bluuebunny/crossref_metadata_2025 huggingface dataset:
Hospital surgical volume and perioperative mortality of pelvic exenteration for gynecologic malignancies
Authors: Matsuo Koji , Matsuzaki Shinya , Mandelbaum Rachel S. , Matsushima Kazuhide , Klar Maximilian , Grubbs Brendan H. , Roman Lynda D. , Wright Jason D.
Published: November 2019

Background and Objectives

To examine the association between hospital surgical volume and perioperative mortality of pelvic exenteration performed for gynecologic malignancies.

Methods

A population‐based retrospective study utilizing the Nationwide Inpatient Sample was conducted to examine pelvic exenteration for gynecologic malignancies from 2001 to 2011. Annualized hospital surgical volume was defined as the average number of procedures a hospital performed per year in which at least one case was performed, and this was correlated to perioperative mortality.

Results

A total 1912 exenterations performed at 181 centers were included. Nearly two thirds of exenteration‐performing centers had a minimum surgical volume of one case per year (121 centers, 66.9%). Perioperative mortality rate was 1.8%. In multivariable analysis surgical volume remained an independent factor for perioperative mortality (adjusted‐odds ratio 0.21; 95% confidence interval, 0.09‐0.49; P < .001). Perioperative mortality rates were 3.7% for the centers with minimum surgical volume (1 exenteration a year), 1.4% for the centers performing more than one but two or less exenterations a year, and 0% for the top decile centers (>2 exenterations a year), respectively (P < .001).

Conclusion

Pelvic exenteration for gynecologic malignancy is a rare surgical procedure with most hospitals performing few cases annually. A higher surgical volume of pelvic exenteration was associated with lower perioperative mortality.
Positional Awake Endoscopy Versus DISE in Assessment of OSA: A Comparative Study
Authors: Askar Sherif M. , Quriba Amal S. , Hassan Elham M. , Awad Ali M.
Published: November 2019

Objective

To compare awake endoscopy with Müller's maneuver (MM) during both sitting and supine positions, with drug‐induced sleep endoscopy (DISE) as regard determination of different levels, patterns, and degrees of collapse of the upper airway in adult patients with obstructive sleep apnea (OSA).

Methods

The study included adult patients with OSA symptoms, who had apnea hypopnea index (AHI) > 15. Patients were examined by MM in a sitting position, then during supine position; DISE then followed. Site, pattern, and degree of obstruction were assessed by experienced examiners according to the nose oropharynx hypopharynx and larynx classification.

Results

Eighty‐one adult subjects were included. The most common pattern of collapse at the retro‐palatal level was the concentric pattern, while the predominant pattern at the hypopharyngeal level was the lateral wall collapse. The analysis of the pattern of collapse of the study group revealed that the individual pattern did not change (for the same patient at the same level) in the majority of patients whatever the maneuver or the position.

Conclusion

This study demonstrates the feasibility of positional awake endoscopy for providing valuable surgical information as regard level, pattern, and degree of severity in OSA. The data of positional awake endoscopy were comparable to those gained from DISE with less morbidity and costs. The idea and results of this work provide a useful foundation for future research in this area. Multicenter studies are encouraged to obtain more reliable conclusions and more clear standards aiming at a better surgical planning.

Level of Evidence

4 Laryngoscope, 130:2269–2274, 2020
Efficacy of pentoxifylline–tocopherol–clodronate in mandibular osteoradionecrosis
Authors: Dissard Alexis , P. Dang Nathalie , Barthelemy Isabelle , Delbet Candice , Puechmaille Mathilde , Depeyre Arnaud , Pereira Bruno , Martin Fanny , Guillemin Florent , Biau Julian , Mirafzal Sonia , Mom Thierry , Gilain Laurent , Saroul Nicolas
Published: November 2019

Objectives/Hypothesis

PENTOCLO treatment, associating pentoxifylline, tocopherol, and clodronate, resolves radiation‐induced fibrosis. The main aim of the present study was to prospectively assess efficacy in mandibular osteoradionecrosis (ORN).

Study Design

Prospective cohort study.

Methods

Twenty‐seven patients with mandibular ORN were included in the Pentoclauvergne Study between January 2014 and February 2016. After an initial 28‐day phase of antibiotic, antifungal, and corticosteroid therapy, they received the PENTOCLO association daily until cure or a maximum of 24 months. The main assessment criterion was exposed bone area (EBA); secondary criteria comprised the Subjective, objective, management, and analytic (SOMA) score.

Results

Under PENTOCLO, EBA decreased by 28% at 2 months, 55% at 6 months, and 92% at 24 months; the SOMA score decreased by 23%, 38%, and 50%, respectively. A complete treatment course cured 76.5% of patients at a mean 9.6 months.

Conclusions

PENTOCLO is a simple, well‐tolerated, and effective treatment for mandibular ORN.

Level of Evidence

4 Laryngoscope, 130:E559–E566, 2020
Tonsillar surface swab bacterial culture results differ from those of the tonsillar core in recurrent tonsillitis
Authors: Dickinson Amy , Kankaanpää Hanna , Silén Suvi , Meri Seppo , Haapaniemi Aaro , Ylikoski Jukka , Mäkitie Antti
Published: November 2019

Objectives/Hypothesis

We aimed to determine whether there was a difference between core and surface bacteriology of Finnish adults with recurrent or chronic tonsillitis to understand whether a surface swab is worthwhile and which bacteria are involved.

Study Design

Case series.

Methods

Uninflamed tonsillar surface swabs and core biopsies were taken prior to and during surgery, respectively, in 103 patients aged 16 to 66 years undergoing tonsillectomy for recurrent or chronic tonsillitis. The McNemar test was used to determine differences between the surface and core in the most prevalent bacterial species.

Results

Twenty‐seven bacterial species were isolated in addition to normal flora and were more commonly found in the core (1.11 surface and 4.75 core bacteria isolated per patient). Viridans group streptococci were the most commonly detected bacteria, found in 88% of the patients, mainly in the core. The bacteria in general were mainly isolated from the core. Of the 10 most prevalent bacteria, only group C β‐hemolytic streptococci showed no difference between detection from core and surface swabs. Other bacteria found mainly in the core include Prevotella melaninogenica, Staphylococcus aureus, and fusobacteria.

Conclusions

There is discord between the surface and core bacteria. A different population of bacteria exists in the core, especially anaerobic bacteria, suggesting that a core sample may be useful in evaluating recurrent and chronic tonsillitis.

Level of Evidence

4 Laryngoscope, 2019
Self‐reported mini olfactory questionnaire (Self‐MOQ): A simple and useful measurement for the screening of olfactory dysfunction
Authors: Zou Lai‐quan , Linden Lena , Cuevas Mandy , Metasch Marie‐Luise , Welge‐Lüssen Antje , Hähner Antje , Hummel Thomas
Published: November 2019

Objectives

Olfactory dysfunction is a common problem. However, too little attention has been paid to questionnaires used to evaluate quantitative olfactory dysfunction. Therefore, the current study aimed to develop a simple self‐reported Mini Olfactory Questionnaire (Self‐MOQ) for the screening of quantitative olfactory dysfunction in clinical practice.

Methods

Two hundred and eighty‐five patients who had subjective complaints of olfactory disorder participated. The Sniffin’ Sticks test score was used to define functional anosmia, hyposmia, or normosmia. We assessed the factor structure as well as internal consistency, convergent validity, and discrimination performance.

Results

The results showed that the final version of the Self‐MOQ included only one factor with five items. The Self‐MOQ has a good internal reliability (Cronbach's α = 0.84) and validity (r = −0.60, P < 0.001). The receiver operating characteristic analyses indicated that the Self‐MOQ as compared to a visual analogue scale (VAS) is an effective measure for discriminating normosmic from hyposmic/anosmic patients, anosmic patients, and hyposmic patients.

Conclusion

The Self‐MOQ is a simple, reliable and valid questionnaire to screen olfactory dysfunction in clinical practice that appears to be superior to the use of VASs but does not replace olfactory testing.

Level of Evidence

4

Laryngoscope, 2019
Seasonal variability of calcium carbonate precipitation and dissolution in shallow coral reef sediments
Authors: Stoltenberg Laura , Schulz Kai G. , Cyronak Tyler , Eyre Bradley D.
Published: November 2019

Shallow, permeable calcium carbonate (CaCO3) sediments make up a large proportion of the benthic cover on coral reefs and account for a large fraction of the standing stock of CaCO3. There have been a number of laboratory, mesocosm, and in situ studies examining shallow sediment metabolism and dissolution, but none of these have considered seasonal variability. Advective benthic chambers were used to measure in situ net community calcification (NCC) rates of CaCO3 sediments on Heron Island, Australia (Great Barrier Reef) over an annual cycle. Sediments were, on average, net precipitating during the day and net dissolving at night throughout the year. Night dissolution rates (−NCCNIGHT) were highest in the austral autumn and lowest in the austral winter driven by changes in respiration (R) and to a lesser extent temperature and Ωarag/pH. Similarly, precipitation during the day (+NCCDAY) was highest in March and lowest in winter, driven primarily by benthic net primary production (NPP) and temperature. On average, sediments were net precipitating over a diel cycle (NCC24h) but shifted to net dissolving in July and December. This shift was largely caused by the differential effects of seasonal cycles in organic metabolism and carbonate chemistry on NCCDAY and NCCNIGHT. The results from this study highlight the large variability in sediment CaCO3 dynamics and the need to include repeated measurements over different months and seasons, particularly in shallow reef systems that can experience large swings in light, temperature, and carbonate chemistry.
2D Layered Materials: Synthesis, Nonlinear Optical Properties, and Device Applications
Authors: Guo Bo , Xiao Quan‐lan , Wang Shi‐hao , Zhang Han
Published: November 2019

In recent years, 2D layered materials, including graphene, topological insulators, transition metal dichalcogenides, black phosphorus, MXenes, graphitic carbon nitride, and metal‐organic frameworks, have attracted considerable interest due to their potential applications in the fields of physics, chemistry, biology, and energy. Their rise in the field of nonlinear photonics began around 2009 and has become an important research direction. Here, the synthesis techniques, nonlinear optical properties, integration strategies, and device applications of layered materials are reviewed. In terms of nonlinear optical properties, the focus is on saturable absorption and Kerr nonlinearity. On this basis, their applications in various pulsed lasers, including fiber lasers, solid‐state lasers, waveguide lasers, and related nonlinear optical phenomenon, are summarized. In addition, novel optical devices using layered materials, such as optical modulators, optical polarizers, optical switchers, and even all‐optical device, are also involved. It is believed that the development of 2D layered materials in the field of photonics will continue to deepen, thus laying a good foundation for its practical application.
Quinine Improves the Fungicidal Effects of Antimicrobial Blue Light: Implications for the Treatment of Cutaneous Candidiasis
Authors: Leanse Leon G. , Goh Xueping Sharon , Dai Tianhong
Published: November 2019

Background and Objective

Candida albicans is an opportunistic fungal pathogen of clinical importance and is the primary cause of fungal‐associated wound infections, sepsis, or pneumonia in immunocompromised individuals. With the rise in antimicrobial resistance, it is becoming increasingly difficult to successfully treat fungal infections using traditional antifungals, signifying that alternative non‐traditional approaches must be explored for their efficacy.

Study Design/Materials and Methods

We investigated the combination of antimicrobial blue light (aBL) and quinine hydrochloride (Q‐HCL) for improved inactivation of C. albicans, in vitro and in vivo, relative to either monotherapy. In addition, we evaluated the safety of this combination therapy in vivo using the TUNEL assay.

Results

The combination of aBL (108 J/cm2) with Q‐HCL (1 mg/mL) resulted in a significant improvement in the inactivation of C. albicans planktonic cells in vitro, where a 7.04 log10 colony forming units (CFU) reduction was achieved, compared with aBL alone that only inactivated 3.06 log10 CFU (P < 0.001) or Q‐HCL alone which did not result in a loss of viability. aBL + Q‐HCL was also effective at inactivating 48‐hour biofilms, with an inactivation 1.73 log10 CFU at the dose of 108 J/cm2 aBL and 1 mg/mL Q‐HCL, compared with only a 0.73 or 0.66 log10 CFU by aBL and Q‐HCL alone, respectively (P < 0.001). Transmission electron microscopy revealed that aBL + Q‐HCL induced morphological and ultrastructural changes consistent with cell wall and cytoplasmic damage. In addition, aBL + Q‐HCL was effective at eliminating C. albicans within mouse abrasion wounds, with a 2.47 log10 relative luminescence unit (RLU) reduction at the dose of 324 J/cm2 aBL and 0.4 mg/cm2 Q‐HCL, compared with a 1.44 log10 RLU reduction by aBL alone. Q‐HCL or nystatin alone did not significantly reduce the RLU. The TUNEL assay revealed some apoptotic cells before and 24 hours following treatment with aBL + Q‐HCL.

Conclusion

The combination of aBL + Q‐HCL was effective at eliminating C. albicans both in vitro and in vivo. A comprehensive assessment of toxicity (cytotoxicity and genotoxicity) is required to fully determine the safety of aBL + Q‐HCL therapy at different doses. In conclusion, the combination of aBL and Q‐HCL may be a viable option for the treatment of cutaneous candidiasis. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.
Modified TLR‐mediated downregulation of miR‐125b‐5p enhances CD248 (endosialin)‐induced metastasis and drug resistance in colorectal cancer cells
Authors: Park Ga‐Bin , Jeong Jee‐Yeong , Kim Daejin
Published: November 2019

CD248, also called endosialin or tumor endothelial marker‐1, is markedly upregulated in almost all cancers, including colon cancers. Changes in microRNA profiles are one of the direct causes of cancer development and progression. In this study, we investigated whether a change in CD248 expression in colon cancer cells could induce drug resistance after chemotherapy, and we explored the relationship between miR‐125b‐5p levels and CD248 expression in Toll‐like receptor (TLR)‐modified chemoresistant colon cancer cells. TLR2/6 and TLR5 upregulation in drug‐resistant colon cancer cells contributed to miR‐125b‐5p downregulation and specificity protein 1 (Sp1)‐mediated CD248 upregulation via nuclear factor‐kappa B (NF‐κB) activation. Exposure to specific TLR2/6 or TLR5 ligands enhanced the expression of mesenchymal markers as well as the migratory activity of oxaliplatin‐ or 5‐fluorouracil‐resistant colon cancer cells. The transfection of a synthetic miR‐125b‐5p mimic into chemoresistant cells prevented Sp1 and CD248 activation and significantly impaired invasive activity. Furthermore, Sp1 or CD248 gene silencing as well as miR‐125b‐5p overexpression markedly reversed drug resistance and inhibited epithelial‐mesenchymal transition in colon cancer cells. Taken together, these results suggest that changes in miR‐125b‐5p levels play an important role in Sp1‐mediated CD248 expression and the development of drug resistance in TLR‐mutated colon cancer cells.
High‐Tech Futures in “Silicon Holler”
Authors: Hayes Lauren
Published: November 2019

Technology training and job placement programs are becoming common forms of economic development in the United States, presenting hopeful futures for rural regions facing job loss. While these endeavors often draw on local identities to market new programs, they also involve multiple stakeholders who represent a diversity of experiences and work history. This essay discusses the way that individuals negotiate efforts to create a “Silicon Holler” tech industry in rural Appalachia.
Time Lag
Authors: Jusionyte Ieva
Published: November 2019

This article draws on ethnographic fieldwork with emergency responders in southern Arizona and northern Sonora that I conducted between 2015 and 2017 and my professional training and volunteer service as a paramedic. In retelling an episode when an aspiring wildland firefighter collapsed and died in a remote desert in the southwestern United States, I examine how rural space is experienced as time.
Manufacturing Home
Authors: Shapiro Nicholas
Published: November 2019

Making the colonist’s home mobile, disregarding local ecologies and building practices, is foundational to the settler‐colonial project. This article tracks the mobile home from its role as a key architecture of occupation and settlement by the British Empire to being a superlative embodiment of hydrocarbon‐infused commodities and homes after World War II. As the violences of mobile home ownership are coterminous with the violences of settler colonialism, an equitable vision of affordable housing cannot stop at achieving racial parity for toxic/classist loans (for often toxic homes) or greater protections for colonial land tenure.
Rural Alaska: The Struggle for Subsistence
Authors: DiNovelli‐Lang Danielle , Hébert Karen
Published: November 2019

“Rural” in Alaska does not mean the countryside. It is instead a bureaucratic category that both invokes and undercuts the Alaska Native territory that it has, as a result of political compromise, come to represent. As such, it has been a site of intense turmoil and negotiation since the 1970s. In this essay, we zoom in on a rural location marked by struggles to define and shape the character of the rural; in so doing, we explore the tensions embedded in this ambivalent concept.
Expanse
Authors: Simmons Kristen
Published: November 2019

The federal government owns more land in Nevada than any other state. While the acquisition of land as territory is central to the project of settler colonialism, this essay expands the frame by considering the atmospherics of rural America through an indigenous analytic. Reflecting on aboveground atomic testing, the growth of Air Force bases, and conservation imaginaries, the essay examines the work that goes into producing emptiness and what the dream of the expanse allows.
Robust concurrent topology optimization of multiscale structure under single or multiple uncertain load cases
Authors: Cai Jinhu , Wang Chunjie , Fu Zhifang
Published: November 2019

Concurrent topology optimization of macrostructure and material microstructure has attracted significant interest in recent years. However, most of the existing works assumed deterministic load conditions, thus the obtained design might have poor performance in practice when uncertainties exist. Therefore, it is necessary to take uncertainty into account in structural design. This article proposes an efficient method for robust concurrent topology optimization of multiscale structure under single or multiple load cases. The weighted sum of the mean and standard deviation of the structural compliance is minimized and constraints are imposed to both the volume fractions of macrostructure and microstructure. The effective properties of the microstructure are calculated via the homogenization method. An efficient sensitivity analysis method is proposed based on the superposition principle and orthogonal similarity transformation of real symmetric matrices. To further reduce the computational cost, an efficient decoupled sensitivity analysis method for microscale design variables is proposed. The bidirectional evolutionary structural optimization method is employed to obtain black and white designs for both macrostructure and microstructure. Several two‐dimensional and three‐dimensional numerical examples are presented to demonstrate the effectiveness of the proposed approach and the effects of load uncertainty on the optimal design of both macrostructure and microstructure.
Cost‐Effectiveness of Water Promotion Strategies in Schools for Preventing Childhood Obesity and Increasing Water Intake
Authors: Kenney Erica L. , Cradock Angie L. , Long Michael W. , Barrett Jessica L. , Giles Catherine M. , Ward Zachary J. , Gortmaker Steven L.
Published: November 2019

Objective

This study aimed to estimate the cost‐effectiveness and impact on childhood obesity of installation of chilled water dispensers (“water jets”) on school lunch lines and to compare water jets’ cost, reach, and impact on water consumption with three additional strategies.

Methods

The Childhood Obesity Intervention Cost Effectiveness Study(CHOICES) microsimulation model estimated the cost‐effectiveness of water jets on US childhood obesity cases prevented in 2025. Also estimated were the cost, number of children reached, and impact on water consumption of the installation of water jets and three other strategies.

Results

Installing water jets on school lunch lines was projected to reach 29.6 million children (95% uncertainty interval [UI]: 29.4 million‐29.8 million), cost $4.25 (95% UI: $2.74‐$5.69) per child, prevent 179,550 cases of childhood obesity in 2025 (95% UI: 101,970‐257,870), and save $0.31 in health care costs per dollar invested (95% UI: $0.15‐$0.55). In the secondary analysis, installing cup dispensers next to existing water fountains was the least costly but also had the lowest population reach.

Conclusions

Installating water jet dispensers on school lunch lines could also save almost half of the dollars needed for implementation via a reduction in obesity‐related health care costs. School‐based interventions to promote drinking water may be relatively inexpensive strategies for improving child health.
Thermal properties enhancement of poplar wood by substituting poly(furfuryl alcohol) for the matrix
Authors: Dong Youming , Ma Erni , Li Jianzhang , Zhang Shifeng , Hughes Mark
Published: November 2019

Using high‐performance polymers to replace the weak points in wood may be an efficient approach to overcoming certain drawbacks while improving the properties of wood. This study investigated the feasibility of easily replacing part of the wood matrix in poplar wood with renewable poly(furfuryl alcohol) (PFA). The wood was first treated with an alkali solution and was then immersed in a furfuryl alcohol (FA) solution followed by in situ polymerization. After delignification, a large part of hemicelluloses and lignin were removed. In addition, wood porosity increased and more PFA was polymerized in the wood cell walls, resulting in increased weight percent gain and efficient bulking. The thermogravimetric analysis results indicated that the reformation strongly affected the wood thermal stability. A transformation with 30% FA maintained the porous structure of the wood and resulted in the highest maximum degradation temperature. The dynamic mechanical analysis results also indicated that reformation allowed for greater stress transfer at the interface and resulted in a lower damping peak and a higher storage modulus. Our approach, therefore, could provide a promising method to enhance the performance of wood by reforming the wood components and structures.
Conducting polymers are not just conducting: a perspective for emerging technology
Authors: Stejskal Jaroslav
Published: November 2019

Conducting polymers, such as polyaniline and polypyrrole, are organic semiconductors with mixed electronic and ionic conductivity. In addition to electrical properties, their electrochemical activity opens research opportunities in corrosion protection or energy‐storage devices. Conducting polymers are active in catalysis, the photocatalytic decomposition of dyes or electrocatalysts in fuel cells being examples. In contrast to classical polymers, conducting polymers respond to various stimuli by changes in conductivity, colour or other physicochemical parameters; this is used in sensors. Conducting polymers are good adsorbents of organic pollutants in wastewater treatment and are likely to be applicable for environmental issues. The perspectives of these polymers are briefly outlined. © 2019 Society of Chemical Industry
Bifacial amorphous Si quintuple‐junction solar cells for IoT devices with high open‐circuit voltage of 3.5V under low illuminance
Authors: Konagai Makoto , Sasaki Ryo
Published: November 2019

Hydrogenated amorphous Si(a‐Si:H) quintuple‐junction solar cells, which consist of a‐SiOx:H/a‐SiOx:H/a‐Si:H/a‐SiOx:H/a‐SiOx:H, were fabricated by plasma CVD method. The total thickness was 0.6‐0.8 μm. Irradiation intensity (Pin) dependence of the open circuit voltage (Voc) of quintuple‐junction solar cells was measured. The decreasing amount ΔVoc (1/10) of the open‐circuit voltage when the irradiation intensity became 1/10 was 62mV/cell. Voc drops rapidly from around the irradiation intensity of 1mW/cm2 (approximately 1,000 lux). This large Voc reduction is due to leakage current. Then, we discussed the origin of the leakage current, and, finally, by improving the leakage current, a very high open‐circuit voltage Voc of 3.5 V was demonstrated under LED light illumination. Furthermore, we theoretically analyzed Voc as a function of the irradiation intensity, including effects of the leakage current and the film quality of i‐a‐Si(O):H. It was found from the simulation results that it is necessary to increase the shunt resistance Rsh and to lower the defect density of i‐a‐Si(O):H in order to obtain a sufficient Voc‐Pin characteristics for IoT devices application under low illuminance.
Lung function changes before and after pulmonary exacerbation antimicrobial treatment in cystic fibrosis
Authors: Wagener Jeffrey S. , VanDevanter Donald R. , Konstan Michael W. , Pasta David J. , Millar Stefanie J. , Morgan Wayne J.
Published: November 2019

Background

In cystic fibrosis, observation of a lung function drop (as percent predicted forced expiratory volume in 1 s [FEV1]; ppFEV1) frequently precedes pulmonary exacerbation (PEx) diagnosis. Recovery of ppFEV1 to a previous “baseline” is commonly used to assess antimicrobial treatment response. However, not all diagnosed PEx are associated with a ppFEV1 drop, and it is unclear whether these are a different type of PEx from those associated with a ppFEV1 drop.

Methods

We analyzed pre‐ and posttreatment ppFEV1 for PEx recorded in the Epidemiologic Study of Cystic Fibrosis from 2003 through 2005. Baseline, pretreatment, and follow‐up ppFEV1 were the best recorded within 12‐months pre‐PEx, the lowest recorded −30 to +3 days of treatment, and the best recorded during 6‐month follow‐up, respectively. Logistic regression models for return of ppFEV1 to baseline during follow‐up were developed separately for PEx with ≥10%, <10%, and no ppFEV1 drop before treatment.

Results

Of 15 147 PEx, 10 166 (67.1%), 3479 (23.0%), and 1502 (9.9%) presented with a ≥10%, <10%, or no ppFEV1 drop at diagnosis, respectively. 19.5%, 35.2%, and 65.6% of PEx, respectively, had follow‐up ppFEV1 equal to or exceeding baseline; overall 27.7% of all PEx treatments resulted in complete recovery of baseline ppFEV1. Significant predictors of ppFEV1 recovery at follow‐up were younger patient age, absence of Aspergillus, lower baseline ppFEV1, fewer visits during the baseline, lower frequency of prior‐year PEx, shorter elapsed time from baseline measure to treatment, smaller relative ppFEV1 drop before treatment, and non intravenous (ie, oral or inhaled antibiotic) treatment. PEx with ≥10%, <10%, and no ppFEV1 drop before treatment had only modest differences in covariate odds ratios associated with complete ppFEV1 recovery.

Conclusions

Among the 10% of PEx presenting with no apparent ppFEV1 drop, more than one‐third resulted in a decreased ppFEV1 during follow‐up. Risk factors for this outcome were the same as those associated with lack of ppFEV1 recovery among PEx with pretreatment ppFEV1 drops. These results suggest that inherent FEV1 variability, baseline and follow‐up sampling methodologies, ppFEV1 regression to the mean, and underlying lung disease progression complicate this approach for assessing effects of PEx and treatment response.
Vaping‐associated lung injury caused by inhalation of cannabis oil
Authors: Abeles Michael , Popofsky Stephanie , Wen Andy , Valsamis Christina , Webb Angela , Halaby Claudia , Pirzada Melodi
Published: November 2019

Vaping is a growing concern in adolescents, and a growing proportion is using electronic devices to inhale cannabis oil. The short‐term and long‐term effects of cannabis oil inhalation are not well understood. We report on a case of severe acute lung injury secondary to inhalation of cannabis oil via a vape pen, and propose a new term that describes lung injury related to vaping.
Upregulated Expression of Calcium‐Dependent Annexin A6: A Potential Biomarker of Ovarian Carcinoma
Authors: Noreen Shahzadi , Gardner Qurratulann Afza , Fatima Iram , Sadaf Saima , Akhtar Muhammad Waheed
Published: November 2019

Purpose

An early and accurate diagnosis of ovarian carcinoma (OC) may reduce morbidity and mortality of the patients. To improve the clinical outcome in OC patients, the present study is aimed at identifying robust biomarkers for early OC diagnosis.

Experimental Design

In order to look for early‐stage protein markers, a systematic protein profiling approach involving 2‐dimensional electrophoresis coupled with mass spectrometric analyses of human malignant and non‐malignant ovarian biopsy samples, is performed.

Results

Six 2D gel spots, corresponding to five proteins, display statistically significant differential expression in the tumor tissues compared to benign controls (FDR ≤ 0.05; PMF score ≥ 79). Ingenuity pathway analysis predicts two proteins, that is, Ca2+‐dependent membrane‐binding protein annexin A6 (AnxA6) and the metabolic enzyme l‐lactate dehydrogenase A chain, as potential predictive biomarkers. Increased expression of AnxA6 is further ascertained by Western blot and enzyme linked immunosorbent assay in the resected tissues and the plasma samples. The expression is found markedly increasing particularly in the advanced stage tumors.

Conclusions and Clinical Relevance

The significant upregulation of AnxA6 in OC, reported for the first time, is likely to provide insight into the mechanism of OC progression, which may lead to the design of potential diagnostic and therapeutic strategies.
Integrative modeling of protein‐protein interactions with pyDock for the new docking challenges
Authors: Rosell Mireia , Rodríguez‐Lumbreras Luis A. , Romero‐Durana Miguel , Jiménez‐García Brian , Díaz Lucía , Fernández‐Recio Juan
Published: November 2019

The seventh CAPRI edition imposed new challenges to the modeling of protein‐protein complexes, such as multimeric oligomerization, protein‐peptide, and protein‐oligosaccharide interactions. Many of the proposed targets needed the efficient integration of rigid‐body docking, template‐based modeling, flexible optimization, multiparametric scoring, and experimental restraints. This was especially relevant for the multimolecular assemblies proposed in the CASP12‐CAPRI37 and CASP13‐CAPRI46 joint rounds, which were described and evaluated elsewhere. Focusing on the purely CAPRI targets of this edition (rounds 38‐45), we have participated in all 17 assessed targets (considering heteromeric and homomeric interfaces in T125 as two separate targets) both as predictors and as scorers, by using integrative modeling based on our docking and scoring approaches: pyDock, IRaPPA, and LightDock. In the protein‐protein and protein‐peptide targets, we have also participated with our webserver (pyDockWeb). On these 17 CAPRI targets, we submitted acceptable models (or better) within our top 10 models for 10 targets as predictors, 13 targets as scorers, and 4 targets as servers. In summary, our participation in this CAPRI edition confirmed the capabilities of pyDock for the scoring of docking models, increasingly used within the context of integrative modeling of protein interactions and multimeric assemblies.
Identification of repurposable drugs with beneficial effects on glucose control in type 2 diabetes using machine learning
Authors: Koren Gideon , Nordon Galia , Radinsky Kira , Shalev Varda
Published: November 2019

Despite effective medications, rates of uncontrolled glucose levels in type 2 diabetes remain high. We aimed to test the utility of machine learning applied to big data in identifying the potential role of concomitant drugs not taken for diabetes which may contribute to lowering blood glucose. Success in controlling blood glucose was defined as achieving HgA1c levels < 6.5% after 90‐365 days following diagnosis and initiating treatment. Among numerous concomitant drugs taken by type 2 diabetic patients, alpha 1 (α1)‐adrenoceptor antagonist drugs were the only group of medications that significantly improved the success rate of glucose control. Searching the published literature, this effect of α1‐adrenoceptor antagonists has been shown in animal models, where this class of medications appears to induce insulin secretion. In conclusion, machine learning of big data is a novel method to identify effective antidiabetic effects for potential repurposable medications already on the market for other indications. Because these α1‐adrenoceptor antagonists are widely used in men for treating benign prostate hyperplasia (BPH) at age groups exhibiting increased rates of type 2 diabetes, this finding is of potential clinical significance.
Identification and stabilization of a highly selective gastrin‐releasing peptide receptor agonist
Authors: Hoppenz Paul , Els‐Heindl Sylvia , Beck‐Sickinger Annette G.
Published: November 2019

The gastrin‐releasing peptide receptor (GRPR) is part of the bombesin receptor family and a well‐known target in cancer diagnosis and therapy. In the last decade, promising results have been achieved by using peptide‐drug conjugates, which allow selective targeting of GRPR expressing tumor cells. Most ligands, however, have been antagonists even though agonists can lead to higher tumor uptake owing to their internalization. So far, only a few studies focused on the identification of small GRPR‐selective agonists that are metabolically stable. Here, we developed novel bombesin analogs with high selectivity for the GRPR and improved blood plasma stability. The most promising analog [d‐Phe6, β‐Ala11, NMe‐Ala13, Nle14]Bn(6‐14) displays an activity of 0.3nM at the GRPR, a more than 4000‐fold selectivity over the other two bombesin receptors and more than 75% stability in human blood plasma after 24 hours. This analog is proposed as a promising drug shuttle for the intracellular delivery of different payloads in targeted tumor therapy approaches.
Direct Current and Radio Frequency Characterizations of AlGaN/AlN/GaN/AlN Double‐Heterostructure High‐Electron Mobility Transistor (DH‐HEMT) on Sapphire
Authors: Choi Uiho , Kim Hyun-Seop , Lee Kyeongjae , Jung Donghyeop , Kwak Taemyung , Jang Taehoon , Nam Yongjun , So Byeongchan , Kang Myoung-Jin , Seo Kwang-Seok , Han Min , Choi Seokgyu , Lee Sangmin , Cha Ho-Young , Nam Okhyun
Published: November 2019

The AlGaN/AlN/GaN/AlN double‐heterostructure high‐electron mobility transistor (DH‐HEMT) on sapphire substrate is introduced, and its direct current (DC) and radio frequency (RF) characteristics to the conventional GaN‐based single‐heterostructure HEMT (SH‐HEMT) on SiC substrate are compared. The devices having the two‐finger gate are fabricated with gate width of 200 μm and gate length of 500 nm. The DC performance of the DH‐HEMT shows a transconductance of 0.233 S mm−1 and a maximum drain current density of 0.93 A mm−1, comparable with that of the SH‐HEMT. There is less‐pronounced kink‐effect in the DC I–V characteristics, whereas the off‐state subthreshold current is approximately four orders of magnitude higher than that of SH‐HEMT. A pulsed I–V shows a greatly suppressed slump ratio Z1 and Z2 of 1.6% and 4.3% for the DH‐HEMT. It is shown that the performances of a small‐ and a large‐signal characteristics of the DH‐HEMT are equivalent to the GaN SH‐HEMT: the current gain cutoff frequency (fT) and the maximum oscillation frequency (fmax) are 20.1 and 47.6 GHz, and the output power density and the power added efficiency (PAE) at the peak PAE, at 20 V drain voltage and 3.5 GHz frequency, are 3.83 W mm−1 and 57.2%, respectively.
Hierarchical Composite of Rose‐Like VS2@S/N‐Doped Carbon with Expanded (001) Planes for Superior Li‐Ion Storage
Authors: Yang Wenjuan , Luo Ningjing , Zheng Cheng , Huang Shuping , Wei Mingdeng
Published: November 2019

In the present work, a hierarchical composite of rose‐like VS2@S/N‐doped carbon (VS2@SNC) with expanded (001) planes is successfully fabricated through a facile synthetic route. Notably, the d‐spacing of (001) planes is expanded to 0.92 nm, which is proved to dramatically reduce the energy barrier for Li+ diffusion in the composite of VS2@SNC by density functional theory calculation. On the other hand, the S/N‐doped carbon in the composite greatly promotes the electrical conductivity and enhances the structural stability. In addition, the hierarchical structure of VS2@SNC facilitates rapid electrolyte diffusion and increases the contact area between the electrode and electrolyte simultaneously. Benefiting from the merits mentioned above, the VS2@SNC electrode exhibits excellent electrochemical properties, such as a large reversible capacity of 971.6 mA h g−1 at 0.2 A g−1, an extremely high rate capability of 772.1 mA h g−1 at 10 A g−1, and a remarkable cycling stability up to 600 cycles at 8 A g−1 with a capacity of 684.5 mA h g−1, making it a promising candidate as an anode material for lithium‐ion batteries.
Designing sustainably agile and resilient organizations
Authors: Holbeche Linda
Published: November 2019

This article proposes that so powerful are the various forces for change in the business environment, in particular technological advances, that organizations must develop their adaptive capability—or agility—if they are to survive and thrive. An agile organization is one that can intelligently and proactively seize opportunities and react to threats and make timely, effective, sustainable changes that generate competitive advantage and give them some leverage in the marketplace or in their ecosystem. Yet scaling up for agility remains difficult, not least because the quest for agility calls into question organizational paradigms of various kinds—strategy, change management, the nature of leadership, and organizational design. The author provides a practitioner perspective on both the difficulties and the possibilities of developing organizational agility and proposes an adaptive approach to organization design and development that may offer a way forward for organizations wishing to become more agile.
A “system dynamics perspective” of bioenergy governance and local, sustainable development
Authors: Cavicchi Bianca
Published: November 2019

This study investigates the governance of bioenergy systems (BESs) and how it influences the bioenergy policy process and local sustainable development. The study compares the BES in Emilia Romagna and Hedmark. At first, bioenergy was expected to mitigate climate change and to tackle the crisis of the primary sectors and related industries. However, bioenergy policies were not equipped to address cross‐sectoral and multilevel issues. Therefore, they failed to secure the local, sustainable development. Critical weaknesses lie in BES governance. Actors' discourses, rules, and power issues form a complex structure that influences the bioenergy policy process and its outcomes. The study relies on systems thinking and system dynamics, and the pathways approach. It uses the system archetypes to investigate the bioenergy policy feedback dynamics and how to leverage local, sustainable development. Results show that power relations and social opposition are critical to a policy change that best secures local, sustainable development.
Properties of Tool Steels for Application in Hot Stamping
Authors: Niederhofer Philipp , Eger Kathrin , Schwingenschlögl Patrik , Merklein Marion
Published: November 2019

Hot stamped high‐strength steel components for car bodies become increasingly important due to the need to save weight for multiple reasons such as fuel conservation regulations. Tribological systems in tools for hot stamping depend on process parameters and may include, e.g., mechanical and thermal loads as well as adhesive and abrasive wear. Furthermore, the process cycle time should be as short as possible due to economic reasons. Commonly used hot work tool steels mainly suffer from rather low wear resistance, whereas in terms of process cycle time, a high thermal conductivity is desired. Thus, solutions showing optimized combination of key properties for application in hot stamping such as wear resistance, high thermal conductivity, toughness, and hardening behavior need to be found. In this contribution, novel high thermal conductivity hot work tool steels, especially designed for application in hot stamping, are presented and some key properties are compared, e.g., to those of conventional hot work tool steels like 1.2367, which is commonly used in this application. Furthermore, tribological investigations are performed in laboratory tests according to ASTM G65 and G75 as well as a flat strip‐drawing test setup using sheets of 22MnB5 under hot stamping conditions.
Achieving the Control of Nonmetallic Inclusions Morphology and Orientation by Electric Current
Authors: Yan Longge , Zhang Xinfang
Published: November 2019

The evolution of inclusions in electric field is investigated using numerical calculations. Due to electric current bypassing the inclusions, the electric current streamlines are not uniformly distributed but concentrated and distorted around inclusions. This abnormal electric current distribution causes an interaction force of adjacent inclusions, which is determined by the distance and orientation of the inclusions. The interaction force has three effects on the inclusions, i.e., attraction, repulsion, and rotation. The influence of three effects on the morphology, orientation, and distribution of inclusions is discussed. As a result, the inclusions evolve into a chain‐like structure aligned with the current direction, and inclusions separate from each other causing dispersion in the perpendicular direction. The evolution of the inclusions obeys the rule that the improvement of material conductivity reduces the electric free energy. The numerical calculation results are consistent with the experimental phenomena.
Thermomechanical Wear Testing of Metal Matrix Composite Cladding for Potential Application in Hot Rolling Mills
Authors: Domitner Josef , Aigner Michael , Stern Thomas , Paar Armin , Sommitsch Christof , Elizondo Leonel
Published: November 2019

Laser metal deposition (LMD) is utilized to clad the surface of a miniaturized test roll (Ø 40 mm) of tool steel. The cladding consists of two layers: a nickel alloy as intermediate layer deposited onto the surface of the steel substrate, and a metal matrix composite (MMC) as top layer consisting of spherical tungsten carbide particles embedded into the nickel alloy matrix. The thermomechanical wear behavior of the cladding is investigated on a test rig, where the test roll is pressed against an inductively heated load roll. Multiple test runs up to several hours simulating industrial loading conditions are performed. The presented testing procedure enables predicting the time‐dependent abrasive wear behavior of the cladding, in particular for hot rolling mill applications. After testing for 8 h at temperature of 650 °C and at contact pressure of approximately 1 GPa, the maximum depth of the wear mark is about 0.12 mm. Partial cracking, debonding and dissolution of the tungsten carbide particles, as well as formation of iron and chromium oxides at the surface of the wear marks occur. However, as low abrasive wear is observed, the investigated MMC may potentially be applicable for cladding rolls in steel hot rolling mills.
Chemical activation of the Piezo1 channel drives mesenchymal stem cell migration via inducing ATP release and activation of P2 receptor purinergic signaling
Authors: Mousawi Fatema , Peng Hongsen , Li Jing , Ponnambalam Sreenivasan , Roger Sébastien , Zhao Hucheng , Yang Xuebin , Jiang Lin-Hua
Published: November 2019

In this study, we examined the Ca2+-permeable Piezo1 channel, a newly identified mechanosensing ion channel, in human dental pulp-derived mesenchymal stem cells (MSCs) and hypothesized that activation of the Piezo1 channel regulates MSC migration via inducing ATP release and activation of the P2 receptor purinergic signaling. The Piezo1 mRNA and protein were readily detected in hDP-MSCs from multiple donors and, consistently, brief exposure to Yoda1, the Piezo1 channel-specific activator, elevated intracellular Ca2+ concentration. Yoda1-induced Ca2+ response was inhibited by ruthenium red or GsMTx4, two Piezo1 channel inhibitors, and also by Piezo1-specific siRNA. Brief exposure to Yoda1 also induced ATP release. Persistent exposure to Yoda1 stimulated MSC migration, which was suppressed by Piezo1-specific siRNA, and also prevented by apyrase, an ATP scavenger, or PPADS, a P2 generic antagonist. Furthermore, stimulation of MSC migration induced by Yoda1 as well as ATP was suppressed by PF431396, a PYK2 kinase inhibitor, or U0126, an inhibitor of the mitogen-activated protein kinase MEK/ERK signaling pathway. Collectively, these results suggest that activation of the Piezo1 channel stimulates MSC migration via inducing ATP release and subsequent activation of the P2 receptor purinergic signaling and downstream PYK2 and MEK/ERK signaling pathways, thus revealing novel insights into the molecular and signaling mechanisms regulating MSC migration. Such findings provide useful information for evolving a full understanding of MSC migration and homing and developing strategies to improve MSC-based translational applications.
Comparison of the effects of heat and gamma irradiation on the degradation of cross‐linked polyethylene
Authors: Liu Ziyang , Miyazaki Yu , Hirai Naoshi , Ohki Yoshimichi
Published: November 2019

For conducting comparative research, samples of cross‐linked polyethylene (XLPE), made exactly in the same manner as those used in nuclear power plants, were aged in two ways: purely thermally, and concurrently with heat and γ‐irradiation, for long periods up to 2000 h. They were then examined by an indenter, mid‐infrared absorption spectroscopy, broadband dielectric spectroscopy, and measuring the electrical conductivity. As a result, it became clear that the effect of radiation is more dominant than that of heat on the oxidation or carbonyl formation in XLPE. However, heat is a more determining factor on the surface hardness of XLPE. In addition, the complex permittivity of XLPE increases as a result of the appearance of abundant carbonyl groups. Both the carbonyl index and indenter modulus can be indicators of aging. © 2019 Institute of Electrical Engineers of Japan. Published by John Wiley & Sons, Inc.