bluuebunny/crossref_metadata_2025 huggingface dataset:
Reassessing the measurement and presence of therapeutic misconception in a phase 1 setting
Authors: Abernethy Eli R. , Campbell Gavin P. , Hianik Rachel S. , Thomson Mary Catherine , Blee Shannon M. , Sibold Hannah C. , Dixon Margie D. , Switchenko Jeffrey M. , Pentz Rebecca D.
Published: June 2021

Background

Therapeutic misconception (TM) refers to research subjects' failure to distinguish the goals of clinical research from standard personal care. TM has traditionally been determined by questioning the patient about the research study's purpose. Recent research, however, has questioned whether TM is as prevalent as reported due to discrepancies between patient/researcher interpretations of TM questions. The authors have created an interview tool receptive to these advancements to more accurately determine the prevalence of TM.

Methods

Patients were questioned about the trial's purpose as follows: 1) “Is the trial mostly intending to help research and gain knowledge?,” 2) “Is it mostly intending to help you as a person?,” or 3) “Don't know.” Participants were then asked what they thought this question was asking: A) “What my own intentions are for participating,” B) “What the official purpose of the research study is,” or C) “Not sure.” A patient exhibited TM by answering that the official trial purpose was to help him or her.

Results

Patients (n = 98) had a mean age of 60 years, were mostly White (64%), had a combined family annual income ≥$60,000 (61%), and 49% had a college degree. Twelve of 98 patients (12%) definitely exhibited TM. This was much lower than the author's original finding of 68% in a similar cohort. Twenty‐four of 98 patients (24.5%) were unclear about what one or both questions were asking and could not be categorized.

Conclusions

Previously, a patient was thought to have TM if they answered that the purpose of the trial was to benefit to him or her. An additional query about how patients interpreted that question revealed only 12% definitely had TM.

Lay Summary

Therapeutic misconception (TM) refers to research subjects' failure to distinguish the goals of clinical research from standard personal care.

TM signals a basic misunderstanding of the purpose of clinical research, threatening valid informed consent to participate in clinical trials.

TM has traditionally been determined by questioning patients about their research study's purpose. Recent research, however, has questioned whether TM is as prevalent due to discrepancies between patient/researcher interpretations of TM questions.

By developing an interview‐tool receptive to these advancements, we report a lower TM estimate in the phase 1 setting (12%) than we found previously in a similar cohort (68%).
On the new (version 9) American Joint Committee on Cancer tumor, node, metastasis staging for cervical cancer—A commentary
Authors: Torous Vanda F. , Oliva Esther
Published: June 2021

Recently, the American Joint Committee on Cancer (AJCC), in conjunction with the International Union Against Cancer, released an update of their TNM staging for cervical cancer (version 9). Not only does the new version allow for better alignment with the International Federation of Obstetrics and Gynecology (FIGO) system, but there are also important changes that serve to better allow for integration of parameters that clinicians need for management planning and prognosis. These changes are herein outlined in this concise commentary.
Fractal motor activity regulation and sex differences in preclinical Alzheimer's disease pathology
Authors: Gao Lei , Li Peng , Gaba Arlen , Musiek Erik , Ju Yo‐El S. , Hu Kun
Published: June 2021

Introduction

Degradation in fractal motor activity regulation (FMAR), a measure of multiscale self‐similarity of motor control, occurs in aging and accelerates with clinical progression to Alzheimer's disease (AD). Whether FMAR changes occur during the pre‐symptomatic phase of the disease in women and men remains unknown.

Methods

FMAR was assessed in cognitively normal participants (n = 178) who underwent 7 to 14 days of home actigraphy. Preclinical AD pathology was determined by amyloid imaging‐Pittsburgh compound B (PiB) and cerebrospinal fluid (CSF) phosphorylated‐tau181 (p‐tau) to amyloid beta 42 (Aβ42) ratio.

Results

Degradation in daytime FMAR was overall significantly associated with preclinical amyloid plaque pathology via PiB+ imaging (beta coefficient β = 0.217, standard error [SE] = 0.101, P = .034) and increasing CSF tau181‐Aβ42 ratio (β = 0.220, SE = 0.084, P = .009). In subset analysis by sex, the effect sizes were significant in women for PiB+ (β = 0.279, SE = 0.112, P = .015) and CSF (β = 0.245, SE = 0.094, P = .011) but not in men (both Ps > .05). These associations remained after inclusion of daily activity level, apolipoprotein E ε4 carrier status, and rest/activity patterns.

Discussion

Changes in daytime FMAR from actigraphy appear to be present in women early in preclinical AD. This may be a combination of earlier pathology changes in females reflected in daytime FMAR, and a relatively underpowered male group. Further studies are warranted to test FMAR as an early noncognitive physiological biomarker that precedes the onset of cognitive symptoms.
Directional movement of consumer fronts associated with creek heads in salt marshes
Authors: Vu Huy D. , Pennings Steven C.
Published: June 2021

Consumers often deplete local resources and aggregate along edges of remaining resources, forming “consumer fronts.” We examined the factors that promoteSesarma reticulatumcrab aggregations at saltmarsh creek heads to explain the directional but slow movement of these fronts. We also created artificial creek heads to test the hypothesis that hydrological conditions at creek heads create superior habitat for crabs. Soil temperatures were ˜11–12% cooler, hydrogen sulfide concentrations lower (0.0 vs. ˜0.58 mg/L), and dissolved oxygen concentrations twofold higher at the creek head versus the marsh platform. In the artificial creek‐head experiment, altering hydrological conditions led to lower dissolved sulfide levels, higher dissolved oxygen levels, and increased densities of crab burrows andSesarmacrabs. Moreover, the elevation of the soil surface declined rapidly at artificial creek heads versus controls, suggesting that crabs were increasing erosion. Our results suggest that abiotic conditions for crabs are better at the leading edge of the creek head than the trailing edge, explaining the directional movement of the front. Moreover, the speed at which the front propagates appears to be limited by the rate at which the creekhead erodes, rather than by crab mobility. The directional and slow movement ofSesarmafronts compared to consumer fronts of other invertebrates appears to result from the inextricable link betweenSesarmaand marsh geomorphology, whereas other consumer fronts are associated mostly with food resources.
Electronic Properties of Rhenium(I) Carbonyl Complexes Bearing Strongly Donating Hexahydro‐Pyrimidopyrimidine Based Ligands
Authors: Auvray Thomas , Pal Amlan K. , Hanan Garry S.
Published: June 2021

Re(I) tricarbonyl complexes have been synthesized using bi‐ and tridentate ligands equipped with one or two hexahydro‐pyrimidopyrimidine (hpp) units attached to either a pyridine or a pyrazine ring. These complexes have been characterized by NMR, ESI‐MS, vibrational and optical spectroscopies as well as electrochemistry. Their structures were determined via single‐crystal X‐ray crystallography and modelled using both DFT and TD‐DFT methods. The complexes are non‐emissive in solution at room temperature but display emission with mixed intra ligand (major) and metal‐ligand (minor) charge transfer characters at 77 K. Additionally, both pyrazine‐based complexes appear to be emissive in the solid state, presumably due to the presence of intermolecular interactions, as observed in the crystal structure.
Nucleophilic Ring‐Opening of 1,6‐Anhydrosugars: Recent Advances and Applications in Organic Synthesis
Authors: Hazelard Damien , Compain Philippe
Published: June 2021

1,6‐Anhydrosugars provide a valuable source of building blocks for the synthesis of a wide range of compounds of interest, from natural products to medicines. The unique reactivity of these functionalized, homochiral synthons is controlled by the 1,6‐anhydro bridge which locks the conformation of the pyranose ring, provides a dual protection of two hydroxyl groups, and either protects or activates the anomeric position. The concomitant release of the primary hydroxyl group at C‐6 during the ring‐opening step limits protecting group manipulations and enables the design of highly convergent synthetic strategies. In recent years, many examples of stereocontrolled ring‐opening of 1,6‐anhydrosugars by a diversity of nucleophiles, including hetero‐ and C‐nucleophiles, have been reported. The purpose of this review is to present an overview of the recent advances, applications and challenges associated with this process.
Intramolecular Electrochemical Oxybromination of Olefins for the Synthesis of Isoxazolines in Batch and Continuous Flow
Authors: Prabhakar Kale Ajit , Nikolaienko Pavlo , Smirnova Kristina , Rueping Magnus
Published: June 2021

A highly regioselective protocol for the synthesis of isoxazolines through cascade C−O and C−Br bond formation has been developed. The electrochemical approach uses traceless electrons as a sole source of oxidant, thus avoiding the use of stoichiometric organic or inorganic oxidants and provides a mild and environmentally benign alternative pathway for the synthesis of a wide range of valuable substituted isoxazolines from alkenyl oximes in good yields.
Miniature Ion‐selective Electrodes with Mesoporous Carbon Black as Solid Contact
Authors: Zhang Zhehao , Papautsky Ian
Published: June 2021

Herein, we demonstrated miniature solid‐contact ion‐selective electrodes (ISEs) using a commercial mesoporous carbon black (MCB) as ion‐to‐electron transducer. MCB is attractive in its high surface area, good conductivity, relative low cost and availability. ISEs for potassium (K+) and nitrate (NO3−) ions were prepared by subsequently coating the sealed glass capillaries (1.5 mm) with MCB and ion‐selective membranes. Addition of MCB substantially stabilized electrode response by providing adequate double‐layer capacitance and lowering resistance by more than 100× compared to the coated‐wire electrodes. The electrodes exhibited near‐Nernstian slopes of 59.6 (K+ ionophore), 57.8 (K+ ion‐exchanger) and −54.8 (NO3− ion‐exchanger) with standard solutions in the range of 10−5 to 10−1 M. Fast response (∼10 s) and reproducible sensitivities were also obtained in a mixed electrolyte containing interfering ions, although with a baseline drift of 2–10 mV/day in the long term. Importantly, the electrodes can be simply stored in air between measurements and used directly without conditioning in solutions. With simple fabrication and free maintenance, these sensors offer a low cost and convenient alternative to bulk ISEs, especially when sample volumes or space are limited.
An Electrospun Nanofibrous Sensor Based on a Porous (Cr/Zn) Slats Oxide for Voltammetric Detection of Ezetimibe Drug in Real Samples
Authors: Elfiky Mona , Matsuda Atsunori , Salahuddin Nehal
Published: June 2021

Herein, a series of bimetallic slats oxide nanofibers with different molar proportions of Cr: Zn were synthesizedviathe electrospinning method. Nanofibers with a molar proportion of (Cr: Zn=1: 2) [CrZn3] demonstrated a large superficial area (123.3 m2/g) with minimal resistivity. A modulated carbon paste sensor (MCPS) constructed using 1.0 % of [CrZn3] exhibited remarkable surface electrocatalytic activity for oxidation of ezetimibe drug and oxidation reduction of an electroactive probe (K3[Fe(CN6)]). Under optimized conditions, the limit of the detection of the obtained MCPS for ezetimibe in bulk form was 0.024 nmol L−1and its linear range was 0.08–1.5 nmol L−1. The sensor also demonstrated good selectivity toward the drug in human medication and serum fluid.
Riparian vegetation life stages control the impact of flood sequencing on braided river morphodynamics
Authors: Fernandez Rocio L. , McLelland Stuart , Parsons Daniel R. , Bodewes Bas
Published: June 2021

With riverine flooding set to be more frequent in many parts of the world as a result of climate change, the interactions between fluvial morphodynamics and riparian vegetation may depend in part on the sequence of flood events. This paper describes a laboratory study of the geomorphic adjustment of a braided river to sequences of floods across five different strengths of braidplain vegetation. By using alfalfa as a proxy for braidplain vegetation, the differing plant life stages were used to represent the varying strengths of biogeomorphic feedbacks across the floods. Boundary conditions were constrained by sets of experimental runs with both equilibrium sediment loads and deficit loads. Changes in bed topography were monitored and assessed using a detailed digital elevation model, digital imagery and continuous monitoring of the transported sediment. Results demonstrate that in absence of plant colonization, vegetation placed the rivers in a non‐equilibrium condition, in which riparian vegetation encouraged the development of new channels, increased the system channel width and enhanced topographic irregularity, these effects being more noticeable during the low‐flow periods. The morphodynamics was found to be less sensitive to variations in flood discharges as the vegetation influence (strength) increased from minimum to maximum, until vegetation began to die back and the impacts of flood sequences became yet again evident. Although the overall sediment transport rate was reduced under full‐grown vegetation conditions, the presence of the mature plants across the braid bars resulted in the greatest channel scour depths. Results are considered in light of expected changes in flood frequency with climate and likely morphodynamic responses of river systems as a result.
Investigating the Effects of Pesticides on Ramshorn Snails (Planorbella [Helisoma] trivolvis) Infected with Echinostoma spp.
Authors: Svatos Emma , Strasburg Miranda , Boone Michelle D.
Published: June 2021

Globally, parasite-induced diseases in humans and wildlife are on the rise, and pesticide pollution may be a contributing factor. Echinostoma spp. trematode parasites are prominent in North America, and they use ramshorn snails (Planorbella [Helisoma] trivolvis) as intermediate hosts. We investigated the impact of chronic exposure to 1 of 5 pesticide treatments (control, or 50 μg/L of atrazine, glyphosate, carbaryl, or malathion) on uninfected and Echinostoma-infected snails for 41 d in the laboratory. We recorded snail mortality, the number of egg masses laid, change in mass, and behavior. Chronic exposure to atrazine, carbaryl, and malathion significantly decreased snail survival, whereas parasite infection status or exposure to glyphosate did not. Pesticide and parasite treatments did not influence growth or behavior, but parasite infection caused complete reproductive failure in snail hosts. Our results indicated that the direct effects of pesticides could threaten snail populations in natural environments and disrupt host–parasite dynamics.  Environ Toxicol Chem 2021;40:2755–2763. © 2021 SETAC
Shadowboxing the Field: A Black Queer Feminist Praise Song
Authors: Falu Nessette
Published: June 2021

This article situates random public encounters in fieldwork as critical ethnographic “shadowboxing” (James 1999) moments shaping Black queer feminisms for anthropology. Based in Salvador, Bahia, Brazil, I explore the multiangular effects of an impromptu encounter with a gynecologist within the context of the International Women's Day march in 2013. This article maps how my Black queer feminist lens renders visible the rooted mechanisms of power and subsequent erasures of Black women's agency in silence and social action. I rethink how discovery and evidence emerge as “radical data” to frame how Black female bodies become shadows within institutional spaces. It challenges us to boldly call out the radical data that resides beyond the data itself. I engage the scholarship of Black queer and Black feminist scholars as a call for more Black queer feminist praise songs.
Dietary compliance in a randomized double‐blind infant feeding trial during infancy aiming at prevention of type 1 diabetes
Authors: Virtanen Suvi M. , Cuthbertson David , Nucci Anita M. , Hyytinen Mila , Ormisson Anne , Salonen Marja , Turrini Tania , Cummings Elizabeth A. , Bradley Brenda , Tanner‐Blasiar Marilyn , Becker Dorothy J. , Åkerblom Hans K. , Savilahti Erkki , Krischer Jeffrey P. , Knip Mikael ,   the TRIGR Investigators
Published: June 2021

The international Trial to Reduce IDDM in the Genetically at Risk (TRIGR) tested the hypothesis whether extensively hydrolyzed casein‐based versus regular cow's milk‐based infant formula reduces the risk of type 1 diabetes. We describe dietary compliance in the trial in terms of study formula intake, feeding of nonrecommended foods, and serum cow's milk antibody concentration reflecting intake of cow's milk protein among 2,159 eligible newborn infants with a biological first‐degree relative affected by type 1 diabetes and with HLA‐conferred susceptibility to type 1 diabetes. The participating infants were introduced to the study formula feeding at the median age of 15 days with a median duration of study formula use of 63 days. During the intervention, 80% of the infants received study formula. Of these, 57% received study formula for at least 2 months. On average, 45.5 l of study formula were used per infant. Only 13% of the population had received a nonrecommended food by the age of 6 months. The dietary compliance was similar in the intervention and control arm. The reported cow's milk consumption by the families matched very well with measured serum casein IgA and IgG antibody concentration. To conclude, good compliance was observed in this randomized infant feeding trial. Compliance varied between the regions and those infants who were breastfed for a longer period of time had a shorter exposure to the study formula. High dietary compliance in infant feeding trial is necessary to allow accurate interpretation of study results.
Effects of Miao sour soup on hyperlipidemia in high‐fat diet‐induced obese rats via the AMPK signaling pathway
Authors: Yang Hongmei , Xie Jiao , Wang Nanlan , Zhou Qianqian , Lu Yang , Qu Zihan , Wang Huiqun
Published: June 2021

Hyperlipidemia is a common characteristic of obese animals. Identifying the factors involved in the regulation of dietary lipid metabolism is the most beneficial way to improve health. Miao sour soup (MSS) is a fermented food made from tomato and red pepper that contains lycopene, capsaicin, and organic acids. We conducted this study to investigate the regulatory functions and mechanisms of MSS on the blood lipid levels of high‐fat diet‐induced obese rats. In our preventive study, rats were fed normal diet (ND1), high‐fat diet (HFD1), HFD + 4 g/kg BW MSS (HFD + LS1), and HFD + 8 g/kg BW MSS (HFD + HS1). We found that MSS significantly reduced the body weight and fat accumulation and improved the blood lipid levels of rats. MSS significantly increased the expression of AMP‐activated protein kinase‐alpha (AMPKα), attenuated the expression of the adipogenic transcription factor sterol regulatory element‐binding protein‐1c (SREBP‐1c), and suppressed the expression of fatty acid synthase (FAS) and acetyl‐CoA carboxylase alpha (ACCα), the critical regulators of hepatic lipid metabolism. Additionally, we also conducted a treatment study, and we grouped rats to receive ND2, HFD2, PC2, HFD + LS2, and HFD + HS2 for another 10 weeks. MSS treatment reduced the body weight, fat deposition, and percentage of lipid droplets and regulated the plasma lipid content. MSS significantly increased the expression of AMPK and alleviated the expression of SREBP‐1c, ACC, and FAS. Taken together, these findings suggest that MSS prevents and treats hyperlipidemia in obese rats by regulating the AMPK signaling pathway.
Cambrian marine radial cerebroid ooids: Participatory products of microbial processes
Authors: Xiao Enzhao , Riaz Muhammad , Zafar Tehseen , Latif Khalid
Published: June 2021

The Cambrian Miaolingian Series strata at the Kouquan section, North China, are primarily divided into the Xuzhuang, Zhangxia, and Gushan formations. This particular series comprises oolitic limestone in the middle to upper intervals. Thin section observations of carbonate rock samples from the Zhangxia Formation show that the well‐preserved and most remarkable grains among them are cerebroid ooids. Although these ooids have characteristic serrated margins, they are distinct from ooids reported in previous publications due to inconspicuous concentric laminae and radial structures composed of micrite and microspar. To understand the origin of these ooids, we employed petrographic examination, X‐ray diffraction (XRD), scanning electron microscopy (SEM), electron probe microanalysis (EPMA), and isotope analyses to explore their compositions and conditions of development. In addition, the occurrence of these cerebroid ooids is closely related to that of dark‐coloured micrite: most cerebroid ooids and quasi‐cerebroid ooids float inside dark micrite; dark micrite appears in the interior of cerebroid ooids as a radial micrite structure. EPMA and energy‐dispersive X‐ray (EDX) spectroscopy analyses of micrite reveal that the dark micrite consists of lithomicrobial mats. Fine‐scale characterization of the dark micrite inside these cerebroid ooids shows the presence of filamentous and bowl‐shaped calcified microbial fossils and extracellular polymeric substance (EPS) calcified remnants. Isotopic data indicate a variation of δ13C isotopic values between −4.92‰ and −0.11‰ (VPDB) and −9.89‰ and −4.93‰ for δ18O values (VPDB). The negative values of δ13C in the studied ooid suggest the genesis of carbon from the high organic‐rich zone such as the microbial zone. Also, the 13C‐depleted carbon values in the ooids advocate that the carbon is mainly derived from organic sources associated with the sulphate reduction bacterial activity. Thus, isotopic data of this study also provide consistent clues in favour of microbial participation during the genesis of cerebroid ooids. In conclusion, our new findings strongly confirm that the cerebroid ooids of the North China Platform are genetically related to microbial processes.
Regulating AI in Health Care: The Challenges of Informed User Engagement
Authors: Kudina Olya
Published: June 2021

The European Union's proposed Artificial Intelligence Act is a welcome, ambitious law on the regulation of AI systems. However, it underestimates the responsibilities placed on individual users to navigate the implementation of AI. Focusing on the health care sector, this policy piece examines challenges that the proposed law bypasses. First, effective human‐AI collaboration in the diagnostic process hinges on the acknowledgment of AI's mediating role in this process, on forming a diagnostic dialogue between humans and AI. Second, with AI in this mediating role, the meaning of responsibility is changed to accommodate the broadened scope of clinician and patient duties, modified clinical workflows, and emergent medical norms. Finally, the challenge of media literacy concerns both the issues of access to knowledge and the ability to make informed choices regarding human‐AI interaction. This policy piece suggests that embracing the complexity of the use practices is essential to achieving an effective human‐AI partnership, in the medical sector and at large.
Proof‐of‐concept evidence for trimodal simultaneous investigation of human brain function
Authors: Moore Matthew , Maclin Edward L. , Iordan Alexandru D. , Katsumi Yuta , Larsen Ryan J. , Bagshaw Andrew P. , Mayhew Stephen , Shafer Andrea T. , Sutton Bradley P. , Fabiani Monica , Gratton Gabriele , Dolcos Florin
Published: June 2021

The link between spatial (where) and temporal (when) aspects of the neural correlates of most psychological phenomena is not clear. Elucidation of this relation, which is crucial to fully understand human brain function, requires integration across multiple brain imaging modalities and cognitive tasks that reliably modulate the engagement of the brain systems of interest. By overcoming the methodological challenges posed by simultaneous recordings, the present report provides proof‐of‐concept evidence for a novel approach using three complementary imaging modalities: functional magnetic resonance imaging (fMRI), event‐related potentials (ERPs), and event‐related optical signals (EROS). Using the emotional oddball task, a paradigm that taps into both cognitive and affective aspects of processing, we show the feasibility of capturing converging and complementary measures of brain function that are not currently attainable using traditional unimodal or other multimodal approaches. This opens up unprecedented possibilities to clarify spatiotemporal integration of brain function.
Streamflow generation in semi‐arid, glacier‐covered, montane catchments in the upper Shule River, Qilian Mountains, northeastern Tibetan plateau
Authors: Zhou Jiaxin , Ding Yongjian , Wu Jinkui , Liu Fengjing , Wang Shaoping
Published: June 2021

Streamflow generation was investigated using isotopic and geochemical tracers in semiarid, glacier‐covered, montane catchments in the upper Shule River, northeastern Tibetan Plateau. Samples from stream water, precipitation, glacier meltwater, and groundwater were collected at the Suli and Gahe catchments along the Shule River, with an area of 1908 and 4210 km2, respectively. The samples were analysed for stable isotopes of water and major ions. Results of diagnostic tools of mixing models showed that Ca2+, Mg2+ and Cl−, along with δ18O and δ2H, behaved conservatively as a result of mixing of three endmembers. The three endmembers identified by the mixing analysis were surface runoff directly from precipitation, groundwater, and glacier meltwater. Streamflow was dominated by groundwater, accounting for 59% and 60% of streamflow on average in the Suli and Gahe catchments, respectively, with minimum groundwater contribution in July (47% and 50%) and maximum contribution in October (69% and 70%). The contributions of surface runoff were slightly higher in the Suli catchment (25%) than in the Gahe catchment (19%). However, the contributions of glacier meltwater were higher in the Gahe catchment (21%) compared to the Suli catchment (17%), as a result of a higher percentage of glacier covered area in the Gahe catchment. This difference followed well the non‐linear power–law trend of many glacier‐covered catchments around the world. As glacier retreat continues in the future, the reduction of streamflow in glacier‐covered upper Shule catchment likely will be accelerated and possibly elsewhere in the Tibetan Plateau. This study suggests that it is critical to define the turning point of an accelerated reduction in glacier meltwater for glacier‐covered catchments around the world in order to better assess and manage water resources.
Differential impact of COVID‐19 in pregnant women from high‐income countries and low‐ to middle‐income countries: A systematic review and meta‐analysis
Authors: Gajbhiye Rahul K. , Sawant Mamta S. , Kuppusamy Periyasamy , Surve Suchitra , Pasi Achhelal , Prusty Ranjan K. , Mahale Smita D. , Modi Deepak N.
Published: June 2021

Background

SARS‐CoV‐2 has infected a large number of pregnant women.

Objective

To compare clinical, perinatal outcomes of women with COVID‐19 from high‐income countries (HICs) and low‐ to middle‐income countries (LMICs).

Search strategy

Online databases were searched.

Selection criteria

Original studies on pregnant women with COVID‐19 were included.

Data collection and analysis

Information on clinical presentation, co‐morbidities, pregnancy outcomes, neonatal outcomes, and SARS‐CoV‐2 infection in neonates was extracted.

Main results

The pooled estimate of SARS‐CoV‐2 positive neonates is 3.7%. Symptomatic presentations are less common in LMICs compared to HICs (odds ratio [OR] 0.38). Diabetes (OR 0.5), hypertension (OR 0.5), and asthma (OR 0.14) are commonly reported from HICs; hypothyroidism (OR 2.2), anemia (OR 3.2), and co‐infections (OR 6.0) are commonly reported in LMICs. The overall risk of adverse pregnancy outcomes is higher in LMICs compared to HICs (OR 2.4). Abortion (OR 6.2), stillbirths (OR 2.0), and maternal death (OR 7.8) are more common in LMICs. Preterm births and premature rupture of membranes are comparable in both groups. Neonatal deaths (OR 3.7), pneumonia (OR 7.5), and neonatal SARS‐CoV‐2 infection (OR 1.8) are commonly reported in LMICs.

Conclusions

In LMICs, pregnant women and neonates are more vulnerable to adverse outcomes due to COVID‐19.

PROSPERO registration no: CRD42020198743.
Recent advances in antibody‐based immunotherapy strategies for COVID‐19
Authors: Esmaeilzadeh Abdolreza , Rostami Samaneh , Yeganeh Pegah M. , Tahmasebi Safa , Ahmadi Majid
Published: June 2021

The emergence of a new acute respiratory syndrome Coronavirus 2 (SARS‐CoV‐2), the cause of the 2019‐nCOV disease (COVID‐19), has caused a pandemic and a global health crisis. Rapid human‐to‐human transmission, even from asymptomatic individuals, has led to the quick spread of the virus worldwide, causing a wide range of clinical manifestations from cold‐like symptoms to severe pneumonia, acute respiratory distress syndrome (ARDS), multiorgan injury, and even death. Therefore, using rapid and accurate diagnostic methods to identify the virus and subsequently select appropriate and effective treatments can help improvement of patients and control the pandemic. So far, various treatment regimens along with prophylactic vaccines have been developed to manage COVID‐19‐infected patients. Among these, antibody‐based therapies, including neutralizing antibodies (against different parts of the virus), polyclonal and monoclonal antibodies, plasma therapy, and high‐dose intravenous immunoglobulin (IVIG) have shown promising outcomes in accelerating and improving the treatment process of patients, avoiding the viral spreading widely, and managing the pandemic. In the current review paper, different types and applications of therapeutic antibodies in the COVID‐19 treatment are comprehensively discussed.
Mechanistic insights on nsSNPs on binding site of renin and cytochrome P450 proteins: A computational perceptual study for pharmacogenomics evaluation
Authors: Loganathan Lakshmanan , Kuriakose Beena Briget , Mushfiq Sakeena , Muthusamy Karthikeyan
Published: June 2021

Past several decades, therapeutic investigations lead to the discovery of numerous antihypertensive drugs. Although it has been proved for their potency, altered efficacy is common norms in several conditions due to genetic variations. Cytochrome P450 plays a crucial role in drug metabolism and responsible for the pharmacokinetic and pharmacodynamic properties of the drug molecules. Here, we report the deleterious point mutations in the genes associated with the altered response of antihypertensive drug molecules and their metabolizers. Missense variants were filtered as potential nonsynonymous single nucleotide polymorphisms among the available data for the target genes (REN, CYP2D6, CYP3A4). The key objective of the work is to identify the deleterious single nucleotide polymorphisms (SNPs) responsible for the drug response and metabolism for the application of personalized medication. The molecular docking studies revealed that Aliskiren and other clinically approved drug molecules have a high binding affinity with both wild and mutant structures of renin, CYP2D6, and CYP3A4 proteins. The docking (Glide XP) score was observed to have in the range of −8.896 to −11.693 kcal/mol. The molecular dynamics simulation studies were employed to perceive the structural changes and conformational deviation through various analyses. Each studied SNPs was observed to have disparate scoring in the binding affinity to the specific drug molecules. As a prospective plan, we assume this study might be applied to identify the risky SNPs associated with hypertension from the patients to recommend the suitable drug for personalized hypertensive treatment. Further, extensive clinical pharmacogenomics studies are required to support the findings.
Resolvable cycle decompositions of complete multigraphs and complete equipartite multigraphs via layering and detachment
Authors: Bahmanian Amin , Šajna Mateja
Published: June 2021

We construct new resolvable decompositions of complete multigraphs and complete equipartite multigraphs into cycles of variable lengths (and a perfect matching if the vertex degrees are odd). We develop two techniques: layering, which allows us to obtain 2‐factorizations of complete multigraphs from existing 2‐factorizations of complete graphs, and detachment, which allows us to construct resolvable cycle decompositions of complete equipartite multigraphs from existing resolvable cycle decompositions of complete multigraphs. These techniques are applied to obtain new 2‐factorizations of a specified type for both complete multigraphs and complete equipartite multigraphs, with the emphasis on new solutions to the Oberwolfach Problem and the Hamilton–Waterloo Problem. In addition, we show existence of some thickly resolvable cycle decompositions.
MiR equal than others: MicroRNA enhancement for cutaneous wound healing
Authors: Ross Kehinde
Published: June 2021

Keratinocyte migration is vital in the re‐epithelialisation of the skin during wound healing. Multiple factors conspire to impair closure of chronic wounds such as diabetic foot ulcers, venous leg ulcers and pressure wounds. Despite deep mechanistic understanding of microRNA (miRNA) biogenesis and function, the translational potential of these small genetic molecules has not been exploited to promote wound repair. In this review, I focus on miRNAs whose importance for wound healing stems from their impact on epidermal keratinocyte behaviour. These include miR‐21‐5p, miR‐31‐5p, miR‐132‐3p, miR‐19b, miR‐20a, miR‐184, miR‐129‐5p and miR‐335‐5p which regulate diverse aspect of keratinocyte biology such as migration, proliferation, differentiation, inflammation and wound closure. A combinatorial approach where two or more miRNA mimics targeting distinct but complementary wound healing processes is proposed as this may enhance wound repair more effectively than any single miRNA mimic alone.
Bonds of time and space: Divination and the psychiatric encounter
Authors: Baum Emily
Published: June 2021

This essay examines the intersections between divination and psychiatry in the context of modern Chinese history. Throughout the 20th century, subsequent political regimes attempted to drive an ontological wedge between psychiatry, which was deemed scientific, and divination, which was deemed superstitious. While the dichotomy between science and superstition remains a powerful ideology today, it belies the use of divination as a psychotherapeutic tool. Occult practices such as fortune telling and shamanism complement the application of technical psychiatric skills by serving a crucial moral and interpersonal function, one that has important implications for the practice of mental healthcare both within and beyond Asia.
Ritual futures: Spirit mediumship as chronotopic labor
Authors: Ng Emily
Published: June 2021

This essay reflects on the still‐present difficulty in approaching contemporary rural mediumship as coeval with their urban psychotherapeutic counterparts. Drawing on ethnographic work in rural Henan province in central China, I describe how both rurality and spirit mediumship have been rendered anachronistic through national imaginaries, anti‐superstition campaigns, and psychiatric discourses. The essay centers on the case of a spirit medium located in the psychiatric unit, and the social evolutionary and developmentalist temporalities condensed in her cultural psychiatric diagnosis. I then turn to the medium's ritual work and cosmological account, which invert mediumship's position in space and time. The essay approaches mediumship's rituals as a form of chronotopic labor, which reworks the spatio‐temporal coordinates they inherit from within. It closes by bringing together the conundrums of rural mediumship and those of urban psychotherapeutic and diasporic worlds, to consider psychic landscapes of dislocation, and other formulations of futures to come.
Respiratory viruses in the healthy middle ear and middle ear with otitis media with effusion
Authors: Durmaz Bengul , Abdulmajed Olkar , Durmaz Rıza , Koroglu Mehmet , Arı Oguz , Celik Serdal , Kalcioglu Mahmut Tayyar
Published: June 2021

To investigate the presence of respiratory viruses in the middle ear cavity of the individuals with a healthy middle ear and the children with otitis media with effusion (OME). A total of 72 middle ear samples were collected from 25 children with OME (Group 1) and 47 individuals with no middle ear disease (Group 2). Multiplex real‐time polymerase chain reaction was used to investigate the presence of 20 different respiratory viruses. Virus results were compared with bacteriomes of the same populations. At least one respiratory virus was detected in 56% of the patients in Group 1 and 12.8% of the individuals in Group 2. The viral co‐infection rate for Group 1 and 2 was 8% and 2.1%, respectively. In Group 1, adenovirus was the most frequently detected virus with a rate of 24%, either alone (16%) or concurrent with other viruses (8%), followed by influenza B (12%), rhinovirus, and bocavirus (8%) each. Parainfluenza 4, coronavirus OC43, and RSV A/B were detected in 4% of the sample each. In Group 2, rhinovirus was detected in two samples (4.3%) followed by adenovirus, coronavirus OC43, coronavirus E299, and coronavirus NL63 with a rate of 2.1% each. The detection rate of respiratory viruses was significantly higher in children aged 6 to 11 years. There was no positive association between virus and bacteria found in the middle ear cavity. The current study has provided comprehensive data indicating the presence of diverse respiratory viruses in the healthy middle ear cavity. Our results also suggest that respiratory viruses might have a contribution to OME pathogenesis.
Socioeconomic Status and Survival in Nasopharyngeal Carcinoma: A Population‐Based Study
Authors: Brody‐Camp Sabrina , McCoul Edward D. , Lefante John J. , Aslam Rizwan
Published: June 2021

Objectives/Hypothesis

To evaluate survival for nasopharyngeal carcinoma in relation to socioeconomic status.

Study Design

Retrospective cohort study using the Surveillance, Epidemiology, and End Results (SEER) Census Tract‐level Socioeconomic Status Database (2000–2016).

Methods

Patients with nasopharyngeal carcinoma diagnosed between 2000 and 2016 were identified. Data were stratified based on socioeconomic status, divided into three groups: group 1 being the poorest and group 3 the wealthiest. Univariate analysis as well as multivariate Cox regression analysis adjusted for individual variables was performed.

Results

A total of 5,527 patients were included in the study, with 33% in group 1, 34% in group 2, and 33% in group 3. There was a significant difference between groups in regard to age at diagnosis, race, histologic subtype, overall stage, tumor stage, nodal stage, and whether or not they received radiation. Patients in group 1, the poorest socioeconomic status, were more likely to be young (P = .003), black (P < .0001), present with higher overall stage (P = .009), tumor stage (P = .01), and nodal stage (P = .02), and less likely to receive radiation (P = .005). In multivariate analysis, there was a significant difference in survival between the groups, with group 1 patients less likely to survive compared to group 3 (hazard ratio = 1.28; 95% CI 1.07–1.57).

Conclusions

Patients in the poorest socioeconomic status presented with more advanced nasopharyngeal cancer and were less likely to receive radiation when compared with individuals of higher socioeconomic status. The poorest socioeconomic status groups were less likely to survive from their disease when controlling for other variables.

Level of Evidence

NA Laryngoscope, 131:2719–2723, 2021
Three‐Dimensional printed instruments used in a Septoplasty: A new paradigm in Surgery
Authors: Zaidi Syed , Naik Paresh , Ahmed Shahzada
Published: June 2021

Objective

Three‐dimensional (3D) printing has been rapidly adopted by different surgical disciplines. It has shown itself to have improved outcomes in education, pre‐operative planning, and reconstruction. However, using 3D printing to create surgical instruments is a niche within the literature that has not yet been fully explored. The authors present a study in which it is hypothesized that 3D printing surgical instruments can be utilized successfully within ENT surgery.

Methods

As one of the most common ENT operations worldwide, a septoplasty was chosen as the procedure to provide proof of concept. For the septoplasty, five instruments were printed: a scalpel handle, needle holders, toothed forceps, a Cottle/Freer elevator, and a Killian's speculum. The entire set took 224 minutes on average to print, weighed 36 g, and only used approximately 86 pence ($1.20 USD) worth of polylactic acid plastic to create.

Results

All steps in performing a septoplasty on a human cadaver with the 3D printed tools were possible and were undertaken successfully. This yielded a similar outcome to using stainless steel with the added benefit of there being a large reduction in cost and the ability for rapid customization according to the surgeon's preferences.

Conclusion

As technology and mainstream interest in 3D printing develops, the availability of more precise Computer‐Aided Design software will allow for more complex designs of tools to be created. Currently, 3D printing has been shown to be a promising method from which future surgical tools can be fashioned to meet the complex, dynamic demands of surgery.

Level of Evidence

N/A.
Contrasting fishing effort reduction and habitat connectivity as management strategies to promote alewife (Alosa pseudoharengus) recovery using an ecosystem model
Authors: Dias Beatriz S. , Frisk Michael G. , Jordaan Adrian
Published: June 2021

Small pelagics, or forage fish, link lower and higher trophic levels in marine food webs. Recently, attention has been given to the management of forage fish, including anadromous river herring (Alewife Alosa pseudoharengus, blueback herring A. aestivalis) and American shad (A. sapidissima) due to their current depleted status and historically important ecological and economic roles. Little is known about the impact of changes in their biomass on marine food webs and what management practices will promote their recovery. Estimated historical riverine productivity was utilized to evaluate potential ecosystem impacts of the increasing river to ocean connectivity to resemble 19th‐century conditions. The Ecopath with Ecosim modeling framework was used to simulate management strategies, focused on anadromous forage fish, by creating scenarios of fisheries reduction (mixed fishery effort reduction) and river to ocean habitat connectivity (75% of historical connectivity achieved). Sixty‐year simulations covered the entire time series including a 36‐year forecast period to evaluate the ecosystem impacts of management strategies. Results suggest nonlinear relationships and large changes in biomass flows from forage fish to upper trophic levels in the Gulf of Maine ecosystem. Increases in biomass were observed for pelagic sharks, demersal piscivores, and species of conservation concern such as pinnipeds and seabirds, although overall results were strongly influenced by indirect trophic effects. Promoting anadromous forage fish recovery through increased connectivity resulted in the redundancy of marine ecosystem niches that would increase resilience to climate, fisheries, and other perturbations. This study highlights the value of employing ecosystem models for testing management scenarios to contrast different approaches to recover anadromous forage fish towards its former ecological prominence.
Real‐Time Spectral Evolution of Interchain Coupling and Assembling during Solvent Vapor Annealing of Dispersed Conjugated Polymers
Authors: Chou He‐Chun , Hsu Wei‐Chieh , Yang Yajing , Schanze Kirk S. , Luo Shyh‐Chyang , Chen Chi
Published: June 2021

Solvent vapor annealing (SVA) for polymer treatment is widely used for manufacturing organic photovoltaic devices, but the process is poorly understood on the microscopic scale. In this study, an optical monitoring system is designed and used to perform real‐time fluorescence analysis of dispersed poly(3‐hexylthiophene) (P3HT) and para‐phenylene ethynylene (PPE) films during SVA. The initial swelling of aggregates occurs within seconds. Chain rearrangements then occur and an equilibrium state is reached within minutes. Surface morphologies for both P3HT and PPE polymers are examined using atomic force microscopy (AFM) before and after the SVA process. Although similar transformations from random globules to micrometer‐scale nanowires are observed for both polymers, P3HT forms nanowires more easily and quickly than PPE does. The higher solubility of P3HT in chloroform results in superior long‐range order; by contrast, PPE chains align into nanowires only with sufficient free space. Real‐time spectroscopic monitoring of structures and morphological characterization of such structures through AFM during SVA can improve the understanding of how polymer chains rearrange into ordered structures.
Learn Intestinal Failure Tele‐ECHO Project: An innovative online telementoring and case‐based learning clinic
Authors: Winkler Marion F. , Tappenden Kelly A. , Spangenburg Michelle , Iyer Kishore
Published: June 2021

Intestinal failure (IF) is a rare chronic disease requiring intravenous (IV) fluids or parenteral nutrition (PN) dependency for optimal patient health and sustenance. The complex care is best managed by specialized multidisciplinary teams. Patients who have limited access to intestinal rehabilitation centers often receive IV/PN care from clinicians lacking specialty expertise. An innovative videoconferencing project was launched in May 2019 to provide online telementoring and case‐based learning in IF. The Extension for Community Healthcare Outcomes (ECHO) model was adopted to provide education and virtual support via the Learn Intestinal Failure Tele‐ECHO (LIFT‐ECHO) project. Online clinics include patient case presentations, moderated discussion, best‐practice recommendations, and didactic continuing education lectures on IF‐ and PN‐related topics. Participation is interprofessional and international. Via knowledge dissemination and specialty mentorship, LIFT‐ECHO is expected to improve healthcare for patients with IF and transform care delivery by overcoming the limitations in access to expertise.