bluuebunny/crossref_metadata_2025 huggingface dataset:
Should Attendance Be Required in Lecture Classrooms in Dental Education? Two Viewpoints
Authors: Cutler Christopher W. , Parise Mary , Seminario Ana Lucia , Mendez Maria Jose Cervantes , Piskorowski Wilhelm , Silva Renato
Published: June 2020

This Point/Counterpoint discusses the long‐argued debate over whether lecture attendance in dental school at the predoctoral level should be required. Current educational practice relies heavily on the delivery of content in a traditional lecture style. Viewpoint 1 asserts that attendance should be required for many reasons, including the positive impact that direct contact of students with faculty members and with each other has on learning outcomes. In lectures, students can more easily focus on subject matter that is often difficult to understand. A counter viewpoint argues that required attendance is not necessary and that student engagement is more important than physical classroom attendance. This viewpoint notes that recent technologies support active learning strategies that better engage student participation, fostering independent learning that is not supported in the traditional large lecture classroom and argues that dental education requires assimilation of complex concepts and applying them to patient care, which passing a test does not ensure. The two positions agree that attendance does not guarantee learning and that, with the surge of information technologies, it is more important than ever to teach students how to learn. At this time, research does not show conclusively if attendance in any type of setting equals improved learning or ability to apply knowledge.
Does Reflective Learning with Feedback Improve Dental Students’ Self‐Perceived Competence in Clinical Preparedness?
Authors: Ihm Jung-Joon , Seo Deog-Gyu
Published: June 2020

The value of dental students’ self‐assessment is often debated. The aim of this study was to explore whether reflective learning with feedback enabled dental students to more accurately assess their self‐perceived levels of preparedness on dental competencies. Over 16 weeks, all third‐ and fourth‐year students at a dental school in the Republic of Korea took part in clinical rotations that incorporated reflective learning and feedback. Following this educational intervention, they were asked to assess their perceptions of their clinical competence. The results showed that the students reported feeling most confident about performing periodontal treatment (mean 7.1 on a ten‐point scale) and least confident about providing orthodontic care (mean 5.6). The fourth‐year students reported feeling more confident on all the competencies than the third‐year students. Their self‐perceived competence in periodontal treatment and oral medicine significantly predicted the instructors’ clinical evaluations. This study offered insights into determining if structured reflective learning with effective feedback helps to increase dental students’ self‐perceived level of clinical preparedness.
An Exploration of Dental Students’ Assumptions About Community‐Based Clinical Experiences
Authors: Major Nicole , McQuistan Michelle R.
Published: June 2020

The aim of this study was to ascertain which assumptions dental students recalled feeling prior to beginning community‐based clinical experiences and whether those assumptions were fulfilled or challenged. All fourth‐year students at the University of Iowa College of Dentistry & Dental Clinics participate in community‐based clinical experiences. At the completion of their rotations, they write a guided reflection paper detailing the assumptions they had prior to beginning their rotations and assessing the accuracy of their assumptions. For this qualitative descriptive study, the 218 papers from three classes (2011–13) were analyzed for common themes. The results showed that the students had a variety of assumptions about their rotations. They were apprehensive about working with challenging patients, performing procedures for which they had minimal experience, and working too slowly. In contrast, they looked forward to improving their clinical and patient management skills and knowledge. Other assumptions involved the site (e.g., the equipment/facility would be outdated; protocols/procedures would be similar to the dental school's). Upon reflection, students reported experiences that both fulfilled and challenged their assumptions. Some continued to feel apprehensive about treating certain patient populations, while others found it easier than anticipated. Students were able to treat multiple patients per day, which led to increased speed and patient management skills. However, some reported challenges with time management. Similarly, students were surprised to discover some clinics were new/updated although some had limited instruments and materials. Based on this study's findings about students’ recalled assumptions and reflective experiences, educators should consider assessing and addressing their students’ assumptions prior to beginning community‐based dental education experiences.
Identifying Noncognitive Skills That Contribute to Dental Students’ Success: Dental Faculty Perspectives
Authors: Virtue Shannon Myers , Pendergast Laura , Tellez Marisol , Waldron Elizabeth , Ismail Amid
Published: June 2020

The aims of this study were to identify noncognitive factors that dental faculty members perceived to contribute to dental students’ success and to assess dental faculty members’ ratings of the relative importance of these factors to academic performance, clinical performance, and overall success. Out of 184 eligible faculty members at one U.S. dental school, 43 respondents (23.3%) completed a survey in 2015–16. The survey asked respondents to rank the importance of seven noncognitive factors to academic performance, clinical performance, and overall success. Descriptive analysis was conducted to determine the ratings on importance of each noncognitive factor. Two additional open‐ended questions asked faculty members to 1) think of dental students who performed very well and list the noncognitive factors they believed contributed to those students’ success and 2) identify the two most important of those factors that contributed to success. Qualitative analysis was conducted to identify themes in the open‐ended responses. The respondents rated professionalism and preparedness highest in importance for overall success. Preparedness was rated highest in importance for academic performance, and communication was highest in importance for clinical performance. Six themes were identified in the open‐ended responses: communication/interpersonal skills, approach to learning, personal characteristics, professionalism, diverse experiences, and technical abilities. On both open‐ended items, the most frequently cited noncognitive skill was communication/interpersonal skills followed by approach to learning. In this study, dental faculty members perceived communication, preparedness, and professionalism as important skills contributing to dental students’ success.
The Relationship Between Dental Students’ Assessment Ability and Preclinical and Academic Performance in Operative Dentistry
Authors: Lee Cliff , Asher Sheetal R. , Chutinan Supattriya , Gallucci German O. , Ohyama Hiroe
Published: June 2020

Self‐assessment is a critical skill for health care professionals. Because these professionals must be lifelong, self‐directed learners and self‐regulating practitioners, the ability to self‐assess is essential for them. The aims of this study were to measure how dental students self‐assessed and peer‐assessed their performance in preclinical operative procedures and to evaluate any relationship between their assessment ability and preclinical skills or academic performance. The study was conducted from 2015 to 2016. Third‐year students at Harvard School of Dental Medicine self‐assessed their work on four preclinical practical exams: Class II amalgam preparation, Class II amalgam restoration, Class III composite preparation, and Class III composite restoration. Three faculty members graded the same preparations and restorations. The difference between the students’ self‐assessment and the mean faculty assessment was calculated as the student‐faculty (S‐F) gap. An absolute S‐F gap was also calculated with absolute values of differences. A total of 71 students completed these practical exams: 36 in the Class of 2016 and 35 in the Class of 2017. All 71 self‐assessments for each of the four practical exams were collected for a response rate of 100%. The results showed that the mean S‐F gap ranged from 2% to 8%, and the absolute S‐F gap ranged from 7% to 12%. Preclinical performance was correlated with self‐assessment accuracy. Low‐performing students significantly overestimated their self‐assessments compared to the rest of the class. High‐performing students had more accurate self‐assessments and tended to underestimate themselves. Overall, these results showed that the students had room for improving the accuracy of their self‐assessments.
Implication of hsa_circ_0028007 in reinforcing migration, invasion, and chemo‐tolerance of nasopharyngeal carcinoma cells
Authors: Qiongna Dong , Jiafeng Zhang , Yalin Hao , Ping He , Chuan Zhou , Xiaojie Jin , Miaomiao Zhao , Yiting Shao , Hui Zhao
Published: June 2020

Background

Given the reliability of circRNAs in symbolizing cancer progression, this investigation was designed to expound the involvement of hsa_circ_0028007 in regulating chemosensitivity of nasopharyngeal carcinoma (NPC) cells.

Methods

Altogether, 241 pairs of NPC tissues and para‐cancerous normal tissues were collected to identify NPC‐symbolic circRNAs, which have been screened by circRNA microarray in advance. Expressions of the circRNAs were determined by means of real‐time polymerase chain reaction (PCR). Besides, human NPC cell lines (ie, CNE2 and HONE1) were transfected by si‐hsa_circ_0028007 and si‐NC. Scratch assay, transwell assay, and MTT assay were performed to assess migration, invasion, and paclitaxel/cisplatin‐resistance of NPC cell lines.

Results

Hsa_circ_0028007 expression was abnormally heightened within NPC tissues in comparison with matched non‐tumor tissues (P < .05). Over‐expressed hsa_circ_0028007 was strongly associated with advanced (III‐IV) tumor stage, aggressive infiltration, and metastatic lymph nodes of NPC patients (P < .05). Regarding in vitro experiments, hsa_circ_0028007 expression was elevated in CNE2 and HONE1 cell lines as compared with HENE cell line (P < .05). Silencing of hsa_circ_0028007 not merely sensitized CNE2 and HONE1 cells against paclitaxel and cisplatin (P < .05), but also significantly repressed migration and invasion of the cell lines (P < .05).

Conclusion

Hsa_circ_0028007 was involved in facilitating progression and chemo‐resistance of NPC, which might offer an alternative for NPC treatment.
Use of carglumic acid in valproate‐induced hyperammonemia: 25 pediatric cases
Authors: Palomino Pérez Laura María , Martín‐Rivada Álvaro , Cañedo Villaroya Elvira , García‐Peñas Juan José , Cuervas‐Mons Vendrell Margarita , Pedrón‐Giner Consuelo
Published: June 2020

Hyperammonemic encephalopathy is a rare but potentially dangerous complication of the antiepileptic drug (AED) sodium valproate (VPA). We report a retrospective study of 25 pediatric patients, (15 females [60%]; age: 7.6 ± 4.9 years), with different underlying disorders, who suffered from hyperammonemia due to VPA and who were treated with carglumic acid (CA). The duration of treatment with VPA was 15 ± 1 month, with a dose of 40 ± 16.6 mg/kg/d. VPA blood levels were 75.5 ± 60 mg/L with seven patients being overdosed (>100 mg/L). Twenty‐three patients received concomitant treatment with other AEDs. The initial dose of CA was 100 mg/kg. Subsequently, CA doses of 25 mg/kg were given to 22 patients every 6 hours (average treatment length 2.17 ± 1.1 days) until ammonemia was normalized. In nine patients, CA was used in combination with other drugs to treat hyperammonemia. In all cases, blood ammonia levels were brought under control and symptoms of hyperammonemia resolved. Two hours after CA administration, the average reduction in ammonium levels was 53 ± 29 and 88.6 ± 47.5 μmol/L at 24 hours, resulting in a statistically significant decrease when compared to pretreatment levels. There were no statistically significant differences between sexes, in the presence or not of cognitive impairment or previous carnitine treatment. There were no statistically significant differences when comparing treatment with CA plus ammonia scavengers vs CA alone. In 17 patients (68%) VPA was discontinued and 62% of the patients who maintained treatment had recurrent episodes of hyperammonemia.
The possible impairment of respiratory‐related neural loops may be associated with the silent pneumonia induced by SARS‐CoV‐2
Authors: Tan Bai‐Hong , Zhang Yan , Gui Yue , Wu Shuang , Li Yan‐Chao
Published: June 2020

As compared to many other viral pulmonary infections, there existed several peculiar manifestations in the COVID‐19 patients, including the “silence” of pneumonia in both mild and severe cases and a long intensive care unit stay for those requiring invasive mechanical ventilation. Similar silent pneumonia has been documented in the infectioninduced by H5N1 influenza virus HK483 and was found to result from the direct attack of the virus on the bronchopulmonary C‐fibers at the early stage and the final infection in the brainstem at the late stage. The long stay of critical patients in the intensive care unit is possibly due to the depression of central respiratory drive, which resulted in the failure to wean from the mechanic ventilation. Carotid and aortic bodies and bronchopulmonary C‐fibers are two key peripheral components responsible for the chemosensitive responses in the respiratory system, while triggering respiratory reflexes depends predominantly on the putative chemosensitive neurons located in the pontomedullary nuclei. In view of the findings for the H5N1 influenza virus, the silence of pneumonia induced by SARS‐CoV‐2 may be due to the possible impairment of peripheral chemosensitive reflexes as well as the damage to the respiratory‐related central neurons.
COVID‐19: A perspective on Africa's capacity and response
Authors: Dzinamarira Tafadzwa , Dzobo Mathias , Chitungo Itai
Published: June 2020

Global powerhouses with tried and tested health systems have struggled to contain the COVID‐19 pandemic. One is left to wonder what will be left of Africa, the second most populous continent after Asia, which is torn by civil wars, hunger, and diseases like AIDS and TB and, in recent years, the Ebola Virus Disease (EVD). The majority of countries’ health systems, already dependent on donor aid, are ill‐equipped and under‐resourced to deal with the raging pandemic. There is a lack of isolation and intensive care infrastructure, ventilators, and financial resources to bankroll the fight against COVID‐19 pandemic. However, there is some cause for optimism, for example, in West Africa where infrastructure like diagnostic testing facilities, intensive care units, surveillance, and systems for reporting emergencies used during the EVD outbreak of 2013–2016 can be leveraged to fight the COVID‐19 pandemic. Further, a number of African countries have responded swiftly by activating the necessary political and financial tools to combat the pandemic. Technical support from continental bodies like the Africa Centers for Disease Control and global development partners has improved the capacity of the continent to handle the pandemic. In this article, the authors unpack, review, and share a perspective on Africa's capacity to contain and control the COVID‐19 pandemic and review the current response.
Potential for elimination of SAR‐CoV‐2 through vaccination as inspired by elimination of multiple influenza viruses through natural pandemics or mass vaccination
Authors: Chen Ji‐Ming , Sun Ying‐Xue , Chen Ji‐Wang
Published: June 2020

The ongoing pandemic of coronavirus disease 2019 (COVID‐19) caused by the novel virus severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has claimed many lives worldwide. To combat the pandemic, multiple types of vaccines are under development with unprecedented rapidity. Theoretically, future vaccination against COVID‐19 may fall into long‐term costly guerrilla warfare between SARS‐CoV‐2 and humans. Elimination of SARS‐CoV‐2 through vaccination to avoid the potential long‐term costly guerrilla warfare, if possible, is highly desired and worth intensive consideration. Human influenza pandemics emerging in 1957, 1968, and 2009 established strong global herd immunity and led to the elimination of three human influenza viruses, which circulated worldwide for years before the pandemics. Moreover, both clade 7.2 of subtype H5 highly pathogenic avian influenza virus and subtype H7N9 avian influenza virus circulated in poultry in China for years, and they have been virtually eliminated through mass vaccination in recent years. These facts suggest that the rapid establishment of global herd immunity through mass vaccination using an appropriate vaccine could eliminate SARS‐CoV‐2. The coming 2 years are a golden time for elimination through vaccination, which requires tremendous national and international collaboration. This review also prioritizes the efficacy of vaccines for COVID‐19 and elucidates the importance of the development of more live vaccines for COVID‐19.
Can fructose influence the development of obesity mediated through hypothalamic alterations?
Authors: Cargnin‐Carvalho Anderson , de Mello Aline Haas , Bressan Joice Benedet , Backes Kassiane Mathiola , Uberti Marcela Fornari , Fogaça Jéssica Benedet , da Rosa Turatti Cristini , Cavalheiro Eulla Keimili Fernandes Ferreira , Vilela Thais Ceresér , Rezin Gislaine Tezza
Published: June 2020

Epidemiological data from the last decades point to an exponential growth in the number of obese people. Different behavioral factors, mainly associated with food consumption, appear to contribute significantly to its development. Concomitant with increased obesity rates, an increase in the consumption of fructose has been observed; therefore, fructose consumption has been implicated as an important obesogenic factor. However, changes in brain activity due to fructose consumption are possible, especially in relation to hypothalamic satiety mechanisms. In addition, the obese state may provide an environment of chronic inflammation and further contribute to the discontinuation of satiety mechanisms in the hypothalamus. We briefly review the intrinsic alterations to the increased adipose tissue, its connections with the hypothalamus in the control of energy signaling mechanisms and, consequently, the participation of fructose as a co‐adjuvant or trigger. Presenting the current context with clinical trials involving human and animal studies, we seek to contribute to a better understanding of the role of fructose in the progression of obesity.
Metabolic health and lifestyle medicine should be a cornerstone of future pandemic preparedness
Authors: Wood Thomas R. , Jóhannsson Guðmundur F.
Published: June 2020

The recent impact of SARS‐CoV‐2 and coronavirus disease 2019 (COVID‐19) has shown major differences in infrastructure and approach across healthcare systems worldwide. One thing we can already be certain of is that governments and policy makers worldwide will place a greater focus on pandemic preparedness in the future. However, as well as ensuring that robust pipelines for rapid test, highly effective treatment or vaccine, and personal protective equipment (PPE) production are in place, we must address underlying resilience and susceptibility of our populations to infectious disease. Although the true spread and case fatality rate of SARS‐CoV‐2 may not be known for several months or even years, what is becoming increasingly clear is the significant degree to which underlying conditions associated with suboptimal metabolic health appear to be associated with poor outcomes in those with COVID‐19. Considering the nature of these underlying conditions, such as obesity and hypertension, lifestyle‐based approaches are likely to be one of our best tools in order to address ongoing and future disease burden during pandemics.
In Vivo Photodynamic Therapy With a Lipophilic Zinc(II) Phthalocyanine Inhibits Colorectal Cancer and Induces a Th1/CD8 Antitumor Immune Response
Authors: Chiarante Nicolás , Duhalde Vega Maite , Valli Federico , Zotta Elsa , Daghero Hellen , Basika Tatiana , Bollati‐Fogolin Mariela , García Vior María C. , Marino Julieta , Roguin Leonor P.
Published: June 2020

Background and Objectives

Photodynamic therapy (PDT) is an antitumor procedure clinically approved for the treatment of different cancer types. Despite strong efforts and promising results in this field, PDT has not yet been approved by any regulatory authority for the treatment of colorectal cancer, one of the most prevalent gastrointestinal tumors. In the search of novel therapeutic strategies, we examined the in vivo effect of PDT with a lipophilic phthalocyanine (Pc9) encapsulated into polymeric poloxamine micelles (T1107) in a murine colon carcinoma model.

Study Design/Materials and Methods

In vivo assays were performed with BALB/c mice challenged with CT26 cells. Pc9 tumor uptake was evaluated with an in vivo imaging system. Immunofluorescence, western blot, and flow cytometry assays were carried out to characterize the activation of apoptosis and an antitumor immune response.

Results

Pc9‐T1107 effectively delayed tumor growth and prolonged mice survival, without generating systemic or tissue‐specific toxicity. The induction of an apoptotic response was characterized by a decrease in the expression levels of Bcl‐XL, Bcl‐2, procaspase 3, full length Bid, a significant increment in the amount of active caspase‐3 and the detection of PARP‐1 cleavage. Infiltration of CD8+ CD107a+ T cells and higher levels of interferon‐γ and tumor necrosis factor‐α were also found in PDT‐treated tumors.

Conclusions

Pc9‐T1107 PDT treatment reduced tumor growth, inducing an apoptotic cell death and activating an immune response. Lasers Surg. Med. © 2020 Wiley Periodicals LLC
Patients' satisfaction and safety of bulk injection therapy Urolastic for treatment of stress urinary incontinence: A cross‐sectional study
Authors: Casteleijn Fenne M. , Kowalik Claudia R. , Berends Claudia , Blaganje Mija , Lasić Pecev Mateja , van der Linden Ellen , Zwolsman Sandra E. , Roovers Jan‐Paul W. R. , Minnee Pieter
Published: June 2020

Aims

Primary outcome was to evaluate patients' satisfaction after being treated with bulk injection therapy polydimethylsiloxane Urolastic (PDMS‐U) for stress urinary incontinence (SUI). Secondary outcomes were: subjective cure, objective cure, severity of SUI symptoms, complications, reintervention rate, and disease‐specific quality of life. Furthermore, to determine if outcomes worsened during time‐after‐treatment (time‐frames: 0‐12, 13‐24, and ≥25 months).

Methods

In a cross‐sectional design, patients treated with PDMS‐U were recruited for hospital revisit. The primary outcome, patients' satisfaction, was assessed by the surgical satisfaction questionnaire. Subjective cure, objective cure, and severity of symptoms were assessed by the patients global impression of improvement, standardized cough stress test, and Sandvik severity scale, respectively. Medical charts and face‐to‐face interviews were used to determine complications and reinterventions.

Results

About 110 patients participated, 87 revisited the hospital. Median follow‐up was 25 months (interquartile range: 14;35 months). Patients' satisfaction rate was 51%. Subjective and objective cure were respectively 46% and 47%. Most prevalent complications were: urinary retention (22%), pain (15%), and dyspareunia (15%). Exposure and erosion occurred in 7% and 5%, respectively. Reintervention rate of reinjection and excision of bulk material was 6% and 18.0%, respectively. Objective cure significantly worsened during time‐after‐treatment (P = < .05).

Conclusions

About half of the patients being treated with PDMS‐U were satisfied and subjectively cured 2 years after treatment, although the majority still experienced symptoms of SUI. Most complications were mild and transient, however, in 18% excision of bulk material was indicated for severe or persistent complications such as pain, exposure, or erosion.
Contemporary Synthesis of Ultrasmall (sub‐10 nm) Upconverting Nanomaterials
Authors: Joshi Tanmaya , Mamat Constantin , Stephan Holger
Published: June 2020

Due to their unique photophysical properties, upconverting nanoparticles (UCNPs), i. e. particles capable of converting near‐infrared (NIR) photons into tunable emissions in the range of ultraviolet (UV) to NIR, have great potential for use in various biomedical fields such as bioimaging, photodynamic therapy and bioanalytical applications. As far as biomedical applications are concerned, these materials have a number of advantageous properties such as brilliant luminescence and exceptional photostability. Very small “stealth” particles (sub‐10 nm), which can circulate in the body largely undetected by the immune system, are particularly important for in vivo use. The fabrication of such particles, which simultaneously have a defined (ultrasmall) size and the required optical properties, is a great challenge and an area that is in its infancy. This minireview provides a concise overview of recent developments on appropriate synthetic methodologies to produce such UCNPs. Particular attention was given to the influence of both surfactants and dopants used to precisely adjust size, crystalline phase and optical properties of UCNPs.
Assessing public expenditure efficiency at the subnational level in India: Does governance matter?
Authors: Mohanty Ranjan Kumar , Bhanumurthy N. R.
Published: June 2020

The issue of public expenditure efficiency has drawn the attention of both policymakers and researchers globally. The paper attempts to measure the efficiency of government expenditures on the social sector, especially health and education, among the major Indian states using various data envelopment analysis. The paper also attempts to understand what drives public expenditure efficiency. The results suggest that there is a wide variation in the efficiency of public spending as well as scope for resource‐saving at the subnational level in India. It finds that states are spending their resources more efficiently on education than on health and the overall social sector spending. It also finds that quality of governance, economic growth, and mothers' schooling affects the efficiency of education, health, and social sector with governance to have a larger effect compared to other factors. Overall, the study suggests that improving governance could yield better outcomes from public expenditure.

Highlights

The paper looks at understanding the issue of public expenditure of efficiency of education, health, and overall social sector over the 15 year period since the year 2000, broadly covering the millennium development goal period at the subnational level in India.

By using data envelopment analysis, the study derives the efficiency scores for major states for three‐time periods for input‐oriented, output‐oriented, and nonoriented conditions.

The results broadly suggest that there is wide divergence in terms of efficiency levels across the states and also finds some spatial patterns. States in Western region appear to be more efficient than compared to other regions.

Overall, the states appear to be spending efficiently on the education compared to health.

In terms of what explains such divergences in efficiency levels, the study looks at broader determinants‐overall governance‐with conditional variables such as level of incomes and mothers' schooling.

The econometric results suggest that it is the level of governance that affects the efficiency levels at the subnational level in India.
Flame retardant effect and mechanism of benzoxazine as synergist in intumescent flame‐retardant polyoxymethylene
Authors: Lu Zhehong , Feng Weili , Kang Xinglong , Wang Junliang , Xu Hao , Li Jiantong , Wang Yanpeng , Liu Baoying , Fang Xiaomin
Published: June 2020

Benzoxazine monomers of traditional bisphenol‐A benzoxazine (BA‐a) and bisphenol‐A benzoxazine containing trialkoxysilane (BA‐a‐Si) were synthesized and incorporated into polyoxymethylene/ammonium polyphosphate/melamine (POM/APP/ME) to improve the fire retardancy of POM. The flame retardation, thermal, and mechanical properties of POM composites were evaluated by cone calorimeter, limiting oxygen index (LOI), and the Underwriters Laboratories‐94 (UL‐94) vertical burning tests, as well as thermogravimetric analysis and mechanical tests. Addition of BA‐a‐Si (2 wt%) into POM could simultaneously improve its flame retardancy (UL‐94 vertical burning rating to V‐0 rating and LOI value reached 52.1%) and notched impact strength (increased by 33.3% and 100.0% compared with that of POM/APP/ME and POM/APP/ME/BA‐a composites). Notably, compared with POM/APP/ME composite, the smoke productions of both the composites with benzoxazines were significantly suppressed. In contrast, the peak heat release rate and total heat release of composite with 2 wt% BA‐a‐Si were 33.3% and 32.9% lower than those of composite with 2 wt% BA‐a, which were closely related to the formation of high quality and quantity of charred residue. In summary, benzoxazine, especially siloxane‐containing benzoxazine, plays an effective role in flame retarding POM acting as charring agent and synergistic flame retardant.
How I approach peer support in pediatric hematology/oncology
Authors: Nadel Amy L. , Barbach Nancy , Fish Jonathan D.
Published: June 2020

Peer support has begun to gain traction as a mechanism for improving well‐being in medicine. In this paper, we share our experience building, training, and piloting a peer support team based on a “critical incident stress management” model. The HOPES team (Helping Our Peers Endure Stress) is dedicated to, and composed entirely of, members of our division of pediatric hematology/oncology. Peer support will not solve all the well‐being problems afflicting medicine. It is, however, a very good place to start.
Empirical assessment of case‐based methods for identification of drugs associated with upper gastrointestinal bleeding in the French National Healthcare System database (SNDS)
Authors: Thurin Nicolas H. , Lassalle Régis , Schuemie Martijn , Pénichon Marine , Gagne Joshua J. , Rassen Jeremy A. , Benichou Jacques , Weill Alain , Blin Patrick , Moore Nicholas , Droz‐Perroteau Cécile
Published: June 2020

Purpose

Upper gastrointestinal bleeding (UGIB) is a severe and frequent drug‐related event. In order to enable efficient drug safety alert generation in the French National Healthcare System database (SNDS), we assessed and calibrated empirically case‐based designs to identify drug associated with UGIB risk.

Methods

All cases of UGIB were extracted from SNDS (2009‐2014) using two definitions. Positive and negative drug controls were used to compare 196 self‐controlled case series (SCCS), case‐control (CC) and case‐population (CP) design variants. Each variant was evaluated in a 1/10th population sample using area under the receiver operating curve (AUC) and mean square error (MSE). Parameters that had major impacts on results were identified through logistic regression. Optimal designs were replicated in the unsampled population.

Results

Using a specific UGIB definition, AUCs ranged from 0.64 to 0.80, 0.44 to 0.61 and 0.50 to 0.67, for SCCS, CC and CP, respectively. MSE ranged from 0.07 to 0.39, 0.83 to 1.33 and 1.96 to 4.6, respectively. Univariate regressions showed that high AUCs were achieved with SCCS with multiple drug adjustment and a 30‐day risk window starting at exposure. The top‐performing SCCS variant in the unsampled population yielded an AUC = 0.84 and MSE = 0.14, with 10/36 negative controls presenting significant estimates.

Conclusions

SCCS adjusting for multiple drugs and using a 30‐day risk window has the potential to generate UGIB‐related alerts in the SNDS and hypotheses on its potential population impact. Negative control implementation highlighted that low systematic error was generated but that protopathic bias and confounding by indication remained unaddressed issues.
Registration of ‘CP 09‐1385’ sugarcane
Authors: Coto Arbelo O. , Sandhu H.S. , Zhao D. , Gordon V. , Comstock J.C. , Sood S.G. , McCorkle K. , Davidson W. , Baltazar M. , McCord P. , Singh M.P.
Published: June 2020

‘CP 09‐1385’ (Reg. no. CV‐194; PI 691535) sugarcane, a complex hybrid of Saccharum spp., was developed through cooperative research conducted by the USDA–ARS, the University of Florida, and the Florida Sugar Cane League. It was selected from a biparental cross made at the USDA–ARS Sugarcane Field Station in Canal Point, FL, in December 2006 using the cultivars ‘CP 01‐2459’ as the female parent and ‘CP 00‐2188’ as the male parent. CP 09‐1385 was superior to the check cultivars ‘CL 88‐4730’, ‘CP 89‐2143’, and ‘CP 78‐1628’ on sand soils on the basis of cane and sucrose yields, and economic index (i.e., overall profitability). On muck soils, CP 09‐1385 showed superior cane and sucrose yields, and economic index compared with checks CP 78‐1628, CP 89‐2143, and ‘CP 00‐1101’. CP 09‐1385 is resistant to brown rust and showed resistance to Sugarcane mosaic virus under artificial inoculation. It is moderately resistant to orange rust, smut, and Sugarcane yellow leaf virus. This new cultivar is moderately susceptible to leaf scald on muck soils but moderately resistant on sand soils. CP 09‐1385 is moderately susceptible to ratoon stunting disease. These susceptibility levels are within an acceptable range for commercial production. Last, CP 09‐1385 demonstrates moderate to low tolerance to freezing conditions. This cultivar was released in June 2016 to be commercially cultivated in Florida on muck and sand lands.
Effectiveness of fractional exhaled nitric oxide for asthma management in children: A systematic review and meta‐analysis
Authors: Wang Xia , Tan Xiangsheng , Li Qubei
Published: June 2020

Background

Fractional exhaled nitric oxide (FENO) is a noninvasive strategy for diagnosing and managing asthma, but limited evidence is available for the effects of FENO‐guided asthma management in children. This meta‐analysis aimed to evaluate the effectiveness of FENO for asthma management in children.

Methods

In total, six databases were searched, and 23 randomized controlled trials that compared the effects of FENO‐guided asthma management with those not using FENO in pediatric asthma were included. Methodological quality was assessed using the Cochrane risk‐of‐bias tool. Data for relevant endpoints were extracted and analyzed.

Results

Our meta‐analysis of the effectiveness of FENO for asthma management in children showed that FENO‐guided asthma management helped reduce the numbers of children with asthma exacerbations (risk ratio: 0.73; 95% confidence interval [CI:] 0.63‐0.84; P < .0001) and the exacerbation frequency (standardized mean difference: −1.57; 95% CI: −2.25 to −0.88; P < .00001). Furthermore, it improved the predicted forced expiratory volume in 1 minute (weighted mean difference [WMD]: 3.67; 95% CI: 0.91‐6.43; P = .009) and was also found to be associated with an increase of daily inhaled corticosteroid (ICS) dose (WMD: 64.17 μg; 95% CI: 53.59‐74.75; P < .00001).

Conclusions

This meta‐analysis indicated that the FENO‐guided asthma management strategy could partially improve the outcomes of pediatric asthma at the expense of increased ICS use.
Effects of saffron (Crocus sativus L.) supplementation on inflammatory biomarkers: A systematic review and meta‐analysis
Authors: Asbaghi Omid , Sadeghian Mehdi , Sadeghi Omid , Rigi Somaye , Tan Shing Cheng , Shokri Azad , Mousavi Seyed Mohammad
Published: June 2020

The effect of saffron supplementation on subclinical inflammation remains inconclusive. We performed a systematic review and meta‐analysis to summarize available findings on the effect of saffron supplementation on inflammatory biomarkers (C‐reactive protein [CRP], tumor necrosis factor‐α [TNF‐α], and interleukin‐6 [IL‐6]) in adults. We searched PubMed/Medline, Scopus, Web of Science, and Google Scholar databases up to November 2019 using relevant keywords to identify eligible trials. All randomized controlled trials (RCTs) that examined the effect of oral saffron supplementation on plasma concentrations of CRP, TNF‐α, and IL‐6 were included. For each outcome, mean differences and SDs were pooled using a random‐effects model. Overall, eight RCTs were included in this meta‐analysis. The pooled results showed that saffron supplementation did not result in significant changes in serum CRP (weighted mean difference [WMD]: −0.43 mg/L; 95% confidence interval [CI]: −1.04 to 0.17; p = .16), serum TNF‐α (WMD: −1.29 pg/mL; 95% CI: −4.13 to 1.55; p = .37), and IL‐6 concentrations (WMD: 0.11 pg/mL; 95% CI: −0.79 to 1.00; p = .81). Subgroup analysis indicated a significant reduction in serum CRP levels in studies with baseline CRP of ≥3 mg/L, saffron dosage of ≤30 mg/day, and intervention duration of <12 weeks, as well as trials that used crocin. Similarly, saffron was found to decrease TNF‐α in studies that recruited non‐diabetic subjects, subjects with baseline levels of ≥15 pg/mL, and participants with <50 years old, as well as trials that administered saffron at the dosage of ≤30 mg/day. We also found a significant non‐linear effect of saffron dosage on serum CRP concentrations (pnon‐linearity = .03). The overall results indicated that saffron supplementation did not affect inflammatory cytokines. Further high‐quality studies are needed to firmly establish the clinical efficacy of supplemental saffron on inflammatory biomarkers.
Multisystem Langerhans cell histiocytosis in an adult non‐smoker treated with steroid therapy
Authors: Ito Haruka , Ito Masaru , Kakuta Yukio , Kaneko Takeshi , Okudera Koji , Ogura Takashi
Published: June 2020

We describe the case of a 29‐year‐old female non‐smoker who was treated with steroid therapy for a subacute exacerbation of multisystem Langerhans cell histiocytosis (MS‐LCH) with worsening lung, skin, and oral mucosal lesions. The patient developed pneumonia, and computed tomography (CT) showed multiple thin‐walled cavities. Transbronchial lung cryobiopsy (TBLC) specimens revealed Langerhans cells, which were positive for CD1a and S‐100 expression. Similar histological findings were detected in the submandibular gland, skin, and tooth. On the basis of these findings, the patient was diagnosed with MS‐LCH and subsequently treated with steroid therapy. From the literature review, case reports of non‐smokers with pulmonary lesions that worsened and required treatment are rare. Almost all cases recurred and needed additional treatment. This case study contributes to our understanding of the potential role of steroid therapy in MS‐LCH treatment. Additionally, TBLC is a novel, potentially safer, diagnostic tool that has not been previously described for LCH.
The impact of global competitiveness on the growth of bioenergy industry in EU‐28 region
Authors: Alsaleh Mohd , Zubair Azeem Oluwaseyi , Abdul‐Rahim Abdul Samad
Published: June 2020

This study investigates the effect of global competitiveness determinants on the growth of the bioenergy industry in the European Union (EU‐28) region from 1990–2018. Applying the panel fixed effect model, the results revealed that the bioenergy industry grows with an increase in the global competitiveness index. While human capital, innovation ecosystem, markets, enabling environment, and gross domestic product found to be increasing the growth. The finding implies that the growth of the bioenergy industry in EU‐28 developed countries can be effectively strengthened by improving the quality of human capital and enabling environment. Also, the result implies that the growth of the bioenergy industry in EU‐28 developing countries can effectively improve by increasing the quality innovations system and markets. These will eventually contribute to tackling global warming and environmental pollution. The estimated results are considered robust as validated by panel random effect and pooled Ordinary Least Squares estimators. The study recommends for EU‐28 countries to increase the efficiency of global competitiveness indicators to achieve social and environmental objectives. Policymakers should also invest more in global competitiveness factors to increase the supply and accessibility of bioenergy output. The authorities of these countries can equally emphasize on efficiency and sustainability of global competitiveness decomposition to achieve energy security and reduce dependency on fossil fuel.
Feasibility study evaluating arrhythmogenesis and cardiac damage after heart‐base irradiation in mice: A brief communication
Authors: Elliott James , Linder Keith , Nolan Michael W.
Published: June 2020

Radiation‐induced heart disease (RIHD) is a potential cause of morbidity and mortality in dogs undergoing thoracic irradiation. Arrhythmias and sudden death have been documented in dogs undergoing stereotactic body radiation therapy for heart base tumours. A study was proposed to interrogate the effect of different stereotactic‐like radiation prescriptions on RIHD development, including arrhythmogenesis and classical histological endpoints in a mouse model. A pilot study was performed initially. The heart base of CD1 (n = 3) and C57Bl/6J (n = 3) female mice were irradiated (12 Gy × 3, daily) with a clinical linear accelerator. No significant adverse effects were noted and each mouse survived the entire subsequent 3‐month observation period. At various time points, no arrhythmias were identified on ECG analysis. Cardiac histology (haematoxylin and eosin, and picrosirius red staining) was performed at 3 months. In a single CD1 mouse and two C57BI/6J mice, multifocal, minimal, peri‐vascular lymphoplasmacytic inflammation was noted within the irradiated proximal heart. In one mouse of each strain, a small, single focus of fibrinoid vascular necrosis was observed. Overall, there was no significant myocardial necrosis, atrophy or inflammation. Picrosirius red staining revealed no evidence of fibrosis in any mouse. Dosimetric verification indicated that the irradiation was successful and delivered as planned, with an average predicted‐to‐measured dose‐difference within 5%. While this study did not demonstrate significant arrhythmogenesis, certain modifications of the experimental mouse irradiation procedures are discussed which may enable more translationally relevant modelling of the canine cardiac response to SBRT‐like irradiation.
Towards System-Level Validation
Authors: Strasser T. I. , Pröstl Andrén F. , Calin M. , de Jong E. C. W. , Sosnina M.
Published: June 2020

Cyber-physical energy systems or smart grids tend to higher complexity due to the integration of renewables as well as the usage of advanced information and communication technology which is briefly outlined within this chapter. Moreover, the needs for system-level validation approaches, methods, and corresponding tools are discussed. Those needs are tackled by the ERIGrid approach which is also briefly sketched and introduced.
From Scenarios to Use Cases, Test Cases and Validation Examples
Authors: Maki K. , Kulmala A. , Heussen K. , Gehrke O. , Rikos E. , Merino J. , Rossi M. , Pellegrino L. , Sandroni C. , Degefa M. Z. , Taxt H. , Lagos D. , Kotsampopoulos P.
Published: June 2020

Selected validation scenarios and corresponding test cases in the context of the ERIGrid project are presented in this chapter. Furthermore, the benefits of using the ERIGrid validation method and testing tools are discussed on the realized system validation examples.
A 10d view on the KKLT AdS vacuum and uplifting
Authors: Gautason F.F. , Van Hemelryck V. , Van Riet T. , Venken G.
Published: June 2020

Abstract

We analyse the ten-dimensional Einstein equations in the KKLT setting. We verify that the quartic gaugino term is needed to remove singularities in the on-shell action as suggested by Hamada et al. We contrast two approaches that have been taken in the literature when employing the effect of gaugino condensation in the ten-dimensional equations of motion. Here we follow the proposal to insert explicit non-zero fermion bilinar vev into the localised energy-momentum tensor of the 7-branes obtained from varying the 10d off-shell action with respect to the 10d metric. Our procedure is common in semi-classical physics and is manifestly local in 10d. However, it does not lead to the KKLT effective field theory. The alternative procedure of deriving the energy momentum tensor after replacing fermion bilinears by the gaugino vev, might be less well motivated in 10d, but reproduces the results of the KKLT effective field theory.
A novel scenario in the semi-constrained NMSSM
Authors: Wang Kun , Zhu Jingya
Published: June 2020

Abstract

In this work, we develop a novel efficient scan method, combining the Heuristically Search (HS) and the Generative Adversarial Network (GAN), where the HS can shift marginal samples to perfect samples, and the GAN can generate a huge amount of recommended samples from noise in a short time. With this efficient method, we find a new scenario in the semi-constrained Next-to Minimal Supersymmetric Standard Model (scNMSSM), or NMSSM with non-universal Higgs masses. In this scenario, (i) Both muon g-2 and right relic density can be satisfied, along with the high mass bound of gluino, etc. As far as we know, that had not been realized in the scNMSSM before this work. (ii) With the right relic density, the lightest neutralinos are singlino-dominated, and can be as light as 0-12 GeV. (iii) The future direct detections XENONnT and LUX-ZEPLIN (LZ-7 2T) can give strong constraints to this scenario. (iv) The current indirect constraints to Higgs invisible decay

$$ {h}_2\to {\tilde{\chi}}_1^0{\tilde{\chi}}_1^0 $$

h
2

→

χ
˜

1
0

χ
˜

1
0

are weak, but the direct detection of Higgs invisible decay at the future HL-LHC may cover half of the samples, and that of the CEPC may cover most. (v) The branching ratio of Higgs exotic decay h
2
→ h
1
h
1
, a
1
a
1 can be over 20 percent, while their contributions

$$ \left({h}_2\to 4{\tilde{\chi}}_1^0\right) $$

h
2

→
4

χ
˜

1
0

to the invisible decay are very small.
Die interdisziplinäre alterstraumatologische Visite
Authors: Heck J. , Ranker A. , Wranke A. , Kano L. , Macke C. , Rademacher J. , Stichtenoth D. O. , Krause O.
Published: June 2020

Hintergrund

Ein orthogeriatrisches Komanagement kann die Behandlungsqualität alterstraumatologischer Patienten verbessern.

Fragestellung

Ziel dieser Arbeit ist es, Handlungsempfehlungen für den Klinikalltag zu formulieren, um die stationäre Behandlung unfallchirurgischer geriatrischer Patienten zu verbessern.

Material und Methoden

Über einen Zeitraum von 7 Monaten wurden 226 Patienten an 29 definierten, wöchentlichen Tagen unter Berücksichtigung aktueller Laborergebnisse, Vitalparameter, der Medikation sowie der klinischen Einschätzung des Pflegepersonals besprochen und visitiert. Neben Ärzten verschiedener Fachrichtungen (Unfallchirurgie, Geriatrie, Klinische Pharmakologie, Mikrobiologie) nahmen Pflegekräfte und Case Manager an den Visiten teil.

Ergebnisse

Pro Patientenkontakt wurden im Durchschnitt drei Handlungsempfehlungen ausgesprochen (zwei pharmakologische und eine allgemeine Empfehlung [z. B. zum Flüssigkeits- und Delirmanagement]). Pharmakologische und allgemeine Empfehlungen wurden in verschiedene Untergruppen eingeteilt. Die häufigste pharmakologische Empfehlung war, ein Medikament abzusetzen (30,4 % aller pharmakologischen Empfehlungen).

Diskussion

Bei der Pharmakotherapie geriatrischer Patienten müssen Kontraindikationen, Nebenwirkungen, Doppelverordnungen, zirkadiane Aspekte und die Nierenfunktion beachtet werden. Durch regelmäßige Reevaluation medizinischer Fremdkörper kann katheterassoziierten Infektionen vorgebeugt werden. Das Erkennen und die Behandlung eines postoperativen Delirs sind essenzielle Bestandteile einer interdisziplinären alterstraumatologischen Visite. Zur Beurteilung einer antiinfektiven Therapie leistet die Expertise eines Mikrobiologen/Infektiologen einen wertvollen Beitrag.