bluuebunny/crossref_metadata_2025 huggingface dataset:
Ensuring faculty success in online competency‐based education programs
Authors: Newbold Curtis , Seifert Christine , Doherty Brooks , Scheffler Anthony , Ray April
Published: September 2017

Background

The growth of competency‐based programs means faculty are facing new challenges that require different institutional support than traditional programs.

Method

This article identifies how faculty roles are changing and discusses specific challenges for faculty in three diverse institutions, Rasmussen College, Westminster College, and Valdosta State University.

Results and Conclusion

The article recommends actions institutions can implement to better support CBE faculty.
A novel guidewire‐integrated embolic protection filter device with a handy‐folding system: In vitro and in vivo performance assessment
Authors: Watanabe Hiroki , Saito Naritatsu , Nagata Yoshimasa , Yamamoto Erika , Nakatsuma Kenji , Bingyuan Bao , Watanabe Shin , Tazaki Junichi , Kimura Takeshi , Inoue Kanji
Published: September 2017

Objectives

We developed a novel guidewire‐integrated filter device with a handy‐folding system (IFD: Inoue filter device). In vitro and in vivo studies were conducted to evaluate the feasibilityof the IFD.

Background

Although distal atheromatous and thrombotic embolizations remain unresolved critical issues during catheter interventions, distal protection devices are infrequently used partly because of reduced lower maneuverability.

Methods

In the in vitro experiment, we created an experimental circulation model composed of silicone latex tubes, a reservoir, and a roller pump. After the filter device was deployed in the tube, polystyrene fluorescent microspheres were injected and the capture rate was calculated. Ten trials were performed using the IFD and Spider FX. In the in vivo study, five independent operators deployed, and they retrieved the IFD in swine common iliac and internal carotid arteries. The procedural success rate as well as the delivery and retrieval time was evaluated.

Results

In the in vitro study, the mean capture rate was 94% and 35% in the IFD and Spider groups, respectively. In the in vivo study, all procedures were successful, with no complications. The mean delivery time was 281 ± 87 s and 194 ± 67 s and the mean retrieval time was 24 ± 9 and 13 ±1 s in the left internal carotid and the left common iliac arteries, respectively.

Conclusion

Although further studies and improvements are required, the study results indicate that the IFD is feasible.
Three‐Dimensionally Hierarchical Pt/C Nanocomposite with Ultra‐High Dispersion of Pt Nanoparticles as a Highly Efficient Catalyst for Chemoselective Cinnamaldehyde Hydrogenation
Authors: Hu Duo , Fan Wenqian , Liu Zhi , Li Ling
Published: September 2017

A monolithic carbon‐supported Pt nanocomposite with an interconnected three‐dimensionally hierarchical porous carbon framework and ultra‐high dispersion of Pt nanoparticles (Pt/3DHPC) is synthesized by using an effective “liquid phase impregnation template” strategy. The obtained Pt/3DHPC possesses rich mesoporosity and a low amount of oxygen‐containing functional groups, which notably improve the accessible internal surface area of macropores, number of active Pt sites, and electron transfer ability. When used as a catalyst for the selective cinnamaldehyde (CMA) hydrogenation towards cinnamyl alcohol (CMO), Pt/3DHPC exhibits high CMA conversion (92.7 %) and CMO selectivity (91.1 %) at 1 h reaction time, and the corresponding activity (1553.7 h−1) greatly surpasses not only the single‐sized mesoporous carbon and microporous activated carbon‐supported counterparts but also the previously reported Pt catalysts dispersed on other forms of carbon. Furthermore, Pt/3DHPC can be reused at least fifteen times without pronounced decay owing to the strong interaction between Pt and carbon. The present work demonstrates the validity of multiscale control in carbon‐supported Pt catalysts by overall consideration of the mass transportation, and the accessibility, quantity, and capability of active sites towards chemoselective hydrogenation of CMA, which is expected to be extended to other catalysis‐related processes.
Identification of Novel Bacterial Members of the Imine Reductase Enzyme Family that Perform Reductive Amination
Authors: France Scott P. , Howard Roger M. , Steflik Jeremy , Weise Nicholas J. , Mangas‐Sanchez Juan , Montgomery Sarah L. , Crook Robert , Kumar Rajesh , Turner Nicholas J.
Published: September 2017

Reductive amination of carbonyl compounds constitutes one of the most efficient ways to rapidly construct chiral and achiral amine frameworks. Imine reductase (IRED) biocatalysts represent a versatile family of enzymes for amine synthesis through NADPH‐mediated imine reduction. The reductive aminases (RedAms) are a subfamily of IREDs that were recently shown to catalyze imine formation as well as imine reduction. Herein, a diverse library of novel enzymes were expressed and screened as cell‐free lysates for their ability to facilitate reductive amination to expand the known suite of biocatalysts for this transformation and to identify more enzymes with potential industrial applications. A range of ketones and amines were examined, and enzymes were identified that were capable of accepting benzylamine, pyrrolidine, ammonia, and aniline. Amine equivalents as low as 2.5 were employed to afford up to >99 % conversion, and for chiral products, up to >98 % ee could be achieved. Preparative‐scale reactions were conducted with low amine equivalents (1.5 or 2.0) of methylamine, allylamine, and pyrrolidine, achieving up to >99 % conversion and 76 % yield.
Online Flooding Supervision in Packed Towers: An Integrated Data‐Driven Statistical Monitoring Method
Authors: Liu Yi , Liang Yu , Gao Zengliang , Yao Yuan
Published: September 2017

The development of simple and efficient monitoring methods for flooding supervision is an important but difficult task for the safe operation of packed towers. A data‐driven online flooding monitoring method named Bayesian integrated dynamic principal component analysis (IDPCA) is assessed. In the first step of IDPCA, using the fuzzy c‐means clustering method, the multivariate samples collected during plant operation are first classified into several groups. Then, in each subset a dynamic principal component analysis (DPCA) model is constructed to extract the process characteristics. To improve the monitoring performance, Bayesian inference is utilized to combine these DPCA models in a suitable manner. Consequently, the control limits are formulated using the probabilistic analysis. The superiority of IDPCA is illustrated using a lab‐scale packed tower by comparison with the conventional principal component analysis (PCA) and DPCA methods.
Comparing the Dynamic Flow Properties and Compaction Properties of Pharmaceutical Powder Mixtures
Authors: Leaper Mark C. , Ali Kashaf , Ingham Andrew J.
Published: September 2017

The dynamic flow properties and compaction characteristics of mannitol and mannitol‐sodium carbonate mixtures were measured using a Freeman FT4 powder rheometer. The results showed that the mixtures containing up to 30 % sodium carbonate had better flow properties and improved compaction characteristics when compared with mannitol alone. The mixtures were also analyzed using a shear cell, which gave flow functions that varied little between the samples. The feasibility of combining a more expensive pharmaceutical excipient with a cheaper ingredient is demonstrated, without compromising desired powder characteristics. The study may also provide a useful method for assessing the suitability of new formulations for application as direct compression bases, as part of a wider range of powder flow tests.
On the Kinetic and Thermodynamic Properties of Aryl Radicals Using Electrochemical and Theoretical Approaches
Authors: Koefoed Line , Vase Karina H. , Stenlid Joakim H. , Brinck Tore , Yoshimura Yuichi , Lund Henning , Pedersen Steen U. , Daasbjerg Kim
Published: September 2017

In this work, sampled‐current voltammetry performed on a series of aryldiazonium, diaryliodonium, and triarylsulfonium salts allows the determination of the reduction potential of aryl radicals in acetonitrile. Specifically, this is accomplished by measuring the number of electrons consumed in the reduction process as a function of the applied potential. For the phenyl, 4‐bromophenyl, and 4‐nitrophenyl radicals, the reduction potential is found to be −0.91±0.06, −0.90±0.10, and −0.98±0.06 V vs. SCE, respectively. Furthermore, from measurements on an extended series of substituted compounds, it is concluded that the substituent effect on the reduction potential is small, which can be explained by the σ nature of the aryl radical as evidenced from theoretical calculations. At the same time this yields a mean value for the reduction potential of the aryl radical of −0.87 V±0.03 V vs. SCE. Determination of the intrinsic barrier and the standard potential from the data obtained are more uncertain since it is unknown to which extent the competing reference reaction, the electrochemical grafting reaction, is affected by the applied potential. From calculations using density functional theory, the intrinsic barrier for the reduction of the phenyl radical is determined to be 0.32 eV.
Pacman Compounds: From Energy Transfer to Cooperative Catalysis
Authors: Lang Philipp , Schwalbe Matthias
Published: September 2017

In this Concept article we present the syntheses and application of homo and heterodinuclear “Pacman” compounds. This architecture implies that two metal coordination fragments are brought in close vicinity to each other via a covalent linkage to either support energy transfer between the two units or cooperative transformation of a substrate. Nature has shown that the combination of metal fragments, in particular two different metals, can dramatically improve the efficiency of small molecule activation. We exemplify this strategy for the activation of water, dioxygen and carbon dioxide. Furthermore, we present artificial systems in which a positive effect on the catalytic performance because of the combination of two (different) metal centers could be observed. Thus, Pacman‐type compounds are very well suited as structural and functional models for their biological counterparts.
Total Synthesis of Strychnine
Authors: Lee Geun Seok , Namkoong Gil , Park Jisook , Chen David Y.‐K.
Published: September 2017

The total synthesis of the flagship Strychnos indole alkaloid, strychnine, has been accomplished. The developed synthetic sequence features a novel vinylogous 1,4‐addition, a challenging iodinium salt mediated silyl enol ether arylation, a palladium‐catalyzed Heck reaction, and a streamlined late‐stage conversion to strychnine. Furthermore, an application of asymmetric counterion‐directed catalysis (ACDC) in the context of target‐oriented organic synthesis has been rendered access to an optically active material. The synthetic sequence described herein represents the most concise entry to optically active strychnine to date.
Performance Evaluation of a Full‐Scale Constructed Wetland for Treating Stormwater Runoff
Authors: Li Yi Cheng , Zhang Dong Qing , Wang Mo
Published: September 2017

The performance of a stormwater wetland consisting of a retention pond followed by a horizontal subsurface flow (SSF)‐constructed wetland is evaluated during 11 stormwater events. Samples collected from the inlet and outlet of the wetland are analyzed for total suspended solids (TSS), chemical oxygen demand (COD), total nitrogen (TN), ammonium (NH4+‐N), nitrate (NO3−‐N), PO43−, total phosphorus (TP), and trace metals. Despite the high variability in inflow concentrations, high removal efficacies for TSS (84.3%) and COD (79.2%) are observed. The overall nitrogen removal is satisfactory with a removal efficiency (RE) of 53.5% for TN, 56.5% for NH4+‐N, and 76.5% for NO3−‐N. Lower inflow concentrations limit the TP removal (29.5%) and can allow previously sorbed phosphorus to be released from sediments into the water column. In addition, retention pond is limited in removing dissolved and fine fractions. Lower concentrations of heavy metals are observed compared to influent, and the average RE is 67.2% for Zn, 73.2% for Cu, 41.7% for Cr, 7.1% for Cd, 44.1% for Ni, and 60.6% for Pb, respectively. Relatively high levels of Zn in the roots of Phragmites australis are observed, followed by Cu, Ni, and Cr. Mean concentrations of TSS, TN, and TP are all moderately correlated to inflow intensity during stormwater events in contrast to dissolved nutrients. Flow intensity and effluent concentrations of TSS, TN, TP, and PO43− are also significantly positively correlated.
Synthesis and in vitro Biological Evaluation of Ferrocenyl Side‐Chain‐Functionalized Paclitaxel Derivatives
Authors: Plażuk Damian , Wieczorek Anna , Ciszewski Wojciech M. , Kowalczyk Karolina , Błauż Andrzej , Pawlędzio Sylwia , Makal Anna , Eurtivong Chatchakorn , Arabshahi Homayon J. , Reynisson Jóhannes , Hartinger Christian G. , Rychlik Błażej
Published: September 2017

Taxanes, including paclitaxel, are widely used in cancer therapy. In an attempt to overcome some of the disadvantages entailed with taxane chemotherapy, we devised the synthesis of ferrocenyl‐functionalized paclitaxel derivatives and studied their biological properties. The cytotoxic activity was measured with a panel of human cancer cell lines of various tissue origin, including multidrug‐resistant lines. A structure–activity study of paclitaxel ferrocenylation revealed the N‐benzoyl‐ferrocenyl‐substituted derivative to be the most cytotoxic. In contrast, substitution of the 3′‐phenyl group of paclitaxel with a ferrocenyl moiety led to less potent antiproliferative compounds. However, these agents were able to overcome multidrug resistance, as they were virtually unrecognized by ABCB1, a major cellular exporter of taxanes. Interestingly, the redox properties of these ferrocenyl derivatives appear to play a less important role in their mode of action, as there was no correlation between intracellular redox activity and cytotoxicity/cell‐cycle distribution. The antiproliferative activity of ferrocenyl taxanes strongly depends on the substitution position, and good tubulin polymerization inducers, as confirmed by molecular docking, were usually more cytotoxic, whereas compounds with stronger pro‐oxidative properties exhibited lower antiproliferative activity.
Projecting species’ vulnerability to climate change: Which uncertainty sources matter most and extrapolate best?
Authors: Steen Valerie , Sofaer Helen R. , Skagen Susan K. , Ray Andrea J. , Noon Barry R.
Published: September 2017

Species distribution models (SDMs) are commonly used to assess potential climate change impacts on biodiversity, but several critical methodological decisions are often made arbitrarily. We compare variability arising from these decisions to the uncertainty in future climate change itself. We also test whether certain choices offer improved skill for extrapolating to a changed climate and whether internal cross‐validation skill indicates extrapolative skill. We compared projected vulnerability for 29 wetland‐dependent bird species breeding in the climatically dynamic Prairie Pothole Region, USA. For each species we built 1,080 SDMs to represent a unique combination of: future climate, class of climate covariates, collinearity level, and thresholding procedure. We examined the variation in projected vulnerability attributed to each uncertainty source. To assess extrapolation skill under a changed climate, we compared model predictions with observations from historic drought years. Uncertainty in projected vulnerability was substantial, and the largest source was that of future climate change. Large uncertainty was also attributed to climate covariate class with hydrological covariates projecting half the range loss of bioclimatic covariates or other summaries of temperature and precipitation. We found that choices based on performance in cross‐validation improved skill in extrapolation. Qualitative rankings were also highly uncertain. Given uncertainty in projected vulnerability and resulting uncertainty in rankings used for conservation prioritization, a number of considerations appear critical for using bioclimaticSDMs to inform climate change mitigation strategies. Our results emphasize explicitly selecting climate summaries that most closely represent processes likely to underlie ecological response to climate change. For example, hydrological covariates projected substantially reduced vulnerability, highlighting the importance of considering whether water availability may be a more proximal driver than precipitation. However, because cross‐validation results were correlated with extrapolation results, the use of cross‐validation performance metrics to guide modeling choices where knowledge is limited was supported.
Selective regimes and functional anatomy in the mustelid forelimb: Diversification toward specializations for climbing, digging, and swimming
Authors: Kilbourne Brandon M.
Published: September 2017

Anatomical traits associated with locomotion often exhibit specializations for ecological niche, suggesting that locomotor specializations may constitute selective regimes acting on limb skeletal traits. To test this, I sampled 42 species of Mustelidae, encompassing climbing, digging, and swimming specialists, and determined whether trait variation reflects locomotor specialization by performing a principal components analysis on 14 forelimb traits. In addition to Brownian motion models, three Ornstein–Uhlenbeck models of selective regimes were applied to PC scores describing trait variation among mustelids: one without a priori defined phenotypic optima, one with optima based upon locomotor habit, and one with a single phenotypic optimum. PC1, which explained 43.8% of trait variance, represented a trade‐off in long bone gracility and deltoid ridge length vs. long robustness and olecranon process length and distinguished between climbing specialists and remaining mustelids. PC2, which explained 17.4% of trait variance, primarily distinguished the sea otter from other mustelids. Best fitting trait diversification models are selective regimes differentiating between scansorial and nonscansorial mustelids (PC1) and selective regimes distinguishing the sea otter and steppe polecat from remaining mustelids (PC2). Phylogenetic half‐life values relative to branch lengths suggest that, in spite of a strong rate of adaptation, there is still the influence of past trait values. However, simulations of likelihood ratios suggest that the best fitting models are not fully adequate to explain morphological diversification within extant mustelids.
Last and corresponding authorship practices in ecology
Authors: Duffy Meghan A.
Published: September 2017

Authorship is intended to convey information regarding credit and responsibility for manuscripts. However, while there is general agreement within ecology that the first author is the person who contributed the most to a particular project, there is less agreement regarding whether being last author is a position of significance and regarding what is indicated by someone being the corresponding author on a manuscript. Using an analysis of papers published in American Naturalist, Ecology, Evolution, and Oikos, I found that: (1) the number of authors on papers is increasing over time; (2) the proportion of first authors as corresponding author has increased over time, as has the proportion of last authors as corresponding author; (3) 84% of papers published in 2016 had the first author as corresponding author; and (4) geographic regions differed in the likelihood of having the first (or last) author as corresponding author. I also carried out an online survey to better understand views on last and corresponding authorship. This survey revealed that most ecologists view the last author as the “senior” author on a paper (i.e., the person who runs the research group in which most of the work was carried out), and most ecologists view the corresponding author as the person taking full responsibility for a paper. However, there was substantial variation in views on authorship, especially corresponding authorship. Given these results, I suggest that discussions of authorship have as their starting point that the first author will be corresponding author and the senior author will be last author. I also suggest ways of deciding author order in cases where two senior authors contributed equally.
Naming diversity in an evolutionary context: Phylogenetic definitions of the Roucela clade (Campanulaceae/Campanuloideae) and the cryptic taxa within
Authors: Crowl Andrew A. , Cellinese Nico
Published: September 2017

In recent times, evolution has become a central tenet of taxonomy, but nomenclature has consistently been decoupled from the tree‐thinking process, often leading to significant issues in reconciling traditional (Linnaean) names with clades in the Tree of Life. Recent evolutionary studies on the Roucela clade, a group of endemic plants found in the Mediterranean Basin, motivated the establishment of phylogenetic concepts to formally anchor clade names on the Campanuloideae (Campanulaceae) tree. These concepts facilitate communication of clades that approximate traditionally defined groups, in addition to naming newly discovered cryptic diversity in a phylogenetic framework.
Fungal community homogenization, shift in dominant trophic guild, and appearance of novel taxa with biotic invasion
Authors: Anthony M. A. , Frey S. D. , Stinson K. A.
Published: September 2017

Invasion by non‐native plants may fundamentally restructure the soil fungal community. The invasive plant, Alliaria petiolata, produces secondary compounds suppressive to mycorrhizal fungi and may therefore be expected to have generally negative effects on other components of the fungal community. Here, we compared fungal biomass, diversity, community composition, and the relative abundance of fungal trophic guilds, along with edaphic properties of soils collected from uninvaded and invaded plots across six temperate forests. Invaded plots were differentiated from uninvaded plots by lower variation in fungal community composition (beta diversity) and soil properties, higher fungal richness and community evenness (alpha diversity), and a suite of novel saprotrophic and pathotrophic fungi that were consistently present across the invaded landscape and absent from uninvaded forest patches. Invaded plots also had lower ectomycorrhizal but higher saprotrophic and pathotrophic relative abundance, despite there being no difference in fungal biomass between invasion statuses. We hypothesize that shifts in the fungal community with invasion may directly impact plant disease response, soil nutrient cycling processes, and plant performance of the invasive and native plant communities.
Pre‐damage biomass allocation and not invasiveness predicts tolerance to damage in seedlings of woody species in Hawaii
Authors: Lurie Matthew H. , Barton Kasey E. , Daehler Curtis C.
Published: September 2017

Plant‐herbivore interactions have been predicted to play a fundamental role in plant invasions, although support for this assertion from previous research is mixed. While plants may escape from specialist herbivores in their introduced ranges, herbivory from generalists is common. Tolerance traits may allow non‐native plants to mitigate the negative consequences of generalist herbivory that they cannot avoid in their introduced range. Here we address whether tolerance to herbivory, quantified as survival and compensatory growth, is associated with plant invasion success in Hawaii and investigate traits that may enhance tolerance in seedlings, the life stage most susceptible to herbivory. In a greenhouse experiment, we measured seedling tolerance to simulated herbivory through mechanical damage (50% leaf removal) of 16 non‐native woody plant species differing in invasion status (invasive vs. non‐invasive). Seedlings were grown for 2 weeks following damage and analyzed for biomass to determine whether damaged plants could fully compensate for the lost leaf tissue. Over 99% of all seedlings survived defoliation. Although species varied significantly in their levels of compensation, there was no consistent difference between invasive and non‐invasive species. Seedlings of 11 species undercompensated and remained substantially smaller than control seedlings 2 weeks after damage; four species were close to compensating, while one species overcompensated. Across species, compensation was positively associated with an increased investment in potential storage reserves, specifically cotyledons and roots, suggesting that these organs provide resources that help seedlings re‐grow following damage. Our results add to a growing consensus that pre‐damage growth patterns determine tolerance to damage, even in young seedlings which have relatively low biomass. The lack of higher tolerance in highly invasive species may suggest that invaders overcome herbivory barriers to invasion in other ways, such as resistance traits, or that herbivory does not play an important role in the seedling invasion dynamics of these woody species in Hawaii.
The prognostic value of brain natriuretic peptide in patients with heart failure and left ventricular ejection fraction higher than 60%: a sub‐analysis of the J‐MELODIC study
Authors: Kitada Shuichi , Kikuchi Shohei , Tsujino Takeshi , Masuyama Tohru , Ohte Nobuyuki ,   J‐MELODIC study investigators
Published: September 2017

Aims

Cardiac function varies in the population of patients with heart failure (HF) with preserved left ventricular ejection fraction (LVEF; HFpEF). This study investigated the heterogeneity of clinical features associated with HF and the prognostic value of BNP levels in patients with HFpEF.

Methods and results

The study enrolled 288 patients with stable HF and serum creatinine <1.5 mg/dL who were part of the original J‐MELODIC study cohort. They were categorized as having HF with reduced LVEF (HFrEF; EF ≤ 40%, n = 83) or as having HFpEF (EF > 40%, n = 205). Patients with HFpEF were further categorized as having relatively low LVEF (HFrlEF; EF 40–60%, n = 107) or as having relatively high LVEF (HFrhEF; EF ≥ 60%, n = 98). We defined cardiovascular death and hospitalization for HF as adverse events and evaluated the prognostic value of the BNP levels in each group. There was no significant difference in event‐free survival between HFpEF and HFrEF patients or between HFrhEF and HFrlEF patients. A multivariate Cox proportional hazards model revealed that the BNP level was an independent predictor of adverse events in HFrEF patients (hazard ratio: 4.088, 95% confidence interval: 1.178–14.179, P = 0.027) and in HFrlEF patients (hazard ratio: 14.888, 95% confidence interval: 4.969–44.608, P < 0.001) but not in HFrhEF patients (P = 0.767).

Conclusions

The BNP level has prognostic value in HFrlEF but not in HFrhEF. This indicates that HFrhEF and HFrlEF are distinct entities that may require different approaches for the management of HF.
A historical data analysis of water‐energy nexus in the past 30 years urbanization of Wuxi city, China
Authors: Xie Xinghua , Jia Benyou , Han Guoyi , Wu Shiqiang , Dai Jiangyu , Weinberg Josh
Published: September 2017

In this article, the historical data of water and energy consumption of Wuxi City, one of the main cities in the Taihu Lake Basin region in Eastern China, was reviewed and analyzed to map their dynamic changes in the rapid urbanization process of the past 30 years, as the urbanization ratio changed from 24.7% (1983) to 73.7% (2013). Results show that (a) water and energy resources have generally been managed separately in overall social‐economic development planning of the city and region; and (b) the increase of water and energy consumption closely correlates with the rate of urbanization and urban growth. A Water‐Energy Nexus Chart (WENC) is proposed as a potential tool to provide a snapshot on water and energy management to show relative efficiency of water use in energy production and energy use in water treatment and supply provision. © 2017 American Institute of Chemical Engineers Environ Prog, 37: 46–55, 2018
Mesh adaptation using C1 interpolation of the solution in an unstructured finite volume solver
Authors: Sharbatdar Mahkame , Ollivier‐Gooch Carl
Published: September 2017

The goal of this paper is to show the effectiveness of a newly developed estimate of the truncation error calculated based on C1 interpolation of the solution weighted by the adjoint solution as the adaptation indicator for an unstructured finite volume solver. We will show that adjoint‐based mesh adaptation based on the corrected functional using the new developed truncation error estimate is capable of adapting the mesh to improve the accuracy of the functional and the convergence rate. Both discrete and continuous adjoint solutions are used for adaptation. Results are significantly better with new truncation error estimate than with previously used estimates.
A New Golden Age? Proposal for an Innovative Global Health Funding Mechanism for Middle‐Income Countries
Authors: Chaumont Claire , Hsi Jenny , Bohne Christine , Mostaghim Sana , Moon Suerie
Published: September 2017

Despite economic growth and increased global commitment to health financing in the past decades, the health needs of some of the world's most vulnerable people remain overlooked. In particular, middle‐income countries (MICs) often face the conundrum of receiving reduced development assistance for health (DAH) while still being home to most of the world's poor and the majority of the global burden. We believe that this reflects shortcomings in the global DAH system's architecture, which operate on principles that do not respond well to current realities. Hence, we propose a novel mechanism for international health financing and action that specifically addresses the newly emerged strengths and needs of MICs. The Incentives for Health (I4H) Alliance will offer MICs flexible incentives in exchange for their making and meeting health‐related commitments in their countries. Countries can set their own health targets, in alignment with the existing Sustainable Development Goals' framework, and those that achieve them will be subsequently rewarded with financial or other incentives, which are not restricted to the health sector. We believe that the I4H Alliance will promote greater MIC involvement towards global health financing both as incentive providers and recipients; encourage collaboration between Ministries of Health and Finance; and provide a needed complement to traditional DAH mechanisms. We advocate for the creation of I4H at a MICs‐oriented financing institution such as the New Development Bank. We intend I4H to spark new thinking around innovative health financing approaches to ensure that the “golden age” of global health remains ahead.
Effect of the Novel Selective Progesterone Receptor Modulator Vilaprisan on Ovarian Activity in Healthy Women
Authors: Schütt Barbara , Schultze‐Mosgau Marcus‐Hillert , Draeger Corinna , Chang Xinying , Löwen Stephanie , Kaiser Andreas , Rohde Beate
Published: September 2017

This randomized, double‐blind, parallel‐group study in healthy young women investigated the effect of treatment with vilaprisan (0.5, 1, 2, or 4 mg/day for 12 weeks) on ovarian function by assessing the Hoogland score, which is based on the size of follicle‐like structures as determined by transvaginal ultrasound and on estradiol and progesterone serum concentrations. Ovulation inhibition (ie, Hoogland score <6 in treatment weeks 1‐4 and 8‐12) was observed in >80% of the subjects receiving vilaprisan ≥1 mg/day. The effect was dose dependent. With a Bayesian approach, the percentage of subjects with ovulation inhibition was estimated to increase from 37% in subjects receiving 0.5 mg/day vilaprisan to 76%, 86%, and 88% in subjects receiving 1, 2, and 4 mg/day, respectively. Follicle growth was not suppressed during treatment. The majority of subjects receiving ≥1 mg/day had a Hoogland score of 4 (active follicle‐like structures, ie, follicle diameter >13 mm, estradiol >27.2 pg/mL, no progesterone increase) both at beginning and end of treatment. Mean average estradiol as well as mean maximum progesterone concentrations were noticeably decreased during treatment with vilaprisan ≥1 mg/day compared to pretreatment, but estradiol concentrations remained >80 pg/mL. Both hormones returned to pretreatment levels after the end of treatment, indicating a rapid resumption of normal ovarian activity. Amenorrhea occurred in the majority of subjects during treatment at dosages ≥1 mg/day. The adverse events observed in this study confirm the known safety profile of vilaprisan. All in all, the results of this study support the development of vilaprisan for the long‐term treatment of uterine fibroids.
Influence of collars on the primary stability of cementless femoral stems: A finite element study using a diverse patient cohort
Authors: Al‐Dirini Rami M. A. , Huff Daniel , Zhang Ju , Besier Thor , Clement John G. , Taylor Mark
Published: September 2017

For cementless femoral stems, there is debate as to whether a collar enhances primary stability and load transfer compared to collarless designs. Finite Element (FE) analysis has the potential to compare stem designs within the same cohort, allowing for subtle performance differences to be identified, if present. Subject‐specific FE models of intact and implanted femora were run for a diverse cohort (21 males, 20 females; BMI 16.4–41.2 kg/m2, age 50–80 yrs). Collared and collarless versions of Corail® (DePuy Synthes, Warsaw, IN) were sized and positioned using an automated algorithm that aligns the femoral/stem axes, preserves the head‐center location, and maximizes metaphyseal fit. Joint contact and muscle forces simulating peak forces in level gait and stair climbing and were scaled to the body mass and applied to each subject. Three failure scenarios were assessed: Potential for peri‐prosthetic fibrous tissue formation (stem micromotion), potential for peri‐prosthetic bone damage (equivalent strains), and calcar bone remodeling (changes in strain‐energy density). Comparisons were performed using paired t‐tests. Only subtle differences were found (mean 90th percentile micromotion: Collared = 86 µm, collarless = 92.5 µm, mean 90th percentile interface strains: Collared = 733 µϵ, collarless = 767 µϵ, and similar remodeling stimuli were predicted). The slight differences observed were small in comparison with the inter‐patient variability. Statement of clinical significance: Our results suggest that the presence/absence of a collar is unlikely to substantially alter the bone‐implant biomechanics nor the initial mechanical environment. Hence, a collar is likely to have minimal clinical impact. Analysis using different femoral stem designs is recommended before generalising these findings. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1185–1195, 2018.
Future applications of blockchain in business and management: A Delphi study
Authors: White Gareth R.T.
Published: September 2017

Blockchain has the potential to become a significant source of disruptive innovations in business and management. There is a scarcity of knowledge and understanding of blockchain techniques that hinders its academic research and practical application. Business managers need to understand the potential impact and threat of blockchain applications in order to gain and maintain competitive advantage. Blockchain applications appear to offer considerable performance improvement and commercialization opportunities.
Impact of vocal fold augmentation and laryngoplasty on dyspnea in patients with glottal incompetence
Authors: Dion Gregory R. , Fritz Mark A. , Teng Stephanie E. , Marcus Sonya , Fang Yixin , Branski Ryan C. , Amin Milan R.
Published: September 2017

Objectives/Hypothesis

Given that the vocal folds are active organs of respiration, reports of dyspnea in the context of glottic insufficiency are not uncommon. We hypothesize that improved glottal closure via framework surgery or vocal fold augmentation improves dyspnea symptoms.

Study Design

Retrospective review.

Methods

Charts of patients undergoing procedures to correct glottal insufficiency, either via vocal fold augmentation (VFA) or medialization laryngoplasty (ML) between December 2012 and September 2015 were reviewed (n = 189). Modified Borg Dyspnea Scale (MBDS) and Modified Medical Research Council Dyspnea Scale (MMRCDS) data were collected before and after intervention. Age, body mass index (BMI), and sex, as well as pulmonary and cardiac comorbidities were considered. Subgroup analysis was performed on individuals with subjective dyspnea prior to intervention.

Results

For the entire cohort, differences in the MMRCDS and MBDS were not statistically different pre‐ and postintervention (P = .20 and P = .12, respectively). Patients with BMI <30 experienced more improvement on the MBDS (P = .03). Both the MMRCDS and MMBDS improved post‐procedure (P = .001 and P = .001, respectively) in patients reporting dyspnea prior to intervention.

Conclusions

Patients with glottic insufficiency and dyspnea prior to intervention to improve glottic closure had a significant reduction in dyspnea following treatment. Conversely, subjects without complaints of dyspnea prior to intervention had variable outcomes with regard to dyspnea symptoms. Additionally, based on data from the entire cohort, VFA or ML did not worsen dyspnea symptoms. These data may assist in counseling and/or selection of patients considered for procedures to improve glottic closure.

Level of Evidence

4. Laryngoscope, 128:427–429, 2018
Adipose‐derived mesenchymal stromal cells prevented rat vocal fold scarring
Authors: Morisaki Tsuyoshi , Kishimoto Yo , Tateya Ichiro , Kawai Yoshitaka , Suzuki Ryo , Tsuji Takuya , Hiwatashi Nao , Nakamura Tatsuo , Omori Koichi , Kitano Hiroya , Takeuchi Hiromi , Hirano Shigeru
Published: September 2017

Objectives/Hypothesis

This study aimed to reveal the effects of adipose‐derived mesenchymal stromal cells (ASCs) on prevention of vocal fold scarring by investigating how the immediate ASCs transplantation into the injured rat vocal fold affect the levels of gene transcription and translation.

Study Design

Prospective animal experiments with controls.

Methods

ASCs harvested from green fluorescent protein transgenic rat (ASCs group) or saline (sham group) were injected into the thyroarytenoid muscle of Sprague‐Dawley rats immediately after stripping the vocal fold. For histological examinations, larynges were extirpated at 3, 14, and 56 days after the injection. Quantitative real‐time polymerase chain reaction (PCR) analyses were performed at 3 and 14 days after the injection.

Results

Transplanted ASCs were detected only in larynges at day 3. At days 14 and 56, histological examination showed significantly higher amounts of hyaluronic acid and lower deposition of collagen in the ASCs group compared to the sham group. Real‐time PCR revealed that the ASCs group showed low expression of procollagen (Col)1a1, Col1a3, matrix metalloproteinase (Mmp)1 and Mmp8 in each time points. The ASCs group showed high expression of fibroblast growth factor (Fgf)2 and Hepatocyte growth factor (Hgf) compared to the sham group at day 14.

Conclusions

ASCs increased expressions of Fgf2 and Hgf, and suppressed excessive collagen deposition during vocal fold wound healing. Given the fact that ASCs survived no more than 14 days, ASCs were thought to induce upregulations of growth factors' genes in surrounding cells. These results suggested that ASCs have potential to prevent vocal fold scarring.

Level of Evidence

NA. Laryngoscope, 128:E33–E40, 2018
Diagnostic accuracy of current glossoptosis classification systems: A nested cohort cross‐sectional study
Authors: Manica Denise , Schweiger Cláudia , Sekine Leo , Fagondes Simone Chaves , Kuhl Gabriel , Vinicius Collares Marcus , Marostica Paulo José Cauduro
Published: September 2017

Objectives/Hypothesis

To assess the performance of endoscopic grading systems of glossoptosis in identifying severe clinical manifestations in children with Robin sequence (RS).

Study Design

Nested cohort cross‐sectional study.

Methods

All RS patients diagnosed at Hospital Clinics of Porto Alegre from October 2012 to June 2016 were enrolled in this cohort. Patients underwent sleep endoscopy and were classified according to Yellon (Y) and de Sousa et al. (S) scales. Symptom severity evaluation was performed as defined by Cole et al. The outcome of interest was Cole's clinical classification grade 3.

Results

Eighty patients were eligible for analysis. Sensitivity (Y: 56.2%, S: 28.1%, P < .001) and specificity (Y: 85.4%, S: 93.8%, P = .038) in identifying severe clinical symptoms patients (i.e., Cole grade 3) were statistically different between Y and S classifications. A low but significant overall correlation was observed for both Y (rho = 0.372, P < .001) and S (rho = 0.439, P < .001) classifications when compared with Cole classification. Diagnostic odds ratio (DOR) for Y (DOR: 7.53, 95% confidence interval [CI]: 4.15‐10.90) and S (DOR: 5.87, 95% CI: 1.86‐9.87) were equivalent (P = .92). Also, receiver operating characteristic curves area under the curve were not significantly different between them. The positive likelihood ratio was 3.86 (95% CI: 1.82‐8.16) and 4.50 (95% CI: 1.32‐15.36) for Y and S, respectively.

Conclusions

Y and S grading systems showed a low sensitivity and moderate to high specificity in detecting patients with severe clinical manifestations. Correlation between Y/S and Cole et al. grading were also considered low. Development of a more discriminative anatomic grading system is still needed for this specific disorder.

Level of Evidence

2b. Laryngoscope, 128:502–508, 2018
Genome‐Wide Interactions with Dairy Intake for Body Mass Index in Adults of European Descent
Authors: Smith Caren E. , Follis Jack L. , Dashti Hassan S. , Tanaka Toshiko , Graff Mariaelisa , Fretts Amanda M. , Kilpeläinen Tuomas O. , Wojczynski Mary K. , Richardson Kris , Nalls Mike A. , Schulz Christina‐Alexandra , Liu Yongmei , Frazier‐Wood Alexis C. , van Eekelen Esther , Wang Carol , de Vries Paul S. , Mikkilä Vera , Rohde Rebecca , Psaty Bruce M. , Hansen Torben , Feitosa Mary F. , Lai Chao‐Qiang , Houston Denise K. , Ferruci Luigi , Ericson Ulrika , Wang Zhe , de Mutsert Renée , Oddy Wendy H. , de Jonge Ester A. L. , Seppälä Ilkka , Justice Anne E. , Lemaitre Rozenn N. , Sørensen Thorkild I. A. , Province Michael A. , Parnell Laurence D. , Garcia Melissa E. , Bandinelli Stefania , Orho‐Melander Marju , Rich Stephen S. , Rosendaal Frits R. , Pennell Craig E. , Kiefte‐de Jong Jessica C. , Kähönen Mika , Young Kristin L. , Pedersen Oluf , Aslibekyan Stella , Rotter Jerome I. , Mook‐Kanamori Dennis O. , Zillikens M. Carola , Raitakari Olli T. , North Kari E. , Overvad Kim , Arnett Donna K. , Hofman Albert , Lehtimäki Terho , Tjønneland Anne , Uitterlinden André G. , Rivadeneira Fernando , Franco Oscar H. , German J. Bruce , Siscovick David S. , Cupples L. Adrienne , Ordovás José M.
Published: September 2017

Scope

Body weight responds variably to the intake of dairy foods. Genetic variation may contribute to inter‐individual variability in associations between body weight and dairy consumption.

Methods and results

A genome‐wide interaction study to discover genetic variants that account for variation in BMI in the context of low‐fat, high‐fat and total dairy intake in cross‐sectional analysis was conducted. Data from nine discovery studies (up to 25 513 European descent individuals) were meta‐analyzed. Twenty‐six genetic variants reached the selected significance threshold (p‐interaction <10−7), and six independent variants (LINC01512‐rs7751666, PALM2/AKAP2‐rs914359, ACTA2‐rs1388, PPP1R12A‐rs7961195, LINC00333‐rs9635058, AC098847.1‐rs1791355) were evaluated meta‐analytically for replication of interaction in up to 17 675 individuals. Variant rs9635058 (128 kb 3’ of LINC00333) was replicated (p‐interaction = 0.004). In the discovery cohorts, rs9635058 interacted with dairy (p‐interaction = 7.36 × 10−8) such that each serving of low‐fat dairy was associated with 0.225 kg m−2 lower BMI per each additional copy of the effect allele (A). A second genetic variant (ACTA2‐rs1388) approached interaction replication significance for low‐fat dairy exposure.

Conclusion

Body weight responses to dairy intake may be modified by genotype, in that greater dairy intake may protect a genetic subgroup from higher body weight.
Esophagus segmentation in CT via 3D fully convolutional neural network and random walk
Authors: Fechter Tobias , Adebahr Sonja , Baltas Dimos , Ben Ayed Ismail , Desrosiers Christian , Dolz Jose
Published: September 2017

Purpose

Precise delineation of organs at risk is a crucial task in radiotherapy treatment planning for delivering high doses to the tumor while sparing healthy tissues. In recent years, automated segmentation methods have shown an increasingly high performance for the delineation of various anatomical structures. However, this task remains challenging for organs like the esophagus, which have a versatile shape and poor contrast to neighboring tissues. For human experts, segmenting the esophagus from CT images is a time‐consuming and error‐prone process. To tackle these issues, we propose a random walker approach driven by a 3D fully convolutional neural network (CNN) to automatically segment the esophagus from CT images.

Methods

First, a soft probability map is generated by the CNN. Then, an active contour model (ACM) is fitted to the CNN soft probability map to get a first estimation of the esophagus location. The outputs of the CNN and ACM are then used in conjunction with a probability model based on CT Hounsfield (HU) values to drive the random walker. Training and evaluation were done on 50 CTs from two different datasets, with clinically used peer‐reviewed esophagus contours. Results were assessed regarding spatial overlap and shape similarity.

Results

The esophagus contours generated by the proposed algorithm showed a mean Dice coefficient of 0.76 ± 0.11, an average symmetric square distance of 1.36 ± 0.90 mm, and an average Hausdorff distance of 11.68 ± 6.80, compared to the reference contours. These results translate to a very good agreement with reference contours and an increase in accuracy compared to existing methods. Furthermore, when considering the results reported in the literature for the publicly available Synapse dataset, our method outperformed all existing approaches, which suggests that the proposed method represents the current state‐of‐the‐art for automatic esophagus segmentation.

Conclusion

We show that a CNN can yield accurate estimations of esophagus location, and that the results of this model can be refined by a random walk step taking pixel intensities and neighborhood relationships into account. One of the main advantages of our network over previous methods is that it performs 3D convolutions, thus fully exploiting the 3D spatial context and performing an efficient volume‐wise prediction. The whole segmentation process is fully automatic and yields esophagus delineations in very good agreement with the gold standard, showing that it can compete with previously published methods.