bluuebunny/crossref_metadata_2025 huggingface dataset:
Coronary Microvascular Dysfunction in Rheumatoid Arthritis Compared to Diabetes Mellitus and Association With All‐Cause Mortality
Authors: Liao Katherine P. , Huang Jie , He Zeling , Cremone Gabrielle , Lam Ethan , Hainer Jon M. , Morgan Victoria , Bibbo Courtney , Di Carli Marcelo
Published: November 2019

Objective

Coronary microvascular dysfunction (CMD) is a predictor of cardiac death in diabetes mellitus (DM) independent of traditional cardiovascular (CV) risk factors. Rheumatoid arthritis (RA) is a chronic inflammatory condition, with excess CV risk compared to the general population, in which CMD is hypothesized to play a role; however, there are limited data on CMD in RA and any association with clinical outcomes. The objective of this study was to compare the prevalence of CMD in RA to that in DM and to test the association with all‐cause mortality.

Methods

We performed a retrospective cohort study using data from a registry of all patients undergoing stress myocardial perfusion positron emission tomography as part of routine clinical care from 2006 to 2017. The inclusion criterion was a normal perfusion scan. Patients with RA or DM were classified using previously published approaches. Coronary flow reserve (CFR) was calculated for all patients in the registry and linked with mortality data. CMD was defined as CFR <2.0.

Results

We studied 73 patients with RA and 441 patients with DM. Among patients with a normal perfusion scan, the prevalence of CMD in RA was similar to that in DM (P = 0.2). CMD was associated with increased risk for all‐cause mortality in RA (hazard ratio 2.4 [95% confidence interval 1.4–4.2]) as well as increased risk for cardiac‐related death at rates similar to those in DM.

Conclusion

These findings suggest an important role for CMD as a potential contributor to excess CV risk and mortality in RA, as previously observed in DM, as well as evidence for a mechanistic link between inflammation and cardiovascular disease.
Biomimetic Elastomeric Bioactive Siloxane‐Based Hybrid Nanofibrous Scaffolds with miRNA Activation: A Joint Physico‐Chemical‐Biological Strategy for Promoting Bone Regeneration
Authors: Yu Meng , Du Yuzhang , Han Yong , Lei Bo
Published: November 2019

Rapid and efficient disease‐induced or critical‐size bone regeneration remains a challenge in tissue engineering due to the lack of highly bioactive biomaterial scaffolds. Physical structures such as nanostructures, chemical components such as silicon elements, and biological factors such as genes have shown positive effects on bone regeneration. Herein, a bioactive photoluminescent elastomeric silicate‐based nanofibrous scaffold with sustained miRNA release is reported for promoting bone regeneration based on a joint physico‐chemical‐biological strategy. Bioactive nanofibrous scaffolds are fabricated by cospinning poly (ε‐caprolactone) (PCL), elastomeric poly (citrates‐siloxane) (PCS), and bioactive osteogenic miRNA nanocomplexes (denoted PPM nanofibrous scaffolds). The PPM scaffolds possess uniform nanostructures, significantly enhanced tensile stress (≈15 MPa) and modulus (≈32 MPa), improved hydrophilicity (30–60°), controlled biodegradation, and strong blue fluorescence. Bioactive miRNA complexes are efficiently loaded into the nanofibrous matrix and exhibit long‐term release for up to 70 h. The PPM scaffolds significantly promote the adhesion, proliferation, and osteoblast differentiation of bone marrow stem cells in vitro and enhanced rat cranial defect restoration (12 weeks) in vivo. This work reports an attractive joint physico‐chemical‐biological strategy for the design of novel cell/protein‐free bioactive scaffolds for synergistic tissue regeneration.
Amidation, Esterification, and Thioesterification of a Carboxyl‐Functionalized Covalent Organic Framework
Authors: Guo Lei , Jia Shang , Diercks Christian S. , Yang Xuejing , Alshmimri Sultan A. , Yaghi Omar M.
Published: November 2019

Three new post‐synthetic modification reactions, namely amidation, esterification, and thioesterification, were demonstrated on a novel highly crystalline two‐dimensional covalent organic framework (COF), COF‐616, bearing pre‐installed carboxyl groups. The strategy can be used to introduce a large variety of functional groups into COFs and the modifications can be carried out under mild reaction conditions, with high yields, and an easy work‐up protocol. As a proof of concept, various chelating functionalities were successfully incorporated into COF‐616 to yield a family of adsorbents for efficient removal of several contaminants in the water.
Focused Multisensory Anatomy Observation and Drawing for Enhancing Social Learning and Three‐Dimensional Spatial Understanding
Authors: Shapiro Leonard , Bell Kathryn , Dhas Kallpana , Branson Toby , Louw Graham , Keenan Iain D.
Published: November 2019

The concept that multisensory observation and drawing can be effective for enhancing anatomy learning is supported by pedagogic research and theory, and theories of drawing. A haptico‐visual observation and drawing (HVOD) process has been previously introduced to support understanding of the three‐dimensional (3D) spatial form of anatomical structures. The HVOD process involves exploration of 3D anatomy with the combined use of touch and sight, and the simultaneous act of making graphite marks on paper which correspond to the anatomy under observation. Findings from a previous study suggest that HVOD can increase perceptual understanding of anatomy through memorization and recall of the 3D form of observed structures. Here, additional pedagogic and cognitive underpinnings are presented to further demonstrate how and why HVOD can be effective for anatomy learning. Delivery of a HVOD workshop is described as a detailed guide for instructors, and themes arising from a phenomenological study of educator experiences of the HVOD process are presented. Findings indicate that HVOD can provide an engaging approach for the spatial exploration of anatomy within a supportive social learning environment, but also requires modification for effective curricular integration. Consequently, based on the most effective research‐informed, theoretical, and logistical elements of art‐based approaches in anatomy learning, including the framework provided by the observe–reflect–draw–edit–repeat (ORDER) method, an optimized “ORDER Touch” observation and drawing process has been developed. This is with the aim of providing a widely accessible resource for supporting social learning and 3D spatial understanding of anatomy, in addition to improving specific anatomical knowledge.
Simultaneous Detection of Multiple Pathogenic Targets with Stem‐Tagged Primer Sets
Authors: Kim Yong‐Tae , Moon Junhye , Hong In Seok
Published: November 2019

Simultaneous multiple gene detection is indispensable for the detection of various genes in a small sample obtained by an invasive method. A typical detection method is probe‐based fluorescence melting curve analysis by means of real‐time PCR. It is very limited because, for each target, a probe sequence with at least a different Tm must be designed. To overcome this limitation, we developed a simultaneous multiple gene detection method based on a giant amplicon molecular beacon. PCR was performed by attaching stem sequences with different Tm values to each primer set, and the melting Tm was measured by hybridizing the stem sequences at both ends of the amplified amplicon; this generated well‐separated Tm signals. The important point here is that the stem sequence that produces the Tm signal is an arbitrarily selectable sequence unrelated to the target gene. Because it is arbitrarily selectable, the desired Tm can be freely adjusted. As a result, we succeeded in the simultaneous detection of four samples with the use of only one fluorophore. Theoretically, a combination of five fluorophores could detect more than 20 multiple genes simultaneously.
Rapid Biophysical Characterization and NMR Spectroscopy Structural Analysis of Small Proteins from Bacteria and Archaea
Authors: Kubatova Nina , Pyper Dennis J. , Jonker Hendrik R. A. , Saxena Krishna , Remmel Laura , Richter Christian , Brantl Sabine , Evguenieva‐Hackenberg Elena , Hess Wolfgang R. , Klug Gabriele , Marchfelder Anita , Soppa Jörg , Streit Wolfgang , Mayzel Maxim , Orekhov Vladislav Y. , Fuxreiter Monika , Schmitz Ruth A. , Schwalbe Harald
Published: November 2019

Proteins encoded by small open reading frames (sORFs) have a widespread occurrence in diverse microorganisms and can be of high functional importance. However, due to annotation biases and their technically challenging direct detection, these small proteins have been overlooked for a long time and were only recently rediscovered. The currently rapidly growing number of such proteins requires efficient methods to investigate their structure–function relationship. Herein, a method is presented for fast determination of the conformational properties of small proteins. Their small size makes them perfectly amenable for solution‐state NMR spectroscopy. NMR spectroscopy can provide detailed information about their conformational states (folded, partially folded, and unstructured). In the context of the priority program on small proteins funded by the German research foundation (SPP2002), 27 small proteins from 9 different bacterial and archaeal organisms have been investigated. It is found that most of these small proteins are unstructured or partially folded. Bioinformatics tools predict that some of these unstructured proteins can potentially fold upon complex formation. A protocol for fast NMR spectroscopy structure elucidation is described for the small proteins that adopt a persistently folded structure by implementation of new NMR technologies, including automated resonance assignment and nonuniform sampling in combination with targeted acquisition.
Balloon expandable covered stents as primary therapy for hemodynamically stable traumatic aortic injuries in children
Authors: Hiremath Gurumurthy , Morgan Gareth , Kenny Damien , Batlivala Sarosh P , Bartakian Sergio
Published: November 2019

Objectives

To expand on the limited available literature regarding the use of balloon expandable covered stents for the treatment of traumatic aortic injuries (TAI) in the pediatric population.

Background

Although endovascular grafts have largely replaced surgery for TAI repair, there are significant limitations to the use of these grafts in pediatric patients.

Methods

Multicenter, retrospective chart review of pediatric patients with TAI following blunt chest wall trauma. Procedural characteristics, follow‐up, and reinterventions are described.

Results

Six covered stents implanted in five patients. Median patient age was 12 years (11–13 years) and median weight 50 kg (44–54 kg). Procedural success was achieved in all cases. No procedural or postprocedural complications were noted. Median follow‐up time was 24 months (11–36 months).

Conclusions

Balloon expandable covered stent treatment of pediatric patients with TAI is a feasible alternative to open surgical repair, and preferred over endovascular grafts due to graft size limitations and the large delivery systems.
Oxygen Evolution Reaction on Single‐Walled Carbon Nanotubes Noncovalently Functionalized with Metal Phthalocyanines
Authors: Alzate‐Carvajal Natalia , Bolivar‐Pineda Lina M. , Meza‐Laguna Victor , Basiuk Vladimir A. , Basiuk Elena V. , Baranova Elena A.
Published: November 2019

This work reports the facile preparation of single‐walled carbon nanotubes (SWCNTs) noncovalently functionalized with 3d transition metal (II) phthalocyanines MPcs (M=Mn, Fe, Co and Ni) and their electrochemical evaluation towards the oxygen evolution reaction (OER) in alkaline media. The modification of SWCNTs with MPcs improved the potential required for the oxygen evolution reaction in 0.1 M and 1 M KOH by lowering the potential by approximately 120 mV in comparison with unmodified SWCNTs, at a current density of 10 mA cm−1. The onset potential of the hybrids is close to the bulk Ni electrode in 1 M KOH and significantly outperforms Ni and Ir black electrodes in 0.1 M KOH solution. Nickel, cobalt and iron phthalocyanines showed auto‐activation during extended cyclic voltammetry and long‐term chronoamperometric measurements in both KOH concentrations. The excellent electrocatalytic activity of hybrids obtained and the straightforward method of their synthesis opens the possibility of exploring the proposed materials for applications in anion exchange membrane water electrolysis (AEMWE).
The Effect of Anions and pH on the Activity and Selectivity of an Annealed Polycrystalline Au Film Electrode in the Oxygen Reduction Reaction‐Revisited
Authors: Jusys Zenonas , Behm R. Jürgen
Published: November 2019

Aiming at a better understanding of correlations between the activity and selectivity of Au electrodes in the oxygen reduction reaction (ORR) under controlled transport conditions, we have investigated this reaction by combined electrochemical and in situ FTIR measurements, performed in a flow cell set‐up in an attenuated total reflection (ATR) configuration in acid and alkaline electrolytes. The formation of incomplete reduction products (hydrogen peroxyde/peroxyls) was detected by a collector electrode, the onset of OHad formation was probed by bulk CO oxidation. Using an electroless‐deposited, annealed Au film on a Si prism as working electrode and three different electrolytes for comparison (sulfuric acid, perchloric acid, sodium hydroxide solution), we could derive detailed information on the anion adsorption behavior, and could correlate this with the ORR characteristics. The data reveal pronounced effects of the anions and the pH on the ORR characteristics, indicated e. g., by a grossly different activity and selectivity for the 4‐electron pathway to water/hydroxyls, with the onset ranging from ca. 1.0 V in alkaline electrolyte to 0.6 V in sulfuric acid electrolyte, and the selectivity for the 4‐electron pathway ranging from 100 % (alkaline electrolyte, low overpotentials) to 40 % (acidic electrolytes, alkaline electrolyte at high overpotentials). In contrast, the effect of the ORR on the anion adsorption characteristics is small. Anion effects as well as correlations between anion adsorption and ORR are discussed.
Protein Abundance of Hepatic Drug Transporters in Patients With Different Forms of Liver Damage
Authors: Drozdzik Marek , Szelag‐Pieniek Sylwia , Post Mariola , Zeair Samir , Wrzesinski Maciej , Kurzawski Mateusz , Prieto Jesus , Oswald Stefan
Published: November 2019

Hepatocellular transporter levels were quantified using quantitative reverse transcription polymerase chain reaction and liquid chromatography–tandem mass spectrometry methods. Liver function deterioration (Child‐Pugh class C) produced significant protein abundance (mean values) increase (to healthy livers) in P‐gp (to 260% (CV (coefficient of variation) 82%)) and MRP4 (CV 230%) (not detected in healthy livers), decrease in MRP2 (to 30% (CV 126%)), NTCP (to 34% (CV 112%)), OCT1 (to 35% (CV 153%)), OATP1B1 (to 46% (CV 73%)), and OATP2B1 (to 27% (CV 230%)), whereas BSEP (CV 99%), MRP3 (CV 106%), OAT2 (CV 97%), OCT3 (CV 113%), and OATP1B3 (CV 144%) remained unchanged. Alcoholic liver disease produced significant protein downregulation of MRP2 (to 30% (CV 134%)), NTCP (to 76% (CV 78%)), OAT2 (to 26% (CV 117%)), OATP1B1 (to 61% (CV 76%)), OATP1B3 (to 79% (CV 160%)), and OATP2B1 (to 73% (CV 90%)) of healthy tissue values. Hepatitis C produced BSEP (to 47% (CV 99%)) and OATP2B1 (to 74% (CV 91%)) protein reduction. Primary biliary cholangitis and primary sclerosing cholangitis demonstrated P‐gp and MRP4 protein upregulation (to 350% (CV 47%) and 287% (CV 38%), respectively). Autoimmune hepatitis revealed P‐gp (to 410% (CV 49%)) and MRP4 (CV 96%) increase, and MRP2 (to 18% (CV 259%)) protein decrease. Drug transporters' protein abundance depends on liver pathology type and its functional state.
Visible‐Light‐Induced Cleavage of C−S Bonds in Thioacetals and Thioketals with Iodine as a Photocatalyst
Authors: Krumb Matthias , Kammer Lisa Marie , Forster Robert , Grundke Caroline , Opatz Till
Published: November 2019

A protocol for a visible‐light‐induced cleavage of thioacetals and thioketals using molecular iodine as a photocatalyst in combination with oxygen as the terminal oxidant is reported. The reaction proceeds with low catalyst loadings and high chemical yields while the most commonly used N‐ and O‐protecting groups remain untouched in this transformation. Further investigation showed that the reaction also permits the synthesis of unsymmetrical disulfides by cleavage of unsymmetrical thioacetals.
CD71 improves delineation of PNH type III, PNH type II, and normal immature RBCS in patients with paroxysmal nocturnal hemoglobinuria
Authors: Sutherland D. Robert , Richards Stephen J. , Ortiz Fernando , Nayyar Rakesh , Benko Miroslav , Marinov Iuri , Illingworth Andrea
Published: November 2019

Background

The diagnosis of paroxysmal nocturnal hemoglobinuria (PNH) relies on flow cytometric demonstration of loss of glycosyl‐phosphatidyl inositol (GPI)‐anchored proteins from red blood cells (RBC) and white blood cells (WBC). High‐sensitivity multiparameter assays have been developed to detect loss of GPI‐linked structures on PNH neutrophils and monocytes. High‐sensitivity assays to detect PNH phenotypes in RBCs have also been developed that rely on the loss of GPI‐linked CD59 on CD235a‐gated mature RBCs. The latter is used to delineate PNH Type III (total loss of CD59) and PNH Type II RBCs (partial loss of CD59) from normal (Type I) RBCs. However, it is often very difficult to delineate these subsets, especially in patients with large PNH clones who continue to receive RBC transfusions, even while on eculizumab therapy.

Methods

We have added allophycocyanin (APC)‐conjugated CD71 to the existing CD235aFITC/CD59PE RBC assay allowing simultaneous delineation and quantification of PNH Type III and Type II immature RBCs (iRBCs).

Results

We analyzed 24 medium to large‐clone PNH samples (>10% PNH WBC clone size) for PNH Neutrophil, PNH Monocyte, Type III and Type II PNH iRBCs, and where possible, Type III and Type II PNH RBCs. The ability to delineate PNH Type III, Type II, and Type I iRBCs was more objective compared to that in mature RBCs. Additionally, total PNH iRBC clone sizes were very similar to PNH WBC clone sizes.

Conclusions

Addition of CD71 significantly improves the ability to analyze PNH clone sizes in the RBC lineage, regardless of patient hemolytic and/or transfusion status.
Zebrafish etv2 knock‐in line labels vascular endothelial and blood progenitor cells
Authors: Chestnut Brendan , Sumanas Saulius
Published: November 2019

Background

ETS transcription factor Etv2/Etsrp is one of the earliest markers for vascular and hematopoietic progenitors and functions as a key regulator of hematovascular development in multiple vertebrates, including zebrafish. Therefore, transgenic etv2 reporter lines provide a valuable tool to study vasculogenesis and hematopoiesis. However, previously generated zebrafish reporter lines do not fully recapitulate the endogenous pattern of etv2 expression.

Results

Here we used CRISPR/Cas9‐mediated homology‐independent DNA repair approach to knock‐in a Gal4 transcriptional activator into the zebrafish etv2 genomic locus, thus generating etv2
ci32Gt gene trap line. etv2
ci32Gt; UAS:GFP embryos show GFP expression in vascular endothelial, myeloid and red blood cells. Because gal4 insertion interrupts the etv2 locus, homozygous etv2
ci32Gt embryos display defects in vasculogenesis and myelopoiesis, and enable visualizing etv2‐deficient hematovascular progenitors in live embryos. Furthermore, we performed differential transcriptome analysis of sorted GFP‐positive cells from heterozygous and homozygous etv2
ci32Gt embryos. Approximately 500 downregulated genes were identified in etv2
ci32Gt homozygous embryos, which include multiple genes expressed in vascular endothelial and myeloid cells.

Conclusions

The etv2
ci32Gt gene trap line and the data sets of misregulated genes will be valuable resources to study hematopoietic and vascular development.
The role of galanin in the differentiation of mucosal mast cells in mice
Authors: Yamaguchi Tomoko , Ikeda Yumi , Tashiro Katsuhisa , Ohkawa Yasuyuki , Kawabata Kenji
Published: November 2019

Mast cells are generally classified into two phenotypically distinct populations: mucosal‐type mast cells (MMCs) and connective tissue‐type mast cells (CTMCs). However, the molecular basis determining the different characteristics of the mast cell subclasses still remains unclear. Unfortunately, the number of mast cells that can be obtained from tissues is limited, which makes it difficult to study the function of each mast cell subclass. Here, we report the generation and characterization of MMCs and CTMCs derived from mouse BM mast cells (BMMCs). We found that the expression of galanin receptor 3 was elevated in MMCs when compared to the expression in CTMCs. Moreover, intraperitoneal injection of a galanin antagonist reduced MMCs and inhibited the inflammation of dextran sodium sulfate‐induced colitis in mice. Therefore, these results suggest that galanin promotes MMC differentiation in vivo, and provide important insights into the molecular mechanisms underlying the differentiation of mast cell subclasses.
Microalgae wastewater treatment: Biological and technological approaches
Authors: Wollmann Felix , Dietze Stefan , Ackermann Jörg‐Uwe , Bley Thomas , Walther Thomas , Steingroewer Juliane , Krujatz Felix
Published: November 2019

Current global environmental issues raise unavoidable challenges for our use of natural resources. Supplying the human population with clean water is becoming a global problem. Numerous organic and inorganic impurities in municipal, industrial, and agricultural waters, ranging from microplastics to high nutrient loads and heavy metals, endanger our nutrition and health. The development of efficient wastewater treatment technologies and circular economic approaches is thus becoming increasingly important. The biomass production of microalgae using industrial wastewater offers the possibility of recycling industrial residues to create new sources of raw materials for energy and material use. This review discusses algae‐based wastewater treatment technologies with a special focus on industrial wastewater sources, the potential of non‐conventional extremophilic (thermophilic, acidophilic, and psychrophilic) microalgae, and industrial algae‐wastewater treatment concepts that have already been put into practice.
Systematic review of ketogenic diet use in adult patients with status epilepticus
Authors: Mahmoud Sherif Hanafy , Ho‐Huang Ethos , Buhler Jessica
Published: November 2019

Status epilepticus (SE) is a medical emergency that is associated with a significant morbidity and mortality. Recently, there has been significant interest in the use of ketogenic diets (KD) in the management of SE. KD is a high‐fat, low‐carbohydrate, and adequate protein diet that has been shown to be a safe and effective adjuvant to present SE management in patients with refractory epilepsy. Many case reports and case series have demonstrated the potential safety and effectiveness of KD for the acute treatment of SE; however, quality studies remain scarce on this topic. The purpose of this systematic review is to summarize the available evidence for the safety and effectiveness of KD in adults with SE. A literature search was performed in MEDLINE, EMBASE, Cochrane Library, and CINAHL (September 14, 2018). The search was repeated on March 27, 2019, to include any studies published since the original search. Keywords related to KD and SE were used. Studies were selected based on the reported use of the KD in SE. The search resulted in a total of 954 records. After screening and full‐text review, 17 articles were included in this review: four observational studies, 10 case reports, and 3 case series. Based on the observational studies, a total of 38 Patients with SE have been reported. KD was successful in achieving cessation of SE in 31 Patients (82%). The most common adverse effects reported were metabolic acidosis, hyperlipidemia, and hypoglycemia. The current limited evidence suggests that KD might be considered as an option for adult patients with SE. Although promising, the results need to be interpreted with caution due to the inherent bias, confounding and small sample size of the included studies. A randomized controlled trial is recommended to establish role of KD in the management of SE in adults.
Transient perturbation of the left temporal cortex evokes plasticity‐related reconfiguration of the lexical network
Authors: Klaus Jana , Schutter Dennis J. L. G. , Piai Vitória
Published: November 2019

While much progress has been made in how brain organization supports language function, the language network's ability to adapt to immediate disturbances by means of reorganization remains unclear. The aim of this study was to examine acute reorganizational changes in brain activity related to conceptual and lexical retrieval in unimpaired language production following transient disruption of the left middle temporal gyrus (MTG). In a randomized single‐blind within‐subject experiment, we recorded the electroencephalogram from 16 healthy participants during a context‐driven picture‐naming task. Prior to the task, the left MTG was perturbed with real continuous theta‐burst stimulation (cTBS) or sham stimulation. During the task, participants read lead‐in sentences creating a constraining (e.g., “The farmer milks the”) or nonconstraining context (e.g., “The farmer buys the”). The last word was shown as a picture that participants had to name (e.g., “cow”). Replicating behavioral studies, participants were overall faster in naming pictures following a constraining relative to a nonconstraining context, but this effect did not differ between real and sham cTBS. In contrast, real cTBS increased overall error rates compared to sham cTBS. In line with previous studies, we observed a decrease in alpha‐beta (8–24 Hz) oscillatory power for constraining relative to nonconstraining contexts over left temporal–parietal cortex after participants received sham cTBS. However, following real cTBS, this decrease extended toward left prefrontal regions associated with both domain‐general and domain‐specific control mechanisms. Our findings provide evidence that immediately after perturbing the left MTG, the lexical‐semantic network is able to quickly reconfigure, also recruiting domain‐general regions.
Medicaid Policy and Liver Transplant for Alcohol‐Associated Liver Disease
Authors: Lee Brian P. , Vittinghoff Eric , Pletcher Mark J. , Dodge Jennifer L. , Terrault Norah A.
Published: November 2019

Background and Aims

In some states, liver transplantation (LT) for alcohol‐associated liver disease (ALD) is covered by Medicaid only with documentation of abstinence and/or alcohol rehabilitation. Different Medicaid policies may affect the distribution of LT for ALD, particularly post‐2011, as centers have adopted early (i.e., specific abstinence period not required) LT practices.

Approach and Results

We surveyed Medicaid policies in all states actively performing LT and linked state policies to prospectively collected national registry data on LT recipients from 2002 to 2017 with ALD as the primary listing diagnosis. We categorized Medicaid policies for states as “restrictive” (requiring documentation of a specific abstinence period and/or rehabilitation) versus “unrestrictive” (deferring to center eligibility policies). Difference‐of‐differences analysis, comparing 2002‐2011 versus 2012‐2017, evaluated whether restrictive policies were associated with decreased proportion of LTs paid by Medicaid among patients with ALD post‐2011. We performed sensitivity analyses to account for any differences by diagnosis of hepatocellular carcinoma, hepatitis C virus, nonalcoholic steatohepatitis, or Medicare insurance. We also performed a sensitivity analysis to account for any difference by prevalence of ALD among restrictive versus unrestrictive states. Of 10,836 LT recipients in 2002‐2017, 7,091 were from 24 states in the restrictive group and 3,745 from 14 states in the unrestrictive group. The adjusted proportion (95% confidence interval) of LTs paid by Medicaid among restrictive versus unrestrictive states between 2002 and 2011 was 17.6% (15.4%‐19.8%) versus 18.9% (15.4%‐22.3%) (P = 0.54) and between 2012 and 2017, 17.2% (14.7%‐19.7%) versus 23.2% (19.8%‐26.6%) (P = 0.005). In difference‐of‐differences analysis, restrictive (versus unrestrictive) policies were associated with a 4.7% (0.8%‐8.6%) (P = 0.02) absolute lower adjusted proportion of LTs for ALD paid by Medicaid post‐2011.

Conclusions

Restrictive Medicaid policies are present in most states with active LT centers and are associated with lower proportions of LTs for ALD paid by Medicaid post‐2011 compared to states with unrestrictive Medicaid policies. Reevaluation of Medicaid alcohol use policies may be warranted, to align more closely with contemporary center‐level practices.
Land cover effects on soil infiltration capacity measured using plot scale rainfall simulation in steep tropical lowlands of Central Panama
Authors: Litt Guy F. , Ogden Fred L. , Mojica Alexis , Hendrickx Jan M. H. , Kempema Edward W. , Gardner Christopher B. , Bretfeld Mario , Regina Jason A. , Harrison J. Bruce J. , Cheng Yanyan , Lyons W. Berry
Published: November 2019

Understanding land use/land cover (LULC) effects on tropical soil infiltration is crucial for maximizing watershed scale hydro‐ecosystem services and informing land managers. This paper reports results from a multiyear investigation of LULC effects on soil bulk infiltration in steep, humid tropical, and lowland catchments. A rainfall simulator applied water at measured rates on 2 × 6 m plots producing infiltration through structured, granulated, and macroporous Ferralsols in Panama's central lowlands. Time‐lapse electrical resistivity tomography (ERT) helped to visualize infiltration depth and bulk velocity. A space‐for‐time substitution methodology allowed a land‐use history investigation by considering the following: (a) a continuously heavy‐grazed cattle pasture, (b) a rotationally grazed traditional cattle pasture, (c) a 4‐year‐old (y.o.) silvopastoral system with nonnative improved pasture grasses and managed intensive rotational grazing, (d) a 7 y.o. teak (Tectona grandis) plantation, (e) an approximately 10 y.o. secondary succession forest, (f) a 12 y.o. coffee plantation (Coffea canephora), (g) an approximately 30 y.o. secondary succession forest, and (h) a >100 y.o. secondary succession forest. Within a land cover, unique plot sites totalled two at (a), (c), (d), (e), and (g); three at (b); and one at (f) and (h). Our observations confirmed measured infiltration scale dependency by comparing our 12 m2 plot‐scale measurements against 8.9 cm diameter core‐scale measurements collected by others from nearby sites. Preferential flow pathways (PFPs) significantly increased soil infiltration capacity, particularly in forests greater than or equal to 10 y.o. Time‐lapse ERT observations revealed shallower rapid bulk infiltration and increased rapid lateral subsurface flow in pasture land covers when compared with forest land covers and highlighted how much subsurface flow pathways can vary within the Ferralsol soil class. Results suggest that LULC effects on PFPs are the dominant mechanism by which LULC affects throughfall partitioning, runoff generation, and flow pathways.
A comparison of EBV serology and serum cell‐free DNA as screening tools for nasopharyngeal cancer: Results of the Singapore NPC screening cohort
Authors: Tay Joshua K. , Siow Chor H. , Goh Han L. , Lim Chwee M. , Hsu Pon P. , Chan Soh H. , Loh Kwok S.
Published: November 2019

We aimed to evaluate the effectiveness of nasopharyngeal cancer (NPC) screening by comprehensive clinical follow‐up and adjunctive Epstein–Barr virus (EBV) testing. In a prospective cohort study, 524 individuals with a first‐degree family history of NPC were recruited at a university clinical center in Singapore. The cohort was evaluated at baseline and at 6 monthly intervals, with a complete head and neck examination including nasopharyngeal endoscopy. Blood was taken at baseline and at yearly intervals for EBV Viral Capsid Antigen (VCA) IgA, EBV Early Antigen (EA) IgA serology and serum cell‐free EBV DNA. Nasopharyngeal biopsy was performed when any irregularity in the nasopharynx was observed, or when EBV markers were elevated. The mean duration of follow‐up was 57.7 months, with an average of 8.6 clinical visits per participant. Five participants (0.96%) were identified to have NPC, giving a prevalence of 199 per 100,000 person‐years of screening. Four of the five NPC cases identified had asymptomatic T1 disease, at an earlier stage compared to NPC patients diagnosed in the clinic during the same time period (p = 0.0297). All NPC cases identified had elevated EBV‐EA IgA titers ≥1:10, with a specificity of 94.6% and a positive predictive value of 15.2%, outperforming EBV‐VCA IgA and serum EBV DNA. Two NPC cases were biopsied only because of elevated EBV serology titers, with increasing EBV‐EA IgA titers preceding the diagnosis of NPC. In conclusion, screening for NPC is effective in identifying early‐stage disease. Adjunctive EBV‐EA IgA testing improved the effectiveness of screening.
Therapeutic plasma exchange for neuromyelitis optica spectrum disorder: A multicenter retrospective study by the ASFA neurologic diseases subcommittee
Authors: Ipe Tina S. , Raval Jay S. , Fernando Leonor P. , Gokhale Amit , Jacquot Cyril , Johnson Andrew D. , Kim Haewon C. , Monis Grace F. , Mo Yunchun D. , Morgan Shanna M. , Pagano Monica B. , Pham Huy P. , Sanford Kimberly , Schmidt Amy E. , Schwartz Joseph , Waldman Amy , Webb Jennifer , Winters Jeffrey L. , Wu Yanyun , Yamada Chisa , Wong Edward C. C.
Published: November 2019

Importance

Neuromyelitis optica/neuromyelitis optica spectrum disorder patients' response to therapeutic plasma exchange (TPE) is currently incompletely characterized.

Objective

Our study aims to understand the clinical status improvement of neuromyelitis optica/neuromyelitis optica spectrum disorder patients treated with TPE.

Design, Setting, and Participants

This is a multicenter retrospective study conducted between 1 January 2003 and 31 July 2017 at 13 US hospitals performing apheresis procedures. Subjects studied were diagnosed with neuromyelitis optica/neuromyelitis optica spectrum disorder who received TPE during presentation with acute disease.

Main Outcomes and Measures

The primary outcome was clinical status improvement in patients treated with TPE. Secondary measures were procedural and patient characteristics associated with response to treatment.

Results

We evaluated 114 patients from 13 institutions. There was a female predilection. The largest ethnic group affected was non‐Hispanic Caucasian. The average age of diagnosis was 43.1 years. The average time to diagnosis was 3.1 years. On average, five procedures were performed during each treatment series. The most commonly performed plasma volume exchange was 1.0 to 1.25 using 5% albumin as replacement fluid. Most patients (52%) did not require an additional course of TPE and noted “mild” to “moderate” clinical status improvement. Maximal symptom improvement appeared by the fourth or fifth TPE treatment.

Conclusion and Relevance

TPE improved the clinical status of patients. Adults responded more favorably than children. Procedural characteristics, including number of TPEs, plasma volume exchanged, and replacement fluid used, were similar between institutions. TPE was well‐tolerated and had a low severe adverse event profile.
Infinite families of 3‐designs from APN functions
Authors: Tang Chunming
Published: November 2019

Combinatorial ‐designs have nice applications in coding theory, finite geometries, and several engineering areas. A classical method for constructing ‐designs is by the action of a permutation group that is ‐transitive or ‐homogeneous on a point set. This approach produces ‐designs, but may not yield ‐designs. The objective of this paper is to study how to obtain 3‐designs with 2‐transitive permutation groups. The incidence structure formed by the orbits of a base block under the action of the general affine groups, which are 2‐transitive, is considered. A characterization of such incidence structure to be a 3‐design is presented, and a sufficient condition for the stabilizer of a base block to be trivial is given. With these general results, infinite families of 3‐designs are constructed by employing almost perfect nonlinear functions. Some 3‐designs presented in this paper give rise to self‐dual binary codes or linear codes with optimal or best parameters known. Several conjectures on 3‐designs and binary codes are also presented.
The Influence of Arbitrary Breakpoints on Judgments of Maximum Output
Authors: Palmeira Mauricio , Andrade Eduardo , Sharifi Shahin , Mao Wen , Jacob Jorge
Published: November 2019

Consumers often wonder about the product's maximum output: the highest rotation speed of a blender or the best printing quality of a printer. We examine how the number of levels (e.g., a blender with 3 vs. 7 speeds) influences judgments of maximum product output. Objectively speaking, the number of levels is no more than a set of breakpoints in an already predetermined continuum from the product's minimum to maximum output. Nevertheless, because of the ubiquitous association between number of breakpoints and quantity in daily life, consumers do not simply view more levels as a signal of greater precision (i.e., giving consumers more control over the possible outputs). They also incorrectly believe that the product has greater power (i.e., a higher maximum output), even when such an inference is in conflict with diagnostic attribute information (e.g., watts). A series of five studies documents the phenomenon, its asymmetric nature, and its boundary conditions. Reliance on the inaccurate “more levels, more power” lay theory weakens when participants consider a reduction rather than an increase in number of levels, and it disappears when the consumer is presented with an explicit relationship between each level and its corresponding output value (e.g., level 4:400 W).
Influences of synoptic situation and teleconnections on fog‐water collection in the Mediterranean Iberian Peninsula, 2003–2012
Authors: Corell David , Estrela Maria J. , Valiente Jose A. , Azorin‐Molina Cesar , Chen Deliang
Published: November 2019

Fog‐water collection has been widely analysed for its quantification and potential uses; however, there are few studies assessing the synoptic conditions and large‐scale teleconnection patterns that affect its occurrence. Focusing on the Mediterranean Iberian Peninsula, this work aims to analyse the synoptic patterns, both at surface level and 850 hPa geopotential height, that most likely to favour fog‐water collection, and to quantify the relationship between fog‐water collection and the NAOi (North Atlantic Oscillation index), MOi (Mediterranean Oscillation index) as well as WeMOi (Western Mediterranean Oscillation index) teleconnection patterns. For this purpose, daily fog‐water observations from a dense network of 23 fog‐water collectors located along the Mediterranean Iberian Peninsula for 2003–2012 were analysed in relation to synoptic patterns and the three‐teleconnection indices. The major findings are: (a) The most favourable synoptic patterns for fog‐water collection are maritime advections carrying humidity from the Mediterranean basin, and cyclonic circulations, whereas anti‐cyclonic situations generally led to large number of foggy days with low fog‐collection rates. (b) In terms of winds at 850 hPa, the most favourable low‐level flows for fog‐water collection are associated with strong winds (>5.1 m s−1) from the Mediterranean. Atlantic winds generally cause a greater number of fog days than Mediterranean winds, with less fog‐water collection rates. (c) WeMOi has the greatest influence on fog‐water collection, mainly during winter and spring months, with statistically significant negative relationships for most of the stations. MOi also shows a great influence, with a large number of statistically significant negative correlations, mainly during the same months as WeMOi. Lastly, NAOi presented the lowest and no significant negative correlations with fog‐water collection.
Comprehensive Frailty Severity Index for End‐Stage Liver Disease Predicts Early Outcomes After Liver Transplantation
Authors: Raveh Yehuda , Livingstone Joshua , Mahan Jared , Tekin Akin , Selvaggi Gennaro , Bowdon‐Romero Molly , Nicolau‐Raducu Ramona
Published: November 2019

Background

Frailty is rampant in candidates of liver transplantation (LT); however, its impact on posttransplant survival is inconclusive. Most studies have used a single measure of frailty; however, a comprehensive frailty severity index (FSI) has not been developed. The objectives of this study were to (1) evaluate frailty utilizing several metrics, (2) develop an FSI for end‐stage liver disease (ESLD), and (3) determine its predictive abilities for outcomes after LT.

Methods

Frailty metrics included (1) modified nutrition assessment of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition that includes height‐adjusted third lumbar vertebra psoas mass index, (2) physical performance assessment combining Karnofsky Performance Status and pressure injury scale, and (3) Controlling Nutritional Status as a measure of severity of liver disease and inflammation.

Results

Moderate to severe frailty was reported in 52%–97% of recipients depending on the metric. A statistically significant threshold FSI value was identified for each adverse outcome studied. FSI ≥ 14 was associated with decreased survival (88% vs 97% for FSI < 14).

Conclusions

The proposed FSI for ESLD is predictive of poorer outcomes after LT.
Full axillary lymph node dissection and increased breast epidermal thickness 1 year after radiation therapy for breast cancer
Authors: Lin Jolinta Y. , Yang Xiaofeng , Serra Monica , Miller Andrew H. , Godette Karen D. , Kahn Shannon T. , Henry Simone , Brown Gabrielle , Liu Tian , Torres Mylin A.
Published: November 2019

Background

We previously reported a prospective study showing axillary lymph node dissection (ALND) is associated with increased breast skin thickening during and 6 weeks post‐radiation therapy (RT), and now report ALND's long‐term impact at 1 year.

Methods

Among 66 women who received whole breast RT after lumpectomy, objective ultrasound measurements of epidermal thickness over four quadrants of the treated breast were measured at five time points: before RT, week 6 of RT, and 6 weeks, 6 months, and 1 year post‐RT. Skin thickness ratio (STRA) was generated by normalizing for corresponding measurements of the contralateral breast.

Results

A total of 2,436 ultrasound images were obtained. Among 63 women with evaluable data at 1 year, mean STRA significantly increased at 6 months (absolute mean increase of 65%, SD 0.054), and remained elevated at 1 year post‐RT (absolute mean increase of 44%, SD 0.048). In multivariable analysis, ALND compared to sentinel lymph node biopsy, longer interval between surgery and RT, increased baseline STRA, and Caucasian race predicted for more severe changes in STRA at 1 year compared to baseline (all P < .05).

Conclusions

In the setting of whole breast RT, our findings suggest that ALND has long‐term repercussions on breast skin thickening.
Sonoanatomy and Pathology of the Gluteus Minimus Tendon
Authors: Hoffman Douglas F. , Sellon Jacob L. , Moore Brittany J. , Smith Jay
Published: November 2019

Gluteus minimus disorders are a potential source of greater trochanteric or anterior hip pain. Disorders of the gluteus minimus tendon most commonly occur in conjunction with gluteus medius tendon abnormalities but can also occur in isolation. Understanding the sonoanatomy of the gluteus minimus muscle‐tendon unit is a prerequisite for recognizing and characterizing gluteus minimus tendon disorders, which, in turn, guides treatment for patients with greater trochanteric or anterior hip pain syndromes.
Efficacy of Ultrasound and Shear Wave Elastography for the Diagnosis of Breast Cancer–Related Lymphedema
Authors: Polat Ahmet Veysel , Ozturk Mesut , Polat Ayfer Kamali , Karabacak Ufuk , Bekci Tumay , Murat Naci
Published: November 2019

Objectives

To assess the feasibility of ultrasound and shear wave elastography (SWE) in the diagnosis of breast cancer–related lymphedema.

Methods

Forty‐one patients with a history of unilateral breast surgery and axillary dissection or sentinel lymph node excision were included in this prospective study. The patients were classified as having normal findings, latent lymphedema, and clinical lymphedema on the basis of a physical examination, lymphedema index scores, and limb circumference measurements. The thickness and stiffness of the cutaneous and subcutaneous tissue of the forearm and arm were measured by ultrasound and SWE. The thickness and stiffness of the cutaneous and subcutaneous tissue of the affected limb and contralateral limbs of the normal, latent lymphedema, and clinical lymphedema groups were compared.

Results

The mean age ± SD of the 41 patients was 55.42 ± 10.12 years. There were 15 patients with normal findings, 10 with latent lymphedema, and 16 with clinical lymphedema. In the latent lymphedema group, the thickness measurements of the cutaneous tissue of the affected forearm and the cutaneous and subcutaneous tissue of the affected arm were significantly greater than those of the contralateral forearm and arm (P = .034; P = .022; and P = .002, respectively), and the stiffness measurements of the cutaneous and subcutaneous tissue of the affected forearm were significantly greater than those of the contralateral forearm (P = .011; and P = .002). In the clinical lymphedema group, the thickness and stiffness measurements of the cutaneous and subcutaneous tissue of the affected forearm and arm were significantly greater than those of the contralateral limb (P < .001–P = .032).

Conclusions

Ultrasound and SWE are effective for diagnosing breast cancer–related lymphedema even at a latent stage.