bluuebunny/crossref_metadata_2025 huggingface dataset:
Synthesis of bismaleate pentaerythritol ester and its application as PVC auxiliary heat stabilizer
Authors: Gao Xinxin , Jiang Pingping , Zhang Zheming , Li Zhenhua , Li Yuchao , Leng Yan , Zhang Pingbo
Published: October 2021

Diethylene glycol and maleic anhydride are used as raw materials to prepare bismaleic acid dibasic acid without catalyst. This intermediate product reacts with pentaerythritol (PER) to obtain bismaleate pentaerythritol (MDPP) as an auxiliary heat stabilizer. The structure of the product was verified by Fourier infrared test and hydrogen nuclear magnetic spectrum analysis. The ether bond, ester group, carbon–carbon double bond, polyol, and other characteristic structures contained in the molecule can improve thermal stability. Therefore, it can be used as an auxiliary heat stabilizer for PVC and used in combination with the main heat stabilizer. In order to verify the thermal stability performance and further analyze the thermal stability mechanism, testing methods such as thermal aging, Congo red, thermal weight loss, and electrical conductivity were adopted. The results show that when MDPP is added together with calcium/zinc stearate, the thermal stability of PVC is the best. The initial whiteness can reach 40 min, and the static stabilization time is 65 min, which is 15 min higher than the PVC sample with PER and calcium/zinc stearate. It can be seen that MDPP has greatly improved performance compared with the commercial auxiliary heat stabilizer PER.
Highly effective utilization of vinyl copolymer as filtrate reducer of water‐bentonite drilling fluid under ultrasonic oscillations
Authors: Guo Wen‐Yu , Peng Bo
Published: October 2021

The water‐bentonite drilling fluids incorporating the terpolymer of acrylic acid, acrylamide, and 2‐acrylamide‐2‐methyl propane sulfonic acid were prepared by common mechanical agitation of industrial community with superposition of ultrasound. Various performances of the drilling fluids in the absence and presence of ultrasonic oscillations were evaluated, including fluid loss, rheology, mud cake thickness, and surface appearance, adsorptive capacity of terpolymer on bentonite clay as well as clay particle size and distribution. The results showed that the filtrate volume and mud cake thickness as well as rheological values presented downtrend with the increase of ultrasonic time or power. Scanning electron microscope showed that the more smooth‐faced and compact mud cake was formed after ultrasonic oscillations. The analysis of clay particle size confirmed that ultrasonic oscillations could reduce the average particle diameter and broaden the particle size distribution, along with the appearance of ultra‐tiny clay particle components. Adsorbed amount of terpolymer on bentonite was enhanced with introduction of ultrasonic oscillations (as confirmed by total organic carbon analysis). The ultrasound‐induced dispersion and adsorption stemmed from acoustic cavitation and could cooperate with each other, together improving filtration properties.
Electroacupuncture restores intestinal mucosal barrier through TLR4/NF‐κB p65 pathway in functional dyspepsia‐like rats
Authors: Wang Dan , Zhang Jinling , Yang Daye , Wang Junying , Li Jia , Han Yongli , Kang Zhaoxia , Zhang Hongxing
Published: October 2021

Functional dyspepsia (FD) is a common functional gastrointestinal disorder with high morbidity. Electroacupuncture (EA) has been applied to treat FD for a long time. The aim of this study was to investigate the effects of EA and its mechanism about intestinal mucosal barrier in rodent model of FD. Male Sprague–Dawley rats were randomly divided into the control group and the model group. Then, the rats in model group were established to the FD model by multifactor interventions. In Experiment 1, qualified FD‐like rats were randomly divided into three groups: FD, EA, and acupuncture (AP) groups. The interventions of EA and AP lasted 14 days, food intake, and body weight were recorded every 5 days. In Experiment 2, qualified FD‐like rats were randomly divided into five groups: FD, EA, AP, EA + TAK242, and TAK242 groups. The interventions of EA and AP lasted 14 days, while TAK242 injection continued for 6 days. The rats were sacrificed for the measurement of serum Interleukin‐ 6 (IL‐6) and Tumor necrosis factor‐α (TNF‐α) assayed by ELISA. Western blotting was used to assess the expression of TLR4, Myd88, NF‐κB p65, p‐NF‐κB p65, TRAF6, ZO‐1, and occludin in the duodenum. The transmission electron microscope was used to observe the ultrastructure of intestinal epithelial cells. Compared with the rats in the group FD, the rats in EA group had significantly increase of body weight, food intake, and protein expressions of ZO‐1 and occludin, while expressions of TLR4, Myd88, NF‐κB p65, p‐NF‐κB p65, TRAF6 in the duodenum and IL‐6, and TNF‐α in serum were decreased. The EA + TAK242 treatment had similar effects to the EA treatment but with increased potency; compared with EA, AP showed similar but reduced effects. Our data demonstrated that EA is more effective than AP in improving intestine mucosal barrier. The possible mechanisms of EA may involve the TLR4/NF‐κB p65 pathway.
Evaluation of the online learning of veterinary anatomy education during the Covid‐19 pandemic lockdown in Egypt: Students' perceptions
Authors: Mahdy Mohamed A. A. , Sayed Ramy K. A.
Published: October 2021

The sudden shift of veterinary anatomy teaching from traditional to online mode during the coronavirus disease 2019 (Covid‐19) pandemic lockdown was a major challenge used for the first time in Egyptian veterinary medical schools. This study aimed to evaluate the students' perspectives regarding the shift of veterinary anatomy teaching to online mode during the lockdown in Egypt. A total of 502 students from all veterinary medical schools in Egypt (n = 17) answered the questionnaire. The results revealed that nearly two‐thirds of students felt enthusiastic about studying anatomy online during the pandemic. Moreover, approximately 63% of students were satisfied with the provided learning materials, 66% were able to understand anatomy using the online learning system during the lockdown period, 67% were comfortable with technological skills during their online study, and 47% believed that online learning of anatomy could replace face‐to‐face teaching. Therefore, despite the problems associated with the emergency switch to remote teaching, it appears to be a suitable alternative in teaching veterinary anatomy in Egyptian universities during this pandemic crisis in Egyptian universities. Moreover, the study provided several measurements to overcome the common problems associated with this challenging method for future application, such as providing three‐dimensional virtual tools and electronic devices with either free or low‐priced Internet packages, and measuring students' understanding before and after each lecture. This is the first study to solicit the early students' feedback regarding the emergency shift to online veterinary anatomy teaching which might help decision‐makers in Egypt for future implementation of online learning of veterinary anatomy.
Antisolvent‐assisted Crystallization of Centimeter‐sized Lead‐free Bismuth Bromide Hybrid Perovskite Single Crystals with X‐ray Sensitive Merits
Authors: Xu Yaxin , Hu Jiarui , Du Xinyuan , Xiao Xinglin , Li Mingkai , Tang Jiang , Chen Junnian , He Yunbin
Published: October 2021

Hybrid bismuth halides perovskites have emerged as promising candidates for X‐ray detection, due to the strong absorptivity of high‐energy X‐ray photons, high resistivity, large carrier diffusion length and low toxicity. However, the mostly investigated hybrid bismuth iodides single crystals are usually opaque and require a harsh synthesis process. Herein, novel one‐dimensional (1D) pentamethylenediamine bismuth bromide (PDA)BiBr5 single crystals were synthesized via an antisolvent‐assisted crystallization method at room temperature. Bulk (PDA)BiBr5 single crystals have sizes of 10×1.3×1.5 mm3 and high transparency. They are shown to have low density of defects of 2.0×1010 cm−3 and obvious photoconductivity. Moreover, they exhibit large bulk resistivity of 2.13×1011 Ω cm and good X‐ray attenuation coefficient. Consequently, the vertical structured (PDA)BiBr5 single crystal X‐ray photoconductor produces a sensitivity of 3.8 μC Gyair−1 cm−2. This study provides a facile strategy for synthesizing bulk hybrid bismuth bromides single crystals with potential X‐ray detection application.
Production of photoluminescent transparent poly(methyl methacrylate) for smart windows
Authors: El‐Newehy Mohamed H. , Kim Hak Yong , Khattab Tawfik A. , El‐Naggar Mehrez E.
Published: October 2021

Photochromic and long‐lasting photoluminescent transparent, rigid, ultraviolet (UV) protective and superhydrophobic poly(methyl methacrylate) (PMMA) plastic able to switch colour beneath UV irradiation was developed. Photoluminescent transparent PMMA plastic was prepared by the simple polymerization process of methyl methacrylate immobilized with alkaline earth aluminate (AEA) nanoparticles. These colourless PMMA plastic substrates showed a colour switch to greenish underneath UV light as proved using CIELAB screening. The morphology of AEA was evaluated using transmission electron microscopy. Conversely, transparent PMMA samples were evaluated using energy‐dispersive X‐ray spectra, scanning electron microscope, X‐ray fluorescence spectroscopy and for hardness properties. Additionally, the photoluminescence properties were explored by studying excitation and emission spectra. The produced luminescence colourless PMMA plastic substrates displayed excitation band at 370 nm, and three emission peaks at 433, 494 and 513 nm. Photoluminescent PMMA with lower contents of AEA showed fast and reversible photochromism under UV light, while PMMA samples with higher contents of AEA showed long‐lasting luminescence such as a flashlight with the ability to replace electric power. The findings showed that the produced photoluminescence colourless PMMA plastic substrates exhibited enhanced UV shielding and superhydrophobicity.
Marginal improvement in survival among patients diagnosed with metastatic prostate cancer in the second‐line antiandrogen therapy era
Authors: Kim Isaac E. , Jang Thomas L. , Kim Sinae , Lee David Y. , Kim Daniel D. , Singer Eric A. , Ghodoussipour Saum , Stein Mark N. , Aron Monish , Dall’Era Marc A. , Yi Kim Isaac
Published: October 2021

Since 2004, multiple blockbuster drugs have been approved for men with metastatic prostate cancer. Nevertheless, it has been reported that no improvement in survival was observed between 2004 and 2009. Herein, we have analyzed the SEER database to assess the survival outcome of metastatic prostate cancer patients since 2000. The results demonstrated that there was an improvement in both overall and prostate cancer‐specific survival for 4 months among men diagnosed with metastatic prostate cancer from 2010 to 2016 when compared to those in the pre‐2010 period. Interestingly, this survival benefit was limited to patients with bone and visceral metastasis (M1b and M1c stages). Collectively, our observation suggests that despite the new treatment agents such as second‐line antiandrogen therapies introduced in the modern era, the improvement in survival of metastatic prostate cancer patients has been surprisingly small.
Psychological helpline in response to the COVID‐19 pandemic in the Dominican Republic
Authors: Sosa Lovera Angelina , Ureña Ana Jacqueline , Arias Josefina , Araujo Rodríguez Amarilis , Canario Guzmán Julio Arturo
Published: October 2021

The global health emergency due to COVID‐19 is a disruptive event that has had various effects on mental health. Given this emergency, the Dominican Republic intervened to mitigate the negative impact of the pandemic, considering the physical isolation decreed in the country. In this context, the Autonomous University of Santo Domingo and the School of Psychology designed the UASD COVID‐19 Psychological Helpline. The objective of this article is to describe the development, implementation and evaluation of a programme of psychological first aid. The programme aimed to attenuate the impact of morbidity and mortality due to mental health issues associated with the COVID‐19 pandemic through mobile technology. There were 62 psychologists involved and trained to provide care, and a protocol was developed, implemented, monitored and evaluated. Over the course of four months, the programme assisted 497 people. The average age of the participants was 32 years, and 73% were women. The reasons for contacting the helpline included anxiety, stress, depression, domestic violence, suicidal behaviours and other behavioural problems. Following the intervention, most users reported feeling satisfied and having improved emotions. The first psychological aid in the country developed through telephone and chat messaging was an optimal resource since face‐to‐face interaction was not possible. It also reached more people and reduced the attention gap.
Comprehensive Mechanism of CO2 Electroreduction on Non‐Noble Metal Single‐Atom Catalysts of Mo2CS2‐MXene
Authors: Li Neng , Wang Xiao , Lu Xuelian , Zhang Peng , Ong Wee‐Jun
Published: October 2021

In this work, a series of non‐noble metal single‐atom catalysts of Mo2CS2‐MXene for CO2 reduction were systematically investigated by well‐defined density‐functional‐theory (DFT) calculations. It is found that nine types of transitional metal (TM) supported Mo2CS2 (TM‐Mo2CS2) are very stable, while eight can effectively inhibit the competitive hydrogen evolution reaction (HER). After comprehensively comparing the changes of free energy for each pathway in CO2 reduction reaction (CO2RR), it is found that the products of TM‐Mo2CS2 are not completely CH4. Furthermore, Cr‐, Fe‐, Co‐ and Ni‐Mo2CS2 are found to render excellent CO2RR catalytic activity, and their limiting potentials are in the range of 0.245–0.304 V. In particular, Fe‐Mo2CS2 with a nitrogenase‐like structure has the lowest limiting potential and the highest electrocatalytic activity. Ab initio molecular dynamics (AIMD) simulations have also proven that these kinds of single‐atom catalysts with robust performance could exist stably at room temperature. Therefore, these single TM atoms anchored on the surface of MXenes can be profiled as a promising catalyst for the electrochemical reduction of CO2.
New pharmaceuticals approved by FDA in 2020: Small‐molecule drugs derived from amino acids and related compounds
Authors: Liu Aiyao , Han Jianlin , Nakano Arina , Konno Hiroyuki , Moriwaki Hiroki , Abe Hidenori , Izawa Kunisuke , Soloshonok Vadim A.
Published: October 2021

Amino acids (AAs) play an important role in the modern health industry as key synthetic precursors for pharmaceuticals, biomaterials, biosensors, and drug delivery systems. Currently, over 30% of small‐molecule drugs contain residues of tailor‐made AAs or derived from them amino‐alcohols and di‐amines. In this review article, we profile 12 AA‐derived new pharmaceuticals approved by the FDA in 2020. These newly introduced drugs include Tazverik (epithelioid sarcoma), Gemtesa (overactive bladder), Zeposia (multiple sclerosis), Byfavo (induction and maintenance of procedural sedation), Cu 64 dotatate, and Gallium 68 PSMA‐11 (both PET imaging), Rimegepant (acute migraine), Zepzelca (lung cancer), Remdesivir (COVID‐19), Amisulpride (nausea and vomiting), Setmelanotide (obesity), and Lonafarnib (progeria syndrome). For each compound, we describe the spectrum of biological activity, medicinal chemistry discovery, and synthetic preparation.
C3H6/C3H8 Adsorption Behavior Study of Stiffened ZIF‐8 Prepared under an Electric Field
Authors: Lyu Luxi , Wu Houxiao , Li Libo , Wei Yanying , Wang Haihui
Published: October 2021

Metal‐organic frameworks (MOFs) show great potential for adsorption separation. However, MOFs' flexibility may influence their adsorption behaviors. Here, for the first time we prepare ZIF‐8 powder dominated with stiffened ZIF‐8_Cm phase under an external E‐field. By comparison, we find that the flexibility of ZIF‐8 has little influence in equilibrium‐based separation behavior for C3H6/C3H8. However, the stiffened ZIF‐8 formed in E‐field presents an obviously decreased diffusion rate for C3H8, whose C3H6/C3H8 kinetic‐based separation factor is around 2.5 times higher than that of the traditional ZIF‐8 powder.
High Fluorescence Porous Organic Cage for Sensing Divalent Palladium Ion and Encapsulating Fine Palladium Nanoparticles
Authors: Ren Huimin , Liu Chao , Ding Xu , Fu Xianzhang , Wang Hailong , Jiang Jianzhuang
Published: October 2021

Comprehensive Summary

Porous organic cages (POCs) as an innovative type of porous molecular materials enable multifunctional applications. Herein, a fluorescence POC (denoted as 1) has been constructed by means of 5,5'‐((2,5‐dimethoxy‐1,4‐phenylene)bis(ethyne‐2,1‐diyl))diisophthalaldehyde condensing with cyclohexanediamine enantiomer with the aid of trifluoroacetic acid. 1 exhibits the permanent void and prominent fluorescence with relative quantum yield of 73% confirmed by gas sorption and emission experiments, respectively. Moreover, this organic cage is capable of sensing diavalent Pd2+ according to the fluorescence response to the addition of various metal ions. The dispersion of 1 in methanol containing palladium acetate was stirred at 25 oC and then 80 oC to reduce Pd2+ ions into nanoparticles (NPs), leading to the composite (Pd@1) composed of fine Pd NPs with the size of ca. 1.8 nm. The catalytic nature of Pd@1 over NaBH4 promoted the degeneration of nitrobenzene and congo red. This work introduces one new case of POCs with versatile properties and functions, including ion fluorescence recognition, fine Pd NPs stabilizer, and gas adsorption, enriching the family of POC‐based materials.
A novel four‐tier software‐defined network architecture for scalable secure routing and load balancing
Authors: Hongvanthong Sisamouth , Chunlin Li
Published: October 2021

Software‐defined networking is an emerging paradigm for supporting flexible network management. In the traditional architecture for a software‐defined network (SDN), the controller commonly uses a general routing algorithm such as Open Shortest Path First (OSPF), which chooses the shortest path for communication. This may cause the largest amount of network traffic, especially in large‐scale environments. In this paper, we present the design for a novel SDN‐based four‐tier architecture for scalable secure routing and load balancing. In Tier 1, user authentication is conducted using elliptic curve cryptography (ECC); this avoids unnecessary loads from unauthorized users. In Tier 2, packet classification is performed based on the packet characteristics using the fuzzy analytical hierarchy process (fuzzy AHP), and packets are placed into three individual queues. In Tier 3, scalable secure routing is achieved by selecting the optimal path using the improved particle swarm optimization and ant colony optimization algorithms. With these optimization algorithms, we can adaptively change the number of users, the number of switches, and other parameters. In Tier 4, the recommended secure cluster (multicontroller) management is accomplished using an algorithm that employs modified k‐means clustering and a recurrent neural network. Deep reinforcement learning (DRL) is also proposed for updating the controller information. Experimental results are analyzed using the OMNeT++ network simulator, and the evaluated performance displayed improvement over a variety of existing methods in terms of response time (50% to 60%), load (55%), execution time (3.2%), throughput (9.8%), packet loss rate (1.02%), end‐to‐end delay (50%), and bandwidth consumption (45%).
Seasonal and diel movement patterns of brown bears in a population in southeastern Europe
Authors: Bogdanović Neda , Hertel Anne G. , Zedrosser Andreas , Paunović Milan , Plećaš Milan , Ćirović Duško
Published: October 2021

Most animals concentrate their movement into certain hours of the day depending on drivers such as photoperiod, ambient temperature, inter‐ or intraspecific competition, and predation risk. The main activity periods of many mammal species, especially in human‐dominated landscapes, are commonly set at dusk, dawn, and during nighttime hours. Large carnivores, such as brown bears, often display great flexibility in diel movement patterns throughout their range, and even within populations, striking between individual differences in movement have been demonstrated. Here, we evaluated how seasonality and reproductive class affected diel movement patterns of brown bears of the Dinaric‐Pindos and Carpathian bear populations in Serbia. We analyzed the movement distances and general probability of movement of 13 brown bears (8 males and 5 females) equipped with GPS collars and monitored over 1–3 years. Our analyses revealed that movement distances and probability of bear movement differed between seasons (mating versus hyperphagia) and reproductive classes. Adult males, solitary females, and subadult males showed a crepuscular movement pattern. Compared with other reproductive classes, females with offspring were moving significantly less during crepuscular hours and during the night, particularly during the mating season, suggesting temporal niche partitioning among different reproductive classes. Adult males, solitary females, and in particular subadult males traveled greater hourly distances during the mating season in May‐June than the hyperphagia in July–October. Subadult males significantly decreased their movement from the mating season to hyperphagia, whereas females with offspring exhibited an opposite pattern with almost doubling their movement from the mating to hyperphagia season. Our results provide insights into how seasonality and reproductive class drive intrapopulation differences in movement distances and probability of movement in a recovering, to date little studied, brown bear population in southeastern Europe.
Temporal variability in population and community dynamics
Authors: Dallas Tad A. , Kramer Andrew M.
Published: October 2021

Populations and communities fluctuate in their overall numbers through time, and the magnitude of fluctuations in individual species may scale to communities. However, the composite variability at the community scale is expected to be tempered by opposing fluctuations in individual populations, a phenomenon often called the portfolio effect. Understanding population variability, how it scales to community variability, and the spatial scaling in this variability are pressing needs given shifting environmental conditions and community composition. We explore evidence for portfolio effects using null community simulations and a large collection of empirical community time series from the BioTIME database. Additionally, we explore the relative roles of habitat type and geographic location on population and community temporal variability. We find strong portfolio effects in our theoretical community model, but weak effects in empirical data, suggesting a role for shared environmental responses, interspecific competition, or a litany of other factors. Furthermore, we observe a clear latitudinal signal – and differences among habitat types – in population and community variability. Together, this highlights the need to develop realistic models of community dynamics, and hints at spatial, and underlying environmental, gradients in variability in both population and community dynamics.
Application of Transition Metal‐Catalyzed Decarbonylation of Aldehydes in the Total Synthesis of Natural Products
Authors: Selaković Života , Nikolić Andrea M. , Ajdačić Vladimir , Opsenica Igor M.
Published: October 2021

Decarbonylation is an invaluable reaction, utilized by nature and chemists alike. In different life forms, such as prokaryotes, plants and animals, this transformation is catalyzed by aldehyde decarbonylases. In the laboratory, the transition metal‐catalyzed (TMC) decarbonylation, which was first achieved in 1959, is by and large the dominant way for conducting this reaction. The carbon‐carbon bond cleavage is most often made possible by RhCl(PPh3)3 i. e. Wilkinson's catalyst, but other metals are also used, both in academia and in industry. In this review, we chose to present the applications of TMC decarbonylation in the synthesis of natural products and their derivatives. More than 30 examples are showcased and categorized into three categories based on the essence of the role of the aldehyde group in the synthesis. A short outlook is given in the end, listing the different advantages and disadvantages of Wilkinson's catalyst, as well as offering a brief prospect for the future.
Vibrations of flexible pylons with time‐dependent mass attachments under ground induced motions
Authors: Manolis George D. , Dadoulis Georgios I.
Published: October 2021

This work examines how mass attachments that vary with time influence the motion of flexible pylons undergoing ground‐induced vibrations. Specifically, an analytical solution is derived for a time‐dependent, lumped mass attachment placed at the top of a cantilevered pylon undergoing time‐harmonic longitudinal vibrations. At first, the solution to the governing equation of motion entails the recovery of the eigenvalue problem in the presence of a fixed mass. This is then followed by a generalization of this solution to allow for mass variability with time. It is noted that modal analysis no longer yields an uncoupled system of equations for the generalized coordinates, this necessitating a second step modal analysis, which is complicated by the fact that the system matrices are now time dependent. Results are presented in terms of time histories and frequency plots for the pylon displacement amplitude at the top, resulting from harmonic base motion of unit amplitude. The aim is to identify the frequency range over which the presence of a time‐varying mass is either beneficial or detrimental in minimizing the pylon's kinematic response. Since the rate of change of the mass can be either positive or negative, the special cases of constant mass and of no mass can be recovered from the solution. Finally, this methodology can be generalized to include transverse and rotational vibrations of flexible pylons.
Anti‐inflammatory activity of cyanidin‐3‐O‐glucoside and cyanidin‐3‐O‐glucoside liposomes in THP‐1 macrophages
Authors: Hao Xuefang , Guan Rongfa , Huang Haizhi , Yang Kai , Wang Lina , Wu Yuanfeng
Published: October 2021

Cyanidin‐3‐O‐glucoside (C3G) is a kind of water‐soluble pigment widely existing in many plants. It has strong antioxidant and anti‐inflammatory activities. However, C3G cannot exist stably for a long time because of the phenolic hydroxyl groups in its structure. Liposome technology could improve the stability and bioavailability of compounds. Based on our previous studies, C3G liposomes prepared by ethanol injection method have a certain stability in two weeks of storage. In this study, THP‐1 macrophages treated with C3G and C3G liposomes can reduce the levels of inflammatory‐related factors, such as tumor necrosis factor‐a (TNF‐a), interleukin (IL)‐1β, IL‐6, and IL‐8, stimulated by lipopolysaccharide (LPS). Further studies showed that the LPS induction could increase the level of phosphorylated nuclear transcription factor NF‐κB and phosphorylated IkBa, while C3G and C3G liposomes could inhibit the expression of phosphorylated proteins. Moreover, C3G and C3G liposomes could protect macrophages from apoptosis. In conclusion, C3G prepared by liposome technology exhibits anti‐inflammatory activity, which provides a theoretical basis for the food industry to study functional food.
The association of pretreatment low skeletal muscle mass with chemotherapy dose‐limiting toxicity in patients with head and neck cancer undergoing primary chemoradiotherapy with high‐dose cisplatin
Authors: Bril Sandra I. , Al‐Mamgani Abrahim , Chargi Najiba , Remeijer Peter , Devriese Lot A. , de Boer Jan Paul , de Bree Remco
Published: October 2021

Background

Low skeletal muscle mass (SMM) is an adverse prognostic factor for chemotherapy dose‐limiting toxicity (CDLT). In patients with locally advanced head and neck squamous cell carcinoma (HNSCC) undergoing chemoradiotherapy (CRT), low SMM is a predictor for CDLT. We aimed to validate these findings.

Methods

Consecutive LA‐HNSCC patients treated with primary CRT with high‐dose cisplatin were retrospectively included. SMM was measured on pre‐treatment CT‐imaging. A cumulative cisplatin dose below 200 mg/m2 was defined as CDLT.

Results

One hundred and fifty three patients were included; 37 (24.2%) experienced CDLT, and 84 had low SMM (54.9%). Patients with low SMM experienced more CDLT than patients with normal SMM (35.7% vs. 10.1%, p < 0.01). Low SMM (OR 3.99 [95% CI 1.56–10.23], p = 0.01) and an eGFR of 60–70 ml/min (OR 5.40 [95% CI 1.57–18.65], p < 0.01) were predictors for CDLT.

Conclusion

Pre‐treatment low SMM is associated with CDLT in LA‐HNSCC patients treated with primary CRT. Routine SMM assessment may allow for CDLT risk assessment and treatment optimization.
Cost‐effectiveness analysis of vaginal misoprostol versus dinoprostone pessary: A non‐inferiority large randomized controlled trial in France
Authors: Mounie Michael , Costa Nadège , Gaudineau Adrien , Molinier Laurent , Vayssière Christophe , Derumeaux Hélène
Published: October 2021

Objective

To assess the cost‐effectiveness of vaginal misoprostol (PGE1; 25 μg) compared with a slow‐release dinoprostone (PGE2) pessary (10 μg) for labor induction due to an unfavorable cervix at term.

Methods

We used data from an open‐label multicenter, randomized non‐inferiority trial that recruited women for whom labor was induced for medical reasons. The incremental cost‐effectiveness ratio was assessed from the payer's perspective, with the focus on inpatient care costs and using the cesarean deliveries avoided (CDA) rate as the primary analysis and the rate of vaginal delivery within 24 h (VD24) as the secondary analysis.

Results

Analyses were based on 790 women in each group. Differences between treatment arms were the mean cost per patient of €4410 and €4399, a CDA rate of 80.1% and 77.9% and a VD24 rate of 46.1% and 59.4% for dinoprostone and misoprostol, respectively. Dinoprostone is not cost‐effective according to the CDA rate and misoprostol was either a cost‐effective or a dominant strategy according to the VD24.

Conclusion

Misoprostol and dinoprostone have equal cost management with mixed efficacy according to the clinical outcome used. Finally, misoprostol may be an attractive option for hospitals as the price is lower and it is easier to use.

Trial registration

ClinicalTrials.gov: NCT01765881. URL: https://clinicaltrials.gov/ct2/show/NCT01765881. ClinicalTrialRegistrer.eu: 2011–000933–35. URL: https://www.clinicaltrialsregister.eu/ctr‐search/trial/2011‐000933‐35/FR.
Telemedicine facilitates surgical training in placenta accreta spectrum
Authors: Nieto‐Calvache Albaro Jose , Palacios‐Jaraquemada Jose Miguel , Aguilera Lorgio Rudy , Arriaga William , Colonia Alejandro , Aryananda Rozi Aditya , Nieto‐Calvache Alejandro Solo , Maya Juliana , Vergara‐Galliadi Lina Maria , Messa Bryon Adriana
Published: October 2021

Objective

The training of groups responsible for managing patients with placenta accreta spectrum (PAS) is complex because of the lack of hospitals with a high flow of patients and absence of formal educational programs. We report here the results of a virtual training program (VTP) that implemented one‐step conservative surgery (OSCS).

Methods

A prospective observation study of OSCS VTP between three expert groups and PAS reference hospitals without experience in OSCS was performed. Accessible or cost‐efficient web meeting platforms were used to implement the VTP components: baseline observation of the participant's prior knowledge; instructions about essential PAS surgery topics; case selection and joint planning of surgery; expert group “telepresence” during surgery and postoperative debriefing.

Results

One‐step conservative surgery was performed successfully at six hospitals. All patients had increta/percreta with a median intraoperative bleeding of 1300 ml (IQR 825–2325) and surgical time of 184 min (IQR 113–240). All groups considered the VTP very useful (n = 33, 97%) or useful (n = 1, 3%), they would use it again (definitely: n = 27, 81.8%; or probably: n = 6, 18.2%), and they would recommend it to other colleagues.

Conclusion

Tele education and telepresence during PAS surgery facilitates the implementation of OSCS in selected cases.
Knowledge, attitudes, and practices of pharmacists in caring for patients with substance use disorders
Authors: Mihic Tamara , Ng Joan C. Y. , Yong Alison , Yee Anna , Siu Jacky T. P.
Published: October 2021

Background

While pharmacists are optimally positioned to help provide support for those with substance use disorders (SUD), little is known about their knowledge, attitudes, and practices in this area.

Objectives

The primary objective of this study is to assess the knowledge, attitudes, and practices of hospital pharmacists in caring for patients with SUD. The secondary objectives are to identify barriers and facilitators that exist in the current work environment and evaluate how these factors play a role in pharmacists' practice.

Methods

An anonymous, cross‐sectional, online survey of 770 pharmacists employed by Lower Mainland Pharmacy Services in British Columbia was conducted. The survey was comprised of 27 questions, including a mix of qualitative and quantitative questions. The domains of questions explored pharmacists' knowledge of SUD, attitudes toward provincial harm reduction policies, and care provided for different SUD.

Results

A total of 127 pharmacists (16.5%) responded to the survey. Seventy‐two percent of pharmacists received less than 5 hours of schooling on SUD and less than 7% of pharmacists reported feeling adequately prepared by their formal education to care for patients with SUD. Less than a quarter of pharmacists report regularly monitoring and recommending treatment options for patients with SUD. Most pharmacists expressed interest in some form of SUD courses that could help to improve patient care.

Conclusion

In this study of pharmacists, the majority of hospital pharmacists felt unprepared to care for patients with SUD, but expressed interest in education that could help to improve their knowledge and skills.
Renoprotective mechanisms of sodium‐glucose co‐transporter 2 (SGLT2) inhibitors against the progression of diabetic kidney disease
Authors: Ravindran Sreenithya , Munusamy Shankar
Published: October 2021

Sodium‐glucose co‐transporter 2 inhibitors (SGLT2‐Is) have emerged as a promising class of antidiabetic drugs with cardioprotective and renoprotective effects in patients with type 2 diabetes (T2D). The sodium‐glucose co‐transporters 1 and 2 (SGLT 1 and SGLT2) located in the renal proximal tubules are responsible for glucose reabsorption from the glomerular filtrate back into the systemic circulation. Inhibition of SGLT2, which accounts for about 90% of the glucose reabsorption, leads to a significant reduction in blood glucose levels and a concomitant increase in the urinary excretion of glucose (glycosuria). Multiple mechanisms contribute to the nephroprotective effects of SGLT2‐Is in T2D patients. These include: (1) Restoration of the tubuloglomerular feedback by increasing sodium delivery at macula densa, leading to afferent arteriolar constriction and reduced glomerular hyperfiltration, (2) Decreased activation of the intra‐renal renin‐angiotensin‐aldosterone system, which also contributes to reducing glomerular hyperfiltration, (3) Increased production of ketone bodies, which serves as an alternate fuel for adenosine triphosphate production in mitochondria, which helps in attenuating inflammation, and (4) Protection against hypoxia, oxidative stress, and fibrosis. This review elaborates on the key mechanisms that underlie the nephroprotective effects and the adverse effects of SGLT2‐Is in T2D patients with progressive diabetic kidney disease.
Parametric and Nonparametric Methods in Population Pharmacokinetics: Experts’ Discussion on Use, Strengths, and Limitations
Authors: Goutelle Sylvain , Woillard Jean‐Baptiste , Buclin Thierry , Bourguignon Laurent , Yamada Walter , Csajka Chantal , Neely Michael , Guidi Monia
Published: October 2021

Population pharmacokinetics consists of analyzing pharmacokinetic (PK) data collected in groups of individuals. Population PK is widely used to guide drug development and to inform dose adjustment via therapeutic drug monitoring and model‐informed precision dosing. There are 2 main types of population PK methods: parametric (P) and nonparametric (NP). The characteristics of P and NP population methods have been previously reviewed. The aim of this article is to answer some frequently asked questions that are often raised by scholars, clinicians, and researchers about P and NP population PK methods. The strengths and limitations of both approaches are explained, and the characteristics of the main software programs are presented. We also review the results of studies that compared the results of both approaches in the analysis of real data. This opinion article may be informative for potential users of population methods in PK and guide them in the selection and use of those tools. It also provides insights on future research in this area.
Adverse muscle composition predicts all‐cause mortality in the UK Biobank imaging study
Authors: Linge Jennifer , Petersson Mikael , Forsgren Mikael F. , Sanyal Arun J. , Dahlqvist Leinhard Olof
Published: October 2021

Background

Adverse muscle composition (MC) as measured by magnetic resonance imaging has previously been linked to poor function, comorbidity, and increased hospitalization. The aim of this study was to investigate if adverse MC predicts all‐cause mortality using data from UK Biobank.

Methods

There were 40 178 participants scanned using a 6 min magnetic resonance imaging protocol. Images were analysed for thigh fat‐tissue free muscle volume and muscle fat infiltration (MFI) using AMRA® Researcher (AMRA Medical, Linköping, Sweden). For each participant, a sex, weight, and height invariant muscle volume z‐score was calculated. Participants were partitioned into four MC groups: (i) normal MC, (ii) only low muscle volume [<25th percentile for muscle volume z‐score (population wide)], (iii) only high MFI [>75th percentile (population wide, sex‐specific)], and (iv) adverse MC (low muscle volume z‐score and high MFI). Association of MC groups with mortality was investigated using Cox proportional‐hazard modelling with normal MC as referent (unadjusted and adjusted for low hand grip strength, sex, age, body mass index, previous diagnosis of disease (cancer, type 2 diabetes and coronary heart disease), lifestyle, and socioeconomic factors (smoking, alcohol consumption, physical activity, and Townsend deprivation index).

Results

Muscle composition measurements were complete for 39 804 participants [52% female, mean (SD) age 64.2 (7.6) years and body mass index 26.4 (4.4) kg/m2]. Three hundred twenty‐eight deaths were recorded during a follow‐up period of 2.9 (1.4) years after imaging. At imaging, adverse MC was detected in 10.5% of participants. The risk of death from any cause in adverse MC compared with normal MC was 3.71 (95% confidence interval 2.81–4.91, P < 0.001). Only low muscle volume and only high MFI were independently associated with all‐cause mortality [1.58 (1.13–2.21), P = 0.007, and 2.02 (1.51–2.71), P < 0.001, respectively]. Adjustment of low hand grip strength [1.77 (1.28–2.44), P < 0.001] did not attenuate the associations with any of the MC groups. In the fully adjusted model, adverse MC and only high MFI remained significant (P < 0.001 and P = 0.020) while the association with only low muscle volume was attenuated to non‐significance (P = 0.560). The predictive performance of adverse MC [1.96 (1.42–2.71), P < 0.001] was comparable with that of previous cancer diagnosis [1.93 (1.47–2.53), P < 0.001] and smoking [1.71 (1.02–2.84), P = 0.040]. Low hand grip strength was borderline non‐significant [1.34 (0.96–1.88), P = 0.090].

Conclusions

Adverse MC was a strong and independent predictor of all‐cause mortality. Sarcopenia guidelines can be strengthened by including cut‐offs for myosteatosis enabling detection of adverse MC.
The impact of COVID‐19 on multi‐month dispensing (MMD) policies for antiretroviral therapy (ART) and MMD uptake in 21 PEPFAR‐supported countries: a multi‐country analysis
Authors: Bailey Lauren E. , Siberry George K. , Agaba Patricia , Douglas Meaghan , Clinkscales Jessica R. , Godfrey Catherine
Published: October 2021

Introduction

Increasing access to multi‐month dispensing (MMD) of antiretroviral therapy (ART) supports treatment continuity and viral load suppression for people living with HIV (PLHIV) and reduces burden on health facilities. During the COVID‐19 response, PEPFAR worked with ministries of health to scale up MMD and expand eligibility to new groups of PLHIV, including children and pregnant/breastfeeding women. We analysed PEPFAR program data to understand the impact of the policy changes on actual practice.

Methods

We conducted a desk review in 21 PEPFAR‐supported countries to identify and collect official documentation released between March and June 2020 addressing changes to MMD guidance during the COVID‐19 response. MMD coverage, the proportion of all ART clients on MMD, was assessed in the calendar quarters preceding the COVID‐19 response (Q4 2019, October–December 2019; and Q1, January–March 2020) and the quarters following the start of the response (Q2 2020, April–June 2020; Q3 2020, July–September, 2020; Q4 2020, October–December 2020). We used the two‐proportion Z‐test to test for differences in MMD coverage pre‐COVID‐19 (Q4 2019) and during implementation of COVID‐19 policy adaptations (Q2 2020).

Results and discussion

As of June 2020, 16 of the 21 PEPFAR‐supported countries analysed adapted MMD policy or promoted intensified scale‐up of MMD in response to COVID‐19. MMD coverage for all clients on ART grew from 49% in Q4 2019 pre‐COVID‐19 to 72% in Q2 2020 during COVID‐19; among paediatric clients (< 15), MMD coverage increased from 27% to 51% in the same period. Adaptations to MMD policy were associated with a significantly accelerated growth in the proportion of clients on MMD (p < 0.001) for all populations, irrespective of age and dispensing interval.

Conclusions

Access to MMD markedly expanded during the COVID‐19 pandemic, supporting treatment continuity while mitigating exposure to COVID‐19 at health facilities. This model is beneficial in public health emergencies and during disruptions to the healthcare system. Outside emergency contexts, expanded MMD eligibility extends client‐centred care to previously excluded populations. The success in expanding MMD access during COVID‐19 should motivate countries to recommend broader MMD access as a new standard of care.
Study on aqueous film‐forming foam extinguishing agent based on fluorocarbon cationic–hydrocarbon anionic surfactants mixture system
Authors: Yang Yawen , Peng Mengyuan , Sha Min , Fang Jiaqing , Zhang Ding , Pan Renming , Jiang Biao
Published: October 2021

Fluorocarbon surfactants were the main components of aqueous film‐forming foam extinguishing agents (AFFF). Unfortunately, the widely used fluorocarbon surfactant perfluorooctane sulfonate (PFOS) was limited due to its toxicity, bioaccumulation and biodegradability. In this paper, an environmentally friendly quaternary ammonium cationic fluorocarbon surfactant with high surface activity and simple synthesis route was reported. The surface performance and aggregation behavior of the mixed solution of this fluorocarbon surfactant and sodium n‐octyl sulfate were studied by means of surface tension meter and transmission electron microscope (TEM). The results showed that the synergistic effect of sodium n‐octyl sulfate and this fluorocarbon surfactant was significant, and many vesicles could be observed in the mixed solution with the concentration of 0.1 mol/L under TEM. Subsequently, three environmental friendly AFFF formulations (F‐1, F‐2, F‐3) were designed with the mixture of the fluorocarbon surfactant, sodium n‐octyl sulfate and lauryl betaine BS‐12 as foaming agent. Through its foam performance test, it could be seen that F‐3 showed relatively excellent foam performance. The initial foam height h0 was 70 mm, the 25% drainage time was 315 s, the extinguishing time was 28 s, and the burn‐back time was 720 s. This kind of fire extinguishing agent had the potential of fire protection application.
Shear Wave Elastography and Quantitative Ultrasound as Biomarkers to Characterize Deep Vein Thrombosis In Vivo
Authors: Bosio Guillaume , Zenati Nora , Destrempes François , Chayer Boris , Pernod Gilles , Cloutier Guy
Published: October 2021

Objective

Investigate shear wave elastography (SWE) and quantitative ultrasound (QUS) parameters in patients hospitalized for lower limb deep vein thrombosis (DVT).

Method

Sixteen patients with DVT were recruited and underwent SWE and radiofrequency data acquisitions for QUS on day 0, day 7, and day 30 after the beginning of symptoms, in both proximal and distal zones of the clot identified on B‐mode scan. SWE and QUS features were computed to differentiate between thrombi at day 0, day 7, and day 30 following treatment with heparin or oral anticoagulant. The Young's modulus from SWE was computed, as well as QUS homodyned K‐distribution (HKD) parameters reflecting blood clot structure. Median and interquartile range of SWE and QUS parameters within clot were taken as features.

Results

In the proximal zone of the clot, the HKD ratio of coherent‐to‐diffuse backscatter median showed a significant decrease from day 7 to day 30 (P = .036), while the HKD ratio of diffuse‐to‐total backscatter median presented a significant increase from day 7 to day 30 (P = .0491). In the distal zone of the clot, the HKD normalized intensity of the echo envelope median showed a significant increase from day 0 to day 30 (P = .0062). No SWE features showed statistically significant differences over time. Nonetheless, a trend of lower median of Young's modulus within clot for patients who developed a pulmonary embolism was observed.

Conclusion

QUS features may be relevant to characterize clot's evolution over time. Further analysis of their clinical interpretation and validation on a larger dataset would deserve to be studied.