bluuebunny/crossref_metadata_2025 huggingface dataset:
Immediate‐early gene Homer1a intranuclear transcription focus intensity as a measure of relative neural activation
Authors: Witharana Wing K. L. , Clark Benjamin J. , Trivedi Vivek , Mesina Lilia , McNaughton Bruce L.
Published: September 2018

Immediate‐early genes (IEGs) exhibit a rapid, transient transcription response to neuronal activation. Fluorescently labeled mRNA transcripts appear as bright intranuclear transcription foci (INF), which have been used as an all‐or‐nothing indicator of recent neuronal activity; however, it would be useful to know whether INF fluorescence can be used effectively to assess relative activations within a neural population. We quantified the Homer1a (H1a) response of hippocampal neurons to systematically varied numbers of exposures to the same places by inducing male Long‐Evans rats to run laps around a track. Previous studies reveal relatively stable firing rates across laps on a familiar track. A strong linear trend (r2 > 0.9) in INF intensity was observed between 1 and 25 laps, after which INF intensity declined as a consequence of dispersion related to the greater elapsed time. When the integrated fluorescence of the entire nucleus was considered instead, the linear relationship extended to 50 laps. However, there was only an approximate doubling of H1a detected for this 50‐fold variation in total spiking. Thus, the intranuclear H1a RNA fluorescent signal does provide a relative measure of how many times a set of neurons was activated over a ~10 min period, but the dynamic range and hence signal‐to‐noise ratios are poor. This low dynamic range may reflect previously reported reductions in the IEG response during repeated episodes of behavior over longer time scales. It remains to be determined how well the H1a signal reflects relative firing rates within a population of neurons in response to a single, discrete behavioral event.
Pharmacy workforce in Saudi Arabia: Challenges and opportunities: A cross‐sectional study
Authors: Almaghaslah Dalia , Alsayari Abdulrhman , Asiri Rayah , Albugami Najla
Published: September 2018

Background

Saudi Arabia has shown rapid growth in its pharmacy workforce and pharmacy education over the last decade. The health indicators demonstrate an increased need for medications and, thus, the accessibility of pharmacies. Since pharmacists are considered the most accessible health care professionals, the country has experienced a continuous demand to produce more pharmacists.

Objectives

The objectives of the study are to evaluate the pharmacy workforce in Saudi Arabia and to identify pharmaceutical manpower issues.

Methods

A retrospective cross‐sectional approach was used. Data were obtained from the latest version of the Health Statistical Yearbook—Kingdom of Saudi Arabia, 2016; Saudi Commission for Health Specialties publications, 2018.

Results

In general, the exponential increase in the number of pharmacy schools has produced more pharmacists in the rural areas of the country, but inequitable distribution of the workforce still exists. The reliance on nonindigenous pharmacists, especially in the private sector, is substantial. Employed male pharmacists outnumber females, mainly due to the cultural and social factors that limit the participation of women in community pharmacy, which is the largest employment sector. The employment rate shows limited opportunities for Saudi pharmacists at MOH, as they have already Saudised almost all pharmacy positions at their health care facilities. However, the private sector needs to assume responsibility for their share of the renationalisation of the profession in order to provide jobs for local pharmacists.

Conclusions

Regular, more detailed profiling of the pharmacy workforce is an essential step to achieving effective pharmacy workforce planning. Currently, a large gap exists in our knowledge of the country's workforce.
Investigation of dimensionless parameters and geometry effects on heat‐transfer characteristics of liquid sodium flowing over a flat plate
Authors: Kaladgi Abdul Razak , Afzal Asif , AD Mohammad Samee , MK Ramis
Published: September 2018

To improve the cooling performance of a nuclear fuel element, it is important to appraise the effect of dimensionless parameters and the geometry on heat‐transfer characteristic of sodium flowing over a nuclear fuel element. To fulfill this objective, the effects of geometry, Reynolds number (ReH), conductivity ratio (
N
cc
), and dimensionless total heat generation parameter (
Qt) on a two‐dimensional steady flow of liquid coolant flowing over a nuclear fuel element are studied. For this purpose, the stream function‐vorticity formulation method is applied. Full Navier Stokes equations and energy equation for the fluid domain are solved concurrently with conduction equation of fuel element applying finite difference scheme. The pseudotransient form of the vorticity transport and energy equations is solved using the alternating direction implicit method. A line‐by‐line technique is used for other discretized equations. Isotherms are also plotted and studied in detail. From the obtained results it can be concluded that for fixed values of aspect ratio and Re
H there exists a critical value of
Qt and
N
cc beyond and below which peak temperature in the fuel element surpasses its tolerable limit. The results can also be applied to minimize the peak temperature in the nuclear fuel element (hot spots).
Rarefaction and external force effects on gas microflow in a lid‐driven cavity
Authors: Baliti Jamal , Hssikou Mohamed , Alaoui Mohammed
Published: September 2018

In this paper, the regularized 13‐moment approach (R13) is used to investigate the rarefaction effect on rarefied gas flow within a lid‐driven cavity. We will discuss the validity domain of the Navier‐Stokes and Fourier (NSF) solutions using the first order of velocity slip and temperature jump boundary conditions (NSF) and the regularized 10‐moments (R10) in slip and early transition regime. The effect of an external body force is examined in different directions according to the cavity inclination angle. A Maxwell monatomic gas is considered to study the flow and thermal characteristics within the lid‐driven cavity. The NSF method correctly describes the velocity profiles, but it captures only the trend of other macroscopic parameters. The NSF heat flux, which is found to be from the hot regions to the cold ones, loses its validity in the slip regime and beyond to predict an inverted heat flux predicted by both regularized models. Contrary to the R10, which can capture the rarefaction effect in the whole slip regime. The dimensionless shear stress tends to grow by increasing the rarefaction along the moving wall. The external body force affects the shear stress and velocity streamlines symmetry and creates an additional vortex, depending on the inclination angle.
Experimental study on conventional solar still integrated with inclined solar still under different water depth
Authors: Kabeel Abd Elnaby , Taamneh Yazan , Sathyamurthy Ravishankar , Naveen Kumar Padmanabhan , Manokar Athikesavan Muthu , Arunkumar Thirugnanasambantham
Published: September 2018

This study primarily focuses on comparative experimental analysis on standalone conventional solar still (CSS), inclined solar still (ISS), and integrated conventional and inclined solar still (CSS‐ISS) for different parameters that affect the freshwater yield. For enhancing the freshwater yield only a few studies are available on still‐still integration. The present novel study provides a greater improvement in improving the freshwater yield by integrating ISS with CSS. This experimental work mainly concentrates on the importance of water depth (d
w) and mass flow rate of water (
m
w) in the solar still. Water depth inside the conventional still varied from 0.02 to 0.06 m whereas, water is constantly flown with a mass flow rate of 8.33 kg/hour in an ISS with baffles. The experimental result shows that the accumulated freshwater yield from CSS‐ISS, ISS, and CSS were 6.2, 5.04, and 4.24 kg, respectively. CSS‐ISS and ISS produced 46.23% and 18.87% higher productivity than the CSS. From the experimental investigation, it is also identified that the water temperature is significantly improved by 20% using integration as compared with CSS without integration under the same water depth of
d
w =
 0.02 m. The overall improvement in yield was higher in the case of CSS‐ISS. The deviations between experimental and theoretical values of yield from the conventional and modified solar still were in the range of ±7%.
Natural convection heat transfer from a horizontal cylinder using holographic interferometry
Authors: He Zhaohui , Zhu Jinrong , Zhang Jinye , Cheng Chunfu , Hu Ni
Published: September 2018

The natural convection heat transfer from a horizontal cylinder with a uniform wall temperature in an infinite space was experimentally investigated. Infinite fringe interferograms of the cylinder heated from 295.15 to 355.15 K were recorded using the holographic interferometry technique. The temperature field around the cylinder was reconstructed based on phase difference recovery using a MATLAB code. The distributions of the local and average Nusselt numbers over the cylinder were then obtained. A correlation of the average Nusselt number was proposed for a Rayleigh number range of 2.7–6.0 × 104. The experimental results are in good agreement with previous correlations, with a deviation of ±10%. The holographic interferometry technique was found to be satisfactory and reliable for heat transfer analyses.
Comparison of microRNA expressions for the identification of chemical hazards in in vivo and in vitro hepatic injury models
Authors: Hwang So‐Ryeon , Tham Nga Thi Thu , Lee Soo‐ho , Bang Ji‐Hyun , Yi Hee , Park Young‐Il , Lee Hyun‐Kyoung , Kang Hwan‐Goo , Kim Yong‐Sang , Woo Gye‐Hyeong , Ku Hyun‐Ok
Published: September 2018

Biofluid‐based biomarkers provide an efficient tool for hazard identification of chemicals. Here, we explored the potential of microRNAs (miRNAs) as biomarkers for hepatotoxicity of chemicals by linking in vitro to in vivo animal models. A search of the literature identified candidate circulating miRNA biomarkers of chemical‐induced hepatotoxicity. The expression of candidate miRNAs (miR‐122, miR‐151a, miR‐192, miR‐193a, miR‐194, miR‐21, miR‐29c), was determined by real‐time reverse transcription‐polymerase chain reaction in in vivo acute liver injury induced by acetaminophen, and then were further compared with those of in vitro cell assays. Candidate miRNAs, except miR‐29c, were significantly or biologically upregulated by acetaminophen, at a dose that caused acute liver injury as confirmed by hepatocellular necrosis. Except miR‐122 and miR‐193a, other miRNAs elevated in in vivo models were confirmed by in vitro models using HepG2 cells, whereas they failed by in vitro models using human primary hepatocytes. These findings indicate that certain miRNAs may still have the potential of toxicological biomarkers in linking in vitro to in vivo hepatotoxicity.
Hydrogen sulfide attenuates paraquat‐induced epithelial‐mesenchymal transition of human alveolar epithelial cells through regulating transforming growth factor‐β1/Smad2/3 signaling pathway
Authors: Bai You‐Wei , Ye Meng‐Juan , Yang Da‐Long , Yu Meng‐Ping , Zhou Cheng‐Fan , Shen Tong
Published: September 2018

Exogenous H2S donor, sodium hydrosulfide (NaHS), can influence the bleomycin‐induced pulmonary fibrosis by attenuating the epithelial‐mesenchymal transition (EMT) of alveolar epithelial cells, but whether NaHS affects paraquat (PQ)‐induced EMT and the molecular mechanisms remain unclarified. The aim of the present study is to examine the effect of exogenous NaHS on PQ‐induced EMT in human alveolar epithelial cells (A549 cells) and assess if this effect occurs through regulating transforming growth factor (TGF)‐β1/Smad2/3 signaling pathway. The expressions of endogenous H2S producing enzymes, namely cystathionine β‐synthase, cystathionine γ‐lyase and 3‐mercaptopyruvate sulfur transferase, were detected by reverse transcription‐polymerase chain reaction and western blotting. The induced EMT was assessed by morphological and phenotypic characterizations, and the protein level of E‐cadherin and vimentin were detected by western blotting. To investigate the effect of NaHS on PQ‐induced EMT and potential mechanism, A549 cells were pretreated with NaHS before incubating with PQ and then evaluated by morphological changes, cell migration ability, the expression of EMT markers and TGF‐β1/Smad2/3 signaling pathway related proteins. PQ significantly downregulated the expression levels of cystathionine β‐synthase and cystathionine γ‐lyase, but not 3‐mercaptopyruvate sulfur transferase, in a time‐dependent manner in A549 cells. Exogenous NaHS could significantly retard PQ‐induced morphological changes and cell migration ability. Furthermore, exogenous NaHS significantly upregulated the expression of E‐cadherin, whereas it downregulated the expression of vimentin. In addition, exogenous NaHS could also significantly attenuates PQ‐induced TGF‐β1, phosphorylated Smad2/3 proteins expression, which induced by PQ in a time‐dependent manner. This study provides the first evidence that exogenous NaHS attenuates PQ‐induced EMT and migration of human alveolar epithelial cells through regulating the TGF‐β1/Smad2/3 signaling pathway.
Customized antifouling polyacrylonitrile ultrafiltration membranes for effective removal of organic contaminants from aqueous stream
Authors: Beril Melbiah Jegan Stella , Joseph Pramila , Rana Dipak , Nagendran Alagumalai , Nagendra Gandhi Nagarajan , Mohan Doraiswamy Raju
Published: September 2018

BACKGROUND

Ultrafiltration (UF) is a promising separation technique for the removal of macromolecular contaminants. However, the hydrophobic polymeric UF membrane performance suffers from fouling in the long run due to clogging by contaminants at the surface and pores. In this study, anti‐fouling hydrophilic polyacrylonitrile (PAN) UF membranes in the presence of an amphiphilic triblockcopolymer, Pluronic F127 (PF127) were prepared via a phase inversion technique.

RESULTS

The effect of varying concentrations of PF127 on PAN UF membranes was analyzed by attenuated total reflectance–Fourier transform infrared spectroscopy (ATR‐FTIR), by scanning electron microscopy (SEM) and atomic force microscopy (AFM). The filtration characteristics of the membranes were measured in terms of pure water flux, membrane porosity and water content. The separation efficiency of the membranes is explored for contaminants such as bovine serum albumin (BSA), humic acid (HA) and oil. The results revealed that the PAN membrane with 4 wt% of PF127 produced greatest permeate flux of 391 L m−2h−1with minimal fouling. A higher solute rejection of more than 90% was observed for the tailored membranes due to the improvement in surface properties.

CONCLUSION

The inherent hydrophilicity of the high density poly (ethylene oxide) brush‐like layer of PF127 at the membrane–water interface is utilized effectively to restrict the adsorption of the organic contaminants onto the membrane surface. After simple hydraulic washing of PAN/PF127 UF membranes, the flux recovery ratio was augmented which is ascribed to their excellent antifouling property and potential use in water treatment. © 2018 Society of Chemical Industry
Primary care doctor fostering and clinical research training in Sweden: Implications for Japan
Authors: Watari Takashi , Hirose Masahiro , Midlöv Patrik , Tokuda Yasuharu , Kanda Hideyuki , Okayama Masanobu , Yoshikawa Hiroo , Onigata Kazumichi , Igawa Mikio
Published: September 2018

In 2018, a new training program for primary care physicians was launched in Japan. As physicians responsible for the training of new primary care physicians, we have faced many problems, particularly in rural areas. The influence of this new program on primary care physicians in rural areas of Japan has not been sufficiently investigated. The aim of this research was to improve training for primary care physicians in Japan by examining training programs in Sweden, where the population challenges are similar to those seen in Japan. In this paper, we will express our opinions and describe the differences in the primary care fostering systems and clinical research training for generalist in Japan and Sweden.
Measurement of Hydrogen Produced during Magnesium Corrosion in Hydrochloric Acid and the Effect of the Triton X‐100 Surfactant on Hydrogen Production
Authors: Eid Salah
Published: September 2018

The goal of this article is to measure hydrogen produced during the corrosion of magnesium in HCl and the influence of the Triton X‐100 surfactant on hydrogen production. It was found that the hydrogen produced during corrosion of Mg in HCl increased with increasing HCl concentration, stirring rate, temperature, and time of immersion. The addition of the Triton X‐100 surfactant inhibits the amount of hydrogen evolved. The inhibition behavior was explained on the basis of adsorption of Triton X‐100 molecules on the Mg surface creating a barrier for mass and charge transport, which protects the Mg surface from aggressive ions. The activation thermodynamic parameter values were calculated and explicated. Some theoretical chemical parameters were also calculated. The results obtained from the theoretical calculations are in agreement with the practical results.
Biosorptive detoxification of zearalenone biotoxin by surface‐modified renewable biomass: process dynamics and application
Authors: Akar Tamer , Güray Tufan , Yilmazer Dilek Tunc , Tunali Akar Sibel
Published: September 2018

BACKGROUND

Contamination of food, feed, beverages and even drinking water with biotoxins is a growing global concern because of their potential health risks. In this work, surface‐modified sugar beet pulp waste was used for the biosorptive removal of zearalenone biotoxin from contaminated aquatic media.

RESULTS

Infrared, Boehm titration, BET (Brunauer–Emmett–Teller) surface area and point of zero charge analysis were employed for surface characterization. Kinetic and equilibrium studies showed that biotoxin biosorption was well predicted by the pseudo‐second‐order kinetic model and the Langmuir isotherm model. Zearalenone was removed from the solution over a wide pH range (3.0–8.0) and within a short time (15 min). Maximum uptake capacity of modified biomass was recorded as 23.30 ± 0.17 g kg−1. Highest removal yield in a dynamic flow mode (94.56 ± 0.13%) was achieved at 2 mL min−1 flow rate using 30 mg biosorbent. Regeneration experiments revealed high reusability potential of suggested biosorbent. Moreover, its application potential was tested in spiked samples of malt, beer and canned corn liquid.

CONCLUSION

Detoxification potential of this renewable biomass was significantly enhanced after modification. Modified biomass could be used as an efficient and low‐cost green‐type material with good application potential for zearalenone detoxification. © 2018 Society of Chemical Industry
The Hadlock Method Is Superior to Newer Methods for the Prediction of the Birth Weight Percentile
Authors: Blue Nathan R. , Savabi Mariam , Beddow Meghan E , Katukuri Vivek R. , Fritts Cody M. , Izquierdo Luis A. , Chao Conrad R.
Published: September 2018

Objectives

To compare a traditional ultrasound (US) method for estimated fetal weight (EFW) calculation and fetal growth restriction diagnosis with 2 newer methods for the prediction of small for gestational age (SGA) at birth.

Methods

We reviewed deliveries at our institution from January 1, 2013, to March 31, 2017. Singleton, nonanomalous, well‐dated fetuses with a US examination within 2 weeks of delivery were included. Estimated fetal weights and percentiles were calculated by a traditional method (Hadlock et al; Radiology 1991; 181:129–133) and 2 newer methods: Intergrowth‐21st (INTG; Ultrasound Obstet Gynecol 2017; 49:478–486) and Salomon et al (Ultrasound Obstet Gynecol 2007; 29:550–555). We calculated each method's test characteristics to predict SGA (birth weight < 10th percentile) using both traditional (EFW < 10th percentile) and receiver operating characteristic (ROC)‐derived fetal growth restriction cutoffs. Mean percentile discrepancies between EFW and birth weight measurements were calculated to compare method accuracy. We hypothesized that the INTG and Salomon methods would have superior SGA prediction compared with the Hadlock method.

Results

Of 831 pregnancies with a US examination within 2 weeks of delivery, 138 (16.7%) were SGA at birth. Hadlock had the smallest US–birth weight percentile discrepancy (P < .001 versus both INTG and Salomon). When comparing ROC curves, the Hadlock and INTG methods performed comparably, with areas under the curve of 0.91 and 0.90 (P = .08) and optimal EFW cutoffs of the 15th and 22nd percentiles, respectively. The Salomon method performed less well, with an area under the curve of 0.82 (P < .001 versus both Hadlock and INTG methods).

Conclusions

In our study cohort, the Hadlock method predicted the birth weight percentile more accurately than the INTG or Salomon methods and performed comparably with INTG to predict SGA when ROC‐derived cutoffs were used.
Methotrexate Administration to Patients With Presumed Ectopic Pregnancy Leads to Methotrexate Exposure of Intrauterine Pregnancies
Authors: Fridman Dmitry , Hawkins Eleanor , Dar Peer , Chudnoff Scott , Rotenberg Ohad , Chong Woojin , Xie Xianhong , Mehta Sukrant , Levie Mark
Published: September 2018

Objective

To report clinical experience with methotrexate (MTX) treatment for suspected but not definite ectopic pregnancy (EP).

Methods

This was a retrospective cohort study. All patients treated with MTX for presumed EP between 2000 and 2016 were included. Demographic, clinical, sonographic, and outcome data were collected and analyzed.

Results

A total of 820 patients were treated with MTX, 692 (84.4%) of which were lacking definitive features of EP; 155 (22.4%) failed to follow up until complete resolution and were excluded. Retrospective sonographic categorization was applied to 537 patients; of those patients, 393 (73.2%) were categorized as probable EPs, 136 (25.3%) pregnancies of unknown location (PULs), and 8 (1.5%) probable intrauterine pregnancies (IUPs). Sixteen were eventually diagnosed with IUP: 6 from the probable EPs, 9 from the PULs, and 1 from the probable IUP group. Patients with final diagnosis of IUP had higher values of β–human chorionic gonadotropin as well as lower prevalence of adnexal mass (38% versus 74%; P = .003), higher prevalence of intracavitary fluid (44% versus 9%; P = .0004) and thicker endometrium (17.1 ± 11.8 versus 9.7 ± 5.6; P = .04). None of the sonographic parameters were able to distinguish patients with IUP. One patient of the 16 with IUP was diagnosed with a viable pregnancy, and 7 additional patients had a possible viable pregnancy. None of them elected to continue the pregnancy.

Conclusions

Most patients with suspected EP who are eligible for medical treatment lack definitive sonographic features of EP. Treatment with MTX in such cases should be delayed, as clinically reasonable, to improve the diagnosis and prevent inadvertent administration of MTX to patients with a viable IUP.
Effect of Ultrasound‐Guided Intercostal Nerve Block Versus Fluoroscopy‐Guided Epidural Nerve Block in Patients With Thoracic Herpes Zoster: A Comparative Study
Authors: Lee Hyo Jeong , Park Hong Souk , Moon Hyun Im , Yoon Seo Yeon
Published: September 2018

Objectives

To compare the efficacy of a conventional fluoroscopy‐guided epidural nerve block and an ultrasound (US)‐guided intercostal nerve block in patients with thoracic herpes zoster (HZ).

Methods

This work was a comparative study of 38 patients with thoracic HZ pain and a chest wall herpetic eruption, aged 18 years or older, with pain intensity of 5 or greater on a numeric rating scale (NRS) for less than a 1‐month duration. Patients were consecutively enrolled and assigned to 2 groups in which the intervention was either the US‐guided intercostal nerve block or the fluoroscopy‐guided epidural nerve block approach with the addition of a 5‐mL mix of 2.5 mg of dexamethasone plus 0.5% lidocaine. The primary outcome measure was the NRS score reduction for the pain. Secondary outcomes included the duration of treatment, number of repeated injections until the final visit, and proportion of patients with pain relief after the first and final visits.

Results

All patients within both intervention groups showed significant pain relief on the NRS at the final follow‐up point (P < .05). There was no significant difference in the mean value of NRS improvement based on the intervention type. There was also no statistically significant difference in the duration of treatment and the frequency of injection for pain relief.

Conclusions

These findings showed that both the US‐guided intercostal nerve block and the fluoroscopy‐guided epidural nerve block were effective in patients with thoracic HZ. Compared data showed no significant differences in the pain reduction, duration of treatment, and frequency of injection. The US‐guided intercostal nerve block, which is more accessible than the fluoroscopy‐guided epidural nerve block, might be an alternative option for thoracic HZ.
Ultrasound Features of the Normal and Pathologic Periosteum
Authors: Moraux Antoine , Gitto Salvatore , Bianchi Stefano
Published: September 2018

Thickening and elevation of the periosteum from the underlying bone cortex, defined as a periosteal reaction, can be associated with several bone disorders. Although ultrasound (US) has limited possibilities in assessing bones, it can depict a periosteal reaction earlier than plain radiography, thus indicating underlying bone disorders. This pictorial essay aims to illustrate the normal and pathologic US appearances of the periosteum in both children and adults. Several disorders are discussed, such as pediatric bone trauma, infections and tumors, as well as trauma, overuse, including medial tibial stress syndrome, and finally certain seronegative spondyloarthropathies in adults. Whenever US depicts a periosteal reaction, a correlation with clinical and laboratory data is mandatory to differentiate different bone disorders. Computed tomography or magnetic resonance imaging must be performed when an infection or a tumor is suspected based on both US and the clinical presentation.
Limited Added Value of Magnetic Resonance Imaging After Dynamic Transvaginal Ultrasound for Preoperative Staging of Endometriosis in Daily Practice: A Prospective Cohort Study
Authors: Berger Judith P. , Rhemrev Johann , Smeets Maddy , Henneman Onno , English James , Jansen Frank W.
Published: September 2018

Objectives

To assess the added value of magnetic resonance imaging (MRI) after dynamic transvaginal ultrasound (TVUS) in the diagnostic pathway for preoperative staging of pelvic endometriosis.

Methods

A prospective observational study was conducted between April 22, 2014, and May 1, 2015. During that period, 363 patients with a clinical suspicion of endometriosis were included. All patients underwent a history, clinical examination, and dynamic TVUS examination. Most of the patients (n = 274) underwent conservative treatment according to the European Society of Human Reproduction and Embryology guidelines. Eighty‐nine patients were selected for surgery, of whom 72 patients underwent the complete diagnostic pathway: ie, history, clinical examination, dynamic TVUS, and MRI. All data were analyzed by the nonparametric McNemar test for comparing each step in the diagnostic algorithm.

Results

The sensitivity and specificity for the history, pelvic examination, and dynamic TVUS were 93.7% and 55.6% (P < .001), respectively; when MRI findings were included, the sensitivity and specificity were 85.9% and 62.5%. Adding MRI routinely to the diagnostic procedure of endometriosis did not significantly improve the sensitivity or specificity.

Conclusions

There is no significant added value of routine MRI after dynamic TVUS for the preoperative staging of endometriosis.
Prediction of Clinical Prognosis according to Intermetatarsal Distance and Neuroma Size on Ultrasonography in Morton Neuroma: A Prospective Observational Study
Authors: Park Young Hwan , Kim Tae Jin , Choi Gi Won , Kim Hak Jun
Published: September 2018

Objectives

This study aims to evaluate the clinical importance of intermetatarsal distance, size of neuroma, and proportion of neuroma in the intermetatarsal space in examinations of Morton neuroma using ultrasonography.

Methods

Clinical prognosis was observed prospectively after corticosteroid injections in 136 patients with Morton neuroma, and the results were compared with ultrasonographic parameters of intermetatarsal distance, size of neuroma, and proportion of neuroma in the intermetatarsal space.

Results

Twenty‐one patients (15%) did not respond to corticosteroid injections and underwent surgical treatment for Morton neuroma. Logistic regression analysis and receiver operating characteristic curve analysis showed that the size of the neuroma was the sole predictor of failure of corticosteroid injections (P = .002). No other factors were significant for the prediction of clinical prognosis (P > .05).

Conclusions

The size of the neuroma on ultrasonography is the sole predictor of corticosteroid injection failure, while intermetatarsal distance and proportion of neuroma in the intermetatarsal space are not significant when predicting clinical prognosis of Morton neuroma.
Evaluation of Fetal Left Ventricular Size and Function Using Speckle‐Tracking and the Simpson Rule
Authors: DeVore Greggory R. , Klas Berthold , Satou Gary , Sklansky Mark
Published: September 2018

Objectives

This study was conducted to evaluate left ventricular (LV) size and function in healthy fetuses and to test a cohort of fetuses at risk for abnormal function using speckle‐tracking software.

Methods

Two hundred control fetuses were examined between 20 and 40 weeks’ gestation. With the use of offline speckle‐tracking software, the end‐diastolic and end‐systolic volumes were measured and the following computed: stroke volume (SV), SV per kilogram, cardiac output (CO), CO per kilogram, and ejection fraction. These were regressed against 7 independent variables related to the size, weight, and age of the fetuses. Five fetuses with risk factors for LV dysfunction were examined to sample the validity of the data from the control group.

Results

The R2 values for measurements of the end‐diastolic volume, SV, and CO correlated with the 7 independent variables of fetal size and age (0.7–0.78), whereas the SV/kg, CO/kg, and ejection fraction had lower R2 values (0.02–0.1). The measurements were normally distributed (Shapiro‐Wilke > 0.5). The 5 fetuses at risk for abnormal LV function had measurements of LV size and function that were consistent with the expected pathologic condition.

Conclusions

Speckle tracking can provide a comprehensive evaluation of the size and function of the fetal LV.
Fetal Tachycardia Is an Independent Risk Factor for Chromosomal Anomalies in First‐Trimester Genetic Screening
Authors: Espinoza Andres F. , Lee Wesley , Belfort Michael A. , Shamshirsaz Alireza A. , Mastrobattista Joan , Espinoza Jimmy
Published: September 2018

Objectives

The association of an abnormal fetal heart rate (FHR) and chromosomal anomalies in the first trimester of pregnancy remains unclear, probably because of the lack of control for known confounding factors. This study was designed to determine whether an increased FHR is an independent risk factor for chromosomal anomalies between 11 and 14 weeks’ gestation.

Methods

This cohort study included women who underwent first‐trimester genetic screening between 2011 and 2014 at a single institution. A multivariable logistic regression analysis was performed to determine whether an FHR of 170 beats per minute (bpm) or higher, derived from a receiver operating characteristic curve, is an independent risk factor for all chromosomal anomalies while controlling for known confounding factors. P < .05 was considered significant.

Results

An FHR of 170 bpm or higher was observed in 7% (228 of 3254), and chromosomal anomalies were present in 1.0% (31 of 3254) of the population. A higher proportion of fetuses with an FHR of 170 bpm or higher had chromosomal anomalies compared to those with an FHR lower than 170 bpm. An FHR of 170 bpm or higher was an independent risk factor for chromosomal anomalies after controlling for known confounding factors. Of note, in the group of fetuses with a nuchal translucency above the 95th percentile, the frequency of chromosomal anomalies was significantly higher among fetuses with an FHR of 170 bpm or higher compared to those with an FHR lower than 170 bpm.

Conclusions

Fetal tachycardia is a risk factor for chromosomal anomalies during first‐trimester genetic screening, independent of increased nuchal translucency, nuchal septations, and maternal age.
Limited Ultrasound Protocol for Upper Extremity Peripherally Inserted Central Catheter Monitoring: A Pilot Study in the Neonatal Intensive Care Unit
Authors: Motz Patrick , Arnim Amelie von Saint Andre von , Likes Maggie , Chabra Shilpi , Traudt Christopher , Iyer Ramesh S. , Dighe Manjiri
Published: September 2018

Objectives

To assess whether a limited ultrasound (US) scanning protocol to monitor the upper extremity peripherally inserted central catheter (PICC) location in neonates is feasible for experienced US operators.

Methods

A radiologist, who was blinded to the PICC location on chest radiography, performed 14 US scans on 11 neonates with upper extremity PICCs. A US machine with 13–6‐MHz linear and 8–4‐MHz phased array transducers was used for the examinations.

Results

The study population included 54% (n = 6) preterm infants, with 72% (n = 8) weighing less than 1500 g. The US location of the PICC was the same as the chest radiographic report in all 14 scans. A subclavicular long‐axis view of the anterior chest visualized all PICCs in the subclavian or brachiocephalic veins. A parasternal long‐axis right ventricular inflow view was able to visualize PICCs in the superior vena cava (SVC), and a subcostal long‐axis view evaluated PICCs in the lower SVC and heart. The scanning time was location dependent: less than 5 minutes for PICCs in the brachiocephalic or subclavian vein and 5 to 10 minutes for PICCs in the SVC or heart. There were no desaturations below 90%, increases in the fraction of inspired oxygen need, or hypotension episodes during scanning.

Conclusions

A limited US scanning protocol to determine the upper extremity PICC location is feasible. Our protocol needs to be tested in neonatal providers before further dissemination.
Dynamic Changes of the Aspartate Aminotransferase‐to‐Platelet Ratio and Transient Elastography in Predicting a Histologic Response in Patients With Chronic Hepatitis B After Entecavir Treatment
Authors: Sun Jing , Li Yanfang , Sun Xuying , Yu Hong , Liu Youde
Published: September 2018

Objectives

To evaluate the dynamic changes of the aspartate aminotransferase (AST)‐to‐platelet ratio and transient elastography (FibroScan; Echosens, Paris, France) in predicting a histologic response in patients with chronic hepatitis B (CHB) after entecavir treatment.

Methods

A total of 148 patients with CHB were enrolled. Patient information was collected. All patients received liver biopsy and FibroScan before and after 96 weeks of entecavir treatment.

Results

Baseline liver biopsy results showed that there were 7 patients without liver fibrosis (fibrosis stage F0; 4.7%), 51 patients with mild liver fibrosis (F1; 34.5%), and 90 patients with advanced liver fibrosis (>F1; 60.9%). The liver stiffness value and AST‐to‐platelet ratio increased significantly as the METAVIR score of the patients increased from F0 to F4 (P < .001). After antiviral therapy for 96 weeks, the average liver stiffness value measured by FibroScan and the AST‐to‐platelet ratio showed a significant decrease. When we use a decreased liver stiffness value to predict a histologic response, the area under the receiver operating characteristic curve was 0.70 (95% confidence interval, 0.61–0.79; P < .001), and the sensitivity and specificity were 74.3% and 68.8%, respectively. The decrease of the AST‐to‐platelet ratio also could predict the histologic response of patients with CHB; the area under the receiver operating characteristic curve was 0.77 (95% confidence interval, 0.69–0.86; P < .001) with sensitivity of 76.2% and specificity of 70.2%. A multivariate analysis indicated that a high hepatitis B virus DNA viral load (odds ratio, 1.44; P = .04) and high METAVIR score (odds ratio, 1.38; P = .02) were independent risk factors for the histologic response.

Conclusions

Both the AST‐to‐platelet ratio and FibroScan value can effectively predict a histologic response in patients with CHB during entecavir treatment. Therefore, they can be used to monitor these patients during antiviral treatment to avoid multiple liver biopsies.
Secondary Imaging Findings Aid in Prenatal Diagnosis and Characterization of Congenital Diaphragmatic Hernia: Role of an Abnormal Orientation of Vascular Structures and Gallbladder Position
Authors: Didier Ryne A. , DeBari Suzanne E. , Oliver Edward R. , Gebb Juliana S. , Howell Lori J. , Hedrick Holly L. , Adzick N. Scott , Coleman Beverly G.
Published: September 2018

Objectives

To determine whether an abnormal orientation of the abdominal or hepatic vasculature and an abnormal gallbladder position on prenatal ultrasound (US) imaging are associated with intrathoracic liver herniation and postnatal outcomes in cases of congenital diaphragmatic hernia (CDH).

Methods

Children who underwent prenatal US examinations and postnatal CDH repair at our institution were eligible. Prenatal US images were reviewed, and the orientation of the superior mesenteric artery (SMA) and hepatic veins as well as gallbladder position were recorded. Findings were correlated with prenatal US measurements (lung‐to‐head ratio and calculated observed‐to‐expected lung‐to‐head ratio) and postnatal outcomes, including intrathoracic liver herniation, an extracorporeal membrane oxygenation (ECMO) requirement, and mortality.

Results

A total of 175 patients met inclusion criteria. The SMA was shown in 168 cases and had a cephalad orientation in 95.4% (161 of 168), which was not associated with outcome measures and represented bowel herniation. A cephalad orientation of the hepatic veins was identified in 52.6% (90 of 171) and was associated with intrathoracic liver herniation, an ECMO requirement, and mortality (P < .01). In right‐sided CDH, the gallbladder was intrathoracic in 91.3% (21 of 23). In left‐sided CDH, an abnormal gallbladder position was seen in 51.3% (76/152) and was associated with intrathoracic liver herniation, an ECMO requirement, mortality, and lower lung‐to‐head ratio and observed‐to‐expected lung‐to‐head ratio values. When combined, abnormal hepatic vein and gallbladder positions showed good sensitivity and specificity in predicting intrathoracic liver herniation (area under the curve, 0.93).

Conclusions

Abnormal SMA, hepatic vein, and gallbladder positions can be used to improve prenatal characterization of CDH. Accurate depiction of these structures on prenatal US images may aid in patient counseling and postnatal management.
Rapid Assessment of the Neonate With Sonography (RANS) Scan
Authors: Safarulla Azif , Kuhn Walter , Lyon Matthew , Etheridge Rebecca J. , Stansfield Brian , Best Graciela , Thompson Amy , Masoumy Emily , Bhatia Jatinder
Published: September 2018

The use of point‐of‐care sonography in clinical settings such as emergency medicine and intensive care units has increased, but adoption in neonatology has been slow. Unlike the focused assessment with sonography for trauma scan used in adults, a quick bedside scan to rapidly evaluate an acutely deteriorating neonate does not exist. The objective of our article is to introduce a focused bedside ultrasound scan that is easy to learn, rapidly performed, and relatively inexpensive.© 2018 by the American Institute of Ultrasound in Medicine
Reproducibility of Liver‐to‐Thorax Area Ratio Ultrasound Measurements in Congenital Diaphragmatic Hernia
Authors: Novoa y Novoa Victoria Arruga , Sutton Laura F. , Neis Allan E. , Marroquin Amber M. , Coleman Tracey M. , Praska Kathleen A. , Freimund Tamara A. , Ruka Krystal L. , Warzala Vicki L. , Sangi‐Haghpeykar Haleh , Ruano Rodrigo
Published: September 2018

Objectives

The aim of this study was to investigate the reproducibility of a standardized method to assess the ultrasound liver‐to‐thoracic area ratio in fetuses with congenital diaphragmatic hernia.

Methods

We selected 24 images of 9 fetuses diagnosed with left‐sided at our institution between January 2010 and December 2017. Eight operators (1 maternal‐fetal medicine specialist and 7 sonographers) reviewed the selected images and assessed the ultrasound liver‐to‐thoracic area ratio according to a standardized protocol. We evaluated the correlation between operators using the intraclass correlation coefficient and compared agreement between the sonographers and a physician with experience in measuring the ultrasound liver‐to‐thoracic area ratio using a Bland‐Altman analysis.

Results

Good intraoperator reproducibility was observed for the standardized ultrasound liver‐to‐thoracic area ratio (intraclass correlation coefficient, 0.78). Good agreement among sonographers and the physician was also observed for the standardized measurements (bias, 0.01; precision, 0.03; limits of agreement, –0.05 to + 0.07).

Conclusions

We demonstrated that good intraoperator and interoperator reproducibility of ultrasound liver‐to‐thoracic area ratio assessment is feasible after standardizing the method in our center.
Intravascular Ultrasound for Evaluation of Left Gonadal Vein Anatomic Variations During Coil Embolization
Authors: Perdikakis Evangelos , Tzortzis Vasileios , Fezoulidis Ioannis , Rountas Christos
Published: September 2018

We illustrate the intravascular ultrasound (US) findings in the evaluation of left gonadal vein anatomic variations. During a 2‐year period, 4 consecutive patients (mean age, 37 years; range, 28–45 years) with left‐sided varicocele underwent embolization. Intravascular US examinations and retrograde venography were performed to assess varicocele anatomy. Anatomic variants were recorded and categorized. A comparison between intravascular US and fluoroscopic findings was performed. The Fisher exact test was used for statistical analysis (P < .05). Technical success was achieved in all cases. There was a statistically significant difference in the maximum gonadal vein diameter between venography and intravascular US (P = .0087). Intravascular US showed left gonadal vein anatomic variations and better ability in the evaluation of the vein diameter.
Construction of Functional Hyperbranched Poly(phenyltriazolylcarboxylate)s by Metal‐Free Phenylpropiolate‐Azide Polycycloaddition
Authors: Chi Weiwen , Yuan Wei , Du Jun , Han Ting , Li Hongkun , Li Yongfang , Tang Ben Zhong
Published: September 2018

The 1,3‐dipolar cycloaddition of activated internal alkynes with azides has been developed into an efficient polymerization reaction for constructing functional linear 1,4,5‐trisubstitued polytriazoles. However, it is rarely employed for the synthesis of hyperbranched polymers. In this work, metal‐free polycycloadditions of tris(3‐phenylpropiolate)s (1) and tetraphenylethene‐containing diazides (2) are performed in dimethylformamide at 100 °C for 7 and 12 h, producing hyperbranched poly(phenyltriazolylcarboxylate)s (hb‐PPTCs) with high molecular weights and satisfactory regioregularities in good yields. The hb‐PPTCs have good solubility in common organic solvents and high thermal stability. They are non‐emissive in solutions, but emit intensively upon aggregation, showing an aggregation‐induced emission effect. Their aggregates can work as fluorescent sensors for explosive detection with high sensitivity. Furthermore, the polymers can be utilized for the fabrication of 2D fluorescent patterns with high resolution by UV irradiation through copper grid masks.
Hyers‐Ulam stability analysis to implicit Cauchy problem of fractional differential equations with impulsive conditions
Authors: Shah Kamal , Ali Arshad , Bushnaq Samia
Published: September 2018

In this article, we deal with the existence and Hyers‐Ulam stability of solution to a class of implicit fractional differential equations (FDEs), having some initial and impulsive conditions. Some adequate conditions for the required results are obtained by utilizing fixed point theory and nonlinear functional analysis. At the end, we provide an illustrative example to demonstrate the applications of our obtained results.
Optimal policies for inventory systems with concave ordering costs
Authors: Benjaafar Saif , Chen David , Yu Yimin
Published: September 2018

In this paper we study the structure of optimal policies for periodic review inventory systems with concave ordering costs and general demand distributions. By extending the Scarf () model to systems with piecewise linear concave ordering costs, we show that, except for a bounded region, the generalized (s, S) policy is optimal. We do so by (a) introducing the notion of c‐convexity and (b) proving a conditional monotonicity property for the optimal order‐up‐to levels. We also provide conditions under which the generalized (s, S) policy is optimal for all regions of the state space.
Risk of hospitalisation and death related to baclofen for alcohol use disorders: Comparison with nalmefene, acamprosate, and naltrexone in a cohort study of 165 334 patients between 2009 and 2015 in France
Authors: Chaignot Christophe , Zureik Mahmoud , Rey Grégoire , Dray‐Spira Rosemary , Coste Joël , Weill Alain
Published: September 2018

Purpose

Baclofen is widely used off‐label for alcohol use disorders (AUD) in France, despite its uncertain efficacy and safety, particularly at high doses. This study was designed to evaluate the safety of this off‐label use compared to the main approved drugs for AUD (acamprosate, naltrexone, nalmefene).

Methods

This cohort study from the French Health Insurance claims database included patients, aged 18 to 70 years, with no serious comorbidity (assessed by the Charlson score) initiating baclofen or approved drugs for AUD between 2009 and 2015. The risk of hospitalisation or death associated with baclofen, at variable doses over time (from low doses <30 mg/day to high doses ≥180 mg/day), compared to approved drugs, was evaluated by a Cox model adjusted to sociodemographic and medical characteristics.

Results

The cohort included 165 334 patients, 47 614 of whom were exposed to baclofen. Patients exposed to baclofen differed from those treated with approved drugs in terms of sociodemographic and medical characteristics (more females, higher socioeconomic status, fewer hospitalisations for alcohol‐related problems), but these differences tended to fade at higher doses of baclofen. Baclofen exposure was significantly associated with hospitalisation (hazard ratio [HR] = 1.13 [95%CI: 1.09‐1.17]) and death (HR = 1.31 [95%CI: 1.08‐1.60]). The risk increased with dose, reaching 1.46 [1.28‐1.65] for hospitalisation and 2.27 [1.27‐4.07] for death at high doses. Similar results were in patients with a history of hospitalisation for alcohol‐related problems.

Conclusions

This study raises concerns about the safety of baclofen for AUD, particularly at high doses, with higher risks of hospitalisation and mortality than approved drugs.