bluuebunny/crossref_metadata_2025 huggingface dataset:
Hermeneutisation of education in the digital age
Authors: Kuparashvili M D , Nikolaeva A B
Published: December 2020

This article aims to consider the possible inclusion of hermeneutic tools in modern educational models. Such techniques and methods of hermeneutics as understanding, reflection, interpretation can increase the degree of effectiveness of dialogue learning and the value of an educational workshop. In this situation, in our opinion, the educational space will acquire the necessary dynamism and mobility, which is especially important in the digital age. The hypothesis of a new hermeneutic model of education can become the basis for further reasoning in this vector.
Methodology of building a master’s individual educational route for effective development of professional competencies
Authors: Antamoshkina O I , Zinina O V , Olentsova J A
Published: December 2020

The 21st century is characterized by the beginning of informatization and digital technologies. For a modern specialist to solve most problems, it is necessary to have a high level of professional competence and be receptive to innovation. The Bologna system provides for the opportunity to get a bachelor’s degree in one direction, and finish a master’s degree in another. Thus, the master’s program can be applied to both bachelors and specialists who have a diploma in related fields of knowledge (in the same enlarged group of specialties), or completely from other fields of knowledge. Some bachelors and specialists often do not have the necessary knowledge to master a new specialty, which makes it necessary to form an individual educational route. Today, in the system of higher professional pedagogical education, students are given the opportunity to choose the subjects for the variable part of the working curriculum in accordance with the educational program for the training profile. In addition, you can get additional professional education through retraining programs. In this case, the student himself becomes the subject of designing an individual educational route, who chooses a certain additional educational program.
The University digital educational environment potential in the future teacher professional and personal development
Authors: Zakharova M A , Mezinov V N , Mironova E L
Published: December 2020

The transition to digital education is associated with economic, political changes in society, as well as with changes in infrastructural, communicative, and cultural nature. The University digital educational environment role in a professional and personal development system is being updated. The "professional and personal development a future teacher" scientific and theoretical analysis concept made it possible to consider professional and personal development as a becoming a teacher dynamic process, which entails the subject inner essence transformation through the interaction of self-improvement motivation, professional orientation and competence, creativity, personality traits and activities. This study purpose was to study different approaches to understanding this category, disclosing its essence and structure, establishing the basic requirements for its organization. The main research question was in which case the digital educational environment provides professional and personal development, competitiveness formation, communicative equality, the future teacher social experience interactivity. The leading methods in the research were: theoretical and methodological analysis, scientific research interdisciplinary analysis, system analysis, pedagogical interpretation method, comparison, generalization, concretization; experience in organizing multi-level education study, questionnaires, testing. It is shown that a teacher at a university professional and personal development effectiveness largely depends on the students, teachers, the digital educational environment and various conditions’ optimal interaction.
Integration of sustainability in metallurgical education: analysis of educational practices CDIO
Authors: Dubova I V , Sanacheva G S , Gilmanshina T R , Vasyunina N V , Merdak N V
Published: December 2020

Integration of sustainable development in education is now being addressed in numerous educational institutions across the globe. Based on different integration approaches, various teaching methods are being developed, applied and evaluated. A complex relationship exists between curriculum development and sustainable development. The goal of this paper is to present educational practices for integration of sustainable development in engineering education of metallurgy made by Siberian Federal University. We present in this study the results and reflections on the implementation of a specific teaching-learning methodology that has been designed to incorporate sustainability aspects in projects. These 12 ECTS-compulsory subjects are taught following the CDIO standards, according to which the students must develop a somehow innovative product or service from the conception and design to the implementation and operation. The results show that the students perceive that they have developed deep skills in sustainable development, as well as working across disciplines and with different stakeholders.
Academic motivation of students in the period of digital transformation of the educational environment
Authors: Pulyaeva V N , Gibadullin A A , Zerkin D G , Eismunt V V
Published: December 2020

The article presents the results of an empirical study of students of one of the leading financial and economic universities in the country, the main goal of which was to identify the features of motivation for educational activities in the higher education system based on an assessment of a number of psychological variables associated with motivation. At the same time, the authors used a number of psychological diagnostic techniques developed by experts in previous studies: life satisfaction, resilience, etc. The central place in the study is to identify the direction of academic motivation: internal, external and motivation in accordance with the theory of self-determination, which is widespread in modern psychological science personalities of E. Desi and R. Ryan. The study-involved students of various courses and areas of training for bachelor’s and master’s degrees, full-time and part-time studies, as well as those receiving higher education on a budgetary and paid basis. The recommendations developed by the authors to increase the level of motivation of students with low indicators of intrinsic motivation for educational activity are given.
Structural and logical circuits in learning activities under conditions of education digitalization
Authors: Bakeyeva L V , Brylevskaya L I , Pastukhova E V , Romanova Y S , Skepko O A
Published: December 2020

The digitalization of the educational system is more aimed at developing an independent, responsible and creative person. The more knowledge a student receives independently and actively engaged in self-education, the more he needs help, both practical and definite. Digitalization of the educational process requires a special approach to its development, redefining the role of the professor, searching for new possibilities of interaction between all participants, adaptation of existing or development of new methods and means of knowledge transfer and their control. One of the didactic methods of activating the cognitive abilities of students, which include thinking, memorizing, perceiving, imagining and presenting are structural and logical schemes. Their application in educational activities solves several tasks: the meaningful acquisition of new knowledge and increase the intellectual and creative potential of students, the study and use of services, programs or mobile applications to structure information and transform it into clear logical schemes for memory and playback. This article discusses the peculiarities of applying structural and logical schemes at different stages of the educational process in the conditions of education digitalization.
Elaborating test materials for digital assessment of BSc students’ learning outcomes in training area “Agroengineering”, profile "Electrical Equipment and Electrotechnology”
Authors: Zanfirova L V , Kovalenok T P , Ovsyannikova E A , Chistova Ya S , Sergeeva N A
Published: December 2020

The paper considers modern specific features and requirements for engineering education. The authors show changes in the forms, methods and means of professional education. The main engineering activities are specified for training area "Agroengineering". The paper underlines the importance of the comprehensive development of future engineers’ thinking, in particular, theoretical thinking, and the ability of performing logical actions with scientific concepts, using mental operations of comparison, concretizing, generalizing and abstraction. To check the development level of theoretical and logical thinking, the authors developed an educational and diagnostic test on the "Electrical Materials" course to note the necessity and possibilities of using computer testing for the strategic, systematic and objective assessment of students’ knowledge, in terms of the development of their professional thinking and competencies. There is a description of the procedure of elaborating test materials, and the test results are presented. The authors analyze the digital test results at the stage of ongoing control and the number of mistakes that students made when performing tasks of different subtests and sections. Assumptions are made about the possible reasons for the poor outcomes; possible ways to improve the test procedure are offered.
Principal components of implementation of “university-3.0” transformation in the development of innovative-entrepreneurial activities of modern higher educational institutions
Authors: Rakhmatov Shukhrat A , Nizamov Aslitdin B
Published: December 2020

Research of factors of support of innovative-entrepreneurial activities in higher education plays an important role in identifying problems in the management of innovation and entrepreneurship and its economic incentives. Because of the research, the importance of factors supporting innovation and entrepreneurship in higher education was assessed, the principal components of the development of innovation and entrepreneurship as a factor of competitiveness of higher education institutions, “University-3.0” transformation were identified and transformation model was developed.
The emergence of anthropogenic signal in mean and extreme precipitation trend over China by using two large ensembles
Authors: Li Wei , Chen Yang , Chen Weilin
Published: December 2020

Anthropogenic warming may impact mean and extreme precipitation trends by enhancing the water cycle, potentially bringing threats to human societies. The design of national-level policy for disaster prevention and mitigation depends on the reliable detection of anthropogenic forcing in mean and extreme precipitation changes there. The anthropogenic signal might be obscured by strong internal variability at a regional scale. The goal of this study is to investigate the emergence of anthropogenic signal in mean and extreme precipitation trends across China by using two large ensembles (CanESM2-LE and Community Earth System Model (CESM)-LE) of simulations during 1961–2010. Results show that the signal could not be detected in either mean or extreme precipitation trend during the current climate period (1961–2010). Following the RCP8.5 scenario, the signal is projected to emerge in mean precipitation around the 2020s and 2030s in the CanESM2-LE and CESM-LE, respectively, much earlier than in extreme precipitation. For extreme precipitation, the signal could be steadily detected no earlier than the 2030s for CanESM2-LE and the 2040s for CESM-LE. These projected times of emergence in precipitation changes highlight the urgency of preparing for an uncharted hydrological future dominated by anthropogenic warming.
Rydberg multidimensional states: Rényi and Shannon entropies in momentum space
Authors: Aptekarev A I , Belega E D , Dehesa J S
Published: December 2020

In this work the momentum spreading of a multidimensional hydrogenic system in highly excited (Rydberg) states is quantified by means of the Rényi and Shannon entropies of its momentum probability density. These quantities, which rest at the core of numerous fields from atomic and molecular physics to quantum technologies, are determined by means of a methodology based on the strong degree-asymptotics of a modified

L

q

-norm of the Gegenbauer polynomials which control the wavefunctions of these states in momentum space. The leading term of these entropic quantities is found from first principles, i.e. by means of the Coulomb potential parameters (space dimensionality, the nuclear charge) and the states’s hyperquantum numbers, in a rigorous simple manner. It is shown that they fulfill a logarithmic growth scaling law with the principal hyperquantum number n which characterizes the Rydberg state.
The peppermint breath test: a benchmarking protocol for breath sampling and analysis using GC–MS
Authors: Wilkinson M , White I , Hamshere K , Holz O , Schuchardt S , Bellagambi F G , Lomonaco T , Biagini D , Di Francesco F , Fowler S J
Published: December 2020

Exhaled breath contains hundreds of volatile organic compounds (VOCs) which offer the potential for diagnosing and monitoring a wide range of diseases. As the breath research field has grown, sampling and analytical practices have become highly varied between groups. Standardisation would allow meta-analyses of data from multiple studies and greater confidence in published results. Washout of VOCs from ingestion into the blood and subsequently breath could provide data for an initial assessment of inter-group performance. The Peppermint Initiative has been formed to address this task of standardisation. In the current study we aimed to generate initial benchmark values for thermal desorption–gas chromatography–mass spectrometry (TD–GC–MS) analysis of breath samples containing peppermint-derived VOCs using data from three independent European research groups. Initially, headspace analysis of peppermint oil capsules was performed to determine compounds of interest. Ten healthy participants were recruited by each three groups across Europe. The standard Peppermint protocol was followed. In brief, each participant provided a baseline breath sample prior to taking a peppermint capsule, with further samples collected at 60, 90, 165, 285 and 360 min following ingestion. Sampling and analytical protocols were different for each group, in line with their usual practice. Samples were analysed by TD–GC–MS and benchmarking values determined for the time taken for detected peppermint VOCs to return to baseline values. Sixteen compounds were identified in the capsule headspace, and all were confirmed in breath following ingestion of the peppermint capsules. Additionally, 2,3-dehydro-1,8-cineole was uniquely found in the breath samples, with a washout profile that suggested it was a product of metabolism of peppermint compounds. Five compounds (α-pinene, β-pinene, eucalyptol, menthol and menthone) were quantified by all three groups. Differences were observed between the groups, particularly for the recovery of menthone and menthol. The average time taken for VOCs to return to baseline was selected as the benchmark and were 377, 423, 533, 418 and 336 min for α-pinene, β-pinene, eucalyptol, menthone and menthol respectively. We have presented an initial set of easy-to-measure benchmarking values for assessing the performance of TD–GC–MS systems for the analysis of VOCs in breath. These values will be updated when more groups provide additional data.
Advances in continuous-flow based microfluidic PCR devices—a review
Authors: Kulkarni Madhusudan B , Goel Sanket
Published: December 2020

A polymerase chain reaction (PCR) is a method typically active in genetic research, especially to amplify or copy genes. Herein, the application of microfluidic devices for nucleic acid amplification has recently been extensively and vigorously studied and implemented. However, the existing classical instruments are hefty, excessive thermal loss, more power consumption, laborious, and require more execution time. Further, it is hard to establish a platform to integrate, automate, and miniaturize the microdevice on a solo stage for testing and analyzing. There has been substantial innovation in the development of continuous-flow based microfluidic PCR micro-devices in the last few decades because of their widespread applications. The continuous-flow microfluidic PCR microdevice enables several features like compact device, portability, repeatability, miniaturization, and integration with a marginal sample reaction volume. It also permits rapid testing and identification of the genetic sample with high-throughput and increased efficiency and output stability of the microdevice by using minimum accessories for its operation. In this review, the recent trends towards the advancement and miniaturization of the assessments using PCR technique with many distinct novel based microchannel designs, fabrication and bonding method, and other associated approaches in the development of continuous-flow based microfluidic PCR devices for the quantification and detection of the nucleic acids. This review discusses concepts like Automation, Integration, and Miniaturization (AIM) with different approaches and applications using continuous-flow based PCR devices.
Cigarette smoking enhances the metabolic activation of the polycyclic aromatic hydrocarbon phenanthrene in humans
Authors: Luo Kai , Luo Xianghua , Cao Wenhao , Hochalter J Bradley , Paiano Viviana , Sipe Christopher J , Carmella Steven G , Murphy Sharon E , Jensen Joni , Lam Stephen , Golin Andrew P , Bergstrom Lori , Midthun David , Fujioka Naomi , Hatsukami Dorothy , Hecht Stephen S
Published: December 2020

Although it is well established that human cytochrome P450 1 family enzymes are induced by cigarette smoking through activation of the Ah receptor, it is not known whether this leads to increased metabolic activation or detoxification of carcinogenic polycyclic aromatic hydrocarbons (PAH), which are present in cigarette smoke and the general environment. We gave oral doses of deuterated phenanthrene ([D10]Phe), a non-carcinogenic surrogate of carcinogenic PAH such as benzo[a]pyrene, to smokers (N = 170, 1 or 10 μg doses) and non-smokers (N = 57, 1 μg dose). Bioactivation products (dihydrodiol and tetraol) and detoxification products (phenols) of [D10]Phe were determined in 6-h urine to obtain a comprehensive metabolic profile. Cigarette smoking increased the bioactivation of [D10]Phe and decreased its detoxification resulting in significantly different metabolic patterns between smokers and non-smokers (P < 0.01), consistent with increased cancer risk in smokers. The Phe bioactivation ratios ([D10]PheT/total [D9]OHPhe) were significantly higher (2.3 (P < 0.01) to 4.8 (P < 0.001) fold) in smokers than non-smokers. With solid human in vivo evidence, our results for the first time demonstrate that cigarette smoking enhances the metabolic activation of Phe, structurally representative of carcinogenic PAH, in humans, strongly supporting their causal role in cancers caused by smoking. The results suggest potential new methods for identifying smokers who could be at particularly high risk for cancer.
Cerebrospinal Fluid and Plasma Lipopolysaccharide Levels in Human Immunodeficiency Virus Type 1 Infection and Associations With Inflammation, Blood-Brain Barrier Permeability, and Neuronal Injury
Authors: Jiang Wei , Luo Zhenwu , Stephenson Sophie , Li Hong , Di Germanio Clara , Norris Philip J , Fuchs Dietmar , Zetterberg Henrik , Gisslen Magnus , Price Richard W
Published: December 2020

Human immunodeficiency virus (HIV) infection is associated with increased systemic microbial translocation, neuroinflammation, and occasionally, neuronal injury. Whether systemic lipopolysaccharide (LPS) penetrates into the brain and contributes to neuroinflammation remain unknown in HIV. Here, we measured plasma and cerebrospinal fluid (CSF) LPS levels along with biomarkers of neuroinflammation (white blood cell counts and 40 soluble markers) and neurofilament light chain (NfL). Notably, CSF LPS was undetectable in all samples, including 3 HIV-infected individuals with dementia. Increased plasma LPS, neuroinflammation, and blood-brain barrier (BBB) dysfunction were found in untreated HIV-infected individuals, but not in healthy or treated HIV-infected individuals. Plasma LPS levels were directly correlated with various markers of inflammation in both plasma and CSF, as well as with degree of BBB permeability but not with CSF NfL in HIV-infected subjects. These results suggest that the magnitude of microbial translocation associates with neuroinflammation and BBB permeability in HIV without direct penetration into the central nervous system.
Predicting outcomes in central venous catheter salvage in pediatric central line–associated bloodstream infection
Authors: Walker Lorne W , Nowalk Andrew J , Visweswaran Shyam
Published: December 2020

Objective

Central line–associated bloodstream infections (CLABSIs) are a common, costly, and hazardous healthcare-associated infection in children. In children in whom continued access is critical, salvage of infected central venous catheters (CVCs) with antimicrobial lock therapy is an alternative to removal and replacement of the CVC. However, the success of CVC salvage is uncertain, and when it fails the catheter has to be removed and replaced. We describe a machine learning approach to predict individual outcomes in CVC salvage that can aid the clinician in the decision to attempt salvage.

Materials and Methods

Over a 14-year period, 969 pediatric CLABSIs were identified in electronic health records. We used 164 potential predictors to derive 4 types of machine learning models to predict 2 failed salvage outcomes, infection recurrence and CVC removal, at 10 time points between 7 days and 1 year from infection onset.

Results

The area under the receiver-operating characteristic curve varied from 0.56 to 0.83, and key predictors varied over time. The infection recurrence model performed better than the CVC removal model did.

Conclusions

Machine learning–based outcome prediction can inform clinical decision making for children. We developed and evaluated several models to predict clinically relevant outcomes in the context of CVC salvage in pediatric CLABSI and illustrate the variability of predictors over time.
The heart as a pump: governing principles
Authors: Kovács Sándor J.
Published: December 2020

The pumping attributes of the heart remain active topics of investigation and mastery of how the heart functions as a pump is part of the fund of knowledge of physiologists and cardiologists. The advent of high-resolution, real-time imaging (computed tomography, magnetic resonance imaging cardiac catheterization, two- and three-dimensional echocardiography) has continued to advance our understanding of how the four-chambered heart (left heart, right heart) works as it fills and as it empties. The insights that have evolved emanate from a conceptual framework based on motion (kinematics) of selected phases and portions of the four-chambered heart and the contents of the pericardial sac. Concepts include pressure pumping, volume pumping, constant-volume pumping, the relationship between atrial and ventricular function and atrial and ventricular indexes, the role of the heart as a suction pump, laws that govern isovolumic relaxation, and the relationship of intraventricular fluid mechanics to diastolic function and wall motion. Accordingly, by asking such questions as ‘What is the ejection fraction of the pericardial sack, and why does it have the numerical value it has?’ or ‘Why does the left atrium fill in two phases—one in systole and one in diastole?’ or ‘How is atrial conduit volume related to diastolic wall motion?’ one can gain new insights into pumping function. This chapter presents a simple, useful, yet powerful conceptual framework that can be used descriptively or mathematically to addresses these and other clinically important themes.
Are Demethylation Inhibitor Plus Quinone Outside Inhibitor Fungicide Premixes During Flowering Worthwhile for Fusarium Head Blight Control in Wheat? A Meta-Analysis
Authors: Barro Jhonatan Paulo , Santana Flávio Martins , Duffeck Maíra Rodrigues , Machado Franklin Jackson , Lau Douglas , Sbalcheiro Cheila Cristina , Schipanski Carlos André , Chagas Débora Fonseca , Venancio Wilson Story , Dallagnol Leandro Jose , Guterres Caroline Wesp , Kuhnem Paulo , Feksa Heraldo Rosa , Del Ponte Emerson Medeiros
Published: December 2020

Fusarium head blight (FHB), caused mainly by Fusarium graminearum, is best controlled with demethylation inhibitor (DMI) fungicides during flowering. However, the use of premixes of DMI and quinone outside inhibitor (QoI) fungicides to control FHB has increased in Brazil. Data on FHB severity and wheat yields measured in field experiments conducted in Brazil were gathered from both peer- and nonpeer-reviewed sources published from 2000 to 2018. After selection criteria were applied, 73 field trials from 35 bibliographic sources were identified, among which 50% of the data were obtained from cooperative network trials conducted after 2011. To be included in the analysis, DMI plus QoI premixes or tebuconazole were tested in at least 14 trials and 3 years. Four premixes met the criteria. Estimates of percent control (and respective 95% confidence intervals) by a network model fitted to the log of the treatment means ranged from 44.1% (pyraclostrobin plus metconazole applied once; 32.4 to 53.7) to 64.3% (pyraclostrobin plus metconazole; 58.4 to 69.3); the latter did not differ from tebuconazole (59.9%; 53.6 to 65.3). Yield response was statistically similar for pyraclostrobin plus metconazole (532.1 kg/ha; 441 to 623) and trifloxystrobin plus prothioconazole (494.9 kg/ha; 385 to 551), and both differed statistically from a group composed of tebuconazole (448.2 kg/ha; 342 to 554), trifloxystrobin plus tebuconazole (468.2 kg/ha; 385 to 551), azoxystrobin plus tebuconazole (462.4 kg/ha; 366 to 558), and pyraclostrobin plus metconazole applied once (413.7 kg/ha; 308 to 518). The two categories of FHB index (7% cutoff) and yield (3,000 kg/ha cutoff), both in the nontreated check, did not explain the heterogeneity in the estimates. Considering only the fungicide effects on yield, two sequential sprays of tebuconazole or one spray of pyraclostrobin plus metconazole as management choices are likely more profitable than DMI plus QoI premixes sprayed twice during flowering.
Corneal Changes After Belantamab Mafodotin in Multiple Myeloma Patients
Authors: Bausell Rebecca B. , Soleimani Arshia , Vinnett Alfred , Baroni Mariana D. , Staub Sheila A. , Binion Katrina , Jeng Bennie H. , Badros Ashraf Z. , Munir Wuqaas M.
Published: December 2020

Objectives:

To describe progressive corneal microcyst-like epithelial changes (MECs) that developed in patients treated with the investigational drug belantamab mafodotin (belamaf) for refractory multiple myeloma (MM).

Methods:

This is a single center case series of patients with MM receiving the investigational drug belamaf.

Results:

All 12 patients included in this analysis who were treated with belamaf developed MECs that initially appeared in the peripheral cornea and progressed centrally with time. Cessation of therapy resulted in regression of the MECs first in the periphery then centrally. Microcyst-like epithelial changes recurred in all patients on retreatment. With prolonged therapy, eight patients developed corneal staining patterns suggestive of limbal stem cell dysfunction (LSCD).

Conclusion:

We describe MECs and LSCD associated with systemic administration of belamaf. Further study is needed to determine the etiology and composition of the MECs and the mechanism of limbal stem cell involvement.
Audiometric Outcomes Following Transmastoid and Middle Cranial Fossa Approaches for Repair of Cerebrospinal Fluid Otorrhea
Authors: Ren Yin , Tawfik Kareem O. , Cueva Roberto A.
Published: December 2020

Objective:

Describe audiometric outcomes following transmastoid and middle cranial fossa (MCF) approaches for repair of cerebrospinal fluid (CSF) otorhinorrhea.

Study design:

Retrospective case series.

Setting:

Tertiary skull base referral center.

Patients:

Adult patients presenting with CSF otorhinorrhea undergoing operative repair between January 2009 and July 2019.

Intervention:

Transmastoid repair, MCF repair, or a combined approach.

Main outcome measures:

Primary outcome measures included preoperative and postoperative four-frequency pure-tone average (PTA), air-bone gap (ABG) and word recognition score. Secondary outcomes included success of repair, recurrence of CSF leak, and length of stay.

Results:

Twenty-nine patients underwent 32 operations (mean age 52 yr, 75.9% female). Twenty (62.5%) patients underwent transmastoid repair, while 8 (25%) underwent an MCF approach. Patients had significant postoperative improvement in both PTA (34.8 dB preop vs. 24.5 dB postop, p = 0.003) and ABG (20.2 dB preop vs. 8.6 dB postop, p 
= 0.0001). CSF leak recurred in 3 patients (9.4%) over 17-month follow-up. Compared to MCF or combined approaches, transmastoid repair was associated with greater improvement in PTA (15.6 vs. 3.0 dB, p = 0.001) and shorter length of stay (0.3 vs. 1.2 days, p = 0.005). On subset analysis, patients with spontaneous CSF leaks, a single skull base defect, or meningoencephaloceles demonstrated significant audiometric improvements.

Conclusions:

The transmastoid approach for repair of CSF otorhinorrhea is effective, safe, and can be done on an outpatient basis. Patients with spontaneous CSF leaks, a single skull base defect, and associated encephaloceles may have better audiometric outcomes.
Streamlining the Cochlear Implant Evaluation: Utility of Community Audiometry in Cochlear Implant Candidacy Assessment
Authors: Shah Ravi R. , Jeon Jun W. , Naples James G. , Hwa Tiffany P. , Davis Sherrie , Eliades Steven J. , Brant Jason A. , Bigelow Douglas C. , Ruckenstein Michael J.
Published: December 2020

Objective:

To identify redundancy in the cochlear implant candidacy evaluation and assess its financial impact.

Study design:

Retrospective chart review.

Setting:

Tertiary care academic cochlear implant center.

Patients:

One hundred thirty-five patients referred for cochlear implant candidacy evaluation from 2004 through 2019.

Intervention:

Community and academic audiometry were compared in a matched-pair analysis.

Main outcome measures:

Pure-tone audiometry and word recognition scores (WRS) were compared using the Wilcoxon signed-rank test. Cost of repeated audiometry was estimated using the Medicare Provider Utilization and Payment data.

Results:

The majority of pure-tone thresholds (PTT) and pure-tone averages (PTA) had no statistically significant differences between community and academic centers. Only air PTT at 2000 Hz on the right and air PTA on the right demonstrated differences with α = 0.05 after Bonferroni correction. Despite statistical differences, mean differences in PTT and PTA were all under 3.5 dB. WRS were on average lower at the academic center, by 14.7% on the right (p < 0.001) and 10.6% on the left (p = 0.003). Repeating initial audiometry costs patients up to $60.58 and costs the healthcare system up to $42.94 per patient.

Conclusions:

Pure-tone audiometry between community and academic centers did not demonstrate clinically significant differences. Lower academic WRS implies that patients identified as potential cochlear implant candidates based on community WRS are likely suitable to proceed to sentence testing without repeating audiometry, saving patients and the healthcare system time and resources.
Effect of Graft Size on Air-bone Gap Closure in Cartilage Button Tympanoplasty
Authors: Buck Lauren S. , Carter Ellen B. , Carron Christopher J. , Carron Jeffrey D.
Published: December 2020

Objective:

To study the effect of graft size on postoperative air-bone gap in children undergoing butterfly inlay cartilage tympanoplasty using circular punch grafts.

Study Design:

Retrospective case review.

Setting:

Tertiary, academic children's hospital.

Patients:

Children less than 16 years old undergoing circular butterfly inlay tympanoplasty using 4, 5, or 6 mm round grafts.

Intervention:

Butterfly inlay tympanoplasty using circular punch graft harvest technique.

Main Outcome Measures:

Postoperative pure-tone average and air-bone gap.

Results:

Fifty-two children were included in the analysis: 18 in the 4 mm group, 28 in the 5 mm group, and 6 in the 6 mm group. There was no significant difference in either postoperative pure-tone average or air-bone gap among the three groups. Closure rates for the 4, 5, and 6 mm graft groups were 94, 96, and 67%, respectively, for an overall rate of 92%.

Conclusions:

Cartilage button butterfly inlay tympanoplasty with punch graft is an effective method for tympanic membrane repair with similar hearing results among various graft diameters but may have diminished success with perforations requiring grafts larger than 5 mm. Larger case series are necessary to determine if larger defects are best managed with other repair techniques.
Radiological and Audiological Outcomes of the LISTENT LCI-20PI Cochlear Implant Device
Authors: Tan Haoyue , Yao Junji , Li Yun , Zhang Zhihua , Chen Ying , Huang Meiping , Sterkers Olivier , Jia Huan , Wu Hao
Published: December 2020

Objective:

To study the surgical results, intracochlear position of the electrode array (EA) and auditory performance of the LISTENT LCI-20PI cochlear implant device, and daily use status at 3 years.

Study Design:

A retrospective study.

Setting:

A single-tertiary referral center.

Patients:

Between January and December 2016, 20 patients underwent cochlear implantation using the LISTENT LCI-20PI (lateral wall EA).

Intervention:

Cochlear implantation.

Main Outcome Measures:

Measurement of cochlear size, extent of posterior tympanotomy, and insertion depth. Scalar position of the EA evaluated by 3D reconstruction. Auditory outcomes 1 year after implantation and daily use status at 3 years.

Results:

EAs were completely inserted in all cases with an insertion depth of 288 ± 36.8 degrees. One year later, the average sentence recognition score (SRS) was 90 ± 21.7%. EA scalar location was analyzed in 18 patients. Thirteen EAs (72.2%) were fully inserted into the scala tympani (ST) and 5 (27.8%) had shifted from the ST to the scala vestibuli (SV). There was no statistically significant difference in cochlear size, extent of posterior tympanotomy, or insertion depth between these two groups. EAs inserted by cochleostomy had a higher chance of scalar shift than those inserted via the round window (60% vs 15.4%, p = 0.099). SRS at 1 year with full ST insertion was significantly better than in those with scalar shift (99 ± 1.3% vs 83 ± 16.5%, p = 0.002). Three years after implantation, 92% of patients were daily users and 46% were telephone users.

Conclusions:

The LISTENT LCI-20PI provided accredited hearing rehabilitation with a short insertion depth. Full insertion into the ST was associated with better cochlear implantation outcomes.
Robot-assisted Cochlear Implant Electrode Array Insertion in Adults: A Comparative Study With Manual Insertion
Authors: Daoudi Hannah , Lahlou Ghizlene , Torres Renato , Sterkers Olivier , Lefeuvre Vincent , Ferrary Evelyne , Mosnier Isabelle , Nguyen Yann
Published: December 2020

Objective:

To describe the first cochlear array insertions using a robot-assisted technique, with different types of straight or precurved electrode arrays, compared with arrays manually inserted into the cochlea.

Study Design:

Retrospective review.

Setting:

Tertiary otologic center.

Patients:

Twenty cochlear implantations in the robot-assisted group and 40 in the manually inserted group.

Interventions:

Cochlear implantations using a robot-assisted technique (RobOtol) with straight (eight Cochlear CI522/622, and eight Advanced Bionics Hifocus Slim J) or precurved (four Advanced Bionics Hifocus Mid-Scala) matched to manual cochlear implantations. Three-dimensional reconstruction images of the basilar membrane and the electrode array were obtained from pre- and postimplantation computed tomography.

Main Outcome Measures:

Rate and localization of scalar translocations.

Results:

For straight electrode arrays, scalar translocations occurred in 19% (3/16) of the robot-assisted group and 31% (10/32) of the manually inserted group. Considering the number of translocated electrodes, this was lower in the robot-assisted group (7%) than in the manually inserted group (16%) (p < 0.0001, χ
2 test). For precurved electrode arrays, scalar translocations occurred in 50% (2/4) of the robot-assisted group and 38% (3/8) of the manually inserted group.

Conclusion:

This study showed a safe and reliable insertion of different electrode array types with a robot-assisted technique, with a less traumatic robotic insertion of straight electrode arrays when compared with manual insertion.
Successful Treatment With Bortezomib for Refractory and Complicated Acquired Thrombotic Thrombocytopenic Purpura in an Adolescent Girl
Authors: Azapağasi Ebru , Uysal Yazici Mutlu , Eroğlu Nilgün , Albayrak Meryem , Kucur Özge , Fettah Ali
Published: December 2020

Thrombotic thrombocytopenic purpura (TTP) is a rare, dangerous, life-threatening disease characterized by microangiopathic hemolytic anemia and thrombocytopenia, along with organ dysfunction due to microangiopathy-related ischemia. Plasma exchange and steroids are used for initial treatment, and rituximab is often used in refractive patients. Caplacizumab, cyclophosphamide, and splenectomy are among other treatment options. It has been reported that bortezomib, a proteasome inhibitor, can be used in the management of refractory acquired TTP. Herein, we present a 16-year-old female patient who was monitored for acquired TTP and treated with high-dose steroids, plasma exchange, rituximab, cyclophosphamide, and N-acetylcysteine but developed renal, cardiac, gastrointestinal, and neurologic complications. The girl was then successfully treated with bortezomib, and she has been monitored in remission for 6 months. We consider that bortezomib is a beneficial treatment, especially in patients with refractory TTP.
A Case Report of Congenital Thrombotic Thrombocytopenic Purpura: The Peripheral Blood Smear Lights the Diagnosis
Authors: Toret Ersin , Demir-Kolsuz Ozum , Ozdemir Zeynep Canan , Bor Ozcan
Published: December 2020

We report on a 12-year-old boy with congenital thrombotic thrombocytopenic purpura, on who had an erroneous diagnosis as chronic immune thrombocytopenia. The patient presented with complaints of jaundice and skin rash. Laboratory analysis showed nonimmune hemolytic anemia and severe thrombocytopenia. Peripheral blood smear showed 8% schistocytes, polychromasia, and anisocytosis. The ADAMTS13 antigen and activity were suspected to be lower than 5% with any antibodies against the enzyme. The DNA sequence analyses resulted in compound heterozygosity consisting of c.291_391del in exon 3 and c.4143dupA in exon 29. Schistocyte (fragmented erythrocytes) on the peripheral blood smear is a light that illuminates the diagnosis. Early recognition of the disease can prevent inappropriate treatments and morbidities due to organ damage.
Readiness to Change is Related to Real-World Walking and Depressive Symptoms in Chronic Stroke
Authors: Miller Allison , Wright Tamara , Wright Henry , Thompson Elizabeth , Pohlig Ryan T. , Reisman Darcy S.
Published: December 2020

Background and Purpose:

The transtheoretical model is a health behavior model used to understand an individual's readiness to change their behavior. This study aims to apply the transtheoretical model in understanding a person with stroke's readiness to change their activity level, as it relates to physical capacity, physical health, depressive symptoms, self-efficacy, and daily stepping activity.

Methods:

This was a cross-sectional analysis of baseline data from a clinical trial. Participants' readiness to change their activity levels was measured via self-report and daily stepping activity was measured using a step activity monitor. Robust regression (M-estimation with robust standard errors) was used to test the relationship between readiness to change and measures of physical capacity (6-minute walk test, self-selected walking speed), physical health (body mass index, age-adjusted Charlson Comorbidity Index), depressive symptoms (Patient Health Questionnaire-9), self-efficacy (Activities-Specific Balance Confidence Scale), and daily stepping (steps per day).

Results:

A total of 274 individuals were included in the analysis. Adjusted for age, readiness to change was positively related to daily stepping (β = 0.29, P < 0.001) and negatively related to depressive symptoms (β = −0.13, P = 0.01). Readiness to change was not significantly associated with measures of physical capacity, physical health, or self-efficacy.

Discussion:

These results suggest that individuals with stroke in the later stages of change may demonstrate greater daily stepping activity and lower depressive symptoms compared with those in earlier stages.

Conclusions:

Understanding the relationship between readiness to change, daily stepping, and depressive symptoms will help clinicians implement appropriate stage-specific intervention strategies and facilitate greater improvement in activity levels.

Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A333).
Digital blood in massively parallel CPU/GPU systems for the study of platelet transport
Authors: Kotsalos Christos , Latt Jonas , Beny Joel , Chopard Bastien
Published: December 2020

We propose a highly versatile computational framework for the simulation of cellular blood flow focusing on extreme performance without compromising accuracy or complexity. The tool couples the lattice Boltzmann solver Palabos for the simulation of blood plasma, a novel finite-element method (FEM) solver for the resolution of deformable blood cells, and an immersed boundary method for the coupling of the two phases. The design of the tool supports hybrid CPU–GPU executions (fluid, fluid–solid interaction on CPUs, deformable bodies on GPUs), and is non-intrusive, as each of the three components can be replaced in a modular way. The FEM-based kernel for solid dynamics outperforms other FEM solvers and its performance is comparable to state-of-the-art mass–spring systems. We perform an exhaustive performance analysis on Piz Daint at the Swiss National Supercomputing Centre and provide case studies focused on platelet transport, implicitly validating the accuracy of our tool. The tests show that this versatile framework combines unprecedented accuracy with massive performance, rendering it suitable for upcoming exascale architectures.
Metagenomic Analysis Reveals A Possible Association Between Respiratory Infection and Periodontitis
Authors: Liu Zhenwei , Zhang Tao , Wu Keke , Li Zhongshan , Chen Xiaomin , Jiang Shan , Du Lifeng , Lu Saisai , Lin Chongxiang , Wu Jinyu , Wang Xiaobing
Published: December 2020

Periodontitis is an inflammatory disease which is characterized by progressive destruction of the periodontium and causes tooth loss in adults. Periodontitis is known to be associated with dysbiosis of the oral microflora, often linked to various diseases. However, the complexity of plaque microbial communities of periodontitis, and antibiotic resistance and enhanced virulence make this disease difficult to treat. Therefore, we used metagenomic shotgun sequencing in this study to investigate the etiology, antibiotic-resistant genes (ARGs) and virulence genes (VirGs) of periodontitis. We revealed a significant shift in the composition of oral microbiota as well as several functional pathways that were represented significantly more abundant in periodontitis patients than in controls. Additionally, we observed several positively selected ARGs and VirGs with the Ka/Ks ratio > 1 by analyzing our data and a previous periodontitis dataset, indicating that ARGs and VirGs in oral microbiota may suffer from positive selection. Moreover, 5 of 12 positively selected ARGs and VirGs in periodontitis patients were found in the genomes of respiratory tract pathogens. Of note, 91.8% of the background VirGs with at least one non-synonymous single-nucleotide polymorphism for natural selection were also from respiratory tract pathogens. These observations suggest a potential association between periodontitis and respiratory infection at the gene level. Our study enriches the knowledge of pathogens and functional pathways as well as the positive selection of antibiotic resistance and pathogen virulence in periodontitis patients, and provides evidence from the gene level for an association between periodontitis and respiratory infection.
Characterizing superspreading of SARS-CoV-2 : from mechanism to measurement
Authors: Susswein Zachary , Bansal Shweta
Published: December 2020

Superspreading is a ubiquitous feature of SARS-CoV-2 transmission dynamics, with a few primary infectors leading to a large proportion of secondary infections. Despite the superspreading events observed in previous coronavirus outbreaks, the mechanisms behind the phenomenon are still poorly understood. Here, we show that superspreading is largely driven by heterogeneity in contact behavior rather than heterogeneity in susceptibility or infectivity caused by biological factors. We find that highly heterogeneous contact behavior is required to produce the extreme superspreading estimated from recent COVID-19 outbreaks. However, we show that superspreading estimates are noisy and subject to biases in data collection and public health capacity, potentially leading to an overestimation of superspreading. These results suggest that superspreading for COVID-19 is substantial, but less than previously estimated. Our findings highlight the complexity inherent to quantitative measurement of epidemic dynamics and the necessity of robust theory to guide public health intervention.
Analysis of the specificity of the SD Biosensor Standard Q Ag-Test based on Slovak mass testing data
Authors: Hledík Michal , Polechová Jitka , Beiglböck Mathias , Herdina Anna Nele , Strassl Robert , Posch Martin
Published: December 2020

From 31.10. - 1.11.2020 Slovakia has used the SD Biosensor Standard Q Ag-Test for nationwide tests for SARS-CoV-2, in which 3,625,332 persons from 79 counties were tested. Based on this data, we calculate that the specificity of the test is at least 99.6% (with a 97.5% one-sided lower confidence bound). Our analysis is based on a worst case approach in which all positives are assumed to be false positives. Therefore, the actual specificity is expected to exceed 99.6%.
High Frequency and Prevalence of Community-Based Asymptomatic SARS-CoV-2 Infection
Authors: Allan-Blitz Lao-Tzu , Turner Isaac , Hertlein Fred , Klausner Jeffrey D.
Published: December 2020

Approximately 20-40% of SARS-CoV-2 infection is asymptomatic; however, data are limited on drivers of such infection. Among over 730,000 SARS-CoV-2 test results in Los Angeles between August-October, 2020, we found heterogenous frequencies of asymptomatic infection among various sup-populations. Further research is needed to delineate drivers of asymptomatic SARS-CoV-2 infection.