bluuebunny/crossref_metadata_2025 huggingface dataset:
Separation of Serum Proteins by Density Gradient Electrophoresis
Authors: Colehour J K
Published: January 2020

Detailed directions are given for the density gradient electrophoretic separation of serum into protein fractions of gamma, beta, and alpha globulins, and normal and prealbumin.
Commercial Control Sera in the Clinical Chemistry Laboratory
Authors: Klugerman Maxwell R , Boutwell Joseph H
Published: January 2020

1. The control of precision and accuracy in a clinical chemistry laboratory can be achieved only by knowledgeable and careful use of "concurrent standardization" together with the use of control sera in routine analysis. That is, within each series of analyses, both reference standards and control sera should be included as the only means by which the ultimate in reliability can be achieved.

2. The use of standard curves or calibration factors can be tolerated only when the pure reference standard is difficult to obtain, prepare, or maintain. In such cases, however, the curves or factors should be rechecked frequently and a control serum analyzed concurrently with the unknown.

3. The manufacturer or supplier should refrain from advertising his product as simultaneously a standard and a control. Secondly, he should ascertain the shelf-life of his product under the most rigorous conditions likely to be encountered and indicate this information on the label of the individual bottle or on the container of that lot of control sera. Finally, he should make every effort to reduce the cost of his product in order to make it practical for the clinical chemistry laboratory to establish and maintain an adequate control system.
Modification of the Spectrophotometric Determination of Ketone Bodies in Blood Enabling the Total Recovery of β-Hydroxybutyric Acid
Authors: Procos John
Published: January 2020

A method is described for the determination of ketone bodies in blood, based on (1) their conversion to acetone by boiling in Greenberg and Lester's microrefluxing units, (2) the reaction of acetone with alkaline salicylaldehyde by a modification of Thin and Robertson's microdiffusion technic, and (3) the colorimetric determination of salicylacetone in water.

A study of the effects of varying concentrations of dichromate and sulfuric acid on the recoveries of acetoacetic and β-hydroxybutyric acids is presented and the optimum reagent concentrations are established. Recoveries of 100 per cent are obtained for both acetoacetic and β-hydroxybutyric acids. The method is particularly sensitive to small changes of ketone bodies. In the range 0-8 mg. acetone per 100 ml. blood, differences of 0.06 mg./100 ml. are detected with ease.
A Method for Measurement of Cholesterol in Blood Serum
Authors: Mann George V
Published: January 2020

A method for measuring cholesterol in 0.1 ml. of blood serum is described. This uses the saponification and extraction procedure of Abell et al. (4) and the color reaction of Zlatkis et al. (7). The procedure is shown to be accurate and reproducible. It is compared with several commonly used procedures and shown to be equal or superior to these. An adaptation of the method to filter-paper stored samples described. The method is recommended for use in clinical laboratories.
A Simple, Effective Pipet Washer for the Clinical Chemistry Laboratory
Authors: Richter Helmut
Published: January 2020

A simple, effective system is presented by which pipets can be completely and thoroughly cleaned of lipids, blood, and other body fluids which tend to leave a coating—a problem common to hospital and other laboratories.
Determination of Urinary Creatine
Authors: Kurohara Samuel S
Published: January 2020

A method of separation of creatine using ion-exchange chromatography is described. This method is suitable for serial determinations of urinary creatine despite a small contribution by creatinine and guanidino compounds to the color value of the α-naphthol and diacetyl reaction. The creatine coefficients of four patients, determined in duplicates, before and after the induction of creatinuria by X-irradiation are presented to illustrate the applicability of the method described.
Measurement of Urinary Estrogens
Authors: Hobkirk R
Published: January 2020

In a commentary on the existing methodology for the determination of urinary estrogens, data are given for normal ranges in nonpregnancy and pregnancy urine as well as the expected interferences due to medication and substances occurring in high concentrations in disease states. Because of the wide range of normal excretion values, the point is made that only serial analyses of a patient's physiologic course (e.g., in pregnancy associated with diabetes) are of clinical value.
Some Practical Simplifications of Perspiration Electrolyte Analysis ("Sweat Test")
Authors: Dubowski Kurt M
Published: January 2020

A simple, practical, rapid, and effective routine system for recovery and analysis of abdominal perspiration samples is described. The results of its application to control subjects and patients with cystic fibrosis of the pancreas are reported and compared with those of other investigators.
Determination of Glucose by an Improved Enzymatic Procedure
Authors: Washko Mary E , Rice Eugene W
Published: January 2020

The glucose oxidase-peroxidase system for the enzymatic determination of glucose was investigated with respect to the instability of the enzyme reagent, the buffering capacity of the reaction milieu, and the stability and sensitivity of the final chromogen. An improved procedure was developed in which the enzyme solution is both stabilized and more adequately buffered by reconstitution in 40% aqueous glycerol containing 0.04 M phosphate buffer, pH 7.0. The sensitivity and stability of the colored product is markedly increased when a final sulfuric acid concentration of 4.9 N is used.
Modified Folin Methods for the Measurement of Urinary Creatine and Creatinine
Authors: Biggs H G , Cooper James Martin
Published: January 2020

Some of the variables in the Folin method for measurement of urinary creatine and creatinine were studied. The effects of varying the picric acid concentration, volume of solution, and heating time on the conversion of creatine to creatinine were investigated. A study was also made of the results obtained in the chromogenic reaction by varying the concentration of picric acid and sodium hydroxide.

The information from these experiments was utilized to modify the Folin procedure to yield a more convenient method for the measurement of urinary creatinine and creatine.
Effect of High Room-Temperature on Estimation of Blood Cholesterol by Bloor's Method
Authors: Nath R L , Ghosh N K
Published: January 2020

Data are presented showing that in determinations of blood cholesterol in tropical climates, evaporation of solvent during filtration at room temperature (37°) is the cause of erroneous high results. Adjustment of solvent volumes is suggested to correct this.
The Use of lon-Free Serum as a Standard in Clinical Chemistry
Authors: Levy Arthur L
Published: January 2020

An "ion-free serum" is commercially available which is free of most inorganic ions, several enzymes, and many small organic molecules. Other materials are considerably reduced in amount.

The use of this serum for the preparation of blood chemistry standards is described. Varying amounts of ion-free serum and the desired constituent are combined at the time of analysis to cover any range desired. The advantages of this serum are increased accuracy, avoidance of deterioration, and greater versatility.
Determination of Galactose in Blood
Authors: Smith Margaret , Thomas Lloyd E
Published: January 2020

A modification of the orcinol procedure of Brückner has been developed to permit rapid analysis of galactose in blood. The method is sensitive to increased amounts of galactose in blood filtrates, but accurate estimations of low concentrations are difficult because of interfering substances. Calculation of results has been simplified by the use of constants. Their derivations are given.
Serum Glutamic-Oxaloacetic Transaminase Activity
Authors: Amador Elias , Wacker Warren E C
Published: January 2020

The spectrophotometric and colorimetric procedures for the assay of serum glutamic-oxaloacetic transaminase (SGOT) activity are assessed. Directions are given for the preparation of reagents and for a procedure that corrects the errors in the spectrophotometric method without altering its basic simplicity. The colorimetric procedure employing dinitrophenylhydrazine showed poor accuracy due, in part, to a large and variable blank.

The proposed procedure eliminates the troublesome group of analytic results, "borderline" measurements, a source of diagnostic uncertainty.
Estimation of Serum Albumin: A Comparison of Three Methods
Authors: Keyser J W , Stephens B T
Published: January 2020

Comparison of the methyl orange method of estimation of serum albumin with sodium sulfate fractionation and electrophoretic fractionation on paper showed that the sodium sulfate method may occasionally give much lower results than the other two. This may be due to loss of albumin on the precipitated globulins. Of the three, the methyl orange method tended to give the highest results, but was apparently unaffected by the presence of large amounts of abnormal proteins found in the serum of patients with multiple myelomatosis.

In agreement with previous investigators, the dye-binding power of electrophoretically separated albumin was found to be greater than that of the (total) globulins.
Dynamic Control of Calcium, Phosphate, Citrate, and Glucose Levels in Blood Serum
Authors: Natelson Samuel , Pincus Joseph B , Rannazzisi Gandolfo
Published: January 2020

The effect of ACTH, adrenaline, noradrenaline, insulin, parathormone, hydrocortisone, and glucagon on the homeostatic mechanism controlling serum glucose, citrate, calcium, phosphorus, and potassium was studied in fasting rabbits and children. Citrate levels are kept in balance by ACTH, adrenaline, and glucagon, which raise the levels, and by insulin, which lowers them. Stress alone raises citrate levels, probably through adrenaline and ACTH effects.

Calcium levels in rabbits are markedly lowered by ACTH, given I.M., to tetany levels. Adrenaline has a similar, but mild, effect. I. M. parathormone raises calcium levels slowly. ACTH and parathormone may be the antagonists in keeping calcium levels constant.

Insulin, adrenaline, ACTH, glucagon, and parathormone lower phosphate levels. Major factors in lowering phosphate levels acutely evidently are insulin, which moves phosphate into the cell, and parathormone, which moves it through the kidney.

Insulin, adrenaline, ACTH, and glucagon lower potassium levels in the rabbit. Only noradrenaline causes a significant rise.

In the normal child only citrate moves in the same direction (elevates) as in the rabbit after ACTH.

Children with CNS abnormality behaved like normal children except for 3 with febrile convulsions.

Homeostatic control of the constituents studied may be accomplished in the rabbit and the human by a balance of hormonal factors.
Capillary Blood pH by a Dilution Technic
Authors: Ware Arnold G , Nowack Jacques , Westover Leola
Published: January 2020

A technic is described for collecting arterialized capillary blood in a small heparinized polyethylene centrifuge tube. The ρH is measured after dilution and injection into a Beckman micro blood ρH Assembly. Dilution of the blood with saline results in an average increase of 0.027 ρH units. This change in ρH on dilution is eliminated by inclusion of calcium in the diluent.

The ρH of capillary blood drawn and measured as described does not differ significantly from that of undiluted arterial blood drawn from the same patient.
Quantitative Range of Nessler's Reaction with Ammonia
Authors: Leonard Reid H
Published: January 2020

The minimum concentration of mercury required for Nessler's reaction with ammonia approaches 86% of the stoichiometric value. When the mercury concentration is low, nitrogen can be determined in small amounts in the ultraviolet region. The maximum accuracy and working range are shown for 350-600 mµ.
The Unreliability of the Titan Yellow Method for the Determination of Magnesium in Patients Receiving Intravenous Calcium Gluconate
Authors: Anast Constantine S
Published: January 2020

Gluconate was found to interfere with the determination of magnesium by the Titan yellow method. With this method, false low results were found in the serum and urine of patients receiving intravenous calcium gluconate. The interference can be prevented by ashing of the specimen.
Local Depletion of Click Beetle Populations by Pheromone Traps Is Weather and Species Dependent
Authors: van Herk Willem G , Vernon Robert S
Published: January 2020

Several Agriotes click beetle species are important pests of vegetables and field crops. Monitoring for beetles is generally done with pheromone-baited traps maintained in permanent locations. Since dispersal is mostly by walking, such traps may deplete populations around them, leading to underestimations of populations relative to nontrapped areas, and of concomitant risk of wireworm damage to nearby crops. We placed sets of five pitfall traps in field headland areas in 2015–2017, of which two were baited with Agriotes obscurus (L) or Agriotes lineatus (L) (Coleoptera: Elateridae) pheromone. Of these, one was maintained in a permanent location, while the other moved among the remaining positions. Traps were checked weekly over the emergence period. For A. obscurus, fixed and moving traps initially collected similar numbers, but the latter collected significantly more later in the season, indicating depletion around fixed traps. Depletion was most pronounced after a period of cold weather, and around the peak swarming period. Depletion observed for A. lineatus was not statistically significant. This indicates pheromone-baited traps used for walking insects can underestimate populations, but depletion rates vary with species and temperature and should be accounted for when traps are used to develop action thresholds or time control strategies.
Antibiotic resistance: turning evolutionary principles into clinical reality
Authors: Andersson Dan I , Balaban Nathalie Q , Baquero Fernando , Courvalin Patrice , Glaser Philippe , Gophna Uri , Kishony Roy , Molin Søren , Tønjum Tone
Published: January 2020

Antibiotic resistance is one of the major challenges facing modern medicine worldwide. The past few decades have witnessed rapid progress in our understanding of the multiple factors that affect the emergence and spread of antibiotic resistance at the population level and the level of the individual patient. However, the process of translating this progress into health policy and clinical practice has been slow. Here, we attempt to consolidate current knowledge about the evolution and ecology of antibiotic resistance into a roadmap for future research as well as clinical and environmental control of antibiotic resistance. At the population level, we examine emergence, transmission and dissemination of antibiotic resistance, and at the patient level, we examine adaptation involving bacterial physiology and host resilience. Finally, we describe new approaches and technologies for improving diagnosis and treatment and minimizing the spread of resistance.
New Words and New Forms of Linguistic Purism in the 21st Century: The Italian Debate
Authors: Marello Carla
Published: January 2020

Unlike communities of speakers of other Romance languages such as French and Spanish, it has often been noticed that many Italian speakers are not particularly concerned by the inflow of foreign (mainly English) words. One reason for this, according to some scholars, is that standard Italian does not stir up linguistic identity for many native users, while English enjoys great prestige as the international language. In this paper, positions on neologisms of foreign origin are illustrated, using recently updated monolingual Italian dictionaries and also comments on neologisms collected from blogs and websites. Although they have a different status and degree of representativeness, the latter respond faster than dictionaries to doubts concerning the use of loans in Italian texts.
Applications of the Ohsawa–Takegoshi Extension Theorem to Direct Image Problems
Authors: Deng Ya
Published: January 2020

In the 1st part of the paper, we study a Fujita-type conjecture by Popa and Schnell and obtain an effective bound on the generic global generation of direct images of twisted pluricanonical bundles. We also point out the relation between the Seshadri constant and the optimal bound. In the 2nd part, we give an affirmative answer to a question by Demailly, Peternell, and Schneider in a more general setting. As byproducts of our proofs, we extend a result by Fujino and Gongyo on images of weak Fano manifolds to the Kawamata log terminal settings and refine a theorem by Broustet and Pacienza on the rational connectedness of the image.
Dietary cadmium chloride impairs shell biomineralization by disrupting the metabolism of the eggshell gland in laying hens
Authors: Zhu Mingkun , Li Huaiyu , Miao Liping , Li Lanlan , Dong Xinyang , Zou Xiaoting
Published: January 2020

In this study, we identified cadmium (Cd) as a potential endocrine disruptor that impairs laying performance, egg quality, and eggshell deposition and induces oxidative stress and inflammation in the eggshell glands of laying hens. A total of 480 38-wk-old laying hens were randomly assigned into 5 groups that were fed a basal diet (control) or a basal diet supplemented with Cd (provided as CdCl2·2.5 H2O) at 7.5, 15, 30, and 60 mg Cd per kg feed for 9 wk. The results showed that, when compared with the control group, a low dose of dietary Cd (7.5 mg/kg) had positive effects on egg quality by improving albumen height, Haugh unit, yolk color, and shell thickness at the third or ninth week. However, with the increase in the dose and duration of Cd exposure, the laying performance, egg quality, and activities of eggshell gland antioxidant enzymes (catalase [CAT], glutathione peroxide [GSH-Px]), and ATPase (Na+/K+-ATPase, Ca2+-ATPase, and Mg2+-ATPase) deteriorated, and the activity of total nitric oxide synthase (T-NOS) and the level of malondialdehyde (MDA) increased significantly (P < 0.05). The histopathology and real-time quantitative PCR results showed that Cd induced endometrial epithelial cell proliferation accompanied by upregulation of the mRNA levels of progesterone receptor (PgR) and epidermal growth factor receptor (EGFR), downregulation of the mRNA levels of estrogen receptor α (ERα) and interleukin 6 (IL6), and inflammation of the eggshell gland accompanied by significantly increased expression of complement C3 and pro-inﬂammatory cytokine tumor necrosis factor α (TNFα) (P < 0.05). In addition, the ultrastructure of the eggshell showed that dietary supplementation with 7.5 mg/kg Cd increased the palisade layer and total thickness of the shell, but with the increase in dietary Cd supplementation (30 and 60 mg/kg) the thickness of the palisade layer and mammillary layer decreased significantly (P < 0.05), and the outer surface of the eggshell became rougher. Correspondingly, the expression of calbindin 1 (CALB1), ovocalyxin-32 (OCX-32), ovocalyxin-36 (OCX-36), osteopontin (SPP1), and ovocledidin-17 (OC-17) decreased significantly (P < 0.05) with increasing dietary Cd supplementation. Conclusively, the present study demonstrates that dietary supplementation with Cd negatively affects laying performance, egg quality, and eggshell deposition by disturbing the metabolism of eggshell glands in laying hens but has a positive effect on egg quality at low doses.
An Experimental Pharmacokinetics Study of Diazepam and Its Metabolites in Oral Fluid of Chinese Population
Authors: Wang Le-le , Ren Xin-xin , He Yi , Cui Guan-feng , Wei Zhi-wen , Yun Ke-ming
Published: January 2020

Diazepam abuse is widespread all over the word, leading to an increasing number of forensic cases such as suicide, drug-driving and robbery, but relevant studies are limited regarding the extraction of diazepam and its metabolites in oral fluid. This study aimed to investigate the pharmacokinetics of diazepam and its metabolites in oral fluid after a single oral dose in healthy volunteers. There was a total of 28 volunteers, and each ingested 5 mg diazepam orally, then ~2 mL oral fluid were collected from each participant at post-consumption time-points of prior (zero), 1, 2, 4, 8, 12, 24 h and 2, 3, 6, 12 and 15 days, respectively. All samples were extracted with solid-phase extraction and analyzed with high-performance liquid chromatography-tandem mass spectrometry method, and diazepam and nordazepam were detected in the oral fluid of volunteers. Pharmacokinetics of diazepam in oral fluid conformed to a two-compartment model, and k01_HL, k12_HL, k10_HL were 0.7 ± 1.1, 31.4 ± 68.5, 12.1 ± 11.6 h, respectively, nordazepam conformed to an one-compartment model, and k01_HL, k10_HL were 41.5 ± 44.8, 282.3 ± 365.5 h, respectively. Both diazepam and nordazepam could be detected continuously for 15 days, although there were individual differences, and the results regarding diazepam detecting in oral fluid will be of much help in forensic science and drug screening filed.
Results of hip arthroscopy in elite level water polo players with femoroacetabular impingement: return to play and patient satisfaction
Authors: Ramos Nicholas , Youssefzadeh Keon , Gerhardt Michael , Banffy Michael
Published: January 2020

Water polo places significant stress on the hip joint requiring repetitive hip flexion and rotation to elevate the body out of water for passing, shooting and blocking. Femoroacetabular impingement (FAI) is common in water polo athletes; however, no study to date has investigated the results of hip arthroscopy in this patient population. The purpose of this study was to determine return to play rates and satisfaction following hip arthroscopy for FAI in a cohort of elite level water polo players. A retrospective review of our surgical database was performed. Collegiate water polo players with clinical and radiographic FAI who underwent hip arthroscopy were identified. Pre- and post-operative modified Harris hip scores (mHHSs) were obtained. Patient surveys were administered to determine return to play rates, level of return to play, timing of return and patient satisfaction. A Wilcoxon ranked sum test was performed to compare pre- and post-operative outcome scores. Ten patients met inclusion criteria. Average age was 19.5 years old (SD  ±1.08). All patients were male Division 1 collegiate water polo players. Median mHHS improved from 66.0 (SD  ±7.9) pre-operatively to 89.5 (SD  ±3.2) at average 1.6 years (range: 0.4–3.6 years) post-operatively. Patient survey responses demonstrated a 100% return to water polo and 100% return to the same level of play (NCAA Division 1) at mean 5.75 months (SD  ±1.8). All patients (10/10) reported being satisfied with their surgical result. Our study results, suggest that return to sport rates and patient satisfaction are high in water polo players who undergo hip arthroscopy for FAI.
The Role of Neoadjuvant Chemotherapy in Patients With Resectable Malignant Pleural Mesothelioma—An Institutional and National Analysis
Authors: Voigt Soraya L , Raman Vignesh , Jawitz Oliver K , Bishawi Muath , Yang Chi-Fu Jeffrey , Tong Betty C , D’Amico Thomas A , Harpole David H
Published: January 2020

Background

There is no standard of care with respect to the use of neoadjuvant chemotherapy (NAC) in resectable malignant pleural mesothelioma (MPM). We performed an intention-to-treat analysis with data from a single institution and the National Cancer Database (NCDB) to identify whether the use of NAC impacts survival in resectable MPM.

Methods

Patients with MPM who had surgery with curative intent at Duke University from 1995 to 2017 were selected, and the 2004–2015 NCDB was used to identify MPM patients with clinical stage I–IIIB who underwent definitive surgery. For both cohorts, patients were stratified by receipt of NAC. Primary outcomes were overall survival and postresection survival (RS), which were estimated using Kaplan-Meier and multivariable Cox proportional hazards models.

Results

A total of 257 patients met inclusion criteria in the Duke cohort. Compared with immediate resection (IR), NAC was associated with similar overall survival but an increased risk for postresection mortality in both unmatched (adjusted hazard ratio [HR] = 1.85, 95% confidence interval [CI] = 1.21 to 2.83) and propensity-matched (HR = 1.62, 95% CI = 1.03 to 2.55) cohorts. A total of 1949 NCDB patients were included: 1597 (81.9%) IR and 352 (18.1%) NAC. RS was worse for patients undergoing NAC in both unmatched (HR = 1.85, 95% CI = 1.21 to 2.83) and propensity-matched (HR = 1.29, 95% CI = 1.06 to 1.57) analyses compared with patients receiving IR.

Conclusions

In this intention-to-treat study, NAC was associated with worse RS compared with IR in patients with MPM. The risks and benefits of induction therapy should be weighed before offering it to patients with resectable MPM.
Surpassing Certainty with Janet Mock: A Dialogue
Authors: Lyle Timothy S
Published: January 2020

Janet Mock—writer, activist, television host, director—has become a leading voice for transgender women of color in the twenty-first century. In 2014, Mock published Redefining Realness with Atria Books. Shortly thereafter, Mock became a New York Times best-selling writer and garnered the critical praise of folks such as bell hooks, Melissa Harris-Perry, Oprah Winfrey, and more. Hooks described Mock’s work as a guide to transformation, Harris-Perry situated her work in the deep tradition of life writing in African American literature, and Winfrey called her a “fearless new voice” who “changed my way of thinking.” In 2017, Mock published her second memoir, Surpassing Certainty, marking a rare moment in which a transgender woman-of-color writer released a second book with a major publisher.

During our conversation at Babbalucci, a restaurant in her beloved Harlem neighborhood, Mock reflected on her first book in light of the writing of her sophomore release. She also shared insight about writing love and dating storylines for transgender women of color, an amplified focus in Surpassing Certainty, and she discussed the dynamics of disclosure in narrative and life. Further, she ruminated about what constitutes home for her and how to write about space and place. Such remarks importantly center her Hawaiian roots and her multi-ethnic identity. Finally, Mock offered her most recent thoughts on being a trans woman of color in the public sphere in a turbulent national climate—particularly for folks on the margins of the already-marginalized.
‘The Uttermost Perfection of all Wind Instruments’: Franz Tausch (1762–1817) as Virtuoso Clarinettist and Director of the Conservatorium Der Bläseinstrumente in Berlin
Authors: Worthington Emily
Published: January 2020

The life of clarinettist Franz Tausch (1762–1817) spanned a formative period of development both for his instrument and the culture he operated within, yet he has been neglected because of his lack of association with a major composer. Tausch received his musical education at the Mannheim and Munich courts, where he was exposed to broad cultural and musical influences. His compositions for clarinet show his playing to have foreshadowed the virtuosity associated with his pupils Heinrich Baermann and Bernhard Henrik Crusell. This can particularly be seen in his exploitation of the new possibilities afforded by instruments with a fully chromatic bottom octave, as well as in his incorporation of extreme high-register writing in his concertos. Tausch’s transition from a life of court service to successfully establishing himself within the diverse musical culture and social hierarchy of Berlin is documented in the changing nature of his compositions as well as contemporary written sources. His life is a case study of a trajectory typical of many musicians working at the end of the eighteenth century.
MAXI/SSC all-sky maps from 0.7 keV to 4 keV
Authors: Nakahira Satoshi , Tsunemi Hiroshi , Tomida Hiroshi , Nakashima Shinya , Kataoka Ryuho , Makishima Kazuo
Published: January 2020

By accumulating data from the Solid-state Slit Camera (SSC) on board the MAXI mission from 2009 to 2011, diffuse X-ray background maps were obtained in energies of 0.7–1.0, 1.0–2.0, and 2.0–4.0 keV. They are the first to be derived with a solid-state instrument, and to be compared with the previous ROSAT all-sky survey result. While the SSC map in the highest energy band is dominated by point sources and the Galactic diffuse X-ray emission, that in 0.7–1.0 keV reveals an extended X-ray structure, of which the brightness distribution is very similar to that observed with ROSAT about 20 years before. As in the ROSAT result, the emission is dominated by a bright arc-like structure, which appears to be part of a circle of ∼50° radius centered at about (l,b) ∼ (340°, 15°). In addition, the SSC map suggests a fainter and larger ellipse, which is elongated in the north–south direction and roughly centered at the Galactic center. The spectrum of these structures is explained as thin thermal emission from a plasma, with a temperature of ∼0.31 keV and an abundance of ∼0.3 solar. Based on SSC observation conditions including low solar activity, the solar wind charge exchange signals are estimated to be negligible in the present SSC maps, as well as in the >0.56 keV ROSAT map. A brief discussion is given on the results obtained.
Patents and non-invasive prenatal testing: Is there cause for concern?
Authors: Hawkins Naomi
Published: January 2020

Intellectual property rights are key to the translation of discoveries into clinical use in personalised medicine. This article explores the interaction of intellectual property rights, specifically patents, with the field of genomic personalised medicine, through empirical work investigating the role that patents play in the development and delivery of non-invasive prenatal testing (NIPT). Single gene testing (SGT) and NIPT represent examples of two different types of innovation likely to be important in personalised medicine, and which operate differently in terms of how the law is applied in practice. In SGT, on the one hand, previous studies demonstrate that patents have little impact on practice for those developing genetic tests in the public sector in the UK because they are largely ignored. In contrast, however, this qualitative interview study finds that law and law-in-practice in NIPT are much more convergent than found in SGT. Those involved in the development and delivery of NIPT are more aware of patents, and balance the costs and benefits of greater engagement or compliance with patent law, in relation to factors such as freedom to operate, litigation, and licensing, in favour of compliance. Compliance can take different forms; licensing is compliance, as is forbearance from using a patented invention in the absence of a patent licence. This article explores the factors relevant to patent law compliance in NIPT, and further considers the implications for the field of personalised medicine. It argues that, as the prevalent means to promote openness, access, and affordability in biomedicine are founded on the existing legal structures of intellectual property rights, such solutions will only be effective and adopted when these existing legal structures of intellectual property law are recognised and respected in the relevant field. It is therefore essential that such solutions only be deployed with a nuanced understanding of the operation of the law-in-practice.
Lower Reintubation Risk with Noninvasive Ventilation Plus High-Flow Nasal Oxygen
Authors: Rosenberg Karen
Published: January 2020

According to this study:

In patients receiving mechanical ventilation who are at high risk for extubation failure, the use of high-flow nasal oxygen with noninvasive ventilation immediately after extubation significantly reduces the risk of reintubation compared with the use of high-flow nasal oxygen alone.
Advocating for Washington state ARNP payment parity
Authors: Kaplan Louise , Gill Justin
Published: January 2020

Workforce and reimbursement data were collected from a 2018 survey of Washington state advanced registered nurse practitioners (ARNPs). Survey results will be used to improve workforce planning and advocate for payment parity legislation requiring health plans to pay ARNPs the same as physicians for the same service.
Serum Inflammatory Markers in Patients With Knee Osteoarthritis
Authors: Giordano Rocco , Petersen Kristian K. , Andersen Hjalte H. , Simonsen Ole , Arendt-Nielsen Lars
Published: January 2020

Objectives:

Osteoarthritis (OA) is known to be a slowly progressive disease that alters all tissue compartments of the joint involved with a characteristic degradation of the cartilage, bone remodeling, and inflammation. One of the prominent symptoms in OA patients is pain, but a few radiologic, inflammatory, or structurally related biomarkers have shown few if any associations with pain. This study aimed to assess serum levels of 92 markers involved in inflammatory pathways in patients with knee osteoarthritis (KOA) and evaluate their possible associations with the clinical pain intensity.

Materials and Methods:

Serum samples were collected from 127 KOA patients and 39 healthy participants with no knee pain. Each serum sample was analyzed for 92 inflammatory markers using the Proximity Extension Array (PEA) technology. Clinical pain intensity was assessed using a Visual Analog Scale, and patients completed the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire.

Results:

Fifteen markers were significantly different when comparing KOA patients and healthy participants. Two markers, fibroblast growth factor-21 and Eukaryotic translation initiation factor 4E-binding protein 1 (4E-BP1), correlated positively with pain intensity (R=0.235,P=0.008;R=0.233,P=0.008). Moreover, a linear regression model showed interleukin-6, macrophage colony-stimulating factor 1, fibroblast growth factor-21, and tumor necrosis factor superfamily member 12 (TWEAK) as significant independent parameters for pain intensity.

Discussion:

The associations between specific cytokines and KOA pain intensities provide new insights into the understanding of the underlying factors driving the pain in OA.
Accuracy for cytological evaluation in the detection of breast cancer among patients with pathologic nipple discharge: a PRISMA-compliant meta-analysis
Authors: Li Xiao-Qian , Xu Feng , Lei Chu-Qi , Li Jie , Jiang Hong-Chuan
Published: January 2020

Background:

Nipple discharge cytology is a simple non-invasive method that may provide valuable information for detecting underlying malignancy. Several studies have investigated the diagnostic value of cytology in breast cancer patients with pathological nipple discharge, but the results have been highly variable. Herein we presented a systematic review and meta-analysis of published studies pertaining to the diagnostic capacity of nipple discharge cytology in patients with breast cancer.

Methods:

A systematic literature search was performed (Medline/PubMed, Embase, Cochrane Library databases, and Google Scholar) to identify studies that investigated the diagnostic capacity of cytology with regard to breast cancer in patients with pathologic nipple discharge. Two independent researchers identified articles that assessed the sensitivity and specificity of cytological evaluation for breast cancer detection in patients with pathologic nipple discharge published between January 2000 and October 2018. Articles were only included in the meta-analysis if they met predetermined criteria. The characteristics of each study and the data they yielded were summarized. Quality assessment of all articles included was performed using the Methodological Index for Non-randomized Studies Criteria (MINORS) and the Quality Assessment of Diagnostic Accuracy Study 2 (QUADAS-2). Heterogeneity was tested via CochranQtest and theI2statistic using Stata 12.0 and Meta-DiSc 1.4 software, and meta-analysis was performed.

Results:

A total of 286 articles were identified, of which 12 articles including a total of 1476 patients were deemed eligible for inclusion in the meta-analysis. A random-effects model assessing the capacity of nipple discharge cytology to predict breast cancer yielded pooled sensitivity 63% (95% confidence interval [CI]: 53%–72%), specificity 95% (95% CI: 87%–98%), positive likelihood ratio 12.35 (95% CI: 4.87–31.34), and negative likelihood ratio 0.39 (95% CI: 0.30–0.50). The diagnostic odds ratio was 31.88 (95% CI: 11.30–89.98). The area under the summary receiver operating characteristic curve was 0.79 (95% CI: 0.75–0.82).

Conclusion:

The current meta-analysis suggests that nipple discharge cytology is a useful diagnostic modality for detection of breast cancer in patients with pathological nipple discharge, with moderate sensitivity and high specificity.
Men Receive Three Times More Industry Payments than Women Academic Orthopaedic Surgeons, Even After Controlling for Confounding Variables
Authors: Forrester Lynn Ann , Seo Lauren J. , Gonzalez Leah J. , Zhao Caixia , Friedlander Scott , Chu Alice
Published: January 2020

Background

In 2016, orthopaedic surgeons received nearly USD 300 million from industry, with the top 10% of recipients making more than 95% of the total amount. The degree to which gender may be associated with industry compensation has not been well explored; however, this may be confounded by a number of variables, including academic productivity, experience, and other factors. We wished to explore the variability in payment distribution by gender after controlling for these factors.

Questions/purposes

(1) Do men or women academic orthopaedic surgeons receive more payments from industry? (2) To what degree do any observed differences between the genders persist, even after accounting for identifiable factors, including academic rank, scholarly productivity, regional location of university, subspecialty selection as identified by fellowships completed, and years since completion of residency?

Methods

This study was a cross-sectional retrospective analysis of surgeons practicing in orthopaedic surgery academic departments in the United States. Academic orthopaedic surgery departments were identified using the Fellowship and Residency Electronic Interactive Database. Publicly available data on gender, academic rank, scholarly productivity, regional location of university, fellowships completed, and years since residency graduation were collected from institutional websites. Industry funding data for 2016 were obtained from the Centers for Medicare & Medicaid Services Open Payments Database, and scholarly productivity data through 2017 were collected from Scopus. A total of 2939 academic orthopaedic surgeons, 2620 (89%) men and 319 (11%) women from 126 programs were identified. Men and women surgeons were different in most of the variables collected, and all except region of university were associated with differences in industry payments.

Results

The median payment for men surgeons was greater than that for women (USD 1027 [interquartile range USD 125-USD 9616] versus USD 177 [IQR USD 47-USD 1486]; difference of medians, USD 850; p < 0.001]. After accounting for potentially confounding variables like faculty rank, years since residency, H-index and subspecialty choice, women faculty members still received only 29% of payments received by otherwise comparable men orthopaedists (beta coefficient for gender = 0.29 [95% CI 0.20 to 0.44; p < 0.001]).

Conclusions

Women academic orthopaedic surgeons received only 29% of the industry payments received by men, even after controlling for faculty rank, years since residency, H-index, and subspecialty selection. This gender-related disparity may hinder the career advancement of women orthopaedic surgeons.

Clinical Relevance

Increased transparency by companies can help guide orthopaedic surgeons who wish to receive industry funding.
French Kiss Technique: An Anatomical Study and Description of a New Method for Safe Lip Eversion
Authors: Trévidic Patrick , Criollo-Lamilla Gisella
Published: January 2020

BACKGROUND

To minimize complications with injectable fillers, aesthetic practitioners need a detailed knowledge of facial anatomy.

OBJECTIVE

To describe a novel approach (“subtractive anatomy”) to identify locations where lip eversion using filler injections would be well tolerated and to evaluate the “French kiss technique” (FKT) to enhance the length of the lips using a low cohesivity hyaluronic acid filler.

MATERIALS AND METHODS

Twenty hemifaces were dissected from 10 nonembalmed, nonfrozen Caucasian cadavers to assess subtractive anatomy. The FKT “proof-of-concept” evaluation enrolled 120 patients (114 women; mean age 42 years).

RESULTS

The arterial supply of the lips shows marked anatomical variations between patients and when comparing sides of the face in the same person. The dissections revealed a “safe area” for filler injections in the submucosal plane 3 to 4 mm above the vermilion–mucosa junction of the upper lip and 3 to 5 mm below the vermilion–mucosa junction of the lower lip. Preliminary results suggest that FKT is associated with very good cosmetic outcomes and no major complications.

CONCLUSION

Based on our anatomical studies and the literature, we developed the novel FKT for the injection of lip fillers, which produced a marked natural lip plumping effect. Further evaluation is underway.
Synergistic effect of the association between lidocaine and magnesium sulfate on peri-operative pain after mastectomy
Authors: Mendonça Fabricio T. , Pellizzaro Douglas , Grossi Breno J. , Calvano Luise A. , de Carvalho Luiz S.F. , Sposito Andrei C.
Published: January 2020

BACKGROUND

Recently, the use of venous adjuvants, such as lidocaine and magnesium sulfate, has been gaining ground in multimodal analgesia. However, no study has evaluated the impact a combination of the two drugs.

OBJECTIVES

To evaluate the efficacy of venous adjuvants in reducing opioid consumption and pain scores after mastectomy.

DESIGN

Randomised, double-blind, parallel-group, noninferiority clinical trial with a 1 : 1 : 1 : 1 allocation ratio.

SETTING

Hospital de Base do Distrito Federal, Brasilia, Federal District, Brazil from November 2014 to December 2017.

PATIENTS

One-hundred and ninety-eight patients were electively scheduled for mastectomy. Seventy-eight were excluded.

INTERVENTIONS

Intra-operative infusions of remifentanil (0.1 μg kg−1 min−1), lidocaine (3 mg kg−1 h−1), magnesium sulfate (50 mg kg−1 + 15 mg kg−1 h−1) or lidocaine with magnesium sulfate were used. All patients received standard general anaesthesia.

MAIN OUTCOME MEASURES

Peri-operative opioid consumption and pain scores.

RESULTS

The patients who received both lidocaine and magnesium sulfate group (n=30) consumed less alfentanil during surgery (P < 0.001) and less dipyrone (P < 0.001) and morphine (P < 0.001) in the postoperative period. Only two patients (6.7%) in the lidocaine and magnesium sulfate group needed morphine (P < 0.001). These requirements were significantly lower when compared with patients who received remifentanil (n=30; 76.6%) and magnesium sulfate (n=30; 70%; odds ratio 46.0, 95% confidence interval 8.69 to 243.25, P < 0.001, and odds ratio 32.66, 95% confidence interval 6.37 to 167.27, P < 0.001, respectively). The patients of the lidocaine and magnesium sulfate group had lower pain scores in the first 24 h postoperatively using the numerical rating scale and verbal rating scale at discharge from the postanaesthesia care unit (P < 0.001), after 12 h (P < 0.001) and after 24 h (P < 0.001) when compared with the other three groups.

CONCLUSION

Our findings suggest a synergistic effect of the use of both lidocaine and magnesium in peri-operative pain. This may be another potential strategy in the multimodal analgesia regimen.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT02309879.
Subcutaneous Injections of Nanofat Adipose-derived Stem Cell Grafting in Facial Rejuvenation
Authors: Menkes Sophie , Luca Mariotta , Soldati Gianni , Polla Luigi
Published: January 2020

Background:

We aimed to assess whether our novel Nanofat grafting procedure improves skin quality while yielding a regenerative effect and whether this novel technique can also achieve a lifting effect.

Methods:

Patients who requested nonsurgical facial rejuvenation were enrolled between June 2018 and December 2018. Fat was aspirated from the medial thigh, inner part of the knee, or lower abdomen regions. Following aspiration and flushing, microfat was obtained after washing with saline. This microfat was emulsified to obtain a Nanofat suspension, which was injected using a 25-G cannula into the subcutaneous layer at different facial sites. Images were obtained before and at 1, 3, and 6 months after facial rejuvenation. Patients were also administered a survey. Characterization of the isolated stromal vascular fraction (3 patients), and before/after biopsies were performed.

Results:

Fifty patients were included (2 men and 48 women; mean age, 35–65 years; mean follow-up, 9 months). The clinical results were apparent between 2 and 4 weeks after injection, and improvements were continuously observed until 6 months postoperatively. All patients confirmed an improvement in skin quality. A lifting effect was also observed. The data confirm that the Nanofat procedure does not damage cells, maintaining cell viability, and number of adipose-derived stem cells. Biopsies showed an increased dermal cellularity, vascular density, and elastic and collagen fiber density.

Conclusion:

Facial rejuvenation with subcutaneous Nanofat injections appears to be an effective method, representing a skin rejuvenation effect by modifying the pattern of the dermis, although additional studies are necessary.
Restoration of Ear Defects by Prefabricated Radial Forearm Flap
Authors: Trung Vo Thai , Van Long Pham , Van Huynh Thi
Published: January 2020

The case report involved a 36-year-old man. He was injured in a road traffic accident and had extensive third- and fourth-degree facial burns over the right side of his face, with complete loss of his right auricle. We performed a free flap coverage of the right face with the anterolateral thigh (ALT) flap. The reconstruction of his auricle was performed by culturing a cartilage framework on the forearm and transferring it straight to the original location to rebuild the new ear as free flap. Results were assessed 12 months after surgery. The follow-up is still short, but the patient is satisfied with the results achieved.