bluuebunny/crossref_metadata_2025 huggingface dataset:
Concentration of xylooligosaccharides with a low degree of polymerization using membranes and their effect on bacterial fermentation
Authors: Singh Ramkrishna D. , Muir Jane , Arora Amit
Published: September 2020

Xylooligosaccharide (XOS) liquor, enzymatically obtained from almond‐shell hemicellulose and consisting primarily of xylobiose and xylotriose, was refined and concentrated using a combination of membranes and ion‐exchange resin. The concentrated liquor was used for an in vitro fermentation study utilizing different strains of Lactobacillus and Bifidobacterium. Upon ultrafiltration with a 10 kDa membrane, high molecular‐weight components, including enzymes and color‐imparting impurities, could be removed from the liquor. Upon nanofiltration with a 150 Da membrane, at a volume:concentration ratio of 8.9, a retentate containing 79% xylobiose and 41.3% xylotriose was obtained. At the end of filtration, 69.6 ± 3.8% of the initial XOS was recovered, with concentrated xylobiose and xylotriose in the retentate. The resin treatment further improved the purity of the XOS concentrate via decoloration and deacidification. Among the evaluated strains of Lactobacillus and Bifidobacterium, L. acidophilus, B. adolescentis, and B. brevis could ferment XOS to a varying extent, as indicated by their difference in growth, to produce acetate as a predominant short‐chain fatty acid. For Lactobacillus, a 10–12‐fold increase in the bacterial population was observed at the end of 48 h. On the other hand, Bifidobacterium grew slowly to show about a 1.2 to fourfold increase in the bacterial population at the end of 72 h. A bacterial preference for fermenting xylobiose rather than xylotriose or xylotetrose was also observed, justifying the production of XOS with a low degree of polymerization. © 2020 Society of Chemical Industry and John Wiley & Sons, Ltd
Impact of surgical infrastructure and personnel on volume and availability of essential surgical procedures in Liberia
Authors: Adde H A , Duinen A J , Oghogho M D , Dunbar N K , Tehmeh L G , Hampaye T C , Salvesen Ø , Weiser T G , Bolkan H A
Published: September 2020

Background

Essential surgical procedures rank among the most cost-effective of all healthcare interventions. The aim of this study was to enumerate surgical volumes in Liberia, quantify surgical infrastructure, personnel and availability of essential surgical procedures, describe surgical facilities, and assess the influence of human resources and infrastructure on surgical volumes.

Methods

An observational countrywide survey was done in Liberia between 20 September and 8 November 2018. All healthcare facilities performing surgical procedures requiring general, regional or local anaesthesia in an operating theatre between September 2017 and August 2018 were eligible for inclusion. Information on facility infrastructure and human resources was collected by interviewing key personnel. Data on surgical volumes were extracted from operating theatre log books.

Results

Of 70 healthcare facilities initially identified as possible surgical facilities, 52 confirmed operative capacity and were eligible for inclusion; all but one shared surgical data. A national surgical volume of 462 operations per 100 000 population was estimated. The median hospital offered nine of 26 essential surgical procedures. Unequal distributions of surgical infrastructure, personnel, and essential surgical procedures were identified between facilities. In multivariable regression analysis, surgical human resources (β = 0·60, 95 per cent c.i. 0·34 to 0·87; P < 0·001) and infrastructure (β = 0·03, 0·02 to 0·04; P < 0·001) were found to be strongly associated with operative volumes.

Conclusion

The availability of essential surgical procedures in Liberia is extremely low. Descriptive tools can quantify inequalities, guide resource allocation, and highlight rational investment areas.
Neurogenic dysphagia in traditional Chinese medicine
Authors: Liu Jia , Wang Lu‐ning
Published: September 2020

Background

Neurogenic dysphagia is the difficulty in swallowing caused by neurological diseases, which is a very common symptom in neurological disorders. In this paper, we try to summarize the opinions in the pathophysiology and therapy of dysphagia in ancient China (before AD 1840) through the records in the literatures from all the dynasties.

Methods

We searched the databases including Chinese Medical Classics, China National Knowledge Infrastructure, Wanfang Data, MEDLINE, and ISI Proceedings until July 2020, with the search terms “dysphagia” and “difficulty in swallowing” in English and their Chinese equivalents.

Results and Conclusions

The concept of neurogenic dysphagia was first described as Hou Bi in the Yellow Emperor's Internal Classic, which is the first Chinese medical classic and the origin of traditional Chinese medicine (TCM) theory. In the different eras, the pathogenesis of neurogenic dysphagia was explained mainly by three theories in TCM, that is, the wind‐phlegm blocking collaterals, the deficiency of liver and kidney‐essence, and the Qi‐stagnation with static blood. In addition to the TCM prescriptions, acupuncture is characteristic treatment and seems to be effective. However, the evidences of efficacy and safety from clinical trials are still required.
Comparison of nutritional quality and sensory acceptability of biscuits obtained from wheat, native, or extruded sorghum flour
Authors: Yu Miao , Zhu Kai , Wang Xiaohe , Lu Ming , Zhang Liangchen , Fu Xin , Wang Yanqiu , Xiao Zhigang , Yang Qingyu
Published: September 2020

Background and objectives

Sorghum (Sorghum bicolor (L.) Moench) is the fifth leading cereal crop in the world. In recent years, sorghum has gained increasing popularity not only in areas of poor soil quality producing the same amount of fodder as corn but also for its nutrition and functional characteristics. In this study, a fuzzy mathematical model was used in the sensory assessment of wheat, sorghum, and extrusion sorghum flour biscuits to improve the reliability of the conclusion.

Findings

The results showed that sorghum flour (SF) and extrusion sorghum flour (ESF‐80, ESF‐100 and ESF‐120. 80,100 and 120 represent different extrusion temperatures respectively) improved the RS of wheat flour (WF). However, tannins are present in SF and ESF‐100 but not in ESF‐80 and ESF‐120. For the biscuit samples, the WF + SF biscuit (WSFB) and WF + ESF biscuit (WESFB) had more RS. All of the types of biscuits had no tannins, and the amino acid contents were all approximately the same. The fuzzy mathematical model of biscuit sensory assessment indicated that optimum formulations added ESF‐80.

Conclusions

This study shows that ESF‐80 addition improves the nutrition, health composition, and sensory acceptability of biscuits.

Significance and novelty

These results are important for biscuit producers who need more resistant starch in their productions. Our study is the first to provide a fuzzy mathematical model on the sensory assessment of wheat, sorghum, and extrusion sorghum flour biscuits.
Purpuric rash in an adolescent with fever, pancytopenia, and an hemophagocytic lymphohistiocytosis‐like syndrome due to parvovirus B19
Authors: Koliou Maria , Tryfonos Anna , Charalambous Myria
Published: September 2020

A rare case of parvovirus B19 infection associated with fever, hemorrhagic rash, and a clinical course resembling an incomplete HLH syndrome is presented. Parvovirus B19 should be included in the evaluation of febrile purpura and HLH‐like syndrome.
Distinct proportions of cholinergic neurons in the rat prepositus hypoglossi nucleus according to their cerebellar projection targets
Authors: Sugimura Taketoshi , Saito Yasuhiko
Published: September 2020

Cerebellar functions are modulated by cholinergic inputs, the density of which varies among cerebellar regions. Although the prepositus hypoglossi nucleus (PHN), a brainstem structure involved in controlling gaze holding, is known as one of the major sources of these cholinergic inputs, the proportions of cholinergic neurons in PHN projections to distinct cerebellar regions have not been quantitatively analyzed. In this study, we identified PHN neurons projecting to the cerebellum by applying retrograde labeling with dextran‐conjugated Alexa 488 in choline acetyltransferase (ChAT)‐tdTomato transgenic rats and compared the proportion of cholinergic PHN neurons in the PHN projections to four different regions of the cerebellum, namely the flocculus (FL), the uvula and nodulus (UN), lobules III‐V in the vermis (VM), and the hemispheric paramedian lobule and crus 2 (PC). In the PHN, the percentage of cholinergic PHN neurons was lower in the projection to the FL than in the projection to the UN, VM or PC. Preposito‐cerebellar neurons, except for preposito‐FL neurons, included different proportions of cholinergic neurons at different rostrocaudal positions in the PHN. These results suggest that cholinergic PHN neurons project to not only the vestibulocerebellum but also the anterior vermis and posterior hemisphere and that the proportion of cholinergic neurons among projection neurons from the PHN differs depending on cerebellar target areas and the rostro‐caudal regions of the PHN. This study provides insights regarding the involvement of cerebellar cholinergic networks in gaze holding.
A transformative learning journey of a teacher educator in enacting an activist approach in Physical Education Teacher Education
Authors: Luguetti Carla , Oliver Kimberly L.
Published: September 2020

Over the past decades, a body of scholarship has highlighted the benefits of an activist approach in Physical Education Teacher Education (PETE). This body of research shows that an activist approach enables teacher educators, student teachers and young people to work together in order to become conscious of the power structures in society that lead to social inequities. Although we have a body of research on social justice and critical pedagogy in PETE, there is much to learn about physical education teacher educators’ learning journeys in enacting activist approaches. By using a critical autoethnography approach, this study explores a transformative learning journey experienced by the lead author in enacting an activist approach based on young people’s voices. The PETE educator’s learning journey emerged from the reflexive process in the last 8 years with the second author. A critical theoretical framework based on critical pedagogy and feminist studies is employed to discuss the transformative learning journey presented in this paper. By establishing a collective meaning, we aim to provide rich instances of critical pedagogies that add to the project of identifying various approaches to social justice in PETE contexts. This is a relevant story to PETE practitioners who might be attempting to take a critical stance in contemporary university contexts.
Balloon aortic valvuloplasty for urgent treatment of severe aortic stenosis during coronavirus disease 2019 pandemic: a case report
Authors: Attisano Tiziana , Silverio Angelo , Bellino Michele , Tumscitz Carlo , Tarantino Fabio Felice , Santarelli Andrea , Baldi Cesare , Citro Rodolfo , Galasso Gennaro
Published: September 2020

An 86‐year‐old man affected by severe aortic stenosis (AS) was referred to our institution owing to decompensated heart failure. Three months before, the patient was scheduled for transcatheter aortic valve implantation (TAVI), which was postponed owing to the coronavirus disease 2019 (COVID‐19) outbreak. Owing to COVID‐19 suspicion, he underwent nasopharyngeal swab and was temporarily isolated. However, the rapid deterioration of clinical and haemodynamic conditions prompted us to perform balloon aortic valvuloplasty (BAV) as bridge to TAVI. The patient's haemodynamics improved; and the next day, the reverse transcriptase–polymerase chain reaction for COVID‐19 was negative. At Day 5, he underwent TAVI procedure. Subsequent clinical course was uneventful. During COVID‐19 pandemic, the deferral of TAVI procedure should be assessed on a case‐by‐case basis to avoid delay in patients at high risk for adverse events. BAV may be an option when TAVI is temporarily contraindicated such as in AS patients suspected for COVID‐19.
Coronary microvascular dysfunction is associated with exertional haemodynamic abnormalities in patients with heart failure with preserved ejection fraction
Authors: Ahmad Ali , Corban Michel T. , Toya Takumi , Verbrugge Frederik H. , Sara Jaskanwal D. , Lerman Lilach O. , Borlaug Barry A. , Lerman Amir
Published: September 2020

Aims

This study uniquely explored the relationship between coronary microvascular function and exercise haemodynamics using concurrent invasive testing.

Methods and results

Fifty‐one consecutive patients with unexplained cardiac exertion symptoms, non‐obstructive coronary artery disease and normal left ventricular ejection fraction (>50%) underwent haemodynamic exercise assessment and concurrent coronary reactivity testing. Heart failure with preserved ejection fraction (HFpEF) was defined as a pulmonary arterial wedge pressure (PAWP) ≥15 mmHg at rest and/or ≥25 mmHg at peak exercise. Endothelium‐independent coronary microvascular dysfunction (CMD) was defined as a coronary flow reserve (CFR) ≤2.5, while endothelium‐dependent CMD was defined as ≤50% increase in coronary blood flow (CBF) in response to intracoronary acetylcholine infusions. Patients with HFpEF (n = 22) had significantly lower CFR (2.5 ± 0.6 vs. 3.2 ± 0.7; P = 0.0003) and median %CBF increase in response to intracoronary acetylcholine [1 (−35; 34) vs. 64 (−4; 133); P = 0.002] compared to patients without HFpEF (n = 29). PAWP was significantly higher in patients with endothelium‐independent CMD compared to controls during both rest and exercise. This significant elevation was only present during exercise in patients with endothelium‐dependent CMD compared to controls. CFR had significant inverse correlations with PAWP at rest (r = −0.31; P = 0.03) and peak exercise (r = −0.47, P = 0.001). CFR also had positive correlations with maximal exercise capacity (in W/kg) (r = 0.33, P = 0.02).

Conclusions

Coronary microvascular function is inversely associated with filling pressures, particularly during exercise. Both types of CMD are associated with higher filling pressures at peak exercise. These findings underscore the potential mechanism and therapeutic target for CMD and HFpEF.
Cachexia, muscle wasting, and frailty in cardiovascular disease
Authors: Bielecka‐Dabrowa Agata , Ebner Nicole , dos Santos Marcelo Rodrigues , Ishida Junishi , Hasenfuss Gerd , von Haehling Stephan
Published: September 2020

The last several years have seen increasing interest in understanding cachexia, muscle wasting, and physical frailty across the broad spectrum of patients with cardiovascular illnesses. This interest originally started in the field of heart failure, but has recently been extended to other areas such as atrial fibrillation, coronary artery disease, peripheral artery disease as well as to patients after cardiac surgery or transcatheter aortic valve implantation. Tissue wasting and frailty are prevalent among many of the affected patients. The ageing process itself and concomitant cardiovascular illness decrease lean mass while fat mass is relatively preserved, making elderly patients particularly prone to develop wasting syndromes and frailty. The aim of this review is to provide an overview of the available knowledge of body wasting and physical frailty in patients with cardiovascular illness, particularly focussing on patients with heart failure in whom most of the available data have been gathered. In addition, mechanisms of wasting and possible therapeutic targets are discussed.
Wave direction shift triggered severe erosion of beaches in estuaries and bays with limited post‐storm recovery
Authors: Gallop Shari L. , Vila‐Concejo Ana , Fellowes Thomas E. , Harley Mitchell D. , Rahbani Maryam , Largier John L.
Published: September 2020

Many estuaries contain sandy beaches that provide habitats and offer protective buffers for wetlands and infrastructure, alongside cultural and recreational resources. Research underpinning coastal management tends to focus on tide‐ and swell‐dominated sandy beaches, but little attention is given to beaches in estuaries and bays (BEBs) that exist along a continuum of wind/swell wave, tide and riverine influence. BEBs are subject to less wave energy than open coast locations because of the generally narrow window of directions for which ocean waves can propagate through the entrance. However, when storm wave direction coincides with the orientation of the estuary or bay entrance, waves can penetrate several kilometres inside. Here we focus on eight BEBs in two major bays/estuaries in Sydney, Australia and present observations from before and after a major extratropical storm with waves from an atypical direction in June 2016. We quantify magnitudes of beach erosion and recovery rates for 3 years post‐storm. We show that when high‐energy storm waves penetrate bays and estuaries, BEBs can undergo up to 100% of subaerial beach erosion. Three years after the storm, only 5 of the 29 (17%) eroded subaerial beach profiles had recovered to their pre‐storm volume. This is likely due to the lack of low‐frequency, beach‐building waves at BEBs under modal weather conditions in between storms, in contrast to open coast beaches. We also show that the recovery of BEBs may be limited by the absence of adjacent sediment reservoirs due to the dominance of tidal processes mid‐channel. Our study highlights the unique behaviour of BEBs relative to beaches on the open coast, and that shifting wave direction needs to be considered in long‐term beach resilience under climate change. © 2020 John Wiley & Sons, Ltd.
Altered structure and functional connectivity of the hippocampus are associated with social and mathematical difficulties in nonverbal learning disability
Authors: Banker Sarah M. , Pagliaccio David , Ramphal Bruce , Thomas Lauren , Dranovsky Alex , Margolis Amy E.
Published: September 2020

The hippocampus is known to play a critical role in a variety of complex abilities, including visual‐spatial reasoning, social functioning, and math. Nonverbal learning disability (NVLD) is a neurodevelopmental disorder characterized by deficits in visual‐spatial reasoning that are accompanied by impairment in social function or mathematics, as well as motor or executive function skills. Despite the overlap between behaviors supported by the hippocampus and impairments in NVLD, the structure and function of the hippocampus in NVLD has not been studied. To address this gap in the literature, we first compared hippocampal volume and resting‐state functional connectivity in children with NVLD (n = 24) and typically developing (TD) children (n = 20). We then explored associations between hippocampal structure, connectivity, and performance on measures of spatial, social, and mathematical ability. Relative to TD children, those with NVLD showed significant reductions in left hippocampal volume and greater hippocampal‐cerebellar connectivity. In children with NVLD, reduced hippocampal volume associated with worse mathematical problem solving. Although children with NVLD exhibited more social problems (social responsiveness scale [SRS]) and higher hippocampal‐cerebellar connectivity relative to TD children, greater connectivity was associated with fewer social problems among children with NVLD but not TD children. Such an effect may suggest a compensatory mechanism. These structural and functional alterations of the hippocampus may disrupt its putative role in organizing conceptual frameworks through cognitive mapping, thus contributing to the cross‐domain difficulties that characterize NVLD.
Humanized anti‐CD19 chimeric antigen receptor‐T cell therapy is safe and effective in lymphoma and leukemia patients with chronic and resolved hepatitis B virus infection
Authors: Cui Rui , Lyu Cuicui , Li Qing , Jiang Yanyu , Mou Nan , Yang Zhenxing , Liu Xuxiang , Deng Qi , Li Lanfang
Published: September 2020

Chimeric antigen receptor‐T (CAR‐T) cell therapy is a promising treatment for CD19+ B‐cell malignancies. However, elimination of B cells by anti‐CD19 CAR‐T cells may lead to the reactivation of hepatitis B virus (HBV) and related hepatitis in patients with HBV infection. This study aims to evaluate the safety and efficacy of humanized anti‐CD19 CAR‐T (hCAR‐T) therapy in B‐cell malignancies with HBV infection. Twenty relapsed/refractory (r/r) diffuse large B‐cell lymphoma (DLBCL) and acute lymphoblastic leukemia (ALL) patients with HBV infection were treated with hCAR‐T therapy. Among them, five hepatitis B antigen‐positive patients who received antiviral prophylaxis did not develop HBV reactivation, including two patients who received both hCAR‐T and allogeneic hematopoietic stem cell transplantation (allo‐HSCT). Among 15 patients with resolved HBV infection, two received antiviral prophylaxis, and the other 13 did not experience HBV reactivation without antiviral prophylaxis. One patient with resolved HBV infection experienced HBV reactivation 6 months after hCAR‐T therapy and sequential allo‐HSCT. Moreover, HBV infection did not affect in vivo expansion of hCAR‐T cells or increase the risk of severe cytokine release syndrome. In conclusion, hCAR‐T therapy is safe and effective in DLBCL and ALL patients with chronic and resolved HBV infection under proper antiviral prophylaxis.
Ecohydrological responses to surface flow across borders: Two decades of changes in vegetation greenness and water use in the riparian corridor of the Colorado River delta
Authors: Nagler Pamela L. , Barreto‐Muñoz Armando , Chavoshi Borujeni Sattar , Jarchow Christopher J. , Gómez‐Sapiens Martha M. , Nouri Hamideh , Herrmann Stefanie M. , Didan Kamel
Published: September 2020

Hydrological and bioclimatic processes that lead to drought may stress plants and wildlife, restructure plant community type and architecture, increase monotypic stands and bare soils, facilitate the invasion of non‐native plant species and accelerate soil erosion. Our study focuses on the impact of a paucity of Colorado River surface flows from the United States (U.S.) to Mexico. We measured change in riparian plant greenness and water use over the past two decades using remotely sensed measurements of vegetation index (VI), evapotranspiration (ET) and a new annualized phenology assessment metric (PAM) for ET. We measure these long‐term (2000–2019) metrics and their short‐term (2014–2019) response to an environmental pulse flow in 2014, as prescribed under Minute 319 of the 1944 Water Treaty between the two nations. In subsequent years, small‐directed flows were provided to restoration areas under Minute 323. We use 250 m MODIS and 30 m Landsat imagery to evaluate three vegetation indices (NDVI, EVI, EVI2). We select EVI2 to parameterize an optical‐based ET algorithm and test the relationship between ET from Landsat and MODIS by regression approaches. Our analyses show significant decreases in VIs and ET for both the 20‐year and post‐pulse 5‐year periods. Over the last 20 years, EVI Landsat declined 34% (30% by EVIMODIS) and ETLandsat‐EVI declined 38% (27% by ETMODIS‐EVI), overall ca. 1.61 mm/day or 476 mm/year drop in ET; using PAM ETLandsat‐EVI the drop was from 1130 to 654 mm/year. Over the 5 years since the 2014 pulse flow, EVILandsat declined 20% (13% by EVIMODIS) and ETLandsat‐EVI declined 23% (4% by ETMODIS‐EVI) with a 0.77 mm/day or a 209 mm/year 5‐year drop in ET; using PAM ETLandsat‐EVI the drop was from 863 to 654 mm/year. Data and change maps show the pulse flow contributed enough water to slow the rate of loss, but only for the very short‐term (1–2 years). These findings are critically important as they suggest further deterioration of biodiversity, wildlife habitat and key ecosystem services due to anthropogenic diversions of water in the U.S. and Mexico and from land clearing, fires and plant‐related drought which affect hydrological processes.
Post‐GWAS Polygenic Risk Score: Utility and Challenges
Authors: Nguyen Tuan V , Eisman John A
Published: September 2020

Over the past decade, through genome‐wide association studies, more than 300 genetic variants have been identified to be associated with either BMD or fracture risk. These genetic variants are common in the general population, but they exert small to modest effects on BMD, suggesting that the utility of any single variant is limited. However, a combination of effect sizes from multiple variants in the form of the polygenic risk score (PRS) can provide a useful indicator of fracture risk beyond that obtained by conventional clinical risk factors. In this perspective, we review the progress of genetics of osteoporosis and approaches for creating PRSs, their uses, and caveats. Recent studies support the idea that the PRS, when integrated into existing fracture prediction models, can help clinicians and patients alike to better assess the fracture risk for an individual, and raise the possibility of precision risk assessment. © 2020 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
Therapeutic plasma exchange with standard hemodialysis machine as an alternative to dedicated apheresis device: A 5‐year experience
Authors: Pongsittisak Wanjak , Satpanich Panchalee , Kurathong Sathit
Published: September 2020

Patients suffering from various diseases have been shown to benefit from therapeutic plasma exchange (TPE). However, in developing countries, there are many obstacles hindering the establishment and initiation of TPE programs. These include inadequate funding and lack of government healthcare coverage. Our center in Thailand practices a unique membrane plasma separator technique using a hemodialysis machine incorporated with a plasma separator. Over a 5 year period, there were 130 such sessions conducted in 24 patients. The indications for TPE treatment included neurological, hematological, and nephrological diseases. Overall, response to TPE was good. Some TPE‐related adverse events did occur, but none were life‐threatening. Unfortunately, infection remained a problem and was sometimes a cause of death. Future challenges include minimization of infection rates and making TPE treatment readily accessible to patients.
Elevated carcinoembryonic antigen and bronchial obstruction caused by a rotten vegetable leaf mimic lung cancer: A case report
Authors: Sun Ye , Ge Yan L. , Li Li Q. , Liu Yang , Lu Yang , Jing Qin , Chen Yi , Li Wen Q. , Hou Lin L. , Min Pei
Published: September 2020

Background

Tracheobronchial foreign body aspiration is a potentially risky medical event, while the condition often requires early detection and rapid intervention to improve respiratory symptoms and prevent major morbidity. Notably, foreign bodies may not be identified and they are likely to be mistaken for neoplastic lesions. However, CEA, as one of tumor markers, presents to be available for assisting in lung cancer diagnosis, especially for non–small‐cell lung cancer, while the specificity of CEA is not high.

Methods

Here, we described a case of bronchial opening obstruction with elevated carcinoembryonic antigen (CEA) that was firstly misdiagnosed as lung cancer and proved as foreign body aspiration in the upper lobe bronchus of right lung by bronchoscopy.

Results

Carcinoembryonic antigen level increased. CT scan demonstrated a cavitation accompanied by multiple small nodular shadows appeared in the right upper lobe field. Bronchoscopy suggested right upper lobe bronchus was blocked by a brown smooth organism with plenty of purulent materials, which was proved as a rotten vegetable leaf.

Conclusions

Elevated CEA and bronchial obstruction are not typical manifestations of lung cancer. Bronchoscopy is crucial for making a reliable diagnosis.
Population Pharmacokinetic Analysis for Plasma and Epithelial Lining Fluid Ceftolozane/Tazobactam Concentrations in Patients With Ventilated Nosocomial Pneumonia
Authors: Zhang Zufei , Patel Yogesh T. , Fiedler‐Kelly Jill , Feng Hwa‐Ping , Bruno Christopher J. , Gao Wei
Published: September 2020

Ceftolozane/tazobactam (C/T) is a combination of a novel cephalosporin with tazobactam, recently approved for the treatment of hospital‐acquired and ventilator‐associated pneumonia. The plasma pharmacokinetics (PK) of a 3‐g dose of C/T (2 g ceftolozane and 1 g tazobactam) administered via a 1‐hour infusion every 8 hours in adult patients with nosocomial pneumonia (NP) were evaluated in a phase 3 study (ASPECT‐NP; NCT02070757). The present work describes the development of population PK models for ceftolozane and tazobactam in plasma and pulmonary epithelial lining fluid (ELF). The concentration‐time profiles of both agents were well characterized by 2‐compartment models with zero‐order input and first‐order elimination. Consistent with the elimination pathway, renal function estimated by creatinine clearance significantly affected the clearance of ceftolozane and tazobactam. The central volumes of distribution for both agents and the peripheral volume of distribution for tazobactam were approximately 2‐fold higher in patients with pneumonia compared with healthy participants. A hypothetical link model was developed to describe ceftolozane and tazobactam disposition in ELF in healthy participants and patients with pneumonia. Influx (from plasma to the ELF compartment) and elimination (from the ELF compartment) rate constants were approximately 97% lower for ceftolozane and 52% lower for tazobactam in patients with pneumonia versus healthy participants. These population PK models adequately described the plasma and ELF concentrations of ceftolozane and tazobactam, thus providing a foundation for further modeling and simulation, including the probability of target attainment assessments to support dose recommendations of C/T in adult patients with NP.
Three‐dimensional power Doppler ultrasonography indicates that increased placental blood perfusion during the third trimester is associated with the risk of macrosomia at birth
Authors: Zhou Jizi , Xiong Yu , Ren Yunyun , Zhang Ying , Li Xiaotian , Yan Yingliu
Published: September 2020

Purpose

To investigate the association between placental blood perfusion and the occurrence of macrosomia at birth.

Methods

This was a prospective cohort study including women with singleton pregnancies that aimed to measure placental blood perfusion using three‐dimensional (3D) power Doppler ultrasonography in the second and third trimester. We acquired three indices of placental blood flow, including vascularization index (VI), flow index (FI), vascularization flow index (VFI), along with routine two‐dimensional (2D) biometric measurements, including abdominal circumference (AC) and estimated fetal weight (EFW). Pregnancy outcomes were divided into two groups: newborns with a normal birth weight and those with macrosomia. We then compared all of the recorded variables between these two groups. We also determined the predictive efficiency of each variable using receiver‐operating characteristic (ROC) curves.

Results

The placental 3D power Doppler indices, including VI and FI, were significantly higher in the third trimester of pregnancies developing macrosomia, but not during the second trimester, as compared to those with a normal birth weight. ROC curves analysis for third‐trimester VI and FI suggested a slight ability to predict macrosomia; this was also the case for AC and EFW. Interestingly, VI showed high sensitivity and low specificity, while FI showed low sensitivity and high specificity; this was also the case for AC and EFW.

Conclusions

Three‐dimensional power Doppler ultrasound indices were significantly higher during the third‐trimester for pregnancies developing macrosomia. However, these indices had only moderate ability to predict macrosomia.
Dental students’ perception about using videos in teaching professionalism: A Saudi Arabian experience
Authors: Al‐Khalifa Khalifa S. , Gaffar Balgis O.
Published: September 2020

Objective

To describe the development and evaluation of using videos (watched and student‐generated) for teaching stronger interpersonal communication skills to dental students.

Methodology

We used the Experiential Learning Theory to develop a professionalism course for third‐year dental students. Videos were used as the core method of teaching communication skills. Students were guided to produce videos that addressed an array of communication scenarios. Quantitative data was collected using a Likert‐scale questionnaire to assess students’ perceptions about watching and generating videos. The questionnaire was divided into 3 parts: the first part assessed students’ perceptions and skills gained when producing videos. The second part assessed students’ perceptions about watching videos to gain knowledge. The last part assessed their perceptions about their overall learning experience.

Results

A total of 110 students, 50 males and 60 females, were enrolled in the course. Developing team skills and a better understanding of professional communication with patients were acknowledged by 85% and 80% of students respectively during video production. Improved problem‐solving skills were reported by 77% students while involved in video production. While watching motivational interviewing strategies and interpersonal skills videos, 86% stated that watching the videos improved their understanding of professional behavior with colleagues. Only 33% felt that they had enough time to prepare videos and only 38% were willing to prepare videos in the future.

Conclusion

Using videos in teaching communication skills was found effective. Producing videos had more benefits than simply watching videos. Caution should be given when allocating time for such activities.
Clinical outcomes of patients with COVID‐19 and HIV coinfection
Authors: Nagarakanti Sandhya R. , Okoh Alexis K. , Grinberg Sagy , Bishburg Eliahu
Published: September 2020

Background

Patients with human immunodeficiency virus (HIV) infection may be at an increased risk for morbidity and mortality from the coronavirus disease 2019 (COVID‐19). We present the clinical outcomes of HIV patients hospitalized for COVID‐19 in a matched comparison with historical controls.

Methods

We conducted a retrospective cohort study of HIV patients admitted for COVID‐19 between March 2020 and April 2020 to Newark Beth Israel Medical Center. Data on baseline clinical characteristics and hospital course were documented and compared with that of a matched control group of COVID‐19 patients who had no history of HIV. Kaplan–Meier survival curves and the log‐rank tests were used to estimate and compare in‐hospital survival between both unmatched and matched groups.

Results

Twenty‐three patients with HIV were hospitalized with COVID‐19. The median age was 59 years. The rates of in‐hospital death, the need for mechanical ventilation, and intensive care unit (ICU) admission were 13% (n = 3), 9% (n = 2), and 9% (n = 2), respectively. The HIV infection was well‐controlled in all patients except for three patients presented with acquired immune deficiency syndrome (AIDS). All AIDS patients were discharged home uneventfully. A one‐to‐one propensity matching identified 23 COVID‐19 patients who served as a control group. In both pre‐ and post‐match cohorts, survival between HIV and control groups were comparable.

Conclusions

In our cohort of HIV‐infected patients hospitalized for COVID‐19, there was no difference in mortality, ICU admission, and the need for mechanical ventilation when compared with a matched control of COVID‐19 patients with HIV.
Phylogenetic analysis of SARS‐CoV‐2 in the first few months since its emergence
Authors: Pereson Matías J. , Mojsiejczuk Laura , Martínez Alfredo P. , Flichman Diego M. , Garcia Gabriel H. , Di Lello Federico A.
Published: September 2020

During the first few months of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) evolution in a new host, contrasting hypotheses have been proposed about the way the virus has evolved and diversified worldwide. The aim of this study was to perform a comprehensive evolutionary analysis to describe the human outbreak and the evolutionary rate of different genomic regions of SARS‐CoV‐2. The molecular evolution in nine genomic regions of SARS‐CoV‐2 was analyzed using three different approaches: phylogenetic signal assessment, emergence of amino acid substitutions, and Bayesian evolutionary rate estimation in eight successive fortnights since the virus emergence. All observed phylogenetic signals were very low and tree topologies were in agreement with those signals. However, after 4 months of evolution, it was possible to identify regions revealing an incipient viral lineage formation, despite the low phylogenetic signal since fortnight 3. Finally, the SARS‐CoV‐2 evolutionary rate for regions nsp3 and S, the ones presenting greater variability, was estimated as 1.37 × 10−3 and 2.19 × 10−3 substitution/site/year, respectively. In conclusion, results from this study about the variable diversity of crucial viral regions and determination of the evolutionary rate are consequently decisive to understand essential features of viral emergence. In turn, findings may allow the first‐time characterization of the evolutionary rate of S protein, crucial for vaccine development.
Utility of RSV rapid diagnostic assays in hospitalized children in Amman, Jordan
Authors: Freeman Megan C. , Haddadin Zaid , Lawrence Lindsey , Piya Bhinnata , Krishnaswami Shanthi , Faouri Samir , Shehabi Asem , Williams John V. , Khuri‐Bulos Najwa , Halasa Natasha
Published: September 2020

Background

Respiratory syncytial virus (RSV) is the leading cause of acute respiratory infections in children worldwide and a frequent cause of hospitalization. Rapid diagnostic assays (RDAs) are available for RSV and they help guide management; however, they are underutilized in developing countries. We compared molecular diagnostics to RSV RDA in hospitalized children in Amman, Jordan.

Materials and Methods

Children under 2 years of age, admitted with fever and/or respiratory symptoms were enrolled prospectively from March 2010 to 2012. Demographic and clinical data were collected through parent/guardian interviews and medical chart abstraction. RSV RDAs were performed, and nasal/throat swabs were tested for RSV using quantitative reverse transcription‐polymerase chain reaction (qRT‐PCR).

Results

RSV RDA and PCR were performed on specimens from 1271 subjects. RSV RDA had a sensitivity of 26% and a specificity of 99%, with positive and negative predictive values of 98.6% and 43%, respectively. RDA‐positive patients had fewer days of symptoms at presentation and were more likely to have a history of prematurity, lower birth weight, require supplemental oxygen, and a longer hospitalization as compared with subjects with negative RDA. Multivariate analysis showed only lower birth weight, lack of cyanosis on examination, and lower cycle threshold to be independently associated with positive RDA (p ≤ .001).

Conclusion

RSV RDAs had high specificity, but low sensitivity as compared with qRT‐PCR. Positive RDA was associated with patients with a more severe disease, as indicated by oxygen use, longer length of stay, and higher viral load. Implementation of RDAs in developing countries could be an inexpensive and expedient method for predicting RSV disease severity and guiding management.
The concept of alimentation and transdisciplinary research
Authors: Aguilera José M
Published: September 2020

Although the term ‘alimentation’ has existed in the English language since the late 16th century, its use is infrequent. In Latin languages, particularly French, ‘alimentation’ conveys a holistic notion of the process by which humans produce, procure, prepare, share, indulge in, and digest their foods. Thus, the concept of alimentation encompasses and integrates human, technological, sociocultural, and environmental domains. This article delves into the origins of the term ‘alimentation’ and its use in the foreign scientific literature, and particularly in the social sciences. Unlike ‘food and nutrition’, alimentation provides a broader frame for the grand challenges of what, how, and with whom we eat. This approach should lead to transdisciplinary research (TDR) interfacing several knowledge domains (e.g., environmental, technological, socio‐cultural, nutritional, etc.) and involving key stakeholders. Possible outcomes of TDR in alimentation are inspiring and meaningful collaborations, innovative methodologies for integrating knowledge, transformative learning of researchers, enriched educational experiences for students, focused community action, and improved public policy. The term ‘alimentation’ is appropriately used in French and other Latin languages. Alimentation embraces human, technological, sociocultural, and environmental issues This holistic concept views agriculture, food, and nutrition as parts of a broader process Transdisciplinary research interfaces several dimensions of food and eating. © 2020 Society of Chemical Industry
Non‐invasive setup for grape maturation classification using deep learning
Authors: Ramos Rodrigo P , Gomes Jéssica S , Prates Ricardo M , Simas Filho Eduardo F , Teruel Barbara J , dos Santos Costa Daniel
Published: September 2020

Background

The San Francisco Valley region from Brazil is known worldwide for its fruit production and exportation, especially grapes and wines. The grapes have high quality not only due to the excellent morphological characteristics, but also to the pleasant taste of their fruits. Such features are obtained because of the climatic conditions present in the region. In addition to the favorable climate for grape cultivation, harvesting at the right time interferes with fruit properties.

Results

This work aims to define grape maturation stage of Syrah and Cabernet Sauvignon cultivars with the aid of deep‐learning models. The idea of working with these algorithms came from the fact that the techniques commonly used to find the ideal harvesting point are invasive, expensive, and take a long time to get their results. In this work, convolutional neural networks were used in an image classification system, in which grape images were acquired, preprocessed, and classified based on their maturation stage. Images were acquired with varying illuminants that were considered as parameters of the classification models, as well as the different post‐harvesting weeks. The best models achieved maturation classification accuracy of 93.41% and 72.66% for Syrah and Cabernet Sauvignon respectively.

Conclusions

It was possible to correctly classify wine grapes using computational intelligent algorithms with high accuracy, regarding the harvesting time, corroborating chemometric results. © 2020 Society of Chemical Industry
Potential roles of dimethysulfoxide in regional sulfur cycling and phytoplankton physiological ecology in the NE Subarctic Pacific
Authors: Herr Alysia E. , Dacey John W. H. , Kiene Ronald P. , McCulloch Ross D. , Schuback Nina , Tortell Philippe D.
Published: September 2020

We measured the concentration and turnover rates of dimethylsulfoxide (DMSO) across the northeast Subarctic Pacific (NESAP) to better understand the role of this compound in regional sulfur cycling and phytoplankton physiological ecology. Using ship‐track observations and Lagrangian drifter surveys, we examined the spatial and temporal components of DMS and DMSO variability, comparing rates of DMSO reduction with simultaneous measurements of dimethylsulfide (DMS) oxidation and dimethylsulfoniopropionate (DMSP) cleavage. Our results show high concentrations and rapid turnover of DMSO across much of our NESAP survey region. DMS and DMSO concentrations ranged from < 1 nM to maxima of 26 nM and 183 nM, respectively, and exhibited a nonlinear positive relationship. Rate constants for DMSO reduction to DMS ranged from < 1 to 6.5 d−1 and were correlated to bacterial production and phytoplankton taxonomic composition. DMSO reduction rates exceeded dissolved DMSP cleavage at nearly all stations, and exceeded DMS oxidation rates at four stations where DMSO reduction and DMS oxidation were measured simultaneously. At these stations, net DMS production from DMSO ranged from 0.50 to 7.18 nM d−1. During our Lagrangian survey, DMSO concentrations decreased during periods of peak mid‐day irradiance. A strong correlation between DMSO concentrations, non‐photochemical quenching and photochemical efficiency of photosystem II (Fv/Fm) suggest a potential role for DMSO in photo‐protection, supporting previous suggestions of an anti‐oxidant function for this molecule. Our findings highlight the potential contribution of DMSO to net DMS production in the NESAP, and suggest a role for this compound in phytoplankton physiological ecology.
Sequential Use of Normothermic Regional and Ex Situ Machine Perfusion in Donation After Circulatory Death Liver Transplant
Authors: Ghinolfi Davide , Dondossola Daniele , Rreka Erion , Lonati Caterina , Pezzati Daniele , Cacciatoinsilla Andrea , Kersik Alessia , Lazzeri Chiara , Zanella Alberto , Peris Adriano , Maggioni Marco , Biancofiore Giandomenico , Reggiani Paolo , Morganti Riccardo , De Simone Paolo , Rossi Giorgio
Published: September 2020

In Italy, 20 minutes of a continuous flat line on an electrocardiogram are required for declaration of death. In the setting of donation after circulatory death (DCD), prolonged warm ischemia time prompted the introduction of abdominal normothermic regional perfusion (NRP) followed by postprocurement ex situ machine perfusion (MP). This is a retrospective review of DCD liver transplantations (LTs) performed at 2 centers using sequential NRP and ex situ MP. From January 2018 to April 2019, 34 DCD donors were evaluated. Three (8.8%) were discarded before NRP, and 11 (32.4%) were discarded based on NRP parameters (n = 1, 3.0%), liver macroscopic appearance at procurement and/or biopsy results (n = 9, 26.5%), or severe macroangiopathy at back‐table evaluation (n = 1, 3.0%). A total of 20 grafts (58.8%; 11 uncontrolled DCDs, 9 controlled DCDs) were considered eligible for LT, procured and perfused ex situ (9 normothermic and 11 dual hypothermic MPs). In total, 18 (52.9%; 11 uncontrolled) livers were eventually transplanted. Median (interquartile range) no‐flow time was 32.5 (30‐39) minutes, whereas median functional warm ischemia time was 52.5 (47‐74) minutes (controlled DCD), and median low‐flow time was 112 minutes (105‐129 minutes; uncontrolled DCD). There was no primary nonfunction, while postreperfusion syndrome occurred in 8 (44%) recipients. Early allograft dysfunction happened in 5 (28%) patients, while acute kidney injury occurred in 5 (28%). After a median follow‐up of 15.1 (9.5‐22.3) months, 1 case of ischemic‐type biliary lesions and 1 patient death were reported. DCD LT is feasible even with the 20‐minute no‐touch rule. Strict NRP and ex situ MP selection criteria are needed to optimize postoperative results.