bluuebunny/crossref_metadata_2025 huggingface dataset:
Cardiac rehabilitation delivery in low/middle-income countries
Authors: Pesah Ella , Turk-Adawi Karam , Supervia Marta , Lopez-Jimenez Francisco , Britto Raquel , Ding Rongjing , Babu Abraham , Sadeghi Masoumeh , Sarrafzadegan Nizal , Cuenza Lucky , Anchique Santos Claudia , Heine Martin , Derman Wayne , Oh Paul , Grace Sherry L
Published: June 2019

Objective

Cardiac rehabilitation (CR) availability, programme characteristics and barriers are not well-known in low/middle-income countries (LMICs). In this study, they were compared with high-income countries (HICs) and by CR funding source.

Methods

A cross-sectional online survey was administered to CR programmes globally. Need for CR was computed using incident ischaemic heart disease (IHD) estimates from the Global Burden of Disease study. General linear mixed models were performed.

Results

CR was identified in 55/138 (39.9%) LMICs; 47/55 (85.5% country response rate) countries participated and 335 (53.5% programme response) surveys were initiated. There was one CR spot for every 66 IHD patients in LMICs (vs 3.4 in HICs). CR was most often paid by patients in LMICs (n=212, 65.0%) versus government in HICs (n=444, 60.2%; p<0.001). Over 85% of programmes accepted guideline-indicated patients. Cardiologists (n=266, 89.3%), nurses (n=234, 79.6%; vs 544, 91.7% in HICs, p=0.001) and physiotherapists (n=233, 78.7%) were the most common providers on CR teams (mean=5.8±2.8/programme). Programmes offered 7.3±1.8/10 core components (vs 7.9±1.7 in HICs, p<0.01) over 33.7±30.7 sessions (significantly greater in publicly funded programmes; p<0.001). Publicly funded programmes were more likely to have social workers and psychologists on staff, and to offer tobacco cessation and psychosocial counselling.

Conclusion

CR is only available in 40% of LMICs, but where offered is fairly consistent with guidelines. Governments should enact policies to reimburse CR so patients do not pay out-of-pocket.
Impact of telemedicine interventions on mortality in patients with acute myocardial infarction: a systematic review and meta-analysis
Authors: Marcolino Milena Soriano , Maia Luciana Marques , Oliveira João Antonio Queiroz , Melo Laura Defensor Ribeiro , Pereira Bruno Leonardo Duarte , Andrade-Junior Diomildo Ferreira , Boersma Eric , Ribeiro Antonio Luiz
Published: June 2019

Background

Despite the promise of telemedicine to improve care for ischaemic heart disease, there are significant obstacles to implementation. Demonstrating improvement in patient-centred outcomes is important to support development of these innovative strategies.

Objective

To assess the impact of telemedicine interventions on mortality after acute myocardial infarction (AMI).

Methods

Articles were searched in MEDLINE, Cochrane Central Register of Controlled Trials, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Base de Dados de Enfermagem (BDENF), Indice Bibliográfico Español en Ciencias de la Salud (IBECs), Web of Science, Scopus and Google Scholar, from January 2004 to January 2018. Study selection and data extraction were performed by two independent reviewers. In-hospital mortality (primary outcome), and door-to-balloon (DTB) time, 30-day mortality and long-term mortality (secondary outcomes) were assessed. Random effects models were applied to estimate pooled results.

Results

Thirty non-randomised controlled and sevenquasi-experimentalstudies were included (16 960 patients). They were classified as moderate or serious risk of bias by ROBINS-I (Risk Of Bias In Non-randomized Studies–of Interventions tool). In 31 studies, the intervention was prehospital ECG transmission. Telemedicine was associated with reduced in-hospital mortality compared with usual care (relative risk (RR) 0.63(95% confidence interval[CI] 0.55 to 0.72); I2<0.001%). DTB time was consistently reduced (mean difference −28 (95% CI −35 to –20) min), but showed large heterogeneity (I2=94%). Thirty-day mortality (RR 0.62;95% CI 0.43 to 0.85) and long-term mortality (RR 0.61(95% CI 0.40 to 0.92)) were also reduced, with moderate heterogeneity (I2=52%).

Conclusions

There is moderate-quality evidence that telemedicine strategies, in particular ECG transmission, combined with the usual care for AMI are associated with reduced in-hospital mortality and very-low quality evidence that they reduce DTB time, 30-day mortality and long-term mortality.
Factors influencing long-term heart failure mortality in patients with obstructive hypertrophic cardiomyopathy in Western Sweden: probable dose-related protection from beta-blocker therapy
Authors: Javidgonbadi Davood , Andersson Bert , Abdon Nils-Johan , Schaufelberger Maria , Östman-Smith Ingegerd
Published: June 2019

Objective

In order to avoid effects of referral bias, we assessed risk factors for disease-related mortality in a geographical cohort of patients with hypertrophic obstructive cardiomyopathy (HOCM), and any therapy effect on survival.

Methods

Diagnostic databases in 10 hospitals in the West Götaland Region yielded 251 adult patients with HOCM (128 male, 123 female). Case notes were reviewed for clinical data and ECG and ultrasound findings. Beta-blockers were used in 71.3% of patients from diagnosis (median metoprolol-equivalent dose of 125 mg/day), and at latest follow-up in 86.1%; 121 patients had medical therapy alone, 88 short atrioventricular delay pacing and 42 surgical myectomy. Mean follow-up was 14.4±8.9 (mean±SD) years. Primary endpoint was disease-related death, and secondary endpoint heart failure deaths.

Results

There were 65 primary endpoint events. Independent risk factors for disease-related death on multivariate Cox hazard regression were: female sex (p=0.005), age at diagnosis (p<0.001), outflow gradient ≥50 mm Hg at diagnosis (p=0.036) and at follow-up (p=0.001). Heart failure caused 62% of deaths, and sudden cardiac death 17%. Late independent predictors of heart failure death were: female sex (p=0.003), outflow gradient ≥50 mm Hg at latest follow-up (p=0.032), verapamil/diltiazem therapy (p=0.012) and coexisting hypertension (p=0.031), but not other comorbidities. Neither myectomy nor pacing modified survival, but early and maintained beta-blocker therapy was associated with dose-dependent reduction in disease-related mortality in the multivariate model (p=0.028), and final dose was also associated with reduced heart failure mortality (p=0.008). Kaplan-Meier survival curves analysed in initial dose bands of 0–74, 75–149 and ≥150 mg metoprolol/day showed 10-year freedom from disease-related deaths of 83.1%, 90.7% and 97.0%, respectively (ptrend=0.00008). Even after successful relief of outflow obstruction by intervention, there was survival benefit of metoprolol doses ≥100 mg/day (p=0.01).

Conclusions

In population-based HOCM cohorts heart failure is a dominant cause of death and on multivariate analysis beta-blocker therapy was associated with a dose-dependent cardioprotective effect on total, disease-related as well as heart failure-related mortality.
Perceptually regulated training does not influence the differentiated RPE response following 16-weeks of aerobic exercise in adults with spinal cord injury
Authors: Hutchinson Michael John , Valentino Sydney Ella , Totosy de Zepetnek Julia , MacDonald Maureen Jane , Goosey-Tolfrey Victoria Louise
Published: June 2019

This study investigated the effect of prolonged familiarisation with ratings of perceived exertion (RPE) on the peripheral (RPEP) and central (RPEC) RPE responses to moderate–vigorous exercise in adults with spinal cord injury (SCI). RPEP and RPEC characterise the exertion of the working musculature and cardiorespiratory systems, respectively. Nineteen participants (age, 41.4 ± 11.4 years; peak oxygen uptake, 19.2 ± 7.2 mL·kg−1·min−1) with chronic SCI were randomly assigned to RPE-guided (n = 11; EXP) or active control (n = 8; CON) groups. EXP performed 16-weeks of RPE-guided, supervised aerobic training for 20 min, twice weekly, at RPE 3–6 (Category-Ratio 10 scale). CON had access to the same exercise equipment but received no specific advice on their exercise-training regime. Participants completed a graded exercise test, using an arm crank ergometer at pre- and post-training to determine peak oxygen uptake, with RPEP and RPEC recorded every minute throughout tests. Sixteen weeks training did not improve peak oxygen uptake. RPE decreased post-training at 50% (p = 0.02) and 70% peak oxygen uptake (p = 0.03), though there was no effect of group at either intensity (p = 0.54, 0.42, respectively). At 70% peak oxygen uptake, RPEP was greater than RPEC (4.2 ± 1.7 vs 3.4 ± 1.8, p < 0.005). Training with RPE-guidance for 16 weeks had no additional effect on the differentiated RPE responses to moderate-vigorous exercise in adults with SCI.

Novelty In adults with SCI, differentiated RPE responses were not different between those who did, and did not, perform 16 weeks of RPE-guided training. This challenges whether familiarisation with RPE is necessary to be an effective regulator of exercise intensity in this population.
Alpha-decay half-lives of polonium isotopes in the mass range of 186–218
Authors: Hosseini S. S. , Hassanabadi H. , Akrawy Dashty T. , Zarrinkamar S.
Published: June 2019

The [Formula: see text]-decay (AD) half-life (HL) of [Formula: see text]Po [Formula: see text] isotopes is studied systematically within the modified Coulomb and proximity potential model (MCPPM). The computed HLs are compared with the existing theoretical formulae including Royer, AKRE, Ren B and MRen B. This study considers the role of neutron shell closure [Formula: see text] on the AD HLs. The comparison with the experimental data indicates the acceptability of the results.
INNOVATION AND KNOWLEDGE SHARING OF SME IN AN EMERGING ECONOMY; THE MODERATING EFFECT OF TRANSFORMATIONAL LEADERSHIP STYLE
Authors: AFRIYIE SAMUEL , DU JIANGUO , MUSAH ABDUL-AZIZ IBN
Published: June 2019

Enriching the literature on innovation and knowledge management, this paper examines the impact of various types of innovation (product, process, marketing, and organization) on the knowledge sharing of SMEs through transformational leadership. A total of 437 samples were collected from SMEs owners/managers in the service sector of a developing economy through a quantitative method. The data were analyzed using a SMART PLS-SEM. The findings confirmed the hypotheses that innovation have a significant influence on knowledge sharing; whiles as transformational leadership had a non-moderating effect. Besides consolidating the existing theory on the importance of innovation for explaining a variation in knowledge sharing activities, the findings also inform SMEs and policymakers to be cautious of implementing transformational leadership style as it may have a non-moderating impact in today’s entrepreneurial activities. Finally, we believe that this study will provide researchers with some key aspects to explore in this area of study and encourage applications of objective and subjective measures to improve the validity of results.
A New Hybrid Feature Subset Selection Framework Based on Binary Genetic Algorithm and Information Theory
Authors: Shukla Alok Kumar , Singh Pradeep , Vardhan Manu
Published: June 2019

The explosion of the high-dimensional dataset in the scientific repository has been encouraging interdisciplinary research on data mining, pattern recognition and bioinformatics. The fundamental problem of the individual Feature Selection (FS) method is extracting informative features for classification model and to seek for the malignant disease at low computational cost. In addition, existing FS approaches overlook the fact that for a given cardinality, there can be several subsets with similar information. This paper introduces a novel hybrid FS algorithm, called Filter-Wrapper Feature Selection (FWFS) for a classification problem and also addresses the limitations of existing methods. In the proposed model, the front-end filter ranking method as Conditional Mutual Information Maximization (CMIM) selects the high ranked feature subset while the succeeding method as Binary Genetic Algorithm (BGA) accelerates the search in identifying the significant feature subsets. One of the merits of the proposed method is that, unlike an exhaustive method, it speeds up the FS procedure without lancing of classification accuracy on reduced dataset when a learning model is applied to the selected subsets of features. The efficacy of the proposed (FWFS) method is examined by Naive Bayes (NB) classifier which works as a fitness function. The effectiveness of the selected feature subset is evaluated using numerous classifiers on five biological datasets and five UCI datasets of a varied dimensionality and number of instances. The experimental results emphasize that the proposed method provides additional support to the significant reduction of the features and outperforms the existing methods. For microarray data-sets, we found the lowest classification accuracy is 61.24% on SRBCT dataset and highest accuracy is 99.32% on Diffuse large B-cell lymphoma (DLBCL). In UCI datasets, the lowest classification accuracy is 40.04% on the Lymphography using k-nearest neighbor (k-NN) and highest classification accuracy is 99.05% on the ionosphere using support vector machine (SVM).
Influence of glaciations on North Sea petroleum systems
Authors: Medvedev Sergei , Hartz Ebbe H. , Schmid Daniel W. , Zakariassen Erik , Varhaug Per
Published: June 2019

Even in tectonically inactive areas/times, the vertical motions of the Earth's interior may be significant due to glaciation. The most recent ice age massively changed the surface of northern Europe, leading to isostatic re-equilibration. We quantify the vertical motions resulting from three glacial-related mass redistribution mechanisms using, as an example, the North Sea throughout the Quaternary: (1) ice-sheet loading, (2) erosion, including glacial carving of fjords; (3) and sediment deposition. These processes yielded up to 1 km of vertical displacement of the lithosphere across the North Sea, and the corresponding sediment-tilting changed the geometry of petroleum systems and hydrocarbon migration routes. Using the Base Cretaceous Unconformity as a top seal proxy, we analyse the consequences in the Norwegian North Sea. Comparing well data to models, we suggest that tilting the Troll Field back towards its early Quaternary position flattens the palaeo-oil–water contact (palaeo-OWC), which today is tilted by up to 70 m. The Johan Sverdrup Field shows a more complex history. Hints of a palaeo-OWC tilted can be seen in permeable reservoirs, whereas deeper sporadic oil shows cannot be explained by simple tilt models. Our study illustrates how glacial-related processes may influence the development of giant oil and gas accumulations.
MiR-718 mediates the indirect interaction between lncRNA SEMA3B-AS1 and PTEN to regulate the proliferation of hepatocellular carcinoma cells
Authors: Zhong Yuchuan , Li Yan , Song Tao , Zhang Dapeng
Published: June 2019

It has been reported that SEMA3B-AS1 is a tumor-suppressive lncRNA in gastric cardia adenocarcinoma. We explored the possible involvement of SEMA3B-AS1 in hepatocellular carcinoma (HCC). We found that SEMA3B-AS1 was downregulated in HCC tissues compared with noncancer tissues and was not affected by hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. In addition, SEMA3B-AS1 expression was not affect by cancer development, and low SEMA3B-AS1 levels were closely correlated with poor survival. SEMA3B-AS1 in HCC tissues was inversely correlated with microRNA (miR)-718 and positively correlated with PTEN. In HCC cells, SEMA3B-AS1 overexpression resulted in upregulated, while miR-718 overexpression resulted in downregulated phosphatase and tensin homolog (PTEN) expression. In addition, miR-718 overexpression attenuated the effects of SEMA3B-AS1 overexpression. SEMA3B-AS1 and PTEN overexpression resulted in a reduced proliferation rate of HCC cells, while miR-718 overexpression resulted in an increased rate. In addition, miR-718 overexpression attenuated the effects of SEMA3B-AS1 overexpression. Therefore, miR-718 may mediate the indirect interaction between lncRNA SEMA3B-AS1 and PTEN to regulate the proliferation of hepatocellular carcinoma cells.
Acute suppression of insulin resistance-associated hepatic miR-29 in vivo improves glycemic control in adult mice
Authors: Hung Yu-Han , Kanke Matt , Kurtz C. Lisa , Cubitt Rebecca , Bunaciu Rodica P. , Miao Ji , Zhou Liye , Graham James L. , Hussain M. Mahmood , Havel Peter , Biddinger Sudha , White Phillip J. , Sethupathy Praveen
Published: June 2019

MicroRNAs (miRNAs) are important posttranscriptional regulators of metabolism and energy homeostasis. Dysregulation of certain miRNAs in the liver has been shown to contribute to the pathogenesis of Type 2 diabetes (T2D), in part by impairing hepatic insulin sensitivity. By small RNA-sequencing analysis, we identified seven hepatic miRNAs (including miR-29b) that are consistently aberrantly expressed across five different rodent models of metabolic dysfunction that share the feature of insulin resistance (IR). We also showed that hepatic miR-29b exhibits persistent dysregulation during disease progression in a rat model of diabetes, UCD-T2DM. Furthermore, we observed that hepatic levels of miR-29 family members are attenuated by interventions known to improve IR in rodent and rhesus macaque models. To examine the function of the miR-29 family in modulating insulin sensitivity, we used locked nucleic acid (LNA) technology and demonstrated that acute in vivo suppression of the miR-29 family in adult mice leads to significant reduction of fasting blood glucose (in both chow-fed lean and high-fat diet-fed obese mice) and improvement in insulin sensitivity (in chow-fed lean mice). We carried out whole transcriptome studies and uncovered candidate mechanisms, including regulation of DNA methyltransferase 3a ( Dnmt3a) and the hormone-encoding gene Energy homeostasis associated ( Enho). In sum, we showed that IR/T2D is linked to dysregulation of hepatic miR-29b across numerous models and that acute suppression of the miR-29 family in adult mice leads to improved glycemic control. Future studies should investigate the therapeutic utility of miR-29 suppression in different metabolic disease states.

Enho; insulin resistance; liver; microRNA-29 (miR-29); UCD-T2DM
Psychologic Distress Is Associated with Cancer-Specific Mortality among Patients with Cervical Cancer
Authors: Lu Donghao , Andrae Bengt , Valdimarsdóttir Unnur , Sundström Karin , Fall Katja , Sparén Pär , Fang Fang
Published: June 2019

Emerging evidence suggests a role of psychologic factors in the progression of different cancer types. However, it is unclear whether psychologic distress around the time of diagnosis of invasive cervical cancer places patients at a higher risk of cancer-specific mortality, independently of tumor characteristics and treatment modalities. We conducted a nationwide cohort study, including 4,245 patients with newly diagnosed cervical cancer during 2002–2011 in Sweden. Psychologic distress was indicated by a clinical diagnosis of depression, anxiety, or stress reaction and adjustment disorders, or the experience of a stressful life event, including death or severe illness of a family member, divorce, or between jobs, from one year before cancer diagnosis and onwards. We calculated the HRs of cancer-specific mortality among the patients exposed to psychologic distress, compared with unexposed patients, controlling for socioeconomic characteristics and other known prognostic indicators such as tumor and treatment characteristics. We found that patients exposed to psychologic distress had an increased risk of cancer-specific mortality (HR 1.33; 95% CI, 1.14–1.54). The association was primarily driven by distress experienced within one year before or after diagnosis (HR 1.30; 95% CI, 1.11–1.52), but not thereafter (HR 1.12; 95% CI, 0.84–1.49). In summary, our study shows that psychiatric disorders and stressful life events around cancer diagnosis are associated with increased cancer-specific mortality among patients with cervical cancer, independent of tumor characteristics and treatment modality.

Significance:

These findings support the integration of psychologic screening and intervention in the clinical management of patients with cervical cancer, particularly around the time of cancer diagnosis.
A Standardized Protocol for Maximum Repetition Rate Assessment in Children
Authors: Diepeveen Sanne , van Haaften Leenke , Terband Hayo , de Swart Bert , Maassen Ben
Published: June 2019

Background/Aims: Maximum repetition rate (MRR) is often used in the assessment of speech motor performance in older children and adults. The present study aimed to evaluate a standardized protocol for MRR assessment in young children in Dutch. Methods: The sample included 1,524 children of 2–7 years old with no hearing difficulties and Dutch spoken in their nursery or primary school and was representative for children in the Netherlands. The MRR protocol featured mono-, tri-, and bisyllabic sequences and was computer-implemented to maximize standardization. Results: Less than 50% of the 2-year-olds could produce >1 monosyllabic sequence correctly. Children who could not correctly produce ≥2 monosyllabic sequences could not produce any of the multisyllabic sequences. The effect of instruction (“faster” and “as fast as possible”) was small, and multiple attempts yielded a faster MRR in only 20% of the cases. MRRs did not show clinically relevant differences when calculated over different numbers of repeated syllables. Conclusions: The MRR protocol is suitable for children of 3 years and older. If children cannot produce at least 2 of the monosyllabic sequences, the multisyllabic tasks should be omitted. Furthermore, all fast attempts of each sequence should be analyzed to determine the fastest MRR.
Revised Equations to Estimate Glomerular Filtration Rate from Serum Creatinine and Cystatin C in China
Authors: Yang Min , Zou Yonghua , Lu Tong , Nan Yule , Niu Jianying , Du Xin , Gu Yong
Published: June 2019

Aim: Our previous study demonstrated that the cystatin C-based chronic kidney disease (CKD)-EPI equation and combined by serum creatinine (CKD-EPIscr-cys) had better capability to accurately evaluate glomerular filtration rate in the CKD participants. Considering that the accuracy of estimated glomerular filtration rate (eGFR) remains less ideally, it is essential to modify the equation by including the Chinese eGFR racial factor in order to improve its performance. Methods: Two prospective cohorts were enrolled in 2 medical centers. New equations were developed in 529 participants and validated in 313 participants. Reference glomerular filtration rate (rGFR) was taken by 99mTc-DTPA renal dynamic imaging method (Gates method). The primary outcomes of this study were bias, precision (interquartile range of difference [IQR]), and accuracy (the proportion of eGFR within 30% of rGFR [P30] and root mean square error [RMSE]) of eGFR versus rGFR. Results: In a development data set, Chinese coefficients for CKD-EPIscr (C-CKD-EPIscr), CKD-EPIcys (C-CKD-EPIcys), and CKD-EPIscr-cys (C-CKD-EPIscr-cys) were 0.871, 0.879, and 0.891, respectively. In a validation data set, C-CKD-EPIcys was the most accurate with highest P30 value (62.3%), relative lowest IQR (15.45), and RMSE (0.80) among 6 equations, though the bias of C-CKD-EPIcys was not better than CKD-EPIcys. C-CKD-EPIscr and C-CKD-EPIscr-cys equations were improved in bias (p < 0.001), ­precision, and accuracy (p = 0.004 and <0.001 for P30) compared with CKD-EPIscr and CKD-EPIscr-cys. Conclusion: C-CKD-EPIcys was the most accurate with the highest P30 value, relative lowest IQR, and RMSE among 6 equations. C-CKD-EPIscr and C-CKD-EPIscr-cys equations were improved in bias, precision, and accuracy. Other external validation of these equations is needed.
Long-Term Efficacy of Sublingual Mite Immunotherapy in Monosensitized and Polysensitized Children with Allergic Rhinitis: A 7-Year Prospective Study
Authors: Cui Long , Li Jun , Li Yong , Xia Zhongfang
Published: June 2019

Background: Several foreign studies have shown long-term efficacy of sublingual immunotherapy (SLIT), but data on the long-term efficacy of SLIT in China are still lacking. Objective: We aimed to prospectively evaluate the long-term efficacy of a 2-year SLIT with Dermatophagoides farinae(D. farinae) drops in mono- and polysensitized children with allergic rhinitis (AR). Methods: Eighty house dust mite (HDM)-sensitized children (aged 4–11 years) with AR were enrolled in this prospective study. There were 40 children in both the monosensitized (to HDM only) and polysensitized groups. Both groups were treated with standardized SLIT (D. farinae drops) for 2 years, combined with pharmacotherapy according to their individual requirements, and were followed up for 7 years. A combined symptom and medication score (CSMS) was assessed and compared between the 2 groups during and after SLIT. Safety was evaluated based on adverse events (AEs). Results: There were 31 (77.5%) monosensitized and 29 (72.5%) polysensitized children who completed the study. After 2-year SLIT, the CSMS of 2 groups significantly decreased compared to baseline. The improvement persisted during the first 5 years at each visit, with a significant difference (all p < 0.01). In the monosensitized group, the CSMS significantly increased during the 6th and the 7th year compared to year 2 (both p < 0.05). Meanwhile, the polysensitized group showed a significant worsening of CSMS from the 5th to the 7th year (all p < 0.05). Furthermore, there was a statistical difference between the 2 groups in the 5th year of the study (p < 0.05). No severe AEs were reported. Conclusions: The study confirmed the long-term effects which lasted for 7 years after 2-year SLIT in mono- and polysensitized children. Compared with the polysensitized children, the monosensitized children noted a more sustained benefit.
Refractory Oral Ulcer Responsive to Infliximab: A Case Report
Authors: Ito Keiko , Shikata Kentaro , Haba Kouichi , Ito Takaaki
Published: June 2019

Purpose: Some oral ulcers are refractory to treatment. Recently, anti-tumor necrosis factor-alpha (anti-TNF-α) agents have been shown to induce relatively long remissions of refractory oral ulcers. Methods: A 69-year man presented with a sore throat caused by a pharyngeal ulcer in the soft palate and subsequently repeatedly developed oropharyngolaryngeal ulcers and an ulcer in the ileocecal region. Intestinal Behçet disease was suspected, but he did not meet the diagnostic criteria for this condition. Seven months after the initial presentation, he developed a lingual ulcer that did not resolve despite treatment with prednisolone. Given the suspicion of intestinal Behçet disease, 300 mg of infliximab was administered intravenously. Results: After the third dose of infliximab with prednisolone, the ulcer began to improve. He received infliximab every 8 weeks thereafter and developed no new oropharyngolaryngeal ulcers during the 17 months after the first infusion of infliximab. Conclusions: When a patient has refractory oral ulcers, attention must be paid to digestive symptoms and whether the patient has a systemic disease such as Behçet disease investigated. Furthermore, administration of infliximab to patients with refractory ulcers can be considered even when they do not fulfill the clinical criteria for a systemic disease.
Emotion Recognition in Kindergarten Children
Authors: Covic Amra , von Steinbüchel Nicole , Kiese-Himmel Christiane
Published: June 2019

Background/Aims: Recognition and understanding of emotions are essential skills in nonverbal communication and in everyday social functioning. These are already evident in infancy. We aimed to compare how young children recognize facial emotional expressions from static faces versus vocal emotional expressions from speech prosody. Methods: Participants were 313 kindergarten children (162 girls, mean age = 51.01, SD 9.65 months; range 36–72). The design consisted of a visual and an auditory block (with 45 randomized trials each). Children were seated in front of a 14-inch laptop monitor and received visual stimuli (photos of faces) or auditory stimuli (spoken sentences) via loudspeakers. Results: Recognizing emotions from looking at static faces was found to be easier compared to interpreting emotions transmitted by speech prosody alone. The ability to interpret emotions from both faces and speech prosody increased with age. It was easier to identify a “happy” emotion from a facial expression than an “angry” or “sad” one, whereas a “sad” emotion could be more easily recognized from speech prosody alone than facial imagery alone. Girls were significantly better than boys in identifying “sad” facial expressions. Conclusion: The results of the study are discussed in terms of educational implications for nonverbal communication.
Endoscopic Evaluation of Neoadjuvant Chemotherapeutic Efficacy in Gastric Cancer before Gastrectomy Might be as Useful as Histological Assessment after Gastrectomy
Authors: Sugawara Noriaki , Ota Kazuhiro , Terazawa Tetsuji , Tanaka Ryo , Akutagawa Hiroshi , Yamaguchi Toshifumi , Imai Yoshiro , Harada Satoshi , Kojima Yuichi , Tashiro Keitaro , Kii Takayuki , Lee Sang-Woong , Kawai Masaru , Egashira Yutaro , Goto Masahiro , Uchiyama Kazuhisa , Hirose Yoshinobu , Takeuchi Toshihisa , Higuchi Kazuhide
Published: June 2019

Background: Neoadjuvant chemotherapy for advanced gastric cancer is expected to improve prognoses. However, as there is no method to evaluate neoadjuvant chemotherapeutic efficacy before gastrectomy, some patients at high risk for a poor prognosis undergo gastrectomy. The aim of the present study was to investigate whether endoscopy could be useful for assessing the efficacy of neoadjuvant chemotherapy. Methods: In this retrospective study, we analyzed the data of 41 patients who received neoadjuvant chemotherapy followed by gastrectomy at our institution to investigate whether responsiveness to neoadjuvant chemotherapy, as assessed with endoscopy, can serve as a surrogate marker for histological grades 1b or higher in the Japanese Classification of Gastric Carcinoma (JCGC) scheme. Results: There were 32 (78.0%) responders and 9 (22.0%) nonresponders to neoadjuvant chemotherapy, as observed in endoscopic evaluations. Among the endoscopic responders, 24 (75.0%) had cancer of histological grade 1b or higher, and 15 (46.9%) had cancer of grade 2 or higher. Among the endoscopic nonresponders, 1 (11.1%) patient had histological grade 1b cancer. Compared with endoscopic nonresponders, endoscopic responders were more likely to show a histological response (chi-square test: p = 0.0005 for JCGC grade 1b or higher; p = 0.0099 for JCGC grade 2 or higher). Conclusions: Most endoscopic responders showed JCGC histological responses. Evaluation of neoadjuvant chemotherapeutic efficacy by endoscopy in gastric cancer may be useful before gastrectomy. As this was a retrospective study, further investigations are required. The protocol was approved by the ethics review committee at Osaka Medical College (No. 2422) and was registered in the University Hospital Medical Information Network Clinical Trial Registry (UMIN000033088).
Successful Closure of Bronchopleural Fistula by Catheter-Assisted Intrabronchiolar Insertion of Microvascular Plug: A Case Report
Authors: Nadeem Rashid , Elhoufi Ashraf M. , Abuhijleh Raed H. , Saleh Ayman , Zahra Ahmed N.
Published: June 2019

Bronchopleural fistula (BPF) is a pathological connection between the bronchial tree and pleural space usually formed as a result of local or systemic illness affecting pulmonary or pleural tissue. It is associated with significant morbidity and prolonged stay in the hospital. We present the case of a 33-year-old male with multiple sclerosis with multiple co-morbidities who developed respiratory failure from pneumonia requiring mechanical ventilation (MV) and tracheostomy. He developed pneumothorax which remained persistent despite medical management and chest tube insertion suggesting BPF. A high-resolution CT chest confirmed BPF. The patient was not a suitable candidate for endoscopic or surgical repair. An occlusive microvascular plug was placed under fluoroscopy to close the leak. High-resolution chest CT confirmed resolution of air leak. The patient was subsequently discharged to a long-term ventilator facility for liberation of MV. Follow-up after discharge revealed successful liberation from the ventilator. BPF management is a challenge which requires multidisciplinary approach and careful assessment to choose the best approach for treatment especially in high-risk patients with a compromised pulmonary status. For patients who are not suitable candidates for surgical or endoscopic repair, radiologically guided application of an occluding device or sealants are attractive options.
Pilot Program Combining Acceptance and Commitment Therapy with Stuttering Modification Therapy for Adults who Stutter: A Case Report
Authors: Freud Debora , Levy-Kardash Omer , Glick Ittai , Ezrati-Vinacour Ruth
Published: June 2019

Background: The impact of stuttering far exceeds its effects on speech production itself. It includes increased anxiety levels and avoidance of speech situations that may impact the general quality of life. Therefore, psychological treatment methods have been incorporated into speech therapy programs with positive results. Acceptance and commitment therapy (ACT) is a relatively recent addition to the field of stuttering. In this case report, we present a pilot program of integrating acceptance and commitment therapy (ACT) with stuttering modification therapy for adults who stutter. Method: Eight adults who stutter entered the approximately year-long program, which consisted of three parts: group ACT, individual/pair stuttering modification therapy, and monthly stabilization/follow-up sessions. Results: Improvement was observed in group mean measures of mindfulness skills, speech-related attitudes, anxiety, daily communication, quality of life, and stuttering frequency. Improvement in quality of life was also self-described by participants throughout the program. Conclusions: Participant improvement and positive self-reports suggest a potentially promising effect of combining ACT with stuttering modification therapy. Further research is needed to evaluate treatment efficacy.
Clinicopathologic Features and Treatment Characteristics of Congenital Corneal Opacity Infants and Children Aged 3 Years or Less: A Retrospective Single Institution Analysis
Authors: Miao Sen , Lin Qi , Liu Yang , Song Yao-Wen , Zhang Ying-Nan , Pan Zhi-Qiang
Published: June 2019

Objective: In this retrospective single institution study, we investigated the clinicopathologic features and treatment characteristics of 90 patients with congenital corneal opacities (CCO) (117 eyes) who were 3 years and younger and treated at our hospital. Subject and Methods: We reviewed the clinical data of patients with CCO who presented for the first time for treatment at our hospital between January 1, 2017, and December 31, 2017. CCO were classified using the “STUMPED” (Sclerocornea, Tears in Descement’s membrane, Metabolic, Peters, Endothelial dystrophy and Dermoid) method and confirmed by pathological examination. ­Results: Seventy percent of the patients had unilateral CCO. Iridocorneal adhesions (61 eyes, 52.1%) and cataracts (22 eyes, 18.8%) were the 2 most common ocular abnormalities. Systemic abnormalities were present in 5 patients (5.6%), including growth retardation (4 patients) and congenital brain defects (1 patient). Eighty-five eyes (72.6%) underwent penetrating keratoplasty (PK), and lamellar keratoplasty (LK) was performed in 30 (25.6%) eyes. Forty-seven (95.9%) eyes with Peters anomaly and all 16 eyes with sclerocornea received PK, and all 24 eyes with dermoids were treated with LK. Conclusion: Our study demonstrates that CCO has varied manifestations in infants and young children in China. A thorough medical history, careful clinical examination, and the use of accessory examinations such as ultrasound biomicroscopy are critical for the accurate diagnosis and classification of CCO and to provide guidance on therapeutic choices.
Plasticizer Interaction With the Heart
Authors: Jaimes Rafael , McCullough Damon , Siegel Bryan , Swift Luther , McInerney Daniel , Hiebert James , Perez-Alday Erick A. , Trenor Beatriz , Sheng Jiansong , Saiz Javier , Tereshchenko Larisa G , Posnack Nikki Gillum
Published: June 2019

Background:

Phthalates are used as plasticizers in the manufacturing of flexible, plastic medical products. Patients can be subjected to high phthalate exposure through contact with plastic medical devices. We aimed to investigate the cardiac safety and biocompatibility of mono-2-ethylhexyl phthalate (MEHP), a phthalate with documented exposure in intensive care patients.

Methods:

Optical mapping of transmembrane voltage and pacing studies were performed on isolated, Langendorff-perfused rat hearts to assess cardiac electrophysiology after MEHP exposure compared with controls. MEHP dose was chosen based on reported blood concentrations after an exchange transfusion procedure.

Results:

Thirty-minute exposure to MEHP increased the atrioventricular node (147 versus 107 ms) and ventricular (117 versus 77.5 ms) effective refractory periods, compared with controls. Optical mapping revealed prolonged action potential duration at slower pacing cycle lengths, akin to reverse use dependence. The plateau phase of the action potential duration restitution curve steepened and became monophasic in MEHP-exposed hearts (0.18 versus 0.06 slope). Action potential duration lengthening occurred during late-phase repolarization resulting in triangulation (70.3 versus 56.6 ms). MEHP exposure also slowed epicardial conduction velocity (35 versus 60 cm/s), which may be partly explained by inhibition of Na
v
1.5 (874 and 231 µmol/L half-maximal inhibitory concentration, fast and late sodium current).

Conclusions:

This study highlights the impact of acute MEHP exposure, using a clinically relevant dose, on cardiac electrophysiology in the intact heart. Heightened clinical exposure to plasticized medical products may have cardiac safety implications—given that action potential triangulation and electrical restitution modifications are a risk factor for early after depolarizations and cardiac arrhythmias.
Two new species of Rourea (Connaraceae) from Minas Gerais, Brazil
Authors: TOLEDO CÁSSIO A. P. , SOUZA VINICIUS CASTRO
Published: June 2019

While developing taxonomic studies about Connaraceae in Brazil, two new species of Rourea were discovered. Rourea barbata and R. prostrata are here described and illustrated. The new taxa belong to Rourea subgen. Rourea sect. Multifoliolatae and comparisons to morphologically similar species are provided, along with notes on their distribution, habitat, taxonomy and conservation status.
Eugenia caipora, a new species of Eugenia sect. Pseudeugenia (Myrtaceae) from northeastern Brazil
Authors: LIMA LOURENÇO ANA RAQUEL DE , COSTA-LIMA JAMES LUCAS DA , DE OLIVEIRA CHAGAS EARL CELESTINO
Published: June 2019

Eugenia caipora (Myrtaceae), a new species from northeastern Brazil, is here described; it occurs in restinga vegetation, Tabuleiros litorâneos (Tabuleiro savanna), and seasonal forests in Ceará, Rio Grande do Norte, Paraíba, Pernambuco and Alagoas. The new species is morphologically similar to Eugenia azuruensis, though differing by the leaf blades abaxially glabrous to puberulent (vs. densely tomentose in E. azuruensis), non-mucronate (vs. mucronate), with flat margins (vs. revolute), calyx lobes 4–5 mm wide (vs. 6–10 mm), rounded at the apex (vs. apiculate), and petals 5–15 mm long (vs. 20–24 mm). A table of diagnostic characters for the new and related species and photographs of morphological diagnostic characters are provided.
Contributions to the Andean Senecioneae (Compositae)—I. Two new species of Werneria
Authors: CALVO JOEL , BELTRÁN HAMILTON
Published: June 2019

Two new species of Werneria are described from the central Andes. Both species are compared with the morphologically closest taxa and useful characters for their proper identification are provided. Detailed pictures of living plants and a distribution map are also presented.
Morphological features of the eggs of Pentatomidae (Hemiptera: Heteroptera)
Authors: MATESCO VIVIANA C. , FÜRSTENAU BRENDA B. R. J. , BERNARDES JORGE L.C. , SCHWERTNER CRISTIANO F. , GRAZIA JOCÉLIA
Published: June 2019

Eggs of 14 species within two subfamilies (Edessinae and Pentatominae, tribes Carpocorini, Nezarini, Pentatomini, Procleticini, and one unplaced species) of neotropical pentatomids were studied with scanning electron microscopy, and their external morphology was characterized in detail (chorion surface, operculum, and aero-micropylar processes). Eggs of these species have similar characteristics to those already described for other pentatomids. Most of them are barrelshaped, except in Edessa meditabunda (with spherical eggs) and Odmalea basalis (whose eggs have flattened lateral faces). A “T”-shaped ruptor ovis is present in all studied species; eclosion line at the operculum rim may be visible or not. Average size of eggs (length x width) ranges from 0.9 ± 0.12 x 0.9 ± 0.05 mm (Euschistus picticornis) to 2.1 ± 0.12 x 1.7 ± 0.10 mm (Chinavia erythrocnemis); the number of the aero-micropylar processes ranges from 10 (C. musiva) to 86 (C. obstinata). Chorion surface has a variable aspect: eggs of Euschistus spp., Loxa deducta, and Pallantia macunaima have the spinose chorion type; C. erythrocnemis, C. longicorialis, C. obstinata, C. pengue, and Grazia tincta have a reticulate chorion; C. musiva, O. basalis, and E. meditabunda have a granulated chorion; and Thyanta humilis has a salebrose chorion type. All the species with described eggs in the Edessinae share the same diagnostic features. In Pentatominae, we did not identify shared characters among the species at subfamily or tribe level. Chorion sculpture pattern and aero-micropylar processes shape, as well as number, are diagnostic features at genus level; however, a few species could be identified in the egg stage.
Description of the larva of Oulimnius echinatus Berthélemy (Coleoptera: Elmidae: Elminae)
Authors: ČIAMPOR JR. FEDOR , ČIAMPOROVÁ-ZAŤOVIČOVÁ ZUZANA , KODADA JÁN
Published: June 2019

The mature larva of Oulimnius echinatus Berthélemy is described for the first time, based on material from Mallorca (Spain). Morphologically the larva of O. echinatus resembles those of O. jaechi Hernando, Ribera & Aguilera and O. fuscipes (Reiche, 1879), from which it differs in the distinctly denser dorsal granulation, the less prominent setiferous tubercle on posterior angles of tergites and the absence of mesal setiferous tubercle on tergites and ventrites. We used for the first time scanning electron microscopy to describe the morphology of an Oulimnius larva. The genus Oulimnius Gozis occurs in Europe, North Africa and North America (Kodada & Jäch 2005; Jäch et al. 2006). To date, 16 species and subspecies have been described, although the systematic position of the two American species within the genus is open to question.
The phylogeny of Opoptera butterflies, and an assessment of the systematic position of O. staudingeri (Lepidoptera, Nymphalidae)
Authors: PENZ CARLA M.
Published: June 2019

This study provides a species-level phylogeny for the Neotropical brassoline genus Opoptera Aurivillius based on 37 morphological characters. A revised generic definition is given, and two species groups are supported. The syme-group includes three species from the Brazilian Atlantic forest. The aorsa-group includes O. staudingeri (Godman & Salvin) from Central America, three species from western and northern South America, and one species from the Atlantic forest. Two subspecies are elevated to species status: O. hilaris Stichel, NEW STATUS and O. bracteolata Stichel, NEW STA- TUS. Two new combinations are proposed: O. hilaris fuscata Stichel, NEW COMBINATION and O. hilaris colombiana Rothshild, NEW COMBINATION. Diagnoses and illustrations of habitus and genitalia are provided for the eight recognized Opoptera species. Wing color, male scent organs, and male and female genitalic morphology are described and discussed.
Revision of some types of the South American tribes Nycteliini, Praocini, and Scotobiini (Coleoptera: Tenebrionidae), with new synonymies
Authors: FLORES GUSTAVO E.
Published: June 2019

Based on my revision of the types of the Neotropical genera Nyctelia Latreille, 1825 (Nycteliini), Praocis Eschscholtz, 1829 (Praocini), Scotobius Germar, 1824, and Emmallodera Blanchard, 1842 (Scotobiini), nine NEW SYNONYMIES are proposed and illustrated: Nyctelia roigi Marcuzzi, 1977 with N. quadricarinata Fairmaire, 1905; Praocis freyi Marcuzzi, 1977 with P. uretai Kulzer, 1958; Praocis larraini Marcuzzi, 2001 with P. pentachorda Burmeister, 1875; Praocis sivestrii Marcuzzi, 2001 with P. striolicollis Fairmaire, 1883; Praocis baloghi Marcuzzi, 2001 with P. montana Kulzer, 1958; Scotobius freudei Marcuzzi, 1977 with S. akidioides bicostatus Kulzer, 1955; Scotobius kulzeri Marcuzzi, 1977 and S. contrerasi Marcuzzi, 1977 with S. alaticollis Kulzer, 1955; and Emmallodera ceii Marcuzzi, 1977 with E. obesa costata Kulzer, 1955. A statement on the differences between Nyctelia blapoides Fairmaire, 1905 and N. kulzeri Marcuzzi, 1977 is presented, as well as a redescription of N. blapoides.
The tadpole of the toadlet Scaphiophryne marmorata from Madagascar
Authors: GROSJEAN STÉPHANE , VENCES MIGUEL
Published: June 2019

The genus Scaphiophryne Boulenger comprises eight species of microhylid toadlets (Vences et al. 2003; Glos et al. 2005), all of which are endemic to Madagascar. They are characterized by a unique larval morphology, intermediate between Orton's (1953) types II and IV (Blommers-Schlösser 1975; Wassersug 1984). Recently, Grosjean et al. (2007) provided a comparative study of larval morphology of the genus, and found evidence for two morphological subgroups based on larval characters. Tadpoles remained unknown for only two species, Scaphiophryne boribory Vences, Raxworthy, Nussbaum & Glaw, and S. marmorata Boulenger. Three tadpoles of S. marmorata were collected by M. Vences, H. Kurrer and L. du Preez on 7 February 2006 close to Andasibe (18°56′S/48°25′E, 915 m a.s.l.), in a large temporary pond of about 15 m diameter and maximum water depth of 1 m, at the edge of rainforest. They were found syntopically with larvae of Paradoxophyla palmata and Boophis pauliani. Identity of one of these specimens (ZSM 554/2008) was verified by DNA barcoding; the sequence of a fragment of the 16S rRNA gene has the Genbank accession number EU717878 and was identical to a sequence of an adult specimen from the same locality (accession AY834191). Vouchers were deposited in the Zoologische Staatssammlung München, Germany (ZSM). We here provide a detailed description of these larvae, based mainly on one specimen at stage 39, ZSM 555/2008 (field number ZCMV 3602). Measurements were taken using a stereo microscope (Zeiss Stereo Discovery) using landmarks as in Grosjean et al. (2007).
An unexpected hotspot of moth biodiversity in Chilean northern Patagonia (Lepidoptera, Geometridae)
Authors: HAUSMANN AXEL , PARRA LUIS E.
Published: June 2019

In a small area around Huinay station, northern Patagonia (Chile), 75 geometrid moth species were collected at light in three subsequent nights, 87 in a short 11-day period under suboptimal weather conditions. This surprisingly high diversity is due to lack of habitat destruction and complete overlap of Valdivian and Patagonian fauna elements. An annotated neighbour joining tree of COI data (5’ barcoding fragment) is presented and the taxonomy of all species is discussed. Three new combinations are proposed: Danielaparra fragmentata (Dognin, 1906), comb. n., transferred from Hoplosauris; Hoplosauris multivirgulata (Mabille, 1885), comb. n., transferred from Physoloba; Calta debilis (Butler, 1882), comb. n., transferred from Odontothera. Daniela viridis (Parra, 1996) is a new synonym of Danielaparra fragmentata.