bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Decision Support System‐Assisted Pharmacy Intervention Reduces Feeding Tube–Related Medication Errors in Hospitalized Patients: A Focus on Medication Suitable for Feeding‐Tube Administration
Authors: Wasylewicz Arthur T. M. , van Grinsven Renske J. B. , Bikker Jessica M. W. , Korsten Hendrikus H. M. , Egberts Toine C. G. , Kerskes Catharina H. M. , Grouls Rene J. E.
Published: May 2020

Background

Administering medication through an enteral feeding tube (FT) is a frequent cause of errors resulting in increased morbidity and cost. Studies on interventions to prevent these errors in hospitalized patients, however, are limited.

Objective

The objective was to study the effect of a clinical decision support system (CDSS)–assisted pharmacy intervention on the incidence of FT‐related medication errors (FTRMEs) in hospitalized patients.

Methods

A pre‐post intervention study was conducted between October 2014 and May 2015 in Catharina Hospital, the Netherlands. Patients who were admitted to the wards of bowel and liver disease, oncology, or neurology; using oral medication; and had an enteral FT were included. Preintervention patients were given care as usual. The intervention consisted of implementing a CDSS‐assisted pharmacy check while also implementing standard operating procedures and educating personnel. An FTRME was defined as the administration of inappropriate medication through an enteral FT. The incidence was expressed as the number of FTRMEs per medication administration. Multivariate Poisson regression was used to calculate the incidence ratio (IR) comparing both phases.

Results

Eighty‐one patients were included, 38 during preintervention and 43 during the intervention phase. Incidence of FTRMEs in the preintervention phase was 0.15 (95% CI, 0.07–0.23) vs 0.02 (95% CI, 0.00–0.04) in the intervention phase, resulting in an adjusted IR of 0.13 (95% CI, 0.10–0.18).

Discussion

Incidence of FTRMEs, as well as the IR, is comparable to previous studies.

Conclusion

The intervention resulted in a substantial reduction in the incidence of FTRMEs.
A Meta‐Analytic Review of the Association Between Alienation Appraisals and Posttraumatic Stress Disorder Symptoms in Trauma‐Exposed Adults
Authors: McIlveen Rachel , Curran David , Mitchell Ryan , DePrince Anne , O'Donnell Katie , Hanna Donncha
Published: May 2020

Ehlers and Clark's (2000) cognitive model of posttraumatic stress disorder (PTSD) highlights the importance of negative appraisals in maintaining posttraumatic stress. Recent research suggests that alienation appraisals, defined as feeling disconnected from the self and others, mediate the association between traumatic experiences and subsequent PTSD symptoms. To our knowledge, no systematic review has yet explored the relation between alienation appraisals and PTSD symptoms in trauma‐exposed adults, despite the important clinical implications posed by this association. A systematic search of the SCOPUS, Web of Science, PsycInfo, MEDLINE, CINAHL Plus, and PILOTS databases resulted in 470 studies, nine of which met full inclusion criteria. Studies were quality‐assessed for risk of bias using the Quality Assessment Tool for Studies with Diverse Designs (QATSDD) quality assessment tool. A random‐effects meta‐analysis for the association between alienation appraisals and PTSD symptoms showed a large total effect size, r = .57, 95% CI [.46, .66], z = 8.41, p < .001. This large effect suggests that as alienation appraisals increase, PTSD symptoms increase. Although a strong positive association was found between alienation and PTSD symptoms, the mechanism of this association remains unclear. Limitations of the research included significant heterogeneity across studies and the fact that data were correlational. Future research to explore why alienation appraisals are significant in posttraumatic stress may further help to inform therapeutic approaches to targeting alienation appraisals in trauma survivors. Recommendations are made for the clinical assessment of alienation appraisals when exploring the impact of the traumatic experience on the survivor.
Safety Assessment of an A‐Scan Ultrasonic System for Ophthalmic Use
Authors: Petrella Lorena , Fernandes Paulo , Santos Mário , Caixinha Miguel , Nunes Sandrina , Pinto Carlos , Morgado Miguel , Santos Jaime , Perdigão Fernando , Gomes Marco
Published: May 2020

Objectives

This study describes the safety assessment of an A‐scan ultrasonic system for ophthalmic use. The system is an investigational medical device for automatic cataract detection and classification.

Methods

The risk management was based on the International Organization for Standardization (ISO) standard DIN EN ISO 14971:2009‐10 and International Electrotechnical Commission (IEC) standard IEC 60601‐2‐37. The calibration of the ultrasonic field was conducted according to the standards IEC 62127‐1:2007 and IEC 62359:2010. The uncertainty on measurements was delineated in agreement with the guide JCGM 100:2008.

Results

After risk management, all risks were qualitatively classified as acceptable. The mechanical index (0.08 ± 0.05), soft tissue thermal index (0.08 ± 0.08) and spatial‐peak temporal‐average intensity (0.56 ± 0.59 mW/cm2) were under the maximum index values indicated by the US Food and Drug Administration guidance, Marketing Clearance of Diagnostic Ultrasound Systems and Transducers (0.23, 1, and 17 mW/cm2, respectively).

Conclusions

This study presents a practical approach for the safety assessment of A‐scan ultrasonic systems for ophthalmic use. The safety evaluation of a medical device is mandatory before its use in clinical practice. However, the safety monitoring throughout its life cycle should also be considered, since many device components may deteriorate over time and use.
Bioclimate and arbuscular mycorrhizal fungi regulate continental biogeographic variations in effect of nitrogen deposition on the temperature sensitivity of soil organic carbon decomposition
Authors: Wang Qingkui , Zhao Xuechao , Tian Peng , Liu Shengen , Sun Zhaolin
Published: May 2020

The temperature sensitivity (Q10) of soil organic carbon (SOC) decomposition is an important parameter for those seeking accurate projections of SOC dynamics and its feedback on climate change in terrestrial ecosystems. However, how Q10 responds to N deposition across environmental gradients and the underlying mechanism remain largely unresolved. We conducted a novel incubation experiment with periodically varying temperature based on the of soil origin sites to elucidate the responses of Q10 to N addition across China. Our results demonstrated that N addition effects (NAEs) on Q10 were negatively related to latitude and were strongly site dependent. Bioclimatic, edaphic, and microbial variables together explained 50.1% of the total variation in NAEs on Q10, but bioclimate (16.0%) had the greater explanation than edaphic (11.8%) and microbial properties (6.3%). The response of soil exchangeable Ca2+ to N addition was a predictive power for NAEs on Q10, contributing 7.2% relative importance in regulating this variation. Furthermore, arbuscular mycorrhizal fungi indicated by Glomeromycota were the best microbial predictor and contributed 10.9% relative importance in the variation regulating NAEs on Q10. Overall, our results suggest that increasing N addition will increase the sensitivity of SOC decomposition to global warming and highlight the importance of bioclimate, exchangeable Ca2+, and arbuscular mycorrhizal fungi in predicting the response of Q10 to N deposition in natural terrestrial ecosystems. The biogeographic variation in response of Q10 to N deposition should be considered in carbon‐climate models to decrease the prediction uncertainties of SOC dynamics and its feedback to global warming.
Land use impacts on benthic bioturbation potential and carbon burial in Brazilian mangrove ecosystems
Authors: Bernardino Angelo F. , Sanders Christian J. , Bissoli Lorena B. , Gomes Luiz Eduardo de O. , Kauffman J. Boone , Ferreira Tiago O.
Published: May 2020

The potential of Blue Carbon as an integral part of global climate change adaptation and mitigation strategies requires quantification of drivers and rates of organic carbon (OC) burial and storage. However, there is limited recognition of how land use impacts benthic assemblages, their bioturbation potential, and OC burial in mangrove forests and tidal flats. Here we evaluated the effects of mangrove deforestation on benthic bioturbation potential (BPc), sediment accretion rates (SARs), and OC and total nitrogen (TN) burial in mangrove soils and tidal flat sediments from three estuaries in tropical Brazil. SARs based on 210Pb dating varied significantly among undisturbed estuaries (2.1–18.6 mm yr−1) and the OC and TN burial rates were respectively 46% and 16% higher than global averages. The cleared mangrove sites had a twofold lower SAR, 40‐fold lower OC burial, and over 100‐fold lower TN burial when compared to undisturbed forests, revealing the pervasive impacts of land use. Variation in benthic assemblage structure and BPc among sites suggests that the composition and activity of macrofaunal communities may facilitate OC burial in some cases, yet the global extent and significance of bioturbation requires further study. Our work reveals a strong spatial variability in C burial in undisturbed mangrove forests and a decreased capacity of mangroves to accumulate C and sediments due to land use effects.
Atomic Layer Deposition for Polypropylene Film Engineering—A Review
Authors: Song Guanghui , Tan Daniel Q.
Published: May 2020

Polypropylene (PP) polymers are used extensively as dielectric layers, packaging films, and separation membranes, etc. Structure, chemistry, and surface features of PP films dominate their performance and durability. Modification of PP films is carried out using atomic layer deposition (ALD) among other techniques to coat uniform layer of nanometer inorganic material on the surface and inside the pores of PP films to serve the purpose of target applications better. Controlling the reaction temperature, precursor pulsing time, and number of cycles during deposition predominate the thickness, morphology, and composition of the coated layer and hence the performance of PP films. Overall, the ALD technique has been proven to be advantageous in advancing PP film properties such as hydrophilicity, UV resistance, membrane separators, dielectric and mechanical strength, etc., primarily through the controllable formation of nanometer coating on PP films. This review discusses the recent advancements and prospective of ALD in the modification and functionalization of PP films for various applications to provide some insights and motivations to design high‐performance novel PP films by well leveraging the ALD technique.
Examining consumers’ sensory experiences with color: A consumer neuroscience approach
Authors: Stillman Paul , Lee Hyojin , Deng Xiaoyan , Unnava Hanumantha Rao , Fujita Kentaro
Published: May 2020

This research advances neuroscience as a tool with which to study consumers’ visual mental imagery. Applying these methods, we suggest that the presence or absence of color is a critical dimension along which consumers’ visualizations can vary, and explore when and why color of visual mental imagery becomes more prominent. Using functional magnetic resonance imaging (fMRI), we find neural evidence for distinguishing black‐and‐white (BW) versus color visualization, and that visual mental imagery becomes increasingly monochrome (vs. colorful) when consumers imagine distant (vs. near) future events. Our neural evidence further suggests construal level as the underlying mechanism of this effect, showing common regions of activation for imagining distant future events, engaging in high‐level construal, and forming BW mental imagery. We discuss the implication of these findings and the benefits of fMRI techniques for marketing in general.
Accreditation in regulated markets
Authors: Grepperud Sverre , Pedersen Pål Andreas
Published: May 2020

We study firms that supply a vertically and horizontally differentiated service in a market with regulated prices. The incentives for seeking accreditation are more significant for sellers of below‐average quality services relative to sellers of above‐average quality services. For homogenous firms, profits are lower in equilibria where both firms seek accreditation relatively to equilibria where neither does. Private and social accreditation incentives typically differ. The welfare optimal reimbursement rate is independent of a firm's actual accreditation decision but dependent on the accreditation decision of the rival. Hence, policies that give extra financial support to firms that accredit are likely to promote inefficiency.
Two different genetic etiologies for tuberous sclerosis complex (TSC) in a single family
Authors: Mowrey Kate , Koenig Mary Kay , Szabo Charles A. , Samuels Joshua , Mulligan Shannon , Pearson Deborah A. , Northrup Hope
Published: May 2020

Background

Tuberous sclerosis complex (TSC) is an autosomal dominant genetic condition that involves abnormalities of the skin, hamartomas in the heart, brain, and kidneys, seizures, as well as TSC‐associated neuropsychiatric disorders (TAND). About 90%–95% of individuals with TSC will have an identifiable pathogenic variant in either TSC1 or TSC2. We present here two family members with clinical diagnoses of TSC that were later determined to be due to two different genetic etiologies.

Methods

A 2‐year‐old Caucasian female (Patient 1) was born to non‐consanguineous healthy parents and was determined to have a clinical diagnosis of TSC at 2 months old. Her paternal great‐uncle (Patient 2) was also known to have a clinical diagnosis of TSC. Sequencing and deletion/duplication analysis for TSC1 and TSC2 were performed on both individuals.

Results

Mutation analysis revealed that both Patient 1 and Patient 2 had identifiable pathogenic variants in TSC2. Patient 1 had c.4800_4801delTG (p.Cys1600Trpfs*2), while Patient 2 had c.4470_4471delinsTT (p.Glu1490_Lys1491delinsAsp*).

Conclusion

To our knowledge, our clinical report is of significance as it is the third kindred to be identified with affected members with two distinct genetic etiologies for TSC. Our case report highlights the importance of incorporating genetic testing into the clinical evaluation for individuals with features suggestive of TSC.
Diagnostic cytogenetic testing following positive noninvasive prenatal screening results of sex chromosome abnormalities: Report of five cases and systematic review of evidence
Authors: Xie Xiaolei , Tan Weihe , Li Fuguang , Carrano Eric , Ramirez Paola , DiAdamo Autumn , Grommisch Brittany , Amato Katherine , Chai Hongyan , Wen Jiadi , Li Peining
Published: May 2020

Background

Follow‐up cytogenetic analysis has been recommended for cases with positive noninvasive prenatal screening (NIPS) results. This study of five cases with numerical and structural sex chromosomal abnormalities (SCA) and a review of large case series of NIPS provided guidance to improve prenatal diagnosis for SCA.

Methods

Following positive NIPS results for SCA, karyotype analysis, chromosomal microarray analysis (CMA), fluorescence in situ hybridization (FISH), and locus‐specific quantitative PCR were performed on cultured amniocytes, chorionic villi cells, and stimulated lymphocytes. Review of large case series was performed to evaluate the NIPS positive rate, follow‐up rate of cytogenetic analysis, positive predictive value (PPV) for major types of SCA, and relative frequencies of subtypes of major SCA.

Results

Of the five cases with positive NIPS for SCA, case 1 showed a mosaic pattern of monosomy X and isodicentric Y; case 2 showed a mosaic pattern of monosomy X confined to the placenta; cases 3 and 4 had an isochromosome of Xq, and case 5 showed a derivative chromosome 14 from a Yq/14p translocation of maternal origin. Review of literature showed that mean positive rate of NIPS for SCA was 0.61%, follow‐up rate of cytogenetics analysis was 76%, and mean PPV for SCA was 48%. Mosaic patterns and structural rearrangements involving sex chromosomes were estimated in 3%–20% and 3% of SCA cases, respectively.

Conclusion

These five cases further demonstrated the necessity to pursue follow‐up cytogenetic analysis to characterize mosaic patterns and structural abnormalities involving sex chromosomes and their value for prenatal genetic counseling. A workflow showing the performance of current NIPS and cytogenetic analysis for SCA was summarized. These results could facilitate an evidence‐based approach to guide prenatal diagnosis of SCA.
Anthocyanin‐Biofortified Colored Wheat Prevents High Fat Diet–Induced Alterations in Mice: Nutrigenomics Studies
Authors: Sharma Saloni , Khare Pragyanshu , Kumar Ashish , Chunduri Venkatesh , Kumar Aman , Kapoor Payal , Mangal Priyanka , Kondepudi Kanthi Kiran , Bishnoi Mahendra , Garg Monika
Published: May 2020

Scope

Effective health‐promoting results of either anthocyanins or whole wheat against chronic diseases are well reported. The current study is designed to understand the effect and underlying mechanism of anthocyanins‐biofortified whole wheat on high‐fat diet (HF)‐induced obesity and its comorbidities.

Method and Results

Mice are fed a HFD supplemented with isoenergetic white, purple, or black whole wheat for 12 weeks and analyzed by physiological, biochemical, and nutrigenomics studies (qRT‐PCR and RNA‐Seq analysis). Black wheat significantly reduces body weight gain and fat pad. Both black and purple wheats reduce total cholesterol, triglyceride, and free fatty acid levels in serum, with the restoration of blood glucose and insulin resistance. Black wheat significantly elevates the expression of enzymes related to fatty acid balancing, β‐oxidation, and oxidative stress that supported the biochemical and physiological positive outcomes. Moreover, the transcriptome analysis of adipose and liver tissue reveals activation of multiple pathways and genes related to fatty acid‐β oxidation (crat, acca2, lonp2 etc.), antioxidative enzymes (gpx1, sod1, nxnl1 etc.), along with balancing of fatty acid metabolism specifically in black wheat supplemented mice.

Conclusion

Taken together, the results suggest that the incorporation of colored wheat (especially black wheat) in the diet can prevent obesity and related metabolic complications.
Undertreatment of overactive bladder among men with lower urinary tract symptoms in the United States: A retrospective observational study
Authors: Burnett Arthur L. , Walker David R. , Feng Qi , Johnston Karissa M. , Lozano‐Ortega Greta , Nimke David , Hairston John C.
Published: May 2020

Aims

To characterize the epidemiology and treatment patterns of adult men (≥40 years) diagnosed with, or treated for, overactive bladder (OAB) and/or benign prostatic hyperplasia (BPH).

Methods

This retrospective observational study used data extracted from the IBM MarketScan Commercial Claims and Encounters database and the Medicare Supplemental Coordination of Benefits database. Men with BPH and/or OAB were identified and observed to assess treatment and diagnostic patterns.

Results

Within the entire study sample (N = 462 400), BPH diagnosis (61.5%) and BPH treatment (73.7%) were more common than the corresponding values for OAB (25.8% and 7.0%, respectively). Notably, among diagnosed individuals, the dispensation of a corresponding treatment was more likely in individuals diagnosed with BPH (183 672 out of 284 416 = 64.6%) compared with OAB (16 468 out of 119 236 = 13.8%). Among newly diagnosed and/or treated patients (n = 196 576), only 60.3% received treatment. Among treated patients, most experienced only a single type of treatment (93.4%), 6.6% went on to receive a secondary treatment and 3.5% a tertiary. The most common primary treatment was alpha‐blocker monotherapy (76.9%) followed by tadalafil monotherapy (16.4%). Among those untreated at first diagnosis, the median time between diagnosis and treatment initiation was 128 days.

Conclusions

Diagnosis and management of OAB among males are challenging given the inherent overlap in symptoms observed with BPH. Unsurprisingly, we found that BPH is diagnosed and treated more frequently than OAB; but the differences between diagnosis and treatment patterns for the two conditions highlight the potential undertreatment of OAB and misdirection of therapy for men with a combination of voiding and storage symptoms.
In utero exposure to analgesic opioids and language development in 5‐year old children
Authors: Skovlund Eva , Selmer Randi , Skurtveit Svetlana , Brandlistuen Ragnhild E. , Handal Marte
Published: May 2020

Purpose

An increasing consumption of opioids has been reported. The primary aim of the present study was follow‐up of neurocognitive development in children exposed to analgesic opioids during pregnancy, using three different validated instruments to assess language and communication development at 5 years.

Methods

The Norwegian Mother and Child Cohort Study (MoBa) prospectively included pregnant women 1999 to 2008. Participants reported medication use at pregnancy week 17/18 and 30, and 6 months after birth. Children's language competence and communication skills at 5 years were reported by mothers on three different validated scales; The Ages and Stages Questionnaire (ASQ), The Speech and Language Assessment Scale (SLAS) and The Twenty Statements about Language‐Related Difficulties list (Language20Q).

Results

A total of 27 428 women with 33 407 singleton pregnancies were included. Use of analgesic opioids was reported in 584 pregnancies (1.7%). No associations between opioid use and lower language competence or communication skills were found. For ASQ, the OR of being in the lowest category vs the group with maximum mean score was 0.82 (95%CI 0.57, 1.17), for SLAS the OR of scoring worse than typical for age vs better than typical for age was 0.84 (0.61, 1.17) in children exposed to opioids in utero. For Language20Q using the best performance category as reference, the OR of scoring in the lower performance category was 0.57 (0.35, 0.91) with exposure to opioids.

Conclusion

Use of analgesic opioids in pregnant women does not seem to negatively affect language development or communication skills in children at 5 years.
The critical organic modifier aliphatic tail length for the formation of poly(methyl methacrylate)‐montmorillonite nanocomposites
Authors: Tiwari Rajkiran R. , Natarajan Upendra
Published: May 2020

In this article, we report the influence of organic modifier structure (alkyl chain length C8‐C20, single vs ditallow) and thereby, the effect of hydrophobicity on the structure, thermal and mechanical properties of poly(methyl methacrylate) (PMMA)‐clay hybrids. Melt processed PMMA‐clay hybrids were characterized using wide‐angle X‐ray diffraction, transmission electron microscopy, and differential scanning calorimetry. The organoclays having an alkyl chain length of more than 12 CH2 groups resulted in the formation of nanocomposites. The glass transition temperature (Tg) of PMMA increased in the presence of clay. The mean‐field lattice model was used to predict the free energy for nanocomposite formation, which showed a reasonable match with the experimental results and provided a general guideline for the proper selection of polymer and organoclay (ie, organic modifier) to obtain nanocomposite. Tensile modulus showed maximum improvement of 58% for the nanocomposites compared to 9% improvement for the composites. Tensile modulus increased with increases in the alkyl chain length of the organic modifier and clay loading. The level of improvement for the tensile properties of nanocomposites prepared from primary and secondary ammonium‐modified clay is the same as that obtained with the commercial organoclays.
Advances in CAR T Therapy for Hematologic Malignancies
Authors: Freyer Craig W. , Porter David L.
Published: May 2020

The introduction of chimeric antigen receptor T‐cell (CAR T) therapy has resulted in a paradigm shift in the management of relapsed/refractory B‐cell malignancies. Patients with acute lymphoblastic leukemia and non‐Hodgkin’s lymphoma who had exhausted all meaningful treatment options now have an opportunity for long‐term remission and possibly cure. CAR T is rapidly expanding into the treatment paradigm for multiple myeloma with approvals expected in the near future. CAR T for chronic lymphocytic leukemia may not be far behind, while CAR T studies in Hodgkin lymphoma and acute myeloid leukemia are ongoing. Such therapeutic success brings challenges in toxicity management related to cytokine release syndrome and immune effector cell–associated neurotoxicity syndrome. Our understanding of these unique syndromes is evolving, with predictive models and additional treatment strategies on the horizon. This review aims to summarize the progress of CAR T therapeutics within malignant hematology thus far and highlight ongoing advances in the field.
Reliability and Validity of a New Transfer Assessment Form for Stroke Patients
Authors: Kitamura Shin , Otaka Yohei , Murayama Yudai , Ushizawa Kazuki , Narita Yuya , Nakatsukasa Naho , Kondo Kunitsugu , Sakata Sachiko
Published: May 2020

Introduction

Transferring is a basic skill that is essential for mobility independence and indispensable for expanding activities of daily living of stroke patients using a wheelchair. Therefore, transfer independence is an important issue that greatly affects daily life in the hospital and at home. To offer an effective intervention to acquire a skill, developing an assessment for individual subtasks that comprise transferring would assist the identification of specific tasks that prevent independence in patients and facilitate interventions to improve transferring independence.

Objective

To examine the reliability and validity of a newly developed transfer assessment form, the Bed‐wheelchair transfer Tasks Assessment Form (BTAF), for stroke patients to evaluate subtasks required for transferring.

Design

Validation and test‐retest studies.

Setting

Subacute rehabilitation wards in Japan.

Participants

A total of 82 therapists for verifying content validity; 30 patients for validation and test‐retest study.

Interventions

Not applicable.

Main Outcome Measures

The content validity was initially assessed based on a questionnaire. Subsequently, four occupational therapists used the form to evaluate the video‐recorded transferring performances of stroke participants. Two assessors evaluated each performance once and then 2 weeks later. The inter‐rater reliability, intra‐rater reliability, internal consistency, and concurrent validity were examined.

Results

Fleiss's κ coefficient for inter‐rater reliability for each item of the form was 0.66 or more. Cohen's κ coefficient for intra‐rater reliability for each item was 0.73 or more. Cronbach's coefficient alpha ranged from 0.90 to 0.93. Spearman's rank correlation coefficients between the mean scores of our form and scores of the functional independence measure item “transfer to bed/chair/wheelchair” ranged from 0.53 to 0.78 (P < .01).

Conclusions

The form demonstrated good reliability and validity. Its usefulness and efficacy should be further investigated in stroke patients to facilitate rehabilitation.
Genetic Algorithms as a Tool for Dosing Guideline Optimization: Application to Intermittent Infusion Dosing for Vancomycin in Adults
Authors: Colin Pieter J. , Eleveld Douglas J. , Thomson Alison H.
Published: May 2020

This paper demonstrates the use of a genetic algorithm (GA) for the optimization of a dosing guideline. GAs are well‐suited to derive combinations of doses and dosing intervals that go into a dosing guideline when the number of possible combinations rule out the calculation of all possible outcomes. GAs also allow for different constraints to be imposed on the optimization process to safeguard the clinical feasibility of the dosing guideline. In this work, we demonstrate the use of a GA for the optimization of intermittent vancomycin administration in adult patients. Constraints were placed on the dose strengths, the length of the dosing intervals, and the maximum infusion rate. In addition, flexibility with respect to the timing of the first maintenance dose was included in the optimization process. The GA‐based optimal solution is compared with the Scottish Antimicrobial Prescribing Group vancomycin guideline.
A Phenomenological Model of Mott's Insulator–Metal Phase Transition in 3D and 2D Boron‐Doped Diamond
Authors: Kukushkin Vladimir A.
Published: May 2020

A phenomenological model of Mott's insulator–metal phase transition in boron‐doped diamond is suggested and developed. It is shown that the transition critical boron atom concentration in 3D samples at room temperature calculated on its base coincides with the experimental data. It allows to use the model for the evaluation of the transition critical sheet boron atom concentration for an experimentally much less investigated case of 2D boron‐doped diamond. This gives a value of 3.3 × 1013 cm−2 at room temperature in agreement with experimental data on so‐called delta layers. The latter are thin boron‐doped layers embedded in intrinsic diamond and can be used for the creation of the conductive channels of high‐speed diamond field‐effect transistors.
Occurrence of Sharp Hydrogen Effusion Peaks of Hydrogenated Amorphous Silicon Film and Its Connection to Void Structures
Authors: Jafari Sahar , Linke Jonathan , Wendt Michael , Terheiden Barbara , Meyer Sylke , Lausch Dominik
Published: May 2020

The amount of hydrogen released from plasma‐enhanced chemical vapor (PECVD) deposited hydrogenated amorphous silicon (a‐Si:H) layers is determined by gas effusion measurements. A sharp peak (SP) is observed in the effusion spectra of samples with substrate temperature T
S ≥ 200 °C. Light microscopic images indicate the formation of bubbles after deposition for all samples and film deterioration after effusion measurement in correlation with the presence of the hydrogen SPs. Change in substrate temperature varies with the microstructure of the film, the hydrogen concentration, and the density. A low T
S leads to a porous structure with large number of interface bubbles, and therefore no hydrogen‐induced SP appears during hydrogen effusion. Whereas high T
S causes a compact a‐Si:H film in which the hydrogen effusion is limited by the longer diffusion, while the number of interface bubbles decreases. The storage of near substrate hydrogen in the bubbles in compact material leads to a local explosion by increase in excessive pressure. The difference between the low temperature peak and the position of the SP in the effusion spectra indicates the time required to fill the interface bubbles with hydrogen, which decreases with increasing film density, suggesting that the volume of the interface bubble decreases.
Effect of equilibration time on clinical and neonatal outcomes in human blastocysts vitrification
Authors: Mitsuhata Shingo , Hayashi Momoko , Fujii Yoshitaka , Motoyama Hiroaki , Endo Yuji
Published: May 2020

Purpose

Prolonged exposure to equilibration solutions may be detrimental to an embryo's developmental potential, whereas a shorter exposure may affect the penetration of cryoprotectants into blastomeres. The purpose of this study was to evaluate the effects of different equilibration times on the clinical and neonatal outcomes of human blastocyst vitrification.

Methods

This is a retrospective study based on data collected between November 2008 and November 2015. A total of 192 blastocysts (80 non‐expanded and 112 expanded) obtained from 167 patients were analyzed. The blastocysts were divided into two groups according to their equilibration time: 8‐11 minutes or 12‐15 minutes. The clinical and neonatal outcomes of warmed blastocysts were evaluated.

Results

The survival, implantation, and live birth rates of non‐expanded blastocysts were not different between the two groups, but they significantly improved for the expanded blastocysts in the 12‐15 minutes group compared to the 8‐11 minutes group. The results were similar for the neonatal outcomes after vitrified embryo transfer, when partitioned by equilibration time and blastocyst stage at vitrification.

Conclusions

For the non‐expanded blastocysts, a shortened equilibration time (8‐11 minutes) is sufficient for effective vitrification.
Stability and stabilization for singularly perturbed systems with Markovian jumps
Authors: Wang Guoliang , Xu Lei
Published: May 2020

This article focuses on the stability and stabilization problems of singularly perturbed jump systems. Here, the singularly perturbed parameter (SPP) is also with Markov switching and satisfies any with positive bound predefined. First, stability conditions expressed ϵi‐free but involving its bound are developed by constructing an ϵi‐dependent Lyapunov function. Then, a method for state feedback stabilization controller depending on SPP is proposed, whose conditions are given in terms of linear matrix inequalities. Moreover, some special cases about deterministic SPP are considered too. Finally, two practical examples are used to demonstrate the effectiveness and superiorities of the proposed methods.
Non‐Conjugated Polymer Based on Polyethylene Backbone as Dopant‐Free Hole‐Transporting Material for Efficient and Stable Inverted Quasi‐2D Perovskite Solar Cells
Authors: Gu Jianmin , Ji Ruiqi , Xu Wenjie , Yin Chengrong , Wen Kaichuan , Gao Han , Yang Rong , Pan Zhengwu , Wang Kai , Zhang Chenglong , Li Renzhi , Lin Jinyi , Xie Linghai , Wang Jianpu , Huang Wei
Published: May 2020

Quasi‐2D perovskites with excellent stability have been recognized as an alternative to 3D counterparts for perovskite solar cells (PSCs). Although the power conversion efficiency (PCE) of quasi‐2D PSCs has increased over 18% by the compositional controlling and solvent engineering of perovskites, fewer studies have been conducted to exploit charge transport layers and investigate their interface relationships with quasi‐2D perovskites. To achieve high efficiency and good long‐term stability for quasi‐2D PSCs, hole‐transporting materials (HTMs) with matched energy levels and good chemical compatibility with quasi‐2D perovskites are explored and investigated. Herein, a novel non‐conjugated polymer based on polyethylene backbone, poly[3,6‐(4,4′‐dimethoxytriphenylamino)‐9‐vinyl‐9H‐carbazole] (PVCz‐OMeTPA), is easily synthesized and investigated as a promising dopant‐free HTM for quasi‐2D PSCs. Due to its more suitable energy levels, good hole mobility, as well as excellent film‐forming ability to assist the formation of high‐quality quasi‐2D perovskite films, the optimized p–i–n structured quasi‐2D PSCs based on PVCz‐OMeTPA exhibit the best PCE of 17.22%. The unencapsulated quasi‐2D PSCs based on PVCz‐OMeTPA maintain 82% of the initial efficiency after 1400 h under a relative humidity of ≈40% and sustain over 81% of the original efficiency after aging for 600 h upon 70 °C of continuous annealing.
Using grooving and corner strip‐batten techniques for seismic strengthening of square reinforced concrete columns with fiber‐reinforced polymer composites
Authors: Saljoughian Alireza , Mostofinejad Davood
Published: May 2020

This study represents the results of an empirical program investigating the behavior of square reinforced concrete (RC) columns retrofitted using longitudinal carbon fiber‐reinforced polymer (CFRP) composites under simulated seismic loading. The main challenges to tackle are the premature buckling and the debonding of the longitudinal FRP composites on the tension and compression sides of the columns, respectively. To postpone both, the two versions of the grooving methods (GM), that is, the externally bonded reinforcement on grooves (EBROG) and the externally bonded reinforcement in grooves (EBRIG), were employed and the results were compared with those obtained under the traditional externally bonded reinforcement (EBR) procedure. Another aspect of the study involves investigating the influence of the recently developed corner strip‐batten (CSB) method on confining column specimens. For these purposes, seven half‐scale RC columns strengthened using FRP sheets were subjected to reversal cyclic loading. Experimental results exhibited that using the EBRIG and EBROG methods simultaneously with CSB technique could prevent altogether the debonding and buckling of longitudinal CFRP sheets. It was also found that the application of FRP strips utilizing the GM and CSB methods could produce an important increment in the performance of the RC columns in different terms such as ductility and lateral strength.
Evaluation of different wind fields for the investigation of the dynamic response of offshore wind turbines
Authors: Nybø Astrid , Nielsen Finn Gunnar , Reuder Joachim , Churchfield Matthew J. , Godvik Marte
Published: May 2020

As the size of offshore wind turbines increases, a realistic representation of the spatiotemporal distribution of the incident wind field becomes crucial for modeling the dynamic response of the turbine. The International Electrotechnical Commission (IEC) standard for wind turbine design recommends two turbulence models for simulations of the incident wind field, the Mann spectral tensor model, and the Kaimal spectral and exponential coherence model. In particular, for floating wind turbines, these standard models are challenged by more sophisticated ones. The characteristics of the wind field depend on the stability conditions of the atmosphere, which neither of the standard turbulence models account for. The spatial and temporal distribution of the turbulence, represented by coherence, is not modeled consistently by the two standard models. In this study, the Mann spectral tensor model and the Kaimal spectral and exponential coherence model are compared with wind fields constructed from offshore measurements and obtained from large‐eddy simulations. Cross sections and durations relevant for offshore wind turbine design are considered. Coherent structures from the different simulators are studied across various stability conditions and wind speeds through coherence and proper orthogonal decomposition mode plots. As expected, the standard models represent neutral stratification better than they do stable and unstable. Depending upon the method used for generating the wind field, significant differences in the spatial and temporal distribution of coherence are found. Consequently, the computed structural design loads on a wind turbine are expected to vary significantly depending upon the employed turbulence model. The knowledge gained in this study will be used in future studies to quantify the effect of various turbulence models on the dynamic response of large offshore wind turbines.
Gluon-photon signatures for color octet at the LHC (and beyond)
Authors: Cacciapaglia G. , Deandrea A. , Flacke T. , Iyer A.M.
Published: May 2020

Abstract

We consider a color octet scalar particle and its exotic decay in the channel gluon-γ using an effective Lagrangian description for its strong and electromagnetic interactions. Such a state is present in many extensions of the Standard Model, and in particular in composite Higgs models with top partial compositeness, where couplings to photons arise via the Wess-Zumino-Witten term. We find that final states with one or two photons allow for a better reach at the LHC, even for small branching ratios. Masses up to 1.2 TeV can be probed at the HL-LHC by use of all final states. Finally, we estimate the sensitivity of the hadronic FCC.
Synthesis and biological evaluation of α- and β-hydroxy substituted amino acid derivatives as potential mGAT1–4 inhibitors
Authors: Andreß Janina C. , Böck Michael C. , Höfner Georg , Wanner Klaus T.
Published: May 2020

In this study, we report the synthesis and biological evaluation of a variety of α- and β-hydroxy substituted amino acid derivatives as potential amino acid subunits in inhibitors of GABA uptake transporters (GATs). In order to ensure that the test compounds adopt a binding pose similar to that presumed for related larger GAT inhibitors, lipophilic residues were introduced either at the amino nitrogen atom or at the alcohol function. Several of the synthesized compounds were found to exhibit similar inhibitory activity at the GAT subtypes mGAT2, mGAT3, and mGAT4, respectively, as compared with the reference N-butylnipecotic acid. Hence, these compounds might serve as starting point for future developments of more complex GAT inhibitors.
Lokale Lappenplastiken als letzter Versuch vor der Unterschenkelamputation: eine Übersicht
Authors: Jakubietz Rafael G. , Meffert Rainer H. , Jakubietz Michael G. , Seyfried Florian , Schmidt Karsten
Published: May 2020

Hintergrund

Die Weichgewebsrekonstruktion bei alten Patienten stellt eine Herausforderung dar. Der freie Gewebetransfer kann bei gesunden Patienten trotz hohen Alters mit hoher Erfolgsrate durchgeführt werden. Bei multimorbiden Patienten, die für den freien Gewebetransfer nicht in Betracht kommen, werden häufig lokale Lappenplastiken eingesetzt, welche mit einer hohen Komplikationsrate assoziiert sind. Gerade solche Rettungseingriffe müssen so gewählt werden, dass eine Amputation durch die Wahl der Entnahmestelle nicht nachteilig beeinflusst wird oder gar unmöglich wird.

Methode

Drei distal basierte lokale Lappenplastiken wie Suralis‑, Peronaeus-brevis- und Propellerlappenplastik werden im Hinblick auf die Platzierung der Entnahmestelle sowie die Komplikationen der Wundheilungsstörung diskutiert.

Ergebnisse

Die Entnahmestelle der Suralislappenplastik ist nachteilig, da die proximale, dorsale Wadenregion betroffen ist, die im Falle einer Unterschenkelamputation die Weichteildeckung des Stumpfes ermöglicht.

Schlussfolgerung

Soll eine lokale Lappenplastik als „Rettungseingriff“ als Versuch der Vermeidung einer Unterschenkelamputation bei für einen freien Gewebetransfer nichtgeeigneten Patienten zum Einsatz kommen, gilt es, Lappenplastiken zu wählen, die die Entnahmestelle außerhalb der dorsalen, proximalen Wade platzieren, um die Weichteildeckung einer Stumpfbildung potenziell zu ermöglichen.
Toxicity of fluoride: critical evaluation of evidence for human developmental neurotoxicity in epidemiological studies, animal experiments and in vitro analyses
Authors: Guth Sabine , Hüser Stephanie , Roth Angelika , Degen Gisela , Diel Patrick , Edlund Karolina , Eisenbrand Gerhard , Engel Karl-Heinz , Epe Bernd , Grune Tilman , Heinz Volker , Henle Thomas , Humpf Hans-Ulrich , Jäger Henry , Joost Hans-Georg , Kulling Sabine E. , Lampen Alfonso , Mally Angela , Marchan Rosemarie , Marko Doris , Mühle Eva , Nitsche Michael A. , Röhrdanz Elke , Stadler Richard , van Thriel Christoph , Vieths Stefan , Vogel Rudi F. , Wascher Edmund , Watzl Carsten , Nöthlings Ute , Hengstler Jan G.
Published: May 2020

Recently, epidemiological studies have suggested that fluoride is a human developmental neurotoxicant that reduces measures of intelligence in children, placing it into the same category as toxic metals (lead, methylmercury, arsenic) and polychlorinated biphenyls. If true, this assessment would be highly relevant considering the widespread fluoridation of drinking water and the worldwide use of fluoride in oral hygiene products such as toothpaste. To gain a deeper understanding of these assertions, we reviewed the levels of human exposure, as well as results from animal experiments, particularly focusing on developmental toxicity, and the molecular mechanisms by which fluoride can cause adverse effects. Moreover, in vitro studies investigating fluoride in neuronal cells and precursor/stem cells were analyzed, and 23 epidemiological studies published since 2012 were considered. The results show that the margin of exposure (MoE) between no observed adverse effect levels (NOAELs) in animal studies and the current adequate intake (AI) of fluoride (50 µg/kg b.w./day) in humans ranges between 50 and 210, depending on the specific animal experiment used as reference. Even for unusually high fluoride exposure levels, an MoE of at least ten was obtained. Furthermore, concentrations of fluoride in human plasma are much lower than fluoride concentrations, causing effects in cell cultures. In contrast, 21 of 23 recent epidemiological studies report an association between high fluoride exposure and reduced intelligence. The discrepancy between experimental and epidemiological evidence may be reconciled with deficiencies inherent in most of these epidemiological studies on a putative association between fluoride and intelligence, especially with respect to adequate consideration of potential confounding factors, e.g., socioeconomic status, residence, breast feeding, low birth weight, maternal intelligence, and exposure to other neurotoxic chemicals. In conclusion, based on the totality of currently available scientific evidence, the present review does not support the presumption that fluoride should be assessed as a human developmental neurotoxicant at the current exposure levels in Europe.
Combined hepatocellular-cholangiocarcinoma: which preoperative clinical data and conventional MRI characteristics have value for the prediction of microvascular invasion and clinical significance?
Authors: Wang Xiaolong , Wang Wentao , Ma Xijuan , Lu Xin , Li Shaodong , Zeng Mengsu , Xu Kai , Yang Chun
Published: May 2020

Objectives

To explore which preoperative clinical data and conventional MRI findings may indicate microvascular invasion (MVI) of combined hepatocellular-cholangiocarcinoma (cHCC-CCA) and have clinical significance.

Methods

The study enrolled 113 patients with histopathologically confirmed cHCC-CCA (MVI-positive group [n = 56], MVI-negative group [n = 57]). Two radiologists retrospectively assessed the preoperative MRI features (qualitative analysis of morphology and dynamic enhancement features), and each lesion was assigned according to the LI-RADS. Preoperative clinical data were also evaluated. Logistic regression analyses were used to assess the relative value of these parameters as potential predictors of MVI. Recurrence-free survival (RFS) rates after hepatectomy in the two groups were estimated using Kaplan–Meier survival curves and compared using the log-rank test.

Results

The majority of cHCC-CCAs were categorized as LR-M. On multivariate analysis, a higher serum AFP level (OR, 0.523; 95% CI, 0.282–0.971; p = 0.040), intratumoral fat deposition (OR, 14.368; 95% CI, 2.749–75.098; p = 0.002), and irregular arterial peritumoral enhancement (OR, 0.322; 95% CI, 0.164–0.631; p = 0.001) were independent variables associated with the MVI of cHCC-CCA. After hepatectomy, patients with MVI of cHCC-CCA showed earlier recurrence than those without MVI (hazard ratio [HR], 0.402; 95% CI, 0.189–0.854, p = 0.013).

Conclusion

A higher serum AFP level and irregular arterial peritumoral enhancement are potential predictive biomarkers for the MVI of cHCC-CCA, while intratumoral fat detected on MRI suggests a low risk of MVI. Furthermore, cHCC-CCAs with MVI may have worse surgical outcomes with regard to early recurrence than those without MVI.

Key Points

• Higher serum levels of AFP combined with irregular arterial peritumoral enhancement are independent risk factors for the MVI of cHCC-CCA, while fat deposition might be a protective factor.

• cHCC-CCA with MVI may have a higher risk of early recurrence after surgery.

• Most cHCC-CCAs were categorized as LR-M in this study, and no significant difference was found in MVI based on LI-RADS category.