bluuebunny/crossref_metadata_2025 huggingface dataset:
Scoliosis in Friedreich's ataxia: longitudinal characterization in a large heterogeneous cohort
Authors: Rummey Christian , Flynn John M. , Corben Louise A. , Delatycki Martin B. , Wilmot George , Subramony Sub H. , Bushara Khalaf , Duquette Antoine , Gomez Christopher M. , Hoyle J. Chad , Roxburgh Richard , Seeberger Lauren , Yoon Grace , Mathews Katherine D. , Zesiewicz Theresa , Perlman Susan , Lynch David R.
Published: May 2021

Objective

The objective of this study was to characterize the incidence and progression of scoliosis in the natural history of Friedreich’s ataxia (FRDA) and document the factors leading to the requirement for corrective surgery.

Methods

Data on the prevalence of scoliosis and scoliosis surgery from up to 17 years of follow‐up collected during a large natural history study in FRDA (1116 patients at 4928 visits) were summarized descriptively and subjected to time to event analyses.

Results

Well over 90% of early or typical FRDA patients (as determined by age of onset) developed intermediate to severe scoliosis, while patients with a later onset (>14 years) had no or much lower prevalence of scoliosis. Diagnosis of scoliosis occurs during the onset of ataxia and in rare cases even prior to that. Major progression follows throughout the growth phase and puberty, leading to the need for surgical intervention in more than 50% of individuals in the most severe subgroup. The youngest patients appear to delay surgery until the end of the growth period, leading to further progression before surgical intervention. Age of onset of FRDA before or after reaching 15 years sharply separated severe and relatively mild incidence and progression of scoliosis.

Interpretation

Scoliosis is an important comorbidity of FRDA. Our comprehensive documentation of scoliosis progression in this natural history study provides a baseline for comparison as novel treatments become available.
Tandem Organic Solar Cells with 18.7% Efficiency Enabled by Suppressing the Charge Recombination in Front Sub‐Cell
Authors: Liu Gongchu , Xia Ruoxi , Huang Qiri , Zhang Kai , Hu Zhicheng , Jia Tao , Liu Xiang , Yip Hin‐Lap , Huang Fei
Published: May 2021

The maximum photocurrent in tandem organic solar cells (TOSCs) is often obtained by increasing the thicknesses of sub‐cells, which leads to recombination enhancement of such devices and compromises their power conversion efficiency (PCE). In this work, an efficient interconnecting layer (ICL) is developed, with the structure ZnO NPs:PEI/PEI/PEDOT:PSS, which enables TOSCs with very good reproducibility. Then, it is discovered that the optimal thickness of the front sub‐cell in such TOSCs can be reduced by increasing the proportion of a non‐fullerene acceptor in the active layer. The non‐fullerene acceptor used in this work has a much larger absorption coefficient than the donor in the front sub‐cell, and the absorption reduction of donor can be well complemented by that of the acceptor when increasing the acceptor proportion, thus leading to a significant overall absorption enhancement even with a thinner film. As a result, the optimal thickness of the front sub‐cell is reduced and its charge recombination is suppressed. Ultimately, the use of this ICL combined with fine‐turning of the composition in the front sub‐cell enables an efficient TOSC with a very high fill factor of 78% and an excellent PCE of 18.71% (certified by an accredited institute to be 18.09%) to be obtained.
Enhancing Light–Matter Interactions in MoS2 by Copper Intercalation
Authors: Stern Chen , Twitto Avraham , Snitkoff Rifael Z. , Fleger Yafit , Saha Sabyasachi , Boddapati Loukya , Jain Akash , Wang Mengjing , Koski Kristie J. , Deepak Francis Leonard , Ramasubramaniam Ashwin , Naveh Doron
Published: May 2021

The intercalation of layered compounds opens up a vast space of new host–guest hybrids, providing new routes for tuning the properties of materials. Here, it is shown that uniform and continuous layers of copper can be intercalated within the van der Waals gap of bulk MoS2 resulting in a unique Cu–MoS2 hybrid. The new Cu–MoS2 hybrid, which remains semiconducting, possesses a unique plasmon resonance at an energy of ≈1eV, giving rise to enhanced optoelectronic activity. Compared with high‐performance MoS2 photodetectors, copper‐enhanced devices are superior in their spectral response, which extends into the infrared, and also in their total responsivity, which exceeds 104 A W−1. The Cu–MoS2 hybrids hold promise for supplanting current night‐vision technology with compact, advanced multicolor night vision.
Revisiting Intercalation‐Induced Phase Transitions in 2D Group VI Transition Metal Dichalcogenides
Authors: Wang Mengjing , Xu Shiyu , Cha Judy J.
Published: May 2021

Intercalation of alkali metals is widely studied to introduce a structural phase transition from 2H to 1T′ in 2D group VI transition metal dichalcogenides (TMDCs). This highly efficient phase transition method has enabled an access to a library of phases with novel physical and chemical properties attractive for functional devices and electrochemical catalysis. However, despite numerous studies that have predicted that charge doping mainly contributes to the structural phase transition in the intercalation process, a mechanistic understanding of the phase transition at the atomic level has not been fully revealed. Furthermore, the coupled effects of strain and other intrinsic or extrinsic factors on the intercalation‐induced phase transition have not been quantitatively determined. Herein, the progress of the intercalation‐induced phase transition is briefly overviewed and the knowledge gaps in the current understanding of phase transition and intercalation in 2D TMDCs are highlighted. To fully gain the microscopic picture of the intercalation‐induced phase transition, in situ multimodal probes to monitor the real‐time structure−property relationship during intercalation are suggested. The proposed research directions further direct material scientists to efficiently engineer phase transition pathways in 2D materials to explore novel functional phases.
Regulating the Stable Lithium and Polysulfide Deposition in Batteries by a Gold Nanoparticle Modified Vertical Graphene Host
Authors: Han Zhiyuan , Huang Zhijia , Li Tong , Zhang Yunbo , Zhou Guangmin , Zhang Chen , Ma Jiabin , Kang Feiyu , Lv Wei
Published: May 2021

3D hosts have been widely investigated to stabilize the lithium (Li) metal anode (LMA) for next‐generation high‐energy‐density batteries. However, the complicated porous structure and the lithiophobic framework always lead to nonuniform Li deposition and low host utilization. Herein, Au nanoparticle (NP)–modified vertical graphenes, which are grown on flexible graphite paper, are prepared as the 3D host (denoted Au‐VG‐GP) to guide Li nucleation and deposition. It is shown that the vertical graphene structure with the low tortuosity effectively decreases the ion diffusion resistance and avoids the formation of a concentration gradient, ensuring uniform ion distribution in the 3D host. At the same time, the uniformly distributed Au NPs act as heterogeneous seeds guiding fast and uniform Li nucleation and growth. As a result, the Au‐VG‐GP host effectively stabilizes the LMA and achieves a high Coulombic efficiency in the half‐cells. A small overpotential and long cycling stability are also achieved for the LMA in the symmetrical cells and full batteries with such a host. In addition, such a host can also guide uniform and high‐capacity deposition of Li2S in the cathode of lithium–sulfur batteries, showing its potential uses in energy storage devices based on a dissolution–deposition mechanism.
Intelligent Soft Surgical Robots for Next‐Generation Minimally Invasive Surgery
Authors: Zhu Jiaqi , Lyu Liangxiong , Xu Yi , Liang Huageng , Zhang Xiaoping , Ding Han , Wu Zhigang
Published: May 2021

Endowed with the expected visions for future surgery, minimally invasive surgery (MIS) has become one of the most rapid developing areas in modern surgery. Soft robotics, which originates from interdisciplinary advances in materials, fabrication, and electronics, featuring better adaptability and safer interaction, holds great promises in addressing current technical challenges in MIS, which are difficult to be solved with current rigid robotic technologies. For the first time, herein, the expected characteristics of next‐generation MIS from the surgeons’ perspectives are analyzed and the recent progress of soft surgical instruments from three different aspects is comprehensively summarized: engineering design, fabrication techniques, and human–robot interaction. Perspectives of next‐generation soft surgical robots are then discussed, where some exciting possibilities are emphasized. It is believed that further developments of intelligent soft robotics enable the next‐generation MIS to agilely navigate to the target and conduct dexterous diagnostic or therapeutic procedures without any trade‐offs in invasiveness and ultimately be a propitious solution for future surgery.
Induced defense and its cost in two bryophyte species
Authors: Chen Yong‐Da , Moles Angela , Bu Zhao‐Jun , Zhang Ming‐Ming , Wang Zu‐Cheng , Zhao Hong‐Yan
Published: May 2021

Premise

Current knowledge about defense strategies in plants under herbivore pressure is predominantly based on vascular plants. Bryophytes are rarely consumed by herbivores since they have ample secondary metabolites. However, it is unknown whether bryophytes have induced defenses against herbivory and whether there is a trade‐off between growth and defense in bryophytes.

Methods

In an experiment with two peatland bryophytes, Sphagnum magellanicum Brid. and S. fuscum (Schimp.) H. Klinggr., two kinds of herbivory, clipping with scissors and grazing by mealworms (Tenebrio molitor L.) were simulated. At the end of the experiment, we measured growth traits, carbon‐based defense compounds (total phenolics and cellulose) and storage compounds (total nonstructural carbohydrates) of these two Sphagnum species.

Results

Grazing but not clipping increased total phenolics and C:N ratio and reduced biomass production and height increment. A negative relationship between biomass production and total phenolics was found in S. magellanicum but not in S. fuscum, indicating a growth–defense trade‐off that is species‐specific. Grazing reduced the sugar starch content of S. magellanicum and the sugar of S. fuscum. Either clipping or grazing had no effect on chlorophyll fluorescence (including actual and maximum photochemical efficiency of photosystem II) except that a significant effect of clipping on actual photochemical efficiency in S. fuscum was observed.

Conclusions

Our results suggest that Sphagnum can have induced defense against herbivory and that this defense can come at a cost of growth. These findings advance our knowledge about induced defense in bryophytes, the earliest land plants.
Fifty years of recognizable patterns of human malformation: Insights and opportunities
Authors: Innes A. Micheil , Lynch Danielle C.
Published: May 2021

Now in its 7th edition, Smith's Recognizable Patterns of Human Malformation was first published in 1970. This 1st edition comprised 135 “dysmorphic syndromes of multiple primary defects” and 12 “single syndromic malformations resulting in secondary defects.” Of the former, other than a few chromosomal and environmental disorders, most were heritable conditions of then unknown etiology. In 2021, the majority of these conditions are now “solved,” a notable exception is Hallermann‐Streiff syndrome. The “solved” conditions were typically clinically delineated decades prior to understanding the underlying etiology, which rarely required recent technologies such as exome sequencing (ES) to elucidate. The 7th edition includes nearly 300 syndromes, sequences, and associations. An increasing number of conditions first appearing in the latest editions are sporadic, with many solved using either array CGH or ES. We have reviewed all syndromes that have appeared in “Smith's” with a focus on inheritance, heterogeneity, and year and method of etiologic discovery. Several themes emerge. Genetic heterogeneity and pleiotropy of genes are frequent. Several of the currently “unresolved” syndromes are clinically diverse such as Dubowitz syndrome. Multiple recurrent constellations of embryonic malformations, with VACTERL association as a paradigm, are increasingly likely to have a shared pathogenesis requiring further study.
Enantioselective Total Synthesis of the Archaeal Lipid Parallel GDGT‐0 (Isocaldarchaeol)**
Authors: Falk Isaac D. , Gál Bálint , Bhattacharya Ahanjit , Wei Jeremy H. , Welander Paula V. , Boxer Steven G. , Burns Noah Z.
Published: May 2021

Archaeal glycerol dibiphytanyl glycerol tetraethers (GDGT) are some of the most unusual membrane lipids identified in nature. These amphiphiles are the major constituents of the membranes of numerous Archaea, some of which are extremophilic organisms. Due to their unique structures, there has been significant interest in studying both the biophysical properties and the biosynthesis of these molecules. However, these studies have thus far been hampered by limited access to chemically pure samples. Herein, we report a concise and stereoselective synthesis of the archaeal tetraether lipid parallel GDGT‐0 and the synthesis and self‐assembly of derivatives bearing different polar groups.
Multifunctional epoxy composites modified with a graphene nanoplatelet/carbon nanotube hybrid
Authors: Kopsidas Sotirios , Olowojoba Ganiu B.
Published: May 2021

Epoxies are a class of thermoset polymers which find use in high performance applications. However, epoxies are inherently brittle and are poor conductors of electricity, which limits their ability to be employed in functional applications. Carbon nanomaterials have attracted considerable attention as filler materials, due to their combination of outstanding properties. In the present work, an epoxy polymer was modified with a hybrid nanofiller, consisting of graphene nanoplatelets (GNPs) and carbon nanotubes (CNTs) at a mass ratio of 9:1, using three‐roll milling. Addition of 1 wt% resulted in an increase of eight orders of magnitude in the electrical conductivity and a 182% increase in the fracture energy, GIC, of the epoxy. CNTs contributed greatly in the reduction of the percolation threshold, which was 10 times lower than that of conventional GNP/epoxy composites, while the increase in toughness was entirely attributed to the GNPs, predominantly through the mechanism of crack deflection. The toughening contribution of the hybrid nanofiller was theoretically calculated using analytical modeling, which showed excellent agreement between the predicted and experimental values of GIC.
Production of polyurethane elastomer from highly reactive acetic acid lignin‐derived polyols with reduced molecular weights
Authors: He Tian , Zhu Wenxiang , Liu Mingyou , Tian Xiaofei , Chen Fangeng
Published: May 2021

Highly reactive polyols were prepared from modified acetic acid lignin (AAL) by a two‐step combination of mild hydrothermal degradation and hydroxylation. The AAL‐based polyols became relatively reactive and compatible with diisocyanate, with a reduction in the number average molecular weight (Mn) from 2923 to 684 g/mol and an increase in the hydroxyl content from 5.21 to 9.13 mmol/g. The mechanical performance and thermal properties of the AAL‐based polyurethane elastomers (LPUEs) strongly depended on the molecular weight and hydroxyl content of the AAL‐based polyols in the partial substitution of polytetramethylethylene ether glycol (PTMEG). This study proposed the prospective utilization of AAL as an alternative resource in the synthesis of polymers and biomaterials. © 2021 Society of Industrial Chemistry and John Wiley & Sons Ltd.
Simple TLC–spectrodensitometric method for studying lipophilicity and quantitative analysis of hypoglycemic drugs in their binary mixture
Authors: Abbas Noha S. , Mohamed Yahya Abduh Salim , Derayea Sayed M. , Omar Mahmoud A. , Saleh Gamal A.
Published: May 2021

A selective and simple salting‐out‐assisted thin‐layer chromatographic methodology was developed for the simultaneous determination of two oral hypoglycemic drugs, dapagliflozin (DAPA) and metformin (MET) in their pure forms, tablets and spiked human plasma samples. Silica gel 60 F254 plates were used in the separation of the two drugs using a mobile phase consisting of 0.5 m (NH4)2SO4 and methanol (3:7, v/v). The plates were scanned in the reflectance mode at λmax = 237 nm. The obtained retardation factor (Rf) values for DAPA and MET were 0.77 ± 0.02 and 0.25 ± 0.02, respectively. The thin‐layer chromatography method was validated according to International Conference on Harmonization guidelines. The peak areas were linearly increased with the increases in concentrations of 45–1,000 and 50–1,500 ng/band for DAPA and MET, respectively. Moreover, the method was applied to estimate the molecular lipophilicity parameters of DAPA and MET via retention data. The suggested method was efficiently utilized for the analysis of DAPA and MET in pharmaceutical tablets and plasma samples with recoveries 98.4–100.4 and RSDs in the ranges of 1.4–2.6 and 2.2–3.0% for DAPA and MET, respectively.
Investigating the association between serum human papillomavirus type 16 E7 antibodies and risk of head and neck cancer
Authors: Huang Cheng‐Chih , Su Yu‐Chu , Chang Chan‐Chi , Lee Wei‐Ting , Ou Chun‐Yen , Wu Yuan‐Hua , Wu Shang‐Yin , Lai Yu‐Hsuan , Huang Jehn‐Shyun , Chen Ken‐Chung , Hsueh Wei‐Ting , Tsai Sen‐Tien , Yen Chia‐Jui , Chang Jang‐Yang , Tsai Mei‐Ling , Lin Chen‐Lin , Weng Ya‐Ling , Yang Han‐Chien , Chen Yu‐Shan , Hsiao Jenn‐Ren , Chang Jeffrey S.
Published: May 2021

Human papillomavirus (HPV) is recognized as a major cause of oropharyngeal cancer (OPC) in Western countries. Less is known regarding its contribution to the OPC occurring in Asia. The current study aimed to investigate the association between antibody responses to HPV16 E7 and head and neck cancer (HNC) risk in a hospital‐based case–control study conducted in Taiwan with 693 HNC cases and 1,035 controls. A positive association was observed between seropositivity to HPV16 E7 and OPC risk, whereas no significant association was found in the non‐OPC cases. The increased OPC risk associated with seropositivity to HPV16 E7 was more significant among nonbetel quid or noncigarette users. Seropositivity to HPV16 E7 showed moderate agreement with P16 expression in OPC. OPC patients that were seropositive to HPV16 E7 or p16 positive were more highly educated and less likely to use alcohol, betel quids, and cigarettes compared to HPV16 E7 seronegative or p16 negative OPC patients. Furthermore, patients with p16 positive OPC were more likely to be women compared to patients with p16 negative OPC, likely owing to the low prevalence of alcohol, betel quid, and cigarette users among women. Overall, this study suggested that similar to Western countries, HPV may also be an important risk factor of OPC in Taiwan. With the declining consumption of betel quids and cigarettes in Taiwan, a higher percentage of OPC cases in Taiwan will be attributed to HPV in the future. Public health measures, including HPV vaccination, need to be implemented to prevent the occurrence of HPV‐positive OPC.
Helpful and unhelpful elements of synchronous text‐based therapy: A thematic analysis
Authors: Dhesi Meera , Sefi Aaron , Donati Mark , Hayes Jacqueline , Cooper Mick
Published: May 2021

Within the UK, there has been a growth of services delivering online therapy to young people. This study identifies the factors that young people find helpful and unhelpful in synchronous text‐based therapy (STBT), and the processes by which these factors may be of value. Thirteen young people, aged between 14 and 18, were interviewed synchronously online. All participants had had a minimum of four sessions of STBT. Data were analysed thematically. Four main domains of helpful and unhelpful factors were identified: 1) anonymity, 2) access, 3) communication, and 4) control. Control was a particularly important element for young people and was an underlying aspect across all themes. Young people not only valued several aspects of STBT but also recognised its limitations. Further research should explore the contexts in which online counselling may be helpful or not.
Applications of Mechanochemistry for the Synthesis of DNA on Ionic Liquid Supports
Authors: Johnston Christopher , Hardacre Christopher , Migaud Marie E.
Published: May 2021

The standard methodology for the synthesis of oligonucleotides is the solid‐phase method. Here, we report the first case of mechanochemistry being directly applied to synthesising a dinucleotide on a soluble support. While mechanochemistry eliminates the need to solubilise a supported oligomer in the solution phase for phosphoramidite coupling, the support still confers the benefit of being able to purify the product by precipitation or by simple liquid‐liquid extractions as needed. Furthermore, this study also explores the use of mechanochemistry in the initial functionalisation of the ionic liquid support with a nucleoside monomer.
A Phase 1 Open‐Label, Fixed‐Sequence Pharmacokinetic Drug Interaction Trial to Investigate the Effect of Cannabidiol on the CYP1A2 Probe Caffeine in Healthy Subjects
Authors: Thai Ching , Tayo Bola , Critchley David
Published: May 2021

This pharmacokinetic (PK) drug‐interaction trial investigated the effects of repeated dosing of a plant‐derived pharmaceutical formulation of highly purified cannabidiol (CBD; Epidiolex in the United States and Epidyolex in Europe; 100 mg/mL oral solution) on caffeine clearance via modulation of cytochrome P450 (CYP) 1A2 activity in healthy adults. In this phase 1 open‐label, fixed‐sequence trial, all subjects received a single 200 mg caffeine dose and placebo on day 1. Subjects then titrated CBD from 250 mg once daily to 750 mg twice daily between days 3 and 11 and took 750 mg CBD twice daily between days 12 and 27. On day 26, subjects received a single 200‐mg caffeine dose with their morning CBD dose. Plasma concentrations of caffeine and its CYP1A2‐mediated metabolite, paraxanthine, were determined on days 1 and 26 and PK parameters derived using noncompartmental analysis. Safety was monitored throughout. Sixteen subjects enrolled, and 9 completed treatment. When caffeine was administered with steady‐state CBD, caffeine exposure increased by 15% for Cmax and 95% for AUC0‐∞, tmax increased from 1.5 to 3.0 hours, and t1/2 increased from 5.4 to 10.9 hours compared with caffeine administered with placebo. Under the same conditions, paraxanthine exposure decreased by 22% for Cmax and increased by 18% for AUC0‐∞, tmax increased from 8.0 to 14.0 hours, and t1/2 increased from 7.2 to 13.7 hours. Overall, there were no unexpected adverse events; diarrhea was most common, and 6 subjects discontinued because of elevated liver transaminases. These data suggest that CBD is an inhibitor of CYP1A2.
Nonlinear adaptive normalized least mean absolute third algorithm for the control of five‐level distribution static compensator
Authors: Bansal Praveen , Singh Alka
Published: May 2021

This paper presents the design and control of single‐phase five‐level cascaded H‐bridge multilevel inverter (CHB‐MLI) as a shunt active power filter (SAPF) unit to mitigate the various power quality (PQ) problems such as reactive power burden, injection of harmonics in the supply, poor power factor, and so on. The control of CHB‐MLI has been done using the normalized least mean absolute third (NLMAT) algorithm, which overcomes the shortcoming of conventional least mean square (LMS), normalized LMS (NLMS), and least mean absolute third (LMAT) algorithm. The control algorithm is designed in MATLAB Simulink, and its scaled down prototype model is developed in the laboratory to find the fundamental active component of load current and to mitigate the aforementioned PQ problems. The proposed system is tested for single‐phase grid‐connection, and it works satisfactorily under steady state and dynamic load conditions. A dSpace1104 microcontroller is used to test the proposed algorithm and to generate firing pulses. Besides, the detailed comparison in the context of mean square error (MSE), weights convergence and intermediate error with conventional LMS, NLMS, and LMAT algorithm have also been discussed. Moreover, the harmonic distortion observed in the source current is within stipulated IEEE‐519 limits.
Adjuvant breast cancer treatments cardiotoxicity and modern methods of detection and prevention of cardiac complications
Authors: Bikiewicz Agata , Banach Maciej , von Haehling Stephan , Maciejewski Marek , Bielecka‐Dabrowa Agata
Published: May 2021

The most common cancer diagnosis in female population is breast cancer, which affects every year about 2.0 million women worldwide. In recent years, significant progress has been made in oncological therapy, in systemic treatment, and in radiotherapy of breast cancer. Unfortunately, the improvement in the effectiveness of oncological treatment and prolonging patients' life span is associated with more frequent occurrence of organ complications, which are side effects of this treatment. Current recommendations suggest a periodic monitoring of the cardiovascular system in course of oncological treatment. The monitoring includes the assessment of occurrence of risk factors for cardiovascular diseases in combination with the evaluation of the left ventricular systolic function using echocardiography and electrocardiography as well as with the analysis of the concentration of cardiac biomarkers. The aim of this review was critical assessment of the breast cancer therapy cardiotoxicity and the analysis of methods its detections. The new cardio‐specific biomarkers in serum, the development of modern imaging techniques (Global Longitudinal Strain and Three‐Dimensional Left Ventricular Ejection Fraction) and genotyping, and especially their combined use, may become a useful tool for identifying patients at risk of developing cardiotoxicity, who require further cardiovascular monitoring or cardioprotective therapy.
Feasibility of remote speech analysis in evaluation of dynamic fluid overload in heart failure patients undergoing haemodialysis treatment
Authors: Amir Offer , Anker Stefan D. , Gork Ittamar , Abraham William T. , Pinney Sean P. , Burkhoff Daniel , Shallom Ilan D. , Haviv Ronit , Edelman Elazer R. , Lotan Chaim
Published: May 2021

Aims

This study aimed to assess the ability of a voice analysis application to discriminate between wet and dry states in chronic heart failure (CHF) patients undergoing regular scheduled haemodialysis treatment due to volume overload as a result of their chronic renal failure.

Methods and results

In this single‐centre, observational study, five patients with CHF, peripheral oedema of ≥2, and pulmonary congestion‐related dyspnoea, undergoing haemodialysis three times per week, recorded five sentences into a standard smartphone/tablet before and after haemodialysis. Recordings were provided that same noon/early evening and the next morning and evening. Patient weight was measured at the hospital before and after each haemodialysis session. Recordings were analysed by a smartphone application (app) algorithm, to compare speech measures (SMs) of utterances collected over time. On average, patients provided recordings throughout 25.8 ± 3.9 dialysis treatment cycles, resulting in a total of 472 recordings. Weight changes of 1.95 ± 0.64 kg were documented during cycles. Median baseline SM prior to dialysis was 0.87 ± 0.17, and rose to 1.07 ± 0.15 following the end of the dialysis session, at noon (P = 0.0355), and remained at a similar level until the following morning (P = 0.007). By the evening of the day following dialysis, SMs returned to baseline levels (0.88 ± 0.19). Changes in patient weight immediately after dialysis positively correlated with SM changes, with the strongest correlation measured the evening of the dialysis day [slope: −0.40 ± 0.15 (95% confidence interval: −0.71 to −0.10), P = 0.0096].

Conclusions

The fluid‐controlled haemodialysis model demonstrated the ability of the app algorithm to identify cyclic changes in SMs, which reflected bodily fluid levels. The voice analysis platform bears considerable potential as a harbinger of impending fluid overload in a range of clinical scenarios, which will enhance monitoring and triage efforts, ultimately optimizing remote CHF management.
Regaining Lost Protections: Status of the Revisions to the Canadian Fisheries Act
Authors: Imhof JG , Lapointe NW , Metikosh S , Hasler CT
Published: May 2021

The Fisheries Act (Act), a long-standing Act protecting fisheries in Canada, was changed in 2012 to redefine its central purpose to the management of fisheries in Canada. Along with this refocus were changes that appeared to reduce protections for habitat and all fish. After an outcry by scientists, Indigenous peoples, and environmental organizations, the Act was revised in 2019 to “restore lost protections” thought to have been lost in the 2012 changes. To a large degree most of the “lost protections” have been restored, while other portions of the 2012 Act have been maintained. Challenges remain under the amended Act in efficiently implementing development and conservation projects while achieving the newly clarified purpose of the Act—the conservation and protection of fish and fish habitat.
Providers' perspectives on the performance of primary healthcare centres in India: The missing link
Authors: Bangalore Sathyananda Rajeshwari , Krumeich Anja , Manjunath Usha , de Rijk Angelique , van Schayck C. P.
Published: May 2021

Background

Primary healthcare centres (PHCs) form the foundation of the Indian public health system, and thus their effective functioning is paramount in ensuring the population's health. The World Health Organisation (WHO) has set six aspects of performance assessment for general health systems, which are hardly applicable to the PHC setup in a low‐ and middle‐income country. The Primary Health Care Performance Initiative (PHCPI) has prescribed a framework with five domains consisting of 36 indicators for primary healthcare performance assessment from a policy point of view. For the assessment to be realistic, it should include inputs from stakeholders involved in care delivery, so this study examines the perspectives of healthcare providers at PHCs in India.

Methodology

The authors used qualitative research methodology in the form of responsive evaluations of healthcare provider's interviews to understand the indicators of PHC performance.

Results and Conclusion

The study results showed that healthcare providers considered efficient teamwork, opportunities for enhancing provider skills and knowledge, job satisfaction, effective PHC administration, and good community relationship as PHC performance assessment. These domains of performance could be considered the ‘missing link’ in PHC assessment, since they are deemed important by providers and did not coincide with the WHO aspects and the PHCPI performance assessment framework.
Present as a partner and a parent: Mothers’ and fathers’ perspectives on father participation in prenatal care
Authors: Walsh Tova B. , Carpenter Emma , Costanzo Molly A. , Howard Lanikque , Reynders Rachel
Published: May 2021

Supportive father involvement during pregnancy can positively impact maternal and child outcomes. Father participation in prenatal care is increasing, yet little research exists to understand how mothers and fathers experience father participation in prenatal care and their preferences for father participation. We interviewed expectant first‐time mothers (N = 22) and fathers (N = 20) to learn about fathers’ participation in prenatal care, perceptions of providers’ treatment of fathers, and preferences for father participation. Interviews were coded using principles of grounded theory. Father participation ranged from attendance at visits considered “important” (e.g., ultrasounds) to attendance at every appointment. Experiences of father participation varied, with many describing it as both an important act of support for the mother and part of assuming the role of father. Most participants saw great value in father participation in prenatal care as an opportunity for fathers to learn how to support a healthy pregnancy, bond with their developing baby, and share joy and/or worries with mothers. Participants generally felt that fathers were made to feel welcome and wanted providers to be inclusive of fathers during appointments. Results of this study suggest that father participation presents an opportunity for prenatal care providers to foster fathers’ positive involvement in pregnancy, support for mothers, and preparation to parent.
Rethinking Leadership in the Fourth Industrial Revolution: Lessons for Construction Business Organizations
Authors: Alade Kehinde , Windapo Abimbola , Wachira‐Towey Isabella N.
Published: May 2021

The Fourth Industrial Revolution (4IR) is changing the way organizations function and provide services. However, scholars are of the view that the construction industry is struggling to catch up with the pace of change. Some studies have queried whether leadership is required to drive the change agenda. The current study employed a quantitative research approach and a cross‐sectional survey research design to obtain information from a sample of 408 construction executives across the nine provinces of South Africa. The leadership orientation and functions of the executives employed toward the adaptation to 4IR were examined. The current study found that only a few 4IR technologies, namely, internet of things, three‐dimensional printers, and cloud computing are mostly adopted in South African construction organizations. Further, it was found that the leader functions of executing and coaching are not being employed. Based on these findings, it is concluded that there are gaps in the perceived functions of leaders in implementing 4IR in South African construction organizations, which impacts on the ability of construction companies to improve their services in the 4IR era. The study recommends a rethinking for construction leaders to fully benefit from the 4IR.
Sapropterin dihydrochloride therapy in dihydropteridine reductase deficiency: Insight from the first case with molecular diagnosis in Brazil
Authors: Lourenço Charles Marques , Dovidio Janaina , Lopes Isabela F. , Silva Laís C. , Almeida Marcela , Vagnini Laura , Fonseca Jacqueline , Carneiro Zumira A. , Thöny Beat
Published: May 2021

Tetrahydrobiopterin (BH4) is a cofactor that participates in the biogenesis reactions of a variety of biomolecules, including l‐tyrosine, l‐3,4‐dihydroxyphenylalanine, 5‐hydroxytryptophan, nitric oxide, and glycerol. Dihydropteridine reductase (DHPR, EC 1.5.1.34) is an enzyme involved in the BH4 regeneration. DHPR deficiency (DHPRD) is an autosomal recessive disorder, leading to severe and progressive neurological manifestations, which cannot be exclusively controlled by l‐phenylalanine (l‐Phe) restricted diet. In fact, the supplementation of neurotransmitter precursors is more decisive in the disease management, and the administration of sapropterin dihydrochloride may also provide positive effects. From the best of our knowledge, there is limited information regarding DHPRD in the past 5 years in the literature. Here, we describe the medical journey of the first patient to have DHPRD confirmed by molecular diagnostic methods in Brazil. The patient presented with two pathogenic variants of the quinoid dihydropteridine reductase (QDPR) gene—which codes for the DHPR protein, one containing the in trans missense mutation c.515C>T (pPro172Leu) in exon 5 and the other containing the same type of mutation in the exon 7 (c.635T>C [p.Phe212Ser]). The authors discuss their experience with sapropterin dihydrochloride for the treatment of DHPRD in this case report.
Impact of right atrial structural remodeling on recurrence after ablation for atrial fibrillation
Authors: Takagi Takahito , Nakamura Keijiro , Asami Masako , Toyoda Yasutake , Enomoto Yoshinari , Moroi Masao , Noro Mahito , Sugi Kaoru , Nakamura Masato
Published: May 2021

Background

Recurrence of atrial fibrillation (AF) after pulmonary vein isolation (PVI) is associated with left atrial (LA) remodeling; however, its association with right atrial (RA) remodeling remains unclear.

Objective

This study aimed to identify whether RA structural remodeling could predict recurrence of AF after PVI.

Methods

This study prospectively analyzed 245 patients with AF who had undergone PVI. RA and LA volumes were determined by contrast‐enhanced computed tomography. Atrial structural remodeling was defined as an atrial volume of ≥110 mL according to previous reports and receiver operating characteristic curve analysis.

Results

After excluding 32 patients, 213 patients were analyzed. During a follow‐up period of 12 months, 41 patients (19%) demonstrated atrial arrhythmia recurrence after PVI. With the Cox proportional‐hazards model, RA structural remodeling was the only predictor of arrhythmia recurrence (hazard ratio, 1.012; 95% confidence interval 1.003‐1.021; P = .009). Kaplan–Meier analysis showed that arrhythmia recurrence was more frequent in the RA structural remodeling group compared with the group without RA remodeling (log‐rank, P < .001), and the arrhythmia‐free survival rates in these groups at 12 months were 68.0% and 91.4%, respectively. Additionally, there was a significant difference in recurrence‐free survival after RA structural remodeling in each type of AF (log‐rank, P < .001).

Conclusions

RA structural remodeling is a useful predictor of clinical outcome after PVI regardless of the type of AF. Our results suggest that patients without RA structural remodeling may be good candidates for successful ablation with PVI.
In situ backside Raman spectroscopy of zinc oxide nanorods in an atmospheric‐pressure dielectric barrier discharge plasma
Authors: Knust Steffen , Ruhm Lukas , Kuhlmann Andreas , Meinderink Dennis , Bürger Julius , Lindner Jörg K. N. , de los Arcos de Pedro Maria Teresa , Grundmeier Guido
Published: May 2021

This work presents in situ backside Raman spectroscopy as a method for the investigation of atmospheric‐pressure plasma modification of thin oxide films on metals. By using the backside of a permeable electrode, various contributions from the plasma (UV radiation, electrons, etc.) are blocked, which allows us to solely evaluate the effect of the plasma effluent. This approach is applied to study the influence of different gas mixtures (Ar, Ar/H2O, and Ar/O2) on the plasma treatment of zinc oxide nanorod films. The spectral analysis reveals the interaction of the plasma effluent with the zinc sublattice, introducing defects dependent on the plasma gas‐phase composition. The in situ measurements show that both the effluent/surface interaction and the resulting defects induce lattice stress in the wurtzite structure. Ex situ Raman measurements demonstrate that the defect stability over time depends on the defect type. The results for the dielectric barrier discharge plasma modification of ZnO‐nanostructured thin films indicate that the presented Raman spectroscopic setup is suitable for a variety of systems with a focus on remote plasma modifications.
Active‐matrix mesh electronics thin‐film‐transistor arrays for biometrics‐under‐display and biomedical applications
Authors: Kronemeijer Auke Jisk , Peeters Bart , de Haas Gerard , Verbeek Roy , Bel Thijs , van de Laar Robert , Ugalde Lopez Leslye Astrid , Peters Laurens C. J. M. , Gelinck Gerwin H.
Published: May 2021

A monolithic manufacturing process is presented for the realization of active‐matrix meshed thin‐film‐transistor (TFT) arrays on foil with physical voids between pixels, realizing membrane‐like electronic arrays. The process is scalable to large‐area substrates and enables (improved performance of) biometrics‐under‐display applications. Moreover, membrane‐like TFT arrays provide opportunities for the use of TFT technology, and broader large‐area thin‐film electronics, in new applications in the domain of biomedical electronics, as demonstrated by example use cases of in vivo electrophysiology of the brain as well as in vitro electrophysiology in smart microwell plates.
A quantitative perspective of Porter's industry forces framework for investment analysis
Authors: Jung Sang Hoon , Jeong Yong Jin
Published: May 2021

Porter's industry forces framework is an important tool for external analysis of firms, but its qualitative nature presents numerous limitations to be used in investment analysis. This study introduces a quantitative perspective of the framework using financial information proxies. This allows investors to gauge the external factors quantitatively and to gain enhanced framework usability. In order to test its validity, the correlation movements of our quantitative perspective have been analysed. For demonstration of enhanced usability, our quantitative perspective, alongside machine learning models, was used to predict business performances. The empirical results indicate that our quantitative perspective of the framework corroborates with its original definition and that it exhibits enhanced usability than the original framework.
Discontinuous Galerkin FEMs for a gradient beam in static carbon nanotube applications
Authors: Eptaimeros Konstantinos G. , Koutsoumaris Constantinos Chr.
Published: May 2021

The engineering applications of the innovative materials, such as carbon nanotubes (CNTs) and graphene sheets, constitute a developing branch of the modern science. CNTs, in particular, exhibit extraordinarily mechanical properties capable of making them a reliable material for the above applications. The simulation of the mechanical response of a CNT is effectively conducted by a generalized beam model. This work investigates the response of a CNT, subjected to a static loading, by means of a gradient beam model. Given that the existence of a boundary layer is demonstrated by the analytical solutions of the aforementioned problem, the interior penalty discontinuous Galerkin finite element methods (IPDGFEMs) are crucial to its solution. The hp‐version IPDGFEMs are developed in this study for the solution of a static gradient elastic beam in bending, derived from two different equilibrium formulations, for the first time. An a priori error analysis is also performed for the above method, and numerical simulations are then carried out. A comparison is finally drawn between the exact deflection and those of the IPDGFEM and the conforming C2‐continuous finite element method (C2CFEM) for a number of discretizations and each length scale that is investigated. The deduced results highlight the suitability, the efficiency, and the accuracy of the investigated models over the already existing ones, and they have considerable significance for the engineering design in the range of micro and nanodimensions.
Simultaneous T2 and mapping of multiple sclerosis lesions with radial RARE‐EPI
Authors: Herrmann Carl J. J. , Els Antje , Boehmert Laura , Periquito Joao , Eigentler Thomas Wilhelm , Millward Jason M. , Waiczies Sonia , Kuchling Joseph , Paul Friedemann , Niendorf Thoralf
Published: May 2021

Purpose

The characteristic MRI features of multiple sclerosis (MS) lesions make it conceptually appealing to pursue parametric mapping techniques that support simultaneous generation of quantitative maps of 2 or more MR contrast mechanisms. We present a modular rapid acquisition with relaxation enhancement (RARE)‐EPI hybrid that facilitates simultaneous T2 and mapping (2in1‐RARE‐EPI).

Methods

In 2in1‐RARE‐EPI the first echoes in the echo train are acquired with a RARE module, later echoes are acquired with an EPI module. To define the fraction of echoes covered by the RARE and EPI module, an error analysis of T2 and was conducted with Monte Carlo simulations. Radial k‐space (under)sampling was implemented for acceleration (R = 2). The feasibility of 2in1‐RARE‐EPI for simultaneous T2 and mapping was examined in a phantom study mimicking T2 and relaxation times of the brain. For validation, 2in1‐RARE‐EPI was benchmarked versus multi spin‐echo (MSE) and multi gradient‐echo (MGRE) techniques. The clinical applicability of 2in1‐RARE‐EPI was demonstrated in healthy subjects and MS patients.

Results

There was a good agreement between T2/ values derived from 2in1‐RARE‐EPI and T2/ reference values obtained from MSE and MGRE in both phantoms and healthy subjects. In patients, MS lesions in T2 and maps deduced from 2in1‐RARE‐EPI could be just as clearly delineated as in reference maps calculated from MSE/MGRE.

Conclusion

This work demonstrates the feasibility of radially (under)sampled 2in1‐RARE‐EPI for simultaneous T2 and mapping in MS patients.
Farm simulation platforms increase undergraduate skills and confidence in decision‐support technologies
Authors: Basche Andrea , Krupek Fernanda Souza , Chatterjee Nilovna , Speth Carol
Published: May 2021

As agriculture increasingly moves into a digital realm, it is important for future professionals to gain experience with predictive and computer‐based technologies. Farm simulation platforms can be efficient tools for crop management and natural resources courses, yet limited research has demonstrated their efficacy in undergraduate education. We implemented a module utilizing a farm simulation platform in a high enrollment undergraduate crop management course. The module included asynchronous video content and four synchronous course periods with activities related to crop planting dates, water cycling with different crop rotations, fertilizer impacts on yield and environment, as well as a competition activity to optimize profit with different management considerations. In our assessments, we found that students increased knowledge and confidence in how to use the software, awareness of related simulation platforms, how to make data‐driven crop management decisions as well as how to develop and test hypotheses. Students reported learning a range of skills, including how to utilize the software to understanding the impact of crop management on yield, and specifically noted that these skills would be beneficial for future careers in farming, consulting, business, or policy. Additionally, students reported challenges such as difficulties with data interpretation and software use. For successful implementation of similar modules, we recommend providing students with a step‐by‐step activity manual, ensuring adequate teaching team support, and developing a supportive classroom environment. Our results demonstrate that farm simulation platforms can be successfully implemented into undergraduate courses to support students in navigating technologies beneficial for future careers.