bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determination of Shanzhiside Methylester in Rat Plasma by Uplc-Ms/Ms and its Application to a Pharmacokinetic Study
Authors: Weng Qinghua , Chen Yichuan , Zhong Zuoquan , Wang Qianqian , Chen Lianguo , Wang Xianqin 
Published: June 2020

Introduction:
In this study, we used UPLC-MS/MS to detect shanzhiside methylester in
rat plasma, and investigated its pharmacokinetics in rats.

Materials and Methods:
Diazepam was utilized as an internal standard (IS), and acetonitrile precipitation
method was used to process the plasma samples. Chromatographic separation was
achieved using a UPLC BEH C18 column using mobile phase of methanol-0.1 % formic acid with
gradient elution. Electrospray ionization (ESI) tandem mass spectrometry in multiple reaction
monitoring (MRM) mode with positive ionization was applied.

Results:
The results indicated that within the range of 5-4000 ng/mL, linearity of shanzhiside
methylester in rat plasma was acceptable (r>0.995), and the lower limit of quantification (LLOQ)
was 5 ng/mL. Intra-day and inter-day precision RSD of shanzhiside methylester in rat plasma were
lower than 14%. Accuracy range was between 87.3 % and 109.1 %, and matrix effect was between
99.2% and 106.3%.

Conclusion:
The method was successfully applied in the pharmacokinetics of shanzhiside methylester
in rats after intravenous administration.
Occurrence of blaTEM and blaROB in Haemophilus species Causing Respiratory Tract Infections
Authors: Khurana Prerna , Shenoy Suchitra 
Published: June 2020

Background:
Emergence of resistance to some antibiotics in Haemophilus influenzae, a
respiratory pathogen is a cause of concern. The aim is to study the antibiotic susceptibility pattern
of Haemophilus isolates from respiratory infections with reference to beta-lactam resistance.

Methods:
This is a laboratory based prospective study done in the department of microbiology in
a tertiary care center after institutional ethics committee clearance. Haemophilus influenzae isolates
from respiratory tract specimens over a period of one year were subjected to antibiotic susceptibility
tests. Beta-lactamase production was detected by nitrocefin disc. hpd gene, blaTEM and
blaROB genes were detected by PCR. The data was analysed using SPSS 11.5 version.

Results:
Of the 162 isolates, 89.5% were from sputum specimens. Ampicillin resistance was seen
in 5 (3.09%) isolates. The ampicillin resistant strains were positive for beta-lactamase enzyme and
blaTEM gene. BLNAR and isolates with blaROB gene were not found.

Conclusion:
In case of Haemophilus influenzae respiratory tract infection empirical treatment
with amoxicillin clavulanate or third generation cephalosporin may be the drugs of choice in our
geographic area.
Improving Adherence to Adjuvant Hormonal Therapy Among Disadvantaged Women Diagnosed with Breast Cancer in South Carolina: Proposal for a Multimethod Study
Authors: Felder Tisha M , Heiney Sue P , Hebert James R , Friedman Daniela B , Elk Ronit , Franco Regina , Gansauer Lucy , Christensen Barbara , Ford Marvella E 
Published: June 2020

Background
Current clinical guidelines recommend that hormone receptor–positive breast cancer survivors take adjuvant hormonal therapy (AHT) for 5 to 10 years, following the end of definitive treatment. However, fewer than half of patients adhere to the guidelines, and suboptimal adherence to AHT is associated with an increased risk of breast cancer mortality. Research has extensively documented sociodemographic and disease-specific factors associated with adherence to AHT, but very little evidence exists on behavioral factors (eg, knowledge, patient-provider communication) that can be modified and targeted by interventions.

Objective
The goal of this study is to develop and test a theory-based, multilevel intervention to improve adherence to AHT among breast cancer survivors from racially and socioeconomically disadvantaged backgrounds (eg, Medicaid-insured). The specific aims are to (1) explore multilevel (eg, patient, health care system) factors that influence adherence to AHT; (2) develop a theory-based, multilevel intervention to improve adherence to AHT; and (3) pilot test and evaluate the intervention developed in Aim 2.

Methods
For Aim 1, we will recruit breast cancer survivors and health care professionals to participate in semistructured interviews to gain their perspectives about barriers and facilitators to AHT use. We will conduct a directed content analysis of the Aim 1 qualitative interview data. For Aim 2, we will integrate Aim 1 findings and current literature into the design of a multilevel intervention using an Intervention Mapping approach. For Aim 3, we will recruit Medicaid-insured breast cancer survivors to assess the feasibility of the pilot intervention.

Results
From May 2016 to July 2018, we completed interviews with 19 breast cancer survivors and 23 health care professionals in South Carolina. We will conduct a directed content analysis of the qualitative interview data. Results from this analysis will be used, in combination with current literature, to design (Aim 2) and pilot test a theory-based multilevel intervention (Aim 3) in Summer 2021. Results of the pilot are expected for Fall 2021.

Conclusions
This study will provide a deeper understanding of how to improve adherence to AHT, using a novel and multilevel approach, among socioeconomically disadvantaged breast cancer survivors who often experience disproportionate breast cancer mortality.

International Registered Report Identifier (IRRID)
DERR1-10.2196/17742
DRUGS IN PREGNANCY
Authors: AL-ANI OMAR ABDULWAHID 
Published: June 2020

Objective: During pregnancy, various drugs associated with a contraindication, hence their application is limited and dangerous to mothers along with the fetus. Even though during pregnancy, medication is less preferred but in some instances cannot escape treating the ailments in mother. So here we discussed the medication that can be used safely during pregnancy along with the drugs which are unsafe or highly contraindicated for both mother and the fetus; the problems or complications may be attributed to possible drug interactions during the pregnancy.
Methods: The study was conducted from October 2018 until February 2019 in Baghdad, Iraq. It is conducted in four hospitals: Baghdad teaching hospital, Iraqi Red Crescent Society, Saint Raphael (Al Rahibat) Hospital, and Al-Elwiya Educational Hospital. The medical staff in these hospitals assessed for their knowledge about drug effects, complications, and safety during pregnancy. Those medical staff assayed was divided into three groups: Physicians, pharmacists, and other medical staff (47 pharmacists, 38 physicians, and 15 nurses who participated in this study).
Results: We found that the majority of doctors and pharmacists useful information on pregnancy categories which is a good indicator of the knowledge of these specialists as the subject of drugs and their impact on pregnant women and the fetus is sensitive and vital because it affects all segments of society.
Conclusion: It is the responsibility of all clinicians, including pharmacists, to counsel patients with complete, accurate, and current information on the risks and benefits of using medications during pregnancy.
STUDY OF MEDICATION ERRORS BY PROSPECTIVE OBSERVATIONAL APPROACH IN WARANGAL HOSPITALS
Authors: RAVULA SHIVANI , JANGA AKHILA , POONURU RAJASEKHAR 
Published: June 2020

Objective: The objective of the study was to determine the prevalence of medication errors occurring in a multispecialty hospital in Warangal.
Methods: A prospective observational study was conducted in Rohini Superspeciality Hospital, Hanamkonda, Warangal, from October 2018 to March 2019, to study the prevalence of medication errors.
Results: In this study, 500 patients were selected, of which 160 were identified with medication errors. Two hundred and seventy-one medication errors were identified among these patients, of which 100 (60.63%) patients were male and 24.37% of patients were female.
Conclusion: This present study manifests that medication errors were predominate in males than in females and also the common age group was 50–60 years.
EXAMINATION OF PHYTOCHEMICAL CONSTITUENTS – USING SEED EXTRACT OF MADHUCA LONGIFOLIA
Authors: D MANIKANDAN , S PARVEEN , PA PERIASAMY 
Published: June 2020

Objective: Our main scope and objective are to prepare seed extract of Madhuca longifolia, to characterize them using phytochemical activity studies, and to study the presence of so many bioactive substances established phytochemical activity and anti-foot ulcer treatment.
Methods: Weighed 75 g of plant sample (without preliminary drying) accurately (precisely weighed to within 0.10 g) in a tarred evaporating dish. Care was taken so that no substantial amount of moisture is lost during preparation and that was representative of the official sample and the sample has been made to screening to following studies such as physicochemical constants, determination of moisture content, evaluation of pH of aqueous solution, evaluation of total ash, evaluation of acid-insoluble ash, evaluation of extractive values, evaluation of water-soluble extractive, evaluation of alcohol-soluble extractive, and preliminary phytochemical screening phytochemical profile of M. longifolia seed.
Results: The presence of so many bioactive substances established phytochemical activity and anti-foot ulcer treatment using M. longifolia seed which supports the traditional tribal medicinal consumption of the plant.
Conclusion: The quality of the plant can be estimated by determining the physical parameters. These investigations are of great importance for carrying out the revalidation and it was accomplished from the phytochemical study that the solvent extract contains flavonoid, carbohydrate, saponin, tannin, glycoside, protein, alkaloid, and amino acid which are responsible for various pharmacological actions and promotes that biological study is required to explore their potential therapeutic activities.
ADHERENCE AND ASSOCIATED ADVERSE DRUG REACTION WITH ANTIDEPRESSANTS MEDICATION AMONG DEPRESSION PATIENTS IN PSYCHIATRIC HOSPITAL IN POKHARA, NEPAL
Authors: MARASINE NIRMAL RAJ , SANKHI SABINA , LAMICHHANE RAJENDRA , MARASINI NABIN RAJ , BAHADUR DANGI NIM 
Published: June 2020

Background: The present study determined the prescription pattern of antidepressants, adverse drug reactions (ADRs), the level of adherence, and factors affecting it.
Methods: This prospective cross-sectional study was conducted with depression patients (n=174; 55.74% female) from August 2019 to November 2019 at a psychiatric hospital of Pokhara, Kaski, Nepal. The Naranjo ADR Probability Scale was employed to assess the ADRs. The rate of medication adherence (MA) was determined using Morisky MA Measurement Scale-Eight. Descriptive statistics (median, interquartile range, frequency, and percentage), bivariate analysis, and Chi-square test were used; p<0.05 was taken as significant in multivariate analysis.
Results: Selective serotonin reuptake inhibitors (SSRIs) were found to be the most commonly prescribed antidepressants (58.04%) followed by serotonin and noradrenaline reuptake inhibitors (SNRIs; 13.79%). More than half of the patients had a low level of adherence (52.29%) and about 74.13% experienced ADR. The most common ADRs were insomnia (17.05%) and anxiety (17.05%). Female were found to be more non-adherent compared to male (odds ratio 1.011; 95% confidence interval; 0.507–1.832). The level of adherence was found to be associated with the probability and severity of ADR.
Conclusion: The majority of patients used SSRIs. ADRs were more prevalent. However, adherence to medications was extremely poor in the hospital, which was attributed to factors such as gender, occupation, education, and ADRs.
THE DENGUE VACCINES: ASSESSMENT OF FUTURE PROSPECTS, TREATMENT, AND VACCINE CHALLENGES
Authors: KALYANI GADE , N THANUSHREE 
Published: June 2020

Objectives: As per the national survey data, the prevalence of dengue has been still rising consistently, and the burden of the disease is predominantly affecting the adults with progression toward the DF, dengue hemorrhagic fever, and dengue shock syndrome. The higher hospitalization rate result in massive mortality.
Methods: Vector control alone cannot reduce the transmission of viral infection, so effective vaccine development is made high priority.
Results: Several vaccine candidates including live attenuated, live chimeric, inactivated and many other vector vaccines are key elements needed to achieve the dengue public health targets. Global strategies like diagnosis, care management, outbreak preparedness and integrated surveillance, sustainable vector control, and future vaccine implementation are needed to be addressed.
Conclusion: This review mainly describes the dengue treatment challenges, in addition to a brief discussion of dengue vaccine challenges and future outlook on dengue that might help in making efficacious vaccine in near future.
PREVALENCE AND CLINICAL CONSEQUENCES OF POLYPHARMACY ON MEDICATION PROFILE AMONG THE ELDERLY IN A TERTIARY CARE TEACHING HOSPITAL
Authors: MN LAKSHMI PRASANNA , UNNISA AZIZ 
Published: June 2020

Objective: A sharp increase in chronic diseases for elderly patients has been observed in recent years resulting in polypharmacy, which may lead to drug-drug interactions (DDI’s), drug-related problems, adverse drug reactions (ADR’s), and many more issues in these patients. The present study was conducted to assess the clinical consequences of polypharmacy and its prevalence in the older adult population.
Methods: Our work is a prospective, observational study carried out in a tertiary care teaching hospital. The polypharmacy prescriptions were identified (taking at least five medications), and drug-drug interactions were detected by Micromedex® DrugReax® System 2.0 version. The medication profiles were also checked for inappropriate prescribing according to Beers Criteria 2015.
Results: In the study, the mean age of patients was found to be 72.4±8.8 years. Most of the patients (81.8%) had more than two and less than five diseases. The mean number of drugs prescribed in all the prescriptions was found to be 7.4±2.6. According to Beers Criteria-2015, 3.83% of the total medications prescribed were inappropriate, 74.1% of moderate DDI’s were observed in patients, and 50.2% of the DDI’s observed theoretically were documented as fair.
Conclusion: The impact of polypharmacy on consequences such as the length of stay, DDI’s, and DRP’s was also found to be significant. This study concludes that the medication profile of older adult patients should be assessed regularly for the rationality of drug therapy to maximize the therapeutic response positively with the lowest number of medications possible.
100-OR: High-Affinity Islet Autoantibodies Predict Progression to Diabetes in Those Who Seroconvert after Age 10
Authors: FROHNERT BRIGITTE I. , DONG FRAN , WAUGH KATHLEEN , STECK ANDREA , NORRIS JILL M. , YU LIPING , REWERS MARIAN 
Published: June 2020

The objective of this study was to determine if islet autoantibodies (IA) can develop de novo in youth ≥10 y. We also explored the risk of progression to T1D in youth seroconverting to IA after 10 y.
From the prospective DAISY birth cohort (n=2547), we excluded those who were ever previously IA positive, disenrolled prior to age 10, or had &gt;24 month gap in annual IA testing, leaving 917 for analysis. Seroconversion was defined as IA+ by radiobinding assays for insulin, GAD, IA-2 or ZnT8 autoantibodies, confirmed within 3-6 months. The same autoantibodies were also measured by electrochemiluminescence (ECL) assays, to identify high-affinity IA.
IA developed after age 10 at a higher rate (p=0.049) in first-degree relatives than in general population youth with increased-risk HLA (Figure 1); there was no difference by sex or race/ethnicity. Of the 35 IA+ seroconverters, 6 progressed to T1D, during a median follow-up of 5.04 years (IQR: 3.56-8.45). This included 2 of 5 individuals who were multiple IA+ at seroconversion, with at least one IA confirmed as high-affinity by ECL. Among those with a single persistent IA+ at seroconversion, 4/9 youth with high-affinity IA (ECL+) progressed to T1D, compared to 0/21 of the youth with low-affinity IA (ECL-).
In conclusion, seroconversion continues after age 10. In our genetically at-risk cohort, all who progress to T1D had high-affinity IA confirmed by ECL.

Disclosure
B.I. Frohnert: None. F. Dong: None. K. Waugh: None. A. Steck: None. J.M. Norris: None. L. Yu: None. M. Rewers: None.

Funding
JDRF (5-ECR-2017-388-A-N); National Institutes of Health (R01DK32493)
1003-P: Estimating an Optimal Meal Bolus for Persons with Diabetes on Multiple Daily Injections Therapy without Carb Counting
Authors: JIANG BOYI , ZHONG YUXIANG , AGRAWAL PRATIK , CORDERO TONI L. , VIGERSKY ROBERT 
Published: June 2020

Background: MDI therapy requiring carbohydrate (carb) counting can be burdensome for persons with diabetes (PWD). We conducted an in-silico feasibility study assessing the glycemic performance of a post-prandial rather than a carb-based bolus optimizer.
Methods: The data were collected from seven adults with T1D (Gender:M2/F5; Age:22-45) on MDI using the Guardian™ Connect continuous glucose monitoring system. All participants had three bolus events matched to three meals for ≥7 days. In the training stage, a glucose-insulin minimal model extracted the rate of glucose appearance in blood (Ra) for each meal. The Ra was taken as an input to adjust in-silico simulated bolus amounts until the greatest time in sensor glucose range (70-180 mg/dL, TIR) within 4hrs was reached. In the testing stage, two bolus strategies were tested: the average of the adjusted bolus from the training set (Uniform Bolus) and the average of the adjusted bolus from the training set associated with the time of day (TOD) of the meal announcement (TOD Bolus).
Results: We found increased TIR for TOD Bolus strategy compared to the User Bolus (baseline) strategy (See Table below).
Conclusion: The data suggested that the automated bolus optimizer without carb counting may allow for an increased time spent in the target range, without comprising time spent below range while reducing the burden of carb counting for PWD on MDI.

Disclosure
B. Jiang: Employee; Self; Medtronic. Y. Zhong: Employee; Self; Medtronic. P. Agrawal: None. T.L. Cordero: Employee; Self; Medtronic. R. Vigersky: Employee; Self; Medtronic.
1015-P: Insulin-Excipient–Induced Inflammation and Pharmacokinetic Variability
Authors: HIDAU MAHENDRA K. , KESSERWAN CHAFICA , QIAO YI , KREUTZER DON , KLUEH ULRIKE 
Published: June 2020

Objective: To evaluate the impact of phenol-based insulin-excipient induced inflammation on insulin pharmacokinetic (PK) variability in diabetic mice and to evaluate effects of anti-inflammatory agents (dexamethasone and cromolyn) in minimizing excipient induced inflammation.
Methods: Using a modified murine air pouch model, saline or insulin excipients were continuously infused for durations of 1 and 3 days. Subsequently, a single subcutaneous insulin injection of 0.3U (1:100; Humalog) was placed into the air pouch. Blood samples were taken periodically. Bioanalysis was done by ELISA for PK evaluation. A separate analysis determined effects of anti-inflammatory agents co-infused with insulin on maintaining glycemia during infusion pump therapy while extending its lifespan. Tissue was analyzed by standard histopathology (H and E).
Results: Primary PK values Cmax, Tmax, AUC (0-120) for saline and excipient infused groups are depicted in Figure 1A and 1B. The excipient group demonstrated lower Tmax, AUC (0-120) and Cmax as compared to saline group. Figure 1C depicts a significantly greater degree of inflammation in all excipient treated groups. Usage of co-infusion with anti-inflammatory agents extends insulin infusion set lifespan.
Conclusion: Insulin excipients induce site specific inflammation that alters insulin PK and diminishes the in vivo insulin bioavailability. Confirmation in a porcine model is underway.

Disclosure
M.K. Hidau: None. C. Kesserwan: None. Y. Qiao: None. D. Kreutzer: Other Relationship; Self; Abbott Laboratories, cell and molecualar tissue enginnering (cmte). U. Klueh: Research Support; Self; Abbott. Other Relationship; Self; Cell and Molecular Tissue Engineering, LLC.

Funding
The Leona M. and Harry B. Helmsley Charitable Trust
102-OR: Detection of Diabetes from Whole-Body Magnetic Resonance Imaging Using Deep Learning
Authors: WAGNER ROBERT , DIETZ BENEDIKT , MACHANN JÜRGEN , SCHWAB PATRICK , DIENES JULIA K. , REICHERT STEFFEN , BIRKENFELD ANDREAS L. , HAERING HANS-ULRICH , SCHICK FRITZ , STEFAN NORBERT , HENI MARTIN , PREISSL HUBERT , SCHÖLKOPF BERNHARD , BAUER STEFAN , FRITSCHE ANDREAS 
Published: June 2020

Obesity is one of the main drivers of the globally rising prevalence of type 2 diabetes (T2D). Yet, obesity is not uniformly associated with metabolic consequences. The location of fat accumulation is critical for metabolic health. Specific patterns of body fat distribution, such as an increased ratio of visceral to subcutaneous fat, are closely related to insulin resistance which is crucial in the pathogenesis of T2D. There might be further, hitherto unknown features of body fat distribution which could additionally contribute to the disease. We used a machine learning approach with dense convolutional neural networks (DCNN) to detect diabetes related variables from 2371 T1-weighted whole-body magnetic resonance image (MRI) data sets. Each single measurement was labelled by sex, age, BMI, insulin sensitivity, HbA1c and prediabetes or incident diabetes. The result was compared to conventional models using segmented body fat compartment volumes. Anatomical labels were assigned to locations in the DCNN gradient heatmaps that are critical for discrimination. The AUC-ROC was 0.87 for the discrimination of diabetes and 0.68 for prediabetes. Classification performance was superior to conventional models. Mean absolute regression errors were comparable to those of the conventional models. Heatmaps clearly showed that lower visceral abdominal regions were most critical in diabetes classification, while other significant areas comprised upper legs, arms and the neck region.Our results show that diabetes is detectable from whole-body MRI without any blood glucose measurement. Our technique of heatmap visualization unravels plausible anatomical regions and highlights the leading role of fat accumulation in the lower abdomen in the pathogenesis of T2D.

Disclosure
R. Wagner: Advisory Panel; Self; Novo Nordisk A/S. Speaker’s Bureau; Self; Novo Nordisk A/S. Other Relationship; Self; Eli Lilly and Company. B. Dietz: None. J. Machann: None. P. Schwab: Employee; Self; Roche Pharma. J.K. Dienes: Advisory Panel; Spouse/Partner; Novo Nordisk A/S. Speaker’s Bureau; Spouse/Partner; Novo Nordisk A/S. Other Relationship; Spouse/Partner; Eli Lilly and Company. S. Reichert: Other Relationship; Self; Lilly Diabetes. A.L. Birkenfeld: None. H. Haering: None. F. Schick: None. N. Stefan: None. M. Heni: Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Sanofi. Speaker’s Bureau; Self; Novo Nordisk A/S. H. Preissl: None. B. Schölkopf: None. S. Bauer: None. A. Fritsche: None.

Funding
German Federal Ministry of Education and Research (01GI0925)