bluuebunny/crossref_metadata_2025 huggingface dataset:
Methods Matter: Methods for Sampling Microplastic and Other Anthropogenic Particles and Their Implications for Monitoring and Ecological Risk Assessment
Authors: Hung Charlotte , Klasios Natasha , Zhu Xia , Sedlak Meg , Sutton Rebecca , Rochman Chelsea M
Published: August 2020

To inform mitigation strategies and understand how microplastics affect wildlife, research is focused on understanding the sources, pathways, and occurrence of microplastics in the environment and in wildlife. Microplastics research entails counting and characterizing microplastics in nature, which is a labor-intensive process, particularly given the range of particle sizes and morphologies present within this diverse class of contaminants. Thus, it is crucial to determine appropriate sampling methods that best capture the types and quantities of microplastics relevant to inform the questions and objectives at hand. It is also critical to follow protocols with strict quality assurance and quality control (QA/QC) measures so that results reflect accurate estimates of microplastic contamination. Here, we assess different sampling procedures and QA/QC strategies to inform best practices for future environmental monitoring and assessments of exposure. We compare microplastic abundance and characteristics in surface-water samples collected using different methods (i.e., manta and bulk water) at the same sites, as well as duplicate samples for each method taken at the same site and approximate time. Samples were collected from 9 sampling sites within San Francisco Bay, California, USA, using 3 different sampling methods: 1) manta trawl (manta), 2) 1-L grab (grab), and 3) 10-L bulk water filtered in situ (pump). Bulk water sampling methods (both grab and pump) captured more microplastics within the smaller size range (<335 µm), most of which were fibers. Manta samples captured a greater diversity of morphologies but underestimated smaller-sized particles. Inspection of pump samples revealed high numbers of particles from procedural contamination, stressing the need for robust QA/QC, including sampling and analyzing laboratory blanks, field blanks, and duplicates. Choosing the appropriate sampling method, combined with rigorous, standardized QA/QC practices, is essential for the future of microplastics research in marine and freshwater ecosystems. Integr Environ Assess Manag 2021;17:282–291. © 2020 SETAC

KEY POINTS

It is critical to determine appropriate sampling methods that best capture the types and quantities of microplastics relevant to inform the questions and objectives at hand. Adhering to protocols with strict quality assurance and quality control (QA/QC) measures ensures that results reflect accurate estimates of microplastic contamination. Taking duplicate samples can reveal the variability between samples at a single site. Manta samples capture a greater diversity of morphologies than do grab samples, but they underestimate smaller-sized particles.
Process mapping of the urgent red cell exchange procedure for patients with severe complications of sickle cell disease at a centralized hemapheresis service
Authors: Smith Jacob A. , Seheult Jansen N. , Sevcik Joan , Kiss Joseph E. , Kaplan Alesia
Published: August 2020

Sickle cell disease (SCD) patients require urgent red cell exchange (RCE) procedures for acute chest syndrome (ACS), demanding a coordinated effort of multiple clinical services. Execution of RCE is a multistep process from the time the procedure is requested to the time the procedure is initiated. A retrospective review of patients with SCD requiring urgent RCE for ACS and stroke from 2012 to 2017 was performed at a centralized hemapheresis service covering a multihospital healthcare system. A total of 30 urgent RCE procedures performed on 28 patients were evaluated. The time required for red blood cell (RBC) preparation was the longest step in the process (median 3.8 hours). Furthermore, RBC preparation time was longer for sickle cell patients with RBC alloimmunization compared with nonalloimmunized patients (8.6 vs 3.8 hours, P = .03). One mortality event occurred in Ab− group. This study identified potentially modifiable factors, which impact the time to implementation of RCE in one service area. It highlights the importance of a structured and coordinated approach for the efficient and timely delivery of this vital treatment modality.
Hetero type III‐B rotaxane dendrimers
Authors: Kwan Chak‐Shing , Leung Ken Cham‐Fai
Published: August 2020

Type III‐B rotaxane dendrimer is a member of the rotaxane dendrimer family, but it is defined as dendritic polyrotaxane, branched through rings. Such rotaxane dendrimers have been synthesized through versatile copper‐catalyzed azide‐alkyne cycloaddition reactions. In order to incorporate more functionalities into type III‐B rotaxane dendrimers, three different potential functionalities—azobenzene toward light switch, daisy chain toward higher degree of contraction, and extension and cyclobis (paraquat‐p‐phenylene) (CBPQT) toward redox chemistry—were combined into the original design of type III‐B rotaxane dendrimers. Two azo‐based G1/G2 and four new G1 and G2 hetero type III‐B rotaxane dendrimers were synthesized and characterized by 1H NMR spectroscopy and electrospray ionization mass spectrometry.
Analysis of microRNA processing machinery gene (DROSHA, DICER1, RAN, and XPO5) variants association with end‐stage renal disease
Authors: Fawzy Manal S. , Abu AlSel Baraah T. , Toraih Eman A.
Published: August 2020

Background

MicroRNA (miRNA) processing machinery gene variant was associated with several diseases. We aimed to explore for the first time the association of machinery gene (DROSHA rs10719A/G; DICER1 rs3742330A/G; RAN rs14035C/T; and XPO5 rs11077T/G) variants with the susceptibility and phenotype of end‐stage renal disease (ESRD).

Method

A total of 281 participants (98 ESRD patients and 183 healthy volunteers) were enrolled. Real‐Time TaqMan allelic discrimination assay was applied for the genotyping of the specified variants. Multiple logistic regression models, univariate, multivariate, and principal component analyses were carried out.

Results

Carrying one DICER1 rs3742330*G allele conferred protection against developing ESRD [heterozygote comparison: OR = 0.30, 95% CI = 0.15‐0.62, dominant model: OR = 0.35, 95% CI = 0.17‐0.70]. Similarly, for XPO5 rs11077T/G, homozygote and heterozygote carriers of G variant were less likely to develop ESRD [homozygote comparison: adjusted OR = 0.23, 95% CI = 0.11‐0.50, and heterozygote comparison: OR = 0.50, 95% CI = 0.22‐0.92, and allelic model: OR = 0.46, 95% CI = 0.34‐0.70]. RAN rs14035*TT subjects were 5 times more likely to develop ESRD while being heterozygote (CT) have twice the risk [homozygote comparison: 5.18, 95% CI = 2.28‐11.8, heterozygote comparison: OR = 2.12, 95% CI = 1.10‐409]. Subgroup analysis also detected DICER1 rs3742330*A, XPO5 rs11077*T, and RAN rs14035*T as genetic risk determinants for ESRD development in both sex and age categories. Two genotype combinations of DROSHA/DICER1/XPO5/RAN were associated with increased susceptibility to ESRD [A‐A‐T‐T: OR = 9.49, 95%CI = 2.48‐36.31 (P = .001) and G‐A‐T‐T: OR = 5.92, 95%CI = 1.77‐19.83 (P = .004), respectively].

Conclusion

Variants and combined genotypes of DICER1 rs3742330, XPO5 rs11077, and RAN rs14035 might be associated with ESRD development in the study population. Integrating molecular analysis in ESRD risk stratification is warranted.
Icariin ameliorates endothelial dysfunction in type 1 diabetic rats by suppressing ER stress via the PPARα/Sirt1/AMPKα pathway
Authors: Yao Wenhui , Wang Kai , Wang Xiniao , Li Xinran , Dong Jieyan , Zhang Yusheng , Ding Xuansheng
Published: August 2020

Icariin (ICA), as a flavonoid glycoside, is associated with the improvement of vascular complications in diabetes. However, its protective mechanisms remain to be well‐established. Here, we tested the hypothesis that ICA attenuates vascular endothelial dysfunction by inhibiting endoplasmic reticulum (ER) stress in type 1 diabetes. In streptozotocin‐induced diabetic rats, ICA positively affected acetylcholine‐induced vasodilation and phenylephrine‐induced vasoconstriction in aortas. ICA treatment significantly attenuated ER stress in diabetic rats and high‐glucose induced human umbilical vein endothelial cells. Incubation with ICA in vitro attenuated vascular reactivity in diabetic rats, which was blocked by the ER stress inducer, and peroxisome proliferator‐activated receptor α (PPARα), sirtuin1 (Sirt1), or AMP‐activated protein kinase‐α (AMPKα) inhibitors. Western blot showed that ICA activated the PPARα/Sirt1/AMPKα pathway, which contributed to reducing ER stress and activating endothelial nitric oxide synthase in vivo and vitro. Our results implicate that ICA normalizes ER stress to attenuate endothelial dysfunction by the regulation of the PPARα/Sirt1/AMPKα pathway.
Putative adult neurogenesis in palaeognathous birds: The common ostrich (Struthio camelus) and emu (Dromaius novaehollandiae)
Authors: Mazengenya Pedzisai , Bhagwandin Adhil , Ihunwo Amadi O.
Published: August 2020

In the current study, we examined adult neurogenesis throughout the brain of the common ostrich (Struthio camelus) and emu (Dromaius novaehollandiae) using immunohistochemistry for the endogenous markers PCNA which labels proliferating cells, and DCX, which stains immature and migrating neurons. The distribution of PCNA and DCX labelled cells was widespread throughout the brain of both species. The highest density of cells immunoreactive to both markers was observed in the olfactory bulbs and the telencephalon, especially the subventricular zone of the lateral ventricle. Proliferative hot spots, identified with strong PCNA and DCX immunolabelling, were identified in the dorsal and ventral poles of the rostral aspects of the lateral ventricles. The density of PCNA immunoreactive cells was less in the telencephalon of the emu compared to the common ostrich. Substantial numbers of PCNA immunoreactive cells were observed in the diencephalon and brainstem, but DCX immunoreactivity was weaker in these regions, preferentially staining axons and dendrites over cell bodies, except in the medial regions of the hypothalamus where distinct DCX immunoreactive cells and fibres were observed. PCNA and DCX immunoreactive cells were readily observed in moderate density in the cortical layers of the cerebellum of both species. The distribution of putative proliferating cells and immature neurons in the brain of the common ostrich and the emu is widespread, far more so than in mammals, and compares with the neognathous birds, and suggests that brain plasticity and neuronal turnover is an important aspect of cognitive brain functions in these birds.
Peroral cholangioscopy‐guided forceps biopsy versus fluoroscopy‐guided forceps biopsy for extrahepatic biliary lesions
Authors: Onoyama Takumi , Hamamoto Wataru , Sakamoto Yuri , Kawahara Shiho , Yamashita Taro , Koda Hiroki , Kawata Soichiro , Takeda Yohei , Matsumoto Kazuya , Isomoto Hajime
Published: August 2020

Background and Aim

Endoscopic retrograde cholangiopancreatography (ERCP)‐related tissue acquisition, including fluoroscopy‐guided forceps biopsy (F‐FB), is a common technique in diagnosing indeterminate biliary lesions. Recently, peroral cholangioscopy (POCS) and POCS‐guided forceps biopsy (POCS‐FB) has also been used for the diagnosis of indeterminate biliary lesions. However, it is uncertain which of those techniques were superior for the diagnosis of extrahepatic cholangiocarcinoma (ECC). We aimed to evaluate the diagnostic yield and safety of F‐FB for indeterminate biliary lesions compared with POCS‐FB.

Methods

Patients who underwent F‐FB or POCS‐FB to evaluate indeterminate biliary lesions between October 2011 and August 2019 were enrolled retrospectively. We carried out propensity score matching to balance these clinical differences between the F‐FB group and POCS‐FB group. In the propensity score‐matched cohort, we compared the diagnostic performance of F‐FB with that of POCS‐FB based on the pathological evaluation. We also evaluate adverse events associated with F‐FB and POCS‐FB.

Results

We enrolled 113 patients with biliary diseases, and 62 patients were analyzed in the propensity score‐matched cohort. Sensitivity, specificity, and accuracy of F‐FB were 82.4, 100, and 90.3%, and for POCS‐FB, those values were 83.3, 100, and 90.3%, respectively. There were no significant differences in the diagnostic performance between F‐FB and POCS‐FB. There were also no significant differences in the occurrence of adverse events between F‐FB and POCS‐FB (41.9 vs 29.0%, P = 0.289).

Conclusions

The diagnostic yield of F‐FB for ECC is similar to that of POCS‐FB. POCS‐FB is not necessary for the initial pathological diagnosis of indeterminate biliary lesions.
Diagnostic utility of the serum–ascites albumin gradient in Mexican patients with ascites related to portal hypertension
Authors: Cervantes Pérez Enrique , Cervantes Guevara Gabino , Cervantes Pérez Gabino , Cervantes Cardona Guillermo Alonso , Fuentes Orozco Clotilde , Pintor Belmontes Kevin Josué , Guzmán Ramírez Bertha Georgina , Reyes Aguirre Laura Lizeth , Barbosa Camacho Francisco José , Bernal Hernández Aldo , González Ojeda Alejandro
Published: August 2020

Background and Aim

Analysis of ascitic fluid is necessary to determine the etiology and to distinguish portal hypertension (PH)‐related and unrelated ascites. Numerous diagnostic parameters have been studied, but no single parameter has completely distinguished these. We aimed to validate the serum albumin–ascites gradient (SAAG) for the diagnosis of ascites secondary to PH and to establish cutoff points to predict PH using its sensitivity and specificity.

Methods

This was a cross‐sectional study conducted on patients diagnosed with ascites of any etiology. The SAAG and albumin concentration in ascitic fluid (AFA) were measured to establish their sensitivity and specificity for determining the presence or absence of PH. Cutoff points and levels of statistical significance were established based on the area under the curve.

Results

Eighty‐seven patients were evaluated, of whom 74 (84%) were men, with an average age of 54.0 ± 13.6 years. Seventy‐two (83%) were diagnosed at admission with PH‐related ascites and 15 (17%) with non‐PH‐related ascites. SAAG correctly classified 48 (67%) patients, but 24 (33%) were classified incorrectly, while AFA classified 59 (82%) correctly and only 13 (17%) incorrectly. The diagnostic accuracy of SAAG was 57 versus 73% for AFA. AFA had a sensitivity of 82% and specificity of 66% (95% confidence interval [CI]: 0.63–0.93), while SAAG had a sensitivity of 66% but a specificity of 86% (95% CI: 0.72–0.95).

Conclusions

The SAAG showed poor diagnostic performance with low sensitivity but high specificity. The diagnostic accuracy of AFA is superior to that of SAAG in discriminating between PH and non‐PH ascites.
Pain management with opioids in adults
Authors: Montgomery Lori S.
Published: August 2020

Given the ubiquitous nature of opioids in the treatment of pain, it is an interesting paradox that this class of medications also represents one of the least understood components of clinical pain medicine. For many years, there has been intense interest in the mechanisms of opioid activity, but this has not resulted in a corresponding increase in convincing clinical data. This review focuses primarily on the evidence surrounding the long‐term use of opioids in chronic pain, but discussions of this research are often conflated with the very different data governing acute and cancer‐related pain, where evidence of efficacy is clearer. It is therefore important to clarify the evidence‐based indications for opioid therapy. There remains very little evidence that opioids improve function or quality of life beyond 3 months in people with chronic pain conditions. In all three patient populations, the development of tolerance, dependence, hyperalgesia and withdrawal are key phenomena that affect the patient experience, and in particular the decision to remain on opioids in the long term. This is a common thread that connects the opioid literature in all of these spheres, and justifies the burgeoning interest in these phenomena in the basic science literature. There is an urgent need to address these negative consequences of opioid use, in order to maximize the therapeutic benefit that opioids can offer.
Modelling global impacts of climate variability and trend on maize yield during 1980–2010
Authors: Yin Xiaomeng , Leng Guoyong
Published: August 2020

Enhanced understanding of historical climate impacts on crop yield is critical for adaptation and mitigations within the context of global warming. Previous impact assessments rely on statistical or process‐based models, each with its own strength and weakness. To date, a global‐scale comparison between process‐based and statistical models in assessing climate impacts on yield variability and trends is lacking. Here, we leverage both statistical and process models to estimate global impacts of climate variability and trend on maize yield between 1980 and 2010. To allow for reasonable comparability, we develop a novel emulator to mimic each of eight global process‐based maize models, based on which the common set of climate scenarios are used for driving both statistical and process models. Results show that climate variability controls 42% of global maize yield variations in statistical model, while large discrepancy is found in process‐based models with R2 ranging from 0.22 to 0.61, especially at the country scale. Both statistical and most process models suggest that historical climate trend has led to a yield loss by 1.51–3.80% during the period 1980–1990. As for the period 1991–2000, however, the observed negative climate impacts are only captured by two process models. In contrast to the positive climate impact in statistical model, most of process‐based models simulated negative climate effects for the period 2001–2010, due to large yield sensitivity to maximum temperature in process models. This study highlights the large discrepancies not only among the eight process‐based models but also between statistical and process‐based models in simulating yield response to climate variation and trends, which has great implications for projecting future crop yields under climate change.
Comparison of Variations Between Spectral Doppler and Gaussian Surface Integration Methods for Umbilical Vein Blood Volume Flow
Authors: Rubin Jonathan M. , Li Sibo , Fowlkes J. Brian , Sethuraman Shriram , Kripfgans Oliver D. , Shi William , Treadwell Marjorie C. , Jago James R. , Leichner Ronald D. , Pinter Stephen Z.
Published: August 2020

Objectives

We are studying a new method for estimating blood volume flow that uses 3‐dimensional ultrasound to measure the total integrated flux through an ultrasound‐generated Gaussian surface that intersects the umbilical cord. This method makes none of the assumptions typically required with standard 1‐dimensional spectral Doppler volume flow estimates. We compared the variations in volume flow estimates between techniques in the umbilical vein.

Methods

The study was Institutional Review Board approved, and all 12 patients gave informed consent. Because we had no reference standard for the true umbilical vein volume flow, we compared the variations of the measurements for the flow measurement techniques. At least 3 separate spectral Doppler and 3 separate Gaussian surface measurements were made along the umbilical vein. Means, standard deviations, and coefficients of variation (standard deviation/mean) for the flow estimation techniques were calculated for each patient. P < .05 was considered significant.

Results

The ranges of the mean volume flow estimates were 174 to 577 mL/min for the spectral Doppler method and 100 to 341 mL/min for the Gaussian surface integration (GSI) method. The mean standard deviations (mean ± SD) were 161 ± 95 and 45 ± 48 mL/min for the spectral Doppler and GSI methods, respectively (P < .003). The mean coefficients of variation were 0.46 ± 0.17 and 0.18 ± 0.14 for the spectral Doppler and GSI methods respectively (P < 0.002).

Conclusions

The new volume flow estimation method using 3‐dimensional ultrasound appears to have significantly less variation in estimates than the standard 1‐dimensional spectral Doppler method.
Obstetric Ultrasound Screening in a Rural Area of Lebanon One Small Step With a Promising Major Impact
Authors: Snaifer Elie , Hassan Hala , Daher Lea , Sabbagh Anthony , Farah Marwan , Farekh Issa , Chalouhi Gihad E.
Published: August 2020

Objectives

Our aim was to evaluate the conditions and to weigh the potential impact of an obstetrical ultrasound screening intervention on pregnant patients in an underserved area of Lebanon with the presence of refugees.

Methods

We performed a cross‐sectional study in a rural region in North Lebanon. Monthly second‐trimester obstetrical ultrasound scans were offered to patients. A thorough analysis of the population's characteristics was done, the anomalies discovered were documented and follow up recommendations were offered.

Results

268 screening ultrasounds were performed over a one‐year period. The patients' mean age was 27.5 ± 8.5 years with a 35% consanguinity rate. A positive personal history of abnormalities was recognized in 34% of cases, and a positive family history in 21% of them. The average gestational age was of 23.3 ± 1.4 weeks of gestation. We found a rate of 8.6% inaccurate dating, 20% growth abnormalities, and 12% morphological abnormalities requiring follow‐up. These latter included defects affecting multiple organ systems among which renal, neurological, and cardiac structures were the most frequently affected (2.5%, 2%, and 1.6% respectively). Overall, 35.8% of the screened cases required a follow‐up for 1 or more abnormal findings.

Conclusions

The findings confirmed the necessity to introduce a prenatal ultrasound screening program in rural areas of Lebanon where refugees are settled. The lack of adequate ultrasound screening in these regions presents major threats that can hinder any pregnancy. Our simple intervention tackles the burden of diagnosis of these risks in up to 35.8% of pregnancies and thus can help improve outcomes.
Seasonal Use of Latrines by Bobcats: Implications for Monitoring Programs
Authors: Hilts Dylan J. , Gehring Thomas M. , Nielsen Clayton K. , Etter Dwayne R. , Brown Shelby M. , Truax Robert R.
Published: August 2020

Latrines serve as important communication networks among felids for transmitting information relative to social dominance, reproductive status, and defense of hunting areas. During January 2011–August 2012, we monitored 10 bobcat (Lynx rufus) latrines in the northern Lower Peninsula (NLP) of Michigan, USA, using motion‐sensitive cameras to estimate bobcat visitation and scat deposition rates among 3 biological seasons (mating, kitten‐rearing, non‐mating). Bobcat visitation rates differed among the 3 seasons. We found equal number of visits during the mating and kitten‐rearing seasons, and lower visitation rates during the non‐mating season. Scat deposition rates differed among the 3 seasons. We found a net gain of scats deposited during the mating and non‐mating seasons, whereas there was a net loss of scats during the kitten‐rearing season. An artificial latrine protocol we developed yielded visitation at 4 of 12 artificial latrine sites. Monitoring natural and artificial latrines during the mating and kitten‐rearing seasons could provide valuable data for managing bobcat populations. © 2020 The Wildlife Society.
Distinct Clinical Pathology and Microbiota in Chronic Rhinosinusitis With Nasal Polyps Endotypes
Authors: Abbas Elrayah E. , Li Chuan , Xie Ao , Lu Shan , Tang Li , Liu Yinhui , Elfadil Ayman , Wen Shu
Published: August 2020

Objectives/Hypothesis

Eosinophilic and noneosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP and NECRSwNP) show distinguished clinical pathology, but their underlying mechanism remains unclear. We aimed to investigate the clinical, hematological, and histopathological changes in chronic rhinosinusitis with nasal polyps (CRSwNP) endotypes and its association with microbiota.

Study Design

A comparative cross‐sectional study.

Methods

A comparative study of 46 patients with CRSwNP (34.69 ± 16.39 years old) who underwent endoscopic sinus surgery were recruited and subdivided into ECRSwNP and NECRSwNP groups based on eosinophilic tissue inflammation; 12 healthy controls were also included. A structured histopathological analysis was conducted, and complete blood count was determined in patients. Endoscopic‐guided middle meatus swabs and fecal samples were collected from the patients and controls and subsequently subjected to 16S rRNA gene sequencing on Illumina MiSeq.

Results

Compared to NECRSwNP, ECRSwNP showed a statistically significant increase in the computed tomography score, endoscopic score, blood eosinophil percentage, tissue eosinophil count, inflammation degree, subepithelial edema, and eosinophil aggregation. Airway microbiota communities differed among the three groups. The abundance of Moraxella and Parvimonas was significantly higher in the ECRSwNP group. Distinct microbiota dysbiosis in CRSwNP endotypes was found to be correlated with different clinical pathologies. Moreover, the gut microbiota in ECRSwNP and NECRSwNP showed dysbiosis, that is, significant decrease in the abundance of Actinobacteria in the former and significant increase in the abundance of Enterobacterales and several genera in NECRSwNP.

Conclusions

Significant clinical pathology and microbiota changes were evident in patients with ECRSwNP and NECRSwNP. Distinct microbiota dysbiosis was correlated with different clinical pathologies. Understanding these differences may improve the prognosis and treatment of chronic rhinosinusitis.

Level of Evidence

4 Laryngoscope, 131:E34–E44, 2021
Inflammatory Effects of Thickened Water on the Lungs in a Murine Model of Recurrent Aspiration
Authors: Nativ‐Zeltzer Nogah , Ueha Rumi , Nachalon Yuval , Ma Betty , Pastenkos Gabrielle , Swackhamer Clay , Bornhorst Gail M. , Lefton‐Greif Maureen A. , Anderson Johnathon D. , Belafsky Peter C.
Published: August 2020

Objective

Liquid thickeners are commonly recommended in individuals with dysphagia and recurrent aspiration as a strategy for pneumonia prevention. The goal of this study was to examine the effects of small amounts of aspirated liquid thickener on the lungs.

Study design

Animal model. Prospective small animal clinical trial.

Methods

Adult Sprague Dawley rats (n = 19) were divided into two groups and underwent three intratracheal instillations of either xanthan gum‐based nectar‐thick water (0.1–0.25 mL/kg) or water‐only control over the course of 8 days. Blood was collected from a peripheral vein on days 1 and 8 and submitted for complete blood count (CBC) analysis. Rats were euthanized 10 days after the last instillation, and the lungs were harvested. Histopathology was conducted on lung specimens by a blinded licensed veterinary pathologist and scored for evidence of lung injury and pneumonia.

Results

Fifteen animals (8 nectar‐thickener group, 7 control group) survived until the endpoint of the study (day 18). Serum CBC did not show abnormalities at any timepoint in either group. Histological evidence of lung inflammation and edema were significantly greater in the nectar‐thick group compared to controls (P < .05). Signs of inflammation included aggregates of foamy macrophages, expansion of bronchiolar lymphoid tissue, and large numbers of eosinophilic intraalveolar crystals. Histiocytic and neutrophilic pneumonia was noted in one animal that received thickened liquids.

Conclusion

Recurrent aspiration of small amounts of thickened water resulted in significant pulmonary inflammation in a murine model of aspiration. Results of this study support the need for further investigation of liquid thickener safety and its efficacy in reducing the pulmonary complications of swallowing disorders.

Level of Evidence

NA Laryngoscope, 131:1223–1228, 2021
Oncological and Functional Outcomes of Primary and Salvage Total Laryngectomy
Authors: Bertolin Andy , Lionello Marco , Zanotti Claudia , Franz Leonardo , Giacomelli Luciano , Rizzotto Giuseppe , Marioni Gino
Published: August 2020

Objectives

To evaluate and compare the oncological and functional outcomes of total laryngectomies (TL) performed as first line treatment or for salvage after failure of conservative approaches for treating advanced laryngeal carcinoma (LSCC).

Study Design

A retrospective cohort study.

Methods

A cohort of 217 patients who underwent TL was divided according to whether the procedure was for primary treatment of their LSCC (101 patients) or for recurrences after conservative surgery or chemo‐radiotherapy (116 patients).

Results

The overall survival rate and disease‐specific survival rate were significantly higher in the primary TL group than in the salvage TL group (P = .04 and P = .01, respectively). The recurrence rate was significantly higher and the disease‐free survival (in months) was shorter for patients who had salvage TL than for those who had primary TL (P = .00 and P = .01, respectively). The salvage TL group also included significantly more cases of postoperative pharyngo‐cutaneous fistula needing salivary stent positioning, and experienced significantly longer hospital stays than the primary TL group (P = .04 and P = .03, respectively).

Conclusion

Oncological and functional outcomes of primary TL were significantly better than after salvage TL. If salvage TL was performed after conservative surgery had failed, the oncological and functional results were better than after the failure of organ‐preserving protocols. This could justify a first attempt at conservative surgery for intermediate‐advanced LSCC in selected cases, reserving chemo‐radiotherapy only for patients unsuitable for surgery.

Level of Evidence

4 Laryngoscope, 131:E569–E575, 2021
Biliary Reconstruction in Adult Living Donor Liver Transplantation: The All‐Knots‐Outside Technique
Authors: Pamecha Viniyendra , Sasturkar Shridhar Vasantrao , Sinha Piyush Kumar , Mohapatra Nihar , Patil Nilesh
Published: August 2020

Biliary complications (BCs) following living donor liver transplantation (LDLT) can lead to significant morbidity and occasional mortality. The present study describes our experience of the all‐knots‐outside technique (AKOT) of biliary reconstruction (BR) and its impact on BCs. A retrospective analysis was performed using prospectively collected data of 330 consecutive adult patients undergoing LDLT from July 2011 to February 2018 with a minimal follow‐up of 24 months. Only 2.8% required hepaticojejunostomy and were excluded. In an initial 122 patients, BR was performed with the standard technique (ST), and AKOT was performed in the subsequent 208 patients. In the AKOT group, a single anastomosis was attempted even for multiple ducts whenever feasible. A major BC was defined as requiring endoscopic, percutaneous, or surgical interventions. In the AKOT group, significantly more patients received a left lobe graft (5.7% versus 18.3%; P = 0.001), had shorter warm ischemia time (44.6 versus 27 minutes; P < 0.001), and had a left hepatic artery (LHA) in the right lobe that was used for arterial reconstruction (48 [39.3%] versus 122 [58.6%]; P = 0.003). The incidence of BCs in the entire cohort was 47 (14.2%). For the ST versus AKOT groups, the overall BCs (27/122 [22.1%] versus 20/208 [9.6%]; P = 0.003) and major BCs (20.5% versus 6.7%; P < 0.001) decreased significantly. In the multivariate analysis, the number of bile ducts (hazard ratio [HR], 4.18; 95% confidence interval [CI], 1.62‐10.78; P = 0.003), number of anastomoses (HR, 2.03; 95% CI, 1.03‐4.02; P = 0.04), and technique of anastomosis (HR, 0.36; 95% CI, 0.19‐0.68; P = 0.002) predicted BCs. In conclusion, in adult LDLT, with standardization of the donor and recipient surgery, preferential use of LHA for right lobe arterial reconstruction, reduction in the number of anastomoses, and AKOT for BR significantly decreased the incidence of BCs.
MODERN PLASMA‐BASED DESORPTION/IONIZATION: FROM ATOMS AND MOLECULES TO CHEMICAL SYNTHESIS
Authors: Molnar Brian T. , Shelley Jacob T.
Published: August 2020

Since the first mass spectrometry (MS) experiments were conducted by Thomson and Aston, plasmas have been used as ionization sources. Historically, plasma ion sources were used for these experiments because they were one of the few known sources of gas‐phase ions at the time and they were relatively simple to setup and operate. Since then, developments in plasma ionization have continued to inform and motivate advances in other areas of MS. For example, plasma‐desorption MS demonstrated ionization of large peptides and polymers more than 10 years before the first descriptions of electrospray ionization (ESI) and matrix‐assisted laser desorption/ionization (MALDI). As a result, significant effort was placed on development of ionization approaches, mass analysis, and detection approaches for very large molecules: even before the advent of ESI and MALDI. Since then, new analytical challenges and opportunities in plasma ionization have arisen. In this review, the emerging trends in plasma‐based ionization for several areas of MS will be discussed, including molecular ionization, elemental ionization, hybrid elemental and molecular ion sources, and unique chemical transformations. © 2020 John Wiley & Sons Ltd. Mass Spec Rev
LASER DESORPTION/ABLATION POSTIONIZATION MASS SPECTROMETRY: RECENT PROGRESS IN BIOANALYTICAL APPLICATIONS
Authors: Ding Xuelu , Liu Kun , Shi Zhenyan
Published: August 2020

Lasers have long been used in the field of mass spectrometric analysis for characterization of condensed matter. However, emission of neutrals upon laser irradiation surpasses the number of ions. Typically, only one in about one million analytes ejected by laser desorption/ablation is ionized, which has fueled the quest for postionization methods enabling ionization of desorbed neutrals to enhance mass spectrometric detection schemes. The development of postionization techniques can be an endeavor that integrates multiple disciplines involving photon energy transfer, electrochemistry, gas discharge, etc. The combination of lasers of different parameters and diverse ion sources has made laser desorption/ablation postionization (LD/API) a growing and lively research community, including two‐step laser mass spectrometry, laser ablation atmospheric pressure photoionization mass spectrometry, and those coupled to ambient mass spectrometry. These hyphenated techniques have shown potentials in bioanalytical applications, with major inroads to be made in simultaneous location and quantification of pharmaceuticals, toxins, and metabolites in complex biomatrixes. This review is intended to provide a timely comprehensive view of the broadening bioanalytical applications of disparate LD/API techniques. We also have attempted to discuss these applications according to the classifications based on the postionization methods and to encapsulate the latest achievements in the field of LD/API by highlighting some of the very best reports in the 21st century. © 2020 John Wiley & Sons Ltd.
Setting behaviour, mechanical properties and heat generation under alternate current magnetic fields of Fe3O4/TiO2/PMMA composite bone cement
Authors: Kubota Moe , Yokoi Taishi , Ogawa Tomoyuki , Saito Shin , Furuya Maiko , Yokota Kotone , Kanetaka Hiroyasu , Jeyadevan Balachandran , Kawashita Masakazu
Published: August 2020

Poly(methyl methacrylate) (PMMA) bone cement has excellent mechanical properties and is injectable; therefore, it is widely used as a filler for bone defects. To realize further effective treatment of bone defects, the design of PMMA cement containing magnetite (Fe3O4) and titania (TiO2), with good bone‐bonding properties and potential for application in magnetic hyperthermia treatment, is proposed. The ceramic content of the PMMA composite bone cements was varied from 20 mass% to 45 mass%. The setting behaviour, microstructure, compressive strength and heat generation under alternate current (AC) magnetic fields of the PMMA composite bone cements were evaluated. Determination of the setting temperature and time for the PMMA composite cements revealed that the maximum temperature during setting decreased with increasing Fe3O4 and TiO2 content while the setting time increased. The PMMA composite cements had dense microstructures regardless of the ceramic content. The nominal compressive strength for the samples ranged between 83 MPa and 94 MPa, which is sufficient for bone‐filling applications. Furthermore, the PMMA composite cement containing 25 mass% Fe3O4 generated heat under AC magnetic field, and its temperature reached 42.3°C after 10 min. Therefore, our findings contribute to the development of novel PMMA bone cements using functional ceramic components.
Laser‐pyrolysed paper electrodes for the square‐wave anodic stripping voltammetric detection of lead
Authors: Tasić Nikola , de Sousa de Oliveira Lucas , Paixão Thiago R. L. C. , Moreira Gonçalves Luís
Published: August 2020

Single‐use screen‐printed electrodes are relatively economical, still, they may not be cheap enough for low‐income countries when including shipping costs, places where often in situ water analysis is of great relevance. This work displays the proof of concept of applying laser‐pyrolysed paper electrodes (LPPEs) for lead (Pb) quantification. By simply and carefully burning ordinary cardboard with a commercially available CO2 laser, it was possible to fabricate low‐cost electrodes with a carbon‐based material as the electroactive surface. By means of square‐wave anodic stripping voltammetry (SWASV), and using zinc (Zn) as an internal standard (Ep = −1.02 vs. Ag), a limit of detection (LOD) of 6 ppb was attained for lead (Ep = −0.46 V vs. Ag) along with other suitable analytical performance parameters, such as 4% of repeatability and 5% of reproducibility.
A novel SLC26A4 splicing mutation identified in two deaf Chinese twin sisters with enlarged vestibular aqueducts
Authors: Zhou Kai , Huang Lancheng , Feng Menglong , Li Xinlei , Zhao Yi , Liu Fei , Wei Jiazhang , Qin Danxue , Lu Qiutian , Shi Min , Qu Shenhong , Tang Fengzhu
Published: August 2020

Background

Variants in the SLC26A4 gene are correlated with nonsyndromic hearing loss with an enlarged vestibular aqueduct (EVA). This study aimed to identify the genetic causes in a Chinese family with EVA, and the pathogenicity of the detected variants.

Methods

We collected blood samples and clinical data from a pair of deaf twin sisters with EVA and their family members. As controls, a group of 500 normal‐hearing people were enrolled in our study. Twenty‐one exons and flanking splice sites of the SLC26A4 gene were screened for pathogenic mutations by polymerase chain reaction and bidirectional Sanger sequencing. Minigene assays were used to verify whether the novel SLC26A4 intronic mutation influenced the normal splicing of mRNA.

Results

Hearing loss in the twins with EVA was diagnosed using auditory tests and imaging examinations. Two pathogenic mutations, c.919‐2A>G and c.1614+5G>A were detected in SLC26A4, the latter of which has not been reported in the literature. The minigene expression in vitro confirmed that c.1614+5G>A could cause aberrant splicing, resulting in skipping over exon 14.

Conclusions

On the SLC26A4 gene, c.1614+5G>A is a pathogenic mutation. This finding enriches the mutational spectrum of the SLC26A4 gene and provides a basis for the genetic diagnosis of EVA.
Audit of forced care in California fuels discussion of flaws in law
Authors: Enos Gary
Published: August 2020

An audit examining implementation of California's law governing the provision of involuntary mental health treatment has found several flaws in the system of care for persons with serious mental illness. However, the audit itself is coming under some criticism as well, for not taking a deep enough dive into contributing issues such as inadequate state funding and outdated standards to determine the need for involuntary treatment.
House passes FY 2021 spending bill with SAMHSA increases
Authors: Canady Valerie A.
Published: August 2020

The U.S. House of Representatives last week approved its Labor–Health and Human Services (HHS) spending bill for FY 2021, which includes major funding increases for the Substance Abuse and Mental Health Service Administration (SAMHSA), along with level funding for key mental health programs and services.
CMS approves new company to accredit psychiatric hospitals
Authors: Canady Valerie A.
Published: August 2020

The Centers for Medicare & Medicaid Services (CMS) last month granted DNV GL Healthcare, a nationally renowned certification body, deeming authority to accredit psychiatric hospitals, making it the second national accrediting organization outside of the Joint Commission to certify psychiatric facilities.
Convolutional neural network‐based dosimetry evaluation of esophageal radiation treatment planning
Authors: Jiang Dashan , Yan Hui , Chang Na , Li Teng , Mao Ronghu , Du Chi , Guo Bin , Liu Jianfei
Published: August 2020

Purpose

A dosimetry evaluation model for treatment planning of esophageal radiation therapy is developed using a deep learning model. The model predicts dose volume histogram (DVH) from distance to target histogram (DTH) based on stacked de‐noise auto‐encoder (SDAE) and one‐dimensional convolutional network (1D‐CN).

Method

First, SDAE is used to extract the features from the curves of DTH and DVH. Then 1D‐CN model is employed to learn the relationship between the features of DTH and DVH, and later used to predict the features of DVH from the features of DTH. Finally, the curve of DVH is restored from the features of DVH based on SDAE. Two hundred and seventy treatment plans are used for training 1D‐CN and another sixty‐three treatment plans are used for evaluating this model. This method is also compared with another two popular prediction methods based on support vector machine (SVM) and U‐net.

Results

Based on the experimental result, the proposed model achieves the lowest dose endpoint error comparing to the other models. The average prediction error on planned target volume, left lung, right lung, heart, and spinal cord is 2.94% for the proposed model, while the average prediction errors are 6.79% and 3.41% for SVM and U‐net, respectively.

Conclusions

A dosimetry evaluation method based on SDAE and 1D‐CN is developed in characterizing the correlation relationship between DTH and DVH of treatment plans. The results show that the model could be trained more efficiently in this framework and the DVH could be predicted with higher accuracy comparing to those existing methods. It provides a useful tool in supporting automated treatment planning of esophageal intensity‐modulated radiotherapy.
Modeling of progressive damage in concrete using multidimensional virtual internal bond method
Authors: Jalwadi Sudhindra N. , Bhandakkar Tanmay K.
Published: August 2020

Damage simulation via tensile and shear failure modes in quasi‐brittle material like concrete is computationally challenging. Multidimensional virtual internal bond (MVIB) method is one of the promising method developed to capture shear failure in materials like concrete. It assumes continuum as an assemblage of material points joined by normal and shear bonds possessing harmonic potential and bond density evolution function, which degrades with deformation to yield at macroscopic level, stress–strain law with inbuilt feature of failure via Cauchy–Born rule. The degradation of bond‐density in MVIB method originally based solely on compressive failure is extended to include tensile failure synonymous with tension and compression asymmetry in concrete. The modified MVIB model is applied to a variety of problems, and the effect of inclusion of both tensile and compressive failure is thoroughly assessed. Through the example of two notches in a square plate subjected to biaxial loading, a systematic study of damage evolution vis‐à‐vis biaxial loading ratio is presented. Capture of crack closure and formation of crack retarding protective shield are unique outcomes of the present work.
Love of life and its association with well‐being in Iranian psychiatric outpatients
Authors: Dadfar Mahboubeh , Abdel‐Khalek Ahmed M. , Lester David
Published: August 2020

Aim

The aims of this study were as follows: (a) to investigate the psychometric properties of the Love of Life Scale (LLS); (b) to explore sex differences in LLS scores; (c) to explore LLS correlations with spiritual health and psychological well‐being; and (d) to compare the mean LLS score with previous studies.

Design

A cross‐sectional study.

Methods

A sample of 191 Iranian psychiatric outpatients was recruited from clinics at the School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), which is affiliated with the Iran University of Medical Sciences. They responded to the Farsi versions of the LLS, the Spiritual Well‐Being Scale (SWS) and the World Health Organization‐five Well‐Being Index (WHO‐5).

Results

Cronbach alpha for the LLS was 0.95, and a principal component analysis (PCA) of the LLS items extracted one component labelled "Love of life." The sex difference in LLS scores was not significant. All the correlations between the scales were statistically significant and positive. Patients who had high scores for their love of life had better spiritual health and psychological well‐being.

Discussion

The present sample obtained a lower mean LLS score than college students from eight countries except one. Further research should explore predictors of the love of life.
Caring for home‐dwelling parents with dementia: A qualitative study of adult‐child caregivers' motivation
Authors: Dombestein Heidi , Norheim Anne , Aase Karina
Published: August 2020

Aim

To explore adult children's motivation in caregiving for their home‐dwelling parents with dementia.

Design

Qualitative design with a phenomenological approach.

Methods

Semi‐structured individual interviews with 21 adult sons and daughters who were caregivers for a parent with dementia. Data were analysed using systematic text condensation.

Results

Inspired by self‐determination theory, three categories were identified in the empirical data representing the main motivational drivers for adult‐child caregivers: relatedness (to the parent with dementia, the parent's spouse, other persons), competence (in handling dementia, in the parent's need) and autonomy (freedom of choice, innate values and tasks). Caregivers report relatedness as their key motivational driver.

These results imply that nurses and other health professionals should value the importance of relatedness when interacting with dementia caregivers and establish belonging support structures. Further research should generate more knowledge of the positive motivational drivers, including interventions to improve relatedness, competence and autonomy.