bluuebunny/crossref_metadata_2025 huggingface dataset:
Incidence and Risk Factors Associated with Post Tibial Plateau Fracture Deep Venous Thrombosis: A Prospective Cohort Study
Authors: Qureshi Abdul Samad , Khan Dildar Ahmed , Ali Sikandar , Iqbal Mohammad Faheem
Published: July 2021

Objective: The purpose behind this study was to determine the incidence and risk factors associated with post tibial plateau fracture deep venous thrombosis (DVT)

Materials and Methods: A prospective study was conducted in a tertiary care hospital, Indus Medical College & Hospital, Tando Muhammad Khan to recruit those patients who were undergoing orthopedic surgeries during the periods of eighteen months. All the adult patients of both gender planned for surgery due to tibial plateau fracture were enrolled under this study. Duplex ultrasound was performed to detect the presence of underlying postoperative DVT. Post-operatively patients were assessed for potential risk factors associated with higher incidence of DVT. 

Results: For the final analysis, 344 patients were included among them majority were males (n = 219, 63.66%) with overall mean age and SD was 47.52±12.02 years. The most common cause of fracture was road traffic accident (n = 178, 51.74%). The overall incidence of post-operative DVT observed in our study was 9.30% (n = 32). Mean age 40.19±6.10 years, increased mean duration of operation 3.01±.078 hours, increased mean duration of post-hospitalization 18.49±7.37 days, raised mean WBC counts 20.12±5.64, and increased mean D-dimer levels 3.24±3.09 (laboratory cut off value 0.5mg/L) were significantly associated with higher incidence of DVT in patients operated for tibial plateau fractures.

Conclusion: This prospective analysis has identified the potential modifiable risk factors associated with DVT. Consideration should be given to the preventable and treatable risk factors to prevent from the DVT associated complications.
Review on Prasramsini Yonivyapad (Pelvic Organ Prolapse)
Authors: Pathan Karishma U. , Asokan V. , Sonam . , Roy Babita
Published: July 2021

Laxity of vaginal canal and uterine descent is one of the conditions commonly seen in peri-menopausal age with predominance of vata dosha, also seen as a complication of prolonged labour. syandana-prolapse, kshobhana-irritation, dushprasuta-difficult labour and other features of vitiation of pitta dosha are seen in prasramsini yonivyapad. Local therapy play an important role in these conditions. The descent of an organ is called Sramsana and condition called Prasramsini. Prasramsini yonivyapad is enumerated in pittaja yonivyapad by Sushruta which may be co-related with 1st and 2nd degree uterine prolapse. This condition is seen in peri-menopausal or postmenopausal period although young age group with distress during labour is no exemption. Prasramsini is a vatanubandhi, pittaja yonivyapad, the drugs with the properties of vata and pitta doshahara, kashaya rasa, balya and agnideepana can be selected. Vaginal tamppon is helpful to strengthen the vagina and cervix. In Ayurveda, local treatment of Prasramsini yonivyapad is sthanapavartana, pichu dharana and veshavara pinda with gophana bandha.
Review on Overview of Substance Abuse among Medical Practitioners
Authors: Bhugaonkar Mandar Ghanshyam , Jha Rakesh Kumar , Zilate Sarju
Published: July 2021

Substance Misuse, also known as substance abuse, is a disease marked by a harmful habit of using illicit or legal substances or medications such as alcohol, heroin, cocaine, or substituted amphetamines such as methamphetamine and MDMA. Drug abuse deeply impact physician's brain and behavior such that they are unable to control the use of drug to the point that it interferes with the ability to function which may harm patients and cause medical errors. The fact is, physicians can easily access various opioids and substituted amphetamines. This article review is the examination of existing published research articles on substance abuse among health care workers. This literature was reviewed using PubMed and google scholar search criteria set so that all the article could be found in English language along with certain keywords such as Health care workers, addiction, opioids, drug abuse. I gone through various articles, of which 10 articles related to study. It was found that substance abuse in medical workers were greater than general people and keeps increasing at an alarming rate. The most favored drug by health care workers is alcohol, the incidence of opioids and some nonopioids anesthetic agent abuse. Especially propofol, most commonly used by anesthetic department and emergency medicine. There is wide difference between general public and health care workers regarding drug abuse. Although Health care workers had a better prognosis but 10%-15% of health care are workers susceptible to drug violence at some point in their lives.
The Efficacy of Physical Therapy Rehabilitation Program for Women Following a Modified Radical Mastectomy: A Case Report
Authors: Gaur Vibhuti , Deshpande Shruti , Burhani Tasneem
Published: July 2021

Background: The most commonly identified cancer is breast cancer. In either the lobules or the breast ducts, the cancer normally grows. Infiltrating ductal carcinoma is the most common subtype. It may appear as a lump or mass; changes in the skin or nipple; breast rash or redness; or lymphadenopathy.

Presenting Complains and Investigations: the patient presented with the complains of  swelling and pain in the left breast in lower outer quadrant since 6 months, which was initially small in size and gradually increased and reached up this level 2x2 cm which placed in infra areolar region covering lower inner and outer quadrant. USG and cytology reports showed bilateral breast with axilla. Right breast was normal, enlarged lymph node in the right axilla measuring 15.2 x 4.6 mm with maintained hilum S/O reactive lymphadenopathy. In left breast there is E/O ill-defined taller than wider irregular hypoechoic lesion with spiculated margins, measuring approximately 15.9 x 12.4 mm in lower inner quadrant containing multiple foci of calcification within showing central vascularity OB doppler on elastography lesion is stiff, in left axilla there is E/O on enlarged USG lymph node present measuring 10.2 x 6.7 mm with maintained hilum S/O reactive lymphadenopathy. Impression of F/S/O malignant lesion in the left breast lymphadenopathy.

Diagnosis: Left sided infiltrating ductal carcinoma.

Therapeutic Intervention and Outcomes: Physical therapy intervention involved a variety of range of motion exercises, strengthening exercises, resistance conditioning, breathing exercises, lymphoedema treatment and scar management. This intensive outpatient program is a successful way to enhance the mobility of the shoulder and ROM during the initial 6-week treatment cycle after surgery. Shoulder range of motion was increased, patient was able to do basic activities of daily living like dressing, bathing, combing, etc. Edema was reduced.

Conclusion: Shoulder stiffness after modified radical mastectomy is the commonest complication. Upper limb mobility exercises reduced the shoulder stiffness. Breathing exercises improved the respiration. Strengthening and general aerobic exercises helped the patient to get back on her normal routine.
A Lunch Break Time and Its Impact on Employees Health, Performance and Stress on Work
Authors: Hakro Saifullah , Jameel Arif , Hussain Abid , Aslam Muhammad Shahzad , Khan Waris Ali , Sadiq Saiqa , Nisar Asma
Published: July 2021

Employees’ health, performance, and stress problem have become a major issue in today’s workplace globally. These problems are linked to various factors. In this study, we contributed the rationality of having a one-hour lunch break at the workplace. Drawing on extant literature, we developed a theoretical model in this study. The results showed a positive impact on employees’ health, performance and reduced stress at work if the favorable one-hour lunch break is practiced. The study also gives support to prevent absenteeism, improve job satisfaction, and employees' positive attitude towards work.
Caries Prevention in Adults- Knowledge, Attitude and Practices among Indian Dental Professionals
Authors: Sindi Abdulelah Sameer , Jeri Sumaya Yousuf , Sharma Sarika , Nagrale Renuka G. , Kumar Amit , Jawaid Moazzam , Chhabra Kumar Gaurav
Published: July 2021

Background: Dentists must have accurate knowledge and affirmative attitudes about dental care in order to prevent dental caries. Therefore, the present was conducted with aim to find out knowledge, attitude and actual practices (KAP) for caries prevention in adults on Indian dentist

Material and Methods: This cross-sectional questionnaire study was conducted on private dental practitioners of Ghaziabad city. Knowledge on preventive dentistry was assessed by 16 questions with true/false or multiple choice pattern. A total of 8 questions each were utilized for attitude and practices, respectively on a 5-point likert scale. Student’s t-test and One way ANOVA followed by post hoc test was applied to determine the relationship between mean scores of KAP and demographic variables. The significance level was set at below 0.05.

Results: Slightly better scores for KAP was found in participants belonging to <30 years of age. The total mean KAP scores of dentists were 8.9 ± 2.2, 26.1 ± 1.7, 21.1 ± 1.9, respectively. Approximately 37% dentist agreed or strongly agreed that fluoride application can prevent dental caries in adults. And 31.5% dentist never advised/performed fluoride application in high caries patients.

Conclusion: Strategies to update dentists’ knowledge and practices of primary preventive measures for dental caries may be beneficial in promoting oral health. Findings help in emphasizing the inception and initiation of preventive oral health policies and services in the Indian scenario.
Evaluation of Platelet Counts in the Normal Pregnancy and other Gestational Conditions at Tertiary Care Hospital of Sindh
Authors: Palwasha . , Bhatti Kanwal Abbas , Gul Fahmida , Memon Sameena Gul , Shaikh Pashmina
Published: July 2021

Background: During gestational period, the most common disorder is hypertension that directly affects the gestation. The frequency of gestational hypertension is increasing day by day and ultimately the pressure is developed on the endothelial wall. Gestational hypertension mostly reduces the platelet counts.

Aim of Study: The major theme of this research is evaluating the count of platelet during pregnancy and other gestational conditions.

Methodology: A Retrospective research was carried out for the period of 06 months at Gynae and Obstetrics ward at tertiary care hospital of Sindh, Pakistan. Total 104 females were selected with different gestational age and trimester. A questionnaire was filled by all participants that were comprised of demographic data and gestational conditions such as preeclampsia, eclampsia, parity and seizure episodes. Females with highest risk factors diseases such as Diabetes, Hepatic disorder, Anemia, renal disorder and cardio vascular disease were not included in our research. Blood samples were collected from all selected participants for proper platelet count and data was compared with normal ranges of platelet count among the pregnant females. Data was analyzed by using statistical software 24.00 versions.

Results: It was observed that 49 patients were having normal pregnancy, 32 had preeclampsia and 23 had eclampsia. 38 participants were first timer & 52 were having second time parity. 58 participants had 2nd trimester of pregnancy. According to condition of anemia, 27 had severe anemic condition whereas 43 had moderate anemic condition. 49 participants had reduced level of platelet count and 17 had very low platelet count. Severity of gestation can be managed through proper management and physician instructions. Hypertension was measured through severity scale, 29 patients had moderate level of hypertension and 22 had severe level of hypertension. 19 participants had very abnormal level of blood count.

Conclusion: It was concluded that proper diagnostic test should be conducted on time for proper management of reduced platelet count and there should be proper mass counseling should be conducted in order to overcome the deficiency of platelet count. There should be proper diet and exercise during pregnancy that can manage the condition of hypertension.  Severity of gestation can be managed through proper management and physician instructions.
Frequency and Sensitivity Patterns of Staphylococcus Aureus in a Tertiary Care Setting
Authors: Khawaja Aneela , Ejaz Asma , Abeer . , Arshad Faiqa , Saleem Zaheer , Farooq Umar , Aneela Syeda
Published: July 2021

Background: Staphylococcus aureus (SA) is a major etiological pathogen causing multiple infections and broadly known as a serious public health challenge faced due to antibiotic resistance. It is the need of time that infection prevention and control strategies; and antibiotic stewardship policies have to be employed conjointly to minimize the extended rise of antibiotic resistance.

Objectives: To determine the frequency and sensitivity patterns of Staphylococcus aureus in tertiary care setting.

Study Design: Descriptive study

Place & Duration of Study: Pathology Laboratory of tertiary care center from 1st March’ 2020 till 28th February’ 2021.

Materials & Methods: A total 643 Staph. aureus isolated from various clinical specimens received in a tertiary care hospital; were processed and identified by culture, staining and bench tests. Sensitivity testing was done by Disc Diffusion method. Resistance to cefoxitin(30µg) was labelled as Methicillin Resistant Staphylococcus aureus (MRSA). Constitutive and Inducible Clindamycin resistance was also evaluated. (CLSI, 2020-21).

Results: During the study period 125 (19.44%) MRSA were recovered. Statistically, gender distribution regarding MRSA was significant, most of SA was recovered from blood (53.68%), while 46.31% from pus and wound swabs. The frequency of MRSA from Surgical and allied wards was higher (52.63%) than Medicine and allied wards (47.36%). Sensitivity to vancomycin, linezolid and tigecycline was noted 100% by all the isolates. Sensitivity to clindamycin and Doxycycline was 68.42% and 64.81% respectively; while resistance to erythromycin, ciprofloxacin and trimethoprim/sulfamethoxazole was 73.68%, 60% and 57.89%, respectively.

Conclusion: The hazardous infections due to Staphylococcus aureus are worrisome in the present therapeutic scenario. A levelheaded prescription of sensitive antibiotics has to be ensured to minimize the rising frequency of resistant strains of SA.
Formulation and Evaluation of Ethyl Cellulose Based Fluconazole Nanosponges
Authors: Yadav Jayadeep R. , Jagdale Swati C. , Chabukswar Anuruddha R.
Published: July 2021

Background and Objective: Fluconazole (FLZ) is a novel triazole antifungistatic drug; topical administration of FLZ resulted in systemic absorption and skin inflammation, and thereby failed to achieve mycological eradication, resulting in low patient compliance and undermining therapy effectiveness. The aim of this study was to use the emulsion solvent evaporation technique to create FLZ-loaded nanosponges (NSs) using ethylcellulose (EC) and polyvinyl alcohol (PVA) as a stabiliser. Materials and Method: By varying the drug concentration (FLZ), EC, and PVA, four formulations were developed, each of which was then optimized through particle characterization (polydispersity index (PDI), scanning electron microscopy (SEM), zeta potential (ZP), drug entrapment, and loading efficiency). Results: SEM (Scanning Electron Microscope) analysis showed that the particle sizes of FLZ inclusion complexes ranged from 150 2 to 250 5 nm. The ZP was strong enough to produce stable formulations. FLZ was released from the nano sponges in a regulated manner for 24 hours in both in vitro and in vivo experiments. FTIR and DSC were used to validate the association of the FLZ with the nanosponges. The crystalline nature of FLZ was modified to an amorphous state due to the complexation with the nanosponges, according to an XRPD analysis. The FLZ nanosponges were found to be stable in a stability analysis. Conclusion: Therefore, ethyl cellulose-based nanosponges provide a novel method for controlling the release of FLZ for antifungal effects.
Nuclear PPAR-γ Activation Modulates Inflammation and Oxidative Stress in Attenuating Chemotherapy-Induced Neuropathic Pain in Vivo
Authors: Pasupulati Haritha , Padi Satyanarayana S. V. , Dodoala Sujatha , Koganti Prasad V. S. R. G.
Published: July 2021

Background: Paclitaxel-induced painful neuropathy is a major dose-limiting side effect and can persist for up to two years after completing treatment that greatly affects both the course of chemotherapy and quality of life in cancer patients. Peroxisome proliferator-activated receptor (PPAR)-γ belongs to a family of nuclear receptors known for their transcriptional and regulatory roles in metabolism, inflammation, and oxidative stress. However, the role of PPAR-γ activation on paclitaxel-induced neuropathic pain is not yet known.

Objective: To investigate whether pioglitazone, a PPAR-γ agonist reduce paclitaxel-induced neuropathic pain and to elucidate underlying mechanisms.

Methodology: Peripheral neuropathy was induced by administration of paclitaxel (2 mg/kg per injection) intraperitoneally on four alternate days (days 0, 2, 4, 6). Thermal hyperalgesia and mechanical allodynia were assessed and the markers of inflammation and nitroso-oxidative stress were estimated.

Results: Pioglitazone did not induce hypoalgesia and had no effect on locomotor activity. Repeated oral administration of pioglitazone (10 and 20 mg/kg,) for 2 weeks started 14 days after paclitaxel injection markedly attenuated paw withdrawal responses to thermal (hyperalgesia) and mechanical (allodynia) stimuli. Further, pioglitazone administration significantly reduced elevated level of pro-inflammatory cytokine, TNF-α, in both the dorsal root ganglia and the spinal cord accompanied by marked decrease in oxidative stress parameters as well as increase in activity of antioxidant defense enzyme, superoxide dismutase, in the spinal cord after paclitaxel injection.

Conclusion: The results of the present study demonstrate that pioglitazone, a PPAR-γ agonist exerted antinociceptive effect in paclitaxel-induced neuropathic pain through inhibiting neuroimmune inflammation in both the periphery and spinal cord and by reducing nitroso-oxidative stress in spinal cord. Our findings strongly suggest pharmacological activation of PPAR-g as a promising therapeutic target in paclitaxel-induced peripheral neuropathy and provide rationale for the clinical evaluation.
Production and Tensile Behavior of Novel Powder Wire Mesh Composite Porous Plates
Authors: Li Chaozhong , Zhou Zhaoyao
Published: July 2021

A new type of powder wire mesh composite porous plate (PWMCPP) is successfully fabricated by the composite rolling and solid‐state sintering of stainless steel powder and wire mesh. Tensile tests are carried out, and the microstructure and fracture morphology are observed. The results show that the tensile strength of the PWMCPP decrease first and then increase with increasing mesh volume fraction and mesh diameter and increase with increasing sintering temperature. It is found that when the mesh volume fraction exceeds 65% and the sintering temperature exceeds 1310 °C, the tensile properties of the PWMCPP show the phenomenon of secondary plastic deformation work hardening with a saddle shape change. The tensile strength increased from 433 to 593 MPa, with an increase ratio of 36.95%, and the elongation increased from 33.17% to 55.7%, with an increase ratio of 67.92%. Herein, not only a method for preparing a composite of stainless steel powder and mesh is offered but also a useful reference for improving the tensile properties of the PWMCPP and expanding the application range (especially in the field of porous bearing) of porous metal materials is provided.
Piezoelectric Drop‐On‐Demand Inkjet Printing of High‐Viscosity Inks
Authors: Bernasconi Roberto , Brovelli Stefano , Viviani Prisca , Soldo Marco , Giusti Domenico , Magagnin Luca
Published: July 2021

Drop‐on‐demand inkjet printing of highly viscous fluids represents a highly attractive emerging technology for advanced material deposition. The jetting of viscous inks, such as concentrated polymer solutions and nanoparticle suspensions, is a key enabling technology for many industrial applications, ranging from microelectronics to biomedicine and ceramics manufacturing. Currently available standard inkjet printers typically operate in a relatively narrow viscosity range (up to 16 mPa s), and alternative drop‐on‐demand printing techniques (such as laser‐induced forward transfer) present limited industrial applicability. In this context, the development of a piezoelectric‐driven printhead capable of jetting high‐viscosity fluids is of great interest. Herein, a prototype of such a device is presented and its performance is evaluated using model fluids at increasing viscosities. Specifically, the dependence of emitted droplets’ properties on jetting parameters is evaluated and linked to the physical characteristics of the system. In optimal conditions, piezoelectric jetting of solutions characterized by viscosities in excess of 200 cP is achieved. Finally, as an applicative example, the jetting of functional inks is attempted. A ZnO suspension and a poly(3,4‐ethylenedioxythiophene) (PEDOT) based solution are successfully jetted to demonstrate the applicability of the developed printhead to the deposition of ceramic suspensions and concentrated polymer solutions.
A qualitative assessment of emergency medicine residents’ receptivity to feedback
Authors: Fredette Jenna , Michalec Barret , Billet Amber , Auerbach Heather , Dixon Jessica , Poole Christy , Bounds Richard
Published: July 2021

Background

Effective feedback is the cornerstone of competency‐based education. The emergency department (ED) is a unique learning and feedback environment. Developing our understanding of emergency medicine (EM) residents’ experiences around feedback will improve resident training and inform EM faculty development programs.

Objective

This qualitative study explores the feedback culture and practices in EM and resident's experiences and attitudes toward feedback in this specific training environment.

Methods

At a large categorical EM program, 15 residents voluntarily participated in semistructured interviews regarding feedback. These individual interviews were performed by a nonphysician investigator and transcripts underwent an inductive multistep coding process. Transcripts were analyzed to identify common factors influencing feedback and then comparisons were made between residents to explore the interconnectedness of identified factors and further categorize consistent themes.

Results

Factors inherent to the ED environment make the delivery of effective feedback challenging. Residents also revealed that feedback‐seeking/‐avoidant behavior and receptivity to feedback are multifactorial. Residents actively seek feedback when they feel that they performed well but tend to avoid feedback interactions when they expect constructive feedback. Finally, residents filter feedback based on attending personality and perceived practice style as well as their own desired practice style.

Conclusions

It is important for program leaders to understand their residents’ experiences with feedback and engage both faculty and residents in conversations around feedback delivery and receptivity. An improved understanding of these experiences might also reveal barriers to performance assessment and guide efforts to improve the accuracy and reliability of resident evaluations.
Dose‐response relationship between World Trade Center dust exposure and hepatic steatosis
Authors: Jirapatnakul Artit , Yip Rowena , Branch Andrea D. , Lewis Sara , Crane Michael , Yankelevitz David F. , Henschke Claudia I.
Published: July 2021

Background

The World Trade Center (WTC) attack exposed thousands of workers to toxic chemicals that have been linked to liver diseases and cancers. This study examined the relationship between the intensity of WTC dust exposure and the risk of hepatic steatosis in the WTC General Responders Cohort (GRC).

Methods

All low‐dose computed tomography (CT) scans of the chest performed on the WTC GRC between September 11, 2001 and December 31, 2018, collected as part of the World Trade Center Health Program, were reviewed. WTC dust exposure was categorized into five groups based on WTC arrival time. CT liver density was estimated using an automated algorithm, statistics‐based liver density estimation from imaging. The relationship between the intensity of WTC dust exposure and the risk of hepatic steatosis was examined using univariate and multivariable regression analyses.

Results

Of the 1788 WTC responders, 258 (14.4%) had liver attenuation less than 40 Hounsfield units (HU < 40) on their earliest CT. Median time after September 11, 2001 and the earliest available CT was 11.3 years (interquartile range: 8.0–14.9 years). Prevalence of liver attenuation less than 40 HU was 17.0% for arrivals on September 11, 2001, 16.0% for arrivals on (September 12, 2001 or September 13, 2001), 10.9% for arrivals on September 14–30, 2001, and 9.0% for arrivals on January 10, 2001 or later (p = 0.0015). A statistically significant trend of increasing liver steatosis was observed with earlier arrival times (p < 0.0001). WTC arrival time remained a significant independent factor for decreased liver attenuation after controlling for other covariates.

Conclusions

Early arrival at the WTC site was significantly associated with increasing hepatic steatosis.
Incidence and timing of biphasic anaphylactic reactions: a retrospective cohort study
Authors: Ichikawa Motohiro , Kuriyama Akira , Urushidani Seigo , Ikegami Tetsunori
Published: July 2021

Aim

We investigated the frequency of overall biphasic reactions, biphasic reactions that met the diagnostic criteria of anaphylaxis, and biphasic reactions that caused a severe abnormality in vital signs in patients who visited the emergency department of a tertiary hospital.

Methods

This retrospective cohort study included patients aged 18 years or over who presented with anaphylaxis at the emergency department of a tertiary care hospital between January 2014 and December 2016. The primary outcome was the incidence of biphasic reactions that caused a severe abnormality in vital signs and developed within 7 days. Secondary outcomes were the frequency of overall biphasic reactions and those that met the diagnostic criteria of anaphylaxis.

Results

In total, 437 patients aged over 18 years visited the emergency department during the study period. Among them, 202 were enrolled in this study. The proportion of patients who had overall biphasic reactions, those that met the diagnostic criteria of anaphylaxis, and those with a severe abnormality in vital signs was 8.9%, 3.0%, and 1.0%, respectively. Overall, 32.7% of patients were hospitalized, but hospitalization aided in the treatment of severe biphasic reactions at the early stage in only one patient.

Conclusion

We found that 8.9% of adult patients with anaphylaxis had a biphasic reaction, but biphasic reactions together with severe abnormalities in vital signs were rare.
Chiral Distorted Hexa‐peri‐hexabenzocoronenes Bearing a Nonagon‐Embedded Carbohelicene
Authors: Medel Miguel A. , Cruz Carlos M. , Miguel Delia , Blanco Victor , Morcillo Sara P. , Campaña Araceli G.
Published: July 2021

A new family of chiral saddle‐helix hybrid nanographenes is reported. The first hexa‐peri‐hexabenzocoronene (HBC) analogues bearing a nine‐membered carbocycle are presented. Furthermore, for the first time, π‐extended carbo[n]helicenes containing a nine‐membered ring as part of the helical moiety have been synthesized. The combination of a [5]helicene moiety and a nonagon ring in a single chiral motif induces a tremendous distortion from planarity into the nanographenic structures compared to other saddle‐helix hybrids such as heptagon‐ and octagon‐containing π‐extended carbo[5]helicenes. In fact, the interplanar angle of the two terminal rings reaches the largest angle (134.8°) of a carbohelicene reported to date, thus being by far the most twisted helicene yet prepared. Photophysical properties evaluation showed improved absorption dissymmetry factors (|gabs|=4.2×10−3) in the new family of nonagon‐containing π‐extended carbo[5]helicenes.
Effect of crump rubber on the solid particle erosion response of epoxy composites
Authors: Shahapurkar Kiran , Soudagar Manzoore Elahi M. , Shahapurkar Pavan , Mathapathi Mahantayya , Khan T. M. Yunus , Mujtaba M. A. , Ali M. D. Irfan , Thanaiah Kumara , Siddiqui Md Irfanul Haque , Ali Masood Ashraf
Published: July 2021

Present investigation characterizes solid particle erosion response of neat epoxy and crump rubber filled epoxy composites. Three types of composites were prepared by reinforcing crump rubber particles (10, 20 and 30 vol.%) in epoxy matrix. Neat epoxy samples were also prepared for comparison. Thermo gravimetric analysis revealed crump rubber composites have higher stability as compared with neat epoxy specimen. Differential scanning calorimeter tests reveal higher glass transition temperature for crump rubber composites as compared with neat epoxy specimens. Erosion rate of the samples have been studied for different angles of impingement (30, 45, 60 and 90°) and erodent impact velocity (30, 45 and 60 m/s). 30 vol.% of crump rubber reinforced epoxy composites reveal better resistance to erosion in comparison with other composites and neat epoxy; attributed to the elastic nature of crump rubber particles to absorb impact energy of erodent particles. For all the specimens, maximum erosion is noted at 60° angle of impingement indicating semi‐ductile response to erosion. Erosion efficiency and velocity exponent of samples also substantiate the semi‐ductile behavior. Morphology of the eroded surfaces was analyzed using scanning electron microscope. Property map is used to compare the results available from the literature with the present study.
Fast quasi‐sliding mode control of unknown QUAVs: A data‐driven cascade control approach
Authors: Weng Yongpeng , Nan Dong , Wang Ning
Published: July 2021

In this paper, the fast trajectory tracking of unknown quadrotor unmanned aerial vehicles (QUAVs) in the presence of disturbances and unmodeled dynamics is addressed, whereby a novel fast quasi‐sliding mode control (FQSMC) approach via data‐driven cascade control technique is proposed. Salient contributions include (1) an equivalent data‐based model for unknown QUAV, via data‐driven technique, is innovatively established, thereby contributing to data‐driven sliding‐mode surface which effectively deals with the model‐unavailable problem; (2) within this scheme, quasi‐sliding mode controller and finite‐time quasi‐sliding mode controller in a cascade form, by utilizing the high‐order sliding mode control strategy, virtual control scheme, and finite‐time control technique, are devised for outer‐loop position subsystem and inner‐loop attitude subsystem, respectively, thereby contributing to fast tracking speed and strong robustness to disturbances and unmodeled dynamics; (3) utilizing the Lyapunov approach and finite‐time theory, the finite‐time asymptotic tracking of the attitude subsystem and thereafter the asymptotic tracking of the position subsystem can be guaranteed. Simulation studies are finally conducted to testify the efficacy and superiority of the devised FQSMC scheme.
Effect of Nigella sativa oil on pharmacokinetics and pharmacodynamics of gliclazide in rats
Authors: Adiwidjaja Jeffry , Sasongko Lucy
Published: July 2021

Nigella sativa oil (NSO) has been used widely for its putative anti‐hyperglycemic activity. However, little is known about its potential effect on the pharmacokinetics and pharmacodynamics of antidiabetic drugs, including gliclazide. This study aimed to investigate herb–drug interactions between gliclazide and NSO in rats. Plasma concentrations of gliclazide (single oral and intravenous dose of 33 and 26.4 mg/kg, respectively) in the presence and absence of co‐administration with NSO (52 mg/kg per oral) were quantified in healthy and insulin resistant rats (n = 5 for each group). Physiological and treatment‐related factors were evaluated as potential influential covariates using a population pharmacokinetic modeling approach (NONMEM version 7.4). Clearance, volume of distribution and bioavailability of gliclazide were unaffected by disease state (healthy or insulin resistant). The concomitant administration of NSO resulted in higher systemic exposures of gliclazide by modulating bioavailability (29% increase) and clearance (20% decrease) of the drug. A model‐independent analysis highlighted that pre‐treatment with NSO in healthy rats was associated with a higher glucose lowering effect by up to 50% compared with that of gliclazide monotherapy, but not of insulin resistant rats. Although a similar trend in glucose reductions was not observed in insulin resistant rats, co‐administration of NSO improved the sensitivity to insulin of this rat population. Natural product–drug interaction between gliclazide and NSO merits further evaluation of its clinical importance.
Clinical phenotype in infants with negative Zika virus immunoglobulin M testing born to mothers with confirmed Zika virus infection during pregnancy
Authors: Godfred‐Cato Shana , Newton Suzanne , Adams Laura , Valencia‐Prado Miguel , Lake‐Burger Heather , Morrison Andrea , Jones Abbey M. , Olson Samantha M. , Roth Nicole M. , Tong Van T. , Gilboa Suzanne M. , Meaney Delman Dana , Honein Margaret A. , Staples Jennifer Erin , Moore Cynthia A.
Published: July 2021

Background

Recommended testing for both infants with Zika‐associated birth defects (i.e., microcephaly and selected brain or eye anomalies) and infants without birth defects whose mothers had laboratory evidence of possible Zika virus (ZIKV) infection during pregnancy includes nucleic acid amplification testing (NAAT) and immunoglobulin M (IgM) testing within days after birth. Brain and eye defects highly specific for congenital ZIKV infection have been described; sporadic reports have documented negative ZIKV testing in such infants.

Methods

Infants from the U.S. Zika Pregnancy and Infant Registry and Zika Birth Defects Surveillance with Zika‐associated birth defects and maternal and infant laboratory testing for ZIKV and two congenital infections (i.e., cytomegalovirus [CMV] and toxoplasmosis) were reviewed for phenotype and laboratory results. Infants with at least one defect considered highly specific for congenital ZIKV infection were designated as having congenital Zika syndrome (CZS) clinical phenotype for this study.

Results

Of 325 liveborn infants with Zika‐associated birth defects and laboratory evidence of maternal ZIKV infection, 33 (10%) had CZS clinical phenotype; 172 (53%) had ZIKV IgM testing with negative or no ZIKV NAAT. ZIKV IgM was negative in the remaining 121 infants, and for 90%, testing for CMV and toxoplasmosis was missing/incomplete. Among 11 infants testing negative for ZIKV IgM, CMV, and toxoplasmosis, 2 infants had CZS clinical phenotype.

Conclusions

These data add support to previous reports of negative ZIKV IgM testing in infants with clear maternal and phenotypic evidence of congenital ZIKV infection. Follow‐up care consistent with the diagnosis is recommended regardless of infant ZIKV test results.
Exometabolome profiling reveals activation of the carnitine buffering pathway in fed‐batch cultures ofCHOcells co‐fed with glucose and lactic acid
Authors: Vappiani Johanna , Eyster Tom , Orzechowski Keegan , Ritz Diana , Patel Pramthesh , Sévin Daniel , Aon Juan
Published: July 2021

Adjustments to CHO cell physiology were recently observed during implementation of a Raman spectroscopy‐based glucose and lactate control strategy. To further understand how these cells, under monoclonal antibody (mAb) production conditions, utilized the extra lactic acid fed, we performed a comprehensive semi‐quantitative and time‐dependent analysis of the exometabolome. This study focused on the CHO cell's metabolic shift from the fifth day of culture. We compared relative levels of extracellular metabolites in the absence or presence of a 2 g/L lactic acid setpoint while glucose was kept at 4 g/L. Our hypothesis is that extra lactic acid would supply more pyruvate, favoring oxidative phosphorylation. We subsequentially uncovered several carnitine derivatives as biomarkers of the simultaneous activation of TCA anaplerotic pathways as well as a carbon‐buffering pathway. CHO cells exhibited a balance between intermediates from (i) amino acid catabolism, (ii) fatty acidβ‐oxidation, and (iii) pyruvate from glycolysis and lactic acid; and the secretion of their intermediate carnitine derivatives. In addition, 3‐hydroxy‐methyl‐glutaric acid (HMG) and mevalonate syntheses were found as biomarkers of alternative acyl group removal. Together, under a limited capacity to assimilate the surplus of acyl‐CoA groups as well as an ability to maintain the acyl‐CoA: free CoA ratio for proper and continuous functioning of the TCA cycle, CHO cells activate the carnitine‐buffering system, HMG, and mevalonate pathways.
Health services utilization, out‐of‐pocket expenditure, and underinsurance among insured non‐elderly cancer survivors in the United States, 2011–2015
Authors: Karim Mohammad A. , Singal Amit G. , Ohsfeldt Robert L. , Morrisey Michael A. , Kum Hye‐Chung
Published: July 2021

Background

High out‐of‐pocket (OOP) expenditure and inadequate insurance coverage may adversely affect cancer survivors. We aimed to characterize the extent and correlates of healthcare utilization, OOP expenditures, and underinsurance among insured cancer survivors.

Methods

We used 2011–2015 Medical Expenditure Panel Survey data to identify a nationally representative sample of insured non‐elderly adult (age 18–64 years) cancer survivors. We used negative binomial, two‐part (logistic and Generalized Linear Model with log link and gamma distribution), and logistic regression models to quantify healthcare utilization, OOP expenditures, and underinsurance, respectively, and identified sociodemographic correlates for each outcome.

Results

We identified 2738 insured non‐elderly cancer survivors. Adjusted average utilization of ambulatory, non‐ambulatory, prescription medication, and dental services was 14.4, 0.51, 24.9, and 1.4 events per person per year, respectively. Higher ambulatory and dental services utilization were observed in older adults, females, non‐Hispanic Whites, survivors with a college degree and high income, compared to their counterparts. Nearly all (97.7%) survivors had some OOP expenditures, with a mean adjusted OOP expenditure of $1552 per person per year. Adjusted mean OOP expenditures for ambulatory, non‐ambulatory, prescription medication, dental, and other health services were $653, $161, $428, $194, and $83, respectively. Sociodemographic variations in service‐specific OOP expenditures were generally consistent with respective utilization patterns. Overall, 8.8% of the survivors were underinsured.

Conclusion

Many insured non‐elderly cancer survivors allocate a substantial portion of their OOP expenditure for healthcare‐related services and experience financial vulnerability, resulting in nearly 8.8% of the survivors being underinsured. Utilization of healthcare services varies across sociodemographic groups.
Group 15 and 16 Nitrene‐Like Pnictinidenes
Authors: Mitchell Erica C. , Wolf Mark E. , Turney Justin M. , Schaefer Henry F.
Published: July 2021

Pnictinidenes are an increasingly relevant species in main group chemistry and generally exhibit proclivity for the triplet electronic ground state. However, the elusive singlet electronic states are often desired for chemical applications. We predict the singlet‐triplet energy differences (ΔEST=ESinglet−ETriplet) of simple group 15 and 16 substituted pnictinidenes (Pn−R; Pn=P, As, Sb, or Bi) with highly reliable focal‐point analyses targeting the CCSDTQ/CBS level of theory. The only cases we predict to have favorable singlet states are P−PH2 (−3.2 kcal mol−1) and P−NH2 (−0.2 kcal mol−1). ΔEST trends are discussed in light of the geometric predictions as well as qualitative natural bond order analysis to elucidate some of the important electronic structure features. Our work provides a rigorous benchmark for the ΔEST of fundamental Pn−R moieties and provides a firm foundation for the continued study of heavier pnictinidenes.
Tunable Photoswitching in Norbornadiene (NBD)/Quadricyclane (QC) – Fullerene Hybrids
Authors: Lorenz Patrick , Wullschläger Florian , Rüter Antonia , Meyer Bernd , Hirsch Andreas
Published: July 2021

With respect to molecular switches, initializing the quadricyclane (QC) to norbornadiene (NBD) back‐reaction by light is highly desirable. Our previous publication provided a unique solution for this purpose by utilizing covalently bound C60. In this work, the fundamental processes within these hybrids has been investigated. Variation of the linker unit connecting the NBD/QC moiety with the fullerene core is used as a tool to tune the properties of the resulting hybrids. Utilizing the Prato reaction, two unprecedented NBD/QC – fullerene hybrids having a long‐rigid and a short‐rigid linker were synthesized. Molecular dynamics simulations revealed that this results in an average QC–C60 distance of up to 14.2 Å. By comparing the NBD–QC switching of these derivatives with the already established one having a flexible linker, valuable mechanistic insights were gained. Most importantly, spatial convergence of the QC moiety and the fullerene core is inevitable for an efficient back‐reaction.
Real‐life effectiveness of biological therapies on symptoms in severe asthma with comorbid CRSwNP
Authors: Mümmler Carlo , Dünzelmann Kristin , Kneidinger Nikolaus , Barnikel Michaela , Munker Dieter , Gröger Moritz , Canis Martin , Behr Jürgen , Koch Andrea , Haubner Frank , Milger Katrin
Published: July 2021

Background

We aimed to evaluate the effectiveness of different antibody therapies on nasal polyp symptoms in patients treated for severe asthma.

Methods

We performed a retrospective analysis of patients with severe asthma and comorbid CRSwNP who were treated with anti‐IgE, anti‐IL‐5/R or anti‐IL‐4R. CRSwNP symptom burden was evaluated before and after 6 months of therapy.

Results

Fifty patients were included hereof treated with anti‐IgE: 9, anti‐IL‐5/R: 26 and anti‐IL‐4R: 15 patients. At baseline median SNOT‐20 was similar among groups (anti‐IgE: 55, anti‐IL‐5/R: 52 and anti‐IL‐4R: 56, p = 0.76), median visual analogue scale (VAS) for nasal symptoms was 4, 7 and 8 (p = 0.14) and VAS for total symptoms was higher in the anti‐IL‐4R group (4, 5 and 8, p = 0.002). After 6 months SNOT‐20 improved significantly in all patient groups with median improvement of anti‐IgE: −8 (p < 0.01), anti‐IL‐5/R: −13 (p < 0.001) and anti‐IL‐4R: −18 (p < 0.001), with larger improvement in the anti‐IL‐4R group than in anti‐IgE (p < 0.001) and anti‐IL‐5/R (p < 0.001) groups. VAS nasal symptoms improved by median anti‐IgE: 0 (n.s.), anti‐IL‐5/R: −1 (p < 0.01) and anti‐IL‐4R: −3 (p < 0.001), VAS total symptoms by anti‐IgE: −1 (n.s.), anti‐IL‐5/R: −2 (p < 0.001) and anti‐IL‐4R: −2 (p < 0.001).

Conclusions

Treatment by all antibodies showed effectiveness in reducing symptoms of CRSwNP in patients with severe asthma, with the largest reduction observed in anti‐IL‐4R‐treated patients.
Concordance of human equilibrative nucleoside transporter‐1 expressions between murine (10D7G2) and rabbit (SP120) antibodies and association with clinical outcomes of adjuvant chemotherapy for pancreatic cancer: A collaborative study from the JASPAC 01 trial
Authors: Okamura Yukiyasu , Boku Narikazu , Ghaneh Paula , Greenhalf William , Yasukawa Satoru , Narimatsu Hiroto , Fukutomi Akira , Konishi Masaru , Morinaga Soichiro , Toyama Hirochika , Maeda Atsuyuki , Shimizu Yasuhiro , Nakamori Shoji , Sata Naohiro , Yamakita Keisuke , Takahashi Amane , Takayama Wataru , Yamaguchi Ryuzo , Tomikawa Moriaki , Yanagisawa Akio , Neoptolemos John P. , Uesaka Katsuhiko
Published: July 2021

Background

Expression of human equilibrative nucleoside transporter‐1 (hENT1) is reported to predict survival of gemcitabine (GEM)‐treated patients. However, predictive values of immunohistochemical hENT1 expression may differ according to the antibodies, 10D7G2 and SP120.

Aim

We aimed to investigate the concordance of immunohistochemical hENT1 expression between the two antibodies and prognosis.

Methods

The subjects of this study were totally 332 whose formalin‐fixed paraffin‐embedded specimens and/or unstained sections were obtained. The individual H‐scores and four classifications according to the staining intensity were applied for the evaluation of hENT1 expression by 10D7G2 and SP120, respectively.

Results

The highest concordance rate (79.8%) was obtained when the cut‐off between high and low hENT1 expression using SP120 was set between moderate and strong. There were no correlations of hENT1 mRNA level with H‐score (p = .258). Although the hENT1 mRNA level was significantly different among four classifications using SP120 (p = .011), there was no linear relationship among them. Multivariate analyses showed that adjuvant GEM was a significant predictor of the patients with low hENT1 expression using either 10D7G2 (Hazard ratio [HR] 2.39, p = .001) or SP120 (HR 1.84, p < .001). In contrast, agent for adjuvant chemotherapy was not significant predictor for the patients with high hENT1 expression regardless of the kind of antibody.

Conclusion

The present study suggests that the two antibodies for evaluating hENT1 expression are equivalent depending on the cut‐off point and suggests that S‐1 is the first choice of adjuvant chemotherapy for pancreatic cancer with low hENT1 expression, whereas either S‐1 or GEM can be introduced for the pancreatic cancer with high hENT1 expression, no matter which antibody is used.
Carbon‐Based Composites as Anodes for Microbial Fuel Cells: Recent Advances and Challenges
Authors: Gao Xingyuan , Qiu Shuxian , Lin Ziting , Xie Xiangjuan , Yin Wei , Lu Xihong
Published: July 2021

Owing to the low price, chemical stability and good conductivity, carbon‐based materials have been extensively applied as the anode in microbial fuel cells (MFCs). In this review, apart from the charge storage mechanism and anode requirements, the major work focuses on five categories of carbon‐based anode materials (traditional carbon, porous carbon, nano‐carbon, metal/carbon composite and polymer/carbon composite). The relationship is demonstrated in depth between the physicochemical properties of the anode surface/interface/bulk (porosity, surface area, hydrophilicity, partical size, charge, roughness, etc.) and the bioelectrochemical performances (electron transfer, electrolyte diffusion, capacitance, toxicity, start‐up time, current, power density, voltage, etc.). An outlook for future work is also proposed.
Study of the Parameters Impacting the Photocatalytic Reduction of Carbon Dioxide in Ionic Liquids
Authors: Peng Yulan , Szeto Kai C. , Santini Catherine C. , Daniele Stéphane
Published: July 2021

The front cover artwork is provided by the CP2M laboratory at the University of Lyon (France). The image shows the photocatalytic reduction of CO2 to CO in a bare ionic liquid (IL) medium after an initial CO2 pre‐activation step via the elaboration of an IL–carboxylate complex that bends the CO2. Read the full text of the Article at 10.1002/cptc.202100006.