bluuebunny/crossref_metadata_2025 huggingface dataset:
Bronchus compression relieved by patent ductus arteriosus stenting
Authors: Zayed Wagih M. , Bhandari Krishna , Guyon Peter W. , El‐Sabrout Hannah , Ryan Justin , Ratnayaka Kanishka , El‐Sabrout Aaron , Moore John W. , El‐Said Howaida
Published: September 2020

Background

Patent ductus arteriosus (PDA) stenting is evolving as an alternative to surgical aorto‐pulmonary shunts for infants with ductal‐dependent pulmonary blood flow. Given anatomical proximity, the PDA can compress the ipsilateral bronchus. We report a case series of four patients with bronchial compression by a tortuous PDA who underwent PDA stenting.

Methods

Our four patients received PDA stents for ductal‐dependent pulmonary blood flow despite preprocedure imaging evidence of bronchial compression. We reviewed the cross‐sectional chest imaging to assess the degree of bronchial compression and the variables that affect it, namely PDA size, PDA tortuosity, and the anatomical relationship between the compressed bronchus and the PDA.

Results

Three out of the four patients had postprocedure imaging, and all showed relief of the previously seen bronchial compression. Post‐PDA stenting patients had a smaller and straight PDA with significant lateralization away from the compressed bronchus. None of the four patients developed symptoms of bronchial compression poststenting.

Conclusions

Our study suggests that pre‐existing bronchial compression does not preclude PDA stenting. Stent placement in an engorged and tortuous PDA led to significant improvement in pre‐existing bronchial compression. Improvement may be attributed to PDA shrinkage, straightening, and lateralization. Further studies are needed to confirm our findings.
Preparation of a Hollow Nanocomposite with Gold‐Embedded Zeolitic Imidazolate Framework‐67 for the Electrochemical Determination of Dopamine
Authors: Dong Yuhua , Liu Jianbo , Zheng Jianbin
Published: September 2020

This work employed a polystyrene sphere as a template to synthesize a hollow nanocomposite with gold‐embedded zeolitic imidazolate framework‐67 (H‐Au@ZIF‐67). The morphological and structural characteristics of the prepared composite were investigated by using scanning electron microscopy, transmission electron microscopy, X‐ray diffraction and energy‐disperse spectroscopy, indicating that H‐Au@ZIF‐67 with a sunflower‐shaped cross section was successfully prepared. The synthesized H‐Au@ZIF‐67 was used to construct a dopamine electrochemical sensor, which showed good linearity scope of 0.25–438.75 μM with a high sensitivity of 332.1 μA mM−1 cm−2 and low detection limit of 0.04 μM. These results showed that the H‐Au@ZIF‐67 can be a good electrode modification material for dopamine sensing.
E‐Waste Mistakenly Disposed of as Recyclable Waste: A Case Study from Brazil
Authors: de Oliveira José Diego , Neto José Francisco de Oliveira , Mendonça Silva Maisa , Santos Simone Machado
Published: September 2020

High e‐waste production has become a growing worldwide challenge in waste management. Several studies show negative consequences for the environment and public health from improper e‐waste management. In this context, this paper presents a characterization of e‐waste sent to recyclable waste picker cooperatives in a Brazilian city. E‐waste is mistakenly disposed of by the population as common recyclable waste and collected through special selective collection programs. The research also evaluated aspects related to the risks and opportunities inherent to e‐waste handling by cooperatives. The results showed that i) the population very often discards e‐waste along with common recyclable waste; ii) cooperative members unsafely dismantle e‐waste for resale, because the profitability of these materials is much higher than that of ordinary recyclables; and iii) the municipality must make the population aware of the separation and disposal of e‐waste. More than just a challenge for managers, proper e‐waste management is a market with high environmental and economic potential, both negative and positive, and complete knowledge and mastery of it will show what will prevail. The results of this research may support a proposal for continuous monitoring and analysis of the flow of e‐waste to better manage this type of waste.
Genomic expression assay testing among American Indian and Alaska Native women with breast cancer
Authors: Marmor Schelomo , Longacre Colleen F. , Altman Ariella M. , Hui Jane Y. C. , Jensen Eric H. , Tuttle Todd M.
Published: September 2020

Background

Breast cancer is one of the most common causes of cancer mortality for all women, including American Indian and Alaska Native (AI/AN) women. The use of the 21‐gene recurrence score (RS) appears to be predictive of the benefit of chemotherapy for women with estrogen receptor (ER)–positive breast cancer. The objective of the current study was to compare RS testing between AI/AN and non‐Hispanic White (NHW) women with breast cancer.

Methods

The Surveillance, Epidemiology, and End Results program was used to identify women with ER‐positive breast cancer from 2004 through 2015. Multivariable logistic regression was used to evaluate factors associated with RS use, with high‐risk RS, and with chemotherapy use among those with a high‐risk RS.

Results

A total of 363,387 NHW patients and 1951 AI/AN patients with ER‐positive breast cancer were identified. AI/AN women were found to be less likely to undergo RS testing and, when tested, were more likely to have a high‐risk RS. In the multivariable logistic regression analysis, AI/AN women were found to be significantly more likely to have a high‐risk RS (odds ratio,1.28; 95% confidence interval, 1.01‐1.66). Among untested women, chemotherapy use was higher for AI/AN women; however, the use of chemotherapy was not found to be significantly different between the groups with a high‐risk RS. Using Cox proportional hazards models, AI/AN race was found to be significantly associated with worse overall survival.

Conclusions

AI/AN women were less likely to undergo RS testing compared with NHW women and were more likely to have a high‐risk RS. Reversing the disparity in genomic expression assay testing is critical to ensure guideline‐based breast cancer treatment and improve survival rates for AI/AN women with breast cancer.
The diencephalon of two carnivore species: The feliform banded mongoose and the caniform domestic ferret
Authors: Pillay Sashrika , Bhagwandin Adhil , Bertelsen Mads F. , Patzke Nina , Engler Gerhard , Engel Andreas K. , Manger Paul R.
Published: September 2020

This study provides an analysis of the cytoarchitecture, myeloarchitecture, and chemoarchitecture of the diencephalon (dorsal thalamus, ventral thalamus, and epithalamus) of the banded mongoose (Mungos mungo) and domestic ferret (Mustela putorius furo). Using architectural and immunohistochemical stains, we observe that the nuclear organization of the diencephalon is very similar in the two species, and similar to that reported in other carnivores, such as the domestic cat and dog. The same complement of putatively homologous nuclei were identified in both species, with only one variance, that being the presence of the perireticular nucleus in the domestic ferret, that was not observed in the banded mongoose. The chemoarchitecture was also mostly consistent between species, although there were a number of minor variations across a range of nuclei in the density of structures expressing the calcium‐binding proteins parvalbumin, calbindin, and calretinin. Thus, despite almost 53 million years since these two species of carnivores shared a common ancestor, strong phylogenetic constraints appear to limit the potential for adaptive evolutionary plasticity within the carnivore order. Apart from the presence of the perireticular nucleus, the most notable difference between the species studied was the physical inversion of the dorsal lateral geniculate nucleus, as well as the lateral posterior and pulvinar nuclei in the domestic ferret compared to the banded mongoose and other carnivores, although this inversion appears to be a feature of the Mustelidae family. While no functional sequelae are suggested, this inversion is likely to result from the altricial birth of Mustelidae species.
Enhancement of total lipid production in vegetative tissues of alfalfa and sainfoin using chemical mutagenesis
Authors: Wijekoon Champa P , Singer Stacy D. , Weselake Randall J , Petrie James R. , Singh Surinder , Jayawardhane Kethmi N. , Shah Saleh , Chen Guanqun , Eastmond Peter J. , Acharya Surya N
Published: September 2020

Alfalfa (Medicago sativa L.) and sainfoin (Onobrychis viciifoila Scop.) are two key forage legumes for the western Canadian cattle industry. Despite the high protein content, drawbacks to their use exist, including inefficient protein digestibility and energy use efficiency in the ruminant system, leading to economic losses and negative environmental impacts. Increasing the proportion of lipids in the diet of cattle is known to mitigate greenhouse gas emissions; however, the above two forage legumes possess only trace quantities of lipids in the shoot tissues used by the ruminants. In the current study, chemical mutagenesis was used as a conventional breeding approach to enhance lipid levels in the vegetative tissues of alfalfa and sainfoin. The mutagenesis procedures for these two forages need to be firmly established. We developed protocols for ethyl methanesulfonate (EMS)‐mediated mutagenesis by optimizing mutagen concentration and seed soaking duration. The EMS‐treated populations were assessed for morphological variants and total shoot lipid content (TSLC). Fatty acid composition was examined in a subset of plants with increased TSLC. Within 24 mo, the screening process identified mutagenized plants with significant increases in TSLC (3–5% on a dry weight basis), and a subset of these also displayed alterations in fatty acid composition in both species. These genotypes provide a novel source of germplasm for the future improvement of these two forage species.
Hyperprogression: A novel response pattern under immunotherapy
Authors: Han Xue‐jiao , Alu Aqu , Xiao Yi‐nan , Wei Yu‐quan , Wei Xia‐wei
Published: September 2020

Checkpoint blockade therapy has shown significant therapeutic benefits and resulted in durable responses in patients with various tumors. However, accumulating evidence has demonstrated that 4‐29% of all patients with cancers with various histologies may suffer from tumor flare following such therapy. This novel tumor response pattern, termed hyperprogression, is a potentially deleterious side effect of checkpoint blockade therapy that accelerates disease progression in a subset of patients. In this review, we describe possible immune checkpoint blockade biomarkers and the epidemiology, different definitions, and predictors of hyperprogression based on the research findings and further present the available evidence supporting pathophysiological hypotheses that might explain hyperprogression during checkpoint blockade therapy. We also compare hyperprogression and pseudoprogression. Finally, we discuss areas requiring further study.
Evaluation of B‐cell intracellular signaling by monitoring the PI3K‐Akt axis in patients with common variable immunodeficiency and activated phosphoinositide 3‐kinase delta syndrome
Authors: del Pino‐Molina Lucía , Torres Canizales Juan M. , Rodríguez‐Pena Rebeca , López‐Granados Eduardo
Published: September 2020

Background

Primary antibody deficiencies (PADs) are characterized by hypogammaglobulinemia and impaired B‐cell differentiation. Patients with common variable immunodeficiency (CVID) present severe reductions in at least 2 serum immunoglobulins and impaired terminal differentiation of B cells. Most patients with CVID do not appear to present monogenic defects. Activated phosphoinositide 3‐kinase delta syndrome (APDS), caused by gain‐of‐function mutations in the PIK3CD gene (p110δ), can present in patients with a CVID‐like phenotype. Memory B‐cell differentiation requires the orchestrated activation of numerous intracellular signaling pathways, which promote transcriptional programs required for long‐term B‐cell survival. The aim of this study was to develop a flow cytometry assay to trace the PI3K‐Akt‐mTOR pathway, a critical component of B‐cell homeostasis, and analyze its status in PADs.

Methods

We analyzed the intracellular expression of Akt and S6 by flow cytometry and their phosphorylation status in both baseline conditions and upon B‐cell receptor activation with anti‐IgM in various primary B‐cell subsets of patients with CVID and APDS.

Results

B cells from CVID patients showed reduced phosphorylation in Akt and S6 proteins after anti‐IgM stimulation. Constitutive high baseline B‐cell levels of Akt and S6 phosphorylation in a patient with APDS were reduced once m‐TOR inhibition therapy was initiated.

Conclusions

Intracellular flow cytometry can be routinely employed to explore alterations in the PI3K‐Akt‐mTOR pathway in B cells from patients with PADs. AKT and S6 phosphorylation levels are informative biomarkers that could be employed as mTOR inhibitors for monitoring therapies targeting this pathway.
Temperature, topography, soil characteristics, and NDVI drive habitat preferences of a shade‐tolerant invasive grass
Authors: Bowen Anna K. M. , Stevens Martin H. H.
Published: September 2020

Aim

Despite the large literature documenting the negative effects of invasive grasses, we lack an understanding of the drivers of their habitat suitability, especially for shade‐tolerant species that do not respond positively to canopy disturbance. We aimed to understand the environmental niche and potential spatial distribution of a relatively new invasive species, wavyleaf basketgrass (Oplismenus undulatifolius(Ard.) Roem. & Schult, WLBG) by leveraging data available at two different spatial scales.

Location

Mid‐Atlantic region of the United States.

Methods

Maximum entropy modeling (Maxent) was used to predict the habitat suitability of WLBG at the regional scale and the landscape scale. Following variable evaluation, model calibration, and model evaluation, final models were created using 1,000 replicates and projected to each study area.

Results

At the regional scale, our best models show that suitability for WLBG was driven by relatively high annual mean temperatures, low temperature seasonality and monthly range, low slope, and high cumulative Normalized Difference Vegetation Index (NDVI). At the landscape scale, suitability was highest near roads and streams, far from trails, at low elevations, in sandy, moist soil, and in areas with high NDVI.

Main Conclusions

We found that invasion potential of this relatively new invader appears high in productive, mesic habitats at low slope and elevations. At the regional scale, our model predicted areas of suitable habitat far outside areas where WLBG has been reported, including large portions of Virginia and West Virginia, suggests serious potential for spread. However, large portions of this area carry a high extrapolation risk and should therefore be interpreted with caution. In contrast, at the landscape level, the suitability of WLBG is largely restricted to areas near current presence points, suggesting that the expansion risk of this species within Shenandoah National Park is somewhat limited.
The impact of parental contact upon cortical noxious‐related activity in human neonates
Authors: Jones Laura , Laudiano‐Dray Maria Pureza , Whitehead Kimberley , Meek Judith , Fitzgerald Maria , Fabrizi Lorenzo , Pillai Riddell Rebecca
Published: September 2020

Background

Neonates display strong behavioural, physiological and cortical responses to tissue‐damaging procedures. Parental contact can successfully regulate general behavioural and physiological reactivity of the infant, but it is not known whether it can influence noxious‐related activity in the brain. Brain activity is highly dependent upon maternal presence in animal models, and therefore this could be an important contextual factor in human infant pain‐related brain activity.

Methods

Global topographic analysis was used to identify the presence and inter‐group differences in noxious‐related activity in three separate parental contexts. EEG was recorded during a clinically required heel lance in three age and sex‐matched groups of neonates (a) while held by a parent in skin‐to‐skin (n = 9), (b) while held by a parent with clothing (n = 9) or (c) not held at all, but in individualized care (n = 9).

Results

The lance elicited a sequence of 4–5 event‐related potentials (ERPs), including the noxious ERP (nERP), which was smallest for infants held skin‐to‐skin and largest for infants held with clothing (p=0.016). The nERP was then followed by additional and divergent long‐latency ERPs (> 750 ms post‐lance), not previously described, in each of the groups, suggesting the engagement of different higher level cortical processes depending on parental contact.

Conclusions

These results show the importance of considering contextual factors in determining infant brain activity and reveal the powerful influence of parental contact upon noxious‐related activity across the developing human brain.

Significance

This observational study found that the way in which the neonatal brain processes a noxious stimulus is altered by the type of contact the infant has with their mother. Specifically, being held in skin‐to‐skin reduces the magnitude of noxious‐related cortical activity. This work has also shown that different neural mechanisms are engaged depending on the mother/infant context, suggesting maternal contact can change how a baby's brain processes a noxious stimulus.
Overactivity assessment in chronic pain: The development and psychometric evaluation of a multifaceted self‐report assessment
Authors: Andrews Nicole E. , Chien Chi‐Wen , Ireland David , Varnfield Marlien
Published: September 2020

Background

Overactivity in the context of chronic pain (i.e. activity engagement that significantly exacerbates pain) is an important clinical issue that has gained empirical attention in the last decade. Current assessment concepts of overactivity tend to focus on frequency to quantify the severity of the pain behaviour. This study aimed to develop and validate a more comprehensive self‐assessment, the Overactivity in Persistent Pain Assessment (OPPA).

Methods

A sample of 333 individuals with chronic pain completed the OPPA. A subset of 202 individuals also completed a set of existing measures of pain‐related outcomes and activity patterns. The remaining 131 participants were provided with a second copy of the OPPA to fill in one week following their initial assessment.

Results

A principal component analysis confirmed that the OPPA items were best represented by a single construct. The OPPA was found to correlate with pain‐related measures in an expected way that is supported by both theory and qualitative data. When compared to existing overactivity measures, the OPPA was the only measure to contribute significantly to the regression models predicting higher levels of pain severity, more pain interference and lower levels of activity participation after controlling for age, gender and activity avoidance. In addition, the OPPA scale exhibited acceptable internal consistency and good test–retest reliability.

Conclusion

The results of this study reinforce the potentially important role of overactivity in the maintenance of pain‐related suffering and supports a corresponding assessment tool with preliminary psychometric evidence for clinical and research applications.

Significance

This study deconstructs the overactivity concept and develop a corresponding assessment based on five quantifiable severity features: severity of pain exacerbation, maladaptive coping strategies used, impact on occupational performance, recovery time and frequency. Results of the psychometric evaluation indicate that this comprehensive assessment of overactivity severity features may be necessary to understand the impact of overactivity on pain severity and physical functioning from both a clinical and research perspective.
Drive for thinness provides an alternative, more meaningful, severity indicator than the DSM‐5 severity indices for eating disorders
Authors: Krug Isabel , Binh Dang An , Granero Roser , Agüera Zaida , Sánchez Isabel , Riesco Nadine , Jimenez‐Murcia Susana , Menchón Jose M. , Fernandez‐Aranda Fernando
Published: September 2020

Objective

To assess an alternative trans‐diagnostic indicator for severity based on drive for thinness (DT) for anorexia nervosa (AN), bulimia nervosa (BN), binge‐eating disorder (BED), and other specified feeding or eating disorder (OSFED), and to compare this new approach to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM‐5) severity categories for EDs.

Method

A total of 2,811 ED [428 AN‐restrictive (AN‐R), 313 AN‐binge purging (AN‐BP), 1,340 BN, 329 BED, 154 OSFED/atypical AN (AT), and 223 OSFED/purging disorder (PD)] patients were classified using: (a) The DSM‐5 severity categories and (b) a DT categorisation. These severity classifications were then compared based on ED symptoms, general psychopathology, personality, and impulsive behaviours.

Results

For the DSM‐5 categories, most ED patients fell into the ‘mild’ to ‘moderate’ categories. Using the DT categories, AN patients were mainly represented in the ‘low’ DT category, and BN, OSFED/AT, and PD in the ‘high’ DT category. The clinically significant findings were stronger for the DT than the DSM‐5 severity approach (medium‐to‐large effect sizes). AN‐BP and AN‐R provided the most pronounced effects.

Conclusion

Our findings question the clinical value of the DSM‐5 severity categorisation, and provide initial support for an alternative DT severity approach for AN.

Highlights 

This study assessed an alternative trans‐diagnostic drive for thinness (DT) severity.

Category for all eating disorder (ED) sub‐types, and then compared this to the Diagnostic and Statistical Manual of Mental Disorders‐5 (DSM‐5) severity indices for EDs.

ED symptoms, general psychopathology, personality, and impulsive behaviours were assessed using both classifications in a total of 2,811 female patients diagnosed with EDs.

Clinically significant findings were stronger for the DT than the DSM‐5 severity category (medium‐to‐large effect sizes); there was differentiation of the anorexia nervosa (AN) patients into mainly ‘low’ DT, and bulimia nervosa (BN) spectrum patients into mainly ‘high’ DT, vs. most patients were clustered in the ‘mild‐to‐moderate’ DSM‐5 categories.

Our findings provide initial support for an alternative trans‐diagnostic DT severity category that may be more clinically meaningful than the DSM‐5 severity indices for EDs.
Prediagnostic circulating levels of sex hormones and survival in esophageal adenocarcinoma
Authors: Xie Shao‐Hua , Ness‐Jensen Eivind , Langseth Hilde , Gislefoss Randi E. , Mattsson Fredrik , Lagergren Jesper
Published: September 2020

Sex hormonal differences may contribute to the strong male predominance in esophageal adenocarcinoma (EAC), but whether sex hormone levels influence survival in EAC is unstudied. Our study aimed to assess associations between prediagnostic sex hormone levels and survival in EAC. In a population‐based cohort study, 244 male EAC patients from the Janus Serum Bank Cohort in Norway were followed up through 2018. Associations between prediagnostic serum levels of 12 sex hormone measures and disease‐specific mortality were assessed using multivariable Cox regression, providing hazard ratios (HR) with 95% confidence intervals (CI) adjusted for age, calendar year, body mass index, tobacco smoking, physical activity and surgical resection. Higher levels of sex hormone‐binding globulin (SHBG) indicated decreased disease‐specific mortality (HR 0.68, 95% CI 0.44‐1.07, highest vs lowest tertile). In stratified analyses by surgery, such associations remained in nonoperated patients (HR 0.58, 95% CI 0.35‐0.96, highest vs lowest tertile), but not in operated patients. Higher levels of follicle‐stimulating hormone (FSH) were associated with increased disease‐specific mortality in an exposure‐response pattern; HRs for the middle and highest tertiles vs the lowest tertile were 1.35 (95% CI 0.89‐2.05) and 1.61 (95% CI 1.06‐2.43), respectively. No clear associations were observed with serum levels of dehydroepiandrosterone sulfate, luteinizing hormone, prolactin, testosterone, 17‐OH‐progesterone, progesterone, estradiol, androstenedione, testosterone:estradiol ratio or free testosterone index. These findings suggest that higher endogenous levels of SHBG and lower levels of FSH may increase the survival in EAC. The other 10 examined sex hormone measures may not influence the survival.
Impact of DNA damage repair defects and aggressive variant features on response to carboplatin‐based chemotherapy in metastatic castration‐resistant prostate cancer
Authors: Slootbeek Peter H. J. , Duizer Marleen L. , van der Doelen Maarten J. , Kloots Iris S. H. , Kuppen Malou C. P. , Westgeest Hans M. , Uyl‐de Groot Carin A. , Pamidimarri Naga Samhita , Ligtenberg Marjolijn J. L. , van Oort Inge M. , Gerritsen Winald R. , Schalken Jack A. , Kroeze Leonie I. , Bloemendal Haiko J. , Mehra Niven
Published: September 2020

Platinum‐based chemotherapy is not standard of care for unselected or genetically selected metastatic castration‐resistant prostate cancer (mCRPC) patients. A retrospective assessment of 71 patients was performed on platinum use in the Netherlands. Genetically unselected patients yielded low response rates. For a predefined subanalysis of all patients with comprehensive next‐generation sequencing, 30 patients were grouped based on the presence of pathogenic aberrations in genes associated with DNA damage repair (DDR) or aggressive variant prostate cancer (AVPC). Fourteen patients (47%) were DDR deficient (DDRd), of which seven with inactivated BRCA2 (BRCA2mut). Six patients classified as AVPC. DDRd patients showed beneficial biochemical response to carboplatin, largely driven by all BRCA2mut patients having >50% prostate‐specific antigen (PSA) decline and objective radiographic response. In the wild‐type BRCA2 subgroup, 35% had a >50% PSA decline (P = .006) and 16% radiographic response (P < .001). Median overall survival was 21 months for BRCA2mut patients vs 7 months (P = .041) for those with functional BRCA2. AVPC patients demonstrated comparable responses to non‐AVPC, including a similar overall survival, despite the poor prognosis for this subgroup. In the scope of the registration of poly‐(ADP)‐ribose polymerase inhibitors (PARPi) for mCRPC, we provide initial insights on cross‐resistance between PARPi and platinum compounds. By combining the literature and our study, we identified 18 patients who received both agents. In this cohort, only BRCA2mut patients treated with platinum first (n = 4), responded to both agents. We confirm that BRCA2 inactivation is associated with meaningful responses to carboplatin, suggesting a role for both PARPi and platinum‐based chemotherapy in preselected mCRPC patients.
“Whatever you do, just don't let him notice you're a woman!” General beliefs on women's gender ideology as a function of topic in mixed‐gender negotiations
Authors: Manea Claudia‐Neptina , Demoulin Stéphanie , Yzerbyt Vincent
Published: September 2020

How one approaches gender differences in general likely influences the way one handles mixed‐gender negotiations. In the present paper, we examine general beliefs on how women negotiators do—as opposed to how they “should”—handle gender in order to increase their chances of success. First, we hypothesised that people's general beliefs would support a sexblindness ideology according to which gender is, and indeed should be, ignored in order to succeed. Second, because negotiation comes across as a stereotypically masculine activity, we predicted that prescriptions regarding what women should do to succeed would commonly favour assimilationism (the belief that women need to assimilate to male norms) over sexawareness (the belief that gender differences should be acknowledged and celebrated). We nevertheless predicted a general belief that women might stay away from these prescriptions and rely more on their gender (i.e. endorse sexawareness over assimilationism) within feminine as compared to masculine and neutral‐topic negotiations. Together, our two experiments confirm these predictions. We discuss our results in terms of the consequences on women's gender ideology‐based strategies, a potentially relevant aspect to their actual negotiating outcomes.
Monitoring physiological status during mid‐ and long‐distance running for smart healthcare
Authors: Hu Guyue , Gunn Stephen
Published: September 2020

The whole of society faces with the problems of sub‐health and population aging. Every person has concerned how to get rid of sub‐health status. It is particularly important to prevent and cure disease for everyone. Monitoring physiological status becomes extremely important to accurately assess health status. In this paper, we establish a system to monitor the physiological status during mid‐ and long‐distance running. The mid‐ and long‐distance running is a common exercise and easy to practice. In order to monitor physiological status, we first collect photoplethysmogram signals, blood pressure, and temperature by using wearable devices. For photoplethysmogram signals, a fast median filtering algorithm is used to remove the noises. The denoised signals are extracted 11 features. Then, the 11 extracted features from photoplethysmogram signals, blood pressure, and temperature are input into a weighted one‐class support vector machine (WOC‐SVM) for training. The abnormal status can be identified 86.4% by the trained WOC‐SVM model.
Biology of the Endothelium
Authors: Lüscher Thomas F. , Barton Matthias
Published: September 2020

The endothelium releases factors that control vascular relaxation and contraction, thrombogenesis and fibrinolysis, and platelet activation and inhibition. Maintaining the functional integrity of the endothelium, therefore, is critical for the preservation of blood flow and the prevention of thrombosis. This article reviews the primary endothelium‐dependent substances that promote either relaxation (e.g., nitric oxide, prostacyclin) or contraction (e.g., endothelin) of blood vessels, including their physiology, mechanism of effect, and role in endothelial dysfunction. Risk factors for cardiovascular disease, such as hypertension, hypercholesterolemia, diabetes, vascular aging, and estrogen deficiency, are discussed in terms of their contributions to endothelial dysfunction, which may be the initial step in atherogenesis.
Endothelial Dysfunction in Essential Hypertension
Authors: Panza Julio A.
Published: September 2020

In the last decade, significant advances have occurred in our understanding of the presence and nature of endothelial dysfunction in a number of cardiovascular conditions, including hypertension. Endothelium‐derived nitric oxide (NO) is recognized as an important mediator of endothelium‐dependent vascular relaxation, and a defect in the endothelium‐derived NO system—possibly decreased synthesis and/or release of NO by endothelial cells—is now known to cause the abnormal response to acetylcholine in hypertensive vessels and to account at least in part for the increased vascular resistance observed in hypertension. Extensive research by our laboratory and others to determine the nature of the defect in the NO system has found that the defect is not related to decreased availability of L‐arginine, the NO precursor, or to a defect at the muscarinic receptor level or a specific G protein‐dependent intracellular signal‐transduction pathway; nor is it related to extracellular inactivation of NO by superoxide anion. These findings have contributed to our understanding of endothelial dysfunction in essential hypertension and have pointed out distinctions between the mechanisms leading to this vascular abnormality in hypertensive and hypercholesterolemic patients. While the exact nature of the NO system defect in hypertension is still to be clarified, the vasoconstrictive and proatherogenic effects of endothelial dysfunction probably contribute to the cardiovascular complications associated with elevated blood pressure. Continued research targeted at the identification of the precise mechanism(s) responsible for endothelial dysfunction in hypertension may lead to the development of novel therapeutic strategies to reduce the vascular complications associated with the hypertensive process.
Growth Factors as a Potential New Treatment for Ischemic Heart Disease
Authors: Bauters Christophe
Published: September 2020

Growth factors such as fibroblast growth factor (FGF) and vascular endothelial growth factor (VEGF) exert important effects on endothelial cells in vitro and in vivo. This article reviews the effect of these two growth factors on endothelial dysfunction in various animal models of vascular disease: (1) collateral circulation supplying an ischemic territory, (2) balloon injury, and (3) diet‐induced experimental atherosclerosis. Endothelial dysfunction may limit the beneficial effects of collateral vessels on tissue perfusion. Administration of VEGF or basic FGF (bFGF) augments collateral development in different models of hindlimb ischemia by enhancing neovascularity and by facilitating the recovery of endothelial function in the collateral circulation. Similarly, studies performed after balloon angioplasty have demonstrated abnormal responses of previously dilated sites to endothelium‐dependent agonists. Administration of VEGF or bFGF increases endothelial regrowth and normalizes endothelium‐dependent responses after experimental angioplasty. Finally, endothelium‐dependent relaxation is impaired in diet‐induced experimental atherosclerosis. It was recently demonstrated that hypercholesterolemic rabbits treated with bFGF had significantly better endothelium‐dependent responses than those not treated with bFGF. These results show that in vivo administration of the endothelial cell growth factors VEGF and bFGF leads to significant improvement in endothelium‐dependent responses and supports the concept of using these growth factors as a new therapeutic strategy for patients with vascular diseases.
Impact of a pharmacist‐driven azithromycin de‐escalation initiative for community‐acquired pneumonia
Authors: Shakeraneh Pegah , Steele Jeffrey M. , Seabury Robert W. , Thomas Stephen J. , Paolino Kristopher M. , Miller Christopher D. , Probst Luke A. , Kufel Wesley D.
Published: September 2020

Background

Community‐acquired pneumonia (CAP) is a commonly encountered infection and cause of hospitalization. Discontinuation of atypical antibiotic coverage when atypical bacteria are the unlikely cause of CAP represents a potential antimicrobial stewardship opportunity.

Study Objective

To compare azithromycin duration, hospital length of stay (LOS), 30‐day all‐cause or pneumonia readmission, and in‐hospital mortality before and after implementation of a pharmacist‐driven azithromycin de‐escalation initiative in the setting of negative laboratory data for atypical bacteria in immunocompetent, nonintensive care unit (non‐ICU) patients treated for CAP.

Design

Single‐center, quasi‐experimental study.

Setting

A 472‐bed academic medical center in Syracuse, NY.

Patients

Patients were included if they were ≥18 years old, diagnosed with CAP, and had a negative Legionella pneumophila urinary antigen and negative Biofire FilmArray Respiratory Panel for Mycoplasma pneumoniae and Chlamydia pneumoniae. Patients were excluded if they were immunocompromised, admitted to an ICU during hospitalization, prescribed azithromycin for an alternate indication, or had evidence of atypical bacteria.

Measurements and Main Results

A total of 983 patients received an azithromycin‐containing regimen for CAP during the study period with 458 and 525 patients in preintervention and postintervention cohorts, respectively. After exclusion criteria were applied, 90 and 100 patients were included in the preintervention and postintervention cohorts, respectively. Demographic and clinical characteristics were mostly similar between cohorts. A statistically significant reduction in azithromycin duration (2 days [interquartile range (IQR) 1‐2.75] vs 5 days [IQR 3‐6], P < .001) and hospital LOS (3 days [IQR 2‐5] vs 5 days [IQR 3‐8.25], P < .001) were observed in the postintervention cohort compared with the preintervention cohort. No statistically significant difference was identified for 30‐day all‐cause 30‐day readmission (15.6% vs 13.0%, P = .614), 30‐day readmission secondary to pneumonia (4.44% vs 2.0%, P = .926), or in‐hospital mortality (1.1% vs 1.0%, P = 1.000) between cohorts.

Conclusion

Implementation of a pharmacist‐driven azithromycin de‐escalation initiative for immunocompetent, non‐ICU patients with CAP was associated with a decrease in azithromycin duration and hospital LOS without increasing 30‐day all‐cause or pneumonia readmission, or in‐hospital mortality.
Therapeutic Protein Drug Interaction Potential in Subjects With Psoriasis: An Assessment Based on Population Pharmacokinetic Analyses of Sensitive Cytochrome P450 Probe Substrates
Authors: Sathe Abhishek G. , Othman Ahmed A. , Mohamed Mohamed‐Eslam F.
Published: September 2020

Elevated cytokine levels in inflammatory diseases are associated with downregulation of certain cytochrome P450 (CYP) enzymes. Upon treatment with some cytokine‐targeting therapeutic proteins, the CYP enzymes levels may be restored resulting in therapeutic protein–mediated drug interactions (TP‐DI). These analyses characterized the worst‐case scenario for CYP1A2, 2C9, and 3A‐based TP‐DI potential in patients with psoriasis by comparing the pharmacokinetics of probe substrates between healthy volunteers and subjects with moderate to severe psoriasis. Data for the CYP probe substrates midazolam (CYP3A), caffeine (CYP1A2), and S‐warfarin (CYP2C9) from 7 drug interaction studies (1 in patients with psoriasis and 6 in healthy subjects) were pooled to develop a population pharmacokinetics model for each substrate. A 2‐compartment model with absorption lag time for midazolam, a 1‐compartment model with 5 transit absorption compartments for caffeine, and a 3‐compartment model with absorption lag time for S‐warfarin best described the observed data. Apparent oral clearance and relative bioavailability for caffeine and S‐warfarin were not significantly different between the subject populations. Psoriasis patients were estimated to have 17% lower midazolam oral bioavailability than healthy volunteers. Compounded with other covariate effects, the ratio of median post hoc area under the plasma concentration–time estimates in subjects with psoriasis relative to healthy subjects was 0.96, 1.13, and 0.65 for midazolam, caffeine, and S‐warfarin, respectively. Therefore, inflammation in psoriasis had no relevant effect on reducing CYP1A2, 2C9, and 3A activities in vivo and no significant TP‐DIs mediated through these enzymes are expected in patients with psoriasis. This approach can potentially be used in lieu of dedicated TP‐DI studies to identify TP‐DI risks within a disease area.
Implementation of an online treatment planning exercise focused on vulnerable patient groups
Authors: Nair Rohit U. , Marchini Leonardo , Johnsen David C. , Xie Xian J.
Published: September 2020

The coronavirus disease 2019 (COVID‐19) pandemic presented formidable challenges in our ability to impart in‐person extra‐mural clinical training, including the Geriatric and Special Needs Program, to a group of 20 fourth‐year dental students. A new course delivery format was developed wherein students used a validated Rapid Oral Health Deterioration (ROHD) risk assessment tool to critically appraise clinical case information relating to a young adult with special needs. In the alternative virtual educational approach that was created, students applied an interprofessional practice concept leading to patient treatment planning outcomes. Providing adequate information, additional reading resources, a response template, clear instructions and a process‐oriented assessment policy all ensured a good level of participation from students in the alternative learning format. An association was noted between students’ staging of risk for ROHD and their subsequent recommendations for treatment.
A new diagnostic indication device of a biomarker growth differentiation factor 15 for mitochondrial diseases: From laboratory to automated inspection
Authors: Koga Yasutoshi , Povalko Nataliya , Inoue Eisuke , Ishii Akiko , Fujii Katsunori , Fujii Tatsuya , Murayama Kei , Mogami Yukiko , Hata Ikue , Ikawa Masamichi , Fukami Kei , Fukumoto Yoshihiro , Nomura Masatoshi , Ichikawa Kazuki , Yoshida Kaori
Published: September 2020

Mitochondrial diseases (MDs) are occasionally difficult to diagnose. Growth differentiation factor 15 (GDF15) has been reported as a biomarker useful for not only diagnosing MDs, but also evaluating disease severity and therapeutic efficacy. To enable the measurement of serum GDF15 concentrations at medical institutions, we developed a new latex‐enhanced turbidimetric immunoassay (LTIA) as an automated diagnostic indication test for MDs. We also examined the equivalency of specificity and sensitivity in measuring serum GDF15 concentrations between a commercially available enzyme‐linked immunosorbent assay (ELISA) kit and a novel LTIA device in patients with MDs, disease controls, and healthy controls. A clinical performance study used a newly developed LTIA device and an existing ELISA kit to measure the concentrations of GDF15 in 35 MD patients, 111 disease controls, and 86 healthy controls. The median (first quartile‐third quartile) of serum GDF15 concentrations measured with the LTIA device was significantly higher (P < .001) in MD patients (1389.0 U/mL [869.5‐1776.0 U/mL]) than in healthy controls (380.5 U/mL [330.2‐471.8 U/mL]); the interquartile ranges did not overlap between MD patients and healthy controls. The areas under the curve in disease and healthy controls were 0.812 (95% confidence interval [CI]: 0.734‐0.886) and 0.951 (95% CI: 0.910‐0.992), respectively. The automated, high‐throughput technology‐based LTIA device has definite advantages over the ELISA kit in shorter processing time and lower estimated cost per sample measurement. The LTIA device of GDF15 may be a sufficiently reliable, frontline, diagnostic indicator of individuals with suspected MDs in the general population.
Anticoagulant activity of apixaban can be estimated by multiple regression analysis
Authors: Unami Naoko , Ise Yuya , Suzuki Hidenori
Published: September 2020

Background

Information on apixaban anticoagulant activity is required to prevent major bleeding or thrombosis during its use.

Methods

We enrolled 194 patients with nonvalvular atrial fibrillation (NVAF) in whom warfarin was replaced with apixaban: 105 (54.1%) received the standard dose of apixaban (5 mg twice daily [BID]; 5 mg group) and 89 (45.9%) received a reduced dose (2.5 mg BID; 2.5 mg group). Multiple regression analysis was performed to predict the prothrombin time of apixaban (PTa) based on factors including age, body weight (BW), serum creatinine, and CHA2DS2‐VASc score.

Results

PTa and PT of warfarin (PTw) were significantly correlated in both groups (correlation coefficient R = 0.239 [P = .014] in the 5 mg group; R = 0.248 [P = .019] in the 2.5 mg group). PTa in the 5 mg group was predicted as follows: 16.952‐0.036 × BW +0.299 × CHA2DS2‐VASc score (P < .0004; R = 0.378). However, in the 2.5 mg group, PTa could not be predicted. The mean of the predicted and measured PTa values in the 5 mg group was 15.6 s, which was similar to the mean measured PTa of 15.5 s in the 2.5 mg group.

Conclusions

PT can be predicted by a formula including simple clinical parameters in patients receiving the standard dose of apixaban. This simple predictive formula may help to stratify bleeding and thrombosis risks in patients treated with apixaban.
Atomic force microscopy imaging for nanoscale and microscale assessments of extracellular matrix in intervertebral disc and degeneration
Authors: Cauble Meagan A. , Mancini Nickolas S. , Kalinowski Judith , Lykotrafitis George , Moss Isaac L.
Published: September 2020

Degeneration of the intervertebral disc (IVD) is a condition that is often associated with debilitating back pain. There are no disease‐modifying treatments available to halt the progression of this ubiquitous disorder. This is partly due to a lack of understanding of extracellular matrix (ECM) changes that occur at the micro‐ and nanometer size scales as the disease progresses. Over the past decade, atomic force microscopy (AFM) has been utilized as a tool to investigate the impact of disease on nanoscale structure of ECM in bone, skin, tendon, and dentin. We have expanded this methodology to include the IVD and report the first quantitative analysis of ECM structure at submicron size scales in a murine model for progressive IVD degeneration. Collagen D‐spacing, a metric of nanoscale structure at the fibril level, was observed as a distribution of values with an overall average value of 62.5 ± 2.5 nm. In degenerative discs, the fibril D‐spacing distribution shifted towards higher values in both the annulus fibrosus and nucleus pulposus (NP) (P < .05). A novel microstructural feature, collagen toroids, defined by a topographical pit enclosed by fibril‐forming matrix was observed in the NP. With degeneration, these microstructures became more numerous and the morphology was altered from circular (aspect ratio 1.0 ± 0.1) to oval (aspect ratio 1.5 ± 0.4), P < .005. These analyses provide ECM structural details of the IVD at size scales that have historically been missing in studies of disc degeneration. Knowledge gained from these insights may aid the development of novel disease‐modifying therapeutics.
Diels‐Alder reaction rate in the solid state and the evidence of the location of molecular complexes between the reagents on the reaction pathway
Authors: Kiselev Vladimir D. , Kolesnikova Anastasia O. , Dinikaev Ildar F. , Shulyatiev Alexey A. , Klimovitskii Alexander E. , Kornilov Dmitry A.
Published: September 2020

The rate of reactions in the solid phase with uniform grinding of crystals of dienes, anthracene, and 9,10‐dimethylanthracene, with dienophiles, tetracyanoethylene, N‐phenylmaleimide, and 4‐phenyl‐1,2,4‐triazoline‐3,5‐dione, has been studied. It was shown that, despite the high difference in the reaction rates in solution, the rates of these reactions in the solid phase are much closer. For anthracene‐tetracyanoethylene and 9,10‐dimethylanthracene‐tetracyanoethylene pairs, it was concluded that their intermolecular complexes are on the reaction pathway.
CSF Leaks due to Electric Scooter Injury
Authors: Kim Jee‐hong , Ge Marshall , Su Peiyi , Suh Jeffrey D. , Ference Elisabeth H.
Published: September 2020

Background

There has been a rapid increase in electric motorized scooter (e‐scooter) usage after the introduction of dockless, shareable devices.

Methods

Case series from three tertiary hospitals in Los Angeles between May‐September 2019.

Results

Five patients had skull base fractures and CSF leaks or pneumocephalus after e‐scooter accident, none wore helmets. Two patients were treated with observation alone, two patients were treated with lumbar drain or external ventriculostomy placement, and one patient died of their injuries prior to definitive management.

Conclusion

Without appropriate safety policies in place, the number of such injuries may increase as the use of e‐scooters increase. Laryngoscope, 131:E1035–E1037, 2021