bluuebunny/crossref_metadata_2025 huggingface dataset:
Rapid Method for the Extraction, Cleanup, and GLC Determination of Toxic Residues of Temik
Authors: Maitlen Jay C , Mcdonough Leslie M , Beroza Morton
Published: February 2020

The gas chromatographic method previously reported for determining the toxic residues of Temik was modified. The combined toxic residues are extracted from the crop with dichloromethane, the extract is evaporated onto a n adsorbent mixture, and the residue is extracted with acetonitrile, oxidized by hydrogen peroxide-acetic acid, chromatographed through Florisil, and analyzed by gas chromatography. The time needed to analyze samples in batches of 10 was reduced to 1.8 hr/sample, or less than half the time required for the original procedure. The sensitivity of the method applied to apples, potatoes, cucumbers, alfalfa, and cottonseed ranged from 0.007 to 0.010 ppm, and recoveries from samples fortified with 0.02 to 1.50 ppm pesticide ranged from 72 to 114%.
Proposed Test Method for Antimicrobial Laundry Additives
Authors: Petrocci A N , Clarke Paul
Published: February 2020

A laboratory model is proposed for testing chemicals to determine both efficacy as laundry disinfectants or sanitizers and residual bacteriostatic effects on finished fabrics. The model is flexible enough to accommodate many of the variables encountered in different laundry processes. Data developed in collaborative studies are presented. Further collaborative investigations are recommended.
Polarographic Determination of Thimerosal Tincture and Solution NF
Authors: Beyer Ernest B
Published: February 2020

In a revised procedure for the polarographic determination of thimerosal tincture and solution, a smaller diameter column containing less resin eliminated the problem of channeling and incomplete elution of thimerosal. The anion exchange resin provides sufficient cleanup so that direct comparison of sample and standard diffusion currents is possible instead of the standard addition technique originally specified. Recoveries for Thimerosal Tincture and Solution NF were 101 and 100%, respectively. The method is recommended for collaborative study.
Cholinesterase Inhibition Autoanalysis of Insecticidal Organophosphates and Carbamates
Authors: Voss Günther
Published: February 2020

An automated cholinesterase inhibition method gave satisfactory results during the development of insecticidal organophosphates and carbamates. Up to 40 samples/hr were analyzed with a precision equal to that of purely chemical methods performed manually. The lower limit of detectability of the method depends primarily on the inhibition potency of the particular compound under investigation and upon whether the system is operated in a pre-inhibition (most sensitive) or simultaneous inhibition (least sensitive) mode. Monocrotophos, for example, was analyzed in the concentration ranges of 0.1–2.0, 1–20, 10–200, and 100–2000 ppm; the last two concentration ranges were analyzed in the simultaneous inhibition mode. Sensitivities better than those achieved with human plasma cholinesterase, i.e., 0.1 ppm for monocrotophos, were obtained by using a more sensiive type of cholinesterase, such as peacock plasma cholinesterase. Examples of experinents, such as determinations of the stability if formulations, rates of hydrolysis, parti timing behavior of insecticides, solubilities in water, and the determination of a cholineserase-inhibiting impurity in a technical samde of phosphamidon, are also described and locumented by original AutoAnalyzer reordings.
Gas Chromatographic Determination of Phenolic Amines
Authors: Coffin D E
Published: February 2020

Phenolic amines tyramine, octopamine, synephrine, β-methoxyoctopamine, and β-methoxysynephrine are isolated on a cation exchange resin and quantitatively determined by GLC of their trifluoroacetyl derivatives. Recoveries of 80–85% for tyramine and 90–100% for the four other phenolic amines were obtained for standards and for standards added to orange or apple juices. Phenolic amines were not detected in commercial apple juices. Synephrine was found in all commercial orange juice samples at levels of 12.5 to 23.4 mg/L juice. Another component, apparently a phenolic amine, was found in all orange juices examined.
Cyclodiene Chemistry. I. Derivative Formation for the Identification of Heptachlor, Heptachlor Epoxide, cis-Chlordane, frans-Chlordane, and Aldrin Pesticide Residues by Gas Chromatography
Authors: Chatj Alfred S Y , Cochrane W P
Published: February 2020

Specific chemical methods for the GLC identification of several organochlorine pesticides are described. The simultaneous dehydrochlor ination of cis-chlordane and trans-chlordane, isomerization of heptachlor epoxide, and hydroxy derivatization of heptachlor was achieved by refluxing with potassium tert.-butoxide/tert.-butanol. This procedure, together with subsequent silylation for the identification of the hydroxy derivatives, constitutes a suitable method for the routine confirmation of the parent pesticides down to levels of 0.01 ppm, when present in 10 g sample extracts. In another investigation, heptachlor and aldrin were selectively converted to their correspondi ng chloroacetate derivatives. By this procedure, levels down to 0.02 ppm heptachlor and 0 04 p pm aldrin in a 10 g sample extract can be identified. The selective conversion of aldrin to dieldrin by monoperphthalic acid is also reported.
Note on Nomenclature of Dieldrin and Related Compounds
Authors: Benson Walter R
Published: February 2020

Dieldrin is discussed as an example of polycyclohydrocarbon pesticides whose nomenclature is confusing. The name dieldrin applies to more than one form of the compound and, depending on the system of nomenclature used, more than one spatial structure can be implied.
Chemical Alterations in Fish Tissue During Storage at Low Temperatures
Authors: Wood Garnett , Hintz Lane , Salwin Harold
Published: February 2020

Chemical changes that occur in the proteins, nucleotides, and lipids of fish tissue during storage at low temperatures were investigated. Homogenized tissue, prepared from fresh rock-fish (striped hass, Roccus species), was stored up to six days at temperatures from -10° to 4°C and then analyzed. At 0°C and below, the solubility of myofibrillar proteins decreased. There were also changes in polyacrylamide gel electrophoretic patterns of protein extracts. The total nucleotide content decreased rapidly at all temperatures. The lipids were extracted from each sample and separated into neutral lipids, phospholipids, and free fatty acids by column chromatography. The fatty acid composition of each fraction was determined by gas chromatography. In the fresh tissue, polyunsaturated acids occurred in greatest proportion in the free fatty acid and phospholipid fractions, whereas inono-unsaturated acids were inofe highly concentrated in the neutral lipids. The percentages of saturated acids were approximately the same in all fractions. During storage, there were considerably larger losses of individual acids from phospholipids than from neutral lipids. The polyunsaturated acids of the phospholipid fraction were affected most. Over 10% of these aeids were lost in six days at ice temperature, but only a small proportion of the losses was accounted for by increases in free fatty acids. Oxidative proo esses may account for the imbalance because the rate of oxidation, as measured by the thio-barbituric acid test, increased with storage temperature in the same manner as the rale at which unsaturated fatty acids were lost from the pliospliolipuls. Losses of polyunsaturated acids from the neutral lipids were much smaller, suggesting a selectively protective mechanism or environment in that fraction. The changes in the phospholipid fatty acids may provide the basis for useful objective tests of fish lecomposilion.
Colorimetric Determination of Hydrocortisone in Milk
Authors: Trucksess Mary W , Donoso Julian , Craig Gerald
Published: February 2020

Hydrocortisone is extracted from milk with chloroform, and the extract is cleaned up on an activated Florisil column. The hydrocortisone is determined colorimetrically by reaction with phenylhydrazine hydrochloride. The method is sensitive to concentrations of 0.005 μg/ml, and milk volumes of 300 ml are easily processed. Recoveries of standards are about 70%, with good reproducibility.
Atomic Absorption Spectrophotometric Determination of Water-Soluble Boron in Fertilizers
Authors: Melton James R , Hoover William L , Howard Peggy A
Published: February 2020

Water-soluble boron is extracted into a mixlure of 2-ethyl-l,3-hexanediol and methyl isobutyl ketone for determination by atomic absorption spectrophotometry. The extraction procedure brings the fertilizer sample, water, and extraction solvent in contact simultaneously. The organic layer which contains the extracted boron is aspirated into the flame. There are no significant interferences from elements commonly found in fertilizers. The proposed method is fast and accurate for determining water-soluble boron in fertilizers.
Enzymatic Determination of Starch in Feeds, Feed Ingredients, and Feces
Authors: Turner W W
Published: February 2020

Starch is determined in various materials such as feeds, grains, cereals, grasses, and feces by the combination of some existing techniques plus new methodology. Samples are extracted with aqueous alcohol and hydrolyzed with HCl; the resulting glucose is measured with a glucose oxidase enzyme system. The actual handling operations, including troublesome nitrations and constant temperature baths, are minimized or eliminated.
Note on Adsorption of Aflatoxin Standards to Glass
Authors: Rodricks J V
Published: February 2020

Aflatoxins deposited as dry films in glass vials are adsorbed to the surface and are not completely recovered by the addition of solvent. The concentrations of solutions prepared from dry films must be determined by UV absorptivity measurements.
Quantitation of Food Adulterants by Multiple Radial Immunodiffusion. II. Wheat in Bread Sold as “Wheat-free” for the Use of Allergy Patients
Authors: Lietze Arthur
Published: February 2020

Multiple radial immunodiffusion was used to measure wheat antigens in so-called wheatfree bread manufactured for the use of patients allergic to wheat. One brand of this bread was found to have no detectable wheat antigens. Another brand contained three wheat antigens in 94.5, 52, and 74%, respectively, of the amounts which would have been present if the bread had been made of wheat flour. The data suggest that this bread was adulterated with wheat gluten rather than wheat flour.
Collaborative Study of a Method for Determination of Monosodium Glutamate in Food Products
Authors: Fernandez-Flores E , Johnson Arthur R , Blomquist Victor H
Published: February 2020

A method was collaboratively studied for the determination of monosodium glutamate as glutamic acid in food products. Six samples were submitted to each of nine collaborators. The quantity of monosodium glutamate in the samples ranged from 0.3 to 10%. The average recovery was 101.9% with a standard deviation of 3.6%. The method is recommended for adoption as official first action.
Liaison Report on Malt Beverages and Brewing Materials
Authors: Stone Irwin
Published: February 2020

Two new A SBC methods for beer analysis are presented to the AOAC for adoption: “Alcohol by Kefractometer” and “Beer Bitterness.” The first is a rapid alternative procedure to the present distillation technique. The latter replaces, in part, the isohumulones methods now used. The new edition of Official Methods of Analysis will also contain the “Total Haze After Chilling” method which partly replaces turbidity 10.010–10.015. The ASBC now has 12 technical subcommittees working on a comprehensive program for the development and testing of new analytical methods of interest to the brewing industry. Two additional subcommittees will probably be authorized to investigate the determination of traces of heptyl-p-hydroxybenzoate and tannins in beer, both of which are of interest to the AOAC.
Uptake of Chlordane Vapors by Foodstuffs of Low Moisture Content
Authors: Yeo Chee Yee , Bevenue Arthur
Published: February 2020

Wheat flour, polished rice, and cane sugar were exposed to chlordane vapors for an extended period of time, up to and including 90 days. Flour and rice, in bulk form, adsorbed about three times as much chlordane compared to the amount adsorbed by the sugar. Packaging the foodstuffs in polyethylene containers noticeably decreased the uptake of chlordane by the commodities. Flour packaged in Kraft paper bags contained six times the amounts of chlordane residues compared to the amounts found in flour packaged in polyethylene bags, but only one-third the amount found in the bulk samples for the same period of storage time.
Gas Chromatographic Column for Pesticide Analysis
Authors: Windham E S
Published: February 2020

A new mixed column is proposed for GLC of pesticides, consisting of 8% QF-1 and 2% OV-17 on 80–100 mesh Gas Ohrom Q. Operating parameters are compatible with the 10% DC-200 column, but most pesticides elute sooner. Complete baseline separation is achieved with p,p’-DDE, dieldrin, o,p’-DDT, and p,p’-DDD. A table of relative retention times of 42 pesticides is presented.
All-Purpose Gas-Liquid Chromatographic Column for Pharmaceuticals
Authors: Alber Larry L
Published: February 2020

A 6’ column containing 3% OV-17 on Gas Chrom Q was evaluated as a universal GLC column for pharmaceuticals. With isothermal column temperatures ranging from 50 to 300°C, the following have been chromatographed: alcohols, anesthetics, anticholinergics, antihistamines, antiseptics, barbiturates, sterols, steriods, sulfonamides, sympathomimetics, and xanthine alkaloids.
(Dis)integration in Global Resource Governance: Extractivism, Human Rights, and Investment Treaties
Authors: Cotula Lorenzo
Published: February 2020

As global material consumption rests on the large-scale production of commodities for food, energy, and raw materials, the governance of natural resources—from national legislation to international trade, investment, and human rights law—has long provided policy arenas for deepening economic integration. Concerns about ‘resource nationalism’ and critiques of investor–state dispute settlement have raised questions as to whether the world might be entering a phase of economic dis-integration. To problematize linear accounts of (dis)integration, this article explores the legal arrangements that integrate resource-dependent countries into the global economy. It argues that natural resource extraction is facilitated by a legal regime that sustains dis-integration patterns in global resource governance—including relations between state-based and traditional governance systems; between extractive enclaves and national territories; and between different spheres of international regulation. Some of the recent contestation, then, reflects efforts to (re)integrate dis-integrated legal and social realities, by more fully recognizing local systems of practice and belief and more effectively considering human rights in investment processes.
Preclinical and clinical investigation of intratumoral chemotherapy pharmacokinetics in DIPG using gemcitabine
Authors: Green Adam L , Flannery Patrick , Hankinson Todd C , O’Neill Brent , Amani Vladimir , DeSisto John , Knox Aaron , Chatwin Hannah , Lemma Rakeb , Hoffman Lindsey M , Mulcahy Levy Jean , Raybin Jennifer , Hemenway Molly , Gilani Ahmed , Koschmann Carl , Dahl Nathan , Handler Michael , Pierce Angela , Venkataraman Sujatha , Foreman Nicholas , Vibhakar Rajeev , Wempe Michael F , Dorris Kathleen
Published: February 2020

Background

Hundreds of systemic chemotherapy trials in diffuse intrinsic pontine glioma (DIPG) have not improved survival, potentially due to lack of intratumoral penetration, which has not previously been assessed in humans.

Methods

We used gemcitabine as a model agent to assess DIPG intratumoral pharmacokinetics (PK) using mass spectrometry.

Results

In a phase 0 clinical trial of i.v. gemcitabine prior to biopsy in children newly diagnosed with DIPG by MRI, mean concentration in 4 biopsy cores in patient 1 (H3K27M diffuse midline glioma) was 7.65 µM. These compare favorably to levels for patient 2 (mean 3.85 µM, found to have an H3K27-wildtype low-grade glioma on histology), and from a similar study in adult glioblastoma (adjusted mean 3.48 µM). In orthotopic patient-derived xenograft (PDX) models of DIPG and H3K27M-wildtype pediatric glioblastoma, gemcitabine levels and clearance were similar in tumor, pons, and cortex and did not depend on H3K27 mutation status or tumor location. Normalized gemcitabine levels were similar in patient 1 and the DIPG PDX.

Conclusions

These findings, while limited to one agent, provide preliminary evidence for the hypotheses that lack of intratumoral penetration is not why systemic chemotherapy has failed in DIPG, and orthotopic PDX models can adequately model intratumoral PK in human DIPG.
Superficial Cutaneous Zygomycosis Presenting as Resistant Intertrigo: A Case Report
Authors: McMahon Devon E , Hysell Kristen , Montgomery Mary , Frangos Jason
Published: February 2020

Zygomycosis is an angioinvasive fungal infection with a high mortality rate. Cutaneous zygomycosis is the second most common form of the disease, typically characterized by necrotic eschars in an immunocompromised host. We report an unusual case of superficial intertrigo resistant to conventional therapies caused by Mucor circinelloides in a patient with HIV and diabetes.
Applause Invitations in Political Speeches: A Comparison of Two British Party Political Leaders (Theresa May and Jeremy Corbyn)
Authors: O’Gorman Victoria , Bull Peter
Published: February 2020

This study was focussed on 11 rhetorical devices used to invite collective applause in speeches by two opposing British party political leaders, Theresa May and Jeremy Corbyn. The analysis was based on 14 speeches (delivered at party conferences in 2016 and during the general election campaign of 2017), transcribed verbatim from video recordings. These speeches were closely matched between the two politicians in terms of speech duration, and when and where they took place. Almost all the incidents of collective audience applause (98%) occurred in response to the 11 rhetorical devices. Regardless of their opposing political views, the two party leaders used similar devices when delivering a speech. While they did not differ significantly in the mean duration of collective applause received, Corbyn was significantly higher in terms both of the frequency of his rhetorical devices and in the frequency with which he received collective applause. Given the careful matching technique employed in this study, it arguably provides us with the clearest demonstration to date of the role played by rhetorical devices in inviting collective audience applause.
How far actually is the Galactic Center IRS 13E3 from Sagittarius A*?
Authors: Tsuboi Masato , Kitamura Yoshimi , Tsutsumi Takahiro , Miyawaki Ryosuke , Miyoshi Makoto , Miyazaki Atsushi
Published: February 2020

The Galactic Center IRS 13E cluster is a very intriguing infrared object located at ${\sim } 0.13$ pc from Sagittarius A$^\ast$ (Sgr A$^\ast$) in projection distance. There are arguments both for and against the hypothesis that a dark mass like an intermediate mass black hole (IMBH) exists in the cluster. We recently detected the rotating ionized gas ring around IRS 13E3, which belongs to the cluster, in the H30$\alpha$ recombination line using ALMA. The enclosed mass is derived to be $M_{\mathrm{encl.}}\simeq 2\times 10^{4}\, M_\odot$, which agrees with an IMBH and is barely less than the astrometric upper limit mass of an IMBH around Sgr A$^\ast$. Because the limit mass depends on the true three-dimensional (3D) distance from Sgr A$^\ast$, it is very important to determine it observationally. However, the 3D distance is indefinite because it is hard to determine the line-of-sight (LOS) distance by usual methods. We attempt here to estimate the LOS distance from spectroscopic information. The CH$_3$OH molecule is easily destroyed by the cosmic rays around Sgr A$^{\ast }$. However, we detected a highly excited CH$_3$OH emission line in the ionized gas stream associated with IRS 13E3. This indicates that IRS 13E3 is located at $r\gtrsim 0.4$ pc from Sgr A$^{\ast }$.
Design and performance of a high-pressure xenon gas TPC as a prototype for a large-scale neutrinoless double-beta decay search
Authors: Ban S , Hirose M , Ichikawa A K , Iwashita Y , Kikawa T , Minamino A , Miuchi K , Nakadaira T , Nakajima Y , Nakamura K D , Nakamura K Z , Nakaya T , Obara S , Sakashita K , Sekiya H , Sugashima B , Tanaka S , Ueshima K , Yoshida M
Published: February 2020

A high-pressure xenon gas time projection chamber, with a unique cellular readout structure based on electroluminescence, has been developed for a large-scale neutrinoless double-beta decay search. In order to evaluate the detector performance and validate its design, a 180 L size prototype is being constructed and its commissioning with partial detector has been performed. The obtained energy resolution at 4.0 bar is 1.73 $\pm$ 0.07% (FWHM) at 511 keV. The energy resolution at the $^{136}$Xe neutrinoless double-beta decay $Q$-value is estimated to be between 0.79 and 1.52% (FWHM) by extrapolation. Reconstructed event topologies show patterns peculiar to the track endpoint that can be used to distinguish $0\nu\beta\beta$ signals from gamma-ray backgrounds.
The Influence of the Dedicated Education Unit Clinical Model on Standardized Test Scores
Authors: Flott Elizabeth A. , Schoening Anne M. , McCafferty Kandis , Beiermann Trisha , Hercinger Maribeth
Published: February 2020

While the dedicated education unit (DEU) clinical model is being increasingly integrated into prelicensure nursing programs, a lack of research investigating objective measures of this model is evident. Standardized test scores were compared between students who had a DEU experience and those completing the same rotation in a traditional model. Although no statistically significant differences were noted, some scores were higher for students in the DEU model. Findings suggest the DEU does not negatively impact scores, making it a valid alternative to the traditional model. Further research is needed as few studies have investigated objective outcomes for the DEU model.
Effect of Rho-associated kinase inhibitor on human corneal endothelial cell apoptosis
Authors: Achiron Asaf , Feldman Anna , Karmona Lily , Pe'er Liron , Avizemer Haggay , Bartov Elisha , Burgansky Zvia , Rosner Mordechai , Vishnevskia-Dai Vicktoria
Published: February 2020

Purpose:

To evaluate whether exposure to Rho-associated protein kinase (ROCK) inhibitor will promote human-cultured corneal endothelial cells (CECs) survival in a commercial storage medium.

Setting:

Edith Wolfson Medical Center, Holon, and Sheba Medical Center, Tel Hashomer, Israel.

Design:

Experimental study.

Methods:

Fragments of human donor corneolimbal rings were stored in commercial storage media for 1 week, half with the addition of 10 μM ROCK inhibitor (Y-27632). Evaluation of CECs for early and late apoptosis\necrosis rates was performed using anti-human CD166 antibody and flow cytometric double staining analysis of propidium iodide and Annexin V.

Results:

CECs of 6 corneolimbal rings demonstrated a reduced early apoptosis rate (4.35% ± 1.07% vs 12.18% ± 5.5%, P = .026) and a reduced late apoptosis\necrosis rate (5.5% ± 2.39% vs 9.43% ± 2.61%, P = .004) compared with control. Subsequently, the rate of apoptotic CECs expressing ROCK was significantly lower in cells exposed to ROCK inhibitor compared with cells that were not (19.01% ± 4.17 vs 30.42% ± 4.27, P < .001).

Conclusions:

ROCK inhibitor reduced endothelial cell loss in vitro and might be used to limit or slow CEC loss in donor corneal tissue during eye banking. This might be a promising new method for promoting future graft survival.
Uveal and capsular biocompatibility of a new hydrophobic acrylic microincision intraocular lens
Authors: Balendiran Vaishnavi , Werner Liliana , Ellis Nathan , Shumway Caleb , Jiang Bill , Kamae Kai , Mamalis Nick
Published: February 2020

Purpose:

To evaluate uveal biocompatibility and capsular bag opacification of a new hydrophobic acrylic microincision intraocular lens (IOL) in comparison with a commercially available 1-piece hydrophobic acrylic IOL.

Setting:

John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA.

Design:

Experimental study.

Methods:

Eight New Zealand rabbits underwent bilateral phacoemulsification and implantation of the preloaded Nanex multiSert+ IOL in one eye and a commercially available preloaded lens (AcrySof IQ in UltraSert, model AU00T0) in the contralateral eye. A slitlamp examination was performed weekly for 4 weeks. The rabbits were then killed humanely and their globes enucleated. Capsular bag opacification was assessed from the Miyake-Apple view, and the eyes were subjected to histopathologic evaluation.

Results:

Postoperative inflammatory reactions were similar between the test and control eyes in the 8 New Zealand rabbits. The mean postmortem central posterior capsule opacification (PCO) was 0.93 ± 0.73 in the test group and 1.19 ± 0.53 in the control group. The mean postmortem peripheral PCO was 1.75 ± 0.92 in the test group and 2.06 ± 0.77 in the control group. Central and peripheral PCO scores were not statistically different between the test and control groups (P = .41 and P = .35, respectively, 2-tailed t test: paired 2-sample for means).

Conclusions:

A new 1-piece hydrophobic acrylic microincision IOL incorporating an ultraviolet–ozone treatment on the posterior surface performed similarly to a commercially available 1-piece hydrophobic acrylic IOL in terms of uveal and capsular biocompatibility in the rabbit model. To our knowledge, this is the first hydrophobic acrylic microincision IOL to demonstrate similar PCO performance when compared with a conventional, commercially available IOL.
Change in optical axial length after cataract surgery: segmental method vs composite method
Authors: Goto So , Maeda Naoyuki , Noda Toru , Ohnuma Kazuhiko , Iehisa Ikko , Koh Shizuka , Nishida Kohji
Published: February 2020

Purpose:

To compare the changes in axial length (AL) obtained after cataract surgery by partial coherence interferometry (PCI), swept-source optical coherence tomography with the composite method (SS-OCT/CM), and SS-OCT with the segmental method (SS-OCT/SM).

Setting:

National Hospital Organization, Tokyo Medical Center, Japan.

Design:

Retrospective case series.

Methods:

AL was measured preoperatively and 1 month postoperatively by PCI, SS-OCT/CM, and SS-OCT/SM.

Results:

Two hundred sixty-eight eyes in 139 patients who underwent cataract surgery were included. The mean ALs measured by PCI and SS-OCT/CM decreased significantly from 24.14 ± 1.58 to 24.05 ± 1.58 mm (P < .0001) and from 24.15 ± 1.58 to 24.05 ± 1.59 mm (P < .0001), respectively. The mean differences between the preoperative and postoperative AL were 0.083 ± 0.044 mm (PCI) and 0.096 ± 0.045 mm (SS-OCT/CM), respectively; Bland–Altman analysis revealed fixed bias between the preoperative and postoperative values. The mean preoperative and postoperative ALs measured by SS-OCT/SM were 24.12 ± 1.54 and 24.12 ± 1.54 mm, respectively (P = 0.97). The mean difference between the preoperative and postoperative ALs was 0.00 ± 0.03 mm on SS-OCT/SM; Bland–Altman analysis indicated good agreement between these values.

Conclusions:

The difference between preoperative and postoperative ALs is less with SS-OCT/SM than with PCI or SS-OCT/CM. Assuming that AL is not altered by cataract surgery, AL measurement is more accurate by SS-OCT/SM than by PCI or SS-OCT/CM.
Hyperpigmented Patch With Linear Extension
Authors: Sable Kimberly A. , Lake Eden
Published: February 2020

This is the case of a 29-year-old man with a well-demarcated, irregularly shaped, hyperpigmented patch located on the dorsal left hand with linear extension spreading across the distal medial surface. The patch initially presented as an erythematous lesion accompanied by burning, which subsided. A multiple-choice clinical question addressing the underlying diagnosis is offered. An answer is provided with a follow-up discussion focusing on underlying pathology, typical clinical presentation, and suggested management guidelines.
Anthropomorphizing Atopy
Authors: Thelwall Saheeda , Thelwall Mike
Published: February 2020

Atopic dermatitis or eczema affects a substantial minority of children and adults. Patients may treat their symptoms through skin care regimes, diet restrictions, and/or prescribed topical corticosteroids. The patient perspective is important because of the long-term self-administered treatment regime and the potential psychological effects on relationships from a visible disease. This article assesses the potential of public social media data to give new insights into patient perspectives through a thematic analysis of a random sample of 400 tweets from 2019 matching the query, “my eczema.” Although the most common use of Twitter is to announce a flare-up, it is also used to express anger and discuss possible treatments. New themes not previously reported include the use of humor to discuss the condition and giving eczema agency: discussing it as if it had a will of its own. These may be defense strategies against the potential of eczema to strike at any time or the fear of negative reactions or blame from friends. This highlights the importance of nurses and others helping patients to deal with the psychological effects of eczema.
A Ringed Enigma
Authors: Zahirsha Zisansha , Lake Eden
Published: February 2020

Granuloma annulare is a poorly understood disease typically presenting as localized, nonscaly, annular plaques on the dorsal extremities. Clinical variants, such as generalized, patch, perforating, and subcutaneous types, exist. Therefore, granuloma annulare has a broad range of clinical morphologies and presentations. Knowledge of the clinical features, prognosis, and treatment options of the disease is critical for providers to appropriately diagnose and manage the condition.
Sternum-Sparing HVAD Implantation with Attachment of the Outflow Graft to the Descending Aorta
Authors: Kawabori Masashi , Critsinelis Andre , Kurihara Chitaru , Sugiura Tadahisa , Morgan Jeffrey A.
Published: February 2020

The standard approach for implanting an HVAD left ventricular assist device (LVAD) is performing a median sternotomy and sewing the outflow graft to the ascending aorta. However, in patients with sternal comorbidities, it may be advantageous to use a sternum-sparing approach. We retrospectively studied eight patients who underwent HVAD implantation for destination therapy via a left subcostal or fifth/sixth intercostal space incision. With this procedure, the outflow graft was sewed to the descending aorta. Ninety-day and one-year survival rates were 87.5% and 75%, respectively. Two patients (25%) died during the perioperative period: one from multisystem organ failure and the other from unrelated causes. We adjusted the HVAD speed to open the aortic valve once every three to four beats. Compared with other continuous-flow LVAD implantations performed at our institution during the study period (n = 437), this technique resulted in shorter bypass times and a lower incidence of infection; it was not associated with an increased incidence of heart failure, aortic root thrombosis, pump thrombosis, progression of aortic insufficiency, or ischemic neurologic dysfunction. Our findings suggest that a sternum-sparing approach for HVAD implantation is feasible and may be a safe option in patients with serious comorbidities that preclude the use of traditional implantation techniques.
Deprescribing Proton Pump Inhibitors in an Academic, Primary Care Clinic
Authors: Nallapeta Naren , Reynolds Jessica L. , Bakhai Smita
Published: February 2020

Goal:

The goal of this study was to reduce the percentage of inappropriately prescribed proton pump inhibitors (PPIs) in patients aged 50 and older from 80% (baseline) to 60% within 12 months in an academic, internal medicine clinic.

Background:

The use of PPIs has increased drastically worldwide. Internal medicine clinic patients had inappropriate use of PPIs for an average of 4 to 5 years.

Study:

A multidisciplinary quality improvement team used the Plan-Do-Study-Act Model of health care improvement and performed a root cause analysis to identify barriers to inappropriate use of PPIs. The outcome measure was the percentage of patients inappropriately prescribed PPI. Process measures were completion rates of PPI risk assessment and esophagogastroduodenoscopy. Interventions included the creation of customized electronic health record templates and education to providers and patients. Analysis was performed using monthly statistical process control charts.

Results:

The average rate of PPI discontinuation was 51.1% (n=92/180), which corresponds to 30.0% inappropriate PPI usage within 12 months. The mean PPI discontinuation rate in the 1-year prestudy, study and 6 months poststudy period was 2.0%, 32.0%, and 49.7%, respectively. The mean esophagogastroduodenoscopy completion rate was 49.8% from the baseline of <30%.

Conclusions:

We achieved a statistically significant and sustainable reduction of inappropriate PPI use to 30% from the baseline rates of 80% and surpassed our goal within 12 months. This quality improvement was unique as no pharmacy personnel was utilized in this process. The multifaceted strategies in a safety-net internal medicine clinic resulted in successful deprescribing of PPI and can be replicated in other setting.
Increased Acid Exposure on Pretransplant Impedance-pH Testing Is Associated With Chronic Rejection After Lung Transplantation
Authors: Lo Wai-Kit , Moniodis Anna , Goldberg Hilary J. , Feldman Natan , Chan Walter W.
Published: February 2020

Goal:

The goal of this study was to assess the relationship between pretransplant measures of reflux and longer-term outcomes of chronic allograft rejection in lung transplant recipients.

Background:

Bronchiolitis obliterans syndrome (BOS) is a primary measure of morbidity and mortality following lung transplantation, and a manifestation of chronic lung allograft dysfunction (CLAD). Acid reflux has been associated with early allograft injury through a proposed mechanism of aspiration and activation of the inflammatory cascade, but its association with chronic rejection is unclear.

Study:

This was a retrospective cohort study of lung transplant recipients undergoing impedance-pH testing off proton pump inhibitor from 2007 to 2016. Patients with pretransplant antireflux surgery were excluded. Time-to-event analysis using the Cox proportional hazards model was applied to assess the relationship between pretransplant reflux measures and the development of BOS, defined histologically and clinically. A secondary analysis was completed using CLAD as the outcome variable.

Results:

Fifty-one subjects (59% men, mean age: 56, mean follow-up: 2.2 y) met inclusion criteria for the study. The BOS endpoint was reached in 13 subjects (28%). In time-to-event analyses, BOS was associated with increased acid exposure, defined as >4.2% of time with pH<4 [hazard ratio (HR): 4.18; 95% confidence interval (CI): 1.31-13.4; P=0.01], and elevated DeMeester score >14.7 (HR: 3.08; 95% CI: 1.02-9.26; P=0.04), with confirmation from Kaplan-Meier analyses. The secondary analysis demonstrated a similar association between increased acid exposure and CLAD (HR: 3.28; 95% CI: 1.09-9.88; P=0.03), which persisted on multivariate models.

Conclusion:

Increased acid exposure on pretransplant reflux testing was associated with the development of BOS and CLAD, both measures of chronic allograft rejection, after lung transplantation, and may provide clinically relevant information to improve lung allograft survival through aggressive reflux management.
Adopting Open Educational Resources in a Nursing Informatics Course
Authors: Riley Elizabeth , Carmack Jeffrey K.
Published: February 2020

Background

Open educational resources (OERs) provide many benefits in nursing education, such as continuously updated course content and textbook cost savings.

Purpose

The purpose of this study was to determine the effectiveness of OER adoption by analyzing final course grades (to measure student performance) and course evaluations (to measure student satisfaction) in an online nursing informatics course in an RN-BSN completion program.

Methods

This study used a quantitative, retrospective design to compare course grades and student course satisfaction between an OER-based (n = 70) and textbook-only (n = 73) nursing informatics course.

Results

A Mann-Whitney U test revealed a statistically significant difference in mean course grades (P = .03, r = 0.18) for the OER group. There were no differences in course satisfaction between the textbook and OER groups (P = .41, r = 0.18).

Conclusion

The results showed that courses designed with OER content can improve student performance in nursing informatics while maintaining course satisfaction.
Profiling ACE2 expression in colon tissue of healthy adults and colorectal cancer patients by single-cell transcriptome analysis
Authors: Chen Haoyan , Xuan Baoqin , Yan Yuqing , Zhu Xiaoqiang , Shen Chaoqin , Zhao Gang , Ji Linhua , Xu Danhua , Xiong Hua , Yu TaChung , Li Xiaobo , Liu Qiang , Chen Yingxuan , Cui Yun , Hong Jie , Fang Jing-Yuan
Published: February 2020

A newly identified novel coronavirus (2019-nCoV) has caused numerous acute respiratory syndrome cases in Wuhan China from December 2019 to Feb 2020. Its fast spreading to other provinces in China and overseas is very likely causing a pandemic. Since the novel coronavirus has been reported to be capable of endangering thousands of lives, it is extremely important to find out how the coronavirus is transmitted in human organs. Apart from fever and respiratory complications, gastrointestinal symptoms are observed in some patients with 2019-nCoV but the significance remains undetermined. The cell receptor angiotensin covering enzyme II (ACE2), which is the major receptor of SARS-nCoV, has been reported to be a cellular entry receptor of 2019-nCoV as well. Here, to more precisely explore the potential pathogen transmission route of the 2019-nCoV infections in the gastrointestinal tract, we analyzed the ACE2 RNA expression profile in the colon tissue of healthy adults and colorectal cancer patients of our cohort and other databases. The data indicates that ACE2 is mainly expressed in epithelial cells of the colon. The expression of ACE2 is gradually increased from healthy control, adenoma to colorectal cancer patients in our cohort as well as in the external Asian datasets. According to the expression profile of ACE2 in colon epithelial cells, we speculate adenoma and colorectal cancer patients are more likely to be infected with 2019-nCoV than healthy people. Our data may provide a theoretical basis for the classification and management of future 2019-nCoV susceptibility people in clinical application.
Phase-adjusted estimation of the number of Coronavirus Disease 2019 cases in Wuhan, China
Authors: Wang Huwen , Wang Zezhou , Dong Yinqiao , Chang Ruijie , Xu Chen , Yu Xiaoyue , Zhang Shuxian , Tsamlag Lhakpa , Shang Meili , Huang Jinyan , Wang Ying , Xu Gang , Shen Tian , Zhang Xinxin , Cai Yong
Published: February 2020

An outbreak of clusters of viral pneumonia due to a novel coronavirus (2019-nCoV / SARS-CoV-2) happened in Wuhan, Hubei Province in China in December 2019. Since the outbreak, several groups reported estimated R0 of Coronavirus Disease 2019 (COVID-19) and generated valuable prediction for the early phase of this outbreak. After implementation of strict prevention and control measures in China, new estimation is needed. An infectious disease dynamics SEIR (Susceptible, Exposed, Infectious and Removed) model was applied to estimate the epidemic trend in Wuhan, China under two assumptions of Rt. In the first assumption, Rt was assumed to maintain over 1. The estimated number of infections would continue to increase throughout February without any indication of dropping with Rt = 1.9, 2.6 or 3.1. The number of infections would reach 11,044, 70,258 and 227,989, respectively, by 29 February 2020. In the second assumption, Rt was assumed to gradually decrease at different phases from high level of transmission (Rt = 3.1, 2.6 and 1.9) to below 1 (Rt = 0.9 or 0.5) owing to increasingly implemented public heath intervention. Several phases were divided by the dates when various levels of prevention and control measures were taken in effect in Wuhan. The estimated number of infections would reach the peak in late February, which is 58,077–84,520 or 55,869–81,393. Whether or not the peak of the number of infections would occur in February 2020 may be an important index for evaluating the sufficiency of the current measures taken in China. Regardless of the occurrence of the peak, the currently strict measures in Wuhan should be continuously implemented and necessary strict public health measures should be applied in other locations in China with high number of COVID-19 cases, in order to reduce Rt to an ideal level and control the infection.
The cross-sectional study of hospitalized coronavirus disease 2019 patients in Xiangyang, Hubei province
Authors: Ai Jin-Wei , Chen Jun-Wen , Wang Yong , Liu Xiao-Yun , Fan Wu-Feng , Qu Gao-Jing , Zhang Mei-Ling , Pei Sheng-Duo , Tang Bo-Wen , Yuan Shuai , Li Yang , Wang Li-Sha , Huang Guo-Xin , Pei Bin
Published: February 2020

Objective

To describe the epidemiological and clinical characteristics of the Coronavirus Disease 2019 (COVID-19) hospitalized patients and to offer suggestions to the urgent needs of COVID-19 prevention, diagnosis and treatment.

Methods

We included 102 confirmed COVID-19 cases hospitalized in Xiangyang No.1 people’s hospital, Hubei, China until Feb 9th, 2020. Demographic data, laboratory findings and chest computed tomographic (CT) images were obtained and analyzed.

Findings

All cases were confirmed by real-time RT-PCR, including 52 males and 50 females with a mean age of 50.38 years (SD 16.86). Incubation time ranged from one to twenty days with a mean period of 8.09 days (SD 4.99). Fever (86[84.3%] of 102 patients), cough (58[57%]), fatigue (28[27%]), shortness of breath (24[23%]), diarrhea (15[15%]), expectoration (13[12%]), inappetence (11[10%]) were common clinical manifestations. We observed a decreased blood leukocyte count and lymphopenia in 21 (20.6%) and 56 (54.9%) patients, respectively. There were 66 (68%) of 97 patients with elevated C-reactive protein levels and 49 (57.6%) of 85 with increased erythrocytes sedimentation rate. Higher levels of procalcitonin and ferritin were observed in 19 (25.3%) of 75 and 12 (92.3%) of 13 patients, respectively. Eight patients were admitted to intensive care unit (ICU), six developed respiratory failure, three had multiple organ failure and three died. The cumulative positivity rate over three rounds of real-time RT-PCR was 96%. One-hundred patients were found with typical radiological abnormalities in two rounds of chest CT scans, indicating a 98% consistency with real-time RT-PCR results.

Interpretation

Most COVID-19 patients in Xiangyang were secondary cases without sex difference, and the rate of severe case and death was low. Middle-to-old-age individuals were more susceptible to the virus infection and the subsequent development of severe/fatal consequences. The average incubation period was longer among our patients. We recommend prolonging the quarantine period to three weeks. Three times real-time RT-PCR plus two times CT scans is a practical clinical diagnosis strategy at present and should be used to increase the accuracy of diagnosis, thereby controlling the source of infection more effectively.
Risks Associated with Animal-Assisted Intervention Programs: A Literature Review
Authors: Dalton Kathryn R. , Waite Kaitlin B. , Ruble Kathy , Carroll Karen C. , DeLone Alexandra , Frankenfield Pam , Serpell James A. , Thorpe Roland J. , Morris Daniel O. , Agnew Jacqueline , Rubenstein Ronald C. , Davis Meghan F.
Published: February 2020

The benefits of animal-assisted interventions (AAI), to utilize companion animals as an adjunctive treatment modality, is well-established and a burgeoning research field. However, few studies have evaluated the potential hazards of these programs, such as the potential for therapy animals to transfer hospital-associated pathogens between individuals and the hospital environment. Here we review the current literature on the possible risks of hospital-based AAI programs, including zoonotic pathogen transmission. We identified twenty-nine articles encompassing reviews of infection control guidelines and epidemiological studies on zoonotic pathogen prevalence in AAI. We observed substantial heterogeneity in infection control practices among hospital AAI programs. Few data confirmed pathogen transmission between therapy animals and patients. Given AAI’s known benefits, we recommend that future research utilize a One Health framework to evaluate microbial dynamics among therapy animals, patients, and hospital environments. This framework may best promote safe practices to ensure the sustainability of these valuable AAI programs.

Highlights

Despite the many benefits of animal-assisted interventions (AAI) for patients, there is a risk of therapy animals becoming vectors of hospital pathogens.

There is an absence of literature on transmission of hospital pathogens between patients and therapy animals during an AAI session.

More research is needed to improve the safety and utilization of this important adjunctive therapy.
Temporal and state abstractions for efficient learning, transfer and composition in humans
Authors: Xia Liyu , Collins Anne G. E.
Published: February 2020

Humans use prior knowledge to efficiently solve novel tasks, but how they structure past knowledge to enable such fast generalization is not well understood. We recently proposed that hierarchical state abstraction enabled generalization of simple one-step rules, by inferring context clusters for each rule. However, humans’ daily tasks are often temporally extended, and necessitate more complex multi-step, hierarchically structured strategies. The options framework in hierarchical reinforcement learning provides a theoretical framework for representing such transferable strategies. Options are abstract multi-step policies, assembled from simpler one-step actions or other options, that can represent meaningful reusable strategies as temporal abstractions. We developed a novel sequential decision making protocol to test if humans learn and transfer multi-step options. In a series of four experiments, we found transfer effects at multiple hierarchical levels of abstraction that could not be explained by flat reinforcement learning models or hierarchical models lacking temporal abstraction. We extended the options framework to develop a quantitative model that blends temporal and state abstractions. Our model captures the transfer effects observed in human participants. Our results provide evidence that humans create and compose hierarchical options, and use them to explore in novel contexts, consequently transferring past knowledge and speeding up learning.
TNF controls a speed-accuracy tradeoff in the apoptotic decision to restrict viral spread
Authors: Oyler-Yaniv Jennifer , Oyler-Yaniv Alon , Maltz Evan , Wollman Roy
Published: February 2020

Early commitment to apoptosis is an important antiviral strategy. However, fast decisions that are based on limited evidence can be erroneous and cause unnecessary cell death and tissue damage. How cells optimize their decision making strategy to account for both speed and accuracy is unclear. Here we show that exposure to TNF, which is secreted by macrophages during viral infection, causes cells to change their decision strategy from “slow and accurate” to “fast and error-prone”. Mathematical modeling combined with experiments in cell culture and mouse corneas show that the regulation of the apoptotic decision strategy is critical to prevent HSV-1 spread. These findings demonstrate that immune regulation of cellular cognitive processes dynamically changes a tissues’ tolerance for self-damage, which is required to protect against viral spread.