bluuebunny/crossref_metadata_2025 huggingface dataset:
Molecular set transformer: attending to the co-crystals in the Cambridge structural database
Authors: Vriza Aikaterini , Sovago Ioana , Widdowson Daniel , Kurlin Vitaliy , Wood Peter A. , Dyer Matthew S.
Published: September 2022

Molecular set transformer is a deep learning architecture for scoring molecular pairs found in co-crystals, whilst tackling the class imbalance problem observed on datasets that include only successful synthetic attempts.
Tailoring spin waves in 2D transition metal phosphorus trichalcogenides via atomic-layer substitution
Authors: Ruiz Alberto M. , Esteras Dorye L. , Rybakov Andrey , Baldoví José J.
Published: September 2022

We investigated Janus 2D transition metal phosphorus trichalcogenides and their potential for magnonic applications.
Uranium oxide hydrate frameworks with Er(iii) or Y(iii) ions: revealing structural insights leading to the low symmetry
Authors: Ablott Timothy A. , Lu Kimbal T. , Aughterson Robert D. , Zhang Yingjie
Published: September 2022

Two uranium oxide hydrate frameworks with trivalent Er or Y ions crystallised in the triclinic P1̄ space group have been synthesised and characterised.
Kinetics, products and pathways for the removal of pentachlorophenol (PCP) by sulfidated nanoscale zero-valent iron (S-nZVI)
Authors: Cheng Fang , Hou Jun , Wu Jun , Xu Yi , Miao Lingzhan , Xia Jun , Huo Zongli
Published: September 2022

Sulfidated nanoscale zero-valent iron (S-nZVI) was applied in the treatment of pentachlorophenol (PCP)-polluted water to explore the reaction pathways and the effects of water chemistry on PCP adsorption and transformation.
Efficient adsorption of low concentration rare-earth ions by carbides derived from excess sludge: preparation, performance and mechanism
Authors: Li Xuerong , Ma Xinyu , Ye Song , Wang Junfeng , Chen Yunnen , Zhong Changming
Published: September 2022

Experimental study on the adsorption of low concentration rare earth wastewater (rare earth ion concentration 185.70 mg L−1) by different carbonization products prepared from excess sludge by different carbonization processes.
Efficient separation of electrode active materials and current collector metal foils from spent lithium-ion batteries by a green deep eutectic solvent
Authors: Hua Yunhui , Xu Zhenghe , Zhao Baojun , Zhang Zuotai
Published: September 2022

The opposite electrostatic potential between the oxygen atoms on the carbonate ion and the hydrogen atoms on PVDF makes the potassium carbonate–ethylene glycol deep eutectic solvent suitable for electrode material separation.
The aspect ratio effect on the cytotoxicity of inert nano-particles flips depending on particle thickness, and is one of the reasons for the literature inconsistency
Authors: Brill-Karniely Yifat , Schwob Ouri , Benny Ofra
Published: September 2022

Nanoparticle thickness makes a critical effect on the cytotoxicity: non-functionalized nano-rods thicker than 35 nm would commonly be more toxic when they are longer, however for thinner particles the longer they are the safer they would be.
In situcrafting of a 3D N-doped carbon/defect-rich V2O5−x·nH2O nanosheet composite for high performance fibrous flexible Zn-ion batteries
Authors: Pan Rui , Zheng Anqi , He Bing , Xiong Yuwei , Han Fengsai , Wei Lei , Li Qingwen , Zhang Qichong , Yin Kuibo , Sun Litao
Published: September 2022

In situanodic oxidation strategy is demonstrated to fabricate flexible long-life and high-capacity aqueous zinc-ion batteries adopting a 3D N-doped/defect-rich V2O5−x·nH2O nanosheets as fibrous cathodes and Zn nanosheets arrays as the anode.
Chemical ordering and temperature effects on the thermal conductivity of Ag–Au and Ag–Pd bimetallic bulk and nanocluster systems
Authors: Taherkhani Farid , Fortunelli Alessandro
Published: September 2022

Understanding the heat transfer mechanisms in bimetallic nanoparticles, e.g. to promote heat transfer in a nanofluid, is a significant problem for industrial and fluid mechanics related applications.
Building a Z-scheme heterojunction with Keggin-type heteropolymer modified two-dimensional g-C3N4 for significant photocatalytic performance
Authors: Han Huimin , Liu Jinyuan , Wang Bin , Zhu Shumin , Jia Shihao , Tang Qi , Hua Yingjie , Li Huaming , Wang Chongtai , Xu Hui
Published: September 2022

Building Z-scheme heterojunction systems is a high-efficiency pathway to improve the utilization of visible light.
Dearomative logic in natural product total synthesis
Authors: Huck Christopher J. , Boyko Yaroslav D. , Sarlah David
Published: September 2022

This review explores the strategies and tactics of effective dearomative retrosynthetic logic, illustrated through numerous outstanding examples of contemporary natural product total synthesis.
Cooperative photoredox/gold catalysed cyclization of 2-alkynylbenzoates with arenediazonium salts: synthesis of 3,4-disubstituted isocoumarins
Authors: Pirovano Valentina , Brambilla Elisa , Fanciullacci Giorgia , Abbiati Giorgio
Published: September 2022

Gold runs into the light. A cooperative catalytic approach to unprecedented 3,4 hetero-disubstituted isocoumarins.
Robust synthesis of 2′-azido modified RNA from 2′-amino precursors by diazotransfer reaction
Authors: Moreno Sarah , Ramos Pittol José M. , Hartl Markus , Micura Ronald
Published: September 2022

One-step conversion chemistry makes RNA with internal site-specific 2′-azido modifications readily accessible from 2′-amino RNA; it is significantly more efficient compared to thus far used phosphotriester chemistry to generate such RNA.
Closed-loop chemical recycling of poly(ε-caprolactone) by tuning reaction parameters
Authors: Su Jiafeng , Xu Guangqiang , Dong Bingzhe , Yang Rulin , Sun Hongguang , Wang Qinggang
Published: September 2022

The first ε-CL polymerization/PCL depolymerization closed-loop chemical recycling process was developed under the catalysis of Mg(HMDS)2.
Preparation of asphalt-based microporous organic polymers with sulfur bridges
Authors: Di Tuo , Lei Yujie , Meng Zhaohui , Xia Yunxia , Ma Xingyu , Jiang Heng , Li Tiesheng , Zhao Tiansheng , Li Lei
Published: September 2022

The construction of microporous organic polymers (MOPs) with sustainable building blocks is essential for their scale-up preparation and practical applications.
A supramolecular hyperbranched polymer constructed by the host–guest interaction and complementary metal-coordination interaction
Authors: Huang Zhe , Rao Shenghui , Fan Wenjie , Duan Zhaozhao , Bai Yang , Huang Xiaohui , Xu Fenfen , Li Hui
Published: September 2022

A supramolecular hyperbranched polymer was constructed based on pillararene-based host–guest recognition and complementary terpyridyl-based metal coordination.
Switchable construction of oxa-heterocycles with diverse ring sizes via chemoselective cyclization controlled by dibrominated compounds
Authors: Hu Fangzhi , Wang Liang , Wang Peng , Ding Zhanshuai , Chen Yuzhuo , Xu Lubin , Liu Xiong-Li , Li Shuai-Shuai
Published: September 2022

Switchable construction of oxa-heterocycles with diverse ring sizes has been developed by performing dibrominated-compound-controlled chemoselective cyclization and subsequent derivatization.
Recent advances in photo- and electro-enabled radical silylation
Authors: Ren Li-Qing , Li Na , Ke Jie , He Chuan
Published: September 2022

This review aims to highlight the recent advances in the area of radical type silylation reactions mediated by photo- and electrocatalysis.
Views of Chinese middle school chemistry teachers on critical thinking
Authors: Wan Yanlan , Yao Ruoqing , Li Qi , Bi Hualin
Published: September 2022

Critical thinking, a rational and open higher-order thinking mode in human cognition, is becoming imperative to success in modern life. Therefore, cultivating students’ critical thinking has become a common goal of education reform worldwide. Teachers play a crucial role in cultivating students’ critical thinking. However, existing studies have paid little attention to teachers, especially middle school teachers’ knowledge and understanding of critical thinking. Therefore, this study aimed to explore the perspectives of ten Chinese middle school chemistry teachers on critical thinking using concept maps, thinking aloud, and in-depth interviews based on concept maps. Results showed that most of the teachers believed that critical thinking means reflection and questioning and requires evidence awareness. All teachers had a positive attitude towards critical thinking and believed that it can promote evidence awareness, problem solving, decision making, teaching evaluation, logic, and systematisation. Teachers recognised that critical thinking can be taught, and the major factors affecting the development of students’ critical thinking were the environment, students themselves, teachers, evaluation, subject characteristics, and types of knowledge. Several strategies for developing students’ critical thinking in chemistry teaching were proposed, including setting diversified and different types of chemistry courses, developing controversial curriculum themes in real situations, and implementing experimental, project-based, problem solving, and history-based teaching. In addition, this study showed that teachers and students promoted the development of critical thinking within one another. Further, this study demonstrated an effective methodology for probing individual subjective thoughts.
Self-healing mixed matrix membranes containing metal–organic frameworks
Authors: Mondal Prantik , Cohen Seth M.
Published: September 2022

Self-healable mixed-matrix membranes (MMMs) are described with adjustable mechanical strength, dynamic covalent chemistry, and metal–organic frameworks (MOFs) that degrade a toxic chemical warfare agent (CWA) simulant.
Reversible stability of colloids switched by CO2 based on polyhexamethylene guanidine
Authors: Huang Xiaoling , Zhu Zhuoyan , Luo Zheng , Zhao Weihang , Wang Yufeng , Shi Yiwen , Su Xin
Published: September 2022

By using polyhexamethylene guanidine as a CO2-switchable amine, crude oil emulsions containing normal surfactant were demulsified and recovered reversibly.
Sharpening Our Tools: A Systematic Review to Identify Diagnostically Accurate Language Sample Measures
Authors: Ramos Michelle N. , Collins Penelope , Peña Elizabeth D.
Published: September 2022

Purpose:

This systematic review provides a comprehensive summary of the diagnostic accuracy of English language sample analysis (LSA) measures for the identification of developmental language disorder.

Method:

An electronic database search was conducted to identify English publications reporting empirical data on the diagnostic accuracy of English LSA measures for children aged 3 years or older.

Results:

Twenty-eight studies were reviewed. Studies included between 18 and 676 participants ranging in age from 3;0 to 13;6 (years;months). Analyzed measures targeted multiple linguistic domains, and diagnostic accuracy ranged from less than 25% to greater than 90%. Morphosyntax measures achieved the highest accuracy, especially in combination with length measures, and at least one acceptable measure was identified for each 1-year age band up to 10 years old.

Conclusion:

Several LSA measures or combinations of measures are clinically useful for the identification of developmental language disorder, although more research is needed to replicate findings using rigorous methods and to explore measures that are informative for adolescents and across diverse varieties of English.

Supplemental Material:

https://doi.org/10.23641/asha.21183247
Optimal control and stabilization for NCSs with multiple memoryless channels and hold‐input compensation
Authors: Li Xueyang , Han Chunyan , Wang Wei
Published: September 2022

This paper investigates the optimal control problem for networked control systems over multiple Markovian packet loss channels under hold‐input compensation strategy. In this situation, the actuator receives the control signals from the controller via the individual channels. The system is transformed into a Markovian jump linear system by introducing a new Markovian jump variable. By giving a new maximum principle for such a system, a coupled difference Riccati‐type equation is developed, which in turn gives necessary and sufficient conditions for the solvability of optimal control problems in the finite horizon. Furthermore, for the infinite horizon case, the Markovian jump linear system is mean square stabilizable if and only if a set of coupled algebraic Riccati‐type equation has a particular solution. Finally, numerical simulations are presented to illustrate the control effects of the proposed optimal controllers.
Fuzzy model based fault estimation and fault tolerant control for flexible spacecraft with unmeasurable vibration modes
Authors: Li Yanbo , Xu Wei , Chang Lin
Published: September 2022

This paper investigates the problem of anti‐disturbance fault estimation and attitude tracking fault tolerant control for a flexible spacecraft subject to actuator faults, external disturbances, input saturation, and configuration misalignment. Different form the traditional methods, both the nonlinear dynamics subsystem and attitude control system are reconstructed into Takagi–Sugeno fuzzy models, where partial nonlinear term is remained to assist the design of fuzzy controller. A fuzzy fault estimation observer with proportional–integral adaptive laws is first designed. Without measuring any dynamic information of flexible appendages, estimated values of unknown actuator faults and vibration disturbances of flexible appendages can be obtained simultaneously. This is the most important advantage of the proposed fault estimation scheme over the previous methods. Then, a fuzzy sliding mode fault tolerant control scheme, based on fewer fuzzy rules and less computational burden, is developed under the framework of feedback linearisation and feedforward compensation. The actuator faults and vibration disturbances are counteracted in real time. Regional pole placement and virtual controller with input saturation are adopted to tune the control input and avoid the radical control torque scheduling. Finally, numerical simulations are given to illustrate the validity of the proposed fault estimation and fault tolerant control strategies.
LSTM and CNN application for core-collapse supernova search in gravitational wave real data
Authors: Iess Alberto , Cuoco Elena , Morawski Filip , Nicolaou Constantina , Lahav Ofer
Published: September 2022

Context.Core-collapse supernovae (CCSNe) are expected to emit gravitational wave signals that could be detected by current and future generation interferometers within the Milky Way and nearby galaxies. The stochastic nature of the signal arising from CCSNe requires alternative detection methods to matched filtering.

Aims.We aim to show the potential of machine learning (ML) for multi-label classification of different CCSNe simulated signals and noise transients using real data. We compared the performance of 1D and 2D convolutional neural networks (CNNs) on single and multiple detector data. For the first time, we tested multi-label classification also with long short-term memory (LSTM) networks.

Methods.We applied a search and classification procedure for CCSNe signals, using an event trigger generator, the Wavelet Detection Filter (WDF), coupled with ML. We used time series and time-frequency representations of the data as inputs to the ML models. To compute classification accuracies, we simultaneously injected, at detectable distance of 1 kpc, CCSN waveforms, obtained from recent hydrodynamical simulations of neutrino-driven core-collapse, onto interferometer noise from the O2 LIGO and Virgo science run.

Results.We compared the performance of the three models on single detector data. We then merged the output of the models for single detector classification of noise and astrophysical transients, obtaining overall accuracies for LIGO (~99%) and (~80%) for Virgo. We extended our analysis to the multi-detector case using triggers coincident among the three ITFs and achieved an accuracy of ~98%.
Clinical Concerns on Sex Steroids Variability in Cisgender and Transgender Women Athletes
Authors: Di Luigi Luigi , Greco Emanuela A , Fossati Chiara , Aversa Antonio , Sgrò Paolo , Antinozzi Cristina
Published: September 2022

In the female athletic community, there are several endogenous and exogenous variables that influence the status of the hypothalamus-pituitary-ovarian axis and serum sex steroid hormones concentrations (e. g., 17β-estradiol, progesterone, androgens) and their effects. Moreover, female athletes with different sex chromosome abnormalities exist (e. g., 46XX, 46XY, and mosaicism). Due to the high variability of sex steroid hormones serum concentrations and responsiveness, female athletes may have different intra- and inter-individual biological and functional characteristics, health conditions, and sports-related health risks that can influence sports performance and eligibility. Consequently, biological, functional, and/or sex steroid differences may exist in the same and in between 46XX female athletes (e. g., ovarian rhythms, treated or untreated hypogonadism and hyperandrogenism), between 46XX and 46XY female athletes (e. g., treated or untreated hyperandrogenism/disorders of sexual differentiation), and between transgender women and eugonadal cisgender athletes. From a healthcare perspective, dedicated physicians need awareness, knowledge, and an understanding of sex steroid hormones’ variability and related health concerns in female athletes to support physiologically healthy, safe, fair, and inclusive sports participation. In this narrative overview, we focus on the main clinical relationships between hypothalamus-pituitary-ovarian axis function, endogenous sex steroids and health status, health risks, and sports performance in the heterogeneous female athletic community.
Epidemiology of injuries in elite Korean adolescent football (soccer)
athletes: A prospective cohort study
Authors: Kim June chul , Park Ki Jun
Published: September 2022

Abstrct

Objectives This study attempted to analyze the injury patterns during
training by sex and determine whether cardiopulmonary function and bone mineral
density (BMD) were related to the patterns of injuries in elite adolescent
footballers.

Methods Since 2021, data for consisted of 96 adolescent football athletes
(52 men and 44 women) who underwent intensive training in Korea and participated
in competitions. For cardiopulmonary function, minute ventilation (VE), volume
oxygen maximum (VO2max), and ventilation threshold (VT) were measured. BMD was
measured measure systemic BMD and bone mass. The injury incidence rates (IIR)
per 1000 training of hours. χ2 tests were performed to compare injury
patterns between sex. Simple linear regression was used to evaluate the
relationship between variables.

Results The overall IIR was 4.80 (4.32–5.32) per 1000 h of
training. Female had a higher rate than male (p=0.008). We observed
differences in injury severity between men and women (p=0.040). Both the
cardiopulmonary function and BMD were related to IIR in all athletes. The body
regions with the most injuries were the lower extremities (52.05%),
trunk (23.84%), upper extremities (16.71%), and head and neck
(7.40%). Cardiopulmonary function and BMD were not related to the
location of the injury. However, Cardiopulmonary function and BMD were related
to the IIR of severe and ligament injury.

Conclusion The sex was found to affect rate and severity of injury.
Cardiopulmonary function and BMD were related to the injury patterns. Our
findings can help promote the performance improvement of elite football athletes
and the development of injury prevention program.
Both Amide-Bearing α- and β-Amino Acids from Natural Aspartic Acid Are Efficient Organocatalysts for Enantioselective Aldol Reactions
Authors: Wen Gen-Fa , Zhang Rui , Da Chao-Shan , Zhang Chu-Yu
Published: September 2022

This work aims to compare and explore the different catalytic efficiencies of structurally similar α- and β-amino acids in an asymmetric aldol transformation. Interestingly, aspartic acid is not only an α-amino acid, but also a β-amino acid. Thus, by modifying one of the two acidic groups of aspartic acid, two sets of α- and β-amino acids, 14 amino acids in total, were prepared and used as organocatalysts. The two types of amino acid, interestingly, achieved similar high catalytic efficiencies in the asymmetric aldol transformation under different optimal conditions. The ideal β-amino acid, in some cases, even achieved significantly higher enantioselectivity than the ideal α-amino acid, although α-amino acids are extensively demonstrated to be highly efficient organocatalysts in this asymmetric transformation.
Reducing care time after implementing protocols for acute ischemic stroke: a systematic review
Authors: Leite Karina Fonseca de Souza , dos Santos Samuel Ribeiro , Andrade Rubia Laine de Paula , de Faria Mariana Gaspar Botelho Funari , Saita Nanci Michele , Arcêncio Ricardo Alexandre , Isaac Igor Simões da Silva , de Rezende Carlos Eduardo Menezes , Villa Tereza Cristina Scatena , Pontes Neto Octavio Marques , Monroe Aline Aparecida
Published: September 2022

Background The treatment of acute ischemic stroke with cerebral reperfusion therapy requires rapid care and recognition of symptoms.

Objective To analyze the effectiveness of implementing protocols for acute ischemic stroke in reducing care time.

Methods Systematic review, which was performed with primary studies in Portuguese, English, and Spanish published between 2011 and 2020. Inclusion criteria: study population should comprise people with acute ischemic stroke and studies should present results on the effectiveness of using urgent care protocols in reducing care time. The bibliographic search was conducted in June 2020 in the LILACS, MEDLINE, Embase, Scopus, CINAHL, Academic Search Premier, and SocINDEX databases. The articles were selected, and data were extracted by two independent reviewers; the synthesis of the results was performed narratively. The methodological quality of articles was evaluated through specific instruments proposed by the Joanna Briggs Institute.

Results A total of 11,226 publications were found, of which 35 were included in the study. Only one study reported improvement in the symptoms-onset-to-door time after protocol implementation. The effectiveness of the therapeutic approach protocols for ischemic stroke was identified in improving door-to-image, image-to-needle, door-to-needle and symptoms-onset-to-needle times. The main limitation found in the articles concerned the lack of clarity in relation to the study population.

Conclusions Several advances have been identified in in-hospital care with protocol implementation; however, it is necessary to improve the recognition time of stroke symptoms among those who have the first contact with the person affected by the stroke and among the professionals involved with the prehospital care.
Misdiagnoses in a Brazilian population with amyotrophic lateral sclerosis
Authors: Borghetti Vinicius Stefani , Cintra Vívian Pedigone , Ramos Jean de Oliveira , Marques Vanessa Daccach , Onofre Patrícia Toscano , Santana Victor Augusto Souza , Bezerra Lua Flora Pereira , Tomaselli Pedro José , Santos André Cleriston José dos , Sobreira Claudia Ferreira da Rosa , Marques Jr Wilson
Published: September 2022

Background Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease that affects the upper and lower motor neurons. The correct diagnosis at the onset of the disease is sometimes very difficult, due to the symptoms being very similar to those of other neurological syndromes.

Objective This study aimed to analyze the initial manifestations, the specialty of the first physician visited due the initial complaint, the misdiagnoses, as well as the unnecessary surgical interventions in a new ALS Brazilian population.

Methods The medical records of 173 patients with typical ALS were reviewed.

Results The present study demonstrated that other symptoms, besides weakness, were very frequent as initial presentation of ALS, and orthopedics was the medical specialty most sought by patients at the onset of symptoms. Our frequency of misdiagnoses was 69.7%, and in 7.1% of them, an unnecessary surgical intervention was performed.

Conclusions Amyotrophic lateral sclerosis presents a very large pool of signs and symptoms; therefore, there is an urgent need of increasing the disease awareness to other specialties due to the high frequency of misdiagnoses observed in clinical practice.
Autonomic and cardiorespiratory responses to the active tilt test in individuals with Parkinson disease: cross-sectional study
Authors: Valente Heloisa Balotari , Gervazoni Natacha de Lima , Laurino Maria Júlia Lopez , Vanzella Laís Manata , Stoco-Oliveira Mileide Cristina , Rodrigues Mariana Viana , André Larissa Borba , Ribeiro Felipe , Carvalho Augusto Cesinando de , Vanderlei Luiz Carlos Marques
Published: September 2022

Background The Parkinson disease (PD) is frequently associated with autonomic dysfunctions. However, data regarding the influence of PD on the autonomic responses to postural changes is limited.

Objective To analyze and compare the autonomic responses, evaluated through linear and non-linear methods of heart rate variability, and cardiorespiratory parameters in two groups: Parkinson disease (PDG) and control (CG), at rest and during the active tilt test.

Methods A total of 48 participants were analyzed (PDG: n = 25;73.40 ± 7.01 years / CG: n = 23;70.17 ± 8.20 years). The autonomic modulation and cardiorespiratory parameters were evaluated at rest and during the active tilt test. To assess the autonomic modulation the linear indices, at the time (rMSSD, SDNN) and frequency (LF, HF, LF/HF) domains, and the non-linear indices, obtained through the Poincaré plot (SD1, SD2, SD1/SD2), were calculated. The cardiorespiratory parameters evaluated were heart rate (HR), systolic (SBP), and diastolic blood pressure (DBP), peripheral oxygen saturation (SpO2), and respiratory rate.

Results At rest, the PDG presented significantly lower values of rMSSD, SDNN, LF, HF, SD1, SD2, and DBP, and higher values of SpO2. During test, in the PD group, modifications were observed in HR, and SBP, besides a reduced parasympathetic response, and an increased global modulation. The qualitative analysis of the Poincaré plot showed that the PDG has a lower dispersion of the RR intervals during rest and the active tilt test.

Conclusion Individuals with PD present reduced global variability and parasympathetic modulation at rest, and reduced parasympathetic response and damage in HR regulation when performing the active tilt test, compared with controls.
I would be better off dead: investigating suicidal ideation in people with epilepsy
Authors: Tedrus Gloria Maria de Almeida Souza , Souza Daniela de Carvalho Mendonça de
Published: September 2022

Background It is known that the risk of suicidal behavior in adult people with epilepsy (PWEs) is high. However, the associated clinical and psychosocial factors are still being discussed.

Objective To assess the risk of suicide in PWEs and relate it to resilience and quality of life (QoL) as well as with clinical variables.

Methods The item “I'd be better off dead” of the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) was related to the resilience scale, clinical aspects, the presence of depression, and the Quality of Life in Epilepsy Inventory (QOLIE-31) scores of PWEs, with a p < 0.05.

Results A total of 271 PWEs were assessed, 50.6% were female, with a mean age of 46.6 (± 15.8) years, and a mean age at 1st seizure of 24.1 (± 18.5) years. Risk for suicide occurred in 50 (19.3%) cases. In multiple logistic regression, the factors that explain the risk of suicide were female sex, depression, and lower scores on the QOLIE-31 and on the resilience scale. In the classification and regression trees, the order of importance of the variables was depression > resilience > age > QoL > age at 1st seizure.

Conclusion The risk of suicide was high, and it was associated with demographic aspects, clinical variables, QoL, and resilience. A higher risk of suicide was associated with lower resilience regardless of the presence or absence of depression. In the presence of depression, a higher risk of suicide was associated with the early onset of epilepsy. In the absence of depression, the risk of suicide was associated with low QoL in young adults.
Neuromuscular diseases and social distance resulting from the COVID-19 pandemic
Authors: Maciel Flaviana Kelly de Lima , Grossklauss Luis Fernando , Favero Francis Meire , Sá Cristina dos Santos Cardoso de
Published: September 2022

Background Coronavirus 2 severe acute respiratory syndrome (SARS-CoV-2), generically called COVID-2019, classified as a pandemic by the World Health Organization, has made health practices around the world face unique challenges. Since then, physical distancing and measures such as confinement have been adopted by different governments to control human-to-human transmission. This distance affected the treatment of individuals with progressive diseases such as neuromuscular diseases (NMDs).

Objective To identify how patients with NMDs performed the therapeutic routine during social distancing and confinement resulting from the COVID-19 pandemic.

Methods Application of a questionnaire prepared in the Google forms application, whose link for access and participation was sent by email or WhatssApp for family members and/or individuals with DNMs to respond. The questionnaire consisted of multiple-choice questions, divided into the following sections: personal data, treatments performed before and during the pandemic, activities performed during confinement, and characterization of motor function in activities of daily living comprising the period between September and October 2020.

Results We observed a significant reduction in medical appointments for patients with NMDs. On the other hand, the results showed that most patients underwent motor and/or respiratory physiotherapy in person or by telemonitoring. The study participants reported spending more time playing indoors, and all pointed out motor changes during social distancing.

Conclusion There were changes in the therapeutic routine of patients with NMDs during the period of social distancing due to COVID-19.
Predictors of functional communication in people with aphasia after stroke
Authors: Fernandes Adriana , Fraga-Maia Helena , Maso Iara , Matos Isabela Guimarães , Gomes Lene , Matos Matheus , Santana Andressa , Oliveira-Filho Jamary , Jesus Pedro Antônio de , Pinto Elen Beatriz
Published: September 2022

Background Aphasia, the most common language disorder secondary to stroke, has been associated with increased mortality, longer hospitalization and rehabilitation times, worse performance in daily activities, increased financial burden, and short- and long-term complications. Aphasia can negatively impact functional communication skills, including social networks, social activities, relationships with other people and social support.

Objective To evaluate patients with poststroke aphasia in their respective residences to investigate potential predictors of functional communication.

Methods The prospective cohort included patients with poststroke aphasia aged 18 years or older who resided in the city of Salvador, Northeastern Brazil. Following discharge from the Stroke Unit (SU), the individuals themselves, or their guardians, were contacted by telephone to schedule a home visit no less than three months after discharge. At baseline, sociodemographic and clinical data were collected, in addition to the scores on the National Institutes of Health Stroke Scale (NIHSS) and modified Barthel Index (mBI). The American Speech-Language-Hearing Association Functional Assessment of Communication Skills for Adults (ASHA FACS) was applied at the patients' homes. Multivariate linear regression was employed using the total score on the ASHA FACS as the outcome of interest.

Results A multivariate analysis of the associated factors identified using the linear regression revealed that only functional capacity (as assessed by the mBI) upon discharge from the SU remained as an independent predictor of functional communication performance (β = 0.042; 95% confidence interval [95%CI] = 0.013–0.071; p = 0.002).

Conclusion The functional capacity to perform daily activities, evaluated upon discharge from a stroke unit, was identified as a potential predictor of functional communication performance, regardless of the time elapsed after the stroke.
Brain volume loss and physical and cognitive impairment in naive multiple sclerosis patients treated with fingolimod: prospective cohort study in Buenos Aires, Argentina
Authors: Rojas Juan Ignacio , Patrucco Liliana , Pappolla Agustín , Sánchez Francisco , Cristiano Edgardo
Published: September 2022

Background The percentage of brain volume loss (PBVL) has been classically considered as a biomarker in multiple sclerosis (MS).

Objective The objective of the present study was to analyze if the PBVL during the 1st year after the onset of the disease predicts physical and cognitive impairment (CI).

Methods Prospective study that included naïve patients without cognitive impairment who initiated MS treatment with fingolimod. Patients were followed for 3 years and relapses, expanded disability status scale (EDSS) progression (defined as worsening of 1 point on the EDSS), the annual PBVL (evaluated by structural image evaluation using normalization of atrophy [SIENA]), and the presence of CI were evaluated. Cognitive impairment was defined in patients who scored at least 2 standard deviations (SDs) below controls on at least 2 domains. The PBVL after 1 year of treatment with fingolimod was used as an independent variable, while CI and EDSS progression at the 3rd year of follow-up as dependent variables.

Results A total of 71 patients were included, with a mean age of 35.4 ± 3 years old. At the 3rd year, 14% of the patients were classified as CI and 6.2% had EDSS progression. In the CI group, the PBVL during the 1st year was - 0.52 (±0.07) versus -0.42 (±0.04) in the no CI group (p < 0.01; odds ratio [OR] = 2.24; 95% confidence interval [CI]: 1.72–2.44). In the group that showed EDSS progression, the PBVL during the 1st year was - 0.59 (±0.05) versus - 0.42 (±0.03) (p < 0.01; OR = 2.33; 95%CI: 1.60–2.55).

Conclusions A higher PBVL during the 1st year in naïve MS patients was independently associated with a significant risk of CI and EDSS progression.
Thomas Willis' legacy on the 400th anniversary of his birth
Authors: Teive Hélio Afonso Ghizoni , Coutinho Léo , Camargo Carlos Henrique Ferreira , Munhoz Renato Puppi , Walusinski Olivier
Published: September 2022

To celebrate the 400th anniversary of the birth of Thomas Willis, his main contributions to the development of neurosciences, in particular neurology, are presented. Willis coined the term neurology and contributed significantly to the field of neuroanatomy, with the description of the arterial circle—located at the base of the brain—, which bears his name. He also described the striatum and cranial nerves. Furthermore, as a clinical neurologist, Willis participated in the description of various diseases, including myasthenia gravis and restless legs syndrome.
Role of Viscoelastic and Conventional Coagulation Tests for Management of Blood Product Replacement in the Bleeding Patient
Authors: Matkovic Eduard , Lindholm Paul F.
Published: September 2022

An important aim of viscoelastic testing (VET) is to implement transfusion algorithms based on coagulation test results to help reduce transfusion rates and improve patient outcomes. Establishing a rapid diagnosis and providing timely treatment of coagulopathy is the cornerstone of management of severely bleeding patients in trauma, postpartum hemorrhage, and major surgery. As the nature of acute bleeding and trauma leads to an unstable and tenuous physiologic state, conventional coagulation tests (CCTs) are too slow to diagnose, manage, and also course correct any hemostatic abnormalities that accompany an acute critical illness. Viscoelastic point-of-care tests strongly correlate with results from standard laboratory tests but are designed to enable clinicians to make timely, informed bleeding management decisions when time to intervene is critical. These assays provide an individualized and goal-oriented approach to patient blood management and are increasingly becoming involved in transfusion algorithms. The scope of this review aims to evaluate the current literature on VETs and their impact on actionable outputs in clinical decision making and their relationship to CCT.
Low-Molecular-Weight Heparin Resistance and Its Viscoelastic Assessment in Critically Ill COVID-19 Patients
Authors: Bösch Johannes , Rugg Christopher , Schäfer Volker , Lichtenberger Philipp , Staier Nikolai , Treichl Benjamin , Rajsic Sasa , Peer Andreas , Schobersberger Wolfgang , Fries Dietmar , Bachler Mirjam
Published: September 2022

Critically ill COVID-19 patients present an inflammatory and procoagulant status with a high rate of relevant macro- and microvascular thrombosis. Furthermore, high rates of heparin resistance have been described; yet, individualized anticoagulation by drug monitoring has not been sufficiently researched. We analyzed data from critically ill COVID-19 patients treated at Innsbruck Medical University Hospital with routinely adapted low-molecular-weight heparin (LMWH) doses according to anti-Xa peak levels, and regularly performed ClotPro analyses (a viscoelastic hemostatic whole blood test). A total of 509 anti-Xa peak measurements in 91 patients were categorized as below (<0.008 IU/mL/mg), within (0.008–0–012 IU/mL/mg) or above (> 0.012 IU/mL/mg) expected ranges with respect to the administered LMWH doses. Besides intergroup comparisons, correlations between anti-Xa levels and ClotPro clotting times (CTs) were performed (226 time points in 84 patients). Anti-Xa peak levels remained below the expected range in the majority of performed measurements (63.7%). Corresponding patients presented with higher C-reactive protein and D-dimer but lower antithrombin levels when compared with patients achieving or exceeding the expected range. Consequently, higher enoxaparin doses were applied in the sub-expected anti-Xa range group. Importantly, 47 (51.6%) patients switched between groups during their intensive care unit (ICU) stay. Anti-Xa levels correlated weakly with IN test CT and moderately with Russell's viper venom (RVV) test CT. Critically ill COVID-19 patients present with a high rate of LMWH resistance but with a variable LMWH response during their ICU stay. Therefore, LMWH–anti-Xa monitoring seems inevitable to achieve adequate target ranges. Furthermore, we propose the use of ClotPro's RVV test to assess the coagulation status during LMWH administration, as it correlates well with anti-Xa levels but more holistically reflects the coagulation cascade than anti-Xa activity alone.
Management Strategies for Sexuality Complaints after Gynecologic Cancer: A Systematic Review
Authors: Pizetta Luciane Machado , Reis Augusto da Cunha , Méxas Mirian Picinini , Guimarães Vanessa de Almeida , de Paula Carmen Lucia
Published: September 2022

Objective To explore the main sexuality complaints of gynecologic cancer survivors after treatment and to identify the care strategies provided.

Data Source Searches were conducted in six electronic databases: Scopus, Web of Science, LILACS, MEDLINE, PsychINFO, and EMBASE.

Study Selection Articles published between 2010 and 2020 were selected and the following descriptors were used in the English language: female genital neoplasms and gynaecological cancer. The methodological quality of the studies used the Mixed Methods Appraisal Tool (MMAT).

Data Collection The primary data extracted were: names of the authors, year of publication, country of origin, objective and type of study, data collection instrument, sample size and age range, types of cancer, and symptoms affected with the strategies adopted.

Data Summary A total of 34 out of 2,536 screened articles were included. The main strategies found for patient care were patient-clinician communication, practices for sexuality care, individualized care plan, multiprofessional team support, and development of rehabilitation programs. For sexuality care, the most common practices are pelvic physiotherapy sessions and the use of vaginal gels and moisturizers.

Conclusion The main complaints identified in the scientific literature were low libido and lack of interest in sexual activity, vaginal dryness, pain during sexual intercourse, and stenosis. Different care strategies may be adopted, such as follow-up with a multidisciplinary health team and sexual health rehabilitation programs, which could minimize these symptoms and ensure the quality of life of patients.
Predictors of Refractoriness and Survival following Transarterial Chemoembolization for Hepatocellular Carcinoma: Outcomes from a Southeast Asian Cohort
Authors: Kuhn Rudolf V. , Ignacio Glenn Marc G. , Jamias Jade D. , Teh Catherine S.C.
Published: September 2022

Purpose Patients with hepatocellular carcinoma (HCC) become refractory to repeated sessions of transarterial chemoembolization (TACE). The aim of this study was to identify predictors associated with overall survival and refractoriness following repetitive TACE of HCC among patients in Southeast Asia.

Methods The clinical and laboratory characteristics and radiologic response of 39 patients treated with conventional TACE (range 2 to 5) with mitomycin from January 2012 to June 2018 were retrospectively analyzed. Patients were mostly male with a median age of 59 years and belonged to the BCLC B stage with a median tumor size of 7.5 cm.

Results The median overall survival was 23.2 months and the overall mortality at 5 years was 36%. Multivariate Cox regression analysis revealed that Child–Pugh (CP) score (hazard ratio [HR] = 3.47, p = 0.044), AST (HR = 7.6, p = 0.021), tumor size (HR = 5.47, p = 0.033), progressive disease on Choi criteria (HR = 5.47, confidence interval [CI] 1.15–25.99, p = 0.033), neutrophil-lymphocyte ratio (HR = 1.25, p = 0.049), and nodular enhancement on follow-up computed tomography (CT; HR = 1.98, p = 0.034) were independent risk factors for poor survival. ALT (p = 0.005), enhancement (p = 0.003), CP score (p = 0.010), and progressive disease on Choi criteria (p = 0.022) were predictive of TACE refractoriness/failure.

Conclusion Elevated liver enzymes, CP score, and progressive disease on Choi criteria accurately predict TACE refractoriness and failure, allowing early identification of patients who might benefit from other therapies.
Application of Activators Ecarin and Factor Xa in Thrombelastography for Measurement of Anticoagulant Effect of Direct Oral Anticoagulants Using TEG 5000
Authors: Artang Ramin , Brod Camille , Nielsen Jorn Dalsgaard
Published: September 2022

There are situations where monitoring direct oral anticoagulants (DOACs) would be useful, including bleedings and trauma. The thromboelastographic technique has proven useful in bleeding situations in trauma and heart surgery. The aim of this study was to examine the effect of DOACs on all currently commercially available conventional TEG®5000 assays as well as novel modified assay using Ecarin and human factor Xa (HFXa). Healthy male volunteers were given single dose of oral dabigatran 150 mg, rivaroxaban 20 mg, or apixaban 5 mg. Kaolin, RapidTEG, functional fibrinogen, PlateletMapping assay, and novel modified assays using Ecarin and HFXa were prepared. All TEG parameters were recorded. DOAC concentrations were correlated to the parameters with highest response to the DOAC effect. Sensitivity and negative predictive value of the parameter with highest response to DOAC concentration of 50 ng/mL was calculated. None of the conventional TEG assays demonstrated significant response to the effect on apixaban. Using Ecarin, reaction time R was strongly correlated with dabigatran concentrations. Using HFXa assay, R was strongly correlated with rivaroxaban and apixaban concentrations: r = 0.96, 0.84, and 0.86, respectively; p < 0.0001 for all. The R times obtained with the modified assays demonstrated strong sensitivity and negative predictive values for DOAC levels of ≥50 ng/mL. We have demonstrated that TEG®5000 can monitor the DOAC effect on hemostasis when the appropriate activator is used with significant correlation with DOAC concentrations. Larger clinical studies are warranted for correlation of TEG profile and clinical outcomes.
Evaluation of Correlation and Agreement between SpO2/FiO2 ratio and PaO2/FiO2 ratio in Neonates
Authors: Muniraman Hemananda K. , Kibe Rutuja , Namjoshi Abhijeet , Song Ashley Y. , Lakshmanan Ashwini , Ramanathan Rangasamy , Biniwale Manoj
Published: September 2022

Objectives This article evaluates correlation and agreement between oxygen saturation (SpO2)/fraction of inspired oxygen (FiO2) (SF) ratio and partial pressure of oxygen (PaO2)/FiO2 (PF) ratio. It also derives and validates predictive PF ratio from noninvasive SF ratio measurements for clinically relevant PF ratios and derives SF ratio equivalent of PF ratio cutoffs used to define acute lung injury (ALI, PF < 300) and acute respiratory distress syndrome (ARDS, PF < 200).

Methods Retrospective cohort study including neonates with respiratory failure over a 6-year study period. Correlation and agreement between PF ratio with SF ratio was analyzed by Pearson's correlation coefficient and Bland–Altman analysis. Generalized estimating equation was used to derive PF ratio from measured PF ratio and derive corresponding SF ratio for PF ratio cutoffs for ALI and ARDS.

Results A total of 1,019 paired measurements from 196 neonates with mean 28 (± 4.7) weeks' gestational age and 925 (± 1111) g birth weight were analyzed. Strong correlation was noted between SF ratio and PF ratio (r = 0.90). Derived PF ratios from regression (1/PF = –0.0004304 + 2.0897987/SF) showed strong accuracy measures for PF ratio cutoffs < 200 (area under the curve [AUC]: 0.85) and < 100 (AUC: 0.92) with good agreement. Equivalent SF ratio to define ALI was < 450, moderate ARDS was < 355, and severe ARDS was < 220 with strong accuracy measures (AUC > 0.81, 0.84, and 0.93, respectively).

Conclusion SF ratio correlated strongly with PF ratio with good agreement between derived PF ratio from noninvasive SpO2 source and measure PF ratio. Derived PF ratio may be useful to reliably assess severity of respiratory failure in neonates. Further studies are needed to validate SF ratio with clinical illness severity and outcomes.
Von Willebrand Factor Multimer Analysis and Classification: A Comprehensive Review and Updates
Authors: Saadalla Abdulrahman , Seheult Jansen , Pruthi Rajiv K. , Chen Dong
Published: September 2022

Von Willebrand factor (VWF) is a multimeric glycoprotein with essential roles in primary hemostasis. Patients with von Willebrand disease (VWD), due to quantitative and/or qualitative defects of VWF usually experience mucocutaneous bleeding. Based on the laboratory results of VWF antigen, various VWF activities, factor VIII activity, and VWF multimer patterns, VWD can be categorized as type 1, 2, and 3 VWD. VWF multimer analysis by either manual or semi-automated electrophoresis and immunoblotting is a critical part of the laboratory testing to differentiate type 1, type 2 VWD, and subtypes of type 1 or 2 VWD. The multimer distribution patterns can also help to understand the underlying molecular mechanism of VWF synthesis, multimerization, and clearance defects in VWD. This review will cover VWF synthesis, multimerization, secretion, VWF multimer analysis, and VWF multimer interpretation of various types and subtypes of VWD.