.
High‐Throughput Image Cytometry Detection Method for CAR‐T Transduction, Cell Proliferation, and Cytotoxicity Assays
Authors: Wang Yufei , Chan Leo Li‐Ying , Grimaud Marion , Fayed Atef , Zhu Quan , Marasco Wayne A.
Published: November 2020

Chimeric antigen receptor (CAR)‐T cell therapy has drawn much attention due to its recent clinical success in B‐cell malignancies. In general, the CAR‐T cell discovery process consists of CAR identification, T‐cell activation, transduction, and expansion, as well as assessment of CAR‐T cytotoxicity. The current evaluation methods for the CAR‐T discovery process can be time‐consuming, low‐throughput and requires the preparation of multiple sacrificial samples in order to produce kinetic data. In this study, we employed the use of a plate‐based image cytometer to monitor anti‐CAIX (carbonic anhydrase IX) G36 CAR‐T generation and assess its cytotoxic potency of direct and selective killing against CAIX+ SKRC‐59 human renal cell carcinoma cells. The transduction efficiency and cytotoxicity results were analyzed using image cytometry and compared directly to flow cytometry and Chromium 51 (51Cr) release assays, showing that image cytometry was comparable against these conventional methods. Image cytometry method streamlines the assays required during the CAR‐T cell discovery process by analyzing a plate of T cells from CAR‐T generation to in vitro functional assays with minimum disruption. The proposed method can reduce assay time and uses less cell samples by imaging and analyze the same plate over time without the need to sacrifice any cells. The ability to monitor kinetic data can allow additional insights into the behavior and interaction between CAR‐T and target tumor cells. © 2020 International Society for Advancement of Cytometry
Neuronal NADPH oxidase 2 regulates growth cone guidance downstream of slit2/robo2
Authors: Terzi Aslihan , Roeder Haley , Weaver Cory J. , Suter Daniel M.
Published: November 2020

NADPH oxidases (Nox) are membrane‐bound multi‐subunit protein complexes producing reactive oxygen species (ROS) that regulate many cellular processes. Emerging evidence suggests that Nox‐derived ROS also control neuronal development and axonal outgrowth. However, whether Nox act downstream of receptors for axonal growth and guidance cues is presently unknown. To answer this question, we cultured retinal ganglion cells (RGCs) derived from zebrafish embryos and exposed these neurons to netrin‐1, slit2, and brain‐derived neurotrophic factor (BDNF). To test the role of Nox in cue‐mediated growth and guidance, we either pharmacologically inhibited Nox or investigated neurons from mutant fish that are deficient in Nox2. We found that slit2‐mediated growth cone collapse, and axonal retraction were eliminated by Nox inhibition. Though we did not see an effect of either BDNF or netrin‐1 on growth rates, growth in the presence of netrin‐1 was reduced by Nox inhibition. Furthermore, attractive and repulsive growth cone turning in response to gradients of BDNF, netrin‐1, and slit2, respectively, were eliminated when Nox was inhibited in vitro. ROS biosensor imaging showed that slit2 treatment increased growth cone hydrogen peroxide levels via mechanisms involving Nox2 activation. We also investigated the possible relationship between Nox2 and slit2/Robo2 signaling in vivo. astray/nox2 double heterozygote larvae exhibited decreased area of tectal innervation as compared to individual heterozygotes, suggesting both Nox2 and Robo2 are required for establishment of retinotectal connections. Our results provide evidence that Nox2 acts downstream of slit2/Robo2 by mediating growth and guidance of developing zebrafish RGC neurons.
An infrared spectroscopic approach to characterise white powders, easily applicable in the context of drug checking, drug prevention and on‐site analysis
Authors: Deconinck Eric , Aït‐Kaci Camille , Raes Andries , Canfyn Michaël , Bothy Jean‐Luc , Duchateau Céline , Mees Corenthin , De Braekeleer Kris , Gremaux Lies , Blanckaert Peter
Published: November 2020

More and more events, such as the summer music festivals, are considering the possibilities for implementing on‐site testing of psychoactive drugs in the context of prevention and harm reduction. Although the on‐site identification is already implemented by plenty of drug checking services, the required rapid quantitative dosing of the composition of illicit substances is still a missing aspect for a successful harm reduction strategy at events. In this paper, an approach is presented to identify white powders as amphetamine, cocaine, ketamine or others and to estimate the purity of the amphetamine, cocaine and ketamine samples using spectroscopic techniques hyphenated with partial least squares (PLS) modelling. For identification purposes, it was observed that mid‐infrared spectroscopy hyphenated with PLS‐discriminant analysis allowed the distinction between amphetamine, cocaine, ketamine and other samples and this with a correct classification rate of 93.1% for an external test set. For quantitative estimation, near‐infrared spectroscopy was more performant and allowed the estimation of the dosage/purity of the amphetamine, cocaine and ketamine samples with an error of more or less 10% w/w. An easily applicable, practical and cost‐effective approach for on‐site characterisation of the majority of the psychoactive samples encountered in Belgian nightlife settings based on IR spectroscopy was proposed.
On the road of dried blood spot sampling for antidoping tests: Detection of GHRP‐2 abuse
Authors: Reverter‐Branchat Gemma , Segura Jordi , Pozo Oscar J.
Published: November 2020

Dried blood spots (DBSs) sampling is gaining support by the antidoping community because of simplicity and cost‐effective characteristics, especially in collection, transport, and storage. Nevertheless, DBS applicability demands specific studies for each of the analytes proposed for testing. Here, GHRP‐2 has been selected as a representing member of the growth hormone‐releasing peptides (GHRPs) family to provide further evidence of DBS suitability for GHRPs abuse detection in sport testing. An analytical procedure to extract GHRP‐2 and its main metabolite (AA‐3) from DBS and to detect them by liquid chromatography–tandem mass spectrometry (LC–MS/MS) has been developed. The method has been validated for the detection of GHRP‐2. Specificity and identification capabilities have been assessed in agreement with antidoping guidelines. The low AA‐3 levels found in DBS samples prevented its effective application for the determination of this metabolite. The limit of detection (LoD) for GHRP‐2 has been established at 50 pg/ml. Long‐term stability (>2 years) has been confirmed. The procedure has been successfully applied to actual DBS samples from an administration study with a single intravenous dose of GHRP‐2 (100 μg) being detected up to 4 h after drug injection. GHRP‐2 concentrations have been higher in venous blood DBS than in capillary blood DBS. Despite the observed differences, a similar detection window has been achieved independently of the type of blood used.

In summary, this study provides specific evidence supporting DBS usefulness to detect GHRP‐2, and potentially other GHRPs family members, for antidoping tests.
Screen‐detected disordered eating and related traits in a large population sample of females in mainland China: China Health and Nutrition Survey
Authors: Yao Shuyang , Zhang Ruyue , Thornton Laura M. , Peat Christine M. , Qi Baiyu , Du Shufa , Wang Huijun , Zhang Bing , Bulik Cynthia M.
Published: November 2020

Objective

We describe the prevalence and sociodemographic factors associated with screen‐detected disordered eating and related traits in a population‐based sample of women in China. We also explored prevalence trends over time.

Method

A total of 4,218 females aged 12–50 were sampled from 15 provinces as part of the China Health and Nutrition Survey (CHNS) in 2015. The SCOFF questionnaire screened for disordered eating and the selected questions from the Eating Disorders Examination‐Questionnaire measured dietary restraint, shape concerns, and weight concerns. Body mass index (BMI) was measured and sociodemographic factors captured urban/rural residence, age, ethnicity, income, education, marital status, and occupational status. We calculated the prevalence of screen‐detected disordered eating and related traits broadly and across several dimensions and compared prevalence estimates to 2009 and 2011 reports.

Results

We detected 296 individuals who screened positive for disordered eating on the SCOFF (prevalence = 7.04%). Positive screens were associated with urban residence (p = .002) and higher education levels (p < .001). Scores on restraint, shape concerns, and weight concerns were all higher for individuals in urban versus village locations (all p's < .001), and with higher BMI (p < .001) for shape and weight concerns. The prevalence of screen‐detected disordered eating increased numerically across 2009, 2011, and 2015.

Discussion

The prevalence of screen‐detected disordered eating in mainland China was comparable to other populations worldwide obtained from a recent meta‐analysis. The distribution of disordered eating and related traits varied by several sociodemographic factors, which include age, BMI, urban/rural residence, education, and income, suggesting important directions for case detection and intervention in China.
Sudden cardiogenic shock mimicking fulminant myocarditis in a surviving teenager affected by severe acute respiratory syndrome coronavirus 2 infection
Authors: Garau Giovanni , Joachim Sabrina , Duliere Guy‐Loup , Melissopoulou Maria , Boccar Sandrine , Fraipont Vincent , Dugauquier Christophe , Troisfontaines Pierre , Hougrand Olivier , Delvenne Philippe , Hoffer Etienne
Published: November 2020

In the context of the coronavirus disease 2019 pandemic, myocardial injury is a relatively frequent finding. Progression to cardiogenic shock has been rarely described, especially in healthy young patients. The underlying mechanisms are to date controversial. A previously healthy 18‐year‐old female teenager affected by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) developed fulminant cardiogenic shock requiring a prompt extracorporeal membrane oxygenation support. Cardiac involvement was predominant compared with the pulmonary one. Myocardial biopsies were performed; and in order to clarify the pathophysiology of the acute heart failure, optical and transmission electron microscopy study was realized. Two additional immunohistology techniques were developed in order to (i) detect a SARS‐CoV‐2 recombinant fusion nucleoprotein by using a specific antibody and (ii) study fractalkine expression induced by activated endothelium because this molecule is well known to be elevated in patients with severe cytokine release syndrome. SARS‐CoV‐2 genome was not detected in the myocardium. Even if the clinical presentation, laboratory markers, and cardiac imaging techniques strongly suggested fulminant myocarditis, histology and immunohistology were not fully consistent with this diagnosis according to the Dallas criteria. Although rare suspected coronavirus particles were found by transmission electron microscopy in the cardiac endothelium, neither significant immunoreactivity for the viral nucleocapsid protein nor image suggestive of endotheliitis was detected. Intense endothelial immunoreactivity pattern for fractalkine expression was observed. From a clinical point of view, the left ventricular systolic function gradually improved, and the patient survived after a long stay in the intensive care unit. Our observations suggest that a massive cytokine storm induced by SARS‐CoV‐2 infection was the main cause of the cardiogenic shock, making a direct viral injury pathway very unlikely.
Cardiac adaptations to 60 day head‐down‐tilt bed rest deconditioning. Findings from the AGBRESA study
Authors: Hoffmann Fabian , Rabineau Jérémy , Mehrkens Dennis , Gerlach Darius A. , Moestl Stefan , Johannes Bernd W. , Caiani Enrico G. , Migeotte Pierre Francois , Jordan Jens , Tank Jens
Published: November 2020

Aims

Reduced physical activity increases the risk of heart failure; however, non‐invasive methodologies detecting subclinical changes in myocardial function are not available. We hypothesized that myocardial, left ventricular, systolic strain measurements could capture subtle abnormalities in myocardial function secondary to physical inactivity.

Methods and results

In the AGBRESA study, which assessed artificial gravity through centrifugation as potential countermeasure for space travel, 24 healthy persons (eight women) were submitted to 60 day strict −6° head‐down‐tilt bed rest. Participants were assigned to three groups of eight subjects: a control group, continuous artificial gravity training on a short‐arm centrifuge (30 min/day), or intermittent centrifugation (6 × 5 min/day). We assessed cardiac morphology, function, strain, and haemodynamics by cardiac magnetic resonance imaging (MRI) and echocardiography. We observed no differences between groups and, therefore, conducted a pooled analysis. Consistent with deconditioning, resting heart rate (∆8.3 ± 6.3 b.p.m., P < 0.0001), orthostatic heart rate responses (∆22.8 ± 19.7 b.p.m., P < 0.0001), and diastolic blood pressure (∆8.8 ± 6.6 mmHg, P < 0.0001) increased, whereas cardiac output (∆−0.56 ± 0.94 L/min, P = 0.0096) decreased during bed rest. Left ventricular mass index obtained by MRI did not change. Echocardiographic left ventricular, systolic, global longitudinal strain (∆1.8 ± 1.83%, P < 0.0001) decreased, whereas left ventricular, systolic, global MRI circumferential strain increased not significantly (∆−0.68 ± 1.85%, P = 0.0843). MRI values rapidly returned to baseline during recovery.

Conclusion

Prolonged head‐down‐tilt bed rest provokes changes in cardiac function, particularly strain measurements, that appear functional rather than mediated through cardiac remodelling. Thus, strain measurements are of limited utility in assessing influences of physical deconditioning or exercise interventions on cardiac function.
Dielectrophoresis: Developments and applications from 2010 to 2020
Authors: Sarno Benjamin , Heineck Daniel , Heller Michael J. , Ibsen Stuart D.
Published: November 2020

The 20th century has seen tremendous innovation of dielectrophoresis (DEP) technologies, with applications being developed in areas ranging from industrial processing to micro‐ and nanoscale biotechnology. From 2010 to present day, there have been 981 publications about DEP. Of over 2600 DEP patents held by the United States Patent and Trademark Office, 106 were filed in 2019 alone. This review focuses on DEP‐based technologies and application developments between 2010 and 2020, with an aim to highlight the progress and to identify potential areas for future research. A major trend over the last 10 years has been the use of DEP techniques for biological and clinical applications. It has been used in various forms on a diverse array of biologically derived molecules and particles to manipulate and study them including proteins, exosomes, bacteria, yeast, stem cells, cancer cells, and blood cells. DEP has also been used to manipulate nano‐ and micron‐sized particles in order to fabricate different structures. The next 10 years are likely to see the increase in DEP‐related patent applications begin to result in a greater level of technology commercialization. Also during this time, innovations in DEP technology will likely be leveraged to continue the existing trend to further biological and medical‐focused applications as well as applications in microfabrication. As a tool leveraged by engineering and imaginative scientific design, DEP offers unique capabilities to manipulate small particles in precise ways that can help solve problems and enable scientific inquiry that cannot be addressed using conventional methods.
Perampanel in real‐world clinical care of patients with epilepsy: Interim analysis of a phase IV study
Authors: Wheless James , Wechsler Robert T. , Lancman Marcelo , Aboumatar Sami , Patten Anna , Malhotra Manoj
Published: November 2020

Objective

To assess the retention rate, efficacy, safety, and dosing of perampanel administered to patients with epilepsy during routine clinical care in the retrospective phase IV, PROVE Study (NCT03208660).

Methods

Exposure, efficacy, and safety data were obtained from the medical records of patients initiating perampanel after January 1, 2014, across 29 US study sites. The cutoff date for this interim analysis was October 10, 2018. The primary efficacy endpoint was retention rate. Secondary efficacy endpoints included median percent changes in seizure frequency, seizure‐freedom rate, and overall investigator impression of seizure effect.

Results

All enrolled patients (N = 1121) received perampanel. Mean (standard deviation [SD]) cumulative duration of exposure to perampanel was 16.6 (14.7) months; overall mean (SD) daily perampanel dose was 5.7 (2.7) mg. Perampanel uptitration occurred weekly (21.1%), biweekly (23.8%), every 3 weeks (1.5%), other (43.3%), and unknown (10.3%). Across the Safety Analysis Set (N = 1121), retention rate on perampanel at 24 months was 49.5% (n = 319/645).

At 12 months, the median reduction in seizure frequency per 28 days from baseline in the small number of patients for whom data were available was 75.0% (n = 85), and 30/85 (35.3%) patients were seizure free. Based on investigator impression at the end of treatment, improvement, no change (ie, stable), or worsening of seizures was reported in 54.3%, 33.7%, and 12.0% of patients, respectively.

Treatment‐emergent adverse events occurred in 500 (44.6%) patients; the most common were dizziness (9.2%), aggression (5.4%), and irritability (4.5%). Serious treatment‐emergent adverse events occurred in 32 (2.9%) patients.

Significance

Favorable retention and sustained efficacy were demonstrated for ≥12 months following initiation of perampanel during routine clinical care in patients with epilepsy.
Energy absorption characteristics in hybrid composite materials for marine applications under impact loading: Case of tidal current turbine
Authors: Laaouidi Houda , Tarfaoui Mostapha , Nachtane Mourad , Trihi Mourad
Published: November 2020

The tidal current turbine is the most efficient way to extract energy from the sea. This system can be prone to critical loads such as impact accidental in the installation and maintenance phase. Indeed, several complex modes of damage susceptible to harming the stability of the structure are studied to conceive hybrid composite nozzles with better resistance to damage. For this reason, two scenarios of low‐velocity impact of a hybrid composite nozzle (glass/carbon) were investigated. In both cases, the impact was realized in the region of the trailing edge of the nozzle, and the results obtained were compared between three different laminated. On the other hand, damage modeling was formulated using the finite element method based on the Hashin criteria. Energy conservation of the nozzle was verified to validate the numerical model. Also, the effects of the impact velocity and the panel's flexibility on the initiation and propagation of damage have been studied. Depending on the results, the stacking sequence significantly influences the formation of damage. However, the results show that the hybrid nozzle with CGG (carbon/glass/glass) stacking has a higher impact resistance compared to other laminates.
Liver Fibrosis Index FIB‐4 Is Associated With Mortality in COVID‐19
Authors: Li Yijia , Regan James , Fajnzylber Jesse , Coxen Kendyll , Corry Heather , Wong Colline , Rosenthal Alexandra , Atyeo Caroline , Fischinger Stephanie , Gillespie Elizabeth , Chishti Rida , Baden Lindsey , Yu Xu G , Alter Galit , Kim Arthur , Li Jonathan Z
Published: November 2020

Coronavirus disease 2019 (COVID‐19) is associated with adverse outcomes, including need for invasive mechanical ventilation and death in people with risk factors. Liver enzyme elevation is commonly seen in this group, but its clinical significance remains elusive. In this study, we calculated the Fibrosis‐4 (FIB‐4) score for a cohort of hospitalized patients with COVID‐19 and assessed its association with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) RNA, inflammatory cytokine levels, and clinical outcome. A total of 202 hospitalized participants who tested positive for SARS‐CoV‐2 by nasopharyngeal sampling were included in this analysis. FIB‐4 was calculated for each participant using the alanine aminotransferase, aspartate aminotransferase, age, and platelet count. We evaluated the association between FIB‐4 and mortality using both multivariate logistic regression and Cox proportional hazards model. Correlations between FIB‐4 and SARS‐CoV‐2 RNA and cytokine levels were evaluated using the Spearman test. Among the 202 participants, 22 died. The median FIB‐4 in participants who survived and died were 1.91 and 3.98 (P < 0.001 by Mann‐Whitney U test), respectively. Each one‐unit increment in FIB‐4 was associated with an increased odds of death (odds ratio, 1.79; 95% confidence interval, 1.36, 2.35; P < 0.001) after adjusting for baseline characteristics including sex, body mass index, hypertension, diabetes, and history of liver diseases. During hospitalization, FIB‐4 peaked and then normalized in the survival group but failed to normalize in the death group. FIB‐4 was positively correlated with the level of SARS‐CoV‐2 viral load and monocyte‐associated cytokines, especially interleukin‐6 and interferon gamma–induced protein 10. Conclusion: FIB‐4 is associated with mortality in COVID‐19, independent of underlying conditions including liver diseases. FIB‐4 may be a simple and inexpensive approach to risk‐stratify individuals with COVID‐19.
Elevation‐dependent changes in reference evapotranspiration due to climate change
Authors: Sun Juying , Wang Genxu , Sun Xiangyang , Lin Shan , Hu Zhaoyong , Huang Kewei
Published: November 2020

The Food and Agriculture Organizations' (FAO) Penman–Monteith reference evapotranspiration (ET0) is a crucial index in the research of water and energy balance. Temporal and spatial variations in ET0 from 1981–2017 were investigated in the Hengduan Mountains, China. The results showed a change point around the year 2000 in ET0 series. ET0 decreased and increased significantly by +3.200 mm/year (p < 0.01) from 1981–2000 and by +4.109 mm/year (p < 0.01) from 2001–2017, respectively. The contribution analysis shows that the positive significant contribution of air temperature (TA) was offset by negative effects of decreases in downward shortwave radiation (Rs) and wind speed (WS) and an increase in actual vapour pressure (ea), causing the decrease in ET0 from 1981 to 2000. WS was the largest contributing factor for the decrease in ET0 from 1981 to 2000 during spring, winter and annually, while Rs and ea were the largest negative contributors in summer and autumn, respectively. An increase in TA was responsible for the increase in ET0 in all seasons except winter and the annual scale in 2001–2017. The sensitivity analysis shows that ET0 was most sensitive to TA, and WS was the least sensitive variable. The trends of ET0 increased with elevation; we denote this as the elevation‐dependence of ET0 changes. The elevation‐dependence was also noted for the trends of WS and ea, with higher elevations showing larger changes in WS and lower changes in ea. Besides, the sensitivities of TA, Rs and ea decreased with elevation, while that of WS increased slightly with elevation. A comprehensive investigation into the trends of climatic drivers and their sensitivities revealed complex trends of the contributions of climatic variables on ET0 with elevation, with no uniform trend existed in seasons. The results will contribute to our understanding of the response of ET0 to climate change in a mountainous area, and provide a guideline for the water resources management under climate change.
Geospatial barriers to healthcare access for breast cancer diagnosis in sub‐Saharan African settings: The African Breast Cancer—Disparities in Outcomes Cohort Study
Authors: Togawa Kayo , Anderson Benjamin O. , Foerster Milena , Galukande Moses , Zietsman Annelle , Pontac Johanna , Anele Angelica , Adisa Charles , Parham Groesbeck , Pinder Leeya F. , McKenzie Fiona , Schüz Joachim , dos Santos‐Silva Isabel , McCormack Valerie
Published: November 2020

We examined the geospatial dimension of delays to diagnosis of breast cancer in a prospective study of 1541 women newly diagnosed in the African Breast Cancer—Disparities in Outcomes (ABC‐DO) Study. Women were recruited at cancer treatment facilities in Namibia, Nigeria, Uganda and Zambia. The baseline interview included information used to generate the geospatial features: urban/rural residence, travel mode to treatment facility and straight‐line distances from home to first‐care provider and to diagnostic/treatment facility, categorized into country/ethnicity (population)‐specific quartiles. These factors were investigated in relation to delay in diagnosis (≥3 months since first symptom) and late stage at diagnosis (TNM: III, IV) using logistic regression, adjusted for population group and sociodemographic characteristics. The median (interquartile range) distances to first provider and diagnostic and treatment facilities were 5 (1‐37), 17 (3‐105) and 62 (5‐289) km, respectively. The majority had a delay in diagnosis (74%) and diagnosis at late stage (64%). Distance to first provider was not associated with delay in diagnosis or late stage at diagnosis. Rural residence was associated with delay, but the association did not persist after adjustment for sociodemographic characteristics. Distance to the diagnostic/treatment facility was associated with delay (highest vs lowest quartile: odds ratio (OR) = 1.56, 95% confidence interval (CI) = 1.08‐2.27) and late stage (overall: OR = 1.47, CI = 1.05‐2.06; without Nigerian hospitals where mostly local residents were treated: OR = 1.73, CI = 1.18‐2.54). These findings underscore the need for measures addressing the geospatial barriers to early diagnosis in sub‐Saharan African settings, including providing transport or travel allowance and decentralizing diagnostic services.
An empirical analysis of the use of agricultural mobile applications among smallholder farmers in Myanmar
Authors: Thar So Pyay , Ramilan Thiagarajah , Farquharson Robert J. , Pang Alexis , Chen Deli
Published: November 2020

Mobile phone applications (apps) designed to assist smallholder farmers improve decision‐making have been revolutionizing the agriculture sector. These apps offer solutions to farmer information needs by providing weather information, crop market trends, pest and disease damage identification, and advice on pesticide and fertilizer use. They also facilitate interaction with fellow farmers, extension workers and other stakeholders in the value chain who are interested in information exchange. Much previous research has investigated the contribution of mobile apps to agricultural production. This study explored the agricultural mobile apps available in Myanmar, analyzed factors affecting their use and assessed the potential for farm‐based decision support. Our findings indicate that when introducing mobile‐based tools, focus should be given to younger, more educated farmers growing more specialized crops. The main constraints to adopt agricultural apps are lack of access to smartphone and/or internet (63%) and lack of digital knowledge (20%). However, smallholder farmers in Myanmar were optimistic and positive toward agricultural apps for effective utilization. We also found that majority of the surveyed farmers were familiar with information received through Facebook groups. Incorporating useful information and functions from an agricultural mobile app to a Facebook Page could have a more useful and sustainable impact.
AgI‐promoted one‐pot synthesis of aminoindolizines via sequential Mannich‐Grignard addition and intramolecular cyclization in water
Authors: Guguloth Veeranna , Balaboina Ramesh , Paidakula Suresh , Thirukovela Narasimha S. , Vadde Ravinder
Published: November 2020

The efficient synthesis of aminoindolizines in ecofriendly water with broad substrate scope from the mild and readily available AgI‐catalyzed one‐pot three‐component reaction of pyridine‐2‐carboxaldehyde, secondary amines, and terminal alkynes proceeds through the sequential Mannich‐Grignard addition as well as intramolecular cyclization was reported for the first time.
Delayed retreat of the summer monsoon over the Indochina Peninsula linked to surface warming trends
Authors: Liu Yang , Cook Kerry H. , Vizy Edward K.
Published: November 2020

The Indochina Peninsula (ICP) is dominated by a tropical monsoon climate, and changes of the prevailing winds here have a marked impact on moisture and aerosol transport. September to early October is within the monsoon retreat period that is preceded by a change in the zonal wind from westerly to easterly. Here, we show the long‐term change of the monsoon retreat date and its related climate factors. Climatologically, the zonal wind is primarily controlled by the meridional land–sea temperature gradient through the geostrophic balance. A simple physical model suggests that a 1 K increase in this gradient is associated with a zonal wind speed change of 2.17 m·s−1, and this estimate is consistent with reanalyses. Over the most recent 40 years there has been a positive trend of 0.107 K·decade−1 in the gradient, and linear regression shows that the average rate of delay of the summer monsoon retreat date over the ICP associated with trend in land–sea contrast is 23.5 day·K−1. The mixing ratio gradient also makes a contribution to the monsoon retreat but its significance is lower than the land–sea temperature contrast. The ICP is located in a transitional zone bounded by three sub‐regions of Asia‐Pacific monsoon system; the delayed ICP monsoon retreat is most consistent with changes of the East Asian‐Western North Pacific monsoon.
A measurement method of the focal distance of the virtual image in an augmented reality or virtual reality device
Authors: Hong Hyungki
Published: November 2020

In most augmented reality (AR) or virtual reality (VR) devices, a virtual image is formed in front of the eye at a specific focal distance. Focal distance is the distance to the virtual image produced by the virtual image optics and is a display parameter of interest. In this study, a method to measure the focal distance is proposed. A positive lens was added adjacent to the AR device, and the image of the virtual image formed by this lens was photographed at the different distances with the translation of complementary metal–oxide–semiconductor (CMOS), which was used as two‐dimensional spatial sensor arrays. Grating pattern with the various line thickness was used as input signal. Once the distance of the image of the virtual image formed by the addition of the positive lens was determined, the focal distance of the virtual image was found from the lens equation. The measurement accuracy of the proposed method with regard to the CMOS translation step was compared with the other conventional methods.
Pain Experience and Tolerance of Awake In‐Office Upper Airway Procedures: Influencing Factors
Authors: Whited Chad W. , Lubin Jonathan , Marka Nicholas , Koszewski Ian J. , Hoffman Matthew R. , Schoeff Stephen , Dailey Seth H.
Published: November 2020

Objectives/Hypothesis

Awake, unsedated in‐office upper airway procedures are performed frequently and have high completion rates, yet less is known about the patients' pain experience and potentially influencing factors. It is also unclear if patients' pain experiences become worse with repeated procedures. We identified procedure‐ and patient‐related factors that might influence procedural completion and pain scores.

Study Design

Retrospective chart review.

Methods

Pre‐, intra‐, and post‐procedure pain scores were collected prospectively for awake unsedated upper airway procedures performed at a single institution over a 5‐year period. Patient factors reviewed were demographics, body mass index, psychiatric and/or pain diagnosis, and related medications. Procedure factors reviewed were procedure type, route, side, and performance of the same procedure multiple times. Patients reported their pain level before, during, and after the procedure using a standard 0 to 10 scale. Maximum pain score change (PΔmax), or the difference between highest and lowest reported pain levels, was calculated. Descriptive and multivariate analyses were performed.

Results

Procedure completion was 98.7% for 609 first time patients and 99.0% in 60 patients undergoing 292 repeat procedures. PΔmax did not covary with age, gender, or BMI. PΔmax covaried with pain and psychiatric conditions and associated medications. PΔmax was highest for injection medialization and lowest for tracheoscopy. PΔmax decreased over time for those undergoing multiple identical procedures.

Conclusions

Procedures were performed with a very high completion rate and low pain scores. Age, sex, and BMI did not affect pain experience. A combination of pain and psychiatric conditions did. Injection medialization had the highest PΔmax and tracheoscopy the lowest.

Level of Evidence

4 Laryngoscope, 131:E1580–E1588, 2021
Controllable, Bidirectional Water/Organic Vapors Responsive Actuators Fabricated by One‐Step Thiol‐Ene Click Polymerization
Authors: Song Yanjiao , He Jianghua , Zhang Yuetao
Published: November 2020

It is challenging to synthesize stimuli‐responsive materials with the well‐balanced performance of fast stimulus–response speed, good mechanical strength, multi‐functionality, and deformation diversity as well. This work reports a facile, one‐step thiol‐ene click polymerization strategy for preparation of water/acetone vapor‐responsive hierarchical films, by using diallyl terephthalate (P) as hydrophobic ene‐monomer, 1,4‐diallyl‐1,4‐diazabicyclo [2.2.2]octane‐1,4‐diium bromide (B) as hydrophilic ene‐monomer, and pentaerythritol tetra(3‐mercaptopropionate) (PETMP) as thiol monomer. Besides, by taking advantage of the specific hydrophilic/hydrophobic induction effect of substrate and adjusting the molar ratio of P to B, P60B40‐HPI film is fabricated on hydrophilic substrate “with plasma treatment” whereas P80B20‐HPO film is obtained on hydrophobic substrate “without plasma treatment”. Their “upper‐dense and lower‐porous” structural feature ensured the excellent combination of fast stimuli‐response speed endowed by the porous structure and good mechanical strength enhanced by the upper dense surface. Both films are bidirectional water/acetone vapor‐responsive materials, but their bending directions responding to the stimuli factors are completely opposite. This strategy showed great potential in the development of smart stimuli‐responsive materials.