bluuebunny/crossref_metadata_2025 huggingface dataset:
Infant consumption of 100% lactose‐based and reduced lactose infant formula in the United States: Review of NHANES data from 1999 to 2020
Authors: DiMaggio Dina M. , Abersone Ilze , Porto Anthony F.
Published: June 2024

Objectives

An acceptable alternative to human milk is US Food and Drug Administration (US FDA)‐registered infant formula, which must meet the requirements of the US FDA Infant Formula Act. Human milk contains lactose, but some infant formulas may contain alternative carbohydrate sources such as corn syrup solids, maltodextrin, and sucrose. Recent research shows that infant‐formula made with corn syrup solids may be associated with increased obesity risk in the first 5 years of life. A previous study found that of all formulas purchased, 59.0% were lactose‐reduced. More US infants consume infant formula with nonlactose carbohydrates more frequently than is medically necessary. The purpose of this study is to use National Health and Nutrition Examination Survey (NHANES) data to describe the type and prevalence of nonlactose carbohydrates consumed in infant formula.

Methods

NHANES data from 1999 to 2020 was used to perform cross‐sectional analyses and analyses of comparison of prevalence over time on consumption of nonlactose carbohydrate sources in infant formulas.

Results

We identified 3709 unique infant identifiers associated with 36,084 feeding sessions. More than half of the feeding sessions involved a formula with at least one nonlactose carbohydrate. Feeding sessions involving a formula with at least one nonlactose carbohydrate increased by 163% from 1999–2004 to 2017–2020; formulas containing single or multiple nonlactose carbohydrate types account for the increase in prevalence.

Conclusions

This study highlights an increase in the consumption of infant formula containing a nonlactose carbohydrate. More studies are needed to understand the short‐ and long‐term effects of early exposure to these carbohydrates.
Medial opening wedge high tibial osteotomy performs similarly irrespective of body mass index
Authors: Mabrouk Ahmed , Risebury Michael , Yasen Sam
Published: June 2024

Purpose

This study investigates the effect of the body mass index (BMI) on the early (2 years) to midterm (5 years) results of medial opening wedge high tibial osteotomy (MOWHTO).

Methods

A prospectively maintained single‐centre database of 1138 knee osteotomies, between 2002 and 2022, was retrospectively reviewed. Adult patients who underwent MOWHTO for symptomatic unicompartmental medial knee osteoarthritis (OA), with varus knee malalignment, having failed conservative management, were included. Patients were categorized into three groups according to their BMI as per the classification from the National Institute for Health and Care Excellence (NICE): the healthy weight (HW) group (BMI of 18.5–24.9 kg/m2), the overweight (OW) (BMI of 25–29.9 kg/m2), and the obesity (OB) group (BMI ≥ 30 kg/m2). Multiple patient‐reported outcome measures (n = 6) were recorded preoperatively and at 2 and 5 years postoperatively. Deformity analysis was undertaken preoperatively and postoperatively. The relative risk (RR) of the complications between the HW, OW and OB groups was calculated. The rate of conversion to arthroplasty, and 5 and 10 years survivorship were recorded, as well as the hazard ratio (HR) of BMI on survivorship.

Results

A total of 574 cases were included in the study: the HW group (n = 96), the OW group (n = 233) and the OB group (n = 245), with a mean BMI of 23 ± 1.5 kg/m2, 27.4 ± 1.4 kg/m2 and 34.4 ± 3.8 kg/m2, respectively. The mean follow‐up was 13.3 years (4.8–20.3). The mean mechanical tibiofemoral angle corrections were in the HW group: 7.1 ± 3°, OW group: 6.6 ± 3.5° and OB group: 7.1 ± 3.8°, with no intergroup significant difference (p = n.s.). Clinically, despite lower preoperative scores in the OW and OB groups, no difference was observed postoperatively amongst the three groups. The overall complication rate was 12.5% in the HW group, 6.8% in the OW group, and 9.8% in the OB group. There was no significant difference in the RR of complications between the HW and OW groups (RR = 0.6, 95% confidence interval [CI] = 0.3–1.3) (p = 0.2), and the HW and OB groups (RR = 0.8; 95% CI = 0.3–2.2) (p = 0.7). There was no overall significant difference in survival outcomes based on the BMI between the three groups (p = 0.4). The HR of conversion to arthroplasty between the HW and OW groups was 1.4 [95% CI = 0.6–3.5](p = 0.5) and between the HW and OB groups was 1.8 [95% CI = 0.8–4.4] (p = 0.2).

Conclusion

BMI has no significant effect on either the radiological corrections, clinical outcomes, complications or survivorship of MOWHTO at short‐ to medium‐term follow‐up. No specific cutoff point for BMI can be recommended as a contraindication to MOWHTO.

Level of Evidence

Level IV, Retrospective cohort study.
Glenoid bone loss and Hill‐Sachs width percentage score are useful to select optimal operation for the treatment of glenohumeral instability in overhead athletes: Arthroscopic Bankart repair with remplissage versus open Latarjet
Authors: Gereli Arel , Yozgatli Tahir Koray , Yilmaz Edip , Gamli Alper , Bayram Berhan , Kocaoglu Baris
Published: June 2024

Purpose

Glenohumeral instability with combined bone lesion in contact and overhead athletes with subcritical bone loss is challenging to treat with high recurrent instability. Treatment options are arthroscopic Bankart repair with remplissage and Latarjet operations. However, there is no consensus on their effectiveness. This study aims to compare the clinical outcomes and return to sports after both operations and whether evaluating the glenoid bone loss and Hill‐Sachs width to calculate the total bone loss can help determine the appropriate operation.

Methods

In this retrospective comparative analysis, 30 athletes who underwent index arthroscopic Bankart repair with remplissage (n = 16) or Latarjet procedure (n = 14) between 2017 and 2020 were included. Computed tomography (CT) and magnetic resonance imaging (MRI) were routinely performed. The quick Disabilities of the Arm, Shoulder and Hand (qDASH), American Shoulder and Elbow Surgeons (ASES), instability severity index (ISI) scores and range of motion (ROM) were recorded preoperatively and at a mean follow‐up of 53 months (SD = 12). Follow‐up included time‐to‐return sports, self‐perceived sports performance level and complications/recurrent dislocations.

Results

Preoperative qDASH, ASES, ISI scores, ages and genders were similar. The Latarjet group had significantly larger glenoid bone loss, Hill‐Sachs width and total bone loss (p < 0.01). Both groups had significant improvement in patient‐reported outcomes (PROs) after the operations (p < 0.01). Athletes with a total bone loss <25% underwent arthroscopic Bankart repair with remplissage and total bone loss ≥25% underwent Latarjet procedure, and there were no differences between the groups in terms of postoperative PROs, ROM, time‐to‐return sports and performance. There were no re‐dislocations.

Conclusion

Arthroscopic Bankart repair with remplissage or Latarjet procedure can adequately address glenohumeral instability with combined bone lesions. Patients with total bone loss scores greater than or equal to 25 may particularly benefit from the Latarjet procedure, while the minimally invasive arthroscopic Bankart repair with remplissage can yield equally satisfying scores for total bone loss less than 25.

Level of Evidence

Level III.
Predicting Therapeutic Response to Hypoglossal Nerve Stimulation Using Deep Learning
Authors: Alapati Rahul , Renslo Bryan , Jackson Laura , Moradi Hanna , Oliver Jamie R. , Chowdhury Mohsena , Vyas Tejas , Bon Nieves Antonio , Lawrence Amelia , Wagoner Sarah F. , Rouse David , Larsen Christopher G. , Wang Ganghui , Bur Andrés M.
Published: June 2024

Objectives

To develop and validate machine learning (ML) and deep learning (DL) models using drug‐induced sleep endoscopy (DISE) images to predict the therapeutic efficacy of hypoglossal nerve stimulator (HGNS) implantation.

Methods

Patients who underwent DISE and subsequent HGNS implantation at a tertiary care referral center were included. Six DL models and five ML algorithms were trained on images from the base of tongue (BOT) and velopharynx (VP) from patients classified as responders or non‐responders as defined by Sher's criteria (50% reduction in apnea‐hypopnea index (AHI) and AHI < 15 events/h). Precision, recall, F1 score, and overall accuracy were evaluated as measures of performance.

Results

In total, 25,040 images from 127 patients were included, of which 16,515 (69.3%) were from responders and 8,262 (30.7%) from non‐responders. Models trained on the VP dataset had greater overall accuracy when compared to BOT alone and combined VP and BOT image sets, suggesting that VP images contain discriminative features for identifying therapeutic efficacy. The VCG‐16 DL model had the best overall performance on the VP image set with high training accuracy (0.833), F1 score (0.78), and recall (0.883). Among ML models, the logistic regression model had the greatest accuracy (0.685) and F1 score (0.813).

Conclusion

Deep neural networks have potential to predict HGNS therapeutic efficacy using images from DISE, facilitating better patient selection for implantation. Development of multi‐institutional data and image sets will allow for development of generalizable predictive models.

Level of Evidence

NA Laryngoscope, 134:5210–5216, 2024
Standard metrics for characterizing episodic salinization in freshwater systems
Authors: Neville J. A. , Emanuel R. E. , Nelson N. G. , Bernhardt E. S. , Ardón M.
Published: June 2024

Salinization threatens freshwater resources and freshwater‐dependent wetlands in coastal areas worldwide. Many research efforts focus on gradual or chronic salinization, but the phenomenon is also episodic in nature, particularly in small streams and artificial waterways. In surface waters, salinization events may coincide with storms, droughts, wind tides, and other episodic events. A lack of standardized quantitative methods and metrics for describing and discussing episodic salinization hinders cross‐disciplinary efforts by scientists and others to analyze, discuss, and make recommendations concerning these events. Here, we present a set of metrics that use statistics which describe flow characteristics in rivers and streams as a template for empirically describing and characterizing salinization events. We developed a set of metrics to quantify the duration, magnitude, and other characteristics of episodic salinization, and we apply the metrics to extensive time‐series data from a field site in coastal North Carolina. We then demonstrate the utility of these metrics by coupling them with ancillary data to perform an unsupervised classification that groups individual salinization events by their primary meteorological driver. We provide simple and flexible code needed to compute metrics in any environment experiencing salinization events in hopes that it will facilitate more standardized approaches to the quantification and study of widespread freshwater salinization.
Negative Voltage Electrospinning for the Production of Highly Efficient PVDF Filters
Authors: Gotti Carlo , Torsello Monica , Onesti Riccardo , Tanganelli Gianmarco , Sensini Alberto , Boi Cristiana , Fabiani Davide , Focarete Maria Letizia , Zucchelli Andrea
Published: June 2024

In recent years, the demand for filter media has increased dramatically, driven by the need to manufacture personal protective equipment and for various applications in the industrial and civil sectors. Nanofiber‐based membranes are proposed as potential alternatives to commercial filtration devices. This study presents the design and implementation of an innovative pre‐industrial electrospinning setup, combining a negatively charged spinneret and a positively charged counter‐electrode, capable of producing polyvinylidene fluoride (PVDF) nanofibers with an average diameter of 410 nm and electrostatic surface potential values 3.7 times higher compared to a conventional electrospinning process, eliminating the need for further post‐treatment. These properties are essential for improving mechanical and electrostatic filtration of small particles, including infectious droplets. The surface potential of the membranes is also long‐lasting, as evidenced by tests one year after manufacture. As a case‐study, these filters are used to manufacture surgical masks, reporting excellent performance in terms of bacterial filtration efficiency (BFE) up to 99.9%, and breathability (29.8±4.5 Pa cm−2) when compared to commercially available meltblown polypropylene (PP) face masks, and also complied with the stringent European standard (EN14683:2019) for type‐II surgical masks. Furthermore, the pre‐industrial setup allows for increased production capacity of up to 42 000 m2 per year, suitable for large‐scale production.
Long‐Lasting Antibacterial PDMS Surfaces Constructed from Photocuring of End‐Functionalized Polymers
Authors: Li Biao , Pang Chuming , Chen Shiguo , Hong Liangzhi
Published: June 2024

A challenge remains in the development of anti‐infectious coatings for the inert surfaces of biomedical devices that are prone to bacterial colonization and biofilm formation. Here, a facile photocuring method to construct functionalized polymeric coatings on inert polydimethylsiloxane (PDMS) surfaces, is developed. Using atom transfer radical polymerization (ATRP) initiator bearing thymol group, hydrophilic DMAEMA and benzophenone (BP)‐containing monomers are copolymerized to form polymers with end functional groups. An end‐functionalized biocidal coating is then constructed on the inert PDMS surface in one step using a photocuring reaction. The functionalized PDMS surfaces show excellent antibacterial and antifouling properties, are capable of completely eradiating MRSA within ≈6 h, and effectively inhibit the growth of biofilms. In addition, they have good stability and long‐lasting antibacterial activity in body fluid environments such as 0.9% saline and urine. According to bladder model experiments, the catheter's lifespan can be extended from ≈7 to 35 days by inhibiting the growth and migration of bacteria along its inner surface. The photocuring technique is therefore very promising in terms of surface functionalization of inert biomedical devices in order to minimize the spread of infection.
FAP positive cancer‐associated fibroblasts promote tumor progression and radioresistance in esophageal squamous cell carcinoma by transferring exosomal lncRNA AFAP1‐AS1
Authors: Zhou Xilei , Tong Yusuo , Yu Changhua , Pu Juan , Zhu Weiguo , Zhou Yun , Wang Yuandong , Xiong Yaozu , Sun Xinchen
Published: June 2024

Cancer‐associated fibroblasts (CAFs) are abundant and heterogeneous stromal cells in the tumor microenvironment, which play important roles in regulating tumor progression and therapy resistance by transferring exosomes to cancer cells. However, how CAFs modulate esophageal squamous cell carcinoma (ESCC) progression and radioresistance remains incompletely understood. The expression of fibroblast activation protein (FAP) in CAFs was evaluated by immunohistochemistry in 174 ESCC patients who underwent surgery and 78 pretreatment biopsy specimens of ESCC patients who underwent definitive chemoradiotherapy. We sorted CAFs according to FAP expression, and the conditioned medium (CM) was collected to culture ESCC cells. The expression levels of several lncRNAs that were considered to regulate ESCC progression and/or radioresistance were measured in exosomes derived from FAP+ CAFs and FAP– CAFs. Subsequently, cell counting kit‐8, 5‐ethynyl‐2′‐deoxyuridine, transwell, colony formation, and xenograft assays were performed to investigate the functional differences between FAP+ CAFs and FAP– CAFs. Finally, a series of in vitro and in vivo assays were used to evaluate the effect of AFAP1‐AS1 on radiosensitivity of ESCC cells. FAP expression in stromal CAFs was positively correlated with nerve invasion, vascular invasion, depth of invasion, lymph node metastasis, lack of clinical complete response and poor survival. Culture of ESCC cells with CM/FAP+ CAFs significantly increased cancer proliferation, migration, invasion and radioresistance, compared with culture with CM/FAP– CAFs. Importantly, FAP+ CAFs exert their roles by directly transferring the functional lncRNA AFAP1‐AS1 to ESCC cells via exosomes. Functional studies showed that AFAP1‐AS1 promoted radioresistance by enhancing DNA damage repair in ESCC cells. Clinically, high levels of plasma AFAP1‐AS1 correlated with poor responses to dCRT in ESCC patients. Our findings demonstrated that FAP+ CAFs promoted radioresistance in ESCC cells through transferring exosomal lncRNA AFAP1‐AS1; and may be a potential therapeutic target for ESCC treatment.
Understanding REM Sleep Behavior Disorder through Functional MRI: A Systematic Review
Authors: Churchill Lachlan , Chen Yu‐Chi , Lewis Simon J.G. , Matar Elie
Published: June 2024

Neuroimaging studies in rapid eye movement sleep behavior disorder (RBD) can inform fundamental questions about the pathogenesis of Parkinson's disease (PD). Across modalities, functional magnetic resonance imaging (fMRI) may be better suited to identify changes between neural networks in the earliest stages of Lewy body diseases when structural changes may be subtle or absent. This review synthesizes the findings from all fMRI studies of RBD to gain further insight into the pathophysiology and progression of Lewy body diseases. A total of 32 studies were identified using a systematic review conducted according to PRISMA guidelines between January 2000 to February 2024 for original fMRI studies in patients with either isolated RBD (iRBD) or RBD secondary to PD. Common functional alterations were detectable in iRBD patients compared with healthy controls across brainstem nuclei, basal ganglia, frontal and occipital lobes, and whole brain network measures. Patients with established PD and RBD demonstrated decreased functional connectivity across the whole brain and brainstem nuclei, but increased functional connectivity in the cerebellum and frontal lobe compared with those PD patients without RBD. Finally, longitudinal changes in resting state functional connectivity were found to track with disease progression. Currently, fMRI studies in RBD have demonstrated early signatures of neurodegeneration across both motor and non‐motor pathways. Although more work is needed, such findings have the potential to inform our understanding of disease, help to distinguish between prodromal PD and prodromal dementia with Lewy bodies, and support the development of fMRI‐based outcome measures of phenoconversion and progression in future disease modifying trials. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
Lyapunov‐type inequality to general second‐order elliptic equations
Authors: Oza Priyank
Published: June 2024

We establish Lyapunov‐type inequality for equations concerning general class of second‐order non‐symmetric elliptic operators with singular coefficients. Our approach is based on the probabilistic representation of solutions and stochastic calculus. We also discuss a Lyapunov‐type inequality for equations pertaining to second‐order symmetric operator with some regularity assumptions on the coefficients and a nonlinear Neumann boundary condition.
Alleviation of Menopausal Symptoms by Yam (Dioscorea japonica Thunb.) and Gromwell (Lithospermum erythrorhizon Sieb. Et Zucc.) Extracts in Ovariectomized Mice
Authors: Park Hyejeong , Ha Hyunju , Lee Hyeji , Lee Gyeongwhan , Go Gwang‐woong , Yoon Tae Mi , Kim Tae Yeol , Kim Wooki
Published: June 2024

Scope

The decline in estrogen during menopause contributes to a variety of menopausal symptoms, for which hormone replacement therapy (HRT) has been extensively applied. Regarding side effects and limited effectiveness of HRT for specific individuals, there is a growing interest in safe alternatives such as phytoestrogens which are structurally analogous to estrogens. This study aims to investigate the efficacy of yam and gromwell extracts, rich in bioactive compounds, and the synergistic effect of extracts on symptoms induced by estrogen deficiency in ovariectomized (OVX) mice.

Methods and results

OVX mice receive dietary intervention of either yam, gromwell extract, or their mixture for 14 weeks. Sham‐operated mice and E2‐injected OVX mice serve as positive controls. Following 14 weeks of oral administration, blood, adipose tissue, vagina, uterus, femurs, and tibias are harvested for further investigation. Consequently, yam and gromwell extracts ameliorate menopausal conditions such as weight gain, glucose intolerance, dyslipidemia, and osteoporosis in estrogen‐deficient OVX mice. In addition, the mixture of yam and gromwell extracts synergistically aids in the relief of the indications.

Conclusion

These results indicate the potential use of yam and gromwell extracts, as well as their mixture, for the development of healthy functional foods to modulate menopausal symptoms.
Rotary excitation of non‐sinusoidal pulsed magnetic fields: Towards non‐invasive direct detection of cardiac conduction
Authors: Albertova Petra , Gram Maximilian , Blaimer Martin , Bauer Wolfgang Rudolf , Jakob Peter Michael , Nordbeck Peter
Published: June 2024

Purpose

There is a need for high resolution non‐invasive imaging methods of physiologic magnetic fields. The purpose of this work is to develop a MRI detection approach for non‐sinusoidal magnetic fields based on the rotary excitation (REX) mechanism which was previously successfully applied for the detection of oscillating magnetic fields in the sub‐nT range.

Methods

The new detection concept was examined by means of Bloch simulations, evaluating the interaction effect of spin‐locked magnetization and low‐frequency pulsed magnetic fields. The REX detection approach was validated under controlled conditions in phantom experiments at 3 T. Gaussian and sinc‐shaped stimuli were investigated. In addition, the detection of artificial fields resembling a cardiac QRS complex, which is the most prominent peak visible on a magnetocardiogram, was tested.

Results

Bloch simulations demonstrated that the REX method has a high sensitivity to pulsed fields in the resonance case, which is met when the spin‐lock frequency coincides with a non‐zero Fourier component of the stimulus field. In the experiments, we found that magnetic stimuli of different durations and waveforms can be distinguished by their characteristic REX response spectrum. The detected REX amplitude was proportional to the stimulus peak amplitude (R2 > 0.98) and the lowest field detection was 1 nT. Furthermore, the detection of QRS‐like fields with varying QRS durations yielded significant results in a phantom setup (p < 0.001).

Conclusion

REX detection can be transferred to non‐sinusoidal pulsed magnetic fields and could provide a non‐invasive, quantitative tool for spatially resolved assessment of cardiac biomagnetism. Potential applications include the direct detection and characterization of cardiac conduction.
Token sales design under network effect
Authors: Liu Zhao , Cai Xiaoqiang , Xu Fasheng , Zhang Lianmin
Published: June 2024

This paper explores the use of initial coin offerings (ICOs) as a means of fundraising for companies through the issuance of blockchain‐based tokens. Specifically, we investigate how a company can implement ICOs and issue tokens supported by its products while taking into account the presence of network effects. We examine several aspects of ICOs, including the impacts of network effect on the company's optimal token sales design, such as the optimal token issuance price, the ICO cap (which refers to the number of tokens to be issued), and the amount of funds raised. We also consider the cases of deterministic and uncertain network effects, the impacts of limited speculators purchasing tokens during the ICO period, the comparison between ICOs and traditional bank financing, and the impact of ICO cost. The research unfolds in five key parts. Firstly, leveraging a baseline model, we derive equilibrium outcomes and the optimal token sales design, discerning the impact of deterministic and uncertain network effects. Notably, network effect uncertainty consistently benefits companies, ensuring profit resilience despite potential challenges, although in the face of such uncertainty, the ICO company may decrease the raised fund. Secondly, we investigate the consequences of a limited number of speculators in the ICO landscape, finding that adjustments on the token sales design are not required under low expected network effect. Thirdly, a comparative study between ICOs and bank financing reveals distinctive advantages of ICOs. ICOs prove capable of decreasing profit volatility while maintaining an equivalent profit compared to traditional bank financing. This insight offers valuable guidance for companies seeking optimal financing methods aligned with their risk preferences. Lastly, the impact of ICO cost on outcomes and token sales design is scrutinized. Contrary to expectations, ICO cost does not uniformly lead to an increase in the ICO cap, underscoring the nuanced relationship between costs and fundraising strategies.
Texture analysis of ultrasonography to differentiate metastatic from nonmetastatic cervical lymph nodes in mandibular gingival squamous cell carcinoma
Authors: Kawashima Yusuke , Abe Hiroshi , Hagimoto Aya , Miyakoshi Masaaki , Kawabata Yoshihiro , Indo Hiroko , Tanaka Tatsuro
Published: June 2024

Aim

This study aimed to distinguish between metastatic and nonmetastatic cervical lymph nodes (CLNs) in patients with mandibular gingival squamous cell carcinoma using texture analysis of lymph nodes on ultrasonography images.

Methods

A total of 29 metastatic and 34 nonmetastatic CLNs were selected for this study. Fifty‐six texture characteristics were retrieved from the ultrasonography images using the LIFEx software.

The Mann–Whitney U test was used to evaluate measurable differences in texture characteristics between metastatic and nonmetastatic CLNs. The ability of the surface features to distinguish between metastatic and nonmetastatic CLNs was illustrated using receiver operating characteristic curves. Youden's J statistic was used to determine the receiver operating characteristic curve cutoff values with maximal sensitivity and specificity.

Results

Gray‐level nonuniformity, run length nonuniformity, coarseness, strength, and zone size nonuniformity showed the most notable contrast between the metastatic and nonmetastatic CLNs (p < 0.001). Zone size nonuniformity showed an area under the curve value of 0.827, sensitivity of 0.645, and specificity of 0.972 at the cutoff value of 1010.538.

Conclusion

Qualitative characteristics may be the optimal surface features to distinguish between metastatic and nonmetastatic CLNs and predict CLN metastasis in patients with mandibular gingival squamous cell carcinoma.
Bilabial double lip with blepharochalasis in Laffer‐Aschers syndrome: Report of a rare association
Authors: Ujjya  , Lonyal Jatin , Singh Khushboo , Gupta Srishti R. , Gupta Shalini R.
Published: June 2024

Background

Laffer‐Aschers syndrome (LAS), a rare congenital idiopathic condition, is characterized by double upper lip, recurrent edema of upper eyelids (blepharochalasis), and occasional nontoxic goiter (NTG).

Case Presentation

Two rare cases of bilabial double lip involvement in LAS are presented in young males with blepharochalasis, causing aesthetic concerns and requiring surgical correction for rehabilitation. Evaluation for NTG was negative in both cases. A rare association with alopecia areata was also noted in one case, reported only once before.

Conclusion

The etiology, clinical features, differential diagnosis, investigations, and management are discussed with review of literature of bilabial double lip in LAS.
Comparative fracture surface analysis of adhesively bonded dissimilar lap joints: Nanosilica effect
Authors: Dizaji Shahram A. , Khabaz‐Aghdam Ata , Kandemir Ayşe Çağıl
Published: June 2024

This research presents a comparative analysis of the fracture surfaces of adhesively bonded dissimilar single lap joints (DSLJs) and investigates the effect of nanosilica (NS) additives on their fracture behavior and performance. The study focuses on DSLJs composed of aluminum (Al), stainless steel (SS), copper (Cu), and carbon fiber reinforced polymer (CFRP) adherends bonded with an epoxy adhesive. The fracture surface of DSLJs is further analyzed by introducing two parameters: fractional total fracture area (aT) and the surface sensitivity of each adherend (aSurface). These parameters serve as benchmarks to predict the final load capacity of the adhesive joints. It is found that a decrease in and an increase in the sensitivity of the adherend with a lower Young's modulus lead to higher load capacity. Tensile tests revealed that incorporating NS up to a critical weight percentage of 0.6 wt% improves the proposed surface parameters and significantly contributes to higher levels of load capacity and absorbing greater amounts of energy to failure. Furthermore, numerical simulations offer insights into stress distribution and the mechanism of plastic deformation propagation, providing additional support for the experimental findings.

Highlights

NS up to 0.6 wt% enhances the mechanical properties of DSLJs.

NS–epoxy interactions characterized through Fourier transform infrared and transmission electron microscopy analysis.

Fracture surface patterns help to predict the final load capacity of DSLJs.

Plastic propagation in epoxy verifies fracture surface pattern in DSLJs.
Deformation and energy absorption properties of hollow glass microsphere/polyurethane lightweight core reinforced carbon fiber tubes under lateral compression
Authors: Wang He , Deng Qingyang , Wang Xiao , Chen Lijie
Published: June 2024

Polyurethane has been widely studied as a lightweight reinforcing material. This paper uses two types of hollow glass microspheres to modify polyurethane in different proportions to prepare a variety of lightweight cores for reinforcing carbon fiber tubes. A quasi‐static lateral compression test was performed on the reinforced carbon fiber tube to analyze the effect of reinforcement materials on mechanical properties, failure modes and crashworthiness. The results show that BR20 reinforcement material has the best effect on enhancing the mechanical properties and crashworthiness of the structure, and its energy absorption is 3.5 times higher than that of carbon fiber tubes. Hollow glass microspheres can improve the reinforcing effect of polyurethane. Lightweight cores prepared from different types of hollow glass microspheres show different failure modes during lateral compression (polyurethane and BR60 show better ductility, and BR20 shows shear failure). The BR20 and BR60 are mixed in different proportions, the reinforced polyurethane foam reinforced carbon fiber tube can have little difference in the energy absorption. The addition of BR20 and BR60 showed a large difference in the force‐displacement curve during the compression stage. A qualitative analysis is conducted based on the effect of the total energy absorption of the structure on the reinforcement materials.

Highlights

The lightweight core is prepared by hollow glass microspheres and polyurethane.

Reinforcement materials enhance the lateral compression performance.

Reinforcement materials enhance the crashworthiness performance.

Reinforcement materials affect failure modes.

The proportion of BR20 and BR60 affects the performance of the lightweight core.
A new approach to photochromic nanofiber‐based ultraviolet sensors with grayscale adaptation
Authors: Morsümbül Seniha , Akçakoca Kumbasar E. Perrin , Alır Kıyak Simge , Alemdar Iraz Gizem
Published: June 2024

The purpose of UV sensors is to detect ultraviolet radiation, which is crucial for various applications, such as skin protection, environmental monitoring, and industrial processes where UV exposure poses risks. These sensors provide real‐time data to ensure safety and optimize performance in relevant fields. In this context, the aim of this study was to develop easy‐to‐use UV sensors using photochromic nanofibrous materials. Photochromic nanofibers were obtained by electrospinning thermoplastic polyurethane and a spirooxazine dye. Two solvent systems (only dimethylformamide and a dimethylformamide:dichloromethane mixture) and three dye concentrations (0.5%, 2%, and 5%) were used to produce the nanofibers. Uniform and bead‐free nanofibers were obtained using a dimethylformamide:dichloromethane solvent system. The fatigue resistance of the photochromic nanofibers was tested, revealing a maximum color loss of 14% after 20 on‐off UV cycles. Nanofibers produced with a dimethylformamide:dichloromethane solvent system and a 0.5% dye concentration were chosen for UV sensor design due to their high total color difference. These photochromic nanofibers served as UV indicators, and a grayscale‐ adapted scale was used for evaluation. A UV sensor prototype capable of accurately determining UV exposure levels was successfully developed using photochromic nanofibers. This spectrally selective UV sensor can offer remarkable potential in managing the impact of UVR in our day‐to‐ day life.

Highlights

Bead‐free, uniform nanofibers were obtained using a DMF:DCM solvent system.

The nanofibers returned to their original colorless state in 5 min.

The photochromic nanofibers showed high fatigue resistance.

The nanofiber color indicated the UV intensity by comparing via adapted grayscale.
Use of the iPRISM webtool in a learning community to assess implementation context and fit of a novel clinical decision support tool for physical therapy triage in acute care hospitals
Authors: Johnson Joshua K. , Sullivan Jennifer L. , Trinkley Katy E. , Lapin Brittany , Passek Sandra , Asp Valerie , Ford Bryan , Rabin Borsika A.
Published: June 2024

Background

The iPRISM webtool is an interactive tool designed to aid the process of applying the Practical, Robust Implementation and Sustainability Model (PRISM) for the assessment of and fit with context. A learning community (LC) is a multidisciplinary group of partners addressing a complex problem. Our LC coproduced the Physical TheraPy frEqueNcy Clinical decIsion support tooL (PT‐PENCIL) to guide the use of physical therapist services in acute care hospitals.

Objective

To describe our LC's activities to co‐produce the PT‐PENCIL, use of the iPRISM webtool to assess its preimplementation context and fit, and develop a multicomponent implementation strategy for the PT‐PENCIL.

Design

A descriptive research design.

Setting

Three tertiary care hospitals.

Participants

Thirteen LC partners: six clinical physical therapists, three rehabilitation managers, three researchers, and a bioinformaticist.

Interventions

Not applicable.

Outcome Measures

Using the iPRISM webtool, expected fit of the PT‐PENCIL was rated 1 (not aligned) to 6 (well aligned) for each PRISM domain and expected reach, effectiveness, adoption, implementation, and maintenance were rated 1 (not likely at all) to 6 (very likely). Discrete implementation strategies were identified from the Expert Recommendations for Implementing Change.

Results

The process spanned 18 meetings over 8 months. Ten LC partners completed the iPRISM webtool. PRISM domains with the lowest expected alignment were the “implementation and sustainability infrastructure” (mean = 4.7 out of 6; range = 3–6) and the “external environment” (mean = 4.9 of 6; range = 4–6). Adoption was the outcome with the lowest expected likelihood (mean = 4.5 out of 6; range = 1–6). Six discrete implementation strategies were identified and combined into a multicomponent strategy.

Conclusions

Within a LC, we used existing implementation science resources to co‐produce a novel clinical decision support tool for acute care physical therapists and develop a strategy for its implementation. Our methodology can be replicated for similar projects given the public availability of each resource used.
Digitally skilled or digitally competent? Evaluating the impact of e‐Facilitation on young volunteers in Italy
Authors: Olivanti Francesco , Gastaldi Luca
Published: June 2024

e‐Facilitation services are one of the instruments employed by policymakers to foster digital inclusion. Literature has hypothesized several benefits stemming from these services, including positive effects on the tutors (e‐Facilitators) in terms of competences and employability. Our study takes advantage of a new e‐Facilitation program implemented in Italy—the Servizio Civile Digitale (SCD)—to assess whether the policy is impacting the tutors' skills and to evaluate whether there is a trade‐off in effectiveness due to an ambiguous policy formulation. To deepen these aspects, we have administered two survey waves to SCD applicants, following treatment (recruited) and control group (non‐recruited) for 7 months after the launch of the program. Next, we applied Difference‐in‐Differences, panel models, and a matching model to estimate the treatment effect and control for potential confounders. Results show that volunteers are more active online, use more devices, and perceive improvements in their soft skills, but do not improve in other dimensions of digital competence. This can be explained by the recruitment strategies followed by SCD organizations to maximize their impact on citizens. Our identification is threatened by several sources of potential bias. We address these threats whenever possible, but unobservable factors might still play a role.
Congo red removal from aqueous solution via biosorption onto Trametes trogii‐loaded poly(hydroxyethyl methacrylate) cryogel
Authors: Sarıkaya Aslı Göçenoğlu , Kopar Emre Erden , Osman Bilgen
Published: June 2024

In this study, Trametes trogii‐loaded poly(2‐ hydroxyethyl methacrylate) cryogel (Tt‐PHEMA) was prepared and used as a biosorbent to remove Congo Red (CR), from aqueous solutions. The biomass and Tt‐PHEMA cryogel were characterized with scanning electron microscopy and Fourier Transform infrared spectroscopy. Macroporosity degree (%) and swelling ratio (%) of the Tt‐PHEMA cryogel were determined as 78.3% and 61.04%, respectively. The effect of loaded biomass amount, pH, initial CR concentration, temperature, and contact time were investigated detailedly. The maximum biosorption capacity of Tt‐PHEMA cryogel was 156.71 ± 1.22 mg g−1 at pH 6.0 at 45°C. Biosorption capacity was increased from 125.92 ± 1.524 mg g−1 to 156.71 ± 1.22 mg g−1 with increasing temperature from 25 to 45°C, demonstrating that the biosorption process was endothermic. The biosorption data were well fitted to the Freundlich isotherm and pseudo‐second‐order kinetic models. The negative Gibbs free energy change values showed favorable biosorption. The Tt‐PHEMA cryogel was easily regenerated with ethanol and used repeatedly five times without a significant change in the biosorption capacity. As a result, Trametes trogii‐loaded PHEMA cryogel has an application potential for CR removal from wastewater, taking advantage of interconnected macroporous structure cryogels.
Synchronous improvement in mechanical properties and dielectric performance of poly(silylene arylether arylacetylene) by introducing trifluoromethyl groups
Authors: Gong Changjun , Lv Shuaikang , Liu Shuyue , Yuan Qiaolong , Tang Junkun , Huang Farong
Published: June 2024

Poly(silylene arylether arylacetylene) (PSEA) resin is a promising material for preparing an advanced wave‐transparent composite because of excellent thermal stability and good dielectric properties. Herein, a novel poly(silylene arylether arylacetylene) resin with trifluoromethyl groups (PSEAF) was synthesized by Grignard coupling reaction, and the effects of the incorporation of trifluoromethyl groups on various properties of PSEAF resin and quartz fiber reinforced composites were investigated. Compared to PSEA, the PSEAF resin exhibits better solubility and processability, and lower apparent activation energy for curing reactions. After thermal curing reactions, the PSEAF resin converts to an amorphous crosslinked network with the temperature at 5% weight loss (Td5) around 470 °C. The cured PSEAF resin possesses improved mechanical properties and dielectric properties. The flexural strength arrives at 64.4 MPa, and the dielectric constant (ε) and dielectric loss (tanδ) at 30 MHz are 2.75 and 4.3 × 10−3, respectively. Besides, the quartz fiber reinforced PSEAF composite simultaneously shows ε of 3.3, theoretical wave transmittance |T|2 of 91.4% at 7 GHz, and flexural strength of 350 MPa.
Validation of the Integrated Palliative Care Outcome Scale (IPOS) in adults with cystic fibrosis
Authors: Georgiopoulos Anna M. , DiFiglia Stephanie , Seng Elizabeth K. , Portenoy Russell , Chaudhary Nivedita , Wei Ruobin , Berdella Maria N. , Friedman Deborah , Kier Catherine , Linnemann Rachel W. , Middour‐Oxler Brandi , Stables‐Carney Teresa , Walker Patricia , Wang Janice , Yonker Lael M. , Dhingra Lara
Published: June 2024

Background

A primary palliative care model for cystic fibrosis (CF) recommends using the Integrated Palliative Care Outcome Scale (IPOS) for screening. Validation of the IPOS is needed.

Methods

This secondary analysis utilized baseline data from a multisite trial of the palliative care model, Improving Life with CF. Adults with CF completed the IPOS, the Memorial Symptom Assessment Scale‐CF (MSAS‐CF), the CF Questionnaire‐Revised (CFQ‐R), the Patient Health Questionnaire (PHQ‐8), the Generalized Anxiety Disorder (GAD‐7), and the Perceived Stress Scale (PSS). IPOS structure was assessed using Cronbach α coefficients and a factor analysis. Construct validity was evaluated through bivariate relationships between IPOS scores and other questionnaire scores, and linear regressions assessing the extent to which the IPOS explains variance in quality‐of‐life domains.

Results

The sample comprised 256 adults with complete IPOS data. α coefficients were .86 for the IPOS total score, .81 for the Physical Symptoms subscale, .79 for the Emotional Symptoms subscale, and .63 for the Communication/Practical Issues subscale. A two‐component factor structure best aligned with the current subscales. IPOS scores were significantly associated with other measures; associations with MSAS‐CF and CFQ‐R subscales differentiated the IPOS Physical and Emotional subscales. The IPOS total score provided unique information about the variance in the CFQ‐R Physical Functioning and Respiratory Symptoms domain scores.

Conclusions

In adults with CF, the IPOS has acceptable internal consistency and there is evidence of construct validity. These findings support adoption of the IPOS in the primary palliative care model for CF.
Image‐guided multiparametric magnetic resonance imaging‐transrectal ultrasound fusion biopsy augmented with a sextant versus an extended template random biopsy: Comparison of cancer detection rates, complication and functional outcomes
Authors: Adams Eric S. , Deivasigamani Sriram , Kotamarti Srinath , Wolf Steven , Mottaghi Mahdi , Aminsharifi Ali , Taha Terek , Seguier Denis , Michael Zoe , Ivey Michael , Gupta Rajan T. , Polascik Thomas J.
Published: June 2024

Purpose

To compare the efficacy of a novel fusion template “reduced six‐core systemic template and multiparametric magnetic resonance imaging/transrectal ultrasound (mpMRI/TRUS) fusion targeted biopsy” (TBx+6c), with mpMRI/TRUS fusion‐targeted biopsy and 12‐core systematic biopsy template (TBx+12c) in the diagnosis of prostate cancer (PCa).

Materials and Methods

This is an institutional review board approved single‐center observational study involving adult men undergoing fusion‐targeted biopsies for the diagnosis of PCa. Patients were sorted into cohorts of TBx+6c or TBx+12c based on the systematic biopsy template used. The study's main objective was to determine the cancer detection rate (CDR) for overall PCa and clinically significant PCa (csPCa) and the secondary objectives were to compare complication rates and functional outcome differences between the cohort.

Results

A total of 204 patients met study's inclusion criteria. TBx+6c group had 120 patients, while TBx+12c cohort had 84 patients. The groups had similar baseline characteristics and overall CDR in the TBx+6c cohort was 71.7% versus 79.8%, compared to the TBx+12c (p = 0.18) whereas, the csPCa detection rate in the TBx+6c group was 50.8% versus 54.8% in the TBx+12c group (p = 0.5). TBx+6c cohort had lower overall complication rate of 3% versus 13%, (p = 0.01) and ≥ grade 2 complication rates (1 (1%) vs. 3(4%), p = 0.03) compared to the TBx+12c cohort. There were no differences in IIEF‐5 (p = 0.5) or IPSS (p = 0.1) scores at baseline and 2‐weeks and 6‐weeks post‐biopsy.

Conclusion

TBx+6c cohort, when compared to the TBx+12c cohort, demonstrated comparable diagnostic performance along with similar functional outcomes and lower complication rates. These results suggest the importance of further exploring the clinical implications of adopting a TBx+6c schema for PCa diagnosis in comparison to the widely used TBx+12c schema through a multicenter randomized controlled trial.
Structural characterization of sphingomyelins from tissue using electron‐induced dissociation
Authors: Yan Tingting , Prentice Boone M.
Published: June 2024

Rationale

Sphingomyelins (SMs) and resulting metabolic products serve important functional and cell signaling roles and can act as potential biomarkers and therapeutic targets in many pathological disorders. SMs each contain a sphingoid base, an amide‐linked fatty acyl chain, and a phosphocholine headgroup. Despite these simple building blocks, variations and modifications of both the sphingoid base and the fatty acyl chain result in a diverse array of structurally complicated SM compounds. Conventional tandem mass spectrometry (MS/MS) using the collision‐induced dissociation (CID) method only provides limited structural information, necessitating other tools to unravel the structural complexity of these lipids.

Methods

We utilize electron‐induced dissociation (EID) and sequential CID/EID approaches to elucidate detailed structural features of SMs. Integrating the CID/EID method into an imaging MS workflow enables accurate identification of SMs directly from kidney tissue.

Results

The application of EID enables identification of SMs at the molecular species level, identifying the sphingosine base and the amide‐linked fatty acyl chains. Furthermore, removal of the phosphocholine headgroup via CID followed by sequential EID in an MS3 analysis (CID/EID) enhances the structural information obtained. CID/EID provides diagnostic fragmentation patterns revealing the hydroxylation site and double bond position in both the sphingosine base and amide‐linked fatty acyl chains.

Conclusions

Detailed structural information of SMs from synthetic standards and biological tissue samples is obtained using an alternative electron‐based dissociation method. Accurate characterization of SMs promises to better inform studies of tissue biochemistry, lipid metabolism, and molecular pathology.
Meigs syndrome presenting with recurrent unilateral pleural effusion
Authors: Ng Boon Hau , Johari How Sarah Hani , Abeed Nik Nuratiqah Nik , Low Hsueh Jing , Osman Rose Azzlinda , Yu‐Lin Andrea Ban
Published: June 2024

Pelvic tumours are a rare cause of pleural effusion. We describe an approach to a case of Meigs syndrome with recurrent unilateral pleural effusion. A woman in her 60s' presented with recurrent right‐sided pleural effusion, leading to cough and shortness of breath. Thoracentesis yielded exudative pleural fluid with cytology negative for malignancy. Pleuroscopy revealed inflamed pleura, and pleural biopsy was consistent with inflammatory changes. The patient's cancer antigen 125 level was elevated at 256 U/mL. Given the high suspicion of malignancy, a computed tomography scan of the chest, abdomen, and pelvis was performed and revealed ascites and a large left ovarian and uterine mass. The patient underwent a total abdominal hysterectomy and bilateral salphingo oophorectomy after experiencing three additional episodes of pleural effusion. Histological examination revealed the left ovarian mass to be a cellular fibroma and the uterine masses to be leiomyomata. Following the operation, there was no recurrence of pleural effusion.