bluuebunny/crossref_metadata_2025 huggingface dataset:
Safety and efficacy of orally administered telmisartan for the treatment of systemic hypertension in cats: Results of a double‐blind, placebo‐controlled, randomized clinical trial
Authors: Coleman Amanda E. , Brown Scott A. , Traas Anne M. , Bryson Lawrence , Zimmering Tanja , Zimmerman Alicia
Published: March 2019

Background

Information regarding the efficacy of telmisartan for feline systemic arterial hypertension is limited.

Objectives

To evaluate the safety and efficacy of PO administered telmisartan solution in hypertensive cats.

Animals

Client‐owned cats with indirect systolic arterial blood pressure (SBP) of 160‐200 mm Hg, based on multiple measurements.

Methods

This multicenter trial consisted a 28‐day, prospective, randomized, double‐blind, placebo‐controlled, parallel group, efficacy phase and a 154‐day extended‐use telmisartan phase. Hypertensive cats were randomly assigned to receive 1.5 mg telmisartan/kg PO q12h for 14 days, followed by 2 mg telmisartan/kg PO q24h, or equivalent volume of placebo. Systolic blood pressure was measured on days 0, 14, and 28. Change in SBP compared to baseline was calculated for days 14 and 28. Telmisartan efficacy was defined as significant decrease in SBP at day 14 compared to placebo and a clinically relevant (>20 mm Hg) decrease in SBP at day 28.

Results

Two‐hundred twenty‐one cats were included. On day 14, least squares mean (95% confidence interval) SBP decrease was significantly larger in telmisartan‐treated (−23.3 mm Hg [−28.2 to −18.3]) versus placebo‐treated (−7.5 mm Hg [−13.6 to −1.5]) cats (P = .0005). On day 28, telmisartan treatment resulted in a clinically relevant SBP decrease (−23.9 mm Hg [−27.8 to −20.0]), whereas placebo did not (−11.6 mm Hg [−17.4 to −5.9 mm Hg]). The decrease in SBP persisted over the 6‐month trial in telmisartan‐treated cats.

Conclusions and Clinical Importance

Telmisartan significantly decreased SBP to a clinically relevant extent and was well tolerated in hypertensive cats.
Vitamin D metabolism in dogs with and without hypercalciuric calcium oxalate urolithiasis
Authors: Groth Elizabeth M. , Lulich Jody P. , Chew Dennis J. , Parker Valerie J. , Furrow Eva
Published: March 2019

Background

There are abnormalities in vitamin D metabolism in people with calcium nephrolithiasis, but limited data are available on vitamin D status in dogs with calcium oxalate (CaOx) urolithiasis.

Objective

To compare serum concentrations of vitamin D metabolites in dogs with and without hypercalciuric CaOx urolithiasis.

Animals

Thirty‐eight dogs with (n = 19) and without (n = 19) a history of CaOx urolithiasis and hypercalciuria.

Methods

Retrospective cross‐sectional study. Serum 25‐hydroxyvitamin D [25(OH)D], 1,25‐dihydroxyvitamin D [1,25(OH)2D], and 24,25‐dihydroxyvitamin D [24,25(OH)2D] were measured. The ratios of 25(OH)D/24,25(OH)2D and 1,25(OH)2D/25(OH)D were compared between cases and controls.

Results

There were no significant differences between cases and controls when comparing 25(OH)D, 24,25(OH)2D, 1,25(OH)2D, or 1,25(OH)2D/25(OH)D. Cases had higher 25(OH)D/24,25(OH)2D (median = 1.40, range = 0.98‐1.58) compared to controls (median = 1.16, range = 0.92‐2.75;P = .01). There was overlap in the ranges for 25(OH)D/24,25(OH)2D between cases and controls, but 6 cases (32%) had ratios above the control dog range. There was a moderate positive correlation between the ratio of 25(OH)D/24,25(OH)2D and urinary calcium‐to‐creatinine ratios (r = 0.40, 95% confidence interval = 0.10‐0.64;P = .01).

Conclusions and Clinical Importance

These data suggest that decreased conversion of 25(OH)D to 24,25(OH)2D occurs in a subset of dogs with CaOx urolithiasis. Abnormalities in vitamin D metabolism might contribute to stone risk in dogs.
Cholangiocarcinoma: Epidemiology and risk factors
Authors: Khan Shahid A. , Tavolari Simona , Brandi Giovanni
Published: March 2019

Cholangiocarcinoma (CCA) is a heterogeneous disease arising from a complex interaction between host‐specific genetic background and multiple risk factors. Globally, CCA incidence rates exhibit geographical variation, with much higher incidence in parts of the Eastern world compared to the West. These differences are likely to reflect differences in geographical risk factors as well as genetic determinants. Of note, over the past few decades, the incidence rates of CCA appear to change and subtypes of CCA appear to show distinct epidemiological trends. These trends need to be interpreted with caution given the issues of diagnosis, recording and coding of subtypes of CCA. Epidemiological evidences suggest that in general population some risk factors are less frequent but associated with a higher CCA risk, while others are more common but associated with a lower risk. Moreover, while some risk factors are shared by intrahepatic and both extrahepatic forms, others seem more specific for one of the two forms. Currently some pathological conditions have been clearly associated with CCA development, and other conditions are emerging; however, while their impact in increasing CCA risk as single etiological factors has been provided in many studies, less is known when two or more risk factors co‐occur in the same patient. Moreover, despite the advancements in the knowledge of CCA aetiology, in Western countries about 50% of cases are still diagnosed without any identifiable risk factor. It is therefore conceivable that other still undefined etiologic factors are responsible for the recent increase of CCA (especially iCCA) incidence worldwide.
Evaluating the association of serum ferritin and hepatic iron with disease severity in non‐alcoholic fatty liver disease
Authors: Buzzetti Elena , Petta Salvatore , Manuguerra Roberta , Luong Tu Vinh , Cabibi Daniela , Corradini Elena , Craxì Antonio , Pinzani Massimo , Tsochatzis Emmanuel , Pietrangelo Antonello
Published: March 2019

Background & Aims

Hyperferritinemia, with or without increased hepatic iron, represents a common finding in non‐alcoholic fatty liver disease (NAFLD). However, it is unclear whether it reflects hepatic inflammation or true iron‐overload and, in case the latter is confirmed, whether this influences disease progression. We therefore explored the association between serum ferritin, degree and pattern of hepatic iron deposition and liver disease severity in patients with NAFLD.

Methods

We selected 468 patients with biopsy‐proven NAFLD from 2 European centres. Iron, hepatic and metabolic parameters were collected at the time of liver biopsy. Iron deposits in hepatocytes and reticuloendothelial cells were assessed and graded. Diagnosis of non‐alcoholic steatohepatitis (NASH) and fibrosis staging were performed.

Results

A total of 122 (26%) patients had hyperferritinemia, whereas stainable hepatic iron was found in 116 (25%) patients (38% predominantly in hepatocytes, 20% in reticuloendothelial cells and 42% in both). Subjects with stainable hepatic iron, particularly those with a mixed pattern, had higher serum ferritin and transaminases but only a mixed pattern of iron deposition was among the variables significantly associated with presence of NASH. Serum ferritin was not associated with presence of NASH, however it increased with worsening fibrosis stage (F3 compared to F0‐F1), and significantly decreased in stage F4.

Conclusions

A mixed pattern of hepatic iron deposition is associated with the presence of steatohepatitis, while serum ferritin increases with worsening fibrosis up to pre‐cirrhotic stage. In individual NAFLD patients, serum ferritin could be evaluated as part of non‐invasive diagnostic panels but not on its own.
Localized pressure stimulation using turf‐like structures can improve skin perfusion in the foot
Authors: Behforootan Sara , Chatzistergos Panagiotis E. , Chockalingam Nachiappan , Healy Aoife , Naemi Roozbeh
Published: March 2019

Objective

Improving perfusion under the skin can potentially reduce ulceration and amputation risk in people with diabetic foot. Localized pressure stimulation has been proven capable of improving skin perfusion in the scalp but its effectiveness for the foot has not been tested. In this study, localized pressure stimulation was realized using flexible turf‐like structures (TLS) with dense vertical fibers and their ability to increase perfusion was assessed.

Methods

The skin in the rearfoot, midfoot, and forefoot of nine healthy volunteers was stimulated using two TLS with different stiffness and one wound filler material that generated a uniform compression. Changes in perfusion were assessed using laser speckle.

Results

Mechanical stimulation significantly increased perfusion in the forefoot and midfoot areas with the TLS achieving higher and more long‐lasting increase compared to the wound filler. The stiffer of the two TLS appeared to be the most effective for the forefoot achieving a significant increase in perfusion that lasted for 25.5 seconds immediately after stimulation.

Conclusion

The results of this study indicate that localized pressure stimulation is more effective compared to uniform compression for improving skin perfusion in the healthy foot. Further research in people with diabetic foot disease is needed to verify the clinical value of the observed effect.
Real‐world use—Isavuconazole at a large academic medical center
Authors: Hassouna Habiba , Athans Vasilios , Brizendine Kyle D.
Published: March 2019

Background

Isavuconazole use in the real‐world setting has not been extensively described. Subgroups of patients with particular prognostic significance, such as previous triazole prophylaxis or treatment and the important subgroup treated empirically for invasive fungal infection, have beforehand been excluded from trials.

Objectives

We aimed to determine treatment response and safety in these patients at a large US transplant and cancer centre.

Patients/Methods

We conducted a retrospective cohort study of all adult inpatients administered ≥3 doses of isavuconazole between June 2015 and October 2017.

Results

Ninety‐one adults were identified. Six (7%) received primary prophylaxis, 10 (11%) treatment then secondary prophylaxis and 75 (82%) treatment only. Overall treatment response was 62%. Six‐week mortality was 24%. Sixty‐three per cent of 32 patients treated with isavuconaozle following prophylaxis with another antifungal agent exhibited a treatment response. Among 49 patients switched from treatment with another agent, 53% had a treatment response. Thirty‐four patients received isavuconazole empirically, and 65% demonstrated a treatment response. Individuals given isavuconazole prophylaxis developed no breakthrough invasive fungal infections. One patient discontinued isavuconazole due to hepatotoxicity.

Conclusions

Real‐world isavuconazole use appears safe and is associated with treatment responses in varied patients including critically important subgroups previously unreported.
‘At the crossroads towards polyploidy’: genomic divergence and extent of homoploid hybridization are drivers for the formation of the ox‐eye daisy polyploid complex (Leucanthemum, Compositae‐Anthemideae)
Authors: Wagner Florian , Ott Tankred , Zimmer Claudia , Reichhart Verena , Vogt Robert , Oberprieler Christoph
Published: March 2019

Polyploidy plays a paramount role in phytodiversity, but the causes of this evolutionary pathway require further study. Here, we use phylogenetic methods to examine possible polyploidy‐promoting factors by comparing diploid representatives of the comprehensive European polyploid complex Leucanthemum with members of its strictly diploid North African counterpart Rhodanthemum.

We investigate genetic divergence and gene flow among all diploid lineages of both genera to evaluate the role of genomic differentiation and hybridization for polyploid speciation. To test whether hybridization in Leucanthemum has been triggered by the geological conditions during its diversification, we additionally generate a time‐calibrated phylogeny of 46 species of the subtribe Leucantheminae.

Leucanthemum shows a significantly higher genetic divergence and hybridization signal among diploid lineages compared with Rhodanthemum, in spite of a similar crown age and diversification pattern during the Quaternary.

Our study demonstrates the importance of genetic differentiation among diploid progenitors and their concurrent affinity for natural hybridization for the formation of a polyploid complex. Furthermore, the role of climate‐induced range overlaps on hybridization and polyploid speciation during the Quaternary is discussed.
Oral levodopa rescues retinal morphology and visual function in a murine model of human albinism
Authors: Lee Helena , Scott Jennifer , Griffiths Helen , Self Jay E. , Lotery Andrew
Published: March 2019

Albinism is a group of disorders characterized by pigment deficiency and abnormal retinal development. Despite being a common cause for visual impairment worldwide, there is a paucity of treatments and patients typically suffer lifelong visual disability. Residual plasticity of the developing retina in young children with albinism has been demonstrated, suggesting a post‐natal window for therapeutic rescue. L‐3, 4 dihydroxyphenylalanine (L‐DOPA), a key signalling molecule which is essential for normal retinal development, is known to be deficient in albinism. In this study, we demonstrate for the first time that post‐natal L‐DOPA supplementation can rescue retinal development, morphology and visual function in a murine model of human albinism, but only if administered from birth or 15 days post‐natal age.
Putrescine alleviates aluminum toxicity in rice (Oryza sativa) by reducing cell wall Al contents in an ethylene‐dependent manner
Authors: Zhu Chun Quan , Cao Xiao Chuang , Bai Zhi Gang , Zhu Lian Feng , Hu Wen Jun , Hu An Yong , Abliz Buhailiqem , Zhong Chu , Liang Qing Duo , Huang Jie , Zhang Jun Hua , Jin Qian Yu
Published: March 2019

Aluminum (Al3+) toxicity in acidic soils limits crop productivity worldwide. In this study, we found that putrescine (PUT) significantly alleviates Al toxicity in rice roots. The addition of 0.1 mM PUT promoted root elongation and reduced the Al content in the root apices of Nipponbare (Nip) and Kasalath (Kas) rice under Al toxicity conditions. Exogenous treatment with PUT reduced the cell wall Al content by reducing polysaccharide (pectin and hemicellulose) levels and pectin methylesterase (PME) activity in roots and decreased the translocation of Al from the external environment to the cytoplasm by downregulating the expression of OsNRAT1, which responsible to encode an Al transporter protein Nrat1 (Nramp aluminum transporter 1). The addition of PUT under Al toxicity conditions significantly inhibited ethylene emissions and suppressed the expression of genes involved in ethylene biosynthesis. Treatment with the ethylene precursor 1‐aminocylopropane‐1‐carboxylic acid (ACC) significantly improved ethylene emission, inhibited root elongation, increased the Al accumulation in root tips and the root cell wall, and increased cell wall pectin and hemicellulose contents in both rice cultivars under Al toxicity conditions. The ethylene biosynthesis antagonist aminoethoxyvinylglycine (AVG, inhibitor of the ACC synthase) had the opposite effect and reduced PME activity. Together, our results show that PUT decreases the cell wall Al contents by suppressing ethylene emissions and decreases the symplastic Al levels by downregulating OsNRAT1 in rice.
Robust Causal Structure Learning with Some Hidden Variables
Authors: Frot Benjamin , Nandy Preetam , Maathuis Marloes H.
Published: March 2019

We introduce a new method to estimate the Markov equivalence class of a directed acyclic graph (DAG) in the presence of hidden variables, in settings where the underlying DAG among the observed variables is sparse, and there are a few hidden variables that have a direct effect on many of the observed variables. Building on the so-called low rank plus sparse framework, we suggest a two-stage approach which first removes the effect of the hidden variables and then estimates the Markov equivalence class of the underlying DAG under the assumption that there are no remaining hidden variables. This approach is consistent in certain high dimensional regimes and performs favourably when compared with the state of the art, in terms of both graphical structure recovery and total causal effect estimation.
Sedimentary architecture of an ancient linear megadune (Barremian, Neuquén Basin): Insights into the long‐term development and evolution of aeolian linear bedforms
Authors: Argüello Scotti Agustín , Veiga Gonzalo D.
Published: March 2019

Linear aeolian bedforms are the most abundant bedform type in Earth's dune fields, and are very common in the Solar System. Despite their abundance, the long‐term development of these bedforms and its impact upon the resulting sedimentary architecture in the geological record is still poorly understood. The aim of this paper is to study the exposed record of an ancient linear megadune in order to discuss its development and the factors that impact the sedimentary architecture of aeolian linear bedforms. The outcrops of the ancient Troncoso Sand Sea (Barremian, Neuquén Basin, Argentina) provide a unique opportunity to study a preserved megadune record with an external body geometry that confirms its linear morphology. Architectural analysis reveals significant differences in cross‐stratified set bodies and bounding surfaces’ features and allows for the identification of three architectural complexes within the bedform's record. Analysis of deterministic models, sedimentary body relative chronology and distribution suggest that these architectural complexes result from distinctive phases in bedform development. It also clearly shows that construction of the megadune was achieved by expansion from a core, and that its development was characterized by sustained growth and strong longitudinal dynamics, without net accumulation. This study indicates how sustained bedform growth, rather than accretion, can be a critical factor conditioning linear bedform architecture towards a more ‘classic’ (bimodal bounding surface and cross‐bedding dip directions) concentric sedimentary architecture style. Furthermore, this research reveals how this style of architecture could only be relatively common in the geological record when related to bedform topography preservation.
Along‐strike consistency of an extensional detachment system, West Cyclades, Greece
Authors: Coleman Mark , Dubosq Renelle , Schneider David A. , Grasemann Bernhard , Soukis Konstantinos
Published: March 2019

The Lavrion district of the Attica Peninsula, Greece, exposes the West Cycladic Detachment System (WCDS), a low‐angle crustal‐scale extensional fault system separating tectonostratigraphic units of the Cycladic Blueschist Unit. New multiple single‐grain fusion and step‐heated white mica 40Ar/39Ar ages integrated with existing (U–Th)/He ages and independent paleothermometry resolves a syn‐ to post‐orogenic deformation history. A structurally higher unit records Oligocene greenschist facies deformation that evolved into brittle conditions by the middle Miocene, and shares a similar history to Serifos at the southern end of the detachment system. The structurally lowest unit remained ductile until the late Miocene, preserving pervasive post‐orogenic structures, similar to along‐strike structures at the centre, deepest part of the fault. The similarities of structural styles and the timing of deformation across > 150 km of strike length of the detachment system indicates tens of kilometers of offset and extraordinary potential for correlating observations along Cycladic‐style detachment systems.
FDG‐PET/MRI imaging for the management of alveolar echinococcosis: initial clinical experience at a reference centre in Austria
Authors: Lötsch Felix , Waneck Fredrik , Groger Mirjam , Auer Herbert , Kaczirek Klaus , Rausch Ivo , Wadsak Wolfgang , Hacker Marcus , Lagler Heimo , Ramharter Michael , Karanikas Georgios
Published: March 2019

Background

[18F]‐2‐fluoro‐2‐deoxy‐D‐glucose (18F‐FDG) positron emission tomography/computed tomography (FDG‐PET/CT) imaging provides important information about the size and metabolic activity of lesions caused by Echinococcus multilocularis and is therefore recommended for the initial assessment and follow‐up of human alveolar echinococcosis (AE). The introduction of positron emission tomography/magnetic resonance imaging (PET/MRI) into clinical practice in affluent health care systems provides an alternative dual imaging modality, which has not yet been evaluated for AE.

Objective

Here, we describe the initial clinical experience with comparative PET/CT and PET/MR imaging in four human AE patients at an Austrian reference centre.

Results

PET/MR imaging showed comparable diagnostic capacity for liver lesions attributable to E. multilocularis infection, with a discrepancy only in the assessment of calcifications in one patient. Effective doses of radiation were 30.4–31 mSV for PET/CT, which were reduced in PET/MRI to the exposure of 18F‐FDG only (4.9–5.5 mSv).

Conclusions

PET/MRI provides comparable diagnostic information for AE management. The reduction in radiation exposure compared to PET/CT may be of particular importance for children and young patients not amenable for curative surgery requiring repeated long‐term follow‐up with dual imaging modalities. Further studies are warranted to prospectively evaluate the potential of PET/MRI in the management of AE.
Haptoglobin phenotypes with weak antioxidant capacity increase risk factors of cardiovascular disease in Ghanaian HIV‐infected patients on highly active antiretroviral therapy
Authors: Tagoe Emmanuel Ayitey , Tagoe Ishmael Nii Ayibontey , Kuleape Joshua Agbemefa , Puplampu Peter , Amanquah Seth , Asare‐Anane Henry , Quaye Osbourne
Published: March 2019

Objective

Highly active antiretroviral therapy (HAART) has considerably reduced HIV/AIDS‐related morbidity and mortality; however, the therapy has been associated with the development of cardiovascular disease (CVD), and genetic predisposition factors may aggravate disease outcome. This study was aimed at investigating the relationship between haptoglobin phenotypes and risk factors of CVD in HIV patients.

Methods

A total of 105 HIV sero‐positive patients on HAART and 75 HIV‐infected HAART‐naïve individuals were enrolled in the study. Socio‐demographics and clinical characteristics of the participants were obtained using a well‐structured questionnaire. Lipid profile, lactate dehydrogenase (LDH) and haptoglobin (Hp) phenotypes were analysed from serum whiles haemoglobin (Hb) level, CD4+ cell count and HIV viral RNA load were determined using whole blood.

Results

Atherogenic index of plasma (AIP) was significantly higher in patients on HAART than the naïve group (P < 0.05). Age, BMI, visceral fat, systolic blood pressure LDH and lipid variables strongly and positively correlated with AIP (P < 0.05), with the exception of HDL‐c (P < 0.001) which showed a negative correlation. HAART was associated with hypertension (χ2 = 4.33, P = 0.037), hypercholesterolaemia (χ2 = 10.99, P < 0.001), elevated LDL‐c (χ2 = 10.30, P < 0.001) and decreased HDL‐c (χ2 = 3.87, P = 0.09). Hp2‐2 and Hp0 collectively was strongly associated with hypertension (OR = 2.54, P = 0.011), obesity (OR = 5.97, P < 0.001) and hypercholesterolaemia (OR = 2.99, P < 0.001).

Conclusion

HIV/AIDS patients on HAART expressing Hp phenotypes with weak antioxidant capacity have an increased risk of developing CVD.
Survey of surgical specialists’ content preferences in radiology reports for extrahepatic portosystemic shunts
Authors: Plested Mark J. , Drees Randi
Published: March 2019

The aim of this prospective, survey study was to assess the opinions of specialist surgeons as to the preferred content, nomenclature, and classification of extrahepatic portosystemic shunts for inclusion in radiology reports. A link to an online survey was sent by email to members of the European College of Veterinary Surgeons and the Association of Veterinary Soft Tissue Surgeons, and was made available on the American College of Veterinary Surgeons web forum and Facebook page. There were 93 respondents (survey sent to over 2500 email addresses and made available in two online locations). Most respondents agreed that they both review the images themselves (87/92, 95%) and read the radiology report (82/92, 89%) prior to surgery. Most respondents believed that the radiology report should contain a detailed anatomic description of the insertion (83/92, 90%), origin (54/91, 59%), and course (70/92, 76%) of the shunt, as well as a measure of the diameter of the shunting vessel at its insertion (54/92, 59%). Most respondents (70/90, 78%) disagreed that a brief description of shunt type, such as portocaval or portophrenic, was sufficient. Respondents were undecided regarding the use of an alphanumeric classification system (36/92, 39% agree; 32/92, 35% disagree). There was agreement that details of the presence or absence of urolithiasis (91/93, 98%), renomegaly (54/93, 58%), and peritoneal fluid (72/92, 78%) should be included in the report. The results of this study will help to guide reporting radiologists in providing descriptions of extrahepatic portosystemic shunts that include information most preferred by the recipient surgeons.
Oxy-Combustion Modeling for Direct-Fired Supercritical CO2 Power Cycles
Authors: Strakey Peter A.
Published: March 2019

Supercritical CO2 power cycles for fossil energy power generation will likely employ oxy-combustion at very high pressures, possibly exceeding 300 bar. At these high pressures, a direct fired oxy-combustor is more likely to behave like a rocket engine than any type of conventional gas turbine combustor. Issues such as injector design, wall heat transfer, and combustion dynamics may play a challenging role in combustor design. Computational fluid dynamics modeling will not only be useful, but may be a necessity in the combustor design process. To accurately model turbulent reacting flows, combustion submodels appropriate for the conditions of interest as defined by the turbulent time and length scales as well as chemical kinetic time scales are necessary. This paper presents a comparison of various turbulence–chemistry interaction (TCI) modeling approaches on a canonical, single injector, direct-fired sCO2 combustor. Large eddy simulation is used to model the turbulent combustion process with varying levels of injector oxygen concentration while comparing the effect of the combustion submodel on CO emissions and flame shape. While experimental data are not yet available to validate the simulations, the sensitivity of CO production and flame shape can be studied as a function of combustion modeling approach and oxygen concentration in an effort to better understand how to approach combustion modeling at these unique conditions.
Influence of Copper Oxide on Femtosecond Laser Surface Processed Copper Pool Boiling Heat Transfer Surfaces
Authors: Kruse Corey , Tsubaki Alfred , Zuhlke Craig , Alexander Dennis , Anderson Mark , Peng Edwin , Shield Jeff , Ndao Sidy , Gogos George
Published: March 2019

Pool boiling heat transfer with the use of femtosecond laser surface processing (FLSP) on copper surfaces has been studied. FLSP creates a self-organized micro/nanostructured surface. In the previous pool boiling heat transfer studies with stainless steel FLSP surfaces, enhancements in critical heat flux (CHF) and heat transfer coefficients (HTCs) were observed compared to the polished reference surface. However, this study shows that copper FLSP surfaces exhibit reductions in both CHF and HTCs consistently. This reduction in heat transfer performance is a result of an oxide layer that covers the surface of the microstructures and acts as an insulator due to its low thermal conductivity. The oxide layer was observed and measured with the use of a focused ion beam milling process and found to have thickness of a few microns. The thickness of this oxide layer was found to be related to the laser fluence parameter. As the fluence increased, the oxide layer thickness increased and the heat transfer performance decreased. For a specific test surface, the oxide layer was selectively removed by a chemical etching process. The removal of the oxide layer resulted in an enhancement in the HTC compared to the polished reference surface. Although the original FLSP copper surfaces were unable to outperform the polished reference curve, this experiment illustrates how an oxide layer can significantly affect heat transfer results and dominate other surface characteristics (such as increased surface area and wicking) that typically lead to heat transfer enhancement.
Matched transaural synthesis with probe microphones for psychoacoustical experiments
Authors: Shore Aimee , Tropiano Anthony J. , Hartmann William M.
Published: March 2019

Transaural synthesis using loudspeaker signals determined through contemporaneous ear canal calibration is proposed as an alternative to headphone presentation for critical psychoacoustical experiments. The proposed technique can afford greater accuracy, improved reproducibility, and continuous signal monitoring. It allows the experimenter to compare listener responses to real and virtual presentations. In this article, the advantages of transaural (three or four loudspeakers) compared to crosstalk cancellation (two loudspeakers) are shown through computer modeling and manikin measurements in a moderately reverberant room. Measurements employ binaurally challenging signals and speech from a distant source. Transaural synthesis is shown to be a better solution to the essential inverse problem resulting in reduced average synthesis amplitudes, fewer large-amplitude outliers, improved amplitude and phase accuracy for real and imagined sources, and improved noise immunity. Immunity to inadvertent listener head rotation depends sensitively on loudspeaker placement and is not an advantage in general. Appendixes review the relevant mathematical foundation and extend it to the relationship between ear canal signals and eardrum signals.
Nanoscale Lamb wave–driven motors in nonliquid environments
Authors: Lu Jinsheng , Li Qiang , Qiu Cheng-Wei , Hong Yu , Ghosh Pintu , Qiu Min
Published: March 2019

A nanoscale rotary motor driven by optically excited Lamb wave working in air or vacuum is achieved.
Topological materials discovery by large-order symmetry indicators
Authors: Tang Feng , Po Hoi Chun , Vishwanath Ashvin , Wan Xiangang
Published: March 2019

A modern algorithm discovers many topological materials with large-order symmetry indicators in a single sweep.
Bilateral alkylamine for suppressing charge recombination and improving stability in blade-coated perovskite solar cells
Authors: Wu Wu-Qiang , Yang Zhibin , Rudd Peter N. , Shao Yuchuan , Dai Xuezeng , Wei Haotong , Zhao Jingjing , Fang Yanjun , Wang Qi , Liu Ye , Deng Yehao , Xiao Xun , Feng Yuanxiang , Huang Jinsong
Published: March 2019

Anchoring monolayer bilateral amines on perovskite passivates surface defects, reinforces grain boundaries, and enhances stability.
Macrocyclization of peptidoarylacetamides with self-assembly properties through late-stage palladium-catalyzed C(sp
2
)▬H olefination
Authors: Tan Jiantao , Wu Jie , Liu Shu , Yao Hequan , Wang Huan
Published: March 2019

Pd-catalyzed late-stage C(sp
2
)▬H activation allows the generation of self-assembling cyclic peptides.
Wireless, battery-free optoelectronic systems as subdermal implants for local tissue oximetry
Authors: Zhang Hao , Gutruf Philipp , Meacham Kathleen , Montana Michael C. , Zhao Xingyue , Chiarelli Antonio M. , Vázquez-Guardado Abraham , Norris Aaron , Lu Luyao , Guo Qinglei , Xu Chenkai , Wu Yixin , Zhao Hangbo , Ning Xin , Bai Wubin , Kandela Irawati , Haney Chad R. , Chanda Debashis , Gereau Robert W. , Rogers John A.
Published: March 2019

Wireless, battery-free optoelectronic systems enable localized tissue oximetry in tether-free, awake animal models.
Beyond Piperacillin-Tazobactam: Cefepime and AAI101 as a Potent β-Lactam−β-Lactamase Inhibitor Combination
Authors: Papp-Wallace Krisztina M. , Bethel Christopher R. , Caillon Jocelyne , Barnes Melissa D. , Potel Gilles , Bajaksouzian Saralee , Rutter Joseph D. , Reghal Amokrane , Shapiro Stuart , Taracila Magdalena A. , Jacobs Michael R. , Bonomo Robert A. , Jacqueline Cédric
Published: March 2019

Impeding, as well as reducing, the burden of antimicrobial resistance in Gram-negative pathogens is an urgent public health endeavor. Our current antibiotic armamentarium is dwindling, while major resistance determinants (e.g., extended-spectrum β-lactamases [ESBLs]) continue to evolve and disseminate around the world.
High Genetic Potential for Proteolytic Decomposition in Northern Peatland Ecosystems
Authors: Graham Emily B. , Yang Fan , Bell Sheryl , Hofmockel Kirsten S.
Published: March 2019

Nitrogen (N) is a common limitation on primary productivity, and its source remains unresolved in northern peatlands that are vulnerable to environmental change. Decomposition of complex organic matter into free amino acids has been proposed as an important N source, but the genetic potential of microorganisms mediating this process has not been examined. Such information can inform possible responses of northern peatlands to environmental change. We show high genetic potential for microbial production of free amino acids across a range of microbial guilds in northern peatlands. In particular, the abundance and diversity of bacterial genes encoding proteolytic activity suggest a predominant role for bacteria in regulating productivity and contrasts with a paradigm of fungal dominance of organic N decomposition. Our results expand our current understanding of coupled carbon and nitrogen cycles in northern peatlands and indicate that understudied bacterial and archaeal lineages may be central in this ecosystem’s response to environmental change.
Cellular DNA Topoisomerases Are Required for the Synthesis of Hepatitis B Virus Covalently Closed Circular DNA
Authors: Sheraz Muhammad , Cheng Junjun , Tang Liudi , Chang Jinhong , Guo Ju-Tao
Published: March 2019

Persistent HBV infection relies on stable maintenance and proper functioning of a nuclear episomal form of the viral genome called cccDNA, the most stable HBV replication intermediate. One of the major reasons for the failure of currently available antiviral therapeutics to cure chronic HBV infection is their inability to eradicate or inactivate cccDNA. We report here a chemical genetics approach to identify host cellular factors essential for the biosynthesis and maintenance of cccDNA and reveal that cellular DNA topoisomerases are required for both
de novo
synthesis and intracellular amplification of cccDNA. This approach is suitable for systematic screening of compounds targeting cellular DNA metabolic enzymes and chromatin remodelers for their ability to disrupt cccDNA biosynthesis and function. Identification of key host factors required for cccDNA metabolism and function will reveal molecular targets for developing curative therapeutics of chronic HBV infection.
Genome-Wide Screening for Enteric Colonization Factors in Carbapenem-Resistant ST258 Klebsiella pneumoniae
Authors: Jung Hea-Jin , Littmann Eric R. , Seok Ruth , Leiner Ingrid M. , Taur Ying , Peled Jonathan , van den Brink Marcel , Ling Lilan , Chen Liang , Kreiswirth Barry N. , Goodman Andrew L. , Pamer Eric G.
Published: March 2019

Klebsiella pneumoniae
is a common cause of bloodstream infections in immunocompromised and hospitalized patients, and over the last 2 decades, some strains have acquired resistance to nearly all available antibiotics, including broad-spectrum carbapenems. The U.S. Centers for Disease Control and Prevention has listed carbapenem-resistant
K. pneumoniae
(CR
-Kp
) as an urgent public health threat. Dense colonization of the intestine by CR
-Kp
and other antibiotic-resistant bacteria is associated with an increased risk of bacteremia. Reducing the density of gut colonization by CR
-Kp
is likely to reduce their transmission from patient to patient in health care facilities as well as systemic infections. How CR
-Kp
expands and persists in the gut lumen, however, is poorly understood. Herein, we generated a highly saturated mutant library in a multidrug-resistant
K. pneumoniae
strain and identified genetic factors that are associated with dense gut colonization by
K. pneumoniae
. This study sheds light on host colonization by
K. pneumoniae
and identifies potential colonization factors that contribute to high-density persistence of
K. pneumoniae
in the intestine.
Tight Regulation of Extracellular Superoxide Points to Its Vital Role in the Physiology of the Globally Relevant
Roseobacter
Clade
Authors: Hansel Colleen M. , Diaz Julia M. , Plummer Sydney
Published: March 2019

Formation of reactive oxygen species (ROS) through partial reduction of molecular oxygen is widely associated with stress within microbial and marine systems. Nevertheless, widespread observations of the production of the ROS superoxide by healthy and actively growing marine bacteria and phytoplankton call into question the role of superoxide in the health and physiology of marine microbes. Here, we show that superoxide is produced by several marine bacteria within the widespread and abundant
Roseobacter
clade. Superoxide levels outside the cell are controlled via a tightly regulated balance of production and decay processes in response to cell density and life stage in batch culture. Removal of extracellular superoxide leads to substantial growth inhibition. These findings point to an essential role for superoxide in the health and growth of this ubiquitous group of microbes, and likely beyond.
Rectal duplication cyst causing acute urinary retention with bladder outlet obstruction: an unusual presentation
Authors: Sharma Ashish , Agarwal Samarth , Kumar Manoj , Sankhwar Satyanarayan
Published: March 2019

Anterior rectal duplication cyst is rare entity with <50 reported cases to date. It has myriad presentations like bleeding per rectum, constipation, rectal prolapsed and intestinal obstruction due to extrinsic compression of rectum. However, the association of enlarged duplication cyst compressing the bladder neck or ureter, and leading to bladder outlet obstruction or hydroureteronephrosis is extremely rare with only a handful of reported cases. We report a rare case of large anterior rectal duplication cyst in a young girl leading to acute urinary retention with bladder outlet obstruction which was eventually managed by laparoscopic-assisted transabdominal surgical excision of the cyst. The authors believe that such an association has not been previously reported in this age group.
An atypical presentation of Sweet’s syndrome in a myelofibrosis patient
Authors: Thebo Umera , Tummala Sirisha , Nassereddine Samah , Haroun Faysal
Published: March 2019

A 46-year-old man with no significant medical history presented to haematology with symptoms of fatigue, dyspnoea on exertion and weight loss. Physical examination revealed a lesion on the right shin and splenomegaly. Labs were significant for leucocytosis with immature components, thrombocytosis and 3% peripheral blasts on smear. A bone marrow biopsy confirmed a diagnosis of myelofibrosis (MF). Dynamic International Prognosis Scoring system was 2. He was started on ruxolitnib, with decitabine added subsequently prior to definitive therapy with an allogenic haematopoietic stem cell transplant. His course with decitabine was complicated with febrile neutropaenia with multiple tender erythematous plaques unresponsive to antibacterial and antifungal coverage. A skin biopsy showed neutrophilic dermatitis, consistent with a diagnosis of Sweet’s syndrome (SS) and empirical treatment with glucocorticoids was initiated resulting in resolution of symptoms. This report reviews the literature for cases of SS in the setting of MF.
Extreme sleep pattern in Lewy body dementia: a hypothalamic matter?
Authors: Londos Elisabet , Hansson Oskar , Rosén Ingmar , Englund Elisabet
Published: March 2019

Excessive sleep during the night and for >2 hours during the day is part of the fluctuating wakefulness criterion of dementia with Lewy bodies (DLB). The phenomenon ‘sleep days’ is not uncommon in nursing homes. Here, we describe a woman who, for months, slept for 3 days and nights in a row and thereafter was awake for 3 days and nights. Electroencephalogram (EEG) showed slow background activity and increased delta activity. No epileptiform activity was detected. Polysomnography showed a severely disturbed, markedly fragmented sleep pattern. On her death, neuropathology revealed degeneration and loss of neurons along with α-synuclein-containing Lewy body inclusions and neurites in the substantia nigra, locus coeruleus, hypothalamus, and neocortex, thus fulfilling the criteria of DLB, cortical type. We propose that the hypothalamic degeneration contributed significantly to the clinical profile in this case. We suggest that patients with sleep days should be investigated for other DLB signs.
A case of refractory ventricular fibrillation successfully treated with low-dose esmolol
Authors: Hwang Charles W , Gamble Ginger , Marchick Michael , Becker Torben K
Published: March 2019

Current advanced cardiac life support (ACLS) guidelines for the management of ventricular fibrillation (VF) and pulseless ventricular tachycardia is defibrillation. However, refractory VF, which is defined as VF that persists despite three defibrillation attempts, is challenging for all ACLS providers; the best resuscitation strategy for patients that persist in refractory VF remains unclear. We report on a 51-year-old man who presented to the emergency department with chest pain and subsequently went into witnessed VF cardiac arrest. Despite standard ACLS management consisting of high-quality cardiopulmonary resuscitation, serial epinephrine and serial defibrillation, the return of spontaneous circulation (ROSC) was unable to be achieved. Double sequential defibrillation (DSD) was attempted multiple times unsuccessfully. After administration of low-dose esmolol, he immediately achieved ROSC. DSD and β-blockade are increasingly recognised in the literature and practice for refractory VF. However, to the best of our knowledge, this is the first case of refractory VF that responded to low-dose esmolol β-blockade.
Thrombus risk versus bleeding risk: a clinical conundrum
Authors: Ng Elisabeth , Ekladious Adel , Wheeler Luke P
Published: March 2019

A 62-year-old man presented to the Emergency Department with dyspnoea and central pleuritic chest pain radiating posteriorly to between the scapulae. His medical history included hypertension, osteoporosis and chronic kidney disease secondary to focal segmental glomerulosclerosis with relapsing nephrotic syndrome. Significant examination findings included a loud palpable P2 and a displaced apex beat. An ECG revealed sinus tachycardia with a right-bundle branch block and p-pulmonale. A CT pulmonary angiogram and aortogram demonstrated extensive bilateral pulmonary emboli and a descending thoracic aortic dissection. Subsequent ultrasound of the lower limbs confirmed an extensive, non-occlusive deep vein thrombosis in the right calf. Management of this patient involved therapeutic anticoagulation and tight blood pressure control, with plans for surgical repair delayed due to worsening renal impairment and subsequent supratherapeutic anticoagulation. Co-existence of an aortic dissection and PE has been rarely described and optimal management remains unclear.
Transverse colon volvulus in a patient with sickle cell disease
Authors: Abdulla Hussain Adnan , Hamza Eman , Dhaif Ali
Published: March 2019

Although colonic volvulus is a relatively rare cause of large bowel obstruction, accounting for up to 5% of all cases of intestinal obstruction, transverse colon volvulus is extremely uncommon compared with volvulus of the sigmoid colon or caecum and is responsible for only 3% of all reported cases. We report an unusual case of spontaneous volvulus of the transverse colon in a young man with sickle cell disease who underwent resection with primary anastamosis. Having a high index of suspicion and early operative intervention allowed for this patient to have an uneventful postoperative course.
Assessment of patient experience profiles and satisfaction with expectations of treatment effects by using latent class analysis based on a national patient experience survey in Taiwan
Authors: Chiou Shang-Jyh , Lee Pei-Chen , Chang Yu-Hsuan , Huang Pei-Shan , Lee Li-Hui , Lin Kuan-Chia
Published: March 2019

Objectives

Health system responsiveness is a complicated issue that guides researchers wishing to design an efficient methodology for enhancing understanding of perspectives regarding healthcare systems. This study examined the relationship between patient experience profiles and satisfaction with expectations of treatment effects.

Design

This was a cross-sectional study. We used eight items obtained from latent class analysis to develop patient experience profiles.

Setting

Primary care users in Taiwan.

Participants

This study conducted an annual National Health Insurance survey in Taiwan and sampled from those who had experience with the medical service in primary care clinics in 2015.

Primary outcome measure

Respondents were asked to indicate the extent of their satisfaction with their expectation of treatment effects (or symptom improvement).

Results

The proportions of participants in groups 1–4 were 34%, 24%, 29% and 12%, respectively. Patients in good health were more satisfied with their expectations of treatment effects (OR 1.639, p=0.007). Furthermore, group 4 (-eAll) were less satisfied with their expectations of treatment effects than those in the other three groups (ORs: group 1 (+eAll): 9.81, group 2 (-CwR): 4.14 and group 3 (-CnR): 4.20).

Conclusions

The results revealed that experiences of poor accessibility and physician–patient relationships affected the patients’ expectations. Therefore, greater accessibility and more positive physician–patient relationships could lead to higher patient satisfaction with their expectations of treatment effects. Furthermore, the findings could assist authorities in targeting specific patients, with the objective of improving their healthcare service experience. They could also serve as a mechanism for improving the quality of healthcare services and increase accountability in healthcare practices.