bluuebunny/crossref_metadata_2025 huggingface dataset:
Virtual and Augmented Reality Enhancements to Medical and Science Student Physiology and Anatomy Test Performance: A Systematic Review and Meta‐Analysis
Authors: Moro Christian , Birt James , Stromberga Zane , Phelps Charlotte , Clark Justin , Glasziou Paul , Scott Anna Mae
Published: December 2020

Virtual and augmented reality have seen increasing employment for teaching within medical and health sciences programs. For disciplines such as physiology and anatomy, these technologies may disrupt the traditional modes of teaching and content delivery. The objective of this systematic review and meta‐analysis is to evaluate the impact of virtual reality or augmented reality on knowledge acquisition for students studying preclinical physiology and anatomy. The protocol was submitted to Prospero and literature search undertaken in PubMed, Embase, ERIC, and other databases. Citations were reviewed and articles published in full assessing learning or knowledge acquisition in preclinical physiology and anatomy from virtual or augmented reality were included. Of the 919 records found, 58 eligible articles were reviewed in full‐text, with 8 studies meeting full eligibility requirements. There was no significant difference in knowledge scores from combining the eight studies (626 participants), with the pooled difference being a non‐significant increase of 2.9 percentage points (95% CI [−2.9; 8.6]). For the four studies comparing virtual reality to traditional teaching, the pooled treatment effect difference was 5.8 percentage points (95% CI [−4.1; 15.7]). For the five studies comparing augmented reality to traditional teaching, the pooled treatment effect difference was 0.07 (95% CI [−7.0; 7.2]). Upon review of the literature, it is apparent that educators could benefit from adopting assessment processes that evaluate three‐dimensional spatial understanding as a priority in physiology and anatomy. The overall evidence suggests that although test performance is not significantly enhanced with either mode, both virtual and augmented reality are viable alternatives to traditional methods of education in health sciences and medical courses.
Introduction of team‐based learning improves understanding of glucose metabolism in biochemistry among undergraduate students
Authors: Eguchi Hironobu , Sakiyama Haruhiko , Naruse Hitoshi , Yoshihara Daisaku , Fujiwara Noriko , Suzuki Keiichiro
Published: December 2020

Team‐based learning (TBL) is an active learning method used in many educational institutions. However, there are few examples of its use in basic medicine, such as biochemistry in medical schools. This study used TBL to teach glucose metabolism to first‐year medical students. The process was in four phases: preclass preparation, readiness assurance tests, advanced questions, and a TBL test, with peer evaluation and a questionnaire. There were positive correlations between the TBL test, peer evaluation, and individual readiness test performance. Tests were taken immediately after learning and 2 weeks later, and scores decreased significantly less with TBL than traditional lectures (−2.3% vs. −17.5%). This suggests that TBL was more effective than traditional lectures in supporting knowledge retention. We used a Moodle system to facilitate communication between students and teachers, and this was evaluated positively by both groups. It was particularly useful for managing TBL. These findings suggest that TBL could be used to improve student performance in biochemistry.
Enhancement of select cognitive domains with rosiglitazone implicates dorsal hippocampus circuitry sensitive to PPARγ agonism in an Alzheimer's mouse model
Authors: Cortez IbDanelo , Hernandez Caterina M. , Dineley Kelly T.
Published: December 2020

Introduction

Several clinical studies have tested the efficacy of insulin‐sensitizing drugs for cognitive enhancement in Alzheimer's disease (AD) patients, as type 2 diabetes (T2D) is a well‐recognized risk factor for AD. Pilot studies assessing FDA‐approved diabetes drugs in subjects with early‐stage disease have found cognitive benefit in subjects comorbid for insulin resistance. In AD mouse models with concomitant insulin resistance, we have shown that 4 weeks of RSG can reverse peripheral and central insulin resistance concomitant with rescue of hippocampus‐dependent fear learning and memory and hippocampal circuitry deficits in 9‐month‐old (9MO) Tg2576 mice with no effect in wild‐type (WT) mice. Bioinformatics analysis of genomic and proteomic data reveals an intimate link between PPARγ and MAPK/ERK signaling in the hippocampus. We then demonstrated a direct interaction between PPARγ and phospho‐ERK in vitro and in vivo during memory consolidation. The translational value of this discovery is evidenced by the positive correlational relationship between human AD postmortem brain levels of pERK‐PPARγ nuclear complexes with cognitive reserve.

Methods

We tested whether insulin sensitizer therapy could rescue spatial navigation, context discrimination, and object recognition learning and memory in aged wild‐type and Tg2576 mice in addition to hippocampus‐dependent contextual fear learning and memory, as we have previously reported.

Results

We found that rosiglitazone treatment improved cognitive domains that predominantly rely upon the dorsal hippocampus rather than those that additionally engage the ventral hippocampus.

Conclusion

These results suggest that insulin sensitizer therapy with rosiglitazone improved age‐ and AD‐related learning and memory deficits in circuit selective ways.
Circulating CEA‐positive and EpCAM‐negative tumor cells might be a predictive biomarker for recurrence in patients with gastric cancer
Authors: Miki Yuichiro , Yashiro Masakazu , Kuroda Kenji , Okuno Tomohisa , Togano Shingo , Masuda Go , Kasashima Hiroaki , Ohira Masaichi
Published: December 2020

It has been reported that circulating tumor cells (CTCs) are beneficial for predicting tumor stage or treatment response. Although epithelial cell adhesion molecules (EpCAMs) and cytokeratin (CK) have been often used for the identification of CTCs, other tumor markers have not been fully investigated as detecting tools for CTCs. Thus, this study aims to clarify the significance of carcinoembryonic antigen (CEA, CD66e)‐positive CTCs in patients with gastric cancer. A total of 150 patients with gastric cancer were enrolled in this study. The mononuclear fraction of peripheral blood was enriched by Ficoll. The number of cells was enumerated depending on the positivity of EpCAM and CEA or CK by flow cytometry. The association of these cells with clinicopathologic characteristics was investigated. The mean age was 70 (range 28–92). The macroscopic type of gastric cancer was classified as 0/1/2/3/4/5 in 59/11/22/38/16/4 patients, respectively. Seventy‐one patients (47.3%) were diagnosed with intestinal‐type cancer, while 76 patients (50.7%) were diagnosed with the diffuse type. The mean numbers of cells with EpCAM−CK+, EpCAM+CK−, EpCAM+CK+, EpCAM−CEA+, EpCAM+CEA−, and EpCAM+CEA+ were 618, 237, 19.9, 1147, 291, and 7.41, respectively. The number of EpCAM−CEA+cells was significantly higher in patients with stage II–III and IV than in patients with stage I. The 3‐year RFS rate in patients with a high number of EpCAM−CEA+cells (>=622) was 57.5%, while it was 79.3% in patients with a low number of EpCAM−CEA+cells (<622) (log‐rank p = 0.0079). Thus, we conclude that CEA‐positive CTCs will be a clinically beneficial biomarker in patients with gastric cancer.
Clinical presentations and outcomes of COVID‐19 infection in sickle cell disease patients: Case series from Komfo Anokye teaching hospital, Ghana
Authors: Hardy Yasmine O. , Amenuke Divine A. Y. , Abukari Yakubu , Oti‐Acheampong Alexander , Hutton‐Mensah Kojo , Amoah‐Dankwah James , Amoabeng Kontoh Samuel , Danso Kwabena Asimeng , Berchie Patrick Opoku , Otu‐Ansah Caleb
Published: December 2020

Patients with sickle cell disease and COVID‐19 may not have a more dire outcome than the general population. Nevertheless, they may present with acute chest syndrome and other sickle cell crises which should be aggressively managed.
Validation of an oncology‐specific opioid risk calculator in cancer survivors
Authors: Riviere Paul , Vitzthum Lucas K. , Nalawade Vinit , Deka Rishi , Furnish Timothy , Mell Loren K. , Rose Brent S. , Wallace Mark , Murphy James D.
Published: December 2020

Background

Clinical guidelines recommend that providers risk‐stratify patients with cancer before prescribing opioids. Prior research has demonstrated that a simple cancer opioid risk score might help identify to patients with cancer at the time of diagnosis with a high likelihood of long‐term posttreatment opioid use. This current project validates this cancer opioid risk score in a generalizable, population‐based cohort of elderly cancer survivors.

Methods

This study identified 44,932 Medicare beneficiaries with cancer who had received local therapy. Longitudinal opioid use was ascertained from Medicare Part D data. A risk score was calculated for each patient, and patients were categorized into low‐, moderate‐, and high‐risk groups on the basis of the predicted probability of persistent opioid use. Model discrimination was assessed with receiver operating characteristic curves.

Results

In the study cohort, 5.2% of the patients were chronic opioid users 1 to 2 years after the initiation of cancer treatment. The majority of the patients (64%) were at low risk and had a 1.2% probability of long‐term opioid use. Moderate‐risk patients (33% of the cohort) had a 5.6% probability of long‐term opioid use. High‐risk patients (3.5% of the cohort) had a 75% probability of long‐term opioid use. The opioid risk score had an area under the receiver operating characteristic curve of 0.869.

Conclusions

This study found that a cancer opioid risk score could accurately identify individuals with a high likelihood of long‐term opioid use in a large, generalizable cohort of cancer survivors. Future research should focus on the implementation of these scores into clinical practice and how this could affect prescriber behavior and patient outcomes.

Lay Summary

A novel 5‐question clinical decision tool allows physicians treating patients with cancer to accurately predict which patients will persistently be using opioid medications after completing therapy.
Follow‐up of patients subjected to direct and indirect pulp capping of young permanent teeth. A retrospective study
Authors: Llena Carmen , Hernández Miriam , Melo Maria , Sanz José Luis , Forner Leopoldo
Published: December 2020

Objective

A retrospective study of the success rate of direct pulp capping (DPC) and indirect pulp capping (IPC) was carried out in children between 6–14 years‐old, considering separately primary caries or caries affecting teeth with molar incisor hypomineralization (MIH).

Material and methods

Data were collected in a dental public health service. Following the inclusion criteria, 232 treatments were analyzed. Success was defined by the presence of a functional tooth without clinical signs or symptoms of pulpal or periapical disease. The success rate was correlated to patient gender, the affected tooth and the indication of therapy using the chi‐squared and Fisher exact test. The success time related to treatment type was evaluated through the Mann–Whitney test.

Results

The IPC and DPC success rate was 99.4%, and 84.6%, respectively (p = .01). Success was significantly lower when caries affected teeth with MIH than when caries affected teeth without MIH (p = .01). The mean survival for DPC and IPC was 14.07 ± 1.30 and 15.98 ± 0.80 months, respectively (p = .07).

Conclusions

When caries were located in teeth that were not affected by MIH, IPC was significantly more successful than DPC, but did not differ significantly when caries were placed in teeth with MIH.

Key points

Minimally invasive therapy is a successful approach for decayed young permanent teeth.

The success of IPC was greater than the success of DPC wen caries was placed in teeth not affected by MIH.

In teeth not affected by MIH the success of DPC or IPC did not differ significantly.
Implant functionalization with mesoporous silica: A promising antibacterial strategy, but does such an implant osseointegrate?
Authors: Vandamme Katleen , Thevissen Karin , Mesquita Marcelo F. , Coropciuc Ruxandra‐Gabriella , Agbaje Jimoh , Thevissen Patrick , da Silva Wander José , Vleugels Jozef , De Cremer Kaat , Gerits Evelien , Martens Johan A. , Michiels Jan , Cammue Bruno P. A. , Braem Annabel
Published: December 2020

Objectives

New strategies for implant surface functionalization in the prevention of peri‐implantitis while not compromising osseointegration are currently explored. The aim of this in vivo study was to assess the osseointegration of a titanium‐silica composite implant, previously shown to enable controlled release of therapeutic concentrations of chlorhexidine, in the Göttingen mini‐pig oral model.

Material and Methods

Three implant groups were designed: macroporous titanium implants (Ti‐Porous); macroporous titanium implants infiltrated with mesoporous silica (Ti‐Porous + SiO2); and conventional titanium implants (Ti‐control). Mandibular last premolar and first molar teeth were extracted bilaterally and implants were installed. After 1 month healing, the bone in contact with the implant and the bone regeneration in the peri‐implant gap was evaluated histomorphometrically.

Results

Bone‐to‐implant contact and peri‐implant bone volume for Ti‐Porous versus Ti‐Porous + SiO2 implants did not differ significantly, but were significantly higher in the Ti‐Control group compared with Ti‐Porous + SiO2 implants. Functionalization of titanium implants via infiltration of a SiO2 phase into the titanium macropores does not seem to inhibit implant osseointegration. Yet, the importance of the implant macro‐design, in particular the screw thread design in a marginal gap implant surgery set‐up, was emphasized by the outstanding results of the Ti‐Control implant.

Conclusions

Next‐generation implants made of macroporous Ti infiltrated with mesoporous SiO2 do not seem to compromise the osseointegration process. Such implant functionalization may be promising for the prevention and treatment of peri‐implantitis given the evidenced potential of mesoporous SiO2 for controlled drug release.
Curriculum making as relational practice: A qualitative ego‐network approach
Authors: Hizli Alkan Sinem
Published: December 2020

Professional networks of teachers have been well documented in education studies but there is still a need for a fine‐grained analysis of teachers' ego‐networks in the context of curriculum making. It is important to understand the nature and dynamics of teachers' connections and how teachers mediate their practices accordingly. This study employed a qualitative approach to examine eight secondary school teachers' ego‐networks from Scotland and Wales, which were constructed to talk about curriculum making. The aim of this study is to explore curriculum making as relational practice and to examine the structure, composition and the content of teachers' networks by drawing upon a critical realist perspective. Findings suggested that the qualities the relationships possess (relational goods & evils), context (national and organisational) and teacher agency are the three mechanisms to understand how teachers‐mediated curriculum making through their ego‐networks.
Nano‐Sized Au Particle‐Modified Carbon Nanotubes as an Effective and Stable Cathode for Li−CO2 Batteries
Authors: Kong Yulong , Gong Hao , Song Li , Jiang Cheng , Wang Tao , He Jianping
Published: December 2020

Lithium‐carbon dioxide (Li−CO2) batteries show a great potential in the fields of CO2 fixation and energy storage, and moreover the research of Li−CO2 batteries is of great significance to the practical application of Lithium‐air (Li‐air) batteries. However, the sluggish kinetics and high charging potential causing by the wide band gap insulator Li2CO3 make it extremely important to research cathode catalysts that can promote the decomposition of Li2CO3 and reduce the charge potential. Here, we prepared a composite of Au nanoparticles uniformly distribute on carbon nanotubes (CNTs) network (AuNPs/CNTs) as an efficient cathode catalyst. Benefitted by the small sized Li2CO3 which is easier to decompose during charge process, the AuNPs/CNTs‐based batteries exhibit a high specific capacity of 6399 mAh g−1, a low overpotential of 1.53 V and a stable cycling performance of 46 cycles, demonstrating the conspicuous catalytic performance of AuNPs/CNTs.
Unique Solvatochromic Behavior of Unsymmetrical Platinum‐Dithiolene Complexes Coordinated by 4,4’‐Dinonyl‐2,2’‐Bipyridine
Authors: Hori Aoi , Kim Yuna , Tahara Keishiro , Kadoya Tomofumi , Yamada Jun‐ichi , Kubo Kazuya
Published: December 2020

Unsymmetrical metal dithiolene complexes [(nonyl‐bpy)Pt(dmit)] (1) and [(nonyl‐bpy)Pt(C8H4S8)] (2) (nonyl‐bpy=4,4‐dinonyl‐2,2‐bypiridine, dmit=4,5‐disulphanyl‐1,3‐dithiol‐2‐thionate(2−), C8H4S82−=2‐{(4,5‐ethylenedithio)‐1,3‐dithiole‐2‐ylidene}‐1,3‐dithiole‐4,5‐dithiolate(2−)) are synthesized in this study. For 1, two electronic absorption bands at approximately 466 and 584 nm in chloroform are observed and assigned to an intra‐ligand π−π* transition in the dmit moiety and an intramolecular‐mixed metal/ligand‐to‐ligand charge transfer transition (LL'CT) from its highest occupied molecular orbital (HOMO) to the lowest unoccupied molecular orbital (LUMO), respectively. Complex 2 exhibits two absorption bands at approximately 450 and 676 nm in chloroform. Both bands correspond to LL'CT from HOMO‐1 to LUMO and HOMO to LUMO. With increasing solvent polarity, the absorption bands from the HOMO‐LUMO transitions for 1 and 2 shift hypsochromically. Conversely, the 1 and 2 absorption bands exhibit red and blue shifts, respectively.
Heterobimetallic Carbene Complexes Bearing Cyclometalated IrIII/RhIII and Mixed NHCPy/PPh3 Coordinated PdII Centers: Structures and Tandem Catalysis
Authors: Majumder Adhir , Nath Saha Tarak , Majumder Niladri , Naskar Rajat , Pal Kuntal , Maity Ramananda
Published: December 2020

Heterobimetallic complexes bearing NHC donor ligands are gaining immense popularity in organometallic chemistry and tandem catalysis. It is known that the NHC reacts with PdII in the presence of pyridine to yield PEPPSI type complexes and the NHC ligands having ortho‐C−H proton easily orthometalate to IrIII or RhIII centers. Combining these two methodologies in a stepwise fashion, we present here a series of heterobimetallic IrIII−PdII and RhIII−PdII complexes from a dicarbene donor ligand featuring cyclometalated IrIII or RhIII and mixed
/PPh3 coordinated PdII centers. All the heterobimetallic complexes have been structurally characterized by X‐ray crystallographic analysis. The heterobimetallic complexes featuring mixed
coordinated PdII centers show better activity in tandem Suzuki‐Miyaura/transfer hydrogenation reactions compared to both, the heterobimetallic complexes possessing PEPPSI type PdIIcenters, and the equimolar mixture of their mononuclear PdII and RhIII or IrIII counterparts. The heterobimetallic complex featuring cyclometalated IrIII and mixed
coordinated PdII center shows excellent selectivity for 4‐biphenylmethanol (isolated yield: 92 %) in tandem catalysis.
Preparation and characterization of gamma oryzanol loaded zein nanoparticles and its improved stability
Authors: Rodsuwan Ubonphan , Pithanthanakul Usaraphan , Thisayakorn Krittiya , Uttapap Dudsadee , Boonpisuttinant Korawinvich , Vatanyoopaisarn Savitri , Thumthanaruk Benjawan , Rungsardthong Vilai
Published: December 2020

Gamma oryzanol (GO), a bioactive ingredient found in rice bran oil, performs a variety of biological effects such as antioxidant activity, reduction of total cholesterol, anti‐inflammation, and antidiabetes. However, GO is water‐insoluble and normally degrades through oxidation. Thus a nano‐encapsulation technique was investigated to improve its stability and quality. In this research, gamma oryzanol was successfully encapsulated into zein nanoparticles. The fabrication parameters including pH, zein concentration (0.3, 0.4, and 0.5% w/v), and % GO loading (30, 40, and 50% by weight) were investigated. Particle size, zeta potential, yield, encapsulation efficiency and the stability or GO retention during the storage were determined. The morphology of gamma oryzanol loaded zein nanoparticles (GOZNs) was observed by scanning electron micrographs and transmission electron microscope. The increase of zein concentration and % GO loading resulted to an increase of yield, encapsulation efficiency, and particle size. The particle size of the GOZNs ranged from 93.24–350.93, and 144.13–833.27, and 145.27–993.13 nm for each zein concentration with 3 loading levels, respectively. Nano‐encapsulation exhibited higher % GO retention compared with nonencapsulated GO during 60 days storage both at 4°C and −18°C. In vitro study indicated the sustained release of GO in the simulated gastric fluid followed by simulated intestinal fluid. This finding indicated a high potential for the application of insoluble GO with improved stability by encapsulation with the hydrophobic zein protein.
Life cycle assessment synthesis of the carbon footprint of Arabica coffee: Case study of Brazil and Vietnam conventional and sustainable coffee production and export to the United Kingdom
Authors: Nab Carmen , Maslin Mark
Published: December 2020

Over 9.5 billion kg of coffee is produced annually and demand is expected to triple by 2050. Hence, the identification and quantification of the greenhouse gas emission footprint of coffee is essential if it is to become a more sustainable crop. We have produced a detailed life cycle assessment of the carbon equivalent footprint of coffee produced in Brazil and Vietnam and exported to the United Kingdom. The average carbon footprint of Arabica coffee from both countries was calculated as 15.33 (±0.72) kg of carbon dioxide equivalent per 1 kg of green coffee (kg CO2e kg−1) for conventional coffee production and 3.51 (±0.13) kg CO2e kg−1 for sustainable coffee production. The 77% reduction in carbon footprint for sustainable coffee production in comparison to conventional production was due to exportation of coffee beans via cargo ship rather than freight flight and the reduction of agrochemical inputs. Based on our results, further reductions could be made through optimal use of agrochemicals; reduced packaging; more efficient water heating; renewable energy use; roasting beans before exportation; and carbon offsetting. Applying these recommendations correctly through certification schemes could mitigate other environmental impacts of coffee cultivation.
Domains of awareness in Alzheimer's disease: The influence of executive function
Authors: Lacerda Isabel B , Santos Raquel L , Belfort Tatiana , Neto José Pedro S , Dourado Marcia C N
Published: December 2020

Objective

Awareness is a developing area in dementia research and the evaluation of its domains has been increasingly included as part of care for people with Alzheimer's disease (PwAD). Our aim is to examine whether executive dysfunction is associated with awareness domains.

Methods

A consecutive series of 75 people with mild‐to‐moderate Alzheimer's disease completed assessments about global cognitive function, executive functioning, and their awareness of disease. Their primary caregivers' dyad provided information about demographics, awareness of disease, dementia severity, neuropsychiatric symptoms, and functional status.

Results

Different types of executive dysfunction were presented as a predictor for awareness of disease (cognitive flexibility, inhibitory control, and working memory), of emotional state (short‐term memory and attention) and of social functioning and relationships (visuospatial organization, integrative functions, and abstract thinking). Awareness of cognitive functioning and health condition and of functional activity impairments exhibit only global cognitive function as a predictor.

Conclusions

Findings confirm some degree of independence between awareness domains. The importance of identifying differences in domains of awareness relies in the understanding of awareness as a clinical phenomenon in order to guide the management and support of PwAD and their caregivers.
Impact of evaporation on field capacity during water drainage redistribution in a soil
Authors: Aldrees Ali , Hafsi Amine
Published: December 2020

To this day, field capacity (FC) is rarely defined in the context of soil properties, and the use of non‐physical simplistic models is the common way to normalize water content at FC. In this study, the problem of water drainage redistribution in a soil column with and without the presence of evaporation (EV) was extensively studied. Analytical solutions for the Richards equation were established for the case of water drainage redistribution through a deeply wetted soil water column with and without EV at FC conditions. Water retention and depth evolution curves were plotted first, using different EV values of (2 , 5 and 8 ) and second, for different drainage redistribution durations of (1 day, 4 days and 6 days) where EV was set to zero for the case with no EV or to a fixed value of 5 for the case with EV. The results suggest that EV plays a significant role in soil water drainage suggesting that, in the presence of EV, the FC drying front reaches much higher depths in the soil water profile than if EV is turned off. It was also concluded that FC reaches deeper depths faster the stronger EV is acting at the surface of a soil water column. Additionally, the results suggest that the texture of the soil receiving drainage controls the amount of water available for EV and as a result, EV was found to play a stronger role the smaller the hydraulic conductivity of the soil is.
Peripheral blood stem cell collection in children with extremely low body weight (≤8 kg). What have we learned over the past 25 years and where are the limits?
Authors: Grèze Victoria , Rouel Nadège , Rochette Emmanuelle , Merlin Etienne , Halle Pascale , Plantaz Dominique , Deméocq François , Kanold Justyna
Published: December 2020

Hematopoietic progenitor cells‐apheresis (HPC‐A) collection is now a routine procedure for autologous hematopoietic stem cell transplantation. Here we present our 25 years' experience of HPC‐A collection in children weighing 8 kg or less, with a focus on the evolution of our standard operating procedures, and the safety limits for these young patients, in the Pediatric Apheresis Unit of Clermont‐Ferrand University Hospital (France). Fifteen children weighing 8 kg or less underwent 26 HPC‐A collections over 25 years. Median CD34+ cell yield by leukapheresis was 4.4 106/kg. No procedure‐related complications were encountered during or after the collection. No patient had profound thrombocytopenia or anemia that needed post‐collection transfusions. Our experience in pediatric oncology patients who underwent HPC‐A collections shows that this procedure can be performed even in the smallest of children with no increase in toxicity provided all precautions are taken to ensure that the procedure is carried out under the ideal conditions.
Opioid Treatment for Neonatal Opioid Withdrawal Syndrome: Current Challenges and Future Approaches
Authors: McPhail Brooks T. , Emoto Chie , Butler Dawn , Fukuda Tsuyoshi , Akinbi Henry , Vinks Alexander A.
Published: December 2020

Chronic intrauterine exposure to psychoactive drugs often results in neonatal opioid withdrawal syndrome (NOWS). When nonpharmacologic measures are insufficient in controlling NOWS, morphine, methadone, and buprenorphine are first‐line medications commonly used to treat infants with NOWS because of in utero exposure to opioids. Research suggests that buprenorphine may be the leading drug therapy used to treat NOWS when compared with morphine and methadone. Currently, there are no consensus or standardized treatment guidelines for medications prescribed for NOWS. Opioids used to treat NOWS exhibit large interpatient variability in pharmacokinetics (PK) and pharmacodynamic (PD) response in neonates. Organ systems undergo rapid maturation after birth that may alter drug disposition and exposure for any given dose during development. Data regarding the PK and PD of opioids in neonates are sparse. Pharmacometric methods such as physiologically based pharmacokinetic and population pharmacokinetic modeling can be used to explore factors predictive of some of the variability associated with the PK/PD of opioids in newborns. This review discusses the utility of pharmacometric techniques for enhancing precision dosing in infants requiring opioid treatment for NOWS. Applying these approaches may contribute to optimizing the outcome by reducing cumulative drug exposure, mitigating adverse drug effects, and reducing the burden of NOWS in neonates.
Slippery when wet: The free surface of the articular cartilage
Authors: Raspanti Mario , Protasoni Marina , Zecca Piero Antonio , Reguzzoni Marcella
Published: December 2020

The free surface of the articular cartilage must withstand compressive and shearing forces, maintain a low friction coefficient and allow oxygen and metabolites to reach the underlying matrix. In many ways it is critical to the physiology of the whole tissue and its disruption always involves deep pathological alterations and loss of the joint integrity. Being very difficult to image with section‐based conventional techniques, it was often described by previous research in conflicting terms or entirely overlooked. High‐magnification face‐on observations with high resolution scanning electron microscopy and with scanning probe microscopy revealed a very thin, delicate superficial layer rich in glycoconjugates, which may explain the very low friction coefficient of the tissue but which was very easily altered and/or dissolved in the preparation. Beneath this superficial sheet lies a thicker coat of thin, highly uniform, slightly wavy collagen fibrils lying parallel to the surface and mutually interconnected by a huge number of interfibrillar glycosaminoglycan bridges. These bridges and the collagen fibrils form an extended reticular structure able to redistribute tensile and compressive stress across a larger area of the surface and hence a greater volume of tissue.
Filling quality of several obturation techniques in the presence of apically separated instruments: A Micro‐CT study
Authors: Türker Sevinç Aktemur , Uzunoğlu‐Özyürek Emel , Kaşikçi Sena , Öndeş Melike , Geneci Ferhat , Çelik Hakan Hamdi
Published: December 2020

Separated root canal instruments may affect the quality of root canal obturation and hence the survival of endodontically treated teeth. Obturation techniques may influence filling‐quality. The aim was to evaluate the obturation quality of teeth filled with different obturation techniques in the presence of apically separated instruments using micro‐computed tomography (μ‐CT). Notched ProTaper F2 rotary‐files were separated in the apical third of 36‐human mandibular incisors with single root/canal and mature apex. Samples were filled by an endodontist according to one of the following obturation techniques (n = 12): cold lateral‐compaction (CLC), single‐cone (SC) and thermoplastic injection (TI). Samples were scanned by the Skyscan 1,274® μ‐CT device after 1‐week at 37°C in 100% humidity. Images of the sections were evaluated with CTan software in terms of total‐volume and volume percentage of the filling materials and voids between coronal end of the separated instrument and gutta‐percha/sealer filled void‐free sections. Data was analyzed using Kruskal‐Wallis and Mann Whitney‐U tests with a significance level of 5%. Kruskal–Wallis revealed differences among groups (p < 0.05).Pairwise comparisons revealed that less volume of voids were measured in SC (0.02 ± 0.03 mm3) compared to CLC (0.15 ± 0.16 mm3) and TI (0.18 ± 0.24 mm3) (p < 0.05); while TI was statistically similar with CLC (p > 0.05). Percentages of volumes of voids and filling materials were as follows for SC, CLC and TI, respectively: 8.88 ± 18.52% and 24.45 ± 38.40%, 46.92 ± 33.53% and 53.07 ± 33.53%, 40.54 ± 33.85% and 42.79 ± 34.45%. The obturation technique may have a significant impact on the volume of voids in the presence of a separated file. No obturation technique produced a void‐free root canal filling.
Diffusion‐weighted double‐echo steady‐state with a three‐dimensional cones trajectory for non‐contrast‐enhanced breast MRI
Authors: Moran Catherine J. , Cheng Joseph Y. , Sandino Christopher M. , Carl Michael , Alley Marcus T. , Rosenberg Jarrett , Daniel Bruce L. , Pittman Sarah M. , Rosen Eric L. , Hargreaves Brian A.
Published: December 2020

The image quality limitations of echo‐planar diffusion‐weighted imaging (DWI) are an obstacle to its widespread adoption in the breast. Steady‐state DWI is an alternative DWI method with more robust image quality but its contrast for imaging breast cancer is not well‐understood. The aim of this study was to develop and evaluate diffusion‐weighted double‐echo steady‐state imaging with a three‐dimensional cones trajectory (DW‐DESS‐Cones) as an alternative to conventional DWI for non‐contrast‐enhanced MRI in the breast. This prospective study included 28 women undergoing clinically indicated breast MRI and six asymptomatic volunteers. In vivo studies were performed at 3 T and included DW‐DESS‐Cones, DW‐DESS‐Cartesian, DWI, and CE‐MRI acquisitions. Phantom experiments (diffusion phantom, High Precision Devices) and simulations were performed to establish framework for contrast of DW‐DESS‐Cones in comparison to DWI in the breast. Motion artifacts of DW‐DESS‐Cones were measured with artifact‐to‐noise ratio in volunteers and patients. Lesion‐to‐fibroglandular tissue signal ratios were measured, lesions were categorized as hyperintense or hypointense, and an image quality observer study was performed in DW‐DESS‐Cones and DWI in patients. Effect of DW‐DESS‐Cones method on motion artifacts was tested by mixed‐effects generalized linear model. Effect of DW‐DESS‐Cones on signal in phantom was tested by quadratic regression. Correlation was calculated between DW‐DESS‐Cones and DWI lesion‐to‐fibroglandular tissue signal ratios. Inter‐observer agreement was assessed with Gwet's AC. Simulations predicted hyperintensity of lesions with DW‐DESS‐Cones but at a 3% to 67% lower degree than with DWI. Motion artifacts were reduced with DW‐DESS‐Cones versus DW‐DESS‐Cartesian (p < 0.05). Lesion‐to‐fibroglandular tissue signal ratios were not correlated between DW‐DESS‐Cones and DWI (r = 0.25, p = 0.38). Concordant hyperintensity/hypointensity was observed between DW‐DESS‐Cones and DWI in 11/14 lesions. DW‐DESS‐Cones improved sharpness, distortion, and overall image quality versus DWI. DW‐DESS‐Cones may be able to eliminate motion artifacts in the breast allowing for investigation of higher degrees of steady‐state diffusion weighting. Malignant breast lesions in DW‐DESS‐Cones demonstrated hyperintensity with respect to surrounding tissue without an injection of contrast.

Level of Evidence

2.

Technical Efficacy Stage

1.
Safety evaluation of mice exposed to 7.0–33.0 T high‐static magnetic fields
Authors: Tian Xiaofei , Lv Yue , Fan Yixiang , Wang Ze , Yu Biao , Song Chao , Lu Qingyou , Xi Chuanying , Pi Li , Zhang Xin
Published: December 2020

Magnetic resonance imaging (MRI) of 7 T and higher can provide superior image resolution and capability. Clinical tests have been performed in 9.4 T MRI, and 21.1 T small‐bore‐size MRI has also been tested in rodents. Although the safety issue is a prerequisite for their future medical application, there are very few relevant studies for the safety of static magnetic fields (SMFs) of ≧20 T. The aim of this study was to assess the biological effects of 7.0–33.0 T SMFs in healthy adult mice. This was a prospective study, in which 104 healthy adult C57BL/6 mice were divided into control, sham control, and 7.0–33.0 T SMF‐exposed groups.The sham control group and SMF group were handled identically, except for the electric current for producing SMF. A separate control group was placed outside the magnet and their data were used as normal range. After 1 h exposure, all mice were routinely fed for another 2 months while their body weight and food/water consumption were monitored. After 2 months, their complete blood count, blood biochemistry, key organ weight, and histomorphology were examined. All data are normally distributed. Differences between the sham and SMF‐exposed groups were evaluated by unpaired t test. Most indicators did not show statistically significant changes or were still within the normal ranges, with only a few exceptions. For example, mono % in Group 2 (11.1 T) is 6.03 ± 1.43% while the normal range is 6.60–9.90% (p < 0.05). The cholesterol level in 33 T group is 3.38 ± 0.36 mmol/L while the normal range is 2.48–3.29 mmol/L (p < 0.05). The high‐density lipoprotein cholesterol level in 33 T group is 2.54 ± 0.29 mmol/L while the normal reference range is 1.89–2.43 mmol/L (p < 0.01). Exposure to 7.0–33.0 T for 1 h did not have detrimental effects on normal adult mice.

Level of Evidence

1

Technical Efficacy Stage

1
Risk Factors for Multiple Tympanostomy Tube Placements in Children: Systematic Review and Meta‐Analysis
Authors: Goel Alexander N. , Omorogbe Aisosa , Hackett Alyssa , Rothschild Michael A. , Londino Aldo V.
Published: December 2020

Objectives/Hypothesis

To determine the rate and predictors of receiving multiple tympanostomy tube (TT) placements in children.

Study Design

Systematic review and meta‐analysis.

Methods

PubMed, EMBASE, and Cochrane Library databases were searched for studies reporting the risk factors for receiving repeat TT (r‐TT) placements in children with chronic otitis media with effusion or recurrent acute otitis media. These articles were systematically reviewed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) recommendations. Data were pooled using a random‐effects model.

Results

Twenty‐one studies involving a total of 290,897 children were included. Among all patients, 24.1% (95% confidence interval (CI), 18.2%–29.9%) underwent ≥2 TT placements and 7.5% (95% CI, 5.7%–9.4%) underwent ≥3 TT placements. Craniofacial disease (odds ratio (OR) 5.13, 95% CI, 1.57–16.74) was the strongest predictor of r‐TT. Younger age at initial TT placement and shorter TT retention time were also significantly associated with r‐TT. Receipt of primary adenoidectomy with initial TT placement was associated with decreased odds of r‐TT (OR, 0.46; 95% CI, 0.39–0.55). Long‐term tubes also significantly reduced the odds of r‐TT (OR, 0.27; 95% CI, 0.17–0.44).

Conclusions

About 1 in 4 children receiving TT will receive at least one repeat set of TT and about 1 in 14 will receive multiple repeat sets. Concurrent adenoidectomy and long‐term tubes reduced the incidence of r‐TT. Younger patients and those with earlier extrusion of the initial set are at increased risk for repeat surgery. The identification of these risk factors may improve parental counseling and identify patients who might benefit from closer follow‐up.

Level of Evidence

NA Laryngoscope, 131:E2363–E2370, 2021
Long‐Term Follow‐Up on Systemic Bevacizumab Treatment in Recurrent Respiratory Papillomatosis
Authors: Evers Georg , Schliemann Christoph , Beule Achim , Schmidt Lars‐Henning , Schulze Arik B. , Kessler Christina , Hoffmann Thomas K. , Wiewrodt Rainer , Groll Andreas H. , Bleckmann Annalen , Rudack Claudia , Berdel Wolfgang E. , Mohr Michael
Published: December 2020

Objectives/Hypothesis

Recurrent respiratory papillomatosis (RRP) is a primarily benign disease affecting the entire respiratory tract. Treatment is challenging and usually involves surgical interventions and adjuvant medications. Previously, promising results on systemic administration of bevacizumab have been reported. However, experience on long‐term systemic use in patients with RRP is not yet available. Here, we present our long‐term follow‐up on RRP patients undergoing systemic bevacizumab treatment.

Study Design

Case series.

Methods

To describe experience on long‐term systemic bevacizumab administration, we performed the underlying investigation. Clinical, radiological, and bronchoscopy data were collected.

Results

To date, a total of n = 5 patients has been treated with systemic bevacizumab at Muenster University Hospital. With a median follow‐up since first systemic bevacizumab administration of 95.5 months long‐term follow‐up is illustrated. Following bevacizumab treatment partial remission or very good partial remission were achieved in all patients. After papilloma recurrence/progression due to bevacizumab discontinuation, further response was documented in all patients in whom bevacizumab was started again. In one patient, bevacizumab was discontinued due to loss of efficacy. Lung cancer developed in one patient with pulmonary papillomatosis prior to bevacizumab administration whereas three patients suffered from malignant transformation during bevacizumab treatment. Systemic bevacizumab led to long‐term reduction in surgical interventions in all patients. Except from mild proteinuria and hypertension in two patients therapy was well tolerated.

Conclusions

Systemic bevacizumab represents a promising long‐term treatment option for aggressive forms of papillomatosis. Rate of malignant transformation under bevacizumab treatment, optimal treatment schedule, and influence on survival should be further evaluated in clinical trials.

Level of Evidence

4 Laryngoscope, 131:E1926–E1933, 2021
Mechanisms Underlying the Antifibrotic Potential of Estradiol for Vocal Fold Fibrosis
Authors: Ozawa Satomi , Mukudai Shigeyuki , Sugiyama Yoichiro , Branski Ryan C. , Hirano Shigeru
Published: December 2020

Objectives/Hypothesis

Vocal fold fibrosis remains a significant clinical challenge. Estrogens, steroid hormones predominantly responsible for secondary sexual characteristics in women, have been shown to alter wound healing and limit fibrosis, but the effects on vocal fold fibrosis are unknown. We sought to elucidate the expression of estrogen receptors and the effects of estrogens on TGF‐β1 signaling in rat vocal fold fibroblasts (VFFs).

Study Design

In vitro.

Methods

VFFs were isolated from 10‐week‐old, male Sprague–Dawley rats, and estrogen receptor alpha (ERα) and G protein‐coupled receptor 30 (GPR30) were examined via immunostaining and quantitative polymerase chain reaction (qPCR). VFFs were treated with estradiol (E2, 10−7, 10−8 or 10−9 M) ± transforming growth factor beta 1 (TGF‐β1, 10 ng/mL). ICI 182,780 (ICI, 10−7 M) or G36 (10−7 M) were employed as antagonists of ERα or GPR30, respectively. qPCR was employed to determine estrogen receptor‐mediated effects of E2 on genes related to fibrosis.

Results

ERα and GPR30 were expressed in VFFs at both the protein and the mRNA levels. E2 (10−7 M) did not alter Smad3, Smad7, Acta2 mRNA, or extracellular matrix related genes. However, the combination of E2 (10−8 M) and TGF‐β1 significantly increased Smad7 (P = .03) and decreased Col1a1 (P = .04) compared to TGF‐β1 alone; this response was negated by the combination of ICI and G36 (P = .009).

Conclusions

E2 regulated TGF‐β1/Smad signaling via estrogen receptors in VFFs. These findings provide insight into potential mechanisms of estrogens on vocal fold injury with the goal of enhanced therapeutics for vocal fold fibrosis.

Level of Evidence

NA Laryngoscope, 131:2285–2291, 2021
Answering for yourself versus others: Direct versus indirect estimates of charitable donations
Authors: Jang Hyunkyu , Irwin Julie R.
Published: December 2020

When researchers ask about behavior in ethical contexts such as charitable giving, they sometimes use indirect questions (e.g., “what would another student donate?”), to allow people to project their actual desires onto the other without social desirability concerns. Despite their prevalence, there is a surfeit of research on whether indirect measures reflect actual behavior better than direct questions (e.g., “how much would you donate”). We addressed this study question, focusing on sensitivity accuracy, which is whether the measure moves up or down as actual behavior does. To measure sensitivity, we elicited direct, indirect, and actual monetary donations from each respondent. Across four studies, and many controls and manipulations, direct measures were significantly more sensitive than indirect measures. Our findings argue for caution in the use of indirect measures of prosocial behavior and also appear to rule out projection as the only/primary driver of indirect responses. Happily, though, these results provide a potential bright spot for researchers: with some minor guidelines and adjustments, direct measures can be, we argue, profitably used to estimate actual behavior in ethical domains.
Environmentally framed eWOM messages of different valence: The role of environmental concerns, moral norms, and product environmental impact
Authors: Filieri Raffaele , Javornik Ana , Hang Haiming , Niceta Aurelio
Published: December 2020

Consumers are increasingly interested to know about the environmental impact (EI) of products and, at the same time, they form attitudes after reading online consumer reviews. Drawing on negativity bias, schema congruity theory, and norm‐activation model, we investigate the effects of environmentally framed electronic word‐of‐mouth messages of different valence, on perceived review usefulness, product attitude and purchase intention in products with low versus high EI. Two factorial experiments (positive vs. negative reviews; low vs. high EI) were conducted respectively with a sample of 321 Italian and 250 French consumers. The findings of the two studies show a partial support of the moderating role of product EI, suggesting that products perceived to have a high impact on the environment strengthen the impact of a positive or a negative review carrying environmental messages. The effect of a positive and a negative review is contingent upon the level of consumers' environmental concern. Negative reviews of high impact products are more impactful in contexts in which environmental concerns are high, while positive reviews are more significant when environmental concerns are low. The perceived usefulness of a negative review about high impact products influences consumers' attitude and purchase intention when moral norms are high.
#MeToo, #MeThree, #MeFour: Twitter as community building across academic and corporate institutions
Authors: Kachen Axenya , Krishen Anjala S. , Petrescu Maria , Gill Rebecca D. , Peter Paula C.
Published: December 2020

This netnography‐based inquiry of the #MeToo movement on Twitter recognizes the relationships between organizations and individuals in varying levels of power and how social media can mitigate power dynamics in reporting systems for sexual harassment and assault. We study both academia and corporations as cultural institutions within which sexual harassment survivors are historically disenfranchised and convinced not to voice their stories. Distinct elements of these structures create differences in how vulnerable individuals face persecution. This paper explores the relationships between university and corporate contexts within the ecological framework of harassment. Our multidisciplinary study contributes to existing literature by extracting two samples of tweets (n = 1248 university and n = 1290 corporate) with three different unguided analytic tools to explore their semantic meaning, valence and emotionality, and overall sentiment. Drawing from our findings and literature review, we discuss the history of #MeToo as an amplification tool; Twitter as a social movement mechanism; and the roles of power, retaliation, and risk across institutions in relation to survivors of sexual violence and harassment.