bluuebunny/crossref_metadata_2025 huggingface dataset:
The Protective Effect of Teprenone on Aspirin-Related Gastric Mucosal Injuries
Authors: Zhao Jing , Fan Yihong , Ye Wu , Feng Wen , Hu Yue , Cai Lijun , Lu Bin
Published: June 2019

Objective. Aspirin usage is associated with increased risk of gastrointestinal bleeding. The present study explored the potential of teprenone, an antiulcerative, in preventing aspirin-related gastric mucosal injuries. Methods. 280 patients with coronary diseases, naïve to aspirin medication, were admitted between 2011 and 2013 at the First Affiliated Hospital of Zhejiang Chinese Medical University and randomized into two groups (n=140). The aspirin group received aspirin enteric-coated tablets 100 mg/day, while the aspirin+teprenone group received teprenone 50 mg 3 times/day along with aspirin. The patients were recorded for gastrointestinal symptoms and gastric mucosal injuries during a follow-up period of 12 months with 3-month intervals. Results. During the 3-month follow-up, no significant difference was observed in the incidence rate of gastrointestinal symptoms between the two groups (P=0.498). However, the incidence rate of gastrointestinal symptoms was significantly lower in the aspirin+teprenone group than in the aspirin group during the follow-ups at 6 months (P=0.036) and 12 months (P=0.036). The incidence rate of gastric mucosal injuries in the aspirin group was significantly increased at 12 months compared to that at 3 months (P=0.016). The incidence rates at 12 months and cumulative for the entire follow-up period in the aspirin+teprenone group were both significantly lower than those of the aspirin group (P=0.049 and P=0.001, respectively). Conclusion. Long-term use of low-dose aspirin causes varying degrees of gastric mucosal damages and gastrointestinal symptoms; the severity will increase within a certain range with the extension of medication duration. Teprenone mitigates the gastrointestinal symptoms caused by low-dose aspirin, lowering both the incidence and severity of gastric mucosal injuries and exerting a positive protective effect.
Improving Outcome in Infantile Autism with Folate Receptor Autoimmunity and Nutritional Derangements: A Self-Controlled Trial
Authors: Ramaekers Vincent Th. , Sequeira Jeffrey M. , DiDuca Marco , Vrancken Géraldine , Thomas Aurore , Philippe Céline , Peters Marie , Jadot Annick , Quadros Edward V.
Published: June 2019

Background. In contrast to multiple rare monogenetic abnormalities, a common biomarker among children with infantile autism and their parents is the discovery of serum autoantibodies directed to the folate receptor alpha (FRα) localized at blood-brain and placental barriers, impairing physiologic folate transfer to the brain and fetus. Since outcome after behavioral intervention remains poor, a trial was designed to treat folate receptor alpha (FRα) autoimmunity combined with correction of deficient nutrients due to abnormal feeding habits. Methods. All participants with nonsyndromic infantile autism underwent a routine protocol measuring CBC, iron, vitamins, coenzyme Q10, metals, and trace elements. Serum FRα autoantibodies were assessed in patients, their parents, and healthy controls. A self-controlled therapeutic trial treated nutritional derangements with addition of high-dose folinic acid if FRα autoantibodies tested positive. The Childhood Autism Rating Scale (CARS) monitored at baseline and following 2 years of treatment was compared to the CARS of untreated autistic children serving as a reference. Results. In this self-controlled trial (82 children; mean age ± SD: 4.4 ± 2.3 years; male:female ratio: 4.8:1), FRα autoantibodies were found in 75.6 % of the children, 34.1 % of mothers, and 29.4 % of fathers versus 3.3 % in healthy controls. Compared to untreated patients with autism (n=84) whose CARS score remained unchanged, a 2-year treatment decreased the initial CARS score from severe (mean ± SD: 41.34 ± 6.47) to moderate or mild autism (mean ± SD: 34.35 ± 6.25; paired t-test p<0.0001), achieving complete recovery in 17/82 children (20.7 %). Prognosis became less favorable with the finding of higher FRα autoantibody titers, positive maternal FRα autoantibodies, or FRα antibodies in both parents. Conclusions. Correction of nutritional deficiencies combined with high-dose folinic acid improved outcome for autism, although the trend of a poor prognosis due to maternal FRα antibodies or FRα antibodies in both parents may warrant folinic acid intervention before conception and during pregnancy.
Study on Mechanical and Ecological Properties of Fly Ash Substrate for Ecological Slope Protection
Authors: Wan Juan , Zhu Jun , Xiao Henglin , Ma Qiang
Published: June 2019

In order to realize the resource utilization of fly ash, a kind of ecological slope protection substrate was prepared by mixing fly ash produced by MSW incineration into slope protection soil. Through the direct shear test and a leaching experiment on ion pollutants, the influence that shear strength of the substrate changed with root content, ash content, and moisture content and the ecological effects of leach liquor were investigated. The results showed the following: (1) When the optimum moisture content is about 24.9%, the shear strength of the substrate is the maximum. (2) Fly ash can improve the shear strength of the soil, which can reach 1.67 times as much as that of plain soil, and the optimum content of fly ash is 5%–6.7%. (3) The root system can increase the cohesion and internal friction angle of the substrate soil but mainly increases the cohesion of the substrate soil. (4) Plants grow taller in ash‐mixed soil than in plain soil. (5) When the fly ash content is 20%, the ion concentrations of Cl, Cu, and Zn are the highest: 220.7, 0.153, and 1.526 mg/L, respectively. All of them are lower than the standard limit of class V water and gradually decrease with time. Therefore, the leaching liquid will not cause environmental pollution and meet the ecological requirements.
Proresolving Lipid Mediators: Endogenous Modulators of Oxidative Stress
Authors: Leuti Alessandro , Maccarrone Mauro , Chiurchiù Valerio
Published: June 2019

Specialized proresolving mediators (SPMs) are a novel class of endogenous lipids, derived byω-6 andω-3 essential polyunsaturated fatty acids such as arachidonic acid (AA), docosahexaenoic acid (DHA), and eicosapentaenoic acid (EPA) that trigger and orchestrate the resolution of inflammation, which is the series of cellular and molecular events that leads to spontaneous regression of inflammatory processes and restoring of tissue homeostasis. These lipids are emerging as highly effective therapeutic agents that exert their immunoregulatory activity by activating the proresolving pathway, as reported by a consistent bulk of evidences gathered in the last two decades since their discovery. The production of reactive oxygen (ROS) and nitrogen (RNS) species by immune cells plays indeed an important role in the inflammatory mechanisms of host defence, and it is now clear that oxidative stress, viewed as an imbalance between such species and their elimination, can lead to many chronic inflammatory diseases. This review, the first of its kind, is aimed at exploring the manifold effects of SPMs on modulation of reactive species production, along with the mechanisms through which they either inhibit molecular signalling pathways that are activated by oxidative stress or induce the expression of endogenous antioxidant systems. Furthermore, the possible role of SPMs in oxidative stress-mediated chronic disorders is also summarized, suggesting not only that their anti-inflammatory and proresolving properties are strictly associated with their antioxidant role but also that these endogenous lipids might be exploited in the treatment of several pathologies in which uncontrolled production of ROS and RNS or impairment of the antioxidant machinery represents a main pathogenetic mechanism.
The Additive Interaction between Body Mass Index and Hypertension Family History in Han and Yugur: The China National Health Survey (CNHS)
Authors: Yu Chengdong , Zhao Hongjun , Pan Li , Zhang Jia , Wang Xiaoyang , Chang Lijun , Tuo Ya , Xi Jin’en , Liu Bin , Wang Ye , Ren Huiru , He Huijing , Ren Xiaolan , Shan Guangliang
Published: June 2019

Objective. To estimate the additive interaction of body mass index (BMI) and family history of hypertension (FHH) on hypertension and explore whether the interaction could be influenced by behavioural risk factors. Methods. The cross-sectional data on 5791 participants were from the China National Health Survey in Gansu province in 2016. We assessed the additive interaction by calculating the relative excess risk due to interaction (RERI), the attributable proportion due to interaction (AP), and the synergy index (SI). Results. ORs for hypertension were highest in Han (13.52, 95% CI: 9.45 to 19.34) and Yugur (13.85, 95% CI: 8.48 to 22.63) with the combination of obesity and FHH. The interaction of BMI and FHH was significant in Han people, with the RERI, AP, and SI and their 95% CIs being 2.48 (1.13 to 3.82), 0.33 (0.19 to 0.47), and 1.61 (1.26 to 2.07) for overweight and FHH and 6.32 (1.91 to 10.73), 0.47 (0.27 to 0.67), and 2.02 (1.33 to 3.07) for obesity and FHH, respectively. The interaction of BMI and FHH was not significant in Yugur people. Adjustment for behavioural risk factors had little influence on the interactions, and risks of hypertension remained increased. Conclusions. BMI and FHH were associated with hypertension, and the interaction of BMI and FHH on hypertension was significant in Han but not in Yugur people. Behavioural risk factors had little influence on the associations and interactions. The exacerbation of hypertension risks by overweight or obesity in hypertension families deserves attention in weight control and community care.
Case Report: Kryptonite—A Rare Case of Left-Sided Bilothorax in a Sickle Cell Patient
Authors: Reddy Vikas D. , Al-Khateeb Anas , Hussain Muhammad , Patel Varun , Kadri Muqueet , Patel Rutwik , Maruboyina Siva Prasad , Miller Richard A. , DePasquale Joseph R.
Published: June 2019

Bilothorax is a rare cause of an exudative pleural effusion. The diagnosis is confirmed by a pleural fluid to serum bilirubin ratio of greater than 1. Typically, bilothorax presents as a right-sided effusion due to its proximity to the liver and biliary system. Herein, we present a case of isolated left-sided bilothorax in a 43-year-old female admitted with sickle cell crisis. Only one other case of isolated spontaneous left-sided bilothorax has been described in the literature. A thoracentesis performed on admission demonstrated greenish fluid and bilothorax was suspected, with a pleural fluid to serum bilirubin ratio greater than 1 confirming the diagnosis. A magnetic resonance cholangiopancreatography (MRCP) showed an abnormal 90-degree acute angulation in the mid-to-distal common bile duct with proximal common bile duct and intrahepatic bile ducts dilation. This was further confirmed with an endoscopic retrograde cholangiopancreatography (ERCP), which did not reveal any extravasation of contrast into the left pleural space. Ultimately, despite the use of various modalities, no definitive cause of bilothorax was identified. Postthoracentesis imaging revealed evidence of fibrothorax, a direct and permanent complication of bilothorax. The presence of an isolated left-sided bilothorax, along with the lack of a confirmed etiology, makes this case unique.
Expression and Clinical Significance of Decoy Receptor 3 in Acute-on-Chronic Liver Failure
Authors: Lin Su , Wu Bing , Lin Yehong , Wang Mingfang , Zhu Yueyong , Jiang Jiaji , Zhang Lurong , Lin Jianhua
Published: June 2019

Aims. To explore the expression level and clinical significance of decoy receptor 3 (DcR3) in patients with acute-on-chronic liver failure (ACLF).Methods. Serum DcR3 levels were measured by enzyme-linked immunosorbent assay (ELISA) in 76 patients with ACLF and 41 non-ACLF patients with chronic liver disease. Blood routine and liver functions were accessed for their correlations with DcR3.Results. Serum DcR3 in ACLF patients was significantly higher than that in non-ACLF patients. It was positively correlated with neutrophilic granulocyte, aspartate aminotransferase, prothrombin time, and international standardized ratio, but negatively correlated with platelet and serum albumin. At the early stage, the level of DcR3 was not significantly different between the survival and nonsurvival group of ACLF. However, at the late stage, DcR3 increased in nonsurvival and gradually decreased in survivals. The baseline DcR3 could not sufficiently predict the outcome of ACLF, while the change of DcR3 within the first week displayed a better predictive value than model for end-stage liver disease (MELD) score.Conclusions. DcR3 was highly expressed in patients with ACLF and correlated with several clinical indices. Dynamic change of DcR3 might predict the prognosis of ACLF.
Direct Oral Anticoagulant Use and Risk of Diverticular Hemorrhage: A Systematic Review of the Literature
Authors: Turpin MacKenzie , Gregory Peter
Published: June 2019

Background. Anticoagulants carry a significant risk of gastrointestinal bleeding. With the increase in use and availability of direct oral anticoagulants (“DOACs”) more data are available regarding the risks of these medications. With diverticular bleeds being common, and hospitalization associated with gastrointestinal bleed increasing 30-day mortality, it is paramount to better understand the potential risks of using DOACs in this population. Methods. A systematic review of the literature was undertaken, using the databases PubMed, EMBASE, Cochrane Library, and CINAHL. Two reviewers independently searched the literature, and initial screening was performed through title and abstract reading. Search terms included “direct” AND “anticoagulant” AND “diverticular bleed” OR “diverticular hemorrhage”. The references of the selected studies were manually reviewed for any further relevant articles. Results. Literature search across the databases garnered 182 articles—157 unique abstracts after duplicate removal. Based on inclusion and exclusion criteria, 6 studies were deemed relevant. The selected studies’ reference lists yielded no further relevant articles. Discussion. Across the 6 studies, the incidence of diverticular bleeding in patients using DOACs was extremely low. Of 23,990 patients taking DOACs identified from two separate institutions, only 60 were found to have diverticular hemorrhage. Similarly, among 15,056 patients with diverticular hemorrhage, only 246 (1.6%) among them were taking DOACs. Generally, the studies found no increased diverticular bleeding rate between patients taking DOACs and those who were taking other anticoagulants, such as warfarin, or the general population. The studies also did not find an increased risk of rebleeding with DOAC continuation. Conclusion. The evidence suggests the risk of diverticular bleed among DOAC users is equivocal to those not taking DOACs, and the overall incidence of diverticular bleed in the DOAC population is low. As it stands, the risk of thrombotic events from not starting DOACs apparently outweighs the risk of diverticular bleed.
Testing Episodic Memory in Elderly Subjects: Not as Simple as It Looks
Authors: Boelaarts Leo , Meyer Sascha R.A. , Scheltens Philip , de Jonghe Jos F.M.
Published: June 2019

Background/Aims: The available episodic memory tests are not specifically constructed to examine older subjects. Their use in outpatient memory clinics may result in aborted test administration. We used a strict adherence to the test protocol in cognitively healthy, amnestic mild cognitive impairment (aMCI), and Alzheimer’s disease dementia subjects to assess the possibility of preventing this. Methods: This is a cross-sectional study in memory outpatient subjects with a mean age of 74.5 years. Primary study outcomes were: number of missing values and test results in the Visual Association Test (VAT) and the 15 Word Test (15WT). Results: A strict adherence to the test protocol resulted in a 10-fold decrease in the number of missing values in the VAT. For the 15WT this could not be realized mostly because the test was deemed too demanding for 1 in 6 patients. Conclusions: This study is one of the few examining the applicability of well-known episodic memory tests in older subjects. A strict adherence to the test protocol reduced the number of missing values. Floor effects were stronger for the 15WT than for the VAT. Results favor the use of the VAT in senior subjects and show the unsuitability of the 15WT in this group.
Thrombectomy Outcomes in Acute Ischemic Stroke due to Middle Cerebral Artery M2 Occlusion with Stent Retriever versus Aspiration: A Multicenter Experience
Authors: Atchaneeyasakul Kunakorn , Malik Amer M. , Yavagal Dileep R. , Haussen Diogo C. , Jadhav Ashutosh P. , Bouslama Mehdi , Kenmuir Cynthia L. , Desai Shashvat , Grossberg Jonathan A. , Chaturvedi Seemant , Jovin Tudor G. , Nogueira Raul G.
Published: June 2019

Objective: To examine outcomes for thrombectomy devices used for treatment of acute ischemic stroke (AIS) with middle cerebral artery (MCA) M2 segment emergent large vessel occlusion (ELVO) as the optimal device for such reperfusion is not clearly defined. Methods: A retrospective cohort study of consecutive AIS patients with MCA M2 ELVO undergoing thrombectomy from 3 academic medical centers was conducted from October 1999 through June 2016. The patients were divided based on the device utilized. Multivariate analysis of associations between devices (stent retriever or aspiration only [manual or pump aspiration system]) was performed. Primary outcomes were good recanalization (i.e., modified thrombolysis in cerebral infarction score ≥2b) and a favorable modified Rankin scale (mRS) score (i.e. ≤2). The secondary outcome was symptomatic intracerebral hemorrhage (sICH). Results: A total of 197 AIS patients underwent MCA M2 ELVO thrombectomy with either a stent retriever (n = 120) or aspiration only (n = 77). The aspiration-only group utilized either manual (n = 38) or pump aspiration (n = 39). Utilization of a stent retriever over manual aspiration is independently associated with higher odds of a favorable mRS score (OR = 3.2; 95% CI 1.02–9.7) and lower odds of sICH (OR = 0.09; 95% CI 0.03–0.31). Utilization of a stent retriever over a pump aspiration system is independently associated with higher odds of good recanalization (OR = 3.8; 95% CI 1.5–9.6). Utilization of a newer-generation pump aspiration catheter compared to a stent retriever resulted in similar rates of favorable mRS scores, sICH, successful recanalization, and mortality. Conclusion: Utilization of a newer-generation pump aspiration catheter compared to a stent retriever resulted in similar outcomes, but worse outcomes were seen with the manual aspiration technique. These findings need to be confirmed with a large randomized trial utilizing stent retrievers and newer-generation pump aspiration systems.
Anxiety in Late Life: An Update on Pathomechanisms
Authors: Hellwig Sabine , Domschke Katharina
Published: June 2019

Anxiety disorders are common, yet clinically underrecognized in late life, with estimated prevalence rates ranging from 1.2 to 15%. They are highly comorbid with depression, sleep disorders, and substance use disorders, may accelerate cognitive decline, and potentially catalyze morbidity and mortality risk in the elderly. Thus, a more detailed knowledge about the underlying mechanisms of late-life anxiety disorders is urgently warranted. Age-related genetic, neuroimaging, neuroendocrine, and neuropsychological markers as well as late-life specific psychosocial aspects, particularly loss and isolation, have been identified as prominent pathogenetically relevant and thus potentially targetable factors. Personalized treatments based on individual biological and biographic markers, innovative therapeutic approaches, and preventive strategies have great potential to alleviate the high individual and societal burden of late-life anxiety disorders.
Assessing HIV/AIDS Knowledge, Awareness, and Attitudes among Senior High School Students in Kuwait
Authors: Alhasawi AlMunther , Grover Saroj Bala , Sadek Ali , Ashoor Ibrahim , Alkhabbaz Iqbal , Almasri Sameh
Published: June 2019

Objectives: An estimated 1.8 million individuals worldwide became newly infected with human immunodeficiency virus (HIV) in 2016, which amounts to 5,000 new infections per day. This includes 160,000 children. The HIV epidemic not only affects the health of individuals but also impacts households, communities, and the development and economic growth of nations [1]. The prevention and control of HIV infection and acquired immune deficiency syndrome (AIDS) are recognized as a national priority in Kuwait. This study assesses the knowledge, awareness, and attitudes about HIV/AIDS among senior high school students in Kuwait. Materials and Methods: A cross-sectional study was conducted in a convenience sample of 346 students in 8 randomly selected high schools in 3 governorates of Kuwait, using a questionnaire designed to measure the student’s knowledge and attitude towards HIV/AIDS. The survey questionnaire was administered to the students in their classrooms. Results: This study revealed that the students were knowledgeable with regard to the nature and mode of transmission of HIV/AIDS, but they needed a more detailed understanding of the disease to prevent stigmatization and discrimination of an infected person. Conclusion: This study provides a benchmark for further elaborate studies in the community to develop appropriate health education and awareness programs.
Spinal Intramedullary Ganglioglioma in Children: An Unusual Location of a Common Pediatric Tumor
Authors: Deora Harsh , Sumitra Sivakoti , Nandeesh Bevinahalli Nanjegowda , Bhaskara Rao Malla , Arivazhagan Arimappamagan
Published: June 2019

Ganglioglioma is a common CNS tumor in children, mostly found in the temporal lobe, causing epilepsy. Spinal gangliogliomas are very rare, accounting for 1.1% of all intramedullary spinal tumors. The management principles and the need for adjuvant therapy are not yet well defined in this cohort. BRAF V600E mutation in spinal ganglioglioma has been described in a few series recently. In this report, we describe 3 children with spinal ganglioglioma at different locations, and their expression of BRAF V600E mutation and follow-up. In addition, we review the recent literature on pediatric spinal ganglioglioma management.
Influence of the Extent of Intraventricular Hemorrhage on Functional Outcome and Mortality in Intracerebral Hemorrhage
Authors: Roeder Sebastian S. , Sprügel Maximilian I. , Sembill Jochen A. , Giede-Jeppe Antje , Macha Kosmas , Madžar Dominik , Lücking Hannes , Hoelter Philip , Gerner Stefan T. , Kuramatsu Joji B. , Huttner Hagen B.
Published: June 2019

Background and Objective: Intraventricular hemorrhage (IVH) is a verified independent prognostic parameter in patients with intracerebral hemorrhage (ICH). However, the impact of the extent of IVH on clinical outcomes is unestablished. Methods: We analyzed 1,112 consecutive primary ICH patients of the UKER-ICH cohort (NCT03183167) and hypothesized that there is no difference in outcome between patients without IVH and patients with minor IVH not leading to obstructive hydrocephalus. Propensity score matching and multivariable analyses were performed to account for imbalances in baseline characteristics. Primary outcome was defined as functional outcome 3 months after ICH ­assessed using the modified Rankin Scale (mRS) dichotomized into favorable (mRS = 0–3) and unfavorable outcome (mRS = 4–6). Secondary outcomes included mortality at 3  months and a Graeb score-based threshold analysis for association of the extent of IVH with unfavorable clinical outcome. Results: Among the 461 out of 1,112 (41.5%) ICH patients with IVH, 191 out of 461 (41.4%) showed IVH without obstructive hydrocephalus and no requirement of external ventricular drain (EVD) placement. After adjusting for baseline imbalances we found no difference in functional outcome at 3 months between patients without IVH (No-IVH) and patients with IVH not requiring EVD (IVH-w/o-EVD): mRS 0–3: No-IVH 64/161 (39.8%) vs. IVH-w/o-EVD 53/170 (31.2%); p = 0.103. However, there was a trend toward a higher mortality in IVH-w/o-EVD patients (mRS 6: No IVH 40/161 [24.8%] vs. IVH-w/o-EVD 57/170 [33.5%]; p = 0.083). Multivariable analysis revealed that a Graeb score >2 was independently associated with unfavorable outcome (mRS 4–6: OR 3.16 [1.54–6.48]; p = 0.002), and higher mortality (mRS 6: OR 2.57 [1.40–4.74]; p = 0.002) in IVH patients. Conclusions: Small amounts of intraventricular blood (Graeb score ≤2) not leading to obstructive hydrocephalus are not associated with unfavorable outcome or death after ICH. Thus, IVH per se should not be considered a binary variable in outcome prediction for ICH patients.
Impact of Diabetes Mellitus on Postoperative Complications Following Laparoscopic Hysterectomy for Benign Indications
Authors: Corrigan Kelly E. , Vargas Maria V. , Robinson Hannah N. , Gu Alex , Wei Chapman , Tyan Paul , Singh Neha , Tappy Erryn E. , Moawad Gaby N.
Published: June 2019

Background: Current research pertaining to minimally invasive gynecologic surgical outcomes in the context of diabetes mellitus (DM) is limited. This study seeks to evaluate the association between DM and postoperative complications following laparoscopic hysterectomy for benign indications. Methods: The American College of Surgeons National Surgical Quality Improvement Program database was utilized. We identified laparoscopic hysterectomies completed for benign indications from 2007 to 2016 using current procedural terminology codes. Complications were evaluated by DM status: non-insulin-dependent DM (NIDDM), insulin-dependent DM (IDDM), and non-DM. Postoperative complications were evaluated utilizing univariate and multivariate analyses. Results: We identified 56,640 laparoscopic hysterectomies. Though both the IDDM and NIDDM cohorts had an increased incidence of postoperative complications compared to the non-diabetes cohort. The IDDM group had the highest incidence of all 3 cohorts. Compared to non-DM, the IDDM group had higher odds of reintubation (OR 4.23; 95% CI 1.59–11.19), urinary tract infection (OR 1.45; 95% CI 1.022–2.069), and extended length of stay (OR 1.75; 95% CI 1.36–2.26). Conclusion: Both NIDDM and IDDM were independent risk factors for postoperative complications after laparoscopic hysterectomy. However, the IDDM cohort had the highest odds of complications. Diabetic patients should be carefully counseled regarding their elevated risk of perioperative complications.
Determinants of Patient Delay in Transient Ischemic Attack
Authors: Dolmans L. Servaas , Hoes Arno W. , Bartelink Marie-Louise E.L. , Kappelle L. Jaap , Rutten Frans H. ,   for the MIND-TIA Study Group
Published: June 2019

Introduction: Early diagnosis and stroke preventive treatment in patients with transient ischemic attack (TIA) are crucial, but hampered by delayed reporting of symptoms. Previous studies on causes of patient delay provided inconsistent results. We aimed to assess determinants of patient delay among patients with symptoms suggestive of TIA. Methods: We interviewed participants referred by their general practitioner to an outpatient TIA clinic within 72 h from symptom onset. We determined (i) the exact time from symptom onset to the first contact with a medical service (patient delay); (ii) demographic and clinical characteristics; (iii) patient’s initial perception, and reaction to symptoms; and (iv) patient’s knowledge about TIA. We used multivariable linear regression to identify determinants of patient delay. Results: We interviewed 202 suspected TIA patients (mean age 67.7 (SD 13.7) years, 111 (55.0%) male), of whom 123 (60.9%) received a definite diagnosis of TIA or minor stroke. Median patient delay was 1.5 (interquartile range 0.4–14.6) hours. Of all patients, 119 (58.9%) considered a TIA (or stroke) as the cause of their symptoms. Among them, 30 (25.2%) thought it was a medical emergency, while of the 83 not considering TIA as the cause of symptoms 38 (45.8%) thought of a medical emergency. Independently related to increased delay were (i) symptom onset out of hours, (ii) absence of dysarthria, (iii) being unaware that TIA requires urgent treatment, (iv) not considering the event an emergency, and (v) knowledge of TIA symptoms. Results for patients with a definite diagnosis of TIA/minor stroke were similar to those with alternative diagnoses. Conclusion: Patients still tend to wait till office hours to report TIA symptoms. Speech difficulties, and specifically dysarthria, are related to shorter delay. To reduce patient delay, awareness of TIA symptoms should increase and more importantly lay people should be educated to consider a TIA an emergency.
The Transient Receptor Potential Vanilloid 4 Agonist RN-1747 Inhibits the Calcium Response to Histamine
Authors: Pfanzagl Beatrix , Pfragner Roswitha , Jensen-Jarolim Erika
Published: June 2019

Background: Sensitization of transient receptor potential (TRP) cation channels probably contributes to intestinal hypersensitivity, a hallmark of gastrointestinal disorders. Histamine acting via histamine 1 receptor (H1R) to open TRP cation channels might also be involved. Method: The enterochromaffin cell line P-STS, responsive to histamine via H1R, was used as model to study possible synergism between histamine and TRP vanilloid 4 (TRPV4) pathways. Results: The TRPV4 antagonist RN-1734, but not HC-067047, inhibited the cytoplasmic calcium response to histamine in P-STS cells. However, also pre-incubation with the TRPV4 agonist RN-1747 strongly inhibited the calcium response to histamine in P-STS as well as HeLa cells. This inhibitory effect of RN-1747 was not due to its known TRP melastatin 8 (TRPM8) antagonism, as the TRPM8 antagonist RQ-00203078 showed no significant effect on the histamine-induced calcium response of P-STS or HeLa cells. Conclusion: The TRPV4 agonist RN-1747, and possibly also the structurally similar TRPV4 antagonist RN-1734, should be used with caution because of yet unidentified interference with histamine signaling via H1R.
Effective and efficient network anomaly detection system using machine learning algorithm
Authors: Nawir Mukrimah , Amir Amiza , Yaakob Naimah , Bi Lynn Ong
Published: June 2019

Network anomaly detection system enables to monitor computer network that behaves differently from the network protocol and it is many implemented in various domains. Yet, the problem arises where different application domains have different defining anomalies in their environment. These make a difficulty to choose the best algorithms that suit and fulfill the requirements of certain domains and it is not straightforward. Additionally, the issue of centralization that cause fatal destruction of network system when powerful malicious code injects in the system. Therefore, in this paper we want to conduct experiment using supervised Machine Learning (ML) for network anomaly detection system that low communication cost and network bandwidth minimized by using UNSW-NB15 dataset to compare their performance in term of their accuracy (effective) and processing time (efficient) for a classifier to build a model. Supervised machine learning taking account the important features by labelling it from the datasets. The best machine learning algorithm for network dataset is AODE with a comparable accuracy is 97.26% and time taken approximately 7 seconds. Also, distributed algorithm solves the issue of centralization with the accuracy and processing time still a considerable compared to a centralized algorithm even though a little drop of the accuracy and a bit longer time needed.
Design and implementation of microstrip rotman lens for ISM band applications
Authors: Al-Obaidi Mohammed K. , Mohd Ezri , Abdullah Noorsaliza , Dahlan Samsul Haimi , Ali Jawad
Published: June 2019

This work presents the design and implementation of Rotman lens as a beam steering device for Industrial, Scientific, and Medical (ISM) applications. 2.45 GHz is considered as a center frequency design with (2-6) GHz frequency bandwidth. The beam steering is examined to cover ±21o scan angle with maximum main lobe magnitude 10.1 dBi, rectangular patch antennas are used as radiation elements to beam the output far field. The work is extended to compare between the tapered line which is used for matching between 50-Ω ports and lens cavity. CST microwave simulation studio results show that the rectangular taper line can yield 2 dB return loss less than linear taper line with a little bit shifting in responses for same input and load impedance.
Design & investigation of 10x10 gbit/s MDM over hybrid FSO link under different weather conditions and fiber to the home
Authors: Ghazi Alaan , Aljunid S. A. , Noori Awab , Syed Idrus Syed Zulkarnain , Rashidi C. B. M. , Al-dawoodi Aras
Published: June 2019

In this paper, we design and investigate 10-channels of mode division multiplexer (MDM) over hybrid free-space optics (FSO) link in several weather conditions to achieve the maximum possible medium range and fiber to the home (FTTH) for high bandwidth access networks. System capacity can be effectively increased with the use of MDM over hybrid FSO-FTTH. In this study, a 10-channel MDM over FSO-FTTH system has been analyzed in different weather conditions that operate at 1550 nm wavelength. The simulated system has transmitted 100 Gbit/s up for a distance of 3200 meters FSO in superbly clear weather condition. It also transmitted 100 Gbit/s up for a distance of 650 meters FSO during heavy rain. The validation of this study is measures based on eye diagrams bit-error rates (BER) that have been analyzed.
Configurations of memristor-based APUF for improved performance
Authors: Loong Teo Julius Han , Noor Hashim Noor Alia , Ghazali Azrul , Hamid Fazrena Azlee
Published: June 2019

The memristor-based arbiter PUF (APUF) has great potential to be used for hardware security purposes. Its advantage is in its challenge-dependent delays, which cannot be modeled by machine learning algorithms. In this paper, further improvement is proposed, which are circuit configurations to the memristor-based APUF. Two configuration aspects were introduced namely varying the number of memristor per transistor, and the number of challenge and response bits. The purpose of the configurations is to introduce additional variation to the PUF, thereby improve PUF performance in terms of uniqueness, uniformity, and bit-aliasing; as well as resistance against support vector machine (SVM). Monte Carlo simulations were carried out on 180 nm and 130 nm, where both CMOS technologies have produced uniqueness, uniformity, and bit-aliasing values close to the ideal 50%; as well as SVM prediction accuracies no higher than 52.3%, therefore indicating excellent PUF performance.
Heat distribution under microwave heating treatment
Authors: Abdul Nyzam Siti Zulaika , Rahim Rosemizi Abd
Published: June 2019

This paper presents the process of microwave heating treatment to kill the rice weevil to improve the quality and quantity of rice for industrial storage purpose. Since many years ago, heat uniformity has been a major drawback of microwave heating application. The heat distribution in rice after undergoing four treatments with a microwave frequency of 2.4 GHz at the different power level of 540 and 900W with different time treatment of 50 and 80 seconds are shown in this paper. The samples are placed inside a square container, 8.5 cm x 8.5 cm x 2 cm. Each sample contains 15 adults of rice weevil of Sitophilus Oryzae placed randomly in the container and the mortality of the rice weevil for adult stages from each treatment are observed and interpreted in Analysis of Variance (ANOVA) technique.
Gain enhancement of microstrip patch antenna using artificial magnetic conductor
Authors: Bahari Norfatihah , Jamlos Mohd Faizal , Isa Muammar Mohamad
Published: June 2019

The paper presents an artificial magnetic conductor (AMC) structure to enhance the gain of the double microstrip patch antenna. By placing this kind of metamaterial in between the two Rogers RT5880 substrates, the antenna achieved lots of improvement especially in terms of size miniaturization, bandwidth, return loss, gain and efficiency. The antenna is intended to operate at 16 GHz where the prospect fifth generation (5G) spectrum might be located. Integration of AMC structure into the proposed antenna helps to improve nearly 16.3% of gain and almost 23.6% of size reduction.
Identification of persuasive elements in Islamic knowledge website using Kansei engineering
Authors: Daud Nor Aziah , Aminudin Nurul Izzati , Redzuan Fauziah , Ashaari Noraidah Sahari , Muda Zurina
Published: June 2019

The global explosions of the internet and direct use by individuals, organizations and Islamic scholars to spread the knowledge and events have witnessed massive growth over the years. The users refuse to use online Islamic websites as references which causes the acceptance rate of the online learning method still low. This paper presents the identifications of persuasive elements in Islamic knowledge website. The objective of this study is to identify the persuasive element using Kansei Engineering (KE) method for online Islamic knowledge website design. Therefore, Kansei words related to online Islamic knowledge were identified. After that, the Kansei words (KWs) were evaluated in order to be used as persuasive elements. Ten specimens of Islamic websites were chosen and evaluated with 30 emotions of KWs. 38 students from one of the public universities accomplished the evaluation experiment. The gathered KWs were then analyzed using multivariate analysis such as Factor Analysis to identify the persuasive elements. Based on Factor Analysis, the finding of this research revealed four main pillars which are credibility-motivated, reliability, Islamic identity and functional. The two additional pillars are updated and belief. The pillars were then compared with the persuasive elements in the previous research. Although there are some limitations and constraint during the conduct of the research, this study also contributes to the design persuasive elements for Islamic website knowledge in the future.
A genetic algorithm based task scheduling system for logistics service robots
Authors: Harun Sariffuddin , Ibrahim Mohd Faisal
Published: June 2019

The demand for autonomous logistics service robots requires an efficient task scheduling system in order to optimise cost and time for the robot to complete its tasks. This paper presents a Genetic algorithm (GA) based task scheduling system for a ground mobile robot that is able to find a global near-optimal travelling path to complete a logistics task of pick-and-deliver items at various locations. In this study, the chromosome representation and the fitness function of GA is carefully designed to cater for a single load logistics robotic task. Two variants of GA crossover are adopted to enhance the performance of the proposed algorithm. The performance of the scheduling is compared and analysed between the proposed GA algorithms and a conventional greedy algorithm in a virtual map and a real map environments that turns out the proposed GA algorithms outperform the greedy algorithm by 40% to 80% improvement.
Tooth segmentation using dynamic programming-gradient inverse coefficient of variation
Authors: Muad Anuar Mikdad , Mohamed Bahaman Nur Sakinah , Hussain Aini , Mohd Yusof Mohd Yusmiaidil Putera
Published: June 2019

Teeth provide meaningful clues of an individual. The growth of the teeth is correlated with the individual age. This correlation is widely used to estimate age of an individual in applications like conducting forensic odontology, immigration, and differentiating juveniles and adolescents. Current forensic dentistry largely depends on laborious investigation process that is performed manually and can be influenced by human factors like fatigue and inconsistency. Digital panoramic radiograph dental images allow noninvasive and automatic investigation to be performed. This paper presents analyses on third molar tooth segmentation for the population in Malaysia, ranging from persons age of 5 years old to 23 years old. Two segmentation techniques: gradient inverse coefficient of variation with dynamic programming (DP-GICOV) and Chan-Vese (CV) were employed and compared. Results demonstrated that the accuracy of DP-GICOV and CV were 95.3%, and 81.6%, respectively.
Evaluating users’ emotions for Kansei-based Malaysia higher learning institution website using Kansei checklist
Authors: Turumogan Punitha , Baharum Aslina , Ismail Ismassabah , Mohamed Noh Nor Azida , Ab Fatah Nur Shahida , Mat Noor Noorsidi Aizuddin
Published: June 2019

Emotions play a crucial role in human-computer interaction. Emotion research in the field of human-computer interaction has only started recently and continuously evolving through the investigation and understanding of emotional effects. Thus, it forms an intelligent interaction between human and computer by responding effectively to the humans’ feelings. Emotional design generates remarkable user experiences for websites as the emotional experiences create an intense impression on our long-term memory. Recent scientific findings recommend emotional elements to be considered in designing websites as emotions influences one’s perception, conception and decision-making throughout the interaction with a website. A poorly designed user interface leads to bad user interaction while rising the users’ arousal and a displeasing user experience with a website elicits dissatisfaction emotion where consecutively results in avoidance and prevents revisit to the website. This proves the importance of emotional engagement in a website design. This research evaluated users’ emotions toward a Malaysian higher learning institution website which was designed in accordance with the standard Kansei-based web design guideline. The result justified the standard Kansei-based web design guideline for website of higher learning institutions in Malaysia.
Detection of Aedes aegypti larvae using single shot multibox detector with transfer learning
Authors: Aqil Mohd Fuad Mohamad , Ruddin Ab Ghani Mohd , Ghazali Rozaimi , Izzuddin Tarmizi Ahmad , Sulaima Mohamad Fani , Jano Zanariah , Sutikno Tole
Published: June 2019

The flavivirus epidemiology has reached an alarming rate which haunts the world population including Malaysia. In fact, World Health Organization has proposed and practised many methods of vector control through environmental management, chemical and biological orientations but still cannot fully overcome the problem. This paper proposed a detection of Aedes Aegypti larvae in water storage tank using Single Shot Multibox Detector with transfer learning. The objective of the study was to acquire the training and the performance metrics of the detection. The detection was done using SSD with Inception_V2 through transfer learning. The experimental results revealed that the probability detection scored more than 80% accuracies and there was no false alarm. These results demonstrate the effectiveness of the model approach.
Evaluation of patient electrocardiogram datasets using signal quality indexing
Authors: Nayan Nazrul Anuar , Hamid Hafifah Ab
Published: June 2019

Electrocardiogram (ECG) is widely used in the hospital emergency rooms for detecting vital signs, such as heart rate variability and respiratory rate. However, the quality of the ECGs is inconsistent. ECG signals lose information because of noise resulting from motion artifacts. To obtain an accurate information from ECG, signal quality indexing (SQI) is used where acceptable thresholds are set in order to select or eliminate the signals for the subsequent information extraction process. A good evaluation of SQI depends on the R-peak detection quality. Nevertheless, most R-peak detectors in the literature are prone to noise. This paper assessed and compared five peak detectors from different resources. The two best peak detectors were further tested using MIT-BIH arrhythmia database and then used for SQI evaluation. These peak detectors robustly detected the R-peak for signals that include noise. Finally, the overall SQI of three patient datasets, namely, Fantasia, CapnoBase, and MIMIC-II, was conducted by providing the interquartile range (IQR) and median SQI of the signals as the outputs. The evaluation results revealed that the R-peak detectors developed by Clifford and Behar showed accuracies of 98% and 97%, respectively. By introducing SQI and choosing only high-quality ECG signals, more accurate vital sign information will be achieved.
A efficacy of different buffer size on latency of network on chip (NoC)
Authors: Wahida Binti Zulkefli Farah , Ehkan P. , N. M. Warip M. , Phing Ng. Yen.
Published: June 2019

Moore's prediction has been used to set targets for research and development in semiconductor industry for years now. A burgeoning number of processing cores on a chip demand competent and scalable communication architecture such as network-on-chip (NoC). NoC technology applies networking theory and methods to on-chip communication and brings noteworthy improvements over conventional bus and crossbar interconnections. Calculated performances such as latency, throughput, and bandwidth are characterized at design time to assured the performance of NoC. However, if communication pattern or parameters set like buffer size need to be altered, there might result in large area and power consumption or increased latency. Routers with large input buffers improve the efficiency of NoC communication while routers with small buffers reduce power consumption but result in high latency. This paper intention is to validate that size of buffer exert influence to NoC performance in several different network topologies. It is concluded that the way in which routers are interrelated or arranged affect NoC’s performance (latency) where different buffer sizes were adapted. That is why buffering requirements for different routers may vary based on their location in the network and the tasks assigned to them.
Classification of different types of metal from recyclable household waste for automatic waste separation system
Authors: Yusoff Siti Hajar , Mahat Sazali , Midi Nur Shahida , Mohamad Sarah Yasmin , Zaini Syasya Azra
Published: June 2019

Nowadays, solid waste has become a major problem in Malaysia. However, most people in Malaysia are not aware and take this problem for granted. The rising number of population and massive development in recent years indirectly generated an enormous value of household waste, making the household waste the main generator for solid waste in Malaysia. It stated that only 5 percent of an average 30,000 tons of waste have been recycled in Malaysia. The purpose of the paper is to design a system to separate the metal recyclable household waste automatically and record the data waste collected. There are total of four detectors used to separate the non-metal, steel, copper and aluminum metal waste. The average time used to complete metal separation process by using the proposed prototype is 14.5 seconds. This paper includes a mechanical part, programming part, an electronic design and also the data collected from this proposed system. The system will be programmed using Arduino Mega as a microcontroller to control all the electronic component in the system.
Principal component analysis for human gait recognition system
Authors: Khalifa Othman O. , Jawed Bilal , Shah Newaj Bhuiyn Sharif
Published: June 2019

This paper represents a method for Human Recognition system using Principal Component Analysis. Human Gait recognition works on the gait of walking subjects to identify people without them knowing or without their permission. The initial step in this kind of system is to generate silhouette frames of walking human. A number of features couldb be exytacted from these frames such as centriod ratio, heifht, width and orientation. The Principal Component Analysis (PCA) is used for the extracted features to condense the information and produces the main components that can represent the gait sequences for each waiking human. In the testing phase, the generated gait sequences are recognized by using a minimum distance classifier based on eluclidean distance matched with the one that already exist in the database used to identify walking subject.