bluuebunny/crossref_metadata_2025 huggingface dataset:
Hormone‐mediated foraging strategies in an uncertain environment: Insights into the at‐sea behavior of a marine predator
Authors: DeRango Eugene J. , Schwarz Jonas F. L. , Piedrahita Paolo , Páez‐Rosas Diego , Crocker Daniel E. , Krüger Oliver
Published: May 2021

Hormones are extensively known to be physiological mediators of energy mobilization and allow animals to adjust behavioral performance in response to their environment, especially within a foraging context.

Few studies, however, have narrowed focus toward the consistency of hormonal patterns and their impact on individual foraging behavior. Describing these relationships can further our understanding of how individuals cope with heterogeneous environments and exploit different ecological niches.

To address this, we measured between‐ and within‐individual variation of basal cortisol (CORT), thyroid hormone T3, and testosterone (TEST) levels in wild adult female Galápagos sea lions (Zalophus wollebaeki) and analyzed how these hormones may be associated with foraging strategies. In this marine predator, females exhibit one of three spatially and temporally distinct foraging patterns (i.e., “benthic,” “pelagic,” and “night” divers) within diverse habitat types.

Night divers differentiated from other strategies by having lower T3 levels. Considering metabolic costs, night divers may represent an energetically conservative strategy with shorter dive durations, depths, and descent rates to exploit prey which migrate up the water column based on vertical diel patterns.

Intriguingly, CORT and TEST levels were highest in benthic divers, a strategy characterized by congregating around limited, shallow seafloors to specialize on confined yet reliable prey. This pattern may reflect hormone‐mediated behavioral responses to specific risks in these habitats, such as high competition with conspecifics, prey predictability, or greater risks of predation.

Overall, our study highlights the collective effects of hormonal and ecological variation on marine foraging. In doing so, we provide insights into how mechanistic constraints and environmental pressures may facilitate individual specialization in adaptive behavior in wild populations.
Top predators govern multitrophic diversity effects in tritrophic food webs
Authors: Ceulemans Ruben , Guill Christian , Gaedke Ursula
Published: May 2021

It is well known that functional diversity strongly affects ecosystem functioning. However, even in rather simple model communities consisting of only two or, at best, three trophic levels, the relationship between multitrophic functional diversity and ecosystem functioning appears difficult to generalize, because of its high contextuality. In this study, we considered several differently structured tritrophic food webs, in which the amount of functional diversity was varied independently on each trophic level. To achieve generalizable results, largely independent of parametrization, we examined the outcomes of 128,000 parameter combinations sampled from ecologically plausible intervals, with each tested for 200 randomly sampled initial conditions. Analysis of our data was done by training a random forest model. This method enables the identification of complex patterns in the data through partial dependence graphs, and the comparison of the relative influence of model parameters, including the degree of diversity, on food‐web properties. We found that bottom‐up and top‐down effects cascade simultaneously throughout the food web, intimately linking the effects of functional diversity of any trophic level to the amount of diversity of other trophic levels, which may explain the difficulty in unifying results from previous studies. Strikingly, only with high diversity throughout the whole food web, different interactions synergize to ensure efficient exploitation of the available nutrients and efficient biomass transfer to higher trophic levels, ultimately leading to a high biomass and production on the top level. The temporal variation of biomass showed a more complex pattern with increasing multitrophic diversity: while the system initially became less variable, eventually the temporal variation rose again because of the increasingly complex dynamical patterns. Importantly, top predator diversity and food‐web parameters affecting the top trophic level were of highest importance to determine the biomass and temporal variability of any trophic level. Overall, our study reveals that the mechanisms by which diversity influences ecosystem functioning are affected by every part of the food web, hampering the extrapolation of insights from simple monotrophic or bitrophic systems to complex natural food webs.
Parathormone levels add prognostic ability to N‐terminal pro‐brain natriuretic peptide in stable coronary patients
Authors: Gutiérrez‐Landaluce Carlos , Aceña Álvaro , Pello Ana , Martínez‐Milla Juan , González‐Lorenzo Óscar , Tarín Nieves , Cristóbal Carmen , Blanco‐Colio Luis M. , Martín‐Ventura José Luis , Huelmos Ana , López‐Castillo Marta , Alonso Joaquín , López Bescós Lorenzo , Alonso‐Pulpón Luis , González‐Parra Emilio , Egido Jesús , Mahíllo‐Fernández Ignacio , Lorenzo Óscar , González‐Casaus María Luisa , Tuñón José
Published: May 2021

Aims

There are controversial data on the ability of the components of mineral metabolism (vitamin D, phosphate, parathormone [PTH], fibroblast growth factor‐23 [FGF23], and klotho) to predict cardiovascular events. In addition, it is unknown whether they add any prognostic value to other well‐known biomarkers.

Methods and results

In 969 stable coronary patients, we determined plasma levels of all the aforementioned components of mineral metabolism with a complete set of clinical and biochemical variables, including N‐terminal pro‐brain natriuretic peptide (NT‐proBNP), high‐sensitivity troponin I (hs‐TnI), and high‐sensitivity C‐reactive protein. Secondary outcomes were ischaemic events (any acute coronary syndrome, stroke, or transient ischaemic attack) and heart failure or death. The primary outcome was a composite of the secondary outcomes. Median follow‐up was 5.39 years. Age was 60 (52–72) years. Median glomerular filtration rate was 80.4 (65.3–93.1) mL/min/1.73 m2. One‐hundred and eighty‐five patients developed the primary outcome. FGF23, PTH, hs‐TnI, and NT‐proBNP were directly related with the primary outcome on univariate Cox analysis, while Klotho and calcidiol were inversely related. On multivariate analysis, only PTH (HR 1.058 [CI 1.021–1.097]; P = 0.002) and NT‐proBNP (HR 1.020 [CI 1.012–1.028]; P < 0.001) were independent predictors of the primary outcome but also for the secondary outcome of heart failure or death (HR 1.066 [CI 1.016–1.119]; P = 0.009 and HR 1.024 [CI 1.014–1.034]; P < 0.001, respectively). PTH was the only biomarker that predicted ischaemic events (HR 1.052 [1.010–1.096]; P = 0.016). Patients were divided in two subgroups according to FGF23 plasma levels. PTH retained its prognostic value only in patients with FGF23 levels above the median (>85.5 RU/mL) (P < 0.001) but not in patients with low FGF23 levels (P = 0.551). There was a significant interaction between FGF23 and PTH (P = 0.002). However, there was no significant interaction between PTH and both klotho and calcidiol levels.

Conclusions

Parathormone is an independent predictor of cardiovascular events in coronary patients, adding complimentary prognostic information to NT‐proBNP plasma levels. This predictive value is restricted to patients with high FGF23 plasma levels. This should be considered in the design of future studies in this field.
Wearable cardioverter‐defibrillator: friend or foe in suspected myocarditis?
Authors: Blaschke Florian , Lacour Philipp , Dang Phi Long , Parwani Abdul Shokor , Hohendanner Felix , Walter Thula , Klingel Karin , Kühl Uwe , Heinzel Frank R. , Sherif Mohammad , Boldt Leif‐Hendrik , Pieske Burkert , Tschöpe Carsten
Published: May 2021

Aim

Wearable cardioverter defibrillator (WCD, LifeVest, and Zoll) therapy has become a useful tool to bridge a temporarily increased risk for sudden cardiac death. However, despite extensive use, there is a lack of evidence whether patients with myocarditis and impaired LVEF may benefit from treatment with a WCD.

Methods and results

We conducted a single‐centre retrospective observational study analysing patients with a WCD prescribed between September 2015 and April 2020 at our institution. In total, 135 patients were provided with a WCD, amongst these 76 patients (mean age 48.9 ± 13.7 years; 84.2% male) for clinically suspected myocarditis. Based on the results of the endomyocardial biopsy and, where available cardiac magnetic resonance imaging, 39 patients (51.3%) were diagnosed with myocarditis and impaired LVEF and 37 patients (48.7%) with dilated cardiomyopathy (DCM) without evidence of cardiac inflammation. The main immunohistopathological myocarditis subtype was lymphocytic myocarditis in 36 (92.3%) patients, and four patients (10.3%) of this group had an acute myocarditis. Three patients had cardiac sarcoidosis (7.7%). Ventricular tachycardia occurred in seven myocarditis (in total 41 VTs; 85.4% non‐sustained) and one DCM patients (in total one non‐sustained ventricular tachycardia). Calculated necessary WCD wearing time until ventricular tachycardia occurrence is 86.41 days in myocarditis compared with 6.46 years in DCM patients.

Conclusions

Our data suggest that myocarditis patients may benefit from WCD therapy. However, as our study is not powered for outcome, further randomized studies powered for the outcome morbidity and mortality are necessary.
Frequency, predictors, and prognosis of heart failure with improved left ventricular ejection fraction: a single‐centre retrospective observational cohort study
Authors: Li Qing , Qiao Yu , Tang Jiong , Guo Yulong , Liu Ke , Yang Bangguo , Zhou Yingqiu , Yang Kai , Shen Shuqin , Guo Tao , Guo Jinrui
Published: May 2021

Aims

An improved left ventricular ejection fraction (HFiEF) was observed across heart failure (HF) patients with a reduced or mid‐range ejection fraction (HFrEF or HFmrEF, respectively). We postulated that HFiEF patients are clinically distinct from non‐HFiEF patients.

Methods and results

A total of 447 patients hospitalized due to a clinical diagnosis of HF (LVEF <50% at baseline) were enrolled from September 2017 to September 2019. Echocardiogram re‐evaluation was conducted repeatedly over 6 months of follow‐up after discharge. The primary endpoint included the composite of HF hospitalization and all‐cause mortality. Subjects (n = 184) with HFiEF (defined as an absolute LVEF improvement≥10%) were compared with 263 non‐HFiEF (defined by <10% improvement in LVEF) subjects. Multivariable Cox regression was performed and identified younger age, smaller left ventricular end diastolic dimension (LVEDD), beta‐blocker use, AF ablation and cardiac resynchronization therapy (CRT) as independent predictors of HFiEF. According to Kaplan–Meier analysis, HFiEF subjects had lower cardiac composite outcomes (P = 0.002) and all‐cause mortality (P = 0.003) than non‐HFiEF subjects. Multivariate Cox survival analysis revealed that non‐HFiEF (compared with HFiEF) was an independent predictor of both the primary endpoints (HR = 0.679, 95% CI: 0.451–0.907, P = 0.012), which was driven by all‐cause mortality (HR = 0.504, 95% CI: 0.256–0.991, P = 0.047).

Conclusions

These data confirm that compared with non‐HFiEF, HFiEF is a distinct HF phenotype with favourable clinical outcomes.
Inhalation of publicly available indoor insecticide spray caused myocardial infarction type II: a case report
Authors: Habedank Dirk , Stubbe Beate , Ewert Ralf , Kroll Alexandra , Atmowihardjo Iskandar , Habedank Birgit
Published: May 2021

We report on a 70‐year‐old woman who tried to eliminate ants from her kitchen by applying a publicly available insecticide spray. Immediately afterwards, she felt dyspnoea, superseded by heavy chest pain. High‐sensitivity troponin concentration increased from 33 to 149 ng/L (cut‐off 50 ng/L). Significant coronary stenosis was excluded by coronary angiography, and the myocardial damage was classified as myocardial infarction type II. After exclusion of other potential mechanisms, we consider a cardiotoxic effect of the insecticide mixture of cypermethrin, tetramethrin, and piperonyl butoxide possible. We conclude that consumer information has to be improved. This concerns sustainable control measures adapted to the target insect species (in this case, the black garden ant Lasius niger), and differentiation between authorized and non‐authorized but notified products. The instructions for use should give clear information on vulnerable groups and recommend personal protective equipment. Physicians and authorities should be alert to cardiac side‐effects of insecticides.
Experimental Studies on Gas Hydrate‐Based CO2 Storage: State‐of‐the‐Art and Future Research Directions
Authors: Wang Pengfei , Teng Ying , Zhao Yusheng , Zhu Jinlong
Published: May 2021

Hydrate‐based CO2 storage is considered a potentially effective way of reducing greenhouse gas emissions and slowing down global warming. Herein, the locations in the ocean and permafrost that meet the requirements for hydrate‐based CO2 storage are summarized. Furthermore, research progress and shortcomings of hydrate‐based CO2 storage are analyzed. The two main methods for hydrate‐based CO2 storage are direct CO2 hydrate storage and CO2–CH4 hydrate replacement. Direct CO2 hydrate storage on the seabed and in the subsea (or permafrost) is proposed, and CO2 formation experiments on different scales are conducted. Various porous media are used to simulate the natural sediment and investigate the hydrate formation equilibrium and kinetics. CO2–CH4 replacement is preferred because it combines the benefits of CO2 storage and CH4 production. The hydrate equilibrium of different CO2–CH4 mixture hydrates is measured using different methods. Nuclear magnetic resonance and Raman spectroscopy are commonly used to study the hydrate structure characteristics and mass transfer properties. Macrokinetics are usually conducted in a high‐pressure vessel to analyze the effects of the experimental conditions on the replacement results. Nevertheless, the replacement rate and hydrate properties should be investigated further.
Multisource evidence theory‐based fraud risk assessment of China's listed companies
Authors: Qiu Shi , Luo Yuansheng , Guo Hongwei
Published: May 2021

Financial fraud has great negative impact on capital markets. It misleads investors and the government and will hurt the development of the capital market in China. To detect corporate fraud, an artificial intelligence‐based method is proposed to evaluate the fraud risk. A new model for assessing the fraud risk of listed companies in China is put forward. The proposed approach collects multisource evidence from inside and outside listed companies. The internal evidence for fraud risk assessment is gathered by a machine‐learning method. The external evidence for fraud risk assessment is obtained by a web crawler. An evidence theory‐based is employed for integrating the multisource evidence. The Fraud Risk Assessment Model based on Multisource Evidence Theory is established. The proposed model is applied to assess the fraud risk of the listed companies in China. The results indicate that the proposed model is effective at evaluating the fraud risk of listed companies, and it also has a higher precision, recall, and F‐1 measure than the traditional probability model.
Interest rates forecasting: Between Hull and White and the CIR#—How to make a single‐factor model work
Authors: Orlando Giuseppe , Bufalo Michele
Published: May 2021

In this work, we present our findings of the so‐called CIR#, which is a modified version of the Cox, Ingersoll, and Ross (CIR) model, turned into a forecasting tool for any term structure. The main feature of the CIR# model is its ability to cope with negative interest rates, cluster volatility, and jumps. By considering a dataset composed of money market interest rates during turmoil and calmer periods, we show how the CIR# performs in terms of directionality of rates and forecasting error. Comparison is carried out with a revamped version of the CIR model (denoted
), the Hull and White model, and the exponentially weighted moving average (EWMA) which is often adopted whenever no structure in data is assumed. To confirm the analysis, testing and validation is performed on both historical and ad hoc data with different metrics and clustering criteria.
Ribes himalense as potential source of natural bioactive compounds: Nutritional, phytochemical, and antioxidant properties
Authors: Sun Qing , Wang Na , Xu Wenhua , Zhou Huakun
Published: May 2021

Ribes himalense Royle ex Decne. (family Saxifraaceae, subfamily Grossulariaceae, genus Ribes) is a wild berry fruit with illustrated health‐promoting features, which widely distributed in Northwest China are deficiently exploited. This study aimed to assess the potential of a Ribes himalense as a source of natural bioactive compounds through characterizing its nutraceutical characteristics, phytochemicals properties, and antioxidant ability. Fresh berries were quantitatively analyzed for proximate composition, minerals, vitamins, amino acids, total polyphenols, total flavonoids, anthocyanins, procyanidin, and polysaccharides contents through China National Food Safety Standard; the characterization and identification of extracts of wild berries obtained with ethanol 30%, ethanol 50%, and ethanol 95% were firstly performed by UPLC‐Triple‐TOF‐MS2. Furthermore, antioxidant activity of the ethanol extract was evaluated via different assay methods such as DPPH, ABTS, and FRAP. The results indicated that the most important bioactive composition was procyanidin (0.72%), polyphenols (0.49%), total flavonoids (0.38%), vitamin C (64.6 mg/100g FW), and K (218.44 mg/100 g FW), and a total of 95 compounds were detected with polyphenols, flavonoids, and proanthocyanidins as the dominant, and also ethanol extract possessed stronger antioxidant activity. These results suggested that Ribes himalense fruit has great potential in protecting human health, with the focus on the development of functional products.
Mucoepidermoid carcinoma of the parotid gland: Twenty‐year experience in treatment and outcomes
Authors: Chan Stephen A. , Van Abel Kathryn M. , Lewis Jean E. , Routman David M. , Garcia Joaquin J. , Karp Emily E. , Price Daniel L. , Janus Jeffrey R. , Kasperbauer Jan L. , Moore Eric J.
Published: May 2021

Background

Parotid gland mucoepidermoid carcinoma (MEC) has published five‐year cancer‐specific survival (CSS) rates of 77%–97%, with variance related to grade.

Methods

Patients receiving primary surgery for parotid gland MEC from 1995 to 2014 at a tertiary medical center underwent clinical review, histopathologic review, and cytogenetic analysis. Survival outcomes were evaluated.

Results

Among 58 patients, T/N/M classification was as follows: T1 in 35 patients, T2 in 14, T4a in 9, N0 in 53, N1 in 2, N2b in 3. Histologic grade was low in 27, intermediate in 17, and high in 12 patients with 98% MAML2 positivity. All patients underwent parotidectomy, and seven patients received adjuvant radiation therapy. CSS was 100% at 5 years and 94.1% at 10 and 15 years. Two patients experienced locoregional recurrence.

Conclusions

Treatment with adequate surgical resection and adjuvant radiation therapy for high‐grade or advanced‐stage tumors yields excellent survival, independent of clinical stage or pathologic grade.
Cell‐based model systems for genome instability: Dissecting the mechanistic basis of chromothripsis in cancer
Authors: Kolb Thorsten , Ernst Aurélie
Published: May 2021

Chromothripsis is a form of genomic instability that was shown to play a major role in cancer. Beyond cancer, this type of catastrophic event is also involved in germline structural variation, genome mosaicism in somatic tissues, infertility, mental retardation, congenital malformations and reproductive development in plants. Several assays have been developed to model chromothripsis in vitro and to dissect the mechanistic basis of this phenomenon. Cell‐based model systems are designed with different strategies, such as the formation of nuclear structures called micronuclei, telomere fusions or the induction of exogenous DNA double‐strand breaks. Here, we review a range of model systems for chromothripsis and the mechanistic insights gained from these assays, with a particular focus on chromothripsis in cancer.
Understanding women's wage growth using indirect inference with importance sampling
Authors: Sauer Robert M. , Taber Christopher
Published: May 2021

The goal of this work is to investigate the effects of time out of the labor market for childcare on women's lifecycle wage growth. We develop a dynamic lifecycle model of human capital, fertility, and labor supply for women. We estimate by indirect inference using importance sampling and formalize the use of this procedure. The results indicate a modest effect of fertility‐induced non‐employment spells on human capital accumulation. The difference in human capital among prime‐age women would be approximately 2.4% higher at its peak if the relationship between fertility and working were eliminated, and 4.7% higher if the relationship between marriage and fertility was also eliminated.
The brief sense of community scale: Testing dimensionality and measurement invariance by gender among Hispanic/Latinx youth
Authors: Lardier David T. , Opara Ijeoma , Cantu Irene , Garcia‐Reid Pauline , Reid Robert J.
Published: May 2021

Psychological sense of community is defined as feelings of belongingness and a shared belief that community members will meet one another's needs. Psychological sense of community has four dimensions: membership, influence, needs fulfillment, and emotional connection. In this study, multigroup confirmatory factor analysis was used to examine the first and second‐order factor structure of the brief sense of community scale (BSCS) between male and female Hispanic/Latinx adolescents from an urban community (N = 947). To help validate the BSCS model, the second‐order factor model was tested with regression to predict the measures of intrapersonal psychological empowerment and ethnic identity, as constructs conceptually related to psychological sense of community. Findings support that: (1) psychological sense of community can be measured through the BSCS and as a four‐factor model among Hispanic/Latinx youth, supporting McMillan and Chavis's (1986) original theoretical discussions; (2) while no differences between genders were present at the model‐level, there was path‐specific variation; and (3) intrapersonal psychological empowerment and ethnic identity were associated with psychological sense of community.
Opinions of adults affected with later‐onset lysosomal storage diseases regarding newborn screening: A qualitative study
Authors: Lisi Emily C. , Ali Nadia
Published: May 2021

Lysosomal storage diseases (LSDs) are a heterogeneous group of conditions causing substrate accumulation leading to progressive organ damage. Newborn screening (NBS) for several LSDs has become available in recent years due to advances in technology and treatment availability. While early initiation of treatment is lifesaving for those with infantile presentations, controversy continues regarding diagnosis of milder, later‐onset diseases in infancy, including creation of pre‐symptomatic populations of ‘patients‐in‐waiting’, the potential for medicalization, stigmatization, and/or discrimination. In‐depth interviews were conducted with 36 adults [11 with Fabry disease (FD), 8 with Gaucher disease (GD), and 17 with late‐onset Pompe disease (LOPD)], to determine their perspectives on NBS for their respective conditions. Thirty‐four of 36 participants were in favor of NBS; both participants not in favor had GD1. Emergent themes influencing participants favorably toward NBS included earlier age of onset, a long diagnostic odyssey, less efficacious treatment, and the desire to have made different life decisions (e.g., relationships, career, or lifestyle) with the knowledge of their diagnosis. Concerns about insurance discrimination and psychological or physical burdens were associated with less favorable opinions of NBS. The ability for parents to make future reproductive decisions based their child's NBS result was considered favorably by some participants and unfavorably by others. Participants’ specific condition (GD1, FD, or LOPD) contributed to these experiences differently. Participants with LOPD and FD favored NBS to initiate earlier treatment and prevent irreversible organ damage, whereas fewer patients with GD1 mentioned this benefit. Participants with LOPD had the longest diagnostic odyssey, while those with FD were more likely to report feeling misunderstood and experiencing accusations of malingering, both contributing to favorable views of NBS. Results expand prior quantitative findings by illuminating how participants’ lived experiences can shape opinions about NBS. By understanding how currently affected individuals perceive the lifelong impact of a NBS result, genetic counselors can provide better anticipatory guidance to the parents of individuals diagnosed with a later‐onset LSD by NBS.
Video consultations during the coronavirus disease 2019 pandemic are associated with high satisfaction for both doctors and patients
Authors: Zorron Cheng Tao Pu Leonardo , Raval Manjri , Terbah Ryma , Singh Gurpreet , Rajadurai Anton , Vaughan Rhys , Efthymiou Marios , Chandran Sujievvan
Published: May 2021

Background and Aim

Telehealth has become the standard of care during the COVID‐19 outbreak. This study aimed to assess doctor and patient satisfaction of endoscopy‐related telehealth clinics with video consultations.

Methods

A prospective observational study of patients consecutively booked to attend two endoscopy‐related telehealth clinics at an ambulatory tertiary care setting was conducted from July to October 2020. Data collected from our previously published study using phone consultations (data collected in April–May 2020) were used as a control arm. The primary outcome (satisfaction) was assessed through the six‐question score (6Q_score) as per previous research. Secondary outcomes included failure‐to‐attend (FTA) rate and perceived necessity of physical examination/in‐person follow‐up appointment.

Results

There were 962 endoscopy clinic appointments between July and October, of which 157 were conducted through video. Data on 127 doctor questionnaires and 94 patient questionnaires were analyzed. The median age (years) of patients reviewed via video [57, interquartile range (IQR) 48–66] was lower than those reviewed via phone (65, IQR 55–74, P < 0.01). Patient average 6Q_score was higher with video compared to phone (85.1% vs 78.4%, P = 0.01), as was doctors' 6Q_score (97.5% vs 91.9%, P = 0.02). FTA rates remained similar between the two assessments (6.4% in April/May and 4.4% between July/October, P = 0.12). The requirement for in‐person follow‐up/physical examination was identified in two video consultations (1.6%).

Conclusion

Video consultations during the COVID‐19 outbreak demonstrated higher patient and doctor satisfaction compared to phone consultations. There was no significant difference in FTA rates and need for in‐person follow‐up consultations/physical examination between the telehealth two modalities.
Follicular regulatory T cell biology and its role in immune-mediated diseases
Authors: Ye Yishan , Wang Mowang , Huang He
Published: May 2021

Follicular regulatory T (Tfr) cells are recently found to be a special subgroup of regulatory T (Treg) cells. Tfr cells play an important role in regulating the germinal center (GC) response, especially modulating follicular helper T (Tfh) cells and GC-B cells, thereby affecting the production of antibodies. Tfr cells are involved in the generation and development of many immune-related and inflammatory diseases. This article summarizes the advances in several aspects of Tfr cell biology, with special focus on definition and phenotype, development and differentiation, regulatory factors, functions, and interactions with T/B cells and molecules involved in performance and regulation of Tfr function. Finally, we highlight the current understanding of Tfr cells involvement in autoimmunity and alloreactivity, and describe some drugs targeting Tfr cells. These latest studies have answered some basic questions in Tfr cell biology and explored the roles of Tfr cells in immune-mediated diseases.
Thirty percent ethanol locks ineffective in preventing central line–associated bloodstream infection in pediatric intestinal rehabilitation patients
Authors: Mohandas Anisha , Isava‐Quintero Alejandro , Duro Debora
Published: May 2021

Background

Intestinal failure patients dependent on parental nutrition are reliant on central venous catheters and are at increased risk for central line–associated bloodstream infection (CLABSI). Seventy percent ethanol has been widely used for prophylaxis; however, it is known to have multiple adverse effects. This study demonstrates the implementation of a 30% ethanol lock protocol for CLABSI prevention in a community‐based hospital intestinal rehabilitation program.

Methods

This case series reports rates of CLABSI, compromised central venous catheter, and analysis of community bacterial pathogens.

Results

A 42.1% increase in CLABSI and a 125% increase in compromised central venous catheters were noted after initiation of the 30% ethanol lock protocol.

Conclusion

It can be concluded that for the pediatric intestinal rehabilitation patient, 30% ethanol did not provide adequate CLABSI prophylaxis. This study indicates the need for larger sample sizes or the use of other concentrations of ethanol locks ranging between 30% and 70%.
Development of expert working groups and a learning management system within the Australian National Fabrication Facility
Authors: Jarvis Karyn , Macky Stephanie , Fitzpatrick Jane
Published: May 2021

The Australian National Fabrication Facility (ANFF) is a federally funded facility that provides real open access to state‐of‐the‐art microfabrication and nanofabrication facilities for both academic and industry researchers. The ANFF network has over 500 instruments spread across 20 sites in Australia. Since its inception in 2007, ANFF has grown to approximately 3000 users and 200,000 user hours per year. As ANFF operations are spread across eight geographically separated nodes, such growth has demonstrated the need for more consistent processes across the organization. An expert working group program is being implemented to facilitate knowledge sharing between ANFF nodes within instrument groups. The development of an online learning management system is in progress to standardize training across ANFF to create a consistent learning experience. The goals of these two initiatives are to increase communication, share knowledge, standardize processes, reduce duplication, and increase quality across the Australia wide ANFF network.
Doppler‐Guided Acoustically Active Injection Catheter
Authors: Katayama Minako , Gades Naomi M. , Singh Vijay P. , Devick Katrina L. , Zarbatany David , Vaitkus Veronica V. , Belohlavek David L. , Fortuin F. David , Belohlavek Marek
Published: May 2021

Percutaneous transendocardial injections of therapeutic agents into the myocardium may not always be effective. We used an animal model for assessing the efficacy of the injections using linoleic acid as a testing agent. Efficacious delivery into the myocardium of a beating heart was indicated by rapidly developed local myocardial necrosis and wall motion abnormalities using echocardiography. We employed this experimental model to test our innovative technology, an acoustically active injection catheter. The Doppler ultrasound‐guided acoustically active injection catheter effectively delivers the substance to the myocardium but needs further technical improvements to minimize an unwanted systemic distribution of the agent.
Patients' Perceptions of Resident Surgeon Involvement in Otolaryngology
Authors: Urban Matthew J. , Brown Hannah J. , Kim Jae , Eggerstedt Michael , Debettencourt Joseph B. , Husain Inna , Papagiannopoulos Peter , Tajudeen Bobby A. , Batra Pete S. , LoSavio Phillip S.
Published: May 2021

Objectives

To assess patient acceptance of resident involvement in otolaryngologic procedures and to evaluate the impact of a written preoperative educational pamphlet.

Study Design

Prospective cohort study.

Methods

This is a prospective survey study at a large tertiary care academic center. In addition to standard perioperative instructions and informed consent, 87 out of 183 patients received a pamphlet with information on the role of the otolaryngology resident.

Results

Greater than 90% of all patients surveyed recognized that resident physicians are directly involved in delivering care at teaching hospitals and may have assisted in their surgical procedure. Ninety percent of patients receiving educational pamphlets were aware residents may have performed portions of their procedure versus 71% in the control group (P = .001). Ninety‐seven percent of patients receiving pamphlets wanted to know how much of their procedure was performed by a resident versus 71% of the control group (P < .001), and patients undergoing single‐surgeon procedures were less likely to want to know how much was performed by a resident (P < .05). Ninety‐six percent in the pamphlet group agreed that residents improved the quality of their care versus 79% of the control group (P = .001).

Discussion

Resident surgeons are well received by the large majority of otolaryngology patients. Structured perioperative information regarding surgical training facilitates an honest and open informed consent discussion between the patient and surgeon and helps to establish a solid foundation of trust.

Conclusion

Implementation of this practice is simple and inexpensive. It should be considered for any clinical practice with a focus on surgical education.

Level of Evidence

4 Laryngoscope, 131:2448–2454, 2021
Getting what is needed, when it's needed: Sharing information, knowledge, and know‐how in a Collaborative Learning Health System
Authors: Keck Christian , Hartley David M. , Havens Mary , Margolis Peter A. , Seid Michael
Published: May 2021

Background

Collaborative Learning Health Systems (CLHS) improve outcomes in part by facilitating collaboration among all stakeholders. One way to facilitate collaboration is by creating conditions for the production and sharing of medical and non‐medical resources (information, knowledge, and knowhow [IKK]) so anybody can get “what is needed, when it's needed” (WINWIN) to act in ways that improve health and healthcare. Matching resources to needs can facilitate accurate diagnosis, appropriate prescribing, answered questions, provision of emotional and social support, and uptake of innovations.

Objectives

We describe efforts in ImproveCareNow, a CLHS improving outcomes in pediatric inflammatory bowel disease (IBD), to increase the number of patients and families creating and accessing IKK, and the challenges faced in that process.

Methods

We applied tactics such as outreach through trusted messengers, community organizing, and digital outreach such as sharing resources on our website, via social media, and email to increase the number of people producing, able to access, and accessing IKK. We applied an existing measurement system to track our progress and supplemented this with community feedback.

Results

In August of 2017 we identified and began measuring specific actions to track community growth. The number of patients and families producing IKK has increased by a factor of 2.7, using resources has increased by a factor of 4.1 and aware of resources as increased by a factor of 4.0. We identified challenges to measurement and scaling.

Conclusions

It is possible to intentionally increase the number of patients and caregivers engaged with a CHLS to produce and share resources to improve their health.
Organocatalytic Ring‐Opening Alternating Copolymerization of Epoxides and Cyclic Anhydrides by a Simple Organobase/Urea Binary Catalyst
Authors: Zhu Xingji , Wang Rui , Kou Xinhui , Liu Fusheng , Shen Yong
Published: May 2021

Although several organocatalysts have been reported for the efficient ring‐opening alternating copolymerization (ROAC) of epoxides and cyclic anhydrides, the low catalytic activity still remains as a problem. Thus, there is still a motivation to develop new simple and high active organocatalysts. In this contribution, an organic cyclic trimeric phosphazene base (CTPB) is used as catalyst in combination with different ureas for the ROAC of phthalic anhydride with a variety of epoxides. The CTPB/urea binary catalysts exhibit high catalytic activities, producing perfectly alternating polyesters without formation of ether linkages. Polyesters with diverse structures, well‐defined chain‐ends, as well as low dispersities are successfully obtained.
On the lack of interior regularity of the p‐Poisson problem with p>2
Authors: Weimar Markus
Published: May 2021

In this note we are concerned with interior regularity properties of the p‐Poisson problem with . For all we constuct right‐hand sides f of differentiability such that the (Besov‐) smoothness of corresponding solutions u is essentially limited to . The statements are of local nature and cover all integrability parameters. They particularly imply the optimality of a shift theorem due to Savaré [J. Funct. Anal. 152
(1998), 176–201], as well as of some recent Besov regularity results of Dahlke et al. [Nonlinear Anal. 130 (2016), 298–329].
On coupled nonlinear evolution system of fractional order with a proportional delay
Authors: Ahmad Israr , Alrabaiah Hussam , Shah Kamal , Nieto Juan J. , Mahariq Ibrahim , Ur Rahman Ghaus
Published: May 2021

A qualitative analysis for a nonlinear system of fractional pantograph evolution differential equations (FPEDEs) has been established. Conditions about the solution of the underlying equations have been established in the direction of the existence and uniqueness of the solution. Using results of fixed‐point theorems of Krasnoselskii iterations in Banach spaces, we develop the required results. This research work is enriched by establishing the results related to Ulam–Hyers (UH) stability of the problem under consideration via the tools of nonlinear analysis. To validate the reliability of the obtained results, some pertinent examples are given in the manuscript.
Accuracy and reproducibility of effective atomic number and electron density measurements from sequential dual energy CT
Authors: Schaeffer Colin J. , Leon Stephanie M. , Olguin Catherine A. , Arreola Manuel M.
Published: May 2021

Purpose

This study assesses the accuracy of effective atomic number (Zeff) and electron density measurements acquired from dual energy CT and characterizes the response to clinically relevant variables representative of challenges in patient imaging, including: phantom size, material position within the phantom, variation over time, off‐center positioning, and large cone beam angle.

Methods

The Gammex Multi‐Energy CT head and body phantoms were used to measure Zeff and electron density from 35 rod inserts that mimic tissues and varying concentrations of iodine and calcium. Scans were performed on a Canon Aquilion ONE Genesis CT scanner over a period of 6 months using default dual energy protocols appropriate for each phantom size. Theoretical Zeff and electron density values were calculated using data provided by the phantom manufacturer and compared to the measurements. Sources of variance were separated and quantified to identify the influences of random photon statistics, ROI placement, and variation over time. A subset of measurements were repeated with the phantom shifted in the vertical and horizontal directions, and over all slices in the volumetric scan.

Results

All measurements showed strong correlation (r > 0.98) with their corresponding theoretical values; however, the system did demonstrate a bias of −0.58 atomic units in the body phantom and 0.28 atomic units in the head phantom for Zeff measurements. The mean absolute percent error (MAPE) was 6.3% for the body phantom and 3.2% for the head phantom. Electron density measurements of the body and head phantoms gave MAPE values of 4.6% and 1.0%, respectively. Zeff and electron density measurements significantly varied within the solid water background, showing a positional dependence within the phantom that dominated the total standard deviation in measurements. Zeff values dropped by 0.2 atomic units when the phantom was off‐center; electron density measurements were less affected by phantom position. Along the z‐axis, the accuracy drops off markedly at more than 50‐60 mm from the central slice.

Conclusion

The Canon dual energy system offers an accurate way of measuring the Zeff and electron density of clinically relevant materials. Accuracy could be improved further by calibration to remove bias, careful attention to centering within the FOV, and avoiding measurements at the edges of the cone beam.
Bilanz 2020: Sanofi
Authors: Bulmahn Maren
Published: May 2021

Das französische Pharmaunternehmen Sanofi sieht sich stabil und auf dem richtigen Weg. Transaktionen laufen vor allem in den USA.
Trendbericht Physikalische Chemie: Zweidimensionale Halbleiter
Authors: Lauth Jannika , Niebur André
Published: May 2021

Atomar dünne kolloidale 2‐D‐Halbleiter bieten Potenzial für die Optoelektronik und photonische Quantentechnologie.
Bilanz 2020: Henkel
Authors: Bulmahn Maren
Published: May 2021

Der Düsseldorfer Konzern Henkel hat im Jahr 2020 weniger verdient als im Vorjahr. Die Dividende bleibt gleich. Die digitalen Geschäfte nahmen zu.
Bilanz 2020: Borealis
Authors: Bulmahn Maren
Published: May 2021

Das österreichische Unternehmen Borealis gehört nun zu 75 Prozent dem Wiener Unternehmen OMV und ist Europas zweitgrößter Polyolefinproduzent.
A survey of coping strategies among clinical nurses in China during the early stage of coronavirus disease 2019 pandemic: A cross‐sectional study
Authors: Tang Jiao , Zhang You , Xiong Fangfang , Li Fuying , Zheng Zehong , Gao Xi , Luo Zhongchen
Published: May 2021

Aims

To investigate coping strategies and identify their associated factors among Chinese clinical nurses during the early stage of coronavirus disease 2019 pandemic.

Design

A cross‐sectional study.

Methods

This study was conducted in seven designated hospitals involved in the diagnosis and treatment of the coronavirus disease 2019 in the southwest of China between 1 February and 31 March, 2020. Multiple linear regression was conducted to explore the association of different factors with the coping strategies of nurses.

Results

Nurses’ positive coping was associated with higher psychological capital (B = 0.185, 95% CI 0.158–0.213), social support (B = 0.292, 95% CI 0.244–0.340) and lower frustration (B = −0.065, 95% CI −0.123 to −0.007). In contrast, higher frustration (B = 0.091, 95% CI 0.044–0.139), lower performance (B = −0.054, 95% CI −0.101 to −0.007) and psychological capital (B = −0.035, 95% CI −0.055 to −0.014) were associated with negative coping.
A study protocol to evaluate the implementation and effectiveness of the Clinical Nurse Leader Care Model in improving quality and safety outcomes
Authors: Bender Miriam , Williams Marjory , Cruz Maricela F. , Rubinson Claude
Published: May 2021

Aims

Patients are harmed or die every year because of unsafe, inappropriate or inadequate healthcare delivery. Registered Nurses are a recognized patient safety strategy. However, variability in research findings indicate the relationship is not as simple as “more nurses=better outcomes.” Hence, currently there exists no evidence‐based frontline nursing care model. One emerging model is the Clinical Nurse Leader care model.

Design

This Hybrid Type II Implementation‐Effectiveness study will evaluate the effect of the care model on standardized quality and safety outcomes and identify implementation characteristics that are sufficient and necessary to achieve outcomes.

Methods

This study leverages a natural experiment in 66 clinical care units in nine hospitals across five states in the United States that have implemented the Clinical Nurse Leader care model.

Results

Findings will elucidate Registered Nurse's mechanisms of action as organized into frontline models of care and link actions to improved care quality and safety.
Mode I and mode II delamination of carbon/glass/epoxy hybrid composite: A statistics‐based analysis
Authors: Monticeli Francisco Maciel , Pitanga Midori Yoshikawa , Cioffi Maria Odila Hilário , Voorwald Herman Jacobus Cornelis
Published: May 2021

The delamination of a carbon/glass/epoxy hybrid composite was studied experimentally to analyze the effect of reinforcement heterogeneity on data dispersion. A statistical approach was applied to evaluate the effect of the carbon/glass/epoxy hybrid composite on the individual modes (I and II) of delamination. The analysis of variance evidenced the contribution of reinforcement type in strain energy release ratio (SERR). Curve fitting for the quasi‐static test was performed with the Weibull distribution model to predict the energy release versus crack length with different reliability levels. The 60% reliability curve presented the best fit with the average of the experimental data. For all reliability levels, the hybrid composite showed an increase in SERR.
Chemiresistor sensor using elastomer‐functionalized carbon nanotube nanocomposites for the detection of gasoline spills
Authors: Kim Tae Y. , Koo Kwon M. , Yun Gayeong , Kim Yangsoo
Published: May 2021

Two types of multi‐walled carbon nanotube (MWNT)‐based elastomer nanocomposites are used as a sensor material for the detection of gasoline spills by applying the interdigitated electrode (IDE) device. MWNT‐g‐polyisoprene (PI) and Si‐MWNT/natural rubber (NR) are prepared by applying “grafting‐from” and “grafting‐to” process, respectively. When compared based on the identical condition of gasoline sensing test, the maximum response value to the exposure of gasoline is 17.5 for MWNT‐g‐PI sensor and 12.9 for Si‐MWNT/NR sensor, which reach the maximum in less than 3 min. The MWNT‐g‐PI sensor selectively detects gasoline, and its response is completely reversible. It shows that the longer chain length of PI brings about the larger response of MWNT‐g‐PI sensor to gasoline. The sensitivity of MWNT‐g‐PI sensor highly depends on both how much gasoline is exposed to the sensor and what bias voltage is applied to the IDE device. The IDE sensor using MWNT‐g‐PI nanocomposites effectively detects gasoline spills.
Analysis of electrostatic coupling throughout the laboratory evolution of a designed retroaldolase
Authors: Coulther Timothy A. , Pott Moritz , Zeymer Cathleen , Hilvert Donald , Ondrechen Mary Jo
Published: May 2021

The roles of local interactions in the laboratory evolution of a highly active, computationally designed retroaldolase (RA) are examined. Partial Order Optimum Likelihood (POOL) is used to identify catalytically important amino acid interactions in several RA95 enzyme variants. The series RA95.5, RA95.5–5, RA95.5–8, and RA95.5–8F, representing progress along an evolutionary trajectory with increasing activity, is examined. Computed measures of coupling between charged states of residues show that, as evolution proceeds and higher activities are achieved, electrostatic coupling between the biochemically active amino acids and other residues is increased. In silico residue scanning suggests multiple coupling partners for the catalytic lysine K83. The effects of two predicted partners, Y51 and E85, are tested using site‐directed mutagenesis and kinetic analysis of the variants Y51F and E85Q. The Y51F variants show decreases in kcat relative to wild type, with the greatest losses observed for the more evolved constructs; they also exhibit significant decreases in kcat/KM across the series. Only modest decreases in kcat/KM are observed for the E85Q variants with little effect on kcat. Computed metrics of the degree of coupling between protonation states rise significantly as evolution proceeds and catalytic turnover rate increases. Specifically, the charge state of the catalytic lysine K83 becomes more strongly coupled to those of other amino acids as the enzyme evolves to a better catalyst.