bluuebunny/crossref_metadata_2025 huggingface dataset:
Functional Nanomaterials in Biomedicine: Current Uses and Potential Applications
Authors: Diez‐Pascual Ana María , Rahdar Abbas
Published: June 2022

Nanomaterials, that is, materials made up of individual units between 1 and 100 nanometers, have lately involved a lot of attention since they offer a lot of potential in many fields, including pharmacy and biomedicine, owed to their exceptional physicochemical properties arising from their high surface area and nanoscale size. Smart engineering of nanostructures through appropriate surface or bulk functionalization endows them with multifunctional capabilities, opening up new possibilities in the biomedical field such as biosensing, drug delivery, imaging, medical implants, cancer treatment and tissue engineering. This article highlights up‐to‐date research in nanomaterials functionalization for biomedical applications. A summary of the different types of nanomaterials and the surface functionalization strategies is provided. Besides, the use of nanomaterials in diagnostic imaging, drug/gene delivery, regenerative medicine, cancer treatment and medical implants is reviewed. Finally, conclusions and future perspectives are provided.
Prognostic communication about lung cancer in the precision oncology era: A multiple‐perspective qualitative study
Authors: Petrillo Laura A. , Shimer Sophia E. , Zhou Ashley Z. , Sommer Robert K. , Feldman Jill E. , Hsu Kelly E. , Greer Joseph A. , Traeger Lara N. , Temel Jennifer S.
Published: June 2022

Background

Although most patients with cancer prefer to know their prognosis, prognostic communication between oncologists and patients is often insufficient. Targeted therapies for lung cancer improve survival yet are not curative and produce variable responses. This study sought to describe how oncologists communicate about prognosis with patients receiving targeted therapies for lung cancer.

Methods

This qualitative study included 39 patients with advanced lung cancer with targetable mutations, 14 caregivers, and 10 oncologists. Semistructured interviews with patients and caregivers and focus groups or interviews with oncologists were conducted to explore their experiences with prognostic communication. One oncology follow‐up visit was audio‐recorded per patient. A framework approach was used to analyze interview transcripts, and a content analysis of patient–oncologist dialogue was conducted. Themes were identified within each source and then integrated across sources to create a multidimensional description of prognostic communication.

Results

Six themes in prognostic communication were identified: Patients with targetable mutations develop a distinct identity in the lung cancer community that affects their information‐seeking and self‐advocacy; oncologists set high expectations for targeted therapy; the uncertain availability of new therapies complicates prognostic discussions; patients and caregivers have variable information preferences; patients raise questions about progression by asking about physical symptoms or scan results; and patients' expectations of targeted therapy influence their medical decision‐making.

Conclusions

Optimistic patient–oncologist communication shapes the expectations of patients receiving targeted therapy for lung cancer and affects their decision‐making. Further research and clinical guidance are needed to help oncologists to communicate uncertain outcomes effectively.
An intelligence model for detection of PCOS based on k‐means coupled with LS‐SVM
Authors: Faris Najlaa Nsrulaah , Miften Firsas Saber
Published: June 2022

Polycystic ovary syndrome (PCOS) is a hormonal disorder that affects women at an early age. Manual detection of PCOS is a challenging task for specialists, however, detection of PCOS as quick and accurate could save the lives of millions of women over the world. Current studies use high dimension features which leads to a low estimation accuracy, and high execution time. However, in this article, we develop a new intelligence system to classify PCOS based on k‐means coupled with a LS‐SVM (K‐M‐SVM) using a lower number of features. The original dataset is preprocessed and then k‐means is applied to select the most powerful features based on Euclidean distance to classify PCOS. It was found that the k‐means cluster had a high potential in selection the most influential features and eliminating the poor ones. As a result, a total of six features are chosen to represent PCOS data from the original features. The selected feature set are fed to the LS‐SVM to classify them into healthy and no healthy segments. Our findings showed that the proposed model (K‐M‐SVM) outperformed the state of the art, and it gained an accuracy of 99%.
Mechanistic Differences between Electrochemical Hydrogenation and Hydrogenolysis of 5‐Hydroxymethylfurfural and Their pH Dependence
Authors: Yuan Xin , Lee Kwanpyung , Bender Michael T. , Schmidt J. R. , Choi Kyoung‐Shin
Published: June 2022

Hydrogenation and hydrogenolysis are two important reactions for electrochemical reductive valorization of biomass‐derived oxygenates such as 5‐hydroxymethylfurfural (HMF). In general, hydrogenolysis (which combines hydrogenation and deoxygenation) is more challenging than hydrogenation (which does not involve the cleavage of carbon–oxygen bonds). Thus, identifying factors and conditions that can promote hydrogenolysis is of great interest for reductive valorization of biomass‐derived oxygenates. For the electrochemical reduction of HMF and its derivatives, it is known that aldehyde hydrogenation is not a part of aldehyde hydrogenolysis but rather a competing reaction; however, no atomic‐level understanding is currently available to explain their electrochemical mechanistic differences. In this study, combined experimental and computational investigations were performed using Cu electrodes to elucidate the key mechanistic differences between electrochemical hydrogenation and hydrogenolysis of HMF. The results revealed that hydrogenation and hydrogenolysis of HMF involve the formation of different surface‐adsorbed intermediates via different reduction mechanisms and that lowering the pH promoted the formation of the intermediates required for aldehyde and alcohol hydrogenolysis. This study for the first time explains the origins of the experimentally observed pH‐dependent selectivities for hydrogenation and hydrogenolysis and offers a new mechanistic foundation upon which rational strategies to control electrochemical hydrogenation and hydrogenolysis can be developed.
Immunogenic cell death‐inducing small molecule inhibitors: Potential for immunotherapy of cancer
Authors: Guo Zong Sheng , Kalinski Pawel , Chen Hongqi , Zhu Zhi
Published: June 2022

Small molecule inhibitors (SMIs) of key signalling pathways are known to induce multiple types of regulated cell death, including immunogenic cell death (ICD). The resulting antitumor immunity helps to overcome the resistance of cancer cells to cell death, resulting in improved cancer therapy. SMIs, especially those inducing multimodal cell death and ICD, can be critical components in rational combinations for cancer immunotherapy.
Internet of Things data management: A systematic literature review, vision, and future trends
Authors: Shirvanian Naser , Shams Maryam , Rahmani Amir Masoud
Published: June 2022

The Internet of Things (IoT) is expected to connect devices with unique identifiers over a network to create an equilibrium system with high speeds and volumes of data while presenting an interoperability challenge. The IoT data management system is indispensable for attaining effective and efficient performance because IoT sensors generate and collect large amounts of data used to express large data sets. IoT data management has been analyzed from various perspectives in numerous studies. In this study, a Systematic Literature Review (SLR) method was used to investigate the various topics and key areas that have recently emerged in IoT data management. This study aims to classify and evaluate studies published between 2015 and 2021 in IoT data management. Therefore, the classification of studies includes five categories, data processing, data smartness application, data collection, data security, and data storage. Then, studies in each field are compared based on the proposed classification. Each study investigates novel findings, simulation/implementation, data set, application domain, experimental results, advantages, and disadvantages. In addition, the criteria for evaluating selected articles for each domain of IoT data management are examined. Big data accounts for the highest percentage of data processing fields in IoT data management, at 34%. In addition, fast data processing, distributed data, artificial intelligence data with 22%, and data uncertainty analysis account for 11% of the data processing field. Finally, studies highlight the challenges of IoT data management and its future directions.
Trapping and releasing of single microparticles and cells in a microfluidic chip
Authors: Lv Dan , Zhang Xiaoling , Xu Mengli , Cao Wenyue , Liu Xing , Deng Jinan , Yang Jun , Hu Ning
Published: June 2022

A microfluidic device was designed and fabricated to capture single microparticles and cells by using hydrodynamic force and selectively release the microparticles and cells of interest via negative dielectrophoresis by activating selected individual microelectrodes. The trap microstructure was optimized based on numerical simulation of the electric field as well as the flow field. The capture and selective release functions of the device were verified by multi‐types microparticles with different diameters and K562 cells. The capture efficiencies/release efficiencies were 95.55% ± 0.43%/96.41% ± 1.08% and 91.34% ± 0.01%/93.67% ± 0.36% for microparticles and cells, respectively. By including more traps and microelectrodes, the device can achieve high throughput and realize the visual separation of microparticles/cells of interest in a large number of particle/cell groups.
Transformer‐based time series prediction of the maximum power point for solar photovoltaic cells
Authors: Agrawal Palaash , Bansal Hari Om , Gautam Aditya R. , Mahela Om Prakash , Khan Baseem
Published: June 2022

This paper proposes an improved deep learning‐based maximum power point tracking (MPPT) in solar photovoltaic cells considering various time series‐based environmental inputs. Generally, artificial neural network‐based MPPT algorithms use basic neural network architectures and inputs which do not represent the ambient conditions in a comprehensive manner. In this article, the ambient conditions of a location are represented through a comprehensive set of environmental features. Furthermore, the inclusion of time‐based features in the input data is considered to model cyclic patterns temporally within the atmospheric conditions leading to robust modeling of the MPPT algorithm. A transformer‐based deep learning architecture is trained as a time series prediction model using multidimensional time series input features. The model is trained on a dataset containing typical meteorological‐year data points of ambient weather conditions from 50 locations. The attention mechanism in the transformer modules allows the model to learn temporal patterns in the data efficiently. The proposed model achieves a 0.47% mean average percentage error of prediction on non‐zero operating voltage points in a test dataset consisting of data collected over a period of 200 consecutive hours; resulting in the average power efficiency of 99.54% and peak power efficiency of 99.98%. The proposed model is validated through real‐time simulations. The proposed model performs power point tracking in a robust, dynamic, and nonlatent manner, over a wide range of atmospheric conditions.
Analysis of damage characteristics of fine and medium‐fine cracked sandstones under a complex stress path
Authors: Hu Huarui , Xia Binwei , Li Yang , Luo Yafei , Peng Jiajun
Published: June 2022

In underground engineering such as mining and tunnel excavation, the rock mass is often subjected to repeated loading and unloading stress environments. Herein, true triaxial cyclic loading and unloading tests are carried out on fine sandstone and medium‐fine sandstone specimens with cracks of different angles. The test results show that the mechanical properties of fine sandstone and medium‐fine sandstone samples show obvious differences, and the crack angle has a significant effect on the mechanical properties of the sandstone specimen. During the experimentation, the expansion phenomenon of medium‐fine sandstone is more obvious than that of fine sandstone, and its brittleness is also weaker. The damage law of the sample has nothing to do with the type of sandstone. The damage caused by the stress in the σ1 direction varies linearly with the cumulative damage of the specimen, however, the damage caused by the directions of σ2 and σ3 grow nonlinearly in terms of the cumulative damage of the specimen. The hysteretic loop dissipated energy of the same type of sandstone specimens at different angles are dissimilar, and the dissipated energy increases with the increase of the crack angle. Based on the equivalent irreversible strain and the hysteretic loop dissipated energy, the damage law of the rock strength is analyzed. The obtained results reveal that the index based on the equivalent irreversible strain is helpful in exploring the damage degree of rock in the initial stage of cyclic loading and unloading. Furthermore, the damage index established based on the energy dissipation concept is beneficial to predicting the damage and failure law of rock in the advanced stage of loading.
Assessment of the Potential Ecotoxicological Effects of Pharmaceuticals in the World's Rivers
Authors: Bouzas-Monroy Alejandra , Wilkinson John L. , Melling Molly , Boxall Alistair B. A.
Published: June 2022

During their production, use, and disposal, active pharmaceutical ingredients (APIs) are released into aquatic systems. Because they are biologically active molecules, APIs have the potential to adversely affect nontarget organisms. We used the results of a global monitoring study of 61 APIs alongside available ecotoxicological and pharmacological data to assess the potential ecotoxicological effects of APIs in rivers across the world. Approximately 43.5% (461 sites) of the 1052 sampling locations monitored across 104 countries in a recent global study had concentrations of APIs of concern based on apical, nonapical, and mode of action–related endpoints. Approximately 34.1% of the 137 sampling campaigns had at least one location where concentrations were of ecotoxicological concern. Twenty-three APIs occurred at concentrations exceeding “safe” concentrations, including substances from the antidepressant, antimicrobial, antihistamine, β-blocker, anticonvulsant, antihyperglycemic, antimalarial, antifungal, calcium channel blocker, benzodiazepine, painkiller, progestin, and lifestyle compound classes. At the most polluted sites, effects are predicted on different trophic levels and on different endpoint types. Overall, the results show that API pollution is a global problem that is likely negatively affecting the health of the world's rivers. To meet the United Nations' Sustainable Development Goals, work is urgently needed to tackle the problem and bring concentrations down to an acceptable level. Environ Toxicol Chem 2022;41:2008–2020. © 2022 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC.
Particle‐resolved simulations of four‐way coupled, polydispersed, particle‐laden flows
Authors: Yao Yinuo , Biegert Edward , Vowinckel Bernhard , Köllner Thomas , Meiburg Eckart , Balachandar Sivaramakrishnan , Criddle Craig S. , Fringer Oliver B.
Published: June 2022

We present a collocated‐grid framework for direct numerical simulations of polydisperse particles submerged in a viscous fluid. The fluid‐particle forces are coupled with the immersed boundary method (IBM) while the particle‐particle forces are modeled with a combination of contact and lubrication models, adapted for collocated grids. Our method is modified from the staggered‐grid IBM of previous authors to a collocated‐grid IBM by adapting the fluid and particle solvers. The method scales well on high‐performance parallel computing platforms. It has been validated against various cases and is able to reproduce experimental results. Tuning parameters have been thoroughly calibrated to ensure the accuracy of the method. Finally, we demonstrate the capability of the method to simulate both monodispersed and bidispersed fluidized beds and reproduce the power law relationship between the inflow velocity and the porosity.
Functional and biomechanical assessment of the hand following ulnar forearm free flap transfer: Prospective self‐controlled study
Authors: Al‐Aroomi Maged Ali , Mashrah Mubarak Ahmed , Qi Zhongzheng , Sun Changfu , Duan Weiyi
Published: June 2022

Background

There is a shortage of well‐designed self‐controlled studies evaluating hand biomechanics following ulnar forearm flap (UFF) harvest. This study was conducted to evaluate objective and subjective functional outcomes of the donor's hand following UFF harvest.

Methods

All patients undergoing UFF were included for analysis. Grip strength, wrist movement, forearm supination and pronation, pinch strengths, sensation to light touch and temperature, and hand dexterity were assessed preoperatively and at 1, 3, and 6 months postoperatively. In addition, DASH score (disabilities of the arm, shoulder, and hand score) and Patient and Observer Scar Assessment Scale (POSAS) were analyzed.

Results

A total of 18 patients were enrolled. A significant reduction in grip strength for donor's hand was observed between preoperative and postoperative 1 and 3 months (mean difference = 14 kg, 7.38 kg, respectively, p = 0.000 for all). A similar trend was observed for pinch strength and range of motion (p < 0.05). Three months after surgery, there is still a significant reduction in tip pinch, tripod pinch, wrist extension, and supination. All biomechanics outcomes returned to preoperative baseline at 6 months after surgery. No patients suffered significant changes in sensation to light touch, temperature, and numbness by 6 months. There was a significant increase in DASH score by 3.37 points 6 months after operation (p = 0.000). The POSAS score indicates satisfaction with the appearance of the donor site.

Conclusions

UFF is a safe and reliable option for oral cavity reconstruction with minimum donor site morbidities, mainly when cosmesis is paramount. Furthermore, objective hand biomechanics ultimately returns to its preoperative state within 6 months after surgery.
Evaluation of patient satisfaction with nursing services before and after implementation of the Health System Transformation Plan in Iran: A cross‐sectional study
Authors: Jannati Yadollah , Babajani Abolfazl , Kolaei Maedeh Ghasemi , Mohsenipouya Hossein , Mousavinasab Nouraddin , Gorji Mohammad A. H. , Mamun Mohammed A.
Published: June 2022

Background and Aims

How healthcare service delivery is achieved after implementing the Health System Transformation Plan (HSTP) is investigated in the present study by assessing the patients' satisfaction with nursing care services compared to before HSTP.

Methods

This cross‐sectional study was conducted in Iranian hospitals during two periods, that is, before (N = 300) and after (N = 279) HSTP, whereas the Patient Satisfaction Instrument was used to assess the satisfaction with nursing services.

Results

About 57.7% and 4.7% of the patients were dissatisfied with nursing care services, whereas 34% and 77.4% for moderate satisfaction, and 8.3% and 17.9% for total satisfaction, before and after HSTP, respectively. The mean score of overall satisfaction was 57.33 (±11.17) and 70.84 (±11.99) before and after HSTP, respectively (p < 0.001), which represents there is an improvement in healthcare services delivery after HSTP. Although none of the sociodemographic factors were significantly associated with satisfaction, higher satisfaction was found among the coronary care unit (CCU) hospitalized patients.

Conclusion

The patients' overall satisfaction with nursing care services after HSTP was increased, although higher satisfaction was observed in the patients of special wards such as CCU. Therefore, using more care facilities and equipment and engaging more skilled nursing staff in other wards is highly recommended.
Voxelotor versus other therapeutic options for sickle cell disease: Are we still lagging behind in treating the disease?
Authors: Tayyaba Rehan Syeda , Hussain Hassan ul , Malik Farheen , Usama Rana Muhammad , Tahir Muhammad Junaid , Asghar Muhammad Sohaib
Published: June 2022

Background

Sickle cell disease (SCD) is one of the most prevalent hemoglobinopathies that affects around 275,000 neonates annually. Until 2017, hydroxyurea was the only available drug for SCD treatment. Later on, L‐glutamine and crizanlizumab have shown promising results in SCD therapy.

Objectives

There were limited pharmacological options for the disease when in November, 2019, voxelotor was approved for the treatment of SCD patients after showing promising results in the clinical HOPE trial. Despite its favorable results, some life‐threatening side effects were also observed. Uncertainty regarding the use of available pharmaceutical therapies for SCD is the major hurdle for the survival of patients.

Discussion & Conclusion

An immediate attention needs to be drawn towards the drawbacks of limited pharmacological options for SCD. Article calls out to conduct more extensive trials in this advanced era of medicine where ambiguity regarding the use of SCD drugs still prevails.
Metal replacement in the syntheses of MAMBMC heterometallic metal‐string complexes: MPdM'(dpa)4Cl2
Authors: Cheng Ming‐Chuan , Lee Gene‐Hsiang , Lin Tien‐Sung , Liu Yu‐Chiao , Chiang Ming‐Hsi , Chen Chun‐hsien , Peng Shie‐Ming
Published: June 2022

Demonstrated herein is a synthetic strategy for MAMBMC‐type heteronuclear metal‐string complexes (HMSC) in which the terminal metals can be tailored via a displacement reaction based on the relative coordination strength. The stability ruler Ni > Co > (Fe; Mn) > Cd > Cu is derived in this study. Accordingly, MPdM'(dpa)4Cl2 (M ≠ M') can be obtained by the reaction of M' ion with MPdM(dpa)4Cl2 if the relative stability is M' > M. Six MAMBMC‐type HMSCs (2–7) with Pd at the central position are successfully synthesized. Unprecedented properties of metal strings, such as the structures, electrochemistry, and magnetism, are found. The static repulsion between terminal metals can dominate the metal–palladium distances. A shorter distance of Pd–M' at the opposite site can lengthen the Pd–M distance. The redox potentials of metal cores are influenced by this remote static repulsion. Besides, the nature of Cu with a weak spin‐exchange communication can induce the ferromagnetic coupling mediated by the central Pd in CuPdCo and CuPdNi HMSCs, and these are the first examples of ferromagnetism mediated by the central Pd metal among metal strings.
Characterization of giant neuroendocrine cells in the pregnant New Zealand white rabbit vagina demonstrated by histological, histochemical, and immunohistochemical methods
Authors: Mustafa Fatma El‐Zahraa A.
Published: June 2022

The vagina is part of the genitalia and constitutes part of the birth canal. Sperm is deposited into vagina, and it acts in transport of sperm. Pregnancy is a complex process involving different physiological changes in the body associated with hormonal and metabolic alterations that control maternal and fetal demands. During pregnancy, neuroendocrine cells in rabbit vagina are considered part of the diffuse neuroendocrine system observed throughout the body. Giant neuroendocrine cells in rabbit vagina during pregnancy have not been observed previously. This study detected the presence of giant neuroendocrine cells in the vagina of the pregnant rabbit. The presence of these cells was demonstrated with the use of different histological techniques, including hematoxylin and eosin, PAS, combined Alcian blue‐PAS, Crossmon's trichrome, and the Grimelius silver method. Giant neuroendocrine cells were observed in late‐pregnancy intraepithelial sites and on the lamina propria. These cells were characterized by vacuolated basophilic cytoplasm with PAS‐ and PAS‐AB‐positive granules. Moreover, neuroendocrine cells exhibited an argyrophilic character. Immunohistochemically, neuroendocrine cells in rabbit vagina during pregnancy demonstrated positive immunoreactivity to neuron‐specific enolase (NSE) with different intensities, mild immunoreactivity to the vascular endothelial growth factor (VEGF), and negative immunoreactivity to CD68.

Highlights

Neuroendocrine cells on the vagina of the female rabbit during pregnancy are considered part of the diffuse neuroendocrine system.

Giant neuroendocrine cells on the vagina of the rabbit during pregnancy have not been observed previously.

Giant neuroendocrine cells were demonstrated intraepithelial and on the lamina propria.

Immunohistochemically, neuroendocrine cells demonstrated positive immunoreactivity to NSE and VEGF, and negative immunoreactivity to CD68.
The Hospital Value‐Based Purchasing Program: Do hospitalists improve health care value
Authors: Spaulding Aaron , Tafili Aurora , Dunn Ajani , Hamadi Hanadi
Published: June 2022

Introduction

As healthcare organizations examine the associated benefits of employing a larger hospitalist workforce, there is a need to better understand the association with patients' quality, experience, and efficiency. However, there is a lack of information regarding how hospital use of hospitalists over time influences hospital scoring on quality programs, such as the Center for Medicare and Medicaid Services (CMS) Hospital Inpatient Value‐Based Purchasing (HVBP) Program. This study examines the association between hospitalist staffing between 2014 and 2019 and HVBP scores.

Methods

We used a cross‐sectional panel study design. Total Performance Score (TPS) and its domains were obtained from CMS from 2014 to 2019 and merged with the American Hospital Association Annual Survey Database. We utilized random‐effects multivariable panel regression models and zero‐inflated negative binomial regression to examine the association between the hospitalist‐staffing ratio and the HVBP Program. All models were adjusted for hospital characteristics.

Results

A total of 2126 hospitals were included in the study. The average ratio of hospitalists per staffed bed was 0.06, with a standard deviation of 0.15. This study suggests that hospitals that employ a higher percentage of hospitalists see improvement in their overall TPS (β = 5.40; p < .001), Patient Experience (β = 2.49; p <.05), and Efficiency (incidence‐rate ratio= 1.41; p < .001) domain. However, the Clinical Care domain was no different in organizations employing more hospitalists.

Conclusion

There are benefits associated with TPS, Patient Experience, and Efficiency from employing hospitalists. Managers should seek opportunities to leverage hospitalists' expertise in providing care, particularly in improving care processes.
Early treatment with thiamine and mortality among patients with alcohol use disorder who are hospitalized for pneumonia
Authors: Baron Sarah W. , Yu Pei‐Chun , Imrey Peter B. , Southern William N. , Deshpande Abhishek , Rothberg Michael B.
Published: June 2022

Background

The paucity of research linking thiamine treatment with improved outcomes may be driving its underutilization among patients at risk for Wernicke encephalopathy.

Objective

To assess relationships of thiamine usage to outcomes of patients hospitalized with alcohol use disorder and pneumonia.

Design, Setting and Participants

This is a retrospective cohort study of adult patients hospitalized with pneumonia who also have alcohol use disorder and were treated with benzodiazepines during the initial two hospital days, between 2010 and 2015 at hospitals participating in the Premier Healthcare Database.

Exposure

Any thiamine treatment, and, among those treated, high‐dose thiamine treatment, during the initial two hospital days.

Main Outcome and Measures

Death on days 3–14 of hospitalization (primary); discharge home; transfer to intensive care unit; length of stay (LOS). We used propensity‐weighted models to estimate treatment effects.

Results

Among 36,732 patients from 625 hospitals, 26,520 (72.2%) patients received thiamine, with mortality of 6.5% and 8.1% among recipients and nonrecipients, respectively. With propensity score adjustment, thiamine was associated with reduced mortality (odds ratio [OR]: 0.80, 95% confidence interval [CI]: 0.75–0.85) and more frequent discharges to home (OR: 1.10, 95% CI: 1.06–1.14). Other outcomes were similar. Relative to low‐dose thiamine, high‐dose thiamine was not associated with mortality (adjusted OR: 0.99, 95% CI: 0.89–1.10), but LOS was longer (ratio of means: 1.06, 95% CI: 1.04–1.08), and discharges to home were less frequent (OR: 0.92, 95% CI: 0.87–0.97).

Conclusion

Thiamine is not reliably given to patients with pneumonia and alcohol use disorder receiving benzodiazepines. Improving thiamine administration may represent an opportunity to save lives in this high‐risk group of inpatients.
Fracture analysis of healthy and osteoporotic femora using clinical CT images, phantomless densitometry, and linear FE method
Authors: Mirzaei Majid , Jafari Reyhaneh , Allaveisi Farzaneh , Jafari Hamed , Alavi Fatemeh
Published: June 2022

Computational fracture analysis has become a growing branch of orthopedic research. Particularly, the associated methods provide reliable tools for the analysis of 3D CT‐based models of bone. This paper reports the results of such analyses for 15 human femora (healthy and osteoporotic) under different loading orientations (85 different analysis cases). A new method was developed for the calculation of the density distribution in the models from ordinary clinical CT images without calibration phantom. This method, along with a strain‐energy‐based linear finite element (FE) analysis scheme, was used to predict the fracture strength and pattern of 10 cadaveric femora, for which the mechanical testing results and calibrated FE models were already available. The very good agreement and consistency between different sets of results showed the reliability and accuracy of the new density calibration method, as well as the linear analysis scheme. Accordingly, the method was applied to five new clinical images, gathered from two clinics that used different scanners with different protocols. The strength and fracture pattern of each one of these specimens were analyzed under 15 different loading conditions. A consistent behavior was found for variation of the fracture load and pattern of all specimens with the loading orientations, while very clear contrasts were observed between the strength amplitudes of healthy and osteoporotic specimens. The proposed methods can be easily applied to ordinary daily (even archived) clinical CT scans to conduct fast and reliable fracture analysis of human femora for general bone research and opportunistic studies of osteoporosis and trauma.
Stability analysis of tranexamic acid in the presence of various antiseptic solutions
Authors: Heckmann Nathanael D. , Chung Brian C. , Kang Hyunwoo P. , Chang Myles W. , Wang Jennifer C. , Weber Alexander E. , Omid Reza , Evseenko Denis
Published: June 2022

Tranexamic acid (TXA) effectively reduces blood loss and transfusion risk during total joint arthroplasty. Additionally, intraoperative irrigation with various antiseptic solutions is often utilized for the management and prevention of surgical site infection. However, interactions between various antiseptic solutions and TXA have not been investigated. The purpose of this in vitro study is to evaluate the stability of TXA in the presence of common orthopedic antiseptic solutions. Five antiseptic solutions—0.1% chlorhexidine (CHX) gluconate, 10% povidone‐iodine (BTD), 0.5% sodium hypochlorite (Dakin's), 3% hydrogen peroxide (H2O2), and 1.5% H2O2—and a 0.9% normal saline (NS) control were obtained. A stock 100 mg/ml TXA solution was diluted in each antiseptic solution to a concentration of 10.0 mg/ml to generate reference standard and stability samples. TXA stability in each solution was measured using high performance liquid chromatography at t = 0 and t = 120 min and reported as mean percent of theoretical concentration (MPT) with associated relative standard deviation (RSD). All experiments were performed in triplicate at room temperature. At t = 0 min, TXA remained stable when mixed with 0.9% NS, 0.1% CHX, 10% BTD, 3% H2O2, and 1.5% H2O2 (MPT range: 102.0%−105.0%, RSD range: 0.80%−2.92%). Only 0.5% Dakin's led to significant degradation of TXA at t = 0 min (MPT: 14.3%, RSD:1.28%). At t = 120 min, TXA stability persisted for all compounds except Dakin's 0.5% (MPT: 18.4%, RSD: 28.7%). TXA efficacy may be significantly diminished when 0.5% Dakin's is used as an intraoperative irrigation solution. CHX, BTD, and H2O2 do not degrade TXA.
Lactobacillus plantarum supplementation alleviates liver and intestinal injury in parenteral nutrition‐fed piglets
Authors: Wang Weipeng , Wang Ying , Liu Yang , Tian Xinbei , Chen Shanshan , Lu Ying , Wu Bo , Xiao Yongtao , Cai Wei
Published: June 2022

Objective

Long‐term parenteral nutrition (PN) causes PN‐associated liver disease, for which therapeutic approaches are limited. This study aimed to investigate the effects of Lactobacillus plantarum CGMCC 1258 (LP) on liver and intestinal injury in PN‐fed neonatal piglets.

Methods

The piglets received PN with or without oral LP for 14 days. The levels of liver enzymes and inflammatory markers were measured using biochemical kits and quantitative real‐time polymerase chain reaction. Serum fibroblast growth factor 19 (FGF19) was detected using an enzyme‐linked immunosorbent assay. The bile acid (BA) profiles in the liver, serum, and intestinal contents were determined using ultraperformance liquid chromatography coupled with mass spectrometry. The composition of intestinal bacteria was analyzed with 16S rRNA gene amplicon sequencing.

Results

LP supplementation was associated with improved markers of liver disease, inflammation, and oxidative stress in PN‐fed piglets. Moreover, markers of intestinal injury and inflammation were alleviated by LP in PN‐fed piglets. Mechanistically, LP increased the abundance of Lactobacillus in ileal contents and stimulated FGF19 expression in ileal mucosa. Subsequently, it increased the expression of small heterodimer partner (SHP) and inhibited cholesterol 7α‐hydroxylase (CYP7A1) expression in the liver. Additionally, LP altered the systemic composition and metabolism of BAs.

Conclusions

LP alleviated liver and intestinal injury in PN‐fed neonatal piglets by altering the composition of intestinal bacteria and BAs.
Potassium deficiency reduces sugar yield in sugar beet through decreased growth of young plants
Authors: Füllgrabe Henrik , Claassen Norbert , Hilmer Reinhard , Koch Heinz‐Josef , Dittert Klaus , Kreszies Tino
Published: June 2022

Background

Optimum potassium (K) nutrition is essential for high sugar yield and quality of beet crops.

Aims

We quantified the effect of potassium deficiency on sugar beet dry matter and sugar yield formation during the growing season.

Methods

Sugar beets were grown on low, medium, and high soil K concentrations in a long‐term K fertilizer field experiment on a silt loam alluvial soil. Plants were harvested at four time points during the growing season, including the final harvest. At each harvest, the dry matter yield and K concentration of leaves and beets (when applicable) were recorded, allowing us to study their growth rates in different growth phases. At the final harvest, sugar concentration and internal beet quality were measured.

Results

Low soil K concentrations resulted in an approximately 10% lower sugar yield compared to high soil K supply. Interestingly, retarded growth of low K plants already occurred during the germination phase and in the first weeks thereafter, whereas later on, growth rates were similar. Higher soil K levels led to an increased K uptake rate and thus a higher final total K uptake. High K plants showed rapid youth growth and reached their maximum growth rates earlier than plants grown under low K conditions. The initial differentiation between the low and high K treatments persisted because the plants subsequently grew at similar growth rates at both low and high soil K supplies.

Conclusion

The early growth reduction in the low K treatment was probably caused by the low amount of K stored in sugar beet seeds in combination with low K availability in the soil. It is concluded that under overall low soil K conditions, adequate amounts of K fertilizer should be applied to meet the demand of sugar beet seedlings for maximum growth and final sugar yield. Banded K fertilizer application next to the plant rows is supposed to be efficient for this purpose.
Clinical Application of Shear Wave Elastography With Shear Wave Dispersion Imaging in the Preoperative Evaluation of Hepatic Parenchyma in Patients With Liver Tumors
Authors: Wang Kun , Zhang Shuchen , Zhou Wenyan , Wen Li , Zhang Shanshan , Yu Dong
Published: June 2022

Objectives

This study aimed to compare the diagnostic accuracy of shear wave elastography (SWE) with that of shear wave dispersion (SWD) in evaluation of hepatic parenchyma in patients with liver tumors before resection.

Methods

A total of 174 patients with liver tumors were prospectively enrolled. SWE and SWD examinations were performed. Fibrosis stage and necroinflammatory activity were determined histopathologically according to the Scheuer standard. We compared the diagnostic accuracy of SWE and SWD.

Results

Both SWE and SWD values of the liver were highly correlated with liver fibrosis stage (P < .05, respectively). Both SWE and SWD values of the liver were moderately correlated with necroinflammatory activity (P < .05, respectively). Both SWE and SWD values of the liver were not correlated with steatosis (P > .05, respectively). Both SWE and SWD values were significantly different among the patients with different stages of liver fibrosis (P < .001, respectively). The area under the receiver operating characteristic (ROC) curve of SWE value was 0.982, 0.977, 0.969, and 0.984 for predicting S ≥ 1, S ≥ 2, S ≥ 3, and S = 4, respectively. The optimal cutoff SWE values were 6.9, 7.9, 8.7, and 10.6 kPa for S ≥ 1, S ≥ 2, S ≥ 3, and S = 4, respectively. The area under the ROC curve of SWD value was 0.967, 0.960, 0.925, and 0.954 for predicting S ≥ 1, S ≥ 2, S ≥ 3, and S = 4, respectively. The optimal cutoff SWD values were 11.2, 12.0, 13.2, and 16.0 m/s/kHz for S ≥ 1, S ≥ 2, S ≥ 3, and S = 4, respectively.

Conclusions

SWE and SWD could be noninvasive and accurate for predicting the stage of liver fibrosis in patients with liver tumors before surgery. SWE was more accurate than SWD in predicting severe fibrosis (S ≥ 3) and cirrhosis (S = 4).
De‐Novo Depression, Prophylactic Antidepressant, and Survival in Patients With Head and Neck Cancer
Authors: Panwar Aru , McGill Trevon , Lydiatt Daniel , Militsakh Oleg , Lindau Robert , Coughlin Andrew , Sayles Harlan , Smith Russell , Lydiatt William
Published: June 2022

Objective

To study the association between the development of moderate or greater depression during curative‐intent therapy and overall survival (OS) in patients with stages II‐IV head and neck cancer (HNC).

Methods

In this secondary analysis of a randomized double‐blind placebo‐controlled trial, of 148 eligible participants diagnosed with stages II‐IV HNC but without baseline depression, 125 were evaluable and were randomly allocated to prophylactic escitalopram oxalate (n = 60) or placebo (n = 65). Participants were followed for development of moderate or greater depression, using Quick Inventory of Depressive Symptomatology‐Self Report (QIDS‐SR, range 0–27, score ≥11 indicated moderate or greater depression), and were stratified by demographics; cancer site and stage; and primary treatment modality (surgery with or without radiotherapy vs. radiotherapy with or without chemotherapy). Single variable and multivariable Cox proportional‐hazard models were used to evaluate differences in OS.

Results

Clinically significant depression developed in 22 of 125 patients (17.6%) during HNC treatment. The mean follow‐up was 5.0 years (SD 2.4). OS was similar for patient groups, when stratified by development of moderate or greater depression (HR 0.54 [CI, 0.21–1.43]) or use of prophylactic antidepressant (HR 0.64 [CI, 0.34–1.21]).

Conclusion

There was no significant association between OS and development of moderate or greater depression in patients being treated for stages II‐IV HNC, or between OS and use of prophylactic antidepressant escitalopram. Prophylactic antidepressant may be considered in patients with HNC for prevention of clinically significant depression and may offer improved quality of life outcomes.

Level of Evidence

2 Laryngoscope, 133:856–862, 2023
Multi‐Institutional Study of Patient‐Reported Outcomes of Paradoxical Vocal Fold Motion
Authors: Schonman Ian , Mudd Pamela A. , Ivancic Ryan , Ryan Marisa A. , Ongkasuwan Julina , Prager Jeremy , Smith Marshall E. , Goudy Steven L. , Rana Md Sohel , Wiet Gregory J. , Bauman Nancy M.
Published: June 2022

Objective

To explore patient‐reported outcome measures of pediatric paradoxical vocal fold motion through a multi‐institutional study of geographically diverse United States medical facilities to assess long‐term management and outcomes.

Methods

Eligible participants >8 years of age diagnosed with PVFM over a 10‐year period from 7 tertiary pediatric hospitals were invited to complete a survey addressing study objectives.

Results

65 participants completed the survey, of whom 80% were female, 75% reported a 3.5 grade point average or better, and 75% identified as competitive athletes or extremely athletic individuals. Participants rated their perceived efficacy of 13 specific treatments. Only five treatments were considered effective by a majority of the participants who tried them. The treatments that participants tried most often were breathing exercises (89.2%), bronchodilator treatments (45%), and allergy medications (35.4%). 78.8% of participants reported receiving more than one treatment and 25% reported receiving a combination of bronchodilators, anticholinergics, and steroids. At the time of PVFM diagnosis, 38% of participants had no idea when their symptoms would completely resolve. 23.3% of participants did not experience symptom resolution until greater than 1 year after diagnosis.

Conclusions

Traditional management tools such as breathing exercises and biofeedback treatments may not provide the long‐term benefit that providers anticipate. In addition to these commonly used management strategies, highly efficacious techniques such as counseling and lifestyle management should be incorporated into the long‐term management of patients whose symptoms are refractory to traditional care.

Level of Evidence

4 Laryngoscope, 133:970–976, 2023
Association of Concurrent Olfactory Dysfunction and Probable Rapid Eye Movement Sleep Behavior Disorder with Early Parkinson's Disease Progression
Authors: Chen Ying , Xue Nai‐Jia , Fang Yi , Jin Chong‐Yao , Li Yao‐Lin , Tian Jun , Yan Ya‐Ping , Yin Xin‐Zhen , Zhang Bao‐Rong , Pu Jia‐Li
Published: June 2022

Background

Parkinson's disease (PD), with either rapid eye movement sleep behavior disorder (RBD) or olfactory dysfunction (OD), has been associated with disease progression. However, there is currently heterogeneity in predicting prognosis.

Objectives

To identify whether the concurrent presence of OD and probable RBD (pRBD) in PD (Dual hit in PD, PD‐DH) is associated with disease progression.

Methods

We included 420 patients with de novo PD from the Parkinson's Progression Markers Initiative: 180 PD only (PD), 82 PD with OD (PD‐OD), 94 PD with pRBD (PD‐pRBD), and 64 PD with both OD and pRBD (PD‐DH). Participants underwent motor and nonmotor evaluations, dopamine transporter imaging, and cerebrospinal fluid (CSF) assessment. Data were analyzed with generalized estimating equations and Cox proportional hazards analysis.

Results

The PD‐DH subtype was associated with higher scores and faster progression rates in Movement Disorder Society–Unified PD Rating Scale (MDS‐UPDRS) Parts II and III. Also, patients in PD‐DH group had faster deterioration in nonmotor symptoms, including MDS‐UPDRS Part I score, Montreal Cognitive Assessment, Hopkins Verbal Learning Test–Revised, Wechsler Memory Scale‐Third edition (WMS‐III) Letter Number Sequencing score, Symbol Digit Modalities Test, and Scales for Outcomes in PD–Autonomic scores, with all P values <0.002. Moreover, the PD‐DH subtype had a higher mild cognitive impairment risk (hazard ratio = 1.756, 95% confidence interval [CI] = 1.132–2.722; P = 0.012), faster decline in caudate standard uptake values (β = −0.03, 95% CI = −0.06 to −0.008, P = 0.012), and CSF α‐synuclein levels (β = −77, 95% CI = −149 to −5, P = 0.034) than the PD group.

Conclusion

Coexisting pRBD and OD in patients with PD may be associated with faster progressions in motor measurements and in cognitive and autonomic symptoms, indicating PD‐DH as a more aggressive subtype for PD.
Reconstruction of the superficial femoral vessels with muscle flap coverage for soft tissue sarcomas of the proximal thigh
Authors: Homsy Pauliina , Kantonen Ilkka , Salo Juho , Albäck Anders , Tukiainen Erkki
Published: June 2022

Background

Surgical resection of soft tissue sarcoma with a margin of healthy tissue may necessitate resection and reconstruction of major blood vessels together with soft tissues of the proximal thigh to preserve the limb. The long‐term functional outcomes of these reconstructions remain unestablished. The aim of this report was to assess the vascular and functional outcomes of soft tissue sarcoma patients with femoral vessel reconstructions.

Patients and Methods

Patients who had undergone oncovascular reconstruction during the treatment of proximal thigh soft tissue sarcoma in 2014–2020 were reviewed for details of the vascular and soft tissue reconstructions, and the oncological and functional outcomes. This included eight patients of a median age 59 (range 19–77) years. All had a reconstruction of at least the superficial femoral artery and vein as well as soft tissue reconstruction with a muscle flap. All vessel reconstructions were done with either autologous vein (six grafts/four patients) or allograft (10 grafts/six patients). A microvascular latissimus dorsi flap, with a skin island, was incorporated to cover the vascular grafts in five patients. A pedicled sartorius or gracilis muscle flap was used to fill the defect in three patients.

Results

Graft patency was assessed in seven patients with a median follow‐up of 48 (1–76) months. The arterial graft was patent in 6/8 and the vein graft in 2/8 patients. The gait had returned to normal in five of the six patients assessed. The median MTSS was 70 (43–87)% and the TESS 90 (75–100)%. No local recurrence of the sarcoma was detected.

Conclusions

Vascular reconstruction combined with soft tissue reconstruction enables limb‐sparing surgery in patients with soft tissue sarcoma involving proximal femoral vessels. Although the surgeries are complex with high early morbidity, the achieved long‐term functional outcomes are worthwhile.