bluuebunny/crossref_metadata_2025 huggingface dataset:
Interaction effect of cassava starch × buriti oil on the physical properties of edible films
Authors: de Souza Mariele Nascimento , Piedade Ana Beatriz Silva , Santos Thaynara Pegoraro , de Britto Vitória França , Nascimento Edgar , de Faria Jorge Luiz Brito , de Faria Rozilaine Aparecida Pelegrine Gomes
Published: November 2022

This work aimed to develop and characterize edible films made with cassava starch and buriti oil in a factorial scheme to verify the effect of the interaction between these factors on the physical properties. The experiment was developed in an entirely randomized design in a 2 × 3 factorial scheme. They were prepared with six different formulations evaluating thickness, water solubility, moisture, water activity, chromaticiy (C*), total color difference (ΔE*), opacity and light transmittance, tensile strength and elongation at break, thermogravimetric analysis, and differential scanning calorimetry. There were effects of each factor on the film properties as well as interaction effects. It was found that with the increase in the concentration of buriti oil, there was a decrease in water solubility, tensile strength, and elongation at break. Higher concentrations of cassava starch increased the thickness and tensile strength. On the other hand, it decreased the moisture content, water solubility, and elongation at break. Transparency, C*, and ΔE* were influenced by the interaction effect between the factors. On the other hand, films with higher oil content showed greater thermal degradation. We conclude that films made with 6% cassava starch and 1% buriti oil present better mechanical and thermal properties with the possibility of application in the food industry.
Performance evaluation of WS2 as buffer and Sb2S3 as hole transport layer in CZTS solar cell by numerical simulation
Authors: Riyad Md. Nur Hossain , Sunny Adil , Khatun Most. Marzia , Rahman Sabrina , Ahmed Sheikh Rashel Al
Published: November 2022

This study reports on performance enhancement of a Cu2ZnSnS4 solar cell introducing Sb2S3 as hole transport layer (HTL) along WS2 as buffer layer. We have investigated photovoltaic (PV) characteristics by utilizing SCAPS‐1D. A comparative analysis on PV performances between conventional CZTS/CdS and proposed Ni/Sb2S3/CZTS/WS2/FTO/Al solar cells is presented. It is revealed that “spike like” band structure at the CZTS/WS2 interface having smaller conduction band offset makes it potential alternative to commonly used CdS buffer. This report also evaluates that the Sb2S3 as an HTL inserted at the rear of CZTS enhances performances by reducing carrier recombination at back interface with appropriate band alignment. The impacts of thickness, carrier concentration of different layers, and bulk defect density in CZTS as well as the interface defects on cell outputs are analyzed. The influences of temperature, work function, and cell resistances are also examined. Optimum absorber thickness of 1.0 μm along doping density of 1017 cm−3 is selected. A maximum efficiency of 30.63% is achieved for the optimized CZTS cell. Therefore, these results suggest that Sb2S3 as HTL and WS2 as buffer layer can be employed effectively to develop highly efficient and low‐cost CZTS solar cells.
First report of Megacollybia platyphylla (Marasmiaceae) from India based on morphology and molecular phylogenetic inferences
Authors: Verma Komal , Mehmood Tahir , Hashmi Syed Azhar Jawad , Singh Upendra , Sharma Yash Pal
Published: November 2022

In the present communication, a species of Megacollybia (M. platyphylla) belonging to the family Marasmiaceae has been described and illustrated for the first time in the Indian mycobiota. This is a lignicolous species found on the dead tree trunks of Cedrus deodara from the Union Territory of Jammu and Kashmir. Here, we investigated the identity of M. platyphylla based on detailed morphology and nrITS‐based phylogeny.
Typification of seven names in the genus Verbascum (Scrophulariaceae) from Iran
Authors: Shirali Zeynab , Negaresh Kazem , Salehi Salmi Mohamad Reza
Published: November 2022

As part of the nomenclatural revision of the genus Verbascum (Scrophulariaceae) in Iran, we noted that seven names are still untypified. Thus, we have carried out a nomenclatural investigation which led to the designation of seven lectotypes for V. cheiranthifolium var. asperulum, V. flavidum, V. macrocarpum, V. sinuatum var. adenosepalum, V. straussii, V. suwarowianum var. pseudopersicum and V. szovitsianum.
Health professionals delivering oral health interventions in early childhood: A scoping review of Australian and New Zealand literature
Authors: Nation Alison , Pukallus Margaret , Stormon Nicole , Foley Michael , Lalloo Ratilal
Published: November 2022

Issue Addressed

Dental caries is highly prevalent in very young Australian and New Zealand children. Health professionals other than registered dental professionals can help prevent early childhood caries, promoting oral health to assist families establish preventative oral health habits at a child's early age. This review identifies oral health promotion (OHP) delivered by nondental health professionals in Australia and New Zealand involving very young children.

Methods

Databases (MEDLINE, CINAHL, Embase, Emcare, Web of Science, Scopus, ProQuest, Google Scholar, TROVE) and digital libraries were searched between 2001 and 2021 for eligible studies and grey literature. Studies with a focus on preventative oral health strategies in a primary health care context were included.

Results

The review identified 76 studies. Seven met the inclusion criteria, and were conducted in Australia across metropolitan, rural, and remote settings. Studies that successfully engaged nondental health professionals to promote oral health to families reported a positive change in oral health practices among very young children. Delivering OHP during a child's early life stage positively influenced their oral health outcomes.

Conclusions

Integration of dental and primary health care increased access to oral health care and advanced positive oral health outcomes for children. With adequate training, resources, and support mechanisms, nondental health professionals can deliver oral health strategies that facilitate behaviour change in parents to improve children's oral health.

So What? Health promotion generates enabling conditions that support and empower families to improve and maintain their oral health. Nondental health professionals can play a crucial role promoting oral health for very young children and improving equitable access to preventative oral health care.
Firm's cost of debt firstly changes conservatism and then leads the choices of future diversification strategies: Evidence from Asian countries
Authors: Sumiyana Sumiyana , Usmayanti Vivi
Published: November 2022

This study investigates how firms’ debt cost affects their conservatism in the first stage, and then leads their future strategies in the second stage. Moreover, it shows that firms would likely ignore their conservatism when choosing a strategy, especially diversification. Then, it presents two interrelated novelties. First, firms operate with a low cost of debt, constructing their high conservatism. As a result, they would likely choose a cost‐reduction strategy. Conversely, firms with low conservatism usually choose diversification strategies because they are at the lowest risk. Second, this study highlights that the firms’ diversification strategies are a conundrum while considering the cost of debt and conservatism when applied by firms operating the business in developing countries. Operating in emerging economies, firms could choose a higher debt cost and simultaneously ignore conservatism, maintaining their creditors as funding. Moreover, this research examines Asian countries' data using ordinary least‐square (OLS) and two‐stage last‐square (2‐SLS). In addition, 2‐SLS outperforms in the staged‐associative examinations. Thus, this research reveals that the cost of debt, conservatism and chosen strategies relate to simple staging. As a result, they acquire the highest cost of debt, with the high‐risk level affecting their weighted cost of capital. Finally, this research infers that firms' costs of debt and conservatism are not mutually exclusive and sequentially affect their future strategic choices. It, therefore, suggests that when firms choose diversification strategies, they might probably take a high cost of debt, accompanied by a highly conservative level.
The relationship of superoxide dismutase and malondialdehyde levels with left ventricular geometry and function in patients with primary hypertension
Authors: Wei Na , Wang Jian , Hao Meifang , Zhang Jingxuan , Li Tingting , Hao Yaohong , Zhao Yufang , Kang Caihong , Zan Yu , Xing Xueqing
Published: November 2022

Introduction

To investigate the relationship of superoxide dismutase (SOD) and malondialdehyde (MDA) levels with left ventricular geometry (LVG) and function in patients with primary hypertension (PH).

Methods

A total of 222 PH patients and 25 healthy control (HC)s were enrolled in this study. All subjects underwent echocardiography and blood biochemical examination. PH patients were divided into four groups based on Ganau classification: normal geometry (NG) group, concentric remodeling (CR) group, eccentric hypertrophy (EH) group, and concentric hypertrophy (CH) group. Pearson correlation analysis and logistic regression analysis were used to analyze the relationship between SOD and MDA with left ventricular structure and function.

Results

Compared to the HC, NG and CR groups, MDA level was higher while SOD level was lower in the EH and CH groups (all P < 0.001). SOD level was negatively correlated with IVSd, LVDd, LVPW, and global longitudinal strain (GLS), but positively correlated with LVEF. MDA level was positively correlated with IVSd, LVPW, and GLS, while negatively correlated with e'/a' and LVEF. SOD and MDA were independently associated with CR (OR = 0.970, P = 0.003; OR = 1.204, P = 0.043), EH (OR = 0.879, P < 0.001; OR = 2.197, P = 0.001) and CH (OR = 0.796, P < 0.001; OR = 3.669, P < 0.001).

Conclusion

The SOD and MDA levels were correlated with LVG and function in PH patients. SOD and MDA may be important influencing factors of LVG change.
Didactic and clinical nutrition content in dental hygiene programs: Directors’ perspective
Authors: Onofrietti Stacy L. , Gurenlian JoAnn
Published: November 2022

Purpose

Concern over inadequacy and implementation processes of nutritional content in dental hygiene education program (DHEP) curriculum policy at both a didactic level and clinical level exists. The purpose of this qualitative study was to examine the DHEP extent and practices of didactic and clinical nutrition content, identify DHEP barriers to increasing nutrition education content, and determine the need for a nutrition content curriculum standard from the director's perspective.

Methods

A qualitative descriptive design was utilized, and DHEP directors were recruited through purposive sampling. Interviews were transcribed directly following each interview and data was analyzed simultaneously. The thematic analysis process was a hybrid approach incorporating both the inductive and deductive approaches.

Results

Four major themes emerged from the study: value of nutrition services, power, capacity building expectations, and nutrition curriculum distribution. The directors’ intentions with nutritional content for the DHEP were not consistent with what occurred in implementation. The findings revealed a disconnect in the directors’ ability to implement adequate nutrition curriculum content. The lack of power as the educational leader in the form of decreased autonomy due to policy implications filtered across all interviews. The findings further noted the capacity building expectations needed among DHEPs in the areas of faculty and student calibration.

Conclusions

Multiple challenges impact the ability of program directors to implement accurate and adequate didactic and clinical related nutrition content in DHEPs. Future research, including DHEP directors and faculty teaching nutrition courses across the United States, would be beneficial in developing a broader perspective and creating a nutrition model standard.
The voluntary operant and the operant nature of volition: Three views
Authors: Neuringer Allen
Published: November 2022

Many philosophers, psychologists, and lay folk associate volition with autonomy (actions are independent of an individual's environment) and free will (individuals originate their actions). Most behaviorists hold these views to be incompatible with behavior analyses. The present paper describes volition as interpreted by B. F. Skinner, Howard Rachlin, and Allen Neuringer. Skinner relates volition to positively reinforced operant behavior. That works because, like operants, voluntary actions are free, in the sense of not physically constrained; they affect their environments, often resulting in positive outcomes, and are sometimes unpredictable. Rachlin, while incorporating Skinnerian methods, interprets volition within his own Teleological Behaviorism framework. For Rachlin, reinforcement of an individual response is often incompatible with voluntary control, thereby disagreeing with Skinner. Responses are voluntary only when they are members of extended response patterns. Neuringer also begins with Skinner's operants, but argues that, under the control of reinforcing consequences, both voluntary actions and operant responses are sometimes predictable and other times “truly” unpredictable. Neuringer does not assume that environments determine voluntary actions, thereby disagreeing with Skinner and Rachlin. Taken together, the agreements and disagreements among these three behaviorists may help to shed light on the relationship between operants and volition.
Inside Zambia's ‘new normal:’ COVID‐19 policy responses and implications for peri‐urban food security and livelihoods
Authors: Manda Simon
Published: November 2022

This paper explores COVID‐19 policy responses and experiences of their impact on food systems and livelihoods, and other factors shaping vulnerability among peri‐urban small‐scale farmers in Zambia. We draw on household surveys and case studies, multi‐level interviews and group discussions to make sense of ‘new normal’ policy (in)action and its (in) effectiveness in shaping peri‐urban production, market linkages and livelihoods during the pandemic. Results show COVID‐19 policy responses affected peri‐urban production supply and demand for food and inputs. The ‘new normal’ policy responses aimed at striking a balance between health concerns and economic development as a pathway to recovery have not been followed by systematic peri‐urban agriculture support, leading to failure to stimulate production and drive urban market linkages, including supermarkets. Findings bring nuance to fragilities in national food systems and the need for long‐term and transformative interventions that can strengthen peri‐urban agriculture and livelihoods beyond the pandemic.
Correlation of Intravoxel Incoherent Motion and Diffusion Kurtosis MR Imaging Models With Reactive Stromal Grade in Prostate Cancer
Authors: Duan Zhiqing , Fang Shaobo , Hu Jiawei , Tao Juan , Zhang Kai , Deng Xiyang , Wang Shaowu , Liu Yajie
Published: November 2022

Background

Reactive stroma is recognized as one of the independent prognostic factors in prostate cancer (PCa). Intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI) may be useful for assessing the reactive stromal grade (RSG).

Purpose

To investigate whether IVIM and DKI models can evaluate RSG in PCa patients.

Study Type

Retrospective.

Subjects

A total of 56 PCa patients aged 73 years on average confirmed by MRI and transrectal ultrasound (MRI/TRUS) fusion biopsy divided into two subgroups (18 high RSG and 38 low RSG).

Field Strength/Sequence

A 3 T/T1WI‐fs, T1WI, T2WI‐fs, T2WI, DWI, IVIM, and DKI.

Assessment

Apparent diffusion coefficient (ADC), pure diffusion coefficient (D), pseudo‐diffusion coefficient (D*), perfusion fraction (f), mean diffusion (MD), mean kurtosis (MK) were obtained. Patients were divided into high RSG PCa (>50% reactive stroma) and low RSG PCa (≤50% reactive stroma) groups on hematoxylin and eosin (H&E) stained sections.

Statistical Tests

Spearman correlation and independent sample t‐test or Wilcoxon's rank sum test was used to investigate the relationship between each imaging parameter and RSG. The combined parameters were calculated using a binary logistic regression model. Receiver operating characteristic (ROC) analysis was used to explore the value of individual and combined parameters to differentiate between high and low RSG group. Area under the ROC curves (AUC) > 0.7 were used as reference standards.

Results

ADC, D, f, and MD values showed positive correlation with RSG (r = 0.489, 0.619, 0.318, and 0.544, respectively); MK showed negative correlation with RSG (r = −0.444). ADC, D, f, and MD values were significantly lower in the low RSG group than in the high RSG group. The combined model showed the best diagnostic ability to differentiate low and high RSG groups (AUC = 0.887).

Data Conclusion

Parameters of IVIM and DKI may be promising methods for assessment of RSG in PCa patients.

Evidence Level

3.

Technical Efficacy

Stage 3.
Micellar enhanced ultrafiltration of phenol with dodecylpyridinium chloride and sodium dodecylbenzene sulfonate
Authors: Ontiveros Jesús F. , Bullón Johnny , Cárdenas Antonio
Published: November 2022

Micellar enhanced ultrafiltration is a surfactant‐based separation process for wastewater treatment. The ultrafiltration of dodecyl pyridinium chloride (DPC) and sodium dodecyl benzene sulfonate (SDBS) solutions was realized with 5 kDa and 15 kDa molecular weight cut‐off ceramic membranes. Surfactant concentrations under and over the micellar critical concentration at three different pressures were studied, and their effects on permeate flux and retention are reported. It was found that an increase in pressure operation, in 0.8–1.8 bar range, causes a lower surfactant concentration in permeate by the presence of a polarization layer. These systems were studied for phenol removal. DPC/phenol system (73.5 mM/0.53 mM) reaches a 61% removal of organic solute. SDBS/phenol system (14.7 mM/0.58 mM) reaches a 25% removal, both with 5 kDa membrane at 1.8 bar. In the case of the cationic surfactant the micelle's positive charge plays a preponderant role in attracting the phenol molecules, while the SDBS does not present this electrostatic interaction.
Osteoconductivity and neurotoxicity of silver‐containing hydroxyapatite coating cage for spinal interbody fusion in rats
Authors: Nakashima Takema , Morimoto Tadatsugu , Hashimoto Akira , Kii Sakumo , Tsukamoto Masatsugu , Miyamoto Hiroshi , Todo Mitsugu , Sonohata Motoki , Mawatari Masaaki
Published: November 2022

Background

The use of spinal instrumentation is an established risk factor for postoperative infection. To address this problem, we prepared silver‐containing hydroxyapatite coating, consisting of highly osteoconductive hydroxyapatite interfused with silver. The technology has been adopted for total hip arthroplasty. Silver‐containing hydroxyapatite coating has been reported to have good biocompatibility and low toxicity. However, no studies about applying this coating in spinal surgery have addressed the osteoconductivity and direct neurotoxicity to the spinal cord of silver‐containing hydroxyapatite cages in spinal interbody fusion.

Aim

In this study, we evaluated the osteoconductivity and neurotoxicity of silver‐containing hydroxyapatite‐coated implants in rats.

Materials & Methods

Titanium (non‐coated, hydroxyapatite‐coated, and silver‐containing hydroxyapatite‐coated) interbody cages were inserted into the spine for anterior lumbar fusion. At 8 weeks postoperatively, micro‐computed tomography and histology were performed to evaluate the osteoconductivity of the cage. Inclined plane test and toe pinch test were performed postoperatively to assess neurotoxicity.

Results

Micro‐computed tomography data indicated no significant difference in bone volume/total volume among the three groups. Histologically, the hydroxyapatite‐coated and silver‐containing hydroxyapatite‐coated groups showed significantly higher bone contact rate than that of the titanium group. In contrast, there was no significant difference in bone formation rate among the three groups. Data of inclined plane and toe pinch test showed no significant loss of motor and sensory function in the three groups. Furthermore, there was no degeneration, necrosis, or accumulation of silver in the spinal cord on histology.

Conclusions

This study suggests that silver‐hydroxyapatite‐coated interbody cages produce good osteoconductivity and are not associated with direct neurotoxicity.
Outcome of Imaging and Biopsy of BI‐RADS Category 3 Lesions
Authors: Polat Dogan S. , Merchant Kanwal , Hayes Jody , Omar Lena , Compton Lindsay , Dogan Basak E.
Published: November 2022

Objectives

To identify biopsy rates and indications for BI‐RADS 3 lesions in a large cohort of patients and compare with follow‐up compliance and malignancy outcomes.

Methods

We retrospectively reviewed all BI‐RADS category‐3 lesions seen on mammography and/or ultrasound between 2013 and 2015. Patient age, lesion size, follow‐up rates at 6‐, 12‐, and 24‐months were collected. Biopsy timing, indication, and outcomes (malignant vs benign) were recorded using at least 2‐year follow‐up or biopsy pathology as endpoint.

Results

Of 2319 BI‐RADS 3 lesions in 2075 women analyzed, biopsy was performed in 173 (7.5%). Most biopsies were performed upfront (99, 57.2%), followed by at 6 (44, 25.4%), 12 (21, 12.1%), and 24‐month follow‐up (9, 5.2%; P < .001). Palpable (P < .001) and larger (median 1.4 vs 1.0 cm, P < .001) lesions in women <40 years (15.2% vs 4.8%, P < .001) were more likely to undergo biopsy. Most biopsies were prompted by patient/physician desire (64.5%, P < .001). Of 783 lesions with available endpoint, 5 (0.6%) were cancer. All cancers were identified either at presentation (in 0–5 months, n = 1) or 6‐month follow‐up (in 5–9 months, n = 4) with biopsy prompted by either morphology change (n = 3) or lesion growth (n = 2). Of the 1855 lesions which were expected for follow up, only 310 (16.7%) underwent all follow‐ups, while 482 (26.1%) had two, 489 (26.5%) one, and 565 (30.6%) had no follow‐up.

Conclusions

In our cohort, BI‐RADS category 3 lesions had significantly higher biopsy rates compared with the small malignancy rate, all of which were identified at baseline or first follow‐up. Overall patient follow‐up compliance low. Imaging follow‐up, especially at first 6‐month time point, should be encouraged in BI‐RADS 3 lesions, instead of upfront biopsies.
How is the z‐Average Molar Mass Related to the Sedimentation Data?
Authors: Ye Xiaodong , Chen Yonggang , Wu Chi
Published: November 2022

Nowadays, students, professors, and researchers in the field of polymer education and research know how different average molar masses of polymer chains are defined in textbooks, but not everyone knows that these different averages actually come from different experimental methods, not purely from different mathematical definitions and calculations. Some of the detailed knowledge have been lost in literature and even textbooks during the polymer development process. The z‐average molar mass (Mz) is one of the typical examples; namely, why it is called the z‐average and how it is related to the concentration profile inside an ultracentrifuge cell. Currently, it is rather difficult, if not impossible, to find how to derive the final equation used in the calculation of Mz. It is the purpose of this paper to show a simple and nontedious derivation of how to obtain Mz from a sedimentation experiment, very different from the original old paper published by Lansing and Kraemer in 1935. It is also experimentally shown how to calculate Mz by using the ultracentrifuge data from a mixture of three polystyrene standards.
Regularity via one vorticity component for the 3D axisymmetric MHD equations
Authors: Guo Zhengguang , Chen Fangru
Published: November 2022

In this paper, we investigate the regularity criteria of axisymmetric weak solutions to the three‐dimensional (3D) incompressible magnetohydrodynamics (MHD) equations with nonzero swirl component. By making use of techniques of the Littlewood–Paley decomposition, we show that weak solutions to the 3D axisymmetric MHD equations become regular if the swirl component of vorticity satisfies that , which partially gives a positive answer to the marginal case for the regularity of MHD equations.
Foliations by curves on threefolds
Authors: Cavalcante Alana , Jardim Marcos , Santiago Danilo
Published: November 2022

We study the conormal sheaves and singular schemes of one‐dimensional foliations on smooth projective varieties X of dimension 3 and Picard rank 1. We prove that if the singular scheme has dimension 0, then the conormal sheaf is μ‐stable whenever the tangent bundle is stable, and apply this fact to the characterization of certain irreducible components of the moduli space of rank 2 reflexive sheaves on and on a smooth quadric hypersurface . Finally, we give a classification of local complete intersection foliations, that is, foliations with locally free conormal sheaves, of degree 0 and 1 on Q3.
On the regularity and symmetry of periodic traveling solutions to weakly dispersive equations with cubic nonlinearity
Authors: Pei Long
Published: November 2022

We consider the a priori regularity and symmetry of periodic traveling wave solutions to a class of weakly dispersive equations with cubic nonlinearity. We prove that any continuous periodic traveling wave solution of small amplitude is symmetric if it satisfies the reflection criterion proposed recently by Bruell and Pei. Moreover, we confirm that continuous periodic traveling waves with singular crests or troughs, which correspond to large‐amplitude waves, are also symmetric if some cancellation structure appears near the singular points or if the wave profile has only a single singular point per period. Included in the results as particular cases are periodic traveling waves with peak, cusp, or stump type singular structures. The argument and results also apply to dispersive equations with more general nonlinearity which is non‐smooth.
Global regularity for 2D Boussinesq equations with partial viscosity in the half plane
Authors: Tan Zhong , Xu Saiguo
Published: November 2022

In this paper, we study the initial‐boundary value problem of two‐dimensional Boussinesq equations with either zero viscosity or zero thermal dissipation in the half plane
. We show the global regularity for these two cases with
initial data and corresponding boundary conditions, based on the existence of global weak solutions. Our result can be regarded as a complement to the works of Chae in 2006, Lai, Pan and Zhao in 2011, and Zhao in 2010.
Satisfaction with web‐based courses on clinical practice guidelines for psychiatrists: Findings from the “Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE)” project
Authors: Iida Hitoshi , Okada Tsuyoshi , Nemoto Kiyotaka , Hasegawa Naomi , Numata Shusuke , Ogasawara Kazuyoshi , Miura Kenichiro , Matsumoto Junya , Hori Hikaru , Iga Jun‐ichi , Ichihashi Kayo , Hashimoto Naoki , Yamada Hisashi , Ohi Kazutaka , Yasui‐Furukori Norio , Fukumoto Kentaro , Tsuboi Takashi , Usami Masahide , Furihata Ryuji , Takaesu Yoshikazu , Hishimoto Akitoyo , Muraoka Hiroyuki , Katsumoto Eiichi , Nagasawa Tatsuya , Ochi Shinichiro , Komatsu Hiroshi , Kikuchi Saya , Takeshima Masahiro , Onitsuka Toshiaki , Tamai Shinichiro , Kubota Chika , Inada Ken , Watanabe Koichiro , Kawasaki Hiroaki , Hashimoto Ryota
Published: November 2022

To disseminate, educate, and validate psychiatric clinical practice guidelines, the Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE) project was launched in 2016. In this study, we investigated whether the web‐based courses offered by this project would be as effective as the face‐to‐face courses. We analyzed and compared survey answers about overall participant satisfaction with the course and answers regarding clinical knowledge of schizophrenia and major depressive disorder between 170 participants who took the web‐based courses in 2020 and 689 participants who took the face‐to‐face courses from 2016 to 2019. The web‐based course participants completed the survey questions about satisfaction with the web‐based courses. The web‐based courses were conducted using a combination of web services to make it as similar as possible to the face‐to‐face courses. The degree of satisfaction assessed by the general evaluation of the web‐based courses was higher than what was expected from the face‐to‐face courses. The degree of satisfaction was similar for the courses on schizophrenia and major depressive disorder. In addition, there were no significant differences in overall satisfaction and clinical knowledge between web‐based and face‐to‐face courses. In conclusion, the web‐based courses on clinical practice guidelines provided by the EGUIDE project were rated as more satisfying than the face‐to‐face course that the participants expected to take and no differences in the effectiveness of either course. The results suggest that, after the COVID‐19 pandemic, it would be possible to disseminate this educational material more widely by adopting web‐based courses additionally face‐to‐face courses.
Skeletal evidence for two external auditory canal disorder cases from medieval China
Authors: Zhao Dongyue , He Letian , Xing Fulai
Published: November 2022

Ear diseases, especially external auditory canal (EAC) disorders, are rarely reported in paleopathology. This study reports on the archaeological skeletal remains of two adults from the medieval period in China that presented with bony destruction in the external auditory canal (EAC). The observed pathological changes were evaluated macroscopic and microscopic, and micro‐CT (micro‐computed tomography) was used to examine the extent of lesion involvement. The lesions in Case 1 involved the EAC and mastoid process with smooth and regular margins. We, therefore, concluded that EAC cholesteatoma is the most likely diagnosis. In Case 2, the lesion was in the superior and posterior walls of the EAC as well as in the mastoid air cells. In this case, we arrive at the diagnosis of EAC infection. Furthermore, the potential impact of these ear diseases has been discussed. This report addresses the lack of detailed descriptions of EAC diseases in previous paleopathological publications and emphasizes the fact that the diagnosis of ear diseases in this context requires comprehensive observations of lesions as well as of all adjacent structures.
Preparation of degradable aliphatic polyester elastomers with tunable strength and elasticity via photo‐crosslinking
Authors: Kang Feifei , Yang Yan , Wang Wenpin , Li Zhibo
Published: November 2022

Degradable polyester elastomers are highly desirable for biomedical applications. Here, highly transparent and degradable aliphatic polyester elastomers were prepared using the ring‐opening copolymerization (ROCP) of commercial monomers, followed by a photo‐crosslinking process. A series of the semi‐crystalline copolyester (PMBL‐co‐PBL‐co‐PCL) precursors with different molecular weights and pendent vinyl contents were synthesized by one‐pot ROCP of α‐methylene‐γ‐butyrolactone (MBL), ε‐caprolactone (ε‐CL) and γ‐butyrolactone (γ‐BL). Then, UV irradiation was applied to photo‐crosslink the precursors to obtain several elastomers. The obtained aliphatic polyester elastomers (CPEs) displayed excellent mechanical properties with high tensile strength (11.3 MPa), high elongation at break (1300%) and high elastic recovery (about 99% after 10 hysteresis cycles). In addition, the elastomer showed much better stability than uncrosslinked (co)polyesters, but maintained degradability in the basic aqueous solution, with ~30% of the mass loss in 1 M NaOH solution after 30 days. Through efficient ROCP, we demonstrated a strategy to prepare degradable CPEs bearing high strength, good elasticity, excellent resilience and degradation capability, which can serve as sustainable elastomers for various applications.
Effects of telehealth on functional capacity, mental health and quality of life among older people with dementia: LAPESI telehealth protocol for a randomized controlled trial
Authors: Tsen Carolina , Andreatto Carla Andreza de Almeida , Aily Jéssica Bianca , Pelicioni Paulo Henrique Silva , Neto Décio Bueno , Mattiello Stela Márcia , Gomes Grace Angélica de Oliveira , de Andrade Larissa Pires
Published: November 2022

Background

Telehealth can be an alternative action at a distance that can help as a form of motor intervention, alleviating the deleterious effects arising from social distancing on functional capacity, mental health and quality of life among older people with dementia during the COVID‐19 pandemic.

Purpose

We aim to analyze the effects of a telehealth program on functional capacity, mental health and quality of life among older people with dementia and their caregivers.

Methods

seventy‐eight individuals with mild and moderate dementia and their caregivers will answer an anamnesis and be evaluated through Clinical Dementia Assessment Score. They will also be evaluated by blinded examiners in terms of functional capacity (Activities of Daily Living Questionnaire and World Health Organization Disability Assessment Schedule 2.0), mental health (Mini‐Mental State Examination, Clock Drawing Test, Verbal Fluency test and the Neuropsychiatric Inventor) and quality of life (Quality of Life in Alzheimer's Disease scale). Afterward, the volunteers will be randomized into the telehealth training group and the control group. The TR will perform systematic physical and cognitive exercises in 50‐min sessions three times a week with professional monitoring, while the CG will receive non‐systematized guidance, both for 12 weeks. Participants will be evaluated at baseline, immediately after the three‐month interventions and with a 12‐week follow‐ up.

Discussion

Technological approaches such as telehealth can be a viable alternative in home care service during times of pandemic. We expect that older people with dementia and their caregivers have high adherence to the telehealth program and improve their functional capacity, mental health and quality of life of older people with dementia. Telehealth is an alternative that can contribute to public policies and the development of effective intervention strategies that neutralize adverse outcomes. It can also be presented as an alternative to home care services, which could reduce demands for health resources.
A nonparametric simultaneous confidence band for biomarker effect on the restricted mean survival time
Authors: Teng Wen , Jiang Wenyu , Chen Bingshu E.
Published: November 2022

Study of prognostic and predictive biomarkers plays an important role in the design and analysis of clinical trials. The Cox proportional hazards model is often used to study the biomarker main effect and the treatment‐biomarker interaction effect for survival data. The estimated effects can be biased if the proportional hazards assumption is violated. The restricted mean survival time is becoming popular in clinical studies for having a clear intuitive interpretation. In this article, we first propose nonparametric methods to make statistical inference for the one‐sample problem of the biomarker effect on the restricted mean survival time; we then extend the methods to the two‐sample problem for studying the difference in the biomarker effects between treatment groups in clinical trials. For a given biomarker, the restricted mean survival time is estimated by kernel smoothing methods with the inverse probability of censoring weights. We prove the consistency for the estimates and develop simultaneous confidence bands for the biomarker effects on the restricted mean survival time. The simultaneous confidence bands are evaluated in extensive simulation studies and are found to have good finite sample performance. We then apply the proposed methods to a breast cancer study conducted by the Breast International Group (BIG) to illustrate how the Ki67 biomarker, a protein marker of cell proliferation, affects the survival time of patients, compared between the treatment groups.
Where might brewers make better managers than MBAs?
Authors: Behrens Alfredo
Published: November 2022

The cross‐cultural analysis is largely bounded to countries, as organizational culture analysis is to corporations. This exploratory analysis brings the two together to signal what leadership styles might fit best in which markets. Populations tending to selflessness and obedience might respond more poorly to typical MBA‐trained business leaders.
Correction to: The Safety Assessment of Insects and Products There of As Novel Foods in the European Union
Authors: Precup Gabriela , Ververis Ermolaos , Azzollini Domenico , Rivero-Pino Fernando , Zakidou Panagiota , Germini Andrea
Published: November 2022

The book was inadvertently published with an incorrect affiliation. Ermolaos Ververis is affiliated to National and Kapodistrian University of Athens (NKUA), Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, Athens, Greece and EFSA, Nutrition and Food Innovation Unit, Novel Foods Team, Parma, Italy.
Non-periodic solutions of the Goła̧b–Schinzel type functional equation
Authors: Chudziak Jacek
Published: November 2022

We determine the solutions of the Goła̧b-Schinzel type functional equation in the class of non-periodic functions. Applying this result we give a positive answer to the problem raised by E. Jabłońska (Aequationes Math 87:125–133, 2014).
A phase 1b single-arm trial of intratumoral oncolytic virus V937 in combination with pembrolizumab in patients with advanced melanoma: results from the CAPRA study
Authors: Silk Ann W. , O’Day Steven J. , Kaufman Howard L. , Bryan Jennifer , Norrell Jacqueline T. , Imbergamo Casey , Portal Daniella , Zambrano-Acosta Edwin , Palmeri Marisa , Fein Seymour , Wu Cai , Guerreiro Leslie , Medina Daniel , Bommareddy Praveen K. , Zloza Andrew , Fox Bernard A. , Ballesteros-Merino Carmen , Ren Yixin , Shafren Darren , Grose Mark , Vieth Joshua A. , Mehnert Janice M.
Published: November 2022

Background

CAPRA (NCT02565992) evaluated Coxsackievirus A21 (V937) + pembrolizumab for metastatic/unresectable stage IIIB–IV melanoma.

Methods

Patients received intratumoral V937 on days 1, 3, 5, and 8 (then every 3 weeks [Q3W]) and intravenous pembrolizumab 2 mg/kg Q3W from day 8. Primary endpoint was safety.

Results

Median time from first dose to data cutoff was 32.0 months. No dose-limiting toxicities occurred; 14% (5/36) of patients experienced grade 3‒5 treatment-related adverse events. Objective response rate was 47% (complete response, 22%). Among 17 responders, 14 (82%) had responses ≥ 6 months. Among 8 patients previously treated with immunotherapy, 3 responded (1 complete, 2 partial). Responses were associated with increased serum CXCL10 and CCL22, suggesting viral replication contributes to antitumor immunity. For responders versus nonresponders, there was no difference in baseline tumor PD-L1 expression, ICAM1 expression, or CD3+ infiltrates. Surprisingly, the baseline cell density of CD3+CD8− T cells in the tumor microenvironment was significantly lower in responders compared with nonresponders (P = 0.0179).

Conclusions

These findings suggest responses to this combination may be seen even in patients without a typical “immune-active” microenvironment.

Trial registration number

NCT02565992.
Significance of hypergammaglobulinemia in patients with chronic myelomonocytic leukemia
Authors: Zack Marie-Therese , Geissler Klaus
Published: November 2022

Chronic inflammation is often indicated by a relative increase in the gamma globulin fraction in the serum electrophoresis. In a retrospective study, we analyzed the prevalence of relative hypergammaglobulinemia in 60 patients with chronic myelomonocytic leukemia (CMML), its potential prognostic impact, and potential correlations with laboratory and molecular features. Relative hypergammaglobulinemia (> 20%) was found in 25/60 (42%) patients. The median survival of patients with relative hypergammaglobulinemia was significantly shorter than in patients without hypergammaglobulinemia (10 vs. 24 months, p = 0.018). There was no difference between the groups regarding leukocyte count, hemoglobin value, and platelet count, but a higher prevalence of NRAS mutations and a lower prevalence of ZRSR2 mutations in patients with hypergammaglobulinemia. Our results show that hypergammaglobulinemia is present in a proportion of CMML patients and that this abnormality is associated with poor overall survival. The role of chronic inflammation in the pathophysiology of CMML needs to be further investigated.
Die Klimakrise als ethische Herausforderung
Authors: Kenner Lukas , Kenner Samuel , Prainsack Barbara , Wallner Peter , Lemmerer Kathrin , Weitensfelder Lisbeth , Hutter Hans-Peter
Published: November 2022

Der Klimawandel ist eine Gefahr für Gesundheit und soziale Sicherheit von Milliarden von Menschen. Gesundheit und Lebensqualität werden unter dem Einfluss der Klimakrise zunehmend auf vielfältige Weise beeinträchtigt. Der Anstieg der globalen Temperaturen hat häufigere, stärkere Extremwetterereignisse zur Folge, die insgesamt und speziell in der Gesundheitsversorgung zur weiteren Aggravierung von Ungleichheit, Diskriminierung und Ungerechtigkeit beitragen. Zudem begünstigen die klimatischen Bedingungen die Übertragung zahlreicher Infektionskrankheiten und ihr Vordringen in neue Regionen. Sozio-ökonomisch benachteiligte Gebiete mit schwacher Gesundheitsinfrastruktur, etwa im globalen Süden, werden am wenigsten in der Lage sein, ohne gezielte Unterstützung die Folgen der Klimakrise zu bewältigen. Oberstes Gebot ist es, die Verringerung der Treibhausgasemissionen in den Bereichen Verkehr, Energie- und Nahrungsmittelproduktion zu erreichen – auf globaler, nationaler und regionaler Ebene, um negative Gesundheitsfolgen zu mildern. Das Pariser Übereinkommen (2015) ist daher auch als entscheidendes Gesundheitsabkommen zu begreifen. Der Fokus dieses Beitrages liegt auf ethischen Aspekten des Klimawandels im Gesundheitsbereich.
Igbo-Ukwu Textiles: AMS Dating and Fiber Analysis
Authors: McIntosh Susan Keech , Cartwright Caroline R.
Published: November 2022

Thurstan Shaw’s excavations at Igbo-Ukwu revealed many artifacts and technologies that remain astonishing, unique, and incompletely understood, both within Africa and more broadly, even after 50 years. Among these are the textiles recovered primarily from Igbo Isaiah, where fragments were preserved by contact with the bronze artifacts gathered in what has been interpreted as a shrine. In the 1960s, an analysis of 20 textile samples was unable to identify the plant fibers used to weave the fabric. In this article, we report the results of new fiber identifications based on the SEM study of two Igbo-Ukwu fabric samples curated by the British Museum. The combination of bast fibers from one or more species of the fig tree (Ficus genus) and leaf fibers from Raphia sp. provides evidence of a complex indigenous weaving technology that has largely disappeared from Africa. An AMS date on one of the samples provides an important new element to our understanding of the culture and chronology of Igbo-Ukwu. A final section positions the Igbo-Ukwu cloth within the known history of textiles in Africa, emphasizing sub-Saharan West Africa over the past two millennia.
Topographic Mapping of the Primary Sensory Cortex Using Intraoperative Optical Imaging and Tactile Irritation
Authors: Polanski Witold H. , Oelschlägel Martin , Juratli Tareq A. , Wahl Hannes , Krukowski Pawel M. , Morgenstern Ute , Koch Edmund , Steiner Gerald , Schackert Gabriele , Sobottka Stephan B.
Published: November 2022

The determination of exact tumor boundaries within eloquent brain regions is essential to maximize the extent of resection. Recent studies showed that intraoperative optical imaging (IOI) combined with median nerve stimulation is a helpful tool for visualization of the primary sensory cortex (PSC). In this technical note, we describe a novel approach of using IOI with painless tactile irritation to demonstrate the feasibility of topographic mapping of different body regions within the PSC. In addition, we compared the IOI results with preoperative functional MRI (fMRI) findings. In five patients with tumors located near the PSC who received tumor removal, IOI with tactile irritation of different body parts and fMRI was applied. We showed that tactile irritation of the hand in local and general anesthesia leads to reliable changes of cerebral blood volume during IOI. Hereby, we observed comparable IOI activation maps regarding the median nerve stimulation, fMRI and tactile irritation of the hand. The tactile irritation of different body areas revealed a plausible topographic distribution along the PSC. With this approach, IOI is also suitable for awake surgeries, since the tactile irritation is painless compared with median nerve stimulation and is congruent to fMRI findings. Further studies are ongoing to standardize this method to enable a broad application within the neurosurgical community.
Effect of Remote Ischaemic Conditioning on the Inflammatory Cytokine Cascade of COVID-19 (RIC in COVID-19): a Randomized Controlled Trial
Authors: Lukhna Kishal , do Carmo Helison R. P. , Castillo Alejandro Rossell , Davidson Sean M. , Geffen Hayli , Giesz Sara , Golforoush Pelin , Bovi Ticiane Gonçalez , Gorag Diana , Salama Alan , Imamdin Aqeela , Kalkhoran Siavash , Lecour Sandrine , Perroud Mauricio W. , Ntsekhe Mpiko , Sposito Andrei C. , Yellon Derek M.
Published: November 2022

Purpose

Patients hospitalized with COVID-19 may develop a hyperinflammatory, dysregulated cytokine “storm” that rapidly progresses to acute respiratory distress syndrome, multiple organ dysfunction, and even death. Remote ischaemic conditioning (RIC) has elicited anti-inflammatory and cytoprotective benefits by reducing cytokines following sepsis in animal studies. Therefore, we investigated whether RIC would mitigate the inflammatory cytokine cascade induced by COVID-19.

Methods

We conducted a prospective, multicentre, randomized, sham-controlled, single-blind trial in Brazil and South Africa. Non-critically ill adult patients with COVID-19 pneumonia were randomly allocated (1:1) to receive either RIC (intermittent ischaemia/reperfusion applied through four 5-min cycles of inflation (20 mmHg above systolic blood pressure) and deflation of an automated blood-pressure cuff) or sham for approximately 15 days. Serum was collected following RIC/sham administration and analyzed for inflammatory cytokines using flow cytometry. The endpoint was the change in serum cytokine concentrations. Participants were followed for 30 days.

Results

Eighty randomized participants (40 RIC and 40 sham) completed the trial. Baseline characteristics according to trial intervention were overall balanced. Despite downward trajectories of all cytokines across hospitalization, we observed no substantial changes in cytokine concentrations after successive days of RIC. Time to clinical improvement was similar in both groups (HR 1.66; 95% CI, 0.938–2.948, p 0.08). Overall RIC did not demonstrate a significant impact on the composite outcome of all-cause death or clinical deterioration (HR 1.19; 95% CI, 0.616–2.295, p = 0.61).

Conclusion

RIC did not reduce the hypercytokinaemia induced by COVID-19 or prevent clinical deterioration to critical care.

Trial Registration

ClinicalTrials.gov Identifier: NCT04699227.