bluuebunny/crossref_metadata_2025 huggingface dataset:
Population‐based outcome analysis of diffuse large B‐cell lymphoma in people living with HIV infection and competent individuals
Authors: Conconi Annarita , Zucca Emanuele , Margiotta‐Casaluci Gloria , Darling Katharine , Hasse Barbara , Battegay Manuel , Staehelin Cornelia , Novak Urban , Schmid Patrick , Scherrer Alexandra , Dirnhofer Stephan , Kwee Ivo , Nassi Luca , Cavalli Franco , Gaidano Gianluca , Bertoni Francesco , Bernasconi Enos ,   Swiss HIV Cohort study (SHCS)
Published: August 2018

The prognostic factors and outcome of 58 acquired immunodeficiency syndrome‐related diffuse large B‐cell lymphoma (AR‐DLBCL) patients from the Swiss HIV Cohort Study, diagnosed from 2004 to 2011, were compared with those of 326 immunocompetent (IC)‐DLBCL from the Hematology Division of the Amedeo Avogadro University (Italy) and the Oncology Institute of Southern Switzerland. Median follow‐up was 6 years; 5‐year overall survival (OS) was 68% (95% CI: 63%‐73%) in IC‐DLBCL and 63% (95% CI: 49%‐75%) in AR‐DLBCL (P = .220). The acquired immunodeficiency syndrome‐related lymphoma international prognostic index predicted OS in AR‐DLBCL. Among 148 patients younger than 61 years (40 AR‐DLBCL and 108 IC‐DLBCL) treated with RCHOP/RCHOP‐like regimens, 20 IC‐DLBCL and 9 AR‐DLBCL patients died and OS was not significantly different. A higher proportion of early deaths occurred in the AR‐DLBCL: indeed, 1‐year OS was 94% (95% CI: 87%‐97%) in IC‐DLBCL and 82% (95% CI: 66%‐91%) in AR‐DLBCL patients. After rituximab and active antiretroviral therapy introduction, AR‐DLBCL and IC‐DLBCL patients treated with curative intent have similar long‐term survival.
The NIH's slow response to the AIDS epidemic and the dismissal of Pasteur's contributions: Learning from history
Authors: Promislo Mark
Published: August 2018

The National Institutes of Health's (NIH) slow response to the AIDS epidemic in the early 1980s led to deaths and missed opportunities to stop the spread of the disease. In addition, the NIH systematically diminished the contributions of the scientists at the Pasteur Institute who discovered HIV and produced a superior AIDS test. I analyze these events by applying three social theories to the global response to the epidemic. Structuration, interorganizational learning, and negotiated order theories shed light on (1) the delay by the NIH in providing grants for AIDS research, (2) the inability of the NIH to learn about the epidemic from the Centers for Disease Control and Prevention, and (3) the NIH's dismissal of AIDS discoveries by a team of Pasteur scientists. Lastly, I give suggestions to enable effective cooperation among health agencies to better respond to future epidemics.
Health in All local Policies: Lessons learned on intersectoral collaboration in a community‐based health promotion network in Denmark
Authors: Christensen Julie Hellesøe , Bloch Paul , Møller Signe Rysbjerg , Søgaard Cecilie Prüsse , Klinker Charlotte Demant , Aagaard‐Hansen Jens , Bentsen Peter
Published: August 2018

Health promotion increasingly involves collaboration with civil society organisations and the private sector rather than being implemented exclusively by public sector stakeholders. Health in All Policies (HiAP) is an approach that promotes health in policy‐making across public sectors. This study explored intersectoral integration and collaboration for health promotion at a local community level through a qualitative single case study of a local community network in Denmark: the Husum Health Network. The paper describes and discusses strengths, weaknesses, and challenges of HiAP‐inspired local efforts to build alliances and supportive environments for health within an inter‐organisational community‐based network. The data were generated from participant observations made at 11 meetings and events organised by the network partners and nine qualitative, semi‐structured interviews with Husum Health Network partners conducted from August 2014 to February 2015. The data were analysed using a theoretical framework introduced by Axelsson and Axelsson (2006) to characterise aspects of integration and differentiation between organisations. With high levels of structural and functional differentiation between the partners, the network provided an opportunity to exercise inter‐organisational integration at the local level. Integration was fostered by knowledge sharing, face‐to‐face interaction, and communal events. However, the loose structure of the network was a challenge to its sustainability and achievement. We argue that Health in All local Policies is a meaningful concept in the context of local community development only when referring to the polices and strategies of all stakeholder organisations involved in decision‐making and agenda setting, and not just local government institutions.
Out‐of‐pocket expenditure for health care: District level estimates for Haryana state in India
Authors: Prinja Shankar , Kaur Gunjeet , Gupta Rakesh , Rana Saroj Kumar , Aggarwal Arun Kumar
Published: August 2018

Introduction

In this paper, we present district level out‐of‐pocket (OOP) expenditures with respect to outpatient consultation within last 15 days and hospitalization in last 1 year for Haryana state.

Methods

The data from a large cross‐sectional household survey covering all 21 districts of Haryana comprising of randomly selected 79 742 households were analyzed. Of the total sample, 56 056 households consisting of 314 639 individuals in 21 districts of Haryana state were surveyed to gather information on OOP expenditure incurred on outpatient consultation within last 15 days. Similarly, 59 901 households and 324 977 respondents were interviewed to elicit OOP expenditures for any hospitalization during the 1 year preceding the survey. Mean OOP expenditure per OP consultation, per hospitalization as well as per capita were computed. Mean OOP expenditure was also estimated by the type of provider, gender, and district.

Results

The mean OOP expenditure for OP consultation and hospitalization in Haryana was Indian National Rupees (INR) 1005 (US Dollar [USD] 16.1; 95% CI: INR 934‐1076) and INR 22 489 (USD 360.0; 95% CI: INR 21 375‐23 608), respectively. Mean per capita OOP expenditure for OP consultation, which was INR 85 (USD 1.3) in Haryana, varied from INR 595 (USD 9.5) in district Panipat to INR 29 (USD 0.5) in district Kaithal.

Conclusion

This is the first study to comprehensively present district level estimates for OOP expenditure for health care. These estimates are useful for policy planning, and preparation for district and state health accounts.
GIS‐based method to delimit spheres of influence for a medical consortium: Experience of a pediatric medical consortium, Shanghai
Authors: Xiong Xuechen , Zhou Shuai , Huo Zhaohua , Luo Li
Published: August 2018

Background

To improve the utilization efficiency of health care services, the concept of a “regional medical consortium” has attracted more attention during the most recent round of health care reform in China. Shanghai, a municipality of China, has made many efforts to promote its regional medical consortium project. In this paper, the pediatric medical consortium of Shanghai will serve as an example to introduce the main tasks and groundwork of the Shanghai medical consortium and will underscore Shanghai's exploration of the vertical integration of medical resources.

Methods

This study delimits the service areas of leading hospitals, which can help determine the spheres of influence of top hospitals geographically. With this information, regional hospitals or community hospitals can find alliance hospitals and leading hospitals more easily. These efforts can be realized using ArcGIS for spatial data analysis.

Results

According to the locations of leading hospitals and actual patient distributions at these hospitals, the natural areas of influence of leading hospitals are illustrated. Then, hospitals other than leading hospitals can select allied hospitals in the same area of influence. In this way, connections in a medical consortium will be tighter, and hospitals will be better able to meet the actual demands of patients.

Conclusions

In this paper, we introduce a geographic method to delimit the spheres of influence of hospitals based on actual health‐seeking behaviors of patients by analyzing the spatial distribution of hospitalization probability. Within the boundaries of a sphere of influence, a geographic connection between the leading hospital and the general hospital is established automatically. Based on this geographic connection, leading hospitals should provide technological support to general hospitals located in their sphere of influence, while the general hospitals should provide spare medical resources in return. Thus, the medical consortium can be formed geographically and operate more smoothly.
Selection of small plasma peptides for the auxiliary diagnosis and prognosis of epithelial ovarian cancer by using UPLC/MS‐based nontargeted and targeted analyses
Authors: Lu Xin , Li Yiqun , Xia Bairong , Bai Yunfan , Zhang Kun , Zhang Xiaohan , Xie Hongyu , Sun Fengyu , Hou Yan , Li Kang
Published: August 2018

Epithelial ovarian cancer (EOC) is the leading cause of gynecologic cancer‐related death due to its nonspecific characteristics compared to benign cases and poor prognosis after conventional therapies. Small peptides (SPs) demonstrated to have potential for diagnosis and prognosis were focused on in our study for the discovery of biomarkers that address these issues. Metabolic profiles of 15 SPs, including nine dipeptides and six tripeptides were acquired from plasma samples of 140 EOC and 158 benign ovarian tumor (BOT) patients. Partial least square discriminant analysis showed separations between EOC and BOT subjects of different age brackets. Hyp‐Leu, Glu‐Trp and Phe‐Phe were selected as promising predictive SP‐biomarkers for better EOC diagnosis compared to conventional biomarkers. Combined Hyp‐Leu, Glu‐Trp and CA125 presented an area under the curve (AUC) of 0.904, with a sensitivity and specificity of 0.804 and 0.944, respectively. This finding suggested that the combination of these biomarkers performed much better than CA125 alone. Hyp‐Leu and Gly‐Phe‐Trp showed significantly improved performances in the log‐rank tests and Kaplan–Meier curves demonstrating their prognostic potential. All SP‐biomarkers proved to have excellent stabilities at room temperature. Correlation network analysis implied latent conversions among amino acids, dipeptides and tripeptides during EOC. In conclusion, the selected SPs in combination with CA125 show profound promise for discriminating EOCs from BOTs and for predicting the progression after surgery, which provides invaluable information for clinicians in the precision diagnosis and treatment of EOC.
Randomized controlled trial of continuous Doppler versus intermittent fetoscope fetal heart rate monitoring in a low‐resource setting
Authors: Mdoe Paschal F. , Ersdal Hege L. , Mduma Estomih , Moshiro Robert , Dalen Ingvild , Perlman Jeffrey M. , Kidanto Hussein
Published: August 2018

Objective

To compare the frequency of abnormal fetal heart rate (FHR) detection between continuous Doppler and intermittent fetoscope monitoring.

Method

A randomized controlled open‐label trial was conducted between February 1, 2016, and January 31, 2017, at Haydom Lutheran hospital, Tanzania. Women in active labor with singleton pregnancies and normal FHR at admission were randomly allocated in a 1:1 ratio to receive either continuous or intermittent FHR monitoring. The primary outcome was abnormal FHR detection.

Results

2652 women were enrolled; 1340 received continuous monitoring and 1312 received intermittent monitoring. Continuous FHR monitoring detected abnormal FHR in 108 (8.1%) participants versus 40 (3.0%) participants in the intermittent monitoring group (risk ratio [RR] 2.64, 95% confidence interval [CI] 1.8–3.7; P<0.001). The increased detection rate in the continuous versus intermittent monitoring group was associated with an increase in rate of subsequent intrauterine resuscitations (89 [6.6%] vs 42 [3.2%]; RR 2.07, 95% CI 1.4–2.9; P<0.001). In total, 92 (3.5%) infants had adverse perinatal outcomes, with no significant differences between groups.

Conclusion

Continuous FHR monitoring increased identification of abnormal FHR and subsequent intrauterine resuscitations.

ClinicalTrials.gov: NCT02790814.
Lipid peroxidation, DNA damage, and apoptosis in dengue fever
Authors: Cherupanakkal Cleetus , Samadanam Daisy Mariya , Muthuraman Krishna Raja , Ramesh Surya , Venkatesan Amrit , Balakrishna Pillai Agiesh Kumar , Rajendiran Soundravally
Published: August 2018

Interplay between the apoptosis, DNA damage, and oxidative stress as a host response to dengue viral infections remains unclear. Peripheral blood mononuclear cells (PBMCs) were isolated from 60 dengue infected patients, 20 patients with febrile illness other than dengue (OFI) and 10 non‐febrile illness (NFI) patients. DNA damage in the PBMCs was assessed using single cell gel electrophoresis and stages of apoptosis underwent by the PBMCs were studied by Annexin–PI staining using flow cytometry. Plasma levels of malondialdehyde levels were estimated using thiobarbituric acid assay. Dengue infected individuals had showed increased DNA damage than NFI and OFI controls at the time of admission. Annexin–PI staining revealed increased frequency of apoptotic cells in dengue infected PBMCs than controls during the admission time. Similar pattern was observed in samples collected around defervescence. Within the dengue cases, percentage of live cells was higher in non‐severe dengue than severe dengue at both the time points. Follow‐up samples in dengue showed less number of live cells and higher percentage of apoptotic cells with respect to their baseline and this was reversed in case of OFI. Plasma malondialdehyde levels were found to be relatively higher in dengue cases than controls at admission and around defervescence. Significant positive correlation between DNA damage, apoptosis, and plasma malondialdehyde levels might pave a way for understanding the complex interactions between virus and hosts response thereby aids in identifying plausible immunopathological links contributing to disease pathogenesis. © 2018 IUBMB Life, 70(11):1133–1143, 2018
Characterization of Maternal and Neonatal Pharmacokinetic Behavior of Ceftazidime
Authors: Dallmann André , van den Anker John , Pfister Marc , Koch Gilbert
Published: August 2018

Ceftazidime is a parenteral cephalosporin frequently used in pregnant women for treatment of urinary tract or intrauterine infections. Despite its regular use in pregnant women, ceftazidime disposition in both mother and fetus is not well understood, and a pharmacokinetic (PK) model that allows characterization and simulation of both maternal and preterm neonatal ceftazidime disposition is not available. In this study, 10 pregnant women with suspected or proven intrauterine infections in the late second and early third trimester were treated with 1 g of ceftazidime intravenously every 6 hours. During ceftazidime treatment, one maternal and umbilical cord blood sample was taken at delivery to quantify ceftazidime concentrations in the mother and preterm neonate. Data showed that ceftazidime concentrations in the mother were comparable to those observed in the neonate. Based on these data, a PK model was developed to describe maternal disposition, ceftazidime distribution over the placenta, and elimination in the neonate. The maternal substructure of the model was parameterized according to a previously reported ceftazidime model with minor adjustments to account for pregnancy‐related effects on renal elimination of ceftazidime. The expanded population PK model with an additional neonatal compartment was fitted to measured drug concentrations in the neonate. The neonatal elimination rate constant at delivery was close to that estimated for the mother. The presented results show that ceftazidime readily crosses the placenta and indicate that perinatal PK behavior of ceftazidime in preterm neonates can be expected to be similar to those observed in their mothers.
The Sounds of Silence: Inferences from the Absence of Word‐of‐Mouth
Authors: Weaver Kimberlee , Hamby Anne
Published: August 2018

While past work has explored some of the reasons why people themselves may remain silent in a group, almost no research has examined the mirror image of this question: How do consumers construe the silence of others? Do they project the opinions of the speakers in a conversation onto the silent individuals, assuming that silence signals agreement? Do they have a usual or “default” naïve theory of silence that they use to explain it across multiple contexts—i.e., “silence usually signals disagreement?” Or does silence act as a mirror, reflecting observers’ own opinions back at them? Three experiments contrasted perceivers’ estimates of conversational silence with their estimates of unknown opinions outside the conversation. Estimates of opinions outside the conversation generally followed an agreement‐with‐the‐speakers rule—the more an opinion was expressed in the group, the more consumers assumed others would support it too. In contrast, silence inside the conversation was interpreted very differently, serving as a mirror for participants’ own thoughts, even when the vocal majority favored the opposite position. Results suggest a process whereby observers project the reason they personally would have been silent in the group (given their opinion) onto silence, leading to an inference that the silents agree with the self.
Health Impacts of a Public–Private Partnership Rural Roads Maintenance Programme
Authors: Chong Alberto , Valdivia Martin
Published: August 2018

We provide evidence of health impacts of a public–private rural roads maintenance programme in Peru, which is characterized by a contracting mechanism that employs small local firms. Using a difference‐in‐differences approach, we find that improved roads connectivity leads to positive health externalities. © 2018 John Wiley & Sons, Ltd.
Discrimination of wild and domestic deer musk using isotope ratio mass spectrometry
Authors: He Yi , Wang Jingzhu , Wang Mengzhen , Zhang Jingfang
Published: August 2018

Musk is the dried secretion of the musk pod (sac) of adult male musk deer, and has been used as perfume and traditional medicine for thousands of years. Steroid was regarded as 1 of the most important active compounds in musk. In order to protect the wild musk deer, musk deer farming has been carried out in China, India, and Nepal. However, it is hard to differentiate the 2 origins of musk by morphological identification. No other method has been reported so far for the discrimination of wild and domestic deer musk. The establishment of a reliable discrimination method has become an urgent work. In the present study, 6 batches of wild deer musk and 14 batches of domestic deer musk were collected. Analysis of steroid components in musk was carried out with GC‐MS/MS. Androgen, progestin, estrogen, and sterol were detected in those samples. Large diversity was observed in the concentrations of steroids in musk. No obvious difference could be observed in steroid concentrations between wild and domestic deer musk by principal component analysis and cluster analysis. Furthermore, the δ13C values of steroids were determined by gas chromatography/combustion coupled with isotopic ratio mass spectrometry. There were significant differences (P < .01) in steroid δ13C values between wild origin musk and domesticated origin musk. Isotopic ratio mass spectrometry can be used to discriminate wild and domestic deer musk.
Mortality outcome and predictive risk factors for death in patients with heart failure and reduced ejection fraction who declined implantable cardioverter defibrillator implantation in Singapore
Authors: Khoo Chun Yuan , Allen John Carson , Chia Shaw Yang , Chan Laura Lihua , Lim Choon Pin , Sim David , Ching Chi Keong
Published: August 2018

Background

There have been conflicting data regarding the risk of sudden cardiac death (SCD) in Asian population with reduced left ventricular ejection fraction (LVEF). We aim to study mortality outcome and its risk predictors in patients with reduced LVEF who declined an implantable cardioverter defibrillator (ICD) implantation and assess whether current ICD guidelines for primary prevention are applicable to the population in Singapore.

Methods

This prospective observational study involved 240 consecutive patients who fulfilled the ACC/AHA/HRS criteria for ICD implantation for primary prevention of SCD but declined ICD implantation. Baseline characteristics and mortality outcomes through May 2017 were collected via case‐note review after a mean follow‐up of 44.8 ± 16.6 months.

Results

Majority of our patients were Chinese (71.3%), followed by Malays (16.2%) and Indians (10.8%). Mean age (±SD) was 61 ± 10 years, and 84% were male. Majority were in New York Heart Association (NYHA) functional classes I (46.7%) and II (46.3%). Over a mean follow‐up of 44.8 ± 16.6 months, all‐cause mortality rate was 34.6%. Diabetes mellitus (HR = 1.57; 95% CI, 1.01‐2.44; P = 0.047) and chronic kidney disease (CKD; HR = 1.95; 95% CI, 1.17‐3.23; P = 0.010) were independent predictors of mortality. Patients in NYHA classes II (HR = 2.15; 95% CI, 1.32‐3.50; P = 0.002) and III (HR = 2.82; 95% CI, 1.34‐5.96; P = 0.007) showed higher risk of death.

Conclusion

The mortality rate was comparable with major primary prevention trials. ICD guideline recommendations for primary prevention may thus be applicable to our local population. Patients with diabetes, CKD, and poorer NYHA status exhibited higher mortality rates.
MR lymphography in patients with upper limb lymphedema: The GPS for feasibility and surgical planning for lympho‐venous bypass
Authors: Zeltzer Assaf A. , Brussaard Carola , Koning Merel , De Baerdemaeker Randy , Hendrickx Benoit , Hamdi Moustapha , de Mey Johan
Published: August 2018

Background and Objectives

Lymphedema is caused by insufficient lymphatic drainage leading to abnormal accumulation of interstitial fluid within soft tissues. Lympho‐venous anastomosis (LVA), as a surgical option for selected patients, is widely applied. Through preoperative localization of functional lymphatics with indocyanine green, real time visualization of functioning lymphatic vessels is possible. This examination is time consuming and operator dependant and is not suitable to differentiate the ratio of fat hypertrophy to liquid edema.

We investigated whether MR lymphangiography is accurate for imaging functional lymphatics and adjacent veins in arms. Furthermore, we investigated the accuracy and predictability of preoperative mapping for the feasibility of performing LVA and the preoperative decision making in lymphedema surgery.

Methods

A prospective study was performed in which 25 patients suffering from lymphedema of the upper extremity were examined. MR lymphography with contrast agent injection in a deep dermal plane was performed.

Results

Precise localization of lymphatic vessels crossing a vein was achieved in 18 of 25 arms. In 16 of the 18 patients in whom functional lymphatics were localized with an adjacent vein on MRI an LVA was performed successfully.

Conclusions

MR lymphangiography is an accurate and reproducible method for imaging and mapping of lymphatic channels in the lymphedemateous limb.
The prognostic value of serum thyroid‐stimulating hormone level post‐lobectomy in low‐ and intermediate‐risk papillary thyroid carcinoma
Authors: Park Jae Hyun , Lee Yu‐mi , Lee Yi Ho , Hong Suck Joon , Yoon Jong Ho
Published: August 2018

Background: This study was undertaken to determine the optimal thyroid‐stimulating hormone (TSH) value associated with structural recurrence in patients with low‐risk or intermediate‐risk papillary thyroid carcinoma (PTC) who underwent thyroid lobectomy.

Methods: Patients with PTC (n = 1047) who received thyroid lobectomy and central compartment node dissection were included in the study.

Results: Structural recurrence occurred in 42 of the patients (4.0%), and no patient died of PTC. Multivariate analysis showed a primary tumor size (with a cut‐off of 0.85 cm) and serum TSH level measured 1 year after the initial surgery (cut‐off 1.85 mU/L) independently predicted structural recurrence.

Conclusions: TSH levels during the early postoperative period need to be monitored and maintained in the lower normal range even in patients with low‐ or intermediate‐risk PTC undergoing thyroid lobectomy.
Oncologic outcomes after robot‐assisted versus laparoscopic distal pancreatectomy: Analysis of the National Cancer Database
Authors: Raoof Mustafa , Nota Carolijn L. M. A. , Melstrom Laleh G. , Warner Susanne G. , Woo Yanghee , Singh Gagandeep , Fong Yuman
Published: August 2018

Background

How the oncologic outcomes after robotic distal pancreatectomy (RDP) compare to those after laparoscopic distal pancreatectomy (LDP) remains unknown.

Methods

Using the National Cancer Database (NCDB), we analyzed all patients undergoing LDP or RDP for resectable pancreatic adenocarcinoma over a 4‐year period (2010‐2013).

Results

Of the 704 eligible patients, 605 (86%) underwent LDP and 99 (14%) underwent RDP. The median follow‐up for patients was 25 months. There were no differences in the two groups with respect to sociodemographic, clinicopathologic, or treatment characteristics. On comparing LDP versus RDP, there was no difference in the margin‐positive rate (15% vs 16%; P = 0.84); lymph nodes examined (12 vs 11; P = 0.67); overall survival (hazard ratio [HR], 1.1, 95% confidence intervals [CI], 0.7 to 1.7; 28 vs 25 months; P = 0.71); hospital stay (6 vs 5 days; P = 0.14); time to chemotherapy (50 vs 52 days; P = 0.65); 30‐day readmission (9.4% vs 9.1%; P = 0.92); and mortality (1% vs 0%; P = 0.28). Patients undergoing LDP had a significantly higher conversion rate to open or minimally invasive pancreatic cancer resections compared with RDP (27% vs 10%; P < 0.001).

Conclusion

The early national experience with RDP demonstrates similar oncologic outcomes to LDP, with a significantly lower conversion rate.
Patterns of failure following the excision of in‐transit lesions in melanoma and the influence of excisional margins
Authors: Gonzalez Alexandra B. , Baum Christian L. , Brewer Jerry D. , Arpey Christopher J. , Harmsen William S. , Suman Vera J. , Markovic Svetomir N. , Jakub James W.
Published: August 2018

Background and Objectives

To describe the patterns of failure in patients with in‐transit (IT) melanoma undergoing surgical excision.

Methods

A retrospective review of patients who underwent their first IT lesion(s) resection between May 2005 and September 2014. Cumulative incidence of local failure (new lesion within 2 cm of IT resection) was estimated. Associations between clinicopathologic characteristics, local failure, and any recurrence were analyzed.

Results

One hundred and thirty patients presented to our institution with IT disease over the study period and met the inclusion criteria. The 2‐year cumulative incidence of local failure was 19.5%. Twenty‐four patients developed disease within 2 cm of the resected IT disease; however, only eight were isolated local events. Cumulative incidence of local failure and of any disease differed with respect to less than 1 year disease‐free interval (DFI) from primary melanoma to first IT event, and having greater than 1 IT lesion at presentation. Incidence of local failure was not found to differ with respect to gross margin greater than 5 mm, after adjusting for DFI and greater than 1 IT lesions.

Conclusions

Patients with greater than 1 IT lesion and a DFI less than 1 year are at a higher risk of failure after surgical excision of a first IT event. Very few failures were isolated local disease within 2 cm of the IT resection scar, regardless of IT excision margin.
Immediate lymphatic reconstruction
Authors: Johnson Anna Rose , Singhal Dhruv
Published: August 2018

Although surgical and medical treatment options are available for the treatment of chronic lymphedema, there is no cure. Recent advances in microsurgery have provided an opportunity to perform immediate lymphatic reconstruction after lymphadenectomy for disease prevention. In this review, we provide the historical background leading to a paradigm shift in performing this procedure. We will also discuss the current evidence for immediate lymphatic reconstruction, potential oncologic procedures amenable to this approach, and detail ongoing challenges.
Occupancy, habitat, and abundance of the Sacramento Valley red fox
Authors: Black Kathleen M. , Preckler‐Quisquater Sophie , Batter Tom J. , Anderson Stacy , Sacks Benjamin N.
Published: August 2018

The Sacramento Valley red fox (Vulpes vulpes patwin) is a native subspecies of conservation need endemic to the northern portion of California's Central Valley, USA. We conducted an occupancy survey to investigate habitat use and obtain a crude, range‐wide estimate of abundance. We used 2 previously developed red fox distribution models based on presence‐only data to stratify sampling of 107 sites with baited cameras for ≥90 days during March 2013–June 2016, resulting in red fox detections at 30 sites. All detections occurred in 1 of the 93 sites where 1 or both previous presence‐only models predicted occurrence. Red fox occurrence was positively associated with dry agriculture, human development, and proximity to grassland, and negatively associated with wetlands and flooded agriculture. The models predicted that 34.21% of the 12,000‐km2 Sacramento Valley landscape contained red foxes, which we estimate corresponded to approximately 1,600 breeding individuals. This estimate is comparable to that of the federally endangered California San Joaquin kit fox (Vulpes macrotis mutica), underscoring its potential vulnerability and conservation need. Targeted efforts to enhance its habitat, such as juxtaposition of grassland patches with agricultural and rural residential structures through conservation easements, could benefit conservation of the Sacramento Valley red fox. © 2018 The Wildlife Society.
Forms and vertical distributions of soil phosphorus in newly formed coastal wetlands in the Yellow River Delta estuary
Authors: Qu Fanzhu , Shao Hongbo , Meng Ling , Yu Junbao , Xia Jiangbao , Sun Jingkuan , Li Yunzhao
Published: August 2018

To study the forms and vertical distributions of soil phosphorus (P) in a newly formed coastal wetland in the Yellow River Delta estuary, China, two transects from the Yellow River bank to the bare beach that encompassed a variety of vegetation covers were selected for soil sampling and field monitoring. A modified sequential fractionation method was used to partition the soil P, and the related properties were measured. The soils in this newly formed estuarine coastal wetland, only covered by salt‐tolerant plant communities, are strongly alkaline (pH 8.4–9.2) with high soil salinity (mean, 6.23‰). The content of total P (Pt) ranged from 548.3 to 728.5 mg kg−1 in these soils. Dil.HCl‐Pi (extracted with 1 M HCl) was the highest P fraction (mean, 58.1–72.8%), whereas NaHCO3‐Pi was the lowest fraction (mean, 0.4–1.7%) of all the P forms. Vertical distributions showed a surface accumulation of Resin‐P. Resin‐P, NaHCO3‐Pi, NaOH‐Pi, and Conc.HCl‐Pi (extracted with 11.3 M HCl) were positively or negatively correlated with some properties. Attributed to the spatial deposition and hydrology, Dil.HCl‐Pi presented a poor correlation with Ca. The results also showed some clear differences in the P forms and P availability among vegetation covers. The vegetation cover could modify the soil quality, and Suaeda heteroptera, as the pioneer plant community species, significantly enhanced the freely exchangeable Pi and increased P availability, providing important ideas for salt‐soil sustainable use.
Agroforestry systems: Meta‐analysis of soil carbon stocks, sequestration processes, and future potentials
Authors: Shi Lingling , Feng Wenting , Xu Jianchu , Kuzyakov Yakov
Published: August 2018

Agroforestry (AF) has the potential to restore degraded lands, provide a broader range of ecosystem goods and services such as carbon (C) sequestration and high biodiversity, and increase soil fertility and ecosystem stability through additional C input from trees, erosion prevention, and microclimate improvement. Advantages and processes for global C sequestration in AF are unknown. We used a meta‐analysis of 427 soil C stock data pairs grouped into four main AF systems—alley cropping, windbreaks, silvopastures, and homegardens—and evaluated changes in AF and adjacent control cropland or pasture. Mean soil C stocks in AF (1‐m depth) were 126 Mg C·ha−1, which is 19% more than that in cropland or pasture. The highest C stocks in soil were in subtropical homegardens, AF with younger trees, and topsoil (0–20 cm). Increased soil C stocks in AF were lower than aboveground C stocks in most AF systems, except alley cropping. Homegardens stored the highest C in both aboveground and belowground, especially in the subsoil (20–100 cm). Advantages of AF ecosystem services focusing on mechanisms of belowground C sequestration were analyzed. AF could store 5.3 × 109 Mg additional C in soil on 944 Mha globally, with most in the tropics and subtropics. AF systems could greatly contribute to global soil C sequestration if used in larger areas. Future investigations of AF should include (a) mechanistic‐ and process‐based studies (instead of common monitoring and inventories), (b) models linking forest and crop growth with soil water and C and nutrient cycling, and (c) accurate assessments of the AF area worldwide based on the remote sensing approaches.
Hydrogen Flush After Cold Storage as a New End‐Ischemic Ex Vivo Treatment for Liver Grafts Against Ischemia/Reperfusion Injury
Authors: Tamaki Ichiro , Hata Koichiro , Okamura Yusuke , Nigmet Yermek , Hirao Hirofumi , Kubota Toyonari , Inamoto Osamu , Kusakabe Jiro , Goto Toru , Tajima Tetsuya , Yoshikawa Junichi , Tanaka Hirokazu , Tsuruyama Tatsuaki , Tolba Rene H. , Uemoto Shinji
Published: August 2018

Cold storage (CS) remains the gold standard for organ preservation worldwide, although it is inevitably associated with ischemia/reperfusion injury (IRI). Molecular hydrogen (H2) is well known to have antioxidative properties. However, its unfavorable features, ie, inflammability, low solubility, and high tissue/substance permeability, have hampered its clinical application. To overcome such obstacles, we developed a novel reconditioning method for donor organs named hydrogen flush after cold storage (HyFACS), which is just an end‐ischemic H2 flush directly to donor organs ex vivo, and, herein, we report its therapeutic impact against hepatic IRI. Whole liver grafts were retrieved from Wistar rats. After 24‐hour CS in UW solution, livers were cold‐flushed with H2 solution (1.0 ppm) via the portal vein (PV), the hepatic artery (HA), or both (PV + HA). Functional integrity and morphological damages were then evaluated by 2‐hour oxygenated reperfusion at 37°C. HyFACS significantly lowered portal venous pressure, transaminase, and high mobility group box protein 1 release compared with vehicle‐treated controls (P < 0.01). Hyaluronic acid clearance was significantly higher in the HyFACS‐PV and ‐PV + HA groups when compared with the others (P < 0.01), demonstrating the efficacy of the PV route to maintain the sinusoidal endothelia. In contrast, bile production and lactate dehydrogenase leakage therein were both significantly improved in HyFACS‐HA and ‐PV + HA (P < 0.01), representing the superiority of the arterial route to attenuate biliary damage. Electron microscopy consistently revealed that sinusoidal ultrastructures were well maintained by portal HyFACS, while microvilli in bile canaliculi were well preserved by arterial flush. As an underlying mechanism, HyFACS significantly lowered oxidative damages, thus improving the glutathione/glutathione disulfide ratio in liver tissue. In conclusion, HyFACS significantly protected liver grafts from IRI by ameliorating oxidative damage upon reperfusion in the characteristic manner with its route of administration. Given its safety, simplicity, and cost‐effectiveness, end‐ischemic HyFACS may be a novel pretransplant conditioning for cold‐stored donor organs.
Multipurpose Antifouling Coating of Solid Surfaces with the Marine‐Derived Polymer Fucoidan
Authors: Jeong Yeonwoo , Thuy Le Thi , Ki So Hyun , Ko Sangwon , Kim Suyeob , Cho Woo Kyung , Choi Joon Sig , Kang Sung Min
Published: August 2018

The control of biofouling, which is the unwanted adsorption of biomolecules and organisms on solid surfaces, is a prerequisite for wider applicability of the functional materials that are currently being used in biomedical industries. One of the frequently used methods for controlling biofouling is the use of surface coatings with antifouling materials. Herein, fucoidan, which is a marine‐derived polysaccharide, is reported as a new type of antifouling material that is safe and broadly applicable. Fucoidan is conjugated with catechols, which are known to act as adhesives for grafting functional molecules onto solid substrates. Fucoidan catechol (FD‐C) is subsequently utilized for robust fucoidan coatings of solid substrates, and the FD‐C‐coated surfaces show excellent antifouling capability for fouling organisms, including platelets and bacteria. The FD‐C coating is also confirmed to be nonirritating upon skin contact, demonstrating its potential use in public places for inhibiting contagions.
Hydrolytic Stability of Methacrylamide and Methacrylate in Gelatin Methacryloyl and Decoupling of Gelatin Methacrylamide from Gelatin Methacryloyl through Hydrolysis
Authors: Zheng Jing , Zhu Mengxiang , Ferracci Gaia , Cho Nam‐Joon , Lee Bae Hoon
Published: August 2018

Gelatin methacryloyl (GelMA; GM) is a promising nature‐derived photocurable material that can mimic the extracellular matrix because GelMA features tailorable mechanical properties, proteolytic degradation, and good cell adhesion. GelMA contains not only methacrylamide but also methacrylate. However, the hydrolytic stability of methacrylamide and methacrylate groups of GelMA in aqueous solutions has not been scrutinized. Here, the structural change of GelMA through hydrolysis is investigated for the first time. The structural change of hydrolyzed GelMA is quantitatively identified using colorimetric and 1H NMR methods. The methacrylate groups decompose markedly at high pH solutions, but the methacrylamide groups remain stable. Further, pure gelatin methacrylamide is successfully decoupled from GelMA for a better understanding of GelMA structure and future use for biomedical applications.
Highly Flame Retardant Melamine‐Formaldehyde Cross‐Linked Cellulose Nanofibrils/Sodium Montmorillonite Aerogels with Improved Mechanical Properties
Authors: Wang Liang , Cui Lingyan , Sánchez‐Soto Miguel , Shou Wan , Xia Zhaopeng , Liu Yong
Published: August 2018

A facile cross‐linking strategy to construct flame retardant cellulose nanofibril (CNF)/sodium montmorillonite (MMT) aerogels with improved mechanical properties, by incorporating melamine‐formaldehyde (MF) resins into precursor suspensions followed by a freeze‐drying process, is reported in this work. Scanning electron microscopy images indicate that MF cross‐linking does not significantly change the microstructures of CNF and CNF/MMT aerogels. However, the cross‐linking improves the materials' mechanical and flame properties. By incorporating 50 wt% of MF, the compression moduli and compressive stress of CNF aerogels increase by 316% and 114%, respectively. The limiting oxygen index (LOI) value of CNF aerogels also increases from 17.1% to 23.4%. Further addition of MMT increases the CNF aerogels' LOI value to 57% and increases the maximum decomposition temperature by nearly 20 °C. This occurs because MMT and MF induce a synergistic effect which improves the flame retardant properties of the CNFs aerogels. In CNF/MMT composite aerogels, the introduction of 34 wt% of MF leads to a 54.6% reduction of the peak of heat release rate and a 53.2% decrease in total heat release. CNF aerogels made from sustainable feedstocks with excellent mechanical properties and high flame retardancy, like those discussed herein, show promise as fire resistant biofoams.
Validation of UV Spectrophotometric Method for Quantifying Ketoconazole Encapsulated in Ethyl Cellulose Microspheres
Authors: Saez Vivian , Freitas Juliana M. , Hernández José R. , Regina Elias Mansur Cláudia
Published: August 2018

Ketoconazole (KZ) is an antifungal drug used to treat several mycoses. It has poor solubility and causes some adverse effects after its administration. For that reason, it has been included in various drug delivery systems such as polymeric microspheres. Ethyl cellulose is a water‐insoluble polymer widely used to encapsulate drugs because of its safety, good stability, easy fabrication, and cheapness. The amount of drug encapsulated per microspheres mass is a very important parameter to be precisely determined because it defines the mass of particles to be included in a single formulation dose. This work was aimed to validate an ultraviolet (UV) spectrophotometric method to quantify KZ encapsulated in ethyl cellulose microspheres. The KZ‐loaded microspheres were obtained by the emulsion − solvent evaporation method. The UV spectrophotometric method was validated following the ICH Guideline for validation of analytical procedures. The wavelength (247 nm) was selected from the spectrum of KZ (10 μg mL) in dichloromethane. The method was linear within the range 2–12 μg mL (slope: 0.0264; R2 = 0.9976). The accuracy was 99 ± 3, 98 ± 2, and 101 ± 2% for the low, medium and high range respectively. The intra‐assay relative standard deviation (RSD) was 1.8% while the inter‐assay RSD between days was 1.7%. The method, that is simple, rapid, precise, accurate and reproducible, was successfully applied to determine the content of KZ encapsulated in the ethyl cellulose microspheres.
Evaluation of Toluene Adsorption by Porous Resins: Batch and Continuous Flow Studies
Authors: Silva Carla M. F. , Rocha Paulo C. S. , Lucas Elizabete F.
Published: August 2018

Water contaminated with monoaromatic hydrocarbons must be treated before being discharged due to the high toxicity of these compounds. Various treatment methods are currently used, among them processes that involve adsorption. Polymeric resins has been used to treat water and then it is a promising method to be applied for removing various compounds from oily water. In this work, two polymeric resins (divinylbenzene − DVB and methylmethacrylate‐divinylbenzene − MMA‐DVB), previously synthesized, were evaluated for removal of toluene from water. Batch tests were performed to study the adsorption equilibrium using the Langmuir and Freundlich models, while the adsorption kinetics were analyzed by the pseudo first‐order and pseudo second‐order models. Besides this, the saturation and regeneration were analyzed with continuous flow tests. The empirical model of Freundlich described the adsorption equilibrium data better than the theoretical model of Langmuir. Likewise, the pseudo first‐order model best represented the experimental data regarding the adsorption kinetics of the systems studied. In the batch tests, the resin DVB was most efficient in removing toluene, but it reached equilibrium with a longer contact time. The continuous flow tests showed that the two systems presented good removal performance; however, DVB column could treat ≈600 bed volumes of water while MMA‐DVB treated only ≈280. The absorbents revealed great potential to be regenerated.
Fourier amplitude sensitivity test applied to dynamic combined finite‐discrete element methods–based simulations
Authors: Godinez Humberto C. , Rougier Esteban , Osthus Dave , Lei Zhou , Knight Earl , Srinivasan Gowri
Published: August 2018

Fracture propagation plays a key role for a number of applications of interest to the scientific community, from dynamic fracture processes like spallation and fragmentation in metals to failure of ceramics, airplane wings, etc. Simulations of material deformation and fracture propagation rely on accurate knowledge of material characteristics such as material strength and the amount of energy being dissipated during the fracture process. Within the combined finite‐discrete element method (FDEM) framework material fracture behavior is typically described through a parametrized softening curve, which defines a stress‐strain relationship unique to each material. We apply the Fourier amplitude sensitivity test to explore how each of these parameters influences the simulated damage processes and to determine the key input parameters that have the most impact on the model response. We present several sensitivity numerical experiments for the simulation of a split Hopkinson pressure bar (SHPB) test for weathered granite samples using different combinations of model parameters. We validate the obtained results against SHPB experimental data. The experiments show that the model is mostly sensitive to parameters related to tensile and shear strengths, even in the presence of other parameter perturbations. The results suggest that the specification of tensile and shear strengths at the interfaces dominate the stress‐time history of the FDEM simulation of SHPB test.
Modelling white matter with spherical deconvolution: How and why?
Authors: Dell'Acqua Flavio , Tournier J.‐Donald
Published: August 2018

Since the realization that diffusion MRI can probe the microstructural organization and orientation of biological tissuein vivoand non‐invasively, a multitude of diffusion imaging methods have been developed and applied to study the living human brain. Diffusion tensor imaging was the first model to be widely adopted in clinical and neuroscience research, but it was also clear from the beginning that it suffered from limitations when mapping complex configurations, such as crossing fibres. In this review, we highlight the main steps that have led the field of diffusion imaging to move from the tensor model to the adoption of diffusion and fibre orientation density functions as a more effective way to describe the complexity of white matter organization within each brain voxel. Among several techniques, spherical deconvolution has emerged today as one of the main approaches to model multiple fibre orientations and for tractography applications. Here we illustrate the main concepts and the reasoning behind this technique, as well as the latest developments in the field. The final part of this review provides practical guidelines and recommendations on how to set up processing and acquisition protocols suitable for spherical deconvolution.
Accelerating the iterative solution of convection–diffusion problems using singular value decomposition
Authors: Pitton G. , Heltai L.
Published: August 2018

The discretization of convection–diffusion equations by implicit or semi‐implicit methods leads to a sequence of linear systems usually solved by iterative linear solvers such as the generalized minimal residual method. Many techniques bearing the name of recycling Krylov space methods have been proposed to speed up the convergence rate after restarting, usually based on the selection and retention of some Arnoldi vectors. After providing a unified framework for the description of a broad class of recycling methods and preconditioners, we propose an alternative recycling strategy based on a singular value decomposition selection of previous solutions and exploit this information in classical and new augmentation and deflation methods. The numerical tests in scalar nonlinear convection–diffusion problems are promising for high‐order methods.
Recruiting heroes to campus: Crafting powerful narratives to drive enrollment
Authors: Sutton Halley
Published: August 2018

Consider this scenario: Your institution shells out money on marketing and digital initiatives that result in a high number of inquiries and click‐throughs on your website, but little to no return in enrollment numbers. If that sounds familiar, the problem may not be your outreach — it may be that you are not telling a cohesive story about your institution.