bluuebunny/crossref_metadata_2025 huggingface dataset:
Teaching residents to teach: A pilot study for an innovative online curriculum
Authors: Karademos Jonathan E. , Yarris Lalena M. , Steinberg Eric
Published: February 2024

Introduction

Resident‐as‐teacher (RAT) curricula have improved teaching behavior, ability, and confidence among resident participants. However, there are limited data on the appropriate format, length, and content. With teaching being a core residency competency and residents delivering one‐third of student teaching in the clinical setting, properly training residents in clinical teaching is essential. We created a formal, scalable, asynchronous RAT curriculum. We report the pilot implementation of this curriculum along with feasibility, user acceptability, and preliminary knowledge outcomes.

Methods

In this pilot pre–post interventional study, senior emergency medicine residents completed a formalized online education curriculum during their “teach month.” The curriculum consisted of three online modules completed weekly over a 4‐week rotation. Topics included adult learning, assessment and feedback, and group teaching. Several surveys were sent to residents before and after curriculum implementation. The surveys rated satisfaction and asked several education‐specific knowledge questions to assess learning. Ratings were analyzed using means and confidence intervals (95%). Knowledge questions were graded and then analyzed by ANOVA and Fisher's LSD test.

Results

After the online modules were completed, the intervention group residents’ mean score on knowledge questions was significantly higher than that prior to the curriculum and significantly higher than that the control group (previous graduated residents; 6.00 vs. 2.70, p = 0.0001; and 6.00 vs. 3.00, p = 0.0003, respectively). This score was maintained 3 months after completing the online modules. Intervention group residents were more satisfied with the online education resources than the control group (p = 0.048).

Conclusions

Residents participating in a formalized online curriculum during their teach month demonstrate a high comprehension of education concepts and increased satisfaction with the provided educational resources and report high satisfaction with the teach month. Our pilot study suggests that a short online education‐focused curriculum is an effective method of providing RAT training and may be applicable to clinical teachers across specialties and experience levels.
Measuring specialty crop grower willingness to pay for genetic modification and genetic editing
Authors: Abbey Marie , Smith Alan G. , Yue Chengyan , Marson Corissa , Lai Yufeng , Stowers Carrie
Published: February 2024

In contrast to the widespread adoption of agricultural commodities modified using biotechnology, the adoption rate of bioengineered specialty crops by growers remains low. The use of bioengineered crops has been controversial since their introduction in the 1990s due to concerns about their potentially harmful effects to human health, the environment, and other socioeconomic issues. To identify grower preferences, perceived opportunities, and barriers to growing bioengineered crops, we surveyed Minnesota specialty crop growers using a web‐based survey. The survey measured whether adoption rates are influenced by the specific trait of the modification, the method of bioengineering (genetically modified [GM] vs. genetically edited [GE]), or the end use of the crop being grown (ornamental vs food). Overall willingness‐to‐pay for both GM and GE potatoes was significantly lower than for conventional potatoes, and nearly a quarter (25%) of our respondents never chose a bioengineered option no matter the benefits. Results were similar for petunias, but fewer respondents (18%) refused to consider the bioengineering option. The type of bioengineering did not have as significant an impact on adoption rate as price or end use. The bioengineered ornamental crop had a higher willingness to adopt than the bioengineered food crop. [EconLit Citations: Q160 Agricultural R & D; Agricultural Technology; Biofuels; Agricultural Extension Services. O330 Technological Change: Choices and Consequences; Diffusion Processes].
Potential impact of unblinding on observed treatment effects in Alzheimer's disease trials
Authors: Wolters Frank J. , Labrecque Jeremy A.
Published: February 2024

INTRODUCTION

Adverse effects of monoclonal antibodies against amyloid beta are common, and may affect validity of randomized controlled trials (RCTs) through unblinding of participants.

METHODS

We used observations from published phase 3 RCTs in Alzheimer's disease to calculate the magnitude of unblinding effects on cognition that would be required to explain observed cognitive benefits in RCTs.

RESULTS

In trials of lecanemab, aducanumab, and donanemab, incidence of amyloid‐related imaging abnormalities with active treatment ranged from 22% to 44%, the vast majority of which presumably led to unblinding. Effects of unblinding on the Clinical Dementia Rating Sum of Boxes required to fully explain observed drug effects ranged from 1.1 point (95% confidence interval: 0.2–2.0) with aducanumab, to 3.3 points (2.1–4.4) with donanemab and 3.7 points (2.0–5.6) with lecanemab. Infusion‐related reactions were common, with potential unblinding effects particularly for lecanemab. Similar patterns were observed for the Alzheimer's Disease Assessment Scale Cognitive subscale.

DISCUSSION

Psychological treatment effects due to unblinding may explain a substantial share of observed treatment effects in RCTs.
Relationship between extravascular leakage and clinical outcome on computed tomography of isolated traumatic brain injury
Authors: Ito Hiroshi , Nakamura Youhei , Togami Yuki , Onishi Shinya , Nakao Shunichiro , Ogura Hiroshi , Oda Jun
Published: February 2024

Aim

This study investigated whether contrast extravasation on computed tomography (CT) angiography in patients with traumatic brain injury (TBI) is associated with death or surgical procedures.

Methods

Patients over 18 years old, directly brought in by ambulance with an isolated head injury and confirmed to have acute intracranial hemorrhage on a CT scan upon admission between 2010 and 2020, were included. The primary outcome was mortality, and the secondary outcome was neurosurgical procedures performed from admission to discharge from the intensive care unit. Multivariable logistic regression analyses were performed to evaluate the association between these outcomes and contrast extravasation.

Results

The analysis included 188 patients with a median age of 65 years, 123 men (65.4%), 34 deaths (18.1%), and 91 surgeries (48.4%). Among the 66 patients with contrast extravasation, 22 (33.3%) died and 47 (71.2%) required surgery. Among the 122 patients with no contrast extravasation, 12 (9.8%) died, and 44 (36.1%) required surgery. The presence or absence of extravascular leakage was associated with death (odds ratio, 3.6 [95% CI: 1.2–12.2]) and surgery (odds ratio, 7.6 [95% CI: 2.5–22.7]).

Conclusion

Contrast extravasation was associated with mortality and performance of surgery in patients with an isolated head injury.
B,N‐Embedded Hetero[9]helicene Toward Highly Efficient Circularly Polarized Electroluminescence
Authors: Guo Wei‐Chen , Zhao Wen‐Long , Tan Ke‐Ke , Li Meng , Chen Chuan‐Feng
Published: February 2024

The intrinsic helical π‐conjugated skeleton makes helicenes highly promising for circularly polarized electroluminescence (CPEL). Generally, carbon helicenes undergo low external quantum efficiency (EQE), while the incorporation of a multi‐resonance thermally activated delayed fluorescence (MR‐TADF) BN structure has led to an improvement. However, the reported B,N‐embedded helicenes all show low electroluminescence dissymmetry factors (gEL), typically around 1×10−3. Therefore, the development of B,N‐embedded helicenes with both a high EQE and gEL value is crucial for achieving highly efficient CPEL. Herein, a facile approach to synthesize B,N‐embedded hetero[9]helicenes, BN[9]H, is presented. BN[9]H shows a bright photoluminescence with a maximum at 578 nm with a high luminescence dissymmetry factor (|glum|) up to 5.8×10−3, attributed to its inherited MR‐TADF property and intrinsic helical skeleton. Furthermore, circularly polarized OLED devices incorporating BN[9]H as an emitter show a maximum EQE of 35.5 %, a small full width at half‐maximum of 48 nm, and, more importantly, a high |gEL| value of 6.2×10−3. The Q‐factor (|EQE×gEL|) of CP‐OLEDs is determined to be 2.2×10−3, which is the highest among helicene analogues. This work provides a new approach for the synthesis of higher helicenes and paves a new way for the construction of highly efficient CPEL materials.
Density and viscosity of deep eutectic solvents at different temperatures and compositions: Measurement and prediction model
Authors: Wang Haiou , Wang Yinuo , Wang Shizhuo , Li Hongjuan , Peng Sheng , Wang Yatao , Li Hao , Fang Jing
Published: February 2024

Deep eutectic solvents (DESs) are becoming increasingly promising as environmentally friendly solvents, and accurate prediction of their density and viscosity is crucial for their successful industrial application. However, existing density and viscosity prediction models primarily rely on temperature variations and often overlook changes in the molar ratio of hydrogen bond acceptors (HBA) to hydrogen bond donors (HBD) in DESs, limiting their practicality. Therefore, in this study, several binary and ternary DESs were synthesized using choline chloride (ChCl) as the hydrogen bond donor. The densities and viscosities of these DESs were measured, and prediction models for the density and viscosity of DESs based on temperature and molar ratio were developed. These models were used to forecast the density and viscosity of DESs at different temperatures and molar ratios. The model parameters are calibrated using experimental data from this research. Finally, the model is utilized to predict the density and viscosity of DESs mentioned in this paper, as well as DESs with varying HBAs and HBDs. The results demonstrate that the discrepancy between the literature value, experimental value, and calculated value is less than 6%, confirming the universal applicability and reliability of the prediction model proposed in this study.
Interactions between inland water‐based recreation and freshwater turtles: A review
Authors: Berberi Albana , Guay Jessika D. , Bulté Grégory , Cooke Steven J. , Davy Christina M. , Nguyen Vivian M.
Published: February 2024

Outdoor recreation brings countless benefits to humans. Understanding the inevitable human interactions with nature is essential for conserving the outdoors for years to come. Water‐based recreation in freshwater ecosystems is increasing in popularity, but freshwater biodiversity is in global decline.

The aim of this review is to explore the interactions between water users and freshwater turtles during inland water‐based recreation.

Thirty articles (most based in North America) were found to study human–turtle interactions during water‐based recreation, 29 of which reported water‐based recreational activities posing negative effects on freshwater turtle populations. Negative, direct effect interactions included boat collisions with turtles and accidental hooking of turtles with fishhooks. Negative, indirect effect interactions included human presence near habitats used by turtles and wake action with subsequent shoreline erosion. One article reported a positive interaction between humans and freshwater turtles when installing a non‐disruptive turtle observation deck.

Eleven articles discussed conservation measures to mitigate turtle risks during water‐based recreation, but none evaluated their efficacy. Conservation measures included regulating boat types, sizes and access points, protecting habitats used by turtles, designating ‘no wake’ boating zones, restricting fishing permits, installing turtle basking perches, promoting public awareness and outreach and implementing participatory science and stewardship programmes.

Future research on human–freshwater turtle interactions during inland water‐based recreation could explore the efficacy of conservation measures, potential interactions outside of regularly studied boating and fishing activities and recreation‐induced turtle habitat alterations. Also, future research could explore the human dimension side of human–turtle interactions, including perceptions and knowledge from water users on the interactions they experience, and their awareness and actions of pro‐environmental behaviours to protect turtles during water‐based recreation.
Selection of parameters to assess the welfare of free‐ranging Indo‐Pacific humpback dolphins using expert opinion survey
Authors: Serres Agathe , Platto Sara , Li Songhai
Published: February 2024

Animal welfare assessments have recently been suggested to be useful for free‐ranging animals. Nevertheless, few standardized welfare assessment frameworks have been built for wildlife, including cetaceans.

Coastal cetaceans like Indo‐Pacific humpback dolphins (Sousa chinensis, IPHDs) that form resident populations impacted by a wide range of human activities are subject to reliable photo‐identification efforts and thus represent perfect candidates for welfare monitoring.

Parameters that may inform us on some aspects of the welfare of free‐ranging IPHDs were selected through literature review. A panel survey including three consecutive rounds was then conducted to collect the opinion of selected experts on these parameters.

The survey allowed the validation of a list containing 31 parameters that provide information on the welfare of IPHDs. The opinion of experts also allowed to set the modalities of the data collection required to measure/observe these parameters.

After establishing a consistent scoring method and testing it on existing data, this standardized framework will allow for obtaining a wide picture of the living conditions of IPHDs. Variations across time periods, among dolphin populations and locations, or following major environmental changes (e.g., conservation measures or human disturbances) could then be analysed.

Added to traditional conservation approaches, standardized welfare monitoring will greatly participate in the conservation of these animals.
Directionality of Halogen‐Bonds: Insights from 2D Energy Decomposition Analysis
Authors: Herrmann Barbara , Svatunek Dennis
Published: February 2024

Halogen bonds are typically observed to have a linear arrangement with a 180° angle between the nucleophile and the halogen bond acceptor X−R. This linearity is commonly explained using the σ‐hole model, although there have been alternative explanations involving exchange repulsion forces. We employ two‐dimensional Distortion/Interaction and Energy Decomposition Analysis to examine the archetypal H3N⋯X2 halogen bond systems. Our results indicate that although halogen bonds are predominantly electrostatic, their directionality is largely due to decreased Pauli repulsion in linear configurations as opposed to angled ones in the I2 and Br2 systems. As we move to the smaller halogens, Cl2 and F2, the influence of Pauli repulsion diminishes, and the energy surface is shaped by orbital interactions and electrostatic forces. These results support the role of exchange repulsion forces in influencing the directionality of strong halogen bonds. Additionally, we demonstrate that the 2D Energy Decomposition Analysis is a useful tool for enhancing our understanding of the nature of potential energy surfaces in noncovalent interactions.
Microsurgical anatomy of the glossopharyngeal nerve
Authors: Joo Wonil
Published: February 2024

The glossopharyngeal nerve is a complicated and mixed nerve including sensory, motor, parasympathetic, and visceral fibers. It mediates taste, salivation, and swallowing. The low cranial nerves, including IXth, Xth, and XIth, are closely related, sharing some nuclei in the brainstem. The glossopharyngeal nerve arises from the spinal trigeminal nucleus and tract, solitary tract and nucleus, nucleus ambiguous, and inferior salivatory nucleus in the brainstem. There are communicating branches forming a neural anastomotic network between low cranial nerves. Comprehensive knowledge of the anatomy of the glossopharyngeal nerve is crucial for performing surgical procedures without significant complications. This review describes the microsurgical anatomy of the glossopharyngeal nerve and illustrates some pictures involving the glossopharyngeal nerve and its connective and neurovascular structures.
Myocardial infarction with nonobstructive coronaries (MINOCA) following rabies postexposure prophylaxis: A case report
Authors: Dhungana Reechashree , Pokharel Prajjwal , Poudel Chandra Mani , Khanal Raja Ram , Shakya Smriti , Gajurel Ratna Mani
Published: February 2024

Key Clinical Message

This case underscores the importance of considering myocardial infarction with nonobstructive coronary arteries (MINOCA) in patients experiencing acute chest pain following rabies vaccination, emphasizing the need for heightened awareness and further research into the association between MINOCA and Rabies vaccination.

Rabies is a vaccine‐preventable deadly viral disease prevalent in Asia and Africa that causes thousands of deaths annually. Rabies pre (PrEP) and postexposure prophylaxis (PEP) is highly effective in annulling rabies‐associated deaths. The adverse reactions following rabies vaccination are typically mild. Myocardial infarction with non‐obstructive coronary arteries (MINOCA) is a rare condition, and its association with rabies vaccination is unprecedented. We present a case of a 43‐year‐old male with MINOCA following Rabies PEP. A 43‐year‐old male, nonsmoker and nonalcoholic, presented to the ER with complaints of acute onset left sided chest pain following the completion of the third dose of intradermal rabies vaccine, whose clinical features, ECG changes and lab reports were suggestive of acute presentation of inferior wall MI. Coronary angiography was performed, which however revealed normal coronaries with only slow flow being noted in the left anterior descending (LAD) artery. Echocardiography later showed a normal study with no other relevant diagnosis unveiled on further investigations. Hence a diagnosis of vaccine‐induced MINOCA was made. Treatment included antiplatelet therapy, statins, and beta‐blockers. MINOCA following rabies vaccination is an unprecedented finding. The clear etiology behind this couldn't be ascertained. The patient's treatment was conventional, emphasizing the need for further research and clinical trials in MINOCA diagnosis and management. This case highlights the need for clinicians to consider MINOCA in patients with acute chest pain post‐rabies vaccination. Further research is essential to unravel the association between MINOCA and rabies vaccination, paving the way for optimal management strategies.
Molybdenum Catalyzed Acceptorless Dehydrogenation of Alcohols for the Synthesis of Quinolines
Authors: Garcia Beatriz , Royo Beatriz
Published: February 2024

The first molybdenum triazolylidene complexes catalyzing the atom‐economical synthesis of quinolines through acceptorless dehydrogenative coupling of alcohols is reported. A new family of Mo(0) complexes bearing chelating bis‐1,2,3‐triazolylidene, pyridyl‐1,2,3‐triazolylidene, and bis‐triazole ligands have been prepared and applied as catalysts for the synthesis of quinolines. Interestingly, Mo complexes bearing bis‐1,2,3‐triazolylidene ligands with alkyl groups (Et, n‐Bu) displayed superior catalytic activities than those containing aryl substituents on the triazolylidene rings. Control experiments corroborated that the catalytic reaction involves the dehydrogenation pathway.
Thermodynamics of Reversible Hydrogen Storage: Are Methoxy‐Substituted Aromatics better through Oxygen Functionality?
Authors: Samarov Artemiy A. , Müller Karsten , Wasserscheid Peter , Verevkin Sergey P.
Published: February 2024

An attractive option for the storage of hydrogen is the reversible hydrogenation of an aromatic substance, a so‐called liquid organic hydrogen carrier. For hydrogen release, it is desirable to find substances with low enthalpies of reaction for dehydrogenation. It has been demonstrated that substitution, e.g., with methyl groups, on the ring can have a positive effect in this regard. In this study, thermochemical properties of methoxy‐substituted pyridines and quinolines and their respective hydrogenated counterparts have been analyzed from a thermodynamic point of view. Combustion calorimetry has been utilized to measure the enthalpy of formation and the transpiration method for determining the vapor pressure. Additionally, high‐level quantum‐chemical approaches have been applied to obtain caloric data in the gas phase, which provide a basis for comparison and evaluation of the experimental data. The results reveal two main effects of methoxy substitution. First, oxygenated substituents like methoxy groups have stronger effect on the Gibbs energy of reaction and thus the temperature needed thermodynamically for hydrogen release than methyl groups. Second, the effect is highly depending on the position of the substitution on the ring. Particularly methoxy groups close to a N heteroatom can have a significant positive effect, which might enable hydrogen release at equilibrium temperatures more than 50 K lower than for their unsubstituted analogue.
Common Transition Metal Oxide Nanomaterials in Electrochemical Sensors for the Diagnosis of Monoamine Neurotransmitter‐Related Disorders
Authors: Elugoke Saheed E. , Ganesh Pattan‐Siddappa , Kim Sang‐Youn , Ebenso Eno E.
Published: February 2024

Monoamine neurotransmitters are essential for learning, mental alertness, emotions, and blood flow, among other functions. Fatal neurological disorders that signal the imbalance of these biomolecules in the human system include Parkinson's disease, myocardial infarction, Alzheimer's disease, hypoglycemia, Schizophrenia, and a host of other ailments. The diagnosis of these monoamine neurotransmitter‐related conditions revolves around the development of analytical tools with high sensitivity for the four major monoamine neurotransmitters namely dopamine, epinephrine, norepinephrine, and serotonin. The application of electrochemical sensors made from notable metal oxide nanoparticles or composites containing the metal oxide nanoparticles for the detection of these monoamine neurotransmitters was discussed herein. More importantly, the feasibility of the application of the ZnO, CuO, and TiO2 nanoparticle‐based electrochemical sensors for a comprehensive diagnosis of monoamine neurotransmitter‐related conditions was critically investigated in this review.
Recent Progress in Atomically Dispersed Non‐noble Metal Catalysts for Electrochemical Two‐electron Oxygen Reduction Reaction
Authors: Xu Hui , Zhang Shengbo , Zhang Haimin
Published: February 2024

Electrochemical two‐electron oxygen reduction reaction (2e− ORR) has emerged as an efficient route to generate hydrogen peroxide (H2O2) under ambient conditions, being a promising alternative to the traditional energy‐intensive anthraquinone process and direct synthesis route using H2 and O2. However, this 2e− ORR process still requires highly efficient electrocatalysts to adsorb and activate O2 with two‐electron reaction pathway. Among all investigated 2e− ORR electrocatalysts to date, non‐noble metal single atom catalysts (SACs) with tunable electronic structure and different coordination structures manifest great potential in controlling ORR pathway to obtain high‐efficiency H2O2 production. In this review, recent advances and achievements in tuning non‐noble metal SACs for selective 2e− ORR to H2O2 are systematically summarized. Especially, the strategies to effectively regulate the catalytic active sites of non‐noble metal SACs for optimizing the binding strength of key oxygenated intermediates during 2e− ORR are emphatically exhibited and reviewed. Finally, we also point out the challenges and outlooks about the development of non‐noble metal SACs in H2O2 electrosynthesis and the diverse utilization of in‐situ formed H2O2 for biomass upgrading. This review would be helpful to guide the design and development of efficient SACs for electrochemical 2e− ORR to H2O2 under ambient conditions.
Pioneering the direct large‐scale laser printing of flexible “graphenic silicon” self‐standing thin films as ultrahigh‐performance lithium‐ion battery anodes
Authors: Kothuru Avinash , Cohen Adam , Daffan Gil , Juhl Yonatan , Patolsky Fernando
Published: February 2024

Recent technological advancements, such as portable electronics and electric vehicles, have created a pressing need for more efficient energy storage solutions. Lithium‐ion batteries (LIBs) have been the preferred choice for these applications, with graphite being the standard anode material due to its stability. However, graphite falls short of meeting the growing demand for higher energy density, possessing a theoretical capacity that lags behind. To address this, researchers are actively seeking alternative materials to replace graphite in commercial batteries. One promising avenue involves lithium‐alloying materials like silicon and phosphorus, which offer high theoretical capacities. Carbon–silicon composites have emerged as a viable option, showing improved capacity and performance over traditional graphite or pure silicon anodes. Yet, the existing methods for synthesizing these composites remain complex, energy‐intensive, and costly, preventing widespread adoption. A groundbreaking approach is presented here: the use of a laser writing strategy to rapidly transform common organic carbon precursors and silicon blends into efficient “graphenic silicon” composite thin films. These films exhibit exceptional structural and energy storage properties. The resulting three‐dimensional porous composite anodes showcase impressive attributes, including ultrahigh silicon content, remarkable cyclic stability (over 4500 cycles with ∼40% retention), rapid charging rates (up to 10 A g−1), substantial areal capacity (>5.1 mAh cm−2), and excellent gravimetric capacity (>2400 mAh g−1 at 0.2 A g−1). This strategy marks a significant step toward the scalable production of high‐performance LIB materials. Leveraging widely available, cost‐effective precursors, the laser‐printed “graphenic silicon” composites demonstrate unparalleled performance, potentially streamlining anode production while maintaining exceptional capabilities. This innovation not only paves the way for advanced LIBs but also sets a precedent for transforming various materials into high‐performing electrodes, promising reduced complexity and cost in battery production.
Bright Fluorescent p‐Phenylene‐bridged Triarylmethyl Highly Stable Diradical
Authors: Hattori Yohei , Yamamoto Kohei , Kitajima Ryota , Uchida Kingo
Published: February 2024

Two units of highly stable luminescent triarylmethyl radical, (3,5‐dichloro‐4‐pyridyl)bis(2,4,6‐trichlorophenyl)methyl radical (PyBTM), were bridged by p‐phenylene linker. The photoluminescence quantum yield (PLQY) of PyBTM−PhPyBTM was at most 0.4 % in various organic solvents. Adding two mesityl groups on the terminals did not improve the PLQY. In the MesPyBTM−PhPyBTM−Mes, the mesityl group did not worked as an electron donor unlike the previously reported monoradical MesPyBTM. However, adding two n‐hexyl groups on the bridging p‐phenylene did greatly improve it, and the PLQY of the PyBTM−(Hex2Ph)PyBTM was 7 % in dichloromethane and acetone, and 12 % in poly(methyl methacrylate) (PMMA) film. Twisting p‐phenylene linker by hexyl groups hindered the π‐conjugation and suppressed the non‐radiative decay of the excited state.
On Haptotropic Rearrangements of Diphosphene and Diarsene Ligands in Titanium Complexes
Authors: Petrov Andrey , Wellnitz Tim , Hennersdorf Felix , Reiß Fabian , Hering‐Junghans Christian
Published: February 2024

Dipnictenes of the type RE=ER (E=P, As, Sb, Bi) are the isovalence electronic heavier analogs of alkenes. Although diphosphenes and dipnictenes in general show a variety of binding modes in metal complexes, little is known about haptotropic shift reactions involving these ligands. Herein, we report an unprecedented η2 to η1 rearrangement of the dipnictene ligands in titanocene complexes of the type Cp2Ti(Pn2Ar2) (Pn=P, As; Ar=2,4,6‐Me3‐C6H2, Mes; 2,6‐iPr2‐C6H3, Dip; 2,4,6‐iPr3‐C6H2, Tip), initiated by Lewis basic ligands (L=MeCN, PMe3, AdNC, CO). In the presence of L the dipnictene ligand changes its hapticity from η2 to η1 and complexes of the general form Cp2Ti(L)(Pn2Ar2) with a succinctly different electronic structure are obtained. Electronically, the new complexes are best described as biradicaloids with antiferromagnetically coupled (via a π‐bond) [Cp2TiIII]⋅+ and [Pn2Ar2]⋅− fragments. However, the biradical character of these systems is affected by the electronic features of the co‐ligand and significantly decreases moving from PMe3/MeCN (σ‐donors) to CNAd/CO (σ‐donors/π‐acceptors).
A DNA Force Circuit for Exploring Protein‐Protein Interactions at the Single‐Molecule Level†
Authors: Ma Kangkang , Xiong Luoan , Wang Zhuofei , Hu Xin , Qu Lihua , Zhao Xuetong , Li Yao , Yu Zhongbo
Published: February 2024

Comprehensive Summary

Protein‐protein interactions (PPIs) play a crucial role in drug discovery and disease treatment. However, the development of effective drugs targeting PPIs remains challenging due to limited methodologies for probing their spatiotemporal anisotropy. Here, we propose a single‐molecule approach using a unique force circuit to investigate PPI dynamics and anisotropy under mechanical forces. Unlike conventional techniques, this approach enables the manipulation and real‐time monitoring of individual proteins at specific amino acids with defined geometry, offering insights into molecular mechanisms at the single‐molecule level. The DNA force circuit was constructed using click chemistry conjugation methods and genetic code expansion techniques, facilitating orthogonal conjugation between proteins and nucleic acids. The SET domain of the MLL1 protein and the tail of histone H3 were used as a model system to demonstrate the application of the DNA force circuit. With the use of atomic force microscopy and magnetic tweezers, optimized assembly procedures were developed. The DNA force circuit provides an exceptional platform for studying the anisotropy of PPIs and holds promise for advancing drug discovery research targeted at PPIs.
Impact of prior cancer history on survival in brain malignancy: A propensity score‐adjusted, population‐based study
Authors: Ebad Ur Rehman Mohammad , Faraz Fatima , Cheema Huzaifa Ahmad , Ashruf Omer S. , Raheel Hamna , Naqvi Syeda Zainab Ali , Jabeen Nimrah , Abid Areesha , Mumtaz Malik Haris , Iftikhar Ahmad , Ibrahim Ahmed , Swed Sarya
Published: February 2024

Background

Individuals with a Prior Cancer History (PCH) are often excluded from clinical trials. However, a growing body of evidence suggests that prior cancer history does not present adverse outcomes on cancer patients. The evidence on the survival of brain cancer patients in this regard remains widely unknown.

Methods

We conducted a retrospective cohort study to estimate the prevalence and impact of prior cancer on survival of patients diagnosed with brain cancer. Data of patients who were diagnosed with brain cancer as their first or second primary malignancy between 2000 and 2019 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Propensity Score Matching (PSM) was used to ensure comparable baseline characteristics among the patients. Survival analysis was conducted using the Kaplan–Meier method, as well as multivariate Cox proportional hazard and multivariate competing risk models.

Results

Out of 42 726 patients, 1189 (2.78%) had PCH. Genitourinary (40.4%), Breast (13.6%), Hematologic and Lymphatic (11.4%), and Gastrointestinal malignancies (11.3%) were the most common types of prior cancer. PCH served as a significant risk factor for Overall Survival (OS) (Adjusted Hazard Ratio [AHR] 1.26; 95% CI [1.15–1.39]; p < .001) but did not have a statistically significant impact on Brain Cancer‐Specific Survival (BCSS) (AHR 0.97; 95% CI [0.88–1.07]; p = .54). Glioblastoma exhibited the most substantial and statistically significant impact on survival as compared to other histological types. Of all the organs systems, only prior Gastrointestinal and Hematologic and Lymphatic malignancies had a statistically significant impact on OS of patients.

Conclusion

Our findings indicate that PCH does not exert a substantial impact on the survival of brain cancer patients, except in cases involving gastrointestinal or hematologic and lymphatic PCH, or when the brain cancer is glioblastoma.
Bioequivalence Between a New Omalizumab Prefilled Syringe With an Autoinjector or with a Needle Safety Device Compared with the Current Prefilled Syringe: A Randomized Controlled Trial in Healthy Volunteers
Authors: Sangana Ramachandra , Xu Yan , Shah Bharti , Tian Xianbin , Zack Julia , Shakeri‐Nejad Kasra , Kalluri Sampath , Jones Ieuan , Ligueros‐Saylan Monica , Taylor Angel Fowler , Jain Devendra Kumar , Scosyrev Emil , Uddin Alkaz , Laurent Nathalie , Paganoni Paola
Published: February 2024

Omalizumab is an anti‐IgE monoclonal antibody currently approved for the treatment of asthma, nasal polyps/chronic rhinosinusitis with nasal polyps, and chronic spontaneous urticaria. Omalizumab is available as an injection in a prefilled syringe (PFS) with a needle safety device (NSD). New product configurations were developed to reduce the number of injections per dose administration, improve patient convenience and treatment compliance. The objective of this randomized open‐label 12‐week study was to demonstrate pharmacokinetic bioequivalence between (1) new PFS with autoinjector (PFS‐AI), (2) new PFS‐NSD configuration, and (3) current PFS‐NSD configuration. Each new configuration was considered bioequivalent to the current configuration if the confidence intervals (CIs) for the geometric mean ratios (GMR) were contained in the 0.80‐1.25 range for maximum concentration (Cmax), area under the concentration‐time curve until the last quantifiable measurement (AUClast), and AUC extrapolated to infinity (AUCinf). Safety was assessed throughout the study. In total, 193 healthy volunteers were randomized at 1:1:1 ratio to omalizumab 1×300 mg/2 mL via new PFS‐AI (n = 66), omalizumab 1×300 mg/2 mL via new PFS‐NSD (n = 64), or omalizumab 2×150 mg/1 mL via current PFS‐NSD (n = 63). Comparing new PFS‐AI versus current PFS‐NSD, the GMRs were: Cmax, 1.085; AUClast, 1.093; AUCinf, 1.100. Comparing new PFS‐NSD versus current PFS‐NSD, the GMRs were: Cmax, 1.006; AUClast, 1.016; AUCinf, 1.027. The 95% CIs for all GMR parameters were contained within the 0.80‐1.25 range. Safety findings were consistent with the known safety profile of omalizumab. Single‐dose omalizumab administered as the new PFS‐AI or new PFS‐NSD was bioequivalent to the current PFS‐NSD.
Using leaf micromorphology to characterize Iranian species of Ribes (Grossulariaceae)
Authors: Rezaee Chamanie Kosar , Beygom Faghir Marzieh , Mahmoodi Mohammad , Kazempour Osaloo Shahrokh , Moradi Aiuob
Published: February 2024

This electron microscope study investigated the micromorphological characteristics of the leaf epidermis of 5 species (10 populations) of Ribes (Grossulariaceae) in Iran: R. biebersteinii, R. uva‐crispa, R. orientale, R. aureum, and R. khorasanicum. Samples were collected and identified, and the similarities between the species were evaluated using information from micromorphological traits of leaf epidermis and multivariate analysis (cluster analysis and principal component analysis). The traits useful for discriminating the species were presence or absence of hairs and glandular trichomes, presence or absence of granular with verrucae on hair surface, position of hairs on epidermal surface, hair location on the leaf (lamina, leaf margin, midrib), stomata shape, wax distribution on stomata, prominence and shape of anticlinal walls and outer periclinal layer, and epicuticular wax sculpturing. An identification key based on these leaf micromorphological characters is provided for Ribes species in Iran. The multivariate analysis of micromorphological traits was efficient for inter‐ and intra‐specific delimitation. The present findings correspond to a large extent with existing classifications.
BrainAGE: Revisited and reframed machine learning workflow
Authors: Kalc Polona , Dahnke Robert , Hoffstaedter Felix , Gaser Christian ,   Alzheimer's Disease Neuroimaging Initiative
Published: February 2024

Since the introduction of the BrainAGE method, novel machine learning methods for brain age prediction have continued to emerge. The idea of estimating the chronological age from magnetic resonance images proved to be an interesting field of research due to the relative simplicity of its interpretation and its potential use as a biomarker of brain health. We revised our previous BrainAGE approach, originally utilising relevance vector regression (RVR), and substituted it with Gaussian process regression (GPR), which enables more stable processing of larger datasets, such as the UK Biobank (UKB). In addition, we extended the global BrainAGE approach to regional BrainAGE, providing spatially specific scores for five brain lobes per hemisphere. We tested the performance of the new algorithms under several different conditions and investigated their validity on the ADNI and schizophrenia samples, as well as on a synthetic dataset of neocortical thinning. The results show an improved performance of the reframed global model on the UKB sample with a mean absolute error (MAE) of less than 2 years and a significant difference in BrainAGE between healthy participants and patients with Alzheimer's disease and schizophrenia. Moreover, the workings of the algorithm show meaningful effects for a simulated neocortical atrophy dataset. The regional BrainAGE model performed well on two clinical samples, showing disease‐specific patterns for different levels of impairment. The results demonstrate that the new improved algorithms provide reliable and valid brain age estimations.
A budget impact analysis of a powered hybrid mattress to prevent pressure ulcers in the Austrian inpatient setting: An original research
Authors: Eichhober Gerald , Voit Marco , Meyer Franz , Walter Evelyn
Published: February 2024

Background and Aims

Pressure ulcer is a considerable health problem and is associated with an increased hospital length of stay (LOS), nursing effort, costs, and reduced quality of life. The aim of this analysis is to compare the economic, clinical, and nursing benefit after the implementation of the powered hybrid mattress Dyna‐Form Mercury Advance SMARTcare® in 2019 with the situation in 2017 (rental systems Arjo BariAir® and Arjo TheraKair Visio®, and purchased foam mattresses Arjo Simuflex®) using a single center.

Methods

In the framework of a budget impact analysis, a difference‐in‐difference approach was used to compare pre‐implementation longitudinal data (2017) with post‐implementation data (2019). The longitudinal data comprise the mattress resource use, patient characteristics, and LOS. The care effort was gathered based on a full survey of all 75 members of the nursing staff using the online tool “LimeSurvey.” In this survey, the resource use of the different mattress systems was identified in terms of time (minutes or days). This analysis was performed from the hospital perspective and included direct costs of mattress systems, Austrian diagnostic‐related group costs for the hospital stay and nursing staff costs for 2019.

Results

Based on 1253 patients “at‐risk,” the total yearly costs implementing the powered hybrid mattress amounts to 654,248€ compared with 901,469€ when using Arjo products. The budget impact shows a cost advantage of 247,221€. Furthermore, the powered hybrid mattress system leads to fewer nursing‐staff time in minutes per year (−1,031,097 min [1,993,204 vs. 3,024,302]); 242€ are saved per patient. Compared with the Arjo products, fewer inpatient cases of pressure ulcers (−44 cases [0 vs. 44]) were documented.

Conclusion

Despite the higher total outlay of costs associated with the powered hybrid mattress, the long‐term savings potential showed a significant cost advantage per annum for the single center. Therefore, the use of the hybrid mattress leads to considerable economic, clinical, and nursing benefits.
Clinical decision support systems (CDSS) in assistance to COVID‐19 diagnosis: A scoping review on types and evaluation methods
Authors: Ameri Arefeh , Ameri Atefeh , Salmanizadeh Farzad , Bahaadinbeigy Kambiz
Published: February 2024

Background and Aims

Due to the COVID‐19 pandemic, a precise and reliable diagnosis of this disease is critical. The use of clinical decision support systems (CDSS) can help facilitate the diagnosis of COVID‐19. This scoping review aimed to investigate the role of CDSS in diagnosing COVID‐19.

Methods

We searched four databases (Web of Science, PubMed, Scopus, and Embase) using three groups of keywords related to CDSS, COVID‐19, and diagnosis. To collect data from studies, we utilized a data extraction form that consisted of eight fields. Three researchers selected relevant articles and extracted data using a data collection form. To resolve any disagreements, we consulted with a fourth researcher.

Results

A search of the databases retrieved 2199 articles, of which 68 were included in this review after removing duplicates and irrelevant articles. The studies used nonknowledge‐based CDSS (n = 52) and knowledge‐based CDSS (n = 16). Convolutional Neural Networks (CNN) (n = 33) and Support Vector Machine (SVM) (n = 8) were employed to design the CDSS in most of the studies. Accuracy (n = 43) and sensitivity (n = 35) were the most common metrics for evaluating CDSS.

Conclusion

CDSS for COVID‐19 diagnosis have been developed mainly through machine learning (ML) methods. The greater use of these techniques can be due to their availability of public data sets about chest imaging. Although these studies indicate high accuracy for CDSS based on ML, their novelty and data set biases raise questions about replacing these systems as clinician assistants in decision‐making. Further studies are needed to improve and compare the robustness and reliability of nonknowledge‐based and knowledge‐based CDSS in COVID‐19 diagnosis.
Surviving maternal sepsis: Clinical, laboratory, and treatment features
Authors: Ribeiro‐do‐Valle Carolina C. , Luz Adriana G. , Pacagnella Rodolfo C. , Cecatti José G.
Published: February 2024

Objective

To describe clinical, laboratory, and antibiotic treatment characteristics in pregnant or recently pregnant women diagnosed with maternal sepsis.

Methods

A retrospective cohort study was conducted in a Brazilian tertiary hospital from March 2014 until February 2018. The hospital implemented a Sepsis Protocol, based on the Brazilian Ministry of Health recommendation. All women who were pregnant or recently pregnant (up to 42 days postpartum), and who presented with suspected sepsis were included. Unconfirmed infections were excluded. Three hundred sixty‐five women were included and divided into three groups according to sepsis severity (SEPSIS‐2): sepsis, severe sepsis, and septic shock. Clinical, laboratory, and management characteristics were described and compared.

Results

Pregnancy‐related and respiratory tract infections were the greater causes of maternal sepsis, and the urinary tract was the major cause of septic shock. We found almost total compliance with blood culture sample collection, and samples were positive in 10.8% of the cases, and in 41% of septic shock patients. Escherichia coli was the most common pathogen found and it was resistant to third‐generation cephalosporins in none of the blood cultures and 3.3% of the urine cultures. Using the AWaRe (Access, Watch and Reserve) classification groups of antibiotics, Access and Watch antibiotics were used in virtually all women. We did not find any fatal maternal outcomes.

Conclusion

Maternal sepsis is seldom the result of resistant microorganisms in this setting and the use of Access group antibiotics is widely possible. Health professionals' awareness of and institutional policies for maternal sepsis are crucial to its adequate treatment and better outcomes.
A case of successful treatment of Fournier's gangrene through conservative management and elective debridement
Authors: Takahashi Toshifumi , Maruno Kouhei , Hazama Tatsuya , Yamada Yuya , Nakashima Masakazu , Kikkawa Kazuro , Tamaki Masahiro , Ito Noriyuki
Published: February 2024

Introduction

Fournier's gangrene refers to a necrotizing fasciitis that mainly affects the perineal region and a condition that requires immediate debridement. This case involved elective debridement of Fournier's gangrene after the general condition was improved through antibiotic treatment instead of requesting an emergency debridement.

Case presentation

The patient was an 85‐year‐old man with a performance status of 4 admitted to a nursing home. He was transferred by ambulance with a fever. Blood tests showed a markedly elevated inflammatory response, and computed tomography revealed widespread aerodermectasia around the right testis to the lower abdomen. The patient was diagnosed with Fournier's gangrene. However, his family declined emergency surgical debridement. The patient's general condition was improved with antibiotics, and debridement was eventually performed. After 52 days of hospitalization, the patient was transferred to another hospital.

Conclusion

This study describes the successful treatment of Fournier's gangrene through conservative treatment followed by elective debridement.
Identifying and matching 12‐level multistained glomeruli via deep learning for diagnosis of glomerular diseases
Authors: He Qiming , Zeng Siqi , Ge Shuang , Wang Yanxia , Ye Jing , He Yonghong , Guan Tian , Wang Zhe , Li Jing
Published: February 2024

The assessment of glomerular lesions is a fundamental step toward the diagnosis of glomerular diseases. This requires diagnosis and fusion of information from all the glomeruli at multiple levels and stainings. The lack of research on multi‐level multistained glomerular identification and matching has resulted in renal pathologists devoting much time and attention to this time‐consuming and labor‐intensive process. This limits the overall efficiency of the diagnosis of glomerular diseases. This paper constructed a dataset consisting of 600 cases, each containing 12 levels of whole slide images from H&E, PAS, Masson trichrome, and PASM staining. The glomeruli identifying and matching was proposed. First, a multistained transformer‐based Mask R‐CNN is proposed to extract the position and contours of the glomeruli. Second, coherent point drift‐based coarse matching and hybrid feature‐based fine matching achieve pairwise matching. Finally, the voting‐based cross‐matching realizes 12‐level multistained matching. This system constitutes a practical human‐computer interface. Intensive experiments were conducted to validate the ability to identify and match 12‐level multistained glomeruli. The mAP@50 for detection and segmentation reached 95.40% and 95.70%, respectively. The basic and comprehensive matching rates of the glomeruli matching reached 98.25% and 74.59%, respectively. Visualization results further demonstrate that the model achieved accurate identification and matching. The proposed system achieves accurate identification and matching of 12 levels of multistained glomeruli and can serve as a tool for pathological diagnosis of glomerular diseases by simplifying the diagnostic process. More importantly, this system can lay the foundation for the fully automated assisted diagnosis of glomerular diseases.