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Magnetic resonance diffusion tensor imaging (DTI) can detect microstructural changes in peripheral nerves. Studies have reported that the median nerve apparent diffusion coefficient (ADC), a quantification of water molecule diffusion direction, is sensitive in diagnosing carpal tunnel syndrome (CTS). Five databases were searched for studies using ADC to investigate CTS. A pparent diffusion coefficient (measured in mm2/s) were pooled in random-effects meta-analyses. Twenty-two studies met criteria yielding 592 patients with CTS and 414 controls. Median nerve ADC were measured at the level of the distal radioulnar joint (CTS ADC: 1.11, 95% CI: 1.07-1.15, I2 = 54%; control ADC: 1.04, 95% CI: 1.01-1.07, I2 = 57%), pisiform (CTS ADC: 1.39, 95% CI: 1.37-1.42, I2 = 0%; control ADC: 1.27, 95% CI: 1.23-1.31, I2 = 59%), hamate (CTS ADC: 1.40, 95% CI: 1.36-1.43, I2 = 58%; control ADC: 1.27, 95% CI: 1.25-1.28, I2 = 47%), and as an combination of several measurements (CTS ADC: 1.40, 95% CI: 1.37-1.47, I2 = 100%; control ADC: 1.39, 95% CI: 1.24-1.53, I2 = 100%). Median nerve ADC is decreased in individuals with CTS compared to controls at the levels of the hamate and pisiform. ADC cut-offs to diagnose CTS should be established according to these anatomic levels and can be improved through additional studies that include use of a wrist coil.

Hematopoietic stem cell transplantation-associated thrombotic microangiopathy (HSCT-TMA) is a severe and potentially life-threatening complication. HSCT-TMA is often underdiagnosed due to multifactorial pathophysiology and a historic lack of standard diagnostic criteria. Identification of the multi-hit hypothesis and the key role of the complement system, particularly the lectin pathway of complement, has led to development of treatments targeting the underlying pathogenesis of HSCT-TMA. Additional research is ongoing to investigate the efficacy and safety of these targeted therapies in patients with HSCT-TMA. Advanced practice providers (APPs; nurse practitioners and physician assistants) and pharmacists are critical members of the multidisciplinary HSCT team and ensure management of patients throughout the continuum of care. Additionally, pharmacists and APPs can improve patient care through medication management of complex regimens; transplant education for patients, staff, and trainees; evidence-based protocol and clinical guideline development; assessment and reporting of transplant-related outcomes; and quality improvement initiatives to improve outcomes. Understanding the presentation, prognosis, pathophysiology, and treatment options for HSCT-TMA can improve each of these efforts.

Purpose Given the variation in clinical practice, a clinician-centric, standardized process to implement and validate clinical pharmacy outcome measures was developed. Summary Four specialty clinics with embedded clinic-based pharmacists underwent an iterative process to define, refine, and implement the build of electronic health record functionality for outcome measure data collection and reporting. Starting with a list of identified measures, clinic workgroups met to discuss each measure and identify gaps in measure implementation. Information technology experts created electronic documentation forms with discrete data and reports based on criteria specified by the clinic workgroups. Of 32 outcome measures identified as priorities for demonstrating pharmacists’ impact in previous research, 29 were implemented for routine monitoring through this project. Implementation strategies included identification through existing reporting, development of discrete documentation tools within the electronic health record, and development of new reporting tools from available discrete data fields. Time to implementation decreased from the first to the last pilot clinic implementation, as demonstrated through a 9-day reduction in electronic documentation form development and 31-day reduction in report development turnaround time. Conclusion A standardized and reproducible process was developed for the implementation of clinical pharmacy outcomes measures for 4 specialty clinics. The process was successfully utilized to develop measurable outputs for a variety of oncology and nononcology specialty disease states based upon multidisciplinary stakeholder input.

This study investigated the phytochemical constituents and evaluated the total phenolic content, it also determined the antioxidant and antibacterial activities of the ethanol (EtOH) extract of the whole plant of Dicliptera verticillata. The phytochemical study was carried out using repeated silica gel column chromatography followed by Sephadex LH-20 to purify the extract which afforded three known compounds: lutein (1), shikimic acid (2) and guaiacylglycerol (3). The structures of these compounds were identified after analyses of their NMR and MS data and comparison of these data with those reported in the literature. The antioxidant and antibacterial activities were evaluated by the 2,2-diphenyl-1-picrylhydrazyl radical assay and the broth macrodilution method, respectively. The EtOH extract showed moderate antioxidant activity (63.9%; IC50 40.16 μg/mL), weak total phenolic content and had a bactericidal effect against both Gram-positive (Staphylococcus aureus) and Gram-negative bacteria (Klebsiella pneumonia and Escherichia coli). This is the first report on the isolation of compounds (1–3), as well as the total phenolic content and the antibacterial and antioxidant activities of the EtOH extract of D. verticillata.

Inertial sensors are widely used in human motion monitoring. Orientation and position are the two most widely used measurements for motion monitoring. Tracking with the use of multiple inertial sensors is based on kinematic modelling which achieves a good level of accuracy when biomechanical constraints are applied. More recently, there is growing interest in tracking motion with a single inertial sensor to simplify the measurement system. The dead reckoning method is commonly used for estimating position from inertial sensors. However, significant errors are generated after applying the dead reckoning method because of the presence of sensor offsets and drift. These errors limit the feasibility of monitoring upper limb motion via a single inertial sensing system. In this paper, error correction methods are evaluated to investigate the feasibility of using a single sensor to track the movement of one upper limb segment. These include zero velocity update, wavelet analysis and high-pass filtering. The experiments were carried out using the nine-hole peg test. The results show that zero velocity update is the most effective method to correct the drift from the dead reckoning-based position tracking. If this method is used, then the use of a single inertial sensor to track the movement of a single limb segment is feasible.

A new caffeic acid ester, eriocaffeate (1), and a new ceramide, erioceramide (2) along with eight known compounds, genistein (3), genistin (4), lupinisoflavone A (5), quercetin (6), lupeol (7), a mixture of β-sitosterol (8) and stigmasterol (9), and β-sitosterol-3-O-β- d -glucopyranoside (10) were obtained after the phytochemical investigation of the CH2Cl2/MeOH (1:1, v/v) extract from the roots of Eriosema glomeratum. The structures of the new compounds were elucidated by analyses of their spectroscopic data including 1D- and 2D-NMR, HRESI-MS, and ESI-MS/MS as well as chemical conversions. The cytotoxicity of isolated compounds 1−6 was determined against three human [lung (A549), breast (MCF7), and cervical (HeLa)] cancer cell lines. Compounds 3 and 6 possessed the activities on all the tested three cell lines, MCF7 (IC50 = 88.9 and 42.6 μM), A549 (IC50 = 42.1 and 28.2 μM), and HeLa (IC50 = 27.4 and 19.1 μM), respectively. Compound 4 showed selective moderate activity with the IC50 value of 68.7 μM on the HeLa cancer cell line.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.There is minimal available guidance on the process for selection of clinical outcomes measures to demonstrate the impact of clinic-based pharmacists (CBPs) despite an increased need and desire for outcomes data. The overall aims of this project were to (1) develop a standardized process for identifying clinical outcomes measures impacted by CBPs and (2) identify and prioritize potential clinical outcomes measures to track for CBPs within 4 specialty clinic pilot sites.To develop a standardized process for identification and prioritization of measures, 4 consecutive Plan-Do-Study-Act (PDSA) cycles were performed with 4 different specialty clinics serving as pilot sites. Following each pilot cycle, rapid cycle improvements were implemented. A modified Delphi methodology served as the framework for measure selection and included gathering expert stakeholder insights regarding importance, feasibility, and validity of potential measures. Measures were identified via environmental scan of existing validated quality metrics, clinical guidelines, and other relevant literature.The primary outcome for this project was the development and refinement of a standardized process for measure identification and prioritization. The secondary outcome was narrowed and ranked lists of stakeholder-prioritized measures for 4 CBP-embedded pilot specialty clinics. These lists included 12 cardiothoracic transplant, 6 breast oncology, 9 neurology, and 7 gynecologic oncology measures.The measure identification and prioritization process developed was successfully utilized to identify and prioritize outcomes measures to track for 4 CBP-embedded specialty clinics. Due to the successful use of the process in a variety of specialty clinics, the standardized process has significant potential for expansion.

Supplemental material, sj-docx-2-han-10.1177_15589447221096706 for Can Diffusion Tensor Imaging Apparent Diffusion Coefficient Diagnose Carpal Tunnel Syndrome? A Systematic Review and Meta-Analysis by Adam G. Evans, Maurice D. Morgan, Benjamin A. Aiken, Patrick E. Assi, Jeremy T. Joseph, Tigran Kesayan, Lauren M. Mioton, Isaac V. M. Esteve, J. Bradford Hill, Wesley P. Thayer and Salam Al Kassis in HAND

Supplemental material, sj-docx-1-han-10.1177_15589447221096706 for Can Diffusion Tensor Imaging Apparent Diffusion Coefficient Diagnose Carpal Tunnel Syndrome? A Systematic Review and Meta-Analysis by Adam G. Evans, Maurice D. Morgan, Benjamin A. Aiken, Patrick E. Assi, Jeremy T. Joseph, Tigran Kesayan, Lauren M. Mioton, Isaac V. M. Esteve, J. Bradford Hill, Wesley P. Thayer and Salam Al Kassis in HAND

Digital phenotyping is the term given to the capturing and use of user log data from health and wellbeing technologies used in apps and cloud-based services. This paper explores ethical issues in making use of digital phenotype data in the arena of digital health interventions. Products and services based on digital wellbeing technologies typically include mobile device apps as well as browser-based apps to a lesser extent, and can include telephony-based services, text-based chatbots, and voice-activated chatbots. Many of these digital products and services are simultaneously available across many channels in order to maximize availability for users. Digital wellbeing technologies offer useful methods for real-time data capture of the interactions of users with the products and services. It is possible to design what data are recorded, how and where it may be stored, and, crucially, how it can be analyzed to reveal individual or collective usage patterns. The paper also examines digital phenotyping workflows, before enumerating the ethical concerns pertaining to different types of digital phenotype data, highlighting ethical considerations for collection, storage, and use of the data. A case study of a digital health app is used to illustrate the ethical issues. The case study explores the issues from a perspective of data prospecting and subsequent machine learning. The ethical use of machine learning and artificial intelligence on digital phenotype data and the broader issues in democratizing machine learning and artificial intelligence for digital phenotype data are then explored in detail.

Surface to hand transfer of viruses represents a potential mechanism for human exposure. An experimental process for evaluating the touch transfer of aerosol-deposited material is described based on controlling surface, tribological, and soft matter components of the transfer process. A range of high-touch surfaces were evaluated. Under standardized touch parameters (15 N, 1 s), relative humidity (RH) of the atmosphere around the contact transfer event significantly influenced transfer of material to the finger-pad. At RH < 40%, transfer from all surfaces was

The Master of Business Administration (MBA) plays a significant role in developing managers in a plethora of global organizations. In most circles, it is considered a degree to develop corporate managers. With the leadership failures of organizations like pharmaceutical price collusion and price increase of 539% of Perrigo Pharmaceuticals, the fake account fraud practices at Wells Fargo, sexual harassment issues at Uber, the Equifax data breach, and the video of a forcible, bloody removal of a passenger on a United Airlines in the U.S., there has been increased criticism concerning the effectiveness of current MBA programs and leadership development in general. This qualitative research study explores how the curriculum of the MBA of the future should look.

Nonhealing wounds possess elevated numbers of pro-inflammatory M1 macrophages, which fail to transition to anti-inflammatory M2 phenotypes that promote healing. Hemoglobin (Hb) and haptoglobin (Hp) proteins, when complexed (Hb-Hp), can elicit M2-like macrophages through the heme oxygenase-1 (HO-1) pathway. Despite the fact that nonhealing wounds are chronically inflamed, previous studies have focused on non-inflammatory systems, and do not thoroughly compare the effects of complexed vs individual proteins. We aimed to investigate the effect of Hb/Hp treatments on macrophage phenotype in an inflammatory, lipopolysaccharide (LPS)-stimulated environment, similar to chronic wounds. Human M1 macrophages were cultured in vitro and stimulated with LPS. Concurrently, Hp, Hb, or Hb-Hp complexes were delivered. The next day, 27 proteins related to inflammation were measured in the supernatants. Hp treatment decreased a majority of inflammatory factors, Hb increased many, and Hb-Hp had intermediate trends, indicating that Hp attenuated overall inflammation to the greatest extent. From this data, Ingenuity Pathway Analysis software identified high motility group box 1 (HMGB1) as a key canonical pathway-strongly down-regulated from Hp, strongly up-regulated from Hb, and slightly activated from Hb-Hp. HMGB1 measurements in macrophage supernatants confirmed this trend. In vivo results in diabetic mice with biopsy punch wounds demonstrated accelerated wound closure with Hp treatment, and delayed wound closure with Hb treatment. This work specifically studied Hb/Hp effects on macrophages in a highly inflammatory environment relevant to chronic wound healing. Results show that Hp-and not Hb-Hp, which is known to be superior in noninflammatory conditions-reduces inflammation in LPS-stimulated macrophages, and HMGB1 signaling is also implicated. Overall, Hp treatment on M1 macrophages in vitro reduced the inflammatory secretion profile, and also exhibited benefits in in silico and in vivo wound-healing models.

The need for integrity and reliability in the supply chain and logistics management operations has a well-established array of theoretical frameworks that guide organizations and managers in the field. However, what is missing is a comprehensive, established framework for logistics and supply chain cybersecurity. The emerging area of cyber-supply chain security continues to lack suitable models to help secure critical data and systems. In all industries and fields today, cybersecurity is no longer just an information technology issue. It is a business sustainability and business strategy issue. The human factors in the cyber-supply chain operations represent the actions or events when human error results in a successful hack or data breach. Today, protecting logistics and supply chain organizations from cyber and data security risks is no longer just an information technology employee function. Every organizational employee has a responsibility in the data protection process. Progressive organizations are ones that can create methods, policies, and approaches that encourage employees to play an active role in the information and cybersecurity process. This paper explores innovative approaches around open-door systems as a proactive data security and cybersecurity risk reduction organizational strategy. This research provides cyber-supply chain practitioners and scholars an array of concepts to help them understand and describe the dynamics of cyber-supply chain and logistics management data security vulnerabilities and opportunities for process improvements.

Supplemental material, Appendix_1 for Why do people call crisis helplines? Identifying taxonomies of presenting reasons and discovering associations between these reasons by Robin Turkington, Maurice D Mulvenna, Raymond R Bond, Siobhan O’Neill, Courtney Potts, Cherie Armour, Edel Ennis and Catherine Millman in Health Informatics Journal

Chronic skin wounds are hypoxic and are stalled in a pro-inflammatory state. Hemoglobin (Hb)-based oxygen carriers have shown potential in increasing oxygen delivery to aid wound healing. Macrophages also take up Hb, thus altering their phenotype and the regulation of inflammation. Herein, we compared the effect of Hb and polymerized Hbs (PolyHbs) on the phenotype of human macrophages. Macrophages were incubated with Hb or different forms of PolyHbs, and the inflammatory secretion profile was analyzed. PolyHbs were produced by polymerizing Hb in the relaxed (R) or tense (T) quaternary state and by varying the molar ratio of the glutaraldehyde crosslinking agent to Hb. Hb decreased the secretion of most measured factors. PolyHb treatment led to generally similar secretion profiles; however, Hb had more similar trends to R-state PolyHb. Ingenuity pathway analysis predicted positive outcomes in wound healing and angiogenesis for T-state PolyHb prepared with a 30:1 (glutaraldehyde:Hb) polymerization ratio. When tested in diabetic mouse wounds, T-state PolyHb resulted in the greatest epidermal thickness and vascular endothelial CD31 staining. Thus, the effects of PolyHb on macrophages are affected by the polymerization ratio and the quaternary state, and T-state PolyHb yields secretion profiles that are most beneficial in wound healing.

The effectiveness of anticancer chemotherapy is greatly impeded by the resistance of malignant cells to cytotoxic drugs. In this study, the cytotoxicity of the crude extract (DCB) and compounds isolated from the bark of Dichrostachys cinerea, namely, betulinic acid (1), glyceryl-1-hexacosanoate (2), 7-hydroxy-2-(4-hydroxyphenyl)-4H-chromen-4-one (3), and 6-hydroxy-2-(4-hydroxyphenyl)-4H-chromen-4-one (4), was investigated. The study was extended to the assessment of the mode of induction of apoptosis by DCB and compound 1. The resazurin reduction assay was used for cytotoxicity studies. Assessments of cell cycle distribution, apoptosis, mitochondrial membrane potential (MMP), and reactive oxygen species (ROS) were performed by flow cytometry. Constituents of DCB were isolated by column chromatography. Triterpenoid 1 and flavone 4 had cytotoxic effects towards the 9 tested cancer cell lines with IC50 values below 50 μM. The recorded IC50 values varied from 7.65 μM (towards multidrug-resistant CEM-ADR5000 leukemia cells) to 44.17 μM (against HepG2 hepatocarcinoma cells) for 1, 18.90 μM (CCRF-CEM leukemia cells) to 88.86 μM (against HCT116p53+/+ colon adenocarcinoma cells) for 4, and 0.02 μM (against CCRF-CEM cells) to 122.96 μM (against CEM/ADR5000 cells) for doxorubicin. DCB induced apoptosis in CCRF-CEM cells mostly mediated by MMP alteration and enhanced ROS production; compound 1 induced apoptosis through caspases activation and MMP alteration and increased ROS production. Dichrostachys cinerea is an interesting cytotoxic plant and deserves more studies leading to new antineoplastic agents to fight cancer and mostly leukemia.

The study determined the technical efficiency of small-scale irrigated crop farmers in Taraba and Gombe States, Nigeria. Data were collected from a cross section of 337 irrigated crop farmers in five Local Government Areas of Taraba State and eight Local Government Areas of Gombe State using purposive and simple random sampling techniques. Structured questionnaire was the main instrument for primary data collection. The analytical tools employed were descriptive statistics and stochastic frontier production function model. The socio-economic characteristics of the respondents revealed that majority (92.28%) of them were males, with mean age of 44 years and had some form of formal education. Most (59.05%) of them cultivated an average of 2.54 hectares using personal savings. On their cropping systems, fourteen cropping systems were identified with mixed cropping system accounting for 61.12% of the cropping systems and 83.56% of the total hectares allocation, an indication that mixed cropping was the dominant cropping system among the irrigated farmers. The result of the maximum likelihood estimates of the stochastic frontier production function revealed that the coefficients of farm size (p = 0.01), seed (p = 0.01) and agrochemicals (p = 0.05) were all significant and positively related to crop output among the respondents. The technical efficiency indices of the sampled farmers ranged from 0.44 - 0.96 with a mean of 0.78, indicating that crop farmers in the study area were technically efficient in their production systems although were operating below the frontier output. The inefficiency model revealed that age, gender, farming experience and extension contact were found to increase technical efficiency of the farmers. The study recommends more subsidies on farm inputs, more extension services and the training of farmers on farm management among others.

Picrasma javanica Blume (Simaroubaceae) is a medium-sized tree that is distributed widely in tropical Asia. In our previous study, we isolated quassinoids from P. javanica bark collected in Myanmar, and reported their antiproliferative activities. In our ongoing research for the discovery of bioactive compounds from Myanmar medicinal plants, two new quassinoids, (16R)-methoxyjavanicin B (1) and (16S)-methoxyjavanicin B (2), along with seven known compounds (3–9), were isolated during the phytochemical investigation of the CHCl3 soluble portion of the MeOH extract of P. javanica wood. The structures of the new compounds were elucidated by analyses of their spectroscopic data (1D- and 2D-NMR, HRESIMS, and CD). A cytotoxicity assay revealed that compound 8 showed moderate activities against all tested cancer cell lines, the human lung (A549), breast (MCF7), and cervical (HeLa), and the normal fibroblast cell line, with IC50 values ranging from 48.6 to 65.9 μM. Furthermore, the antibacterial assay demonstrated that 1 and 2 had the highest activities (MIC value of 1.6 μM each), followed by 5 and 3 (MIC values of 3.1 and 6.3 μM, respectively) against the Gram-positive bacterium B. subtilis.

In the hypotrich ciliate Euplotes, many individual basal bodies are grouped together in tightly packed clusters, forming ventral polykinetids. These groups of basal bodies (which produce compound ciliary organelles such as cirri and oral membranelles) are cross-linked into ordered arrays by scaffold structures known as "basal-body cages." The major protein comprising Euplotes cages has been previously identified and termed "cagein." Screening a E. aediculatus cDNA expression library with anti-cagein antisera identified a DNA insert containing most of a putative cagein gene; standard PCR techniques were used to complete the sequence. Probes designed from this gene identified a macronuclear "nanochromosome" of ca. 1.5 kb in Southern blots against whole-cell DNA. The protein derived from this sequence (463 residues) is predicted to be hydrophilic and highly charged; however, the native cage structures are highly resistant to salt/detergent extraction. This insolubility could be explained by the coiled-coil regions predicted to extend over much of the length of the derived cagein polypeptide. One frameshift sequence is found within the gene, as well as a short intron. BLAST searches find many ciliates with evident homologues to cagein within their derived genomic sequences.

Following Cayley, MacMahon, and Sylvester, define a non-unitary partition to be an integer partition with no part equal to one, and let $\nu(n)$ denote the number of non-unitary partitions of size $n$. In a 2021 paper, the sixth author proved a formula to compute $p(n)$ by enumerating only non-unitary partitions of size $n$, and recorded a number of conjectures regarding the growth of $\nu(n)$ as $n\to \infty$. Here we refine and prove some of these conjectures. For example, we prove $p(n) \sim \nu(n)\sqrt{n/\zeta(2)}$ as $n\to \infty$, and give Ramanujan-like congruences between $p(n)$ and $\nu(n)$ such as $p(5n)\equiv \nu(5n)\ (\operatorname{mod} 5)$., Comment: 9 pages, to appear in The Journal of the Ramanujan Mathematical Society

A retention and motivation issue exists in organizations among Generation Y in the United States. The exploratory case study design allowed the researcher to garner in-depth analysis of the participants' perspectives regarding human capital as a function of innovation in organizational culture. The diffusion of Innovation and the human capital theory were the foundation guiding the study. Three themes emerged from the data: 1) training and development, 2) rules and regulations, 3) motivation. Training and development involved training focused on career development and upward mobility. Rules and regulations involved inflexible guidelines that impede innovation. Motivation involved the necessary culture needed to engage Generation Y employees and build morale. Three recommendations were provided for organizational leadership: 1) leadership acquire a good understanding of Generation Y employees, 2) invest in Generation Y's training and career development, 3) adopt ways to motivate Generation Y employees.

Three new quassinoids, javanicinols A and B (1 and 2) and 4-keto-(16S)-methoxyjavanicin B (3), together with three known quassinoids (4-6) were isolated from the chloroform-soluble fraction of the methanol extract of the Picrasma javanica wood. The structures of 1-3 were determined by spectroscopic analyses, including 1D and 2D NMR, HRESIMS, and CD. The anti-HIV-1 viral protein R (Vpr) assay revealed that 1 and 2 exhibited potent anti-Vpr activities at 1.25 μM. Furthermore, the assay also revealed the potent anti-Vpr activities of (16R)-methoxyjavanicin B (7) and (16S)-methoxyjavanicin B (8), which were previously isolated from the Picrasma javanica wood.

A new coumaronochromone, eriocoumaronochromone (1), and a new alkanoyl-dihydrofuranoflavone glycoside, robusflavone C (2), as well as seven known compounds, 6-prenylpinocembrin (3), desmoxyphyllin A (4), prutin (5), genistein (6), vitexin (7), kaempferol (8), and p-hydroxy benzoic acid (9), were obtained after phytochemical re-investigation of the EtOAc-soluble portion from the EtOH extract of the twigs of Eriosema robustum. The structures of the new compounds were elucidated by analyses of their spectroscopic data (1D- and 2D- NMR, and HR-ESIMS) and chemical conversion. 1 and 2 exhibited weak antioxidant activity with IC50 340.3 ± 0.1 and 524.6 ± 0.1 μM in 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical assay, and possessed weak antimicrobial activity with MICs > 150 μg/mL against Bacillus subtilis, Staphylococcus aureus, Klebsiella pneumoniae, Escherichia coli, Candida albicans, and Saccharomyces cerevisiae.