bluuebunny/crossref_metadata_2025 huggingface dataset:
Acute hyperkinetic movement disorders in Italian paediatric emergency departments
Authors: Raucci Umberto , Parisi Pasquale , Vanacore Nicola , Garone Giacomo , Bondone Claudia , Palmieri Antonella , Calistri Lucia , Suppiej Agnese , Falsaperla Raffaele , Capuano Alessandro , Ferro Valentina , Urbino Antonio Francesco , Tallone Ramona , Montemaggi Alessandra , Sartori Stefano , Pavone Piero , Mancardi Margherita , Melani Federico , Ilvento Lucrezia , Pelizza Maria Federica , Reale Antonino
Published: March 2018

Introduction

Limited data exist on epidemiology, clinical presentation and management of acute hyperkinetic movement disorders (AHMD) in paediatric emergency departments (pED).

Methods

We retrospectively analysed a case series of 256 children (aged 2 months to 17 years) presenting with AHMD to the pEDs of six Italian tertiary care hospitals over a 2-year period (January 2012 to December 2013).

Results

The most common type of AHMD was tics (44.5%), followed by tremors (21.1%), chorea (13.7%), dystonia (10.2%), myoclonus (6.3%) and stereotypies (4.3%). Neuropsychiatric disorders (including tic disorders, psychogenic movement disorders and idiopathic stereotypies) were the most represented cause (51.2%). Inflammatory conditions (infectious and immune-mediated neurological disorders) accounted for 17.6% of the cases whereas non-inflammatory disorders (including drug-induced AHMDs, genetic/metabolic diseases, paroxysmal non-epileptic movements and idiopathic AHMDs) accounted for 31.2%. Neuropsychiatric disorders prevailed among preschoolers and schoolers (51.9% and 25.2%, respectively), non-inflammatory disorders were more frequent in infants and toddlers (63.8%), whereas inflammatory conditions were more often encountered among schoolers (73.3%). In 5 out of 36 Sydenham’s chorea (SC) cases, tics were the presentation symptom on admission to emergency department (ED), highlighting the difficulties in early diagnosis of SC. Inflammatory disorders were associated with a longer hospital stay and a greater need of neuroimaging test compared with other disorders.

Conclusions

This study provides the first large sample of paediatric patients presenting to the ED for AHMDs, helping to elucidate the epidemiology, aetiology and clinical presentation of these disorders.
Mental health and well-being concerns of fly-in fly-out workers and their partners in Australia: a qualitative study
Authors: Gardner Benjamin , Alfrey Kristie-Lee , Vandelanotte Corneel , Rebar Amanda L
Published: March 2018

Objectives

Fly-in fly-out (FIFO) work involves commuting long distances to the worksite and living in provided accommodation for 1–4 weeks while on shift. While the potentially detrimental impact of FIFO work on the health and well-being of workers has been documented, little attention has been paid to how workers, or their partners, cope with this impact. This study sought to investigate how workers and their partners negotiate the impact of FIFO on their mental health and well-being.

Design

The study design was qualitative. FIFO workers and partners responded to open-ended questions on concerns about the FIFO lifestyle and the support they use.

Setting

Australian FIFO workers and partners responded to the questions via email.

Participants

Participants were 34 FIFO workers (25 men,Mage=41 years) and 26 partners of FIFO workers (26 women,Mage=40 years).

Results

Participant-validated thematic analysis generated three main themes: managing multiple roles, impact on mental health and well-being, and social support needs. Results revealed difficulties in adjusting between the responsibilities of perceptually distinct on-shift and off-shift lives, and managing potential psychological distance that develops while workers are on site. Participants emphasised the importance of maintaining quality communication and support from family members. Workers and partners attempted to maintain mental health and well-being by regularly engaging with support networks, although many felt organisational support was tokenistic, stigmatised or lacking.

Conclusions

Recommendations for enhancing support provided by FIFO organisations are offered. In particular, organisations should emphasise the importance of good mental health and well-being, maintain transparency regarding potential challenges of FIFO lifestyles, and offer professional support for managing multiple social roles and effective communication.
Phosphodiesterase-5 inhibitors and the heart: compound cardioprotection?
Authors: Hutchings David Charles , Anderson Simon George , Caldwell Jessica L , Trafford Andrew W
Published: March 2018

Novel cardioprotective agents are needed in both heart failure (HF) and myocardial infarction. Increasing evidence from cellular studies and animal models indicate protective effects of phosphodiesterase-5 (PDE5) inhibitors, drugs usually reserved as treatments of erectile dysfunction and pulmonary arterial hypertension. PDE5 inhibitors have been shown to improve contractile function in systolic HF, regress left ventricular hypertrophy, reduce myocardial infarct size and suppress ischaemia-induced ventricular arrhythmias. Underpinning these actions are complex but increasingly understood cellular mechanisms involving the cyclic GMP activation of protein kinase-G in both cardiac myocytes and the vasculature. In clinical trials, PDE5 inhibitors improve symptoms and ventricular function in systolic HF, and accumulating epidemiological data indicate a reduction in cardiovascular events and mortality in PDE5 inhibitor users at high cardiovascular risk. Here, we focus on the translation of underpinning basic science to clinical studies and report that PDE5 inhibitors act through a number of cardioprotective mechanisms, including a direct myocardial action independent of the vasculature. We conclude that future clinical trials should be designed with these mechanisms in mind to identify patient subsets that derive greatest treatment benefit from these novel cardioprotective agents.
Systematic review and meta-analysis on outcome differences among patients with TICI2b versus TICI3 reperfusions: success revisited
Authors: Kaesmacher Johannes , Dobrocky Tomas , Heldner Mirjam R , Bellwald Sebastian , Mosimann Pascal J , Mordasini Pasquale , Bigi Sandra , Arnold Marcel , Gralla Jan , Fischer Urs
Published: March 2018

Objective

A reperfusion quality of thrombolysis in cerebral infarction (TICI)≥2b has been set as the therapeutic angiography target for interventions in patients with acute ischaemic stroke. This study addresses whether the distinction between TICI2b and TICI3 reperfusions shows a clinically relevant difference on functional outcome.

Methods

A systematic literature review and meta-analysis was carried out and presented in conformity with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria to test the primary hypothesis that TICI2b and TICI3 reperfusions are associated with different rates of modified Rankin Scale (mRS) ≤2 at day 90. Secondary endpoints included rates of haemorrhagic transformations, mortality and excellent functional outcome (mRS ≤1). Summary estimates of ORs (sOR) with 95% CI were calculated using the inverse variance heterogeneity model accounting for multiple true effect sizes.

Results

Fourteen studies on 2379 successfully reperfused patients were included (1131 TICI3, 1248 TICI2b). TICI3 reperfusions were associated with higher rates of functional independence (1.74, 95% CI 1.44 to 2.10) and excellent functional outcomes (2.01, 95% CI 1.60 to 2.53), also after including adjusted estimates. The safety profile of patients with TICI3 was superior, as demonstrated by lower rates of mortality (sOR 0.59, 95% CI 0.37 to 0.92) and symptomatic intracranial haemorrhages (sOR 0.42, 95% CI 0.25 to 0.71).

Conclusion

TICI3 reperfusions are associated with superior outcome and better safety profiles than TICI2b reperfusions. This effect seems to be independent of time and collaterals. As reperfusion quality is the most important modifiable predictor of patients’ outcome, a more conservative definition of successful therapy and further evaluation of treatment approaches geared towards achieving TICI3 reperfusions are desirable.
Oxo-analogues of 20-hydroxyecdysone in the synthesis of novel fluorinated ecdysteroid derivatives
Authors: Savchenko Rimma G. , Apaeva Anastasia V. , Kostyleva Svetlana A. , Mozgovoj Oleg S. , Odinokov Victor N. , Parfenova Lyudmila V.
Published: March 2018

Novel side chain ω-fluorinated ecdysteroid analogues were obtained starting from ω-functionalized ecdysteroids. Thus, the reaction of diacetonides of 25RS-hydroxy- and 24-hydroxy 27-nor- and 25,26,27-tris-nor-20-hydroxyecdysone derivatives with diethylaminosulfur trifluoride (DAST) involves replacement of the terminal hydroxyl group and dehydration at the 14-position to give 25RS-fluoro- and 24-fluoro-14-anhydro analogues of ecdysteroids.
Research Notes: User Identification Model Based on Mouse Behaviors
Authors: Wang Bailing , Liu Hongri , Wang Kaixin , Xin Guodong , Song Jia
Published: March 2018

This study investigates the user identification method based on the computer mouse dynamic behaviors. One of the purposes is to refine seven types of mouse actions, and about 110 dimensional features have been employed from user session statistics and operating characteristics. And then, two basic techniques, principal component analysis (PCA) and weighted multiclassifier, are used to lay out the mouse behavior. Combing PCA and the new proposed classifier, two experiments on identification and authentication have been carried out. By validating the selected mouse data, the accuracy rate is as high as 85% in the identification experiment, and the false rejection rate (FRR) reaches 5.5% and false acceptance rate (FAR) reaches 8.8% in the authentication experiment. The results show that the proposed methods and the selected features can be well applied in practice.
Research Notes: Distributed Shadow for Router Security Defense
Authors: Li Yufeng , Tian Le , Qiu Han , Zhang Chuanhao
Published: March 2018

Router security defense technologies emerging in recent years could hardly detect and block the new booming threats with unknown signatures such as hardware Trojan, zero-day attacks, etc. We present a novel router defense technology, distributed router shadow, which builds a closed execution environment to deceive attacks entering into the router, thereby misleading the attackers into regarding it as the real attack target and executing the suspicious code to maximize the chances of detonating the system exploit; thus the original router is prevented from attacking and the suspicious code can be detected. Our experiment and analysis show that the router shadow can defend not only attacks with signature but also some new attacks without signature.
Research Notes: User Influence in Microblog Based on Interest Graph
Authors: Zhai Lidong , Wang Jingya , Hu Chaojian , Li Jun
Published: March 2018

Microblog is currently the largest social networking platform in China. In recent years, as a social media, the influence of microblog continues to expand. The users who have large influence play a guiding role in the spread of microblog, and even guide the trends of public opinion. Therefore, we propose an influence analysis method to find microblog users who are with great influence, which is of great significance for the research and mining of microblog. User influence analysis in microblog has great difficulties due to the limited amount of microblog information, quick updates and nonstandard microblog language. First, we use the label propagation algorithm combined with LDA algorithm to divide users by the user interest graph, according to the social relationship of microblog users and the content they generate. Then, depending on different interest areas, an improved PageRank algorithm based on user interaction behavior is proposed to calculate the user’s influence. Experiments on the real datasets show that the proposed method outperforms the traditional algorithms.
Android-SRV: Scenario-Based Runtime Verification of Android Applications
Authors: Zhang Pengcheng , Cheng Kun , Gao Jerry
Published: March 2018

With the wide-spread usage of Android systems, Android applications have become the target of mobile malwares. Therefore, an effective verification approach for Android applications is essential. Runtime verification based on monitors is one of the most promising techniques to check the software’s behaviors. Currently, there are a number of monitoring approaches for Android applications. However, these approaches mainly have two limitations. First, there is no effective mechanism to reduce the load on Android applications caused by monitors. Second, these approaches mainly rely on logic-based specifications, which are complex and not intuitive for being used in practice.

In order to address these two limitations, this paper proposes a scenario-based runtime verification approach for Android applications (called Android-SRV). The approach concentrates on providing a dynamic and usable solution for monitoring applications during execution with the help of aspect-oriented programming. It will translate the scenario-based specification (called property sequence charts (PSCs)) into multi-valued automata (MAs), and then generate AspectJ codes from the MA. Finally, these AspectJ codes are weaved into the target system as monitors. Considering the impact of the monitors on performance load in the Android system, the paper proposes local and cloud collaboration mechanisms to reduce the impact. The scenario-based specification is more intuitive than the traditional logic-based specifications. The approach is shown to be an effective means for monitoring Android applications with controlled overload.
The Value of Ozone in CT-Guided Drainage of Multiloculated Pyogenic Liver Abscesses: A Randomized Controlled Study
Authors: Li Bing , Liu Chuan , Wang Lang , Li Yang , Du Yong , Zhang Chuan , Xu Xiao-xue , Yang Han Feng
Published: March 2018

Objective. This study was designed to compare the effects of catheter drainage alone and combined with ozone in the management of multiloculated pyogenic liver abscess (PLA). Methods. The prospective study included 60 patients diagnosed with multiloculated PLA. All patients were randomly divided into two groups: catheter drainage alone (group I) and catheter drainage combined with ozone (group II). Drainage was considered successful when (1) the abscess cavity was drained and (2) clinical symptoms were resolved. Kruskal-Wallis nonparametric test was used to compare the success rates, length of stay (LOS), and need for further surgery of the two groups. P<0.05 indicates significant difference. Results. All patients’ catheters were successfully placed under CT guidance. Group I was treated with catheters alone and group II was treated with catheters and ozone. The success rates of groups I and II were 86% and 96%, respectively (P<0.05). And compared with group II, the duration of fever in group I was longer (P<0.05), and the LOS was also longer (P<0.05). Conclusion. Catheter drainage combined with ozone is an effective and safe treatment in multiloculated PLA. The Clinical Registration Number is ChiCTR1800014865.
Ultrasonographic Characterization of thedb/dbMouse: An Animal Model of Metabolic Abnormalities
Authors: Faita Francesco , Di Lascio Nicole , Rossi Chiara , Kusmic Claudia , Solini Anna
Published: March 2018

The availability of an animal model able to reliably mirror organ damage occurring in metabolic diseases is an urgent need. These models, mostly rodents, have not been fully characterized in terms of cardiovascular, renal, and hepatic ultrasound parameters, and only sparse values can be found in literature. Aim of this paper is to provide a detailed, noninvasive description of the heart, vessels, liver, and kidneys of thedb/dbmouse by ultrasound imaging. Sixteen wild type and thirty-fourdb/dbmale mice (11-week-old) were studied. State-of-the-art ultrasound technology was used to acquire images of cardiovascular, renal, and hepatic districts. A set of parameters describing function of the selected organs was evaluated.db/dbmice are characterized by systolic and diastolic dysfunction, confirmed by strain analysis. Abdominal aortic and carotid stiffness do not seem to be increased in diabetic rodents; furthermore, they are characterized by a smaller mean diameter for both vessels. Renal microcirculation is significantly compromised, while liver steatosis is only slightly higher indb/dbmice than in controls. We offer here for the first time anin vivodetailed ultrasonographic characterization of thedb/dbmouse, providing a useful tool for a thoughtful choice of the right rodent model for any experimental design.
The Role of Immunosenescence in Neurodegenerative Diseases
Authors: Costantini Erica , D’Angelo Chiara , Reale Marcella
Published: March 2018

Aging is characterized by the progressive decline of physiological function and tissue homeostasis leading to increased vulnerability, degeneration, and death. Aging-related changes of the innate and adaptive immune system include decline in the preservation and enhancement of many immune functions, such as changes in the number of circulating monocytic and dendritic cells, thymic involution, T cell polyfunctionality, or production of proinflammatory cytokines, and are defined as immunosenescence. Inflammatory functions are increased with age, causing the chronic low-grade inflammation, referred to as inflamm-aging, that contribute, together with immunosenescence, to neurodegenerative diseases. In this review, we discuss the link between the immune and nervous systems and how the immunosenescence and inflamm-aging can contribute to neurodegenerative diseases.
Output-Feedback Nonlinear Adaptive Control Strategy of the Single-Phase Grid-Connected Photovoltaic System
Authors: Abouloifa Abdelmajid , Aouadi Chaouqi , Lachkar Ibtissam , Boussairi Yasser , Aourir Meriem , Hamdoun Abdellatif
Published: March 2018

This paper addresses the problem of controlling the single-phase grid connected to the photovoltaic system through a full bridge inverter with LCL-filter. The control aims are threefold: (i) imposing the voltage in the output of PV panel to track a reference provided by the MPPT block; (ii) regulating the DC-link voltage to guarantee the power exchange between the source and AC grid; (iii) ensuring a satisfactory power factor correction (PFC). The problem is dealt with using a cascade nonlinear adaptive controller that is developed making use of sliding-mode technique and observers in order to estimate the state variables and grid parameters, by measuring only the grid current, PV voltage, and the DC bus voltage. The control problem addressed by this work involves several difficulties, including the uncertainty of some parameters of the system and the numerous state variables are inaccessible to measurements. The results are confirmed by simulation under MATLAB∖Simulink∖SimPowerSystems, which show that the proposed regulator is robust with respect to climate changes.
Convolutional Recurrent Neural Networks for Observation-Centered Plant Identification
Authors: Liu Xuanxin , Xu Fu , Sun Yu , Zhang Haiyan , Chen Zhibo
Published: March 2018

Traditional image-centered methods of plant identification could be confused due to various views, uneven illuminations, and growth cycles. To tolerate the significant intraclass variances, the convolutional recurrent neural networks (C-RNNs) are proposed for observation-centered plant identification to mimic human behaviors. The C-RNN model is composed of two components: the convolutional neural network (CNN) backbone is used as a feature extractor for images, and the recurrent neural network (RNN) units are built to synthesize multiview features from each image for final prediction. Extensive experiments are conducted to explore the best combination of CNN and RNN. All models are trained end-to-end with 1 to 3 plant images of the same observation by truncated back propagation through time. The experiments demonstrate that the combination of MobileNet and Gated Recurrent Unit (GRU) is the best trade-off of classification accuracy and computational overhead on the Flavia dataset. On the holdout test set, the mean 10-fold accuracy with 1, 2, and 3 input leaves reached 99.53%, 100.00%, and 100.00%, respectively. On the BJFU100 dataset, the C-RNN model achieves the classification rate of 99.65% by two-stage end-to-end training. The observation-centered method based on the C-RNNs shows potential to further improve plant identification accuracy.
Comparative Study between Ethanolic andβ-Cyclodextrin Assisted Extraction of Polyphenols from Peach Pomace
Authors: El Darra Nada , Rajha Hiba N. , Debs Espérance , Saleh Fatima , El-Ghazzawi Iman , Louka Nicolas , Maroun Richard G.
Published: March 2018

Peach byproducts are often regarded as food waste despite their high content in health-promoting components. Amongst the latter, polyphenols are bioactive molecules with significant health benefits. The present study investigated an eco-friendly and cost-effective method using a GRAS food additive,β-cyclodextrin (β-CD), for the recovery of polyphenols from peach pomace.β-CD assisted extraction of polyphenols was compared to that of conventional solvent (ethanol) extraction at the same concentrations (10 mg/mL, 20 mg/mL, 30 mg/mL, 40 mg/mL, and 50 mg/mL) in terms of quality (antiradical activity) and quantity. The extract obtained by 50 mg/mLβ-CD assisted extraction showed the highest polyphenol (0.72 mg GAE/g DM) and flavonoid (0.35 mg catechin/g of DM) concentrations as maximal antiradical activity (6.82%) and a noted antibacterial activity. Our results showed the competitiveness ofβ-CD assisted extraction to recover a high quantity and quality of polyphenols from peach pomace suggestingβ-CD as a green alternative method for phenolic extraction.
Efficacy of Psychosocial Interventions for People with Multiple Sclerosis: A Meta-Analysis of Specific Treatment Effects
Authors: Sesel Amy-Lee , Sharpe Louise , Naismith Sharon L.
Published: March 2018

Background: Psychosocial interventions are often used as an adjunct to the medical management of multiple sclerosis (MS). However, the efficacy of such approaches for a range of psychosocial indications remains unclear. Objective: To determine the efficacy of psychosocial therapies for people with MS (PwMS). Methods: We searched 6 electronic databases (Medline, Embase, PsycINFO, Cochrane Central Register of Controlled Trials, CINAHL, and Clinicaltrials.gov) until April 21, 2016, for randomized controlled trials reporting the effect of psychological interventions for depressive symptoms, anxiety, pain, fatigue, or health-related quality of life (HRQoL) in PwMS. Results: The search yielded 356 articles with 13 included studies (n = 1,617). Benefits of psychological interventions were found for depressive symptoms (Cohen’s d = 0.281), anxiety (d = 0.285), fatigue (d = 0.228), and mental (d = 0.398) and total HRQoL (d = 0.444), but not physical HRQoL. There were insufficient studies to meta-analyze posttreatment outcomes for pain. Interventions were more effective for HRQoL for patients with relapsing-remitting MS and when treatment doses were larger. Cognitive behavioral therapy (CBT) was not efficacious for PwMS when considered alone. Conclusion: Psychosocial interventions have a significant, positive impact across a range of outcomes for PwMS with small, yet consistent, effect sizes. There was some indication that CBT was less efficacious than other interventions. However, this may be due to smaller treatment doses in CBT studies.
An Adaptive Multi-hop Clustered Voting to Improve the Message Trust in Vehicular Ad-hoc Networks
Authors: Mirzaei Fatemeh , Mollamotalebi Mahdi
Published: March 2018

The Vehicular Ad-hoc Network (VANET) is used in intelligent transportation systems to make communication between vehicles and make appropriate decisions with regard to road or traffic conditions. Some main research issues in VANETs are unreliability in communication, delay/precision of decision making, information overheads, and handling the nodes dynamicity. This paper aimed to provide an efficient voting method to improve the reliability of decision making for message voting. It also reduces the voting delay and network information overhead. The proposed method is simulated in NS2. The experimental results indicated that the proposed method’s decision making precision is improved between 6 % and 30 % compared to similar methods in the literature, under conditions such as traffic amount, number of nodes and operation period time. It also reduces the number of transferred packets between 1 % and 9 % in different environmental conditions.
O tirano e o látego: um estudo sobre a violência de Estado em dois romances de Dyonélio Machado
Authors: Salgado Marcus Rogerio
Published: March 2018

O presente artigo é um estudo sobre as representações da violência de Estado figuradas nos romances Desolação e Passos perdidos, do escritor sul rio-grandense Dyonélio Machado. Para tanto, faz-se necessário compreender a formação da consciência política do personagem Manivela nas duas narrativas, cujas ações ocorrem durante o período autoritário getulista, de forma a explicitar as articulações metonímicas que se verificam nas duas obras não apenas entre história e literatura, como também entre forma estética, análise da subjetividade e processo social.
Cartografias da cidadania diferenciada em Luiz Ruffato e Guillermo Saccomanno
Authors: Lehnen Leila
Published: March 2018

O ensaio examina a relação entre o espaço urbano e a constituição e/ou a erosão da cidadania em seleções da coleção Inferno provisório, de Luiz Ruffato, e a novela El pibe, do escritor argentino Guillermo Saccomano. Estes textos traçam uma cartografia literária dos espaços proletários e dos direitos cidadãos (assim como a falta destes) associados a estes espaços. Os livros demonstramficcionalmente o processo dinâmico da cidadania, sua implementação desigual e como a cartografia material e imaginária reflete, reforça e, por vezes, questiona estas configurações.
Kinesin-1 Is a New Actor Involved in Platelet Secretion and Thrombus Stability
Authors: Adam Frédéric , Kauskot Alexandre , Kurowska Mathieu , Goudin Nicolas , Munoz Isabelle , Bordet Jean-Claude , Huang Jian-Dong , Bryckaert Marijke , Fischer Alain , Borgel Delphine , de Saint Basile Geneviève , Christophe Olivier D. , Ménasché Gaël
Published: March 2018

Objective—

Platelet secretion is crucial for many physiological platelet responses. Even though several regulators of the fusion machinery for secretory granule exocytosis have been identified in platelets, the underlying mechanisms are not yet fully characterized.

Approach and Results—

By studying a mouse model (cKO [conditional knockout]
Kif5b
) lacking Kif5b (kinesin-1 heavy chain) in its megakaryocytes and platelets, we evidenced unstable hemostasis characterized by an increase of blood loss associated to a marked tendency to rebleed in a tail-clip assay and thrombus instability in an in vivo thrombosis model. This instability was confirmed in vitro in a whole-blood perfusion assay under blood flow conditions. Aggregations induced by thrombin and collagen were also impaired in cKO
Kif5b
platelets. Furthermore, P-selectin exposure, PF4 (platelet factor 4) secretion, and ATP release after thrombin stimulation were impaired in cKO
Kif5b
platelets, highlighting the role of kinesin-1 in α-granule and dense granule secretion. Importantly, exogenous ADP rescued normal thrombin induced-aggregation in cKO
Kif5b
platelets, which indicates that impaired aggregation was because of defective release of ADP and dense granules. Last, we demonstrated that kinesin-1 interacts with the molecular machinery comprising the granule-associated Rab27 (Ras-related protein Rab-27) protein and the Slp4 (synaptotagmin-like protein 4/SYTL4) adaptor protein.

Conclusions—

Our results indicate that a kinesin-1–dependent process plays a role for platelet function by acting into the mechanism underlying α-granule and dense granule secretion.
Risk Stratification for Bleeding Complications in Patients With Venous Thromboembolism: Application of the HAS‐BLED Bleeding Score During the First 6 Months of Anticoagulant Treatment
Authors: Brown Joshua D. , Goodin Amie J. , Lip Gregory Y. H. , Adams Val R.
Published: March 2018

Background

The Hypertension, Abnormal renal/liver function, Stroke, Bleeding, Labile International Normalized Ratio (INR), Elderly, Drugs or alcohol use (
HAS
‐
BLED
) score has strong predictive validity for major bleeding complications, but limited validation has been conducted in venous thromboembolism (
VTE
). This study evaluates the
HAS
‐
BLED
score in a large cohort of
VTE
patients.

Methods and Results

A retrospective cohort of adults ≥18 years with primary diagnosis of
VTE
between January 1, 2010 and November 31, 2013 were identified in an insurance claims database. Patients were tracked until death, any bleed event, or end of study period.
HAS
‐
BLED
score and components were evaluated via proportional hazard models. Cumulative incidence functions were reported at 30, 60, 90, and 180 days. N=132 280 patients with a
VTE
were identified, with 73.8% having
HAS
‐
BLED
scores of 0 to 2, 3.6% score ≥4, and 4789 bleeding events (3.6% all patients). A 1‐point
HAS
‐
BLED
score increase was associated with 20% to 30% bleeding rate increase overall, but in a cancer cohort only the increase from 3‐ to 4‐points was significant for all bleeds (cs
HR
=1.41, 95%
CI
: 1.17–1.69; sd
HR
=1.40, 95%
CI
: 1.17–1.69) and major bleeds (cs
HR
=1.66, 95%
CI
: 1.26–2.20; sd
HR
=1.66, 95%
CI
: 1.25–2.19). Adding cancer to the model as an independent covariate provided the strongest association among all covariates, with cs
HR
=2.25 (95%
CI
: 1.98–2.56) and sd
HR
=2.11 (95%
CI
: 1.85–2.41) in the model for major bleeds.

Conclusions

The
HAS
‐
BLED
score has good predictive validity for bleeding risks in patients with VTE. The addition of cancer as an independent bleeding risk factor merits consideration, possibly as part of the “B” criterion (“bleeding tendency or predisposition”).
Euryalid brittle stars from the International Indian Ocean Expedition 1963–64 (Echinodermata: Ophiuroidea: Euryalida)
Authors: BAKER ALAN N. , OKANISHI MASANORI , PAWSON DAVID L.
Published: March 2018

Fourteen species of euryalids are reported from collections made in the eastern and western Indian Ocean during the International Indian Ocean Expedition. Three new species are described: Astrocladus goodingi from the Comoro Islands, Astrocladus socotrana from the northwestern Indian Ocean near the island of Socotra, and Astrocyclus somaliensis from off northeastern Somalia. Range extensions are documented for Asteronyx luzonicus, Astroglymma sculptum, Astrocladus ludwigi, Asteromorpha capensis and Squamophis amamiensis.
A new species of Wahydra from Ecuador (Hesperiidae, Hesperiinae, Anthoptini)
Authors: CARNEIRO EDUARDO , DOLIBAINA DIEGO R. , GRISHIN NICK V. , WARREN ANDREW D.
Published: March 2018

Recent taxonomic studies on the genus Wahydra Steinhauser, 1991, have described five new species in the past two years, from high elevations in the Andes Mountains. A markedly distinct species of Wahydra is herein described and illustrated based on a single male specimen from Ecuadorian Andes, Wahydra graslieae A. Warren, Carneiro & Dolibaina, sp. nov. The new species is compared with other species of Wahydra, as well as with the somewhat similar species Lerema viridis (Bell, 1942) and Tigasis viridenex (Weeks, 1901).
Description of two new species of Lysmata Risso, 1816 (Decapoda, Lysmatidae) from the China seas, with remarks on Lysmata vittata (Stimpson 1860)
Authors: WANG YAN-RONG , SHA ZHONG-LI
Published: March 2018

Two new species of Lysmata Risso, 1816 are described and illustrated from the China seas. L. brevrostrus sp. nov. is characterized by the short rostrum not reaching the distal margin of the eyes, and the rostral ventral margin unarmed with tooth; L. parvispinosus sp. nov. is characterized by the dactylus of posterior three pereiopods tapering (not biunguiculate) and the flexor margin of the dactylus bearing two basal inconspicuous spinules. A morphologically variable species, L. vittata (Stimpson 1860), is discussed based on specimens collected from the China seas.
A review of Problepsis Lederer, 1853 (Lepidoptera: Geometridae) from China, with description of two new species
Authors: XUE DAYONG , CUI LE , JIANG NAN
Published: March 2018

The Chinese species of the genus Problepsis Lederer, 1853 are reviewed: 18 species are reported from China. Two new species, P. stueningi sp. nov. and P. batangnensis sp. nov. are described. One new combination is established: Problepsis transvehens (Prout, 1918) comb. nov. Two new synonyms are established: P. conjunctiva conjunctiva Warren, 1893 (= P. conjunctiva subjunctiva Prout, 1917 syn. n.), Problepsis discophora Fixsen, 1887 (= P. changmei Yang, 1978 syn. n.). Two species, P. plagiata (Butler, 1881) and P. apollinaria (Guenée, 1858), and one subspecies, P. discophora kardakoffi Prout, 1938, are newly recorded for China. Diagnoses for all discussed Chinese species are provided. External features and genitalia are depicted.
Ingroup relationships of Lagerpetidae (Avemetatarsalia: Dinosauromorpha): a further phylogenetic investigation on the understanding of dinosaur relatives
Authors: MÜLLER RODRIGO TEMP , LANGER MAX CARDOSO , DIAS-DA-SILVA SÉRGIO
Published: March 2018

Despite representing a key-taxon in dinosauromorph phylogeny, Lagerpertidae is one of the most obscure and enigmatic branches from the stem that leads to the dinosaurs. Recent new findings have greatly increased our knowledge about lagerpetids, but no phylogenetic analysis has so far included all known members of this group. Here, we present the most inclusive phylogenetic study so far conducted for Lagerpetidae. Phylogenetic analyses were performed based on three independent data matrixes. In two of them, Lagerpeton chanarensis Romer, 1971 is the sister taxon to all other known Lagerpetidae, whereas Ixalerpeton polesinensis Cabreira et al., 2016 is in a sister group relationship with a clade that includes PVSJ 883 and Dromomeron. Conversely, the other analysis supports an alternative topology, where I. polesinensis is the sister taxon to either L. chanarensis or all other Lagerpetidae. Although coeval and geographically close, I. polesinensis and PVSJ 883 do not form a clade exclusive of other lagerpetids. As previously suggested D. gigas Martínez, Apaldetti, Correa & Abelín, 2016 is the sister taxon of D. romeri Irmis et al., 2007. The phylogenetic analyses also indicate that the earliest lagerpetids are restricted to southwestern Pangea, whereas later forms spread across the entire western portion of the supercontinent. Finally, quantification of the codified characters of our analysis reveals that Lagerpetidae is one of the poorest known among the Triassic dinosauromorph groups in terms of their anatomy, so that new discoveries of more complete specimens are awaited to establish a more robust phylogeny.
Physical Compatibility and Chemical Stability of Injectable and Oral Ranitidine Solutions
Authors: Fleming Kelly , Donnelly Ronald F.
Published: March 2018

Objectives: The physical compatibility and chemical stability of ranitidine hydrochloride injectable solutions and oral syrup were studied to define beyond-use dates (BUDs). Methods: Ranitidine hydrochloride injectable solutions of 25 mg/mL packaged in glass vials and 5 mg/mL in polypropylene (PP) syringes were prepared in triplicate. Samples were refrigerated and protected from light (PFL) or stored at 25°C and either exposed to light (ETL) or PFL. Ranitidine hydrochloride oral syrup 15 mg/mL in unit-dose amber PP syringes were prepared in triplicate and then kept at 25°C. Samples were collected at days 0, 7, 14, 28, 56, and 91. Additional samples were collected at 6 months and at 6, 9, and 12 months for the 25 mg/mL solution and oral syrup, respectively. Physical parameters of pH, clarity, and color were obtained at each collection time. A validated stability-indicating high-performance liquid chromatography (HPLC) method was used to determine the chemical stability. Results: Formulations had no significant change in pH or clarity. Although some samples yellowed, this was not associated with a decrease in concentration. The 25 mg/mL solution remained above 98.6% for 6 months, whereas the 5 mg/mL solution remained above 93.5% for 91 days under all storage conditions. At 25°C, the oral syrup retained greater than 98.8% for 12 months. Conclusions: The ranitidine hydrochloride injectable solutions were stable for 6 months and 91 days under the 3 storage conditions, respectively, for the 25 mg/mL solution in glass vials and 5 mg/mL solution in PP syringes. The 15 mg/mL oral syrup in unit-dose amber PP syringes was stable for 12 months at 25°C and PFL.
Cultural U-Turns in Mental Well-Being: Acknowledging the Dilemma
Authors: Tobert Natalie
Published: March 2018

Today on social media I see an uprising of anger against Western psychiatry and its 19th- and 20th-century practices used to address mental distress and extreme experiences. I notice movements in social media groups that support people in new frameworks of understanding. At the same time, many practitioners realize that their biomedical training does not fit the spirit of our times: there are psychiatrists and psychologists who question the original diagnoses of their professions. Across Europe, America, and Australia, there are new practices set up by mental health service providers who want to see the status quo changed. Colleagues are reevaluating the nature of human consciousness and subtle energy, and they want to end stigma and the myth of labels. They are listening more closely to ancient wisdoms of indigenous people. I wrote this article to acknowledge our dilemma between challenging frameworks of knowledge, to explore the gap between different perspectives, and to suggest that we need a cultural U-turn toward more sensitive training in our educational institutions.
The Influence of Physical Attractiveness on Belief in a Just World
Authors: Westfall R. Shane , Millar Murray G. , Lovitt Aileen
Published: March 2018

Previous work has consistently found that belief in a just world is strongly correlated with societal privilege. In the present study, we examined the influence of physical attractiveness on belief in a just world. We hypothesized that physically attractive individuals would be stronger endorsers of belief in a just world, whereas less attractive individuals would be less likely to endorse belief in a just world. Both self-rated attractiveness (experiment one) and attractiveness rated by other persons (experiment two) were found to predict endorsement of belief in a just world. Additionally, both attractiveness measures were found to have a relationship with participant’s level of life satisfaction. These findings suggest that physical attractiveness powerfully affects our subjective experience as a human and that just-world beliefs are driven, at least in part, by personal experience with inequality.
Assessing New Diagnoses of HIV Among American Indian/Alaska Natives Served by the Indian Health Service, 2005-2014
Authors: Reilley Brigg , Haberling Dana L. , Person Marissa , Leston Jessica , Iralu Jonathan , Haverkate Rick , Siddiqi Azfar-E-Alam
Published: March 2018

Objectives:

The objectives of this study were to use Indian Health Service (IHS) data from electronic health records to analyze human immunodeficiency virus (HIV) diagnoses among American Indian/Alaska Natives (AI/ANs) and to identify current rates and trends that can support data-driven policy implementation and resource allocation for this population.

Methods:

We analyzed provider visit data from IHS to capture all AI/AN patients who met a definition of a new HIV diagnosis from 2005 through 2014 by using International Classification of Diseases, Ninth Revision, Clinical Modification codes. We calculated rates and trends of new HIV diagnoses by age, sex, region, and year per 100 000 AI/ANs in the IHS user population.

Results:

A total of 2273 AI/ANs met the definition of newly diagnosed with HIV from 2005 through 2014, an average annual rate of 15.1 per 100 000 AI/ANs. Most (356/391) IHS health facilities recorded at least 1 new HIV diagnosis. The rate of new HIV diagnoses among males (21.3 per 100 000 AI/ANs) was twice as high as that among females (9.5 per 100 000 AI/ANs; rate ratio = 2.2; 95% confidence interval, 2.1-2.4); by age, rates were highest among those aged 20-54 for males and females. By region, the Southwest region had the highest number (n = 1016) and rate (19.9 per 100 000 AI/ANs) of new HIV diagnoses. Overall annual rates of new HIV diagnoses were stable from 2010 through 2014, although diagnosis rates increased among males ( P < .001) and those aged 15-19 ( P < .001), 45-59 ( P < .001), and 50-54 ( P = .01).

Conclusions:

New HIV diagnoses, derived from provider visit data, among AI/ANs were stable from 2010 through 2014. AI/ANs aged 20-54, particularly men, may benefit from increased HIV prevention and screening efforts. Additional services may benefit patients in regions with higher rates of new diagnoses and in remote settings in which reported HIV numbers are low.
Home-Monitoring of Peak Expiratory Flow Rate using Mini-Wright Peak Flow Meter in Diagnosis of Asthma1
Authors: Prior John G , Cochrane G M
Published: March 2018

Home-monitoring of peak expiratory flow rate using the mini-Wright peak flow meter is a useful technique for determining whether or not unexplained respiratory symptoms are caused by asthma. It is of particular value when airflow obstruction cannot be demonstrated at the time of consultation.
Tuberculous Peritonitis in Association with Pancytopenia and Pseudo-Obstruction of the Colon
Authors: Couse N , Tyrrell D , McMurray N , Tanner W A
Published: March 2018

We report the case of a 72-year-old woman with tuberculous peritonitis, complicated by the unusual association of pancytopenia and pseudo-obstruction of the colon.
The Mildly Abnormal Cervical Smear: Patient Anxiety and Choice of Management
Authors: Jones M H , Singer A , Jenkins D
Published: March 2018

Argument continues over the best management of women with a first mildly dyskaryotic cervical smear: should they be referred for prompt colposcopy, or should they be kept under cytological review, with recourse to colposcopy if the abnormality persists? One consideration is the amount of anxiety generated. We measured anxiety, retrospectively, in two groups of women who had been managed by one or other method.

Colposcopy caused more anxiety than cytological surveillance. When told that their smear was mildly abnormal, 47% of the immediate-colposcopy group (n=182), compared with 33% of the surveillance group (n=163), thought they had cancer. None the less, there was a general preference for immediate colposcopy.

Whatever the relative merits of these two strategies for clinical management, it is clear that both forms of screening, and especially colposcopy, demand better information for patients.
A systematic review of the diagnostic utility of simple tests of change after trial removal of cerebrospinal fluid in adults with normal pressure hydrocephalus
Authors: Scully Aileen Eugenia , Lim Edwin Choon Wyn , Teow Pei Pei , Tan Dawn May Leng
Published: March 2018

Objective:

To synthesize the evidence regarding the diagnostic value of simple ancillary tests post cerebrospinal fluid drainage in normal pressure hydrocephalus.

Data sources:

MEDLINE, CINAHL, PsycINFO, Scopus, Web of Science, and Cochrane library databases; last searched on 12 September 2017.

Review methods:

This review was performed applying the steps of the PRISMA statement. The QUADAS 2 tool was used to assess the risk of bias. Prospective and retrospective trials were systematically reviewed, and data on diagnostic accuracy were extracted. Meta-analysis (where possible) was performed. Hierarchical summary receiver operating characteristic package was used to calculate pooled estimates of included diagnostic studies.

Results:

Seventeen trials (with 812 subjects in total) were identified for inclusion in the meta-analyses for the 18-meter walk test, video-recorded gait performance, cognitive test, and Timed Up and Go Test. The summary estimates of sensitivity and specificity for the 18-meter walk test was 0.83 (95% CI 0.57 to 0.99) and 0.67 (95% CI 0.33 to 0.95), video-recorded gait performance was 0.85 (95% CI 0.47 to 0.99) and 0.68 (95% CI 0.33 to 0.96), cognitive test was 0.82 (95% CI 0.41–0.99) and 0.75 (95% CI 0.39–0.99), and Timed Up and Go Test was 0.89 (95% CI 0.79–0.95) and 0.63 (95% CI 0.24–0.90), respectively.

Conclusion:

This review highlights the diagnostic value of the 18-meter walk test, video-recorded gait performance, cognitive test, and Timed Up and Go Test in predicting shunt outcomes among adults with normal pressure hydrocephalus.
Knotless retroperitoneoscopic nephron-sparing surgery for small renal masses: Comparison of bipolar sutureless technique and barbed suture technique
Authors: Ye Jianfei , Zhang Shudong , Tian Xiaojun , Wang Guoliang , Zhao Lei , Ma Lulin
Published: March 2018

Objective

Laparoscopic knot-tying and suturing are the most difficult steps in shortening the warm ischemia time and learning curve of laparoscopic nephron-sparing surgery. This study was performed to demonstrate the safety, oncological efficacy, and technical tips of sutureless retroperitoneal laparoscopic nephron-sparing surgery (RPNSS).

Methods

This retrospective study included 78 cases of RPNSS using a sutureless technique and 126 cases of RPNSS using a single-layer barbed self-retaining suture technique performed from December 2012 to December 2016.

Results

The mean warm ischemia time was significantly shorter in the sutureless technique group than in the barbed self-retaining suture technique group (6.8 vs. 21.1 minutes, respectively). There was no significant difference in the mean age, body mass index, R.E.N.A.L. Nephrometry score, operative time, maximal tumor diameter, intraparenchymal depth, blood loss, operative time, transfusion rate, complication rate, or postoperative hospital stay between the two groups. No open conversion was needed. No positive margins or local recurrence were observed during follow-up.

Conclusions

The sutureless technique was proven to be safe and oncologically effective and may allow novice laparoscopic surgeons to easily and quickly master RPNSS, a technically difficult procedure.
Racial Differences in Children’s Trauma Symptoms Following Complex Trauma Exposure
Authors: Wamser-Nanney Rachel , Cherry Kathryn E. , Campbell Claudia , Trombetta Elise
Published: March 2018

Complex trauma exposure has been defined as multiple or chronic interpersonal trauma that begins early in life, which leads to widespread dysregulation. Previous studies have reported that minorities may be at greater risk for trauma exposure and symptoms; yet, racial differences have not been investigated in the context of complex trauma. The aim of the present study was to determine if there are racial disparities in children’s trauma exposure and outcomes among 167 child survivors of complex trauma (3-18 years, M = 9.90, SD = 3.92; 61.67% female; 62.2% Black). Black children endorsed a greater number of trauma types and were more likely to have experienced community violence and have been placed in child protective custody than White children. Caregivers of White children endorsed higher levels of select internalizing symptoms and social concerns whereas Black children reported higher levels of sexual concerns than White children. White children who experience complex trauma may be at higher risk for some trauma-related difficulties. Alternatively, caregivers of White children may perceive them to have, or be more willing to acknowledge, higher levels of symptoms than Black children. Future work is needed to further investigate the role of race in disclosure of trauma exposure and related symptoms.