bluuebunny/crossref_metadata_2025 huggingface dataset:
Telepresent mechanical ventilation training versus traditional instruction: a simulation-based pilot study
Authors: Ciullo Anna , Yee Jennifer , Frey Jennifer A , Gothard M David , Benner Alma , Hammond Jared , Ballas Derek , Ahmed Rami A
Published: February 2018

Background

Mechanical ventilation is a complex topic that requires an in-depth understanding of the cardiopulmonary system, its associated pathophysiology and comprehensive knowledge of equipment capabilities.

Introduction

The use of telepresent faculty to train providers in the use of mechanical ventilation using medical simulation as a teaching methodology is not well established. The aim of this study was to compare the efficacy of telepresent faculty versus traditional in-person instruction to teach mechanical ventilation to medical students.

Materials and methods

Medical students for this small cohort pilot study were instructed using either in-person instruction or telementoring. Initiation and management of mechanical ventilation were reviewed. Effectiveness was evaluated by pre- and post-multiple choice tests, confidence surveys and summative simulation scenarios. Students evaluated faculty debriefing using the Debriefing Assessment for Simulation in Healthcare Student Version (DASH-SV).

Results

A 3-day pilot curriculum demonstrated significant improvement in the confidence (in person P<0.001; telementoring P=0.001), knowledge (in person P<0.001; telementoring P=0.022) and performance (in person P<0.001; telementoring P<0.002) of medical students in their ability to manage a critically ill patient on mechanical ventilation. Participants favoured the in-person curriculum over telepresent education, however, resultant mean DASH-SV scores rated both approaches as consistently to extremely effective.

Discussion

While in-person learners demonstrated larger confidence and knowledge gains than telementored learners, improvement was seen in both cases. Learners rated both methods to be effective. Technological issues may have contributed to students providing a more favourable rating of the in-person curriculum.

Conclusions

Telementoring is a viable option to provide medical education to medical students on the fundamentals of ventilator management at institutions that may not have content experts readily available.
Gunshot victimisations resulting from high-volume gunfire incidents in Minneapolis: findings and policy implications
Authors: Koper Christopher S , Johnson William D , Stesin Kenneth , Egge Jeffery
Published: February 2018

Laws restricting large ammunition magazines for semiautomatic weapons are intended to reduce firearm deaths and injuries by preventing gun attacks involving high numbers of shots. However, data on shootings from high-volume gunfire (HVG) incidents are extremely limited. This study examined gunshot victimisations resulting from HVG attacks (>10 shots fired) using police data on shootings in Minneapolis, Minnesota from January through August 2014 (n=135 to 167). Shots fired estimates were generated from police reports based on physical evidence recovered, reported gunshot victims, and accounts of witnesses and actors. HVG incidents accounted for 20%–28% of victims and were more likely to involve multiple victims. Most HVG cases seemed likely to have involved a gun with a large capacity magazine though these data were limited. Restricting large ammunition magazines may have greater potential for preventing shootings than previously estimated, but further studies of this issue are needed.
Team interaction challenges for medical leadership
Authors: McGuire Stephen John
Published: February 2018

Background

Team interaction in medical practice directly affects patients, organisations and individual doctors. This study aimed to gather a set of quantitative data to identify (1) the aspects of team performance where doctors are comfortable and (2) where to focus development activities.

Methods

Doctors were invited to undertake a 1-hour online course exploring concepts related to team formation, performance and dysfunction. This included completing the Healthy Team Member Self-Assessment questionnaire, designed specifically to collect the desired quantitative data. Questionnaire responses were then collated as a survey and analysed in line with the study’s aims.

Results

202 participants completed the questionnaire including 45 consultants, 85 doctors in training, 24 locums, 3 medical directors, 6 general practitioners and 35 other doctors. Five practice or hospital managers and five other healthcare professionals also submitted results. Collective analysis of the participants’ self-assessment reveals a number of behaviours where doctors indicate improvements are required, including: 45% are not challenging or giving feedback to their colleagues, 42% not proactively seeking honest feedback, 40% not discussing progress towards goals and 39% not discussing support they require to fulfil their role. In addition, unhelpful disparities of perception within teams are suggested. A Wilcoxon-Mann-Whitney test confirmed a statistically significant difference between the 33% of consultants who state their team is in the unproductive ‘Storming’ stage of development and just 12% of all other participants stating the same (P=0.0008). Feelings of ‘I am committed but others are not’ and ‘I am willing to help others but they are not willing to help me’ are also suggested.

Conclusions

The author relates these issues to the duty of candour, proposing that both individual doctors and medical leadership have responsibilities to ensure improvements. In particular, individual doctors should ensure ongoing development in team interaction skills, and medical leadership must foster the appropriate culture for individuals to function within real teams.
Variability of cardiovascular magnetic resonance (CMR) T1 mapping parameters in healthy volunteers during long-term follow-up
Authors: aus dem Siepen Fabian , Baumgärtner Christian , Müller-Henessen Matthias , André Florian , Messroghli Daniel , Ochs Marco , Riffel Johannes , Giannitsis Evangelos , Katus Hugo A , Friedrich Matthias G , Buss Sebastian J
Published: February 2018

Background

Myocardial T1 and extracellular volume (ECV) derived from cardiovascular MRIs are more and more widely accepted as important markers for diagnosis, risk prediction and monitoring of cardiac disease. Yet data regarding long-term stability of myocardial T1 mapping are lacking. The aim of this study was to investigate the long-term stability of native and postcontrast T1 mapping values in healthy volunteers.

Methods

18 strictly selected healthy volunteers (52±10 years, 12 men) were studied on a Philips Achieva 1.5 Tesla scanner. T1 relaxation times were measured before and 15 min after a bolus contrast injection of gadolinium diethylenetriamine penta-acetic acid (DTPA) (0.2 mmol/kg) using a single-breath-hold modified Look-Locker inversion recovery 3(3)3(3)5 sequence. ECV was calculated using native and postcontrast T1 times of myocardium and blood correcting for blood haematocrit. Exams were repeated 3.6±0.5 years later under the same conditions and using the same scan protocols.

Results

Cardiac biomarkers (high-sensitivity troponin T and N terminal pro-brain natriuretic peptide) remained unchanged, as well as left ventricular mass, and global and longitudinal function. No significant change occurred regarding native T1 times (1017±24 ms vs 1015±21 ms; P=0.6), postcontrast T1 times (426±38 ms vs 413±20 ms; P=0.13) or ECV (22%±2% vs 23%±2%; P=0.3). Native T1 time and ECV appeared to be better reproducible than postcontrast T1, resulting in lower coefficients of variation (ECV: 3.5%, native T1: 1.3%, postcontrast T1: 6.4%) and smaller limits of agreement (ECV: 2%/−2%, native T1: 39 ms/−35 ms, postcontrast T1: 85 ms/−59 ms).

Conclusions

During long-term follow-up, native T1 and ECV values are very robust markers, whereas postcontrast T1 results appear less stable.
Critical appraisal of cardiology guidelines on revascularisation: clinical practice
Authors: Dobies David R , Barber Kimberly R
Published: February 2018

Evidence-based medicine (EBM) provides clinicians with beneficial information. Nonetheless, study findings are often arbitrary, speculative or provisional. The current state of misleading evidence exists in all applications, including those for guideline recommendations. We conductedan appraisal of the American College of Cardiologyand European Society of Cardiology Guidelines for revascularisation of complex coronary anatomy to determine the veracity of the evidence that recommendations were based on. Study-specific critical appraisals were conducted by the authors on the 5-year Synergy between percutaneous coronary intervention with Taxus and cardiac surgery (SYNTAX) and future revascularisation evaluation in patients with diabetes mellitus: optimal management of multivessel disease (FREEDOM) Trials. Each appraisal was performed according the standard EBM practices. A thorough design and analytic critique was performed for each study and the results presented and explained. The guideline recommendations were reviewed in terms of the veracity of the evidence cited. The relative difference in major adverse cardiac and cerebrovascular event (MAACE) rates between coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) are not the 30% level reported by the SYNTAX Trial but closer to 11% difference when study limitations are factored in. Similarly, the 30% effect size in MAACE rates between procedures from the FREEDOM Trial is closer to a non-significant 5% relative difference when limitations are adjusted for. Based on the actual findings of each study, outcomes from procedures by CABG or PCI for multivessel revascularisation are similar and contradict the conclusions of the study authors as well as the recommendations. These recommendations fail to inform current clinical practice.
Neurosyphilis in patients with HIV
Authors: Hobbs Emily , Vera Jaime H , Marks Michael , Barritt Andrew William , Ridha Basil H , Lawrence David
Published: February 2018

Syphilis is a resurgent sexually transmitted infection in the UK that is disproportionately diagnosed in patients living with HIV, particularly in men who have sex with men. Syphilis appears to present differently in patients with HIV, particularly in those with severe immunosuppression. Progression to neurosyphilis is more common in HIV coinfection and can be asymptomatic, often for several years. The presentations of neurosyphilis vary but can include meningitis, meningovascular disease, general paresis and tabes dorsalis. There is debate about the circumstances in which to perform a lumbar puncture, and the current gold standard diagnostics have inadequate sensitivity. We recommend a pragmatic approach to lumbar punctures, interpreting investigations and deciding when to consider treatment with a neuropenetrative antibiotic regimen.
Prevalence of axial spondyloarthritis in patients with acute anterior uveitis: a cross-sectional study utilising MRI
Authors: Sykes Mark P , Hamilton Louise , Jones Colin , Gaffney Karl
Published: February 2018

Objective

Acute anterior uveitis (AAU) is the most common extra-articular manifestation of axial spondyloarthritis (axSpA). In this study, patients presenting with AAU were evaluated clinically and with MRI in order to estimate the prevalence of axSpA.

Methods

Consecutive patients presenting to a university teaching hospital between February 2014 and March 2015 with AAU were invited to participate. Those with a history of chronic back pain (CBP) beginning <45 years were evaluated clinically and with MRI of thoracolumbar spine and sacroiliac joints.

Results

Of 366 patients with AAU, 57 had a pre-existing diagnosis of axSpA; 77 others fulfilled the study eligibility criteria and 73 (95%) completed the study. Seventeen patients (23.3%) were diagnosed with axSpA by an experienced rheumatologist; of these, eight were human leucocyte antigen-B27 negative. Including those with a previous diagnosis, this equates to a minimum axSpA prevalence of 20.2%; one-quarter of patients were previously undiagnosed.

Conclusion

This is the first study to actively search for the presence of axSpA in unselected patients presenting with AAU utilising MRI as an essential part of the assessment. There is a significant burden of undiagnosed axSpA in patients with AAU, but there does not appear to be a simple mechanism for screening. We recommend that ophthalmologists refer all patients with AAU with CBP, onset <45 years, to rheumatology for further evaluation.
How to identify which patients with asymptomatic carotid stenosis could benefit from endarterectomy or stenting
Authors: Paraskevas Kosmas I , Veith Frank J , Spence J David
Published: February 2018

Offering routine carotid endarterectomy (CEA) or carotid artery stenting (CAS) to patients with asymptomatic carotid artery stenosis (ACS) is no longer considered as the optimal management of these patients. Equally suboptimal, however, is the policy of offering only best medical treatment (BMT) to all patients with ACS and not considering any of them for prophylactic CEA. In the last few years, there have been many studies aiming to identify reliable predictors of future cerebrovascular events that would allow the identification of patients with high-risk ACS and offer a prophylactic carotid intervention only to these patients to prevent them from becoming symptomatic. All patients with ACS should receive BMT. The present article will summarise the evidence suggesting ways to identify these high-risk asymptomatic individuals, namely: (1) microemboli detection on transcranial Doppler, (2) plaque echolucency on Duplex ultrasound, (3) progression in the severity of ACS, (4) silent embolic infarcts on brain CT/MRI, (5) reduced cerebrovascular reserve, (6) increased size of juxtaluminal hypoechoic area, (7) identification of intraplaque haemorrhage using MRI and (8) carotid ulceration. The evidence suggests that approximately 10%–15% of patents with asymptomatic stenosis might benefit from intervention; this will become more clear after publication of ongoing studies comparing stenting or endarterectomy with best medical therapy. In the meantime, no patient should be offered intervention unless there is evidence of high risk of ipsilateral stroke, from modalities such as those discussed here.
Endarterectomy versus stenting for stroke prevention
Authors: Naylor A Ross
Published: February 2018

The European Society for Vascular Surgery (ESVS) has recently prepared updated guidelines for the management of patients with symptomatic and asymptomatic atherosclerotic carotid artery disease, with specific reference to the roles of best medical therapy, carotid endarterectomy (CEA) and carotid artery stenting (CAS). In symptomatic patients, there is a drive towards performing carotid interventions as soon as possible after onset of symptoms. This is because it is now recognised that the highest risk period for recurrent stroke is the first 7–14 days after onset of symptoms. The guidelines advise that there is a role for both CEA and CAS, but the levels of evidence are slightly lower for CAS than for CEA. This is because 30-day risks of death/stroke in the randomised controlled trials (RCTs) were significantly higher than after CEA (especially in the first 7–14 days after onset of symptoms) and there are concerns that the results obtained in the RCTs may not be generalisable into routine clinical practice. In asymptomatic patients, the 2018 ESVS guidelines were the first to recommend that CEA/CAS should be targeted into a smaller cohort of patients who may be ‘higher risk for stroke’ on medical therapy. As with symptomatic patients, the ESVS guidelines advise that there is a potential role for both CEA and CAS, but the levels of evidence are again slightly lower for CAS than for CEA. This is because 30-day risks of death/stroke in the two largest RCTs, which used credentialed (experienced CAS practitioners), were only just within the accepted 3% risk threshold and there remain concerns that the results obtained in RCTs may not be generalisable into routine clinical practice.
Probabilistic bridge weigh-in-motion
Authors: OBrien Eugene J. , Zhang Longwei , Zhao Hua , Hajializadeh Donya
Published: February 2018

Conventional bridge weigh-in-motion (BWIM) uses a bridge influence line to find the axle weights of passing vehicles that minimize the sum of squares of differences between theoretical and measured responses. An alternative approach, probabilistic bridge weigh-in-motion (pBWIM), is proposed here. The pBWIM approach uses a probabilistic influence line and seeks to find the most probable axle weights, given the measurements. The inferred axle weights are those with the greatest probability amongst all possible combinations of values. The measurement sensors used in pBWIM are similar to BWIM, containing free-of-axle detector sensors to calculate axle spacings and vehicle speed and weighing sensors to record deformations of the bridge. The pBWIM concept is tested here using a numerical model and a bridge in Slovenia. In a simulation, 200 randomly generated 2-axle trucks pass over a 6 m long simply supported beam. The bending moment at mid-span is used to find the axle weights. In the field tests, 77 pre-weighed trucks traveled over an integral slab bridge and the strain response in the soffit at mid-span was recorded. Results show that pBWIM has good potential to improve the accuracy of BWIM.
Secondary dips and the asymptotics
Authors: Troshin S. M. , Tyurin N. E.
Published: February 2018

We point out how to detect experimentally the energy region where asymptotics start to manifest themselves by relating the appearance of the secondary dips in the differential cross-section of elastic scattering [Formula: see text] with the beginning of the asymptotic energy region. The consideration relies on differential characteristics. The impact parameter picture of proton–proton interactions is used.
Mechanisms of Organizational Culture for Fostering Corporate Entrepreneurship: A Systematic Review and Research Agenda
Authors: Arz Christopher
Published: February 2018

Organizational culture ranks among the highly relevant factors for fostering corporate entrepreneurship and has attracted increasing research interest in recent years. Despite a growing body of scholarly work, to date there is limited understanding of which specific cultural mechanisms create an organizational environment where entrepreneurial activities flourish. The current state of knowledge is characterized by diverse, and partly conflicting, theoretical predictions and empirical findings. Furthermore, the complex and contested nature of organizational culture makes it difficult to derive useful propositions for managerial actions that will serve practitioners and theorists alike. To address these issues and encourage future work, this study uses a systematic review and develops an analytical framework, thereby considering eight general dimensions of organizational culture across different levels. As the theorization on these dimensions is unsuited to addressing practical realities, this article is built upon a realist account so as to shed light on the specific mechanisms through which the general cultural dimensions operate. This approach allows for more a fine-grained understanding of how organizational culture fosters corporate entrepreneurship and enables future research avenues to be identified.
Prediction of breakdown strength of cellulosic insulating materials using artificial neural networks
Authors: Singh Sakshi , Mohsin M. M. , Masood Aejaz
Published: February 2018

In this research work, a few sets of experiments have been performed in high voltage laboratory on various cellulosic insulating materials like diamond-dotted paper, paper phenolic sheets, cotton phenolic sheets, leatheroid, and presspaper, to measure different electrical parameters like breakdown strength, relative permittivity, loss tangent, etc. Considering the dependency of breakdown strength on other physical parameters, different Artificial Neural Network (ANN) models are proposed for the prediction of breakdown strength. The ANN model results are compared with those obtained experimentally and also with the values already predicted from an empirical relation suggested by Swanson and Dall. The reported results indicated that the breakdown strength predicted from the ANN model is in good agreement with the experimental values.
TrustyFeer: A Subjective Logic Trust Model for Smart City Peer‐to‐Peer Federated Clouds
Authors: Kurdi Heba , Alshayban Bushra , Altoaimy Lina , Alsalamah Shada
Published: February 2018

Cloud computing plays a major role in smart cities development by facilitating the delivery of various services in an efficient and effective manner. In a Peer‐to‐Peer (P2P) federated clouds ecosystem, multiple Cloud Service Providers (CSPs) collaborate and share services among them when experiencing a shortage in certain resources. Hence, incoming service requests to this specific resource can be delegated to other members. Nevertheless, the lack of preexisting trust relationship among CSPs in this distributed environment can affect the quality of service (QoS). Therefore, a trust management system is required to assist trustworthy peers in seeking reliable communication partners. We address this challenge by proposing TrustyFeer, a trust management system that allows peers to evaluate the trustworthiness of other peers based on subjective logic opinions, formulated using peers’ reputations and Service Level Agreements (SLAs). To demonstrate the utility of TrustyFeer, we evaluate the performance of our method against two long‐standing trust management systems. The simulation results show that TrustyFeer is more robust in decreasing the percentage of services that do not conform to SLAs and increasing the success rate of exchanged services by good CSPs conforming to SLAs. This should provide a trustworthy federated clouds ecosystem for a better, more sustainable future.
Antihypertensive Medications and Change in Stages of Chronic Kidney Disease
Authors: Komaroff Marina , Tedla Fasika , Helzner Elizabeth , Joseph Michael A.
Published: February 2018

Objectives. The goal of this study is to estimate the change in the relationships between use of five classes of antihypertensive medications and stages of Chronic Kidney Disease (CKD) in American adults treated for hypertension. Methods. The US National Health and Nutrition Examination Survey (NHANES) data sets 1999–2012 were used with the final analytical sample of 3,045 participants. Population prevalence estimates were calculated using the NHANES survey design weights. Inferential analyses were done with binomial logistic regression models. Results. The odds of advanced (3, 4, and 5 combined) versus early CKD stages (1 and 2 combined) were significantly higher among patients treated with Angiotensin Receptor Blockers (ARB) versus those not treated with ARB in 2009–2012 (adjusted odds ratio (95% confidence interval) = 2.52 (1.32–4.80)). From 1999 to 2012, the increase in this relationship was significant (p=0.0023) for users of ARB polytherapy and in users of ARB in patients with albuminuria (p=0.0031). Conclusion. Aggressive pharmacological management of hypertension with ARB as add-on therapy may have accelerated kidney damage in American adults. However, prospective longitudinal studies are needed to establish proper temporal sequence in this relationship.
Testing for NRAS Mutations in Serous Borderline Ovarian Tumors and Low-Grade Serous Ovarian Carcinomas
Authors: Sadlecki Pawel , Grzanka Dariusz , Grabiec Marek
Published: February 2018

The Idylla NRAS Mutation Test, performed on the Biocartis Idylla system, is an in vitro diagnostic tool for the qualitative assessment of 18 NRAS mutations in codons 12, 13, 59, 61, 117, and 146. Low-grade serous ovarian cancer (LGSC) represents less than 10% of all serous ovarian carcinomas. LGSCs are believed to arise from preexisting cystadenomas or serous borderline tumors (SBOTs) that eventually progress to an invasive carcinoma. The molecular analysis of cancer-causing mutations and the development of targeted biological therapies constitute a milestone in the diagnosis and therapy of ovarian malignancies. According to some authors, NRAS may be an important oncogene for the progression of SBOT to a frankly invasive disease. The primary aim of this study was to verify if a fully integrated, real-time PCR-based Idylla system can be used for the rapid determination of the NRAS mutation status in patients with serous borderline ovarian tumors and low-grade serous ovarian carcinomas. The study included tissue specimens from 12 patients with histopathologically verified ovarian masses, operated on at the Department of Obstetrics and Gynecology, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz (Poland), between January 2009 and June 2012. The mean age of the study patients was 52.5 years (range 27–80 years). NRAS mutation in codon 13 (G13D, p.Gly13Asp; nucleotide: c.38G>A) was found in one patient, a woman with low-grade serous ovarian carcinoma. To the best of our knowledge, our experiment was the first published study using the novel Idylla NRAS Mutation Test for the evaluation of ovarian tumors in a clinical setting. The Idylla platform is an interesting ancillary first-line rapid and fully automated instrument to detect NRAS mutations in SBOTs and LGSCs. However, the clinical usefulness of this method still needs to be verified in larger groups of cancer patients.
Comparative Analysis of Cellular and Growth Factor Composition in Bone Marrow Aspirate Concentrate and Platelet-Rich Plasma
Authors: Sugaya Hisashi , Yoshioka Tomokazu , Kato Toshiki , Taniguchi Yu , Kumagai Hiroshi , Hyodo Kojiro , Ohneda Osamu , Yamazaki Masashi , Mishima Hajime
Published: February 2018

The purpose of this study was to quantify the stem cell and growth factor (GF) contents in the bone marrow aspirate concentrate (BMAC) and platelet-rich plasma (PRP) prepared from whole blood using a protocol established in our laboratory. We examined 10 patients with osteonecrosis of the femoral head who were treated by autologous BMAC transplantation at our hospital between January 2015 and June 2015. We quantified CD34+ and CD31−CD45−CD90+CD105+ cells in BMAC and PRP by flow cytometry. Additionally, we measured various GFs, that is, basic fibroblast growth factor (b-FGF), platelet-derived growth factor-BB (PDGF-BB), vascular endothelial growth factor (VEGF), transforming growth factor-β1 (TGF-β1), and bone morphogenetic protein-2 (BMP-2) in BMAC and PRP using enzyme-linked immunosorbent assays and statistical analyses. CD34+ and CD31−45−90+105+ cells accounted for approximately 1.9% and 0.03% of cells in BMAC and no cells in PRP. The concentration of b-FGF was higher in BMAC than in PRP (P<0.001), whereas no significant differences in the levels of PDGF-BB, VEGF, TGF-β1, and BMP-2 were observed between the two types of sample. BMAC had an average of 1.9% CD34+ and 0.03% CD31−45−90+105+ cells and higher levels of b-FGF than those of PRP.
De Novo Sequencing of a Sparassis latifolia Genome and Its Associated Comparative Analyses
Authors: Xiao Donglai , Ma Lu , Yang Chi , Ying Zhenghe , Jiang Xiaoling , Lin Yan-quan
Published: February 2018

Known to be rich in β-glucan, Sparassis latifolia (S. latifolia) is a valuable edible fungus cultivated in East Asia. A few studies have suggested that S. latifolia is effective on antidiabetic, antihypertension, antitumor, and antiallergen medications. However, it is still unclear genetically why the fungus has these medical effects, which has become a key bottleneck for its further applications. To provide a better understanding of this fungus, we sequenced its whole genome, which has a total size of 48.13 megabases (Mb) and contains 12,471 predicted gene models. We then performed comparative and phylogenetic analyses, which indicate that S. latifolia is closely related to a few species in the antrodia clade including Fomitopsis pinicola, Wolfiporia cocos, Postia placenta, and Antrodia sinuosa. Finally, we annotated the predicted genes. Interestingly, the S. latifolia genome encodes most enzymes involved in carbohydrate and glycoconjugate metabolism and is also enriched in genes encoding enzymes critical to secondary metabolite biosynthesis and involved in indole, terpene, and type I polyketide pathways. As a conclusion, the genome content of S. latifolia sheds light on its genetic basis of the reported medicinal properties and could also be used as a reference genome for comparative studies on fungi.
Ginkgo biloba Leaf Extract Protects against Myocardial Injury via Attenuation of Endoplasmic Reticulum Stress in Streptozotocin‐Induced Diabetic ApoE−/− Mice
Authors: Tian Jinfan , Liu Yanfei , Liu Yue , Chen Keji , Lyu Shuzheng
Published: February 2018

Diabetes was induced in high‐fat diet‐fed ApoE−/− mice via administration of low‐dose streptozotocin (STZ) for five days. Mice were then treated with GBE (200 or 400 mg/kg) by gastric gavage daily for 12 weeks. Mice in the untreated diabetic group received saline instead, and nondiabetic C57BL/6J mice served as controls. Collagen І and ІІІ mRNA expression was measured by real‐time PCR. TNF‐α, IL‐1β mRNA levels, and NF‐κB expression were determined to analyze intramyocardial inflammation. Hallmarks of endoplasmic reticulum stress‐ (ERS‐) related apoptosis pathways, including phosphorylated c‐Jun N‐terminal kinase (p‐JNK), C/EBP homologous protein (CHOP), caspase‐12, and cleaved caspase‐3, were analyzed by Western blotting. Diabetic ApoE−/− myocardial injury was associated with increased cardiomyocyte apoptosis (increased expression of p‐JNK, CHOP, caspase‐12, and cleaved caspase‐3), interstitial fibrosis (increased mRNA levels of collagen І and ІІІ), and inflammation (increased mRNA levels of TNF‐α and IL‐1β, and NF‐κB expression). GBE at 200 and 400 mg/kg/day significantly attenuated cardiomyocyte apoptosis, collagen deposition, and inflammation in diabetic mice via inhibition of the p‐JNK, CHOP, and caspase‐12 pathways. Serum levels of the proinflammatory cytokines (IL‐6, IL‐1β, and TNF‐α), blood glucose, and lipid profiles were also regulated by GBE treatment. GBE might be beneficial in the treatment of diabetic myocardial injury.
The Relationship between Serum Zinc Level and Heart Failure: A Meta-Analysis
Authors: Yu Xuefang , Huang Lei , Zhao Jinyan , Wang Zhuoqun , Yao Wei , Wu Xianming , Huang Jingjing , Bian Bo
Published: February 2018

Zinc is essential for the maintenance of normal cellular structure and functions. Zinc dyshomeostasis can lead to many diseases, such as cardiovascular disease. However, there are conflicting reports on the relationship between serum zinc levels and heart failure (HF). The purpose of the present study is to explore the relationship between serum zinc levels and HF by using a meta-analysis approach. PubMed, Web of Science, and OVID databases were searched for reports on the association between serum zinc levels and HF until June 2016. 12 reports with 1453 subjects from 27 case-control studies were chosen for the meta-analysis. Overall, the pooled analysis indicated that patients with HF had lower zinc levels than the control subjects. Further subgroup analysis stratified by different geographic locations also showed that HF patients had lower zinc levels than the control subjects. In addition, subgroup analysis stratified by HF subgroups found that patients with idiopathic dilated cardiomyopathy (IDCM) had lower zinc levels than the control subjects, except for patients with ischemic cardiomyopathy (ICM). In conclusion, the results of the meta-analysis indicate that there is a significant association between low serum zinc levels and HF.
Analysis of Changes in Retinal Thickness in Type 2 Diabetes without Diabetic Retinopathy
Authors: Jiang Jing , Liu Yan , Chen Yingchao , Ma Bo , Qian Yiwen , Zhang Zhenzhen , Zhu Dongqing , Wang Zhiliang , Xu Xiaofang
Published: February 2018

Objective. To examine the changes in retinal thickness of patients with diabetes without DR. Designs. A randomization, crossover, retrospective practice. Participants. 43 diabetic patients and 43 ethnic-, age-, and sex-matched controls. Methods. Full retinal thicknesses of ten areas were assessed using spectral domain optical coherence tomography. Confounding variables, such as age, gender, and glycated haemoglobin (HbA1c) level, were assessed by regression analysis. Main Outcome Measures. Mean retinal thickness of ten areas. Results. The mean thickness of the fovea was 215.8 ± 18.9 μm in the diabetes group and 222.0 ± 18.6 μm in the control group (p=0.04). The mean thickness of the temporal parafovea was 319.9 ± 16.7 μm in the diabetes group and 326.0 ± 14.4 μm in the control group (p=0.01). The mean thickness of the temporal perifovea was 276.4 ± 27.9 μm in the diabetes group and 284.8 ± 17.4 μm in the control group (p=0.02). There were no significant differences in retinal thickness between groups in other areas (p>0.05). Regression analysis revealed that decreased retinal thickness of the temporal perifovea was associated with a higher HbA1c level (>8.7%) (p=0.04). Conclusion and Relevance. Subtle structural changes in the retina may occur in diabetes without DR. Decreased retinal thickness appeared to begin in the fovea and temporal areas. A high HbA1c level was the main factor influencing retinal thickness.
Efficacy and Safety of Argon Plasma Coagulation for Hemorrhagic Chronic Radiation Proctopathy: A Systematic Review
Authors: Peng Yanan , Wang Haizhou , Feng Juerong , Fang Shilin , Zhang Meng , Wang Fan , Chang Ying , Shi Xianyan , Zhao Qiu , Liu Jing
Published: February 2018

Hemorrhagic chronic radiation proctopathy (CRP) is a common complication after pelvic radiotherapy in patients with prostate or gynecological cancers. This systematic review was conducted to evaluate the efficacy and safety of argon plasma coagulation (APC) in treating hemorrhagic CRP. The databases of PubMed, Embase, and Cochrane Library were searched for related studies from inception to July 2017. Finally, 33 studies were identified with a total of 821 hemorrhagic CRP patients. After APC treatment, hemoglobin levels increased from 7.7–13.4 g/L to 11–14 g/L (including 15 studies). All (n=33) studies reported an effective rate in rectal bleeding, among which five studies had a rate of 100%. Short-term complications were reported in 31 studies, while long-term complications in 33 studies and no complication in 11 studies. As for the severe complications, perforation was reported by 2 out of 33 studies, and the incidences were 3.3% (1/30) and 3.7% (1/27), respectively. As for APC setting, argon gas flow rate (median 1.5 L/min) and electric power (median 50 W) had no significant influence on complications and hemostasis. In conclusion, current literature indicated that APC therapy was an effective and safe strategy for hemorrhagic CRP, and large-scale prospective studies are needed to warrant our study.
Bacterial Profile, Antibacterial Resistance Pattern, and Associated Factors from Women Attending Postnatal Health Service at University of Gondar Teaching Hospital, Northwest Ethiopia
Authors: Bitew Kifilie Abebaw , Dagnew Mulat , Tegenie Birhanemeskel , Yeshitela Biruk , Howe Rawleigh , Abate Ebba
Published: February 2018

Introduction. Surgical site infection is a vital cause of maternal mortality and morbidity, especially in resource-limited countries. The rise of antibiotic resistance bacterial infection poses a big threat to this vulnerable population. However, there is lack of studies around the study area. Objective. The purpose of this study was to identify bacterial profile, antibacterial resistance pattern, and associated factors among mothers attending postnatal care health service. Methods. Institutional based cross-sectional study was conducted on 107 study participants at University of Gondar Teaching Hospital from 1 January 2016 to 30 May 2016. Wound swab, aspirate, and biopsy were collected and performed for culture and drug resistance testing. Data were entered and analyzed by using SPSS version 20. Bivariate and multivariate logistic regression models were fitted to determine the associated factors for bacterial infection. Odds ratio (95% CI) was calculated to determine the strength of statistically significant associated factors. Result. Bacterial growth was confirmed in 90 (84.1%) of 107 study participants suspected to have surgical site infection. The predominant bacterial isolates were S. aureus (41.6%), E. coli (19.8%), K. pneumoniae (13.9%), coagulase negative Staphylococcus (12.9%), and Enterobacter spp. (4%). The majority of isolates were resistant to ampicillin, amoxicillin, and tetracycline but susceptible to ceftriaxone and amikacin. Multidrug-resistant bacteria species were isolated. Using a procedure such as cesarean section and episiotomy for delivery and premature rapture of membrane had strong association with bacterial infection. Conclusion. The high prevalence of bacterial profile and isolation of multidrug-resistant bacteria pose a big threat to postnatal mothers and their children. Factors such as cesarean section, episiotomy for delivery, and premature rapture of membrane were predictors for bacterial infection. Therefore, there should be done a continuous surveillance as well as rational use of antibiotics and a longitudinal study using phenotypic and genotypic methods will be done.
Bayesian Correction for Misclassification in Multilevel Count Data Models
Authors: Nelson Tyler , Song Joon Jin , Chin Yoo-Mi , Stamey James D.
Published: February 2018

Covariate misclassification is well known to yield biased estimates in single level regression models. The impact on hierarchical count models has been less studied. A fully Bayesian approach to modeling both the misclassified covariate and the hierarchical response is proposed. Models with a single diagnostic test and with multiple diagnostic tests are considered. Simulation studies show the ability of the proposed model to appropriately account for the misclassification by reducing bias and improving performance of interval estimators. A real data example further demonstrated the consequences of ignoring the misclassification. Ignoring misclassification yielded a model that indicated there was a significant, positive impact on the number of children of females who observed spousal abuse between their parents. When the misclassification was accounted for, the relationship switched to negative, but not significant. Ignoring misclassification in standard linear and generalized linear models is well known to lead to biased results. We provide an approach to extend misclassification modeling to the important area of hierarchical generalized linear models.
A Brief Review on the Pathological Role of Decreased Blood Flow Affected in Retinitis Pigmentosa
Authors: Yang Yi Jing , Peng Jun , Ying Deng , Peng Qing Hua
Published: February 2018

Retinitis pigmentosa (RP) represents a clinically and genetically heterogeneous disease characterized by progressive photoreceptor loss. In recent years, research has been rarely made in blood flow affected in RP. The specific mechanism of blood flow affected in RP is not completely clear. A number of studies indicated that the decreased blood flow was related to RP. According to clinical observation and treatment experience, Chinese medicine considered that blood stasis runs throughout the RP disease progression, and the blood stasis corresponding to Chinese herbal medicine has a positive effect on the clinical treatment of RP. Therefore, we proposed that the decreased blood flow may participate in the lesion. In this article, we will review the findings on the decreased blood flow affected in RP from the perspective of modern medicine and Chinese medicine.
Strength Characteristics and Slope Stability of Expansive Soil from Pingdingshan, China
Authors: Zhai Ju-yun , Cai Xiang-yong
Published: February 2018

By analyzing the characteristics of expansive soil from Pingdingshan, China, the shear strength parameters at different water contents, dry densities, and dry‐wet cycles of expansive soil are obtained. It is found that, at higher soil‐water content, the internal friction angle is 0° and the shallow layer of expansive soil slope will collapse and destroy; this has nothing to do with the height of the slope and the size of the slope. The parameters of soil influenced by atmosphere are the ones which have gone through dry‐wet cycles, and the parameters of soil without atmospheric influence are the same as those of natural soil. In the analysis of slope stability, the shear strength parameters of soil can be determined by using the finite element method, and the stability coefficient of the expansive soil slope can be calculated.
When Do Orthopaedic Oncologists Consider the Implantation of Expandable Prostheses in Bone Sarcoma Patients?
Authors: Gilg Magdalena M. , Wibmer Christine , Bergovec Marko , Grimer Robert J. , Leithner Andreas
Published: February 2018

Introduction. Indications discussed for the implantation of expandable prostheses in bone sarcoma patients are unclear. This survey aimed to analyse common practice with this implant type in orthopaedic oncology. Methods. A web-based survey was sent to 98 orthopaedic oncology surgeons. Factors reported in literature to influence the decision on the implantation of a growing prosthesis were covered in individual questions and three case scenarios. Results. The completion rate of the survey was 45% (n = 44). Twenty-seven of 44 surgeons (61%) had implanted between 1 and 15 expandable prostheses within three years. The minimum median patient age was 6.5 years, and 3–5 cm of predicted growth deficit was the minimum before implanting a growing prosthesis. One-third of surgeons do not use growth calculation methods. Two out of three surgeons would rather not implant a growing prosthesis in children with metastatic disease. Conclusions. Our survey confirmed the literature with 3-4 cm as the minimum estimated growth deficit. The minimum age for the implantation of a growing prosthesis is approx. 6.6 years, and therefore the patients are younger than those reported in previous publications. One-quarter of orthopaedic surgeons do not use growing prostheses at all. It remains unclear whether growing prostheses are indicated in patients with metastatic disease.
Joint Scheduling Optimization of Virtual Power Plants and Equitable Profit Distribution Using Shapely Value Theory
Authors: Tan Zhong-fu , Li Huan-huan , Ju Li-wei , Tan Qing-kun
Published: February 2018

The installation capacity of wind and solar photovoltaic power is continually increasing, which makes renewable energy grid connection and power generation an important link of China’s power structure optimization. A virtual power plant (VPP) is an important way to help distributed energy resource grid connection and promote renewable energy industry development. To study the economic scheduling problem of various distributed energy resources and the profit distribution problem of VPP alliance, this study builds a separate operation scheduling model for individual VPP and a joint operation scheduling model for VPP alliance, as well as the profit distribution model. The case study verifies the feasibility and effectiveness of the proposed model. The sensitivity analysis provides information about VPP decision-making in accordance with the policy environment development trend.
Leveraging KVM Events to Detect Cache-Based Side Channel Attacks in a Virtualization Environment
Authors: Paundu Ady Wahyudi , Fall Doudou , Miyamoto Daisuke , Kadobayashi Youki
Published: February 2018

Cache-based side channel attack (CSCa) techniques in virtualization systems are becoming more advanced, while defense methods against them are still perceived as nonpractical. The most recent CSCa variant called Flush + Flush has showed that the current detection methods can be easily bypassed. Within this work, we introduce a novel monitoring approach to detect CSCa operations inside a virtualization environment. We utilize the Kernel Virtual Machine (KVM) event data in the kernel and process this data using a machine learning technique to identify any CSCa operation in the guest Virtual Machine (VM). We evaluate our approach using Receiver Operating Characteristic (ROC) diagram of multiple attack and benign operation scenarios. Our method successfully separate the CSCa datasets from the non-CSCa datasets, on both trained and nontrained data scenarios. The successful classification also include the Flush + Flush attack scenario. We are also able to explain the classification results by extracting the set of most important features that separate both classes using their Fisher scores and show that our monitoring approach can work to detect CSCa in general. Finally, we evaluate the overhead impact of our CSCa monitoring method and show that it has a negligible computation overhead on the host and the guest VM.
Design and Optimization of Annular Flow Electromagnetic Measurement System for Drilling Engineering
Authors: Ge Liang , Li Hailong , Wang Qing , Wei Guohui , Hu Ze , Liao Junbi , Li Junlan
Published: February 2018

Using the downhole annular flow measurement system to get real-time information of downhole annular flow is the core and foundation of downhole microflux control drilling technology. The research work of electromagnetic flowmeter in recent years creates a challenge to the design of downhole annular flow measurement. This paper proposes a design and optimization of annular flow electromagnetic measurement system for drilling engineering based on the finite element method. Firstly, the annular flow measuring and optimization principle are described. Secondly, a simulation model of an annular flow electromagnetic measurement system with two pairs of coil is built based on the fundamental equation of electromagnetic flowmeter by COMSOL. Thirdly, simulations of the structure of excitation system of the measurement system are carried out, and simulations of the size of the electrode’s radius are also carried out based on the optimized structure, and then all the simulation results are analyzed to evaluate the optimization effect based on the evaluation indexes. The simulation results show that optimized shapes of the excitation system and electrode size can yield a better performance in the annular flow measurement.