bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of rotational and orbital atherectomy for the treatment of calcific coronary lesions: Insights from the VA clinical assessment reporting and tracking (CART) program
Authors: Barrett Christopher , Warsavage Theodore , Kovach Christopher , McGuinn Erin , Plomondon Mary E. , Armstrong Ehrin J. , Waldo Stephen W.
Published: May 2020

Background

Previous studies suggested that pre‐treatment of coronary artery calcification (CAC) with rotational atherectomy (RA) prior to stent deployment improved procedural success but was not associated with a concomitant improvement in clinical outcomes. Orbital atherectomy (OA) has demonstrated similar benefits, though there are few data comparing the safety and efficacy of the two modalities.

Methods

Patients who underwent PCI of a native coronary lesion with RA or OA from 2014 to 2018 within the Veterans Affairs Healthcare System were identified. Propensity matched cohorts were generated to compare the clinical and safety outcomes following either RA or OA. The primary endpoint was the rate of 30‐day major adverse cardiovascular and cerebrovascular events (MACCE), including all‐cause mortality, repeat myocardial infarction, target vessel revascularization, and stroke.

Results

We identified 1,091 patients that underwent atherectomy during the study period, 640 (59%) treated with RA and 451 (41%) treated with OA. Among a propensity‐matched cohort consisting of 950 patients, there was no significant difference in MACCE for patients who underwent RA or OA (7.1 vs. 8.2%, p = .36). Components of the primary outcome including 30‐day mortality, myocardial infarction, target vessel revascularization, and stroke were also similar in the matched cohort. Additionally, procedural complications including perforation, no‐reflow, dissection, and in‐stent thrombosis were comparable across both treatment strategies.

Conclusions

Both rotational and orbital atherectomy are safe and effective strategies for the treatment of calcified coronary plaque prior to stent deployment, with similarly low rates of peri‐procedural adverse events.
Prompt treatment of disseminated HSV‐2 infection in a patient with compromised cellular immunity: A case of aborted hemophagocytic lymphohistiocytosis?
Authors: Tsimpidakis Antonios , Tsilingiris Dimitrios , Remountaki Eleni , Zouridaki Eftychia , Rigopoulos Dimitrios , Nicolaidou Electra
Published: May 2020

Recognition of unusual manifestations such as disseminated HSV or HSV‐related hemophagocytic lymphohistiocytosis among individuals with impaired cellular immunity and prompt treatment initiation are essential for a favorable outcome.
The Structure and Liquid Flow Effect of Melt during NaCl Crystal Growth
Authors: Li Yongtao , Li Yongju , Yang Zhenxiao , Zhang Xuejian , Zeng Fanming , Li Chun , Lin Hai , Su Zhongmin , Mahadevan Chelliah Kamalakshiammal , Liu Jinghe
Published: May 2020

The quasi‐lattice model of NaCl melt is proposed by the ion movement characteristics, melt structure, and radial distribution function of ions, which is composed of regular and irregular regions. These regions are connected by an irregular interface with a thickness of several sublayers, and the ions on the interface are continuously and rapidly transferred. The mixed transmission kinetic equation of NaCl melt is analyzed theoretically by using the heat transfer equation and hydrodynamic equation. The liquid flow effect of NaCl melt and the temperature distribution in crystal are analyzed according to the numerical results. It is found that the shape of a solid–liquid interface will change with the rotation rate or diameter increase. The related properties of the NaCl melt are calculated. These studies of the NaCl melt provide theoretical support to a further study on crystal growth, other alkali halide, and alkaline earth metal halide melt.
Research on spiking rat EPO as internal standard in doping control samples for detection of EPO using SAR‐PAGE analysis with biotinylated primary antibody
Authors: Zhou Xinmiao , He Sen , Zhang Lisi , Shen Li , He Chunji
Published: May 2020

According to the current Technical Document (TD) for erythropoietin (EPO), SAR‐PAGE is the most commonly applied method for both screening and confirmation procedures. Although this method is effective and robust, it lacks an internal standard (IS) to monitor the efficiency of analysis for each sample covering every step of the whole procedure, including preparation, immunopurification, and western blotting. This internal standard needs to be recognized by both anti‐EPO antibodies used for immunopurification and western blotting, respectively. Besides that, the band of IS could not be allowed to interfere with the recognition of all types of targeted EPO and analogs. To meet these two principles, rat EPO was selected. In this study, rat EPO was used to spike both urine and blood samples at the beginning of analysis. After preparation and immunopurification, single blotting was performed with biotinylated AE7A5 as the primary antibody, followed by incubation with streptavidin‐coupled HRP. Based on the comparison of different immunopurification methods, the AB‐286‐NA antibody coupled to M‐280 magnetic beads was the better choice for urine samples, whereas the MAIIA column was suitable for blood samples. All these methods were validated for selectivity, repeatability, and sensitivity. The modified method in this study could not only eliminate the cross‐reactivity between antibodies but also monitor the whole procedure of the analysis of EPO with spiked rat EPO. Besides that, rat EPO could also be used as an indicator for monitoring the presence of protease(s) in urine samples.
Quantification and validation of nine nonsteroidal anti‐inflammatory drugs in equine urine using gas chromatography–mass spectrometry for doping control
Authors: Göktaş Eylem Funda , Kabil Erol , Arıöz Filiz
Published: May 2020

Nonsteroidal anti‐inflammatory drugs (NSAIDs) are commonly used in therapeutic doses in human and veterinary medicine for the treatment of inflammation, pain, and fever. A method for the simultaneous determination of nine NSAIDs, known as therapeutic prohibited substances, in equine urine was developed and fully validated according to the European Commission Decision 2002/657/EC and Association of Official Racing Chemists criteria. The validation was performed for naproxen, flunixin, ketoprofen, diclofenac, eltenac, meclofenamic acid, phenylbutazone, vedaprofen, and carprofen in equine urine in accordance with the International Screening Limits (ISL) regulated by International Federation of Horseracing Authorities. After basic hydrolysis, samples were extracted with a C18 cartridge using automated solid‐phase extraction. Several derivatization reagents were investigated, and trimethylphenylammonium hydroxide/methanol (20/80, v/v) was selected. Analyses were carried out using gas chromatography–mass spectrometry with selected ion monitoring mode, but the method can be applied to a large number of analytes. The within‐laboratory reproducibility was not more than 12.8% (≤15%), and mean relative recoveries ranged from 91.1% to 104.1% for inter‐day and intra‐day precision. The decision limits (CCα) and detection capabilities (CCβ) were evaluated at concentrations near the ISL for each therapeutic substance. The validation results demonstrated that the method is highly reproducible, easily applicable, and suitable for the analysis of some NSAIDs in equine urine that have not been previously published. Finally, the method was also applied to known positive samples.
Digital technology can revolutionize mental health services delivery: The COVID‐19 crisis as a catalyst for change
Authors: Taylor C. Barr , Fitzsimmons‐Craft Ellen E. , Graham Andrea K.
Published: May 2020

The unprecedented COVID‐19 crisis presents an imperative for mental health care systems to make digital mental health interventions a routine part of care. Already because of COVID‐19, many therapists have rapidly moved to using telehealth in place of in‐person contact. In response to this shift, Waller and colleagues compiled a series of expert recommendations to help clinicians pivot to delivering teletherapy to address eating disorders during COVID‐19. However, numerous barriers still impede widespread adoption and implementation of digital interventions. In this commentary, we aim to extend the recommendations for clinicians offered by Waller and colleagues by presenting a roadmap of the systems‐ and policy‐level requirements that are needed. We advocate for addressing barriers associated with training, licensing, safety, privacy, payment, and evaluation, as these factors have greatly limited use of these promising interventions. We also indicate that longer‐term goals should include introducing truly innovative digital mental health practices, such as stepped‐care models and simultaneously providing preventive and self‐management services in addition to clinical services, into the health care system. Now is the time to catalyze change and comprehensively address the barriers that have prevented widespread delivery of these efficacious digital services to the millions of people who would benefit.
Fermentation Improves Calcium Bioavailability in Moringa oleifera leaves and Prevents Bone Loss in Calcium‐deficient Rats
Authors: Dai Jiahe , Tao Liang , Shi Chongyin , Yang Shuwen , Li Depeng , Sheng Jun , Tian Yang
Published: May 2020

Nowadays, there is an increasing demand of healthier plant calcium supplements. Moringa oleifera leaves (MOL) are rich in calcium and thus are promising candidates for developing efficient calcium supplements. Here, using fermentation‐based approaches, we developed a Moringa oleifera leaf ferment (MOLF), which contents higher levels of calcium. The therapeutic potential of the MOLF was also examined both in vitro and in vivo. Nine lactic acid bacteria and four yeasts were tested for better fermentation of MOL. Calcium‐deficient rats were used for evaluating the therapeutic effects of MOLF. The results of liquid fermentation showed that the mixture of Lactobacillus reuteri, Lactobacillus acidophilus, and Candida utilis elevated the content of MOL calcium most strikingly, with the content of calcium increased nearly 2.4‐fold (from 2.08% to 4.90%). The resulting MOLF was then subjected to cell experiments and animal experiments. The results showed that calcium absorption in Caco‐2 cells in MOLF group was higher than that in CaCl2 group significantly. Interestingly, in calcium‐deficient rats, MOLF treatment significantly increased the thickness of cortical bone, rat body weight, wet weight of the femur, and the femur bone density, whereas it decreased osteoclast numbers. These results indicate that microbial fermentation increased calcium bioavailability of MOL, promote the growth and development of calcium‐deficient rats, bone calcium deposition, and bone growth; enhance bone strength; reduce bone resorption; and prevent calcium deficiency.
Profiling global cancer incidence and mortality by socioeconomic development
Authors: Lortet‐Tieulent Joannie , Georges Damien , Bray Freddie , Vaccarella Salvatore
Published: May 2020

Economic and living conditions have improved over time in most countries, although often in association with detrimental lifestyle and environmental changes that are major determinants of cancer. In this ecological study, we assess the association between national socioeconomic levels and incidence and mortality rates for all cancers combined and 27 cancer types, in 175 countries. We obtained national level cancer incidence and mortality estimates for 2018 from GLOBOCAN and computed an index of socioeconomic development based on national education and income levels extracted from the United Nations Development Programme. Cancer incidence rates are strongly positively associated with the national socioeconomic level for all cancers combined and for a large number of cancer types, in both sexes. Conversely, the association between socioeconomic development and cancer mortality rates is less clear. The most common pattern for type‐specific cancers is an increasing incidence rate with a relatively stable mortality rate as socioeconomic development increases. Despite the high incidence rates for many cancer types, mortality rates are relatively low in high‐income countries, partly due to the availability of early detection and effective treatments. As socioeconomic development continues to rise, countries with currently low‐ and medium‐development levels may experience large increases in the incidence of several cancers. Given the limited resources and lack of infrastructure, increases in incidence rates in low‐income countries will likely be paralleled by increases in mortality rates. Efforts to plan, implement and evaluate prevention programs must therefore be considered as greater priorities in Low‐ and Middle‐income countries.
Risk of QTc prolongation among cancer patients treated with tyrosine kinase inhibitors
Authors: Abu Rmilah Anan A. , Lin Grace , Begna Kebede H. , Friedman Paul A. , Herrmann Joerg
Published: May 2020

QTc interval prolongation can lead to life‐threatening complications such as Torsade de Pointes (TdP), ventricular tachycardia (VT) and sudden cardiac death (SCD). It can occur with tyrosine kinase inhibitors (TKIs) but comparative real‐world analyses on the incidence and complication rates are scarce. We retrospectively reviewed all cancer patients treated with TKI therapy at Mayo Clinic between January 2005 and December 2018 and had at least two ECGs (before and after TKI). For each TKI type, we determined the administration rate and incidence of QTc prolongation. QTc prolongation was defined as a corrected QT interval (by Fridericia formula) ≥450 ms in men and ≥470 ms in women. A total of 618 cancer patients were included with 902 TKI administrations, of which 654 (72.5%) were accounted for by pazopanib, sunitinib, imatinib, nilotinib and dasatinib. QTc prolongation (any grade) was reported in 28.8%, most commonly with nilotinib (38.7%) and dasatinib (41.7%). A QTc interval ≥500 ms and a QTc increase ≥60 ms was documented in 46 and 63 administrations, respectively. Life‐threatening toxicity was seen in 14 cases (5.4% of QTc prolongation cases) including VT in 9, SCD in 3 and TdP in two administrations. The response to QTc prolongation was: discontinuation in 68%, dose reduction in 13.5%, temporary hold in 8.1% and no action in 10.4%. In conclusion, QTc prolongation with TKI therapy is very common (∼1/3 of cases) and in 5% (1.7% overall) associated with life‐threatening complications. These data support recommendations for careful ECG monitoring in cancer patients undergoing TKI therapy.
Impact of cervicitis on performance of cervical cancer screening using HRHPV testing and visual evaluation in women living with HIV in Botswana
Authors: Painter Helena , Erlinger Adrienne , Simon Boikhutso , Morroni Chelsea , Ramogola‐Masire Doreen , Luckett Rebecca
Published: May 2020

Cervicitis may affect the accuracy of cervical cancer screening in women living with HIV, even when testing for high‐risk HPV is used.
Long intergenic noncoding RNA 00021 promotes glioblastoma temozolomide resistance by epigenetically silencing p21 through Notch pathway
Authors: Zhang Shitao , Guo Shiwen , Liang Chen , Lian Minxue
Published: May 2020

Increasing findings are suggesting the vital roles of long noncoding RNAs (lncRNAs) in the glioblastoma tumorigenesis. However, whether the novel lncRNA LINC00021 modulates temozolomide (TMZ) resistance of glioblastoma is still unclear. Clinically, lncRNA LINC00021 was significantly up‐regulated in glioblastoma, especially the TMZ‐resistant tissue and cells, and the LINC00021 overexpression was closely correlated to TMZ resistance and unfavorable prognosis. Functionally, LINC00021 positively promoted the TMZ resistance and reduced apoptosis. Mechanistically, transcription factor E2F1 activated the expression of LINC00021. Moreover, LINC00021 regulated the glioblastoma TMZ resistance through Notch pathway and epigenetically silenced p21 expression via recruiting EZH2. Collectively, present research indicates the critical roles of lncRNA LINC00021 in glioblastoma genesis, providing a novel insight for TMZ resistance in glioblastoma.
Evaluation of phase transformation behaviors of zeolite and antibacterial properties against Gram‐positive and ‐negative bacteria
Authors: Ishak Siti Nabihan , Malek Nik Ahmad Nizam Nik , Yusop Zulkifli , Williams Craig D. , Suhartono Suhartono , Syafiuddin Achmad
Published: May 2020

This study deals with the synthesis of zeolite from natural kaolinite using hydrothermal treatment and evaluation of its phase transformation behaviors. The synthesized zeolites were modified with silver ion by using the ion exchange method for the enhancement of antibacterial properties. The characterizations were performed by using X‐ray diffraction spectroscopy, Fourier‐transform infrared spectroscopy, field emission scanning electron microscopy, and energy‐dispersive X‐ray. Disk diffusion technique (DDT) was used for the evaluation of the antibacterial property of the modified zeolites. This study observed the transformation of kaolinite into amorphous metakaolin after calcination treatment at 900°C and the successful reconstruction of amorphous metakaolin into synthesized crystal zeolite in the presence of sodium hydroxide as an activating agent. It was also found that the zeolite type A was produced at 100°C, while sodalites were produced at 120 and 140°C. DDT analysis revealed that the modified zeolites showed significant antibacterial capability against Escherichia coli ATCC 11229 and Staphylococcus aureus ATCC 6538. In general, the present study has proven that the zeolites can be synthesized from natural material and can be modified with silver ion to enhance their antibacterial activity.
Developing knowledge‐based planning for gynaecological and rectal cancers: a clinical validation of RapidPlan™
Authors: Shepherd Meegan , Bromley Regina , Stevens Mark , Morgia Marita , Kneebone Andrew , Hruby George , Atyeo John , Eade Thomas
Published: May 2020

Introduction

To create and clinically validate knowledge‐based planning (KBP) models for gynaecologic (GYN) and rectal cancer patients. Assessment of ecologic generalisability and predictive validity of conventional planning versus single calculation KBP was reviewed against practical metrics of planning time (PT) and radiation oncologist plan preference.

Method

Study cohorts were 34 and 42 consecutively treated GYN and rectal cancer patients dosimetrically archived within the centre’s research databank. For model training, structures and dose distributions from 22 and 32 GYN and rectal volumetric‐modulated arc therapy (VMAT) plans were used in RapidPlan™. Prescription doses ranged from 45 to 60Gy in 25 fractions using a simultaneous integrated boost to 2–4 targets and up to 9 organ‐at‐risk volumes. For model validation, 12 GYN and 10 rectal were independent of the archive and a single pass KBP VMAT plan was created. Each plan was evaluated against the archived treated plan under blinded conditions for radiation oncologist preference using standard dosimetric quality parameters.

Results

All 22 plans generated in the KBP validation cohort met pre‐set GYN and rectal cancer dosimetric quality metrics. Fifty per cent of GYN plans and eighty per cent of rectal plans were judged superior to the manually optimised plans. KBP reduced PT considerably for both tumour sites.

Conclusion

Single pass KBP for GYN and rectal cancer patients produced clinically acceptable treatment plans which were non‐inferior to conventionally optimised plans in 14 of 22 cases. Efficiencies captured by KBP will have predictable impacts on institutional workflows and resource allocation to facilitate adaptive planning.
Full wave numerical analysis of wideband and high directive log spiralTHzphotoconductive antenna
Authors: Dhiflaoui Amira , Yahyaoui Ali , Yousaf Jawad , Aguili Taoufik , Hakim Bandar , Rmili Hatem , Mittra Raj
Published: May 2020

This study presents, for the first time, a novel design of ultra‐wideband (UWB), circularly polarized and highly directive log‐spiral THz photoconductive antenna. The proposed antenna is simulated in High Frequency Structure Simulator using gold as the antenna electrode material which is backed by a quartz substrate (εr= 3.78, tan δ = 0.0001) and hemispherical silicon‐based lens with a diameter of 140 μm. A comprehensive detailed parametric study of the antenna design parameters is performed in the frequency range of 1 to 6 THz for the optimal design of the developed antenna structure. The optimal antenna structure with integrated lens has UWB characteristics with −10 dB impedance bandwidth of 5 THz and 3 dB axial ratio bandwidth of around 4 THz. The observed directivity and half‐power beam width of the presented design varies in the range 5 to 12 dBi and 34° to 62°, respectively, for the frequency range of 1 to 4 THz. The wideband, high directivity as well as high‐efficiency (>50%) characteristics of the proposed design make it a favorable choice for the THz sensing and imaging applications.
Evidence linking the role of periodontal viruses in coronary artery disease with and without periodontitis
Authors: Ilango Paavai , Mahendra Jaideep , Mahendra Little , Cherian Sanjay M. , Kathaperumal Kumanan , Suresh Vasugi , Mahalingam Arulpari , T. Abirami
Published: May 2020

Background

Viruses are considered to be a newer family associated with inflammatory diseases. Yet the role of periodontal viruses in coronary artery diseases (CAD) remains unclear. Thus, the current study aims to evaluate the prevalence of periodontal viruses and compare the same in cardiac samples of CAD patients with and without periodontitis.

Methods

A total of 60 patients with CAD indicated for coronary artery bypass graft surgery (CABG) were included. These were grouped into 36 patients with healthy periodontium (CAD only) and 24 patients with periodontitis (CAD + P). The demographic variables, cardiac parameters and periodontal parameters were recorded. Cardiac tissue samples were collected during the CABG surgery and were analyzed by reverse transcriptase polymerase chain reaction for periodontal viruses such as Epstein‐Barr virus (EBV), cytomegalovirus (CMV) and Herpes simplex virus. All the parameters were statistically analyzed.

Results

Among the demographic variables, age was statistically significant between the groups. Plaque index, bleeding index, probing depth, and clinical attachment level (CAL) were significantly higher in CAD+P group (P˂0.05). Periodontal viruses such as EBV and CMV were significantly higher (62.5% and 75% respectively,P˂0.05) in the cardiac samples of the CAD+P than CAD only (25% and 47.2%, respectively). A significant association between EBV and CAL was revealed by multiple logistic regression analysis. (B = 0.374,P = 0.046)

Conclusions

The results revealed a higher prevalence of periodontal viruses such as EBV and CMV in CAD patients with periodontitis suggesting it as one of the risk factors for CAD. This is supported by the fact that severity of periodontal disease (CAL) is associated with the presence of EBV in coronary artery plaque samples in the current study.
Diagnosis of peri‐implant status after peri‐implantitis surgical treatment: Proposal of a new classification
Authors: Ravidà Andrea , Galli Matthew , Siqueira Rafael , Saleh Muhammad H. A. , Galindo‐Moreno Pablo , Wang Hom‐Lay
Published: May 2020

Background

The 2017 World Workshop classified peri‐implant diseases into health, peri‐implant mucositis, and peri‐implantitis. The aim of this article is to build upon this recent classification and propose a framework for the diagnosis of peri‐implant status after surgical treatment for peri‐implantitis.

Methods

A literature review was conducted to discuss the relevant diagnostic, clinical, and radiographic parameters, including probing depth, bleeding on probing, visual inspection, and radiographic bone loss. Case definitions of possible treatment outcomes were discussed, and a flowchart was constructed to guide post‐treatment diagnosis according to the possible clinical scenarios which can be encountered in daily practice.

Results

Three possible treatment outcomes were identified after resective treatment of peri‐implantitis: 1) peri‐implant health with a reduced support, 2) peri‐implant mucositis with a reduced support, and 3) recurrent/refractory peri‐implantitis. After regenerative treatment for peri‐implantitis, the peri‐implant condition was classified according to the same diagnoses with the addition of peri‐implant health or peri‐implant mucositis after complete regeneration for cases where complete regeneration was attained. Criteria for successful treatment of peri‐implantitis were proposed. After resective therapy, a successful treatment outcome was defined as peri‐implant health with a reduced support, whereas, after regenerative therapy, a successful outcome was described as either peri‐implant health after complete regeneration or peri‐implant health with a reduced support.

Conclusions

The proposed classification system of peri‐implant status after surgical treatment for peri‐implantitis provides a framework for diagnosing the various forms of peri‐implant stability or disease to guide clinical decision‐making post‐treatment.
Characterization of a Jian‐like sherd with the optical microscope, confocal Raman, wavelength‐dispersive X‐ray fluorescence, and portable XRF spectrometers
Authors: Simsek Franci Gulsu , Akkas Tugce , Yildirim Sinem , Yilmaz Suat , Birdevrim Ahmet Nejat
Published: May 2020

The ceramic masterpieces that belong to the private collections and art galleries are rarely studied with analytical instruments to define the authenticity, provenance, and characteristics of the materials because the scientific investigations are required to be solely noninvasive for characterizing the unfractured genuine objects. A monographic program, Blue Print, which was initiated by a German cultural heritage foundation, Art & Science Endowment Trust (ASET) Stiftung, aims at developing on‐site research protocols for systematic research investigations on the fragmentary samples, with and without verifiable archeological contexts. For that reason, a combination of analytical techniques was carried out on a Jian‐like sherd, which was assumed to be produced either as a genuine artifact between the 11th and late 14th centuries ad or as a Qing Dynasty copy (1644–1911 ad). Before slicing the sherd, confocal Raman microscopy was used to define the red glaze signature and the crystals formed on the glazed surface, whereas portable X‐ray fluorescence (XRF) (pXRF) was used to define the composition of the glaze and body. Afterward, the sherd was cut and polished for the characterization with a zoom microscope, wavelength‐dispersive XRF (WD‐XRF), and Raman. The macroscopic examination revealed the presence of a glassy black colored interface layer, which was detected between the body and red glaze. The composition of the red glaze was determined with XRF and Raman spectrometers, and the presence of cadmium sulfoselenide (CdSxSe1−x, 0 ≤ x ≤ 1) with a high amount of zirconium (WD‐XRF: 2.20 wt.%, pXRF: 1.55‐wt.% ZrO2) was found. Additionally, Raman measurements evidenced the presence of epsilon‐hematite crystals formed on the blackened red glazed surface. Unlike the glaze composition, the elemental content of the body is almost the same (Al2O3: 25.7 wt.%, Fe2O3: 8.19 wt.%, K2O: 2.54 wt.%) with the genuine Jian wares already documented by artistic and scientific examinations.
Effects of anxiety on dental students' noncognitive performance in their first objective structured clinical examination
Authors: Wu Ju‐Hui , Du Je‐Kang , Lee Chen‐Yi , Lee Huey‐Er , Tsai Tsuen‐Chiuan
Published: May 2020

Patient‐dentist discourse is a core nonoperational competency in dental education. The skills of querying patients and responding to questions are noncognitive attributes, and their evaluation by the standardized patient objective structured clinical examination (OSCE) is particularly necessary. However, it is not clear whether students' test anxiety affects these attributes. This study aims to examine the relationship between dental students' state‐trait anxiety, noncognitive performance, and examination results during their first OSCE. A single dental school cohort (n = 226) of 5 year students attending their first clinical examination from 2014 to 2017 was studied. Participants completed the Chinese Mandarin Version State‐Trait Anxiety Inventory Y form before taking the OSCE. The difference between state and trait anxiety levels was compared by paired t test. Gender differences and the effect of age group in these anxiety levels were analyzed using multivariate analysis of variance. Moreover, gender, age group, state anxiety, and trait anxiety scores were compared with the OSCE items of noncognitive performance using a chi‐square test. Students showed significantly higher state anxiety than trait anxiety levels; moreover, women showed significantly higher state anxiety than men. Furthermore, gender, age group, state anxiety, and trait anxiety had no association with the noncognitive performance examination results. Most participants showed moderate state and trait anxiety levels during their first OSCE. Further, the state‐trait anxiety had no significant effect on their noncognitive performance. However, 26.5% of participants did not pass the examination; therefore, dental educators should increase communication skill training courses during clerkship training to improve students' noncognitive attributes.
Academic Affiliation and Surgical Volume Predict Survival in Head and Neck Cancer Patients Receiving Surgery
Authors: Farquhar Douglas R. , Masood Maheer M. , Lenze Nicholas R. , Sheth Siddharth , Patel Samip N. , Lumley Catherine , Zanation Adam M. , Weissler Mark C. , Olshan Andrew F. , Hackman Trevor G.
Published: May 2020

Objective

To determine whether the academic affiliation or surgical volume affects the overall survival (OS) of human papillomavirus (HPV)–negative head and neck squamous cell carcinoma (HNSCC) patients receiving surgery.

Methods

A retrospective study of 39 North Carolina Medical Centers was conducted. Treatment centers were classified as academic hospitals, community cancer centers, or community hospitals and were divided into thirds by volume. The primary outcome was 5‐year OS. Hazard ratios (HR) were determined using Cox proportional hazard models, adjusting for demographics, tumor site, stage, insurance status, tobacco use, alcohol use, stage, chemotherapy, and radiation therapy. Patients were also stratified by stage (early stage and advanced stage).

Results

Patients treated at community cancer centers had significantly better 5‐year OS (HR 0.68, 95% confidence interval [CI] = 0.48–0.98), and patients treated at academic hospitals trended toward better 5‐year OS (HR 0.72, 95% CI = 0.50–1.04) compared to patients treated at community hospitals. The effect for academic affiliation on survival was more pronounced for patients with advanced stage cancer at diagnosis (HR 0.60, 95% CI = 0.37–0.95). There were no significant survival differences among early stage patients by treatment center type. Top‐third (HR = 0.64, 95% CI = 0.42–0.96) centers by surgical volume had significantly better 5‐year OS, and middle‐third (HR = 0.71, 95% CI = 0.51–1.03) centers by volume trended toward better 5‐year OS when compared to the bottom‐third centers by volume.

Conclusion

Patients treated at academic hospitals, community cancer centers, and hospitals in the top third by case volume have favorable survival for HPV‐negative HNSCC. The effect for academic hospitals is most pronounced among advanced stage patients.

Level of Evidence

4 Laryngoscope, 131:E479–E488, 2021
Chronic Aspiration Pneumonitis Caused by Spontaneous Cerebrospinal Fluid Fistulae of the Skull Base
Authors: Or Maya , Buchanan Ian A. , Sizdahkhani Saman , Hurth Kyle , Amba Samridhi , Seltzer Justin , Khan Roozehra A. , Brunswick Andrew S. , Wrobel Bozena B. , Zada Gabriel
Published: May 2020

Objectives/Hypothesis

Spontaneous cerebrospinal fluid (CSF) leaks of the skull base are associated with obesity, multiparity, and elevated intracranial pressure. Although spontaneous CSF leaks often present with rhinorrhea, they can be an underdiagnosed cause of chronic aspiration pneumonitis, a complication that has not been previously reported in detail.

Study Design

Retrospective case series.

Methods

The authors retrospectively reviewed all patients undergoing surgical repair of CSF fistulae at the University of Southern California between 2011 and 2018 to identify those presenting with pulmonary symptoms including dyspnea, aspiration, chronic cough, and shortness of breath caused by chronic noniatrogenic CSF pneumonitis.

Results

Symptomatic chronic pneumonitis was evident in six of 20 patients with spontaneous CSF rhinorrhea. Five women (mean body mass index = 36) had CSF leaks arising from the fovea ethmoidalis (n = 4) and lateral sphenoid region (n = 1). One man had a middle fossa floor dehiscence draining through the eustachian tube. All patients had bilateral ground‐glass opacities in their lungs on computed tomography imaging that were attributed to spontaneous CSF fistulae arising from noniatrogenic skull base defects, and one patient underwent a biopsy of a lung lesion at another hospital showing chronic bronchiolitis and adjacent peribronchiolar metaplasia. Five patients underwent endoscopic endonasal repair using an autologous fascial graft and pedicled nasoseptal flap, and one underwent craniotomy for repair. All patients underwent successful repair with no complications or evidence of recurrence. Upon repair of the spontaneous CSF leaks, both pneumonitis symptoms and ground‐glass opacities on imaging resolved in all six cases.

Conclusions

Skull base CSF fistulae should be considered as a reversible cause of chronic pneumonitis that is not alleviated or worsens with standard treatment.

Level of Evidence

4 Laryngoscope, 131:462–466, 2021
The role of sodium channels in sudden unexpected death in pediatrics
Authors: Rochtus Anne M. , Goldstein Richard D. , Holm Ingrid A. , Brownstein Catherine A. , Pérez‐Palma Eduardo , Haynes Robin , Lal Dennis , Poduri Annapurna H.
Published: May 2020

Background

Sudden Unexpected Death in Pediatrics (SUDP) is a tragic event, likely caused by the complex interaction of multiple factors. The presence of hippocampal abnormalities in many children with SUDP suggests that epilepsy‐related mechanisms may contribute to death, similar to Sudden Unexplained Death in Epilepsy. Because of known associations between the genes SCN1A and SCN5A and sudden death, and shared mechanisms and patterns of expression in genes encoding many voltage‐gated sodium channels (VGSCs), we hypothesized that individuals dying from SUDP have pathogenic variants across the entire family of cardiac arrhythmia‐ and epilepsy‐associated VGSC genes.

Methods

To address this hypothesis, we evaluated whole‐exome sequencing data from infants and children with SUDP for variants in VGSC genes, reviewed the literature for all SUDP‐associated variants in VGSCs, applied a novel paralog analysis to all variants, and evaluated all variants according to American College of Medical Genetics and Genomics (ACMG) guidelines.

Results

In our cohort of 73 cases of SUDP, we assessed 11 variants as pathogenic in SCN1A, SCN1B, and SCN10A, genes with long‐standing disease associations, and in SCN3A, SCN4A, and SCN9A, VGSC gene paralogs with more recent disease associations. From the literature, we identified 82 VGSC variants in SUDP cases. Pathogenic variants clustered at conserved amino acid sites intolerant to variation across the VGSC genes, which is unlikely to occur in the general population (p < .0001). For 54% of variants previously reported in literature, we identified conflicting evidence regarding pathogenicity when applying ACMG criteria and modern population data.

Conclusion

We report variants in several VGSC genes in cases with SUDP, involving both arrhythmia‐ and epilepsy‐associated genes. Accurate variant assessment as well as future studies are essential for an improved understanding of the contribution of sodium channel‐related variants to SUDP.
Three‐dimensional vector field inversion formula using first moment transverse transform in quaternionic approaches
Authors: Kim Dojin , Wongsason Patcharee
Published: May 2020

We present the reconstruction formula for the solenoidal part of a vector field compactly supported in a unit ball of
by using a new type of transform called the first integral moment transverse transform. In contrast to the first integral moment transform, this transform is an integral over line components perpendicular to the rays weighted according to the length of the rays. The solenoidal part is set by the quaternionic inversion formula and consequently decomposed into two parts by using techniques where the tangential and normal parts of its Radon transform are applied. The processes to obtain the inversion formula utilize the techniques of Katsevich and Schuster's work. The main differences from this work are the approach to achieve the first integral moment transverse transforms and a more compact inversion formula in a quaternion perspective.
A point‐to‐point protein–protein interaction assay reveals the signaling interplays among plant hormones and environmental cues
Authors: Sun Kaiwen , Xue Xiangwen , Liu Nana , Zhu Ziqiang , Li Hong
Published: May 2020

As sessile organisms, plants must properly coordinate their growth and developmental programs with changes in the environment. The integration of exogenous environmental cues with endogenous plant hormone responses often occurs through physical protein–protein interactions (PPIs). However, a comprehensive PPI network that mediates environmental and hormonal responses has not been established. In this study, we initially cloned 113 phytohormone‐related genes and 29 light signaling components of Arabidopsis and then individually tested their mutual interactions (in total 2,655 tests) using a yeast‐two‐hybrid approach to ultimately identify 141 interactions. Based on these interaction results, we next revealed the signaling cross talk between jasmonate and abscisic acid by characterizing the JAZ1‐PYL4 and JAZ1‐ABI1 interactions. Thus, we generated a useful resource for the community to explore the molecular mechanisms underlying signaling interactions between plant hormones and/or with light.
Engineering Protein Venoms as Self‐Assembling CXCR4‐Targeted Cytotoxic Nanoparticles
Authors: Serna Naroa , Cano‐Garrido Olivia , Sánchez‐García Laura , Pesarrodona Mireia , Unzueta Ugutz , Sánchez‐Chardi Alejandro , Mangues Ramon , Vázquez Esther , Villaverde Antonio
Published: May 2020

Protein venoms are effective cytotoxic molecules that when conveniently targeted to tumoral markers can be exploited as promising anticancer drugs. Here, it is explored whether the structurally unrelated melittin, gomesin, and CLIP71 could be functionally active when engineered, in form of GFP fusions, as self‐assembling multimeric nanoparticles. Incorporated in modular constructs including a C‐terminal polyhistidine tag and an N‐terminal peptidic ligand of the cytokine receptor CXCR4 (overexpressed in more than 20 human neoplasias), these venoms are well produced in recombinant bacteria as proteolytically stable regular nanoparticles ranging between 12 and 35 nm. Being highly fluorescent, these materials selectively penetrate, label, and kill CXCR4+ tumor cells in a CXCR4‐dependent fashion. The obtained data support the concept of recombinant venoms as promising drugs, through the precise formulation as tumor‐targeted nanomaterials for selective theragnostic applications in CXCR4+ cancers.
The use of tattoos to identify unknown bodies
Authors: Birngruber C. G. , Martinez Peña E. G. , Corrales Blanco L. , Holz F.
Published: May 2020

The identification of unknown bodies is the fulfilment of a moral obligation towards the deceased, serves to maintain legal security within a society, and gives families the certainty they need to mourn. Taking into account respective local conditions, the aim should always be to achieve a secure and quick identification. To achieve this goal, a functioning cooperation between investigating authorities and forensic sciences is essential.

The main objective of this study was to clarify the potential role of tattoos in the identification process of unknown deceased persons in the state of Jalisco, Mexico. Post-mortem data of 2045 bodies from the Instituto Jaliscience de Ciencias Forenses in Guadalajara were evaluated.

Of the deceased 46% were tattooed (male: 47%, female: 39%), with 29% of all bodies (male: 29%, female: 26%) showing tattoos at body locations usually visible in everyday life (i.e. head and neck, forearms and hands). The male bodies were most frequently tattooed on the shoulders and upper arms, followed by the forearms and hands and the torso. Female bodies mostly showed tattoos on the forearms and hands, followed by the torso and legs.

Taking local tattooing habits into account, the authors developed a classification for tattoo motives. With decreasing frequency, the following keywords could be assigned to the motives: letters and/or numbers, human, symbol (other), plant, symbol (religious), animal, object, tribal/ornament/geometry, fantasy/demon/comic, other.

Results of the study indicate the great importance of tattoos as a possible mean of identification in Jalisco, Mexico – either as a stand-alone identification method, as a complementary tool or for planning and prioritizing subsequent investigations.
Aerial Root Structure and Its Significance for Function in Dracaena draco
Authors: Jura-Morawiec Joanna , Monroy Pedro , Marrero Aguedo , Tulik Mirela
Published: May 2020

The dragon tree,Dracaena draco,is a vulnerable species. In response to stress it forms aerial roots (AR). Although the exact function of these AR is unknown, it has been the subject of speculation on the basis of morphological observations. This study aims to investigate the structural organization of theD. dracoAR compared to the background of the structure of its soil roots. The material was obtained from the collection of dragon trees growing at Jardín Botánico Canario "Viera y Clavijo" on Gran Canaria as well as from the plants obtained from the commercial nursery. Based on hand-cut sections and permanent preparations, we analysed (a) AR structure along its length encompassing the active and dormant state of the AR tip, as well as (b) the general structural organization of the soil roots (stem-borne, lateral and fine roots). We observed that AR are similar to the lateral soil roots in terms of the distribution of the primary and secondary tissues. AR are protected by rhizodermis and/or hypodermis which undergoes metacutization during the transition from the active to dormant state of the AR tip. Chloroplasts are present in cortical parenchyma cells along the entire length of the AR. The obtained anatomical findings are discussed in the context of the putative AR functions.
A new type of singular perturbation approximation for stochastic bilinear systems
Authors: Redmann Martin
Published: May 2020

Model order reduction (MOR) techniques are often used to reduce the order of spatially discretized (stochastic) partial differential equations and hence reduce computational complexity. A particular class of MOR techniques is balancing related methods which rely on simultaneously diagonalizing the system Gramians. This has been extensively studied for deterministic linear systems. The balancing procedure has already been extended to bilinear equations, an important subclass of nonlinear systems. The choice of Gramians in Al-Baiyat and Bettayeb (In: Proceedings of the 32nd IEEE conference on decision and control, 1993) is the most frequently used approach. A balancing related MOR scheme for bilinear systems called singular perturbation approximation (SPA) has been described that relies on this choice of Gramians. However, no error bound for this method could be proved. In this paper, we extend SPA to stochastic systems with bilinear drift and linear diffusion term. However, we propose a slightly modified reduced order model in comparison to previous work and choose a different reachability Gramian. Based on this new approach, an $$L^2$$

L
2

-error bound is proved for SPA which is the main result of this paper. This bound is new even for deterministic bilinear systems.
Diverse community energy futures in Saskatchewan, Canada
Authors: Hurlbert Margot , Osazuwa-Peters Mac , Rayner Jeremy , Reiner David , Baranovskiy Petr
Published: May 2020

This research explores peoples’ place attachment and context surrounding power production and energy futures. Facilitated, deliberative focus groups were conducted as comparative case studies in three fossil fuel-dependent cities in Saskatchewan Canada: Estevan (situated next to the provincial centers of coal, oil and gas production), Saskatoon (situated more northerly and furthest from coal, oil and gas production) and the capital city of Regina. (situated between the other two communities). This study supports the conclusions: (1) participants believed the focus groups improved their knowledge surrounding power production; (2) although there is strong support for wind and solar power production, there is a gap in implementation; and (3) place-based location impacts perceptions of power production sources. Participants were surveyed before and after focus group meetings to explore the perceptions and preferences of power productions sources. All three communities favored renewables in the order of solar and wind. Estevan, supported carbon capture and sequestration (CCS) to a greater degree and perceived much lower risk surrounding CCS than the other two communities. This may be explained by information gaps in this community. Participants were far less likely to believe a climate crisis is occurring, and while recognizing health concerns surrounding coal, they spent considerably more time discussing the loss of coal and its impact on their economy. Saskatoon, the community furthest from coal oil and gas production, spent considerable time discussing renewables, and when asked about coal, oil and gas identified the need to transition and retrain dependent workers. Although the uranium sector is present in Saskatchewan and in closer proximity to Saskatoon, there was little knowledge or support for new small modular nuclear reactors.

Graphic abstract
Estimation of Self-Neutralisation Rates in a Lignite Pit Lake
Authors: Opitz Joscha , Alte Matthias , Bauer Martin , Schäfer Wolfgang , Söll Thomas
Published: May 2020

Natural anaerobic biogeochemical processes used for passive treatment of AMD were observed in the extensive shallow water zone of a polymictic pit lake in the former German lignite district of Upper Palatinate. Although continuously fed by acidic metalliferous groundwater, lake-pH increased from 3.5 to circumneutral over a little more than 10 years. The natural attenuation processes were studied and quantified using a regional surface- and groundwater flow model linked with hydrochemical monitoring datasets to establish a simple mass balance. The acidity inflow was estimated at ≈ 5900 kmol over the period 2014–2018, which corresponds to an average inflow of ≈ 1190 kmol/a. This estimate is in very good accordance with an acidity inflow rate for the period 2000–2014 estimated from acidity deposition in the sediment based on sediment core analyses plus the calculated cumulative acidity outflow based on extrapolation of pre-neutralisation acidity levels in the pit lake, together yielding a total acidity of ≈ 15,000 kmol, which corresponds to an inflow rate of ≈ 960 kmol/a. The results strongly indicate that the pit lake self-neutralised due to beneficial environmental and ecological conditions, amplified and potentially initialised by the circumneutral discharge from a chemical mine water treatment plant, and that well-known biogeochemical mechanisms such as natural microbial sulfate reduction were the driving force. The results give rise to perspectives concerning the potential development of pit lakes if ecological considerations are considered.