bluuebunny/crossref_metadata_2025 huggingface dataset:
Continuous‐flow microwave‐assisted extraction coupled with online single drop microextraction prior to GC‐MS for determination of amide herbicides in rice samples
Authors: Wu Lijie , Li Zhanchao
Published: December 2020

A rapid method based on continuous‐flow microwave‐assisted extraction and online single drop microextraction was first developed and applied to the determination of amide herbicides in rice. The present method has the advantages of both continuous‐flow microwave‐assisted extraction and online single drop microextraction, which combines extraction, separation, preconcentration, and sample introduction in one step. By continuous‐flow microwave‐assisted extraction, analytes were first extracted from the rice samples using 15% methanol–water, and then concentrated into single drop. The microdrop was retracted into microsyringe and directly analyzed by gas chromatography with mass spectrometry without any filtration or clean‐up process. The method greatly simplifies the sample treatment procedure, reduces consumption of toxic organic solvent, and extends the application of single drop microextraction to complex solid samples. Several parameters were optimized by Box–Behnken design. Under optimal experimental conditions, good linearity was observed in the range of 2.0–500.0 μg/kg. The limits of detection and quantification were in the range of 0.3–1.5 and 1.1–5.1 μg/kg, respectively. The intra‐ and inter‐day precisions were between 1.9 and 4.8%. The present method was used to the analysis of real rice samples, and the recoveries of analytes were between 80.3 and 102.3% with the relative standard deviations ranging from 1.1 to 6.9%.
Rigid Video Laryngoscopy for Intubation in Severe Pierre Robin Sequence: A Retrospective Review
Authors: Peterson Joseph D. , Puricelli Michael D. , Alkhateeb Ahmed , Figueroa Aaron D. , Fletcher Steven L. , Smith Richard J. H. , Kacmarynski Deborah S. F.
Published: December 2020

Objectives/Hypothesis

The anatomy of children with severe Pierre Robin sequence can present a challenge for direct laryngoscopy and intubation. Advanced techniques including flexible fiberoptic laryngoscopic intubation have been described but require highly specialized skill and equipment. Rigid video laryngoscopy is more accessible but has not been described in this population.

Study Design

Retrospective cohort study.

Methods

A retrospective review was completed at a tertiary care center of all children between January 2016 and March 2020 with Pierre Robin sequence who underwent a mandibular distraction osteogenesis procedure. Intubation events were collected, and a descriptive analysis was performed. A univariate logistic regression model was applied to direct laryngoscopy and flexible fiberoptic laryngoscopy with rigid video laryngoscopy as a reference.

Results

Twenty‐five patients were identified with a total of 56 endotracheal events. All patients were successfully intubated. Direct laryngoscopy was successful at first intubation attempt in 47.3% (9/19) of events. Six direct laryngoscopy events required switching to another device. Rigid video laryngoscopy was successful at first intubation attempt in 80.5% (29/36) of events. Two cases required switching to another device. Flexible fiberoptic laryngoscopy was found successful at first intubation attempt in 88.9% (8/9) of events. Direct laryngoscopy was 4 times more likely to fail first intubation attempt when compared to rigid video laryngoscopy (P < .05). There was no significant difference between rigid video laryngoscopy and flexible fiberoptic laryngoscopy for intubation.

Conclusions

For children with Pierre Robin sequence rigid video laryngoscopy should be considered as a first attempt intubation device both in the operating room and for emergent situations.

Level of Evidence

4 Laryngoscope, 131:1647–1651, 2021
Comparison of Autofluorescence With Near‐Infrared Fluorescence Imaging Between Primary and Secondary Hyperparathyroidism
Authors: Takeuchi Mika , Takahashi Takeshi , Shodo Ryusuke , Ota Hisayuki , Ueki Yushi , Yamazaki Keisuke , Horii Arata
Published: December 2020

Objectives

To examine the role of autofluorescence (AF) monitoring with near‐infrared fluorescence imaging (NIFI) in identifying parathyroid lesions in primary or secondary hyperparathyroidism (P‐HPT or S‐HPT) surgeries.

Study Design

Prospective study.

Methods

Twelve lesions each were resected from 12 and 3 patients with P‐HPT and S‐HPT, respectively. The mean and maximum AF intensities of the lesions normalized to that of the thyroid tissue for in situ and ex vivo preparations were compared between P‐HPT and S‐HPT. Subjective visual classifications of AF intensity were compared with postoperative quantitative assessments. The unevenness of AF distribution inside the lesions was assessed by determining the ratio of maximum to mean AF intensity and comparing them with the corresponding ratio for normal parathyroid glands (PGs).

Results

In all quantitative comparisons (in situ/ex vivo, mean, and maximum AF), AF intensities of P‐HPT were stronger than those of S‐PHT. The AF‐positive rate in in situ subjective visual classification was higher for P‐HPT (100% vs. 33%). Subjective visual classifications showed a positive correlation with AF intensities. The ratio of maximum to mean AF was higher in P‐HPT and S‐HPT than in normal PGs.

Conclusions

For P‐HPT, AF intensity in both in situ and ex vivo preparations was sufficiently high and correlated with the subjective visual classification, suggesting that NIFI may be useful for confirming P‐HPT lesions. In contrast, NIFI may have only a minor role in S‐HPT surgeries owing to the weak‐AF of S‐HPT lesions. HPT lesions show an uneven AF intensity distribution compared with normal PGs.

Level of Evidence

3 Laryngoscope, 131:E2097–E2104, 2021
Characterisation of self‐repairing layer formed by oleic acid modified magnesium silicate hydroxide
Authors: Qin Yuan , Wang Libo , Yang Gang , Yang Yi , Wu Mingxia
Published: December 2020

Serpentine, whose main component is magnesium silicate hydroxide (MSH), has excellent friction properties. To explore the self‐repair mechanism of pure MSH under natural working conditions, MSH was synthesised by hydrothermal method and modified with oleic acid (OA). The optimal concentration of OA‐MSH was added to the air‐conditioning compressor simulator. The self‐repairing layers were studied by scanning electron microscope, Raman, and transmission electron microscope. The results show that OA‐MSH is well uniformly dispersed in lubricating oil and has significant anti‐friction performance. When the concentration is 1.0 wt%, the friction performance is best. The surface self‐repairing layer is composed of a 1.5 μm thick transition layer and a 20 nm amorphous carbon‐based film under the conditions of air‐conditioning compressors. There are dislocation cells, nanocrystals, and Mn2(Fe2+, Mg)5Si8O22(OH)2 in the transition layer. The formation mechanism of the self‐repairing layer on piston surface can be divided into three stages: nano‐crystallisation, mechanical alloying and lubricating oil crack deposition.
Adenosine Diphosphate and the P2Y13 Receptor Are Involved in the Autophagic Protection of Ex Vivo Perfused Livers From Fasted Rats: Potential Benefit for Liver Graft Preservation
Authors: Papegay Bérengère , Nuyens Vincent , Albert Adelin , Cherkaoui‐Malki Mustapha , Andreoletti Pierre , Leo Oberdan , Kruys Véronique , Boogaerts Jean G. , Vamecq Joseph
Published: December 2020

Studies on how to protect livers perfused ex vivo can help design strategies for hepatoprotection and liver graft preservation. The protection of livers isolated from 24‐hour versus 18‐hour starved rats has been previously attributed to autophagy, which contributes to the energy‐mobilizing capacity ex vivo. Here, we explored the signaling pathways responsible for this protection. In our experimental models, 3 major signaling candidates were considered in view of their abilities to trigger autophagy: high mobility group box 1 (HMGB1), adenosine monophosphate–activated protein kinase (AMPK), and purinergic receptor P2Y13. To this end, ex vivo livers isolated from starved rats were perfused for 135 minutes, after which perfusate samples were studied for protein release and biopsies were performed for evaluating signaling protein contents. For HMGB1, no significant difference was observed between livers isolated from rats starved for 18 and 24 hours at perfusion times of both 0 and 135 minutes. The phosphorylated and total forms of AMPK, but not their ratios, were significantly higher in 24‐hour fasted than in 18‐hour fasted livers. However, although the level of phosphorylated AMPK increased, perfusing ex vivo 18‐hour fasted livers with 1 mM 5‐aminoimidazole‐4‐carboxamide ribonucleotide, an AMPK activator, did not protect the livers. In addition, the adenosine diphosphate (ADP; and not adenosine monophosphate [AMP]) to AMP + ADP + adenosine triphosphate ratio increased in the 24‐hour starved livers compared with that in the 18‐hour starved livers. Moreover, perfusing 24‐hour starved livers with 0.1 mM 2‐[(2‐chloro‐5‐nitrophenyl)azo]‐5‐hydroxy‐6‐methyl‐3‐[(phosphonooxy)methyl]‐4‐pyridinecarboxaldehyde (MRS2211), a specific antagonist of the P2Y13 receptor, induced an increase in cytolysis marker levels in the perfusate samples and a decrease in the levels of autophagic marker microtubule‐associated proteins 1 light chain 3 II (LC3II)/actin (and a loss of p62/actin decrease), indicating autophagy inhibition and a loss of protection. The P2Y13 receptor and ADP (a physiological activator of this receptor) are involved in the protection of ex vivo livers. Therapeutic opportunities for improving liver graft preservation through the stimulation of the ADP/P2Y13 receptor axis are further discussed.
Study examines link between emotional support animals, MH
Authors: Canady Valerie A.
Published: December 2020

A first‐of‐its‐kind study examining the links between emotional support animals (ESAs) and improvements in an individual's mental, emotional and/or physical health has found that nearly all participants felt an increased sense of security and activity levels. The research, coincidentally, has been released around the same time the U.S. Department of Transportation (DOT) announced it is revising its regulations on ESAs on flights.
Estimating Recreational Fishing Effort Using Autonomous Cameras at Boat Ramps versus Creel Surveys
Authors: Dutterer Andrew C. , Dotson Jason R. , Thompson Brandon C. , Paxton Christopher J. , Pouder William F.
Published: December 2020

Measuring fishing effort is a common practice in fisheries management. Traditional access-point or roving creel surveys rely on in-person interaction between management agency personnel and anglers, the cost of which can restrict where and when the surveys can be performed. Increasing the efficiency of the techniques that are used to estimate recreational fishing effort would benefit management agencies by reducing costs or allowing for sampling at more waterbodies. We investigated using motion-triggered game cameras installed at boat ramps to capture the number of fishing trips, number of anglers, and trip durations to be used in estimating fishing effort. We tested boat ramp cameras at five lakes in the Florida Panhandle and peninsular Florida having diversity in their fisheries and user-group characteristics and ranging from small (<300 ha) to large (>12,000 ha). On three of the lakes, we concurrently conducted roving creel surveys, allowing us to compare the methods’ estimates of fishing effort, costs, and personnel time. The camera-based estimates of fishing effort were similar to those from the roving creel survey but tended to exceed them, including up to a factor of 2.22 in one case. These differences in effort estimates may have been due to several things such as erroneously designating some nonfishing trips as fishing trips during photo analysis, overestimating time spent fishing by ascribing all of the time between launch and retrieval to fishing, or underestimating fishing effort via roving creel surveys, as creel clerks might have occasionally missed anglers during the angler counts. Roving creel surveys were 1.25–2.50 times as expensive as camera counts because the cameras required less personnel effort. The detection probabilities that were calculated from the camera results ranged from 0.57 to 1.00, but the value was ≥ 0.86 at four of the five lakes. Despite some challenges, boat ramp cameras provided an effective, cost-beneficial tool for estimating fishing effort.
One dimensional SbO2/Sb2O3@NC microrod as anode for lithium‐ion and sodium‐ion batteries
Authors: Han Zhengsi , Zheng Jihui , Kong Fanjun , Tao Shi , Qian Bin
Published: December 2020

Sb‐based oxides electrodes have received tremendous attention owing to their high theoretical capacities and electrochemical activities. However, the huge volume change during ion insertion/extraction process and poor electronic conductivity limit their wide applications in the electrochemical energy storage. In this study, SbO2/Sb2O3 nanoparticles embedded in N‐doped carbon fibers are successfully synthesized. The composite can display a high reversible specific capacity of 622 mAh g−1 for lithium‐ion batteries and a desirable reversible capacity 307 mAh g−1 for sodium‐ion batteries at current density of 100 mA g−1. Such superior lithium and sodium storage performance can be ascribed to that carbon fibers can effectively restrict the large volume change and enhance the electrochemical stability.
How to select effective electrocatalysts: Nano or single atom?
Authors: Ou Honghui , Wang Dingsheng , Li Yadong
Published: December 2020

Electrocatalysis is viewed as one of the most effective ways to mitigate the energy problems and produce fuels or value‐added chemicals in a gentle manner. However, duo to the limited electrochemical properties of various systems, there is an intensive search for highly efficient electrocatalysts by more rational control over the topographic structure, chemical structure, and electronic structure. At present, the development of electrocatalysts mainly includes two directions: (1) nanoparticle electrocatalysts, and (2) single atom site electrocatalysts (SACs). Nanoparticle and SACs display their own advantages, and have been widely studied in the field of electrocatalysis. Considering the state‐of‐the‐art progress for nanoparticles or SACs, the selection of effective electrocatalysts has been a topic of great research value. Therefore, this paper summarizes the advantages, commonalities, and problems of nanoparticle and SACs, as well as their developing methods and experiences. In addition, the selection of nanoparticle and SACs in electrocatalytic reactions was discussed from the aspects of their respective influencing factors, active sites and synergistic effect. Finally, the research of nanoparticle and single atom sites electrocatalysts were prospected, providing a general guidance for the selection of efficient electrocatalysts.
Chronic pain and weight regain in a lifestyle modification trial
Authors: Goessl Cody L. , Befort Christie A. , Pathak Ram D. , Ellerbeck Edward F. , VanWormer Jeffrey J.
Published: December 2020

Objective

Obesity and chronic pain often co‐occur and exert bidirectional influences on one another. How patients with obesity and chronic pain respond to weight loss treatments, however, remains unclear. This study evaluated body weight, physical activity, and diet outcomes in participants with and without chronic pain in a 2‐year behavioral weight loss trial.

Methods

An analytical cohort of 397 adults was assembled from a Midwestern healthcare system that participated in the larger trial. Participants with chronic pain 1 year prior to, or during, the trial were identified using a validated medical records algorithm. Mixed models were used to estimate changes in outcomes over 24 months.

Results

One‐third of participants (n = 130) had chronic pain. After adjustment for age, sex, body mass index, and trial arm, weight loss was similar in both groups at 6‐months (−7.0 ± 0.8 kg with chronic pain vs. −7.7 ± 0.6 kg without). Participants with chronic pain had significantly less weight loss at 24‐months relative to those without (−3.6 ± 0.5 vs. −5.2 ± 0.4 kg; p = 0.007). Physical activity, screen time, dietary fat, fruit/vegetable consumption, and sugar‐sweetened beverage intake improved similarly in both groups over time.

Conclusions

Participants with chronic pain lost ∼33% less weight over 2 years, which was driven by greater weight regain after the first 6 months. Future research should test tailored weight loss maintenance strategies for individuals with chronic pain.
SHELTER‐IN‐PLACE ORDERS AND PUBLIC HEALTH: EVIDENCE FROM CALIFORNIA DURING THE COVID‐19 PANDEMIC
Authors: Friedson Andrew I. , McNichols Drew , Sabia Joseph J. , Dave Dhaval
Published: December 2020

A shelter‐in‐place order (SIPO) is one of the most restrictive non‐pharmaceutical interventions designed to curb the spread of COVID‐19. On March 19, 2020, California Governor Gavin Newsom issued the first statewide SIPO in the United States. The order closed non‐essential businesses and required residents to shelter in place for all but essential activities such as grocery shopping, retrieving prescriptions from a pharmacy, or caring for relatives. This study is the first in the economics literature to estimate the effect of a statewide SIPO on public health. Using daily state‐level coronavirus data and a synthetic control research design, we find that California's statewide SIPO reduced COVID‐19 cases by 160.9 to 194.7 per 100,000 population by April 20, one month following the order. We further find that California's SIPO led to as many as 1,566 fewer COVID‐19 deaths during this period. Back‐of‐the‐envelope calculations suggest that there were about 649 to 703 job losses per life saved, and about 14 to16 job losses per case averted during this post‐treatment period.
Study of the nanostructure of free volume and ionic conductivity of polyvinyl alcohol doped with NaI
Authors: Hmamm M. F. M. , Zedan I. T. , Mohamed Hamdy F. M. , Hanafy T. A. , Bekheet A. E.
Published: December 2020

Positron annihilation lifetime (PAL), AC conductivity, and impedance spectroscopy have been applied for the investigation of polyvinyl alcohol (PVA) doped with different concentrations of NaI in the range from zero to 25 wt%. Wide‐angle x‐ray diffraction measurements reveal that the addition of NaI to the PVA structure leads to a decrease in the crystallinity of the sample. The free volume size obtained from PAL measurements increases with the increase of the NaI concentration on PVA. NaI acts as an inhibitor of positronium formation on the doped polymer with inhibition constant of 0.028 (Mol%)−1. The ionic conductivity of the investigated sample was found to be correlated with the free volume size, which indicates the major role of free volume in the conduction mechanism. The AC conductivity of the prepared samples is measured at room temperature in the frequency range from 50 Hz to 5 MHz. The calculated values of frequency exponent s indicate the hopping mechanism in ionic conductivity. Impedance spectroscopy of PVA doped with different concentrations of NaI was studied. The appeared semi‐circle, in the Nyquist plot, denotes the bulk influence of PVA with different concentrations of NaI. This has been attributed to the parallel connection of bulk resistance and bulk capacitance. Also, the semi‐circle radius of Cole‐Cole plots was found to decrease with the increase of the concentration ratio (wt%) of NaI. So, the increase of the conductivity of PVA with the increase of NaI contents has been investigated.
Positron annihilation spectroscopy studies of implanted polymer membranes
Authors: Constantin Florin , Petruneac Marta , Focsaneanu Marin
Published: December 2020

Two different polymer membranes, polyethylene and Nafion, have been sequentially implanted under vacuum at room temperature with 90 keV copper ions up to 1017 ions/cm2; after each implantation step, the targets were subjected to analysis with Positron annihilation lifetime spectroscopy and coincidence Doppler broadening spectroscopy. Both membranes revealed a similar behavior regarding the high fluence superficial implantation, but with different degree of magnitude. In order to endorse the Positrons annihilation spectroscopy results, scanning electron microscopy coupled with energy‐dispersive energy has been performed on the same targets, despite its lower sensitivity.
Effect of internal mold release agent on flexural and inter laminar shear properties of carbon and glass fabric reinforced thermoset composites
Authors: Mishra Rajesh , Behera Bijoy K. , Rajpurohit Ashok N. , Behera Promoda , Petru Michal , Muller Miroslav
Published: December 2020

The study is focused on thermoset composites reinforced with carbon and glass woven fabrics. Two types of thermoset resins, for example, epoxy and vinyl ester were used as the matrix. Varying concentrations of internal mold releasing (IMR) agent was used in the resin. The composites were cured both at room temperature and at 80°C. The flexural properties were studied using 3‐point bending test method. Further theinter‐laminar shear strength (ILSS) was investigated using the short beam shear strength test based on 3‐point bending. The flexural modulus of room temperature cured epoxy resin is higher than that of high temperature cured epoxy resin and cured vinyl ester resin. The flexural modulus is lowest for 1% IMR sample in epoxy system and the modulus for 0% and 2% epoxy are not significantly different. Lowest flexural strength and modulus can be observed for the combination of reinforcement and curing conditions for samples containing 1% IMR for the epoxy systems. Carbon fiber is found to be less compatible with the vinyl ester resin system and the addition of IMR to the resin degraded the properties further. Inter‐laminar shear strength for epoxy‐based composites is not much affected by presence of IMR, but in case of vinyl ester based composites there is a decrease in ILSS on addition of IMR agent. The study explains variation in flexural properties on addition of IMR and change of curing conditions. These results can be used for ascertaining variation in mechanical properties in real use.
Low flammability and smoke epoxy resins with a novel DOPO‐based imidazolone derivative
Authors: Li Lei , Li Shan , Wang Hao , Zhu Zongmin , Yin Xianze , Mao Jiawei
Published: December 2020

In this work, a DOPO‐based imidazolone derivative named DHI was synthesized using DOPO, 5‐amino‐2‐benzimidazolinone and 4‐hydroxybenzaldehyde as raw materials. The chemical structure of DHI was characterized by 1H‐NMR, 31P‐NMR and Fourier transform infrared spectra (FTIR). Then, a series of different flame‐retardant epoxy resin (EP) thermosets were prepared by mixing flame retardant DHI. The thermal properties of the cured EPs was investigated by thermogravimetry analysis (TGA) and differential scanning calorimeter (DSC), and the results showed the thermal stability and glass transition temperature (Tg) of the cured EP modified with DHI declined slightly compared with that of neat EP. The limited oxygen index (LOI) and UL94 test results exhibited DHI imparted good flame retardancy to EP. The EP‐4 (phosphorus content of 1.25%) possessed a LOI value of 36.5% and achieved a V‐0 rating. Furthermore, the peak of heat release rate (PHRR) and total heat release rate (THR) of EP‐4 decreased by 38.7% and 24.5%, respectively. Excitedly, the total smoke production (TSP) of EP‐4 sample declined by 62.5%, which meant DHI also made EP obtain excellent smoke suppression property. Moreover, the flame‐retardant mechanism was studied by scanning electron microscopy (SEM) and pyrolysis‐gas chromatography/mass spectrometry (Py‐GC/MS). It was reasonable inferred that DHI could not only promote EP to form dense char layer in condensed phase, but also restrain combustion in gaseous phase through catching the free radicals sourced from the degradation of EP.
Pathology of childhood rhabdomyosarcoma: A consensus opinion document from the Children's Oncology Group, European Paediatric Soft Tissue Sarcoma Study Group, and the Cooperative Weichteilsarkom Studiengruppe
Authors: Rudzinski Erin R. , Kelsey Anna , Vokuhl Christian , Linardic Corinne M. , Shipley Janet , Hettmer Simone , Koscielniak Ewa , Hawkins Douglas S. , Bisogno Gianni
Published: December 2020

The diagnosis and classification of rhabdomyosarcoma (RMS) has undergone several shifts over the last 30 years. While the main diagnostic categories remained the same, changes in the histologic criteria necessary for diagnosis, as well as varied reliance on immunohistochemical and molecular data over time, have created confusion, particularly regarding how these shifts impacted risk stratification and enrollment onto clinical trials. The goal of this report is to review the evolution and current status of RMS diagnosis, focusing on diagnostic criteria in the Children's Oncology Group (COG), the European Paediatric Soft Tissue Sarcoma Group (EpSSG), and the Cooperative Weichteilsarkom Studiengruppe (CWS). In addition, we emphasize research tools used to classify RMS and address biological questions within current clinical trials run by each group. The INternational Soft Tissue SaRcoma ConsorTium (INSTRuCT) initiative will maximize potential to optimize risk stratification by recognizing and accounting for differences in historical data and current practices.
Patterns of medication use at end of life by pediatric inpatients with cancer
Authors: Prozora Stephanie , Shabanova Veronika , Ananth Prasanna , Pashankar Farzana , Kupfer Gary M. , Massaro Stephanie A. , Davidoff Amy J.
Published: December 2020

Objective

To describe medication utilization patterns by pediatric inpatients with cancer during their last week of life.

Methods

This retrospective study used data from the Vizient Clinical Database/Resource Manager, a national compilation of clinical and resource use data from over 100 academic medical centers and affiliates. Patients (0‐21 years) with malignancy who died during hospitalization (2010‐2017) were included (N = 1659). Medications were categorized as opioid, benzodiazepine, gastrointestinal related, chemotherapy, anti‐infectives, or vasopressors. Exposure to each group was ascertained for all patients at 1 week and 1 day prior to death. Factors associated with exposure were examined using generalized estimating equations, and summarized using adjusted odds ratios (aORs).

Results

Over the last week of life, there was increased use of opioids (76% to 82%, aOR = 1.55, P < .001) and benzodiazepines (53% to 66%, aOR = 1.36, P = .02), while gastrointestinal‐related medication use decreased (92% to 89%, aOR = 0.69, P = .001). Patients had decreased exposure to chemotherapy (10% to 5%, aOR = 0.46, P < .001) and anti‐infectives (82% to 73%, aOR = 0.41, P = .002). Vasopressor use increased as death approached (15% to 28%, aOR = 1.67, P = .04). Factors significantly associated with exposure varied with medication category, and included age, race, length of stay, malignancy type, death in the intensive care unit, history of hematopoietic stem cell transplant, and do‐not‐resuscitate status.

Conclusion

During the week preceding death, administration of symptom management medications increased for children with cancer, but use was not universal. Potentially life‐sustaining medications were often continued. Variability in utilization suggests differences in provider/family decision making that warrant further study to develop an evidence‐based approach to end‐of‐life care.
Assessing Diagnostic and Severity Grading Accuracy of Ultrasound Measurements for Carpal Tunnel Syndrome Compared to Electrodiagnostics
Authors: Chen Yin‐Ting , Miller Olson Emily K. , Lee Sung‐hoon , Sainani Kristin , Fredericson Michael
Published: December 2020

Background

The combined sensory index (CSI) is the most sensitive electrodiagnostic criteria for carpal tunnel syndrome (CTS), and the CSI and Bland criteria have been shown to predict surgical treatment outcomes. The proposed ultrasound measurements have not been assessed against the CSI for diagnostic accuracy and grading of CTS severity.

Objective

To investigate the use of ultrasound evaluations for both diagnosis and assessment of severity grading of CTS in comparison to electrodiagnostic assessment.

Design

All patients underwent an electrodiagnostic evaluation using the CSI and Bland severity grading. Each patient underwent an ultrasound evaluation including cross‐sectional area (CSA), the change in CSA from the forearm to the tunnel (∆CSA), and the wrist‐forearm ratio (WFR). These measurements were assessed for diagnostic and severity grading accuracy using the CSI as the gold standard.

Setting

Tertiary academic center.

Participants

All patients referred for electrodiagnostic evaluation for CTS were eligible for the study. Only those with idiopathic CTS were included and those with prior CTS treatment were also excluded. Ninety‐five patients were included in the study.

Interventions

Not applicable.

Main Outcome Measures

The primary study outcome measure was concordance between CSI diagnosis and severity categories and the ultrasound measurements. Both outcomes were also assessed using Bland criteria.

Results

Optimal cut‐points for diagnosis of CTS were found to be CSA ≥12 mm2, ∆CSA ≥4 mm2, WFR ≥1.4. Using these cut‐points, C‐statistics comparing diagnosis of CTS using ultrasound measurements versus using the CSI ranged from 0.893‐0.966. When looking at CSI severity grading compared to ∆CSA, however, the C‐statistics were 0.640‐0.661 with substantial overlap between severity groups.

Conclusions

Although ultrasound measurements had high diagnostic accuracy for CTS based on the CSI criteria, ultrasound measurements were unable to adequately distinguish between CSI severity groups among patients with CTS.
Sustainable school‐improvement in complex adaptive systems: A scoping review
Authors: Koh Gloria A. , Askell‐Williams Helen
Published: December 2020

School‐improvement initiatives are implemented with admirable goals, often requiring substantial human and material resources. However, many fail to be sustainable beyond short‐term funding cycles or the enthusiasm of local initiators. Typically, implementation and improvement are viewed linearly and as static end‐products that fail to consider that schools are complex adaptive systems (CAS) that are continuously and recursively challenged with change. To investigate sustainable school‐improvement within CAS, we used PRISMA‐SR guidelines to conduct a scoping review of peer‐reviewed journal articles extracted from six databases using keywords synonymous with ‘complex or adaptive system’, ‘sustain’, ‘school’ and ‘initiative’. The search process yielded 1146 articles but only 16 of those articles met our inclusion/exclusion criteria that specified that authors present an integrated view of sustainable implementation in schools conceptualised as CAS. Within the selected 16 articles, key components for sustainability in schools described as CAS included access to adequate funding and resources, engagement and involvement of stakeholders, the ability of stakeholders to adapt to change, formation of collaborative partnerships, and the development of supportive policies and procedures. Some important issues arose, such as the tendency of the ‘whole school approach’ to be reduced to information dissemination activities that do not adequately deal with components of complex systems, and the increasing recognition that older implementation models that seek ‘institutionalisation’ fail to appreciate that sustainability is a process, not an end goal. This scoping review highlights the need to recognise the complexity and adaptivity of school systems for successful and sustained implementation of school‐improvement initiatives.
Ecological thresholds and regime shifts within hydrologically modified rivers: A 75+ year retrospective analysis
Authors: Delong Michael D. , Thorp James H. , Anderson Jeffrey R.
Published: December 2020

Theoretical models have spurred empirical testing to understand how anthropogenic disturbances cause sudden shifts between alternative functional states. Most studies are done over short periods of time, making it difficult to determine the occurrence of ecological thresholds or regime shifts. This study used carbon stable isotope ratios (δ13C) from museum specimens of fish, mussels, and snails over a timeline of 75+ years to ascertain if trophic structure of two hydrologically modified rivers changed between premodification and postmodification periods. An alternative state model following Scheffer's shallow lake model was developed. As long‐lived species, mussels and snails are time integrators with long tissue turnover time and serve as a surrogate for the balance of benthic and pelagic basal food resource contributions to fish biomass. Hydrological datasets over the period of record for the Upper Mississippi (UMR) and lower Ohio (LOR) rivers were placed in 5‐year intervals, as were δ13C data for invertivorous and piscivorous fish. The model indicated changes in δ13C of fish relative to changes in mean stage height (UMR) and mean minimum stage height (LOR) over time. Evidence based on the model and empirical data of δ13C‐stage height relationship suggests a regime shift occurred during the postdam period in the LOR. Postdam, fish from the UMR revealed little change in δ13C of invertivores, whereas postdam decreases in variability of δ13C for piscivores shifted from a threshold to an unstable equilibrium. Decreases in hydrological variability led to a loss of resilience, with both rivers becoming metastable due to hydrological modification.
Thiazole‐Modified C3N4 Interfacial Layer for Defect Passivation and Charge Transport Promotion in Perovskite Solar Cells
Authors: Wang Lian , Fu Lin , Li Bo , Li Hui , Pan Lu , Chang Bohong , Yin Longwei
Published: December 2020

Despite the conspicuous achievements in perovskite solar cells (PSCs), further improvement of the power conversion efficiency (PCE) is hindered by substantially detrimental carrier recombination resulting from the high interfacial charge defect density and inferior charge transport kinetics. Herein, an interface engineering strategy is developed to introduce a Lewis base thiophene or thiazole–modified C3N4 layer at the electron transfer layer (ETL)/perovskite interface to constitute a stepwise energy band alignment and passivate defects at interfaces of the perovskite film. Attributed to its well‐matched energy level with TiO2 and perovskite, the charge extraction efficiency and charge transfer dynamics can be promoted remarkably, greatly inhibiting charge recombination at the interface. Furthermore, thiophene and thiazole can donate the lone pair electrons in S or N atoms to undercoordinated Pb2+, which effectively passivates the electronic trap states caused by halogen vacancies, thereby greatly minimizing trap‐assisted nonradiative recombination in the PSCs. Eventually, the thiazole–C3N4/perovskite‐based devices acquire an outstanding efficiency of 19.23%, supported by an enhanced open‐circuit voltage (VOC) of 1.11 V with improved moisture stability. This work provides an avenue for interfacial energy level modulation and defect passivation strategies for a rational interface microstructure design for meliorating the performance of PSCs.
Simultaneous determination of paracetamol and caffeine in aqueous samples by ultrasound‐assisted emulsification microextraction coupled with high‐performance liquid chromatography
Authors: Rahimi Marzieh , Khorshidi Neda , Heydari Rouhollah
Published: December 2020

Today, due to the growth of the pharmaceutical industry and the high consumption of drugs, monitoring of drug residues in environmental samples because of their destructive effects on the environment and humans is essential. In the present work, ultrasound‐assisted emulsification‐microextraction coupled with high‐performance liquid chromatography as a simple and fast method was applied for simultaneous determination of paracetamol and caffeine in the aqueous samples. Effective parameters on the extraction efficiencies of these analytes such as type and volume of extraction solvent, pH of sample solution, salt concentration, sonication, and centrifuging times were studied and optimized. Under the optimum conditions, the calibration graphs were linear in the range of 30.0–1100.0 ng/mL for paracetamol and 50.0–400.0 ng/mL for caffeine. The limits of detection were 9.7 and 15.2 ng/mL for paracetamol and caffeine, respectively. The proposed method was successfully applied for the determination of these drugs in different aqueous samples.
Retracing Economic Impact of Climate Change Disasters in Africa: Case Study of Drought Episodes and Adaptation in Kenya
Authors: Nthambi Mary , Ijioma Uche Dickson
Published: December 2020

Valuation studies have shown that drought occurrences have more severe economic impact compared to other natural disasters such as floods. In Kenya, drought has presented complex negative effects on farming communities. The main objective of this chapter is to analyze the economic impacts of drought and identify appropriate climate change adaptation measures in Kenya. To achieve this objective, an empirical approach, combined with secondary data mined from World Bank Climate Knowledge Portal and FAOSTAT databases, has been used in three main steps. First, historical links between population size and land degradation, temperature and rainfall changes with drought events were established. Second, economic impacts of drought on selected economic indicators such as quantities of staple food crop, average food value production, number of undernourished people, gross domestic product, agriculture value added growth, and renewable water resources per annum in Kenya were evaluated. Third, different climate change adaptation measures among farmers in Makueni county were identified using focused group discussions and in-depth interviews, for which the use of bottom-up approach was used to elicit responses. Findings from the binary logistic regression model show a statistical relationship between drought events and a selected set of economic indicators. More specifically, drought events have led to increased use of pesticides, reduced access to credit for agriculture and the annual growth of gross domestic product. One of the main recommendations of this chapter is to involve farmers in designing and implementing community-based climate change adaptation measures, with support from other relevant stakeholders.
Surprised by Values: An Introduction to Values-Based Practice and the Use of Personal Narratives in This Book
Authors: Fulford Bill
Published: December 2020

This chapter provides an introduction to the book. Section
2
explains some of the features of values that have shaped values-based practice. Section
3
outlines the key framework elements of values-based practice and describes how this book extends its scope from individual to cultural values. Section
4
, explains the organisation of the book around the framework elements of values-based practice. Section
5
justifies the prominent role given to personal narratives in the book: just as randomised controlled trials are among the best ways to learn about evidence, so, we argue, are personal narratives among the best ways to learn about values. A linking theme of the chapter is the many surprises presented by values in the context of contemporary person-centred clinical care.
African Personhood, Humanism, and Critical Sankofaism: The Case of Male Suicide in Ghana
Authors: Kong Camillia
Published: December 2020

Suicide in Ghana is criminalised and those who survive suicide attempts are subject to significant social condemnation. Paradoxically, studies show that male suicide is often driven by individuals’ strong sense of responsibility to meet social norms and expectations around gender as well as the internalisation of societal views that death would be preferable to shame and disgrace. This contradiction prompts a critical re-examination of the communitarian tradition of African personhood which posits an intimate link between the individual attainment of socially affirmed roles and the status of personhood. Through an analysis of the Akan concept of critical sankofaism I suggest that African approaches to suicide may draw upon important adaptive, critical resources internal to African cultural values, thus highlighting the progressive potential of the African tradition. I show specifically how male gender norms and societal responses to suicide attempts distort core humanistic values at the heart of African communitarian personhood.
Spiritual, Religious and Ethical Values in a Suicidal Individual
Authors: Lopes Ana Cristina , Correia Diogo Telles
Published: December 2020

Religious and spiritual experiences can appear in mental health practice as far as they often structure what aspects of psychopathological phenomena are present, sometimes making it difficult to determine whether some experiences should be classified as symptoms of a psychiatric disorder or crises within spiritual life.

We present a clinical vignette of a 62-year-old sacristan who was admitted to the Psychiatric Emergency Room for suicidal thoughts in the context of physical sequelae of a cardiac episode. He confessed that, in the process of coping with his illness, he had a distressing experience of guilt and of losing his religious faith and shared the intention to take his own life by hanging himself.

Themes that emerge in the discussion include issues related to the boundaries of psychiatric diagnosis, the spiritual dimension of mental health and the values that underlie clinical decision-making regarding a suicidal individual.

Incorporating religious and spiritual perspectives in the clinical assessment of patients is essential to understand individual’s framework of cultural values and social attitudes on disease.
Cultural Values, Religion and Psychosis: Five Short Stories
Authors: Wong Michael TH , Wilson Fiona , Davidson Dennisa , Hick Caitlin , Howie Andrew
Published: December 2020

The impact of cultural values and religion on the experience, expression and perception of psychosis and serious mental illness is examined through five case narratives that involve patients of diverse illness experience and personal, cultural, religious and spiritual backgrounds. A recurrent theme among these five case narratives is that in all these respects, there is a complex interplay of values between Anglo-European religion, Māori spirituality and secular psychiatry. Within this clinical context, the health and well-being of patients living with psychosis and serious mental illness are more than the control of symptoms and behaviour and instead involves a perspective of meaning and significance which impacts on how patients recover their identity, roles, capacity and relationships.
Linking Science with People: An Introduction to Part IV, Science
Authors: Fulford Bill
Published: December 2020

This chapter outlines how the contributions to this Part illustrate the role of a culturally enriched model of values-based practice in linking science with people. Chapters 25, “A Cross-Cultural Values-Based Approach to the Diagnosis and Treatment of Dissociative (Conversion) Disorders,” 26, “Treatment of Social Anxiety Disorder or Neuroenhancement of Socially Accepted Modesty? The Case of Ms. Suzuki,” 27, “Nontraditional Religion, Hyper-religiosity, and Psychopathology: The Story of Ivan from Bulgaria,” and 28, “Journey into Genes: Cultural Values and the (Near) Future of Genetic Counselling in Mental Health” explore the three principles of values-based practice defining its relationship with evidence-based practice. Chapters 29, “Policy-Making Indabas to Prevent “Not Listening”: An Added Recommendation from the Life Esidimeni Tragedy,” 30, “Covert Treatment in a Cross-Cultural Setting,” and 31, “Discouragement Towards Seeking Health Care of Older People in Rural China: The Influence of Culture and Structural Constraints” then give examples of the rich resources of the wider values tool kit for linking science with people (the African indaba, transcultural ethics, and anthropology). The concluding chapter, the autobiographical chapter 32, “Discovering Myself, a Journey of Rediscovery,” illustrates the role of cultural values (particularly of the positive StAR values) in recovery. A cross-cutting theme of the contributions to this Part is the importance of the cultural and other values impacting on psychiatric diagnostic assessment in supporting best practice in person-centered mental health care.
Non-traditional Religion, Hyper-Religiosity and Psychopathology: The Story of Ivan from Bulgaria
Authors: Mitrev I. , Mantarkov M. Y.
Published: December 2020

We present the story of a young Bulgarian man, who converted to Orthodox Judaism, a religious denomination highly unusual in his country of birth. He has adhered rigorously to religious rules; he has spent most of his time reading religious texts and watching religious videos on the internet. He has not socialized with anyone other than his parents outside his religion. He refuses to study and work, and his only wish is to go to Israel and study Judaism there living on donations. The diagnostic judgments of a number of psychiatrists and a clinical psychologist ranged from “an absence of mental disorder” to “Paranoid schizophrenia.” Diagnostic differences could be attributed to cultural factors and the influence of value judgments in diagnostic assessments.
Antonella: ‘A Stranger in the Family’—A Case Study of Eating Disorders Across Cultures
Authors: Di Nicola Vincenzo
Published: December 2020

The story of Antonella illustrates the way in which cultural and other values impact on the presentation and treatment of eating disorders. Displaced from her European home culture to live in Canada, Antonella presents with an eating disorder and a fluctuating tableau of anxiety and mood symptoms linked to her lack of a sense of identity. These arose against a background of her adoption as a foundling child in Italy and her attachment problems with her adoptive family generating chronically unfixed and unstable identities, resulting in her cross-cultural marriage as both flight and refuge followed by intense conflicts. Her predicament is resolved only when after an extended period in cultural family therapy she establishes a deep cross-species identification by becoming a breeder of husky dogs. The wider implications of Antonella’s story for understanding the relationship between cultural values and mental health are briefly considered.
Values-Based Practice When Engaging with Voice-Hearers
Authors: Austin Rosalind
Published: December 2020

This chapter explores the values issues arising in voice-hearing through the resources of a new skills-based approach to working with values called values-based practice. The chapter is focused on the experiences of two voice-hearers, Paul and Mary, so as to highlight the diversity of ways that people experience voice-hearing, and how a correspondingly nuanced way of supporting voice-hearers is needed. It employs an inclusive definition of values covering anything that matters or is important to the person concerned. The chapter demonstrates that values-based practice in voice-hearing supports shared decision-making when working with values challenges in health care. Both Paul’s and Mary’s stories offer illustrations of the complex and sometimes conflicting values associated with voice-hearing.