bluuebunny/crossref_metadata_2025_split huggingface dataset:
Future Perspectives for Patient-Centric Pharmaceutical Drug Product Design with Regard to Solid Oral Dosage Forms
Authors: Drumond Nélio 
Published: October 2019

AbstractPurposeAdditional costs for healthcare provision are expected for cases where the level of care provided is not according to the patient’s needs and demands. To address these issues and reduce costs, fundamental changes need to be made on how healthcare provision is administered to patients, which raises the opportunity for the implementation of patient-centric systems.MethodsThis review addresses the importance of implementing a patient-centric approach in current healthcare provision and emphasizes the need to adjust current development and business models for a successful application of patient-centric care.ResultsTo increase awareness and avoid confusion, the purpose of patient-centric pharmaceutical drug product design is reviewed in detail and future market opportunities for patient-centric drug products are discussed.ConclusionsWith regard to solid oral dosage forms, the subject of patient-centric pharmaceutical drug product design will focus more on the customization of existing technologies (e.g., dosage form size reduction) to address the needs of specific patient populations such as pediatrics, geriatrics, dysphagia patients, or the cognitively impaired.
Spectrophotometric assessment of bowel perfusion during low anterior resection: a prospective study
Authors: Darwich Ibrahim , Rustanto Darmadi , Friedberg Ronald , Willeke Frank 
Published: October 2019

Abstract
Good perfusion of the bowel and a tension-free anastomosis are the two main prerequisites for an uneventful anastomotic healing in rectal surgery. This prospective cohort study investigates the noninvasive intraoperative spectrophotometric assessment of the bowel perfusion using a device called “Oxygen to See” (O2C®). Forty patients, planned for low anterior resection, were prospectively enrolled in this study to undergo an intraoperative spectrophotometric assessment of the bowel. Three different O2C® parameters were collected from the colonic and the rectal stumps before fashioning the anastomosis: SO2 (capillary venous oxygen saturation), rHb (relative hemoglobin amount), and flow (blood flow velocity). Bowel perfusion was also assessed with the cold-steel-test (CST), which involves severing the colic marginal artery of Drummond at the tip of the colon stump. The data collected from the spectrophotometric measurement and the CST were analyzed for correlation of both methods with respect to each other and to the outcome of the anastomosis. Nine patients were excluded due to different reasons, thus leaving 31 patients for statistical analysis. Three flow parameters collected at the colonic stump significantly predicted an anastomotic leak (p: 0.0057; p: 0.0250; p: 0.0404). One rHb parameter collected at the rectal stump correlated weakly with the anastomotic outcome (p: 0.0768). The CST did not correlate significantly with anastomotic leak (p: 0.1195), but showed significant correlations to some rHb values. Intraoperative noninvasive spectrophotometric measurement is feasible and could be a useful method in assessing bowel perfusion before fashioning a colorectal anastomosis.
Diagnostic stability and long-term symptomatic and functional outcomes in first-episode antipsychotic-naïve patients with schizophrenia
Authors: Klærke Lea R. , Baandrup Lone , Fagerlund Birgitte , Ebdrup Bjørn H. , Pantelis Christos , Glenthøj Birte Y. , Nielsen Mette Ø. 
Published: October 2019

AbstractObjective:In a prospective cohort design, we investigated: i) diagnostic stability of initially antipsychotic-naïve schizophrenia patients, ii) symptom severity including symptomatic remission, and iii) functional remission including full recovery.Methods:We included 143 antipsychotic-naïve patients with first-episode schizophrenia or schizoaffective disorder. After 4–18 years, we clinically re-evaluated diagnosis, symptom severity and functioning for 70 patients. From the nationwide Danish registers, we extracted pragmatic outcome measures for 142 patients. We examined associations between baseline variables (age at diagnosis, sex, and premorbid intelligence) and long-term outcome status (symptomatic and functional remission).Results:At 4–18 years follow-up, 80% met the criteria for schizophrenia or schizoaffective disorder, however, despite the high diagnostic stability 53% met the criteria of symptomatic and/or functional remission. Symptomatic remission characterized 34% of the patients and was associated with female sex, better premorbid intelligence, and a younger age at schizophrenia diagnosis. Functional remission characterized 41% of the patients and 17% of patients met criteria for full recovery both of which were associated with female sex. The clinically re-evaluated patients did not differ from the drop-outs on key register-based variables.Conclusion:We confirm the emerging evidence of a decreasing long-term diagnostic stability of schizophrenia, and a protective role of female sex. The association between premorbid intelligence and symptomatic remission underscores the pertinence of including cognitive deficits in the diagnostic category of schizophrenia. The association between younger age at diagnosis and symptomatic remission may reflect positive effects of early detection or a drift in the interpretation of the diagnostic classification system.
In‐office balloon dilation of the Eustachian tube under local anesthesia: A retrospective review
Authors: Dean Marc 
Published: October 2019

ObjectiveTo study the effectiveness and feasibility of in office balloon dilation of the Eustachian tube (BDET) utilizing a novel anesthetic protocol. Study design: retrospective review.MethodsRetrospective chart review looking at the tolerability and effectiveness of stand‐alone BDET in an office setting utilizing a novel topical anesthesia protocol in 33 patients with Eustachian tube dysfunction as defined by an ETDQ‐7 score greater than 2.2 and type B or C tympanograms for greater than 3 months despite maximal medical management, including at least 4 weeks of nasal steroids.ResultsBDET in the office was well tolerated with 94% (31/33) of patients completing the procedure as planned. No adverse effects or complications were reported; however, the planned dilation time was cut short in one case due to significant discomfort and aborted prior to dilation in another due significant coughing. Tympanograms normalized at six weeks in 87.1% (27/31) of patients who underwent dilation.ConclusionThis study demonstrates that performing BDET in an office setting utilizing a local anesthesia protocol is feasible and effective when the unique barometric considerations of BDET are addressed.
Topside Ionospheric Conditions During the 7–8 September 2017 Geomagnetic Storm
Authors: Jimoh Oluwaseyi , Lei Jiuhou , Zhong Jiahao , Owolabi Charles , Luan Xiaoli , Dou Xiankang 
Published: October 2019

AbstractThe uplooking total electron contents (TECs) from the GRACE, SWARM‐A, TerraSAR‐X, and MetOp‐A satellites and in situ electron density (Ne) from SWARM‐A were utilized to investigate the topside ionospheric conditions during the 7–8 September 2017 geomagnetic storm. The rate of TEC index (ROTI) and rate of density index (RODI), which are derivative indices of TEC and Ne, respectively, were also used to characterize the topside ionospheric irregularities. The main results of this study are as follows: (1) There were significant enhancements seen in the uplooking TEC during the first main phase of the storm. (2) The uplooking TEC did not show unusual enhancement at the morning and evening local times in the Asian‐Australian sector during the recovery phase of the storm. (3) Prominent TEC hemispheric asymmetry at the middle and high latitudes was observed at both day and night sectors. (4) Long‐duration recovery of topside TEC with respect to the prestorm condition was also detected in this event. (5) Nighttime ROTI enhancements were presented in a wide latitudinal range from the equator to the poles during the main phases of the storm. (6) The ionospheric electric field disturbances associated with IMF‐Bzfluctuations probably played a very important role in triggering ionospheric irregularities during the relatively weak geomagnetic activity on 7 September, which implies that ionospheric irregularities do not necessarily occur under the severe geomagnetic conditions only.
The Storm‐Time Ring Current Response to ICMEs and CIRs Using Van Allen Probe Observations
Authors: Mouikis C. G. , Bingham S. T. , Kistler L. M. , Farrugia C. J. , Spence H. E. , Reeves G. D. , Gkioulidou M. , Mitchell D. G. , Kletzing C. A. 
Published: October 2019

AbstractUsing Van Allen Probe observations of the inner magnetosphere during geomagnetic storms driven by interplanetary coronal mass ejections (ICMEs) and corotating interaction regions (CIRs), we characterize the impact of these drivers on the storm‐time ring current development. Using 25 ICME‐ and 35 CIR‐driven storms, we have determined the ring current pressure development during the prestorm, main, early‐recovery, and late‐recovery storm phases, as a function of magnetic local time, L shell and ion species (H+, He+, and O+) over the 100‐ to 600‐keV energy range. Consistent with previous results, we find that during the storm main phase, most of the ring current pressure in the inner magnetosphere is contributed by particles on open drift paths drifting duskward leading to a strong partial ring current. The largest difference between the ICME and CIR ring current responses during the storm main and early‐recovery phases is the difference in the response of the <~55‐keV O+ to these drivers. While the H+ pressure response shows similar source and convection patterns for ICME and CIR storms, the O+ pressure response is significantly stronger for ICME storms. The ICME O+ pressure increases more strongly than H+ with decreasing L and peaks at lower L shells than H+.
Isolated Auroral Spots Observed by DMSP/SSUSI
Authors: Zhou Su , Luan Xiaoli , Pierrard Viviane , Han Desheng 
Published: October 2019

AbstractThis work reports auroral spots event observed by the SSUSI instruments on board the DMSP spacecraft between 22 and 23 July 2009 during the recovery phase of a moderate magnetic storm. The spots were observed between 18:00 and 02:00 magnetic local time and stayed at ~60° magnetic latitude. They lasted for ~10 hr and corotated with ~64% of the Earth's rotational speed. In situ observations indicate that the isolated auroral spots were produced by energetic ions at energies between 10 and 240 keV, with significantly anisotropic electron (30–300 keV) precipitations. It is expected that the energetic ions originate from the ring current and can be scattered by the EMIC waves through cyclotron resonance. The energetic electrons can be precipitated by the nonresonant interaction between the electrons and EMIC waves, which is suggested by previous works.
Quasi Two‐, Three‐, and Six‐Day Planetary‐Scale Wave Oscillations in the Upper Atmosphere Observed by TIMED/SABER Over ~17 Years During 2002–2018
Authors: Liu Guiping , England Scott L. , Janches Diego 
Published: October 2019

AbstractWe present for the first time the global climatology of two‐, three‐, and six‐day planetary waves in the upper atmosphere using nearly 17 years of temperature observations by Thermosphere Ionosphere and Mesosphere Electric Dynamics/Sounding of the Atmosphere using Broadband Emission Radiometry (TIMED/SABER) during January 2002–December 2018. The observations span the altitude range ~30–110 km and are continuously available over 50°S–50°N latitudes throughout the time interval. The amplitudes and phases of the oscillations with periods in the ranges of 1.5–2.5, 2.5–3.5, and 5.5–6.5 days, and longitudinal zonal wave numbers of W3 (westward propagating wave number‐3) and E1 (eastward propagating wave number‐1) are determined from the two‐dimensional (2‐D) least squares analysis of the data. The study finds that the two‐day W3 waves can penetrate into the equatorial region, although they are mostly observed at higher latitudes. The three‐ and six‐day E1 waves are trapped at low latitudes, and their amplitudes vary with latitude following a Gaussian function with the maximum centered at the equator and the e‐folding width of 27° and 24° latitudes. In the equatorial region, the monthly mean amplitudes are ~3.8–4.8 K for the three‐day waves, and the two‐ and six‐day waves have relatively smaller amplitudes. The waves have the amplitude maximums around solstices and the minimums close to equinoxes. The peak amplitudes are larger during the solar maximum than during the solar minimum, and superimposed with the quasi two‐year cycle. The vertical wavelengths are approximately 30–40 km, suggesting the propagations to the equatorial upper atmosphere. The climatology revealed could be useful for general circulation models.
Characteristics and Sources of Hourly Trace Elements in Airborne Fine Particles in Urban Beijing, China
Authors: Cui Yang , Ji Dongsheng , Chen Hui , Gao Meng , Maenhaut Willy , He Jun , Wang Yuesi 
Published: October 2019

AbstractTo better investigate the characteristics and sources of trace elements (TEs) in PM2.5 in urban Beijing, a 1‐year hourly observation was continuously made using an online multi‐element analyzer from 1 June 2016 to 31 May 2017. The average concentrations of 14 individual TEs ranged from 1.1 (V) to 900 ng/m3 (K). The occurrence levels of most TEs of interest in Beijing were lower than those in most domestic cities, but higher than those in most foreign countries. The formation of sulfate increased with the concentrations of all studied TEs during autumn and winter. Dust, industry, biomass burning and waste incineration, vehicle emissions, coal combustion, and oil combustion were identified by the positive matrix factorization (PMF) model, which accounted for 36.3%, 10.7%, 27.1%, 13.7%, 7.6%, and 4.6%, respectively, of the total elements. All factors exhibited higher concentrations on weekends than on weekdays. Local vehicular emissions and industry contributed to the loading of TEs, but dust, biomass burning and waste incineration, coal combustion, and oil combustion from neighboring areas appeared to be dominant sources of TEs. Except for dust and industry, the four other sources of TEs were mainly located in the south and southeast areas of the sampling site. The analysis by conditional probability function and potential source contribution function showed that the distribution of the PMF sources of TEs roughly agreed with the location of the main point sources. Overall, this work provides more detailed information on the characteristics of the TEs for the scientific community and modelling work.
Three‐Dimensional Mapping of Lightning‐Produced Ionospheric Reflections
Authors: Malins J. B. , Obenberger K. S. , Taylor G. B. , Dowell J. 
Published: October 2019

AbstractThe powerful high‐frequency/very high frequency radio emissions that occur during lightning flashes can be used as a signal of opportunity to study the bottom side ionosphere. The lightning emission is bright, broad spectrum, and short in duration, providing an ideal signal of opportunity for making ionograms. This study continues previous work in Obenberger et al. (2018), where the direct line of sight signal from lightning can be cross correlated with megahertz frequency radio telescope observations to reveal ionogram traces created from the reflected lightning signals. This process was further developed to automate production of ionograms made from individual lightning flashes over the course of several hours, as well as create new techniques to detect the lightning signal using the all‐sky‐imaging mode. By using the Long Wavelength Array Sevilleta radio telescope as an interferometer, the point of reflection of the lightning signal for each frequency of the ionogram can be located in the ionosphere, instantaneously revealing density gradients within the ionosphere on minute time scales. We also explore the minimum size stations required for the application of this technique, which we found to be at least 32 antennas.
Additive manufactured dielectric Gutman lens
Authors: Bjorkqvist O. , Zetterstrom O. , Quevedo‐Teruel O. 
Published: October 2019

In this Letter, the design of a 3D printed fully dielectric Gutman lens is presented. The authors demonstrate the feasibility of using highly accessible and cheap additive manufacturing technology to produce a compact and high performing antenna lens. The lens is designed to operate at band and utilises a flat feed surface that approximates the focal sphere. The flat feed surface allows for beam steering that requires only translational movement of the feed. The lens has a measured realised gain of 20 dBi with 3 dB scan loss at . The lens finds applications in systems that require high gain antennas, such as the new generation of satellite and 5G communications and radar technology.
Two‐ and three‐winding coupled‐inductor‐based high step‐up DC–DC converters for sustainable energy applications
Authors: Eskandarpour Azizkandi Mahmoodreza , Sedaghati Farzad , Shayeghi Hossein , Blaabjerg Frede 
Published: October 2019

This study proposes two configurations for a non‐isolated, high step‐up, single‐switch, coupled‐inductor‐based DC–DC converter. A coupled inductor and voltage multiplier cells are used in the presented topologies to obtain a high voltage gain. Also, a passive clamp circuit is applied in the topologies to reduce voltage stress of the main power switch. This leads to utilising a power switch with lower on‐state resistance, which decreases the conduction loss. Several advantages such as low operating duty cycle, high voltage conversion ratio, reduced voltage stress of semiconductors, low turn ratio of the coupled inductor, leakage inductance energy recovery and high efficiency operation make the presented structures appropriate for sustainable energy applications. The operational principle and steady‐state analysis of the suggested topologies in continuous conduction mode are expressed in detail. Also, design procedure and theoretical efficiency of the topologies are presented. Then, the suggested topologies are compared with several similar high step‐up topologies to prove their advantages. Finally, the performance and feasibility of the proposed DC–DC converter configurations are confirmed through experimental measurement results of 29 V input and 435 V/213 W and 480 V/238 W output laboratory prototypes at 50 kHz switching frequency.
Quantitative assessment of effective regurgitant orifice: impact on risk stratification, and cut-off for severe and torrential tricuspid regurgitation grade
Authors: Peri Yogev , Sadeh Ben , Sherez Chen , Hochstadt Aviram , Biner Simon , Aviram Galit , Ingbir Meirav , Nachmany Ido , Topaz Guy , Flint Nir , Keren Gad , Topilsky Yan 
Published: October 2019

Abstract

Aims
Asses the added value of quantitative evaluation of tricuspid regurgitation (TR), the proper cut-off value for severe TR and ‘torrential TR’ based on outcome data. The added value of quantitative evaluation of TR, and the cut-off values associated with increased mortality are unknown.

Methods and results
In patients with all-cause TR assessed both qualitatively and quantitatively by proximal iso-velocity surface area method, long-term and 1-year outcome analysis was conducted. Thresholds for excess mortality were assessed using spline curves, receiver-operating characteristic curves, and minimum P-value analysis. The study involved 676 patients with all-cause TR (age 73.9 ± 14 years, male 45%, ejection fraction 52.9 ± 14%). Effective regurgitant orifice (ERO) was strongly associated with decreased survival in unadjusted [hazard ratio (HR) 2.38 (1.79–3.01), P &lt; 0.0001 per 0.1 cm2 increment] and adjusted [2.6 (1.25–5.0), P = 0.01] analyses. Quantitative grading was superior to qualitative grading in prediction of outcome (P &lt; 0.01). The optimal cut-off value for the best separation in survival between groups of patients with severe vs. lesser degree of TR was 0.35 cm2 [P &lt; 0.0001, HR =2.0 (1.5–2.7)]. ERO negatively impacted survival, even when including only the subgroup of patients with severe TR [HR 1.5 (1.01–2.3); P = 0.04]. The optimal threshold corresponding for the best separation for survival between groups of patients with severe vs. ‘torrential’ TR was 0.7 cm2 [P = 0.005, HR =2.6 (1.2–5.1)].

Conclusion
TR can be severe and even ‘torrential’ and is associated with excess mortality. Quantitative assessment of TR by ERO measurement is a powerful independent predictor of outcome, superior to standard qualitative assessment. The optimal cut-off above which mortality is increased is 0.35 cm2, similar albeit slightly lower than suggested in recent guidelines. Torrential TR &gt;0.7 cm2 is associated with poorer survival compared to patients with severe TR (ERO &gt; 0.4 cm2 and &lt;0.7 cm2).
Matrix-Delivered Autologous Mesenchymal Stem Cell Therapy for Refractory Rectovaginal Crohn’s Fistulas
Authors: Lightner Amy L , Dozois Eric J , Dietz Allan B , Fletcher Joel G , Friton Jessica , Butler Greg , Faubion William A 
Published: October 2019

Abstract

Background
Crohn’s rectovaginal fistulizing disease remains notoriously difficult to treat. A phase I clinical trial to evaluate the safety and feasibility of a novel protocol using a mesenchymal stem cell (MSC)–coated Gore Bio-A fistula plug for the treatment of medically and surgically refractory Crohn’s rectovaginal fistulas was conducted.

Methods
Five patients underwent an autologous subcutaneous adipose tissue harvest via a 2-cm abdominal wall incision at time of exam under anesthesia (EUA) with seton placement. MSCs were isolated, expanded, and impregnated on the plug. After 6 weeks, patients returned to the operating room for placement of the MSC-coated plug. The primary end points were safety and feasibility; the secondary end point was clinical and radiographic healing at 6 months.

Results
Five female patients (median age [range], 49 [38–53] years) with a median disease duration (range) of 23 (7–34) years who were on biologic (n = 5) or combination therapy (n = 3) had successful harvest and expansion of MSCs and delivery of the Gore Bio-A plug. There were no serious adverse events or adverse events related to the MSCs or plug during the 6-month follow-up. At 6 months, 3 patients had complete cessation of drainage, and 2 had &gt;50% reduction in drainage; all had a persistent fistula tract identified on magnetic resonance imaging and EUA at 6 months.

Conclusions
Surgical placement of an autologous adipose-derived MSC-coated fistula plug in diverted patients with Crohn’s rectovaginal fistulas was safe and feasible. All patients had a reduction in the size of their fistula tract, and 3 of 5 had cessation of drainage, but none achieved complete healing.
This was a phase I clinical trial of autologous mesenchymal stem cells on a plug for rectovaginal Crohn’s fistulas.