bluuebunny/crossref_metadata_2025 huggingface dataset:
Increases in the extreme rainfall events: Using the Weibull distribution
Authors: Olivera Sazcha , Heard Christopher
Published: October 2018

The frequency of extreme weather events, such as severe floods, storms, hurricanes, and droughts, seems to have increased in recent years. The analysis of trends and other changes in the distribution of these phenomena uses the extreme value theory. This study proposes the use of the Weibull distribution for the evaluation of extreme events in precipitation. A correct assessment of probabilities of extreme precipitation events and their changes is important for stakeholders, particularly in agriculture, infrastructure, tourism, and insurance. This paper provides a simple approach in showing the trends in extreme precipitation in the western part of Mexico. The methodology has an additional virtue as it enables the calculation of probabilities of change in extreme events. With this, it is feasible to develop new methodologies for better understanding of climate change.
The suitability of chili pepper (Capsicum annuum L.) for alleviating human micronutrient dietary deficiencies: A review
Authors: Olatunji Tomi L. , Afolayan Anthony J.
Published: October 2018

Human micronutrient dietary deficiency remains an enormous global problem and probably accounts for the cause of many chronic health conditions and diseases. Above two (2) billion individuals on the planet today have been estimated to be deficient in major minerals and vitamins, predominantly zinc, iodine, vitamin A, and iron primarily due to inadequate dietary intake. The eradication of deficiencies in micronutrient on a sustainable basis will be conceivable only when diets of vulnerable populace provide all required nutrients in adequate amounts. Among the numerous approaches toward eradicating human dietary deficiency, feeding on a wide range of foods, especially vegetables that have an array of micronutrients, is still perceived as the best sustainable solution. The universal consumption of chili peppers (Capsicum annuum), known for their high nutritional content (which includes a good range of vitamins, minerals, phytochemicals, and dietary fiber), may play a role in decreasing human micronutrient deficiencies. Significant portions of recommended daily nutrients could be supplied by the incorporation of nutrient‐rich chili pepper into human diets which could help in combating nutrient deficiencies. This present review, therefore, gives an overview of the universal occurrence of micronutrient deficiency. It also discusses approaches that have been used to tackle the situation while stressing the potentials of chili pepper as a promising vegetable which could be utilized in alleviating human micronutrient dietary deficiencies. For all available information provided, research databases (Science direct, Academic journals, PubMed, and Google Scholar) were searched independently using keyword search strategy. Titles and abstracts were examined initially, and full papers were retrieved if studies met the inclusion criteria.
Hydrogenation towards Synthetic Sandalwood Odorants in Fragrance Industry
Authors: Dupau Philippe
Published: October 2018

The use of metal hydrides as historical reagents for selective carbonyl group reduction is often still a really highly convenient solution for laboratory‐scale transformations due to the lack of requirement for specific equipment. Nevertheless, based on safety, environmental, but also economical industrial constraints, metal hydride reductions were replaced by hydrosilylation, hydrogen transfer, and mostly hydrogenation reactions. Among many other advantages, the use of hydrogen as a reducing agent indeed represents the most sustainable solution for implementation of such chemical transformation on industrial scale. Whereas heterogeneous catalysts have been initially sparsely employed, the most recent developments towards the synthesis of highly active and efficient homogeneous catalysts have become an indisputable solution for selective hydrogenation of both ketones and aldehydes in sandalwood odorant production according to green chemistry principles.
Maximizing physical layer security in relay‐assisted multicarrier nonorthogonal multiple access transmission
Authors: Khan Wali Ullah
Published: October 2018

This letter investigates the physical layer security of dual‐hop nonorthogonal multiple access (NOMA) networks. We consider a multicarrier transmission scenario which consists of a single source, a relay, an eavesdropper, and multiple users. Our objective is to maximize the sum secure rate of the system with optimal power allocation over different sub‐carriers at the source. Because of the rate expression and binary variable, the optimization problem is formulated as a nonconvex and mixed integer programming problem. Thus, the optimal solution is obtained through duality theory which is considered to be an efficient method for solving nonconvex optimization problems. We compare the performance of the proposed NOMA scheme with orthogonal frequency multiple access (OFDMA) scheme. Our simulation results show that the proposed NOMA scheme has good performance in convergence and significantly outperforms the traditional OFDMA scheme.
Ticagrelor use in acute myocardial infarction: Balancing evidence‐based medicine with affordability
Authors: Walker Andrew L. , Sorensen Teshia , Gabriel Paolo P. , Sledge Tyler , Morshedzadeh Jack H. , Owan Theophilus , Shah Rashmee U.
Published: October 2018

Study objective

Data from randomized controlled trials support a mortality benefit with ticagrelor vs clopidogrel among patients with acute myocardial infarction (AMI). Many health care providers preferentially treat patients with AMI with ticagrelor. The goal of this study was to determine the association between out‐of‐pocket drug costs and ticagrelor continuation compared with switching to clopidogrel among patients hospitalized for AMI, after a pharmacist‐led discussion on outpatient copayment costs for ticagrelor.

Design

Retrospective cohort study.

Setting

A tertiary care academic medical center.

Patients

Patients with AMI were hospitalized between February 15, 2015 and January 23, 2017, who were loaded with ticagrelor on presentation.

Main results

Of 143 patients with AMI loaded with ticagrelor, 70 (49%) were switched to clopidogrel after cost discussion. The median monthly ticagrelor copayment was $268.29 (interquartile range [IQR] $45‐$350) for switchers vs $18 (IQR $6‐$24) for nonswitchers (P < .001). Patients with copayments of $100/month or more were 3.4 times more likely to switch to clopidogrel (relative risk 3.41, 95% confidence interval 2.12‐5.47), compared with patients with copayments of less than $100/month.

Conclusions

After a discussion of outpatient costs, half of patients with AMI were switched from ticagrelor to clopidogrel when given the choice.
Hospital admission rates of patients enrolled in pharmacist vs nurse anticoagulation management services
Authors: Tarasiuk Natalia , Parker Marcie , Russo‐Alvarez Giavanna , Cristiani Cari , Wai Maya
Published: October 2018

Introduction

Various health care professionals provide dedicated anticoagulation management services (AMS). There is limited literature describing head‐to‐head trials comparing outcomes among different types of AMS.

Objectives

The primary objective is to compare all‐cause hospitalizations between pharmacist‐ and nurse‐managed AMS. The secondary objectives are to characterize admissions, readmissions, and emergency department visits.

Methods

This study is a retrospective, observational cohort. Patients were included if they were 18 y of age or older and had an anticoagulation management consult for either the pharmacist‐ or nurse‐managed anticoagulation clinics from July 1, 2013 to June 30, 2014. Patients were excluded if they had a lapse of 10 wk without a point‐of‐care International normalized ratio draw or had a duration of warfarin management less than 2 wk. The study period included the duration of warfarin management or up to 1 y of warfarin management after the initial consult, whichever was shorter.

Results

A total of 824 and 547 patients were identified in the pharmacist‐ and nurse‐managed groups, respectively. A total of 250 patients were randomized in each arm. After accounting for exclusion criteria, 242 and 245 patients were included in the pharmacist‐ and nurse‐managed groups, respectively. Baseline characteristics differed between the groups based on poverty status, race, stroke risk score, previous admissions, and international status. The primary outcome occurred in 55 (22.7%) of the pharmacist‐managed patients and 86 (35%) of the nurse‐managed patients (P = 0.002). When accounting for differences in baseline characteristics, there was a statistically significant decrease in all‐cause hospitalizations in the pharmacist group (odds ratio = 0.63; 95% confidence interval [0.39‐0.98]). Indication for warfarin, types of admissions, emergency department visits, and 30‐d readmissions was similar between the groups. Time in therapeutic range was different between the groups.

Conclusion

This hypothesis‐generating study found a difference in AMS performed by pharmacists and nurses. Pharmacists reduced hospitalization rates within the first year of AMS.
Impact of a pharmacist‐driven transition of care program for patients with acute coronary syndromes
Authors: Gorman Emma M. , Brown Geoffrey W. , Costello Jessica N. , Woodruff Ashley E.
Published: October 2018

Background

Pharmacist‐driven transition of care (TOC) initiatives have been shown to reduce rates of medication errors and readmission rates in several patient populations, including heart failure. Existing literature evaluating pharmacist‐driven TOC initiatives targeting patients with acute coronary syndromes (ACSs) are limited.

Objective

To assess the impact of a newly implemented pharmacist‐driven TOC initiative on readmission rates in patients with ACS.

Methods

This was a retrospective, single‐center, pre‐post observational cohort study. Institutional review board approval was obtained. Patients were matched for age, gender, and ACS type with a historical cohort who received no pharmacist TOC intervention. The primary outcome was the 90‐day all‐cause readmission rate. Secondary outcomes included 30‐ and 90‐day cardiovascular‐related readmission rates as well as the 30‐day all‐cause readmission rate. Individual components of a pharmacist‐driven TOC initiative were also evaluated to determine what, if any, aspect of the program had the greatest association with reduced readmission.

Results

A total of 300 patients were included in the study; 150 patients in the pharmacist TOC group and 150 patients in the historical control group. There was a statistically significant reduction in all readmissions at 90 days in the pharmacist TOC group compared with the historical control group (24.7% vs 13.3%, P = .0124). Cardiovascular‐related readmissions were also significantly reduced in the pharmacist TOC group at 30 days (11.3% vs 4.7%, P = .0333) and at 90 days (16.7% vs 8.0%, P = .0225). A higher percentage of patients who were not readmitted received pharmacist medication history and reconciliation compared with patients who were readmitted (129 [99.2%] vs 18 [90%], respectively, P = .046).

Conclusions

The implementation of a pharmacist‐driven TOC initiative targeting ACS patients was associated with reduced readmission rates.
Establishing a standardized clinical pharmacy practice model within the Veterans Health Administration: Evolution of the credentialing and professional practice evaluation process
Authors: McFarland Michael Shawn , Groppi Julie , Ourth Heather , Moore Tera , Jorgenson Terri , Torrise Virginia , Morreale Anthony
Published: October 2018

Developing a standardized practice model and a consistent process for the provision of clinical pharmacy services has been described by some as the “Achilles heel of the clinical pharmacy discipline.” The foundation of a standardized practice model and therefore a consistent care process requires evaluation of the competencies of the providers practicing in the model. The credentialing and privileging process is intended to verify that the health care professional has obtained the requisite qualifications to practice within a certain setting and exhibits the clinical acumen to provide care to patients. The process of credentialing and privileging along with the professional practice evaluation (PPE) process varies across the country. The Clinical Pharmacy Practice Office within the Veterans Health Administration has defined a system‐wide process and solidified the elements essential to clinical pharmacist scope of practice, as well as ensuring the robustness of the pharmacist PPE process within the Department of Veterans Affairs (VA). While specific to the VA, this framework may be considered by other health care systems in creating a process for pharmacist providers.
An implementation system for medication optimization: Operationalizing comprehensive medication management delivery in primary care
Authors: Livet Melanie , Blanchard Carrie , Sorensen Todd D. , Roth McClurg Mary
Published: October 2018

The implementation system described in this article is a customizable blueprint for delivery of comprehensive medication management (CMM) and other medication optimization services. This system is the result of merging implementation science expertise with lessons learned from the parent study, the “CMM in Primary Care” grant. This system is comprised of a number of components, including implementation steps and strategies (ie, activities, practical resources such as assessments and informational materials, and learning supports). While these components are integral to any implementation effort, this project describes their unique operationalization for delivery of CMM in a primary care context. Application of this system is illustrated through an example focused on improving the delivery of CMM by pharmacist‐led teams in primary care settings.
Pharmacists' role in glycemic management in the inpatient setting: An opinion of the endocrine and metabolism practice and research network of the American College of Clinical Pharmacy
Authors: Donihi Amy C. , Moorman John M. , Abla Alicia , Hanania Raja , Carneal Dustin , MacMaster Heidemarie Windham
Published: October 2018

The objective of this opinion paper was to identify and describe the role of pharmacists in ensuring safe and optimal management of patients with glycemic excursions in the inpatient setting. The role of the pharmacist includes involvement in admission medication history and reconciliation, formulary management of glucose‐lowering medications and devices, individual patient medication management, discharge transition of care, and interprofessional collaboration with other health care providers. Recommendations are based on review of published guidelines and literature focusing on the management of patients with hypo‐ and hyperglycemia in the hospital as well as during the time of transition to and from the inpatient setting.
Assessment of chronic disease management among patients with diabetes and coronary artery disease receiving care in a cardiology clinic
Authors: Pearson Scott M. , Shakowski Courtney , Vande Griend Joseph P. , Page Robert L. , Khanna Amber D. , Wright Garth C. , Saseen Joseph J.
Published: October 2018

Background

Patients with coronary artery disease (CAD) often have multiple comorbidities (eg, diabetes, hypertension, and hyperlipidemia). It is unclear if these comorbidities are adequately managed among patients established in a cardiology clinic.

Methods

This retrospective, observational study used electronic medical record data from 1 January 2014 to 31 October 2017 to examine the achievement of five chronic disease quality measures (glycated hemoglobin, A1C ≤ 9.0%, blood pressure, BP < 140/90 mm Hg, antiplatelet agent, moderate/high‐intensity statin, and annual influenza vaccine). Additional measures of optimal care were also assessed (A1C ≤ 8.0%, A1C ≤ 7.0%, blood pressure < 130/80 mm Hg, high‐intensity statin, pneumococcal polysaccharide vaccination (PPSV23)). Patients were identified from the University of Colorado Health Cardiac and Vascular Center (CVC) with CAD, diabetes, and at least two CVC visits within a 24‐month period (n = 295).

Results

The primary outcome measures with highest achievement were for antiplatelet and moderate/high‐intensity statin prescribing (91% and 89%, respectively). The measure with lowest achievement was receipt of influenza vaccination (69%). Women were less likely than men to achieve at least four of the five measures (adjusted odds ratio [OR], 0.44; 95% confidence interval [CI], 0.24‐0.80). Patients with two or more primary care provider (PCP) visits within the past year were more likely to achieve at least four measures compared with patients with less than two PCP visits (adjusted OR, 2.22; 95% CI, 1.14‐4.31). When applying optimal measures, 41% of patients achieved an A1C ≤7%, 52% achieved a blood pressure of <130/80 mm Hg, and 66% were prescribed high‐intensity statins.

Conclusions

Achievement for chronic care quality measures was high but performance could be improved, especially among women and patients with infrequent PCP visits. Increased collaboration and communication between primary care and cardiology may improve care for these patients.
Comprehensive analysis of aberrantly expressed profiles of messenger RNA in alcoholic liver disease
Authors: Sun Jinhui , Li Baolong , Sun Antao , Zhao Kunpeng , Ma Yanchun , Zhao Jiuli , Pan Hui , Song Qingrui , Wang Yan , Yu Chunyu , Wang Cui , Zhang Huan , Zhang Wenwen , Kong Chenfan
Published: October 2018

Background

Alcoholic liver disease (ALD) is one of the major cause of morbidity and mortality of clinical liver disease worldwide. Until today, although many general therapies are carried out and several molecular targets have been proposed to act as the potential therapeutic targets, more accurate molecular targets and more effective therapeutic methods remain needed.

Material and Methods

In the study, we analyze the differential expression genes (DEGs) between the patients with ALD and healthy controls. Gene Ontology enrichment and KEGG signaling pathway analysis are performed to identify the function of DEGs. Some significant molecules are proposed to act as the potential therapeutic targets for ALD. RNA data of 15 ALD tissues and 7 normal tissues for RNA expression analysis were obtained. DEGs in ALD samples compared with normal tissues identified through the limma R package and subjected to network analysis.

Results

As a result, we obtained a total of 274 DEGs that mainly involved in biological processes related to the angiogenesis, stress reaction, synthesis, and metabolism of organic acids. Network analysis obtained several genes with high network degree and fold change. Some significant molecules are proposed to act as the potential therapeutic targets for ALD.

Conclusions

Our research identified some new progression‐related genes of alcohol liver diseases, which could be regarded as the new targets for the early diagnosis and therapeutic management in ALD.
Development of a techno‐economic framework for natural gas dehydration via absorption using Tri‐Ethylene Glycol: a comparative study on conventional and stripping gas dehydration processes
Authors: Kong Zong Yang , Mahmoud Ahmed , Liu Shaomin , Sunarso Jaka
Published: October 2018

BACKGROUND

To date, none of the existing techno‐economic analyses on natural gas dehydration via absorption using triethylene glycol takes into consideration the profit assessment. This work addresses this shortcoming by developing a techno‐economic framework that evaluates the economic feasibility of three different dehydration processes, i.e., conventional dehydration process, stripping gas dehydration process using sale gas, and stripping gas dehydration process using nitrogen, which can meet the maximum water dew point requirement set by local authorities (e.g., Malaysia) for pipeline‐transported natural gas.

RESULTS

Our techno‐economic analyses reveal that the maximum water dew point specification of −25 °C can only be achieved by using a stripping gas dehydration process that consumes more than 260 Nm3 h−1 of sale gas or 435 Nm3 h−1 of nitrogen. In particular, the use of sale gas as stripping gas with an optimum flow rate of 260 Nm3 h−1 generates the highest annual net profit margin, of about $29 million. Such a profit margin is higher with respect to the use of nitrogen as stripping gas and the conventional dehydration process by about $1.6 million and $300 000, respectively. The minimum water dew point specification of 5 °C, on the other hand, can be achieved by all three analysed dehydration processes.

CONCLUSION

The use of sale gas as stripping gas becomes more justifiable economically relative to the conventional dehydration process and the other alternative (the use of nitrogen as stripping gas) and when a low water dew point specification of −25 °C is required for natural gas. © 2018 Society of Chemical Industry
Adjustable pervaporation performance of Zr‐MOF/poly(vinyl alcohol) mixed matrix membranes
Authors: Wu Guorong , Li Yongliang , Geng Yanzi , Lu Xiaoyu , Jia Zhiqian
Published: October 2018

BACKGROUND

Polymer membranes often display trade‐off effects between permeation flux and separation factor in pervaporation, and exploring the strategies for breaking the effects is crucial. In this study, by altering the organic linkers (1,4‐benzenedicarboxylate acid, 2‐hydroxyterephthalic acid, 2,5‐dihydroxyterephthalic acid and biphenyl‐4,4‐dicarboxylate), UiO‐66, UiO‐66‐OH, UiO‐66‐(OH)2 and UiO‐67 were prepared and incorporated in poly(vinyl alcohol) (PVA) membranes for pervaporation of 90 wt% ethanol solution for the first time.

RESULTS

The membrane properties and pervaporation performances were tuned, and anti‐trade‐off effects were demonstrated for UiO‐66/PVA, UiO‐66‐OH/PVA and UiO‐66‐(OH)2/PVA mixed matrix membranes (MMMs). For the UiO‐66‐(OH)2/PVA MMM with 1.0 wt% loading, the permeation flux, separation factor and pervaporation separation index (PSI) were increased by 16, 14 and 32% respectively and the water permeance and selectivity were increased by 24 and 10% respectively, while the swelling degree in 90 wt% ethanol declined by 28% in comparison with that of pristine PVA membrane.

CONCLUSION

The pervaporation performance of the UiO‐66‐(OH)2/PVA MMM demonstrated good potential in alcohol dehydration. © 2018 Society of Chemical Industry
Differences between FLIM phasor analyses for data collected with the Becker and Hickl SPC830 card and with the FLIMbox card
Authors: Ranjit Suman , Malacrida Leonel , Gratton Enrico
Published: October 2018

The phasor approach to FLIM (Fluorescence Lifetime Imaging Microscopy) is becoming popular due to the powerful fit free analysis and the visualization of the decay at each point in images of cells and tissues. However, although several implementation of the method are offered by manufactures of FLIM accessories for microscopes, the details of the conversion of the decay to phasors at each point in an image requires some consideration. Here, we show that if the decay is not properly acquired, the apparently simple phasor transformation can provide incorrect phasor plots and the results may be misinterpreted. In particular, we show the disagreement in experimental data acquired on the same samples using the two cards (FLIMbox, frequency domain and Becker & Hickl BH 830, time domain) and the effect produced by using the BH 830 card with different settings. This difference in data acquisition translates to the assignment of phasor components calculated using different acquisition parameters. This effect is already present in the original data that are not acquired with the proper parameters for the phasor conversion. We also show that the difference in the resolution of components already exists in the data acquired in the time domain when used with settings that do not allow acquisition of the fluorescence decay on a sufficient large time scale.

Research highlights

This paper is intended to made researchers aware of some simple requirements for the conversion of time‐domain data (typically TCSPC) to phasors. The use of phasors for FLIM analysis has seen a surge of popularity. Since the phasor approach is a fit free method and has a powerful visualization of the data, it appears very simple to use. This paper shows that when the original data in the time domain is not acquired with the proper time range to cover the lifetimes in a sample, the conversion to phasors can produce very erroneous results. These results are appearing more frequently in the literature since many of the manufacturers of FLIM accessories for microscopes are now offering the phasor analysis in their software. Here, we show that the phasor transformation per se cannot correct for the problems with data acquisition and that one is misled to think that the “phasor approach” is a universal fix for the lack of the proper time range for data acquisition.
An electron microscopy three‐dimensional characterization of titania nanotubes
Authors: Andrzejczuk Mariusz , Rasiński Marcin , Roguska Agata , Pisarek Marcin , Lewandowska Malgorzata
Published: October 2018

To characterize complex, three‐dimensional nanostructures, modern microscopy techniques are needed, such as electron tomography and focused ion beam (FIB) sectioning. The aim of this study was to apply these two techniques to characterize TiO2 nanotubes in terms of their size, shape, volume, porosity, geometric surface area, and specific surface area (SSA). For these experiments, titania nanotubes were fabricated by means of the electrochemical oxidation of titanium at a voltage of 20 V for 2 hr followed by heat treatment at 450°C for 3 hr to change the amorphous structure into a crystalline anatase structure. The quantitative data obtained from the FIB and electron tomography reconstructions show a high similarity in porosity and some differences in SSA. These might be the result of differences in resolution between the two reconstruction techniques.
Morphological alterations in the ovaries of Amblyomma cajennense semi‐engorged ticks exposed to ethanolic extract of Acmella oleracea
Authors: Anholeto Luís Adriano , de Oliveira Patrícia Rosa , Rodrigues Rodney Alexandre Ferreira , Yamane Lais Thiemi , Castro Karina Neoob de Carvalho , Camargo‐Mathias Maria Izabel
Published: October 2018

The present study analyzed the effects of different concentrations of Acmella oleracea crude ethanolic extract (EEAO) on the development of germ cells from semi‐engorged Amblyomma cajennense females in order to evaluate the potential of this natural chemical as a strategy to control these important ectoparasites. A hundred semi‐engorged females were divided into five groups (duplicates) (10 animals/group): Control 1 (distilled water); Control 2 (solvent ethanol 50% and DMSO 1%); and Treatment I to III (3.1, 6.2, and 12.5 mg/mL of EEAO, respectively). For the exposure of the ticks to the extract was used the Adult Immersion Test. After the exposition, the ovaries were removed and submitted to histological analysis using Harris hematoxylin and aqueous eosin. The histochemical tests were performed using PAS and Bromophenol blue staining techniques, for the detection of total polysaccharides and total protein, respectively. The extract caused significant alterations in the oocytes, including changes in the shape of the cells, disorganization, and cytoplasmic vacuolation, decrease in the number of yolk granules and germ vesicle fragmentation. These alterations were more intense in the oocytes in initial developmental stages (I and II). The results obtained in this study confirm the cytotoxic potential of the ethanolic extract of A. oleracea on the germ cells of A. cajennense females, opening up the possibility to use this extract as an alternative to control these ectoparasites.
Cytokine-mediated modulation of the hepatic miRNome: miR-146b-5p is an IL-6-inducible miRNA with multiple targets
Authors: Kirchmeyer Mélanie , Servais Florence A , Hamdorf Matthias , Nazarov Petr V , Ginolhac Aurélien , Halder Rashi , Vallar Laurent , Glanemann Matthias , Rubie Claudia , Lammert Frank , Kreis Stephanie , Behrmann Iris
Published: October 2018

Interleukin-6 (IL-6)-type cytokines play important roles in liver (patho-)biology. For instance, they regulate the acute phase response to inflammatory signals and are involved in hepatocarcinogenesis. Much is known about the regulation of protein-coding genes by cytokines whereas their effects on the miRNome is less well understood. We performed a microarray screen to identify microRNAs (miRNAs) in human hepatocytes which are modulated by IL-6-type cytokines. Using samples of 2 donors, 27 and 68 miRNAs (out of 1,733) were found to be differentially expressed upon stimulation with hyper-IL-6 (HIL-6) for up to 72 h, with an overlap of 15 commonly regulated miRNAs. qPCR validation revealed that miR-146b-5p was also consistently up-regulated in hepatocytes derived from 2 other donors. Interestingly, miR-146b-5p (but not miR-146a-5p) was induced by IL-6-type cytokines (HIL-6 and OSM) in non-transformed liver-derived PH5CH8 and THLE2 cells and in Huh-7 hepatoma cells, but not in HepG2 or Hep3B hepatoma cells. We did not find evidence for a differential regulation of miR-146b-5p expression by promoter methylation, also when analyzing the TCGA data set on liver cancer samples. Inducible overexpression of miR-146b-5p in PH5CH8 cells followed by RNA-Seq analysis revealed effects on multiple mRNAs, including those encoding IRAK1 and TRAF6 crucial for Toll-like receptor signaling. Indeed, LPS-mediated signaling was attenuated upon overexpression of miR-146b-5p, suggesting a regulatory loop to modulate inflammatory signaling in hepatocytes. Further validation experiments suggest DNAJC6, MAGEE1, MPHOSPH6, PPP2R1B, SLC10A3, SNRNP27, and TIMM17B to be novel targets for miR-146b-5p (and miR-146a-5p).

IL-6-type cytokines up-regulate miR-146b-5p expression in liver cells, an anti-inflammatory miRNA with multiple targets shared with miR-146a-5p.
Understanding Contributing Factors to Cultural Identity of Pakistani Americans
Authors: Bashir Huma A. , Tang Mei
Published: October 2018

This qualitative study explores the experiences of 3 generations of Pakistani Americans with an aim to understand the contributing factors to their cultural identity and the meaning of their experiences. The sample consists of 1st‐, 1.5‐, and 2nd‐generation Pakistani Americans. Data were collected via semistructured interviews and a focus group and were analyzed using thematic analysis. Results revealed 5 common themes intertwined across generational groups: awareness of cultural identity differences are situational; sense of loss; positive experience; awareness of 2 cultures; and culture and religion. Implications for counseling Pakistani Americans are discussed.

Este estudio cualitativo explora las experiencias de tres generaciones de estadounidenses de origen paquistaní, con el objetivo de comprender los factores que contribuyen a su identidad cultural y el significado de sus experiencias. La muestra incluye personas estadounidenses de origen paquistaní de primera, 1.5 y segunda generación. Los datos fueron recopilados a través de entrevistas semiestructuradas y un grupo de enfoque, y fueron analizados usando el análisis temático. Los resultados revelaron cinco temas comunes entrelazados a lo largo de grupos generacionales: la conciencia de que las diferencias de identidad cultural son situacionales; el sentimiento de pérdida; las experiencias positivas; la conciencia de dos culturas; y la cultura y religión. Se discuten las implicaciones para la consejería de personas estadounidenses de origen paquistaní.
Demonstration of circumferential heterogeneity in displacement and strain in the abdominal aortic wall by spiral cine DENSE MRI
Authors: Iffrig Elizabeth , Wilson John S. , Zhong Xiadong , Oshinski John N.
Published: October 2018

Background

Knowledge of tissue properties of the abdominal aorta can improve understanding of vascular disease and guide interventional approaches. Existing MRI methods to quantify aortic wall displacement and strain are unable to discern circumferential heterogeneity.

Purpose

To assess regional variation in abdominal aortic wall displacement and strain as a function of circumferential position using spiral cine displacement encoding with stimulated echoes (DENSE).

Study Type

Prospective.

Population

Cardiovascular disease‐free men (n = 8) and women (n = 9) ages 30–42.

Sequences

Prospective electrocardiogram (ECG)‐gated and navigator echo‐gated spiral, cine 2D DENSE and retrospective ECG‐gated phase contrast MR (PCMR) sequences at 3T.

Assessment

In‐plane displacement values of the aortic wall acquired with DENSE were used to determine radial and circumferential aortic wall motion. A quadrilateral‐based 2D strain calculation method was implemented to determine strain from the displacement field. Peak displacement and its radial and circumferential contributions as well as peak circumferential strain were compared among eight circumferential wall segments. Distensibility was calculated using PCMR and compared with homogenized circumferential strain.

Statistical Tests

To account for repeated measurements in volunteers, linear mixed models for mean sector values were created for displacement magnitude, circumferential displacement, radial displacement, and circumferential strain. Comparisons were made between sectors. Calculated distensibility and homogenized circumferential strain were compared using Bland–Altman analysis. Statistical significance was defined as P < 0.05.

Results

Displacement was highest in the anterior wall (1.5 ± 0.7 mm) and was primarily in the radial as compared with circumferential direction (1.04 ± 0.05 mm vs. 0.81 ± 0.42 mm). Circumferential strain was highest in the lateral walls (left 0.16 ± 0.05 and right 0.21 ± 0.12) with homogenized circumferential strain of 0.14 ± 0.05.

Data Conclusion

DENSE imaging in the abdominal aortic wall demonstrated that the anterior aortic wall exhibits the greatest displacement, while the lateral wall experiences the largest circumferential strain.

Level of Evidence: 3

Technical Efficacy: Stage 2

J. Magn. Reson. Imaging 2019;49:731–743.
Illuminating the On‐Campus Experience of LGBTQ Students Through Photovoice
Authors: Bardhoshi Gerta , Grieve Kimberly , Swanston Jeremy , Suing Michael , Booth Jamar
Published: October 2018

The authors used photovoice to illuminate the on‐campus experiences of lesbian, gay, bisexual, transgender, and queer college students (n = 8) attending a public university in the Midwest. Participants attended 6 photovoice sessions, which the authors transcribed and analyzed, using photographs to contextualize themes. Overarching themes reflected negative experiences on campus, including feeling categorized and practicing self‐censorship. However, students also identified safe zones and advocacy as themes related to their on‐campus experiences. The authors present implications for counseling practitioners and scholars.
The Use of Biofeedback in College Counseling
Authors: Fish Matthew , Russoniello Carmen , Clemmons‐James Dominiquie M.
Published: October 2018

The authors present a biofeedback training model and explore 4 specific biofeedback modalities—electromyography, electrodermal activity, thermal, and neurofeedback—that can be integrated into the clinical setting by college counselors. In addition, the authors provide information about how college counselors can become board certified in biofeedback and neurofeedback. Clinical implications and applications for college counselors are also discussed.
Beyond Complex Trauma: An Existential View of Adverse Childhood Experiences
Authors: Zyromski Brett , Dollarhide Colette T. , Aras Yahyahan , Geiger Sarah , Oehrtman J. P. , Clarke Halley
Published: October 2018

Adverse childhood experiences (ACEs) can trigger a variety of existential reactions that disrupt physical, mental, and behavioral health. This article explores the implications of ACEs for the development of children, adolescents, and adults. Examining ACEs through an existential lens, the authors provide a way to conceptualize clients with multiple ACEs and offer suggestions for interventions.
An Idealist's View of Humanistic Psychotherapy
Authors: Palacios Alfredo F.
Published: October 2018

Counselors encounter fundamental philosophical problems when attempting to understand another person, including the notion of agency and the nature of reality outside the mind. This author discusses the Kantian conception of truth, agency, and the relationship of the mind's external reality to psychotherapy, and its implications for humanism and theories of knowing.
Periodontal disease increases the risk for onset of systemic comorbidities in dental hospital attendees: An 18‐year retrospective cohort study
Authors: Zhao Dan , Zhen Zhe , Pelekos George , Yiu Kai Hang , Jin Lijian
Published: October 2018

Background

Periodontal disease closely links to various systemic diseases. This l8‐year retrospective cohort study investigated whether poor periodontal condition may increase the risk for onset of systemic comorbidities.

Methods

A total of 488 individual dental folders from 17 400 dental hospital attendees registered from 1996 to 1998 were randomly selected, and these participants were free of diabetes, cardiovascular disease, chronic obstructive pulmonary disease, cancer, stroke, cognitive impairment, hypertension, and dyslipidemia in the Clinical Management System. The records of periodontal examination and orthopantomogram on the first registration were obtained, and full‐mouth bone level (BL) was measured. Onsets of the eight comorbidities concerned above until 2016 were retrieved from the system.

Results

The participants with worse periodontal status on their first registration had significantly higher numbers of the eight comorbidities/mortality during the 18‐year follow‐ups than their counterparts (P < 0.05). BL presented as bone loss/age was independently correlated to the comorbidity profiles in two multivariate models (0 to 1 versus ≥2; 0 to 2 versus ≥3) after adjusting for age and sex (odds ratio [OR] = 1.87; OR = 2.18, P < 0.05), highlighting that the individuals with more bone resorption exhibited a greater number of the comorbidities as compared with their counterparts. Moreover, those with onsets of more comorbidities showed worse periodontal conditions according to four parameters employed (community periodontal index, BL, bone loss/age and number of remaining teeth) (P < 0.05).

Conclusions

Within the limitations of this 18‐year retrospective cohort study, our findings provide the first evidence that periodontal disease experience to some extent reflects the host susceptibility to onset of common systemic comorbidities. Further studies with larger sample sizes and appropriate adjustment of critical confounders are highly warranted to substantiate the current observation.
Holocene relative mean sea‐level changes in the Wadden Sea area, northern Netherlands
Authors: Meijles Erik W. , Kiden Patrick , Streurman Harm‐Jan , van der Plicht Johannes , Vos Peter C. , Gehrels W. Roland , Kopp Robert E.
Published: October 2018

Although the Netherlands has a long tradition of sea‐level research, no Holocene relative sea‐level curve is available for the north of the country. Previous studies hypothesized that the relative sea‐level reconstruction for the western Netherlands is also valid for the northern part of the country. However, glacial isostatic adjustment (GIA) models predict a lower and steeper relative sea‐level curve because of greater postglacial isostatic subsidence. Long‐term data of relative sea‐level change are important to inform GIA models and understand postglacial vertical land motion related to the rebound of Fennoscandia and neotectonic activity. We compiled and evaluated a set of basal peat radiocarbon dates to reconstruct the Holocene relative mean sea‐level rise in the Dutch Wadden Sea area. For the early Holocene, this reconstruction is lower than the western Netherlands curve. After 6400 cal a BP, the curve for the Wadden Sea is statistically indistinguishable from that for the western Netherlands, a result that conflicts with GIA model results. It remains to be investigated whether the problem lies with the GIA model predictions or with the quality of the available data. Additional basal peat radiocarbon dates from suitable sites should be collected to further resolve this problem.
Atmospheric corrosion of low carbon steel in a coastal zone of Ecuador: Anomalous behavior of chloride deposition versus distance from the sea
Authors: Guerra Juan C. , Castañeda Abel , Corvo Francisco , Howland Juan J. , Rodríguez Joelis
Published: October 2018

Atmospheric corrosion of low carbon steel exposed in a coastal tropical zone of Manabí, Ecuador, was determined. Specimens were exposed at six outdoor exposure sites located at different distances from the sea. The atmosphere is classified as coastal. Wind speed threshold for an increase in chloride deposition rate was determined. The behavior of chloride deposition rate versus distance from the sea is anomalous due to the presence of an estuary. Corrosion by weight loss was evaluated up to 1 year of exposure. Only a slight difference in atmospheric corrosion rate is noticed between wet and dry periods. Chloride deposition interaction with RH–temperature complex and with wind speed shows significant statistical influence on atmospheric corrosion of low carbon steel. Corrosivity category of the atmosphere high (C4) is the most predominant classification level in the zone. Prediction indicates corrosivity category high (C4) will remain up to 20 years of exposure. Different morphologies of corrosion products were identified by SEM. Lepidocrocite, goethite, magnetite, and akaganeite are the main crystalline phases determined by XRD. Protective ability index previously proposed for rust layers is not useful to apply in coastal sites.
Gingerenone A Sensitizes the Insulin Receptor and Increases Glucose Uptake by Inhibiting the Activity of p70 S6 Kinase
Authors: Chen Junhong , Sun Jing , Prinz Richard A. , Li Yi , Xu Xiulong
Published: October 2018

Scope

The bioactive constituents in ginger extract are responsible for anti‐hyperglycemic effects and the underlying mechanisms are incompletely understood. Gingerenone A (Gin A) has been identified as an inhibitor of p70 S6 (S6K1), a kinase that plays a critical role in the pathogenesis of insulin resistance. This study aims to evaluate if Gin A can sensitize the insulin receptor by inhibiting S6K1 activity.

Methods and results

Western blot analysis reveals that Gin A induces phosphatidylinositide‐3 kinase (PI3K) feedback activation in murine 3T3‐L1 adipocytes and rat L6 myotubes, as evidenced by increased AKTS473 and S6K1T389 but decreases S6S235/236 and insulin receptor substrate 1 (IRS‐1)S1101 phosphorylation. Western blot and immunoprecipitation analysis reveal that Gin A increases insulin receptor tyrosine phosphorylation in L6 myotubes and IRS‐1 binding to the PI3K in 3T3‐L1 adipocytes. Confocal microscopy reveals that Gin A enhances insulin‐induced translocation of glucose transporter 4 (GLUT4) into the cell membrane in L6 cells. 2‐NBDG (2‐N‐(Nitrobenz‐2‐oxa‐1,3‐diazol‐4‐yl)amino)‐2‐deoxyglucose) Fluorescent assay reveals that Gin A enhances insulin‐stimulated glucose uptake in 3T3‐L1 adipocytes and L6 myotubes.

Conclusions

Gin A overcomes insulin resistance and increases glucose uptake by inhibiting S6K1 activity. Gin A or other plant‐derived S6K1 inhibitors could be developed as novel antidiabetic agents.
Admission 25‐Hydroxyvitamin D Levels Are Associated With Functional Status at Time of Discharge from Intensive Care Unit in Critically Ill Surgical Patients
Authors: Brook Karolina , Otero Tiffany M.N. , Yeh D. Dante , Canales Cecilia , Belcher Donna , Quraishi Sadeq A.
Published: October 2018

Background

Vitamin D status is associated with length of stay (LOS) and discharge destination in critically ill patients. To further understand this relationship, we investigated whether admission 25‐hydroxyvitaminD (25OHD) levels are associated with discharge functional status in the intensive care unit (ICU).

Methods

In this retrospective study, data from 2 surgical ICUs at a large teaching hospital were analyzed. 25OHD levels were measured within 24 hours of ICU admission and Functional Status Score for the ICU (FSS‐ICU) was calculated within 24 hours of ICU discharge for all patients. To investigate the association of vitamin D status with FSS‐ICU, we constructed linear and logistic regression models, controlling for body mass index, Nutrition Risk in the Critically Ill score, ICU LOS, and cumulative protein or caloric deficit during ICU admission.

Results

Mean 25OHD level and FSS‐ICU was 19 (SD 8) ng/mL and 17 (SD 4), respectively, in the analytic cohort (n = 300). Each unit increase in 25OHD level was associated with a 0.2 increment in FSS‐ICU (β = .20; 95% CI 0.14–0.25). Patients with 25OHD levels <20 ng/mL had >3‐fold risk of low FSS‐ICU (<17) compared with patients with 25OHD >20 ng/mL (OR 3.45; 95% CI 1.96–6.08).

Conclusions

Our results suggest that vitamin D status at admission is associated with discharge FSS‐ICU in critically ill surgical patients. Future studies are needed to validate our results, to build upon our findings, and to determine whether optimizing 25OHD levels can improve functional status and other important clinical outcomes in ICU patients.
Pathophysiology and Treatment of Gastrointestinal Motility Disorders in the Acutely Ill
Authors: Deane Adam M. , Chapman Marianne J. , Reintam Blaser Annika , McClave Stephen A. , Emmanuel Anton
Published: October 2018

Gastrointestinal dysmotility causes delayed gastric emptying, enteral feed intolerance, and functional obstruction of the small and large intestine, the latter functional obstructions being frequently termed ileus and Ogilvie syndrome, respectively. In addition to meticulous supportive care, drug therapy may be appropriate in certain situations. There is, however, considerable variation among individuals regarding what gastric residual volume identifies gastric dysmotility and would encourage use of a promotility drug. While the administration of either metoclopramide or erythromycin is supported by evidence it appears that, dual‐drug therapy (erythromycin and metoclopramide) reduces the rate of treatment failure. There is a lack of evidence to guide drug therapy of ileus, but neither erythromycin nor metoclopramide appear to have a role. Several drugs, including ghrelin agonists, highly selective 5‐hydroxytryptamine receptor agonists, and opiate antagonists are being studied in clinical trials. Neostigmine, when infused at a relatively slow rate in patients receiving continuous hemodynamic monitoring, may alleviate the need for endoscopic decompression in some patients.