bluuebunny/crossref_metadata_2025 huggingface dataset:
Solution‐Processable Thermally Crosslinked Organic Radical Polymer Battery Cathodes
Authors: Wang Shaoyang , Park Albert Min Gyu , Flouda Paraskevi , Easley Alexandra D. , Li Fei , Ma Ting , Fuchs Gregory D. , Lutkenhaus Jodie L.
Published: January 2020

Organic radical polymers are promising cathode materials for next‐generation batteries because of their rapid charge transfer and high cycling stability. However, these organic polymer electrodes gradually dissolve in the electrolyte, resulting in capacity fade. Several crosslinking methods have been developed to improve the performance of these electrodes, but they are either not compatible with carbon additives or compromise the solution processability of the electrodes. A one‐step post‐synthetic, carbon‐compatible crosslinking method was developed to effectively crosslink an organic polymer electrode and allow for easy solution processing. The highest electrode capacity of 104 mAh g−1 (vs. a theoretical capacity of 111 mAh g−1) is achieved by introducing 1 mol % of the crosslinker, whereas the highest capacity retention (99.6 %) is obtained with 3 mol % crosslinker. In addition, mass transfer was observed in situ by using electrochemical quartz crystal microbalance with dissipation monitoring. These results may guide future electrode design toward fast‐charging and high‐capacity organic electrodes.
Diagnosing diabetic foot osteomyelitis
Authors: Senneville Eric M. , Lipsky Benjamin A. , van Asten Suzanne A.V. , Peters Edgar J.
Published: January 2020

Bone involvement during an infection of the diabetic foot represents a serious complication associated with a high risk of amputation, prolonged antibiotic treatment and hospitalization. Diabetic foot osteomyelitis (DFOs) require a multidisciplinary approach given the usual complexity of these situations. DFO should be suspected in most cases especially in the most severe forms of soft tissue diabetic foot infections (DFIs) where the prevalence of bone infection may be up to 60%. Suspicion is based on clinical signs in particular a positive probe‐to‐bone (PTB) test, elevated inflammatory biomarkers especially erythrocyte sedimentation rate and abnormal imaging assessment using plain X‐ray as a first‐line choice. The combination of PTB test with plain X‐ray has proven effective in the diagnosis of DFO. The confirmation (definite) diagnosis of DFO is based on the results of a bone sample examination obtained by either surgical or percutaneous biopsy. Sophisticated imaging examinations such as Magnetic Resonance Imaging (MRI) and nuclear imaging techniques are useful where doubt persists after first‐line imaging assessment. These techniques may also help localize the bone infection site and increase the diagnostic performance of percutaneous bone biopsy. The quality of the microbiological documentation of DFO is likely to improve the adequacy of the antimicrobial therapy especially when medical (ie, no surgical resection of the infected bone tissues) is considered. The use of new (molecular) techniques for the identification of the bone pathogens have not yet proven superiority on classic cultural techniques for the management of such patients.
LC‐MS/MS method for the quantification of new psychoactive substances and evaluation of their urinary detection in humans for doping control analysis
Authors: Olesti Eulalia , Pascual Jose Antonio , Ventura Mireia , Papaseit Esther , Farré Magí , de la Torre Rafael , Pozo Oscar J.
Published: January 2020

The constant legal adaptation of new psychoactive substances (NPS), challenges their evaluation in different fields. In sports, NPS are prohibited in competition with a reporting limit (RL) of 50 ng/mL for the parent compound or a metabolite. However, there is a lack of comprehensive methodologies and excretion studies for monitoring NPS. This work aims to develop an analytical methodology for the NPS quantification and to evaluate the suitability of monitoring the urinary parent stimulants after NPS misuse. A method for the quantification of 14 common NPS was developed and validated. The method was found to be linear in the range 1–1000 ng/mL, and was shown to be accurate and precise. A lowest limit of quantification (LLOQ) of 1 ng/mL was established for all analytes except for benzylpiperazine (5 ng/mL). The method was able to confirm the identity of the analytes at the LLOQ for most NPS. The methodology was applied to the quantification of the parent compound in urine samples collected from an observational study where several healthy volunteers (n ≥ 6 per drug) ingested active doses of mephedrone (MEPH), methylone (MDMC), 2,5‐dimetoxy‐4‐ethylphenetylamine (2C‐E), or 6‐(2‐aminopropyl)benzofuran (6‐APB). It was observed that for MDMC and 6‐APB, the quantification of the urinary parent drug at the current RL is a proper strategy for detecting their misuse. However, this strategy seems to be insufficient for evaluating MEPH and 2C‐E misuse. Monitoring the most abundant metabolite of MEPH (4′‐carboxy‐MEPH) and the reduction of the RL to 10 ng/mL for the 2C‐E evaluation are proposed.
In vivo metabolism of the designer anabolic steroid hemapolin in the thoroughbred horse
Authors: Waller Christopher C. , Weththasinghe Sumudu A. , McClure Lauren , Cawley Adam T. , Suann Craig , Suann Emily , Sutherland Emma , Cooper Elliot , Heather Alison , McLeod Malcolm D.
Published: January 2020

Hemapolin (2α,3α‐epithio‐17α‐methyl‐5α‐androstan‐17β‐ol) is a designer steroid that is an ingredient in several “dietary” and “nutritional” supplements available online. As an unusual chemical modification to the steroid A‐ring could allow this compound to pass through antidoping screens undetected, the metabolism of hemapolin was investigated by an in vivo equine drug administration study coupled with GC‐MS analysis. Following administration of synthetically prepared hemapolin to a thoroughbred horse, madol (17α‐methyl‐5α‐androst‐2‐en‐17β‐ol), reduced and dihydroxylated madol (17α‐methyl‐5α‐androstane‐2β,3α,17β‐triol), and the isomeric enone metabolites 17β‐hydroxy‐17α‐methyl‐5α‐androst‐3‐en‐2‐one and 17β‐hydroxy‐17α‐methyl‐5α‐androst‐2‐en‐4‐one, were detected and confirmed in equine urine extracts by comparison with a library of synthetically derived reference materials. A number of additional madol derivatives derived from hydroxylation, dihydroxylation, and trihydroxylation were also detected but not fully identified by this approach. A yeast cell‐based androgen receptor bioassay of available reference materials showed that hemapolin and many of the metabolites identified by this study were potent activators of the equine androgen receptor. This study reveals the metabolites resulting from the equine administration of the androgen hemapolin that can be incorporated into routine GC‐MS antidoping screening and confirmation protocols to detect the illicit use of this agent in equine sports.
Spironolactone use is associated with improved outcomes in heart failure with mid‐range ejection fraction
Authors: Enzan Nobuyuki , Matsushima Shouji , Ide Tomomi , Kaku Hidetaka , Higo Taiki , Tsuchihashi‐Makaya Miyuki , Tsutsui Hiroyuki
Published: January 2020

Aims

Spironolactone has been shown to improve outcomes in patients with heart failure (HF) with reduced ejection fraction (EF). We investigated whether the discharge use of spironolactone could be associated with better long‐term outcomes among patients with HF with mid‐range EF (HFmrEF).

Methods and results

We analysed HFmrEF (left ventricular EF 40–49%) patients enrolled in the Japanese Cardiac Registry of Heart Failure in Cardiology, which prospectively studied the clinical characteristics, treatments, and long‐term outcomes of patients hospitalized due to HF. Patients were divided into two groups according to the use of spironolactone at discharge. The primary outcome was a composite of all‐cause death or HF rehospitalization. A total of 457 patients had HFmrEF. The mean age was 69.3 years and 286 (62.6%) were male. Among them, spironolactone was prescribed at discharge in 158 patients (34.6%). Chronic kidney disease (7.6% vs. 16.8%, P = 0.007) was less prevalent and loop diuretics (89.2% vs. 70.2%, P < 0.001) were more often prescribed in patients with spironolactone. During a mean follow‐up of 2.2 years, patients with spironolactone had a lower incidence rate of the primary outcome than those without it (171.5 vs. 278.8 primary outcome per 1000 patient‐years, incidence rate ratio 0.61, 95% confidence interval 0.44–0.86; P = 0.004). After multivariable adjustment, spironolactone use at discharge was associated with a significant reduction in the composite of all‐cause death or HF rehospitalization (adjusted hazard ratio 0.63, 95% confidence interval 0.44–0.90, P = 0.010).

Conclusions

Among patients with HF hospitalized for HFmrEF, spironolactone use at discharge was associated with better long‐term outcomes.
Corner‐ and Side‐Opened Cage Silsesquioxanes: Structural Effects on the Materials Properties
Authors: Imoto Hiroaki , Ueda Yukiho , Sato Yuri , Nakamura Masashi , Mitamura Koji , Watase Seiji , Naka Kensuke
Published: January 2020

Open‐cage silsesquioxane, in which traditional closed‐cage silsesquioxane is partially hydrolyzed, is a promising class of building blocks for constructing organic‐inorganic hybrids. It has advantages of high thermal stability, low crystallinity, transparency, designability, etc. Although the structural effects of closed‐cage silsesquioxanes have been elucidated in detail so far, those of open‐cages have never been studied. Herein, we synthesized corner‐ and side‐opened cage silsesquioxanes having carbazole units at the open moieties. The former was amorphous in the solid state and polymer matrix, while the latter formed crystalline structures. These different packing structures caused significant difference in the performance as an emission layer of organic light emitting device.
Anacardic acid mitigates liver fat accumulation and impaired glucose tolerance in mice fed a high‐fat and high‐sucrose diet
Authors: Chung Sangwon , Shin Eun Ju , Choi Hyo‐Kyoung , Park Jae Ho , Hwang Jin‐Taek
Published: January 2020

In this study, we evaluated the effects of anacardic acid (AA), a phenolic lipid found in cashew nuts (Anacardium occidentale), on metabolic disorders related to obesity, fatty liver disease, and diabetes using both in vitro and in vivo models. The application of AA led to a reduction in lipid accumulation in 3T3‐L1 cells without observable cytotoxicity. Results from Western blot analysis revealed that AA treatment also led to decreased expression of fatty acid synthase and peroxisome proliferator‐activated receptor gamma. In vivo studies were performed to evaluate the effects of AA treatment on fatty liver disease and diabetes. Mice fed a high‐fat and high‐sucrose diet had significantly higher body and liver weights, and higher levels of liver fat, cholesterol, fasting glucose, and homeostasis model assessment of insulin resistance (HOMA‐IR). However, 12 weeks of oral treatment with 500 μg/kg BW AA slowed down lipid accumulation rates in the liver and mitigated insulin resistance in these mice. Thus, AA may reduce lipid levels and have an antidiabetic effect.
Immune checkpoint inhibitors in advanced nasopharyngeal carcinoma: Beyond an era of chemoradiation?
Authors: Masterson Liam , Howard James , Gonzalez‐Cruz Jazmina , Jackson Christopher , Barnett Catherine , Overton Lewis , Liu Howard , Ladwa Rahul , Simpson Fiona , McGrath Margie , Wallwork Ben , Jones Terry , Ottensmeier Christian , Chua Melvin L.K. , Perry Chris , Khanna Rajiv , Panizza Benedict , Porceddu Sandro , Lechner Matt
Published: January 2020

Now is an exciting era of development in immunotherapy checkpoint inhibitors and their effect on the treatment of NPC. While the general prognosis of R/M disease is poor, immunotherapy offers some promise in a malignancy associated with EBV and characterized by a peritumoural immune infiltrate. Our study aims to review past and on‐going clinical trials of monoclonal antibody therapies against the checkpoint inhibitors (e.g. PD1 and CTLA‐4), in R/M NPC. All randomized and nonrandomized controlled trials involving immune checkpoint inhibitor interventions for treatment of NPC were included in the study. We utilized a validated “risk of bias” tool to assess study quality. Four separate Phase I–II trials report the potential of PD1 inhibitor treatment for patients with NPC. Within the observed groups, camrelizumab combined with chemotherapy achieved an objective response in 91% of patients as first‐line treatment for metastatic NPC (PFS 68% at 1‐year) but this was associated with a high rate of grade >3 adverse events (87%; CTCAE version 4.03). The remaining three studies focused on recurrent NPC disease in patients who had received at least one line of prior chemotherapy. Within this group, camrelizumab monotherapy achieved an objective response in 34% of patients (PFS 27% at 1‐year; range across all three studies 20.5–34%). No NPC trial has yet reported on specific outcomes for non‐PD1 checkpoint inhibitors but 11 on‐going studies include alternative targets (e.g. PD‐L1/CTLA‐4) as combination or monotherapy treatments. In considering checkpoint immunotherapies for NPC, initial results show promise for anti‐PD1 interventions. Further phase I–III trials are in progress to clarify clinical outcomes, fully determine safety profiles, and optimize drug combinations and administration schedules.
The impact of educational interventions on antibiotic prescribing for acute upper respiratory tract infections in the ambulatory care setting: A quasi‐experimental study
Authors: Craddock Kaitlyn , Molino Suzanne , Stranges Paul M. , Suda Katie J. , Bleasdale Susan C. , Radosta Jonathan , Kannampallil Thomas , Shapiro Nancy L. , Gross Alan E.
Published: January 2020

Objective

To identify the proportion of viral acute upper respiratory tract infections (AURTI) inappropriately treated with antibiotics before and after the implementation of a multimodal outpatient antibiotic stewardship initiative in a real‐world setting.

Design

Pre‐post, quasi‐experimental study.

Patients

Adult patients with a diagnosis of either acute bronchitis, influenza, unspecified viral infection, or unspecified AURTI who visited internal medicine (IM) or family medicine (FM) ambulatory care clinics at an urban, academic health system in 2016 and 2017.

Interventions

Provider education including the dissemination of an institutional guideline and algorithm for the treatment of AURTI occurred in FM and IM clinics. In the FM clinics, a roundtable discussion with clinicians promoting safe and appropriate antibiotic prescribing was conducted, and patient‐facing educational posters were placed in exam rooms and clinic waiting areas describing the FM teams' commitment to using antibiotics only when necessary.

Results

A total of 2817 patient encounters met study inclusion criteria. In total, inappropriate antibiotic prescribing had a relative decrease of 24% after implementation of the interventions (17.2% [235/1362] preintervention vs 13.1% [191/1455] postintervention; P = .02). During the preintervention period, 25.4% (143/563) of the encounters in the IM clinics were associated with inappropriate antibiotic prescribing compared with 19% (108/568) in the postintervention period (P < .01). Relative to the IM clinics, the FM clinics had a lower proportion of encounters associated with inappropriate antibiotic prescribing at baseline. In FM clinics, 11.5% (92/799) of encounters were associated with inappropriate antibiotic prescribing during the preintervention period compared with 9.4% (83/887) during the postintervention period (P = .15).

Conclusions

Simple educational interventions may decrease inappropriate antibiotic prescribing for AURTIs in outpatient settings. In addition, the incremental benefit of patient‐facing education may be limited outside of randomized studies or in settings with low baseline antibiotic prescribing rates for AURTIs. Therefore, additional studies outside of randomized trials are needed.
Impact of team‐based care on appropriate statin therapy prescribing in ***HIV‐infected patients
Authors: Hester Elizabeth K. , Caulder Celeste R. , Penzak Scott R.
Published: January 2020

Introduction

Statins have historically been underutilized in patients living with ***HIV infection (PLWH) despite reported rates of cardiovascular disease twice that of the general population.

Objective

To evaluate the impact of team‐based pharmacy services on appropriate statin prescribing compared with standard care in an HIV primary care clinic.

Methods

A retrospective chart review of adult PLWH was conducted for appropriate statin prescribing according to 2013 American College of Cardiology/American Heart Association cholesterol guidelines. Patient outcomes were stratified by team‐based care defined as physician/pharmacy collaboration, and standard care defined as primary care without clinical pharmacy services. The primary outcome was the percentage of patients receiving appropriate statin therapy in the two groups. Secondary outcomes included percentage of patients receiving appropriate statin therapy, number of patients indicated for therapy but untreated, and achievement of low‐density lipoprotein (LDL) goal reduction. Chi‐square analysis was used for nominal comparisons, and logistic regression was used to identify predictors of appropriate statin prescribing.

Results

Three hundred fifty‐two charts were screened, 114 of which met inclusion criteria. Eighty‐nine patients (61%) received team‐based care and 25 (22%) received standard care. Appropriate statin prescribing was observed in a greater percentage of patients in the team‐based care group compared with the standard care group (86% vs 54%, respectively; P < .001). More patients receiving team‐based care were also prescribed statin therapy when indicated (98% vs 88%; P < .001). Team‐based care was a predictor of appropriate statin prescribing (odds ratio 10.31, P < .001); however, LDL goal reduction was achieved in <30% in both groups.

Conclusion

Patients living with HIV infection receiving team‐based care that included a clinical pharmacist were significantly more likely to be prescribed appropriate statin therapy compared with patients receiving standard care. Nonetheless, achieving goal LDL reduction remained a challenge in these patients regardless of approach to care (team‐based vs standard).
From the military to college and beyond: Growing a culturally sensitive program to support veteran success
Authors: Ulrich Stefanie , Freer Benjamin D.
Published: January 2020

This paper addresses the unique characteristics of veterans and the role military culture continues to play for post‐service veterans. We describe a series of programs developed to provide critically important assistance to current and recent student veterans by connecting them to a network of veteran peers and mentors. Through a discussion of psychological distress and healing, stigma, and the challenges of college, we hoped to galvanize student veterans to recognize the value of psychological well‐being. We additionally offer suggestions, based on years of work with veterans, on the development of programs and the provision of clinical services for the veteran community.
A case analysis of service‐member trauma processing related to art therapy within a military‐intensive outpatient program
Authors: Maltz Brenda , Hoyt Tim , Uomoto Jay , Herodes Megan
Published: January 2020

Objectives

Art therapy has been widely used in clinical settings and has shown preliminary success in military trauma. This case study describes a mask‐making art therapy directive facilitated by a board‐certified art therapist as an adjunct to group posttraumatic stress disorder (PTSD) treatment in a military‐intensive outpatient program.

Methods

Described are clinical outcome measures, linguistic analysis of a personal journal, evaluation of this service‐member's artwork, and experiences in the program.

Results

Mask‐making, as a trauma‐focused group‐art therapy directive, expanded the understanding of treatment progress reflected in journal notes, mask imagery, and by a change in linguistic indices of trauma processing, despite an overall increase in PTSD symptoms as he confronted his traumatic experiences. He reported improvement in coping and successfully returned to full military duty following treatment.

Conclusions

This case study suggests that art therapy and written narrative, combined with standardized self‐report assessments, may more accurately indicate improvement in overall PTSD treatment.
Suitability of the multidimensional scale of perceived social support as a measure of functional social support among incarcerated adults with major depressive disorder
Authors: Wittenborn Andrea K. , Natamba Barnabas K. , Rainey Melinda , Zlotnick Caron , Johnson Jennifer
Published: January 2020

The multidimensional scale of perceived social support (MSPSS) is a 12‐item measure of functional social support (SS); however, the psychometric properties of the MSPSS have not been evaluated in prisoners. We used measures of known‐groups validity, convergent and discriminant validity, internal consistency reliability and factor structure to assess the suitability of the MSPSS for measuring SS among 184 individuals in prison in the U.S., who were diagnosed with depression. The MSPSS was correlated with scores on scales measuring related constructs (i.e., loneliness), and uncorrelated with unrelated constructs (i.e., verbal ability). Correlations among items of the MSPSS on the same subscale were large, and small to moderate among items of different subscales. The overall Cronbach's α for the scale was 0.93. Confirmatory factor analysis showed that the theorized three‐factor solution for the MSPSS (i.e., significant other, family, and friends) provided a good fit for the data. We recommend using the MSPSS to measure perceived SS among incarcerated individuals.
Narrative identities of overseas Filipino domestic worker community in Macao (SAR) China
Authors: Vargas Marenel C. , Garabiles Melissa R. , Hall Brian J.
Published: January 2020

Domestic workers comprise roughly one‐fourth of the total number of overseas Filipino workers (OFWs). They leave the Philippines primarily to provide financial assistance to their families they leave behind. Most of the existing studies investigated the problems they experience at work and with their families. Some studies focused on how they cope with these problems. However, little is known about the narrative identities of this group of labor migrants. This study addresses this gap by identifying the narrative identities of the community of Filipino domestic workers in Macao Special Administrative Region, China. This study utilized qualitative interviews to plot the identities into a three‐part timeline: Premigration, during migration, and imagined future. Results show that, before migration, the community of domestic workers identifies as hands‐on mothers and inadequate mothers. During migration, work‐ and family‐related identities are present: Modern‐day slave, inadequate, fighter, self‐sacrificing, employer's family, and hands‐on mother. In an imagined future, the community of domestic workers identifies as successful retired OFWs, reconciled life partners, hands‐on mothers, and inadequate mothers. Findings highlight the multiple, interacting identities in community narratives and their corresponding effects on experiences. Implications on policies and programs for this labor migrant group are discussed.
LncRNA NKILA inhibits the proliferation and promotes the apoptosis of CSCC cells by downregulating miRNA‐21
Authors: Wang Jinou , Zhu Zhi , Qiu Hui , Liu Chang , Chang Xiaoying , Qi Yafei , Lv Qingjie
Published: January 2020

Long noncoding RNA (lncRNA) NKILA has been well studied in several types of human tumors as a tumor suppressor, while its involvement in cervical squamous cell carcinoma (CSCC) remains unclear. In our studies, we found that serum NKILA was at lower levels and serum microRNA‐21 (miRNA‐21) was at higher levels in patients with early stage CSCC than in the healthy female. Altered expression of NKILA and miRNA‐21 can effectively separate patients with CSCC at an early stage from healthy controls. Serum levels of NKILA were significantly and negatively correlated with miRNA‐21 in patients with CSCC but not in normal controls. Overexpression of NKILA mediated the inhibited expression of miRNA‐21 in CSCC cells, but mimic transfection of miRNA‐21 did not significantly change the expression level of NKILA. Overexpression of NKILA repressed the proliferation and promoted the apoptosis of CSCC cells, while miRNA‐21 showed opposite functions. In addition, miRNA‐21 mimic transfection reduced the effects of NKILA on CSCC cells. Collectively, lncRNA NKILA could repress the proliferation and promote the apoptosis of CSCC cells by downregulating miRNA‐21.
Identification of potential miRNA biomarkers for traumatic osteonecrosis of femoral head
Authors: Liu Guan‐Zhi , Chen Chen , Kong Ning , Tian Run , Li Yi‐Yang , Li Zhe , Wang Kun‐Zheng , Yang Pei
Published: January 2020

Traumatic osteonecrosis of femoral head (TONFH) is a common orthopedic disease caused by physical injury in hip. However, the unclear pathogenesis mechanism of TONFH and lacking of simple noninvasive early diagnosis method cause the necessity of hip replacement for most patients with TONFH. In this study, we aimed to identify circulating microRNAs (miRNAs) by integrated bioinformatics analyses as potential biomarker of TONFH. mRNA expression profiles were downloaded from the Gene Expression Omnibus database. Then we combined two miRNA screen methods: Weighted gene co‐expression network analysis and fold change based differentially expressed miRNAs analysis. As a result, we identified 14 key miRNAs as potential biomarkers for TONFH. Besides, 302 target genes of these miRNAs were obtained and the miRNA–mRNA interaction network was constructed. Furthermore, the results of Kyoto Encyclopedia of Gene and Genome pathway analysis, Gene Ontology function analysis, protein–protein interaction (PPI) network analysis and PPI network module analysis showed close correlation between these 14 key miRNAs and TONFH. Then we established receiver operating characteristic curves and identified 6‐miRNA signature with highly diagnosis value including miR‐93‐5p (area under the curve [AUC] = 0.93), miR‐1324 (AUC = 0.92), miR‐4666a‐3p (AUC = 0.92), miR‐5011‐3p (AUC = 0.92), and miR‐320a (AUC = 0.89), miR‐185‐5p (AUC = 0.89). Finally, the results of quantitative real‐time polymerase chain reaction confirmed the significantly higher expression of miR‐93‐5p and miR‐320a in the serum of patients with ONFH. These circulating miRNAs could serve as candidate early diagnosis markers and potential treatment targets of TONFH.
Facing the surgeon's nightmare: Incidence and management of postoperative pancreatic fistulas grade C after pancreaticoduodenectomy based on the updated definition of the International Study Group of Pancreatic Surgery (ISGPS)
Authors: Luu Andreas Minh , Krasemann Lukas , Fahlbusch Tim , Belyaev Orlin , Janot‐Matuschek Monika , Uhl Waldemar , Braumann Chris
Published: January 2020

Background

Postoperative pancreatic fistulas (POPF) grade C represent a rare but feared complication following pancreaticoduodenectomy (PD). They can contribute significantly to postoperative morbidity and mortality.

Methods

We performed a retrospective chart review for all patients who had undergone pancreatic head resection between 2007 and 2016 to identify those who suffered from POPF grade C according to the updated definition of the International Study Group of Pancreatic Surgery (ISGPS).

Results

A total of 722 patients underwent PD. Twenty‐three patients (3.19%) developed a POPF grade C. Cardiovascular diseases, soft pancreatic texture and main pancreatic duct diameter were identified as risk factors (P < .05). Reoperation was necessary in all affected patients on postoperative day 12 ± 9 on average. Mortality was significantly associated with POPF grade C (P < .05) being present in 39.1% (9/23).

Conclusions

POPF grade C after PD remains a serious complication with a high level of morbidity and mortality. Surgical treatment is the sole curative therapy and thus the treatment of choice.
Liver function test abnormalities in a longitudinal cohort of Thai individuals treated since acute HIV infection
Authors: Peluso Michael J , Colby Donn J , Pinyakorn Suteeraporn , Ubolyam Sasiwimol , Intasan Jintana , Trichavaroj Rapee , Chomchey Nitiya , Prueksakaew Peeriya , Slike Bonnie M , Krebs Shelly J , Jian Ningbo , Robb Merlin L , Phanuphak Praphan , Phanuphak Nittaya , Spudich Serena , Ananworanich Jintanat , Kroon Eugène ,   on behalf of the SEARCH010/RV254 Study Group
Published: January 2020

Introduction

Liver disease is a common cause of non‐AIDS morbidity and mortality in people living with HIV (PLHIV), but the prevalence and significance of liver function test (LFT) abnormalities in early HIV infection is unknown. This study aimed to characterize LFTs in a large cohort of participants with acute HIV infection initiating immediate antiretroviral therapy (ART) and examine the association between LFTs and biomarkers of HIV infection and inflammation.

Methods

We measured LFTs at the time of HIV diagnosis and at 4, 12, 24 and 48 weeks after ART initiation in 426 Thai individuals with acute HIV infection from 2009 to 2018. A subset of individuals had data available at 96 and 144 weeks. We excluded individuals with concomitant viral hepatitis. Alanine aminotransferase (ALT) was the primary outcome of interest; values greater than 1.25 times the upper limit of normal were considered elevated. Analyses utilized descriptive statistics, non‐parametric tests and multivariate logistic regression.

Results

Sixty‐six of the 426 individuals (15.5%) had abnormal baseline ALT levels; the majority (43/66, 65.5%) had Grade 1 elevations. Elevated baseline ALT correlated with Fiebig stages III to V (p = 0.001) and baseline HIV RNA >6 log10 copies/mL (p = 0.012). Baseline elevations resolved by 48 weeks on ART in 59 of the 66 individuals (89%). ALT elevations at 24 and 48 weeks correlated with Fiebig stages I to II at diagnosis (p < 0.001), baseline plasma HIV RNA levels <6 log10 copies/mL (p < 0.001), abnormal baseline ALT (p < 0.001), baseline CD4 >350 cells/μL (p = 0.03) and older age (p = 0.03). Individuals initiating efavirenz‐based regimens were more likely to have elevated ALT levels at 48 weeks compared with those on non‐efavirenz‐based regimens (p = 0.003).

Conclusions

One in six people with acute HIV infection have elevated LFTs. Clinical outcomes with ART started in acute HIV are generally good, with resolution of ALT elevations within 48 weeks on ART in most cases. These results suggest a multifactorial model for hepatic injury involving a combination of HIV‐associated and ART‐associated processes, which may change over time.
Transcriptional regulation of neutrophil differentiation and function during inflammation
Authors: Ai Zhichao , Udalova Irina A.
Published: January 2020

Neutrophils are the most abundant leukocytes in innate immunity where they elicit powerful effector functions to eliminate invading pathogens and modulate the adaptive as well as the innate immune response. Neutrophil function must be tightly regulated during inflammation and infection to avoid additional tissue damage. Increasing evidence suggests that transcription factors (TFs) function as key regulators to modulate transcriptional output, thereby controlling cell fate decision and the inflammatory responses. However, the molecular mechanisms underlying neutrophil differentiation and function during inflammation remain largely uncharacterized. Here, we provide a comprehensive overview of TFs known to be crucial for neutrophil maturation and in the signaling pathways that control neutrophil differentiation and activation. We also outline how emerging genomic and single-cell technologies may facilitate further discovery of neutrophil transcriptional regulators.
Base metal‐catalyzed hydrogen isotope exchange
Authors: Yang Haifeng , Hesk David
Published: January 2020

Hydrogen isotope exchange (HIE) has played an increasingly important role in deuteration and tritiation of compounds in the pharmaceutical industry. Transition metal‐catalyzed HIE methods have gained considerable attention in the past decades, and most of these methods were comprehensively reviewed in 2010 in a special JLCR issue. It covered a wide variety of HIE catalysis systems involving precious metal catalysts, and a relatively small percentage of base metal catalysts, with a major focus on heterogeneous nickel. While base metal catalysts have remained underdeveloped for HIE chemistry relative to second and third row transition metal catalysts, in recent years, the first examples of homogeneous iron, nickel, and cobalt catalysts have been introduced to the field. Hence, in this review, we describe the recent development of base metal catalysts for HIE and their applications in isotopic labeling of pharmaceutical compounds. These research efforts have resulted in the development of labeling approaches that complement traditional methods in terms of activity and selectivity, thus diversifying the methodologies available for isotope chemists.
Time perspective balance and team adaptation in dynamic task contexts
Authors: Waller Mary J. , Franklin Ashley E. , Parcher Dana B.
Published: January 2020

The concept of time perspective balance has attracted increased attention from scholars in the past decade, reflected in published evidence suggesting positive outcomes ranging from enhanced mood to life satisfaction for those individuals possessing balance among their past, present, and future time perspectives, and assumedly able to shift their time perspective to match situational demands. In this paper, we consider the notion of time perspective balance in an organizational setting within which much consequential adaptation often occurs—the team environment—and explore different configurations of time perspective balance in teams facing dynamic task contexts. Drawing from work on situational awareness, we first consider the mechanism by which time perspective balance likely influences individual adaptation in dynamic task‐focused situations. Next, we postulate what types of team configurations—ones with more balanced time perspective uniformity or ones with more time perspective variety—might be more appropriate in dynamic contexts given key team conditions. We illustrate our analysis with examples from healthcare team settings and offer ideas for future research.
Pregnancy in Liver Transplantation
Authors: Rahim Mussarat N. , Long Lisa , Penna Leonie , Williamson Catherine , Kametas Nikos A. , Nicolaides Kypros H. , Heneghan Michael A.
Published: January 2020

Pregnancy after liver transplantation (LT) is increasingly common and is a frequent scenario that transplant physicians, obstetricians, and midwives encounter. This review summarizes the key issues surrounding preconception, pregnancy‐related outcomes, immunosuppression, and breastfeeding in female LT recipients. Prepregnancy counseling in these patients should include recommendations to delay conception for at least 1‐2 years after LT and discussions about effective methods of contraception. Female LT recipients are generally recommended to continue immunosuppression during pregnancy to prevent allograft rejection; however, individual regimens may need to be altered. Although pregnancy outcomes are overall favorable, there is an increased risk of maternal and fetal complications. Pregnancy in this cohort remains high risk and should be managed vigilantly in a multidisciplinary setting. We aim to review the available evidence from national registries, population‐based studies, and case series and to provide recommendations for attending clinicians.
A male infant with Xq22.2q22.3 duplication containing PLP1 and MID2
Authors: Chanchani Swati R. , Xie Hongyan , Sekhon Gurbax , Melikishvili Ana M. , Moyer Harasink Sue , Pall Harpreet , Giampietro Philip F.
Published: January 2020

Background

The Xq22.2 q23 is a complex genomic region which includes the genes MID2 and PLP1 associated with FG syndrome 5 and Pelizaeus–Merzbacher disease, respectively. There is limited information regarding the clinical outcomes observed in patients with deletions within this region.

Methods

We report on a male infant with intrauterine growth retardation (IUGR) who developed head titubation and spasticity during his postnatal hospital course.

Results

Chromosome microarray revealed a 6.7 Mb interstitial duplication of Xq22.2q22.3. Fluorescence in situ hybridization showed that the patient's mother also possessed the identical duplication in the Xq22.3q22.3 region. Among the 34 OMIM genes in this interval, the duplication of the PLP1 (OMIM# 300401) and MID2 (OMIM# 300204) appears to be the most significant contributors to the patient's clinical features. Mutations and duplications of PLP1 are associated with X‐linked recessive Pelizaeus–Merzbacher disease (PMD). A single case of a Xq22.3 duplication including the MID2 has been reported in boy with features of FG syndrome. However, our patient's clinical features are not consistent with the FG syndrome phenotype.

Conclusion

Our patient's clinical features appear to be influenced by the PLP1 duplication but the clinical effect of other dosage sensitive genes influencing brain development cannot be ruled out.
Compound heterozygous mutations in FBN1 in a large family with Marfan syndrome
Authors: McInerney‐Leo Aideen M. , West Jennifer , Wheeler Lawrie , Leo Paul J. , Summers Kim M. , Anderson Lisa , Brown Matthew A. , West Malcolm , Duncan Emma L.
Published: January 2020

Background

Marfan syndrome (MFS) is a dominant monogenic disorder caused by mutations in fibrillin 1 (FBN1). Rarely, compound heterozygosity for FBN1 mutations has been described.

Methods

A large kindred with MFS was assessed clinically over decades, and genetically using exome and/or Sanger sequencing.

Results

A previously identified FBN1 missense variant (p.Tyr754Cys) was confirmed in all subjects with MFS. An additional variant (p.Met2273Thr), previously associated with incomplete MFS, was identified in three siblings. These three compound heterozygous individuals had aortic dilatation at early age (all <30 years): one also had cerebral and ocular aneurysms; and one, who had undergone surgical repair aged 18 years, died from aortic dissection at 31 years. In contrast, their heterozygous father (p.Tyr754Cys) with MFS died at 57 years (myocardial infarction) without requiring surgical intervention and one heterozygous (p.Tyr754Cys) sibling has aortic dilatation presenting >40 years but not requiring surgical intervention. Another heterozygous (p.Tyr754Cys) sibling did require aortic root repair (28 years). The heterozygous (p.Met2273Thr) mother had aortic dilatation diagnosed at age 68 years but has not required surgical repair.

Conclusion

Although compound heterozygosity or homozygosity is rare in MFS, it should be considered when there is an unusually severe phenotype in a subset of family members.
Technical Note: Radiotherapy dose characterization of gel dosimetry using shear wave elasticity imaging
Authors: Xie Wei‐Huan , Su Chun‐Ting , Kao Yu‐Chieh Jill , Chang Tung‐Hao , Chang Yuan‐Jen , Yao Chun‐Hsu , Hsieh Bao‐Yu
Published: January 2020

Purpose

Radiotherapy is an effective treatment for many types of cancer in clinical settings. Gel dosimetry has the potential to record three‐dimensional (3D) dose distribution compared to a conventional ion chamber. As the elasticity of the gel is altered after irradiation due to gel polymerization, we aim to measure the dose recorded in gel dosimetry with ultrasonic shear wave elasticity imaging (SWEI), a nondestructive and quantitative elasticity imaging tool.

Methods

In this study, a cylindrical N‐isopropylacrylamide (NIPAM) polymer gel with a diameter of 10 cm and a height of 10 cm and with cellulose as an ultrasonic scatterer was irradiated by a linear accelerator with the irradiation parameters of 6 MV x‐ray, dose rate of 100 cGy/min and field size of 10  20 mm2. The six gel phantoms were irradiated with the dose of 0, 1, 3, 5, 8, or 10 Gy. The gel phantoms were measured with SWEI at 24, 36, and 48 h after x‐ray irradiation. The two‐dimensional (2D) shear wave velocity and Young’s modulus maps corresponding to x‐ray dose distribution were reconstructed following a time‐of‐flight reconstruction from a set of time‐series displacement maps. The spatial resolution of the reconstructed SWEI image is ~1 mm.

Results

Our results show that the elastic modulus increases linearly as irradiation dose increases (R2 = 0.94 at 24 h, R2 = 0.98 at 36 h, R2 = 0.98 at 48 h), suggesting that the gel elasticity is highly associated with x‐ray irradiation dose at 36 h post irradiation, and the dose resolution was 0.66 kPa/Gy. From the 3D elastic modulus maps, the dose distribution along the depth and lateral direction can be reflected in the NIPAM gel dosimetry using SWEI as well.

Conclusions

In this study, the irradiated NIPAM gel phantom was quantitatively measured with SWEI for the first time to read the dose distribution recorded in the gel dosimetry. The results suggest that the gel elasticity is highly associated with x‐ray irradiation dose. In the future, 2D/or 3D dose distribution from intensity modulated radiotherapy (IMRT) or other potential particle radiotherapy will be measured and reconstructed with SWEI and compared with the dose map from a treatment planning system (TPS) in the clinic.
Quality measures in electrodiagnosis: Carpal tunnel syndrome—An AANEM Quality Measure Set
Authors: Zivkovic Sasha , Gruener Gregory , Arnold Michele , Winter Carrie , Nuckols Teryl , Narayanaswami Pushpa ,   and the Quality Improvement Committee of the American Association of Neuromuscular & Electrodiagnostic Medicine
Published: January 2020

Carpal tunnel syndrome (CTS) is a common neuromuscular condition and a major cause of work‐related disability. As healthcare in the United States transitions toward a value‐based system from fee‐for‐service, quality measures assume importance in the evaluation of care provided. This report from the American Association of Neuromuscular & Electrodiagnostic Medicine Quality Improvement Committee provides an introduction to quality measures and outlines a quality measurement set for the electrodiagnosis of CTS. The measures attempt to standardize technical requirements for electrodiagnostic (EDX) studies of CTS, the criteria for diagnosing median neuropathy at the wrist and assessing its severity, and the role of operative EDX testing. The assumption is that implementation of these measures will improve the accuracy of CTS diagnosis when EDX is performed, help exclude mimics, and, therefore, improve care of patients with CTS with the ultimate goal of improving outcomes. Postimplementation assessment of outcomes will refine these measures.
Burst‐modulated wide‐pulse neuromuscular electrical stimulation enhances H‐reflex recruitment in rats
Authors: Qu Wen , Hou Wensheng , Zhao Yun , Shu Bin , Chen Lin , Zheng Xiaolin , Wang Xing , Wu Xiaoying
Published: January 2020

Introduction

In this study we investigated whether burst‐modulated wide‐pulse neuromuscular electrical stimulation (NMES) can improve the H‐reflex and activation efficiency of sensory fibers.

Methods

NMES‐induced electromyography (EMG) was recorded from hindpaw plantar muscles in 11 anesthetized rats. A burst‐modulated wide pulse (mWP) with three carrier frequencies (2 kHz, 5 kHz, and 10 kHz) and a continuous wide‐pulse (WP) were delivered to the tibial nerve of each rat. The evoked Hoffman (H)‐reflexes were measured to evaluate nerve activation efficiency using the H‐reflex recruitment curve (HRC).

Results

Relative to WP simulation, mWP stimulation required less electrical charge to excite sensory fibers and improved the H‐reflex recruitment. Greater electrical charge and smaller recruitment gains were obtained with increased carrier frequency of mWP.

Discussion

mWP NMES can improve stimulation efficiency and improve recruitment of sensory fibers on tibial nerve stimulation, which may help to optimize NMES stimulus parameters.
Metabolic differentiation and quantification of gymnemic acid in Gymnema sylvestre (Retz.) R.Br. ex Sm. leaf extract and its fermented products
Authors: Khan Jalaluddin , Sheoran Sunita , Khan Washim , Panda Bibhu Prasad
Published: January 2020

Introduction

Gymnemagenin is the bioactive metabolite found in Gymnema sylvestre leaves and possesses different therapeutic potential. Due to its lower abundance and higher market potential, gymnemagenin was obtained from chemical conversion and bacterial biotransformation.

Objective

To obtain the probiotic‐based fermentative conversion of gymnemic acid‐enriched G. sylvestre leaf extract to gymnemagenin‐containing nutraceuticals and its metabolites based chromatographic comparison.

Material and Methods

Gymnema sylvestre leaves were extracted through soxhalation, and the extract was prepared and characterised. Gymnemic acid was fermented, separately, by Lactobacillus casei, Lactobacillus rhamnosus, Bifidobacterium bifidum, and by their mix co‐culture. The fermented materials were analysed for their gymnemagenin content, antioxidant potential, antidiabetic potential, and metabolomics analysis.

Results

Extraction yielded about 35% w/w of raw plant material, and 8.5% was found to be as total saponin content. Extract at higher concentration (≥ 5%, w/v) significantly altered the growth behaviour of probiotics. High‐performance thin‐layer chromatography (HPTLC) based quantification of gymnemagenin revealed that a maximum increase of 95.5% gymnemagenin was found in extract incubated with B. bifidum followed by mix co‐culture containing (B. bifidum, L. casei, and L. rhamnosus), L. casei, and L. rhamnosus. However, liquid chromatography mass spectrometry (LC‐MS) analysis resulted in the identification of a total of 56 metabolites.

Conclusion

Chromatographically profiled, and probiotic‐based fermented G. sylvestre leaves can be used as a potent nutraceutical for diabetes and other metabolic disorders.
An examination of psychological characteristics and their relationship to academic entitlement among millennial and nonmillennial college students
Authors: Keener Ashley
Published: January 2020

Academic entitlement (AE) has been a concern among college educators due to millennial college students entering the educational setting. Although there is theoretical justification to support such conjecture, it remains unclear whether AE is more prevalent among this generation. The present study examines the relationship between narcissism, self‐esteem, gratitude, and AE between millennial and nonmillennial college students. Among millennial college students, narcissism, self‐esteem, and gratitude were found to be significant predictors of AE; however, among nonmillennial college students, only self‐esteem was found to be a significant predictor. Findings were consistent with the literature in that they demonstrate that millennial college students may be more prone to narcissism than previous generations. Implications for future research and practice are discussed.
Progress in degradation of volatile organic compounds based on low‐temperature plasma technology
Authors: Chang Zhengshi , Wang Cong , Zhang Guanjun
Published: January 2020

On the basis of plasma technology, the progress of the volatile organic compounds' (VOCs') degradation by low‐temperature plasma alone is discussed first, including reactor types, influencing factors of plasma degradation of VOCs and the reaction mechanism between plasma and VOCs. Then, the research status of three VOC degradation technologies (catalysis, adsorption, and biotechnology) and their synergistic degradation of VOCs with plasma are reviewed, including the effect of catalyst position on VOC degradation, the interaction mechanism between plasma and catalyst; the factors affecting the adsorption of VOCs by carbon‐based adsorbents and zeolite, the degradation of VOCs by plasma‐assisted adsorbent; the features of different biological systems, the influencing factors of VOC degradation by the biotrickling system, and the degradation of VOCs by plasma‐assisted biotreatment. Finally, the prospects of developments in high‐tech based on plasma are discussed.