bluuebunny/crossref_metadata_2025 huggingface dataset:
Specific heat capacity and phase transition on 148—158Sm nucleiin microscopic core plus two-quasiparticle model
Authors: Shi Zhu-Yi  , Ji Shi-Yin  ,   (1)贵州教育学院物理系，贵阳  550003; (2)贵州民族学院物理系，贵阳  550025
Published: December 2020

Using microscopic core plus two-quasiparticle model, the ground-band, β-band, γ-band and partial high spins states at zero temperature in even 148—158 Sm isotopes are successfully reproduced, these values are coincident with recent experimental one. Under canonical ensemble theory, their finite temperature specific heat capacity is calculated. Seeing that the peak of specific heat capacity is the signal of phase transition, it is by means of this approach that the phase transition of model thermo-excited, one from the superfluid nuclear phase to the normal phase, and one from the deformed shape to the spherical shape taken place in nuclei may be described untidily. The aligned energy and the identity of two-quasiparticle are discussed, and then the thermal stability of nuclear shape is investigated.
Antibiotic Sensitivity Patterns and Plasmid Profile of Bacteria Isolated from Some Swimming Pools in Akure, Nigeria
Authors: Onifade A. K. , Francis B. E. , Aiyenuro E. A.
Published: December 2020

Aims: To evaluate the antibiotic sensitivity profile of bacteria isolated from swimming pools in Akure, Nigeria.

Place and Duration of Study: Department of Microbiology, The Federal University of Technology, Akure Ondo state Nigeria between May and July, 2018.

Methodology: Water samples were collected in the morning and evening periods including weekends, from ten (10) swimming pools in Akure, Ondo State, Nigeria. The temperature and the pH of the water samples were measured and recorded at the time of collection. The types and loads of bacteria at different times of each day were determined for each of the swimming pools. Characterization and Identification of the various bacterial isolates were based on Gram-staining techniques and biochemical tests. Antibacterial susceptibility profile of the isolates was evaluated using standard methods. Escherichia coli and Staphylococcus aureus being resistant to multiple antibiotics were subjected to plasmid analysis.

Results: Bacteria isolated include; E. coli which had the highest occurrence rate (25%), S. aureus (18.75%), Shigella flexneri (14.50%), Klebsiella pneumoniae (14.50%), Proteus mirabilis (9.37%), Citrobacter freundii (6.25%) Pseudomonas aeruginosa (6.25%) Enterobacter faecalis (3.13%) and Salmonella bongori (3.13%). Ciprofloxacin, pefloxacin and tarivid recorded remarkable zones of inhibition against the isolates. The isolates were notably resistant towards chloramphenicol and septrin. The isolates were further examined for the presence of conjugative plasmids. The results showed that their resistance was chromosomal mediated.

Conclusion: Despite the fact that these pools meet the World Health Organization minimum requirement, Microbiological examination of the swimming pools revealed that most of them are contaminated with various pathogenic microorganisms which are potentially harmful.
Effects of Herbal Medicine Use on Adherence to Conventional Anticancer Drugs
Authors: Karungi Christine , Asiimwe Philip , Ssentongo Conrad , Tuhaise Sharon Primah , Oloro Joseph
Published: December 2020

Background: Use of herbal medicines alongside conventional anticancer drugs is common among cancer patients. This may potentially cause reduced adherence to conventional anti-cancer drugs, unpredictable side effects and unknown drug-herb interactions. This in the long run could result in poor clinical outcomes.

Aim: This study was conducted to investigate how use of herbal medicines affects adherence to conventional anti-cancer drugs, to determine the proportion of patients using both conventional and herbal anticancer medicines and to identify the common herbal medicines used alongside conventional anti-cancer drugs by patients at the Mbarara Regional Referral Hospital Oncology unit.

Methods and Findings: A cross-sectional study was conducted in the oncology clinic of Mbarara Regional Referral Hospital found in Mbarara district, Uganda. Data was collected between 20th March and 20th April 2019 from 122 participants who met the inclusion criteria with subsequent consenting. Our primary outcome was adherence and secondary outcome was to investigate whether cancer patients use herbal medicines alongside conventional anti-cancer drugs.

Our study had 122 patients most of them belonging to the Banyankole tribe, 75 (61.5%) being males. Of the 72 (59.02%) patients who used herbal medicine, 40 (55.56%) were males and 66.67% of the herbal users reported relief from herbal medicines. Aloe Vera was the most commonly used herb. Most of the patients 77 (63.1%) showed high adherence, this was greater in the non-herbal users than in the herbal users (COR=1.62) though this was not significant (p=0.399).

Conclusion: It is most likely that majority of cancer patients use at least one herb during their course of life. The results did not show a significant relationship between herbal medicine use and adherence to conventional anti-cancer drugs. The high proportion of herbal medicine users calls for more research into the area to provide further information that can help optimize cancer treatment outcomes.
Osteitis in Systemic Sclerosis: A Nationwide Case–Control Retrospective Study
Authors: Cosse Cyril , Kernéis Solen , Lescoat Alain , Pugnet Gregory , Truchetet Marie‐Elise , Priollet Pascal , Diot Elisabeth , Martin Mickael , Maurier François , Viallard Jean François , Agard Christian , Granel Brigitte , Berthier Sabine , Fagedet Dorothée , Watelet Bénédicte , Toquet Ségolène , Luque Paz David , Giret Chloé , Cerles Olivier , Dion Jérémie , Nguyen Christelle , Raffray Loïc , Bertolino Julien , Jourde Wendy , Le Jeunne Claire , Mouthon Luc , Chaigne Benjamin
Published: December 2020

Objective

Systemic sclerosis (SSc) is an autoimmune connective tissue disorder characterized by skin fibrosis, vasculopathy, and dysimmunity. Data regarding osteitis in SSc are scarce.

Methods

We performed a nationwide multicenter, retrospective, case–control study including patients with SSc, according to the 2013 American College of Rheumatology/European Alliance of Associations for Rheumatology classification, with a diagnosis of osteitis. The objectives of the study were to describe, to characterize, and to identify associated factors for osteitis in patients with SSc.

Results

Forty‐eight patients were included. Twenty‐six patients (54.1%) had osteitis beneath digital tip ulcers. Physical symptoms included pain (36 of 48, 75%), erythema (35 of 48, 73%), and local warmth (35 of 48, 73%). Thirty‐one (65%) patients had median (interquartile range) C‐reactive protein levels >2 mg/liter of 8 (2.7–44.3) mg/liter. On radiography, computed tomography, or magnetic resonance imaging, osteitis was characterized by swelling or abscess of soft tissues, with acro‐osteolysis or lysis in 28 patients (58%). Microbiological sampling was performed in 45 (94%) patients. Most pathogens were Staphylococcus aureus (43.8%), anaerobes and Enterobacteriaceae (29.1%), and Pseudomonas aeruginosa (10.4%). Management comprised antibiotics in 37 (77.1%) patients and/or surgery in 26 (54.2%). Fluoroquinolones were used in 22 (45.8%) patients, and amoxicillin plus β‐lactamase inhibitor in 7 (14.6%). Six (12.6%) patients relapsed, 6 (12.6%) patients had osteitis recurrence, 15 (32%) sequelae, and 2 patients had septic shock and died.

Conclusion

This study confirmed digital tip ulcers as an associated factor for osteitis and revealed a high rate of functional sequelae. Antimicrobial therapy with oral fluoroquinolone or intravenous amoxicillin and β‐lactamase inhibitor are used as first‐line antibiotic therapy in SSc patients with osteitis.
Study of existing drug, prazosin, offers hope for highly struggling AUD patients
Authors: Enos Gary
Published: December 2020

Results of a new study of an old drug's potential to relieve some of the most painful symptoms associated with alcohol use disorder (AUD) offer hope, but they also remind the research community why the process of identifying viable treatments remains so painstakingly complex.
A father's grief: Shaken from silence when pandemic diverts attention from addiction
Authors: Williams Bill
Published: December 2020

In early March, as the COVID‐19 pandemic disrupted lives everywhere, but especially in New York City, my wife, Margot, and I fled our Manhattan apartment to our house in the rural Catskills.
Total Synthesis of Calothrixin B via an Intramolecular Baylis‐Hillman Cyclization/6π Electrocyclization/Dehydro‐aromatization Sequence and a Specific Oxidative Quinone Formation
Authors: Liu Yuancui , Xu Mei , Xie Kaiqiang , Liu Sheng
Published: December 2020

A short total synthesis of bioactive alkaloid calothrixin B have been accomplished with atom and step economy from commercially available starting materials. The key cyclization involved a Baylis−Hillman/6π electrocyclization/dehydroaromatiz‐ation sequence to construct the pentacyclic skeleton. Reduction of the resulting lactam followed by oxidation led to the characteristic quino[4,3‐b]carbazole framework. This intermediate underwent a direct oxidation with high regioselectivity to yield the final product.

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Triage physicians in an academic emergency department: Impact on resident education
Authors: Jen Maxwell , Goubert Ronald , Toohey Shannon , Zuabi Nadia , Wray Alisa
Published: December 2020

Background

Overcrowding in emergency departments (EDs) in the United States has been linked to worse patient outcomes. Implementation of countermeasures such as a physician‐in‐triage (PIT) system have improved patient care and decreased wait times. The purpose of this study was to evaluate how a PIT system affects medical resident education in an academic ED.

Methods

This was a retrospective observational comparison of resident metrics at a single‐site, urban, academic ED before and after implementing a PIT system. Resident metrics of average emergency severity index (ESI), patients‐per‐hour, and in‐training‐examination scores were measured before and six months after the implementation of the PIT system.

Results

In total, 18,231 patients were evaluated by all residents in the study period before PIT implementation compared to 17,008 in the study period following PIT implementation. The average ESI among patients evaluated by residents decreased from 3.00 to 2.68 (p < 0.01, 95% confidence interval [CI] = 0.31 to 0.33), while average resident patient‐per‐hour rate decreased from 1.41 to 1.32 (p < 0.01, 95% CI = 0.05 to 0.13] and ITE scores saw no statistically significant change of 76.11 to 78.26 (p = 0.26, 95% CI = −5.75 to 1.45). While these differences are statistically significant, they are likely not clinically significant.

Conclusions

Our implementation of PIT system at one academic medical center minimally increased the acuity and minimally decreased the number of patients that residents see. This suggested that in our center, a PIT program did not detract from ED resident clinical education. However, further research with alternative markers in multiple centers is needed.
Outcomes of screening for gammopathies in children and adults with Gaucher disease type 1 in a cohort from Brazil and the United States
Authors: Abell Katherine , Chadwell Sarah E. , Burrow Thomas Andrew , Becker Ana Paula Pizzio , Bailey Laurie , Steele Paul , Zhang Xue , Islas‐Ohlmayer Miguel , Bittencourt Rosane , Schwartz Ida Vanessa Doederlein , Prada Carlos E.
Published: December 2020

Multiple myeloma is the most common hematological malignancy in Gaucher disease type 1 (GD1). There is a lack of outcome data and consensus regarding screening of gammopathies. This study explores utility of screening in Porto Alegre, Brazil, and Cincinnati, Ohio. A retrospective analysis of clinical information and laboratory data from GD1 patients was performed. Over 19 years, 68 individuals with GD1 (31 males, 37 females) underwent screening, and 20 (29.4%) had abnormalities. Twelve (17.6%) had polyclonal gammopathy (mean age 24.2 years, p = .02), seven (10%) had monoclonal gammopathy of uncertain significance (MGUS; mean age 52.7 years, p = .009). One had multiple myeloma (age 61 years). Risk factors for MGUS included male gender (p = .05), p.N409S allele (p = .032). MGUS developed in six of 62 treated and two of four untreated individuals. Of those with MGUS receiving treatment, four were on enzyme replacement therapy (ERT) and one on substrate reduction therapy (SRT). Gammopathy normalized in 13 treated individuals (10 polyclonal, three MGUS) and remained abnormal in two treated individuals (two polyclonal, two MGUS). Gammopathy relapse was seen in one individual with MGUS and three with polyclonal gammopathy. This study describes screening for gammopathies and identifies risk factors in individuals with GD1.
Concurrent measurement of nitrate and ammonium in water and soil samples using ion‐selective electrodes: Tackling sensitivity and precision issues
Authors: Fayose Tolulope , Thomas Ellen , Radu Tanja , Dillingham Peter , Ullah Sami , Radu Aleksandar
Published: December 2020

In this paper, we demonstrate the suitability, sensitivity, and precision of low‐cost and easy‐to‐use ion‐selective electrodes (ISEs) for concurrent detection of NH4+ and NO3‐ in soil and water by technical and non‐technical end‐users to enable efficient soil and water management exposed to chronic reactive nitrogen loading. We developed a simplified methodology for sample preparation followed by the demonstration of an analytical methodology resulting in improvements of sensitivity and precision of ISEs. Herein, we compared and contrasted ISEs with traditional laboratory‐based technique such as Flow Injection Analysis (FIA) and portable colorimetric assay followed by comparisons of linear regression and Bayesian nonlinear calibration approaches applied on both direct potentiometry and standard addition modes of analysis in terms of in‐field applications and improvement of sensitivity and precision. The ISEs were validated for sensing on a range of ambient soil and water samples representing a range of NH4+ and NO3‐ concentrations from pristine to excessive saturation conditions. Herein developed methodology showed excellent agreement with lab‐based and portable analytical techniques while demonstrating improvements in precision and sensitivity analysis illustrated by a decrease in confidence intervals by 50‐60%. We also demonstrated the utilization of the entire ISE response curve thus removing the biases originating from linear approximation which is often currently employed. Therefore, we show that ISEs are robust yet low cost and an easy to use technology that can enable high‐frequency measurement of mineral N and help to improve our understanding of N transformation processes as influenced by soil management, fertilization, land use, and climate change.
Can we identify cystic fibrosis from skeletal remains? A proposed differential diagnosis
Authors: Beasley Melanie M. , Remy Clare K.
Published: December 2020

Cystic fibrosis (CF) is the most common genetic disease within populations with European ancestry and affects approximately 60,000 individuals living in North America and Europe. With recent medical advancement, the life span of CF patients has been extended by decades and bone disease has been observed as a common complication of long‐term survivors. In addition to bone disease and associated bone fracturing, living CF patients have a unique etiology of chronic sinusitis, which manifests as a medial bulge in the lateral walls of the nasal aperture, distinct from non‐CF chronic sinusitis. We suggest that available data from medical literature is sufficient evidence to indicate that CF can be identified during skeletal analysis, but future work is needed to quantify the sensitivity of the lesions for confirming a CF diagnosis.
Regulation of Synovial Inflammation and Tissue Destruction by Guanylate Binding Protein 5 in Synovial Fibroblasts From Patients With Rheumatoid Arthritis and Rats With Adjuvant‐Induced Arthritis
Authors: Haque Mahamudul , Singh Anil K. , Ouseph Madhu M. , Ahmed Salahuddin
Published: December 2020

Objective

Rheumatoid arthritis synovial fibroblasts (RASFs) are crucial mediators of synovial inflammation and joint destruction. However, their intrinsic immunoregulatory mechanisms under chronic inflammation remain unclear. Thus, the present study was undertaken to understand the role of a newly identified GTPase, guanylate binding protein 5 (GBP‐5), in RA pathogenesis.

Methods

The expression of GBP1–GBP7 transcripts was evaluated using quantitative reverse transcription–polymerase chain reaction in RA synovial tissue or synovial tissue unaffected by RA. Our investigation on transient small interfering RNA (siRNA) knockdown and lentiviral overexpression in human RASFs examined the regulatory role of GBP‐5 on proinflammatory cytokine signaling pathways. Unbiased whole transcriptome RNA sequencing analysis was used to assess the impact of GBP‐5 on RASF molecular functions. These findings were confirmed using a rat model of adjuvant‐induced arthritis (AIA) in vivo.

Results

Among different GBPs evaluated, GBP‐5 was selectively up‐regulated in RA synovial tissue (P < 0.05; n = 4) and in the joints of rats with AIA (P < 0.05; n = 6) and was significantly induced in human RASFs by interleukin‐1β (IL‐1β), tumor necrosis factor (TNF), and/or interferon‐γ (IFNγ) (P < 0.05; n = 3). Bioinformatics analysis of RNA sequencing data identified cytokine–cytokine receptor signaling as a major function altered by GBP‐5, with IL‐6 signaling as a primary target. Knockdown of GBP‐5 amplified IL‐1β–induced IL‐6, IL‐8, and epithelial neutrophil–activating peptide 78/CXCL5 production by 44%, 54%, 45%, respectively, and matrix metalloproteinase 1 (MMP‐1) production by several‐fold—effects that reversed with exogenously delivered GBP‐5. Lack of GBP‐5 increased IFNγ‐induced proliferation and migration of human RASFs. GBP‐5 knockdown in vivo using intraarticular siRNA exacerbated disease onset, severity, synovitis, and bone destruction in rat AIA.

Conclusion

Expressed by RASFs in response to cytokine stimulation, GBP‐5 has potential to restore cellular homeostasis and blunt inflammation and tissue destruction in RA.
Early neurological deterioration in cardiogenic cerebral embolism due to nonvalvular atrial fibrillation: Predisposing factors and clinical implications
Authors: Cong Lin , Ma Weining
Published: December 2020

Purpose

The aim of the study was to investigate factors which may predispose patients to early neurological deterioration (END) and explore peripheral biomarkers for the prediction of END in cardiogenic cerebral embolism (CCE) patients.

Methods

Patients diagnosed with CCE within 24 hr of onset between January 2017 and January 2019 were included in this study. END was defined as an increase of ≥2 on the National Institutes of Health Stroke Scale (NIHSS) or the emergence of new neurological symptoms within 3 days of admission. Binary logistic regression was used to investigate the factors associated with END. Receiver operating characteristic (ROC) curves were then generated to determine the predictive value of the potential biomarkers and the optimal cutoff values.

Results

Of the 129 (male, 55.81%; mean age 71.85 ± 11.99 years) CCE patients, 55 patients with END were identified. Hemorrhage transformation (HT), coronary heart disease (CHD), diastolic blood pressure, cystatin C levels, NIHSS score, and platelet‐to‐lymphocyte ratio (PLR) at admission were independently associated with END. A peripheral cystatin C level ≥ 1.41 mg/L and a PLR ≥ 132.97 were predictive factors for END in CCE patients. The lymphocyte‐to‐monocyte ratio (LMR) was negatively independently associated with HT, and LMR < 2.31 may predict the occurrence of HT in patients with CCE.

Conclusions

Of the potential predisposing factors considered, increased cystatin C and PLR were associated with END within 3 days of CCE, and a decreased LMR may have predictive value for HT in CCE patients.
Antemortem diagnosis of human rabies: A case report
Authors: Goravey Wael , Husain Ahmed , Ali Gawahir A. , Al Maslamani Muna A. , Ziglam Hisham
Published: December 2020

Antemortem diagnosis of rabies is challenging, and usually, more than one test modality is needed to confirm the diagnosis. No effective treatment exists so far, and the Milwaukee Protocol is debatable.
Novel doses of sacubitril/valsartan in patients unable to tolerate traditional therapy: Effects on N‐terminal pro B‐type natriuretic peptide levels
Authors: Pandey Amitabh C. , Jer Derek , Kuo Ruth S. , Yoo David H. , Christophy Antonio , Mohan Rajeev C. , Srivastava Ajay V. , Heywood James Thomas
Published: December 2020

Background

Widespread use of angiotensin receptor blocker and neprilysin inhibitor (ARNI) remains low, and many patients are unable to tolerate the medication due to hypotension at the currently recommended starting dose.

Hypothesis

The aim of this study is to assess if lower than standard doses of ARNI, sacubitril/valsartan (S/V), significantly reduces NT‐proBNP and leads to any change in diuretic dose, serum potassium, or creatinine.

Methods

In a retrospective study of 278 patients who were started on a low dose S/V at a single medical center, 45 patients were selected for the study cohort. Patients were subcategorized to Group 1 (n = 10): very low dose S/V (half a tab of 24/26 mg BID), Group 2 (n = 10): very low dose titrated to low dose S/V, and Group 3 (n = 25): low dose S/V (24/26 mg BID). NT‐proBNP, diuretic dose, serum potassium, and creatinine were compared before and after initiation of S/V.

Results

Among all groups, there was a significant reduction in NT‐proBNP level (Group 1: p < .01, Group 2: p < .01, and Group 3: p < .001). In addition, there was a significant reduction in diuretic dose across all groups combined (furosemide 53 mg/day vs. 73 mg/day; p = .03), with 17.8% (8/45) patients being able to discontinue their diuretic completely. There was no significant change in potassium or creatinine.

Conclusions

Lower than standard dose of S/V significantly reduces NT‐proBNP and diuretic requirement without change in potassium or creatinine, which provides hope that patients who cannot tolerate standard doses of S/V due to hypotension may be able to receive the benefits of S/V therapy.
Development of fin‐innervating motor neurons after peripheral target removal in medaka fish
Authors: Chiba Akina , Soma Kenichi , Watanabe Keisuke , Nagashima Hiroshi , Sato Noboru
Published: December 2020

Peripheral targets regulate the development and survival of the nerve centers that serve them, because the elimination of the target normally results in massive death of the developing neurons that innervate it. This widely accepted theory appears to be well supported by developing limbs and their innervation in tetrapods, but it is unclear whether this concept applies to primitive vertebrates that have paired appendages. In this study, we examined the development of spinal motor neurons following pectoral fin bud removal (FBR) in medaka fish. After FBR, motor axons initially extended to the plexus region in a morphologically normal pattern. During the period of fin innervation, motor axons in the FBR‐medaka failed to form the normal brachial plexus and elongated ventrally toward the abdominal region. In the ventral horn that would normally innervate the pectoral fin, however, neurons did not undergo cell death following FBR. There were no differences in the numbers of axons in the ventral roots between the FBR and control sides. Motor neuron markers, RALDH2 and FOXP1, that are expressed in limb‐innervating motor neurons in the lateral motor column in tetrapods, were also expressed in the ventral horns of both the control and FBR sides in medaka fish. These results suggest that, although both tetrapod and medaka motor neurons share the same molecular characteristics for innervating paired appendages, the fates of neurons differ following the removal of their peripheral target. Therefore, the relationship between the peripheral target and its nerve center may be altered among vertebrates.
Ecosystem engineering in the streambed: Net‐spinning caddisflies influence hydraulic properties
Authors: MacDonald Michael J. , Albertson Lindsey K. , Poole Geoffrey C.
Published: December 2020

Hydropsychid (net‐spinning caddisfly) larvae are aquatic macroinvertebrate ecosystem engineers, altering streambed properties by creating silk nets and retreats. Recent research has shown that caddisfly silk binds stream sediments and alters streambed cohesion, yet potential influences of caddisfly activity on streambed hydrologic properties have not received similar scrutiny. Utilizing a novel downward flow permeameter, we demonstrate how net‐spinning caddisfly colonization of the streambed interstitia at moderate but common densities (2000 m−2) can reduce vertical hydraulic conductivity (KV) by up to 55% in streambed sediments (coarse sand—medium gravel; median diameter = 12.91 mm). Additionally, organic matter content within sediment columns showed that occupation by caddisflies resulted in twice the ash‐free dry mass (AFDM) of noncaddisfly (primarily microbial) organic matter at the end of our experiments relative to control systems that lack caddisflies. These results suggest that net‐spinning caddisflies may restrict hyporheic exchange, alter streambed hydrologic residence time distributions and increase per‐unit‐volume biotic metabolic demand for stream solutes in the hyporheic zone, with the potential to alter whole‐stream biogeochemical processes.
Response of benthic macroinvertebrates to different hydropower off‐stream diversion schemes
Authors: Quadroni Silvia , Salmaso Francesca , Gentili Gaetano , Crosa Giuseppe , Espa Paolo
Published: December 2020

Despite significant advancement in environmental flow science, the release of minimum flows (MFs) still represents one of the main measures globally adopted to mitigate off‐stream diversion in regulated rivers. In the Lake Como basin (Italy), we monitored water‐depleted reaches below hydropower reservoirs and intakes and reaches unimpacted by water withdrawal. Our aim was to verify if the gradient in streamflow alterations resulted in detectable differences in the structure and functions of benthic assemblages, possibly identifying streamflow metrics explaining the observed differences. The macroinvertebrate assemblages sampled below reservoirs showed significant differences from those from unimpacted reaches, including the reduced relative richness of Ephemeroptera, Plecoptera and Trichoptera (mainly stoneflies) and the higher abundance and richness of dipterans. These differences were well explained by the corresponding streamflow pattern, characterized by a rather constant flow throughout the year, occasionally interrupted by sharp peaks related to spilling episodes. In contrast, the shift from unimpacted conditions was minor for benthic assemblages collected at reaches below intakes, where the seasonal streamflow variation was partly preserved. Our results suggest that an increase of the e‐flow released by hydropower dams during the seasons characterized by larger run‐offs could support improved benthic assemblages. Dewatered river sections below reservoirs could thus be prioritized for updating the current MF management, in the study area as well as in comparable contexts. At least to our knowledge, specific investigations are so far unavailable regarding the exploration of the different responses of benthic macroinvertebrates to intakes and reservoirs operations.
Non‐cardiac biopsy sites with high frequency of transthyretin amyloidosis
Authors: Dasari Surendra , Dispenzieri Angela , Mansour Shareef , Muppa Prasuna , Kurtin Paul J. , Theis Jason D. , Vrana Julie A. , Grogan Martha , Kourelis Taxiarchis , Gertz Morie A. , McPhail Ellen D.
Published: December 2020

Aims

Cardiac scintigraphy, a non‐invasive technique for diagnosing ATTR cardiac amyloidosis, lacks specificity in patients with concomitant monoclonal gammopathy (up to 40% of cases). For these patients, amyloid type is often established by endomyocardial biopsy (EMB), which has clinical risk. This study aimed to investigate the frequency of ATTR in amyloid‐positive tendon/synovium, urinary bladder, and prostate biopsies, sites for which prior biopsy specimens might exist for patients suspected of having cardiac amyloidosis, and, when available, determine the amyloid type concordance rate with other anatomic sites and provide clinical data regarding subsequent development of cardiac amyloidosis.

Methods and results

We queried our reference laboratory database of 19,298 amyloid specimens from myriad anatomic sites typed by mass spectrometry‐based proteomics (LC‐MS/MS) to investigate the frequency of ATTR amyloid in tendon/synovium, urinary bladder, and prostate. The amyloid type was ATTR in 104/138 (75.4%) tendon/synovium, 173/453 (38.0%) urinary bladder, and 27/81 (33.3%) prostate samples. Of 62 patients with available clinical data, 12 (19%) had bona fide ATTR cardiac amyloidosis prior to/concomitant with the non‐cardiac site biopsy. Of the remaining 14 with follow‐up, 8 developed bona fide and 2 probable cardiac amyloidosis; at last follow‐up 4 had no evidence of cardiac amyloidosis. Fourteen of 16 patients (87.5%) for whom we typed both non‐cardiac and cardiac sites had concordant amyloid types. There were 2 discordant cases (prostate = ASem1/heart = AL and urinary bladder = AL/heart = ATTR); only the latter is potentially clinically consequential.

Conclusions

In patients suspected of having cardiac amyloidosis based on cardiac scintigraphy, LC‐MS/MS typing of Congophilic deposits in pre‐existing biopsy specimens from non‐cardiac sites may help establish the cardiac amyloid type, obviating the need for EMB. However, if the amyloid type identified in the non‐cardiac site is not in keeping with other clinical features, then EMB for typing the cardiac amyloid might be indicated.
Microbial biotransformation of Pericarpium Citri Reticulatae (PCR) by Aspergillus niger and effects on antioxidant activity
Authors: Wang Fu , Chen Lin , Chen Shiwei , Chen Hongping , Liu Youping
Published: December 2020

Pericarpium Citri Reticulatae (PCR), the mature fruit peel of Citrus reticulata Blanco and its different cultivars, is an important citrus by‐product with beneficial health and nutritive properties. However, due to the lack of value‐added methods for its development and utilization, a large amount of PCR is discarded or wasted. To explore a possibly more effective method to utilize PCR, we compared the chemical and biological differences before (CK) and after (CP) microbial transformation of PCR by Aspergillus niger. UPLC‐ESI‐MS/MS, HPLC, and LC‐MS methods were used to compare the chemical profiles of CK and CP. The results demonstrated that microbial biotransformation by A. niger could transform flavonoid compounds by utilizing the carbohydrate and amino acid nutrients in PCR. This could also promote the accumulation of polyhydroxyflavones compounds in CP. The antioxidant assay demonstrated that CP had significantly greater free radical‐scavenging activity than CK. The higher antioxidant activity of CP may result from the high level of flavonoids with associated phenolic hydroxyl groups. Microbial biotransformation is an effective method for improving the antioxidant capacity of PCR and may be effective and useful in other natural product situations.
Confidentiality and treatment refusal: Conservative shifts on reproductive rights by Brazilian medical boards
Authors: Cesario Alvim Gomes Juliana , Figueira Mendes Corina Helena
Published: December 2020

Brazil has witnessed a conservative shift in recent years, reflected in setbacks in the field of reproductive rights. Commentators have drawn attention to changes in public policies and legislation that follow this shift. However, due attention has not been paid to changes in the professional standards regulating medical practice and their subsequent consequences for reproductive rights. Against this backdrop, this article examines two recent resolutions enacted by Brazilian medical boards, which violate ethical duties and the law. The first imposes a duty for doctors to disclose confidential medical information about their patients in sexual abuse cases. The second one determines that a pregnant woman's right to refuse medical treatment should be evaluated considering the fetus. This article argues that conservative setbacks operate not only through visible means, such as enacted legislation, but also furtively ‐ through professional medical resolutions. It also asserts that, in such a context, the debate about women's bodily autonomy shifts once again from the human rights ground to the medical field, where it has traditionally been subjected to control and coercion. Finally, it points out the risk that these rules might be used to legitimize new conservative laws and public policies.
Adherence rates to a prediction tool identifying women with an increased gestational diabetes risk: An implementation study
Authors: van Montfort Pim , Scheepers Hubertina C. J. , van Dooren Ivo M. A. , Meertens Linda J. E. , Wynants Laure , Zelis Maartje , Zwaan Iris M. , Spaanderman Marc E. A. , Smits Luc J. M.
Published: December 2020

Objective

The best screening strategy for gestational diabetes mellitus (GDM) remains a topic of debate. Several organizations made a statement in favor of universal screening, but the volume of oral glucose tolerance tests (OGTT) required may burden healthcare systems. As a result, many countries still rely on selective screening using a checklist of risk factors, but reported diagnostic characteristics vary. Moreover, women's discomfort due to an OGTT is often neglected. Since 2017, obstetric healthcare professionals in a Dutch region assessed women's GDM risk with a prediction model and counseled those with an increased risk regarding an OGTT.

Methods

From 2017 to 2018, 865 women were recruited in a multicenter prospective cohort.

Results

In total, 385 women (48%) had an increased predicted GDM risk. Of all women, 78% reported that their healthcare professional discussed their GDM risk. Predicted GDM risks were positively correlated with conducting an OGTT.

Conclusion

Implementation of a GDM prediction model resulted in moderate rates of OGTTs performed in general, but high rates in high‐risk women. As 25% of women experienced discomfort from the OGTT, a selective screening strategy based on a prediction model with a high detection rate may be an interesting alternative to universal screening.

Study cohort registration

Netherlands Trial Register: NTR4143; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4143.
Reimagining Literacy Assessment through a New Literacies Lens
Authors: Forzani Elena , Corrigan Julie A. , Slomp David
Published: December 2020

Discussions about literacy assessment can often be polarizing for teachers, school administrators, and other stakeholders. Given the diverse and often charged perspectives on assessment within both the profession and the broader public discourse, it can be difficult to engage in productive dialogue about the role that literacy assessment plays in promoting or inhibiting effective models of literacy education. This department provides perspectives, questions, and research that enables readers to better advocate for themselves and their students as they develop their own assessment programs and respond to assessment programs that are imposed on them.
A Review of Theory and Methods for Sociocultural Research in Science and Engineering Education
Authors: McVee Mary B. , Swenson Jessica , English Ken , Shanahan Lynn
Published: December 2020

This forum reviews a mix of resources to inform pedagogy and related educational practices that foreground representations of youth and their literacy practices within and outside of school.
Developing the language to immigrate: Immigration Discourses in the lives of Mexican immigrant youth
Authors: Martínez Isabel
Published: December 2020

Authors featured in this department share anthropological perspectives and qualitative insights to redefine community in adolescent and adult literacy practice.
Books and Freedom: A Lesson on Literacy
Authors: Germán Lorena
Published: December 2020

Young people in literacy classes sometimes think their teachers are not listening to them. The practitioners featured in this column listen to questions posed by their students and respond to them, with the goal of enhancing English language arts instruction for a range of young people and educators.
Salivary and serum oxidative stress biomarkers and advanced glycation end products in periodontitis patients with or without diabetes: A cross‐sectional study
Authors: Altıngöz Sema Merve , Kurgan Şivge , Önder Canan , Serdar Muhittin A. , Ünlütürk Uğur , Uyanık Metin , Başkal Nilgün , Tatakis Dimitris N. , Günhan Meral
Published: December 2020

Background

Non‐invasive methods for periodontitis diagnosis would be a clinically important tool. This cross‐sectional study aimed to investigate the association between oxidative stress, glycation, and inflammation markers and periodontal clinical parameters in periodontitis and periodontally healthy patients with type 2 diabetes and corresponding systemically healthy controls.

Methods

Sixty‐seven periodontally healthy (DM‐H, n = 32) and periodontitis (DM‐P, n = 35) patients with type 2 diabetes, and 54 systemically healthy periodontitis (H‐P, n = 26) and periodontally healthy (H‐H, n = 28) controls were included. Clinical periodontal parameters, body mass index, fasting glucose, hemoglobin A1c (HbA1c), along with saliva and serum 8‐hydroxy‐2′‐deoxyguanosine (8‐OHdG), malondialdehyde (MDA), 4‐hydroxy‐2‐nonenal (4‐HNE), advanced glycation end products (AGE), AGE receptor (RAGE) and high sensitivity C‐reactive protein (hsCRP) levels were recorded and analyzed.

Results

Salivary 8‐OHdG levels were significantly higher in periodontitis compared to periodontally healthy patients, regardless of systemic status (P < 0.001). Salivary MDA levels were significantly higher in all disease groups compared to H‐H group (P≤ 0.004). Serum AGE levels were significantly higher in diabetic groups than systemically healthy groups (P < 0.001) and in H‐Pcompared to H‐H (P < 0.001). Bleeding on probing (BOP) and clinical attachment level (CAL) strongly correlated with salivary 8‐OHdG and serum hsCRP (P < 0.001). In systemically healthy patients, salivary 8‐OHdG was the most accurate marker to differentiate periodontitis from controls (AUC = 0.84). In diabetics salivary 4‐HNE and RAGE were the most accurate (AUC = 0.85 for both).

Conclusion

Salivary 8‐OHdG alone or in combination with 4‐HNE, AGE and RAGE for diabetics, and salivary 8‐OHdG alone or in combination with MDA and hsCRP for systemically healthy persons, could potentially serve as non‐invasive screening marker(s) of periodontitis.
Seeking to Understand the Conditions Under Which Exposure‐Based Writing Therapy for Posttraumatic Stress Disorder is an Effective Approach: A Commentary on Dawson et al. (2020)
Authors: Thompson‐Hollands Johanna , Sloan Denise M. , Marx Brian P.
Published: December 2020

Exposure‐based writing interventions for posttraumatic stress disorder (PTSD) have shown promise when compared with waitlist conditions, placebo writing control conditions, and evidence‐based, trauma‐focused treatments. Recently, Dawson et al. (2020) conducted a systematic review and meta‐analysis to examine existing published randomized controlled trials investigating exposure‐based writing interventions. The findings were encouraging; however, the studies included in the meta‐analysis had a high degree of methodological heterogeneity. Our own work examining exposure‐based writing as an intervention for PTSD has demonstrated that methodological differences in the structure of exposure‐based writing can have a meaningful impact on treatment outcome. Accordingly, we urge caution in interpreting the meta‐analysis findings reported by Dawson and colleagues and encourage investigation into better understanding the mechanisms underlying exposure‐based writing interventions to further propel this important area of work.
Accuracy and Completion Rate of the Fetal Anatomic Survey in the Super Obese Parturient
Authors: Simmons Pamela M. , Wendel Michael P. , Whittington Julie R. , San Miguel Kelly , Ounpraseuth Songthip T. , Magann Everett F.
Published: December 2020

Objective

To determine the completion rate of ultrasound in with a body mass index (BMI) ≥ 50 to women with BMI 18.5 to 29.9.

Study Design

This study was a retrospective cohort study. Women with a singleton pregnancy, age 18 to 45 with a BMI ≥50 that delivered between 2013–2016 were compared to women with a BMI 18.5 to 29.9 during that same time period to assess the accuracy and, as a second aim, the completion rate of the fetal anatomic survey. Data were analyzed using two‐sample t test, chi‐square test, or logistic regression as appropriate.

Results

Eighty‐one cases with a BMI ≥50 were compared with 81 patients with a BMI 18.5 to 29.9. Maternal demographics and timing (gestational age) at the time of the ultrasound were similar between groups. In women with a BMI 18.5 to 29.9, completion of anatomy was 58% of the time with the first ultrasound, 81% with second ultrasound, and 84% with the third ultrasound. In women with BMI ≥50, completion of anatomy was 10% of the time with the first ultrasound, 33% with the second ultrasound, and 42% with the third ultrasound. Each time frame was statistically significant. Agreement level on the accuracy to detect fetal anomalies between groups were not statistically significant between the groups.

Conclusion

In women with a BMI ≥50 compared to women with BMI of 18.8 to 29.9, more ultrasounds are needed to complete the anatomic survey although overall accuracy in fetal anomaly detection is similar.
Platelets Stimulate Liver Regeneration in a Rat Model of Partial Liver Transplantation
Authors: Liang Chen , Takahashi Kazuhiro , Furuya Kinji , Oda Tatsuya , Ohkohchi Nobuhiro
Published: December 2020

Living donor liver transplantation (LDLT) is sometimes associated with impaired regeneration and severe ischemia/reperfusion injury (IRI) in the graft, resulting in small‐for‐size syndrome (SFSS). Platelets were previously reported to stimulate liver regeneration in models of hepatectomy, but the evidence in partial liver transplantation (LT) is lacking. In this study, a rat model of partial LT was used, and the impact of thrombopoietin (TPO)‐induced perioperative thrombocytosis on graft regeneration, IRI, and survival was investigated. In experiment 1, a 30% partial LT was performed. Under thrombocytosis, SFSS was attenuated, as shown by decreased levels of serum aminotransferases, bilirubin, and ascites. Serum hepatocyte regeneration–related cytokines, including insulin‐like growth factor‐1, hepatocyte growth factor, interleukin 6 (IL6), and tumor necrosis factor α (TNF‐α), were elevated. In addition, the proliferative signaling pathways, Ki‐67‐labeling index, proliferating cell nuclear antigen (PCNA)–labeling index, mitotic index, and liver/body weight ratio were increased under thrombocytosis. The platelet‐induced regeneration was independent of TPO because increases in the Ki‐67‐labeling and PCNA‐labeling indexes were eliminated after reducing platelet counts by antiplatelet serum in rats administered with TPO. For IRI, thrombocytosis did not aggravate oxidative stress or downstream signaling pathways, necrosis, or apoptosis in the graft. After Kupffer cell (KC) depletion, the platelet‐induced attenuation of serum aminotransferases, increased serum levels of IL6 and TNF‐α, and proliferation‐related signaling pathways were eliminated. Moreover, platelet accumulation in the graft decreased substantially. In experiment 2, a 20% partial LT was performed, and thrombocytosis improved postoperative survival. In conclusion, our results suggested that thrombocytosis stimulated graft regeneration and prolonged survival without aggregating IRI after partial LT, and KCs vitally contributed to platelet‐derived regeneration. Platelet therapies to increase perioperative platelet counts may improve the outcomes after LDLT.
Seminar addresses identifying, dismantling structural racism
Authors: Canady Valerie A.
Published: December 2020

Advocating for racially equitable public policies by taking action beyond the walls of clinics, hospitals and treatment centers is critical as challenges about racial issues and health disparities continue, according to a professor and leader in cultural psychiatry during the New York Association for Psychiatric Rehabilitation Services (NYAPRS) 11th Annual Rehabilitation and Recovery Academy last month.
Court ruling on conversion therapy concerning to advocates
Authors: Canady Valerie A.
Published: December 2020

An appeals court ruling overturning two local Florida ordinances' ban on conversion therapy for minors and indicating that “speech‐based therapy” is a violation of the First Amendment is raising concerns among psychologists and mental health advocates who say the decision puts patients at risk of psychological harm.
Pandemic taking ‘deadly toll’ on MH of front‐line HC workers
Authors: Canady Valerie A.
Published: December 2020

Health care workers are experiencing conditions that have been compared to a war zone, continuously witnessing the direct effects of the pandemic as it spreads throughout communities, says Mental Health America (MHA) in its new survey released Dec. 1.
Substrate integrated waveguide E‐plane tapering in low‐temperature co‐fired ceramic
Authors: Haarla Jaakko , Ala‐Laurinaho Juha , Lahti Markku , Viikari Ville
Published: December 2020

This letter discusses the design, manufacture, and characterization of a substrate‐integrated waveguide E‐plane tapering. The tapering facilitates the integration of two waveguides with varying heights for, that is, conductor‐backed coplanar waveguide to rectangular waveguide integration. A simultaneous top‐ and bottom‐sided, λ/4‐based stepped tapering for the 71–86 GHz band is designed using low‐temperature co‐fired ceramic technology. The fabricated design is measured using two E‐plane taperings in back‐to‐back configuration. The reflection coefficient better than −11.8 dB, and the transmission coefficient larger than −1.4 dB at the full 71–86‐GHz range for a single tapering is extracted from the measurement using time‐gating.
An evaluation of MRI lumbar spine scans within a community‐based diagnostic setting
Authors: Hudson Darren , Knapp Karen , Benwell Martin
Published: December 2020

Background

With an ongoing move towards more management of patients within the community setting, demand for magnetic resonance imaging (MRI) is increasing and commonly used in lower back conditions. There is well recorded overuse of MRI in this scenario which goes against evidence‐based practice and adds to rising healthcare costs.

Methods

The study was a retrospective review of lumbar spine MRI scans performed within a community‐based setting over an 18‐month period. The review took a randomised purposive sample of patients (n = 450); looking at adherence to, and relevance of, guidelines in managing lower back conditions. Data extracted provided information on demographics and prevalence of clinical presentation and report observations.

Results

There is variation in practice and utlisation of MRI with this patient group which warrants further exploration. Results support inappropriate use, lacking adherence to guidelines and pathways, leading to unnecessary imaging. 46% of referrals were considered clinically justified with 38% of report findings considered abnormal and of clinical relevance. Chi‐square and binomial logistic regression were used to assess the significance and relationship of any factors on referral justification and report outcome. No difference was found between type of referrer, with patient age and leg symptoms being significant factors.

Conclusion

The study highlights the opportunity to integrate better referral criteria to improve referral quality, its suitability and the relevance of final reports. In the current climate this would help manage appropriate use of imaging resources during the post COVID‐19 pandemic recovery phase, as well as support recommendations regarding diagnostic reform and a move towards more community‐based diagnostics.