bluuebunny/crossref_metadata_2025 huggingface dataset:
Relationship between physician financial incentives and clinical pathway compliance: a cross-sectional study of 18 public hospitals in China
Authors: Bai Jie , Bundorf Kate , Bai Fei , Tang Huiqin , Xue Di
Published: May 2019

Objectives

Many strategies have been either used or recommended to promote physician compliance with clinical practice guidelines and clinical pathways (CPs). This study examines the relationship between hospitals’ use of financial incentives to encourage physician compliance with CPs and physician adherence to CPs.

Design

A retrospectively cross-sectional study of the relationship between the extent to which patient care was consistent with CPs and hospital’s use of financial incentives to influence CP compliance.

Setting

Eighteen public hospitals in three provinces in China.

Participants

Stratified sample of 2521 patients discharged between 3 January 2013 and 31 December 2014.

Primary outcome measures

The proportion of key performance indicators (KPIs) met for patients with (1) community-acquired pneumonia (pneumonia), (2) acute myocardial infarction (AMI), (3) acute left ventricular failure (heart failure), (4) planned caesarean section (C-section) and (5) gallstones associated with acute cholecystitis and associated cholecystectomy (cholecystectomy).

Results

The average implementation rate of CPs for five conditions (pneumonia, AMI, heart failure, C-section and cholecystectomy) based on 2521 cases in 18 surveyed hospitals was 57% (ranging from 44% to 67%), and the overall average compliance rate for the KPIs for the five conditions was 69.48% (ranging from 65.07% to 77.36%). Implementation of CPs was associated with greater compliance within hospitals only when hospitals adopted financial incentives directed at physicians to promote compliance.

Conclusion

CPs are viewed as important strategies to improve medical care in China, but they have not been widely implemented or adhered to in Chinese public hospitals. In addition to supportive resources, education/training and better administration in general, hospitals should provide financial incentives to encourage physicians to adhere to CPs.
Comparison of olanexidine versus povidone-iodine for preventing surgical site infection in gastrointestinal surgery: study protocol for a multicentre, single-blind, randomised controlled clinical trial
Authors: Takeuchi Masashi , Obara Hideaki , Kawakubo Hirofumi , Shinoda Masahiro , Okabayashi Koji , Mayanagi Shuhei , Irino Tomoyuki , Fukuda Kazumasa , Nakamura Rieko , Wada Norihito , Kitago Minoru , Yagi Hiroshi , Abe Yuta , Oshima Go , Hori Shutaro , Tsuruta Masashi , Ishida Takashi , Yokose Takahiro , Hirukawa Kazuya , Isobe Yoh , Sekimoto Yasuhito , Harada Hirohisa , Maeda Yusuke , Shito Masaya , Kondo Takayuki , Sato Yasunori , Kitagawa Yuko
Published: May 2019

Introduction

The prevalence of surgical site infection (SSI) remains higher in gastrointestinal surgery than in other surgeries. Although several guidelines have indicated the efficacy of chlorhexidine and povidone-iodine in reducing the SSI rate, the optimal recommendation has still not been established. Therefore, it is necessary to determine the more effective antiseptic for surgical site preparation. Olanexidine (1.5% olanedine, Otsuka Pharmaceutical Factory, Tokushima, Japan), which is a new antiseptic in Japan, has antimicrobial activity against a wide range of bacteria, including Gram-positive and Gram-negative bacteria. Our study will contribute to determining a new antiseptic for use in gastrointestinal and other surgeries.

Methods and analysis

We propose a multicentre, randomised controlled clinical trial for comparing two treatments, that is, 1.5% olanexidine or 10% povidone-iodine, for surgical skin preparation to prevent SSI in clean-contaminated gastrointestinal surgeries with surgical wounds. Patients aged ≥20 years at the time of consent will be included. The primary outcome measure is the 30-day postoperative SSI rate. For the primary analysis, which is aimed at comparing the treatment effects, the adjusted risk ratio and its 95% CI will be estimated using the Mantel-Haenszel method.

Ethics and dissemination

The protocol was first approved by the Institutional Review Board of Keio University School of Medicine, followed by the institutional review board of each participating site. Participant recruitment began in June 2018. The final results will be published in international peer-reviewed medical journals.

Trial registration number

UMIN 000031560; Pre-results.
Engaging primary care physicians in system change – an interpretive qualitative study in a remote and rural health region in Northern British Columbia, Canada
Authors: Snadden David , Reay Trish , Hanlon Neil , MacLeod Martha
Published: May 2019

Objectives

To describe how physicians were engaged in primary healthcare system change in a remote and rural Canadian health authority.

Design

A qualitative interpretive study based on a hermeneutic approach.

Methods

34 transcribed in-depth interviews with physicians and administrators relevant to physician engagement were purposively sampled from a larger data set of 239 interviews gathered over a 3-year period from seven communities engaged in primary healthcare transformation. Interviews were coded and analysed interpretively to develop common themes.

Setting

This research is part of a larger study, Partnering for Change I, which investigated the efforts of Northern Health, a rural regional health authority in British Columbia, to transform its healthcare system to one grounded in primary care with a focus on interdisciplinary teams. It reports how physician engagement was accomplished during the first 3 years of the study.

Participants

Interviews with 34 individuals with direct involvement and experience in the processes of physician engagement. These included 10 physicians, three Regional Executives, 18 Primary Healthcare coordinators and three Division of Family Practice leads.

Results

Three major interconnected themes that depicted the process of engagement were identified: working through tensions constructively, drawing on structures for engagement and facilitating relationships.

Conclusions

Physician engagement was recognised as a priority by Northern Health in its efforts to create system change. This was facilitated by the creation of Divisions of Family Practice that provided a structure for dialogue and facilitated a common voice for physicians. Divisions helped to build trust between various groups through allowing constructive conversations to surface and deal with tensions. Local context mattered. Flexibility in working from local priorities was a critical part of developing relationships that facilitated the design and implementation of system reform.
Projecting stunting and wasting under alternative scenarios in Odisha, India, 2015–2030: a Lives Saved Tool (LiST)-based approach
Authors: Mishra Nihar Ranjan , Mohanty Sanjay K , Mittra Devjit , Shah Mansi , Meitei Wahengbam Bigyananda
Published: May 2019

Objective

Although nutrition-specific interventions are designed based on maternal, household and community-level correlates, no attempt has been made to project stunting and wasting and identify intervention priorities in India. The objective of this paper is to model the stunting and wasting in the state of Odisha, India by scaling up maternal and child health interventions under alternative scenarios.

Design

This study primarily used data from National Family Health Survey 4, 2015–2016.

Measures

The LiST (Lives Saved Tool) software is used to model the nutritional outcomes and prioritise interventions. The projections were carried out under four alternative scenarios: scenario 1—if the coverage indicators continued based on past trends; scenario 2—scaled up to the level of the richest quintile; scenario 3—scaled up to that of Tamil Nadu; and scenario 4—scaled up to an aspirational coverage level.

Results

In 2015, out of 3.52 million under-5 children in Odisha, around 1.20 million were stunted. By 2030, the numbers of stunted children will be 1.11 million under scenario 1, 1.07 million under scenario 2, 1.09 million under scenario 3 and 0.89 million under scenario 4. The projected stunting level will be 25% under scenario 4 and around 31% under all other scenarios. By 2030, the level of wasting will remain unchanged at 20% under the first three scenarios and 4.3% under scenario 4. Appropriate complementary feeding would avert about half of the total stunting cases under all four scenarios, followed by zinc supplementation. Water connection at home, washing hands with soap and improved sanitation are other effective interventions.

Conclusion

Sustaining the maternal and child health interventions, promoting evidence-based stunting and wasting reduction interventions, and a multisectoral approach can achieve the World Health Assembly targets and Sustainable Development Goals of undernutrition in Odisha.
Violence against older women: a protocol for a systematic review of qualitative literature
Authors: Meyer Sarah R , Lasater Molly E , Garcia-Moreno Claudia
Published: May 2019

Introduction

There is sparse evidence globally concerning patterns of and types of violence against women aged 50 and older. Improved understanding of older women’s experiences of violence, including types of violence, perpetrators and health impacts, is needed to address evident gaps in the literature, address requirements for monitoring and reporting on global sustainable development goal indicators, and inform policy and programming for preventing and responding to violence against older women. The aim of the systematic review is to identify, evaluate and synthesise qualitative studies from all countries, exploring violence against women aged 50 and above, identifying types and patterns of violence, perpetrators of violence and impacts of violence on various health outcomes for older women.

Methods and analysis

A systematic search for qualitative studies of violence against older women will be conducted in the following databases: PubMed, PsycINFO, Embase, CINAHL, PILOTS, ERIC, Social Work Abstracts, International Bibliography of the Social Sciences, Social Services Abstracts, ProQuest Criminal Justice and Dissertations and Theses Global. Studies will be focused on violence against older women (aged 50 and above), using qualitative methodology, exploring women’s experiences of any type of violence perpetrated by any type of perpetrator. Two authors will independently review titles and abstracts retrieved through the search strategy. Data extraction will be conducted independently by one author and quality assessment will be conducted by two authors, using an adapted version of the Critical Appraisal Skills Programme scale. Data will be analysed and synthesised using a thematic synthesis approach.

Ethics and dissemination

Ethics approvals are not required as primary data are not being collected. Findings will be disseminated through a publication in a peer-reviewed journal and used to inform development of a module to measure violence against older women, for use in specialised violence against women surveys.

PROSPERO registration number

CRD42019119467
Evaluation of the safety and effectiveness of oral propranolol in patients with von Hippel-Lindau disease and retinal hemangioblastomas: phase III clinical trial
Authors: González-Rodríguez Beatriz , Villar Gómez de las Heras Karina , Aguirre Daniel T , Rodríguez-Padial Luis , Albiñana Virginia , Recio-Poveda Lucía , Cuesta Angel M , Botella Luisa Mª , Jiménez-Escribano Rosa María
Published: May 2019

Background

von Hippel-Lindau disease (VHL) is a multisystem cancer syndrome caused by mutations in theVHLgene. Retinal hemangioblastoma is one of the most common tumours, and when it appears near the optic nerve, its treatment is challenging and risky. To date, no treatment has proven effective in changing the course of the disease. This study was designed to evaluate the safety and effectiveness of propranolol in controlling these tumours.

Methods

Seven patients were included. All patients took a daily dose of 120 mg of propranolol for 1 year. Clinical variables were assessed at baseline, and at 1, 3, 6, 9 and 12 months. The primary endpoint of the study was the number and size of retinal hemangioblastomas. On every visit, retinal outcomes and blood biomarkers (such as vascular endothelial growth factor (VEGF) and miR210) were analysed.

Results

Number and size of retinal hemangioblastomas remained stable in all patients. All of them had initially increased levels of VEGF and miR210. There was a gradual reabsorption of retinal exudation in two patients, correlating with a progressive decrease of both biomarkers. The only adverse effect reported was hypotension in one patient.

Conclusions

Propranolol could be used to treat retinal hemangioblastomas in VHL patients, although more studies are needed to determine the ideal dose and long-term effect. VEGF and miR210 should be explored as biomarkers of disease activity. As far as we know, these are the first biomarkers proposed to monitor the VHL disease activity.

Trial registration number

2014-003671-30
Evaluation of optic canal anatomy and symmetry using CT
Authors: Zhang Xinxin , Lee Yueh , Olson Daniel , Fleischman David
Published: May 2019

Objective

We aim to describe the anatomy and symmetry patterns of the optic canal in patients having undergone maxillofacial CT imaging.

Methods

In this retrospective chart review, we included all patients who received sinus and maxillofacial CT at the University of North Carolina hospitals between 2008 and 2016, without facial or cranial fractures or other medical conditions that would affect optic canal size. We measured the length of ≥75% enclosed canal, minimum cross-sectional area and minimum diameter bilaterally using iNtuition TeraRecon (Durham, North Carolina) and compared bilateral symmetry using a 20 % difference threshold. Each parameter above was compared among white, black, non-white and non-black patients.

Results

Of 335 patients, the mean canal length was 5.61±2.22 mm. The mean minimum area was 11.84±3.11 mm2. The mean minimum diameter was 3.28±0.55 mm. A total of 39.4% (132/335) of patients had asymmetric canal lengths, 18.8% (63/335) had asymmetric minimum areas, and 12.5% (42/335) had asymmetric minimum diameters. No differences were found between racial groups. The right optic canal was larger than the left (right: 12.12 mm vs left: 11.55 mm, p<0.0001).

Conclusion

Optic canal asymmetry is not uncommon. It may affect risk of papilloedema severity, explain cases of unilateral or asymmetric papilloedema and possibly asymmetric glaucoma.
Meta-analysis of the accuracy of termination of resuscitation rules for out-of-hospital cardiac arrest
Authors: Ebell Mark H , Vellinga Akke , Masterson Siobhan , Yun Phillip
Published: May 2019

Background

Our objective was to perform a systematic review of studies reporting the accuracy of termination of resuscitation rules (TORRs) for out-of-hospital cardiac arrest (OHCA).

Methods

We performed a comprehensive search of the literature for studies evaluating the accuracy of TORRs, with two investigators abstracting relevant data from each study regarding study design, study quality and the accuracy of the TORRs. Bivariate meta-analysis was performed using the mada procedure in R.

Results

We identified 14 studies reporting the performance of 9 separate TORRs. The sensitivity (proportion of eventual survivors for whom the TORR recommends resuscitation and transport) was generally high: 95% for the European Resuscitation Council (ERC) TORR, 97% for the basic life support (BLS) TORR and 99% for the advanced life support (ALS) TORR. The BLS and ERC TORR were more specific, which would lead to fewer futile transports, and all three of these TORRs had a miss rate of ≤0.13% (defined as a case where a patient is recommended for termination but survives). The pooled proportion of patients for whom each rule recommends TOR was much higher for the ERC and BLS TORRs (93.5% and 74.8%, respectively) than for the ALS TORR (29.0%).

Conclusions

The BLS and ERC TORRs identify a large proportion of patients who are candidates for termination of resuscitation following OHCA while having a very low rate of misclassifying eventual survivors (<0.1%). Further prospective validation of the ERC TORR and direct comparison with BLS TORR are needed.
Blood pressure in athletic preparticipation evaluation and the implication for cardiac remodelling
Authors: Hedman Kristofer , Moneghetti Kegan J , Christle Jeffrey W , Bagherzadeh Shadi P , Amsallem Myriam , Ashley Euan , Froelicher Victor , Haddad Francois
Published: May 2019

Objectives

To explore blood pressure (BP) in athletes at preparticipation evaluation (PPE) in the context of recently updated US and European hypertension guidelines, and to determine the relationship between BP and left ventricular (LV) remodelling.

Methods

In this retrospective study, athletes aged 13–35 years who underwent PPE facilitated by the Stanford Sports Cardiology programme were considered. Resting BP was measured in both arms; repeated once if ≥140/90 mm Hg. Athletes with abnormal ECGs or known hypertension were excluded. BP was categorised per US/European hypertension guidelines. In a separate cohort of athletes undergoing routine PPE echocardiography, we explored the relationship between BP and LV remodelling (LV mass, mass/volume ratio, sphericity index) and LV function.

Results

In cohort 1 (n=2733, 65.5% male), 34.3% of athletes exceeded US hypertension thresholds. Male sex (B=3.17, p<0.001), body mass index (BMI) (B=0.80, p<0.001) and height (B=0.25, p<0.001) were the strongest independent correlates of systolic BP. In the second cohort (n=304, ages 17–26), systolic BP was an independent correlate of LV mass/volume ratio (B=0.002, p=0.001). LV longitudinal strain was similar across BP categories, while higher BP was associated with slower early diastolic relaxation.

Conclusion

In a large contemporary cohort of athletes, one-third presented with BP levels above the current US guidelines’ thresholds for hypertension, highlighting that lowering the BP thresholds at PPE warrants careful consideration as well as efforts to standardise measurements. Higher systolic BP was associated with male sex, BMI and height and with LV remodelling and diastolic function, suggesting elevated BP in athletes during PPE may signify a clinically relevant condition.
Bedside mental status and outcome in elderly patients admitted for acute coronary syndromes
Authors: Briet Clément , Blanchart Katrien , Lemaître Adrien , Roux Isabelle , Lavergne Kelly , Rocamora Amelia , Bignon Mathieu , Ardouin Pierre , Sabatier Remi , Roule Vincent , Beygui Farzin
Published: May 2019

Objective

We investigated whether mental status assessed by simple bedside tests in elderly patients admitted for acute coronary syndromes (ACS) was associated with higher risk of mortality.

Methods

We used the data from a prospective, open, ongoing cohort of patients≥75 years old admitted for ACS to a tertiary centre. Cognitive impairment (CogI) was defined by delirium detected by the Confusion Assessment Method or an abnormal Mini Mental State Examination score. A Cox model adjusted on predefined correlates of mortality was used to assess the relationship between CogI and 1-year mortality.

Results

Six-hundred consecutive patients with mental status assessment within 48 hours after admission were included. CogI was identified in 172 (29%) patients among whom 153 (25.5%) had an abnormal Mini Mental State Evaluation and 19 (3.2%) delirium. Death occurred in 49 (28.6%) patients with and 43 (10.5%) patients without CogI at 1 year. There was a significant association between CogI and 1-year mortality (adjusted-HR 2.4, 95% CI 1.53 to 3.62), p<0.001) independent of other covariables. CogI was also independently associated with higher rates of in-hospital bleeding and mortality as well as 3-month rates of all-cause, cardiovascular-related and heart failure-related rehospitalisation.

Conclusions

CogI detected by simple bedside tests in patients≥75 admitted for ACS is associated with an increased risk of 1-year mortality and 3 month rehospitalisation independent of other correlates of poor outcome.
Ozone-primed neutrophils promote early steps of tumour cell metastasis to lungs by enhancing their NET production
Authors: Rocks Natacha , Vanwinge Céline , Radermecker Coraline , Blacher Silvia , Gilles Christine , Marée Raphael , Gillard Alison , Evrard Brigitte , Pequeux Christel , Marichal Thomas , Noel Agnes , Cataldo Didier
Published: May 2019

Background

Air pollution, including particulates and gazes such as ozone (O3), is detrimental for patient’s health and has repeatedly been correlated to increased morbidity and mortality in industrialised countries. Although studies have described a link between ambient particulate matter and increased lung cancer morbidity, no direct relation has yet been established between O3exposure and metastatic dissemination to lungs.

Objectives

To outline the mechanisms through which pulmonary O3exposure modulates metastasis kinetics in an experimental mouse model of O3exposure.

Methods

Metastatic responses to pulmonary O3exposure were assessed using a reliable experimental mouse model of concomitant pulmonary O3exposure and tumour cell injection. Roles of neutrophils in O3-induced lung metastasis were highlighted using blocking anti-Ly6G antibodies; moreover, the implication of neutrophil extracellular traps (NETs) in metastatic processes was evaluated usingMRP8cre-Pad4lox/loxmice or by treating mice with DNase I.

Results

Pulmonary O3exposure strongly facilitates the establishment of lung metastasis by (1) Inducing a pulmonary injury and neutrophilic inflammation, (2) Influencing very early steps of metastasis, (3) Priming neutrophils’ phenotype to release NETs that favour tumour cell colonisation in lungs. The ability of O3-primed neutrophils to enhance lung colonisation by tumour cells was proven after their adoptive transfer in Balb/c mice unexposed to O3.

Conclusions

Pulmonary neutrophils induced by O3promote metastatic dissemination to lungs by producing NETs. These findings open new perspectives to improve treatment and prevention strategies in patients affected by metastatic diseases.
Scale-model test for disposal pit of high-level radioactive waste and theoretical evaluation of self-sealing of bentonite-based buffers
Authors: Komine Hideo
Published: May 2019

Bentonite is attracting greater attention in Japan and some other countries as a buffer for use in repositories of high-level radioactive waste (HLW). Bentonite-based buffers for HLW disposal are expected, because of their swelling deformation, to fill spaces between buffers and walls of disposal pits or between buffers and waste containers designated as overpack. Bentonite has a self-sealing capability. This study conducts scale-model tests simulating the relation between the buffer and interstitial space. It also investigates the validity of theoretical equations for swelling presented by Komine and Ogata (published in 2003 and 2004) to evaluate buffer self-sealing capabilities by comparing calculated and experimentally obtained results of scale-model tests. Results of the experimental work and calculations described herein highlight bentonite’s self-sealing capability and demonstrate the high applicability of these Komine and Ogata equations to quantify filling of interstitial spaces by bentonite-based buffer swelling.
Effect of nonstructural components on the dynamic characteristics of light-frame wood buildings
Authors: Hafeez Ghazanfarah , Doudak Ghasan , McClure Ghyslaine
Published: May 2019

This research deals with ambient vibration measurements (AVM) in 16 multi-storey light-frame wood buildings with wood-based shear walls as the main lateral load resisting system. Its primary objective is to evaluate the effect of nonstructural sheathing panels and the connectivity between firewall-separated buildings, on the modal properties of the tested buildings. Lower natural frequencies, corresponding mode shapes and equivalent structural damping were extracted from the AVM records. The study confirmed that the increase in stiffness of the finished buildings was dominant over their increase in mass when sway mode periods of finished buildings and bare structural frameworks are compared. The stiffening effect of gypsum wallboard was deemed significant and should be accounted for in seismic design. The study also indicates that even when the building section were only nominally connected to the firewall, composite action in the lateral response was taking place.
In-medium thermal conductivity and diffusion coefficients of a hot hadronic gas mixture
Authors: Gangopadhyaya Utsab , Ghosh Snigdha , Sarkar Sourav
Published: May 2019

The relativistic kinetic theory approach has been employed to estimate for a hot mixture constituting of nucleons and pions, four transport coefficients that characterize heat flow and diffusion. Medium effects on the cross-section for binary collisions ([Formula: see text]) have been taken into consideration by incorporating self-energy corrections to modify the [Formula: see text] and [Formula: see text] meson propagators for [Formula: see text] interaction and the [Formula: see text] propagator for [Formula: see text] interaction. The temperature dependence of the various coefficients has been studied for several values of the baryon chemical potential.
Community Detection in Social Networks: Literature Review
Authors: Rani Seema , Mehrotra Monica
Published: May 2019

Due to easy and cost-effective ways, communication has amplified many folds among humans across the globe irrespective of time and geographic location. This has led to the construction of an enormous and a wide variety of social networks that is a network of social interactions or personal relations. Social network analysis (SNA) is the inspection of social networks in order to understand the participant’s arrangement and behaviour. Discovering communities from the social network has become one of the key research areas in SNA. Communities discovered from social networks facilitate its members so as to interact with relatable people who have similar or comparable interests. However, in present time, the enormous growth of social networks demands an intensive investigation of recent work carried out for identifying community division in social networks. This paper is an attempt to enlighten the ongoing developments in the domain of Community detection (CD) for SNA. Additionally, it sheds light on the algorithms which use meta-heuristic optimisation techniques to hit upon the community structure in social networks. Further, this paper gives a comparison of proposed methods in recent years and most frequently used optimisation approaches in the domain of CD. It also describes some application areas where CD methods have been used. This guides and encourages researchers to probe and take ahead the work in the area of detecting communities from social networks.
Why Legal Transplants?
Authors: Goldbach Toby S.
Published: May 2019

In examining how laws and legal institutions move across jurisdictions, comparative law scholars have employed the metaphor of a legal transplant to conceptualize both the hazards and benefits of taking in another legal system's rules. As law and society scholars become increasingly interested in the international domain, they will naturally seek out disciplines that have grappled with issues of law and culture, diffusion of governance structures, and the social processes involved in transnational lawmaking. We can thus learn a great deal from the rich literature on legal transplants. However, we should also be wary of its anemic examination of relations of power and strive to employ empirical methods to measure the social forces and factors involved. This article gives an historical overview of the key developments and debates within the legal transplant literature and suggests new directions for further research intended for a sociology of the movement of law.
Passing the Vascular Barrier: Endothelial Signaling Processes Controlling Extravasation
Authors: Wettschureck Nina , Strilic Boris , Offermanns Stefan
Published: May 2019

A central function of the vascular endothelium is to serve as a barrier between the blood and the surrounding tissue of the body. At the same time, solutes and cells have to pass the endothelium to leave or to enter the bloodstream to maintain homeostasis. Under pathological conditions, for example, inflammation, permeability for fluid and cells is largely increased in the affected area, thereby facilitating host defense. To appropriately function as a regulated permeability filter, the endothelium uses various mechanisms to allow solutes and cells to pass the endothelial layer. These include transcellular and paracellular pathways of which the latter requires remodeling of intercellular junctions for its regulation. This review provides an overview on endothelial barrier regulation and focuses on the endothelial signaling mechanisms controlling the opening and closing of paracellular pathways for solutes and cells such as leukocytes and metastasizing tumor cells.
Impact of Sea Surface Temperature and Surface Air Temperature on Maximizing Typhoon Rainfall: Focusing on Typhoon Maemi in Korea
Authors: Choi Jeonghyeon , Lee Jeonghoon , Kim Sangdan
Published: May 2019

In this study, the effects of surface air temperature (SAT) and sea surface temperature (SST) changes on typhoon rainfall maximization are analysed. Based on the numerically reproduced Typhoon Maemi, this study tried to maximize the typhoon-induced rainfall by increasing the amount of saturated water vapour in the atmosphere and the amount of water vapour entering the typhoon. Using the Weather Research and Forecasting (WRF) model, which is one of the regional climate models (RCMs), the rainfall simulated by WRF while increasing the SAT and SST to various sizes at initial conditions and boundary conditions of the model was analysed. As a result of the simulated typhoon rainfall, the spatial distribution of total rainfall depth on the land due to the increase combination of SAT and SST showed a wide variety without showing a certain pattern. This is attributed to the geographical location of the Korean peninsula, which is a peninsula between the continent and the ocean. In other words, under certain conditions, typhoons may drop most of the rainfall on the southern sea of the peninsula before landing on the peninsula. For instance, the 6-hour duration maximum precipitation (MP) in Busan Metropolitan City was 472.1 mm when the SST increased by 2.0°C. However, when the SST increased by 4.0°C, the MP was found to be 395.3 mm, despite the further increase in SST. This indicates that the MP at a particular area and the increase in temperature do not have a linear relationship. Therefore, in order to maximize typhoon rainfall, it is necessary to repeat the numerical experiment on various conditions and search for the combination of SAT and SST increase which is most suitable for the target typhoon.
Selection of Sustainable Supplementary Concrete Materials Using OSM-AHP-TOPSIS Approach
Authors: Ahmed Mohd. , Qureshi M. N. , Mallick Javed , Ben Kahla Nabil
Published: May 2019

Due to resource scarcity, environmental impact, and socioeconomic constraints, sustainable criteria should be given prime importance in the construction industry. The sustainability in concrete can be attained using supplementary materials. The numbers of supplementary concrete materials (SCMs) are available ranging from industries by-products, agro-products, waste product, and newly engineered materials. The selection of the supplementary materials is challenging due to the wide range of environmental, technical, and economic constraints. The paper proposes a decision support framework considering technical, environmental, social, and economic sustainability criteria for ranking of concrete supplementary material. The decision framework includes the optimal scoring method- (OSM-) based shortlisting of supplementary materials, with technical and cost characteristics, and subsequent prioritizing material according to sustainable potentiality order using AHP-TOPSIS. The stability of the ranking of sustainable concrete supplementary materials has been verified using sensitivity analysis. The present study develops decision support framework by employing technical characteristics of the most technically sound material used as concrete material. The technical, environmental, and socioeconomic sustainable performance indicators have considered its selection to obtain much needed sustainability and to boost the eco-friendly environment. From the proposed MCDM framework, it is found that engineered siliceous materials and agriculture-based industrial waste products as SCMs will prove to be most sustainable in the construction industry.
Elevated Serum Homocysteine Levels Have Differential Gender-Specific Associations with Motor and Cognitive States in Parkinson’s Disease
Authors: Bakeberg Megan C. , Jefferson Alexa , Riley Maddeson , Byrnes Michelle , Ghosh Soumya , Mastaglia Frank L. , Horne Malcom K. , McGregor Sarah , Stell Rick , Kenna Jade , Walters Sue , Hince Dana , Anderton Ryan S.
Published: May 2019

Background. Studies attempting to elucidate an association between homocysteine and symptom progression in Parkinson’s disease (PD) have had largely discrepant findings. This study aimed to investigate elevated serum homocysteine levels and symptom progression in a cohort of PD patients.Methods. Serum homocysteine, folate, and vitamin B12 levels were measured in 205 people with PD and 78 age-matched healthy controls. People with Parkinson’s disease underwent a battery of clinical assessments to evaluate symptom severity, including motor (MDS-UPDRS) and cognitive (ACE-R) assessments. Multivariate generalised linear models were created, controlling for confounding variables, and were used to determine whether serum markers are associated with various symptom outcome measures.Results. People with Parkinson’s disease displayed significantly elevated homocysteine levels (p<0.001), but not folate or vitamin B12 levels, when compared to healthy controls. A significant positive correlation between homocysteine and MDS-UPDRS III score was identified in males with Parkinson’s disease (rs = 0.319,p<0.001), but not in females, whereas a significant negative correlation between homocysteine levels and total ACE-R score was observed in females with Parkinson’s disease (rs = −0.449,p<0.001), but not in males. Multivariate general linear models confirmed that homocysteine was significantly predictive of MDS-UPDRS III score in male patients (p=0.004) and predictive of total ACE-R score in female patients (p=0.021).Conclusion. Elevated serum homocysteine levels are associated with a greater motor impairment in males with Parkinson’s disease and poorer cognitive performance in females with Parkinson’s disease. Our gender-specific findings may help to explain previous discrepancies in the literature surrounding the utility of homocysteine as a biomarker in PD.
Dural and Leptomeningeal Spine Metastases of Breast Cancer
Authors: Matos Fernando , Cerqueira Luís
Published: May 2019

We present a case of a 57-year-old female diagnosed with invasive ductal breast cancer, which was treated and in remission for 12 years. In 2018 she presented a progressive dorsal back pain, which prevented her from performing basic tasks. An MR study was performed and revealed the presence of an extramedullary metastatic sleeve located in the thoracic intradural space. Concomitant multiple small nodular foci were adhering diffusely to the spinal cord, compatible with leptomeningeal metastatic disease. The occurrence of both forms of spread in the spine is uncommon, and its distinction on imaging is of particular importance taking into account the differences in treatment approach and prognosis.
Effects of Additive β-Cyclodextrin on the Performances of Green Tea Infusion
Authors: Dai Qianying , Liu Sitong , Jin Huozhu , Jiang Yurong , Xia Tao
Published: May 2019

The effects of the added β-cyclodextrin (β-CD) in the tea infusion extraction on color quality of green tea (Camellia sinensis) infusion have been investigated in detail. Due to the added β-CD, the color of the tea infusion can be brightened effectively, and meanwhile, compared to conventional extraction, the retentions of tea polyphenols, catechins, and chlorophyll have also been proved to be increased greatly. Furthermore, the additive β-CD can also increase the viscosity of the tea infusion. In addition, the existing β-CD can lower the oxygen solubility ratio in tea infusions effectively, from which a high-quality tea infusion can be prepared ready for further processing.
Buckling Analysis and Stability of Compressed Low‐Carbon Steel Rods in the Elastoplastic Region of Materials
Authors: Partskhaladze Gaioz , Mshvenieradze Ingusha , Medzmariashvili Elguja , Chavleshvili Gocha , Yepes Victor , Alcala Julian
Published: May 2019

This paper presents new approaches for solving a problem of the stability of compressed rods in the elastoplastic working region of materials. It is known that the columns of buildings, supports of engineering devices, drill rods of oil, and gas extraction industry may be subjected to significant risk of stability loss. Nowadays, there are design methods based on test results defining the relations (e.g., critical stresses‐slenderness) to avoid this risk due to stability loss, but the precision and limits of definition are not always known. The main objectives of the study were to develop new approaches that would allow specifying the values of critical stresses of compressed elements beyond the proportional limit. The problem of stability of the compressed elements in the elastoplastic region was studied according to the stability theory. The authors suggested an original approach to the issue; in particular, the determination of values of the critical stresses and the finding of the points of the bifurcation were carried out by the tangent established by experimental results and by the approximation of the so‐called double modulus. Comparative analysis showed the advantage of the proposed approach, particularly that the new critical curves were located below the curves of Engesser‐Karman and Shanley and above the critical curves established by building codes. A new approach for the determination of critical stresses in the elastoplastic region was developed through which the structural reliability and economic efficiency was increased by almost 12% compared to the existing approaches.
Identification of Antidiabetic Metabolites from Paederia foetida L. Twigs by Gas Chromatography-Mass Spectrometry-Based Metabolomics and Molecular Docking Study
Authors: Tan Dai Chuan , Kassim Nur Kartinee , Ismail Intan Safinar , Hamid Muhajir , Ahamad Bustamam Muhammad Safwan
Published: May 2019

Paederia foetida L. (Rubiaceae) is a climber which is widely distributed in Asian countries including Malaysia. The plant is traditionally used to treat various diseases including diabetes. This study is to evaluate the enzymatic inhibition activity of Paederia foetida twigs extracts and to identify the metabolites responsible for the bioactivity by gas chromatography-mass spectrometry (GC-MS) metabolomics profiling. Three different twig extracts, namely, hexane (PFH), chloroform (PFC), and methanol (PFM), were submerged for their α-amylase and α-glucosidase inhibition potential in 5 replicates for each. Results obtained from the loading column scatter plot of orthogonal partial least square (OPLS) model revealed the presence of 12 bioactive compounds, namely, dl-α-tocopherol, n-hexadecanoic acid, 2-hexyl-1-decanol, stigmastanol, 2-nonadecanone, cholest-8(14)-en-3-ol, 4,4-dimethyl-, (3β,5α)-, stigmast-4-en-3-one, stigmasterol, 1-ethyl-1-tetradecyloxy-1-silacyclohexane, ɣ-sitosterol, stigmast-7-en-3-ol, (3β,5α,24S)-, and α-monostearin. In silico molecular docking was carried out using the crystal structure α-amylase (PDB ID: 4W93) and α-glucosidase (PDB ID: 3WY1). α-Amylase-n-hexadecanoic acid exhibited the lowest binding energy of -2.28 kcal/mol with two hydrogen bonds residue, namely, LYS178 and TYR174, along with hydrophobic interactions involving PRO140, TRP134, SER132, ASP135, and LYS172. The binding interactions of α-glucosidase-n-hexadecanoic acid complex ligand also showed the lowest binding energy among 5 major compounds with the energy value of -4.04 kcal/mol. The complex consists of one hydrogen bond interacting residue, ARG437, and hydrophobic interactions with ALA444, ASP141, GLN438, GLU432, GLY374, LEU373, LEU433, LYS352, PRO347, THR445, HIS348, and PRO351. The study provides informative data on the potential antidiabetic inhibitors identified in Paederia foetida twigs, indicating the plant has the therapeutic effect properties to manage diabetes.
Ingestion of Partial Denture after General Anesthesia Induction and Ventılation: A Rare Case Report
Authors: Akelma Hakan , Salik Fikret , Başol Ömer , Bilge Hüseyin , Yıldırım Akif , Özgün Şule
Published: May 2019

The swallowing of dentures during general anaesthesia is a significant problem for anesthesiologists. It is seen more often in patients with psychiatric disorders, mental retardation, alcoholism, or poor quality dentures. It has become an important issue for anesthesiologists preoperatively due to the increase in the proportion of dentures associated with prolongation of life. In elderly, the use of partial fixed prosthesis increases and the risk of swallowing dentures is increased. In this case report, it was presented that the denture was swallowed spontaneously before intubation while the patient was ventilated preoperatively.
Intralesional Triamcinolone for Fistulous Tracts in Hidradenitis Suppurativa: An Uncontrolled Prospective Trial with Clinical and Ultrasonographic Follow-Up
Authors: Álvarez Pedro , García-Martínez F. Javier , Poveda Ines , Pascual José Carlos
Published: May 2019

Background: There is little evidence on the use of intralesional triamcinolone (ILT) for managing fistulous tracts in hidradenitis suppurativa (HS). Objective: To assess the clinical and ultrasound response to ILT for single fistulous lesions in HS patients. Methods: A prospective open-label study was conducted to assess response to ILT (40 mg/mL) for fistulous tracts in HS. Consecutive patients (Hurley II stage exclusively) presenting to our department were recruited from August 2016 to August 2018. They received a single injection of ILT as the sole treatment. Lesions were assessed clinically and by ultrasound at baseline and 90 days. Results: Of the 53 included HS patients with fistulous tracts, 36 (67.9%) were women, 30 (56.6%) were smokers, and 36 (67.9%) were obese or overweight (body mass index ≥25). Median Sartorius score was 9.0 (IQR 9.0–36.0), and median duration of the lesion treated was 6 months (IQR 3.0–12.0). Fistulous tracts were injected with 0.5 mL triamcinolone 40 mg/mL. Seven patients were lost to follow-up. At 90 days, 20 (43.5%) lesions showed clinical and ultrasound resolution, 13 (28.3%) showed only clinical resolution while persisting on ultrasound, and 13 (28.3%) persisted both clinically and on ultrasound. Mean clinical size decreased from 17.0 to 5.1 mm (p < 0.0001), while mean length on ultrasound decreased from 16.0 to 8.6 mm (p < 0.0001). Limitations: Small sample size and no control group. Conclusions: Our study suggests that ILT is beneficial for small fistulous tracts in HS.
International Academy of Cytology Yokohama System for Reporting Breast Fine-Needle Aspiration Biopsy Cytopathology: A Review of Predictive Values and Risks of Malignancy
Authors: Hoda Raza S. , Brachtel Elena F.
Published: May 2019

Objective: We aimed to assess the risk of malignancy (ROM) and predictive values in prior breast cytology studies as a basis for the new International Academy of Cytology (IAC) Yokohama system for reporting breast fine-needle aspiration biopsy (FNAB) cytology, which classifies cytologic diagnoses into 5 categories: (1) insufficient material, (2) benign, (3) atypical, (4) suspicious of malignancy, and (5) malignant. Study Design: Publications between January 1, 1997, and December 31, 2017, that studied the performance characteristics of FNAB from palpable and nonpalpable breast masses were identified through the PubMed database. Data for number of total cases and cases within each diagnostic category, if available, were collected. Performance characteristics, including absolute sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and ROM for each category were recorded or, when possible, calculated. Results: The literature review resulted in a case cohort of 33,341 breast FNABs, drawn from 27 studies. Pooling these cases together, the ROM for insufficient material, benign, atypical, suspicious, and malignant were 30.3, 4.7, 51.5, 85.4, and 98.7%, respectively. The complete sensitivity and specificity were 96.3 and 98.8%, correspondingly. The PPV and NPV were 98.7 and 95.3%, correspondingly. The false-negative and false-positive rates were 3.7 and 1.0%, respectively. Conclusions: This meta-analysis demonstrates that the diagnostic categories of the new IAC Yokohama System each carry an implied ROM, which increases from the benign to malignant categories. This study also shows the high sensitivity and specificity of FNAB for breast lesions.
Serum NfL (Neurofilament Light Chain) Levels and Incident Stroke in Adults With Diabetes Mellitus
Authors: Korley Frederick K. , Goldstick Jason , Mastali Mitra , Van Eyk Jennifer E. , Barsan William , Meurer William J. , Sussman Jeremy , Falk Hayley , Levine Deborah
Published: May 2019

Background and Purpose—

Effective stroke prevention depends on accurate stroke risk prediction. We determined the discriminative ability of NfL (neurofilament light chain) levels for distinguishing between adults with diabetes mellitus who develop incident stroke and those who remain stroke free during a 7-year follow-up period.

Methods—

We performed a case-control study of participants selected from the previously completed ACCORD trial (Action to Control Cardiovascular Risk in Diabetes). Cases were all ACCORD subjects who were stroke free at enrollment and developed incident stroke during follow-up (n=113). Control subjects (n=250) were randomly selected ACCORD subjects who had no stroke events either before or after randomization. NfL was measured in baseline samples using Single Molecule Array technology (Quanterix).

Results—

Baseline NfL levels were higher in stroke subjects, compared to controls, after adjusting for age, race, blood pressure, weight, and the Framingham Stroke Risk Score. Relative to the subjects in the lowest quintile of NfL levels, the hazard ratios of incident stroke for subjects in the second to fifth quintiles were 3.91 (1.45–10.53), 4.05 (1.52–10.79), 5.63 (2.16–14.66), and 9.75 (3.84–27.71), respectively, after adjusting for race and Framingham Stroke Risk Score. Incorporating NfL levels into a predictive score that already included race and Framingham Stroke Risk Score increased the score’s C statistic from 0.71 (95% CI, 0.66–0.77) to 0.78 (95% CI, 0.73–0.83),
P
<0.001. Older age, nonwhite race, higher systolic blood pressure, glomerular filtration rate <60, and higher hemoglobin A1C were independent predictors of serum NfL in this cohort but diastolic blood pressure, durations of hypertension or diabetes mellitus, and lipid levels were not. In total, cardiovascular disease risk factors explained 19.2% of the variability in baseline NfL levels.

Conclusions—

Serum NfL levels predict incident stroke and add considerably to the discriminatory power of the Framingham Stroke Risk Score in a cohort of middle-aged and older adults with diabetes mellitus.