bluuebunny/crossref_metadata_2025 huggingface dataset:
Insights into complexation and enantioselectivity of uranyl‐2‐(2‐hydroxy‐3‐methoxyphenyl)‐9‐(2‐hydroxyphenyl)thiopyrano[3,2‐h]thiochromene‐4,7‐dione with R/S‐organophosphorus pesticides
Authors: Yang Rong , Xiao Yang , Tao Xue‐bing , Ma Ming‐jie , Wu Zhi‐lin , Liao Li‐fu , Xiao Xi‐lin , Nie Chang‐ming
Published: June 2021

In order to explore the enantioselectivity of new uranyl receptors to chiral organophosphorus pesticides (COPs), we designed a novel ligand: 2‐(2‐hydroxy‐3‐methoxyphenyl)‐9‐(2‐hydroxyphenyl)thiopyrano[3,2‐h]thiochromene‐4,7‐dione (HTTDN) and constructed a new receptor of Uranyl‐HTTDN by complexation of HTTDN with uranyl. The complexation and enantioselectivity of Uranyl‐HTTDN to COPs of R/S‐methamidophos (R/S‐MAPs) and R/S‐acephates (R/S‐APs) were studied using density functional theory (DFT) method in this paper. The results showed that in vacuum and toluene, Uranyl‐HTTDN could effectively recognize R/S‐MAPs by complexation with oxygen of phosphoryl of methamidophos, with enatioselectivity coefficients of 91.80% and 86.74%, respectively. In vacuum, water, and acetone, Uranyl‐HTTDN could also effectively identify R/S‐APs by the oxygen of phosphoryl coordinating with U, and enatioselectivity coefficients toward R/S‐APs were 99.41%, 91.09%, and 93.84%, respectively. These results could provide valuable information and theoretical reference for the further experiments of COPs separation.
Comparing vibrissal morphology and infraorbital foramen area in pinnipeds
Authors: Milne Alyx O. , Muchlinski Magdalena N. , Orton Llwyd D. , Sullivan Matthew S. , Grant Robyn A.
Published: June 2021

Pinniped vibrissae are well‐adapted to sensing in an aquatic environment, by being morphologically diverse and more sensitive than those of terrestrial species. However, it is both challenging and time‐consuming to measure vibrissal sensitivity in many species. In terrestrial species, the infraorbital foramen (IOF) area is associated with vibrissal sensitivity and increases with vibrissal number. While pinnipeds are thought to have large IOF areas, this has not yet been systematically measured before. We investigated vibrissal morphology, IOF area, and skull size in 16 species of pinniped and 12 terrestrial Carnivora species. Pinnipeds had significantly larger skulls and IOF areas, longer vibrissae, and fewer vibrissae than the other Carnivora species. IOF area and vibrissal number were correlated in Pinnipeds, just as they are in terrestrial mammals. However, despite pinnipeds having significantly fewer vibrissae than other Carnivora species, their IOF area was not smaller, which might be due to pinnipeds having vibrissae that are innervated more. We propose that investigating normalized IOF area per vibrissa will offer an alternative way to approximate gross individual vibrissal sensitivity in pinnipeds and other mammalian species. Our data show that many species of pinniped, and some species of felids, are likely to have strongly innervated individual vibrissae, since they have high values of normalized IOF area per vibrissa. We suggest that species that hunt moving prey items in the dark will have more sensitive and specialized vibrissae, especially as they have to integrate between individual vibrissal signals to calculate the direction of moving prey during hunting.
Evidence of determinate growth in an American alligator (Alligator mississippiensis) based on long‐term recapture and osteohistological confirmation
Authors: Rainwater Thomas R. , Woodward Holly N. , Woodward Allan R. , Wilkinson Philip M.
Published: June 2021

Despite the general perception that crocodilians exhibit indeterminate growth, recent long‐term field studies and laboratory investigations have independently suggested that growth in these animals is determinate. In this study, we had the unique opportunity to examine skeletal growth in a wild adult American alligator (Alligator mississippiensis) based on change in body length measurements (snout‐vent length) in the field and confirm these findings using osteohistological analyses (presence/absence of an external fundamental system [EFS]) of long bones. The alligator was captured and measured five times over 7 years and exhibited no discernable growth during that period, suggesting skeletal maturity had been attained at or prior to its first capture. Our field assessment of determinate growth in this alligator was osteohistologically confirmed by the presence of an EFS in the animal's humerus, femur, tibia, and fibula. To our knowledge, this study is the first to report determinate growth in a wild crocodilian using both field and laboratory methods, providing further evidence of this growth pattern in crocodilians.
Rational Design of Diphenyldiacetylene‐Based Fluorescent Materials Enabling a 365‐nm Light‐Initiated Topochemical Polymerization
Authors: Zhu Mingjie , Zhu Liangliang
Published: June 2021

Photopolymerization of diacetylenes usually requires stringent reaction conditions like high energy irradiation of 254‐nm light or even γ‐rays, which are generally harmful to the human body and thus mild conditions with lower energy irradiation are required. In this study, different diphenyldiacetylene (DPDA) derivatives were rationally designed followed by the investigation of their photopolymerization behavior. It was found that the para‐substituted amino groups could render the absorption band of DPDA bathochromically shifted, ensuring a 365‐nm light wavelength coverage. On this basis, an organogel system was constructed by chemically modifying cholesteryl and lipoic acid onto the DPDA moiety in aromatic solvents. Such uniform self‐assemblies further facilitated to a rather high degree of polymerization by 365‐nm irradiation. As a kind of fluorescent materials, the whole polymerization process of this system can be visualized by a photoluminescent signal.
Adaptive finite‐time control for turbo‐generator of power systems with prescribed performance
Authors: Liang Qi , Yang Qinmin , Meng Wenchao , Li Yunpeng
Published: June 2021

Control of turbo‐generator is facing great challenges resulting from more renewable energies injected into power systems, and it is still a challenging task to improve the accuracy and convergence speed when the operation point changes. In this paper, an adaptive finite‐time controller design is proposed for turbo‐generators in the presence of bounded disturbances and unknown system dynamics. Compared with existing methods, the finite‐time stability rather than asymptotic stability or uniformly ultimately bounded (UUB) can be guaranteed and prescribed transient performance can be achieved. First, the constant constraints on the system states and terminal sliding mode (TSM) manifold are proposed to enhance the transient performance. Furthermore, the uncertainties of the system are overcome by the neural network (NN), and both the bounded external disturbances and the reconstruction error of NN are handled by an adaptive term and a robust term. In addition, the important chattering‐free property could be achieved by the boundary layer. Finally, the finite‐time stability of the output in the system is rigidly proved via Lyapunov analysis, and the effectiveness of the theoretical result is substantiated by extensive simulations.
Gastrointestinal symptoms and sensory abnormalities associated with behavioral problems in children with neurodevelopmental disorders
Authors: Kurokawa Shunya , Nomura Kensuke , Miyaho Katsuma , Sanada Kenji , Iwamoto Chiaki , Naraoka Minori , Yoneda Shintaro , Tomizawa Yoshihiro , Sawae Yukinori , Iwanaga Ryuichiro , Mimura Masaru , Kishimoto Taishiro
Published: June 2021

Behavioral problems directly affect the quality of life of caregivers and children with autism spectrum disorder (ASD) and/or attention‐deficit/hyperactivity disorder (ADHD), and is known to be associated with clinical factors such as gastrointestinal (GI) symptoms, sensory abnormalities, intellectual abilities, and use of medication. However, previous studies have not considered these relationships comprehensively. We conducted a cross‐sectional study of 6–12‐year‐old children with diagnoses of ASD and/or ADHD at two hospitals in Japan. Scores for the aberrant behavior checklist (ABC), autism‐spectrum quotient (AQ), and Conners 3, as well as information on daily sleep and exercise, GI symptoms, and Short Sensory Profile, were collected. Each factor was subjected to a correlation analysis to investigate its effect on ABC scores. A stepwise multiple linear regression analysis for the factors with p < 0.05 was performed. Data were obtained from 60 patients with a mean age of 8.3 years; 21 had ASD alone, 18 had ADHD alone, and 21 had ASD + ADHD. The correlation analyses identified six factors associated with ABC severity: (a) methylphenidate use, (b) Conners hyperactivity score, (c) Conners inattention score, (d) AQ score, (e) SSP score, and (f) GI symptom score. The multiple regression showed that “GI symptoms” and “sensory abnormalities” were independently associated with ABC severity. Although further studies are needed to show a causal relationship, appropriate assessment of GI symptoms and sensory abnormalities may help alleviate some problematic behaviors and improve the quality of life of children with neurodevelopmental disorders and their families.

Lay summary

Behavioral problems in children with neurodevelopmental disorders are known to be associated with many factors. This study aimed to comprehensively investigate the known factors. We have discovered that “gastrointestinal symptoms” and “sensory abnormalities” were independently associated with Behavioral problems. Our results suggest that it is important for clinicians and caregivers to pay more attention to children's GI symptoms and sensory abnormalities that may not present as obvious symptoms or complaints.
Piloting During a Pandemic
Authors: Emerson Brock
Published: June 2021

Key Takeaways

Four pilot teams shared experiences with piloting during the COVID‐19 pandemic, emphasizing that thoughtful planning streamlines the piloting process while mitigating the risk of transmitting illness.

Remote access to and control of pilot equipment, along with the use of virtual communication platforms, enabled teams to successfully perform pilot‐scale studies.

Operating pilot systems through the pandemic allowed teams to respond to drastic changes on a small scale to mitigate risks around full‐scale processes at the treatment plant.
Polymer‐Driven Nitrosamine Formation in Houston's Drinking Water
Authors: Wolde‐Kirkos Abate T. , Joshi Narendra , Thakur Shubha
Published: June 2021

Key Takeaways

After finding nitrosamines in its water system, the City of Houston studied how polymer coagulants and different stages of water purification affect nitrosamine formation.

Results showed that as polymer dose increased and as water backwash or recycled water was mixed in, nitrosamine levels increased.

Utilities should remove nitrosamine precursors from source water and optimize polymer dosage to reduce nitrosamines in the purification plant and drinking water distribution system.
Biosensors and biomarkers for determining gestational diabetes mellitus and jaundice in children
Authors: Peng Shuangqin , Wang Qin , Xiong Guoping , Gopinath Subash C.B. , Lei Gang
Published: June 2021

Gestational diabetes and jaundice are the correlated diseases predominantly found in mother and newborn child. Jaundice is a neonatal complication with an increased risk when mother has gestational diabetes. Mothers with diabetes at an early stage of gestational age are at higher risk for hyperbilirubinemia (jaundice) and hypoglycemia. So, it is mandatory to monitor the condition of diabetes and jaundice during the pregnancy period for a healthy child and safest delivery. On the other hand, nanotechnology has displayed a rapid advancement that can be implemented to overcome these issues. The development of high‐performance diagnosis using appropriate biomarkers provides their efficacy in the detection gestational diabetes and jaundice. This review covers the aspects from a fast‐developing field to generate nanosensors in the nanosized dimensions for the applications to overcome these complications by coupling diagnostics with biomarkers. Further, the serum‐based biomarkers have been discussed for these inborn complications and also the diagnosis with the current trend.
Innovativer und nachhaltiger Ersatzneubau von Betonbrücken
Authors: Wirker Andreas , Donner Ralf , Flederer Holger , Bösche Thomas
Published: June 2021

Der Ersatzneubau von Straßenbrücken wird künftig enorm an Bedeutung gewinnen. Da die Brückenerneuerung in Deutschland gegenwärtig nahezu ausschließlich am Standort des Bauwerks erfolgt, werden durch lange Bauzeiten erhebliche Verkehrseinschränkungen verursacht. Das hier vorgestellte und von der Bundesanstalt für Straßenwesen beauftragte Forschungsvorhaben zeigt Vorgehensweisen auf, mit denen die Bauzeit im Bereich der Verkehrstrasse erheblich reduziert werden kann. Durch separate Lösungsansätze für die Unterbauten, Überbauten und Kappen sowie die Bauverfahren stehen Kombinationsmöglichkeiten für verschiedenste Anwendungsfälle zur Verfügung. Die sofortige Anwendbarkeit einzelner Varianten ist gegeben, da diese vom Regelwerk abgedeckt sind. Für die stringente Anwendung der Fertigteilbauweise besteht die Notwendigkeit, noch weiterführende Toleranzanforderungen im Regelwerk zu definieren. Für einzelne Varianten besteht noch Forschungsbedarf. Mit den erarbeiteten Lösungen kann die Bauzeit vor Ort und damit auch die Einschränkung des Verkehrs um bis zu 66 % verringert und die CO2‐Emmisionen erheblich reduziert werden. Die Kostensteigerung bleibt dabei moderat. Gleichzeitig sollten bei künftigen Vorhaben auch die externen Kosten mit einbezogen werden, da sich dadurch die Vorteile der Fertigteilbauweise noch wirtschaftlicher herauskristallisieren. Eine wesentliche Voraussetzung für die Umsetzung der modularen Bauweise ist die grundsätzliche Bereitschaft, diese anzuwenden.
Neural response to trauma‐related and trauma‐unrelated negative stimuli in remitted and persistent pediatric post‐traumatic stress disorder
Authors: Wang Peng , Peng Zu‐Lai , Liu Lu , An Li , Liu Yu‐Xin , Cao Qing‐Jiu , Sun Li , Ji Ning , Chen Yun , Yang Bin‐Rang , Wang Yu‐Feng
Published: June 2021

Introduction

Most youths who suffer from post‐traumatic stress disorder (PTSD) lose their diagnosis in the first 1–2 years. However, there are few studies on this brain mechanism, and the heterogeneity of the findings is partially due to the different stimuli applied and the mixed trauma history. Therefore, the use of trauma‐related/unrelated stimuli to study the remittance mechanism of earthquake‐induced PTSD could advance our knowledge of PTSD and inspire future treatment.

Methods

Thirteen youths with PTSD, 18 remitted participants, and 18 control participants underwent functional magnetic resonance imaging (fMRI), while viewing trauma‐related pictures, trauma‐unrelated negative pictures, and scrambled pictures.

Results

Under trauma‐unrelated condition, the neural activity of the left hippocampus in the remitted group was between the two other groups. Under trauma‐related condition, the PTSD and the remitted group exhibited higher neural activity in the right middle occipital gyrus than controls. The remitted group showed higher neural activity in the right parahippocampal gyrus and right lingual gyrus under trauma‐related condition than trauma‐unrelated condition, while no significant difference was found in PTSD group.

Conclusion

PTSD status‐related group differences are mainly reflected in the left hippocampus under the trauma‐unrelated condition, while the hyperactivity in the right middle occipital gyrus under trauma‐related condition could be an endophenotype for PTSD.
Patterns and trends of cancer incidence in children and adolescents in China, 2011–2015: A population‐based cancer registry study
Authors: Sun Kexin , Zheng Rongshou , Zhang Siwei , Zeng Hongmei , Wang Shaoming , Chen Ru , Wei Wenqiang , He Jie
Published: June 2021

Background

Cancer is a major concern for children and adolescents worldwide. This study aims to report on cancer incidence patterns at age 0–19 years in 2011–2015 and their trends in 2000–2015.

Methods

We collected data on malignancies in population of 0–19 years submitted by high‐quality population‐based cancer registries in China. Age‐standardized rates by world standard population (WSR) and annual percent change (APC) were calculated.

Results

In total, 215 cancer registries from 30 provinces contributed datasets during 2011–2015. Twenty‐two registries provided continuous data for trend analysis from 2000 to 2015. In total 16,954 malignancies occurred in 177,416,582 person‐years. WSRs were 93.32 and 96.03 per million person‐years in children aged 0–14 and 0–19 years. Incidence rates were higher in boys than in girls and were higher in urban area than in rural area. In children aged 0–14 years, the top three common diagnostic groups were leukemia, central nervous system (CNS) tumors, and lymphomas in both sexes. In adolescents aged 15–19 years, the top three common diagnostic groups were leukemia, epithelial tumors and melanoma, and CNS tumors in boys and epithelial tumors and melanoma, leukemia, and germ cell and gonadal tumors in girls. WSRs for cancers in 0–19 years of age increased significantly in boys from 2000 to 2005 (APC = 5.3%, 95% CI: 2.3%–8.3%) and in girls from 2000 to 2015 (APC = 1.2%, 95% CI: 0.1%–2.4%).

Conclusions

Cancer incidence in children and adolescents is on the rise in China. The observed age, sex, and geographical variations in cancer incidence should be used to inform targeted prevention and control policies.
Predicting anxiety in cancer survivors presenting to primary care – A machine learning approach accounting for physical comorbidity
Authors: Haun Markus W. , Simon Laura , Sklenarova Halina , Zimmermann‐Schlegel Verena , Friederich Hans‐Christoph , Hartmann Mechthild
Published: June 2021

Background

The purpose of this study was to explore predictors for anxiety as the most common form of psychological distress in cancer survivors while accounting for physical comorbidity.

Methods

We conducted a secondary data analysis of a large study within the German National Cancer Plan which enrolled primary care cancer survivors diagnosed with colon, prostatic, or breast cancer. We selected candidate predictors based on a systematic MEDLINE search. Using supervised machine learning, we developed a prediction model for anxiety by splitting the data into a 70% training set and a 30% test set and further split the training set into 10‐folds for cross‐validating the hyperparameter tuning step during model selection. We fit six different regression models, selected the model that maximized the root mean square error (RMSE) and fit the selected model to the entire training set. Finally, we evaluated the model performance on the holdout test set.

Results

In total, data from 496 cancer survivors were analyzed. The LASSO model (α = 1.0) with weakly penalized model complexity (λ = 0.015) slightly outperformed all other models (RMSE = 0.370). Physical symptoms, namely, fatigue/weakness (β = 0.18), insomnia (β = 0.12), and pain (β = 0.04), were the most important predictors, while the degree of physical comorbidity was negligible.

Conclusions

Prediction of clinically significant anxiety in cancer survivors using readily available predictors is feasible. The findings highlight the need for considering cancer survivors’ physical functioning regardless of the degree of comorbidity when assessing their psychological well‐being. The generalizability of the model to other populations should be investigated in future external validations.
Different and better than you: The interplay between social identity, moral identity, and social comparison
Authors: Rehman Khan Shazia
Published: June 2021

The aim of this research was to answer the question whether moral identity affects the relationship between one's social identity and social comparison. Drawing from the concept of social identity theory, social cognitive theory and self‐consistency theory, it was theorized that moral identity may positively affect the relationship between social identity and social comparison through the importance of group membership for individuals. Two studies were conducted (N = 267, N = 307) for this purpose. The results of the studies lend support to the hypothesized framework, explaining the complex relationship of the moral identity with social identity, and how seeing oneself as moral can fuel social comparison. Thus, the results highlight the boundary condition under which social comparisons will be increased or decreased. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement.
Multi‐level tetrahedralization‐based accelerator for ray‐tracing animated scenes
Authors: Aman Aytek , Demirci Serkan , Güdükbay Uğur , Wald Ingo
Published: June 2021

We describe a hybrid acceleration structure for ray tracing. The hybrid structure is a Bounding Volume Hierarchy (BVH) where the leaf nodes are tetrahedralized for a decent ray‐surface intersection performance. We use the hybrid acceleration structure (BTH) in a two‐level acceleration structure for rendering animated scenes. There is a BVH at the top level in this two‐level structure and the proposed hybrid structure (BTH) at the bottom level. We test the proposed two‐level structure (BVH‐BTH) for various animated scenes and obtained promising results against other acceleration structures in terms of rendering times. The two‐level BVH‐BTH structure outperforms the two‐level BVH structure for the tested dynamic scenes.
Local control editing paradigms for part‐based 3D face morphable models
Authors: Ghafourzadeh Donya , Fallahdoust Sahel , Rahgoshay Cyrus , Beauchamp Andre , Aubame Adeline , Popa Tiberiu , Paquette Eric
Published: June 2021

We propose an approach to construct realistic 3D facial morphable models (3DMM) that allows an intuitive facial attribute editing workflow. Current face modeling methods using 3DMM suffer from a lack of local control. We thus create a 3DMM by combining local part‐based 3DMM for the eyes, nose, mouth, ears, and facial mask regions. Our local principal component analysis (PCA)‐based approach uses a novel method to select the best eigenvectors from the local 3DMM to ensure that the combined 3DMM is expressive, while allowing accurate reconstruction. We provide different editing paradigms, all designed from the analysis of the data set. Some use anthropometric measurements from the literature and others allow the user to control the dominant modes of variation extracted from the data set. Our part‐based 3DMM is compact, yet accurate, and compared to other 3DMM methods, it provides a new trade‐off between local and global control. We tested our approach on a data set of 135 scans used to derive the 3DMM, plus 19 scans that served for validation. The results show that our part‐based 3DMM approach has excellent generative properties and allows the user intuitive local control.
Structured Peer Feedback Exchange in Group Supervision of Beginning Supervisors
Authors: Kemer Gulsah , Rocha Johana , Reiter Alyssa , Dominguez Vanessa N. , Giresunlu Yesim
Published: June 2021

We examined the scope of peer feedback exchanged during group supervision of beginning supervisors throughout a semester‐long doctoral‐level experiential counseling supervision course. Concept mapping revealed 13 clusters representing five areas of beginning supervisors' peer feedback. Supervisors of supervisors and supervisor training programs may use these results to structure experiential supervision experiences.
Thin‐Film Filtration of Difficult‐to‐Filter Suspensions Using Polymeric Membranes
Authors: Lam Zihim , Anlauf Harald , Nirschl Hermann
Published: June 2021

Fine‐grained particle systems build up a highly consolidated and thin layer on the filter medium and cause a high filter cake resistance. The objective of the novel thin‐film filtration process is an effective mechanical separation of these particle systems using membranes on a vacuum drum filter. The mechanical stability of the membrane is evaluated since a roller is required for the cake discharge and the filtration performance is compared with that of a commonly used filter cloth. Analyses reveal that the surface porosity is the crucial factor for the mechanical stability of the membrane. Furthermore, the filter cloth shows a higher filter media resistance than the membrane. A significant increase in the specific dry mass throughput and a particle‐free filtrate could be achieved.
Tumor‐associated lymphocytes and macrophages are related to stromal elastosis and vascular invasion in breast cancer
Authors: Chen Ying , Klingen Tor Audun , Aas Hans , Wik Elisabeth , Akslen Lars A
Published: June 2021

The tumor microenvironment plays a critical role in breast cancer progression. Here, we investigated tumor‐infiltrating lymphocytes (TILs) and associations with macrophage numbers, tumor stromal elastosis, vascular invasion, and tumor detection mode. We performed a population‐based retrospective study using data from The Norwegian Breast Cancer Screening Program in Vestfold County (2004–2009), including 200 screen‐detected and 82 interval cancers. The number of TILs (CD45+, CD3+, CD4+, CD8+, and FOXP3+) and tumor‐associated macrophages (CD163+) was counted using immunohistochemistry on tissue microarray slides. Lymphatic and blood vessel invasion (LVI and BVI) were recorded using D2‐40 and CD31 staining, and the amount of elastosis (high/low) was determined on regular HE‐stained slides. High numbers of all TIL subsets were associated with LVI (p ≤ 0.04 for all), and high counts of several TIL subgroups (CD8+, CD45+, and FOXP3+) were associated with BVI (p ≤ 0.04 for all). Increased levels of all TIL subsets, except CD4+, were associated with estrogen receptor‐negative tumors (p < 0.001) and high tumor cell proliferation by Ki67 (p < 0.001). Furthermore, high levels of all TIL subsets were associated with high macrophage counts (p < 0.001) and low‐grade stromal elastosis (p ≤ 0.02). High counts of CD3+, CD8+, and FOXP3+ TILs were associated with interval detected tumors (p ≤ 0.04 for all). Finally, in the luminal A subgroup, high levels of CD3+ and FOXP3+ TILs were associated with shorter recurrence‐free survival, and high counts of FOXP3+ were linked to reduced breast cancer‐specific survival. In conclusion, higher levels of different TIL subsets were associated with stromal features such as high macrophage counts (CD163+), presence of vascular invasion, absence of stromal elastosis, as well as increased tumor cell proliferation and interval detection mode. Our findings support a link between immune cells and vascular invasion in more aggressive breast cancer. Notably, presence of TIL subsets showed prognostic value within the luminal A category.
Predictive value of the age, creatinine, and ejection fraction score in patients with myocardial infarction with nonobstructive coronary arteries
Authors: Gao Side , Ma Wenjian , Huang Sizhuang , Lin Xuze , Yu Mengyue
Published: June 2021

Background

Little is known about risk stratification in patients with myocardial infarction with nonobstructive coronary arteries (MINOCA). We investigated whether the age, creatinine, and ejection fraction (ACEF) score (age [years]/ejection fraction [%] + 1 [if creatinine >176 μmol/L]) might predict long‐term outcomes after MINOCA.

Hypothesis

The ACEF score enables accurate risk prediction in patients with MINOCA.

Methods

A total of 1179 patients with MINOCA were enrolled and divided based on their ACEF score tertile levels. The primary endpoint was a composite of major adverse cardiovascular events (MACE), including all‐cause death, nonfatal MI, nonfatal stroke, revascularization, and hospitalization for unstable angina or heart failure. Kaplan–Meier and Cox regression analyses were performed. Discrimination was defined as the area under the curve (AUC) using receiver operating characteristic analysis.

Results

During the median follow‐up of 41.7 months, patients with MINOCA with higher ACEF score tertiles had a significantly higher incidence of MACE (6.3%, 12.5%, and 23.8%, respectively; p < .001). The adjusted risk of MACE increased with the rising ACEF score tertiles (1st tertile as reference; 2nd tertile: HR 2.70, 95% CI: 1.38–5.29, p = .004; and 3rd tertile: HR 5.35, 95% CI: 2.72–10.51, p < .001). Moreover, an elevated ACEF score was closely associated with an increased risk of MACE overall (HR 4.23, 95% CI: 3.37–5.30, p < .001) and in subgroups (all p < .05). The ACEF score also yielded a good predictive value (AUC 0.79) for MACE.

Conclusion

Elevated ACEF scores were strongly associated with a poor prognosis after MINOCA. This simple and valid risk score may facilitate risk stratification and decision making in the population with MINOCA.
Gender differences in acute myocardial infarction—A nationwide German real‐life analysis from 2014 to 2017
Authors: Kuehnemund Leonie , Koeppe Jeanette , Feld Jannik , Wiederhold Achim , Illner Julia , Makowski Lena , Gerß Joachim , Reinecke Holger , Freisinger Eva
Published: June 2021

Background

Female sex was reported to be associated with an unfavorable outcome in acute myocardial infarction (AMI). In this nationwide analysis we assessed sex differences in acute outcomes of AMI and recent trends in patient healthcare.

Methods

We analyzed 875 735 German cases hospitalized with a main diagnosis of ST‐ (STEMI) and non ST‐elevation myocardial infarction (NSTEMI) between January 01 2014 and December 31 2017 regarding morbidity, in‐hospital mortality and treatments. A multivariable logistic regression model was designed to evaluate the use of interventions and their impact on in‐hospital mortality.

Results

STEMI cases decreased from 72 894 in 2014 to 68 213 in 2017, with 70% assignable to men. Female sex was associated with older age (74 vs. 62 years), and higher prevalence of cardiovascular risk factors such as chronic kidney disease (19.2% vs. 12.5%), hypertension (69.0% vs. 65.0%) and left ventricular heart failure (36.0% vs. 32.1%). In NSTEMI, female sex was also associated with older age (78 vs. 71 years), and higher prevalence of cardiovascular risk factors such as chronic kidney disease (29.7% vs. 23.9%), hypertension (77.4% vs. 74.5%) and left ventricular heart failure (40.5% vs. 36.4%). Overall, 74.3% of female and 81.3% of male STEMI cases received percutaneous coronary intervention (PCI, p < 0.001). In NSTEMI, PCI was performed in 40.8% of female and 52.0% of male cases (p < 0.001). In‐hospital mortality was notably increased in female patients with STEMI (15.0% vs. 9.6%; p < 0.001; OR 1.07; 95% CI 1.03–1.10) and NSTEMI (8.3% vs. 6.3%; p < 0.001; OR 0.91; 95% CI 0.89–0.93) compared to males.

Conclusions

Our nationwide real‐world data document that in‐patient STEMI cases continue to decrease in women and men. The observed higher in‐hospital mortality in women was largely attributed to a more unfavorable risk and age distribution rather than to female‐intrinsic factors. Women with AMI continue to be less likely to receive revascularization therapies.
Material, behavioral, and psychological financial hardship among survivors of childhood cancer in the Childhood Cancer Survivor Study
Authors: Fair Douglas , Park Elyse R. , Nipp Ryan D. , Rabin Julia , Hyland Kelly , Kuhlthau Karen , Perez Giselle K. , Nathan Paul C. , Armstrong Gregory T. , Oeffinger Kevin C. , Robison Leslie L. , Leisenring Wendy , Kirchhoff Anne C.
Published: June 2021

Background

Medical financial burden includes material, behavioral, and psychological hardship and has been underinvestigated among adult survivors of childhood cancer.

Methods

A survey from 698 survivors and 210 siblings from the Childhood Cancer Survivor Study was analyzed. The intensity of financial hardship was estimated across 3 domains: 1) material, including conditions that arise from medical expenses; 2) behavioral, including coping behaviors to manage medical expenses; and 3) psychological hardship resulting from worries about medical expenses and insurance, as measured by the number of instances of each type of financial hardship (0, 1‐2, and ≥3 instances). Multivariable logistic regressions were conducted to examine the clinical and sociodemographic predictors of experiencing financial hardship (0‐2 vs ≥3 instances).

Results

The intensity of financial hardship did not significantly differ between survivors and siblings. Survivors reported more instances of material hardship than siblings (1‐2 instances: 27.2% of survivors vs 22.6% of siblings; ≥3 instances: 15.9% of survivors vs 11.4% siblings; overall P = .03). In multivariable regressions, insurance was protective against all domains of financial hardship (behavioral odds ratio [OR], 0.12; 95% confidence interval [CI], 0.06‐0.22; material OR, 0.37; 95% CI, 0.19‐0.71; psychological OR, 0.10; 95% CI, 0.05‐0.21). Survivors who were older at diagnosis, female, and with chronic health conditions generally had higher levels of hardship. Brain radiation and alkylating agents were associated with higher levels of hardship.

Conclusions

Material, behavioral, and psychological financial burden among survivors of childhood cancer is common.
Receipt of guideline‐concordant care among young adult women with breast cancer
Authors: White Dolly P. , Kurian Allison W. , Stevens Jennifer L. , Liu Benmei , Brest Ariel E. , Petkov Valentina I.
Published: June 2021

Background

Little is known about the real‐world care of young adult (YA) females (aged 20‐39 years) with breast cancer. This study describes factors associated with the receipt of guideline‐concordant care (GCC) among YAs.

Methods

The authors identified 1259 YA women with invasive breast cancer diagnosed in 2013 in the National Cancer Institute's Patterns of Care study. Hospital records were re‐abstracted, and treatment was verified. Using the National Comprehensive Cancer Network's 2013 breast cancer guidelines, the authors assessed the receipt of GCC by cancer subtype among a subset of YAs (n = 952). Associations between sociodemographic and clinical factors and GCC receipt were examined.

Results

Most YAs were 35 to 39 years old (51.2%) and partnered (56.4%); half had hormone receptor–positive (HR+)/human epidermal growth factor receptor 2–negative (HER2−) tumors. GCC was found for 81.7% of YAs. Relationships between sociodemographic and clinical factors and GCC receipt differed by subtype. Stage was the only significant predictor of GCC receipt for all subtypes (stage II vs III: odds ratio [OR] for HR+/HER2+, 0.20; 95% confidence interval [CI], 0.08‐0.50; OR for HR−/HER2+, 0.13; 95% CI, 0.07‐0.25; OR for HR−/HER2−, 3.86; 95% CI, 1.55‐9.62; OR for HR+/HER2−, 2.81; 95% CI, 1.63‐5.80).

Conclusions

GCC is high among YAs with breast cancer. The effects of sociodemographic factors and treatment facility size on GCC differ by subtype. Consistent with recommendations, tumor biology, not age, is associated with GCC for all subtypes. Future studies should assess the effect of GCC on survival among YAs.
The PREPARE for Your Care program increases advance care planning engagement among diverse older adults with cancer
Authors: Nouri Sarah S. , Barnes Deborah E. , Shi Ying , Volow Aiesha M. , Shirsat Nikita , Kinderman Anne L. , Harris Heather A. , Sudore Rebecca L.
Published: June 2021

Background

Advance care planning (ACP) is low among older adults with cancer. In a secondary analysis of randomized trial data, the authors compared the efficacy of the PREPARE for Your Care (PREPARE) website plus an easy‐to‐read advance directive (AD) with an AD only among older adults with and without cancer.

Methods

Safety net, primary care patients in San Francisco were included if they were 55 years old or older, were English‐ or Spanish‐speaking, and had 2 or more chronic conditions. The authors determined cancer diagnoses by using International Classification of Diseases, Ninth Revision/Tenth Revision codes. The primary outcome was new ACP documentation in the medical record at 15 months; the secondary outcomes were self‐reported ACP engagement, ease of use, satisfaction, and depression/anxiety. The authors used mixed effects logistic and linear regression adjusted for prior ACP, health literacy, and clinician, including a cancer interaction term.

Results

Of 986 participants, 220 (22%) had cancer. The mean age was 63 years (SD, 6 years), 61% were women, 81% were of a minority race/ethnicity, 45% were Spanish‐speaking, 39% had limited health literacy, and 27% had prior ACP. New ACP documentation was higher in the PREPARE arm versus the AD‐only arm among participants with cancer (62% vs 43%; P = .01) and without cancer (38% vs 28%; P = .01), as was ACP engagement in both arms (P < .001), with no interactions by cancer. Ease of use and satisfaction were high, and depression/anxiety was low, with no differences by study arm or by cancer/no cancer.

Conclusions

PREPARE plus an easy‐to‐read AD increased ACP documentation and engagement among diverse older adults with cancer more than an AD alone, with no increase in depression or anxiety between study arms or by cancer. PREPARE may help to decrease ACP disparities among patients with cancer.

Lay Summary

Advance care planning (ACP) is the process of sharing values, goals, and preferences for medical care, but engagement in ACP is low among older adults with cancer.

Among 986 English‐ and Spanish‐speaking older adults from a safety net hospital, an interactive, multimedia, web‐based ACP program (PREPARE for Your Care at https://prepareforyourcare.org/) plus an easy‐to‐read advance directive increased ACP documentation and engagement more than an advance directive alone.

There were no differences in this increase in ACP between older adults with cancer and older adults without cancer. Also, engaging in ACP did not result in increased depression or anxiety.
Multiscale generative adversarial network for real‐world super‐resolution
Authors: Sun Ying , Yang Zhiwen , Tao Bo , Jiang Guozhang , Hao Zhiqiang , Chen Baojia
Published: June 2021

Recently, most deep convolutional neural networks used for image super‐resolution have achieved impressive performance on ideal datasets. However, these methods always fail in real‐world super‐resolution, and the results are blurred and structurally deformed. In this paper, a multiscale generative adversarial network (MGAN) is proposed to alleviate these issues. The model's multiscale loss function can effectively reduce the solution space and obtain the best features to reconstruct the image. The degraded framework based on kernel estimation and noise injection is mainly applied to obtain LR images that share the same domain with real‐world pictures. Moreover, the gradient branch is presented to provide other structural priors for SR processing. Simultaneously, to obtain better visual effects, LPIPS is used for perceptual losses instead of Visual Geometry Group (VGG). The competitive results show that our MGAN model outperforms the state‐of‐the‐art methods, resulting in lower noise and better visual quality, and reflects the superiority in image structure restoration.
A quinazoline‐based bromodomain inhibitor, CN210, ameliorates indomethacin‐induced ileitis in mice by inhibiting inflammatory cytokine expression
Authors: Noguchi Takehisa , Hidaka Kyosuke , Kobayashi Satsuki , Matsumoto Kenjiro , Yoshioka Makoto , Hu Xin , Maloney David J. , Yang Shyh‐Ming , Kato Shinichi
Published: June 2021

Inhibitors of bromodomain and extra‐terminal motif (BET) proteins are emerging epigenetic therapeutics that suppress gene expressions that drive cancer and inflammation. The present study examined anti‐inflammatory effects of a quinazoline‐based BET inhibitor, CN210, in a murine ileitis model. CN210 was given orally 30 min before and 24 h after a subcutaneous administration of indomethacin. Macroscopic and histological evidences of ileitis, mucosal myeloperoxidase (MPO) activity and cytokine expressions were evaluated 48 h after the indomethacin administration. To further characterize the anti‐inflammatory pathways modulated by CN210, its effects on RAW264 cells treated with lipopolysaccharide (LPS) were investigated. Competitive ligand binding and docking studies of CN210 to CREB‐binding protein (CBP) and p300 were also performed. Oral administration of CN210 significantly reduced the severity of ileitis, normalized both proinflammatory MPO activity and concomitant cytokine expressions induced by indomethacin administration. Furthermore, CN210 attenuated the expression of cytokines and reversed the activation of nuclear factor κB (NF‐κB) and mitogen‐activated protein kinases (MAPK) induced by LPS. Competitive ligand binding assays showed that CN210 bound to the bromodomains of two paralogous histone acetyltransferases, CBP and p300, in addition to the bromodomains of BET proteins. Docking studies of CN210 to the bromodomains of CBP and p300 showed a similarity to the binding mode of SGC‐CBP30, a specific CBP/p300 inhibitor. CN210 ameliorates indomethacin‐induced ileitis by inhibiting the expression of inflammatory cytokines through the attenuation of NF‐κB and MAPK pathways. CN210 thus represents a new mode of therapy for non‐steroidal anti‐inflammatory drug‐induced ileitis and inflammatory bowel disease.
Mindfulness‐based interventions for eating disorders: The potential to mobilize multiple associative‐learning change mechanisms
Authors: Roos Corey R. , Sala Margaret , Kober Hedy , Vanzhula Irina A. , Levinson Cheri A.
Published: June 2021

Mindfulness is a two‐component skill that includes mindful awareness (attentional monitoring of present moment experience) and mindful acceptance (adopting an attitude of acceptance toward this experience). Although mindfulness‐based interventions (MBIs) are efficacious for many conditions, there is a lack of research on MBIs for eating disorders (EDs). We propose that MBIs may be promising for EDs given their potential to mobilize not one, but multiple associative‐learning change mechanisms in EDs–defined as adaptive processes of change involving one of two forms of associative‐learning: Pavlovian and operant learning. We hypothesize how MBIs–via increasing either mindful awareness or mindful acceptance–may mobilize up to eight associative‐learning change mechanisms, two involving Pavlovian learning, and six involving operant learning. We also elaborate on similarities and differences between MBIs and CBT approaches for EDs, as well as opportunities for synergy. Finally, we present recommendations for future research related to the development and evaluation of novel MBI interventions for EDs and the testing of mechanisms and patient‐treatment matching hypotheses.
Changes in treatment needs for chronic postoperative hypoparathyroidism during initiation of conventional treatment compared to stable phase of treatment
Authors: Storm Pernille , Underbjerg Line , Rejnmark Lars
Published: June 2021

Introduction

In our clinical experience, need for doses of active vitamin D and calcium supplements changes during the period following a diagnosis of postsurgical hypoparathyroidism (HypoPT), but only sparse data are available. In the present study, we aimed to investigate the magnitude of changes in need for activated vitamin D (alfacalcidol) and calcium supplements during initiation of therapy as well as time to be expected until a stable phase was achieved. Furthermore, we determined the frequency of (unexpected) episodes of hypo‐ and hypercalcaemia after reaching a steady state for alfacalcidol and calcium.

Methods

Retrospective study of twenty‐four patients with chronic postsurgical HypoPT (>6 months) diagnosed from 2016 to 2018. Data were extracted from medical records on doses of alfacalcidol and calcium as well as ionized plasma calcium levels (P‐Ca2+) from time of diagnosis and until 86 weeks after surgery.

Results

Patients were treated with alfacalcidol and calcium in order to maintain a stable concentration of P‐Ca2+. Our data demonstrated a great variation in treatment needs until 11 weeks after surgery, where the mean doses of alfacalcidol stabilize, while calcium doses stabilized a bit earlier. After the stable phase had emerged, 21 out of 24 patients continued to have one or more episodes of spontaneous hypo‐ or hypercalcaemia.

Conclusions

Patients with chronic HypoPT attain a steady state for alfacalcidol 11 weeks after the diagnosis. Continuous monitoring of P‐Ca2+ is of continued importance after reaching steady state due to a high frequency of spontaneous hypo‐ or hypercalcaemia.
Temperature, soil moisture, and microbial controls on CO2 and CH4 emissions from a permafrost peatland
Authors: Song Yanyu , Song Changchun , Hou Aixin , Sun Li , Wang Xianwei , Ma Xiuyan , Jiang Lei , Liu Chao , Gao Jinli
Published: June 2021

Peatlands are significant carbon dioxide (CO2) sinks and methane (CH4) sources. In this study, we investigated changes in CO2 and CH4 emissions from topsoil (0–20 cm) to subsoil (20–40 cm) in a permafrost peatland, and the related soil microbial abundance in response to increasing temperature and soil water content by using an incubation experiment. Our results indicated that CO2 and CH4 emissions from the permafrost peatland are highly sensitive to temperature and soil water content. CO2 emissions from topsoil and subsoil at 15°C were 3.36 and 2.74 times larger, respectively, compared to those at 5°C under the field moisture condition, and were 1.70 times larger under the waterlogged treatment in both topsoil and subsoil. CH4 emissions from 0–20 to 20–40 cm soils at 15°C were 34 and 83 times larger, respectively, than those at 5°C under the original state and 17 and 32 times larger under the waterlogged treatment. These results indicated that CH4 emissions are more sensitive than CO2 emissions, and waterlogged conditions could decrease temperature sensitivity of CO2 and CH4 emissions. Microbial analyses showed that the cumulative emissions amount of CO2 positively correlated with bacterial, fungal, and methanotroph abundances. Positive relationships were observed between CH4 emissions and abundances of bacteria, fungi, and archaea. These findings suggested that changes in temperature and water content alter CO2 and CH4 emissions from permafrost peatlands through controlling abundances of soil bacteria, fungi, archaea, and methanotrophs. These variables bear importance in accurately estimating C emissions from permafrost peatlands.
Experimental testing of hybrid sliding‐rocking bridge columns under torsional and biaxial lateral loading
Authors: Salehi Mohammad , Sideris Petros , Liel Abbie B.
Published: June 2021

Hybrid sliding‐rocking (HSR) bridge columns are precast concrete segmental columns with unbonded posttensioning, end rocking joints, and intermediate sliding joints. Having been developed for construction in seismic regions, HSR columns offer self‐centering, energy dissipation, and low damageability. Recent advances in the computational modeling of HSR columns have resulted in the proposal of a number of refinements to their original design, leading to the introduction of Second‐Generation HSR columns. Compared to First‐Generation HSR columns, Second‐Generation HSR columns use a reduced number of sliding joints made of high‐performance polytetrafluoroethylene (PTFE) materials to provide desirable levels of sliding and frictional energy dissipation. The seismic performance of Second‐Generation HSR columns was recently investigated through an extensive experimental study. The present paper discusses the major results of the tests performed on two half‐scale HSR column specimens under combined lateral‐torsional loading and biaxial lateral loading to demonstrate their performance under such loading scenarios. A variety of loading protocols were used to test each column specimen, including both cyclic and arbitrary paths. Both columns sustained minimal damage under displacement demands representing 975‐ and 2475‐year seismic hazards, meeting their design objectives. Because of the torsional sliding at sliding joints, the column subjected to lateral‐torsional loading did not exhibit any distinct torsional damage. The biaxial lateral loading was, however, found more damaging to HSR columns than torsional and uniaxial lateral loading.