bluuebunny/crossref_metadata_2025 huggingface dataset:
Enucleation for haemophthalmus secondary to choroidal neovascularisation in polypoidal choroidal vasculopathy: a therapeutic and diagnostic dilemma
Authors: Azmi Noor Aniah , Ahem Amin , Mustapha Mushawiahti , Bastion Mae-Lynn Catherine
Published: September 2016

We report a case of enucleation for painful blind eye secondary to recurrent bleeding from choroidal neovascularisation in an eye that was irradiated following presumed metastatic breast carcinoma to the choroid. A 58-year-old woman with a history of treated breast malignancy presented with haemophthalmus and intractable glaucoma in the right eye. One year previously she had presented with right vitreous haemorrhage with subretinal mass that had been irradiated given her history of breast carcinoma. Following irradiation, vitrectomy was performed to clear the blood. Intraoperative and postoperative angiography findings suggested a diagnosis of breakthrough bleeding secondary to polypoidal choroidal vasculopathy. At this presentation, however, the intraocular bleeding was recurrent resulting in elevated intraocular pressure and pain. Despite repeat surgery and medical therapy, the eye had to be enucleated. Histopathology showed choroidal neovascularisation.
Loperamide-induced hypopituitarism
Authors: Napier Catherine , Gan Earn H , Pearce Simon H S
Published: September 2016

Loperamide is the most commonly used antidiarrhoeal medication in the UK. We report a serious and hitherto undocumented adverse effect of chronic use in a 45-year-old man with inflammatory bowel disease. He presented to the endocrine clinic with fatigue and low libido; biochemical assessment revealed hypogonadism and adrenal insufficiency without any elevated adrenocorticotropic hormone. When symptoms allowed, loperamide was reduced and a short synacthen test (SST) showed a ‘clear pass’ with a normal peak cortisol of 833 nmol/L. Later, worsening diarrhoea necessitated an escalation in loperamide use again. While taking a daily dose of 15–20 mg (recommended daily maximum 16 mg) reassessment revealed a fall in peak cortisol on SST to 483 nmol/L, a subnormal response. Clinicians should exercise caution when relying on loperamide to manage their patients’ chronic diarrhoea and remain mindful of the possibility of drug-induced life-threatening adrenal insufficiency.
Atypical presentation of acute fulminant neonatal necrotising enterocolitis: diagnostic superiority of sonographic evaluation over plain radiography of abdomen
Authors: Ramasamy Vidya , Teo Harvey , Rajadurai Victor Samuel , Chandran Suresh
Published: September 2016

A female preterm infant was born to a non-consanguineous couple at 35 weeks of gestation. On day 8 of life, while on full feeds, she developed prolonged apnoea and bradycardia, requiring respiratory support. Her abdomen was soft with unremarkable serial abdominal X-rays. Her septic screen was negative. Metabolic acidosis was worsening despite treatment. Echocardiography showed evidence of high pulmonary pressures. With further deterioration, an ultrasound scan of the abdomen was requested in view of the rising suspicion of abdominal pathology in the absence of sepsis and metabolic disorders. Mural oedema, pneumatosis and portal venous gas, consistent with diagnosis of necrotising enterocolitis, were noted in the ultrasound images. An emergency laparotomy showed extensive small bowel necrosis. Despite maximal medical support, the infant died. This case highlights the importance of imaging using an ultrasound scanner in the diagnosis of necrotising enterocolitis in preterm infants having intractable metabolic acidosis, subtle abdominal signs and unremarkable abdominal X-rays.
Diagnosis and management of intersection syndrome as a cause of overuse wrist pain
Authors: Chatterjee Robin , Vyas Jay
Published: September 2016

Wrist pain due to repetitive motion or overuse is a common presentation in primary care. This case reports the rare condition of intersection syndrome as the cause of the wrist pain in an amateur tennis player. This is a non-infectious, inflammatory process that occurs where tendons in the first extensor compartment intersect the tendons in the second extensor compartment. Suitable history and examination provided the diagnosis, which was confirmed by MRI. Management consisted of early involvement of the multidisciplinary team, patient education, workplace and sporting adaptations, rest, analgesia, reduction of load, protection and immobilisation of the affected joint followed by a period of rehabilitation.
Two atypical cases of isolated migrainous paraesthesia
Authors: Prakash Sanjay , Rathore Chaturbhuj
Published: September 2016

A large number of migraineurs have various transient neurological symptoms in the absence of headache at one time or another. Such transient neurological symptoms largely represent the typical migraine auras without headaches. Isolated visual aura is the most common aura in this category. Sensory aura is the second most common aura. However, the literature is sparse regarding isolated sensory aura without headache. Herein, we are reporting two cases of recurrent paraesthesia that fulfilled the International Classification of Headache Disorders (ICHD-3β) criteria of typical migrainous sensory aura without headache. Review of the literature suggests that upper limb involvement is almost universal (>90%) in the typical sensory aura. However, our both cases were unusual in this aspect. Case 1 had recurrent spontaneous paraesthesia predominantly on the left side of the face. Case 2 had recurrent spontaneous paraesthesia in either the left or right lower limb. Both cases responded to antimigraine drugs.
TreatmentAndPrevention for femaleSex workers in South Africa: protocol for the TAPS Demonstration Project
Authors: Gomez Gabriela B , Eakle Robyn , Mbogua Judie , Akpomiemie Godspower , Venter W D Francois , Rees Helen
Published: September 2016

Introduction

Updated guidelines from the WHO recommend antiretroviral treatment for adults with HIV at any CD4 count and daily oral pre-exposure prophylaxis (PrEP) for people at substantial risk of HIV infection. However, implementation challenges may hinder the ability of programmes to translate these recommendations into successful practice. This demonstration project is the first to integrate PrEP and immediate treatment (ITx) for female sex workers (FSWs) in South Africa to answer operational research questions.

Methods and analysis

This is a prospective cohort study where the main outcome is retention at 12 months. The study population is recruited into two arms across two urban sites: (1) PrEP for HIV-negative FSWs (n=400) and (2) ITx for HIV-positive FSWs with CD4 greater than national guidelines (n=300). We investigate process and other health indicators, uptake and use of PrEP and ITx through qualitative research, and evaluate cost-effectiveness analysis combined with estimates of impact through epidemiological modelling.

Ethics and dissemination

TheTreatmentAndPrevention for femaleSex workers in South Africa (TAPS) Project was designed as an implementation study before emtricitabine/tenofovir disoproxil fumarate was licenced as an indication for PrEP in South Africa. Therefore, clinical trial requirements for ethical and South African Medicines Control Council approvals were followed. Results will be disseminated to participants, local health officials and other stakeholders, as well as in peer-reviewed journals and at conferences.
Risk assessment and suicide by patients with schizophrenia in secondary mental healthcare: a case–control study
Authors: Lopez-Morinigo Javier-David , Ayesa-Arriola Rosa , Torres-Romano Beatriz , Fernandes Andrea C , Shetty Hitesh , Broadbent Matthew , Dominguez-Ballesteros Maria-Encarnacion , Stewart Robert , David Anthony S , Dutta Rina
Published: September 2016

Objectives

To investigate the role of risk assessment in predicting suicide in patients with schizophrenia spectrum disorders (SSDs) receiving secondary mental healthcare. We postulated that risk assessment plays a limited role in predicting suicide in these patients.

Design

Retrospective case–control study.

Setting

Anonymised electronic mental health record data from the South London and Maudsley National Health Service (NHS) Foundation Trust (SLaM) (London, UK) linked with national mortality data.

Participants

In 242 227 SLaM service users up to 31 December 2013, 635 suicides were identified. 96 (15.1%) had a SSD diagnosis. Those who died before 1 January 2007 (n=25) were removed from the analyses. Thus, 71 participants with SSD who died from suicide over the study period (cases) were compared with 355 controls.

Main outcome measure

Risk of suicide in relation to risk assessment ratings.

Results

Cases were younger at first contact with services (mean±SD 34.5±12.6 vs 39.2±15.2) and with a higher preponderance of males (OR=2.07, 95% CI 1.18 to 3.65, p=0.01) than controls. Also, suicide occurred within 10 days after last contact with services in half of cases, with the most common suicide methods being hanging (14) and jumping (13). Cases were more likely to have the following ‘risk assessment’ items previously recorded: suicidal history (OR=4.42, 95% CI 2.01 to 9.65, p<0.001), use of violent method (OR=3.37, 95% CI 1.47 to 7.74, p=0.01), suicidal ideation (OR=3.57, 95% CI 1.40 to 9.07, p=0.01) and recent hospital discharge (OR=2.71, 95% CI 1.17 to 6.28, p=0.04). Multiple regression models predicted only 21.5% of the suicide outcome variance.

Conclusions

Predicting suicide in schizophrenia is highly challenging due to the high prevalence of risk factors within this diagnostic group irrespective of outcome, including suicide. Nevertheless, older age at first contact with mental health services and lack of suicidal history and suicidal ideation are useful protective markers indicative of those less likely to end their own lives.
Using multimedia tools and high-fidelity simulations to improve medical students' resuscitation performance: an observational study
Authors: Wang Candice , Huang Chin-Chou , Lin Shing-Jong , Chen Jaw-Wen
Published: September 2016

Objectives

The goal of our study was to shed light on educational methods to strengthen medical students' cardiopulmonary resuscitation (CPR) leadership and team skills in order to optimise CPR understanding and success using didactic videos and high-fidelity simulations.

Design

An observational study.

Setting

A tertiary medical centre in Northern Taiwan.

Participants

A total of 104 5–7th year medical students, including 72 men and 32 women.

Interventions

We provided the medical students with a 2-hour training session on advanced CPR. During each class, we divided the students into 1–2 groups; each group consisted of 4–6 team members. Medical student teams were trained by using either method A or B. Method A started with an instructional CPR video followed by a first CPR simulation. Method B started with a first CPR simulation followed by an instructional CPR video. All students then participated in a second CPR simulation.

Outcome measures

Student teams were assessed with checklist rating scores in leadership, teamwork and team member skills, global rating scores by an attending physician and video-recording evaluation by 2 independent individuals.

Results

The 104 medical students were divided into 22 teams. We trained 11 teams using method A and 11 using method B. Total second CPR simulation scores were significantly higher than first CPR simulation scores in leadership (p<0.001), teamwork (p<0.001) and team member skills (p<0.001). For methods A and B students' first CPR simulation scores were similar, but method A students' second CPR simulation scores were significantly higher than those of method B in leadership skills (p=0.034), specifically in the support subcategory (p=0.049).

Conclusions

Although both teaching strategies improved leadership, teamwork and team member performance, video exposure followed by CPR simulation further increased students' leadership skills compared with CPR simulation followed by video exposure.
Exclusion of patients with concomitant chronic conditions in ongoing randomised controlled trials targeting 10 common chronic conditions and registered at ClinicalTrials.gov: a systematic review of registration details
Authors: Buffel du Vaure Céline , Dechartres Agnès , Battin Constance , Ravaud Philippe , Boutron Isabelle
Published: September 2016

Objectives

To systematically assess registration details of ongoing randomised controlled trials (RCTs) targeting 10 common chronic conditions and registered at ClinicalTrials.gov and to determine the prevalence of (1) trial records excluding patients with concomitant chronic condition(s) and (2) those specifically targeting patients with concomitant chronic conditions.

Design

Systematic review of trial registration records.

Data sources

ClinicalTrials.gov register.

Study selection

All ongoing RCTs registered from 1 January 2014 to 31 January 2015 that assessed an intervention targeting adults with coronary heart disease (CHD), hypertension, heart failure, stroke/transient ischaemic attack, atrial fibrillation, type 2 diabetes, chronic obstructive pulmonary disease, painful condition, depression and dementia with a target sample size ≥100.

Data extraction

From the trial registration records, 2 researchers independently recorded the trial characteristics and the number of exclusion criteria and determined whether patients with concomitant chronic conditions were excluded or specifically targeted.

Results

Among 319 ongoing RCTs, despite the high prevalence of the concomitant chronic conditions, patients with these conditions were excluded in 251 trials (79%). For example, although 91% of patients with CHD had a concomitant chronic condition, 69% of trials targeting such patients excluded patients with concomitant chronic condition(s). When considering the co-occurrence of 2 chronic conditions, 31% of patients with chronic pain also had depression, but 58% of the trials targeting patients with chronic pain excluded patients with depression. Only 37 trials (12%) assessed interventions specifically targeting patients with concomitant chronic conditions; 31 (84%) excluded patients with concomitant chronic condition(s).

Conclusions

Despite widespread multimorbidity, more than three-quarters of ongoing trials assessing interventions for patients with chronic conditions excluded patients with concomitant chronic conditions.
Study protocol for a multicentre randomised controlled trial:Safety,Tolerability, efficacy and quality of lifeOf a human recombinant alkalinePhosphatase in patients with sepsis-associatedAcuteKidneyInjury (STOP-AKI)
Authors: Peters Esther , Mehta Ravindra L , Murray Patrick T , Hummel Jürgen , Joannidis Michael , Kellum John A , Arend Jacques , Pickkers Peter
Published: September 2016

Introduction

Acute kidney injury (AKI) occurs in 55–60% of critically ill patients, and sepsis is the most common underlying cause. No pharmacological treatment options are licensed to treat sepsis-associated AKI (SA-AKI); only supportive renal replacement therapy (RRT) is available. One of the limited number of candidate compounds in clinical development to treat SA-AKI is alkaline phosphatase (AP). The renal protective effect of purified bovine intestinal AP has been demonstrated in critically ill sepsis patients. To build on these observations, ahuman recombinantAP (recAP) was developed, of which safety and efficacy in patients with SA-AKI will be investigated in this trial.

Methods

This is a randomised, double-blind, placebo-controlled, 4-arm, proof-of-concept, dose-finding adaptive phase IIa/IIb study, conducted in critically ill patients with SA-AKI. A minimum of 290 patients will be enrolled at ∼50 sites in the European Union and North America. The study involves 2 parts. Patients enrolled during Part 1 will be randomly assigned to receive either placebo (n=30) or 1 of 3 different doses of recAP (n=30 per group) once daily for 3 days (0.4, 0.8 or 1.6 mg/kg). In Part 2, patients will be randomly assigned to receive the most efficacious dose of recAP (n=85), selected during an interim analysis, or placebo (n=85). Treatment must be administered within 24 hours after SA-AKI is first diagnosed and within 96 hours from first diagnosis of sepsis. The primary end point is the area under the time-corrected endogenous creatinine clearance curve from days 1 to 7. The key secondary end point is RRT incidence during days 1–28.

Ethics and dissemination

This study is approved by the relevant institutional review boards/independent ethics committees and is conducted in accordance with the ethical principles of the Declaration of Helsinki, guidelines of Good Clinical Practice, Code of Federal Regulations and all other applicable regulations. Results of this study will reveal the efficacy of recAP for the improvement of renal function in critically ill patients with SA-AKI and will be published in a peer-reviewed scientific journal.

Trial registration number

NCT02182440; Pre-results.
Motor control exercise for symptomatic lumbar disc herniation: protocol for a systematic review and meta-analysis
Authors: Pourahmadi Mohammad Reza , Taghipour Morteza , Ebrahimi Takamjani Ismail , Sanjari Mohammad Ali , Mohseni-Bandpei Mohammad Ali , Keshtkar Abbas Ali
Published: September 2016

Introduction

Lumbar disc herniation (LDH) is a common condition in adults and can impose a heavy burden on both the individual and society. It is defined as displacement of disc components beyond the intervertebral disc space. Various conservative treatments have been recommended for the treatment of LDH and physical therapy plays a major role in the management of patients. Therapeutic exercise is effective for relieving pain and improving function in individuals with symptomatic LDH. The aim of this systematic review is to evaluate the effectiveness of motor control exercise (MCE) for symptomatic LDH.

Methods and analysis

We will include all clinical trial studies with a concurrent control group which evaluated the effect of MCEs in patients with symptomatic LDH. We will search PubMed, SCOPUS, PEDro, SPORTDiscus, CINAHL, CENTRAL and EMBASE with no restriction of language. Primary outcomes of this systematic review are pain intensity and functional disability and secondary outcomes are functional tests, muscle thickness, quality of life, return to work, muscle endurance and adverse events. Study selection and data extraction will be performed by two independent reviewers. The assessment of risk of bias will be implemented using the PEDro scale. Publication bias will be assessed by funnel plots, Begg's and Egger's tests. Heterogeneity will be evaluated using the I2statistic and the χ2test. In addition, subgroup analyses will be conducted for population and the secondary outcomes. All meta-analyses will be performed using Stata V.12 software.

Ethics and dissemination

No ethical concerns are predicted. The systematic review findings will be published in a peer-reviewed journal and will also be presented at national/international academic and clinical conferences.

Trial registration number

CRD42016038166.
Patient characteristics, treatment and survival in pulmonary carcinoid tumours: an analysis from the UK National Lung Cancer Audit
Authors: Hobbins Stephanie , West Doug , Peake Michael , Beckett Paul , Woolhouse Ian
Published: September 2016

Objectives

Pulmonary carcinoid (PC) is a rare tumour with good prognosis following surgical resection. However, little is known regarding patient characteristics and use of other treatments modalities. Our objective was to review patient characteristics, treatment and survival for patients with PC and contrast these results with other forms of non-small cell lung cancer (NSCLC).

Setting

Audit data from UK National Lung Cancer Audit (NLCA) 2008–2013.

Participants

184 906 lung cancer cases were submitted to the NLCA.

Outcome measures

Primary outcome—survival rates between PC and NSCLC. Secondary outcome—differences in performance status, lung function and treatment modality between PC and NSCLC.

Results

PC histology was recorded in 1341 (0.73%) patients and non-carcinoid NSCLC histology in 162 959 (87.4%) cases. 91% of patients with PC had good performance status (Eastern Cooperative Oncology Group (ECOG) 0–1), compared with only 53% of NSCLC. 66% of PC had localised disease. Of all PC cases, 77% were treated with surgery, 6.2% received chemotherapy and 3.6% received radiotherapy, with the remainder treated with best supportive care. Overall 1-year and 3-year survival rates for PC were 92% and 84.7%, respectively. In contrast, 1-year and 3-year survival rates for NSCLC were 36.2% and 15.6%, However, 3-year survival for PC markedly decreased with worsening performance status and advanced disease to 23.8% for performance status ECOG 3–4 and 33.6% for stage IV disease.

Conclusions

In contrast to other forms of NSCLC, the majority of patients with PC present with good performance status, preserved lung function and early stage disease amenable to surgical resection. However, 1 in 5 patients with PC has metastatic disease which is associated with poor prognosis, as is poor performance status at presentation. We believe these data will help clinicians provide accurate prognostic predictions stratified according to patient characteristics at presentation, as well as guide future clinical trials.
Randomised controlled trial of effect of whole soy replacement diet on features of metabolic syndrome in postmenopausal women: study protocol
Authors: Liu Zhao-min , Ho Suzanne , Hao Yuan-tao , Chen Yu-ming , Woo Jean , Wong Samuel Yeung-shan , He Qiqiang , Xie Yao Jie , Tse Lap Ah , Chen Bailing , Su Xue-fen , Lao Xiang-qian , Wong Carmen , Chan Ruth , Ling Wen-hua
Published: September 2016

Introduction

Metabolic syndrome (MetS) is a public health problem in postmenopausal women. Whole soy foods are rich in unsaturated fats, high quality plant protein and various bioactive phytochemicals that may have a beneficial role in the management of MetS. The aim of the study is to examine the effect of whole soy replacement diet on the features of MetS among postmenopausal women.

Methods and analysis

This will be a 12-month, randomised, single-blind, parallel controlled trial among 208 postmenopausal women at risk of MetS or with early MetS. After 4 weeks' run-in, subjects will be randomly allocated to one of two intervention groups, whole soy replacement group or control group, each for 12 months. Subjects in the whole soy group will be required to include four servings of whole soy foods (containing 25 g soy protein) into their daily diet iso-calorically, replacing red or processed meat and high fat dairy products. Subjects in the control group will remain on a usual diet. The outcome measures will include metabolic parameters as well as a 10-year risk for ischaemic cardiovascular disease. We hypothesise that the whole soy substitution diet will notably improve features of MetS in postmenopausal women at risk of MetS or with early MetS. The study will have both theoretical and practical significance. If proven effective, the application of the whole soy replacement diet model will be a safe, practical and economical strategy for MetS prevention and treatment.

Ethics and dissemination

Ethics approval has been obtained from the Ethics Committee of the Chinese University of Hong Kong. The results will be disseminated via conference presentations and papers in academic peer reviewed journals. Data files will be deposited in an accessible repository.

Trial registration number

NCT02610322.
Cardiac involvement in adult and juvenile idiopathic inflammatory myopathies
Authors: Schwartz Thomas , Diederichsen Louise Pyndt , Lundberg Ingrid E , Sjaastad Ivar , Sanner Helga
Published: September 2016

Idiopathic inflammatory myopathies (IIM) include the main subgroups polymyositis (PM), dermatomyositis (DM), inclusion body myositis (IBM) and juvenile DM (JDM). The mentioned subgroups are characterised by inflammation of skeletal muscles leading to muscle weakness and other organs can also be affected as well. Even though clinically significant heart involvement is uncommon, heart disease is one of the major causes of death in IIM. Recent studies show an increased prevalence of traditional cardiovascular risk factors in JDM and DM/PM, which need attention. The risk of developing atherosclerotic coronary artery disease is increased twofold to fourfold in DM/PM. New and improved diagnostic methods have in recent studies in PM/DM and JDM demonstrated a high prevalence of subclinical cardiac involvement, especially diastolic dysfunction. Interactions between proinflammatory cytokines and traditional risk factors might contribute to the pathogenesis of cardiac dysfunction. Heart involvement could also be related to myocarditis and/or myocardial fibrosis, leading to arrhythmias and congestive heart failure, demonstrated both in adult and juvenile IIM. Also, reduced heart rate variability (a known risk factor for cardiac morbidity and mortality) has been shown in long-standing JDM. Until more information is available, patients with IIM should follow the same recommendations for cardiovascular risk stratification and prevention as for the corresponding general population, but be aware that statins might worsen muscle symptoms mimicking myositis relapse. On the basis of recent studies, we recommend a low threshold for cardiac workup and follow-up in patients with IIM.
Vertical load-carrying behavior and design models for micropiles considering foundation configuration conditions
Authors: Kyung Doohyun , Kim Daehong , Kim Garam , Lee Junhwan
Published: September 2016

In the present study, the vertical load-carrying behavior of micropile foundations with various configuration conditions was investigated based on results from model load tests. Considered configuration conditions included micropile inclination angle, spacing of micropiles, and types of micropile foundations. The ultimate load capacity of micropiles varied with installation angle, showing an initial increase and peak followed by a gradual decrease with further increase in installation angle. The ultimate load capacity of micropiled rafts was affected by both installation angle and micropile spacing. The load-carrying mechanism of micropiles for the inclined condition was proposed based on the decomposed axial and lateral load and resistance components. Using the proposed load-carrying mechanism and test results obtained in this study, the load capacity ratio for an inclined micropile was proposed. The group effect and interaction effect factors for group micropiles and micropiled rafts were proposed, respectively, all of which can be used to estimate the load-carrying capacity of micropile foundations. Field load tests were conducted and it was seen that estimated results using the proposed method were in good agreement with measured results. Additional comparison with case examples from the literature also confirmed the validity of the proposed method.
Development and assessment of a new method for combining catch per unit effort data from different fish sampling gears: multigear mean standardization (MGMS)
Authors: Gibson-Reinemer Daniel K. , Ickes Brian S. , Chick John H.
Published: September 2016

Fish community assessments are often based on sampling with multiple gear types. However, multivariate methods used to assess fish community structure and composition are sensitive to differences in the relative scale of indices or measures of abundance produced by different sampling methods. This makes combining data from different sampling gears and methods a serious challenge. We developed a method of combining catch per unit effort data that standardizes catch per unit effort data across gear types, which we call multigear mean standardization (MGMS). We evaluated how well MGMS and other types of standardization reflect underlying community structure through a computer simulation that generated model riverine-fish communities and simulated sampling data for two gears. In these simulations, combining sampling observations from two gears with MGMS produced community structure estimates that were highly correlated with true community structure under a variety of conditions that are common in large rivers. Our simulation results indicate that the use of MGMS to combine data from different sampling gears is an effective data manipulation method for the analysis of fish community structure.
Design of elliptic cylindrical thermal cloak with layered structure
Authors: Yuan Xuebo , Lin Guochang , Wang Youshan
Published: September 2016

Thermal cloak has potential applications in thermal protection and sensing. Based on the theories of spatial transformation and effective medium, layered structure of elliptic cylindrical thermal cloak was designed. According to theoretical analysis and numerical simulation, the layered structure has typical characteristics of perfect thermal cloak. The external temperature field remains unchanged, while the internal temperature gradient decreases obviously. Meanwhile, the cloaking effect is stable in any direction. The cloaking effect can be improved by increasing the number of discretization layers or reducing the cloak thickness. The elliptic cylindrical cloak can be considered as cylindrical cloak when the focal distance is close to zero. This study has provided an effective way for realizing thermal cloak with more complex shapes.
Synthesis and evaluation of factors affecting the in vitro bioactivity and antibacterial activity of bioactive glass ceramics
Authors: Riaz Madeeha , Zia Rehana , Saleemi Farhat
Published: September 2016

In the present study, two novel silicate glass-ceramics having chemical composition 38SiO2–41CaO–6P2O5–([Formula: see text])Na2O–[Formula: see text]CaF2 ([Formula: see text], 0.43 mol%) were synthesized. These glass derivatives were subjected to stimulated body fluid for 24 days in SBF under static condition at [Formula: see text]C in order to evaluate the bioactive properties of specimens. The antibacterial activity of glass ceramics against three pathogenic bacteria was determined using the modified Kirby Bauer method. It was found that the antibacterial activity primarily depends on the dissolution rate; faster release of ions caused rapid increase in the pH of the solution. Antibacterial properties were found to be strongly affected by changes in the pH of supernatant. The in vitro bioactivity assays showed that both glass derivatives were capable of bonding with bone and secondly effectively inhibit bacteria. However, the glass ceramic without CaF2 (B2) showed high dissolution rate, better bioactive ability and stronger antibacterial efficacy.
RELIABILITY AND VALIDITY STUDY OF A MEASUREMENT METHOD FOR THE GLENOID VERSION BY A 3-DIMENSIONAL BONE MODEL FROM 3.0 TESLA MRI
Authors: Kanno Yohei , Toda Hajime , Horiuchi Tsutomu , Nagai Katsuaki , Katayose Masaki
Published: September 2016

Objective: The authors investigated reliability and validity of 3D-MRI bone model of scapula by comparing the Glenoid versions that were measured each in 3D-CT images and 3D-MRI images. Materials and Methods: The scapula extraction DICOM data of MRI and CT was made to extract only a scapular domain. The scapula bone model was made with the scapula extraction DICOM data of MRI and CT. Glenoid version was measured on the scapula bone model. The mean and standard deviation of the Glenoid version was calculated by each imaging method (CT and MRI). Intraclass reliability of each imaging method (CT and MRI) and agreement between the two methods were evaluated. This was accomplished by calculating two separate measures of agreement: the intraclass correlation coefficient (ICC) and the Bland–Altman analysis. Results: Glenoid version measured from the 3D-CT images averaged [Formula: see text]0.679[Formula: see text][Formula: see text][Formula: see text]3.797, with an ICC of 0.975. Glenoid version measured from the 3D-MRI images averaged [Formula: see text]0.801[Formula: see text][Formula: see text][Formula: see text]3.682, with an ICC of 0.980. Conclusions: 3D-MRI bone model of scapula evaluated the reliability and the validity. 3D-MRI bone model of scapula was found to measure like 3D-CT bone model of scapula.
Persistence of reduced neuromotor noise in long-term motor skill learning
Authors: Huber Meghan E. , Kuznetsov Nikita , Sternad Dagmar
Published: September 2016

It is well documented that variability in motor performance decreases with practice, yet the neural and computational mechanisms that underlie this decline, particularly during long-term practice, are little understood. Decreasing variability is frequently examined in terms of error corrections from one trial to the next. However, the ubiquitous noise from all levels of the sensorimotor system is also a significant contributor to overt variability. While neuromotor noise is typically assumed and modeled as immune to practice, the present study challenged this notion. We investigated the long-term practice of a novel motor skill to test whether neuromotor noise can be attenuated, specifically when aided by reward. Results showed that both reward and self-guided practice over 11 days improved behavior by decreasing noise rather than effective error corrections. When the challenge for obtaining reward increased, subjects reduced noise even further. Importantly, when task demands were relaxed again, this reduced level of noise persisted for 5 days. A stochastic learning model replicated both the attenuation and persistence of noise by scaling the noise amplitude as a function of reward. More insight into variability and intrinsic noise and its malleability has implications for training and rehabilitation interventions.
Neuron-glia cross talk revealed in reverberating networks by simultaneous extracellular recording of spikes and astrocytes' glutamate transporter and K+ currents
Authors: Wanke Enzo , Gullo Francesca , Dossi Elena , Valenza Gaetano , Becchetti Andrea
Published: September 2016

Astrocytes uptake synaptically released glutamate with electrogenic transporters (GluT) and buffer the spike-dependent extracellular K+ excess with background K+ channels. We studied neuronal spikes and the slower astrocytic signals on reverberating neocortical cultures and organotypic slices from mouse brains. Spike trains and glial responses were simultaneously captured from individual sites of multielectrode arrays (MEA) by splitting the recorded traces into appropriate filters and reconstructing the original signal by deconvolution. GluT currents were identified by using dl-threo-β-benzyloxyaspartate (TBOA). K+ currents were blocked by 30 μM Ba2+, suggesting a major contribution of inwardly rectifying K+ currents. Both types of current were tightly correlated with the spike rate, and their astrocytic origin was tested in primary cultures by blocking glial proliferation with cytosine β-d-arabinofuranoside (AraC). The spike-related, time-locked inward and outward K+ currents in different regions of the astrocyte syncytium were consistent with the assumptions of the spatial K+ buffering model. In organotypic slices from ventral tegmental area and prefrontal cortex, the GluT current amplitudes exceeded those observed in primary cultures by several orders of magnitude, which allowed to directly measure transporter currents with a single electrode. Simultaneously measuring cell signals displaying widely different amplitudes and kinetics will help clarify the neuron-glia interplay and make it possible to follow the cross talk between different cell types in excitable as well as nonexcitable tissue.
Reduced temporal processing in older, normal-hearing listeners evident from electrophysiological responses to shifts in interaural time difference
Authors: Ozmeral Erol J. , Eddins David A. , Eddins Ann C.
Published: September 2016

Previous electrophysiological studies of interaural time difference (ITD) processing have demonstrated that ITDs are represented by a nontopographic population rate code. Rather than narrow tuning to ITDs, neural channels have broad tuning to ITDs in either the left or right auditory hemifield, and the relative activity between the channels determines the perceived lateralization of the sound. With advancing age, spatial perception weakens and poor temporal processing contributes to declining spatial acuity. At present, it is unclear whether age-related temporal processing deficits are due to poor inhibitory controls in the auditory system or degraded neural synchrony at the periphery. Cortical processing of spatial cues based on a hemifield code are susceptible to potential age-related physiological changes. We consider two distinct predictions of age-related changes to ITD sensitivity: declines in inhibitory mechanisms would lead to increased excitation and medial shifts to rate-azimuth functions, whereas a general reduction in neural synchrony would lead to reduced excitation and shallower slopes in the rate-azimuth function. The current study tested these possibilities by measuring an evoked response to ITD shifts in a narrow-band noise. Results were more in line with the latter outcome, both from measured latencies and amplitudes of the global field potentials and source-localized waveforms in the left and right auditory cortices. The measured responses for older listeners also tended to have reduced asymmetric distribution of activity in response to ITD shifts, which is consistent with other sensory and cognitive processing models of aging.
Developmental experience-dependent plasticity in the first synapse of the Drosophila olfactory circuit
Authors: Golovin Randall M. , Broadie Kendal
Published: September 2016

Evidence accumulating over the past 15 years soundly refutes the dogma that the Drosophila nervous system is hardwired. The preponderance of studies reveals activity-dependent neural circuit refinement driving optimization of behavioral outputs. We describe developmental, sensory input-dependent plasticity in the brain olfactory antennal lobe, which we term long-term central adaption (LTCA). LTCA is evoked by prolonged exposure to an odorant during the first week of posteclosion life, resulting in a persistently decreased response to aversive odors and an enhanced response to attractive odors. This limited window of early-use, experience-dependent plasticity represents a critical period of olfactory circuit refinement tuned by initial sensory input. Consequent behavioral adaptations have been associated with changes in the output of olfactory projection neurons to higher brain centers. Recent studies have indicated a central role for local interneuron signaling in LTCA presentation. Genetic and molecular analyses have implicated the mRNA-binding fragile X mental retardation protein and ataxin-2 regulators, Notch trans-synaptic signaling, and cAMP signal transduction as core regulatory steps driving LTCA. In this article, we discuss the structural, functional, and behavioral changes associated with LTCA and review our current understanding of the molecular pathways underlying these developmental, experience-dependent changes in the olfactory circuitry.
In VitroandIn VivoBiofilm Characterization of Methicillin-ResistantStaphylococcus aureusfrom Patients Associated with Pharyngitis Infection
Authors: Gowrishankar Shanmugaraj , Kamaladevi Arumugam , Balamurugan Krishnaswamy , Pandian Shunmugiah Karutha
Published: September 2016

The present investigation was deliberately aimed at evaluating the biofilm-forming ability of 63 clinical MRSA isolates recovered from pharyngitis patients through different phenotypic assays. The molecular detection of adhesion (icaA/icaD/icaB/icaC), adhesins (fnbA/fnbB,clfA, andcna), staphylococcal accessory regulator (sarA), andα-toxin (hla) genes was done by employing polymerase chain reaction (PCR). Out of 63 isolates, 49 (77.8%) were found slime positive by the Congo red agar (CRA) method and 44 (69.8%) as biofilm positive by the quantitative microtitre plate assays. The results of MATH assay showed that most of the test pathogens are hydrophilic in nature. The molecular investigation of biofilm-associated genes revealed that 84.13% (n=53) of isolates were found positive foricaADBCgenes. ThefnbAandfnbBgenes were present in 49 (77.8%) and 51 (81%) MRSA isolates, respectively. In addition, 58.7% (n=37), 73% (n=46), and 69.8% (n=44) of the isolates harboured theclfA,cna, andhlagenes, respectively. Further, nearly 81% (n=51) of the isolates were found positive for the genesarAand all theicanegative isolates were also negative for the gene. Furthermore, the results ofin vivoadherence assay unveiled the factual commonness in thein vitroadherence method.
Repeatability and Reproducibility of Quantitative Corneal Shape Analysis after Orthokeratology Treatment Using Image-Pro Plus Software
Authors: Mei Ying , Tang Zhiping , Li Zhouyue , Yang Xiao
Published: September 2016

Purpose.To evaluate the repeatability and reproducibility of quantitative analysis of the morphological corneal changes after orthokeratology treatment using “Image-Pro Plus 6.0” software (IPP).Methods.Three sets of measurements were obtained: two sets by examiner 1 with 5 days apart and one set by examiner 2 on the same day. Parameters of the eccentric distance, eccentric angle, area, and roundness of the corneal treatment zone were measured using IPP. The intraclass correlation coefficient (ICC) and repetitive coefficient (COR) were used to calculate the repeatability and reproducibility of these three sets of measurements.Results.ICC analysis suggested “excellent” reliability of more than 0.885 for all variables, and COR values were less than 10% for all variables within the same examiner. ICC analysis suggested “excellent” reliability for all variables of more than 0.90, and COR values were less than 10% for all variables between different examiners. All extreme values of the eccentric distance and area of the treatment zone pointed to the same material number in three sets of measurements.Conclusions. IPP could be used to acquire the exact data of the characteristic morphological corneal changes after orthokeratology treatment with good repeatability and reproducibility. This trial is registered with trial registration number:ChiCTR-IPR-14005505.
An Iterative Method for the Uniformity Improvement of Edge-Lit Backlight
Authors: Yan Jin-Ren , Li De-Cong , Wang Zhi-Kun , Rao Wen-Ping
Published: September 2016

A simple iterative optimization method is developed to improve the exiting light uniformity of the edge-lit backlight module. The method uses the relative deviation of the average luminous flux of the entire light guide plate (LGP) and the luminous flux of each region as constraint criterion and the ratio of the luminous flux of each region to the average luminous flux of the LGP as adjustment coefficient to adjust the density of the microstructures in each region. This process loops until the relative deviations of all regions meet a prespecified threshold value. A LGP based on microprism structure is presented to validate the method. The initial values, which represent the size of the microstructures manufactured on the bottom surfaces of the LGP, d0-dependent luminous fluxes, microstructure size distributions, iterations of the LGP, and the relative deviation of each region are discussed. The simulation results show that it is a very practical method for the uniformity improvement of the backlight when an appropriate initial value is selected and the final uniformity is better than 90% after optimization.
A Novel Evaluation Approach for Tourist Choice of Destination Based on Grey Relation Analysis
Authors: Guo Xudong , Sun Zilai
Published: September 2016

The decision-making process of choosing an ideal tourism destination is influenced by a number of psychological and nonpsychological variables. Tourists need a method to quickly and easily select a suitable destination. Driven by this practical decision issue, a novel approach of tourist destination evaluation, grey relation analysis (GRA), is developed and applied to the ranking evaluation of Taiwan tourism destinations in China. In the evaluating process, we apply entropy to calculate the weight of each index, which is a more objective method of calculating weights. The results of the study indicate that although the same size is small and the distribution of data is unknown, GRA can still be successfully used in evaluating tourist destinations. In addition, we compare the GRA results with the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) and show that more accurate ranking results can be obtained.
Analysis of Relationship between the Body Mass Composition and Physical Activity with Body Posture in Children
Authors: Wyszyńska Justyna , Podgórska-Bednarz Justyna , Drzał-Grabiec Justyna , Rachwał Maciej , Baran Joanna , Czenczek-Lewandowska Ewelina , Leszczak Justyna , Mazur Artur
Published: September 2016

Introduction. Excessive body mass in turn may contribute to the development of many health disorders including disorders of musculoskeletal system, which still develops intensively at that time.Aim. The aim of this study was to assess the relationship between children’s body mass composition and body posture. The relationship between physical activity level of children and the parameters characterizing their posture was also evaluated.Material and Methods. 120 school age children between 11 and 13 years were enrolled in the study, including 61 girls and 59 boys. Each study participant had the posture evaluated with the photogrammetric method using the projection moiré phenomenon. Moreover, body mass composition and the level of physical activity were evaluated.Results. Children with the lowest content of muscle tissue showed the highest difference in the height of the inferior angles of the scapulas in the coronal plane. Children with excessive body fat had less slope of the thoracic-lumbar spine, greater difference in the depth of the inferior angles of the scapula, and greater angle of the shoulder line. The individuals with higher level of physical activity have a smaller angle of body inclination.Conclusion. The content of muscle tissue, adipose tissue, and physical activity level determines the variability of the parameter characterizing the body posture.
The Effect of Different Cleaning Protocols on Post Space: A SEM Study
Authors: Lo Giudice Giuseppe , Lizio Angelo , Giudice Roberto Lo , Centofanti Antonio , Rizzo Giuseppina , Runci Michele , Alibrandi Angela , Cicciù Marco
Published: September 2016

Aim. Purpose of the present paper is to analyze the efficiency of different post-space irrigation protocols.Methods. 28 single rooted teeth were endodontically treated. After post-space preparation every sample was assigned to one of three experimental groups and to one control group. In each group different irrigation protocols were performed as follows: EDTA (Group A), 37% orthophosphoric acid (Group B), and EDTA + 37% orthophosphoric acid with ultrasounds activation (Group C). In the control group (Group D) the irrigate association was not activated by ultrasounds. Three zones (coronal, middle, and apical) of each sample were analyzed by using Scan Electron Microscopy (SEM) without any metallization procedures. The presence of smear layer on the canal surface was qualitatively evaluated by applying Serafino’s score with values included between 0 and 2.Results. The results of the research showed how Group C recorded the better results (0.81±0.72). Group A and Group B showed lower mean scores (1.06±0.69and1.08±0.77); Group D showed the lowest mean score of1.30±0.69. The SEM observation analysis demonstrated how the smear layer presence decreased in the crown-apical direction.Conclusions. The different post-space treatments statistically determine significant differences on the dentinal surfaces cleansing. The absence of ultrasonic activation lowers the cleansing efficacy of endocanalar irrigants, showing sensible differences among each post-space zone.