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Objective: To investigate sociodemographic and healthcare system barriers to access and utilization of alternative treatments to positive airway pressure (PAP) in the management of adult obstructive sleep apnea (OSA). Data Sources: PubMed, Embase, and Web of Science databases were searched from 2003 to 2023 for English‐language studies containing original data on sociodemographic and healthcare system barriers to PAP‐alternative treatments for adult OSA. Review Methods: Studies were assessed using the Preferred Reporting Items for Systematic Reviews and Meta‐analyses Extension for Scoping Reviews (PRISMA‐ScR) guidelines. Title and abstract screening, full‐text review, and data collection were conducted by two investigators independently. Results: Out of 1,615 studies screened, 13 studies met inclusion criteria and reported on a total of 1,206,115 patients who received PAP alternative treatments, including surgery (n = 9 studies), and oral appliances (OAs) (n = 3 studies). The chance of receiving a PAP‐alternative treatment such as surgery was greater among patients aged 39 years or younger, had body mass index below 30 kg/m2, fewer comorbidities, private insurance, and a higher occupational and income status. The decision of individuals to receive PAP alternative treatments was influenced by increased patient education from providers, as well as improvements in daytime sleepiness and partner perception of snoring and apnea. Conclusion: Cumulative evidence suggests that several sociodemographic and healthcare system factors are associated with decreased use of PAP alternatives when PAP therapy fails. Investigation of interventions to eliminate these potential barriers may improve access and treatment outcomes. Laryngoscope, 134:3903–3909, 2024 [ABSTRACT FROM AUTHOR]

Today's era of smart technologies has shifted the paradigm of how things work in almost every domain. This change has also affected the utmost need of human beings, that is, sustainability in healthcare. With the help of technologies like the Internet of medical things (IoMT) devices and cloud‐based applications, doctors can now monitor and diagnoses their patients remotely. In the data analytics process for health‐care data, more precision and challenges are present. Data must be transferred from a lower layer to final storage (cloud‐based) during data ingestion so that subsequent operations such as mining, accessing, and streaming can be performed on these data. This article addresses some of the important issues to maintain sustainability in healthcare like authentication, smart scheduling of devices, the removal of redundant data on the final layer, and improving access times for stored data. Bloom filter (a probabilistic data structure)‐based solutions are proposed at different layers of IoMT (edge‐fog‐cloud). The comparative analysis of state‐of‐art techniques with the proposed has shown significant improvement over various metrics. The proposed framework has been evaluated experimentally on real health‐care datasets. [ABSTRACT FROM AUTHOR]

The introduction of fluorinated moieties into drugs as well as the increase of their overall three‐dimensionality have become key strategies amongst medicinal chemists to generate sets of compounds with favorable drug‐like properties. However, the introduction of fluorinated cyclopropane ring systems which combines both strategies is not widely exploited to date. This paper reports synthetic strategies exploiting the reactivity of gem‐difluorocyclopropenes in dipolar cycloaddition reactions with azomethine ylides to afford sets of new fluorine‐containing 3‐azabicyclo[3.1.0]hexanes. In addition, the unexpected formation of complex trifluorinated scaffolds arising from proline esters and gem‐difluorocyclopropenes is highlighted along with computational studies to elucidate the underlying mechanism. This study presents new avenues towards pharmaceutically relevant fluorinated 3‐azabicyclo[3.1.0]hexanes that are accessible via robust and short synthetic sequences. [ABSTRACT FROM AUTHOR]

With the onset of pandemics and accrescent stress among people, heart disease has become one of the leading contributors to premature deaths worldwide. Early prognosis of this disorder is the most viable strategy for increasing the prospects of individuals' survival. Numerous methods exploiting machine learning algorithms for heart disease prediction have been reported in the literature, but they all suffer from overfitting problems. Conspicuously, to improve the prediction accuracy, in this research work, an efficient meta‐heuristic‐based feature selection technique, namely NSGA‐II, is employed. The proposed solution aims to reduce the feature set and thus improve the prediction accuracy supported by intelligent machine learning models. The presented classifier is trained and validated using a comprehensive heart disease dataset by utilizing NSGA‐II selected features with 10‐fold cross‐validation. For performance validation, the results of the proposed model are compared with the state‐of‐the‐art machine learning algorithms, such as a k‐nearest neighbour, support vector machine, Bayesian belief networks, random forest, and naive bayes. The simulation results highlight the improved performance of the proposed model with NSGA‐II and achieve a high prediction accuracy of 97.32%. Furthermore, results of sensitivity (92.84%), specificity (92.60%), precision (91.25%), and F‐measure (92.17%) prove the utility of the proposed approach for heart disease prediction over all other variants. [ABSTRACT FROM AUTHOR]

The oxygen reduction reaction (ORR) limits the efficiency of oxygen‐associated energy conversion in fuel cells and air‐metal batteries. Today, expensive noble metal catalysts are often utilized to enhance the ORR and the resulting conversion efficiency in those devices. Hence, there is an intensive research to find efficient electrodes, exhibiting a favorable electronic structure, for ORR based on abundant materials that can be manufactured using low cost processes. In that context, metal‐free carbon‐based nanostructures and conducting polymers have been actively investigated. The negatively doped poly(benzimidazobenzophenanthroline) (BBL) as an efficient and stable oxygen cathode material is reported here. Compared to the benchmark p‐doped conducting polymer poly(3,4‐ethylendioxythiophene) (PEDOT), the BBL provides electrocatalysis that fully reduces dioxygen into water, via a (2 + 2)‐electron transfer pathway with hydrogen peroxide (H2O2) as an intermediate; while PEDOT limits the ORR to H2O2. It is demonstrated that n‐doped BBL is a promising air electrode material for low‐cost and ecofriendly model fuel cells, without the need of any co‐catalysts, and its performance is found to be superior to p‐doped PEDOT air electrodes. [ABSTRACT FROM AUTHOR]

Abstract: Melatonin and serotonin are important signaling and stress mitigating molecules that play important roles across growth and development in plants. Despite many well‐documented responses, a systematic investigation of the entire metabolic pathway (tryptophan, tryptamine, and N‐acetylserotonin) does not exist, leaving many open questions. The objective of this study was to determine the responses of Hypericum perforatum (L.) to melatonin, serotonin, and their metabolic precursors. Two well‐characterized germplasm lines (#4 and 112) created by mutation and a haploid breeding program were compared to wild type to identify specific responses. Germplasm line 4 has lower regenerative and photosynthetic capacity than either wild type or line 112, and there are documented significant differences in the chemistry and physiology of lines 4 and 112. Supplementation of the culture media with tryptophan, tryptamine, N‐acetylserotonin, serotonin, or melatonin partially reversed the regenerative recalcitrance and growth impairment of the germplasm lines. Quantification of phytohormones revealed crosstalk between the indoleamines and related phytohormones including cytokinin, salicylic acid, and abscisic acid. We hypothesize that melatonin and serotonin function in coordination with their metabolites in a cascade of phytochemical responses including multiple pathways and phytohormone networks to direct morphogenesis and protect photosynthesis in H. perforatum. [ABSTRACT FROM AUTHOR]

N-Benzylthiazolidine-2-thione is the key for the synthesis of pharmaceutically important compounds. A novel route for the synthesis of N-benzylthiazolidine-2-thione through of CS2 with N-benzylaziridine in the presence of 1,3-di-tert-butylimidazolium-2-dithocarboxylate ( catalyst I) has been proposed by reliable computations performed within the formalism of density functional theory. The mechanism of the proposed reaction is similar to the of tertiary aziridines and using a recyclable catalyst that is reported to provide access to 3-substituted 2-oxazolidones with excellent yield. Because the rate determining step needs to surmount a high energy barrier, the reaction route has been deciphered in high boiling solvent (1, 2-ethanediol). The highlight of the mechanistic route detailed here is that the proposed pathway is a cyclic process that is exothermic in nature with the regeneration of the catalyst and involves simple reagents. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Goss's wilt and leaf blight is a bacterial disease of maize (Zea mays L.) caused by the Gram-positive bacterium Clavibacter michiganen-sis subsp. nebraskensis. Goss's wilt has re-emerged as an important disease in the western United States and is spreading to other areas. Although the reasons for this re-emergence are not completely known, it is important to understand the genetic basis of resistance to Goss's wilt. The objective of this study was to map the quantitative trait loci (QTL) underlying resistance to Goss's wilt. To achieve this objective, joint linkage and linkage mapping in 3 of the 25 nested association mapping families were used. Three biparental linkage mapping families including 'B73' x 'Oh43', B73 x 'HP301', and B73 x 'P39' were evaluated for Goss's wilt in Nebraska. Eleven QTL were detected on chromosomes 1, 2, 3, 4, 5, and 10 through joint linkage mapping. The joint linkage model explained 45% of the phenotypic variation for Goss's wilt. Linkage mapping in each of the three families identified nine, six, and four QTL in the families B73 x Oh43, B73 x HP301, and B73 x P39, respectively. Joint linkage and linkage analysis were also conducted within each environment to detect any environment-specific QTL. However, most of the QTL were colocalized with QTL detected in across environment joint linkage and linkage mapping. These results will help us to understand the genetic basis of resistance to Goss's wilt better and may facilitate maize breeding programs to incorporate resistance to Goss's wilt into the maize germplasm. [ABSTRACT FROM AUTHOR]

1-Aryl-1,2,3,4-tetrahydroisoquinolines (THIQ) are key intermediates and products in the pharmaceutical industry. A new method involving intramolecular nucleophilic addition of α-amino carbanions to in-situ-generated arynes in N-Boc-protected (Boc = tert-butoxycarbonyl) amine substrates is presented for the synthesis of these compounds. Surprisingly, a similar reaction in Lewis-acid-complexed tertiary amines failed. These results have been analysed using quantum chemical calculations on the intermediates involved in the reactions. [ABSTRACT FROM AUTHOR]

Electrocatalysis for energy‐efficient chemical transformations is a central concept behind sustainable technologies. Numerous efforts focus on synthesizing hydrogen peroxide, a major industrial chemical and potential fuel, using simple and green methods. Electrochemical synthesis of peroxide is a promising route. Herein it is demonstrated that the conducting polymer poly(3,4‐ethylenedioxythiophene), PEDOT, is an efficient and selective heterogeneous catalyst for the direct reduction of oxygen to hydrogen peroxide. While many metallic catalysts are known to generate peroxide, they subsequently catalyze decomposition of peroxide to water. PEDOT electrodes can support continuous generation of high concentrations of peroxide with Faraday efficiency remaining close to 100%. The mechanisms of PEDOT‐catalyzed reduction of O2 to H2O2 using in situ spectroscopic techniques and theoretical calculations, which both corroborate the existence of a chemisorbed reactive intermediate on the polymer chains that kinetically favors the selective reduction reaction to H2O2, are explored. These results offer a viable method for peroxide electrosynthesis and open new possibilities for intrinsic catalytic properties of conducting polymers. The conducting polymer PEDOT is a robust electrocatalyst for efficient electrochemical production of hydrogen peroxide (H2O2) via cathodic reduction of oxygen. [ABSTRACT FROM AUTHOR]

Complexation of pyridines (I) with BF3 allows the regioselective 2,6-dilithiation or 2-lithiation with LDA. [ABSTRACT FROM AUTHOR]

Monolithiation-electrophilic substitution of BF3-complexed methylpyridines (I) proceeds exclusively at position 6 of the pyridine ring, leaving the methyl groups unsubstituted. [ABSTRACT FROM AUTHOR]

Summary Optical transport has emerged as a candidate solution to cope with the rising data transmission challenges of enormously evolving data. In the bufferless environment, only the ingress node beholds the buffering to speed up the data transfer in the form of data bursts. However, such networks are prone to data contention issues that degrade the overall performance and eventually result in burst loss. The paper proposes a machine learning (ML) inspired deflection routing (DR) algorithm to overcome contention issues in optical burst switching (OBS) network. The contending burst is first evaluated and assigned the priority order as per the available bits. Based on the burst traffic analysis, support vector machine (SVM) kernels are trained to select an alternate route and redirected the bursts to a new output node. It has been observed that for 65% of cases, radial basis function (RBF) kernel demonstrated the best results among the three kernel functions. The work further shows that ML offers a wiser decision to avoid and overcome contention in the deflection of the route of the contenting bursts. Moreover, the proposed DR scheme has achieved the highest throughput and packet delivery ratio (PDR) with an average delay of 9.66 s using an OBS network deployed with 10 groups of nodes. When compared against the contention scenario and the existing work, the proposed DR outperformed the existing technique with a 4% to 11% margin. [ABSTRACT FROM AUTHOR]

Objective: To identify patient-reported outcome measures (PROMs) used to measure adult obstructive sleep apnea (OSA)-related quality of life in sleep surgery and analyze key psychometric properties in the original design and development of each PROM., Data Sources: PubMed, Web of Science, Embase, PsychINFO, and CINAHL., Review Methods: A systematic review was performed using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Disease-specific instruments assessing sleep-related quality of life that were used in sleep surgery studies and validated in patients with sleep disorders were included. The Consensus-based Standards for the Selection of Health Status Measurement Instruments (COSMIN) criteria were used to evaluate methodological quality., Results: A total of 2494 abstracts were retrieved, and 216 underwent full-text review. Seven PROMs assessing sleep-related quality of life were identified. Only one (14%) PROM (SAQLI) was developed using both patient and physician input, and none were rated as "adequate" for content validity. Two PROMs utilized patients with sleep-disordered breathing during content development and none specifically queried patients considering surgery. Six (86%) PROMs demonstrated "very good" analysis of internal consistency per COSMIN criteria, and six (86%) included data on test-retest reliability., Conclusion: Several PROMs are utilized in sleep-related quality-of-life assessments for patients treated with OSA surgery. The measurement properties of these PROMs are of variable quality, and notably, no PROMs meet adequate quality measurements for content validity. New and updated PROMs for OSA-related quality of life should consider input from sleep surgery patients and providers. Laryngoscope, 2024., (© 2024 The Author(s). The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.)

Objective: This study aimed to describe trends in opioid prescriptions among US sleep surgeons between 2013 and 2021 via a retrospective analysis conducted using publicly available data., Methods: Utilizing the CMS part D database, we analyzed data from 82 sleep surgeons, focusing on metrics including number of opioid beneficiaries and claims, opioid cost, and opioid day supply per beneficiary. We employed statistical methods including ANOVA, t-tests, Fisher's exact test with Monte Carlo Simulation, and regression models., Results: There were no significant changes in the number of opioid claims (p = 0.782) or beneficiaries per provider (p = 0.590) nor was there a decrease in opioid day supply per beneficiary (p = 0.489) over time. Surgeons who graduated residency before 2000 prescribed significantly more opioids over the course of the study period compared to those graduating after 2000 with higher opioid day supply per beneficiary (13.34 vs. 7.42, p < 0.001), higher opioid beneficiaries per provider (21.62 vs. 19.36, p = 0.028), and higher opioid claims per provider (30.30 vs. 21.78, p < 0.001). A significant annual decrease in opioid cost per beneficiary (ANOVA, p = 0.006) was noted., Conclusions: This study illuminates a significant impact of provider years in practice on opioid prescribing trends, alongside a decreasing trend in opioid cost per beneficiary. Despite the evolving paradigm emphasizing opioid reduction and evidence of decreasing opioid prescriptions in other otolaryngology subspecialties, our findings depict that opioid prescriptions among sleep surgeons remained stable from 2013 to 2021., Level of Evidence: III Laryngoscope, 2024., (© 2024 The American Laryngological, Rhinological and Otological Society, Inc.)

Two-hundred pregnancies involving 100 women with essential thrombocythemia (ET) were accessed from Mayo Clinic databases (1990-2023). Median platelet count displayed a decline during pregnancy, nadiring at 48% of baseline, in the third trimester: 704-369 × 10 9 /L. Live birth rate was 72%. Of 53 (27%) unintentional pregnancy losses, 48 (24%) occurred in the first trimester. Other fetal complications included preterm birth 3%, intrauterine growth retardation 3%, and stillbirth 1%. Maternal complications included major hemorrhage (7%), preeclampsia (6%), thrombosis (1%), and placental abruption (0.5%). Antepartum management included no specific therapy in 52 (26%), aspirin alone in 112 (56%), aspirin combined with cytoreductive drugs or systemic anticoagulants in 23 (12%), and other permutations in the remaining. Postpartum systemic anticoagulation was documented in 29 (15%) pregnancies. Unintentional first-trimester loss was predicted by prior fetal loss (43% vs. 18%; p < .01), diabetes mellitus (DM; 67% vs. 23%; p = .02), and absence of aspirin therapy (45% vs. 14%; p < .01); the salutary effect of aspirin therapy was independent of the other two risk factors and apparent in both high (presence of ≥1 risk factor; 33% vs. 61%; p = .07) and low (absence of both risk factors; 10% vs. 34%; p < .01) risk scenarios. The benefit of aspirin therapy, in preventing first-trimester loss, was significant in both JAK2-mutated (18% vs. 50%; p < .01) and CALR-mutated (8% vs. 43%; p < .01) cases. Aspirin use was also associated with a lower risk of venous thrombosis (0% vs. 3%; p = .03). By contrast, the use of systemic anticoagulation, antepartum or postpartum, did not influence fetal or maternal complication rates. CALR mutation and DM predicted maternal hemorrhage (13% vs. 4%; p = .05) and preeclampsia (33% vs. 5%; p = .03), respectively. The current study demonstrates the protective role of aspirin in preventing first-trimester loss in ET, independent of driver mutation status or other risk factors., (© 2024 Wiley Periodicals LLC.)