Notes

Ethical dilemmas within the management of infants using necrotizing enterocolitis totalis.
© 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.Ambulatory blood pressure monitoring (ABPM) is considered a good intervention strategy to avoid misdiagnosis of hypertension and allow for targeted treatment of patients with hypertension. This study sought to assess the contribution of ABPM to blood pressure (BP) control and antihypertensive therapy at a cardiac clinic in Ghana. Medical records of 97 patients, aged 18-85 years (mean 55), were reviewed. Among patients with clinic BP (CBP) and ambulatory BP recorded on the same day, we assessed for the different hypertension phenotypes, CBP control 6 months following ABPM, and changes to antihypertensive therapy after review of the ABPM records in patients with controlled and uncontrolled ambulatory BP. From the clinic and ambulatory BP records measured at baseline, the proportion of patients with white-coat uncontrolled hypertension (WUCH) was 19.5% (17/87) and those with masked uncontrolled hypertension (MUCH) was 16.1% (n = 14). A significant reduction in average systolic CBP in the overall cohort (-6.2 mm Hg, P less then .01) and in the uncontrolled subgroup (-8.8 mm Hg, P less then .001) at follow-up was observed. After review of the ABPM records, 51.7% of the patients on treatment had changes made in their antihypertensive therapy. Antihypertensive therapy was deintensified or left unchanged in majority of the patients with WUCH and sustained controlled hypertension. In patients with MUCH and true uncontrolled hypertension (TUCH), therapy was intensified. In conclusion, ABPM improved clinical decision-making for antihypertensive therapy and BP control. ABPM should therefore be used more often in hypertension and cardiac clinics in low/middle-income countries for optimal care. © 2020 Wiley Periodicals, Inc.Mixed-halide wide-bandgap perovskites are key components for the development of high-efficiency tandem structured devices. However, mixed-halide perovskites usually suffer from phase-impurity and high defect density issues, where the causes are still unclear. By using in situ photoluminescence (PL) spectroscopy, it is found that in methylammonium (MA+ )-based mixed-halide perovskites, MAPb(I0.6 Br0.4 )3 , the halide composition of the spin-coated perovskite films is preferentially dominated by the bromide ions (Br- ). Additional thermal energy is required to initiate the insertion of iodide ions (I- ) to achieve the stoichiometric balance. Notably, by incorporating a small amount of formamidinium ions (FA+ ) in the precursor solution, it can effectively facilitate the I- coordination in the perovskite framework during the spin-coating and improve the composition homogeneity of the initial small particles. The aggregation of these homogenous small particles is found to be essential to achieve uniform and high-crystallinity perovskite film with high Br- content. As a result, high-quality MA0.9 FA0.1 Pb(I0.6 Br0.4 )3 perovskite film with a bandgap (Eg ) of 1.81 eV is achieved, along with an encouraging power-conversion-efficiency of 17.1% and open-circuit voltage (Voc ) of 1.21 V. This work also demonstrates the in situ PL can provide a direct observation of the dynamic of ion coordination during the perovskite crystallization. © 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.The increase histopathological evaluation of prostatectomy specimens rises the workload on pathologists. Automated histopathology systems, preferably directly on unstained specimens, would accelerate the pathology workflow. In this study, we investigate the potential of quantitative analysis of Optical Coherence Tomography (OCT) to separate benign from malignant prostate tissue automatically. Twenty fixated prostates were cut, from which 54 slices were scanned by OCT. Quantitative OCT metrics (attenuation coefficient, residue, goodness-of-fit) were compared for different tissue types, annotated on the histology slides. selleckchem To avoid misclassification, the poor-quality slides, and edges of annotations were excluded. Accurate registration of OCT data with histology was achieved in 31 slices. After removing outliers, 56% of the OCT data was compared with histopathology. The quantitative data could not separate malignant from benign tissue. Logistic regression resulted in malignant detection with a sensitivity of 0.80 and a specificity of 0.34. Quantitative OCT analysis should be improved before clinical use. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.Out-of-office blood pressure (BP) monitoring appears to be a very useful approach to hypertension management insofar it allows to obtain multiple measurements in the usual environment of each individual, allows the detection of hypertension phenotypes, such as white-coat and masked hypertension, and appears to have superior prognostic value than the conventional office BP measurements. Out-of-office BP can be obtained through either home or ambulatory monitoring, which provide complementary and not identical information. Home BP monitoring yields BP values self-measured in subjects' usual living environment; it is an essential method for the evaluation of almost all untreated and treated subjects with suspected or diagnosed hypertension, best if combined with telemonitoring facilities, also allowing long-term monitoring. There is also increasing evidence that home BP monitoring improves long-term hypertension control rates by improving patients' adherence to prescribed treatment. In Latin American Countries, it is widely available, being relatively inexpensive, and well accepted by patients. Current US, Canadian, Japanese, and European guidelines recommend out-of-office BP monitoring to confirm and refine the diagnosis of hypertension. © 2020 Wiley Periodicals, Inc.Pulse wave velocity (PWV) is a valid, clinically feasible marker of arterial stiffening, and a strong predictor of outcomes. The present study aimed to compare aortic elastic properties in patients with abdominal aortic aneurysms (AAA), with or without coronary artery disease (CAD), as well as healthy individuals. A total of 130 patients with AAA, eligible for interventional repair, and 30 healthy individuals, comprising the control group (HC), were enrolled. Presence of CAD was identified by coronary angiography. Aortic PWV (aPWV) was measured using the Arteriograph. aPWV was found considerably higher in AAA patients compared with HC group (11.5 ± 2.9 vs 7.3 ± 1.6 m/s, P 12.8 m/s) are more likely to also have CAD, and this may be considered by vascular surgeons when evaluating patients' cardiovascular risk. © 2020 Wiley Periodicals, Inc.Endoscopic submucosal dissection (ESD) is generally used to treat a variety of superficial gastric mucosal and submucosal lesions. Nevertheless, ESD is more difficult and complicated compared to traditional endoscopic mucosal resection (EMR) and also requires longer operation time, which can increase the incidence of various complications including delayed bleeding, perforation, and infection. Among them, delayed hemorrhage is a major post-ESD complication. The early and accurate evaluation and precaution of post-ESD bleeding for gastric lesions is related to the success rate of the operation and the safety of patients. At present, there are many studies about the risks and preventative measures for delayed hemorrhage after gastric ESD, but there are still many problems that have not been solved. Therefore, this article will review the risk factors, precautions and treatments for delayed hemorrhage after the ESD of gastric lesions. The endoscopist should fully understand these risk factors, precautions and treatment methods to ensure the safety and effectiveness of the entire ESD process. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.African Americans have a wide range of continental genetic ancestry. It is unclear whether racial differences in blood pressure (BP) control are related to ancestral background. The authors analyzed data from the Jackson Heart Study, a cohort exclusively comprised of self-identified African Americans, to assess the association between estimated West African ancestry (WAA) and BP control (systolic and diastolic BP 86.3%). The proportion of participants with controlled BP in the lowest-to-highest WAA quartile was 75.2%, 76.1%, 76.6%, and 74.4%. The prevalence ratios (95% CI) for controlled BP comparing Q2, Q3, and Q4 to Q1 of WAA were 1.00 (0.93-1.08), 1.02 (0.94-1.10), and 0.99 (0.91-1.07), respectively. Among African Americans in the Jackson Heart Study taking antihypertensive medication, BP control rates did not differ across quartiles of WAA. © 2020 Wiley Periodicals, Inc.Cutaneous squamous cell carcinoma (cSCC) is a common skin cancer with metastatic potential. To reduce reoperations due to nonradical excision, there is a need to develop a technique for identification of tumor margins preoperatively. Photoacoustic (PA) imaging is a novel imaging technology that combines the strengths of laser optics and ultrasound. Our aim was to determine the spectral signature of cSCC using PA imaging and to use this signature to visualize tumor architecture and borders. Two-dimensional PA images of 33 cSCCs and surrounding healthy skin were acquired ex vivo, using 59 excitation wavelengths from 680 to 970 nm. The spectral response of the cSCCs was compared to healthy tissue, and the difference was found to be greatest at wavelengths in the range 765 to 960 nm (P less then  .05). Three-dimensional PA images were constructed from spectra obtained in the y-z plane using a linear stepper motor moving along the x-plane. Spectral unmixing was then performed which provided a clear three-dimensional view of the distribution of tumor masses and their borders. © 2020 The Authors. Journal of Biophotonics published by WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.OBJECTIVE To evaluate the genetic association between rs16969968 and lung cancer risk by meta-analysis. DATA SOURCE We searched eligible studies from MEDLINE, Web of Science and EMBASE up to Dec, 2017. STUDY SELECTION Association studies concerning rs16969968 and lung cancer risk were included. We assessed the association strength between this polymorphism and risk of lung cancer by calculating odds ratios (OR) and 95% confidence interval (95%CI). RESULTS A total of 26 data sets comprising 30 772 lung cancers and 90 954 controls were included. rs16969968 was found to be associated with lung cancer risk in population of European ancestry in all models (A vs. G OR = 1.30, 95%CI 1.27-1.33, P less then 0.001; AA + GA vs. GG OR = 1.38, 95%CI 1.33-1.43, P less then 0.001; AA vs. GG + GA OR = 1.45, 95%CI 1.38-1.53, P less then 0.001), consistent with previous genome-wide association study (GWAS). However, no association was observed in Asians (A vs. G OR = 1.19. 95%CI 0.95-1.49, P = 0.131). The minor allele A may increase the risk of lung cancer in both smokers (OR = 1.33, 95%CI 1.29-1.39, P less then 0.001) and nonsmokers (OR = 1.25, 95%CI 1.12-1.39, P less then 0.001). There was no obvious publication bias in all analyses. CONCLUSIONS Our analysis provided more evidence that rs16969968 is a susceptibility locus of lung cancer in the Caucasians and that it may be not associated with the risk in the Asians. © 2020 John Wiley & Sons Ltd.
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