bluuebunny/crossref_metadata_2025 huggingface dataset:
Demographic Distribution of Oculoplastic Disorders in Port Harcourt Nigeria
Authors: Ejimadu C. S. , Chinawa N. E. , Theophilus B.
Published: December 2019

Aim: To find the age and gender variation in oculoplastic-related disorders in Port Harcourt.

Methods: This study was a hospital-based retrospective study involving retrieval of records of all oculoplastic disorders University of Port Harcourt Teaching Hospital (UPTH), Nigeria. The various ocular disorders in the hospital are routinely entered into an Ophthalmology register from where the data were extracted. Data analysis was performed using United States Centers for Disease Control and Prevention (CDC) Epi-Info version 7 software.

Results: The commonest case was Chalazion (32%) followed by Ocular Surface Squamous Neoplasia (8.9%), Thyroid Eye Disease, Nasolacrimal Duct Obstruction both contributing 5.7% each. There were 49 (39.8%) males and 74 (60.2%) females. The male to female ratio was 2:3.The commonest affected age group was 21-30 years (33.3%),followed by 31-40 years(15.5%).The least affected age group were those that were above 70 years which constituted 2.4%.

Conclusion: Female gender and the age group of 21-30 were seen more with oculoplastic conditions probably due to the more sensitivity of females and also of these young adults to cosmetic blemishes posed oculoplastic related cases.
Family History of Rheumatic, Autoimmune, and Nonautoimmune Diseases and Risk of Rheumatoid Arthritis
Authors: Kronzer Vanessa L. , Crowson Cynthia S. , Sparks Jeffrey A. , Myasoedova Elena , Davis John
Published: December 2019

Objective

Since comorbidities such as autoimmune diseases may be associated with rheumatoid arthritis (RA) risk, we hypothesized that a family history of these other conditions might also predict RA. Therefore, we aimed to determine the association between family history of 79 comorbidities and RA.

Methods

This case–control study identified 821 cases of RA in the Mayo Clinic Biobank (positive predictive value 95%) and matched 3 controls to each case based on age, sex, recruitment year, and location. Patients self reported family history and characteristics (adjusted). Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) for RA risk according to the presence of family history for each comorbidity, adjusted for body mass index, race, and smoking.

Results

Family history of several conditions was associated with developing RA, including rheumatic autoimmune diseases (ORadj 1.89 [95% CI 1.41–2.52]), pulmonary fibrosis (ORadj 2.12 [95% CI 1.16–3.80]), inflammatory bowel disease (ORadj 1.45 [95% CI 1.05–1.98]), hyper/hypothyroidism (ORadj 1.34 [95% CI 1.10–1.63]), and obstructive sleep apnea (ORadj 1.28 [95% CI 1.05–1.55]). Parkinson’s disease and type 2 diabetes mellitus were associated with a statistically decreased risk of RA that did not reach the prespecified significance threshold of P < 0.01 (ORadj 0.70 [95% CI 0.49–0.98] and ORadj 0.81 [95% CI 0.67–0.97], respectively). Analyses among 143 cases of incident RA were similar and also suggested an association with a family history of autism (OR 10.5 [95% CI 2.51–71.3]).

Conclusion

Family history of several autoimmune and nonautoimmune comorbidities was associated with increased risk of RA, providing an opportunity to identify novel populations at risk for RA.
Cu Intercalation and Br Doping to Thermoelectric SnSe2 Lead to Ultrahigh Electron Mobility and Temperature‐Independent Power Factor
Authors: Zhou Chongjian , Yu Yuan , Zhang Xiangzhao , Cheng Yudong , Xu Jingtao , Lee Yong Kyu , Yoo Byeongjun , Cojocaru‐Mirédin Oana , Liu Guiwu , Cho Sung‐Pyo , Wuttig Matthias , Hyeon Taeghwan , Chung In
Published: December 2019

Due to its single conduction band nature, it is highly challenging to enhance the power factor of SnSe2 by band convergence. Here, it is reported that simultaneous Cu intercalation and Br doping induce strong Cu–Br interaction to connect SnSe2 layers, otherwise isolated, via “electrical bridges.” Atom probe tomography analysis confirms a strong attraction between Cu intercalants and Br dopants in the SnSe2 lattice. Density functional theory calculations reveal that this interaction delocalizes electrons confined around SnSe covalent bonds and enhances charge transfer across the SnSe2 slabs. These effects dramatically increase electron mobility and concentration. Polycrystalline SnCu0.005Se1.98Br0.02 shows even higher electron mobility than pristine SnSe2 single crystal and the theoretical expectation. This results in significantly improved electrical conductivity without reducing effective mass and Seebeck coefficient, thereby leading to the highest power factor of ≈12 µW cm−1 K−2 to date for polycrystalline SnSe2 and SnSe. It even surpasses the value for the state‐of‐the‐art n‐type SnSe0.985Br0.015 single crystal at elevated temperatures. Surprisingly, the achieved power factor is nearly independent of temperature ranging from 300 to 773 K. The engineering thermoelectric figure of merit ZTeng for SnCu0.005Se1.98Br0.02 is ≈0.25 between 773 and 300 K, the highest ZTeng ever reported for any form of SnSe2‐based thermoelectric materials.
The Quest for Zero Loss: Unconventional Materials for Plasmonics
Authors: Cortie Michael B. , Arnold Matthew D. , Keast Vicki J.
Published: December 2019

There has been an ongoing quest to optimize the materials used to build plasmonic devices: first the elements were investigated, then alloys and intermetallic compounds, later semiconductors were considered, and, most recently, there has been interest in using more exotic materials such as topological insulators and conducting oxides. The quality of the plasmon resonances in these materials is closely correlated with their structure and properties. In general gold and silver are the most commonly specified materials for these applications but they do have weaknesses. Here, it is shown how, in specific circumstances, the selection of certain other materials might be more useful. Candidate alternatives include TixN, VO2, Al, Cu, Al‐doped ZnO, and Cu–Al alloys. The relative merits of these choices and the many pitfalls and subtle problems that arise are discussed, and a frank perspective on the field is provided.
Soft Hybrid Scaffold (SHS) Strategy for Realization of Ultrahigh Energy Density of Wearable Aqueous Supercapacitors
Authors: Shang Jian , Huang Qiyao , Wang Lei , Yang Yu , Li Peng , Zheng Zijian
Published: December 2019

Future wearable electronics requires safe and high‐energy‐density supercapacitors (SCs). Commercial SCs making use of organic electrolytes show high energy density, but the flammability of the electrolyte raises serious safety concerns. Aqueous SCs, on the other hand, are very safe, but the energy density is low due to the much narrower voltage window and the difficulty of fabricating thick electrodes. A new materials strategy named soft hybrid scaffold (SHS), which allows easy buildup of ultrathick electrodes made of 3D porous pseudo‐material‐modified carbon networks, is reported. The carbon network provides excellent mechanical stability and electric conductivity, the hierarchically porous structures ensure rapid ionic transport, and the pseudomaterials enlarge the electrochemical window. Asymmetric aqueous SCs using SHS electrodes show higher energy density than both commercial organic SCs and literature‐reported aqueous SCs, with good cycle life and mechanical flexibility. The aqueous SC device is tailorable, waterproof, and fire‐retardant, representing a high safety toward practical applications.
Mechanotunable Plasmonic Properties of Colloidal Assemblies
Authors: Brasse Yannic , Gupta Vaibhav , Schollbach H. C. Tomohiro , Karg Matthias , König Tobias A. F. , Fery Andreas
Published: December 2019

Noble metal nanoparticles can absorb incident light very efficiently due to their ability to support localized surface plasmon resonances (LSPRs), collective oscillations of the free electron cloud. LSPRs lead to strong, nanoscale confinement of electromagnetic energy which facilitates applications in many fields including sensing, photonics, or catalysis. In these applications, damping of the LSPR caused by inter‐ and intraband transitions is a limiting factor due to the associated energy losses and line broadening. The losses and broad linewidth can be mitigated by arranging the particles into periodic lattices. Recent advances in particle synthesis, (self‐)assembly, and fabrication techniques allow for the realization of collective coupling effects building on various particle sizes, geometries, and compositions. Beyond assemblies on static substrates, by assembling or printing on mechanically deformable surfaces a modulation of the lattice periodicity is possible. This enables significant alteration and tuning of the optical properties. This progress report focuses on this novel approach for tunable spectroscopic properties with a particular focus on low‐cost and large‐area fabrication techniques for functional plasmonic lattices. The report concludes with a discussion of the perspectives for expanding the mechanotunable colloidal concept to responsive structures and flexible devices.
Robust Triboelectric Nanogenerator with Ratchet‐like Wheel‐Based Design for Harvesting of Environmental Energy
Authors: Gao Qi , Li Yikang , Xie Zhijie , Yang Weixiong , Wang Zheng , Yin Mengfei , Lu Xiaohui , Cheng Tinghai , Wang Zhong Lin
Published: December 2019

In this study, a ratchet‐like wheel‐based and spring‐assisted sustainable triboelectric nanogenerator (RS‐TENG) is fabricated for an efficient harvesting of rotational motion. The multitooth structure of the ratchet‐like wheel and force of the spring are used to convert the rotational motion induced by mechanical energy in the environment (such as wind energy) into a reciprocating linear motion of the movable parts, making two triboelectric layers of each sub‐triboelectrification unit produce contact–separation motion to achieve power output. The power output of one subunit is ≈0.37 mW at a uniform speed of 60 rpm, and the power output can increase to 6.05 mW by parallel connection of six subunits. The RS‐TENG with parallel connection of six subunits exhibits an open‐circuit voltage of 320 V throughout the 8 h of continuous operation (≈345 600 contact–separation events), reflecting its excellent durability and robustness. The thermometer can be stably powered at a wind speed of 15.5 m s−1 by the rectifier circuit and a 330 µF commercial capacitor. The above experiments show that RS‐TENG can not only harvest the mechanical energy around the environment for self‐powered sensing, but also exhibit an improved output performance and outstanding robustness.
Iridium‐Catalyzed Cycloisomerization of Alkynoic Acids: Synthesis of Unsaturated Lactones
Authors: Huang Yi , Zhang Xianghe , Dong Xiu‐Qin , Zhang Xumu
Published: December 2019

The iridium‐catalyzed cycloisomerization of various alkynoic acids was successfully developed, and a series of five‐, six‐, and especially seven‐membered unsaturated lactones were constructed with moderate yields and excellent regioselectivities (up to 68% yield, >99:1 rr). In addition, the indole compound can be easily prepared with 75% yield through this efficient synthetic methodology. Moreover, a plausible mechanism for this Ir‐catalyzed cycloisomerization of alkynoic acids was proposed.

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Copper‐Catalyzed [3+2] Annulation of 2‐Arylidene‐1,3‐Indandiones with N‐Acetyl Enamides for the Synthesis of Spiropyrrolines
Authors: Duan Jindian , Mao Yiyang , Zhang Lei , Zhu Ning , Fang Zheng , Guo Kai
Published: December 2019

A copper‐catalyzed intermolecular [3+2] annulation of 2‐arylidene‐1,3‐indandiones with N‐acetyl enamides has been developed to assemble spirocyclic pyrrolines, which are important building blocks for organic synthesis and drug discovery. This heteroannulation protocol tolerates various functional groups and proceeds in good to excellent yields. Mechanistic studies reveal that the reactions might involve radical processes.

1‐Pyrrolines are important core structural constituents of numerous naturally occurring compounds and pharmaceuticals.[1] On the other hand, spiroindane‐1,3‐diones have been the focus of considerable attention due to their prevalence in many natural products that possess varied and extensive biological activities, which include antitumor, antibiotic,[2] and antiproliferative activity on HL60 and apoptosis resistant leukemia cell lines.[3] Accordingly, a number of synthetic strategies have been investigated to construct these skeletons.[4] Considering the biomedical importance of the two classes of compounds, the introduction of spiroindane‐1,3‐dione group into the pyrroline core structure may further broaden the utilization of these compounds and potentially benefit drug‐discovery efforts.[5]

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Declining ages at menarche in an agrarian rural region of Poland
Authors: Rogers Mary P. , Lee Katharine M. N. , Galbarczyk Andrzej , Klimek Magdalena , Klein Laura D. , Zabłocka‐Słowińska Katarzyna , Jasienska Grazyna , Clancy Kathryn B. H.
Published: December 2019

Objective

Age at menarche in Poland has varied with political and socioeconomic changes. An increase in age at menarche corresponded to a period of economic crisis and food rationing between 1976 and 1989. Experiencing food shortages in utero or during childhood development can affect menarcheal timing, but this national effect may be buffered in local agrarian regions growing their own food. Here we examine patterns of age at menarche over time in the rural, agrarian Beskid Wyspowy region of southern Poland.

Methods

This study examined menarcheal timing using data collected from Polish women (n = 1326) recruited at the Mogielica Human Ecology Study Site between 2003 and 2018. Simple linear regressions were used to assess changing ages at menarche over time. Comparisons between ages at menarche for women born before and after the fall of communism in 1989 were assessed via one‐way analysis of variance.

Results

Age at menarche has declined over time in the Beskid Wyspowy region of southern Poland from 1920 to 2000 (R2 = .08, P < .0001). There was not a statistically significant increase or decrease in age at menarche for women born and growing up during the period of food rationing.

Conclusions

The declining age at menarche is likely reflective of a transitioning environment, suggesting that major socioeconomic changes affect life history traits like pubertal timing. Living in agricultural regions may have helped buffer the increasing ages at menarche seen in other areas of Poland during times of food rationing.
Reference ranges for knee height in Argentine children and adolescents aged 2 to 18 years
Authors: Ruiz Brunner Maria M. , Cuestas Eloisa , Cieri Maria E. , Cuestas Eduardo
Published: December 2019

Objectives

Measurement of height is essential in the anthropometric assessment of growth and nutritional status. In some conditions, height measurement may be difficult or impossible. Proxy measurement such as knee height (KH) have been proposed to predict stature in such cases, but reference percentile ranges and charts for healthy, well‐nourished children are currently unavailable. This study was designed to develop sex‐specific KH reference percentile ranges and charts in Argentine children ranging from 2 to 18 years of age.

Methods

We collected and analyzed cross‐sectional data for KH from 861 Argentine children and adolescents aged 2 to 18 years. Generalized additive models for location, scale, and shape were used to calculate semiparametric smoothed percentile reference ranges, and charts by age and sex. Linear regression and correlation analyses were performed to know the association between KH and height.

Results

The new reference ranges show that KH growth rose sharply until puberty. Peak KH velocity occurs 1 year earlier than peak height velocity. At puberty KH growth decelerated rapidly in females and increased slightly until 15 years and plateaued at this age, while it had a more gradual deceleration in males up to 11 years old, later increased slightly until 17 years and plateaued at this age. The correlation coefficient between height and KH was r = 0.98 for both sexes (p < .001).

Conclusions

The new reference percentile ranges for KH measures for healthy children and adolescents provide a useful growth and nutritional assessment tool in a wide variety of settings. KH has a strong agreement with stature.
Remote Implementation of a Fredkin Gate via Virtual Excitation of an Atom‐Cavity‐Fiber System
Authors: Sun Guang‐Qing , Wu Jin‐Lei , Niu Wei , Yu Wan‐Rang , Ji Xin
Published: December 2019

Simple operations and robust results are always of interest for any quantum tasks. Herein, a novel scheme is proposed for implementing a Fredkin gate via the virtual excitation of an atom‐cavity‐fiber system. The scheme is to control the nonlocal state‐swap of two spatially separated target atoms according to the state of the control atom at hand. In the scheme, only the control atom at hand needs the laser to drive and the virtual excitation of the atom‐cavity‐fiber system effectively suppresses the decoherence. By numerical simulations, appreciated parameters are chosen and it is shown that the Fredkin gate can be implemented with high fidelity. Although the operation time error has slightly stronger influence on the fidelity than atom‐cavity coupling strength error, the robustness of the scheme can be effectively improved against the operation time error by adopting Gaussian pulse to replace the constant pulse. In addition, the scheme can be generalized to implement alternative Fredkin gates by controlling the non‐local state‐swap of two remote atoms or of two remote and spatially separated atoms, which will be undoubtedly of benefit to the distributed quantum computation and remote quantum information processing.
Efficient Ultraviolet Nanosources Based on Third‐Harmonic Generation in Dielectric–Metal Composite Nanodisks
Authors: Kim Kwang‐Hyon , An Jong‐Kwan , Rim Wi‐Song
Published: December 2019

Dielectric materials with high indices have recently attracted much attention in the community of nanophotonics. Severe optical losses in visible–ultraviolet (UV) region, however, limit their applications. This article proposes dielectric–metal nanocomposites as alternative high‐index materials for Mie‐resonance‐based applications. Such composite materials have high indices in the range of wavelength longer than plasmon resonance of inclusion metal nanoparticles, while they have much lower losses in the range from blue‐violet down to near‐UV compared with commonly used high‐index materials such as silicon, enabling near‐UV generation with high efficiency based on third‐harmonic generation (THG). The numerical results show that ZnO nanodisk containing silver nanoparticles can generate near‐UV radiation at 351.3 nm via THG with an efficiency about 20 times higher compared with silicon nanodisk under same pumping condition. Significantly high THG efficiency of 0.015% has been predicted with such a composite nanodisk supported by aluminum substrate under pumping with a peak intensity of 20 GW cm−2, a spot size of 0.8 , a duration of 50 fs at 1054 nm, respectively.
Amorphous Metal–Organic Framework‐Dominated Nanocomposites with Both Compositional and Structural Heterogeneity for Oxygen Evolution
Authors: Liu Chao , Wang Jing , Wan Jingjing , Cheng Yan , Huang Rong , Zhang Chaoqi , Hu Wenli , Wei Guangfeng , Yu Chengzhong
Published: December 2019

Amorphous metal–organic frameworks (aMOFs) are an emerging family of attractive materials with great application potential, however aMOFs are usually prepared under harsh conditions and aMOFs with complex compositions and structures are rarely reported. In this work, an aMOF‐dominated nanocomposite (aMOF‐NC) with both structural and compositional complexity has been synthesized using a facile approach. A ligand‐competition amorphization mechanism is proposed based on experimental and density functional theory calculation results. The aMOF‐NC possesses a core–shell nanorod@nanosheet architecture, including a Fe‐rich Fe‐Co‐aMOF core and a Co‐rich Fe‐Co‐aMOF shell in the core–shell structured nanorod, and amorphous Co(OH)2 nanosheets as the outer layer. Benefiting from the structural and compositional heterogeneity, the aMOF‐NC demonstrates an excellent oxygen evolution reaction activity with a low overpotential of 249 mV at 10.0 mA cm−2 and Tafel slope of 39.5 mV dec−1.
Thrombolysis for submassive pulmonary embolism with left ventricular outflow tract obstruction
Authors: Chong M. S. F. , Aron J.
Published: December 2019

The decision to administer thrombolysis in submassive pulmonary embolism is undertaken based on risk stratification to prevent further cardiorespiratory deterioration. Although right ventricular dysfunction has been used to risk stratify haemodynamically stable patients with acute pulmonary embolism, there is still much controversy in the use of thrombolysis for its treatment. The European Society of Cardiology guidelines suggest thrombolysis should be reserved for rescue reperfusion. However, we present a unique case of submassive pulmonary embolism in which transthoracic echocardiography visualised dynamic left ventricular outflow tract obstruction secondary to right ventricular dilatation, which led to the decision to instigate thrombolysis therapy. A 68‐year‐old man presented with submassive pulmonary embolism with evidence of right ventricular dysfunction but was haemodynamically stable. He was initially commenced on anticoagulation but echocardiography revealed significant right ventricular dilatation and left ventricular outflow tract obstruction, signifying a high risk of impending cardiac arrest. After deliberation, full‐dose thrombolysis was administered. Subsequently the patient's symptoms and haemodynamics improved significantly and repeat echocardiography demonstrated that the right ventricular and left ventricular size and function had returned to normal. We suggest echocardiography is used to assess right heart, left heart and outflow dynamics to individualise thrombolysis therapy in patients with submassive pulmonary embolism.
Experimental and theoretical studies of Mn(II) and Co(II) metal complexes of a tridentate Schiff's base ligand and their biological activities
Authors: Jain Pallavi , Kumar Dinesh , Chandra Sulekh , Misra Namita
Published: December 2019

We have used the condensation method to synthesize 2‐acetyl‐5‐methylsemicarbazone ligand. Manganese(II) and Cobalt(II) complexes having formula [ML2]X2 were synthesized where M = Mn(II) and Co(II), L = ligand, X = Cl−, CH3COO−, NO3−, ½SO42−. The characterization data suggests the octahedral geometry for all the synthesized complexes. Tridentate nature of the 2‐acetyl‐5‐methylsemicarbazone ligand was revealed by IR studies. Molar conductance analysis suggested the electrolytic nature of the complexes. The theoretical study includes geometrical optimization, HOMO‐LUMO energy gap, energetic parameters and dipole moment. These results also confirmed the tridentate nature of the ligand and the octahedral geometry of complexes. The molecular electrostatic potential (MEP) study suggested the reactive sites for an electrophilic or nucleophilic attack in the ligand. We tested the synthesized compounds for their antifungal and antibacterial action via well diffusion method and found that parent ligand after the coordination with the metal ion showed more effective inhibition against bacteria and fungi.
Effects of class‐specific, synthetic, and natural proteinase inhibitors on life‐history traits of the cotton bollworm Helicoverpa armigera
Authors: Kuwar Suyog S. , Pauchet Yannick , Heckel David G.
Published: December 2019

Herbivorous insects have more difficulty obtaining proteins from their food than do predators and parasites. The scarcity of proteins in their diet requires herbivores to feed voraciously, thus heavily damaging their host plants. Plants respond to herbivory by producing defense compounds, which reduce insect growth, retard development, and increase mortality. Herbivores use both pre‐ and postdigestive response mechanisms to detect and avoid plant defense compounds. Proteinase inhibitors (PIs) are one example of plant compounds produced as a direct defense against herbivory. Many insects can adapt to PIs when these are incorporated into artificial diets. However, little is known about the effect of PIs on diet choice and feeding behavior. We monitored the diet choice, life‐history traits, and gut proteinase activity of Helicoverpa armigera larvae using diets supplemented with synthetic and natural PIs. In choice experiments, both neonates and fourth‐instar larvae preferred the control diet over PI‐supplemented diets, to varying degrees. Larvae that fed on PI‐supplemented diets weighed less than those that fed on the control diet and produced smaller pupae. Trypsin‐specific PIs had a stronger effect on mean larval weight than did other PIs. A reduction of trypsin activity but not of chymotrypsin activity was observed in larvae fed on PI‐supplemented diets. Therefore, behavioral avoidance of feeding on plant parts high in PIs could be an adaptation to minimize the impact of this plant's defensive strategy.
B Cell Synovitis and Clinical Phenotypes in Rheumatoid Arthritis: Relationship to Disease Stages and Drug Exposure
Authors: Rivellese F. , Humby F. , Bugatti S. , Fossati‐Jimack L. , Rizvi H. , Lucchesi D. , Lliso‐Ribera G. , Nerviani A. , Hands R. E. , Giorli G. , Frias B. , Thorborn G. , Jaworska E. , John C. , Goldmann K. , Lewis M. J. , Manzo A. , Bombardieri M. , Pitzalis C. ,   the PEAC‐R4RA Investigators
Published: December 2019

Objective

To define the relationship of synovial B cells to clinical phenotypes at different stages of disease evolution and drug exposure in rheumatoid arthritis (RA).

Methods

Synovial biopsy specimens and demographic and clinical data were collected from 2 RA cohorts (n = 329), one of patients with untreated early RA (n = 165) and one of patients with established RA with an inadequate response to tumor necrosis factor inhibitors (TNFi‐IR; n = 164). Synovial tissue was subjected to hematoxylin and eosin and immunohistochemical staining and semiquantitative assessment for the degree of synovitis (on a scale of 0–9) and of CD20+ B cell infiltrate (on a scale of 0–4). B cell scores were validated by digital image analysis and B cell lineage–specific transcript analysis (RNA‐Seq) in the early RA (n = 91) and TNFi‐IR (n = 127) cohorts. Semiquantitative CD20 scores were used to classify patients as B cell rich (≥2) or B cell poor (<2).

Results

Semiquantitative B cell scores correlated with digital image analysis quantitative measurements and B cell lineage–specific transcripts. B cell–rich synovitis was present in 35% of patients in the early RA cohort and 47.7% of patients in the TNFi‐IR cohort (P = 0.025). B cell–rich patients showed higher levels of disease activity and seropositivity for rheumatoid factor and anti–citrullinated protein antibody in early RA but not in established RA, while significantly higher histologic synovitis scores in B cell–rich patients were demonstrated in both cohorts.

Conclusion

We describe a robust semiquantitative histologic B cell score that closely replicates the quantification of B cells by digital or molecular analyses. Our findings indicate an ongoing B cell–rich synovitis, which does not seem to be captured by standard clinimetric assessment, in a larger proportion of patients with established RA than early RA.
Bauphysikalische und ökologische Bewertung adaptiver Fassadenkonstruktionen auf Raumebene
Authors: Harder Nadine , Schlegl Friederike , Flemming Daniela , Di Bari Roberta , Albrecht Stefan , Leistner Philip , Park Sumee
Published: December 2019

Eine Antwort auf den großen und fortschreitenden Ressourcenverbrauch im Bauwesen können leichte und zugleich adaptive Lösungsansätze für Gebäudehüllen und ‐strukturen darstellen. Dazu müssen sie sowohl für schadensfreie Bauwerke mit passender Aufenthaltsqualität als auch für eine deutlich höhere Ressourceneffizienz sorgen. Beides gilt für den gesamten Lebensweg und trotz der für die Adaptivität benötigen zusätzlichen Betriebsenergie. Im Rahmen einer vorangegangenen Untersuchung adaptiver Leichtbaukonstruktionen [1] für Fassaden wurde die bauphysikalische Funktionalität und Umweltwirkung einiger Beispiele auf Bauteilebene behandelt. Im hier vorliegenden Beitrag wird nun der Betrachtungshorizont auf die Raumebene erweitert, um z. B. neben Kennwerten für Wärme‐ und Feuchteschutz der Hülle auch die Behaglichkeit im Raum als Bewertungsmaßstab heranzuziehen. Natürlich erhöhen sich damit der Aufwand und die Komplexität der Bilanz, dafür lässt sich aber fundierter das Anwendungspotenzial adaptiver Alternativen einschätzen und über deren Weiterverfolgung entscheiden. Dazu werden drei herkömmliche, teils massive und teils leichte Konstruktionen, sowie vergleichbare adaptive Fassaden auf Raumebene untersucht und bewertet. Als wesentliche Bewertungskriterien gelten dabei quantitative Aussagen zur Erfüllung bauphysikalischer Anforderungen und zu ökologischen Umweltwirkungen. Im Ergebnis der methodenübergreifenden Forschung zeigt sich, dass adaptive Konstruktionen fallspezifisch, z. B. standortbezogen, beachtliches Potenzial zur Ressourcenreduktion ohne Funktionseinschränkungen mit sich bringen.
Continuous ultrafiltration/diafiltration using a 3D‐printed two membrane single pass module
Authors: Tan Ruijie , Franzreb Matthias
Published: December 2019

A 3D printed ultrafiltration/diafiltration (UF/DF) module is presented allowing the continuous, simultaneous concentration of retained (bio‐)molecules and reduction or exchange of the salt buffer. Differing from the single‐pass UF concepts known from the literature, DF operation does not require the application of several steps or units with intermediating dilution. In contrast, the developed module uses two membranes confining the section in which the molecules are concentrated while the sample is passing. Simultaneously to this concentration process, the two membranes allow a perpendicular in and outflow of DF buffer reducing the salt content in this section. The module showed the continuous concentration of a dissolved protein up to a factor of 4.6 while reducing the salt concentration down to 47% of the initial concentration along a flow path length of only 5 cm. Due to single‐pass operation the module shows concentration polarization effects reducing the effective permeability of the applied membrane in case of higher concentration factors. However, because of its simple design and the capability to simultaneously run UF and DF processes in a single module, the development could be economically beneficial for small scale UF/DF applications.
An NIR‐based PAT approach for real‐time control of loading in Protein A chromatography in continuous manufacturing of monoclonal antibodies
Authors: Thakur Garima , Hebbi Vishwanath , Rathore Anurag S.
Published: December 2019

Control of column loading in Protein A chromatography is a crucial part of development of robust and flexible process platforms for continuous production of monoclonal antibody (mAb) products. In this paper, we propose a control system that uses near infrared spectroscopy (NIRS) flow cells to accomplish the above. Two applications have been demonstrated using a periodic counter‐current continuous chromatography setup. The first application involves use of single NIR flow cell before the inlet of the loading column to measure the concentration of mAb in the harvested broth. Measurement was in real‐time (every 3 s) and within ±0.05 mg/ml, significantly better than making UV‐based concentration estimations. The second application involved use of an additional NIR flow cell at the outlet of the loading column to measure column breakthrough in real time. The concentration data was transferred to a Python‐based monitoring and control algorithm layered over a Cadence BioSMB system. The program could successfully run a three‐column periodic counter current method on the BioSMB whereas controlling loading to ensure optimal resin utilization in each loading cycle phase based on precharacterized dynamic binding capacity models, whereas maintaining periodic elutions. The system was tested with multiple perturbations in harvest concentration, modeled after deviations that could arise downstream of a perfusion cell culture system. The results show that the proposed control is a spectroscopy‐based process analytical technology tool that facilitates real time monitoring and control of loading in process chromatography. It is adaptable to any continuous chromatography equipment and is very well suited for implementation in a continuous mAb production train.
Systematic review of learning curves in robot-assisted surgery
Authors: Soomro N. A. , Hashimoto D. A. , Porteous A. J. , Ridley C. J. A. , Marsh W. J. , Ditto R. , Roy S.
Published: December 2019

Background

Increased uptake of robotic surgery has led to interest in learning curves for robot-assisted procedures. Learning curves, however, are often poorly defined. This systematic review was conducted to identify the available evidence investigating surgeon learning curves in robot-assisted surgery.

Methods

MEDLINE, Embase and the Cochrane Library were searched in February 2018, in accordance with PRISMA guidelines, alongside hand searches of key congresses and existing reviews. Eligible articles were those assessing learning curves associated with robot-assisted surgery in patients.

Results

Searches identified 2316 records, of which 68 met the eligibility criteria, reporting on 68 unique studies. Of these, 49 assessed learning curves based on patient data across ten surgical specialties. All 49 were observational, largely single-arm (35 of 49, 71 per cent) and included few surgeons. Learning curves exhibited substantial heterogeneity, varying between procedures, studies and metrics. Standards of reporting were generally poor, with only 17 of 49 (35 per cent) quantifying previous experience. Methods used to assess the learning curve were heterogeneous, often lacking statistical validation and using ambiguous terminology.

Conclusion

Learning curve estimates were subject to considerable uncertainty. Robust evidence was lacking, owing to limitations in study design, frequent reporting gaps and substantial heterogeneity in the methods used to assess learning curves. The opportunity remains for the establishment of optimal quantitative methods for the assessment of learning curves, to inform surgical training programmes and improve patient outcomes.
Influence of primary tumour and patient factors on survival in patients undergoing curative resection and treatment for liver metastases from colorectal cancer
Authors: Scherman P. , Syk I. , Holmberg E. , Naredi P. , Rizell M.
Published: December 2019

Background

Resection of the primary tumour is a prerequisite for cure in patients with colorectal cancer, but hepatic metastasectomy has been used increasingly with curative intent. This national registry study examined prognostic factors for radically treated primary tumours, including the subgroup of patients undergoing liver metastasectomy.

Methods

Patients who had radical resection of primary colorectal cancer in 2009–2013 were identified in a population-based Swedish colorectal registry and cross-checked in a registry of liver tumours. Data on primary tumour and patient characteristics were extracted and prognostic impact was analysed.

Results

Radical resection was registered in 20 853 patients; in 38·7 per cent of those registered with liver metastases, surgery or ablation was performed. The age-standardized relative 5-year survival rate after radical resection of colorectal cancer was 80·9 (95 per cent c.i. 80·2 to 81·6) per cent, and the rate after surgery for colorectal liver metastases was 49·6 (46·0 to 53·2) per cent. Multivariable analysis identified lymph node status, multiple sites of metastasis, high ASA grade and postoperative complications after resection of the primary tumour as strong risk factors after primary resection and following subsequent liver resection or ablation. Age, sex and primary tumour location had no prognostic impact on mortality after liver resection.

Conclusion

Lymph node status and complications have a negative impact on outcome after both primary resection and liver surgery. Older age and female sex were underrepresented in the liver surgical cohort, but these factors did not influence prognosis significantly.
Recommendations from the ERAS® Society for standards for the development of enhanced recovery after surgery guidelines
Authors: Brindle M. , Nelson G. , Lobo D. N. , Ljungqvist O. , Gustafsson U. O.
Published: December 2019

Background

ERAS® Society guidelines are holistic, multidisciplinary tools designed to improve outcomes after surgery. The enhanced recovery after surgery (ERAS) approach was initially developed for colorectal surgery and has been implemented successfully across a large number of settings, resulting in improved patient outcomes. As the ERAS approach is increasingly being adopted worldwide and new guidelines are being generated for new populations, there is a need to define an ERAS® Society guideline and the methodology that should be followed in its development.

Methods

The ERAS® Society recommended approach for developing new guidelines is based on the creation of multidisciplinary guideline development groups responsible for defining topics, planning the literature search, and assessing the quality of the evidence.

Results

Clear definitions for the elements of an ERAS guideline involve multimodal and multidisciplinary approaches impacting on multiple patient outcomes. Recommended methodology for guideline development follows a rigorous approach with systematic identification and evaluation of evidence, and consensus-based development of recommendations. Guidelines should then be evaluated and reviewed regularly to ensure that the best and most up-to-date evidence is used consistently to support surgical patients.

Conclusion

There is a need for a standardized, evidence-informed approach to both the development of new ERAS® Society guidelines, and the adaptation and revision of existing guidelines.
Robot‐assisted versus laparoscopic partial nephrectomy for anatomically complex T1b renal tumors with a RENAL nephrometry score ≥7: A propensity score‐based analysis
Authors: Deng Wen , Li Junhua , Liu Xiaoqiang , Chen Luyao , Liu Weipeng , Zhou Xiaochen , Zhu Jingyu , Fu Bin , Wang Gongxian
Published: December 2019

Objectives

To present the perioperative, functional, and oncological outcomes of robot‐assisted partial nephrectomy (RPN) compared with laparoscopic partial nephrectomy (LPN) for anatomically complex T1b renal tumors with RENAL nephrometry scores ≥7.

Patients and methods

One hundred and seventy patients, during the study period, were retrospectively reviewed in our analysis according to inclusion criteria. Propensity score matching (PSM) (1:1) method was applied to impose restrictions on the potential baseline confounders. The comparisons of perioperative and functional outcomes between the RPN and LPN groups were conducted and analyzed after PSM, Kaplan‐Meier analyses were performed to assess the differences about oncological outcomes between the two groups before and after PSM.

Results

One hundred and nine and 61 T1b renal tumors with RENAL scores ≥7 were identified in the LPN and RPN groups, respectively. All significant differences in baseline characteristics disappeared after PSM. Except for 3 patients missing an appropriate pair, all the patients in the RPN group were successfully matched to 58 patients in the LPN group in a 1:1 ratio. Within the matched cohort, the RPN group was related to a significantly shorter mean operating time (OT) (P = .040), shorter mean warm ischemia time (WIT) (P = .023), and shorter median postoperative hospital stay (P = .023). The possibilities of surgical conversion, postoperative complication, and positive surgical margin were similar in the LPN and RPN groups. And there was also no significant difference in the pathological, renal functional, and oncological outcomes between the two series.

Conclusions

For patients with anatomically complex T1b renal tumors with a RENAL nephrometry score ≥7, RPN had an advantage over LPN in reducing OT, WIT, and postoperative hospital stay length without increasing the risk of complications and weakening the oncological control, while the two surgical methods were similar in renal functional preservation.
Stent underexpansion due to heavy coronary calcification resistant to rotational atherectomy: A case for coronary lithoplasty?
Authors: Tovar Forero Maria Natalia , Van Mieghem Nicolas M. , Daemen Joost
Published: December 2019

Stent underexpansion is frequently observed in calcified coronary lesions and increases the risk of future adverse cardiac events. Current plaquemodification techniques might not be suitable when calcium deposition is circumferential and deep inside the vessel wall. We report a case during which coronary lithoplasty was used as an adjuvant therapy to improve severe stent underexpansion after failed atherectomy and high‐pressure non‐compliant balloon dilatations.
Recent Advances in Visible‐Light‐Driven Hydrogen Evolution from Water using Polymer Photocatalysts
Authors: Jayakumar Jayachandran , Chou Ho‐Hsiu
Published: December 2019

Efficient polymer photocatalysts that mimic natural photosynthesis to generate H2 through the visible‐light‐promoted splitting of water are ideal systems for the conversion of solar energy into usable fuel with high energy density and in an environmentally friendly manner. In this article, we review recent reports on donor‐acceptor‐based π‐conjugated polymers as photocatalysts, including conjugated linear polymers, microporous polymers, triazine frameworks, covalent organic frameworks, polymer dots, and other related organic polymers, which show superior photocatalytic activity and robust stability under visible‐light irradiation, for hydrogen production. Moreover, their syntheses and material design strategies, photophysical properties, proposed mechanisms, and applications are systematically summarized. Finally, recent research on and challenges related to organic polymer photocatalysts are discussed. This minireview will help readers to more easily understand the recent advances in and future direction of this field.
Oxygen Evolution on Metal‐oxy‐hydroxides: Beneficial Role of Mixing Fe, Co, Ni Explained via Bifunctional Edge/acceptor Route
Authors: Vandichel Matthias , Busch Michael , Laasonen Kari
Published: December 2019

Oxygen evolution reaction (OER) via mixed metal oxy hydroxides [M(O)(OH)] may take place on a large variety of possible active sites on the actual catalyst. A single site computational description assumes a 4‐step electrochemical mechanism with coupled H+/e− transfers between 4 intermediates (M‐*, M‐OH, M=O, M‐OOH). We also consider bifunctional routes, in which an unstable M‐OOH species converts via a proton shuttling pathway to a thermodynamically more favourable bare M‐* site, O2 and a hydrogenated acceptor site; the acceptor site takes up the proton forming a hydrogenated acceptor site after recombination with an electron from the catalyst material. Here, we combine pure metal γ‐M(O)(OH) edge sites (M=Fe, Co, Ni) with as proton‐acceptor sites different threefold coordinated oxygens on β‐(M,M’)(O)(OH) terraces (M,M’=Fe, Co, Ni). The acceptor sites on these terraces have of a M’2MO motif. Our combinatorial study results in a ranking of the bifunctional OER activity on a 3D‐volcano plot. By studying various bi‐ and tri‐metallic oxy hydroxide combinations, we show that their excellent experimental OER activity results from bifunctionality and provide a roadmap to construct innovative low overpotential OER catalysts.
Exploring the Relationships Between Counseling Students’ Cultural Factors, Academic Aptitude, and Self‐Efficacy
Authors: Oh Seungbin , Hahs‐Vaughn Debbie L. , Hagedorn Bryce
Published: December 2019

The authors explored the pattern of change in counseling students’ (N = 373) counseling self‐efficacy (CSE) throughout their program and the influence of identifying variables. Results indicated that specific factors significantly predicted students’ initial CSE levels and the rate of CSE change. Implications for future research and counselor education programs are presented.
New Counselor Educators’ Scholarly Productivity: Supportive and Discouraging Environments
Authors: Borders L. DiAnne , Gonzalez Laura M. , Umstead Lindsey K. , Wester Kelly L.
Published: December 2019

Eighteen new counselor educators shared in‐depth reports of their efforts to establish an early record of scholarly productivity, critical to their success in academe. Analyses of their experiences using consensual qualitative research methods revealed components of both highly positive and highly discouraging program environments and their impact on participants’ research goals.
Manipulating the Ultralong Organic Phosphorescence of Small Molecular Crystals
Authors: Jia Wenyong , Wang Qian , Shi Huifang , An Zhongfu , Huang Wei
Published: December 2019

Ultralong organic phosphorescence (UOP) of metal‐free organic materials has received considerable attention recently owing to their long‐lived emission lifetimes, and the fact that they present an attractive alternative to persistent luminescence in inorganic phosphors. Enormous research effort has been devoted on improving UOP performance in metal‐free organic phosphors by promoting the intersystem crossing (ISC) process and suppressing the non‐radiative decay of triplet state excitons. This minireview summarizes the recent advances in the rational approaches for manipulating the UOP properties of small molecular crystals, such as phosphorescence lifetime, efficiency, and emission colors. Finally, the present challenges and future development of this field are proposed. This review will provide a guideline to rationally design more advanced metal‐free organic phosphorescence materials for potential applications.
Optical Control of Cytokine Production Using Photoswitchable Galactosylceramides
Authors: Hartrampf Nina , Seki Toshiyuki , Baumann Andreas , Watson Philip , Vepřek Nynke A. , Hetzler Belinda E. , Hoffmann‐Röder Anja , Tsuji Moriya , Trauner Dirk
Published: December 2019

α‐Galactosylceramides are glycosphingolipids that show promise in cancer immunotherapy. After presentation by CD1d, they activate natural killer T cells (NKT), which results in the production of a variety of pro‐inflammatory and immunomodulatory cytokines. Herein, we report the synthesis and biological evaluation of photochromic derivatives of KRN‐7000, the activity of which can be modulated with light. Based on established structure–activity relationships, we designed photoswitchable analogues of this glycolipid that control the production of pro‐inflammatory cytokines, such as IFN‐γ. The azobenzene derivative α‐GalACer‐4 proved to be more potent than KRN‐7000 itself when activated with 370 nm light. Photolipids of this type could improve our mechanistic understanding of cytokine production and could open new directions in photoimmunotherapy.
A Chiral Macrocyclic Tetra‐N‐Heterocyclic Carbene Yields an “All Carbene” Iron Alkylidene Complex
Authors: DeJesus Joseph F. , Jenkins David M.
Published: December 2019

The first chiral macrocyclic tetra‐N‐heterocyclic carbene (NHC) ligand has been synthesized. The macrocycle, prepared in high yield and large scale, was ligated onto palladium and iron to give divalent C2‐symmetric square planar complexes. Multinuclear NMR and single crystal X‐ray diffraction demonstrated that there are two distinct NHCs on each ligand, due to the bridging chiral cyclohexane. Oxidation of the iron(II) complex with trimethylamine N‐oxide yielded a bridging oxo complex. Diazodiphenylmethane reacted with the iron(II) complex at room temperature to give a paramagnetic diazoalkane complex; the same reaction yielded the “all carbene” complex at elevated temperature. Electrochemical measurements support the assignment of the “all carbene” complex being an alkylidene. Notably, the diazoalkane complex can be directly transformed into the alkylidene complex, which had not been previously demonstrated on iron. Finally, a test catalytic reaction with a diazoalkane on the iron(II) complex does not yield the expected cyclopropane, but actually the azine compound.