bluuebunny/crossref_metadata_2025 huggingface dataset:
Rapid Synthesis of Functionalized Hydrocarbazolones via Indole C2−H Activation Using Enone Functionality as a Directing Group/Electrophilic Species
Authors: Yanagawa Mai , Harada Shingo , Hirose Shumpei , Nemoto Tetsuhiro
Published: February 2021

Hydrocarbazolones are a key structural unit in many natural bioactive compounds and are thus a valuable synthetic target. A rhodium‐catalyzed C−H functionalization reaction with acceptor/acceptor diazo compounds was developed for synthesizing 2,3‐fused indole variants. An α,β‐unsaturated enone was utilized as a directing group for site‐selective C−H activation and as an electrophile for the subsequent cyclization. Overall, the developed annulation enabled the rapid assembly of synthetically valuable hydrocarbazolones from readily available indoles. Additionally, computational investigations were conducted to elucidate the reaction pathway and rationalize the experimentally observed site‐selectivity.

magnified image
Corn residue baling and grazing impacts on corn yield under irrigated conservation tillage systems
Authors: Ruis Sabrina J. , Burr Charles , Blanco‐Canqui Humberto , Olson Brian , Reiman Mark , Rudnick Daran , Baller Johnna , Hanford Kathryn
Published: February 2021

Crop residue grazing or baling is common in the western Corn Belt. However, its impacts on subsequent crop yields under different irrigation levels and tillage systems are unclear. We investigated the impacts of corn (Zea mays L.) residue baling and cattle grazing on soil compaction, water content, and corn yield under full and limited irrigated no‐till in Nebraska during three years. In Years 2 and 3, an additional tillage treatment (strip till) was implemented to evaluate its effects on grain yield under the above treatments. Residue removal effects on compaction and water content did not vary with irrigation level. Grazing (3.68 animal units ha−1) minimally impacted compaction and soil profile water content compared to no removal. Baling increased cone index by 34–53% in the 0‐to‐12.5‐cm depth and decreased water content by 6 cm compared to no removal. Residue removal effects on yield did not depend on irrigation. Residue removal impacts depended on tillage in Year 3 only. Full irrigation increased corn yields up to 11% compared to limited irrigation. Strip till increased yield by 11% compared to no‐till in Year 2 only. Baling and grazing had no effect on corn yield in Year 1, but baling and grazing increased yield by 9% compared to no removal in Year 2, likely due to lower water content. In Year 3, grazing and baling increased yield by 9% under no‐till but not strip till. Overall, grazing had minimal impacts while baling increased yield and compaction and decreased water content with few variations due to irrigation or tillage.
Regulative Electronic States around Ruthenium/Ruthenium Disulphide Heterointerfaces for Efficient Water Splitting in Acidic Media
Authors: Zhu Jiawei , Guo Yao , Liu Fang , Xu Hanwen , Gong Lei , Shi Wenjie , Chen Ding , Wang Pengyan , Yang Yue , Zhang Chengtian , Wu Jinsong , Luo Jiahuan , Mu Shichun
Published: February 2021

Theoretical calculations unveil the charge redistribution over abundant interfaces and the enhanced electronic states of Ru/RuS2heterostructure. The resulting surface electron‐deficient Ru sites display optimized adsorption behavior toward diverse reaction intermediates, thereby reducing the thermodynamic energy barriers. Experimentally, for the first time the laminar Ru/RuS2heterostructure is rationally engineered by virtue of the synchronous reduction and sulfurization under eutectic salt system. Impressively, it exhibits extremely high catalytic activity for both OER (201 mV @ 10 mA cm−2) and HER (45 mV @ 10 mA cm−2) in acidic media due to favorable kinetics and excellent specific activity, consequently leading to a terrific performance in acidic overall water splitting devices (1.501 V @ 10 mA cm−2). The in‐depth insight into the internal activity origin of interfacial effect could offer precise guidance for the rational establishment of hybrid interfaces.
Possibly extreme, probably not: Is possibility theory the route for risk‐averse decision‐making?
Authors: Le Carrer Noémie
Published: February 2021

Ensemble forecasting has become popular in weather prediction to reflect the uncertainty about high‐dimensional, nonlinear systems with extreme sensitivity to initial conditions. By means of small strategical perturbations of the initial conditions, sometimes accompanied with stochastic parameterisation schemes of the atmosphere–ocean dynamical equations, ensemble forecasting aims at sampling possible future scenario and ideally at interpreting them in a Monte‐Carlo‐like approximation. Traditional probabilistic interpretations of ensemble forecasts do not take epistemic uncertainty into account nor the fact that ensemble predictions cannot always be interpreted in a density‐based manner due to the strongly nonlinear dynamics of the atmospheric system. As a result, probabilistic predictions are not always reliable, especially in the case of extreme events. In this work, we investigate whether relying on possibility theory, an uncertainty theory derived from fuzzy set theory and connected to imprecise probabilities, can circumvent these limitations. We show how it can be used to compute confidence intervals with guaranteed reliability, when a classical probabilistic postprocessing technique fails to do so in the case of extreme events. We illustrate our approach with an imperfect version of the Lorenz 96 model and demonstrate that it is promising for risk‐averse decision‐making.
Crowd‐sourced observations for short‐range numerical weather prediction: Report from EWGLAM/SRNWP Meeting 2019
Authors: Hintz Kasper S. , McNicholas Callie , Randriamampianina Roger , Williams Hywel T. P. , Macpherson Bruce , Mittermaier Marion , Onvlee‐Hooimeijer Jeanette , Szintai Balázs
Published: February 2021

Crowd‐sourced observations (CSO) offer great potential for numerical weather prediction (NWP). This paper offers a synthesis of progress, challenges and opportunities in this area based on a special session of the EWGLAM Meeting in 2019, concentrating on high‐resolution limited‐area models (LAMs). Two main application areas of CSO are described: data assimilation and verification. One part of data assimilation developments concentrates on smartphone pressure observations, which represent a large volume of data. However, special care has to be taken about data protection and the quality of observations. In this paper, two examples are presented: the SMAPS experiment from Denmark and the uWx experiment from the United States. Another data assimilation topic is citizen observations with low‐cost weather sensors; here an example from Norway is presented using Netatmo stations. The other application area is the use of CSO for model verification. One novel method developed in the United Kingdom is applying social media data to detect severe weather events. This approach is especially important because one future application area of LAM NWP models is impact‐oriented warnings.
Disseminated Saprochaetecapitata fungal infection in a patient with acute myeloid leukemia
Authors: Duarte Delfim , Morais Cátia Iracema , Azevedo Rosa , Coelho Fernando , Martins Anabela , Pereira Brigitte , Coelho Sara , Domingues Nelson , Lebre Ana , Trigo Filipe , Romero Iracema , Guimarães Maria Augusta , Mariz José Mário , Faria Filomena
Published: February 2021

The case highlights the importance of actively obtaining informative samples at an early stage and of prompt initiation of combination therapy with antifungal drugs.
Characterization of the Effect of Cell Design on Li−S Battery Resistance Using Electrochemical Impedance Spectroscopy
Authors: Kilic Aysegul , Eroglu Damla
Published: February 2021

The effect of two critical cathode design parameters, electrolyte‐to‐sulfur (E/S) and carbon‐to‐sulfur (C/S) ratios, on the kinetic and transport resistances in a Li−S cell is determined as a function of discharge depth by using electrochemical impedance spectroscopy. Electrolyte, charge transfer, and Li2S film resistances are identified as the major contributors to cell resistance. Both E/S and C/S ratios have a significant impact on cell resistance, predominantly at the early and final stages of discharge. The E/S ratio controls the cathode kinetics in the first plateau together with Li2S precipitation near the end of discharge. Consequently, the highest cell resistances are obtained for the cell with the lowest E/S ratio of 6 mL g−1. Increasing the E/S ratio up to 19 mL g−1 decreases the resistances considerably, no notable change is achieved after this point. On the other hand, the C/S ratio reflects a tradeoff between high electrochemically active surface area vs. sufficient and homogeneous S loading in the cathode. The minimum cell resistance is attained for the cell with C/S=1; any increase or decrease in the C/S ratio leads to higher resistances. The results suggest a mechanistic interpretation of the connection between cathode design and cell performance in Li−S batteries.
Adsorption, Stretching, and Breaking Processes in Single‐Molecule Conductance of para‐Benzenedimethanethiol in Gold Nanogaps: A DFT‐NEGF Theoretical Study**
Authors: Guan Si‐Yuan , Cai Zhuan‐Yun , Liu Jia , Pang Ran , Wu De‐Yin , Ulstrup Jens , Tian Zhong‐Qun
Published: February 2021

Electrical and mechanical properties of gold‐para‐benzenedimethanethiol (BDMT)‐gold molecular junctions with different binding configurations have been investigated using density functional theory (DFT) combined with a non‐equilibrium Green's function (NEGF) approach. We first determined the most stable structure in total electronic energy by geometry optimization of the molecular junction. We then studied how different stretching processes affect the conductance and the stretching forces. Particularly, two stretching modes can bring about different conductance behavior. When only a single‐end molecular contact in interfacial configurations at the top and bridge sites is stretched, the molecular conductance first decreases exponentially. This is followed by a flat platform, and finally produced an abrupt conductance drop from the fracture of interfacial chemical bond Au−Au. In the junction with a double‐end stretching mode, the fracture of Au−S bond occurs either between the sulfur‐bonded gold atom and the underlying Au surfaces, or at either of the two Au−S bonds in the double‐end stretching mode at the top‐pyramidal site. The latter interfacial structure consists of a four‐Au‐atom pyramidal structure adsorbed on gold surface, resulting in a sharp conductance increase just before complete fracture. This is closely associated with resonance tunneling of beta spin electrons in the critical fracture state of interfacial Au−S bonds in gold‐BDMT‐gold molecular junction.
Renewable Power‐to‐Gas: A Technical and Economic Evaluation of Three Demo Sites Within the STORE&GO Project
Authors: Schlautmann Ruth , Böhm Hans , Zauner Andreas , Mörs Friedemann , Tichler Robert , Graf Frank , Kolb Thomas
Published: February 2021

For a successful energy transition, Power‐to‐Gas (PtG) offers the opportunity to convert renewable electricity to substitute natural gas. This renewable synthetic natural gas (SNG) can be used for long‐term storage, transport, or can be integrated into other energy sectors. Main challenges for the commercial application of PtG are to achieve a high PtG process efficiency, dynamic operation capability, and low investment and production costs. Within the STORE&GO project, three demo sites were developed, operated, and evaluated. An overall efficiency of > 75 % is possible, the SNG production costs are expected to drop to less than 10 €‐Cent kWh−1 in 2050.
Chelating Guanidinates for Dysprosium(III) Single‐Molecule Magnets†
Authors: Jin Peng‐Bo , Yu Ke‐Xin , Zhai Yuan‐Qi , Luo Qian‐Cheng , Wang Yi‐Dian , Zhang Xu‐Feng , Lv Yi , Zheng Yan‐Zhen
Published: February 2021

Main observation and conclusion

Two chelating guanidinate‐based dysprosium(III) complexes, namely the monomeric {(Me3Si)2NC(NiPr)2}2Dy(μ‐Cl)2Li(THF)2 1 and the dimeric [{(Me3Si)2NC(NiPr)2}2Dy(μ‐Cl)]2 2, have been confirmed to be single‐molecule magnets. Moreover, the alteration from 1 to 2 leads to an obvious mitigated quantum tunnelling of magnetization at zero field of the hysteresis loop and much enhanced magnetic relaxation barrier (up to 312 K). 5% dilution with the yttrium(III) analogue for 2 shows no clear change for the hysteresis, indicating the single‐ion nature of the magnetic behavior.
Divergent Synthesis of N‐Heterocycles by Merging Borane‐Mediated Cyclopropane Ring‐Opening and Hydride Abstraction
Authors: Zhang Zi‐Yu , Ren Jie , Zhang Ming , Xu Xiu‐Fang , Wang Xiao‐Chen
Published: February 2021

Main observation and conclusion

Herein, we report the synthesis of N‐heterocycles by borane‐catalyzed dehydrogenative cyclization of 2‐cyclopropyl‐N,N‐dimethylanilines. Borane‐mediated cyclopropane ring‐opening and borane‐mediated hydride abstraction from an N‐methyl group are the key steps. The substituent at the cyclopropyl unit was found to greatly influence the reaction pathway and thus determined the major reaction product.
Research Progress on Zero Discharge and Resource Utilization of Industrial High‐Salt Wastewater
Authors: Liu Dan , Liu Qiongqiong , Zhang Yan
Published: February 2021

With the continuous expansion of industrial enterprises, a large amount of difficult‐to‐treat high‐salt wastewater with complex components is produced. If it is not treated properly and discharged directly, it can not only be a wasted resource but also cause great damage to the ecological environment. Therefore, how to achieve zero discharge and resource utilization, reduce the treatment cost, and the generation of secondary pollution have become the bottlenecks that need to be broken through in current wastewater treatment. Among many methods, the concentrated crystallization coupling technology has broad development and application prospects due to its advantages such as low energy consumption, green economy, and high purity of salt‐separated products. Combining with source and composition of high‐salt wastewater, the research progress of wastewater treatment technology is reviewed, and its actual application status is analyzed, to provide a certain reference for the further resource treatment of high‐salt wastewater and the realization of true zero discharge in the future.
Cortisol promotes breast‐to‐brain metastasis through the blood‐cerebrospinal fluid barrier
Authors: Herrera Robert A. , Deshpande Krutika , Martirosian Vahan , Saatian Behnaz , Julian Alex , Eisenbarth Rachel , Das Diganta , Iyer Mukund , Neman Josh
Published: February 2021

Background

Elevated basal cortisol levels are present in women with primary and metastatic breast cancer. Although cortisol's potential role in breast‐to‐brain metastasis has yet to be sufficiently studied, prior evidence indicates that it functions as a double‐edged sword—cortisol induces breast cancer metastasis in vivo, but strengthens the blood‐brain‐barrier (BBB) to protect the brain from microbes and peripheral immune cells.

Aims

In this study, we provide a novel examination on whether cortisol's role in tumor invasiveness eclipses its supporting role in strengthening the CNS barriers. We expanded our study to include the blood‐cerebrospinal fluid barrier (BCSFB), an underexamined site of tumor entry.

Methods and Results

Utilizing in vitro BBB and BCSFB models to measure barrier strength in the presence of hydrocortisone (HC). We established that lung tumor cells migrate through both CNS barriers equally while breast tumors cells preferentially migrate through the BCSFB. Furthermore, HC treatment increased breast‐to‐brain metastases (BBM) but not primary breast tumor migratory capacity. When examining the transmigration of breast cancer cells across the BCSFB, we demonstrate that HC induces increased traversal of BBM but not primary breast cancer. We provide evidence that HC increases tightness of the BCSFB akin to the BBB by upregulating claudin‐5, a tight junction protein formerly acknowledged as exclusive to the BBB.

Conclusion

Our findings indicate, for the first time that increased cortisol levels facilitate breast‐to‐brain metastasis through the BCSFB—a vulnerable point of entry which has been typically overlooked in brain metastasis. Our study suggests cortisol plays a pro‐metastatic role in breast‐to‐brain metastasis and thus caution is needed when using glucocorticoids to treat breast cancer patients.
LRRK2 inhibition potentiates PARP inhibitor cytotoxicity through inhibiting homologous recombination‐mediated DNA double strand break repair
Authors: Chen Lifeng , Hou Jing , Zeng Xiangyu , Guo Qiang , Deng Min , Kloeber Jake A , Tu Xinyi , Zhao Fei , Wu Zheming , Huang Jinzhou , Luo Kuntian , Kim Wootae , Lou Zhenkun
Published: February 2021

PARP inhibitors induce DNA lesions, the repair of which are highly dependent on homologous recombination (HR), and preferentially kill HR‐ deficient cancers. However, cancer cells have developed several mechanisms to transform HR and confer drug resistance to PARP inhibition. Therefore, there is a great clinical interest in exploring new therapies that induce HR deficiency (HRD), thereby sensitizing cancer cells to PARP inhibitors. Here, we found that GSK2578215A, a high‐selective and effective leucine‐rich repeat kinase 2 (LRRK2) inhibitor, or LRRK2 depletion suppresses HR preventing the recruitment of RAD51 to DNA damage sites through disruption of the interaction of RAD51 and BRCA2. Moreover, LRRK2 inhibition or depletion increases the susceptibility of ovarian cancer cells to Olaparib in vitro and in vivo. In clinical specimens, LRRK2 high expression is high related with advanced clinical characteristics and poor survival of ovarian cancer patients. All these findings indicate ovarian cancers expressing high levels of LRRK2 are more resistant to treatment potentially through promoting HR. Furthermore, combination treatment with an LRRK2 and PARP inhibitor may be a novel strategy to improve the effectiveness of LRRK2 expression ovarian cancers.
Deep learning for load balancing of SDN‐based data center networks
Authors: Babayigit Bilal , Ulu Banu
Published: February 2021

With the development of new communication technologies, the amount of data transmission has increased gradually. To satisfy this increasing computing resource demand effectively, the number of data center networks (DCNs), which are structures composed of servers connected with well‐organized‐switches, has increased worldwide. However, traditional switches do not efficiently satisfy the needs of DCNs. In recent years, an emerging networking architecture software‐defined network (SDN) has been proposed to manage the DCNs to control network switches and to deploy new network protocols. However, the main challenge in DCNs is to balance the load among servers. One potential solution for this challenge is to use machine learning (ML) techniques to tackle network transmission demand. A recent successful ML technique is deep learning (DL) which makes prediction, classification, and decisions by handling large amounts of data. Although DL has drawn increasing attention in many research fields, its applications to networking problems are scarce. In this paper, a DL technique is proposed for the load‐balancing of SDN‐based DCNs. To train the DL network, the variable load values among links are used. The response time for load balancing of the DL technique is compared with those of different ML algorithms, such as an artificial neural network (ANN), support vector machine (SVM), and logistic regression (LR). The experimental results reveal that the response‐time results of ANN and DL are lower than those of the SVM and LR algorithms. Also, DL accuracy is higher than ANN accuracy. As a result, DL is very efficient for the load balancing of SDN‐based DCNs.
How far will you go before switching hands? Handedness on the long pegboard across the lifespan
Authors: Scharoun Benson Sara M. , Williams Nicole , Tucker Jessica , Bryden Pamela J.
Published: February 2021

Handedness is a significant behavioral asymmetry; however, there is debate surrounding the age at which hand preference develops, and little research has been conducted on handedness in older adults. The current study examined performance on the long pegboard, to identify similarities and differences in young children (ages 4–7 years), older children (ages 8–12 years), young adults (ages 18–25 years), and older adults (ages 70+ years). Average time per hole, number of hand switches, and errors were assessed with left‐ and right‐hand starts. A left‐right ratio was computed from the long pegboard, along with laterality quotients from the Waterloo Handedness Questionnaire (WHQ). Results revealed faster performance when participants started the task on the right side of the long pegboard with the right‐hand, coupled with a later switch to the left‐hand. There was a greater number of errors with left‐hand starts, and an earlier switch to the right‐hand. Age was a significant predictor of the average time per hole and number of errors. Long pegboard ratio and WHQ laterality quotient were only correlated for adults. Together, findings offer insight regarding age‐related effects in handedness and support the long pegboard as a useful measure of handedness.
Pulmonary Abnormalities in Liver Disease: Relevance to Transplantation and Outcome
Authors: Raevens Sarah , Boret Maxine , De Pauw Michel , Fallon Michael B. , Van Vlierberghe Hans
Published: February 2021

Pulmonary disease in liver cirrhosis and portal hypertension (PH) constitutes a challenging clinical scenario and may have important implications with regard to prognosis, liver transplantation (LT) candidacy, and post‐LT outcome. Pre‐LT evaluation should include adequate screening for pulmonary diseases that may occur concomitantly with liver disease as well as for those that may arise as a complication of end‐stage liver disease and PH, given that either may jeopardize safe LT and successful outcome. It is key to discriminate those patients who would benefit from LT, especially pulmonary disorders that have been reported to resolve post‐LT and are considered “pulmonary indications” for transplant, from those who are at increased mortality risk and in whom LT is contraindicated. In conclusion, in this article, we review the impact of several pulmonary disorders, including cystic fibrosis, alpha 1‐antitrypsin deficiency, hereditary hemorrhagic telangiectasia, sarcoidosis, coronavirus disease 2019, asthma, chronic obstructive pulmonary disease, pulmonary nodules, interstitial lung disease, hepatic hydrothorax, hepatopulmonary syndrome, and portopulmonary hypertension, on post‐LT survival, as well as the reciprocal impact of LT on the evolution of lung function.
Analysis of mixed convection in an inclined square cavity using nanofluids with Vajjha and Das' nanofluid model
Authors: Shamadhani Begum A. , Chamkha Ali J.
Published: February 2021

In this article, the effects of angle of inclination on heat transfer by mixed convection have been analyzed numerically in a square cavity packed with a CuO nanofluid. Cavity boundaries are constructed by having sinusoidal varying temperature on sidewalls, inactive horizontal walls, and the hot passing plate at the center of the cavity. The transport equations for fluid and heat are solved using the finite‐volume method with SIMPLE algorithm. The Richardson number (Ri) varying from 0.01 to 100, inclination angle (γ) from 0° to 90°, wall speed ratios (λ) from 0 to 3 and volume fraction of nanoparticles (φ) from 0.0 to 0.1 are given and represented in the form of flow fields, temperature fields, and mean heat transfer graphs. It is detected that the principal flow constraints have a substantial impact on the flow lines and thermal lines. Specifically, the structures of cavity inclination, existence of copper nanoparticles, and the hot wall in motion at the midpoint of the cavity are established to enrich the overall rate of heat transfer. Correspondingly, in the present study, the Vajjha and Das model is taken into account for the effective thermal conductivity and viscosity of the nanofluid; application of this model is beneficial for the industries working in a high‐temperature environment.
Optimization of an effective quick coupling valve for pressurized irrigation*
Authors: Gharebaghi P. , Ahmadi H. , Hemmati M. , Rezaverdinejad V.
Published: February 2021

Quick coupling valves are commonly used to make an easy and quick connection/disconnection of a sprinkler to/from the supporting pipeline. However, significant headloss occurs during the operation of the irrigation system by this valve. In the present study, water flow through a standard quick coupling valve was numerically modelled by computational fluid dynamics (CFD). In addition, different turbulence models were run to determine the effect of any component of the valve on flow characteristics. Comparison between numerical and observed data from the experiments on the prototype confirmed the validity of standard k‐ε as a high precision model. Three‐dimensional numerical simulation of the steady‐state flow under different rates of flow showed that the spring had the least negative effect among the installed components inside the quick coupling valve. On the other hand, the body length of the valve, especially the length of the inlet part of the valve, played the main role in the pressure drop. Unexpectedly, the installed sealing O‐ring reduced the headloss. Moreover, an effective modification was carried out on the components of an ordinary valve by increasing by 20 mm the length of the valve from the inlet side and modifications in trim elements. Finally, the findings revealed that 50% of headloss occurred in the developed valve compared to the ordinary type regardless of the flow rate.
A multivariate assessment of climate change projections over South America using the fifth phase of the Coupled Model Intercomparison Project
Authors: Thaler Valerie , Loikith Paul C. , Mechoso C. Roberto , Pampuch Luana Albertani
Published: February 2021

This study presents results from an assessment of climate change projections over South America using fifth phase of the Coupled Model Intercomparison Project models. Change in near‐surface temperature, precipitation, evapotranspiration, integrated water vapour transport (IVT), sea level pressure (SLP), and wind at three pressure levels is quantified across the multi‐model suite. Additionally, model agreement for the sign and significance of projected change is assessed within the ensemble. Models are in strong agreement that the highest magnitude of projected warming will be over tropical regions. The CMIP5 models project a decrease in precipitation for all seasons over southern South America, especially along the northern portions of the present‐day mid‐latitude storm track. This is consistent with a robustly projected poleward shift of the Pacific extratropical high‐pressure system and mid‐latitude storm track indicated by a systematic increase in SLP and decrease in westerly wind magnitude over the region. Decreased precipitation for the months of September, October, and November is also projected, with strong model agreement, over portions of northern and northeastern Brazil, coincident with decreases in SLP and increases in evapotranspiration. IVT is broadly projected to decrease over southern South America, coincident with the projected poleward shift of the mid‐latitude storm track, with increases projected in the vicinity of the South Atlantic Convergence Zone in spring and summer. Results provide a comprehensive picture of climate change across South America and highlight where model consensus on change is most robust.
Advanced Practice Provider Clinics: Expediting Care For Children Undergoing Tympanostomy Tube Placement
Authors: Belsky Michael A. , Konanur Anisha , Sim Edward , Yan Annie , Shaffer Amber D. , Williams Kathryn , Martsolf Grant R. , Chi David , Jabbour Noel
Published: February 2021

Objective/Hypothesis

Advanced practice provider (APP) employment is becoming common in pediatric otolaryngology practices, though few studies have evaluated the consequences that APP‐led clinics have on access to care. The objectives of this study were: 1) to investigate whether access to bilateral myringotomy with tympanostomy tube placement (BMT) for recurrent acute otitis media (RAOM) differed between patients seen in otolaryngologist and APP‐led clinics 2) to compare clinical characteristics of patients seen by provider type.

Methods

Retrospective cohort study at an academic, tertiary care pediatric otolaryngology practice. All children were <18 years old and underwent evaluation for RAOM followed by BMT. We compared time in days from scheduling pre‐operative appointment to appointment date and time from appointment to BMT between patients seen by APPs and otolaryngologists using Mann–Whitney U tests and multivariate linear regression models. We compared clinical characteristics by provider type using Mann–Whitney U tests and Fisher exact tests.

Results

A total of 957 children were included. Children seen by APPs had significantly shorter wait times for appointments (median 19 vs. 39 days, P < .001) and shorter times from preoperative appointment to BMT (median 25 vs. 37 days, P < .001). Patients seen by otolaryngologists had increased prevalence of craniofacial abnormalities, Down Syndrome, hearing loss, history of otologic surgery, and higher ASA physical status classification.

Conclusions

Children seen by APPs received care more quickly than those seen by otolaryngologists. Patients seen by otolaryngologists tended to be more medically complex. Implementation of independent APP clinics may expedite and improve access to BMT for children with RAOM.

Level of Evidence

3 Laryngoscope, 131:2133–2140, 2021
Barriers to Decannulation After Double‐Stage Laryngotracheal Reconstruction
Authors: Koenigs Maria B. , Behzadpour Hengameh K. , Zalzal George H. , Preciado Diego A.
Published: February 2021

Objectives/Hypothesis

To identify any potential barriers for decannulation in children undergoing double‐staged laryngotracheal reconstruction (dsLTR) beyond the severity of disease itself.

Study Design

Case series with chart review.

Methods

We performed a retrospective chart review from 2008 to 2018 of 41 children who had undergone dsLTR as primary treatment for laryngotracheal stenosis at a stand‐alone tertiary children's hospital. We examined the effect of demographic, medical, and surgical factors on successful decannulation and time to decannulation after dsLTR.

Results

Of the 41 children meeting inclusion criteria who underwent dsLTR, 34 (82%) were decannulated. Age, gender, race, insurance status, medical comorbidity, and multilevel stenosis did not predict overall decannulation. Insurance status did not impact time to decannulation (P = .13, Log‐rank). Factors that increased length of time to decannulation were the use of anterior and posterior cartilage grafts (P = .001, Log‐rank), history of pulmonary disease (P = .05, Log rank), history of cardiac disease (P = .017, Log‐rank), and race/ethnicity (P = .001 Log‐rank).

Conclusion

In a cohort with a similar decannulation rates to previous dsLTR cohorts, we identified no demographic or medical factors that influenced overall decannulation. We did observe that pulmonary comorbidity, cardiac comorbidity, and race/ethnicity lengthens time to decannulation.

Level of Evidence

4 Laryngoscope, 131:2141–2147, 2021
Usefulness of Exam Questions and Vital Signs for Predicting the Outcome of Objective Vestibular Tests
Authors: Cohen Helen S. , Sangi‐Haghpeykar Haleh , Watts Megan , Sweeney Alex D. , Peng Angela S.
Published: February 2021

Objectives/Hypothesis

To determine the value of standard clinic screening questions and vital signs in predicting abnormal vestibular function, indicated by standard objective diagnostic tests.

Study Design

Retrospective records review.

Methods

We reviewed electronic medical records of 150 patients seen by the neurotologists or the physician assistant they supervised, in an out‐patient tertiary care clinic, between June 2018 and March 2020, and subsequently referred for the complete objective vestibular test battery (VB).

Results

Of standard questions asked during the initial exam about vertigo, disequilibrium, lightheadedness and oscillopsia, only vertigo predicted an abnormal response on the VB. More males than females had abnormal VB responses, P < .05. Pulse was not related to VB score. Significantly more subjects with blood pressure in the range for stage 2 hypertension (blood pressure [BP] stage 2) had abnormal than normal results on the VB, P < .00001. Subjects with BP stage 2 had high rates of diabetes (34.2%) and hypertension (68.4%) as diagnosed by their primary care physicians or cardiologists.

Conclusion

Complaints of subjective vertigo and BP in the range of hypertension stage 2 are most likely to predict abnormal findings on the VB. Therefore, during an examination of a patient who comes in complaining of dizziness, two measures may be the most useful for screening: BP in the range of hypertension type 2, when BP is taken by a nurse, and a question to determine whether or not the patient has true vertigo.

Level of Evidence

3 Laryngoscope, 131:1382–1385, 2021
Experience with the use of intraoperative continuous nerve monitoring in video‐assisted neck surgery and external cervical incisions
Authors: Noda Takuya , Ishisaka Tomo , Okano Keiichiro , Kobayashi Yoshiaki , Shimode Yuzo , Tsuji Hiroyuki
Published: February 2021

Objectives

Recurrent laryngeal nerve (RLN) injury is one of the severe complications in thyroid surgery. Therefore, intraoperative nerve monitoring (IONM) has been widely used to identify the RLN and confirm its integrity. Recently, the usefulness of continuous IONM (CIONM) with automatic, periodic stimulation to the vagus nerve during thyroid surgery was reported. This study aimed to report our experience with minimally invasive video‐assisted endoscopic endocrine neck surgery (VANS), during which, CIONM was successfully applied for the first time.

Methods

Consecutive patients who underwent thyroid surgery with CIONM, performed in our department using either external neck incision surgery or VANS between July 2017 and June 2019, were retrospectively analyzed.

Results

A total of 22 patients who underwent thyroid surgery with neck incision (14 cases; 7 men and 7 women; age, 21‐75 years [mean, 52 years]) or VANS (8 cases; 8 women, age, 20‐61 years [mean, 41 years]) were enrolled in this study. The addition of CIONM in VANS prolonged the operation's duration by approximately 30 minutes as the endoscopic surgery was technically more difficult. No intra‐ and postoperative incidence of transient or permanent RLN palsy was observed in any patient, except for three patients who underwent external neck incision surgery in whom combined resection was unavoidable due to tumor invasion of the RLN.

Conclusion

We reported the first successful application of CIONM during thyroidectomy using VANS. Future clinical trials should clarify the benefits of CIONM when compared to intermittent IONM in VANS.

Level of Evidence

5.
A Solvent‐Free and Water‐Resistant Dipole–Dipole Interaction‐Based Super Adhesive
Authors: Liu Bo , Xu Ziyang , Fan Chuanchuan , Cui Chunyan , Yao Yuan , Xiao Meng , Liu Wenguang
Published: February 2021

Water‐resistant and high‐strength adhesion on different surfaces has attracted considerable attention for decades. However, the adhesion performances of conventional adhesives suffer from deterioration in adhesion performances under water or wet conditions. This work proposes a dipole–dipole interaction strategy for fabricating a solvent‐free adhesive that is synthesized via simple one‐step copolymerization of dipole monomer acrylonitrile (AN), crosslinker poly(ethylene glycol) diacrylate (PEGDA) with variable length, and a monomer‐soluble initiator that initiates room‐temperature polymerization. The dipole–dipole interactions from cyan groups in AN concurrently contribute to strong cohesion and adhesion strength in bonding to a wide range of substrates including aluminum, ceramic, glass fiber, epoxy resin, polyethylene terephthalate, wood, and fractured large segmental bone. The adhesion strengths are dependent upon the length of PEGDA, and the shorter PEGDA‐crosslinked PAN adhesive demonstrates outstanding water‐resistant adhesion spanning pH 2 to pH 10 for 30 days with adhesion strength ranging from 3.31 to 3.97 MPa due to strong dipole–dipole pairing shielding. This dipole–dipole interaction and co‐dissolution strategy open a new avenue for creating high‐strength water‐resistant adhesives for promising applications in engineering and hard‐tissue repair.
Broadband adiabatic inversion cross‐polarization to integer‐spin nuclei with application to deuterium NMR
Authors: Altenhof Adam R. , Wi Sungsool , Schurko Robert W.
Published: February 2021

Solid‐state NMR (SSNMR) spectroscopy of integer‐spin quadrupolar nuclei is important for the molecular‐level characterization of a variety of materials and biological solids; of the integer spins, 2H (S = 1) is by far the most widely studied, due to its usefulness in probing dynamical motions. SSNMR spectra of integer‐spin nuclei often feature very broad powder patterns that arise largely from the effects of the first‐order quadrupolar interaction; as such, the acquisition of high‐quality spectra continues to remain a challenge. The broadband adiabatic inversion cross‐polarization (BRAIN‐CP) pulse sequence, which is capable of cross‐polarization (CP) enhancement over large bandwidths, has found success for the acquisition of SSNMR spectra of integer‐spin nuclei, including 14N (S = 1), especially when coupled with Carr–Purcell/Meiboom–Gill pulse sequences featuring frequency‐swept WURST pulses (WURST‐CPMG) for T2‐based signal enhancement. However, to date, there has not been a systematic investigation of the spin dynamics underlying BRAIN‐CP, nor any concrete theoretical models to aid in its parameterization for applications to integer‐spin nuclei. In addition, the BRAIN‐CP/WURST‐CPMG scheme has not been demonstrated for generalized application to wideline or ultra‐wideline (UW) 2H SSNMR. Herein, we provide a theoretical description of the BRAIN‐CP pulse sequence for spin‐1/2 → spin‐1 CP under static conditions, featuring a set of analytical equations describing Hartmann–Hahn matching conditions and numerical simulations that elucidate a CP mechanism involving polarization transfer, coherence exchange, and adiabatic inversion. Several experimental examples are presented for comparison with theoretical models and previously developed integer‐spin CP methods, demonstrating rapid acquisition of 2H NMR spectra from efficient broadband CP.
Influence of cognitive function and nurse support on malnutrition risk in nursing home residents
Authors: Pakai Annamária , Havasi‐Sántha Emese , Mák Erzsébet , Máté Orsolya , Pusztai Dorina , Fullér Noémi , Zrínyi Miklós , Oláh András
Published: February 2021

Aim

To predict malnutrition risk of older residents by cognitive function, nurse support and self‐care capacity as primary measures of interest.

Design

Cross‐sectional, correlation design with linear regression analysis.

Methods

Older residents over 60 years of age were randomly selected from nursing homes. Mini Mental State Exam and the Mini Nutritional Assessment were used were as main measures.

Results

Lower malnutrition risk was associated with better cognitive functioning. Improved independence of self‐feeding was also linked to reduced nutritional risk. Nurse support was positively related to BMI and cognitive impairment. General self‐care capacity and ‘appetite the week before’ were key predictors of malnutrition risk; 1‐point increase in both variables caused nutritional risk to decrease by 1.73 and 1.38 points, respectively. That is, a 1‐point increase in self‐care capacity and appetite would decrease malnutrition risk by 5.76% and 4.6%. The regression model explained significant amount (65.6%) of variance in malnutrition risk.
Impact of trade openness, human capital, and institutional performance on economic growth: Evidence from Organization of Islamic Cooperation countries
Authors: Ali Sajid , Yusop Zulkornain , Kaliappan Shivee Ranjanee , Chin Lee , Nazar Raima
Published: February 2021

The study analyzes the impact of trade openness, human capital, and institutional performance on economic growth in OIC countries. The traditional methodologies of panel data ignore the issues of cross‐sectional dependence (CD) and heterogeneity and give spurious results. A novel econometric technique “dynamic common correlated effects (DCCE)” is used to tackle these issues. The long‐run estimates indicate that trade openness, human capital, and public expenditure have a positive and significant association with economic growth for higher‐income and overall OIC countries. However, trade openness has a negative, and human capital has an insignificant correlation with economic growth in lower‐income OIC countries. Institutional performance is positively correlated with economic growth in all groups of OIC countries. The study tends to support the call for the continuation of trade openness and human capital formation policies for overall and higher‐income OIC countries to get benefits in the form of economic growth.
Suitability of databases in the Asia‐Pacific for collaborative monitoring of vaccine safety
Authors: Duszynski Katherine M. , Stark James H. , Cohet Catherine , Huang Wan‐Ting , Shin Ju‐Young , Lai Edward Chia‐Cheng , Man Kenneth K. C. , Choi Nam‐Kyong , Khromava Alena , Kimura Tomomi , Huang Kui , Watcharathanakij Sawaeng , Kochhar Sonali , Chen Robert T. , Pratt Nicole L.
Published: February 2021

Introduction

Information regarding availability of electronic healthcare databases in the Asia‐Pacific region is critical for planning vaccine safety assessments particularly, as COVID‐19 vaccines are introduced. This study aimed to identify data sources in the region, potentially suitable for vaccine safety surveillance. This manuscript is endorsed by the International Society for Pharmacoepidemiology (ISPE).

Methods

Nineteen countries targeted for database reporting were identified using published country lists and review articles. Surveillance capacity was assessed using two surveys: a 9‐item introductory survey and a 51‐item full survey. Survey questions related to database characteristics, covariate and health outcome variables, vaccine exposure characteristics, access and governance, and dataset linkage capability. Other questions collated research/regulatory applications of the data and local publications detailing database use for research.

Results

Eleven databases containing vaccine‐specific information were identified across 8 countries. Databases were largely national in coverage (8/11, 73%), encompassed all ages (9/11, 82%) with population size from 1.4 to 52 million persons. Vaccine exposure information varied particularly for standardized vaccine codes (5/11, 46%), brand (7/11, 64%) and manufacturer (5/11, 46%). Outcome data were integrated with vaccine data in 6 (55%) databases and available via linkage in 5 (46%) databases. Data approval processes varied, impacting on timeliness of data access.

Conclusions

Variation in vaccine data availability, complexities in data access including, governance and data release approval procedures, together with requirement for data linkage for outcome information, all contribute to the challenges in building a distributed network for vaccine safety assessment in the Asia‐Pacific and globally. Common data models (CDMs) may help expedite vaccine safety research across the region.
Nivolumab plus ipilimumab, with or without enzalutamide, in AR‐V7‐expressing metastatic castration‐resistant prostate cancer: A phase‐2 nonrandomized clinical trial
Authors: Shenderov Eugene , Boudadi Karim , Fu Wei , Wang Hao , Sullivan Rana , Jordan Alice , Dowling Donna , Harb Rana , Schonhoft Joseph , Jendrisak Adam , Carducci Michael A. , Eisenberger Mario A. , Eshleman James R. , Luo Jun , Drake Charles G. , Pardoll Drew M. , Antonarakis Emmanuel S.
Published: February 2021

Background

AR‐V7‐positive metastatic prostate cancer is a lethal phenotype with few treatment options and poor survival.

Methods

The two‐cohort nonrandomized Phase 2 study of combined immune checkpoint blockade for AR‐V7–expressing metastatic castration‐resistant prostate cancer (STARVE‐PC) evaluated nivolumab (3 mg/kg) plus ipilimumab (1 mg/kg), without (Cohort 1) or with (Cohort 2) the anti‐androgen enzalutamide. Co‐primary endpoints were safety and prostate‐specific antigen (PSA) response rate. Secondary endpoints included time‐to‐PSA‐progression‐free survival (PSA‐PFS), time‐to‐clinical/radiographic‐PFS, objective response rate (ORR), PFS lasting greater than 24 weeks, and overall survival (OS).

Results

Thirty patients were treated with ipilimumab plus nivolumab (N = 15, Cohort 1, previously reported), or ipilimumab plus nivolumab and enzalutamide (N = 15, Cohort 2) in patients previously progressing on enzalutamide monotherapy. PSA response rate was 2/15 (13%) in cohort 1 and 0/15 in cohort 2, ORR was 2/8 (25%) in Cohort 1 and 0/9 in Cohort 2 in those with measureable disease, median PSA‐PFS was 3.0 (95% confidence interval [CI]: 2.1–NR) in cohort 1 and 2.7 (95% CI: 2.1–5.9) months in cohort 2, and median PFS was 3.7 (95% CI: 2.8–7.5) in cohort 1 and 2.9 (95% CI: 1.3–5.8) months in cohort 2. Three of 15 patients in cohort 1 (20%, 95% CI: 7.1%–45.2%) and 4/15 patients (26.7%, 95% CI: 10.5%–52.4%) in cohort 2 achieved a durable PFS lasting greater than 24 weeks. Median OS was 8.2 (95% CI: 5.5–10.4) in cohort 1 and 14.2 (95% CI: 8.5–NA) months in cohort 2. Efficacy results were not statistically different between cohorts. Grade‐3/4 adverse events occurred in 7/15 cohort 1 patients (46%) and 8/15 cohort 2 patients (53%). Combined cohort (N = 30) baseline alkaline phosphatase and cytokine analysis suggested improved OS for patients with lower alkaline phosphatase (hazards ratio [HR], 0.30; 95% CI: 0.11–0.82), lower circulating interleukin‐7 (IL‐7) (HR, 0.24; 95% Cl: 0.06–0.93) and IL‐6 (HR, 0.13; 95% Cl: 0.03–0.52) levels, and higher circulating IL‐17 (HR, 4.53; 95% CI: 1.47–13.93) levels. There was a trend towards improved outcomes in men with low sPD‐L1 serum levels.

Conclusion

Nivolumab plus ipilimumab demonstrated only modest activity in patients with AR‐V7‐expressing prostate cancer, and was not sufficient to justify further exploration in unselected patients. Stratification by baseline alkaline phosphatase and cytokines (IL‐6, −7, and −17) may be prognostic for outcomes to immunotherapy.
Examination of Spontaneous Orientation Polarization in Wet‐Processed Tris(8‐hydroxyquinolinato)aluminum Film Measured by Rotary Kelvin Probe Method
Authors: Ohara Masahiro , Watanabe Tatsuya , Tanaka Yuya , Ishii Hisao
Published: February 2021

Recently, a spontaneous orientation polarization (SOP) has attracted much attention as an important factor improving the performance of organic light‐emitting devices. However, so far, SOP is reported only for films fabricated by vacuum vapor deposition, and no direct attempt is made to examine the existence of SOP for wet‐processed film. To examine this phenomenon, it is necessary to completely exclude light illumination in the sample system, as photocarriers can reduce or eliminate the surface potential caused by the SOP formation. Herein, the SOP of wet‐processed tris(8‐hydroxyquinolinato)aluminum (Alq3) film on an indium‐tin‐oxide substrate is investigated using a novel rotary Kelvin probe method. Film formation and surface potential measurement are conducted under completely dark condition. A surface potential shift of −0.33 V is observed for a 1 μm thick film of Alq3, indicating that the SOP of wet‐processed Alq3 film is negligible, in contrast to vacuum‐evaporated film.