bluuebunny/crossref_metadata_2025 huggingface dataset:
Transferência do Gerenciamento de Serviços Públicos de Saúde a Organizações Sociais: Estudo de Caso do Hospital Estadual Central
Authors: Castro Sandra Mara de , Caliman Douglas Roriz
Published: November 2020

O objetivo do estudo é descrever e analisar a implantação e execução de um novo modelo de gestão de saúde implantado no Espírito Santo, a partir do estudo de caso do Hospital Estadual Central gerenciado por uma Organização Social de Saúde. O trabalho caracterizou-se por um estudo de caso, descritivo com analises qualitativas. Verificou-se que a principal motivação para a implantação do modelo de Organização Social de Saúde foi à fragilidade da gestão das unidades públicas estaduais sem resolutividade para os pacientes que necessitavam de atendimentos nas unidades hospitalares. Pode-se concluir que o modelo adotado de gerenciamento das unidades hospitalares públicas por Organizações Sociais no Espírito Santo são importantes para os serviços públicos hospitalares, pois garantem a entrega de seus produtos a população capixaba e o maior controle do Estado com os recursos públicos utilizados na gestão da saúde.
Eficiência dos Gastos Públicos em Saúde no Brasil: Estudo Sobre o Desempenho de Estados Brasileiros
Authors: Andrett Marcia , Lunkes Rogério João , Rosa Fabricia Silva da , Brizolla Maria Margarete Baccin
Published: November 2020

O objetivo do presente estudo é verificar a eficiência dos gastos públicos estaduais com saúde no Brasil. Para atender este objetivo foram analisados, no período de 2005 a 2014, os vinte e seis estados brasileiros e o Distrito Federal. Os dados foram coletados do Sistema de Coletas de Dados Contábeis dos Entes da Federação e do Departamento de Informática do Sistema Único de Saúde. A análise da eficiência é realizada por meio do método de Análise Envoltória de Dados. Os resultados revelam que dentre as 27 unidades federativas, apenas o Estado do Maranhão se mostrou eficiente em todo o período analisado (2005 a 2014), sendo que 9 se mostraram eficientes em pelo menos 1 ano no período analisado com relação aos indicadores de saúde. Conclui-se que os 26 estados brasileiros e o Distrito Federal apesar dos esforços financeiros com a saúde, o desempenho está aquém do nível esperado de eficiência para o atendimento à população com vacinação, atenção básica, internações, atendimento ambulatorial e número de estabelecimentos de saúde.
Racismo: Uma Questão de Saúde Pública e de Gestão na Perspectiva de Gênero
Authors: Ferreira Claudia Aparecida Avelar
Published: November 2020

As iniquidades em saúde estão associadas as demandas socioeconômicas, raciais e de gênero, e a mulher negra encontra-se em condições de desvantagem devido o mito da democracia racial, não recebendo um tratamento humanizado como as mulheres brancas. O objetivo do estudo foi fazer uma revisão de literatura sobre o racismo e as consequências na saúde em termos de gênero alinhado a gestão usando como método a revisão narrativa. O racismo institucional fortalece as mazelas contra as mulheres negras demonstrando a necessidade de uma gestão eficiente em saber lidar com os grupos considerados minoritários no sistema capitalista , tendo como proposta uma liderança inclusiva, para treinar, capacitar e fortalecer o diálogo sobre a desnaturalização do racismo e reduzir o índice de doenças prevalentes nesta população e também o absenteísmo. Como o racismo é histórico e as vicissitudes de um preconceito de marca sugere-se desconstruir este mito de democracia racial de forma continua nas instituições públicas,privadas e filantrópicas, através da reestruturação das políticas públicas , valorização e reconhecimento do potencial das mulheres e principalmente mulheres negras.
Eficiência nos Gastos dos Hospitais: Um Estudo Sobre o Sistema Diagnosis Related Groups (DRG)
Authors: Roschel Lucas Facciuto , Flach Leonardo , Mattos Luísa Karam de , Lunkes Rogério
Published: November 2020

O sistema de classificação de pacientes hospitalares Diagnosis Related Groups (DRG) tem sido utilizado por diversos países como o principal meio de pagamento prospectivo aos hospitais. Trata-se de um importante meio de remuneração no setor de saúde suplementar. O DRG tem como premissas o apoio na gestão de custos, melhorias na eficiência dos gastos hospitalares e diminuição do tempo de internação dos pacientes. Esta pesquisa tem por objetivo analisar o estado da arte científica sobre a eficiência nos gastos dos hospitais com o uso do Diagnosis Related Groups, a partir de artigos de periódicos internacionais que utilizaram modelos de regressão. Os dados foram analisados por meio de estatística descritiva e análise interpretativa. Os resultados apontam que os países desenvolvidos possuem o domínio da produção acadêmica neste tema. Porém, ainda há espaço para aprimoramentos e novas pesquisas, bem como adaptações do DRG para os países em desenvolvimento. Os resultados apontam que o DRG já foi implantado com sucesso em diversos países, e sugere-se sua aplicação nos hospitais brasileiros. Isto permitiria a eficiência no controle sobre os custos, e a realização de um modelo de pagamento por classificações e grupos, ou seja, baseado na taxa básica multiplicada por um peso relativo em peso específico para cada DRG. Portanto, os resultados desta pesquisa apontam efeito positivo para explicar o período de permanência nos hospitais e as variações nos custos, a partir de um relevante método para o segmento de remuneração dos serviços de saúde.
Território, Trabalho e Saúde: Repercussões Socioambientais do Estilo de Vida em Duas Comunidades da Reserva de Desenvolvimento Sustentável do Tupé, Manaus, Amazonas
Authors: Mariosa Duarcides Ferreira , Camilo Maria Virgínia Righetti Fernandes
Published: November 2020

O objetivo do texto é analisar as condições socioambientais e epidemiológicas da população adulta de duas comunidades ribeirinhas da Reserva de Desenvolvimento Sustentável do Tupé, Manaus, Amazonas (RDS do Tupé), comparando níveis de incidência do Diabetes Mellitus em dois grupos populacionais distintos, colocados em pontos opostos de desenvolvimento socioeconômico – a RDS do Tupé e a cidade de Manaus. Trata-se de um estudo de caso, baseado em pesquisa de campo e uso de estatísticas fornecidas pelo Ministério da Saúde e IBGE – Instituto Brasileiro de Geografia e Estatística, de caráter exploratório, descritivo e transversal que emprega as técnicas de análise ecológica de grupos múltiplos e de observação etnográfica para examinar a influência das condições socioambientais nas taxas de ocorrência do Diabetes Mellitus. A análise dos dados coletados sugere que fatores sociais determinantes do Diabetes Mellitus, como o sedentarismo e a obesidade, são influenciados pelo estilo de vida típico das comunidades analisadas, afetando muito mais mulheres que os homens e que a forma não homogênea da distribuição territorial da doença exigiria ajustes nos planos de Gestão das Políticas Públicas de Saúde. Com isso, a substituição das categorias empíricas homem/mulher, fundamentada na diferença biológica entre os sexos, pela categoria analítica de gênero, que supõe a existência de relações de poder entre os sexos, implica também considerar nos estudos socioambientais e de saúde coletiva as construções sociais da identidade subjacentes às práticas que incorporam as condições materiais de vida e de existência social no território.
Work experience of tourism and recreation students and the level of social competence. Selected issues
Authors: Alejziak Bożena
Published: November 2020

The aim of this article is to present results of a study concerning the level of social competences displayed by students of tourism and recreation and how it relates to their work experience. The author hypothesized that the fact of being employed could help to differentiate between different levels of social competences in the student population. Factors such as the length of work experience, positions held, work abroad, internships, and voluntary work were analysed. The study was based on quantitative and qualitative data collected using such tools such as the Social Competence Questionnaire and the Questionnaire for Self-Assessment of Student’s Professional Achievements in order to identify forms of professional activity among the respondents. Full-time students of tourism and recreation were found to have an average level of social competences, and their work experience, considered as a form of social training, did not differentiate between different levels of social competence. No statistically significant correlations were found between the level of social competence and internships at secondary schools, internships at university, work experience in general and in tourism and recreation in particular, and voluntary work. Also, positions held did not differentiate the level of social competence. It could therefore be concluded that the respondents’ work experience was too short to have a measurable effect on the level of their social competences, which take much more time to develop and depend on personal and environmental factors.
Guarantee and Reflexivity
Authors: Echeverri Santiago ,   Journal of Philosophy Inc.
Published: November 2020

The rule account of self-conscious thought holds that a thought is self-conscious if and only if it contains a token of a concept-type that is governed by a reflexive rule. An account along these lines was discussed in the late 1970s. Nevertheless, very few philosophers endorse it nowadays. I shall argue that this summary dismissal is partly unjustified. There is one version of the rule account that can explain a key epistemic property of self-conscious thoughts: GUARANTEE. Along the way, I will rebut a number of objections and introduce two constraints on how the reflexive rule is implemented.
Navigating Recalcitrant Emotions
Authors: Grzankowski Alex ,   Journal of Philosophy Inc.
Published: November 2020

In discussions of the emotions, it is commonplace to wheel out examples of (for instance) people who know that rollercoasters aren’t dangerous but who fear them anyway. Such cases are well known to have been troubling for cognitivists who hold the emotions are (at least in part) judgments or beliefs. But more recently, it has been argued that the very theories that emerged from the failure of cognitivism (perceptual theories and other neo-cognitivist approaches) face trouble as well. One gets the sense that the theory that can accomplish this will win a crucial point over its competitors. In the present paper I offer a new approach to making sense of the normative tension to which recalcitrant emotions give rise. Interestingly, the approach is one that can be adopted by anyone willing to grant that emotions are themselves governed by norms.
Empirical research of the role of international law in the work of the UN Security Council
Authors: Milić Tatjana
Published: November 2020

Interest of international law scholars into an empirical research has increased in the last decade. This paper is an example of one such research. The author has empirically analyzed positions on the use of force against the Federal Republic of Yugoslavia to test hypothesis about the operational role of international law in the work of the UN Security Council: whether it was used in the formation of positions, in the assessment of the situation, and in proposing its solution. Introductory part of the paper presented basic features and development of empirical research of international law. It is followed by the review of theoretical assumptions on the role of international law. Next sections of the paper presented hypothetical framework, methods and results of this empirical research. Finally, the author made concluding remarks on research findings, as well as emphasized necessity to develop practical knowledge on empirical research of international law and to open a discussion on the potential and limits of its application.
Police operating and evidence procedures in resolving the criminal act of robbery in the Republic of Serbia
Authors: Dmitrašinović Saša
Published: November 2020

The criminal act of robbery is a complex criminal act in the field of property crime with the elements of violence, as stated in the Criminal Law of the Republic Of Serbia by the Provision 206 of the Criminal Law. The dynamics and the frequency of the manifestations of such criminal acts in everyday life, along with the scope and the intensity of the consequences, all contribute to the continual interest in the research and in the need to provide a deeper insight into this phenomenon. The focus of this research, therefore, is on recognizing the state and tendencies, and on taking specific measures in the field of confronting the acts of robbery. More specifically, the paper mainly examines the police operating procedures in implementing operating and evidence procedures and in criminal processing and resolving the criminal act. The paper is particularly focused on the comparative analysis of operating and evidence procedures, and their interdependency in efficient resolving of criminal acts and in raising evidence.
New data on first attempts to codify Law in the Principality of Serbia (1827-1837)
Authors: Drakić Gordana , Stanković Uroš
Published: November 2020

The article reveals new data on first attempts of codification of civil law in the Prinipality of Serbia. The attempts lasted from 1827, the year in which prime codification works are recorded, to 1837, when French Civil Code was rejected as a role model of future Serbian code. The revelations came from archive materials and non-Serbian literature and press. They are related to the work of the first and second codification committee, draft civil code composed between 1834 and 1837 and some details regarding the engagement of expert lawyers for the purpose of drawing up civil code.
Allocation of profit to members of limited liability company and differences in relation to other corporate legal payments
Authors: Marjanski Vladimir
Published: November 2020

Given that there is a relatively large number of professional and scientific papers in the domestic scientific literature dealing with the economic issue of dividend payment policy, and that few are devoted to the legal aspects of profit sharing, the subject of this paper will be discussed analysis of the regulation relating to the distribution of profits to members of a limited liability company. Also, since in business practice there is often no correct understanding of the legal nature of the various payments to members of a limited liability company who also originate from the same initial bookkeeping source of funds - balance sheet profit, the work will also make a clear distinction between the payment of profits in relation to other payments of a corporate-legal nature.
Atypical Arrays to Stimulate Multiplicative Thinking
Authors: Bajwa Neet Priya , Tobias Jennifer M.
Published: November 2020

Two types of tasks have the potential to help second graders attend to structure and use initialmultiplicative ideas in their strategies to find the total.
Problems to Ponder
Authors: Ingrassia Steve , Rawding Molly
Published: November 2020

Problems to Ponder provides 28 varying, classroom-ready mathematics problems that collectively span PK–12, arranged in the order of the grade level. Individuals are encouraged to submit a problem or a collection of problems directly to mtlt@nctm.org. If published, the authors of problems will be acknowledged.
Validating a Patient-Reported Outcomes–Derived Algorithm for Classifying Symptom Complexity Levels Among Patients With Cancer
Authors: Watson Linda , Qi Siwei , DeIure Andrea , Photitai Eclair , Chmielewski Lindsi , Smith Louise
Published: November 2020

Background:The patient-reported outcomes (PROs) symptom complexity algorithm, derived from self-reported symptom scores using the Edmonton Symptom Assessment System and concerns indicated on the Canadian Problem Checklist, has not been validated extensively.Methods:This is a retrospective chart review study using data from the Alberta Cancer Registry and electronic medical records from Alberta Health Services. The sample includes patients with cancer who visited a cancer facility in Alberta, Canada, from February 2016 through November 2017 (n=1,466).Results:The effect size (d=1.2) indicates that the magnitude of difference in health status between the severe- and low-complexity groups is large. The symptom complexity algorithm effectively classified subgroups of patients with cancer with distinct health status. Using Karnofsky performance status, the algorithm shows a sensitivity of 70.3%, specificity of 84.1%, positive predictive value of 79.1%, negative predictive value of 76.7%, and accuracy of 77.7%. An area under the receiver operating characteristic of 0.824 was found for the complexity algorithm, which is generally regarded as good, This same finding was also regarded as superior to the alternative algorithm generated by 2-step cluster analysis (area under the curve, 0.721).Conclusions:The validity of the PRO-derived symptom complexity algorithm is established in this study. The algorithm demonstrated satisfactory accuracy against a clinician-driven complexity assessment and a strong correlation with the known group analysis. Furthermore, the algorithm showed a higher screening capacity compared with the algorithm generated from 2-step cluster analysis, reinforcing the importance of contextualization when classifying patients’ symptoms, rather than purely relying on statistical outcomes. The algorithm carries importance in clinical settings, acting as a symptom complexity flag, helping healthcare teams identify which patients may need more timely, targeted, and individualized patient symptom management.
Role of Postoperative Radiotherapy in Nonmetastatic Head and Neck Adenoid Cystic Carcinoma
Authors: Chen Yue , Zheng Zi-Qi , Chen Fo-Ping , Yan Jian-Ye , Huang Xiao-Dan , Li Feng , Sun Ying , Zhou Guan-Qun
Published: November 2020

Background: Head and neck adenoid cystic carcinoma (ACC) is a rare malignant tumor that is prone to local recurrence. The NCCN Guidelines for Head and Neck Cancers recommend that all patients with ACC receive postoperative radiotherapy (PORT). However, whether PORT can improve local control and which patients can benefit from PORT are unknown. This study aimed to assess the role of PORT and provide individualized suggestions for postoperative therapy in patients with ACC. Patients and Methods: We retrospectively reviewed patients with nonmetastatic head and neck ACC who underwent surgery with or without PORT. Recursive partitioning analysis (RPA) was performed to categorize the patients and predict local recurrence-free survival (LRFS). The survival outcome was compared between non-PORT and PORT groups. Results: A total of 319 patients were included. PORT was identified as a prognostic factor for LRFS in univariate (P=.01) and multivariate analysis (P<.01). However, it did not improve distant metastasis-free survival, disease-free survival, or overall survival in univariate analysis. RPA categorized patients into 3 prognostic groups: low-risk (negative margin, T1–T2, primary location = major or minor salivary gland), intermediate-risk (negative margin, T1–T2, primary location = other locations instead of a major or minor salivary gland; negative margin, T3–T4; positive margin, without bone invasion), and high-risk (positive margin, with bone invasion). Significant LRFS improvements in the PORT group were observed among intermediate-risk (P<.01) and high-risk patients (P<.05). LRFS improvements among low-risk patients were relatively insignificant (P=.10). Conclusions: PORT was shown to be a positive prognostic factor for improved LRFS in ACC. Furthermore, PORT could significantly improve LRFS in intermediate-risk and high-risk patients with ACC, but whether low-risk patients could benefit from PORT needs further study.
Use of 18F-FDG PET/CT as an Initial Staging Procedure for Stage II–III Breast Cancer: A Multicenter Value Analysis
Authors: Hyland Colby J. , Varghese Flora , Yau Christina , Beckwith Heather , Khoury Katia , Varnado William , Hirst Gillian L. , Flavell Robert R. , Chien A. Jo , Yee Douglas , Isaacs Claudine J. , Forero-Torres Andres , Esserman Laura J. , Melisko Michelle E.
Published: November 2020

Background: Metastatic staging imaging is not recommended for asymptomatic patients with stage I–II breast cancer. Greater distant metastatic disease risk may warrant baseline imaging in patients with stage II–III with high-risk biologic subtypes. NCCN Guidelines recommend considering CT of the chest, abdomen, and pelvis (CT CAP) and bone scan in appropriate patients. CT CAP and bone scan are considered standard of care (SoC), although PET/CT is a patient-centered alternative. Methods: Data were available for 799 high-risk patients with clinical stage II–III disease who initiated screening for the I-SPY2 trial at 4 institutions. A total of 564 complete records were reviewed to compare PET/CT versus SoC. Costs were determined from the payer perspective using the national 2018 Medicare Physician Fee Schedule and representative reimbursements to the University of California, San Francisco (UCSF). Incremental cost-effectiveness ratio (ICER) measured cost of using PET/CT per percent of patients who avoided a false-positive (FP). Results: The de novo metastatic disease rate was 4.6%. Imaging varied across the 4 institutions (P<.0001). The FP rate was higher using SoC versus PET/CT (22.1% vs 11.1%; P=.0009). Mean time between incidental finding on baseline imaging to FP determination was 10.8 days. Mean time from diagnosis to chemotherapy initiation was 44.3 days with SoC versus 37.5 days with PET/CT (P=.0001). Mean cost per patient was $1,132 (SoC) versus $1,477 (PET/CT) using the Medicare Physician Fee Schedule, with an ICER of $31. Using representative reimbursements to UCSF, mean cost per patient was $1,236 (SoC) versus $1,073 (PET/CT) for Medicare, and $3,083 (SoC) versus $1,656 (PET/CT) for a private payer, with ICERs of −$15 and −$130, respectively. Conclusions: Considerable variation exists in metastatic staging practices. PET/CT reduced FP risk by half and decreased workup of incidental findings, allowing for earlier treatment start. PET/CT may be cost-effective, and at one institution was shown to be cost-saving. Better alignment is needed between hospital pricing strategies and payer coverage policies to deliver high-value care.
Emerging Tools for Design and Implementation of Water Quality Monitoring Based on IoT
Authors: Skarga-Bandurova Inna , Krytska Yana , Velykzhanin Artem , Barbaruk Lina , Suvorin Oleksandr , Shorokhov Mikhail
Published: November 2020

The article provides a conceptual framework for developing real-time water monitoring system based on IoT technology. The process, strategy and knowledge base for multidisciplinary research on IoT systems and prerequisites for real-world application of IoT technology into continuous water quality monitoring are discussed. The study expands current efforts aimed at leveraging customized IoT solutions for better instrumentation and the continued integration of sensor data into networks. The process of system design from scratch and base components of IoT-based water quality monitoring system for surface water are described. While the focus of this article is on system design, opportunities to improve the system components for the management of water resources with continuous water quality monitoring are much broader. In this view, perspectives and development issues of IoT-based water quality monitoring are also discussed.
Knowledge Discourses and Coherence in Professional Education
Authors: Hermansen Hege
Published: November 2020

In recent years, significant attention has been paid to the relationship between different knowledge domains in professional education, based on the assumption that achieving coherence between domains is important for student learning and educational quality. In particular, much research has addressed questions of knowledge integration across different sites of learning. However, less attention has been paid to the epistemic diversity of the campus-based programme context and to how relationships between knowledge domains are constructed within epistemically diverse professional programmes. This article addresses this gap by examining how program leaders discursively position disciplinary knowledge in relation to the mandate of teacher education. The data consist of interviews and logs from 20 program leaders at four higher education institutions. The analysis identifies four accounts of the role of disciplinary knowledge in teacher education. The article concludes by discussing implications for efforts to achieve coherence and knowledge integration in professional education.
Assessment of the current practice of psychiatric pharmacists in the United States
Authors: Silvia Richard J. , Lee Kelly C. , Bostwick Jolene R. , Cobb Carla D. , Goldstone Lisa W. , Moore Tera D. , Payne Gregory H. , Ho Jessica L.
Published: November 2020

Introduction

A comprehensive review of psychiatric pharmacy practice has never been performed in the United States. As psychiatric pharmacists become more involved in mental illness treatment, determining the current state of practice is important to help advance the specialty. The Professional Affairs Committee of the College of Psychiatric and Neurologic Pharmacists (CPNP) was charged with performing this review to define current psychiatric pharmacy practice.

Methods

An electronic survey was sent to all pharmacist members of CPNP and all nonmember Board Certified Psychiatric Pharmacists (BCPPs) in the United States in late summer 2019. The survey consisted of 36 questions across multiple domains to obtain information about respondents' education and training background, practice setting and type, and information about prescriptive authority and other areas. An initial e-mail invitation was sent along with 2 reminder e-mails over the subsequent 2 weeks.

Results

A total of 334 of 1015 pharmacists completed the survey (32.9%). Responders completed a postgraduate residency 77.8% of the time, and 88.3% were BCPP. Practice settings were split evenly between inpatient and outpatient practices or a combination of the 2. Among respondents, 46.5% reported having prescriptive authority as part of their practice, and 41.3% reported treating nonpsychiatric as well as psychiatric illnesses. Prescriptive authority was more likely in outpatient practices and in those treating nonpsychiatric illnesses.

Discussion

The current practice of psychiatric pharmacy is incredibly varied in terms of practice setting, activities performed, and services provided. Further exploration is needed to help determine the optimal role of psychiatric pharmacists.
Engineering protein fragments via evolutionary and protein–protein interaction algorithms: de novo design of peptide inhibitors for FOF1‐ATP synthase
Authors: Ruiz‐Blanco Yasser B. , Ávila‐Barrientos Luis Pablo , Hernández‐García Enrique , Antunes Agostinho , Agüero‐Chapin Guillermin , García‐Hernández Enrique
Published: November 2020

Enzyme subunit interfaces have remarkable potential in drug design as both target and scaffold for their own inhibitors. We show an evolution‐driven strategy for the de novo design of peptide inhibitors targeting interfaces of the Escherichia coli FoF1‐ATP synthase as a case study. The evolutionary algorithm ROSE was applied to generate diversity‐oriented peptide libraries by engineering peptide fragments from ATP synthase interfaces. The resulting peptides were scored with PPI‐Detect, a sequence‐based predictor of protein–protein interactions. Two selected peptides were confirmed by in vitro inhibition and binding tests. The proposed methodology can be widely applied to design peptides targeting relevant interfaces of enzymatic complexes.
Proton vs Hyperarc™ radiosurgery: A planning comparison
Authors: Boczkowski A. , Kelly P. , Meeks S. L. , Erhart K. , Bova F. J. , Willoughby T. R.
Published: November 2020

For many patients, stereotactic radiosurgery (SRS) offers a minimally invasive, curative option when surgical techniques are not possible. To date, the literature supporting the efficacy and safety of SRS treatment techniques uses photon beams. However, with the number of proton therapy facilities exponentially growing and the favorable physical properties of proton beam radiation therapy, there is an opportunity to develop proton therapy techniques for SRS. The goal of this paper is to determine the ability of clinical proton treatment planning systems to model small field dosimetry accurately and to compare various planning metrics used to evaluate photon SRS to determine the optimum beam configurations and settings for proton SRS (PSRS) treatment plans. Once established, these plan settings were used to perform a planning comparison on a variety of different SRS cases and compare SRS metrics between the PSRS plans and HyperArc™ (VMAT) SRS plans.
Ante‐ and postmortem tau in autosomal dominant and late‐onset Alzheimer’s disease
Authors: Chen Charles D. , Holden Timothy R. , Gordon Brian A. , Franklin Erin E. , Li Yan , Coble Dean W. , Luo Hongbo , Bateman Randall J. ,   for the Dominantly Inherited Alzheimer Network (DIAN) and for the Dominantly Inherited Alzheimer Network Trials Unit (DIAN‐TU), Ances Beau M. , Perrin Richard J. , Benzinger Tammie L. S. , Cairns Nigel J. , Morris John C.
Published: November 2020

Antemortem tau positron emission tomography imaging suggests elevated tau pathology in autosomal dominant versus late‐onset Alzheimer’s disease at equivalent clinical stages, but does not implicate the specific tau pathologies responsible. Here we made stereological measurements of tau neurofibrillary tangles, neuritic plaques, and neuropil threads and found compared to late‐onset Alzheimer’s disease, autosomal dominant Alzheimer’s disease showed even greater tangle and thread burdens. Regional tau burden resembled that observed in tau imaging of a separate cohort at earlier clinical stages. Finally, our results suggest tau imaging measures total tau burden in Alzheimer’s disease, composed predominantly of tangle and thread pathology.
Composite Nanostructure Construction on the Grain Surface of Li‐Rich Layered Oxides
Authors: Wang Errui , Zhao Yang , Xiao Dongdong , Zhang Xu , Wu Tianhao , Wang Boya , Zubair Muhammad , Li Yuqiang , Sun Xueliang , Yu Haijun
Published: November 2020

Li‐rich layered oxides (LLOs) are fascinating high‐energy cathodes for lithium‐ion batteries (LIBs), but still suffer from critical drawbacks that retard their practical applications. Although surface modification is effective to protect LLOs from structural deterioration, the delicate design of structures on a grain surface with promising scalability for industrial application is still challenging. Herein, using the atomic layer deposition (ALD) technique, a composite nanostructure comprising a uniform LiTaO3 coating layer (≈3 nm) and a spinel interlayer structure (≈1 nm) is constructed on the grain surface of industrial LLO (Li1.13Mn0.517Ni0.256Co0.097O2) agglomerated spheres. The surface composite nanostructure can not only enhance the structural/interfacial stability of the LLO, but also facilitates Li+ diffusion, thereby significantly improving its cycle stability, rate performance, thermal stability, and voltage maintenance. Specifically, the LLO coated with 10 ALD cycles exhibits a small voltage decay rate of 0.9 mV per cycle, a reversible capacity of 272.8 mAh g−1 at 0.1 C, and a capacity retention of 85% after 200 cycles at 1 C, suggesting the important role of surface composite nanostructure for improving the electrochemical performance. This work provides new insights into the composite nanostructure design on the grain surface of cathode materials for high‐performance LIBs.
Metal–Organic‐Framework‐Based Photocatalysts Optimized by Spatially Separated Cocatalysts for Overall Water Splitting
Authors: Zhang Jijie , Bai Tianyu , Huang Hui , Yu Mei‐Hui , Fan Xiaobin , Chang Ze , Bu Xian‐He
Published: November 2020

Efficient charge separation and utilization are critical factors in photocatalysis. Herein, it is demonstrated that the complete spatial separation of oxidation and reduction cocatalysts enhances the efficacy of charge separation and surface reaction. Specifically, a Pt@NH2‐UiO‐66@MnOx (PUM) heterostructured photocatalyst with Pt and MnOx as cocatalysts is designed for the optimization of the NH2‐UiO‐66 photocatalyst. Compared with the pristine NH2‐UiO‐66, Pt@NH2‐UiO‐66 (PU), and NH2‐UiO‐66@MnOx (UM) samples, the PUM sample exhibits the highest hydrogen production activity. As cocatalysts, Pt favors trapping of electrons, while MnOx tends to collect holes. Upon generation from NH2‐UiO‐66, electrons and holes flow inward and outward of the metal–organic framework photocatalyst, accumulating on the corresponding cocatalysts, and then take part in the redox reactions. The PUM photocatalyst greatly prolongs the lifetime of the photogenerated electrons and holes, which favors the electron–hole separation. Furthermore, the PUM sample facilitates overall water splitting in the absence of sacrificial agents, thereby demonstrating its potential as a modification method of MOF‐type semiconductors for the overall water‐splitting reaction.
Creating Synergy of Microporous Hydrophilic–Organophilic Surfaces in Zeolite@Nano‐Titania Particles for Rapid Removal of Diverse Pollutants in Water
Authors: Shaw Ruchi , Madan Shubhangi , Tiwari Sangeeta , Tiwari Sandeep Kumar
Published: November 2020

The present work reports the synergy between microporous titania (hydrophilic surface) and zeolite (organophilic surface) through coating of nano‐titania particles in multilayers on zeolite (Ze) surface (Ze‐TiO2 core‐shell particles). The microporous hydrophilic shell, by virtue of its high wetting properties and van der Waals forces, attracts solvated analytes from water causing rapid diffusion across the solid–liquid interface. The stronger ionic/organophilic attraction by the core (zeolite) enables the pollutants from shell to migrate to the core leaving shell deficient for further adsorption. It establishes a continuous flow of analytes from bulk to the core through favorably charged hydrophilic layers of anatase TiO2 till the high‐capacity zeolite is completely adsorbed. Porous layers of TiO2 (shell) introduce rapid physiosorption of analytes while chemisorption mechanism is retained by zeolite core as confirmed by kinetic and isotherm studies on adsorption of heavy metal ion (Pb(II)) and organic dye (methylene blue). The mechanism of adsorption is substantiated by intraparticle diffusion model. The material holds promise as multifunctional adsorbent for rapid and efficient removal of diverse pollutants from water.
Bio‐Inspired Conformable and Helical Soft Fabric Gripper with Variable Stiffness and Touch Sensing
Authors: Hoang Trung Thien , Phan Phuoc Thien , Thai Mai Thanh , Lovell Nigel H. , Do Thanh Nho
Published: November 2020

There are many instances in nature where continuum, helical manipulators are used to efficiently grasp different objects with various shapes and sizes. Inspired by nature, this paper introduces a continuum, flat, scalable, helical soft‐fabric robotic gripper that is thin and lightweight with stiffness tunability and sensory feedback. The gripper is fabricated by a facile method of simple insertion using a computerized technique from apparel engineering and controlled by a miniature hydraulic source to grasp different objects at different scales and weights. It uses a thermally activated variable stiffness structure (VSS) for high load capacity that can complete a softening‐stiffening cycle within 24 s, which is among the fastest results reported so far. In addition, a highly stretchable liquid metal‐based soft sensor with an enhanced sensing sensitivity (15 times more sensitive compared to conventional designs) is embedded into the gripper to provide real‐time touch sensing. The gripper successfully grasped various objects of different geometries and weights (up to 220 times of its mass) and retrieved them from confined hollow spaces. Its excellent performance and versatility make it an ideal candidate for various domains, including industry, exploration, rescue, and other applications in confined and hazardous environments such as gas/oil or drainage sectors.
Prodrug‐Loaded Zirconium Carbide Nanosheets as a Novel Biophotonic Nanoplatform for Effective Treatment of Cancer
Authors: Liu Quan , Xie Zhongjian , Qiu Meng , Shim Inseob , Yang Yunlong , Xie Sisi , Yang Qinhe , Wang Dou , Chen Shiyou , Fan Taojian , Ding Bo , Guo Ziheng , Adah Dickson , Yao Xinhuang , Zhang Yuhua , Wu Hong , Wu Zongze , Wei Chaoying , Wang Hongzhong , Kim Hyeong Seok , Zou Qingshuang , Yan Qiaoting , Cai Zhen , Kim Jong Seung , Liu Li‐Ping , Zhang Han , Cao Yihai
Published: November 2020

Conventional chemotherapy and photothermal therapy (PTT) face many major challenges, including systemic toxicity, low bioavailability, ineffective tissue penetration, chemotherapy/hyperthermia‐induced inflammation, and tumor angiogenesis. A versatile nanomedicine offers an exciting opportunity to circumvent the abovementioned limitations for their successful translation into clinical practice. Here, a promising biophotonic nanoplatform is developed based on the zirconium carbide (ZrC) nanosheet as a deep PTT‐photosensitizer and on‐demand designed anticancer prodrug SN38‐Nif, which is released and activated by photothermia and tumor‐overexpressed esterase. In vitro and in vivo experimental evidence shows the potent anticancer effects of the integrated ZrC@prodrug biophotonic nanoplatform by specifically targeting malignant cells, chemotherapy/hyperthermia‐induced tumor inflammation, and angiogenesis. In mouse models, the ZrC@prodrug system markedly inhibits tumor recurrence, metastasis, inflammation and angiogenesis. The findings unravel a promising biophotonic strategy for precision treatment of cancer.
Growing Perovskite Quantum Dots on Carbon Nanotubes for Neuromorphic Optoelectronic Computing
Authors: Li Jinxin , Dwivedi Priyanka , Kumar Kowsik Sambath , Roy Tania , Crawford Kaitlyn E. , Thomas Jayan
Published: November 2020

Brain‐inspired (neuromorphic) computing that offers lower energy consumption and parallelism (simultaneous processing and memorizing) compared to von Neumann computing provides excellent opportunities in many computational tasks ranging from image recognition to speech processing. To accomplish neuromorphic computing, highly efficient optoelectronic synapses, which can be the building blocks of optoelectronic neuromorphic computers, are necessary. Currently, carbon nanotubes (CNTs), an attractive candidate to develop circuit‐level photonic synapses, provide weak light responses. The inferior photoresponse of CNTs increases the energy consumption of neuromorphic optoelectronic devices. Herein, a method to grow organic–inorganic halide perovskite quantum dots (PQDs) directly on multiwall CNTs (MWCNTs) to increase the photosensitivity of optoelectronic synapses is demonstrated. The new hybrid material synchronizes the high photoresponse of PQDs and the excellent electrical properties of MWCNTs to provide photonic memory under very low light intensity (125 µW cm−2). However, neat MWCNTs do not show any detectable light response at the tested light intensity, as high as 25 mW cm−2. Since the PQDs are grown directly on and in the MWCNTs, the hybrid PQD‐MWCNT provides a new direction for the future MWCNT‐based optoelectronic devices for neuromorphic computing with a potential to break the von Neumann bottleneck.
Impacts of Minority Charge Carrier Injection on the Negative Capacitance, Steady‐State Current, and Transient Current of a Single‐Layer Organic Semiconductor Device
Authors: Moon Chang‐Ki , Choi Ja‐Yun , Han Yoonjay , Lee Chang‐Heon , Kim Jang‐Joo
Published: November 2020

Space charge limited current theory is often used to analyze electrical characteristics of single‐layer organic semiconductor devices using Ohmic and Schottky contacts for injection of majority and minority carriers, respectively. However, significant deviations from this theory in the current density–voltage and capacitance–frequency characteristics of the devices have been frequently observed. For instance, the increase in current density is not proportional to the voltage‐square and the capacitance becomes negative at low frequencies. Here, it is presented that the minority carriers in a single‐layer device despite a large Schottky barrier give rise to the negative capacitance at low frequencies and the drastic increase in steady‐state current density at high voltages. The leaky electrons at the hole‐dominant device are demonstrated by inserting an electron scavenger layer. The transient current of the device shows the injection and transport properties of electrons by low and dispersive mobility. The negative capacitance of the device at low frequencies is a response of the minority carrier injection. The current density increases drastically at high voltages due to the increasing minority carriers that redistribute the electric field, which is not shown at low voltages. Finally, the device model incorporating minority charge carriers fully describes the electrical characteristics of the device.
Human neonates prefer colostrum to mature milk: Evidence for an olfactory bias toward the “initial milk”?
Authors: Klaey‐Tassone Magali , Durand Karine , Damon Fabrice , Heyers Katrin , Mezrai Nawel , Patris Bruno , Sagot Paul , Soussignan Robert , Schaal Benoist ,   the MILKODOR Consortium
Published: November 2020

Objectives

Colostrum is the initial milk secretion which ingestion by neonates warrants their adaptive start in life. Colostrum is accordingly expected to be attractive to newborns. The present study aims to assess whether colostrum is olfactorily attractive for 2‐day‐old newborns when presented against mature milk or a control.

Methods

The head‐orientation of waking newborns was videotaped in three experiments pairing the odors of: (a) colostrum (sampled on postpartum day 2, not from own mother) and mature milk (sampled on average on postpartum day 32, not from own mother) (n tested newborns = 15); (b) Colostrum and control (water; n = 9); and (c) Mature milk and control (n = 13).

Results

When facing the odors of colostrum and mature milk, the infants turned their nose significantly longer toward former (32.8 vs 17.7% of a 120‐s test). When exposed to colostrum against the control, they responded in favor of colostrum (32.9 vs 16.6%). Finally, when the odor of mature milk was presented against the control, their response appeared undifferentiated (26.7 vs 28.6%).

Conclusions

These results indicate that human newborns can olfactorily differentiate conspecific lacteal fluids sampled at different lactation stages. They prefer the odor of the mammary secretion ‐ colostrum ‐ collected at the lactation stage that best matches the postpartum age of their own mother. These results are discussed in the context of the earliest mother‐infant chemo‐communication. Coinciding maternal emission and offspring reception of chemosignals conveyed in colostrum may be part of the sensory precursors of attunement between mothers and infants.
Validating plasminogen activator inhibitor‐1 as a poor prognostic factor in sepsis
Authors: Hoshino Kota , Nakashio Maiko , Maruyama Junichi , Irie Yuhei , Kawano Yasumasa , Ishikura Hiroyasu
Published: November 2020

Aim

Our previous report indicated that plasminogen activator inhibitor‐1 (PAI‐1) levels of ≥83 ng/mL in patients with sepsis tended to be associated with disseminated intravascular coagulation (DIC), suppressed fibrinolysis, multiple organ dysfunction, and mortality. Therefore, the present study aimed to validate whether 83 ng/mL was a useful cut‐off value for using PAI‐1 levels to predict a poor prognosis in sepsis.

Methods

Patients with sepsis were included in this single‐center retrospective study. The patients were classified as having high or low PAI‐1 values (<83 ng/mL versus ≥83 ng/mL), and were compared in terms of their pre‐DIC state, intensive care unit‐free days, continuous renal replacement therapy‐free days, ventilator‐free days, catecholamine‐free days, and 28‐day survival rate.

Results

The high PAI‐1 group included 61 patients (54%) and the low PAI‐1 group included 52 patients (46%). The high PAI‐1 group had significantly higher frequencies of a pre‐DIC state within 1 week (P = 0.009). There was no significant difference in ventilator‐free days. However, the high PAI‐1 group had significantly lower values for intensive care unit‐free days (P = 0.01), continuous renal replacement therapy‐free days (P = 0.02), and catecholamine‐free days (P = 0.02). The high PAI‐1 group also had a significantly lower 28‐day survival rate based on the Kaplan–Meier analysis (log–rank, P = 0.03).

Conclusion

Patients with sepsis and PAI‐1 levels of ≥83 ng/mL had elevated risks of coagulopathy, organ failure, and mortality. Thus, these results suggest that 83 ng/mL could be a useful cut‐off value for prognostication based on PAI‐1 levels in this setting.
Therapeutic efficacy for traumatic asphyxia with a focus on cardiac arrest
Authors: Kikuta Shota , Ishihara Satoshi , Kai Soichiro , Nakayama Haruki , Matsuyama Shigenari , Kawase Tetsunori , Nakayama Shinichi
Published: November 2020

Aim

To investigate the clinical features of traumatic asphyxia, specifically the presence of cardiac arrest and therapeutic efficacy. This review will be useful for future emergencies.

Methods

Sixteen traumatic asphyxia cases from our hospital between April 2007 and March 2019 were reviewed and divided into three groups: those experiencing cardiac arrest at the time of rescue (group A, six cases), those experiencing cardiac arrest after rescue (group B, five cases), and those who did not experience cardiac arrest (group C, five cases).

Results

All cases had abnormal findings in the skin or conjunctiva. The total mortality rate reached 56%. Among the 11 cases in groups A and B that resulted in cardiac arrest, 10 had an Injury Severity Score of 16 or higher and an Abbreviated Injury Scale score in the chest of 3 or higher. The patients’ injuries included pneumothorax, flail chest, and pericardial hematoma. The heartbeat was restarted in seven cases, and two cases completely recovered.

Conclusion

In some traumatic asphyxia cases, the treatment course was relatively effective even with cardiac arrest; thus, life support efforts should not be spared in such cases.
Adhesive small bowel obstruction – an update
Authors: Tong Jia Wei Valerie , Lingam Pravin , Shelat Vishalkumar Girishchandra
Published: November 2020

Small bowel obstruction (SBO) accounts for 12–16% of emergency surgical admissions and 20% of emergency surgical procedures. Even with the advent of laparoscopic surgery, intra‐abdominal adhesions remain a significant cause of SBO, accounting for 65% of cases. History and physical examination are essential to identify signs of bowel ischemia as this indicates a need for urgent surgical exploration. Another critical aspect of evaluation includes establishing the underlying cause for obstruction and distinguishing between adhesive and non‐adhesive etiologies as adhesive SBO (ASBO) can be managed non‐operatively in 70–90% of patients. A patient with a history of abdominopelvic surgery along with one or more cardinal features of obstruction should be suspected to have ASBO until proven otherwise. Triad of severe pain, pain out of proportion to the clinical findings, and presence of an abdominal scar suggest possible closed‐loop obstruction. Computed tomography has higher sensitivity and specificity compared to plain films and is recommended by the Bologna guidelines. Correcting fluid and electrolyte imbalance is an initial crucial step to mitigate severe hypovolemia. Patients should proceed with surgery if symptoms of bowel compromise are present, or if symptoms do not resolve or have worsened. Surgery is indicated in patients with ischemia, strangulation, perforation, peritonitis, or failure of non‐operative treatment. With advances in minimal access technology and increasing experience, laparoscopic adhesiolysis is recommended. Mechanical adhesion barriers are an effective measure to prevent adhesion formation.