bluuebunny/crossref_metadata_2025 huggingface dataset:
Anomalous Nernst effect of a ferromagnetic film on a semiconductor
Authors: Deng S. , Kraft R. , Fischer G. , Sürgers C.
Published: December 2020

Measuring the anomalous Nernst effect of magnetically ordered thin films on substrates is often hampered by the mismatch between different thermal conductivities and the unknown temperature gradient in the film. Here, we demonstrate that for ferromagnetic films deposited on a semiconducting substrate, the Nernst effect of the semiconductor can serve as an internal reference for estimating the local temperatures present in the film and substrate. The Nernst effect in semiconductors is particularly large in the temperature region above 200 K where the semiconductor shows a strong change in the charge carrier concentration. As an example, we have studied the anomalous Nernst effect of 28 nm thick ferromagnetic Mn5Ge3C0.8 films deposited on p-type Ge(111) substrates with the temperature gradient oriented either parallel or perpendicular to the film plane. From the additional contribution of the Nernst effect arising from the substrate and comparison with theory, we estimate the temperature gradient in the substrate and thin film for both configurations and determine the thermoelectric coefficients of the film.
Metal-semiconductor transition in thin film MAPbI3 perovskite
Authors: Campanari Valerio , Lucci Massimiliano , Castriotta Luigi Angelo , Paci Barbara , Generosi Amanda , Guaragno Marco , Francini Roberto , Cirillo Matteo , Di Carlo Aldo
Published: December 2020

The structural and electronic properties of the methylammonium lead iodide (MAPbI3, MA = CH3NH3) perovskite are investigated as a function of temperature by transport measurements, in situ x-ray diffraction, and optical emission. Lowering the temperature, a transition from the tetragonal to the orthorhombic phase takes place, around 160 K. Such structural transition, monitored by temperature-dependent in situ x-ray diffraction and optical emission, is followed by an inversion of the temperature dependence of the electrical resistivity from a semiconductor-like dependence to a metal-like one. The temperature for such semiconductor-metal transition, depending both on the applied electric field and on the optical excitation, is always below the phase transition temperature. The results demonstrate that perovskite materials display interesting scenarios in which lattice structural transitions combined with optical or electrical excitation strongly affect transport properties. The consequences of these characteristics are analyzed in fundamental and applied science perspectives.
Tregs self-organize into a computing ecosystem and implement a sophisticated optimization algorithm for mediating immune response
Authors: Marsland Robert , Howell Owen , Mayer Andreas , Mehta Pankaj
Published: December 2020

Significance

Understanding the origins and mechanisms underlying autoimmune diseases represents a major conceptual problem in immunology. It is now clear that regulatory T cells (Tregs) play an important role in suppressing autoimmune responses, but we lack an algorithmic understanding of how they function. Here we present a simple mathematical model that organizes known biology and suggests that Tregs implement a sophisticated optimization algorithm to prevent autoimmune responses. We propose experimental tests of these ideas and discuss implications of our results for autoimmune diseases.
The mosquito taste system and disease control
Authors: Baik Lisa S. , Carlson John R.
Published: December 2020

Mosquitoes are a widely diverse group of organisms, comprising ∼3,500 species that live in an enormous range of habitats. Some species are vectors of diseases that afflict hundreds of millions of people each year. Although understanding of mosquito olfaction has progressed dramatically in recent years, mosquito taste remains greatly understudied. Since taste is essential to feeding, egg laying, and mating decisions in insects, improved understanding of taste in mosquitoes could provide new mechanistic insight into many aspects of their behavior. We provide a guide to current knowledge in the field, and we suggest a wealth of opportunities for research that are now enabled by recent scientific and technological advances. We also propose means by which taste might be exploited in new strategies for mosquito control, which may be urgently needed as the geographical ranges of vector species increase with climate change.
Intrinsic electronic conductivity of individual atomically resolved amyloid crystals reveals micrometer-long hole hopping via tyrosines
Authors: Shipps Catharine , Kelly H. Ray , Dahl Peter J. , Yi Sophia M. , Vu Dennis , Boyer David , Glynn Calina , Sawaya Michael R. , Eisenberg David , Batista Victor S. , Malvankar Nikhil S.
Published: December 2020

Significance

The ability to understand and modulate protein conductance is central to many biological processes and for the technological applications of electronic biomaterials. However, measurements of intrinsic protein conductivity are lacking. Here, we employ a four-electrode method to measure contact-free electronic conductivity of an individual protein microcrystal that exhibits efficient hole transport over micrometers via stacked tyrosines. Combined experimental and computational studies show that both the energetics and proximity of the proton acceptor to tyrosine determine the rate of hole transport. Our mechanistic studies on model systems with atomic-resolution structures may help identify design principles to engineer electronic conductivity in proteins of interest for a wide range of applications, including artificial photosynthesis, biocatalysis, prevention of oxidative damage, and nucleic acid biosynthesis.
Cryoelectron microscopy structure and mechanism of the membrane-associated electron-bifurcating flavoprotein Fix/EtfABCX
Authors: Feng Xiang , Schut Gerrit J. , Lipscomb Gina L. , Li Huilin , Adams Michael W. W.
Published: December 2020

Significance

Electron bifurcation is a recently recognized mechanism of biological energy conservation that is widespread in anaerobic microorganisms and provides low-potential, high-energy electrons to drive otherwise nonspontaneous metabolic reactions. Here we describe the structure of a membrane-associated bifurcating enzyme from an aerobic microorganism. Termed Fix/EtfABCX, this enzyme is used by some nitrogen-fixing microbes to drive the low-potential reduction of nitrogen gas to ammonia. Fix/EtfABCX is a superdimer and a catalytic mechanism is proposed involving six flavins, two of which bifurcate, four iron-sulfur clusters, and two menaquinones. Fix/EtfABCX shares structural similarity with mammalian quinone oxidoreductase involved in mitochondrial fatty acid oxidation, suggesting an unexpected evolutionary link between bifurcating and nonbifurcating systems.
Topographic connectivity reveals task-dependent retinotopic processing throughout the human brain
Authors: Knapen Tomas
Published: December 2020

Significance

Vision is organized retinotopically—according to the reference frame of the retina. How much of the brain is retinotopically organized remains unknown, because traditional retinotopic mapping experiments require strict fixation and sparse stimuli. Conversely, in everyday vision we use eye movements and interaction, to derive meaning from our complex surroundings. Here, I discover retinotopic activations by explaining brain-wide BOLD signals during several experiments in terms of the pattern on the surface of primary visual cortex. This revealed visually organized processing also in regions outside the visual system, in brain regions traditionally thought devoted to memory. This visual organization in default-mode network and hippocampus speaks to the joint operation of sensations and memory in everyday vision and mental life.
Deep learning for in vivo near-infrared imaging
Authors: Ma Zhuoran , Wang Feifei , Wang Weizhi , Zhong Yeteng , Dai Hongjie
Published: December 2020

Significance

Near-infrared (NIR) fluorescence imaging using biocompatible dyes such as ICG in the NIR-I (800–1,000 nm) has facilitated tumor imaging and imaging-guided surgery, but suffers from shallow imaging depth, low contrast, and poor clarity caused by light scattering and autofluorescence. On the other hand, fluorescence imaging in NIR-IIb (1,500–1,700 nm) affords much improved spatial resolution and deeper tissue penetration, but currently relies on fluorophores not approved for human use. This work presents a deep-learning–based approach to transform a blurred NIR-I image to a much higher-clarity image like in NIR-IIb, leading to an image closely resembling the ground truth. The deep-learning–enabled high-resolution NIR imaging could facilitate basic biomedical research and empower diagnostics and imaging-guided surgery in the clinic.
Association of meeting both muscle strengthening and aerobic exercise guidelines with prevalent overweight and obesity classes ‐ results from a nationally representative sample of German adults
Authors: Tittlbach Susanne A. , Hoffmann Sascha W. , Bennie Jason A.
Published: December 2020

Objectives: German national physical activity guidelines specify adults (≥18 years) should engage in at least: (i) 150 min of aerobic moderate‐to‐vigorous‐intensity physical activity/week (MVPA); and (ii) muscle‐strengthening exercise (MSE) 2 days/week. However, the relationship between MVPA and MSE and overweight/obesity has not been examined among German adults. Aim of this study was to examine whether meeting the guidelines for both MVPA and MSE is associated with a lower prevalence of overweight/obesity compared to meeting MVPA or MSE alone or none of them, among a nationally representative sample of German adults. Methods: The cross‐sectional study drew data from the 2014 German Health Update (GEDA) (n=22,822; ≥18 years). Physical activity (MVPA‐MSE), height/weight, socio‐demographic, health and lifestyle factors were assessed by self‐report via validated questionnaires. Generalized linear models with Poisson regression were used to assess prevalence ratios of Body Mass Index‐derived (BMI) overweight/obesity across categories of physical activity guideline adherence (met neither; MSE only; MVPA only; met both). Results: Compared to other physical activity groups, meeting both the MVPA‐MSE guidelines was associated with the lowest prevalence rate of overweight/obesity (Adjusted Prevalence Ratios [APR] range: 0.25‐0.73). Associations between BMI and physical activity were strongest among Class II obesity (APR range: 0.25‐0.45). The associations remained consistent after adjusting sociodemographic and lifestyle factors. Conclusions: Meeting the combined MVPA‐MSE guideline, as suggested in the German national physical activity recommendations, showed the lowest overweight/obesity prevalence. Promoting uptake and adherence of both MVPA and MSE at the population level could help to reduce the public health burden of obesity.

Highlights

Meeting both muscle strengthening and aerobic exercise guidelines show the lowest overweight/obesity prevalence in a German representative sample of adults. Promoting uptake and adherence of both MVPA and MSE at the population level could help to reduce the public health burden of obesity.
Influence of the viscoelectric effects on the electrokinetic power generation controlled by an osmotic semi-membrane placed on a parallel-plate microchannel
Authors: Sánchez G , Méndez F
Published: December 2020

In the present work, we develop a theoretical study for predicting the streaming potential and, therefore, the electric power generation in a system composed of a semi-permeable osmotic membrane inserted in a slit microchannel. Both physical systems are communicated through the forced microcirculation of an electrolyte employing the use of a saline gradient, which is established between the external faces of the membrane, creating the suction force needed to induce a hydrodynamic flow. In this manner, we externally impose a uniform volumetric flow rate to promote simultaneous hydrodynamic and electrokinetic fields, replacing the usual external pressure gradient with an equivalent osmotic pressure force. The viscoelectric effects of the electrolyte solution are included in the present analysis. The resulting non-linear governing equations for the motion are written in dimensionless form and permit us to derive an integro-differential equation for the velocity field, which is solved by an iterative method. With the aid of these previous results, the electric energy, in terms of an electrokinetic streaming potential and the streaming current, is generated for this combined system. This proposed electric power generation technique converts the energy of a saline gradient into electrical energy, avoiding the mechanical use of an external pressure gradient.
Dual-band and dual-polarized programmable metasurface unit with independent channels
Authors: Niu Ling Yun , Zhang Hao Chi , He Pei Hang , Tang Min , Wang Meini , Zhang Le Peng , Bai Guo Dong , Mao Junfa , Cui Tie Jun
Published: December 2020

Highly efficient aperture use and real-time control are important for current RF systems to achieve outstanding system performance. In this paper, we propose a novel dual-band and dual-polarized programmable metasurface unit (PMU) with two switchable phase states. Utilizing the dual-band and dual-polarized properties of parasitic patch antennas, the PMU can realize independent control of two channels by switching the PIN diodes. Because of the separation of frequency bands and orthogonal polarizations, the PMU posesses high isolation between two channels. Meanwhile, spoof surface plasmon polariton and choke structures are designed to further improve channel isolation. Each channel of the PMU has two states (state ‘0’ and state ‘1’) with a 180° phase difference between them, which is the basis for constructing programmable metasurfaces. The simulated and measured results illustrate the excellent performance of the proposed PMU. Through a detailed discussion of the functions of metasurfaces composed of the proposed PMU, the independent control of two channel beams is demonstrated in real time. Hence, the proposed dual-band and dual-polarized PMU may find wide applications in satellite communications, radar systems and other scenarios.
Scattering modes of skyrmions in a bilayer system with ferromagnetic coupling
Authors: Vojkovic S , Cacilhas R , Pereira A R , Altbir D , Núñez Á S , Carvalho-Santos V L
Published: December 2020

Magnetic skyrmions are quasiparticle-like textures that are topologically different from a single domain magnetization state. Their topological protection, combined with the low current density needed to move them, make these objects relevant to be used as information storage structures. In such a context, the analysis of the interactions between skyrmions is interesting and relevant for future applications. In this work, through micromagnetic simulations and numerical calculations, we studied the interaction between two skyrmions living on different parallel ferromagnetic racetracks connected by an exchange-like interaction. The upper and lower racetracks are separated by a height offset and the interaction between the upper and the lower skyrmion is analyzed in terms of the magnetic and geometrical parameters. Three states are predicted, as a function of these parameters: scattered or free skyrmions, bound skymions, and annihilated skyrmions. Our results, presented in a phase diagram, demonstrate that even in the case here called free skyrmions, there is a small and brief interaction when both are close enough, but the skyrmion in the top layer does not drag the skyrmion in the bottom layer. For bound skyrmions, both keep linked during larger times. In the latter case, there are strong changes in the velocity of the skyrmions induced by the effect of a higher effective mass when both are coupled.
Glassy dynamics of model colloidal polymers: Effect of controlled chain stiffness*
Authors: Li Jian , Zhang Bo-kai , Li Yu-Shan
Published: December 2020

Colloidal polymers with tunable chain stiffness have been successfully assembled in experiments recently. Similar to molecular polymers, chain stiffness is an important feature which can distinctly affect the dynamical behaviors of colloidal polymers. Hence, we model colloidal polymers with controlled chain stiffness and study the effect of chain stiffness on glassy behaviors. For stiff chains, there are long-ranged periodic intrachain correlations besides two incompatible local length scales, i.e., monomer size and bond length. The mean square displacement of monomers exhibits sub-diffusion at intermediate time/length scale and the sub-diffusive exponent increases with chain stiffness. The data of localization length of stiff polymers versus rescaled volume fraction for different monomer sizes can gather close to an exponential curve and decay slower than those of flexible polymers. The increase of chain stiffness linearly increases the activation energy of the colloidal-polymer system and thus makes the colloidal polymers vitrify at lower volume fraction. Static and dynamic equivalences between stiff colloidal polymers of different monomer sizes have been checked.
Detection of 28 Corticosteroids in Pharmaceutical and Proprietary Chinese Medicinal Products Using Liquid Chromatography–Tandem Mass Spectrometry
Authors: Chan Candace Yim , Ng Sau Wah , Ching Chor Kwan , Mak Tony Wing Lai
Published: December 2020

With their potent anti-inflammatory effects, corticosteroids are popular adulterants in illicit health products for allergies, dermatitis and pain control. Their illegal supply over the counter is also a common practice for similar conditions. Prolonged, unsupervised usage of corticosteroids often leads to severe adverse effects including Cushing syndrome, adrenal insufficiency and immunosuppression. Confirming clinical suspicion of unsupervised corticosteroid usage is challenging. Apart from evaluating the adrenal function, identifying the concerned drug is the most direct proof of its consumption. While detecting corticosteroids or their metabolites in biological specimens is convincing evidence of their usage, such approach is analytically difficult. More importantly, this approach would not be useful if the patient has stopped taking the drug for some time—a situation that is often encountered clinically. We advocate a more direct approach by measuring corticosteroids in suspicious medicinal products. In the current study, a liquid chromatography–tandem mass spectrometry method for simultaneous detection of 28 corticosteroids in pharmaceutical and proprietary Chinese medicine products was developed and validated for the purpose. The method was applied to 388 cases of suspected unsupervised corticosteroids usage. Among 1,000 products tested, corticosteroids were found in 276 of them and confirmed the clinical suspicion.
Plasma Inflammatory Biomarkers Predict CD4+ T-cell Recovery and Viral Rebound in HIV-1 Infected Africans on Suppressive Antiretroviral Therapy
Authors: Kroeze Stefanie , Rossouw Theresa M , Steel Helen C , Wit Ferdinand W , Kityo Cissy M , Siwale Margaret , Akanmu Sulaimon , Mandaliya Kishor , De Jager Marleen , Ondoa Pascale , Reiss Peter , Rinke De Wit Tobias F , Kootstra Neeltje A , Hamers Raph L
Published: December 2020

This multicountry prospective study investigated whether persistent systemic inflammation, measured by 8 plasma biomarkers, in HIV-1-infected Africans during suppressive antiretroviral therapy (ART) (viral load <50 copies/mL), was associated with CD4+ T-cell recovery and viral rebound (>1000 copies/mL) during long-term treatment. On-ART sCD14 and C-reactive protein concentrations were inversely associated with subsequent CD4+ T-cell counts. Risk of viral rebound was increased for participants with higher on-ART CXCL10 concentrations and reduced for those with a greater sCD163 decline during the first year of ART. Persistent systemic inflammation predicted CD4+ T-cell recovery and viral rebound, warranting further mechanistic research in relation to clinical outcomes.
Measurement of cell volume using in-line digital holography
Authors: Ling Hangjian , Sridhar Kaushik , Gollapudi Sumanth , Kumar Jyoti , Ohgami Robert S
Published: December 2020

The measurement of the volume of blood cells is important for clinical diagnosis and patient management. While digital holography microscopy has been used to obtain such information, previous off-axis setups usually involve a separated reference beam and are thus not very easy to implement. Here, we use the simple in-line Gabor setup without separation of a reference beam to measure the shape and volume of cells mounted on glass slides. Inherent to the in-line holograms, the reconstructed phase of the object is affected by the virtual image noise, producing errors in the cell volume measurement. We optimized our approach to use a single hologram without phase retrieval, increasing distance between cell and hologram plane to reduce the measurement error of cell volume to less than 6% in some instances. Therefore, the in-line Gabor setup can be a useful and simple tool to obtain volumetric and morphologic cellular information.
Preliminary evidence of fluorescence in Mediterranean heterobranchs
Authors: Betti F , Bavestrello G , Cattaneo-Vietti R
Published: December 2020

Biofluorescence, the ability to exploit light with short wavelengths, such as ultraviolet (UV) and blue, and re-emit it with lower energy and longer wavelengths, is considered a widespread phenomenon among marine animals and has many ecological roles in intra- and interspecific communication. Heterobranch sea slugs are believed to rely almost exclusively on their colour patterns for survival, with coloration serving as camouflage or as a warning to predators of heterobranch toxicity (aposematic coloration). Since solar light is progressively absorbed by seawater with a constant loss of longer wavelengths, it is unclear how heterobranch coloration can maintain its ecological role below the water surface. The present study investigates, for the first time, in situ biofluorescence in 53 species of Mediterranean Heterobranchia to determine whether these animals rely on light emission to enhance the visibility of their colour patterns. The ability to fluoresce when illuminated by UV and blue light (wavelengths <470 nm) appeared to be quite widespread among nudibranchs (i.e. found in c. one-third of the encountered species), while no evidence of light emission was found in non-nudibranch heterobranchs. The majority of fluorescent species were Cladobranchia belonging to the superfamilies Fionoidea and Aeolidioidea. Nudibranchs fluoresced in four different colours, with green being the most common. Light emission was often restricted to particular body regions, such as the cerata of Cladobranchia. These preliminary data might indicate that fluorescence plays an essential role in the enhancement of nudibranch aposematic coloration.
Hydrogen–deuterium exchange reveals a dynamic DNA-binding map of replication protein A
Authors: Ahmad Faiz , Patterson Angela , Deveryshetty Jaigeeth , Mattice Jenna R , Pokhrel Nilisha , Bothner Brian , Antony Edwin
Published: December 2020

Replication protein A (RPA) binds to single-stranded DNA (ssDNA) and interacts with over three dozen enzymes and serves as a recruitment hub to coordinate most DNA metabolic processes. RPA binds ssDNA utilizing multiple oligosaccharide/oligonucleotide binding domains and based on their individual DNA binding affinities are classified as high versus low-affinity DNA-binding domains (DBDs). However, recent evidence suggests that the DNA-binding dynamics of DBDs better define their roles. Utilizing hydrogen–deuterium exchange mass spectrometry (HDX-MS), we assessed the ssDNA-driven dynamics of the individual domains of human RPA. As expected, ssDNA binding shows HDX changes in DBDs A, B, C, D and E. However, DBD-A and DBD-B are dynamic and do not show robust DNA-dependent protection. DBD-C displays the most extensive changes in HDX, suggesting a major role in stabilizing RPA on ssDNA. Slower allosteric changes transpire in the protein–protein interaction domains and linker regions, and thus do not directly interact with ssDNA. Within a dynamics-based model for RPA, we propose that DBD-A and -B act as the dynamic half and DBD-C, -D and -E function as the less-dynamic half. Thus, segments of ssDNA buried under the dynamic half are likely more readily accessible to RPA-interacting proteins.
Variable Diagnostic Performance of Stool Xpert in Pediatric Tuberculosis: A Systematic Review and Meta-analysis
Authors: Gebre Meseret , Cameron Lindsay Hatzenbuehler , Tadesse Getachew , Woldeamanuel Yohannes , Wassie Liya
Published: December 2020

Background

Difficult specimen collection and low bacillary load make microbiological confirmation of tuberculosis (TB) in children challenging. In this study, we conducted a systematic review and meta-analysis to assess the diagnostic accuracy of Xpert on stool for pediatric tuberculosis.

Methods

Our search included studies from 2011 through 2019, and specific search terms were used to retrieve articles from Pubmed, EMBASE, BIOSIS, ClinicalTrials.gov, and Google Scholar. Risk of bias was assessed using the QUADAS 2 tool. The protocol was registered in PROSPERO (CRD42018083637). Summary estimates of sensitivity and specificity were conducted using meta-disc Software assuming a random-effects model.

Results

We identified 12 eligible studies, which included data from 2177 children, of whom 295 (13.6%) had bacteriologically confirmed TB on respiratory specimens. The pooled sensitivity of Xpert MTB/RIF on stool specimens compared with bacteriologically confirmed tuberculosis with respiratory specimens was 0.50 (95% CI, 0.44–0.56) with an I2 of 86%, which was statistically significant (P < .001). The pooled specificity was 0.99 (95% CI, 0.98–0.99; I2 = 0.0%; P = .44).

Conclusions

Despite the observed heterogeneity, stool may be considered an additional specimen to support diagnosis of pulmonary TB in children, especially in settings where it is impossible to get respiratory samples. Further studies should evaluate its optimization as a diagnostic tool.
START-Play Physical Therapy Intervention Impacts Motor and Cognitive Outcomes in Infants With Neuromotor Disorders: A Multisite Randomized Clinical Trial
Authors: Harbourne Regina T , Dusing Stacey C , Lobo Michele A , McCoy Sarah W , Koziol Natalie A , Hsu Lin-Ya , Willett Sandra , Marcinowski Emily C , Babik Iryna , Cunha Andrea B , An Mihee , Chang Hui-Ju , Bovaird James A , Sheridan Susan M
Published: December 2020

Objective

Our objective was to evaluate the efficacy of the Sitting Together and Reaching to Play (START-Play) intervention in young infants with neuromotor disorders.

Method

This randomized controlled trial compared usual care early intervention (UC-EI) with START-Play plus UC-EI. Analyses included 112 infants with motor delay (55 UC-EI, 57 START-Play) recruited at 7 to 16 months of age across 5 sites. START-Play included twice-weekly home visits with the infant and caregiver for 12 weeks provided by physical therapists trained in the START-Play intervention; UC-EI was not disrupted. Outcome measures were the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley); the Gross Motor Function Measure; reaching frequency; and the Assessment of Problem Solving in Play (APSP). Comparisons for the full group as well as separate comparisons for infants with mild motor delay and infants with significant motor delay were conducted. Piecewise linear mixed modeling estimated short- and long-term effects.

Results

For infants with significant motor delay, positive effects of START-Play were observed at 3 months for Bayley cognition, Bayley fine motor, and APSP and at 12 months for Bayley fine motor and reaching frequency outcomes. For infants with mild motor delay, positive effects of START-Play for the Bayley receptive communication outcome were found. For the UC-EI group, the only difference between groups was a positive effect for the APSP outcome, observed at 3 months.

Conclusion

START-Play may advance reaching, problem solving, cognitive, and fine motor skills for young infants with significant motor delay over UC-EI in the short term. START-Play in addition to UC-EI may not improve motor/cognitive outcomes for infants with milder motor delays over and above usual care.

Impact

Concepts of embodied cognition, applied to early intervention in the START-Play intervention, may serve to advance cognition and motor skills in young infants with significant motor delays over usual care early intervention.

Lay Summary

If you have a young infant with significant delays in motor skills, your physical therapist can work with you to develop play opportunities to enhance your child’s problem solving, such as that used in the START-Play intervention, in addition to usual care to help your child advance cognitive and motor skills.
Design, manufacture and testing of a prototype obstacle-detection device at blind corners: an automated highway system technology
Authors: Atombo Charles , Gbey Emmanuel , Holali Apevienyeku Kwami
Published: December 2020

Traffic accidents on highways are attributed mostly to the "invisibility" of oncoming traffic and road signs. "Speeding" also causes drivers to reduce the effective radius of the vehicle path in the curve, thus trespassing into the lane of the oncoming traffic. The main aim of this paper was to develop a multisensory obstacle-detection device that is affordable, easy to implement and easy to maintain to reduce the risk of road accidents at blind corners. An ultrasonic sensor module with a maximum measuring angle of 15° was used to ensure that a significant portion of the lane was detected at the blind corner. The sensor covered a minimum effective area of 0.5 m2 of the road for obstacle detection. Yellow light was employed to signify caution while negotiating the blind corner. Two photoresistors (PRs) were used as sensors because of the limited number of pins on the microcontroller (Arduino Uno). However, the device developed for this project achieved obstacle detection at blind corners at relatively low cost and can be accessed by all road users. In real-world applications, the use of piezoelectric accelerometers (vibration sensors) instead of PR sensors would be more desirable in order to detect not only cars but also two-wheelers.
Longitudinal Changes in Hearing Aid Use and Hearing Aid Management Challenges in Infants
Authors: Visram Anisa Sadru , Roughley Amber Jemima , Hudson Caroline Louise , Purdy Suzanne Carolyn , Munro Kevin James
Published: December 2020

Objective:

If the benefits of newborn hearing screening and early intervention are to be fully realized, there is a need to understand the challenges of hearing aid management in infants. The aim was to investigate longitudinal changes in hearing aid use and hearing aid management challenges in very young infants.

Design:

Eighty-one primarily female (99%) caregivers of infant hearing aid users completed a questionnaire about hearing aid management experiences, first when their infants were 3 to 7 months old (1 to 6 months after hearing aid fitting) and again at 7 to 21 months of age. Hearing aid data logging was compared with caregiver reports of daily use for 66 infants.

Results:

The main hearing aid management challenges reported by caregivers were performing listening checks and troubleshooting. These challenges reduced over the approximately 5-month time period but remained a problem with around a quarter of respondents still not confident or unsure about troubleshooting, and around a third not performing a daily listening check. Mean daily hearing aid use, obtained from data logging, declined significantly over time from 6.6 to 5.3 hours. Further analysis revealed reduced hearing aid use was primarily among infants with profound losses (n = 11). Caregivers overestimated daily hours of use at both time points. Caregivers reported difficulty with the infants pulling out their hearing aids, especially at the later time point.

Conclusions:

The findings from this relatively large sample of caregivers of young infants, assessed at two time points, revealed significant challenges in hearing aid management, including highly variable daily hearing aid use. Interventions that use behavior change techniques may be needed to ensure intentions are consistently turned into successful actions, if the benefits of newborn hearing screening and early intervention are to be fully realized.
Exceptional response to cyclophosphamide and dexamethasone in a patient with metastatic castrate-resistant prostate cancer and RB1 mutation
Authors: Dohogne Briana , Arif-Tiwari Hina , Bracamonte Erika , Babiker Hani M.
Published: December 2020

Rates of prostate cancer relapsing from anti-androgen therapies are increasing in the United States and worldwide. It has been suggested that this is caused by variant and altered lineage marker expression within the tumor, allowing for lineage plasticity that then facilitates therapeutic resistance. The genomic landscape of castrate-resistant prostate cancer has been well-defined with the advent of next-generation sequencing, but the clinical applications of these findings as measured by patient outcomes remains poorly understood. Here, we report on a patient with recurrent, metastatic castrate-resistant prostate cancer and identified RB1 mutation with progressive symptomatology, who was treated with cyclophosphamide and dexamethasone after other standard treatment regimens failed. After completing 2 years of treatment, he experienced complete resolution of his symptoms. Disease remission was confirmed on multiple imaging modalities and through serial measurements of prostate-specific antigen levels that showed a reduction of 99%. Our patient’s case supports ongoing research that genetic profiling can help elucidate key biological and molecular tumor components, which can then inform targeted, individualized treatment approaches in the management of recurrent, castrate-resistant prostate cancer.
Evodiamine inhibits vasculogenic mimicry in HCT116 cells by suppressing hypoxia-inducible factor 1-alpha-mediated angiogenesis
Authors: Zeng Di , Zhou Peng , Jiang Rong , Li Xiao-peng , Huang Shi-ying , Li Dan-yang , Li Guo-li , Li Li-sha , Zhao Shuang , Hu Ling , Ran Jian-hua , Chen Di-long , Wang Ya-ping , Li Jing
Published: December 2020

Evodiamine (Evo), a quinazoline alkaloid and one of the most typical polycyclic heterocycles, is mainly isolated from Evodia rugulosa. Vasculogenic mimicry (VM) is a newly identified way of angiogenesis during tumor neovascularization, which is prevalent in a variety of highly invasive tumors. The purpose of this study was to investigate the effect and mechanism of Evo on VM in human colorectal cancer (CRC) cells. The number of VM structures was calculated by the three-dimensional culture of human CRC cells. Wound-healing was used to detect the migration of HCT116 cells. Gene expression was detected by reverse transcription-quantitative PCR assay. CD31/PAS staining was used to identify VM. Western blotting and immunofluorescence were used to detect protein levels. The results showed that Evo inhibited the migration of HCT116 cells, as well as the formation of VM. Furthermore, Evo reduced the expression of hypoxia-inducible factor 1-alpha (HIF-1α), VE-cadherin, VEGF, MMP2, and MMP9. In a model of subcutaneous xenotransplantation, Evo also inhibited tumor growth and VM formation. Our study demonstrates that Evo could inhibit VM in CRC cells HCT116 and reduce the expression of HIF-1α, VE-cadherin, VEGF, MMP2, and MMP9.
Long-term outcomes of percutaneous coronary intervention for in-stent chronic total occlusion
Authors: Gong Ming-Lian , Mao Yi , Liu Jing-Hua
Published: December 2020

Background

The development of the technique has improved the success rate of percutaneous coronary intervention (PCI) for in-stent chronic total occlusion (IS-CTO). However, long-term outcomes remain unclear. The present study sought to investigate long-term outcomes of PCI for IS-CTO.

Methods

A total of 474 IS-CTO patients were enrolled at two cardiac centers from 2015 to 2018 retrospectively. These patients were allocated into either successful or failed IS-CTO PCI groups. The primary endpoint (major adverse cardiac events [MACE]) consisted of recurrent angina pectoris (RAP), target-vessel myocardial infarction (MI), heart failure, cardiac death, or ischemia-driven target-vessel revascularization (TVR) at follow-up. Multivariable Cox regression analysis was used to investigate the association between treatment appropriateness and clinical outcomes.

Results

A total of 367 patients were successfully treated with IS-CTO PCI while 107 patients had failed recanalization. After a median follow-up of 30 months (interquartile range: 17–42 months), no significant difference was observed between the two groups for the following parameters: cardiac death (successful PCI vs. failed PCI: 0.9% vs. 2.7%; adjusted hazard ratio [HR]: 1.442; 95% confidence interval [CI]: 0.21–9.887; P = 0.709), RAP (successful PCI vs. failed PCI: 40.8% vs. 40.0%; adjusted HR: 1.025; 95% CI: 0.683–1.538; P = 0.905), heart failure (successful PCI vs. failed PCI: 6.1% vs. 2.7%; adjusted HR: 0.281; 95% CI: 0.065–1.206; P = 0.088), target-vessel related MI (successful PCI vs. failed PCI: 1.5% vs. 2.7%; adjusted HR: 1.150; 95% CI: 0.221–5.995; P = 0.868), MACE (successful PCI vs. failed PCI: 44.2% vs. 45.3%; adjusted HR: 1.052; 95% CI: 0.717–1.543; P = 0.797). More patients were free of angina in the successful IS-CTO PCI group compared with failed PCI in the first (80.4% vs. 60%, P < 0.01) and second years (73.3% vs. 60.0%, P = 0.02) following up. Successful IS-CTO PCI had a lower incidence of MACE in the first and second years (20.2% vs. 40.0%, P < 0.01; 27.9% vs. 41.3%, P = 0.023) compared with failed PCI. After a median follow-up of 30 months, the reocclusion rate was 28.5% and TVR was 26.1% in the successful IS-CTO PCI group. Receiving >18 months of dual antiplatelet therapy (DAPT) was an independent predictor of decreased risk of TVR (HR: 2.682; 95% CI: 1.295–5.578; P = 0.008) or MACE (without TVR) (HR: 1.898; 95% CI: 1.036–3.479; P = 0.038) in successful IS-CTO PCI.

Conclusions

After a median follow-up of 30 months, the successful IS-CTO PCI group had MACE similar to that of the failed PCI group. However, the successful IS-CTO PCI group had improved angina symptoms and were free from requiring coronary artery bypass grafting in the first or second years. To decrease MACE, DAPT was found to be essential and recommended for at least 18 months for IS-CTO PCI.
Association between serum bilirubin concentration and Parkinson's disease: a meta-analysis
Authors: Jin Jia-Ning , Liu Xian , Li Ming-Juan , Bai Xin-Ling , Xie An-Mu
Published: December 2020

Background:

The antioxidant effects of bilirubin in Parkinson's disease (PD) have recently gained much attention from the research community. However, results from these studies have been conflicting. This meta-analysis is conducted to assess the relationship between the serum bilirubin concentration and the risk of PD.

Methods:

Two reviewers performed a systematic literature search across five databases (MEDLINE, PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials). The case-control studies regarding bilirubin levels in PD patients published up to April 2020 were included. These studies were subjected to rigorous scrutiny and data extraction to determine the standard mean difference (SMD) and the 95% confidence interval (CI), which were analyzed using the Stata V.12.0 statistical software.

Results:

A total of eight studies which included 1463 PD cases and 1490 controls were incorporated into our meta-analysis. SMD analysis showed that there was a higher total bilirubin (TBIL) and direct bilirubin (DBIL) levels in PD patients compared with controls (for TBIL, SMD: 0.300, 95% CI: 0.050–0.549, P = 0.018; for DBIL, SMD: 0.395, 95% CI: 0.102–0.688, P = 0.008). However, no significant relationship was found between the serum indirect bilirubin and PD patients (SMD: −0.223, 95% CI: −0.952–0.505, P = 0.548). A subgroup analysis based on ethnicity indicated that the serum TBIL was higher in PD patients of Caucasian descent in contrast to matched healthy controls (SMD: 0.511, 95% CI: 0.324–0.698, P = 0.000, I
2 = 58.0%).

Conclusion:

Higher serum bilirubin levels in PD patients suggest that bilirubin might play a role in the pathogenesis of PD and have the potential to be utilized as a biochemical marker for PD diagnosis and treatment.
Ingenol Mebutate
Authors: Peterson Hannah , Luke Janiene
Published: December 2020

An actinic keratosis is a premalignant lesion of abnormal keratinocytes that develops on sun-exposed areas of the skin. Actinic keratoses are concerning because they can progress to squamous cell carcinoma in a minority of cases. The purpose of this column is to highlight some of the more commonly encountered drugs in dermatology. Ingenol mebutate (Picato) is a topical cream derived from the sap of the Euphorbia peplus plant and is approved by the Food and Drug Administration for use in the treatment of actinic keratoses. In this article, the role of ingenol mebutate as a dermatologic treatment for actinic keratoses will be discussed, and more specifically, this article will bring further understanding to the mechanism of action, administration, dosage, patient education points, adverse effects, and viable alternatives to this medication.
Case Study
Authors: Russell Nancy Gentry
Published: December 2020

Squamous cell carcinoma is the second most common nonmelanoma skin cancer, and it may present in a variety of ways. Several common conditions, including some that are benign, may mimic squamous cell carcinoma. It is critical for clinicians to be knowledgeable of the presentation of squamous cell carcinoma and other conditions that may present similarly to prevent a delayed or missed diagnosis. This case will be helpful for providers in general dermatology practice as it describes a presentation of squamous cell carcinoma and differential diagnoses considered.
The Prescription of Long-Acting Opioids for Working-Age Patients With Workers’ Compensation or Chronic Illness Diagnoses in the United States
Authors: Topper Leah , Rosas Valeria Menendez , Aarkoti Malathi , Doucette John , Nabeel Ismail
Published: December 2020

Objective:

To examine associations of workers’ compensation, chronic conditions, age, sex, and race/ethnicity with primary prescription of long-acting opioids (LAO) among working-age patients in ambulatory care.

Methods:

Using the National Ambulatory Medical Care Survey (2010 to 2016), we conducted descriptive, bivariate, and multivariate logistic regression analyses of patients aged 18 to 64 with an LAO as their primary medication.

Results:

Those prescribed an LAO were more likely to be men (adjusted odds ratio [aOR] = 1.48, 95% CI 1.13, 1.91), have workers’ compensation (aOR = 2.00, 95% CI 1.12, 3.57), or have diagnoses of lower back pain (aOR = 4.70, 95% CI 3.51, 6.29), arthritis (aOR = 1.53, 95% CI 1.11, 2.09), or depression (aOR = 1.69; 95% CI 1.24, 2.31). Hispanic ethnicity/race had a lower likelihood of LAO use compared with non-Hispanic White (aOR = 0.58; 95% CI 0.37, 0.90).

Conclusions:

Male sex, workers’ compensation, and diagnoses of lower back pain, arthritis, or depression were independently associated with increased LAO prescription odds.
Make the Right Diagnosis: My Pearls for Working Up Hip-related Pain
Authors: Byrd J.W. Thomas
Published: December 2020

The origin of pain around the hip is commonly more elusive than other joints; often obscured by compensatory disorders. Hip problems tend to be multifactorial and require a multidisciplinary approach in the evaluation. The best strategy is to team with a capable physical therapist to unveil the layers of problems. Ultrasonography and imaging/ultrasound-guided injections can be the most valuable adjunct to the history and physical examination. Plain radiographs are an essential element in the workup. Magnetic resonance imaging can underestimate damage in the joint, but positive findings can sometimes be the normal consequence of age and activity. Magnetic resonance imaging is often as important for what it rules out as much as what it rules in. Computed tomography scans with 3-dimensional reconstructions can be especially helpful in surgical planning but are not used in routine screening, being thoughtful of radiation exposure even with low-dose protocols. Arthroscopic access to the hip is more challenging than other joints, and similarly, unlocking its clinical secrets can be more imposing as well.
Decision-making in the Borderline Hip
Authors: Nepple Jeffrey J. , Fowler Lucas M. , Larson Christopher M.
Published: December 2020

Borderline acetabular dysplasia represents a “transitional acetabular coverage” pattern between more classic acetabular dysplasia and normal acetabular coverage. Borderline dysplasia is typically defined as a lateral center-edge angle of 20 to 25 degrees. This definition of borderline dysplasia identifies a relatively narrow range of lateral acetabular coverage patterns, but anterior and posterior coverage patterns are highly variable and require careful assessment radiographically, in addition to other patient factors. Treatment decisions between isolated hip arthroscopy (addressing labral pathology, femoroacetabular impingement bony morphology, and capsular laxity) and periacetabular osteotomy (improving osseous joint stability; often combined with hip arthroscopy) remain challenging because the fundamental mechanical diagnosis (instability vs. femoroacetabular impingement) can be difficult to determine clinically. Treatment with either isolated hip arthroscopy or periacetabular osteotomy (with or without arthroscopy) appears to result in improvements in patient-reported outcomes in many patients, but with up to 40% with suboptimal outcomes. A patient-specific approach to decision-making that includes a comprehensive patient and imaging evaluation is likely required to achieve optimal outcomes.
The role of CHA2DS2-VASc score in evaluating patients with atrial fibrillation undergoing percutaneous coronary intervention
Authors: Parfrey Shane , Teh Andrew W. , Roberts Louise , Brennan Angela , Clark David , Duffy Stephen J. , Ajani Andrew E. , Reid Christopher M. , Freeman Melanie
Published: December 2020

Objective

The aim of the review was to assess whether CHA2DS2-VASc score is predictive of mortality in patients with atrial fibrillation undergoing percutaneous coronary intervention (PCI).

Background

The CHA2DS2-VASc score is validated in predicting stroke risk in atrial fibrillation. The optimum management strategy for these patients undergoing PCI is still debated.

Methods

The CHA2DS2-VASc score was calculated in consecutive patients with atrial fibrillation undergoing PCI in a large Australian registry between 2007 and 2013. Patients were divided into low (1–2), intermediate (3–4) and high (≥5) groups. Clinical and procedural data, 30-day, 1-year and long-term outcomes were compared between the groups.

Results

A total of 564 patients were included in our analysis. Patients with high CHA2DS2-VASc scores had higher mortality rates at 1-year (2, 8, 15; P = 0.002) and long-term (6, 20, 37; P < 0.001). High-risk patients were more likely to have renal impairment and multivessel disease. Increasing CHA2DS2-VASc score was associated with increased risk of stroke (0, 2, 6; P = 0.03). However, only 41.9% received anticoagulation, with no difference across the risk groups. When compared to low-risk, intermediate [HR 3.57; 95% confidence interval (CI), 1.28–9.92; P = 0.015] and high (hazard ratio 7.82; 95% CI, 2.88–21.24; P < 0.001) CHA2DS2-VASc scores were significant predictors of long-term mortality.

Conclusions:

Higher CHA2DS2-VASc scores in patients with atrial fibrillation undergoing PCI are associated with significantly worse outcomes. Despite being high-risk, the patients in this cohort are likely undertreated with anticoagulation. Close clinical follow-up with greater utilization of anticoagulation and optimal medical therapy has the potential to improve long-term outcomes.