bluuebunny/crossref_metadata_2025 huggingface dataset:
Global surgery and the sustainable development goals
Authors: Roa L , Jumbam D T , Makasa E , Meara J G
Published: January 2019

Background

The field of global surgery has gained significant recent momentum, catalysed by the 2015 publication of the Lancet Commission on Global Surgery, Disease Control Priorities 3 and World Health Assembly resolution 68.15. These reports characterized the global burden of disease amenable to surgical care, called for global investment in surgical systems, and recognized surgery and anaesthesia as essential components of universal health coverage.

Methods

A strategy proposed to strengthen surgical care is the development of national surgical, obstetric and anaesthesia plans (NSOAPs). This review examined how NSOAPs could contribute to the achievement of sustainable development goals (SDGs) 1, 3, 5, 8, 9, 10, 16 and 17 by 2030, focusing on their potential impact on the healthcare systems in Ethiopia, Tanzania and Zambia.

Results

Due to the cross-cutting nature of surgery, obstetrics and anaesthesia, investing in these services will escalate progress to achieve gender equality, economic growth and infrastructure development. Universal health coverage will not be achieved without addressing the financial ramifications to the poor of seeking and receiving surgical care. NSOAPs provide a strategic framework and a data collection platform for evidence-based policy-making, accountability and implementation guidance.

Conclusion

The development and implementation of data-driven NSOAPs should be recognized as a powerful road map to accelerate achievement of the SDGs by 2030.
Growing research in global surgery with an eye towards equity
Authors: Hedt-Gauthier B L , Riviello R , Nkurunziza T , Kateera F
Published: January 2019

Background

Global surgery research is often generated through collaborative partnerships between researchers from both low- and middle-income countries (LMICs) and high-income countries (HICs). Inequitable engagement of LMIC collaborators can limit the impact of the research.

Methods

This article describes evidence of inequities in the conduct of global surgery research and outlines reasons why the inequities in this research field may be more acute than in other global health research disciplines. The paper goes on to describe activities for building a collaborative research portfolio in rural Rwanda.

Results

Inequities in global surgery research collaborations can be attributed to: a limited number and experience of researchers working in this field; time constraints on both HIC and LMIC global surgery researchers; and surgical journal policies. Approaches to build a robust, collaborative research portfolio in Rwanda include leading research trainings focused on global surgery projects, embedding surgical fellows in Rwanda to provide bidirectional research training and outlining all research products, ensuring that all who are engaged have opportunities to grow in capacities, including leading research, and that collaborators share opportunities equitably. Of the 22 published or planned papers, half are led by Rwandan researchers, and the research now has independent research funding.

Conclusion

It is unacceptable to gather data from an LMIC without meaningful engagement in all aspects of the research and sharing opportunities with local collaborators. The strategies outlined here can help research teams build global surgery research portfolios that optimize the potential for equitable engagement.
The relationship between mindfulness, spiritual well‐being and chronic depression: Different predictors in distinct phases of treatment
Authors: Ramadas Eduardo , Simões Sónia Catarina
Published: January 2019

Objective

This study sought to analyse the relationship between mindfulness, spiritual well‐being and chronic depression, together with the possible predictive power of the independent variables, during and after a therapeutic intervention. Clients were treated in a residential therapeutic unit for a period of 3–6 months.

Method

The research sample consisted of 63 patients, 28 females and 35 males, between 15 and 57 years old (M = 32.84, SD = 10.24), separated into two groups: residential phase (In‐Treatment) and after termination of treatment (Post‐Treatment). The In‐Treatment group included 32 participants halfway into treatment, and the Post‐Treatment group included 31 participants who had concluded the intervention at least 1 year previously. All the clients had been diagnosed with chronic depression disorder. The instruments used were as follows: the Beck Depression Inventory‐II, the Five facet mindfulness questionnaire and the spiritual well‐being questionnaire.

Results

Mindfulness dimensions are more relevant during treatment, contrary to spiritual well‐being dimensions. There were significant negative associations between mindfulness and depression in the In‐Treatment group. In the Post‐Treatment group, there were significant negative associations between all the spiritual dimensions (barring the transcendental dimension) and depression. The non‐reactivity dimension of mindfulness was a significant predictor of depression in the In‐Treatment group, while the environmental dimension of spiritual well‐being was a significant predictor in the Post‐Treatment group.

Conclusion

The results support the known associations between the studied variables, but indicate that in different phases of treatments, mindfulness and spiritual well‐being have a different impact.
Mnx(PO4)y/NPC As a High Performance Bifunctional Electrocatalyst for Oxygen Electrode Reactions
Authors: Wang Shuai , Nam Gyutae , Li Ping , Jang Haeseong , Wang Jia , Kim Min Gyu , Wu Zexing , Liu Xien , Cho Jaephil
Published: January 2019

Developing highly efficient and durable bifunctional electrocatalyst for oxygen reduction (ORR) and oxygen evolution reaction (OER) is quite important for developing rechargeable zinc‐air batteries. Herein, one kind of manganese phosphate‐based electrocatalyst (Mnx(PO4)y/NPC) with high specific surface area (1106.9 m2 g−1) is prepared via a facile and scalable avenue, which possesses remarkable catalytic performance for the both ORR and OER, indicated by a more positive half‐wave potential of 0.87 V in 0.1 M KOH for the ORR as well as an overpotential of 0.37 V to achieve the current density of 10 mA cm−2 in 1 M KOH for the OER. Furthermore, the Mnx(PO4)y/NPC assembled rechargeable zinc‐air battery shows an excellent charge‐discharge cycling performance, revealed by the smaller sum of charge‐discharge potentials, comparable to that of Pt/C+IrO2. This research adds a new kind of electrocatalyst into the family of non‐noble metal‐based bifunctional electrocatalyst for rechargeable zinc‐air batteries.
Survival after a cancer diagnosis among solid organ transplant recipients in the United States
Authors: D’Arcy Monica E. , Coghill Anna E. , Lynch Charles F. , Koch Lori A. , Li Jie , Pawlish Karen S. , Morris Cyllene R. , Rao Chandrika , Engels Eric A.
Published: January 2019

Background

Transplant recipients have an elevated risk of cancer because of immunosuppressive medications used to prevent organ rejection, but to the authors’ knowledge no study to date has comprehensively examined associations between transplantation status and mortality after a cancer diagnosis.

Methods

The authors assessed cases in the US general population (N=7,147,476) for 16 different cancer types as ascertained from 11 cancer registries. The presence of a solid organ transplant prior to diagnosis (N=11,416 cancer cases) was identified through linkage with the national transplantation registry (1987‐2014). Cox models were used to examine the association between transplantation status and cancer‐specific mortality, adjusting for demographic characteristics and cancer stage.

Results

For the majority of cancers, cancer‐specific mortality was higher in transplant recipients compared with other patients with cancer. The increase was particularly pronounced for melanoma (adjusted hazard ratio [aHR], 2.59; 95% confidence interval [95% CI], 2.18‐3.00) and cancers of the breast (aHR, 1.88; 95% CI, 1.61‐2.19), bladder (aHR, 1.85; 95% CI, 1.58‐2.17), and colorectum (aHR, 1.77; 95% CI, 1.60‐1.96), but it also was increased for cancers of the oral cavity/pharynx, stomach, pancreas, kidney, and lung as well as diffuse large B‐cell lymphoma (aHR range, 1.21‐1.47). Associations remained significant after adjustment for first‐course cancer treatment and generally were stronger among patients with local‐stage cancers for whom potentially curative treatment was provided, including patients with melanoma (aHR, 3.82; 95% CI, 2.94‐4.97) and cancers of the colorectum (aHR, 2.77; 95% CI, 2.07‐3.70), breast (aHR, 2.08; 95% CI, 1.50‐2.88), and prostate (aHR, 1.60; 95% CI, 1.12‐2.29), despite the lack of an association for prostate cancer overall.

Conclusions

For multiple cancer types, transplant recipients with cancer appear to have an elevated risk of dying of their cancer, even after adjustment for stage and treatment, which may be due to impaired immunity.
Impact of adjuvant chemotherapy in patients with adverse features and variant histology at radical cystectomy for muscle‐invasive carcinoma of the bladder: Does histologic subtype matter?
Authors: Berg Sebastian , D’Andrea David , Vetterlein Malte W. , Cole Alexander P. , Fletcher Sean A. , Krimphove Marieke J. , Marchese Maya , Lipsitz Stuart R. , Sonpavde Guru , Noldus Joachim , Shariat Shahrokh F. , Kibel Adam S. , Trinh Quoc‐Dien , Mossanen Matthew
Published: January 2019

Background

The use of adjuvant chemotherapy (AC) in pure urothelial carcinoma of the bladder is established. Regarding variant histology, there is a gap in knowledge concerning the optimal treatment after radical cystectomy (RC). The objective of this study was to assess the effect of AC on overall survival (OS) in patients who had pure urothelial carcinoma, urothelial carcinoma with concomitant variant histology, or another pure variant histology.

Methods

Within the National Cancer Data Base, 15,397 patients who underwent RC for nonmetastatic, localized carcinoma of the bladder and had positive lymph nodes (T2N+) or locally advanced stage (≥T3N0/N+) were identified, excluding those who had previously received neoadjuvant chemotherapy. Multivariable Cox regression models were used to examine the specific effect of AC on OS stratified by each distinct histologic subtype, including pure urothelial carcinoma, micropapillary or sarcomatoid differentiation, squamous cell carcinoma, adenocarcinoma, and neuroendocrine tumors. To account for immortal time bias, Cox regression analyses and Kaplan‐Meier analyses were conducted with a landmark at 3 months.

Results

In multivariable landmark analyses, AC compared with initial observation was associated with an OS benefit for patients who had pure urothelial carcinoma (hazard ratio, 0.87; 95% confidence interval, 0.82‐0.91), whereas no differences were observed with regard to those who had variant histology.

Conclusions

Multivariable Cox regression landmark analysis revealed a survival benefit from AC for patients with a pure urothelial carcinoma. However, a survival benefit of AC for patients who had urothelial carcinoma with concomitant variant histology or other pure variant histology was not demonstrated.
Considering the effects of temperature × nutrient interactions on the thermal response curve of carrying capacity
Authors: Lemoine Nathan P.
Published: January 2019

Climate warming will likely destabilize populations or drive consumers locally extinct. These predictions arise from consumer–resource models incorporating temperature‐dependent parameters, and the accuracy of these predictions hinges on the validity of temperature scalings for each parameter. Among all parameters, carrying capacity (K) is the most ill‐defined and the temperature scaling of this parameter has no empirically verified foundation. Most studies assume that K declines exponentially with warming, but others have assumed a positive or no relationship between K and temperature. Here, I developed a theoretical foundation for a temperature scaling of K based on physiological principles of temperature and nutrient limitation of phytoplankton growth. The trade‐off between thermodynamics and nutrient uptake yields a unimodal thermal response curve for K, and this prediction is supported by empirical data on both phytoplankton and insects. Analyses of consumer–resource models demonstrate the primacy of K in determining predictions of coexistence and stability. Since K exerts a dominant influence on model predictions, ecologists should carefully consider the temperature scaling of K for the species and region in question to ensure accurate estimates of population stability and extinction risk.
Transcriptomes of human mesenchymal cells isolated from the right ventricle and epicardial fat differ strikingly both directly after isolation and long‐term culture
Authors: Stępniewski Jacek , Florczyk‐Soluch Urszula , Szade Krzysztof , Bukowska‐Strakova Karolina , Czapla Justyna , Matuszczak Sybilla , Jarosz‐Biej Magdalena , Langrzyk Agnieszka , Tomczyk Mateusz , Rumieńczyk Izabela , Kulecka Maria , Mikuła Michał , Ostrowski Jerzy , Jaźwa‐Kusior Agnieszka , Zembala Marian , Józkowicz Alicja , Zembala Michał Oskar , Dulak Józef
Published: January 2019

Aims

Mesenchymal stromal cells isolated from different tissues are claimed to demonstrate similar therapeutic potential and are often incorrectly named mesenchymal stem cells. However, through comparison of such cells is lacking. This study aimed to compare the transcriptome of mesenchymal cells of the same phenotype isolated from the heart muscle and epicardial fat of the same patient, before and after culture.

Methods and results

Cells were isolated from biopsies of the right ventricle and epicardial fat collected from five patients (three men and two women, mean age 59.4 ± 2.6) who underwent heart transplantation due to ischaemic cardiomyopathy. In both tissues, immunophenotyping revealed three distinct populations: (i)CD31−CD45−CD90+CD34+CD146−, (ii) CD31−CD45−CD90+CD34−CD146+, and (iii) CD31−CD45−CD90−CD34−CD146+, of which only the first one could be grown after sorting. Material for RNA‐seq was collected from these cells before culture (250 cells) and at passage 6 (5000 cells). Transcriptomic analysis revealed that cells of the same phenotype (CD31−CD45−CD90+CD34+CD146−) upon isolation preferentially clustered according to the tissue of origin, not to the patient from whom they were isolated. Genes up‐regulated in the right ventricle‐derived cells were related to muscle physiology while down‐regulated genes included those encoding proteins with transmembrane signalling receptor activity. After six passages, heart‐derived and fat‐derived cells did not acquire similar transcriptome. Cells isolated from the right ventricle in comparison with their epicardial fat‐derived counterparts demonstrated higher level of transcripts related, among others, to RNA processing and muscle development. The down‐regulated genes were involved in the nucleosome assembly, DNA packaging and replication, and interleukin‐7‐mediated signalling pathway. Cells from epicardial fat demonstrated higher heterogeneity both before and after culture. Cell culture significantly changed gene expression profile within both tissues.

Conclusions

This study is an essential indication that mesenchymal cells isolated from different tissues do not demonstrate similar properties. Phenotypic identification and ease of isolation cannot be considered as a criterion in any therapeutic utilization of such cells.
Helios+ and Helios− Treg subpopulations are phenotypically and functionally distinct and express dissimilar TCR repertoires
Authors: Thornton Angela M. , Lu Jinghua , Korty Patricia E. , Kim Yong Chan , Martens Craig , Sun Peter D. , Shevach Ethan M.
Published: January 2019

The transcription factor Helios is expressed in a large subset of Foxp3+ Tregs. We previously proposed that Helios is a marker of thymic derived Treg (tTreg), while Helios− Treg were induced from Foxp3− T conventional (Tconv) cells in the periphery (pTreg). To compare the two Treg subpopulations, we generated Helios‐GFP reporter mice and crossed them to Foxp3‐RFP reporter mice. The Helios+ Treg population expressed a more activated phenotype, had a slightly higher suppressive capacity in vitro and expressed a more highly demethylated TSDR but were equivalent in their ability to suppress inflammatory bowel disease in vivo. However, Helios+ Treg more effectively inhibited the proliferation of activated, autoreactive splenocytes from scurfy mice. When Helios+ and Helios− Treg were transferred to lymphoreplete mice, both populations maintained comparable Foxp3 expression, but Foxp3 expression was less stable in Helios− Treg when transferred to lymphopenic mice. Gene expression profiling demonstrated a large number of differentially expressed genes and showed that Helios− Treg expressed certain genes normally expressed in CD4+Foxp3− T cells. TCR repertoire analysis indicated very little overlap between Helios+ and Helios− Treg. Thus, Helios+ and Helios− Treg subpopulations are phenotypically and functionally distinct and express dissimilar TCR repertoires.
Risk of adverse events in patients prescribed long‐term opioids: A cohort study in the UK Clinical Practice Research Datalink
Authors: Bedson John , Chen Ying , Ashworth Julie , Hayward Richard A. , Dunn Kate M. , Jordan Kelvin P.
Published: January 2019

Background

Long‐term opioid prescribing for musculoskeletal pain is controversial due to uncertainty regarding effectiveness and safety. This study examined the risks of a range of adverse events in a large cohort of patients prescribed long‐term opioids using the UK Clinical Practice Research Datalink.

Methods

Patients with musculoskeletal conditions starting a new long‐term opioid episode (defined as ≥3 opioid prescriptions within 90 days) between 2002 and 2012 were included. Primary outcomes: major trauma and intentional overdose (any). Secondary outcomes: addiction (any), falls, accidental poisoning, attempted suicide/self‐harm, gastrointestinal pathology and bleeding, and iron deficiency anaemia. “Control” outcomes (unrelated to opioid use): incident eczema and psoriasis.

Results

A total of 98,140 new long‐term opioids users (median age 61, 41% male) were followed for (median) 3.4 years. Major trauma risk increased from 285 per 10,000 person‐years without long‐term opioids to 369/10,000 for a long‐term opioid episode (<20 mg MED), 382/10,000 (20–50 mg MED), and 424/10,000 (≥50 mg MED). Adjusted hazard ratios were 1.09 (95% CI; 1.04, 1.14 for <20 mg MED vs. not being in an episode of long‐term prescribing), 1.24 (95% CI; 1.16, 1.32: 20–50 mg MED) and 1.34 (95% CI; 1.20, 1.50: ≥50 mg MED). Significant dose‐dependent increases in the risk of overdose (any type), addiction, falls, accidental poisoning, gastrointestinal pathology, and iron deficiency anaemia were also found.

Conclusions

Patients prescribed long‐term opioids are vulnerable to dose‐dependent serious adverse events. Opioid prescribing should be reviewed before long‐term use becomes established, and periodically thereafter to ensure that patients are not being exposed to increased risk of harm, which is not balanced by therapeutic benefit.

Significance

Long‐term opioid use is associated with serious adverse events such as major trauma, addiction and overdose. The risk increases with higher opioid doses. Opioid prescribing should be reviewed before long‐term use becomes established, and periodically thereafter to assess ongoing effectiveness.
Hydrogen‐Mediated Electron Transfer in Hybrid Microbial–Inorganic Systems and Application in Energy and the Environment
Authors: Xiu Siyuan , Yao Jiani , Wu Gaoming , Huang Yumeng , Yang Bin , Huang Ying , Lei Lecheng , Li Zhongjian , Hou Yang
Published: January 2019

The conversion of electrical energy to chemical energy is a promising approach to store and utilize renewable electricity. Hybrid microbial–inorganic systems incorporating abiotic catalysts with biocatalysts have been proved to efficiently achieve this conversion. To couple electrocatalytic reactions with microorganism metabolism, H2 can be an ideal mediator for energy and electron transfer between electrodes and microorganisms. In hydrogen‐mediated hybrid microbial–inorganic systems, H2 is produced at the cathodes with abiotic hydrogen evolution reaction catalysts. H2 then functions as an energy carrier and electron donor for hydrogen‐oxidizing microorganisms. Hybrid microbial–inorganic systems have been prevalently used for energy and environmental applications. Herein, the principle, applications, and current challenges of the hybrid microbial–inorganic systems are summarized.
Zircon U–Pb age, Hf isotope, and geochemistry of Late Permian to Triassic igneous rocks from the Jiapigou gold ore belt, NE China: Petrogenesis and tectonic implications
Authors: Wutiepu Wukeyila , Yang Yanchen , Han Shijiong , Guo Yufei , Nie Shijia , Liu Chao , Fan Wenliang
Published: January 2019

The Jiapigou gold ore belt is located in the northeastern corner of the wedge‐shaped North China Craton and is hosted by Neoarchean basement gneiss and amphibolite, along with late Palaeozoic and Mesozoic granitoids. In this paper, whole‐rock major and trace element geochemistry together with zircon U–Pb ages and Lu–Hf isotope compositions are reported for Late Permian to Triassic igneous rocks from the gold belt. The dominant population of zircons in all these rocks shows oscillatory growth zoning in CL images, and relatively high Th/U ratios (0.10–5.23) that are indicative of a magmatic origin. Zircon U–Pb data indicate that the igneous rocks formed during two major phases: ca. 252 Ma and ca. 230–213 Ma. Geochemically, the Late Permian (ca. 252 Ma) diorites are high‐K calc‐alkaline in composition and low total Fe2O3, MgO, and CaO contents, and represented by enrichment in LILEs relative to HFSEs and HREEs, all of which are indicative of a postcollision high‐K calc‐alkaline granite affinity. In contrast, the Late Triassic (ca. 230–213 Ma) igneous rocks are mainly quartz syenite porphyries, felsites, and granodiorites, and are variable medium‐ to high‐K calc‐alkaline series and exhibit a negative Eu anomaly with A‐type affinities, indicating an extensional environment. In addition, in situ Hf isotopic analyses of zircons from four dated samples reveal that they have εHf(t) values of −3.0 to +2.2, with two‐stage model (TDM2) ages range from 964 to 1,210 Ma, indicating that they probably originated from the partial melting of a dominantly Mesoproterozoic to Neoproterozoic crustal source. On the basis of the geochemical data and regional geological investigations, we further propose that the Jiapigou gold ore belt in the Late Permian was formed in a postcollisional tectonic setting, whereas an extensional tectonic setting in the Late Triassic that caused lithospheric thinning during a postorogenic event.
Sensory dysphagia: A case series and proposed classification of an under recognized swallowing disorder
Authors: Santoso Laura F. , Kim Daniel Y. , Paydarfar David
Published: January 2019

Background

Although sensory feedback is a vital regulator of deglutition, it is not comprehensively considered in the standard dysphagia evaluation. Difficulty swallowing secondary to sensory loss may be termed “sensory dysphagia” and may account for cases receiving diagnoses of exclusion, like functional or idiopathic dysphagia.

Methods and Results

Three cases of idiopathic dysphagia were suspected to have sensory dysphagia. The patients had (1) effortful swallowing, (2) globus sensation, and (3) aspiration. Endoscopic sensory mapping revealed laryngopharyngeal sensory loss. Despite normal laryngeal motor function during voluntary maneuvers, laryngeal closure was incomplete during swallowing. The causes of sensory loss were identified: cranial neuropathy from Chiari malformation, immune‐mediated neuronopathy, and nerve damage from prior traumatic intubation.

Conclusions

Sensory loss may cause dysphagia without primary motor dysfunction. Sensory dysphagia should be classified as a distinct form of swallowing motility disorder to improve diagnosis. Increasing awareness and developing appropriate assessment tools may advance dysphagia care.
Understanding changes in the water budget driven by climate change in cryospheric‐dominated watershed of the northeast Tibetan Plateau, China
Authors: Xu Min , Kang Shichang , Wang Xiaoming , Pepin Nick , Wu Hao
Published: January 2019

Glacial retreat and the thawing of permafrost due to climate warming have altered the hydrological cycle in cryospheric‐dominated watersheds. In this study, we analysed the impacts of climate change on the water budget for the upstream of the Shule River Basin on the northeast Tibetan Plateau. The results showed that temperature and precipitation increased significantly during 1957–2010 in the study area. The hydrological cycle in the study area has intensified and accelerated under recent climate change. The average increasing rate of discharge in the upstream of the Shule River Basin was 7.9 × 106 m3/year during 1957–2010. As the mean annual glacier mass balance lost −62.4 mm/year, the impact of glacier discharge on river flow has increased, especially after the 2000s. The contribution of glacier melt to discharge was approximately 187.99 × 108 m3 or 33.4% of the total discharge over the study period. The results suggested that the impact of warming overcome the effect of precipitation increase on run‐off increase during the study period. The evapotranspiration (ET) increased during 1957–2010 with a rate of 13.4 mm/10 years. On the basis of water balance and the Gravity Recovery and Climate Experiment and the Global Land Data Assimilation System data, the total water storage change showed a decreasing trend, whereas groundwater increased dramatically after 2006. As permafrost has degraded under climate warming, surface water can infiltrate deep into the ground, thus changing both the watershed storage and the mechanisms of discharge generation. Both the change in terrestrial water storage and changes in groundwater have had a strong control on surface discharge in the upstream of the Shule River Basin. Future trends in run‐off are forecasted based on climate scenarios. It is suggested that the impact of warming will overcome the effect of precipitation increase on run‐off in the study area. Further studies such as this will improve understanding of water balance in cold high‐elevation regions.
Evaluation of the transferability of survival calculators for stage II/III colon cancer across healthcare systems
Authors: Jorissen Robert N. , Croxford Matthew , Jones Ian T. , Ward Robyn L. , Hawkins Nicholas J. , Gibbs Peter , Sieber Oliver M.
Published: January 2019

Adjuvant! Online Inc (A!O), the Memorial Sloan Kettering Cancer Center (MSKCC), MD Anderson (MDA) and Mayo Clinic (MC) provide calculators to predict survival probabilities for patients with resected early‐stage colon cancer, trained on data from United States (US) patient cohorts or patients enrolled in international clinical trials. Limited data exist on the transferability of calculators across healthcare systems. Calculator transferability to Australian community practice was evaluated for 1,401 stage II/III patients. Calibration and discrimination were assessed for overall (OS), cancer‐specific (CSS) or recurrence‐free survival (RFS). The US patient cohort‐based calculators, A!O, MSKCC and MDA, significantly overestimated risks of recurrence and death in Australian patients, with 5‐year OS, CSS and RFS prediction differences of −6.5% to −9.9%, −9.1% to −14.4% and − 3.8% to −6.8%, respectively (p < 0.001). Significant heterogeneity in calibration was observed for subgroups by tumor stage and treatment, age, gender, tumor location, ECOG and ASA score. Calibration appeared acceptable for the clinical trial patient‐based MC calculator, but restricted tool applicability (stage III patients, ≥12 examined lymph nodes, receiving adjuvant treatment) limited the sample size. Compared to AJCC 7th edition tumor staging, calculators showed improved discrimination for OS, but no improvement for CSS and RFS. In conclusion, deficiencies in calibration limited transferability of US patient cohort‐based survival calculators for early‐stage colon cancer to the setting of Australian community practice. Our results demonstrate the utility for multi‐feature survival calculators to improve OS predictions but highlight the importance for performance assessment of tools prior to implementation in an external health care setting.
The “great” controlling nucleotide coenzymes
Authors: Veech Richard L. , Todd King Michael , Pawlosky Robert , Kashiwaya Yoshihiro , Bradshaw Patrick C. , Curtis William
Published: January 2019

Nucleotide coenzymes dot the map of metabolic pathways providing energy to drive the reactions of the pathway and play an important role in regulating and controlling energy metabolism through their shared potential energy, which is widely unobserved due to the paradox that the energy in the coenzyme pools cannot be determined from the concentration of the coenzyme couples. The potential energy of the nucleotide couples in the mitochondria or the cytoplasm is expressed in the enzyme reactions in which they take part. The energy in these couples, [NAD+]/[NADH], [NADP+]/[NADPH], [acetyl CoA]/[CoA], and [ATP]/[ADP]x[Pi], regulates energy metabolism. The energy contained in the couples can be altered by suppling energy equivalents in the form of ketones, such as, D‐β‐hydroxybutyrate to overcome insulin resistance, to restore antioxidants capacity, to form potential treatments for Alzheimer's and Parkinson's diseases, to enhance life span, and to increase physiological performance. © 2019 IUBMB Life, 71(5):565–579, 2019
Effects of Shear and Surface Roughness on Reducing the Attachment of Oscillatoria sp. Filaments on Substrates
Authors: Hassan Muhammad Fadzli , Lee Heow Pueh , Lim Siak Piang
Published: January 2019

The effects of surface roughness and shear on the attachment of Oscillatoria sp. algal filaments onto SS314 stainless steel coupons were investigated. Average surface roughness was used to systematically characterize the surface condition. An annular biofilm reactor with a spinning inner cylinder was used to create a uniform shear flow over the coupons. As far as the authors are able to establish, these systematic methods have yet to be used in the study of microalgae deposition. It was postulated that increasing average surface roughness would lead to an increase in the amount of algae deposited, whereas an increase in shear would lead to a decrease in algae deposition and reduce the algae lengths by way of fragmentation. The results indicate that an increasing surface roughness would increase the amount of algal strands that might deposit on the coupons, whereas shear was found to have the effect of reducing the amount of algae that might attach on the coupons.
Derivation of an occupational exposure limit for diacetyl using dose‐response data from a chronic animal inhalation exposure study
Authors: Beckett Evan M. , Cyrs William D. , Abelmann Anders , Monnot Andrew D. , Gaffney Shannon H. , Finley Brent L.
Published: January 2019

Occupational exposure limits (OELs) have been previously proposed for diacetyl; however, most of these values are based on worker cohort studies that are known to have several limitations and confounders. In this analysis, an 8 hour time‐weighted average (TWA) OEL for diacetyl was derived based on data from a chronic, 2 year animal inhalation study recently released by the US National Toxicology Program. In that study, complete histopathology was conducted on male and female mice and rats exposed to 0, 12.5, 25 or 50 ppm diacetyl. Several responses in the lower respiratory tract of rats (the more sensitive species) were chosen as the critical endpoints of interest. Benchmark concentration (BMC) modeling of these endpoints was used to estimate BMC values associated with a 10% extra risk (BMC10) and the associated 95% lower confidence bound (BMCL10), which were subsequently converted to human equivalent concentrations (HECs) using a computational fluid dynamics‐physiologically based pharmacokinetic (CFD‐PBPK) model to account for interspecies dosimetry differences. A composite uncertainty factor of 8.0 was applied to the human equivalent concentration values to yield 8 hour TWA OEL values with a range of 0.16‐0.70 ppm. The recommended 8 hour TWA OEL for diacetyl vapor of 0.2 ppm, based on minimal severity of bronchiolar epithelial hyperplasia in the rat, is practical and health‐protective.
Reducing Alcohol‐Related Consequences Among High School Seniors: Efficacy of a Brief, Web‐Based Intervention
Authors: Doumas Diana M. , Esp Susan
Published: January 2019

The authors examined the efficacy of a brief, web‐based personalized feedback intervention on reducing alcohol‐related consequences among high school seniors (N = 105) using a group‐randomized controlled design. Results of repeated measures mixed‐models analyses indicated significant intervention effects over time for alcohol‐related consequences at 30‐day and 6‐month follow‐up assessments. Drinking risk status moderated intervention effects such that results were only significant for high‐risk drinkers (i.e., students reporting initiation of heavy episodic drinking at baseline).
Upscaling of W zeolite direct synthesis from coal fly ash and its water adsorption capacity
Authors: Gamero‐Vega Karen Y , Medina‐Ramírez Adriana , Khamkure Sasirot , Orozco‐Núñez Sylvia I , Aguilera‐González Elsa N , Gamero‐Melo Prócoro
Published: January 2019

BACKGROUND

Alkaline amorphization of fly ash (FA) and crystallization of the potassium W zeolite from the resultant amorphous materials was carried out at different scales by a straightforward hydrothermal method. The experimental factors and levels were evaluated during the FA amorphization study by variation of the metallic hydroxide, concentration, temperature and time for the hydrothermal reaction.

RESULTS

The alkaline FA hydrothermal activation study quantified a set of optimal conditions to obtain amorphous materials easy to be recrystallized into W zeolite. The activation process at laboratory scale involved the hydrothermal treatment of 3.6 g FA with 74.43 mEq KOH dissolved in 21 mL water at 125 °C for 4 h. A product with ≤94.7% of the amorphous phase was obtained. The direct zeolitization of FA was performed at 175 °C for 16 h with a KOH:FA weight ratio of 0.33 and molar ratios of 1.64, 17.08 and 3.90 for SiO2:KOH, H2O:SiO2 and SiO2:Al2O3, respectively. An amount of dried zeolitic material c.25% higher than the weight of FA used was obtained.

CONCLUSION

Adsorbents formulated with the W zeolite showed higher water adsorption capacity than the commercial molecular sieves used by industry for drying wet natural gas. © 2019 Society of Chemical Industry
Unusual tubular cystic lesion compressing inferior vena cava
Authors: Rana Surinder S , Shah Jimil , Sharma Ravi , Gupta Rajesh
Published: January 2019

Fluid collections are important local complications of acute pancreatitis (AP). They are usually located in peri‐pancreatic region but can also be found in various atypical locations like mediastinum, spleen, liver, pelvis or neck. Such pancreatic fluid collections in atypical locations can cause diagnostic dilemma and may cause delay in management. We report an interesting case of AP who presented to us with a walled‐off necrosis mimicking a long cystic mass lesion surrounding the IVC.
Primary hepatic lymphoma: A rare case report
Authors: Mehta Nishkarsh , Jayapal Loganathan , Goneppanavar Mangala , Nelamangala Ramakrishnaiah Vishnu Prasad
Published: January 2019

Primary hepatic lymphoma (PHL) is a rare clinical entity comprising 0.016% of all cases of non‐Hodgkin's lymphoma and 0.4% of extranodal non‐Hodgkin's lymphoma and can be missed easily. Here, we report a case of PHL treated with primary hepatic resection followed by an Rituximab Cyclophosphamide Doxorubicin Vincristine Prednisone (R‐CHOP) chemotherapy regimen, diagnosed after postoperative biopsy report. The patient presented with complaints of pain abdomen, vomiting, anorexia, and weight loss. She had hepatomegaly and no other significant finding. Blood investigations were unremarkable. Biopsy or fine needle aspiration cytology (FNAC) was not taken before surgery. Contrast‐enhanced computed tomography of the abdomen demonstrated well‐defined solid mass with central hypodense fluid attenuating area in the liver with a thin pseudocapsule. The differential diagnoses considered were secondary to the liver, hepatocellular carcinoma, and hemangioma. Left hepatectomy with the removal of the middle hepatic vein was performed. The postoperative biopsy was reported as diffuse large B cell lymphoma of the liver.
Association between miRNA‐146a rs2910164 (G/C) polymorphism with the susceptibility to chronic HBV infection and spontaneous viral clearance in an Iranian population
Authors: Khanizadeh Sayyad , Hasanvand Banafsheh , Nikoo Hadi Razavi , Anbari Khatereh , Adhikary Hemanta , Shirkhani Somayeh , Lashgarian Hamed Esmaeili
Published: January 2019

Hepatitis B virus (HBV) infection is one of the clinical dilemmas in chronic liver diseases. MicroRNAs (miRNAs) are small noncoding RNA molecules that play an important role in the pathogenesis of liver diseases and single nucleotide polymorphisms (SNPs) in miRNA genes affect the clinical course of HBV infection. Previous studies have shown that miRNA‐146a rs2910164 polymorphism can be associated with the pathogenesis of liver diseases such as hepatocellular carcinoma. The present study investigated the association between miRNA‐146a rs2910164 polymorphism and susceptibility to HBV infection in an Iranian population.

The study comprised 266 patients with chronic HBV infection, 172 patients with spontaneous viral clearance (SVC) after acute HBV infection, and 266 healthy control adjusted for sex and age. The genotyping of the miRNA‐146a rs2910164 polymorphism was performed by polymerase chain reaction‐restriction fragment length polymorphism (PCR‐RFLP) method.

Our data revealed that GG genotype and G allele of miRNA‐146a rs2910164 SNP is dominated (P < 0.001) in patients with chronic HBV infection (Odds ratio [OR] = 3.92; 95% confidence interval [CI] = 2.1‐7.32). miRNA‐146a rs2910164 polymorphism showed a statistically significant association (P < 0.001) between CC genotype and allele C with SVC (OR = 2.92; 95% CI = 1.56‐546).

Our findings suggest miRNA‐146a SNP (C/G) in our population may be associated with the susceptibility to HBV infection and CC genotype is associated with SVC. Also, the GG genotype and G allele at miRNA‐146a rs2910164 is associated with chronic HBV infection in our population.
A hierarchical analysis of the impact of methodological decisions on statistical downscaling of daily precipitation and air temperatures
Authors: Pryor Sara C. , Schoof Justin T.
Published: January 2019

Despite the widespread application of statistical downscaling tools, uncertainty remains regarding the role of model formulation in determining model skill for daily maximum and minimum temperature (Tmax and Tmin), and precipitation occurrence and intensity. Impacts of several key aspects of statistical transfer function form on model skill are evaluated using a framework resistant to model overspecification. We focus on: (a) model structure: simple (generalized linear models, GLMs) versus complex (artificial neural networks, ANNs) models. (b) Predictor selection: Fixed number of predictors chosen a priori versus stepwise selection of predictors and inclusion of grid point values versus predictors derived from application of principal components analysis (PCA) to spatial fields. We also examine the influence of domain size on model performance. For precipitation downscaling, we consider the role of the threshold used to characterize a wet day and apply three approaches (Poisson and Gamma distributions in GLM and ANN) to downscale wet‐day precipitation amounts. While no downscaling formulation is optimal for all predictands and at 10 locations representing diverse U.S. climates, and due to the exclusion of variance inflation all of the downscaling formulations fail to reproduce the range of observed variability, models with larger suites of prospective predictors generally have higher skill. For temperature downscaling, ANNs generally outperform GLM, with greater improvements for Tmin than Tmax. Use of PCA‐derived predictors does not systematically improve model skill, but does improve skill for temperature extremes. Model skill for precipitation occurrence generally increases as the wet‐day threshold increases and models using PCA‐derived predictors tend to outperform those based on grid cell predictors. Each model for wet‐day precipitation intensity overestimates annual total precipitation and underestimates the proportion derived from extreme precipitation events, but ANN‐based models and those with larger predictor suites tend to have the smallest bias.
A quantile–quantile adjustment of the EURO‐CORDEX projections for temperatures and precipitation
Authors: Cardell M.F. , Romero R. , Amengual A. , Homar V. , Ramis C.
Published: January 2019

Projections of climate change impacts over Europe are derived using a new quantile–quantile adjustment method. E‐OBS high‐resolution gridded data sets of daily observed precipitation and 2‐m surface minimum and maximum temperatures have been used as the current climate baseline. For projections, the same meteorological variables have been obtained from a set of regional climate models (RCMs) integrated in the EURO‐CORDEX project, and by considering the RCP4.5 and RCP8.5 future emissions scenarios. To enhance the reliability of RCM data at local scale, new developments of a previous quantile–quantile adjustment have been applied to the simulated regional scenarios. This method focuses not only on the bulk spectrum of the cumulative distribution functions but also on its tails. Results show an overall improvement in reproducing the present climate baseline when using calibrated series instead of raw RCM outputs. Next, we have used these locally adjusted series to quantify the climate change signal through a number of annual and seasonal indicators. A significant increase of the minimum and maximum temperatures in all seasons is projected over Europe, being more marked in the Mediterranean for summer and autumn. Prospects on future seasonal and annual changes in precipitation are more diverse, showing an overall decrease in southern Europe and the Mediterranean, while precipitation is expected to increase towards the north of the continent. With these sources of information at hand, including and accounting for the identification of the most vulnerable geographical areas, policy makers and stakeholders can respond more effectively to the future challenges imposed by climate change.
Establishing the chromatographic fingerprint of traditional Chinese medicine standard decoction based on quality by design approach: A case study of Licorice
Authors: Zhang Hui , Wang Jianan , Chen Yan , Shen Xiaowei , Jiang Huijie , Gong Xingchu , Yan Jizhong
Published: January 2019

A novel analytical quality by design approach for developing a chromatographic fingerprint was established for analyzing complex traditional Chinese medicine, using a licorice standard decoction as an example. Considering the characteristics of integrity and ambiguity, the resolution of eight common peaks, total peak number, capacity factor distributions, and peak purity were selected as potential critical method attributes for assessing the quality of the chromatographic fingerprint. A central composite design was used to evaluate the relationship between critical method attributes and critical method parameters, including column temperature, wavelength, flow rate, formic‐acid concentration, and gradient parameters. A standard probability method was employed to calculate the design space of the fingerprint analysis parameters and evaluate the robustness of the methodology. The optimized high‐performance liquid chromatography fingerprint conditions were acetonitrile and 0.1% formic acid water gradient elution (0‐5 min, 5–19% A; 5–10 min, 19% A; 10–50 min, 19–42% A; 50–54 min, 42–100% A; 54–60 min, 100% A), column temperature 25±5°C, detection wavelength 265 nm. The design space of fingerprint analytical method based on the analytical quality by design approach not only met the requirements of the fingerprint analysis, but also improved the robustness and applicability of the fingerprint method.
Analysis of thermolabile residual solvents in a spray dried dispersion using static headspace gas chromatography
Authors: Oliveira Antonio , Bambrick Stephen T. , Pfund Laura Y. , Diamandopoulos Panos , Gong Xiaoyi , Liang Xihui , Mowery Mark D. , Zheng Jinjian
Published: January 2019

In this study, we discuss the development of a static headspace gas chromatography method for the analysis of residual acetone as well as its enriched impurities including mesityl oxide and diacetone alcohol, in a spray dried dispersion. The major challenges include the instability of mesityl oxide and diacetone alcohol at high temperature and peak tailing of diacetone alcohol. It was found that the headspace oven temperature has to be controlled to 150°C or below to prevent degradation beyond an acceptable level (< 1%). The peak tailing of diacetone alcohol was attributed to the “Phase Soaking” effect due to excessive diluent, which may condense and temporarily modify the stationary phase. The peak shape of diacetone alcohol is dependent on the column loading capacity and the peak area of N‐methyl pyrrolidone, the solvent that elutes after diacetone alcohol. The headspace oven temperature was set at 140°C, where the highest response ratio of diacetone alcohol/N‐methyl pyrrolidone at 1.46 and thus the best sensitivity was obtained. The calculated quantitation limits were 1 ppm for acetone, 3 ppm for mesityl oxide and 31 ppm for diacetone alcohol. The method successfully passed validation criteria for specificity, linearity, accuracy, and precision.
Antifibrotic effect of mitomycin‐C on human vocal cord fibroblasts
Authors: Szabó Diána , Kovács Dávid , Endrész Valéria , Igaz Nóra , Jenovai Kitti , Spengler Gabriella , Tiszlavicz László , Molnár József , Burián Katalin , Kiricsi Mónika , Rovó László
Published: January 2019

Objective

Acquired laryngotracheal stenosis is a potentially life‐threatening situation and a very difficult and challenging problem in laryngology. Therefore, new trends and innovative approaches based on antifibrotic drugs and minimally invasive regimens are being developed to attenuate laryngotracheal fibrosis and scarring. The purpose of this study was to examine the efficacy of mitomycin‐C (MMC) to reverse the transforming growth factor (TGF)‐β‐induced differentiation of MRC‐5 fibroblast and human primary vocal cord fibroblasts to reveal the possible applicability of MMC to laryngotracheal fibrotic conditions.

Methods

Human primary fibroblast cells were isolated from vocal cord specimens of patients undergoing total laryngectomy. The established primary vocal cord fibroblast cell cultures as well as the MRC‐5 human fibroblast cells were treated with 5 ng/mL TGF‐β alone and then with 0.5 µg/mL MMC for 24 hours. Differentiation of fibroblasts was characterized by α‐smooth muscle actin (α‐SMA) immunhistochemistry, Western blot analysis, and real‐time polymerase chain reaction. Cell motility was assessed by wound‐healing assay.

Results

Elevated α‐SMA mRNA and protein expression as well as increased cell motility were observed upon TGF‐β exposures. However, after MMC treatments the TGF‐β‐induced fibroblasts exhibited a significant decrease in α‐SMA expression and wound‐healing activity. Therefore, TGF‐β‐stimulated fibroblast‐myofibroblast transformation was reversed at least in part by MMC treatment. Histopathological examinations of tissue specimens of a laryngotracheal stenosis patient supported these findings.

Conclusion

Antifibrotic effects of MMC were demonstrated on the human MRC‐5 cell line and on primary vocal cord fibroblast cultures. These results verify that MMC can be used with success to reverse upper airway stenosis by reverting the myofibroblast phenotype.

Level of Evidence

NA

Laryngoscope, 129:E255–E262, 2019