bluuebunny/crossref_metadata_2025_split huggingface dataset:
Application of Spray Drying Technique for Flowability enhancement of Divalproex Sodium
Authors: Ghanbarzadeh Saeed , Valizadeh Hadi , Yaqoubi Shadi , Asdagh Arash , Hamishehkar Hamed 
Published: September 2017

Abstract
Background Tablets and capsules are the most accepted and widely used solid dosage forms in the medical therapy. Flow property of the powders is playing a key role in the various pharmaceutical fields especially in the fomulation of tablets and capsules. The high hygroscopic crystalline structure of anhydrous Divalproex sodium (DVX) makes it to be appear as waxy white ﬂakes with almost no powder flowability which cause serious problems during the tabletting and capsule filling procedures.
Purpose The main objective of this study was to improve the flowability of DVX powder.
Methods DVX was mixed with mannitol or lactos in different ratios, dissolved in water and differet binary mixtures of ethanol:water, and finally spray dried with different spray drying conditions. Particle size and powders morphology were assessed by Scanning Electron Microscopy (SEM). The poweder flowability was assessed by measurmet of Hausner ratio (HR), Carr’s index (CI) and angle of repose (AOR) indexes. Furthermore, the content uniformity of DVX in spray-dried powders was determined by using a validated HPLC technique.
Results The results showed that spray drying technique improved DVX flowability by forming spherical particles with narrow size distribution AOR value of DVX was decrease from not flowable to 36.1° in spray dried solid dispersion indicating the improvmet of powder flowability from very poor to fair/good condition.
Conclusion Findings suggest that the spray drying technique improves DVX flowability and may pave the way for improvement in the tabletting procedure of DVX.
Insertion of percutaneous endoscopic gastrostomy tubes with jejunal extensions using the “wedge” technique: a novel method to prevent retrograde tube migration into the stomach
Authors: Sey Michael , Gregor Hannah , Gregor Jamie , Yan Brian 
Published: September 2017

Abstract
Background and study aim In percutaneous endoscopic gastrostomy (PEG) with jejunal extension (PEGJ) procedures, retrograde migration of the jejunal extension tube into the stomach during endoscope withdrawal is a frustrating problem. We describe the novel “wedge” technique for inserting the jejunal extension tube, utilizing single-balloon enteroscopy to anchor it in place.
Patients and methods Prospective 1-year study of consecutive patients undergoing PEGJ insertion at a single tertiary care center. The primary outcome was number of pyloric intubations required to place the jejunal extension tube. Secondary outcomes included success rate, time, and complications related to jejunal extension tube insertion.
Results 17 patients underwent the procedure. The jejunal extension tube was inserted at the first attempt in 15 patients (88.2 %) and 2 required another pyloric intubation. Abdominal X-ray showed that all PEGJ tubes were successfully seated in the proximal jejunum. The mean (SD) time required for jejunal extension insertion was 16.9 (8.6) minutes. Two adverse events occurred due to PEG insertion although none were related to the jejunal extension insertion itself.
Conclusions: The “wedge” technique is an effective and easy method for inserting a jejunal extension tube after PEG insertion.
Balanced Coagonist of GLP-1 and Glucagon Receptors Corrects Dyslipidemia by Improving FGF21 Sensitivity in Hamster Model
Authors: Patel Vishal , Joharapurkar Amit , Kshirsagar Samadhan , Patel Hiren , Pandey Dheerendra , Patel Dipam , Sutariya Brijesh , Patel Maulik , Bahekar Rajesh , Jain Mukul 
Published: September 2017

AbstractHyperlipidemia is often associated with obesity and diabetes, and can lead to serious complications like atherosclerosis and fatty liver disease. Coagonist of GLP-1 and glucagon receptors is a therapy under clinical investigation for treatment of obesity and diabetes. In this study, we have characterized the mechanism of hypolipidemic effect of a balanced coagonist using high cholesterol-fed hamsters. Tyloxapol-induced hypertriglyceridemia, lipolysis in adipose tissue, and bile homeostasis were assessed after repeated dose treatment of the coagonist of GLP-1 and glucagon receptors (Aib2 C24 chimera 2, SC). Antagonists of GLP-1, glucagon, and FGF21 receptors were coadministered, and FGF21 sensitivity was determined in liver and adipose tissue. Repeated dose treatment of coagonist reduced cholesterol and increased FGF21 in blood and liver. Coagonist treatment reduced hepatic triglyceride secretion, increased lipolysis and reduced body weight. Antagonism of GLP-1 and glucagon receptors partially blocked the effect of the coagonist on lipid metabolism in circulation and liver, while FGF21 receptor antagonist completely abolished it. Glucagon and GLP-1 receptors antagonists blocked the action of coagonist on cholesterol excretion and bile flow in liver, but FGF21 antagonist was not effective. Treatment with the coagonist increased expression of FGF21, FGF21R and cofactor ßKlotho in liver and adipose. In conclusion, coagonist of GLP-1 and glucagon receptors improved lipid metabolism in liver of dyslipidemic hamsters. This effect is partially mediated by GLP-1 and glucagon receptors, and the improved FGF21 sensitivity could be the mechanism of hypolipidemic action of the coagonist of GLP-1/glucagon receptors.
Universal nanodroplet branches from confining the Ouzo effect
Authors: Lu Ziyang , Schaarsberg Martin H. Klein , Zhu Xiaojue , Yeo Leslie Y. , Lohse Detlef , Zhang Xuehua 
Published: September 2017

Significance
The phenomenon of spontaneous nanodroplet formation termed the “Ouzo effect” is the basis for many processes, from preparation of pharmaceutical products, to formulation of cosmetics and insecticides, to liquid–liquid microextraction. This work attempts to disentangle the effects of concentration gradients from the extrinsic mixing dynamics by spatiotemporally following the nanodroplet formation from the Ouzo effect confined in a quasi-2D geometry. We observe striking universal branch structures of the nucleating droplets under the external diffusive field, analogous to the ramification of stream networks in large scale, and the enhanced local mobility of colloidal particles driven by the concentration gradient emerging from the development of the branch patterns. We further demonstrate that these nanodroplets can be exploited for single-step nanoextraction and detection.
Cortically coordinated NREM thalamocortical oscillations play an essential, instructive role in visual system plasticity
Authors: Durkin Jaclyn , Suresh Aneesha K. , Colbath Julie , Broussard Christopher , Wu Jiaxing , Zochowski Michal , Aton Sara J. 
Published: September 2017

Significance
Previous studies have demonstrated a role of state-specific neural activity in plasticity; however, a mechanism for these changes has yet to be elucidated. Here, we demonstrate that sensory response changes occur in thalamic neurons immediately following novel visual experience, but that subsequent nonrapid eye movement (NREM) oscillations are required for subsequent response changes in the primary visual cortex (V1). Consequently, we show that disruption of NREM oscillations specifically blocks sleep-dependent plasticity in V1. We conclude that following a novel sensory experience, neural activity patterns unique to NREM facilitate transfer of information from the visual thalamus to the V1, leading to adaptive response changes in V1 neurons.
Public willingness to pay for a US carbon tax and preferences for spending the revenue
Authors: Kotchen Matthew J , Turk Zachary M , Leiserowitz Anthony A 
Published: September 2017

Abstract
We provide evidence from a nationally representative survey on Americans’ willingness to pay (WTP) for a carbon tax, and public preferences for how potential carbon-tax revenue should be spent. The average WTP for a tax on fossil fuels that increases household energy bills is US$177 per year. This translates into an average WTP of 14% more on average for households across the United States, where energy costs differ significantly across states. Regarding the tax revenues, Americans are most in support of using the money to invest in clean energy and infrastructure. There is relatively less support for reducing income or payroll taxes, returning dividends to households, and other expenditure categories. Finally, Americans support using the tax revenues to assist displaced workers in the coal industry enough to compensate each miner nearly US$146 000 upon passage of a carbon tax.
Characteristics of Interim Deans at U.S. Medical Schools: Implications for Institutions and Individuals
Authors: Bunton Sarah A. , Sass Pamela , Sloane Rae Anne , Grigsby R. Kevin 
Published: September 2017

Purpose
To provide a baseline, descriptive understanding of individuals serving as interim deans at U.S. medical schools. Over the past quarter century, roughly 9% to 16% of all medical school deans were serving as interim leaders. This research reviews demographic characteristics, how long they served, and the impact of having served on one’s likelihood of serving as a permanent dean.

Method
The Association of American Medical Colleges’ Council of Deans national database was the data source for this study. The authors reviewed counts and information by year for academic years 1989–1990 through 2014–2015 to yield a snapshot of interim dean counts. The authors analyzed data by demographic characteristics—namely, sex, race/ethnicity, degree, specialty, and years of service—and compared data with those of permanent deans. Descriptive statistics are presented.

Results
Overall, between 14 and 27 individuals served as interim deans during each academic year in this study (9%–16% of all unique individuals with a dean or interim dean appointment). Of all individuals serving as interim deans in this time frame, 88% were men (228/259) and 86% were white (222/259). The average time in the interim dean role was roughly 13 months, and a high percentage went on to serve as permanent deans (ranging from 15% to 63%).

Conclusions
The results of this study add detail to the collective understanding of these leaders in medical schools. The authors discuss how individuals and institutions can facilitate success and preparedness for an interim dean appointment.
Comparison of the Inhibitory Mechanisms of Diethyl Citrate, Sodium Citrate, and Phosphonoformic Acid on Calcification Induced by High Inorganic Phosphate Contents in Mouse Aortic Smooth Muscle Cells
Authors: Duan Chao-Yang , Zhang Chong-Yu , Sun Xin-Yuan , Gui Bao-Song , Guo Da , Ouyang Jian-Ming 
Published: September 2017

Objective:
This study aimed to investigate the differences and inhibitory effects of diethyl citrate (Et2Cit), sodium citrate (Na3Cit), and phosphonoformic acid (PFA) on calcification induced by high inorganic phosphate (Pi) contents in mouse aortic smooth muscle cells (MOVAS) and to develop drugs that can induce anticoagulation and inhibit vascular calcification (VC).

Methods:
Alive and fixed MOVAS were assessed for 14 days in the presence of high Pi with increasing Et2Cit, Na3Cit, and PFA concentrations. Calcification on MOVAS was measured through Alizarin red staining and the deposited calcium amount; apoptosis was detected by annexin V staining; and cell transdifferentiation was examined by measuring smooth muscle lineage gene (α-SMA) expression and alkaline phosphatase activity.

Results:
Coincubation of MOVAS with Et2Cit, Na3Cit, and PFA significantly decreased Pi-induced VC in live MOVAS, and the apoptotic rate was reduced by low inhibitor concentrations. The 3 inhibitors could prevent the alkaline phosphatase activity induced by high Pi contents and increased the expression of α–smooth muscle actin genes. Thus, the transdifferentiation of MOVAS into osteoblast-like cells was blocked. Their inhibitory effects exhibited concentration dependence. The inhibitory effect of each inhibitor at the same concentration showed the following trend: PFA > Na3Cit > Et2Cit.

Conclusions:
Et2Cit, Na3Cit, and PFA prevented the calcification of MOVAS and inhibited the osteochondrocytic conversion of vascular smooth muscle cells. Thus, Et2Cit and Na3Cit as anticoagulants may alleviate VC in clinical applications.
Diagnostic Approach to Ocular Infections Using Various Techniques From Conventional Culture to Next-Generation Sequencing Analysis
Authors: Eguchi Hiroshi , Hotta Fumika , Kuwahara Tomomi , Imaohji Haruyuki , Miyazaki Chika , Hirose Miou , Kusaka Shunji , Fukuda Masahiko , Shimomura Yoshikazu 
Published: September 2017

Abstract:
Ocular infection is caused by both endogenous (resident) and exogenous (environmental) microbes. As the ocular surface interacts with both outer environment and its own resident microbiota, clinical ocular samples are predicted to contain a diverse set of microorganisms. Microscopy of sample smears is an important step in the diagnostic process of infectious diseases to interpret the culture results. Traditional culture techniques have several limitations in the detection and/or identification of uncharacterized bacteria of environmental origin. Molecular biological techniques, such as polymerase chain reaction of pathogen-specific virulence genes, 16S rRNA gene clone library analysis, and next-generation sequencing of 16S rDNA amplicons, compensate for diagnostic culture techniques in diagnosing infectious diseases. These techniques are expected to provide novel insights into the ocular microbiota and pathology of ocular infections. In this article, we describe various ocular infections, including contact lens–related keratitis, silicone buckle infection, and dacryocystitis, which were analyzed using molecular biological techniques. The advantages and disadvantages of these highly sensitive and inclusive microbiological detection systems for ocular infections are discussed.
Differences in Myoelectric and Body-Powered Upper-Limb Prostheses: Systematic Literature Review Update 2013–2016
Authors: Carey Stephanie L. , Stevens Phil M. , Highsmith M. Jason 
Published: September 2017

ABSTRACT
Prosthesis users often make a choice between a myoelectric or body-powered upper-limb prosthesis. The choice may be determined using factors such as cost, insurance limitations, function, sensory feedback, and cosmesis. An updated systematic review was conducted to determine differences between myoelectric and body-powered prostheses in the past 3 years (mid-2013 to 2016) since the previous review. An additional 43 unique publications were identified. Ultimately, three of the publications were included, adding evidence to two previously developed empirical evidence statements regarding the potential need for multiple control strategies to facilitate intuitive prosthetic control and the value of task training in improving function. However, there is still insufficient evidence to conclude that either the myoelectric or body-powered prosthesis provides an overall advantage. Although excluded from this literature review, research on hybrid prostheses such as the DEKA arm and on sensation and haptic feedback is emerging. There is still a need for more empirical evidence regarding functional differences in upper-limb prostheses.
Physiatrist Perspective on Upper-Limb Prosthetic Options: Using Practice Guidelines to Promote Patient Education in the Selection and the Prescription Process
Authors: Melton Danielle H. 
Published: September 2017

ABSTRACT
The purpose of this perspective is to outline the role of the treating physician, often a physiatrist, in caring for people with upper-limb loss with regard to prosthetic options. The rehabilitation process begins by encouraging the individual with amputation to take ownership in his or her care by establishing goals, researching prosthetic options, and directing the decision making of their team. The systematic review of the literature confirmed that there is limited empirical evidence to guide the prosthetic selection process. Many obstacles hinder the selection process including cost/insurance coverage, access to experienced training in prosthetic use, and unrealistic expectations for the prosthesis to restore the patient's limb. Standards of care vary greatly among institutions, both nationally and worldwide, exposing the need for a practical civilian model system of care using available resources to achieve the best possible outcomes. Guidelines must incorporate evidence-based practice when available along with expert opinion while integrating surgical and technological advances as these mature. Using goal-oriented, patient-centered shared decision making optimizes prosthetic selection.
Active Upper-Limb Prostheses: The International Perspective
Authors: Kannenberg Andreas 
Published: September 2017

ABSTRACT
The purpose of this article is to give an overview on the perspective of different health care systems around the world on the coverage of active upper-limb prostheses for individuals with an upper-limb amputation. Because no authoritative statistics are publicly available, data were collected by interviewing acknowledged professionals in the field of upper-limb prosthetic rehabilitation as well as by obtaining estimates of market sizes from Ottobock's business unit, national market managers, and clinical prosthetists specialized in upper-limb prosthetics in various countries.
Countries may be placed in one of three categories upon the basic approach to the provision of active upper-limb prostheses:
1. Industrialized countries with health care systems that grant access to all types of active upper-limb prostheses (e.g., Western and Northern Europe). In these countries, myoelectric/externally powered upper-limb prostheses are considered standard of care. However, adoption levels vary depending on differences in coverage policies. In countries with health care systems that cover several upper-limb prostheses at a time, 80% to 90% of patients use myoelectrics as their primary prosthesis. If the health care system covers only one prosthesis at a time, the proportion of myoelectric prostheses may decline to 50% to 60%.
2. Industrialized countries with health care systems that limit access to active upper-limb prostheses primarily to body-powered devices (e.g., United States, Canada, Australia, New Zealand, Japan). In these countries, myoelectric/externally powered prostheses require approved exceptions from coverage policies and are typically used by less than 35% to 40% of all patients with active prostheses. However, in some specialized urban rehabilitation clinics, the share of myoelectric prostheses may reach up to 70%.
3. Countries with health care systems that provide passive or no upper-limb prostheses to the majority of their beneficiaries (e.g., Eastern Europe, Latin America, Asia, Africa). Although the scientific evidence for upper-limb prosthetics is the same around the world, coverage policies and funding vary remarkably and result in strikingly different adoption rates of active upper-limb prosthetic technologies among different countries. Among industrialized countries, the most important difference seems to be whether policies only consider prosthetic function or also psychosocial aspects for determining medical necessity of the available active prosthetic technologies and designs.
Caregiver Appraisals of Anxiety, Pain, and Behavioral Changes Among Children After Ambulatory Surgery
Authors: Hennessey Erin , Hickman Ronald L. , Toly Valerie Boebel , Gary Faye A. 
Published: September 2017

Background:
Preoperative anxiety is very common across the age continuum; however, for children who experience anxiety, it can be especially challenging. On the basis of the report of caregivers, this anxiety can sometimes lead to negative behaviors postoperatively.

Purpose:
The purpose of this study was to examine the relationship between pediatric trait anxiety and postoperative outcomes in pediatric patients who undergo ambulatory surgery.

Methods:
A quantitative cross-sectional descriptive research design study of 64 caregivers was conducted. Inclusion criteria consisted of caregivers of children aged 1–8 years who underwent ambulatory surgery and provided informed consent. Measures administered included the Post Hospitalization Behavioral Questionnaire to evaluate postoperative behavior of patients after discharge from the hospital, Parents' Postoperative Pain Measure-Short Form to evaluate pain of a child after surgery, and Screen for Child Anxiety Related Emotional Disorders to evaluate children's anxiety. Data were analyzed using measures of central tendencies and bivariate correlational analysis.

Results:
Caregivers' appraisals of trait anxiety in children undergoing ambulatory surgery were low, whereas negative postoperative behaviors and pain levels were high. The only statistically significant relationship was a negative correlation between trait anxiety and postoperative pain of children who underwent ambulatory surgery.

Conclusions:
Central to this finding is the importance of developing adaptive skills of children to improve postoperative outcomes such as pain management. However, this study showed that trait anxiety is not related to postoperative negative behaviors.
Hirschsprung’s Disease: How to Prevent Enterocolitis With Rectal Irrigations
Authors: Yegerlehner Lauren , Blunk Trina 
Published: September 2017

Abstract
Hirschsprung’s disease is a condition where intestinal motility is compromised because of the absence of ganglion cells in the submucosal and myenteric plexus. A suction rectal biopsy is the definitive way to diagnose Hirschsprung’s disease. Enterocolitis is an inflammation of the small intestines and colon, which can be caused by bacterial overgrowth. Rectal irrigations are performed to help evacuate stool and gas from the small intestines and colon. It is important to perform adequate rectal irrigations on patients to prevent enterocolitis. Because of the importance of preventing enterocolitis, appropriate education is needed on Hirschsprung’s disease and enterocolitis and how to perform rectal irrigations effectively. A pilot study of 210 Neonatal Intensive Care Unit registered nurses was conducted to give education via poster presentation to deliver information on Hirschsprung’s disease and how to prevent enterocolitis with rectal irrigations. A pretest was administered before viewing the educational material. The test contained three questions on the topic. The poster was reviewed, and the questions were repeated utilizing a posttest to evaluate retention. Of the 210 Neonatal Intensive Care Unit registered nurses evaluated, there was an overall improvement on the three areas measured. The rates varied with each question. There was a 4.8% increase with Question 1, a 1.4% increase with Question 2, and a 10% increase with Question 3. These results showed an overall retention of the education provided. This was an effective way to educate a large group of nurses who provide bedside care to neonates with Hirschsprung’s disease. With this education, the nurses are better equipped to perform successful irrigations, thereby preventing enterocolitis.