bluuebunny/crossref_metadata_2025 huggingface dataset:
Determining threatened species distributions in the face of limited data: Spatial conservation prioritization for the Chinese giant salamander (Andrias davidianus)
Authors: Chen Shu , Cunningham Andrew A. , Wei Gang , Yang Jian , Liang Zhiqiang , Wang Jie , Wu Minyao , Yan Fang , Xiao Hanbin , Harrison Xavier A. , Pettorelli Nathalie , Turvey Samuel T.
Published: February 2018

The purpose of this study was to determine whether limited occurrence data for highly threatened species can provide useful spatial information to inform conservation. The study was conducted across central and southern China. We developed a habitat suitability model for the Critically Endangered Chinese giant salamander (Andrias davidianus) based on one biotic and three abiotic parameters from single‐site locality records, which represent the only relevant environmental data available for this species. We then validated model quality by testing whether increased percentage of predicted suitable habitat at the county level correlated with independent data on giant salamander presence. We randomly selected 48 counties containing historical records which were distinct from, and independent of, the single‐site records used to develop the model, and 47 additional counties containing >50% predicted suitable habitat. We interviewed 2,812 respondents near potential giant salamander habitat across these counties and tested for differences in respondent giant salamander reports between counties selected using each method. Our model predicts that suitable giant salamander habitat is found widely across central and southern China, with counties containing ≥50% predicted suitable habitat distributed in 13 provinces. Counties with historical records contain significantly more predicted suitable habitat than counties without historical records. There are no statistical differences in any patterns of respondent giant salamander reports in surveyed counties selected from our model compared with the areas of known historical giant salamander distribution. A Chinese giant salamander habitat suitability model with strong predictive power can be derived from the restricted range of environmental variables associated with limited available presence‐only occurrence records, constituting a cost‐effective strategy to guide spatial allocation of conservation planning. Few reported sightings were recent, however, with most being over 20 years old, so that identification of areas of suitable habitat does not necessarily indicate continued survival of the species at these locations.
Relaxivity Enhancement of Ditopic Bishydrated Gadolinium(III) Complexes Conjugated to Mesoporous Silica Nanoparticles
Authors: Carniato Fabio , Tei Lorenzo , Martinelli Jonathan , Botta Mauro
Published: February 2018

Dinuclear Gd3+ complexes containing thermodynamically stable and bishydrated GdAAZTA (AAZTA = 6‐amino‐6‐methylperhydro‐1,4‐diazepinetetraacetic acid) chelates were covalently linked to the surfaces of mesoporous silica nanoparticles and decorated with poly(ethylene glycol) (PEG5000) molecules. The surface and textural properties of the samples were analyzed. A detailed 1H NMR relaxometric characterization as a function of the applied magnetic‐field strength was performed for the conjugated systems in aqueous solutions to evaluate their efficacy as potential magnetic resonance imaging (MRI) diagnostic probes. The samples showed enhanced longitudinal relaxivity values (37.5 mm–1 s–1 per ion at 0.7 T and 310 K) compared with those of the free complex (+270 %) and related nanosystems based on monohydrated Gd3+ chelates (+42 %). The relaxivity gain is the result of the rational design of the ditopic complex, as it ensures an increased hydration state (q = 2), improvement of the rotational dynamics and a fast rate of water exchange between the inner coordination sphere and the bulk. These favourable properties are obtained without compromise to the high thermodynamic stability and kinetic inertness of the chelating units.
Direct Electricity Generation from Dissolved Cellulosic Biomass in an Alkaline Fuel Cell
Authors: Liu X. H. , Dong F. , Liu P. , Li Z. , Tong Y. D. , Feng M. N. , Hao M. Q. , Wang Y. , Zhang P. P.
Published: February 2018

Cellulose, which accounts for more than half of the carbon content in plants, has become a popular feedstock for biofuel production. In this work, direct electricity generation from dissolved cellulosic biomass in an alkaline fuel cell is explored without energy‐intensive process. The effect of different cellulose dissolution solvents on the electricity production is investigated. Results show dissolution treatment can remarkably affect the fuel cell performance. When NaOH/urea/thiourea is chosen as a solvent, the specific capacity of cellulose is about sixfold higher than that using only NaOH as solvent. The limiting current density and the maximum power density reach 0.85 mA cm−2 and 0.07 mW cm−2, respectively. This power density surpasses those of any existing biotic or abiotic designs. Electrochemical characterizations demonstrate that the remarkable activity improvement towards the cellulose oxidation reaction in NaOH/urea/thiourea aqueous solution is due to the lower charger transfer resistance and higher energy transfer efficiency.
Critical Infrastructure Protection Required on Electric Grid Continually Changing
Authors: Hilt David W.
Published: February 2018

The supply of electricity since the days of Thomas Edison and George Westinghouse has been an ever‐changing and rapid‐growth environment. One of the most significant changes came in 1964, when seven separate systems were connected to ultimately form what is known today as the Eastern Interconnection. In it, all of the generators, transmission lines, and loads operate as one very large system. The interconnections—Eastern, Western, Texas, and Quebec—operate with all generators in synchronization, making them essentially one very large machine (Exhibit 1).
Regulatory Support Needed for Digital Revolution
Authors: DeCotis Paul A.
Published: February 2018

State and federal regulators and regional planning organizations can support the digital shift by developing rules and regulations that support long‐term investment in digital technologies.
Taking Stock of NEPA at 48
Authors: Russo Thomas
Published: February 2018

The National Environmental Policy Act (NEPA) turned 48 with the new year. I thought it would be a good idea to sit back and ponder whether NEPA has resulted in “environmentally responsible projects” or is just a long‐winded compliance exercise, and an expensive one at that.
Distinct methylation profile of mucinous ovarian carcinoma reveals susceptibility to proteasome inhibitors
Authors: Liew Phui‐Ly , Huang Rui‐Lan , Weng Yu‐Chun , Fang Chia‐Lang , Hui‐Ming Huang Tim , Lai Hung‐Cheng
Published: February 2018

Mucinous type of epithelial ovarian cancer (MuOC) is a unique subtype with a poor survival outcome in recurrent and advanced stages. The role of type‐specific epigenomics and its clinical significance remains uncertain. We analyzed the methylomic profiles of 6 benign mucinous adenomas, 24 MuOCs, 103 serous type of epithelial ovarian cancers (SeOCs) and 337 nonepithelial ovarian cancers. MuOC and SeOC exhibited distinct DNA methylation profiles comprising 101 genes, 81 of which exhibited low methylation in MuOC and were associated with the response to glucocorticoid, ATP hydrolysis‐coupled proton transport, proteolysis involved in the cellular protein catabolic process and ion transmembrane transport. Hierarchical clustering analysis showed that the profiles of MuOC were similar to colorectal adenocarcinoma and stomach adenocarcinoma. Genetic interaction network analysis of differentially methylated genes in MuOC showed a dominant network module is the proteasome subunit beta (PSMB) family. Combined functional module and methylation analysis identified PSMB8 as a candidate marker for MuOC. Immunohistochemical staining of PSMB8 used to validate in 94 samples of ovarian tumors (mucinous adenoma, MuOC or SeOC) and 62 samples of gastrointestinal cancer. PSMB8 was commonly expressed in MuOC and gastrointestinal cancer samples, predominantly as strong cytoplasmic and occasionally weak nuclei staining, but was not expressed in SeOC samples. Carfilzomib, a second‐generation proteasome inhibitor, suppressed MuOC cell growth in vitro. This study unveiled a mucinous‐type‐specific methylation profile and suggests the potential use of a proteasome inhibitor to treat MuOC.
Beyond Chemical Synthesis: Self‐Organization?!
Authors: Lehn Jean‐Marie
Published: February 2018

The present text presents briefly some general considerations on the steps from molecular synthesis to the development of chemistry beyond the molecule, towards mastering progressively the processes underlying the generation of complex matter by self‐organization.
Near‐infrared bone densitometry: A feasibility study on distal radius measurement
Authors: Chung Chun , Chen Yu‐Pin , Leu Tsai‐Hsueh , Sun Chia‐Wei
Published: February 2018

Osteoporosis, defined as decreased bone mineral density (BMD), poses patients in dangers for fracture risk and has become a major public health problem worldwide because of is associated morbidity, mortality and costs. Without doubt, early detection and timely intervention are important to successfully manage osteoporosis and its associated complications. The dual‐energy x‐ray absorptiometry (DXA) is the most popular and standard method to measure BMD. However, limitations including radiation exposure and availability restrict its application for osteoporosis screening among general population. In this study, we developed a simple method to detect human distal radius bone density based on near infrared (NIR) image system. Among 10 volunteers (including 5 young and 5 elderly participants) receiving bone density measurement using our NIR image system at the ultradistal part of bilateral distal radius, we demonstrated a strong correlation between the optical attenuation and BMD measured with DXA, which may facilitate predicting bone density status. We hope our potential NIR image system may open a new avenue for development of osteoporosis screening facilities and help in prevention of osteoporosis related fracture and its associated complications in the near future. Pearson's correlations between BMD values from the DXA and light intensity of NIR system.
Non‐invasive optical method for real‐time assessment of intracorneal riboflavin concentration and efficacy of corneal cross‐linking
Authors: Lombardo Giuseppe , Villari Valentina , Micali Norberto L. , Leone Nancy , Labate Cristina , De Santo Maria P. , Lombardo Marco
Published: February 2018

Keratoconus is the primary cause of corneal transplantation in young adults worldwide. Riboflavin/UV‐A corneal cross‐linking may effectively halt the progression of keratoconus if an adequate amount of riboflavin enriches the corneal stroma and is photo‐oxidated by UV‐A light for generating additional cross‐linking bonds between stromal proteins and strengthening the biomechanics of the weakened cornea. Here we reported an UV‐A theranostic prototype device for performing corneal cross‐linking with the ability to assess corneal intrastromal concentration of riboflavin and to estimate treatment efficacy in real time. Seventeen human donor corneas were treated according to the conventional riboflavin/UV‐A corneal cross‐linking protocol. Ten of these tissues were probed with atomic force microscopy in order to correlate the intrastromal riboflavin concentration recorded during treatment with the increase in elastic modulus of the anterior corneal stroma. The intrastromal riboflavin concentration and its consumption during UV‐A irradiation of the cornea were highly significantly correlated (R = 0.79; P = .03) with the treatment‐induced stromal stiffening effect. The present study showed an ophthalmic device that provided an innovative, non‐invasive, real‐time monitoring solution for estimating corneal cross‐linking treatment efficacy on a personalized basis.
Nature of hydration shells of a polyoxy‐anion with a large cationic centre: The case of iodate ion in water
Authors: Sharma Bikramjit , Chandra Amalendu
Published: February 2018

The structural nature of the solvation shells of an iodate ion, which is known to be a polyoxy‐anion with a large cationic centre, is investigated by means of Born–Oppenheimer molecular dynamics (BOMD) simulations using BLYP and the dispersion corrected BLYP‐D3 functionals. The iodate ion is found to have two distinct solvation regions around the positively charged iodine (iodine solvation shell or ISS) and the negatively charged oxygens (oxygen solvation shell or OSS). We have looked at the spatial, orientational, and hydrogen bond distributions of water in the two solvation regions. It is found that the water orientational profile in the ISS is typical of a cation hydration shell. The hydrogen bonded structure of water in the OSS is found to be very similar to that of the bulk water structure. Thus, the iodate ion essentially behaves like a positively charged iodine ion in water as if there is no anionic part. This explains why the cationic character of the iodate ion was prominently seen in earlier studies. The arrangement of water molecules in the two solvation shells and in the intervening regions around the iodate ion is further resolved by looking at structural cross‐correlations. The electronic properties of the solvation shells are also looked at by calculating the solute–solvent orbital overlap and dipole moments of the solute and solvation shell water. We have also performed BOMD simulations of iodate ion‐water clusters at experimentally relevant conditions. The simulation results are found to be in agreement with experimental results. © 2018 Wiley Periodicals, Inc.
Rat choice in rapidly changing concurrent schedules
Authors: McLean Anthony P. , Grace Randolph C. , Shevchouk Olesya T. , Cording Jacinta R.
Published: February 2018

In two experiments, experimentally naïve rats were trained in concurrent variable‐interval schedules in which the reinforcer ratios changed daily according to a pseudorandom binary sequence. In Experiment 1, relative response rates showed clear sensitivity to current‐session reinforcer ratios, but not to previous sessions' reinforcer ratios. Within sessions, sensitivity to the current session's reinforcement rates increased steadily, and by session end, response ratios approached matching to the current‐session reinforcer ratios. Across sessions, sensitivity to the current session's reinforcer ratio decreased with continued exposure to the pseudorandom binary sequence, contrary to expectations based on previous studies demonstrating learning sets. Using a second group of naïve rats, Experiment 2 replicated the main results from Experiment 1 and showed that although there were increases over sessions in both changeover rate and response rate during the changeover delay, neither could explain the accompanying reductions in sensitivity. We consider the role of reinforcement history, showing that our results can be simulated using two separate representations, one local and one nonlocal, but a more complex approach will be needed to bring together these results and other history effects such as learning sets and spontaneous recovery.
Synthesis of Benzazolyl Pyrimidines Under Ultrasonication and Their Antimicrobial Activity
Authors: Kayathi Narendra Babu , Sowmya Donthamsetty V. , Adivireddy Padmaja , Venkatapuram Padmavathi
Published: February 2018

(1) The benzoxazolyl/benzothiazolyl/benzimidazolyl pyrimidines were prepared under ultrasonication in the presence of pyridine/dimethylaminopyridine and triethylamine. (2) Better yields were recorded in 4‐(N,N‐dimethylamino)pyridine and Et3N. (3) The presence of electron withdrawing chloro, bromo, and nitro substituents enhanced antimicrobial activity (13c, 13e, 14e: minimum inhibitory concentration = 6.25 μg/well against Bacillus subtilis; 13e, 14e: minimum inhibitory concentration = 6.25 μg/well against Aspergillus niger).
Aortic valve stenosis and aortic diameters determine the extent of increased wall shear stress in bicuspid aortic valve disease
Authors: Farag Emile S. , van Ooij Pim , Planken R. Nils , Dukker Kayleigh C.P. , de Heer Frederiek , Bouma Berto J. , Robbers‐Visser Danielle , Groenink Maarten , Nederveen Aart J. , de Mol Bas A.J.M. , Kluin Jolanda , Boekholdt S. Matthijs
Published: February 2018

Background

Use of 4‐dimensional flow magnetic resonance imaging (4D‐flow MRI) derived wall shear stress (WSS) heat maps enables identification of regions in the ascending aorta with increased WSS. These regions are subject to dysregulation of the extracellular matrix and elastic fiber degeneration, which is associated with aortic dilatation and dissection.

Purpose

To evaluate the effect of the presence of aortic valve stenosis and the aortic diameter on the peak WSS and surface area of increased WSS in the ascending aorta.

Study Type

Prospective.

Subjects

In all, 48 bicuspid aortic valve (BAV) patients (38.1 ± 12.4 years) and 25 age‐ and gender‐matched healthy individuals.

Field Strength/Sequence

Time‐resolved 3D phase contrast MRI with three‐directional velocity encoding at 3.0T.

Assessment

Peak systolic velocity, WSS, and aortic diameters were assessed in the ascending aorta and 3D heat maps were used to identify regions with elevated WSS.

Statistical Tests

Comparisons between groups were performed by t‐tests. Correlations were investigated by univariate and multivariate regression analysis.

Results

Elevated WSS was present in 15 ± 11% (range; 1–35%) of the surface area of the ascending aorta of BAV patients with aortic valve stenosis (AS) (n = 10) and in 6 ± 8% (range; 0–31%) of the ascending aorta of BAV patients without AS (P = 0.005). The mid‐ascending aortic diameter negatively correlated with the peak ascending aortic WSS (R = –0.413, P = 0.004) and the surface area of elevated WSS (R = –0.419, P = 0.003). Multivariate linear regression analysis yielded that the height of peak WSS and the amount of elevated WSS depended individually on the presence of aortic valve stenosis and the diameter of the ascending aorta.

Data Conclusion

The extent of increased WSS in the ascending aorta of BAV patients depends on the presence of aortic valve stenosis and aortic dilatation and is most pronounced in the presence of AS and a nondilated ascending aorta.

Level of Evidence: 2

Technical Efficacy: Stage 2

J. MAGN. RESON. IMAGING 2018;48:522–530.
Use of microelectrode near‐field signals to determine catheter contact
Authors: Levy Mathew R. , Merchant Faisal M. , Langberg Jonathan J. , Delurgio David B.
Published: February 2018

Background

The utility of standard distal bipolar electrograms (sEGMs) for assessing catheter‐tissue contact may be obscured by the presence of far‐field signals. Microelectrode electrograms (mEGMs) may overcome this limitation.

Methods

We compared 5 mEGM characteristics (amplitude, frequency content, temporal signal variability, presence of injury current, and amplitude differential between bipoles) with the sEGM for determining tissue contact in 20 patients undergoing ablation of typical atrial flutter. Visualization of catheter‐tissue contact by intracardiac echocardiography (ICE) served as the gold standard for assessing contact. Correlation between electrograms and ICE‐verified contact level was reported as percent concordance.

Results

Three of 5 mEGM characteristics demonstrated significantly better concordance with ICE‐verified contact level than the sEGM (52% concordance with ICE): mEGM frequency content (59% concordance with ICE, P < .001 for comparison with sEGM); mEGM amplitude (concordance 59%, P < .001); and mEGM presence of injury current (56% concordance, P = .001). Concordance of amplitude differential between mEGM bipoles with ICE (49%) was not significantly different than the sEGM (P = .638) whereas mEGM temporal variability (39%) was significantly worse than the sEGM. Using a median of all 5 mEGM characteristics provided additive information (concordance with ICE 64%) and was significantly better than all of the individual mEGM characteristics except frequency content (P = .976).

Conclusion

Microelectrode EGMs (in particular frequency content, amplitude, and presence of injury current) can improve real‐time assessment of catheter contact compared to the use of standard bipolar EGMs. Broader use of mEGMs may enhance ablation efficacy.
Effective and safe lead extraction using the bidirectional rotational Evolution® sheath in a child with congenital heart disease
Authors: Migliore Federico , Cipriani Alberto , Ferretto Sonia , Hadas Dan , Iliceto Sabino , Leoni Loira
Published: February 2018

We reported a challenging transvenous lead extraction procedure for lead failure in a child with congenital heart disease. Our report demonstrates that the new hand‐powered bidirectional rotational Evolution RL (Cook Medical, USA) mechanical extraction sheath is an effective and safe tool for the extraction of chronically implanted leads in children.
Electrocardiographic changes and exposure to solvents
Authors: Assadi Seyedeh Negar
Published: February 2018

Background

Occupational exposures can cause cardiovascular disorders. Some exposures may be harmful, and exposures to chemicals such as metal welding fumes, gases, and pesticides, and stress related to physical and occupational hazard, which results in cardiovascular disorders such as arrhythmia, could be prevented. The objective of this study was to determine the electrocardiographic changes in occupational exposure to organic solvents.

Methods

It was a historical cohort study and was carried out on workers of industries. The study was carried out with flexible interview, physical examination, checklist for obtaining clinical history, and electrophysiology test. Group 1 included the workers in the production line of solvent and paint, group 2 included administrative personnel, and group 3 included workers from other industries who did not have solvent exposure. A number of participants in group 1, group 2, and group 3 were 500, 498, and 501, respectively. Electrocardiographic changes were recorded in health issues.

Results

The frequency of arrhythmia, P wave, and QRS complex changes were highest in group 1. The risk of arrhythmia was 1.15 (1.08‐1.49), P wave change was 1.02 (1.01‐2.28) which was significant and considered as highest risk,, and QRS complex change was highest in group 1, whose relative risk was 1.53 (1.46‐1.61). ST segment and T wave changes (depression or elevation) were highest in group 1 and had no significant differences (P < .05).

Conclusion

Working in solvent industry is a risk of developing arrhythmia. Exposure to chemical especially solvent agents mostly affects the cardiovascular system and is effective on electrocardiography, which must be prevented.
Implantable cardioverter defibrillator in nonischemic cardiomyopathy: A systematic review and meta‐analysis
Authors: Khan Safi U. , Ghimire Subash , Talluri Swapna , Rahman Hammad , Khan Muhammad U. , Nasir Fahad , Kaluski Edo
Published: February 2018

The evidence to support implantable cardioverter defibrillator (ICD) in subjects with nonischemic cardiomyopathy (NICM) for primary prevention of sudden cardiac death (SCD) is not robust. This meta‐analysis intends to assess the impact of routine ICD implantation for primary prevention of mortality due to SCD in NICM based on all the published randomized clinical trials (RCTs). Six RCTs were selected using PubMed/Medline, EMBASE, and CENTRAL from inception to December 2016. Outcomes were calculated as random‐effects relative risk (RR) and risk difference (RD) with 95% confidence interval (CI). Patients were randomized to ICD arm and control arm (usual care, medical treatment, and anti‐arrhythmic drugs). ICD significantly reduced all‐cause mortality in NICM patients (RR, 0.74, 95% CI, 0.56‐0.97, P = .03, I2 = 40). Mortality benefit was achieved due to a significant reduction in sudden cardiac death (SCD) (RR, 0.47, 95% CI, 0.30‐0.73, P < .001, I2 = 0). There were no statistical differences between two groups with regard to risk of noncardiac mortality, non‐SCD, cardiac arrest, cardiac transplant, sustained ventricular tachycardia (VT), and VT requiring medical treatment. Our results support efficacy of ICDs at reducing all‐cause mortality due to a reduction in SCD.
Acute electrical and hemodynamic effects of endocardial biventricular pacing using the WiSE CRT system and conventional epicardial biventricular pacing
Authors: Leo Milena , Webster David , Betts Tim R.
Published: February 2018

Wireless left ventricular endocardial pacing with the WiSE CRT system has recently become available as alternative to conventional epicardial CRT pacing. We report the first comparison of the acute electrical and hemodynamic response produced by the two CRT pacing modalities in a patient undergoing WiSE CRT implant after a failed conventional CRT procedure. WiSE CRT pacing showed an additive acute benefit compared with conventional CRT. These findings could potentially translate into long‐term clinical benefit and introduce the potential for tri‐ventricular pacing using both systems simultaneously.
Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) in clinical practice
Authors: Li Ka Hou Christien , Bazoukis George , Liu Tong , Li Guangping , Wu William K. K. , Wong Sunny Hei , Wong Wing Tak , Chan Yat Sun , Wong Martin C. S. , Wassilew Katharina , Vassiliou Vassilios S. , Tse Gary
Published: February 2018

Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is an inherited myocardial disease characterized by fibro‐fatty replacement of the right ventricular myocardium, and associated with paroxysmal ventricular arrhythmias and sudden cardiac death (SCD). It is currently the second most common cause of SCD after hypertrophic cardiomyopathy in young people <35 years of age, causing up to 20% of deaths in this patient population. This condition has a male preponderance and is more commonly found in individuals of Italian and Greek descent. To date, there is no single diagnostic test for ARVC/D and the diagnosis is made based on clinical, electrocardiographic, and radiological findings according to the Revised 2010 Task Force Criteria. In this review, we will discuss the mainstay treatment which includes pharmacotherapy, implantable cardioverter‐defibrillator insertion for abortion of sudden cardiac death, and in the advanced stages of the disease cardiac transplantation.
Atrial fibrillation deteriorates tricuspid regurgitation following implantable cardioverter defibrillator lead placement in patient with hypertrophic obstructive cardiomyopathy
Authors: Mohri Takato , Saji Mike , Murai Tatsuya , Takayama Morimasa
Published: February 2018

Although atrial fibrillation (AF) often exists in patients with hypertrophic obstructive cardiomyopathy (HOCM), combination of tricuspid regurgitation (TR) and AF after implantation of pacemaker/implantable cardioverter defibrillator (ICD) lead and its optimal management have not been well discussed in this population. Herein, we present a patient with HOCM who subsequently died due to severe heart failure and deterioration of TR following ICD lead placement with AF. Autopsy findings demonstrated that ICD leads were entrapped by anomaly structure in the right atrium and ventricle, which might affect deterioration of TR.
Temporary external implantable cardioverter‐defibrillator as a bridge to reimplantation after infected device extraction
Authors: Dębski Maciej , Ząbek Andrzej , Boczar Krzysztof , Urbańczyk‐Zawadzka Małgorzata , Lelakowski Jacek , Małecka Barbara
Published: February 2018

Patients with cardiac implantable electronic devices (CIED) and endovascular infection represent a difficult management group. The explantation of an implantable cardioverter‐defibrillator (ICD) system deprives the patient of the protection against life‐threatening ventricular tachyarrhythmias. In this study, we describe feasibility and clinical outcomes of bridging with temporary dual‐coil ICD lead and external ICD following the extraction of a CIED due to endovascular infection and compare the performance of this approach to other available options.
Late Ratchet syndrome involving isolated left ventricular lead dislodgement post‐cardiac resynchronization therapy defibrillator generator change
Authors: Tan Vern Hsen , Wong Kelvin
Published: February 2018

Lead dislodgement following cardiac implantable electronic device (CIED) generator change is rare. We report a case including the postulate mechanism of an isolated left ventricular lead dislodgement 3 months after cardiac resynchronization therapy defibrillator pulse generator change.
Lung cancer knowledge and screening in the context of the Malaysian population
Authors: Loh Jia Fui , Tan Shir Ley
Published: February 2018

Aim

To assess Malaysians‘ knowledge of lung cancer and their willingness to undergo lung cancer screening.

Method

A cross‐sectional study was conducted in the general population using self‐administered questionnaires.

Results

A total of 385 responses were included in the analysis (55.3% female, 44.7% male; mean age 31.8 ± 12.8 years). The most commonly known risk factors for lung cancer were those related to tobacco exposure and air pollution. The average number of recognised signs/symptoms was 9.8 ± 3.1. In comparison to never‐smokers, current/ex‐smokers tend to perceive themselves at a higher risk of developing lung cancer (p < 0.0005) and 65.3% of the respondents held positive attitudes toward the effectiveness of early detection of lung cancer.

Conclusions

There is a low awareness of the non‐specific warning signs of lung cancer among the population. A substantial majority of the respondents were willing to participate in screening if they had been informed they were at high risk of developing lung cancer.
Outcomes of a pharmacist‐managed clinic for underserved persons with unmanaged type 2 diabetes mellitus
Authors: Lefebvre Ashley L. , Zullo Andrew R. , Dapaah‐Afriyie Ruth , Collins Christine M. , Elsaid Khaled A.
Published: February 2018

Background

A multidisciplinary approach is recommended for the management of type 2 diabetes mellitus (DM).

Aim

To evaluate the impact of a pharmacist intervention on haemoglobin A1c (HbA1c), systolic blood pressure (SBP), diastolic blood pressure (DBP), and diabetes‐related hospitalisations in an underserved cohort with unmanaged type 2 DM.

Methods

This analysis was a retrospective cohort study. Criteria for inclusion were persons with unmanaged type 2 DM defined as HbA1c values ≥8% at time of enrolment, ≥18 years old, and enrolment in a pharmacist‐managed clinic for ≥12 months. Pre‐ and post‐intervention differences in HbA1c, SBP and DBP values were assessed using repeated measures analysis of variance (ANOVA). The risk of diabetes‐related hospitalisations was estimated during the 12 months prior and during the 12 months post‐intervention, and the relative risk (RR) was calculated.

Results

Mean HbA1c values at 3, 6 and 12 months post‐intervention were lower than baseline values (p < 0.05). There was no significant difference in mean HbA1c values at 6 or 12 months compared to 3 months post intervention. Mean SBP values at 3, 6 and 12 months were lower than baseline (p < 0.05). Likewise, mean DBP values at 6 and 12 months were lower than baseline (p < 0.05). The estimated RR of diabetes‐related hospitalisations was 0.40 (95% CI: 0.20–0.83; p = 0.013).

Conclusion

Enrolment in a pharmacist‐managed diabetes program was associated with a significant reduction in HbA1c, SBP and DBP and reduction in risk of diabetes‐related hospitalisations in an underserved cohort of patients with diabetes over a 12‐month period.
Histopathological changes resulting from selective internal radiotherapy (SIRT)
Authors: Justinger Christoph , Gruden Juliana , Kouladouros Konstantinos , Stravodimos Christos , Reimer Peter , Tannapfel Andrea , Binnenhei Martin , Bentz Martin , Tatsch Klaus , Rüdiger Thomas , Schön Michael R.
Published: February 2018

Background

Selective internal radiotherapy (SIRT) has emerged as an effective therapy for patients with liver malignancies. Here, we report our analysis of histopathological changes in tumors and healthy liver tissue after SIRT and liver resection. Our main intent was to determine if specific histopathological changes occur in tumor and normal liver tissues.

Methods

We identified 17 patients in whom SIRT was applied to achieve liver resectability. Samples were taken from the resected liver tissue. The tumor, tumor peripheries, and tumor‐free tissue were examined microscopically.

Results

Microspheres were identified in the vascular tumor bed, tumor‐free liver, and portal tract. More microspheres were detected in the tumor than in the healthy liver tissue. When the effects of SIRT were analyzed, most patients showed a partial pathological response. Specific histopathological changes could not be described. We did not find any typical signs of radiation‐induced hepatitis in healthy liver tissue.

Conclusions

Our findings support the clinical experience of effective tumor control after SIRT together with minimal impairment of healthy liver tissue. The observed histopathological changes suggest that SIRT might play a role in preoperative downsizing of liver malignancies.
Histological expression of methionine adenosyl transferase (MAT) 2A as a post‐surgical prognostic surrogate in patients with hepatocellular carcinoma
Authors: An Jihyun , Na Seong Kyun , Shim Ju Hyun , Park Yang Soon , Jun Mi Jung , Lee Joo Ho , Song Gi‐Won , Lee Hac Chu , Yu Eunsil
Published: February 2018

Background and Objectives

Deregulation of methionine adenosyltransferase (MAT) is involved in hepatocarcinogenesis. This study aimed to investigate the prognostic implications of the level of histological MAT1A and MAT2A in patients with resected hepatocellular carcinoma (HCC).

Methods

A total of 210 patients with HCC who underwent curative resection between 2004 and 2011 were included. The levels of MAT proteins were immunohistochemically measured.

Results

MAT1A and MAT2A were over‐expressed in 134 (63.8%) and 124 (59.1%) of the 210 tumor tissues, respectively. Up‐regulation of tumoral MAT1A was independently associated with male gender, and inversely related to tumors >5 cm (adjusted odds ratios [OR] 2.59, P = 0.008, and OR 0.44, P = 0.012, respectively). Enhanced MAT2A expression was significantly related to age ≥60 years and serum AFP >200 ng/mL (OR 0.51, P = 0.030; and OR 2.65, P = 0.003; respectively). Tumoral MAT2A over‐expression independently predicted an increased rate of recurrence within 1 year after hepatectomy (adjusted hazard ratio [HR] 2.45, P = 0.012), but that was not the case for MAT1A expression (HR 0.90, P = 0.744). High MAT2A was also an independent predictor of early recurrence (HR 2.54, P = 0.034) in the subset of patients without microvascular invasion (n = 155).

Conclusions

Over‐expression of MAT2A in HCC may be a useful biomarker for predicting and monitoring tumor recurrence, especially early after hepatic resection.
Aortic Diameters and Mild Functional Aortic Regurgitation in Hypertensive and Normotensive People: Do They Carry the Same Meaning?
Authors: Vriz Olga , Bertin Nicole , Bossone Eduardo , Palatini Paolo
Published: February 2018

Objectives

The association between the aortic root diameter and aortic regurgitation in hypertensive and normotensive people is still disputed, and the underlying mechanisms remain to be clearly elucidated. We aimed to investigate the relationship between the aortic root diameter and trivial to mild functional aortic regurgitation in never‐treated hypertensive patients with a new diagnosis compared with healthy normotensive participants.

Methods

A total of 182 hypertensives and 232 age‐matched normotensives were included in the study. Anthropometric and office blood pressure (BP) measurements, echocardiography, and a carotid stiffness assessment were performed in all of the participants. Aortic measures for the annulus, sinuses of Valsalva, sinotubular junction, and ascending aorta were taken in late diastole according to the leading‐edge method.

Results

The mean age of all participants was 52 years. Hypertensive patients had a significantly higher body surface area, mean arterial pressure, and pulse pressure (P < .0001) than normotensive participants. Annulus and sinotubular junction diameters adjusted for confounders and indexed to the body surface area were significantly higher in normotensives than in hypertensives. The prevalence of functional aortic regurgitation was higher in hypertensives (34.8% versus 15.4%; P < .0001). Among the hypertensives, no difference in aortic diameters was found between patients with or without functional aortic regurgitation, whereas normotensives with functional aortic regurgitation had larger aortic root diameters. Aging and BP among the hypertensives were the main determinants of functional aortic regurgitation.

Conclusions

Hypertensive patients had a smaller indexed aortic root diameter than normotensive participants but had a higher prevalence of trivial to mild functional aortic regurgitation. The aging process is the main determinant of functional aortic regurgitation in both groups, but high BP also plays an important role in hypertensives.
Phosphorus recycling in deeply oxygenated sediments in Lake Superior controlled by organic matter mineralization
Authors: Li Jiying , Zhang Yishu , Katsev Sergei
Published: February 2018

Remobilization of phosphorus from aquatic sediments has been extensively investigated in systems prone to anoxia, while studies in well‐oxygenated systems have been rare. The recycling efficiency of P in the offshore sediments in the Great Lakes, in particular, is still poorly known. We investigated phosphorus cycling at 13 locations (26–318 m water depth) in oligotrophic Lake Superior where oxygen penetrates into sediments by 2–12 cm. Vertical distributions of iron and phosphorus were measured in porewater and solid fractions, and transformation rates and vertical fluxes were calculated. Whereas a significant fraction of P is bound to ferric Fe in surface sediments, P effluxes into the water column (2.5–7.0 μmol m−2 d−1) are only weakly affected by iron reduction, because Fe : P ratios in surface sediment are high (∼ 40–80 mol : mol), and P sorption capacity is far from its limit. In contrast to organic rich systems where P effluxes are sensitive to redox conditions, phosphate effluxes in organic‐poor well‐oxygenated Lake Superior are controlled by the rates of organic phosphorus mineralization, similar to marine sediments. The efficiency of P recycling in Lake Superior sediments, however, is substantially lower than in marine sediments due to different P biogeochemistry. Only ∼ 12% of deposited P is returned to the water column. While burial into sediments is the dominant sink for P in the lake, sediments still contribute up to 40% of total water column P inputs. Similar behavior should be expected in other well‐oxygenated freshwater systems, such as other large oligotrophic lakes.
Nitrogen uptake and nitrification in the subarctic North Atlantic Ocean
Authors: Peng Xuefeng , Fawcett Sarah E. , van Oostende Nicolas , Wolf Martin J. , Marconi Dario , Sigman Daniel M. , Ward Bess B.
Published: February 2018

Nitrification, the oxidation of ammonium to nitrite and then nitrate, is often discounted as a source of nitrate in euphotic zone waters due to photoinhibition of nitrifying microorganisms and/or competition for ammonium with phytoplankton. However, there have also been counterarguments that nitrification represents a significant “regenerated” nitrate source to phytoplankton, augmenting the “new” nitrate supplied via physical processes. If nitrification is an appreciable nitrate source in the euphotic zone, then the assumption of a balance between nitrate uptake and organic matter export will overestimate export production. We investigated the relative importance of nitrification and nitrate uptake in the subarctic North Atlantic in late spring and late summer. The rates and vertical distributions of primary production, nitrogen uptake, and ammonium and nitrite oxidation were determined through isotope tracer experiments and the distributions of the nitrogen and oxygen isotopes of nitrate. In surface waters, ammonium and nitrite oxidation rates were low, representing an average of 5.2% and 2.5% of total euphotic zone nitrate uptake, respectively. The nitrogen and oxygen isotopes of nitrate confirmed that nitrification was not significant within the euphotic zone. Comparison of the rates of nitrogen uptake and primary production showed that while springtime phytoplankton growth could be fully supported by new nitrate and recycled ammonium, up to 50% of summertime productivity was likely fueled by dissolved organic nitrogen (DON). Uptake of DON implies that the fraction of primary production exported from surface waters in the late summer was significantly lower than the measured nitrate and ammonium uptake rates suggest.
Inconsequential effects of flooding in 2014 on lakes in the Peace‐Athabasca Delta (Canada) due to long‐term drying
Authors: Remmer Casey R. , Klemt Wynona H. , Wolfe Brent B. , Hall Roland I.
Published: February 2018

Climate‐driven decline in freshwater supplied by rivers draining the hydrographic apex of western North America has ramifications for downstream ecosystems and society. For the Peace‐Athabasca Delta (PAD), floods from the Peace and Athabasca rivers are critical for sustaining abundant shallow water habitat, but their frequency has been in decline for decades over much of its area. Here, we assess current hydrological and limnological status in the PAD by integrating spatial and temporal data. Analysis of water isotope compositions and water chemistry measured at numerous lakes across the delta shows that hydro‐limnological effects of the large‐scale ice‐jam flood event of 2014 failed to persist beyond the early ice‐free season of 2015. Isotope‐inferred paleohydrological records from five hydrologically representative lakes in the PAD indicate that periodic desiccation during the Little Ice Age occurred at the most elevated basin in response to locally arid climatic conditions, yet other lower elevation sites were influenced by high water level on Lake Athabasca owing to increased snowmelt‐ and glacier‐derived river discharge. In contrast, water isotope data during the past 15 yr at all five lakes consistently document the strong role of evaporation, a trend which began in the early to mid‐20th century according to sediment records and is indicative of widespread aridity unprecedented during the past 400 yr. We suggest that integration of hydrological and limnological approaches over space and time is needed to inform assessment of contemporary lake conditions in large, complex floodplain landscapes.
Broadband Nonlinear Photonics in Few‐Layer MXene Ti3C2Tx (T = F, O, or OH)
Authors: Jiang Xiantao , Liu Shunxiang , Liang Weiyuan , Luo Shaojuan , He Zhiliang , Ge Yanqi , Wang Huide , Cao Rui , Zhang Feng , Wen Qiao , Li Jianqing , Bao Qiaoliang , Fan Dianyuan , Zhang Han
Published: February 2018

Studies of the nonlinear optical phenomena that describe the light‐matter interactions in 2D crystalline materials have promoted a diverse range of photonic applications. MXene, as a recently developed new 2D material, has attracted considerable attention because of its graphene‐like but highly tunable and tailorable electronic/optical properties. In this study, we systematically characterize the nonlinear optical response of MXene Ti3C2Tx nanosheets over the spectral range of 800 nm to 1800 nm. A large effective nonlinear absorption coefficient (βeff∼‐10−21 m2/V2) due to saturable absorption is observed for all of the testing wavelengths. The contribution of saturable absorption is two orders of magnitude higher than other lossy nonlinear absorption processes, and the amplitude of βeff strongly depends on the light bleaching level. A negative nonlinear refractive index (n2∼‐10−20 m2/W) with value comparable to that of the intensively studied graphene was demonstrated for the first time. These results demonstrate the efficient broadband light signal manipulating capabilities of Ti3C2Tx, which is only one member of the large MXene family. The capability of an efficient broadband optical switch is strongly confirmed using Ti3C2Tx as saturable absorbers for mode‐locking operation at 1066 nm and 1555 nm, respectively. A highly stable femtosecond laser with pulse duration as short as 159 fs in the telecommunication window is readily obtained. Considering the diversity of the MXene family, this study may open a new avenue to advanced photonic
devices.
Defining Optimal Surgical Treatment for Recurrent Hepatocellular Carcinoma: A Propensity Score Matched Analysis
Authors: Ma Ka Wing , Chok Kenneth Siu Ho , She Wong Hoi , Chan Albert Chi Yan , Cheung Tan To , Dai Wing Chiu , Fung James Yan Yue , Lo Chung Mau
Published: February 2018

Salvage liver transplantation (sLT) and repeated resection (RR) are effective treatments for recurrent hepatocellular carcinoma (HCC), and comparisons of the oncological outcomes between these 2 modalities were scarce. Consecutive patients admitted for either sLT or RR for recurrent HCC were recruited. All patients in the present series received either prior hepatectomy, ablative therapy, or both before RR or sLT. Patient demographic, perioperative, and outcome data were analyzed. A survival analysis was performed after propensity score matching. There were 277 eligible patients recruited, and 67 and 210 of them underwent sLT and RR, respectively. Significant differences in preoperative hemoglobin, albumin, Model of End‐Stage Liver Disease (MELD) score, and tumor number were found between the sLT and RR groups. After 1:3 propensity score matching, there were 36 sLT and 108 RR patients for comparison. The median age, MELD, alpha fetoprotein, and tumor size and number of the matched population were 57 years, 7.5, 16 ng/mL, 2.5 cm, and 1, respectively. There was no difference in the hospital mortality and complication rate (Clavien IIIa or above) between the groups. The recurrence rate after RR was significantly higher than for the patients who received sLT (72.2% versus 27.8%; P < 0.001). Following RR, 3 patients received liver transplantation for further recurrence, and 54.6% of the patients developed nontransplantable recurrence. The 5‐year disease‐free survival (DFS) and overall survival (OS) were both superior in the sLT group (DFS, 71.6% versus 32.8%, P < 0.001; OS, 72.8% versus 48.3%, P = 0.007). In conclusion, sLT is superior to RR for treatment of recurrent HCC in terms of DFS and OS. The high rate of nontransplantable recurrence after reresection underscores the importance of timely sLT.
Improving Growth for Infants ≤1250 Grams Receiving an Exclusive Human Milk Diet
Authors: Huston Robert K. , Markell Andrea M. , McCulley Elizabeth A. , Gardiner Stuart K. , Sweeney Sean L.
Published: February 2018

Background

An exclusive human milk diet (EHM) fortified with human milk‐based fortifier decreases necrotizing enterocolitis (NEC) compared to maternal milk supplemented with preterm formula and bovine fortifier (PTF). Growth has been less with EHM and also maternal milk supplemented with donor human milk and bovine fortifier (HMBF). The objective was to evaluate the effect of a standardized feeding protocol on the growth of infants ≤1250 g birth weight supported with EHM and HMBF. The effect on the incidence of NEC was also evaluated.

Design/Methods

A retrospective study of growth before and after implementation of a feeding protocol for infants who received either EHM or HMBF. Primary outcomes were weight, length, and head circumference gain velocities from birth to discharge. The incidence of NEC was also recorded.

Results

Analysis of covariance for 379 total infants showed that earlier day of life for fortification to 24 Kcal/oz was associated with increased weight gain (p = 0.0166) and length gain (p = 0.0064). Implementation of the feeding protocol was associated with increased head circumference gain (p = 0.006). EHM was associated with decreased incidence of NEC (p = 0.0302).

Conclusions

Implementation of a standardized feeding protocol including earlier fortification of maternal milk was associated with improved growth for infants receiving human milk feedings. EHM significantly decreased NEC. Earlier fortification had no effect on NEC.