bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact assessment of technologies diffusion: a mixed methods analysis
Authors: Rezaei-Moghaddam Kurosh , Tohidyan Far Somayeh
Published: December 2019

Background

Impact assessment is an important process that helps the policy makers to understand the consequences of possible and actual government interventions. Assessing the impacts and consequences is considered as applicable means for policy makers and planners of projects, since not only it measures and presents the plans’ developments, but also for determining their impacts on the target group. Therefore, the purpose of this paper was to assess the impacts of laser-land-leveling technology in Iran, comparing the impacts among two groups of farmers adopting traditional-leveling and laser-land-leveling projects and identifying factors influencing perception regarding laser-land-leveling technology impacts.

Methodology

The research draws on a mixed-methods approach, which includes two distinct research phases. First, 375 farmers were selected using survey based on stratified random sampling for quantitative part. Twenty-Seven farmers were also interviewed in the qualitative phase.

Results

The most important impacts of laser-land leveling were uniform germination of the crop, uniform distribution of water, decrease of soil erosion, increasing positive competition, and increasing net income. In addition, the results revealed that adopters of laser-land leveling expressed more impacts than another group.

Conclusions

Attitude towards water and soil resources’ conservation was the most important variable to predict the impacts’ perception among traditional-leveling adopters. It is necessary to officials to increase the information of farmers regarding different consequences of the project and contributing them to make proper decisions for farm management.
Spill-in counts in the quantification of 18F-florbetapir on Aβ-negative subjects: the effect of including white matter in the reference region
Authors:   for the Alzheimer’s Disease Neuroimaging Initiative, López-González Francisco Javier , Moscoso Alexis , Efthimiou Nikos , Fernández-Ferreiro Anxo , Piñeiro-Fiel Manuel , Archibald Stephen J. , Aguiar Pablo , Silva-Rodríguez Jesús
Published: December 2019

Background

We aim to provide a systematic study of the impact of white matter (WM) spill-in on the calculation of standardized uptake value ratios (SUVRs) on Aβ-negative subjects, and we study the effect of including WM in the reference region as a compensation. In addition, different partial volume correction (PVC) methods are applied and evaluated.

Methods

We evaluated magnetic resonance imaging and18F-AV-45 positron emission tomography data from 122 cognitively normal (CN) patients recruited at the Alzheimer’s Disease Neuroimaging Initiative (ADNI). Cortex SUVRs were obtained by using the cerebellar grey matter (CGM) (SUVRCGM) and the whole cerebellum (SUVRWC) as reference regions. The correlations between the different SUVRs and the WM uptake (WM-SUVRCGM) were studied in patients, and in a well-controlled framework based on Monte Carlo (MC) simulation. Activity maps for the MC simulation were derived from ADNI patients by using a voxel-wise iterative process (BrainViset). Ten WM uptakes covering the spectrum of WM values obtained from patient data were simulated for different patients. Three different PVC methods were tested (a) the regional voxel-based (RBV), (b) the iterative Yang (iY), and (c) a simplified analytical correction derived from our MC simulation.

Results

WM-SUVRCGMfollowed a normal distribution with an average of 1.79 and a standard deviation of 0.243 (13.6%). SUVRCGMwas linearly correlated to WM-SUVRCGM(r= 0.82, linear fit slope = 0.28). SUVRWCwas linearly correlated to WM-SUVRCGM(r= 0.64, linear fit slope = 0.13). Our MC results showed that these correlations are compatible with those produced by isolated spill-in effect (slopes of 0.23 and 0.11). The impact of the spill-in was mitigated by using PVC for SUVRCGM(slopes of 0.06 and 0.07 for iY and RBV), while SUVRWCshowed a negative correlation with SUVRCGMafter PVC. The proposed analytical correction also reduced the observed correlations when applied to patient data (r= 0.27 for SUVRCGM,r= 0.18 for SUVRWC).

Conclusions

There is a high correlation between WM uptake and the measured SUVR due to spill-in effect, and that this effect is reduced when including WM in the reference region. We also evaluated the performance of PVC, and we proposed an analytical correction that can be applied to preprocessed data.
Cosmological N-body simulations: a challenge for scalable generative models
Authors: Perraudin Nathanaël , Srivastava Ankit , Lucchi Aurelien , Kacprzak Tomasz , Hofmann Thomas , Réfrégier Alexandre
Published: December 2019

Deep generative models, such as Generative Adversarial Networks (GANs) or Variational Autoencoders (VAs) have been demonstrated to produce images of high visual quality. However, the existing hardware on which these models are trained severely limits the size of the images that can be generated. The rapid growth of high dimensional data in many fields of science therefore poses a significant challenge for generative models. In cosmology, the large-scale, three-dimensional matter distribution, modeled with N-body simulations, plays a crucial role in understanding the evolution of structures in the universe. As these simulations are computationally very expensive, GANs have recently generated interest as a possible method to emulate these datasets, but they have been, so far, mostly limited to two dimensional data. In this work, we introduce a new benchmark for the generation of three dimensional N-body simulations, in order to stimulate new ideas in the machine learning community and move closer to the practical use of generative models in cosmology. As a first benchmark result, we propose a scalable GAN approach for training a generator of N-body three-dimensional cubes. Our technique relies on two key building blocks, (i) splitting the generation of the high-dimensional data into smaller parts, and (ii) using a multi-scale approach that efficiently captures global image features that might otherwise be lost in the splitting process. We evaluate the performance of our model for the generation of N-body samples using various statistical measures commonly used in cosmology. Our results show that the proposed model produces samples of high visual quality, although the statistical analysis reveals that capturing rare features in the data poses significant problems for the generative models. We make the data, quality evaluation routines, and the proposed GAN architecture publicly available at https://github.com/nperraud/3DcosmoGAN.
Mepivacaine-induced anaphylactic shock in a pregnant woman undergoing combined spinal and epidural anesthesia for cesarean delivery: a case report
Authors: Takahashi Miyuki , Hotta Kunihisa , Inoue Soichiro , Takazawa Tomonori , Horiuchi Tatsuo , Igarashi Takashi , Takeuchi Mamoru
Published: December 2019

Background

Anaphylactic shock during pregnancy is a rare but life-threatening event for both the mother and the newborn.

Case presentation

A 42-year-old woman, who was pregnant with twins, was scheduled for cesarean delivery under combined spinal and epidural anesthesia. An epidural catheter was placed uneventfully. After spinal anesthesia, the patient exhibited skin symptoms and severe hypotension. The patient was diagnosed with anaphylaxis, and subsequently, treatment was started. Fetal heart rate monitoring revealed sustained bradycardia, and it was decided to proceed with cesarean delivery. After delivery, the mother’s vital signs recovered. Both infants were intubated due to birth asphyxia. Currently, the twins are 4 years old and exhibit no developmental problems. Clinical examination identified mepivacaine as the causative agent of anaphylaxis.

Conclusions

This case report highlights that upon occurrence of anaphylaxis during pregnancy, maternal treatment and fetal assessment should be started immediately. Indication for immediate cesarean delivery should be considered and a definite identification of the causative factor pursued.
Design and validation of a food frequency questionnaire (FFQ) for the nutritional evaluation of food intake in the Peruvian Amazon
Authors: García Rodríguez María , Romero Saldaña Manuel , Alcaide Leyva José Manuel , Moreno Rojas Rafael , Molina Recio Guillermo
Published: December 2019

Background

Food frequency questionnaires (FFQs) are dietary surveys widely used in studies of nutritional epidemiology because they are inexpensive, easy to complete and provide significant information on dietary intake over a long period of time. FFQs should be written specifically for each study group since diet may be influenced by ethnicity, culture, economic status and environmental factors. The aim of the authors on this work was to design and validate a food frequency questionnaire for the Peruvian Amazon population.

Methods

Three hundred three individuals were selected and completed three 24-h recalls (R24). Two FFQs were conducted on two different occasions (FFQ.1 and FFQ.2). The validity of the FFQ was evaluated by comparing the relationship between the average daily nutrient intake estimated by the FFQs and that obtained by the three R24. The reproducibility was measured by comparing the mean nutrient intake of the two FFQs carried out. The correlations were assessed using the Pearson correlation coefficient, the intraclass correlation coefficient (ICC), the Lin correlation coefficient (CCC) and the Bland–Altman plot.

Results

The results obtained to establish the validity showed a high correlation, with an average Pearson’s correlation coefficient of 0.70, a CCI of 0.65 and a CCC of 0.60. Approximately 60% of the nutrients had a CCC above 0.60. In terms of reproducibility, better results were obtained, with an average Pearson’s correlation coefficient of 0.67, 0.64 for CCI and 0.58 for CCC.

Conclusions

The correlation coefficients show good validity and reproducibility, and therefore, the FFQ we have developed may be considered a useful and valid tool to estimate the dietary intake of the Peruvian Amazon population.
Can a relational mindset boost analogical retrieval?
Authors: Goldwater Micah B. , Jamrozik Anja
Published: December 2019

Background

Memory retrieval is driven by similarity between a present situation and some prior experience, but not all similarity is created equal. Analogical retrieval, rooted in the similarity between two situations in their underlying structural relations, is often responsible for new insights and innovative solutions to problems. However, superficial similarity is instead more likely to drive spontaneous retrieval. How can we make analogical retrieval more likely? Inducing a relational mindset via an analogical reasoning task has previously been shown to boost subsequent relational thinking. In this paper, we examined whether inducing a relational mindset could also boost analogical retrieval.

Results

We find that a relational mindset can increase analogical retrieval if induced before information is encoded in the first place, amplifying the effect of a clearly labelled relational structure. On the other hand, inducing a relational mindset at the time of retrieval did not increase analogical retrieval.

Conclusion

This work further demonstrates the central importance of high-quality relational encoding for subsequent relation-based analogical retrieval, and that inducing a relational mindset can improve those encodings.
Learning hierarchically organized science categories: simultaneous instruction at the high and subtype levels
Authors: Nosofsky Robert M. , Slaughter Colin , McDaniel Mark A.
Published: December 2019

Background

Most science categories are hierarchically organized, with various high-level divisions comprising numerous subtypes. If we suppose that one’s goal is to teach students to classify at the high level, past research has provided mixed evidence about whether an effective strategy is to require simultaneous classification learning of the subtypes. This past research was limited, however, either because authentic science categories were not tested, or because the procedures did not allow participants to form strong associations between subtype-level and high-level category names. Here we investigate a two-stage response-training procedure in which participants provide both a high-level and subtype-level response on most trials, with feedback provided at both levels. The procedure is tested in experiments in which participants learn to classify large sets of rocks that are representative of those taught in geoscience classes.

Results

The two-stage procedure yielded high-level classification performance that was as good as the performance of comparison groups who were trained solely at the high level. In addition, the two-stage group achieved far greater knowledge of the hierarchical structure of the categories than did the comparison controls.

Conclusion

In settings in which students are tasked with learning high-level names for rock types that are commonly taught in geoscience classes, it is best for students to learn simultaneously at the high and subtype levels (using training techniques similar to the presently investigated one). Beyond providing insights into the nature of category learning and representation, these findings have practical significance for improving science education.
Distribution and recombination of Wolbachia endosymbionts in Korean coleopteran insects
Authors: Jeong Gilsang , Han Taeman , Park Haechul , Park Soyeon , Noh Pureum
Published: December 2019

Background

Wolbachia are among the most prevalent endosymbiotic bacteria and induce reproductive anomalies in various invertebrate taxa. The bacterium has huge impacts on host reproductive biology, immunity, evolution, and molecular machinery. However, broad-scale surveys of Wolbachia infections at the order scale, including the order Coleoptera, are limited. In this study, we investigated the Wolbachia infection frequency in 201 Coleopteran insects collected in Korea.

Results

A total of 26 species (12.8%) belonging to 11 families harbored Wolbachia. The phylogenetic trees of based on partial 16S rRNA gene sequences and partial Wolbachia surface protein (wsp) gene sequences were largely incongruent to that of their hosts. This result confirms that Wolbachia evolved independently from their hosts,

Conclusion

Phylogenetic trees suggest that complex horizontal gene transfer and recombination events occurred within and between divergent Wolbachia subgroups.
Development and content validation of the Healthcare Transition Outcomes Inventory for young adults with type 1 diabetes
Authors: Pierce Jessica , Aroian Karen , Schifano Elizabeth , Gannon Anthony , Wysocki Tim
Published: December 2019

Background

The literature on the specification and measurement of the outcomes of the healthcare transition from pediatric to adult centered-care is scarce and methodologically weak. To address these gaps, we conducted a series of studies to develop a multidimensional, multi-informant (young adults, parents, and healthcare providers) measure of healthcare transition outcomes for young adults with type 1 diabetes (T1D), the Healthcare Transition Outcomes Inventory (HCTOI). The current study describes the development and refinement of the HCTOI item pool.

Methods

Following Patient Reported Outcomes Measurement Information System (PROMIS) standards, the research team conducted qualitative interviews to define six content domains of healthcare transition outcomes from the perspectives of multiple stakeholders, developed an initial item pool of the HCTOI based on the six domains, analyzed expert item ratings and feedback for content validation, and conducted cognitive interviews with informants (patients, parents, and healthcare providers) for further item pool refinement.

Results

Qualitative findings revealed six healthcare transition outcome domains: 1) Biomedical markers of T1D control; 2) Navigation of a new health care system; 3) Possession of T1D self-management skills and knowledge; 4) Integration of T1D care into emerging adult roles; 5) Balance of parental involvement with autonomy; and 6) Attainment of T1D “ownership.” An initial pool of 88 items focused on the extent to which a young adult with T1D is successful on each of the six domains. Experts rated all content domains and all but six items as relevant. In addition to suggesting additional items, experts were concerned about the length of the measure, response burden, and whether every informant type would have sufficient knowledge to rate items in particular content domains. Cognitive interviews resulted in retaining all six content domains, but dropping some items and yielded fewer items for the healthcare provider version (47 items versus 54 items for the young adult- and parent-versions).

Conclusions

Expert review and cognitive interviews confirmed that all six domains of HCT outcomes were relevant and both procedures resulted in retaining a sufficient number of clear and representative items for each content domain. The HCTOI represents the first multi-informant, rigorously developed item pool that comprehensively measures the multiple components of the transition from pediatric to adult specialty healthcare.
Factors that influence rheumatologists’ anti-tumor necrosis factor alpha prescribing decisions: a qualitative study
Authors: Gavan Sean P. , Daker-White Gavin , Payne Katherine , Barton Anne
Published: December 2019

Background

Treatment decisions for any disease are usually informed by reference to published clinical guidelines or recommendations. These recommendations can be developed to improve the relative cost-effectiveness of health care and to reduce regional variation in clinical practice. Anti-tumor necrosis factor alpha (anti-TNF) treatments are prescribed for people with rheumatoid arthritis according to specific recommendations by the National Institute for Health and Care Excellence in England. Evidence of regional variation in clinical practice for rheumatoid arthritis may indicate that different factors have an influence on routine prescribing decisions. The aim of this study was to understand the factors that influence rheumatologists’ decisions when prescribing anti-TNF treatments for people with rheumatoid arthritis in England.

Methods

Semi-structured one-to-one telephone interviews were performed with senior rheumatologists in different regions across England. The interview schedule addressed recommendations by the National Institute for Health and Care Excellence, prescribing behavior, and perceptions of anti-TNF treatments. Interviews were recorded digitally, transcribed verbatim, and anonymized. Data were analyzed by thematic framework analysis that comprised six stages (familiarization; coding; developing the framework; applying the framework; generating the matrix; interpretation).

Results

Eleven rheumatologists (regional distribution - north 36%; midlands: 36%; south: 27%) participated (response rate: 24% of the sampling frame). The mean duration of the interviews was thirty minutes (range: 16 to 56 min). Thirteen factors that influenced anti-TNF prescribing decisions were categorized by three nested primary themes; specific influences were defined as subthemes: (i) External Environment Influences (National Institute for Health and Care Excellence Recommendations; Clinical Commissioning Groups; Cost Pressures; Published Clinical Evidence; Colleagues in Different Hospitals; Pharmaceutical Industry); (ii) Internal Hospital Influences (Systems to Promote Compliance with Clinical Recommendations; Internal Treatment Pathways; Hospital Culture); (iii) Individual-level Influences (Patient Influence; Clinical Autonomy; Consultant Experience; Perception of Disease Activity Score-28 (DAS28) Outcome).

Conclusions

Factors that influenced anti-TNF prescribing decisions were multifaceted, seemed to vary by region, and may facilitate divergence from published clinical recommendations. Strategic behavior appeared to illustrate a conflict between uniform treatment recommendations and clinical autonomy. These influences may contribute to understanding sources of regional variation in clinical practice for rheumatoid arthritis.
Pathogenicity of some entomopathogenic fungal strains to green peach aphid, Myzus persicae Sulzer (Homoptera: Aphididae)
Authors: Javed Khadija , Javed Humayun , Mukhtar Tariq , Qiu Dewen
Published: December 2019

Pathogenicity of four fungal strains, two of Beauveria bassiana (designated as BB-72 and BB-252), and two of Lecanicillium lecanii (designated as V-4 and CS-625) to green peach aphid, Myzus persicae Sulzer (Homoptera: Aphididae) was assessed. All treatments showed highly significant effects on the mortality of the aphid when applied as filtrate or conidia. The application methods did not have a significant effect on the mortality rate. The overall mortalities caused by both applications were statistically similar. The maximum overall mortality was caused by BB-72, followed by CS-625 in both application methods. On the other hand, (V-4) caused the minimum mortality rate, followed by (BB-252), which was statistically similar to those caused by V-4. The time also had significant effects on aphid mortality rates. The mortality was the minimum after 3 days reaching its maximum after 10 days. As the number of days increased, there was a corresponding increase in the mortality showing a direct relationship between mortality and time. The maximum mean individual mortality of 95% was caused by CS-625, followed by BB-72 (92%) after 10 days with the conidial application. Similarly, the combined effects of the three most virulent fungal strains showed highly significant differences on the mortality of peach aphid. The combination BB-72 + BB-252 showed the highest percent mortality, followed by BB-72 + BB-252 + CS-625. The combinations BB-72 + CS-625 and BB-252 + CS-625 had statistically similar effects of causing aphid mortality.
Influence of pelvic inclination on sit to stand task in stroke patients
Authors: Darwish Moshera Hassan , Ahmed Sandra , Ismail Manar El-sayed , Khalifa Heba Ahmed
Published: December 2019

Background

Stroke results in an impaired sit to stand (STS) task. Pelvic movements are essential in daily living activities. Few studies investigated the effect of spine and pelvis separately on functional activities in stroke patients.

Objective

The study aimed to assess the angles of pelvic inclination (anterior and posterior pelvic tilt angles) (APT and PPT) during sitting position and during STS movement. It aimed also to determine the influence of sagittal pelvic tilt angles on STS performance in stroke patients.

Patients and methods

Thirty male hemi-paretic stroke patients (GI) and 15 matched healthy volunteer subjects (GII) represented the sample of this study. Stroke patients were assigned into two equal groups (group Ia and Ib). Sagittal pelvic tilt angles were measured by using the palpation meter inclinometer during sitting position and during initiation and mid of STS by using two dimensional (2D) video-based motion analysis system. Time of five repetitions STS test was used to assess the ability to perform STS task.

Results

The results showed a significant increase of PPT angle during static sitting, a significant decrease in APT angle during initiation and mid of STS task and a significant increase in time taken for five repetitions STS test in both stroke groups (P < 0.05).

Conclusion

Abnormal pelvic alignment and movements affect the functional performance of stroke patients during sitting and sit to stand task.

Trial registration

NCT03053154. Registered January 22, 2017. Retrospectively registered.
Role of routine hysteroscopy in previous failed ICSI: a continuous clinical dilemma
Authors: Al-Temamy Emad , El-Omda Fahd , Salama Sameh , Salem Sondos , Abd ElRasheed Mazen , Ammar Sherif
Published: December 2019

Background

The benefit of hysteroscopy could extend beyond the treatment of intrauterine abnormalities. Irrigation of the cavity with saline may have a beneficial effect on implantation and pregnancy rates, since saline mechanically washes harmful anti-adhesive glycoprotein molecules on the endometrial surface involved in endometrial receptivity, i.e., cyclooxygenase-2 (COX-2), mucin-1 (MUC-1), and integrin.

Objective

The aim of this study is to evaluate the role and benefit of routine hysteroscopy prior to ICSI in women with previous failed ICSI.

Patients and methods

This prospective study has been carried out, at the outpatient clinic, on 100 women that have undergone hysteroscopy as a part of the infertility workup. Women were categorized into three groups according to the number of previous failed IVF/ICSI, once (n = 37), twice (n = 33), and thrice (n = 30).

Results

After analyzing the data, we found that hysteroscopy was associated with 39% overall clinical pregnancy rate in women with previous/repeat IVF/ICSI failure. Treatment of polyp was associated with 58.3% clinical pregnancy rate (NNT = 1.71). Treatment of intrauterine adhesions was associated with 16.7% clinical pregnancy rate (NNT = 6). Treatment of submucous myoma and uterine septum showed a 75% and 50% clinical pregnancy rate, respectively.

Conclusion

Hysteroscopic examination in women with previous failed ICSI may improve pregnancy rate even in the absence of uterine pathology. Consequently, hysteroscopy examination may be proposed as a routine step prior to ICSI in case of previous failure.
Nutraceutical potentials of synergic foods: a systematic review
Authors: Natarajan Tharani Devi , Ramasamy Janci Rani , Palanisamy Kirthika
Published: December 2019

Food synergy is a concept of linking foods to health. Food consists of mixtures of nutrients, serving as a fuel for the body. When synergistic foods are put together, the evidence for potential health benefits becomes stronger than individual foods. Nutrient deficiency is a known phenomenon in many individuals, and synergy plays a very important role in combating the nutritional deficiency. Today’s consumer expresses high interest to build knowledge on the active role of food in their well-being, as well as in the prevention of non-transmissible chronic diseases. Functional foods and their active compounds play a vital role in preventing chronic diseases, improving immunity, and decreasing infections. The concept of synergy is an overthinking in nutrition research which can enhance effective dietary planning value added to the forthcoming nutrition research. This paper gives an overview of various synergic combinations of food components and their interactions within the food and with the human system to attain ideal health benefits.
Non-randomness distribution of micro-RNAs on human chromosomes
Authors: Boroumand Fariba , Saadat Iraj , Saadat Mostafa
Published: December 2019

Background

Micro-RNA (miRNA) is one of the non-coding RNAs that exist in human genome. miRNAs play an important role in the expression of target genes. Several studies have indicated that organization of human genome is not random. In order to investigate the distribution of miRNAs on human chromosomes, the present study was carried out.

Results

Using the data from miRBase database, we found 1913 loci coding for miRNAs (MIRs). Human chromosome bands 1p36, 1q22, 1q24, 2q13, 2q35, 3p21, 6p21, 7q22, 8p23, 8q24, 9q22, 9q34, 11q12-q13, 12q13, 14q32, 16p13, 16q24, 17p13, 17q11, 17q21, 17q25, 19p13, 19q13, 20q13, 21p11, 22q13, and Xq26-q28 were significantly bearing higher number of MIRs. The 14q32 and 19q13 with 4.11 and 3.59 MIRs per mega-base pair, respectively, were the most MIR-richest human chromosomal bands. The number of MIRs on chromosomal bands significantly decreased as a function of distance from telomere (r = − 0.949, df = 5,P = 0.001).

Conclusions

Our current data suggest that MIRs are not randomly distributed on human genomes.
In vivo measurement of stent length by using intravascular ultrasound
Authors: Algowhary Magdy , Taha Salma , Hasan-Ali Hosam , Matsumura Akihiko
Published: December 2019

Background

What happens to stent length when deployed in a coronary artery? It is the aim of this study.

Results

Consecutive 95 balloon-expandable stents (BES) were studied by intravascular ultrasound (IVUS) imaging. The stent length was measured from the longitudinal view in two ways: (1) edge-to-edge length (E-E) measured between distal and proximal stent frames located at one IVUS quadrant and (2) area-to-area length (A-A) measured between distal and proximal stent frames located at two or more IVUS quadrants. IVUS measurements were compared with the manufacturer-stated length (M-L). The median E-E length was significantly longer than M-L, 18.76 mm [interquartile range (IQR) 15.65–23.60] versus 18.00 mm (IQR 15.00–23.00), respectively, p < 0.0001. Also, the median A-A length was significantly longer, 18.36 mm (IQR 15.19–23.47), p < 0.0001, than M-L. Moreover, the E-E length was significantly different from A-A length, p < 0.0001. Among the stent groups, the differences were significantly present in all drug-eluting stent and bare metal stent (BMS) comparisons, p < 0.0001, except the A-A length versus M-L in BMS only. By multivariate analysis, the predictors of difference in stent length were as follows: lesion length, p = 0.01; pre-intervention minimal diameter of the external elastic membrane (EEM), p = 0.03; lesions present in the left anterior descending branch, p = 0.03; and M-L, p = 0.04.

Conclusions

In the present study, the length of BES measured by IVUS was significantly different from the manufacturer-stated length. In addition to the manufacturer length, other important factors such as lesion length, pre-intervention diameter of EEM, and affected vessel determine the stent length.
Psychiatric morbidity among Egyptian patients seeking rhinoplasty
Authors: Omar Abdelnasser , Eid Maissa , Ali Ramy , El Missiry Marwa , Gawad Ahmed Adel Abdel , El Ghoneimy Soheir
Published: December 2019

Background

Rhinoplasty is one of the most common cosmetic surgeries performed on the face; seeking this operation can be influenced by socio-cultural factors, personality factors, and psychiatric morbidity. The purpose of this study is to identify the prevalence and profile of psychiatric morbidities that would present among those individuals seeking rhinoplasty and to recognize the importance of preoperative psychiatric assessment.

Results

50.8% of the study sample fulfilled the DSM-IV criteria for Axis I and Axis II psychiatric disorders. The most prevalent diagnosis among the whole group was mixed personality disorder (15.2%) followed by body dysmorphic disorder (10.2%), borderline personality disorder (6.8%), and then anxiety disorders (5%). Data revealed that female non-married subjects who were performed with a previous cosmetic operation suffered significantly from psychiatric morbidity. Subjects with psychiatric morbidity showed significant (P, 0.000) higher scores in MBSRQ health orientation and weight preoccupation than their non-psychiatric counterparts.

Conclusion

This study demonstrated a high prevalence of psychiatry morbidity in individuals requesting rhinoplasty. It seems important to screen individuals for mental health problems preoperatively to detect crucial psychiatric problems; thus, we can avoid subsequent risk for both individuals and cosmetic surgeons.
Clip and wire localization of locally advanced malignant breast masses in patients undergoing neoadjuvant chemotherapy and breast conservation therapy
Authors: Shalaby Lamiaa Adel Salah El Din , Khallaf Emad Salah el din , Moussa Mohamed Mahmoud
Published: December 2019

Background

In locally advanced breast cancers, the use of preoperative systemic therapy has been shown to induce tumor response and to improve the local control rate after subsequent surgery and radiation therapy. The purpose of the study is to evaluate the accuracy of localization of breast malignant masses in patients who received neoadjuvant chemotherapy and will undergo conservative breast surgery by using clip and wire marker.

Results

Clip placement was done in 20/20 cases (100%). There was no mammographic evidence of clip migration or complication related to the clip insertion. Wire localization of tumor bed marked by radiopaque clip 1-day preoperative was done in 18/20 patient (90%), the other 2 patients, the masses were clinically palpable (10%). Accurate localization by wire was positive in 18/18 cases. Clip and wire retrieval were positive in all cases.

Conclusion

Clip markers can be used for tumor localization in breast cancer patients undergoing neoadjuvant chemotherapy without migration. Clips are tolerated and safe for the patient, easily visualized on imaging, do not interfere with treatment response, and are cost-effective. Also, serves as a guide for post-neoadjuvant chemotherapy localization when the tumor is not palpable.
An improved method to characterize the full-scale pore system and dual pore model of tight sands
Authors: Zhu Yurui , Lu Zhengyuan , Feng Mingshi , Wang Jun , Li Zhipeng
Published: December 2019

Tight sands have pore systems with complex structures and widely distributed pore sizes. We have studied the characteristics of these pore systems to better understand their important role in the accumulation and migration mechanisms of oil and gas reservoirs, which may enhance our ability to evaluate reservoir quality and predict reservoir production. To this end, we carried out thin-section analysis, scanning electron microscopy, pressure-controlled porosimetry (PCP), and rate-controlled porosimetry (RCP) to describe the pore systems of a typical tight-sand reservoir in East Asia. We improved a differential-distribution-based splicing method to reveal the full-scale pore systems using PCP and RCP. We found that the typical pore radius distribution in our target reservoir exhibits two peaks: at radius [Formula: see text] and at radius [Formula: see text]. Based on pore shapes and connections, intergranular pores are network structures and clay-host pores are tree-like structures. Intragranular pores, in contrast, can be different structures under different conditions. If wide throats are present, intragranular pores function as typical tree-like pores; if throats are narrow, they serve as the pore parts of a network-pore system. Network pores are the primary contributors to porosity and permeability, whereas tree-like pores mainly contribute to porosity. In some high-clay sands, however, the tree-like pores may also contribute to permeability. Based on their fractal characteristics, we divided the pore systems of tight sands into three types: (1) a network-structure-controlled intergranular pore system, (2) a tree-like-structure-controlled clay-host pore system, and (3) a network-structure-controlled intergranular-intragranular pore system.
Threading a pathway through the forest of mood and personality disorders
Authors: Tyrer Peter
Published: December 2019

The classification of mood and personality disorders has become unnecessarily complicated. It has become bogged down by well-meaning but unhelpful subcategories that puzzle the will of clinicians to make useful judgements. The answer is to think of bipolar, depressive and personality disorders as each constituting a spectrum of severity and not to be too preoccupied with individual labels. It would also be useful to avoid the diagnostic chimera of borderline personality disorder, a condition that defies proper classification.
Can dietary supplements maintain cognition in mid- to late-life?
Authors: Smith Alexander L. W.
Published: December 2019

Cognitive health, and prevention of its decline to dementia, has risen in prominence with a corresponding exploration of modifiable risk factors to prevent a decline in cognitive health with age. This commentary discusses a new Cochrane review that examines the effect of vitamin and mineral supplementation in maintaining cognitive health in cognitively healthy adults in mid- and late-life. From a heterogeneous body of evidence, the quality of which ranged from very low to moderate, the review draws the conclusions of little or no benefit of supplements.
Estrogens and Glucocorticoids in Mammary Adipose Tissue: Relationships with Body Mass Index and Breast Cancer Features
Authors: Laforest Sofia , Pelletier Mélissa , Denver Nina , Poirier Brigitte , Nguyen Sébastien , Walker Brian R , Durocher Francine , Homer Natalie Z M , Diorio Caroline , Andrew Ruth , Tchernof André
Published: December 2019

Context

Adipose tissue is an important site for extragonadal steroid hormone biosynthesis through the expression and activity of P450 aromatase, 11β-hydroxysteroid dehydrogenase (HSD) 1, and 17β-HSDs. The contribution of steroid hormones produced by adjacent adipose tissue for the progression and survival of breast tumors is unknown.

Objective

To quantify estrogens (estradiol, estrone) and glucocorticoids (cortisol, cortisone) in breast adipose tissue from both healthy and diseased women and their relationships with adiposity indices and breast cancer prognostic markers.

Design and setting

Breast adipose tissue was collected at time of surgery.

Patients

Pre- and postmenopausal women undergoing partial mastectomy for treatment of breast cancer (n = 17) or reduction mammoplasty (n = 6) were studied.

Interventions

Relative estrogen and glucocorticoid amounts were determined by liquid chromatography tandem mass spectrometry.

Results

The targeted steroids were reliably detected and quantified in mammary adipose tissues. Women with ER+/PR+ tumor had higher relative estradiol amount than women with ER–/PR– tumor (P < .05). The ratio of estradiol-to-estrone was higher in lean women than in women with a body mass index (BMI) ≥ 25 kg/m2 (P < .05). Mixed-model analyses showed that estradiol, cortisone, and cortisol were negatively associated with tumor size (P < .05). Relationships between glucocorticoids and tumor size remained significant after adjustment for BMI. The cortisol-to-cortisone ratio was negatively associated with tumor stage (P < .05) independently of BMI.

Conclusions

We reliably quantified estrogens and glucocorticoids in breast adipose tissue from healthy women and women suffering from breast cancer. Our findings suggest that smaller breast tumors are associated with higher relative amounts of estradiol and cortisol in adipose tissue.
Screening for Nonclassic Congenital Adrenal Hyperplasia in the Era of Liquid Chromatography-Tandem Mass Spectrometry
Authors: Chesover Alexander D , Millar Heather , Sepiashvili Lusia , Adeli Khosrow , Palmert Mark R , Hamilton Jill
Published: December 2019

Context

Screening for and diagnosing non classic congenital adrenal hyperplasia (NCCAH) uses serum 17-hydroxyprogesterone (17OHP) thresholds established from immunoassay data; however, a new liquid-chromatography tandem mass spectrometry (LC-MS/MS) method results in lower 17OHP values. The evolution of immunoassays is also challenging our diagnostic cut-off for glucocorticoid insufficiency and few data re-evaluate the utility of testing for glucocorticoid insufficiency in NCCAH.

Objective

(1) Evaluate the 17OHP threshold that predicts NCCAH in children using LC-MS/MS, and (2) determine the prevalence of glucocorticoid insufficiency in NCCAH.

Methods

A retrospective chart review of pediatric patients who underwent ACTH stimulation tests with cortisol and 17OHP measurements from 2011 to 2018 for assessment of NCCAH. Other adrenal pathologies were excluded. A cortisol < 415 nmol/L defined glucocorticoid insufficiency. Published correlation data determined a 17OHP of 3.3 nmol/L by LC-MS/MS was equivalent to 6 nmol/L by immunoassay. Data analysis was by measures of diagnostic accuracy.

Results

Of 188 patients included, 23 (12%) had NCCAH (21/23 had genetic confirmation); the remaining 2 had peak 17OHP > 30 nmol/L. Baseline 17OHP ≥ 6 nmol/L most accurately screened for NCCAH—sensitivity and specificity 96%. Almost all genetically confirmed NCCAH (20/21) had peak 17OHP > 30 nmol/L; all subjects with other diagnoses peaked < 30 nmol/L. Glucocorticoid insufficiency was present in 55% with NCCAH.

Conclusions

Despite the increased specificity of LC-MS/MS, a baseline 17OHP ≥ 6 nmol/L most accurately screened for NCCAH; this supports current practice guidelines. This threshold identified all with glucocorticoid insufficiency, notably prevalent in our cohort and for whom glucocorticoid stress dosing should be considered.
Glucagon-Like Peptide 1 and Atrial Natriuretic Peptide in a Female Mouse Model of Obstructive Pulmonary Disease
Authors: Balk-Møller Emilie , Windeløv Johanne Agerlin , Svendsen Berit , Hunt Jenna , Ghiasi Seyed Mojtaba , Sørensen Charlotte Mehlin , Holst Jens Juul , Kissow Hannelouise
Published: December 2019

Glucagon-like peptide-1 (GLP-1) is protective in lung disease models but the underlying mechanisms remain elusive. Because the hormone atrial natriuretic peptide (ANP) also has beneficial effects in lung disease, we hypothesized that GLP-1 effects may be mediated by ANP expression. To study this putative link, we used a mouse model of chronic obstructive pulmonary disease (COPD) and assessed lung function by unrestrained whole-body plethysmography. In 1 study, we investigated the role of endogenous GLP-1 by genetic GLP-1 receptor (GLP-1R) knockout (KO) and pharmaceutical blockade of the GLP-1R with the antagonist exendin-9 to -39 (EX-9). In another study the effects of exogenous GLP-1 were assessed. Lastly, we investigated the bronchodilatory properties of ANP and a GLP-1R agonist on isolated bronchial sections from healthy and COPD mice.

Lung function did not differ between mice receiving phosphate-buffered saline (PBS) and EX-9 or between GLP-1R KO mice and their wild-type littermates. The COPD mice receiving GLP-1R agonist improved pulmonary function (P < .01) with less inflammation, but no less emphysema compared to PBS-treated mice. Compared with the PBS-treated mice, treatment with GLP-1 agonist increased ANP (nppa) gene expression by 10-fold (P < .01) and decreased endothelin-1 (P < .01), a peptide associated with bronchoconstriction. ANP had moderate bronchodilatory effects in isolated bronchial sections and GLP-1R agonist also showed bronchodilatory properties but less than ANP. Responses to both peptides were significantly increased in COPD mice (P < .05, P < .01).

Taken together, our study suggests a link between GLP-1 and ANP in COPD.
Stickler Syndrome: Airway Complications in a Case Series of 502 Patients
Authors: Zimmermann Julia , Stubbs Daniel J. , Richards Allan J. , Alexander Philip , McNinch Annie M. , Matta Basil , Snead Martin P.
Published: December 2019

Background:

Patients with Stickler syndrome often require emergency surgery and are often anesthetized in nonspecialist units, typically for retinal detachment repair. Despite the occurrence of cleft palate and Pierre-Robin sequence, there is little published literature on airway complications. Our aim was to describe anesthetic practice and complications in a nonselected series of Stickler syndrome cases. To our knowledge, this is the largest such series in the published literature.

METHODS:

We retrospectively identified patients with genetically confirmed Stickler syndrome who had undergone general anesthesia in a major teaching hospital, seeking to identify factors that predicted patients who would require more than 1 attempt to correctly site an endotracheal tube (ETT) or supraglottic airway device (SAD). Patient demographics, associated factors, and anesthetic complications were collected. Descriptive statistical analysis and logistic regression modeling were performed.

RESULTS:

Five hundred and two

anesthetic events were analyzed. Three hundred ninety-five (92.7%) type 1 Stickler and 63 (96.9%) type 2 Stickler patients could be managed with a single attempt of passing an ETT or SAD. Advanced airway techniques were required on 4 occasions, and we report no major complications. On logistic regression, modeling receding mandible (P = .0004) and history of cleft palate (P = .0004) were significantly associated with the need for more than 1 attempt at airway manipulation.

CONCLUSIONS:

The majority of Stickler patients can be anesthetized safely with standard management. If patients have a receding mandible or history of cleft, an experienced anesthetist familiar with Stickler syndrome should manage the patient. We recommend that patients identified to have a difficult airway wear an alert bracelet.
Moderate-to-Deep Sedation Using Target-Controlled Infusions of Propofol and Remifentanil: Adverse Events and Risk Factors: A Retrospective Cohort Study of 2937 Procedures
Authors: Barends Clemens R. M. , Driesens Mendy K. , van Amsterdam Kai , Struys Michel M. R. F. , Absalom Anthony R.
Published: December 2019

BACKGROUND:

In the University Medical Center Groningen in Groningen, the Netherlands, moderate-to-deep sedation is provided by nursing staff trained and supervised by the anesthesia department using protocol-based target-controlled infusions (TCIs) of propofol and remifentanil. The aim of this retrospective cohort study was to investigate the incidence of events with potential adverse health consequences within this service model and the risk factors for the occurrence of these events.

METHODS:

We retrospectively interrogated a database containing the computerized anesthetic records of 2937 procedures where moderate-to-deep sedation was provided using TCI administration of propofol and remifentanil between May 2014 and October 2017. The primary outcome measures were the incidence of sedation-related events with potential adverse health consequences and risk factors for the occurrence of such events. The events under investigation were unplanned intensive care unit (ICU) admission, need for cardiopulmonary resuscitation (CPR), death on the day of the procedure due to sedation-related events, cardiovascular events (arrhythmias, hypertension, and hypotension), pulmonary events (aspiration, desaturation, unplanned tracheal intubation), anaphylactic or allergic reactions, and the termination of the procedure due to sedation-related events. Cardiovascular and pulmonary events were classified as severe, significant, or moderate. Events were identified by using computer algorithms to search the computerized records from all included procedures.

RESULTS:

Data from 2937 procedures were analyzed. No patients suffered catastrophic events (death, need for CPR, or unplanned ICU admission). Thirty-two severe sedation-related events occurred in 32 procedures. Severe desaturation (0.6%; 95% confidence interval [CI], 0.4–0.9) and severe hypertension (0.2%; 95% CI, 0.04–0.37) were the most common severe events. Significant hypotension (8.8%; 95% CI, 7.73–9.77) and significant desaturation (1.6%; 95% CI, 1.12–2.02) were found to be the most common events with potential adverse health consequences. No patient suffered lasting health consequences. Average mean and maximum targeted effect-site concentrations (Cet) for propofol were 2.6 ± 0.83 and 3.3 ± 1.09 µg·mL−1, respectively, and for remifentanil 0.84 ± 0.18 and 0.99 ± 0.22 ng·mL−1, respectively. Maximum Cets of propofol were lower among patients with higher body mass index (BMI) and were higher among patients of younger age. Higher BMI was a risk factor for desaturation. Increased age and lower BMI were risk factors for hypotension. Longer procedure time was a risk factor for both desaturation and hypotension.

CONCLUSIONS:

Moderate-to-deep sedation by propofol and remifentanil TCI has a low incidence of catastrophic and severe events.