bluuebunny/crossref_metadata_2025 huggingface dataset:
MRI Investigation of the Differential Impact of Left Ventricular Ejection Fraction After Myocardial Infarction in Elderly vs. Nonelderly Patients to Predict Readmission for Heart Failure
Authors: Marcos‐Garcés Víctor , Merenciano‐González Héctor , Gavara José , Gabaldón‐Pérez Ana , López‐Lereu María P. , Monmeneu José V. , Nuñez Julio , Pérez Nerea , Ríos‐Navarro César , de Dios Elena , Chorro Francisco J. , Valente Filipa , Lorenzatti Daniel , Domenech‐Ximenos Blanca , Alonso Tello Albert , Maymí‐Ballesteros Manel , Rello‐Sabaté Pau , Morr Carlos Igor , Ortiz‐Pérez Jose T. , Rodríguez‐Palomares Jose F. , Bodí Vicente
Published: February 2023

Background

Patients with ST‐segment elevation myocardial infarction (STEMI), especially elderly individuals, have an increased risk of readmission for acute heart failure (AHF).

Purpose

To study the impact of left ventricular ejection fraction (LVEF) by MRI to predict AHF in elderly (>70 years) and nonelderly patients after STEMI.

Study Type

Prospective.

Population

Multicenter registry of 759 reperfused STEMI patients (23.3% elderly).

Field Strength/Sequence

1.5‐T. Balanced steady‐state free precession (cine imaging) and segmented inversion recovery steady‐state free precession (late gadolinium enhancement) sequences.

Assessment

One‐week MRI‐derived LVEF (%) was quantified. Sequential MRI data were recorded in 579 patients. Patients were categorized according to their MRI‐derived LVEF as preserved (p‐LVEF, ≥50%), mildly reduced (mr‐LVEF, 41%–49%), or reduced (r‐LVEF, ≤40%). Median follow‐up was 5 [2.33–7.54] years.

Statistical Tests

Univariable (Student's t, Mann–Whitney U, chi‐square, and Fisher's exact tests) and multivariable (Cox proportional hazard regression) comparisons and continuous‐time multistate Markov model to analyze transitions between LVEF categories and to AHF. Hazard ratios (HR) with 95% confidence intervals (CIs) were computed. P < 0.05 was considered statistically significant.

Results

Over the follow‐up period, 79 (10.4%) patients presented AHF. MRI‐LVEF was the most robust predictor in nonelderly (HR 0.94 [0.91–0.98]) and elderly patients (HR 0.94 [0.91–0.97]). Elderly patients had an increased AHF risk across the LVEF spectrum. An excess of risk (compared to p‐LVEF) was noted in patients with r‐LVEF both in nonelderly (HR 11.25 [5.67–22.32]) and elderly patients (HR 7.55 [3.29–17.34]). However, the mr‐LVEF category was associated with increased AHF risk only in elderly patients (HR 3.66 [1.54–8.68]). Less transitions to higher LVEF states (n = 19, 30.2% vs. n = 98, 53%) and more transitions to AHF state (n = 34, 53.9% vs. n = 45, 24.3%) were observed in elderly than nonelderly patients.

Data Conclusion

MRI‐derived p‐LVEF confers a favorable prognosis and r‐LVEF identifies individuals at the highest risk of AHF in both elderly and nonelderly patients. Nevertheless, an excess of risk was also found in the mr‐LVEF category in the elderly group.

Evidence Level

2.

Technical Efficacy

Stage 2.
Higher atmospheric evapotranspiration demand intensified drought in semi‐arid sandy lands, northern China
Authors: Hu Hongjiao , Liu Xinping , He Yuhui , Zhang Tonghui , Xu Yuanzhi , Wang Lilong
Published: February 2023

Drought seriously endangers the development of agro‐pastoral ecotone in arid and semi‐arid regions. However, drought evolution characteristics of semi‐arid sandy grassland and its drivers are not well understood in the complex climate change context. Thus, in this paper, the revised standardized precipitation evaporation indices on one‐month (SPEI‐1) and growing‐season (SPEI‐6) scale, flash drought and dry spells (DS) were calculated as drought indicators, and the temporal variabilities and meteorological drivers of drought in Horqin Sandy Land during the growing period (April–September) from 2007 to 2021 were studied. The results showed that SPEI‐1 and SPEI‐6 exhibited negative trends and periodic change. This drought aggravation was manifested in increased grades and numbers of drought months. Flash droughts can occur every month during the growing season. And its occurrence was not only positively correlated with all drought events in frequency but also synchronized in time. The increased number of DS showed an asymmetrical shift towards 7‐day‐and‐longer DS. SPEI sensitivity to precipitation (P) was noticeably higher than to atmospheric evapotranspiration demand (AED) at both monthly and growing season scales. SPEI sensitivity to AED was modulated by P amounts, which was higher during low P period. Apart from the amounts of P and AED, their temporal variability also strongly determined how they affect the drought severity. P was also the main driver for flash drought and long DS, but AED with larger amount and higher variability is the reason for their aggravation. Our results demonstrate the complexity of drought intensification in semi‐arid sandy grasslands and highlight the important role of AED anomalies in it.
Risk factors and longitudinal regenerative outcomes of sinus membrane perforation during lateral window sinus floor elevation: A retrospective analysis up to 9 years
Authors: Prajapati Saumya , Ninneman Shale , Zarrabi Ida , Daubert Diane , Wang I‐Chung , Hsu Yung‐Ting
Published: February 2023

Background

Lateral‐window sinus floor elevation (LSFE) is a reliable procedure to reconstruct the posterior maxilla for implant therapy. This retrospective study aimed to investigate risk factors associated with Schneiderian membrane perforation (SMP) occurrence during LSFE and longitudinal regenerative outcomes following LSFE up to 9 years.

Methods

Patients who had LSFE between 2010 and 2019 were included. All demographic and surgical‐related data were retrieved from existing electronic health records. Radiographs were used to evaluate the vertical dimensional changes of ridge and graft materials and the potential anatomic factors of SMP.

Results

A total of 122 LSFE procedures in 99 patients were included in the study. Mean ridge height gain and graft shrinkages were 9.5 ± 3.47 and 1.57 ± 2.85 mm. The influence of the healing period on graft shrinkage showed a positive trend; the longer the healing period, the greater the graft shrinkage (p = 0.09). The pathology in the sinus showed a positive correlation with SMP (p = 0.07). However, other anatomical factors did not negatively impact SMP and subsequent ridge height gain (p > 0.05).

Conclusions

With inherent limitation, the findings with up to 9 years of follow‐up indicate a consistent ridge remodeling lasting for about 3 years after LSFE procedures. SMP or membrane thickening may not significantly affect the ridge gain following LSFE. The healing period had the most significant influence on graft shrinkage, showing that the longer the healing time between LSFE and implant placement, the greater the graft shrinkage.
Yellow rail auditory detection during the non‐breeding season
Authors: Butler Christopher J. , Olsen Tabitha W. , Wilson Jennifer K. , Woodrow Jarrett (Woody) Olen , Johnson Cameron , Barron Trey
Published: February 2023

Yellow rails (Coturnicops noveboracensis) are secretive, nocturnal marsh birds that are challenging to survey. During the breeding season, males will respond to click‐click vocalization call playbacks and can also be detected using autonomous recording units (ARUs). Yellow rails will occasionally vocalize click‐click during spring migration but seldom, if ever, use this vocalization during autumn and winter. Consequently, detections of yellow rails have relied on effort‐intensive approaches such as draglines or serendipitous encounters. On 28 January 2022, we documented yellow rails vocalizing an unfamiliar call at a coastal marsh in Texas, USA. The vocalization was vaguely reminiscent of a sandhill crane (Antigone canadensis) call, and thus we called this vocalization a bugle. The bugle vocalization appears to be undocumented in the literature. To explore the frequency of vocalizations, we set out 4 ARUs at San Bernard National Wildlife Refuge, Texas from 30 January through 5 February 2022. We were also able to incorporate this vocalization into call‐playback surveys for multiple rail species at 5 sites along the Texas Gulf Coast from 14 February through 7 May 2022. Bugle vocalizations captured using ARUs appear to be most frequent from 1600–1800, and we tallied 327 of these vocalizations on ARUs during 1 week. Additionally, 31 individuals were detected during call‐playback surveys. The majority (21 of 31 individuals) came in response to playing the bugle vocalizations, while the remaining vocalizations were approximately evenly split between unsolicited vocalizing prior to the start of call playback, vocalizing in response to the click‐click call, and responding to other rail species playbacks. All vocalization responses during call playback were the bugle call. We suggest that future non‐breeding surveys for yellow rails use ARUs and call‐playback approaches that incorporate the bugle vocalization to document the presence of this species more efficiently.
Temporal and spatial population dynamics of the nomadic short‐eared owl across the western United States
Authors: Miller Robert A. , Buchanan Joseph B. , Pope Theresa L. , Carlisle Jay D. , Moulton Colleen E. , Booms Travis L.
Published: February 2023

The short‐eared owl (Asio flammeus) is a species of conservation concern in the western United States, and populations are declining throughout its range. Because of its low site fidelity, nomadic lifestyle, and irruptive breeding dynamics across large landscapes, estimating trends at regional or broader scales is difficult. To address that challenge, we recruited community‐science participants to implement a multi‐year survey of short‐eared owls across a study area encompassing 8 western states: California, Idaho, Montana, Nevada, Oregon, Utah, Washington, and Wyoming. We stratified our study area by potential habitat, established 50 spatially balanced transects per state, each with 8–11 survey points, and visited each transect twice per year to perform a 5‐minute point count. From 2018–2020, transect occupancy rates of short‐eared owls were highly variable within individual states but reasonably stable over our study area. California, Idaho, Utah, and Washington were the only states where occupancy rates were stable year to year, with the most stability in Utah and Washington. More monitoring may be warranted to address spatial and temporal variability in abundance of this species that may be influenced by small‐mammal cycles. Our results illustrate the large movements of individuals across regions that may be required to support the North American population, emphasizing the need for broad geographic monitoring and conservation strategies for short‐eared owls.
Emigration and survival correlate with different precipitation metrics throughout a grassland songbird's annual cycle
Authors: Silber Katy M. , Mohankumar Narmadha M. , Hefley Trevor J. , Boyle W. Alice
Published: February 2023

Many exogenous factors may influence demographic rates (i.e., births, deaths, immigration, emigration), particularly for migratory birds that must cope with variable weather and habitat throughout their range and annual cycle. In midcontinental grasslands, disturbance (e.g., fire and grazing) and precipitation influence variation in grassland structure and function, but we know little about when and why precipitation is associated with grassland species' vital rates. We related estimates of detection, survival, and emigration to a priori sets of precipitation metrics to test the putative alternative factors influencing movement and mortality in grasshopper sparrows (Ammodramus savannarum). This species is a migratory songbird that exhibits exceptionally high rates of within‐season and between‐season dispersal. Between 2013 and 2020, we captured and resighted grasshopper sparrows in northeastern Kansas, USA, compiling capture histories for 1,332 adult males. We tested predictions of climatic hypotheses explaining variation in survival and emigration throughout a grasshopper sparrow's annual cycle; both survival and emigration were associated with the El Niño‐Southern Oscillation precipitation index (ESPI). Survival was positively related with ESPI during winter, and temporary emigration was curvilinearly related to breeding season ESPI lagged 2 years, with the highest site fidelity associated with intermediate rainfall values. The relationship between rainfall and temporary emigration likely reflects the influence of weather over multiple years on vegetation structure with consequent effects on local demography. This study provides compelling support for the idea that grassland species respond to high interannual variability by adopting dispersal strategies unlike those of many well‐studied migrant birds. Furthermore, the results imply that the consequences of increasing climatic extremes may not be immediately apparent, with demographic consequences lasting for at least a few years.
Holocene glacial oscillations in the Tyroler Valley (NE Greenland)
Authors: Garcia‐Oteyza Ciria Julia , Oliva Marc , Palacios David , M. Fernández‐Fernández José , Schimmelpfennig Irene , Medialdea Alicia , Fernandes Marcelo , Giralt Santiago , Jomelli Vincent , Antoniades Dermot ,   ASTER TEAM
Published: February 2023

Although the spatiotemporal oscillations of the Greenland Ice Sheet (GrIS) during the last millennia have played a prominent role in global environmental changes, its glacial response to the natural variability still needs to be better constrained. Here, we focused on the reconstruction of the glacial behavior and deglaciation process along the Tyroler Valley (74° N, 22° E), within the Northeast Greenland National Park. This NW‐SE valley connects with the GrIS via the Pasterze Glacier and divides two ice caps (A.P. Olsen Land and Payer Land), this last one feeding two piedmont glaciers (Copeland and Kløft glaciers). For this study, we combined the interpretation of the spatial pattern of geomorphological features and the chronological framework defined by a new dataset of 15 10Be cosmic‐ray exposure (CRE) ages from glacially polished bedrock surfaces and moraine boulders together with one optically stimulated luminescence (OSL) age of a glaciolacustrine deposit. CRE ages indicate that the deglaciation of the lowest parts of the valley and the exposure of the highest slopes took place during the Early Holocene, at ca. 10–8.5 ka (ka = thousand year [BP]). Furthermore, this ice thinning also favored the disconnection of the valley tributary glaciers. Samples from the moraines of the two tributary glaciers indicate that the deglaciation was not continuous, but it was interrupted by at least three phases of glacial advance during the Neoglacial cooling (before ca. 5.9 ka), and the Little Ice Age (LIA, 0.6, and 0.3 ka). The larger piedmont glacier (Copeland Glacier) occupied the valley floor during these major advances, damming the river and allowing the formation of a proglacial glacial lake upvalley, as confirmed by the OSL date of lacustrine sediments that yielded an age of 0.53 ± 0.06 ka. In short, our study provides new evidence of the relative stability of GrIS and the regional ice caps in the area, in which glacial fronts have been rather stable since their advances during the Neoglacial and the LIA.
Optical Phase‐Sensitive Reflectometry Based on Orthogonal Frequency‐Division Multiplexed LFM Signal in Fractional Fourier Domain
Authors: Zhao Can , Wang Li , Wu Hao , Tang Ming
Published: February 2023

Linear frequency modulated (LFM) phase‐sensitive optical time‐domain reflectometry (φ‐OTDR) relieves the trade‐off between sensing range and spatial resolution; however, it is still limited by low sidelobe suppression ratio and signal fading. Fractional Fourier transform (FrFT) is applied to LFM φ‐OTDR for signal generation and compression. An LFM pulse is generated using the p‐order FrFT of a direct current signal and then compressed using FrFT with order 1−p to achieve a high sidelobe suppression ratio. Orthogonal frequency‐division multiplexing in the fractional Fourier domain is utilized to suppress signal fading. In experiments, fading‐free distributed phase measurement is realized using a multiplexed LFM probe pulse generated using a 0.4‐order FrFT. Dynamic sensing is demonstrated via single‐frequency or sweep‐frequency vibration, thereby validating high sensing performance. This work will not only open up a route for signal processing in LFM pulse based high‐performance φ‐OTDR, but also has significant potential for applications in other sensing systems using LFM signals.
Assessment of Axial Postural Abnormalities in Parkinsonism: Automatic Picture Analysis Software
Authors: Artusi Carlo Alberto , Geroin Christian , Imbalzano Gabriele , Camozzi Serena , Aldegheri Stefano , Lopiano Leonardo , Tinazzi Michele , Bombieri Nicola
Published: February 2023

Background

Software‐based measurements of axial postural abnormalities in Parkinson's disease (PD) are the gold standard but may be time‐consuming and not always feasible in clinical practice. An automatic and reliable software to accurately obtain real‐time spine flexion angles according to the recently proposed consensus‐based criteria would be a useful tool for both research and clinical practice.

Objective

We aimed to develop and validate a new software based on Deep Neural Networks to perform automatic measures of PD axial postural abnormalities.

Methods

A total of 76 pictures from 55 PD patients with different degrees of anterior and lateral trunk flexion were used for the development and pilot validation of a new software called AutoPosturePD (APP); postural abnormalities were measured in lateral and posterior view using the freeware NeuroPostureApp (gold standard) and compared with the automatic measurement provided by the APP. Sensitivity and specificity for the diagnosis of camptocormia and Pisa syndrome were assessed.

Results

We found an excellent agreement between the new APP and the gold standard for lateral trunk flexion (intraclass correlation coefficient [ICC] 0.960, IC95% 0.913–0.982, P < 0.001), anterior trunk flexion with thoracic fulcrum (ICC 0.929, IC95% 0.846–0.968, P < 0.001) and anterior trunk flexion with lumbar fulcrum (ICC 0.991, IC95% 0.962–0.997, P < 0.001). Sensitivity and specificity were 100% and 100% for detecting Pisa syndrome, 100% and 95.5% for camptocormia with thoracic fulcrum, 100% and 80.9% for camptocormia with lumbar fulcrum.

Conclusions

AutoPosturePD is a valid tool for spine flexion measurement in PD, accurately supporting the diagnosis of Pisa syndrome and camptocormia.
Polynomial stability of a transmission problem involving Timoshenko systems with fractional Kelvin–Voigt damping
Authors: Guesmia Aissa A , Mohamad Ali Zeinab , Wehbe Ali , Youssef Wael
Published: February 2023

In this work, we study the stability of a one‐dimensional Timoshenko system with localized internal fractional Kelvin–Voigt damping in a bounded domain. First, we reformulate the system into an augmented model and using a general criteria of Arendt–Batty we prove the strong stability. Next, we investigate three cases: The first one when the damping is localized in the bending moment, the second case when the damping is localized in the shear stress, we prove that the energy of the system decays polynomially with rate
in both cases. In the third case, the fractional Kelvin–Voigt is acting on the shear stress and the bending moment simultaneously. We show that the system is polynomially stable with energy decay rate of type
, provided that the two dampings are acting in the same subinterval. The method is based on the frequency domain approach combined with multiplier technique.
Multipleμ‐stability analysis of time‐varying delayed quaternion‐valued neural networks
Authors: Chouhan Shiv Shankar , Das Subir , Singh Sunny , Shen Hao
Published: February 2023

This article addresses the multiple ‐stability analysis of ‐dimensional quaternion‐valued neural networks (QVNNs) with unbounded time‐varying delays (UTVD) and two general classes of activation functions (AFs). Firstly, the QVNNs are decomposed into four equivalent real‐valued systems, and based on the geometrical configuration of the AFs, the state space is divided into disjoint regions. Considering the properties of AFs, several sufficient conditions are derived to ensure the coexistence of equilibria, out of which are locally ‐stable. Moreover, some sufficient conditions for multiple exponential stability, multiple power stability, and multiple log stability are also derived in this article. Finally, two numerical examples are presented. The first example validates the effectiveness of the proposed theoretical results while the second example illustrates the application of QVNNs on the associative memory, which shows that QVNNs have the ability to reliably retrieve true‐color image patterns.
The role of pain catastrophizing in pain perception among patients with rheumatoid arthritis without clinical signs of inflammation
Authors: Abe Takeo , Tamura Masao , Azuma Naoto , Matsui Kiyoshi
Published: February 2023

Objective

Pain in rheumatoid arthritis (RA) is considered to be associated with non‐inflammatory factors, including physical disabilities, psychiatric disorders, and pain catastrophizing (PC). PC is reportedly a key driver in the development of pain in patients with RA without clinical signs of inflammation; however, previous studies enroled patients with RA who were potentially in an inflammatory state. Hence, our aim was to investigate the role of PC as the possible link between pain, physical disabilities, and psychiatric disorders in patients with RA without clinical signs of inflammation.

Materials and Methods

In this cross‐sectional study, 81 patients with RA without clinical signs of inflammation were included; all patients had serum C‐reactive protein levels <0.5 mg/dL, without any inflammatory joints. We examined the demographic and clinical data and administered the pain visual analogue scale (VAS), pain catastrophizing scale (PCS), Health Assessment Questionnaire Disability Index (HAQ‐DI), and patient version of the Brief Scale for Psychiatric Problems in Orthopaedic Patients (pBS‐POP). A series of multivariate‐adjusted multiple regression analyses were performed to examine the associations between PC and pain intensity, physical disabilities, and psychiatric disorders.

Results

We found associations between all the above‐mentioned variables in separate models with HAQ‐DI, pBS‐POP, and PCS scores. However, in the model associated with pain VAS, the PCS score (β = 0.34, p = 0.0073) emerged as the only variable showing a statistically significant association.

Conclusions

PC is associated with pain in patients with RA without clinical signs of inflammation, and this association may be mediated through pathways involving physical disabilities and psychiatric disorders.
Effects of hypobaric hypoxia during a simulated ultra‐long‐haul flight on inflammation and regeneration after muscle trauma and muscle trauma‐hemorrhagic shock
Authors: Zhang Liyuan , Voss Joachim G. , Soulakova Julia N. , St. Pierre Schneider Barbara
Published: February 2023

Introduction/Aims

Because wounded warfighters or trauma victims may receive en route care to the closest medical facility via airplane transport, we investigated the effects of extended mild hypobaric hypoxia (HB), the environmental milieu of most airplanes, on inflammation and regeneration after muscle trauma or monotrauma (MT) and muscle trauma‐hemorrhagic shock or polytrauma (PT).

Methods

Male C57BL/6N mice were assigned to one of six groups pertaining to injury (control/uninjured, MT, and PT) and atmospheric pressure exposure (HB and normobaric normoxia, NB). Body mass, blood and muscle leukocyte number by flow cytometry, immunohistochemistry, or both, and the muscle relative mRNA level of selected genes involved in inflammation and muscle regeneration were examined at ~1.7, 4, 8, and 14 days post trauma (dpt). At 14 dpt, the proportion of smaller‐ and larger‐sized myofibers at the regenerating site of MT mice was determined.

Results

Greater body mass loss, an increased number of blood and muscle leukocytes, and differential muscle relative mRNA levels were observed in MT and PT groups compared to controls. The MT+HB or PT+HB mice demonstrated more body mass loss and altered relative mRNA level than the corresponding NB mice. Additionally, a subgroup of MT+HB mice demonstrated a greater proportion of smaller myofibers (250 to 500 μm2) than MT+NB mice at 14 dpt.

Discussion

HB exposure after muscle trauma alone may prolong regeneration. Following HB exposure, therapies that promote oxygenation may be needed during this muscle recovery.
Utilizing machine learning and lipidomics to distinguish primary lateral sclerosis from amyotrophic lateral sclerosis
Authors: Lee Ikjae , Stingone Jeanette A. , Chan Robin Barry , Mitsumoto Hiroshi
Published: February 2023

Introduction/Aims

There are currently no imaging or blood diagnostic biomarkers that can differentiate amyotrophic lateral sclerosis (ALS) from primary lateral sclerosis (PLS) patients early in their disease courses. Our objective is to examine whether patients with PLS can be differentiated from ALS reliably by using plasma lipidome profile and supervised machine learning.

Methods

40 ALS and 28 PLS patients derived from the Multicenter Cohort study of Oxidative Stress (COSMOS) and 28 healthy control volunteers (CTR) were included. ALS, PLS, and CTR were matched by age and sex. Plasma samples were obtained after overnight fasting. Lipids were extracted from the plasma samples and analyzed using liquid chromatography/mass spectrometry to obtain relative concentrations of 392 lipid species. The lipid data were partitioned into training and testing datasets randomly. An elastic net algorithm was trained using cross‐validation to classify PLS vs ALS and PLS vs CTR. Final accuracy was evaluated in the testing dataset.

Results

The elastic net model trained with labeled PLS and ALS training lipid dataset demonstrated accuracy (number classified correctly/total number), sensitivity, and specificity of 100% in classifying PLS vs ALS in the unlabeled testing lipid dataset. Similarly, the elastic net model trained with labeled PLS and CTR training lipid datasets demonstrated accuracy, sensitivity, and specificity of 88% in classifying PLS vs CTR in the unlabeled testing lipid dataset.

Discussion

Our study suggests PLS patients can be accurately distinguished from ALS and CTR by combining lipidome profile and supervised machine learning without clinical information.
Consistency of uroflowmetry analysis in children among observers
Authors: Sekerci Cagri Akin , Tanidir Yiloren , Tarcan Tufan , Yucel Selcuk
Published: February 2023

Aim

The aim of the study is to compare the intra‐ and inter‐observer interpretations of the same uroflowmetry study at two different times.

Materials and Methods

Two‐hundred children with a voided volume of 50% above the expected bladder capacity were included. All traces were asked to be evaluated by 11 observers two times in a time span of 1 month. These observers consist of pediatric urologists (n = 2), pediatric urology fellows (n = 2), urology residents (n = 5), and certified urodynamics nurses (n = 2). Each uroflowmetry was asked to be assessed for three domains: voided volume (VV), detrusor sphincter dyssynergia (DSD), and flow curve pattern (FCP).

Results

Of the 200 patients with a median age of 10 (4–18) years, 128 (64%) were girls and 72 (36%) boys. The maximum flow rate and the median voided volume were found to be 20 (4–61) mL/s and 232 (116–781) mL. The Fleiss' kappa coefficient of VV, DSD, and FCP in the first assessment was 0.510, 0.501, and 0.346. In the second assessment, κ values were 0.530, 0.422, and 0.373. The best‐agreed findings were similar at both times. These were found to be low VV (0.602 and 0.626) and intermittent pattern (0.500 and 0.553). Interpreters were found to have a statistically significant difference in agreement with their own interpretation at different times.

Conclusion

Both inter‐ and intra‐observer reliability of the agreement point out the problem in the standardization of uroflowmetry. Inter‐ and intra‐observer reliability of uroflowmetry interpretation can be increased by defining precise numbers and numerical algorithms.
Causal associations of sleep apnea and snoring with type 2 diabetes and glycemic traits and the role of BMI
Authors: Wang Jiao , Campos Adrian I. , García‐Marín Luis M. , Rentería Miguel E. , Xu Lin
Published: February 2023

Objective

Sleep apnea and snoring have been associated with type 2 diabetes, with BMI playing a role in the pathway, but the directions of causality are unclear. This study examined the causal associations of sleep apnea and snoring with type 2 diabetes while assessing the role of BMI using multiple genetic methods.

Methods

Five genetic methods were used: two‐sample; bidirectional univariable Mendelian randomization (MR) inverse variance‐weighted (MR‐IVW); multivariable MR‐IVW; network MR; and latent causal variable method.

Results

Compared with univariable MR‐IVW, the odds ratio (95% CI) of type 2 diabetes for genetically predicted sleep apnea and snoring using the largest genome‐wide association study decreased dramatically, from 1.61 (95% CI: 1.16‐2.23) to 1.08 (95% CI: 0.59‐1.97) and from 1.98 (95% CI: 1.25‐3.13) to 1.09 (95% CI: 0.64‐1.86) after adjustment for BMI. Network MR showed that BMI accounts for 67% and 62% of the total effect of sleep apnea and snoring on type 2 diabetes, respectively. The latent causal variable suggested that sleep apnea and snoring have no direct causal effect on type 2 diabetes.

Conclusions

These results first suggest that the associations of sleep apnea and snoring with type 2 diabetes were mainly driven by BMI. The possible indirect effects of sleep apnea and snoring on type 2 diabetes through BMI cannot be ruled out.
Transverse Maxillary Deficiency Predicts Increased Upper Airway Collapsibility during Drug‐Induced Sleep Endoscopy
Authors: Thuler Eric , Seay Everett G. , Woo John , Lee Jane , Jafari Niusha , Keenan Brendan T. , Dedhia Raj C. , Schwartz Alan R.
Published: February 2023

Objective

To examine the relationship between craniofacial skeletal anatomy and objective measures of pharyngeal collapse obtained during drug‐induced sleep endoscopy. We hypothesized that transverse maxillary deficiency and an increased pharyngeal length will be associated with higher levels of pharyngeal collapsibility.

Study Design

Cross‐sectional analysis in a prospective cohort.

Setting

University Hospital.

Methods

A cross‐sectional analysis was conducted in a cohort of consecutive patients from the positive airway pressure (PAP) alternatives clinic who underwent computed tomography (CT) analysis and drug‐induced sleep endoscopy for characterization of upper airway collapsibility. PAP titration was used to determine pharyngeal critical pressure (PCRIT) and pharyngeal opening pressure (PhOP). CT metrics included: Transverse maxillary dimensions (interpremolar and intermolar distances) and pharyngeal length (posterior nasal spine to hyoid distance).

Results

The cohort (n = 103) of severe obstructive sleep apnea (Apnea and Hipopnea Index 32.1 ± 21.3 events/h) was predominantly male (71.8%), Caucasian (81.6%), middle‐aged (54.4 ± 14.3 years), and obese (body mass index [BMI] = 30.0 ± 4.9 kg/m2). Reduced transverse maxillary dimensions were associated with higher PCRIT (intermolar distance: β [95% confidence interval, CI] = −.25 [−0.14, −0.36] cmH2O/mm; p = .03) and PhOP (Interpremolar distance: β = −.25 [−0.14, −0.36] cmH2O/mm; p = .02). Longer pharyngeal length was also associated with higher PCRIT (β = .11 [0.08, 0.14] cmH2O/mm, p = .04) and PhOP (β [95% CI] = .06 [0.03, 0.09] cmH2O/mm, p = .04). These associations persisted after adjustments for sex, age, height, and BMI.

Conclusion

Our results further the concept that skeletal restriction in the transverse dimension and hyoid descent are associated with elevations in pharyngeal collapsibility during sleep, suggesting a role of transverse deficiency in the pathogenesis of airway obstruction.
Reduced Risk of Corporal Tumors in Patients With Head and Neck Paragangliomas With p.Pro81Leu Mutations
Authors: Miller Katherine M. , Sbeih Firas , Contrera Kevin , Reddy Chandana A. , Marquard Jessica , Eng Charis , Lorenz Robert R.
Published: February 2023

Objective

Patients with head and neck paragangliomas who are positive for the SDHD p.Pro81Leu (P81L) mutation are thought to have a distinct phenotype from other SDHx mutations, but few studies have focused on this mutation. The objective of this study was to determine the hazard of developing a second primary, metastatic, or recurrent paraganglioma in SDHx patients with or without P81L.

Study Design

Retrospective chart review of 60 patients with head and neck paragangliomas and genetic testing, followed for a median of 9 years.

Setting

Single academic medical center.

Methods

Univariable Cox proportional hazards regression evaluated second primary and recurrent paragangliomas in patients with SDHD P81L, SDHx non‐P81L, and nonhereditary paraganglioma.

Results

This series comprised 31 patients without SDHx, 14 with SDHD P81L, and 15 with other SDHx mutations. At a median 9 years of follow‐up, corporal (not head and neck) second primary paragangliomas occurred in 31% of patients with SDHx non‐P81L mutations, compared with 0% and 4% of patients with SDHD P81L and without SDHx mutations, respectively. Second corporal paragangliomas were more likely in patients with SDHx non‐P81L mutations than in those without a mutation (hazard ratio = 5.461, 95% confidence interval: 0.596‐50.030, p = .13).

Conclusion

This is the first study to report a lower likelihood of corporal tumors for patients with head and neck paragangliomas with SDH mutations positive for P81L. Larger studies are needed to determine if head and neck paraganglioma patients with P81L qualify for less intensive imaging surveillance to screen for second primary paragangliomas outside the head and neck.
Auditory Outcomes in Children Who Undergo Cochlear Implantation Before 12 Months of Age: A Systematic Review
Authors: Wu Shannon S. , Sbeih Firas , Anne Samantha , Cohen Michael S. , Schwartz Seth , Liu Yi‐Chun C. , Appachi Swathi
Published: February 2023

Objective

To systematically review the literature to determine auditory outcomes of cochlear implantation in children ≤12 months old.

Data Source

PubMed, EMBASE, Medline, CINAHL, Cochrane, Scopus, and Web of Science databases were searched from inception to 9/1/2021 using PRISMA guidelines.

Review Methods

Studies analyzing auditory outcomes after cochlear implantation (CI) in children ≤12 months of age were included. Non‐English studies and case reports were excluded. Outcome measures included functional and objective auditory results. Two independent reviewers evaluated each abstract and article. Heterogeneity and bias across studies were evaluated.

Results

Of 305 articles identified, 17 met inclusion criteria. There were 642 children ages 2 to 12 months at CI. The most common etiologies of hearing loss were congenital CMV, meningitis, idiopathic hearing loss, and GJB2 mutations and other genetic causes. All studies concluded that early CI was safe. Overall, outcomes improved following early CI: IT‐MAIS (9 studies), LittlEARS (4 studies), PTA (3 studies), CAP (3 studies), GASP (3 studies), and LNT (3 studies). Nine studies compared outcomes to an older implantation group (>12 months); of these (n = 450 early CI, n = 1189 late CI), 8 studies showed earlier CI achieved comparable or better auditory outcomes than later implantation, whereas 1 study (n = 120) concluded no differences in speech perception improvement.

Conclusion

Auditory outcomes were overall improved in children ≤12 months old undergoing CI. Studies that compared early to late CI demonstrated similar or better auditory outcomes in early implantation group. Given the comparable safety profile and critical time period of speech and language acquisition, earlier CI should be considered for infants with hearing loss.
Electrospun short nanofibers to improve damage resistance of carbon fiber composites
Authors: Shakil Usaid Ahmed , Abu Hassan Shukur , Yahya Mohd Yazid
Published: February 2023

Carbon composites are sensitive to matrix cracking, delamination, and fiber‐matrix debonding induced by external transverse loading. Such invisible damages demand frequent non‐destructive testing (NDT) owing to their tendency to propagate in brittle composites. Application of carbon composites in safety critical structures have urged researchers to design for superior damage resistance. Bulk modification of matrices through nanoparticles is one such technique that exploits high surface area and mechanical properties of nano‐reinforcements to engineer desired interfaces and improve mechanical properties. This study adopts the same technique to investigate effect of electrospun nylon 6 short nanofiber addition on damage resistance of carbon fiber/epoxy composites. Different concentrations (0.05, 0.1, 0.2, and 0.4 wt% of epoxy) of short nanofibers were prepared to modify epoxy and fabricate carbon laminates. Quasi‐static indentation tests confirmed improvement of 8.7, 8.8, and 53% in peak force, displacement and elastic toughness of carbon composites at optimum nanofiber concentration (0.05 wt%). External damage area marginally improved though directional damage growth was suppressed. Delaminated area reduced by 12.6% at optimum nanofiber concentration. Suppression of compressive fiber failure and enhanced interlaminar bonding were credited to offer superior performance. In general, development of nanofiber‐rich zones declined the load bearing response above optimum concentration.
Belonging from the perspectives of individuals with disabilities: A scoping review
Authors: Raines Alexandra R. , Francis Grace L. , Fujita Megan , Macedonia Anna
Published: February 2023

Belonging is an individualized and complex phenomenon that is understudied among individuals with disabilities. Currently, there is an absence of voices of individuals with disabilities regarding their experiences and perspectives. This scoping review aimed to identify the extent, range, and nature of research on belonging from the experiences of individuals with disabilities between 1974 and 2020. Collectively, 4441 articles were screened and a total of 13 studies were extracted and fully reviewed. The authors present findings on variables related to belonging, positive influence of belonging, and barriers to belonging. Limitations and future research are discussed.
Predictors of depression among adolescents joining selected public secondary schools in Nairobi County, Kenya
Authors: Mokaya Aggrey G. , Kikuvi Gideon M. , Mutai Joseph , Khasakhala Lincoln I. , Memiah Peter
Published: February 2023

Depression is common among adolescents more so during the transition to secondary school, and the psychosocial and emotional changes that accompany adolescence. This study sought to assess the prevalence and predictors of depression among students joining public secondary schools in Nairobi County. The study was carried out at five selected public secondary schools in Nairobi County covering 539 students between the ages of 11 and 18 years. The Patient Health Questionnaire‐Adolescent version (PHQ‐A) was used to collect data on depression. For suicidal behavior, the Suicide Behavior Questionnaire‐revised version was used. The Adolescent Peer Relations Instrument was used to assess bullying victimization. These were augmented by a sociodemographic questionnaire. Depression prevalence rates were generated using a generalized linear model customized with a log link and a Poisson distribution for a common binary outcome. The prevalence of depression was found to be 14.5%, with a mean PHQ‐A score of 6.16 (SD = 3.16). Predictors of depression were suicide risk (adjusted prevalence ratio [aPR] = 3.07, confidence interval, CI [1.94–4.88]; p < .001) and lifetime alcohol use (aPR = 2.24, CI [1.36–3.68]; p = .001). Depression is prevalent among adolescents joining secondary schools in Nairobi County. Counselor‐led school‐based cognitive behavioral therapy could be a sustainable strategy for reducing depression symptoms and guiding preventive efforts among adolescents in this context.
Integration of Hybrid Dendrimers and Their Generations for Modulated Spatio‐Temporal Action
Authors: Kharangate Kalyani , Shende Pravin
Published: February 2023

Hybrid dendrimers constitute a unique class of well‐defined complex architecture featured with a central domain and bifurcated branches with two different dendritic sequences for their atomic configuration and functional groups at the periphery. This review article pioneers the field of new hybrid dendrimers using different generations by nanoconjugation with metals, carbohydrates, nucleotides, proteins/peptides, carbosilane, urea, silica, stem cells, guanidine, etc. The smart dendrimers contain desirable electrical, magnetic, optical, and biological attributes to increase surface area, monodisperse behavior, dose reduction, dissolution, permeability, long‐term stability, and significant decrement in nanotoxicity studies. The higher encapsulation of lipid soluble and insoluble moieties explores an excellent platform for the delivery of drugs (ibuprofen, indomethacin, etc.), nucleic acids (oligonucleotide, siRNA, and aptamer), genetic materials , and chemical diagnostic agents (gadolinium chelates and superparamagnetic iron oxide particles) for imaging. Owing to their flexibility in structural adaptability, different health conditions like glaucoma, inflammation, microbial infection, neurodegenerative problems (Alzheimer's disease and Parkinsonism), and cancer are benefited using such long‐lasting drug delivery. Advancements in molecular engineering techniques, 3D printing, artificial intelligence, robotic, green synthesis, and microwave‐assisted methods aid in the development of economically reliable and personalized pharmaceutical hybrid dendritic systems resembling antibodies, globular proteins, stem cells, enzymes, and genetic materials.
Variation in clinical practice guidelines for use of palivizumab in preventing severe respiratory syncytial viral (RSV) disease in high‐risk infants
Authors: Stiboy Eunice , Chan Mei , Islam Md Saiful , Saravanos Gemma L. , Lui Kei , Jaffe Adam , Homaira Nusrat
Published: February 2023

Background

Uniformity and compliance with clinical practice guidelines (CPGs) for use of palivizumab in preventing severe respiratory syncytial viral infection in Australian high‐risk infants remain unclear.

Methods

An online survey was conducted across the Australian and New Zealand Neonatal Network (ANZNN) to determine clinical practices around palivizumab. A literature search was also performed to identify and compare national and international guidelines.

Results

A total of 65 of 422 ANZNN members completed the survey. Respondents included 61 senior medical staff of consultants/staff specialists (78%) and four nursing staff (6%). According to the survey, infants most likely to be recommended palivizumab included preterm infants born <29 weeks gestational age (GA) (30%), children with chronic lung diseases (CLDs) born <32 weeks GA (40%), and with hemodynamically significant heart disease (35%). Many of the respondents (53%) stated that CPGs for palivizumab were developed locally.

Literature search identified 20 guidelines (10 international and 10 domestic); 16 (80%) recommended palivizumab use in preterm infants, 16 (80%) recommended use in infants with CLD, 17 (85%) in congenital heart disease and 6 (30%) in bronchopulmonary dysplasia (BPD). Eight (40%) guidelines provided specific recommendations for immunocompromised infants. Canada, Western Australia, and American Academy of Paediatrics provided recommendations for Indigenous children. Frequency and dosage of palivizumab was universal across all CPGs. None of the international guidelines obtained were from low‐ or middle‐income countries.

Conclusions

Standardization of CPGs may improve clinical decision making around use of palivizumab in high‐risk infants.
Improvements in body mass index of children with cystic fibrosis following implementation of a standardized nutritional algorithm: A quality improvement project
Authors: Gokdemir Yasemin , Eralp Ela Erdem , Ergenekon Almala Pinar , Yegit Cansu Yilmaz , Yanaz Muruvvet , Mursaloglu Hakan , Uzunoglu Burcu , Kocamaz Damla , Tastan Gamze , Filbrun Amy , Enochs Catherine , Bouma Sandra , Iwanicki Courtney , Karakoc Fazilet , Nasr Samya Z. , Karadag Bulent
Published: February 2023

Background

A collaboration between the University of Michigan (UM) Cystic Fibrosis Center (CFC) and Marmara University (MU) CFC was initiated in MU through conducting Quality Improvement projects (QIP). The global aim was to improve nutritional status of children with CF (cwCF), with a specific aim to increase the mean BMI percentile (BMIp) for cwCF by 10 percentile points in 12 months.

Methods

Body mass index (BMI) percentiles of cwCF were categorized as: nutritionally adequate (BMIp ≥ 50%); at risk (BMIp 25%–49%); urgently at risk (BMIp 10%–25%); critically at risk (BMIp < 10%). Appropriate interventions were made according to BMIp category every three months. Forced expiratory volume in one‐second percent predicted (FEV1pp), and health‐related quality of life (HRQoL) were evaluated.

Results

One hundred and eight‐two cwCF with a mean age of 9.1 ± 4.3 years were included in the project. Baseline BMIp increased from 25.6 to 37.2 at the 12th month (p < 0.001). In the critically at‐risk group BMIp increased from 3.6 to 20.5 (p < 0.001), in the urgently at risk group from 15.9 to 30.8 (p < 0.001), in the at risk group from 37.0 to 44.2 (p < 0.079) and in the nutritionally adequate group the increase was from 66.8 to 69.5 (p < 0.301). FEV1pp also improved significantly, from 81.3 ± 20.6 to 85.9 ± 20.8 (p < 0.001). Physical functioning, eating problems, and respiratory symptoms domains of the HRQoL evaluation improved (p < 0.05).

Conclusion

This project has led to significant improvements in BMIp, FEV1pp and HRQoL of cwCF; similar projects could easily be implemented by centers in other developing countries.
Vibrational Spectra of HNIW and its Isotopologues: A Combined Experimental and Computational Study
Authors: Burton Mark A. , Steele Brad A. , Crowhurst Jonathan C. , Racoveanu Ana , Kuo I‐Feng W. , Shaw William L. , Gee Richard H.
Published: February 2023

Incorporating isotopically labelled materials in degradation experiments could help unravel the mechanism(s) of decomposition through use of the kinetic isotope effect. Characterizing synthesized isotopologues however requires an understanding of what observable signals are affected by the isotopic substitution. As vibrational spectroscopy can distinguish between isotopologues, it is an ideal characterization technique to evaluate isotopic variants. To this end, the vibrational spectra of HNIW and its deuterated (2H), 13C, 15N (all), 15N (nitro), and 18O isotopologues have been computationally predicted in the gas phase using density functional theory. These results are compared to experimentally measured FTIR/ATR and Raman spectra of both unsubstituted HNIW and 15N‐labeled HNIW in which the six nitro groups were synthetically tagged with 15N atoms (15Nnitro−HNIW). The experimental isotopic frequency shift for the −NO2 asymmetric stretching frequencies agrees with that theoretically calculated (∼35.7 cm−1 vs. 36.5 cm−1, respectively). Furthermore, analysis of the theoretically predicted frequency shifts for all isotopologues suggest the −NO2 bending modes are lower in frequency than previously reported. This assignment is supported by the experimentally measured isotopic shift of ∼10.1 cm−1 for these features (consistent with the predicted shift of ∼13.1 cm−1). This work expands our current understanding of the vibrational modes in HNIW as well as provides a method for future work on similar systems.