bluuebunny/crossref_metadata_2025 huggingface dataset:
Advances in MXene Films: Synthesis, Assembly, and Applications
Authors: Li Xiaohua , Ran Feitian , Yang Fan , Long Jun , Shao Lu
Published: March 2021

A growing family of two-dimensional (2D) transition metal carbides or nitrides, known as MXenes, have received increasing attention because of their unique properties, such as metallic conductivity and good hydrophilicity. The studies on MXenes have been widely pursued, given the composition diversity of the parent MAX phases. This review focuses on MXene films, an important form of MXene-based materials for practical applications. We summarized the synthesis methods of MXenes, focusing on emerging synthesis strategies and reaction mechanisms. The advanced assembly technologies of MXene films, including vacuum-assisted filtration, spin-coating methods, and several other approaches, were then highlighted. Finally, recent progress in the applications of MXene films in electrochemical energy storage, membrane separation, electromagnetic shielding fields, and burgeoning areas, as well as the correlation between compositions, architecture, and performance, was discussed.
Indices of peripheral leukocytes predict longer overall survival in breast cancer patients on eribulin in Japan
Authors: Takahashi Masato , Inoue Kenichi , Mukai Hirofumi , Yamanaka Takashi , Egawa Chiyomi , Miyoshi Yasuo , Sakata Yukinori , Muramoto Kenzo , Ikezawa Hiroki , Matsuoka Toshiyuki , Tsurutani Junji
Published: March 2021

Background

It was reported that eribulin regulates the tumor microenvironment, including the immune system, by inducing vascular remodeling. Lymphocyte counts are a critical index of immune response in patients. The non-Asian, global EMBRACE study has suggested that baseline absolute lymphocyte count (ALC) may be a predictor of the survival benefit of eribulin in breast cancer patients. We examined whether the baseline ALC is a potential predictor of overall survival (OS) in Japanese patients with HER2-negative advanced breast cancer treated with eribulin.

Methods

This was a post hoc analysis of data from a post-marketing observational study of eribulin in Japan. The OS by baseline ALC was estimated using the Kaplan–Meier method, with the cut-off value of 1500/μL for ALC. The OS by baseline neutrophil-to-lymphocyte ratio (NLR), a general prognostic index in breast cancer patients, was also estimated, with the cut-off value of 3.

Results

The median OS was longer in patients with an ALC of ≥ 1500/μL than in those with an ALC of < 1500/μL (19.4 vs. 14.3 months; hazard ratio [HR]: 0.628; 95% confidence interval [CI]: 0.492, 0.801). Patients with an NLR of ≥ 3 showed shorter OS than those with an NLR of < 3 (13.2 vs. 18.8 months; HR: 1.552; 95% CI 1.254, 1.921), and NLR also separated OS in patients with an ALC of < 1500/μL.

Conclusions

Consistent with the findings of a previous study involving a non-Asian, Western population, our study suggested that baseline ALC may be a predictive factor for the survival benefit of eribulin in Japanese patients.
The influence of fucoidan on stability, adsorption and electrokinetic properties of ZnO and TiO2 suspensions
Authors: Matusiak Jakub , Grządka Elżbieta , Bastrzyk Anna , Pasieczna-Patkowska Sylwia
Published: March 2021

Stabilization of nano-oxide suspensions is a very important process. Nowadays, synthetic polymers are used to increase stability of the colloidal systems. However, this solution is not ecological and incompatible with the principles of green chemistry. Instead of synthetic polymers, their natural counterparts can be used. Herein, we present the use of natural bioactive polysaccharide—fucoidan as a stabilizer of nano-zinc(II) and nano-titanium(IV) oxide suspensions. These two oxides are commercially available and are widely used in the cosmetic and pharmaceutical industries. The turbidimetric studies (Turbiscan Lab) showed that the addition of fucoidan leads to the increase of stability and that the effect depends on the polymer concentration. To fully describe the systems’ stability, the adsorption (UV–Vis and FT-IR/PAS) and the electrokinetic properties (zeta potential and surface charge density) were studied. The obtained results indicate that fucoidan adsorbs by the electrostatic and non-electrostatic interactions on the used oxides forming the tight adsorption layer. The following paper thoroughly explains the stabilization mechanism of fucoidan toward the nano-oxide suspensions. Moreover, the presented results could be useful in the preparation of new cosmetic and pharmaceutical products containing nano-oxides.
COVID-19 vaccines: rapid development, implications, challenges and future prospects
Authors: Kashte Shivaji , Gulbake Arvind , El-Amin III Saadiq F. , Gupta Ashim
Published: March 2021

COVID-19 has affected millions of people and put an unparalleled burden on healthcare systems as well as economies throughout the world. Currently, there is no decisive therapy for COVID-19 or related complications. The only hope to mitigate this pandemic is through vaccines. The COVID-19 vaccines are being developed rapidly, compared to traditional vaccines, and are being approved via Emergency Use Authorization (EUA) worldwide. So far, there are 232 vaccine candidates. One hundred and seventy-two are in preclinical development and 60 in clinical development, of which 9 are approved under EUA by different countries. This includes the United Kingdom (UK), United States of America (USA), Canada, Russia, China, and India. Distributing vaccination to all, with a safe and efficacious vaccine is the leading priority for all nations to combat this COVID-19 pandemic. However, the current accelerated process of COVID-19 vaccine development and EUA has many unanswered questions. In addition, the change in strain of SARS-CoV-2 in UK and South Africa, and its increasing spread across the world have raised more challenges, both for the vaccine developers as well as the governments across the world. In this review, we have discussed the different type of vaccines with examples of COVID-19 vaccines, their rapid development compared to the traditional vaccine, associated challenges, and future prospects.
Emotional abuse interacts with borderline personality in adolescent inpatients with binge-purging eating disorders
Authors: Spiegel J. , Arnold S. , Salbach H. , Gotti E. G. , Pfeiffer E. , Lehmkuhl U. , Correll C. U. , Jaite C.
Published: March 2021

Purpose

Childhood abuse is associated with an increased risk of developing eating disorders (EDs) as well as personality disorders (PDs). However, their interaction is still uncertain, particularly in adolescents. This study investigates the correlations between childhood emotional neglect (CEN), childhood emotional abuse (CEA), and obsessive-compulsive and borderline personality styles in female adolescent inpatients with eating disorders (EDs).

Methods

One hundred and twenty-eight inpatients (ages 14-18) were assessed, 54 were diagnosed with restricting-type anorexia nervosa (AN-R) and 33 with a binge-purging ED [BP-ED; comprising patients with binge-purging type anorexia nervosa (AN-BP), n = 15, and bulimia nervosa (BN), n = 18]. Fifty healthy participants made up the control group (CG). CEN and CEA were assessed with the Childhood Trauma Questionnaire, while the Personality Style and Disorder Inventory was implemented to determine personality styles.

Results

A MANOVA revealed a significant main effect of CEA on spontaneous-borderline personality style [F(8,119) = 17.1, p < 0.001, η2 = 0.126], as well as a main effect of ED group on spontaneous-borderline [F(2,119) = 3.1, p = 0.048, η2 = 0.050]. A significant interaction between ED group, CEA, and spontaneous-borderline was found [F(2,119) = 3.5, p = 0.034, η2 = 0.055] with BP-ED showing significantly higher scores in CEA (9.3 ± 4.0) and in spontaneous-borderline (14.2 ± 6.2).

Conclusions

Considering CEA and borderline personality style in adolescent inpatients with BN or AN-BP may help improve the understanding of the etiology and maintenance of BP-ED and provide more effective treatment targets.

Level of evidence

Level III, case–control analytic study.
Railway wheel profile fine-tuning system for profile recommendation
Authors: Ye Yunguang , Vuitton Jonas , Sun Yu , Hecht Markus
Published: March 2021

This paper develops a wheel profile fine-tuning system (WPFTS) that comprehensively considers the influence of wheel profile on wheel damage, vehicle stability, vehicle safety, and passenger comfort. WPFTS can recommend one or more optimized wheel profiles according to train operators’ needs, e.g., reducing wheel wear, mitigating the development of wheel out-of-roundness (OOR), improving the shape stability of the wheel profile. Specifically, WPFTS includes four modules: (I) a wheel profile generation module based on the rotary-scaling fine-tuning (RSFT) method; (II) a multi-objective generation module consisting of a rigid multi-body dynamics simulation (MBS) model, an analytical model, and a rigid–flexible MBS model, for generating 11 objectives related to wheel damage, vehicle stability, vehicle safety, and passenger comfort; (III) a weight assignment module consisting of an adaptive weight assignment strategy and a manual weight assignment strategy; and (IV) an optimization module based on radial basis function (RBF) and particle swarm optimization (PSO). Finally, three cases are introduced to show how WPTFS recommends a wheel profile according to train operators’ needs. Among them, a wheel profile with high shape stability, a wheel profile for mitigating the development of wheel OOR, and a wheel profile considering hunting stability and derailment safety are developed, respectively.
USP11 suppresses CHK1 activation by deubiquitinating CLASPIN
Authors: Zhao Hongchang , Wang Zhifeng , Zhu Min , Liao Ji , Xu Xingzhi
Published: March 2021

CLASPIN is an essential mediator of ATR-dependent CHK1 activation in the DNA replication checkpoint. K6-linked polyubiquitination of CLASPIN promotes its chromatin loading and subsequent CHK1 activation. Here, we found that ubiquitin-specific protease 11 (USP11) deubiquitinates the K6-linkage polyubiquitinated form of CLASPIN. Under steady-state conditions, USP11 interacts with CLASPIN, reducing CLASPIN K6-linked ubiquitination levels. In response to replication stress, USP11 is phosphorylated by ATR and subsequently disassociated from CLASPIN, promoting CLASPIN chromatin loading, CHK1 activation and ultimately genome stability. Taken together, our findings uncover a novel function of USP11 in negatively regulating CHK1 activation by suppressing CLASPIN chromatin loading.
Associations between the identity domains of future plans and education, and the role of a major curricular internship on identity formation processes
Authors: den Boer Liselotte , Klimstra Theo A. , Denissen Jaap J.A.
Published: March 2021

Introduction

Experiences during the last years of college could stimulate identity formation processes within and across the domains of future plans and education. In the present study, the first research question addressed how identity formation dimensions for education and future plans were associated with each other during the last years in education. The second research question addressed whether identity processes (i.e., identity levels, changes herein, and the associations among identity variables between and within domains) would be different for students who were doing an internship versus those who did not.

Method

We used a longitudinal design with three measurement occasions. Participants were Dutch psychology college students (N = 287; 83.3% women; M age = 21.8 years, SD = 2.0). We used two different self‐report instruments to measure identity processes (i.e., commitment and exploration) in the domains of future plans and education.

Results

We found that commitments in the domains of future plans and education were significantly associated. Enrollment in a practical internship was largely unrelated to identity processes, as it did not explain individual differences in identity levels, changes herein and associations between and within domains.

Conclusions

Our results suggest integration between educational identity and future plans for commitment processes. At a group level, a practical internship in itself did not explain individual differences in identity processes.
Cross-Sectional Study of Sexual Activity and Satisfaction Among Older Adult's ≥60 Years of Age
Authors: Stentagg Magnus , Skär Lisa , Berglund Johan Sanmartin , Lindberg Terese
Published: March 2021

Introduction

Despite the rapidly increasing population of older adults, little is currently known about sexual activity and sexual satisfaction among the oldest people.

Aim

The present study aimed to investigate sexual activity and sexual satisfaction among people of ≥60 years of age. We also examined whether sexual activity and sexual satisfaction were influenced by age, gender, cohabiting, socioeconomic factors, education, functional ability, and self-reported health.

Methods

We performed a descriptive analysis of self-stated sexual activity and sexual satisfaction among 1680 participants who were 60 years and older from the Swedish National Study on Aging and Care. Chi-square tests and logistic regression were used to analyze relationships between factors.

Main Outcome Measure

Sexual activity and sexual satisfaction.

Results

Among participants aged ≥90 years, about 10% were sexually active. Within the total study population, 46% (654/1680) were sexually active. Overall, sexually activity was more commonly reported by men (55%) than women (40%). However, men in all age cohorts reported sexual dissatisfaction more commonly than women. In the total sample, 24% (246/1680) reported dissatisfaction with their sex life. Sexual activity and sexual satisfaction were positively associated with self-reported health and cohabitation.

Conclusion

The present results suggest that sexual activity is present throughout life. For persons older than 90 years, about 10% of participants were sexually active, regardless of gender. Every third man reported dissatisfaction with his sex life. Women were more satisfied with their sex lives than men, and this difference varies more widely among age cohorts. These findings confirm that it is important that health professional take sexuality into account during caring encounters with older persons.
Treatment Patterns and Healthcare Outcomes with Collagenase Clostridium Histolyticum vs Surgery in Peyronie's Disease: A Retrospective Claims Database Analysis
Authors: Trost Landon , Huang Huan , Han Xu , Burudpakdee Chakkarin , Hu Yiqun
Published: March 2021

Introduction

Treatments for Peyronie's disease (PD) include surgical management and collagenase clostridium histolyticum (CCH).

Aims

To evaluate PD treatment trends after CCH approval and compare clinical outcomes in CCH- and surgery-treated cohorts.

Methods

Patients newly diagnosed with PD between January 2011 and December 2017 were identified in a U.S. claims database. Cohorts initiating treatment with CCH or surgery between January 2014 and June 2017 were included. Patients were continuously enrolled ≥6 months before and ≥12 months after index date. Post-treatment penile complications and analgesic use were compared 1 year after procedure in propensity score-matched cohorts.

Main outcome measures

The main outcome measures of this study were treatment patterns, penile complications, and analgesic use.

Results

In the newly diagnosed PD cohort, 1,609 patients received CCH and 1,555 patients had surgery. Overall CCH or surgery treatment rate/year increased from 9.8% in 2014 to 15.5% in 2017, with <1% receiving verapamil or interferon. Initial treatment ratios of CCH to surgery increased from approximately 1:1 (2014) to 2:1 (2017). In the unmatched CCH (n = 1,227) and surgery (n = 620) cohorts, more (P < .05) surgery-treated patients received analgesics (particularly opioids), oral PD therapies, vacuum erection devices, and phosphodiesterase-5 inhibitors before the index date. After propensity score matching (n = 620/cohort), newly occurring postprocedural complications during the follow-up period were higher in the surgery cohort (25.3% vs 18.4%, P = .003). The surgery cohort had significantly (P < .05) higher rates of erectile dysfunction (65.0% vs 44.8%), penile pain (17.9% vs 8.9%), and penile swelling (8.1% vs 5.2%) and was more likely to be prescribed opioids (93.3% vs 38.9%; P < .0001) or non-steroidal anti-inflammatory drugs (27.0% vs 20.3%; P = .006).

Conclusion

CCH demonstrated fewer complications and less analgesic use than surgery and was used as the initial therapy for PD twice as often as surgery.
Danish Health Professional Students' Attitudes Toward Addressing Sexual Health: A Cross-Sectional Survey
Authors: Gerbild Helle , Larsen Camilla Marie , Junge Tina , Laursen Birgitte Schantz , Areskoug-Josefsson Kristina
Published: March 2021

Introduction

Danish health professional (HP) students' attitudes toward addressing sexual health are unknown.

Aim

To investigate Danish HP students' attitudes toward addressing sexual health in their future professions, and to assess differences in perceived competences and preparedness between professional programs.

Methods

A Danish national survey of nursing, occupational therapy, and physiotherapy students was conducted. Totally, 1,212 students were invited to respond to an online questionnaire “The Students' Attitudes toward Addressing Sexual Health.”

Main Outcome Measure

The main outcome measures investigated were Danish HP students' attitudes toward addressing sexual health in their future professions, and differences in perceived competences and preparedness depending on the professional program.

Results

A total of 584 students (48%; nursing 44%, occupational therapy 70%, physiotherapy 43%) responded. Mean total score ranged between 63.7 and 66.3 (±8.3–8.8) classifying students in the low-end of the class: “comfortable and prepared in some situations.” No clinically relevant differences were determined between the professional programs with respect to perceived competences and preparedness to address sexual health.

Conclusion

In the field of addressing sexual health, most Danish HP students reported positive attitudes and a need for basic knowledge, competences, communication training, and education.
Expression of MicroRNAs (miR-15b, miR-16, miR-138, miR-221, and miR-222) as Biomarkers of Endothelial Corpus Cavernosum Dysfunction in a Diabetic Alcoholic Murine Model
Authors: Tiraboschi Ricardo Brianezi , Neto Fermino Sanches Lizarte , da Cunha Tirapelli Daniela Pretti , de Bessa Jose , Miranda Eduardo Paula , de Assis Cirino Mucio Luiz , Tirapelli Luis Fernando , Tucci Silvio , Molina Carlos Augusto Fernandes
Published: March 2021

Introduction

MicroRNAs (miRNAs) are short noncoding RNA molecules that regulate gene expression and are related to endothelial dysfunction (EnD). Recently, miRNAs have also been explored as potential biomarkers and target molecular therapy of erectile dysfunction (ED). Could the miRNAs be the tip of the iceberg of chronic arterial disease foreshadowed by the ED?

Aim

To investigate the expression of miR-15b, miR-16, miR-138, miR-221, and miR-222 in corpus cavernosum (CC) and peripheral blood in a rat model of endothelium dysfunction secondary to diabetes (DM) and alcohol consumption to assess potential endothelial lesion biomarkers.

Methods

Twenty males Wistar rats were divided into 4 groups: control group (C), alcohol consumption group (A), diabetic group (D), diabetic-alcohol consumption group (D + A). DM was alloxan-induced and alcohol consumption was through progressive increase of ethanol concentration in drinkable water. After 7 weeks, miRNAs expressions from CC and blood sample were evaluated by real-time PCR. Functional assessment of CC was performed in an acetylcholine endothelium-dependent relaxation pharmacological study.

Main Outcome Measure

miRNA expression in CC and blood were evaluated; pharmacological study in CC strips was conducted to validate EnD.

Results

We found that 3 miRNAs (miR-16, miR-221, and miR-222) were downregulated in the CC in the D+A group, while all 5 miRNAs were downregulated in the blood of D and D + A groups. The endothelium-dependent relaxation induced by acetylcholine was significantly decreased in groups A, D, and D + A. Diagnostic accuracy estimated by AUC, to discriminating groups A, D, and D + A from controls, was superior to >0.9 in all plasmatic miRNAs.

Conclusion

miRNAs downregulation was identified in both CC and blood notably in DM associated with alcohol consumption animals (D + A), the greatest endothelial injury potential group. Serum miRNAs have also demonstrated high diagnostic accuracy properties in predicting CC relaxation dysfunction labeling EnD.
Efficacy and Safety of Avanafil in Chinese Subjects With Erectile Dysfunction: A Multi-Center, Randomized, Double-Blinded, Placebo-Controlled Phase III Clinical Trial
Authors: Jiang Hui , Lin Haocheng , Li Fubiao , Dai Yutian , Zhang Xiangsheng , Jiang Tao , Deng Junhong
Published: March 2021

Introduction

The incidence of erectile dysfunction (ED) increases with age in mainland China and phosphodiesterase 5 inhibitors (PDE5i) are the major drugs used for its treatment.

Aim

To determine the efficacy and safety of Chinese developed avanafil as therapy for ED in China.

Methods

This phase III trial was carried out in 7 medical centers in China. Eligible subjects suffering from ED were allocated randomly into 3 groups (ratio 1:1:1) and orally received a placebo, 100 or 200 mg avanafil for a total of 12 weeks.

Main Outcome Measures

The primary endpoint was changes in erectile function (EF) domain scores according to the International Index of EF (IIEF) questionnaire from baseline to week 12 of therapy. Secondary endpoints assessments were changes in the response rates of SEP, Q2 and Q3; changes in IIEF other domain scores. Safety evaluation monitored treatment-emergent adverse events (TEAEs), serious TEAEs, laboratory test results, vital signs and electrocardiographs.

Results

Of 218 randomized ED subjects, 182 (83.5%) completed the study. After 12-week therapy, alterations from baseline of the mean IIEF-EF domain scores in the 100 mg and 200 mg groups were greater than for the placebo (all P < .05) group. The changes in mean SEP Q2 response rates from baseline to week 12 in the placebo, 100 mg and 200 mg groups were 5.4%, 22.3% and 22.1%, and SEP Q3 response rate were 22.7%, 42.6% and 38.1%, respectively. Avanafil treatment (regardless of dose) improved EF vs placebo for most of other secondary efficacy endpoints studied (all P < .05). No differences were detected in efficacy endpoints between the 100 and 200 mg dosage groups (all P > .05) or in the incidence of TEAEs and drug-related TEAEs among the 3 groups (all P > .05).

Conclusion

Avanafil (100 or 200 mg) was effective and generally well tolerated in Chinese subjects with ED.
Treatment of hyperglycemia not associated with NAFLD improvement in children with type 2 diabetes mellitus
Authors: Beauchamp Giovanna , Barr Mary M. , Vergara Ariana , Ashraf Ambika , Bril Fernando
Published: March 2021

Background and objectives:

Nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM) have become public health problems in the pediatric population. However, the relationship between these two conditions is not well understood. The primary objective of this study was to assess whether treatment of hyperglycemia in obese, treatment-naive children with type 2 diabetes (T2DM) was asso-ciated with an improvement of surrogate markers of NAFLD.

Materials and methods:

This retrospective, longitudinal study included 151 obese children with a diag-nosis of T2DM (Age: 14 ± 1 years, 72% female children, BMI: 98.6th percentile, and A1c: 10.3 ± 0.2%). Clinical/demographic information was collected before patients started any diabetes treatment and 1 and 3 years after starting metformin and/or insulin therapy.

Results:

Forty-eight patients (32%) had abnormal ALT/AST (i.e., >40 U/L), suggestive of NAFLD. After 1 year of therapy, there were no significant differences in plasma ALT among patients started on insulin, metformin, or combination: 5±4 vs. -10 ± 3 vs. -2±2 IU/L, respectively, P = .07. Of note, changes in plasma ALT were small, despite a significant reduction of A1c in patients prescribed insulin (alone or with metformin): -2.8 ± 1.0%, P = .01, and -2.7 ± 0.3%, P < .001, respectively. In line with this, no significant correlations were found between changes in A1c and plasma aminotransferases. In contrast, changes in plasma AST/ALT were more strongly associated with BMI changes (r = 0.32, P < .001, and r = 0.19, P = .04, respectively). Similar results were observed after 3 years of follow-up.

Conclusions:

Nonalcoholic fatty liver disease is highly prevalent in obese children with T2DM. Treatment of hyperglycemia with metformin and/or insulin did not result in any significant improvement in sur-rogate markers of NAFLD (i.e., plasma aminotransferases). While changes in ALT and/or AST may not perfectly reflect histological changes in NAFLD, our findings suggest that the treatment of hyperglycemia per se may not be associated with NAFLD improvement.
PFOS dominates PFAS composition in ambient fine particulate matter (PM2.5) collected across North Carolina nearly 20 years after the end of its US production
Authors: Zhou J. , Baumann K. , Mead R. N. , Skrabal S. A. , Kieber R. J. , Avery G. B. , Shimizu M. , DeWitt J. C. , Sun M. , Vance S. A. , Bodnar W. , Zhang Z. , Collins L. B. , Surratt J. D. , Turpin B. J.
Published: March 2021

Quarterly PFOS concentrations (pg m−3) in ambient PM2.5 in North Carolina, US. Highest concentrations were measured during July–September.
Surface-reconstructed formation of hierarchical TiO2 mesoporous nanosheets with fast lithium-storage capability
Authors: Liu Yuan , Ding Chenfeng , Xie Peitao , Yan Xiaodong , Feng Mei , Liu Yaochun , Liu Chunzhao , Yu Yunhua , Lin Yuanhua
Published: March 2021

A simple dual-templated synthesis method was used to produce novel porous TiO2 nanosheets with a surficial nanoarchitecture that deliver high lithium-storage capacity at high rates.
Prognostic Significance of Concomitant Superficial Vein Thrombosis in Patients with Deep Vein Thrombosis of the Lower Limbs
Authors: Dubois-Silva Álvaro , Barbagelata-López Cristina , Piñeiro-Parga Patricia , Francisco Iria , Falgá Conxita , Tirado Raimundo , Suriñach José María , Vela Jerónimo Ramón , Mella Carmen , Quere Isabelle , Siniscalchi Carmine , Monreal Manuel ,   the RIETE Investigators
Published: March 2021

Background The prognostic significance of concomitant superficial vein thrombosis (SVT) in patients with lower-limb deep vein thrombosis (DVT) has not been consistently evaluated.

Methods We used the RIETE (Registro Informatizado de Enfermedad TromboEmbólica) registry to compare the rates of subsequent pulmonary embolism (PE), recurrent DVT, major bleeding or death in patients with lower-limb DVT, according to the presence or absence of concomitant SVT.

Results From March 2015 to May 2020, there were 8,743 patients with lower-limb DVT. Of these, 745 (8.5%) had concomitant SVT. Most patients (97.4% in both subgroups) received anticoagulant therapy (median duration: 138 vs. 147 days). During follow-up (median: 193 vs. 210 days), 156 (1.8%) patients developed subsequent PE, 336 (3.8%) had recurrent DVT, 201 (2.3%) had major bleeding and 844 (9.7%) died. Patients with concomitant SVT had a higher rate of subsequent PE (rate ratio [RR]: 2.11; 95% confidence interval [95%CI]: 1.33–3.24) than those with isolated DVT, with no significant differences in the rates of recurrent DVT (RR: 0.80; 95%CI: 0.50–1.21), major bleeding (RR: 0.77; 95%CI: 0.41–1.33) or death (RR: 0.81; 95%CI: 0.61–1.06). On multivariable analysis, patients with DVT and SVT concomitantly were at increased risk of subsequent PE during anticoagulation (adjusted hazard ratio [HR]: 2.23; 95%CI: 1.22–4.05) and also during the entire follow-up period (adjusted HR: 2.33; 95%CI: 1.49–3.66).

Conclusion Patients with lower-limb DVT and SVT concomitantly are at increased risk of developing PE. Further studies are needed to externally validate our findings and to determine if these patients could benefit from a different management strategy.
Lung Resection in Children with Necrotizing Pneumonia: Outcome and Follow-up
Authors: Frybova Barbora , Koucky Vaclav , Pohunek Petr , Cejnarova Kristyna , Coufal Stepan , Kokesova Alena , Dotlacil Vojtech , Petrasova Natalia , Pos Lucie , Snajdauf Jiri , Hlava Stepan , Polivka Natali , Rygl Michal
Published: March 2021

Introduction The number of patients with necrotizing pneumonia has increased in recent years. The aim of this study is to review the incidence, management, and outcome of pediatric necrotizing pneumonia requiring surgical therapy and to prove that lung resection results in favorable development of patients. We hypothesize that overall lung function in children after lung resection does not differ from that of the healthy population.

Materials and Methods A retrospective tertiary referral center study with a prospective follow-up spirometric study of patients with necrotizing pneumonia managed between January 2010 and December 2019 was performed.

Results The study cohort consisted of 1,295 patients admitted to the pediatric department for community-acquired pneumonia; 47 patients developed necrotizing pneumonia, 36 of whom underwent parenchymal lung resection. A 5-year rise in the occurrence of necrotizing pneumonia requiring resection was 77%, with a significant increase in the last 3 years (p < 0.05). The median age at the time of surgery was 32.5 (interquartile range [IQR]: 32.25) months. Streptococcus pneumoniae was the most prevalent pathogen (83%), although 53.3% of these patients were vaccinated against the agent. In 67% of patients, preresection procedures were performed: drainage of pneumothorax (17%), drainage of empyema (46%), drainage of empyema with use of alteplase (25%), and thoracoscopic decortication (12%). Surgical procedures included lobectomy (72.2%), wedge resection (13.9%), bilobectomy (8.3%), and pneumonectomy (5.6%). The postoperative complication was bronchopleural fistula in three patients. There were two (5.5%) postoperative deaths due to multiple organ failure. The follow-up spirometry was performed 43.3 (median, IQR 23.8–66.7) months after surgical intervention. Normal lung function was detected in 35 (64.8%) patients, restrictive pattern in 6 (11.1%) patients, obstructive pattern in 11 (20.4%) patients, and combined in 2 (3.7%) patients.

Conclusion The number of patients with necrotizing pneumonia requiring resection has increased significantly in the last 3 years (p < 0.05). Aggressive surgical treatment results in significant clinical improvement in most cases and favorable lung function outcome. Long-term follow-up showed normal spirometry in 64.8% of cases.
Correlation between Common Channel Length and Urethral Length in Cloacal Malformations
Authors: Abdelmalak Abokandil Mohamed , Waheeb Saber , Eltagy Gamal , Khairi Ahmad , Farghaly Yasmine , Aly Salmaa
Published: March 2021

Introduction This research aimed to study the relationship between common channel length and urethral length in cloaca patients by different diagnostic modalities and the ability of common channel length to predict the urethral length.

Materials and Methods The study was conducted on 30 cases of cloaca managed at Alexandria University Children Hospital and Cairo University Children Hospital from August 2018 to December 2019. Preoperative assessment included cystovaginoscopy and magnetic resonance imaging (MRI) studies with a recording of common channel length and urethral length by each modality.

Results There is substantial similarity between MRI and cystoscopy in measuring common channel length; 11 patients had common channel length 1 to 3 cm by cystoscopy. It is the same number by MRI measurement. Nineteen patients had common channel length 3 to 5 cm by cystoscopy and MRI. In total, 16 had urethral length <1.5 cm by MRI, while 14 patients with urethral length <1.5 cm by cystoscopy. However, there is a moderate negative correlation by MRI between common channel length and urethral length, while by cystovaginoscope, there is no significant correlation between common channel length and urethral length.

Conclusion Applying MRI or cystoscopy in the preoperative assessment of cloaca cases is equivalent to measuring common channel length, not measuring urethral length. Besides that, the common channel length cannot predict the urethral length.
Effective stiffness and thermal expansion of three-phase multifunctional polymer electrolyte coated carbon fibre composite materials
Authors: Schutzeichel M O H , Kletschkowski T , Monner H P
Published: March 2021

Multifunctional composites including polymer electrolyte coated carbon fibres and polymer matrix systems gained recent interest in light-weight design related research areas. Compared to classical fibre reinforced plastics, the interphase, made by electropolymerisation on the fibre surface, represents a new, third material phase. The coating serves as ion-conducting separator in structural batteries and as insulating layer in energy transmitting multifunctional composites. The importance of this study is related to the fact, that multifunctional applications, based on such composites, are exposed to temperature changes in many cases. The coating material, acting as thin interphase, shows a significant temperature dependant Young’s modulus, determining the overall macroscopic behaviour under thermal loads. The new influences on the effective elastic properties of the composite are determined in this work in a 3D microstructural simulation approach based on a unit cell geometry. For the first time, the resulting effective properties are discussed towards the state of research and future work. First, the effective elastic stiffness is computed by isothermal virtual material testing, applying unit strain modes on the unit cell. Second, a uniform temperature change is applied and the effective thermal expansion coefficients are computed. The results show that a change of stiffness in the coating domain has a great influence on the effective stiffness in the transversal isotropic plane. The effective thermal expansion of the composite is also highly sensitive to the thermal expansion behaviour of the coating phase. Main conclusions are drawn towards multiphysical material simulation: Influences of the coating material properties have to be taken into account to compute effective properties. In particular, it is necessary to include the temperature dependant stiffness and the coefficients of thermal expansion of the interphase, which affect effective properties significantly. A thermo-mechanic coupled microscale model is needed to represent in-situ properties of such composites for applications with heat exposure.
A Cultural Dance Program Improves Hypertension Control and Cardiovascular Disease Risk in Native Hawaiians: A Randomized Controlled Trial
Authors: Kaholokula Joseph Keawe'aimoku , Look Mele , Mabellos Tricia , Ahn Hyeong Jun , Choi So Yung , Sinclair Ka'imi A , Wills Thomas A , Seto Todd B , de Silva Māpuana
Published: March 2021

Background

Native Hawaiians have higher hypertension (HTN) and cardiovascular disease (CVD) rates than non-Hispanic whites, calling for culturally responsive interventions to close this gap.

Purpose

We tested the effects of a 6-month behavioral intervention, a cultural dance program based on hula (the customary dance of Hawai'i), for improving blood pressure (BP) and CVD risk among Native Hawaiians with uncontrolled HTN.

Methods

In a randomized controlled trial, we tested the effects of the hula-based intervention among 263 Native Hawaiians with uncontrolled HTN (systolic ≥ 140 or ≥ 130 mmHg if diabetes) and no CVD at enrollment. All participants received a brief culturally tailored heart health education before random assignment to the hula-based intervention (n = 131) or the education-only waitlist control (n = 132). Intervention received hula lessons and group-based activities for 6 months. Control received only 1-week education through 6 months.

Results

Intervention yielded greater reductions in systolic (−15.3 mmHg) and diastolic (−6.4 mmHg) BP than control (−11.8 and −2.6 mmHg, respectively) from baseline to 6 months (p < .05). At 6 months, 43% of intervention participants compared to 21% of controls achieved a HTN stage <130/80 mmHg (p < .001). The 10-year CVD risk reduction was two times greater for the intervention group than the control group based on the Framingham Risk Score calculator. All improvements for intervention participants were maintained at 12 months.

Conclusions

This trial represents one of the few rigorously conducted examinations of an Indigenous practice leveraged for health promotion, with implications for other ethnic populations.
Decoding gene therapy: Current impact and future considerations for health-system and specialty pharmacy practice
Authors: Canfield Scott L
Published: March 2021

Purpose

To provide health systems with baseline knowledge on existing and pipeline gene therapy treatments, including considerations that health-system pharmacies and specialty pharmacy programs may reference when evaluating and implementing services around gene therapies.

Advancements in research and biotechnology have recently led to the development and launch of the first commercially available gene therapy treatments in the United States. These treatments have the ability to significantly alter and even effectively cure diseases. Alongside these significant advances and clinical benefits, these therapies present unique challenges due to their cost and complexity. Given the large number of additional gene therapy treatments that are currently in late-stage clinical development, stakeholders across the healthcare industry must increasingly adapt and ready themselves to meet these challenges. The diagnosis and treatment of patients with diseases being targeted by gene therapies largely occurs within health systems, and judging by the gene therapy pipeline, this trend is likely to continue. To prepare for these novel treatments, health systems must understand and consider the methods in which gene therapies are developed, procured, reimbursed, administered, and monitored.

Conclusion

The future of health-system pharmacy practice must include comprehensive gene therapy services and stakeholder engagement strategies to ensure patients have access to these life-changing treatments.
Comparison of provider satisfaction with specialty pharmacy services in integrated health-system and external practice models: A multisite survey
Authors: Anguiano Rebekah H , Zuckerman Autumn D , Hall Elizabeth , Diamantides Erica , Kumor Lisa , Duckworth Deborah L , Peter Megan , Sorgen Patrick J , Nathanson Amy , Kandah Huda-Marie , Dura Jillian , Campbell Udobi
Published: March 2021

Purpose

The purpose of this study is to obtain insight into providers’ satisfaction with services offered by health-system integrated specialty pharmacies and to determine whether providers’ perceptions of services offered under an integrated model differ from perceptions of external specialty pharmacy services.

Methods

A multi-site, cross-sectional, online survey of specialty clinic healthcare providers at 10 academic health systems with integrated specialty pharmacies was conducted. The questionnaire was developed by members of the Vizient Specialty Pharmacy Outcomes and Benchmarking Workgroup and was pretested at 3 pilot sites prior to dissemination. Prescribers of specialty medications within each institution were identified and sent an email invitation to participate in the study that included a link to the anonymous questionnaire. Respondents were asked to rate their agreement with 10 statements regarding quality of services of integrated and external specialty pharmacies on a 5-point scale (1 = strongly disagree, 5 = strongly agree). An analysis to determine differences in providers’ overall satisfaction with the integrated and external specialty pharmacy practice models, as well as differences in satisfaction scores for each of the 10 statements, was performed using paired-samples t tests.

Results

The mean (SD) score for overall satisfaction with integrated specialty pharmacies was significantly higher than the score for satisfaction with external specialty pharmacies: 4.72 (0.58) vs 2.97 (1.20); 95% confidence interval, 1.64-1.87; P < 0.001. Provider ratings of the integrated specialty pharmacy model were also higher for all 10 items evaluating the quality of services (P < 0.05 for all comparisons).

Conclusion

The study results confirm that the health-system integrated specialty pharmacy practice model promotes high rates of provider satisfaction with services and perceived benefits.
Innovation, Resiliency, and Genius in Intensive English Programs: Decolonializing Recruitment and Contradictory Advocacy
Authors: Litzenberg Jason
Published: March 2021

This article considers Intensive English Programs (IEPs) affiliated with higher education institutions of the Global North from the perspective of a decolonial option in which English is viewed as a tool of modernity used for colonization and the maintenance of unequal socioeconomic and power structures. Via nuanced description (Pennycook and Makoni 2020) of two colonizing practices typical to IEPs—namely, recruitment and advocacy—the article argues that the traits of resiliency, innovation, and genius commonly ascribed to IEPs are qualities that lend themselves to the refoundation, reconfiguration, and reconstruction (de Sousa Santos 2019) of alternative visions. In this way, IEPs have the opportunity to promote the liberatory visions of applied linguistics’ practitioners and to positively influence decolonialization of the field. Because of their historical involvement in English language teaching and the industry it has spawned, applied linguists have an obligation to foster these changes, which need not affect the ability of IEPs to conduct language pedagogy or to provide the field with opportunities for research, teacher training, and professional development.
Information content of trees: three-taxon statements, inference rules and dependency
Authors: Rineau Valentin , Zaragüeta Rene , Bardin Jérémie
Published: March 2021

The three-taxon statement is the fundamental unit of rooted trees in cladistics, stating that for three terminal taxa, two are more related to each other than to a third. Because of their fundamental role in phylogenetics, three-taxon statements are present in methodological research of various disciplines in evolutionary biology; for example consensus methods, supertree methods, species-tree methods, distance metrics and even phylogenetic reconstruction. However, three-taxon statement methods are subject to important flaws related to information redundancy. Here we aim to study the behaviour of three-taxon statements and the interactions among them in order to enhance their performance in evolutionary studies. We show how specific interactions between three-taxon statements are responsible for the emergence of redundancy and dependency within trees, and how they can be used for the improvement of weighting procedures. Our proposal is subsequently tested empirically in the supertree framework using simulations. We show that three-taxon statements using fractional weights perform much better than classical methods such as MRP (matrix representation with parsimony) or methods using unweighted statements. Our study shows that appropriate fractional weighting of three-taxon statements is of critical importance for removing redundancy in any method using them, such as in consensus, supertrees, distance metrics, and phylogenetic or biogeographical analyses.
Radiomics: a new tool to differentiate adrenocortical adenoma from carcinoma
Authors: Torresan F , Crimì F , Ceccato F , Zavan F , Barbot M , Lacognata C , Motta R , Armellin C , Scaroni C , Quaia E , Campi C , Iacobone M
Published: March 2021

Background

The main challenge in the management of indeterminate incidentally discovered adrenal tumours is to differentiate benign from malignant lesions. In the absence of clear signs of invasion or metastases, imaging techniques do not always precisely define the nature of the mass. The present pilot study aimed to determine whether radiomics may predict malignancy in adrenocortical tumours.

Methods

CT images in unenhanced, arterial, and venous phases from 19 patients who had undergone resection of adrenocortical tumours and a cohort who had undergone surveillance for at least 5 years for incidentalomas were reviewed. A volume of interest was drawn for each lesion using dedicated software, and, for each phase, first-order (histogram) and second-order (grey-level colour matrix and run-length matrix) radiological features were extracted. Data were revised by an unsupervised machine learning approach using the K-means clustering technique.

Results

Of operated patients, nine had non-functional adenoma and 10 carcinoma. There were 11 patients in the surveillance group. Two first-order features in unenhanced CT and one in arterial CT, and 14 second-order parameters in unenhanced and venous CT and 10 second-order features in arterial CT, were able to differentiate adrenocortical carcinoma from adenoma (P < 0.050). After excluding two malignant outliers, the unsupervised machine learning approach correctly predicted malignancy in seven of eight adrenocortical carcinomas in all phases.

Conclusion

Radiomics with CT texture analysis was able to discriminate malignant from benign adrenocortical tumours, even by an unsupervised machine learning approach, in nearly all patients.
Partial effects in non-linear panel data models with correlated random effects
Authors: Abrevaya Jason , Hsu Yu-Chin
Published: March 2021

Nonlinearity and heterogeneity are known to cause difficulties in estimating and interpreting partial effects. This paper provides a systematic characterization of the various partial effects in nonlinear panel data models that might be of interest to empirical researchers. The interpretation of the partial effects depends upon (i) whether the distribution of unobserved heterogeneity is treated as fixed or allowed to vary with covariates, and (ii) whether one is interested in particular covariate values or an average over such values. The characterization covers partial-effects concepts already in the literature but also includes new concepts for partial effects. A simple panel probit design highlights that the different partial effects can be quantitatively very different.