bluuebunny/crossref_metadata_2025 huggingface dataset:
The Intersection of Medicine and Disability
Authors: Iglesias Marcos
Published: December 2020

Many physicians were not formally trained in the evaluation and management of disability and must understand the language of disability, how disability is evaluated, what to expect from a medical evaluation, and how to communicate effectively to achieve the best outcomes. The very language of disability is complex and often is misunderstood. For example, the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, defines impairment as “a significant deviation, loss, or loss of use of any body structure or body function in an individual with a health condition, disorder, or disease.” In contrast, disability is variously defined by the administrative or legal system with jurisdiction, and the AMA Guides broadly defines disability as “activity limitations and/or participation restrictions in an individual with a health condition, disorder, or disease.” Another useful concept is “needless disability” or days away from work that are not medically necessary; workless populations experience a two- to threefold increased risk of poor general health, including higher rates of cardiovascular disease, lung cancer, and respiratory infections, among other problems that contribute to an excess mortality of 20% among individuals in this group. Physicians help establish but are not the final arbiters of disability determinations; their role is to provide accurate, complete, and clear information that allows others to determine the presence, extent, and compensability of disability.
Pelvic Impairments
Authors: Talmage James , Blaisdell Jay
Published: December 2020

Pelvic fractures are relatively uncommon, and in workers’ compensation most pelvic fractures are the result of an acute, high-impact event such as a fall from a roof or an automobile collision. A person with osteoporosis may sustain a pelvic fracture from a lower-impact injury such as a minor fall. Further, major parts of the bladder, bowel, reproductive organs, nerves, and blood vessels pass through the pelvic ring, and traumatic pelvic fractures that result from a high-impact event often coincide with damaged organs, significant bleeding, and sensory and motor dysfunction. Following are the steps in the rating process: 1) assign the diagnosis and impairment class for the pelvis; 2) assign the functional history, physical examination, and clinical studies grade modifiers; and 3) apply the net adjustment formula. Because pelvic fractures are so uncommon, raters may be less familiar with the rating process for these types of injuries. The diagnosis-based methodology for rating pelvic fractures is consistent with the process used to rate other musculoskeletal impairments. Evaluators must base the rating on reliable data when the patient is at maximum medical impairment and must assess possible impairment from concomitant injuries.
Challenges in Rating Multiple Upper Extremity Conditions: A Case of Quadrilateral Space Syndrome and Medial Elbow Injury
Authors: Martin Douglas W.
Published: December 2020

Physicians sometimes are challenged with clinical presentations that do not fit perfectly within the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides); in such cases, the evaluator is instructed to apply clinical judgment and common sense when determining an impairment, with particular consideration of the effect of the medical condition on the individual's activities of daily living. In this case presentation, a 35-year-old male private security guard injured his right elbow performing a bench press while on assignment. After magnetic resonance imaging and electrodiagnostic evaluation, the patient underwent surgery that included a medial elbow Nirschl procedure and an ulnar nerve submuscular transposition. The patient underwent twelve months of rehabilitation, but he continues to experience a pins-and-needles sensation and perceives upper arm strength loss. Twenty-four months after surgery, the patient declines surgical treatment for quadrilateral space syndrome and presents for an impairment rating evaluation. Accepted medical conditions under the workers’ compensation program include quadrilateral space syndrome, medial epicondylopathy, and ulnar nerve entrapment at the elbow (cubital tunnel syndrome). The AMA Guides, Sixth Edition, does not include a listing for quadrilateral space syndrome, and the author discusses the challenges of teasing out functional limitations when multiple diagnoses are present within the same limb. Evaluators should note that the AMA Guides recommends using the impairment rating that most closely represents the actual functional loss.
Rating Physical Residuals of Breast Disfigurement
Authors: Demeter Stephen L.
Published: December 2020

A 48-year-old woman was working as a hostess in a lounge and was struck in the chest when a fight arose; afterwards, she noticed discomfort and a warm sensation in her left breast, which over the course of months remained smaller and also became distorted in comparison with her previous size, shape, contour, and comparison with her right breast. Ten years previously, she had received double lumen prostheses (saline on the outside and silicone gel on the inside). One year later she was found to be at maximum medical improvement (MMI) and described no signs or symptoms although her sexual life reportedly changed, with less frequency and satisfaction. Tables present the fifth edition criteria for rating permanent impairment due to skin disorders; fifth edition criteria for rating permanent impairment due to facial disorders and/or disfigurement; and sixth edition criteria for rating permanent impairment due to mammary disorders. Section 10.9 of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, mentions that coexisting psychiatric impairment would be rated using the mental and behavioral disorders chapter, which contains one reference to cosmetic abnormalities and requires a “severe cosmetic deformity with no ability to lactate.” Thus the only way to provide an impairment rating using the fifth edition for this individual is to perform a psychological evaluation; in the sixth edition, it is the only permissible rating.
Part II: Psychological Factors In Delayed And Failed Recovery and Unnecessary Disability
Authors: Caruso Garson , Kertay Les
Published: December 2020

Part two of this two-part article on psychological factors in delayed and failed recovery and resultant unnecessary work disability (DFRUD) considers both conceptual and practical interventions, including specific evaluation and treatment methods. The authors propose five categories of intervention for DERUD: 1) advance and operationalize our knowledge base; 2) make conceptual and practical shifts in our approaches; 3) place greater emphasis on prevention; 4) improve recognition of potentially difficult cases, and 5) apply specific management approaches and tools. Further, the authors propose conceptual and practical changes that should be made: Eliminate the dualistic separation of mind and body and the scientific reductionism that follows; change the focus from disability to capability; reduce improper workers’ compensation claims; improve the administrative and medical management of valid claims; enhance collegiality and communication among all stakeholders; and adopt a cost-utility vs absolute cost approach. The overarching goals of managing DFRUD include optimizing administrative and clinical treatment of the worker; protecting all stakeholders from excess; and overcoming barriers to intervention. To these ends, three activities can optimize the process: Intervene early; avoid iatrogenicity (ie, shorten claim durations and reduce costs); and stratify risk and employ stepped care. Barriers to meaningful intervention in DFRUD include questions of jurisdiction and responsibility for management (eg, does management of DFRUD fall to insurers or clinicians); who will pay; what are the maladaptive health cognitions and/or psychiatric comorbidities; and how can clinician behavior be altered to implement evidence-based practice?
Review of Symptoms and Signs for Working Adults with Median Nerve Entrapment
Authors: Melhorn J. Mark , Hegmann Kurt T.
Published: December 2020

Physicians often must evaluate patients who present with symptoms in a median nerve distribution and typically diagnose carpal tunnel syndrome (CTS), but an accurate diagnosis is critical to determine causation and to define possible impairment. CTS is a constellation of symptoms and signs that result from mononeuropathy of the median nerve in the carpal tunnel; symptoms typically include tingling and/or numbness, dysesthesias, and/or pain in the radial palm and palmar aspect of the thumb, index, middle, and perhaps ring fingers. The American Academy of Orthopaedic Surgeons suggests use of the CTS-6 scoring aid (shown in a table) as a clinical aid for diagnosing CTS. Electrodiagnostic testing, nerve conduction studies in particular, are considered the gold standard for diagnosis of CTS, but research suggests that the definitions of relevant sensory and assignment of CTS are sensitive to threshold changes from a latency of, eg, >4.4 msec vs >4.5 msec. Other factors to consider include whether there are effects from the known association between wrist ratio and CTS and assessing the benefits of neuromuscular ultrasound to diagnose CTS. Nocturnal paresthesias and paresthesias while holding onto an object were sensitive indicators of the presence of CTS but use of the Phalen and Hoffmann-Tinel signs has significant potential to be unreliable.
Rating Survivors of COVID-19 for Permanent Impairment
Authors: Talmage James B. , Hyman Mark H. , Snyder Robert B.
Published: December 2020

The current pandemic of COVID-19 cases includes cases identified in emergency medical technicians, nurses, physicians, and others with occupational exposure to the SARS-CoV-2 virus. Many of these health care professionals have filed workers' compensation claims that have been accepted. Each accepted claim will eventually need a physician to declare the individual “at maximal medical improvement” or the equivalent phrase in the jurisdiction involved. The next step is for the physician to rate permanent impairment, if present, so the case can be administratively closed. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) is used by many jurisdictions, but the AMA Guides does not mention COVID-19 or have guidance on how to assess individuals for impairment after recovery from this illness. This article provides preliminary guidance on rating permanent impairment within the respiratory, cardiac, vascular, neurologic, renal, gastrointestinal, and/or mental systems in COVID-19 survivors. Current references on the manifestations of COVID-19 illness in these body systems are included, which can be used as references to support documented impairment related to this illness.
Fundamental Principles of Independent Medical Examination
Authors: Feinberg Steven , Brigham Christopher R.
Published: December 2020

An independent medical evaluation (IME) is a specialized examination or evaluation best performed by a physician who has special training and experience in assessing issues unique to an IME. IMEs must be independent, and opinions should be consistent and impartial and based on evidence-based medicine. An IME includes the essential elements of a medical assessment, including a history, a physical examination (usually), and review of records and studies, followed by clinical impressions or diagnoses, and then by recommendations. The medical assessment may include other practitioners, eg, psychologists and chiropractors. Depending on the referral request, the IME typically discusses disability (the definition depends on the local jurisdiction) based on deficits in the person's activities of daily living. In the IME, the evaluator may be asked to consider claims issues that include causation, apportionment, impairment, work ability, appropriateness, and costs of medical care and/or future needs. The physician who performs the examination does not provide care to the individual and provides medical opinions about issues associated with the case. Impartiality, objectivity, and an understanding of medicolegal issues are required of the evaluator. IME reports are not confidential and likely will be read by many stakeholders in a claim. Accordingly, nonmedical personnel should find it easy to read and understand the IME.
Virtual Medical and Impairment Assessments
Authors: Brigham Christopher R. , Fearon Helene , Feinberg Steven , Gelinas Barry , Langham David , Melhorn J. Mark
Published: December 2020

Virtual independent medical evaluations (IMEs) have become and are likely to remain common even after the coronavirus disease 2019 (COVID-19) pandemic ends, but virtual health care and virtual examinations are not simply a matter of moving to a new platform—rather, they require a transformation that affects all stakeholders. Innovative solutions necessitated by virtual IMEs potentially can improve both quality and efficiency. The American Medical Association (AMA) defines telemedicine as health-related services that are synchronous and asynchronous and include a variety of tools and platforms that allow clinicians to connect with one another and patients (a box provides information about AMA's ongoing telehealth initiative). Physicians who plan to perform virtual evaluations must have the appropriate policies, procedures, and security in place; resources are available from the AMA Guides series of publications. Each component of the virtual IME, including each data element, should be assessed to determine best practices and how to use virtual technologies successfully. The credibility of virtual IMEs may hinge on the examiner's ability to explain both what was done and why it was as efficacious as an in-person alternative or perhaps as useful as any other alternative under the circumstances. One challenge is to master the tools used in virtual IMEs and another is to obtain stakeholders' acceptance of the virtual process, but this will come with time, experience, and effective physician performance.
AMA Guides, Sixth Edition: Conceptual Foundations and Philosophy
Authors: Blaisdell Jay , Talmage James B.
Published: December 2020

This article provides an overview of the conceptual foundations of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition. Impairment assessment in the sixth edition underwent a “paradigm shift” compared to the AMA Guides, Fifth Edition, in which its impairment rating methodology is based on the World Health Organization's (WHO's) International Classification of Functioning, Disability and Health (ICF) framework. Impairment rating is but one of several determinants of disability, and the one most amenable to physician assessment.
Fundamental Principles of the AMA Guides, Sixth Edition
Authors: Blaisdell Jay , Talmage James B.
Published: December 2020

Appropriately assessing impairment mandates that the physician be familiar with the principles of assessing impairment, as reflected in Chapter 1, Conceptual Foundations and Philosophy, and Chapter 2, Practical Applications of the Guides. Based on this knowledge, the physician will then apply the processes and criteria provided in specific chapters. All impairment rating reports should be divided into three main sections: clinical evaluation, analysis of the findings, and discussion. To obtain the highest level of competency, the rating physician should be familiar with jurisdictional requirements that effectively supplant AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) methodology.
Fundamentals of Maximum Medical Improvement
Authors: Talmage James B.
Published: December 2020

This is a brief introduction to maximum medical improvement (MMI), which is pertinent to permanent impairment assessment. The definition and explanation of MMI according to the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, is discussed.
Issues in California Workers' Compensation: Substantial Medical Evidence, Causation, and Apportionment
Authors: Feinberg Steven D.
Published: December 2020

This article describes special aspects of addressing and defining substantial medical evidence, causation, and apportionment in the California Workers' Compensation system. Substantial medical evidence is framed in terms of reasonable medical probability, and the opinion must be based on fact and not be speculative. The issue of whether the injury occurred in the course of employment is left to the Trier of Fact (WCAB judge). The issue of arising out of employment is a medical issue left to the physician. Apportionment applies to both the industrial and nonindustrial cause of the disability.
Laser‐Induced Plasmas for Broadband Cavity‐Enhanced Absorption Spectroscopy
Authors: Keary Bryan P. , Ruth Albert A.
Published: December 2020

The combination of cavity‐enhanced absorption spectroscopy (CEAS) with the phenomenon of laser‐induced breakdown has yielded a variation of CEAS in which the emission from a laser‐induced plasma (LIP) is utilized as a pulsed incoherent broadband light source in the center of a high‐finesse optical cavity. In comparison to standard CEAS implementations, this approach places light directly inside the resonator without injection through the cavity mirrors. The broadband optical emission from the pulsed LIP facilitates the measurement of spectra through (i) time‐dependent cavity ring‐down spectroscopy (CRDS) and (ii) intensity‐dependent incoherent broadband cavity‐enhanced absorption spectroscopy (IBBCEAS) methodologies. Additionally, from the broadband ring‐down time of light within the cavity, cavity mirror reflectivities may be calibrated in situ, thus enabling absolute extinction coefficient measurements with IBBCEAS.

The IBBCEAS approach possesses numerous advantages over the CRDS approach in terms of measurement speed and achievable signal‐to‐noise ratios (SNRs). However, it is limited by the presence of an offset in the measured absorption that arises due to the absorption of light that occurs between LIP formation and commencement of data collection. This offset motivated the development of a numerical correction procedure which allows spectra measured in this way to be corrected to improve their overall accuracy.
Clinical and radiological predictors of epidermal growth factor receptor mutation in nonsmall cell lung cancer
Authors: Dang Yutao , Wang Ruotian , Qian Kun , Lu Jie , Zhang Haixiang , Zhang Yi
Published: December 2020

Purpose

To determine the prognostic factors of epidermal growth factor receptor (EGFR) mutation status in a group of patients with nonsmall cell lung cancer (NSCLC) by analyzing their clinical and radiological features.

Materials and methods

Patients with NSCLC who underwent EGFR mutation detection between 2014 and 2017 were included. Clinical features and general imaging features were collected, and radiomic features were extracted from CT data by 3D Slicer software. Prognostic factors of EGFR mutation status were selected by least absolute shrinkage and selection operator (LASSO) logistic regression analysis, and receiver operating characteristic (ROC) curves were drawn for each prediction model of EGFR mutation.

Results

A total of 118 patients were enrolled in this study. The smoking index (P = 0.028), pleural retraction (P = 0.041), and three radiomic features were significantly associated with EGFR mutation status. The areas under the ROC curve (AUCs) for prediction models of clinical features, general imaging features, and radiomic features were 0.284, 0.703, and 0.815, respectively, and the AUC for the combined prediction model of the three models was 0.894. Finally, a nomogram was established for individualized EGFR mutation prediction.

Conclusions

The combination of radiomic features with clinical features and general imaging features can enable discrimination of EGFR mutation status better than the use of any group of features alone. Our study may help develop a noninvasive biomarker to identify EGFR mutation status by using a combination of the three group features.
Koolen‐de Vries syndrome in the first adulthood patient of Southern India ancestry
Authors: Pascolini Giulia , Gaudioso Federica , Fadda Maria Teresa , Laino Luigi , Ferraris Alessandro , Grammatico Paola
Published: December 2020

Koolen‐de Vries syndrome (KdVS, MIM#610443) is a rare malformation condition mainly characterized by cognitive impairment in association with craniofacial and visceral anomalies. The core phenotype is caused by mutations in the chromatin remodeler KANSL1 (MSL1V1, KIAA1267, KAT8 Regulatory NSL Complex Subunit 1, MIM#612452), which maps to 17q21.31 critical genomic region (Koolen et al., Nature Genetics 2012;44:639–641). Considering its molecular basis, KdVS is included in the group of Developmental Disorders of Chromatin Remodeling (DDCRs), also termed chromatinopathies. We describe the first KdVS patient of Southern India ethnicity, harboring the typical de novo 17q21.31 microdeletion, including KANSL1. Observed facial features and congenital anomalies are in line with the already reported KdVS phenotype, suggesting that phenotypic features are consistent across different ethnicities.
Emphysematous cholecystitis during the treatment of heat stroke
Authors: Yoshiyama Naomasa , Okada Hideshi , Miyake Takahito , Kitagawa Yuichiro , Fukuta Tetsuya , Yasuda Ryu , Matsuo Mikiko , Hatano Yuichiro , Tomita Hiroyuki , Yoshida Shozo , Ogura Shinji
Published: December 2020

Background

During a heat stroke, microvascular injury may occur as a result of thermal damage and systemic hypoperfusion. We present a case of an older woman who experienced emphysematous cholecystitis during a treatment of heat stroke.

Case presentation

A 91‐year‐old woman presented unconscious with a blood pressure, pulse, and core temperature of 73/48 mmHg, 135 bpm, and 39.8°C, respectively. The patient was diagnosed with heat stroke. Twenty‐two hours after arrival, the patient fell into septic shock. We diagnosed emphysematous cholecystitis and performed an emergency cholecystectomy. As the bile culture was positive for Clostridium perfringens, meropenem was administered. The patient was transferred for rehabilitation 32 days after admission.

Conclusions

Emphysematous cholecystitis can present during a treatment of heat stroke. An abdominal X‐ray examination should be performed during treatment of heat stroke in the acute phase regardless of the physical assessment.
Thyroid storm associated with type 2 amiodarone‐induced thyrotoxicosis due to long‐term administration: a case report
Authors: Takemoto Kiyoshi , Takada Shimon
Published: December 2020

Background

There are two types of amiodarone‐induced thyrotoxicosis (AIT). Type 1 AIT is increased synthesis of thyroid hormone, whereas type 2 AIT is excess release of thyroid hormone due to a destructive thyroiditis. However, cases leading to amiodarone‐induced thyroid storm are rare.

Case presentation

A 75‐year‐old man with a history of chronic heart failure, nonsustained ventricular tachycardia, and atrial fibrillation was treated with amiodarone from age 72. He was presented to the emergency department with edema of the legs and dyspnea on exertion for 3 weeks. He was diagnosed with thyroid storm associated with type 2 AIT on the basis of no pre‐existing thyroid disease and long‐term amiodarone administration without appropriate medical attention and thyroid function tests.

Conclusion

This case report suggests that amiodarone can cause not only AIT but also thyroid storm. Regular medical appointment and thyroid function tests can avoid this critical illness.
Polyhedral oligomeric silsesquioxane polyimide nanocomposites for color filters and flexible conductive films
Authors: Qian Min , Zhou Bo , Liu Gang , Gao Yang , Niu Yueping , Gong Shangqing
Published: December 2020

Color filters and conductive films are widely used in spacecraft, while the lack of lightweight, flexibility, and atomic oxygen (AO) durability confine their potential applications in low earth orbit. In this study, a clear poly(amic acid) with an empirical 20 wt% polyhedral oligomeric silsesquioxane (POSS) solid content is designed for transparency and AO durability. Red, green, blue, and yellow dyes are reinforced with small amounts of 1–5 wt% in POSS polyimides for color filters. A silver nanowire network film is infiltrated onto the POSS polyimide for conductive film. Erosion depth upon hyperthermal AO exposure, surface morphology, surface chemistry, optical transparency, and conductivity have been systematically investigated. The erosion yields of all 20 wt% POSS polyimides decrease by an order of magnitude when subjected to 2.32 ± 0.05 and 2.39 ± 0.06 × 1020 atoms cm−2 AO fluences, as passivating SiOx networks are formed on film surface. The small‐amount dye additives into polyimides do not introduce obvious changes in AO durability and surface chemistry. The silver nanowire infiltrated POSS polyimide film shows a 65.7% transmittance at 550 nm and a sheet resistance of 8.50 ± 0.36 Ohm square−1. This study reveals promising attempts of POSS‐polyimide‐based color filters and flexible conductive films for potential space applications.
Consumer disclosure
Authors: Kim Tami , Barasz Kate , John Leslie K.
Published: December 2020

As technological advances enable consumers to share more information in unprecedented ways, today's disclosure takes on a variety of new forms, triggering a paradigm shift in what “disclosure” entails. This review introduces two factors to conceptualize consumer disclosure: how (i.e., actively vs. passively) and between whom (i.e., consumers and/or firms) disclosure occurs. We begin by exploring the drivers of active disclosure occurring in both social and commercial contexts: characteristics of (a) the discloser, (b) the situation in which the disclosure occurs, (c) the information being disclosed, and (d) others. Second, we review the limited but growing research on passive disclosure by focusing on (a) inferences observers make based on passively shared information, and (b) expectations disclosers have regarding the use and collection of passively shared information. Because the current understanding of passive disclosure is limited, we also outline what we see as fruitful avenues of future research. We conclude by pointing out what we perceive as key managerial insights.
High fibrinogen‐to‐albumin ratio is associated with hemorrhagic transformation in acute ischemic stroke patients
Authors: Ruan Yiting , Yuan Chengxiang , Liu Yuntao , Zeng Yaying , Cheng Haoran , Cheng Qianqian , Chen Yunbin , Huang Guiqian , He Weilei , He Jincai
Published: December 2020

Introduction

Hemorrhagic transformation (HT) is a complex and multifactorial complication among patients with acute ischemic stroke (AIS), and the inflammatory response has been considered as a risk factor for HT. We aimed to evaluate the stratification of FAR (fibrinogen‐to‐albumin ratio), an inflammatory biomarker, in HT patients.

Methods

A total of 256 consecutive stroke patients with HT and 256 age‐ and gender‐matched stroke patients without HT were included in this study. HT during hospitalization was diagnosed by follow‐up imaging assessment and was classified into hemorrhagic infarction (HI) and parenchymal hematoma (PH) according to the recommendations of European Cooperative Acute Stroke Study II classification. Blood samples were obtained at admission.

Results

Higher levels of FAR were observed in patients with HT compared with the non‐HT group [10.29 (8.39–12.95) vs. 8.60 (7.25–10.8), p < .001], but no significant difference was found between the PH and HI [10.88 (8.72–13.40) vs. 10.13 (8.14–12.60), p > .05]. Patients were assigned to groups of high FAR (≥9.51) and low FAR (<9.51) based on the optimal cut‐off value. After adjustment for potential confounders, the high FAR remained independently associated with the increased risk of HT (OR = 5.027, 95% CI = 5.027 (2.309–10.942), p < .001).

Conclusions

High FAR was independently associated with the increased risk of HT after AIS.
Production of biodiesel by Burkholderia cepacia lipase as a function of process parameters
Authors: Ostojčić Marta , Budžaki Sandra , Flanjak Ivana , Bilić Rajs Blanka , Barišić Iva , Tran Nghiep Nam , Hessel Volker , Strelec Ivica
Published: December 2020

Despite the already established route of chemically catalyzed transesterification reaction in biodiesel production, due to some of its shortcomings, biocatalysts such as lipases present a vital alternative. Namely, it was noticed that one of the key shortcomings for the optimization of the enzyme catalyzed biodiesel synthesis process is the information on the lipase activity in the reaction mixture. In addition to making optimization difficult, it also makes it impossible to compare the results of the independent research. This article shows how lipase intended for use in biodiesel synthesis can be easily and accurately characterized and what is the enzyme concentration that enables achievement of the desired level of fatty acid methyl esters (FAME) in the final product mixture. Therefore, this study investigated the effect of two different activity loads of Burkholderia cepacia lipase on the biodiesel synthesis varying the pH and temperature optimal for lipase activity. The optimal lipase pH and temperature were determined by two different enzyme assays: spectrophotometric and titrimetric. The B. cepacia lipase pH optimum differentiated between assays, while the lipase optimally hydrolyzed substrates at 50°C. The analysis of FAME during 24 hr of biodiesel synthesis, at two different enzyme concentrations, pH 7, 8, and 10, and using two different buffers, revealed that the transesterification reaction at optimal pH, 1 hr reaction time and lipase activity load of 250 U per gram of reaction mixture was sufficient to produce more than 99% FAME.
Predictive Biomarkers for Immune Checkpoint Inhibitors in Metastatic Breast Cancer
Authors: Sivapiragasam Abirami , Ashok Kumar Prashanth , Sokol Ethan S. , Albacker Lee A. , Killian Jonathan K. , Ramkissoon Shakti H. , Huang Richard S. P. , Severson Eric A. , Brown Charlotte A. , Danziger Natalie , McGregor Kimberly , Ross Jeffrey S.
Published: December 2020

We examined a large dataset of female metastatic breast cancers (MBCs) profiled with comprehensive genomic profiling (CGP) to identify the prevalence and distribution of immunotherapy responsiveness‐associated biomarkers. DNA was extracted from 3831 consecutive MBCs: 1237 (ERpos/HER2neg), 1953 ERneg/HER2amp, and 641 triple‐negative breast cancer (TNBC). CGP was performed using the FoundationOne® or FoundationOne®CDx NGS assay. Tumor mutational burden (TMB) and microsatellite instability (MSI) were determined in a subset of cases. PD‐L1 expression in immunocytes in a subset of cases was determined by immunohistochemistry using the companion diagnostic VENTANA PD‐L1 SP142 Assay. The median age of the cohort was 54 years (range 20–89). Genomic alterations (GAs)/tumor were similar (range: 5.9–7.3). Markers of potential immune checkpoint inhibitor (ICPI) benefit included: CD274 (PD‐L1) amplification (1%–3%), BRAF GA (1%–4%), TMB of ≥10 mutations/Mb (8%–12%), MSI‐high (0.1%–0.4%), PBRM1 GA (1%), and positive PD‐L1 staining of immunocytes ranging from 13% in ERpos/HER2neg and 33% in ERneg/HER2amp to 47% in the TNBC group. Potential markers of ICPI resistance included inactivating STK11 GA (1%–2%) and MDM2 amplification (3%–6%). MTOR pathway targets were common with lowest frequency in TNBC. ERBB2 short variant mutations were most frequent ERpos/HER2neg and absent in TNBC. BRCA1/2 GA were least frequent in ERneg/HER2amp. The demonstrations of clinical benefit of immunotherapy in MBC support the need for development and utilization of biomarkers to guide the use of ICPIs for these patients. In addition to guiding therapy selection, CGP shows potential to identify GA linked to response and resistance to ICPI in MBC.
Comparison of the prevalence and associated factors of hyperactive delirium in advanced cancer patients between inpatient palliative care and palliative home care
Authors: Hamano Jun , Mori Masanori , Ozawa Taketoshi , Sasaki Jun , Kawahara Masanori , Nakamura Asumi , Hashimoto Kotaro , Hisajima Kazuhiro , Koga Tomoyuki , Goto Keiji , Fukumoto Kazuhiko , Morimoto Yuri , Goshima Masahiro , Sekimoto Go , Baba Mika , Oya Kiyofumi , Matsunuma Ryo , Azuma Yukari , Imai Kengo , Morita Tatsuya , Shinjo Takuya
Published: December 2020

Background

Hyperactive delirium is known to increase family distress and the burden on health care providers. We compared the prevalence and associated factors of agitated delirium in advanced cancer patients between inpatient palliative care and palliative home care on admission and at 3 days before death.

Methods

This was a post hoc exploratory analysis of two multicenter, prospective cohort studies of advanced cancer patients, which were performed at 23 palliative care units (PCUs) between Jan and Dec 2017, and on 45 palliative home care services between July and Dec 2017.

Results

In total, 2998 patients were enrolled and 2829 were analyzed in this study: 1883 patients in PCUs and 947 patients in palliative home care. The prevalence of agitated delirium between PCUs and palliative home care was 5.2% (95% CI: 4.2% ‐ 6.3%) vs. 1.4% (0.7% ‐ 2.3%) on admission (p < 0.001) and 7.6% (6.4% ‐ 8.9%) vs. 5.4% (4.0% ‐ 7.0%) 3 days before death (p < 0.001). However, multivariate logistic regression analysis revealed that the place of care was not significantly associated with the prevalence of agitated delirium at 3 days before death after adjusting for prognostic factors, physical risk factors, and symptoms.

Conclusions

There was no significant difference in the prevalence of agitated delirium at 3 days before death between inpatient palliative care and palliative home care after adjusting for the patient background, prognostic factors, symptoms, and treatment.
Effects of Hericium erinaceus powder on the digestion, gelatinization of starch, and quality characteristics of Chinese noodles
Authors: Wang Lei , Tian Yingpeng , Chen Zhaoqing , Chen Jie
Published: December 2020

Background and objectives

To improve the nutritional value and flavor of traditional Chinese noodles, Hericium erinaceus powder (HEP) was incorporated into Chinese noodles. The effects of HEP on the digestion, gelatinization of starch, and quality characteristics of Chinese noodles were analyzed.

Findings

The results showed that adding HEP could significantly reduce starch digestion rate and digestion extent in noodle, and the antioxidant capacity and gelatinization temperature were also positively related to the amount of HEP. The water absorption and cooking loss of noodles were improved by HEP, and noodle color was also impacted, showing increased L*, a* and b* values. Incorporation of HEP apparently affected texture profile analysis of noodles, resulting in increased hardness, gumminess, and chewiness. When <6% of HEP was incorporated, noodle quality was not dramatically changed, although starch digestibility was significantly inhibited. More HEP could further reduce starch digestion and increase antioxidant capacity; however, noodle quality might be deteriorated.

Conclusions

In our study, it found that incorporation up to a 6% of HEP into the noodles yielded an acceptable product with improved nutraceutical properties.

Significance and novelty

The results provided guidance for the development of functional noodles and facilitated the comprehensive application of HEP.
Flow development and prediction of solids concentration in a large gas‐solids turbulent fluidized bed
Authors: Ma Zhunzhun , Ma Hongfang , Qian Weixin , Li Yongzheng , Zhang Haitao , Sun Qiwen , Ying Weiyong
Published: December 2020

In a 5 m high turbulent fluidized bed with a 0.3 m inner diameter, local solids concentration in the dense region and axial pressure difference along the column were measured using an optical fibre probe (PC6M) and differential pressure sensors (PX653), respectively. The time‐series signals of the solids concentration fluctuations are analyzed via statistical methods. The axial and radial profiles of solids concentration are non‐uniform. In the developing dense region, the radial profiles of solids concentration are significantly influenced by operating conditions, and the fluctuation of solid concentration is considerably enhanced with the development of flow. In the fully developed dense region, the axial solids concentration decreases monotonously with height, and the radial profiles of solids concentration are exponential. The flow development in the dense region could be accelerated by the superficial gas velocity. Based on the analysis of the characteristics of the radial solids concentration distribution in the dense region, an empirical correlation of this distribution is proposed. The formulated correlation is found to be consistent with the experimental data reported in the literature.
Estimating uncertainties and parameters for fundamental models used in online monitoring and control
Authors: Liu Qiujun A. , Karimi Hadiseh , McAuley Kimberley B.
Published: December 2020

Many model‐based online process monitoring and control applications rely on state estimation techniques that use noisy process data to update states, thereby ensuring that imperfect model predictions are consistent with process behaviour. Techniques for tuning state estimators are reviewed, and their effectiveness and limitations are summarized in this article. A new simultaneous parameter and estimator tuning (SPET) methodology is proposed, one in which parameter estimation techniques for stochastic differential equations (SDEs) are used to simultaneously estimate measurement‐error covariances and model‐error covariances along with the model parameters. The resulting information is then used to compute state‐estimator tuning information. This study shows how SPET can be used, along with old dynamic process data, to obtain reliable tuning information. The proposed methodology is tested using a nonlinear two‐state continuous stirred‐tank reactor (CSTR) model with simulated data. Comparisons are made with a more‐conventional approach that uses WLS to estimate fixed model parameters and autocovariance least squares (ALS) to estimate extended Kalman filter (EKF) tuning factors. The main benefit of the proposed approach is that fixed model parameters and tuning factors for the EKF are estimated simultaneously, resulting in significant improvements to state estimates and online model predictions.
Immobilization of Cadmium in Neutral Soil in a Vegetable Cultivation Mode Using Thiolated Palygorskite
Authors: He Lizhi , Xu Yingming , Huang Qingqing , Liang Xuefeng
Published: December 2020

Cd pollution in agricultural soil and its subsequent accumulation in crops are a global concern. In situ immobilization is an efficient remediation method; however, there are only few reported amendments for neutral soil. In this study, thiolated palygorskite (TPAL) is employed as a potential amendment. To comprehensively investigate the remediation effects and associated mechanisms of TPAL, a pot‐scale cultivation experiment with pakchoi and romaine lettuce is conducted. TPAL reduces the available Cd concentrations in the soil by 38.12–57.54% at doses of 0.1–0.3% and subsequently decreases Cd accumulation in the leafy vegetables. TPAL clearly decreases the ζ potentials of the amended soil and increases their maximum sorption capacity to promote Cd fixation in the soil. Correlation and principal component analyses confirm that the immobilization effect is correlated with the maximum sorption capacity of the soil for Cd2+. Furthermore, TPAL reduces the biological concentration factors to inhibit the transfer of Cd from the soil to the roots of the vegetables. TPAL increases the vegetable biomass and has no elevating effects on the soil pH or available concentrations of trace elements in the soil, illustrating its environmental friendliness. Overall, TPAL is a good immobilization amendment for Cd‐contaminated neutral soils.
A Sustainable Palladium‐Intercalated Montmorillonite Clay Catalytic System for Imine Hydrogenation under Mild Conditions
Authors: Gupta Unnati , Krishnapriya R. , Sharma Rakesh K
Published: December 2020

A series of palladium nanoparticles (Pd NPs) intercalated montmorillonite clay catalysts is reported for hydrogenation of 3‐diphenyl prop‐2‐en‐1‐imine under mild reaction conditions. Pd/clay catalyst was prepared by a simple wet‐impregnation method, and the physicochemical properties were characterized extensively by various techniques including N2 adsorption, XRD, TEM, XPS and TPR etc., which showed the intercalation of active Pd NPs between the clay layers. The effect of reaction conditions such as catalyst loading, reaction time, temperature and H2 pressure is explored, and thereby a plausible mechanism is proposed. The optimum amount of 6 wt % Pd/clay catalyst showed significant catalytic activity to yield 3‐phenyl propyl aniline with 100 % conversion and selectivity under 5 bar pressure and a shorter reaction period of 3.5 h at 100 °C. The developed catalytic system unveiled excellent reusability over five cycles and hence paved the way for industrial applications.
Tuning the Conduction Band Potential of Bi‐based Semiconductors Using a Combination of Organic Ligands
Authors: Lei Longfei , Han Liuyuan , Wang Jiajia , Liu Yuanyuan , Wang Zeyan , Wang Peng , Zheng Zhaoke , Cheng Hefeng , Dai Ying , Huang Baibiao
Published: December 2020

Most Bi‐based semiconductors are incapable of photocatalytic reduction reaction from a thermodynamic view, owing to relatively positive conduction band potentials (ECB). Here, a novel Bi‐based metal–organic framework (Bi‐MBA, MBA=4‐mercaptobenzoic acid) with excellent photocatalytic reduction activities is developed. The ECB of Bi‐MBA locates at −1.38 eV, which is able to efficiently reduce O2, CrVI and CO2. Theoretical calculations reveal the significant contribution of organic ligand (MBA) to the conduction band. Our results provide an effective route to improve the photocatalytic reduction activities of Bi‐based photocatalysts.
A Comparative Review of Metal‐Based Charge Carriers in Nonaqueous Flow Batteries
Authors: Palmer Travis C. , Beamer Andrew , Pitt Tristan , Popov Ivan A. , Cammack Claudina X. , Pratt Harry D. , Anderson Travis M. , Batista Enrique R. , Yang Ping , Davis Benjamin L.
Published: December 2020

Energy storage is becoming the chief barrier to the utilization of more renewable energy sources on the grid. With independent service operators aiming to acquire gigawatts in the next 10–20 years, there is a large need to develop a suite of new storage technologies. Redox flow batteries (RFB) may be part of the solution if certain key barriers are overcome. This Review focuses on a particular kind of RFB based on nonaqueous media that promises to meet the challenge through higher voltages than the organic and aqueous variants. This class of RFB is divided into three groups: molecular, macromolecular, and redox‐targeted systems. The growing field of theoretical modeling is also reviewed and discussed.
Cytological diagnosis of Brunner's gland adenoma (hyperplasia): A diagnostic challenge
Authors: Ortiz Requena Domenika , Rojas Claudia , Garcia‐Buitrago Monica
Published: December 2020

Brunner's gland adenoma (hyperplasia) (BGA/H) is a benign gastrointestinal lesion, usually asymptomatic and frequently detected incidentally by endoscopy as a submucosal nodule. Most BGA/Hs are diagnosed by their typical cytological morphology and immunohistochemical features, characterized by monomorphic cells arranged as loosely clusters of epithelial cells with abundant, clear, and granular cytoplasm, eccentrically located nuclei, and immunoreactivity for MUC‐6. The combination of the clinical and pathological features is essential for rendering a correct diagnosis. Herein, we report two cases of BGA/H, including their cytologic and histologic features, and a literature review of the clinicopathologic findings along with its differential diagnoses.
Early diagnosis of diabetic peripheral neuropathy based on infrared thermal imaging technology
Authors: Zhou Qiang , Qian Zhihui , Wu Jianan , Liu Jing , Ren Lei , Ren Luquan
Published: December 2020

Aims

The purpose of this study was to detect and compare the surface temperature of plantar vessels in mild diabetic peripheral neuropathy (DPN) patients and healthy controls, to explore a simple, convenient and reliable method for early diagnosis of DPN, and to explore the influence of sex and age on vascular surface temperature.

Materials and Methods

In this study, 60 mild DPN patients (30 males and 30 females) and 60 healthy volunteers were randomly recruited according to their age and sex. Intra‐class correlation coefficient was used to evaluate the repeatability of skin temperature measurement in the vascular area. A general linear model was used to analyse the difference of skin temperature between mild DPN patients and healthy controls.

Results

The infrared detection results of skin temperature corresponding to blood vessels showed excellent test–retest reliability. There was no significant difference in skin temperature between sex and age. But there were significant differences in skin temperature between mild DPN patients and healthy controls, except for the posterior tibial artery.

Conclusions

For mild DNP patients, in case of no obvious abnormality in the infrared detection of lower extremity arterial surface temperature, the small vessels have shown early abnormal body surface temperature, that is, the surface temperature of related vessels increased. The research conclusions of this article not only enable us to better understand the correlation between body surface temperature and hemodynamic parameters, but also provide an in vivo, non‐invasive, and convenient way of thinking and methods for early diagnosis of DPN.
Making and shaping endochondral and intramembranous bones
Authors: Galea Gabriel L. , Zein Mohamed R. , Allen Steven , Francis‐West Philippa
Published: December 2020

Skeletal elements have a diverse range of shapes and sizes specialized to their various roles including protecting internal organs, locomotion, feeding, hearing, and vocalization. The precise positioning, size, and shape of skeletal elements is therefore critical for their function. During embryonic development, bone forms by endochondral or intramembranous ossification and can arise from the paraxial and lateral plate mesoderm or neural crest. This review describes inductive mechanisms to position and pattern bones within the developing embryo, compares and contrasts the intrinsic vs extrinsic mechanisms of endochondral and intramembranous skeletal development, and details known cellular processes that precisely determine skeletal shape and size. Key cellular mechanisms are employed at distinct stages of ossification, many of which occur in response to mechanical cues (eg, joint formation) or preempting future load‐bearing requirements. Rapid shape changes occur during cellular condensation and template establishment. Specialized cellular behaviors, such as chondrocyte hypertrophy in endochondral bone and secondary cartilage on intramembranous bones, also dramatically change template shape. Once ossification is complete, bone shape undergoes functional adaptation through (re)modeling. We also highlight how alterations in these cellular processes contribute to evolutionary change and how differences in the embryonic origin of bones can influence postnatal bone repair.