bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison Of Bolus Ephedrine, Mephentermine And Phenylephrine For The Management Of Hypotension During Spinal Anaesthesia For Caesarean Section – A Clinical Study
Authors: Ekramuddin Dr. , Satyam Dr. , Jha Dr. Ashutosh , Hasnat Dr. Sabir
Published: December 2024

Background: Anaesthesia to a parturient is not only unique but also requires highest degree of care because the
anaesthesiologist has to look after two individuals, the mother and fœtus. Hypotension during spinal anaesthesia
for caesarean delivery can have detrimental effects on both mother and neonate. These effects include decreased
utero-placental blood flow, impaired foetal oxygenation with asphyxial stress and foetal acidosis and maternal
symptoms of low cardiacoutput such as nausea, vomiting, dizziness and decreased consciousness. Vasopressor
like Ephedrine, Mephentermine, Phenylephrine, are used for treating the hypotension. In this study we compared
the efficacy of Ephedrine, Mephentermine and Phenylephrine in treating the hypotension for caesarean section
and their desirable side effects.
Materials and Methods: In this prospective randomised controlled study, 90 patients of ASA physical status I
and II belonging to age group of 18-35 years undergoing elective or emergency LSCS under sub-arachnoid block
were randomly allocated into 3 groups of 30patients each, Group E (Ephedrine) and Group M (Mephentermine)
and Group P (Phenyephrine). Group E received Inj Ephedrine 6 mg IV bolus, Group M received Inj
Mephentermine 6 mg IV bolus and Group P received Inj Phenylephrine 100 microgram IV bolus for spinal
anaesthesia. The changes in hemodynamic parameters, neonatal outcome, side-effects and usage of rescue
vasopressor were compared between the groups.
Results: The mean age in group P was 24.2 years, in group E 25.7 years and in group M was 25.7 years, which
was similar across the groups. The time between induction and delivery was 87.8 sec in group P, 89.4 sec in
group E and 89.6 sec in group M. The time at which 1st vasopressor dose given was 5.2 min in group P, 4.8 min
in group E and 4.87 min in group M. The mean heart rate was lower in group P at all the points of study after
episode of hypotension. The bolus drug requirement was highest in group P with mean of 3.52 followed by group
M with mean of 2.86 and group E with mean of 2.55. The group E required rescue analgesia 73% of time, group
M 70% of time and group P also 70% of time in study. The mean APGAR score at 1 minute was 8.2 in group P,
8.4 in group E and 8.6 in group M.
Conclusion: During subarachnoid block for cesarean delivery, all three of the study's vasopressors—
phenylephrine, ephedrine, and mephentermine—effectively maintained arterial blood pressure and were safe to use in the treatment of hypotension. Compared to ephedrine and mephentermine, phenylephrine significantly lowered heart rate, which may be helpful for cardiac patients or those in whom tachycardia is not desired
A Comparative Evaluation Of Efficacy Between Besdata, Ambu Ascope, And Macintosh Laryngoscope For Intubation In Adult General Surgical Patients
Authors: Sharma Anant Kumar , Ali Qazi Ehsan , Amir Syed Hussain , Parashar Ankita
Published: December 2024

Background: In the context of general surgical operations, patient safety and procedure success are directly tied
to the effectiveness of endotracheal intubation equipment. The comparative effectiveness of these devices in actual
clinical situations is essential, notwithstanding the many technical breakthroughs that have been made.
Objective: The purpose of this research was to compare the performance of three different intubation devices—
the Besdata, the Ambu aScope, and the Macintosh Laryngoscope—in adult patients undergoing general surgical
procedures.
Methods: Between 2019 and 2022, researchers from Jawaharlal Nehru Medical College of AMU in Aligarh's
Department of Anaesthesiology and Critical Care gathered data. Ninety patients were recruited, ranging in age
from 20 to 70 years and in weight from 40 to 70 kg. After getting participants' consent, they were split into three
groups at random. The Ambu aScope was used to intubate patients in Group A, the Besdata was used in Group
B, and the Macintosh laryngoscope was used in Group M. Age, gender, height, and weight were recorded, as well
as the participant's Mallampati status.
Results: There was universal success with intubation using all three devices. Average intubation times were found
to be quickest using the Ambu aScope, then the Besdata, and finally the Macintosh Laryngoscope. The incidence
of postoperative sore throat was lowest in patients intubated using the Macintosh Laryngoscope and greatest in
those intubated with the Besdata. Ambu aScope had the best percentage of success on the first attempt. There
were no statistically significant variations between patients in terms of demographic information or Mallampati
grade.
Conclusion: While each of the three tools was useful, it also had its own set of advantages and disadvantages. It is important to consider the patient's anatomy, the clinician's level of expertise, and the clinical setting before settling on an intubation device.
Causes Of Time Delay In Construction Projects In Libya
Authors: Mukhtar Mahmoud Mukhtar Ahmad , Mohamed Mohamed Ali Elghadaffi
Published: December 2024

Time delay in the construction industry is a global problem and considered as one of the most significant
problems worldwide. Libyan construction industry is also no exception to it, and it is known that to consider the
project successful is complete on time within predicted costt. As a result of many reasons, this is more
noticeably in developing countries as time delay is a normal result of poor project performance. In Libyan
construction industry, budget overrun and time extension are the main problems facing all project parties
including clients, contractors, subcontractors and suppliers. This research aims to determine the main causes
that result in construction delays in Libya according to the owners, contractors and consultants participated in
the questionnaire. The outcome of this study is that the main significant elements that often lead to time delay in
Libyan construction projects are: delay in payment by client, financial difficulties by contractors, corruption, security issues, market inflation and frequent change by client during construction projects implementation.
Enhancing Organizational Safety with ARIF Framework: A New Paradigm for Adaptive Resilience
Authors: Ho Chee Kit , Tan Sunny , Heng Jovan Bowen
Published: December 2024

Traditional safety systems primarily focus on robustness and resilience, aiming to create environments that
resist disruptions or recover swiftly from them. However, the concept of antifragility, introduced by Nassim
Nicholas Taleb, offers a transformative approach to safety management. Antifragility extends beyond resilience
by enabling systems not only to withstand stress but to thrive and improve when faced with adversity. This paper
explores the integration of antifragility into safety culture and systems, proposing strategies to enhance safety
performance, reduce costs, and more effectively manage risks. Through the analysis of real-world examples and
empirical test results, the paper demonstrates the practical application of antifragility, illustrating how adopting
this approach can lead to more adaptive and resilient safety systems. This work highlights the potential for antifragility to shift the paradigm in safety management, moving from a focus on mere survival to a strategy of continuous improvement and growth under stress.
A time‐resolved live cell imaging assay to identify small molecule inhibitors of FGF2 signaling
Authors: Ahmed Mennatallah , Legrand Cyril , Yagüe Relimpio Ana , Beretta Carlo A. , Muschko Alina , Wegehingel Sabine , Müller Hans‐Michael , Sehr Peter , Will David W. , Lewis Joe D. , Nickel Walter
Published: May 2019

Fibroblast growth factor 2 (FGF2) is a cell survival factor with crucial functions in tumor‐induced angiogenesis. Here, we describe a novel time‐resolved FGF2 signaling assay based upon live cell imaging of neuroblastoma cells. To validate this system, we tested 8960 small molecules for inhibition of FGF2 signaling with kinetic resolution. Hit compounds were validated in dose‐response experiments for FGF2 signaling, FGF receptor antagonism, downstream ERK phosphorylation and FGF2‐dependent chemoresistance in a cellular leukemia model system. The new screening system for FGF2 signaling inhibitors has unique features, deselecting compounds with pleiotropic effects on cell proliferation and, along with the experimental pipeline reported, great potential for the discovery of new classes of FGF2 signaling inhibitors that block FGF2 dependent tumor cell survival.
Neurobiology of Risk Taking and Impulsivity
Authors: Nagel Michael
Published: May 2019

Risk taking and impulsivity are common behavioral traits during adolescence. That is not to say that children and adults do not engage in similar behaviors; however, such behaviors are more numerous and extreme during adolescence. This may be one of the reasons why during adolescence young people are at a much greater risk of injury or death as a result of placing themselves in harm's way. It is also during adolescence that behaviors associated with experimentation (i.e., illicit drug use, alcohol consumption, and unprotected sex) can lead to aversive outcomes, largely as a consequence of preventable risk taking. Interestingly, there appears to be a neurobiological link to adolescent risk taking and impulsivity, which when considered offers a framework for understanding and engaging adolescents that goes beyond culture and context.
Identity Development Processes
Authors: Frisén Ann , Eriksson Py Liv
Published: May 2019

During adolescence, individuals gradually start to think more about identity issues as a result of their more advanced emotional, cognitive, and social abilities and new demands from society. One key developmental task of adolescence is, therefore, to develop a stable and coherent identity. This entry outlines the two main approaches to identity development processes, the one focusing on exploration and commitment processes and the other on narrative identity processes. Within these two approaches, important aspects of the domains and contexts in which adolescents develop their identity are highlighted.
Blood neurofilament light as a potential endpoint in Phase 2 studies in MS
Authors: Sormani Maria Pia , Haering Dieter A. , Kropshofer Harald , Leppert David , Kundu Uma , Barro Christian , Kappos Ludwig , Tomic Davorka , Kuhle Jens
Published: May 2019

Objectives

To assess whether neurofilament light chain (NfL) could serve as an informative endpoint in Phase 2 studies in patients with relapsing–remitting multiple sclerosis (RRMS) and estimate the sample size requirements with NfL as the primary endpoint.

Methods

Using data from the Phase 3 FREEDOMS study, we evaluated correlation of NfL at Month 6 with 2‐year outcomes: relapses, confirmed disability worsening (CDW), new or enlarging T2 lesions (active lesions), and brain volume loss (BVL). We compared the proportion of treatment effect (PTE) on 2‐year relapses and BVL explained by 6‐month log‐transformed NfL levels with the PTE explained by the number of active lesions over 6 months. We estimated sample size requirements for different treatment effects.

Results

At Month 6, blood NfL levels (pg/mL, median [range]) were lower in the fingolimod arm (fingolimod (n = 132) 18 [8–247]; placebo (n = 114) 26 [8–159],P < 0.001). NfL at 6 months correlated with number of relapses (r = 0.25,P < 0.001), 6‐month CDW (hazard ratio 1.83,P = 0.012), active lesions (r = 0.46,P < 0.001), and BVL (r = −0.41,P < 0.001) at Month‐24. The PTE (95% CI) on 24‐month relapses and BVL explained by 6‐month NfL was 25% (8–60%) and 60% (32–132%), and by 6‐month active lesions was 28% (11–66%) and 45% (18–115%), respectively. Assuming a 20–40% treatment‐related reduction in NfL levels, 143‐28 patients per arm will be required.

Conclusions

Blood NfL may qualify as an informative and easy‐to‐measure endpoint for future Phase 2 clinical studies that captures both inflammatory‐ and noninflammatory‐driven neuroaxonal injury in RRMS.
Biomimetic Composite Scaffolds to Manipulate Stem Cells for Aiding Rheumatoid Arthritis Management
Authors: Zhao Yue , Wang Zhonghan , Jiang Yingnan , Liu Hou , Song Shanliang , Wang Chenyu , Li Zuhao , Yang Zhe , Liu He , Wang Jincheng , Yang Bai , Lin Quan
Published: May 2019

Stem cell transplantation is a promising alternative therapy for rheumatoid arthritis (RA) patients, with the potential to suppress autoimmune inﬂammation and prevent joint damage. However, widespread application of RA therapy based on stem cell transplantation is limited due to poor migration, local retention, and uncontrolled differentiation of stem cells. Here, inspired by the dynamic construction of bone matrix, a structurally and functionally optimized scaffold for loading bone marrow stem cells (BMSCs) is designed to aid RA management. The composite scaffolds consist of stiff 3D printing porous metal scaffolds (3DPMS) and soft multifunctional polysaccharide hydrogels, wherein 3DPMS meet the requirements for large‐scale bone defects caused by RA. Attractively, the fabricated hydrogels on the composite scaffold are self‐healable, injectable, biocompatible, and biodegradable, which endow the resultant scaffold many aspects mimicking the extracellular matrix (ECM). After encapsulation of BMSCs, hydrogels are administered into the inner pores of 3DPMS, abbreviated as BMSCs@3DPMS/hydrogels. In this study, BMSCs@3DPMS/hydrogels have a good effect on improving RA, such as remodeling of knee joint articular cartilage, inhibition of inﬂammatory cytokines, and promotion of subchondral bone regeneration. Besides RA, the innovative scaffolds may also serve as an ideal biomaterial for other bone regenerative therapies in various orthopedic diseases.
Coupled Whispering Gallery Mode Resonators via Template‐Assisted Assembly of Photoluminescent Microspheres
Authors: Smith Marcus J. , Zeng Qingji , Lafalce Evan , Yu Shengtao , Zhang Shuaidi , Vardeny Zeev Valy , Tsukruk Vladimir V.
Published: May 2019

This study reports a facile method for the assembly of large, array style, coupled dye‐doped microsphere resonators by template‐assisted, in which an aqueous suspension of colloidal microspheres assemble on a patterned template. By exploiting the high resolution of 3D (two‐photon) lithography derived templates, closely packed large arrays, hundreds to thousands of dimers with controlled gap spacing, only limited by the size of the substrate can be achieved. Dye‐doped emissive microspheres with Q‐factors >2.5 × 102 can be achieved and trapped into predetermined cavity positions, thereby controlling the distance between adjacent microspheres. This design allows to scale down dimer spacing from usual 400 nm for traditional photolithography to very small spacing of 50 nm. It is found that exciting individual microspheres in the ensemble shows intense optical cavity modes, whereas closely coupled pairs show controlled mode splitting. Coupling between photoluminescent microspheres is strongly influenced by the gap distance, with strong coupling, equating to normal mode splitting, arising as the gap distance is reduced below traditional sub‐micrometer scale. The coupled dimer assemblies are promising candidates for advancing the development of large‐area coupled nanophotonic structures, beyond the spatial resolution‐limited photolithographical derived arrays.
Portable Low‐Pressure Solar Steaming‐Collection Unisystem with Polypyrrole Origamis
Authors: Li Weigu , Li Zheng , Bertelsmann Karina , Fan Donglei Emma
Published: May 2019

Solar steaming has emerged as a promising green technology that can address the global issue of scarcity of clean water. However, developing high‐performance, cost‐effective, and manufacturable solar‐steaming materials, and portable solar steaming‐collection systems for individuals remains a great challenge. Here, a one‐step, low‐cost, and mass‐producible synthesis of polypyrrole (PPy) origami‐based photothermal materials, and an original portable low‐pressure controlled solar steaming‐collection unisystem, offering synergetic high rates in both water evaporation and steam collection, are reported. Due to enhanced areas for vapor dissipation, the PPy origami improves the water evaporation rate by at least 71% to 2.12 kg m−2 h−1 from that of a planar structure and exhibits a solar–thermal energy conversion efficiency of 91.5% under 1 Sun. When further controlling the pressure to ≈0.17 atm in the steaming‐collection unisystem, the water collection rate improves by up to 52% systematically and dramatically. Although partial energy is utilized toward obtaining low‐pressure, evaluations show that the overall energy efficiency is improved remarkably in the low‐pressure system compared to that in ambient pressure. Furthermore, the device demonstrates effective decontamination of heavy metals, bacteria, and desalination. This work can inspire new paradigms toward developing high‐performance solar steaming technologies for individuals and households.
3D‐Printed Flexible Tactile Sensor Mimicking the Texture and Sensitivity of Human Skin
Authors: Wang Haihang , Yang Hongmei , Zhang Sheng , Zhang Li , Li Jiusheng , Zeng Xiangqiong
Published: May 2019

The development of 3D printing technology toward multifunction devices may affect various fields from intelligent systems and wearable electronic devices to energy storage and flexible light‐emitting devices. A new type of piezoresistive sensor is designed by mimicking the texture and sensitivity of human skin. It is fabricated by 3D printing with a new kind of ink that is composed of interconnected polydimethylsiloxane microspheres (MPs) with carbon nanotubes distributed on their surfaces. This structure gives an electronic skin fabricated from these sensors modulus similar to that of human skin; furthermore, it elastically deforms under external forces. The response of the electronic skin to shear forces is evaluated by simulating the touch behavior of human skin, and it is found that the tactile sensors are sensitive to applied shear forces. They demonstrate sensitivity as low as 2.08 kPa−1 at a pressure of just 0.12 kPa, with short response time (50 ms), high durability (over 8000 cycles), and flexibility.
Site‐ and Stereoselective Phosphoramidation of Carbohydrates Using a Chiral Catalyst and a Chiral Electrophile
Authors: Glazier Daniel A. , Schroeder John M. , Blaszczyk Stephanie A. , Tang Weiping
Published: May 2019

Carbohydrates are the most prevalent class of naturally occurring biomolecules. They mediate cell signaling, bacterial virulence, and metabolism, among other functions. The site‐selective functionalization of carbohydrates has been a long‐standing problem in chemistry. Phosphoramidates are a particularly challenging functional group to install stereoselectively because of the chirality at the phosphorus center. As such, the site‐ and stereoselective phosphoramidation of carbohydrates has never been achieved. We have developed the first site‐ and stereoselective phosphoramidation reaction of carbohydrates using a chiral catalyst and a chiral electrophile. This method offers a convenient solution for the selective synthesis of phosphoramidated carbohydrate‐containing prodrugs and natural products.

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Wideband Epsilon‐Near‐Zero Supercoupling Control through Substrate‐Integrated Impedance Surface
Authors: He Yijing , Li Yue , Zhou Ziheng , Li Hao , Hou Yuefeng , Liao Shaolin , Chen Pai‐Yen
Published: May 2019

The supercoupling phenomenon of electromagnetic wave through arbitrary shaped epsilon‐near‐zero (ENZ) material channels has attracted considerable attention recently, leading to numerous intriguing applications. It has been demonstrated that around the cutoff frequency of fundamental TE10 mode, waveguide behaves as the 2D homogenous ENZ material. However, for a given waveguide geometry, the ENZ operating bandwidth is inherently narrow and the center frequency is fixed. Here, a reconfigurable ENZ medium is proposed and experimentally demonstrated with a wideband‐tunable supercoupling effect by means of inserting a metasurface inside the waveguide, named as substrate‐integrated impedance surface (SIIS). With different insertion depth (which can be mechanically tuned) of SIIS, the ENZ supercoupling frequency can be precisely controlled. The proposed technique not only achieves wideband tuning of the ENZ supercoupling, especially to control the enhanced group delay of the electromagnetic waves, thereby offering a promising way toward for tunable slow‐light devices, such as light storage and processing components.
Proanthocyanidin Interferes with Intrinsic Antibiotic Resistance Mechanisms of Gram‐Negative Bacteria
Authors: Maisuria Vimal B. , Okshevsky Mira , Déziel Eric , Tufenkji Nathalie
Published: May 2019

Antibiotic resistance is spreading at an alarming rate among pathogenic bacteria in both medicine and agriculture. Interfering with the intrinsic resistance mechanisms displayed by pathogenic bacteria has the potential to make antibiotics more effective and decrease the spread of acquired antibiotic resistance. Here, it is demonstrated that cranberry proanthocyanidin (cPAC) prevents the evolution of resistance to tetracycline in Escherichia coli and Pseudomonas aeruginosa, rescues antibiotic efficacy against antibiotic‐exposed cells, and represses biofilm formation. It is shown that cPAC has a potentiating effect, both in vitro and in vivo, on a broad range of antibiotic classes against pathogenic E. coli, Proteus mirabilis, and P. aeruginosa. Evidence that cPAC acts by repressing two antibiotic resistance mechanisms, selective membrane permeability and multidrug efflux pumps, is presented. Failure of cPAC to potentiate antibiotics against efflux pump‐defective mutants demonstrates that efflux interference is essential for potentiation. The use of cPAC to potentiate antibiotics and mitigate the development of resistance could improve treatment outcomes and help combat the growing threat of antibiotic resistance.
Polyoxometalate‐Derived Ultrasmall Pt2W/WO3 Heterostructure Outperforms Platinum for Large‐Current‐Density H2 Evolution
Authors: Peng Ye‐Wang , Shan Changsheng , Wang Hong‐Juan , Hong Lu‐Ying , Yao Shuang , Wu Rui‐Juan , Zhang Zhi‐Ming , Lu Tong‐Bu
Published: May 2019

Platinum (Pt)‐based catalysts with high Pt utilization efficiency for efficient H2 evolution are attracting extensive attention to meet the issues of energy exhaustion and environmental pollution. Herein, a one‐step electrochemical method is demonstrated to construct ultrafine heterostructure Pt2W/WO3 on reduced graphene oxide (RGO) by injecting multielectrons into the Preyssler anion [NaP5W30O110]14− to codeposit with anodic deliquescent Pt cations. The resulting Pt2W/WO3/RGO shows much higher performance than that of commercial Pt catalysts for large‐current‐density H2 evolution, which can deliver a large current density of 500 mA cm−2 with an overpotential of only 394 mV, much lower than that of 20% Pt/C (578 mV). Comparisons with control experiments and density functional theory (DFT) calculations both suggest that the much enhanced activity can be mainly attributed to the synergistic cooperation of different components to drive fast and continuous hydrogen desorption on Pt2W/WO3/RGO, while it could not run normally for 20% Pt/C under similar conditions due to the formation of huge bubbles on the electrode surface. The effective integration of high catalytic activity and hydrogen desorption ability into a single material can yield advanced materials for large‐current‐density H2 evolution with remarkable stability.
Incorporating Solvate and Solid Electrolytes for All‐Solid‐State Li2S Batteries with High Capacity and Long Cycle Life
Authors: Shin Minjeong , Gewirth Andrew A.
Published: May 2019

The development of all‐solid‐state lithium–sulfur batteries is hindered by the poor interfacial properties at solid electrolyte (SE)/electrode interfaces. The interface is modified by employing the highly concentrated solvate electrolyte, (MeCN)2−LiTFSI:TTE, as an interlayer material at the electrolyte/electrode interfaces. The incorporation of an interlayer significantly improves the cycling performance of solid‐state Li2S batteries compared to the bare counterpart, exhibiting a specific capacity of 760 mAh g−1 at cycle 100 (330 mAh g−1 for the bare cell). Electrochemical impedance spectroscopy shows that the interfacial resistance of the interlayer‐modified cell gradually decreases as a function of cycle number, while the impedance of the bare cell remains almost constant. Cross‐section scanning electron microscopy (SEM)/ energy dispersive X‐ray spectroscopy (EDS) measurements on the interlayer‐modified cell confirm the permeation of solvate into the cathode and the SE with electrochemical cycling, which is related to the decrease in cell impedance. In order to mimic the full permeation of the solvate across the entire cell, the solvate is directly mixed with the SE to form a “solvSEM” electrolyte. The hybrid Li2S cell using a solvSEM electrolyte exhibits superior cycling performance compared to the solid‐state cells, in terms of Li2S loading, Li2S utilization, and cycling stability. The improved performance is due to the favorable ionic contact at the battery interfaces.
Improving Preprocedure Time Out Compliance Using Remote Audiovisual Observation
Authors: Dobbie Mary , Fitzpatrick Maureen , Kent Martha , Wojtal O'Neill Mara
Published: May 2019

Health care organization leaders can help prevent surgical errors by ensuring compliance with standardized preprocedure time outs that require the active participation and engagement of the entire surgical team. Some surgical department leaders have used remote video observation without audio to monitor compliance with the time out. After a sentinel event occurred, leaders at our large academic medical center initiated a quality improvement project to audit compliance with the standardized preprocedure time out. We used remote audiovisual observation to ensure that all members of the procedure team were adhering strictly to the elements of the preprocedure time out in all invasive procedure areas. Since the beginning of this remote auditing process, team member compliance with the standardized preprocedure time out has improved.
A data‐driven particle filter for terrain based navigation of sensor‐limited autonomous underwater vehicles
Authors: Melo José , Matos Aníbal
Published: May 2019

In this article a new Data‐Driven formulation of the Particle Filter framework is proposed. The new formulation is able to learn an approximate proposal distribution from previous data. By doing so, the need to explicitly model all the disturbances that might affect the system is relaxed. Such characteristics are particularly suited for Terrain Based Navigation for sensor‐limited AUVs, where typical scenarios often include non‐negligible sources of noise affecting the system, which are unknown and hard to model. Numerical results are presented that demonstrate the superior accuracy, robustness and efficiency of the proposed Data‐Driven approach.
Abnormal auditory mismatch fields are associated with communication impairment in both verbal and minimally verbal/nonverbal children who have autism spectrum disorder
Authors: Matsuzaki Junko , Kuschner Emily S. , Blaskey Lisa , Bloy Luke , Kim Mina , Ku Matthew , Edgar James Christopher , Embick David , Roberts Timothy P. L.
Published: May 2019

Abnormal auditory discrimination neural processes, indexed by mismatch fields (MMFs) recorded by magnetoencephalography (MEG), have been reported in verbal children with ASD. Association with clinical measures indicates that delayed MMF components are associated with poorer language and communication performance. At present, little is known about neural correlates of language and communication skills in extremely language impaired (minimally‐verbal/non‐verbal) children who have ASD: ASD‐MVNV. It is hypothesized that MMF delays observed in language‐impaired but nonetheless verbal children with ASD will be exacerbated in ASD‐MVNV. The present study investigated this hypothesis, examining MMF responses bilaterally during an auditory oddball paradigm with vowel stimuli in ASD‐MVNV, in a verbal ASD cohort without cognitive impairment and in typically developing (TD) children. The verbal ASD cohort without cognitive impairment was split into those demonstrating considerable language impairment (CELF core language index <85; “ASD‐LI”) versus those with less or no language impairment (CELF CLI >85; “ASD‐V“). Eighty‐four participants (8‐12 years) were included in final analysis: ASD‐MVNV: n = 9, 9.67 ± 1.41 years, ASD: n = 48, (ASD‐V: n = 27, 10.55 ± 1.21 years, ASD‐LI: n = 21, 10.67 ± 1.20 years) and TD: n = 27, 10.14 ± 1.38 years. Delayed MMF latencies were found bilaterally in ASD‐MVNV compared to verbal ASD (both ASD‐V and ASD‐LI) and TD children. Delayed MMF responses were associated with diminished language and communication skills. Furthermore, whereas the TD children showed leftward lateralization of MMF amplitude, ASD‐MVNV and verbal ASD (ASD‐V and ASD‐LI) showed abnormal rightward lateralization. Findings suggest delayed auditory discrimination processes and abnormal rightward laterality as objective markers of language/communication skills in both verbal and MVNV children who have ASD. Autism Res 2019, 12: 1225–1235. © 2019 International Society for Autism Research, Wiley Periodicals, Inc.

Lay Summary

Brain imaging showed abnormal auditory discrimination processes in minimally‐verbal/non‐verbal children (MVNV) who have autism spectrum disorder (ASD). Delays in auditory discrimination were associated with impaired language and communication skills. Findings suggest these auditory neural measures may be objective markers of language and communication skills in both verbal and, previously‐understudied, MVNV children who have ASD.
Predicting reamputation risk in patients undergoing lower extremity amputation due to the complications of peripheral artery disease and/or diabetes
Authors: Czerniecki J M , Thompson M L , Littman A J , Boyko E J , Landry G J , Henderson W G , Turner A P , Maynard C , Moore K P , Norvell D C
Published: May 2019

Background

Patients undergoing amputation of the lower extremity for the complications of peripheral artery disease and/or diabetes are at risk of treatment failure and the need for reamputation at a higher level. The aim of this study was to develop a patient-specific reamputation risk prediction model.

Methods

Patients with incident unilateral transmetatarsal, transtibial or transfemoral amputation between 2004 and 2014 secondary to diabetes and/or peripheral artery disease, and who survived 12 months after amputation, were identified using Veterans Health Administration databases. Procedure codes and natural language processing were used to define subsequent ipsilateral reamputation at the same or higher level. Stepdown logistic regression was used to develop the prediction model. It was then evaluated for calibration and discrimination by evaluating the goodness of fit, area under the receiver operating characteristic curve (AUC) and discrimination slope.

Results

Some 5260 patients were identified, of whom 1283 (24·4 per cent) underwent ipsilateral reamputation in the 12 months after initial amputation. Crude reamputation risks were 40·3, 25·9 and 9·7 per cent in the transmetatarsal, transtibial and transfemoral groups respectively. The final prediction model included 11 predictors (amputation level, sex, smoking, alcohol, rest pain, use of outpatient anticoagulants, diabetes, chronic obstructive pulmonary disease, white blood cell count, kidney failure and previous revascularization), along with four interaction terms. Evaluation of the prediction characteristics indicated good model calibration with goodness-of-fit testing, good discrimination (AUC 0·72) and a discrimination slope of 11·2 per cent.

Conclusion

A prediction model was developed to calculate individual risk of primary healing failure and the need for reamputation surgery at each amputation level. This model may assist clinical decision-making regarding amputation-level selection.
Comparative study of breast cancer with or without concomitant Paget disease: An analysis of the SEER database
Authors: Chen Shijing , Chen Huaquan , Yi Ying , Jiang Xuemei , Lei Hai , Luo Xue , Chen Yu , Liu Sha , Yuan Dan , Jia Xinjian , Li Junyan
Published: May 2019

Background

Most mammary Paget disease (MPD) is associated with underlying in situ or invasive breast cancer. The objective of this study was to compare the clinicopathological characteristics and survival outcomes between breast cancer with Paget disease (PD) and breast cancer alone.

Methods

From the Surveillance, Epidemiology, and End Results (SEER) database, 2000‐2015, of the US National Cancer Institute, we identified 1569 women who had PD with invasive ductal carcinoma (PD‐IDC) and 1489 women who had PD with ductal carcinoma in situ (PD‐DCIS). Independent demographic and clinicopathological variables as well as survival outcomes of these patients were compared to patients with the corresponding breast cancer without concomitant PD.

Results

PD‐IDC and PD‐DCIS both had worse survival outcomes and poorer tumor characteristics than the corresponding disease without PD. Contrary to in the breast cancer alone groups, in the breast cancer with PD groups, the HR status (P = 0.182 in PD‐IDC and P = 0.371 in PD‐DCIS), HER2 status (P = 0.788 in PD‐IDC and P = 0.643 in PD‐DCIS), and combined molecular subtype (P = 0.196 in PD‐IDC and P = 0.853 in PD‐DCIS) were not found to affect disease prognosis. After matching tumor characteristics and treatment approaches, PD‐IDC as well as PD‐DCIS exhibited no significant difference in disease prognosis with corresponding IDC and DCIS. Finally, by comparative analysis, a kind of PD‐DCIS (ICD‐O‐3 code 8543/3) showed many invasive behaviors (31.8% of 8543/3 patients had stage I‐III cancer) and was associated with worse survival outcomes than the other type of PD‐DCIS.

Conclusions

Breast cancer with concomitant PD was associated with more aggressive tumor characteristics and worse survival outcomes. The HR status, HER2 status, and combined molecular subtype could not affect the prognosis of breast cancer with PD. Moreover, a portion of the PD‐DCIS cases were invasive breast cancer cases that required special treatment.
Infantile osteomyelitis of the fourth rib causing the occurrence of a lung abscess
Authors: Mori Sayo , Onoyama Sagano , Takimoto Tomoko , Morooka Yuya , Furuno Kenji
Published: May 2019

Infantile osteomyelitis of the rib is rare but can be complicated by intrapleural pyogenic lesions. Even if findings suggest another infection focus, osteomyelitis should be considered if there are changes on radiographs. In addition, it can be prevented by maintaining the dermal barrier function through skin care.
Investigation of the Inhibiting Role of Hydrogen in the Steam Reforming of Methanol
Authors: Gac Wojciech , Zawadzki Witold , Greluk Magdalena , Słowik Grzegorz , Machocki Andrzej , Papavasiliou Joan , Avgouropoulos George
Published: May 2019

Steam reforming of methanol (SRM) was investigated over palladium zinc oxide catalyst modified with chromium, copper supported on alumina modified manganese oxide and commercial copper catalyst supported on zinc oxide modified with alumina. These catalysts showed high activity and selectivity towards hydrogen and carbon dioxide at low reaction temperatures. Temperature‐programmed desorption, diffuse reflectance infrared Fourier‐transform spectroscopy and catalytic performance studies, indicated that the presence of hydrogen in the gas stream influenced the course of SRM reaction. Such effects were related to hydrogen concentration over the catalysts, the reaction temperature and also the type of catalyst. Semi‐kinetic catalytic studies evidenced that an increase in hydrogen concentration in gas stream led to the decrease of methanol conversion at low‐reaction temperatures and decrease of selectivity to CO2 at high reaction temperatures. It was pointed out that strong interactions of hydrogen with the surface of catalysts may retard transformation of surface species into the SRM products.
Organic Additives for the Enhancement of Laminar Flow in a Brain‐Vessels‐Like Microchannel Assembly
Authors: Ling Fiona W. M. , Heidarinik Somaye , Abdulbari Hayder A.
Published: May 2019

Organic polymers were extracted from okra, aloe vera, and hibiscus leaves and used as drag‐reducing additives (DRAs) to enhance the laminar flow in custom‐made microchannels that simulate the human brain vessels. The experiment was conducted using an open‐loop microfluidic system. The flow enhancement performance was evaluated as the function of percentage of flow increment of mucilage additives at different concentrations. Okra mucilage showed greater flow enhancement performance at higher mucilage concentration while both aloe vera and hibiscus mucilage performed better at lower additive concentration. The findings prove the potential of these organic polymers as DRAs to enhance the blood flow.
Simulation of Crude Palm Oil Dilution in a Palm Oil Mill Using Computational Fluid Dynamics
Authors: Mohammad Fauzi Ahmad Hafiidz , Saifuddin Md Nabil Ab Adzim , Kasim Farizul Hafiz , Abu Bakar Muhamad Husaini , Zakaria Zaki Yamani , Abu Bakar Mohamad Zailani
Published: May 2019

Computational fluid dynamics (CFD) simulation was applied to simulate the dilution of undiluted crude oil (UCO) in a dilution tank of a palm oil mill. Fluid flow and mixing characteristics were examined. Considering the mixing behavior, the mixing of dilution water and UCO occurred as soon as these fluids entered the dilution tank, and the oil mass fraction in the mixture decreased gradually towards the outlet of the tank. Meanwhile, the velocity of dilution water and UCO declined as the fluids moved from their respective inlets. The intensity of turbulence flow remained until near the tank outlet. For the parametric study, the oil mass fraction of diluted crude oil (DCO) increased with higher UCO flow rate and oil mass fraction in the UCO but declined with higher dilution water flow rate.
Enzyme Promiscuity as a Remedy for the Common Problems with Knoevenagel Condensation
Authors: Koszelewski Dominik , Ostaszewski Ryszard
Published: May 2019

A new protocol based on lipase‐catalyzed tandem reaction toward α,β‐enones/enoesters is presented. For the synthesis of the desired products the tandem process based on enzyme‐catalyzed hydrolysis and Knoevenagel reaction starting from enol acetates and aldehyde is developed. The relevant impact of the reaction conditions including organic solvent, enzyme type, and temperature on the course of the reaction was revealed. It was shown that controllable release of the active methylene compound from the corresponding enol carboxylate ensured by enzymatic reaction diminishes significantly the formation of the unwanted co‐products. Furthermore, this protocol was extended by including a second tandem chemoenzymatic transformation engaging various aldehyde precursors. After a careful optimization of the reaction conditions, the target products were obtained with yields up to 86 % and with excellentE/Z‐selectivity.
Efficient racemization of N‐phenylacetyl‐D‐glufosinate for L‐glufosinate production
Authors: Xu Jian‐Miao , Li Fang‐Long , Xue Ya‐Ping , Zheng Yu‐Guo
Published: May 2019

Most amino acids contain chiral centres and exist as both D‐enantiomer and L‐enantiomer. The optically pure enantiomer is often more valuable than the racemate. Enzymatic resolution provides an effective strategy to obtain optically pure amino acids but often results in large amounts of unwanted isomer. In this study, optically pure L‐glufosinate (L‐PPT) was obtained by coupling amidase‐mediated hydrolysis of N‐phenylacetyl‐D,L‐glufosinate with racemization of N‐phenylacetyl‐D‐glufosinate (NPDG), which exclusively exhibits effective herbicidal properties compared with its D‐enantiomer. To improve the yield of L‐PPT, the racemization reaction conditions were optimized, and through single‐factor experiments, the optimal reaction temperature, reaction time, and mole ratio of phenylacetic acid to NPDG were determined to be 150°C, 30 minutes, and 1.5, respectively. The response surface methodology was applied to further optimize the racemization conditions, and the final yield of L‐PPT reached 96.13% with optimum reaction temperature of 154°C, reaction time of 23 minutes, and phenylacetic acid/NPDG mole ratio of 1.7, respectively. Moreover, adding a small amount of acetic anhydride further raised the yield of L‐PPT to 97.02%.
Implementing Big Data Analytics in Small Firms: A Situated Human Practice Approach
Authors: Gurău Călin , Ranchhod Ashok
Published: May 2019

This study identifies and addresses an important gap in the nascent literature on big data analytics, using a longitudinal case study to investigate the implementation and application of big data analytics into a small firm specialized in transport logistics. Our research is rooted in Practice Theory, considering the implementation of new technologies in organizations as a result of multiple social negotiations, interpretations, and interactions. Our findings indicate the importance and centrality of human factors in decision‐making and operational implementation, technology representing only a means to a clearly specified and collectively assumed objective. Big data analytics adoption and use in the case‐study firm represents a gradual process, with each stage justified by the need to solve the problems caused by heavy and unpredictable road traffic. This approach validates the entrepreneurial effectuation model, which defines a firm's strategy as a fragmented but continuous effort to find and implement effective solutions to the market challenges encountered.
Plasma proteome plus site‐specific N‐glycoprofiling for hepatobiliary carcinomas
Authors: Chang Ting‐Tsung , Cheng Ji‐Hong , Tsai Hung‐Wen , Young Kung‐Chia , Hsieh Sun‐Yuan , Ho Cheng‐Hsun
Published: May 2019

Hepatobiliary cancer is the third leading cause of cancer death worldwide. Appropriate markers for early diagnosis, monitoring of disease progression, and prediction of postsurgical outcome are still lacking. As the majority of circulating N‐glycoproteins are originated from the hepatobiliary system, we sought to explore new markers by assessing the dynamics of N‐glycoproteome in plasma samples from patients with hepatocellular carcinoma (HCC), cholangiocarcinoma (CCA), or combined HCC and CCA (cHCC‐CCA). Using a mass spectrometry‐based quantitative proteomic approach, we found that 57 of 5358 identified plasma proteins were differentially expressed in hepatobiliary cancers. The levels of four essential proteins, including complement C3 and apolipoprotein C‐III in HCC, galectin‐3‐binding protein in CCA, and 72 kDa inositol polyphosphate 5‐phosphatase in cHCC‐CCA, were highly correlated with tumor stage, tumor grade, recurrence‐free survival, and overall survival. Postproteomic site‐specific N‐glycan analyses showed that human complement C3 bears high‐mannose and hybrid glycoforms rather than complex glycoforms at Asn85. The abundance of complement C3 with mannose‐5 or mannose‐6 glycoform at Asn85 was associated with HCC tumor grade. Furthermore, stepwise Cox regression analyses revealed that HCC patients with a hybrid glycoform at Asn85 of complement C3 had a lower postsurgery tumor recurrence rate or mortality rate than those with a low amount of complement C3 protein. In conclusion, our data show that particular plasma N‐glycoproteins with specific N‐glycan compositions could be potential noninvasive markers to evaluate oncological status and prognosis of hepatobiliary cancers.
An emulation model in critical thinking used to develop learning outcomes in inter professional practice
Authors: Leary Kecia S. , Marchini Leonardo , Hartshorn Jennifer , Johnsen David C.
Published: May 2019

Interprofessional education (IPE) and interprofessional practice (IPP) are essential for the comprehensive care of patients. A goal of this paper is to articulate learning outcomes likely to improve patient outcomes. Yet learning outcomes in IPE are “systematically lacking” in consistency.

Objective

An approach offered here and the main purpose of this paper is to develop and implement an IPE learning outcome by applying emulation concepts from the education literature. In dental situations, emulation has been used to derive the thought process of the expert succinctly enough for the novice to apply to the next patient.

Methods

The expert's thought process thus becomes the learning outcome, the learning guide, and the assessment instrument. In IPE/IPP, several experts make up the team. The resulting learning outcome is the collection of key questions from respective health care team members. Team members are primary care, pharmacy, nursing, social work, nutrition, and dentistry. The resulting list of questions has not been reported and was applied to patient planning in a geriatric/special needs clinic.

Results

Students were more likely to apply questions from disciplines that were preceded by didactic instruction—primary care, pharmacy, nutrition, and dentistry—and less likely to apply questions from nursing and social work.

Conclusions

Although still in the early stages, the model is viable to guide learning and assess performance to a level of grasping the concept. The exercise is student led. For the practitioner, the learning outcome becomes the performance outcome. Further model development is ongoing with limited models for comparison.
Disturbance history mediates climate change effects on subtropical forest biomass and dynamics
Authors: Souza Alexandre F. , Longhi Solon Jonas
Published: May 2019

The responses of forest communities to interacting anthropogenic disturbances like climate change and logging are poorly known. Subtropical forests have been heavily modified by humans and their response to climate change is poorly understood. We investigated the 9‐year change observed in a mixed conifer‐hardwood Atlantic forest mosaic that included both mature and selectively logged forest patches in subtropical South America. We used demographic monitoring data within 10 1 ha plots that were subjected to distinct management histories (plots logged until 1955, until 1987, and unlogged) to test the hypothesis that climate change affected forest structure and dynamics differentially depending on past disturbances. We determined the functional group of all species based on life‐history affinities as well as many functional traits like leaf size, specific leaf area, wood density, total height, stem slenderness, and seed size data for the 66 most abundant species. Analysis of climate data revealed that minimum temperatures and rainfall have been increasing in the last few decades of the 20th century. Floristic composition differed mainly with logging history categories, with only minor change over the nine annual census intervals. Aboveground biomass increased in all plots, but increases were higher in mature unlogged forests, which showed signs of forest growth associated with increased CO2, temperature, and rainfall/treefall gap disturbance at the same time. Logged forests showed arrested succession as indicated by reduced abundances of Pioneers and biomass‐accumulators like Large Seeded Pioneers and Araucaria, as well as reduced functional diversity. Management actions aimed at creating regeneration opportunities for long‐lived pioneers are needed to restore community functional diversity, and ecosystem services such as increased aboveground biomass accumulation. We conclude that the effects of climate drivers on the dynamics of Brazilian mixed Atlantic forests vary with land‐use legacies, and can differ importantly from the ones prevalent in better known tropical forests.