bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment and Optimization of the Pediatric Parenteral Nutrition Preparation Process in a Hospital Pharmacy
Authors: Mourkogianni Eleni , Karatza Aggeliki , Vinni Eleni , Papadimitriou Evangelia , Avgoustakis Konstantinos , Panagi Zoi 
Published: February 2020

AbstractBackgroundParenteral nutrition (PN) is associated with risks that could threaten the clinical condition of premature neonates hospitalized in the neonatal intensive care unit. In this work, risk‐analysis methodology was implemented to contain the risks associated with the PN production process and improve PN safety.MethodsThe Failure Modes, Effects, and Criticality Analysis was performed by a multidisciplinary team. All potential failure modes of the PN preparation process were recorded, and associated risks were scored based on their severity, occurrence, and detectability, with a risk priority number (RPN). All identified failure scenarios and the respective work stages were ranked in descending order of criticality. Corrective actions were proposed to address critical points, and the safety of the process was reassessed by the same method in a prospective manner.ResultsThe highest RPN scores were obtained with the PN composition calculation performed manually (RPN: 530) or electronically (RPN: 478), completion of the PN medical order form (RPN: 354), manual compounding of PN admixtures (RPN: 258), and the structure/organization/maintenance of the PN preparation unit (RPN: 133). The quality and safety of PN admixtures could be compromised by many critical factors, such as the increased particle‐microbial load in the unit and the inadequate training/experience of the involved health professionals and their incompliance with the given instructions. The implementation of the proposed corrective measures is expected to reduce the risks of the overall PN production process by 67.5%.ConclusionsImprovement of the PN production process through risk‐analysis methodologies enhances safety for premature neonates.
NUTRIC Score: Isolated and Combined Use With the NRS‐2002 to Predict Hospital Mortality in Critically Ill Patients
Authors: Machado dos Reis Audrey , Marchetti Julia , Forte dos Santos Amanda , Franzosi Oellen Stuani , Steemburgo Thais 
Published: February 2020

AbstractBackgroundIdentification of nutritional risk in critically ill patients is a challenge because each nutritional screening tool has its specific characteristics. The objective was to evaluate the performance of the modified Nutrition Risk in Critically ill (mNUTRIC) score, used alone or in combination with the Nutritional Risk Screening 2002 (NRS‐2002) score, to predict hospital mortality in critically ill patients.MethodsA prospective study was performed with patients admitted to the intensive care unit (ICU) from October 2017 to April 2018. Multiple logistic regression analysis was used to test for complementarity between the mNUTRIC and NRS‐2002. A receiver operating characteristic (ROC) curve was used to identify the performance of the instruments to predict mortality. This study was conducted in accordance with the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) statement.Results384 patients were evaluated (51.8% female mean age 59.6 ± 16.7 years). High nutritional risk was detected in 54.4% by the NRS‐2002 and 48.4% by mNUTRIC. The overall mortality rate was 36.5% (n = 140). Patients in whom nutritional risk was identified both by mNUTRIC and by NRS‐2002 (score ≥5) had a twofold greater risk of in‐hospital mortality (RR = 2.29; 95%CI: 1.42–3.68; p = 0.001). The area under the ROC curve to predict mortality was 0.693 for mNUTRIC; 0.645 for NRS‐2002; and 0.666 for mNUTRIC and NRS‐2002 combined.ConclusionsThe mNUTRIC and NRS‐2002 scores had similar performance in predicting hospital mortality. The mNUTRIC has better discriminant ability to quantify the risk of mortality in critically ill patients.
Enhanced trans‐to‐cis photoisomerization quantum yield of azobenzene spatially confined in silver nanoparticle aggregates
Authors: Sun Lili , Wang Changshun , Pan Yujia , Chen Tianyu , Lv Ziyao 
Published: February 2020

AbstractPhotoisomerization of azobenzene spatially confined in silver nanoparticle (AgNP) aggregates and in ethanol solution was monitored by Raman spectroscopy inside optically clear colorimetric dishes. After ultraviolet irradiation, overall Raman intensity assigned to trans‐azobenzene of these two samples decreased, and notably, a cis peak appeared at 599 cm−1, assigned to C─N═N─C torsional mode. The Raman intensity at 1,007 cm−1, assigned to trans‐azobenzene, was recorded versus irradiation time for analyzing the trans‐to‐cis photoisomerization quantum yield (PQY). By combining our theoretical derivation and standard curve of Raman spectra, the trans‐to‐cis PQY of azobenzene in AgNP aggregates was roughly calculated to be 79.0% higher than that in ethanol solution. The enhancement mechanism was discussed in terms of the competition between enhanced local optical field from surface plasmon resonance and the accelerated nonradiative decay of excited azobenzene molecules together.
Development and validation of a nomogram for predicting cancer‐specific survival of surgical resected stage I‐II adenosquamous carcinoma of the lung
Authors: Li Hao , Wang Zhenfan , Yang Fan , Wang Jun 
Published: February 2020

AbstractObjectivesPrimary lung adenosquamous carcinoma (ASC) is a rare cancer subtype and has a poor prognosis. The prognostic factors for resected early‐stage ASC remain unclear. We aimed to develop a nomogram to predict lung cancer‐specific survival (LCSS) of patients undergoing surgical resection for stage I‐II ASC.MethodsData of patients undergoing resection for stage I‐II ASC and diagnosed between 2004‐2015 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. All the included patients were randomized at a 7:3 ratio into a training and a validation cohort. We selected and integrated significant prognostic factors based on competing for risk regression to build a nomogram. The performance of the nomogram was evaluated using Harrell's concordance index (C‐index) and calibration plots.ResultsA total of 988 patients (530 men and 458 women) undergoing surgical resection for stage I‐II ASC were identified and randomized into a training (692, 70%) cohort and a validation cohort (296, 30%). The baseline characteristics were similar in the training and validation cohorts. Age, T stage, N stage, and the number of examined lymph nodes were independent prognostic factors for LCSS and were used in the nomogram. The calibration plots showed that the 3‐ and 5‐year LCSS probabilities were consistent between the nomogram prediction and the actual observation. The C‐index of the nomogram was 0.671 (95%CI: 0.618‐0.724) and 0.635 (95%CI: 0.557‐0.713) in the training cohort and validation cohort, respectively. We developed a risk classification system based on the nomogram to stratify patients into high‐ and low‐risk of cancer‐specific death groups. Patients with a similar risk shared similar prognostic prediction regardless of the stage category and patients with the same risk shared similar prognoses despite the different stage category.ConclusionsWe developed a competing risk nomogram to reliably predict cancer‐specific survival of patients undergoing surgical resection for stage I‐II ASC. The nomogram might be a useful tool to identify patients undergoing surgical resection for ASC who could be suitable candidates for adjuvant chemotherapy.
Hydrologic connectivity determines dissolved organic matter biogeochemistry in northern high‐latitude lakes
Authors: Johnston Sarah Ellen , Striegl Robert G. , Bogard Matthew J. , Dornblaser Mark M. , Butman David E. , Kellerman Anne M. , Wickland Kimberly P. , Podgorski David C. , Spencer Robert G. M. 
Published: February 2020

AbstractNorthern high‐latitude lakes are undergoing climate‐induced changes including shifts in their hydrologic connectivity with terrestrial ecosystems. How this will impact dissolved organic matter (DOM) biogeochemistry remains uncertain. We examined the drivers of DOM composition for lakes in the Yukon Flats Basin in Alaska, an arid region of low relief that is characteristic of over one‐quarter of circumpolar lake area. Utilizing the vascular plant biomarker lignin, chromophoric dissolved organic matter (CDOM), and ultrahigh‐resolution mass spectrometry, we interpreted DOM compositional changes using lake‐water stable isotope (δ18O‐H2O) composition as a proxy for lake hydrologic connectivity with the landscape. We observed a relative decrease in CDOM in more hydrologically isolated lakes (enriched δ18O‐H2O) without a corresponding decrease in dissolved organic carbon (DOC) concentration. Although DOC and CDOM were weakly correlated, a significant positive relationship between lignin and CDOM (r2 = 0.67) demonstrates that optical parameters are useful for estimating lignin concentration and thus vascular plant contribution to lake DOM. Indicators of allochthonous DOM, including lignin carbon normalized yields, CDOM aromaticity proxies, and relative abundances of polyphenolic and condensed aromatic compound classes, were negatively correlated with δ18O‐H2O (r2 > 0.45), suggesting there is little allochthonous DOM supplied to many of these hydrologically isolated lakes. We conclude that decreased lake hydrologic connectivity, driven by ongoing climate change (i.e., decreased precipitation, warming temperatures), will reduce allochthonous DOM contributions and shift lakes toward lower CDOM systems with ecosystem‐scale ramifications for heat transfer, photochemical reactions, productivity, and ultimately their biogeochemical function.
Dysprosium Mid‐Infrared Lasers: Current Status and Future Prospects
Authors: Majewski Matthew R. , Woodward Robert I. , Jackson Stuart D. 
Published: February 2020

AbstractWith growing interest in the mid‐infrared spectral region, dysprosium has recently been revisited for efficient high‐performance infrared source development. Despite historically receiving less attention than other rare earth ions, in recent years lasers utilizing the dysprosium ion as the laser material have set record mid‐infrared performance, including tunability from 2.8 to 3:4 µm (in addition to 4:3 µm lasing), continuous wave powers exceeding 10 W, greater than 73% slope efficiencies, and even ultrafast pulsed operation. Herein, the unique energy level structure and spectroscopy of the dysprosium ion are examined and the major developments that have led to this resurgence of interest and subsequent record mid‐infrared laser performance are surveyed. Also mid‐infrared applications of emerging dysprosium lasers are highlighted, in addition to surveying the many opportunities that lie ahead.
Directly Modulated Single‐Mode Tunable Quantum Dot Lasers at 1.3 µm
Authors: Wan Yating , Zhang Sen , Norman Justin C. , Kennedy MJ , He William , Tong Yeyu , Shang Chen , He Jian‐Jun , Tsang Hon Ki , Gossard Arthur C. , Bowers John E. 
Published: February 2020

AbstractWavelength tunable lasers are increasingly needed as key components for wavelength resource management technologies in future dense wavelength division multiplexing (DWDM) systems. While material systems with multiple quantum wells as an active region are widely used in long‐wavelength tunable lasers, the unique advantages of InAs/GaAs quantum dots (QDs) for low‐power operation, excellent thermal stability, and wide spectral bandwidth may open a new avenue in this field. Combining the advantages of QDs with a special designed half‐wave coupled cavity structure, directly modulated, single‐mode, tunable InAs/GaAs QD lasers are demonstrated at 1.3 µm wavelength range. The half‐wave coupler provides an active–active coupled‐cavity tunable structure without involving gratings or multiple epitaxial growths, producing synchronous power transfer in the two output waveguides and high single‐mode selectivity. 27‐channel wavelength switching is achieved with side‐mode‐suppression‐ratio of around 35 dB. Under continuous‐wave electrical injection, over 9 mW output power can be measured with 716 kHz Lorentzian linewidth, 4 GHz 3‐dB bandwidth, and 8 Gbit s−1 non‐return‐to‐zero signal modulation by directly probing the chip.
Use of Physiologically Based Kinetic Modeling to Predict Rat Gut Microbial Metabolism of the Isoflavone Daidzein to S‐Equol and Its Consequences for ERα Activation
Authors: Wang Qianrui , Spenkelink Bert , Boonpawa Rungnapa , Rietjens Ivonne M. C. M. , Beekmann Karsten 
Published: February 2020

ScopeTo predict gut microbial metabolism of xenobiotics and the resulting plasma concentrations of metabolites formed, an in vitro–in silico‐based testing strategy is developed using the isoflavone daidzein and its gut microbial metabolite S‐equol as model compounds.Methods and resultsAnaerobic rat fecal incubations are optimized and performed to derive the apparent maximum velocities (Vmax) and Michaelis–Menten constants (Km) for gut microbial conversion of daidzein to dihydrodaidzein, S‐equol, and O‐desmethylangolensin, which are input as parameters for a physiologically based kinetic (PBK) model. The inclusion of gut microbiota in the PBK model allows prediction of S‐equol concentrations and slightly reduced predicted maximal daidzein concentrations from 2.19 to 2.16 µm. The resulting predicted concentrations of daidzein and S‐equol are comparable to in vivo concentrations reported.ConclusionThe optimized in vitro approach to quantify kinetics for gut microbial conversions, and the newly developed PBK model for rats that includes gut microbial metabolism, provide a unique tool to predict the in vivo consequences of daidzein microbial metabolism for systemic exposure of the host to daidzein and its metabolite S‐equol. The predictions reveal a dominant role for daidzein in ERα‐mediated estrogenicity despite the higher estrogenic potency of its microbial metabolite S‐equol.
Technical Note: A fast inverse direct aperture optimization algorithm for volumetric‐modulated arc therapy
Authors: MacFarlane Michael , Hoover Douglas A. , Wong Eugene , Battista Jerry J. , Chen Jeff Z. 
Published: February 2020

PurposeIn a recent article, our group proposed a fast direct aperture optimization (DAO) algorithm for fixed‐gantry intensity‐modulated radiation therapy (IMRT) called fast inverse direct aperture optimization (FIDAO). When tested on fixed‐gantry IMRT plans, we observed up to a 200‐fold increase in the optimization speed. Compared to IMRT, rotational volumetric‐modulated arc therapy (VMAT) is a much larger optimization problem and has many more delivery constraints. The purpose of this work is to extend and evaluate FIDAO for inverse planning of VMAT plans.MethodsA prototype FIDAO algorithm for VMAT treatment planning was developed in MATLAB using the open‐source treatment planning toolkit matRad (v2.2 dev_VMAT build). VMAT treatment plans using one 3600 arc were generated on the AAPM TG‐119 phantom, as well as sample clinical liver and prostate cases. The plans were created by first performing fluence map optimization on 28° equispaced beams, followed by aperture sequencing and arc sequencing with a gantry angular sampling rate of 4°. After arc sequencing, a copy of the plan underwent DAO using the prototype FIDAO algorithm, while another copy of the plan underwent DAO using matRad's DAO method, which served as the conventional algorithm.ResultsBoth algorithms achieved similar plan quality, although the FIDAO plans had considerably fewer hot spots in the unspecified normal tissue. The optimization time (number of iterations) for FIDAO and the conventional DAO algorithm, respectively, were: 65 s (245) vs 602 s (275) in the TG‐119 phantom case; 25 s (85) vs 803 s (159) in the liver case; and 99 s (174) vs 754 s (149) in the prostate case.ConclusionsThis study demonstrated promising speed enhancements in using FIDAO for the direct aperture optimization of VMAT plans.
Adenosine accumulation causes metabolic disorders in testes and associates with lower testosterone level in obese mice
Authors: Yang Xiao , Zhao Yang , Sun Qi , Yang Yunxia , Gao Yan , Ge Wenhao , Liu Junhao , Xu Xi , Zhang Jianfa 
Published: February 2020

AbstractOverweight and obese men face numerous health problems, including type 2 diabetes, subfertility, and even infertility. However, few studies have focused on the effects of nutritional status and obesity‐related regulatory signals on fertility deficiency. Our previous observations have shown that the elevation of plasma 5'‐adenosine monophosphate (5'‐AMP) and the accumulation of adenosine in liver and muscle of obese diabetic db/db mice are related to insulin resistance. Here, we found that adenosine accumulation in testis is a common marker of both genetic obesity and high‐fat‐diet induced obese mice. An messenger RNA sequencing analysis indicated that 78 upregulated genes and 155 downregulated genes in the testis of 5'‐AMP‐treated mice overlapped with the same genes in the testis of ob/ob mice, and these genes belonged to the clusters of steroid metabolic process and regulation of hormone levels, respectively. Serum testosterone was reduced in ob/ob and 5'‐AMP‐treated mice. Metabolomic analysis based on 1H nuclear magnetic resonance showed that the testicular metabolic profiles of ob/ob mice were similar to those of 5'‐AMP treated mice. Exogenous 5'‐AMP inhibited the phosphorylation of AKT and mammalian target of rapamycin signal transduction and reduced the proliferating cell nuclear antigen expressions in testes. Our results suggest that the accumulation of adenosine causes metabolic disorders in testes and associates lower testosterone level in obese mice.
Experiences of physical activity and exercise in individuals with systemic sclerosis: A qualitative study
Authors: Pettersson Henrik , Nordin Annica , Svenungsson Elisabet , Alexanderson Helene , Boström Carina 
Published: February 2020

AbstractIntroductionExercise is emerging as an important part of the treatment in systemic sclerosis‐patients with no‐mild lung involvement. However, it has not been studied how patients experience physical activity and exercises. We thus explored and described experiences of physical activity/exercises in systemic sclerosis‐individuals.MethodSixteen systemic sclerosis‐patients were purposefully recruited to represent variation in gender, age, and lung disease. Semi‐structured individual interviews were performed, transcribed and analyzed with qualitative content analysis.ResultsThree themes (categories) emerged: 1) Essential for life and health (An effective treatment, Reduces fear of deterioration, and Feeling healthy and satisfied with oneself); 2) Disease‐related hinders and other barriers (Disease consequences, Risk of worsening, and Non‐disease related barriers); and 3) Self‐care and/or support (Self‐confidence in physical activity/exercise, and, Education and support from healthcare and other).ConclusionsPhysical activity/exercises were experienced as essential for life and health and as an effective treatment. It reduced fear of deterioration and made the participants feel healthy and satisfied with oneself. However, participants also experienced disease‐related barriers like shortness of breath and pain, and they expressed a risk of worsening. Participants felt confidence in their physical activity/exercises and expressed that education and support from healthcare could be facilitating. Our findings add new knowledge about how systemic sclerosis‐patients perceive physical activity/exercise and can contribute to the development of patient education and PA/exercise programs.
Influence of body position on dynamics of the pelvic floor measured with transperineal ultrasound imaging in men
Authors: Cowley David , Stafford Ryan E. , Hodges Paul W. 
Published: February 2020

AbstractAimsThis paper aims to evaluate the feasibility of transperineal ultrasound imaging (TPUS) for visualizing the motion of pelvic landmarks associated with striated pelvic floor muscle contraction in men in standing; to compare the locations of pelvic landmarks between sitting and standing; and to compare the effects of different body positions on measures of pelvic floor muscle contraction.MethodsThirty‐five men awaiting prostatectomy volunteered to participate. Participants performed three repetitions of submaximal pelvic floor contraction in sitting and again in standing. Movement of pelvic landmarks with contraction was recorded using an ultrasound imaging transducer placed on the perineum.ResultsThe feasibility of TPUS in men in standing was demonstrated through the visualization of three out of four pelvic landmarks in more than 95% of images in the standing position. Analysis of pelvic landmarks and their respective relationships with muscle shortening demonstrated that the anorectal junction and urethrovesical junction were lower and the estimated length of puborectalis was shorter in standing than sitting. The mid‐urethra (striated urethral sphincter) and anorectal junction (puborectalis) landmark displaced further cranially in standing than sitting.ConclusionsTPUS can be used to visualize three pelvic landmarks in men with cancerous prostates. Puborectalis is shorter at rest in standing than sitting, and elevation of the mid‐urethra and the anorectal junction is more in standing than sitting. Together these findings indicate that feedback for pelvic floor muscle training is possible in both positions, but the position needs to be standardized for a comparative assessment.
Application of different bark fractions in polypropylene composites: UV and thermal stability
Authors: Peng Yao , Nair Sandeep S. , Chen Heyu , Farnood Ramin , Yan Ning , Cao Jinzhen 
Published: February 2020

AbstractFor the comprehensive and value‐added utilization of bark, different fractions such as bark extractives (BE), bark fibers (BF), micron‐sized unbleached cellulose particles (UBCP), and bleached cellulose particles (BCP) were produced from western red cedar (Thuja plicata) bark. These fractions were melt compounded with polypropylene (PP) to make composites. The presence of lignin in UBCP significantly increased composite thermal stability. The addition of UBCP and BE alleviated the photodegradation of composites, increasing the UV stability. However, the addition of BCP accelerated the UV weathering process. The antioxidation and heat‐insulating properties of lignin in UBCP were confirmed in this study.