bluuebunny/crossref_metadata_2025 huggingface dataset:
Intuitive and Regressive Justifications†
Authors: Potter Michael
Published: September 2020

In his recent book, Quine, New Foundations, and the Philosophy of Set Theory (2018), Sean Morris attempts to rehabilitate Quine’s NF as a possible foundation for mathematics. I explain why he does not succeed.
A comparison of physical function instruments in psoriatic arthritis: HAQ-DI vs MDHAQ vs PROMIS10 global physical health
Authors: Wan Marilyn T , Walsh Jessica A , Craig Ethan T , Husni M Elaine , Scher Jose U , Reddy Soumya M , Leung Ying-Ying , Ogdie Alexis 
Published: September 2020

Objectives

Physical function is a core outcome in PsA. We examined the construct validity and responsiveness of three commonly used instruments to assess physical function in PsA: HAQ disability index (HAQ-DI), MultiDimensional HAQ (MDHAQ) and the Patient-Reported Outcomes Measurement Information System (PROMIS®) Global-10.

Methods

Between 2016 and 2019, patients with PsA were enrolled in the Psoriatic Arthritis Research Consortium longitudinal cohort study in the USA. Correlations were calculated at baseline and among change scores using Spearman’s correlation coefficient. Standardized response means were calculated. Agreement with the 20% improvement cut-off was used to determine the potential effect of using MDHAQ or the PROMIS Global-10 physical health (GPH) subscore in place of HAQ-DI when assessing the ACR20.

Results

A total of 274 patients were included in the analysis. The mean age of patients was 49 years and 51% were male. At baseline, the mean HAQ-DI was 0.6 (s.d. 0.6; range 0–3), the mean MDHAQ was 1.8 (s.d. 1.6; range 0–10) and the mean GPH T-score was 43.4 (s.d. 9.3; range 0–100). All three instruments were strongly correlated at baseline (rho 0.75–0.85). Change scores were moderately correlated (rho 0.42–0.71). Among therapy initiators, the mean change between two visits in HAQ-DI, MDHAQ and GPH was −0.1 (s.d. 0.4), −0.2 (s.d. 1.2) and 2.5 (s.d. 6.1), respectively. The standardized response means were 0.18, 0.16 and 0.41, respectively.

Conclusion

The three instruments tested are not directly interchangeable but have overall similar levels of responsiveness.
STUDIES OF RADON LEVELS, RADIUM CONCENTRATION, AND ESTIMATED EFFECTIVE DOSE IN DWELLINGS AND SOILS IN GOLD MINING TOWNS IN ABIREM OF EASTERN REGION OF GHANA
Authors: Otoo F , Arhin I , Darko E O
Published: September 2020

Studies have been carried in 126 dwellings for indoor radon levels and 43 soil samples for radium and radon exhalation rate of Abirem communities in Eastern region of Ghana. The measurements were done using CR-39 and HPGe techniques. Indoor radon and mean concentration ranged from 23.8 to 125.7 Bq/m3, 54.7 ± 23.7 Bq/m3. Bedroom, kitchen, and sitting varied from 30.8 to 125.7 Bq/m3, 23.8–63.9 Bq/m3 and 23.8 to 58.4 Bq/m3. Strong and weak Pearson correlation were found between radium and radon in soil, radium and indoor radon concentration. Radium concentration and mean were found to be varied from 19.5 to 38.9 Bq/kg, 29.0 ± 16.0 Bq/kg. The radon exhalation rate and mean in soil were also found to be varied from 21.3 to 112.1 μBq/m2h, 65.1 ± 27.6 μBq/m2h. Indoor radon values and radium concentration in dwellings and soil recorded 8% and 38%, respectively, more than action proposed by WHO and UNSCEAR 2000. The estimated annual effective doses and cancer risk were less than the average values recommended by UNSCEAR and ICRP.
Development of Executive Functions as Reflected in Daily Life Behaviors in Young Adults at Ultra-High Risk for Psychosis: Associations With Symptoms and Functioning
Authors: Glenthøj Louise Birkedal , Hjorthøj Carsten , Kristensen Tina Dam , Wenneberg Christina , Nordentoft Merete , Jepsen Jens Richardt Møllegaard
Published: September 2020

There is a paucity of evidence on executive functions (EF) as reflected in daily life behaviors in individuals at ultra-high risk (UHR) for psychosis. This prospective follow-up study investigated the 1-year development in EF in UHR compared to healthy controls (HC) and how this change may relate to change in severity of clinical symptoms, social communication, and functioning. UHR (N = 132) and HC (N = 66) were assessed with the Behaviour Rating Inventory of Executive Function–Adult version (BRIEF-A) self and informant report at baseline and 12 months follow-up comprising the Behavioral Regulation Index (BRI) and the Metacognition Index (MI). Additionally, data on depressive-, negative-, and attenuated psychotic symptoms and everyday social functioning were collected. The study found UHR to display large baseline impairments in EF in real life on both self- and informant reports. UHR and HC showed a significantly different development of EF over time, with UHR displaying greater improvements in EF compared to HC. Change in clinical symptoms did not relate to improvements in EF, except for depressive symptoms negatively associating with the development of the MI. Improvements on the BRI and MI were significantly associated with improvements in social functioning. Findings suggest the potential of UHR individuals displaying a larger ongoing maturational development of daily life EF than HC that seems predominantly independent of development of clinical symptoms. If replicated, this supports a maturational trajectory of daily life EF in UHR that approaches, but do not reach, the level of HC and may indicate a window of opportunity for targeted remediation approaches.
Five-Year Cumulative Exposure to Antipsychotic Medication After First-Episode Psychosis and its Association With 19-Year Outcomes
Authors: Bergström Tomi , Taskila Jyri J , Alakare Birgitta , Köngäs-Saviaro Päivi , Miettunen Jouko , Seikkula Jaakko
Published: September 2020

Background

The long-term effectiveness of antipsychotic maintenance treatment after first-episode psychosis (FEP) is contested. In this real-world observational study, we examined how cumulative exposure to antipsychotics within the first 5 years from FEP was associated with the 19-year outcome.

Methods

Finnish national registers were used to detect all patients who were hospitalized due to non-affective psychosis in the mid-1990s, and who were treatment naïve prior to the inclusion period (N = 1318). Generalized linear models with logit link function were used to estimate how cumulative exposure to antipsychotics within the first 5 years from onset was associated with mortality, work capability, and the use of psychiatric services at the end of the 19-year follow-up. To adjust for confounding by indication, the primary outcome analyses implemented stabilized inverse probability of treatment weighting using propensity scores.

Results

Persons with a higher cumulative exposure to antipsychotics within the first 5 years from FEP were more likely to still be receiving antipsychotics (adjusted odds ratio [OR] = 2.1; 95% CI: 1.5−2.8), psychiatric treatment (OR = 1.4; 95% CI: 1.1−1.7), and disability allowances (OR = 1.3; 95% CI: 1.01−1.6) at the end of the 19-year follow-up, as compared to low/zero-exposure. Higher cumulative exposure was also associated with higher mortality (OR = 1.5; 95% CI: 1.1–2.1).

Conclusions

After adjustment for confounders, moderate and high cumulative exposure to antipsychotics within the first 5 years from FEP was consistently associated with a higher risk of adverse outcomes during the 19-year follow-up, as compared to low or zero exposure. Due to potential unmeasured confounding, controlled trials are needed.
Sleep duration regularity, but not sleep duration, is associated with microvascular function in college students
Authors: Hoopes Elissa K , Berube Felicia R , D’Agata Michele N , Patterson Freda , Farquhar William B , Edwards David G , Witman Melissa A H
Published: September 2020

Study Objectives

Vascular dysfunction is a hypothesized mechanism linking poor sleep habits to an increased incidence of cardiovascular diseases (CVDs). However, the vascular profile associated with free-living sleep duration and sleep regularity has not been well elucidated, particularly in young adults. Thus, this study aimed to evaluate the associations between mean sleep duration, regularity in sleep duration, and peripheral vascular function in young adult college students.

Methods

Fifty-one healthy undergraduate students (20 ± 1 years) completed 14 days of 24-hour wrist actigraphy and subsequent vascular assessments. Macrovascular function was measured using brachial artery flow-mediated dilation (FMD) while microvascular function was measured via passive leg movement (PLM).

Results

Mean sleep duration was unrelated to FMD and PLM. Conversely, more irregular sleep duration (14-day sleep duration standard deviation [SD]) was unfavorably associated with all three measures of PLM-induced hyperemia (peak leg blood flow [LBF], p = 0.01; change in LBF from baseline to peak, p < 0.01; LBF area under the curve, p < 0.01), and remained significant in regression models which adjusted for sex, body mass index, blood pressure, physical activity, alcohol and caffeine consumption, and sleep duration (all p < 0.05). When using a median split to dichotomize “low” and “high” sleep duration SD groups, those demonstrating high variability in sleep duration exhibited ~45% lower PLM responses compared with those demonstrating low variability.

Conclusions

Irregular sleep duration is associated with poorer microvascular function as early as young adulthood. These findings support the growing body of evidence that irregular sleep patterns may be an independent and modifiable risk factor for CVD.
Forage quality and beef cow preference is affected by wrap type of conventional and reduced-lignin alfalfa round bales stored outdoors
Authors: Reiter Amanda S , DiCostanzo Alfredo , Webb Megan , Zeltwanger Josh , Sheaffer Craig C , Jaqueth Aubrey , Martinson Krishona L
Published: September 2020

Storing hay outdoors can result in detrimental changes in forage quality. Additionally, alfalfa (Medicago sativa L.) cultivar may influence dry matter intake (DMI) and hay waste when feeding livestock. The objectives were to determine the effects of conventional or reduced-lignin alfalfa round bales stored outdoors and wrapped with plastic twine, net wrap, or B-Wrap on forage quality, beef cow preference, and hay waste. Round bales made from reduced-lignin (n = 12) or conventional (n = 12) alfalfa cultivars were baled and stored outdoors for 16 mo. Within each cultivar, four bale replicates were bound with plastic twine, net wrap, or B-Wrap. After storage, bales were fed in a switchback design with period confounded with alfalfa cultivar to 18 lactating Angus cows (Bos Taurus L.). The pairs had ad libitum access to three round-bale feeders where bales of each wrap type were placed for eight 48 h periods. Position of round bale wrap type was rotated according to a Latin Square arrangement. Bales were weighed and waste surrounding each feeder was collected at 24 and 48 h to calculate DMI and hay waste. Statistical significance was set at P < 0.05. Alfalfa cultivar did not impact any of the response variables (P > 0.05). At feeding, round bales wrapped in net wrap had greater (P < 0.015) moisture content (16.4%) compared with those wrapped with B-Wrap (12.8%). Neutral detergent fiber was lower (P = 0.03) in bales wrapped in B-Wrap (46%) compared with twine-tied bales (49%) while net wrapped bales were not different. Total digestible nutrients (P = 0.02), and relative feed value (P = 0.04) were lower in twine-tied bales compared with B-Wrap while net wrapped bales were not different. Twine (7.1 × 106 colony forming units [CFU]/g) and net wrap (4.7 × 106 CFU/g) bales had greater (P < 0.0001) mold counts than B-Wrap bales (4.8 × 104 CFU/g), while concentrations of other forage components and yeast counts were not different among wrap types (P > 0.05). Total DMI, and DMI during the first 24 h, were greater (P ≤ 0.032) for B-Wrap bales compared to twine-tied bales indicating preference for hay wrapped in B-Wrap; net wrapped bales were not different. Dry matter intake in the first 24 h was negatively associated with the mold count (r = −0.52; P = 0.02), and hay waste was not affected by wrap type (P > 0.05). These results confirm that wrap type affected forage quality and mold counts, which in turn influenced beef cattle preference of round bales stored outdoors.
Cannabinoids for the Treatment of Opioid Use Disorder: Where is the Evidence?
Authors: Suzuki Joji , Weiss Roger D.
Published: September 2020

With the growing public interest in the potential therapeutic benefits of cannabis and cannabinoids in the treatment of opioid use disorder (OUD), some states have now either added or proposed to add OUD as an indication for their state's medical marijuana program. However, these initiatives are based on weak evidence which at present do not support the listing of cannabis or cannabinoids as a treatment for OUD. Nevertheless, studying the potential therapeutic applications of carefully chosen components of cannabis or cannabinoids to treat specific aspects of OUD is not without scientific merit. Given the high rates of treatment discontinuation among those taking medications for OUD, interventions that further improve clinical outcomes are especially needed. The potential therapeutic applications of cannabis and cannabinoids in the treatment of OUD are worthy of further study, but it should be conducted with the same rigor that we expect of all pharmaceutical products. Until we have more research to show their efficacy, policy makers and clinicians should refrain from portraying cannabis and cannabinoids as evidence-based treatments for OUD.
Non-prescription Fentanyl Positive Toxicology: Prevalence, Positive Predictive Value of Fentanyl Immunoassay Screening, and Description of Co-substance Use
Authors: Kerensky Todd , LaRochelle Marc , Fan Shu-Ling , Kosakowski Sarah , Wason Kristin , Walley Alexander Y.
Published: September 2020

Objectives:

Opioid overdose deaths in Massachusetts linked to illicitly-manufactured fentanyl have increased dramatically. In response, an urban safety-net hospital added urine fentanyl testing with reflex confirmation testing to its standard urine toxicology panel. The goals of this study were to describe fentanyl toxicology test results, identify the positive predictive value of presumptive fentanyl immunoassay, and describe co-substance use among those with unexpected fentanyl positive results.

Methods:

We included urine toxicology tests from January through June 2016 analyzed at an urban safety-net hospital. We excluded tests from individuals prescribed or administered fentanyl within the preceding 72 hours. Positive fentanyl immunoassay tests underwent reflex chromatography confirmation testing. Samples that confirmed positive for acetyl fentanyl and/or fentanyl and/or norfentanyl were considered true positives.

Results:

Of 11,873 urine samples, 10.4% of samples screened fentanyl positive and 8.8% were confirmed fentanyl positive. The positive predictive value of a positive urine fentanyl screen was 85.7%. Of 4398 unique patients, 13.2% had at least 1 test confirmed positive for nonprescription fentanyl. Patients with a confirmed fentanyl positive drug test were more likely to have positive urine drug test for barbiturates, benzodiazepines, cocaine, methadone, and opiates, and less likely to have oxycodone or buprenorphine.

Conclusions:

At an urban safety-net hospital, nonprescription fentanyl use was common and was associated with greater use of other substances favoring routine fentanyl testing. Although the positive predictive value of the screening test was high, confirmation testing detected substantial numbers of false positives, especially in older patients. Therefore, fentanyl confirmation testing should be used when results will change treatment approach and patient education.
Prescription Tranquilizer/Sedative Misuse Motives Across the US Population
Authors: Schepis Ty S. , Wastila Linda , McCabe Sean Esteban
Published: September 2020

Objectives:

Roughly 6.5 million US residents engaged in prescription tranquilizer/sedative (eg, benzodiazepines, Z-drugs) misuse in 2018, but tranquilizer/sedative misuse motives are understudied, with a need for nationally representative data and examinations of motives by age group. Our aims were to establish tranquilizer/sedative misuse motives and correlates of motives by age cohort, and whether motive-age cohort interactions existed by correlate.

Methods:

Data were from the 2015 to 2018 US National Survey on Drug Use and Health, with 223,520 total respondents (51.5% female); 6580 noted past-year prescription tranquilizer/sedative misuse motives (2.4% overall, 50.3% female). Correlates included substance use (eg, opioid misuse), mental (eg, suicidal ideation) and physical health variables (e.g., inpatient hospitalization). Design-based, weighted cross-tabulations and logistic regression analyses were used, including analyses of age cohort-motive interactions for each correlate.

Results:

Prescription tranquilizer/sedative misuse motives varied by age group, with the highest rates of self-treatment only motives (ie, sleep and/or relax) in those 65 and older (82.7%), and the highest rates of any recreational motives in adolescents (12–17 years; 67.5%). Any tranquilizer/sedative misuse was associated with elevated odds of substance use, mental health, and physical health correlates, but recreational misuse was associated with the highest odds. Age-based interactions suggested stronger relationships between tranquilizer/sedative misuse and mental health in adults 50 and older.

Conclusions:

Any tranquilizer/sedative misuse signals a need for substance use and mental health screening, with intervention needs most acute in those with any recreational motives. Older adult tranquilizer/sedative misuse may be more driven by undertreated insomnia and anxiety/psychopathology than in younger groups.
Maternal and Neonatal Outcomes in Hospital-Based Deliveries With Water Immersion
Authors: Sidebottom Abbey C. , Vacquier Marc , Simon Kathrine , Wunderlich Whitney , Fontaine Patricia , Dahlgren-Roemmich Dawn , Steinbring Shannon , Hyer Barbara , Saul Lisa
Published: September 2020

OBJECTIVE:

To compare neonatal intensive care unit (NICU) or special care nursery admission for deliveries with water immersion compared with deliveries in the matched control group without water immersion. Secondary outcomes included adverse neonatal diagnoses, maternal infections, and perineal lacerations.

METHODS:

We conducted a retrospective study using electronic health record data (2014–2018) from two health systems (eight hospitals), with similar clinical eligibility, associated with low risks of intrapartum complications, and implementation policies for waterbirth. The water immersion group included women intending waterbirth. Water immersion was recorded prospectively during delivery. The comparison population were women who met the clinical eligibility criteria for waterbirth but did not experience water immersion during labor. Comparison cases were matched (1:1) using propensity scores. Outcomes were compared using Fischer's exact tests and logistic regression with stratification by stage of water immersion.

RESULTS:

Of the 583 women with water immersion, 34.1% (199) experienced first-stage water immersion only, 65.9% (384) experienced second-stage immersion, of whom 12.0% (70) exited during second stage, and 53.9% (314) completed delivery in the water. Neonatal intensive care unit or special care nursery admissions were lower for second-stage water immersion deliveries than deliveries in the control group (odds ratio [OR] 0.3, 95% CI 0.2–0.7). Lacerations were lower in the second-stage immersion group (OR 0.5, 95% CI 0.4–0.7). Neonatal intensive care unit or special care nursery admissions and lacerations were not different between the first-stage immersion group and their matched comparisons. Cord avulsions occurred for 0.8% of second-stage water immersion deliveries compared with none in the control groups. Five-minute Apgar score (less than 7), maternal infections, and other adverse outcomes were not significantly different between either the first- or second-stage water immersion groups and their control group.

CONCLUSION:

Hospital-based deliveries with second-stage water immersion had lower risk of NICU or special care nursery admission and perineal lacerations than matched deliveries in the control group without water immersion.
Improved Outcomes With an Enhanced Recovery Approach to Cesarean Delivery
Authors: Mullman Luciana , Hilden Patrick , Goral Jan , Gwacham Nnamdi , Tauro Caitlin , Spinola Kristen , Rosales Kim , Collier Sheila , Holmes Lynice , Maccione Janice , Pitera Richard , Miller Richard , Yodice Paul
Published: September 2020

OBJECTIVE:

To examine the results of a quality-improvement study that implemented an enhanced recovery after surgery (ERAS) program for cesarean delivery.

METHODS:

A pre–post design was used to assess changes in opioid use, length of stay, and costs among all patients undergoing cesarean delivery before and after implementation of an evidence-based ERAS pathway for the preoperative, intraoperative, and postoperative management of patients beginning December 2018.

RESULTS:

A total of 3,679 cesarean deliveries (scheduled and emergent) were included from January 1, 2018, through August 31, 2019, of which 2,171 occurred before implementation on December 17, 2018, and 1,508 occurred postimplementation. Eighty-four percent of patients received opioids as inpatients after cesarean delivery during the preimplementation period, as compared with 24% in the postimplementation period (odds ratio [OR] 16.8, 95% CI 14.3–19.9). Among patients who required any opioids, the total morphine milligram equivalents also significantly decreased (median 56.5 vs 15.0, mean relative change 0.32, 95% CI 0.28–0.35). Compared with the preimplementation period, those in the postimplementation period had a shorter postcesarean length of stay (3.2 vs 2.7 days, mean relative change 0.82, 95% CI 0.80–0.83, median 3 days in both periods), lower median direct costs by $349 (mean relative change 0.93, 95% CI 0.91–0.95), and no change in the 30-day readmission rate (1.4% vs 1.7%, OR 0.83, 95% CI 0.49–1.41).

CONCLUSION:

An ERAS approach for the cesarean delivery population is associated with improved outcomes including decreases in opioid use, length of stay, and costs.
Development and Validation of a Highly Sensitive Liquid Chromatography-Tandem Mass Spectrometry Technique to Determine Levamisole in Plasma and Saliva
Authors: Veltkamp Floor , Pistorius Marcel C. M. , Bouts Antonia H. M. , Mathôt Ron A. A. ,   on behalf of the LEARNS consortium
Published: September 2020

Background:

Levamisole is used as a steroid-sparing drug for the treatment of frequently relapsing or steroid-dependent idiopathic nephrotic syndrome in children. As part of a large multicentre randomized controlled trial with levamisole, pharmacokinetic and pharmacodynamic parameters of levamisole in children with idiopathic nephrotic syndrome were investigated, as well as the feasibility of using saliva as an alternative and patient-friendly matrix for determining levamisole concentrations. In this study, the authors presented the development and validation of a highly sensitive method for determining levamisole in plasma and saliva using liquid chromatography-tandem mass spectrometry (LC-MS/MS).

Methods:

In 100 μL samples, proteins were precipitated with 750 μL acetonitrile/methanol 420:80 (v/v) with levamisole-D5 as an internal standard. Calibration standards were prepared over a range of 0.1 ng/mL–50 ng/mL. To determine ultrafiltration efficiency, the ultrafiltrate was obtained by centrifuging blank plasma samples over the filter. Both filtered and nonfiltered samples were analyzed.

Results:

For plasma, accuracy and within-run and between-run imprecision were between 95.0% and 100% and <14.5%, respectively, and for saliva, between 100.9% and 107.5%, and <13.3%. No significant matrix effects were observed. Samples were stable at benchtop for 24 hours and −80°C, for at least 14 months (stability experiments ongoing). The ultrafiltration efficiency of unbound concentrations in plasma was lower than 85% (58.9%) but stable, and, therefore, the observed concentration should be corrected.

Conclusions:

Based on observations, the developed measure can determine levamisole concentrations in participant saliva samples.
Feasibility of an Interdisciplinary Intervention to Promote Balance Confidence in Lower-Limb Prosthesis Users: A Case Study
Authors: Churchill Rachel , Schneider Kristin L. , Calamari John E. , Henderson Roberta , Hwang Sungsoon , Major Matthew J. , Duncan Chad , Stachowiak Aaron , Reddin Christopher , Rosenblatt Noah J.
Published: September 2020

Introduction

Low confidence in ones' ability to maintain balance during daily activities is a prevalent issue for lower-limb prosthesis users (LLPUs) that negatively impacts psychosocial function but is not currently addressed in rehabilitation. The purpose of this case study was to demonstrate feasibility of an intervention that combines cognitive behavioral therapy techniques with physical therapy to increase balance confidence, reduce avoidance behaviors, and increase community participation in LLPU.

Materials and Methods

A 58-year-old man with a unilateral transtibial amputation completed eight 120-minute intervention session, which included physical therapy in the form of virtual reality active gaming targeting balance and gait adaptability, followed by psychoeducation, cognitive restructuring, and a brief exposure exercise. The intervention was intended to improve balance and gait while addressing beliefs regarding physical abilities and their impact on behavior. All exercises were individually tailored to address real-world, subject-specific distress-inducing situations, identified jointly by a licensed physical therapist and behavioral counselor that were present throughout all intervention sessions. The primary outcome, balance confidence, was quantified before, during, immediately after, and 1 month after completion of the intervention. Additional measures of physical function and community participation were also assessed.

Results

Objective balance measures (Berg Balance Scale) improved by 9 points from baseline to follow-up, and balance confidence improved from 48.5% at baseline to 91.9% at 1-month follow-up. Gains in gait self-efficacy and reductions in fear-avoidance behavior mirrored this change.

Conclusions

This case study demonstrates that a multicomponent intervention is feasible and may provide a positive and helpful experience for LLPU to meaningfully improve balance confidence and reduce avoidance behavior.
Bernard J. Miller: MD, ScD. (Hon), FACS: Lifelong Surgeon-Scientist and Critical Contributor to the Gibbon Heart-Lung Machine
Authors: Bauer Tyler M. , Tchantchaleishvili Vakhtang , Miller Stanton B.
Published: September 2020

Bernard J. Miller, MD, ScD. (Hon), FACS, is known as a critical contributor for his work in the John H. Gibbon, MD, laboratory for his work on the heart-lung machine (HLM). In this setting, Dr. Miller developed the fluid control servo system, which was necessary to prevent malfunctioning of the HLM and prevent air emboli. Additionally, Dr. Miller assisted in conceiving and testing the left ventricular vent, the positive–negative pressure ventilator, and the HLM oxygenator; these inventions were all the product of extensive collaboration between the International Business Machines Corporation and the members of Dr. Gibbon’s laboratory. Furthermore, Dr. Miller was a surgical assistant and perfusionist in the first successful open-heart surgery. Herein, we seek to describe Dr. Miller’s story and his contributions to the HLM, as well as the contributions that were developed by the laboratory at that time. Additionally, we describe critical events leading up to the first successful use of the HLM on May 6, 1953, including a previously unreported use of the HLM for partial bypass of the right heart at Pennsylvania Hospital in 1952. Finally, we present the rest of Dr. Miller’s professional and personal successes after his work on the HLM ended.
Point-of-Care Ultrasound to Confirm Umbilical Line Placement
Authors: Kochan Michael J. , Kim Jane S. , Hoffman Suma B. , Mola Sara J. , Kim Jae H. , Viscardi Rose M.
Published: September 2020

Introduction

Neonatal intensive care unit (NICU) provider point-of-care ultrasound (POCUS) procedural competency for umbilical line placement confirmation has not been defined, and the necessary training to achieve competency has not been previously studied. This study's objective was to test the hypothesis that a simulation-enhanced curriculum will improve NICU providers' POCUS competency to confirm umbilical line placement.

Methods

Neonatal intensive care unit providers without prior ultrasound experience were randomized to a curriculum with or without simulation-based training. Competency for catheter detection, tip localization, and scan interpretation on patients was determined using learning curve-cumulative summation, a specific statistical tool designed to indicate when a predefined level of performance is reached. Differences in success rates were analyzed by χ2 test.

Results

Two thirds (22/33) of participants completed 10 scans. Three (simulation) and 1 (control) attained catheter detection competency (P = 0.28). The simulation group was more successful for catheter detection (81% vs. 69%, P = 0.04) and scan interpretation (61% vs. 48%, P = 0.04). Success did not differ by umbilical vessel location, provider role, or duration of NICU experience.

Conclusions

A simulation-enhanced POCUS curriculum improved catheter detection rate and scan interpretation, but there was no difference in procedural competency between groups on ultrasound scans performed on patients with umbilical catheters. We speculate that more than 10 scans may be needed for NICU providers to obtain POCUS competency.
Changing Trends in Liver Transplantation: Challenges and Solutions
Authors: Ivanics Tommy , Abreu Phillipe , De Martin Eleonora , Sapisochin Gonzalo
Published: September 2020

Despite improvements in postliver transplant outcomes through refinements in perioperative management and surgical techniques, several changing trends in liver transplantation have presented challenges. Mortality on the waitlist remains high. In the United States, Europe, and the United Kingdom, there is an increasing need for liver transplantation, primarily as a result of increased incidence of nonalcoholic steatohepatitis-related cirrhosis and cancer indications. Meanwhile, donor suitability has decreased, as donors are often older and have more comorbidities. Despite a mismatch between organ need and availability, many organs are discarded. Notwithstanding this, many solutions have been developed to overcome these challenges. Innovative techniques in allograft preservation, viability assessment, and reconditioning have allowed the use of suboptimal organs with adequate results. Refinements in surgical procedures, including live donor liver transplantations, have increased the organ pool and are decreasing the time and mortality on the waitlist. Despite many challenges, a similar number of solutions and prospects are on the horizon. This review seeks to explore the changing trends and challenges in liver transplantation and highlight possible solutions and future directions.
Differential response to cytotoxic therapy explains treatment dynamics of acute myeloid leukaemia patients: insights from a mathematical modelling approach
Authors: Hoffmann H. , Thiede C. , Glauche I. , Bornhaeuser M. , Roeder I.
Published: September 2020

Disease response and durability of remission are very heterogeneous in patients with acute myeloid leukaemia (AML). There is increasing evidence that the individual risk of early relapse can be predicted based on the initial treatment response. However, it is unclear how such a correlation is linked to functional aspects of AML progression and treatment. We suggest a mathematical model in which leukaemia-initiating cells and normal/healthy haematopoietic stem and progenitor cells reversibly change between an active state characterized by proliferation and chemosensitivity and a quiescent state, in which the cells do not divide, but are also insensitive to chemotherapy. Applying this model to 275 molecular time courses ofnucleophosmin 1-mutated patients, we conclude that the differential chemosensitivity of the leukaemia-initiating cells together with the cells’ intrinsic proliferative capacity is sufficient to reproduce both, early relapse as well as long-lasting remission. We can, furthermore, show that the model parameters associated with individual chemosensitivity and proliferative advantage of the leukaemic cells are closely linked to the patients’ time to relapse, while a reliable prediction based on early response only is not possible based on the currently available data. Although we demonstrate with our approach, that the complete response data is sufficient to quantify the aggressiveness of the disease, further investigations are necessary to study how an intensive early sampling strategy may prospectively improve risk assessment and help to optimize individual treatments.
What is pathogen-mediated insect superabundance?
Authors: Donnelly Ruairí , Gilligan Christopher A.
Published: September 2020

When increasing abundance of insect vectors is manifest across multiple fields of a crop at the landscape scale, the phenomenon is sometimes referred to as insect superabundance. The phenomenon may reflect environmental factors (i.e.
environmentally mediated insect superabundance
, EMiS), including climatic change. A number of pathogens, however, are also known to modify the quality of infected plants as a resource for their insect vectors. In this paper, we term increasing vector abundance when associated with pathogen modification of plants as
pathogen-mediated insect superabundance
(henceforth PMiS). We investigate PMiS using a new epidemiological framework. We formalize a definition of PMiS and indicate the epidemiological mechanism by which it is most likely to arise. This study is motivated by the occurrence of a particularly destructive cassava virus epidemic that has been associated with superabundant whitefly populations in sub-Saharan Africa. Our results have implications for how PMiS can be distinguished from EMiS in field data. Above all, they represent a timely foundation for further investigations into the association between insect superabundance and plant pathogens.
Inflow restrictions can prevent epidemics when contact tracing efforts are effective but have limited capacity
Authors: Malmberg Hannes , Britton Tom
Published: September 2020

When a region tries to prevent an outbreak of an epidemic, two broad strategies are available: limiting the inflow of infected cases by using travel restrictions and quarantines or limiting the risk of local transmission from imported cases by using contact tracing and other community interventions. A number of papers have used epidemiological models to argue that inflow restrictions are unlikely to be effective. We simulate a simple epidemiological model to show that this conclusion changes if containment efforts such as contact tracing have limited capacity. In particular, our results show that moderate travel restrictions can lead to large reductions in the probability of an epidemic when contact tracing is effective but the contact tracing system is close to being overwhelmed.
The adsorption and mechanism of the nitrification inhibitor nitrapyrin in different types of soils
Authors: Zhang Zhongqing , Gao Qiang , Yang Jingmin , Li Yue , Liu Jinhua , Wang Yujun , Su Hongge , Wang Yin , Wang Shaojie , Feng Guozhong
Published: September 2020

The nitrapyrin was easily adsorbed by soil, but most current studies have focused on comparing the effects of nitrapyrin application at different soil organic matter levels and in different soil types. The adsorption kinetics and isotherm adsorption of the nitrification inhibitor nitrapyrin in black soil, chernozem and planosol were studied in this paper. The adsorption kinetics were fitted by quasi-second-order kinetic equation (

R
2

≥
0.8907,
p
< 0.05) with a lower acting energy of adsorption (

E
a

< 8.0 kJ mol
−1
). The isotherm was fitted by the Langmuir equation (

R
2

≥
0.9400
*
,
p
< 0.05). The adsorption mechanism was determined to involve a spontaneous endothermic reaction accompanied mainly by physical adsorption to the surface that belonged to the ‘
L
’ isotherm curve (
n
> 1). Temperature promoted the adsorption of nitrapyrin in these three soils, and the maximum adsorption occurring at different temperatures following the order of black soil > planosol > chernozem. The adsorption capacity and rate decreased with decreasing soil organic matter. For the black soil, the nitrapyrin EC adsorption rate was more than seven times higher than that of nitrapyrin CS. The result would determine the dose of nitrapyrin required for availability in different types of soils and to provide a theoretical basis for elucidating the adsorption of nitrapyrin in the soil environment.
Graphitic mesoporous carbon-silica composites from low-value sugarcane by-products for the removal of toxic dyes from wastewaters
Authors: Janekarn Intuorn , Hunt Andrew J. , Ngernyen Yuvarat , Youngme Sujittra , Supanchaiyamat Nontipa
Published: September 2020

Highly porous carbon-silica composites (CSC) were prepared for the first time through a simple wet impregnation process and subsequent pyrolysis of low-value sugarcane by-products, namely molasses. These CSC materials demonstrate a distinct range of functionalities, which significantly differ from similar materials published in the literature. Importantly, the carbon-silica composites prepared at 800°C exhibited exceptional adsorption capacities for the azo-dye congo red (445 mg g
−1
), due to the graphitic carbon coating and unique functionality including C-O-C within the porous structure. Congo red adsorption capacity of the highly mesoporous graphitic carbon-silica composites significantly exceeds that of commercial activated carbon and silica, these carbon-silica composites therefore represent an effective step towards the development of porous bio-derived adsorbent for remediation of dye wastewaters. Both the porous properties (surface area and pore size distribution) and the functionality of the carbon coating were dependent on the temperature of preparation. The sustainable synthetic methods employed led to a versatile material that inherited the mesoporosity characteristics from the parent silica, demonstrating mesoporous volumes greater than 90% (as calculated from the total pore volume). Adsorption on the 800°C prepared carbon-silica composites demonstrated an excellent fit with the Langmuir isotherm and the pseudo-first-order kinetic model.
Foraging behaviour and habitat-use drives niche segregation in sibling seabird species
Authors: Reisinger Ryan R. , Carpenter-Kling Tegan , Connan Maëlle , Cherel Yves , Pistorius Pierre A.
Published: September 2020

To mediate competition, similar sympatric species are assumed to use different resources, or the same but geographically separated resources. The two giant petrels (
Macronectes
spp.) are intriguing in that they are morphologically similar seabirds with overlapping diets and distributions. To better understand the mechanisms allowing their coexistence, we investigated intra- and interspecific niche segregation at Marion Island (Southern Indian Ocean), one of the few localities where they breed in sympatry. We used GPS tracks from 94 individuals and remote-sensed environmental data to quantify habitat use, combined with blood carbon and nitrogen stable isotope ratios from 90 individuals to characterize their foraging habitat and trophic ecology. Females of both species made distant at-sea foraging trips and fed at a similar trophic level. However, they used distinct pelagic habitats. By contrast, males of both species mainly foraged on or near land, resulting in significant sexual segregation, but high interspecific habitat and diet overlap. However, some males showed flexible behavioural strategies, also making distant, pelagic foraging trips. Using contemporaneous tracking, environmental and stable isotope data we provide a clear example of how sympatric sibling species can be segregated along different foraging behaviour dimensions.
Sisal xylem fibre-based activated carbon fibres for fuel adsorption: effect of thermal stabilization of diammonium phosphate
Authors: Deng Zhuo , Hu Jian , Li Hailong
Published: September 2020

Activated carbon fibres (ACFs) are considered as the next generation of activated carbon products. However, lack of structural diversity in pore structure and high prices of raw materials for ACFs has restrained the development of ACF materials. In this paper, a sisal-based activated carbon fibre (SACF) material was prepared from sisal wastes with a unique thermal stabilization treatment to maintain fibrous shapes of SACFs while dispersing in solutions, and the SACFs were prepared as raw fibre materials for fuel evaporation emissions controlling products. Experimental results of N
2
adsorption showed that SACF has a typical I-type adsorption isotherm, with specific surface area of SACF samples of approximately 1200 m
2
g
−1
, and mainly microporous pore structure. Compared with commercial samples (specific surface area, 1841.29 m
2
g
−1
), the butane working capacities of SACF for advanced fuel evaporation emissions controlling product was 0.4 g/100 ml higher. Furthermore, two dynamic models, Thomas model and Clark model, were applied to adsorption breakthrough data, which showed excellent fit. And it indicated from the adsorption breakthrough curves and parameters of both models that the SACF has better performance in fuel adsorption and desorption process than the commercial samples.
How directed is a directed network?
Authors: MacKay R. S. , Johnson S. , Sansom B.
Published: September 2020

The trophic levels of nodes in directed networks can reveal their functional properties. Moreover, the trophic coherence of a network, defined in terms of trophic levels, is related to properties such as cycle structure, stability and percolation. The standard definition of trophic levels, however, borrowed from ecology, suffers from drawbacks such as requiring basal nodes, which limit its applicability. Here we propose simple improved definitions of trophic levels and coherence that can be computed on any directed network. We demonstrate how the method can identify node function in examples including ecosystems, supply chain networks, gene expression and global language networks. We also explore how trophic levels and coherence relate to other topological properties, such as non-normality and cycle structure, and show that our method reveals the extent to which the edges in a directed network are aligned in a global direction.
CycleRank
, or there and back again: personalized relevance scores from cyclic paths on directed graphs
Authors: Consonni Cristian , Laniado David , Montresor Alberto
Published: September 2020

Surfing the links between Wikipedia articles constitutes a valuable way to acquire new knowledge related to a topic by exploring its connections to other pages. In this sense,
Personalized PageRank
is a well-known option to make sense of the graph of links between pages and identify the most relevant articles with respect to a given one; its performance, however, is hindered by pages with high indegree that function as hubs and obtain high scores regardless of the starting point. In this work, we present
CycleRank
, a novel algorithm based on cyclic paths aimed at finding the most relevant nodes related to a topic. To compare the results of
CycleRank
with those of
Personalized PageRank
and other algorithms derived from it, we perform three experiments based on different ground truths. We find that
CycleRank
aligns better with readers’ behaviour as it ranks in higher positions the articles corresponding to links that receive more clicks; it tends to identify in higher position related articles highlighted by editors in ‘See also’ sections; and it is more robust to global hubs of the network having high indegree. Finally, we show that computing
CycleRank
is two orders of magnitude faster than computing the other baselines.
Core–periphery structure in directed networks
Authors: Elliott Andrew , Chiu Angus , Bazzi Marya , Reinert Gesine , Cucuringu Mihai
Published: September 2020

Empirical networks often exhibit different meso-scale structures, such as community and core–periphery structures. Core–periphery structure typically consists of a well-connected core and a periphery that is well connected to the core but sparsely connected internally. Most core–periphery studies focus on undirected networks. We propose a generalization of core–periphery structure to directed networks. Our approach yields a family of core–periphery block model formulations in which, contrary to many existing approaches, core and periphery sets are edge-direction dependent. We focus on a particular structure consisting of two core sets and two periphery sets, which we motivate empirically. We propose two measures to assess the statistical significance and quality of our novel structure in empirical data, where one often has no ground truth. To detect core–periphery structure in directed networks, we propose three methods adapted from two approaches in the literature, each with a different trade-off between computational complexity and accuracy. We assess the methods on benchmark networks where our methods match or outperform standard methods from the literature, with a likelihood approach achieving the highest accuracy. Applying our methods to three empirical networks—faculty hiring, a world trade dataset and political blogs—illustrates that our proposed structure provides novel insights in empirical networks.
The impacts of body mass on immune cell concentrations in birds
Authors: Ruhs Emily Cornelius , Martin Lynn B. , Downs Cynthia J.
Published: September 2020

Body mass affects many biological traits, but its impacts on immune defences are fairly unknown. Recent research on mammals found that neutrophil concentrations disproportionately increased (scaled hypermetrically) with body mass, a result not predicted by any existing theory. Although the scaling relationship for mammals might predict how leucocyte concentrations scale with body mass in other vertebrates, vertebrate classes are distinct in many ways that might affect their current and historic interactions with parasites and hence the evolution of their immune systems. Subsequently, here, we asked which existing scaling hypothesis best-predicts relationships between body mass and lymphocyte, eosinophil and heterophil concentrations—the avian functional equivalent of neutrophils—among more than 100 species of birds. We then examined the predictive power of body mass relative to life-history variation, as extensive literature indicates that the timing of key life events has influenced immune system variation among species. Finally, we ask whether avian scaling patterns differ from the patterns we observed in mammals. We found that an intercept-only model best explained lymphocyte and eosinophil concentrations among birds, indicating that the concentrations of these cell types were both independent of body mass. For heterophils, however, body mass explained 31% of the variation in concentrations among species, much more than life-history variation (4%). As with mammalian neutrophils, avian heterophils scaled hypermetrically (b=0.19 ± 0.05), but more steeply than mammals (approx. 1.5 ×; 0.11 ± 0.03). As such, we discuss why birds might require more broadly protective cells compared to mammals of the same body size. Overall, body mass appears to have strong influences on the architecture of immune systems.