bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors associated with the choice of primary treatment at the community level among the middle‐aged and elderly in China
Authors: Tao Tiantian , Hou Lili , Shao Rong
Published: December 2020

Background

As China is still in the process of establishing the hierarchical medical system, people have full autonomy in choosing medical institutions when they need to see a doctor. The basic working of a hierarchical medical system involves four parts: primary treatment at the community level, two‐way referral, a partition of emergency and chronic disease, and a joint effort among different healthcare facilities. This study examines factors associated with primary healthcare use in a middle‐aged and elderly Chinese population.

Methods

Our study is a cross‐sectional and observational survey involving 1659 adults aged 45 and above. The data are from the 2015 China Health and Retirement Longitudinal Study. According to the Andersen behavioral model, we used logistic regression to analyze the influencing factors of healthcare services utilization, including predisposing, enabling, and need factors. We also compared the relative importance of factors to healthcare services utilization by analysis of variance.

Results

During the recently 1‐month period, 63.89% of the sample had their last visit to a primary healthcare facility. In the final logistic model, there were three predisposing characteristics (education level, children number, and work status), three enabling factors (household status, out‐of‐pocket expenses, and travel time to the healthcare facilities), and one need factor (three specific chronic diseases) were significantly associated with primary healthcare use. Having received more education, taking more travel time to the healthcare facility, paying more out‐of‐pocket expenses, and having heart problems were associated with a lower probability of choosing the primary healthcare facility. However, having more children, being still at work, with agricultural household status, diabetes, and arthritis were associated with a higher likelihood of having primary healthcare facility visits. Among all the factors, the three most powerful determinants were out‐of‐pocket expenses, travel time to the healthcare facility, and education.

Conclusions

Policymakers need to consider these factors when improving the system of primary treatment at the community level, including improving reimbursement policy to distinguish the payment standard between hospitals and primary healthcare facilities.
Hypophosphatasia: A Case of Two Patients With Spinal Cord Compression From Increase in Ligamentous Ossifications During Treatment
Authors: Laroche Michel , Couture Guillaume , Faruch Marie , Ruyssen‐Witrand Adeline , Porquet‐Bordes Valérie , Salles Jean Pierre , Degboe Yannick
Published: December 2020

Treatment with asfotase alfa has transformed the prognosis of hypophosphatasia in children and improves the bone and muscle signs in adults. The doses used in adults are the same as in children, whereas bone remodeling is different between them. We report on the cases of two patients treated with 1 mg/kg/day of asfotase alfa who developed spinal cord compression from spinal ossifications during treatment. The first patient, 50 years old, presented after 2 years of treatment with quadraparesis secondary to an increase in ossifications of the cervical vertebral ligaments. The neurological damage was resolved after laminectomy, and the patient was then treated for 18 months with doses of 80 mg per week, without recurrence of the bone and muscle signs. The second patient, 26 years old, 78 kg, developed pain and cervical stiffness with pyramidal tract irritation secondary to ossifications of the vertebral ligaments. This improved with a reduction of doses to 80 mg/week, which then, after 6 months of follow‐up, enabled maintained improvement of the bone and muscle pain that was initially obtained. To our knowledge, these are the first reported cases of increased spinal ligamentous ossifications with neurological complications. Biological monitoring in adults does not seem to enable asfotase alfa doses to be adjusted. The levels of serum alkaline phosphatase (ALP) while on the recommended treatment of 1 mg/kg/day are significantly supraphysiological (5000 to 20,000 IU) and the assays of pyrophosphate and pyridoxal phosphate are not correlated with clinical efficacy. In both of our patients, the treatment with 80 mg of asfotase alfa per week, which was proposed after the occurrence of spinal complications, seemed as effective, after a follow‐up of 18 months and 6 months, as the initial treatment for improving the bone and muscle signs, and could be provided as “attack” doses after healing of the pseudoarthroses. © 2021 American Society for Bone and Mineral Research © 2020 The Authors. JBMR Plus published by Wiley Periodicals LLC. on behalf of American Society for Bone and Mineral Research.
Low‐Dose Tamoxifen Induces Significant Bone Formation in Mice
Authors: Xie Zhihui , McGrath Cody , Sankaran Jeyantt , Styner Maya , Little‐Letsinger Sarah , Dudakovic Amel , van Wijnen Andre J , Rubin Janet , Sen Buer
Published: December 2020

Use of the selective estrogen receptor modulator Tamoxifen (TAM) is a mainstay to induce conditional expression of Cre recombinase in transgenic laboratory mice. To excise β‐cateninfl/fl in 28‐day‐old male and female Prrx1‐CreER/β‐cateninfl/fl mice (C57BL/6), we utilized TAM at 150 mg/kg; despite β‐catenin knockout in MSC, we found a significant increase in trabecular and cortical bone volume in all genders. Because TAM was similarly anabolic in KO and control mice, we investigated a dose effect on bone formation by treating wild‐type mice (WT C57BL/6, 4 weeks) with TAM (total dose 0, 20, 40, 200 mg/kg via four injections). TAM increased bone in a dose‐dependent manner analyzed by micro–computed tomography (μCT), which showed that, compared to control, 20 mg/kg TAM increased femoral bone volume fraction (bone volume/total volume [BV/TV]) (21.6% ± 1.5% to 33% ± 2.5%; 153%, p < 0.005). With TAM 40 mg/kg and 200 mg/kg, BV/TV increased to 48.1% ± 4.4% (223%, p < 0.0005) and 58% ± 3.8% (269%, p < 0.0001) respectively, compared to control. Osteoblast markers increased with 200 mg/kg TAM: Dlx5 (224%, p < 0.0001), Alp (166%, p < 0.0001), Bglap (223%, p < 0.0001), and Sp7 (228%, p < 0.0001). Osteoclasts per bone surface (Oc#/BS) nearly doubled at the lowest TAM dose (20 mg/kg), but decreased to <20% control with 200 mg/kg TAM. Our data establish that use of TAM at even very low doses to excise a floxed target in postnatal mice has profound effects on trabecular and cortical bone formation. As such, TAM treatment is a major confounder in the interpretation of bone phenotypes in conditional gene knockout mouse models. © 2020 The Authors. JBMR Plus published by Wiley Periodicals LLC. on behalf of American Society for Bone and Mineral Research.
Surface modifications affect iron oxide nanoparticles' biodistribution after multiple‐dose administration in rats
Authors: Fahmy Heba M. , Abd El‐Daim Taiseer M. , Ali Omnia A. , Hassan Asmaa A. , Mohammed Faten F. , Fathy Mohamed M.
Published: December 2020

Iron oxide nanoparticles (IONPs) possess many utilizable physical and chemical properties and have an acceptable level of biocompatibility. Therefore, they are extensively used in different medical applications. Hence, the challenge is to modify the surfaces of prepared iron oxide nanoformulations with a biocompatible coat to enhance their biosafety. In this study, different formulations of IONPs with different capping agents (citrate [Cit‐IONPs], curcumin [Cur‐IONPs], and chitosan [CS‐IONPs]) were prepared and characterized using various physicochemical techniques. The biodistribution of iron and the histopathology of affected tissues were assessed after Cit‐IONPs, Cur‐IONPs, CS‐IONPs, and commercial ferrous sulfate were orally administered to adult female Wistar rats for 10 consecutive days at a dose of 4 mg/kg of body weight/day. The results were compared with a control group injected orally with saline. The iron content in the kidneys, liver, and spleen was measured by atomic absorption spectroscopy. Histopathological alterations were also examined. The biodistribution results demonstrate that iron accumulated mainly in the liver tissue, whereas the lowest liver accumulation was observed after the administration of Cit‐IONPs or CS‐IONPs, respectively. In contrast, the administration of CS‐IONPs displayed the highest spleen iron accumulation. The ferrous sulfate (FeSO4)‐treated group showed the highest kidney iron accumulation as compared with the other groups. The histopathological examination revealed that signs of toxicity were predominant for groups treated with Cit‐IONPs or commercial FeSO4. However, Cur‐IONPs and CS‐IONPs showed mild toxicity when administered at the same doses. The results obtained in the present study will provide insights into the expected in vivo effects after administration of each nanoformulation.
Self‐injury recovery: A person‐centered framework
Authors: Lewis Stephen P. , Hasking Penelope A.
Published: December 2020

Growing interest has been paid to the concept of non‐suicidal self‐injury (NSSI) recovery. In research, and sometimes clinical practice, the focus has been on NSSI cessation, with recovery operationalised with reference to the time since someone last self‐injured. Yet, perspectives from people with lived experience of NSSI indicate that recovery is much more complex. Drawing on recent empirical work, and the voices of people with lived experience of NSSI, we outline a new framework for conceptualizing NSSI recovery. We argue that recovery is nonlinear and multifaceted, comprising: Realistic Expectations and Setbacks; Normalizing Thoughts and Urges; Fostering Self‐efficacy; Identifying Strengths; Finding Alternatives; Addressing Underlying Adversities; Addressing and Accepting Scarring; Navigating Disclosures; and Self‐acceptance. In presenting research and clinical implications of this new framework, we propose that this framing offers a more complete understanding of NSSI recovery—one conducive to optimizing wellbeing and promoting resilience among individuals with lived experience.
Ivermectin inhibits extracellular vesicle secretion from parasitic nematodes
Authors: Loghry Hannah J. , Yuan Wang , Zamanian Mostafa , Wheeler Nicolas J. , Day Timothy A. , Kimber Michael J.
Published: December 2020

Lymphatic filariasis (LF) is a disease caused by parasitic filarial nematodes that is endemic in 49 countries of the world and affects or threatens over 890 million people. Strategies to control LF rely heavily on mass administration of anthelmintic drugs including ivermectin (IVM), a macrocyclic lactone drug considered an Essential Medicine by the WHO. However, despite its widespread use the therapeutic mode of action of IVM against filarial nematodes is not clear. We have previously reported that filarial nematodes secrete extracellular vesicles (EVs) and that their cargo has immunomodulatory properties. Here we investigate the effects of IVM and other anti‐filarial drugs on parasitic nematode EV secretion, motility, and protein secretion. We show that inhibition of EV secretion was a specific property of IVM, which had consistent and significant inhibitory effects across nematode life stages and species, with the exception of male parasites. IVM inhibited EV secretion, but not parasite motility, at therapeutically relevant concentrations. Protein secretion was inhibited by IVM in the microfilariae stage, but not in any other stage tested. Our data provides evidence that inhibiting the secretion of immunomodulatory EVs by parasitic nematodes could explain, at least in part, IVM mode of action and provides a phenotype for novel drug discovery.
Liquid biopsy for disease monitoring after anti‐CD19 chimeric antigen receptor T cell in diffuse large B‐cell lymphoma
Authors: Maluquer Clara , Bellosillo Beatriz , Mussetti Alberto , Domingo‐Domènech Eva , Parody Rocío , Fernández‐Ibarrondo Lierni , Velasco Roser , Moreno‐González Gabriel , Sanz Gabriela , Cortés Montserrat , Sureda Anna
Published: December 2020

Objectives

Chimeric antigen receptor T cells (CARTs) against CD19 antigen represent an effective therapy for relapsed/refractory diffuse large B‐cell lymphoma (rrDLBCL). There is no diagnostic test able to predict which patients with residual disease will relapse from those that will reach a delayed complete response. Positron emission tomography/computed tomography scan (PET‐CT) is characterized by a significant number of false positive results after immunotherapy. Circulating tumor DNA (ctDNA) may be a good‐useful tool to quantify minimal residual disease and for monitoring disease response.

Methods

We present a patient with DLBCL treated with CART cells in which we tested the combined use of ctDNA and PET‐CT scan.

Results

Disease reassessment with PET‐CT scan showed a partial remission (3 weeks) and a very good partial remission (2 months). A clinical progression at 3 months was confirmed with PET‐CT scan. Levels of ctDNA progressively decreased and became undetectable. An initial increase in KMT2D p.E4385G variant allele frequency confirmed disease progression.

Conclusions

Our case shows how the complementary use of ctDNA and PET‐CT scan could be a helpful tool in the clinical management of these patients.
Increased brain plasmin levels following experimental ischemic stroke in male mice
Authors: Mindel Ekaterina , Weiss Ronen , Bushi Doron , Gera Orna , Orion David , Chapman Joab , Shavit‐Stein Efrat
Published: December 2020

Many coagulation factor proteases are increased in the brain during ischemic stroke. One of these proteases is plasmin. In this study we established a novel method for direct quantitative measurement of plasmin activity in male mouse brain slices using a sensitive fluorescent substrate in the presence of specific protease inhibitors. In both the ischemic and contralateral hemispheres, plasmin activity increased 3, 6, and 24 hr following stroke in comparison to healthy mice (F(3, 72) = 39.5, p < 0.0001, repeated measures ANOVA) after the induction of permanent middle cerebral artery occlusion (PMCAo). Plasmin activity was higher in the ischemic hemisphere (F(1,36) = 9.1, p = 0.005) and there was a significant interaction between time and ischemic hemisphere (F(3,36) = 4.4, p = 0.009). Plasmin activity was correlated with infarct volume (R2 = 0.5289, p = 0.0009 by Spearman). The specificity of the assay was verified utilizing tissue‐type plasminogen activator (tPA)‐deficient mice which, as expected, had significantly lower levels of plasmin 24 hr following ischemia compared to wild‐type mice (ischemic (0.6 ± 0.23 and 1.94 ± 0.5, respectively), p = 0.049 and contralateral hemispheres (0.13 ± 0.14 and 0.75 ± 0.10, respectively), p = 0.018 by t test). There is a time‐dependent increase in plasmin levels and an association of higher levels of plasmin with larger infarct volumes in an experimental stroke model. This suggests caution in the use of recombinant tPA (rtPA) and that plasmin inhibition in the brain may be a therapeutic target in acute ischemic stroke.
Impact of a poor functional capacity on the clinical outcomes in patients with a pacemaker implantation –Results from the Japanese Heart Rhythm Society Registry –
Authors: Arimoto Takanori , Watanabe Eiichi , Kohno Ritsuko , Shimeno Kenji , Kikuchi Kan , Doi Atsushi , Inoue Kanki , Nitta Takashi , Nogami Akihiko , Abe Haruhiko , Okumura Ken
Published: December 2020

Background

Functional capacity (FC) correlates with mortality in various cardiovascular diseases. The aim of this study was to examine whether cardiac pacemaker implantations improve the FC and affect the prognosis.

Methods and Results

We prospectively enrolled 621 de novo pacemaker recipients (age 76 ± 9 years, 50.7% male). The FC was assessed by metabolic equivalents (METs) during the implantation and periodically thereafter. The patients were a priori classified into poor FC (<2 METs, n = 40), moderate FC (2 ≤ METs < 4, n = 239), and good FC (≥4 METs, n = 342). Three months after the pacemaker implantation, poor FC or moderate FC patients improved to a good FC by 43%. The distribution of the three FCs remained at those levels until after 1 year of follow‐up (P = .18). During a median follow‐up of 2.4 years, 71 patients (11%) had cardiovascular hospitalizations and 35 (5.6%) all‐cause death. A multivariate Cox analysis revealed that a poor FC at baseline was an independent predictor of both cardiovascular hospitalization (hazard ratio [HR] 2.494, P = .012) and all‐cause death (HR 3.338, P = .016). One year after the pacemaker implantation, the eight who remained with a poor FC had a high mortality rate of 37.5% (P < .01).

Conclusion

Approximately half of the poor or moderate FC patients improved to good FC 3 months after the pacemaker implantation. The baseline FC predicted the prognosis, and patients with an improved FC after the pacemaker implantation had a better prognosis.
Vitamin C in orthopedic practices: Current concepts, novel ideas, and future perspectives
Authors: Oakes Bennett , Bolia Ioanna K. , Weber Alexander E. , Petrigliano Frank A
Published: December 2020

Vitamin C (ascorbic acid), is an important antioxidant that has been applied broadly in the field of orthopaedics. Current research on vitamin C examines the molecule's role in bone and tendon physiology, as well as joint replacement and Postoperative pain. Most laboratory and human studies associate the use of vitamin C with improved bone health and tendon healing. Recent literature moderately supports the use of vitamin C to improve functional outcomes, decreased postoperative pain, and prevent complex regional pain syndrome following orthopaedic procedures. The perioperative use of vitamin C in patients undergoing joint replacement surgery and anterior cruciate ligament reconstruction is still under investigation. Overall, there is need for high‐quality human trials to confirm whether vitamin C can potentiate the outcomes of orthopaedic procedures and to determine optimal dosage and means of administration to maximize its proposed benefits. The purpose of this review was to summarize the application of vitamin C in orthopaedic practices and to identify potential areas for future study.
Reusable vs disposable nasopharyngolaryngoscopes: Cost analysis and resident survey
Authors: Walczak Ryan , Arnold Mark , Grewal Jeewanjot , Yuan Xiao , Suryadevara Amar , Marzouk Haidy
Published: December 2020

Objective

Assess the quality of a new disposable nasopharyngolaryngoscope (NPL) through resident feedback at multiple academic institutions and provide a cost analysis of reusable and disposable NPLs at a single academic center.

Study Design

An online survey was distributed to residents at institutions throughout the United States that have implemented use of a disposable NPL (Ambu aScope 4 Rhinolaryngo).

Setting

Cost analysis performed at a single academic center. Resident survey distributed to multiple residency programs throughout the United States.

Subjects and Methods

The survey collected demographic information and asked residents to rate the new disposable NPL and other reusable NPLs using a 5‐point Likert scale. A cost analysis was performed of both reusable and disposable NPLs using information obtained at a single academic center.

Results

The survey was distributed to 109 residents throughout the country and 37 were completed for a response rate of 33.9%. The disposable NPL was comparable to reusable NPLs based on ergonomics and maneuverability, inferior in imaging quality (P < .001), and superior in setup (P < .001), convenience (P < .001), and rated better overall (P < .04). The disposable NPL was found to be cheaper per use than reusable NPLs at $171.82 and $170.36 compared to $238.17 and $197.88 per use for the reusable NPL if the life span is 1 year and 5 years respectively.

Conclusion

Disposable NPLs may offer an alternative option and initial feedback obtained from resident physicians is favorable. Cost analysis favors disposable NPLs as the cost‐effective option.

Level of Evidence

NA.
A Four‐Armed Polyacrylic Acid Homopolymer Binder with Enhanced Performance for SiOx/Graphite Anode
Authors: Luo Chao , Wu Xiufen , Zhang Tian , Chi Shang‐Sen , Liu Zhengying , Wang Jun , Wang Chaoyang , Deng Yonghong
Published: December 2020

The large‐scale application of Si‐based anodes is impeded by their fast capacity decay, which is mainly attributed to the huge volume expansion upon cycling. The employment of functional binders is one efficient method to mitigate this issue. In this work, a four‐armed polyacrylic acid (4A‐PAA) homopolymer is explored as a remarkably effective binder for Si‐based anodes. The 4A‐PAA binder is prepared via an atom transfer radical polymerization, followed by ester hydrolysis. Compared to the conventional linear polyacrylic acid (PAA) binder, the 4A‐PAA not only shows enhanced toughness due to its decreased molecular regularity and intramolecular hydrogen bond but also exhibits increased binding strength because of its multidimensional binding structure. As a result, the SiOx/graphite electrode using the 4A‐PAA retains a capacity retention of 89.1% and a capacity of 558.1 mAh g−1 after 200 cycles at 0.16 A g−1, which are superior to the PAA electrode, corresponding to 80.4% and 469.3 mAh g−1, respectively. The improved performance is attributed to the employment of the 4A‐PAA, which mitigates the volume change of the SiOx/graphite anode. This work not only offers a promising binder for Si‐based anodes but also presents a universal solution for other anodes with high volume expansion during cycling.
Impact of Obstructive Sleep Apnea on Cognitive and Motor Functions in Parkinson's Disease
Authors: Elfil Mohamed , Bahbah Eshak I. , Attia Mahmoud M. , Eldokmak Mohamed , Koo Brian B.
Published: December 2020

Introduction

Parkinson's disease (PD) is a chronic neurodegenerative disorder that presents with motor and non‐motor manifestations. Amongst the non‐motor features, various forms of sleep disturbances can occur, and obstructive sleep apnea (OSA) is considered to be a common comorbidity. We conducted this systematic review and meta‐analysis to assess the impact of OSA on cognitive and motor functions in PD.

Methods

The information sources of for this systematic review and meta‐analysis were PubMed, SCOPUS, Web of Science, and ScienceDirect. Studies meeting the following criteria were included: (1) studies including idiopathic PD patients, (2) studies using polysomnography to categorize PD patients into PD with OSA and PD without OSA, and (3) studies with observational designs (case–control, cohort, or cross‐sectional). Data analysis was performed using RevMan.

Results

Our meta‐analysis showed that OSA was associated with significantly lower scores of Montreal Cognitive Assessments (MoCA) (mean difference (MD) = −0.70, 95% confidence interval (CI) [−1.28, −0.13], P = 0.01) and Mini‐Mental State Examination (MMSE) (MD = −0.69, 95% CI [−1.17, −0.21], P = 0.005). Moreover, the score of the motor part of the Unified Parkinson's Disease Rating Scale (UPDRS III) was significantly higher in PD patients with OSA as compared with those without OSA (MD = 1.63, 95% CI [0.03, 3.23], P = 0.049).

Conclusions

OSA is associated with increased severity of PD‐associated cognitive dysfunction and motor symptoms. However, further studies are needed to corroborate these findings, assess the underlying mechanisms by which OSA influences the motor and cognitive functions in PD, and investigate whether OSA can accelerate the neurodegenerative process of PD. © 2020 International Parkinson and Movement Disorder Society
Optimization and modeling of thermal conductivity and viscosity of Cu/engine oil nanofluids by NSGA‐II using RSM
Authors: Esfe Mohammad Hemmat , Motallebi Sayyid Majid
Published: December 2020

This study provides the optimization of the thermophysical properties of Cu/engine oil nanofluid. In this optimization, the objective functions were determined using response surface methodology (RSM) to analyze the experimental data of nanofluid viscosity and thermal conductivity (TC). Two equations are presented for the accurate prediction of TC and viscosity data. The nondominated sorting genetic algorithm II (NSGA‐II) method was used for multi‐objective optimization (Mo‐O), and Pareto's front was introduced to study optimal viscosity and TC. According to the results, the highest TC and the lowest viscosity occur when the temperature and solid volume fraction of the nanofluid are at their maximum values.
Numerical investigation for the fractional nonlinear space‐time telegraph equation via the trigonometric Quintic B‐spline scheme
Authors: Khater Mostafa M. A. , Nisar Kottakkaran Sooppy , Mohamed Mohamed S.
Published: December 2020

This manuscript employs the trigonometric Quintic B‐spline (TQBS) scheme for investigating the numerical solution of the conformable fractional nonlinear time‐space telegraph equation. This model is derived by Oliver Heaviside 1880 to describe the cutting‐edge or voltage of an electrified transmission range with the day yet distance from an electrified transmission or electromagnetic wave's application. In Hamed and Khater, three recent computational schemes (sech–tanh expansion method; extended sinh–Gorden expansion method; and extended simplest equation method) have been applied to the fractional model for constructing the exact traveling wave solutions. Many distinct solutions have been obtained, and some of them have been sketched in two, three‐dimensional, and density plots. Here, these solutions are investigated to evaluate the initial and boundary conditions that apply the suggested numerical scheme. The accuracy of the constructed exact solutions is investigated by calculating the absolute value of error. The most accurate numerical schemes of the three applied computational schemes have been illustrated.
Discrete generalized fractional operators defined using h‐discrete Mittag‐Leffler kernels and applications to AB fractional difference systems
Authors: Othman Mohammed Pshtiwan , Abdeljawad Thabet
Published: December 2020

This study investigates the h‐fractional difference operators with h‐discrete generalized Mittag‐Leffler kernels (
in the sense of Riemann type (namely, the ABR) and Caputo type (namely, the ABC). For which, we will discuss the region of convergent. Then, we study the h‐discrete Laplace transforms to formulate their corresponding AB‐fractional sums. Also, it is useful in obtaining the semi‐group properties. We will prove the action of fractional sums on the ABC type h‐fractional differences and then it can be used to solve the system of ABC h‐fractional difference. By using the h‐discrete Laplace transforms and the Picard successive approximation technique, we will solve the nonhomogeneous linear ABC h‐fractional difference equation with constant coefficient, and also we will remark the h‐discrete Laplace transform method for the continuous counterpart. Meanwhile, we will obtain a nontrivial solution for the homogeneous linear ABC h‐fractional difference initial value problem with constant coefficient for the case δ ≠ 1. We will formulate the relation between the ABC and ABR h‐fractional differences by using the h‐discrete Laplace transform. By iterating the fractional sums of order −(ϕ, δ, 1), we will generate the h‐fractional sum‐differences, and in view of this, a semigroup property will be proved. Due to these new powerful techniques, we can calculate the nabla h‐discrete transforms for the AB h‐fractional sums and the AB iterated h‐fractional sum‐differences. Furthermore, we will obtain some particular cases that can be found in examples and remarks. Finally, we will discuss the higher order case of the h‐discrete fractional differences and sums.
Dynamics for stochastic Fitzhugh–Nagumo systems with general multiplicative noise on thin domains
Authors: Li Fuzhi
Published: December 2020

This paper is devoted to studying the dynamics for stochastic Fitzhugh–Nagumo equations with general multiplicative noise on thin domains, where the noise is described by a general stochastic process instead of the usual Wiener process. The measurability of the solution operator is proved, which yields to the measurability of the random attractor. We then show the existence and upper semi‐continuity of these attractors when a family of (n + 1)‐dimensional thin domains degenerates onto an n‐dimensional domain under the topology of p‐times Lebesgue space.
Geometrical model for calculating the effect of surface morphology on total x‐ray output of medical x‐ray tubes
Authors: Siller Maximilian , Minkkinen Mika , Bogust Pamela , Jelinek Alexander , Schatte Jürgen , Bostrom Neil , Greenland Kasey , Knabl Wolfram , Clemens Helmut , Pippan Reinhard , Maier‐Kiener Verena
Published: December 2020

Purpose

Correlation of characteristic surface appearance and surface roughness with measured air kerma (kinetic energy released in air) reduction of tungsten‐rhenium (WRe) stationary anode surfaces.

Methods

A stationary anode test system was developed and used to alter nine initially ground sample surfaces through thermal cycling at high temperatures. A geometrical model based on high resolution surface data was implemented to correlate the measured reduction of the air kerma rate with the changing surface appearance of the samples. In addition to the nine thermally cycled samples, three samples received synthetic surface structuring to prove the applicability of the model to nonconventional surface alterations. Representative surface data and surface roughness values were acquired by laser scanning confocal microscopy.

Results

After thermal cycling in the stationary anode test system, the samples showed surface features comparable to rotating anodes after long‐time operation. The established model enables the appearance of characteristic surface features like crack networks, pitting, and local melting to be linked to the local x‐ray output at 100 kV tube voltage ,10° anode take off angle and 2 mm of added Al filtration. The results from the conducted air kerma measurements were compared to the predicted total x‐ray output reduction from the geometrical model and show, on average, less than 10 % error within the 12 tested samples. In certain boundaries, the calculated surface roughness Ra showed a linear correlation with the measured air kerma reduction when samples were having comparable damaging characteristics and similar operation parameters. The orientation of the surface features had a strong impact on the measured air kerma rate which was shown by testing synthetically structured surfaces.

Conclusions

The geometrical model used herein considers and describes the effect of individual surface features on the x‐ray output. In close boundaries arithmetic surface roughness Ra was found to be a useful characteristic value on estimating the effect of surface damage on total x‐ray output.
A new data augmentation method based on local image warping for medical image segmentation
Authors: Liu Hong , Cao Haichao , Song Enmin , Ma Guangzhi , Xu Xiangyang , Jin Renchao , Liu Tengying , Liu Lei , Liu Daiyang , Hung Chih‐Cheng
Published: December 2020

Purpose

The segmentation accuracy of medical images was improved by increasing the number of training samples using a local image warping technique. The performance of the proposed method was evaluated in the segmentation of breast masses, prostate and brain tumors, and lung nodules.

Methods

We propose a simple data augmentation method which is called stochastic evolution (SE). Specifically, the idea of SE stems from our thinking about the deterioration of the diseased tissue and the healing process. In order to simulate this natural process, we implement it according to the local distortion algorithm in image warping. In other words, the irregular deterioration and healing processes of the diseased tissue is simulated according to the direction of the local distortion, thereby producing a natural sample that is indistinguishable by humans.

Results

The proposed method is evaluated on four segmentation tasks of breast masses, prostate, brain tumors, and lung nodules. Comparing the experimental results of four segmentation methods based on the UNet segmentation architecture without adding any expanded data during training, the accuracy and the Hausdorff distance obtained in our approach remain almost the same as other methods. However, the dice similarity coefficient (DSC) and sensitivity (SEN) have both improved to some extent. Among them, DSC is increased by 5.2%, 2.8%, 1.0%, and 3.2%, respectively; SEN is increased by 6.9%, 4.3%, 1.2%, and 4.5%, respectively.

Conclusions

Experimental results show that the proposed SE data augmentation method could improve the segmentation accuracy of breast masses, prostate, brain tumors, and lung nodules. The method also shows the robustness with different image datasets and imaging modalities.
The impact of intellectual disability nurse specialists in the United Kingdom and Eire Ireland: An integrative review
Authors: Bur Jennifer , Missen Karen , Cooper Simon
Published: December 2020

Aim

To identify and evaluate the impact of Intellectual Disability Nurse Specialists person‐centred care for people with intellectual disability.

Design

An Integrative review of the literature was performed between January 2007–December 2017.

Methods

Searching the PubMed Library of Medicine, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Medline Ovid, PsychINFO, Health Source: Nursing/Academic edition. A total of eight articles were selected for the final study example, including four mixed methods studies and four qualitative studies.

Results

Three Intellectual Disability Nurse Specialist models were evaluated, and three main themes emerged: person‐centred care, organizational and practice development.

Conclusion

The Intellectual Disability Nurse Specialist expert knowledge and skills contribute to the development of effective systems and processes. The results highlighted the complex nature of the Intellectual Disability Nurse Specialist role and the importance of ongoing development, promotion and evaluation and their contribution to care in the healthcare setting.
An assessment of the health sustainability of sanitation in Ghana: A quantitative analysis
Authors: Basiru Ibrahim , Arkorful Vincent Ekow , Xu Yi , Gyekye Eugene Kwasi , Ibrahim Abu Hanifa
Published: December 2020

The present study aims to assess the improvements of sanitation system of Kumasi metropolitan area. Sanitation conditions in Africa remain awful with approximately 20% of the population reported to still engage in open defecation in Sub‐Saharan Africa, despite major improvements in other climes of the world. In Ghana, the impacts of poor sanitation systems range from negatively impacting natural resources water quality, to causing health threats to the populations involved. Using health as selected sustainable sanitation, this research assesses reported cases of diseases and deaths associated with unsatisfactory sanitation from 2008 to 2015. Both primary and secondary data were employed. The primary data was collected through interview with key informants by purposive sampling. Quantitative data were analyzed via primary descriptive statistical methods. Results indicate slight improvements in the sanitation system. Our findings suggest that the number of diseases is high due to poor sanitation. However, statistics of deaths are minimal, and these were ascribed to improvements in health care in Ghana. The study has offered recommendations in order to improve sanitation system within the metropolis toward more sustainability. The research is significant because theory developers, researchers, policy makers, and practitioners can make use of its findings to tackle the problems of sustainable sanitation since theories and practices of sustainable sanitation are constantly evolving.
Layer‐by‐Layer‐Assembled Capsule Size Affects the Efficiency of Packaging and Delivery of Different Genetic Cargo
Authors: Tarakanchikova Yana V. , Muslimov Albert R. , Zyuzin Mikhail V. , Nazarenko Irina , Timin Alexander S. , Sukhorukov Gleb B. , Lepik Kirill V.
Published: December 2020

The lack of an efficient and versatile intracellular nucleic acids delivery platform impedes the clinical implementation of gene therapy. Advances in layer‐by‐layer (LbL) technology have led to the production of LbL polymer capsules, a promising universal delivery tool. The biocompatibility, sufficient packaging capacity, safety, low cost, and high variability of structure and composition of the LbL capsules make it possible to meet the requirements for clinical‐grade nonviral gene transfer. Here, the possibility of polymeric LbL capsules of different sizes (micrometer and sub‐micrometer‐sized) to serve as universal nonviral carriers for messenger RNA (mRNA) and small interfering RNA (siRNA) is considered. In particular, the internalization of capsules into human mesenchymal stem cells (hMSCs, as an example of adult primary stem cells), capsule uptake, and intracellular delivery of mRNA and siRNA is studied. Importantly, the use of micrometer‐ or sub‐micrometer‐sized polymer capsules (MicCaps and SubCaps) allows the mRNA or siRNA to be packaged and transferred into hMSCs with high efficiency. While the uptake efficiency is comparable between MicCaps and SubCaps, the latter are significantly more efficient than MicCap when transferring siRNAs. These results demonstrate the potential of the LbL capsules as a universal gene delivery platform, which can be tuned according to the properties of genetic cargo.
Impact of Extracellular Polymeric Substance in the Inactivation of Harmful Algae by Ag2O/g‐C3N4 under Visible Light
Authors: Fan Gongduan , Lin Jiuhong , Xia Mingqian , Luo Jing , Du Banghao , Pang Heliang , Yan Zhongsen
Published: December 2020

Photocatalysis has attracted much attention as an emerging algae removal technology, but the inactivation performance is inevitably affected by the extracellular polymeric substance (EPS) produced by algae. In this study, a photocatalyst (Ag2O/g‐C3N4) with efficient algae inactivation is adopted to investigate the interactions with EPS, and the impact of EPS on photocatalytic algae removal is studied. The results show that EPS can adhere to the surface of Ag2O/g‐C3N4 by electrostatic force. The interaction with EPS decreases the surface zeta potential of the Ag2O/g‐C3N4 from 7.71 to −22.3 mV with the increase in EPS concentration, and the maximum ratio of particle size increases from 825 to 1281 nm. In addition, the interaction with EPS inhibits the release of Ag+ in Ag2O/g‐C3N4 by half, thus, the toxicity of metal ions will be alleviated. Meanwhile, EPS can also be degraded by Ag2O/g‐C3N4, indicating that EPS can work as a radical scavenger to protect the algae cells. Without the protection of EPS, 97.8% of algae cells are inactivated after 5 h photocatalysis. Therefore, more attention should be given to the interaction between EPS and photocatalyst to promote the design and application of the photocatalytic.
Mental health history and social barriers impacting caregivers of infants with cystic fibrosis
Authors: Gillespie Michelle L. , Nemastil Christopher J. , Moore‐Clingenpeel Melissa , Gilmore Diana , Dell Mary L. , Krivchenia Katelyn
Published: December 2020

Objectives

Caregivers of infants with cystic fibrosis (CF) carry a heavy treatment burden for their child along with the inherent difficulties of raising an infant. This study investigated the impact of self‐reported caregiver mental health diagnoses and social barriers during the 1st year of life on clinical outcomes.

Methods

A retrospective chart review was conducted for infants seen in a large tertiary hospital CF clinic over a 5‐year period. Baseline characteristics were collected, and documentation from physician and social work notes were reviewed. Demographics and clinical characteristics were compared by the presence or absence of self‐reported mental health diagnoses, social barriers, and “emotional concern.”

Results

Analyses were conducted on 71 patients. Thirty‐five percent of caregivers disclosed mental health diagnoses, 52% identified social barriers to care, and 55% reported feeling upset or fatigued. Having a caregiver with a self‐reported mental health diagnosis was associated with tobacco smoke exposure (p < .001) and increased odds of hospitalizations (odds ratio [OR], 3.01; 95% confidence interval [CI], 1.49–6.06), emergency department/urgent care visits (OR, 3.17; 95% CI, 1.32–7.64), and longer lengths of stay (OR, 1.93; 95% CI, 1.69–2.20). Caregivers who expressed emotional concern had infants with significantly lower weight‐for‐length percentiles (p = .012).

Discussion

Caregiver mental health and social barriers to care are important determinants to address as they may impact clinical outcomes in infants with CF. Identifying barriers and struggles early increases the likelihood that clinical teams can intervene and provide support. Further research into mental health and socioeconomic barriers faced by caregivers of infants with CF is crucial.
A High‐Photocurrent and Fast‐Response Polarity‐Controlled ZnO‐Based UV Photodetector Grown by a Sol–Gel Process
Authors: Lee Gun‐Woo , Baek Seung‐Hye , Kim Hee‐Wung , Lee Sung‐Nam
Published: December 2020

Oxygen‐polar (O‐polar) and nonpolar ZnO‐based UV photodetectors (PDs) are fabricated using a sol–gel (SG) method on polarity‐controlled ZnO seed layers grown by atomic layer deposition (ALD). O‐polar c‐plane and nonpolar a‐plane ZnO films grown using the SG process are obtained using ALD‐grown ZnO seed layers on c‐plane and r‐plane sapphire substrates, respectively. In addition, the photoluminescence intensity of the O‐polar c‐plane ZnO film is higher than that of the nonpolar a‐plane ZnO film owing to the introduction of the ZnO seed layer. Therefore, the resulting photocurrent of the O‐polar c‐plane ZnO PD is higher than that of the nonpolar a‐plane ZnO PD. Furthermore, regardless of the crystal polarity, the carrier concentration and the mobility of the ZnO film deposited using the SG method significantly increase because of the ZnO seed layer. In particular, the carrier concentration of the nonpolar a‐plane ZnO film is 2.5 times higher than that of the O‐polar c‐plane ZnO film. Therefore, the time‐dependent photoresponsivity of the nonpolar a‐plane ZnO PD is faster than that of the O‐polar c‐plane ZnO PD. These results indicate that the ZnO seed layers can effectively control the crystal polarity of ZnO films grown using the SG method.
Phytotherapics in COVID19: Why palmitoylethanolamide?
Authors: Pesce Marcella , Seguella Luisa , Cassarano Sara , Aurino Laura , Sanseverino Walter , Lu Jie , Corpetti Chiara , Del Re Alessandro , Vincenzi Martina , Sarnelli Giovanni , Esposito Giuseppe
Published: December 2020

At present, googling the search terms “COVID‐19” and “Functional foods” yields nearly 500,000,000 hits, witnessing the growing interest of the scientific community and the general public in the role of nutrition and nutraceuticals during the COVID‐19 pandemic. Many compounds have been proposed as phytotherapics in the prevention and/or treatment of COVID‐19. The extensive interest of the general public and the enormous social media coverage on this topic urges the scientific community to address the question of whether which nutraceuticals can actually be employed in preventing and treating this newly described coronavirus‐related disease. Recently, the Canadian biotech pharma company “FSD Pharma” received the green light from the Food and Drug Administration to design a proof‐of‐concept study evaluating the effects of ultramicronized palmitoylethanolamide (PEA) in COVID‐19 patients. The story of PEA as a nutraceutical to prevent and treat infectious diseases dates back to the 1970s where the molecule was branded under the name Impulsin and was used for its immunomodulatory properties in influenza virus infection. The present paper aims at analyzing the potential of PEA as a nutraceutical and the previous evidence suggesting its anti‐inflammatory and immunomodulatory properties in infectious and respiratory diseases and how these could translate to COVID‐19 care.
Joint analysis of mixed types of outcomes with latent variables
Authors: Pan Deng , Wei Yingying , Song Xinyuan
Published: December 2020

We propose a joint modeling approach to investigating the observed and latent risk factors of mixed types of outcomes. The proposed model comprises three parts. The first part is an exploratory factor analysis model that summarizes latent factors through multiple observed variables. The second part is a proportional hazards model that examines the observed and latent risk factors of multivariate time‐to‐event outcomes. The third part is a linear regression model that investigates the determinants of a continuous outcome. We develop a Bayesian approach coupled with MCMC methods to determine the number of latent factors, the association between latent and observed variables, and the important risk factors of different types of outcomes. A modified stochastic search item selection algorithm, which introduces normal‐mixture‐inverse gamma priors to factor loadings and regression coefficients, is developed for simultaneous model selection and parameter estimation. The proposed method is subjected to simulation studies for empirical performance assessment and then applied to a study concerning the risk factors of type 2 diabetes and the associated complications.
Thioglucopyranose Ligands Promote Phase‐Transfer of Cadmium Selenide Quantum Dots from Organic Solvents to Water
Authors: Carrizo Antonella F. , Argüello Juan E. , Schmidt Luciana C. , Colomer Juan P.
Published: December 2020

The attainment of water‐dispersible cadmium selenide quantum dots (CdSe QDs) with bright luminescence and tunable optical properties represents a great challenge to improve their biological applications. Indeed, over the last years, fluorescent materials have been widely applied for sensing and bioimaging, thus promoting research in the field of life science. Herein, we present the functionalization of CdSe QDs with peracetylated thioglucopyranose (2,3,4,6‐Tetra‐O‐acetyl‐1‐thio‐β‐D‐glucopyranose) and the subsequent deprotection reaction. This novel protocol performed at room temperature and under mild conditions allows the phase‐transfer of the functionalized nanoparticles from organic solvents into water. The CdSe QDs in water showed higher photoluminescent efficiency than their nanoparticle precursors in organic solvents. Our results represent an effective methodology useful to obtain water‐soluble QDs to foster the potential uses for glycobiological studies.
Depolymerization of End‐of‐Life Poly(lactide) to Lactide via Zinc‐Catalysis
Authors: Alberti Christoph , Enthaler Stephan
Published: December 2020

The chemical recycling of poly(lactide) (PLA), especially the initial depolymerization step was studied. High molecular weight PLA was depolymerized in the presence of zinc catalyst to lactide, the industrial relevant chemical for the synthesis of high molecular weight PLA; therefore, an efficient recycling is feasible without the need for depolymerization reagents. An excellent performance was observed for zinc(II) acetate with turnover frequencies of up to ∼260 h−1at 200–210 °C. Noteworthy, the lactide was isolated in high purity by reactive distillation. Furthermore, the zinc(II) acetate catalyst was recycled up to five times.
A Green Catalyst Fe(OTs)3/SiO2 for theSynthesis of 4‐Pyrrolo‐12‐oxoquinazolines
Authors: Sai Allaka Bhargava , Basavoju Srinivas , Rama Krishna Gamidi
Published: December 2020

An efficient and eco‐friendly diversity‐oriented synthetic protocol has been presented to synthesize structurally versatile drug‐like molecules under solvent‐free grinding in the presence of Fe(OTs)3/SiO2 as a catalyst. The use of Fe(OTs)3/SiO2 as a recyclable and reusable catalyst has been explored in the synthetic domino protocol involving one‐pot, three component reaction for the synthesis of 4‐pyrrolo‐12‐oxoquinazolines with special features of the protocol like high atom‐economy, operational simplicity, short reaction time and high selectivity with excellent yields.