bluuebunny/crossref_metadata_2025 huggingface dataset:
Financial Hardship after Hematopoietic Cell Transplantation: Lack of Impact on Survival
Authors: Khera Nandita , Albelda Randy , Hahn Theresa , Coronado Diana Salas , Odejide Oreofe O. , Soiffer Robert J. , Abel Gregory A.
Published: February 2018

Background: Financial hardship is a growing challenge for patients with blood cancer who undergo hematopoietic cell transplantation (HCT), and it is associated with poor patient-reported outcomes. In contrast, little is known about the potential impact of patient-reported financial hardship on post-HCT survival.

Methods: We sought to describe the association of financial hardship with survival after HCT in a prospectively assembled cohort of patients from three large transplant centers (n = 325).

Results: There was no association between financial hardship measures assessed at 6 months post-HCT and 1- or 2-year survival after HCT.

Conclusions: Patient-reported financial distress after HCT does not seem to adversely affect post-HCT survival.

Impact: When assessing the effectiveness of interventions to ameliorate familial financial burden among HCT, the focus should be on patient-reported outcomes rather than survival. Cancer Epidemiol Biomarkers Prev; 27(3); 345–7. ©2018 AACR.
The Impact of Onychomycosis on Quality of Life: A Systematic Review of the Available Literature
Authors: Gupta Aditya K. , Mays Rachel R.
Published: February 2018

Purpose: Onychomycosis is a nail disorder that is increasing in prevalence worldwide. The psychological and social limitations caused by onychomycosis can potentially undermine the work and social lives of those experiencing these negative effects. This review aimed to evaluate the randomized controlled trials (RCTs) available in the current literature on the impact onychomycosis has on quality of life (QoL). Methods: A systematic review was performed using the databases PubMed, PsycINFO, Scopus, ClinicalTrials.gov, and Cochrane Library on July 18, 2017. Only RCTs with clinical effects described in English were included for review. Results: Ten RCTs reported QoL outcomes for patients suffering from onychomycosis. Treatment satisfaction was statistically significant from baseline to end of treatment in 100.0% (4/4) measures which reported on satisfaction with treatment; mental health was also significant in 100.0% (3/3), symptoms index rating in 100.0% (2/2), symptom frequency in 75.0% (3/4), overall problems in 75.0% (3/4), functional activities in 75.0% (6/8), appearance problems in 66.7% (2/3), symptom distress in 57.1% (4/7), and stigma in 40.0% (2/5). The OnyCOE-tTM and the NailQoL were the most used common outcome measures to describe QoL. Conclusion: The study sanctions that onychomycosis physically and psychologically distresses patients’ lives. Further research should include validated outcome measures to more effectively treat onychomycosis.
Long-Term Follow-Up of 4 Patients with Conjunctival Amyloidosis
Authors: Prager Alisa J. , Habib Larissa A. , Gambogi Talita , Busam Klaus J. , Marr Brian P.
Published: February 2018

Conjunctival amyloidosis is a rare cause of ocular inflammation, mass, and hemorrhage that can be difficult to diagnose and treat. In this case series, we describe 4 patients with a histopathological diagnosis of conjunctival amyloidosis treated at a single institution. All patients underwent surgical excision and biopsy. On histopathological examination, 3 patients had local deposition of either kappa or lambda monoclonal immunoglobulin light chains, favoring localized amyloid light-chain amyloidosis. Systemic workup to exclude rheumatologic disorders (e.g., anti-neutrophil cytoplasmic antibody and rheumatoid factors) and hematological disorders (e.g., imaging, biopsies, and serum protein electrophoresis/urine protein electrophoresis) was negative except for a positive abdominal fat biopsy in 1 patient. Patients were followed for an average of 6.1 years (range 4 months to 15 years) with stable ocular disease.
Cilostazol Attenuates Angiotensin II–Induced Abdominal Aortic Aneurysms but Not Atherosclerosis in Apolipoprotein E–Deficient Mice
Authors: Umebayashi Ryoko , Uchida Haruhito A. , Kakio Yuki , Subramanian Venkateswaran , Daugherty Alan , Wada Jun
Published: February 2018

Objective—

Abdominal aortic aneurysm (AAA) is a permanent dilation of the abdominal aorta associated with rupture, which frequently results in fatal consequences. AAA tissue is commonly characterized by localized structural deterioration accompanied with inflammation and profound accumulation of leukocytes, although the specific function of these cells is unknown. Cilostazol, a phosphodiesterase III inhibitor, is commonly used for patients with peripheral vascular disease or stroke because of its anti-platelet aggregation effect and anti-inflammatory effect, which is vasoprotective effect. In this study, we evaluated the effects of cilostazol on angiotensin II–induced AAA formation.

Approach and Results—

Male apolipoprotein E–deficient mice were fed either normal diet or a diet containing cilostazol (0.1% wt/wt). After 1 week of diet consumption, mice were infused with angiotensin II (1000 ng/kg per minute) for 4 weeks. Angiotensin II infusion increased maximal diameters of abdominal aortas, whereas cilostazol administration significantly attenuated dilatation of abdominal aortas, thereby, reducing AAA incidence. Cilostazol also reduced macrophage accumulation, matrix metalloproteinases activation, and inflammatory gene expression in the aortic media. In cultured vascular endothelial cells, cilostazol reduced expression of inflammatory cytokines and adhesive molecules through activation of the cAMP–PKA (protein kinase A) pathway.

Conclusions—

Cilostazol attenuated angiotensin II–induced AAA formation by its anti-inflammatory effect through phosphodiesterase III inhibition in the aortic wall. Cilostazol may be a promising new therapeutic option for AAAs.
Long-Term Outcome of Substrate Modification in Ablation of Post–Myocardial Infarction Ventricular Tachycardia
Authors: Wolf Michael , Sacher Frédéric , Cochet Hubert , Kitamura Takeshi , Takigawa Masateru , Yamashita Seigo , Vlachos Konstantinos , Cheniti Ghassen , Frontera Antonio , Martin Ruairidh , Thompson Nathaniel , Massoullié Grégoire , Lam Anna , Martin Claire , Collot Florent , Duchateau Josselin , Pambrun Thomas , Denis Arnaud , Derval Nicolas , Hocini Mélèze , Haïssaguerre Michel , Jaïs Pierre
Published: February 2018

Background:

Long-term results of substrate modification for ablation of ventricular tachycardia (VT) have not been reported. We report long-term outcomes of substrate elimination targeting local abnormal ventricular activities (LAVA) for post–myocardial infarction VT.

Methods and Results:

One hundred fifty-nine consecutive patients undergoing first ablation were included (65±11 years, 92% implantable cardioverter defibrillators, 54% storms, and 73% appropriate shocks). LAVA were identified in 92% and VT was inducible in 73%. Complete LAVA elimination and noninducibility after ablation were achieved in 64% and 85%. During a median follow-up of 47 months (interquartile range, 34–82), single-procedure ventricular arrhythmia (VA)–free survival was 55% (10% storms and 19% shocks). The VA-free survival was 73%, 68%, 61%, 55%, and 49% after 1, 2, 3, 4, and 5 years, respectively. Complete LAVA elimination was associated with improved outcomes: VA-free survival of 82% at 1 year and 61% at 5 years. In the subgroup treated with multielectrode mapping and real-time image integration, VA-free survival was 86% and 65% at 1 year and 4 years, respectively. Including repeat procedures in 18% of pts (1.3±0.6 ablations/pt) outcomes improved to 69% VA-free survival (2% storms and 9% shocks) during median 46-month follow-up. Overall survival was 91% at 1 year and 77% at 5 years of follow-up.

Conclusions:

In this monocentric study, substrate modification targeting LAVA for post–myocardial infarction VT resulted in a substantial reduction of VT storm and implantable cardioverter defibrillator shocks and up to 49% of patients free from arrhythmia at 5 years after a single procedure. Complete LAVA elimination, multielectrode mapping, and real-time integration were associated with improved VA-free survival.
Repolarization Heterogeneity Measured With T-Wave Area Dispersion in Standard 12-Lead ECG Predicts Sudden Cardiac Death in General Population
Authors: Kenttä Tuomas V. , Sinner Moritz F. , Nearing Bruce D. , Freudling Rebecca , Porthan Kimmo , Tikkanen Jani T. , Müller-Nurasyid Martina , Schramm Katharina , Viitasalo Matti , Jula Antti , Nieminen Markku S. , Peters Annette , Salomaa Veikko , Oikarinen Lasse , Verrier Richard L. , Kääb Stefan , Junttila M. Juhani , Huikuri Heikki V.
Published: February 2018

Background:

We developed a novel electrocardiographic marker, T-wave area dispersion (TW-Ad), which measures repolarization heterogeneity by assessing interlead T-wave areas during a single cardiac cycle and tested whether it can identify patients at risk for sudden cardiac death (SCD) in the general population.

Methods and Results:

TW-Ad was measured from standard digital 12-lead ECG in 5618 adults (46% men; age, 50.9±12.5 years) participating in the Health 2000 Study—an epidemiological survey representative of the Finnish adult population. Independent replication was performed in 3831 participants of the KORA S4 Study (Cooperative Health Research in the Region of Augsburg; 49% men; age, 48.7±13.7 years; mean follow-up, 8.8±1.1 years). During follow-up (7.7±1.4 years), 72 SCDs occurred in the Health 2000 Survey. Lower TW-Ad was univariately associated with SCD (0.32±0.36 versus 0.60±0.19;
P
<0.001); it had an area under the receiver operating characteristic curve of 0.809. TW-Ad (≤0.46) conferred a hazard ratio of 10.8 (95% confidence interval, 6.8–17.4;
P
<0.001) for SCD; it remained independently predictive of SCD after multivariable adjustment for clinical risk markers (hazard ratio, 4.6; 95% confidence interval, 2.7–7.4;
P
<0.001). Replication analyses performed in the KORA S4 Study confirmed an increased risk for cardiac death (unadjusted hazard ratio, 5.5; 95% confidence interval, 3.2–9.5;
P
<0.001; multivariable adjusted hazard ratio, 1.9; 95% confidence interval, 1.1–3.5;
P
<0.05).

Conclusion:

Low TW-Ad, reflecting increased heterogeneity of repolarization, in standard 12-lead resting ECGs is a powerful and independent predictor of SCD in the adult general population.
Neuroprotective Effects of MAGL (Monoacylglycerol Lipase) Inhibitors in Experimental Ischemic Stroke
Authors: Choi Sang-Ho , Arai Allison L. , Mou Yongshan , Kang Byeongteck , Yen Cecil Chern-Chyi , Hallenbeck John , Silva Afonso C.
Published: February 2018

Background and Purpose—

MAGL (monoacylglycerol lipase) is an enzyme that hydrolyzes the endocannabinoid 2-arachidonoylglycerol and regulates the production of arachidonic acid and prostaglandins—substances that mediate tissue inflammatory response. Here, we have studied the effects of the selective MAGL inhibitors JZL184 and MJN110 and their underlying molecular mechanisms on 3 different experimental models of focal cerebral ischemia.

Methods—

SHR (spontaneously hypertensive rats) and normotensive WKY (Wistar Kyoto) rats were subject to an intracortical injection of the potent vasoconstrictor endothelin-1, permanent occlusion of a distal segment of the middle cerebral artery via craniectomy, or transient occlusion of the middle cerebral artery by the intraluminal suture method. JZL184 or MJN110 was administered 60 minutes after focal cerebral ischemia. Infarct volumes, hemispheric swelling, and functional outcomes were assessed between days 1 to 28 by magnetic resonance imaging, histology, and behavioral tests.

Results—

Pharmacological inhibition of MAGL significantly attenuated infarct volume and hemispheric swelling. MAGL inhibition also ameliorated sensorimotor deficits, suppressed inflammatory response, and decreased the number of degenerating neurons. These beneficial effects of MAGL inhibition were not fully abrogated by selective antagonists of cannabinoid receptors, indicating that the anti-inflammatory effects are caused by inhibition of eicosanoid production rather than by activation of cannabinoid receptors.

Conclusions—

Our results suggest that MAGL may contribute to the pathophysiology of focal cerebral ischemia and is thus a promising therapeutic target for the treatment of ischemic stroke.
Melanosternarchus amaru, a new genus and species of electric ghost knifefish (Gymnotiformes: Apteronotidae) from the Amazon Basin
Authors: BERNT MAXWELL J. , CRAMPTON WILLIAM G. R. , ORFINGER ALEXANDER B. , ALBERT JAMES S.
Published: February 2018

We describe Melanosternarchus amaru as a new genus and species of Apteronotidae from the deep channels of blackwater and clearwater tributaries of the Amazon River in Brazil and Peru. The new species superficially resembles members of the widespread “Apteronotus” bonapartii species group, from which it can be readily distinguished by expanded bones of the infraorbital laterosensory canal. It can further be distinguished from all other apteronotids by a unique combination of characters: reduced premaxillary dentition, a large gape, and an absence of scales from the entire dorsum. A molecular phylogenetic analysis using three mitochondrial loci and one nuclear locus (~3000 bp) places this genus as sister to Compsaraia, and these two genera together as a clade sister to Pariosternarchus; all nodes with strong statistical support. The clade formed by these three genera includes five species, four of which are restricted to the Amazon basin. The apparent habitat preference of the new species for low-conductivity blackwater and clearwater rivers has not been reported in other apteronotid species.
Description of a new species of Isagoras Stål (Phasmatodea: Pseudophasmatidae: Xerosomatinae: Prexaspini) from the State of Minas Gerais, Brazil
Authors: HELEODORO RAPHAEL AQUINO , RAFAEL JOSÉ ALBERTINO
Published: February 2018

Isagoras aurocaudata sp. nov. is being described from two female specimens from the States of Minas Gerais, Brazil. Diagnostic characters for the new species are the yellowish compound eye with brown spots, the yellowish spot at basal third of tegmina and the yellowish abdomen segments 8–11. Furthermore, Isagoras aurocaudata sp. nov. is compared to species of Isagoras Stål and Planudes Stål.
A new blind snake of the genus Letheobia (Serpentes: Typhlopidae) from Rwanda with redescriptions of L. gracilis (Sternfeld, 1910) and L. graueri (Sternfeld, 1912) and the introduction of a non-invasive preparation procedure for scanning electron microscopy in zoology
Authors: DEHLING J. MAXIMILIAN , HINKEL HARALD H. , ENSIKAT HANS-JÜRGEN , BABILON KENNY , FISCHER EBERHARD
Published: February 2018

A new species of blind snake in the genus Letheobia is described from Akagera National Park in eastern Rwanda. The new species is most similar to species of the L. gracilis complex, particularly L. gracilis and L. graueri. It differs from all other species of the genus by a unique combination of morphological characters, including the highest number of middorsal scale rows (834) and the most extreme elongation (total-length/midbody-width ratio 131) of all species in the genus and of any species of snake in the world; 22-22-22 longitudinal scale rows; snout in dorsal profile rounded, in lateral profile bluntly rounded with an angular horizontal edge ventrally; rostral broad, posteriorly rounded; eyes invisible; supralabial imbrication pattern T-0; tail short (1.3 percent of total length) with an apical spine; and a pink life colouration. The holotype of the new species was collected in gallery forest at a lake shore surrounded by savanna at 1300 m elevation. We produced scanning electron microscope images of the heads of the investigated specimens applying a liquid-substitution preparation procedure which does not require coating or drying and thus does not irreversibly damage the investigated samples. The obtained images allow an easy and more accurate examination of the scalation.
Vehicle-mounted net sampling of airborne micro-Heteroptera in western Liberia, West Africa: 1. Isometopinae (Miridae)
Authors: KRÜGER ANDREAS
Published: February 2018

A vehicle-mounted “car-net” is a rarely used technique of insect sampling. In Liberia, it was used over several consecutive months, and the first results of taxonomic analyses of Heteroptera from the by-catch are presented, namely on the mirid subfamily Isometopinae (“jumping tree bugs”). So far, no isometopine species have been known from Liberia.        New records of Isometopinae in Liberia are provided including: Isometopus slateri (Akingbohungbe), Myiomma cobbeni Akingbohungbe, M. rubra Smith, and M. rubrovenata Smith. Additional new species are described, including: Isometopus bongensis sp. nov., Paloniella garmsi sp. nov., P. erinacea sp. nov., Ptisca liberiense sp. nov., Myiomma albostiolata sp. nov., M .brunnea sp. nov., M. fuscipes sp. nov., M. goellneri sp. nov. and M. variabilis sp. nov. A new genus with one included species is similarly described as follows: Bongiella nodistylis gen. nov. et sp. nov.
Two new species of the family Cunaxidae (Acari: Prostigmata) from Madagascar
Authors: KALÚZ STANISLAV , STARÝ JOSEF
Published: February 2018

Two new mite species from Madagascar, based on female specimens, viz. Armascirus skvarlai sp. nov. and Cunaxa corpuzrarosae sp. nov. (Acari: Prostigmata: Cunaxidae), are described and figured. Armascirus skvarlai sp. nov. differs from the related species A. gimpeli Smiley, 1992 by having long hysterosomal platelets, thin and long lateromedial sts on the palpal genu, and from A. ozarkensis Skvarla & Dowling, 2012 by having a cone-shaped proterosomal shield with straight lateral edges, and by its nearly triangular hysterosomal shield. Cunaxa corpuzrarosae sp. nov. differs from the related species C. potchensis Den Heyer, 1979 by having 4 pairs of sts between coxae IV and the genital region, and by having a short stout palpal femoral apophysis; and from C. mageei Smiley, 1992 and C. neogazella Smiley, 1992 by having much shorter hysterodorsal and palpal tibiotarsal setae.
Discovery of a new stonefly genus with three new species from mid-Cretaceous Burmese amber (Plecoptera: Perlidae)
Authors: CHEN ZHI-TENG , WANG BO , DU YU-ZHOU
Published: February 2018

A new fossil stonefly genus of the subfamily Acroneuriinae Klapálek, 1914 (Plecoptera: Perlidae), Largusoperla gen. nov. is reported based on three well-preserved specimens in mid-Cretaceous amber from northern Myanmar. Three new species of this new genus, L. acus sp. nov, L. flata sp. nov and L. arcus sp. nov. are described and illustrated. This is the first report of stonefly specimens from mid-Cretaceous Burmese amber. The taxonomic placement of the new genus is discussed.
Implementing Social Change: A Qualitative Analysis of Counseling Psychologists’ Engagement in Advocacy
Authors: Kozan Saliha , Blustein David L.
Published: February 2018

In recent years, many counseling psychology training programs in the United States have adopted social justice principles into training. Although previous studies have provided thought-provoking discussions on social justice advocacy, they mostly reflected the voices of psychologists in academia; therefore, the advocacy work of practitioners has been neglected. In order to explore the advocacy experiences of counseling psychologists in practice, we utilized qualitative content analysis to analyze semistructured interviews with 11 practitioners who were trained in social justice-oriented counseling psychology doctoral programs. The findings were clustered under three domains: (a) participants’ development of a social justice orientation, (b) different ways of implementing advocacy in practice, and (c) positioning advocacy in psychology. The interviews depicted resources and challenges with regard to integrating advocacy into practice indicating that counseling psychologists continue to struggle with systemic barriers that limit their advocacy actions. We discuss implications for research, practice, and training in counseling psychology.
An analysis of inclusion gaps in sustainable development themes: Findings from a review of recent social work literature
Authors: Bexell Sarah M , Decker Sparks Jessica L , Tejada Jacqueline , Rechkemmer Andreas
Published: February 2018

Recently, humans have negatively altered ecosystems more rapidly and extensively than in any other time in human history, contributing to gains in well-being and economic development for some, while threatening the security of most, particularly oppressed populations. We comprehensively reviewed recent social work literature (2010–2015) to examine gaps in environmental sustainability themes relevant to social work practice. Peer-reviewed manuscripts, dissertations/theses and white papers were examined. A total of 71 papers (less than 1% of social work literature) met inclusion criteria. Although our call is to protect human health and well-being, recent literature does not account for sustainability even with evidence that environmental issues directly impact clients, hindering practice efficacy.
Parental and Self-Weight Perceptions in U.S. Children and Adolescents, NHANES 2005-2014
Authors: Ling Jiying , Stommel Manfred
Published: February 2018

This study aimed to describe the parental and child self-weight perceptions and their associated sociodemographic factors. The 2005-2014 National Health and Nutrition Examination Survey (NHANES) sample of 16,869 children aged 2 to 17 years was used. For overweight/obese children aged 2 to 15 years, 61.2% of parents underestimated their child’s weight. For overweight/obese children aged 8 to 17 years, 55.2% underestimated their own weight. For children aged 8 to 15 years, 77.8% parents and children agreed on the weight classification. Parents of boys and those with low income were more likely to underestimate their child’s weight. Girls, older children, and those living in larger or high-income families were less likely to underestimate their own weight. Hispanic and Black children tended to underestimate their weight. With increasing child age, parents and children were more likely to disagree on the child’s weight. Future efforts should focus on low-income families with larger number of children and Hispanic and Black young children who were more likely to underestimate their weight.
Neuroimaging utilization and findings in headache outpatients: Significance of red and yellow flags
Authors: Young Nathan P , Elrashidi Muhamad Y , McKie Paul M , Ebbert Jon O
Published: February 2018

Background

Neuroimaging for headache commonly exceeds published guideline recommendations and may be overutilized.

Methods

We conducted a retrospective cross-sectional study of all outpatient community patients at Mayo Clinic Rochester who underwent a neuroimaging study for a headache indication in 2015. We assessed the neuroimaging utilization pattern, clinical application of red flags, and concordance with neuroimaging guidelines.

Results

We identified 190 outpatients who underwent 304 neuroimaging studies for headache. The median age was 46.5 years (range 18–91 years), 65% were female, and most reported no prior history of headache (n = 97, 51%). A minority of patients had prior brain imaging studies (n = 44, 23%) and neurological consultations for headache (n = 29, 15%). Few studies were ordered after consultation with a neurologist (n = 14, 7%). Seventy-seven percent of patients were documented to have a “red flag” justifying the imaging study. Abnormal neuroimaging findings were found in 3.1% of patients with warning flags (5/161); carotid dissection (n = 3) and reversible cerebral vasoconstrictive syndrome (n = 2). An estimated 35% of patients were imaged against guidelines.

Conclusions

The prevalence of serious causes of headache in a community practice was low despite the presence of a documented red flag symptom. Inadequate understanding or application of red flags may be contributing to recommendations to image patients against current guidelines. Interventions to reduce unnecessary neuroimaging of patients with headache need to be designed and implemented.
State–Voluntary Relations in Contemporary Welfare Systems: New Politics or Voluntary Action as Usual?
Authors: Coule Tracey M. , Bennett Ellen
Published: February 2018

In this article, we analyze two landmark reviews of British voluntary action to cast a critical gaze on the recurrent claim that voluntarism is facing a new era of ever more turbulent welfare systems and dramatic changes in state–voluntary relations. Rather than representing a new era, we find the current climate may be more accurately considered a collage of past relations. By this, we mean a composition of reality that assembles different aspects of past realities to create a seemingly new era. This suggests that conventional discursive institutional accounts of policy change, which downplay the interrelated dynamics of stability and change, are inadequate for explaining the evolution of state–voluntary relations specifically and policy reform more broadly. Debates about public policy and the role to be played by voluntary action among scholarly and practitioner communities would be better served by greater understanding of the historical experience that has formed today’s institutions.
Unmanned air vehicles for targeting tasks
Authors: Ashokkumar Chimpalthradi R
Published: February 2018

Unmanned aerial vehicle in surveillance and reconnaissance operations are well known with its flight operations confining to the lateral and longitudinal plane where the altitude is maintained constant. The objective in these operations is to have a wide field of view when camera is mounted underneath the aircraft. However, in obstacle detection algorithms as well as in weapon-target assignments by an unmanned combat air vehicle, the sensors such as cameras and radars are mounted along the X direction of the body fixed frame. The unmanned vehicles with such sensor locations are expected to offer obstacle-camera and weapon-target line-of-sight engagements. These operations by the unmanned vehicles are referred as targeting tasks. In this paper, a procedure to use unmanned vehicles as targeting systems in pitch plane is presented with respect to a fixed order controller at the inner loop. The remote pilot's inputs at the outer loop is disengaged and to mimic these inputs, various flight path angles are scheduled thus depicting autonomous characteristics. Illustrations to depict targeting tasks are provided.
Utilizing tension reduction in a dielectric elastomer actuator to produce compression for physiological application
Authors: Edher Hamza , Maupas Louise , Nijjer Sunraaj , Salehian Armaghan
Published: February 2018

A common prophylaxis against peripheral vascular diseases utilizes pneumatic active compression systems. Although effective, traditional active compression systems require the use of an air compressor and pump and are, therefore, ill-suited for ambulatory use. The current work introduces a novel approach to developing an ambulatory smart material–based active compression system. The actuation system is composed of a belt-like mechanism connected in conjunction with a multi-layered dielectric elastomer actuator. The belt mechanism allows compression to be applied directly with voltage application. By doing so, the proposed design limits the period during which the actuator should be charged and improves system power efficiency and lifetime. An analytical model which defines the pre-compression exerted by the actuation system before voltage application is presented and validated experimentally. Experimental results for the belt mechanism characterization, dielectric elastomer actuator characterization and actuation system testing are presented. Through experimental testing, it is shown that the initial pre-compression can be fine-tuned by varying the parameters of the system as defined in the analytical model, and that the pre-compression has little effect on the consequent actuation output amplitudes.
Should Children With Cleft Palate Receive Early Long-Term Tympanostomy Tubes
Authors: Shaffer Amber D. , Ford Matthew D. , Choi Sukgi S. , Jabbour Noel
Published: February 2018

Objectives:

To determine whether children with cleft palate might benefit from early long-term tympanostomy tubes with the hypothesis that receiving multiple tubes is associated with shorter duration of first tubes.

Design:

Retrospective cohort study.

Setting:

Tertiary care children’s hospital.

Participants:

Records from 401 consecutive children with cleft palate ± cleft lip, born April 2005 to April 2010, were reviewed. After exclusion of children with cleft repair at an outside hospital, no follow-up after 5 years of age, intact secondary palate, no tubes, or tube replacement at palatoplasty, 105 children remained.

Main Outcome Measure:

Number of tubes.

Results:

Armstrong grommet tubes were placed at a median age of 6.7 months (range 2.3-19.6 months). Tubes were replaced in 55.3% of patients, with 34.0% receiving ≥3 sets. Duration of first tubes was significantly longer for children with 1 set of tubes compared with those with multiple sets (median 26 vs 19 months, P = .004). Otorrhea, but not perforation, was associated with longer duration of first tubes (median 27 vs 20.5 months, P = .028). Cleft type did not impact the proportion of patients with multiple tubes. Median age at last tube placement for children with multiple tubes was 5.0 years (range 1.9-8.7 years).

Conclusion:

Short duration of first tubes is associated with receiving multiple tubes. Because most patients require repeat tubes and many require tubes until school age, there is a significant need for controlled, prospective trials of early long-term tube placement in this population.
Cleft Lip and Palate in CHARGE Syndrome
Authors: Isaac Kathryn V. , Ganske Ingrid M. , Rottgers Stephen A. , Lim So Young , Mulliken John B.
Published: February 2018

Objective:

Infants with syndromic cleft lip and/or cleft palate (CL/P) often require more complex care than their nonsyndromic counterparts. Our purpose was to (1) determine the prevalence of CL/P in patients with CHARGE syndrome and (2) highlight factors that affect management in this subset of children.

Design:

This is a retrospective review from 1998 to 2016.

Patients:

Patients with CHARGE syndrome were diagnosed clinically and genetically.

Main Outcomes Measures:

Prevalence of CL/P was determined and clinical details tabulated: phenotypic anomalies, cleft types, operative treatment, and results of repair.

Results:

CHARGE syndrome was confirmed in 44 patients: 11 (25%) had cleft lip and palate and 1 had cleft palate only. Surgical treatment followed our usual protocols. Two patients with cardiac anomalies had prolonged recovery following surgical correction, necessitating palatal closure prior to nasolabial repair. One of these patients was too old for dentofacial orthopedics and underwent combined premaxillary setback and palatoplasty, prior to labial closure. Velopharyngeal insufficiency was frequent (n = 3/7). All patients had feeding difficulty and required a gastrostomy tube. All patients had neurosensory hearing loss; anomalies of the semicircular canals were frequent (n = 3/4). External auricular anomalies, colobomas, and cardiovascular anomalies were also common (n = 8/11). Other associated anomalies were choanal atresia (n = 4/11) and tracheoesophageal fistula (n = 2/11).

Conclusions:

CHARGE syndrome is an under-recognized genetic cause of cleft lip and palate. Hearing loss and speech and feeding difficulties often occur in these infants. Diagnosis can be delayed if the child presents with covert phenotypic features, such as chorioretinal colobomas, semicircular canal hypoplasia, and unilateral choanal atresia.
A battle tank simulator for eye and hand coordination tasks under horizontal whole-body vibration
Authors: Campos Luiz CA , Menegaldo Luciano L
Published: February 2018

This paper describes the development of a simulator to reproduce gunner’s target tracking tasks in a main battle tank, under whole-body vibration conditions. For specifying the vibration and tracking conditions, three-degree-of-freedom acceleration was measured in a tracked armored vehicle, equipped with a 105 mm cannon, running in a battlefield test track. The electrohydraulic dynamics of the turret systems was experimentally identified as black-box autoregressive functions. A pneumatic actuation system and a real-time control software were designed to reproduce horizontal, single-axis periodic motion with the dominant frequency observed in field measurements. The control software displays the target and sight points and acquires the turret pointing command from an adapted gunner’s handle joystick. The root mean square error between target and simulated turret position allows assessing gunner’s target acquisition and tracking performance under periodic vibration.
Effect of dimethyl fumarate on renal disease progression in a genetic ortholog of nephronophthisis
Authors: Oey Oliver , Rao Padmashree , Luciuk Magdalena , Mannix Carly , Rogers Natasha M , Sagar Priyanka , Wong Annette , Rangan Gopala
Published: February 2018

Dimethyl fumarate is an FDA-approved oral immunomodulatory drug with anti-inflammatory properties that induces the upregulation of the anti-oxidant transcription factor, nuclear factor erythroid-derived factor 2. The aim of this study was to determine the efficacy of dimethyl fumarate on interstitial inflammation and renal cyst growth in a preclinical model of nephronophthisis. Four-week-old female Lewis polycystic kidney disease (a genetic ortholog of human nephronophthisis-9) rats received vehicle (V), 10 mg/kg (D10) or 30 mg/kg (D30) ( n = 8–9 each) dimethyl fumarate in drinking water for eight weeks. Age-matched Lewis control rats were also studied ( n = 4 each). Nuclear factor erythroid-derived factor 2 was quantified by whole-slide image analysis of kidney sections. Renal nuclear factor erythroid-derived factor 2 activation was partially reduced in vehicle-treated Lewis polycystic kidney disease rats compared to Lewis control (21.4 ± 1.7 vs. 27.0 ± 1.6%, mean ± SD; P < 0.01). Dimethyl fumarate upregulated nuclear factor erythroid-derived factor 2 in both Lewis Polycystic Kidney Disease (D10: 35.9 ± 3.8; D30: 33.6 ± 3.4%) and Lewis rats (D30: 34.4 ± 1.3%) compared to vehicle-treated rats ( P < 0.05). Dimethyl fumarate significantly reduced CD68+ cell accumulation in Lewis polycystic kidney disease rats (V: 31.7 ± 2.4; D10: 23.0 ± 1.1; D30: 21.5 ± 1.9; P < 0.05). In Lewis polycystic kidney disease rats, dimethyl fumarate did not alter the progression of kidney enlargement (V: 6.4 ± 1.6; D10: 6.9 ± 1.2; D30: 7.3 ± 1.3%) and the percentage cystic index (V: 59.1 ± 2.7; D10: 55.7 ± 3.5; D30: 58.4 ± 2.9%). Renal dysfunction, as determined by the serum creatinine (Lewis + V: 26 ± 4 vs. LPK + V: 60 ± 25 P < 0.01; LPK + D10: 47 ± 7; LPK + D30: 47 ± 9 µmol/L), and proteinuria were also unaffected by dimethyl fumarate treatment. In conclusion, the upregulation of nuclear factor erythroid-derived factor 2 by dimethyl fumarate reduced renal macrophage infiltration in nephronophthisis without adverse effects, suggesting that it could potentially be used in combination with other therapies that reduce the rate of renal cyst growth.

Impact statement

This is the first study to investigate the effects of dimethyl fumarate in a model of cystic kidney disease. The study assessed the therapeutic efficacy of dimethyl fumarate in upregulating renal nuclear factor erythroid-derived factor 2 expression, reducing macrophage accumulation and cyst progression in a Lewis polycystic kidney disease rat model. This study demonstrates that dimethyl fumarate significantly upregulated renal nuclear factor erythroid-derived factor 2 expression and attenuates renal macrophage infiltration, but had no effect on renal cyst progression, cardiac enlargement, and improving renal function.
Endovascular Management of SVC Syndrome due to Fibrosing Mediastinitis—A Feasibility and Safety Analysis
Authors: Majumdar Shamaita , Shoela Ramy , Kim David J. , Ramaswamy Raja , Mani Naganathan , Salter Amber , Akinwande Olaguoke
Published: February 2018

Purpose:

To assess the outcomes of endovascular management for superior vena cava (SVC) syndrome secondary to fibrosing mediastinitis (FM).

Methods:

Between January 2004 and December 2016, 10 consecutive patients with endovascularly managed SVC syndrome secondary to FM were identified in an institutional database. Venograms were performed to assess the severity and location of the lesion and allow measurement for stent selection. Standard stenting and angioplasty techniques were utilized to establish luminal patency. The safety, feasibility, clinical success, and the primary and secondary patency were evaluated. Kaplan-Meier survival analysis was used to determine median duration of stent patency. A log-rank test was used to test differences in prior stent use.

Results:

Our cohort was predominantly female (7/10) with an average age of 42.2 years. Of the 10 patients, 3 had undergone endovascular stenting at an outside institution prior to referral to our institution due to new, recurrent, or worsening symptoms. All patients underwent venography demonstrating stenosis (8/10) or occlusion (2/10) at initial presentation. Stenting or angioplasty was technically successful in 9 (90.0%) patients. Eight of 10 patients had primary stenting, while 1 achieved vascular patency and symptom resolution with angioplasty alone. Median duration of primary patency was 31.3 months (95% confidence interval: 5.9-103). Six (54.5%) patients required secondary revision procedures. Median duration of secondary patency was 6.1 months, with 25% of revisions occurring by 4 months and 75% occurring by 20.9 months. All treated patients (9/9) reported symptomatic relief at 1-month follow-up, establishing a clinical success rate of 100%. There were no 30-day adverse effects related to the procedure.

Conclusion:

This study demonstrates that endovascular therapy is a safe and feasible approach for managing FM-related SVC syndrome.
Influence of the ground effect on airdrop mission performance analysis
Authors: Mao Yuhao , Dong Wenhan , Zhu Jiahai , Liu Ri , Chang Jinyong
Published: February 2018

Aimed at determining the ground effect’s influence on the process of ultralow-altitude airdrop, this article studies the corresponding changes in aerodynamic characteristics caused by the ground effect. Through analyzing the longitudinal long- and short-period modes and the lateral mode, this work evaluates the impact that the ground effect has on the level-off and the traction stages during an airdrop mission, with reference to corresponding flight quality standards. Accordingly, these findings provide a reference for the design of flight control regarding airdrop capabilities and support a theory for corresponding ground experiments.
Favorable and unfavorable health conditions within OECD countries: An exploratory study
Authors: Park Myung-Bae , Nam Eun Woo , Kim Chun-Bae , Lee Hae Jong , Lee Kwang-Soo , Koh Sang-Baek
Published: February 2018

Objectives:

This study compared the physical, mental, and social health levels among Organization for Economic Co-operation and Development countries.

Methods:

We sampled from 34 Organization for Economic Co-operation and Development member countries and divided physical, mental, and social health into three domains based on World Health Organization health definitions.

Results:

A multivariate hierarchical cluster analysis was conducted to group countries that were similar in terms of health. Regarding physical health, Japan, South Korea, Sweden, Switzerland, and ten more countries reported favorable health conditions. For mental health, Australia, Canada and eight more countries revealed favorable conditions. Finally, in terms of social health, Austria, Finland, Iceland, and seven more countries reported favorable conditions. Sweden and Switzerland reported the best health conditions aggregated across all three domains. Conversely, Estonia, Hungary, and Turkey reported comparatively poorer health across all three domains when compared with other Organization for Economic Co-operation and Development countries.

Conclusions:

We suggested that mental health policy should be further strengthened in cases of Korea and Japan. In case of the Eastern Bloc countries, health policies should be established focusing on health equity for effective improvement of indicators.
Let the Pleasure Guide Your Resistance Training Intensity
Authors: ELSANGEDY HASSAN MOHAMED , MACHADO DANIEL GOMES DA SILVA , KRINSKI KLEVERTON , DUARTE DO NASCIMENTO PAULO HENRIQUE , DE AMORIM OLIVEIRA GLEDSON TAVARES , SANTOS TONY MEIRELES , HARGREAVES ELAINE A. , PARFITT GAYNOR
Published: February 2018

Purpose

The purpose of this study was to evaluate the feasibility and reliability of the Feeling Scale (FS) to self-regulate resistance training (RT) intensity.

Methods

Sixteen sedentary men (39.7 ± 7.5 yr) performed 3 familiarization sessions, 2 one-repetition maximum (1RM) testing, and 16 RT sessions (four sessions for each FS descriptor; randomized). The FS descriptors were “very good” (FS + 5), “good” (FS + 3), “fairly good” (FS + 1), and “fairly bad” (FS − 1). Resistance exercises were leg press, chest press, knee extension, and seated biceps curl. Participants were instructed to select a load associated with the verbal/numerical descriptor of the FS to perform three sets of 10 repetitions.

Results

Participants lifted a significantly greater %1RM as the FS level decreased from FS + 5 to FS − 1 (P < 0.001). The mean %1RM values for the FS descriptors of +5, +3, +1, and −1, respectively, were as follows: leg press, 42.5% ± 9.5%, 58.2% ± 7.4%, 69.9% ± 7.0%, and 80.7% ± 5.4%; knee extensor, 37.4% ± 9.6%, 54.5% ± 9.3%, 65.3% ± 8.7%, and 78.2% ± 5.9%; chest press, 42.4% ± 11.3%, 54.9% ± 11.4%, 66.4% ± 12.6%, and 78.2% ± 13.5%; and biceps curl, 39.0% ± 8.1%, 54.0% ± 9.7%, 68.4% ± 5.9%, and 83.2% ± 3.0%. The interclass correlation coefficient over the four experimental sessions ranged from 0.73 to 0.99 for %1RM and from 0.77 to 0.99 for weight lifted, with a coefficient of variation of approximately 7%, 4%, 2%, and 2% for FS descriptors of +5, +3, +1, and −1, respectively.

Conclusion

This study is the first to demonstrate that the FS can be used to self-regulate exercise intensity in RT. The lower the FS descriptor, the higher the weight lifted. In addition, the load self-selected for each FS descriptor was reliable across the four sessions.
Exercise Improves Physical Activity and Comorbidities in Obese Adults with Asthma
Authors: FREITAS PATRÍCIA DUARTE , SILVA ALINE GRANDI , FERREIRA PALMIRA GABRIELE , DA SILVA ANALUCI , SALGE JOÃO MARCOS , CARVALHO-PINTO REGINA MARIA , CUKIER ALBERTO , BRITO CLAUDIA M. , MANCINI MARCIO C. , CARVALHO CELSO R. F.
Published: February 2018

Introduction

Obese adults with asthma have an increased number of comorbidities and reduced daily life physical activity (DLPA), which may worsen asthma symptoms. Exercise is recommended to improve asthma outcomes; however, the benefits of exercise for psychosocial comorbidities and physical activity levels in obese adults with asthma have been poorly investigated.

Objective

This study aimed to assess the effects of exercise on DLPA, asthma symptoms, and psychosocial comorbidities in obese adults with asthma.

Methods

Fifty-five grade II obese adults with asthma were randomly assigned to either a weight loss program + exercise program (WL + E group, n = 28) or a weight loss program + sham (WL + S group, n = 27). The WL + E group incorporated aerobic and resistance muscle training into the weight loss program (nutrition and psychological therapies), whereas the WL + S group performed breathing and stretching exercises. DLPA, asthma symptoms, sleep quality, and anxiety and depression symptoms were quantified before and after treatment.

Results

After 3 months, the WL + E group presented a significant increase in daily step counts (3068 ± 2325 vs 729 ± 1118 steps per day) and the number of asthma symptom–free days (14.5 ± 9.6 vs 8.6 ± 11.4 d·month−1) compared with the WL + S group. The proportion of participants with improvements in depression symptoms (76.4% vs 16.6%) and a lower risk of developing obstructive sleep apnea (56.5% vs 16.3%) was greater in the WL + E group than that in the WL + S group (P < 0.05). Significant improvements in sleep efficiency (6.6% ± 5.1% vs 1.3% ± 4.7%) and latency (−3.7 ± 5.9 vs 0.2 ± 5.6 min) were also observed in the WL + E group.

Conclusions

Our results strongly suggest that exercise training plus a weight loss program improves DLPA, sleep efficiency, and depression and asthma symptoms in obese adults with asthma.
Comparing photon and proton-based hypofractioned SBRT for prostate cancer accounting for robustness and realistic treatment deliverability
Authors: Goddard Lee C , Brodin N Patrik , Bodner William R , Garg Madhur K , Tomé Wolfgang A
Published: February 2018

Objective:

To investigate whether photon or proton-based stereotactic body radiation therapy (SBRT is the preferred modality for high dose hypofractionation prostate cancer treatment. Achievable dose distributions were compared when uncertainties in target positioning and range uncertainties were appropriately accounted for.

Methods:

10 patients with prostate cancer previously treated at our institution (Montefiore Medical Center) with photon SBRT using volumetric modulated arc therapy (VMAT) were identified. MRI images fused to the treatment planning CT allowed for accurate target and organ at risk (OAR) delineation. The clinical target volume was defined as the prostate gland plus the proximal seminal vesicles. Critical OARs include the bladder wall, bowel, femoral heads, neurovascular bundle, penile bulb, rectal wall, urethra and urogenital diaphragm. Photon plan robustness was evaluated by simulating 2 mm isotropic setup variations. Comparative proton SBRT plans employing intensity modulated proton therapy (IMPT) were generated using robust optimization. Plan robustness was evaluated by simulating 2 mm setup variations and 3% or 1% Hounsfield unit (HU) calibration uncertainties.

Results:

Comparable maximum OAR doses are achievable between photon and proton SBRT, however, robust optimization results in higher maximum doses for proton SBRT. Rectal maximum doses are significantly higher for Robust proton SBRT with 1% HU uncertainty compared to photon SBRT (p = 0.03), whereas maximum doses were comparable for bladder wall (p = 0.43), urethra (p = 0.82) and urogenital diaphragm (p = 0.50). Mean doses to bladder and rectal wall are lower for proton SBRT, but higher for neurovascular bundle, urethra and urogenital diaphragm due to increased lateral scatter. Similar target conformality is achieved, albeit with slightly larger treated volume ratios for proton SBRT, >1.4 compared to 1.2 for photon SBRT.

Conclusion:

Similar treatment plans can be generated with IMPT compared to VMAT in terms of target coverage, target conformality, and OAR sparing when range and HU uncertainties are neglected. However, when accounting for these uncertainties during robust optimization, VMAT outperforms IMPT in terms of achievable target conformity and OAR sparing.

Advances in knowledge:

Comparison between achievable dose distributions using modern, robust optimization of IMPT for high dose per fraction SBRT regimens for the prostate has not been previously investigated.