bluuebunny/crossref_metadata_2025 huggingface dataset:
Adherence to Nucleos(t)ide Analogue Therapies for Chronic Hepatitis B Infection: A Systematic Review and Meta‐Analysis
Authors: Ford Nathan , Scourse Roz , Lemoine Maud , Hutin Yvan , Bulterys Marc , Shubber Zara , Donchuk Dmytro , Wandeler Gilles
Published: September 2018

Successful treatment outcomes for chronic hepatitis B virus (HBV) infection requires high levels of adherence to treatment. We searched three databases and abstracts from two conferences up to January 2018 for studies reporting the proportion of patients who were adherent to HBV antiviral therapy and pooled data using random effects meta‐analysis. We included 30 studies, providing data for 23,823 patients. Overall, adherence to treatment was 74.6% (95% confidence interval [CI] 67.1%‐82.1%). Adherence was similar in high‐income settings (75.1%; 95% CI, 65.4%‐85.0%) and in low‐income and middle‐income settings (72.9%; 95% CI, 57.8%‐88.0%). Reported barriers to adherence included forgetting, limited understanding of the importance of adherence, and change to routine.
Conclusion
: There is a need to reinforce assessment and reporting of adherence as a routine part of HBV care and to assess the extent to which evidence‐based interventions to improve adherence to medication for human immunodeficiency virus [HIV] and other chronic diseases are effective for HBV infection.
Autoimmune Hepatitis During Ledipasvir/Sofosbuvir Treatment of Hepatitis C: A Case Report
Authors: Covini Giovanni , Bredi Elena , Badalamenti Salvatore , Roncalli Massimo , Aghemo Alessio , Colombo Massimo
Published: September 2018

We report the case of a woman with chronic hepatitis C and idiopathic thrombocytopenic purpura (ITP) who developed autoimmune hepatitis (AIH) during antiviral therapy with ledipasvir (LDV)/sofosbuvir (SOF). The onset of acute hepatitis rose two weeks after starting treatment with LDV/SOF when HCV‐RNA tested negative, suggesting a link between rapid HCV clearance and de novo autoimmune diseases. Conclusion: This case report proposes new immunologic scenarios in patients with hepatitis C virus (HCV) with laboratory or clinical signs of autoimmunity during direct‐acting antiviral (DAA) therapy.
Outcomes of Pregnancy in Mothers With Cirrhosis: A National Population‐Based Cohort Study of 1.3 Million Pregnancies
Authors: Hagström Hannes , Höijer Jonas , Marschall Hanns‐Ulrich , Williamson Catherine , Heneghan Michael A. , Westbrook Rachel H. , Ludvigsson Jonas F. , Stephansson Olof
Published: September 2018

There are limited data on pregnancy outcomes in women with cirrhosis. To address this gap, we examined the records of singleton births from Sweden’s National Patient Register (NPR), Cause of Death Register (CDR), and Medical Birth Register (MBR) between 1997 and 2011 to assess exposure and pregnancy‐related and liver‐related outcomes of pregnant women with cirrhosis. Exposure status was defined as having an International Classification of Diseases (ICD) code for cirrhosis obtained prior to or during pregnancy. Poisson regression with cluster‐robust standard errors was used to estimate relative risks (RRs) adjusted for maternal age, smoking, and body mass index (BMI). We identified 103 pregnancies in women with cirrhosis and compared these to 1,361,566 pregnancies in women without cirrhosis. Pregnancies in women with cirrhosis were at increased risk of caesarean delivery (36% versus 16%, respectively; adjusted RR [aRR], 2.00; 95% confidence interval [CI], 1.47‐2.73), low birth weight (15% versus 3%; aRR, 3.87; 95% CI, 2.11‐7.06), and preterm delivery (19% versus 5%; aRR, 3.51; 95% CI, 2.16‐5.72). Rates of maternal mortality during pregnancy (no cases), gestational diabetes, preeclampsia, small for gestational age, congenital malformations, and stillbirth were not increased when compared to the pregnant women without cirrhosis. There were 12 hospitalizations during pregnancy due to liver‐related events, including one case with bleeding esophageal varices. Conclusion: Women with cirrhosis are at increased risk for adverse pregnancy outcomes. However, severe maternal and fetal adverse events were rare in our study, and most pregnancies in women with cirrhosis ended without complications.
The effects of living in an outdoor enclosure on hippocampal plasticity and anxiety‐like behavior in response to nematode infection
Authors: Cope Elise C. , Opendak Maya , LaMarca Elizabeth A. , Murthy Sahana , Park Christin Y. , Olson Lyra B. , Martinez Susana , Leung Jacqueline M. , Graham Andrea L. , Gould Elizabeth
Published: September 2018

The hippocampus of rodents undergoes structural remodeling throughout adulthood, including the addition of new neurons. Adult neurogenesis is sensitive to environmental enrichment and stress. Microglia, the brain's resident immune cells, are involved in adult neurogenesis by engulfing dying new neurons. While previous studies using laboratory environmental enrichment have investigated alterations in brain structure and function, they do not provide an adequate reflection of living in the wild, in which stress and environmental instability are common. Here, we compared mice living in standard laboratory settings to mice living in outdoor enclosures to assess the complex interactions among environment, gut infection, and hippocampal plasticity. We infected mice with parasitic worms and studied their effects on adult neurogenesis, microglia, and functions associated with the hippocampus, including cognition and anxiety regulation. We found an increase in immature neuron numbers of mice living in outdoor enclosures regardless of infection. While outdoor living prevented increases in microglial reactivity induced by infection in both the dorsal and ventral hippocampus, outdoor mice with infection had fewer microglia and microglial processes in the ventral hippocampus. We observed no differences in cognitive performance on the hippocampus‐dependent object location task between infected and uninfected mice living in either setting. However, we found that infection caused an increase in anxiety‐like behavior in the open field test but only in outdoor mice. These findings suggest that living conditions, as well as gut infection, interact to produce complex effects on brain structure and function.
Associations of adult‐attained height and early life energy restriction with postmenopausal breast cancer risk according to estrogen and progesterone receptor status
Authors: Elands Rachel J. J. , Offermans Nadine S. M. , Simons Colinda C. J. M , Schouten Leo J. , Verhage Bas A. , van den Brandt Piet A. , Weijenberg Matty P.
Published: September 2018

Adult‐attained height is a marker for underlying mechanisms, such as cell growth, that may also influence postmenopausal breast cancer (BC) risk, perhaps specifically hormone‐sensitive BC subtypes. Early life energy restriction may inhibit these mechanisms, resulting in shorter height and a reduced postmenopausal BC risk. Women (62,573) from the Netherlands Cohort Study completed a self‐administered questionnaire in 1986 when 55–69 years old, and were followed‐up for 20.3 years (case–cohort: Nsubcohort = 2,438; Ncases = 3,354). Cox multivariable‐adjusted hazard ratios (HR) and 95% confidence intervals (CI) were estimated for BC risk overall and by estrogen and progesterone receptor subtypes in relation to height and early life energy restriction during the Hunger Winter, War Years, and Economic Depression. Although energy restriction can only influence longitudinal growth in women exposed before and/or during the growth spurt, it may also influence BC risk when occurring after the growth spurt, possibly through different growth processes. Therefore, Cox analyses were additionally conducted according to timing of energy restriction in relation to the growth spurt. Height was associated with an increased BC risk (HRper 5cm = 1.07, 95%CI:1.01–1.13), particularly hormone receptor‐positive BC. Energy restriction before and/or during the growth spurt was associated with a decreased hormone receptor‐positive BC risk. Energy restriction during the Hunger Winter increased the estrogen receptor‐negative BC risk regardless of the timing of energy restriction. In conclusion, height and energy restriction before and/or during the growth spurt were both associated with hormone receptor‐positive BC risk, in the direction as expected, indicating critical exposure windows for hormonal growth‐related mechanisms.
Epigenetic regulation of Amphiregulin and Epiregulin in colorectal cancer
Authors: Bormann Felix , Stinzing Sebastian , Tierling Sascha , Morkel Markus , Markelova Maria Rivera , Walter Jörn , Weichert Wilko , Roßner Florian , Kuhn Natalia , Perner Juliane , Dietz Johanna , Ispasanie Sylvia , Dietel Manfred , Schäfer Reinhold , Heinemann Volker , Sers Christine
Published: September 2018

Expression of the epidermal growth factor ligands amphiregulin (AREG) and epiregulin (EREG) is positively correlated with a response to EGFR‐targeted therapies in colorectal cancer. Gene‐body methylation sites, which show a strong inverse correlation with AREG and EREG gene expression, were identified in cell lines using targeted 454 FLX‐bisulfite sequencing and SIRPH analyses for AREG/EREG promoters and intragenic CpGs. Upon treatment of colorectal cancer cells with 5‐aza‐2′‐desoxycytidine, methylation decreases at specific intragenic CpGs accompanied by upregulation of AREG and EREG gene expression. The same AREG gene‐body methylation was also found in human colorectal cancer samples and is independent of KRAS and NRAS mutations. Methylation is specifically decreased in the tumor epithelial compartment as compared to stromal tissue and normal epithelium. Investigation of a promoter/enhancer function of the AREG exon 2 region revealed a potential promoter function in reverse orientation. Retrospective comparison of the predictive power of AREG gene‐body methylation versus AREG gene expression using samples from colorectal cancer patients treated with anti‐EGFR inhibitors with complete clinical follow‐up revealed that AREG expression is superior to AREG gene methylation. AREG and EREG genes undergo a complex regulation involving both intragenic methylation and promoter‐dependent control.
Reviewing Rare Earth Succinate Frameworks from the Reticular Chemistry Point of View: Structures, Nets, Catalytic and Photoluminescence Applications
Authors: Bernini Maria C. , Gomez Germán E. , Brusau Elena V. , Narda Griselda E.
Published: September 2018

The intense development that Metal‐Organic Frameworks have experienced along the last two decades, reflects the interest on these compounds as a new generation of multifunctional materials with diverse applications. The first works of Prof. Omar Yaghi devoted to obtain open frameworks by combining rigid aromatic linkers and a variety of metal centers, encouraged the creativity of the scientific community to designcoordination polymers employing aliphatic ligands as multitopic building blocks . Here, a revision of the literature dedicated to rare earth coordination networks mainly based in succinate ligand and derivatives is performed. A structural analysis of 2D and 3D frameworks based on rare earth elements and succinate, was carried out considering their inner connectivities and topologies with focus on those compounds with potential photoluminescent and catalytic technological applications. Thus, a variety of optical behaviours regarding the emission mechanisms, colours, lifetimes, quantum yields as well as chemical/thermal sensing properties are presented and compared with related phases found in literature. The catalytic performance of several rare earth‐succinates in three important reactions is discussed in terms of their acidity, dimensionality and available active centers towards the formation of the desired products analysing parameters such as selectivity, yields and TOFs.
The rooting reflex as an infant feeding cue
Authors: Glodowski Kathryn R. , Thompson Rachel H. , Martel Lauren
Published: September 2018

Experts in infant health and development consider the rooting reflex a cue of a baby's hunger and recommend feeding the infant when this reflex occurs. However, the relation between rooting and infant feeding status has not been well established in the literature. In the current study, seven parents documented the occurrence of their newborns' rooting, crying, and a control reflex (palmar grasp) before, after, and between naturally occurring feedings. For all participants, rooting occurred during a greater percentage of reflex checks prior to feedings, whereas the palmar grasp occurred during a similar percentage of checks across these time periods. These results provide empirical support for the rooting reflex as a feeding cue. However, data for only one dyad suggested a high probability of the rooting reflex occurring without crying during prefeeding checks. Thus, our data do not provide evidence that feeding in response to the rooting reflex would preempt infant crying.
Determination of potential oxidative damage, hepatotoxicity, and cytogenotoxicity in male Wistar rats: Role of indomethacin
Authors: Hilal Ahmad Mir , Fatima Mahino , Hossain Mohd. Mobarak , Mondal Amal Chandra
Published: September 2018

The present study demonstrated the indomethacin (INDO) induced oxidative stress, hepatotoxicity, and genotoxicity in male Wistar rats. Animals were orally administrated INDO at doses of 0.302 and 0.605 (mg/kg b.w.) for 2 weeks. Reduced glutathione (GSH), superoxide dismutase (SOD), catalase (CAT), and lipid peroxidation (LPO) activities/levels were measured in the liver, kidney, and brain tissues. The aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) activities, total bilirubin (TBIL) levels, and histopathological changes were determined in the liver tissues. Micronucleus frequency (micronucleus test) and DNA damage (comet assay) tests were performed in the bone marrow cells and leukocytes, respectively. Results show that INDO treatment decreased the GSH, SOD, and CAT levels/activities and increased the LPO, ALT, AST, ALP, and TBIL activities/levels. INDO induced significant hepatic injury and micronucleus and DNA damage. Thus, the current investigations confirm the oxidative stress, hepatotoxic, and genotoxic properties of INDO in the male Wistar rats.
Quantification of intraepidermal nerve fiber density using three‐dimensional microscopy
Authors: Kim Dai Hyun , Na Ji Eun , Lee Se Jeong , Sun Woong , Ahn Hyo Hyun , Kim Byung‐Jo , Rhyu Im Joo
Published: September 2018

Three‐dimensional microscopy provides more extended depth of penetration compared with conventional light microscopy and is known to be useful in clinical evaluation of thick biological specimens. Skin nerve biopsy together with the quantification of intraepidermal nerve fibers in multiple thick sections has been widely adopted for evaluating peripheral neuropathies. The aim of the present study was to evaluate the effectivity of three‐dimensional microscopy in reducing the required time and inter‐rater discrepancies, especially in the case of personnel not familiar with the quantification methods. A total of six cryo‐sectioned specimens were analyzed for the study and the skin samples were collected from one patient with postherpetic neuralgia who voluntarily participated in the study. Two investigators, a physician and non‐physician assessed the intraepidermal nerve fiber densities and required analysis time using three different methods including direct visualization of tissue slides, and analysis with two‐ and three‐dimensional images. Three‐dimensional microscopy could produce images that enabled reliable evaluation of intraepidermal nerve fibers; the accuracy of analysis was statistically comparable between the physician and non‐physician (p > .05). Three‐dimensional microscopy also enabled the non‐physician to proceed meaningfully faster evaluation compared with the direct visualization method (p = .03). Three‐dimensional microscopy could be one of the useful methods to improve accuracy and convenience of the analysis of intraepidermal nerve fibers especially appropriate for unaccustomed physician or non‐physician.

Research Highlights

Three‐dimensional microscopy is capable of producing images with more extended depth of penetration compared with conventional light microscopy and has been known to be suitable for clinical evaluation of thick biological specimens. Cutaneous nerve biopsy and the quantification of nerve fibers in thick sections has been widely adopted for evaluating peripheral neuropathies. Three‐dimensional microscopy could be especially appropriate for unaccustomed physician or non‐physician to improve accuracy and convenience of the analysis of intraepidermal nerve fibers.
Efficient Catalytic Synthesis of 3,4‐Dihydropyrimidin‐2‐ones/thiones via Little Acidic Ionic Liquid Combined with Rapid Heating Ways
Authors: Zhang Guo‐Ping , Tian Da‐Yu , Shi Wang‐Ming
Published: September 2018

Catalytic synthesis of 3,4‐dihydropyrimidin‐2(1H)‐ones/thiones was efficiently promoted by as little as 2.5 mol% of Brønsted acidic ionic liquid [(CH2)3SO3HMIM]HSO4 catalyst loading via rapid heating ways. Interestingly, rapid heating effectively improved yields to avoid side products. Furthermore, the mechanism has been speculated that the reaction proceeds may be via rapidly one‐step condensation rather than slowly step‐by‐step condensation. In addition, the catalyst can be recovered for repeated use (up to seven times), and a whole green reaction process adds to its practical applicability.
Intrapatient Comparison of the Hepatobiliary Phase of Gd‐BOPTA and Gd‐EOB‐DTPA in the Differentiation of Hepatocellular Adenoma From Focal Nodular Hyperplasia
Authors: Vanhooymissen Inge J.S.M.L. , Thomeer Maarten G. , Braun Loes M.M. , Gest Bibiche , van Koeverden Sebastiaan , Willemssen Francois E. , Hunink Myriam , De Man Robert A. , Ijzermans Jan N. , Dwarkasing Roy S.
Published: September 2018

Background

Current imaging guidelines do not specify the preferred hepatobiliary contrast agent when differentiating hepatocellular adenoma (HCA) from focal nodular hyperplasia (FNH) on MRI.

Purpose

To analyze intrapatient differences in the hepatobiliary phase (HBP) after use of both gadobenate dimeglumine (Gd‐BOPTA) and gadoxetic acid (Gd‐EOB‐DTPA)‐enhanced MRI to differentiate HCA from FNH.

Study Type

Retrospective.

Population

Patients who underwent both Gd‐BOPTA and Gd‐EOB‐DTPA‐enhanced MRI, including 33 patients with 82 lesions (67 HCA; 15 FNH), with a step‐down reference standard of pathology, 20% regression, identical appearance to earlier biopsied lesions, and stringent imaging findings.

Field Strength/Sequence

1.5T and 3T HBP of Gd‐BOPTA and Gd‐EOB‐DTPA‐enhanced MRI, precontrast fat‐suppressed T1‐weighted sequence.

Assessment

Signal intensities relative to the surrounding liver in the HBP were assessed by two observers.

Statistical Tests

Sensitivity and specificity of HCA diagnosis were calculated for both contrast agents. Interobserver agreement was evaluated using Cohen's kappa; differences in degree of certainty for scoring a lesion were calculated by means of the Wilcoxon signed rank test. Differences in signal intensity between Gd‐BOPTA and Gd‐EOB‐DTPA were calculated using McNemar's test.

Results

Almost perfect agreement was found between observers for scored signal intensities with both contrast agents. In 30 of the 82 lesions (37%) a difference was observed between contrast agents in the HBP, with Gd‐EOB‐DTPA proving correct in all but one of the discordant lesions. When distinguishing HCA from FNH, Gd‐BOPTA showed a sensitivity of 46% (31/67) and a specificity of 87% (13/15), while the sensitivity and specificity of Gd‐EOB‐DTPA was 85% (57/67) and 100% (15/15), respectively. A risk of misclassifying HCA as FNH typically occurs for Gd‐BOPTA when lesions are intrinsically hyperintense (P < 0.005).

Data Conclusion

The HBP of Gd‐EOB‐DTPA shows superior accuracy in ruling out HCA in comparison with Gd‐BOPTA, especially when the lesion is intrinsically hyperintense on T1‐weighted imaging.

Level of Evidence: 3

Technical Efficacy: Stage 3

J. Magn. Reson. Imaging 2019;49:700–710.
Artificial Intelligence Applied to Osteoporosis: A Performance Comparison of Machine Learning Algorithms in Predicting Fragility Fractures From MRI Data
Authors: Ferizi Uran , Besser Harrison , Hysi Pirro , Jacobs Joseph , Rajapakse Chamith S. , Chen Cheng , Saha Punam K. , Honig Stephen , Chang Gregory
Published: September 2018

Background

A current challenge in osteoporosis is identifying patients at risk of bone fracture.

Purpose

To identify the machine learning classifiers that predict best osteoporotic bone fractures and, from the data, to highlight the imaging features and the anatomical regions that contribute most to prediction performance.

Study Type

Prospective (cross‐sectional) case–control study.

Population

Thirty‐two women with prior fragility bone fractures, of mean age = 61.6 and body mass index (BMI) = 22.7 kg/m2, and 60 women without fractures, of mean age = 62.3 and BMI = 21.4 kg/m2.

Field Strength/ Sequence: 3D FLASH at 3T.

Assessment

Quantitative MRI outcomes by software algorithms. Mechanical and topological microstructural parameters of the trabecular bone were calculated for five femoral regions, and added to the vector of features together with bone mineral density measurement, fracture risk assessment tool (FRAX) score, and personal characteristics such as age, weight, and height. We fitted 15 classifiers using 200 randomized cross‐validation datasets.

Statistical Tests:Data: Kolmogorov–Smirnov test for normality. Model Performance: sensitivity, specificity, precision, accuracy, F1‐test, receiver operating characteristic curve (ROC). Two‐sidedt‐test, withP< 0.05 for statistical significance.

Results

The top three performing classifiers are RUS‐boosted trees (in particular, performing best with head data, F1 = 0.64 ± 0.03), the logistic regression and the linear discriminant (both best with trochanteric datasets, F1 = 0.65 ± 0.03 and F1 = 0.67 ± 0.03, respectively). A permutation of these classifiers comprised the best three performers for four out of five anatomical datasets. After averaging across all the anatomical datasets, the score for the best performer, the boosted trees, was F1 = 0.63 ± 0.03 for All‐features dataset, F1 = 0.52 ± 0.05 for the no‐MRI dataset, and F1 = 0.48 ± 0.06 for the no‐FRAX dataset.

Data Conclusion:Of many classifiers, the RUS‐boosted trees, the logistic regression, and the linear discriminant are best for predicting osteoporotic fracture. Both MRI and FRAX independently add value in identifying osteoporotic fractures. The femoral head, greater trochanter, and inter‐trochanter anatomical regions within the proximal femur yielded better F1‐scores for the best three classifiers.

Level of Evidence:2

Technical Efficacy:Stage 2

J. Magn. Reson. Imaging 2019;49:1029–1038.
Repeatability of Arterial Spin Labeling MRI in Measuring Blood Perfusion in the Human Eye
Authors: Khanal Safal , Turnbull Philip R.K. , Vaghefi Ehsan , Phillips John R.
Published: September 2018

Background

Quantifying blood perfusion in ocular tissues is challenging, partly because the majority of the blood is carried by the choroid, which is difficult to visualize because it is located between the retina and sclera.

Purpose/Hypothesis

To evaluate the intra‐ and interday repeatability of MRI measures of chorio‐retinal blood perfusion.

Study Type

Prospective, cross‐sectional, observational study.

Population

Twenty young healthy adults (six male, age: 25 ± 5 years) scanned twice within a single session repeated at the same time of day on 2 days.

Field Strength/Sequence

Arterial spin labeling (ASL) MRI at 3.0T using pseudocontinuous ASL (PCASL) labeling scheme and a 3D turbo‐gradient‐spin‐echo (TGSE) acquisition, including axial T2‐weighted structural images using a 2D turbo‐spin‐echo (TSE) sequence.

Assessments

Region‐of‐interest analysis for assessment of chorio‐retinal blood perfusion.

Statistical Tests

Intra‐ and interday repeatability of measures analyzed using intraclass correlation coefficients (ICC), Pearson's correlation analysis, paired t‐tests, and Bland–Altman plots.

Results

The mean chorio‐retinal perfusion was 77.86 (standard deviation [SD] = 29.80) ml/100ml/min. Perfusion measurements correlated strongly within a single session (r = 0.95, 95% confidence interval [CI] [0.880–0.980], P < 0.001) and between the two sessions based on a single run (r = 0.80 [0.582–0.913], P < 0.001), and two runs (r = 0.80 [0.479–0.918], P < 0.001). There were mean differences of 2.69 [16.85 to –22.23] ml/100ml/min for intraday measures, –7.44 [27.45 to –42.32] ml/100ml/min for single‐run interday measures, and 5.73 [28.71 to –40.17] ml/100ml/min for two‐run interday measures, but none were significant (all P > 0.05).

Data Conclusion

Quantitative ASL‐MRI measurements of chorio‐retinal blood perfusion showed high intra‐ and interday repeatability. The ASL‐MRI technique provides reliable measures of chorio‐retinal perfusion in vivo.

Level of Evidence: 1

Technical Efficacy Stage: 2

J. Magn. Reson. Imaging 2019;49:966–974.
Mumps outbreak investigation in Jaisalmer, Rajasthan, India, June‐September 2016
Authors: Moghe Chandrakant S , Goel Pramod , Singh Jalam , Nayak Naina Ram , Dhuria Meera , Jain Ruchi , Yadav Rajesh , Saroha Ekta , Sodha Samir V , Aggarwal C S , Venkatesh Srinivas
Published: September 2018

Mumps, a vaccine‐preventable disease, cause inflammation of salivary glands and may cause severe complications, such as encephalitis, meningitis, deafness, and orchitis/oophoritis. In India, mumps vaccine is not included in the universal immunization program and during 2009 to 2014, 72 outbreaks with greater than 1500 cases were reported. In August 2016, a suspected mumps outbreak was reported in Jaisalmer block, Rajasthan. We investigated to confirm the etiology, describe the epidemiology, and recommend prevention and control measures. We defined a case as swelling in the parotid region in a Jaisalmer block resident between 23 June 2016 and 10 September 2016. We searched for cases in health facilities and house‐to‐house in affected villages and hamlets. We tested blood samples of cases for mumps immunoglobulin M (IgM) enzyme‐linked immunosorbent assay (ELISA). We found 162 cases (60% males) with a median age of 9.4 years (range: 7 month‐38 years) and 65 (40%) were females. Symptoms included fever (70%) and bilateral swelling in neck (65%). None of them were vaccinated against mumps. Most (84%) cases were school‐going children (3‐16 years old). The overall attack rate was 2%. Village A, with two hamlets, had the highest attack rate (hamlet 1 = 13% and hamlet 2 = 12%). School A of village A, hamlet 1, which accommodated 200 children in two classrooms, had an attack rate of 55%. Of 18 blood samples from cases, 11 tested positive for mumps IgM ELISA. This was a confirmed mumps outbreak in Jaisalmer block that disproportionately affected school‐going children. We recommended continued surveillance, 5‐day absence from school, and vaccination.
Messy Play Therapy in the Treatment of Food Aversion in a Patient With Intestinal Failure: Our Experience
Authors: Chiatto Fabrizia , Coletta Riccardo , Aversano Andrea , Warburton Tracy , Forsythe Lynette , Morabito Antonino
Published: September 2018

Background

Food aversion (FA) is an eating behavior where children refuse solid or fluid intake. FA can compromise the weaning off parenteral nutrition (PN) in children with intestinal failure (IF), reducing their quality of life (QoL). Around 25% of children with IF experience FA, but few data are available on interventions to get over FA. Messy play therapy (MPT) uses sensory activities to provide another meaningful avenue for learning in children by creating a fun way to experience new textures. This study aims to assess the efficacy of MPT in FA.

Methods

Demographic data and MPT intervention were retrospectively recorded between 2004 and 2017. Food was categorized by tastes and textures. Data are expressed as median and interquartile range (25%–75%).

Results

Twelve children were identified. MPT was started at 9 (6–16) months with an enrolling time within the program of 10.11 (7.75–12.5) months. MPT was ended after 19.5 (16.75–28.5) months, and all patients achieved tolerance to oral diet. Significant improvement in savory (P = .001), sweet (P = .002), and mixed texture (P = .001) of food intake was reported. Better QoL and mealtimes with family were reported at median follow‐up of 39 (24–56) months.

Conclusions

MPT seems to be a positive intervention to overcome FA. In our experience, the children have gone from not tolerating any intake to tolerating an oral diet, which means enjoying their mealtimes. Further studies are needed to evaluate the effectiveness of MPT in a larger scale of patients.
Applicability of Standardized Early Fetal Heart Examination in the Obese Population
Authors: Asoglu Mehmet Resit , Yao Ruofan , Seger Lindsey , Turan Ozhan Mehmet , Turan Sifa
Published: September 2018

Objective

This study aimed to evaluate the impact of obesity on early evaluation of fetal cardiac landmarks using a standardized examination method at the time of nuchal translucency scan.

Methods

This was a cross‐sectional study of an ongoing prospective cohort at high risk for congenital heart defects. We used a standardized examination protocol using 2‐dimensional sonography with power Doppler in the evaluation of fetal cardiac landmarks consisting of 4‐chamber view, outflow tract relationship, and transverse arches view. The study population was stratified based on maternal body mass index into nonobese (<30 kg/m2) and obese (≥30 kg/m2). Groups were compared in terms of satisfactory evaluation of fetal cardiac landmarks, transvaginal sonography use, and scan times required for the evaluations. Subanalysis was performed by further categorizing obesity into nonmorbid obesity (30.0–39.9 kg/m2) and morbid obesity (≥40 kg/m2).

Results

A total of 190 patients were evaluated. Of these, 48.4% (n = 92) were obese. The most common indication for fetal cardiac assessment was maternal pregestational diabetes mellitus (42.6%). Transvaginal sonography was utilized in one nonobese woman (1.4%) and 11 obese women (12%) (P = .002). The satisfactory evaluation of 4‐chamber view, outflow tract relationship, transverse arches view, and all views were not significantly different between groups (P > .05). The scan time was about 5 minutes longer in the obese group compared with nonobese group (P = .020).

Conclusions

Obesity does not hamper early evaluation of fetal cardiac landmarks around the time of nuchal translucency scan. However, obese patients are more likely to require transvaginal examinations.
Experimental and quantum chemical investigations on the oxidative stability of sesame oil base stock with synthetic antioxidant additives
Authors: Sabarinath Sankaran Nair , Prabhakaran Nair Kumarapillai , Rajendrakumar Perikinalil Krishnan
Published: September 2018

Depleting resources and increasing environmental pollution caused by the petroleum products made researchers to think about its biodegradable counterparts. Vegetable oils due to its characteristics such as availability, renewability, eco‐friendliness, and biodegradability are progressively encouraged as a replacement for mineral oils in lubricant industry, while enhancement of few properties like the oxidative stability aids in the efficient use of them as the base stock. A generous amount of unsaturation in vegetable oils decreases oxidative stability and improves the pour point. Hence, a compromise between these two properties (pour point and oxidative stability) is critical in vegetable oil‐based lubricant. In this regard, sesame oil (SESO) possesses high pour point, and presence of natural antioxidants in it imparts superior oxidative stability than any other vegetable oils with a higher level of unsaturation. The addition of certain synthetic antioxidants to the SESO helps in the further improvisation of its oxidative stability to suit it for lubricant purpose. In the present work, the oxidative stability of SESO blended with octyl gallate (OG), salicyl hydroxamic acid, 2,5‐di‐tert‐butyl hydroquinone (DTBHQ), and tertbutyl hydroquinone (TBHQ) are assessed using hot oil oxidation test (HOOT) and differential scanning calorimetry (DSC, ASTM E2009‐08). The results are further compared with commercially available mineral oil‐based lubricant, SAE20W40. HOOT results show that a blend of SESO + 1.5%DTBHQ + 0.5%OG possesses higher oxidative stability than other antioxidant blends with SESO. In addition, from the DSC results, it is observed that the oxidative onset temperature (OOT) for abovementioned combination (268.10°C) shows an increase of 46.6% than the value of neat SESO (182.79°C) and is nearer to SAE20W40 (277.38°C). Fourier‐transform infrared spectroscopy results show that SESO + 1.5%DTBHQ + 0.5%OG combination subjected to HOOT hampers oxidation and hence increases the oxidative stability. The tribological properties of neat and antioxidant added SESO are studied using a four‐ball tester. Quantum chemical studies are also performed for antioxidant molecules on the basis of bond dissociation energies, ionisation potential, and HOMO‐LUMO energy gap to identify the dominant antioxidant mechanisms.
Evidences of the Effect of GO and rGO in PCL Membranes on the Differentiation and Maturation of Human Neural Progenitor Cells
Authors: Sánchez‐González Sandra , Diban Nazely , Bianchi Fabio , Ye Hua , Urtiaga Ane
Published: September 2018

The effect of doping graphene oxide (GO) and reduced graphene oxide (rGO) into poly(ε‐caprolactone) (PCL) membranes prepared by solvent induced phase separation is evaluated in terms of nanomaterial distribution and compatibility with neural stem cell growth and functional differentiation. Raman spectra analyses demonstrate the homogeneous distribution of GO on the membrane surface while rGO concentration increases gradually toward the center of the membrane thickness. This behavior is associated with electrostatic repulsion that PCL exerted toward the polar GO and its affinity for the non‐polar rGO. In vitro cell studies using human induced pluripotent cell derived neural progenitor cells (NPCs) show that rGO increases marker expression of NPCs differentiation with respect to GO (significantly to tissue culture plate (TCP)). Moreover, the distinctive nanomaterials distribution defines the cell‐to‐nanomaterial interaction on the PCL membranes: GO nanomaterials on the membrane surface favor higher number of active matured neurons, while PCL/rGO membranes present cells with significantly higher magnitude of neural activity compared to TCP and PCL/GO despite there being no direct contact of rGO with the cells on the membrane surface. Overall, this work evidences the important role of rGO electrical properties on the stimulation of neural cell electro‐activity on PCL membrane scaffolds.
Preparation of Poly(Bulky N‐Heterocyclic Carbene) as the Self‐Supporting Catalyst toward Suzuki–Miyaura Reaction
Authors: Peng Liangyi , Zhang Weiqiang , Deng Chunyan , Wang Zhen , Zhang Yingxue , Qian Hao
Published: September 2018

A novel self‐supporting palladium catalyst based on a polymer containing bulky N‐heterocyclic carbene [P(b‐NHC‐Pd)] is prepared successfully by a simple method, and its palladium content reaches 1.35 mmol g−1. Due to the bulky structure of NHC‐PdCl2‐3‐chloropyridine and high content of palladium active sites, this catalyst exhibits excellent catalytic activity for a wide variety of different substrates in Suzuki–Miyaura reaction in air atmosphere. Owing to its heterogeneous performance, the catalyst can be easily separated and reused. After six recycles, the catalytic activity decreases little. Hence, P(b‐NHC‐Pd) could be employed as a recoverable catalyst for cross‐coupling reactions.
Lawsuit aims to block implementation of ‘discriminatory’ final policy rule
Authors: Canady Valerie A.
Published: September 2018

Seven health, advocacy and consumer groups on Sept. 14 filed a lawsuit in federal court against the Trump administration to enforce Affordable Care Act (ACA) protections they say would be eroded if a planned final rule is implemented. The rule is unlawful, they said, and would not only weaken protections of individuals with pre‐existing conditions, but also erode past gains with parity.
NSDUH finds treatment gaps remain for consumers with MI
Authors: Canady Valerie A.
Published: September 2018

A new report by the Substance Abuse and Mental Health Services Administration (SAMHSA) finds that transitional‐age youth, ages 18 to 25, have increasing rates of serious mental illness, major depression and suicidality. Additionally, major gaps in treatment exist for individuals with mental health and substance use disorders.
Preparation of Polymer Microparticles through Nonaqueous Suspension Polycondensations. Part II—Effects of Operating Variables on Properties of Poly(butylene succinate)
Authors: Dutra Luciana , de Souza Márcio Nele , Pinto José Carlos
Published: September 2018

Poly(butylene succinate) (PBS) is a biodegradable polyester that finds many applications in the fields of personal care and cosmetics due to its excellent properties, such as the easy processibility, good thermal resistance, and adequate rates of degradation in aqueous media. For this reason, in the present work PBS microparticles are produced through nonaqueous suspension polycondensations at different operation conditions for the first time. Particularly, the present work investigates the effects of operation variables on particle size and molar mass distributions of the final products. The obtained results indicate that both time and temperature affect the final characteristics of the produced material, although temperature is the most influential variable. Besides, it is shown that particle size distributions are controlled by the rates of particle coalescence, with the increase of average particle diameters with the increase of stirring speed in the analyzed experimental range.
Validation of pressure drop assessment using 4D flow MRI‐based turbulence production in various shapes of aortic stenoses
Authors: Ha H , Kvitting JP , Dyverfeldt P , Ebbers T
Published: September 2018

Purpose

To validate pressure drop measurements using 4D flow MRI‐based turbulence production in various shapes of stenotic stenoses.

Methods

In vitro flow phantoms with seven different 3D‐printed aortic valve geometries were constructed and scanned with 4D flow MRI with six‐directional flow encoding (ICOSA6). The pressure drop through the valve was non‐invasively predicted based on the simplified Bernoulli, the extended Bernoulli, the turbulence production, and the shear‐scaling methods. Linear regression and agreement of the predictions with invasively measured pressure drop were analyzed.

Results

All pressure drop predictions using 4D Flow MRI were linearly correlated to the true pressure drop but resulted in different regression slopes. The regression slope and 95% limits of agreement for the simplified Bernoulli method were 1.35 and 11.99 ± 21.72 mm Hg. The regression slope and 95% limits of agreement for the extended Bernoulli method were 1.02 and 0.74 ± 8.48 mm Hg. The regression slope and 95% limits of agreement for the turbulence production method were 0.89 and 0.96 ± 8.01 mm Hg. The shear‐scaling method presented good correlation with an invasively measured pressure drop, but the regression slope varied between 0.36 and 1.00 depending on the shear‐scaling coefficient.

Conclusion

The pressure drop assessment based on the turbulence production method agrees well with the extended Bernoulli method and invasively measured pressure drop in various shapes of the aortic valve. Turbulence‐based pressure drop estimation can, as a complement to the conventional Bernoulli method, play a role in the assessment of valve diseases.
Zero‐gradient‐excitation ramped hybrid encoding (zGRF‐RHE) sodium MRI
Authors: Blunck Yasmin , Moffat Bradford A. , Kolbe Scott C. , Ordidge Roger J. , Cleary Jon O. , Johnston Leigh A.
Published: September 2018

Purpose

Fast bi‐exponential transverse signal decay compounds sodium image quality. This work aims at enhancing image characteristics using a special case of ramped hybrid encoding (RHE). Zero‐gradient‐excitation (zGRF)‐RHE provides (1) gradient‐free excitation for high flip angle, artifact‐free excitation profiles and (2) gradient ramping during dead‐time for the optimization of encoding time (tenc) to reduce T2* signal decay influence during acquisition.

Methods

Radial zGRF‐RHE and standard radial UTE were investigated over a range of receiver bandwidths in simulations, phantom and in vivo brain experiments. Central k‐space in zGRF‐RHE was acquired through single point measurements at the minimum achievable TE. T2* blurring artifacts and image SNR and CNR were assessed.

Results

zGRF ‐RHE enabled 90° flip angle artifact‐free excitation, whereas gradient pre‐ramping provided greater tenc efficiency for any readout bandwidths. Experiments confirmed simulation results, revealing sharper edge characteristics particularly at short readout durations (TRO). Significant SNR improvements of up to 4.8% were observed for longer TRO.

Conclusion

zGRF ‐RHE allows for artifact‐free high flip angle excitation with time‐efficient encoding improving on image characteristics. This hybrid encoding concept with gradient pre‐ramping is trajectory independent and can be introduced in any center‐out UTE trajectory design.
Wave‐LORAKS: Combining wave encoding with structured low‐rank matrix modeling for more highly accelerated 3D imaging
Authors: Kim Tae Hyung , Bilgic Berkin , Polak Daniel , Setsompop Kawin , Haldar Justin P.
Published: September 2018

Purpose

Wave‐CAIPI is a novel acquisition approach that enables highly accelerated 3D imaging. This paper investigates the combination of Wave‐CAIPI with LORAKS‐based reconstruction (Wave‐LORAKS) to enable even further acceleration.

Methods

LORAKS is a constrained image reconstruction framework that can impose spatial support, smooth phase, sparsity, and/or parallel imaging constraints. LORAKS requires minimal prior information, and instead uses the low‐rank subspace structure of the raw data to automatically learn which constraints to impose and how to impose them. Previous LORAKS implementations addressed 2D image reconstruction problems. In this work, several recent advances in structured low‐rank matrix recovery were combined to enable large‐scale 3D Wave‐LORAKS reconstruction with improved quality and computational efficiency. Wave‐LORAKS was investigated by retrospective subsampling of two fully sampled Wave‐encoded 3D MPRAGE datasets, and comparisons were made against existing Wave reconstruction approaches.

Results

Results show that Wave‐LORAKS can yield higher reconstruction quality with 16×‐accelerated data than is obtained by traditional Wave‐CAIPI with 9×‐accerated data.

Conclusions

There are strong synergies between Wave encoding and LORAKS, which enables Wave‐LORAKS to achieve higher acceleration and more flexible sampling compared to Wave‐CAIPI.
Body Composition with Dual‐Energy X‐Ray Absorptiometry and Bioelectrical Impedance Analysis in Breast Cancer Survivors
Authors: Lee Kyuwan , Sami Nathalie , Sweeney Frank C. , Dieli‐Conwright Christina M.
Published: September 2018

Background

Because obesity is an independent risk factor for breast cancer recurrence, assessment of body composition is crucial to guide weight management in breast cancer survivors (BCS). This study assessed whether dual‐energy x‐ray absorptiometry (DXA) and bioelectrical impedance analysis (BIA) yield similar results for body composition in BCS.

Methods

Body fat percentage, lean body mass, and fat mass were estimated using DXA and BIA under fasting conditions in 89 BCS. BMI categories included normal (18–24.99 kg/m2; n = 28), overweight (25.0–29.9 kg/m2; n = 21), obese (>30 kg/m2; n = 23), and severely obese BCS (>35 kg/m2; n = 17). Agreement between the devices was assessed by Bland–Altman analysis.

Results

There was no agreement between the 2 devices for body fat percentage (DXA: 44.2 ± 6.2% vs BIA: 40.4 ± 7.8%), lean body mass (DXA: 39.1 ± 7.6 kg vs BIA: 42.9 ± 5.9 kg), and fat mass (DXA: 32.4 ± 10.8 kg vs BIA: 30.6 ± 11.0 kg; P < .001). These findings were consistent in normal, overweight, and obese BCS. There was agreement between the 2 devices for fat mass (DXA: 48.7 ± 7.2 kg vs BIA: 47.9 ± 5.7 kg) in severely obese BCS (P = .102), possibly due to small sample size.

Conclusions

BIA may underestimate body fat percentage and fat mass and overestimate lean body mass, compared with DXA. Future studies are warranted to assess the use of these 2 devices in a larger cohort of BCS within BMI categories.
Long‐Term Nasogastric Versus Percutaneous Endoscopic Gastrostomy Tube Feeding in Older Asians With Dysphagia: A Pragmatic Study
Authors: Jaafar Mohamad Hasif , Mahadeva Sanjiv , Tan Kit Mun , Chin Ai‐Vyrn , Kamaruzzaman Shahrul B. , Khor Hui Min , Saedon Nor Izzati , Tan Maw Pin
Published: September 2018

Background

A barrier to gastrostomy feeding exists among Asian clinicians and caregivers due to negative perceptions regarding complications. We compared clinical and nutrition outcomes in older dysphagic Asian patients with nasogastric (NG) or gastrostomy tube feeding using a pragmatic study design.

Methods

The choice of enteral tube access was determined by managing clinicians and patients/caregivers. Comparisons of tube feeding methods were made during a 4‐month period, adjusting statistically for inherent confounders.

Results

A total of 102 participants (NG: n = 52, gastrostomy: n = 50) were recruited over 2 years from 2013 to 2015. Subjects on long‐term NG tube feeding were older (82.67 ± 7.15 years vs 76.88 ± 7.37 years; P < .001) but both groups had similar clinical indications (stroke: 63.5% NG vs 54% gastrostomy; P = .33). After adjustment for confounders, gastrostomy feeding was associated with fewer tube‐related complications (adjusted odds ratio [aOR] = 0.19; 95% confidence interval [CI] = 0.06–0.60) and better complication‐free survival rate (aOR = 0.32; 95% CI = 0.12–0.89) at 4‐month follow‐up. Anthropometric and biochemical nutrition parameters improved significantly in both groups at 4 months, but no significant differences were observed at the end of the study.

Conclusion

Gastrostomy feeding is associated with a greater 4‐month complication‐free survival and lower tube‐related complications compared with long‐term NG feeding in older Asians with dysphagia. However, no differences in nutrition outcomes were observed between NG and gastrostomy feeding at 4 months.