bluuebunny/crossref_metadata_2025 huggingface dataset:
A Synthetic Approach for Oxadiazole‐Decorated Azobenzene Photoswitches
Authors: Dobre Adela F. , Hanganu Anamaria , Nicolau Ioana , Popescu Codruta C. , Paun Anca , Mădălan Augustin M. , Tablet Cristina , Mirea Anca G. , Matache Mihaela
Published: October 2023

This work reports the design and synthesis of novel oxadiazole‐decorated azobenzenes, structural analysis of the resulting compounds and behavior under light irradiation. The synthetic strategy involved constructing amino functionalized heterocyclic key intermediates which were used either to yield electrophilic diazonium salts able to react with phenol moieties or as nucleophilic partners in Bayer‐Mills reaction with nitroso‐substituted derivatives. The amino‐derived oxadiazole intermediates were investigated by absorption and emission spectroscopy providing blue and green emitted light. The target oxadiazole‐decorated azobenzenes were structurally characterized, including solid‐state structures, and subsequently used in irradiation experiments in order to take advantage of the azo group known to provide photoswitching abilities. We noticed quenching of the emissive properties in presence of the azo group; however, all compounds were very stable to repeated cycles of light irradiation. In addition, according to structural diversification we could obtain half‐lives of the meta stable isomers within hours to hundreds of hours range. The experimental results were very well correlated with DFT calculations.
Analytical computation of driving point impedance in mutually coupled inhomogeneous ladder networks
Authors: Lakshmi Prasanna K. , Mondal Mithun
Published: October 2023

Electrical systems are traditionally modeled as homogeneous ladder networks, disregarding the inherent inhomogeneity found in real‐world systems. This can result in inaccuracies in analysis and design. The driving point impedance (DPI) is a crucial parameter for studying electrical systems, as it can be conveniently measured at the terminals. However, existing methods for calculating DPI have limitations, including increased complexity, high computational demands, convergence issues, and challenges in capturing high‐frequency effects. A new approach for computing DPI of inhomogeneous ladder networks, reducible to series and shunt impedance circuit form, is introduced in this research. The method is based on state‐space formulations and projective matrix analysis. It offers improved accuracy as compared with existing methods and can be applied to a wide range of networks. Simulation results from a six‐section mutually coupled inhomogeneous ladder network validate the effectiveness of the proposed approach. This research addresses the disregarded factors of inhomogeneity and mutual coupling within traditional approaches, presenting a significant advancement in the analysis and design of electrical systems.
Leukotriene antagonists reduce epileptic seizures‐related hospitalization in older adult populations with allergic rhinitis or asthma: A population‐based cohort study using the Shizuoka Kokuho database: The Shizuoka study
Authors: Imaichi Yutaro , Nakatani Eiji , Fukutomi Yuma , Kuriyama Nagato , Mori Kiyoshi , Sugawara Akira
Published: October 2023

Objective

Managing the risk of epileptic seizures in older adults is increasingly important as the population ages. Leukotriene receptor antagonists (LTRAs) are commonly used to treat asthma or allergic rhinitis. Preclinical studies suggest that LTRAs have antiepileptic effects; however, few population‐based etiological studies on this topic have been available. Our study explored whether LTRAs reduce hospitalization risk associated with epileptic seizures in older individuals with asthma or allergic rhinitis.

Methods

We conducted a new‐user design analysis using the Shizuoka Kokuho database. We included all individuals aged 60‐89 years who had at least one episode of allergic rhinitis or asthma during the study period. We compared individuals who newly started LTRAs with those who did not take LTRAs. Propensity score matching was used to balance the baseline characteristics of the participants. We compared the hazard ratios for seizure‐related hospitalization between new LTRA users and non‐users and performed subgroup analyses.

Results

Our matched cohorts consisted of 64 724 new users and non‐users of LTRAs who were aged 60‐89 years and had asthma or allergic rhinitis. During the observation period, 377 (0.58%) and 595 (0.92%) incidents were observed in the LTRA new‐user and non‐user groups, respectively. The hazard ratio for seizure‐related hospitalization was 0.75 (95% confidence interval [CI]: 0.62‐0.92) in the LTRA new‐user group compared with the non‐user group. Subgroup analysis revealed that the hazard ratio was weak in diabetic patients (1.31; 95% CI: 0.72‐2.38).

Significance

This study indicated that LTRAs reduced seizure‐related hospitalization in older adult patients with allergic rhinitis or asthma. We could not evaluate the severity and related diseases of epileptic seizures during LTRAs. Further studies, including observational studies, detailed multicenter prospective studies, and clinical trials, are needed to validate these findings.

Plain Language Summary

This study examined if leukotriene receptor antagonists (LTRAs), commonly used for asthma or allergies, could lower seizure risk in older adults. Analyzing health records of 60‐89 year‐olds with asthma or allergies, we found a reduced rate of seizure‐related hospitalizations in those starting LTRAs, though this was not as evident in diabetic patients. Our results suggest potential benefits of LTRAs in preventing seizures in older adults with respiratory issues, but further research is needed to confirm these findings.
Microbial modulation of hormone signaling, proteomic dynamics, and metabolomics in plant drought adaptation
Authors: Kaya Cengiz
Published: October 2023

The symbiotic synergy between proteome shifts in plants and microbial colonization orchestrates adaptive responses. This thorough review delves into the less explored domain of proteomic and metabolomic changes triggered by drought stress, shedding light on how they are influenced by interactions with microbiota. Notably, microbial mediation at the crossroads of hormone signaling, proteomic and metabolomic dynamics in drought adaptation emerges as a crucial focal point. Understanding the regulatory mechanisms that orchestrate these complex interactions offers a holistic view of the molecular foundation underlying a plant's ability to endure water scarcity. The insights gained from this exploration hold the potential to reshape agricultural practices and enhance drought‐tolerance through microbiota‐mediated mechanisms, supported by proteomic and metabolomic insights. As this review seamlessly integrates the latest developments in understanding drought stress responses, microbiota dynamics, proteomics and metabolomic, it reveals the interconnected molecular basis that underlies these aspects. Specifically, the review emphasizes the crucial role of microbial mediation at the crossroads of hormone signaling, proteomic and metabolomic dynamics during drought adaptation. This enhanced understanding of the intricate interactions among these components presents new opportunities for envisioning sustainable agricultural approaches in the face of the escalating challenges presented by intensifying drought scenarios.
Exploring stakeholders' response to travel needs of commuters with disability in the Accra Metropolitan Assembly
Authors: Odame Prince Kwame , Amoako‐Sakyi Regina Obilie , Abane Albert , Zuidgeest Mark
Published: October 2023

Access to public transport increases vulnerable people's social mobility, facilitates economic integration and improves general well‐being. This is possible given the low vehicular acquisition and low cost required to enjoy public transport services. Unfortunately, the discourse on the responsiveness of public transport services to the disability community in the Global South has been viewed from users' perspectives, leaving out key stakeholders whose actions impact persons with disability (PWDs') mobility needs. This study seeks to fill the gap by exploring stakeholders' responses to the travel needs of commuters with disability in the Accra Metropolitan Assembly. Employing an exploratory research design, this study purposively engaged five national stakeholders on transport and disability issues. All interviews and transcripts were transcribed using MaxQDA. The qualitative data analysis was iterative as the study adopted a thematic analytical approach to explore participants' opinions. From the data, all stakeholders did not have a disability‐inclined transport agenda or policy despite making various attempts to meet the travel needs of PWDs. Some attempts include the reliance on one's discretion as seen in the case of transport operators, while other stakeholders appeared to offer little support due to financial and administrative bottlenecks. Transport‐oriented stakeholders cared little about PWD while disability‐oriented stakeholders cared little about transport issues. This study recommends a consultative action framework to guide all stakeholders in ensuring the delivery of barrier‐free transport services to the disability community.
The health care experiences of people with head and neck cancer: A scoping review
Authors: Checklin Martin , O'Halloran Robyn , Foster Abby M. , Hutchison Alana , Wilson Thomas , Bowen Alanna , Vat Laura , Lawson Nadine , Lenne Priscilla , Packer Rebecca L.
Published: October 2023

Background

Understanding health care experience in head and neck cancer (HNC) is becoming increasingly important due to changes in the disease profile, survivorship, and a greater appreciation of patient health care experience as an important outcome measure. People with HNC encounter many different types of health care professionals and health care touchpoints.

Method

Through systematic database searching, this scoping review of qualitative English‐language studies describes the self‐reported care experiences of those with HNC across the health care continuum, and describes the current state of the literature.

Results

Overall, the 95 studies identified were heterogeneous and investigated a broad range of topics. Trends across studies showed research centered on hospital‐based care, conducted in developed countries, with more studies on feeding than other aspects of care. Generic qualitative research frameworks, with individual interviews, were the preferred method of data collection.

Conclusion

Despite identifying many studies, there are significant gaps in our understanding of the HNC patient experience.
Revitalizing hope for older adults: The use of the novel Arexvy for immunization against respiratory syncytial virus
Authors: Abbasi Haleema Q. , Oduoye Malik O.
Published: October 2023

Introduction

Respiratory syncytial virus (RSV), an RNA virus of the family Paramyxoviridae, is the most common cause of respiratory tract diseases, including upper and lower respiratory tract infections in adults. Researchers worldwide have been working for decades to develop an RSV vaccine that is both safe and cost‐effective.

Aim

This correspondence aims to highlight the recent breakthroughs in the immunization against RSV for older adults (60 years and above), encompassing the newly sanctioned prophylactic agent by the FDA, drawing attention to its side effects that need to be taken care of and providing clear recommendations to maximize the potential influence of these advancements on RSV‐related diseases globally.

Methodology

We did a literature search on RSV among older adults and its treatment on PubMed, Google Scholar, ResearchGate and FDA databases within 10 years. Keywords used for our search were; “Respiratory Syncytial Virus,” “Older adults,” “FDA,” “Arexvy,” and “Immunization.”

Result

We found approximately 6000–10,000 lives and 60,000–160,000 hospital admissions among adults aged 65 years and older each year in the world, especially in the United States of America. Currently, there is no vaccine or targeted treatment for RSV for the most affected individuals, that is, the older adults, who are given supportive care. Recently, the USA‐ Food and Drug Administration (FDA) approved Arexvy (a recombinant subunit RSV vaccine) based on its encouraging results demonstrating acceptable safety and efficacy in a large‐scale multi‐centered Phase 3 trial.

Conclusion

Authorization of Arexvy, although a breakthrough in the field of research, needs to be approached with a blend of optimism tempered by caution. Robust studies, including large‐scale randomized controlled trials, prospective cohort studies and systematic reviews and meta‐analyses, need to be conducted to ascertain its safety and efficacy.
Assessing body mass index stages, individual diabetes and hypertension history effects on the risk of developing hypertension among Ghanaians: A cross‐sectional study
Authors: Iddrisu Abdul‐Karim , Adam Mohammed
Published: October 2023

Background and Aims

This study aimed to understand the relationship between body mass index (BMI), diabetes and hypertension history, and other risk of hypertension among Ghanaians.

Methods

The BMI data are categorized according to the World Health Organization (WHO) definition. The data were obtained from the WHO Study on global AGEing and adult health (WHO SAGE) Ghana Wave 2. Descriptive statistics were used to summarize the variables, and the association between these variables and hypertension was assessed using the χ². Multivariable logistic regression was used to examine the relationship between hypertension and different BMI levels and other variables.

Results

Obesity class II individuals have about a 4‐fold higher risk of developing hypertension compared to underweight individuals. Obesity class III, class I, and preobesity individuals have approximately a 3‐fold higher risk. Normal weight is associated with increased hypertension risk. Both males and females show a significant increase in hypertension risk across all BMI categories. History of hypertension is linked to a 2.2‐fold increased risk. Diabetes history is associated with hypertension when considering other factors. Elevated hypertension risk is observed among married, divorced, and widowed males then never married males. Only widowed females showed an increased risk. Older age significantly increases hypertension risk, particularly in females. Vegetable servings reduce hypertension risk, while fruit servings are associated with an increased risk. Vigorous exercise increases hypertension risk, particularly in females.

Conclusion

Regular check‐ups are recommended for married, divorced, and widowed males, focusing on blood pressure (BP) levels. Regular exercise from young age helps lower BP in later years. Individuals with a history of hypertension should follow BP control measures. Encouraging the consumption of the right combination of vegetables and fruits can help lower BP. Female tobacco smoking should be strongly discouraged due to a 54% increased risk of developing hypertension.
Frailty syndrome and associated factors among patients with hypertension: A cross‐sectional study in Kumasi, Ghana
Authors: Sakyi Samuel A. , Tawiah Phyllis , Senu Ebenezer , Ampofo Ransford O. , Enimil Anthony K. , Amoani Benjamin , Anto Enoch O. , Opoku Stephen , Effah Alfred , Abban Elizabeth , Frimpong Joseph , Frimpong Emmaunel , Bannor Lydia Oppong , Kwayie Afia A. , Naturinda Emmanuel , Ansah Eugene A. , Baidoo Bright T. , Kodzo Kini E. , Ayisi‐Boateng Nana K.
Published: October 2023

Background and Aim

Frailty is a condition marked by accumulation of biological deficits and dysfunctions that come with aging and it is correlated with high morbidity and mortality in patients with cardiovascular diseases, particularly hypertension. Hypertension continues to be a leading cause of cardiovascular diseases and premature death globally. However, there is dearth of literature in sub‐Saharan Africa on frailty syndrome among hypertensives on medication. This study evaluated frailty syndrome and its associated factors among Ghanaian hypertensives.

Methods

This cross‐sectional study recruited 303 patients with hypertension from the University Hospital, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana. Data on sociodemographic, lifestyle and clinical factors were collected using a well‐structured questionnaire. Medication adherence was measured using Adherence in Chronic Disease Scale, and frailty was assessed by Tilburg Frailty Indicator. Statistical analyses were performed using SPSS Version 26.0 and GraphPad prism 8.0. p‐value of < 0.05 and 95% confidence interval (CI) were considered statistically significant.

Results

The prevalence of frailty was 59.7%. The proportion of high, medium and low medication adherence was 23.4%, 64.4% and 12.2%, respectively. Being ≥ 70years (adjusted odds ratio [aOR]: 8.33, 95% CI [3.72–18.67], p < 0.0001), unmarried (aOR: 2.59, 95% CI [1.37–4.89], p = 0.0030), having confirmed hypertension complications (aOR: 3.21, 95% CI [1.36–7.53], p = 0.0080), medium (aOR: 1.99, 95% CI [1.05–3.82], p = 0.0360) and low antihypertensive drug adherence (aOR: 27.69, 95% CI [7.05–108.69], p < 0.0001) were independent predictors of increased odds of developing frailty syndrome.

Conclusion

Approximately 6 out of 10 Ghanaian adult patients with hypertension experience frailty syndrome. Hypertension complications, older age, being unmarried, and low antihypertensive drug adherence increased the chances of developing frailty syndrome. These should be considered in intervention programmes to prevent frailty among patients with hypertension.
Partial excisional tapering: Report of initial four cases of a novel modification of ureteroplasty for megaureter
Authors: Taguchi Motohiro , Kanematsu Akihiro , Yamamoto Shingo
Published: October 2023

Introduction

We report our initial experience with a novel ureteroplasty technique that combines the advantages of excisional tapering and folding.

Methods and cases

Following dissection of the megaureter, the distal ureteral end was transected at a point with an appropriate caliber to create a neo‐orifice, which was left intact. Only the proximally redundant part of the ureter was excised and closed over a 10F catheter, following which the ureter was anastomosed to the bladder with an indwelling ureteral stent. This procedure was performed in four pediatric patients. Case 1 involved a 6‐year‐old girl with continuous urinary incontinence due to ureteral ectopia in a duplex system. Cases 2 and 3 involved infants with refluxing megaureter. Case 4 involved a 9‐year‐old boy with a ureteral stone impacted in a megaureter. All four patients achieved successful outcomes without ureteral obstruction.

Conclusion

This ureteroplasty technique is a promising alternative in specific patients.
Pharmacokinetics and Pharmacodynamics of Ranitidine and Famotidine in Healthy Elderly Subjects: A Double‐Blind, Placebo‐Controlled Comparison
Authors: Bisson Chantal , St.‐Laurent Maurice , Michaud Jean‐Thomas , LeBel Marc
Published: October 2023

The pharmacokinetics and pharmacodynamics of ranitidine and famotidine were studied in 13 healthy elderly volunteers. On 3 mornings separated by a 1‐week wash‐out period, each subject received a single oral dose of ranitidine 300 mg, famotidine 40 mg, and placebo in a crossover, randomized fashion with double‐dummy administration. Plasma and urine concentrations of ranitidine and famotidine were determined by high‐performance liquid chromatography. Intragastric pH was measured for 24‐hours with an antimony probe. Famotidine's plasma half‐life (4.42 hrs) was significantly longer than ranitidine's (3.14 hrs, p<0.05, paired t test). The 24‐hour, area under the curve of pH profiles of the two drugs were significantly different from placebo (p<0.05, analysis of variance and Fisher PLSD test) but not from each other. The duration of effect (defined as median pH>4) was similar for ranitidine and famotidine, 10.3 and 9.9 hours, respectively (p=0.713, paired Student's t test). Thus both agents exhibited a similar duration of 24‐hour antisecretory response under these study conditions.
QT Interval Prolongation and Torsades de Pointes Due to Erythromycin Lactobionate
Authors: Oberg Kristin C. , Bauman Jerry L.
Published: October 2023

Study Objectives. To discern the frequency of torsades de pointes and QT prolongation in patients receiving intravenous erythromycin lactobionate; to examine the degree of QT prolongation and QT dispersion due to intravenous erythromycin in a typical clinical setting; and to identify any concurrent factors that might predispose patients to excessive QT prolongation or torsades de pointes while receiving intravenous erythromycin.

Design. Retrospective cohort trial.

Setting. A university teaching hospital.

Patients. All inpatients who received intravenous erythromycin lactobionate during a 1‐year period.

Measurements and Main Results. The records of 278 consecutive patients were analyzed, of whom 49 had 12‐lead electrocardiograms while receiving and not receiving erythromycin. The dosages of erythromycin ranged from 18–83 (42 pL 18) mg/kg/day. Of the 49 patients, the baseline QTc was 432 ± 39 msec, compared with 483 ± 62 msec during erythromycin therapy (p<0.01). In 30 of 49 patients with heart disease, the increase in QTc due to erythromycin was 15 ± 11%, compared with 8.6 ± 10% in the 19 patients without heart disease (p<0.05). The degree of QTc dispersion was 34 ± 16 msec at baseline, compared with 80 ± 35 msec with erythromycin (p<0.01). Overall, 19 (39%) of 49 patients had a moderate to severe delay in ventricular repolarization (QTc ≥ 500 msec). Of the 278 patients prescribed intravenous erythromycin over the year, it caused torsades de pointes in just one (≤ 0.4%).

Conclusion. Erythromycin lactobionate‐induced torsades de pointes is rare, although QT prolongation is common. Some patients may be at risk for suffering torsades de pointes due to this agent, particularly if heart disease or other factors that may further delay ventricular repolarization are present.
Outcome Analysis of a Pharmacist‐Managed Anticoagulation Service
Authors: Wilt Vickie M. , Gums John G. , Ahmed Osman I. , Moore Leah M.
Published: October 2023

The primary objective of this study was to determine if a pharmacist‐managed anticoagulation monitoring service (AMS) improved the outcomes of patients receiving warfarin in a family practice setting and was cost effective in treating and preventing thromboembolic disorders. A retrospective chart review was performed on all patients at the University of Florida's Family Practice Residency Program who received warfarin pharmacotherapy between October 1, 1988, and December 15, 1993. The outcomes of patients followed by AMS were compared with those of a control group consisting of patients receiving warfarin but followed only by their physician. Outcomes were evaluated based on the number of thromboembolic and hemorrhagic events, as well as unplanned clinic visits, emergency room visits, and hospital admissions. Cost of hospital admissions, emergency room visits, and participation in the AMS were analyzed. During 28 person‐years of treatment, control subjects sustained 12 thromboembolic events (2 pulmonary embolisms, 1 cerebrovascular accident, and 9 deep venous thromboses) and 2 minor and 5 major hemorrhagic events. The study group reported two minor hemorrhagic events during a total of 60 person‐years. The control group was 20 times more likely than the study group to experience any event (rate ratio 20, 95% CI 5–87). In addition, hospitalization and emergency room charges indicated an actual cost of $119,074.95 for the control group's events. The cost to this group for 28 person‐years of participation in the AMS would have been $5040.00. A potential cost avoidance of $4072.68 per person‐year of follow‐up may have been possible if these patients had been followed by the AMS. A pharmacist‐managed AMS in a family practice setting can result in improved outcomes for patients receiving warfarin and is cost effective.
Analysis of the Practice of Nutrition Support Pharmacy Specialists
Authors: Holcombe Beverly J. , Thorn Deborah B. , Strausburg Kathleen M. , Ponto James A. , Caiola Stephen M. , Powers Tony , Bertino Joseph S. , Leitinger Ellen A. , Robinson Lawrence A.
Published: October 2023

In 1988 the Board of Pharmaceutical Specialties (BPS) recognized nutrition support pharmacy practice (NSPP) as one of four specialty areas in pharmacy. The BPS appointed a specialty council to develop and manage the process for board certification of qualified specialists. One step was to identify and validate activities performed by the specialists. This was accomplished by conducting a study that delineated the role of these practitioners and also provided information for developing a blueprint for a certification examination. The results revealed the types of practice settings, education, and training for specialists, and the distribution of professional time devoted to nutrition support activities.
Therapeutic Equivalence of a Generic Slow‐Release Theophylline Tablet
Authors: Hendeles Leslie , Breton Amalia L. , Beaty Russell , Harman Eloise
Published: October 2023

Study Objective. To evaluate the relative bioavailability and clinical efficacy of two slow‐release theophylline products.

Design. Randomized, double‐blind, crossover trial.

Setting. A university‐affiliated clinical research center.

Patients. Fourteen adults with asthma.

Interventions. The patients received a generic slow‐release theophylline tablet or Theo‐Dur at bedtime for 5 nights.

Measurements and Main Results. Serum drug concentrations were measured after the last dose. Attenuation of exercise‐induced bronchospasm (EIB) was included as a surrogate for efficacy. There was no significant difference in extent of absorption. The mean differences between the generic product and Theo‐Dur in area under the curve was −13.9 μg/ml‐hr−1 (95% CI −41 to 12.9, p=0.3) and in peak concentration (Cmax), −0.5 μg/ml (95% CI −1.7 to 2.7, p=0.6). In contrast, the generic product was absorbed more rapidly; the mean differences in the time to peak concentration (Tmax) was −3.0 hours (95% CI −4.3 to −1.7, p=0.0003), in trough concentration (Cmin), −0.9 μg/ml (95% CI −1.9 to −0.01, p=0.05), and in fluctuation between Cmax and Cmm, +128% (95% CI 40 to 217, p=0.008). Neither product effectively attenuated EIB, since mean serum concentrations during the exercise challenges were unexpectedly below 10 μg/ml after both products.

Conclusion. These two products are not bioequivalent, but the difference in absorption rates is unlikely to be clinically important in most patients (i.e., they are therapeutic equivalents).
Sepsis Syndrome and Associated Sequelae in Patients at High Risk for Gram‐Negative Sepsis
Authors: Conboy Kathleen , Welage Lynda S. , Walawander Cynthia A. , Duffy Linda C. , Welliver Robert C. , Zielezny Maria A. , DiPiro Joseph T. , Raebel Marsha A. , Grasela Thaddeus H.
Published: October 2023

We conducted a prospective surveillance study of 80 hospitals across the United States to determine the incidence of sepsis syndrome and its associated sequelae in hospitalized patients over age 18 years who were administered antibiotics for suspected or documented gram‐negative infection. A sample of 1754 hospitalized patients were followed from onset of antimicrobial therapy to discharge or death. Mortality rates (MR) varied depending on the suspected source of sepsis syndrome. For patients in whom the syndrome was associated with community‐acquired urinary tract infections, mortality was 20% (relative risk [RR] = 0.51, p<0.05), for those with trauma 20.6% (RR = 0.51, p<0.05), and patients with nosocomial respiratory tract infections 57.1% (RR = 1.66, p<0.05). More than two complications occurred in 65.2% of patients under age 60 years (MR 31%), 40.8% of those age 60–80 (MR 42%), and 35.6% of patients older than 80 years (MR 33.3%, p>0.05). Various patient populations had significant differences in both the incidence of the syndrome and its complications, and consequent mortality. Perhaps morbidity as well as mortality should be used as outcomes when testing the efficacy of innovative therapies for sepsis.
Is Antidepressant Use Changing? Prevalence and Clinical Correlates in Two New England Communities
Authors: Hume Anne L. , Barbour Marilyn M. , Lapane Kate L. , Carleton Richard A.
Published: October 2023

We attempted to determine whether the prevalence of antidepressant use had increased in population‐based samples between 1981 and 1993, and compared the characteristics of antidepressant users and nonusers. Data were derived from six biennial, random sample, cross‐sectional household surveys conducted between 1981 and 1993 in two southeastern New England communities. For each survey, point prevalence estimates were determined for the major antidepressant categories. Antidepressant users were most likely to be women, slightly older, and less likely to be employed than nonusers (p<0.0001). Comorbid conditions and concurrent drug therapy were present more frequently among users. The overall prevalence of antidepressant use per 1000 population increased from 7.8 (95% confidence interval 4.3, 11.3) in 1981–1982 to 31.4 (95% CI 23.9, 38.9) in 1992–1993, especially among women and respondents between ages 40 and 59 years.
Trends in Antimicrobial Resistance Among Today's Bacterial Pathogens
Authors: Thornsberry Clyde
Published: October 2023

Resistance of nosocomial and community‐acquired pathogens to antimicrobial agents is a serious problem with significant clinical consequences. Microbiologic surveillance data, such as those provided by the National Nosocomial Infections Surveillance System, supply information on current nosocomial pathogens in the United States. Many species show resistance to commonly used antimicrobials and, in many cases, it is emerging resistance. Resistance in many gram‐negative bacteria is caused by β‐lactamase production. Escherichia coli, the leading nosocomial pathogen, is capable of hyperproducing TEM‐1 β‐lactamase. A novel form of resistance in Klebsiella pneumoniae and E. coli is caused by extended‐spectrum cephalosporinases. Many Enterobacteriaceae can be induced to produce group 1 β‐lactamase by exposure to broad‐spectrum cephalosporins and other β‐lactams. Thirty percent of Haemophilus influenzae isolates are resistant to ampicillin because of β‐lactamase production. Issues of concern in gram‐positive species include multiple antimicrobial resistance in methicillin‐resistant Staphylococcus aureus, enterococci, and coagulase‐negative staphylococci, and increasing β‐lactam resistance in Streptococcus pneumoniae. To minimize the development of resistance, antimicrobials must be administered judiciously, and infection‐control practices must be instituted and followed.
Effect of Erythromycin on Ethanol's Pharmacokinetics and Perception of Intoxication
Authors: Min David I. , Noormohamed Saleem E. , Flanigan Michael J.
Published: October 2023

Study Objective. To determine the effect of erythromycin on ethanol's pharmacokinetics and perception of intoxication.

Design. Double‐blind, randomized, placebo‐controlled, crossover study.

Setting. A clinical research center.

Participants. Ten healthy volunteers.

Interventions. Erythromycin base 500 mg or identical placebo was administered 3 times/day for 7 days. On day 8, ethanol 0.8 g/kg was administered by mouth concurrently with erythromycin or placebo. A 2‐week washout period was allowed between each treatment arm.

Measurements and Main Results. Twelve blood samples were obtained over a 12‐hour period to determine ethanol concentrations. Perception of intoxication was determined at each time point using a 10‐cm visual analog scale. Ethanol concentrations were determined using a gas chromatographic method. Mean ± SD ethanol pharmacokinetics for erythromycin versus placebo were time to peak ethanol plasma concentrations 1.1 ± 0.4 hours versus 1.3 ± 0.3 hours, peak ethanol concentrations 118 ± 18 mg/dl versus 114 ± 27 mg/dl, ethanol oral clearance (CL/F) 2.9 ± 0.8 ml/min/kg versus 3.4 ± 2.2 ml/min/kg, and area under the curve 481 ± 104 mg·hour/dl versus 465 ± 132 mg·hour/dl (p>0.05). The blood ethanol concentrations and perception of intoxication scores on a visual analog scale were well correlated (r2=0.78, p<0.01). Mean ± SD areas under the effect versus time curve were 35.1 ± 20.7 cm/hour and 31.5 ± 18.2 cm/hour for erythromycin and placebo, respectively (p>0.05).

Conclusion. Oral erythromycin base 1500 mg/day compared with placebo does not alter ethanol's pharmacokinetics or perception of intoxication in healthy volunteers.
National Survey of Once‐Daily Dosing of Aminoglycoside Antibiotics
Authors: Schumock Glen T. , Raber Susan R. , Crawford Stephanie Y. , Naderer Odin J. , Rodvold Keith A.
Published: October 2023

To evaluate the scope of once‐daily dosing of intravenous aminoglycoside antibiotics, a questionnaire was designed and mailed to a random sample of pharmacy directors at 500 acute care hospitals in the United States. The response rate was 68.4%. Nineteen percent of the respondents reported use of once‐daily dosing of aminoglycosides. Affiliation with a pharmacy residency program and the presence of a pharmacokinetic consultation service by the pharmacy department were associated with this practice (p<0.05). No other statistically significant differences were found. Reported indications, contraindications, and dosing were consistent with those found in the literature. The profession of pharmacy, as demonstrated by pharmacy residency programs and pharmacokinetic consultation services, appears to have been instrumental in implementing this method of dosing aminoglycosides.
Toxic Epidermal Necrolysis After Initiation of Felbamate Therapy
Authors: Travaglini Maryann T. , Morrison Richard C. , Ackerman Bruce H. , Haith Linwood R. , Patton Mary Lou
Published: October 2023

A 33‐year‐old woman with a 13‐year history of partial complex seizures experienced toxic epidermal necrolysis requiring management in a regional burn treatment center after 16 days of single‐agent treatment for epilepsy with felbamate 3600 mg/day. Within 24 hours the target lesions involved 45% of her total body surface area. They coalesced and progressed to exfoliation involving the mucosa and the conjunctiva. The patient was hospitalized for 25 days. Reports in the literature describe life‐threatening rashes after treatment with felbamate in combination with other anticonvulsant agents. We believe this to be the first reported case of felbamate‐induced toxic epidermal necrolysis induced by single‐agent therapy. Although felbamate provides many advantages as an anticonvulsant, its structure can be arranged to a conformation in space similar to that of hydantoins and barbiturates, and thus warrants careful patient monitoring for life‐threatening rashes.
Soluble FcγRIII (CD16) and Immunoglobulin G Levels in Seminal Plasma of Men with Immunological Infertility
Authors: SEDOR JOHN , CALLAHAN HUGH J. , PERUSSIA BICE , LATTIME EDMUND C. , HIRSCH IRVIN H.
Published: October 2023

ABSTRACT: Receptors for the Fc region of the immunoglobulin G (IgG) (Fc gamma R) have been recognized as a link between humoral and cellular immune responses. A soluble form of FcγRIII (CD16) has been found in seminal plasma (SP), which may modulate immunosuppression of antisperm immune responses in the male and female reproductive tracts. SP from some individuals apparently have lower levels of FcγRIII, but it is not known whether the diminished activities are due to low receptor concentration or steric interference from IgG. To test the hypothesis that different levels are due to steric interference, relative levels of FcγRIII were measured in SP using monoclonal antibody 3G8 in an amplified enzyme‐linked immunosorbent assay (ELISA) system. Men who were positive for antisperm antibodies (ASA) by Sperm Mar and direct immunobead assay (N = 26) and negative for ASA (N = 26) were tested. Individuals who were ASA positive had lower detectable levels than those who were ASA negative (t = 1.99, P = 0.05). Therefore, variation in FcγRIII levels may be due to steric interference from IgG. IgG subclass concentrations in SP of both groups were determined using an ELISA method and compared to FcγRIII levels. Slight correlations were seen for lgG1 (r2 = 0.237, P < 0.001), IgG2 (r2 = 0.204, P < 0.001), and total IgG (r2 = 0.299, P < 0.001) in relation to FcγRIII levels in ASA‐negative SP specimens. We conclude that ASA‐positive SP has lower detectable levels of FcγRIII and that some variability in ASA‐negative SP can be attributed to variance in IgG subclass levels, especially IgG1 and IgG2. Therefore, we can conclude that lower levels of FcγRIII in some SP specimens are due to steric interference from IgG.
Effect of Chloroquine on the Formation of Tight Junctions in Cultured Immature Rat Sertoli Cells
Authors: OKANLAWON ABAYOMI , DYM MARTIN
Published: October 2023

ABSTRACT: Adjoining immature Sertoli cells in the seminiferous epithelium form a tight junctional complex leading to the development of the blood‐testis barrier. Protease and antiprotease activities have been implicated in the process of formation of tight junctions. Here, we report the effect of chloroquine, an antimalarial drug with antiprotease activity, on the development of intercellular tight junctions in cultured immature rat Sertoli cells. For positive control, the classical lysosomotropic agent ammonium chloride was used. Sertoli cells were seeded in serum‐free defined medium at a density of 3 × 106 cells/0.64‐cm2 well on Matrigel‐covered Millicell‐HA filters. Chloroquine at concentrations ranging from 25 to 100 μM was added to the outer chamber of the bicameral system on either day 1 or 7 of the culture. The formation of the tight junction was monitored by the measurement of the transepithelial resistance (TER) at 24‐hour intervals using an impedance meter. TER in untreated controls was 50 ohms/cm2 on day 1; it increased progressively to 80 ohms/cm2 by day 7 and plateaued until day 12. The cells treated from day 1 with chloroquine also showed a dose‐dependent progressive increase in TER until day 9, reaching 225 ohms/cm2 in cells treated with the 100 μM concentration. In comparison to controls, the increase in TER was significantly higher. In cells treated with chloroquine starting from day 7 of culture onwards, there was no observable difference in TER from the untreated control. These observations demonstrate that chloroquine and ammonium chloride increase the TER of immature Sertoli cells in the bicameral chamber.
Testicular Composition, Number of A Spermatogonia, Germ Cell Ratios, and Number of Spermatids in Three Different Breeds of Boars
Authors: OKWUN OKWUN E. , IGBOELI GAIUS , LUNSTRA DONALD D. , FORD J. JOE , JOHNSON LARRY
Published: October 2023

ABSTRACT: Seminal quality, including the number of spermatozoa in the ejaculate, varies among breeds of boars. Variation in seminal quality may be explained by breed differences in testicular size and composition. The objective of this study was to characterize testicular composition and population sizes of germ cells and somatic cells in three different breeds of boars. Testes from mature and normal Meishan (M, n = 5; age 225 days), Whitecross (WC, n = 5; age 346 days), and West African (WA, n = 5; age 322 days) boars were either fixed in Zenker‐formol or perfused with glutaraldehyde, embedded in Epon, sectioned at 0.5 μm or 20 μm and evaluated stereologically for germ cells, Leydig cells, Sertoli cells, and other testicular structures. The paired parenchymal weight was higher (P < 0.05) in the WC (498 ± 35 g) than in the M (247 ± 17 g) or WA (133 ± 10 g). The nuclear volumes per boar of Sertoli cells, type A spermatogonia, leptotene, zygotene, pachytene, secondary spermatocytes, spermatids with spherical nuclei, and spermatids with elongated nuclei were higher (P < 0.05) in the WC than in the M or WA. The nuclear volumes per boar of blood vessels and Leydig cells were exceptionally higher (P < 0.05) in the M than in the WC or WA. The average germ cell nuclear diameters were similar (P < 0.05) for the M and WC but least (P < 0.05) in the WA breed. Also, the nuclear diameters of Leydig cells and Sertoli cells were higher (P < 0.05) in the M than in the WC or WA. The population sizes of all the intratubular components were positively correlated (P < 0.05) with testicular size (weight). Volume density of seminiferous tubules was similar in the WA and WC, but was lowest in the M, who had the highest density of Leydig cells. However, due to the larger testes, all germ cell types and Sertoli cells were higher in the WC than in the WA or M. The M and WA had similar low numbers of type A spermatogonia, but there was less germ cell degeneration in M than in WA, such that M spermatids were intermediate in number between WA and WC.
The impact of gestational diabetes on the development of fetal frontal lobe: A case–control study from a tertiary center
Authors: Sahin Refaettin , Tanacan Atakan , Serbetci Hakki , Agaoglu Zahid , Haksever Murat , Ozkavak Osman Onur , Karagoz Busra , Kara Ozgur , Sahin Dilek
Published: October 2023

Purpose

To determine the effects of gestational diabetes mellitus (GDM) on fetal frontal lobe development.

Methods

This study was conducted prospectively between May 2023 and August 2023 in Ankara City Hospital perinatology clinic. Maternal age, maternal body mass index (BMI), gestational week (GW), biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), femur length (FL), estimated fetal weight (EFW), frontal antero‐posterior diameter (FAPD), occipito‐frontal diameter (OFD), FAPD/OFD ratio, and FAPD/HC ratio, were compared between GDM (n = 40) and low risk controls (n = 56).

Results

The mean maternal age was found higher in the GDM group compared to control group (p = 0.002). Maternal BMI was significantly higher in the GDM group than the control group (p = 0.01). Abdominal circumference (AC) was significantly higher in the GDM group compared to control group (p = 0.04). EFW was significantly higher in the GDM group compared to control group (p = 0.04). FAPD/OFD ratio was found to be higher in the GDM group than in the control group (p = 0.001). Among GDM patients, no statistically significant difference was found in the ultrasound measurements between the groups receiving insulin treatment and those without treatment. According to the correlation analysis results a moderate, positive, and statistically significant correlation was present between FAPD/OFD and GDM. In perinatal outcomes, the rate of neonatal intensive care unit admission was significantly higher in the GDM group.

Discussion

Fetal frontal lobe development seems to be affected by GDM.
Understanding type and quality of relationships between individuals with chromosome 18 syndromes and their siblings
Authors: Larson Catherine Cody , O'Donnell Louise , Soileau Bridgette , Van Riper Marcia , Stark Debra , Hale Daniel E. , Cody Jannine D.
Published: October 2023

Siblings of individuals with disabilities hold a pivotal and sometimes unappreciated position in the lives of their brother or sister. We sought to understand the unique challenges and opportunities in relationships between children with chromosome 18 conditions and their siblings and to identify the ways to support this relationship. Participants were recruited through the lay advocacy organization, the Chromosome 18 Registry & Research Society. Fifty‐seven siblings from 36 families participated, using an investigator designed instrument, were asked to agree or disagreed with statements from four content areas (information and knowledge about the syndrome, feelings about the sibling relationship, involvement with and caregiving for their sibling, and support and advocacy). Siblings reported that they know their sibling with a disability very well and reported a wide range of emotions regarding their sibling. There was a strong sense of pride in their brother/sister's abilities, and many participants reported attempts to help others understand their brother/sister. Many siblings reported a dislike for the common assumption that their affected sibling is a burden on the family. Most participants reported feeling some degree of responsibility for their affected sibling, but many also reported that they enjoy this role. Sixty‐three parents from 36 families responded to the survey. Most parents felt their typically developing children enjoyed teaching new things to their affected child as well as being a good role model for them. Most parents also felt their typically developing child was comfortable telling others about their sibling's condition. Recommendations for interventions and future research are discussed.
Elusive properties of infinite graphs
Authors: Csernák Tamás , Soukup Lajos
Published: October 2023

A graph property is said to be elusive (or evasive) if every algorithm testing this property by asking questions of the form “is there an edge between vertices and ?” requires, in the worst case, to ask about all pairs of vertices. The unsettled Aanderaa–Karp–Rosenberg conjecture is that every nontrivial monotone graph property is elusive for any finite vertex set. We show that the situation is completely different for infinite vertex sets: the monotone graph properties “every vertex has degree at least ” and “every connected component has size at least ,” where and are natural numbers, are not elusive for infinite vertex sets, but the monotone graph property “the graph contains a cycle” is elusive for arbitrary vertex set. On the other hand, we also prove that every algorithm testing some natural monotone graph properties, for example, “every vertex has degree at least ” or “connected” on the vertex set should check “lots of edges,” more precisely, all the edges of an infinite complete subgraph.
Reappraisal of surgical and survival outcomes of 500 consecutive cases of robotic pancreaticoduodenectomy
Authors: Shyr Bor‐Shiuan , Shyr Yi‐Ming , Chen Shih‐Chin , Wang Shin‐E , Shyr Bor‐Uei
Published: October 2023

Background

The role of the robotic approach for pancreaticoduodenectomy has not been well established with robust data. This study aimed to reappraise feasibility and justification of robotic pancreaticoduodenectomy (RPD) over time.

Methods

A total of 500 patients undergoing RPD were enrolled and divided into early (first 250 patients) and late (last 250 patients) groups for a comparative study.

Results

The conversion rate was 8.8% overall and was significantly lower in the late group (5.6% vs. 12.0%; p = .012). The overall median intraoperative blood loss was 130 mL. Radicality of resection was similar between early and late groups. The overall surgical mortality after RPD was 1.3%. The overall surgical morbidity and major complication was 44.1% and 13.2%, respectively, and similar between early and late groups. Chyle leakage was the most common complication after RPD (25.0%), followed by postoperative pancreatic fistula (POPF). The POPF rate was 8.6% overall, with 5.9% in the early group and 11.0% in the late group, p = .051. The overall delayed gastric emptying rate was 3.5%. The late group had better survival outcomes than those of the early group after RPD for ampullary adenocarcinoma (p = .027) but not for pancreatic head adenocarcinoma.

Conclusions

Reappraisal of this study has confirmed that RPD is not only technically feasible without increasing surgical risks but also oncologically justified without compromising survival outcomes for both pancreatic head and other periampullary cancers over time. Moreover, RPD is associated with the benefits of low surgical mortality, blood loss, and delayed gastric emptying.