bluuebunny/crossref_metadata_2025 huggingface dataset:
A Prospective Observational Study on Incidence, Implications and Management of Seizures Following Stroke
Authors: Sunny Angel , Alan J.K , Arali Megha S , Babu Sara , Ahmed Syed Khaleel , Naik Vinod
Published: November 2024

Background: Seizures following a stroke often indicate a more severe incident, typically resulting in extended hospital stays and a heightened risk of long-term disability. Management strategies generally include the use of anti-epileptic drugs to mitigate the frequency and severity of seizures.
Objectives: this study aims to evaluate the   incidence and risk factors assosciated for seizures after stroke, differentiating between acute symptomatic seizures and late seizures. Additionally, it assess dependency levels of patients after stroke and management of seizures after stroke.
Methodology: We conducted prospective observational study for 6 months which includes patients who were diagnosed with cerebrovascular accident, past history of cerebrovascular accident, experienced single or recurrent seizures of different types.
Results: Out of 150 patients observed, 67 experienced seizures following stroke. Majority of these patients were male (99) predominantly aged between 50-75. Hypertension was found to be the major risk factor affecting 106(75.2%) individuals.Ischemic stroke were common. In terms of seizure occurrence, 27 patients experienced acute symptomatic seizure and 40 late onset seizure. Activity of daily living was assessed using Barthel Index Scale in which total dependency showed statistically significant relevance (P =0.01).
Conclusion: In summary, the leading cause of seizure in adults is stroke. While both ischemic and hemorrhagic stroke may increase the risk of seizure, our study reveals that occurrence of seizure is greater following ischemic compared to hemorrhagic. A clinical pharmacist plays a vital role in determining prophylactic AED treatment for stroke patients and monitor to improve patient’s quality of life.
A Scale to Analyse the Societal Attitude of Farmers towards Adoption of Scientific Water Efficient Practices in Command Areas
Authors: Y. H. Preeti, , Suresha S. V. , Ranganatha A. D. , Achoth Lalith , Mudalagiriyappa
Published: November 2024

Water is an essential yet limited natural resource, vital for sustaining life on Earth. Command areas refer to regions supplied by irrigation systems, such as canal networks or reservoirs, which deliver water to agricultural lands. Effective water management in these regions is crucial for optimizing resources, ensuring fair distribution, and enhancing crop production and productivity. While many scales exist to measure farmers' attitudes, none specifically assess attitudes toward adopting scientific, water-efficient practices in command areas. This study attempts to address this gap by developing and standardizing a scale to evaluate farmers' societal attitudes toward such practices. The resulting scale, which has demonstrated high reliability and validity, consists of 40 statements divided into six categories: (a) maintenance of field channels and distributaries, (b) on-farm water management, (c) water-saving techniques, (d) crop selection and cultivation practices, (e) excess water management techniques, and (f) policy, administration, and extension. An Ex-post facto research design was adopted, and the scale was administered to 40 farmers using a simple random sampling technique in the Tungabhadra command area of Karnataka during the 2023-24 period. Findings reveal that a significant majority of farmers (80%) exhibited attitudes ranging from less favourable to favourable toward scientific water-efficient practices, whereas only one-fourth (20%) displayed a more favourable attitude toward these practices.
Pharmacokinetic evaluation of novel pH‐sensitive poly(2‐methoxyethyl methacrylate‐co‐itaconic acid) microgels in rabbits
Authors: Rashid Zermina , Ranjha Nazar Mohammad , Rashid Fareeha , Razzaq Rabia
Published: December 2018

Novel copolymeric microgels of 2‐methoxyethyl methacrylate and itaconic acid have been proposed for pH‐responsive oral delivery of therapeutics. In vitro evaluation confirmed the potential of p(MEMA‐co‐IA) microgels to protect the drug from harsh environment of stomach and to deliver drug in response to pH of the external environment over extended period of time. In the present study, p(MEMA‐co‐IA) microgels have been evaluated for the pharmacokinetic parameters of model drug, esomeprazole in rabbits. Single‐dose noncompartmental study was conducted by oral administration of drug solution and drug‐loaded microgel. On comparison, it was found that the microgels have delayed the release of drug to about 2 hr, with decreased Cmax, prolonged tmax, increased AUC0−t, and prolonged MRT. The differences were statistically significant. In conclusion, p(MEMA‐co‐IA) microgels have potential for preferential drug delivery into higher pH environment over prolonged period of time.
Genomics of body fat percentage may contribute to sex bias in anorexia nervosa
Authors: Hübel Christopher , Gaspar Héléna A. , Coleman Jonathan R. I. , Finucane Hilary , Purves Kirstin L. , Hanscombe Ken B. , Prokopenko Inga ,   MAGIC investigators, Graff Mariaelisa , Ngwa Julius S. , Workalemahu Tsegaselassie ,   Eating Disorders Working Group of the Psychiatric Genomics Consortium,   Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium,   Schizophrenia Working Group of the Psychiatric Genomics Consortium,   Tourette Syndrome/Obsessive‐Compulsive Disorder Working Group of the Psychiatric Genomics Consortium, O'Reilly Paul F. , Bulik Cynthia M. , Breen Gerome
Published: December 2018

Anorexia nervosa (AN) occurs nine times more often in females than in males. Although environmental factors likely play a role, the reasons for this imbalanced sex ratio remain unresolved. AN displays high genetic correlations with anthropometric and metabolic traits. Given sex differences in body composition, we investigated the possible metabolic underpinnings of female propensity for AN. We conducted sex‐specific GWAS in a healthy and medication‐free subsample of the UK Biobank (n = 155,961), identifying 77 genome‐wide significant loci associated with body fat percentage (BF%) and 174 with fat‐free mass (FFM). Partitioned heritability analysis showed an enrichment for central nervous tissue‐associated genes for BF%, which was more prominent in females than males. Genetic correlations of BF% and FFM with the largest GWAS of AN by the Psychiatric Genomics Consortium were estimated to explore shared genomics. The genetic correlations of BF%male and BF%female with AN differed significantly from each other (p < .0001, δ = −0.17), suggesting that the female preponderance in AN may, in part, be explained by sex‐specific anthropometric and metabolic genetic factors increasing liability to AN.
Stable carbon and nitrogen isotope inter‐ and intra‐individual dietary reconstruction from the late 14th to early 18th century site of Alytus, Lithuania
Authors: Whitmore Katie M. , Dupras Tosha L. , Williams Lana J. , Skipitytė Raminta , Schultz John J. , Jankauskas Rimantas
Published: December 2018

Objectives

The Baltic region, particularly Lithuania, was a politically vibrant area of Eastern Europe during the medieval and early modern period. To better understand the diet of Lithuanians during the late 14th to early 18th century, we examine stable carbon and nitrogen isotope ratios from bone and dentin samples from the site of Alytus. We investigate possible dietary differences based on sex, age, and religious practice, as well as dietary changes throughout an individual's lifetime, within the broader European milieu.

Materials and methods

Stable carbon and nitrogen isotope analysis was conducted on bone (n = 35) and dentin (n = 38) collagen samples from a total of 39 individuals buried in the cemetery at Alytus (late 14th to early 18th centuries).

Results

Results indicate individuals at Alytus consumed a C3 terrestrial based diet. The δ13C and δ15N values are not significantly different between bone and dentin, and did not vary by sex.

Discussion

The diet at Alytus was homogeneous between males and females and between tissue types. The lack of evidence indicating substantial consumption of fish is unexpected given widespread Catholic fasting practices and marine resource trade throughout Europe. Comparisons with other populations indicate that individuals from Alytus differ in diet from contemporaneous Polish–Lithuanian Commonwealth elites. Comparison of the diets of non‐elite individuals in the Eastern Baltic region also reveals dietary variability.
Fine liquid blowing: A high Reynolds number, high production rate nanofiber manufacturing technique
Authors: Rawlins John , Kang Jinhee
Published: December 2018

A novel gas‐assisted jetting process, term fine liquid blowing, is used to improve the production rate of making nanofiber from polymer solution. A high‐velocity gas stream is introduced through a central protruding core needle, while a liquid is introduce via an adjacent satellite needle. This arrangement avoids passing the high‐velocity gas over the surface of the slow flowing liquid and results in the stable acceleration of the liquid flow on its approach to the tip of the core needle, where it interacts with the high‐velocity gas, initiating numerous liquid jets at elevated Reynolds numbers of up to more than 800. The method was used to produce poly (vinyl alcohol) nonwoven fiber mats at polymer solution feed rates of up to 900 mL h, surpassing other conventional methods. The produced fibers were of diameters ranging from 96 to 430 nm. Over the tested range, polymer flow rate did not show significant influence on the resulting fiber diameter. © 2018 Wiley Periodicals, Inc. J. Appl. Polym. Sci. 2019, 136, 47384.
The addition effect of hollow glass microsphere on the dispersion behavior and physical properties of polypropylene/clay nanocomposites
Authors: Jung Bich Nam , Kang DongHo , Cheon Solmi , Shim Jin Kie , Hwang Sung Wook
Published: December 2018

Polypropylene (PP) nanocomposites have been widely researched for last decade due to its high mechanical property and multiple usages in various industrial fields from automobile to consumer packaging. Dispersion of nanoclay in polyethylene and PP is the key factor due to their hydrophobic property. Adding surfactant or introducing a polymer with a functional group, and modifying a natural clay with organic ions have been tried to achieve the better dispersion of clay in polymer matrix. In this study, the PP/clay nanocomposite with maleic anhydride grafted PP and hollow glass microspheres (HGMs) at various compositions were prepared and characterized. The addition of HGMs to PP/clay nanocomposites significantly improved the tensile stress at yield point except 7 wt % of HGMs. It is assumed that this could be due to not only the reinforcing effect of HGMs in PP, but the crushing effect of HGMs on the clay resulting in interlayer increase of clay as well. The barrier properties was also found to be improved about 32% max resulting from the better dispersion and presence of HGMs. It could be assumed that the HGMs could act as a ball creating a ball milling crush force to achieve the better dispersion of clay in the polymer and improve nanocomposite performance. © 2018 Wiley Periodicals, Inc. J. Appl. Polym. Sci. 2019, 136, 47476.
Rapid prototyping of proteins: Mail order gene fragments to assayable proteins within 24 hours
Authors: Dopp Jared Lynn , Rothstein Samuel Michael , Mansell Thomas Joseph , Reuel Nigel Forest
Published: December 2018

In this study, we present a minimal template design and accompanying methods to produce assayable quantities of custom sequence proteins within 24 hr from receipt of inexpensive gene fragments from a DNA synthesis vendor. This is done without the conventional steps of plasmid cloning or cell‐based amplification and expression. Instead the linear template is PCR amplified, circularized, and isothermally amplified using a rolling circle polymerase. The resulting template can be used directly with cost‐optimized, scalably‐manufactured Escherichia coli extract and minimal supplement reagents to perform cell‐free protein synthesis (CFPS) of the template protein. We demonstrate the utility of this template design and 24 hr process with seven fluorescent proteins (sfGFP, mVenus, mCherry, and four GFP variants), three enzymes (chloramphenicol acetyltransferase, a chitinase catalytic domain, and native subtilisin), a capture protein (anti‐GFP nanobody), and 2 antimicrobial peptides (BP100 and CA(1–7)M(2–9)). We detected each of these directly from the CFPS reaction using colorimetric, fluorogenic, and growth assays. Of especial note, the GFP variant sequences were found from genomic screening data and had not been expressed or characterized before, thus demonstrating the utility of this approach for phenotype characterization of sequenced libraries. We also demonstrate that the rolling circle amplified version of the linear template exhibits expression similar to that of a complete plasmid when expressing sfGFP in the CFPS reaction. We evaluate the cost of this approach to be $61/mg sfGFP for a 4 hr reaction. We also detail limitations of this approach and strategies to overcome these, namely proteins with posttranslational modifications.
Extracellular hemoglobin combined with an O2‐generating material overcomes O2 limitation in the bioartificial pancreas
Authors: Mouré Anne , Bacou Elodie , Bosch Steffi , Jegou Dominique , Salama Apolline , Riochet David , Gauthier Olivier , Blancho Gilles , Soulillou Jean‐Paul , Poncelet Denis , Olmos Eric , Bach Jean‐Marie , Mosser Mathilde
Published: December 2018

The bioartificial pancreas encapsulating pancreatic islets in immunoprotective hydrogel is a promising therapy for Type 1 diabetes. As pancreatic islets are highly metabolically active and exquisitely sensitive to hypoxia, maintaining O2 supply after transplantation remains a major challenge. In this study, we address the O2 limitation by combining silicone‐encapsulated CaO2 (silicone‐CaO2) to generate O2 with an extracellular hemoglobin O2‐carrier coencapsulated with islets. We showed that the hemoglobin improved by 37% the O2‐diffusivity through an alginate hydrogel and displayed antioxidant properties neutralizing deleterious reactive O2 species produced by silicone‐CaO2. While the hemoglobin alone failed to maintain alginate macroencapsulated neonate pig islets under hypoxia, silicone‐CaO2 alone or combined to the hemoglobin restored islet viability and insulin secretion and prevented proinflammatory metabolism (PTGS2 expression). Interestingly, the combination took the advantages of the two individual strategies, improved neonate pig islet viability and insulin secretion in normoxia, and VEGF secretion and PDK1 normalization in hypoxia. Moreover, we confirmed the specific benefits of the combination compared to silicone‐CaO2 alone on murine pseudo‐islet viability in normoxia and hypoxia. For the first time, our results show the interest of combining an O2 provider with hemoglobin as an effective strategy to overcome O2 limitations in tissue engineering.
Diagnostic utility of immunohistochemical analysis and Epstein–Barr virus‐encoded small RNAs in situ hybridisation of cell block sections obtained using fine‐needle aspiration in nasopharyngeal carcinoma with lymph node metastasis
Authors: Zhang Yanlin , Yu Xiaomeng , Yang Yan , Wang Yunhong , Chen Shuyuan , Zhou Xiaoge
Published: December 2018

Objective

This study aimed to investigate the diagnostic utility of immunohistochemistry (IHC) analysis (FNA) and Epstein–Barr virus‐ (EBV) encoded small RNAs (EBERs) in situ hybridisation analyses of cell block (CB) sections obtained using fine needle aspiration in nasopharyngeal carcinoma (NPC) with lymph node metastasis.

Methods

A total of 38 FNA biopsies were collected using a Youyi aspirator. The cytomorphology, CB‐based histomorphology, IHC, and EBERs in situ hybridisation were observed and the sensitivity/final diagnostic rates were compared with those of simple smears and a combination of smears and CBs.

Results

The 38 cases of metastatic lymph nodes from NPC displayed the morphological characteristics of non‐keratinising carcinoma in cell smears and CB sections. The tumour cells showed high expression of CK5/6, P63, Ki‐67, and EBERs (94.7%, 36/38 cases) in the CB sections. The sensitivity and the final diagnostic rates were lowest with the simple cell smears (86.8%, 33/38 and 71.1%, 27/38 cases), moderate with the smears combined with CB sections (92.1%, 35/38 cases and 81.6%, 31/38 cases), and the highest with IHC and EBERs in situ hybridisation (94.7%, 36/38 and 94.7%, 36/38 cases).

Conclusions

FNA has great value in the diagnosis of NPC with lymph node metastases, and using cell smears combined with IHC and EBERs in situ hybridisation of CB sections could help clinical doctors promptly identify the primary lesions.
Role of fine‐needle aspiration in post liver transplant patients: A clinical/cytological review
Authors: Rohra Prih , Mir Fatima , Lin Diana Murro , Furlan Karina , Javidiparsijani Sara , Lucero David , Gattuso Paolo
Published: December 2018

Background

Fine‐needle aspiration (FNA) of superficial and deep‐seated lesions has been used with high sensitivity and specificity in the diagnosis of neoplastic and nonneoplastic lesions. However, literature of FNA in posttransplant patients is sparse, especially in postliver transplant. We undertook a retrospective study to evaluate the utility of FNA in the clinical management of post liver transplant patients.

Methods

We searched our institution's surgical/cytologic databases (November1993–February2016) to identify liver transplant cases and FNA procedures performed on allograft liver recipients. Institutional IRB approval was obtained for this study.

Results

886 liver allograft recipients were reviewed, 41(5%) of which were transplanted for hepatocellular carcinoma. 62/886(7%) underwent an FNA procedure. 39males and 23females included with mean age of 58years. Mean time between transplant and FNA was 34months.

21/62(34%) were malignant neoplasms, most common malignancy was adenocarcinoma: 8cases(3lung,3pancreas,1colon,1cholangiocarcinoma)and 8cases of transplanted hepatocellular carcinoma patients had recurrence, 6 in the allograft liver and 1case each of metastasis to the iliac bone and periportal lymph node. 3cases were squamous‐cell carcinoma (2lung and 1scalp). 2cases were posttransplant lymphoproliferative disorders.

34/62(55%) cases were benign aspirates from various organs (8lung,6liver,5pancreas,4breast,3thyroid,3lymph‐nodes and 1case each of salivary gland, bile‐duct,intraabdominal,abdominal wall,and oral cavity) 0.6/62(10%) cases were inflammatory.

22cases had histologic correlation: 5true‐positives,16true‐negatives,1false‐negative (a patient with parotid mucoepidermoid carcinoma whose FNA diagnosis was sialadenitis), and no false‐positive. The sensitivity was 83% and the specificity was 100%. The positive predictive value was 100% and the negative predictive value was 94%.

Conclusions

This review shows that 40/62(65%) of the aspirates were benign lesions, indicating that a conservative approach is recommended in the clinical management of these patients, especially since the interval between transplant and FNA was on average 34months. FNA is a safe, minimally invasive method to follow‐up these patients.
Alignment‐based design and synthesis of new antimicrobial Aurein‐derived peptides with improved activity against Gram‐negative bacteria and evaluation of their toxicity on human cells
Authors: Madanchi Hamid , Akbari Shabnam , Shabani Ali Akbar , Sardari Soroush , Farmahini Farahani Yekta , Ghavami Ghazaleh , Ebrahimi Kiasari Ramin
Published: December 2018

Considering the worldwide increasing prevalence of resistance to traditional antibiotics, it is necessary to find new antibiotics to deal with this issue. Recently, antimicrobial peptides (AMPs) have been proposed as new antimicrobial agents. Aureins are a family of AMPs that are isolated from Green and Golden Bell Frogs. These peptides have a favorable antibacterial activity against Gram‐positive bacteria. We designed two peptides derived from natural Aurein enjoying alignment‐based design method. After synthesis of the peptides, their secondary structure was checked by circular dichroism. Consequently, the antibacterial effects of these peptides were investigated by determining the minimum inhibitory concentration (MIC) and bactericidal concentration. Eventually, the toxicity of these peptides was determined by MTT (3‐[4, 5‐dimethylthiazol‐2‐yl]‐2, 5‐diphenyltetrazolium bromide) assay on normal human skin cells (Hu02 cell line). Natural Aurein1.2 was used as a natural control to compare the properties in all stages. The results indicated that these new peptides had medium‐upward antimicrobial activity against Escherichia coli, Pseudomonas aeruginosa, and Bacillus subtilis (MIC of 8–64 μg/mL) and weak bactericidal activity against Staphylococcus aureus (MIC of 128–256 μg/mL). Also, MTT assays results showed that AureinN2 is less toxic than AureinN1 and Aurein1.2. Toxicity of AureinN2 for Hu02 cell lines was between 20 and 40% at the concentration of 8–500 μg/mL. In this study, we were able to improve antimicrobial activity of two synthetic derivatives of the Aurein family against Gram‐negative bacteria by using machine‐learning algorithm and other in silico methods.
Enhancing the value of public vintage seismic data in the Italian offshore
Authors: Diviacco Paolo , Firetto Carlino Marco , Busato Alessandro
Published: December 2018

Vintage geophysical data represent a huge heritage for the whole scientific community (Sopher, 2018; Schaming et al., 2017; Diviacco et al., 2015) because, despite the antiquated acquisition methods and processing tools, they are generally characterized by high penetration and wide regional extension. Nowadays such large‐scale projects are in fact very difficult to take place, considering environmental, geopolitical, and funding issues. In addition, reprocessing vintage seismic profiles using up‐to‐date software and tools, it is now possible to further increase their original signal‐to‐noise ratio. Italian offshore areas have been widely investigated by a dense network of multichannel seismic reflection profiles, acquired by the Italian Authorities in the years 1960, 1970, and 1980 of the last century in the perspective of mineral prospecting. This asset of data has been recovered, reprocessed, and made accessible within a demanding project undertaken by Istituto Nazionale di Oceanografia e di Geofisica Sperimentale (OGS). The present work aims at describing the data recovery and reprocessing methodologies applied to enhance the quality of these vintage multichannel‐seismic reflection profiles, and at detailing how to access this huge dataset, that have been made compliant with the FAIR principles (Findable, Accessible, Interoperable, Reusable) and available through the OGS‐SNAP data management web portal.

Open Practices

This article has earned an Open Data badge for making publicly available the digitally‐shareable data necessary to reproduce the reported results. The data is available at https://doi.org/10.6092/SNAP.cbbba251c17b55c737836768c8737589. Learn more about the Open Practices badges from the Center for Open Science: https://osf.io/tvyxz/wiki.
Long‐term outcome and pattern of failure for patients with nasopharyngeal carcinoma treated with intensity‐modulated radiotherapy
Authors: Tian Yun‐Ming , Liu Ming‐Zhu , Zeng Lei , Bai Li , Lin Cheng‐guang , Huang Shao‐Min , Deng Xiao‐Wu , Chong‐Zhao  , Lu Tai‐Xiang , Han Fei
Published: December 2018

Purpose

To analyze the long‐term outcome and pattern of failure for patients with nasopharyngeal carcinoma (NPC) after intensity‐modulated radiotherapy (IMRT).

Methods and materials

Patients with NPC after IMRT from 2001 to 2008 were recruited (n = 865). Clinical features, laboratory data, and treatments were collected.

Results

The 10‐year local recurrence‐free survival, distant metastasis‐free survival, and disease‐specific survival (DSS) were 92.0%, 83.4%, and 78.6%, respectively. A total of 209 patients died: 59% of whom died from distant metastasis. The 10‐year DSS was higher in patients who received chemoradiotherapy than those who received IMRT alone for patients with high‐risk stage III disease, while there was no survival difference for patients with stage II and low‐risk stage III disease.

Conclusions

IMRT provides satisfactory long‐term survival for patients with NPC. Distant metastasis has been the most common reason for failure. Adding chemotherapy did not improve survival in patients with stage II and low‐risk stage III disease.
Comparison of contemporary staging systems for oropharynx cancer in a surgically treated multi‐institutional cohort
Authors: Elicin Olgun , Broglie Martina A. , Fankhauser Niklaus , Stoeckli Sandro J. , Pasche Philippe , Reinhard Antoine , Bongiovanni Massimo , Huber Gerhard F. , Morand Grégoire B. , Soltermann Alex , Arnold Andreas , Dettmer Matthias S. , Arnoux André , Stauffer Edouard , Espeli Vittoria , Martucci Francesco , Aebersold Daniel M. , Giger Roland
Published: December 2018

Background

Between the publication of the Union of International Cancer Control staging system (UICC) 7th and 8th editions, other staging algorithms for oropharyngeal squamous cell carcinoma (OPSCC) were proposed from Radiation Therapy Oncology Group (RTOG), MD Anderson Cancer Center (MDACC), and Yale University.

Methods

With C‐statistics, the above‐mentioned five staging algorithms were compared for overall and relapse‐free survival endpoints in a multi‐institutional cohort of OPSCC cases (n = 338) treated with primary surgery.

Results

Pathological UICC 8th ed yielded the highest C‐indexes in the entire cohort and in the HPV− subset, whereas MDACC was superior for HPV+ OPSCC. RTOG was the simplest and holistic algorithm with a noninferior discriminatory power.

Conclusion

UICC 8th ed, MDACC, and RTOG offer moderate and comparable efficacy for staging in this OPSCC patient cohort undergoing surgical treatment. Notable discrepancy between clinical and pathological UICC 8th ed algorithms poses potential concerns in diagnosis, treatment, research, and data management.
An ab initio‐based global potential energy surface for the SH3 system and full‐dimensional state‐to‐state quantum dynamics study for the H2 + HS → H2S + H reaction
Authors: Xu Xin , Chen Jun , Liu Shu , Zhang Dong H.
Published: December 2018

An accurate potential energy surface for the ground electronic state of SH3 system has been constructed with 41,882 high level ab initio energy points and the neural network fitting method. The time‐dependent wave packet method has been used to calculate the first state‐to‐state differential cross sections for the title reaction up to 1.2 eV in full dimensions, based on the reactant–product decoupling scheme. It is found that the majority of H2S are produced in the ground vibrational state, with a large fraction of available energy for the reaction ending up as product translational motion. The differential cross sections at the threshold energy are dominated by a very narrow peak in the backward direction. With the increase of collision energy, the width of the angular distribution increases considerably, which is a typical feature of a direct reaction via abstract mechanism, similar to the H2 + OH → H2O + H reaction. © 2018 Wiley Periodicals, Inc.
Nonadiabatic scattering of NO off Au3 clusters: A simple and robust diabatic state manifold generation method for multiconfigurational wavefunctions
Authors: Robertson Christopher , González‐Vázquez Jesús , Corral Ines , Díaz‐Tendero Sergio , Díaz Cristina
Published: December 2018

The presence of nonadiabatic effects during the interaction of small molecules with metals has been observed experimentally for the last decades. Specially remarkable are the effects found for NO/Au, where experiments have suggested the presence of very strong vibronic coupling during the molecular scattering. However, the accurate inclusion of the nonadiabatic effects in periodic boundary conditions (PBC) theoretical methods remain an unapproachable challenge. Here, aiming to give some theoretical insight to the strong vibronic coupling, we have adopted a pragmatic point of view, taking use of an auxiliary simplified system, NO/Au3. We show the importance of nonadiabatic coupling, during the scattering of NO from a Au3 cluster, using a diabatic representation of 12 electronic states of the system, including a few charge‐transfer states. Our diabatic representation is obtained by rotating the orbital and configuration interaction (CI) vectors of a restricted active space (RAS) wavefunction. We present a strategy for extracting the best effective manifold of states relevant to the system, below some prescribed energy, directly from the RAS CI vectors. This scheme is able to disentangle a large dense manifold of adiabatic states with strong coupling and crossings. This approach is also shown to work for multireference configuration interaction (MRCI). By performing quantum propagations, we observed an increase in vibrational redistribution with increasing initial vibrational or translational energies. We suggest that these nonadiabatic effects should also be present at smaller energies in larger clusters. © 2018 Wiley Periodicals, Inc.
Quality of primary care provided in community clinics in Japan
Authors: Ozaki Makiko , Matsumura Shinji , Iwamoto Momoko , Kamitani Satoshi , Higashi Takahiro , Toyama Manabu , Bito Seiji , Waza Kazuhiro
Published: December 2018

Background

Quality indicators (QIs) for primary care are used worldwide. To date, however, the use of QIs to assess the quality of primary care in Japan has not been reported besides diabetes care. Here, we used QIs to evaluate the quality of primary care services provided by local clinics in Japan.

Methods

Four primary care clinics participated in the retrospective medical chart review in 2015. To assess primary care quality, we used 18 process‐oriented QIs from the Quality Indicators for Primary Care practice in Japan (QIPC‐J) those we previously developed by using a modified Delphi appropriateness method, which comprises 39 QIs in five categories (Comprehensive care/Standardized care, Access, Communication, Coordination, and Understanding of patient's background). Adult subjects were selected from among patients who visited each clinic within the previous one year using medical claims data. We collected data by reviewing medical charts, and calculated the quality score for each QI and clinic.

Results

A cumulative total of 4330 medical charts were reviewed. The overall quality score was 31.5%. Adherence to QIs ranged from 3.2% to 85.6%. Some quality scores varied substantially between clinics but the overall quality of care among clinics varied less, from 29.2% to 34.0%.

Conclusions

The quality of primary care services provided by local clinics in Japan varies by both QI and clinic. Strategies to improve the quality of care are warranted.
Humoral response to Clostridium difficile in inflammatory bowel disease, including correlation with immunomodulatory treatment
Authors: Henriksson Gunnel , Bredberg Johan , Wullt Marlene , Lyrenäs Ebbe , Hindorf Ulf , Ohlsson Björn , Grip Olof
Published: December 2018

Background and Aim

An abnormal immune response to intestinal bacteria has been observed in Crohn's disease (CD). Clostridium difficile infection incidence and severity are increased in CD, but reports on the humoral response have provided conflicting results. We aimed to shed light on the possible role of C. difficile in CD pathogenesis by paying attention to the influence of immunomodulatory treatment on the humoral response.

Methods

A total of 71 consecutive outpatients with CD, 67 with ulcerative colitis (UC), and 121 healthy controls were analyzed for serum IgA and IgG to C. difficile toxins A and B.

Results

IgA levels were similar in all study groups. IgG to toxin A was increased similarly in CD and UC (P = 0.02 for both). In contrast, IgG to toxin B was elevated only in CD patients not receiving disease‐modifying anti‐inflammatory bowel disease drugs (DMAID) (n = 16) (P = 0.0001), while the CD medication subgroup (n = 47) had a level similar to healthy controls. The UC results were not influenced by DMAID treatment.

Conclusion

Our findings add support to the idea of a disturbed interaction between intestinal cells and the microbiota being part of the CD disease mechanism. An abnormal immune response to C. difficile toxin B may be a critical component of this interaction.
Low fermentable oligosaccharides, disaccharides, monosaccharides, and polypols diet and irritable bowel syndrome in Asia
Authors: Zhang Yihe , Ma Zheng Feei , Zhang Hongxia , Pan Binyu , Li Yeshan , Majid Hazreen A , Lee Yeong Yeh
Published: December 2018

Functional bowel disorders, including irritable bowel syndrome (IBS), are a chronic condition that can significantly reduce patients’ quality of life. Therefore, this paper will review the roles of a low fermentable oligosaccharides, disaccharides, monosaccharides, and polypols (FODMAP) diet in treating IBS, particularly in an Asian setting. About 20% of the general population is diagnosed with IBS. However, there are limited effective medical therapies available for treating IBS. Therefore, IBS presents a major challenge to the health‐care providers. Recently, there is an increasing interest in the use of a diet low in FODMAP for the treatment of IBS. A low FODMAP diet can decrease the delivery of readily fermentable substrates to the small intestine and colon, thereby improving functional gastrointestinal symptoms.
A sandwich ELISA for detecting the hemagglutinin of avian influenza A (H10N8) virus
Authors: Chen Lingling , Ruan Feier , Liu Mingbin , Zhou Jianfang , Song Wenjun , Qin Kun
Published: December 2018

Novel influenza A virus (H10N8) infected human with fatality in China during 2013‐2014. It is important to detect such nonprevalent subtype influenza A virus in clinic and regular surveillance in the early stage for effective control and prevention from the potential pandemic. Unavailability of convenient rapid diagnosis for this subtype virus in resources‐limited setting is an obstacle for timely recognizing human case. In the present study, a panel of mouse H10 specific monoclonal antibodies (mAbs) was generated, two of which were used to develop a sandwich enzyme‐linked immunosorbent assay (ELISA) for detecting the hemagglutinin of avian influenza A (H10N8) virus. ELISA results showed high sensitivity with the lowest detection limit of 0.5HAU/50 μL for live virus, which laid a foundation for clinic use as a promising diagnostic methodology.
HPLC determination of γ‐aminobutyric acid and its analogs in human serum using precolumn fluorescence labeling with 4‐(carbazole‐9‐yl)‐benzyl chloroformate
Authors: Yu Yanxin , You Jinmao , Sun Zhiwei , Ji Zhongyin , Hu Na , Zhou Wu , Zhou Xuxia
Published: December 2018

In this study, a simple analytical method for the determination of γ‐aminobutyric acid, gabapentin, and baclofen by using high‐performance liquid chromatography with fluorescence detection was developed. An amidogen‐reactive fluorescence labeling reagent, 4‐(carbazole‐9‐yl)‐benzyl chloroformate was first used to sensitively label these analytes. The completed labeling of these analytes can be finished rapidly only within 5 min at the room temperature (25°C) to form 4‐(carbazole‐9‐yl)‐benzyl chloroformate labeled fluorescence derivatives. These labeled derivatives expressed strong fluorescence property with the maximum excitation and emission wavelengths of 280 and 380 nm, respectively. The labeled derivatives were analyzed using a reversed‐phase Eclipse SB‐C18 column within 10 min with satisfactory shapes. Excellent linearity (R2 > 0.995) for all analytes was achieved with the limits of detection and the limits of quantitation in the range of 0.25−0.35 and 0.70−1.10 μg/L, respectively. The proposed method was used for the simultaneous determination of γ‐aminobutyric acid and its analogs in human serum with satisfactory recoveries in the range of 94.5–97.5%.
Point‐of‐Care Ultrasonography (POCUS) in a Community Emergency Department: An Analysis of Decision Making and Cost Savings Associated With POCUS
Authors: Van Schaik Graham W. W. , Van Schaik Katherine D. , Murphy Michael C.
Published: December 2018

Objectives

Point‐of‐care ultrasonography (POCUS) is an increasingly integral part of emergency medicine. This study investigated community emergency department physicians’ choices regarding ultrasonography as a branch point in clinical decision making.

Methods

During shifts covering all days of the week and all time‐spans over a 3‐month period, emergency department physicians were interviewed whenever POCUS was used. Questions focused on the role of POCUS in clinical management and on tests avoided because of ultrasonography use. Cost savings attributable to POCUS were calculated using Center for Medicare and Medicaid Services and FairHealth data. Anonymization of data precluded follow‐up testing to account for misdiagnosis.

Results

On average, POCUS use eliminated $1134.31 of additional testing for privately insured patients, $2826.31 for out‐of‐network or uninsured patients, and $181.63 for Center for Medicare and Medicaid Services patients. Differences were significant when the total cost of eliminated additional testing was compared to a baseline of no savings (p < .001). Aggregate cost savings remained significant when analyses were broadened to include POCUS encounters that did not yield changes in management (p < .001).

Conclusions

When physicians’ clinical expertise suggests that POCUS may be indicated, its use results in significant cost savings, even in encounters in which management is not directly impacted. POCUS, when incorporated earlier and more frequently into community hospital emergency medicine diagnostic protocols, can lower direct and indirect costs associated with diagnostic workups. Community emergency departments, in particular, would benefit from additional investigation informing specific guidelines for the integration of POCUS into clinical management and the role that this has in cost savings.
Cerebral Artery Vasospasm Detection Using Transcranial Doppler Signal Analysis
Authors: Elzaafarany Khaled , Aly Moustafa H. , Kumar Gyanendra , Nakhmani Arie
Published: December 2018

Objectives

Silent cerebral artery vasospasm in aneurysmal subarachnoid hemorrhage causes serious complications such as cerebral ischemia and death. A transcranial Doppler (TCD) ultrasound system is a noninvasive device that can effectively detect cerebral artery vasospasm as soon as it sets in, even before and in the absence of clinical deterioration. Continuous or even daily TCD monitoring is challenging because of the operator expertise and certification required in the form of a trained sonographer and interpretive experience required in the form of an additionally trained and certified physician to perform these studies. This barrier exists because of a lack of automation for detection (without human intervention) of cerebral artery vasospasm using TCD ultrasound. To overcome this barrier, we present an algorithm that automates detection of cerebral artery vasospasm.

Methods

We extracted features such as the energy, energy entropy, zero‐crossing rate, spectral centroid, spectral speed, spectral entropy, spectral flux, spectral roll‐off, harmonic ratio, chroma, and Mel frequency cepstral coefficients for signal classification. Then we applied principal component analysis to reduce the data dimensionality.

Results

All of the chosen features were used for training a decision‐tree classifier. The algorithm had high accuracy for cerebral artery vasospasm detection, with overall sensitivity of 87.5% and specificity of 89.74%.

Conclusions

The algorithm has the potential for development into a continuous cerebral artery vasospasm monitor.
Occupancy of freshwater turtles across a gradient of altered landscapes
Authors: Buchanan Scott W. , Buffum Bill , Puggioni Gavino , Karraker Nancy E.
Published: December 2018

Turtles are one of the most threatened groups of vertebrates worldwide. In the northeastern United States, a legacy of centuries of dramatic landscape alteration has affected freshwater turtle populations, but the relationships between the current landscape and distributions and abundances of freshwater turtles remain poorly understood. We used a stratified random approach to select 88 small, isolated wetlands across a gradient of forest cover throughout Rhode Island, USA, and systematically sampled freshwater turtles in these wetlands. We report estimates of relative abundance and used a canonical correspondence analysis to investigate relationships between species relative abundance and environmental covariates. We also investigated which environmental covariates affect the occurrence and detection probabilities of each species. Eastern painted turtles (Chrysemys picta picta) and common snapping turtles (Chelydra serpentina) were widespread (occurring in 83% and 63% of wetlands, respectively) and relatively abundant. Spotted turtles (Clemmys guttata) were far less common, occurring in 8% of wetlands, and exhibited a positive association with shallow wetlands surrounded by forest. Non‐native red‐eared sliders (Trachemys scripta elegans) occurred in 10% of wetlands and exhibited a positive association with road density, likely reflecting a positive relationship between slider occurrence and human population density. Identifying landscape‐scale habitat features that are associated with the occurrence of sensitive species can improve the ability of biologists to identify and protect turtle populations. © 2018 The Wildlife Society.
Comparison of endoscopic and microscopic ear surgery in pediatric patients: A meta‐analysis
Authors: Han Sang‐Yoon , Lee Doh Young , Chung Juyong , Kim Young Ho
Published: December 2018

Objectives

Recently, the endoscope has been increasingly introduced for middle‐ear surgery. To evaluate the postoperative outcomes of endoscopic ear surgery (EES) in pediatric patients, we did a qualitative analysis with a systematic review and quantitative analysis with meta‐analysis of available literature.

Methods

Studies reporting the comparative surgical outcomes of EES in pediatric patients were systematically reviewed by searching the MEDLINE, PubMed, and Embase databases from database inception through 2017. The selected articles included clinical studies conducted with at least 30 subjects and at least one postoperative parameter, including residual or recurrent cholesteatoma and graft success in tympanoplasty. Two investigators independently reviewed all studies and extracted the data using a standardized form. A meta‐analysis was performed using a random‐effects model and qualitative review was performed on the smaller studies.

Results

Ten studies were identified as appropriate for quantitative meta‐analysis and 19 studies for qualitative analysis. In the meta‐analysis, residual or recurrence rate of cholesteatoma was significantly lower in the EES group than in the microscopic ear surgery (MES) group (odds ratio [OR]: 0.56, 95% confidence interval [CI]: 0.38‐0.84, P = .005). The graft success rate of tympanoplasty was not statistically different between EES and MES groups (OR: 0.72, 95% CI: 0.41‐1.26, P = .249). In the qualitative analysis, most of the studies reported similar audiological outcomes after tympanoplasty and success rate of cholesteatoma removal between the two groups.

Conclusions

It appears that EES reduces the risk of residual cholesteatoma in children and that the success of perforation closure is equivalent to MES.

Laryngoscope, 129:1444–1452, 2019
Efficacy of tranexamic acid on operative bleeding in endoscopic sinus surgery: A meta‐analysis and systematic review
Authors: Kim Do Hyun , Kim Subin , Kang Haram , Jin Ho Jun , Hwang Se Hwan
Published: December 2018

Objectives

Tranexamic acid might help control bleeding during surgery because of antifibrinolytic characteristics. We aimed to evaluate the effectiveness of systemic tranexamic acid compared to control in blood loss, operative time, and surgical field and incidence of postoperative emesis and thromboembolism in endoscopic sinus surgery.

Methods

Two authors independently searched six databases (PubMed, SCOPUS, Embase, the Web of Science, Google Scholar, and the Cochrane database) from their inception to July 2018. The included studies compared perioperative tranexamic acid administration (treatment group) with a placebo, and the outcomes of interest were intraoperative morbidities, including surgical time, operative bleeding, and hypotension; postoperative morbidities such as nausea and vomiting; and coagulation profiles.

Results

Seven studies comprising 562 participants were reviewed in this study. Operative time (standardized mean difference (SMD) = −0.60; 95% confidence interval (CI)[−0.93, −0.29]) and intraoperative blood loss (SMD = −0.66; 95% CI [−0.86, −0.46]) were statistically lower in the treatment group than placebo group; and the quality of the surgical field (SMD = −0.80; 95% CI [−1.12; −0.48]) and surgeon satisfaction (SMD = 1.74; 95% CI [1.36; 2.13]) were statistically higher in the treatment group than the placebo group. By contrast, there were no significant differences in the hemodynamic (SMD = 0.08; 95% CI [−0.20; 0.37]) and coagulation profiles (SMD = −0.18; 95% CI [−0.42, 0.07]) of the two groups. Additionally, tranexamic acid had no significant effect on emetic or thrombotic events compared to placebo.

Conclusion

This meta‐analysis showed that the systemic administration of tranexamic acid could decrease operative time and blood loss intraoperatively, increasing the satisfaction of surgeons. It did not provoke intraoperative hemodynamic instability, postoperative emetic events, or coagulation profile abnormality. Only a small number of studies were enrolled, so further trials are needed to confirm the results of this study. Laryngoscope, 129:800–807, 2019
Septal fractures predict poor outcomes after closed nasal reduction: Retrospective review and survey
Authors: Arnold Mark A. , Yanik Susan C. , Suryadevara Amar C.
Published: December 2018

Objectives/Hypothesis

To determine outcomes of patients with displaced nasal bone fractures after closed nasal reduction (CNR).

Study Design

Retrospective patient review.

Methods

Review of all patients presenting to the emergency department of a tertiary‐care, level 1 trauma hospital with a nasal bone fracture over a 2‐year period, followed by telephone survey after CNR.

Results

Six hundred seven patients presented to the emergency department in 2015 and 2016 with a diagnosis of nasal bone fracture. Of these, 134 patients met inclusion criteria and underwent CNR without septal reduction. Those with sports‐related injuries and those with a septal fracture identified on computed tomography imaging were significantly more likely to undergo CNR. Ninety‐one patients completed the post‐CNR telephone survey. Over 90% of patients were satisfied with the procedure. However, patients with septal fractures reported worse outcomes, as 53.6% versus 24.1% (P = .0025) disagreed that CNR improved nasal breathing. Of all patients, 11 (2%) eventually underwent septorhinoplasty, with the presence of septal fracture on imaging a significant risk factor.

Conclusions

Nasal bone fractures are a common injury, often managed initially with CNR. Patients with septal fractures should be counseled on the high risk of posttraumatic nasal deformity and obstruction despite CNR. In addition, addressing a septal fracture found on imaging may be warranted with either closed septal reduction or early aggressive management given the poorer outcomes seen in the present study. Although these patients are more likely to have definitive treatment, many forego later intervention despite persistent symptoms, emphasizing the need for early intervention or close follow‐up.

Level of Evidence

3

Laryngoscope, 129:1784–1790, 2019