bluuebunny/crossref_metadata_2025 huggingface dataset:
Ecological Discord and the Importance of Scale in Scientific Inquiry
Authors: Hernández Fidel
Published: August 2020

Scale is widely recognized today as an important concept in ecology because the scale of investigation determines the patterns and processes that can be observed. Ecological investigations can produce different outcomes depending on the scale at which observations are made, and ecological disagreements have occurred simply because investigators addressed the same question using different scales. Here I draw on quail research to illustrate the importance of scale in ecological studies and how lack of scale consideration can lead to discord. I use northern bobwhite (Colinus virginianus) as the focal species and discuss 2 areas of investigation (woody‐cover requirements and influence of rainfall) that are characterized by confusion and disagreement but where consideration of scale brings clarity. In the process, I discover 2 formerly unrecognized patterns: northern bobwhite use of woody cover is inversely related with spatial extent of observation, and the influence of rainfall on northern bobwhite abundance decreases with decreasing spatial extent. In both cases, consideration of scale clarifies muddled knowledge and creates a unified framework for management. Future ecological investigations should formulate research questions within a scale framework, provide an explicit statement of scale in methods, and interpret findings within a scale context to help advance wildlife science and management. © 2020 The Wildlife Society.
Functional Results and Learning Curve of Endoscopic Stapes Surgery: A 10‐Year Experience
Authors: Lucidi Daniela , Molinari Giulia , Reale Marella , Alicandri‐Ciufelli Matteo , Presutti Livio
Published: August 2020

Objectives/Hypothesis

To assess hearing outcomes and complications of endoscopic stapes surgery by a single surgeon in a 10‐year period, to compare these data with conventional microscopic procedures by the same operator, and to describe the learning curve of endoscopic stapedotomy.

Study Design

Retrospective study.

Methods

This is a retrospective study on patients who underwent endoscopic stapes surgery performed by the same senior surgeon, experienced both in microscopic and endoscopic techniques, between January 2009 and December 2018. Audiological data were compared, and intraoperative and postoperative complications were collected. The surgeon's last 30 cases of microscopic stapedotomy were enrolled as the control group. The results of the first 100 endoscopic stapes surgeries were analyzed separately to create a cumulative sum (CUSUM) control chart for learning curve assessment.

Results

One hundred seventy‐eight endoscopic and 30 microscopic stapes surgeries were included. In the endoscopic group, the mean postoperative air–bone gap was 8.2 dB. No significant differences between the endoscopic and microscopic preoperative and postoperative values were reported. A total of eight complications (4.5%) were observed in the endoscopic cohort, although in the control group, no complication occurred. The mean surgical time was 51.9 minutes in the endoscopic group versus 48.2 minutes in the microscopic group (P > .05). No association between stapedotomy success and the increasing number of procedures was found.

Conclusions

Our article demonstrates that functional results from endoscopic stapes surgery are similar to those from microscopic stapes surgery in terms of both safety and efficacy. After gaining endoscopic experience, the surgical duration of stapes surgery will be adequate starting from the first cases.

Level of Evidence

4 Laryngoscope, 131:885–891, 2021
Organic vs. Inorganic Tracheobronchial Airway Foreign Body Aspiration: Does Type/Duration Matter?
Authors: Hughes Charlotte K. , Christensen Christine L. , Maturo Stephen C. , O'Connor Peter R. , Dion Gregory R.
Published: August 2020

Objective

We sought to determine the time course of clinical and histologic differences between aspirated inorganic and organic foreign bodies.

Study Design

In‐vivo.

Methods

Twenty Sinclair miniature swine (Sus scrofa domesticus) were divided into two groups—inorganic or organic foreign bodies. Either an organic (peanut) or an inorganic (Lego) foreign body was placed within a bronchus and left for 3, 5, 7, 14 or 21 days. The airway was reassessed at the predetermined endpoint at which time endoscopic, gross, and histopathological findings were documented. Specimens were scored with a pathologic scoring system to assess injury severity from the foreign body.

Results

Foreign bodies were successfully placed in all 20 swine. Two animals required early euthanasia due to respiratory compromise. The foreign body was identified grossly in eight (40%) animals. An additional three (15%) had microscopic evidence suggestive of a previous foreign body of an undetermined duration. There was no difference in injury severity between organic and inorganic foreign bodies. The 3‐day group had injuries limited to the bronchial lining, whereas the longer duration groups had bronchial and adjacent lung parenchymal involvement. There was no difference in injury severity between days 5 and 21.

Conclusions

Airway foreign bodies initially cause bronchial damage. After 5 days, the foreign body causes lung parenchymal changes. There was no difference in airway lesion severity between organic and inorganic foreign bodies.

Level of Evidence

N/A Laryngoscope, 131:490–495, 2021
Hidden Electrode Failure in a Cochlear Implant User
Authors: Gärtner Lutz , Büchner Andreas , Illg Angelika , Lenarz Thomas
Published: August 2020

When the impedance of an electrode contact is highly increased in a cochlear implant, a failure of the appropriate electrode seems obvious. We present a case where impedances of some electrodes were at the lower edge of the normal range and not regarded as suspicious neither by the clinical fitting software nor by in‐vivo tests conducted by the implant manufacturer. However, speech comprehension was substantially degraded and sound perception distorted. Also, on the affected electrodes, loudness perception was compromised and responses of the electrically evoked compound action potential were no longer measureable. After re‐implantation, the subjective sound percept was clear again and speech comprehension scored much better than before. Later, inspection of the explant revealed shorts on the device and the implant was classified as device failure. Our case shows the importance of collecting longitudinal data of cochlear implant patients, i.e. device related technical measurements and hearing performance data, and the consideration of all these data in cases of patient complaints or suspected implant failures. Laryngoscope, 131:E1275–E1278, 2021
Actin‐Associated Gene Expression is Associated with Early Regional Metastasis of Tongue Cancer
Authors: Lee Doh Young , Kang Young , Im Nu‐Ri , Kim Byoungjae , Kwon Tack‐Kyun , Jung Kwang‐Yoon , Baek Seung‐Kuk
Published: August 2020

Objectives

We aimed to analyze gene expression profile of tongue cancer associated with early lymph node metastasis using the cancer genome atlas (TCGA) data.

Study design

Basic research.

Methods

A total of 515 patients with matched RNAseq data of primary tumor and clinical data from TCGA data were extracted. To compare gene expression profile between early T‐stage tongue cancer with cervical lymph node metastasis and late T‐stage tongue cancer without cervical metastasis, genomic data of following two groups was assessed; 1) group 1: T1/2 and N2/3 (n = 41), 2) group 2: T4 and N0 (n = 65). Using R and limma package in bioconductor program, differentially expressed genes (DEGs) were extracted. Gene ontology and pathway enrichment analysis were performed using the DAVID online tool. FFPE tissue of 285 patients were evaluated for the validation of relevant genes by imunofluorescence (IF) and immunohistochemical (IHC) stain.

Results

A total of 225 DEGs were found, and 50 genes were highly significant with absolute fold change over eight. Gene ontology and pathway enrichment analysis revealed that most of the upregulated genes were associated with actin cytoskeleton and included following genes: ANKRD23, NO3, PDLIM3, MUSTN1, TNNT3, MYBPC1, MB, MYH3, TTN, ACTA1, and ACTC1. When comparing tongue cancer with cN0pN0 vs. pN0pN+ using the total tongue cancer cohort of TCGA, ACTA1 was the only parameter which was associated with hidden lymph node metastasis in T1/2 (P = .019). Perineural invasion was significantly associated with high expression of ACTA1 (P < .001). IF and IHC analysis revealed that actin was overexpressed, while E‐cadherin and N‐cadherin were not significantly different.

Conclusions

Actin associated genes, especially overexpression of ACTA1 may be associated with early regional metastasis of tongue cancer.

Level of Evidence

3 Laryngoscope, 131:813–819, 2021
Reducing Aerosolized Particles and Droplet Spread in Endoscopic Sinus Surgery during COVID‐19
Authors: Jones Huw A. S. , Salib Rami J. , Harries Philip G.
Published: August 2020

Objectives

The presence of high SARS‐Cov‐2 viral loads in the upper airway, including the potential for aerosolized transmission of viral particles, has generated significant concern amongst otolaryngologists worldwide, particularly those performing endoscopic sinus surgery (ESS). We evaluated a simple negative‐pressure mask technique to reduce viral exposure.

Methods

Two models simulating respiratory droplets >5–10 μm and fine respiratory nuclei <5 μm using fluorescein dye and wood smoke, respectively, were utilized in a fixed cadaveric study in a controlled environment. Using ultraviolet light, fluorescein droplet spread was assessed during simulated ESS with powered microdebrider and powered drilling. Wood smoke ejection was used to evaluate fine particulate escape from a negative‐pressure mask using digital subtraction image processing.

Results

The use of a negative‐pressure mask technique resulted in 98% reduction in the fine particulate aerosol simulation and eliminated larger respiratory droplet spread during simulated ESS, including during external drill activation.

Conclusions

As global ear, nose & throat (ENT) services resume routine elective operating, we demonstrate the potential use of a simple negative‐pressure mask technique to reduce the risk of viral exposure for the operator and theatre staff during ESS.

Level of Evidence

5 Laryngoscope, 131:956–960, 2021
Fractional Microablative CO2 Laser‐Related Histological Changes on Vulvar Tissue in Patients With Genitourinary Syndrome of Menopause
Authors: Pagano Tiziana , Travaglino Antonio , Raffone Antonio , Vallone Roberta , Buonfantino Cira , De Rosa Pasquale , Locci Mariavittoria , Guadagno Elia , Insabato Luigi , Salvatore Stefano , De Placido Giuseppe
Published: August 2020

Background and Objectives

Fractional CO2 laser has been proposed as an effective treatment for the genitourinary syndrome of menopause (GSM). However, the effects of laser treatment on vulvar tissue have never been assessed. We aimed to assess histological changes related to fractional CO2 laser in vulvar tissue from GSM patients.

Study Design/Materials and Methods

A single‐center observational prospective cohort study was performed enrolling all GSM patients from July 2017 to October 2018. Patients underwent three outpatient vulvovaginal applications of fractional CO2 laser and vulvar biopsy before and after treatment. Rates of histological changes in vulvar tissue, the difference in means of Vulva Health Index (VuHI), Vaginal Health Index (VHI), Visual Analogue Scale scores for GSM symptoms, and procedure‐related pain, and rate of patient's overall satisfaction with treatment were assessed. Univariate comparisons between continuous variables were performed by using the paired t‐test (α error = 0.05).

Results

Of 20 enrolled patients, 18 underwent all laser applications, and 15 underwent both vulvar biopsies. 93.3% of patients showed remodeling of vulvar connective tissue; 80% showed improvement in vulvar epithelium trophism and 86.7% showed neovascularization. Differences in means between before and after treatment were significant for VuHI, VHI, and all GSM symptoms. Means ± standard deviation of the degree of pain at each laser application were 4.4 ± 0.9, 3.7 ± 1.6, and 2.9 ± 1.9. The rate of overall satisfaction with the treatment was 72.2%.

Conclusions

Fractional CO2 laser leads to a restoration of the normal architecture of vulvar tissue, with significant improvement in GSM‐related signs and symptoms, and overall satisfaction with the treatment in most GSM patients. Lasers Surg. Med. © 2020 Wiley Periodicals LLC
Validation of Serum Neurofilament Light Chain as a Biomarker of Parkinson's Disease Progression
Authors: Mollenhauer Brit , Dakna Mohammed , Kruse Niels , Galasko Douglas , Foroud Tatiana , Zetterberg Henrik , Schade Sebastian , Gera Roland G. , Wang Wenting , Gao Feng , Frasier Mark , Chahine Lana M. , Coffey Christopher S. , Singleton Andrew B. , Simuni Tanya , Weintraub Daniel , Seibyl John , Toga Arthur W. , Tanner Caroline M. , Kieburtz Karl , Marek Kenneth , Siderowf Andrew , Cedarbaum Jesse M. , Hutten Samantha J. , Trenkwalder Claudia , Graham Danielle
Published: August 2020

Background

The objective of this study was to assess neurofilament light chain as a Parkinson's disease biomarker.

Methods

We quantified neurofilament light chain in 2 independent cohorts: (1) longitudinal cerebrospinal fluid samples from the longitudinal de novo Parkinson's disease cohort and (2) a large longitudinal cohort with serum samples from Parkinson's disease, other cognate/neurodegenerative disorders, healthy controls, prodromal conditions, and mutation carriers.

Results

In the Parkinson's Progression Marker Initiative cohort, mean baseline serum neurofilament light chain was higher in Parkinson's disease patients (13 ± 7.2 pg/mL) than in controls (12 ± 6.7 pg/mL), P = 0.0336. Serum neurofilament light chain increased longitudinally in Parkinson's disease patients versus controls (P < 0.01). Motor scores were positively associated with neurofilament light chain, whereas some cognitive scores showed a negative association.

Conclusions

Neurofilament light chain in serum samples is increased in Parkinson's disease patients versus healthy controls, increases over time and with age, and correlates with clinical measures of Parkinson's disease severity. Although the specificity of neurofilament light chain for Parkinson's disease is low, it is the first blood‐based biomarker candidate that could support disease stratification of Parkinson's disease versus other cognate/neurodegenerative disorders, track clinical progression, and possibly assess responsiveness to neuroprotective treatments. However, use of neurofilament light chain as a biomarker of response to neuroprotective interventions remains to be assessed. © 2020 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
Analysis of rare variants of autosomal‐dominant genes in a Chinese population with sporadic Parkinson’s disease
Authors: Zheng Ran , Jin Chong‐Yao , Chen Ying , Ruan Yang , Gao Ting , Lin Zhi‐Hao , Dong Jia‐Xian , Yan Ya‐Ping , Tian Jun , Pu Jia‐Li , Zhang Bao‐Rong
Published: August 2020

Background

To date, several studies have suggested that genes involved in monogenic forms of Parkinson's disease (PD) contribute to unrelated sporadic cases, but there is limited evidence in the Chinese population.

Methods

We performed a systematic analysis of 12 autosomal‐dominant PD (AD‐PD) genes (SNCA, LRRK2, GIGYF2, VPS35, EIF4G1, DNAJC13, CHCHD2, HTRA2, NR4A2, RIC3, TMEM230, and UCHL1) using panel sequencing and database filtration in a case‐control study of a cohort of 391 Chinese sporadic PD patients and unrelated controls. We evaluated the association between candidate variants and sporadic PD using gene‐based analysis.

Results

Overall, 18 rare variants were discovered in 18.8% (36/191) of the index patients. In addition to previously reported pathogenic mutations (LRRK2 p.Arg1441His and p.Ala419Val), another four unknown variants were found in LRRK2, which also contribute to PD risk (p = 0.002; odds ratio (OR) = 7.83, 95% confidence intervals (CI) = 1.76–34.93). The cumulative frequency of undetermined rare variants was significantly higher in PD patients (14.1%) than in controls (3.5%) (p = 0.0002; OR=4.54, 95% CI = 1.93‐10.69).

Conclusion

Our results confirm the strong impact of LRRK2 on the risk of sporadic PD, and also provide considerable evidence of the existence of additional undetermined rare variants in AD‐PD genes that contribute to the genetic etiology of sporadic PD in a Chinese cohort.
Study finds COVID‐19 survivors exhibit MH signs one month after treatment
Authors: Canady Valerie A.
Published: August 2020

A significant number of patients who survived the COVID‐19 outbreak have presented with at least one mental health disorder, such as anxiety disorders, insomnia, mood disorders or post‐traumatic stress disorder (PTSD) at one‐month follow‐up after hospital treatment, according to a new study conducted by researchers in Milan, Italy.
Terahertz refractive index sensor with high sensitivity based on two‐core photonic crystal fiber
Authors: Mishra Gyan Prakash , Kumar Dharmendra , Chaudhary Vijay Shanker , Sharma Sneha
Published: August 2020

This article contributes a highly sensitive novel refractive index (RI) sensor based on two‐core photonic crystal fiber (PCF) is proposed in the terahertz (THz) frequency regime. The sensing performance of the proposed RI sensor is based on the mode‐coupling theory. Two vertical cores of the PCF divided by the central air hole, act as two separate waveguides. The analyte whose refractive index being sensed is filled in the central air hole of the PCF. A full‐vector finite element method (FEM) approach is used to investigate the sensor. Numerical data reveal that the sensitivities of the proposed PCF are 672 600, 940480, 1035300, 1332200, and 1 827 300 nm/RIU for the RI sensing range of analyte from 1.30 to 1.33, 1.34 to 1.37, 1.38 to 1.40, 1.41 to 1.43, and 1.44 to 1.46, respectively. This indicates that the proposed RI sensor is highly sensitive to the refractive index of the analyte.
Highly efficient 5.8‐GHz class E−1 frequency doubler using a transmission‐line‐based notch filter
Authors: Shin Dong‐Jun , Choi Ui‐Gyu , Oh Juntaek , Yang Jong‐Ryul
Published: August 2020

An inverse class E frequency doubler is proposed to improve power conversion efficiency by using a transmission‐line‐based notch filter. The notch filter implemented using a transmission line is used at the output network in the doubler to suppress both fundamental and high‐order harmonic signals by a switching‐mode operation. A fourth harmonic signal is also reduced by using the quarter‐wavelength transmission line at the output network. Two frequency doublers with the proposed output network are optimized at different input power values and implemented on an FR4 PCB. In the measurement results, the doubler optimized at a low driving power shows a power conversion efficiency of 26.3% and an output power of 11.2 dBm for an input power of 11.5 dBm. The signal rejection levels of the low‐power optimized doubler power are −32, −40.1, and −31.7 dBc at the fundamental frequency, third harmonics, and fourth harmonics, respectively. The doubler optimized at a high driving power shows a power conversion efficiency of 24.6%, an output power of 13.7 dBm, and a signal rejection of less than −29.8 dBc, respectively.
Wideband circularly polarized antenna for dual‐band operation
Authors: Sung Y.
Published: August 2020

In this paper, we propose a wideband antenna with circular polarization (CP) characteristics in two different bands. The proposed antenna consists of two radiator elements on the top layer of the substrate and a feeding structure on the bottom layer of the substrate. A square wide slot with 45° rotation achieves low resonant frequency. High resonant frequency is formed by a square patch implemented in a square slot. To obtain CP characteristics in the low‐frequency band, a pair of opposite edges of the ground plane/substrate is cut off. By applying a pair of slits to the diagonal part of the patch antenna, good CP performance can be obtained in the high‐frequency band. The measured 3‐dB axial ratio (AR) bandwidths are 11% and 10.4% in two different bands, respectively. Right‐handed CP (RHCP) characteristics are exhibited in both bands; these measurements are congruent with the simulated data.
The Saudi National Mental Health Survey: Sample design and weight development
Authors: Mneimneh Zeina N. , Heeringa Steven G. , Lin Yu‐Chieh , Altwaijri Yasmin A. , Nishimura Raphael
Published: August 2020

Objectives

To describe the sample design and weighting procedures used in the Saudi National Mental Health Survey (SNMHS).

Methods

A multistage clustered area probability design was used to select the SNMHS sample with one male and one female KSA citizen ages 15–65 surveyed in each sample household.

Results

A design representative of the household population was developed and modified iteratively to adjust for unanticipated field complications. These modifications, along with variation in within‐household probabilities of selection and geographic–demographic variation in response rates were accounted for through survey weights. Design‐based estimation methods were used to adjust for the effects of these weights and of geographic clustering. Design effects were estimated and simulations were carried out on bias‐variancetrade‐offs in weight trimming to evaluate the implication of design features for precision of estimates.

Conclusions

The multiple purposes of the survey will require the use of different weights for different types of analyses, including household and person weights as well as weights for proxy reports about household members whose disabilities prevented them from participating in the survey. It will be important to use these different weights appropriately in the diverse analyses that will be undertaken with the SNMHS data.
Twelve‐month prevalence and severity of mental disorders in the Saudi National Mental Health Survey
Authors: Altwaijri Yasmin A. , Al‐Habeeb Abdulhameed , Al‐Subaie Abdullah S. , Bilal Lisa , Al‐Desouki Majid , Shahab Mona K. , Hyder Sanaa , Sampson Nancy A. , King Andrew J. , Kessler Ronald C.
Published: August 2020

Objectives

To estimate 12‐month prevalence and severity of mental disorders in the Saudi National Mental Health Survey (SNMHS).

Methods

The SNMHS is a face‐to‐face community epidemiological survey in a nationally representative household sample of citizens aged 15 to 65 in the Kingdom of Saudi Arabia (KSA) (n = 4,004). The World Health Organization (WHO) Composite International Diagnostic Interview (CIDI) was used to estimate 12‐month prevalence of common DSM‐IV mental disorders.

Results

Twelve‐month prevalence of any DSM‐IV/CIDI disorder is 20.2%. Most common are anxiety disorders (12.3%) followed by mood (6.8%), disruptive behavior (5.4%), eating (3.2%), and substance use (1.9%) disorders. The proportion of 12‐month cases rated serious (39.0% of all cases) is high across virtually all disorders relative to the proportions found in CIDI surveys in other high‐income countries. Younger people have significantly elevated odds of mood and disruptive behavior disorders and serious disorders. Women have significantly elevated odds of anxiety and mood disorders and serious disorders. Previously married people have significantly elevated odds of most disorder classes and serious disorders.

Conclusions

Both 12‐month prevalence and severity of DSM‐IV/CIDI disorders are high in Saudi Arabia compared to other high‐income countries that carried out comparable surveys.
Lifetime prevalence and age‐of‐onset distributions of mental disorders in the Saudi National Mental Health Survey
Authors: Altwaijri Yasmin A. , Al‐Subaie Abdullah S. , Al‐Habeeb Abdulhameed , Bilal Lisa , Al‐Desouki Majid , Aradati Maggie , King Andrew J. , Sampson Nancy A. , Kessler Ronald C.
Published: August 2020

Objectives

To estimate lifetime prevalence of mental disorders in the Saudi National Mental Health Survey (SNMHS).

Methods

The SNMHS is a face‐to‐face community epidemiological survey in a nationally representative household sample of citizens ages 15–65 in the Kingdom of Saudi Arabia (KSA) (n = 4,004). The World Health Organization (WHO) Composite International Diagnostic Interview (CIDI) was used to estimate lifetime prevalence of common DSM‐IV mental disorders.

Results

Estimated lifetime prevalence of any DSM‐IV/CIDI disorder is 34.2% and lifetime morbid risk is 38.0%. Anxiety disorders are by far the most prevalent (23.2%) followed by disruptive behavior (11.2%), mood (9.3%), eating (6.1%), and substance use (4.0%) disorders. Synthetic estimates of cohort effects suggest that prevalence of many disorders has increased in recent cohorts. Onsets typically occur in childhood for a number of anxiety and disruptive behavior disorders and in adolescence or early adulthood for most other disorders, although age‐of‐onset distributions for drug abuse is much later (median age of 31) than in CIDI surveys carried out in other high‐income countries.

Conclusions

Lifetime mental disorders are highly prevalent in Saudi Arabia and typically have early ages‐of‐onset.
Review and prospect: NMR spectroscopy denoising and reconstruction with low‐rank Hankel matrices and tensors
Authors: Qiu Tianyu , Wang Zi , Liu Huiting , Guo Di , Qu Xiaobo
Published: August 2020

Nuclear magnetic resonance (NMR) spectroscopy is an important analytical tool in chemistry, biology, and life science, but it suffers from relatively low sensitivity and long acquisition time. Thus, improving the apparent signal‐to‐noise ratio and accelerating data acquisition became indispensable. In this review, we summarize the recent progress on low‐rank Hankel matrix and tensor methods, which exploit the exponential property of free‐induction decay signals, to enable effective denoising and spectra reconstruction. We also outline future developments that are likely to make NMR spectroscopy a far more powerful technique.
Dynamic volumetric hyperpolarized 13C imaging with multi‐echo EPI
Authors: Deh Kofi , Granlund Kristin L. , Eskandari Roozbeh , Kim Nathaniel , Mamakhanyan Arsen , Keshari Kayvan R.
Published: August 2020

Purpose

To generate dynamic, volumetric maps of hyperpolarized [1‐13C]pyruvate and its metabolic products in vivo.

Methods

Maps of chemical species were generated with iterative least squares (IDEAL) reconstruction from multiecho echo‐planar imaging (EPI) of phantoms of thermally polarized 13C‐labeled chemicals and mice injected with hyperpolarized [1‐13C]pyruvate on a preclinical 3T scanner. The quality of the IDEAL decomposition of single‐shot and multishot phantom images was evaluated using quantitative results from a simple pulse‐and‐acquire sequence as the gold standard. Time course and area‐under‐the‐curve plots were created to analyze the distribution of metabolites in vivo.

Results

Improved separation of chemical species by IDEAL, evaluated by the amount of residual signal measured for chemicals not present in the phantoms, was observed as the number of EPI shots was increased from one to four. Dynamic three‐dimensional metabolite maps of [1‐13C]pyruvate,[1‐13C]pyruvatehydrate, [1‐13C]lactate, [1‐13C]bicarbonate, and [1‐13C]alanine generated by IDEAL from interleaved multishot multiecho EPI of live mice were used to construct time course and area‐under‐the‐curve graphs for the heart, kidneys, and liver, which showed good agreement with previously published results.

Conclusions

IDEAL decomposition of multishot multiecho 13C EPI images is a simple, yet robust method for generating high‐quality dynamic volumetric maps of hyperpolarized [1‐13C]pyruvate and its products in vivo and has potential applications for the assessment of multiorgan metabolic phenomena.
Voluntary winging of the scapula: Proposed diagnostic criteria
Authors: Seror Paul , Roren MK Alexandra , Garofoli Romain , Zauderer Jennifer , Rannou Francois , Lefevre‐Colau Marie Martine
Published: August 2020

We report a series of 10 patients with unilateral, dynamic, winged scapula (WS), without cause, that was diagnosed as voluntary winging of the scapula (VWS). We compared clinical, electrodiagnostic, and other examination data for 10 patients with VWS and 146 with dynamic WS‐related neuromuscular disorders, to establish a detailed pattern of the VWS subtype. In VWS, electrodiagnostic and other examinations did not reveal any neuromuscular or orthopedic cause. Winging was dynamic, obvious, neither medial nor lateral, and mainly involved the inferior angle of the scapula, in young patients. VWS never appeared during floor push‐ups. Patients could produce WS at will with the index and healthy shoulder, between 25° and 65° of anterior elevation, or with shoulder internal rotation. VWS is a benign disorder that can be distinguished from neuromuscular WS by normal electrodiagnostic results for muscles and nerves of both shoulders and two specific clinical tests.
Otolith Microchemistry of Common Carp Reflects Capture Location and Differentiates Nurseries in an Interconnected Lake System of the North American Midwest
Authors: Swanson Reid G. , Gagnon Joel E. , Miller Loren M. , Dauphinais Justine D. , Sorensen Peter W.
Published: August 2020

The Common Carp Cyprinus carpio is an invasive fish whose populations have grown to ecologically damaging levels in the North American Midwest. It has been shown that some shallow nursery habitats contribute disproportionally to population growth of Common Carp in interconnected Midwestern lake systems. The ability of managers to discriminate which shallow basins are producing Common Carp across these systems could increase the efficacy of management practices aimed at disrupting recruitment. We tested whether adult and juvenile Common Carp collected across an interconnected Midwestern lake system could be distinguished based on the concentrations of 11 trace elements measured in their otoliths using laser ablation and high-resolution inductively coupled plasma mass spectrometry (n = 157). Elemental concentrations in water were also measured with inductively coupled plasma mass spectrometry and found to differ among sites and between habitats, indicating that variation in otolith microchemistry was likely. Aluminum, barium, copper, iron, potassium, lithium, magnesium, sodium, phosphorus, and strontium in the edge region of otoliths differed significantly among Common Carp from all capture sites. Barium, iron, lithium, manganese, and phosphorus differed significantly among juvenile Common Carp from three nursery basins. Aluminum, barium, copper, iron, potassium, lithium, sodium, phosphorus, and strontium were significantly different between nursery and nonnursery habitats. We then investigated the ability to use these elemental otolith edge signatures to differentiate capture locations and distinguish between locations that are active and putative nursery habitats. Quadratic discriminant analysis could classify otoliths to collection site with an accuracy of 54%. Quadratic discriminant analysis had increased accuracy when restricted to juvenile Common Carp (76%) and when classifying Common Carp to nursery and nonnursery habitat types (87%). Further analysis of otolith and water microchemistry indicates temporal instability and suggests a need to collect a multiyear library of otoliths prior to utilization by managers.
The influence of the void fraction on the particle migration: A coupled computational fluid dynamics–discrete element method study about drag force correlations
Authors: Kanitz Manuela , Grabe Juergen
Published: August 2020

Granular soils subjected to flow through their soil skeleton can show a behaviour in which fine particles migrate through the pore space between coarser particles. This process is called internal instability or suffusion. This contribution deals with the numerical analysis of the migration of fine particles in a soil column subjected to fluid flow with unresolved coupled computational fluid dynamics–discrete element method (CFD–DEM) with special regards to the used drag force correlation. The contribution investigates the influence of the Schiller–Naumann model and its extension with a voidage term on the migration behaviour of fine particles. The voidage term is further varied with a parameter, which controls the impact of the change of the void fraction on the drag force. It could be observed that the Schiller–Naumann model does not yield in a suffusive behaviour while the extended models show significant particle migration. Thereby, increasing the impact of the void fraction on the drag force results in stronger particle migration. These results reveal the need for good validation techniques. They indicate how the drag force correlation can be adapted to depict the correct particle migration behaviour.
Obesity as a risk factor for poor outcomes after sling surgery in women with stress urinary incontinence: A systematic review and meta‐analysis
Authors: Barco‐Castillo Catalina , Plata Mauricio , Zuluaga Laura , Serrano Adolfo , Gómez Andrea , Santander Jessica , Caicedo Juan I. , Azuero Julián , Echeverry Mariana , Trujillo Carlos Gustavo
Published: August 2020

Purpose

Obesity is one of the main risk factors for stress urinary incontinence (SUI) and has also been associated with worse surgical outcomes. However, the literature is heterogeneous and inconclusive. The goal of this study was to perform a systematic review and meta‐analysis to evaluate cure rates and perioperative complications in obese women.

Materials and Methods

A literature search of OVID, MEDNAR, Embase, Scopus, Web of Science, PubMed, and CENTRAL databases was conducted. Randomized controlled trials comparing cure rates and failure of treatment in normal and obese patients, who underwent mid‐urethral sling surgery, were identified. A systematic review of subjective and objective cure rates, and complications was performed. Meta‐analyses of dichotomous data under the random‐effects model were applied using Review Manager 5.3. Nonrandomized comparative studies and gray literature were excluded.

Results

A total of 219 studies were identified. Four randomized controlled trials were included for evaluation. The risk of bias evaluation was performed according to the Cochrane Handbook for Systematic Reviews of Interventions. One study was excluded due to missing data on the outcomes. Patients were stratified according to their body mass index as obese (>30 kg/m2) and nonobese (<30 kg/m2). Complications could not be meta‐analyzed. The meta‐analysis of subjective (risk ratio [RR] = 1.69 [95% confidence interval [CI]: 1.32‐2.16]) and objective (RR = 1.62 [95% CI: 1.26‐2.07]) cure rates disfavored obese women.

Conclusions

This meta‐analysis shows that obesity is a risk factor for the nonsuccessful treatment of SUI with tension‐free mid‐urethral sling. Differences in regards to the surgical approach and its association with obesity could not be established with the current evidence.
Systematic Review of Energy Initiation Rates and Refeeding Syndrome Outcomes
Authors: Matthews‐Rensch Kylie , Capra Sandra , Palmer Michelle
Published: August 2020

The limited, low‐level evidence available on refeeding syndrome (RFS) is likely a result of there being no universally accepted definition of RFS. Cautious feeding is typically recommended to prevent RFS‐related adverse outcomes; however, these recommendations are outdated. This systematic review aimed to summarize the RFS literature, describe feeding methods used, and determine whether higher or lower energy rates at commencement of feeding were associated with RFS or RFS‐related adverse outcomes. Databases were searched for interventional and observational studies examining feeding and RFS‐related adverse events in adult patients. Data extracted included study design, participant descriptions, energy intake, and incidence of RFS‐related adverse outcomes. Studies were compared based on assertive (>20 kcal/kg/d) or conservative (≤20 kcal/kg/d) feeding initiation rates. Of 2803 abstracts, 24 studies were included (1 randomized control trial, 23 observational studies). Fifteen studies were classified as assertive. Feeding methods varied greatly, making interpretations difficult. Incidence of hypophosphatemia varied widely and was reported at rates of up to 74% for assertive studies and 72% for conservative studies. Similarly, diagnosed RFS was reported at rates of up to 20% for both types of studies. Time to achieve goal feeding rate appeared to have no influence on incidence of RFS‐related adverse outcomes. No consensus was found regarding the best method of feeding, energy initiation, or the time to achieve goal feeding rate that minimizes risk of RFS. There is currently limited evidence to suggest that higher‐energy feeding initiation rates have detrimental impacts on those at risk of RFS; however, further research is necessary.
Network reliability: Heading out on the highway
Authors: Brown Jason I. , Colbourn Charles J. , Cox Danielle , Graves Christina , Mol Lucas
Published: August 2020

A variety of probabilistic notions of network reliability of graphs and digraphs have been proposed and studied since the early 1950s. Although grounded in the engineering and logistics of network design and analysis, the research also spans pure and applied mathematics, with connections to areas as diverse as combinatorics and graph theory, combinatorial enumeration, optimization, probability theory, real and complex analysis, algebraic topology, commutative algebra, the design and analysis of algorithms, and computational complexity. In this paper we describe the landscape of various notions of network reliability, the roads well traveled, and some that appear likely to lead to meaningful and important journeys.
Two‐step discretization method for 2D/3D Allen–Cahn equation based on RBF‐FD scheme
Authors: Yao Lin , Zhang Xindong , Li Ning
Published: August 2020

In this article, a two‐step discretization method based on multi‐quadrics (MQ) radial basis function (RBF) is presented for solving Allen–Cahn (AC) equation with integer derivative for time and space. In the first step, backward Euler formula with Newton iterative method is used to discrete the time direction of AC equation. And RBF method is applied in space for solving semi‐discrete linearized problem on a coarse mesh. In the second step, finite difference (FD) and radial basis function‐finite difference (RBF‐FD) methods are used to solve the problem on a fine mesh, respectively. Numerical tests for the equation are obtained to verify the feasibility and computational efficiency of the considered process. In addition, the comparison between FD and RBF‐FD shows that solutions obtained by RBF‐FD are higher accuracy.
Lifestyle behaviors among undergraduate nursing students: A latent class analysis
Authors: Macedo Tassia T. S. , Mussi Fernanda C. , Sheets Debra , Campos Ana C. P. , Patrão Ana L. , Freitas Caren L. M. , Paim Melissa A. S.
Published: August 2020

This is a cross‐sectional study whose objective was to identify clustering of lifestyle behaviors among undergraduate nursing students to inform health promotion efforts and improve health outcomes later in life. All 353 undergraduate nursing students from the School of Nursing in a public university, Bahia, Brazil were invited to participate. The inclusion and exclusion criteria were according to the major project. Participants must be enrolled and attending the 1st to 10th semester, with a minimum age of 18 years. Participants were excluded if they had any physical disabilities that limited the collection of anthropometric measures or were completing an internship off‐campus. A total of 286 undergraduate nursing students met the criteria and completed the survey. The questionnaires included standardized measures for demographic, academic, and lifestyle behaviors (e.g., tobacco use, alcohol use, physical activity level, sedentary behavior, and fruits and vegetables consumed). Latent class analysis was performed to identify any clustering of lifestyle behaviors. Descriptive analyses indicated that 3.1% of the students were smokers, 23.1% consumed alcohol, 34.3% were inactive, 85.0% were sedentary, and 80.8% did not consume recommended amounts of fruits and vegetables. Latent class analysis produced four distinct subtypes of health risk: (a) low‐health risk (33.57%); (b) moderate‐health risk (27.97%); (c) high‐health risk (19.58%); and (d) very high‐health risk (18.88%). Approximately 38.5% of students were in the very high or high‐risk classes. The proportion of students with very high and high‐health risks emphasizes the importance of health promotion programs for university nursing students.
Outpatient pain clinic and intranasal fentanyl to improve sickle cell disease outcomes
Authors: Myrick Raven , Blakemore Shaundra , Waite Emily , Pernell Brandi , Madan‐Swain Avi , Hilliard Lee , Lebensburger Jeffrey
Published: August 2020

Background

Acute pain events are a leading complication for sickle cell patients. In an attempt to improve pain outcomes, we developed an outpatient pain clinic, and included intranasal fentanyl in the opioid emergency department (ED) pain order set. We evaluated admission rates and opioid administration for patients that attended both the outpatient pain clinic and ED within a 3‐month period.

Methods

We recorded the admission rate, IV morphine equivalents, and time from triage for each opioid order and administration from both an outpatient pain clinic and ED visit within a 3‐month period for an individual pediatric patient with sickle cell disease.

Results

Thirty patients received acute pain management in both settings. We identified a significant reduction in hospital admission when patients received care in the pain clinic as compared to the ED (17% vs 43%, P = .02). Additionally, outpatient pain clinic patients received significantly less IV morphine equivalents than patients received in the ED (5.6 vs 10.6 IV morphine equivalents, P < .0001). In the ED, intranasal fentanyl was administered in a significantly shorter time than patients ordered intravenous opioid (43 vs 75 min, P = .02). The mean time to receiving an opioid in the outpatient pain clinic was 57 min.

Conclusion

The use of an outpatient pain clinic can reduce admission rates as compared to the ED. The use of intranasal fentanyl reduced the time to first opioid administration in the ED. Patient‐centered research or quality improvement projects should continue to focus on novel approaches to acute pain event management.
Pilot study of the combination of sorafenib and fractionated irinotecan in pediatric relapse/refractory hepatic cancer (FINEX pilot study)
Authors: Keino Dai , Yokosuka Tomoko , Hirose Ayana , Sakurai Yukari , Nakamura Wataru , Fujita Sachio , Hayashi Akiko , Miyagawa Naoyuki , Iwasaki Fuminori , Hamanoue Satoshi , Yanagimachi Masakatsu , Shiomi Masae , Goto Shoko , Kitagawa Norihiko , Tanaka Mio , Nozawa Kumiko , Tanaka Yukichi , Goto Hiroaki
Published: August 2020

Background

Preclinical observations suggested a synergistic effect of sorafenib (SFN) and irinotecan (CPT‐11) in hepatoblastoma (HB). Thus, we conducted a feasibility study of fractionated CPT‐11 combined with SFN to develop a new therapy against relapsed/refractory pediatric hepatic cancer (HC).

Procedure

The study was originally designed as a phase I, standard 3+3 dose‐finding study to evaluate dose‐limiting toxicities (DLTs) for the regimen and the optimal CPT‐11 dose in combination with SFN against relapsed/refractory pediatric HC, including HB and hepatocellular carcinoma (HCC). The enrolled patients received SFN at 200 mg/m2 every 12 hours or 400 mg/m2 every 24 hours daily combined with CPT‐11 at 20 mg/m2/day on days 1 to 5 as an initial level 1 dose.

Results

Six patients with HB (n = 4) or HCC (n = 2) were enrolled and treated with CPT‐11 dose level 1. The median age at enrollment was 8.7 (6.2‐16.3) years. All patients received platinum‐containing chemotherapy, and five or two patients received CPT‐11 or SFN before enrollment, respectively. Regimen toxicities were evaluable in all patients. One of six patients experienced a grade 4 transaminase levels increase, which was defined as a DLT per protocol. Grade 3/4 neutropenia and a grade 3 transaminase level increase occurred in three patients and one patient, respectively. All patients reported grade 1/2 toxicities such as anemia, skin toxicity, gastrointestinal symptoms, and hypoalbuminemia.

Conclusions

Although the study was terminated before determining the maximum‐tolerated CPT‐11 dose, SFN and CPT‐11 at the level 1 dose were concluded to be tolerable in pediatric patients with HC.
Influence of stack sequence on the mechanical characteristics of hybrid composites analyzed using cone beam computed tomography and scanning electron microscopy
Authors: Shenoy Heckadka Srinivas , Pai Ballambat Raghuvir , Kini Manjeshwar Vijay , Kumar Mathangi , Hegde Pranav , Kamath Ajith
Published: August 2020

The hybridization of composites has recently seen an exponential growth in acceptance due to its ability to improve the property such as toughness of composites. Hybridization of fibers is known to give a better balance of properties and increases the opportunity to use natural fibers, thereby reducing the impact on the environment without compromising utility. This study deals with hybridization of ultrahigh‐molecular‐weight polyethylene (UHMWPE) with natural fibers such as flax and jute using phenol formaldehyde as the resin. Composite panels of 4 mm thickness, comprising of eight layers were fabricated in six different fiber stack sequences using hand lay‐up and compression molding techniques. The effect of stack sequence on the composites' flexural, interlaminar shear, and impact properties were investigated using scanning electron microscopy and cone beam computed tomography techniques. Composites with outer UHMWPE fibers and having flax fibers as inner core were found to have superior flexural and interlaminar shear properties of 44.45 and 5.52 MPa, respectively. Also composites with surface layers of flax fibers displayed maximum impact strength of 91.08 kJ/m2. The results indicate that the stack sequence has a significant influence on the properties of the composite under flexural and impact loading.
Fracture mechanisms and micromechanical deformation processes of polyethylene/calcium carbonate nanocomposite films
Authors: Mohsenzadeh Meymanat Sadat
Published: August 2020

The fracture behavior of medium density polyethylene/calcium carbonate (MDPE/CaCO3) nanocomposites was evaluated using the essential work of fracture (EWF) test. Fracture surfaces and the deformation zone in front of the precrack were studied using different microscopy techniques. Microscopic observations proved that extensive shear deformation of matrix due to debonding of nanoparticles plays the most important role on deformation mechanism of polyethylene nanocomposite. Large quantities of energy can be absorbed by plastic deformation of matrix polymer. This is why the specific plastic work (wp) of nanocomposites is higher than that of polyethylene. The presence of voids formed due to debonding of nanoparticles, reduces the load carrying capacity of the matrix and consequently leads to the reduction of the specific EWF (we). Besides, it causes easily crack propagation that may restricts the area where plastic deformation takes place and results in the reduction of plastic zone shape factor (β).
Saturated fats and the management of diabetes: the debates, controversies and consensus
Authors: Twenefour Douglas , Shields Emma
Published: August 2020

People with diabetes are at an increased risk of cardiovascular diseases and the important role of dietary changes is well established. However, the specific role of saturated fats in reducing this risk continues to be debated. The debates have been fuelled by publications of large studies reporting seemingly conflicting results. This article looks at the role of saturated fats in diabetes management, teases out the nuances in the opposing positions of the debate, and provides practical recommendations. Copyright © 2020 John Wiley & Sons.