bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diffusion and catalyst efficiency in hierarchical zeolite catalysts
Authors: Peng Peng , Gao Xiong-Hou , Yan Zi-Feng , Mintova Svetlana 
Published: August 2020

Abstract
The preparation of hierarchical zeolites with reduced diffusion limitation and enhanced catalyst efficiency has become a vital focus in the field of zeolites and porous materials chemistry within the past decades. This review will focus on the diffusion and catalyst efficiency of hierarchical zeolites and industrial catalysts. The benefits of diffusion and catalyst efficiency at two levels of hierarchies (zeolitic component level and industrial catalyst level) from a chemical reaction engineering point of view will be analysed. At zeolitic component level, three types of mesopores based on the strategies applied toward enhancing the catalyst effectiveness factor are presented: (i) ‘functional mesopores’ (raising effective diffusivity); (ii) ‘auxiliary mesopores’ (decreasing diffusion length); and (iii) ‘integrated mesopores’ (a combination thereof). At industrial catalyst level, location and interconnectivity among the constitutive components are revealed. The hierarchical pore interconnectivity in multi-component zeolite based industrial catalysts is exemplified by fluid catalytic cracking and bi-functional hydroisomerization catalysts. The rational design of industrial zeolite catalysts at both hierarchical zeolitic component and catalyst body levels can be fully comprehended using the advanced in situ and/or operando spectroscopic, microscopic and diffraction techniques.
Enhanced Surveillance for Histoplasmosis—9 States, 2018–2019
Authors: Benedict Kaitlin , McCracken Stephanie , Signs Kimberly , Ireland Malia , Amburgey Victoria , Serrano Jose Antonio , Christophe Natalie , Gibbons-Burgener Suzanne , Hallyburton Sara , Warren Kimberly A , Keyser Metobo Alison , Odom Racheal , Groenewold Matthew R , Jackson Brendan R 
Published: August 2020

Abstract

Background
Histoplasmosis is often described as the most common endemic mycosis in the United States, but much remains unknown about its epidemiology among the general population.

Methods
We conducted enhanced surveillance in 9 states during 2018–2019 by identifying cases through routine surveillance and interviewing 301 patients about their clinical features and exposures.

Results
Before being tested for histoplasmosis, 60% saw a health care provider ≥3 times, and 53% received antibacterial medication. The median time from seeking health care to diagnosis (range) was 23 (0–269) days. Forty-nine percent were hospitalized, and 69% said that histoplasmosis interfered with their daily activities (median [range], 56 [2–3960] days). Possible exposures included handling plants (48%) and bird or bat droppings (24%); 22% reported no specific exposures. Only 15% had heard of histoplasmosis before their illness.

Conclusions
Histoplasmosis can be severe and prolonged. Additional educational efforts to increase public and provider awareness and reduce delays in diagnosis are needed.
Using Therapeutic Drug Monitoring to Treat KPC-Producing Klebsiella pneumoniae Central Nervous System Infection With Ceftazidime/Avibactam
Authors: Yasmin Mohamad , Hanrahan Jennifer , Marshall Steven , Lodise Thomas P , Chen Liang , Perez Federico , Kreiswirth Barry , Bonomo Robert A 
Published: August 2020

Abstract
This report describes the treatment of Klebsiella pneumoniae carbapenemase (KPC)–3–producing multidrug-resistant K. pneumoniae with ceftazidime/avibactam (CAZ-AVI) in a patient who developed postneurosurgical meningitis and bacteremia. Therapeutic drug monitoring of cerebrospinal fluid and blood samples demonstrated CAZ-AVI concentration levels 20-fold greater than the minimum inhibitory concentration in the first 60 minutes postinfusion, providing evidence for the utility of CAZ-AVI in treating KPC–Klebsiella pneumoniae central nervous system infections.
Care Work and the Family in Catholic Reformation Tuscany
Authors: Maglaque Erin 
Published: August 2020

Abstract
This article examines the care work undertaken by wet-nurses employed by Florence’s foundling hospital, the Spedale degli Innocenti. Left in a basin outside the Innocenti, infants were nursed for a few days in the hospital before being assigned to the homes of wet-nurses living in the villages and remote sharecropped farms of rural Tuscany. Some wet-nurses committed ‘fraud’ — so labelled by the institution — by contriving to receive a wage for wet-nursing their own infants, covertly exchanging the infant delegated to them by the hospital in return for their own. Their ‘fraud’ allows us to challenge assumptions by both historians and feminist economists concerning commercialization and measurement of women’s work; historians might more critically reflect on the systems of monitoring and auditing women’s work that gave rise to our archives. Finally, by receiving a wage for mothering, these wet-nurses allow us to perceive the historical contingency of our most deeply naturalized assumptions about the nature of work and the family. Wet-nursing fraud reveals that definitions of work were always predicated upon concomitant definitions of the family.
Immunity to measles in Italian children and adolescents: a persistent problem in view of measles elimination
Authors: Marchi Serena , Monti Martina , Viviani Simonetta , Remarque Edmond J , Esposito Susanna , Principi Nicola , Ruggiero Luca , Montomoli Emanuele , Trombetta Claudia Maria 
Published: August 2020

Abstract

Background
Despite efforts to increase coverage by two doses of measles vaccine in Italy, measles continues to circulate, with over 13 000 cases of disease since 2013. This study aimed to evaluate immunity to measles in Italian children and adolescents.

Methods
A total of 378 serum samples from subjects aged 9 months–18 years were collected in Northern, Central and Southern regions of Italy between 2012 and 2016. Specific IgG antibodies against measles were measured by a commercial ELISA kit.

Results
The frequency of IgG-positive samples ranged from 10.5% in infants under 1 year to 98.3% in children aged 6–7 years. The frequency of IgG was 72.2% in subjects aged 1–2 years, 85.6% in those aged 3–5 years and 88.3 and 86.8% in those aged 8–10 and 11–18 years, respectively. In Northern Italy, IgG prevalence was consistent with data on vaccination coverage, whereas some differences were observed in samples from subjects aged more than 8 years in Central and Southern Italy.

Conclusions
Our findings confirm that a large proportion of children and adolescents in Italy are still susceptible to measles. While data on first- and second-dose measles vaccination are essential, they are not sufficient to identify susceptible population cohorts to be targeted by vaccination.
Professional Migration, Occupational Challenge, and Mental Health: Medical Practitioners in New Zealand, 1850–1890s
Authors: Tomkins Alannah , Coleborne Catharine 
Published: August 2020

Summary
Australasian colonies were promoted as ‘lands of opportunity’ for British medical practitioners of the Victorian period, but once there doctors often found that any problems they faced had travelled with them. Furthermore, the act of migration could add to personal difficulty. This article builds on existing work about the challenges confronting doctors in England, and on the potential of asylum records to address the consequences of migration, to consider the experiences of men who chose to move round the globe. It concerns practitioners’ turbulent careers in New Zealand, with an emphasis on their poor mental health and suicide. Official and personal sources are used to evaluate the impact of professional drivers, and the consequences for medical men. It concludes that migration did not mitigate professional stresses and instead induced or exacerbated personal crisis. The visibility of alcohol-related distress is particularly marked in contrast to evidence for practitioners in England.
Anthropometric, Biochemical, and Food Consumption Parameters are Associated with Venous Leg Ulcer Area and Duration
Authors: Melo Paulla G. , Mota João F. , Nunes Cynthia A. B. , Amaral Kelle V. A. , Coelho Alexandre S. G. , Bachion Maria M. 
Published: August 2020

ABSTRACT

OBJECTIVE
To describe the dietary habits and anthropometric and biochemical parameters of patients with active venous leg ulcers and to verify the association of these variables with wound duration and area.

DESIGN, SETTING, AND PARTICIPANTS
A cross-sectional study conducted with 33 participants diagnosed with venous leg ulcers in outpatient care.

MAIN OUTCOME MEASURES
Socioeconomic data, anthropometric parameters, biochemical parameters, food consumption, and wound characteristics were analyzed by an interprofessional team.

MAIN RESULTS
Participants were an average of 58 ± 13 years, 57.6% women, 84.8% overweight, and had a median wound duration of 10 months (range, 1–192 months) and an average wound area of 5 cm2 (range, 0.22–61.1 cm2). Diets were typically hypocaloric and hypoproteic, with a low amount of vitamin A and magnesium. Wound duration was negatively associated with polyunsaturated fat intake (P = .032), whereas wound area was significantly associated with lipid intake (P = .002) and C-reactive protein (P = .040).

CONCLUSIONS
Patients with active venous leg ulcers were overweight (leading to systemic inflammation) and had low consumption of calories, protein, and micronutrients that could support cicatrization. Wound area was associated with a high-fat diet, whereas wound duration was negatively associated with polyunsaturated fat intake.
Left Ventricular Geometry in COPD Patients
Authors: Heubel Alessandro Domingues , Roscani Meliza Goi , Kabbach Erika Zavaglia , Agnoleto Aline Galvão , Camargo Patrícia Faria , dos Santos Polliana Batista , Borghi-Silva Audrey , Mendes Renata Gonçalves 
Published: August 2020

Purpose:
Chronic obstructive pulmonary disease (COPD) and abnormalities of left ventricular (LV) geometry often coexist. This study aimed to verify whether LV geometry is associated with airflow obstruction, functional capacity, and grip strength in COPD patients.

Methods:
Thirty-seven COPD patients (GOLD II, III, and IV) were allocated to three groups according to LV geometry as assessed by transthoracic echocardiography: normal (n = 13), concentric LV remodeling (n = 8), and concentric LV hypertrophy (LVH) (n = 16). Lung function was assessed using spirometry. The Duke Activity Status Index (DASI) was used to estimate functional capacity, and grip strength measurement was performed using a hydraulic hand dynamometer.

Results:
The concentric LVH group presented lower DASI scores (P = .045) and grip strength (P = .006) when compared with the normal group. Correlations analysis showed the following: relative wall thickness negatively correlated with forced expiratory volume in the first second (r = −0.380; P = .025) and DASI score (r = −0.387, P = .018); LV mass index negatively correlated with grip strength (r = −0.363, P = .038).

Conclusions:
In COPD patients, LV geometry is associated with airflow limitation, functional capacity, and grip strength. Specifically, concentric LV remodeling is associated with increased airflow limitation and decreased functional capacity whereas increased LV mass is associated with decreased grip strength.
Cardiac Rehabilitation Is Associated With Improved Physical Function in Frail Older Adults With Cardiovascular Disease
Authors: Lutz Andrew H. , Delligatti Amanda , Allsup Kelly , Afilalo Jonathan , Forman Daniel E. 
Published: August 2020

Purpose:
Frailty is highly prevalent among older adults with cardiovascular disease (CVD) and is associated with greater than 2-fold risk for morbidity and mortality, independent of age and comorbidities. Many candidates are not referred to cardiac rehabilitation (CR) under the assumption that they are too frail to benefit. We hypothesized that CR is associated with similar benefits for frail adults as for intermediate-frail and nonfrail adults.

Methods:
Retrospective analysis of CVD patients who completed a phase II CR program. Patients classified as frail by meeting ≥2 frailty criteria and intermediate-frail by meeting 1 criterion, including 6-min walk distance (6MWD) <300 m, gait speed ≤0.65 m/sec or 0.76 m/sec normalized to height and sex, tandem stand <10 sec, Timed Up & Go (TUG) <15 sec, and weak hand grip strength per Fried criteria. Changes within and between groups were compared before and after completion of CR.

Results:
We evaluated 243 patients; 75 were classified as frail, 70 as intermediate-frail, and 98 as nonfrail. Each group improved in all measures of frailty except for tandem stand. There were no significant differences in pre- to post-CR measures for 6MWD, gait speed, tandem stand, or hand grip strength between groups. Frail patients showed greater improvement in TUG than the other groups (P = .007).

Conclusion:
Among frail patients, CR was associated with improvements in multiple domains of physical function. Gains achieved by frail adults were similar to or greater than those achieved by intermediate-frail and nonfrail patients. These data provide strong rationale for referring all eligible patients to CR, including frail patients. Those who are most physically impaired may derive gains that have proportionally greater ramifications.
Impact of COVID-19 Pandemic on Physical Activity in Patients With Implantable Cardioverter-Defibrillators
Authors: Sassone Biagio , Mandini Simona , Grazzi Giovanni , Mazzoni Gianni , Myers Jonathan , Pasanisi Giovanni 
Published: August 2020

Purpose:
The coronavirus disease-2019 (COVID-19) pandemic has been spreading rapidly worldwide since late January 2020. The strict lockdown strategy prompted by the Italian government, to hamper severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) spreading, has reduced the possibility of performing either outdoor or gym physical activity (PA). This study investigated and quantified the reduction of PA in patients with automatic implantable cardioverter-defibrillators (ICDs) for primary prevention of sudden death.

Methods:
Daily PA of 24 patients was estimated by processing recorded data from ICD-embedded accelerometric sensors used by the rate-responsive pacing systems.

Results:
During the forced 40-d in-home confinement, a mean 25% reduction of PA was observed as compared with the 40-d confinement-free period (1.2 ± 0.3 vs 1.6 ± 0.5 hr/d, respectively, P = .0001).

Conclusions:
This objective quantification of the impact of the COVID-19 pandemic on PA determined by an ICD device showed an abrupt and statistically significant reduction of PA in primary prevention ICD patients, during the in-home confinement quarantine. To counteract the deleterious effects of physical inactivity during the COVID-19 outbreak, patients should be encouraged to perform indoor exercise-based personalized rehabilitative programs.
MULTIPLE INTRAVITREAL INJECTIONS DO NOT CAUSE ANTERIOR SCLERAL THINNING
Authors: Schwartz Shulamit , Reinhertz Noa , Neudorfer Meira , Loewenstein Anat , Iglicki Matias , Zur Dinah 
Published: August 2020

Purpose:
To evaluate possible changes in anterior scleral thickness and structure and changes in the anterior segment in eyes receiving multiple intravitreal injections using ultrasound biomicroscopy imaging.

Methods:
Prospective, interventional, nonrandomized, cross-sectional study. Both eyes from 33 patients previously treated at least by 15 intravitreal injections in one eye only for retinal diseases were included. Intravitreal injections were performed by ophthalmologists using an aseptic standardized procedure. Ultrasound biomicroscopy examination was performed in all eyes, and scleral thickness was measured at the pars plana in four quadrants. Anterior chamber depth and ciliary body size were measured. Scleral thickness in the study eye was compared with the fellow eye. Secondary outcome measures were 1) anterior chamber depth; 2) ciliary body size; 3) scleral qualitative changes in the study eye compared with the fellow eye and 4) risk factors for scleral thinning.

Results:
There was no statistically significant difference in scleral thickness between the study and fellow eyes when comparing each quadrant between the two eyes (P = 0.86 superotemporal; P = 0.76 superonasal; P = 0.72 inferonasal; P = 0.55 inferotemporal). Scleral thickness was neither related to the number of injections nor to the duration of treatment in the treated eye.

Conclusion:
Multiple intravitreal injections do not impact scleral thickness in a clinical practice using different injection sites.
SQUARE GRID DEFORMATION ANALYSIS OF THE MACULA AND POSTOPERATIVE METAMORPHOPSIA AFTER MACULAR HOLE SURGERY
Authors: Park Sun Ho , Park Keun Heung , Kim Hwa Yeong , Lee Jae Jung , Kwon Han Jo , Park Sung Who , Byon Ik Soo , Lee Ji Eun 
Published: August 2020

Purpose:
To investigate the correlation between postoperative metamorphopsia and macular deformation after macular hole surgery.

Methods:
This study included 28 eyes of 28 patients who underwent vitrectomy and internal limiting membrane removal for an idiopathic macular hole. The retinal vasculatures were compared between preoperative and postoperative photographs, and postoperative deformation of the macula was assessed as deformation of the square grid. The displacement of each node was measured, and deformation of the grid was calculated as differences in the coordinates of the adjacent nodes. These parameters were analyzed to find correlation with metamorphopsia measured using the M-charts after 6 postoperative months.

Results:
The average deformations in the vertical and horizontal lines of the grid were 94.29 μm and 49.72 μm, respectively. Perifoveal deformation was significantly greater than parafoveal deformation (P = 0.001∼0.019). The multiple regression analysis demonstrated that the vertical M-score correlated with superior perifoveal deformation of the vertical line on the fovea (P = 0.036), and the horizontal M-score correlated with temporal perifoveal deformation of the horizontal line on the fovea (P = 0.032).

Conclusion:
The parafoveal tissue was displaced with the fovea concurrently after internal limiting membrane removal in macular hole surgery causing perifoveal deformation, which correlated with postoperative metamorphopsia.
The Achilles’ Heel of Pancreatic Cancer: Targeting pancreatic cancer's unique immunologic characteristics and metabolic dependencies in clinical trials
Authors: Siolas Despina , Morrissey Christy , Oberstein Paul E. 
Published: August 2020

Abstract
Pancreatic ductal adenocarcinoma (PDAC) has a high mortality rate and is notoriously refractory to multiple cancer treatments. In recent years, cancer therapy has expanded beyond traditional cytotoxic chemotherapy to targeted agents and immunotherapy which have been successfully implemented in many cancers. Despite robust pre-clinical research, these novel therapies have only had a small impact on PDAC. However, there have been successes with emerging clinical data supporting a potential role for checkpoint inhibitor therapy and targeted therapy with poly (ADP-ribose) polymerase inhibitors for select subsets of PDAC patients. In this clinical review, we discuss recent pre-clinical evidence for targeting metabolic pathways as well as prevalent intratumoral immune subsets, and focus on clinical trials designed to test novel agents in PDAC. The challenge of translating pre-clinical findings to patients remains substantial and many clinical trials yield negative results, but collaborative efforts and renewed focus on novel clinical trials have led to optimism that we will identify additional options for PDAC patients and change outcomes for this deadly disease.
Factors associated with the performance of primary dental health care in Brazil
Authors: Reis Clarice Magalhães Rodrigues dos , Mendes Suellen da Rocha , Matta-Machado Antônio Thomaz Gonzaga da , Mambrini Juliana Vaz de Melo , Werneck Marcos Azeredo Furquim , Abreu Mauro Henrique Nogueira Guimarães de 
Published: August 2020

Abstract
This study evaluated the factors associated with the performance of Brazilian Oral Health Teams (OHTs).
This is multilevel research that used data from 12,386 Brazilian OHTs in 2012. The OHTs performance was estimated in previous research by using Item Response Theory model, which employed 20 questions about dental procedures in Primary Care. The first level covariates were based on OHTs procedures such as: the record of pregnant woman dental appointment, provision of dentistry home care, dental appointments scheduled choices, and OHTs in charge for more than 5000 individuals. Moreover, the use of guidelines was accessed concerning delivering prostheses in primary care, referring to secondary care, referring to suspected oral cancer, and providing care towards patients with special needs. Variables included in level 2 were GINI and Human Development Index. Multilevel linear regression models were constructed, estimating linear regression coefficients, 95% confidence intervals, and P values.
OHTs performance was different among the 3,613 municipalities analyzed (P < .001), with 36.7% of the variation in the performance of the OHTs being attributed to the variability between municipalities. The adjusted model showed that higher performance OHTs reported attention to pregnant women, dentistry home care and use of dental care guidelines (P < .001). There were lower performance scores for those OHTs with more restricted scheduling (P < .05), compared to those that reported scheduling appointments at any day and time. The best OHTs and population ratio led to a better performance score (P = .010). At the municipal level, better socioeconomic status was associated with better performance of the OHTs (P < .001).
OHTs with higher performance are associated with oral health services organizations and municipalities’ socioeconomic status.
Optimized Trientine‐dihydrochloride Therapy in Pediatric Patients With Wilson Disease
Authors: Mayr Toni , Ferenci Peter , Weiler Markus , Fichtner Alexander , Mehrabi Arianeb , Hoffmann Georg Friedrich , Mohr Isabelle , Pfeiffenberger Jan , Weiss Karl Heinz , Teufel‐Schäfer Ulrike 
Published: August 2020

ABSTRACTObjectives:The aim of the study was to investigate the efficacy and safety of trientine‐dihydrochloride (TD) in pediatric patients with Wilson disease (WD) and the effect of different weight‐based dosages on their clinical and biochemical outcome.Methods:We retrospectively reviewed the clinical data of 31 children with WD receiving TD therapy ages under 18 years at the time of diagnosis. Outcome measures included parameters of copper metabolism and liver function tests. To examine the impact of different weight‐based dosages, 2 dosage subgroups were analyzed. Group 1 received less than 20 mg/kg TD per day, group 2 more than 20 mg · kg−1 · day−1.Results:Median follow‐up was 60 (5–60) months in the total study group. During TD therapy, nonceruloplasmin‐bound copper was reduced from mean 1.53 (0.01–6.95) at baseline to 0.62 (0.01–4.57) μmol/l. 24h‐urinary copper excretion diminished to 1.85 (0.8–9.6) μmol/day approximating the therapeutic goal of 1.6 μmol/day. Seven of 31 patients (22.6%) required discontinuation of TD treatment, in 4 cases it was because of adverse events (ulcerative colitis, gingival and breast hypertrophy, hirsutism, elevation of transaminases).Investigations about weight‐based dosage showed no significant difference of any laboratory parameter between the 2 cohorts. But in terms of clinical safety, adverse effects because of TD were only found in 6.7% of children in group 1 (<20 mg · kg−1 · day−1, median follow‐up 60 [9–60] months), whereas in group 2 (>20 mg · kg−1 · day−1, median follow‐up 60 [14–60] months), it was 63.6%.Conclusions:TD proves to be an efficacious alternative chelating agent for children with WD. Weight‐based dosages above the recommended 20 mg · kg−1 · day−1 may increase the rate of adverse effects in pediatric patients.