bluuebunny/crossref_metadata_2025 huggingface dataset:
Describing the delivery of clinical pharmacy services via telehealth: A systematic review
Authors: Melton Tyler , Jasmin Hilary , Johnson Haden F. , Coley Annika , Duffey Sawyer , Renfro Chelsea P.
Published: August 2021

Introduction

Telehealth offers a promising opportunity for the delivery of clinical pharmacy services by increasing the accessibility of health care, extending the reach of clinical services, and allowing pharmacists to engage with patients who might otherwise be overlooked. The objectives of the project were to discover effective strategies for the delivery of clinical pharmacy services via telehealth and to identify core components of comprehensive medication management (CMM) that are deliverable via telehealth.

Methods

A systematic literature review was performed by searching four databases (Cumulative Index to Nursing and Allied Health Literature [CINAHL], PubMed, Scopus, and Web of Science) for relevant citations using keywords and subject headings relating to telemedicine, clinical pharmacy services, and health conditions. Studies were eligible for inclusion in the review if the interventions they describe involved telehealth technologies and pharmacist care. Blind screening of abstracts and full‐text review was completed by six researchers divided into teams of two. Any discrepancies were resolved by the corresponding author.

Results

Fifty‐nine studies met the inclusion criteria, most (n = 53) of which were conducted in the U.S. Five studies (8.5%) reported pharmacist training as an implementation strategy. The telehealth technologies most regularly utilized were telephone‐based interventions (n = 45), videoconferences (n = 13), and web‐based (n = 4) interventions, with five studies using a combination of technologies. Most studies focused on hypertension (n = 22), diabetes (n = 20), or lipid‐related (n = 14) disease state management. Eighteen studies qualified as CMM (n = 18), with most involving all five essential CMM functions.

Conclusion

This systematic review study highlights opportunities for pharmacists to deliver clinical pharmacy services using telehealth. The majority of clinical pharmacy services described in the accessed literature was provided via telephone and focused on targeted monitoring of disease states. While studies reporting the use of CMM interventions were limited, there is an opportunity to increase the application of CMM principles as healthcare systems transition to providing more telehealth services.
Phone a pharmacist: Telepharmacy services at freestanding emergency departments
Authors: Campbell Matthew J. , Tietz David , Sayles Stephen , Hustey Frederic , Phelan Michael P.
Published: August 2021

Introduction

Emergency medicine (EM) pharmacy practice has experienced significant growth in the past decade, but the scope of services provided for freestanding emergency departments (FSEDs) has not been previously described.

Objectives

The primary objective was to describe EM pharmacist interventions provided through telepharmacy services for three FSEDs.

Methods

This was a retrospective chart review conducted in three FSEDs that are part of a large health system. EM pharmacists provide remote clinical coverage for the FSEDs. Pharmacist interventions for FSED patients between 1 January 2017 and 31 December 2018 were eligible for inclusion. Documentation related to non‐direct patient care activities was excluded. Drug therapy recommendations were categorized by therapeutic drug class and the proportion associated with Institute for Safe Medication Practices (ISMP) high‐alert medications was analyzed. The clinical significance of a random sample of drug therapy recommendations was rated using a validated scale. Data was analyzed descriptively and a weighted Kappa statistic was calculated to assess inter‐rater reliability.

Results

A total of 4313 interventions met inclusion criteria with drug therapy recommendations accounting for 38.4% of all interventions. Of 1664 drug therapy recommendations, there were 1424 linked to a medication with the most frequently implicated therapeutic classes being antimicrobial agents (n = 732; 51.4%), vaccines (n = 168; 11.8%), and cardiovascular agents (n = 90; 6.3%). ISMP high‐alert medications accounted for 11% (n = 157) of these recommendations with antithrombotic agents (n = 51; 32.5%), insulin (n = 34; 21.7%), and opioids (n = 20; 12.7%) most frequently implicated. In a random sample of drug therapy recommendations, 19.2% were rated as significant errors by both reviewers with moderate inter‐rater reliability (κ = 0.55; SE 0.09). When assessing the value of service, 59% of interventions were rated as significant by both reviewers with fair inter‐rater reliability (κ = 0.22; SE 0.05).

Conclusion

EM pharmacists provided clinically significant drug therapy recommendations through telepharmacy services which may represent a novel approach to optimize patient care in FSEDs.
Clinical pharmacy specialists providing consistent comprehensive medication management with increased efficiency through telemedicine during the COVID19 pandemic
Authors: Thomas Ashley M. , Baker Jennifer W. , Hoffmann Terry J. , Lamb Kristen
Published: August 2021

Introduction

The Veterans Affairs (VA) has been at the forefront of harnessing the skills of clinical pharmacy specialists (CPS) in patient‐aligned care teams (PACT) to improve patient care outcomes and create access for veterans. With the unfortunate arrival of Coronavirus disease 2019 (COVID19), PACT CPS were duty‐bound to expand telehealth services at an accelerated rate. The purpose of this quality improvement analysis is to compare CPS efficiency as well as some objective patient metrics to assess for a change in the quality of care. This is the first study to compare the efficiency and quality of care by CPS in the VA pre‐COVID19 and during the COVID19 pandemic.

Methods

This is a retrospective review of PACT CPS comprehensive medication management from 3/10/19 to 11/30/19 and 3/10/20 to 11/30/20. Data points focused on clinic encounters, patient accountability to appointments, disease state expansion, and markers of disease‐state management. Given diabetes and hypertension are the main disease states managed by most PACT CPS', the study evaluated changes in hemoglobin A1c (HbA1c) and blood pressure (BP) between the two cohorts as well. Data were analyzed using GraphPad Software or Microsoft Excel. A student T‐test was used for continuous data and Chi‐squared or Fishers Exact for nominal data.

Results

The total number of PACT CPS encounters increased 32% in 2020, and the number of unique patients increased by 12%. There were a statistically significant increase in telephone and direct‐to‐consumer (DCT) video visits. The rates of no shows and cancellations significantly decreased between 2019 and 2020. There was no difference in the average change in HbA1c or average blood pressure between the two study groups.

Conclusions

When PACT CPS services transitioned from primarily face‐to‐face visits to all virtual care, the consistency of care improved, and the quality of care was not compromised.
Review of telehealth interventions for childhood obesity in minority, low‐income or underserved populations: Opportunity for pharmacists
Authors: Barefield Kimberly L. , Rollins Brent
Published: August 2021

There has been a steady increase in childhood obesity, comparable to that seen in adults, over the past decade with the incidence almost tripling. As seen in adults, there are trends in discrepancy among gender, ethnicity, race, and underserved populations in the incidence of childhood obesity. Effective interventions for childhood obesity need to be broad including both diet and exercise, but there is little evidence on the most effective approach. The use of telehealth interventions to treat childhood obesity in ethnic, low‐income, and underserved populations could be an effective platform. The pharmacist is a health care professional that is easily accessible to these populations and can assist with lifestyle modification counseling for weight loss. The purpose of this review is to summarize and evaluate the effectiveness of telehealth modalities on weight loss in overweight/obese children identified as minority, low‐income, or underserved populations. The review found there were many different forms of telehealth interventions utilized which may have influenced the success of evaluated outcomes. The majority of modalities did not improve BMI or BMI z‐score when not accompanied by a form of real‐time intervention. Studies, where telehealth was accompanied by motivational coaching, did show a significant decrease in BMI and/or BMI z‐score.
Therapeutic plasma exchange in patients with severe obesity (BMI >40): A survey of practices in the United States
Authors: Babariya Shraddha Patel , Vivero Angelica , Peedin Alexis , Karp Julie Katz
Published: August 2021

Background

The prevalence of obesity in the United States is estimated at 42.4% and expected to increase over the next decade. Therefore, understanding how to best perform certain medical procedures on severely obese (SO) patients is a necessity. This study presents results on the current methods of performing therapeutic plasma exchange (TPE) on SO patients. This paper aims to contribute to the existing literature by providing new insights into calculating plasma volume (PV) for TPE in SO patients.

Methods

Blood Bank/Apheresis Directors at all institutions with pathology residency and/or blood banking/transfusion medicine fellowship programs were asked to complete a 5‐question online survey about their institutional policies regarding TPE in SO patients. Survey data were analyzed to determine if institutions have policies in place to calculate PV in SO patients.

Results

Out of the 144 institutions contacted, 45 (31%) completed the survey. Nine (20%) institutions had a policy to calculate PV differently for SO patients, 7 (16%) reported a specific body mass index (BMI) above which they alter PV calculation, and 7 (16%) reported a maximum volume exchanged in SO patients.

Conclusion

A minority of responding institutions had specific policies in place to calculate PV for TPE in SO patients. Practice patterns for calculating PV for TPE in SO patients varied, with some institutions adjusting PV calculations and others setting a maximum volume to be exchanged regardless of BMI. These findings highlight the need for establishing a clear method of calculating PV in SO patients.
Synthesis of nanorods assembled V‐doped WO3 microspheres and the catalytic performance in thermal decomposition of ammonium perchlorate
Authors: Li Xiongjian , Hu Hao , Chen Piao , Yang Shuijin
Published: August 2021

V‐doped WO3 microspheres composed of nanorods radially grown from the center were fabricated via a simple hydrothermal method. The as‐obtained products were characterized by several techniques such as X‐ray powder diffraction (XRD), energy dispersive spectrometer (EDS), scanning electron microscopy (SEM), transmission electron microscopy (TEM), Fourier transform infrared spectroscopy (FTIR), Raman spectrum, and Brunauer–Emmett–Teller (BET). It was found that V atoms were incorporated inside the hexagonal WO3 lattice. On the basis of time‐dependent experiments, the formation mechanism for the as‐prepared V‐doped WO3 micro‐nanostructures was discussed. In addition, the catalytic properties of the synthesized material on the thermal decomposition of ammonium perchlorate (AP) were evaluated by thermal gravimetric and differential thermal analysis (TG/DTA), which showed the thermal decomposition temperatures of AP in the presence of 1, 2, and 4 wt% of V‐doped WO3 micro‐nanostructures were reduced to 399, 393, and 380°C, respectively.
Clinical presentation and natural history of Barth Syndrome: An overview
Authors: Taylor Carolyn , Rao Emily S. , Pierre Germaine , Chronopoulou Estathia , Hornby Brittany , Heyman Andrea , Vernon Hilary J.
Published: August 2021

Barth Syndrome is a rare X‐linked disorder caused by pathogenic variants in the gene TAFAZZIN, which encodes for an enzyme involved in the remodeling of cardiolipin, a phospholipid primarily localized to the inner mitochondrial membrane. Barth Syndrome is characterized by cardiomyopathy, skeletal myopathy, neutropenia, and growth abnormalities, among other features. In this review, we will discuss the clinical presentation and natural history of Barth Syndrome, review key features of this disease, and introduce less common clinical associations. Recognition and understanding of the natural history of Barth Syndrome are important for ongoing patient management and developing endpoints for the demonstration of efficacy of new and emerging therapies.
Ultra‐fast liquid chromatography method coupled with ultraviolet detection to quantify dimethylsulfoxide, dimethylformamide and dimethylacetamide in short half‐lives radiopharmaceuticals
Authors: Fouque Julien , Rusu Timofei , Huguet Samuel , Branquinho Emilie Da Costa , Blondeel‐Gomes Sandy , Rezaï Keyvan , Madar Olivier
Published: August 2021

Radiolabelling with short half‐lives radionuclides (e.g., fluorine‐18 and carbon‐11) must be as efficient and as fast as possible. Nucleophilic radiofluorinations and radiomethylations are conducted in polar aprotic solvents, such as dimethylsulfoxyde (DMSO), N,N‐dimethylformamide (DMF) and N,N‐dimethylacetamide (DMA), at high temperature. Those solvents are classified as toxic according to the ICH guidelines and must be evaluated in drug such as radiopharmaceuticals. Headspace gas chromatography is the standard method for the quantification of residual solvents but is not optimized for a rapid quantification of low vapor pressure solvents such as DMSO, DMF and DMA in radiopharmaceuticals. Direct injection gas chromatography is an interesting option without incubation step but the analysis run‐time remains beyond 10 min long. In consequence, we developed a very simple ultra‐high performance liquid chromatography method coupled with UV detection. Following the EMA requirements, we successfully validated a 3‐min run‐time analysis for quantification of three solvents in short half‐lives radiopharmaceuticals. We currently use this method for the quality control of radiopharmaceuticals produced in our PET center.
Preoperative Radiomics Approach to Evaluating Tumor‐Infiltrating CD8+ T Cells in Patients With Pancreatic Ductal Adenocarcinoma Using Noncontrast Magnetic Resonance Imaging
Authors: Bian Yun , Liu Cong , Li Qi , Meng Yinghao , Liu Fang , Zhang Hao , Fang Xu , Li Jing , Yu Jieyu , Feng Xiaochen , Ma Chao , Zhao Zengrui , Wang Li , Xu Jun , Shao Chengwei , Lu Jianping
Published: August 2021

Background

CD8+T cell in pancreatic ductal adenocarcinoma (PDAC) is closely related to the prognosis and treatment response of patients. Accurate preoperative CD8+ T‐cell expression can better identify the population benefitting from immunotherapy.

Purpose

To develop and validate a machine learning classifier based on noncontrast magnetic resonance imaging (MRI) for the preoperative prediction of CD8+ T‐cell expression in patients with PDAC.

Study Type

Retrospective cohort study.

Population

Overall, 114 patients with PDAC undergoing MR scan and surgical resection; 97 and 47 patients in the training and validation cohorts.

Field Strength/Sequence/3 T

Breath‐hold single‐shot fast‐spin echo T2‐weighted sequence and noncontrast T1‐weighted fat‐suppressed sequences.

Assessment

CD8+ T‐cell expression was quantified using immunohistochemistry. For each patient, 2232 radiomics features were extracted from noncontrast T1‐ and T2‐weighted images and reduced using the Wilcoxon rank‐sum test and least absolute shrinkage and selection operator method. Linear discriminative analysis was used to construct radiomics and mixed models. Model performance was determined by its discriminative ability, calibration, and clinical utility.

Statistical Tests

Kaplan–Meier estimates, Student's t‐test, the Kruskal–Wallis H test, and the chi‐square test, receiver operating characteristic curve, and decision curve analysis.

Results

A log‐rank test showed that the survival duration in the CD8‐high group (25.51 months) was significantly longer than that in the CD8‐low group (22.92 months). The mixed model included all MRI characteristics and 13 selected radiomics features, and the area under the curve (AUC) was 0.89 (95% confidence interval [CI], 0.77–0.92) and 0.69 (95% CI, 0.53–0.82) in the training and validation cohorts. The radiomics model included 13 radiomics features, which showed good discrimination in the training cohort (AUC, 0.85; 95% CI, 0.77–0.92) and the validation cohort (AUC, 0.76; 95% CI, 0.61–0.87).

Data Conclusions

This study developed a noncontrast MRI‐based radiomics model that can preoperatively determine CD8+ T‐cell expression in patients with PDAC and potentially immunotherapy planning.

Evidence Level

5

Technical Efficacy

Stage 2
Procedural outcome of lead explant and countertraction‐assisted femoral lead extraction in Thai patients with cardiac implantable electronic device infection
Authors: Jiratham‐Opas Jirarat , Prasertwitayakij Narawudt , Nantsupawat Teerapat , Wongcharoen Wanwarang
Published: August 2021

Background

Cardiac implantable electronic device (CIED) implantation rate has been increasing worldwide. Despite proper surgical technique and preincisional intravenous antibiotics, the incidence of infected CIED remains high and leads to serious complications. When encountered with CIED infection, complete CIED system removal is indicated. Several lead extraction approaches have shown a high success rate. However, the facilities are limited in Thailand. In our current practice, we perform lead extraction using the Dotter basket snare femoral approach as our primary method. There are no prior data on this countertraction‐assisted transfemoral technique. Therefore, we aim to study the procedural outcome of countertraction‐assisted transfemoral lead removal technique of CIED infection in Thai patients.

Methods

Patients diagnosed with CIED infection and with a history of device infection were retrospectively included. Simple manual removal was performed. In case of failure, we proceeded with the modified countertraction‐assisted transfemoral technique.

Results

There were 35 patients in the study. The success rate was 94.3%. Most of the leads, 62.8%, were removed by simple manual traction. In the 37.1% who required further femoral approach lead extractions, procedural failure was observed in 5.7% and procedure‐related adverse events in 5.6%. CIED infection‐related death accounted for 5.7% and nosocomial infection‐related death, 2.8%.

Conclusion

The success rate of CIED infection lead explant and countertraction‐assisted transfemoral lead extraction technique was high with small complications and can be performed without advanced facilities. However, the procedure required a main center with a cardiovascular thoracic surgery support team.
Carcass characteristics and meat evaluation of cattle finished in temperate pasture and supplemented with natural additive containing clove, cashew oil, castor oils, and a microencapsulated blend of eugenol, thymol, and vanillin
Authors: Mottin Camila , Ornaghi Mariana Garcia , Carvalho Venício Macêdo , Guerrero Ana , Vital Ana Carolina Pelaes , Ramos Tatiane Rogelio , Bonin Edinéia , Lana de Araújo Fabiana , de Araújo Castilho Ricardo , do Prado Ivanor Nunes
Published: August 2021

BACKGROUND

Forty crossbred steers were supplemented with different doses (from 0 control to 6000 mg/animal/day) of natural additive blend containing clove essential oil, cashew oil, castor oil, and a microencapsulated blend of eugenol, thymol, and vanillin for 80 days. Carcass characteristics, drip loss, and antioxidant activity were evaluated 24 h post mortem on longissimus thoracis, and the effects of aging (until 14 days) were evaluated for water losses (thawing/aging and cooking), texture, color, and lipid oxidation.

RESULTS

The use of the natural additive blend did not modify (P > 0.05) carcass characteristics but did, however, modify body composition (P < 0.05). Drip losses were unaffected by the treatments tested (P > 0.05). There was an observed quadratic effect (P < 0.05) on losses from thawing/aging on the first day of storage. Regarding the effects of natural additives on cooking losses, there was a quadratic effect (P < 0.05) among the treatments on day 7 of aging. Differences between days of aging were only observed with control treatment. Shear force was similar among treatments on days 1 and 7 of aging. On day 14 a linear effect (P < 0.05) was observed. Also, a linear effect (P < 0.05) appeared on meat lightness, meat from the control group being clearer on day 1. No changes were observed in redness among treatments or days of storage (P > 0.05). Yellowness was not modified by the treatments (P > 0.05)but only by the days of storage in control and the lowest dosage used.

CONCLUSION

The blend of natural additives has potential use in pasture feeding and could improve meat quality. However, doses should be adjusted. © 2021 Society of Chemical Industry.
Positive effect of compound amino acid chelated calcium from the shell and skirt of scallop in an ovariectomized rat model of postmenopausal osteoporosis
Authors: Song Jiale , Liu Guofeng , Song Yahui , Jiao Kui , Wang Shanglong , Cao Tingfeng , Yu Jia , Wei Yuxi
Published: August 2021

BACKGROUND

Osteoporosis has become an important public health issue with the increase of aging population, and afflicts millions of people worldwide, particularly elderly or postmenopausal women. In the present study, we prepared compound amino acid chelated calcium (CAA‐Ca) from processing by‐products of Chlamys farreri, and evaluated its effect on postmenopausal osteoporosis with an ovariectomized (OVX) rat model.

RESULTS

A 60‐day treatment of OVX rats with CAA‐Ca significantly enhanced the bone mineral density (BMD) and the bone calcium content. Meanwhile, some bone morphometric parameters, trabecular bone number (Tb.N), trabecular bone volume fraction (BV/TV), trabecular bone thickness (Tb.Th) and cortical bone wall thickness (Ct.Th), were also increased by 8.20%, 118.18%, 32.99% and 19.10%, respectively. In addition, the alkaline phosphatase (ALP) levels in serum were significantly reduced after CAA‐Ca treatment, while the blood calcium levels were increased. Mechanistically, CAA‐Ca down‐regulated the levels of receptor activator of nuclear factor‐κB (RANK) and receptor activator of nuclear factor‐κB ligand (RANKL), and up‐regulated osteoprotegerin (OPG) levels in osteoclasts, inhibiting bone resorption and bone loss. Meanwhile, CAA‐Ca treatment raised β‐catenin levels and lowered Dickkopf1 (DKK1) levels in the Wnt signaling pathway of osteoblasts, which can promote calcium absorption and bone formation.

CONCLUSION

The results suggested that CAA‐Ca promoted bone formation, inhibited bone resorption and improved bone microstructure. Therefore, this study contributes to the potential application of CAA‐Ca as a functional food resource in the treatment of postmenopausal osteoporosis. © 2021 Society of Chemical Industry
Deep eutectic solvent‐modified mixed iron hydroxide–silica: Application in magnetic solid‐phase extraction for enrichment of organochlorine pesticides prior to GC‐MS analysis
Authors: Phosiri Preeyaporn , Burakham Rodjana
Published: August 2021

A new type of magnetic material based on silica‐coated mixed iron hydroxides functionalized with deep eutectic solvent was utilized for the magnetic solid‐phase extraction of organochlorine pesticides prior to gas chromatography–mass spectrometry analysis. Choline chloride and phenol were selected as the hydrogen bond acceptor and donor, respectively, for preparing the deep eutectic solvent‐modified magnetic surface. The modified surface possessed superior enrichment capability for organochlorine pesticides. Under optimal extraction conditions, viz., 10 mg sorbent, 5 mL sample solution, and 200 μL acetone (desorption solvent), linearity was obtained in the range 0.005–200 μg/L, with coefficients of determination greater than 0.997. The limits of detection and quantification were as low as 0.6–10 and 5–60 ng/L, respectively, whereas the enrichment factors were in the range of 31–100. The precisions evaluated in terms of the relative standard deviations of the intra‐ and inter‐day experiments were <4.9 and 7.6%, respectively. The developed method was successfully applied for determining the organochlorine residues in agricultural products. Satisfactory recoveries in the range of 71.2–110.3% were obtained, with a relative standard deviation of <8.0%. The proposed material is a promising sorbent for the preconcentration of organochlorine residues.
Feasibility of supercritical fluid extraction‐supercritical fluid chromatography mass spectrometry for the determination of polycyclic aromatic hydrocarbons in particulate matter samples
Authors: Tang Shida , Liu Sharlin , Frank Brian P.
Published: August 2021

There has been an increased interest in the development of green analytical methods for polycyclic aromatic hydrocarbons in environmental samples due to their toxicity and ubiquitous nature. In this work, the feasibility of on‐line supercritical fluid extraction‐supercritical fluid chromatography‐tandem mass spectrometry was investigated for rapid and automated determination of the 16 United States Environmental Protection Agency priority polycyclic aromatic hydrocarbons in particulate matter samples. Three specialty polycyclic aromatic hydrocarbons columns with different stationary phases were screened and an octadecyl‐silica column was selected for method development. Enhanced extraction efficiency was achieved using an extraction program with gradient flow rate and gradient concentration of acetonitrile as a modifier. The method was evaluated by analyzing standard reference materials of urban dust and diesel particulate matter from the National Institute of Standards and Technologies. Possible reasons for the unsatisfactory recoveries with certain polycyclic aromatic hydrocarbons are discussed.
Modeling Cumulative Effects of Climate and Development on Moose, Wolf, and Caribou Populations
Authors: Rempel Robert S. , Carlson Matthew , Rodgers Arthur R. , Shuter Jennifer L. , Farrell Claire E. , Cairns Devin , Stelfox Brad , Hunt Len M. , Mackereth Robert W. , Jackson Janet M.
Published: August 2021

Wildlife models focused solely on a single strong influence (e.g., habitat components, wildlife harvest) are limited in their ability to detect key mechanisms influencing population change. Instead, we propose integrated modeling in the context of cumulative effects assessment using multispecies population dynamics models linked to landscape‐climate simulation at large spatial and temporal scales. We developed an integrated landscape and population simulation model using ALCES Online as the model‐building platform, and the model accounted for key ecological components and relationships among moose (Alces alces), grey wolves (Canis lupus nubilus), and woodland caribou (Rangifer tarandus caribou) in northern Ontario, Canada. We simulated multiple scenarios over 5 decades (beginning 2020) to explore sensitivity to climate change and land use and assessed effects at multiple scales. The magnitude of effect and the relative importance of key factors (climate change, roads, and habitat) differed depending on the scale of assessment. Across the full extent of the study area (654,311km2[ecozonal scale]), the caribou population declined by 26% largely because of climate change and associated predator‐prey response, which led to caribou range recession in the southern part of the study area. At the caribou range scale (108,378 km2), which focused on 2 herds in the northern part of the study area, climate change led to a 10% decline in the population and development led to an additional 7% decline. At the project scale (8,331 km2), which was focused more narrowly on the landscape surrounding 4 proposed mines, the caribou population declined by 29% largely in response to simulated development. Given that observed caribou population dynamics were sensitive to the cumulative effects of climate change, land use, interspecific interactions, and scale, insights from the analysis might not emerge under a less complex model. Our integrated modeling framework provides valuable support for broader regional assessments, including estimation of risk to caribou and Indigenous food security, and for developing and evaluating potential caribou recovery strategies. © 2021 The Authors.The Journal of Wildlife Managementpublished by Wiley Periodicals LLC on behalf of The Wildlife Society.
Predicting Pasture and Forest Landowner Intention to Create Early Successional Habitat
Authors: Meister Hannah M. , Valdez Rene X. , Martin Dustin , Bulluck Lesley P.
Published: August 2021

As human land uses expand across the landscape, the management practices of private landowners are an essential part of effective conservation. Early successional habitats (ESH) and the species that depend on them are a priority in the eastern United States, and efforts to create ESH on private lands has primarily focused on forest landowners and timber harvests. Private pasture lands in a forested landscape present an additional opportunity to create and maintain ESH, yet our understanding of landowner values and attitudes about management strategies in pastures is lacking. To address this, we surveyed private landowners in 5 Virginia counties who own ≥10.1 ha at >610 m elevation (n = 503). Our primary objective was to understand how a variety of factors such as landowner values, past experience with habitat management, and perceived barriers to carrying out habitat management are associated with private landowner intention to carry out 7 ESH management strategies (i.e., reduced mowing, reduced grazing, timber harvests within forest, timber harvests at a field‐forest border, prescribed fire, use of machinery, and use of herbicides to control invasive species) for the benefit of wildlife in the next 5 years. We used boosted regression trees to determine which factors best predicted the intention to carry out each management strategy. We were able to predict accuracy >75% of the time for landowner intention to engage in open pasture and timber management strategies. Landowner values were not consistent across the different management strategies; landowners likely to reduce mowing or grazing valued ecological aspects of their land (e.g., pollinator habitat, water quality), whereas landowners likely to harvest timber valued hunting and revenue. Past experience with wildlife management was the strongest predictor of likelihood to reduce mowing and grazing. Our results suggest that expanding outreach efforts to include pasture management options would engage a broader set of landowners in creating ESH, especially if such efforts highlighted the benefits to pollinator species, water quality, and enhanced opportunities for hunting and other types of recreation. © 2021 The Wildlife Society.
Ergonomic Analysis of Functional Endoscopic Sinus Surgery Using Novel Inertial Sensors
Authors: Arrighi‐Allisan Annie E. , Garvey Katherine L. , Wong Anni , Filip Peter , Shah Janki , Spock Todd , Del Signore Anthony , Cosetti Maura K. , Govindaraj Satish , Iloreta Alfred Marc
Published: August 2021

Objectives/Hypothesis

Suboptimal ergonomics during endoscopic sinus surgery can lead to considerable physical discomfort and fatigue for the surgeon. The purpose of this pilot study is to objectively evaluate the ergonomic positions of trainee and attending surgeons while performing functional endoscopic sinus surgery (FESS).

Study Design

Pilot prospective trial.

Methods

Six surgeons (two attendings and four trainees) performed FESS while wearing 11 inertial measurement units (IMUs) affixed to either side of each major joint. Screen placement was standardized to be 1 m directly in front of the surgeon and on the patient's left, 0–15° declined from the surgeons' eyes. Bed height was standardized such that the workspace was 0 to 10 cm below the elbows. IMU data were analyzed to calculate joint angles. Ideal joint angles (i.e., <10° for neck and trunk) were determined by the validated Rapid Entire Body Assessment tool. Subjects subsequently completed a modified National Aeronautics and Space Administration Task Load Index to assess cognitive and physical burden and pain. Student's t‐test was employed to detect differences between groups.

Results

Trainees adopted positions involving significantly greater neck flexion (9.90° vs. −6.48°, P = .03) and reported significantly higher frustration levels (3.04 vs. 1.33, P = .02) while operating than attendings. For both cohorts, increased operative time was significantly correlated with greater back flexion (r = 0.90, P = .02; r = 0.55, P = .04, respectively).

Conclusions

Our data suggest that trainees operate with higher risk neck postures than do attendings. These data indicate high‐risk operative postures may be borne of inexperience and present an opportunity for postural interventions at an early stage of training.

Level of Evidence

NA Laryngoscope, 132:1153–1159, 2022
Soil meso‐fauna community composition predicts ecosystem multifunctionality along a coastal‐inland gradient of the Bohai Bay
Authors: Kou Xinchang , Tao Yan , Wang Shengzhong , Wu Zhengfang , Wu Haitao
Published: August 2021

Previous studies have determined the importance of soil biodiversity for maintaining ecosystem services and multifunctionality. However, the relationship between soil meso‐fauna biodiversity and ecosystem multifunctionality in the real world has yet to be evaluated. In this study, the relationships between soil meso‐fauna community compositions and ecosystem multifunctionality along a coastal‐inland distance gradient were investigated, including 1 km (1T), 15 km (2T), 30 km (3T), 45 km (4T), and 60 km (5T) locations. Our results showed that the soil properties were significantly indicated a decreasing trend after the 3T line. However, the soil meso‐fauna biodiversity indices were observed to have all reached the peak value at the 4T line. In addition, it was found that the soil meso‐fauna biodiversity indices were highly correlated with the ecosystem multifunctionality. These findings further confirmed the fact that the contributions of the soil meso‐fauna community biodiversity indices (59.34%) to ecosystem multifunctionality were as important as, or even more important than, those of the soil environmental factors (40.66%). Therefore, it was concluded that the variations in ecosystem multifunctionality were closely related to the changes in the soil meso‐fauna community biodiversity. In other words, soil meso‐fauna community compositions can be effectively used to predict ecosystem multifunctionality along coastal‐inland ecosystems. These findings, are the first study to provide empirical evidence linking soil meso‐fauna community compositions to ecosystem multifunctionality in real‐world coastal‐inland ecosystems. Certainly, future studies that combine multi‐trophic levels and consider their interactions will be able to clarify the relationships between the below‐ground soil fauna communities and ecosystem multifunctionality.
Quantifying upwelling in tropical shallow waters: A novel method using a temperature stratification index
Authors: Guillaume‐Castel Robin , Williams Gareth J. , Rogers Justin S. , Gove Jamison M. , Green J. A. Mattias
Published: August 2021

Upwelling has profound effects on nearshore tropical ecosystems, but our ability to study these patterns and processes depends on quantifying upwelling dynamics in a repeatable and rigorous manner. Previous methods often lack the ability to identify individual cold‐pulse events within temperature time series data or require several user‐defined parameters, and therefore previous hydrographic knowledge of the study site. When unavailable, parameters are chosen arbitrarily or from previous studies potentially conducted under different environmental contexts. Previous methods also require the user to manually separate upwelling‐induced cold‐pulse events from those caused by other physical mechanisms like surface downwelling. Here, we present a novel method that uses a temperature stratification index (TSI) to detect upwelling‐induced cold‐water intrusions in tropical waters. We define a cold pulse as a continuous period having an abnormally low TSI, with this criterion based on a climatological threshold of the temperature profile at the study site calculated from the National Centers for Environmental Prediction's Global Ocean Data Assimilation System (GODAS) reanalysis product. Our TSI method is therefore automatically tuned for the study site in question, removing biases associated with user‐defined input parameters. The method also automatically determines the directional origin of the cold‐water mass to isolate upwelling‐induced cooling and can achieve overall cold‐pulse detection rates 10–14.2% higher than previous methods. Our new TSI method can easily be adapted to detect a range of physical processes in shallow waters, including intrusion of water masses through upwelling, downwelling, and horizontal advection.
Deceased Donor Liver Transplantation After Radioembolization for Hepatocellular Carcinoma and Portal Vein Tumoral Thrombosis: A Pilot Study
Authors: Serenari Matteo , Cappelli Alberta , Cucchetti Alessandro , Mosconi Cristina , Strigari Lidia , Monari Fabio , Ravaioli Matteo , Rizzini Elisa Lodi , Fanti Stefano , Golfieri Rita , Cescon Matteo
Published: August 2021

Hepatocellular carcinoma (HCC) with portal vein tumoral thrombosis (PVTT) represents a major concern especially in the field of deceased donor liver transplantation (DDLT). However, when receiving transarterial radioembolization (TARE), a considerable percentage of such patients are able to achieve a radiologic complete response with adequate survival rates. In this pilot prospective study, we evaluated the effect of TARE in downstaging HCC patients with PVTT to meet criteria for DDLT. Between May 2013 and November 2016, patients were evaluated to be enrolled into our “Superdownstaging” protocol. Patients received yttrium‐90 TARE and were enlisted for DDLT in case of complete and sustained (6 months) radiological response. Patients with tumor thrombus in the main trunk and/or in the contralateral portal vein branch were excluded. TARE was effective in downstaging and receiving DDLT in 5/17 patients (29.4%). The 5‐year overall survival was significantly higher in patients who underwent DDLT compared with those who were not transplanted (60.0% versus 0.0%, P = 0.03). Three out of 5 patients developed recurrence within 1 year after LT. The current series showed a clear survival gain in those patients who were able to receive DDLT after TARE but careful selection for DDLT is however advised.
Persistent Water Repellency of Syndiotactic Polymethylene with Perfluoroethyl Hexyloxycarbonyl Side Chains
Authors: Yoshitake Ayano , Kudo Hiroyuki , Matsumoto Hidetoshi , Tokita Masatoshi
Published: August 2021

Polyacrylates bearing long fluoroalkyl (Rf) side chains are known to have ultralow surface energies that are appropriate for functional coating and fabric finishing. However, these long Rf chains cause health concerns because of the risk of toxic and bioaccumulative perfluoroalcanoic acid emission via oxidative degradation. This work demonstrates that incorporating a short Rf chain of perfluoroethylene at the end of the side chains of syndiotactic poly(substituted methylene) (PM) produces hydrophobicity. A contact angle of 105° of PM remains constant for more than 50 s, whereas that of the polyacrylate (PA) with the same side chain rapidly decreases from 85° to 44° over the same period. Such persistent water repellency of the PM is ascribed to a liquid crystal structure comprised the main chains arranged in a 2D hexagonal lattice and side chains that extend perpendicularly from these main chains.
Artemisinin inspired synthetic endoperoxide drug candidates: Design, synthesis, and mechanism of action studies
Authors: Woodley Christopher M. , Amado Patrícia S. M. , Cristiano Maria L. S. , O'Neill Paul M.
Published: August 2021

Artemisinin combination therapies (ACTs) have been used as the first‐line treatments against Plasmodium falciparum malaria for decades. Recent advances in chemical proteomics have shed light on the complex mechanism of action of semi‐synthetic artemisinin (ARTs), particularly their promiscuous alkylation of parasite proteins via previous heme‐mediated bioactivation of the endoperoxide bond. Alarmingly, the rise of resistance to ART in South East Asia and the synthetic limitations of the ART scaffold have pushed the course for the necessity of fully synthetic endoperoxide‐based antimalarials. Several classes of synthetic endoperoxide antimalarials have been described in literature utilizing various endoperoxide warheads including 1,2‐dioxanes, 1,2,4‐trioxanes, 1,2,4‐trioxolanes, and 1,2,4,5‐tetraoxanes. Two of these classes, the 1,2,4‐trioxolanes (arterolane and artefenomel) and the 1,2,4,5‐tetraoxanes (N205 and E209) based antimalarials, have been explored extensively and are still in active development. In contrast, the most recent publication pertaining to the development of the 1,2‐dioxane, Arteflene, and 1,2,4‐trioxanes fenozan‐50F, DU1301, and PA1103/SAR116242 was published in 2008. This review summarizes the synthesis, biological and clinical evaluation, and mechanistic studies of the most developed synthetic endoperoxide antimalarials, providing an update on those classes still in active development.
Savings from crisis residential care makes case for system change in Texas
Authors: Enos Gary
Published: August 2021

An economic evaluation of an Austin, Texas, crisis residential facility has identified estimated savings of a magnitude that even surprised some of the study's co‐authors. The results have instilled hope that as Texas lawmakers consider mental health system reform options, they will look beyond the historic tendency to define system investment as simply building more expensive hospitals.
Gel Point Properties in Batch Free‐Radical Vinyl/Divinyl Copolymerization
Authors: Tobita Hidetaka
Published: August 2021

Gelation is a critical phenomenon, and various simple relationships are expected to hold. On the other hand, it is important to clarify the required conditions for the validity of the relationships. In this theoretical study, the effects of the primary chain connection statistics and the primary chain length distribution change during batch free‐radical vinyl/divinyl copolymerization on the gel point properties are investigated systematically. The weight fraction distribution at the gel point always conforms to the power‐law distribution,W(P)∝P−αwith α = 1.5, as long as the classical chemical kinetics is valid in a closed reaction system. When the primary chain connection statistics is independent of chain length, the cross‐linking density, ρg, of the gel molecule right at the gel point is given by , where is the weight‐average chain length of all primary chains. The random cross‐linking is a special case that belongs to this category. The distribution of the pendant double bonds among polymer molecules having different molecular weights is nonrandom, except for the special cases with equal reactivity of all types of double bonds for which the random cross‐linking applies.
Metformin for pediatric obesity and insulin resistance: a retrospective study within an integrated health care system
Authors: Concepcion Josephine Q. , Tucker Lue‐Yen , Huang Karen
Published: August 2021

Objective

Few treatments exist for pediatric obesity. Metformin holds potential for pediatric weight loss. This large retrospective study examined the effect of metformin on weight, BMI, BMI z score, and cardiometabolic outcomes.

Methods

The study included 7,068 patients aged 10 to 17 years with BMI at or above the 95th percentile and evidence of insulin resistance. The final cohort of 955 patients with BMI data at 0 to 24 months was categorized into three groups: metformin plus intensive lifestyle changes, intensive counseling alone, and routine counseling. In order to adjust for pubertal BMI changes, a subgroup analysis was conducted for adolescents aged 15 to 17 years.

Results

At 6 and 12 months, metformin treatment produced significant reductions in weight (−3.5 kg and −5.3 kg, p < 0.0001), BMI (−1.06 kg/m² and −1.23 kg/m², p < 0.0001), and BMI z score (−0.05 and −0.07, p ≤ 0.002), which continued to decrease at 24 months (−0.05 and −0.08, p = 0.11 and 0.01), compared with control groups. Adolescents aged 15 to 17 years showed similar improvements. Systolic blood pressure and high‐density lipoprotein cholesterol also improved in the metformin group.

Conclusions

Metformin with lifestyle interventions significantly reduced weight, BMI, and BMI z score in pediatric patients with obesity and insulin resistance up to 24 months, compared with intensive and routine counseling alone.
High thermal conductivity of self‐healing polydimethylsiloxane elastomer composites by the orientation of boron nitride nano sheets
Authors: Shang Zhihui , Ding Dongliang , Wang Xu , Liu Bingru , Chen Yanhui , Gong Lei , Liu Zhenguo , Zhang Qiuyu
Published: August 2021

Up to now, low thermally conductive properties and irreversible damage caused by the accidental mechanical failure are still the main negative factors for the wide application of polymer thermal management materials in the microelectronic industry. In this work, we prepared self‐healing polydimethylsiloxane/boron nitride nano sheets (PDMS/BNNSs) composites with high thermal conductivity. PDMS elastomer with the dynamic reversible imine bond acts as the polymer matrix and BNNSs with NH2 in regularly in‐plane arrangement are used as the thermally conductive filler. When the BNNSs filler content is 30 wt%, the thermal conductivity is increased by 588%; The self‐healing efficiency reaches more than 85%, driven by the reversibility of the dynamic imine bond within PDMS; In addition, the tensile strength and the thermal stability exhibit an enhancement of 275% and 31.8°C, respectively, compared to the pure self‐healing PDMS elastomer.
Cripto favors chondrocyte hypertrophy via TGF‐β SMAD1/5 signaling during development of osteoarthritis
Authors: Garcia de Vinuesa Amaya , Sanchez‐Duffhues Gonzalo , Blaney‐Davidson Esmeralda , van Caam Arjan , Lodder Kirsten , Ramos Yolande , Kloppenburg Margreet , Meulenbelt Ingrid , van der Kraan Peter , Goumans Marie‐José , ten Dijke Peter
Published: August 2021

Chondrocytes in mice developing osteoarthritis (OA) exhibit an aberrant response to the secreted cytokine transforming growth factor (TGF)‐β, consisting in a potentiation of intracellular signaling downstream of the transmembrane type I receptor kinase activin receptor‐like kinase (ALK)1 against canonical TGF‐β receptor ALK5‐mediated signaling. Unfortunately, the underlying mechanisms remain elusive. In order to identify novel druggable targets for OA, we aimed to investigate novel molecules regulating the ALK1/ALK5 balance in OA chondrocytes. We performed gene expression analysis of TGF‐β signaling modulators in joints from three different mouse models of OA and found an upregulated expression of the TGF‐β co‐receptor Cripto (Tdgf1), which was validated in murine and human cartilage OA samples at the protein level. In vitro and ex vivo, elevated expression of Cripto favors the hypertrophic differentiation of chondrocytes, eventually contributing to tissue calcification. Furthermore, we found that Cripto participates in a TGF‐β–ALK1–Cripto receptor complex in the plasma membrane, thereby inducing catabolic SMAD1/5 signaling in chondrocytes. In conclusion, we demonstrate that Cripto is expressed in OA and plays a functional role promoting chondrocyte hypertrophy, thereby becoming a novel potential therapeutic target in OA, for which there is no efficient cure or validated biomarker. © 2021 The Authors. The Journal of Pathology published by John Wiley & Sons, Ltd. on behalf of The Pathological Society of Great Britain and Ireland.