bluuebunny/crossref_metadata_2025 huggingface dataset:
Glomerular Filtration Rate, Cardiorenal End Points, and All-Cause Mortality in Type 2 Diabetic Patients
Authors: So Wing Yee , Kong Alice P.S. , Ma Ronald C.W. , Ozaki Risa , Szeto Cheuk Chun , Chan Norman N. , Ng Vanessa , Ho Chung Shun , Lam Christopher W.K. , Chow Chun Chung , Cockram Clive S. , Chan Juliana C.N. , Tong Peter C.Y.
Published: August 2006

OBJECTIVE—Chronic kidney disease (CKD) predicts cardiovascular disease (CVD) in the general population. We investigated the effects of stages of renal function using the estimated glomerular filtration rate (eGFR) on all-cause mortality and cardiovascular end points in a prospective cohort of Chinese type 2 diabetic patients.

RESEARCH DESIGN AND METHODS—Between 1995 and 2000, 4,421 patients without macrovascular disease or end-stage renal disease were recruited. Renal function was assessed by eGFR, as calculated by the abbreviated Modification of Diet in Renal Disease Study Group formula. Clinical end points included all-cause mortality, cardiovascular end point (cardiovascular death, new admissions due to angina, myocardial infarction, stroke, revascularization, or heart failure), and renal end point (reduction in eGFR by >50%, progression of eGFR to stage 5, or dialysis or renal death).

RESULTS—After a median follow-up period of 39.4 months (interquartile range 20.3–55), all-cause mortality rate increased from 1.2% (95% CI 0.8–1.7) to 18.3% (9.1–27.5) (P for trend <0.001) as renal function deteriorated from stage 1 (eGFR ≥90 ml/min per 1.73 m2) to stage 4 (15–29 ml/min per 1.73 m2). The respective rate of new cardiovascular end points also increased from 2.6% (2.0–3.3) to 25.3% (15.0–35.7) (P for trend <0.001). After adjustment for covariates (age, sex, albuminuria, use of renin-angiotensin-aldosterone system [RAAS] inhibitors, lipids, blood pressure, and glycemic control), hazard ratios across different stages of eGFR (≥90, 60–89, 30–59, and 15–29 ml/min per 1.73 m2) for all-cause mortality were 1.00, 1.27, 2.34, and 9.82 (P for trend <0.001), for cardiovascular end points were 1.00, 1.04, 1.05, and 3.23 (P for trend <0.001), and for renal end points were 1.00, 1.36, 3.34, and 27.3 (P for trend <0.001), respectively.

CONCLUSIONS—Chinese type 2 diabetic patients with reduced eGFR were at high risk of developing cardiovascular end points and all-cause mortality, independent of albuminuria and metabolic control.
Ethnic Differences in Perinatal Outcome of Gestational Diabetes Mellitus
Authors: Silva Jana Kaida , Kaholokula Joseph Keawe‘aimoku , Ratner Robert , Mau Marjorie
Published: August 2006

OBJECTIVE— Despite the high rates of gestational diabetes mellitus (GDM) among certain Pacific Islander and Asian ethnic groups in the U.S., little is known about the risk for adverse perinatal outcomes in these populations. We sought to examine ethnic differences in perinatal outcome among Asian and Pacific-Islander women with GDM.

RESEARCH DESIGN AND METHODS— A retrospective review of all women referred to the largest outpatient GDM program in the state of Hawai‘i from 1995 to 2005 was conducted. Patients of Native-Hawaiian/Pacific-Islander, Japanese, Chinese, Filipino, and Caucasian ethnicity were included (n = 2,155). Treatment of all patients consisted of an outpatient education class, dietary management, self-monitoring of blood glucose, and insulin instruction (if indicated). Demographics, maternal and neonatal characteristics, and delivery information were evaluated.

RESULTS— Neonates born to Native-Hawaiian/Pacific-Islander mothers and Filipino mothers had 4 and 2 times the prevalence of macrosomia, respectively, compared with neonates born to Japanese, Chinese, and Caucasian mothers. These differences persisted after adjustment for other statistically significant maternal and fetal characteristics. Ethnic differences were not observed for other neonatal or maternal complications associated with GDM, with the exception of neonatal hypoglycemia and hyperbilirubinemia.

CONCLUSIONS— Significant ethnic differences in perinatal outcomes exist across Asian and Pacific-Islander women with GDM. This finding emphasizes the need to better understand ethnic-specific factors in GDM management and the importance of developing ethnic-tailored GDM interventions to address these disparities.
New-Onset Diabetes and Risk of All-Cause and Cardiovascular Mortality
Authors: Smith Nicholas L. , Barzilay Joshua I. , Kronmal Richard , Lumley Thomas , Enquobahrie Daniel , Psaty Bruce M.
Published: August 2006

OBJECTIVE—Cardiovascular risk associated with new-onset diabetes is not well characterized. We hypothesized that risk of all-cause and cardiovascular mortality would be similar among participants with and without new-onset diabetes in the first years of follow-up and rise over time for new-onset diabetes.

RESEARCH DESIGN AND METHODS—The Cardiovascular Health Study (CHS) is a longitudinal study of cardiovascular risk factors in adults aged ≥65 years. We used CHS participants to define a cohort (n = 282) with new-onset diabetes during 11 years of follow-up. New-onset diabetes was defined by initiation of antidiabetes medication or by fasting plasma glucose >125 mg/dl among CHS participants without diabetes at study entry. Three CHS participants without diabetes were matched for age, sex, and race to each participant with new-onset diabetes at the time of diabetes identification (n = 837). Survival analysis provided adjusted hazard ratios (HRs) for all-cause and cardiovascular mortality.

RESULTS—During a median of 5.9 years of follow-up, there were 352 deaths, of which 41% were cardiovascular. In adjusted analyses, new-onset diabetes was associated with an HR of 1.9 (95% CI 1.4–2.5) for all-cause and 2.2 (1.4–3.4) for cardiovascular mortality compared with no diabetes. Mortality risks were elevated within 2 years of onset, especially cardiovascular risk (4.3 [95% CI 1.7–10.8]), and did not increase over time.

CONCLUSIONS—Our findings indicate that there may be a mortality differential soon after diabetes onset in older adults and suggest that long-term macrovascular damage from atherosclerosis may not be primarily responsible for increased risk.
Is the Number of Documented Diabetes Process-of-Care Indicators Associated With Cardiometabolic Risk Factor Levels, Patient Satisfaction, or Self-Rated Quality of Diabetes Care?
Authors: Ackermann Ronald T. , Thompson Theodore J. , Selby Joseph V. , Safford Monika M. , Stevens Mark , Brown Arleen F. , Narayan K.M. Venkat
Published: August 2006

OBJECTIVE—Simple process-of-care indicators are commonly recommended to assess and compare quality of diabetes care across health plans. We sought to determine whether variation in the number of simple diabetes processes of care across provider groups is associated with variation in other quality indicators, including cardiometabolic risk factor levels, patient satisfaction with care, or patient-rated quality of care.

RESEARCH DESIGN AND METHODS—We used cross-sectional survey and chart audit data for 8,733 patients with diabetes who received care from 68 provider groups nested in 10 health plans that participated in the Translating Research Into Action for Diabetes study. Analyses using hierarchical regression models assessed associations of the mean number of seven simple process measures with each of the following: HbA1c (A1C), systolic blood pressure (SBP), HDL and LDL cholesterol levels, patient satisfaction with care, and patient-rated quality of care.

RESULTS—After adjusting for case-mix differences across groups and plans, an average of one additional documented process of care for each patient in a group or plan was associated with significantly lower mean LDL cholesterol levels (−4.51 mg/dl [95% CI 1.46–7.58]) but not with A1C, SBP, or HDL cholesterol levels. The number of care processes documented was associated with patient satisfaction measures and self-rated quality of diabetes care.

CONCLUSIONS—Variation in the number of simple process-of-care indicators across provider groups or health plans is associated with differences in patient-centered measures of quality, but assessment of the quality of cardiometabolic risk factor control will require more advanced clinical performance indicators.
Decline in Neurophysiological Function After 7 Years in an Adolescent Diabetic Cohort and the Role of Aldose Reductase Gene Polymorphisms
Authors: Thamotharampillai Keerthi , Chan Albert K.F. , Bennetts Bruce , Craig Maria E. , Cusumano Janine , Silink Martin , Oates Peter J. , Donaghue Kim C.
Published: August 2006

OBJECTIVE—This 7-year longitudinal study examines the potential impact of aldose reductase gene (AKR1B1) polymorphisms on the decline of nerve function in an adolescent diabetic cohort.

RESEARCH DESIGN AND METHODS—Patients with type 1 diabetes (n = 262) were assessed with three cardiovascular autonomic tests (heart rate variation during deep breathing, Valsalva maneuver, and during standing from a lying position) and pupillometry (resting pupil diameter, constriction velocity, and reflex amplitude), thermal, and vibration thresholds on the foot. Genotyping was performed for promoters (C-106T and C-12G), (CA)n dinucleotide repeats, and intragenic BamH1 polymorphism.

RESULTS—Median time between first and last assessment was 7.0 years (interquartile range 5.1–11.1), with a median of five assessments (four to seven) per individual. At first assessment, median age was 12.7 years (11.7–13.9), median duration was 5.3 years (3.4–8.0), and median HbA1c was 8.5% (7.8–9.3). All tests declined over time except for two cardiovascular autonomic tests and vibration discrimination. Faster decline in maximum constriction velocity was found to associate with the Z-2 allele (P = 0.045), Z-2/Z-2 (P = 0.026). Slower decline in hot thermal threshold discrimination associated with Z+2 (P = 0.044), Z+2/Z+2 (P < 0.0005), Z+2/T (P = 0.038), and bb (P = 0.0001).

CONCLUSIONS—Most autonomic and quantitative sensory nerve testings declined over time. AKR1B1 polymorphisms were strongly associated with the rate of decline of these complications.
Validation of a Novel Point-of-Care Nerve Conduction Device for the Detection of Diabetic Sensorimotor Polyneuropathy
Authors: Perkins Bruce A. , Grewal Jaspreet , Ng Eduardo , Ngo Mylan , Bril Vera
Published: August 2006

OBJECTIVE—The diagnosis of diabetic sensorimotor polyneuropathy using objective electrophysiological tests is hindered by limited access to the specialized laboratories and technicians that perform and interpret them. We evaluated the performance characteristics of a novel portable and automated point-of-care nerve conduction study device, which can be operated by nontechnical personnel, and compared it with conventional nerve conduction studies performed in a specialist setting.

RESEARCH DESIGN AND METHODS—Seventy-two consecutive patients with diabetes (8 type 1, 64 type 2) from a diabetes and a neuropathy outpatient clinic were evaluated concurrently with conventional nerve conduction studies (the reference standard) and the point-of-care device for sural nerve function (sural nerve amplitude potentials in microvolts [μV]).

RESULTS—Sural nerve amplitude potentials measured by the point-of-care device shared very strong correlation with the reference standard (Spearman’s correlation coefficient 0.95, P < 0.001). The Bland and Altman method yielded agreement despite a small systematic underestimation by the point-of-care device of 1.2 ± 3.4 μV. Despite this small systematic bias, the sensitivity and specificity of normal and abnormal sural nerve amplitude potentials measured by the point-of-care device for the detection of diabetic sensorimotor polyneuropathy defined by standard clinical and electrophysiological criteria were 92 and 82%, respectively.

CONCLUSIONS—A novel point-of-care device has excellent diagnostic accuracy for detecting electrophysiological abnormality in the sural nerve of patients who have diabetes. This automated device represents an alternative to conventional nerve conduction studies for the diagnosis of diabetic sensorimotor polyneuropathy.
Wavelength Scale Singlet Achromatic Microlenses Based on High Refractive Index Materials
Authors: Wang Xueqian , Liu Chuanbao , Qiao Lijie , Zhou Ji , Bai Yang , Sun Jingbo
Published: March 2024

The common methods used for correcting chromatic aberration are typically based on multi‐lens and multi‐material systems, resulting in lens thicknesses that are several orders of magnitude greater than the wavelength and complex combination designs. A method to achieve the singlet achromatic microlens of the wavelength‐scale thickness by utilizing high refractive index materials with an aspherical profile is proposed. A theoretical model based on the dispersion effect is developed to guide the selection of materials and the design of thicknesses for achieving chromatic aberration correction in singlet microlenses of a given diameter and numerical aperture. H‐ZLaF68N (68N) glass, sapphire, and fused silica with relatively high to low refractive index are selected to prepare the singlet achromatic microlenses to verify the validity of the model. The thicknesses of three microlenses are 573, 737 nm, and 1.27 µm, respectively, and all of them have achieved achromatic correction as designed. This indicates that the high refractive index material not only achieves achromatic aberration but also reduces the thickness by ≈50% compared with the conventional low refractive index material of silica glass. The presented wavelength‐scale singlet achromatic microlens hold significant promise for compact wearable devices, dynamic holography, and color projection displays.
Dexmedetomidine target controlled infusion for awake craniotomy†
Authors: Al‐Attar A. , Back M. , Sebastian J.
Published: March 2024

A 73‐year‐old woman underwent an awake craniotomy for the resection of a supratentorial brain tumour. We provided sedation for the surgery using a dexmedetomidine target controlled infusion using the Dyck pharmacokinetic model. Using a target controlled infusion allowed more rapid titration to the desired plasma level compared with a manual infusion, without any unexpected cardiovascular, respiratory or other complications. Rapid titration of sedation during awake craniotomy is desirable, allowing deeper sedation during stimulating parts of the surgery, followed by lighter sedation – or absence of sedation – during cortical mapping. While this can be performed manually, we found utilising the Dyck model in this case simple and quick to use, avoiding the need to manually calculate infusion rates. We believe this is the first report of using a target controlled infusion model to administer dexmedetomidine for awake craniotomy, and suggest it could be considered as an alternative to administering a manual infusion.
Solid‐state fermentation pro‐enzymes supplementation benefits growth performance, health, and intestinal microbiota of broiler chickens fed wheat‐based diet
Authors: Li Jiaheng , Bai Guosong , Gao Yan , Gao Qingtao , Zhong Ruqing , Chen Liang , Wang Yunlong , Ma Teng , Zhang Hongfu
Published: March 2024

Wheat as a kind of diet material can be used for broiler production. However, due to non‐starch polysaccharides in wheat, wheat may lead to lower growth performance and worth health. To reverse the negative effect, solid‐state fermentation pro‐enzymes were added. In this experiment, growth performance, intestinal health‐related genes, short chain fatty acids (SCFAs) and intestinal microbiota were detected to find the effects of wheat meal and combined with enzymes on broiler chickens from 15 to 42 days of age. A total of 432 1‐day‐old Arbor Acres broiler chickens were fed corn‐based diet (CD) for 14 days as the preparation stage of the experiment. Then, they were randomly divided into three groups and fed three different kinds of diets which were corn‐based diet (CD group), wheat‐based diet (WD group), and SFP enzymes supplementation in WD (Enzymes+Wheat‐based diet group). The results showed that compared with broilers in CD group, broilers in WD group had lower weight gain and higher Feed conversion ratio (p < 0.05) during the whole experimental period especially from day 15 to day 21, but there was no significant effect on feed intake (p > 0.05). Moreover, SFP enzymes decreased the spleen index (p < 0.05). Wheat also had trends to decrease the expression of ZO‐1 (p = 0.096) and increase the concentrations of acetate (p < 0.05), butyrate (p < 0.05) and total SCFAs (p < 0.05), in which SFP enzymes caused the opposite results except for butyrate, and SFP enzymes even increased the expression of ZO‐1 (p < 0.001) and OCCLUDIN (p = 0.075) and decreased the expression of TNF‐α (p < 0.01). Meanwhile, wheat enhanced the abundances of Barnesiella and Bifidobacterium (p < 0.05) and inhibited the abundances of Flavonifractor, Sellimonas, Lachnospiraceae_NK4A136_group, Subdoligranulum, and Ruminococcus_gauvreauii_group (p < 0.05), and SFP enzymes could reverse the negative effects, and the changes in microbiota could explain the other different parameters. Collectively, wheat results in inflammation and worse growth performance, but SFP enzymes supplementation in WD benefits chickens' growth performance by improving intestinal barrier function, decreasing inflammation, modulating cecal microbiota and SCFAs production.
The non‐paretic‐hand‐to‐opposite‐ear test: A simple test to detect aphasia and neglect and an indicator of large anterior vessel occlusion in patients with suspected acute stroke
Authors: Herrmann Matthias L. , Franck Clara , Schuchardt Florian F. , Meier Simone , Henningsen Max , Wimmesberger Nicole , Rau Diana , Busch Hans‐Jörg , Taschner Christian A. , Farin‐Glattacker Erik , Brich Jochen
Published: March 2024

Introduction

Aphasia and neglect in combination with hemiparesis are reliable indicators of large anterior vessel occlusion (LAVO). Prehospital identification of these symptoms is generally considered difficult by emergency medical service (EMS) personnel. Therefore, we evaluated the simple non‐paretic‐hand‐to‐opposite‐ear (NPE) test to identify aphasia and neglect with a single test. As the NPE test includes a test for arm paresis, we also evaluated the diagnostic ability of the NPE test to detect LAVO in patients with suspected stroke.

Methods

In this prospective observational study, we performed the NPE test in 1042 patients with suspected acute stroke between May 2021 and May 2022. We analyzed the correlation between the NPE test and the aphasia/neglect items of the National Institutes of Health Stroke Scale. Additionally, the predictive values of the NPE test for LAVO detection were calculated.

Results

The NPE test showed a strong, significant correlation with both aphasia and neglect. A positive NPE test result predicted LAVO with a sensitivity of 0.70, a specificity of 0.88, and an accuracy of 0.85. Logistic regression analysis showed an odds ratio of 16.14 (95% confidence interval 10.82–24.44) for predicting LAVO.

Conclusion

The NPE test is a simple test for the detection of both aphasia and neglect. With its predictive values for LAVO detection being comparable to the results of LAVO scores in the prehospital setting, this simple test might be a promising test for prehospital LAVO detection by EMS personnel. Further prospective prehospital validation is needed.
Ectopic production of beta‐hCG in anal cancer: A case report
Authors: Silverwood Sierra , Kohler Peter , Kier Yelena
Published: March 2024

Key Clinical Message

Beta‐hCG‐producing anal cancer, though rare, poses significant diagnostic challenges and may resist standard therapies. Recognizing the potential for hormone production in anal cancer is important, as it underscores the need for more specialized diagnostic techniques and tailored treatments.

This case report describes the second reported case of ectopic production of beta‐hCG in anal cancer. A 53‐year‐old female presented with a new anal lesion. Biopsy showed a poorly differentiated squamous cell cancer (SCC) with undifferentiated sarcomatoid features, stage IIIA (cT2cN1cM0). Before starting concurrent chemotherapy and radiation, the patient had a positive urine pregnancy test. The beta‐human chorionic gonadotropin (beta‐hCG) production was attributed to the tumor, and upon completion of treatment, beta‐hCG normalized. Six weeks from treatment completion, recurrence was noted along with a positive beta‐hCG urine test. This case aims to highlight beta‐hCG as an ectopic hormone that can indicate the presence of squamous cell anal cancer and discuss the potential implications it may have on management.
Single catheter approach for treatment of premature ventricular contractions
Authors: Dilk Patrick , Dinov Borislav , Darma Angeliki , Bollmann Andreas , Dagres Nikolas , Hindricks Gerhard , Arya Arash
Published: March 2024

Background

Catheter ablation has become one of the main treatment strategies in patients with premature ventricular complexes (PVC). The successful mapping and ablation can be performed with an ablation catheter without additional diagnostic catheters.

Hypothesis

We hypothesize that using a single catheter for PVC ablation may decrease complications, procedure time, and fluoroscopy exposure while maintaining comparable success rates.

Methods

Sixty‐nine consecutive patients with PVC were treated with a single catheter approach compared to a historical cohort, in which a conventional setup was used. Propensity score matching was conducted with a 1:1 ratio. Outcome parameters included acute procedural success with elimination of all premature ventricular contractions after catheter ablation, procedural data as well as complication rates.

Results

Patients treated with a single catheter approach had shorter total procedure (60 minutes [IQR: 47,5–69,0 minutes] vs. 90 minutes [IQR 60–120 minutes]; p = 0.001) and fluoroscopy times (218 seconds [IQR: 110,5–446 seconds] vs. 310 seconds [IQR 190–640 seconds]; p = 0.012), which consecutively leads to a reduction of radiation exposure signified by a lower dose area product (155 cGycm² [IQR 74.4–334.5 cGycm²] vs. 368.4 cGycm² [IQR: 126–905.4 cGycm²]; p value 0.009). Acute procedural success rates were comparable in both groups (54 [84.3%] in the single catheter approach group and 58 [90.6%] in the conventional group; p: 0.287).

Conclusion

A single catheter approach for the treatment of PVC is associated with a reduction of procedure‐ and fluoroscopy time, as well as a lesser radiation exposure, while maintaining equivalent acute success and complication rates compared with a conventionally used catheter setup.
Room‐temperature tunable tunneling magnetoresistance in Fe3GaTe2/WSe2/Fe3GaTe2 van der Waals heterostructures
Authors: Pan Haiyang , Singh Anil Kumar , Zhang Chusheng , Hu Xueqi , Shi Jiayu , An Liheng , Wang Naizhou , Duan Ruihuan , Liu Zheng , Parkin Stuart S. P. , Deb Pritam , Gao Weibo
Published: March 2024

The exceptional properties of two‐dimensional (2D) magnet materials present a novel approach to fabricate functional magnetic tunnel junctions (MTJ) by constructing full van der Waals (vdW) heterostructures with atomically sharp and clean interfaces. The exploration of vdW MTJ devices with high working temperature and adjustable functionalities holds great potential for advancing the application of 2D materials in magnetic sensing and data storage. Here, we report the observation of highly tunable room‐temperature tunneling magnetoresistance through electronic means in a full vdW Fe3GaTe2/WSe2/Fe3GaTe2 MTJ. The spin valve effect of the MTJ can be detected even with the current below 1 nA, both at low and room temperatures, yielding a tunneling magnetoresistance (TMR) of 340% at 2 K and 50% at 300 K, respectively. Importantly, the magnitude and sign of TMR can be modulated by a DC bias current, even at room temperature, a capability that was previously unrealized in full vdW MTJs. This tunable TMR arises from the contribution of energy‐dependent localized spin states in the metallic ferromagnet Fe3GaTe2 during tunnel transport when a finite electrical bias is applied. Our work offers a new perspective for designing and exploring room‐temperature tunable spintronic devices based on vdW magnet heterostructures.
Dysregulation of intercellular communication in vitro and in vivo via extracellular vesicles secreted by pancreatic duct adenocarcinoma cells and generated under the influence of the AG9 elastin peptide‐conditioned microenvironment
Authors: Nannan Lise , Decombis Salomé , Terryn Christine , Audonnet Sandra , Michel Jean , Brassart‐Pasco Sylvie , Gsell Willy , Himmelreich Uwe , Brassart Bertrand
Published: March 2024

Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy with poor prognosis due to its highly metastatic profile. Intercellular communication between cancer and stromal cells via extracellular vesicles (EVs) is crucial for the premetastatic microenvironment preparation leading to tumour metastasis. This study shows that under the influence of bioactive peptides derived from the extracellular matrix microenvironment, illustrated here by the AG‐9 elastin‐derived peptide (EDP), PDAC cells secrete more tumour‐derived EVs. Compared to PDAC‐derived EVs, tumour‐derived EVs resulting from AG‐9 treatment (PDAC AG‐9‐derived EVs) significantly stimulated cell proliferation. At constant amount, tumour‐derived EVs were similarly taken up by PDAC and HMEC‐1 cells. Tumour‐derived EVs stimulated cell proliferation, migration, proteinase secretion, and angiogenesis. Bioluminescence imaging allowed tumour‐derived EV/FLuc+ tracking in vivo in a PDAC mouse model. The biodistribution of PDAC AG‐9‐derived EVs was different to PDAC‐derived EVs. Our results demonstrate that the microenvironment, through EDP release, may not only influence the genesis of EVs but may also affect tumour progression (tumour growth and angiogenesis), and metastatic homing by modifying the in vivo biodistribution of tumour‐derived EVs. They are potential candidates for targeted drug delivery and modulation of tumour progression, and they constitute a new generation of therapeutic tools, merging oncology and genic therapy.
The Hearing of Erastus “Deaf” Smith, Hero of the Texas Revolution
Authors: Todd N. Wendell , Beck Steven D.
Published: March 2024

Objectives

To describe the speech and hearing abilities of Erastus “Deaf” Smith, the first Texas Ranger, and speculate on the etiology of his hearing loss.

Methods

Review of credible historical data of what Erastus could and could not hear, descriptions of his voice, and loudness tolerance. Modern analysis of acoustical physics data generated by 0.69‐inch diameter non‐spinning musket balls.

Results

The onset of Erastus' bilateral hearing loss was early childhood. He could hear some. He was intolerant of very loud sounds. His speech was “weak”, “squeaky” and high‐pitched. He did not use manual communication. He could not hear musket balls passing near his head. The frequency of sound generated by flying 0.69‐inch diameter musket balls has been determined as predominantly in the range of 2000–2500 Hz. In contrast to most bilateral childhood sensorineural hearing losses that are worse in high and mid frequencies, Erastus' hearing loss was worse in the low and mid frequencies – preserving at least some high‐frequency hearing.

Conclusion

Erastus' reverse‐slope hearing problem may well have been attributable to incomplete partition type III. If you can't hear it, you can't speak it.

Level of Evidence

NA Laryngoscope, 134:3532–3536, 2024
Observations on Valence‐Band Electronic Structure and Surface States of Bulk Insulators Based on Fast Stabilization Process of Sample Charging in UPS
Authors: Zhu Lei , Li Wei , Ma Liran , Xu Xuefeng , Luo Jianbin
Published: March 2024

The valence‐band electronic structure is one of the most basic properties of materials and ultraviolet photoelectron spectroscopy (UPS) is the most commonly used technique for its measurement. To obtain credible UPS spectra on insulator surfaces, eliminating the charging effects at the surfaces is essential but is very difficult. Here, a reliable measurement for the valence‐band structure of bulk insulators is shown. It has been observed that, during UPS measurements without any charge compensation, the charging on irradiated insulator surfaces reaches its steady state very quickly and the fluctuation of the charging‐induced surface potential is very small. Therefore, the whole UPS spectrum undergoes just a parallel shift and can be calibrated by comparison with the corresponding X‐ray photoelectron spectroscopy (XPS) spectrum even though XPS often has a poorer resolution than UPS. From the calibrated valence‐band spectra, it is found that noticeable electronic energy levels (i.e., the “surface states”) exist in the bandgap, and based on the density of states (DOS) calculations, the surface states are attributed to the truncation of the bulk periodic structure at the surfaces. This work is anticipated to provide a way to obtain the valence band structure and the surface states of bulk insulators which play crucial roles in many physical processes.
Real‐world experience of direct oral anticoagulant use in a single pediatric center
Authors: Valenti Gianna G. , Sabo Cynthia , Hyde Michelle , Rajpurkar Madhvi
Published: March 2024

Background

Pediatric venous thromboembolism has increased by 130%–200%, specifically in hospitalized children, and direct oral anticoagulants (DOACs) offer several therapeutic advantages.

Methods

This study aims to evaluate the real‐world epidemiological and outcome data from a retrospective review of pediatric patients treated with DOACs from January 1, 2013 to December 31, 2022. In this single‐center, IRB‐approved study, 65 patients were identified and analyzed using SPSS statistical software, and a descriptive statistical analysis was conducted.

Results

Of the 65 patients, 37% were on apixaban, 61.5% were on rivaroxaban, and 1.5% were on dabigatran. Per the 2023 ISTH outcome definitions, one (2%) patient had a major bleeding episode, six (9%) had clinically relevant non‐major bleeding, three (5%) patients had patient‐important heavy menstrual bleeding (HMB), and one (1.5%) patient had minor bleeding. Seven (19%) of 37 postmenarchal patients had evidence of HMB. Six (9.2%) patients had recurrent venous thromboembolism while on a DOAC (one was on apixaban, and five were on rivaroxaban) and were transitioned to other forms of anticoagulation.

Conclusion

Thus, bleeding rates after DOAC therapy are comparable to previous DOAC trials, as well as other anticoagulants in pediatrics. HMB is an important outcome measure and should continue to be investigated. This study reports a higher rate of recurrent thrombosis (9.2%) compared to other trials. However, this observation may be attributed to patients who had ongoing risk factors, as well as a longer duration of study follow‐up. Additional multicentered outcome studies evaluating DOAC use in children are needed to determine long‐term recurrence and HMB risks.
Relationship among Thermodynamic, Growth Kinetics, and Microstructure Characterization of the Simple and Silicon‐Modified Aluminide Coating on Ni‐based Superalloy
Authors: Dai Yanzhang , Zou Jianpeng , Ning Xiaozhi , Wei Hongming , Zhan Wenyi , Li Feiyang
Published: March 2024

This research investigates the effects of pack cementation parameters on the thermodynamics, growth kinetics, and microstructure of the simple and silicon‐modified aluminide coatings on the IN718 superalloy. The growth kinetic modelling of the aluminide coating, activated by NH4Cl, is established as
. further optimizing the kinetics modelling that includes both CaCl2 activator or the mixture of CaCl2 and NH4Cl. The results showed that NH4Cl as an activator generated a higher equilibrium partial pressure of halides, which enhanced the deposition efficiency of active Al atoms and facilitated the significant precipitation of Cr‐rich carbides. Additionally, part of the CaCl2 substitute NH4Cl could maintain a high coating growth rate and reduce the hazards. Adding Si element preferentially combines with Cr formed the Cr9.1Si0.9 phase along grain boundaries, which blocked the inner‐diffusion channels of Al atoms and reduced the thickness of the silicon‐modified aluminide coating compared to simple aluminide coating. These researches revealed the relationship among the thermodynamics, growth kinetics, and microstructure of simple and silicon‐modified aluminide coatings. The thickness and microstructure of coatings can be effectively regulated by adjusting the powder composition, content, and process parameters to achieve precise control.
Enhanced Electrocatalytic Performances by Spatially Confined Aqueous Electrolytes
Authors: Zhang Jie , Cai Dongxi , Li Zesheng
Published: March 2024

Electrocatalysis is an important energy conversion and storage technology that has made significant progress in areas such as fuel cells, hydrogen production from electrolyzed water and electrochemical synthesis. In practical applications, the efficiency and stability of electrocatalytic processes remain challenging. Spatially confined (or called domain‐limited) water refers to the immobilization of water molecules in a limited region near the catalyst surface to form a specific aqueous phase environment. This domain‐limited aqueous phase environment can greatly influence the electrocatalytic efficacy by enhancing adsorption and lowering the proton transport and solvent diffusion energy barriers in the reaction. In recent years, the goal of improving electrocatalytic performance has been successfully achieved through interfacial domain‐limited, microporous domain‐limited and nanoreactor domain‐limited. Spatially domain‐limited water as a novel strategy can significantly enhance the activity and selectivity of electrocatalytic reactions, but understanding its mechanism of action remains a challenge. With a deeper understanding of domain‐limited water and further development of the technology, it is believed that it will bring greater breakthroughs and application prospects in the field of electrocatalysis.
K2CO3 Promoted Spirocyclopropanation of Thiazole‐Derived Oxadienes via 1,4‐Addition‐Induced Dearomatization Reaction
Authors: Yang Kaichuan , Jia Aiqiong , Chen Jiaxin , Tang Yiping , Liu Shen , Deng Junfeng , Zou Kun , Ren Jing
Published: March 2024

A K2CO3 promoted spirocyclopropanation of thiazole‐derived oxadienes with bromomalonate via 1, 4‐addition‐induced dearomatization strategy has been developed. The pathway features a broad substrate scope, operational simplicity and high degree of synthetic efficiency to afford series of functionalized spiro‐cyclopropanation frameworks in 88 %–96 % yields, which enriches the research contents of thiazole‐derived oxadienes involved reactions. All products obtained herein contain two contiguous quaternary centers and their further synthetic applications are also demonstrated.
Development of Molybdenum oxide Promoted CeO2−SiO2 Mixed‐oxide Catalyst for Efficient Catalytic Oxidation of Benzylamine to N‐Benzylidenebenzylamine
Authors: Ravula Madhu , Dosarapu Vijaykumar , Bandalla Siddaramagoud , Mavurapu Satyanarayana , Varkolu Mohan , Rajeevan Aswathi , Baithy Mallesham , Jonnalagadda Sreekantha B. , Sekhar Vasam Chandra
Published: March 2024

This study explores a rational synthesis of a molybdenum‐promoted Ce−Si mixed oxide catalyst (MoO3/CeO2−SiO2) to regulate synergies between MoO3 and SiO2 dopant on CeO2, achieving high selectivity in solvent‐free catalytic oxidative coupling of amines to imines using molecular O2 as the oxidant. Comparative efficiency tests were conducted with bare CeO2, CeO2−SiO2, and MoO3/CeO2 catalysts. Characterization techniques, including XRD, Raman spectroscopy, N2‐adsorption‐desorption analysis, FTIR, NH3−TPD, TEM, and XPS, were employed to assess textural properties, acidic features, promoter and dopant dispersion in CeO2 lattice, and oxygen defects. Mo/Ce−Si catalyst exhibited superior acidic sites and a higher concentration of Ce3+ ions (Iu/ITotal), indicating increased oxygen vacancies. This catalyst demonstrated exceptional performance in the oxidative coupling of benzylamine, providing higher conversion and selectivity to the corresponding imine. Remarkably, the Mo/Ce−Si catalyst maintained consistent performance over five recycling runs. The catalyst also proved effective for the selective oxidative coupling of various amine substrates with diverse steric and electronic properties. Experimental results confirmed a plausible reaction mechanism within the concise catalyst design.
Synthesis and Evaluation of Boronated 4‐Arm Polyethylene Glycol for Application in Transmucosal Drug Delivery
Authors: Kolawole Oluwadamilola Miriam , Agbelusi Tolulope Mathew , Patrojanasophon Prasopchai
Published: March 2024

Polyethylene glycol (PEG) exhibits poor residence on mucosal membranes in the presence of biological fluid, and the influence of PEG boronation on its properties has never been investigated. This project aimed to synthesise boronated 4‐arm PEG and evaluate their pH stability, thermal properties and mucoadhesiveness for potential transmucosal applications. Two types of boronated 4‐armed PEG (B4PEG1 & B4PEG2) and a boronated linear PEG (BLPEG) were synthesized. The degree of boronation, mucoadhesiveness, thermal and pH stability of the polymers were assessed using 1H NMR spectroscopy, viscometry, thermogravimetric analysis and UV–visible spectroscopy, respectively. Gel Permeation Chromatography was employed to confirm PEG boronation. The respective degrees of boronation for B4PEG1 and B4PEG2 were 32.8 % and 46.2 %. The molecular architecture and degree of PEG boronation had a remarkable influence on mucoadhesiveness, pH, and thermal stability. B4PEG2, with a branched architecture and the greatest degree of boronation, exhibited superior mucoadhesiveness and colloidal stability at pH 4 to 8, relative to B4PEG1 and BLPEG. Boronation improved the thermal stability of 4‐arm PEG. This study is the first to demonstrate that PEG boronation could enhance the pH‐sensitivity, thermal stability and mucoadhesiveness of 4‐arm PEG. Boronated 4‐arm PEGs could serve as mucoadhesive polymeric excipients for transmucosal drug delivery.
Energy‐Efficient Synthesis of Haloquinazolines and Their Suzuki Cross‐Coupling Reactions in Propylene Carbonate
Authors: Piros László , Krajsovszky Gábor , Bogdán Dóra , Gáti Tamás , Szabó Pál , Horváth Péter , Mándity István M.
Published: March 2024

Comparative synthesis of some new quinazoline derivatives via tetrakis(triphenylphosphine)palladium(0) catalysed Suzuki‐Miyaura cross‐coupling reaction in “green” propylene carbonate (PC) and dimethoxyethane. Three haloquinazolines were synthesised for Suzuki‐cross‐coupling from 5‐bromoanthranilic acid. Sufficient and easy method for the elimination of PC is developed, thus the optimization of the synthesis of some quinazoline derivatives was carried out. Reactions with 2‐chloro‐6‐bromo‐3‐phenylquinazolin‐4(3H)‐one proceeded faster and with a higher yield in PC than in dimethoxyethane, thus for some reactants PC is a good choice for greener synthesis. Practical considerations for using PC include shorter reaction times, improved yields, and the elimination of unnecessary solvent distillation, leading to significant energy savings. This facilitates the execution of energy‐efficient reactions in a notably environmentally friendly solvent. In contrast to DME, the use of PC does not necessitate special pre‐treatments. Moreover, less PC is required due to its high boiling point and low volatility. Considering these properties, coupled with the consistent need for chromatographic purification, the use of PC in the Suzuki‐Miyaura cross‐coupling reaction emerges as a superior and greener alternative compared to DME.
Tuning Catalytic Activity of Palladium in Direct C−H Arylation of Biologically Active Xanthines using Silver Additive.
Authors: Thakur Pranali , Tinku  , Choudhary Sinjan , Patil Mahendra
Published: March 2024

We describe an efficient and versatile method for the direct C−H arylation of xanthines with aryl halides using Pd/P(o‐tolyl)3 as catalyst and Ag2O as an additive. Silver salts have been frequently used as an additive in the Pd‐catalyzed C−H bond activation reactions albeit in excessive amounts (2 to 4 eq.). Herein, we use of a stoichiometric amount (0.1 to 1 eq.) of Ag2O to obtain the optimum yields of C‐8 arylated products. This method exhibits broad substrate scope and enables synthesis of a wide range of xanthine derivatives by variation of aryl component at the C‐8 position. A key advantage of silver additive is that it reduces the catalyst loading and time required for the completion of reactions. Although kinetic experiments show that the inclusion of silver salt accelerates the rate of reaction, catalytic role of silver salt could not be conceived since the C−H bond cleavage is not a rate determining step. Silver salt presumably act as a terminal oxidant in the catalytic cycle and assist the regeneration of Pd catalyst. Moreover, preliminary assessment of biological activities of xanthines demonstrates that the C‐8 arylated xanthines derivatives efficiently inhibit the α‐Synuclein fibrillation, a key factor behind Parkinson's disease.
Physiological correlates of anxiety in childhood and adolescence: A systematic review and meta‐analysis
Authors: Ko Katherine , Jones Alana , Francis Deanna , Robidoux Serje , McArthur Genevieve
Published: March 2024

Anxiety is one of the most prevalent problems that affects children and adolescents. The vast majority of diagnostic tools for anxiety depend on written or verbal reports from children and adolescents or their significant others. The validity and reliability of such reports can be compromised by their subjective nature. Thus, there is growing interest in whether anxiety can be indexed with objective physiological measures. The key aim of this systematic review and meta‐analysis was to determine which physiological measures are most reliably associated with elevated levels of anxiety amongst children and adolescents. Online databases (e.g., PsycINFO, Embase, Medline) were searched for relevant studies according to pre‐determined criteria. Twenty‐five studies comprising 2502 participants (N = 1160 with high anxiety) met inclusion, identifying 11 groups of physiological measures. Our meta‐analysis revealed that skin conductance level is the most sensitive measure of anxiety (d = 0.83), followed by electromyography (EMG) measures (d = 0.71) and skin conductance response (d = 0.58). However, the included studies varied in terms of subjective measures, study designs, experimental task measures, and physiological measures. Consideration of these differences in methodology offer potential directions for future research.
FDTD Analysis of Electric Field and Step Voltage in a Clay‐Wall House Struck by Lightning
Authors: Uetsuhara Ken , Baba Yoshihiro , Kudo Takeshi
Published: March 2024

The density of lightning flashes is quite high in Rwanda and its neighboring countries in Africa. In rural areas of these countries, there are still many clay‐wall houses. Sometimes people in clay‐wall houses are fatally injured by direct lightning strikes to the houses. In this paper, the electric field in a clay‐wall house and the step voltage on the floor, associated with a direct lightning strike to the house, are analyzed using the finite‐difference time‐domain (FDTD) method. Also, the electric field and the step voltage in the same clay‐wall house but with a horizontal air termination conductor connected to buried vertical bar earth conductors or a square ring earth conductor via bare or insulated down conductors are analyzed using the FDTD method. It has been shown that installing these protection systems reduces the inside electric field and the step voltage on the floor particularly if insulated down conductors are employed. © 2024 Institute of Electrical Engineer of Japan and Wiley Periodicals LLC.
All Ceramic Ion Sensor Using Dielectric BaTiO3 Transducer
Authors: Suzuki Soichiro , Takase Satoko , Shimizu Youichi
Published: March 2024

An all‐solid‐state impedance metric hydrogen‐phosphate ion sensor device has been tried to fabricate using BaTiO3 as a transducer and spinel‐type oxide receptor. AC impedance measurement was carried out using flow‐cell system with boric‐acid buffer solution with hydrogen‐phosphate ion The Co2RhO4/BaTiO3 sensor device was found to show impedance responses to hydrogen‐phosphate ion at 5 × 10−4 M and 1.0 × 10−2 M with the 90% response time of ca. 150 s. The Co2RhO4/BaTiO3 device showed good response characteristics among the tested devices in terms of sensitivity and restoration rate. © 2024 Institute of Electrical Engineer of Japan and Wiley Periodicals LLC.
On the fair scheduling of truck drivers in delivery companies: balancing fairness and profit
Authors: Hamdan Anwar , Hamdan Sadeque , Benbitour Mohammed Hichame , Jradi Samah
Published: March 2024

Fairness is crucial in transportation systems to ensure that all drivers are treated equally and have the same opportunities. Fair payment policies, equal access to work opportunities, and fair scheduling are some of the policies delivery companies implement to ensure fairness between drivers. In this paper, we study a fair scheduling mixed-integer programming problem where we consider a bi-objective function that aims to maximize profit and improve fairness between drivers by minimizing the maximum deviation from the average driving time. To solve this problem, we employ the weighted comprehensive criterion method and propose an iterative population-based heuristic. The results show that the relative gap between the heuristic and exact approach is acceptable. We also report the fairness price which is the relative difference between total profit with and without incorporating fairness. We find out that improving fairness between drivers does not always lead to a significant reduction in total profit. When the reduction in total profit is important, we recommend formulating the scheduling problem differently where instead of minimizing the maximum deviation from the average driving time, drivers are rewarded when their driving times are longer than the average. We explore incorporating the cost of rewarding these drivers in the objective function.
Review of Applications of Vulnerability Assessments to Saltmarsh, Beach, and Mixed Shoreline Systems
Authors: Sargison Nesyah , Crisp Jake RA , Ellison Joanna C
Published: March 2024

With increasing threats from climate change and direct human impacts to coastal systems, vulnerability assessment approaches have been developed to enable prioritisation of management actions. This study reviewed vulnerability assessment literature about saltmarsh, beach and mixed shoreline systems published in English. Literature searches and NVivo software were used to analyse literature available, indicative of patterns and gaps in research. Results showed thirteen different methods used in selected literature to assess vulnerability, and the most commonly used was the indices approach. In saltmarsh systems, most articles employed unique methods rather than repeating established ones, and spatial change methods were rare. The majority of research did not include definitions of vulnerability or an indication of which conceptualisation of vulnerability was being used. Most literature assessed vulnerability to climate change and sea level rise, rather than natural hazards or other human impacts. The mangrove vulnerability assessment literature was far more voluminous relative to applications to beach, saltmarsh or mixed such systems. This review identifies how future research can better assess gaps in knowledge, and progress more unified understanding of coastal vulnerability.