bluuebunny/crossref_metadata_2025 huggingface dataset:
Comorbidities associated with Egyptian diabetic foot disease subtypes
Authors: Rizk Mary N. , Ameen Ashraf I.
Published: September 2023

Introduction

Diabetic foot problems are highly prevalent, responsible for almost 50% of all diabetes-related hospital admissions and a 10-year reduction in life expectancy. The main factors involved in the pathology of diabetic foot are neuropathy, ischemia, and infection. The comorbidities of diabetes are hypertension, obesity, and dyslipidemia. Because of the huge premature morbidity and mortality associated with diabetes, prevention of complications is a key issue and, therefore, it is essential to understand the basic mechanisms that lead to tissue damage.

Aim of the work

The aim of our study was to detect the association between patient comorbidities, chronic complications, and different diabetic foot types for the early detection and management of these conditions.

Patients

We carried out a cross-sectional study of 80 consecutive outpatient Egyptian patients with diabetic foot disease in the National Institute of Diabetes and Endocrinology.

Results

Sixty-three percent were purely neuropathic, followed by 19% that were neuroischemic, whereas 18% were of the ischemic type. Hypertension is the most common comorbid condition and coronary artery disease is highly prevalent in the ischemic and neuroischemic types. The coexistence of hypercholesterolemia, smoking, diabetes, and male sex appears to significantly increase the incidence of ischemic diabetic foot. Nephropathy and retinopathy are significantly associated with neuropathic foot ulcers. Hypertriglyceridemia correlates positively to ischemic and neuroischemic ulcers whereas low HDL and proteinuria correlate positively to both neuropathic and neuroischemic ulcers.

Conclusion

Special attention should be paid toward the identification of patients who are at risk of foot ulceration to help prevent foot problems. Comorbid conditions must also be identified early and managed aggressively.
Study of recurrent antrochoanal polyps: causes and how to minimize recurrence
Authors: Saafan Magdy Eisa , Tomoum Mohamed Osama
Published: September 2023

En

Abstract

Objectives

To conduct a prospective study investigating the causes of repeated recurrences of antrochoanal polyps (ACPs) in an attempt to minimize recurrence.

Materials and methods

Twenty-two patients, with an established diagnosis of a recurrent ACP, were included in the study. A subjective visual analogue scale, endoscopic examination, and computed tomography, both coronal and axial, were performed preoperatively.

Endoscopic sinus surgery was performed in all cases, combined with transcanine antrostomy in some cases, aiming at the complete removal of the polyp.

Postoperatively, improvements in clinical symptoms and endoscopic findings were evaluated using visual analogue scale and endoscopic examination.

Results

The study included 22 patients with recurrence of an ACP one to five times (a total of 38 previous surgeries). The endoscopic transnasal approach was used in 14 cases, whereas a combined endoscopic transcanine approach was used in eight cases. The success rate was 85.7% in the endoscopic transnasal approach and 100% in the combined endoscopic transcanine approach. All patients showed a subjective improvement after surgery but endoscopic recurrence was detected only in two cases after 18–24 months of follow-up.

Conclusion

The main cause of recurrence of ACPs is incomplete removal. Every effort should be made to completely remove the polyp (especially antral part) to avoid recurrence. Endoscopically, this can be performed using 30–45 and 70π telescopes, angled forceps, and performing a very wide middle meatal antrostomy and may be assisted with a canine fossa puncture. The operation preserves healthy antral mucosa and promotes epithelization and mucociliary clearance of the antrum.
Endoscopic management of a pediatric nasoethmoidal mucocele with intraorbital extension
Authors: Radwan Walied , Eladl Hesham Mohammad , Khafagy Yasser
Published: September 2023

En

Abstract

Objective

To evaluate the transnasal endoscopic marsupialization of a pediatric nasoethmoidal mucocele with intraorbital extension in terms of technique, difficulty, and surgical outcome.

Design

Prospective study.

Patients and methods

Seven patients presented with a mucocele with intraorbital extension; they ranged in age from 8 to 14 years (average 11 years), and were treated using the transnasal endoscopic approach from March 2008 to March 2010. All patients underwent transnasal endoscopic marsupialization and were monitored clinically, radiologically, and endoscopically for a mean follow-up period of 15.3 months.

Results

Postoperative nasal examination showed no findings with improved orbital manifestations in all cases. Also, nasal congestion, obstruction, and postnasal discharge disappeared completely. Postoperative computed tomography evaluation indicated a significant improvement on comparison with the preoperative computed tomography score. No major complications were found in the study.

Conclusion

Transnasal endoscopic marsupialization of a pediatric mucocele with intraorbital extension is a safe technique and can be carried out successfully. Combined intensive medical treatment with surgery is important in a mucocele with an orbital manifestation. Nevertheless, this technique requires good experience with the relevant anatomy in a pediatric age group.
Studying some elicited verbal prosodic patterns in Egyptian children
Authors: Bahgat Maged B. A. , Khaled Ashraf M. , Aziz Azza Adel , Osman Dalia M. , Azab Safinaz N.
Published: September 2023

En

Abstract

Background

Despite the large number of native Arabic speakers, Arabic prosodic skills have not been studied thoroughly.

Objectives

This study aimed to examine the perceptual judgment and acoustic characteristics of some elicited verbal prosodic patterns in a group of typically developing Egyptian children aged 2 years 2 months through 5 years 11 months in order to aid in the early identification of prosodic impairment in this age group.

Participants and methods

The sample included 40 healthy typically developing Egyptian children aged 2 years 2 months through 5 years 11 months old. Participants were divided into two groups: group I included 20 children aged 2 years 2 months to 3 years 11 months old. Group II included 20 children aged 4 years 2 months to 5 years 11 months old.

The prosodic patterns studied included socioaffective as well as grammatical patterns. The prosody of each elicited response was perceptually studied and acoustically analyzed. The results obtained were analyzed statistically using comparative and correlation studies.

Results

(a) Significant differences were found between the two groups with respect to the perceptual scores of all the prosodic patterns studied, except resentment and interrogative patterns. (b) Significant differences were found between the two groups with respect to acoustic values. (c) For all the studied parameters, no significant differences were found between males and females. (d) The highest mean perceptual score obtained by the studied group was that obtained for the interrogative pattern, whereas the lowest ones obtained were for exception and warning patterns. (e) A significant positive correlation was found between age and the Total Perceptual Prosodic Scores (TPPS). (f) A significant negative correlation was found between duration and most of the perceptual scores. (g) A significant positive correlation was found between frequency and most of the perceptual scores. (h) A significant positive correlation was found between energy and most of the perceptual scores.

Conclusion

(a) The production of different Arabic prosodic patterns is associated with changes in frequency, duration, and energy. (b) The easiest prosodic patterns to be imitated by children are the interrogative and resentment patterns, whereas the most difficult ones were the exception, disapproval, and warning patterns. (c) Elicited prosodic patterns do not differ with sex in children.
Language assessment in Egyptian children with sickle cell disease
Authors: Shoeib Rasha M. , Said Nithreen M. , Farid Samar M.
Published: September 2023

En

Abstract

Background

Sickle cell disease (SCD) is a blood disorder; however, the central nervous system is one of the organs frequently affected by the disease. Brain insult can begin early in life and often leads to neurocognitive dysfunction. The progression of central nervous system abnormalities in SCD and its effect on language development have not been fully delineated.

Aim

To determine the effect of SCD on language development in Egyptian children with SCD in order to delineate this group as a possible high-risk group for language disorders. In this way, further proper assessment of these children will aid the initiation of an early intervention and prevention of these problems.

Participants and methods

A total of 24 children with SCD were subjected to the language assessment protocol of Ain Shams University Hospitals. These patients underwent language testing using the Standardized Arabic Language Test and hearing assessment including a basic audiological assessment and transient evoked otoacoustic emissions (TEOAEs) testing. The results obtained from this group were compared with the results of 17 normal children who were subjected to the same assessment protocol.

Results

The results of this study showed that the age of acquisition of both the first word and sentence was significantly delayed in children with SCD than their control group. The scores of intelligence quotient and language parameters were significantly lower in the group of children with SCD. The language age deficit was significantly higher in the SCD group than the control group. The expressive language abilities and pragmatics were significantly lower than semantics and receptive abilities in children with SCD. The age of onset of the disease and number of vaso-occlusive crisis showed a significant correlation with the intelligence quotient score and all the language parameters. In terms of audiological assessment, all children of both groups had normal audiograms and tympanograms, but the group of children with SCD showed reduced TEOAEs echo levels in comparison with their control. Moreover, there was a significant correlation between TEOAEs echo levels and language parameters in children with SCD.

Conclusion

SCD is considered as one of the important risk factor that can affect proper language development. Therefore, long-term follow-up of these children is necessary to detect deficits early in life to prevent delayed language development and poor academic achievement.
Post-tonsillectomy hemorrhage due to factor XIII deficiency
Authors: Albahkaly Sameer , Alkhunaizi Arwa , Makki Fawaz
Published: September 2023

Factor XIII deficiency is a very rare disorder, which represents a significant threat to life and can result in significant morbidity. Factor XIII is the final enzyme in the coagulation cascade and is essential for normal homeostasis. There is a very high rate of bleeding in patients who do not receive appropriate prophylaxis. We report a case of patient who presented with profuse secondary post-tonsillectomy hemorrhage few days after the operation.
Development of an Arabic speech intelligibility test for children
Authors: Bassiouny Samia E. , Hegazi Mona A. , Nassar Jilan F. , Ibrahim Mohsen A. , Saber Aml S. , Hamid Ahmed Abdel
Published: September 2023

En

Abstract

Objectives

Speech intelligibility is usually expressed as a percentage of spoken words, sentences, or phonemes correctly identified by a listener or a group of listeners when spoken by a talker or a number of talkers. Communicative disorders could have a deleterious effect on speech intelligibility. To date, there are no Arabic tests measuring speech intelligibility.

Aim

It is necessary to develop and standardize an objective Arabic speech intelligibility test that can be used to estimate the degree of deterioration of speech intelligibility in communicative disorders as an attempt to develop a valid and a reliable tool to assess the efficacy of different therapy programs for different communicative disorders.

Patients and methods

This study was carried out on 200 children with an age range of 4–12 years whose language skills were either fully developed or equivalent for age. All children were selected randomly from the outpatient clinic of phoniatrics and had any of five selected speech disorders affecting speech intelligibility. Each child included in the study was subjected to two evaluations: a subjective rating of the child’s speech intelligibility and the developed Arabic speech intelligibility test, which is meant to be an objective measure.

Results

The results showed a highly significant correlation between the scores of the Arabic speech intelligibility test and the average scores given by raters, the average scores for words, and the average scores for sentences (0.92, 0.98, and 0.84, respectively).

Conclusion

The developed test is proven to be valid and reliable for measuring speech intelligibility in children and could be categorically classified according to ranges of severity.
Posterior scoring pinnaplasty for correction of prominent ears
Authors: Mottaleb Mamdouh S. A. , Ashour Baher M. B.
Published: September 2023

En

Abstract

Aim of work

In this study, we present our experience with correction of prominent ears by posterior scoring only without elevation of the anterior perichondrium of the auricle.

Rationale

By avoiding an anterior subperichondrial flap, we managed to reduce operative time, convalescence, and complications, with no effect on postoperative outcome.
Functional outcome of the facial nerve paralysis after late surgical decompression in otic capsule-sparing fracture
Authors: Aboud Saleh K. , Aini AbAziz , Abdullah Asma
Published: September 2023

Temporal bone fracture (TBF) following head trauma is a well-known cause of facial nerve paralysis (FNP) and almost 22% of all skull fractures are TBF. It has been estimated that 25–70% of TBF are associated with FNP and otic capsule-violating fracture of the petrous portion of the temporal bone is more commonly associated with FNP, although otic capsule-sparing fracture is more common. (a) The incidence of FNP is reported to be 10–25% of otic capsule-sparing fracture. (b) With otic capsule-sparing fractures, FNP is often delayed 2–3 days, and is incomplete and temporary, with good recovery during a period of 6–8 weeks. Most clinicians seldom consider a surgical intervention in delayed FNP; however, surgical exploration may be required for complete recovery. The optimal timing for surgical exploration of traumatic FNP to best preserve facial function is currently controversial. Decompression surgery still has a beneficial effect if performed within 14 days of injury. However, late exploratory surgery is recommended in patients who do not experience recovery of facial nerve function, patients who cannot be operated on early, and who present 1–3 months after TBF with more than 95% denervation on electroneurography. Here, we report a case of delayed-onset FNP of otic capsule-sparing fracture with an excellent outcome after late surgical decompression at 6 months after trauma.
Assessment of the paraglottic space in supracricoid laryngectomy
Authors: AbdelRaouf Mahmoud , Mansy Magdy M. , Raafat Sherif A. , Elsharkawy Louay , AbdelTawab Hazem M.
Published: September 2023

En

Abstract

Background

Supracricoid laryngectomy (SCL) is largely affected by invasion of the tumor into the paraglottic space.

Aim of the work

The aim of this study was to histopathologically examine whether SCL provides adequate safety margins in terms of the paraglottic space or not.

Patients and methods

A prospective study was carried out on 20 patients with advanced cancer larynx staged as T2b, T3 and cases with failed radiotherapy where SCL was performed, followed by whole-organ transverse sections of the specimens to evaluate the relation of the tumor to the paraglottic space.

Results

The local success rate in this study was 90%; one case showed infiltrated surgical margins and the other showed local recurrence 6 months after the operation.

Conclusion

SCL allows for a safe enbloc resection of a malignant tumor in the larynx with complete resection of the paraglottic space. A safety margin of at least 4 mm is needed to eradicate the tumor as revealed by the whole-organ section technique.
Pulmonary hypertension in adults completing tuberculosis treatment
Authors: Allwood B W , Manie S , Stolbrink M , Hunter L , Mathee S , Meintjes G , Amosun S L , Pecoraro A , Walzl G , Irusen E
Published: September 2023

Background. Pulmonary hypertension (PH) after tuberculosis (TB) is typically not included among the chronic lung diseases causing PH (group 3 PH), with few data available to support the inclusion.
Objectives. To determine the prevalence of PH in an adult population completing TB treatment.
Methods. This single-centre, cross-sectional study only included patients with their first documented episode of TB, and who were in the second half of treatment or had recently completed treatment. PH was assessed using transthoracic echocardiography. Questionnaires were also completed and spirometry and a 6-minute walk test were performed.
Results. One hundred patients were enrolled, with a mean age of 37.1 years, of whom 58% were male and 46% HIV positive. The median time since initiation of TB treatment was 22 weeks. The mean (standard deviation) measured right ventricular systolic pressure (RVSP) was 23.6 (6.24) mmHg. One participant had PH (defined as RVSP ≥40 mmHg; 95% confidence interval (CI) 0.0 - 3.0) and a further 3 had possible PH (RVSP ≥35 and <40 mmHg), with a combined PH prevalence of 4% (95% CI 0.2 - 7.8). Airflow obstruction on spirometry was found in 13.3% of 98 patients, while 25.5% had a reduced forced vital capacity. There was no association between RVSP or PH/possible PH and sex, age, HIV status, systemic hypertension, spirometry measurements or 6-minute walking distance. Smoking status was associated with RVSP, but not with the presence of PH/possible PH.
Conclusion. There was a significant prevalence of PH in this preliminary study of predominantly young patients completing treatment for a first episode of TB. Larger and more detailed studies are warranted.
Optogenetic induction of appetitive and aversive taste memories in Drosophila
Authors: Jelen Meghan , Musso Pierre-Yves , Junca Pierre , Gordon Michael D
Published: September 2023

Tastes typically evoke innate behavioral responses that can be broadly categorized as acceptance or rejection. However, research in Drosophila melanogaster indicates that taste responses also exhibit plasticity through experience-dependent changes in mushroom body circuits. In this study, we develop a novel taste learning paradigm using closed-loop optogenetics. We find that appetitive and aversive taste memories can be formed by pairing gustatory stimuli with optogenetic activation of sensory neurons or dopaminergic neurons encoding reward or punishment. As with olfactory memories, distinct dopaminergic subpopulations drive the parallel formation of short- and long-term appetitive memories. Long-term memories are protein synthesis-dependent and have energetic requirements that are satisfied by a variety of caloric food sources or by direct stimulation of MB-MP1 dopaminergic neurons. Our paradigm affords new opportunities to probe plasticity mechanisms within the taste system and understand the extent to which taste responses depend on experience.
Translational regulation enhances distinction of cell types in the nervous system
Authors: Ichinose Toshiharu , Kondo Shu , Kanno Mai , Shichino Yuichi , Mito Mari , Iwasaki Shintaro , Tanimoto Hiromu
Published: September 2023

Multicellular organisms are composed of specialized cell types with distinct proteomes. While recent advances in single-cell transcriptome analyses have revealed differential expression of mRNAs, cellular diversity in translational profiles remains underinvestigated. By performing RNA-seq and Ribo-seq in genetically defined cells in the Drosophila brain, we here revealed substantial post-transcriptional regulations that augment the cell-type distinctions at the level of protein expression. Specifically, we found that translational efficiency of proteins fundamental to neuronal functions, such as ion channels and neurotransmitter receptors, was maintained low in glia, leading to their preferential translation in neurons. Notably, distribution of ribosome footprints on these mRNAs exhibited a remarkable bias toward the 5′ leaders in glia. Using transgenic reporter strains, we provide evidence that the small upstream open-reading frames in the 5’ leader confer selective translational suppression in glia. Overall, these findings underscore the profound impact of translational regulation in shaping the proteomics for cell-type distinction and provide new insights into the molecular mechanisms driving cell-type diversity.
Assessing climbers’ pull-up capabilities by differentiating the parameters involved in power production
Authors: Devise Marine , Quaine Franck , Vigouroux Laurent
Published: September 2023

This study explored the capabilities of sport climbers to pull up with arms. The methodology aimed at assessing (i) concentric capabilities of arm muscles, (ii) body coordination skills (iii) characteristics of energy storage and (iv) capabilities to resist fatigue. Twenty-eight climbers were tested and the force exerted was recorded during three pull-up exercises: jump tests (with or without coordination, or preceded by an eccentric phase), incrementally weighted pull-ups and maximum number of pull-ups. Force, velocity, muscle power and muscle work were analysed using ANOVA with post-hoc tests and principal component analysis. Correlations with climbing level were also studied. Overall, jump test results showed that body coordination and stretch-shortening cycle phenomena contributed significantly to performance but only the body coordination was related to the climber’s grade level. Muscle work and maximum number of pull-ups are correlated with climbing level which showed that the capacity to resist fatigue is another crucial capability of climbers arms. The development of force capacities appeared crucial for performing whereas the velocity capabilities seemed to originate from the climber’s own characteristics/style without correlating with climbing performance. Our study provides the basis for evaluating these parameters in order to help trainers in the diagnosis process and training follow-up.
Soil microbial and enzyme activities in different land use systems of the Northwestern Himalayas
Authors: Mir Yasir Hanif , Ganie Mumtaz Ahmad , Shah Tajamul Islam , Bangroo Shabir Ahmed , Mir Shakeel Ahmad , Shah Aanisa Manzoor , Wani Fehim Jeelani , Qin Anzhen , Rahman Shafeeq Ur
Published: September 2023

Soil microbial activity (SMA) is vital concerning carbon cycling, and its functioning is recognized as the primary factor in modifying soil carbon storage potential. The composition of the microbial community (MC) is significant in sustaining environmental services because the structure and activity of MC also influence nutrient turnover, distribution, and the breakdown rate of soil organic matter. SMA is an essential predictor of soil quality alterations, and microbiome responsiveness is imperative in addressing the escalating sustainability concerns in the Himalayan ecosystem. This study was conducted to evaluate the response of soil microbial and enzyme activities to land conversions in the Northwestern Himalayas (NWH), India. Soil samples were collected from five land use systems (LUSs), including forest, pasture, apple, saffron, and paddy-oilseed, up to a depth of 90 cm. The results revealed a significant difference (p < 0.05) in terms of dehydrogenase (9.97–11.83 TPF µg g−1 day−1), acid phosphatase (22.40–48.43 µg P-NP g−1 h−1), alkaline phosphatase (43.50–61.35 µg P-NP g−1 h−1), arylsulphatase (36.33–48.12 µg P-NP g−1 h−1), fluorescein diacetate hydrolase (12.18–21.59 µg g−1 h−1), bacterial count (67.67–123.33 CFU × 106 g−1), fungal count (19.33–67.00 CFU × 105 g−1), and actinomycetes count (12.00–42.33 CFU × 104 g−1), with the highest and lowest levels in forest soils and paddy-oilseed soils, respectively. Soil enzyme activities and microbial counts followed a pattern: forest > pasture > apple > saffron > paddy-oilseed at all three depths. Paddy-oilseed soils exhibited up to 35% lower enzyme activities than forest soils, implying that land conversion facilitates the depletion of microbiome diversity from surface soils. Additionally, reductions of 49.80% and 62.91% were observed in enzyme activity and microbial counts, respectively, with soil depth (from 0–30 to 60–90 cm). Moreover, the relationship analysis (principal component analysis and correlation) revealed a high and significant (p = 0.05) association between soil microbial and enzyme activities and physicochemical attributes. These results suggest that land conversions need to be restricted to prevent microbiome depletion, reduce the deterioration of natural resources, and ensure the sustainability of soil health.
Comparative sequence analysis elucidates the evolutionary patterns of Yersinia pestis in New Mexico over thirty-two years
Authors: Warren Mary E. , Pickett Brett E. , Adams Byron J. , Villalva Crystal , Applegate Alyssa , Robison Richard A.
Published: September 2023

Background

Yersinia pestis, a Gram-negative bacterium, is the causative agent of plague. Y. pestis is a zoonotic pathogen that occasionally infects humans and became endemic in the western United States after spreading from California in 1899.

Methods

To better understand evolutionary patterns in Y. pestis from the southwestern United States, we sequenced and analyzed 22 novel genomes from New Mexico. Analytical methods included, assembly, multiple sequences alignment, phylogenetic tree reconstruction, genotype-phenotype correlation, and selection pressure.

Results

We identified four genes, including Yscp and locus tag YPO3944, which contained codons undergoing negative selection. We also observed 42 nucleotide sites displaying a statistically significant skew in the observed residue distribution based on the year of isolation. Overall, the three genes with the most statistically significant variations that associated with metadata for these isolates were sapA, fliC, and argD. Phylogenetic analyses point to a single introduction of Y. pestis into the United States with two subsequent, independent movements into New Mexico. Taken together, these analyses shed light on the evolutionary history of this pathogen in the southwestern US over a focused time range and confirm a single origin and introduction into North America.
Suicide Risks of Health Care Workers in the US
Authors: Olfson Mark , Cosgrove Candace M. , Wall Melanie M. , Blanco Carlos
Published: September 2023

Importance

Historically elevated risks of suicide among physicians may have declined in recent decades. Yet there remains a paucity of information concerning suicide risks among other health care workers.

Objective

To estimate risks of death by suicide among US health care workers.

Design, Setting, and Participants

Cohort study of a nationally representative sample of workers from the 2008 American Community Survey (N = 1 842 000) linked to National Death Index records through December 31, 2019.

Main Outcomes and Measures

Age- and sex-standardized suicide rates were estimated for 6 health care worker groups (physicians, registered nurses, other health care–diagnosing or treating practitioners, health technicians, health care support workers, social/behavioral health workers) and non–health care workers. Cox models estimated hazard ratios (HRs) of suicide for health care workers compared with non–health care workers using adjusted HRs for age, sex, race and ethnicity, marital status, education, and urban or rural residence.

Results

Annual standardized suicide rates per 100 000 persons (median age, 44 [IQR, 35-53] years; 32.4% female [among physicians] to 91.1% [among registered nurses]) were 21.4 (95% CI, 15.4-27.4) for health care support workers, 16.0 (95% CI, 9.4-22.6) for registered nurses, 15.6 (95% CI, 10.9-20.4) for health technicians, 13.1 (95% CI, 7.9-18.2) for physicians, 10.1 (95% CI, 6.0-14.3) for social/behavioral health workers, 7.6 (95% CI, 3.7-11.5) for other health care–diagnosing or treating practitioners, and 12.6 (95% CI, 12.1-13.1) for non–health care workers. The adjusted hazards of suicide were increased for health care workers overall (adjusted HR, 1.32 [95% CI, 1.13-1.54]), health care support workers (adjusted HR, 1.81 [95% CI, 1.35-2.42]), registered nurses (adjusted HR, 1.64 [95% CI, 1.21-2.23]), and health technicians (adjusted HR, 1.39 [95% CI, 1.02-1.89]), but adjusted hazards of suicide were not increased for physicians (adjusted HR, 1.11 [95% CI, 0.71-1.72]), social/behavioral health workers (adjusted HR, 1.14 [95% CI, 0.75-1.72]), or other health care–diagnosing or treating practitioners (adjusted HR, 0.61 [95% CI, 0.36-1.03) compared with non–health care workers (reference).

Conclusions

Relative to non–health care workers, registered nurses, health technicians, and health care support workers in the US were at increased risk of suicide. New programmatic efforts are needed to protect the mental health of these US health care workers.
Alcohol Use and Sustained Virologic Response to Hepatitis C Virus Direct-Acting Antiviral Therapy
Authors: Cartwright Emily J. , Pierret Chloe , Minassian Caroline , Esserman Denise A. , Tate Janet P. , Goetz Matthew B. , Bhattacharya Debika , Fiellin David A. , Justice Amy C. , Lo Re Vincent , Rentsch Christopher T.
Published: September 2023

Importance

Some payers and clinicians require alcohol abstinence to receive direct-acting antiviral (DAA) therapy for chronic hepatitis C virus (HCV) infection.

Objective

To evaluate whether alcohol use at DAA treatment initiation is associated with decreased likelihood of sustained virologic response (SVR).

Design, Setting, and Participants

This retrospective cohort study used electronic health records from the US Department of Veterans Affairs (VA), the largest integrated national health care system that provides unrestricted access to HCV treatment. Participants included all patients born between 1945 and 1965 who were dispensed DAA therapy between January 1, 2014, and June 30, 2018. Data analysis was completed in November 2020 with updated sensitivity analyses performed in 2023.

Exposure

Alcohol use categories were generated using responses to the Alcohol Use Disorders Identification Test–Consumption (AUDIT-C) questionnaire and International Classification of Diseases, Ninth Revision and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision diagnoses for alcohol use disorder (AUD): abstinent without history of AUD, abstinent with history of AUD, lower-risk consumption, moderate-risk consumption, and high-risk consumption or AUD.

Main Outcomes and Measures

The primary outcome was SVR, which was defined as undetectable HCV RNA for 12 weeks or longer after completion of DAA therapy. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% CIs of SVR associated with alcohol category.

Results

Among 69 229 patients who initiated DAA therapy (mean [SD] age, 62.6 [4.5] years; 67 150 men [97.0%]; 34 655 non-Hispanic White individuals [50.1%]; 28 094 non-Hispanic Black individuals [40.6%]; 58 477 individuals [84.5%] with HCV genotype 1), 65 355 (94.4%) achieved SVR. A total of 32 290 individuals (46.6%) were abstinent without AUD, 9192 (13.3%) were abstinent with AUD, 13 415 (19.4%) had lower-risk consumption, 3117 (4.5%) had moderate-risk consumption, and 11 215 (16.2%) had high-risk consumption or AUD. After adjustment for potential confounding variables, there was no difference in SVR across alcohol use categories, even for patients with high-risk consumption or AUD (OR, 0.95; 95% CI, 0.85-1.07). There was no evidence of interaction by stage of hepatic fibrosis measured by fibrosis-4 score (P for interaction = .30).

Conclusions and Relevance

In this cohort study, alcohol use and AUD were not associated with lower odds of SVR. Restricting access to DAA therapy according to alcohol use creates an unnecessary barrier to patients and challenges HCV elimination goals.
Practice Analysis and Determining the Knowledge and Skills Expected of a Pediatric Rheumatologist
Authors: Brucia Robert C. , Hayward Kristen , Brunner Hermine I. , Lopez‐Pena Maricarmen , Shenoi Susan , Soybilgic Arzu , Nocton James J.
Published: September 2023

Objective

The scope of clinical practice of pediatric rheumatology has been difficult to define. The lack of definition prevents an accurate understanding of the knowledge and skills required of practicing pediatric rheumatologists. A practice analysis process was used with the goal of establishing a precise definition of clinical pediatric rheumatology practice. The definition of practice will improve training and the creation of relevant certification examinations.

Methods

A practice analysis approach used meetings with a representative panel of pediatric rheumatologists to create a practice analysis document (PAD) and a test content outline (TCO). Panel experience, entrustable professional activities, and the current TCO were used to guide the process. Surveys were administered to fellowship program directors (PDs) and a broader group of practicing pediatric rheumatologists to revise and validate the content of the documents.

Results

A PAD was created, including 14 categories of conditions diagnosed or managed by pediatric rheumatologists and eight domains of practice, with the tasks, knowledge, and skills required to perform these tasks. The survey of PDs (n = 10) indicated that the PAD content is important and useful. A TCO was created and consists of 18 domains used to define content areas to be assessed on certifying examinations. The survey of practicing pediatric rheumatologists (n = 127) indicated that the TCO domains are relevant.

Conclusion

A practice analysis process produced valuable resources for defining the clinical practice of pediatric rheumatology. The PAD and TCO can be used to develop more specific training curricula and to create relevant certification examinations.
Macrophage Membrane‐Coated, Nanostructured Adsorbent Surfaces in a Microfluidic Device for Extracorporeal Blood Cleansing in Bacterially Induced Sepsis
Authors: Liu Sidi , van Beuningen Fleur E. , Xiao Xiang , Le Yu , Zhao Jian , Shi Rui , Ren Yijin , Bouma Hjalmar R. , van der Mei Henny C. , Liu Jian , Busscher Henk J.
Published: September 2023

Sepsis is a dysregulated host response to infection that can lead to life‐threatening organ failure. Circulating bacterial toxins, termed pathogen‐associated molecular patterns (PAMPs), and excess cytokines produced by the immune system play a key role in the response that can progress into organ failure. Yet, no therapy is available to effectively remove these PAMPs and cytokines from the circulation or effectively block their action. Macrophage membrane coatings possess a natural blood compatibility, ideal for coating of adsorbent surfaces in extracorporeal blood‐cleansing. Here, the ability of Escherichia coli‐activated macrophage membrane coatings on silicon nanowired (SiNW) surfaces in a microfluidic device to remove PAMPs and cytokines from blood is determined. In vitro, such membrane‐coated SiNW adsorbent surfaces remove significantly more PAMPS or cytokines from spiked human blood than achieved by hemofiltration. Cleansing of plasma from patients with bacterial sepsis using membrane‐coated SiNW adsorbent surfaces reduces cytokine concentrations to healthy levels. In vivo, this coincides with two‐fold better restoration of healthy cytokine levels after 4 h of extracorporeal blood‐cleansing in rats with lipopolysaccharides (LPS)‐induced sepsis and four‐fold higher survival rates. Collectively, blood‐cleansing microfluidic devices using bacterially activate macrophage membrane‐coated SiNW surfaces are more effective than hemofiltration for therapeutic intervention in septic patients.
Interweaving Elastic and Hydrogen Bond‐Forming Polymers into Highly Tough and Stress‐Relaxable Binders for High‐Performance Silicon Anode in Lithium‐Ion Batteries
Authors: Jeong Daun , Yook Jinsol , Kwon Da‐Sol , Shim Jimin , Lee Jong‐Chan
Published: September 2023

A central challenge in practically using high‐capacity silicon (Si) as anode materials for lithium‐ion batteries is alleviating significant volume change of Si during cycling. One key to resolving the failure issues of Si is exploiting carefully designed polymer binders exhibiting mechanical robustness to retain the structural integrity of Si electrodes, while concurrently displaying elasticity and toughness to effectively dissipate external stresses exerted by the volume changes of Si. Herein, a highly elastic and tough polymer binder is proposed by interweaving polyacrylic acid (PAA) with poly(urea‐urethane) (PUU) elastomer for Si anodes. By systematically tuning molecular parameters, including molecular weights of hard/soft segments and structures of hard segment components, it is demonstrated that the mechanical properties of polymer binders, such as elasticity, toughness, and stress relaxation ability, strongly affect the cycling performance of Si electrodes. This study provides new insight into the rational design of polymer binders capable of accommodating the volume changes of Si, primarily by judicious modulation of the mechanical properties of polymer binders.
Eu3+ Site Distribution and Local Distortion of Photoluminescent Ca3WO6:(Eu3+, K+) Double Perovskites as High‐Color‐Purity Red Phosphors
Authors: Otsuka Takahito , Oka Ryohei , Hayakawa Tomokatsu
Published: September 2023

In this study, Eu3+ and K+ co‐doped Ca3WO6 double perovskite, a high‐color‐purity red phosphor, is quantitatively investigated using synchrotron X‐ray diffraction Rietveld refinement, energy dispersive X‐ray spectroscopy, and high‐resolution PL spectroscopy. The Eu3+ fluorescence line‐narrowing (FLN) results, used to estimate the Eu3+ occupation at given sites (so‐called A and B sites) in the host crystal (A2BMO6; A, B = Ca; M = W), reveal that the Eu3+ ions have a twin distribution in both the A and B sites with high asymmetry ratios of ΛA = 9.7 and ΛB = 10.7, respectively. More interestingly, at lower Eu3+ doping levels, the ions are predominantly located at the B sites (≈75%), indicating that the high color purity of Ca3WO6:(Eu3+, K+) is mainly caused by the high asymmetry ratios of the Eu3+ sites. Rietveld refinement combined with the FLN technique provides more reliable results for increasing the Eu3+ substitution at the A site with Eu3+ and K+ doping concentrations, which lower the lattice energy of Ca3WO6:(Eu3+, K+). The structural distortions owing to K+ co‐doping in terms of the quadratic elongation and bond‐angle variance exhibit good correlations with the Ca(Eu)O12 A‐site cuboctahedra and Ca(Eu)O6 B‐site octahedra, partially accounting for the higher Λ values.
Realistic Modeling of the Electrocatalytic Process at Complex Solid‐Liquid Interface
Authors: Zhao Hongyan , Lv Xinmao , Wang Yang‐Gang
Published: September 2023

The rational design of electrocatalysis has emerged as one of the most thriving means for mitigating energy and environmental crises. The key to this effort is the understanding of the complex electrochemical interface, wherein the electrode potential as well as various internal factors such as H‐bond network, adsorbate coverage, and dynamic behavior of the interface collectively contribute to the electrocatalytic activity and selectivity. In this context, the authors have reviewed recent theoretical advances, and especially, the contributions to modeling the realistic electrocatalytic processes at complex electrochemical interfaces,  and illustrated the challenges and fundamental problems in this field. Specifically, the significance of the inclusion of explicit solvation and electrode potential as well as the strategies toward the design of highly efficient electrocatalysts are discussed. The structure‐activity relationships and their dynamic responses to the environment and catalytic functionality under working conditions are illustrated to be crucial factors for understanding the complexed interface and the electrocatalytic activities. It is hoped that this review can help spark new research passion and ultimately bring a step closer to a realistic and systematic modeling method for electrocatalysis.
One Stone, Three Birds: An Air and Interface Stable Argyrodite Solid Electrolyte with Multifunctional Nanoshells
Authors: Sang Junwu , Pan Kecheng , Tang Bin , Zhang Zhang , Liu Yiyang , Zhou Zhen
Published: September 2023

Li6PS5Cl (LPSC) solid electrolytes, based on Argyrodite, have shown potential for developing high energy density and safe all‐solid‐state lithium metal batteries. However, challenges such as interfacial reactions, uneven Li deposition, and air instability remain unresolved. To address these issues, a simple and effective approach is proposed to design and prepare a solid electrolyte with unique structural features: Li6PS4Cl0.75‐OF0.25 (LPSC‐OF0.25) with protective LiF@Li2O nanoshells and F and O‐rich internal units. The LPSC‐OF0.25 electrolyte exhibits high ionic conductivity and the capability of “killing three birds with one stone” by improving the moist air tolerance, as well as the interface compatibility between the anode or cathode and the solid electrolyte. The improved performance is attributed to the peculiar morphology and the self‐generating and self‐healing interface coupling capability. When coupled with bare LiCoO2, the LPSC‐OF0.25 electrolyte enables stable operation under high cutoff voltage (≈4.65 V vs Li/Li+), thick cathodes (25 mg cm−2), and large current density (800 cycles at 2 mA cm−2). This rationally designed solid electrolyte offers promising prospects for solid‐state batteries with high energy and power density for future long‐range electric vehicles and aircrafts.
Origin and Mechanism of Piezoelectric and Photovoltaic Effects in (111) Polar Orientated NiO Films
Authors: Fan Nana , Wang Yingfei , Liu Bin , Yang Heqing , Liu Shengzhong
Published: September 2023

Based on the current piezoelectric theory, NiO with the centrosymmetric structure is not piezoelectric. However, herein, this study shows the first observation of piezoelectric generation, rectifyingand bulk photovoltaic behaviors in NiO films with [111] orientation and the change in NiO crystal structure in piezoelectric process. The piezoelectric generation, rectifying, and bulk photovoltaic performances are enhanced by increasing (111) orientation, and attenuated and eliminated by applying a persistent stress on the NiO film. The NiO [111] is polar direction, and thus a spontaneous electric field (ES) is in the NiO film with [111] orientation. The existence of Es in (111) oriented NiO film is found to be the physical basis of the piezoelectric generators and photovoltaic and rectifying effects. Thus, NiO piezoelectric, rectifying, and bulk photovoltaic mechanism are presented at the atomic level. The mechanism may rewrite the current piezoelectric theory, and establish a unified theory of polar structure with wide implications. The polar‐orientated films can be used to fabricate piezoelectric generators and other optoelectronic devices with high performances.
Early development and adaptive functioning in children with Bardet‐Biedl syndrome
Authors: Keifer Ekaterina , Berg Richard L. , Richardson Jesse G. , Haws Robert M.
Published: September 2023

This study had two aims. Aim one investigated achievement of 10 developmental milestones in children with Bardet‐Biedl syndrome (BBS). Aim one data were derived from retrospective responses by caregivers of individuals with BBS who are enrolled in the Clinical Registry Investigating Bardet‐Biedl syndrome (CRIBBS). CRIBBS is a natural history registry acquiring serial observations. Aim two investigated early adaptive skills using the Adaptive Behavior Assessment System (ABAS‐II 0–5) completed by caregivers of children with BBS aged from 0 to 5. There were 652 individuals with milestone information (with some variability based on availability of information for specific milestones), and 101 individuals (including 95 among the 652) with ABAS‐II information. Results revealed wide‐ranging delays in adaptive skills, particularly in the domain of Self‐Care. Expressive language appears to be the most frequently delayed developmental milestone. We found a difference by BBS genotype wherein individuals with BBS1 had higher adaptive/developmental scores than individuals with BBS10. Age also carried a significant association with adaptive skills diverging farther from a normative trajectory as children with BBS progress through early childhood.
Divergent Photosensitizer Controlled Reactions of 4‐Hydroxycoumarins and Unactivated Olefins: Hydroarylation and Subsequent [2+2] Cycloaddition
Authors: Chang Rui , Pang Yubing , Ye Juntao
Published: September 2023

Herein, we report a photoinduced approach for hydroarylation of unactivated olefins using 4‐hydroxycoumarins as the arylating reagent. Key to the success of this reaction is the conversion of nucleophilic 4‐hydroxycoumarins into electrophilic carbon radicals via photocatalytic arene oxidation, which not only circumvents the polarity‐mismatch issue encountered under ionic conditions but also accommodates a broad substrate scope and inhibits side reactions that were previously observed. Moreover, divergent reactivity was achieved by changing the photocatalyst, enabling a subsequent [2+2] cycloaddition to deliver cyclobutane‐fused pentacyclic products that are otherwise challenging to access in high yields and with high diastereoselectivity. Mechanistic studies have elucidated the mechanism of the reactions and the origin of the divergent reactivity.
Two‐Dimensional Supramolecular Polymerization of a Bis‐Urea Macrocycle into a Brick‐Like Hydrogen‐Bonded Network
Authors: Rubert Llorenç , Islam Md Faizul , Greytak Andrew B. , Prakash Rahul , Smith Mark D. , Gomila Rosa Maria , Frontera Antonio , Shimizu Linda S. , Soberats Bartolome
Published: September 2023

We report on a dendronized bis‐urea macrocycle 1 self‐assembling via a cooperative mechanism into two‐dimensional (2D) nanosheets formed solely by alternated urea‐urea hydrogen bonding interactions. The pure macrocycle self‐assembles in bulk into one‐dimensional liquid‐crystalline columnar phases. In contrast, its self‐assembly mode drastically changes in CHCl3 or tetrachloroethane, leading to 2D hydrogen‐bonded networks. Theoretical calculations, complemented by previously reported crystalline structures, indicate that the 2D assembly is formed by a brick‐like hydrogen bonding pattern between bis‐urea macrocycles. This assembly is promoted by the swelling of the trisdodecyloxyphenyl groups upon solvation, which frustrates, due to steric effects, the formation of the thermodynamically more stable columnar macrocycle stacks. This work proposes a new design strategy to access 2D supramolecular polymers by means of a single non‐covalent interaction motif, which is of great interest for materials development.
Clinical Issues — October 2023
Authors: Wright Renae
Published: September 2023

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Key words: communication, teamwork, robotic procedures, familiarity, perioperative team.