bluuebunny/crossref_metadata_2025 huggingface dataset:
LSF films formed on YSZ electrolytes via polymeric precursor deposition for solid oxide fuel cell anode applications
Authors: Bilbey Buse , Asghar M. Imran , Arslan Leyla Colakerol , Lund Peter D. , Büyükaksoy Aligul
Published: August 2023

Different materials have been applied as anode in solid oxide fuel cell (SOFC). Perovskite structured materials are promising as an alternative electrode material to Ni. Here, we investigated perovskite‐structured mixed ionic and electronic conducting material, lanthanum strontium ferrite (LSF), which has typically been used as a cathode material. LSF has also shown potential for an anode in SOFC. LSF films with two different compositions, La0.6Sr0.4FeO3 (6LSF) and La0.8Sr0.2FeO3 (8LSF) were fabricated by a polymeric precursor method. The effects of the phase content, surface chemistry, and microstructure on the anode performance were investigated. It was found that a mixture of the Ruddlesden–Popper phase, SrCO3 phases, and rhombohedral perovskite exists in both cell structures. Both cells had Ruddlesden–Popper and SrCO3 phases at their surface, in addition to the rhombohedral perovskite. Symmetrical half‐cell measurements showed that the polarization resistance of 6LSF (0.34 Ω cm2) is lower than that of 8LSF (0.47 Ω cm2), mostly because of its highly porous microstructure as a result of slower A‐site diffusion rates induced by higher Sr content.

The symmetrical 6LSF fuel and air electrodes exhibited ASRelectrode values of 0.34 and 0.14 Ω cm2, respectively, at 800 ˚C.
Computed Tomography Provides Improved Quantification of Trabecular Lumbar Spine Bone Loss Compared to Dual‐Energy X‐Ray Absorptiometry in Ovariectomized Sheep
Authors: Bisazza Katie T , Nelson Brad B , Sikes Katie J , Nakamura Lucas , Easley Jeremiah T
Published: August 2023

Early detection of osteoporosis using advanced imaging is imperative to the successful treatment and prevention of high morbidity fractures in aging patients. In this preclinical study, we aimed to compare dual‐energy X‐ray absorptiometry (DXA) and quantitative computed tomography (QCT) to quantify bone mineral density (BMD) changes in the sheep lumbar spine. We also aimed to determine the relationship of BMD to microarchitecture in the same animals as an estimate of imaging modality precision. Osteoporosis was induced in 10 ewes via laparoscopic ovariectomy and administration of high‐dose corticosteroids. We performed DXA and QCT imaging to measure areal BMD (aBMD) and trabecular volumetric BMD (Tb.vBMD)/cortical vBMD (Ct.vBMD), respectively, at baseline (before ovariectomy) and at 3, 6, 9, and 12 months after ovariectomy. Iliac crest bone biopsies were collected at each time point for micro‐computed tomography (microCT) analysis; bone volume fraction (BV/TV), trabecular number (Tb.N), thickness (Tb.Th), and spacing (Tb.Sp) were reported. aBMD and Tb.vBMD both decreased significantly by 3 and 6 months (p < 0.05) compared with baseline, whereas no changes to Ct.vBMD were observed. Combined (Tb. and Ct.) vBMD was significantly correlated with aBMD at all time points (all p < 0.05). Additionally, greater significant correlations were found between BV/TV and Tb.vBMD at all five time points (R2 = 0.54, 0.57, 0.66, 0.46, and 0.56, respectively) than with aBMD values (R2 = 0.23, 0.55, 0.41, 0.20, and 0.19, respectively). The higher correlation of microCT values with QCT than with DXA indicates that QCT provides additional detailed information regarding bone mineral density changes in preclinical settings. Because trabecular bone is susceptible to rapid density loss and structural changes during osteoporosis, QCT can capture these subtle changes more precisely than DXA in a large animal preclinical model. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
On the directed Oberwolfach problem for complete symmetric equipartite digraphs and uniform‐length cycles
Authors: Francetić Nevena , Šajna Mateja
Published: August 2023

We examine the necessary and sufficient conditions for a complete symmetric equipartite digraph with parts of size to admit a resolvable decomposition into directed cycles of length . We show that the obvious necessary conditions are sufficient for in each of the following four cases: (i) is even; (ii) ; (iii) and or ; and (iv) , and if , then for a prime .
Exposure therapy for health anxiety: Effectiveness and response rates in routine care of an outpatient clinic
Authors: Roth‐Rawald Julia , Maaß Ulrike , Mai Stefanie , Weck Florian
Published: August 2023

Objective

Many randomized controlled trials (RCTs) have demonstrated the efficacy and benefits of exposure therapy in the treatment of health anxiety. However, the application of these research results to routine care has not been considered sufficiently. The aim of this study is to analyze the effectiveness of exposure therapy in the routine treatment of health anxiety patients.

Method

Data were available for 35 patients, who repeatedly filled in comprehensive general questionnaires, and those specific to health anxiety.

Results

The data analysis showed that health anxiety symptoms decreased significantly both posttreatment (Cohen's d = 0.97–1.00) and at follow‐up (Cohen's d = 1.33–1.34). In addition, the scores of depressiveness, somatic symptoms, and psychological distress showed improvements with effect sizes of d = 0.35–0.51. Regarding the primary outcome measures for health anxiety, response rates were 51%–63%, and remission rates were 29%–43%.

Conclusion

Exposure therapy is effective and sustainable regarding the treatment of health anxiety, even under naturalistic conditions, whereas response and remission rates are lower than for RCT.
Uncovering the relationship between community participation and socio‐political control among the migrant population
Authors: Martinez‐Damia Sara , Paloma Virginia , Luesia Juan Fernando , Marta Elena , Marzana Daniela
Published: August 2023

Prior research on psychological empowerment has found that community participation is associated with socio‐political control, which takes place when people perceive control in their socio‐political contexts. However, the process by which this relationship occurs remains an understudied area for migrants. This study aims to: (a) analyze the differences in socio‐political control, critical thinking, and ethnic identity according to membership in migrant community‐based organizations; and (b) propose a predictive model of socio‐political control. A total of 239 first‐generation migrants living in northern Italy completed a questionnaire (48.4% belonged to a migrant community‐based organization). Members were found to have higher levels than nonmembers in all the variables. A moderated mediation model was proposed, whereby ethnic identity was a mediator between community participation and socio‐political control, and critical thinking was a negative moderator between ethnic identity and socio‐political control. Practical implications for enhancing socio‐political control among migrants in receiving societies are discussed.
Prenatal diagnosis of closed gastroschisis: What to expect in the most severe form of gastroschisis? Case report and literature review
Authors: Castro Pedro Teixeira , Matos Ana Paula Pinho , Macedo Nicanor , Ribeiro Gerson , Lopes Jorge , Dittmer Fernanda Parciasepe , Araujo Júnior Edward , Werner Heron
Published: August 2023

Closed gastroschisis (CG) and vanishing gastroschisis (VG) are the most severe forms of evolution of the malformation. In this case, a fetus presented with gastroschisis at 13 weeks, and the gastroschisis was not visualized at 22 weeks of gestation. Distal ileum, cecum, and ascending colon atresia were diagnosed at surgery, and the child is fully enteral‐fed at 5 months of age. In a literature review of 43 cases of prenatal diagnosis of CS‐VG, intrauterine death occurred in 4.5% of cases. 79.6% of the cases underwent surgical treatment. Of these cases, 20% of cases died due to complications of treatment, 26% were still under treatment and 54% are alive with enteral feeding. In 77% of the cases, the closure of the umbilical ring occurred after 26 weeks of gestation and the absence of prenatal diagnosis of CG‐VG during pregnancy has a risk of 71% of death.
ApoE expression in macrophages communicates immunometabolic signaling that controls hyperlipidemia‐driven hematopoiesis & inflammation via extracellular vesicles
Authors: Phu Tuan Anh , Ng Martin , Vu Ngan K. , Gao Alex S. , Raffai Robert L.
Published: August 2023

While apolipoprotein E (apoE) expression by myeloid cells is recognized to control inflammation, whether such benefits can be communicated via extracellular vesicles is not known. Through the study of extracellular vesicles produced by macrophages derived from the bone marrow of Wildtype (WT‐BMDM‐EV) and ApoE deficient (EKO‐BMDM‐EV) mice, we uncovered a critical role for apoE expression in regulating their cell signaling properties. WT‐BMDM‐EV communicated anti‐inflammatory properties to recipient myeloid cells by increasing cellular levels of apoE and miR‐146a‐5p, that reduced NF‐κB signalling. They also downregulated cellular levels of miR‐142a‐3p, resulting in increased levels of its target carnitine palmitoyl transferase 1A (CPT1A) which improved fatty acid oxidation (FAO) and oxidative phosphorylation (OxPHOS) in recipient cells. Such favorable metabolic polarization enhanced cell‐surface MerTK levels and the phagocytic uptake of apoptotic cells. In contrast, EKO‐BMDM‐EV exerted opposite effects by reducing cellular levels of apoE and miR‐146a‐5p, which increased NF‐κB−driven GLUT1‐mediated glucose uptake, aerobic glycolysis, and oxidative stress. Furthermore, EKO‐BMDM‐EV increased cellular miR‐142a‐3p levels, which reduced CPT1A levels and impaired FAO and OxPHOS in recipient myeloid cells. When cultured with naïve CD4+ T lymphocytes, EKO‐BMDM‐EV drove their activation and proliferation, and fostered their transition to a Th1 phenotype. While infusions of WT‐BMDM‐EV into hyperlipidemic mice resolved inflammation, infusions of EKO‐BMDM‐EV increased hematopoiesis and drove inflammatory responses in myeloid cells and T lymphocytes. ApoE‐dependent immunometabolic signaling by macrophage extracellular vesicles was dependent on transcriptional axes controlled by miR‐146a‐5p and miR‐142a‐3p that could be reproduced by infusing miR‐146a mimics & miR‐142a antagonists into hyperlipidemic apoE‐deficient mice. Together, our findings unveil a novel property for apoE expression in macrophages that modulates the immunometabolic regulatory properties of their secreted extracellular vesicles.
Substrate‐controlled chemoselective synthesis of 1‐sulfonylquinazoline‐2,4(1H,3H)‐diones and 2‐sulfonamidobenzonitriles
Authors: Zhao Ping , Zeng Qingle
Published: August 2023

We have developed a diversity‐oriented, substrate‐controlled, chemoselective synthetic method for a variety of structurally diverse 1‐sulfonylquinazoline‐2,4(1H,3H)‐diones and 2‐sulfonamidobenzonitriles. This substrate‐controlled synthesis is accomplished through the condensation reaction of 2‐(sulfonamido)benzamides with or without an N‐methyl group on the amides. The reactions are fulfilled within half an hour at room temperature with solid triphosgene as a convenient condensing agent and pyridine as an acid acceptor. This protocol features easily available starting materials, mild reaction conditions, easy experimental operation, and moderate to excellent yields of products.
Why foreign agricultural investment fails? Five lessons from Ethiopia
Authors: Cochrane Logan , Li Eric P. H. , Dejene Melisew , Husain M. Mustahid
Published: August 2023

In the past two decades, foreign direct investment (FDI) in emerging economies has witnessed substantial growth in the agricultural sector. Globally, more than a quarter of these investments have failed. Beyond case studies, the factors that contribute to these failures have been subject to limited research. To address this research gap, this article draws on a unique data set of 106 investments in Ethiopia, from which failures were identified and detailed case studies analysed to identify the causes of failure. Drawing on the literature on institutional voids, our analysis shows that the high rates of failure in the agricultural sector are often caused by insufficient planning at the proposal stage, assumptions about the availability of expertise, socio‐political and environmental risks, insufficient financing and/or a changing investment landscape and underestimation and/or misunderstanding regarding the limits of extractive approaches. These lessons suggest that while FDI in the agricultural sector has potential, the working approaches require significant transformation. We offer a set of strategic recommendations to mitigate the risk of investment failure in agricultural investment.
MRA for Preoperative Planning and Postoperative Management of Perforator Flap Surgeries: A Review
Authors: Thimmappa Nanda Deepa
Published: August 2023

Perforator flap magnetic resonance angiography (MRA) has emerged as a widely accepted and preferred modality for perforator flap mapping at several institutions. Autologous perforator flaps are a type of reconstructive microsurgical technique that involves transferring skin and fat from one part of the patient's body to another to replace tissue lost due to trauma, cancer resection, or other reasons. Autologous perforator flaps are based on a specific perforating blood vessel perfusing the transferred tissue. Hence, the surgery relies on the precise identification and mapping of perforating vessels to ensure successful outcomes. With its superior soft tissue contrast and multiplanar imaging capabilities, MRA has shown great potential in providing accurate and detailed visualization of perforator anatomy, size, and course. This review article summarizes the current literature on perforator flap MRA, including its technical considerations, imaging protocols, postprocessing, and reporting, specifically for autologous breast reconstructions. The advantages and limitations of MRA in evaluating perforator flaps are discussed, including its role in preoperative planning, intraoperative guidance, and postoperative assessment. Anatomy, brief surgical technique, specific technical modifications, and reporting of most commonly performed autologous breast flaps are described. Recent advancements in Perforator flap surgery and MRA techniques are discussed. Additionally, we examine the emerging role of artificial intelligence and machine learning in improving the accuracy and efficiency of perforator flap MRA interpretation.

Level of Evidence

5

Technical Efficacy

Stage 5
Corticotropin‐releasing factor signaling and its potential role in the prefrontal cortex‐dependent regulation of anxiety
Authors: Yang Xin , Geng Fei
Published: August 2023

A large body of literature has highlighted the significance of the corticotropin‐releasing factor (CRF) system in the regulation of neuropsychiatric diseases. Anxiety disorders are among the most common neuropsychiatric disorders. An increasing number of studies have demonstrated that the CRF family mediates and regulates the development and maintenance of anxiety. Thus, the CRF family is considered to be a potential target for the treatment of anxiety disorders. The prefrontal cortex (PFC) plays a role in the occurrence and development of anxiety, and both CRF and CRF‐R1 are widely expressed in the PFC. This paper begins by reviewing CRF‐related signaling pathways and their different roles in anxiety and related processes. Then, the role of the CRF system in other neuropsychiatric diseases is reviewed and the potential role of PFC CRF signaling in the regulation of anxiety disorders is discussed. Although other signaling pathways are potentially involved in the process of anxiety, CRF in the PFC primarily modulates anxiety disorders through the activation of corticotropin‐releasing factor type1 receptors (CRF‐R1) and the excitation of the cAMP/PKA signaling pathway. Moreover, the main signaling pathways of CRF involved in sex differentiation in the PFC appear to be different. In summary, this review suggests that the CRF system in the PFC plays a critical role in the occurrence of anxiety. Thus, CRF signaling is of great significance as a potential target for the treatment of stress‐related disorders in the future.
Cyclic loading induces anabolic gene expression in ACLs in a load‐dependent and sex‐specific manner
Authors: Paschall Lauren , Carrozzi Sabrina , Tabdanov Erdem , Dhawan Aman , Szczesny Spencer E.
Published: August 2023

Anterior cruciate ligament (ACL) injuries are historically thought to be a result of a single acute overload or traumatic event. However, recent studies suggest that ACL failure may be a consequence of fatigue damage. Additionally, the remodeling response of ACLs to fatigue loading is unknown. Therefore, the objective of this study was to investigate the remodeling response of ACLs to cyclic loading. Furthermore, given that women have an increased rate of ACL rupture, we investigated whether this remodeling response is sex specific. ACLs were harvested from male and female New Zealand white rabbits and cyclically loaded in a tensile bioreactor mimicking the full range of physiological loading (2, 4, and 8 MPa). Expression of markers for anabolic and catabolic tissue remodeling, as well as inflammatory cytokines, was quantified using quantitative reverse transcription polymerase chain reaction. We found that the expression of markers for tissue remodeling of the ACL is dependent on the magnitude of loading and is sex specific. Male ACLs activated an anabolic response to cyclic loading at 4 MPa but turned off remodeling at 8 MPa. These data support the hypothesis that noncontact ACL injury may be a consequence of failed tissue remodeling and inadequate repair of microtrauma resulting from elevated loading. Compared to males, female ACLs failed to increase anabolic gene expression with loading and exhibited higher expression of catabolic genes at all loading levels, which may explain the increased rate of ACL tears in women. Together, these data provide insight into load‐induced ACL remodeling and potential causes of tissue rupture.
External validation of prognostic scores and comparison of predictive accuracy for patients with colorectal cancer with peritoneal metastases considered for cytoreductive surgery and intraperitoneal chemotherapy
Authors: Kozman Mathew A. , Fisher Oliver M. , Liauw Winston , Morris David L. , Cashin Peter H.
Published: August 2023

Background and Objectives

Prognostic scores are developed to facilitate the selection of patients with colorectal cancer peritoneal metastases (CRPM) for treatment with cytoreductive surgery (CRS) ± intraperitoneal chemotherapy (IPC). Three prominent prognostic scores are the Peritoneal Surface Disease Severity Score (PSDSS), the Colorectal Peritoneal Metastases Prognostic Surgical Score (COMPASS), and the modified COloREctal‐Pc (mCOREP). We externally validate these scores and compare their predictive accuracy.

Methods

Data from consecutive CRPM patients who underwent CRS/IPC from 1996 to 2018 was used to externally validate COMPASS, PSDSS, and mCOREP. Analysis evaluated the efficacy of each score in predicting (1) open–close laparotomy—those found at laparotomy to not be eligible for curative intent CRS/IPC, (2) surgical futility—those who underwent open–close laparotomy, palliative debulking surgery, or had an overall survival of less than 12 months, and (3) overall and recurrence‐free survival (OS, RFS).

Results

Prognostic scores were calculated for the 174‐patient external validation cohort. COMPASS was most accurate in predicting open–close laparotomy, futile surgery, and survival (OS and RFS). Area under the curve (AUC) for open–close prediction was 0.78 (95% confidence interval, CI: 0.68–0.87), representing useful discrimination. However, AUC for futility prediction was 0.62 (95% CI: 0.52–0.71), and C‐statistic for OS was 0.65 indicating only possibly helpful discrimination. C‐statistic for RFS was 0.59 indicating poor discrimination.

Conclusion

While COMPASS showed the best statistical behavior, accuracy for several clinically relevant outcomes remains low, and thus applicability to clinical practice limited.
Wideband‐Tunable on‐Chip Microwave Photonic Filter with Ultrahigh‐Q U‐Bend‐Mach–Zehnder‐Interferometer‐Coupled Microring Resonators
Authors: Yan Hao , Xie Yiwei , Zhang Long , Dai Daoxin
Published: August 2023

Microwave photonic filters are a key fundamental subsystem in microwave photonics. A wideband‐tunable on‐chip microwave photonic filter (MPF), which monolithically integrates a dual‐drive Mach‐Zehnder modulator (DDMZM), is proposed with ultrahigh‐Q Mach–Zehnder‐interferometer (MZI)‐coupled microring resonators (MRRs) in cascade and a high‐speed photodetector (PD). It is the first time an MPF has been developed by introducing U‐bend‐MZI‐coupled MRRs whose resonance wavelength and 3 dB bandwidth are tunable. In particular, the ultrahigh‐Q U‐bend‐MZI‐coupled MRRs are realized with ultralow loss broadened silicon waveguides based on a modified Euler curve. For the fabricated U‐bend‐MZI‐coupled MRRs, which have an effective radius of 29 µm, the Q‐factor is as high as 1.3 × 106, while the free spectral range (FSR) is as large as 113 GHz. Furthermore, the introduction of two cascaded U‐bend‐MZI‐coupled MRRs enables the MPF to have flat‐top bandstop (or bandpass) responses with a high extinction ratio (ER) of 20–35 dB as well as a tunable 3 dB bandwidth of 0.15–3 GHz. Meanwhile, the central frequency can be tuned thermally from 2 to 40 GHz. The work provides a feasible route to realize a compact, high spectral resolution, and wideband‐tunable MPF on silicon, enabling a range of RF applications from wireless communication to flexible high‐frequency microwave photonic signal processing.
Anti–myelin‐associated glycoprotein neuropathy: Where do we stand?
Authors: Stino Amro Maher , Elsheikh Bakri , Allen Jeffrey A.
Published: August 2023

Myelin‐associated glycoprotein (MAG) is a transmembrane glycoprotein concentrated in periaxonal Schwann cell and oligodendroglial membranes of myelin sheaths that serves as an antigen for immunoglobulin M (IgM) monoclonal antibodies. Individuals who harbor anti‐MAG antibodies classically develop a progressive autoimmune peripheral neuropathy characterized clinically by ataxia, distal sensory loss, and gait instability, and electrophysiologically by distally accentuated conduction velocity slowing. Although off‐label immunotherapy is common, there are currently no proven effective disease‐modifying therapeutics, and most patients experience slow accumulation of disability over years and decades. The typically slowly progressive nature of this neuropathy presents unique challenges when trying to find effective anti‐MAG therapeutic agents. Drug development has also been hampered by the lack of validated outcome measures that can detect clinically meaningful changes in a reasonable amount of time as well as by the lack of disease activity biomarkers. In this invited review, we provide an update on the state of clinicometric outcome measures and disease activity biomarkers in anti‐MAG neuropathy. We highlight the insensitivity of widely used existing clinicometric outcome measures such as the Inflammatory Neuropathy Cause and Treatment (INCAT) disability score as well as the INCAT sensory subscore in anti‐MAG neuropathy, referencing the two previous negative randomized controlled clinical trials evaluating rituximab. We then discuss newly emerging candidate therapeutic agents, including tyrosine kinase inhibitors and enhanced B‐cell–depleting agents, among others. We conclude with a practical approach to the evaluation and management of anti‐MAG neuropathy patients.
Self‐efficacy, resilience and healthy ageing among older people who have an acute hospital admission: A cross‐sectional study
Authors: Remm Sarah E. , Halcomb Elizabeth , Peters Kath , Hatcher Deborah , Frost Steven A.
Published: August 2023

Aim

To examine the associations between self‐efficacy, resilience and healthy ageing among older people who have an acute hospital admission.

Design

A cross‐sectional study.

Methods

Survey and medical record data were collected from older people on discharge from hospital. The survey measured self‐efficacy with the 6‐item General Self‐Efficacy scale (GSE‐6), resilience with the Brief Resilience Scale (BRS), and healthy ageing with the Selfie Ageing Index (SAI). Medical record data included potential confounders: co‐morbidities, frailty items, previous falls and previous admission in the last 28 days. Multi‐linear regression and Spearman's rank correlation coefficient were used to examine the independent associations between self‐efficacy, resilience and healthy ageing.

Results

Responses were received from 143 older people (mean age 79). After adjusting for potential confounders, co‐morbidities (ß = ‐0.08, p = 0.001) remained negatively associated with healthy ageing, while self‐efficacy (ß = 0.03, p = 0.005) and resilience (ß = 0.05, p < 0.001) remained positively associated with healthy ageing (R2 = 0.243). Positive correlations were found between self‐efficacy (ρ = 0.33, p < 0.01), resilience (ρ = 0.38, p < 0.001) and healthy ageing. Positive correlations were also found between self‐efficacy and resilience (ρ = 0.38, p < 0.01). Those with lower self‐efficacy and resilience were more likely to report reduced activities of daily living, mobility, physical activity and mood.

Conclusion

Findings indicate that while the number of co‐morbidities have negative consequences for healthy ageing among older people who are hospitalised, the promotion of self‐efficacy and resilience can potentially contribute to healthy ageing within the physical and psychological domains.

Implications for Patient Care

Nurses can promote self‐efficacy, which can potentially increase resilience and help to improve self‐management of chronic conditions, functional ability in daily activities, mobility and physical activity and reduce both anxiety and depressive symptoms.

Patient Contribution

Participant feedback throughout the data collection process assisted in the evaluation of study methods and data interpretation. This included processes such as assessing selected tools and clarifying the meanings of healthy ageing factors.
Professional versus personal authenticity in the workplace
Authors: Freebairn‐Smith Laura
Published: August 2023

In this month's column, I am writing about authenticity, a concept that has gained traction in recent years as people work to fully express who they are and what their values are. I think of authenticity as a spectrum, ranging from an almost‐prisoner‐like constrained existence to a free‐love anything‐goes existence. In relation to the workplace, I have concerns about the extremes of this spectrum.
Low‐Lying Tegmen and Surgical Outcomes Following the Middle Cranial Fossa Repair of Superior Canal Dehiscence
Authors: Yang Hong‐Ho , Patel Vishal S. , Yang Isaac , Gopen Quinton S.
Published: August 2023

Objective

To compare treatment response from the middle cranial fossa repair of superior canal dehiscence (SCD) between cases with and cases without low‐lying tegmen (LLT).

Study Design

Cohort study.

Setting

Single tertiary care institution.

Methods

Two investigators independently reviewed preoperative high‐resolution temporal bone computed tomography images and classified the ipsilateral tegmen as either “low‐lying” or “control.” Patients completed a symptom questionnaire and underwent audiometric testing pre‐ and post‐operatively. Multivariable regression models assessed for symptomatic resolution and audiometric improvement following surgery with tegmen status as the primary predictor. Models controlled for patient age, sex, bilateral SCD disease, dehiscence location, prior ear surgery status, surgery duration, and follow‐up duration.

Results

Among a total of 410 cases included, we identified 121 (29.5%) LLT cases. Accounting for all control measures, patients with LLT were significantly less likely to experience overall symptom improvement (adjusted odds ratio: 0.32, 95% confidence interval [CI]: 0.18–0.57, p < .001) and reported a significantly lower proportion of preoperative symptoms that resolved following surgery (adjusted β: −25.6%, 95% CI: −37.0% to −14.3%, p < .001). However, audiometric outcomes following surgery did not differ significantly between patients with and patients without LLT.

Conclusion

This is the first investigation on the relationship between LLT and surgical outcomes following the middle fossa repair of SCD. Patients with LLT reported less favorable symptomatic response but exhibited a similar degree of audiometric improvement.
Loss of heterozygosity does not occur in BRCA1/2 mutant pediatric solid and central nervous system tumors
Authors: Groves Andrew , Ward Abigail , Li Yvonne Y. , Lazo de la Vega Lorena , Nag Anwesha , Forrest Suzanne J. , Gupta Hersh V. , Thorner Aaron R. , Meyerson Matthew , Kamihara Junne , Cherniack Andrew D. , Janeway Katherine A.
Published: August 2023

Utilization of tumor‐only sequencing has expanded in pediatric cancer patients, which can lead to identification of pathogenic variants in genes that may be germline and/or have uncertain relevance to the tumor in question, such as the homologous recombination (HR) pathway genes BRCA1/2. We identified patients with pathogenic BRCA1/2 mutations from somatic tumor sequencing, and performed additional germline sequencing to assess for the presence of loss of heterozygosity (LOH). Of seven patients identified, four (57.1%) mutations were found in the germline and none had associated LOH. Our data suggest that BRCA1/2 mutations identified in this context are likely incidental findings.
Insights into the large‐size graphene improvement effect of the mechanical properties on the epoxy/glass fabric composites
Authors: Peng Qingyan , Tan Xiaodong , Xiong Xiaoman , Wang Yuanfeng , Novotná Jana , Shah Kaushal Vipul , Stempień Zbigniew , Periyasamy Aravin Prince , Kejzlar Pavel , Venkataraman Mohanapriya , Militky Jiri
Published: August 2023

In this study, we investigated how the chemical structural properties, mechanical properties, and morphology of large‐size graphene platelets (LGPs) doped glass fabric (GF)/epoxy composites are affected by varying loading amounts of LGPs. Scanning electron microscope results revealed that the dispersion and filling effect of LGPs can improve the flowability of the resin, reducing the aggregation and shrinkage of the resin on the glass fabric surface, thereby facilitating better resin infiltration and coverage of the glass fabric surface. From the spectrum analysis, the binding of LGPs with epoxy resin was the physical combination, without new chemical groups generated during the curing process. The addition of LGPs improved the ratio of the crystalline phases in the composites, from 30.00% of the GF/epoxy to 57.50% of the GF/epoxy@2.2LGPs. Mechanical properties indicated that the composites exhibited greater tensile strength than pure GF, which progressively increased with increasing LGPs content until it reached 1.5 wt%, then the tensile strength starts to decrease. And the GF/epoxy@1.5 LGPs exhibited 136% enhancement in tensile strength compared to other carbon fillers reinforced composites, which achieved a satisfactory enhancement under relatively low loading content.

Highlights

The effect of the large‐size graphene platelets (LGPs) on the properties of glass fabric (GF)/epoxy composites.

Compared to the glass fabric/epoxy composite, the LGPs doped composite possessed a much higher storage modulus (E′).

The LGPs doped composite exhibited 136% enhancement in tensile strength compared to other carbon fillers reinforced composites.

The addition of LGPs improved the ratio of the crystalline phases in the composites.
Flexible polyaniline/MXene/CNF composite nanofibrous mats as high‐performance supercapacitor electrodes
Authors: Donthula Kiran , Malothu Usha Rani , Araga Ramya , Vooradi Ramsagar , Patnaikuni Venkata Suresh , Reddy M. V. , Kakunuri Manohar
Published: August 2023

In this study, we presented a facile synthesis of ternary composite by depositing polyaniline (PANI) onto electrospun MXene‐embedded carbon nanofibers (CNF) using in situ polymerization. Polymerization duration was varied between 2 and 8 hours to tune fiber diameter and surface area. The physicochemical properties of binary and ternary composites were characterized, such as surface morphology and chemical functional groups and surface area and pore volume. Results indicated that the fiber diameter and micropore volume increased with the deposition of PANI. In order to examine the effect of PANI deposition and other electrode properties on electrochemical performance, electrochemical impedance, galvanostatic charge–discharge, and cyclic voltammetry tests were performed. Flexible binder‐free PANI/MXene/CNF composite electrode with maximum PANI deposition exhibited the maximum specific capacitance of 356 F g−1 at current density of 0.5 A g−1. Further, this electrode demonstrated excellent capacitance retention after 5000 cycles, with 91%. The ternary composite's outstanding performance is primarily related to PANI's enhanced surface area and micropore volume as well as pseudocapacitive charge storage.

Highlights

Synthesis of a flexible binder‐free novel ternary composite electrode.

In‐situ PANI deposition to enhances the ternary electrode surface area and wettability.

Flexible ternary composite electrodes with maximum PANI loading exhibit excellent electrochemical performance.

Comparison of binary and ternary electrode performance with pristine carbon nanofibers.
Fetal cardiac intervention in hypoplastic left heart syndrome with intact or restrictive atrial septum, systematic review, and meta‐analysis
Authors: Mustafa Hiba J. , Aghajani Faezeh , Jawwad Mohammad , Shah Nensi , Abuhamad Alfred , Khalil Asma
Published: August 2023

To investigate outcomes of fetuses with hypoplastic left heart syndrome (HLHS) with an intact or restrictive atrial septum (I/RAS) managed expectantly or with fetal atrial septal intervention (FASI PubMed, Scopus, and Web of Science were searched systematically from inception until April 2023. Outcomes were classified by those who had FASI and those who had expectant management (EM). To estimate the overall proportion of each endpoint, a meta‐analysis of proportions was employed using a random‐effects model. Heterogeneity was assessed using the I2 value. Thirty‐two studies reporting on 746 fetuses with HLHS and I/RAS met our inclusion criteria. Eleven studies (123 fetuses) were in the FASI group and 21 studies (623 fetuses) were in the EM group. Among the 123 FASI cases, 107 (87%) were reported to be technically successful. The mean gestational age (GA) at diagnosis was comparable between the groups (26.2 weeks FASI vs. 24.4 weeks EM group). The mean GA at FASI was 30.4 weeks (95% CI 28.5, 32.5). The mean GA at delivery was also comparable (37.7 weeks FASI vs. 38.1 weeks EM group). Neonatal outcomes, including live birth, neonatal death, and survival to hospital discharge pooled proportions, were also comparable between groups (live birth: 92% (95% CI 64, 99) FASI versus 93% (95% CI 79, 98) in EM, neonatal death: 32% (95% CI 11, 65) FASI versus 30% (95% CI 21, 41) EM, survival to hospital discharge: 37% (95% CI 25, 52) FASI versus 52% (95% CI 42, 61) EM). Age at neonatal death was higher in the FASI group (mean: 17 days FASI vs. 7.2 days EM group). There was a lower rate of postnatal atrial restrictive septum in the FASI group 38% (95% CI 17, 63) compared to the EM group 88% (95% CI 57, 98). Our review shows variations across centers in the selection criteria and techniques used for FASI. Although survival including livebirth, neonatal death, and survival to hospital discharge did not differ between groups, the procedure may translate into a less restrictive septum at birth. Future multicenter studies are needed to better identify the subset of cases that might have improved outcomes, use standardized definitions, unified techniques, utilize core outcome set, and assess long‐term benefits.
Non‐invasive prenatal testing (NIPT): Combination of copy number variant and gene analyses using an “in‐house” target enrichment next generation sequencing—Solution for non‐centralized NIPT laboratory?
Authors: Faldynová Lucie , Walczysková Sylwia , Černá Dita , Kudrejová Monika , Hilscherová Šárka , Kaniová Romana , Širůčková Simona
Published: August 2023

Objective

Recent studies have integrated copy number variant (CNV) and gene analysis using target enrichment. Here, we transferred this concept to our routine genetics laboratory, which is not linked to centralized non‐invasive prenatal testing (NIPT) facilities.

Method

From a cohort of 100 pregnant women, 22 were selected for the analysis of maternal genomic DNA (gDNA) along with fetal cell‐free DNA. Using targeted enrichment, 135 genes were analyzed, combined with aberrations of chromosomes 21, 18, 13, X, and Y. The data were subjected to specificity and sensitivity analyses, and correlated with the results from invasive testing methods.

Results

The sensitivity/specificity was determined for the CNV analysis of chromosomes: 21 (80%/75%), 18 (‐/82%), 13 (100%/67%), and Y (100%/100%). The gene detection was valid for maternal gDNA. However, for cell‐free fetal DNA, it was not possible to determine the boundary between an artifact and a real sequence variant.

Conclusion

The target enrichment method combining CNV and gene detection seems feasible in a regular laboratory. However, this method can only be responsibly optimized with a sufficient number of controls and further validation on a strong bioinformatic background. The present results showed that NIPT should be performed in specialized centers, and that its introduction to isolated laboratories may not provide valid data.
What helps define outcomes in persistent uninterpretable non‐invasive prenatal testing: Maternal factors, fetal fraction or quality scores?
Authors: Lannoo Lore , Van Camp Joke , Brison Nathalie , Parijs Ilse , Vancoillie Leen , Van Den Bogaert Kris , Vermeesch Joris Robert , Devriendt Koen , Van Calsteren Kristel
Published: August 2023

Objectives

To assess maternal characteristics and comorbidities in patients with persistent uninterpretable non‐invasive prenatal testing (NIPT) and to evaluate the association with adverse pregnancy outcome in a general risk population.

Methods

A retrospective cohort study (July 2017–December 2020) was conducted of patients with persistent uninterpretable NIPT samples. Maternal characteristics and pregnancy outcomes were compared with the general Belgian obstetric population.

Results

Of the 148 patients with persistent uninterpretable NIPT, 37 cases were due to a low fetal fraction (LFF) and 111 due to a low quality score (LQS). Both groups (LFF, LQS) showed more obesity (60.6%, 42.4%), multiple pregnancies (18.9%, 4.5%) and more obstetrical complications. In the LQS group, a high rate of maternal auto‐immune disorders (30.6%) was seen and hypertensive complications (17.6%), preterm birth (17.6%) and neonatal intensive care unit (NICU) admission (22%) were significantly increased. In the LFF group hypertensive complications (21.6%), gestational diabetes (20.6%), preterm birth (27%), SGA (25.6%), major congenital malformations (11.4%), c‐section rate (51.4%) and NICU admission (34.9%) were significantly increased. Chromosomal abnormalities were not increased in both groups.

Conclusions

Patients with persistent uninterpretable NIPT have significantly more maternal obesity, comorbidities and adverse pregnancy outcome than the general population and should receive high‐risk pregnancy care. Distinguishing between LFF and LQS optimizes counseling because maternal characteristics and pregnancy outcome differ between these groups.
Approaches to Precision‐based Anticoagulation management in the critically Ill
Authors: Dager William E. , Trujillo Toby C. , Gilbert Brian W.
Published: August 2023

Anticoagulant therapy is commonly associated with a high incidence of avoidable adverse events, especially in the acute care setting. This has led to several initiatives by key national health care stakeholders, including specific attention to The Joint Commission's National Patient Safety Goals, to improve anticoagulation management. The subject of special populations has long been identified as challenging by clinicians with the use of anticoagulants. This is driven in part by numerous variables that can contribute to hard outcomes such as bleeding, thrombosis, length of stay, hospital re‐admission, morbidity, and mortality. Despite the notable effort to improve the use of anticoagulants with numerous clinical trials, guidelines, guidance statements, and other sources of published evidence, notable difficulties continue to challenge practitioners in managing this class of medications. This is especially the case with very diverse critically ill populations where countless variables exist, many of which were never explored in trials or have historically been frequently excluded. Trials evaluating anticoagulation therapy often can only account for small portions of variables that may affect thrombosis and hemostasis, and study methods often do not reflect the constantly changing dynamic conditions seen in unique critically ill patients. Clinicians providing care to the numerous critically ill populations are faced with conditions that lead to relatively small therapeutic windows, which makes designing safe optimal anticoagulation management plans difficult when dealing with complex patients and mechanical support devices. The approach to crafting a successful management plan for anticoagulant therapy must incorporate the numerous variables that are continuously assessed and revised during the patient's time in the intensive care unit. We explore considerations and approaches when developing, assessing, and implementing an individualized or precision‐based management plan that involves the use of anticoagulants in the critically ill. The skills and thought process provided will assist clinicians in managing this unique, variable, and challenging population.
Mechanical reinforcement of waterborne latex pressure‐sensitive adhesives with polymer‐grafted nanoparticles
Authors: Desroches Griffen J. , Gatenil Perapat P. , Nagao Keisuke , Macfarlane Robert J.
Published: August 2023

Waterborne pressure sensitive adhesives (PSAs) consisting of polymer microparticle emulsions (i.e. latex) are more commonly used in commercial applications than solvent‐borne alternatives, as the use of water as a suspension medium provides better consumer safety and reduces environmental impact. However, the lower mechanical performance of waterborne PSAs prevents their use in applications requiring permanent adhesion or strong bonding between substrates. This reduction in mechanical strength is often attributed to void spaces that form during water evaporation and coalescence of the latex particles, and thus a potential strategy to improve PSA strength would be to add filler materials to occupy these voids. Fundamental studies investigating how interfacial interactions between the latex and fillers affect the collective strength of the films would enable better design of adhesive compositions to tailor PSA mechanical properties. Here we report the use of polymer brush‐grafted nanoparticles (PGNPs) as a means of mechanically reinforcing the PSAs, and determine how different aspects of the particle and polymer brush designs enable this improvement in adhesive performance. The PGNPs investigated here are intentionally designed to phase segregate into the aqueous phase of the initial latex suspension, which allows them to both fill free pore volume and also form multivalent supramolecular interactions with the latex particles to form polymer bridges that improve the interconnectivity of the final film. These studies provide insight into potential design strategies for tuning PSA properties with PGNPs, and enable up to 32% improvements to the cohesive strength of the PSAs without the typical deterioration of adhesive strength observed in PSAs using non‐brush‐coated particle fillers.
Poverty, women's autonomy, and girls' educational attainment at the higher secondary level: Insight from the Indian states
Authors: Maity Shrabanti
Published: August 2023

In 2020, the Gross Enrollment Ratio of girls at the higher secondary level in India was 52.4%, down from 98.7% at the elementary level. This difference indicates a serious dropout rate among girls at higher levels of education. This dynamic motivates the twin objectives of this paper. We provide an overview of the scope and determinants of girls' current educational attainment at the higher secondary level for different states in India. In this attempt, we scrutinize the role of poverty and women's autonomy on the educational attainment of girls at the higher secondary level. A self‐developed socioeconomic index is used as a proxy for wealth status which is divided into five quintiles representing the poverty scenario of each state. Women's autonomy is measured by another self‐developed index: the Women's Autonomy Index. The empirical analysis is facilitated by the application of various statistical and econometric tools including multiple regression on the NFHS‐4 data for 28 Indian states. The empirical results suggest that the enhancement of women's autonomy and reductions in poverty enhance girls' educational attainment at the higher secondary level.
Reduced pulmonary oxygen diffusion at 36 weeks of postmenstrual age in small‐for‐gestational‐age preterm infants of less than 32 weeks without bronchopulmonary dysplasia
Authors: Correani Alessio , Lanciotti Lucia , Giorgetti Chiara , Palazzi Maria Laura , Monachesi Chiara , Antognoli Luca , Burattini Ilaria , Cogo Paola , Carnielli Virgilio
Published: August 2023

Background

Small‐for‐gestational‐age (SGA) preterm infants are at increased risk of developing bronchopulmonary dysplasia (BPD). There is limited information on pulmonary oxygen diffusion of SGA preterm infants, particularly in those without BPD.

Objective

To compare the pulmonary oxygen diffusion of SGA to that of appropriate‐for‐gestational‐age (AGA) preterm infants without BPD.

Study Design

Preterm infants with a gestational age (GA) between 24.0 and 31.6 weeks were studied. The oxygen saturation (SpO2), fraction to inspired oxygen (FiO2), and the SpO2 to FiO2 ratio (SFR) were compared between SGA and AGA infants. The association between SGA and SFR at 36 weeks was assessed using a multiple regression analysis. In the subgroup without BPD, SGA were match‐paired for GA and gender with AGA infants.

Results

We analyzed 1189 infants surviving at 36 weeks: 194 (16%) were SGA and 995 (84%) AGA. The incidence of BPD was significantly higher in SGA than AGA infants (32% vs. 13%; p = .000). Out of the 995 infants without BPD, 132 (13%) were SGA and 863 (87%) AGA. SGA was negatively associated with the SFR value at 36 weeks, independently from BPD. SGA infants without BPD had significantly higher (better) SFR at birth, but lower (worse) SpO2 and SFR and from 33 to 36 weeks than their matched AGA counterpart. At 36 weeks, median SpO2 and SFR values were 97.7 versus 98.4 (p = .006) and 465 versus 468 (p = .010) in match‐paired SGA and AGA, respectively.

Conclusion

Among preterm infants of less than 32 weeks and without BPD, SGA infants had a reduced pulmonary oxygen diffusion at 36 weeks in comparison with AGA infants.