bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characterization of a bacterial cellulose-silica nanocomposite prepared from agricultural waste products
Authors: Soemphol Wichai , Charee Panadda , Audtarat Sasiporn , Sompech Supachai , Hongsachart Piyorot , Dasri Thananchai 
Published: January 2020

Abstract
Bacterial cellulose (BC) has attracted considerable scientific interest and can be modified, making it more widely useful in composites with guest nanoparticles. In this study, silica nanoparticles obtained from rice husks were used to prepare BC-silica composite aerogels (CAs) via a sol-gel method. Various amount of silica nanoparticles (3, 6, 9 and 12% w/v) dissolved in 2.5 M NaOH were used as a precursor for inclusion into BC. Subsequently, it was employed to form a SiO2 gel skeleton in a BC matrix by adding 2 M H2SO4, as a catalyst. Increasing levels of silica nanoparticles led progressively lower transmittance values of BC-silica CAs. SEM images revealed a surface morphology of spheroid particles with little agglomeration. The XRD diffraction peaks were gradually covered by a broad peak of silica as increasing silica content. Similarly, FTIR spectroscopy results also indicate the presence of silica in proportion to its content. Furthermore, addition of silica nanoparticles improved the thermal properties using TGA analysis, shifting the decomposition temperature of BC up to 550 °C and retaining of BC weight at least 60% with the BC sample with 3% of silica. This unique characteristic implies that silica had a stabilizing effect on polymeric cellulose. These results demonstrate an economical and environmentally friendly preparation of BC-silica CAs that can benefit material applications.
Effect of grid resolution and spatial representation of NH3 emissions from fertilizer application on predictions of NH3 and PM2.5 concentrations in the United States Corn Belt
Authors: Balasubramanian Srinidhi , McFarland Donald Michael , Koloutsou-Vakakis Sotiria , Fu Kan , Menon Rohit , Lehmann Christopher , Rood Mark J 
Published: January 2020

Abstract
Ammonia (NH3) emissions from fertilizer application is a highly uncertain input to chemical transport models (CTMs). Reducing such uncertainty is important for improving predictions of ambient NH3 and PM2.5 concentrations, for regulatory and policy purposes and for exploring linkages of air pollution to human health and ecosystem services. Here, we implement a spatially and temporally resolved inventory of NH3 emissions from fertilizers, based on high-resolution crop maps, crop nitrogen demand and a process model, as input to the Comprehensive Air Quality Model with Extensions (CAMx). We also examine sensitivity to grid resolution, by developing inputs at 12 km × 12 km and 4 km × 4 km, for the Corn Belt region in the Midwest United States, where NH3 emissions from chemical fertilizer application contributes to approximately 50% of anthropogenic emissions. Resulting predictions of ambient NH3 and PM2.5 concentrations were compared to predictions developed using the baseline 2011 National Emissions Inventory, and evaluated for closure with ground observations for May 2011. While CAMx consistently underpredicted NH3 concentrations for all scenarios, the new emissions inventory reduced bias in ambient NH3 concentration by 33% at 4 km × 4 km, and modestly improved predictions of PM2.5, at 12 km × 12 km (correlation coefficients r = 0.57 for PM2.5, 0.88 for PM-NH4, 0.71 for PM-SO4, 0.52 for PM-NO3). Our findings indicate that in spite of controlling for total magnitude of emissions and for meteorology, representation of NH3 emissions and choice of grid resolution within CAMx impacts the total magnitude and spatial patterns of predicted ambient NH3 and PM2.5 concentrations. This further underlines the need for improvements in NH3 emission inventories. For future research, our results also point to the need for better understanding of the effect of model spatial resolution with regard to both meteorology and chemistry in CTMs, as grid size becomes finer.
An unusual presentation of sporadic Creutzfeldt-Jakob disease
Authors: Podger Hannah , Ipe Anil 
Published: January 2020

Abstract
Sporadic Creutzfeld-Jakob disease (CJD) is a rare neurodegenerative disorder. It is uniformly fatal. Clinical signs include myoclonus, visual disturbances, cerebellar ataxia, akinetic mutism and pyramidal/extrapyramidal signs in addition to a rapidly progressive dementia. Premortem diagnosis is challenging due to the rarity of the condition and the subsequent low index of suspicion held for it. On literature review, isolated language impairment as the first neurological symptom occurs in only about 1% of patients with sporadic CJD (El Tawil et al. (2017, Acta Neurol Scand, 135: 316–23)). We present this patient’s case, marked for the unusual presentation and the rapidity of decline, to emphasise the need for awareness of CJD as an important differential diagnosis on stroke units. In our case, magnetic resonance imaging findings drove the suspicion of sporadic CJD as the diagnosis. This seems to correlate with other case reports recognising CJD presenting with progressive aphasic disorders (Terrin et al. (2017, Neurol Sci, 38: 1535–7); Mandell et al. (1989, Neurology, 39: 55–8); Martory et al. (2012, Eur Neurol, 67: 360–2)).
Sharing the ‘weight’ of obesity management in primary care: integration of registered dietitian nutritionists to provide intensive behavioural therapy for obesity for Medicare patients
Authors: Jacobs Molly , Harris Jordan , Craven Kay , Sastre Lauren 
Published: January 2020

Abstract

Background
Clinical provision of intensive behavioral therapy for obesity (IBTO) has been a reimbursable treatment for obesity since 2012. However, gaps remain in the literature regarding its impact on patient outcomes.

Objectives
The primary objective of this study was to examine the integration of registered dietitian nutritionist provided IBTO into a primary care setting and evaluate clinic outcomes for Medicare Part B beneficiaries. A secondary objective was to examine intensity of IBTO (quantity of IBTO visits) versus clinical outcomes and influence of socioeconomic factors.

Methods
A case–control retrospective chart review was conducted at a rural, Academic Family Medicine Clinic in Eastern North Carolina for patients seen between 1 January 2016 and 1 January 2019. In order to be included in the treatment group, patients had to be female, white or black race, have Medicare insurance and a body mass index ≥ 30 kg/m2.

Results
Mixed model analysis showed statistically significant improvements in clinical outcomes from IBTO treatment. Weight decreased by nearly 3 pounds, while body mass index was half a point lower. A1C was 0.1 units lower for IBTO patients, and they took prescription medication and average of 6 days less than the control group. Minorities and older respondents experienced smaller, all else constant, and annual fixed effects suggest that differentials widen over time.

Conclusions
Registered dietitian nutritionist (RDN) provision of IBTO has demonstrated benefit in improving clinical outcomes including weight, A1C, and reduced medication duration (use) as demonstrated by the IBTO treatment group versus control. IBTO intensity was not predictive of success, and its impact was reduced with older and African American patients. IBTO is beneficial and can be delivered within the primary care setting by a RDN.
Person–Environment Resources for Aging Well: Environmental Docility and Life Space as Conceptual Pillars for Future Contextual Gerontology
Authors: Wahl Hans-Werner , Gerstorf Denis 
Published: January 2020

AbstractA variety of different disciplines in the study of aging have long acknowledged that individual functioning and development are profoundly shaped by the contexts people live in. The Gerontologist has played a central role in publishing and fostering theoretical and empirical work geared toward better understanding many of the questions that revolve around the how and the why. To illustrate, we consider in a first step the environmental docility hypothesis and the life space construct as two landmark concepts published in The Gerontologist and review how these—in conjunction with the later introduced proactivity perspective—have shaped for decades and continue to shape the larger field of (contextual) gerontology. In a second step, we discuss how these two entirely separate conceptualizations could be integrated in a late pas-de-deux. In doing so, we also make use of Wahl & Gerstorf's conceptual framework for studying COntext Dynamics in Aging (CODA) to discuss how these classic concepts can promote future gerontological research.
Prospective Evaluation of Universal BRCA Testing for Women With Triple-Negative Breast Cancer
Authors: Emborgo Trisha S , Saporito Donika , Muse Kimberly I , Barrera Angelica M Gutierrez , Litton Jennifer K , Lu Karen H , Arun Banu K 
Published: January 2020

Abstract

Background
Limited published literature exists on women with triple-negative breast cancer (TNBC) diagnosed over the age of 60 years with breast cancer gene (BRCA) pathogenic variants. Our study determined whether the rate of BRCA pathogenic variants in a prospective cohort of TNBC patients outside the definition of current clinical genetic testing (GT) guidelines warrants a change in recommendations.

Methods
A prospective study of 395 women with TNBC underwent genetic counseling and 380 (96.2%) underwent clinical BRCA GT regardless of age of diagnosis beginning January 2014 to October 2015 at The University of Texas MD Anderson Cancer Center, Houston. TNBC patients older than 60 years who did not meet clinical GT guidelines had comprehensive sequencing and large rearrangement GT as part of the research protocol.

Results
Fifty-one of 380 (13.4%) women with TNBC who underwent clinical BRCA GT were BRCA positive. Of the 86 patients diagnosed at age over 60 years and underwent GT, only two (2.3%) were positive for BRCA. These two patients would have met clinical testing criteria due to family or ancestral history.

Conclusions
Our study does not support universal BRCA testing for TNBC patients diagnosed older than 60 years as their only risk factor for a BRCA pathogenic variant. Both of the positive BRCA patients older than 60 years identified would have met current National Comprehensive Cancer Network criteria for testing. Therefore, our study demonstrates that the National Comprehensive Cancer Network guidelines provide sufficient criteria for identifying BRCA pathogenic variants in women with TNBC at 60 years or younger.
Dynamic games for secure and resilient control system design
Authors: Huang Yunhan , Chen Juntao , Huang Linan , Zhu Quanyan 
Published: January 2020

Abstract
Modern control systems are featured by their hierarchical structure composed of cyber, physical and human layers. The intricate dependencies among multiple layers and units of modern control systems require an integrated framework to address cross-layer design issues related to security and resilience challenges. To this end, game theory provides a bottom-up modeling paradigm to capture the strategic interactions among multiple components of the complex system and enables a holistic view to understand and design cyber-physical-human control systems. In this review, we first provide a multi-layer perspective toward increasingly complex and integrated control systems and then introduce several variants of dynamic games for modeling different layers of control systems. We present game-theoretic methods for understanding the fundamental tradeoffs of robustness, security and resilience and developing a cross-layer approach to enhance the system performance in various adversarial environments. This review also includes three quintessential research problems that represent three research directions where dynamic game approaches can bridge between multiple research areas and make significant contributions to the design of modern control systems. The paper is concluded with a discussion on emerging areas of research that crosscut dynamic games and control systems.
A current understanding of multiple sclerosis
Authors: Shull Catherine , Hoyle Brittany , Iannotta Caylin , Fletcher Eden , Curan Megan , Cipollone Victoria 
Published: January 2020

ABSTRACT
Multiple sclerosis (MS) is an autoimmune inflammatory disorder that affects more than 900,000 Americans. Patient presentations vary widely; therefore, symptom recognition and an understanding of diagnostic criteria are critical in providing timely patient referrals. This article describes recognition and diagnosis of MS using the updated 2017 criteria, and offers an overview of epidemiology, prognosis, and treatment strategies.
Immediate Internal Fixation of Open Ankle Fractures
Authors: Franklin JONATHAN L. , Johnson KENNETH D. , Hansen SIGVARD T. 
Published: January 2020

Abstract
We reviewed thirty-eight cases of open ankle fractures that had been treated with a standard protocol: alignment and splinting of the fracture at the scene of injury if possible, antibiotics administered in the emergency room and continued for forty-eight hours, admission of the patient to the operating room as quickly as possible, copious irrigation and thorough debridement of the wound, immediate rigid anatomical internal fixation, and delayed primary closure at five days. All of the fractures united, but three patients required subsequent ankle fusion because of cartilage damage noted at the initial operation. Of the thirty-five ankles with complete follow-up, the functional result was excellent in twenty-six and fair or poor in nine.
Proteomics-Enriched Prediction Model for Poor Neurologic Outcome in Cardiac Arrest Survivors*
Authors: Distelmaier Klaus , Muqaku Besnik , Wurm Raphael , Arfsten Henrike , Seidel Stefan , Kovacs Gabor G. , Mayer Rupert L. , Szekeres Thomas , Wallisch Christine , Hubner Pia , Goliasch Georg , Heinze Georg , Heinz Gottfried , Sterz Fritz , Gerner Christopher , Adlbrecht Christopher 
Published: January 2020

Objectives:Neurologic outcome prediction in out-of-hospital cardiac arrest survivors is highly limited due to the lack of consistent predictors of clinically relevant brain damage. The present study aimed to identify novel biomarkers of neurologic recovery to improve early prediction of neurologic outcome.Design:Prospective, single-center study,Setting:University-affiliated tertiary care center.Patients:We prospectively enrolled 96 out-of-hospital cardiac arrest survivors into our study.Interventions:None.Measurements and Main Results:Neurologic outcome was assessed by the Cerebral Performance Categories score. To identify plasma biomarkers for poor neurologic outcome (Cerebral Performance Categories score ≥ 3), we performed a three-step proteomics strategy of preselection by shotgun analyses, crosschecking in brain tissue samples, and verification by targeted proteomic analyses using a multistep statistical modeling approach. Sixty-three patients (66%) had a poor neurologic outcome. Out of a total of 299 proteins, we identified α-enolase, 14-3-3 protein ζ/δ, cofilin-1, and heat shock cognate 71 kDa protein as novel biomarkers for poor neurologic outcome. The implementation of these biomarkers into a clinical multimarker model, consisting of previously identified covariates associated to outcome, resulted in a significant improvement of neurologic outcome prediction (C-index, 0.70; explained variation, 11.9%;pfor added value, 0.019).Conclusions:This study identified four novel biomarkers for the prediction of poor neurologic outcome in out-of-hospital cardiac arrest survivors. The implementation of α-enolase, 14-3-3 protein ζ/δ, cofilin-1, and heat shock cognate 71 kDa protein into a multimarker predictive model along with previously identified risk factors significantly improved neurologic outcome prediction. Each of the proteomically identified biomarkers did not only outperform current risk stratification models but may also reflect important pathophysiologic pathways undergoing during cerebral ischemia.
Cytomegalovirus-Induced Hemophagocytic Lymphohistiocytosis
Authors: Jain Hanish , Tambe Ajay , Gada Kunal , Yadava Sanjay , Eranki Ambika 
Published: January 2020

Abstract
Hemophagocytic lymphohistiocytosis (HLH) is a rare immunopathological syndrome, which can be fatal if not diagnosed early. It is characterized by excessive immune activation and can be observed in all age groups depending on the causes of HLH. Here, we describe a case of cytomegalovirus-induced HLH in an immunocompromised host which was diagnosed in the setting of high clinical suspicion and insufficient diagnostic information.
An Update on Epidemiology and Management Trends of Vestibular Schwannomas
Authors: Pandrangi Vivek C. , Han Albert Y. , Alonso Jose E. , Peng Kevin A. , St. John Maie A. 
Published: January 2020

Objective:To determine the current epidemiology and management trends for patients with vestibular schwannomas (VS).Study Design:Retrospective cohort study.Setting:The Surveillance, Epidemiology, and End Results (SEER) tumor registry.Patients:The SEER database was queried to identify patients diagnosed with VS from 1973 to 2015. Demographics, patient and tumor characteristics, and treatment methods were analyzed.Results:A total of 14,507 patients with VS were identified. The mean age at diagnosis was 55 ± 14.9 years. Age-adjusted incidence from 2006 to 2015 was 1.4 per 100,000 per year and remained relatively stable. Incidence across age varied with sex, as younger women and older men had increased incidences comparatively. A higher percentage of patients underwent surgery alone (43%), followed by observation (32%), radiation alone (23%), and combined radiation and surgery (2%). Age 65 and older was associated with observation (odds ratio [OR] 1.417;p = 0.029) whereas age 20 to 39 and 40 to 49 were associated with surgery (OR 2.013 and 1.935;p < 0.001). Older age was associated with radiation. Larger tumor size was associated with surgery and combined treatment. African American patients and American Indian or Alaskan Native patients were more likely to undergo observation than surgery.Conclusions:The overall incidence of VS is 1.4 per 100,000 per year and has remained relatively stable. There is a trend toward more conservative management with observation, which may be secondary to earlier diagnosis given widespread use of magnetic resonance imaging. Further studies are necessary to investigate differences in disease patterns and disparities in management.
Incidence of Congenital Stapes Footplate Fixation Since 1970: A Population-based Study
Authors: Totten Douglas J. , Marinelli John P. , Carlson Matthew L. 
Published: January 2020

Objective:
Several reports have suggested that the incidence of otosclerosis is declining. However, due to the limitations of epidemiologic databases within the United States, little is known about the incidence of congenital stapes footplate fixation (CSFF), much less epidemiological trends over the past 50 years. The current study was conceived to characterize the epidemiology of CSFF over the past five decades using the unique resources of the Rochester Epidemiology Project (REP).

Study Design:
Population-based study.

Patients:
The medical records of every resident of Olmsted County, Minnesota who was diagnosed with CSFF was reviewed from January 1, 1970 to December 12, 2017 using the REP. The population of Olmsted County on January 1, 2017 was 159,689 persons.

Main Outcome Measure:
Incidence of CSFF.

Results:
Sixteen cases of CSFF were identified at a median age at diagnosis of 8 years (IQR, 6–17), eight of whom confirmed by exploratory tympanotomy. Three of the 16 (19%) cases were bilateral, and the median pure-tone average (500, 1k, 2k, 3k Hz) at time of diagnosis was 37 dB (IQR, 31–48). Two (13%) cases were identified in patients bearing a syndromic condition and one (6%) case demonstrated a malformed external ear on physical examination. The incidence rate of surgically confirmed cases among residents of Olmsted County was 0.31 per 100,000 person-years from 1970 to 1979 and 0.28 from 2000 to 2009. No incident cases among residents of Olmsted County were identified since 2010.

Conclusions:
CSFF constitutes a rare disease. Unlike epidemiological trends in otosclerosis, the incidence of surgically confirmed cases of CSFF remained stable over the past 50 years.
Change in Eustachian Tube Function With Balloon Dilation in Adults With Ventilation Tubes
Authors: Alper Cuneyt M. , Teixeira Miriam S. , Rath Tanya J. , Hall-Burton Denise , Swarts J. Douglas 
Published: January 2020

Objective:
Assess the changes in Eustachian tube (ET) function (ETF) with balloon dilation of Eustachian tube (BDET).

Study Design:
Prospective cohort for repeated testing measures.

Setting:
Clinical research center.

Patients:
Eleven adults with at least one patent ventilation tube (VT) inserted for chronic ET dysfunction (ETD) and history of otitis media with effusion.

Interventions:
Subjects with evidence of moderate to severe ETD on the side with a VT underwent unilateral BDET.

Main Outcome Measures:
Changes in ETF parameters after BDET measured by Forced Response Test (FRT), Inflation Deflation Test (IDT), and Pressure Chamber test.

Results:
With the FRT at 11 ml/min, opening pressure (OP) decreased from 458 ± 160 to 308 ± 173 daPa and closing pressure (CP) from 115 ± 83 to 72 ± 81 daPa at the 3-month post-BDET visit. The IDT and Pressure Chamber test showed that the percentage of middle ear (ME) pressure gradient equilibrated with swallows improved from 28 ± 34 to 53 ± 5% for positive and from 20 ± 28 to 38 ± 43% for negative ME pressure. Images from the pre- and post-BDET functional CT scans did not show apparent changes in the anatomy. Comparisons of ETF test parameters pre- and post-BDET suggested that the ET was easier to open and stayed open longer after the procedure. However, during the limited duration of follow-up most subjects continued to have ETD, some requiring VT re-insertion after the study period.

Conclusions:
Adults with severe ETD may benefit from BDET, however ETD may not be completely resolved and patients may continue to need VTs.
Multidetector Computed Tomography Findings of Adhesive Internal Hernias
Authors: Zhang Fengyan , Qiao Ying , Zhang Hui 
Published: January 2020

Objective
To identify multidetector computed tomography (MDCT) findings of surgically confirmed adhesive internal hernias (IHs).

Methods
Two gastrointestinal radiologists performed blinded, independent, and retrospective reviews of MDCT findings from a consecutive cohort of 35 adhesive IH and 41 adhesive small-bowel obstruction cases that had undergone surgery within 48 hours after MDCT. Univariate statistical analyses were performed to assess CT signs of adhesive IHs and CT findings of intestinal necrosis in patients presenting with adhesive IHs.

Results
Dislocated cluster of the intestine (P = 0.005), 2 transitional zones (P = 0.002), and presence of fat in the center sign (P = 0.001) were key CT outcomes that were significantly associated with adhesive IHs. Additionally, intramural hemorrhage was found the MDCT feature indicative of intestinal necrosis (P = 0.028).

Conclusions
This study illustrates specific MDCT findings of IHs, and these observations may help guide early clinical management of the condition.