bluuebunny/crossref_metadata_2025 huggingface dataset:
Gram‐Scale Synthesis of Highly Efficient Rare‐Earth‐Element‐Free Red/Green/Blue Solid‐State Bandgap Fluorescent Carbon Quantum Rings for White Light‐Emitting Diodes
Authors: Meng Ting , Wang Zifei , Yuan Ting , Li Xiaohong , Li Yunchao , Zhang Yang , Fan Louzhen
Published: May 2021

The negative impact of rare‐earth elements (REEs) on the environment, limited supply and high cost prompt the need for REE‐free phosphor‐converted white light‐emitting diodes (LEDs). Here, we report the gram‐scale synthesis of red/green/blue solid‐state bandgap fluorescent carbon quantum rings (R/G/B‐SBF‐CQRs) with high quantum yields up to 30–46 %. This was achieved using cyano‐group‐bearing p‐phenyldiacetonitrile as precursor and forming carbon quantum rings of different diameters through the linkage of curved carbon quantum ribbons of different lengths. The results show the role of cyano groups in inducing the curvature of the carbon quantum ribbons for CQR formation and emission of stable solid‐state bandgap fluorescence. R/G/B‐SBF‐CQRs‐phosphor‐based LEDs emitted warm white light with low CCT (3576 K), high CRI (96.6), and high luminous efficiency (48.7 lm W−1), comparable to REE‐phosphor‐based LEDs.
Collective Vibrational Strong Coupling Effects on Molecular Vibrational Relaxation and Energy Transfer: Numerical Insights via Cavity Molecular Dynamics Simulations**
Authors: Li Tao E. , Nitzan Abraham , Subotnik Joseph E.
Published: May 2021

For a small fraction of hot CO2 molecules immersed in a liquid‐phase CO2 thermal bath, classical cavity molecular dynamics simulations show that forming collective vibrational strong coupling (VSC) between the C=O asymmetric stretch of CO2 molecules and a cavity mode accelerates hot‐molecule relaxation. This acceleration stems from the fact that polaritons can be transiently excited during the nonequilibrium process, which facilitates intermolecular vibrational energy transfer. The VSC effects on these rates 1) resonantly depend on the cavity mode detuning, 2) cooperatively depend on Rabi splitting, and 3) collectively scale with the number of hot molecules. For larger cavity volumes, the average VSC effect per molecule can remain meaningful for up to N≈104 molecules forming VSC. Moreover, the transiently excited lower polariton prefers to relax by transferring its energy to the tail of the molecular energy distribution rather than distributing it equally to all thermal molecules. As far as the parameter dependence is concerned, the vibrational relaxation data presented here appear analogous to VSC catalysis in Fabry–Pérot microcavities.
Transformation Pathway from CdSe Magic‐Size Clusters with Absorption Doublets at 373/393 nm to Clusters at 434/460 nm
Authors: Zhu Jinming , Cao Zhaopeng , Zhu Yongcheng , Rowell Nelson , Li Yan , Wang Shanling , Zhang Chunchun , Jiang Gang , Zhang Meng , Zeng Jianrong , Yu Kui
Published: May 2021

Divergent interpretations have appeared in the literature regarding the structural nature and evolutionary behavior for photoluminescent CdSe nanospecies with sharp doublets in optical absorption. We report a comprehensive description of the transformation pathway from one CdSe nanospecies displaying an absorption doublet at 373/393 nm to another species with a doublet at 433/460 nm. These two nanospecies are zero‐dimensional (0D) magic‐size clusters (MSCs) with 3D quantum confinement, and are labeled dMSC‐393 and dMSC‐460, respectively. Synchrotron‐based small‐angle X‐ray scattering (SAXS) returns a radius of gyration of 0.92 nm for dMSC‐393 and 1.14 nm for dMSC‐460, and indicates that both types are disc shaped with the exponent of the SAXS form factor equal to 2.1. The MSCs develop from their unique counterpart precursor compounds (PCs), which are labeled PC‐393 and PC‐460, respectively. For the dMSC‐393 to dMSC‐460 transformation, the proposed PC‐enabled pathway is comprised of three key steps, dMSC‐393 to PC‐393 (Step 1), PC‐393 to PC‐460 (Step 2 involving monomer addition), and PC‐460 to dMSC‐460 (Step 3). The present study provides a framework for understanding the PC‐based evolution of MSCs and how PCs enable transformations between MSCs.
Exceptional Electrochemical HER Performance with Enhanced Electron Transfer between Ru Nanoparticles and Single Atoms Dispersed on a Carbon Substrate
Authors: Su Panpan , Pei Wei , Wang Xiaowei , Ma Yanfu , Jiang Qike , Liang Ji , Zhou Si , Zhao Jijun , Liu Jian , Lu Gao Qing (Max)
Published: May 2021

Precisely regulating the electronic structures of metal active species is highly desirable for electrocatalysis. However, carbon with inert surface provide weak metal–support interaction, which is insufficient to modulate the electronic structures of metal nanoparticles. Herein, we propose a new method to control the electrocatalytic behavior of supported metal nanoparticles by dispersing single metal atoms on an O‐doped graphene. Ideal atomic metal species are firstly computationally screened. We then verify this concept by deposition of Ru nanoparticles onto an O‐doped graphene decorated with single metal atoms (e.g., Fe, Co, and Ni) for hydrogen evolution reaction (HER). Consistent with theoretical predictions, such hybrid catalysts show outstanding HER performance, much superior to other reported electrocatalysts such as the state‐of‐the‐art Pt/C. This work offers a new strategy for modulating the activity and stability of metal nanoparticles for electrocatalysis processes.
Laryngectomy with a Tritube® and flow‐controlled ventilation
Authors: Bailey J. R. , Lee C. , Nouraei R. , Chapman J. , Edmond M. , Girgis M. , De Zoysa N.
Published: May 2021

We describe the novel use of the TriTube® and Evone® ventilator (Ventinova, Eindhoven, Netherlands) to facilitate curative resection of a transglottic squamous cell carcinoma. A 43‐year‐old man presented with acute laryngeal and subglottic airway obstruction secondary to a stage 4 transglottic squamous cell carcinoma. The patient underwent magnetic resonance imaging followed by a diagnostic panendoscopy. It was decided that tumour resection was appropriate and a management plan was established by a multi disciplinary team. A total laryngectomy was performed. It was determined that failure of translaryngeal tracheal intubation could be rescued with emergency surgical front‐of‐neck airway. General anaesthesia was induced using a total intravenous anaesthesia technique, oxygenation was achieved with high‐flow nasal oxygen and the airway was secured using the TriTube and flow‐controlled ventilation was delivered throughout the procedure using the Evone ventilator. This avoided an awake or emergency tracheostomy, with the associated theoretical risk of tumour seeding, allowed for excellent gas exchange throughout and permitted the surgeons to maintain a closed system during much of the procedure, including during fashioning of the stoma. When traditional laryngectomy tubes are used, this process ordinarily involves multiple extubations and apnoeic periods. Furthermore, the small subglottic tube allowed intra‐operative assessment of the extent of the subglottic tumour, facilitating curative en bloc resection.
Synthesis of chitosan and amine functionalized MCM‐41 nanocomposite for the removal of acetylsalicylic acid from water using central composite design
Authors: Moradpour Nina , Sedaghat Sajjad , Aberoomand Azar Parviz , Behzad Kasra
Published: May 2021

In this study, the synthesis of the mesoporous mobile composite material No. 41 (MCM‐41) modified with 3‐aminopropyltriethoxysilane (APS) and chitosan (Cs) was carried out successfully to form novel Cs/MCM‐41‐APS nanocomposite (NC). It was also reported that its application as an adsorbent has removed aspirin from water. The structure and morphology of NC was characterized using X‐ray diffraction (XRD), Fourier‐transform infrared (FT‐IR), Brunauer–Emmett–Teller (BET), energy‐dispersive X‐ray (EDX), and scanning electron microscope (SEM) techniques. Results showed that the APS (NH2) and chitosan were successfully incorporated onto the MCM‐41, amine group, and Cs, which improved the properties of MCM‐41. The effects of solution pH, initial aspirin concentration, adsorbent dosage, and contact time on the removal amount of aspirin were investigated and evaluated by central composite design with response surface methodology. The optimization factors in the removal process showed that the optimum removal (86%) was obtained using 3 g L−1 of adsorbent, initial aspirin concentration of 30 mg L−1, pH of 4.6, the room temperature, and 55‐min time. The equilibrium data were fitted to Freundlich, Langmuir, and Temkin isotherm models. The results showed that Freundlich (R2 = 0.997) isotherm model was the best fit model compared with Temkin and Langmuir isotherm models. Also, the adsorption process followed the pseudo‐second‐order kinetics model. Reuse studies revealed that the adsorbent could be regenerated and reused for adsorption cycles.
Pelletization and attrition of CaO‐based adsorbent for CO2 capture
Authors: Zhang Hao , Jiang Tao , Yaseen Hamzah A. S. M. , Zhao Yujun , Wang Shengping , Ma Xinbin
Published: May 2021

CaO‐based adsorbent pellets from limestone and carbide slag powder were prepared by an extrusion–spheronization method. Three types of binder and peptizer materials were introduced to improve the adsorption performance and mechanical properties of adsorbent pellets. Weibull statistics was employed to analyze the compressive stress of adsorbent pellets. The results revealed that pseudo‐boehmite and nitric acid were the favorable choice of binder and peptizer for preparing CaO‐based adsorbent pellets with enhanced chemical and mechanical properties. The addition of pseudo‐boehmite (PB) improved the pore distribution characteristics by increasing the pores within 10–100 nm, and the addition of nitric acid brought favorable mechanical reliability by providing a large amount of H+, thereby interacting with multiple PB particles to form a network structure. It was shown that when 3 wt.% pseudo‐boehmite and 15 wt.% nitric acid were used, the favorable performance of the molding pellets could be obtained (carbonation conversion: 36%, compressive stress: 25.3 MPa; attrition rate: 0.46 wt.%/hr), which had promising prospects for practical CO2 removal.
Preparation and characterization of microcellular foamed thermoplastic polyamide elastomer composite consisting of EVA/TPAE1012
Authors: Huang Guotao , Li Suyuan , Li Yucai , Wu Xin , Feng Xinxing , Gui Yuan , Deng Jianping , Wang Cao , Pan Kai
Published: May 2021

Thermoplastic polyamide elastomer (TPAE) is a kind of high‐performance elastomers prepared from nylon hard segments and polyether or polyester soft segments. The hard segments endow TPAE with excellent mechanical properties, while the soft segments provide the desired elasticity. Therefore, the development of TPAE as a high‐performance foam material has broad application prospects. In this work, ethylene‐vinyl acetate copolymer/polyamide‐1012 elastomer (EVA/TPAE1012) composite materials with different compositions were prepared, using ethylene‐vinyl acetate /maleic anhydride graft copolymer (EVA‐g‐MAH) as compatibilizer. Then, EVA/TPAE foamed materials were fabricated by chemical foaming method and batch foaming process, with azodicarbonamide as blowing agent. The resulting composite foams were tested in terms of density, cell properties hardness, resilience, compression recovery, and mechanical strength. The EVA/TPAE1012 foam has a low density (0.14 g cm−3), small cell size (approximately 62.1 μm), and a high cell density (3.08 × 107 cells cm−3). Compared with pure EVA foam, the composite foam not only has an increase in specific strength, resilience and tearing strength, but also has good toughness, which greatly improves the resulting foams' expansion ratio and elongation at break.
Improved properties of poly(butylene adipate‐co‐terephthalate)/calcium carbonate films through silane modification
Authors: Zhang Ting , Zhang Caili , Yang Yang , Yang Fan , Zhao Min , Weng Yunxuan
Published: May 2021

One of the most used inorganic fillers is calcium carbonate which quite efficiently enhances the mechanical characteristics while simultaneously lower the cost of thermoplastics, particularly for biodegradable polyester. Virtually, all studies so far have focused on the quest for the filling and modification of nano‐sized calcium carbonates. However, the quantity of nano‐sized CaCO3 added in the polymer is usually lower than 10%, owing to its high‐surface energy and high‐surface area and makes powder easier to agglomerate. In this work, we prepared poly(butylene adipate‐co‐terephthalate) (PBAT)/calcium carbonate composite films by extrusion‐blown films with up to 40 wt% micro‐sized CaCO3 content. The influence of particle size (5–12 μm) and modification of the particles (with and without silane coupling agents) on the rheological and mechanical properties was thoroughly investigated. Of all the particle sizes employed in this study, the 5 μm (3000 mesh) particles with 30 wt% content coated with 2 wt% aliphatic silane coupling (CA1) agent was observed to furnish the optimum combination of characteristics. The mechanical properties of P7C3/CA1‐2 film even better than that of neat PBAT film. These results provided a simple approach for PBAT/CaCO3 films manufacture with low‐cost and simultaneously with sound mechanical properties, which can be good candidate for mulching films and packaging applications.
Adaptive control of a class of stochastic nonlinear systems with full state constraints and input saturation using multi‐dimensional Taylor network
Authors: Han Yu‐Qun
Published: May 2021

In the paper, a new control algorithm to realize the tracking control for a class of stochastic nonlinear systems with both full state constraints and input saturation is put forward using multi‐dimensional Taylor network (MTN) approach. By introducing a continuous function, the input saturation is converted into a linear model with bounded error. With the help of approximation properties of MTN, by proposing barrier Lyapunov functions (BLFs) and involving the idea of state‐constrained control into backstepping technique, a simple and efficient control scheme is developed. The proposed control scheme can guarantee the system states fall in the given constrained bounds as well as keeping the resulting control system stable. The effectiveness of the proposed control method is demonstrated through two examples.
Parameter estimation and control of an unmanned aircraft‐based transportation system for variable‐mass payloads
Authors: Alatorre Armando , Espinoza Eduardo S. , Sánchez Bonifacio , Ordaz Patricio , Muñoz Filiberto , García Carrillo Luis Rodolfo
Published: May 2021

This paper deals with the development of an adaptive robust controller for an Unmanned Aircraft System with variable mass. The goal is to improve trajectory tracking and energy performance while the aircraft mass is gradually reducing due to payload release. To improve the trajectory tracking performance, we propose an algorithm that merges the concepts of least squares method and sliding mode observer for the estimation of the vehicle mass. The nonlinear observer estimates the linear velocities and accelerations, which are further used to obtain the vehicle mass. A robust adaptive pole placement controller based on the Attractive Ellipsoid Method uses this estimation to update the controllers gains due to the mass variation. To validate the effectiveness of the proposed algorithm for performing aerial transportation and deployment of payloads, we present a numerical example comparing the performance of the proposed method with respect to using Proportional Derivative controllers as well as Robust Controllers.
An investigation of open cluster Melotte 72 using Gaia DR2
Authors: Hendy Yasser , Tadross Ashraf
Published: May 2021

The estimation of the main parameters of star clusters is significant in astrophysical studies. The most important aspect of using the Gaia DR2 survey lies in the positions, parallax, and proper motions of cluster stars with homogeneous photometry that make the membership probability determine with high accuracy. In this respect, depending on Gaia DR2 database, an analysis of the open star cluster Melotte 72 is taking place here. It is located at a distance of 2,345 ± 108 pc with an age of 1.0 ± 0.5 Gyr. In studying the radial density profile, the radius is found to be 5.0 ± 0.15 arcmin. The reddening, the luminosity and mass functions, the total mass of the cluster, and the galactic geometrical distances (X⊙, Y⊙, Z⊙), and the distance from the galactic center (Rg) have been estimated as well. Our study has shown a dynamical relaxation behavior of Melotte 72.
Quality and readability of online patient information on treatment for erectile dysfunction
Authors: Pattenden Trent A. , Raleigh Rachael A. , Pattenden Elle R. , Thangasamy Isaac A.
Published: May 2021

Objectives

To investigate the quality and readability of online patient information on treatment for erectile dysfunction using a Google search.

Materials and methods

The results of a Google search for “erectile dysfunction treatment” were reviewed. Webpages that contained written information on erectile dysfunction except those containing scientific publications and paywall protected webpages were included in further analysis. Typographic and treatment information were recorded. Readability was assessed using the Fleisch‐Kincaid grade level, the Gunning‐Fog index, the Coleman‐Liau index, and Simple Measure of Gobbledygook. Website quality was assessed using the DISCERN instrument, Journal of the American Medical Association (JAMA) benchmark criteria, and presence of Health on the net (HON) code certification. Website typography, discussed treatment types, readability scores, and quality measures were reported. Parametric and nonparametric statistical tests were used to compare the data as appropriate dependent on the normality of data.

Results

Eighty‐one webpages were included. Urologists and hospitals were the most common producers with 15 (18%) each. Seventy‐four (91%) webpages contained specific information on treatment for erectile dysfunction and 15 (19%) contained advertisements. Seventeen (21%) webpages were HON code certified. The median DISCERN score was 35 (IQR 26.5‐44) out of 80. The mean combined readability score was 12.32 (SD 1.91). The median JAMA benchmark score was 1 (IQR 1‐2) out of 4. Google rank had a small negative correlation with DISCERN score (τ = −0.16, P = .036). HON code certified webpages had higher DISCERN scores (median of 44 [IQR 35‐58.5] vs 32.5 [IQR 25.25‐42.25], U = 832, Z = 6561, P < .001). A linear regression was used to predict DISCERN score based on meeting each JAMA benchmark criterion (F(2, 78) = 22.7, P < .001) R2 = 0.368, P < .001. Within this model the effects of meeting attribution (β = 11.09) and currency (β = 8.79) criterion were significant.

Conclusions

The quality of online information on treatment for erectile dysfunction is generally poor. However, easy to identify markers of quality like HON code certification, or meeting JAMA benchmark criterion for attribution and currency may help patients to navigate to better quality online information on treatment for erectile dysfunction. Webpages are written at senior high school level, above any recommendations for patient medical information. Health professionals should use validated instruments to assess the quality of online information on treatment for erectile dysfunction prior to publication to improve their utility for patients.
BPV associated with imaging features of SSI on MRI
Authors: Yu Yong Peng , Zheng Ya Li , Tan Lan , Jiang Ting Ting
Published: May 2021

Objectives

A retrospective study was performed to investigate the relationship between blood pressure variability (BPV) and imaging features of single small infarction (SSI) on magnetic resonance imaging (MRI).

Materials and Methods

Two hundreds and five patients with SSI and 120 healthy subjects matched with age and sex as the control group were enrolled into this study. All subjects came from the Affiliated Hospital to Qingdao University and Qingdao Municipal Hospital from October 2011 to June 2016. Research subjects were classified into different groups. Blood pressure was measured once a day and recorded during the hospitalization period (7–10 days). The followed up data of patients after discharging from hospital was collected from the follow‐up records.

Results

Twenty‐four hours BPV (SBPMean, DSBPMax, DSBPSD, NDBPMax, NDBPSD, and DDBPCV), day‐to‐day, and visit‐to‐visit BPV (SBPMax, SBPSD, DBPMax, and DBPSD) in the SSI group were significantly higher than that in control group. Compared with the giant lacunar group, day‐to‐day BPV (SBPMean, SBPMax, SBPSD, SBPCV, DBPMean, DBPMax, DBPSD), and visit‐to‐visit BPV (SBPMean, SBPMax, SBPSD, DBPMean, DBPMax, DBPSD) were significantly higher in the small lacunar infarct group (p < .05). The 24 hr BPV (SBPMean, DDBPMax, DDBPMean), day‐to‐day BPV (SBPMax, SBPSD, SBPCV), and visit‐to‐visit SBPMax in nonround lesion group were significantly higher than that in round group (p < .05). Compared with nondeep lesion group, some parameters in day‐to‐day BPV and visit‐to‐visit BPV were significantly higher in the deep small lesion group (p < .05).

Conclusion

Increased BPV parameters such as day‐to‐day and visit‐to‐visit (SBPMax, SBPSD, DBPMax) were related to the SSI characterized by small lesion in deep brain region.
Increased risk of stroke among patients with inflammatory bowel disease: A PRISMA‐compliant meta‐analysis
Authors: Chen Yao , Wang Xiang
Published: May 2021

Background

Previous studies on the association between inflammatory bowel disease (IBD) and stroke showed conflicting results.

Methods

Articles published before July 2020 were searched in databases (PubMed, Web of Science, Medline, EMBASE, and Google Scholar). We computed all multivariate odds ratios (ORs) or relative risks (RRs) and 95% confidence intervals (CI) by using STATA 12.0 software.

Results

The meta‐analysis indicated that IBD was associated with an elevated risk of stroke (OR/RR = 1.21, 95% CI 1.08 to 1.34, I2 = 83.6%, p < .001). In addition, both Crohn's disease (CD) and ulcerative colitis (UC) were associated with a higher risk of stroke (CD: OR/RR = 1.25, 95% CI 1.03 to 1.52, I2 = 86.1%, p < .001; UC: OR/RR = 1.09, 95% CI 1.04 to 1.15, I2 = 54.7%, p = .051). Subgroup study showed that IBD was associated with a higher risk of stroke in cohort studies (RR = 1.21, 95% CI 1.08 to 1.36, I2 = 85.0%, p < .001). Subgroup study showed that IBD was related to an elevated risk of stroke in both Caucasian and Asian groups (Caucasian group: OR/RR = 1.13, 95% CI 1.05 to 1.23, I2 = 44.6%, p = .094; Asian group: OR/RR =1.36, 95% CI 1.07 to 1.74, I2 = 92.5%, p < .001).

Conclusion

IBD is a risk factor for stroke. More high‐quality large‐sample epidemiologic studies about the relationship between IBD and stroke should be further conducted.
Enabling the Circular Economy transition: a sustainable lean manufacturing recipe for Industry 4.0
Authors: Ciliberto Cristina , Szopik‐Depczyńska Katarzyna , Tarczyńska‐Łuniewska Małgorzata , Ruggieri Alessandro , Ioppolo Giuseppe
Published: May 2021

Over the past 10 years, the concepts and objectives of circular economy have been increasingly detailed and become strategic issues of international, European, and national policies. However, the transition towards circular production models continues to be affected by several barriers and critical factors that make the transition difficult to achieve. The paper tries to design a relationship between sustainable production and lean production, highlighting the opportunity to invest in reverse‐logistics and how Industry 4.0 system represents a breeding ground for circular economy targets application. The aim of the current study is to examine the relationships among sustainable production, lean production, and Industry 4.0 in order to evidence the need to adopt a lean methodology and Industry 4.0 technologies in a sustainable development perspective for companies. Following a holistic vision, the authors summarize the production principles and formulas, which, although in parallel, lead to similar results and therefore represent the pillars of a competitive and sustainable business. In conclusion, exploring the circular economy principles and production chain model, challenges, opportunities, and future outlooks are formulated.
Nonplatinum‐based therapy with Paclitaxel and Capecitabine for advanced squamous cell carcinomas of the anal canal: A population‐based Danish anal cancer group study
Authors: Truelsen Christina Glismand , Serup‐Hansen Eva , Storm Katrine Smedegaard , Havelund Birgitte Mayland , Kronborg Camilla Skovhus , Spindler Karen‐Lise Garm
Published: May 2021

Background

First‐line platinum‐based therapy for advanced squamous cell carcinomas of the anal canal (SCCA) implies a risk of substantial side effects, and data on second‐line treatment options are limited. Paclitaxel and Capecitabine are a well‐known regimen with a moderate toxicity profile, but its efficacy has not been evaluated.

Methods

We conducted a retrospective study using Danish Hospital Registers of patients treated with Paclitaxel and Capecitabine for inoperable, recurrent, or advanced metastatic SCCA in Denmark, between January 2000 and July 2018.

Results

A total of 52 patients met the eligibility criteria. Median age was 60.7 years (range 42–83). Efficacy was observed, with an overall response rate in patients receiving first‐line (N = 28) and second‐line (N = 23) Paclitaxel and Capecitabine of 39.3% (2 with complete responses) and 17.4%, respectively. Median progression‐free survival (PFS) was 4.5 months (95% CI 3.3–5.9) and 3.8 months (95% CI 2.4–5.5) with OS of 6.7 months (95% CI 5.9–8.5) and 5.9 months (95% CI 3.9–14), respectively. Performance status ≥2 and neutrophil to lymphocyte ratio ≥4 were significantly associated with a short PFS.

Conclusion

This study recognizes Paclitaxel and Capecitabine as a potential regimen for advanced SCCA, when recommended first‐line therapy is not feasible or as a potential second‐line treatment after failure of platinum‐based chemotherapy.
Easy clinical predictor for low BCAA to tyrosine ratio in chronic liver disease patients with hepatocellular carcinoma: Usefulness of ALBI score as nutritional prognostic marker
Authors: Hiraoka Atsushi , Kato Masaya , Marui Kaori , Murakami Taisei , Onishi Kei , Adachi Tomoko , Matsuoka Junko , Ueki Hidetaro , Yoshino Takeaki , Tsuruta Miho , Aibiki Toshihiko , Okudaira Tomonari , Kuroda Taira , Iwasaki Ryuichiro , Suga Yoshifumi , Miyata Hideki , Ninomiya Tomoyuki , Hirooka Masashi , Abe Masanori , Matsuura Bunzo , Michitaka Kojiro , Hiasa Yoichi
Published: May 2021

Background/Aim

Low branched‐chain amino acid (BCAA) to tyrosine ratio (BTR) is known as an indicator of amino acid imbalance. We elucidated usefulness of newly developed albumin–bilirubin (ALBI) score as alternative methods of BTR in patients with naïve hepatocellular carcinoma (HCC) retrospectively.

Materials/Methods

In 842 patients with HCC and without BCAA supplementation (71 years, male 614, Child‐Pugh A:B:C = 689:116:37), relationships among BTR and clinical features were evaluated. Of those, 438 patients, with Milan criteria HCC, treated curatively were divided into the high‐BTR (>4.4) (n = 293) and low‐BTR (≤4.4) (n = 145) groups. The prognostic value of BTR was evaluated using inverse probability weighting (IPW) with propensity score.

Results

The low‐BTR group showed worse prognosis than the other (3‐, 5‐, 10‐year overall survival rates: 88.9% vs. 86.3%/70.5% vs. 78.1%/38.1% vs. 52.3%, respectively; p < 0.001). Multivariate Cox‐hazard analysis adjusted for IPW showed elderly (≥65 years) HR 2.314, p = 0.001), female gender (HR 0.422, p < 0.001), ECOG PS ≥2 (HR 3.032, p = 0.002), low platelet count (HR 1.757, p = 0.010), and low BTR (≤4.4) (HR 1.852, p = 0.005) to be significant prognostic factors. Both serum albumin level (r = 0.370, p < 0.001) and ALBI score (r = −0.389, p < 0.001) showed a significant relationship with BTR. Child‐Pugh class B, modified ALBI grade (mALBI) 2a, and mALBI 2b predictive values for BTR were 3.589, 4.509, and 4.155 (AUC range: 0.735–0.770), respectively, while the predictive value of ALBI score for low‐BTR (≤4.4) was −2.588 (AUC 0.790).

Conclusion

ALBI score −2.588 was a predictor for low‐BTR (≤4.4), which was prognostic factors for early HCC patients, and at least patients with mALBI 2b might have an amino acid imbalance.
Malignancies diagnosed before and after anal squamous cell carcinomas: A SEER registry analysis
Authors: Jani Krupa S. , Lu Shou‐En , Murphy James D. , Romesser Paul B. , Jethwa Krishan R. , Li Diana , Chundury Anupama , Wu Abraham J. , Hathout Lara , Hallemeier Christopher L. , Jabbour Salma K.
Published: May 2021

Background

Increased risk of a second primary malignancy (SPM) before or after diagnosis of anal squamous cell carcinoma (ASCC) has been reported in a previous single‐institution study. We hypothesize that patients diagnosed with ASCC are at increased risk for developing SPMs before or after the diagnosis of ASCC. The primary objective of this study was to identify the diagnoses of cancer most likely to occur as SPMs before or after ASCC.

Methods

This work employs the Surveillance, Epidemiology, and End Results (SEER) Program registry data to conduct a US‐population‐based study of patients diagnosed with ASCC between 1975 and 2016. In patients diagnosed with ASCC, we evaluated the risk of SPMs and the risk of developing ASCC as an SPM after another cancer using standardized incidence ratios (SIR) for all SPMs by calculating the ratio of observed events in the ASCC cohort compared to expected (O/E) events in a matched reference cohort of the general population.

Results

A total of 7,594 patients with primary ASCC were included. Patients with ASCC were at increased risk of the diagnosis of an SPM (SIR = 1.45), particularly cancers of the lung, vulva, oropharynx, or colon. Patients with ASCC had an increased rate of previous malignancy (SIR = 1.23), especially Kaposi sarcoma or vulvar cancer. Overall elevated incidence of SPMs was unrelated to prior radiation treatment. Radiation treatment was associated with increased risk for SPMs in the female genital system but appeared protective against prostate cancer as SPMs.

Conclusions

Our findings support increased surveillance and screening for second malignancies in patients with these diagnoses, as patients with ASCC are often either survivors of a prior cancer diagnosis or are at increased risk of developing later malignancies.
Artificial intelligence in oncology: Path to implementation
Authors: Chua Isaac S. , Gaziel‐Yablowitz Michal , Korach Zfania T. , Kehl Kenneth L. , Levitan Nathan A. , Arriaga Yull E. , Jackson Gretchen P. , Bates David W. , Hassett Michael
Published: May 2021

In recent years, the field of artificial intelligence (AI) in oncology has grown exponentially. AI solutions have been developed to tackle a variety of cancer‐related challenges. Medical institutions, hospital systems, and technology companies are developing AI tools aimed at supporting clinical decision making, increasing access to cancer care, and improving clinical efficiency while delivering safe, high‐value oncology care. AI in oncology has demonstrated accurate technical performance in image analysis, predictive analytics, and precision oncology delivery. Yet, adoption of AI tools is not widespread, and the impact of AI on patient outcomes remains uncertain. Major barriers for AI implementation in oncology include biased and heterogeneous data, data management and collection burdens, a lack of standardized research reporting, insufficient clinical validation, workflow and user‐design challenges, outdated regulatory and legal frameworks, and dynamic knowledge and data. Concrete actions that major stakeholders can take to overcome barriers to AI implementation in oncology include training and educating the oncology workforce in AI; standardizing data, model validation methods, and legal and safety regulations; funding and conducting future research; and developing, studying, and deploying AI tools through multidisciplinary collaboration.
Queer generativity in lesbian, gay, and bisexual older adults: Personal, relational, and political/social behaviours
Authors: Rosati Fau , Pistella Jessica , Giovanardi Guido , Baiocco Roberto
Published: May 2021

Lesbian, gay, and bisexual (LGB) older adults may have had the opportunity to reflect on and process stressful life experiences, and they may be more inclined to practice queer generative behaviours aimed at strengthening sexual minority identities and supporting the sexual minority community. The present study explored the unique patterns of generativity practiced by 27 Italian LGB older adults (60 years and older) through semi‐structured interviews. Using a constructive grounded theory approach, we identified three main forms of queer generativity: (a) personal, involving the reception of generativity from others, the redefinition of religious values, and adjustment to parenting styles according to one's LGB identity, motivated by a desire for personal growth; (b) relational, involving the provision of resources and the pursuit of a career that supports the LGBT+ community, motivated by a desire to care for others; and (c) political/social, involving the creation of new LGBT+ contexts and the transmission of knowledge and experiences to younger LGBT+ persons and allies, motivated by a desire to fight for LGBT+ rights. Queer generativity emerged as a community resilience strategy practiced by LGB older adults to cope with heterosexist and/or ageist social contexts. Implications for policy and community practice are discussed. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement.
A patient‐specific algorithm to achieve commissural alignment with Acurate Neo: The sextant technique
Authors: De Marco Federico , Casenghi Matteo , Spagnolo Pietro , Popolo Rubbio Antonio , Brambilla Nedy , Testa Luca , Bedogni Francesco
Published: May 2021

Aims

The aim of this proof‐of‐concept study was to investigate safety and efficacy of a CT‐scan based patient‐specific algorithm to maximize coronary clearance and secondarily to achieve anatomically correct commissural alignment with the Acurate Neo device.

Method and results

A total of 45 consecutive patients undergoing TAVR with the Acurate Neo THV were prospectively enrolled in the study. Mean age was 81.6 ± 5.5 years, mean STS score was 6.1 ± 3.7. Device success rate was 100%. Aim of the technique was to rotationally deploy the TAVR device with a commissure lying on the bisector between the coronary ostia as calculated on the pre‐procedural CT‐scan. At post‐TAVR CT‐scan, coronary clearance was achieved in 98% of patients with no cases of severe coronary artery overlap. In 42 out of 45 patients, THV was aligned or, at most, mildly misaligned; there were 2 cases of moderate misalignment without any case of severe misalignment. Post‐TAVR selective coronary artery engagement was attempted and succeeded in all patients (100%).

Conclusion

Our CT‐scan based patient‐specific algorithm is safe and proven to be effective in avoiding coronary artery overlap and providing commissural alignment with Acurate Neo in all treated patients.
Carbon material‐based anodes in the microbial fuel cells
Authors: Fan Xiaoqi , Zhou Yun , Jin Xueke , Song Rong‐Bin , Li Zhaohui , Zhang Qichun
Published: May 2021

For the performance improvement of microbial fuel cells (MFCs), the anode becomes a breakthrough point due to its influence on bacterial attachment and extracellular electron transfer (EET). On other level, carbon materials possess the following features: low cost, rich natural abundance, good thermal and chemical stability, as well as tunable surface properties and spatial structure. Therefore, the development of carbon materials and carbon‐based composites has flourished in the anode of MFCs during the past years. In this review, the major carbon materials used to decorate MFC anodes have been systematically summarized, based on the differences in composition and structure. Moreover, we have also outlined the carbon material‐based hybrid biofilms and carbon material‐modified exoelectrogens in MFCs, along with the discussion of known strategies and mechanisms to enhance the bacteria‐hosting capabilities of carbon material‐based anodes, EET efficiencies, and MFC performances. Finally, the main challenges coupled with some exploratory proposals are also expounded for providing some guidance on the future development of carbon material‐based anodes in MFCs.
“Snapshot” Trapping of Multiple Transient Azolyllithiums in Batch
Authors: Inoue Kengo , Feng Yuxuan , Mori Atsunori , Okano Kentaro
Published: May 2021

Recent developments in flow microreactor technology have allowed the use of transient organolithium compounds that cannot be realized in a batch reactor. However, trapping the transient aryllithiums in a “halogen dance” is still challenging. Herein is reported the trapping of such short‐lived azolyllithiums in a batch reactor by developing a finely tuned in situ zincation using zinc halide diamine complexes. The reaction rate is controlled by the appropriate choice of diamine ligand. The reaction is operationally simple and can be performed at 0 °C with high reproducibility on a multigram scale. This method was applicable to a wide range of brominated azoles allowing deprotonative functionalization, which was used for the concise divergent syntheses of both constitutional isomers of biologically active azoles.
A series of COVID‐19 autopsies with clinical and pathologic comparisons to both seasonal and pandemic influenza
Authors: McMullen Phillip , Pytel Peter , Snyder Alexis , Smith Heather , Vickery Jasmine , Brainer James , Guzy Robert , Wu David , Schoettler Nathan , Adegunsoye Ayodeji , Sperling Anne , Hart John , Alpert Lindsay , Chang Anthony , Gurbuxani Sandeep , Krausz Thomas , Husain Aliya N , Mueller Jeffrey
Published: May 2021

Autopsies of patients who have died from COVID‐19 have been crucial in delineating patterns of injury associated with SARS‐CoV‐2 infection. Despite their utility, comprehensive autopsy studies are somewhat lacking relative to the global burden of disease, and very few comprehensive studies contextualize the findings to other fatal viral infections. We developed a novel autopsy protocol in order to perform postmortem examinations on victims of COVID‐19 and herein describe detailed clinical information, gross findings, and histologic features observed in the first 16 complete COVID‐19 autopsies. We also critically evaluated the role of ancillary studies used to establish a diagnosis of COVID‐19 at autopsy, including immunohistochemistry (IHC), in situ hybridization (ISH), and electron microscopy (EM). IHC and ISH targeting SARS‐CoV‐2 were comparable in terms of the location and number of infected cells in lung tissue; however, nonspecific staining of bacteria was seen occasionally with IHC. EM was unrevealing in blindly sampled tissues. We then compared the clinical and histologic features present in this series to six archival cases of fatal seasonal influenza and six archival cases of pandemic influenza from the fourth wave of the ‘Spanish Flu’ in the winter of 1920. In addition to routine histology, the inflammatory infiltrates in the lungs of COVID‐19 and seasonal influenza victims were compared using quantitative IHC. Our results demonstrate that the clinical and histologic features of COVID‐19 are similar to those seen in fatal cases of influenza, and the two diseases tend to overlap histologically. There was no significant difference in the composition of the inflammatory infiltrate in COVID‐19 and influenza at sites of acute lung injury at the time of autopsy. Our study underscores the relatively nonspecific clinical features and pathologic changes shared between severe cases of COVID‐19 and influenza, while also providing important caveats to ancillary methods of viral detection.
Anxiety and prognosis of patients with myocardial infarction: A meta‐analysis
Authors: Wen Yi , Yang Yuan , Shen Jian , Luo Suxin
Published: May 2021

Although anxiety is highly prevalent after myocardial infarction (MI), but the association between anxiety and MI is not well established. This study aimed to provide an updated and comprehensive evaluation of the association between anxiety and short‐term and long‐term prognoses in patients with MI. Anxiety is associated with poor short‐term and long‐term prognoses in patients with MI. We performed a systematic search in the PubMed and Cochrane databases (January 2000–October 2020). The study endpoints were complications, all‐cause mortality, cardiac mortality, and/or major adverse cardiac events (MACEs). Pooled data were synthesized using Stata SE12.0 and expressed as risk ratios (RRs) and 95% confidence intervals (CIs). We included 9373 patients with MI from 16 published studies. Pooled analyses indicated a correlation between high anxiety and poor clinical outcomes (RR: 1.19, 95% CI: 1.13–1.26, p < .001), poor short‐term complications (RR: 1.23, 95% CI: 1.09–1.38, p = .001), and poor long‐term prognosis (RR: 1.27, 95% CI: 1.13–1.44, p < .001). Anxiety was also specifically associated with long‐term mortality (RR: 1.16, 95% CI: 1.01–1.33, p = .033) and long‐term MACEs (RR: 1.54, 95% CI: 1.26–1.90, p < .001). This study provided strong evidence that increased anxiety was associated with poor prognosis in patients with MI. Further analysis revealed that MI patients with anxiety had a 23% increased risk of short‐term complications and a 27% increased risk of adverse long‐term prognosis compared to those without anxiety.
Incorporation of Patient‐Reported Outcomes Measurement Information System to assess quality of life among patients with breast cancer initiating care at an academic center
Authors: Matthys Madeline B. , Dempsey Andre M. , Melisko Michelle E. , Dreher Nickolas , Che Mandy L. , van’t Veer Laura J. , Esserman Laura J. , Basu Amrita
Published: May 2021

Background

Symptom burden and reduced quality of life (QOL) are considerable hurdles in oncology. The authors used the Patient‐Reported Outcomes Measurement Information System (PROMIS), which assesses physical and psychosocial health, to establish a mean symptom burden, examine potential drivers, and characterize severe symptom burden in breast cancer patient subgroups with the goal of characterizing stage IV patient QOL and triaging patients to individualized supportive care services.

Methods

New patients at the University of California San Francisco Breast Care Center received questionnaires with 8 PROMIS domains: depression, anxiety, fatigue, sleep‐related impairment, sleep disturbance, cognitive function, cognitive abilities, and physical function. PROMIS values were scored with the HealthMeasures service and were compared by age, cancer stage, and educational status.

Results

Stage IV patients with breast cancer (n = 169) reported higher depression and fatigue and worse cognitive function, cognitive abilities, and physical function than patients with stage 0 to III disease (n = 2577). As age increased, cognitive function impairment, depression, anxiety, and sleep‐related symptoms decreased. More educated patients showed better physical function and less severe sleep disturbance and fatigue. Across all subgroups, patients with high anxiety had the greatest probability of worse symptom burden and function in other domains.

CONCLUSIONS

This study provides an additional set of PROMIS population estimates across breast cancer demographic groups. The analysis of a large stage IV population reinforces that metastatic patients have impaired QOL across multiple domains. Because anxiety emerged as a potential driver of impaired QOL in other domains, earlier interventions to reduce anxiety could improve QOL overall. These analyses will help to determine appropriate thresholds of intervention.

Lay Summary

Patients receiving treatment for breast cancer can experience decreased quality of life.

This study characterized differences in self‐reported quality of life among patients of different ages, with different stages of cancer, and with different educational backgrounds. This study also examined the effect of decreased quality of life in one area (eg, anxiety) on another area (eg, difficulty in sleeping).

Patients who were younger, had not attended college or technical school, or had stage IV cancer tended to have worse quality of life. Patients who had high levels of anxiety also tended to have high levels of impairment in other areas.
Surgery alone for transorally resected human papillomavirus–driven head and neck cancer—can we de‐intensify adjuvant therapy to 0 Gy and 0 mg/m2?
Authors: Weiss Jared M.
Published: May 2021

Lay Summary

Although smoking has traditionally been the dominant causative factor of head and neck cancer, cancers of the tonsils and base of tongue increasingly are being driven by human papillomavirus, and these cancers are easier to cure.

When radiation is used as the primary curative treatment, a number of studies have shown good outcomes with reduced doses of both radiation and chemotherapy.

New techniques that access the tumor through the mouth instead of the jaw have made surgery dramatically less toxic. Outcomes are favorable, and many patients traditionally given radiation and chemotherapy afterward may be able to safely omit them.
Sunlight exposure in infancy decreases risk of sporadic retinoblastoma, extent of intraocular disease
Authors: Orjuela‐Grimm Manuela , Carreño Silvia Bhatt , Liu Xinhua , Ruiz Ambar , Medina Paola , Ramirez Ortiz Marco A. , Rendon Josefina Romero , Molina Norma Citlali Lara , Pinilla Hector , Hinojosa Daniela , Rodriguez Laura , Connor Anita O' , Rodriguez Fabiola Mejia , Castañeda M. Veronica Ponce , Cabrera‐Muñoz Lourdes
Published: May 2021

Background

Prior ecologic studies suggest that UV exposure through sunlight to the retina might contribute to increased retinoblastoma incidence.

Aims

Our study objectives were (1) to examine the relationship between exposure to sunlight during postnatal retinal development (prior to diagnosis of sporadic disease) and the risk of retinoblastoma, and (2) to examine the relationship between sun exposure during postnatal retinal development, and the extent of disease among children with unilateral and bilateral retinoblastoma.

Methods and results

We interviewed 511 mothers in the EpiRbMx case‐control study about their child's exposure to sunlight during postnatal retinal cell division by examining three time periods prior to Rtb diagnosis coinciding with developmental stages in which outdoor activities vary. Weekly sun exposure was compared by age period, between unilateral (n = 259), bilateral (n = 120), and control (n = 132) children, accounting for two factors affecting UV exposure: residential elevation and reported use of coverings to shield eyes. For cases, association between sunlight exposure and clinical stage was examined by laterality at each age period. After adjusting for maternal education and elevation, sun exposure was lower in cases than controls in all three age periods especially during the first 6 months, and in children 12–23 months whose mothers did not cover their eyes when outdoors. In children diagnosed after 12 months of age, sun exposure during the second year of life (age 12–23 months) appeared inversely correlated (r = −0.25) with more advanced intraocular disease in bilateral Rtb children after adjusting for maternal education, residential elevation, and age of diagnosis (p < .09) consistent with effects of Vitamin D exposure on intraocular spread in earlier transgenic murine models of retinoblastoma, and suggesting potential chemopreventive strategies.

Conclusion

Sun exposure in early childhood is protective for retinoblastoma and may decrease degree of intraocular spread in children with bilateral Rtb.