bluuebunny/crossref_metadata_2025 huggingface dataset:
Usefulness of An Anal Sphincter Injury Mouse Model by Means of a Balloon Catheter and a New Method of Evaluating Anal Sphincter Function
Authors: Yukimoto Ryohei , Miyoshi Norikatsu , Fujino Shiki , Mori Ryota , Ogino Takayuki , Takahashi Hidekazu , Uemura Mamoru , Mizushima Tsunekazu , Doki Yuichiro , Eguchi Hidetoshi
Published: November 2021

Background

The incidence of fecal incontinence is ~2%, and the associated symptoms significantly impact daily life. New treatment methods including electrical stimulation and regenerative therapy using stem cells for fecal incontinence have been reported. We explored the usefulness of an anal sphincter injury mouse model by means of a balloon catheter and focused on the defecation status of mice as a novel method for evaluating anal function. We examined the utility of the mouse model of anal sphincter injury and the efficacy of electrical stimulation as a treatment modality using this model.

Methods

A 10‐mm balloon catheter was used to create an anal sphincter injury model in mice. Sphincter function was evaluated in the noninjured (n = 4), injured (n = 4), noninjured electrical stimulation (n = 4), and injured electrical stimulation (n = 4) groups. Defecation status (defecation frequency in 24 h and fecal weight per stool) and pathological evaluation were used for comparison.

Results

The defecation frequency increased and the fecal weight per stool decreased significantly in the anal sphincter injury model. Pathological evaluation revealed that anal sphincter tears occurred the day after the injury. Meanwhile, the defecation frequency improved on d 7, and the fecal weight per stool gradually normalized to that of the control group and exhibited significant sphincter muscle hypertrophy in the electrical stimulation group.

Conclusion

Anal sphincter injury using a balloon catheter in mice allowed us to create a uniform model. The evaluation of defecation status in mice is a useful method for comparatively evaluating anal function.
Genetic variants of PON1, GSTM1, GSTT1, and locus 9p21.3, and the risk for premature coronary artery disease in Yucatan, Mexico
Authors: García‐González Igrid , Pérez‐Mendoza Gerardo , Solís‐Cárdenas Alberto , Flores‐Ocampo Jorge , Herrera‐Sánchez Luis Fernando , Mendoza‐Alcocer Renan , González‐Herrera Lizbeth
Published: November 2021

Objective

Genetic variants of PON1, rs70587, rs662, rs854560, GSTM1, and GSTT1 and two single nucleotide polymorphisms (SNP) at 9p21.3 locus, rs1333049, and rs2383207; were evaluated in association with the risk for premature coronary artery disease (CAD) in a population of Yucatan, Mexico. These genes are involved in the inactivation of pro‐oxidants and pro‐inflammatory mediators, lipid and xenobiotic metabolism, detoxification of reactive oxygen species, and regulation of cellular proliferation playing key roles in the pathogenesis of atherosclerosis.

Methods

We conducted a matched case–control study with 98 CAD cases and 101 healthy controls. Genotyping of PON1 and 9p21.2 SNP was performed by real time‐PCR and for GSTM1 and GSTT1 with multiplex‐PCR. Odds ratios (OR) were calculated to estimate association and generalized multifactor dimensionality reduction (GMDR) algorithm to identify gene–gene and gene–environment interactions.

Results

The distribution of all allele/genotype frequencies in controls was within Hardy–Weinberg expectations (p > .05) except for GSTM1. The allele/genotype frequencies of the GSTT1 null were significantly higher in CAD cases than in controls, suggesting association with higher risk for developing CAD. The other SNPs did not show any significant independent association with premature CAD. GMDR revealed a significant interaction between GSTT1 and LL55 genotype. Likewise, the body mass index (BMI) and smoking also showed an interaction with GSTT1.

Conclusion

The GSTT1 null allele/genotype is associated with an increased risk of developing premature CAD, the effect of which is not modified by cardiovascular risk factors in the population of Yucatan.
Trends of cigarette smoking and smokeless tobacco use among US firefighters and law enforcement personnel, 1992–2019
Authors: Phan Lilianna , McNeel Timothy S. , Jewett Bambi , Moose Katherine , Choi Kelvin
Published: November 2021

Background

Previous studies indicate tobacco use was more prevalent among firefighters and law enforcement personnel than in the US adult population. Trends of smoking and smokeless tobacco (SLT) use among these first responders are unknown. We examined trends in current smoking and SLT use among US firefighters and law enforcement personnel and compared smoking and SLT use prevalence in firefighters and law enforcement personnel to US adults in non‐first‐responder occupations.

Methods

Trends of smoking and SLT use prevalence among firefighters, law enforcement personnel, and adults in other occupations were assessed by fitting joinpoint regression models using the 1992–2019 Tobacco Use Supplement to the Current Population Survey (TUS‐CPS). We used multivariable logistic regression models adjusted for demographics to examine associations between occupation and smoking and SLT use status using the 2018–2019 TUS‐CPS data. Analyses were conducted in 2021.

Results

From 1992 to 2019, the smoking prevalence declined overall (all p's < 0.01). Though SLT use prevalence among adults in non‐first‐responder occupations declined (annual percentage change [APC] = −1.2%; 95% confidence interval [CI] = −1.7% to −0.7%), no changes were shown among firefighters and law enforcement personnel which suggests SLT use may be increasing among firefighters over time. In 2018–2019, firefighters (adjusted odds ratio [AOR] = 3.4; 95% CI = 1.7 to 6.8) and law enforcement personnel (AOR = 3.2; 95% CI = 2.1 to 4.7) were more likely than adults in non‐first‐responder occupations to use SLT.

Conclusions

While smoking prevalence declined overall, SLT use is higher among firefighters and law enforcement personnel and may be increasing over time among firefighters. Research should examine reasons for SLT use by first responders. Comprehensive tobacco policies and SLT‐specific cessation programs are needed for first responders.
A case–control study of respiratory medication and co‐occurring gastrointestinal prescription burden among persons with Ehlers–Danlos syndromes
Authors: Bascom Rebecca , Dhingra Radha , Francomano Clair A. , Schubart Jane R.
Published: November 2021

We previously reported increased pain and gastrointestinal (GI) medication prescription claims among persons with Ehlers–Danlos syndromes (EDS) and peripubertal increase in opioid and anti‐emetic claims among women with EDS. Herein, we hypothesized a higher proportion of respiratory and co‐occurring respiratory and GI medication prescription claims among persons with EDS compared to their matched controls with increases among peripubertal women with EDS. We compared the proportions of respiratory and co‐occurring respiratory and GI medication prescription claims among persons with EDS (aged 5–62) against their age‐, sex‐, state of residence‐, and earliest claim date‐matched controls using 10 years of private prescription claims data. Prescription claims among persons with EDS versus matched controls were increased for eight medication classes (p < .0001): intranasal/inhaled corticosteroids (ICS) (30.8% vs. 19.0%), oral steroids (30.0% vs. 16.5%), H1‐antihistamines (26.2% vs. 12.2%), short‐acting beta agonists (22.7% vs. 11.6%), decongestants (21.6% vs. 15.9%), leukotriene modifiers (8.9% vs. 3.6%), ICS/long‐acting beta agonists (5.7% vs. 2.9%), muscarinic antagonists (2.5% vs. 0.9%), and co‐occurring prescriptions (29% vs. 10%). Our results suggest a critical time window for peripubertal intervention and research and a need to focus on the pathogenesis and clinical evaluation of EDS‐specific respiratory and aerodigestive disorders.
Hydrogen Bonds Dominate Brønsted Acid Sites in Zeolite SSZ‐42: A Classification of Their Diversity
Authors: Schroeder Christian , Zones Stacey I. , Hansen Michael Ryan , Koller Hubert
Published: November 2021

The zeolite catalyst SSZ‐42 shows a remarkable high abundance (≈80 %) of hydrogen‐bonded Brønsted acid sites (BAS), which are deshielded from the 1H chemical shift of unperturbed BAS at typically 4 ppm. This is due to their interaction with neighboring oxygen atoms in the zeolite framework when oxygen alignments are suitable. The classification and diversity of hydrogen bonding is assessed by DFT calculations, showing that oval‐shaped 6‐rings and 5‐rings allow for a stronger hydrogen bond to oxygen atoms on the opposite ring side, yielding higher experimental chemical shifts (δ (1H)=6.4 ppm), than circular 6‐rings (δ(1H)=5.2 ppm). Cage‐like structures and intra‐tetrahedral interactions can also form hydrogen bonds. The alignment of oxygen atoms is expected to impact their role in the stabilization of intermediates in catalytic reactions, such as surface alkoxy groups and possibly transition states.
Converting waste polystyrene foam into new value‐added materials: A large‐capacity scavenger to remove cationic dyes and heavy metals
Authors: Ye Hao , Xie Zhengfeng , Li Wei , Pu Yanghao , Liu Minyao , Wen Yiping , Liu Yucheng
Published: November 2021

Waste white foam, toxic dyes, and metal ions are difficult to degrade in the ecological environment, posing a serious threat to human health and natural beauty, it is of great significance to design a functional material to jointly solve these problems. This study provided a facile approach to convert waste polystyrene foam into a new acid anhydride modified polystyrene adsorbent (PS‐MA) for the dyes and heavy metals removal from aqueous solution. The as‐obtained absorbent was characterized by Fourier transform infrared spectroscopy, thermogravimetry, scanning electron microscopy, energy dispersive spectroscopy, Brunauer Emmett Teller method, and X‐ray photoelectron spectroscopy. Influencing factors are including, pH, dye concentration, contact time and temperature on the adsorption of methylene blue (MB), safranine T (ST), and Cu(II) were systematically studied. Boehm titration showed that the content of surface carboxyl groups reached 4.53 mmol/g. The maximum adsorption capacity had reached 1405.37 mg/g for MB, 2269.33 mg/g for ST, 65.03 mg/g for Cu(II). Moreover, the kinetic data were in good agreement with the pseudo‐second‐order model and closed to adsorption equilibrium at 20 min. After five times of recycling experiments and the application of mixed dye wastewater with salinity, PS‐MA showed excellent stability and removal ability. Abundant efforts revealed a broad application prospect of PS‐MA materials in water remediation.
Characterizing X‐ray activity cycles of young solar‐like stars with solar observations
Authors: Coffaro Martina , Stelzer Beate , Orlando Salvatore
Published: November 2021

Throughout an activity cycle, magnetic structures rise to the stellar surface, evolve, and decay. Tracing their evolution on a stellar corona allows us to characterize the X‐ray cycles. However, directly mapping magnetic structures is feasible only for the Sun, while such structures are spatially unresolved with present‐day X‐ray instruments on stellar coronae. We present here a new method, implemented by us, that indirectly reproduces the stellar X‐ray spectrum and its variability with solar magnetic structures. The technique converts solar corona observations into a format identical to that of stellar X‐ray observations and, specifically, spectra of the X‐ray satellite XMM‐Newton. From matching these synthetic spectra with those observed for a star of interest, a fractional surface coverage with solar magnetic structures can be associated to each X‐ray observation. We apply this method to two young solar‐like stars: Eri ( Myr), the youngest star to display a coronal cycle ( yr), and Kepler 63 ( Myr), for which the X‐ray monitoring did not reveal a cyclic variability. We found that even during the cycle minimum a large portion of Eri's corona is covered with active structures. Therefore, there is little space for additional magnetic regions during the maximum, explaining the small observed cycle amplitude () in terms of the X‐ray luminosity. Kepler 63 displays an even higher coverage with magnetic structure than the corona of Eri. This supports the hypothesis that for stars younger than Myr the X‐ray cycles are inhibited by a massive presence of coronal regions.
Beneficial effects of PEGylated graphene quantum dot on arrhythmias induced by myocardial infarction
Authors: Rostamzadeh Farzaneh , Najafipour Hamid , Jafarinejad‐Farsangi Saeideh , Ansari‐Asl Zeinab
Published: November 2021

Arrhythmias are one of the leading causes of early death following myocardial infarction (MI) and heart failure. Graphene derivatives have emerged as an therapeutic target that have electrical conductivity. The study aimed to evaluate the impacts of polyethylene glycol–graphene quantum dots (GQDs‐PEG) on arrhythmias created by MI in the rat. Animals were randomly assigned to five groups of sham, MI, and MI + GQDs‐PEG at doses of 5, 10, and 20 mg/kg. MI was induced by the closure of the left anterior descending artery. The day after MI, animals were administered vehicle (phosphate buffered saline) or GQDs‐PEG at different doses every other day for 2 weeks. On day 15, electrocardiogram (ECG), mean arterial pressure (MAP), and heart contractility indices were recorded by the PowerLab data acquisition system. GQDs‐PEG 20 mg/kg increased contractility and improved the reduction of MAP in the MI group. The prolonged QT and QTc intervals, inverted T wave, and deviated ST segment were modified by GQDs‐PEG 10 and 20 mg/kg in rats with MI. The amplitude of the Q wave was also decreased in a dose‐dependent manner in the GQDs‐PEG–treated rats. The results demonstrated that 2 weeks of treatment with GQDs‐PEG normalized ECG abnormalities and improved left ventricular dysfunction in rats with MI.
Prevalence of neural tube defects, maternal HIV status, and antiretroviral therapy from a hospital‐based birth defect surveillance in Kampala, Uganda
Authors: Barlow‐Mosha Linda , Serunjogi Robert , Kalibbala Dennis , Mumpe‐Mwanja Daniel , Williamson Dhelia , Valencia Diana , Tinker Sarah C. , Matovu Joyce Namale , Moore Cynthia A. , Adler Michelle R. , Nelson Lisa , Nankunda Jolly , Nabunya Evelyn , Birabwa‐Male Doreen , Musoke Philippa
Published: November 2021

Background

The estimated prevalence of neural tube defects (NTDs) in Africa is 11.7 per 10,000 live births; however, data on the impact of antiretroviral therapy (ART) during pregnancy and the risk for birth defects in Africa are limited.

Methods

Data from a hospital‐based surveillance program at four hospitals in Kampala, Uganda were used to estimate the baseline prevalence of NTDs and assess potential associations with HIV status and ART use. All live births, stillbirths, and spontaneous abortions delivered at the participating hospitals affected with selected birth defects between August 2015 and December 2018 were included. Trained midwives collected data from hospital records, maternal interviews, photographs, and narrative descriptions of birth defects. We estimated NTD prevalence per 10,000 births (live, stillbirths, spontaneous abortions), prevalence ratios, and 95% confidence intervals (CIs).

Results

A total of 110,752 births from 107,133 women were included in the analysis; 9,394 (8.8%) women were HIV‐infected and among those with HIV infection, 95.6% (n = 8,977) were on ART at delivery. Overall, 109 births were affected with NTDs, giving a prevalence of 9.8 (95% CI [8.2, 11.9]). Spina bifida (n = 63) was the most common type of NTD, with a prevalence of 5.7 (95% CI [4.4, 7.3]), followed by anencephaly (n = 31), with a prevalence of 2.8 (95% CI [2.0, 4.0]).

Conclusion

The prevalence of NTDs among births in Kampala, Uganda is consistent with current estimates for Africa. With the continued introduction of new medications that may be taken during pregnancy, sustainable birth defect surveillance systems and pharmacovigilance are indicated.
An anatomical study defining the safe range of angles in percutaneous iliosacral and transsacral screw fixation
Authors: Do Michael T. , Levine Ari D. , Liu Raymond W.
Published: November 2021

Percutaneous iliosacral screw fixation and transsacral fixation are challenging procedures requiring extensive knowledge of sacral anatomy to avoid damaging nearby neurovascular structures. Greater knowledge of anatomical screw trajectory and size allowances would be helpful to guide surgical placement. An anatomical study of 40 cadaveric sacra in specimens ages 18–65 was performed. Three‐dimensional surface scans were obtained, and computer modeling software was used to simulate a 7.3 mm diameter screw with 1 mm buffer inserted orthogonal to the sacroiliac joint in the pelvic inlet and outlet views. Transsacral screws were also inserted into S1 and S2 vertebrae. For screws orthogonal to the sacroiliac joint, the overall mean screw insertion angle was 4.1° ± 7.5° (range, −18.3° to 22.0°) in the inlet view in the posterior to anterior direction, and 21.7° ± 5.1° (range, 8.2°–36.3°) in the outlet view in the caudal to cranial direction. Before breaching the sacrum, the range of sacral tunnel lengths was between 31.1 and 70.1 mm with a range of diameters between 9.3 and 13.3 mm. Transsacral screws inserted into either the S1 or S2 vertebrae did not breach the sacrum in 40% (16/40) at each level. 30% (12/40) of sacra could not safely accommodate both S1 and S2 transsacral screws. There is an initial screw insertion angle range of −4° to 12° in the inlet view and 16°–27° in the outlet view. There was always adequate size to accept a 7.3 mm or larger screw.
Esophageal length in children: Reference data and a novel predictive equation
Authors: Tinawi Georges K. , Stringer Mark D.
Published: November 2021

Minimal information exists on the length of the child's esophagus, namely the distance from the cricopharyngeus to the esophagogastric junction (EGJ). We aimed to investigate the relationship between esophageal length (EL) and the age, height, and weight of the child. Children undergoing upper gastrointestinal endoscopy between February 2019 and May 2021 at our institution were prospectively audited. Children with anatomical esophageal disorders were excluded. Endoscopic distances from the incisors to the cricopharyngeus and EGJ were obtained, and novel predictive equations derived to predict EL. Intra‐observer agreement for endoscopic measurements showed an intra‐class correlation coefficient of 0.99. A total of 290 children aged 0.4–17.3 years were included in the analysis; they were divided into a model development cohort (n = 261) and a model validation cohort (n = 29). Measured EL correlated best with height (r = 0.92) as compared to age (r = 0.90) or weight (r = 0.83). The optimal equation for predicting EL was 0.156 × height (cm) – 1.336 (adjusted R2 = 0.841); this had a success rate of 76% in the validation cohort. The optimal equation for predicting distance from incisors to EGJ was 0.199 × height (cm) + 6.470 (adjusted R2 = 0.889); this had a success rate of 69% in the validation cohort. This is the first study to report a predictive equation for estimating esophageal length in children. Accurate prediction of esophageal length may assist with clinical esophageal procedures in children such as nasogastric and pH probe placement.
The need for speed in advanced non‐small cell lung cancer: A population kinetics assessment
Authors: Stewart David J. , Maziak Donna E. , Moore Sara M. , Brule Stephanie Y. , Gomes Marcio , Sekhon Harman , Dennie Carole , Lo Bryan , Fung‐Kee‐Fung Michael , Bradford John‐Peter , Reaume Martin Neil
Published: November 2021

Background

Systemic therapy prolongs overall survival (OS) in advanced non‐small cell lung cancer (NSCLC), but diagnostic tests, staging and molecular profiling take time, and this can delay therapy initiation. OS approximates first‐order kinetics.

Methods

We used OS of chemo‐naive NSCLC patients on a placebo/best supportive care trial arm to estimate % of patients dying while awaiting therapy. We digitized survival curves from eight studies, calculated OS half‐life, then estimated the proportion surviving after different times of interest (tn) using the formula: , where EXP signifies exponential, * indicates multiplication, 0.693 is the natural log of 2, and t1/2 is the survival half‐life in weeks.

Results

Across trials, the OS half‐life for placebo/best supportive care in previously untreated NSCLC was 19.5 weeks. Hence, based on calculations using the formula above, if therapy were delayed by 1, 2, 3, or 4 weeks then 4%, 7%, 10%, and 13% of all patients, respectively, would die while awaiting treatment. Others would become too sick to consider therapy even if still alive.

Conclusions

This quantifies why rapid baseline testing and prompt therapy initiation are important in advanced NSCLC. It also illustrates why screening procedures for clinical trial inclusion must be faster. Otherwise, it is potentially hazardous for a patient to be considered for a trial due to risk of death or deterioration while awaiting eligibility assessment. It is also important to not delay initiation of systemic therapy for procedures that add relatively little value, such as radiotherapy for small, asymptomatic brain metastases.
Adherence to follow‐up after the exit cervical cancer screening test at age 60–64: A nationwide register‐based study
Authors: Jørgensen Susanne F. , Andersen Berit , Petersen Lone Kjeld , Rebolj Matejka , Njor Sisse H.
Published: November 2021

Background

In Denmark, human papillomavirus (HPV) testing has replaced cytology in primary cervical cancer screening for women aged 60–64; at this age, women are invited for the last (exit) screening test within the national organized program.

Aim

We investigated the adherence of these women to the recommended follow‐up after a non‐negative (positive or inadequate) HPV test and the overall resource use during that follow‐up.

Materials & Methods

We included all 2926 women aged 60–64 years with nonnegative HPV screening tests between March 2012 and December 2016. All relevant follow‐up tests and procedures were retrieved until the end of 2020 from the highly complete Danish administrative health registers, and the data were linked at the individual level. We determined the extent to which the adherence patterns followed the national recommendations for follow‐up and estimated the total numbers of tests and diagnostic procedures utilized during the entire process.

Results

In total, only 26% of women had follow‐up in accordance with the recommendations; 4% had no follow‐up, 46% had insufficient follow‐up, and 24% had more follow‐up than recommended. We estimated that 17% of women remained in follow‐up for longer than 4 years. The average numbers of diagnostic tests and procedures used after positive HPV screening were higher than expected, even among women who had insufficient follow‐up, that is, those who received less invasive procedures than recommended, or experienced delays in receiving those procedures.

Conclusion

To conclude, we found that the patterns of follow‐up of women with nonnegative primary HPV screening tests at 60–64 often diverged from the recommendations. Addressing these inconsistencies in follow‐up by providing evidence for optimal clinical management should help improve the quality of screening programs and secure an equal and reliable follow‐up care service for all women.
Discovery of Natural Product‐Based Fungicides (III): Semisynthesis and Biological Activity of N‐Phenylpyrazole Sarisan Hybrids as Antifungal Agents
Authors: Hou Enhua , Han Meiyue , Wang Xiaoguang , Cheng Wanqing , Cao Jiangping , Yang Ruige , Guo Yong
Published: November 2021

Many phytopathogenic fungi can easily infect crops, resulting in crop yield reductions. In continuation of our efforts to develop natural product (NP)‐based antifungal agents, a series of N‐phenylpyrazole sarisan hybrids 6a–v were prepared via I2‐mediated oxidative cyclization, and their structures were determined by various spectral analyses including IR, 1H‐NMR and ESI‐MS. Among all N‐phenylpyrazole sarisan hybrids, compounds 6a, 6b, 6e, 6i, 6j and 6r exhibited more encouraging antifungal action against at least two phytopathogenic fungi than the reference fungicide hymexazol. Especially, 6a displayed really encouraging and broad‐spectrum antifungal activity against F. graminearum, V. mali, and F. oxysporum f.sp.niveum with the EC50 values of 12.6±0.9, 18.5±0.2, and 37.4±1.8 μg/mL, respectively. Moreover, the structure‐activity relationships (SARs) were also observed. Additionally, compounds 6a and 6e also exhibited relative low toxicity on normal LO2 cells. This study indicates that these N‐phenylpyrazole sarisan hybrids would shed light on developing novel NP‐based antifungal agents.
Novel intracardiac echocardiography‐guided catheter‐based removal of inoperable tricuspid valve vegetation
Authors: Hammad Tarek A. , Abu‐Omar Yasir , Shishehbor Mehdi H.
Published: November 2021

With the ongoing intravenous drug abuse (IVDA) epidemic, the number of IVDA patients with infective endocarditis is increasing. These cases are often characterized by large vegetations complicated by valvular dysfunction, heart failure, and recurrent septic pulmonary emboli demanding surgical intervention. Latter cannot be offered in a good proportion of the patients due to challenging medical and social complexities. Hence, AngioVac system has been used as an alternative therapy; however, it is associated with high procedural mortality. In this document, we describe in detail the successful treatment of a case of large tricuspid valve vegetation, with prohibitive risk for surgery, using a percutaneous catheter‐based system, the Triever aspiration catheter with FLEX technology, with the guidance of intracardiac echocardiogram.
Respiration‐related variations in Pd/Pa ratio and fractional flow reserve in resting conditions and during intravenous adenosine administration
Authors: Feenstra Rutger G. T. , van Lavieren Martijn A. , Echavarria‐Pinto Mauro , Wijntjens Gilbert W. , Stegehuis Valerie E. , Meuwissen Martijn , de Winter Robbert J. , Beijk Marcel A.M. , Lerman Amir , Escaned Javier , Piek Jan J. , van de Hoef Tim P.
Published: November 2021

Aims

We evaluated the occurrence and physiology of respiration‐related beat‐to‐beat variations in resting Pd/Pa and FFR during intravenous adenosine administration, and its impact on clinical decision‐making.

Methods and Results

Coronary pressure tracings in rest and at plateau hyperemia were analyzed in a total of 39 stenosis from 37 patients, and respiratory rate was calculated with ECG‐derived respiration (EDR) in 26 stenoses from 26 patients. Beat‐to‐beat variations in FFR occurred in a cyclical fashion and were strongly correlated with respiratory rate (R2 = 0.757, p < 0.001). There was no correlation between respiratory rate and variations in resting Pd/Pa. When single‐beat averages were used to calculate FFR, mean ΔFFR was 0.04 ± 0.02. With averaging of FFR over three or five cardiac cycles, mean ΔFFR decreased to 0.02 ± 0.02, and 0.01 ± 0.01, respectively. Using a FFR ≤ 0.80 threshold, stenosis classification changed in 20.5% (8/39), 12.8% (5/39) and 5.1% (2/39) for single‐beat, three‐beat and five‐beat averaged FFR. The impact of respiration was more pronounced in patients with pulmonary disease (ΔFFR 0.05 ± 0.02 vs 0.03 ± 0.02, p = 0.021).

Conclusion

Beat‐to‐beat variations in FFR during plateau hyperemia related to respiration are common, of clinically relevant magnitude, and frequently lead FFR to cross treatment thresholds. A five‐beat averaged FFR, overcomes clinically relevant impact of FFR variation.
Balloon internal fixation: A novel approach to manipulate catheter knotting
Authors: Yan Xian‐Liang , Cheng Yu‐Tong , Sun Tao
Published: November 2021

A successful alternative technique to resolve the catheter knotting during radial access using balloon internal fixation of 5F angiographic catheter in the cath laboratory.
Complex regional pain syndrome following southern Pacific rattlesnake (C. oreganus helleri) envenoming
Authors: House Lawrence McLean , Lewin Matthew R , Naidu Ramana K. , Beqaj Halil
Published: November 2021

Complex regional pain syndrome (CRPS) has rarely been reported in the setting of snakebite but might be more common than previously reported. We present the third case of CRPS reported in North America and the first resulting from a pit‐viper's bite.
Extensive bilateral intracranial calcifications and seizure in iatrogenic hypoparathyroidism: A case report
Authors: Chapagain Parikshit , Khanal Shambhu , Ojha Rajeev , Gautam Niraj , Sayami Matina , Bhandari Roshan
Published: November 2021

Postoperative permanent hypoparathyroidism can exhibit extensive intracranial calcifications involving basal ganglia, thalamus, cerebellum, and cerebral cortex.
Effect of SiO2 on the CO Selective Methanation over SiO2/Ni‐ZrO2 Catalysts
Authors: Guo Qing , Li Shaozhong , Li Jin , Hu Yongke , Li Yanxing
Published: November 2021

CO selective methanation is a reliable and efficient method for deep CO removal from H2‐rich reformate gases in proton exchange membrane fuel cell (PEMFC). In this study, a series of SiO2/Ni‐ZrO2 catalysts with different mass fractions of SiO2 was prepared for CO selective methanation, and the structures and surface chemical properties of Ni‐ZrO2 could be controlled by SiO2. It was found that SiO2 greatly increased the specific surface areas of the catalyst and the dispersion of supported metallic Ni, which endowed the catalyst with higher active Ni surface area and then increased the adsorption quantity of CO, which improved the conversion of CO at low temperature. More importantly, the SiO2 weakened the surface basicity over the Ni‐ZrO2 catalyst, and thus decreased the strength and quantity of CO2 adsorption, which greatly inhibited the methanation of CO2, leading to the higher selectivity for CO methanation. However, the strength of CO adsorption was found to be more related to the methanation of CO, which would be weakened by SiO2 in the catalysts. Meanwhile, the SiO2 increased the strength of H2 adsorption over Ni surface. Therefore, excess SiO2 added into Ni‐ZrO2 enhanced the competitive adsorption between CO and H2 molecules over Ni surface, which weakened CO adsorption, resulting in the increase of CO outlet concentration.
Long‐Lived Room‐Temperature Phosphorescence Based on Hydrogen Bonding Self‐Assembling Supramolecular Film
Authors: Tian Ye , Tong Xinbao , Li Jingjun , Gao Shuiying , Cao Rong
Published: November 2021

Comprehensive Summary

Organic room‐temperature phosphorescence (ORTP) materials have attracted widespread attention in the fields of OLED, optical imaging and sensors. Herein, we successfully prepared a long afterglow IPA‐MA crystalline films using iso‐phthalic acid (IPA) and melamine (MA) by a simple drop‐casting layer‐by‐layer (LBL) method, which achieved an ultra‐long emission lifetime of up to 1.15 s. The drop‐casting LBL method is effective for the fabrication of hydrogen bonded supramolecular crystalline film materials on solid surfaces. The structure of the IPA‐MA crystalline film materials is consistent with that grown by hydrothermal method. Importantly, this method eliminates the high temperature and high pressure conditions of conventional hydrothermal methods and could form supramolecular crystalline thin films very well. In addition, the films have great long afterglow performance and the afterglow time can be controlled by altering the number of film layers. Furthermore, this method is successfully applied in the fields of temperature sensors and anti‐counterfeiting. These results not only provide the foundation for the design of organic long afterglow films, but also expand the application fields of ORTP materials.
Spending outcomes among patients with cancer in accountable care organizations 4 years after implementation
Authors: Erfani Parsa , Phelan Jessica , Orav E. John , Figueroa Jose F. , Jha Ashish K. , Lam Miranda B.
Published: November 2021

Background

The long‐term impact of affordable care organizations (ACOs) on cancer spending remains unknown. The authors examined whether practices that became ACOs altered their spending for patients with cancer in the first 4 years after ACO implementation.

Methods

By using national Medicare data from 2011 to 2017, a random sample of 20% of fee‐for‐service Medicare beneficiaries aged 65 years and older with cancer was obtained (n = 866,532), and each patient was assigned to a practice. Practices that became ACOs in the Medicare Shared Savings Program were matched to non‐ACO practices. Total, cancer‐specific, and service category‐specific yearly spending per patient was calculated. A difference‐in‐differences model was used to determine spending changes associated with ACO status for patients with cancer in the 4 years after ACO implementation.

Results

The introduction of ACOs did not have a significant impact on overall spending for patients with cancer in the 2 years after ACO implementation (difference, −$38; 95% CI, −$268, $191; P = .74). Changes in spending also did not differ between ACO and non‐ACO patients within service categories or among the 11 cancer types examined. The lack of difference in spending for patients with cancer in ACO and non‐ACO practices persisted in the third and fourth years after ACO implementation (difference, −$120; 95% CI, −$284, $525; P = .56).

Conclusions

ACOs did not significantly change spending for patients with cancer in the first 4 years after their implementation compared with non‐ACOs. This prompts a reevaluation of the current efficacy of ACOs in reducing spending for cancer care and may encourage policymakers to reconsider the incentive structures of ACOs.

Lay Summary

Accountable care organizations (ACOs) were developed to curtail health care spending and improve quality, but their effects on cancer spending in their first 2 years have been minimal.

The long‐term impact of ACOs on cancer spending remains unknown.

By using data from 866,532 Medicare beneficiaries with cancer, the authors observed that the association of a practice with an ACO did not significantly change total yearly spending per patient in the first 4 years after ACO implementation.

This finding prompts a reevaluation of the current efficacy of ACOs in reducing spending for cancer care.
The Reaction of o‐Benzyne with Vinylacetylene: An Unexplored Way to Produce Naphthalene
Authors: Monluc Lisa , Nikolayev Anatoliy A. , Medvedkov Iakov A. , Azyazov Valeriy N. , Morozov Alexander N. , Mebel Alexander M.
Published: November 2021

The mechanism and kinetics of the reaction of ortho‐benzyne with vinylacetylene have been studied by ab initio and density functional CCSD(T)‐F12/cc‐pVTZ‐f12//B3LYP/6‐311G(d,p) calculations of the pertinent potential energy surface combined with Rice‐Ramsperger‐Kassel‐Marcus ‐ Master Equation calculations of reaction rate constants at various temperatures and pressures. Under prevailing combustion conditions, the reaction has been shown to predominantly proceed by the biradical acetylenic mechanism initiated by the addition of C4H4 to one of the C atoms of the triple bond in ortho‐benzyne by the acetylenic end, with a significant contribution of the concerted addition mechanism. Following the initial reaction steps, an extra six‐membered ring is produced and the rearrangement of H atoms in this new ring leads to the formation of naphthalene, which can further dissociate to 1‐ or 2‐naphthyl radicals. The o‐C6H4+C4H4 reaction is highly exothermic, by ∼143 kcal/mol to form naphthalene and by 31–32 kcal mol−1 to produce naphthyl radicals plus H, but features relatively high entrance barriers of 9–11 kcal mol−1. Although the reaction is rather slow, much slower than the reaction of phenyl radical with vinylacetylene, it forms naphthalene and 1‐ and 2‐naphthyl radicals directly, with their relative yields controlled by the temperature and pressure, and thus represents a viable source of the naphthalene core under conditions where ortho‐benzyne and vinylacetylene are available.
Machine Learning for Estimating Electron Transfer Rates From Square Wave Voltammetry
Authors: Adams Austen C. , Jha Sauraj , Lary David J. , Slinker Jason D.
Published: November 2021

Electrochemistry of surface‐bound molecules is of high importance for numerous electronic and sensor applications. Extracting the electron transfer rate is beneficial for understanding surface‐bound processes, but it requires experimental or computational rigor. We evaluate methods to determine electron transfer rates from large voltammetry sets from experiments via machine learning using decision tree ensembles, neural networks, and gaussian process regression models. We applied these to reproduce computational measures of electron transfer rates modeled by first principles. The best machine learning models were a random forest with 80 decision trees and a neural network with Bayesian regularization, producing root mean squared errors of 0.37 and 0.49 s−1, respectively, corresponding to mean percent errors of 0.38 % and 0.52 %, respectively. This work establishes machine learning methods for rapidly acquiring electron transfer rates across large datasets for widespread applications.
Development of a point‐of‐care test for the detection of MDMA in latent fingerprints using surface plasmon resonance and lateral flow technology
Authors: Pollard Caroline , Hudson Mark , McDonnell James M. , Royall Paul G. , Wolff Kim
Published: November 2021

To date, a specific point‐of‐care test (POCT) for 3,4‐methylenedioxymethamphetamine (MDMA, ecstasy, ‘E’) in latent fingerprints (LFPs) has not been explored. Other POCTs identify MDMA in sweat by detecting the drug as a cross‐reactant rather than target analyte, thus decreasing the test's sensitivity. The study's aim was to design a sensitive POCT for the detection of MDMA in LFPs using surface plasmon resonance (SPR) and lateral flow immunoassay (LFA) technology. A high‐affinity antibody binding pair was identified using the former technique, deeming the pair suitable for a LFA. Titrations of fluorescently labelled antibody and antigen concentrations were tested to identify a sharp drop‐in signal upon the addition of MDMA to allow a clear distinction between negative and positive outcomes. We trialled the LFA by producing dose response curves with MDMA and a group of drugs that share a similar chemical structure to MDMA. These were generated through spiking the LFA with increasing levels of drug (0–400 pg/10 μl of MDMA; 0–10,000 pg/10 μl of cross‐reactant). Fluorescent test signals were measured using a cartridge reader. The cut‐off (threshold) 60 pg/10 μl calculated better cartridge performance (1.00 sensitivity, 0.95 specificity and 0.98 accuracy), when compared with 40 pg/10 μl. The biggest cross‐reactant was PMMA (250%), followed by MDEA (183%), MBDB (167%), MDA (16%) and methamphetamine (16%). A sensitive LFP screening tool requiring no sample preparation was successfully designed.
Dose of furosemide before admission predicts diuretic efficiency and long‐term prognosis in acute heart failure
Authors: Blázquez‐Bermejo Zorba , Farré Nuria , Caravaca Perez Pedro , Llagostera Marc , Morán‐Fernández Laura , Fort Aleix , de Juan Bagudá Javier , García‐Cosio María Dolores , Ruiz‐Bustillo Sonia , Delgado Juan F.
Published: November 2021

Aims

The outpatient diuretic dose is a marker of diuretic resistance and prognosis in chronic heart failure (HF). Still, the impact of the preadmission dose on diuretic efficiency (DE) and prognosis in acute HF is not fully known.

Methods and results

We conducted an observational and prospective study. All patients admitted for acute HF treated with intravenous diuretic and at least one criterion of congestion on admission were evaluated. Decongestion [physical examination, hemoconcentration, N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) change, and lung ultrasound], DE (weight loss and urine output per unit of 40 mg furosemide), and urinary sodium were monitored on the fifth day of admission. DE was dichotomized into high–low based on the median value. A multivariate Cox regression analysis was conducted to find predictors of HF readmission or mortality. A total of 105 patients were included between July 2017 and July 2019. Mean age was 74.5 ± 12.0 years, 64.8% were male, 33.3% had de novo HF, and mean left ventricular ejection fraction was 46 ± 17%. Median follow‐up was 26 [15–35] months. Low DE based on weight loss was associated with a higher previous dose of furosemide (odds ratio [OR] 1.01 [1.00–1.02]), thiazide treatment before admission (OR 9.37 [2.19–40.14]), and lower diastolic blood pressure (OR 0.95 [0.91–0.98]) in the multivariate regression model. Only previous dose of furosemide (OR 1.01 [1.00–1.02]) and haemoglobin at admission (OR 0.76 [0.58–0.99]) were associated with low DE based on urine output in the multivariate analysis. The correlation between the previous dose of furosemide and DE based on weight loss was poor (r = −0.12; P = 0.209) and with DE based on urine output was weak to moderate (r = −0.33; P < 0.001). Low DE based on weight loss and urine output was associated with lesser decongestion measured by NT‐proBNP (P = 0.011; P = 0.007), hemoconcentration (P = 0.006; P = 0.044), and lung ultrasound (P = 0.034; P = 0.029), but not by physical examination (P = 0.506; P = 0.560). Survival and event‐free survival in acute decompensated HF (ADHF) were lower than in de novo HF; a preadmission dose of furosemide > 80 mg in ADHF identified patients with particularly poor prognosis (log‐rank < 0.001). In ADHF, the preadmission dose of furosemide (hazard ratio [HR] 1.34 [1.08–1.67] per 40 mg) and NT‐proBNP at admission (HR 1.03 [1.01–1.06] per 1000 pg/mL) were independently associated with mortality or HF readmission in the multivariate Cox regression analysis.

Conclusions

The outpatient dose of furosemide before acute HF admission predicts DE and must be taken into account when deciding on the initial diuretic dose. In ADHF, the outpatient dose of furosemide can predict long‐term prognosis better than DE during hospitalization.
Dapagliflozin and atrial fibrillation in heart failure with reduced ejection fraction: insights from DAPA‐HF
Authors: Butt Jawad H. , Docherty Kieran F. , Jhund Pardeep S. , de Boer Rudolf A. , Böhm Michael , Desai Akshay S. , Howlett Jonathan G. , Inzucchi Silvio E. , Kosiborod Mikhail N. , Martinez Felipe A. , Nicolau Jose C. , Petrie Mark C. , Ponikowski Piotr , Bengtsson Olof , Langkilde Anna Maria , Schou Morten , Sjöstrand Mikaela , Solomon Scott D. , Sabatine Marc S. , McMurray John J.V. , Køber Lars
Published: November 2021

Aims

Among patients with heart failure (HF) and reduced ejection fraction (HFrEF), those with atrial fibrillation (AF) may respond differently to certain treatments than patients without AF. We investigated the efficacy and safety of dapagliflozin in patients with HFrEF with and without AF in the Dapagliflozin And Prevention of Adverse‐outcomes in Heart Failure trial (DAPA‐HF). We also examined the effect of dapagliflozin on new‐onset AF.

Methods and results

The primary outcome was the composite of an episode of worsening HF (HF hospitalization or urgent HF visit requiring intravenous therapy) or cardiovascular death. Of the 4744 patients randomized, 1910 (40.3%) had ‘any AF’ (history of AF or AF on enrolment electrocardiogram). Compared with placebo, dapagliflozin reduced the risk of worsening HF or cardiovascular death to a similar extent in patients with and without any AF [hazard ratio (HR) 0.75, 95% confidence interval (CI) 0.62–0.92 and 0.74, 95% CI 0.62–0.88, respectively; p for interaction = 0.88]. Consistent benefits were observed for the components of the primary outcome, all‐cause mortality, and improvement of Kansas City Cardiomyopathy Questionnaire total symptom score. Among patients without AF at baseline, dapagliflozin did not significantly reduce the risk of new‐onset AF compared with placebo (HR 0.86, 95% CI 0.60–1.22). However, patients with new‐onset AF had a 5 to 6‐fold higher risk of adverse outcomes when compared to those without incident AF.

Conclusions

Dapagliflozin, compared with placebo, reduced the risk of worsening HF events, cardiovascular death, and all‐cause death, and improved symptoms, in patients with and without AF. Dapagliflozin did not reduce the risk of new‐onset AF.
Synthesis and electrochemical studies of WO3‐based nanomaterials for environmental, energy and gas sensing applications
Authors: Boateng Emmanuel , Thind Sapanbir S. , Chen Shuai , Chen Aicheng
Published: November 2021

The increase of pollutants in the environment and the rapid decrease of nonrenewable energy resources are putting immense pressure on ecosystems. Semiconductor oxides possess some unique properties that may provide a foundation for the development of advanced functional materials to address the pressing environmental and energy issues. Among various metal oxides, WO3 based nanomaterials with an array of morphologies and sizes can be employed in a wide range of applications, including photocatalysis, water splitting, environmental protection, solar energy, and electrochromic devices. In this review article, following a brief introduction of WO3 and WO3 based nanostructured materials, various synthesis methods used for their fabrication are described and compared. Further, their electrochemical, photoelectrochemical properties, and promising energy and environmental applications are addressed and highlighted.
Electrochemical chemo‐ and biosensors based on microgels immobilized on electrode surface
Authors: Marcisz Kamil , Karbarz Marcin , Stojek Zbigniew
Published: November 2021

Applications of nano‐ and microparticles of hydrogels in the modification of electrode surfaces and corresponding constructions of electrochemical sensors are presented in the study. Despite the fact that such a use of microgels started just a few years ago, several analytical possibilities were offered already. They include monitoring, under various conditions, of drugs including antibiotics, herbicides, glucose, and other molecules. A variety of electrochemical techniques were employed in the measurements.
Electrochemical devices based on conducting surfaces modified with smart hydrogels: Outlook and perspective
Authors: Kaniewska Klaudia , Karbarz Marcin
Published: November 2021

The unique properties of smart hydrogels combined with conducting surfaces opened new possibilities in the construction of novel electrochemical devices. Electrodes modified with thin gel layers demonstrate the properties that are usually unachievable for bare electrodes. Usually a thin gel layer provides a highly permeable matrix for analytes, and can also serve as an immobilizing/impermeable matrix for larger molecules. Hydrogel barriers/layers are able to protect the electrode surface against the unwanted influence of the environment and to isolate the environment from the usually metallic, stiff, and hard electrode surfaces. A layer of hydrogel attached to the electrode surface can also serve as solid electrolyte, buffer and a reservoir for electroactive probes. In addition, the ability of smart gel materials to undergo a reversible volume phase transition related to significant changes in their volume and shape is very interesting from the point of view of the construction of switchable electrochemical systems. Such properties are strongly desired for the construction of various electrochemical devices. This review is focused on recent progress in the above field.
Collaboration and advance planning across campus create more cybersecure universities
Authors: Bannister Mary
Published: November 2021

“Cybersecurity is a threat that changes all the time, so addressing it involves everybody living and breathing security as second nature.” This was a key theme on September 22, 2021, when the National Student Clearinghouse hosted a webinar titled “CyberSecurED: Building a Cyber‐Ready Campus.” The webinar panelists — experts from EDUCAUSE, the Cyber Readiness Institute, REN‐ISAC, and NSC — discussed the role of university registrars and enrollment managers in preventing and responding to cyberattacks.