bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of Cochlear Implantation on Neurocognitive Subdomains in Adult Cochlear Implant Recipients
Authors: Völter Christiane , Götze Lisa , Haubitz Imme , Müther Janine , Dazert Stefan , Thomas Jan Peter
Published: January 2021

Introduction: Age-related hearing loss affects about one-third of the population worldwide. Studies suggest that hearing loss may be linked to cognitive decline and auditory rehabilitation may improve cognitive functions. So far, the data are limited, and the underlying mechanisms are not fully understood. The study aimed to analyze the impact of cochlear implantation on cognition in a large homogeneous population of hearing-impaired adults using a comprehensive non-auditory cognitive assessment with regard to normal-hearing (NH) subjects. Material and Methods: Seventy-one cochlear implant (CI) candidates with a postlingual, bilateral severe or profound hearing loss aged 66.3 years (standard deviation [SD] 9.2) and 105 NH subjects aged 65.96 years (SD 9.4) were enrolled. The computer-based neurocognitive tool applied included 11 subtests covering attention (M3), short- and long-term memory (recall and delayed recall), working memory (0- and 2-back, Operation Span [OSPAN] task), processing speed (Trail Making Test [TMT] A), mental flexibility (TMT B), inhibition (cFlanker and iFlanker), and verbal fluency. CI patients underwent a neurocognitive testing preoperatively as well as 12 months postoperatively. Impact of hearing status, age, gender, and education on cognitive subdomains was studied. Additionally, after controlling for education and age, cognitive performance of CI subjects (n = 41) was compared to that of NH (n = 34). Results: CI users achieved significantly better neurocognitive scores 12 months after cochlear implantation than before in most subtests (M3, [delayed] recall, 2-back, OSPAN, iFlanker, and verbal fluency; all p < 0.05) except for the TMT A and B. A significant correlation could be found between the postoperative improvement in speech perception and in the attentional task M3 (p = 0.01). Hearing status (p = 0.0006) had the strongest effect on attention, whereas education had a high impact on recall (p = 0.002), OSPAN (p = 0.0004), and TMT A (p = 0.005) and B (p = 0.003). Inhibition was mainly age-dependent with better results in younger subjects (p = 0.016). Verbal fluency was predicted by gender as females outperformed men (p = 0.009). Even after controlling for age and education NH subjects showed a significantly better performance than CI candidates in the recall (p = 0.03) and delayed recall (p = 0.01) tasks. Postoperatively, there was no significant difference between the 2 groups anymore. Conclusion: Impact of cochlear implantation on neurocognitive functions differs according to the cognitive subdomains. Postoperatively, CI recipients performed as good as age- and education-matched NH subjects.
Evaluation of Dry Eye after Implantable Collamer Lens Surgery
Authors: Chen Haiting , Feng Xueyan , Niu Guangzeng , Fan Yuxiang
Published: January 2021

Objectives: To evaluate dry eye (DE) and associated meibomian gland dysfunction parameters after Implantable Collamer Lens (ICL) surgery. Methods: This is a prospective observational case series. Patients who underwent ICL implantation without previous ocular diseases or ophthalmic treatments were enrolled. Their Ocular Surface Disease Index (OSDI), noninvasive breakup time (NIBUT), meibography, slit-lamp examination of the lid margin, corneal fluorescein staining (CFS), and Schirmer test I were examined preoperatively and at 1 and 3 months postoperatively. Results: A total of 117 eyes of 60 patients were enrolled, and 107 eyes completed 3-month follow-up period. OSDI, lid marginal abnormality, and meibomian gland (MG) secretion, and meibum quality score were significantly higher at 1 month postoperatively and recovered partially at 3 months after surgeries, while NIBUT was significantly decreased all the time. Patients with previous DE symptoms (OSDI score ≥12) showed not only lower Schirmer and TBUT values but also higher CFS, lid margin score, MG loss, MG secretion, and meibum quality scores compared with those in the control group after operations. Low Schirmer, NIBUT values, and high meibum quality score were determined as risk factors for DE symptoms after ICL surgery. Conclusions: ICL implantation has a bad influence on the ocular surface and MG functions. The influence may be more obvious in patients with existing DE.
УДОСКОНАЛЕННЯ ЕКСТРЕНОЇ МЕДИЧНОЇ ДОПОМОГИ ВІДПОВІДНО ДО МЕДИЧНОЇ РЕФОРМИ НА РІЗНИХ ЕТАПАХ ЇЇ НАДАННЯ
Authors: Kosa T. V.
Published: January 2021

У статті висвітлено потребу врегулювання організації та функціонування служби екстреної медичної допомоги на різних рівнях догоспітального етапу.
ЕФЕКТИВНІСТЬ ВПЛИВУ ЛОКАЛЬНОЇ КРІОТЕРАПІЇ ПРИ МʼЯЗОВИХ ПОРУШЕННЯХ
Authors: Posypenko O. B. , Stelmakh H. O. , Bakaliuk T. H.
Published: January 2021

Стаття присвячена аналізу застосування локальної кріотерапії при мʼязових порушеннях. Можливість регулювання мʼязового тонусу за допомогою кріотерапії має велике практичне значення. Залежно від інтенсивності та тривалості кріовпливу можна досягнути релаксації мʼязів або підвищення їх тонусу.
ДИСТАНЦІЙНЕ НАВЧАННЯ НА КАФЕДРІ СІМЕЙНОЇ МЕДИЦИНИ ДЗ «ДНІПРОПЕТРОВСЬКА МЕДИЧНА АКАДЕМІЯ МОЗ УКРАЇНИ» ОЧИМА СТУДЕНТІВ-МЕДИКІВ ДРУГОГО КУРСУ (АНАЛІЗ РЕЗУЛЬТАТІВ АНОНІМНОГО АНКЕТУВАННЯ)
Authors: Vysochyna I. L. , Avramenko I. V. , Bashkirova N. S.
Published: January 2021

Інформаційні комп’ютерні технології стали невід’ємною частиною освітянського процесу сучасного покоління студентів, у тому числі і студентів медичних ВНЗ, за складних протипандемічних умов, що обумовило напрямок дійсного дослідження, а саме аналіз думки студентів медичних вузів щодо використання дистанційного навчання в умовах карантину під час пандемії COVID-19. Саме тому метою нашого дослідження було провести аналіз результатів анонімного анкетування студентів 2 курсу стоматологічного факультету ДЗ «ДМА», щодо виправдання власних сподівань у відношенні до якості підготовки в дистанційному форматі в умовах карантину COVID-19 під час вивчення дисципліни «Пропедевтика внутрішньої медицини», що дозволить дати оцінку формату on-line викладання очима студентів. Для реалізації вищезазначеної мети було проведено анонімне онлайн-опитування 2-х груп іноземних (російськомовних) студентів 2 курсу (n = 45 студентів) за допомогою платформи Google Form. Узагальнення результатів анонімного анкетування констатувало наявність різного рівня оцінювання (в балах від 1 до 10) такої складової, як виправдання власних сподівань щодо якості підготовки в дистанційному форматі – інтерквартильний розподіл середньої становив 8 балів (МЕ = 8 Q1; Q3 (7; 9,75)), але якість рівня покращення власних практичних компетенцій – лише 5,5 бала (МЕ = 5,5 Q1; Q3 (5; 8)). Найчастішою пропозицією для покращення якості навчання, на думку студентів 2 курсу стоматологічного факультету, є збільшення можливостей для відпрацювання практичних навичок та професійних компетенцій. У переважній більшості студенти 2 курсу стоматологічного факультету мають думку щодо отримання позитивного досвіду навчання в дистанційному форматі, розцінюючи його як нагоду для саморозвитку та самостійного поглиблення теоретичної бази знань. Студенти 2 курсу стоматологічного факультету при вивченні дисципліни «Пропедевтика внутрішньої медицини» вважають, що дистанційна форма навчання може бути лише доповненням до очної частини, а не як тривала самостійна одиниця освітнього процесу, отже, специфіка обраної професії пов’язана з необхідністю засвоєння і вдосконалення практичних навичок та професійних компетенцій.
ВИКОРИСТАННЯ ІНТЕРАКТИВНИХ МЕТОДІВ НАВЧАННЯ У ПІДГОТОВЦІ МАЙБУТНІХ ПЕДІАТРІВ ДО РОБОТИ В КОМАНДІ
Authors: Melnychuk І. М.
Published: January 2021

У статті аргументовано, що обов’язковою професійною характеристикою кваліфікованого та компетентного лікаря-педіатра є володіння вміннями і навичками організації ефективної командної роботи. Педіатру необхідно володіти критичним, творчим мисленням, враховувати альтернативні підходи до вирішення складних медичних проблем, здійснювати всебічний аналіз і прогнозувати наслідки прийнятих рішень, вирішувати можливі конфліктні ситуації, використовувати досвід, набутий під час навчання у вищій школі. Формування такого досвіду уможливлюється за рахунок використання в підготовці майбутніх педіатрів інтерактивних форм і методів навчання з моделюванням процесів роботи в команді в режимі реального часу, участі студентів у ділових іграх, дискусіях, вирішенні квазіпрофесійних ситуативних завдань тощо. 

Теоретичний аналіз наукових публікацій дав змогу узагальнити різні напрями професійної діяльності і специфіку підготовки майбутніх лікарів-педіатрів до роботи за фахом. Встановлено, що дослідники розглядали практичні аспекти професійної підготовки майбутніх педіатрів в Україні та у світі. На основі теоретичного аналізу наукових літературних джерел окреслено сутність роботи в команді, що передбачає наукове обґрунтування процесу командоутворення.

Узагальнено, що науковці пропонують використовувати у професійній підготовці майбутніх педіатрів симуляційні технології, організовуючи заняття студентів у спеціально створених фантомно-симуляційних класах, а також такі інтерактивні методи: «Мозковий штурм», «Мозаїка проблем», «Правильні і помилкові твердження», «Дерево рішень», «Шість капелюхів мислення» та ін. Результатом використання інтерактивних методів стало набуття майбутніми педіатрами досвіду формування команди за рахунок розвитку формальної та неформальної атмосфери, набуття студентами навичок конструктивної міжособистісної взаємодії в команді; відпрацювання навичок ефективного вирішення професійних проблем у команді; створення ресурсу позитивних емоцій для ефективної роботи й зорієнтованості на кращий варіант вирішення професійних завдань, активне та зацікавлене обговорення важливих професійних проблем тощо.
ДИСТАНЦІЙНЕ НАВЧАННЯ ПРИ ВИКЛАДАННІ ПЕДІАТРИЧНИХ ДИСЦИПЛІН: ВИКЛИКИ ЧАСУ
Authors: Platonova O. M. , Stoeva T. V. , Titkova O. V.
Published: January 2021

Актуальність обраного напрямку обумовлена зростанням ролі технологій дистанційного навчання у викладанні медичних дисциплін.

Метою роботи є оцінка перспектив застосування технологій дистанційного навчання при викладанні педіатричних дисциплін, у тому числі в умовах карантинних обмежень.

Дослідження проведене шляхом бібліометричного та контент-аналізу інформаційних джерел, одержаних з електронних баз даних OVID, PubMed, Embase, а також офіційних джерел національних міністерств освіти розвинутих країн світу та країн СНД. Глибина пошуку – 3 роки. Одержані дані упорядковані та проаналізовані із виділенням основних тенденцій у застосуванні та розвитку дистанційного навчання при викладанні педіатричних дисциплін. Додатково проведено анкетування 50 студентів Одеського національного медичного університету та 20 викладачів з кафедр, які викладають педіатричні дисципліни. Статистична обробка проведена методом дисперсійного аналізу з використанням програмного забезпечення MS Excel (Microsoft Inc., США).

Відповідно до наказу МОН України від 16.03.2020 р. № 406, у медичних ВНЗ країни студенти перейшли на дистанційну форму навчання. Для багатьох викладачів та студентів така форма навчання виявилася складною. Поряд із суто технічними проблемами (нестійкість інтернет-з’єднання, невідповідність обладнання вимогам до програмного забезпечення, низький рівень комп’ютерної грамотності літніх викладачів) респонденти зазначали незручність інтерфейсу, складнощі підтримання належного рівня уваги при роботі он-лайн, недостатність набутття практичних навичок. Серед основних проблем викладачі називали складності ідентифікації користувачів, що беруть участь у конференції.

В умовах карантинних обмежень застосування дистанційних технологій дозволяє проводити освітній процес на достатньо високому рівні. Найбільш придатними для потреб дистанційного навчання є платформи Zoom та Microsoft Teams. Лише половина респондентів була задоволена якістю дистанційного навчання під час карантинних обмежень. Це свідчить про недостатню підготовленість як викладачів, так і студентів до такого формату освітнього процесу.
HАУКОВО-МЕТОДИЧНЕ ЗАБЕЗПЕЧЕННЯ НАВЧАJІЬНОГО ПРОЦЕСУ В КРЕМЕНЕЦЬКІЙ ГІМНАЗІЇ (ЛІЦЕЇ) ПРОТЯГОМ 1805–1833 РОКІВ В УРОЧНИЙ ТА ПОЗАУРОЧНИЙ ЧАС
Authors: Vasyluk V. M.
Published: January 2021

Освіта молоді – це майбутнє його народу. Програма й система навчання  Волинської гімназії та ліцею, згідно з рекомендаціями Тадеуша Чацького і Гуго  Коллонтая, у перших класах передбачали вивчення класичних та навчання іноземних мов. З метою розвитку учня програма була складена так, щоб у першу чергу розвивалася памʼять, яка є фундаментом у пошуку майбутніх знань. На вищому рівні, тобто на курсах, переважало вивчення предметів, які вимагали не стільки памʼяті, скільки мислення. Розвивалися також здібності (таланти).

Тексти лекцій складали самі викладачі, учні (студенти) записували ці тексти (конспекти) у свої зошити під час читання текстів лекцій чи дискусій (семінарів). Бібліотека була забезпечена літературою в достатній кількості, а викладацький склад – європейськими професорами.
ВИВЧЕННЯ УРБАНІСТИЧНОЇ ЛЕКСИКИ ТА ПОНЯТТЯ ЛОКУСУ НА ЗАНЯТТЯХ ІЗ ДИСЦИПЛІНИ «УКРАЇНСЬКА МОВА ЯК ІНОЗЕМНА» (НА ПРИКЛАДІ ТЕМИ «У МІСТІ. УРОК 1»)
Authors: Rudenko M. I.
Published: January 2021

В умовах щораз більшої кількості іноземних студентів у ЗВО України перед фахівцями з української мови як іноземної постає проблема розробки нових підходів до її навчання. У руслі комунікативного підходу метою таких занять є вільне спілкування в чужомовному мовному середовищі. Лінгводидактичні чинники зумовлюють вибір викладачем методів та засобів навчання. У статті запропоновано апробоване заняття з дисципліни «Українська мова як іноземна» на тему «У місті. Урок 1». Визначальними для лексико-семантичної системи заняття є урбаністичні поняття, поняття місця (локусу) та розташування. Лексичне наповнення заняття розкривається через укладений текст «У місті» та комплекс граматичних вправ, які підпорядковані головній темі. Текст випереджає розуміння студентів та містить ті граматичні категорії, які є предметом розгляду на занятті. За допомогою таблиць розкрито такі граматичні категорії, як місцевий відмінок іменника та узгодження іменника з прикметником. Вміння використовувати у мовленні місцевий відмінок є дуже важливим при зануренні в іншомовне середовище. Ця граматична категорія розглядається у зіставленні з називним відмінком, що полегшує його вивчення і розуміння. Також розглянуто творення якісно-означальних прислівників від прикметників. Використання таблиць дозволяє візуалізувати граматичний матеріал, структурувати його, також сприяє кращому запам’ятовуванню. Запропоновано тренувальні вправи з метою розрізнення цих частин мови та вживання прикметників і прислівників у реченні з огляду на їх сполучуваність з різними частинами мови. Завдання скомпоновано так, щоб і вивчити новий матеріал, і повторити попередньо вивчений, як-от: узгодження прикметника з іменником. Практичним результатом повинне стати вільне застосування вивченого лексико-граматичного матеріалу у повсякденному спілкуванні.
Estratigrafia da Bacia do Araripe: estado da arte, revisão crítica e resultados novos
Authors: Fambrini Gelson Luís , Silvestre Diego da Cunha , Barreto Junior Aerson Moreira , Silva-Filho Wellington Ferreira da
Published: January 2021

A Bacia do Araripe constitui-se em bacia rifte originada pelo rompimento do Supercontinente Gondwana, conhecida como a bacia interior de registro sedimentar mais completo na Região Nordeste do Brasil. O manuscrito apresenta o estado da arte da estratigrafia da Bacia do Araripe enfocando sua evolução no tempo, nas sequências estratigráficas com base em superfícies de discordâncias, em novos resultados e faz ainda revisão crítica das classificações estratigráficas propostas com vistas à elaboração de classificação integrada. As primeiras propostas estratigráficas foram elaboradas de forma muito abrangente e simplificada. Com o tempo, foram realizados estudos mais minuciosos corroborando uma melhor e mais refinada compartimentação dos pacotes sedimentares presentes. A década de 1980 foi imprescindível para as produções científicas inerentes à geologia da bacia em função do interesse no potencial petrolífero das bacias brasileiras. Não obstante, ainda hoje a bacia é motivadora de inúmeras pesquisas determinantes para um melhor entendimento da geologia local e regional. A Bacia do Araripe tem cinco sequências maiores: Paleozoica, representada pela Formação Cariri; Início de Rifte, constituída pela Formação Brejo Santo e parte inferior da Formação Missão Velha; Rifte, formada pela parte superior da Formação Missão Velha e por toda a Formação Abaiara; e Pós-Rifte, separada em duas sequências — pós-rifte I, constituída pelas formações Barbalha, Crato, Ipubi e Romualdo, e pós-rifte II, caracterizada pelas formações Araripina e Exu. Novos resultados estão incorporados às formações Missão Velha e Abaiara, cuja distinção é demonstrada aqui; também com relação às formações Barbalha e Cariri, novos elementos foram reunidos. Este trabalho foca a viabilidade dos dados, as interpretações propostas conforme as normas estratigráficas e a proposição de uma classificação estratigráfica sequencial.
Use of ACE (Angiotensin-Converting Enzyme) Inhibitors and Risk of Lung Cancer
Authors: Kristensen Kasper Bruun , Hicks Blánaid , Azoulay Laurent , Pottegård Anton
Published: January 2021

Background:

Use of angiotensin-converting enzyme inhibitors (ACEIs)was associated with increased risk of lung cancer in a cohort study from the United Kingdom. We aimed to replicate these findings in a Danish population.

Methods:

We conducted a nested case-control study using data from 4 Danish national health and administrative registries. New users of ACEIs or angiotensin II receptor blockers in Denmark from January 1, 2000 were followed until December 31, 2015, incident lung cancer, death, or emigration. Each lung cancer case was matched with up to 20 controls on age, sex, duration of follow-up, and year of cohort entry using risk-set sampling. Conditional logistic regression was used to estimate odds ratios (ORs) for incident, histologically verified lung cancer with high use of ACEIs defined as a cumulative dose above 3650 defined daily doses. We examined different cumulative doses of ACEI (≤1800, 1801–3650, >3650 defined daily doses), examined whether the association varied with lung cancer histology, and repeated the analyses using thiazides as active comparator.

Results:

We included 9652 lung cancer cases matched to 190 055 controls. High use of ACEIs was associated with lung cancer (adjusted OR, 1.33 [95% CI, 1.08–1.62]). Lower cumulative doses showed neutral associations (≤1800 defined daily doses OR, 1.01 [95% CI, 0.94–1.09]; 1801–3650 defined daily doses OR, 1.03 [95% CI, 0.90–1.19]). CIs were wide and included the null when stratifying on histology. Using thiazides as active comparator yielded comparable results (OR, 1.34 [95% CI, 0.96–1.88]).

Conclusions:

Use of high cumulative ACEI doses was associated with modestly increased odds of lung cancer although use of lower doses showed neutral associations. The established benefits of ACEIs should be considered when interpreting these findings.
An Early Greek Epic
Authors: Mansfeld Jaap
Published: January 2021

The question (once again) is in what cognitively acceptable way the Alētheia and Doxa sections of the epic should be connected, that is to say in what way Parmenides himself may have envisaged the relation between ontological Truth and mistaken human Opinions. An important distinction is found to obtain between the common run of humankind, ignorant and helpless, and an enlightened human elite. The views of this elite serve as an intermediate between the cognitive condition of humanity in general and the arcane knowledge and ontology of the Alētheia section and help to attenuate the dualism by bridging the gap between ignorance and absolute Truth. There is a significant and crucial interplay between the two sections which works both ways, forward from the Alētheia to the Doxa section and backwards from the Doxa to the Alētheia section. Defining characteristics of the elements per se and of their compounds in the Doxa section are reflections of defining properties of Being in the Alētheia section. Conversely, recognition of these elemental characteristics may point the way back to properties of Being. The argument of the epic from fr. B1 to fr. B19 DK is strictly organized by means of reiterated theses and type-scenes, which lend an overarching unity to the poem. This technique itself is not new, but the contents of these reiterated motifs (such as the mention of humans, of the distinction between Being and not-Being, of name-giving, or of defining properties and characteristics) are original. The reiterated motifs which secure the proofs of the main thesis function as hidden persuaders. The story of the extraordinary journey of the anonymous author to the dwelling of his nameless goddess and the revelation he receives from her have been carefully authenticated and stage-managed to provide divine backing for the stunning doctrines put forward and are also aimed at convincing the audience.
Tools for instar determination of European caddisfly larvae (Insecta: Trichoptera)
Authors: WARINGER JOHANN
Published: January 2021

The paper explores the adult-forewing-length to larval-head-width relationship as a basis for instar determination of final instar caddisfly larvae on a family level. In addition, reference data from published sources were used to extract series of percentage-head-width increments and factors-of-increase for penultimate to first instars. This material provides estimates for head widths of earlier instars on the family level.
Synthesis of Gold Nanoparticles in Cyclodextrin-Tetrachloroaurate System
Authors: Pestovsky Yuri S. , Srichana Teerapol
Published: January 2021

Tetrachloroaurate reduction with α-, β-, and γ-cyclodextrin at pH 10.56 was studied in this study by dual-angle dynamic light scattering and spectrophotometry. The nanoparticles were also characterized by scanning electron microscopy. In contrast
with our previous study, the nanoparticles were purified by centrifugation prior to characterization. The reaction is considered to be a promising one-step method for preparation of gold nanoparticles with immobilized cyclodextrins without the need for seeding. Unlike in our previous study,
the reaction mixture was boiled under reflux conditions instead of an open vial. This change sped up the reaction, and extensive aggregation was avoided. For the first time, this study demonstrated that all three cyclodextrins were able to reduce tetrachloroaurate at room temperature as well,
but long incubation periods were necessary. This is the first publication discussing the mechanism of tetrachloroaurate reduction by cyclodextrins. The first stage of the reaction involved tetrachloroaurate hydrolysis despite presence of hydrochloric acid in the commercial preparation of tetrachloroauric
acid (HAuCl4). Tetrachloroaurate was therefore the precursor but not the actual oxidant. The previous hypothesis on autocatalytic decarboxylation of cyclodextrins was therefore proven wrong. Particle growth was accompanied by nucleation, leading to coexistence of nanoparticles and
nanoclusters. The resulting nanoparticles contained a small fraction of aggregates, probably because of sodium chloride generated from hydrochloric acid. However, besides playing this detrimental role, chloride ions facilitated nucleation by stabilizing gold intermediates. The nanoparticles
solutions could be stored at least for three months, which contrasted with our previous work, where the nanoparticles were stable for only three days. For the first time, freeze-drying and reconstitution of the resulting nanoparticles were investigated, and they were shown to be free from
aggregation. The synthesized gold nanoparticles are recommended for use as drug carriers.
Study on the Immunomodulatory Effect of Quercetin Nanoparticles Loaded with Chitosan on a Mouse Model of Ovalbumin-Induced Food Allergy
Authors: Feng Hua , Xiong Xiujuan , Xu Qunying , Zhang Zhongwei , Feng Jiangao , Wu Yongning
Published: January 2021

As a common immune disease, food allergy has become a difficult problem for public health organizations. Food allergies are often accompanied by skin reactions, allergic rhinitis, gastrointestinal diseases, and other complications which can induce anaphylactic shock and even death.
However, mechanisms underlying food allergies are not fully understood. Therefore, exploring the mechanism of induction of food allergy is a critical first step toward discovering a future treatment. Here we constructed a quercetin–chitosan nanoplasmid (QT–CS NPs), which can regulate
the balance of Th1/Th2 cells, and used it to treat ovalbumin (OVA)-induced allergies in mice. The results suggest that compared to natural quercetin, the cytotoxicity of QT–CS NPs was weakened. QT–CS NPs also increased the expression of the Th1 cytokine INF-γ, reduced
the secretion of Th2 cytokine IL-4, regulated the balance drift of Th1/Th2 cells in allergic mice, and demonstrated an excellent immunomodulatory effect. Therefore, QT-CS NPs can provide new treatment ideas for the prevention and treatment of food allergy, and this study can lay an experimental
foundation for the clinical application of QT-CS NPs.
Application of Unsupervised Learning Techniques to Identify Atlantic Tropical Cyclone Rapid Intensification Environments
Authors: Mercer Andrew E. , Grimes Alexandria D. , Wood Kimberly M.
Published: January 2021

Tropical cyclone (TC) track forecasts have improved in recent decades while intensity forecasts, particularly predictions of rapid intensification (RI), continue to show low skill. Many statistical methods have shown promise in predicting RI using environmental fields, although these methods rely heavily upon supervised learning techniques such as classification. Advances in unsupervised learning techniques, particularly those that integrate nonlinearity into the class separation problem, can improve discrimination ability for difficult tasks such as RI prediction. This study quantifies separability between RI and non-RI environments for 2004–16 Atlantic Ocean TCs using an unsupervised learning method that blends principal component analysis with k-means cluster analysis. Input fields consisted of TC-centered 1° Global Forecast System analysis (GFSA) grids (170 different variables and isobaric levels) for 3605 TC samples and five domain sizes. Results are directly compared with separability offered by operational RI forecast predictors for eight RI definitions. The unsupervised learning procedure produced improved separability over operational predictors for all eight RI definitions, five of which showed statistically significant improvement. Composites from these best-separating GFSA fields highlighted the importance of mid- and upper-level relative humidity in identifying the onset of short-term RI, whereas long-term, higher-magnitude RI was generally associated with weaker absolute vorticity. Other useful predictors included optimal thermodynamic RI ingredients along the mean trajectory of the TC. The results suggest that the orientation of a more favorable thermodynamic environment relative to the TC and midlevel vorticity magnitudes could be useful predictors for RI.
ENSO Diversity in a Tropical Stochastic Skeleton Model for the MJO, El Niño, and Dynamic Walker Circulation
Authors: Yang Qiu , Majda Andrew J. , Chen Nan
Published: January 2021

El Niño–Southern Oscillation (ENSO) diversity has a significant impact on global climate and seasonal prediction. However, it is still a challenging problem for present-day global climate models to simulate different types of ENSO events with realistic features simultaneously. In this paper, a tropical stochastic skeleton model for the interactions among wind bursts and the Madden–Julian oscillation (MJO), the El Niño, and the Walker circulation is developed to reproduce both dynamical and statistical features of the ENSO diversity. In this model, the intraseasonal component with state-dependent noise captures general features of wind bursts and the MJO, both of which play important roles in triggering the El Niño. The thermocline feedback is the dominant mechanism for generating the eastern Pacific (EP) El Niño, while a nonlinear zonal advection is incorporated into the model that contributes to the central Pacific (CP) El Niño. Besides, a simple but effective stochastic process describing the multidecadal variation of the background Walker circulation modulates the spatial patterns and occurrence frequency of the EP and CP El Niño. This model succeeds in simulating the quasi-regular moderate EP El Niño, the super El Niño, and the CP El Niño as well as the La Niña simultaneously. It also captures the observed non-Gaussian characteristics of sea surface temperature anomalies in different Niño regions. Individual case studies highlight the outstanding skill of the model in reproducing the observed El Niño episodes and their underlying mechanisms.
WRF Model Moisture Adjustment Method: A Case Study with Wintertime Cloudy Biases in Xinjiang, China
Authors: Song Guiting , Huva Robert , Xing Yu , Zhong Xiaohui
Published: January 2021

For most locations on Earth the ability of a numerical weather prediction (NWP) model to accurately simulate surface irradiance relies heavily on the NWP model being able to resolve cloud coverage and thickness. At horizontal resolutions at or below a few kilometers NWP models begin to explicitly resolve convection and the clouds that arise from convective processes. However, even at high resolutions, biases may remain in the model and result in under- or overprediction of surface irradiance. In this study we explore the correction of such systematic biases using a moisture adjustment method in tandem with the Weather Research and Forecasting (WRF) Model for a location in Xinjiang, China. After extensive optimization of the configuration of the WRF Model we show that systematic biases still exist—in particular for wintertime in Xinjiang. We then demonstrate the moisture adjustment method with cloudy days for January 2019. Adjusting the relative humidity by 12% through the vertical led to a root-mean-square error (RMSE) improvement of 57.8% and a 90.5% reduction in bias for surface irradiance.
Electrospun nanofiber/cotton composite yarn with enhanced moisture management ability
Authors: Mao Ning , Qin Xiaohong , Wang Liming , Yu Jianyong
Published: January 2021

Wet comfort is a critical performance for fabrics, especially when human bodies release sweat in daily life. Despite excellent moisture absorption performance, cotton yarns are still limited in the moisture release/transfer ability. Here, based on a novel electrospinning technology, polyacrylonitrile and polystyrene (PS) electrospun nanofiber/cotton composite yarns were produced, respectively. Under fluorescence microscopic observation, electrospun fibers within the composite yarns showed a uniform distribution. As a result, these composite yarn-based knitted fabrics obtained a good water transport ability and a fast water evaporation rate. According to the moisture management test, PS electrospun nanofiber composite yarn-based fabrics exhibited a relatively high one-way transport index R (400%), claiming an enhanced moisture management performance. Finally, specific surface area tests and finite element analyses were used to analyze the water transport mechanism inside the yarns. The results proved that a small number of electrospun fibers played a predominant role in enhancing the moisture management ability of the composite yarns.
Laryngeal Force Sensor for Suspension Microlaryngoscopy: A Prospective Controlled Trial
Authors: Feng Allen L. , Puka Elefteria , Ciaramella Alex , Rao Vishwanatha M. , Wang Tiffany V. , Naunheim Matthew R. , Song Phillip C.
Published: January 2021

Objectives

The laryngeal force sensor (LFS) provides real‐time force data for suspension microlaryngoscopy. This study investigates whether active use of the LFS can prevent the development of complications.

Study Design

Prospective controlled trial.

Setting

Academic tertiary center.

Methods

The LFS and custom software were developed to track intraoperative force metrics. A consecutive series of 100 patients had force data collected with operating surgeons blinded to intraoperative readings. The subsequent 100 patients had surgeons actively use the LFS monitoring system. Patients were prospectively enrolled, completing pre‐ and postoperative surveys to assess the development of tongue pain, paresthesia, paresis, dysgeusia, or dysphagia.

Results

On univariate analysis, the active monitoring group had lower total impulse (P <. 001) and fewer extralaryngeal complications (P <. 01). On multiple logistic regression, maximum force (odds ratio [OR], 1.08; 95% CI, 1.01‐1.16; P =. 02) was a significant predictive variable for the development of postoperative complications. Similarly, active LFS monitoring showed a 29.1% (95% CI, 15.7%‐42.4%; P <. 001) decrease in the likelihood of developing postoperative complications. These effects persisted at the first postoperative visit for maximum force (P =. 04) and active LFS monitoring (P =. 01). Maximum force (OR, 1.11; 95% CI, 1.04‐1.18; P <. 01) and active LFS monitoring (16.6%; 95% CI, 2.7%‐30.5%; P =. 02) were also predictive for the development of an abnormal 10‐item Eating Assessment Tool score. These effects also persisted at the first postoperative visit for maximum force (P =. 01) and active LFS monitoring (P =. 01).

Conclusion

Maximum force is predictive of the development postoperative complications. Active monitoring with the LFS is able to mitigate these forces and prevent postoperative complications.

Level of Evidence

2.
Long‐term Oncologic Outcomes of 1188 Tis‐T2 Glottic Cancers Treated by Transoral Laser Microsurgery
Authors: Piazza Cesare , Paderno Alberto , Del Bon Francesca , Lancini Davide , Fior Milena , Berretti Giulia , Bosio Paolo , Deganello Alberto , Peretti Giorgio
Published: January 2021

Objective

To evaluate long‐term disease‐specific survival (DSS) and organ preservation (OP) rates in patients affected by Tis‐T2 glottic squamous cell carcinoma (SCC) treated by carbon dioxide transoral laser microsurgery (CO2 TOLMS).

Study Design

Single‐center retrospective cohort study.

Setting

Tertiary academic hospital.

Methods

The study included patients treated by CO2 TOLMS for Tis‐T2 glottic SCC at the Department of Otorhinolaryngology–Head and Neck Surgery of the University of Brescia, Italy, from 1988 to 2018. The male:female ratio was 11.2:1, and the mean age was 64 years (range, 31‐95). T categories were distributed as follows: 124 (10%) Tis, 646 (54%) T1a, 172 (15%) T1b, and 246 (21%) T2.

Results

Ten‐ and 20‐year DSS rates were 97.6% and 96.3%, respectively, and 10‐ and 20‐year OP rates were 94.7% and 93%. During the follow‐up, 91% of patients were treated by CO2 TOLMS alone, while the remaining needed adjunctive treatments. Assessing the impact of multiple sessions of CO2 TOLMS, DSS showed no significant difference in terms of patients treated by 1, 2, or >2 procedures. Conversely, patients treated by >2 sessions of CO2 TOLMS showed a significantly worse OP rate.

Conclusions

Our series validates CO2 TOLMS as a long‐term treatment strategy for early glottic SCC. Salvage CO2 TOLMS provided optimal results in terms of DSS and OP in patients with recurrence after previous transoral surgery.
Cephalometric and Functional Mandibular Reconstructive Outcomes Using a Horizontal Scapular Tip Free Flap
Authors: Sheehan Cameron Charles , Haskins Angela D. , Huang Andrew T. , Hernandez David J.
Published: January 2021

Scapula tip free flaps (STFFs) have become an increasingly popular option for head and neck reconstruction. The aim of this study is to demonstrate the feasibility of using the STFF in a horizontal orientation to take advantage of the anatomy of the scapular tip bone to re‐create a mandibular symphysis. Eight patients underwent oromandibular reconstruction with a horizontally oriented STFF between October 2016 and June 2020. Virtual surgical planning was used to design the bony reconstruction in 6 cases. Primary outcomes, including flap survival, complications, and return to oral diet, were collected. Cephalometric measurements were obtained to compare preoperative and postoperative mandibular projection and width. All flaps survived without compromise, and no fistulas developed postoperatively. Seven patients returned to taking an oral diet. Cephalometric analysis revealed comparable measurements between preoperative and postoperative mandibles and reconstructed mandibles, respectively. STFFs may be oriented horizontally to reconstruct large anterior mandibular defects with satisfactory results.
Expert Consensus Statement: Pediatric Drug‐Induced Sleep Endoscopy
Authors: Baldassari Cristina M. , Lam Derek J. , Ishman Stacey L. , Chernobilsky Boris , Friedman Norman R. , Giordano Terri , Lawlor Claire , Mitchell Ron B. , Nardone Heather , Ruda James , Zalzal Habib , Deneal Adrienne , Dhepyasuwan Nui , Rosenfeld Richard M.
Published: January 2021

Objective

To develop an expert consensus statement on pediatric drug‐induced sleep endoscopy (DISE) that clarifies controversies and offers opportunities for quality improvement. Pediatric DISE was defined as flexible endoscopy to examine the upper airway of a child with obstructive sleep apnea who is sedated and asleep.

Methods

Development group members with expertise in pediatric DISE followed established guidelines for developing consensus statements. A search strategist systematically reviewed the literature, and the best available evidence was used to compose consensus statements regarding DISE in children 0 to 18 years old. Topics with significant practice variation and those that would improve the quality of patient care were prioritized.

Results

The development group identified 59 candidate consensus statements, based on 50 initial proposed topics, that focused on addressing the following high‐yield topics: (1) indications and utility, (2) protocol, (3) optimal sedation, (4) grading and interpretation, (5) complications and safety, and (6) outcomes for DISE‐directed surgery. After 2 iterations of the Delphi survey and removal of duplicative statements, 26 statements met the criteria for consensus; 11 statements were designated as no consensus. Several areas, such as the role of DISE at the time of adenotonsillectomy, were identified as needing further research.

Conclusion

Expert consensus was achieved for 26 statements pertaining to indications, protocol, and outcomes for pediatric DISE. Clinicians can use these statements to improve quality of care, inform policy and protocols, and identify areas of uncertainty. Future research, ideally randomized controlled trials, is warranted to address additional controversies related to pediatric DISE.
Exploring implicit bias in the perceived consequences of prematurity amongst health care providers in North Queensland – a constructivist grounded theory study
Authors: Ireland Susan , Ray Robin , Larkins Sarah , Woodward Lynn
Published: January 2021

Background

A study was done to explore the attitudes of relevant health care professionals (HCP) towards the provision of intensive care for periviable and extremely premature babies.

Methods/design

Applying a constructivist grounded theory methodology, HCP were interviewed about their attitudes towards the provision of resuscitation and intensive care for extremely premature babies. These babies are at increased risk of death and neurodisability when compared to babies of older gestations. Participants included HCP of varying disciplines at a large tertiary centre, a regional centre and a remote centre. Staff with a wide range of experience were interviewed.

Results

Six categories of i) who decides, ii) culture and context of families, iii) the life ahead, iv) to treat a bit or not at all, v) following guidelines and vi) information sharing, emerged. Role specific implicit bias was found as a theoretical construct, which depended on the period for which care was provided relative to the delivery of the baby. This implicit bias is an underlying cause for the negativity seen towards extreme prematurity and is presented in this paper. HCP caring for women prior to delivery have a bias towards healthy term babies that involves overestimation of the risks of extreme prematurity, while neonatal staff were biased towards suffering in the neonatal period and paediatricians recognise positivity of outcomes regardless of neurological status of the child. The implicit bias found may explain negativity towards intensive care of periviable neonates.

Conclusion

Understanding the presence and origins of role specific implicit bias may enable HCP to work together to improve care for parents preparing for the delivery of extremely premature babies.
Reduced intensity of early intensification does not increase the risk of relapse in children with standard risk acute lymphoblastic leukemia - a multi-centric clinical study of GD-2008-ALL protocol
Authors: Li Xin-Yu , Li Jia-Qiang , Luo Xue-Qun , Wu Xue-Dong , Sun Xin , Xu Hong-Gui , Li Chang-Gang , Liu Ri-Yang , Sun Xiao-Fei , Chen Hui-Qin , Lin Yu-Deng , LI Chi-kong , Fang Jian-Pei
Published: January 2021

Background

The prognosis of childhood acute lymphoblastic leukemia (ALL) is optimistic with a 5-year event-free survival (EFS) rate of 70–85%. However, the major causes of mortality are chemotherapy toxicity, infection and relapse. The Guangdong (GD)-2008-ALL collaborative protocol was carried out to study the effect of reduced intensity on treatment related mortality (TRM) based on Berlin-Frankfurt-Münster (BFM) 2002 backbone treatment. The study was designed to elucidate whether the reduced intensity is effective and safe for children with ALL.

Methods

The clinical data were obtained from February 28, 2008 to June 30, 2016. A total of 1765 childhood ALL cases from 9 medical centers were collected and data were retrospectively analyzed. Patients were stratified into 3 groups according to bone marrow morphology, prednisone response, age, genotype, and karyotype information: standard risk (SR), intermediate risk (IR) and high risk (HR). For SR group, daunorubicin was decreased in induction IA while duration was reduced in Induction Ib (2 weeks in place of 4 weeks). Doses for CAM were same in all risk groups - SR patients received one CAM, others got two CAMs.

Results

The 5-year and 8-year overall survival (OS), event-free survival (EFS) and cumulative incidence of relapse (CIR) were 83.5±0.9% and 83.1±1.0%, 71.9±1.1% and 70.9±1.2%, and 19.5±1.0% and 20.5±1.1%, respectively. The 2-year treatment-related mortality (TRM) was 5.2±0.5%. The 5-year and 8-year OS were 90.7±1.4% and 89.6±1.6% in the SR group, while the 5-year and 8-year EFS were 81.5±1.8% and 80.0±2.0%. In the SR group, 74 (15.2%) patients measured minimal residual disease (MRD) on Day 15 and Day 33 of induction therapy. Among them, 7 patients (9.46%) were MRD positive (≥ 0.01%) on Day 33. The incidence of relapse in the MRD Day 33 positive group (n=7) was 28.6%, while in the MRD Day 33 negative group (n=67) was 7.5% (p=0.129).

Conclusions

The results of GD-2008-ALL protocol are outstanding for reducing TRM in childhood ALL in China with excellent long term EFS. This protocol provided the evidence for further reducing intensity of induction therapy in the SR group according to the risk stratification. MRD levels on Day 15 and Day 33 are appropriate indexes for stratification.
The effect of the integration of health services on health care usage among patients with type 2 diabetes in North Karelia, Finland
Authors: Wikström Katja , Lamidi Marja-Leena , Rautiainen Päivi , Tirkkonen Hilkka , Kivinen Petri , Laatikainen Tiina
Published: January 2021

Background

The need to improve the care of people with complex care requirements has been driving the reforms integrating care processes. This study examines the effect of the integration of health services on health care usage and the processes and outcomes of care among type 2 diabetes patients.

Methods

Data include all type 2 diabetes patients who lived in North Karelia, Finland, between 2014 and 2018. Health care contacts and glycated haemoglobin (HbA1c) measurements were obtained from the electronic health records. Logistic, Poisson and linear models with generalised estimating equations and the Friedman test were used to study the differences between years.

Results

The health care usage was highest in 2017, the first year of a new organisation, and smallest in the following year. Before the new organisation, the health care usage was lowest in 2014, being slightly higher compared with 2018. Between the last two years, the mean number of contacts per person declined from 3.25 to 2.88 (-0.37,p < 0.001). The decreasing pattern seen in total health care usage was most obvious among contacts with primary health care nurses. The number of contacts increased only among specialised care nurses between the last two years. The number of HbA1c measurements was also in its lowest in 2018 but in its highest in 2015. Between the years 2014 and 2018, the difference in the mean number of contacts was − 0.05 (p = 0.011) for those not measured, -0.02 (p = 0.225) for those measured and within the target level of HbA1c, and 0.12 (p = 0.001) for those measured and not at the target level of HbA1c.

Conclusions

Health care integration first increased the health care usage but then brought it to a slightly lower level than before. The changes were most obvious in primary health care nurses’ appointments, and no decline was observed in secondary-level care. Even though the numbers of HbA1c measurements and the proportion measured declined, measurements increased among those with poor glycaemic control. The observed changes might reflect the better targeting and more concordant services in different service units.
Cholangiogenic potential of human deciduous pulp stem cell-converted hepatocyte-like cells
Authors: Yuniartha Ratih , Yamaza Takayoshi , Sonoda Soichiro , Yoshimaru Koichiro , Matsuura Toshiharu , Yamaza Haruyoshi , Oda Yoshinao , Ohga Shouichi , Taguchi Tomoaki
Published: January 2021

Background

Stem cells from human exfoliated deciduous teeth (SHED) have been reported to show the in vivo and in vitro hepatic differentiation, SHED-Heps; however, the cholangiogenic potency of SHED-Heps remains unclear. Here, we hypothesized that SHED-Heps contribute to the regeneration of intrahepatic bile duct system in chronic fibrotic liver.

Methods

SHED were induced into SHED-Heps under cytokine stimulation. SHED-Heps were intrasplenically transplanted into chronically CCl4-treated liver fibrosis model mice, followed by the analysis of donor integration and hepatobiliary metabolism in vivo. Immunohistochemical assay was examined for the regeneration of intrahepatic bile duct system in the recipient liver. Furthermore, SHED-Heps were induced under the stimulation of tumor necrosis factor alpha (TNFA).

Results

The intrasplenic transplantation of SHED-Heps into CCl4-treated mice showed that donor SHED-Heps behaved as human hepatocyte paraffin 1- and human albumin-expressing hepatocyte-like cells in situ and ameliorated CCl4-induced liver fibrosis. Of interest, the integrated SHED-Heps not only expressed biliary canaliculi ATP-binding cassette transporters including ABCB1, ABCB11, and ABCC2, but also recruited human keratin 19- (KRT19-) and KRT17-positive cells, which are considered donor-derived cholangiocytes, regenerating the intrahepatic bile duct system in the recipient liver. Furthermore, the stimulation of TNFA induced SHED-Heps into KRT7- and SRY-box 9-positive cells.

Conclusions

Collectively, our findings demonstrate that infused SHED-Heps showed cholangiogenic ability under the stimulation of TNFA in CCl4-damaged livers, resulting in the regeneration of biliary canaliculi and interlobular bile ducts in chronic fibrotic liver. Thus, the present findings suggest that SHED-Heps may be a novel source for the treatment of cholangiopathy.