bluuebunny/crossref_metadata_2025 huggingface dataset:
Impaired glucose metabolism in patients with diabetes, prediabetes, and obesity is associated with severe COVID‐19
Authors: Smith Stephen M. , Boppana Avinash , Traupman Julie A. , Unson Enrique , Maddock Daniel A. , Chao Kathy , Dobesh David P. , Brufsky Adam , Connor Ruth I.
Published: June 2020

Background

Identification of risk factors of severe coronavirus disease 2019 (COVID‐19) is critical for improving therapies and understanding severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) pathogenesis. We analyzed 184 patients hospitalized for COVID‐19 in Livingston, New Jersey for clinical characteristics associated with severe disease. The majority of patients with COVID‐19 had diabetes mellitus (DM) (62.0%), Pre‐DM (23.9%) with elevated fasting blood glucose (FBG), or a body mass index >30 with normal hemoglobin A1c (HbA1C) (4.3%). SARS‐CoV‐2 infection was associated with new and persistent hyperglycemia in 29 patients, including several with normal HbA1C levels. Forty‐four patients required intubation, which occurred significantly more often in patients with DM as compared with non‐diabetics. Severe COVID‐19 occurs in the presence of impaired glucose metabolism in patients, including those with DM, preDM, and obesity. COVID‐19 is associated with elevated FBG and several patients presented with new onset DM or in DKA. The association of dysregulated glucose metabolism and severe COVID‐19 suggests that SARS‐CoV‐2 pathogenesis involves a novel interplay with glucose metabolism. Exploration of pathways by which SARS‐CoV‐2 interacts glucose metabolism is critical for understanding disease pathogenesis and developing therapies.
The feasibility and effectiveness of a streamlined single‐catheter approach for radiofrequency atrial fibrillation ablation
Authors: Chin Shui Hao , O'Brien Jim , Epicoco Gianluca , Peddinti Prithvi , Gupta Akanksha , Modi Simon , Waktare Johan , Snowdon Richard , Gupta Dhiraj
Published: June 2020

Background

Catheter ablation for atrial fibrillation (AF) traditionally requires the use of circular mapping catheter (CMC) for pulmonary vein isolation (PVI). This study aimed to assess the feasibility and effectiveness of a CMC‐free approach for AF ablation performed by a contiguous optimized (CLOSE) ablation protocol.

Methods

A CLOSE‐guided and CMC‐free PVI protocol with a single transseptal puncture was attempted in 67 patients with AF. Left atrial (LA) CARTO voltage mapping was performed with the ablation catheter pre‐ and postablation to demonstrate entry block into the pulmonary veins, and pacing maneuvers were used to confirm exit block.

Results

The CMC‐free approach was successful in achieving PVI in 66 (98.5%) cases, with procedure time of 148 ± 32 minutes, ablation time of 27.5 ± 5.7 minutes, and fluoroscopy time of 7.8 ± 1.0 minutes. First‐pass PVI was seen in 58(86.5%) patients, and pacing maneuvers successfully identified the residual gap in eight of the other nine cases. No complication was observed. At 12 months follow‐up, 60 (89.6%) patients remained free from AF. The CMC‐free approach resulted in a cost saving of £47,190.

Conclusion

A CMC‐free CLOSE‐guided PVI approach is feasible, safe, and cost‐saving, and is associated with excellent clinical outcomes at 1 year.
A prospective multicenter study of direct comparison of feasibility and safety of pulmonary vein isolation using the minimally interrupted apixaban between second‐generation cryoballoon and radiofrequency ablation of paroxysmal atrial fibrillation: J‐HIT apixaban
Authors: Yagishita Atsuhiko , Goya Masahiko , Iesaka Yoshito , Nitta Junichi , Takahashi Atsushi , Nagata Yasutoshi , Hachiya Hitoshi , Inaba Osamu , Inamura Yukihiro , Tanaka Yasuaki , Watanabe Keita , Tao Susumu , Shirai Yasuhiro , Yamamoto Tasuku , Shiohira Shinya , Akiyoshi Kikou , Sekigawa Masahiro , Maeda Shingo , Sasaki Takeshi , Takahashi Yoshihide , Kawabata Mihoko , Hirao Kenzo ,   for the J‐HIT investigators
Published: June 2020

Background

The feasibility and safety of pulmonary vein isolation (PVI) using cryoballoon (CB) for paroxysmal atrial fibrillation (PAF) with minimally interrupted apixaban has not fully explored.

Methods

In this multicenter, randomized prospective study, we enrolled patients with PAF undergoing CB or radiofrequency (RF) ablation with interrupted (holding 1 dose) apixaban. The primary composite end point consisted of bleeding events, including pericardial effusion and major bleeding requiring blood transfusion, or thromboembolic events at 4 weeks after ablation; secondary end points included early recurrence of AF and procedural duration.

Results

A total of 250 patients underwent PVI (125 assigned to the RF ablation and 125 assigned to the CB ablation). The primary end point occurred in 1 patient in the CB ablation group (0.8%; 90% confidence interval [CI], 0.04 to 3.70) and 3 patients in the RF group (2.4%, P = .622; risk ratio, 0333; 90% CI, 0.05 to 2.20). All events were pericardial effusion, all of whom recovered after pericardiocentesis. Early recurrence of AF occurred in 4 patients (3.2%) in the RF group and in 6 patients (4.8%) in the CB group (P = .749). The procedural duration was shorter in the CB group than that in the RF group (136.5 ± 39.9 vs 179.5 ± 44.8 min, P < .001).

Conclusion

CB ablation with minimally interrupted apixaban was feasible and safe in patients with PAF undergoing PVI, which was equivalent to RF ablation.
The platelet‐rich plasma and mesenchymal stem cell milieu: A review of therapeutic effects on bone healing
Authors: Liebig Bethany E. , Kisiday John D. , Bahney Chelsea S. , Ehrhart Nicole P. , Goodrich Laurie R.
Published: June 2020

Platelet‐rich plasma is autologous plasma that contains concentrated platelets compared to whole blood. It is relatively inexpensive to produce, can be easily isolated from whole blood, and can be administered while the patient is in the operating room. Further, because platelet‐rich plasma is an autologous therapy, there is minimal risk for adverse reactions to the patient. Platelet‐rich plasma has been used to promote bone regeneration due to its abundance of concentrated growth factors that are essential to wound healing. In this review, we summarize the methods for producing platelet‐rich plasma and the history of its use in bone regeneration. We also summarize the growth factor profiles derived from platelet‐rich plasma, with emphasis on those factors that play a direct role in promoting bone repair within the local fracture environment. In addition, we discuss the potential advantages of combining platelet‐rich plasma with mesenchymal stem cells, a multipotent cell type often obtained from bone marrow or fat, to improve craniofacial and long bone regeneration. We detail what is currently known about how platelet‐rich plasma influences mesenchymal stem cells in vitro, and then highlight the clinical outcomes of administering platelet‐rich plasma and mesenchymal stem cells as a combination therapy to promote bone regeneration in vivo.
An ex vivo human osteochondral culture model
Authors: Kleuskens Meike W. A. , van Donkelaar Corrinus C. , Kock Linda M. , Janssen Rob P. A. , Ito Keita
Published: June 2020

To reduce animal experimentation and to overcome translational issues in cartilage tissue engineering, there is a need to develop an ex vivo human tissue‐based approach. This study aims to demonstrate that a human osteochondral explant at different stages of osteoarthritis (OA) can be kept in long‐term culture while preserving its viability and composition. Osteochondral explants with either a smooth or fibrillated cartilage surface, representing different OA stages, were harvested from fresh human tibial plateaus. Explants were cultured for 2 or 4 weeks in a double‐chamber culture platform. The biochemical content of the cartilage of cultured explants did not significantly change over a period of 4 weeks and these findings were supported by histology. Chondrocytes mostly preserved their metabolic activity during culture and active bone and marrow were found in the periphery of the explants, while metabolic activity was decreased in the bone core in cultured explants compared to fresh explants. In fibrillated explants, chondrocyte viability decreased in the periphery of the sample in cultured groups compared to fresh explants (fresh, 94 ± 6%; cultured, 64% ± 17%, 2 weeks, and 69% ± 17%, 4 weeks; P < .05). Although biochemical and histological results did not show changes within the cartilage tissue, the viability of the explants should be carefully controlled for each specific use. This system provides an alternative to explore drug treatment and implant performance under more controlled experimental conditions than possible in vivo, in combination with clinically relevant human osteochondral tissue.
Exploring the periodontal disease—ischemic stroke link
Authors: Sen Souvik , Mascari Rachel
Published: June 2020

Multiple risk factors are associated with ischemic stroke. Here, we highlight studies indicating that periodontal disease significantly increases the risk of both primary ischemic stroke and subsequent cardiovascular events. Additionally, studies have shown an association between periodontal disease and multiple causes of ischemic stroke. Finally, we describe an ongoing clinical trial testing the benefit of periodontal disease treatment as a strategy to reduce risk for recurrent cardiovascular events in patients who have had recent ischemic stroke or transient ischemic attack. This article is mostly based on a presentation given in honor of Steven Offenbacher (1950 to 2018).
Machine learning techniques as a tool for predicting overtourism: The case of Spain
Authors: Perles‐Ribes José Francisco , Ramón‐Rodríguez Ana Belén , Moreno‐Izquierdo Luis , Such‐Devesa María Jesús
Published: June 2020

One of the most challenging tasks for tourism scientists is the prediction of potential overtourism situations in the tourist destinations. Until now, some efforts have been proposed for the purpose of establishing early warning systems. However, none of the attempts has tried to make use of a powerful prediction tool that is currently available: machine learning techniques. This article seeks to fill this gap in the existing literature by proposing the use of machine learning techniques in order to predict overtourism issues on a sample of Spanish tourist cities specialized in both, urban and sun and beach tourism products.
Pons Anteroposterior and Cerebellar Vermis Craniocaudal Diameters in Fetuses With Down Syndrome
Authors: Erenel Hakan , Madazli Riza
Published: June 2020

Objectives

To investigate the pons anteroposterior diameter (APD) and cerebellar vermis craniocaudal diameter (CCD) of fetuses with Down syndrome (DS).

Methods

This was a prospective observational study including 200 low‐risk pregnancies and 18 pregnancies with fetuses who had DS. A midsagittal view was obtained to measure the pons APD and cerebellar vermis CCD. Gestational age‐related 5th, mean, and 95th percentiles for the pons APD and cerebellar vermis CCD between 18 and 32 weeks' gestation were created from the low‐risk population. Each measurement of a fetus with DS was plotted on growth charts, and those below the 5th percentile for gestational age were considered small.

Results

The pons APD and cerebellar vermis CCD measurements were below the 5th percentile for gestational age in 7 of the 18 (38.8%) fetuses with DS. Fetuses who had pons APDs below the 5th percentile for gestational age also had cerebellar vermis CCDs below the 5th percentile. Fetuses who had pons and cerebellar vermis measurements below the 5th percentile for gestational age on the initial examination continued to have small measurements during follow‐up.

Conclusions

Fetal pons and cerebellar vermis abnormalities could be observed prenatally in fetuses with DS, which could help in the antenatal counseling and postnatal follow‐up of such pregnancies.
Intellectual capital in East and West African social enterprises
Authors: Sgrò Francesca , Ciambotti Giacomo , Bontis Nick , Ayiku Andrews
Published: June 2020

Purpose

This study aims to identify the main factors of knowledge assets (i.e., human, relational and structural capital) that affect the value creation process of social enterprises located in East and West Africa.

Design

A survey was administered to a sample of social enterprises located in developing countries such as Kenya, Uganda, Sierra Leone and Ghana. The survey was designed to gather background information about social enterprises, social entrepreneurs as well as data pertaining to intellectual capital. Therefore, descriptive statistical analysis, principal component analysis and Pearson correlations were employed to identify the main components of IC for African SEs and the inter‐relationship among intellectual capital components.

Findings

Research findings confirmed that human capital (i.e., a social entrepreneur's knowledge), relational capital (i.e., local and global relationship quality) and structural capital (i.e., long‐term and up‐to‐date firm knowledge) were validated as important resources for African SEs in the value creation process. Moreover, correlation analysis showed that human capital and relational capital were positively correlated; whereas structural capital was positively correlated with the local and global relationship's quality and with the social entrepreneur's skills.

Limitations

The main limitations concern the heterogeneity and the restricted sample size due to challenges in the data gathering process. Moreover, the results could potentially be influenced by the context and the low response rate. However, this study can represent a starting point for future research in this unique but important research setting.

Originality

This study can be considered original for several reasons. First, empirical evidence on knowledge assets in developing countries in Africa is still scarce, despite the potential of being a new frontier for intellectual capital studies and social and economic growth. Second, the use of a survey method as an IC measurement tool in this context is unique. Finally, this study helps in providing a platform for further investigation in Africa.
Pretreatment High MCV as Adverse Prognostic Marker in Nonanemic Patients with Head and Neck Cancer
Authors: Borsetto Daniele , Polesel Jerry , Tirelli Giancarlo , Menegaldo Anna , Baggio Vittorio , Gava Alessandro , Nankivell Paul , Pracy Paul , Fussey Jonathan , Boscolo‐Rizzo Paolo
Published: June 2020

Objective

Mean corpuscular volume (MCV) has been shown in to be a reliable prognostic marker in other cancers; however, no evidence exists on its use in head and neck squamous cell carcinoma (HNSCC). This study aimed to investigate the association between MCV, hemoglobin, platelet count and albumin concentration, and survival in stage III/IVA‐B HNSCC treated with concurrent chemoradiotherapy.

Study Design

Retrospective cohort study.

Methods

In this multicenter retrospective study, we analyzed MCV, platelet count, hemoglobin concentration, and albumin concentration in peripheral blood samples from 260 patients with HNSCC undergoing organ preservation treatment with curative intent at the time of diagnosis. We then analyzed survival outcomes after accounting for confounders using multivariate analysis.

Results

After adjustment for potential confounders, patients with low hemoglobin had a 3.3‐fold higher risk of death (95% confidence interval [CI]: 2.26‐4.81) than those with normal hemoglobin. Patients with an elevated MCV had a 1.54‐fold higher risk of death (95% CI: 1.06‐2.24), independent of site, stage, and human papillomavirus status. Interestingly, the effect of MCV on overall and progression‐free survival was limited to those with a normal pretreatment hemoglobin. We identified no associations between pretreatment platelet count or albumin concentration and survival.

Conclusion

These findings suggest that pretreatment anemia and macrocytosis are independent predictors of lower overall and progression‐free survival in HNSCC patients undergoing organ preservation treatment.

Level of Evidence

III Laryngoscope, 131:E836–E843, 2021
Do high‐frequency air‐bone gaps persist after ossiculoplasty?
Authors: Polanik Marc D. , Trakimas Danielle R. , Castillo‐Bustamante Melissa , Cheng Jeffrey T. , Kozin Elliott D. , Remenschneider Aaron K.
Published: June 2020

Objectives

Conventional reporting of postoperative hearing outcomes utilizes a pure‐tone averaged air‐bone gap (ABG) that is biased toward low frequencies. Consequently, a high‐frequency ABG after otologic surgery may go unnoticed. In this study, we evaluate changes in low‐ and high‐frequency ABG following ossiculoplasty.

Study design

Retrospective review.

Subjects and setting

Consecutive series of patients who underwent ossiculoplasty at a single tertiary care center. Patients with pre‐ and postoperative audiograms were included.

Methods

Low‐frequency ABG was calculated as the mean ABG at 250, 500, and 1000 Hz. High‐frequency ABG was calculated at 4 kHz. Pre‐ and postoperative ABGs were compared.

Results

Thirty‐seven consecutive patients were included. Mean age at surgery was 38 years (range, 7‐77 years). Reconstruction materials included: cartilage (N = 4), hydroxyapatite cement (N = 5), and partial or total ossicular replacement prostheses (N = 20 and N = 8, respectively). Postoperatively, the mean low‐frequency ABG improved by 11.9 ± 15.1 dB (P < .0001) and the mean high‐frequency ABG improved by 5.9 ± 16.0 dB (P = .030). Low‐frequency ABG closure was significantly larger than high‐frequency ABG closure (P = .007). Mean postoperative persistent high‐frequency ABG was 22.0 ± 13.8 dB.

Conclusion

In this series, ossiculoplasty improved ABG across all frequencies, but greater improvements were observed at low frequencies when compared to high frequency. Current reporting standards may not identify persistent high‐frequency ABG. Additional study of the mechanisms of high‐frequency sound conduction in reconstructed middle ears is needed to improve high‐frequency hearing outcomes in ossiculoplasty.

Level of evidence

Level 4.
A maturity grid assessment tool for learning networks
Authors: Lannon Carole , Schuler Christine L. , Seid Michael , Provost Lloyd P. , Fuller Sandra , Purcell David , Forrest Christopher B. , Margolis Peter A.
Published: June 2020

Background

The vision of learning healthcare systems (LHSs) is attractive as a more effective model for health care services, but achieving the vision is complex. There is limited literature describing the processes needed to construct such multicomponent systems or to assess development.

Methods

We used the concept of a capability maturity matrix to describe the maturation of necessary infrastructure and processes to create learning networks (LNs), multisite collaborative LHSs that use an actor‐oriented network organizational architecture. We developed a network maturity grid (NMG) assessment tool by incorporating information from literature review, content theory from existing networks, and expert opinion to establish domains and components. We refined the maturity grid in response to feedback from network leadership teams. We followed NMG scores over time for nine LNs and plotted scores for each domain component with respect to SD for one participating network. We sought subjective feedback on the experience of applying the NMG to individual networks.

Results

LN leaders evaluated the scope, depth, and applicability of the NMG to their networks. Qualitative feedback from network leaders indicated that changes in NMG scores over time aligned with leaders' reports about growth in specific domains; changes in scores were consistent with network efforts to improve in various areas. Scores over time showed differences in maturation in the individual domains of each network. Scoring patterns, and SD for domain component scores, indicated consistency among LN leaders in some but not all aspects of network maturity. A case example from a participating network highlighted the value of the NMG in prompting strategic discussions about network development and demonstrated that the process of using the tool was itself valuable.

Conclusions

The capability maturity grid proposed here provides a framework to help those interested in creating Learning Health Networks plan and develop them over time.
HOW TO RECAPTURE LEADERSHIP'S LOST MOMENT
Authors: Powell Lili , Hunter Jeremy
Published: June 2020

Defining leadership moments happen in a flash. And yet the real experiential skills that moments like these require are rarely ever systematically taught to leaders. Instead, leaders are left to learn them through trial and error, or not at all. People often use a catch‐all colloquial term, chalking up this kind of inefficient and sometimes ineffective learning to “Experience.” To recapture leadership's lost moment, leaders can learn to refocus on their immediate experience so they can lead more mindfully. Our approach emphasizes using intention, attention, and awareness to act and perform skillfully and dynamically in real time. Using diverse practices ranging from meditation, yoga, athletics, and the performing arts, leaders can learn to experience a moment in a high‐definition way that increases the potential for better choices and leadership results. Leading mindfully begins simply and profoundly. Doing the inner work of noticing reactions, you can shift into more productive stances for action. Fueled by more productive intentions, you can increase the odds of moving skillfully into more productive actions. Skillful action then becomes a basis for skillful interaction and coordinated action toward a common goal, which of course is what leadership is really all about.
Deep Brain Stimulation Impact on Social and Occupational Functioning in Parkinson's Disease with Early Motor Complications
Authors: Stoker Valerie , Krack Paul , Tonder Lisa , Barnett Gillian , Durand‐Zaleski Isabelle , Schnitzler Alfons , Houeto Jean‐Luc , Timmermann Lars , Rau Joern , Schade‐Brittinger Carmen , Vidailhet Marie , Deuschl Günther ,   EARLYSTIM Study Group
Published: June 2020

Background

Deep brain stimulation (DBS) improves motor symptoms and quality of life in patients with Parkinson's disease (PD) and early motor complications, suggesting that DBS could be prescribed to the working‐age PD population.

Objectives

To investigate the effect of DBS compared with best medical therapy (BMT) on social, psychosocial, and occupational functioning in patients with PD ≤60 years of age with early motor complications, its correlates, and possible underlying rationale.

Methods

Methods included analyses of the Social and Occupational Functioning Assessment Scale, Scales for Outcomes for Parkinson's–Psychosocial, Professional Fitness, Starkstein Apathy Scale, and Schwab and England Activities of Daily Living Scale from the EARLYSTIM study.

Results

Compared with BMT, DBS resulted in significantly greater improvements from baseline through 24 months in social,occupational, and psychosocial functioning. Yet, work status in the 2 groups did not differ at baseline and 24 months. Physicians reported a significantly higher percentage of patients in the BMT group unable to work at 24 months relative to baseline compared with the DBS group. Apathy was significantly worse in patients for whom physicians overrated ability to work when compared with patients’ own ratings than in the group of patients who physicians' ability to work ratings were comparable to, or worse than, patients' self‐ratings of ability to work.

Conclusions

For patients aged ≤60 years with PD and early motor complications, DBS provided significant improvements in social, occupational, and psychosocial function, but not in the actual work engagement compared with BMT at 2 years. Apathy may impact ability to work.
TP53 p.Arg337His geographic distribution correlates with adrenocortical tumor occurrence
Authors: Seidinger Ana L. , Caminha Isabel P. , Mastellaro Maria J. , Gabetta Carmen S. , Nowill Alexandre E. , Pinheiro Vitória R. P. , Yunes José A.
Published: June 2020

Background

The p.Arg337His mutation of the TP53 is the most frequent germline missense variant associated with cancer described so far in this gene. It is mainly found in the South and Southeastern regions of Brazil, where it has been associated with a high incidence of pediatric adrenocortical (ACT) and choroid plexus tumors. The frequency and geographic distribution of this mutation is largely unknown, except for the Parana State, where a mean prevalence of 0.27% was reported. In the present study, we developed a high‐throughput method for p.Arg337His genotyping, what allowed us to determine the frequency and geographic distribution of this mutation in a cohort from the most populous state in Brazil.

Methods

Consecutive samples from 31,612 newborns from São Paulo State were screened for p.Arg337His. The allelic discrimination was done by real‐time polymerase chain reaction (PCR) and the presence of haplotype A3 in carriers was examined by using allele‐specific oligonucleotide PCR, followed by nested‐PCR to detect the SNP rs9894946.

Results

We found 67 (0.21%) samples positive for this mutation. The highest p.Arg337His frequencies were found in the cities close to the boundary between São Paulo and Minas Gerais State. No association could be found between p.Arg337His and gender, ethnicity, premature birth or twinning. Remarkably, a trend was found between the geographic distribution of p.Arg337His carriers and occurrence of ACT.

Conclusion

We presented for the first time the p.Arg337His frequency among individuals unselected for any disease from a subset of the São Paulo State, the most populous in Brazil. The allele discrimination assay we presented here has proven to be a reliable and efficient method for high‐throughput genotyping. ACT was found to be a good sentinel cancer to suppose p.Arg337His presence in our region.
Virtual Hill Day outlines key policy efforts, encourages hotline support
Authors: Canady Valerie A.
Published: June 2020

Amid a changing field, the National Council for Behavioral Health held its first ever Hill Day at Home event, which focused on key legislation and overcoming struggles during the COVID‐19 crisis to advocate for federal investments and laud behavioral health providers for their capacity in addressing ongoing challenges.
Olmstead anniversary underscores need for more planning
Authors: Canady Valerie A.
Published: June 2020

For people with serious mental illness, living independently in housing and having choices and opportunities for employment and transportation are more important than ever, even though it has been 21 years since the Supreme Court decided, in Olmstead v. L.C., that under the Americans with Disabilities Act (ADA), people with disabilities cannot be unnecessarily segregated and must receive services in the most integrated setting possible. Attendees last week learned about strategies and components of Olmstead planning during a Substance Abuse and Mental Health Services Administration–sponsored webinar.
Report finds untreated eating disorders costing U.S. billions
Authors: Canady Valerie A.
Published: June 2020

Researchers of a new report examining the rise in cases and costs of eating disorders call for a need for treatment and for prioritizing attention to the health and wellness of Americans, especially during the COVID‐19 crisis.
Company moves forward with nondrug treatment for ADHD
Authors: Canady Valerie A.
Published: June 2020

Buoyed by the Food and Drug Administration's recent approval of the first prescription video game for children with attention deficit hyperactivity disorder (ADHD) (see story, beginning on page one), a provider of digital therapeutics delivering evidence‐based therapeutic interventions is moving forward with its own products to treat children with ADHD.
Oscillatory solutions of fractional integro‐differential equations
Authors: Restrepo Joel E. , Suragan Durvudkhan
Published: June 2020

We give necessary conditions to get oscillatory solutions of a class of fractional order neutral differential equations with continuously distributed delay by means of the fractional derivative with respect to a given function. In particular, oscillatory solutions of the considered fractional equations with Caputo and Hadamard type of fractional derivatives are established. Some explicit examples are given to illustrate the main results.
Localization properties for nonlinear equations involving monotone operators
Authors: Galewski Marek
Published: June 2020

Using monotonicity methods, the Lagrange multiplier rule, and some variational arguments, we consider a type of localization results pertaining to the existence of critical points to action functionals on a closed ball. A variant of the Schechter critical point theorem on a ball in Hilbert and Banach spaces is obtained. Applications to nonlinear Dirichlet problem and to partial difference equations are given in the final part of this paper.
About partial boundary dissipation to Timoshenko system with delay
Authors: Ochoa Ochoa Elena , Gómez Ávalos Gerardo , Muñoz Rivera Jaime E.
Published: June 2020

We consider the Timoshenko model with partial dissipative boundary condition with delay, and we prove that the solution decays exponentially to zero, provided the wave speed are equal; this improve earlier result due to Bassam et al and Muñoz Rivera and Naso. Moreover, consider the exponential stability to the corresponding semilinear problems.
Identification of TMCO2 as an acrosome‐associated protein during rat spermiogenesis
Authors: Kaneko Takane , Toh Saori , Mochida Izumi , Iwamori Naoki , Inai Tetsuichiro , Iida Hiroshi
Published: June 2020

We isolated the transmembrane and coiled‐coil domains 2 (Tmco2) gene using a polymerase chain reaction‐based subtraction technique. Tmco2 is predominantly expressed in rat testes starting from 4 weeks of age. Rat TMCO2 consists of 187 amino acids with a predicted molecular mass of 20.6 kDa. When expressed in COS7 cells, TMCO2 was found as vesicle‐like structures in the cytoplasm, whereas TMCO2ΔTM lacking the transmembrane (TM) region was found diffused in the cytoplasm. These results suggest that the TM region in TMCO2 is essential for its specificity of localization. Immunocytochemical analyzes indicated that rat TMCO2 was localized as small semiluminate bodies or cap‐like structures in the vicinity of round spermatid nuclei and as curved lines associated with nuclei of elongated spermatids and caput epididymal spermatozoa. However, it was detected in only a small part of cauda epididymal spermatozoa. Double immunolabeling of the spermatids and spermatozoa with the anti‐TMCO2 antibody and the monoclonal anti‐MN7 antibody showed that TMCO2 was predominantly associated with the inner acrosomal membrane in spermatids and caput epididymal spermatozoa. Our findings suggest that TMCO2 might be involved in the process of acrosome biogenesis, especially binding of acrosome to a nucleus, during spermiogenesis.
Manganese‐based layered oxide cathodes for sodium ion batteries
Authors: Liu Huanqing , Deng Wentao , Gao Xu , Chen Jun , Yin Shouyi , Yang Li , Zou Guoqiang , Hou Hongshuai , Ji Xiaobo
Published: June 2020

Sodium‐ion batteries (SIBs) have attracted enormous interests and considered to be an alternative to lithium‐ion batteries (LIBs) because of the abundant natural resource and low‐cost of sodium. Layered transition metal oxides appear to be potential cathode candidates for SIBs due to their plentiful structural diversity, fast diffusion of Na ions and feasibility for commercialization. In particular, Mn‐based compounds have the advantages of low cost and high theoretical capacities. In this review, the recent progress of Mn‐based layered oxides as cathode materials for SIBs are reviewed and summarized. A deep understanding of the relationship of the structural transition and electrochemical performance in layered oxide cathodes is provided. Moreover, the existing drawbacks are discussed, and several strategies are proposed to help mitigate these issues. Future perspectives are discussed to pave the way for the commercialization of such systems.
Improvement in Protein Delivery for Critically Ill Patients Requiring High‐Dose Propofol Therapy and Enteral Nutrition
Authors: Buckley Christopher T. , Van Matre Edward T. , Fischer Peter E. , Minard Gayle , Dickerson Roland N.
Published: June 2020

Background

Patients with traumatic brain (TBI) injury often require a high dosage of propofol, which can provide an excessive caloric intake. We evaluated our strategy of using liquid protein supplement boluses concurrently with high protein–containing enteral nutrition (EN) formulas and formula rate reduction to avoid caloric overfeeding and inadequate protein intake.

Methods

Adult patients (aged >17 years) with TBI admitted to the trauma intensive care unit (TICU) who received concurrent propofol and EN were retrospectively reviewed. Caloric intakes from propofol and EN were obtained. Actual protein intake was compared with projected protein intakes from high protein content and standard protein content enteral formulas when given at an isocaloric intake.

Results

Fifty‐one patients were enrolled. Average caloric intake from propofol was 356 ± 243 kcal/d or 5 ± 3 kcal/kg/d (range, <1–15 kcal/kg/d). Daily EN caloric intake ranged from 7 ± 4 kcal/kg/d (day 2) to 16 ± 9 kcal/kg/d (day 5; P < .001). Average protein intake ranged from 0.6 ± 0.4 g/kg/d (day 2) to 1.5 ± 0.7 g/kg/d (day 5; P < .001). The modified EN strategy resulted in daily delivery of 24%–38% more protein than an isocaloric regimen with a high protein–content formula and twice as much protein than the standard protein–content formula (P < .001).

Conclusion

The strategy of providing an EN regimen comprised liquid protein boluses, and high and very high protein–containing EN formulas at a reduced rate improved protein delivery without caloric overfeeding.
Why oral palliative care takes a backseat? A national focus group study on experiences of palliative doctors, nurses and dentists
Authors: Venkatasalu Munikumar Ramasamy , Murang Zaidah Rizidah , Husaini Hajah Asmah binti Haji , Idris Deeni Rudita , Dhaliwal Jagjit Singh
Published: June 2020

Aim

Poor oral care among frail older people at the end of life endangers quality of life. However, only few dying people have access to oral palliative care services. Therefore, this study aimed to investigate oral palliative care practices and referral patterns for palliative patients in the Brunei healthcare settings.

Design

An exploratory qualitative study.

Methods

Five focus groups were conducted among palliative care nurses (N = 7), palliative medicine doctors (N = 4), dentists (N = 6), oncologists (N = 4) and oncology nurses (N = 4). Verbatim was analysed using qualitative thematic analysis.

Results

Analyses revealed four distinct themes emerging as current oral palliative care assessment and referral practice in the Brunei healthcare settings: “taking a back seat,” “opportunistic oral care,” “they refused and refused” and “challenging healthcare resources and oral palliative care.”
Burning by numbers: A pilot study using quantitative petrography in the analysis of heat‐induced alteration in burned bone
Authors: Carroll Emily L. , Squires Kirsty E.
Published: June 2020

In the past, experimental research into the histomorphological examination of burned human bone has led to the creation of a criterion for assessing burning intensity, which can be used to infer firing conditions in both archaeological and forensic contexts. Current methods visually compare the microscopic alterations in burned bone with modern bone samples fired at known temperatures and durations. Despite the benefits of this approach, it is hindered by the use of qualitative analysis, which is subject to the expertise of the examiner. This paper reviews previous histomorphological studies of burned bone and presents a new protocol for producing burned bone thin sections. It also introduces quantitative petrography as an alternative statistical method for categorising burning intensity. Four categories of burning intensity were calculated based on the quantified heat‐induced changes identified in a pilot study examining burned porcine bone. These categories were consistent with those produced using more traditional qualitative methods, demonstrating that the results produced in this pilot study are reliable. An interobserver study showed the repeatability of this new method by both anthropologists and non‐anthropologists.
Development, implementation and early results of a 12‐week web‐based intervention targeting 51 children age 5–13 years and their families
Authors: Thorén Annelie , Janson Annika , Englund Erling , Silfverdal Sven‐Arne
Published: June 2020

Background

Internet‐based treatments have proven effective for various health issues. There is a need to scale up interventions targeting children with obesity, also in less densely populated areas where the prevalence in many countries is higher than in urban areas. The aim of this study was to design and implement an internet‐based program as an add‐on to standard treatment for childhood obesity.

Methods

Web‐Childhood Obesity Prevention (Web‐COP) was a prospective feasibility study with a pre‐ post‐ design. The intervention consisted of four group‐based education sessions at the clinic, physical activity on prescription, and a new 12‐week internet‐based program. Web‐COP was offered to children with obesity (International Obesity Task Force Body Mass Index (IOTF‐BMI) ≥ 30 kg/m2) and their parents in two counties in Northern Sweden from August 2018 to June 2019. The primary outcome was change in BMI standard deviation score (BMI‐SDS).

Results

The study included 55 children 5–13 years of age. The internet‐based component was well received, and retention rate was 51/55 (92.7%). Data was analysed for 51 children. Mean BMI‐SDS was 3.3 at start and decreased by 0.2, 0.3, and 0.4 at two, four, and six months from baseline. Using a continuous algorithm, 42/51 (81%), children lowered their BMI‐SDS and 33/51 (65%) lowered their BMI.

Conclusion

Adding group sessions and an internet‐based program to standard care was feasible and two thirds of included children with obesity reduced their BMI.
Addressing global challenges with unconventional insect ecosystem services: Why should humanity care about insect larvae?
Authors: Morimoto Juliano
Published: June 2020

Ecosystem services are essential for the health of current and future generations and key to the sustainable development of our societies. The role of insects in providing ecosystem services has been increasingly recognized, becoming the focus of several management and conservation initiatives world‐wide.

However, ecosystem services framework traditionally overlooks the full range of services that can be provided by insects, largely because services provided by life stages other than the insect adult are often neglected.

In this paper, I first review the traditional ecosystem services primarily attributed to insects, namely edible insects and mass‐rearing for biological control. Next, I provide a collection of unconventional ecosystem services provided by insect larvae which highlights the importance of considering life stage‐specific services in a holistic view of the ecosystem services framework.

In particular, I discuss recent advances that revealed how insect larvae can degrade plastic, which is one of humanity's greatest environmental pollutants, and how larvae can be used to produce biofuel to help overcome the increasing contribution of the fossil fuel industry to climate change. I then discuss how toxic compounds produced by the larvae of some insects provide potential new medicines for clinical treatment and lastly, I discuss a unique example of how the larval stage of insects is entrenched into the cultural values of Aboriginal communities in Australia.

In conclusion, by acknowledging life stage‐specific ecosystem services provided by insects, this paper raises awareness of unconventional services that can underpin innovative solutions to contemporary global challenges, which can ultimately help create more sustainable and culturally diverse societies.
Poly(hydroxybutyrate)‐based systems behavior on the controlled release of NPK fertilizers
Authors: Daitx Tales da Silva , de Lima Vanessa Silva , Gryczak Marcelo , Petzhold Cesar Liberato , Carli Larissa Nardini , Mauler Raquel Santos
Published: June 2020

Here we investigate the behavior of controlled‐release systems based on poly(hydroxybutyrate) (PHB) to propose an actuation mechanism in a designed environment. Two formulations were produced employing 5% pure NPK fertilizer or 30% of bentonite nanoparticles (Bent) previously modified with NPK. The polymeric composites were obtained by melt processing and their thermal properties evaluated. The release of active compounds was evaluated by conductometric analysis in aqueous solutions at different pHs for 30 days, and the results were modulated by the Korsmeyer‐Peppas model. Also, the systems were evaluated for their biodegradation characteristics using different soil types to generate a decomposition profile. In general, the systems showed a good release control, with 40% and 50% of fertilizer being released in 30 days, depending on the conditions and type of polymeric composite employed. The model indicated a linear release of active compounds in the first 30 days, according to the Fick diffusion. Additionally, the compounds were relatively stable in the first 30 days when exposed to biodegradation, being degraded faster speed after this. The efficiency and applicability of the systems were confirmed by the germination tests, which showed that both systems containing NPK favored plant growth, while the system in which the active agents had been previously incorporated into nanoparticles provided a reduction in the waste of agrochemicals. Thus, a novel mechanism of action for polymeric controlled release systems based on thermoplastic biopolymers was determined, supporting more efficient industrial processes.
The role of diffusion tensor imaging metrics in the discrimination between cerebellar medulloblastoma and brainstem glioma
Authors: Duc Nguyen Minh
Published: June 2020

Background

Differentiation between cerebellar medulloblastoma and brainstem glioma is necessary for certain clinical circumstances. We aimed to evaluate the function of diffusion tensor imaging (DTI) metrics in the differentiation between cerebellar medulloblastomas and brainstem gliomas in children.

Procedure

The institutional review board approved this prospective study. Brain magnetic resonance imaging (MRI), including DTI, was assessed in 40 patients, who were divided into two groups: a medulloblastoma group (group 1, n = 25) and a brainstem glioma group (group 2, n = 15). The Mann‐Whitney U test was utilized to compare tumoral fractional anisotropy (FA) and diffusivity (MD) values and tumor‐to‐parenchyma ratios for these values (rFA and rMD, respectively) between the two groups. Receiver‐operating characteristic (ROC) curve analysis and the Youden index were exploited to calculate the cutoff value, along with the area under the curve (AUC), sensitivity, and specificity.

Results

The FA value for medulloblastomas was significantly higher than that for brainstem gliomas (P < 0.05). In contrast, the MD and rMD values for medulloblastoma were significantly lower than those for brainstem gliomas (P < 0.05). A cutoff MD value of 0.97 was identified as the most effective factor for the differential diagnosis between medulloblastomas and brainstem gliomas, which reached a sensitivity of 96%, a specificity of 100%, and an AUC of 99.5%.

Conclusion

DTI metrics play a significant role in the differentiation between medulloblastoma and brainstem glioma in pediatric patients.
A single‐arm study of systemic and sub‐Tenon chemotherapy for Groups C and D intraocular retinoblastoma: A Children's Oncology Group study (ARET 0231)
Authors: Jubran Rima F. , Villablanca Judith G. , Krailo Mark , Piao Jin , Huang Li , Murphree A. Linn , O'Brien Joan , Gombos Dan , Shields Carol L. , Meadows Anna , Chintagumpala Murali
Published: June 2020

Background

Eyes with Group D intraocular retinoblastoma have low salvage rates. A pilot study showed safety and efficacy of sub‐Tenon's fascia carboplatin with systemic chemotherapy supporting further study.

Methods

Children with newly diagnosed bilateral intraocular retinoblastoma with at least one remaining Group C or D eye were treated with six courses of carboplatin/etoposide/vincristine (CEV) with sub‐Tenon's fascia carboplatin for Group C/D eyes during courses 2‐4. Local ophthalmic therapy started at course 3. The primary study objective was to determine the 1‐year failure rate of Group D eyes.

Results

The study closed prematurely due to poor accrual and 22 of 30 patients were evaluable for failure rate, contributing 25 Group D and four Group C eyes. Among the 25 Group D eyes, there were 13 failures within the first year of study enrollment including eight needing external beam radiotherapy (EBR) and five needing enucleation, resulting in 1‐year failure rate of 52%. The failure rate was significantly lower than the historical rate of 70% (P = .039). The 1‐year eye preservation rate for Group D eyes was 80% (20/25). One‐year failure rate for Group C eyes was 25% (1/4); 1‐year preservation rate was 100% without need for EBR. Systemic toxicity included Grade 3 hearing loss in two subjects, infections, neutropenia, and thrombocytopenia. Ocular toxicities included periorbital fat atrophy (13/29 = 45% eyes), optic nerve atrophy (1/29 = 3% eyes), and restrictive fibrosis (1/29 = 3% eyes).

Conclusions

Sub‐Tenon's fascia carboplatin plus CEV was partially effective in Group D intraocular retinoblastoma but had unacceptable ocular toxicities.
Feasibility of FitSurvivor: A technology‐enhanced group‐based fitness intervention for adolescent and young adult survivors of childhood cancer
Authors: Devine Katie A. , Viola Adrienne , Levonyan‐Radloff Kristine , Mackowski Nicholas , Bozzini Brittany , Chandler Alexa , Xu Baichen , Ohman‐Strickland Pamela , Mayans Sherri , Farrar‐Anton Anne , Sahler Olle Jane Z. , Masterson Margaret , Manne Sharon , Arent Shawn
Published: June 2020

Background

This study evaluated the feasibility of a technology‐enhanced group‐based fitness intervention for adolescent and young adult (AYA) survivors of childhood cancer.

Procedure

AYA survivors ages 13‐25 years were randomized to the intervention (eight in‐person group sessions with mobile app and FitBit followed by 4 weeks of app and FitBit only) or waitlist control. Assessments were at 0, 2, 3, 6, and 9 months. Feasibility was evaluated by enrollment, retention, attendance, app engagement, and satisfaction. Secondary outcomes included physical activity, muscular strength/endurance, cardiorespiratory fitness, health‐related quality of life, and fatigue.

Results

A total of 354 survivors were mailed participation letters; 68 (19%) were screened, of which 56 were eligible and 49 enrolled (88% of those screened eligible, 14% of total potentially eligible). Forty‐nine survivors (Mage = 18.5 years, 49% female) completed baseline assessments and were randomized (25 intervention, 24 waitlist). Thirty‐seven (76%) completed the postintervention assessment and 32 (65%) completed the final assessment. On average, participants attended 5.7 of eight sessions (range 1‐8). Overall intervention satisfaction was high (M = 4.3, SD = 0.58 on 1‐5 scale). Satisfaction with the companion app was moderately high (M = 3.4, SD = 0.97). The intervention group demonstrated significantly greater improvement in lower body muscle strength compared to the waitlist postintervention, and small but not statistically significant changes in other secondary measures.

Conclusions

A group‐based intervention with a mobile app and fitness tracker was acceptable but has limited reach due to geographical barriers and competing demands experienced by AYA survivors.