bluuebunny/crossref_metadata_2025 huggingface dataset:
Tuning Aggregation Behavior of Polymer Donor viaMolecular‐Weight Control for Achieving 17.1% Efficiency Inverted Polymer Solar Cells
Authors: Liu Qi , Fang Jin , Wu Jingnan , Zhu Lei , Guo Xia , Liu Feng , Zhang Maojie
Published: April 2021

Main observation and conclusion

Recently, the polymer solar cells (PSCs) based on the PM6 and small molecular acceptor (SMA) Y6 have attracted considerable attention in this community for their outstanding photovoltaic performance. As well known, the molecular weight of polymer has dramatic impact on the blend morphology and photovoltaic performance in the polymer solar cells, especially for those polymers with temperature‐dependent aggregation (TDA) behavior. In this work, a series of PM6 polymers with different weight‐average molecular weights (Mw = 41, 67, 74, 84 and 114 kDa) were synthesized, and the effects of the Mw on the morphology and photovoltaic performance were systematically investigated. Notably, molecular weight induces dramatic influences on the aggregation behaviors of the polymers and their corresponding blend morphology, which were explored by the temperature‐dependent UV‐vis absorptions (TD‐Abs), grazing incidence wide‐angle X‐ray scattering (GIWAXS) and resonant soft X‐ray scattering (R‐SoXS) measurements. Increasing Mw promoted the strong face‐on molecular packing and reduced the blend film domain sizes for enhanced donor‐acceptor interfacial areas, resulting in increased short‐circuit current densities (Jsc) and fill factor (FF). However, polymer donor with high Mw value processed stronger tendency of forming excessive pure donor aggregate, which hampered forming the intermixed phase for efficient charge transport, resulting in the inferior FF. Therefore, the optimized OSCs based on PM6 with moderate molecular weight (Mw = 74 kDa) and Y6 exhibited suitable size and purity of the domains, facilitating well‐balanced charge transport, reducing trap‐assisted recombination and leading to significant enhancement of photovoltaic performance with the optimal PCE of 17.1%. This work indicates that proper and precisely tuning the molecular weight of polymer donor is critical to enhance the photovoltaic performance in PSCs.
Structural Basis of Prolyl Hydroxylase Domain Inhibition by Molidustat
Authors: Figg William D. , McDonough Michael A. , Chowdhury Rasheduzzaman , Nakashima Yu , Zhang Zhihong , Holt‐Martyn James P. , Krajnc Alen , Schofield Christopher J.
Published: April 2021

Human prolyl‐hydroxylases (PHDs) are hypoxia‐sensing 2‐oxoglutarate (2OG) oxygenases, catalysis by which suppresses the transcription of hypoxia‐inducible factor target genes. PHD inhibition enables the treatment of anaemia/ischaemia‐related disease. The PHD inhibitor Molidustat is approved for the treatment of renal anaemia; it differs from other approved/late‐stage PHD inhibitors in lacking a glycinamide side chain. The first reported crystal structures of Molidustat and IOX4 (a brain‐penetrating derivative) complexed with PHD2 reveal how their contiguous triazole, pyrazolone and pyrimidine/pyridine rings bind at the active site. The inhibitors bind to the active‐site metal in a bidentate manner through their pyrazolone and pyrimidine nitrogens, with the triazole π‐π‐stacking with Tyr303 in the 2OG binding pocket. Comparison of the new structures with other PHD inhibitor complexes reveals differences in the conformations of Tyr303, Tyr310, and a mobile loop linking β2–β3, which are involved in dynamic substrate binding/product release.
Breast cancer patients' insurance status and residence zip code correlate with early discontinuation of endocrine therapy: An analysis of the ECOG‐ACRIN TAILORx trial
Authors: Sadigh Gelareh , Gray Robert J. , Sparano Joseph A. , Yanez Betina , Garcia Sofia F. , Timsina Lava R. , Sledge George W. , Cella David , Wagner Lynne I. , Carlos Ruth C.
Published: April 2021

Background

Early discontinuation is a substantial barrier to the delivery of endocrine therapies (ETs) and may influence recurrence and survival. The authors investigated the association between early discontinuation of ET and social determinants of health, including insurance coverage and the neighborhood deprivation index (NDI), which was measured on the basis of patients' zip codes, in breast cancer.

Methods

In this retrospective analysis of a prospective randomized clinical trial (Trial Assigning Individualized Options for Treatment), women with hormone receptor–positive, human epidermal growth factor receptor 2–negative breast cancer who started ET within a year of study entry were included. Early discontinuation was calculated as stopping ET within 4 years of its start for reasons other than distant recurrence or death via Kaplan‐Meier estimates. A Cox proportional hazards joint model was used to analyze the association between early discontinuation of ET and factors such as the study‐entry insurance and NDI, with adjustments made for other variables.

Results

Of the included 9475 women (mean age, 55.6 years; White race, 84%), 58.0% had private insurance, whereas 11.7% had Medicare, 5.8% had Medicaid, 3.8% were self‐pay, and 19.1% were treated at international sites. The early discontinuation rate was 12.3%. Compared with those with private insurance, patients with Medicaid (hazard ratio [HR], 1.53; 95% confidence interval [CI], 1.23‐1.92) and self‐pay patients (HR, 1.65; 95% CI, 1.25‐2.17) had higher early discontinuation. Participants with a first‐quartile NDI (highest deprivation) had a higher probability of discontinuation than those with a fourth‐quartile NDI (lowest deprivation; HR, 1.34; 95% CI, 1.11‐1.62).

Conclusions

Patients' insurance and zip code at study entry play roles in adherence to ET, with uninsured and underinsured patients having a high rate of treatment nonadherence. Early identification of patients at risk may improve adherence to therapy.

Lay Summary

In this retrospective analysis of 9475 women with breast cancer participating in a clinical trial (Trial Assigning Individualized Options for Treatment), Medicaid and self‐pay patients (compared with those with private insurance) and those in the highest quartile of neighborhood deprivation scores (compared with those in the lowest quartile) had a higher probability of early discontinuation of endocrine therapy.

These social determinants of health assume larger importance with the expected increase in unemployment rates and loss of insurance coverage in the aftermath of the coronavirus disease 2019 pandemic. Early identification of patients at risk and enrollment in insurance optimization programs may improve the persistence of therapy.
A novel approach of intensified barnacles mating optimization for the mitigation of power system oscillations
Authors: Devarapalli Ramesh , Bhattacharyya Biplab , Kumari Archana
Published: April 2021

Optimization is the process of attaining the best solution from the available set of prioritized constraints to maximize or minimize the desired function involved in it. It is imperative in engineering to plan and design to find the best out of confined resource and time. A recently recommended barnacles matting optimization (BMO) has been recognized in computing the optimal parameters of the electric power system with excellent performance characteristics. In this paper, the intensified version of BMO has been proposed with the aid of cuckoo search (CS) and traditional particle swarm optimization (PSO). An in‐depth analysis was made on the BMO technique and proposed suitable modifications to deal with the electrical power system stability enhancement issue efficiently. The proposed technique in the power system stabilizer (PSS) parameter computation is validated on the 23 benchmark functions to examine for its suitability. The robustness of the proposed method is presented via statistical analysis and boxplot of the 23 benchmark functions. The PSS parameters are computed in a benchmark two area four machine system using intensified BMO under self‐clearing fault conditions. A multi‐objective function is designed to improve the damping nature offered under system uncertainties, and the comparative analysis is presented among conventional PSS, BMO, intensified BMO with CS and PSO (BMO‐CS and BMO‐PSO), and harris hawks optimizer.
Cooperative Self‐Assembly in Linear Chains Based on Halogen Bonds
Authors: Vermeeren Pascal , Wolters Lando P. , Paragi Gábor , Fonseca Guerra Célia
Published: April 2021

Cooperative properties of halogen bonds were investigated with computational experiments based on dispersion‐corrected relativistic density functional theory. The bonding mechanism in linear chains of cyanogen halide (X−CN), halocyanoacetylene (X−CC−CN), and 4‐halobenzonitrile (X−C6H4−CN) were examined for X = H, Cl, Br, and I. Our energy decomposition and Kohn‐Sham molecular‐orbital analyses revealed the bonding mechanism of the studied systems. Cyanogen halide and halocyanoacetylene chains possess an extra stabilizing effect with increasing chain size, whereas the 4‐halobenzonitrile chains do not. This cooperativity can be traced back to charge separation within the σ‐electronic system by charge‐transfer between the lone‐pair orbital of the nitrogen (σHOMO) on one unit and the acceptor orbital of the C−X (σ*LUMO) on the adjacent unit. As such, the HOMO‐LUMO gap in the σ‐system decreases, and the cooperativity increases with chain length revealing the similarity in the bonding mechanisms of hydrogen and halogen bonds.
Exploring the Use of Serum‐Derived Small Extracellular Vesicles as Liquid Biopsy to Study the Induction of Hepatic Cytochromes P450 and Organic Anion Transporting Polypeptides
Authors: Rodrigues A. David , van Dyk Madelé , Sorich Michael J. , Fahmy Alia , Useckaite Zivile , Newman Lauren A. , Kapetas Asha J. , Mounzer Reham , Wood Linda S. , Johnson Jillian G. , Rowland Andrew
Published: April 2021

Liver‐derived small extracellular vesicles (sEVs), prepared from small sets of banked serum samples using a novel two‐step protocol, were deployed as liquid biopsy to study the induction of cytochromes P450 (CYP3A4, CYP3A5, and CYP2D6) and organic anion transporting polypeptides (OATP1B1 and OATP1B3) during pregnancy (nonpregnant (T0), first, second, and third (T3) trimester women; N = 3 each) and after administration of rifampicin (RIF) to healthy male subjects. Proteomic analysis revealed induction (mean fold‐increase, 90% confidence interval) of sEV CYP3A4 after RIF 300 mg × 7 days (3.5, 95% CI = 2.5–4.5, N = 4, P = 0.029) and 600 mg × 14 days (3.7, 95% CI = 2.1–6.0, N = 5, P = 0.018) consistent with the mean oral midazolam area under the plasma concentration time curve (AUC) ratio in the same subjects (0.28, 95% CI = 0.22–0.34, P < 0.0001; and 0.17, 95% CI = 0.13–0.22, P < 0.0001). Compared with CYP3A4, liver sEV CYP3A5 protein (subjects genotyped CYP3A5*1/*3) was weakly induced (≤ 1.5‐fold). It was also possible to measure liver sEV‐catalyzed dextromethorphan (DEX) O‐demethylation to dextrorphan (DXO), correlated with sEV CYP2D6 expression (r = 0.917, P = 0.0001; N = 10) and 3‐hour plasma DXO‐to‐DEX concentration ratio (r = 0.843, P = 0.002, N = 10), and show that CYP2D6 was not induced by RIF. Nonparametric analysis of liver sEV revealed significantly higher CYP3A4 (3.2‐fold, P = 0.003) and CYP2D6 (3.7‐fold, P = 0.03) protein expression in T3 vs. T0 women. In contrast, expression of both OATPs in liver sEV was unaltered by RIF administration and pregnancy.
Building Protein‐Protein and Protein‐Glycosaminoglycan Interaction Networks Using MatrixDB, the Extracellular Matrix Interaction Database
Authors: Berthollier Coline , Vallet Sylvain D. , Deniaud Madeline , Clerc Olivier , Ricard‐Blum Sylvie
Published: April 2021

The interaction database MatrixDB reports protein‐protein and protein‐glycosaminoglycan interactions in human, mammalian, and model organisms, involving at least one extracellular matrix (ECM) constituent, namely full‐length proteins, ECM multimeric proteins considered as stable complexes, proteoglycans, glycosaminoglycans (GAGs), and bioactive fragments called matricryptins, which are released upon limited proteolysis of ECM proteins. The current version of MatrixDB (as of October 2020) contains 106,543 experimentally supported interactions, with all types of biomolecules combined. MatrixDB is the only database focusing on the curation of ECM protein and GAG interactions. The iNavigator integrated in MatrixDB allows users to build interaction networks online and to filter them according to expression data, quantitative proteomics data, or interaction detection methods. MatrixDB belongs to the International Molecular Exchange (IMEx) consortium, and uses its curation rules to capture interaction data, which are available in standardized exchange formats according to the Human Proteome Organization—Proteomics Standards Initiative (HUPO‐PSI). © 2021 Wiley Periodicals LLC.

Basic Protocol 1: Browse MatrixDB

Basic Protocol 2: Create a list of biomolecules of interest to build interaction networks

Basic Protocol 3: Build and export interaction networks of selected biomolecules using the iNavigator

Basic Protocol 4: Build specific interaction networks using the iNavigator widgets

Basic Protocol 5: Generate 3D models of glycosaminoglycan oligosaccharides using the GAG Builder tool
Community‐Based Participatory Research With Black Churches
Authors: Avent Harris Janeé R.
Published: April 2021

Black Americans are more likely than other racial/ethnic groups to rely on spiritual and religious resources for mental health support. As such, counselors must seek unique ways to reach and understand Black communities. This article provides an overview of Black Americans' help‐seeking behaviors, the significance and culture of the Black Church, and a framework for counselors and counseling researchers to form effective partnerships to conduct community‐based participatory research initiatives that will produce empirical outcomes and promote culturally responsive mental health and wellness programming in Black communities.
African American Women's Substance Use Recovery Experiences: A Phenomenological Inquiry
Authors: Blount Taheera N. , LaGuardia Amanda C. , Fitzpatrick David C.
Published: April 2021

We examined the lived substance use recovery experiences of eight African American women. Specifically, in this study, we examined how participants were able to achieve sustained recovery without the aid of substance use treatment. Using transcendental phenomenological analysis, we found that participants used four components of recovery capital: family, spirituality, religion, and the Black Church. This study has important relevance to working with African American women in substance use recovery.
Changes in the proportions of an active pharmaceutical through cocrystals
Authors: Singh Abhay Pratap , Singh Munendra Pal , Baruah Jubaraj B.
Published: April 2021

In this study, the modulation of amounts sulfathiazolium cations in different 2,6‐pyridinedicarboxylates is demonstrated. An uncommon monoionic sulfathiazolium zinc 2,6‐pyridinedicarboxylate (1:1 electrolyte) complex was characterized. Conventional sulfathiazolium zinc‐bis‐2,6‐pyridinedicarboxylate dianionic complexes (2:1 electrolyte) were formed when hydroxyaromatic compounds such as 1,3‐dihydroxybenzene or 3‐nitrophenol were used as guest components. Thus, with the aid of the hydroxyaromatic molecules the zinc‐bis‐2,6‐pyridinedicarboxylate complexes were stabilized with the relatively large sized sulfathiazolium cations. It was a consequence of domain expansion by the phenolic compounds. Sandwiched aromatic guests between the 2,6‐pyridinedicarboxylates provided appropriate packing to accommodate the two large cations in the self‐assemblies, which helped to modulate the amounts of sulfathiazole in different formulations. Antibacterial activities with E. coli DH5α have shown that the salt and the complexes have lower g/ml antibacterial activity than the parent drug.
Trophic complexity alters the diversity–multifunctionality relationship in experimental grassland mesocosms
Authors: Anujan Krishna , Heilpern Sebastian A. , Prager Case M. , Weeks Brian C. , Naeem Shahid
Published: April 2021

Plant diversity has a positive influence on the number of ecosystem functions maintained simultaneously by a community, or multifunctionality. While the presence of multiple trophic levels beyond plants, or trophic complexity, affects individual functions, the effect of trophic complexity on the diversity–multifunctionality relationship is less well known. To address this issue, we tested whether the independent or simultaneous manipulation of both plant diversity and trophic complexity impacted multifunctionality using a mesocosm experiment from Cedar Creek, Minnesota, USA. Our analyses revealed that neither plant diversity nor trophic complexity had significant effects on single functions, but trophic complexity altered the diversity–multifunctionality relationship in two key ways: It lowered the maximum strength of the diversity–multifunctionality effect, and it shifted the relationship between increasing diversity and multifunctionality from positive to negative at lower function thresholds. Our findings highlight the importance to account for interactions with higher trophic levels, as they can alter the biodiversity effect on multifunctionality.
Acute Toxicity and Transgenerational Effects of Perfluorobutane Sulfonate on Caenorhabditis elegans
Authors: Chowdhury Manjurul Islam , Sana Tanmoy , Panneerselvan Logeshwaran , Dharmarajan Rajarathnam , Megharaj Mallavarapu
Published: April 2021

Perfluorobutane sulfonate (PFBS), due to its increasing use as an alternative to perfluooctane sulfonate (PFOS), is widely detected in humans and the environment, necessitating the evaluation of its potential ecotoxicological risk. We assessed the toxicity and bioaccumulation potential of PFBS in Caenorhabditis elegans, using lethality, locomotion, reproduction, life span, growth, and chemotactic behavior as the effect parameters. In addition, a total of 6 generations of exposed parent animals were monitored for locomotion, brood, and life span behaviors. Life span and brood size were significantly reduced in parent nematodes (P0) following exposure to ≥0.1 mM PFBS, but these negative effects did not transfer to the progeny. Although there was no remarkable effect on reproduction and life span in parent worms exposed to ≤0.01 mM PFBS, multigenerational exposure at 0.0005 mM significantly affected the F4 and F5 progeny. Furthermore, 0.01 to 2.0 mM of PFBS substantially retarded the locomotion behavior of P0 worms. At higher concentrations such as 1.0 mM, this negative effect on locomotion was transferred to the next generation (F1) but later recovered from F2 progeny onward. Our findings demonstrate for the first time that chronic exposure to PFBS at higher concentrations can cause behavioral toxicity and could be transferred to the progeny. These findings have significant implications for the environmental risk assessment of PFBS. Environ Toxicol Chem 2021;40:1971–1980. © 2021 SETAC.
Accelerated long‐term forgetting in individuals with subjective cognitive decline and amyloid‐β positivity
Authors: Tort‐Merino Adrià , Valech Natalia , Laine Matti , Olives Jaume , León María , Ecay‐Torres Mirian , Estanga Ainara , Martínez‐Lage Pablo , Fortea Juan , Molinuevo José Luis , Sánchez‐Valle Raquel , Rodriguez‐Fornells Antoni , Rami Lorena
Published: April 2021

Objectives

We studied a sample of cognitively unimpaired individuals, with and without subjective cognitive decline (SCD), in order to investigate accelerated long‐term forgetting (ALF) and to explore the relationships between objective and subjective cognitive performance and cerebrospinal fluid (CSF) Alzheimer's disease (AD) biomarkers.

Methods

Fifty‐two individuals were included and SCD was quantified through the Subjective Cognitive Decline Questionnaire (SCD‐Q), using its validated cutoff to classify participants as Low SCD‐Q (n = 21) or High SCD‐Q (n = 31). These groups were further subdivided according to the presence or absence of abnormal levels of CSF Aβ42. Objective cognitive performance was assessed with the Ancient Farming Equipment Test (AFE‐T), a new highly‐demanding test that calls for acquisition and retention of novel object/name pairs and allows measuring ALF over a 6‐month period.

Results

The High SCD‐Q group showed a significantly higher free forgetting rate at 3 months compared to the Low SCD‐Q (F [1,44] = 4.72; p < 0.05). When stratifying by amyloid status, High SCD‐Q/Aβ+ showed a significantly lower performance than High SCD‐Q/Aβ–on the final free and cued learning scores (F [1,27] = 6.44, p < 0.05 and F [1,27] = 7.51, p < 0.05, respectively), the 1‐week free and cued recall (F [1,24] = 4.49; p < 0.05 and F [1,24] = 7.10; p < 0.01, respectively), the 1‐week cued forgetting rate (F [1,24] = 5.13; p < 0.05), and the 3‐month cued recall (F [1,24] = 4.27; p < 0.05). Linear regression analyses showed that higher SCD‐Q scores were associated with higher forgetting rates on the AFE‐T (β = −0.212; p < 0.05).

Conclusions

It is possible to detect ALF in individuals with high SCD ratings, appearing especially in those with abnormal CSF Aβ42 levels. Both in research and the clinical field, there is an increasing need of using more demanding cognitive measures, such as the AFE‐T, for identifying and tracking the earliest cognitive changes in these populations.
Evaluation of health appraisal project of primary school children: a study in Egypt
Authors: Rizk Hoda Ibrahim , Abdel‐Razik Madiha Said , Elsebaei Eman Hany
Published: April 2021

Background

School Health insurance (SHI) is working in Egypt since 2003. However, there were no impact indicators that inform policy makers about health status of school children. Therefore, the school health project was conducted by Arab Medical Union (AMU) Medical Syndicate in cooperation with Ministry of Education (MOE), Ministry of Health and Population (MOHP) and Public Health Department, Cairo University to conduct comprehensive medical services to primary school children and to assess the impact of the SHI and the efficiency of AMU project to promote health of children.

Methods

In‐depth interview with policy makers in MOHP, MOE, SHI and secondary analysis of AMU documents. A systematic random sample of 7000 students (7–10 years) was selected which formed 10% of the examined children in AMU project and proportionally distributed in 355 schools in seven Districts in Fayoum Governorate.

Results

SHI was ineffective in providing preventive services to school children. The AMU project was efficient in covering 82% of the targeted students with clinical, preventive and referral services with estimated cost per student were 54.8LE. Clinical findings showed anaemia the major problem (84%), dental (33%), hair/scalp (9%) and visual errors (6%).

Conclusion

The current Primary Health Care facilities needs to improve the quality preventive and curative health services provided to school children. Also, providing health services through medical conveys was of high cost and unsustainable.
Unmasking Inherent Chirality within the Cubane Skeleton
Authors: Yoshino Nana , Kato Yumi , Shimada Yukako , Williams Craig M. , Matsubara Seijiro
Published: April 2021

Cubane, a hexahedral hydrocarbon, can be converted into an asymmetric molecule with a minimum of three substituents. The resulting chiral cubane can be used as a pharmacophore or a chiral ligand. Starting from the cubane carboxamide, the 1,2,3‐substituted compound was synthesized by sequential ortho‐metalation. The 1,3,5‐substituted compound was synthesized by combining site‐selective halogenation and halogen‐metal exchange and the resulting racemate was subjected to enantiomeric resolution by HPLC.
A descriptive audit of healthcare workers exposed to COVID‐19 at a tertiary care center in India
Authors: Mansoor Sadia , Sharma K. Aparna , Ranjan Piyush , Singhal Seema , Meena Jyoti , Kumari Rajesh , Rana Anubhuti , Kumari Archana , Varun Neha , Kumari Sarita , Kumar Sunesh , Bhatla Neerja
Published: April 2021

Objective

To provide a descriptive audit of healthcare workers (HCWs) exposed to COVID‐19, and their contacts, to understand the dynamics of transmission among HCWs.

Methods

Retrospective analysis of contact tracing data of infected HCWs was done from March 1, 2020 to July 31, 2020 at a tertiary care center in New Delhi, India. Contacts were categorized according to the nature of contact and followed for 14 days.

Results

Qualitative RT‐PCR testing was performed on 106 HCWs (from a total of 257) owing to exposure or development of symptoms. Positive results were found in 16 HCWs (6.2%) who were exposed to 120 other HCWs, generating 197 exposure incidents. Of these, 30 (15.2%) exposure incidents were high risk with multiple exposures in 48 (40.0%) HCWs. Exposure to infected HCWs was noted in 3 (18.8%) of 16 positive cases. Of the 197 exposure incidents, 54 (27.4%) were deemed avoidable exposures. Infection prevention and control policies were periodically reviewed, and the department implemented mitigating steps to minimize the risk to healthcare providers.

Conclusion

Instituting appropriate infection prevention and control policies and use of adequate precautions by HCWs is vital to minimize high‐risk exposure to COVID‐19.
Nonparametric learning approach based on infinite flexible mixture model and its application to medical data analysis
Authors: Bourouis Sami , Bouguila Nizar
Published: April 2021

The goal of this paper is to develop an effective approach allowing to capture accurately the intrinsic nature of data using an infinite shifted‐scaled Dirichlet mixture model (InSSDMM). This article extends the finite statistical model to a more efficient multidimensional infinite mixture. The flexibility of the developed framework is demonstrated via some challenging medical applications that concern diabetic retinopathy detection in eye images and pneumonia identification in chest X‐ray scans. The obtained results demonstrate the merits of such approach as compared to many other generative and discriminative models.
Comparisons of orthodontic residents’ performance and attitudes using 2D, 3D, and virtual reality surgical simulation methods
Authors: Sytek Lauren , Inglehart Marita R. , Ramaswamy Vidya , Aronovich Sharon , Edwards Sean , Kim‐Berman Hera
Published: April 2021

Purpose

Advances in virtual reality technology for surgical simulation methods may improve diagnosis and treatment planning of complex orthognathic surgery cases. The objectives were to assess orthodontic residents’ performance and attitudes when treatment planning orthognathic surgery cases using two‐dimensional (2D) digital, three‐dimensional (3D) digital, and virtual reality (VR) surgical simulations.

Methods

The study had a mixed methods study design involving 20 graduate orthodontic residents. Their previous experiences, confidence, and competence with orthodontic diagnosis and surgical treatment planning were assessed with a baseline survey. Each resident completed 2D, 3D, and VR treatment planning and simulation tasks in a randomized order and recorded their diagnosis, objectives, treatment plan, and special surgical concerns for each case using a treatment planning worksheet. The worksheets were scored and quantitative data were analyzed. Attitudinal responses to the simulation experience were captured with a post‐survey and interview.

Results

The number of total prescribed surgical movements was greater for 3D and VR simulation methods (p = 0.001). There were no differences in the overall total written treatment plan analysis score among the three surgical simulation tasks. Participants took longer to complete the VR and 3D tasks (p < 0.001) and asked more questions regarding manipulation (p < 0.001) and software features (p < 0.002) for higher fidelity tools. Analysis of qualitative feedback showed positive attitudes toward higher fidelity tools with regard to visualization, manipulation, and enjoyment of the task.

Conclusions

The results demonstrate that simulation methods of increased fidelity (3D and VR) are appropriate alternatives to 2D conventional orthognathic surgical simulation methods when combined with traditional records. Qualitative feedback confirms residents’ readiness to adopt VR simulation. However, comprehensive training is needed to increase familiarity and comfort with using the new technology.
A comparison of different standard‐setting methods for professional qualifying dental examination
Authors: Abd‐Rahman Aida N.A. , Baharuddin Izyan H. , Abu‐Hassan Mohamed I. , Davies Sally J.
Published: April 2021

Background

The outcome of assessments is determined by the standard‐setting method used. Standard setting is the process of deciding what is good enough. A cutoff score of 50% was commonly used in dental schools in Malaysia. This study aims to compare the conventional, norm‐referenced, and modified‐Angoff standard‐setting methods.

Methods

The norm‐referenced method of standard setting was applied to the real scores of 40 final‐year dental students on a multiple‐choice question (MCQ), a short answer question (SAQ), and an objective structured clinical examination (OSCE). A panel of 10 judges set the standard using the modified‐Angoff method for the same paper in one sitting. One judge set the passing score of 10 OSCE questions after 2 weeks. A comparison of the grades and pass/fail rates derived from the absolute standard, norm‐referenced, and modified‐Angoff methods was made. The intra‐rater and inter‐rater reliabilities of the modified‐Angoff method were assessed.

Results

The passing rate for the absolute standard was 100% (40/40), for the norm‐referenced method it was 62.5% (25/40), and for the modified‐Angoff method it was 80% (32/40). The modified‐Angoff method had good inter‐rater reliability of 0.876 and excellent test–retest reliability of 0.941.

Conclusion

There were significant differences in the outcomes of these three standard‐setting methods, as shown by the difference in the proportion of candidates who passed and failed the assessment. The modified‐Angoff method was found to have good reliability for use with a professional qualifying dental examination.
Exploring global health programs in U.S. dental schools
Authors: Shick Elizabeth , Gross Lilyana , McNair Bryan , Woodmansey Karl
Published: April 2021

Purpose

The purpose of this study was to survey and describe key curricular and extracurricular components of U.S. dental schools’ global health programs.

Methods

A 22‐item web‐based survey invitation was sent to administrators at all 66 US dental schools. Topics included both curricular and extracurricular global health activities offered, including Short‐term Experiences in Global Health (STEGHs). Key components were identified and classified as domains and components for the purpose of discussion: Domain #1: Program support and administrative factors (components: a support, faculty support, and extracurricular activities), Domain #2: Academic teaching (components: global health track, didactic courses, and cultural awareness and communication teaching), and Domain #3: STEGHs, (components: School‐based STEGHs, al organization‐based STEGHs, and exchange programs).

Results

Most notably among respondents, 72% strongly agreed/agreed that global health should be a part of the dental curriculum, 81% strongly agreed/agreed that students benefit from participating in global health experiences, and 43% of schools had a faculty member dedicated to global health work. In this study of dental schools, 44% offered didactic courses in global health, and 62% of schools offered STEGHs.

Conclusion

The results of this study offer a description of key components of global health education programs in U.S. dental schools. Schools surveyed offer a combination of both didactic courses and STEGH programs for their students. Global health education may improve dental students’ skills related to managing a diverse patient population.
Residual antler periosteum holds the potential to partially regenerate lost antler tissue
Authors: Li Chunyi
Published: April 2021

Deer antlers are the only mammalian organs that can fully regenerate, which relies on pedicle periosteum (PP). Interestingly during the growing phase, antlers themselves can regenerate partially lost antler tissue. However, what tissue type in the growing antlers fulfills this role is not known. Following antler removal during the growing phase, a “second” antler regenerates from the stump. In this study, the “second” antler growing from the cut antler base (AB) was examined in both red and sika deer. The results showed that all regenerating antlers were formed from the peripheral edge of the AB, where the antler periosteum (AnP) is located. The growth center showed a clear demarcation from the AB bone in red deer. Therefore, it is highly likely that AnP is the tissue that possesses the potential. Factors that might affect this potential were explored and the main factor was found to be AB calcification, which was controlled by rising androgens. Thus, the ultimate antler regeneration potential of the AnP was assessed through castration and repeated antler removal. The results demonstrated that the regeneration potential of AnP was somewhat limited and inferior to that of the PP. The ability of AnP to achieve partial regeneration may be evolutionarily conserved, as the regeneration of partially lost antlers within the season is secured; whereas, with PP, a new set of antlers in the next season is guaranteed. This two‐level mechanism may signify how evolutionarily important it is for deer to possess reasonably intact antlers.
Client and provider preferences for HIV care: Implications for implementing differentiated service delivery in Thailand
Authors: Lujintanon Sita , Amatavete Sorawit , Sungsing Thanthip , Seekaew Pich , Peelay Jitsupa , Mingkwanrungruang Pravit , Chinbunchorn Tanat , Teeratakulpisarn Somsong , Methajittiphan Pornpen , Leenasirima Prattana , Norchaiwong Amarin , Nilmanat Ampaipith , Phanuphak Praphan , Ramautarsing Reshmie A , Phanuphak Nittaya
Published: April 2021

Introduction

Differentiated service delivery (DSD) for antiretroviral therapy (ART) maintenance embodies the client‐centred approach to tailor services to support people living with HIV in adhering to treatment and achieving viral suppression. We aimed to assess the preferences for HIV care and attitudes towards DSD for ART maintenance among ART clients and providers at healthcare facilities in Thailand.

Methods

A cross‐sectional study using self‐administered questionnaires was conducted in September‐November 2018 at five healthcare facilities in four high HIV burden provinces in Thailand. Eligible participants who were ART clients aged ≥18 years and ART providers were recruited by consecutive sampling. Descriptive statistics were used to summarize demographic characteristics, preferences for HIV services and expectations and concerns towards DSD for ART maintenance.

Results

Five hundred clients and 52 providers completed the questionnaires. Their median ages (interquartile range; IQR) were 38.6 (29.8 to 45.5) and 37.3 (27.3 to 45.1); 48.5% and 78.9% were females, 16.8% and 1.9% were men who have sex with men, and 2.4% and 7.7% were transgender women, respectively. Most clients and providers agreed that ART maintenance tasks, including ART refill, viral load testing, HIV/sexually transmitted infection monitoring, and psychosocial support should be provided at ART clinics (85.2% to 90.8% vs. 76.9% to 84.6%), by physicians (77.0% to 94.6% vs. 71.2% to 100.0%), every three months (26.7% to 40.8% vs. 17.3% to 55.8%) or six months (33.0% to 56.7% vs. 28.9% to 80.8%). Clients agreed that DSD would encourage their autonomy (84.9%) and empower responsibility for their health (87.7%). Some clients and providers disagreed that DSD would lead to poor ART retention (54.0% vs. 40.4%), increased loss to follow‐up (52.5% vs. 42.3%), and delayed detection of treatment failure (48.3% vs. 44.2%), whereas 31.4% to 50.0% of providers were unsure about these expectations and concerns.

Conclusions

Physician‐led, facility‐based clinical consultation visit spacing in combination with multi‐month ART refill was identified as one promising DSD model in Thailand. However, low preference for decentralization and task shifting may prove challenging to implement other models, especially since many providers were unsure about DSD benefits. This calls for local implementation studies to prove feasibility and governmental and social support to legitimize and normalize DSD in order to gain acceptance among clients and providers.
A Life Deliberately Lived: An Existential Portrait of Authenticity, Freedom, and Responsibility in Counseling
Authors: Palacios Alfredo F.
Published: April 2021

To contextualize the scholarship in this special issue, I argue that primary tenets of existentialism are transtheoretical in the counseling profession. Specifically, issues of authenticity, freedom, and responsibility to others are articulated as having shared heritage in existentialism. Deepening the well of existential scholarship can catalyze a renewed relationship between theory and practice.
Trauma and the Question of Free Will: An Existentialist's Guide to Trauma‐Informed Care
Authors: Smith Aaron J. , Lapsansky Erin R.
Published: April 2021

The purpose of this article is to summarize and examine how contemporary traumatological research serves to complicate and enrich what we know about how people attempt to make meaning of their experiences in the aftermaths of traumas.
Histologic and molecular features in pathologic human menisci from knees with and without osteoarthritis
Authors: Monibi Farrah A. , Pannellini Tania , Otero Miguel , Warren Russell F. , Rodeo Scott A.
Published: April 2021

The objective of this study was to evaluate histologic and molecular features of meniscus degeneration in cohorts of patients with and without osteoarthritis (OA) of the knee. Menisci were obtained from patients undergoing total knee arthroplasty for OA (TKA) or arthroscopic partial meniscectomy (APM) for a torn knee meniscus. Degenerative meniscal tears were among the most common tear type in the APM group based on the pattern. Using an integrative workflow for molecular evaluation of formalin‐fixed and paraffin‐embedded tissues, human menisci underwent blinded histologic evaluation and NanoString gene expression analyses. Histology revealed increased proteoglycan content in TKA menisci compared to APM menisci, but otherwise no significant differences in the total pathology score or sub‐scores between patients based on age or cohort. NanoString analyses revealed differential expression of genes primarily associated with the PI3K‐AKT signaling pathway, cell cycle, and apoptosis. These data provide new insights into histological and molecular features of meniscus degeneration in patients with and without knee OA. Histologic assessment of menisci showed similar severity of overall degeneration between cohorts, but there were differences at the molecular level. The dysregulated pathways identified in this study could contribute to early‐onset meniscus degeneration, or to a predisposition to meniscus tears and subsequent knee OA. Further studies that validate genes and pathways uncovered in this study will allow us to evaluate novel approaches to assess and treat meniscal degeneration.
Physicochemical and nutritional properties of high protein emulsion‐type lupin‐based model milk alternatives: effect of protein source and homogenization pressure
Authors: Vogelsang‐O'Dwyer Martin , Sahin Aylin W , Zannini Emanuele , Arendt Elke K
Published: April 2021

BACKGROUND

Plant‐based milk alternatives are becoming more popular. However, many are low in nutrients, particularly protein. More attention is being given to plant protein isolates / concentrates as potential ingredients in high‐protein milk alternative formulations.

RESULTS

The effect of lupin protein source on the physicochemical, functional, and nutritional characteristics of model milk alternatives was investigated. Milk alternatives were produced with either blue lupin or white lupin protein isolate, formulated to contain similar levels of protein and fat as low‐fat cow's milk. Nutritional composition and predicted glycemic properties were measured. The effect of homogenization pressure on the physicochemical properties and storage stability was also assessed, with cow's milk and soy milk alternative analyzed for comparison. Both blue and white lupin milk alternatives were high in protein, low in fermentable oligo‐, di‐ and monosaccharides, and polyols (FODMAPs), and had a low predicted glycemic index. White lupin milk alternatives had smaller particle size as well as greater stability, with less creaming compared to blue lupin milk alternatives, although the former showed slightly higher sediment layers. Increasing homogenization pressure from 180 to 780 bar resulted in smaller particle size, lower separation rate, and greater foamability for both blue and white lupin milk alternatives. White lupin milk alternative homogenized at 780 bar was found to be the most stable product, with a similar separation rate to cow's milk.

CONCLUSIONS

These results indicate that protein source and processing can influence functional properties significantly along with product stability, and this is an important consideration when formulating high‐protein milk alternatives. © 2021 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.
Use of water and ethanol extracts from wine grape seed pomace to prepare an antioxidant toothpaste
Authors: Emmulo Emanuela , Ceccantoni Brunella , Bellincontro Andrea , Mencarelli Fabio
Published: April 2021

BACKGROUND

Extracts of fresh wine grape seeds/skin or of grape pomace seeds were used to prepare antioxidant natural toothpastes.

RESULTS

Ethanol extracted twice more polyphenols than water; ultrasound did not provide any improvement in the extraction. The addition of freeze‐dried ethanol extracts of seeds or skin, at 2% and 10%, to the commercial toothpaste significantly increased the polyphenol content, both from white grape seeds and skin and from red grape seed pomace. The evaluation of time stability (shelf life) revealed a decrease, after 4 months, of 3.9% and 9.4% in total polyphenol content, in 5% and 10% water extracts, but not for ethanol extracts. 1,1‐Diphenyl‐2‐picrilhydrazil1antiradical activity was the highest in 10% of seed water extract toothpaste and, after 4 months, the activity was stable.

CONCLUSION

Ethanol and water are efficient and safe solvents to create natural toothpaste with grape or pomace seed extract with antioxidant activity. © 2021 The Authors.Journal of The Science of Food and Agriculturepublished by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.
Peripheral Vascular Resistance in Cerebral Arteries in Patients With Carotid Atherosclerosis – Substudy Results of the Atherosclerotic Plaque Characteristics Associated With a Progression Rate of the Plaque and a Risk of Stroke in Patients With the Carotid Bifurcation Plaque Study (ANTIQUE)
Authors: Kešnerová Petra , Školoudík David , Herzig Roman , Netuka David , Szegedi Istvan , Langová Kateřina ,   for the ANTIQUE Trial Group
Published: April 2021

Objectives

Transcranial color‐coded duplex sonography (TCCS) enables to measure blood flow characteristics in cerebral vessels, including vascular resistance and pulsatility. The study aims to identify factors influencing pulsatility (PI) and resistance (RI) indices measured using TCCS in patients with carotid atherosclerosis.

Methods

Self‐sufficient patients with atherosclerotic plaque causing 20–70% carotid stenosis were consecutively enrolled to the study. All patients underwent duplex sonography of cervical arteries and TCCS with measurement of PI and RI in the middle cerebral artery, neurological, and physical examinations. Following data were recorded: age, gender, height, weight, body mass index, systolic and diastolic blood pressure, occurrence of current and previous diseases, surgery, medication, smoking, and daily dose of alcohol. Univariant and multivariant logistic regression analysis were used for identification of the factors influencing RI and PI.

Results

Totally 1863 subjects were enrolled to the study: 139 healthy controls (54 males, age 55.52 ± 7.05 years) in derivation cohort and 1724 patients (777 males, age 68.73 ± 9.39 years) in validation cohort. The cut off value for RI was 0.63 and for PI 1.21. Independent factors for increased RI/PI were age (odds ratio [OR] = 1.108/1.105 per 1 year), occurrence of diabetes mellitus (OR = 1.767/2.170), arterial hypertension (OR = 1.700 for RI only), width of the carotid plaque (OR = 1.260 per 10% stenosis for RI only), and male gender (OR = 1.530 for PI only; P ˂.01 in all cases).

Conclusions

The independent predictors of increased cerebral arterial resistance and/or pulsatility in patients with carotid atherosclerosis were age, arterial hypertension, diabetes mellitus, carotid plaque width, and male gender.
Measurement of the Area and Circumference of the Leg
Authors: Milani Hérbene José Figuinha , de Sá Barreto Enoch Quinderé , Araujo Júnior Edward , Cavalheiro Sérgio , Barbosa Maurício Mendes , Moron Antonio Fernandes
Published: April 2021

Objective

To standardize a new technique to evaluate the fetal leg muscle trophism by measuring the area and circumference, and comparing this technique between normal and fetuses with open lumbosacral spina bifida (SB).

Methods

Observational cross‐sectional study was carried out on pregnant women with 26 weeks who were divided into two groups: Group I—fetuses with diagnosis of open lumbosacral SB; Group II—normal fetuses (control). In fetuses with SB, subjective evaluation of the lower limbs was performed (muscle echogenicity and leg movements). To estimate the leg muscle trophism, the measurement of the area and circumference of the leg were standardized, and the reproducibility of this method was performed.

Results

Thirty‐one fetuses with open lumbosacral SB and 51 normal fetuses were evaluated. The measurements of the area and circumference of the leg proved to be highly reproducible (intraclass correlation coefficient—ICC > 0.95). The leg area and circumference measurements were statistically lower in the SB group than in the control group (p < .001). When subjective ultrasound assessment demonstrated hypotrophy of the lower limbs, the measurements of the area and circumference of the leg were statistically lower when compared to normal fetuses (p < .001). Fetuses with open SB with abnormal lower limb movements had lower measurements of the area and circumference of the leg than fetuses with normal movements (p < .001).

Conclusion

A new technique for estimating fetal leg muscle trophism was standardized, which proved to be highly reproducible and was able to show the difference between normal and fetuses with SB.
Corrosion damage in frozen 3.5 wt.% NaCl solution
Authors: Fu Tian , Song Guang‐Ling , Zheng Dajiang
Published: April 2021

Zn and frozen 3.5 wt.% NaCl solution were used to simulate galvanized steel structures exposed to the seawater in the Polar Regions. The conductivity of the frozen salt solution and the corrosion of the Zn were characterized by electrochemical impedance spectroscopy, galvanic current measurement, and surface analyses. The results indicated that the completely frozen 3.5 wt.% NaCl solution was still conductive and corrosive, and the galvanic effect between different metals could not be ignored. The corrosion damage risk of metallic structures, particularly in the joint regions, can be high under freezing marine conditions in the Polar Regions.