bluuebunny/crossref_metadata_2025 huggingface dataset:
Technical Note: Comparison of the internal target volume (ITV) contours and dose calculations on 4DCT, average CBCT, and 4DCBCT imaging for lung stereotactic body radiation therapy (SBRT)
Authors: Dumas Michael , Laugeman Eric , Sevak Parag , Snyder Karen C. , Mao Weihua , Chetty Indrin J. , Ajlouni Munther , Wen Ning
Published: October 2020

Purpose

To investigate the differences between internal target volumes (ITVs) contoured on the simulation 4DCT and daily 4DCBCT images for lung cancer patients treated with stereotactic body radiotherapy (SBRT) and determine the dose delivered on 4D planning technique.

Methods

For nine patients, 4DCBCTs were acquired before each fraction to assess tumor motion. An ITV was contoured on each phase of the 4DCBCT and a union of the 10 ITVs was used to create a composite ITV. Another ITV was drawn on the average 3DCBCT (avgCBCT) to compare with current clinical practice. The Dice coefficient, Hausdorff distance, and center of mass (COM) were averaged over four fractions to compare the ITVs contoured on the 4DCT, avgCBCT, and 4DCBCT for each patient. Planning was done on the average CT, and using the online registration, plans were calculated on each phase of the 4DCBCT and on the avgCBCT. Plan dose calculations were tested by measuring ion chamber dose in the CIRS lung phantom.

Results

The Dice coefficients were similar for all three comparisons: avgCBCT‐to‐4DCBCT (0.7 ± 0.1), 4DCT‐to‐avgCBCT (0.7 ± 0.1), and 4DCT‐to‐4DCBCT (0.7 ± 0.1); while the mean COM differences were also comparable (2.6 ± 2.2mm, 2.3 ± 1.4mm, and 3.1 ± 1.1mm, respectively). The Hausdorff distances for the comparisons with 4DCBCT (8.2 ± 2.9mm and 8.1 ± 3.2mm) were larger than the comparison without (6.5 ± 2.5mm). The differences in ITV D95% between the treatment plan and avgCBCT calculations were 4.3 ± 3.0% and −0.5 ± 4.6%, between treatment plan and 4DCBCT plans, respectively, while the ITV V100% coverages were 99.0 ± 1.9% and 93.1 ± 8.0% for avgCBCT and 4DCBCT, respectively.

Conclusion

There is great potential for 4DCBCT to evaluate the extent of tumor motion before treatment, but image quality challenges the clinician to consistently delineate lung target volumes.
Evaluation of the Economic Benefit of Earlier Systemic Lupus Erythematosus (SLE) Diagnosis Using a Multivariate Assay Panel (MAP)
Authors: Clarke Ann E. , Weinstein Arthur , Piscitello Andrew , Heer Avneet , Chandra Tarun , Doshi Shivang , Wegener John , Goss Thomas F. , Powell Tami
Published: October 2020

Objective

Diagnosis of systemic lupus erythematosus (SLE) made by standard diagnostic laboratory tests (SDLTs) has sensitivity and specificity of 83% and 76%, respectively. A multivariate assay panel (MAP) combining complement C4d activation products on erythrocytes and B cells with SDLTs yields a sensitivity and specificity of 80% and 86%, respectively, presumably enabling earlier SLE diagnosis at lower severity, with associated lower health care costs compared with SDLT diagnoses. We compared the payer budget impact of diagnosing SLE using MAP (incremental cost of $108) versus SDLTs.

Methods

We modeled a health plan of 1 million enrollees. SLE diagnosis among suspected patients was 9.2%. The MAP arm assumed 80%/20% of patients were tested with MAP/SDLTs, versus 100% tested with SDLTs in the SDLT arm. Prediagnosis direct costs were estimated from claims data, and postdiagnosis costs were obtained from the literature. Based on improved MAP performance, the assumed hazard ratio for diagnosis rate compared with SDLTs was 1.74 (71%, 87%, 90%, and 91% of patients who develop SLE are diagnosed in years 1 to 4 compared with 53%, 75%, 84%, and 88% of patients diagnosed with SDLTs).

Results

Total 4‐year pre‐ and postdiagnosis direct costs for patients with suspected SLE tested with MAP were $59 183 666 compared with $61 174 818 tested by SDLTs, with lower costs in the MAP arm due primarily to prediagnosis savings related to reduced hospital admissions.

Conclusion

Incorporating MAP into SLE diagnosis results in estimated 4‐year direct cost savings of $1 991 152 ($0.04 per member per month). By facilitating earlier diagnosis of SLE, MAP may enhance patient outcomes.
Three‐Phase Electrolysis by Gold Nanoparticle on Hydrophobic Interface for Enhanced Electrochemical Nitrogen Reduction Reaction
Authors: Zhang Junchang , Zhao Bo , Liang Wenkai , Zhou Genshu , Liang Zhiqiang , Wang Yawen , Qu Jiangying , Sun Yinghui , Jiang Lin
Published: October 2020

Electrochemical nitrogen reduction reaction (NRR) provides a facile and sustainable strategy to produce ammonia (NH3) at ambient conditions. However, the low NH3 yield and Faradaic efficiency (FE) are still the main challenges due to the competitive hydrogen evolution reaction (HER). Herein, a three‐phase electrocatalyst through in situ fabrication of Au nanoparticles (NPs) located on hydrophobic carbon fiber paper (Au/o‐CFP) is designed. The hydrophobic CFP surface facilitates efficient three‐phase contact points (TPCPs) for N2 (gas), electrolyte (liquid), and Au NPs (solid). Thus, concentrated N2 molecules can contact the electrocatalyst surface directly, inhibiting the HER since the lowered proton concentration and overall enhancing NRR. The three‐phase Au/o‐CFP electrocatalyst presents an excellent NRR performance with high NH3 yield rate of 40.6 µg h−1 mg−1 at −0.30 V and great FE of 31.3% at −0.10 V versus RHE (0.1 m Na2SO4). The N2‐bubble contact angle result and cyclic voltammetry analysis confirm that the hydrophobic interface has a relatively strong interaction with N2 bubble for enhanced NRR and weak electrocatalytic activity for HER. Significantly, the three‐phase Au/o‐CFP exhibits excellent stability with a negligible fluctuation of NH3 yield and FE in seven‐cycle test. This work provides a new strategy for improving NRR and simultaneously inhibiting HER.
Programming Stepwise Motility into a Sheet of Paper Using Inkjet Printing
Authors: Shigemune Hiroki , Maeda Shingo , Iwase Eiji , Hashimoto Shuji , Sugano Shigeki , Sawada Hideyuki
Published: October 2020

Advances in printing technology and design software have enabled the rapid and convenient replication of entities. Herein, a method that provides motility to a paper through inkjet printing and that makes a paper self‐fold along printed lines is presented. A sequence of self‐folding is successfully programmed by modifying the dynamics of self‐folding. The interaction between printing aqueous solutions and a paper is used to program motion. An extremely simple stepwise self‐folding system is constructed by injecting multiple aqueous solutions into an inkjet printer. A new mechanism is also discussed for the self‐folding of the paper by experimentally varying the concentration of additives. The suggested method enables the fabrication of various structures in addition to activating self‐folded structures. Finally, a fundamental experiment using the proposed method to provide heliotropism to a silicone rod is successfully demonstrated.
EP300‐related Rubinstein–Taybi syndrome: Highlighted rare phenotypic findings and a genotype–phenotype meta‐analysis of 74 patients
Authors: Cohen Jennifer L. , Schrier Vergano Samantha A. , Mazzola Sarah , Strong Alanna , Keena Beth , McDougall Carey , Ritter Alyssa , Li Dong , Bedoukian Emma C. , Burke Leah W. , Hoffman Amber , Zurcher Victoria , Krantz Ian D. , Izumi Kosuke , Bhoj Elizabeth , Zackai Elaine H. , Deardorff Matthew A.
Published: October 2020

Pathogenic variants in the homologous and highly conserved genes—CREBBP and EP300—are causal for Rubinstein–Taybi syndrome (RSTS). CREBBP and EP300 encode histone acetyltransferases (HAT) that act as transcriptional co‐activators, and their haploinsufficiency causes the pathology characteristic of RSTS by interfering with global transcriptional regulation. Though generally a well‐characterized syndrome, there is a clear phenotypic spectrum; rare associations have emerged with increasing diagnosis that is critical for comprehensive understanding of this rare syndrome. We present 12 unreported patients with RSTS found to have EP300 variants discovered through gene sequencing and chromosomal microarray. Our cohort highlights rare phenotypic features associated with EP300 variants, including imperforate anus, retained fetal finger pads, and spina bifida occulta. Our findings support the previously noted prevalence of pregnancy‐related hypertension/preeclampsia seen with this disease. We additionally performed a meta‐analysis on our newly reported 12 patients and 62 of the 90 previously reported patients. We demonstrated no statistically significant correlation between phenotype severity (within the domains of intellectual disability and major organ involvement, as defined in our Methods section) and variant location and type; this is in contrast to the conclusions of some smaller studies and highlights the importance of large patient cohorts in characterization of this rare disease.
Immune dysfunction in MGAT2‐CDG: A clinical report and review of the literature
Authors: Poskanzer Sheri A. , Schultz Matthew J. , Turgeon Coleman T. , Vidal‐Folch Noemi , Liedtke Kris , Oglesbee Devin , Gavrilov Dimitar K. , Tortorelli Silvia , Matern Dietrich , Rinaldo Piero , Bennett James T. , Thies Jenny M. , Chang Irene J. , Beck Anita E. , Raymond Kimiyo , Allenspach Eric J. , Lam Christina
Published: October 2020

Glycosylation is a critical post/peri‐translational modification required for the appropriate development and function of the immune system. As an example, abnormalities in glycosylation can cause antibody deficiency and reduced lymphocyte signaling, although the phenotype can be complex given the diverse roles of glycosylation. Human MGAT2 encodes N‐acetylglucosaminyltransferase II, which is a critical enzyme in the processing of oligomannose to complex N‐glycans. Complex N‐glycans are essential for immune system functionality, but only one individual with MGAT2‐CDG has been described to have an abnormal immunologic evaluation. MGAT2‐CDG (CDG‐IIa) is a congenital disorder of glycosylation (CDG) associated with profound global developmental disability, hypotonia, early onset epilepsy, and other multisystem manifestations. Here, we report a 4‐year old female with MGAT2‐CDG due to a novel homozygous pathogenic variant in MGAT2, a 4‐base pair deletion, c.1006_1009delGACA. In addition to clinical features previously described in MGAT2‐CDG, she experienced episodic asystole, persistent hypogammaglobulinemia, and defective ex vivo mitogen and antigen proliferative responses, but intact specific vaccine antibody titers. Her infection history has been mild despite the testing abnormalities. We compare this patient to the 15 previously reported patients in the literature, thus expanding both the genotypic and phenotypic spectrum for MGAT2‐CDG.
School readiness is more than the child: a latent class analysis of child, family, school and community aspects of school readiness
Authors: Christensen Daniel , Taylor Catherine L. , Hancock Kirsten J. , Zubrick Stephen R.
Published: October 2020

In this paper, we aim to contribute to the understanding of the multidimensional nature of school readiness. In a sample of over 4,000 Australian children in their first year of school, we used latent class analysis to examine patterns of school readiness based on child, family, school and community characteristics, and examine the relationship between these patterns of school readiness and subsequent outcomes (reading comprehension, school absence and emotional and behavioural difficulties). We identified four distinct groups: a Developmentally Enabled group (70 per cent of children), a Parenting Risk group (16 per cent of children), an Emotionally Immature Risk group (7 per cent of children) and a Language and Developmental Risks group (7 per cent of children). The four profiles showed differential patterns of association with low reading comprehension and emotional and behavioural difficulties at age 8, but no association with school absence. The study highlights the importance of family, school and community factors when considering school readiness.
Synthesis, characterization, and determination of photophysicochemical properties of peripheral and nonperipheral tetra‐7‐oxy‐3,4‐dimethylcoumarin substituted zinc, indium phthalocyanines
Authors: Özgül Artuç Gamze , Karapınar Begümhan , Özdemir Mücahit , Bulut Mustafa
Published: October 2020

The photochemical and photophysical properties of peripheral and nonperipheral zinc and indium phthalocyanines containing 7‐oxy‐3,4‐dimethylcoumarin synthesized were investigated in this study. 7‐Hydroxy‐3,4‐dimethylcoumarin (1) was synthesized via Pechmann condensation reaction and then the phthalonitrile derivatives [4‐(7‐oxy‐3,4‐dimethylcoumarino)phthalonitrile (2) and 3‐(7‐oxy‐3,4‐dimethylcoumarino)phthalonitrile (3)] were synthesized by nucleophilic aromatic substitution. Phthalocyanine compounds containing coumarin units on peripheral (4 and 5) and nonperipheral (6 and 7) positions were prepared via cyclotetramerization of phthalonitrile compounds. All compounds' characterizations were performed by spectroscopic methods and elemental analysis. The phthalocyanine derivatives' (4–7) photochemical and photophysical properties were studied in DMF. The photophysical (fluorescence quantum yields and lifetimes) and photochemical (singlet oxygen and photodegradation quantum yields) properties of these novel phthalocyanines (4–7) were studied in DMF. They produced good singlet oxygen (e.g., ΦΔ = 0.93 for 7) and showed appropriate photodegradation (in the order of 10−5), which is very important for photodynamic therapy applications.
Parametererregter Festkörperschwingungsdämpfer für biaxial angeregte Ingenieurkonstruktionen
Authors: Reiterer Michael
Published: October 2020

Ein parametererregter Festkörperschwingungsdämpfer wird für die Anwendung zur Schwingungsdämpfung von biaxial angeregten Ingenieurkonstruktionen vorgestellt. Zu Beginn werden die gekoppelten nichtlinearen Bewegungsdifferenzialgleichungen hergeleitet und das Phänomen der Parameterresonanz bei Festkörperschwingungsdämpfern analysiert. Bei Übereinstimmung der vertikalen Schwingfrequenz des Hauptsystems mit einer Parameterresonanzfrequenz wird der Festkörperschwingungsdämpfer zu instabilen parametererregten Schwingungen angeregt. Die Auswirkungen dieser parametererregten Schwingungen auf die erzielbare Dämpfungswirkung werden im ersten Teil des Aufsatzes an einem eingeschossigen Stockwerkrahmen untersucht. Es wird ein Kriterium zur Vermeidung von Parameterresonanz angegeben. Im zweiten Teil des Aufsatzes wird eine Methode zur gezielten Nutzung der Parameterresonanz bei Festkörperschwingungsdämpfern zur Reduktion der vertikalen Schwingungen von Ingenieurkonstruktionen dargelegt und anhand einer biaxial angeregten Fußgängerbrücke verifiziert. Es wird gezeigt, dass sich bei passender Wahl der Dämpferparameter trotz des Auftretens der Parameterresonanz eine über den Schwingungsverlauf stabile Bewegung des Festkörperschwingungsdämpfers ausbildet und dass die max. vertikalen Schwingungsamplituden des Hauptsystems durch gezielte Nutzung des Parameterresonanzeffekts signifikant reduziert werden können.
Point cloud semantic scene segmentation based on coordinate convolution
Authors: Zhang Zhaoxuan , Li Kun , Yin Xuefeng , Piao Xinglin , Wang Yuxin , Yang Xin , Yin Baocai
Published: October 2020

Point cloud semantic segmentation, a crucial research area in the 3D computer vision, lies at the core of many vision and robotics applications. Due to the irregular and disordered of the point cloud, however, the application of convolution on point clouds is challenging. In this article, we propose the “coordinate convolution,” which can effectively extract local structural information of the point cloud, to solve the inapplicability of conventional convolution neural network (CNN) structures on the 3D point cloud. The “coordinate convolution” is a projection operation of three planes based on the local coordinate system of each point. Specifically, we project the point cloud on three planes in the local coordinate system with a joint 2D convolution operation to extract its features. Additionally, we leverage a self‐encoding network based on image semantic segmentation U‐Net structure as the overall architecture of the point cloud semantic segmentation algorithm. The results demonstrate that the proposed method exhibited excellent performances for point cloud data sets corresponding to various scenes.
Safety and efficacy of first‐line cryoablation for para‐hisian ventricular arrhythmias using a cryomapping protocol approach: A case series
Authors: Mizutani Yoshiaki , Yanagisawa Satoshi , Kanashiro Masaaki , Inden Yasuya , Murohara Toyoaki
Published: October 2020

A first‐line cryoablation for para‐Hisian VAs using a strict cryomapping protocol is useful and safe, even if the His bundle potential is recorded on the ablation catheter.
Configurational and Constitutional Dynamics of Enamine Molecular Switches
Authors: Ren Yansong , Kravchenko Oleksandr , Ramström Olof
Published: October 2020

Dual configurational and constitutional dynamics in systems based on enamine molecular switches has been systematically studied. pH‐responsive moieties, such as 2‐pyridyl and 2‐quinolinyl units, were required on the „stator“ part, also providing enamine stability through intramolecular hydrogen‐bonding (IMHB) effects. Upon protonation or deprotonation, forward and backward switching could be rapidly achieved. Extension of the stator π‐system in the 2‐quinolinyl derivative provided a higher E‐isomeric equilibrium ratio under neutral conditions, pointing to a means to achieve quantitative forward/backward isomerization processes. The „rotor“ part of the enamine switches exhibited constitutional exchange ability with primary amines. Interestingly, considerably higher exchange rates were observed with amines containing ester groups, indicating potential stabilization of the transition state through IMHB. Acids, particularly BiIII, were found to efficiently catalyze the constitutional dynamic processes. In contrast, the enamine and the formed dynamic enamine system showed excellent stability under basic conditions. This coupled configurational and constitutional dynamics expands the scope of dynamic C−C and C−N bonds and potentiates further studies and applications in the fields of molecular machinery and systems chemistry.
Palladium‐Catalyzed Aminomethylation of Nitrodienes and Dienones via Double C—N Bond Activation
Authors: Yu Bangkui , Gao Bao , Zhang Xuexia , Zhang Haocheng , Huang Hanmin
Published: October 2020

Main observation and conclusion

A new strategy for the generation of the active Pd‐alkyl species from aminal via C—N bond activation has been established, in which the formation of zwitterionic intermediate through aza‐Michael addition of aminal to nitrodienes or dienones is identified as a key step for the activation of the C—N bond. The efficient strategy has enabled a new palladium‐catalyzed α‐aminomethylation of nitrodienes and dienones via double C—N bond activation. The scope and versatility of the reaction were demonstrated and a broad range of substrates bearing electron‐donating and ‐withdrawing groups on the aromatic rings were all compatible with this reaction to furnish the desired α‐aminomethylated products in moderate to good yields with excellent regioselectivities and E/Z selectivities.
One‐Pot Synthesis of 3‐ to 15‐Mer π‐Conjugated Discrete Oligomers with Widely Tunable Optical Properties
Authors: Liu Hui , Zhang Xiao‐Feng , Wang Li‐Hong , Chen Yan , Ye Dong‐Nai , Chen Long , Wen He‐Rui , Liu Shi‐Yong
Published: October 2020

Main observation and conclusion

A series of all‐donor type alternating (D1‐D2) monodisperse oligomers based on cyclopentadithiophene (CPDT) and 1,4‐difluorobenzene (DFB) with gradually increasing chain lengths containing 3 to 15 monomers were successfully synthesized via one‐pot C—H direct arylation reaction. As confirmed by various structural characterizations, all these long‐chain oligomers are monodispersed with defined structures. The length‐dependent optical and electrochemical properties with the evolution from the shortest oligomer (O1) to the longest oligomer (O7) and their parent polymer P1 have been studied in details. By simply tuning the mixing ratio of discrete oligomers, the photoluminescence (PL) in a wide range of color emissions extending to near‐white can be facilely modulated, illustrating the potential of these monodisperse conjugated oligomers for light emission application. The atom‐, step‐ and pot‐economic synthetic strategy here developed will open the door toward efficient and controllable synthesis of π‐conjugated oligomers for accurate structure‐property relationship study and optic & electronic device applications.
Adolescents’ perceptions of maternal response to negative affect predict emotional reactivity during mother–daughter interaction: A multi‐modal assessment
Authors: O’Brokta Megan M. , Woody Mary L. , McKone Kirsten M. , Amole Marlissa C. , Stone Lindsey B. , Silk Jennifer S.
Published: October 2020

Parental socialization of emotion consists of parental behaviors that scaffold child emotional reactivity and regulation. The current study examined whether adolescents’ perceptions of their mothers’ supportive versus non‐supportive responses to negative emotions could predict adolescent emotional reactivity. Thirty adolescent girls (Mage = 14.41 [1.55]) reported on how their mothers typically respond to their negative emotions and then completed a laboratory‐based mother–adolescent interaction task. A multi‐modal assessment of adolescent emotional reactivity during the interaction included adolescents’ skin conductance levels (SCLs) and state anxiety, and mother–daughter interactions were behaviorally coded to assess how often dyads engaged in both negative and positive escalation (i.e., a pattern of negative or positive behavior of one partner being reciprocated by the other). Adolescents who reported that their mothers used more non‐supportive responses to their negative emotion tended to exhibit higher SCL and engage in more negative escalation with their mothers during the interaction task. Furthermore, adolescents’ SCL was positively correlated with both their state anxiety levels and negative escalation during the task. Together, these findings suggest that adolescents who perceive their mothers as less supportive of negative emotions are more likely to exhibit greater negative emotionality during parent–adolescent interaction, which may relate to risk for emotional disorders.
Context‐dependent effects of a reintroduced ungulate on soil properties are driven by soil texture, moisture, and herbivore activity
Authors: Dodge Vanessa J. , Eviner Valerie T. , Cushman J. Hall
Published: October 2020

Although there is considerable evidence that large mammalian herbivores influence ecosystem‐level processes, studies have reported such widely varying results that generalizations have remained elusive. Here, we use an 18‐year‐old exclosure experiment—stratified across a landscape heterogeneous with respect to soil texture, moisture and herbivore activity—to understand the variable effects of tule elk (Cervus canadensis nannodes), a native reintroduced herbivore, on soil properties along the coast of northern California. Elk significantly increased soil bulk density and created a compacted layer at shallow soil depth, while decreasing infiltration rate and pH. The effects of elk on bulk density, penetration resistance, and pH varied with soil type, being least pronounced in coarse, sandy loams, and greatest in loose sand. The effects of elk on nutrient availability varied along gradients of soil texture and moisture. In coarser soils, elk decreased ammonium availability, but increased it in finer soils. Elk also decreased soil moisture content, in part through their positive effect on bulk density, and this effect was most pronounced in coarser soils. Through decreasing soil moisture content, elk also decreased nitrate availability in coarser soils. At greater levels of elk activity (as measured by dung deposition), the elk effect on bulk density was amplified, and this had a corresponding negative effect on nitrate and phosphate availability. Our study has demonstrated that a better understanding of spatial variation in the effects of herbivores on ecosystems can emerge by evaluating their influences across gradients of soil texture, soil moisture, and herbivore activity. These data enabled us to evaluate several frameworks that have been developed to understand the variable effects of herbivores on ecosystems, which is a significant step in reconciling the many competing ideas put forth to explain the context‐dependent effects of large herbivores on grazed ecosystems.
Skin resistance to water gain and loss has changed in cane toads (Rhinella marina) during their Australian invasion
Authors: Kosmala Georgia K. , Brown Gregory P. , Shine Richard , Christian Keith
Published: October 2020

The water‐permeable skin of amphibians renders them highly sensitive to climatic conditions, and interspecific correlations between environmental moisture levels and rates of water exchange across the skin suggest that natural selection adapts hydroregulatory mechanisms to local challenges. How quickly can such mechanisms shift when a species encounters novel moisture regimes? Cutaneous resistance to water loss and gain in wild‐caught cane toads (Rhinella marina) from Brazil, USA (Hawai'i) and Australia exhibited strong geographic variation. Cutaneous resistance was low in native‐range (Brazilian) toads and in Hawai'ian populations (where toads were introduced in 1932) but significantly higher in toads from eastern Australia (where toads were introduced in 1935). Toads from recently invaded areas in western Australia exhibited cutaneous resistance to water loss similar to the native‐range populations, possibly because toads are restricted to moist sites within this highly arid landscape. Rates of rehydration exhibited significant but less extreme geographic variation, being higher in the native range than in invaded regions. Thus, in less than a century, cane toads invading areas that impose different climatic challenges have diverged in the capacity for hydroregulation.
Context‐aware emergency detection method for edge computing‐based healthcare monitoring system
Authors: Wang Lei , Xu Boyi , Cai Hongming , Zhang Pengzhu
Published: October 2020

When taking physical exercise, healthcare monitoring systems are needed to detect emergencies, such as sychnosphygmia, and so on. However, heterogeneity and privacy make it more challenging to collect and process multi‐source healthcare data in a real time manner. To support healthcare monitoring, in this research, a multi‐layer edge computing‐based framework is designed to detect emergencies in low latency and secure ways. First, a universal data model is defined to process heterogeneous data from multi‐sources such as sensors or smart devices. Then, Gated Recurrent Units‐based (GRU) model is utilized to capture and process physiological data series. Fine‐grained detection models are built and distinguished according to scenario information and individual health persona. In the proposed edge computing‐based framework, detection algorithm computation and physiological index data storage are close to end user sides to support low latency. Meanwhile encryption algorithm is used to protect data privacy. Finally, a case study in the Physical Education Class scenario is implemented to demonstrate the feasibility of our methods. The experimental result shows that our GRU model is more accurate and is three times faster for emergency identification compared with Support Vector Classification model.
Adsorption kinetics and mechanism of di‐n‐butyl phthalate by Leuconostoc mesenteroides
Authors: Zhao Lili , Li Xinlei , Yang Qingxiang , Zhuang Di , Pan Xin , Li Lubo
Published: October 2020

Di‐n‐butyl phthalate (DBP) poses a risk to humans as a ubiquitous environmental contaminant. A strain of Leuconostoc mesenteroides DM12 was chosen from lactic acid bacteria strains to study the DBP binding mechanisms. Adsorption of DBP by strain DM12 reached the highest binding rate of 87% after 11 hr of incubation, which could be explained by pseudo‐second‐order kinetics. The adsorption isotherm coincided with the model of Langmuir–Freundlich, indicating physical and chemical adsorption processes involved. Further, NaIO4 and TCA treatments were used to analyze the DBP binding mechanism of strain DM12, which indicated that peptidoglycan on the bacterial cell wall was involved in the process. The O‐H, C‐O, and N‐H bonds were possibly involved in the binding process as the main functional groups.
The Value Proposition for Adopting a Lean Mindset for Utilities
Authors: Jesuthasan Maureen , Owusu Denise
Published: October 2020

Utility leaders face a variety of management challenges, ranging from climate mitigation to the reduction of operating costs to ­pursuing opportunities to improve employee and customer engagement. All of these obstacles can be alleviated by dedicating focused time for productivity and innovation. While most leaders realize productivity and innovation are important to overall business success, many encounter roadblocks along the way because they.
The Mysterious US Natural Gas Market
Authors: Makholm Jeff D.
Published: October 2020

The natural gas market in the United States—mysterious?
Intranasal mesenchymal stem cell therapy to boost myelination after encephalopathy of prematurity
Authors: Vaes Josine E. G. , van Kammen Caren M. , Trayford Chloe , van der Toorn Annette , Ruhwedel Torben , Benders Manon J. N. L. , Dijkhuizen Rick M. , Möbius Wiebke , van Rijt Sabine H. , Nijboer Cora H.
Published: October 2020

Encephalopathy of prematurity (EoP) is a common cause of long‐term neurodevelopmental morbidity in extreme preterm infants. Diffuse white matter injury (dWMI) is currently the most commonly observed form of EoP. Impaired maturation of oligodendrocytes (OLs) is the main underlying pathophysiological mechanism. No therapies are currently available to combat dWMI. Intranasal application of mesenchymal stem cells (MSCs) is a promising therapeutic option to boost neuroregeneration after injury. Here, we developed a double‐hit dWMI mouse model and investigated the therapeutic potential of intranasal MSC therapy. Postnatal systemic inflammation and hypoxia‐ischemia led to transient deficits in cortical myelination and OL maturation, functional deficits and neuroinflammation. Intranasal MSCs migrated dispersedly into the injured brain and potently improved myelination and functional outcome, dampened cerebral inflammationand rescued OL maturation after dWMI. Cocultures of MSCs with primary microglia or OLs show that MSCs secrete factors that directly promote OL maturation and dampen neuroinflammation. We show that MSCs adapt their secretome after ex vivo exposure to dWMI milieu and identified several factors including IGF1, EGF, LIF, and IL11 that potently boost OL maturation. Additionally, we showed that MSC‐treated dWMI brains express different levels of these beneficial secreted factors. In conclusion, the combination of postnatal systemic inflammation and hypoxia‐ischemia leads to a pattern of developmental brain abnormalities that mimics the clinical situation. Intranasal delivery of MSCs, that secrete several beneficial factors in situ, is a promising strategy to restore myelination after dWMI and subsequently improve the neurodevelopmental outcome of extreme preterm infants in the future.
Bipedicled submental musculofascial “hammock” flap for salvage laryngectomy closure reinforcement
Authors: Hayden Richard E. , Chang Brent A. , Mullin David P. , Patel Andrew K. , Nagel Thomas H. , Howard Brittany E. , Hinni Michael L. , Lott David G. , Donald Carrlene B.
Published: October 2020

Background

The aim of the study was to describe a novel technique for reinforcement of salvage laryngectomy closure using a bipedicled musculofascial submental flap.

Methods

A retrospective cohort study design identified patients who underwent salvage laryngectomy reinforcement with a bipedicled submental hammock flap between January 2008 and December 2016 were compared to salvage laryngectomy patients treated with primary closure of the neopharynx during the same time period. Pharyngocutaneous fistula rates were compared between groups.

Results

Pharyngocutaneous fistula rate in the submental hammock group (2/31, 6.5%) was significantly lower compared to the primary closure group (14/45, 31%, P < .05).

Conclusion

The bipedicled musculofascial submental hammock flap is a viable method for reinforcement of salvage laryngectomy defects. It has a favorable pharyngocutaneous fistula rate compared to primary closure alone and has unique advantages over conventional methods of reinforcement.
Risk factors for carcinoma ex pleomorphic adenoma in patients presenting with recurrence after resection of pleomorphic adenoma
Authors: Yin Linda X. , Van Abel Kathryn M. , Rooker Steven A. , Nagelschneider Alex A. , Olsen Kerry D. , Price Daniel L. , Janus Jeffrey R. , Kasperbauer Jan L. , Moore Eric J.
Published: October 2020

Background

In patients presenting with recurrent pleomorphic adenoma (rPA), clinical evaluation can fail to recognize carcinoma ex PA (cxPA). We aim to identify the risk factors for cxPA.

Methods

This is a single institution retrospective case‐control study from 2000 to 2015. CxPA was diagnosed based on surgical pathology. Demographics, clinical, and social histories were collected.

Results

A number of 13/106 (12.3%) patients were diagnosed with cxPA, of which only 4/13 (31%) had clinical features suspicious for malignancy. Compared to benign rPA, factors associated with cxPA included age >50 (odds ratio [OR] 6.67, 95% confidence interval [CI]: 1.71‐25.98, P < .01), >10 pack‐years of smoking history (OR 3.36, 95% CI: 1.01‐11.14, P = .04), and the largest tumor being >2 cm on pathology (OR 4.42, 95% CI: 1.14‐17.10, P = .03).

Conclusions

In patients presenting with rPA, risk factors for malignant transformation include age >50, significant smoking history, and tumors larger than 2 cm. Clinical signs of malignancy such as rapid growth or pain are not always present.
Chromosome 5 harbors two independent deletion hotspots at 5q13 and 5q21 that characterize biologically different subsets of aggressive prostate cancer
Authors: Möller Katharina , Kluth Martina , Ahmed Malik , Burkhardt Lia , Möller‐Koop Christina , Büscheck Franziska , Weidemann Sören , Tsourlakis Maria‐Christina , Minner Sarah , Heinzer Hans , Huland Hartwig , Graefen Markus , Sauter Guido , Schlomm Thorsten , Dum David , Simon Ronald
Published: October 2020

Deletion of chromosome 5q is common in prostate cancer and is linked to aggressive disease. Most previous studies focused on 5q21 where CHD1 is located, but deletion of mapping studies has identified a second deletion hotspot at 5q13. To clarify the prevalence and clinical relevance of 5q13 deletions and to determine the relative importance of 5q13 and 5q21 abnormalities, a tissue microarray containing samples from 12 427 prostate cancers was analyzed by fluorescence in situ hybridization. Deletion of 5q13 and 5q21 was found in 13.5% and 10%, respectively, of 7932 successfully analyzed cancers. Deletion was restricted to 5q13 in 49.4% and to 5q21 in 32.0% of cancers with a 5q deletion. Only 18.6% of 5q‐deleted cancers had deletions of both loci. Both 5q13 and 5q21 deletions were significantly linked to advanced tumor stage, high Gleason grade, nodal metastasis and early biochemical recurrence (P < .005 each). Cancers with co‐deletion of 5q13 and 5q21 had a worse prognosis than cancers with isolated 5q13 or 5q21 deletion (P = .0080). Comparison with TMPRSS2:ERG fusion status revealed that 5q21 deletions were tightly linked to ERG negativity (P < .0001) while 5q13 deletions were unrelated to the ERG status. In summary, 5q13 deletion and 5q21 deletion are common, but independent genomic alterations with different functional effects lead to aggressive prostate cancer.
Meditations in a Pandemic: What I Feared and Learned About Teaching Online
Authors: Garza Joel
Published: October 2020

Young people in literacy classes sometimes think their teachers are not listening to them. The practitioners featured in this column listen to questions posed by their students and respond to them, with the goal of enhancing English language arts instruction for a range of young people and educators.
The potential roles of exosomal noncoding RNAs in osteosarcoma
Authors: Li Shenglong , Wang Xiaohong
Published: October 2020

Clinically, it is difficult to efficaciously screen and diagnose osteosarcoma (OS) in advance due to the low sensitivity and poor specificity of the existing tumor markers. Exosomes (Exos) are nanoscale vesicles containing RNAs, lipids, and proteins with a diameter of 30–100 nm. They are multivesicular bodies formed during the invagination of lysosomal particles in cells and released extracellularly after fusing with cell membranes. Besides, Exos are important carriers of cell‐to‐cell communication signals and genetic materials in the tumor microenvironment. During tumorigenesis, the tumor cells interplay with immune cells, endothelial cells, and related fibroblasts through Exos and boost cancer development. After altering the surrounding microenvironment, the Exos drive tumor cells to proliferate, speed up angiogenesis, and boost cancers to develop along with body fluid transportation. Currently, Exos are becoming novel noninvasive tumor diagnostic markers with high sensitivity, exerting pivotal impacts in fundamental research and clinical applications. Here, we review the existing literature on the roles of exosomal noncoding RNAs in OS progression and their potential clinical applications as novel biomarkers and therapeutics.
Antibiotics and antimicrobial resistance: Evaluation of the knowledge, attitude, and perception among students and faculty within US dental schools
Authors: Holz Magdalena , Naavaal Shillpa , Stilianoudakis Sprio , Carrico Caroline , Byrne B. Ellen , Myers Garry L.
Published: October 2020

Purpose

This study examined knowledge, attitudes, perceptions, and awareness regarding antibiotic use among students and academic faculty in US dental schools.

Methods

Two questionnaires, 1 for third‐year/fourth‐year dental students and the other for academic deans/department chairs were administered electronically. Questions on demographics, antibiotic knowledge, educational formats, and the role of dentistry in antibiotic stewardship were included. Knowledge about antibiotics and antibiotics stewardship was compared between third‐year and fourth‐year students and between students and academic faculty using t‐test and chi‐squared test at 0.05 significance level.

Results

A total of 18 responses on the academic dean and department chair survey and 172 responses on the dental student survey were collected. Overall, 71% of students reported that they could benefit from more education regarding antibiotics. Both faculty and students agreed that dentistry should play an important role in reducing antimicrobial resistance, but most dental students were "not at all familiar" with the term antimicrobial stewardship and several (32%) were unsure if clinical guidelines were present at their schools.

Conclusion

Improvements to the dental educational curriculum regarding the responsible use of antibiotics, along with the implementation of stewardship programs within dentistry are strongly encouraged.
Evaluation of EDTA, QMix, and Irritrol solutions activated with Er,Cr:YSGG and diode lasers on the push‐out bond strength of filling material
Authors: Saricam Esma , Küçük Meltem , Akyol Meltem
Published: October 2020

This study was conducted to evaluate the effects of ethylenediaminetetraacetic acid (EDTA), Irritrol, and QMix solutions used with manual irrigation and diode and erbium, chromium‐doped yttrium, scandium, gallium, and garnet (Er,Cr:YSGG) laser activation on the bonding ability of sealer to the intraradicular dentin. The root canals of 90 mandibular incisors were instrumented, and the teeth were allocated randomly to nine groups (n = 10/group) receiving final irrigation with different irrigation solutions (EDTA, Irritrol, and QMix) and irrigant activation techniques (manual, diode laser, and Er,Cr:YSGG laser). Following endodontic filling, three sections of 1‐mm thickness were obtained from the middle third of each root. The root filling was subjected to a push‐out test to examine the bond strength of the sealer to dentin. The test data were examined using analysis of variance with a significance level of ɑ < .05. Failure modes were determined by stereomicroscopy, and the surface characteristics of dentin were observed by scanning electron microscopy. Irritrol showed less push‐out bond strength than did the other solutions in the Er,Cr:YSGG laser groups (p < .05). In the diode laser groups, QMix provided greater adhesion than did Irritrol (p < .05). The activation of QMix with the Er,Cr:YSGG laser increased the bond strength more than did manual irrigation (p < .05). No other significant difference was observed between other comparison pairs (p > .05). QMix provided adhesion superior to that of Irritrol when activated with diode and Er,Cr:YSGG lasers. Er,Cr:YSGG laser activation increased the adhesion of filling material with QMix irrigation.
Depression and Anxiety During the COVID‐19 Pandemic in an Urban, Low‐Income Public University Sample
Authors: Rudenstine Sasha , McNeal Kat , Schulder Talia , Ettman Catherine K. , Hernandez Michelle , Gvozdieva Kseniia , Galea Sandro
Published: October 2020

Mental health disparities in the aftermath of national disasters and the protective role of socioeconomic status are both well documented. We assessed the prevalence of depression and anxiety symptoms among underresourced public university students during the COVID‐19 pandemic in New York City. Between April 8, 2020, and May 2, 2020, adult students (N = 1,821) across the CUNY system completed an online survey examining COVID‐19–related stressors and mental health and sociodemographic factors. Using multivariable logistical regression to assess the association between COVID‐19–related stressors and depression and anxiety symptoms, we found a high prevalence and severity of depression and anxiety symptoms. We also observed that more exposure to COVID‐19–related stressors was associated with increased depressive (27.0%, 41.4%, and 63.1% for low‐, medium‐, and high‐level stressors, respectively) and anxiety symptoms (19.3%, 34.6%, 52.2%). In addition, the degree of exposure to COVID‐19–related stressors served as an important predictor of depression and anxiety symptoms. Compared to high levels of stressors, the odds of depression were 0.2, 95% CI [0.2, 0.3] for low‐ and 0.4, 95% CI [0.3, 0.5] for medium‐level stressors; for anxiety, the odds were 0.2, 95% CI [0.2, 0.3] for low and 0.05, 95% CI [0.4, 0.6] for medium stressors. Finally, household savings of less than $5,000 increased the risk of anxiety but not depression symptoms, OR = 1.3, 95% CI [1.0,1.6]. Together, these findings tell a devastating story of psychological distress among students from lower socioeconomic groups living in the COVID‐19 epicenter of the U.S. pandemic.
Treatment of Oligometastatic Disease in Squamous Cell Carcinoma of the Head and Neck
Authors: Vincent Aurora G. , Wang Weitao , Shokri Tom , Ducic Yadranko
Published: October 2020

Objective

No surgical or radiotherapeutic treatment guidelines exist for oligometastatic head and neck squamous cell carcinoma (oHNSCC), and only recently have interventions with curative intent been studied. Herein, we sought to elucidate survival rates among patients with oHNSCC to determine if treatment with curative intent is warranted in this population.

Study Design

Retrospective chart review.

Methods

We retrospectively reviewed cases of oHNSCC treated between March 1998 and March 2018. Fisher's exact test was used to compare patients treated with radiotherapy (RT) to those who underwent surgical excision and to compare outcomes of patients with oligometastases at the time of initial presentation to those that developed oligometastatic disease after primary treatment.

Results

Eighty one patients with metastases to the lungs, ribs, pelvis, vertebral column, liver, clavicle, and sternum were included. Overall, 32 patients (40%) were alive 5 years post‐treatment. The site of metastasis, the modality of treatment, and the time of development of oligometastatic disease did not significantly affect 5‐year survival.

Conclusion

Herein, we demonstrate that multi‐modality treatment of oHNSCC is warranted for some patients with an estimated 40% 5‐year survival. Aggressive treatment of the primary and regional sites is necessary in addition to treatment of the metastatic site and incurs a survival benefit compared to patients with metastatic HNSCC treated with systemic therapy alone. oHNSCC should be approached separately from polymetastatic disease. Patients should be counseled about the possibility for long‐term survival, and aggressive initial treatment with the intention for cure should be considered in this population.

Level of Evidence

4 Laryngoscope, 131:E1476–E1480, 2021
Restless Leg Syndrome and Objectively‐Measured Atherosclerosis in the Canadian Longitudinal Study on Aging
Authors: Zolfaghari Sheida , Dasgupta Kaberi , Postuma Ronald B.
Published: October 2020

Background

Previous studies suggest associations between restless leg syndrome (RLS) and atherosclerosis, but these have primarily been based upon subjective atherosclerotic measures.

Objective

We evaluated associations between RLS and an objective indicator of atherosclerosis, namely carotid intima‐media thickness (cIMT).

Methods

In this cross‐sectional study among 30,097 Canadian Longitudinal Study on Aging (CLSA) participants, we used a four‐item questionnaire to screen for probable‐RLS. cIMT was measured at the bifurcation of the common carotid artery. Associations were tested with linear regression adjusting for age, sex, ferritin, pulmonary disease, smoking, alcohol, physical activity, anxiety, depression, and other sleep diagnoses.

Results

Among 26,304 included participants, 2047 (7.8%) had probable‐RLS. Mean cIMT was higher (0.755 ± 0.17 vs 0.736 ± 0.17, P < 0.001) in those with RLS, even after excluding those without prior atherosclerotic diseases (0.740 ± 0.17 vs 0.723 ± 0.16, P = 0.016).

Conclusion

RLS is associated with objective measures of atherosclerosis. © 2020 International Parkinson and Movement Disorder Society
Custom designed radial forearm free flap for reconstruction of nasomaxillary defects: Report of two cases
Authors: Sieira‐Gil Ramon , Yuste‐Colom Marta , Martí Carles , García Eloy , Fontdevila Joan , Ferrer Ada
Published: October 2020

Nasal amputation and nasomaxillary defects, need to reconstruct the internal lining, osteochondral structure, and external coating of the nose. Authors report a 70‐year‐old male and a 65‐year‐old female treated for nasomaxillary defects (Brown JS, Shaw RJ. The Lancet Oncology 2010;11:1001–1008) due to squamous cell carcinoma (SCC) where the tip of the nose was preserved. A new custom design of the radial forearm free flap (RFFF) consisting on a subcutaneous tissue (SCT) component, a skin paddle for the internal nasal vault lining, and a skin paddle for the external nasal skin coating was raised to treat both total thickness nasal defects. The dimension of each skin paddle corresponds to the defect measurements. The skin incisions of the custom design correspond to those of a conventional RFFF. The SCT component was harvested in a subcutaneous plane continuously with the skin island for the internal nasal lining which is drawn on the ulnar skin of the forearm. The component for the external nasal coating was drawn on the radial skin area of the flap. No postoperative complications and a satisfactory outcome was reported after 1 year of follow‐up. This new custom design of the RFFF is described for reconstruction of nasomaxillary defects when the tip of the nose is preserved.