bluuebunny/crossref_metadata_2025 huggingface dataset:
Learner‐centered Survey of Point‐of‐care Ultrasound Training, Competence, and Implementation Barriers in Emergency Medicine Training Programs in India
Authors: Boniface Keith S. , Drake Aaran , Pyle Matthew , Moideen Fabith , Mehta Sanjay , Poovathumparambil Venugopal , Shokoohi Hamid , Douglass Katherine
Published: November 2019

Background

Point‐of‐care ultrasound (POCUS) is important to the practice of emergency medicine (EM), but requires training to achieve competence. The purpose of this study was to describe the current state of POCUS practice and perceived barriers to the implementation in EM training programs in India.

Methods

A cross‐sectional survey consisting of 28 questions was administered to 378 faculty and residents in postgraduate EM training programs across India.

Results

Data were collected from 159 physicians from 16 institutions; 76% of them were EM residents, with a response rate of 42%. Respondents overwhelmingly reported high interest (91%) in learning POCUS topics. Respondents identified highest levels of comfort with the performance and interpretation of trauma ultrasound (US) and echocardiography. Conversely, there was a scarce interest and low levels of competence in performing obstetric US, which may be a result of the practice of triaging these complaints to obstetricians and gynecologists. Lack of US equipment and dedicated training were the highest rated barriers by a significant margin, which 56% of respondents ranked as “very important.”

Conclusions

While significant interest in POCUS exists among the Indian EM physicians, comfort and competence were limited to trauma and echocardiography applications. Expansion of and comfort with POCUS use in these settings may be sought through improvement of access to US equipment and a dedicated US curriculum.
A Novel Medical Student Assistant Accommodation Model for a Medical Student With a Disability During a Required Clinical Clerkship
Authors: Jauregui Joshua , Strote Jared , Addison Conrad , Robins Lynne , Shandro Jamie
Published: November 2019

Background

As efforts continue to diversify the physician workforce so that it better matches the patient population, the number of medical students with disabilities will increase. U.S. medical schools and emergency medicine (EM) clerkships should be prepared to provide full and meaningful access to learners with disabilities.

Methods

We created a novel means of providing access to a senior medical student with a mobility disability (secondary to a cervical spinal cord injury) to participate in a fourth‐year EM clerkship. We hired four second‐year medical students as intermediaries to perform senior medical student–directed physical examination maneuvers, during his 15 required 8‐hour emergency department shifts. The senior medical student dictated his documentation using Dragon Natural Speaking (Nuance Communications, 2015) voice recognition software.

Results

The senior medical student successfully completed the required clinical clerkship and earned a honors grade for his work. Both the senior medical student and the second‐year medical student intermediaries gave positive feedback about the experience.

Conclusions

Given the significant prevalence of disability among medical students in U.S. medical schools, medical educators should provide greater access to students with disabilities and opportunities for advanced education for all learners by creating innovative clinical curriculum. The authors recommend the student intermediary model for senior medical students with physical disabilities in required clinical clerkships.
Strong dispersal limitation in postfire regeneration of Baker cypress, a rare serotinous conifer
Authors: McNamara Bret A. , Greene David F. , Kane Jeffrey M.
Published: November 2019

Premise

Dispersal capacity primarily determines the spatial establishment patterns that drive range expansions and contractions in tree species. Seedling establishment in Baker cypress (Hesperocyparis bakeri [(Jeps.) Bartel]) relies predominantly on fire events, due to its cone serotiny, shade intolerance, and small seeds that require the optimal conditions of fire‐exposed, mineral soil seedbeds.

Methods

We quantified the density and spatial distribution of post‐disturbance seedlings following the 2014 Eiler Fire in northern California and compared the observed recruitment to predictions from a mechanistic seed dispersal model.

Results

Postfire recruitment was dense, averaging 11 seedlings/m2, and occurred primarily in the first year after fire. We estimated the mean descent velocity of the wingless seeds as ~4 m/s, the highest value reported for any putatively wind‐dispersed tree species. The rapid seed descent contributed to markedly spatially constrained recruitment. Most seedlings (~81%) established within 5 m of the parent tree, and 94% established within 10 m. The maximum observed dispersal distance was 48.5 m; dispersal distance scaled linearly with canopy height. Distributions of modeled seed dispersal distance and observed seedling establishment in Baker cypress did not differ, demonstrating that wind disperses seeds a short distance because of the lack of a wing, and secondary dispersal appeared to be minimal at this recently burned site.

Conclusions

If seed dispersal is solely reliant on wind, migration in response to rapid climate change will be impeded and potentially present difficulties in sustaining populations of this and other obligate seeder species with equally constrained dispersal.
Water insecurity and urban poverty in the Global South: Implications for health and human biology
Authors: Adams Ellis A. , Stoler Justin , Adams Yenupini
Published: November 2019

Objectives

Over half of the world's population (4 billion people) experience severe water scarcity at least one month per year, while half a billion people experience severe water scarcity throughout the year. Despite progress from national and global interventions, a staggering proportion of the Global South remains water insecure. Rapid urban growth and associated demographic changes, climate change, and governance failure have also fostered the growth and expansion of urban informal settlements and slums where widespread poverty and environmental hazards exacerbate the impact of water insecurity on health. This article reflects on the interactions between water insecurity and urban poverty in the Global South across four categories of health outcomes: gastrointestinal diseases, mosquito‐borne diseases, injuries, and mental illness. These examples highlight the mechanisms through which urban poverty exacerbates the adverse health effects of water insecurity.

Methods

The four selected health outcomes were chosen a priori to represent two communicable conditions with well‐developed literatures, and two noncommunicable conditions with newer literatures that have emerged over the last decade. We conducted a narrative literature review of scholarly and gray literature appearing between January 2000 and April 2019 using several online scholarly databases.

Results

Gastrointestinal diseases, mosquito‐borne diseases, injuries, and mental illness all exemplified the relationship between water insecurity and urban poverty through human biological pathways. For each of the four health categories, we identified frontiers for human biology research contributions to the water‐poverty‐health nexus.

Conclusions

We discuss our findings in the context of three crosscutting themes that merit innovative research approaches: stressor interactions and trade‐offs, exposure thresholds, and intervention efficacy. We reiterate that the global burden of disease associated with water insecurity cannot be addressed in isolation from efforts to alleviate extreme poverty.
International meeting on Wolf‐Hirschhorn syndrome: Update on the nosology and new insights on the pathogenic mechanisms for seizures and growth delay
Authors: Nevado Julián , Ho Karen S. , Zollino Marcella , Blanco Raquel , Cobaleda César , Golzio Christelle , Beaudry‐Bellefeuille Isabelle , Berrocoso Sarah , Limeres Jacobo , Barrúz Pilar , Serrano‐Martín Candela , Cafiero Concetta , Málaga Ignacio , Marangi Giuseppe , Campos‐Sánchez Elena , Moriyón‐Iglesias Tania , Márquez Sorangui , Markham Leah , Twede Hope , Lortz Amanda , Olson Lenora , Sheng Xiaoming , Weng Cindy , Wassman Edward Robert , Newcomb Tara , Wassman Edward Robert , Carey John C. , Battaglia Agatino , López‐Granados Eduardo ,   Wolf‐Hirschhorn Spain's Working Group, Douglas Damien , Lapunzina Pablo
Published: November 2019

“An International Meeting on Wolf‐Hirschhorn Syndrome (WHS)” was held at The University Hospital La Paz in Madrid, Spain (October 13–14, 2017). One hundred and twenty‐five people, including physicians, scientists and affected families, attended the meeting. Parent and patient advocates from the Spanish Association of WHS opened the meeting with a panel discussion to set the stage regarding their hopes and expectations for therapeutic advances. In keeping with the theme on therapeutic development, the sessions followed a progression from description of the phenotype and definition of therapeutic endpoints, to definition of genomic changes. These proceedings will review the major points of discussion.
RHAMM inhibits cell migration via the AKT/GSK3β/Snail axis in luminal A subtype breast cancer
Authors: Wang Juan , Li Dan , Shen Wenzhi , Sun Wei , Gao Ruifang , Jiang Pengling , Wang Liang , Liu Yanhua , Chen Yanan , Zhou Wei , Wang Rongrong , Xiang Rong , Stupack Dwayne , Luo Na
Published: November 2019

Breast cancer is one of the most common types of cancer in women. Although the mortality rate of breast cancer has fallen over the past 10 years, effective treatments that reduce the occurrence of breast cancer metastasis remain lacking. In this study, we explored the role of receptor for hyaluronan mediated motility (RHAMM) and the associated signaling pathway in cell migration in luminal A breast cancer. We first examined RHAMM expression levels using human breast tissue microarray and patient breast tissues. We then studied the role of RHAMM in migration in luminal A breast cancer using loss‐of‐function and gain‐of‐function strategies in in vitro models and confirmed these findings in an in vivo model. Finally, we investigated signaling molecules that play a role in cell migration using western blot. Our results demonstrated the following: (a) RHAMM shows high expression levels in malignant breast tissue, (b) RHAMM shows low expression levels in luminal A breast cancer compared to other subtypes of breast cancer, (c) RHAMM inhibits cell migration in luminal A breast cancer, and (d) RHAMM inhibits cell migration via the AKT/GSK3β/Snail axis in luminal A breast cancer. This study demonstrates a novel role of RHAMM in cell migration in luminal A breast cancer and suggests that therapeutic strategies involving RHAMM should be considered for various subtypes of breast cancer.
Synthesis of gold nanoparticles using Crinum macowanii bulb extracts and the application of these materials in blood detections at crime scenes
Authors: Khunoana Sewela , Parani Sundarajen , Oluwafemi Oluwatobi Samuel , Ndinteh Derek Tantoh , Pillay Kriveshini
Published: November 2019

We here in report the synthesis of gold nanoparticles (AuNPs) using a Crinum macowanii bulb water extract. The as‐synthesized AuNPs were characterized using ultraviolet–visible spectroscopy, Fourier transform infrared spectroscopy, X‐ray diffraction, transmission electron microscopy, and a zeta potential‐sizer. The results showed that the as‐synthesized AuNPs were crystalline and mostly spherical in shape with a small mixture of triangular, tetrahedral, hexagonal, octagonal, and diamond shapes. The as‐synthesized AuNPs together with those synthesized by conventional methods were subsequently used as enhancers for the luminol signal in blood detection. It was noted that the AuNPs synthesized from the Crinum macowanii bulb water extract could enhance the chemiluminescence signal for blood detection by luminol to the same extent as AuNPs prepared by conventional methods. Furthermore, both types of AuNPs served as fluorescence enhancers for blood detection when luminol was replaced with the bulb water extract.
Systematic review and narrative synthesis of surgeons' perception of postoperative outcomes and risk
Authors: Dilaver N. M. , Gwilym B. L. , Preece R. , Twine C. P. , Bosanquet D. C.
Published: November 2019

Background

The accuracy with which surgeons can predict outcomes following surgery has not been explored in a systematic way. The aim of this review was to determine how accurately a surgeon's ‘gut feeling’ or perception of risk correlates with patient outcomes and available risk scoring systems.

Methods

A systematic review was undertaken in accordance with PRISMA guidelines. A narrative synthesis was performed in accordance with the Guidance on the Conduct of Narrative Synthesis In Systematic Reviews. Studies comparing surgeons' preoperative or postoperative assessment of patient outcomes were included. Studies that made comparisons with risk scoring tools were also included. Outcomes evaluated were postoperative mortality, general and operation-specific morbidity and long-term outcomes.

Results

Twenty-seven studies comprising 20 898 patients undergoing general, gastrointestinal, cardiothoracic, orthopaedic, vascular, urology, endocrine and neurosurgical operations were included. Surgeons consistently overpredicted mortality rates and were outperformed by existing risk scoring tools in six of seven studies comparing area under receiver operating characteristic (ROC) curves (AUC). Surgeons' prediction of general morbidity was good, and was equivalent to, or better than, pre-existing risk prediction models. Long-term outcomes were poorly predicted by surgeons, with AUC values ranging from 0·51 to 0·75. Four of five studies found postoperative risk estimates to be more accurate than those made before surgery.

Conclusion

Surgeons consistently overestimate mortality risk and are outperformed by pre-existing tools; prediction of longer-term outcomes is also poor. Surgeons should consider the use of risk prediction tools when available to inform clinical decision-making.
PACAP27 mitigates an age‐dependent hippocampal vulnerability to PGJ2‐induced spatial learning deficits and neuroinflammation in mice
Authors: Avila Jorge A. , Kiprowska Magdalena , Jean‐Louis Teneka , Rockwell Patricia , Figueiredo‐Pereira Maria E. , Serrano Peter A.
Published: November 2019

Background

Inflammation in the brain is mediated by the cyclooxygenase pathway, which leads to the production of prostaglandins. Prostaglandin (PG) D2, the most abundant PG in the brain, increases under pathological conditions and is spontaneously metabolized to PGJ2. PGJ2 is highly neurotoxic, with the potential to transition neuroinflammation into a chronic state and contribute to neurodegeneration as seen in many neurological diseases. Conversely, PACAP27 is a lipophilic peptide that raises intracellular cAMP and is an anti‐inflammatory agent. The aim of our study was to investigate the therapeutic potential of PACAP27 to counter the behavioral and neurotoxic effects of PGJ2 observed in aged subjects.

Methods

PGJ2 was injected bilaterally into the hippocampal CA1 region of 53‐week‐old and 12‐week‐old C57BL/6N male mice, once per week over 3 weeks (three total infusions) and included co‐infusions of PACAP27 within respective treatment groups. Our behavioral assessments looked at spatial learning and memory performance on the 8‐arm radial maze, followed by histological analyses of fixed hippocampal tissue using Fluoro‐Jade C and fluorescent immunohistochemistry focused on IBA‐1 microglia.

Results

Aged mice treated with PGJ2 exhibited spatial learning and long‐term memory deficits, as well as neurodegeneration in CA3 pyramidal neurons. Aged mice that received co‐infusions of PACAP27 exhibited remediated learning and memory performance and decreased neurodegeneration in CA3 pyramidal neurons. Moreover, microglial activation in the CA3 region was also reduced in aged mice cotreated with PACAP27.

Conclusions

Our data show that PGJ2 can produce a retrograde spread of damage not observed in PGJ2‐treated young mice, leading to age‐dependent neurodegeneration of hippocampal neurons producing learning and memory deficits. PACAP27 can remediate the behavioral and neurodegenerative effects that PGJ2 produces in aged subjects. Targeting specific neurotoxic prostaglandins, such as PGJ2, offers great promise as a new therapeutic strategy downstream of cyclooxygenases, to combat the neuronal deficits induced by chronic inflammation.
p65/miR‐23a/CCL22 axis regulated regulatory T cells recruitment in hepatitis B virus positive hepatocellular carcinoma
Authors: Li Zhi‐Qin , Wang Hong‐Yan , Zeng Qing‐Lei , Yan Jing‐Ya , Hu Yu‐Shu , Li Hua , Yu Zu‐Jiang
Published: November 2019

Background

CCL22 played critical roles in Tregs recruitment. The upstream regulators modulating CCL22 in hepatocellular carcinoma (HCC) were not clearly understood.

Methods

MiR‐23a, p‐p65, p65, CCL22, and Foxp3 levels were monitored by RT‐qPCR and western blotting. Immunofluorescence assay was used to perform the costaining of Foxp3 and CD4 on liver tissues. Transwell assay was applied to evaluate the migration ability of Tregs. Dual‐luciferase assay was performed to determine relationship of miR‐23a/CCL22 and p65/miR‐23a. Chromatin immunoprecipitation (ChIP) was applied to detect the direct binding of p65 to miR‐23a promoter. Xenograft tumor models were developed to investigate the functions of p65 and miR‐23a in vivo.

Results

HBV infection was associated with reduced survival and increased Tregs recruitment in HCC patients. MiR‐23a was decreased, whereas p65, CCL22, and Foxp3 were increased in HBV+ tumors. MiR‐23a was inversely correlated with CCL22 and Foxp3 expression in HCC. MiR‐23a directly targeted CCL22 3’UTR, leading to CCL22 reduction and attenuated Tregs recruitment. Meanwhile, p65 functioned as a transcription repressor of miR‐23a by directly binding to its promoter. Inhibition of p65 induced miR‐23 expression, leading to less CCL22 expression and Tregs recruitment in vitro. CCL22 was the indispensable effector underlying p65/miR‐23a axis and Tregs recruitment. MiR‐23a inhibitor promoted xenografted tumor growth accompanying with upregulation of CCL22, whereas p65 inhibition exerted opposite effects.

Conclusion

Blockage of p65 disinhibited miR‐23a expression, leading to CCL22 reduction and repress Tregs recruitment. Targeting p65/miR‐23a/CCL22 axis was a novel approach for HBV+ HCC treatment.
Outcomes of a randomized controlled trial assessing a smartphone Application to reduce unmet needs among people diagnosed with CancEr (ACE)
Authors: Livingston Patricia M. , Heckel Leila , Orellana Liliana , Ashley David , Ugalde Anna , Botti Mari , Pitson Graham , Woollett Anne , Chambers Suzanne K. , Parente Phillip , Chirgwin Jacqueline , Mihalopoulos Cathrine , Lavelle Barbara , Sutton Jennifer , Phipps‐Nelson Jo , Krishnasamy Mei , Simons Katherine , Heynsbergh Natalie , Wickramasinghe Nilmini , White Vicki
Published: November 2019

Background

Smartphone technology represents an opportunity to deliver practical solutions for people affected by cancer at a scale that was previously unimaginable, such as information, appointment monitoring, and improved access to cancer support services. This study aimed to determine whether a smartphone application (app) reduced the unmet needs among people newly diagnosed with cancer.

Methods

A single blind, multisite randomized controlled trial to determine the impact of an app‐based, 4‐month intervention. Newly diagnosed cancer patients were approached at three health service treatment clinics.

Results

Eighty‐two people were randomized (intervention; n = 43 and control; n = 39), average age was 59.5 years (SD: 12.9); 71% female; 67% married or in a de facto relationship. At baseline, there were no differences in participants’ characteristics between the groups. No significant effects, in reducing unmet needs, were demonstrated at the end of intervention (4‐month) or 12‐month follow‐up. Overall, 94% used the app in weeks 1‐4, which decreased to 41% in weeks 13‐16. Mean app use time per participant: Cancer Information, 6.9 (SD: 18.9) minutes; Appointment Schedule, 5.1 (SD: 9.6) minutes; Cancer Services 1.5 minutes (SD: 6.8); Hospital Navigation, 1.4 (SD: 2.8) minutes.

Conclusions

Despite consumer involvement in the design of this smartphone technology, the app did not reduce unmet needs. This may have been due to the study being underpowered. To contribute to a meaningful understanding and improved implementation of smartphone technology to support people affected by cancer, practical considerations, such as recruitment issues and access to, and confidence with, apps, need to be considered.

Australian New Zealand Clinical Trials Registration (ACTRN) Trial Registration: 12616001251415; WEF 7/9/2016.
Antitumor activity of celastrol by inhibition of proliferation, invasion, and migration in cholangiocarcinoma via PTEN/PI3K/Akt pathway
Authors: Zhu Biqiang , Wei Yunwei
Published: November 2019

Aim

Cholangiocarcinoma is a malignant tumor originating from bile duct epithelium. Currently, the treatment strategy is very limited and the prognosis is poor. Recent studies reported celastrol exhibits antigrowth and antimetastasis properties in many tumors. Our study aimed to assess the anti‐CCA effects of cholangiocarcinoma (CCA) and the mechanisms involved in it.

Methods

In this study, the long‐term and short‐term antiproliferation effects was determined using colony formation and Cell Counting Kit‐8 (CCK‐8) assays, respectively. Flow cytometry was performed to quantify apoptosis. Furthermore, wound healing and transwell assays were performed to determine the cell migration and invasion capabilities, respectively. To further find the mechanism involved in the celastrol‐induced biological functions, LY204002, a PI3K/Akt signaling inhibitor, and an Akt‐1 overexpression plasmid were employed to find whether PI3K/Akt pathway was involved in the celastrol‐induced CCA cell inhibition. Additionally, short interfering RNA (siRNA) was also used to investigate the mechanism involved in the celastrol‐induced PI3K/Akt signaling inhibition. Western blotting and immunofluorescence assays were also performed to detect the degree of relative proteins. Moreover, we validated the antiproliferation and antimetastasis effects of celastrol in vivo by constructing subcutaneous and lung metastasis nude mice models.

Results

We discovered that celastrol effectively induced apoptotic cell death and inhibited the capacity of migration and invasion in CCA cells. Further mechanistic study identified that celastrol regulated the PI3K/Akt signaling pathway, and the antitumor efficacy was likely due to the upregulation of PTEN, a negative regulator of PI3K/Akt. Blockage of PTEN abolished the celastrol‐induced PI3K/Akt signaling inhibition. Additionally, in vivo experiments conformed celastrol inhibited the tumor growth and lung metastasis with no serious side effects.

Conclusions

Overall, our study elucidated a mechanistic framework for the anti‐CCA effects of celastrol via PTEN/PI3K/Akt pathway.
Analysis of the clinicopathological characteristics, genetic phenotypes, and prognostic of pure mucinous adenocarcinoma
Authors: Chen Zhencong , Li Ming , Ma Ke , Shang Guoguo , Liang Jiaqi , Yin Jiacheng , Luo Jizhuang , Zhan Cheng , Shi Yu , Wang Qun
Published: November 2019

Background

Primary pure mucinous adenocarcinoma of the lung (PMA) is a rare subtype. However, correlations between clinicopathological features and genetic phenotypes with survival have not been described comprehensively.

Methods

Pure mucinous adenocarcinoma patient information collected from the Surveillance, Epidemiology, and End Results (SEER) database, the Department of Thoracic Surgery, Zhongshan Hospital, Fudan University (FDZSH), and the Cancer Genome Atlas (TCGA) were extracted, evaluated, and compared with other lung adenocarcinomas (LUAD) patient data. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway analyses were performed to explore the functional importance of underlying molecular changes. Overall survival (OS) was evaluated with the Kaplan‐Meier method. Univariate and multivariate analysis through Cox proportional hazard regression identified risk factors that predicted OS, and the results were used to construct a nomogram to predict OS for PMA patients.

Results

Overall, 3622 patients, 41 patients, and 15 patients with PMA were identified from the SEER, FDZSH, and TCGA databases, respectively. There were 345 differentially expressed genes, 30 differentially mutated genes and 72 differentially methylated genes were identified between PMA and other LUAD samples. In the SEER database, PMA had a better prognosis compared to other LUAD. Compared with patients with other LUAD, patients with PMA exhibited unique clinicopathological features, including fewer grade III/IV tumors, less pleural invasion, more early‐stage cancer, and more lower lobe carcinomas. Multivariate analyses showed that age, race, T stage, N stage, surgery, and chemotherapy were independent risk factors. The nomogram had a calibration index of 0.724.

Conclusions

Our research identified unique clinicopathological characteristics and genetic phenotypes for PMA and other LUAD. The nomogram accurately predicted OS.
Ceramic Membranes: Materials – Components – Potential Applications
Authors: Meulenberg Wilhelm A. , Schulze‐Küppers Falk , Deibert Wendelin , Gestel Tim Van , Baumann Stefan
Published: November 2019

Gas separation in dense ceramic membranes is driven by the partial pressure gradient across the membrane. The mixed conducting materials most commonly used are single‐phase perovskites or fluorites. In recent years, the development of dual‐phase systems combining a mixed ion‐conducting and electron‐conducting phase has increased. The advantage is that a larger number of very stable materials systems is available. The membrane designs currently used include planar, tubular, hollow‐fiber, and honeycomb membranes. Each of these designs has specific advantages and disadvantages, depending on the application. Innovative joining concepts are also often needed due to the high temperatures involved. These usually involve the use of glass‐ceramic sealants or reactive metal brazes. Applications focus either on the separation of gases alone, i.e., the supply of oxygen or hydrogen, or on membrane reactors. In membrane reactors, a chemical reaction occurs on one or both sides of the membrane in addition to gas separation. The supply of gases is of potential interest for power plants, for the cement, steel, and glass industries, for the medical sector, and for mobile applications. Membrane reactors can be used to produce base chemicals or synthetic fuels.
Clinical outcomes of complex lesions treated with an abluminal groove‐filled biodegradable polymer sirolimus‐eluting stent and durable polymer everolimus‐eluting stent
Authors: Saito Yuichi , Baumbach Andreas , Wijns William , Xu Bo , Kelbæk Henning , Zheng Ming , Morel Marie‐angèle , Anderson Richard , Schächinger Volker , Lansky Alexandra ,   TARGET AC Investigators
Published: November 2019

Background

The Firehawk stent (Shanghai MicroPort Medical Group, Shanghai, China), a novel biodegradable polymer sirolimus‐eluting coronary stent has been evaluated in the randomized TARGET I trial in which low‐risk patients were enrolled with strict eligibility criteria. Recently, the TARGET All Comers study has shown similar results of the Firehawk compared to the XIENCE stent (Abbott Vascular, Santa Clara). However, clinical outcomes in high‐risk patients are unclear.

Methods

The TARGET All Comer study was a randomized trial that assigned patients to either Firehawk or XIENCE implantation. This TARGET AC subanalysis sought to evaluate the 2 year clinical outcomes of patients according to two risk groups; patients meeting all inclusion criteria and no exclusion criteria of the TARGET I trial were classified as “low‐risk,” while their counterparts were classified as “high‐risk.” The primary endpoint was target lesion failure.

Results

A total of 1,585 patients were included, of which 1,334 (84%) were classified as high‐risk. At 2 years, the high‐risk group had a significantly higher rate of TLF than the low‐risk group (9.5% vs. 3.6%, p = .003), mainly driven by increased target vessel myocardial infarction (6.3% vs. 2.4%, p = .02). The Firehawk and XIENCE had no significant differences in TLF among both low‐risk (3.1% vs. 4.2%, p = .66) and high‐risk (9.9% vs. 9.1%, p = .57) patients.

Conclusions

High‐risk patients had worse clinical outcomes at 2 years in the TARGET All Comer study. Outcomes with the Firehawk were similar to the XIENCE stent among both low‐risk and high‐risk patients at 2 years.
Impact of short term oral steroid use for intravenous contrast media hypersensitivity prophylaxis in diabetic patients undergoing nonemergent coronary angiography or interventions
Authors: Amr Bashar S. , Lippmann Matthew , Tobbia Patrick , Isom Nicholas , Dalia Tarun , Buechler Tyler , Pierpoline Michael , Patel Nilay , Hockstad Eric , Wiley Mark , Tadros Peter , Mehta Ashwani , Earnest Matthew , Chen John G. , Gupta Kamal
Published: November 2019

Objectives

Oral steroids are routinely administered in the United States for prophylaxis of iodinated contrast media hypersensitivity (ICMH). We studied the impact of short‐term steroid use in diabetic patients with ICMH undergoing nonemergent coronary angiography.

Methods

We retrospectively analyzed records of diabetic patients with and without ICMH who underwent nonemergent coronary angiography at our center. Primary study endpoint was 30‐day major adverse cardiac events (MACE) and secondary endpoints were pre‐ and postprocedure fasting blood glucose (FBG), highest in hospital blood glucose, pre‐ and postprocedure systolic blood pressure (SBP), and use of intravenous insulin and antihypertensive medications.

Results

A total of 88 diabetics with ICMH (study group) and 76 diabetics without ICMH (control group) undergoing angiography were enrolled. Demographics and hemoglobin A1c values were similar in both groups. Preprocedural FBG was significantly higher in the study group. The study group had significantly higher post angiography FBG (239.93 + 96.88 mg/dl vs. 156.6 + 59.88 mg/dl) and greater use of intravenous (IV) insulin (67.27% vs. 32.43%). Further, those who received steroids had significantly higher systolic SBP postprocedure (146.16 + 25.35 mmHg vs. 130.8 + 21.59 mmHg), a higher incidence of severe hypertension and use of IV antihypertensive medications (80.95% vs. 19.05%) periprocedurally. There were no differences in 30‐day MACE between groups.

Conclusion

Short‐term steroid use for ICMH results in a significant increase in surrogate markers for adverse clinical events after coronary procedures. Study findings highlight the need for better periprocedural management of these patients and to limit steroid prophylaxis to those with only true ICMH.
The spiced fingerprint ‐ superglue and curry powder let latent fingerprints fluoresce
Authors: Fischer Rachel , Oetken Marco
Published: November 2019

In diesem Beitrag werden drei einfache Versuche dargestellt, die eine Einfärbung eines mit der Sekundenkleber‐Methode visualisierten Fingerabdrucks ermöglichen. Herkömmliche Kontraststeigerungsmethoden sind mit einer Gefährdung durch die eingesetzten Chemikalien und/oder mit hohen Kosten verbunden, wodurch der Einsatz im Chemieunterricht erschwert oder sogar unmöglich ist. Die Verwendung von Alltagsprodukten (Holi‐ und Curry‐Pulver) ermöglicht eine neuartige, kostengünstige und schnelle Einfärbung eines Sekundenkleber‐Fingerabdrucks.
Question generation based on chat‐response conversion
Authors: Zhong Sheng‐Hua , Peng Jianfeng , Liu Peiqi
Published: November 2019

Today, thanks to the major breakthrough of sequences to sequences model in the field of natural language, most of the dialogue generation tasks are focused on generating more effective responses. However, the responses proposed by the chat‐bot are only a passive answer or assentation, which does not arouse the desire of people to continue communicating. How to transform the chat robot from a passive reply to an active questioner has become an urgent problem. In this paper, a question generalization method with four types of question proposing schemes are designed, implemented, and tested to automate question generation process. The proposed system is controlled by a probability‐triggered multiple conversion mechanism to actively propose different types of questions. We embed our methods in the mainstream dialogue generation model and demonstrate its effectiveness in dialogue response generalization on a standard dataset. In addition, it achieves good performance in subjective conversational assessment.
Preparing a Single Cell Suspension from Zebrafish Retinal Tissue for Flow Cytometric Cell Sorting of Müller Glia
Authors: Allan Kristin , DiCicco Rose , Ramos Michael , Asosingh Kewal , Yuan Alex
Published: November 2019

Preparation of a single cell suspension from solid tissue is vital for a successful flow cytometry experiment. We report a detailed and reproducible method to produce a quality cell suspension from the zebrafish retina. Zebrafish retinas, especially their Müller glia cells, are of particular interest for their inherent regenerative capacity, making them a useful model for regenerative medicine and cell therapy research. Here, we detail a papain‐based dissociation that is gentle enough to keep cells intact, but strong enough to disrupt cell‐cell and cell‐matrix interactions to yield a cell suspension that produces clean and reliable flow cytometric cell sorting results. This procedure consistently results in over 90% viability and three populations of cells based on GFP expression. The dissociation procedure described herein has been optimized for the collection of Müller glia from Tg(apoe:gfp) zebrafish retinas; however, the overall process may be applicable to other cell types in the fish retina, additional flow cytometric techniques, or preparing cell suspensions from similar tissues. © 2019 International Society for Advancement of Cytometry
Spatially explicit models of seasonal habitat for greater sage‐grouse at broad spatial scales: Informing areas for management in Nevada and northeastern California
Authors: Coates Peter S. , Brussee Brianne E. , Ricca Mark A. , Severson John P. , Casazza Michael L. , Gustafson Kit Benjamin , Espinosa Shawn P. , Gardner Scott C. , Delehanty David J.
Published: November 2019

Defining boundaries of species' habitat across broad spatial scales is often necessary for management decisions, and yet challenging for species that demonstrate differential variation in seasonal habitat use. Spatially explicit indices that incorporate temporal shifts in selection can help overcome such challenges, especially for species of high conservation concern. Greater sage‐grouse Centrocercus urophasianus (hereafter, sage‐grouse), a sagebrush obligate species inhabiting the American West, represents an important case study because sage‐grouse exhibit seasonal habitat patterns, populations are declining in most portions of their range and are central to contemporary national land use policies. Here, we modeled spatiotemporal selection patterns for telemetered sage‐grouse across multiple study sites (1,084 sage‐grouse; 30,690 locations) in the Great Basin. We developed broad‐scale spatially explicit habitat indices that elucidated space use patterns (spring, summer/fall, and winter) and accounted for regional climatic variation using previously published hydrographic boundaries. We then evaluated differences in selection/avoidance of each habitat characteristic between seasons and hydrographic regions. Most notably, sage‐grouse consistently selected areas dominated by sagebrush with few or no conifers but varied in type of sagebrush selected by season and region. Spatiotemporal variation was most apparent based on availability of water resources and herbaceous cover, where sage‐grouse strongly selected upland natural springs in xeric regions but selected larger wet meadows in mesic regions. Additionally, during the breeding period in spring, herbaceous cover was selected strongly in the mesic regions. Lastly, we expanded upon an existing joint–index framework by combining seasonal habitat indices with a probabilistic index of sage‐grouse abundance and space use to produce habitat maps useful for sage‐grouse management. These products can serve as conservation planning tools that help predict expected benefits of restoration activities, while highlighting areas most critical to sustaining sage‐grouse populations. Our joint–index framework can be applied to other species that exhibit seasonal shifts in habitat requirements to help better guide conservation actions.
Spatial and taxonomic biases in bat records: Drivers and conservation implications in a megadiverse country
Authors: Zamora‐Gutierrez Veronica , Amano Tatsuya , Jones Kate E.
Published: November 2019

Biases in data availability have serious consequences on scientific inferences that can be derived. The potential consequences of these biases could be more detrimental in the less‐studied megadiverse regions, often characterized by high biodiversity and serious risks of human threats, as conservation and management actions could be misdirected. Here, focusing on 134 bat species in Mexico, we analyze spatial and taxonomic biases and their drivers in occurrence data; and identify priority areas for further data collection which are currently under‐sampled or at future environmental risk. We collated a comprehensive database of 26,192 presence‐only bat records in Mexico to characterize taxonomic and spatial biases and relate them to species' characteristics (range size and foraging behavior). Next, we examined variables related to accessibility, species richness and security to explain the spatial patterns in occurrence records. Finally, we compared the spatial distributions of existing data and future threats to these species to highlight those regions that are likely to experience an increased level of threats but are currently under‐surveyed. We found taxonomic biases, where species with wider geographical ranges and narrow‐space foragers (species easily captured with traditional methods), had more occurrence data. There was a significant oversampling toward tropical regions, and the presence and number of records was positively associated with areas of high topographic heterogeneity, road density, urban, and protected areas, and negatively associated with areas which were predicted to have future increases in temperature and precipitation. Sampling efforts for Mexican bats appear to have focused disproportionately on easily captured species, tropical regions, areas of high species richness and security; leading to under‐sampling in areas of high future threats. These biases could substantially influence the assessment of current status of, and future anthropogenic impacts on, this diverse species group in a tropical megadiverse country.
Stormflow threshold behaviour in a subtropical mountainous headwater catchment during forest recovery period
Authors: Wei Lezhang , Qiu Zhijun , Zhou Guangyi , Kinouchi Tsuyoshi , Liu Yu
Published: November 2019

Forest ecohydrological feedbacks complicate the threshold behaviour of stormflow response to precipitation or wetting conditions on a long‐term scale (e.g. several years). In this study, the threshold behaviours in an evergreen‐deciduous mixed forested headwater catchment in southern China were examined during 2009–2015, when damaged vegetation was recovering after the great 2008 Chinese ice and snowstorm. The non‐uniqueness of the thresholds and the slow and rapid responses of stormflow at the outlet of the catchment in different hydro‐climate datasets with different maximum values of gross precipitation (P) and sums of precipitation and antecedent soil moisture index (P + ASI) were assessed. The thresholds of P and P + ASI required to trigger stormflows (i.e. ‘generation thresholds’) and the transition from slow to rapid responses of stormflow (i.e. ‘rise thresholds’) were compared both seasonally and annually. The results indicated significant differences in the analysed datasets, highlighting the need to compare thresholds with care to avoid misinterpretation. Seasonal variations in threshold behaviours in the catchment suggested that vegetation canopy interception contributed to higher rise thresholds, and wetter conditions resulted in higher runoff sensitivity to precipitation during the growing and rainy seasons. Furthermore, the generation thresholds were higher in the dormant season, possibly due to drier soil moisture conditions in the near‐channel areas. During the vegetation recovery period, the annual generation thresholds increased, however the rise thresholds did not exhibit a similar trend. The rapid stormflow response above the threshold decreased, possibly due to transpiration and interception of the recovered vegetation. However, the slow stormflow response to small rainfall events below the thresholds was higher in wetter years but lower in drier years, suggesting that the total water input dominated the stormflow response during small rainfall events. In conclusion, the seasonal and annual variations in threshold behaviours highlight that vegetation recovery and hydro‐climatic conditions had a notable impact on the stormflow response.
Lead‐free perovskite MASnBr3‐based memristor for quaternary information storage
Authors: Qian Wen‐Hu , Cheng Xue‐Feng , Zhou Jin , He Jing‐Hui , Li Hua , Xu Qing‐Feng , Li Na‐Jun , Chen Dong‐Yun , Yao Zhi‐Gang , Lu Jian‐Mei
Published: November 2019

Memristors are a new type of circuit element with a resistance that is tunable to discrete levels by a voltage/current and sustainable after removal of power, allowing for low‐power computation and multilevel information storage. Many organic‐inorganic lead perovskites are reported to demonstrate memristive behavior, but few have been considered for use as a multilevel memory; also, their potential application has been hindered by the toxicity of lead ions. In this article, lead‐free perovskite MASnBr3 was utilized in memristors for quaternary information storage. Indium tin oxide (ITO)/MASnBr3/Au memristors were fabricated and showed reliable memristive switching with well‐separated ON/OFF states of a maxima resistance ratio of 102 to 103. More importantly, four resistive states can be distinguished and repeatedly written/read/erased with a retention time of 104 seconds and an endurance of 104 pulses. By investigating the current‐electrode area relationship, Br distribution in the ON/OFF states by in situ Raman and scanning electron microscopy, and temperature‐dependent current decay, the memristive behavior was explicitly attributed to the forming/breaking of conductive filaments caused by the migration of Br− under an electric field. In addition, poly(ethylene terephthalate)‐ITO/MASnBr3/Au devices were found to retain their multiresistance state behavior after being bent for 1000 times, thus demonstrating good device flexibility. Our results will inspire more lead‐free perovskite work for multilevel information storage, as well as other memristor‐based electronics.

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Systematic integration of GATA transcription factors and epigenomes via IDEAS paints the regulatory landscape of hematopoietic cells
Authors: Hardison Ross C. , Zhang Yu , Keller Cheryl A. , Xiang Guanjue , Heuston Elisabeth F. , An Lin , Lichtenberg Jens , Giardine Belinda M. , Bodine David , Mahony Shaun , Li Qunhua , Yue Feng , Weiss Mitchell J. , Blobel Gerd A. , Taylor James , Hughes Jim , Higgs Douglas R. , Göttgens Berthold
Published: November 2019

Members of the GATA family of transcription factors play key roles in the differentiation of specific cell lineages by regulating the expression of target genes. Three GATA factors play distinct roles in hematopoietic differentiation. In order to better understand how these GATA factors function to regulate genes throughout the genome, we are studying the epigenomic and transcriptional landscapes of hematopoietic cells in a model‐driven, integrative fashion. We have formed the collaborative multi‐lab VISION project to conduct ValIdated Systematic IntegratiON of epigenomic data in mouse and human hematopoiesis. The epigenomic data included nuclease accessibility in chromatin, CTCF occupancy, and histone H3 modifications for 20 cell types covering hematopoietic stem cells, multilineage progenitor cells, and mature cells across the blood cell lineages of mouse. The analysis used the Integrative and Discriminative Epigenome Annotation System (IDEAS), which learns all common combinations of features (epigenetic states) simultaneously in two dimensions—along chromosomes and across cell types. The result is a segmentation that effectively paints the regulatory landscape in readily interpretable views, revealing constitutively active or silent loci as well as the loci specifically induced or repressed in each stage and lineage. Nuclease accessible DNA segments in active chromatin states were designated candidate cis‐regulatory elements in each cell type, providing one of the most comprehensive registries of candidate hematopoietic regulatory elements to date. Applications of VISION resources are illustrated for the regulation of genes encoding GATA1, GATA2, GATA3, and Ikaros. VISION resources are freely available from our website http://usevision.org.
Evidence of structural cavities in 3D printed acetabular cups for total hip arthroplasty
Authors: Hothi Harry , Dall'Ava Lorenzo , Henckel Johann , Di Laura Anna , Iacoviello Francesco , Shearing Paul , Hart Alister
Published: November 2019

The use of three‐dimensional (3D) printing to manufacture off‐the‐shelf titanium acetabular cups for hip arthroplasty has increased; however, the impact of this manufacturing technology is yet not fully understood. Although several studies have described the presence of structural cavities in 3D printed parts, there has been no analysis of full postproduction acetabular components. The aim of this study was to investigate the effect of 3D printing on the material structure of acetabular implants, first comparing different designs of 3D printed cups, second comparing 3D printed with conventionally manufactured cups. Two of the 3D printed cups were produced using electron beam melting (EBM), one using laser rapid manufacturing (LRM). The investigation was performed using X‐ray microcomputed tomography, imaging both the entire cups and samples sectioned from different regions of each cup. All 3D printed cups showed evidence of structural cavities; these were uniformly distributed in the volume of the samples and exhibited a prevalent spherical shape. The LRM‐manufactured cup had significantly higher cavity density (p = .0286), with a median of 21 cavities/mm3 compared to 3.5 cavities/mm3 for EBM cups. However, the cavity size was similar, with a median of 20 μm (p = .7385). The conventional cups showed a complete absence of distinguishable cavities. The presence of cavities is a known limitation of the 3D printing technology; however, it is noteworthy that we found them in orthopedic implants used in patients. Although this may impact their mechanical properties, to date, 3D printed cups have not been reported to encounter such failures.